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 AN ADDRESS 
 
 BEFORE THE 
 
 MlDICAl SOCIETY OP TBI STATE 
 
 OF 
 
 NORTH CAROLINA, 
 
 AT 
 
 ITS FIRST ANNUAL COMMUNICATION, 
 
 IN RALEIGH, APRIL 1850. 
 BY THOMAS N. CAMERON, M. D. 
 
 RALEIGH: 
 
 BEATON GALES, PRINTER — REGISTER OFFICE. 
 
 1850. 
 
ADDEESS. 
 
 Mr. President and Gentlemen 
 
 OF the Medical Society : 
 
 In complying with the resolution adopted at your last 
 meeting, I have experienced no little embarrassment in 
 the selection of a subject on which to address you. So 
 many and so important are the topics that present them- 
 selves ; so wide and varied the field ; that the very mul- 
 tiplicity of subjects has created hesitation in the selection. 
 
 If I have rightly comprehended the object, for which 
 this society was formed, it is, that at these annual meet- 
 ings, each member should in turn, to the extent of his 
 ability, contribute what might add to the dignity of the 
 profession ; impart information ; and bind together in 
 stronger ties of fraternity, its different members. I pro- 
 pose therefore, on this occasion, Mr. President, as I con- 
 sider this to be merely an introduction to the yearly lec- 
 ture, to be delivered before the Society, to bring to your 
 notice, some of the popular objections to the profession 
 of Medicine, and briefly present some views in relation 
 to the uncertainty of Medicine, and the duties and re- 
 sponsibilities of the Physician. 
 
 [t has often been urged as an objection to Medical 
 Practitioners, (and perhaps not without reason,) that they 
 were peculiarly selfish in their pursuits, jealous of the 
 success of their competitors for popular favor, and envious 
 of each other. That this feeling is often indulged to an 
 extent, that interferes with the social relations of life, is 
 
4 
 
 a truth, none, I presume, will deny ; and if its effects 
 were to stop here, society would hav^e but little right to 
 complain — but when it is carried into the professional as 
 well as the social affairs of life, the public welfare is 
 concerned, and they have an undoubted right to amend- 
 ment on the conduct of those, who, without just grounds, 
 indulge such feelings. 
 
 From the earliest period of time, when the science of 
 Medicine began to assume that rank, which its intrinsic 
 importance entitled it to take in the estimation of man- 
 kind, the world has been divided between the votaries of 
 learning, and the mere pretenders to the healing art ; and 
 it was as natural as it was just, that those who had de- 
 voted their time, talents and pecuniary means in acqui- 
 ring by a long course of laborious stud)'; the knowled.ire 
 necessary to qualify them to assume the responsible and 
 delicate task of conservators of the public health, should 
 view with distrust, the Charlatan, who, with nothing to 
 recommend him but his own unblushing impudence^ 
 should, by practicing a fraud on the credulity of some, 
 and the ignorance of others, reap the reward which should 
 alone be due to merit. It was, I say, natural under such 
 circumstances, such results should be produced, but, it is 
 a reflection on the profession, that such feelings should be 
 allowed to exist among brethren of the same calling ; 
 standing on the same platform of respectability and equal- 
 ity. It is a lamentable truth, that with us, there is want- 
 ing that " Esprit du Corps" which makes each member 
 jealous, not of, but for^ the honor and reputation of a bro- 
 ther — which makes him at all times and on all proper oc» 
 casions, the defender of his reputation. 
 
 The code of Medical Ethics adopted by the Society, is 
 so full and pointed on this head, that I might be spared 
 the time of adverting to it, if it were not for the fact, that 
 however plausible and beautiful in theory, it is so often 
 neglected in practice. 
 
 <.l»^-ti A 
 
d 
 
 Perhaps there is no one present, who may not have ob- 
 served and perhaps felt the truth of the assertion, that 
 professional jealousy is often destructive of professional 
 usefulness, injurious to the public welfare and derogatory 
 to the character of Medical men. 
 
 It will doubtless be asked, how is such a state of things 
 to be avoided, and how is the evil to be remedied ? By 
 what process can the character of men be so changed as 
 to bring about a result so much to be desired ? 1 answer 
 that much has been done in other Slates to rectify the 
 evil, by the formation of Medical Societies, by which 
 means, the members of the profession are brought into 
 more immediate association; friendships are formed or 
 previous ones confirmed ; character is developed and in- 
 tellectual and moral worth made known and appreciated. 
 1 look upon the formation of this Society as the first and 
 most important step, in the elevation of the Medical Pro- 
 fession in North Carolina. Hitherto, we have lived to 
 ourselves and for ourselves ; known only within the nar- 
 row limits of our professional world, we live and pass off 
 the stage,* unknowing and unknown." Now we have 
 the prospect brightening; each succeeding year will bring 
 before you some aspirant for professional fame ; emula- 
 tion will be aroused ; character will become indispensa- 
 ble ; and from this fountain will flow feelings of kindness 
 for each other and an increased desire to promote 
 the happiness and health of mankind. What nobler 
 emulation can actuate the mind of man, than the desire 
 of increased usefulness to his fellow beings ? What more 
 likely toexcite this desire of usefulness and thirst for knowl- 
 edge, than this assembling of ourselves together, to dis- 
 cuss matters pertaining to the Healing Art ? The Pol.ti- 
 cians of the day have their meetings to discuss measures 
 of State or National policy ; some, fiom a sincere desire 
 to promote the general weal, others, it is to be feared, to 
 advance selfish or designing ends. Gentlemen of the 
 
Legal calling meet still more frequently in the pursuit of 
 their business, where they can discuss questions of law ; 
 but until now the members of our profession have had 
 no opportunity of consultation in general assembly — 
 each, confined to his dull routine of daily business, has 
 been compelled to plod on, without the important auxil- 
 liary of concentrated opinion. Individual energy and 
 talent have doubtless effected much in advancing the cause 
 of Science in every department. There are many and 
 strikings proof of what the unaided ingenuity of man 
 can accomplish. Witness the discovery and appli- 
 cation of the power of steam by Watt, which is now 
 brought to bear so successfully on many of the industrial 
 pursuits of life. Witness too, the more recent invention 
 of the Telegraph, by means of which, for the transmis- 
 sion of intelligence, space is annihilated, and the messages 
 of love, business or pleasure are transmitted with light- 
 ning speed. Yet who doubts that more can be accom- 
 plished by the concentration of mental efforts, by com 
 paring the experience or experiments of each other and 
 by giving the results of these experiments? 
 
 This has been emphatically called the age of progress. 
 Every thing around us and about us, seems to be advan- 
 cing. In every department of Science or Literature ra- 
 pid strides have been made — the inhabitants of the world 
 are vieing with each other in their eftorts to promote 
 the prosperity and alleviate the condition of Mankind. 
 Nor have the Votaries of Medical Science been laggards 
 in the race of fame. The improvements in Chemistry 
 and Surgery alone attest the zeal of the profession and 
 the success with which their efforts have been crowned. 
 The introduction of the use of Chloroform is an era in 
 the annals of Medicine, and as a remedial agent deserves 
 a high rank. To it, Surgery is largely iiidebted ; for by 
 its use, that important branch of our profession is rob- 
 bed of half its terrors. Under its tranquillizing influence 
 
on the patient, the Surgeon proceeds to the performance 
 of the most delicate and important operations almost with 
 the certainty of success, that he is not to be disturbed by 
 the groans and cries of his subject. Here is indeed a 
 triumph of which the skill of Man may well be proud ; 
 and when its use has become more general, in the hands 
 of the judicious practitioner, humanity will have addi- 
 tional cause of gratitude to that beneficent Being who 
 enables the researches of his creatures to find out an 
 antidote to many of the evils that man so often inflicts 
 on himself. 
 
 A very common objection to the Medical profession is 
 its uncertainty. The uncertainty of Medicine is a topic in 
 all circles, and \^et it is one which is very generally mis- 
 understood. The mistake is mainly as to the nature of 
 this uncertainty, its causes, its influence in the treatment 
 of disease, and the best methods of guarding against the 
 errors into which it is liable to lead us. These errors are 
 so numerous and interfere so constantly with the useful- 
 ness of the Physican among all classes of people, that 
 the subject has become one of vast practical impor- 
 tance. It is important not only to the Physician, but to 
 the people, and to them especially ; for they are the suf- 
 lerers from the multiform and often fatal injuries, which 
 these errors engender. The causes which make diseases 
 complicated, and render the Science of Medicine, and 
 consequently, its practice, uncertain, are numerous ; they 
 are familiar to the well-informed and observant physi- 
 cian, but are often overlooked by the community general- 
 ly. They consist in the sympathy which exists between 
 the different organs of the bod}^ — in the influence of un- 
 seen agents or causes — in individual peculiarities of con- 
 stitution, and in mental influences. That these, individ- 
 ually or collectively, exert a powerful influence in modi- 
 fying the various forms of disease, no one, I presume, will 
 question, and the conviction which has been forced upon 
 
8 * 
 
 my mind, is that, of all the causes which becloud the 
 path of the Physician in his attempts to elucidate disease, 
 the influence of the mind upon the body is the greatest — 
 for it never should be forgotten in our observation of dis- 
 ease, that we have not to deal with the body alone, but 
 with the body inhabited by a mind, which is connected 
 with every particle of that body by countless nervous fil- 
 aments, and therefore acting through them upon it, and 
 aflfecting to a greater or less degree, all its diseased con- 
 ditions. The influence of causes acting through the mind 
 is often concealed from our view, and even when it can 
 ■ be plainly seen it is difficult to estimate its amount with 
 correctness. Eff'ects are often produced through the 
 mind, which are attributed by the patient, and sometimes 
 by the Physician, to some remedy that has been adminis- 
 tered. According to a generally received opinion, there 
 is a complex operation of the mind, and it may there- 
 fore be readily and rationally supposed to be liable to 
 disorder, thus exerting a powerful though unseen influ- 
 ence on the many bodily ills, which flesh is heir to. 
 
 In some respects, the mind appears to be governed by 
 laws analagous to those which govern the body; for as 
 continued inaction deprives the body of the power of 
 moving, so inactivity of mind deprives z^ of the power of 
 acting. To this in a great measure is to be ascribed 
 that loss of mental vigor, which so often attends declin- 
 ing age: at this period, fame ceases her allurements; 
 ambition begins to lose its power ; life has little more to 
 promise, the animal spirits are languid, infirmity unfits 
 the body for the exercise of mind, and the individual 
 gradually and unconsciously remits that exercise, and at 
 last falls into dotage. But not only in old age does inac- 
 tivity show its deleterious eflTects on the mind. We often 
 see or hear of men, who in early life gave the fairest 
 promise of future eminence, who, when they have reach- 
 ed their prime, not merely have made no progress in 
 
mental improvement, but have rather retrogaded, and to- 
 gether with the loss of acquired knowledge, have lost the 
 thirst for it — exhibiting the melancholy sight of the waste 
 of talents and the wreck of mind. This may sometimes 
 be occasioned by their having been placed in circum- 
 stances unfavorable to their peculiar turn of mind, for 
 
 "Many a soul sublime. 
 Has felt the influence of malignant Star." 
 
 But oftener, another cause is very evident — elated with 
 the praise bestowed upon their early talents, they con- 
 ceive that without regular exertion, which is the pabu- 
 lum of the mind, they can by their superior powers at- 
 tain any object. Depending on this, they allow inactivity, 
 like a canker, to prey upon the mind, producing a morbid 
 train of feeling which, if not timely corrected, must and 
 will produce its corresponding effects on the physical or- 
 ganization. Who is there, who has not watched the 
 workings of his own consciousness, and has not discover- 
 ed that at certains periods he has an aptitude for certain 
 pursuits, he knows not why, and at others an inaptitude, 
 which renders such pursuits fruitless and impossible ? — 
 What individual is there, who has not occasionally felt 
 that in his choicest moments of inspiration, when all his 
 energies were best attuned to the pursuit of the object 
 before him, there has been, despite his own will, and in 
 contravention of his ow^n desires, some disturbing idea 
 developed as an involuntary point of consciousness ; and 
 this disturbing cause has been so utterly discordant and 
 alien from the previous object of his inquiry, as thorough- 
 ly to destroy that continuous chain of thought, which in- 
 capacitates him forthe time, for further prosperous study? 
 Who is there, who has looked back upon the history of 
 bis own life; who has looked abroad into society; who 
 has reasoned upon its elements, and has not seen, in his in- 
 dividual case and in the case of others, that the best diges- 
 ted plans and best calculated efforts have been rendered 
 I 2 
 
10 
 
 fruitless by the intervention of discordant causes, over 
 which he had no control ; and has not perceived* that the 
 best institutions of society have been rendered nugatory 
 — ^that the bonds of the social and political compact 
 have been weakened — that the wealth, and the power, 
 and the prosperit}-, and the peace of nations have 
 been subverted — that the happiness, and comfort and 
 worth of the whole family of man have been? annihilated, 
 by the agencies of discordant materials, over which they 
 had no efficient control ? It is then a principle in the 
 very constitution ol man's existence, that there will every 
 where be found the operation of discordant and antago- 
 nistic agpncie.5 which will introduce discrepancy into 
 his best calculated plans of agenc} ; and the operation 
 of this principle is universal, extending to, and exerting 
 an influence on, the mental and physical organizations. 
 
 The science of Medicine, in all its departments, is in a 
 very changeable state ; the discoveries, which are made 
 from time to time in Anatomy, Ph3^siology and Pathology, 
 the theories which are put forth and the new remedies 
 and modes of treataient which are continually proposed, 
 keep up a constant excitement in the profession. There 
 are no authorities [-roperly so called in Medicine. The 
 Theologian has his standard authors, who are a kind of 
 authority to which he appeals, and above all, he has the 
 BiBi.E as an unerring standard. The Lavvj-er also, has 
 his standard works, in which are embodied the princi- 
 ples of law, and they are settled authorities to which he 
 can appeal. In Medicine, on the contrary, though there 
 are works which contain the principles of the Science, 
 they have none of that fixed and undisputed authority, 
 which Standard works on other subjects are apt to have. 
 While the lawyer appeals to the '"law," and the divine 
 to the " law" and the *' testimon}^" the doctor often as- 
 sumes the right of disputing all authority, from Hypocra- 
 tes down to the present time, and this very circumstance 
 lessens the respectability of the prossession, causes doubts 
 
11 
 
 in the minds of ihe people as to the value of the Science 
 and adds to the uncertainty of the Healing Art. The 
 Physician is continually meeting with evidence of this. 
 
 And we ought not to be surprised that the great mass 
 of mankind^ should so easily and so willingly become the 
 dupes of that class of empirics, who in the present day 
 over-run the world with their Catholicons, Panaceas and 
 universal Restoratives ? Nor should we wonder, in view 
 of the admitted influence which the mind exercises over 
 the body, at the popular belief now so common, in the 
 curative effects of many of the worthless, if not pernicious 
 nostrums, so profusely sold over the whole country? 
 Paracelsus was called the Prince of Quacks, and England 
 was, but America now may be, styled the Paradise of 
 Quacks. 
 
 It has sometimes been said, that the Ph3^sician, from his 
 familiarity with scenes of distress, becomes unfeeling and 
 incapable of sympathising with others. This may be 
 true of him, if from the first he look at the sufferings of 
 his fellow men, only as a source of profit to himself. If 
 he at the out-set enthrones this perfectly selfish and 
 therefore hardening princi[)le in his bosom, he will of 
 course become devoid of sympathy and benevolence. But 
 if he does not this strange violence to his natural feel- 
 ings, but lets them flow out as he goes forth on his daily 
 errands of relief and mercy to the rich and the poor, and 
 especially, if he be faithful to the poor, who can give him 
 nothing but their blessings and their prayers, his sympa- 
 th}^ and kindness will be drawm out under such a variety 
 of circumstances, that they will become more active, in- 
 stead of blunted and repressed. True, he will not have 
 that mawkish sensibility, which vents itself in tears and 
 mere expression of sympathy, but stops short of action. If 
 ever he had any such romantic aud unpractical sensibili- 
 ty, he has cast it off in his actual service in the field of 
 benevolence into which his profession has necessarily led 
 hira. He has learned over and over the lesson of active 
 
12 
 
 sympathy. He has learned it often under circumstances 
 of discouragement and sometimes without even the show 
 of gratitude being offered to him. He has learned, (lam 
 glad to say, and 1 say it with some pleasing recollections,) 
 with signs of gratitude in his patients which are not to be 
 mistaken He may appear to the casual observer to have 
 merged the feelings of the man in those of the physician 
 — to have surrendered his humanity to the cold and stern 
 demands of science. He may appear to be devoid of 
 sympathy, as he goes to work mid scenes of suffering 
 without a sigh, performing his duties with an unblanched 
 face, a cool and collected air, and a steady hand, w^hile 
 all arounil are full of fear and trembling and pity. Yet, 
 there is sympathy in his bosom, but it is active; it vents it- 
 self in the right way, in action. There is feeling there — 
 it is not destroyed, but its manifestations are under con- 
 trol. It is from this povyer of control which he has ac- 
 quired, that the Physician or Surgeon may appear to 
 others to be without feeling, even when a tide of emotion 
 may be pressing his heart almost to bursting, because he 
 knows that a valuable life is hanging upon those very 
 exertions, which he is making with all the seeming cool- 
 ness of indifference. Before the moment of action ar- 
 rives, his emotions are often oppressive, more so than 
 those of the by slanders ; for he knows all the difficulties 
 and dangers of the case, and sees the point which should 
 excite anxiety. Watch him while preparing for a serious 
 operation. Though he may appear to the careless ob- 
 server perfectly cool and undisturbed, you may see in his 
 unguarded moments a betrayal of the strong under current 
 of feeling, which he endeavors to conceal. The occasion- 
 al sigh, followed perhaps by an incidental remark to a by- 
 stander, as a diversion to his feelings — the slightly tremb- 
 ling hand, as he busies himself in making his prepara- 
 tions, thus findmg relief to the pressure of the excitement 
 within, by external acts, some of them perhaps needless — 
 
13 
 
 these and other signs show it — and these signs may ap- 
 pear up to the last moment of delay. But the instant he 
 begins the operation, they are gone. The hand may 
 tremble, till the knife touches the flesh and the blood be- 
 gins to flow — then it becomes firm and steady, for his 
 feelings have found relief in action. Feeling may and 
 does resume its hold when the action ceases, and if the 
 action ends in relief, it manifests itself in a joyful and 
 triumphant sympathy. It is the conquest which the Phy- 
 sician obtains over his nervous susceptibility and this 
 seeming indifference to the sufferings of others, that has 
 given rise to the erroneous impression, that the practice 
 of Medicine and Surgery necessarily subjects the heart 
 to a hardening process. But it is evident to all reflecting 
 minds, that while he is acquiring this self control, his 
 sympathy with suff*ering is becoming deeper and livelier, 
 the oftener it is called into action. 
 
 The relation which the Physician sustains to the com- 
 munity, is a peculiar one ; no other man has so free ac- 
 cess to so many families among all classes of society ; 
 he is admitted into the very bosom of the families, upon 
 which be attends ; so much is this case, that most per- 
 sons have the feeling that their Physician is a sort of 
 confident, and on that ground they are willing that he 
 should see and hear, in his daily intercourse with them, 
 what would be improper to be seen and heard, without 
 the confidence of intimate friendship ; and when that 
 confidence is abused, how gross the abuse, and how keen- 
 l}' is it felt by those, who have, as a matter of necessity, 
 reposed that confidence ! I say necessit}', for the very 
 nature of the intercourse of the Physician with his pa- 
 tients is such, as to make this confidence necessary ; and 
 the necessity is recognized by both parties. 
 
 I do not refer now, merely to the secrets, which, either 
 from choice or necessity, are so often confided to the 
 Medical man by his patients ; but, I refer to the confi- 
 
14 
 
 1 
 
 dential character which marks his whole intercourse with 
 therri, extending to all those little nameless acts which 
 make up that intercourse. He enters the dwelling of the 
 sick, as if he were one of the family ; and the very office 
 he is to perform, disarms all formality, and pre-supposes 
 intercourse of the most familiar character. The patient 
 is to speak to him, not of a foreign subject, not of some 
 one else, but of himself, of his own body, and that too 
 with sufficient minuteness to communicate an adequate 
 knowledge of his case. In doing this, he calTs into exer- 
 cise not only the scientific acumen of the Physician, but, 
 mingled with this, the sympathy of the confidential friend. 
 
 Sustaining then as the physician does, so intimate a 
 relationship to his patients, his opportunities for influen- 
 cing those around blm must be greater than falls to the 
 lot of those who occupy commanding stations in society. 
 Every man has more influence in his own little commu 
 nity at home by his fire-side, than he has abroad in the 
 great community around him. Familiarity, mutual confi- 
 dence and sympathy are the obvious causes of this ; and 
 the Physician may be said to be at home ever}' where 
 by everybody's fireside ; in the mansion and in the cottage, 
 in the garnished chamber of the wealthy, and in the hum- 
 ble garret of the poor. 
 
 It is a matter of every day's occurrence that he should 
 be at home in all these varied scenes, and he acquires a 
 tact in accomodating himself to them, and to the endless 
 diversity of character which they present. Wherever he 
 goes he enters the family circle. He is received ordina- 
 rily without any preparation and at any hour when ne. 
 cessity calls for it. He sees his patients, too, in every 
 variety of situation, and in just those circumstances cal- 
 culated to develope character. He sees them in their 
 unguarded moments and when sufferings and trials of 
 every variety are acting upon them as tests, searching 
 and sure. He sees much that glitters before the world, 
 
15 
 
 become the merest dross in the sick chamber — and he 
 sees too the gold shining bright in the crucible of afflic- 
 tion. He sees human passion in ever}' form — implacable 
 hatred and love stronger than death ; fallen virtue, and 
 virtue tried ; and proud mental and moral strength ; and 
 childish imbecility in the once mighty and great — every 
 feeling, or passion, or quality, or condition, that can be 
 imagined, in ever}^ possible variet}'^ of phase and degree, 
 is displayed to his view. But it is in the sick room especial- 
 ly, that the influence of the Physician is chiefly felt; 
 here he treads upon sacred ground and has to do with 
 the issues of life and death; here he sees man in the 
 weakness of his humanity, "crushed before the moth,*^ but 
 often too, in the strength of his immortality. Here he is 
 made a witness of the frailty of the tenement, which the 
 immortal spirit inhabits. He has communion with the 
 spirit in its most momentous hours ; while it sees the walls 
 of its habitation crumbling into dust, and lingers about the 
 ruins before its final flight into a world either of light or 
 darkness, of jo}' or of woe. 
 
 A great responsibilit}' rests upon the Physician. — 
 He is often called on to minister relief, where no human 
 skill can avail ; he is looked to, in the dark hours of af- 
 fliction, with confident hope by the friends of the sufferer, 
 when alas 1 hope is cut off, and he is conscious of his own 
 inability to meet their requirements. This, to one of be- 
 nevolent feelings, is a severe trial ; it is under such cir- 
 cumstances, that the Physician becomes practically ac- 
 quainted with the uncertainty of his art, and the insuffi 
 ciency of human efforts. How important then, that he 
 should exercise that severe discipline over himself, which 
 enables him to perform all the varied duties pertaining 
 to his intercourse with his fellow^man, with a due re- 
 gard to their feelings and to the honor of the profession. 
 
 Having performed the task assigned me, Mr. President, 
 imperfectly I know, allow me to express the hope, that 
 
16 
 
 the effort which has been made to place the Medical Pro- 
 fession in this State, on its proper footing, will not be 
 relaxed ; but that renewed and unremitted exertions will 
 be continued, until the Medical Society of North Caroli- 
 na shall haye enrolled on its list of members, all who re- 
 gard its honor and its interests. That, at these annual 
 meetings, we may, by the interchange of acts of courtesy 
 and kindness, draw more closely the bonds of friendship 
 which should unite us; and as we are conscious of the 
 uncertainty of our calling and the solemn responsibility 
 resting on us, we shall endeavor by every means in our 
 power, to rescue our profession from the obloquy which 
 surrounds it.