JAMA. 1890;XV(5):183-184. doi:10.1001/jama.1890.02410310023003.
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The development of the American Commonwealth is without a parallel in the history of modern civilization. Within the present century, and largely within the last fifty years, a continent has been reclaimed and its population increased from three, to between sixty and seventy millions of people.

The home-born increase has been immense, and the currents of immigration have centered upon these shores from nearly every quarter of the globe. Of necessity our conditions have been unique. In the development of institutions, the work has everywhere been one of creation and not of revision, and temporary imperfections must be incident to such a growth. In making provision for the absolute and immediate needs of the people, it was seldom indeed that the ideal could be realized. The obvious duty of the hour while striving for the attainment of the ideal was, in the meantime, to utilize the best we could command.


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