Medical Association of the State of Alabama. 
ANNUAL MESSAGE 
BY 
WM H. ANDERSON, M. D. 
President of the Association, and ex officio President of the State Board of Health, 
First Vice President of the American Medical Association—lBBo-’Bl, Pro- 
fessor of Physiology in the Medical College of Alabama, &c. 
MONTGOMERY ALA.: 
BARRETT & BROWN, STEAM PRINTERS AND BOOKBINDERS. 
1881. 2HE ANNUAL MESSAGE OF THE PRESIDENT 
wm. h Anderson, m. d. 
It becomes my duty, and I deem it my great privilege, to 
deliver to you the Annual Message of the President of the 
Association. No man can feel prouder of this Association 
than myself. Connected with it from its earliest inception, 
I have watched its rise and progress with intense anxiety, 
and now deeply enjoy the promise that it gives of culmina- 
ting into great power and usefulness. States that were old 
when Alabama was a primeval forest have tried to reach the 
point of professional organization which we have attained, 
but have not been able to do so. Whether we have had a 
more plastic material in the profession to work upon than 
they had, or whether we have persevered when they gave up 
the case as hopeless, I do not know ; but certain it is, that in 
some important particulars for the good of the profession 
and of the people, we are at this moment in advance of them 
all in our legislation. 
Let us, for a moment, glance at the means by which we 
have arrived at this elevated stand-point. The earlier meet- 
ings of the Association showed very plainly that we had the 
material in our midst, if we could only get it into good and 
consistent working order. One of our hardest workers and 
deepest thinkers surveyed the situation, and gave the influ- 
ence of his powerful mind to assist in mastering it. He re- 
modeled the Constitution under which we worked, and made 
it more effective. It was presented to the assembled wisdom 
of the Association; but minds less trained to comprehen- 
siveness of thought could not grasp it in its practical detail. 
It seemed to most of us too far reaching for the present 
status of the profession. It asked, as we thought, too much 2 
to be consistent, with the surroundings of the physician and 
the people. Th\} Temple that it would construct, it is true, 
looked beautiful as a whole; but could we build it with the 
means at our disposal ? The architect thought that we 
could ; the actual builders demurred, and threw such ob- 
stacles in the way as almost to discourage the friends of the 
scheme. At length, however, after years of toil and perse- 
verance, after remodeling and changing minor details, we 
got our new Constitution, and have grown strong and power- 
ful under its wise and well conceived measures. Now, what 
shall we do to preserve it—to enrich it—to keep it on a level 
with the growing wants of the age, and to hand it down to 
our posterity as a valuable memento of our wisdom, and our 
love for the well-being of the profession ? 
In the first place, gentlemen, we want to cherish a deeper 
interest in the profession, an interest that will make us 
study assiduously the old matter, which the centuries have 
sifted out from the chaff, and which the learned among us 
consider as indisputably good. The same deep interest 
should be taken in all that is new when it emanates from a 
proper source. We have no time to be idle. The mere fact 
of a local reputation among the patients of his clientele, 
should not make the physician self-satisfied with his knowh 
edge, and cause him to relapse into indifference. Any one 
man’s sphere of observation is necessarily small, and if he 
desires to keep up with his calling he must study the new 
revelations of his department of science) Many of them may 
be worthless—nay, many are mere delusions of ardent and 
enthusiastic investigators; but each man should acquaint 
himself with the so called facts, and judge of them from the 
stand-point of his own experience. He will always learn 
something which will be of benefit to his patients, and even 
if that were not the case, the very fact of his being a student 
in his profession will give him more influence, and widen his 
sphere of usefulness. One man may be intellectually brighter 
than another, may acquire information more rapidly than 
another; but wisdom is the result of thought; it comes o 
O 
spontaneously to no man ; it is the offspring of well-weighed 
facts which have been acquired either by our own experi- 
ence, or the careful investigation of others. If every physi- 
cian in a State would nerve himself up to continued study 
while he is practicing his profession, his sphere of knowl- 
edge would be enlarged, and his usefulness greatly aug- 
mented. I know too well, gentlemen, that the physician in 
the country, in the village, and in the city, is very apt to be- 
come mentally inert when he is partially overcome by physi- 
cal fatigue ; is too prone to listen to the siren voice of indif- 
erence and bodily ease, and thus to lose the golden hours, 
that, in this day of progress, always come freighted with the 
priceless stores of science. By our Constitution, my co- 
workers in the field of medicine, I am not here on this occa- 
sion to deliver to you an essay filled with the attractive 
events of medical history, or the flowers of professional lit- 
erature ; but I am called on, in delivering this message, to 
suggest—to tell you what I conceive to be the wants of the 
profession ; and in my humble opinion more intellectual 
work is required to stamp on the community the impress 
that should attach to the name of every active practitioner. 
This will increase our influence, build up confidence in us, 
and give weight to our opinions at the domestic hearth, in 
our social relations with our fellowmen, and in the form of 
our medical assemblies. 
The discussions that have taken place in this Association 
at its various annual meetings, have certainly brought before 
us an extensive field for contemplation and research. Some 
of the most valuable medicines in the materia medica have 
had their virtues freely ventilated by many of our most ex- 
perienced physicians. These discussions are of greater 
value because they are participated in by active practitioners, 
who have tested the value of the remedies in question in our 
own climate. Locality and the causes of disease incident to 
it, do certainly modify the effect of some medicines; so that 
the therapeutic action of a remedy in Maine need not neces- 
sarily be the same in Alabama where different causes of 4 
disease exist, and where different constitutions are the sub- 
jects of treatment. Hence, I attach great importance to these 
discussions when carried on in a short decisive manner by 
any of our members, either old or young; and I hope they 
will be continued, so far as the transaction of other impor- 
tant business will allow. Sir Thomas Watson calls thera- 
peutics “the final and supreme stage of medicine,” and all 
practical knowledge gained, either by our own experience or 
that of others, is of the first importance to all who practice 
the healing art. 
I now approach, gentlemen, a delicate subject, namely : 
The Ethics of our Profession. We have adopted the “Code” 
of the American Medical Association, and I suppose that we 
must continue to be governed by it on all subjects of ethics. 
But I long to see the day when the profession of Alabama 
will not require any Code, except that unwritten Code, which 
dwells in the bosom of every gentleman in the profession and 
out of it. The members of the Association are the leaders 
of medical thought and medical sentiment in Alabama, To 
the latter belongs the ethics which should govern us. If we 
desire to see the rising generation of physicians occupy a 
high and cultivated stand in society, we must teach them 
both by precept and example. They naturally look to us as 
the exponents of medical demeanor. In our midst, then, 
must begin that culture which abhors all that is base and 
sordid in the relation of one physician to another. The 
acute perception of right and wrong is not given to all men 
alike ; but when sufficient numbers in any organization take 
a very high stand in their social relations, the rest will ab- 
sorb it and be governed accordingly. Virtue, which is the 
basis of all ethics, is a part of every man’s composition, and 
when practiced for its own sake, not for the world’s applause, 
it is the most contagious of all the passions that belong to man; 
and really, if it ought to be the guiding star of any body of 
men, next to that of the sacred ministry, it should be of 
physicians in every capacity of their calling, whether as stu- 
dents, as teachers, or as practitioners. The rights of others— 5 
nay, the welfare of others, in our professional intercourse, 
should always be respected. There is no reputation so bril- 
liant that it cannot be dimmed by even a lack of courtesy to- 
wards our professional brethren ; but when we invade their 
rights, a stain falls upon us which even the mantle of charity 
finds it hard to cover. Gentlemen, in the great drama of 
society, there is no character so beautiful as the learned and 
cultured physician. He goes on his daily rounds to relieve 
the suffering of his fellowmen, and is a shining mark among 
his peers. They do not hesitate to accord to him all the 
encomium he deserves, because his actions strike a chord 
that is ever ready to vibrate in every bosom belonging to 
humanity. 
This unwritten ethics should be taught to every student 
who enters the Doctor’s office as a pupil. Let the founda- 
tion be laid there by the example of his tutor, and then when 
he enters the lecture rooms of the College, the superstructure 
should be built by the moral attitude of his professors. The 
mind of youth is plastic, and moral precepts instilled into it 
by teachers leave an impress which is generally indelible. 
If teachers in colleges would interweave in their lectures, 
when ever opportunity presents, sentiments reaching to a 
high order of manhood, the next generation of physicians 
would require no written Code of Ethics to govern them in 
their intercourse with each other and with the community. 
It has fallen to my lot, fellow-members, on several occasions, 
to sit in courts called to decide on breaches of Medical 
Ethics, and I must say that I always felt deeply humiliated, 
when I had to censure a professional brother for conduct un- 
becoming a physician. Even in that early day, when the 
sage of Cos lectured to his Grecian youth, he imbued them 
with ideas of professional etiquette, which would reflect 
lustre on the medical colleges of the 19th century ; and 
although in the darkness and rudeness of the ages which 
succeeded the Grecian Sage, his precepts were mainly for- 
gotten, yet they revived again in the dawning light of 
later centuries, and found expression in the lives and actions 6 
of some of our immediate medical ancestors whose names 
carry a thrill into the bosom of every student of medical his- 
tory. Let us then, gentlemen, cultivate tone in our profes- 
sion, and we will reap a reward before whose brightness the 
lustre of ill-acquired gold will pale, and fade into utter insig- 
nificance. 
In the history of our profession we have arrived at a period 
when the spirit of the age is emphatically onward. Our 
common country covers a very large area, and the state of 
civilization on the borders is in many instances equal to that 
of the center. Every geographical division, indeed every 
State expects every other State to do its duty towards eleva- 
ting the profession. A wholesome competition is now going 
on between the several States, and while Alabama has taken 
the lead in some respects, she is behind in others. What 
we have done has been accomplished by organization, and 
what we are to do will depend entirely upon better and bet- 
ter organization. The members of the profession must link 
themselves more closely together, and each individual should 
keep himself in close accord with this central body, whose 
influence is now stamping itself on the legislation of the 
country. A distinguished Judge of the Supreme Court, now 
gone to his rest, once told me that the medical profession in 
any country was all-powerful, so far as its own interests 
were concerned, if it would concentrate its forces. This was 
told me when I was a young man, and some thirty years of 
practical experience since has taught me that it was true. 
The laws of a country are generally founded on the immu- 
table basis of justice and of truth ; but it often happens that 
the practical administration of such laws is faulty. This 
leads to skepticism. There are even many skeptics in regard 
to religion, but there are few about the value of rational 
medicine. No matter what a man may think when his body 
is bouyant with health and strength, yet when he feels the 
dire twinges of neuralgia, when the fever rages through his 
veins and threatens to consume him, when the cough seems 
to rack his very soul, he cannot resist crying for help. In 7 
Jiis agony he looks to the physician for relief, and this begets 
that feeling of dependence which, as a general rule, sinks 
deep into his heart. Medicine is to him a mystery. He is 
uneducated in its principles, he knows little of its philoso- 
phy, and hence he yields to him who is his physician and 
his friend. This is the secret of that influence which in the 
aggregate we have over the masses in medical matters. 
As a class we are not busied with politics, we dabble lit- 
tle in commerce, we keep as clear as possible of litigation, 
and this makes us, as it were, a people apart, attending to 
our own business, and that business the preservation of that 
greatest blessing—the health of our fellow men. In the 
earlier times the physician gave medicine for relief and then 
his work was done. But at the present day our benevolent 
profession reaches far out into the great problems that claim 
the attention of society from its circumference to its center. 
From our knowledge of chemistry and its collateral depart- 
ments we have laid the foundation and are rapidly building 
up the science of sanitation. Our work is acknowledged as 
important and useful by the leading statesmen and philan- 
thropists of the day. We have thus not only the claim of 
kindly friendship upon those whom we have relieved, but we 
have in addition, that respect which is given to all classes 
of men who spend their time in carrying out schemes of 
general beneficence. This increases our power with the 
masses and enables us to get the legislation we desire, pro- 
vided we can show that such legislation has no selfish aim 
in view. The public must and will appreciate the sacrifices 
we make for the public good. Why are we here, gentlemen, 
to-day, at an aggregate expense of three or four thousand 
dollars out of our own pockets, an expense which we can ill 
afford to encounter ? Is it for ourselves individually ? Are 
we to be benefitted in person? By no means. We are here 
to consult, to devise, and to put in practice what will be of 
more benefit to the public than to ourselves. We have never 
asked the legislature for the enactment of any law that bore 
the slightest impress of selfishness. We are working only 8 
to elevate our profession by making it useful to our fellow- 
man, in relieving his sufferings, improving his condition, and 
lengthening the span of his natural life. 
One of the grandest philosophers of the last century, the 
celebrated Descartes, said “If it be possible to perfect man- 
kind the means of the perfection will be found in the medi- 
cal sciences.” In making this remark, the philosopher con- 
sidered the “medical sciences” in their broadest sense. Not 
the mere simple attempts to cure bodily ailments, but the 
philanthropic purpose of improving and enlarging the mind, 
of raising the standard of physical comfort, and adding more 
years to human existence. Professor Packard, in his address 
to the Medical Association of Maine in 1879 says, “There are 
certain truths which should be presented to the people, 
certain facts ■which they should know; and they expect to 
hear them from the Profession. If we can fulfill these re- 
quirements as becomes educators and advisors we can obtain 
a hold on the community which we can accomplish in no 
other way. Nothing will sooner convince the people of our 
usefulness than by making ourselves useful to them, noth- 
ing will conduce more towards gaining public respect and 
confidence, than proving ourselves capable instructors and 
counsellors.” I make this long quotation to show that 
throughout the entire country, from Maine to the Gulf of 
Mexico, the sentiment of the profession is unanimous on 
the subject of acquiring influence by a cultivated education. 
No Presidential address to a medical organization like the 
present would be complete at this day without reference to 
hygiene. The subject, I know, is hackneyed; but it must 
be met, even at the expense of being a little tedious. In the 
cities I have to report an increasing interest in Alabama 
about this important subject. The people are at last awaken- 
ing from their dreamy indifference to general sanitation, and 
this is due to the constant efforts of the County Boards of 
Health in presenting the matter more and more clearly to 
their understate ding. No wonder the masses have been for 
many years obtuse on this subject, because they can neither 9 
see nor smell the causes of disease, and it has been difficult 
to acquaint them therewith through their intellectual facul- 
ties. At last, however, through the repeated arguments of the 
Doctors, assisted by the medical and the general press, they 
are beginning to understand that a hidden foe may lurk where 
one is least to be expected. Continued interest on the sub- 
ject of hygiene, in all its bearings, is recommended to the 
members of the Association, and no occasion should be lost 
to ventilate its importance in the social circle and before the 
public. 
As a matter of personal interest, but more particularly as 
President of this Association, I attended the meeting of the 
Public Health Association in New Orleans in December last. 
The large number of valuable papers on the subject of sani- 
tation presented to that body by some of the most distin- 
guished scientists of the country, gave presage of a very deep 
and growing interest in both public and private hygiene. 
Eminent engineers and philanthropists outside of the pro- 
fession were in attendance, showing, that what a few years 
ago belonged only to medical circles, was now becoming, 
through the efforts of the faculty, a subject of all-absorbing 
interest to the most cultivated intellects of the age Prom 
an eminent engineer there we learned that by means of 
modern appliances whole districts of marshy territory, cov- 
ering a large number of square miles, could be drained at a 
comparatively small expense so as to make fertile and pro- 
ductive fields of what was formerly a mere swamp reeking 
with pestilential poison. Drainage for agricultural purposes 
suggested itself to the common sense of mankind centuries 
ago ; but drainage as a sanitary expedient is the offspring of 
medical thought, suggested by microscopic observation and 
chemical research. Minute analysis of an unwholesome at- 
mosphere shows it to be laden with solid particles of almost 
inconceivable fineness. The ordinary physicists might have 
discovered these spores, it is true ; but it took the physician 
to follow up the discovery and to show how the poisonous 
matter entered the blood, or invaded the tissues, and what 10 
averages it produced in the general system. We have only 
entered upon the threshold of this interesting domain of 
science, which it becomes the younger men of the profession 
to pursue with ardor; and if they have not the time or op- 
portunity to make researches themselves they should at least 
keep up with the developments and make practical uses of 
them. 
The past history of the profession is full of encourage- 
ment to persevere in our studies. If we were to take from 
the vast repertory of physical and biological science all that 
has been contributed by medical men, there would be a void 
painful indeed to contemplate. Anatomy would be unknown 
and the wonderful structure of the animal frame, before 
which the most complicated machinery made by human 
hands fades into insignificance, would be shrouded in utter 
darkness. The domain of physiology, now so inviting to 
travel in, and from which we gain so much that is interest- 
ing, instructive, and even necessary to our comfort and hap- 
piness, not only in this world, but in the contemplation of a 
future existence, would be shorn from our present state of 
knowledge, and leave nothing for us to look upon but an 
arid waste ; the grand phenomena of life, in its varied stages 
of growth and development, would cease to be an object of 
the most cherished interest, and leave us with the vague and 
brutal conceptions of the most untutored savage. The great 
botanists of the past, who have unfolded to us the vegetable 
kingdom, with its varied and beautiful attractions, were 
medical scholars in search of the secret paths in the great 
labyrinth of nature. The microscopists who have pene- 
trated into the wonders of the unseen world, and revealed 
the minute structure of those tiny inhabitants that bound 
into life and end their ephemeral existence in less than an 
hour, were members of the profession of medicine. Some 
of the greatest of the living and dead astronomers left the 
labors of the dissecting room to plunge into space and 
fathom its deepest abysses. Many of the geologists who 
withdrew the veil of ignorance that shrouded the eyes of our 11 
ancestors, and pointed to the remote antiquity of the world 
we live in, who traced its passage from a fiery mist floating 
in ether to the green earth that brought forth man and every 
creeping thing that reflects the glory of its Maker, were edu- 
cated in the halls of medical colleges. In the mediaeval revi- 
val of literature and science, the universities were indebted 
to the medical faculty for some of their most illustrious 
professors; and even at the present day many of the dis- 
tinguished scientists who fill the chairs of chemistry, phys- 
ics, and biology are doctors of medicine. Surely, then, we 
do not need encouragement to arduous and continued study. 
I have quoted Sir Thomas Watson as saying that thera- 
peutics “is the final and supreme stage of medicine.” So it 
is in the sense in which he used the word medicine. When 
disease has invaded the system, then therapeutics is our 
chief anchor in staying its progress, and a knowledge of 
remedies our only hope in neutralizing and expelling the 
morbific poison. To this end we must labor in the field of 
pathology and therapeutics, and he who has amassed the 
greatest experience in the use of remedies is generally the 
most successful and the most popular physician. But we 
must go beyond the symptoms and the ravages of disease, 
we must beard the lioness in her den and strangle her 
whelps that they may not mature and go forth to destroy us. 
This is preventive medicine, this is hygiene, and we must 
keep wide awake to its importance. In pure therapeutics, 
we can only act in concert with each other, but in public hy- 
giene, we can call in the aid of the philosopher, the physi- 
cist, and the philanthropist. The field here is larger, the 
scope is wider, and the reward is far more precious and 
enduring. He that makes two blades of grass grow where 
one grew before is of more value to mankind than the whole 
host of politicians. This is the saying of an eminent hu- 
manitarian. In like manner, he who destroys the cause of 
disease, who emasculates the germs of diphtheria and 
small-pox, and who stops the production of the poison that 
gives rise to yellow fever, cholera, and consumption, deserves 12 
to stand on a monument overlooking that of Jenner, or 
Howard, or Napoleon, or Washington. lam pleased to say 
that this Association has been at work on one great branch 
of hygiene. The paper of Dr. Seelye on “ Drainage and 
Under-drainage,” is a valuable acquisition to hygienic liter- 
ature. 
In the Northern and Middle States consumption of the 
lungs carries off about twenty-eight per centum of the adult 
population. In these States we have tolerably reliable sta- 
tistics, and they show a fearful result. In the Southern States, 
outside of the cities, our statistics are too meagre to be relied 
on, but in the cities, tubercular phthisis shows a mortality of 
fully twenty per centum of the adult population. It has been 
proved clearly that a thorough system of drainage lessens 
the mortality by phthisis fifteen per cent. Many other dis- 
eases are also lessened in their danger and in their death- 
rate by good drainage. Hence we cannot disseminate these 
truths too widely among the people. The expense must be 
borne by them, and would be cheerfully met if they were as 
sure of the facts as we are. The medical profession must 
educate them up to the proper point, and, by their united 
effort, it can be done. But this union of thought and senti- 
ment can only be brought about by an organization like our 
own, sending its ramifications into every village and hamlet 
in our state. This idea of perfect organization should im- 
press us the more at this time, from the fact that for the 
want of it we came very near losing, at the last session of 
the legislature, some very important enactments. There 
was even an effort made to repeal laws already in force for 
the passage of which we had labored faithfully for years 
past. If the members of the profession in the several coun- 
ties of the state had taken sufficient interest in enlightening 
the members of the legislature on these subjects before they 
left their homes there would have been no trouble at all. As it 
turned out, however, it took all the energy and fidelity of the 
Senior Censor, assisted by the faculty at Montgomery who 
worked nobly in the cause, to keep up our past legislation and 13 
secure the passage of the law bearing on the important sub- 
ject of vital statistics. We must not allow ourselves to go 
backwards and thus lose the prestige we have acquired. 
This is an inviting theme, gentlemen, to dwell upon, but I 
must leave it for the present. 
In June last, I attended the meeting of the American 
Medical Association, in New York. I had not been present 
at an annual meeting of that Association for twenty years, 
and was very agreeably surprised to find that its former hun- 
dreds of members had swelled to thousands, and that the or- 
ganization was far more complete than it was twenty years 
ago. Among several circles of physicians I had the great 
pleasure to hear the Medical Association of the State of 
Alabama spoken of in the highest terms. The peculiar fea- 
tures of our organization had evidently impressed them- 
selves on the medical faculty of states far distant from us, 
and among these were some of the oldest states in the 
union. When I returned, I addressed the following circular 
to a large number of physicians in Alabama, who did not 
belong to any medical society : 
Mobile, July 25, 1880. 
Dear Doctor : So important do I deem it for the good of the medical 
profession of Alabama that every practitioner in the State should join the 
medical society of his county, that I take the liberty of sending you this cir- 
cular, to calk your attention to the subject. 
By joining your county medical society you become affiliated with the 
Medical Association of the State, and I can assure you that it is not only an 
honor to belong to that body, but it is to the interest of every physician in 
the State to be a member of it. He thus individually is made part and parcel 
of the legal machinery that regulates the practice of medicine in Alabama, ad- 
ministers the health laws of the country, and has a general supervision over 
all the interests of the medical profession. 
At the recent meeting of the American Medical Association, where two 
thousand physicians were present, I had the great satisfaction of hearing, on 
every side, that the profession of Alabama was better organized than that of 
any other State in the Union. This was a great compliment, and I felt so 
proud of it that I determined, on my return home, to write to every physician 
in the State whose name I could get, and urge him at once to join his county 
medical society, so that, by our united efforts, we may keep Alabama in the 
front rank of similar organizations. 
To this important end, doctor, I address you and ask you, in the name and 14 
for the good of our common profession, to become one of us, and to use your 
influence to get all of your medical friends, who are not already members, to 
join your county society. 
I remain, doctor, very respectfully, 
WM. H. ANDERSON, M. D., 
President of the Medical Association of the State of Alabama. 
I have reason to believe that the foregoing appeal bore 
good fruit, since I received more than a dozen responses 
which were favorable. As our Association advances in age 
and usefulness, I am quite sure that we will gather in a large 
majority of the practitioners of the State, and then we will 
realize the golden dreams of the most sanguine among us, 
and become a power for good which will be a bright exam- 
ple for our sister associations in other States. 
At the request of the Senior Censor, I attended, in July 
last, a meeting of the State Board of Health. The meeting 
was held at Blount Springs, and, being ex-officio chairman of 
the b6ard, I presided at its session. This was a very inter- 
esting meeting, at which some valuable papers were read 
and thoroughly considered. These documents formed the 
basis of important legislation for the General Assembly then 
ensuing, and although we hardly expected that some of our 
proposed “ bills” would pass and be enacted into laws, yet 
we thought the time had come to introduce them, and thus 
bring them before the general public for their mature con- 
sideration. These several “ bills” and the arguments in fa- 
for of their passage by the legislature, will be found in Cir- 
cular No. 4, issued by the State Board of Health, and your 
respectful attention is called to the various subjects there 
discussed. lam pleased to say that most complimentary 
allusions have been made to this “ circular ” by the medical 
press of the great eastern cities. The document throughout 
gives substantial evidence that your State Board has not 
been idle, but that it has kept up with the requirements oi 
the age. Progress is its watchword ; and it is to be hoped 
that you will fill all vacancies in its membership with the 
wisest and the best men belonging to our organization. I 
sincerely trust, too, that whenever a meeting of the board is 15 
called by the Senior Censor, or the President, the mem- 
bers composing it will respond to the call, and punctually at- 
tend. This board has great responsibilities, and much 
weight in the legislative councils of the State. 
Among other legislative enactments that I deem it advis- 
able for the State Board of Health to consider, is the 
thorough discussion of the subject of compulsory vaccina- 
tion, with the view of framing a law to be passed by the 
General Assembly. In the cities the municipal authorities 
assume the right of requiring every person to be vaccinated 
on the penalty of fine and imprisonment. In the country, 
however, there are no such laws, and no power to enforce 
vaccination. It occurs to me, that in view of the great im- 
portance of vaccination as a public health measure, the 
county commissioners might be empowered by law to act 
under the advice of their respective county boards of health, 
and to make vaccination, and revaccination when necessary, 
compulsory. If we go no farther than our own State for 
certain data on this subject, we find that the severe epidemic 
of small-pox in Mobile in 1874 was stamped out in less than 
four months, owing to the energetic measures of the board 
of health, assisted by appropriate municipal legislation. 
Since that time, so vigilant has been the board, through its 
special police, that no three cases have occurred in the same 
year, either in the city or county. It should be remembered, 
also, that Mobile, being a seaport town, and the terminus of 
several railroads that extend into every part of the United 
States, is especially liable to receive cases of small-pox. In 
point of fact, such cases are received annually, but the vigi- 
lance of the board of health detects them immediately, and 
so isolates them, and takes other measures to prevent their 
spread, that we seldom hear of a new case among any of our 
citizens. 
QUARANTINE. 
In this connection I may say a few words about quaran- 
tine. The subject of quarantine is always a delicate one to 
handle, inasmuch as it comes in conflict with the natural and 16 
vested rights of individuals for the benefit of the public at 
large. It can be put in force properly only by legal enact- 
ments, and as it is thoroughly understood by medical men 
alone of experience and enlarged ideas, the state is depend- 
ent on our profession for enlightened views to guide it in 
making the necessary laws bearing on the subject. The 
Censors of our Association fully comprehend the magnitude 
of the trust reposed in them, and they have given anxious 
thought to the subject in all its bearings. Irrespective of 
fear or favor they should be supported by every member of 
the Association so that their recommendations may go forth 
with the unanimous consent of the profession of the State. 
In the interval of the legislative sessions, which intervals 
last two years under our present system, more or less discre- 
tion must be given to the State Board of Health, since it has 
to act when danger approaches, and such action sometimes 
must be taken immediately. Nothing can be done, however, 
without money, and an appropriation from the state should 
always be in readiness to meet the necessary expenses. The 
experience of some of the Eastern States has long since 
proved the efiicacy of such a plan, and accordingly some of 
our sister states in the South have placed considerable sums 
in the treasury subject to the call of the State Board of 
Health. Very large amounts can be saved to a state by 
prompt action of the Board of Health in preventing the in- 
gress within its borders of contagious diseases, and especially 
of yellow fever and cholera. It was clearly proved by the 
Cholera Commission that the last invasion of this disease in 
a western city might have been easily prevented with suffi- 
cient law and sufficient money. 
To come nearer home: There are ample data to prove 
that a severe epidemic of yellow fever was prevented in Mo- 
bile in 1878 by the active vigilance of the City Board of 
Health. The members of this Board saw the danger threat- 
ening on every side, and pursuaded the municipal authorities 
to have an appropriation ready to be drawn on when the ex- 
igency of the occasion demanded. This can be easily accom- 17 
plished in the cities ; but the State may be invaded at points 
where there are no local authorities to furnish either law or 
money, and in such cases the State Board should have the 
power to act immediately and should be provided with funds 
for the purpose. To this end we should continue to petition 
the Legislature to have on hand an appropriation ready to 
meet the emergency. Here again we find the advantage of 
unity in professional matters, and of the power we can exert 
by individual action. This subject can be properlv ventila- 
ted among the people so that the members elect of the Leg- 
islature can go into council imbued with the wishes of their 
constituents. It is in this way that every member of the 
profession can, if he chooses to do so, become a part of the 
legal machinery for regulating the sanitary affairs of the 
State. In States further advanced than we are on this 
branch of the subject, Boards of Health have control of every- 
thing that bears on local and general sanitation. In some 
of the cities no building can be erected without a certificate 
from the health authorities attesting that the lot has a proper 
grade for drainage; and even the vaults are located by the 
same authority. 
In New York the Health Board has almost plenary power 
on the subject of sanitation. The trees in the streets are 
planted or removed under its direction. The church bells 
are silenced when they become a nuisance to the sick; the 
schools are especially subject to its guidance so far as crowd- 
ing, sunshine and ventilation are concerned. All stocks of 
fruits, vegetables and meats are inspected, and prohibited 
from being sold if they are found to be impure and unwhole- 
some. The vital statistics are completely under its control, 
and the penalties are heavy for the infraction of its laws. 
The people have been educated to this stringent legislation 
by the constant teaching of the physicians, and they obey 
willingly because they have become satisfied that it is all for 
their own good. In this State we can accomplish the same 
thing if we work together intelligently and harmoniously. 
When Boards of Health are appointed by Governors of States, 
2 18 
or the municipal authorities of cities, they are apt to be made 
by their patronage political machines, and then may become 
dangerous if invested with power. But when they are ap- 
pointed by the medical profession, and are directly answera- 
ble to the profession for their acts, they may be considered 
perfectly trustworthy. Nor should they be of a mixed char- 
acter, having only joint authority with commercial men under 
the plea that business men are necessary to watch the inter- 
ests of commerce. All such mixed organizations are faulty, 
and must prove deleterious to the community to a far greater 
extent than the compensation accruing to commercial inter- 
ests. The laws of Alabama, thanks to the wisdom of this 
Association, have placed the Health Department of the State 
above the arena of politics and the tempoary interests of 
commerce. 
MEDICAL EDUCATION, 
This important subject must not be overlooked in this ad- 
dress. Owing to our peculiar social status since the late war 
the standard of medical education among the rising genera- 
ation of Southern physicians has been lower than we could 
desire. There are many reasons for this. In the first place, 
the general poverty of the population has been such that 
the youth of the country could not avail themselves of a col- 
legiate education in the literary departments, and they were 
thus wanting in the habits of study when they entered our 
Medical Colleges. For the same reason, their knowledge of 
chemistry and physical science was of the most rudimentary 
character, and without a sufficient knowledge of these ad- 
junct departments of learning no medical education can be 
at all complete. But in the past this could not be helped. 
We may regret it but it was beyond our reach to remedy it. 
The colleges, with all their expensive appliances were here at 
hand. Able and experienced professors were ready to teach. 
The country was in want of practicing physicians and it was 
impossible to require of matriculants a knowledge of the sub- 
jects taught in high schools and universities when such in- 19 
stitutions were closed, and the classes they would have had 
were under arms in the field of war. All these were misfor- 
tunes that came upon this generation, and nothing is left for 
us but to regret that it was so. Northern and Eastern Col- 
leges could demand a baccalaureate degree before allowing 
students to matriculate for a medical education, but we could 
not because it was impracticable. The consequence of this 
unfortunate state of things we deplore, but it was not our 
fault, and we should not be called to account for it by our 
professional brothers in more favored sections of our com- 
mon country. The circumstances that surround us however, 
are undergoing a change and prosperity is again dawning on 
our late blighted country. We must take advantage of the 
incoming tide and see to it that our profession shall suffer 
no more. If we do not in the future try to raise the stand- 
ard of medical education it will be our fault and we shall 
deserve reproach. 
I have the highest hopes for amelioration in medical in- 
struction. The American Medical College Association, 
whose late session I attended in New York, is moving wisely 
and with much animus in the matter. The term of attend- 
ance on lectures has already been extended to three years, 
and I think it will be a very short while before a literary de- 
gree, or its equivalent, will be demanded of all students who 
matriculate in the colleges. This, with the extension of the 
course, will do much to raise the general standard of educa- 
tion, and bring into the ranks of the profession annually 
many accomplished scholars. But after all the work must 
be begun by the individual members of the profession. Each 
one of us must advise the young man who contemplates the 
study of medicine to prepare himself with a good English 
and classical education before he goes to a medical college. 
He should be made to know the mortification that must so 
often be suffered by him in after life, when, with his rising 
reputation as a popular physician, he is compelled to meet 
with those who are so far his superiors in general education 
and literary accomplishments. Under the present system it 20 
will not do to trust altogether to the medical colleges to re- 
quire a literary degree, or to make preliminary examination 
before permitting students to matriculate. There are few col- 
leges that will honestly carry out their promise on this head. 
The temptation to get in students both for pecuniary gain 
and for the eclat of large classes, is too great not to be yielded 
to. This plan was tried in Great Britain, but Sir William 
Gull, in his address before the Grand Medical Council, dis- 
tinctly says, “that the preliminary education examination 
has proved good for nothing as a means of selecting men en- 
tering the profession; or for rejecting those who have not 
sufficient intellectual training.” According to the same au- 
thority the baccalaureate degree system is equally faulty, 
since it is a noted fact that many }roung men are crammed 
for the purpose of obtaining a degree. If this be true in 
England, how much more true is it in this country where 
the degree of A. B. is granted by literary, so called, colleges 
whose curriculum does not embrace as much as that of a re- 
spectable high school. It is for these reasons that I call 
upon the members of our Association to discourage ignorant 
young men from entering the profession at all. 
I have for many years entertained the opinion that col- 
leges should not have the powrer of granting degrees with li- 
cense to practice medicine. I think that colleges should 
teach, but that the licensing power should be vested in a 
medical board entirely independent of them, I have thought 
that there should be but one board with such power in any 
State, and that such board should meet annually or semi- 
annually for the purpose of examining candidates for the 
doctor’s degree. About twenty-six years ago, in the early 
part of my professional career, I was appointed Chairman 
of the Committee on Medical Education, then one of the 
standing committees of the American Medical Association. 
Appreciating the high honor of such an appointment so 
early in my professional career, I gave much anxious thought 
to the subject. I corresponded with many distinguished ed- 
ucators in America, in England, and on the Continent, and 21 
the result of my labors was, that I concluded to recommend 
the Association to take such steps as would discourage the 
granting of degrees, with license to practice, by the colleges, 
and to invest the power in a National Board, appointed by 
the Association, the said board to sit for several weeks an- 
nually at the National Capital and to be paid liberally by 
Congress for its services. Some of my professional friends 
thought favorably of the scheme, and before the next meet- 
ing of the Association I submitted my report to the Justices 
of the Supreme Court of the United States, but a majority 
of them, to my great mortification, gave it as their opinion 
that the plan would be unconstitutional. I still think, how- 
ever, that the colleges should be bereft of the power to give 
license to practice, and should be restricted simply to 
teaching. 
I might close here, but I desire to say something on an- 
other subject which may be considered by some of you as 
irrelevant. The 7th Section of the first Article of our Code 
of Ethics, referring “ to the duties of physicians to their pa- 
tients,” says : “ The opportunity which a physician not un- 
frequently enjoys of promoting and strengthening the good 
resolutions of his patients, suffering under the consequences 
of vicious conduct, ought never to be neglected. His coun- 
sels, or even remonstrances, will give satisfaction, not offense, 
if they be proffered with politeness, and evince a genuine 
love of virtue, accompanied by a sincere interest in the wel- 
fare of the person to whom they are addressed.” 
Here, gentlemen, the physician has it in his power to as- 
sume as a laymen the responsibilities that generally attach 
to the order of the clergy. It is a high and a holy privilege 
thus to be able to point to an erring brother the path that 
will lift him from the downward road of immorality and in- 
troduce him, or bring him back, within the pale of moral 
duty. The time, the place, the opportunity, the surrounding 
circumstances, are offered to the physician which are pre- 
sented to no other man, and they should never be neglected. 
When stretched on the bed of sickness caused by debauch, 22 
with the mind and the body both subdued, the patient is in 
a proper frame to receive from the friend who is trying to re- 
store him to physical health, those gentle and kindly ad- 
monitions which may sink deep into his heart and make 
bright the remainder of his career. Doubtless every physi- 
cian within the sound of my voice can recall instances in 
which he has done, or might have done, in this way, a last- 
ing kindness to a fellow-man ; and who will not say, that the 
memory of having been instrumental in doing good of this 
nature is not worth more to him than gold, or silver, or pre- 
cious gems ? These are some of those valued and comfort- 
ing reflections that sweeten the life of the physician and 
raise his spiritual nature above the sordid sphere of the 
wTorld to the realms where all is pure and all is holy. They 
are those rewards of our profession which constitute its true 
grandeur and elevate it above the level of the ordinary call- 
ings of life. Let us, then, improve all such opportunities, 
and thus carry out the teachings of our Code of Ethics, 
whether written or unwritten. Bad, indeed, would be our 
career if we were restricted alone to visiting the sick in or- 
der to prescribe for bodily ailments, and to have our hearts 
torn, as they often are, with the anxiety of watching the un- 
certainty attendant on the phases of disease. Money can 
never pay us for this species of mental torture where the 
feelings are often wrought to the highest pitch through the 
strain of the most delicate parts of our organism. Few of 
us who have had the experience of the general practitioner 
would be willing to go over our professional lives, or advise 
others to study medicine, if there were not some higher 
compensation than dollars and cents for such wear and tear 
of our affections. But when we can, by the opportunities of 
our profession, become moral agents also, and scatter the 
seeds that will ripen into the golden harvest of a high hu- 
manity, we assume the livery of the true philanthropist or 
the devoted priest of God, and feel indeed that we have 
privileges beyond those of most of the other professions. 
In this connection, I may also allude to still another sub- 23 
ject. Our profession has been reproached for leading to in- 
fidelity and atheism. It is too true that some few of its 
great masters in Germany and England, and I am sorry to 
say, one or two highly educated teachers in our own coun- 
try, have gone aside from their legitimate scientific re- 
searches and pretended to prove that the investigations of 
physical science and biology lead to disbelief in any Su- 
preme Architect of the Universe. At any rate they teach, 
that if there is, He is unknowable and incomprehensible to 
the human intellect. I will go into no subtle disquisition to 
show that unity in design must require a Designer, that or- 
der in nature must be produced by an Ordainer. Wiser 
men and deeper thinkers have done this already and have 
responded to every argument brought forward by these un- 
believing philosophers. They have proved that physical 
science depends on the unity of nature, and that unity must 
have its basis in one supernatural Being. But we must not 
disguise the fact that these novel doctrines have startled the 
age. Hence, for the sake of our profession, for the sake of 
science, and for the sake of each one of you individually I 
must briefly refer to them. 
In the language of one of England’s greatest statesmen, I 
may say to you what he said to a public assembly on a late 
occasion. It is this ; “ You live,” says he, “in an age of in- 
quiry, of doubt, of mental restlessness ; in an age, when 
more than at any other, men are unwilling to accept tradi- 
tional solutions of the great mysteries which surround our 
life; and when many brains are bewildered, and many 
hearts are made to ache, by vain efforts to solve problems 
impenetrable by reason. You cannot escape the common 
destiny. Those of you who reflect will inevitably have times 
©f perplexity when the very purposes of life seem obscure 
and doubtful, when traditions appear to fail and reason it- 
self is baffled, and when men ask in their bewilderment, 
‘what does it mean ?’ ” Aye, what does it mean ? What 
mean these deep researches into mental and physical 
science where the mind comes to an abyss it cannot fathom, 24 
and where the past track it has traveled has overwhelmed it 
with so much doubt that it is afraid to return to the simple 
faith with which it started. 
I tell you, gentlemen, what I am afraid it does mean. 
Clothe it in the most powerful logic that is known to the 
scholar; ornament it with the most fascinating periods of 
rhetoric ; dignify it as you may by appeals to your reason 
and better judgment; it still inevitably leads, the great 
masses at any rate, into doubt and disbelief. The traditions 
that guided the good and great of the human race in the 
ages that are past have borne too much fruit to be forgotten 
by us for the new speculations, improperly called revelations, 
of modern science. Not that I ignore the physical research- 
es of these great masters, or am prepared to say that they 
are not seeking after truth. On the contrary, I know that 
they are ; but I stand aghast at the conclusions, which over- 
whelming them, may carry disaster and bitter woe to the 
generation in which we live. They plunge into the depths 
of space, and see the far distant worlds breaking into frag- 
ments, and resolving again into masses to grow once more 
into other worlds. They magnify with their instruments the 
minutest specks of organic matter and find life and action 
pervading every particle subjected to their vision. They 
analyze the brain, and seeing no resting place for the immor- 
tal principle, they ignore it altogether. Because they cannot 
raise the veil to see what there is behind they call it a void 
filled with the very blackness of darkness. And yet, gentle- 
men, in that obscurity behind; in those dark chambers and 
mysterious cells, themselves ever wasting and ever renewing, 
lies the whole domain of thought, the power of reason, the 
play of the imagination, all indeed that makes life dear to us 
here, and inspires us with the hope of a blissful eternity here- 
after. But as their limited vision cannot see what the great 
Creator never intended them to see with their uatural eyes,, 
or to comprehend with their finite intellects, they refuse to 
allow in the body any earthly abiding place for the soul. 
Then comes that doubt which shakes the deeply cherished 25 
traditions of the past, which saps the foundation of our 
present happiness, and dims the lustre of our future hopes. 
As a general rule they agree that design must regulate the 
cosmos, but how and where it reigns in its majestic omnip- 
otence, they set down in their minds as unknowable and un- 
thinkable by the human understanding. They cannot admit 
that there is something behind the veil, which eye has never 
seen and ear has never heard, something which animates the 
little cell and produces its wonderful manifestations, and 
which may live when the mass it animated has filled the 
span of its physical existence. Yes, there must be some- 
thing immortal behind, whose light is too bright for human 
eye to gaze upon ; something whose music would be passing 
sweet if our senses were only attuned to hear it ; and al- 
though this dull and earthly ear may not be delicate enough 
to appreciate the strain, yet still it is there as part and par- 
cel of that higher music which may hereafter bring perfec- 
tion to our happiness and bliss. It should be the province 
of the medical profession to assist in preserving the religious 
sentiment of the future ; and for this reason, our studies lead 
us into that region of matter where the physical and the 
psychical are both inhabitants, where the boundary line of 
each is so dimly marked that it may require a little faith to 
leap the chasm. The advancing steps of science may cause 
some of our past creeds and dogmas to give place to some- 
thing more rational to an elevated understanding. Dogmas 
and creeds are human and may be faulty ; they can be 
changed to suit the changing circumstances that surround 
us, but this need not destroy the underlying faith that dic- 
tated them. There need be no conflict between true faith 
and true science. If there should be, let us hope that the 
sentiment of immortality is so deeply laid, that at the very 
point where human reason fails inspiration may come in to 
bridge us safely over into that realm where present things 
shall have faded away and higher things become eternal 
reality. 
But I can say no more on this subject. You are to be 26 
your own judges of what is right and wrong; and all I can 
tell you is, do not forget that real science, either ancient or 
modern, is nothing but a knowledge of truth ; that truth will 
lead you in the path that is right. But before you give up 
the sublime faith of your ancestors be doubly sure that you 
are not deceived by something that fades into insignificance 
before it. 
It is time however, for me to bring this rambling address 
to a close. To the younger members of the Association I 
have a word to say. It is you who are commencing to scale 
the giddy heights, “where Fame’s proud Temple shines afar.” 
Your ambition is laudable, and let your motto be “Excelsior.” 
The wide and open field is before you. Science spreads a 
rich feast in front of you, and only asks that you come and 
partake. As your ancestry worked for you, so you must 
labor for posterity. You must regard our science as a 
temple wdiose foundations are laid deeply in philosophy. 
Every age as it came and went adorned it with the current 
ideas of the era ; but every succeeding age saw some of its 
beautiful fretwork wear away because it could not resist the 
changes of time. The present century has had a new set of 
architects at work with appliances unknown to the past, and 
we find the structure rise before us bolder and grander than 
at any previous time of its existence. We must contribute 
our share to it in accordance with the approved ideas of our 
age, and thus make new niches to rescue from oblivion the 
great masters of the nineteenth century who have devoted 
their lives to its cause. Those who come after us may sweep 
away some of our work to suit a still more philosophical and 
utilitarian age, but let them at least see that we have not 
been idle or indifferent in our day and generation. 
The result of your studies need not lead to idle specula- 
tion, but will conduct you to usefulness and honor. It will 
make you public benefactors, and assist youin doing good to 
your fellow man; in relieving his sufferings and ministering 
to his infirmities. This is a high privilege and enjoyed by 
no one to the same extent as by the physician. In your fu- 27 
tnre lives I wish you every success, and hope that you will 
realize a golden reward. 
Some of us, gentlemen, have passed the meridian of life 
anci begun to tread the downward path of our earthly exist- 
ence. We have measured the value of human ambition and 
know too well what it costs, and what it is really worth. If 
any of our class has reached a goal which may be the envy 
of others let it be his pride to turn it to the best account. 
Over and often have we breasted the storm in our daily pur- 
suits, pocketed our share of ingratitude, and received also a 
large amount of the best and purest affections of the human 
heart. These latter are the bright oases in the desert of our 
past lives. The memory of them will gild the path 
may yet have to travel and we will cherish them to our latest 
hour. This last hour must ere long come to us all; and let 
me hope that each one of you may spend your declining 
years in peace and happiness ; but still ardent in the cause 
of your profession. Even when you retire from its active 
cares to seek the repose you have justly earned, never tire in 
holding up the dignity and honor of our calling, so that to 
your latest day you may be an example to the young who 
are to follow in your footsteps. Finally, when the summons 
to depart shall come, with clear conscience and the memory 
of a well spent life, may you find in some higher and better 
sphere a happy and Eternal Rest.