Progress of medicine in the South. Address of the President before the Southern Surgical and Gynoecological Association, at the meeting held in Nashville, Tenn., November 13, 1889.

by Hunter McGUIRE, M. D., Ll.D.,
Late Medical Director, Stonewall Jackson (2d) Corps, Army of Northern Virginia, C. S. A.
Mr. President and Fellows of the Southern Surgical and Gynoecological Association, Ladies and Gentlemen:

It is with unassumed diffidence that I appear before you to-night as the presiding officer of this body, and I approach with great hesitation the task of delivering the annual address, in compliance with the established usage of all assemblies of this kind in America.

I feel confident that there are many present who would fill the office with more ability, and that it would have been better for our Society if another had been chosen in my stead. I desire, in the commencement of my remarks, to return my thanks to my fellow members for the honor they have conferred upon me by calling me to preside over the deliberations of this, our Southern Association.

It has been suggested that there was no need for the existence of this Society; that the State, national and international medical associations were sufficient for all that was required for the progress and development of medical science. This was a mistake, as I hope I may be able to show. There is need, throughout the whole South, for county and State associations, and a special need for the existence and perpetuation of this organization.

It goes without saying that union and co-operation have become as indispensable to scientific bodies as in the material walks of life. In all human enterprises, every advance accomplished is by coopera-tive work. In this way laws are perfected; agriculture improved; philosophical investigations consummated; political and philanthropic reforms attained; by it railroads and canals are built; just and equitable laws enacted; civilization extended; tyranny and oppression overthrown; the gospel preached, and civil and religious [4] liberty secured. By union and co-operation alone can the science of medicine be advanced. Isolated, individual men who, in the pride of self-reliance and self-sufficiency, reject the aid and sympathy of their contemporaries, are failures. They may have great ability, they may be faithful and enthusiastic workers in the departments to which they have devoted themselves, but in the end they are disappointed, because they have over-estimated their individual strength, and have not sought the companionship and concurrence of others. No class of men appreciate the value of co-operation more than the medical men throughout the world. Germany, Austria, France, and England have for years shown how co-operation can bring about medical progress, through the deliberations of the respective assemblies that are annually held in these countries. The people of this country, also, in their State and general societies, have added much to the development of medical learning. So highly is co-operative work appreciated by the medical world, that the necessity for an international congress a few years since became imperative. I need not tell this audience what it has already accomplished. At its last meeting, held in Washington, the nature and extent of its labors can only be understood by the examination of the five volumes that contain the contributions of its members; the work is a medical library in itself. America, ever alert, energetic and industrious, always anxious to obtain and practically apply that which is best, has been no laggard in her endeavors to promote the advancement of medical science. Through the American Medical Association how much has been accomplished? In its grand meetings are brought together some of the ablest men of the land. Historic figures many of them have become, and the fruit of their labors will hand them down through ages as among the foremost of their day and generation. Her sister society, the American Surgical Association, although younger, has just cause to be proud of her work. Her field is necessarily restricted to one of the great divisions of medicine—a division of the highest importance. That the field has been well worked, that the harvest has been rich and abundant, and that it has been gathered into our store-houses, I take it for granted none will deny. So I might refer to other associations, and to the congress of these associations, did time permit.

It may be said with truth that, until of late, the South has not kept pace with the North in medical progress and development. This has arisen from a variety of causes. Prior to the late war slavery was antagonistic to the development of dense populations; fertile [5] areas were monopolized by the large planter, and he generally occupied more space than his agricultural needs required. He believed in what he called ‘plenty of elbow room.’ He was opposed to outside intruders, and desired neither the development of towns nor the growth of cities in his vicinity. Criticise this policy as you may, condemn it if you will, I am not engaged in defending it, but am merely stating patent facts, in order to account for the manner in which it retarded the development of medicine. While this was true, yet this state of society produced splendid men and women, probably the grandest on this continent. Culture, grace, elegance, self-reliance, were its legitimate offshoots. Orators, poets, statesmen, soldiers, scientists, lawyers, ministers and physicians, the first and greatest in the whole land, came out of it. What orator have we like Henry or Yancey, what poet like Poe, what scientist like Matthew F. Maury, what statesman like Jefferson, what jurist like Benjamin, what divine like Hoge, what soldier like Stonewall Jackson, what surgeon like Sims? And the women—how can I describe them! They were as cultured as they were refined; they were as beautiful as they were queenly, the loveliest of sweethearts, the noblest of matrons.

Let us look for a moment and see from whence these people of the South came, and what they have done.

The colonial settlers of the southern portion of North America were kindred by ties of blood, by association, and by the laws of common inheritance. They came to this country deeply imbued with the idea of civil liberty. In many instances they were descended from a superior element of the English people. The blood of the cavalier coursed through their veins; they were prepared to organize a government, to undertake the herculean task of creating a country out of chaos. And they accomplished it.

To these settlers were soon afterwards added another stream of emigrants, who came into the South through Maryland and Virginia, and through the seaports of the Carolinas and Georgia. These were the God-loving, tyranny-hating Scotch-Irish, who have left their distinguishing characteristics, to this day, upon the people of every State in the South, from Maryland to the Rio Grande.

When the struggle came for the defense of their rights against the mother-country, how quickly her sons took up arms in defense of the common cause, and how nobly they performed their part it is useless to say, for is not the history of the time filled with accounts of their patriotism and achievements? At the council board, on the [6] platform, and in the field, they stood pre-eminent. The enunciation of principle, the declaration of rights, sprung from the fertile brain of a Southerner, and to-day the readers of American history recognize in Jefferson the foremost thinker of his age. Well has a New Englander, in speaking of Washington and the Southern soldiers of 1776, recently said: ‘We must go back to Athens to find another instance of a society, so small in numbers, and yet capable of such an outburst of ability and force.’ Without the men of the South, the Revolution of 1776 would have gone down into history as the rebellion of that period.

How wonderful it is, that in the comparative seclusion and solitude of an agricultural country, the men should have been reared whose writings on Constitutional government embodied the wisdom and the experience of the patriots of all ages, and whose State papers actually formed the mould in which the constitution of the United Colonies was shaped; and that then, after Southern statemen had formed the most perfect government the world ever saw, that Southern soldiers should have made it an accomplished fact by their skill, valor and endurance.

Edmund Burke, in his speech before the British Parliament March 22, 1775, on the conciliation of the American Colonies, spoke thus of our people:

‘There is, however, a circumstance attending these Southern Colonies which, in my opinion, * * * * makes the spirit of liberty still more high and haughty than in those of the northward. It is that in Virginia and the Carolinas they have a vast multitude of slaves. * * * * And these people of the South are much more strongly and with a higher and more stubborn spirit attached to liberty than those in the northward. Such were all the ancient Commonwealths; such were our Gothic ancestors; and such, in our day, the Poles; and such will be all masters who are not slaves themselves. In such a people the haughtiness of domination combines with the spirit of freedom, fortifies it and renders it invincible.’

Men of Southern birth and Southern rearing were the successful generals in the war of 1812, and the central figures in 1846. The acquisition of territory was made during the administration of Southern men. Louisiana, Florida, Texas, and California were acquired during their terms of office. Upon the Supreme Court bench of the United States they are to be conspicuously found. The Chief Justiceship was held continuously for sixty-three years by Southern men. I need not speak of the orators and statesmen produced in every State in the South—they are household names. [7]

History but repeats itself—like occasions produce like results. The patriot of to-day is but the reflex of the patriot of the past. In our late civil contest—if it be proper to call it so—for was it not rather two sovereignties waging war, the one against the other?— the men of the South once more displayed the same great qualities that had characterized their ancestors in the American Revolution.

Modern Europe stood aghast at the daring of a people they had been taught to regard as effeminate. They had expected that an ephemeral struggle would be made near akin to those which had frequently taken place among the mixed Spanish population to the south of us. Climate, temperature, the pernicious effects of slavery, were all believed to have had their influence, and to have produced a weak and vacillating people. Had luxury enervated them, had they become effeminate, had the increase of wealth and the impress of slavery rendered them physically and intellectually inferior to the men of the North? If any so believe, let the deeds of arms that have passed into history speak. Examine the details of the well-contested battlefields and see if such a declaration is true. Jackson, Lee, Johnson, Claiborne, Stuart and Forrest! What tender thoughts, what hallowed associations gather around the names of these bright stars in the Southern constellation! Does all history, does even the field of romance furnish heroes superior or patriots more noble? They were the leaders of an equally brave and noble people, who, when all save honor was lost, submitted to the inevitable with a dignity born only of true greatness.

And now of the Confederate surgeon let me say a word. How can I express, in adequate terms, my admiration for him! He possessed virtues peculiarly his own. Coming from civil life, it was wonderful to see how rapidly he adapted himself to the discipline of the army and conformed to the requirements of military life. The hardships he endured and the privations to which he was subjected soon transformed him from a novice to a veteran, and I can say, with truth, that before the war ended some of the best military surgeons in the world could be found in the Confederate army. His scanty supply of medicines and hospital stores made him fertile in expedients of every kind. I have seen him search field and forest for plants and flowers, whose medicinal virtues he understood and could use. The pliant bark of a tree made for him a good tourniquet; the juice of the green persimmon, a styptic; a knitting-needle, with its point sharply bent, a tenaculum, and a pen-knife in his hand, a scalpel and bistoury. I have seen him break off one prong of a common [8] table-fork, bend the point of the other prong, and with it elevate the bone in depressed fracture of the skull and save life. Long before he knew the use of the porcelain-tipped probe for finding bullets, I have seen him use a piece of soft pine wood and bring it out of the wound marked by the leaden ball. Years before we were formally told of Nelaton's method of inverting the body in chloroform narcosis, I have seen it practiced by the Confederate Surgeon. Many a time I have seen the foot of the operating-table raised to let the blood go, by gravitation, to the patient's head, when death from chloroform was imminent, and I will add that, in the corps to which I was attached, chloroform was given over 28,000 times, and no death was ever ascribed to its use. Many of the medical officers of this corps were wounded or killed on the field. One, I saw fall at Strasburg, amid the cheers of soldiers at the evidence he gave of devotion to duty. Another, at Sharpsburg, facing an assault before which even veterans quailed and fled, and a third I found upon the bloody field of Cold Harbor dying with a shell-wound through his side. As I knelt down beside him and told him his wound was mortal, he answered, ‘I am no more afraid to die than I was afraid to do my duty.’ They were splendid specimens of a noble race-a race whose achievements astonished the world and wrung from the foe himself a full measure of praise. During the terrible six days which followed the retreat of our army from Richmond, the medical men, by their unswerving devotion to duty and cheerful support, contributed no little to inspire the heroism which turned our defeat into honor, and made Appomattox one of the proudest memories of the war.

The social condition of the South, while it offered unusual and rare advantages to her sons generally, denied to the medical men, save in exceptional instances, the opportunities which were conducive to the progress and development of medicine. This peculiar Society gave to them, however, boldness of thought, independence in investigation, and they possessed the courage of their convictions; they thought well and they thought clearly; they fought their way into position at every leading medical centre in the country. Many of them started life in small towns or rural districts; and after testing their strength and gaining the confidence born of experience, they generally moved to the larger cities, North or South. Is it more than necessary to mention Frick, Goodman and Smith, of Maryland; Hartshorne, Chapman, Horner, Mitchell, Mutter, and J. L. Cabell, of Virginia; Jones, Chas. Caidwell and Dickson, of North [9] Carolina; Geddings, Bellinger, Toland, and Sam. H. Dickson, of South Carolina; Meigs, Arnold, Bedford and Anthony, of Georgia; Eve, of Tennessee; Nott and Baldwin, of Alabama; Stone and Jones, of Louisiana; Dudley, McDowell and Yandell, of Kentucky, to recall to your minds the great instructors in medicine in this country?

How well they performed their part is prominently shown in the lasting impressions they have left behind them. Historic they are, and historic they will continue to be; untold generations will arise to bless them, and they will not fade into obscurity through the lapse of time.

How can I speak except in terms of reverence and praise of the practitioner who remained with his country clientele, and yet established national reputation; struggling under disadvantages which can only be appreciated by those similarly situated—with paucity of material, and the absence of professional association—with the requisite elements of success arrayed against him—he must be a man of genius who advances an idea, demonstrates a fact, constructs a principle, or invents an operation of sufficient importance to arrest the attention of the medical world; truly he must be a man of profound genius.

Of such men were Crawford Long, of Georgia; Mettauer, of Virginia; McDowell, of Kentucky; Sims, of Alabama—Sims, the greatest and grandest of all the men who have recently passed away. Satisfying the requirements of a continent, he traversed the ocean in order to give to Europe the benefit of his learning and experience. He claimed among his patients one or more members of the crowned heads of Europe. The relief that he afforded suffering humanity from diseases that before his day were classed as incurable, can only be estimated by those who have examined the subject in detail. He was the pioneer of gynaecological and abdominal surgery. The fundamental truths established by him will be remembered, their utility recognized, and their principles applied, so long as surgery is a science.

He passed away in the full zenith of his glory, renowned, beloved and respected. The bronze statue, that is to be erected by his professional friends over his mortal remains, will bear but feeble attestation to the reverence with which he is regarded by the civilized world.

Would that good taste and the proprieties of this occasion permitted me to mention the names of men in the profession, living now in the South, who have achieved for themselves great renown. [10] Some of these gentlemen I see before me to night, and I congratulate them upon the fame fairly won by their genius. To the medical students here in such numbers this evening, these distinguished men will say, as they of all others know, that genius is only hard work well directed. Some future speaker, filling the place I occupy now, in fitter and more eloquent words, will tell another audience the names of these men, and they will go down into history as great and grand as those that I have just mentioned.

Organization must be our watchword. In a country, where all is progress, where material resources are being rapidly developed, the medical men of this section must not prove laggards.

Agriculture is in a state of progressive advancement. Our mineral wealth is at last appreciated and turned to valuable account; the hum of the loom, the ring of the anvil and the sound of the forge resound throughout the land. Our waste places are no longer desolate; the increased growth of agricultural products is amazing. The cotton crop of 1888 is more than double the crop of 1860—the time at which was believed the South had reached her hey-day of prosperity.

Last year (1888) the value of the crops in the South was the largest on record, and yet this year (1889) the value of her agricultural products alone, it is estimated, will be increased $125,000,000. Statistics show her rapid growth in other industries to be fully as great, if not greater. And this is the legitimate outcome of the courage, sagacity and industry of her own people—a people born and reared under the Southern sun. For there is no new South; the blood of her patriots of the past flow in the veins of her people to-day, unmixed by any other strain. Blessed with an unequalled climate; with fertile lands, whose products are most varied and abundant; with coal, minerals and precious stones in quantities exceeding the wildest imaginations; inhabited by a people who have shown to the world their patriotism, endurance and valor; with the surplus negro population relegated to Mexico, towards which country, in the providence of God, it is now drifting, the South is advancing and improving in every way.

Villages are springing up in every direction, towns and cities are being located at all important commercial points, and those already established are marked by annual increase both in wealth and population. All these things tend to the advancement of the object we have in view; already there is scarcely a community that is not sufficiently dense to furnish clinical material to those engaged in active [11] practice. How much there is to be learned about diseases peculiar to this South land of ours—the manner in which malaria affects the population, where the miasma is generated; the way it modifies and alters other diseases and surgical conditions existing in the same sections; how acute attacks show themselves; in what way chronic malaria exhibits itself and the pathological changes it brings about— all these should be studied. The effect of prolonged heat in summer and damp cold in winter are conditions worthy of your attention. The drainage of our wet alluvial regions, and the general improvement of our hygienic conditions, are grave problems to solve.

We cannot afford to become mere borrowers, we must be contributors to this our beloved science. Remember, the thought of to-day may be the dogma of to-morrow. He who elucidates an idea, establishes a fact, or creates a system, is an universal benefactor of mankind. How this should stimulate the good men to become workers in this direction.

Modern inventions have annihilated space as to time, and by so doing have brought into a common fold the scientific men of every country and clime. The thought of to-day, to-morrow is the property of mankind.

For all these reasons, gentlemen of the Association, it becomes a matter of paramount importance that you should stimulate your brethren to organize societies in every section of the South. Never leave off trying until county societies are established and actively at work in every county in each Southern State. Foster and encourage the State and district societies; establish close relations with them, and when desirable, induce their members to become your members. If the plan proposed is even partially carried out, before many years this society will become one of the most important in this country.

One thing more is needful for the elevation of the moral as well as the scientific status of our profession, and that is harmony and goodwill for our fellow workers. Nothing contributes to this so much as these annual reunions; by these meetings rivalries cease, distrusts are dispelled, and kindly relations established; old friendships are confirmed, new friends made, and greater tolerance and charity prevail. We are made to see that in the sometimes meagre and uncertain scientific facts in our calling, there is reason for honest difference of opinion. To these meetings every patient and conscientious worker can bring his contribution and add it to the common stock of ascertained knowledge. Let us cultivate a broad [12] and generous appreciation of each other's work; let us eliminate every particle of envy at the success of others; let us heartily commend all who have enlarged the boundaries of our science or who have improved its art. Let us remember that the man who can appreciate what is excellent in others, is the man most likely to accomplish what is excellent himself.

Gentlemen of the Southern Association, let our motto be, lofty aim and united action. As Southern men, let us show to the world that, under changed conditions, we have still the stamina of our forefathers. As members of our beloved profession, let us strive to be first in scientific attainment, first in integrity, first in high purpose for the good of mankind.

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