I SHOULD like to extend my personal welcome to all of you to this 95th meeting of the Association and to express my appreciation for the opportunity to serve as president of this organization. During the years when I had the privilege of introducing the successive presidents, I heard each man say in his own way how deeply he felt the honor you had accorded him. I know now how heartfelt their words were and I share their feelings fully.
Presidents have taken advantage of the opportunity to address this society on a wide range of topics—sometimes of a philosophical or historical nature, sometimes to identify harbingers of neurology's future. I am not a philosopher or a historian, much less a prophet, but I would like to discuss with you a matter which concerns me very much: neurology's position in the present crisis in American medicine and the directions open to us in the immediate future. What we have been experiencing in recent years is a mixed bag of good and bad. After two decades in which useful medical knowledge for the diagnosis and treatment of human diseases has had its greatest period of development, the reputation of American medicine stands at the lowest ebb in its history. As one reflects on this era there comes to mind the oft quoted words of Charles Dickens which he used to describe another turbulent period: