Dr. Gage opens with a reminder of the members who have died since the previous annual meeting and then he introduces his topic by drawing attention to the new and larger room in which they are meeting and the fact that the Society's library has finally integrated with the city's. He warns that these improvements bring with them the responsibility to "strengthen the position and increase the influence of the medical profession in the community," which duty the members must be conscious of and live up to or lapse into relative obscurity.
Since the Society's inception, medicine has made large advances. The microscope has revolutionized all aspects of medicine and from it has emerged the field of histology, the study of tissues. The field of surgery, too, has greatly advanced.
Focusing on the Worcester District Medical Society and its members since 1794 he lauds the Society's strong involvement in relaxing the Massachusetts Medical Society's membership parameters in the early 19th century. Gage continues with a discussion of the Society's library, praising those who gave generously for its expansion. Listing the topics, he acclaims the wide array of interesting, informative, and scientific dissertations presented over the years in front of the membership by members themselves.
Gage asks his colleagues to identify "the objects for which we meet to renew and perpetuate our ancient organization" and urges them to continue the valuable discourse among physicians which increases professional knowledge and strengthens bonds. Furthermore immorality and rivalries among the members must be discouraged.
Dr. Gage makes some suggestions for the Society, the first of which is to provide for new medical school graduates a means by which they could gain the firsthand medical experience lacking in their formal education before setting up practice. Such an arrangement would obligate doctors to keep abreast of the changes in the ever-expanding medical world. He suggests the most effective way to do so is to choose a particular specialty to study so that one might delve into the most intricate details of that field without losing sight of the context of general medicine into which the specialty fits.
Gage believes "a laxity and carelessness in respect to ... observing the phenomenon of individual cases of disease" is totally unacceptable, as observation is the basis of good medical practice and the seed for scientific progress. He suggests forming a uniform system of observation as exists among other medical groups to ensure detailed and useful observations which may then be presented to others for educational purposes. He also proposes creating a pathological collection from cases treated by the members.
The doctor criticizes his colleagues' laxness toward Society duties. He claims it is their duty to participate in the discussions at meetings and to present their own cases. Their absence at meetings is inexcusable. Dr. Gage also believes the Society should hold six meetings a year instead of the traditional three. He suggests the formation of a committee whose job it would be to set the agenda for the upcoming meeting and assign the opening presenter.