>7 VHP/ v y An % * proceedings T, f-. / '/ MEDICAL CONVENTION L; VIRGINIA, THE CITY OF RICHMOND, DECEMBER, 1846. / RICHMOND: PRINTED BY H. K. ELLYSON. 1846: Mi jL J?b t>: Dr- J- H. Mettert of Henrico, Dr a ft ^C°n °f Hanover> Dr- Wm- H- Robertson of Amelia" and Dr. Geo. T. Yerby of Northampton, appeared and took their seats in the Convention. Dr. Haxall, from the Committee on Medical Ethics, submitted a report embodying a printed treatise on that subject, heretofore adopted by the Medical Society of Virginia, and circulated through the State, which is as follows:— Section I. Consultations and the conduct to be observed. 1st. In difficult and protracted cases of disease, whenever the life of the patient is in jeopardy, or the anxiety of the family is greatly excited, every Physician is bound by what is due to his own honor, as well as to the wel- lare of the sick confided to his charge, to assent to a consultation with some member of the profession ; for as the united knowledge of two or more individuals will be calculated to develop more enlarged and satisfac- tory views relative to the nature of the disease, and the indications to be tulnlled, so will their concurrence inspire confidence and energy in the ad- ministration of remedies. He, therefore, who is so far actuated by selfish- ness and arrogance, as to withhold these advantages from his patient not only deserves the charge of inhumanity, but is guilty of a violation of the honor of his profession. 2nd. As consultations are only called in cases of difficulty, and alwavs impose an onerous pecuniary obligation on the sick, a sense of probitv and honor should prevent the Physician whose assistance is requested "from multiplying unnecessarily the number of his visits; and as soon as the cir- cumstances of the case will admit, he should resign all participation in the attendance, unless his continuance be desired by the patient or his friends Jrd. When two or more Physicians are called upon to consult, they should lay aside all animosities and prejudices; no sentiment of rivalship or jeal- ousy should be allowed to mingle in their deliberations; but actuated solely by a noble and disinterested desire to administer relief to the patient, Ihey 10 MEDICAL CONVENTION. should divest themselves of every other feeling but that which has for its object the alleviation of his sufferings. 4th. As the attending Physician is presumed to be best acquainted with the patient and his family, and most conversant with the leading features of the case, courtesy should assign to him the privilege of making the first ex- amination of the sick; after which the consulting Physician should ask such questions as may be necessary to enable him to make up an opinion. This privilege, however, is frequently waived in favor of the Physician called in. For the same reasons, all directions agreed upon, or other communications relative to the case, should be made by the attending Physician. 5th. A Physician, who is called upon to consult, should observe the most honorable and scrupulous regard for the character and standing of the gen- tleman in attendance; his practice, if circumstances require it, should be justified as far as it can be consistently with a conscientious regard for truth and honesty ; and no hint or insinuation should be thrown out which could impair the confidence reposed in him, or affect his reputation. 6th. The time and frequency of meeting should be determined by mutual agreement, and as the regular attendant is charged with the sole execution of the treatment, the consulting Physician should never visit the patient in his absence, unless in cases of emergency when he cannot be found. Neither should he hold any communication relative to the case, with either the sick, the family, or friends, except during the examination of the pa- tient, nor offer any prognostics, or express any opinion but what has been mutually agreed upon. 7th. No discussions should take place in presence of the sick, and con- sultations should be conducted in private. A sense of honor should enjoin it as a sacred obligation upon each Physician, to observe the strictest se- crecy relative to what transpires during their deliberations upon the case ; nor should any circumstance be developed but what has previously met the approbation of both parties. 8th. As an honest difference of opinion may exist upon speculative points of doctrine, without leading to any material difference in practice, theoreti- cal discussions should be avoided in consultations. For however much Fhysicians may differ in their modes of reasoning on a case, or in the phrase- ology they employ, their treatment, which is dictated by judgment and ob- servation, will seldom be found at variance. All merely hypothetical dis- cussions therefore, not bearing directly upon the case, can lead to no useful conclusions, but frequently occasion delay and perplexity, and sometimes give rise to intemperate expressions and angry feelings. 9th. Should an irreconcilable diversity of opinion originate when several individuals are called upon to consult together, the advice of the majority should be considered as decisive. It may sometimes happen that two Phy- sicians cannot agree in their views of the nature of a case, and the treat- ment to be pursued. This is a circumstance much to be deplored, and should always be avoided by mutual concessions if possible, as far as they can be justified by a conscientious regard for the dictates of judgment. But in the event of its concurrence, a third should be called to act as umpire; and if circumstances prevent the adoption of this course, it should then be left to the patient or his friends to select that decision in which he is most willing to confide. But as every Physician relies upon the rectitude of his judgment, he may when left in a minority, politely and consistently retire from any further participation in the management of the case. 10th. As a regular medical education affords presumptive evidence of professional abilities and acquirements, and the only acknowledged right of an individual to the exercise and honors of the profession, no consultation should be held with unqualified persons or quacks, or with such members of MEDICAL CONVENTION. 11 the profession who have by improper conduct outraged its dignity and re- spect. 11th. The utmost punctuality should be observed by Physicians in their visits, when they are to meet for consultation; but as circumstances may transpire to render such punctuality impracticable, the Physician who first arrives should wait fifteen or twenty minutes for his associate, before his introduction to the patient. If either gentleman does not arrive in the time allotted, the other may examine the case, and give his opinion in writing and under seal, to be delivered to his associate on his arrival. Section II. Duties of Physicians to each other. 1st. Every Physician should observe the strictest caution and decorum in his intercourse with a case under the care of another; as the mind of the patient as well as that of his friends, is, by solicitude and anxiety, rendered peculiarly sensible to every thing relating to the management and termina- tion of the case, and is ever ready to seize upon every meddling inquiry and every disingenuous hint, and to construe them in a manner disadvantageous to the Physician employed, and calculated to destroy the confidence reposed in him. 2nd. The same caution and circumspection should be observed, when, from motives of business or friendship, a Physician is prompted to visit an individual who is under the direction of another practitioner; indeed such visits should be avoided, except under peculiar circumstances. A certain undefinable species of assiduities and attentions to families or persons em- ploying another is to be considered as beneath the dignity of a regular prac- titioner, and as making a mere trade of a learned profession ; and all offi- cious interferences in cases of sickness in such families, evince a meanness of disposition unbecoming the character of a Physician or a gentleman; no meddling inquiries should be made concerning them, nor hints given in rela- tion to their nature and treatment, nor any selfish conduct pursued that may directly or indirectly tend to weaken confidence in the Physician who ha3 charge of them. 3rd. It sometimes happens that a Physician is called to visit a patient who has been under the charge of another practitioner, but who from some cause has been either dismissed, or has thought proper to discontinue his visits. Under such circumstances, the Physician last called should not take charge of the case or give advice, except in cases of emergency, without first proposing a consultation with the gentleman who had been in attend- ance ; and in case of his dismissal, or voluntary relinquishment of the case, no unjust or illiberal insinuations should be thrown out in relation to his conduct or practice, but which should be justified, as far as candor and a just regard for truth and probity will permit. 4th. In cases of accident or emergency from other causes, a Physician is sometimes summoned to visit a patient who is under the charge of another, to whom, in consequence of his being out of the way, notice of such call has not been given. It will be proper under such circumstances, for the gentleman last called to resort to such remedies as the urgency of the case may require. But if the condition of the patient will admit of delay, no alteration of the treatment should be made, without a previous consultation with the attending Physician. 5th. As the affairs of life, and the various accidents and contingencies to which a medical man may be exposed, sometimes withdraw him for a pe- riod from the discharge of his duties towards his patients, it may become necessary for one or more of his professional brethren to officiate for him during his absence. When this act of courtesy is exercised for a short pe- IX MEDICAL CONVENTION. riod all fees for services should be handed over to the Physician for whom those services have been rendered. But if a member of the profession neglect his business in quest of pleasure or amusement, regardless of his own interests as well as the claims of those who employ him, he cannot be considered as entitled to the advantages of the frequent and long continued exercise of this fraternal act of courtesy, without awarding to the Physi- cian who officiates, the fees arising from the discharge of his professional duties. . . 6th. As there may be an honest difference of opinion amongst medical men with regard to the nature and treatment of diseases, it should be deemed a violation of medical ethics, for one Physician to charge another with mal- practice, except such accusation be made before legitimate judges, or such persons as are properly empowered or constituted to investigate the circum- stances of the case. 7th. The situation of a Physician, the character of his profession, and the nature of his intercourse with the sick, must of necessity render him to a certain extent the confidant of families, and familiar with the foibles and infirmities of individuals. He should therefore, regard it as a sacred obli- gation to conduct himself with the most scrupulous regard to secrecy; to maintain the most honest and chaste observance of the confidence reposed in him, and never to divulge, except when compelled in obedience to the laws of his country, the nature of the malady he is called upon to treat, the private affairs of families or individuals, the faults or infirmities which may fall under his observation, or any circumstances that could tend to wound the feelings or stigmatize the character or reputation of those whose confi- dence he enjoys. The force of this observation is so great, that courts of justice have sometimes protected professional men in the observance of secrecy. 8th. It should be remembered that the office of a Physician is not exclu- sively one of emolument, but also of benevolence and humanity. As, therefore, he may be summoned in haste to afford assistance in urgent cases of sickness, it always behooves him to obey such calls with promptitude. But as it often happens that more Physicians are called together than are required, courtesy should assign the patient to the first who arrives, who should select from those present any additional assistance that he may deem necessary. In all such cases, however, the individual who officiates should request the family physician, if there be one, to be called, and on his ar- rival should resign the case to him, unless his further attendance be re- quested. 9th. A Physician who is called upon to render his assistance to the wife or child of another practitioner, or to one who is from any cause near and dear to him, should ever remember that he is placed in a situation involving the highest responsibility. Every justifiable deference should therefore be paid to the Physician for whom he officiates, and his opinions and prejudices should be treated with indulgence, as, in the event of the case proving fatal, his feelings might receive a deep and lasting wound from the adoption of a course of treatment which he could not approve, or the rejection of means in which he had confidence. No considerations, however, should prompt a practitioner to sacrifice his judgment, or to abandon those measures which he honestly believed to be expedient. 10th. Where a family expresses to a Physician advanced in years, a de- sire to have united with him in consultation some junior member of the profession, he cannot reasonably object to such a wish, as it implies no mark of disrespect, but should be regarded as the exercise of a just and un- doubted privilege by the patient or his family. MEDICAL CONVENTION. 13 Section III. Conduct for the support of Medical Character. Every man who enters into a fraternity engages by a tacit compact to sub- mit to the laws, and to promote the honor and interest of the association, so far as they are consistent with morality and the general good of mankind. A Physician, therefore, should guard against whatever may injure the gene- ral respectability of the profession, avoid all contumelious representations of the Faculty at large, all general charges against their selfishness or im- probity, and while by unwearied diligence he resorts to every proper means of enriching the science, he should entertain a due respect for his seniors, who have by their labors brought it to the honorable and elevated condition in which he finds it. Section IV. Duties of the Faculty in relation to Q,nackery. 1st. The honor and importance of the profession render it incumbent on it3 members to maintain its respectability, and avoid every act which could compromit its dignity, or forfeit the high respect and confidence reposed in it. He, therefore, who dispenses secret nostrums, or employs intrigue and artifice to secure business, degrades the medical character, and lowers him- self to the level of a mere quack. If the remedy be really serviceable, liberality should induce the Physician to make it public; if it be not, and mystery is to give it importance, this implies disgraceful ignorance, or fraudulent avarice. 2nd. It is also derogatory to the dignity of the profession, and consti- tutes a species of quackery, to resort to public advertisements or private cards or handbills, inviting the attention of individuals affected with parti- cular diseases, publicly offering advice and medicine to the poor gratis, pro- mising radical cure3, and stipulating for "no cure no pay," publishing cases and operations in the daily prints, or suffering such publications to be made; boasting of cures and remedies; adducing certificates of skill and success, or any other similar acts which are commonly resorted to by known quacks and gross pretenders. Section V. Differences of Physicians. When differences among medical men are brought before the public, they never fail to injure the contending parties, do discredit to the profession, and expose it to contempt and ridicule. Misunderstandings when they arise, ought therefore, if possible, to be referred to the arbitration of some discreet members of the profession. Section VI. Duties of Physicians relative to pecuniary compensation for their services. 1st. It is highly desirable, that some uniform rule of charging should be adopted by the members of the profession, by which their interests may be protected, and the community secured against extortion. Such a course is indispensably necessary for the maintenance of the dignity and honor of the profession, and a spirit of harmony amongst its members ; for while it ena- bles patients to know what remuneration will be expected of them in re- turn for the cares and anxieties of their Physician, it will obviate all dis- putes and litigation in the adjustment uf pecuniary demands made for ser- vices. Indeed, the expenses of a medical education, the sacrifices of ease, comfort, and even health, that a Physician is obliged to make, and the har- rassing cares and anxieties to which he is exposed, render it proper that he should be well remunerated for his labor. Individuals, who arc engaged in 14 MEDICAL CONVENTION. other pursuits, generally secure in the course of a few years not only a competency for themselves while living, but even leave at their death ample provision for their families. While it is a notorious fact, that a majority of Phvsicians, with the strictest prudence and economy, and the privation of almost every comfort and social enjoyment, seldom obtain more than will barely afford a scanty support for themselves and families ; and should they be cut off by death, or disabled by disease, those who are dependant upon their exertions are frequently left in destitute circumstances. Every medi- cal man should therefore be firm in the assertion of his rights, and steady in the exaction of a suitable compensation for his services; all should con- cur in some uniform system of charging, and deem it a sacred obligation to adhere as closely to such regulations a3 the circumstances of the case will 2nd. There are some Physicians who have so little regard for the dignity and honor of the profession, and the duties they owe to its members, that with a view of obtaining business by acquiring the appellation of a " cheap doctor," they undervalue their services by the introduction of items into their bills beneath the customary rate of charging, or by demanding a smaller acknowledgment from their patients than is exacted by their breth- ren. Such conduct should be considered as a flagrant violation of the principles of honor and justice, and as meriting the indignation and con- tempt of the fraternity. 3rd. Another course is sometimes resorted to by some practitioners, which is equally unjust and reprehensible. With a view of securing busi- ness and maintaining the favor of their patients, they suffer their fees for services to pass from year to year, unliquidated, and thus not only weaken that sense of obligation which the patient should entertain towards his Phy- sician, but absolutely destroy the prospects of such practitioners as are solely dependent on the proceeds of their profession for support, and who are consequently compelled to require a punctual settlement of their ac- counts. Indeed, it has been very justly remarked by Dr. Rush, " that the sooner a Physician sends in his account after the recovery of his patient, the better." At any rate, every practitioner should, as well in justice to himself as to the profession at large, require a liquidation of his demands at least once a year, unless where some unforeseen accident or misfortune renders such a course improper. 4th. Exorbitant demands, and the exercise of unfeeling rigor in the col- lection of fees, should on the other hand be equally avoided, as derogatory to the feelings of humanity and the principles of justice. Misfortune or accident may render it impossible for a patient to meet promptly the demands of his Physician, although he may feel a just sense of the obliga- tion he owes him for his services. In such cases every humane member of the profession will cheerfully grant that indulgence which the case requires, and accommodate his demand to the circumstances of the individual. But should a feeling of avarice or selfishness on the part of the patient, render it necessary for a practitioner to resort to compulsory measures for the re- covery of his dues, he should remain firm and unwavering in the exaction of his rights. 5th. It is a common remark, that a Physician who is afflicted with dis- ease, is the worst judge of his own case; and as the natural anxiety and solicitude which he experiences at the sickness of a wife or child, or any one who is by the ties of consanguinity rendered peculiarly dear to him, tends to obscure his judgment and render his acts timid and irresolute, the kind offices and professional aid of his brethren, should in such cases be cheerfully and gratuitously afforded him, as well as to those for whom he is disqualified to officiate. But as obtrusive visits and unasked civilities might MEDICAL CONVENTION. 15 embarrass him in making the selection in which he has the greatest confi- dence, they should be avoided as acts of officiousness and indecorum. When, however, a member of the faculty is called to a distance to exercise this act of professional kindness, the expenses of traveling should be de- frayed by those who ask his attendance. No Physician, however, who has abandoned his profession for the purpose of prosecuting any other calling, should expect medical services to be gratuitously rendered ; for, the princi- ple of reciprocity upon which the practice is based, can no longer exist in such cases. 6th. It has been justly observed by Dr. Percival, that " clergymen who experience the res angusta domi, should be visited gratuitously by the facul- ty ; and this exemption should be an acknowledged general rule, that the feeling of individual obligation may be rendered less oppressive." There is, however, no reason for the extension of the same exemption to such as receive large stipends, or are in opulent circumstances, since they can well afford to make a reasonable remuneration for medical attendance, and pos- sess no greater claims upon the members of the profession than any other class of patients; nor should clergymen who are in the regular pursuit of any secular occupation, be entitled to exemption from the customary charges. R. W. HAXALL, M. D., Chair'n. Adopted unanimously. Dr. Chamberlayne, from the Committee on Accounts of De- ceased Individuals, made the following report:—(which was approved, and the committee discharged.) The committee to whom was referred the expediency of memorializing the Legislature to place the accounts of Physicians against deceased indi- viduals, and which have accrued within twelve months prior to their death, in the class of debts of first dignity, have according to order considered the subject, and unanimously report: That however desirable or equitable such a legal enactment would be, they deem it inexpedient to memorialize the Legislature on the subject; and ask to be discharged from its further con- sideration. L. W. CHAMBERLAYNE, M. D.„ Chair'n. Dr. Peebles of Petersburg, from the Committee on Empiricism and Secret Remedies, presented the following report, which was received and adopted: The Committee appointed on Empiricism, beg leave to make the follow- ing report: The success of empirics, the extensive and increasing popularity of nostrums, and those secret modes of treatment which are employed by pre- tenders and charlatans, constitute «MMP the most vital questions which can be brought before this Convention; and the fact that the countenance and patronage which they receive, are not confined to the illiterate, but derived from all classes of society, is truly humiliating to a noble profession, which does now, and has ever engaged the earnest attention of the most enlightened and benevolent among mankind. By Empiricism, is meant the recommendation and use of remedies without a knowledge of their therapeutical effects; and the indiscriminate use of such remedies for all and opposite conditions of the system; the en- couragement of the use of such agents, the composition of which is not 1G MEDICAL CONVENTION. known, but which is concealed from motives of privJte gain, either to the inventor or the person who prescribes them. Empiricism is certainly a growing evil, disreputable to the practitioner of medicine who resorts to it, and injurious to the interests and health of the community generally. It cannot be too severely reprobated and denounced as prejudicial to the country at large and subversive of the interests of the profession, destruc- tive of its honor, and humiliating to science. It makes its appeal to the credulity and ignorance of mankind, and its victims are most frequently the unsuspecting and innocent. It is the resort of imposture and knavery, in most cases, for lucre obtained at the expense of the health and lives of our fellow-men. The philosophic and educated physician is always found opposed to it in all its forms and phases, and it is the duty of the medical faculty generally to denounce it from mere motives of philanthropy. With these views the following resolutions are submitted:— 1st. Resolved, That the medical faculty will refuse all professional inter- course with any physician who prepares, and who uses in his practice, or who advertises for public use any secret remedy. 2nd. Resolved, That under all circumstances, as far as practicable, the medical profession will discourage the use of remedies the constituent ele- ments of which are concealed from the profession generally from motives of gain. 3rd. Resolved, That the practice of physicians in giving certificates as to the efficiency of patent and secret medicines, deserves and receives decided reprobation. 4th. Resolved, That were things ordered as they should be, no man who had not received a proper medical education, would be allowed to practice upon the health and lives of the community ; and in a more advanced state of conservative legislation, the law-making powers might be confidently invoked to prohibit the sale of nostrums, the constituents of which are not plainly set forth on each parcel. 5th. Resolved, That the editor of the Medical News, receive the thanks of the Convention, for his sedulous efforts to expose medical delusion, and that other medical journals be invited to co-operate in an effort so laudable. Your committee would further report, that the course pursued by several of the religious journals of England, in refusing to publish quack advertise- ments, on the ground that they encourge an evil which is exerting a most pernicious influence on the health of the public, receives our most cordial approbation, and they hope that the religious and secular journals of our country will follow so good an example. These journals exert a most potent influence for good or for evil on the minds of those, who, suffering under the nervous and functional derangements incident to improper indul- gence of appetite, or irregular habits, are attracted to any remedy which promises speedy relief, if recommended by its publication in a religious or secular paper, however ridiculous and unfounded may be its claims. J. F. PEEBLES, M. D., Chair'n. Dr. Cabell of the University, from the Committee on Prelimi- nary and Medical Education, asked to be permitted time until to- morrow for the presentation of his report, which was granted. Dr. Broocks, from the Committee on Central Board of Medi- cal Examiners, made the following report; which, after a dis- cussion between that gentleman and Drs. Warner, Haxall, Cabell of the University, Qtuarles, Bolton, Dunbar of Maryland, and Chainbcrlayne of Richmond, was laid on the table. MEDICAL CONVENTION. 17 The Committee to whom the subject of a " State Board of Medical Ex- aminers " was referred, have had the same under consideration, and beg leave to report: That Whereas, the welfare of society requires of the members of the medi- cal profession, a high standard of medical attainments, and it is evident that the increasing competition of the colleges has a tendency to lower the standard; and whereas, we believe that the establishtoent of a Board of Examiners, whose license shall be obtained before any one be permitted to practice medicine or surgery, will in a great measure correct the evil, and produce beneficial influences in this State: Therefore, 1st. Resolved, That it is expedient for the Legislature to legalize a Board of Medical Examiners for each of the three grand divisions of the State, to wit: the trans-alleghany country, the valley, and eastern Virginia, to con- sist of seven members each, whose duty it shall be, to examine the candi- dates upon all the branches of medicine, and to give licenses to practice to such only as may appear, on a rigid and practical examination, to be well qualified. 2nd. Resolved, That no professor or lecturer in any medical school or college should be appointed a member of either of these Boards. 3rd. Resolved, That no one be permitted to practice medicine or surgery in this State, except those already engaged in the practice, and such as may undergo an examination by and obtain license from this Board. 4th. Resolved, That a committee of six, and the President of the Con- vention as chairman, be appointed to petition the Legislature to carry into effect the foregoing resolutions. 5th. Resolved, That in order to receive the concurrence of the Legisla- ture in this scheme of reform, the committee to be appointed under the foregoing resolution, have discretionary power in regard to the mode of ap- pointing the Board of Examiners, but that they be instructed by this Con- vention to use their best endeavors to obtain such a mode of appointment as will give a sure guarantee of the fitness of the members for the discharge of the duties which will devolve upon them. J. N. BROOCKS, M. D., Chair'n. Dr. Quarles of Louisa, from the Committee on a Medical Journal, reported that the establishment of such a Journal, under the supervision of the Medical Society of Virginia., was practicable, and expedient; which report was laid upon the table for the present. The Convention then passed the third and sixth resolutions of its original committee, and recommended them to the mature con- sideration of the Virginia profession. Near 11 o'clock at night, the Convention, on motion, adjourned to meet to-morrow, (Wednesday,) at 11 o'clock. Wednesday, December 16. The Convention met pursuant to adjournment, the President in the chair. 3 18 medical convention. The proceedings were opened with an eloquent and fervid prayer by the Rev. Mr. Hoge of this city. Dr. Cabell, from the Committee on Preliminary and Medical Education, made the following report, which was received and concurred in:— The Committee appointed under a resolution of the Convention to take into consideration the subject of Preparatory Training and Professional Ed- ucation of Medical Students, report:— That they are unanimously of opinion, that great discredit has been brought upon the profession, and upon the medical institutions of the coun- try, by reason of the very slender requirements of learning demanded of late as a passport to the attainment of the honors of the Doctorate. This evil has, they believe, arisen from the hot competition existing among the Medical Colleges of the Union, most of which are entirely beyond the reach of the influence of the action of this Convention. This competition, while it has in other respects produced most useful results, has certainly contributed very largely to lower the standard of attainments required of the candidates for the diploma. This being the source of the evil, it does not appear to this committee that any adequate reform can be obtained, but by a total divorce between the licensing and teaching powers; both of which, however, ought to be retained within the entire control of the pro- fession. As, however, the committee have a right to infer from a recent vote of the Convention, and from the character of the arguments urged in support of that vote, that the majority of this Convention either do not admit the existence of the evil which has been referred to, or are indisposed to take any action in relation to it, the committee do not think it necessary to pre- sent their views in detail; and ask to be discharged from any further con- sideration of the subject. J. L. CABELL, M. D., Chair'n. Dr. J. Beale of Richmond, Dr. J. Dove of Richmond, Dr. B. F. Eppes of Sussex, Dr. W. J. Pendleton of Louisa, Dr. J. A. Snell of Richmond, and Dr. T. Woodley of Kingston, N. C, appeared and took their seats in the Convention. Dr. Hurt of Nottoway moved that the report of the Committee on a Board of State Medical Examiners be taken up by the Con- vention ; and the ayes and noes being ordered, after a short dis- cussion between Drs. Cabell of the University, Chamberlayne of Richmond, and Warner of R, was adopted by the following vote :— Ayes.—Jno. N. Broocks, Wm. Browne, Wm. B. Ball, James Beale, Jas. Bolton, J. A. Cunningham, R. G. Cabell, T. E. Cox, Jas. L. Cabell, G. S. Corbin, V. Y. Conway, F. H. Deane, James Dove, Prof. Dunbar, Jas. A. Forbes, J. P. Harrison, J. M. Hurt, G. W. Harris, John Hendree, A. Hopkins, Wm. B. Lewis, G. G. Minor, H. H. McGuire, C. S. Mills, J. B. McCaw, S. A. Pat- teson, M. B. Poitiaux, J. W. Power, W. P. Palmer, J. A. Reid, J. W. Reins, T. D. Stokes, E. H. Smith, John A. Snell, H. A. MEDICAL CONVENTION. 19 Tatum, T. T. Towles, J. A. Waddell, Wrn. E. Wilson, B. R. Welford, and T. L. Walker.—40. Noes.—L. B. Anderson, Alex'r Archer, R. V. Barksdale, R. H. Berkley, Stapleton Coates, L. W. Chamberlayne, James H. Conway, W. G. Carter, J. G. Cabell, H. Curtis, W. A. Gillespie, R. W. Haxall, A. P. Hodges, T. R. Harrison, S. A. Hinton, Z. Lewis, J. S. Lewis, J. A. Leitch, M. J. C. Meredith, William H. Macon, W. A. Patteson, A. F. Picot, J. N. Powell, C. Q,uarles, Wm. H. Robertson, H. D. Taliaferro, R. K. Taylor, and A. G. Wortham.—28. Dr. Patteson of Chesterfield offered as a substitute for the re- port of the committee, the following preamble and resolutions, which were adopted:— Whereas, it is essential that there should be a divorce between the teaching and licensing power ; Therefore, be it Resolved, That this Convention feels the necessity of some radical change in the admission of candidates for the right to practice physic in this State. Resolved, That we instruct our delegates to the National Con- vention in Philadelphia, to be holden in May next, to use their utmost exertion to carry out the spirit of the foregoing resolution. Dr. Welford of Fredericksburg offered the following resolu- tion :— Resolved, That a committee of seven be appointed by this Con- vention, whose duty it shall be to examine the subject of Medical Education and Medical Police, and report their views to a Gen- eral Convention of the Medical Faculty of Virginia, to be holden in Richmond on the third Monday in May, 1847. Committee under Dr. WelforoVs resolution..—Drs. Welford of Fredericksburg, Warner of Richmond, Curtis of Hanover, J. L. Cabell of the University, McGuire of Winchester, Patteson of Chesterfield, and Mills of Richmond. The Convention then took up the following report from the Committee on a Medical Journal; which, after some remarks by Drs. Quarles of Louisa, Dunbar of Maryland, Hurt of Nottoway, Warner of Richmond, and Bolton of R., (being amended,) was adopted unanimously;— The Committee in relation to the publication of a Medical Journal, re- spectfully report to the Convention: That they consider it both expedient and practicable to publish such a journal; and would embody their views in relation thereto in the following resolutions, viz :— 1st. Resolved, That it is both expedient and practicable to publish a Med- ical and Surgical Journal in the city of Richmond, the price whereof shall not exceed $5. 2nd. Resolved, That the plan and supervision of the publication be refer- red to the Medical Society of Virginia, and that Society be requested to take action in the premises at the earliest practicable time. 20 MEDICAL CONVENTION. 3rd. Resolved, That each member of this Convention be requested to pre- sent his name to the Secretary of thi3 Convention as a subscriber, and that they, and the members of the profession generally in the State, be request- ed to exert themselves to secure subscribers to the journal. 4th. Resolved, That the Physicians in the State should consider it their privilege and duty to sustain the journal by their contributions to its pages. CHARLES QUARLES, M. D., Chair'n. Dr. Deane of Richmond moved the addition of the name of the President of the Convention, to the Committee to " examine the subject of Medical Education;" but, on the declension of Dr. Patteson, he withdrew his nomination. Dr. Warner of Richmond offered the following resolution, which was carried unanimously;— Resolved, That the members of the Medical Society of Vir- ginia, as at present organized, be appointed a Committee upon the Organization of the Medical Faculty of this State, under the charter passed Jan'y 2nd, 1824, with power to prepare By-Laws, &c.; this committee to report to the Convention to be held in Richmond on the third Monday in May, 1847. Dr. Corbin of Warwick offered the following resolutions, which, after being amended, were unanimously adopted:— Resolved, That the thanks of this body be tendered to Dr W. A. Patteson for the able and interesting address that he delivered before them on the evening of the first day of its session, and that a copy be requested for publication. Resolved, That the proceedings of this Convention be publish- ed in pamphlet form, and that the members be requested to con- tribute one dollar and fifty cents each to defray the expense; and that, so far as practicable, the proceedings be distributed among the members of the Convention. Dr. Smith of Dinwiddie offered the following resolution:— Resolved, That the President of this Convention appoint at his convenience, a delegate and alternate from each Congressional district in the State, to the National Medical Convention to be holden in Philadelphia in May, 1847, and that this Convention appoint by ballot four members to represent itself in that body. Adopted. The Convention then proceeded to ballot for its delegates, when it was ascertained, by a committee composed of Drs. Chamber- layne and Bolton, that the following gentlemen were chosen:— Drs. Welford of Fredericksburg, Cabell of the University, W. A. Patteson of Richmond, and McGuire of Winchester. Dr. Welford of Fredericksburg offered the following resolu- tion :— Resolved, That the thanks of this Convention be presented to the Rev. Mr. Jeter and the Rev. Mr. Hoge, for the very accepta- MEDICAL CONVENTION. 21 ble manner in which they have performed the ministerial duties requested of them. Dr. Haxall mov°d the following resolution, which was adopted: Resolved, That Dr. Warner be requested to deliver an address before this body at its next meeting. Dr. Haxall offered the following resolution:— Resolved, That the thanks of this Convention be returned to the Professors of the Richmond Medical College, for the use of this hall during the sitting of the Convention. Adopted unanimously. Dr. Poitiaux moved the following resolution, which was adopt- ed unanimously:— Resolved, That the unanimous thanks of the Convention be tendered to its several officers, for the very able manner in which they have discharged their various duties. Dr. Haxall moved that the Convention adjourn to the third Monday in May, 1847; when the President addressed the body in a feeling and appropriate manner, and then pronounced the first Medical Convention of Virginia adjourned to the third Mon- day in May, 1847. WM. A. PATTESON, M. D, Pres't. James A. Forbes, M. D,, Sec'y. James A. Leitch, M. D, Asst. SeJy. NOTICE TO THE PROFESSION IN THE STATE. The Physicians and Medical Societies of each county and town in the State, are hereby respectfully requested to use their exertions in obtaining subscribers to the Medical Journal ordered to be established by the Conven- tion ; and they are requested to forward the names and address of each sub- scriber to Dr. R. G. Cabell, the Secretary of the Medical Society at Rich- mond, as soon as obtained. ADDRESS OF DR, WM. A. PATTESON, DELIVERED BEFORE THE MEDICAL SOCIETY OF VIRGINIA, [published by request of the convention.] Gentlemen— At a regular meeting of the Society, in May, 1846, you were pleased to adopt a resolution, that the President deliver an address to it, at its next annual meeting. Having the honor to hold at your hands the office of President of the Medical Society of Virginia, which office terminates to-day, the day of the annual meeting, it affords me unfeigned pleasure to comply with your request, and to be permitted in virtue thereof, to return you this poor but willing tribute of the consideration which in my opinion attaches to the office of the Presidency of so learned and philanthropic an association, and to make you some parting suggestions for its future useful- ness and success, to do which this is a most fitting occasion. The veneration of antiquity, gentlemen, overshadows our useful and hon- orable profession. The first authentic medical history that has come down to us is the writings of Hippocrates, who was born at Cos, one of the most inconsiderable of the Grecian islands, in the 4th year of the 79th Olympiad, or 460 years before the birth of Christ, about 2,300 years ago. He prac- ticed physic with great reputation, and died at an advanced age, and his grateful countrymen erected a monument to his memory. His sons Thessa- lus and Draco, and his son-in-law Polybus, were all Physicians of distinc- tion, trained by him, and much of what has come down to us, as his writ- ings, are with good cause attributed to them. Subsequent to the time of Hippocrates, flourished Erasestratus and Hero- philus, who were the first public teachers of anatomy. They taught at the famous city of Alexandria, in Egypt, and were patronized by the princes of the realm. The bodies of criminals were delivered over to them for dissection, and they were sometimes so used before death. Erasestratus and Herophilus boldly questioned the doctrines of Hippocrates, notwith- standing the veneration in which the great father of physic was held, and took great pains in exposing the errors into which he had fallen. Celsus followed these distinguished men of their day, and was born at Rome, in the reign of Augustus Caesar; an ornate and polished scholar, and 24 address. adorned with every acquirement of the Augustan age. He wrote as a bold and accomplished Physician and scholar, and his works yet to be had and read in their original, beautiful latin, contain much valuable practice of use in the present day. His writings on surgery contain principles and practice equal to that of our time, and some of it has been used in modern days as new practice. Aretoeus followed him with an improved class of remedies and farther investigations of diseases. He was a polished and classical scholar, a pro- found investigator and historian of diseases, and has left in his writings as they have come down to us, much valuable practice. He was a great blood- letter, both general and local. The antiquity of this remedial agent which has stood the test of time, proves its high value, as well as the folly of un- qualified opposition to it, and the baseness of its denunciation by the most popular and arrogant of modern quacks, the Thompsonians. The next writer of value is Claudius Galen, a native of Asia Minor, who was educated at the celebrated medical school of Alexandria. Galen set- tled at Rome about the middle of the second century, and practiced physic with deserved and high distinction. Before his day Rome had passed the time of her meridian splendor, and had begun the decline which ended in her fall, and letters and education declined as the sloth and voluptuousness of the princes who followed the republicanism and virtue of her consular days, gained ground. To have been educated at Alexandria was, in a word, to give character, and the respectability and standing of her alumni was proverbial, and re- flected back on their Alma Mater a rich reward, which would now again distinguish that school which shall require of its matriculates a high mark of education, and shall dispense its honors only to such as truly deserve the distinguishing honor of M. D. From the tinv of Galen to the 14th century, there wns hardly any im- provement in our science, and the Physicians of that period were mostly humble followers in his footsteps. After the conquest and destruction of Alexandria, the Arabians cultivated physic, and cultivated it successfully, having possessed themselves of all the sources of learning previously in the hands of the Egyptians, and resorted to by the students of Greece and Rome. The discovery of the mineral acids, soda and potash, and the application of the acids to the solution of metals, and their attempted transmutation into gold, gave rise to the Alchemists, about the 14th century, and to this scot our profession is greatly indebted for much of its subsequent usefulness and dignity. As men ceased to follow the ignus fatuus of the Alchemists, they became better acquainted with chemistry, and in the earlier part of the 15th century, chemistry began to be a regular science, ministering to the wants of man, and beautifying and enriching medicine by its wonderful powers and discoveries. ADDRESS. 25 From these early times, men have been accustomed to associate them- selves together into societies, whenever they had any great and laudable undertaking in view, so as to embody all the force, talent, experience, pru- dence and virtue attached to their community, and thus to exercise in their conclusions, whatever power, physical, intellectual, and moral, the whole body possessed. Physicians acted on this maxim, and first established voluntary associations for the promotion of their profession,—subsequently asking and receiving legal advantages and protection,—corporate privileges with all the powers attaching thereto, to create licentiates in medicine, doc- tors of physic, and to grant honorary degrees, and the various degrees of distinction which attach to high merit. They realized the fable of the bundle of sticks, in union there is strength. These corporate powers en- abled them to promote and advance the profession, to protect themselves, to establish rules and regulations for their own government and that of their members, laws of qualification, the ethics of the profession, and punishment and reward for the unworthy and meritorious. One by one they would have had but little influence, but united they could not be broken, and their censure or approbation were alike the order of dismissal or passport to favor. We, gentlemen, hold from the Legislature of the Commonwealth a charter covering all these rights, privileges, and powers, and it is a solemn duty we owe our profession, to use it wisely and faithfully in executing its provisions, and to the best of our power to render it subservient to the great and worthy ends of its enactment—the preservation, protection, and ad- vancement of the medical profession. Institutions thus established, must also be useful to the communities in which they exist, and commend them- selves to respect and affection from the apparent fact of their utility, or they cannot long endure amongst a free and enlightened people. Medical colleges, societies, and universities have now continued to exist and flourish for more than two thousand years, with the continued approbation and grateful respect of mankind; and their high degree of excellence in some parts of the world, test the great advancement and progress that has been made in our science. Look back now, gentlemen, to the first ages of the profession, and compare the early with the present time. Whilst we vene- rate the great and distinguished progenitors of our science, Hippocrates, Galen, Boerhaave, Stahl, Hoffmann, Cullen, Brown, as men cast in nature's largest mould, and deserving of all esteem, who labored hard, advanced and adorned the profession, with pride we greet the fact, that the advance- ment in our science is such, that the profession when fully acquired, is now like polished and chiseled statuary to the rough marble block, the spark- ling and set diamond to the stone from the quarry. Well, gentlemen, who shall affix limits to the bounds of science ? The magnificent discoveries of the nineteenth century distance all preceding time, and the century is not yet half over. They have already demon- strated that what was once considered airy and visionary dreaming, is sober 4 20 ADDRESS. truth and reason. The discovery of the magnetic telegraph, the powers and application to the business of every day life of electro-magnetism, and steam, show to what the human mind is equal when properly trained and devoted to science. They have overcome time and space, and almost made a family of the world. We are yet but in the infancy of science ; and two thousand years hence, the arts and sciences of the present day, will be re- garded by our posterity, but as the rude acquirements of semi-barbarians in the alphabet of learning. Shall we not hereafter navigate the air as safely and securely as we now do the ocean ? Carry back your thoughts to the time when no man ventured out of sight of land, but only coursed its shores in a little cock-boat. Now what has the mariner's compass ena- bled him to do ;' and steam, and iron machinery, and iron ships, almost defy the elements. These powerful agents will most likely hereafter enable us to sail the ether with like speed and security. Gentlemen of the Society, there is ample field in our noble profession for the exercise of all your time and talents. See what the chemical art, to which we and mankind owe so much, is daily doing. That art which dates from the efforts of the Alchemists in the transmutation of metals, is the great Archimedean lever of medicine. Within the last few years, certainly within the life- time of many of us now present, it has evoked the metalloid bases of ve- getables from their intricate combinations, analyzed metals before unknown, enabled us to compound metals and vegetables into the most elegant and nice prescriptions, and given us a command over diseases, greater than the advance of ten preceding centuries. Morphine, quinine, and the alkaline and metallic combinations are to the profession an army with banners. In other departments rapid strides have also been made. Sodium and potas- sium immortalize the name of Davy, the stethescope Laennec, the lithon- troptor, civiale, and the practice of the physical signs in diseases of the chest, the accomplished Louis. It is even but just now that chemistry has brought to the use and necessities of man the discovery of explosive cotton, and proven that the plant of our country, once used as a rampart behind which the booty and beauty of our land was nobly and signally defended against a mercenary soldiery, may be still more usefully employed to fire the balls of freemen against the foes of freedom. Since this discovery, the nitrate of potash, heretofore necessary in the preparation of gunpowder, may be used in the preservation of butter and cheese and meats for the table, the hydriodate of potash to cure our gouts and rheumatisms, and the cotton of Louisiana will serve in stead to repel our enemies. This branch of our science is the field for exploration, and there yet re- mains to be discovered those things, which, with our accurate knowledge of anatomy, and well investigated physiological laws, will be the remedi- al agents to conquer much that still resists us. I recollect, gentlemen, a few years since, to have read a beautiful letter from the pen of the late Dr. Felix Pascalis of New York, in which he ADDRESS. 27 ventured the opinion, that the remote cause of Asiatic cholera, was a broken balance of the electric forces of the atmosphere, affecting both animal and vegetable life; and that that awful scourge, from which may God hereafter preserve us, depended upon a modified condition of the electricity in space, from which influence we could not escape, and that all our sweeping and cleaning to prevent the cholera, was ridiculous nonsense. It is not many years since that electricity has been so considered one of the constituents of animal and vegetable life, as to command the profound in- vestigations of medical philosophers, but we now well know that we can no more live and breathe and have active functional life, without a daily and hourly supply of electricity, than we can without air or food. Without it we perish and die, and under its disordered and broken influences, we sicken and pine. Vegetable life can even be so governed by its doses, that in sterile and poor lands, it may be quickened into increased vigor and matu- rity. Is it synonymous with the nervous fluid, or is the nervous fluid, elec- tricity under the laws of animal life, and can its sudden abstraction from our systems by bodies negatively charged be cause of death ? What other condition of the animal system can account so satisfactorily, for the sud- den, subtle, and mortal power of Asiatic cholera? It invades a town in the night, and almost with the rapidity of the electric shock are strong men prostrated to the feebleness of infancy, and die as surely as the disease has attacked them, unless we come to the rescue. How far our most efficient agents in its cure, are reproductive in their influences on our organs and their functions, of this animal fluid, or of steadying its broken balances, I leave to other speculators to determine. It is a fine subject of philosophi- cal enquiry. It suffices at present to know, that there never has appeared a disease so certainly mortal if unmet with the strong arm of medicine, that so surely yields to judicious and well directed practice. We may, gentlemen, here be proud of the magnificent triumphs of our art, and boast that the Physician stands like the beacon light of deliverance to a stranded mariner in a tempest tossed ocean. We can throttle this hydra, as we can many others, and hurl them back to Pandora's box, from which they issued to plague mankind. Physicians, who eminently benefit the world, deserve to be canonized by their countrymen. Honors bordering on divine were heaped upon Hippocrates by the city of Athens. The little town of Ley- den, was made notorious as the residence of Dr. Boerhaave, and letters were directed to him, not post marked to Leyden, but to Dr. Boerhaave in Europe. It is not remarkable then that this city should have been illumi- nated, and all the bells of the churches rung on his recovery from a dan- gerous fit of sickness. Jenner immortalized by his discovery of the pro- phylactic powers of the vaccine virus, received a royal present of .£20,000 sterling, and Heinsius had a statue erected to his memory at Vero- na, for having discovered a remedy for a pestilential fever in that city. What was not due to our great and gifted countryman, Dr. Benjamin Rush, 28 ADDRESS. for his discoveries, into the nature and treatment of the yellow fever which ravaged Philadelphia in the year 1793. Permit me here, gentlemen, to add that I regard him not only as the greatest our country has produced, but as one of the greatest medical philosophers the world has ever known, and that but a few days since I listened with delight to the renewed advocacy in the halls of this college, of his great and leading maxim in tbe treatment of diseases, " there is but one fever." Yes, gentlemen, in vigor and boldness of thought, in speculative enquiry far outstripping his age, he looked into futurity in his profession. Bold and brave, but gentle and cautious in his practice, faithful and true in his attentions, learned and accomplished, but modest and unostentatious, devoted to his country, his profession, and to science, a patriot, philanthropist and philosopher, he deserves, as Mr. Abernithey said to Gen'l Washington, when ever spoken of, to have his name called three times, the great, great, great Benj. Rush. From the character of its different branches, ours is necessarily a pro- gressive science,—and hence, though it illy deserves it, has been subjected to the reproach of uncertainty. Day by day improvements are made, which enlarge our knowledge, improve our stock of remedial agents, and chasten and fix firmly their correct application. It corresponds, however, to the mathematical and fixed sciences in many particulars. In those portions of anatomy, for instance, where no improvement can be made, the man and his organs having been over and over again investigated and fully developed for their appropriate functions hundreds of years ago. So, too, of many of the laws of organic life fully ascertained beyond all doubt, and most of our active remedies, resolved into all of their constituent parts, and their pow- ers and forces fully known. But as all correct practice of physic is based on the sciences of anatomy, physiology and materia medica, whilst we have the right to claim much of it as fixed and determinate, so long as there is any thing to discover in either of these departments, or their kindred sciences, we may improve the profession to a greater degree of certainty, and correct the exactitude of the practice to a point of perfection, of which we are yet far, far short. Is not ours, then, a pursuit worthy of the most ambitious aspirant after fame, and the most ardent devotee of science, and the hearts of the tenderest philanthropists? What science so grand as the study of man, his objects and his ends ? What study so full of incentive to the keenest and most microscopic mind, as the laws of organic life ? What pursuit so noble and so lovely as ministering to the wants and miseries of suffering humanity? What discovery so delightful as to unravel the tangled and mysterious web of chronic diseases, and to grapple the destroyer which has invaded the garden of Eden? These, gentlemen, these are the objects^ of our noble and philanthropic profession. Well, therefore, may we claim the distinctive appellation of doctors in medicine, and demand and receive at the hands of governments, and princes, and kings, privileges, re- wards and honorary distinctions. How better can we further these honora- ADDRESS. 29 ble and praiseworthy objects, than by banding together and preserving that " esprit du corps " which is the life-blood of exclusive society. We have the right to demand from the government, that our profession be not invaded by charlatans and quacks, and that the honorary degree of " doctor in med- icine," be entrusted to none but those that are worthy of it; and that the rules of worthiness and fitness be ascertained by fixed and determinate qualifications, to be adjudged by those already interested in preserving the high destinies of the profession, and rendering it most useful to the commu- nity of which it is part. Let, then, the societies and schools of medicine throughout our broad and happy land cooperate, bring mind to mind, shoulder to shoulder, and heart to heart, to enlighten, strengthen and sustain each other in all measures which will tend to furnish us an able and faithful medical faculty, and secure the profession and the public from imposture and the evils which flow from it. The title of doctor in medicine is a high and distinctive appellation, and should assure in its holder all the qualifica- tions which are covered under so eminent and broad a distinction. It is almost an holy calling, was practiced by our Saviour when on earth, in re- lieving the sick and ministering to the afflicted; and we are told it was not deemed unworthy by him to be found sitting in the temple, disputing with the lawyers and doctors, implying thereby that they were the most learned and distinguished of the land. Well now, gentlemen, does the general state and character of the profession throughout the country commend itself to respect and confidence from its consonance to such a model; or is it not a melancholy truth, that in this our age of steam, it seems as if its propulsive power had been felt even in the manufacture of doctors, and that like most things where the supply exceeds the demand, they have deteriorated in value, and become drugs in the market? I speak, gentlemen, with no refer- ence to particulars, but the fact is, that in attempting to cheapen the educa- tion of doctors, you have so cheapened the article produced, that it has lost its distinctive appellation, and the title is now worn by a set of men throughout the country, many of whom ought to be at school learning the rudiments of grammar. You have made it too easy of acquisition, and have thereby impaired its value. I hold it to be clear, that the title of doc- tor in medicine should be worn by none who, at least, do not come up to the assurances plainly set forth in the face of the diploma. It should speak the truth. Read it gentlemen, " oratus homo, artis medicae scientia plenius instructum," and recall its requirements, and then cast your eyes around over the medical community, and see how many come up to its as- surances, and but how certainly almost all fall below the standard which should be the mark of such a distinguishing profession. Let us, then, cooperate earnestly, Societies, Medical Colleges, Universi- ties, and private teachers, in establishing a standard that shall advance, ennoble, dignify and adorn our profession. Determine that none shall study in our offices that are not grammarians, geographers, natural philosophers 30 ADDRESS. and classical linguists; in short, having such acquirements as entitle to the degree of Bachelor of Arts in colleges, and then shall so study and learn the profession as to adorn it. I quote you for instruction on this subject, the remarks of the learned Dr. Gregory of Edinburg, of whom it may be said, as of our own Franklin, " nullum tetigit, quod non ornavit," who says, " a knowledge of the elementary parts of mathematics, of natural history and natural philosophy are essentially connected with it, as well as the sciences of anatomy, botany and chemistry, which are deemed its immedi- ate branches. There are other branches of knowledge which, though not absolutely necessary to the successful practice of physic, are yet such orna- mental acquisitions as no Physician who has had a regular education should be found without,—such are an acquaintance with the Greek and Latin, and French languages. These must all be based on a strictly grammatical education, and such an acquaintance with the world, men and manners, as fits him for the ornate duties of his profession." It is, therefore, evident that no profession requires a greater variety of liberal accomplishments, and that, whether for his profession or the drawing room, a doctor should be a learned gentleman, well bred, and of polished manners and tastes. It cannot, therefore, be filled by the ignorant, coarse and vulgar with any ad- vantage to the individual, but only with injury to the profession. He must be a learned man to practice with success and reputation, and at the same time possess those ornamental qualifications as a gentleman, without which it is difficult to support the honor and rank of the profession. Now, gentlemen, as there is no profession which requires a greater range in the liberal sciences, I think the degrees of preliminary education hereto- fore alluded to are but necessarily reasonable, and should precede its study, and matriculation in Medical Colleges. It so enlarges and expands the in- tellect, and liberalizes the mind, that medical study would then be like seed sown in good land of deep tilth, and a rich harvest would be the reward. Such an amount of education ought, at the least, always to be a condition precedent to graduation as a doctor of medicine. Let no aspirant after medical honors think hard if these become scholastic requirements, for I venture the assertion, that there is no man who has a just conception of the high moral responsibilities of our profession, who will not say " aye " to their truth. [Here the Dr. read from Dr. Stille's address delivered to the students of the Philadelphia Association for medical instruction, aud Dr. Jackson's to the medical class of the University of Pennsylvania.] The ancient Chinese, whom too many of us have been accustomed to regard as barbarians, are so deferential to literature as to decree it the only true aristocracy. By learning, say they in one of their proverbs, the sons of the common people become great; without learning the sons of the great become mingled with the mass of the people; a maxim of the highest value, and whose truth and importance, if realized, would stay somewhat the rush- ADDRESS. 31 ing current, which sets in so strongly to make the gathering of riches as the only true good in our profession, without the high attainments which make it distinguished and honorable. The most important contract, says Dr. Rush, a man can make in life i3 that which is made between a sick man and his doctor, since the subject of it is no less than human life. The breach of this contract, whether by gross ignorance or wilful neglect, is no less a crime than murder, and it is because our penal laws are imperfect, that the punishment of such a crime is not inflicted upon Physicians who are guilty of it. I have seen, and seen with sincere satisfaction, that cases of mal-practice are beginning to com- mand frequent investigation in England, and to be visited with appropriate punishment. I trust it may not be long ere this wholesome jurisprudence becomes common in our favored land. This, gentlemen, is not the work of a day, but if it be set about rightly by all, with the fixed determination of statesmen and philosophers, another age will not witness the downward tendency of our noble profession, but an age productive of Cullens, Browns, Bells, Rushes, Brousseis, and our young country may shoot ahead of Europe and by-gone times, in this fair philosophic field, as far as she has in politics and religion, and whatever feels the impulsive force of freedom. The Society too, might well give attention to correcting the present sys- tem of the pharmaceutical associations of the profession. We are at the mercy of apothecaries, too often without any education in their pursuits. I hold it to be clear, that none should exercise the calling of an apothecary but such as have been regularly instructed in the business. The lives of men are concerned in it. They should be regularly graduated in a school of pharmacy, or at least in the degrees of materia medica and chemistry, in some school of medicine, before they are permitted to exercise the call- ing, and then under control of the laws of the State. The knowledge of physics, and the manufacture, compounding and preparation of them, is no light affair. In most of the European governments, enlightened by science, this is required, and I think in Germany, one of the best regulated in this matter, an apprenticeship of seven years, and graduation in a school of pharmacy, is the requirement. An instruction to our representation in the National Medical Convention, to meet in May next, on this subject, might be wise. I think too, the Society might usefully direct its efforts to have established in our State, some general system of medical statistics. It is the only plan by which the health of countries can be satisfactorily ascertained, and their tendency to the production of particular diseases established, and the rela- tive sanity, of the different parts of the same country proven. We are in the habit of theorizing on this subject and forming conclusions from geog- raphy, topography, cold and heat, dampness or dryness, soils, &c.; but it is only by correct statistics of births and deaths, and from what sorts of diseases they die, that just and true conclusions can be formed. I am of 32 ADDRESS. opinion, that registries of marriages, births and deaths, should be required by law to be kept by the clerks of all the county and corporation courts, and that the diseases of which they die should be reported by the Physi- cians in every case. No body should be interred until report is made of the disease of which it died, and Physicians should be heavily fined whenever they neglect it. If these requirements should be enacted under penal legis- lation, the citizens would soon become accustomed to them, see their utili- ty, and advantages not here mentioned would also be produced, of decided value to the country, and none would neglect them. In furtherance of 3uch measures, and the general utility to our art, it should be regarded as a fixed professional duty and rule, to make autopsies in all uncommon, doubtful and ambiguous cases. Indeed, when time admitted, to make them in all cases, and by studied and steady efforts, to break down the prejudices of our people to the examination of dead bodies, until familiarity would rid it of all objection. It is this alone that has put the continental Physicians so far ahead in their beautiful and sound pathology. Gentlemen of the Society, a frequent recurrence to fundamental princi- ples, is a maxim not less true in government, than in social organizations like ours. I trust, therefore, it will not be deemed inappropriate to call the attention of the Society to the provisions of our charter. It is most ample to effect much good in reference to the subjects of which I have been treating, if it pervaded Virginia in membership, but whilst it is the Medical Society of Virginia, it has for the most part been local in its ope- rations. I should delight to see gentlemen from all parts of the State be- coming members, and aiding us by their medical contributions, and their presence whenever they could be with us. I have thought, gentlemen, if we could induce the profession to form medical societies in at least every senatorial district of our State, either independent, or what I think prefera- ble, auxiliaries of the State Medical Society, and they would send us up their views and opinions, their medical essays, and notice of whatever they thought advantageous to the profession, and we here would discharge a like duty to these auxiliaries, a rapid interchange of thought and opinion would be effected, of mutual advantage. It would in effect be a central commit- tee, and corresponding committees, and we all know well the power of such organizations in controlling conduct and opinion. What better plan can there be than this for forming an unity of opinion in reference to the best interests of the profession, and the interests of the public as connected with the profession. An amendment of the charter might here become necessa- ry, which our liberal legislature would readily grant. You but the other day adopted a system of medical ethics, as a rule of conduct for the profes- sion, which commends itself to the respect of all gentlemen in its ranks. Suppose now, these auxiliary societies were in existence, and should seve- rally adopt this code, it would at once become the medical law of Virginia, and would have such binding moral force, that none would dare deny it. ADDRESS. 33 Suppose, gentlemen, the Medical Convention now assembled in our city should endorse it, how influential would their opinion be in making these rules of conduct binding, and go far to correct errors in conduct and prac- tice, which we all regret. This system and these rules, with such improve- ments as time shall suggest, would make us a medical family of friends, in which we could all do as well, and feel better than we often now do. Gentlemen, within the last few years the Legislature has thought fit to tax lawyers and doctors as a class. How they omitted the clergy as a class, when they thought proper to tax learned professions, I am at a loss to know. They only touched them incidentally as salaried men, in taxing in- come. Perhaps they were afraid or unwilling to tax them as a class, because of their holy calling and kind offices. I rather believe this; but if there is any class of men in the community who work more for nothing than doc- tors, and administer more real love and charity, without the hope of reward, I am yet to learn who they are. The law alluded to is an odious law, and should not be on the statute book of any enlightened community. It is a tax on learning. Property of every kind is the proper subject for taxation, after an « ad valorem " standard. Bring every man to the confessional, and tax all a " per centum " duty on the whole amount of property of all kinds, equal to the wants of the commonwealth. We pay as much tax on our property, whether horses, lands, money at interest, plate, pianos, &c, as the rest of the community, and then have to pay in addition thereto for being a doctor. Why are not the farmers and planters of the country, after paying tax on their property, made to pay a tax for being farmer's and planters ? It is just as reasonable, while taxing trades and professions, to tax all trades and pursuits; and the farmer should as much pay for the name of his pursuit as the lawyer or doctor. Now, gentlemen, this unjust exaction is demanded and received whilst the laws no where recognize us as a profession distinctively, by their protection. How and by what author- ity does the law know me as a doctor? It did not give me my diploma, nor does it protect me against irregulars and quacks. Surely, if we are to be regarded as a distinctive subject of taxation, we should be protected against unlicensed practitioners, and suitable laws be enacted for our benefit. In elucidation of this subject, and in reference to our proper position in the commonwealth, I quote parts of two acts of a sister State, the land of steady habits. The first is from an act in relation to the medical institution of lale College, a college venerable in years and reputation :— " Every medical student shall be required to attend to the study of physic and surgery for two years, with some medical or surgical professor or prac- titioner who is in respectable standing, provided he shall have been graduated at some college; otherwise, to study three years; to have acquired in addition to a thorough English education, acompetent knowledge of the Latin language and of the principles of natural philosophy; to have arrived at the age of twenty-one years; to be of good moral character, and to deliver to the com- 5 34 ADDRESS. mittee of examination a satisfactory dissertation upon some subject in med- icine or surgery, or the auxiliary branches. And every medical student shall attend one course of the lectures under the professors of Yale College, or of some other public medical institution, previous to his being committed to an examination for a license." Another part of an act to incorporate the Medical Society of Connecti- cut is " No Physician or Surgeon who shall have commenced practice sit ce the year 1800, or who shall hereafter commence practice, shall be entitled by law to recover any debt or fees for such practice, unless he shall have been duly licensed by some medical society or college of Physicians ; and all persons licensed to practice physic, and practising within this State, shall of course be members of the Medical Society." Now it surely will be considered that the public have the deepest interest in the character and qualifications of medical men, the acknowledged guard- ians of health and life. That the State, then, may be furnished with an able and faithful medical faculty, and the public as far as possible be pro- tected from imposture and its evils, I ask you, is it not proper that she should adopt measures and pass laws calculated to render them more worthy of the high trust confided to them ? Laws penal in their conse- quences should be enacted to prevent fraud and quackery. Medical skill can be the result of nothing else than patient and profound study, and se- vere and protracted application. It cannot be acquired without expense, both of time and money. That which is said to come without it, is pre- tension and sheer imposture. We are surely entitled to the parental and protecting hand of the government, and I advise the Society to consider whether it is not proper to ask of the Legislature the enactment of such laws as are but just on its part, and due alike to the best interests of the community and the profession. Gentlemen, the great object of our time-honored profession is to serve mankind in its highest interests,—the cure of disease and baffling death. We war with the direst enemy of our race. To defeat him, we must be learned in our profession, industrious, courageous, prudent, patient, and faithful. How delightful and how frequent are our triumphs? When de- feated, as at last we must be, we have the consolation in defeat, that we have done our duty. With feelings like the dying Marmion, when the shades of everlasting night were closing round him, " Above our heads we'll shake the fragments of our blades, And shout for victory." Yes, gentlemen, when contending with disease and death, let us contend as long as we have an inch of ground to stand on, and when we yield, let it only be to that inexorable sentence which has been passed on all mankind, " Mors vincit omnia, et noj morti cedamus." "\ NN SI 4 ^