The custom of presidential addresses before this society has been described by some of my predecessors as" barbaric,"" expected," and" withoutconstitutional ba-sis." Despite these protestations, I have identifiedtwo distinct advantages that accrue to the speaker: It is an opportunity to speak formally on serious issues without the fear of immediate action being taken; and, perhaps of greater personal utility, this is a once-in-a-lifetime opportunity for an individual to publish exactly what he or she pleases in The Journal of Clinical Investigation. With the initiation of this, the 68th Annual Meeting of The American Society for Clinical Investigation, we are bringing to an end the long-standing tradition of meeting regularly in these halls that abut the boardwalk of Atlantic City, NewJersey. The Society first met in this city in the spring of 1911, and by 1923Atlantic City was established as the site of our annual meeting, in con-junction with that ofThe Association of American Physicians. Thus, for more than a half a century, this annual rite of clinical investigation, in recent years a multi-society function, has been known as the Atlantic City Meetings. Beginning in 1977 we will join our sister societies, The Association of American Physicians and The American Federation for Clinical Research, in an annual sojourn around the continent-perhaps in search of a new home that can provide not only formal meeting halls adequate for our combined expansive membership, but also replacements for the boardwalk and those other gathering spots which have served as extensions of our formal sessions and contributed so importantly to the success and scientific quality of our annualmeetings for the past three generations of clinical research. This change in venue warrants some brief reflection of the past history of our society as it has evolved during our 54 consecutive meetings in this city. The scientific contributions of our members and the explosive development in both quantity and quality of academic medicine during theyears since The American Society for Clinical Investigation was founded are matters of record and would gratify the founders of the Society beyond their expectations. It would be presumptuous indeed to at-tempt a review of theseaccomplishments in detail. As stated by JH Austin in a history of The American Society for Clinical Investigation compiled in 1949," no one can comparethe first presidential address with the record of the Society's achievements and not recognize the outstanding success with which our society has served the purposes for which it was founded"(1). Our scientific program this year continues to bear testimony to this success.

Instead, I have chosen to review briefly the issues the Society has faced during its history, as recorded in the minutes of our past meetings, in an attempt to focus on some major unsolved problems that we will continue to encounter in yearsahead. The past topics of concern to the Society can be divided into two general categories: intrinsic issues that deal with the operation and policies of the Society, the conduct of clinical research, and the institutions in which clinical research takes place; and extrinsic issues that include economic, political, and