Medical Society of the State of North Carolina. An.

Transactions of the Medical Society of the State of North Carolina [serial] (Volume 58 (1911)) online

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in order to keep his hold on his patient's confidence. In advis-
ing a consultation with a specialist, the physician should not
do too much prophesying as to the outcome. In fact this rule
is a good one to follow or rather not to follow in our own
cases. Prognosis is nearly always involved in doubt. Espec-
ially is it very doubtful as to absolute cure in many cases.
Nor is it necessary to be prophets of evil. We can nearly al-
ways promise a certain measure of relief from a specialist,
if no more, or we can at least verify or make certain a doubt-
ful diagnosis and this will often satisfy our patients. If the
true condition is explained to them — what the trouble is and
what may be expected from treatment they are better satisfied
even if but little amelioration of their troubles results.

Again, the physician should not send a patient to a spec-
ialist with a cut and dried treatment already mapped out, un-
less the indications for such treatment are absolutely of gen-
eral acceptance. If the patient is expecting a certain line of
treatment, he will naturally be disappointed, either with his
physician or with the specialist, unless a lot of skillful explain-
ing is done. I am trying to convey the idea that the specialist
should not be hampered in following his own judgment as to
diagnosis and treatment by erroneous ideas and mistaken im-
pressions implanted in the mind of the patient by the phy-
sician.



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The very fact that the specialist is a specialist is presump-
tive evidence that his opinion of a case and advice as to treat-
ment is more apt to be correct and should be given greater
weight than that of the physician.

Perhaps the best plan is simply to tell the patient that the
case is one that recjuires the services of a specialist. Give the
specialist the history of the case and make known any
idiosyncrasies of the patient and give any information that
the specialist may ask you for, but be careful not to volunteer
too much either to patient or specialist lest you show how woe-
fully ignorant you are. Don't send a patient to a surgeon with
the idea in his mind that he must be operated on at once. The
surgeon may think it wise to wait a while or possibly not to
operate at all and in this case he must either disregard his own
judgment or put the physician in a bad light, a thing which
no specialist wishes to do when a case is referred to him. It is
best to tell them that the case is one for the surgeon to pass
judgment on ; tell them to go to a hospital and call a surgeon.
Try to disabuse the mind of the patient of the idea that a
hospital is a butcher shop or slaughter pen, an idea quite pre-
valent in some localities. Tell them it is a place where they
can get the proper medical treatment and nursing and where
they can be operated on in case it becomes a necessity.

A few words as to fees. The expenses of preparing to be
a specialist are burdensome. In the first place, the specialist
takes or should take the general medical course.

The parts of the human body are so closely related, the
effect of the derangement of one organ on the others is so great
that he who is conversant only with the diseases of one or two
organs is not properly fitted to treat them. Hence a thorough
foundation in general medicine and a few years general prac-
tice are of almost absolute importance in fitting one to become
a thorough specialist. Add to this the cost of special prepara-
tion and the necessarily heavy- running expenses in the shape
of special instruments, office equipments, etc., and you have a



NORTH CAROLINA MEDICAL SOCIETY



177



basis for the larger fees demanded by the speciahst. In some
sections of the country, especially in the north and west and in
the larger cities generally, there has arisen what is known as
the commission system. That is to say, the specialist collects
large fees and gives the practitioner a certain part of them in
return for sending patients. It is a case of you tickle me and
I'll tickle you. I speak of this practice only to condemn it.
By the time the general practitioner charges a legitimate fee
for his services and the specialist adds his on that, the pocket
of the average patient is sufficiently depleted. A double bleed-
ing in addition to this is neither just nor warranted by ethical
practice. The physician should make his services valuable
enough to the patient to charge a reasonable fee. If he takes
the patient to the specialist, he should charge for the time he
is absent from his work and collect it himself, and not resort
to the subterfuge of collecting it without the patient's knowl-
•edge.

In this matter as in everything else, each tub should stand
on its own bottom.



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TRAITS AND TAINTS.



H. D. Ste;wart, M.D., Monroe.



Since I have gone into a more intimate study of this subject
I wonder at its vastness. No abbreviated treatment will suf-
fice to give it more than scant consideration. Necessarily I
must treat it only in part.

Traits.

Certain habits, customs and natural tendencies may be at-
tributed to nations or to races and these may be called national
traits or racial traits.

To individuals we attribute certain distinguishing charac-
teristics and these may be called family traits or individual
traits.

Every nation has its characteristic racial traits and by these
traits is largely determined its place among the nations of the
earth.

The Jews, the Chinese, the Italians and the Negroes are
familiar examples of the perpetuation of racial traits.

The Jew from the beginning of his creation as a distinct race
has preserved his physical and mental characteristics, his habits
of trade and of occupation.

The Jew does not farm; hence he has no ultimate industrial
basis.

He is dependent upon other races for the real needs of life.
The typical Jew has his Roman nose, his dark hair, his small
dark eyes, indicating cunning and shrewd business policy. He
is a money maker. He is a natural trader. You may take the
child of the Jew, of the Polish or Russian Jew, if you please,
and set him down in a strange land. Though he may never
have seen his forefathers, when he becomes old enough, he
will begin to sell second-handed clothing marked up. This has
become a racial habit.



NORTH CAROLINA MEDICAL SOCIETY. 179

"Dis suit of glothes gost me twenty dollars. I sell it to yon
for vifteen dollars. See de mark dere on it? It cheap, you
cannot buy it anywhere for dot money. It tits you fine. Take
dot suit?"

Lieing seems to be a national or racial trait of the Jewish
merchant or trader. It is natural and he can't help it. It has
been handed down from the fathers.

There are not many criminals amongst the Jews, except,
perhaps in the life of the Ghetto of New York, Chicago and
other large cities. Here they resort to every known device,
legal or criminal, fair or foul, in their money-making and
money-getting traits.

There are also not a few Gentile merchants and traders who
will lie about their wares. Of course all these Jewish and
Gentile lies are supposed to be white lies. But some are black.

In their native lands the Jews have been subjected to very
rigid government. Their rights and their liberties have been
restricted by the reign of absolute monarchies, whose delight
was in the death of the righteous. They have been oppressed,
murdered, massacred, and deprived of property rights and of
the possession of civil liberty. So when they come to America,
the land of civil liberty and civic opportunity, they are natural-
ly fearful lest they offend the powers that be. He does not
often figure in the police court.

The Jew has many noble traits of character. Though he is
a man without a country and has the uttermost parts of the
earth for an habitation, yet he possesses marked home virtues.
He loves his foreparents. He has a fellow-feeling for the
members of his race and a tender remembrance for the land
of his nativity.

The Italian race are of a sturdy, stocky build. They are of
that physique, physiognomy, habit, custom and character which
distinguish the Caucasian races of the Southern climes.

Having been born in a sunny land of fruits, if set down or



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FIFTY-EIGHTH ANNUAL SESSION



landed in a far country amongst strange people, they will set
up fruit stands and sell peanuts and the banana.

If higher classed, they will organize bands and furnish the
best of music to music-loving America. Or .they may produce
the leading artists or give training to the stars of the }kIetro-
politan Opera House or the Manhattan.

If descended from criminal progenitors, they may constitute
the Black-hand or the Mafia or the Cammora.

Music is a national trait in the homes and in the public
parks and palisades of Italy.

The Italians, the Germans, the Poles and the Hungarians
are the greatest musicians of the nations. Why? Because for
generations music has been compulsory in the homes and in
the schools.

If you import a little Chinese and set him down in America,
as soon as he becomes old enough he will start a Chinese
laundry and begin to take in collars and shirts. Or, if he is in
a large city, he may open a store of Occidental Curios.

The Negro race have certain traits of character that will
always hinder their becoming a strong independent race. They
cannot live without the white man's government. They do not
require nor respect virtue of their women. They have no
moral base, no sense of gratitude, no regard for a promise,
no love for truth and honesty. Stealing, lieing, loafing and
promiscuous social intercourse have long since sealed their
social destiny.

A Negro preacher who was very devout, who was held in
great esteem by the members of his race and was especially
beloved by the women of his flock, once asked me for work
at brick-laying. He voluntarily made an engagement with me
to begin work the next Monday morning at 8 o'clock. I did
not see him again for three months. The Sunday love-feasts
must have beclouded his recollection.

The Negroes like to go in crowds. Their delight is in



NORTH CAROLINA MEDICAL SOCIETY. 181

funerals, wakes, campmeetings, festivals, picnics, watermelon
parties and drunken brawls.

I don't know that I have ever seen a negro that didn't like
whiskey and watermelon.

\\'hen a race, in whose individuals the animal nature pre-
dominates any way, are crowded together sixteen to the room,
there can be no virtue, no respect of the marriage vow. It is
necessary to have social segregation and separation to preserve
any race or people. Crowding breeds corruption.

The Jews, the Italians, the Chinese and the Negroes are
very prolific. The Chinese are so prolific and the population
so dense in their native land that life is very cheap. The
Negro's life is not worth very much. Overproduction of hu-
man beings makes cheap human beings, whether it be in the
crowded tenements of our great cities, amongst the many
thousands who are struggling for existence : — or if it be in the
family of seven daughters and none especially beautiful or
attractive.

It is harder to win and to wed the only daughter than it is
to secure some one of seven. In the one case the parents
think, "We have bestowed much upon Sarah, it is hard to give
her up." In the other case the parents think, "Our supply
is greater than the demand and you may have one of the
seven below cost, if you will take her to-day."

\\'henever the sociological limit is exceeded in the produc-
tion of human beings there is likely to be one or more children
in the family that seem to have no place in the world, no
useful disposition, no effective purpose in life, no future, no
independent existence. This means that those who use up and
wear out and destroy human beings for purposes of commerce,
for money-making and for various selfish plans, will take ad-
vantage of the excess of humanity to set a low price in money
on the unfortunate surplus.

For boys and girls, men and women, your children or mine,



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FIFTY-EIGHTH ANNUAL SESSION



are going to take their places in the world according to the
decrees of the law of supply and demand.
Individual Traits.
In family traits we find the chief strength or the chief
weakness of every individual. It is absolutely necessary in
making a correct estimate of a person for any purpose, to get
his family history, moral, mental and physical.

If I had to hire a bank cashier or a man for any position
of great trust, I should want to get the following data upon
which to base my judgment of the risk: Any rogues in the
family? Have his paternal and maternal ancestors been
scrupulously honest? Have there been any gamblers in the
family (any who lived by games of chance or got money un-
scrupulously) from whom he might have inherited the gamb-
ling instinct? Have there been any extravagant high-fliers in
the family who lived beyond their income? Have his people
always paid their honest debts or is he descended from a long
line of deadbeats?

Is he descended from a line of drunkards on either side of
the house? If so, does he take his character and his charac-
teristics from the drunken ancestors?

Mark Twain said, ''Training is everything." So it is, but it
must include birth. It must begin four generations back and
include blood and breeding, if it is to make the perfect speci-
men.

If it is necessary to know the pedigree of a horse, a coav,
a hog or a dog, it is so much more necessary to know the
pedigree of a human being with whom you are to have deal-
ings that may affect and determine not only your business
fortune, but also your eternal welfare and that of your family.
I have known mothers who were very anxious for their
daughters to learn music. But the daughters had no talent for
music. The mothers should, so to speak, have planted the
germ of a great musician long before their daughters were
born. The mother who has no talent for any particular art



NORTH CAROLINA MEDICAL SOCIETY. 183

may commence a generation back and breed up to an artist.
If she will read musical history, read the stories of the lives
of great musicians and go to hear the great artists, she will
making lasting maternal impressions along this line and her
unbegotten or unborn children will have nature's gift of
musical talent. The mother will breed a born musician.

It is so much earsier to breed down than it is to breed up.
There seems to be a natural gravitation for character and in-
dividualism. If the progenitors simply make no effort and
foster no ennobling ambition, the trend will be backward and
downward. Let nature take its course and its course will be
like that of the brute kingdom. To breed upward requires
character and efifort.

The poet is born, not made. The making was in the life
of the foreparents. Edison did not grow into the greatest'
inventor of modern times alone by training and prolonged,
painstaking, concentrated effort. Some foreparent of his had
an electrified brain, which foreshadowed the electric era. The
germ or the seed had been planted and Edison is the product.
So it is with miusicians, orators, teachers, doctors, preachers,
surgeons, politicians, statesmen, merchants, baseball players
and everything else. The training of the material is only sec-
ondary and supplemental.

The natural bent is after the habit and the character of the
fathers. The greatest possible incentive to right living in our-
selves should be that our children may be born well. There is
a world of wealth in good blood. But, young man or young
lady of the blue blood, rest on the laurels of your ancestors and
see where you will land. Take your seat and puff up with
family pride and go through life on the reputation and the
creative powers and created products of your ancestors and
the first thing you know, you will be last and the man at the
bottom who insists on climbing, will be at the top. Individual
effort must be added to your bountiful heritage. The young
human plant must be cared for in the life and the character



184



FIFTY-EIGHTH ANNUAL SESSION



of the parents and in the embryo state and the child hfe, it
we would produce a strong, sturdy, well-rounded, full grown
plant.

I frequently get Congressional graft vegetable seed from
Weshington. The request comes with the seed to report what
success I have with the plant.

I have never yet received any inquiries from Congress nor
from the State Legislature to know what kind of people we
are growing, what kind of seed we are using and what kind
of traits we are sowing. The lawmakers and the politicians
have never asked for any reports along this line. They have
never inquired what legal restrictions need to be placed upon
the marriage and the perpetuation of epileptics, imbeciles, id-
iots, insane people, uncured syphilitics and consumptives,, crim-
inals, confirmed drunkards, double first cousins, all of whom
produce and reproduce State and County charges and threaten
the very existence of our social institutions. The people, the
lawmakers and the medical profession are entirely too ignorant
in regard to such important matters. We pay more attention
to the breeding of domestic (animals) dumb brutes than we do
to the breeding of human beings. If a cow sucks herself, kicks
over the milk pail or runs children, we sell her at once for
beef. If a mare kicks, balks, is a stump-sucker, is mooneyed,
has rheumatism, has weak bowels, is dishfaced, nervous, un-
ruly and has no sense, we discard her as a broodmare. We
wish not to perpetuate the species. But what about the wo-
man? What judgment do we use in choosing the mothers of
our children? There are kickers, balkers and stumpsuckers
amongst women and amongst men too. This question of breed-
ing and perpetuating the human species is really the greatest
problem social economists and political economists have to
solve. Every progenitor of criminals should have a vasectomy
as provided in the State of Indiana by statute. Every male
idiot, imbecile, every male with incurable insanity should



NORTH CAROLINA MEDICAL SOCIETY. 185

have a vasectomy provided by law and passed upon by a com-
mission.

Every idiotic woman, every incurable insane woman, every
half-witted human female should be rendered barren by sur-
gical proceedures lest they propagate their kind and fill our
institution to overflowing with State charges of this kind.

Have you ever observed closely what shapeless, shiftless
human beings have full liberty to propagate their kind without
restrictions? Crosseyed, harelipped, half-witted, etc. The
crosseyes, the harelips and the clubfeet can be corrected by
surgical proceedures and subsequent generations be protected.
The time is coming when the State, from a prophylactic stand-
point, will have to take charge of certain classes of individuals.

There are many popular, sensible (?) )'oung fellows moving
in the best society that would do themselves, their people and
their country less harm, if they had proper guardians appointed
for them. No confirmed drunkard, no uncured syphilitic should
be allowed to marry until a cure is absolute. And to preclude
the possibility of his getting a certificate or passport from
some doctor for a fee, he ought to be required to submit a
report from three honest, responsible physicians.

Any drunkard or syphilitic who becomes guilty of fathering
a child should have a vasectomy imposed as soon as his guilt
is established.

You can study the character of the forefathers by observing
closely the disposition, habits and natural tendencies of their
children. Every walk, the shuffling gait, the carriage of the
head, the physiognomy, the voice, the setting of the feet, the
shape of the head — all mental, moral and physical character-
istics are inherited. We often recognize people by their walk.

If you expect your children to be anything, you must be
something yourself or have an exceptional woman for a wife.
But it is hard on the good woman to sacrifice herself to such
a life. You have no right to be a sorry, self-willed, self-satis-
fied fellow and then deceive a good woman of good family



186



FIFTY-EIGHTH ANNUAL SESSION



into marrying you to save your children from wreck. Many
a family has been saved from dirt, death and the devil by a
good w^ife and mother, strong by birth and inheritance. Some-
times mothers grieve over their wayward boys and follow
them to the very gates of hell. They are being visited with the
sins of a sorry ancestry. It does seem like a cruel fate.

The mother says "Johnnie was always such a good boy, he
is not bad, he is not guilty. Why did he steal ? Why did he
commit murder? Why does he lie? Why did he seduce our
neighbor's innocent girl? Why does my boy waste his sub-
stance upon bad women?" There is only one answer. It was
born in her boy. The harvest is being reaped. Why, have
you never heard of old Bill Smith, the boy's grandfather ? The
biggest devil that ever lived! He used to steal the neighbors'
sheep and hogs, destroy their pasture fences for pure cussed-
ness. He would steal anything he got his hands on. He was
dishonest at heart and constitutionally opposed to paying any
honest debt. The boy resembles him in character. Honesty
runs in families and scrupulous habit in the payment of debts,
in meeting obligations or in keeping promises, is handed down
from the foreparents. On the contrary disregard and dis-
respect for obligations is passed down to the children of dis-
honest parents.

Why did Johnnie commit murder? His maternal uncles,
whom he resembles in character and in life, were high temper-
ed, fighting, brawling fellows, and each committed a wilful
murder in- his day.

Why does Johhnie lie? He had a paternal uncle that was
a natural-born liar. He would make Ananias quit the game
in diffidence. \Miy did Johnnie ruin our neighbor's daughter
and why does he delight to associate with low women? Have
you never heard of old Sam Brown? He was the worst old
whoremonger for miles around. Dear mother, your tears are
only idle tears. They should have been shed two generations
past. You or your husband or both got badly cheated in mar-



NORTH CAROLINA MEDICAL SOCIETY. 187

riage. A gentleman or a gentlewoman is born, not made. The
gentlemanly spirit must begin with the fathers. Nothing irri-
tates me more than to see a large Red Jersey of Mammoth
Black hog occupying two seats of a car while ladies or frail
old men are standing nearby. I hesitate to disturb him. He is
such a specimen of the hog that if I rub against him, I might
get some hog on me.

Great brains and great minds are born, not made. In the
cultivation of the human species it is possible, by beginning
two or three generations back, to attain a greater degree of-
perfection than has ever been attained before. It is possible
to produce greater men, greater talent and greater artists along
all lines than have ever been produced in the past. But the
question of marrying and intermarrying must be scrupulously
and scientifically guarded.

There are three great solemn events in every man's" life —
his birth, the most solemn, his marriage, the next, and the third
requiring extraordinary courage when he has to leave the
parental roof, choose a calling, and giving up the care of father
and mother, become an independent factor in the affairs of
men.

He has not control of his allotment by birth. If he makes
a mistake in his selection of a wife, the chances are she will
outlive him. It pays to take time to choose a wife. Many
men steeped in business and entirely engrossed in money-
making do not have time to marry wisely. So they take some
convenient woman who is looking for just such a catch. In
fact, she readily takes in the situation. She knows exactly
how to bait the old fish and the first thing he knows, or some-
body else knows, she has him drawn in and tied fast. After-
ward he comes to his senses and learns that he is tied up for
life.

In the study and the cultivation of the human kind it is pos-
sible to make blendings and breeds as beautiful as any rose or
vegetable cultivated and perfected by Burbank.



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FIFTY-EIGHTH ANNUAL SESSION



In this IMedical Association we have men with features,
physiognomies and characteristics corresponding with those of
many animals of the brute kingdom.

We have the Hon, the king of the beasts, the daddy rabs,
the fox with his cunning, the skunk, the bear, the white swan
in its purity, the owl with his wisdom, the snail and the ter-
rapin so slow but persistent and sure, the deer swift and always
on the alert.



Online LibraryMedical Society of the State of North Carolina. AnTransactions of the Medical Society of the State of North Carolina [serial] (Volume 58 (1911)) → online text (page 15 of 51)