Medical Society of the State of North Carolina. An.

Transactions of the Medical Society of the State of North Carolina [serial] (Volume 62 (1915)) online

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North Carolina system. We have in North Carolina two narcotic laws —



MEDICAL JURISPKUDENCE AND STATE MEDICINE. 73

one relating to opium and its derivatives in general and the other relating
to cocaine. We pass the law, we make it a misdemeanor, and then we
drop it. We have no machinery. The sheriff and the solicitor may
act if they care to ; the pharmacists of this State have acted in numerous
instances ; but that's voluntary action. So far as the State is concerned
with respect to this law, and a great many other of its penal laws, it
has been content to merely declare the crime and name the penalty.
The Harrison Narcotic Act not only declares the crime and names the
penalty, but it names a tremendous penalty — $2,000 fine or five years
imprisonment or both, in the discretion of the court ; then provides
every possible means of publicity, and then provides a system of inspec-
tion that ramifies the whole country and every detail of the commerce
in opium.

Now, in my judgment, that is the Avay to get at a great task, and if
you gentlemen, as I am sure you are, are in sympathy with that pur-
pose, you are not going to protest against the irksome details of red
tape necessary to this publicity.

I wish to say a word further about the significance of this enactment.
Very clearly, gentlemen, this act is in the nature of a police regulation.
It is aimed directly at what we call moral reform. It finds our people
beginning to be addicted to the habitual use of narcotics, and, knowing
the history of the Eastern nations, practically decadent because of this
one great evil, it levels itself at this great problem, notwithstanding
the immemorial doctrine of this country has been that the United States
as a Nation has nothing whatever to do with the police regulations of
the States. You understand that is why in order to get National pro-
hibition you would have to have a constitutional amendment. The
decisions in the Massachusetts and Kansas and South Carolina cases
have established that.

But, somehow, when we come to the case of the other narcotic, opium,
the Circuit Court of the United States, sitting in the State of Washing-
ton within the last six weeks, has declared absolutely that the Harrison
Narcotic Act is constitutional. I will make known a little distinction,
lest some good brother very much attached to State Rights may feel
that the powers of the State are being impinged upon. That decision
is based upon the judicial recognition of the fact that opium is not
produced in this country and that, therefore, the United States has
the right to trace any opium that comes to our shores from the time it
reaches here until it is consumed, and lay any penalty upon any im-
proper administration of it. We have gotten to the point where our



74 NORTH CAKOLINA MEDICAL SOCIETY.

National Government has undertaken tlie matter of police regulation
or moral reform and gotten by the doctrine of State Eights and all the
other obstacles.

The Government is perfectly safe in the administration of this law
and perfectly secure in attaining the objects for which it was enacted
until it gets to the point of the conscience of the physician. Now, the
United States has passed this law for two purposes. One is to cut off the
supply of opium from the present habitues; the other is to save the
rising generation from becoming addicted to the opium habit; and it
has placed upon the hearts and consciences of the physicians of the
country these two great responsibilities. Gentlemen, we can handle the
pharmacists and the importer, but when we come into the presence of
the physicians of our land the Government bows obeisance. Upon you
are laid two great duties. One is that you shall do nothing to propagate
this habit. A physician told me this morning on the train that a great
many addicts of opium found their first way to it by means of the kindli-
ness of some physician. Of course, you find it necessary to prescribe
narcotics, and the Government recognizes that. The other is that you
shall so deal with the habitue of opium as to save him, if possible.

Now, the law being administered through the physicians, the Govern-
ment hopes that it will be so administered as to gradually free our
country from the bonds of this drug. I don't hesitate to say that the
Government of the United States looks forward to the time when in
place of the 100,000 slaves of morphine and opium in this country there
shall be none, and when the menace of the opium habit shall have utterly
disappeared from our land.

Now, I am asked to discuss what North Carolina shall do. Dr. Ran-
kin named the subject. I told him I would come and speak generally.
I did not know that he would frame his subject in these terms ; but
when I saw that I had this subject I posted myself on the North Caro-
lina law on the subject, and I must say to you, gentlemen, in all candor,
that I don't know that there is anything North Carolina should do
but what she has done. That may be tremendously disappointing to you
gentlemen, but if we are doing well enough we ought to know it. Upon
my reading of the cocaine law and the antinarcotic law of our State, in
which the dispensing of narcotics is placed upon the consciences of our
physicians, I am prepared to say that these two laws, expressing the will
and the mind of the Commonwealth on the subject, in addition to the
Harrison act, which undertakes to provide the means and the method on
the subject and the proper penalty, that in my humble judgment there



MEDICAL JURISPRUDEIfCE AND STATE MEDICINE. 75

would be only one thing for J^orth Carolina to do, and that would be to
provide a system of inspection, and I do not think at this time that would
be a good thing to do, for the simple reason that the United States Gov-
ernment has provided us wuth two inspectors, and they are expert men,
men taken from the scientific ranks, pharmacists.

I^ow, we couldn't have any serious objection to the State putting up a
system of inspection. But the system that the United States has and
the jurisdiction that the United States has is far more efficient — I say
it with all due respect to my State — than any system that the State could
put up. If you gentlemen are inclined not to believe me on that point,
consider for a moment the matter of our laAvs with respect to the manu-
facture of liquor. You see most infrequently, not over once or twice
a year, any one being prosecuted in a superior or county court of I^orth
Carolina for manufacturing liquor ; but if you will read the papers you
will see that there are about 700 or 800 prosecutions in the Federal
courts. Now, why? Simply because with the vast power of the Gov-
ernment, supplemented with the psychological reason that the Govern-
ment of the United States is farther from the individual than the State
is, we find that we have a more efficient jurisdiction. I think I can
give you an illustration. I recollect when I was about eight or nine
years of age my father undertook to cut my hair. The barber had cut it,
and when my father undertook it he found me very restless. I remember
how he said, "William, why don't you sit still like you did when John
Brown, the barber, cut your hair?" There entered not less of respect,
but more of the personal relation. I could take liberties with my father,
but I had a great awe of that barber, whom I had seen but once or twice
in my life.

The Government, with its center at Washington, takes no personal
note and takes no political note of any litigant. The man is tried in a
county in which the jury is not found. He may be tried in Greensboro
with jurors from Wilkes or Cabarrus County. He is tried under the
dry light of the law ; but in the Commonwealth I fear in a great many
instances he is tried in the wet light of the personal relation. So I
prefer, gentlemen of the society, that w^e should maintain our status;
that is, with two strong laws on our statute books expressing the mind
of the Commonwealth on the subject and so giving the United States
the moral support of the Commonwealth, and then leaving to the United
States, Avith its broader jurisdiction, Avith its greater penalties, with its
infinite resources, and with its uniform legislation throughout all the
States, the great task of grappling with this evil.



76 NORTH CAROLINA MEDICAL SOCIETY,

]S^ow, gentlemen, I thank you for your attention. I don't want you
to forget the one word that I said, that in the last analysis the Gov-
ernment, our Government, all other governments, lay this great task of
the conscience of the world, this tremendous social evil, upon the hearts
of the physicians of the race.

I would like to say, in conclusion, that I have brought along with
me all the rulings of the Department and the adjudications in the courts.
I have a copy of the law also with me, and if any one here wishes any
special information I will be glad to undertake to answer him either
publicly or privately.

I thank you very much.

Dr. J. Howell Way : Mr. President and gentlemen : It was a force-
ful, an entertaining, and an instructive address to which we have just
listened, and I wish to take just a moment to express personally and for
this society the pleasure that we have all experienced in having with us
one of North Carolina's most distinguished publicists and a thoughtful
student of the business, professional, and social life of the State, to dis-
cuss this important subject. Years ago we came to the annual sessions of
the State Medical Society and we discussed technical papers in a tech-
nical manner only. We are changing with the times, and with that
change we are including the public, and our influence as a profession and
as individuals is growing stronger. It is a happy sign when men like this
speaker come before us and take part in our discussions.

I move that this society has heard with pleasure and appreciation the
address of the Hon. J. W. Bailey, and that a rising vote of thanks be
extended to him.

Motion seconded and carried by a rising vote.



THE AUTOSEROTHERAPY OF PELLAGRA.*



Dr. Edward J. Wood, Wilmington.



In the Journal A. M. A. for May 8, 1915, E. E. Palmer and W. L.
Secor of Texas recommend this plan of treatment. We have used it in
Wilmington very extensively, and our results have been as strikingly
favorable as the writers'. We modified the treatment in giving more of
the serum at shorter intervals, but there must be more experimental work
done before we can decide these points of detail. It would appear that



•Abstract of address before State Medical Society.



MEDICAL JURISPKUDEISrCE AND STATE MEDICINE. 77

in very grave cases the results were not good or were not permanent ; it
may be that the treatment actually did harm, but in the ordinary case
the improvement was immediate and striking.

The blister is made on any unhairy portion of the body, preferably
over the manubrium sterni, with a cantharides blister plaster about 11/2
inches square. It is left on until the blister forms. The edge of the
plaster is carefully removed and the surface of the blister touched with
tincture of iodine and the contents removed with the hypodermic syringe.
It is injected subcutaneously into the arm in the usual manner.



CHEMISTRY OF PATEI^T MEDICINES.



Pkof. E. Y. Howkll, Chapel Hill.



(Note. — Prof. E. Y. Howell, dean of the Department of Pharmacy at the
University of North Carolina, was invited to participate in the Symposium on
Narcotics and Patent Medicines. His address was listened to with profound
interest. In his discussion. Professor Howell expanded in a most interesting
way, giving definite data on the following topics.)

REFORMS IN MEDICINE.

1. Education and publicity in regard to so-called "patent medicines,"
advertised to the public.

2. On the use, without investigation, of the numerous patent medi-
cines advertised to the physicians exclusively.

3. To the suppression of advertising of doubtful or injurious remedies.

4. To the State's duty to inspect its medicines for human beings, as
well as its cattle, poultry, and plant foods.

5. To devise some means to legally reach those outsiders who, by diag-
nosis blanks and remedies furnished, are practicing medicine in our
State without preparation or license.

6. To the particular investigation of drug habits treated with remedies
containing dope made up to fit the particular case.

7. To the harm done, in the public mind, by premature, spectacular,
and exaggerated announcements of cures, specifics, etc.

8. To volunteer the assurance of aid from the pharmacists in this work
of our State Board of Health and the American Medical Association.



78 NORTH CAROLINA MEDICAL SOCIETY.

SHOULD THE RELIGIOUS PRESS AID AND ABET lA^

SELLIISTG PATENT MEDICINES AND OTHER

NARCOTICS ?



Dr. .T. T. .J. Battle. Greensboro.



For the Medical Society of North Carolina to discuss the question
as to whether or not the religious press of the State is keeping within,
not its legal, but its moral right as to its advertising columns is certainly
out of the ordinary; and for it to be brought up at all is an intimation
that the press is taking money for something that is of no benefit to its
readers, and possibly harmful.

To be more specific, it is a matter of serious regret that so many de-
nominational papers should continue to advertise nostrums of every
description. This regret is intensified when it is realized that so many
of the secular magazines have discontinued them, and many of these,
such as Harper's WeeMy and Collier's, have started crusades against
the sale of them.

When the secular magazines take the lead in a moral movement which
is purely for the good of the people, and quite often against the financial
interests of the magazines, it is a reflection upon the religious periodicals,
as the latter are expected to be in the front rank in e^'ery work the object
of which is the uplift of the citizenship of the State.

Every religious periodical in this State is owned very largely if not
exclusively by ministers ; if not owned, they are edited by them ; and in
the columns of too many of these papers are patent medicine advertise-
ments which are misleading and which are doing much harm to the
people who take such medicines. The owners of these papers know that
this is the case ; and not one of the editors or ministers connected with
them would go in the pulpit or upon any platform and recommend pub-
licly the taking of these nostrums, nor could they be bought at any price
to recommend from the pulpit that they should be taken. Yet they are
carrying these advertisements, and carrying them because of the money
that is in them. In many families in this State the church paper is
read more religiously than the Bible itself, and in the country where
the daily paper is not taken every advertisement even is read. The
editors undoubtedly Avant the people to believe what they have said along
religious lines, and if the real truth was known they do not want them
to believe what is said in their advertisements. This is what might be
termed left-handed religion.



MEDICAL JURISPRUDEiS^CE AXD STATE MEDICINE. 79

The columns of the religious papers are regarded by a great many
people, who believe in the ''old-time religion," as more or less sacred;
and they read the advertisements without taking them even with a "grain
of salt." Fakers are aware of this fact, and that is the reason they are
willing to pay high advertising rates.

If the editors of the religious press realized that they are directly
responsible for making dope fiends out of some of their subscribers,
when their real object is to make them better church members, it would
be calculated to make them consider well before subsidizing their space.
The average reading man puts a "V after most of the reading matter
he sees in the daily papers, and awaits confirmation; but not so with
the average subscriber to the church paper, who has all confidence in
whatever he reads in its columns. He has not been called upon to
grapple with and weigh the many conflicting news items and misleading
advertisements found in so many papers. The daily press, which prac-
tically admits that its columns are subsidized — as in a recent controversy
it admitted that it would not criticise its advertisers — is fast approach-
ing a time when it also will eliminate all advertisements of doubtful or
questionable good.

As the vascular system of an individual distributes the blood to the
entire body, so the press of the State distributes the news over the entire
field. When it comes into the home of the credulous church member, he
sees no difference in the statements made in the reading and in the
advertising columns; he reads them all, believes them all, and acts ac-
cordingly, for it is doubtless true that the best written advertisement
sells the most medicine. The medicines are gotten up for the purpose
of selling, and not for benefiting humanity primarily. The ingredients
and the preparation are Avithheld from the public, for if these Avere
given out it would demonstrate that the claims made were not true. If
some physician who has made a failure in practice has resorted to this
means of deceiving the public, he will give more attention to and pay
more money for the advertisement than for the compounding of the
drugs.

Some of the religious papers have sold their entire advertising space
to a syndicate, sometimes possibly in another State, and it is really more
or less out of their control ; so that Avhen the following quotation is seen
following an advertisement :

"Note. — The Advertising Manager of the is

personally acquainted with You run no risk

whatever in accepting his offer. I have personally witnessed the

remarkable curative power of this in a very

serious case."



80 NORTH CAROLINA MEDICAL SOCIETY,

it is for the purpose of making the reader believe that the advertising
manager of the paper is referred to, while the truth is that it is the
advertising manager of the syndicate who has bought the columns. It is
misleading, and it is intended to be. The shrewdness of this advertise-
ment is seen only when carefully read, as it shifts from the third person
to the first person.

The average man who takes a religious paper — and it may be pos-
sibly the only paper which enters his home — believes what he sees in it.
He is enticed into buying medicines, his money is wasted, and when
no good is done it might be well for him to learn by experience; but
too often real harm is done. Every one must admit that patent medi-
cines are made for the money that is in them. Very fortunately, many
of them do no harm, as the ingredients are worthless and have no effect ;
others have a habit-forming drug in them made for the purpose of
causing a habit so that the sale may continue ; others are really harmful.

It might not be out of place to call attention to some astounding
statements made by this class of commercial adventurers. In looking
over the columns of a religious paper, and reading the advertisements,
I see that they guarantee to cure every known disease. One will use a
liquid, which will give "blessed relief in five minutes" — "put an end to

stomach trouble forever by getting a large fifty-cent case of "

Another will use a powder, curing the same symptoms, but not in so
short a time. Another will use tablets, which will make you "beautiful,
and correct digestion," will digest food "better than your own stomach
can do it." One specimen of water will renew the system in three weeks,
giving you an entirely new body.

Some papers of the State have already thrown these advertisements
overboard, and refuse to allow communications of such doubtful nature
to have any space in their columns. Their influence is more wholesome
and religious. All honor to them.

May the day soon dawn, if it has not already done so, when the entire
religious press will be on the firing line, using every effort to save its
readers not only from useless expense, but from possible danger arising
from the indiscriminate use of patent medicines. It is a duty it owes
to its followers ; and when these advertisements are discontinued it will
stand upon a higher plane, and be of greater service, and will be more
loyal to the God it professes, rather than in the present position of serv-
ing two masters.



MEDICAL JURISPRUDENCE AND STATE MEDICINE. 81

SHOULD A^OETH CAEOLIN'A SEND HER DRUG HABITUES

TO THE CHAI:J^-GANG OR GIVE THEM HUMANE

TREATMENT ?



William M. Jones, M.D., Greensboro.



I was once present at a vandeyille sliow in which the comedian re-
sponded to a very peculiar name, and when being questioned as to who
gave him such a name, made the reply that nobody had given it to him,
but that it had been wished on him. So it is with me and my subject ;
it has been wished on me. Why, I cannot say, and I fear you will not
have the solution when I have finished.

North Carolina cannot send her drug habitues to the chain-gang.
Where is the law for such action ? I will admit that we have some queer
laws, but I do not think that we yet have on our statute books a law pro-
viding that a drug habitue can be sent to the chain-gang for the habit
per se, and, on the other hand, we do not have a statute stating that he
cannot be sent. The drug habitues of the chain-gang are unfortunates
who have come under the heavy hand of the law for some crime com-
mitted. The laAv does not excuse a man who commits a crime when
under the influence of whiskey, and it cannot make an exception of
other drugs. When these cases come before our courts they come charged
with having committed a crime, and, if found guilty, they are sentenced
according to the law for their particular offense. There are a few ex-
ceptions, where the fact has been clearly sho^m that the case is one of
drug addiction, when the court in its discretion may modify the sen-
tence.

This individual cannot be turned loose upon society. He cannot be
allowed his freedom and given the opportunity of repeating his offense,
but must be handled in such a way that he cannot injure innocent sub-
jects or violate the laws of the land. He cannot be sent to the hospital
for the criminal insane, for these hospitals are always full, and besides,
a drug habitue is not what might be termed a bona fide case of insanity,
but is the victim of a habit, Avhich habit has been the cause of a mental
and oftentimes a physical departure from the normal. He cannot be
sent to a private hospital, for there is no provision made for keeping
him under control, were it otherwise possible to send him there. The
court is face to face with a situation, and this must be met. What solu-
tion shall it make of the situation and how shall it decide the question ?
Either by freedom, with or without bond; by suspended judgment, the
6



82 NORTH CAROLINA MEDICAL SOCIETY.

payment of a fine, or by a sentence to tlie jail, workhouse, or county
roads. To give him his freedom is only suspending the inevitable, for
sooner or later, and generally sooner, he is again before the bar of
justice.

In my limited experience with drug habitues who have been sentenced
to the roads, and were I compelled to base my conclusions upon this
limited experience, I would unhesitatingly say that the county roads is
the place for these cases. They certainly get relieved of their habits,
provided their sentence is of sufficient length, and these cases do re-
ceive humane treatment. Is it reasonable to suppose that because a
man is down and out and a convict that he will not receive humane
treatment from the medical profession of !N^orth Carolina? For, if he
does not receive it, but, on the other hand, gets inhumane treatment, it
is the fault of some physician, for these cases are under our care and
protection during the time they are working for the State.

Results can be obtained on the county roads, and results that are as
lasting and permanent as would be received in an institution at an
enormous expense to the State or the individual. I realize the fact that
the outlook would be far more inviting for the drug habitue when con-
victed had we beautiful and elaborate buildings surrounded by large
and commodious grounds, the buildings having tiled walls and marbled
floors, libraries full of the latest and best magazines, lounging rooms
with masterpieces of art upon the walls, and morocco upholstered re-
clining chairs, with hot and cold baths upon every floor, both shower
and tub, and the tubs made of pearl; where meals were served to meet
the most fastidious appetites, upon silver waiters, by full liveried at-



Online LibraryMedical Society of the State of North Carolina. AnTransactions of the Medical Society of the State of North Carolina [serial] (Volume 62 (1915)) → online text (page 10 of 58)