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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tacitly agreed to this arrangement before this splendid donation of Dr.
Murphy's could be available. We trust the Society at this meeting will
take whatever action necessary to carry out this suggestion. Dr. C. S.
Mangum has also procured almost a complete set for the University
Library, and two or three physicians in the State have complete sets,
which they prize very highly.


Complete List of the Metnhersliip of This Society to Date. — The secre-
tary lias also compiled a complete list of the membership of this Society
to date. Much of this valuable work was done by Dr. J. Howell Way
when he magnified the office of secretary. We would recommend that
the incoming secretary be authorized and instructed to go a step further
and secure and keep intact a file of all the legal practitioners in N^orth
Carolina, and that he furnish a list of the same to the collectors of
internal revenue in ]^orth Carolina, in order that they might be aided
in enforcing the law in regard to the prescribing of narcotics. We would
further recommend that the officers of this Society be instructed to co-
operate with the collectors of internal revenue in i!^orth Carolina in any
other way possible in the enforcement of this law. The symposium on
narcotics which will be presented at this session should* call the attention
of the profession, and we trust the people of the State, to the destruction
brought to our people by the use of narcotics, and we would recom-
mend that an additional committee of three or five be appointed to co-
operate Avith our Committee on Public Policy and Legislation to bring
the matter to the attention of the people of our State, and especially
to bring the matter to the attention of the next General Assembly.

State Board of Health. — It is a great pleasure to note the efficiency
of our State Board of Health and the efficient and constructive health
work it is doing. This Society, and the people of the State as well, will
no doubt be pleased to know that jSTorth Carolina is beginning to be
looked up to by the other Southern States as a State who leads in public
health work. The plans of the State Board of Health are well considered
and their policies are constructive, and with Dr. W. S, Rankin as execu-
tive officer these plans and policies are well carried out. I bespeak for
the State Board of Health the continued loyal and hearty cooperation
of every member of this Society.

Health Officer. — The health officer is in greater and greater demand
throughout the State of North Carolina, and even now some ten or
twelve men are devoting their whole time to this work, at a fairly re-
munerative salary. The demand for first-class health officers in North
Carolina will increase rapidly as the days go by; not only in ISTorth
Carolina, but in every medium-size town and in a large percentage of
counties in every State in the Union. The work of health officer, whether
city or county, is peculiarly the function of the physician. The sanitary
engineer, the public health nurse, cannot now nor can they ever take the
place of the physician as health officer. However, if the physicians sit
idly by and do not meet the demands, or do not show sufficient interest
to place one of their profession where a health officer is needed, the sani-


tary engineer is not to be blamed if lie places one of his profession in
such place. We delight to honor Colonel Goethals in accomplishing the
splendid feat of engineering in the construction of the Panama Canal;
but it was not an engineer that discovered the method of transmission
of yellow fever and of malaria, without which discovery the building of
the Panama Canal would have remained impossible. It is the physician
who has made the profession of sanitary engineering possible, and more
honor is due Colonel Gorgas and the men who discovered the methods of
transmission of yellow fever and malaria than is due Colonel Goethals.

The public health nurse is an important factor in the campaign against
disease, just as is the sanitary engineer. The physician in reality makes
the nurse. He has at all times and does now and will ever make the
nurse, of whatever title, possible; and the nurse who assumes that she
knows more than the physician in public health work or in any other
kind of work in her profession is making an egregious blunder. The
physicians must furnish the health officers of this country. They have
never failed to measure up to their opportunity or to their responsibility,
and they will not fail in this instance. A few of the best schools have
put on a course for health officers, at the completion of which they confer
the degree of Doctor of Public Health. It is proper to make mention,
in this connection, of the fact that Dr. W. S. Rankin, secretary of our
State Board of Health, has outlined a plan for training health officers
which in the opinion of those competent to judge will give a physician
far better training than can be given in the schools offering the degree
of Doctor of Public Health, this training, of course, presupposing a cer-
tain amount of knowledge of public health work to begin with.

The Control of Cancer. — The increasing number of deaths from cancer
means, more than anything else, that the physicians do not pay that
attention to the early lesions that the importance of these early lesions
demands. Our knowledge is not sufficient at this time to enable us to
speak of the prevention of cancer, but knowing that in the large per cent
of cases if the early lesions were properly treated the death rate from
cancer would be reduced 50 per cent or more, it is proper to speak of the
control of cancer. Until our research workers have given us more in-
formation in regard to the cause of cancer, the fight resolves itself into
obtaining the cooperation of the physicians in treating the early mani-
festations of cancer and in educating the people to understand what these
early manifestations are and what they mean. It is with pleasure that
we note in the last few months that Dr. John Wesley Long has been
appointed a member of the American Society for the Control of Cancer,
and that through him a good,, large committee of surgeons of this State


has been formed into a State committee for the control of cancer. It is
hoped that the formation of this committee of surgeons will serve to
interest more deeply the surgeons of North Carolina in the prevention
of disease. It is apparent, however, that unless this committee correlates
itself with the State Board of Health the publicity work necessary to
carry out the procedures mentioned above will not be obtained, as this
committee will not be able to afford either the time or the expense

Tuberculosis. — Modesty forbids my saying anything in regard to the
fight against tuberculosis that is now joined in I^orth Carolina except
to emphasize the fact that in this fight the North Carolina doctor has
an important part to play. He is on the picket line and must scent the
approach of this arch, enemy of our civilization, of our people, when yet
in the distance, and sound the alarm. Unless the doctors in the State,
acting in their capacity as. pickets, report the location of the enemy, we
will enter the fight with a heavy handicap.

Early diagnosis of tuberculosis is of equal importance with the early
diagnosis of appendicitis, and there is no excuse for a physician in North
Carolina, no matter how poorly prepared, failing to make diagnosis in a
case of tuberculosis until all the i^eople of average intelligence in the
neighborhood have made the diagnosis from the general symptoms.

There are certain clinical symptoms that can be reported by an average
nurse or intelligent person in the family or community that point so
strongly to tuberculosis that a diagnosis is demanded, at least until it is
proven otherwise by an expert diagnostician after careful and pains-
taking examination ; and the people are becoming more and more
familiar with these clinical symptoms, just as they are with the clinical
sjTiiptoms of appendicitis, and are demanding that the doctors shall at
least advance as rapidly as they in the diagnostic knowledge of tubercu-
losis ; and the doctor in North Carolina who does not do this will appear
to bad advantage among his clientele.

In this connection let me say that tuberculosis is a contagious disease.
It has been placed in this category by more than one State Board of
Health, and it is a reportable disease under the jurisdiction of every
board of health deserving the ' name. It is, then, just as much the
province of the health officer to give expert diagnosis in tuberculosis
suspects as it is in suspects of diphtheria, scarlet fever, smallpox, or
any other contagious disease. To this end the State Board of Health
has provided that any health officer may spend a week or a month or as
long as he desires at the State Sanatorium, perfecting himself in the
diagnosis of tuberculosis and the hygienic handling of the same, with-
out expense to him.


Conservation of Visiofi. — The president took the authority to form a
section on the conservation of vision for this session. We feel that this
is a very important matter in North Carolina at this time. The State
has been 23roviding as best it could for the education of the blind in our
State, and has done well. The State School for the Blind at Raleigh,
under the direction of that able champion of the cause of the blind and
splendid superintendent of the school, Mr. John E. Ray, has been turning
the blind paupers of our State into self-supporting citizens. The State
School for the Blind, then, is an economic institution of far-reaching im-
portance. However, it would seem that when one-third of the blindness
in North Carolina can be prevented by the expenditure of two or three
cents per head or less, that we are pursuing a very short-sighted, not to
say foolish, policy. It would seem that it would be very much better to
build a fence along the edge of the precipice to keep people from falling
over, rather than maintain an ambulance in the valley below and a State
school for the blind. The medical profession, as in all other matters
medical, must use their influence and expend their efforts and intelligence
to bring about the desired result in this particular instance. I would
therefore recommend that this Society form a permanent committee on
the conservation of vision. The title would perhaps better be "The Com-
mission of the Medical Society of the State of North Carolina for the
Conservation of Vision," this commission to act in conjunction with the
State Superintendent of the Blind and his board in conducting an edu-
cational campaign throughout the State for the prevention of blindness
and for the enforcement of the wholesome laws passed by our last Gen-
eral Assembly, the Secretary of the State Board of Health to be ex officio
a member of this commission.

Narcotics. — The use of narcotics in our State affects so vitally the
mental and physical health of our people that I feel com]3elled to bring
again the matter to your attention. In doing so I feel that I cannot do
better than to refer you to the comprehensive and pointed statement on
this subject contained in the president's address of Dr. J. M. Parrott last
year, found on pages 25 and 26 of the proceedings of 1914, and but for
the time required to read it, would embody it as a whole. The resolutions
passed at the Winston meeting in 1908 was the first important stand
taken by this Society in regard to the use of narcotics, referring in this
instance to whiskey. The records of our insane hospitals show that 50
per cent of the patients are there on account of the use of narcotics. We
are spending nearly three-quarters of a million dollars every year caring
for those we have there, to say nothing of the cost of the buildings and
grounds, and there are yet a few hundred insane people in the State who


cannot be admitted for want of room. When it is positively known that
we could save $350,000 annually in the maintenance of our insane hos-
pitals by stopping the use of narcotics — whiskey, opium, cocaine, etc. —
it would seem that we Avould do it as an economic proposition. Until we
do this we should at least make preparation and treat these habitues
before they become insane, and save them to their family, their friends,
and the State, and make of them an economic asset instead of a total
loss. Again we are maintaining an ambulance service in the valley
below at great cost, rather than spend a few dollars to build a fence along
the edge of the precipice to keep our people from falling. Again the
doctor in N^orth Carolina plays an important role. The doctors of I^orth
Carolina must work out these problems, and they have much to do with
the enforcement of the whiskey and narcotic laws.

These things will be fully discussed in the splendid symj^osium on
Narcotics that forms an important part of the program of this meeting,
and for that reason I leave the subject without further comment, except
to say that whiskey or opium or cocaine is just as harmful when put
up in bottles and labeled


and sold through advertisements in religious papers as it is when it is
labeled "Whiskey" and sold in a barroom, or labeled "Opium," with the
skull and crossbones displayed on the wrapper and sold through a drug
store. And it is high time that the religious and all other self-respecting
newspapers in our State cut themselves loose from the unholy alliance
with the patent medicine frauds, by which alliance they are aiding and
abetting in the sale of liquor, opium, cocaine, etc., to the people of our
State (it is worthy of mention that the denominational paper of the
Methodist Church in this State has already severed this alliance), or
else they should come out boldly and say that they are opposed to the
prohibition law; that they are opposed to restricting the sale of nar-
cotics; and that they are in favor of perpetuating a practice that is de-
stroying increasingly large numbers of our people — mind, body, and

Tlie Last General Assembly and Its Attitude Towards Matters Medi-
cal. — It was a great pleasure to note the influence of the medical pro-
fession in !N"orth Carolina as shown in the last General Assembly. The
improvement, or the increase of the stringency of the prohibition laws
of the State would never have been considered for a moment had it not
been for the action taken by this Society at the session in Raleigh, June,
1914, in regard to the prescribing of alcohol as a therapeutic agent, the
said action being perhaps largely a result of the splendid deliverance


of the president, Dr. James M. Parrott, on this subject in his president's
. address. It was openly stated by the strongest advocates of prohibition
measures that they would not vote for any further extension of the pro-
hibition laws as long as whiskey was sold at the drug stores ; but as soon
as your president and your Committee on Public Policy and Legislation
stated the attitude of the State Medical Society these same men were
willing to go to any limit in the prohibition of the sale of alcohol in
North Carolina.

We desire also to express our appreciation of the similar position
taken by and the influence of the ll^orth Carolina Pharmaceutical Asso-
ciation in regard to the sale of alcohol by drug stores in North Carolina.

A letter from a gentleman in this State who is a close observer of men
and measures stated that our Society had done more toward decreasing
the consumption of whiskey in North Carolina than any other organiza-
tion except the church. And it is perhaps not improper for me to say
at this time that this action by our Society has increased largely the
esteem and confidence of our people for the medical profession in our

May I state also that the nonmedical men in the General Assembly
were thoroughly informed in regard to these matters and in regard to
public health matters in general. As an evidence of their intelligence
in this matter we might call to witness the fact that when the only unto-
ward bill, medical or health, was introduced in the General Assembly
j)roviding for opening the sale of opium and its derivatives, the Commit-
tee on Health voted unanimously to report the bill unfavorably, and it
was killed then and there.

Every bill affecting the medical profession, all considered constructive
and progressive, was passed without amendment and without opposition.
Among these we might mention the divorcing of the meeting of the
Board of Medical Examiners from the meeting of this Society and hold-
ing the main meeting annually in the city of Raleigh, at such time as
the Board of Examiners may decide, and holding a second meeting
during the year if desired, and abolishing the temporary license. It
remains to be seen whether or not this law is wise. It may be that it
will place additional burdens on the Board of Examiners, who I am
quite sure are. sufficiently burdened already, and it certainly takes the
board meeting and the young doctors who are participating away from
the influence of this Society just at a time when the young doctors are
entering the profession in our State, and when they should be brought
under the wholesome influence and made to feel the importance of allying
themselves with the organized profession in our State as represented by


this Society. Let us hope that this is not the beginning of the time when
the Board of Medical Examiners shall be completelj^ cut loose from this
Society and become a trophy of ordinary politics.

Another important piece of medical legislation was that allowing
medical students who have completed the first two years in medicine, at
a medical college accredited by our board, to be admitted to examination
on the two years work upon the payment of a fee of $7.50 and to have
credit for the marks made at his final examination after receiving his
degree. There is no real objection to this law, and it should give en-
couragement to the two-year medical schools in our State, which schools
already enjoy an enviable reputation on account of the splendid work
they are doing; but it is not supposed that the framers of this law had
this in mind.

Every bill save one for the improvement of public health laws that
was presented passed without amendment. We might mention the bill
to amend the vital statistics law, the bill to allow counties and towns
to provide money to maintain patients at the State Sanatorium, a bill
incorporating a training school for nurses at the State Sanatorium, a
bill requiring the instillation of a 1 per cent solution of silver nitrate
into the conjunctival sac of every new-born babe and requiring every
midwife or nurse or other person having charge of an infant, noticing
any inflammation or reddening of the eyes of said infant, to immediately
notify the local health officer or other competent physician of such fact,
etc., etc. The only bill that failed was a bill to allow the State Board
of Health to inspect convict camps, jails, etc., throughout the State.
The appropriations were increased for health work as much as could
be expected, perhaps, considering the psychological depression on account
of the low price of cotton. The following increases were made : To the
executive department of the State Board of Health, the Bureau of Vital
Statistics, to the State Laboratory of Hygiene establishing an antitoxin
farm, and to the Bureau of Tuberculosis and to the State Sanatorium.
The laity, as we call the nonmedical men, must needs look to the medical
profession for guidance along all lines having to do with public health.
We have felt for some years that the average medical man did not take
that interest in public health matters that he might do, and that he
might do to his own advancement. It has been frequently remarked in
our hearing that the majority of the lay members of the last General
Assembly were better informed on these matters than the average phy-
sician in the State.

Change Date of Meeting. — The date of our meeting so nearly coincides
with the meeting of the American Medical Association that it is impos-


sible foT many who would like to to attend botli meetings. I therefore
recommend that the date of our meeting be changed to such time as this
Society may decide upon.

Comhined Sections.- — ^It would seem that the section on Medical Juris-
prudence and State Medicine was proper nomenclature in its day and
generation; but this title is an obsolete phrase today. We take it that
the committee had this in mind when it provided for a section on School
Hygiene and Rural Sanitation at the last session. We would recommend
that the whole thing be combined and the title of the combined section
be styled "Public Health and Public Instruction."

Politics versus Scientific Papers. — I have heard frequent criticisms
of our Society, covering a period of quite several years, to the effect that
we were too much given to politics — of the good medical kind, be it ob-
served, however— and to the exclusion of hearing and discuss^n of
scientific papers. Let me oifer tAvo observations on this criticism : First,
I have never yet seen any organization, political, religious, civic, social,
fraternal, college, high school, medical, legal, commercial, industrial,
agricultural, or what not, composed of men or of women or of both, that
was free from politics; nor do I believe that any such organization has
ever or will ever exist, not even in the much vaunted commission gov-
ernment, which is the newest fad of our democratic form of government.
Second, if there are a goodly number of members of this Society who
feel that this criticism is just, it is their duty to do two things : First,
prepare and bring to this Society a sufficient number of scientific papers
to make a program quite to their taste, and be present in person and
read their papers and give to the other scientific papers scientific dis-
cussion ; and, second, to enter into the politics of this Society and make
the said politics conform to their views as to quality, quantity, momen-
tum, and all other specifications desired. Accomplishing their purpose
in whole or in part, it then becomes their bounden duty, as it has ever
been and ever will be, to combine their energy, intellect, and enthusiasm
with the other members of this Society to make of it what it is sure to
be — in fact, now is — one of the strongest and best State medical societies
extant ; one of the most powerful State medical societies known, but one
which wields that power only for the good of our noble profession and
the good of all our people — the brightest star in the galaxy.

Social Service. — There is no phase of social service with which the
doctor is not prominently connected. It was noticeable at the recent
session of the Southern Sociological Congress that every subject pre-
sented was based upon and solvable by proper health conditions. It is
worthy of note that the next session of this Congress will have for its


object pointing out the duties of all organized bodies of people, inelu,ding
the church, in this campaign for health. The various organizations for
social service are simply the announcement of the fact that a goodly
number of our people are answering the question that has been re-
verberating down the halls of time since the time of Cain and Abel, "Am
I my brother's keeper ?" They are anxious to answer this question with
their time and their money; but it devolves upon our profession, upon
you and me, to point the way.

Cooperation. — Cooperation, which is a synonym for organization, is
the most important factor in our present-day civilization. It is the thing
that makes possible our postal system and the small amount of postage
required to carry our letters anywhere in the world. It is the founda-
tion of the success of the Rockefellers, the Vanderbilts, the Dukes, and
,the Cones. It reaches its highest development in Germany's military
organization, making it possible for her to defy the nations of the world
and get away with it. It reaches its lowest development in some of the
county medical societies in I^orth Carolina. In many of the counties
in North Carolina the doctors make no' effort — in fact, not even a pre-
tense — at keeping up a medical organization, which we speak of as a

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 4 of 58)