Skip to main content

Full text of "Transactions of the Medical Association of the State of Alabama"

See other formats


Google 



This is a digital copy of a book that was preserved for generations on Hbrary shelves before it was carefully scanned by Google as part of a project 

to make the world's books discoverable online. 

It has survived long enough for the copyright to expire and the book to enter the public domain. A public domain book is one that was never subject 

to copyright or whose legal copyright term has expired. Whether a book is in the public domain may vary country to country. Public domain books 

are our gateways to the past, representing a wealth of history, culture and knowledge that's often difficult to discover. 

Marks, notations and other maiginalia present in the original volume will appear in this file - a reminder of this book's long journey from the 

publisher to a library and finally to you. 

Usage guidelines 

Google is proud to partner with libraries to digitize public domain materials and make them widely accessible. Public domain books belong to the 
public and we are merely their custodians. Nevertheless, this work is expensive, so in order to keep providing this resource, we liave taken steps to 
prevent abuse by commercial parties, including placing technical restrictions on automated querying. 
We also ask that you: 

+ Make non-commercial use of the files We designed Google Book Search for use by individuals, and we request that you use these files for 
personal, non-commercial purposes. 

+ Refrain fivm automated querying Do not send automated queries of any sort to Google's system: If you are conducting research on machine 
translation, optical character recognition or other areas where access to a large amount of text is helpful, please contact us. We encourage the 
use of public domain materials for these purposes and may be able to help. 

+ Maintain attributionTht GoogXt "watermark" you see on each file is essential for informing people about this project and helping them find 
additional materials through Google Book Search. Please do not remove it. 

+ Keep it legal Whatever your use, remember that you are responsible for ensuring that what you are doing is legal. Do not assume that just 
because we believe a book is in the public domain for users in the United States, that the work is also in the public domain for users in other 
countries. Whether a book is still in copyright varies from country to country, and we can't offer guidance on whether any specific use of 
any specific book is allowed. Please do not assume that a book's appearance in Google Book Search means it can be used in any manner 
anywhere in the world. Copyright infringement liabili^ can be quite severe. 

About Google Book Search 

Google's mission is to organize the world's information and to make it universally accessible and useful. Google Book Search helps readers 
discover the world's books while helping authors and publishers reach new audiences. You can search through the full text of this book on the web 

at |http : //books . google . com/| 






/S \ -^ V-' -: . . 



I 1 



TRANSACTIONS 



OF THB 



MEDICAL ASSOCIATION 



OF THB 



STATE OF ALABAMA. 



^ 



THE STATE BOARD OF HEALTH 



ORGANIZED 1B47-SESSION 1889. 



IMIOlSTTO-OlS^rEJE^Tr, -A.nailj 9-12, 1889. 



• «» * 



MONTGOMERY, ALABAMA : 

THB BBOWN FRIMTINO CO., 8TATB PRINTBR8, BINDBBS & ^TATIOKSBS. ! " * * 

1889. 



* • * • • • • 



TO NEV; YORK 

PUBLIC LIBRARY 

133388A 

ASTOR, LENOX AND 

TILDEN roCNDATlONS 

a 10«4 L 






. - • • • • 



» • • • • , 

■ • • 






« ' t 



COMMITTEE OF PUBLICATION. 



Thomas Albxavdbb Mbans, M. D., Montgomery. 
RiCHABD Fbabbb Michbl, M. D., Montgomery, 
Bbnjamin Jambs Baldwin, M. D., Montgomery, 



Thomas A. Mbans, M. D., Chairman, 



The Minutes of the Proceedings 



OF THJB 



MEDICAL ASSOCIATION 



OF THB 



STATE OF ALABAMA. 



THE MINUTES OF THE PROCEEDINGS. 

SESSION OF 1889. 



THE PEOCEEDINGS OF THE FIRST DAT. 
Mobile, Tuesday, Apbil 9. 

The Association assembled in Temperance Hall at 10 
o'clock, A. M., Tuesday, April 9, 1889. 

The following Counsellors, Delegates, Health OflScers, mem- 
bers of county societies, and visiting physicians from other 
States, appeared and registered : 

GRAND SENIOB GOUNBELLOBS : 

Abebnethy, William Henry, Birmingham, Jefferson county. 
Baldridoe, Milton Columbus, Huntsville, Madison county. 
Cochran, Jerome, Mobile, Mobile county. 
FuRNiss, John Perkins, Selma, Dallas county. 
Godfrey, James Myers, Sumterville, Sumter county. 
Jackson, Walter Clarke, Montgomery, Montgomery county. 
Ketchum, George Augustus, Mobile, Mobile county. 
McKiTTRicK, Adam Alexander, Evergreen, Conecuh county. 
Means, Thomas Alexander, Montgomery, Montgomery county. 
Reese, Augustus Jordan, Mobile, Mobile county. 
Sanders, William Henry, Mobile, Mobile county. 
Sears, John William, Birmingham, Jefferson county. 
Sbelte, Samuel Dibble, Montgomery, Montgomery county. 
Starr, Lucius Ernest, Camden, Wilcox county. 
Weatherly, Job Sobieski, Montgomery, Montgomery county. 

SENIOR COUNSELLORS. 

Cross, Benjamin Franklin, Decatur, Morgan county. 
DuBosE, Wilds Scott, Columbiana, Shelby county. 
Fletcher, Richard Mathew, Madison, Madison county. 
Franklin, Charlks Higgs, Union Springs, Bullock county. 
Gaines, Vivian Pendleton, Mobile, Mobile county, 
Goodwin, Joseph Anderson, Jasper, Walker county. 



8 ALABAMA STATE MEDICAL ASSOCIATION. 

Hill, Samuel Hsnby, Oarrolltoiiy Pickens county. 
Jay, A.NDRBW, Evergreen, Conecuh county. 
Phillips, William Cbawford, Selma, Dallas county. 
Sholl, Edward Henry, Birmingham, Jefferson county. 
Slbdge, William Henry, Livingston, Sumter county. 
Smith, Daniel Edoarly, Mobile, Mobile county. 
Stovall, Andrew McAdams, Jasper, Walker county. 
Thetpord, William Fletcher, Talladega, Talladega county. 
Thomas, Jambs Gray, Mobile, Mobilt* county. 
Ward, Henry Bascom, Cuba, Sumter county. 

.TUNIOB OOUNSELLOBS. 

Baldwin, Benjamin James, Montgomery, Montgomery county. 

BiNFORD, Peter, Somerville, Morgan county. 

Brago, Shirley, Lowndesboro, Lowndes county. 

Hill, Luther Lbonidab, Montgomery, Montgomery county. 

HuoQiNs, Jacob, Newberne, Hale county. 

Inge, Henry Tutwiler, Mobile, Mobile county. 

Jones, John Culbreth Hezekiah, Fairfield P. 0., Stone, Pickens 

county. 
Kbndrick, Joel Beder, Greenville, Butler county. 
McWhorter, Abbott Milton, Gaylesville, Cherokee county. 
Wheeler, William Camp, Cherokee, Colbert county. 
Whelan, Charles, Birmingham, Jefferson county. 
Wilkinson, James Anthony, Flomaton, Escambia county. 

DELEGATES. 

Autauga County Medical Society — E. A. King, Autaugaville ; James 
E. Wilkinson, Prattville. 

Baldwin County Medical Society — ^Edwin Lesley Marechal, Stockton ; 
Joseph Dunlap Trammell, Bay Minette. 

Bibb County Medical Society — Frederick Fannin Gage, Briarfield. 

Bullock County Medical Society — Henry Mitchell Hunter, Union 
Springs. 

Butler County Medical Society— Charles Alston Thigpen, Greenville. 

Calhoun County Medical Society — John M. Crook, Jacksonville; 
John C. LeGrand, Anniston. 

Chambers County Medical Society — William Henry Hudson ; Charles 
Franklin Perry, La Fayette. 

Cherokee County Medical Society — Thomas N. White, Spring Garden. 

Choctaw County Medical Society — Daniel McCall, DeSotoville. 

Clarke County Medical Society — Henry Greorge Davis, Gainestown. 

Conecuh County Medical Society^Hugh Thomas Fountain, Burnt 
Com. 



DELEGATES. 9 

Covington County Medical Society— William J. Head, Andalnsia. 

Crenshaw County Medical Society— Joseph Robert Horn, Luverne; 
Felix M. T. Tankersly, Argus. 

Cullman County Medical Society — M. L. Johnson, Cullman. 

Dallas County Medical Society — James Marion Donald, Marion 
Junction ; Samuel Gilbert Gay, Selma. 

DeKalb County Medical Society — Andrew J. Vann, Collinsville. 

Elmore County Medical Society — James Knox Rushing, Tallassee. 

Escambia County Medical Society— James L. Bass; Stephen Cary 
Henderson, Bre^/ton. 

Etowah County Medical Society — Daniel Harris Baker, Gadsden; 
John Pope Stewart, Attalla. 

Fayette County Medical Society— John Harvey Duncan, Fayette 
Court House. • 

Geneva County Medical Society — Thomas Jefferson Ward, Geneva. 
• Hale County Medical Society — William McNeil Wedge worth, New- 
beme. 

Jackson County Medical Society — Andrew Boyd, Scottsboro. 

Jefferson County Medical Society — Edward Powell Riggs; B. Leon 
Wyman, Birmingham. 

Lamar County Medical Society — Dixie D. Hollis, Sulligent. 

Lauderdale County Medical Society — Perry Isaac Price, Florence. 

Lowndes County Medical Society — Charles Taliaferro Weatherly, 
Benton. 

Macon County Medical Society — William Buchanan Arbery, Nota- 
sulga. 

Madison County Medical Society— Charles A. Robinson, Huntsville. 

Marengo County Medical Society — Charles B. Thomas, McKinley; 
Charles Boaz Whitfield, Demopolis. 

Mobile County Medical Society — Charles A. Mohr; William Barnes- 
more Pape, Mobile. 

Monroe County Medical Society — ^William Wallace McMillan, Mon- 
roeville. 

Montgomery County Medical Society — Glenn Andrews ; George Wil- 
kins McDade, Montgomery. 

Morgan County Medical Society — Howell B. Gwin, Decatur. 

Perry County Medical Society— Charles A. Wilkerson, Marion. 

Russell County Medical Society — Zachary William Williams, Glenn- 
ville. 

St. Clair County Medical Society— Oliver M. Steadham, Easonville. 

Sumter County Medical Society — Mathew Bunyan Cameron, Sumter- 
ville; John McKenzie Henson, Coatopa. 

Talladega County Medical Society— Barklay Wallace Tool, Talladega. 

Tuscaloosa County Medical Society— Eugene DuBose Bondurant; 
Frank Hemdon Sims, Tuscaloosa. 



10 ALABAMA STATE MEDICAL ASSOCIATION. 

Winston County Medical Society — Thomas P. Deweese, Nauvoo, 
Walker county. 

Forty-two county societies, represented by fifty-seven dele- 
gates. 

The counties of Barbour, Blount, Chilton, Clay, Cleburne, 
Coffee, Colbert, Coosa, Dale, Franklin, Henry, Lawrence, Lee, 
Limestone, Marion, Marshall, Pickens, Pike, Randolph, 
Shelby, Tallapoosa, Walker, Washington and Wilcox, sent in 
their reports, but failed in representation. 

The following Health Officers were present : 

Baldwin county — Edward Lesley Marechal, Stockton. 
Choctaw county — Robert Bryant Carr, Pushmataha. 
Jackson county — Andrew Boyd, Scottsboro. 
Jefferson county — John Calhoun Dozier, Birmingham. 
Lowndes county — Shirley Bragg, Lowndesboro. 
Mobile county — ^Thomas S. Scales, Mobile. 
Monroe county — William Wallace McMillan, Monroeville. 
Sumter county — William Henry Sledge, Livingston. 

MEMBERS OF COUNTY SOCIETIES VISITING. 

Clarke county — Benjamin Shields Barnes, Suggsville ; George Wash- 
ington Files, Gosport. 

Choctaw county — William F. Kimbrough, Bladen Springs. 

Jefferson county — William Locrke Chew, RuflRn Coleman, John D. 8. 
Davis, William E. B. Davis, Robert T. Jones, Thomas J. Nixon, 
Birmingham; James C. Curry, Bessemer; Edward Parish Lacy, 
Dolomite ; Thomas Jefferson Brown, Russell McWhorter Cunning- 
ham, John Frederick Huey, Pratt Mines. 

Mobile county — Angelo Festorazzi, James Jefferson Henderson, Henry 
P. Hirshfeld, Samuel Holt Hodgson, James F. Heustis, William 
Jackson, Charles LeBaron, SaTJuel Rutherford Oliphant, Calvin N. 
Owen, Dudley Crawford Randle. 

Montgomery county — John Howard Blue, Montgomery, 

Morgan county — James Enoch Conyngton, Decatur. 

Sumter county — Alexander Menzes Garber, Ijivingston. 



I FRATERNAL MESSENGERS. 



Dr. Landon B. Edwards, of Richmond, secretary of the 
Medical Society of Virginia, and Morris J. Thompson, of Meri- 
dian, delegate from the Mississippi State Medicial Association, 



SUMMARY. 11 

were officially recognized and offered the privileges of the 
floor and debate. 

Mr. Richard Hines, Jr., city editor of the Mobile Register 
and special correspondent of the New Orleans Picayune, and 
Mr. James W. Sharpe, special correspondent of the New Or- 
leans Times-Democrat, were present and received the nsual 
courtesies due them as representatives of the press. 

SUMMABT. 

Grand Senior Counsellors 15 

Senior Oounsellors 16 

Junior Counsellors 12 

Delegates 67 

Health Officers 7 

Members of County Societies and others visiting 24 

Visitors from other States and representatives of the 

Press 4 

Total 136 

George Augustus Ketchum, of Mobile; Edward Henry 
Shell, of Birmingham ; Samuel Dibble Seelye, Job Sobieski 
Weatherly, of Montgomery, ex- presidents; Benjamin Franklin 
Cross, of Decatur; Richard Mathew Fletcher, of Madison; 
James Myers Godfrey, of Sumterville; Lucius Ernest Starr, 
of Camden, ex-vice presidents, were present, and were accorded 
the honors due them. 

There were present of the Board of Censors and Committee 
of Public Health, Drs. Jerome Cochran (Senior Censor), 
Charles Higgs Franklin, George Augustus Ketchum, William 
Henry Sanders, Samuel Dibble Seelye, Job Sobieski Weath- 
erly. 

The Association was called to order by the President, Dr. 
Milton Columbus Baldridge, of Huntsville, at 12 o'clock, noon, 
and opened with prayer by the Rev. J. R. Burgett, D. D., of 
the Government Street Presbyterian Church. 

After which the Hon. Joseph C. Rich, Mayor, on behalf of 
the city and citizens of Mobile, delivered the following — 



12 ALABAMA STATE MEDICAL ASSOCIATION. 

ADDRESS OF WELOOMB. 

Mr, President, and Gentlemen of the State Medical Association : 

I am here to-day on behalf of the people of Mobile to welcome you to 
their city and its homes. I greet you as the worthy representatives of 
a noble calling, as the faithful friends and zealous guardians of public 
interest, and as members of an organization that has accomplished 
great good for the people of Alabama. The organization of the State 
Medical Association was an event of no small importance in the history 
of the State ; and its growth and progress have been watched with in- 
creasing interest and pride. You have organized the best brain of the 
State in the important labor of providing greater security and better 
protection to a people often threatened and sometimes sorely afflicted 
by pestilence and disease. You have stimulated the individual mem- 
bers of your honorable profession to new endeavor in the great science 
of medicine ; you have made more capable and accomplished physicians 
in every community of a State that h <s at all times been justly pruud 
of its medical representatives, and, better than all, you ere fast making 
it impossible for incapable and incompetent men to thrust themselves 
upon the people, or to bring discredit upon you and your high calling. 
In doing this you have ri ndered the people a service the value of 
which cannot be over-estimated; and it has been an unselfish labor 
that is appreciated and will not be forgotten. The record of the State 
Medical Association is a monument to the splendid talents, and to the 
patient industry and honest toil of the physicians of Alabama. You 
have met and overcome difficulties at every step in your progress. 
Unaided, and often without encouragement, you have kept on until 
you have made the Association what we behold it to-day : an organized 
army of science and progress, ceaseless in its vigilance, and tireless in 
its efforts to promote and advance the best interest of a great common- 
wealth. These splendid results are all the more creditable to you, be- 
cause accomplished at the expense of your personal and private in- 
terests. Notwithstanding the fact that the life of the physician is one 
of peculiar hardship and incessant toil, they have always been ready 
and have always found time to answer every call of public duty. In 
time of war and peace alike, the same ready response has been made 
upon the stricken fields of the South ; in the lonely hospitals of pain, 
with the sick and the wounded ; in the homes of our fair southern 
cities that have been made desolate so many times in the past ; in every 
relation, public and private, the conduct of the physician has been 
characterized by so much of heroic courage and loving kindness as to 
ensure to him and his brothers a hearty welcome in every grateful 
community in i the land. These splendid services, performed with 
such courage and fidelity, give to you a passport of friendship and a 
letter of introduction that we recognize with infinite pleasure. We 



ADDRESS OF WELCOME. 13 

esteem your coming an honor to our city, and we sincerely trust that 
we may be able to contribute something to this occasion that may 
make it one memorable in its pleasure to you. I speak no mere words 
of ceremony and formality when I say that you are welcome to Mobile 
and its hospitable homes. 

Dr. T. S. Scales, president of the Mobile Connty Medical 
Society, then welcomed the association on behalf of that 
society in the following language : 

Mr, Prendentf and Gentlemen of the 

Medical Association of the State of Alahama : 

Upon me, as president of the Mobile County Medical Society, de- 
volves the honored but embarrassing duty of extending to you, on 
behalf of said society, a cordial welcome. 

You are here assembled, some from sections of the State represent- 
ing mineral wealth, others from the rich agricultural fields, and others 
from pine forests whose long needles will, at no distant day, point to 
untold wealth. Here assembled you meet still others representing — 
what? Our quiet city by the gulf, a city noted for her elegant fishing 
grounds, her extensive oyster beds, her beautiful shell drive skirting 
our bay and bordered with gigantic magnolias, festooned with 
Spanish moss ; a city noted for the hospitality of her men, and, last but 
not least, the beauty of her women. 

You are here fr>r the purpose of labor ; and yet to properly perform 
labor, there is required a time for refreshment and rest, and it is our 
purpose to be with you during this time of refreshment, when it will 
be our endeavor to have you join us in devouring some of the former 
occupants of our briny deep, to have you test the elegant flavor of our 
oysters, drive down our shell road and feel the invigorating influence 
of the gentle zephyrs from the gulf — ^in various ways experience the 
hospitality of our men and also behold the beauty of our women. I 
say it will be our endeavor, failing in which it is sincerely hoped that 
the failure will be attributed to no lack of motive on our part, but to 
means completely beyond our control. 

Yes, you are here in the cause of labor. There is a law on our 
statute book, enacted doubtless through your wise influence, for the 
regulation of the practice of medicine in the state, and yet there are in 
this city those engaged in the practice of medicine in open violation of 
the contemplated provisions of this law ; evidently there is some defect 
and it rests with you to remedy this defect. 

There is a law in our statute book to provide for the supervision of 
the public health and for the collection of vital statistics in the various 
counties of the state, enacted through your wise counsels, and yet in 



14 ALABAMA STATE MEDICAL ASSOCIATION. 

this county, so far, this law is a failure. It is for you, with the assist- 
ance of the Mobile Medical Society, to remedy this failure. 

There is a law for the regulation of quarantine, and it remains for 
your influence to have this law so amended as to abolish all useless 
and abominable — as well as disgraceful — shot-gun quarantines. 

By virtue of my membership in the Mobile County Medical Society, 
I am also a member of your honorable body, humble though it be, but 
not for one moment would I have it inferred from the preceding remarks 
that I proposed to map out a line of work for you in the future ; not at 
all, but simply to dwell upon the fact that you have work before you, 
and to demonstrate how ill-becoming on my part it would be to con- 
sume further of your valuable time. Therefore, in conclusion, gentle- 
men, allow me again, in the name of your fair daughter, Mobilia, to 
bid you welcome 1 welcome I thrice welcome I to her home, and to wish 
you God-speed in the performance of your laborious duties. 



THE ANNUAL MESSAGE OF THE PRESIDENT, 

Milton Columbus Baldhidge. M. D., Huntsville, 

Grand Senior Gouneellor of the Medical Association of the State of 

Alabama. 



OenUemen of the Medical Association 

of the State of Alahama : 

Again we are permitted by an Allwiee-Providence to assem- 
ble in this oar twenty-first annual session, in order to review 
the work of the past year, consult together, and formulate 
plans for future operations. Representing as we do, every 
portion of our great and growing state from the rocked ribbed 
mountains on the north, replete with verdure and mineral 
wealth, to the gulf city on the south, the gateway of commerce 
to the state, and our emporium of medical learning. The cor- 
dial clasp of fraternal hands and the cheerful smile of mutual 
greeting is marred by the sad reflection that all are not here. 
Death, the common heritage of our race, has been at work in 
our midst, claiming for its victims several of our honored and 
cherished members, one of whom was the orator-elect for this 
occasion, Brice Martin Hughes, of Birmingham, a young man 
of culture and acknowledged ability, whose career of useful- 
cess was commensurate with his short and brilliant profes- 
sional life. James Young, of Decatur, who fell heroically 
contesting the advance of the pestilence in that city, a martyr 
to his trust and an ornament to the profession. Lucky Walker 
Jenkins, health oflBcer of Wilcox county, and Mortimer Harvey 
Jordan, of Birmingham, one of the oldest official members of 
this Association, having been elected Counsellor in 1873, Presi- 
dent in 1884, and was a member of the Board of Censors at 
the time of his death. He was exemplary in deportment, a 
physician of renown, full of honors, and a prestige worthy of 



16 ALABAMA STATE MEDICAL ASSOCIATION. 

emulation. These all died in the faithfnl discharge of profes- 
sional duty. Their names are transferred to the Boll of the 
Dead. We fondly cherish their memory while they rest from 
their labors. 

A careful survey of Association work for the past year will 
reveal the fact, that in some departments, success has attended 
effort with gratifying results, while in others but little progress 
has been made. 

Early in the year an earnest appeal was made to the officers 
of the county societies throughout the state, through our vice- 
presidents, touching the perfection of their organization and 
the details of their work as formulated in our Book of the Kules. 
Enough has been elicited to encourage us, while at the same 
time we are constrained to confess that in some portions of 
the state at least, our expectations have fallen short. In some 
of the counties the work, when done at all, was exceedingly 
imperfect and unsatisfactory for various reasons, which will 
be assigned in the reports of the vice-presidents. 

The present magnitude of our state organization, the co- 
ordinant relation which the several departments sustain one to 
the other, and the present enlistment of several county socie- 
ties into our ranks hitherto undrilled in the importance and 
details of the work, may be fitly compared to an army of 
veterans and recruits legally commissioned for defensive war- 
fare and aggressive movement, engaged in the grand work of 
combatting with disease and death, while at the same time 
their causes are being thoroughly studied in relation to nature 
and prevention. 

At no period in the history of the healing art has advance- 
ment all along the line of medicine been so great, nor does 
any medical organization in all of its details equal this of ours 
in the state of Alabama. And why should we not today in- 
dulge in a spirit of esprit de corps^ take fresh courage in this 
good hour and go forth " conquering and to conquer." 

During the year our organic law was threatened from differ- 
ent parts of the state, by the introduction of sundry bills into 
the general assembly of the state, whose features were as ob- 
jectionable as their tendency was dangerous. 



ANNUAL MESSAGE OF TEE PRESIDENT. 17 

The first bill provided that graduates of the Mobile Medical 
College be admitted to practice in the state without examina- 
tion, for reasons clearly set forth in the petition. 

While that noble institution honored at home and respected 
abroad is jnstly entitled to onr patronage and praise, and while 
its graduates acquit themselves before our boards of ex- 
aminers as creditably as graduates hailing from other medical 
institutions, yet it is obvious that any special legislation look- 
ing to class exemption or local preferment, would be in open 
conflict with the spirit of our constitution, and would serve as 
an entering wedge to the disruption of all our laws to regulate 
the practice of medicine. 

We could not afford by implication to lower the standard, 
and minify the capacity of an institution which is an honor to 
the state and the pride of this Association. A more formida- 
ble bill, and one which was far reaching in its objects, was in 
effect to repeal the law which provides for the examination of 
all medical graduates by our boards of examiners; and was 
presented in the shape of an amendment to section 1298 of 
the Code to regulate the practice of medicine in the state. 
The passage of this bill would have utterly destroyed the 
foundation of our progressive system, and relegated us to a 
forlorn position in the dead past. 

The workings of this law for the last six years has not only 
given satisfaction to the laity at large, but has elevated the 
professional status of our medical men to a much higher plane; 
has created a laudable ambition among us for improvement in 
medical research and appliances, and has proclaimed to the 
world that our successors must be equal, if not superior, to 
ourselves. 

After a conference with the Senior Censor, it was deemed 

expedient to express our opposition to the bills through the 

public press, and by personal appeal to the members of the 

general assembly through physicians in the several counties. 

The effort proved to be entirely successful, for such bills as 

found their way to the committee-room were killed, and the 

others, for fear of a similar fate, were withheld. This being 
2 



18 ALABAMA STATE MEDICAL ASSOCIATION. 

the second attempt which has been made in the general as- 
sembly of the state to circumvent or annul our fundamental 
laws, and each time having met with overwhelming opposition 
and consequent defeat, we may confidently rest assured that at 
least the law to regulate the practice of medicine in the state 
of Alabama is a statutory fixture. And it is no less gratifying 
to know that our initiative position in this vastly important 
matter has met with general approbation throughout the entire 
country, and several of the states have enacted similar laws. 
The law is not only growing in popularity where it has been 
in operation, but the courts have passed upon its constitu- 
tionality in the main, an instance of which recently occurred 
in a decision of the supreme court of the United States in the 
case of Dent against the state of West Virginia, aflirming the 
decision of the supreme court of the state, requiring practi- 
tioners of medicine to secure certificates from the state boards 
of medical examiners, certifying to the standing and reputa- 
tion of the medical colleges granting the diplomas. 

The early outbreak of yellow fever last spring in Florida, 
when announced by our state health oflScer, necessarily gave 
rise to much uneasiness on the part of all concerned. No time 
was lost in adopting every precaution to prevent its advance 
and prevalence in this state ; but in spite of the vigilance of 
the health officer and an early enforcement of the laws to regu- 
late the practice of quarantine, in the month of September it 
made its appearance in the city of Decatur. 

The disastrous effects of the epidemic have a national 
notoriety, while a detailed account of its introduction, progress, 
prevalence and duration, as furnished by the state health 
officer, will suggest to this body matters of vital importance 
now at the close of what many medical men claim to be an ex- 
ceedingly favorable winter for the hybernation and early out- 
break of yellow fever in that and probably other points in the 
state. 

The most important matter for your consideration in this 
connection is that of prevention, which necessarily opens up 
the vexed question of 



ANNUAL MESSAGE OF THE PRESIDENT. 19 

QUABANTINE. 

A painful experience in the northern part of the state last 
fall, growing out of the irrational, inhumane and expensive 
system of local and state quarantine instituted and conducted, 
as it was for the most part by municipal authorities, was not 
in keeping with the spirit of the law to regulate the practice 
of quarantine, as formulated by our state board of health. 
Neither did it give confidence or security to the public. But 
it ignored our constituted head and authority, the state health 
officer, by only according the right to advise, when that advice 
comported with their individual views or local interests. 
The system as it related to railroads, transportation and travel, 
was, in effect, a grand farce. Subjecting the roads to enor- 
mous expense and delay, while travelers from healthy localities 
absolutely uninfected, were often ejected from trains and mer- 
cilessly detained at miserable quarantine stations to do penance 
for municipal caprice, or, as was the case in some instances, 
left by the wayside to suffer and die, all for the want of a 
uniform system of quarantine, properly established and con- 
ducted by a committee of medical experts from the state with 
plenary powers, and backed by a sufficient amount of money 
to carry into operation all necessary quarantine measures. It 
is impracticable for a quarantine officer to manage the details 
of a state quarantine, since he must be present to direct in an in- 
fected place, rather than visit and supervise other places unin- 
fected ; hence the necessity for more than one to successfully 
manage this important and responsible trust. Our county 
boards of health, invaluable as they may be for local purposes 
in case of an invasion of small-pox, or an outbreak of diptheria 
or scarlet fever, are quite powerless for good during the preva- 
lence of yellow fever or cholera, for the reason that their 
functions end with their advice, and that is often disregarded. 
Three- conditions are indispensably necessary to a successful 
quarantine: medical authority, state support, and a uniform 
system of enforcement ; for medical experts are more familiar 
with the conditions, time and details than laymen. They are 
not likely to be influenced by nervous or frightened indi- 



20 ALABAMA STATE MEDICAL ASSOCIATION. 

yiduals, to a precipitate action on the one hand, or delay the 
discharge of duty because of commercial greed on the other. 
This authority should be sufficiently backed financially by the 
state with such appropriations, economically used, as might be 
necessary to meet actual expense consequent upon treatment, 
nursing, feeding, fumigating and disinfecting, thereby pre- 
venting unauthorized solicitations for aid from other states, 
the useless expenditure of money in many instances, and pre> 
serve the dignity of the state as well. 

Again, it should be uniformly conducted in order to com- 
mand confidence and respect. A quarantine advised and par- 
tially controlled by a county board of health in one part of the 
state, while in the other part it is restricted to railroad surveil- 
lance, and often an incompetent inspection of travelers' pass- 
ports, and in another locality sho^gun protection is presumed 
to be the only means of safety to the community. Thus it is 
'^ confusion worse confounded," and the epidemic drags its 
weary length along until material for subsistence is exhausted, 
or a change in temperature stops its ravages. Since yellow 
fever has hitherto been regarded as an exotic, subject to im- 
portation to our shores by means of vessels from foreign ports 
of infection, it is well for the general government to exer- 
cise exclusive control in all matters pertaining to international 
quarantine, the inspection of ports of entry, the detention of 
vessels, and the prevention, if possible, of fresh importations 
to our shores. Should, however, the pestilence evade mari- 
time regulations and find a lodgment in the interior so as to 
assume formidable proportions, then federal co-operation will 
become necessary and be invoked. 

In extending the study of prevention, we are necessarily 
brought to the investigation of the subject of 

PUBLIC SANriATION. 

This theme, though somewhat trite among us, like the 
gospel of Divine truth to which it is closely allied, for " clean- 
liness is akin to godliness," commands our respect, and de- 
mands our careful study. If Moses, the first sanitary officer 



ANNUAL MESSAGE OF THE PRESIDENT. 21 

more than three thousand years ago, was required by Divine 
authority to enforce sanitary laws to promote the health and 
happiness of a people whose posterity were to inhabit the 
globe, is it any the less important now, in this cosmopolitan 
age, with its teeming millions eager for wealth, health and hap- 
piness, to observe and practice such methods as will be con- 
ducive to that end ; nay, more, is it not our duty as a state 
board of health, composed as it is of local boards in every 
county in the state, to amplify and popularize the laws we 
now have in force, thereby enabling us to secure the enact- 
ment of others to meet the demands of our rapidly developing 
state, with its thrifty towns and populous cities ? 

If hygienic improvement and sanitary work becomes equal 
to the demand among us, it must be accomplished by the 
united effort of health boards. In this connection, we would 
quote the language of Dr. J. S. Billings, than whom there is 
no higher authority on this subject, when he said : ^^ We are 
entirely convinced that the future of public hygiene in this 
country depends mainly upon the proper organization of state 
and local boards of health, and upon such recognition of their 
importance and utility by the people and their legislators, that 
the necessary means and powers shall be granted to them to 
enable them to properly perform their duties." 

The building up of large towns and cities by a populace im- 
patient for immediate gain, and unmindful of ulterior results ; 
the increasing facilities for rapid transit, and the unrestricted 
inter-communication of all classes from all countries, are fruit- 
ful factors in the causation of endemic diseases and infectious 
epidemics. It is well known that in the days of slavery 
phthisis was infrequent among the negroes. Now the death 
rate from that cause alone among the adults exceeds all others, 
except, perhaps, pneumonia. And this death rate is much 
greater in the towns and cities than on plantations. A solu- 
tion of the cause is doubtless due tp their defective hygienic 
surroundings, crowded habitations, badly ventilated, and gen- 
erally situated in localities subject to soil polution and defective 
drainage. The colored people are not the only sufferers, but 



22 ALABAMA STATE MEDICAL ASSOCIATION. 

the poorer classes of white people, who are forced from 
economical reasons, to occupy tenement houses in similar locali- 
ties. The state statistics for the last eight years clearly estab- 
lish the truth of these statements, and furnish to all sanitarians 
abundant food for thought. What is probably true in regard 
to the causation of the marvelous increase of phthisis among 
the negroes and working classes in tenement houses is equally 
true in regard to the spread of epidemic diseases. Such locali- 
ties furnish the pabulum necessary to the life and growth of 
infectious poisons, be they what they may. 

It is maintained on high authority that yellow fever is not 
a filth disease, and while that assumptioti is regarded as being 
true, it will not be denied that the peculiar poison of this 
disease has a striking affinity for a peculiar something which 
is the product of defective sanitation. Keep these unknown 
realities apart, and the problem of prevention is solved. In 
proof of this position we cite the fact, that yellow fever has 
been carried to and developed in some cities and towns within 
the fever line during every epidemic for twenty years, and no 
second case occurred, though hundreds doubtless were ex- 
posed; but in all such towns and cities the hygienic sur- 
roundings were good. 

Since sanitation offers so much in the prevention of yellow 
fever, an occasional visitor, it is infinitely of more importance 
when considered in relation to the prevention of other diseases 
which claim their annual victims by thousands. And in its 
application to the prevention of these do we find the widest 
possible range of usefulness and most cogent necessity for its 
practice. The science of hygiene to-day is too broad and com- 
prehensive to find expression in this message. But we must 
be content with noticing only a few important points which 
come within the purview of this state board of health, and 
refer all seekers of information on this very important subject 
to the standard treatises on public hygiene. The duties of the 
state health ofiicer are onerous, requiring hard work, much 
time, and less pay. Much has been accomplished by that officer 
during the last few years, and the success which has crowned 



ANNUAL MESSAGE OF THE PRESIDENT. 23 

his efforts, together with the ever-increasing demands for sani- 
tary attention consequent upon the building of large towns in 
our state, widens the range of operation and creates a demand 
for cooperation on the part of local boards of health. They 
should fully acquaint themselves with the growing necessities 
in each county, and be prepared to advise and instruct in all 
matters pertaining to drainage, water supply, buildings, public 
and private, in the larger towns, prisons, poor-houses, market 
houses, school houses, in regard to light, heat and ventilation ; 
last, but not least, a persistent effort should be made to enlist 
the attention and aid of county commissioners in the matter of 
reclaiming paludal lands, that their fertility and market value 
might be increased, and their malaria diminished by a thorough 
system of drainage. 

It is obvious that difiSculties will often be in the way of 
local boards of health when efforts are being made in this 
direction, by reason of conflicting opinions among the local 
authorities touching the methods and manner of sanitary work. 
The health board may suggest a certain system of sewerage 
for a town, but the authorities and property owners prefer a 
system wholly different, because of its less apparent expense and 
su£Scient for present purposes. Or, the board may recommend 
the importance of abolishing privy sinks, and possibly secure 
the enactment of a municipal ordinance to that effect. The 
law, however, is not enforced because property owners are un- 
willing to be deprived of what they regard as a private right 
and great convenience. The civil officer is at once enjoined 
and the sanitary reform is at an end. Again, a portion of 
marshy land fit for nothing but the production of malaria in 
its present condition could be made valuable by drainage, yet 
there is no legal officer to say just where and how the work 
should be done. 

In order to meet these difficulties it would be well, and I 
\tonld suggest the enactment of a law creating a sanitary en- 
gineer, whose duty it would be to make all necessary observa- 
tions and surveys for public drainage and sewerage, thereby 
securing concert of action on the part of health boards and 



24 ALABAMA STATE MEDICAL ASSOCIATION. 

local authorities, while with a comparatively small outlay of 
mouey in the beginning, incalculable benefit will be derived in 
the end. Then encceas will attend sanitary reform in its 
primary and most important sense, where hitherto in many 
localities it has proved a failure in part or altogether. The 
state has its commissioner of agriculture, immigration agent 
and state geologist, all of whom are very necessary to the 
growth and material prosperity of the state. But certainly no 
one of these, important as they are, can accomplish for the 
ultimate prosperity of the people so much as a sanitary en- 
gineer empowered by state authority and required to cooperate 
with the health boards. These suggestions, though common- 
place in appearance, we think are of vital importance to our 
material growth and prosperity. 

A liberal and intelligent system of public sanitation, faith- 
fully executed throughout the state, constitutes the basis for 
the future development of our numerical force, financial 
strength, and individual healthfulness. More sanitation and 
less quarantine will give greater immunity from disease at a 
minimum expense. The former is absolute and remunerative, 
the latter is temporary and expensive. 

If we, as a state board of health, reach the acme of expecta- 
tions in the great work of preventive medicine, we may not 
rely exclusively on annual messages, sanitary papers, and occa- 
sional circulars from health officers, but adopt other measures 
which will educate the majority of our medical men through- 
out the state in all matters pertaining to this reform. And in 
all probability the most direct and efficient means to secure 
this end would be the publication, under the auspices of this 
association, of a monthly or semi-monthly journal devoted to 
medicine, surgery, sanitation and vital statistics. There are 
about sixteen hundred physicians in the state, and of that 
number about seventy-five constitutes the average attendance 
on our annual assemblies. To this number may be added 
about twenty or thirty irregular visitors and correspondents. 
While but few of the fifteen hundred seldom, if ever, attend, 
though they are annually counted on our roster. Among this 



ANNUAL MESSAGE OF THE PRESIDENT. 25 

large number are to be foond maDj of the best practitioners in 
the state, who, for reasons best known to themselves, have not 
directly allied themselves with the association, nor are they 
fnllj acquainted with its work and aim. 

Oar Transactions compare favorably with the best in the 
land, and we are not want to find fault with them. But they 
do not contain such matter as is best adapted to the wants of the 
busy practitioner ; and, furthermore, the Transactions are only 
brought within reach of the members of the association, many 
of whom never read them, except for reference in regard to 
association work. An old political aphorism is, if you would 
have a great reformatory measure succeed, '' keep it before the 
people." And if we are to be successful in the great work in 
which we are engaged, we must keep our objects and aims 
before the medical men of the state in such a way as will at- 
tract their attention, inspire their efforts, and secure their 
cooperation. If such a monthly could be published, many 
valuable volunteer papers which do not find room in our 
Transactions, the reports of cases, the workings of county 
societies, the prevalence of diseases in different portions of the 
state, reports of county censors and health officers, sanitary im- 
provements, together with suggestions from the state health 
officer. All this would find in it a place. Thus it would be- 
come a monthly oracle of this association, widening its range 
of usefulness, strengthening its forces in every direction with- 
out detracting in the least from the legitimate matter in our 
annual Transactions. We can not afford to be derelict in this 
regard when sister states less favored are publishing one or 
more such journals whose support, in a large degree, is due to 
the patronage of Alabama physicians, and whose literature is a 
continual rebuke to the intelligence, character and ability of 
our own doctors. If it is deemed inexpedient for the associa- 
tion to publish such a journal now, then an arrangement might 
be perfected with a private enterprise, such as is being estab- 
lished at Anniston by Dr. LeGrand. 

One of the most important elements in all sanitary reforms, 
is that of vital and mortuary statistics, because these constitute 



26 ALABAMA STATE MEDICAL ASSOCIATION. 

the basis for perfect calcalations and intelligent operation. 
Sat their successful collection is a problem which must be 
solved in the future, and that solution will doubtless be found 
in educating the medical men of the state, together with the 
masses of the people, to their importance and great necessity. 
In no better way can this be done than by publishing a 
monthly medium, which will reflect the condition, wants and 
capabilities of every county in the state. While the medical 
men will become more and more familiar with the necessities 
of the hour, and by force of personal appeal, under the stimu- 
lus of of professional pride, will adjust themselves to the situa- 
tion, fall into line and press forward, shoulder to shoulder, in 
a cause they have so willingly espoused, and to the accomplish- 
ment of an end, so indispensably necessary to immediate re- 
sults and permanent success in years to come. 

In adjusting ourselves as above indicated to the increasing 
demands for intelligent advice and professional skill, we must 
not be unmindful of the fact that the great store-house of 
medical knowledge is yet full to repletion in every depart- 
ment, and from it we are required to draw daily supplies in 
order to be thoroughly furnished for every good work in the 
line of advancement in this progressive age. Having thus 
briefly and imperfectly reviewed the work of the association 
for the past year, and having suggested to you for your con- 
sideration such additional help as in our opinion would meet 
present demands and future support, we can only add that 
your zeal for good in the various departments of association 
work, which has hitherto been so abundant, should not be suf- 
fered to wax cold, nor should internal dissensions nor personal 
feuds be tolerated among us, for these only tend to weaken 
our forces, lessen our individual friendship, and destroy our 
power for usefulness as well. 

If we remain true to ourselves we have nothing to fear. 
Our object is a common object. Our interest in this great 
work are one and the same. Each and every one of us should 
discharge our whole duty in the several positions to which we 
may be called, remembering that the different departments 



ANNUAL MESSAGE OF THE PRESIDENT. 27 

require a diversity of talent and capability. Some mnet 
formulate, others must execute, and all should blend together 
in one harmonious whole, cherishing at all times a spirit of 
emulation, mingled with professional pride and a laudable 
ambition. 

Let us strive to strip ourselves of all sordid selfishness or 
pedantic bigotry ; and in brotherly love seal our devotion to 
the cause, and arm afresh for the duties and conflicts for the 
years that are to come. 

Our illustrious predecessors were wise in their day, when 
they with truth and philosophy for a basis, laid a foundation 
for the erection of the great professional structure of which 
we are to day the representatives. On us their mantles have 
fallen, and through us must be transmitted to our successors 
the principles and practices which have been evolved from that 
foundation by patience and labor. It is true our present sur- 
roundings and the necessities of to-day differ in many respects 
from those of our * predecessors. Wonderful progress in new 
fields of thought has been made, new theories have been 
adopted to which the old have given place, while the brilliant 
light of recent scientific observations has cleared away the 
misty clouds of the past, illuminates the present, and sheds its 
effulgence along the pathway of the future. Mutation is 
written upon all things mortal, and many of our cherished 
plans of operation must be abrogated by those who are to suc- 
ceed ns, and to their keeping we must confide our trust, and 
with an eye of faith behold in the distance the completion and 
grandnre of that professional structure for which we now 
labor, and in which our hopes are concentrated. 

To the younger members of the profession who are to suc- 
ceed us, we would offer a word of advice and encouragement. 
You are fairly within the vestibule of the great store-house of 
medical knowledge, founded in philosophy by the wisdom, 
experience and unremitting toil of a long line of illustri- 
ous worthies. The rich mines in which you are to delve have 
been opened up, the rubbish of passed ages has been removed, 
and it is expected that you will examine all, and select only 



28 ALABAMA STATE MEDICAL ASSOCIATION. 

the fittest with which to beautify and adorn the stractare com- 
mitted to yonr care. Let not the intellect be dwarfed by 
fanciful theories, nor yonr progress impeded by sinister motives, 
but on this alter immolate yonr time, your talents, and, if nec- 
essary, your life. By so doing you will become benefactors to 
the race, ornaments to the profession, and with the chisel of 
time, carve your names on the tablets of eternity. Then make 
haste slowly, 

" For those who would be great 
Must learn to labor and to wait." 

Gentlemen, in looking over this body I am forcibly re- 
minded that our mission of mercy and labor of love is rapidly 
winding to a close. The members of the old guard are nearly 
extinct; the last fifteen years has robbed our association of 
many familiar faces, and but few are left to honor this occa- 
sion with their presence and counsel. Many of their names 
are enrolled in the Book of the Dead. Our records show 
their abundant labors. We honored them while living, 
cherish their memory though dead, and indulge the hope that 
they enjoy the full fruition consequent upon a life so well 
spent. Some of us are now on the sunset side of life's meri- 
dian, the coming years will be fieet and few, and as life's labor 
is drawing to a close, may each of us enjoy the pleasing re- 
fiection consequent upon a life spent in usefulness, and at last 
when we must succumb to our common foe, may the great 
physician of our souls grant us an abundant entrance into the 
haven of endless rest. 

"What is the existence of man's life 
But open war or slumbered strife ; 
Where sickness to his sense presents 
The combats of the elements, 
And never feel at perfect peace 
Till death's cold hand signs his release." 



BIOGRAPHICAL SKETCH. 29 



BIOGKAPHICAL SKETCH OF DR. M. H. JORDAN, 

BY W. H. JOHNSTON, M. D., OF BIBMINGHAM, 

Grand Senior Counsellor of the Medical Association of the State of 

Alabama. 



Mobumes Habybt Jobdan was born in Jefferson conntj, 
Ala., June 10th, 1844, and died February 6th, 1889, of fibroid 
pthisis, at Birmingham, Ala. I do not propose to give a 
historj of his life, but there are some things I do wish to say 
that I knew about him. 

About fifteen years since a slender, tall, and rather delicate 
looking man came into my ofSce at Selma, Alabama, and was 
introduced to me ; that man was Mortimer Harvey Jordan ; 
that was the beginning of our acquaintance, which ripened into 
the warmest friendship. I met him year after year at the 
meetings of the State Medical Association, and the more I 
knew of him the stronger and stronger grew my attachment to 
him. During the last few years of his life I was intimately 
associated with him. I loved Jordan, and for that reason 
there is some comfort and consolation to me now to ease the 
heart by mentioning the magnificent qualities of heart and 
mind which the good Lord so abundantly bestowed upon him. 
His professional career was a continuous success throughout 
his short life. That success was due to his enthusiastic love of 
his profession. Jordan loved medicine like an ardent sports- 
man does his dog and gun, or the chase. He threw his whole 
soul into it and made it a part of his very existenpe, and then, 
in addition to his love for his profession, he had a big brain, 
sound judgment, diagnostic skill, therapeutical ability. It was 
a source of great delight to him to unravel the mysteries of a 
case which had puzzled others, and then meet successfully the 
therapeutical indications. He was the best *' all around " doc- 



30 ALABAMA STATE MEDICAL ASSOCIATION. 

tor I eveij met, not excepting any I knew in New York city. 
He had a memory that kept ready for use all that he had 
culled from books and magazines and what he had gathered 
from his own experience, and in any emergency it came to his 
relief like magic. It would often times seem as if he had just 
been devoting hours of study for that very case. Under the 
most trying circumstances his judgment was good, his brain 
cool, and that too in defiance of his having physical weakness 
to contend with. If Jordan had been as strong physically as 
he was mentally, I do not think there was anything he could 
not have attained in his profession. I never knew a man who 
was more fertile in therapeutical resources ; when one thing 
failed he was ready with another. He was a capital surgeon. 
He was one of the most skillful of obstetricians, and a first- 
class gynecologist. Jordan could have made a specialty of any 
of these branches, and obtained eminent success anywhere. 
As a lecturer in the Medical College of Mobile, with no previ- 
ous preparation, he was one of the most popular in the school. 
He could have filled a medical chair in any medical college, 
and would have had more students to attend his lectures than 
the majority of the professors. He was eminently practical, 
and stored his mind with practical facts. 

I might go on to a much more lengthy extent in writing of 
his medical ability, but from what I have already said, my 
opinion of his medical acquirements is evident to all. 

In speaking of him, aside from his profession as a man 
among men, I come to his qualities of heart, his purity, his 
sense of right. His love to his fellow man was akin to the 
Divinity that shaped his end. His generous heart and sym- 
pathetic nature drew all to him. Men and women alike loved 
him and had no word but a good one to say when his name 
was mentioned. With three years experience in and amongst 
those he practiced for, I have never heard one word condemn- 
ing him. Anything that was crooked, mean or low was left 
out when Jordan was made. His adaptability to his surround- 
ings was something extraordinary. His knowledge of men 
was almost intuitive, and he was almost invariably correct. 



BIOORAPHTCAL SKETCH. 31 

His social, genial nature won all hearts in palaces or cabins. 
He was a welcome and entertaining guest anywhere. He 
made friends wherever he went. If Jordan was not a genius, 
there are none made. He would have been an eminent suc- 
cess in any profession he might have chosen, because he had 
brain to back him, and then his love of mankind drew all to 
him. There may be more such men, but I, for one, never ex- 
pect to see his like again. His faults all leaned to virtue's 
side. It is a great pleasure to feel that you had the confi- 
dence, respect and good will of such a man. My greatest con- 
solation in being bereft of such a friend is a few words spoken 
to me a few days before his death, and they were these : 
"Johnston, you have been a solid comfort to me." 



32 ALABAMA STATE MEDICAL ASSOCIATION. 



KEPORT OF JOHN PAUL JONES, M. D., OF 

CAMDEN, 

Senior Vice-President and Junior Counsellor of the Medical Association 

of the State of Alabama. 



I submit the following report as Senior Vice-President of 
the Medical Association of the State of Alabama : 

In compliance with the duties imposed on me as vice-presi- 
dent by the rules of this association, I have, so far as possible, 
by correspondence, encouraged the attendance of members on 
the meetings of county societies, and I have urged each county 
society in my division to be represented in this association, 
and I have promoted, as far as I was able to do so, the enforce- 
ment of the health laws of the state. 

The medical society in Lowndes county is in good condition 
and has ten members. There is no opposition to the society, 
although some of the profession are not on the roll of the 
society. The society has monthly meetings and everything is 
working smoothly. Dr. Shirley Bragg is the health oflBcer, 
and deserves the commendation of the association for his 
energy and accuracy in collecting vital and mortuary statistics. 

There are twenty-five members enrolled in the Dallas 
county medical society. Monthly meetings were appointed, 
but during the busy season of the year, there was not always 
a quorum. While there was danger of yellow fever being 
brought to the county, the society met frequently, and gave 
diligent attention to quarantine and sanitary regulations. 
There have been interesting cases reported and discussed at 
their meetings. The county members though rarely attend. 
Dr. J. A. McKinnon is the county health officer, and he has 
been very diligent, systematic and successful in collecting 
vital and mortuary statistics. 



REPORT OF THE SENIOR VICE PRESIDENT. 33 

Batler county medical society has twenty-one members, bot 
ttiere is very little interest taken in the society meetings. 
The cause is probably due to the fact that the grand juries of 
that county have not indicted illegal practitioners, and those 
who fail to report births and deaths, although they have been 
furnished by members of the society with sufficient evidence 
to indict and convict the violators of the law. The county 
health officer, Dr. Job Thigpen, has done all in his power to 
collect statistics, and enforce the law. 

Bullock county medical society has a membership of twenty- 
one. The society meets on the first Tuesday in each month. 
The meetings are usually made interesting by the discussion 
of medical subjects, and the presentation of cases illustrating 
rare or occult diseases. The society, since our annual meeting, 
sustained a loss in the death of Dr. Wm. Boiling, of Fitz- 
patrick. All the doctors in the county arc members except 
three, one of whom, as reported last year, is very old and al- 
most out of the practice, and another is engrossed in farming, 
and gives but little attention to his profession. The best feel- 
ing pervades the society. Dr. K. H. Hayes is a model health 
officer. 

The Macon county medical society, as reported to me by 
letter, "has been a failure from the beginning," so far as the 
collection of vital and mortuary statistics is concerned. The 
principal cause assigned is that the physicians in Macon county 
think that the State ought to pay for the collection of statis- 
tics, and they are apathetic and indifferent. There have been 
only two meetings of the society the past year, and very little 
interest manifested in them. 

Covington county medical society perfected an organization 
before the last meeting of this association, and at that time 
applied for and obtained a charter. I have nothing encourag- 
ing to report from this county. 

There are ten members in the Autauga county medical so- 
ciety. The society has quarterly meetings, poorly attended. 
Although the vital and mortuary statistics in this county are 

not satisfactorily collected, it is not the fault of the health 
3 



34 ALABAMA STATE MEDICAL ASSOCIATION. 

oflScer, Dr. C. P. Smith, who has been very diligent in endeav- 
oring to encoarage the enforcement of their collection, bat he 
has not had the assistance and cooperation of practicing physi- 
cians and assistant health officers in the connty. 

Conecuh county medical society has a small membership. 
It numbers only seven. The members have quarterly meet- 
ings and discuss medical subjects of interest and report unusual 
cases that they may have encountered in their practice. Dr. 
A. A. McKittrick is one of the most efficient health officers in 
my division, and he has succeeded in collecting almost com- 
plete statistics in his connty. 

The Baldwin county medical society has only three members, 
and has held two meetings during the year. This society labors 
under great disadvantages, and deserves credit for keeping up 
its organization. The work of collecting vital and mortuary 
statistics has improved, due no doubt to the fact that Dr. E- 
L. Marechal induced the board of county commissioners to 
make an appropriation for the payment of the health officer's 
salary, who has great difficulty in collecting the statistics on 
account of the limited number of doctors, the extensive and 
sparsely settled territory, and defective mail facilities. 

I regret to report that in Greene county my information is 
that "there is a medical society only in name, and no health 
officer." 

There is a membership of twenty-seven in the Mobile connty 
medical society. The society meets every Saturday night, 
and there is an average attendance of twelve members. The 
society receives a weekly report of health from the health 
officer, and a monthly report is sent to each member. Con- 
sidering the fact that the commissioners court has never made 
an appropriation to pay the health officer of the county, the 
vital statistics are better collected than could be expected. 
"The society is doing fair work, and promises better results in 
the future." 

There are eleven enrolled members in the Dale county 
medical society. The society meets three times a year, with 
an average attendance of five members. The society has not 



REPORT OF THE SENIOR VICE-PRESIDENT. 35 

attained the efficiency and usefulness that it promised last 
year. The doctors in the county manifest but little interest in 
the success of the society. The health officer receives very 
meagre reports from which to make up his statistics, and his 
work is unsatisfactory. There is great room for improvement 
in the Dale county medical society. 

Henry county medical society has a membership of twelve. 
The society meets four times a year. The county is very 
large, and there are a number of illegal practitioners in it, and 
also a number of midwives in the rural districts who are un- 
favorable to the society, and they will not report to the health 
officer. Although he has endeavored to have indictments pre- 
ferred against the offenders the grand juries have failed to find 
bills. The healtli officer has labored faithfully to make his 
work a success, but the opposition and lack of assistance of 
others has prevented his doing so. 

The Monroe county medical society has eleven members, 
but there is not much life or vigor in the body. One great 
reason for this condition is the difficulty of having frequent 
meetings. It is sixty miles between the residences of the 
physicians in the northern and southern portion of the county, 
and the members being separated thus widely from each other 
have only semi annual meetmgs. There are seven physicians 
in the county who are not members of the society. There 
have been two applicants to study medicine, but no one has 
applied for examination to practice the past year. There have 
been no changes in the membership of the society. Dr. W. 
W. McMillan is the efficient health officer of this county. 

The Kussell county medical society has eight members. The 
society meets quarterly. Some of the members manifest a 
great deal of interest in their meetings. The county health 
officer has been unsuccessful in collecting vital statistics. In 
many of the beats he has failed to secure efficient assistant 
health officers. One applicant has been examined to practice 
medicine, and a certificate was granted him. The board of 
censors have been inactive and failed to perform many of the 
duties required of them. 



36 ALABAMA STATE MEDICAL ASSOCIATION. 

The Clarke county medical society has a membership of 
sixteen and is in better condition, and the members are more 
in earnest than at any time since its organization. The society 
has quarterly meetings, and papers arc prepared on medical 
subjects of interest, and discussed. Each member of the so- 
ciety makes a monthly report of vital statistics to the health 
officer. 

The Montgomery county medical society has twenty-six 
members, and meets every Saturday night, except in the 
months of July, August and September, and if necessary 
called meetings are held during these months to transact any 
business that may arise in vacation. Thirty-three regular 
meetings were held by the society in 1888. The society has 
a discussson on some subject on the first and third meeting of 
every month, and the other meetings are dovoted to the rela- 
tion of cases that occur in the daily practice of the members. 
The meetings are interesting and instructive. Dr. P. H. Owen 
is the county health officer, but I am not informed as to his 
success in collecting vital statistics. 

The county medical society of Crenshaw has eight members, 
and meets quarterly. The condition of the society is bad, and 
if there is not more interest taken in it by the members they 
will forfeit their charter. The health officer finds great diffi 
culty in collecting vital statistics. 

There are nineteen members in the Sumter county med- 
ical society, and the society meets quarterly. All of the mem- 
bers, with a few exceptions, are active workers. There are six 
physicians in the county who are not members of the society. 
The collection of vital statistics is not as complete as it should 
be, and, as the health officer, Dr. W. H. Sledge, is endeavoring 
to make it. He has not the co-operation of the assistant health 
officers, two of whom have been indicted for failure to comply 
with the law governing the collection of vital statistics. 

The Macon medical society has ten members, and in the 
language of my correspondent in this county, "the society is 
in a very bad way and apparently growing worse by degrees 
and beautifully less in every respect. It had one or two meet- 



heport of the senior vice president. 37 

ingfi all last year, and Done bo far this year. Monthly meetings 
were called bnt no qnornm attended." The health officer has 
not collected vital statistics. 

There are twelve members of the medical society of Elmore 
county. Little is done by the society except keeping np their 
dues. The meml)ers attempt to have a meeting every third 
month, but the attendance is so small that little or nothing is 
done. The health officer, Dr. O. S. Justice, has made fuller 
reports of vital statistics than has been done heretofore. 

The Washington county medical society has only four mem- 
bers. The society keeps up its organization, and meets twice 
a year. No county in the state has greater difficulties to en- 
counter in maintainiug a medical society. The county extends 
over a large area of very sparsely settled country, with bad 
roads, where there are any, and in many parts of the county 
there are no roads. The people generally are not in sympathy 
with the purposes of the society, and the obsteteric practice is 
done mostly by ignorant midwives, who will make no report 
to the county health officer, and he is therefore unable to col- 
lect accurately vital statistics. 

The Coffee county medical society has had no meeting the 
past year. The members seem to take no interest in the society. 
There has been no health officer in the county since last fall. 
Previous to that time two of the members who had been 
elected to the office removed from the county, and since then 
none of the members have been willing to undertake the du- 
ties of the office. 

The medical society of Barbour county meets quarterly. 
The average attendance is nine, and there has been more inter- 
est manifested during the past year than previous to that time. 
For two years before last December there had been no county 
health officer, but the county now has an efficient health officer. 
The society has grown by the addition of several new mem- 
bers the past year, and the outlook is healthy. 

The Dale county medical society is lukewarm, and those 
who were expected to be active workers have taken little in- 
terest in its advancement. The health officer has made almost 
a failure in the collection of vital and mortuary statistics. 



38 ALABAMA STATE MEDICAL ASSOCIATION. 

Perry county medical society meets in April and October. 
The members are not enthusiastic in society work or interest. 
The average attendance at the meetings is fine. The health 
officer has fairly good success in his efforts to collect vital 
statistics. 

The Marengo county medical society meets regularly twice 
a year. The majority of the members manifest a decided in- 
terest, and they have occasional called meetings. Out of a 
membership of thirteen, ten or twelve attend all the meetings. 
The county health officer is thoroughgoing and efficient in his 
labors. 

The Geneva county medical society meets bi-ennially ; av- 
erage attendance four ; very little interest is manifested. 
Since the removal of Dr. Hilliard from the county the health 
officer has had but poor success in collecting vital statistics. 

The Pike county medical society has held the past year four 
regular meetings, and three called meetings. Recently the 
society proposed to meet monthly. The members are benefited 
by interchange of thoaght and experience at their meetings, 
and a better feeling exists in the society than there has been 
for years. Dr. P. H. Brown makes an efficient health officer. 

The medical society of Escambia county is living, but has 
but little vitality. The society has met once in the past year, 
with an attendance of four members. The county health 
officer, however, has had moderate success in collecting sta- 
tistics. 

The Lee county medical society has not met this year. The 
health officer has done almost nothing in the discharge of his 
duties. Recently some effort has been made to revive the so- 
ciety, but with what success I am unable to report. 

The Wilcox county medical society has had two meetings 
during the past year. Very few of the members take any 
Interest in the society. The society has lost one of its best 
members in the death of Dr. L. W. Jenkins. The present 
health officer. Dr. R. Kilpatrick, is doing his best to collect 
the statistics. 

I regret to state that I can make no report of the medical 



n^POM OP TtrE SPmOR VlCS-PRMStDENf. 39 

society of Ohoctaw. I have written repeatedly to members 
of this society, bnt I have received no reply. 

With this exception, the members of the profession in my 
division have famished me the information which has enabled 
me to make this report, and I take this occasion to retnrn my 
thanks to those who have replied to letters of inquiry that I 
have addressed them since the last meeting of this associa- 
tion. 



40 ALABAMA STATE MEDICAL ASSOCIATION. 



REPORT OF BENJAMIN FRANKLIN CROSS, M. D., 

OF DECATUR, 

Junior Vice-President and Senior Counsellor of the Medical Associa- 
tion of the State of Alabama. 



As Junior Vice-President of the Medical Association of tlie 
States of Alabama, I beg leave to state that owing to the con- 
dition in which I was placed, being cut off from all communi- 
cation for three months on account of the epidemic of yellow 
fever in Decatur, I have had but short time to work ; but, as 
soon as possible, I placed mjself in correspondence with the 
presidents, secretaries, and other members of the county socie 
ties of the department assigned to me, composed of the follow 
ing counties : Bibb, Blount, Colbert, Cleburne, Clay, Coosa 
Cherokee, Calhoun, Chambers, Cullman, DeKalb, Etowah 
Fayette, Franklin, Jackson, Jefferson, Lauderdale, Lamar 
Lawrence, Limestone, Madison, Morgan, Marion, Marshall 
Pickens, Randolph, St. Clair, Tallapoosa, Tuscaloosa, Shelby 
Walker and Winston. 

From a goodly number of these counties I have received 
encouraging reports, but I regret to say that many of them 
have not honored me with a reply. 

Coosa county society has a membership of twelve (12), with 
a prospect of an early increase. During the past year there 
have been four meetings, with a good average attendance. 
From information received, I think there has been considerable 
improvement over the past year. The society has never pros- 
pered or come up to the standard, but as greater effort is now 
being made, with more interest than heretofore, the outlook 
for improvement is fair. The health officer's salary having 
been raised from $25 to $100, he is encouraged to labor more 
zealously in the collection of vital and mortuary statistics. 



KEPORT OF THE JUNIOR VICE-PRESIDENT. 41 

The Colbert county society has, heretofore, done little, if 
EDything, to advance its interests. No increase of niember- 
ship, with a general state of apathy. But for the past year 
there seems to be more interest, and considerable work has been 
done in trying to get the society in good working order, the 
fruits of which have shown themselves in the last twelve 
months. The society has met regularly and the attendance iu> 
creases at each meeting. At their last meeting thirteen mem- 
bers were present, with more interest manifested than ever 
before. The greatest drawback is the ineflSciency of the health 
ofScer, who has not been doing his duty, but recently is im- 
proving, and it is to be hoped that, in the way of collecting 
vital and mortuary statistics, he will do better in future. His 
salary is $100. The membership now is thirteen, with a prospect 
of three more at the next meeting. It is the intention of the 
board of censors to hold monthly meetings. Very little 
attention is paid to public sanitation. 

Lawrence county society, according to my information, is, I 
regret to state, doing but little good. The society does not 
seem to be taking that interest that should inspire them. At 
present there is only a nominal president who has no time to 
look after it. The health o£Bcer seems to take some interest 
and would do fairly well if more interest was taken by the 
society as a whole. 

The Jackson county society has improved in its condition in 
the past year. It met quarterly last year with but little at- 
tendance, but this year they meet monthly, with more interest 
and a far better attendance. Vital and mortuary statistics 
have been poorly collected because of inefficiency and inac- 
tivity on the part of the health officer. The present health 
officer is doing good work and the collection of statistics is 
greatly improved, and we may safely say that Jackson county 
has brighter prospects. Membership 16 ; public sanitation re- 
ceiving due attention. 

The Limestone county society is doing little more than keep- 
ing up its organization. The society never meets except under 
pressure of business on the part of the censors for examination. 



42 ALABAMA J^tATE MEbTCAL A&SOClATlOlt. 

At present the office of president is vacant, bnt I learn from 
the health officer that the annnal report has been made, and 
that the monthly reports were not prompt, which was due to a 
lack of co-operation on the part of some of the best officers. 

My information from Marshall county society is that it has 
been in a languishing condition for the past year. Each meet- 
ing is characterized by the utmost indifference on the part of 
members; none are fully attended, and at the last they failed 
to have a quorum. The health officer deserves some credit for 
his repeated and untiring efforts in trying to keep up the or- 
ganization. He collects vital and mortuary statistics fairly 
well, considering the meagre amount of encouragement re- 
ceived. The commissioners being insufficiently informed as 
to his duties refuse to allow him a salary ; they do not regard 
his labors worth remuneration, nevertheless he continues his 
work as health officer and president, and is doing the best that 
he can. 

Pickens county medical society was granted a charter at 
Eufaula in 1878. This society, so far as I can learn, is doing 
nothing. With a membership of fourteen they can sel- 
dom get a quorum. There was a meeting in March for the 
purpose of reorganizing, with but four members present; 
however, it is to be hoped that since the election of their new 
president the society will throw off its sluggishness and attain 
to a more healthy state. The health officer has endeavored to 
perform his duty faithfully, though he has had considerable 
trouble in getting beat reports. I have no information as to 
the amount of his salary. 

The working condition of the Blount county society, as 
reported to me, is quite ordinary. The meetings have been 
irregular, with but small attendance. The health officer renders 
efficient service; public sanitation has received but little 
thought. The society meets four times a year with a mem- 
bership of fifteen, and is barely holding its own ; a few men 
do the work. There is some selfishness and much carelessness 
among the members. 

DeKalb county medical society has a small membership of 



REPORT OP TtiE JVNlon \^ICE-PRESlt)Eltf. 43 

seven, but seems to be in good working order. They meet 
regularly every quarter, with a fair attendance, interesting 
meetings, and a prospect of addition to their number in the 
near future. The health officer makes his monthly and annual 
reports promptly; his salary is $100. 

Bandolph county society is not doing the work that it should. 
They have not held a meeting this year, although there is a 
membership of eighteen. All interest seems to have left 
them and everything comes to a stand-still. With so many 
members it is reasonable to suppose that a spark of enthusiasm 
could be aroused, and it is to be hoped that they will awaken to a 
sense of their duty. I can say nothing as to the eflSciency of 
the health officer, but learn that he makes his monthly reports 
without remuneration. 

Winston county medical society was chartered one year ago. 
Since then quarterly meetings have been held with a good at- 
tendance. • The outlook for this society is encouraging, and it 
is to be hoped that it will enjoy a bright future. The member- 
ship is six. The health officer is using his utmost endeavors to 
make the society a success ; he has only been reporting since 
November, and, as yet, has not been allowed anything for his 
services. 

Lamar county society is making haste slowly towards any ad- 
vancement. It held only one poorly attended meeting during 
the past year. The health officer, so far as I can learn, is doing 
fairly well, considering his salary, which is only twenty-five dol- 
lars. 

Marion county society was organized a year ago. Considering 
the length of time it has been in existence it is in a good work- 
ing condition. Meetings held regularly every quarter and are 
spicy and interesting. Membership twelve or fifteen. The 
health officer is efficient in the discharge of his duty, with a 
small salary. No information as to the sanitary condition of 
the county. 

St. Clair county society has been recently improved. The 
membership has increased, the working condition excels that 
of last year, and everything is indicative of a more auspicious 



44 ALABAMA STATE MEDICAL ASSOCIATION. 

future. With a membership of twelve the society meets twice 
a year and much interest is manifested. The health oflScer 
has been efficient. His salary was raised from $10 to $20, 
with a promise of more ; hope he will get it. 

The working condition of Morgan county has been much 
improved and is very nearly if not up to the standard. It 
numbers 27 members, and applications for membership are 
on file which will give the society several valuable accessions. 
Meetings are held regularly every month, and are well at- 
tended ; at which time essays are read and important cases 
reported and discussed. At no time in the history of the or- 
ganization has it been so prosperous and full of encouragement ; 
the entire membership is acti^^ and zealous, imd manifests 
much interest in all things pertaining to the advancement and 
dignity of the profession in the county. The health officer has 
tried to do his duty. Public sanitation has received much at- 
tention, particularly in the city of Decatur. The Waring sys- 
tem of drainage, admitted by experts to be the most perfect 
and efficient, has been adopted and will soon be in operation . 
Many of the streets have been graded and macadamized, old 
buildings have been renovated, back alleys thoroughly cleansed, 
and all bedding and bed-clothing used by the sick during the 
prevalence of yellow fever last summer burned. In this con- 
nection I will be excused for a personal reference to four mem- 
bers of the Morgan county society, honored and faithful 
brethren, and my immediate co-laborers, who fell at their post 
of duty during the recent epidemic. No worthier or truer 
men than William C. Gill, William B. Elack, William J. 
Young, and R. V. Williams have been stricken from the ros- 
tra of membership of a medical society or removed from the 
walks of life. After weary weeks of unceasing labors and 
deep solicitude for the welfare of others, each in his turn was 
cat down by the relentless disease. Honored and esteemed by 
all who enjoyed their acquaintance, side by side they sleep in 
"the city of the 3ead." But their virtues and good deeds will 
live in the memories of those for whom they lived and labored 
and died long after the granite shafts at their graves shall have 
crumbled into nothingness. 



REPORT OF THE JUNIOR VICE-PRESIDENT. 45 

Jefferson conntj society is the largest in the state, and is in 
a good working condition. Their meetings are held bi- 
monthly, at which time an essayist is appointed and great in- 
terest is manifested. The society is very prosperous, perhaps, 
some improvement over last year. The present membership 
is about 63, with prospects of an increase, though some were 
recently dropped from the roll. The health officer is doing 
good and efficient work and comes up to the standard with his 
reports. I am not informed as to the amonnt of his salary, but 
think he is fairly well remunerated. The matter of sanitation 
has received proper and strict attention. 

Tlie Madison county society, I am glad to report, is in a 
more hcalthfnl condition than ever before. The member- 
ship is twenty-fonr, and more interest is taken in the 
workings of the society. They have made every effort 
in their power to induce all the physicians in the county to 
interest themselves but, as in every county, there are some 
who are willing to shirk duty by offering any excuse that will 
give them exemption from responsibility. However, all the 
physicians in Huntsville are members and attend the meetings 
well. They meet regularly each month, at which time essays 
are read and cases related and discussed. The health officer is 
not as yet experienced in the duties of his office, having had 
charge of it only nine months of the j)ast year, yet he has 
done his duty well. He has gotten his beat officers interested 
in the matter of collecting statistics, and he bids fair to have 
the county well organized and his subsequent reports up to the 
standard. He makes reports regularly as required by law, and 
is an efficient and active officer. More attention than ever be- 
fore has been given to public sanitation. They are endeavor- 
ing to discharge fully their duty as a county board of health. 
The commissioners recognize this fact and seem to attach more 
importance to their work than generally. The proper relation 
between the society as a board of health and of the board of 
commissioners has been established, and tlie latter board has 
cheerfully furnished the health officer with all the necessary 
books and registers required by him and his beat officers. The 



46 ALABAMA STATE MEDICAL ASSOCIATION. 

salary of the health officer for the present year is fixed at $200 
by the board of commissioners, and the probate judge has re- 
quired him to give the necessary bond for the faithful per- 
formance of his duties. Their board of censors is very 
efficient and discharge their duty earnestly and well, especially 
in reference to public sanitation and the enforcement of the 
law to regulate the practice of medicine. This is a law that 
our state association should define more clearly to the several 
county commissioners. The board of censors meets concur- 
rently with the society and makes full reports of all its doings. 

The Tallapoosa society seems to be in a flourishing condi- 
tion. Much more interest is manifested than during last year, 
and they have decided to hold their meetings every two months 
instead of quarterly as heretofore. Membership about the 
same as last year. The health ofiicer does good work, is faith- 
ful in the collection of statistics, and receives $100. Little 
attention is paid to public sanitation. 

The following counties did not honor me with a corres- 
pondence, viz : Calhoun, Clay, Chambers, Cherokee, Cleburne, 
Cullman, Bibb, Etowah, Fayette, Franklin, Lauderdale, Tus- 
caloosa, Shelby, and Walker. 

I have no direct information from either of the above named 
counties, but from what I can gather I think that they are 
about on a par with their condition of last year. As already 
stated, I have not been able to collect all the necessary data for 
a full and satisfactory report, but enough has been brought 
out to show the necessity of continued energy on the part of 
all concerned, and the importance of edncating the people up 
to a higher standard in all matters pertaining to state medi- 
cine. The county societies should select their best and most 
efficient men for health officers ; those who are in strict sym- 
pathy with the workings of the state association, for such men 
will spare no time, means, or money to aid the furtherance of 
our cause, to magnify our association till it has reached that 
degree of excellence attained by no other state. 



THE REVISION OF THE MINUTES. 47 



THE REVISION OF THE MINUTES OF THE SES- 

SION OF 1888. 

Under the head of the revision of the minntes the Senior 
Censor stated that while there were a goodly number of minor 
errors in the minntes of the previous session, there were none 
of safficient consequence to require formal correction. 



48 ALABAMA STATE MEDICAL ASSOCIATION. 



THE ELEVENTH ANNUAL REPORT OF THE 

SECRETARY. 



JUr. President: 

The State Board of Censors, at the Montgomery session last 
year, recohn mended the adoption of an amendment to the 
ordinance in relation to the publishing committee, and defin- 
ing more specifically its duties. A part of said ordinance 
makes it my duty, as secretary of the association, to deposit 
promptly in the library of the state board of health, all ex- 
changes, books and papers received through this office. In 
obedience thereto, I beg to present the following report. 

Respectfully, 

T. A. Means, M. D., 

Secretary. 

EXCIIANCiES RECKIVED BY THE STATE BOARD OF UEALTH DURING THE 

YEAR 1888. 



California; Tentli Bl-ennial Report of the State Roard of Health, 
*86-8S, 2 copies. 

Georgia; Atlanta Medical and Surjjical Journal, '88-89. 

Indiana; Sixth Annual Report of the State Board of Health, '87. 

Iowa ; Fourth Bi-cnnial Report of the State Board of Health, '87. 

Kentucky; Procee<lin^8 of the Stat^ B ard of Health, '88. 

lyouisiana; Bi-ennial Report of the Board of Health, '86-7. 

New Hampshire; Report of the State Board of Health, '88; Transac- 
tions of the State Medical Society, '88. 

New York; Eighth Annual Report of the State Board of Health, '88. 

Maine; Third Annual Report of the State Board of Health, '87. 

Maryland ; Transactions of the Medical and Ghirurgical Society, '88. 

Massachusetts; Nineteenth Annual Report of the State Board of 
Health, '87. 

Michigan; Transactions of the State Medical Association, '88. 

Missouri ; Transactions of the State Medical Association, '88. 

Ohio; First Annual Report of the State Board of Health, '88. 



THE REPORT OF THE SECRETARY. 49 

Pennsylvania ; Transactions of the Medical Society, '87 ; Second An- 
nual Report of the State Board of Health and Vital Statistics of 
the Commonwealth, '86. 

Texas; Daniels MedicalJonmal, '88*9. 

Virginia; Virginia Medical Monthly, '88. 

Wisconsin ; Annual Report of the State Board of Health, '87 ; Tran- 
. sactions of the State Medical Society, '88. 

The loose and informal way in which members of county 
societies have heretofore received their appointments as dele* 
gates, creates, yearly, confusion in the records. This can be 
remedied with very little trouble. To prevent the possibility 
of mistakes, I repeat my instructions of last year : 

First. — Every appointee should apply to the secretary of his local 
society for a certificate of appointment before leaving home. 

Second. — Immediately after arriving at the place of meeting he should 
see the treasurer, present to him his credentials, pay his dues as dele- 
gate, together with those of his society, if any, taking receipts for the 
same, then show these to the supervisor of the register, who will in- 
struct him how to enter his name, with the county he represents, place 
of residence, date of signature and official position. 

Of the fifty county societies to which copies of the Trans- 
actions were sent, receipts for forty-one copies only were re- 
turned to me. Neglect of so simple a matter forces upon the 
secretary of the association the necessity of an extensive cor- 
respondence in search of missing books, or copies not receipted 
for. To prevent this in future, postals will follow each pack- 
age, notifying secretaries of local societies, that shipment has 
been made, and requesting receipts for them as soon as they 
are received. 

The Rolls and Records, — The book of the rolls remains yet 
incomplete, and is due to no neglect of mine. Annual notices 
and personal appeals have been made to counsellors, but they 
either fail to appreciate the importance of such entries, or 
they are unmindful of their obligations as counsellors. We 
hope better things in the future. 

The Book of Portraits has had but one addition the past 

year, making fifty-five out of the seventy-one entitled to its 
4 



60 ALABAMA STATE MEDICAL ASSOCIATION, 

benefits. Of the grand senior connsellorB, but one remains 
unfilled. • 

There have died of the House of Oonnselors since the open- 
ing of the Book of the Dead, Drs. Edward Armistead Semple 
of Montgomery, 1877; Edward M. Yassar of Cahaba, 1879 ; 
William Horatio Thornton, of Eufaula, 1881 ; Paul De Lacy 
Baker of Eufaula, 1883 ; Edmond Henry Fournier, Edmund 
Pendleton Gaines, and Francis Armstrong Boss of Mobile, 
1884 ; William Thomas McAllister of Marion, Clifford Daniel 
Parke of Selma, 1886 ; William Henry Anderson of Mobile, 
Hobart Cobbs Dugger of Yan Dorn, George Ernest Eumpe of 
Leighton, 1887; Benjamin Hogan Biggs of Selma, 1888 ; Mor- 
timer Harvey Jordan of Birmingham, and George Calvin Kor- 
ris of Wadsworth, 1889. In few instances, no biographies 
could be obtained of deceased counsellors ; otherwise, this book 
is complete. 

The plan inaugurated some years or more since, of sending 
out to secretaries of county societies blank forms to aid them 
in making up their returns, still remains a partial success. I 
am pleased to note, however, decided improvement in every 
detail of these reports. The expense is trifling ; the reward 
priceless to me. 

The charters granted the counties of Covington, Geneva, 
Marion and Winston, upon the recommendation of the Board 
of Censors and approved by the Association at the Mont- 
gomery session, complete the census of counties in the State. 
To each of these charters were executed in due form and sent 
to their respective secretaries early after the close of the ses- 
sion. 

Transcript copies of so much of the president's address as 
relates to the deaths of Drs. William Henry Anderson of Mo- 
bile; Hobart Cobbs Dugger of Yan Dorn; George Ernest 
KumpS of Leighton, and Benjamin Hogan Biggs of Selma, 
were sent to the families of the deceased, as ordered by the 
Association at the Montgomery session. 

On the 9th day of March of the present year, I made requi- 
sition of the Southern Passenger Association of Atlanta, for 



THE REPORT OF THE SECRETARY. 51 

one hondred and eightj-fonr (184) blank forms for secnring 
cheap rates, and distributed one hundred and seventy (170), 
npon application, to counsellors, delegates and others, leaving 
a balance on hand for future use. 

CORRESPONDENCE. 

Mabbaghubbtts Mbdical Socibty. 

At a meeting of the counselors held October 3, 1888, the following re- 
solves were nnanimously adopted : 

That in the opinion of the counselors of the Massachusetts Medical 
Society the present epidemic of yellow fever, in several States of this 
Union, has again made evident the imperative need ot some organiza- 
tion on the part of the general government for the protection of the 
public health — ^an organization that shall be independent of existing 
bureaus, and solely devoted to this most necessary function of any form 
of government. 

That this resolution be sent to the president of the United States, to 
members of Congress, and to the boards of health of the several states. 
Attest : 

Francis W. Goss, 
Recording Secretary, 

Roxbury, Mass., October 3, 1888. 

I have had printed for the use of the Association : 

100 Certificates, form 2 $ 3 00 

600 Envelopes 2 00 

500 Labels 2 00 

500 Return blanks 2 00 

200 Postal cards 2 00 

200 Shipping heads 11 00 

1500 Three-page circulars, 1889 00 

1000 Letter heads, secretary 4 60 

Total $35 50 

March Ist, of this year, I distributed 1500 copies of the fol- 
lowing circular : 



2 ALABAMA STATE MEDICAL ASSOCIATION. 

THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA. 

No8 EHam Speravimus Meliora, 

Office of thb Segrbtary, 
MoNTQOMSBY, ALABAMA, March 1, 1889. 

The Annual Session of the Medical Association of the State of Ala- 
bamai for the current year, will be held in the city of Mobile, com- 
mencing on the Second Tuesday in April (9th )» at 12 o'clock, noon, and 
will continue four days. 

DUTIES of county SOCIETIES. 

Every County Medical Society is required by the constitution of the 
Association, to send to every Annual Session, two (2) delegates to rep- 
resent its interest and wishes, together with the annual fee of one dol- 
lar for every one of its members, not a Counsellor or a Delegate. Mem- 
bers paying this fee will receive each one copy of the Transactions in 
return . 

Every County Medical Society is also required, by the Constitution 
and Ordinances of the Association, to send up an annual report in rela- 
tion to current status and work ; said report to contain the following 
items of information : 

First — ^The revised Register of the County Societies, and the practi- 
tioners of the county, who are not members of the Society. 

Second, — A full account of the work of the Society, number of meet- 
ings held, average attendance, papers read, etc. 

Third, — An account of the work done by the Board of Censors — as 
censors — as a Board of Medical Examiners and as a Committee of Pub- 
lic Health. 

Heretofore many — indeed a large majority of these reports — ^have 
been made out in a very perfunctory and unsatisfactory way. It is 
therefore hoped that more care will he taken hereafter to have them full and 
accurate t especially as to the recording otfull names with date and col- 
lege of graduation, and date and county from which certificates were 
received. Upon the death of a member, the date and college of gradu- 
ations ; date of death and the disease of which he died, should be accu- 
rately given in a foot note in each report, together with a brief sketch of 
his life and labors. All reports in any way defective will be returned 
for correction and amendment. 

In the revision of the four rolls, which is the special order of business 
for the last day of the session, county medical societies that have been 
greatly derelict in the discharge of their duties, under the Constitution of 
the Association and laws of the state, will be liable to censure and depri- 
vation of charter ; and all counsellors who have failed to pay their annual 
dues, or who have failed to attend three successive meetings ^of the As« 



THE REPORT OF THE SECRETARY. 58 

sociation, will be dropped from the college of counsellors. All counsel- 
lors of five (5) years standing, who have not already done so, are earn- 
estly requested to furnish cabinet size photographs of themselves for 
insertion in the Book of Portraits. 

VITAL STATISTICS. 

The administration of the law for the collection of vital statistics and 
the supervision of the public health, in the several counties of the state, 
has imposed upon the Association important and difficult duties ; and 
in order that these duties may be properly discussed and understood, 
it is desirable that the approaching session of the Association should be 
numerously attended. It is, therefore hoped — (1). That every counsel- 
lor will consider it a duty and privilege to be at his post. (2) That 
every county society will come up to the full measure of its constitu- 
tional obligations by sending its full complement of delegates. To 
secure this, it is suggested that each society should provide for the pay- 
ment of a part, or the whole of the expenses of a delegate. 
Regular reports will be submitted on the following subjects, viz : 
(1.) W. E. B. Davis, M. D., Birmingham — Electricity in Gynechol- 

ogy. 

(2) Richard M. Fletcher, M. D., Madison — Eclampsia Gravidarum. 

(3) Vivian P. Gaines, M. D., Mobile — Curability and Treatment of 

Pulmonary Phthisis. 

(4) Thomas J. Johnson, M. D., Decatur — ^Fever: Its Etiology and 

its Relation to Increased Temperature. 

(5) Thomas J. Lee, M. D., Childersburg — Diagnosis and Treatment 

of Uterine Displacements. 

(6) William M. Price, M. D., Florence — Cerebro-Spinal Meningitis. 

(7) E. Powell Riggs, M. D., Birmingham— Dysmenorrhcea : Its 

Causes and Treatment. 

(8) E. Camp Wheeler, M. D., Cherokee — ^Dentition. 

THB OMNIBUS DISCUSSION. 

The attention of members is called to the fact that the plan of the Om- 
nibus Discussion has been changed, sa that the discussion will be based 
on the volunteer papers that may be presented. These papers will be 
read in the order in which they are presented to the secretary, and 
each one will be submitted for discussion as soon as it is read. 

BXPOBTS IN BKLATION TO DISEASES 

Prevalent in the several counties of the state are specially solicited, 
and it is hoped that every member will avail himself of the discussion 
following them. 

It is of the greatest importance that every society should be repre- 
sented in every meeting of the association, and it is earnestiy hoped 



64 ALABAMA STATE MEDICAL ASSOCIATION. 

that none of the societies will fail to make such arrangements as will 
render their representation certain. 

It is proposed that on the evening of the second day of the session, 
there shall be a discassion of the ways and means best calculated to 
secure the successful administration of the laws to regulate the practice 
of medicine, and the laws of the state. To this end, the fullest possible 
attendance of members of the county boards, and county health officers, 
and assistant health officers, is earnestly requested. 

Note — First. Each delegate or member desiring the excursion rate 
must purchase a first-class ticket— either limited or unlimited — from 
point of departure, for which he will pay the regular fare ; and upon 
request, the ticket agent will issue a printed certificate of purchase. 

Second. If through tickets can not be procured at the starting i>oint, 
parties will purchase to the point where such through tickets can be 
obtained and re-purchased through to place of meeting. 

Third. Tickets for the return journey will be sold by the ticket 
agents at the place of meeting, at one-third the highest limited fare, 
only to those holding certificates signed by the ticket agent at point 
where through ticket to place of meeting was purchased and counter- 
signed by the Secretary of the association, certifying that the holder 
has been in attendance at the meeting. 

T. A. Mbans, M. D., 

Secretary. 



REPORT OF THE POBLlSBINO COMMITTEE. 55 



THE Ainif UAL REPORT OF THE PUBUSHING 

COMMITTEE. 



Mr. President: 

The publishing committee beg to present the following special ancT 
circamstantial report of its labors ander section 12 of the ordinance 
defining more in detail its duties : 

There were published of the transactions for 1888 one thousand copies 
at a cost of — 

Printing $879 37 

Binding 200 00 

Postage, packing and shipping 22 00— $1,101 37 

There were printed for distribution at the Mont- 
gomery session 2000 order of business, at a cost of 17 00 

Total expenses of publishing committee $1,118 37 

Of the one thousand copies of the Transactions there were distributed — 

To county societies 530 

counsellors 188 

delegates 100 

correspondents 9 

exchanges — ^associations 8 

societies 16 

state boards of health 6 

medical journals 6 

federal government 7 

state government 5 

Alabama State Board of Health 125 

other sources 1 

Total 1000 

CLASSIFIED LIST OF BXCHANQBS. 

American Medical Association, California State Medical Association, 
Colorado State Board of Health, Connecticut State Medical Society, 
Delaware Medical Society, Florida Medical Society, Georgia State Medi- 
cal Association, Illinois State Board of Health, Indiana State Board of 
Health, Iowa State Board of Health, Louisiana State Board of Health, 



56 ALABAMA STATE MEDICAL ASSOCIATION. 

Maine Medical Society, Massachusetts Medical Society, Michigan State 
Board of Health, Minnesota State Medical Society, Mississippi State 
Medical Association, Missouri State Medical Association, New Hamp- 
shire State Medical Society, New Jersey State Medical Society, New 
\ork State Medical Society, Ohio State Medical Society, Oregon State 
Medical Society, Pennsylvania Medical Society, Rhode Island Medical 
Society, South Carolina State Medical Association, Tennessee State 
Medical Society, Texas State Medical Society, Virginia State Medical 
Association, Wisconsin State Medical Society. 

MEDICAL JOUBNALS. 

Atlanta Medical and Surgical Journal, Cleveland Medical Gazette, 
New Orleans Medical Journal, Practice; Texas Medical Journal, Medi- 
cal Record. 

The publishing committee do not think it adds to the merits of the 
Transactions to have printed in them a long list of unimportant matter, 
and medical journals of little value. They, therefore, respectfully sug- 
gest that only the names of state societies and other organizations 
exchanging with us be hereafter printed in the Transactions. 
Respectfully submitted, 

T. A. Means, M. D., 
E. F. Michel, M. D. 
B. J. Baldwin, 

Publishing Committee. 



THE REPORT OF THE TREASURER. 67 



THE ANNUAL KEPORT OF THE TREASURER. 



Walter Clark Jackson, M. D., Treasurer, 

In account with the Medical Association of the State of Alabama, 

from April 10th, 1887, to April 9tb, 18S8. 

TO DUBS FROM COUNSELORS. 

Abernethy, William Henry, Bell's Landing $ 10 00 

Baldridge, Milton Columbus, Huntsville 1000 

Baldwin, Benjamin James, Montgomery 10 00 

Barclay, James Paxton, Eutaw 10 00 

Bragg, Shirley, Lowndesboro 10 00 

Brockway, Dudley Samuel, Livingston 10 00 

Brown, Pugh H., Troy 10 00 

Bryce, Peter, Tuscaloosa 10 00 

Cason, Davis Elmore, Ashville 10 00 

Gross, Benjamin Franklin, Decatur 10 00 

Cochran, Jerome, Mobile 10 00 

Darby, John Isaac, Columbia 10 00 

Dement, John Jefferson, Huntsville « 10 00 

DuBose, Wilds Scott, Columbiana 10 00 

Emory, Aurelius Grigsby, Opelika 10 00 

Fletcher, Richard Mathew, Madison Station 10 00 

Franklin, Charles Higgs, Union Springs 10 00 

Fumiss, John Perkins, Selma 10 00 

Gaines, Vivian Pendleton, Mobile 10 00 

Gaston, John Brown, Montgomery. . / 10 00 

Godfrey, James Myers, Sumterville 10 00 

Goggans, James Adrian, Alexander City 10 00 

Goodwin, Albert, Eufaula 10 00 

Goodwin, Joseph Anderson, Jasper 10 00 

Hays, Robert Hughes, Union Springs 10 00 

Heacock, John William, Alpine 10 00 

Herbert, Curtis Burke, Greenville 10 00 

Hill, Samuel Henry, Carrollton 10 00 

Hogan, Samuel Mardis, Union Springs 10 00 

Hendrick, Gustavus, Brundidge 10 00 

Hoffman, John Richardson, Athens 10 00 



68 ALABAMA STATE MEDICAL ASSOCIATION. 

Hopping, Daniel Stiles, Letohatchie $ 10 00 

Huger, Richard Proctor, Anniston 10 00 

Huggins, Jacob, Newbem 10 00 

Inge, William Tutwiler, Mobile 10 00 

Jackson, Robert Dandridge, Summerfield 10 00 

Jackson, Walter Clarke, Montgomery 10 00 

Jay, Andrew, Evergreen 10 00 

Jones, Capers Capehart, Lake View 10 00 

Jones, John Paul, Camden 10 00 

Johnston, William Henry, Birmingham 10 00 

Jordan, Mortimer Harvey, Birmingham 10 00 

Kendrick, Joel Beder, Birmingham 10 00 

Kendrick, Joel Cloud, Greenville 10 00 

Kendrick, William Tomlin, Montgomery 10 00 

Ketchum, Greorge Augustus, Mobile 10 00 

Luckie, Jfimes Bucbner, Birmingham 10 00 

Iiowery, Samuel Henry, Huntsville 10 00 

Means, Thomas Alexander, Montgomery 10 00 

Michel, Richard Eraser, Montgomery 10 00 

Mitchell, William Augustus, Eufaula 10 00 

Moody, Joseph, Franconia 10 00 

Mushat, John Patrick, Hayneville 10 00 

McKinnon, John Alexander, Selma 10 00 

McKittrick, Adam Alexander, Evergreen 10 00 

McWhorter, Abbott Milton, Gaylesville 10 00 

Nicholson, Edward Pierson, Valley Head 10 00 

Norris, George Calvin, Wadsworth 10 00 

Nolen,'Abner Jackson, New Site 10 00 

Northern, Thomas, Heflin 10 00 

Pearce, John Washington, Oxford 10 00 

Peterson, Francis Marion, Greensboro 10 00 

Phillips, William Crawford, Sehna 10 00 

Prince, Francis Marion, Bessemer 10 00 

Pritchett, John Albert, Hayneville 10 00 

Redden, Robert James, Sulligent 10 00 

Reese, Augustus Jordan, Mobile 10 00 

Robertson, Thaddeus Lindlay, Birmingham 10 00 

Rorex, James Polk, Scottsboro 10 00 

Rushing, Francis Marion, Elba 10 00 

Sanders, William Henry, Mobile 10 00 

Searcy, James Thomas, Tuscaloosa 10 00 

Sears, John William, Birmingham 10 00 

Seelye, Samuel Dibble, Montgomery 10 00 

Shivers, Offa Lunsford, Marion 10 00 

Sholl, Edward Henry, Birmingham 10 00 

SledgOi William Henry, Livingston 10 00 



TJffE REPORT OF THE TREASURER. 69 

Smith, Daniel Edgarly , Mobile $ 10 00 

Starr, Lucios Earnest, Camden 10 00 

Stovall, Andrew McAdams, Jasper. 10 00 

Thetford, William Fletcher, Talladega 10 00 

Thigpen, Job, Greenville 10 00 

Thomas, James Grey, Mobile 10 00 

Tipton, Frank, Selma 10 00 

Trent, Powhatan Green, Rock Mills 10 00 

Wall, Conrad, Forest Home 10 00 

Ward, Henry Bascom, Cuba 10 00 

Weatherly, Job Sobieski, Montgomery 10 00 

Webb, Robert Dickens, Birmingham 10 00 

Whaley, Lewis, Birmingham 10 00 

Whelan, Charles, Birmingham 10 00 

Wilkerson, Wooten Moore, Montgomery 10 00 

Wilkinson, James Anthony, Flomaton 10 00 

Wright, Milton Roial, Gadsden 10 00 

Amount brought forward $ 940 0^ 

FBOM COUNSBLORS BLBCT. 

Binford, Peter, Sommerville t 10 00 

Harlan, John Jefferson, Hackneyville 10 00 

Hill, Luther Leonidas, Montgomery 10 00 

Jones, John C. H., Stone 10 00 

Wheeler, William Gamp, Cherokee 5 00 

Total amount of dues from Counsellors $ 985 00 

TO AMOUNT OF DUBS FBOM DBLBGATBS. 

AUman, James E., Butler $ 5 00 

Arbery, William B., Macon 5 00 

Baker, James L., Russell 5 00 

Bevans, Joseph, Etowah 5 00 

Blair,Hugh W., Colbert 6 00 

Burke, James P., Madison 6 00 

Chapman, Gross S., Cherokee 5 00 

CiUey, Phillip 1*., Lowndes 5 00 

Coleman, Ruffin, Jefferson 5 00 

Corcoran, George M., Perry 6 00 

Davidson, Alvin Steele, Blount 6 00 

Davis, John D. S., Jefferson 5 00 

Deweese, Thomas P. , Winston 5 00 

Disharoon, Henry B., Randolph 5 00 



f 



60 ALABAMA STATE MEDICAL ASSOCIATION. 

Foster, George W., Jackson $ 5 00 

Gautier, John Hora, Macon 5 00 

Gay, William M., Chambers 6 00 

Goode, Rhette, Mobile 6 00 

Hammond, George A., Henry 5 00 

Hand, Samuel P., Samter 5 00 

Henderson, Samuel C, Escambia 5 00 

Hendricks, Thomas 8., Blount 5 00 

Henson, John M., Sumter 5 00 

Hill, George A., Talladega 5 00 

Hunter, John J., Elmore 5 00 

Ivey, Barna P., Marion 5 00 

Jolly, Arnold, Marion 5 00 

Jones, Ememett L., Lauderdal 5 00 

Jordan, James R., Montgomery 5 00 

Justice, Oscar 8., Elmore 5 00 

Lawrence, George D. W. , Cherokee 5 00 

Lee, Thomas J., Talladega 5 00 

LeGrand, J. 6 00 

Mathews, E. C, Chilton .- 5 00 

May, Samuel W., Crenshaw 6 00 

McConnell, Robert F., St. Clair 5 00 

McCoy, Charles B., Lee 5 00 

Miller, Virgil M., Walker 5 00 

Morton, William L. , Lamar 5 00 

Morton, Thomas B., Fayette 6 00 

Owen, Pascal H., Montgomery 5 00 

Pharr, Edward M., Tallapoosa 5 00 

Sessions, Lewis, Bullock 5 00 

Smisson, Henry J., Dale 5 00 

Thompson, Elias B., Perry 6 00 

Walker, William A., Bullock 6 00 

Weaver, Thomas F., DeKalb , 5 00 

Wedgeworth, William M., Hale 5 00 

Wheeler, William C, Colbert 6 00 

Whiteside, John M. Calhoun 5 00 

Williams, John H., Shelby 5 00 

Woods, Thomas B., Fayette 5 00 

Young, William J., Morgan 6 00 

Total receipts from Delegates $ 265 00 



THE REPORT OF THE TREASURER. 



61 



DUES FROM COUNTY MEDICAL SOCIETIES. 

Autauga County Medical Society $ 600 

Baldwin " " " 3 00 

Barbour " " " 8 00 

Blount " " " 8 00 

Bullock " " " 1600 

Butler " " " 2 00 

Chambers " " *' 7 00 

Cherokee " " " 12 00 

Clarke " " '* 15 00 

Coffee " *• *' 400 

Colbert " " " 5 00 

Conecuh " " *' 5 00 

Crenshaw " " " 4 00 

Coosa " " " 6 00 

Chilton " " '• 9 00 

Clay *' " " 12 00 

Calhoun " " " 2100 

DeKalb " '* " 4 00 

Dale " " " 12 00 

Dallas " " " 17 00 

Elmore " *' " 12 00 

Escambia " " " 6 00 

Etowah •' " " 12 00 

Fayette " " " 9 00 

Franklin ** *' " 8 00 

Geneva ** " " 4 00 

Greene " " " 8 Oo 

Hale '• " *' 1000 

Henry '* " •* 10 00 

Jackson '• " " 9 00 

Jefferson " " " 12 00 

Lamar " " " 9 00 

Lawrence " " " 8 00 

Lee ** " " 6 00 

Limestone " *' " 5 00 

Lowndes •' " '• 6 00 

Macon " " *' 7 00 

Madison '* " •' 17 00 

Marengo *' " " 13 00 

Marion " " " 17 00 

Marshall " " " 13 00 

Mobile " " " 8 00 

Monroe " " " 10 00 

Montgomery" " " 17 00 



62 



ALABAMA STATE MEDICAL ASSOCIATION. 



Morgan County Medical Society $ 



Perry 


<( 


tt 




Pickens 


<( 


tt 




Pike 


« 


<t 




Randolph 


It 


tt 




RuBsell 


«< 


tt 




Shelby 


t€ 


tt • 




St. Clair 


it 


tt 




Sumter 


tt 


tt 




Talladega 


it 


tt 




Tallapoosa 


tt 


tt 




Tuscaloosa 


tt 


tt 




Wallcer 


it 


tt 




Washington 


** 


tt 




Wilcox 


tt 


tt 




Winston 


tt 


it 





$ 18 00 


13 00 


700 


700 


3 00 


600 


800 


600 


18 00 


10 00 


8 00 


13 00 


900 


400 


300 


200 



Total amount from county medical societies $ 546 00 

STATEMENT. 

To amount dues from counsellors $ 085 00 

" " medical societies 646 00 

" " delegates 265 00 

To balance last session 697 98 



Total $ 2,493 98 



CREDITS. 



Joel White. 
tt 



To account of W. D. Brown & Co $1,169 77 

890 

3 00 

14 00 

600 

6 00 

2500 



it 
tt 
it 
it 
it 
tt 
tt 

it 
it 
tt 
ft 
it 






B 

o 

O 



' M. B. Campbell, porterage 

C. W. Holland, running elevator 

J. R, Wing, chairs 

R. F. Dickerson, theatre 

B. J. Baldwin, postage 15 00 

T. A. Means, salary 100 00 

" sundries 18 00 

" postage. 16 80 

W. 0. Jackson, salary. .[ 100 00 

postage and stationery 8 00 



Total credito $1,488 47 

Balance on hand $1,005 51. 



THE REPORT OF THE TREASURER. 63 

Br. W. G. Gross failed to pay his dues. 

The medical societies of Bibb, Ghoctaw, Glebume, Govington, Gull- 
man and Lauderdale counties have failed to send up their membership 
dues. 

Respectfully submitted, 

Waltbb Glabk Jackson, M. D., 

Treasurer, 



64 ALABAMA STATE MEDICAL ASSOCIATION. 



BUSINESS REPORTS OF COUNTY SOCIETIES. 



Autauga County. — Report and daes. No representation. 
Condition improving. Membership, 9. 

Baldmin County. — Report and daes. Represented by 
two delegates and health oflScer. Condition improved. Mem- 
bership, 3. 

Barbour County. — Report and dues. No representation. 
Status and work reasonably satisfactory. Membership, 13 — 
two in excess of last year. 

-ffiftj County. — Report and dues. No representation. The 
creditable showing made by this society one year ago, seems 
not to have been sustained in that of '89. Membership 6. 

Blount County. — Report and dues. No representation. This 
society seems to be in want of a leader. With an active work- 
ing force of 16, much better things are expected. 

BvUock County. — Report and dues. Represented by one 
delegate, one counsellor and health officer. Status and work 
satisfactory. Membership, 18. 

Butler Cov/nty. — Report and dues. Represented by one 
delegate, one counsellor. Condition of this society is reason- 
ably satisfactory, and its energy is increasing. Membership, 
19. 

Calhoun County. — Report and dues. Represented by two 
delegates. Condition flattering. Membership,* 26. 

Chambers County. — Report and dues. No representation. 
Status fair, its work unsatisfactory. Membership, — . 

Cherokee County. — No report. No representation. Con- 
dition unsatisfactory. Membership, — . 

Chilton County. — Report and dues. No representation. 
The fair working order of last year about the same. Member- 
ship, 9. 



BUSINESS REPORTS. 65 

Choctaw County. — 'No report. Dues paid. Bepresented by 
one delegate, health officer, and one member visiting. This 
society has exhibited improvement, and gives promise of fu- 
ture usefulness. Membership, — . 

Clarke County. — Eeport and dues. Bepresented by one 
delegate, one counsellor, and two members visiting. Status 
reasonably fair, and its secretary efficient. Membership, 17. 

Clay County. — Beport and dues. No representation. This 
society has increased in membership by two additions, and 
loses two by removal, and one by resignation. Membership, 
17. 

Cleburne County. — No report ; dues unpaid. No represen- 
tation. Status and work not ascertained. Membership 8, as 
last year. 

Coffee Coimty. — ^Beport and dues. No representation. This 
society has good intentions, but is weak in energy. Member- 
ship, 4. 

Colbert County. — Beport and dues. No representation. 
Condition fairly reasonable. Membership, 14 — two in excess of 
last year's report. 

Conecuh County. — Beport and dues. Bepresented by one 
delegate, two counsellors and health officer. This society, 
although numerically weak, is a model of energy and faithful- 
ness. Membership, 7. 

Coosa Cownty. — Beport and dues. This society, although 
having no representation at this session, presents a creditable 
showing, and stands fair on the records. Membership 12 ; a 
gain of three upon last year. 

Covington county. — ^No report ; dues unpaid. Bepresented by 
one delegate. This society received its charter at the Mont- 
gomery session and recorded a membership of three. Beturns 
the same as last year. 

Crenshaw County. — Beport and dues. Bepresented by two 
delegates. Status reasonably good. Membership, 8. 

Cullman County. — Beport and dues. Bepresented by one 
delegate. This society is not as active as it should be, yet, 
it promises l)etter returns in the future. Membership, 7. 
5 



66 ALABAMA STATE MEDICAL ASSOCIATION. 

Dale County. — Beport and dues. No representaion. This 
sooiety is jouDg, and should make a creditable showing with 
its membership of 11. 

Dallas Cotmty. — Report and does. Represented by two 
delegates and two counsellors. Status and work always grati- 
fying. Membership 24 ; gain of two. 

DeEalh County. — Report and dues. Represented by one 
delegate ; condition reasonably good. Membership, 10 ; gain 
of four. 

Elmore County. — Report and dues. Represented by one 
delegate. The secretary reports this society in fair working 
order, and retains a membership of 13. 

Escambia Cbi^n^y.— Report and dues. Represented by two 
delegates, one counsellor, and health officer. This society is 
active and zealous of good works, has had four accessions since 
last report, and now records a membership of 11. 

Etowah Cownty. — Report and dues. Represented by two 
delegates. The efficient secretary reports this society in good 
condition. Membership 13 ; loss of one. 

Fayette County. — Report and dues. Represented by one 
delegate. Status and work unsatisfactory. Membership, 15 ; 
gain of one. 

Fra/nJdin County.— ^B^TpoTi and dues. No representation. 
This society has not rendered full returns since 1887. Present 
membership, 13. 

Oreene County. — Report and dues. No representation. 
This society is slowly recovering from its embarrassment since 
the surrender of its charter at the Greeneville session, 1885 ; 
has a following of 15. 

Hale County. — Report and dues. Represented by one del- 
egate and one counsellor. Status and work equal to that of 
last year. Membership, 14 ; gain of two. 

Henry CWn^y.— Report and dues. No representation. This 
society has an efficient secretary, and its returns should be 
equal to the mechanical finish of his work. Membership, 12. 

Jackson CourUy. — Report and dues. Represented by one 
delegate, and health officer. Status represented to be reason- 
ably fair. Membership, 16 ; gain of four. 



BUSINESS REPORTS. 67 

Jeferson County. — Eeport and dues. Eepresented by two 
delegates, four counsellors, health oflGicer, and eleven members 
yisiting. This society continues to maintain its reputation as 
the banner county of the StatA. Membership, 50. This 
record is out of proportion to the entire number of physicians 
in the county, seventy-six being outside. With some exer- 
tion on the part of the membership this number can be 
greatly reduced. 

Lamar Cov/nty. — Beport and dues. Eepresented by one 
delegate. Condition same as last year. Membership, 8 ; gain 
of two. 

Lavderdale County, — Beport and dues. Eepresented by 
one delegate. This society is one of the youngest on the list 
of county societies. It reports an active membership of 15. 

Lawrence covmiy, — Beport and dues unpaid. No represen- 
tation ; status and work unsatisfactory. Membership, 19. 

Lee County, — Ko report and dues paid. No representa- 
tion. This society is not as progressive as it should be, with 
an active membership of — . 

Limestone County. — Beport and dues. No representation. 
This society reports a membership of only six, out of twenty 
physicians in the county. In former reports a much better 
showing was made. 

Lowndes county. — Beport; dues unpaid. Bepresented by one 
delegate and health ofScer. Membership of this society has 
decreased numerically, yet it has sustained its reputation for 
energy and effectiveness. Boll of members, 7 — loss, four. 

'Macon county. — Beport and dues. Bepresented by one del- 
egate. Status and work fair and promising. Membership, 
10 — gain of one. 

Madteon ootm^y— Beport and dues. Bepresented by one 
delegate and two counsellors. The secretary reports the society 
in fine condition — better, perhaps, than formerly. Member- 
ship, 24 — gain, two. 

Ma/rengo county. — Beport and dues. Bepresented by two 
delegates. This society remains about the same in efficiency, 
yet records a membership only of 13 — a loss of nine. 



68 ALABAMA STATE MEDICAL ASSOCIATION. 

Mcmon county. — This society sent in do report, has not paid 
its does, nor was it represented. Keferred to the board of 
censors for investigation. Last year's membership, nine. 

Marshall county. — Report and dues. No representation. 
This society has lost one member by removal from the county, 
and one by death. Present status unsatisfactory. Member- 
ship, 10. 

Mobile county. — Report and dues. Represented by two del- 
egates, eight counsellors, health officer and ten visiting. This 
society stands abreast with a number of others of the confed- 
eration, and like them, is active and in close affiliation with 
the association. Membership, 27. 

Monroe county. — Report and dues. Represented by one 
delegate. Condition and work reported to be reasonably sat- 
isfactory. Membership, 11. 

Montgomery county. — Report and dues. Represented by 
two delegates, six counsellors and one member visiting. The 
secretary reports a full and active membership of 29. 

Morgan county. — Report and dues. Represented by one 
delegate, two counsellors, health officer and one visitor. Re- 
cent accessions to the county have swelled the membership to 24. 
Much is hoped for by this increase. 

Perry county. — Report and dues. Represented by one del- 
egate. This society is in good working order, and records a 
membership of 15 — loss of one. 

Pickens county. — Report and dues. Represented by one 
counsellor. Status and work reasonably fair. Membership, 
16 — gain of one. 

Pike county. — Report and dues. No representation. This 
society is not as active as the association hoped for. Now that 
it has an increase of two to its rolls, more is expected of it. 
Membership, 16. 

Randolph covmiy. — Report and dues. No representation. 
Status reasonably satisfactory. Membership, 18. 

Russell county. — ^Report and dues. Represented by one 
delegate. This society, although only two years old, has an 
active force it were well for older societies to imitate. Mem- 
bership, 7. 



BUSINESS REPORTS. 69 

Shelby county. — No report. Daes unpaid. Bepresented bj 
one coQDBellor. Condition and work unaatisfactorj. Mem- 
bership unknown. 

St. Glair county. — ^Beport and daea. BepreseAted by one 
delegate. This society is reported to be in good working 
order and more prosperoas than since its organization at £q- 
fanla in 1878. Membership, 13 — ^gain of five. 

Sumter coimty. — Beport and does. Bepresented by two del- 
egates, two counsellors, health ofiicer and one visitor. This 
society reports its usual activity, and present a working force 
of 17 active and eight honorary members. 

Talladega cownty. — Beport and dues. Bepresented by one 
delegate and one counsellor. This society indicates from its 
rolls a healthy state, carried over, seemingly, from that of last 
year. Membership, 21 — gain of one. 

Tallapoosa county. — Beport and dues. Although having 
no representation, it still preserves its record for efficiency. 
Membership, 19. 

Tuscaloosa county. — Beport and dues. Bepresented by two 
delegates. This society returns a fine membership, but is lack- 
ing in force and activity. Its enrollment numbers 23— -outside 
physicians, ten. 

Walker county. — ^Beport and dues. Bepresented by two 
counsellors. Status and work satisfactory. Membership, 15. 

Washington county. — Beport and dues. Nq representation. 
This society is wanting in energy. More is expected of it than 
a simple registry of names. Membership, four. 

Wilcox county. — ^Beport and dues. Bepresented by one 
counsellor. This is one of the largest and best organized socie- 
ties in the state, yet its returns are unsatisfactory. This should 
not be. Membership, 28. 

Winston county. — Beport. Dues unpaid. Bepresented by 
one delegate. Status reasonably good for one so young. 
Membership, 6. 



70 ALABAMA STATE MEDICAL ASSOCIATION. 



THE SCHEDULE OF SPECIAL COMMITTEES. 



Dr. Edward H. Sholl of Birmingham, chairman of commit- 
tee on the home for the widows and orphans of physicians and 

snperannaated physicians, made the following report : 

Yoar committee, after considering several plans that have been sub- 
mitted to them for action, have concluded that the proposition of the 
Southern Building and Loan Association of Huntsville, is the most 
feasible. On account, however, of a few details which must be thor- 
oughly understood by the members of the county societies, we respect- 
fully suggest that the committee be allowed another year to make their 
report, during which time they hope to get a full and practical expres- 
sion of opinion from every member of the state association on the plan 
before them. 

On motion the report was received and the committee 
granted further time. 

Edward H. Sholl, Robert D. Webb, Benjamin J, Baldwin, 
James T, Searcy, Benjamin F, Cross, Pagh H. Brown, com- 
mittee. 

The committee on the different systems of county jails and 
poor-house management, failing in representation and report, 
was, on motion of the senior censor, discharged. 

Committee : Bichard P. Hnger, Peter Bryce, James T« 
Searcy, 

The committee on badges. Dr. Jerome Cochran, chairman, 
submitted the following report : 

The special committee appointed at the last session of the association 
to consider the question of paying for the button badges purcfiased in 
1884 by the secretary of the association, said committee being composed 
of Drs. Cochran, Seelye and Gaston, with power to act, beg leave to 
report that they have duly investigated all the facts connected with 
this transaction, which they find to be as follows: (1) The secretary 
had no authority given him by the association, or by any of its officers, 



SCHEDULE OF SPECIAL COMMITTEES. 71 

to purchase these badges, but made the purchase on his own individual 
responsibility. (2) It was very soon found out by certain members of 
the association that the badges purchased by the secretary were badges 
belonging to three European orders, and as our counselors could not 
afford to sail under false colors, they were obliged to discontinue the 
use of said badges. (S) The number of badges purchased was very 
large, 454 in all, at a cost of $116.50, or a fraction over twenty-six cents 
apiece ; and they were sold to counselors by the secretary at fifty cents 
each. Upon this basis of facts your committee were of the opinion 
that the secretary should himself pay for the buttons, and so unani- 
mously decided. The secretary refused to abide by this decision. In 
the meantime Mr. Joel White, who imported the buttiOns, is still, after 
waiting five years, doing without his money. The amount now out- 
standing, after deducting a payment of $15.50 from the original account 
of $116.50, is $101.00. There can be no question that Mr. White ought 
to be paid. 

Having failed to accomplish a settlement, as the foregoing statement 
shows, we report the matter back to the association, and ask to be dis- 
charged from any further consideration of it. 

All of which is respectfully submitted, 

JSBOMS COCBBAN, M. D,, 

Chairman, 

On motioD, the association adjourned to meet in Temper- 
ance Hall at 8 o'clock p. m., to attend the annual oration of 
Dr. Ba£Sn Coleman of Birmingham. 

BX0UB8ION. 

At 4 o'clock p. m., members of the association and their 
friends, were given a complimentary ezcnrsion on the bay. 
They went down some twenty miles or more and returned at 
7 o'clock greatly pleased with the trip. 



EvENiNo Sbssiok — Temferanob Hall. 

Dr. M. C. Baldridge, president, called the association to 
order at 8 o'clock, and then introduced the orator of the even- 
ing. Dr. Buffin Ooleman of Birmingham. 

The Mobile Eegister has this to say : 



72 ALABAMA STATS MEDICAL ASSOCIATION. 

Dr. Coleman commenced his address by paying an eloquent tribute 
to Dr. Brice Hughes, who had been chosen as the orator of the associa- 
tion, but who had been claimed by death. He then expressed the 
pleasure of himself and associates at meeting inhospitable Mobile, that 
sat like a queen upon the shores of her beautiful bay, whose name and 
reputation was known far beyond the limits of the State, and who had 
among her citizens in the past so many whose names were honored and 
memories revered, and whose people now maintain their old time repu- 
tation. In this connection the speaker paid a handsome compliment to 
Mrs. Augusta Evans Wilson. 

His theme, he said, was The Higher Education of Women, with 
special reference to their being admitted to the practice of medicine. 
He knew that the statement of his subject would cause many to smile, 
but it was one that he was in earnest in advocating. The objections 
were on scientific and sesthetical grounds. It was claimed that woman 
was not strong enough for sustained mental effort. The truth was that 
women wasted strength enough in the dissipations of fashionable life 
to do the work of carpenters. As to their mental ability it should be 
remembered that the hand that rocks the cradle moves the world, that 
mothers mould the minds of their sons more than fathers do, that all 
great men have had superior women for mothers. 

From an aesthetic standpoint it is claimed that women should lead 
only a domestic life — ^that they should not go out into the world and 
work. He saw no lowering of woman's position because she sought to 
support herself or those dependent on her. On the contrary, he hon- 
ored her for doing so. It is true that, as far as the study of medicine is 
concerned, the ordeal is trying to a beginner, but he believed women 
could stand it. Some had already stood it. 

Dr. Coleman continued in this strain, making many telling hits, 
which were much enjoyed by the audience, and closed by giving a list 
of some of the women who have done noble service in the cause of 
humanity, and by making an appeal to his brother physicians to move 
forward with the progress of the age. 

The remainder of the evening consisted in music and recita- 
tions by a number of the most noted amateur talent of Mobile. 



LIBRA R Y AND MUSE UM. 73 



PROCEEDINGS OF THE SECOND DAT. 

Wednesday, Apbil 10. 

The association convened in Temperance Hall at 10 o^ clock 
a. m., and was called to order by the president, Dr. Baldridge. 

Under the head of miscellaneons business, next in order, 
Dr. B. J. Baldwin of Montgomery introduced an ordinance 
providing for the appointment of a board of trust for a library 
cmd museum for the association^ who shall be invested with 
power to issue bonds in the sum of $5,000, for the purpose of 
erecting a suitable building for a library and museum and resi- 
dence for the State health officer. The ordinance specifies how 
said bonds shall be issued, and makes the State health officer 
custodian of the building, under direction of the said board of 
trust. In lieu of such service he shall be entitled to occupy 
the residence free of charge. Dr. Baldwin said that the object 
was to provide for all time to come a permanent 7*esidence for 
the State health officer^ as well as a permanent location for the 
museum and library of the association. The advantages of 
such a building were manifold. It would stimulate the 
increase of the library and museum, now small, for want of a 
permanent abiding place. 

To accomplish this the association has only to guarantee the 
interest on $5,000 at six per cent, for twenty years — only 
$300 per year. The ordinance further provides for the pay- 
ment of the principal, and by a guaranteed mortgage upon the 
property. If the principal is not paid at the end of twenty 
years, then the bonds can be so issued to run twenty years 
longer. 

Plans of the building showing front, elevation and internal 
arrangements, with all modern improvements, were exhibited 
and explained by Dr. Baldwin. The ordinance and plans were 
referred to the board of censors. 



74 ALABAMA STATE MEDICAL ASSOCIATION. 

The secretary then proceeded to call the schedule of regular 
reporters, and in their order, viz : 

(1) Electricity in Gynecology ; Dr. William E. B. Davis of 
Birmingham. Bead and referred to the Publishing Com- 
mittee. 

(2) Eclampsia .Gravidarum; Dr. Eichard M. Fletcher of 
Madison. Eead and referred to the Publishing Committee. 

(3) Curability and Treatment of Pulmonary Phthisis ; Dr. 
Vivian P. Gaines of Mobile. Eead and referred to the Pub- 
lishing Committee. 

(4) Dysmenorrhoea, its Causes and Treatment; Dr. E. 
Powell Biggs of Birmingham. Read and referred to the Pub- 
lishing Committee. 

(5) Dentition; Dr. William C. Wheeler of Cherokee. 
Bead and referred to the Publishing Committee. 

Volunteer Papers. 

(1) Epicystic Surgical Fistula for Cystoscopic Exploration, 
Intravesical Treatment and Drainage; Dr. John D. S. Davis 
of Birmingham. Bead and referred to the Publishing Com- 
mittee. 

(2) The Complication of Diseases ; Dr. Howell B. Gwin of 
Decatur. Bead and referred to the Publishing Committee. 

(8) Septicsemia; Dr. John P. Stewart of Attalla. Bead 
and referred to the Publishing Committee. 

(4) The Causes of Gonorrhoea and its Treatment in the 
Female ; Dr. Angelo Festorazzi of Mobile. Bead and referred 
to the Publishing Committee. 

(6) Ascites, with Illustrative Case ; Dr. Charles Whelan of 
Birmingham. Bead by Dr. W. E. B. Davis, and referred to 
the Publishing Committee. 

(6) Becent Advances in the Badical Cure of Inguinal Her- 
nia ; Dr. B. Leon Wyman of Birmingham. Bead and referred 
to the Publishing Committee. 



VOLVNTEElt PAPERS. 75 

(7) Ovarian Tnmors, with specimens; Dr. Morris J. 
Thompson of Meridian, Mississippi. Head and referred to the 
Publishing Oommittee. 

(8) Apposition Cat-gut Mat, for Intestinal Anastomosis; 
by Dr. John D. 8. Davis of Birmingham. Read and referred 
to the Publishing Committee. 

- A recess of ten minutes was called. Upon reassembling, 
Dr. George W. McDade of Montgomery read a paper supple- 
mentary to Dr. Davis' paper on Epcystic Surgery. Read and 
referred to the Publishing Committee. 

The secretary read invitations from the Athlestan and 
Manassas clubs, and from the Mobile Chamber of Commerce, 
extending to the members of the association the privileges of 
their rooms, at will, during the session. Thanks were voted 
and returned for the courtesies offered. 



Eybnino Session. 

The association was called to order at 8 o'clock p. m., in 
Temperance Hall, to discuss the health laws of the State. 
These meetings are of constantly increasing interest, not alone 
to .the county health ofScers ; to the county boards of health ; 
to individual members of the association, but to the physicians 
as well as to the public at large. 

The senior censor being the head and front of the meeting, 
gave flattering accounts of the advancement made, especially 
in the collection of births and deaths ; of the general efficiency 
of the various health officers, and of the willingness on the 
part of midwives and others to make their returns as required 
by law. The meeting assumed the shape of an experience 
meeting, questions and answers following in succession. In 
this way all became intensely interested in the work before 
them. 

Adjourned at 9:45 to 10 a. m. to-morrow. 



76 ALABAMA STATE MEDICAL ASSOCIATION. 



PROCEEDINGS OF THE THIRD DAT. 
Thursday, April 11. 

The aesociation was called to order by the president promptly 
at 10 o'clock a. m. Under the head of miscellaneous business, 
next in order, opportunities were offered Dr. John 0. LeOrand 
of Anniston, editor of the Alabama Medical and Surgical 
Journal, and Landon B. Edwards of Richmond, editor of the 
Virginia Medical Monthly, to speak in the interest of their 
respective journals. 

The remaining hours of the morning session were taken up 
in the reading and discussion of volunteer papers. For con- 
venient reference the titles and authors of these several papers 
follows the list of regular essays, page 74. Discussion of them 
may be found under their respective headings. [See appendix 
of Medical and Sanitary Dissertations and Reports.] 

Adjourned until 10 o'clock a. m. to-morrow. 



VOTE OF THANKS. 77 



THE PROCEEDINGS OF THE FOURTH DAT. 

Fbidat April 12. 

The association convened at 10 o'clock a. m., and was called 
to order bj the president. 

Miscellaneons business next in order. 

Dr. Edward H. Shell, of Birmingham, offered the following 
preamble and resolution touching the action of the State 
Health Officer, in the recent epidemic at Decatur : 

Whbrbas, The Medical Association of the State of Alabama, reco^ 
nizes loyalty to a confided tiust as the highest of virtues, therefore, 
be it — 

Resolved, That by this we desire to express our appreciation of the 
faithfulness of our State Health Officer to his trust in the recent epi- 
demic of yellow fever at Decatur, and to commend him for the earnest 
discharge of his duty. 

The preamble and resolution were unanimously adopted. 

Dr. Charles H. Franklin, of Union Springs, from the Board 
of Censors, stated that, at the recent session of that body. Dr. 
Jerome Cochran had been elected State Health Officer for the 
ensuing five years, and 

Moved that the association confirm the action of the Board 
of Censors. 

The motion was unanimously adopted. 

Dr. Samuel D. Seelye, of Montgomery, moved the following 

VOTB OF THANKS. 

Resolved, That the thanks of this association are most heartily ten- 
dered to the Mobile county medical society, and its committee of ar- 
rangements for the perfect manner in which Ihey have ministered to 
the success of this meeting, and the generous hospitalities that have 
been heaped upon us, making our stay here not only profitable as an 
association, but memorable for its social pleasures. 

Resolved, That the thanks of this association are hereby tendered to 



78 ALABAMA STATE MEDICAL ASSOCIATION. 

the citizens of Mobile for the more than generoas reception accorded 
to us, which is in keeping with the reputation of this city for open- 
handed hospitality. 

Resolved, That the thanks of this association are tendered to the 
Athelstan club, for the delightful reception at their roomp, and to the 
Manassas club and Chamber of Commerce for courtesies extended to 
us. 

Resolved, That the thanks of this association are hereby tendered to 
the various railroads centering here, and to the hotels for reduced fare. 

Resolved, That the thanks of this association are hereby tendered to 
the Mobile Register, and the New Orleans Times Democrat, for their 
full and accurate reports of our proceedings. 

Resolved, That the thanks of this association are hereby tendered to 
the ladies and gentlemen who participated in the concert on Tuesday 
night, and made the occasion a delight to us. 

Resolved, That the thanks of this Association are hereby tendered to 
Mr. R. R. Warren, President of the Spring Hill railroad, for the de- 
lightful excursion to Spring Hill. 

Resolved, That the thanks of this association are hereby tendered to 
Mrs. Augusta Evans Wilson, of whom we are all proud, fdr the im- 
promptu reception at her home, which added greatly to the pleasures 
of our excursion to Spring Hill. 

The Senior Censor now proceeded to read the sixteenth 
annual report of the Board of Censors and Committee of 
Public Health. 



THE REPORT OF THE BOARD OF CENSORS. 79 



SIXTEENTH ANNUAL REPORT OF THE BOARD 

OF CENSORS, INCLUDING REPORTS OF THE 

STATE BOARD OF MEDICAL EXAMINERS 

AND COMMITTEE OF PUBLIC HEALTH. 



SUMMARY OF CONTENTS. 



Part I. The Report op the Board of Censors. The Work of the 
State Association — ^The President's Message — ^The Reports of the 
Vice-Presidents — The Report of the Secretary and the Book of the 
Rolls — ^The Report of the Publishing Committee — ^The Report of the 
Treasurer and the Book of Accounts — The Roll of the Correspond- 
ents — Business Reports from County Societies — A New Rule of 
Order — Part IV of the Censors' Report — Counselors by Congres- 
sional Districts — Library and Museum — ^Binding the Book of the 
Rules— The Treasurer's Bond— The Button Badges— The Recent 
Session of the General Assembly. 

Part II. The Report of the State Board of Medical Examiners. 
The Work of the State Board of Medical Examiners— The Admin- 
istration of the Law to Regulate Practice — Printing the Examination 
Papers — The Work of the County Boards of Medical Examiners. 

Part UI. The Report of the State Board of Health. Delinquent 
Counties — Investigation of Delinquent Counties — The Color Blind 
Law — Quarantine Propositions submitted by the State Health Of- 
ficer — Exemption of the State Health Officer from Quarantine Re- 
strictions — Expenditures of the State Board — The Work of the 
County Boards of Health. 

Part IV. Supplementary Papers. The Propositions Adopted at the 
Quarantine Conference held in Montgomery, March, 1889 — Amend- 
ment to the Pharmacy Law. 



80 ALABAMA STATE MEDICAL ASSOCIATION. 



PART I. THE REPOET OF THE BOARD OF CENSORS. 

THB WOBE OF THB STATE ASSOCIATION. 

The Medical Association of the State of Alabama continaes 
to prosper. The individaal connty societies have their nps and 
downs, which for the most part depend on the eflSciency or 
inefiSciency of their officers — especially upon the presidents of 
the societies and the presidents of the boards of censors. This 
is in accordance with the general law governing all sorts of 
organizations. A good general makes a good army. A good 
pastor makes a prosperous congregation. In the application of 
this principle to our county societies it is the part of wisdom 
to keep a good and efficient officer for several terms, or in- 
definitely, when a good officer has been found. It is a mistake 
to insist too much on rotation in office for the purpose of dis- 
tributing the honors as widely as possible amongst the mem- 
bers. 

The president of the state association can add greatly to the 
efficiency of the presidents of the county societies, and there- 
fore to the prosperity of the county organizations over which 
they preside, by keeping up a constant correspondence with 
these officers in regard to the details of their work ; and every 
president of the asso9iation should engage earnestly in this sort 
of supervision from the very beginning of his administration. 
In a word, he should take command of his army promptly and 
should seek to promote the discipline and efficiency of all the 
regiments and companies composing it. We desire to invest 
these suggestions with all possible emphasis, because it is im- 
portant that our presidents should appreciate very thoroughly 
the extent and character of their official duties and obligations. 
Discipline and organization are the miraculous words that insure 
success. To construct out of the scattered members of our pro- 
fession a powerful organization, and through this organization 
to secure concert of action and the prevalence of wise and pru- 
dent counsels is the great and abiding mission of our associa- 
tion. These things our presidents, as our commanders in chief, 



THE REPORT OF THE BOARD OF CENSORS. 81 

and oar vice-presidents, as commanders of divisions, should 
always bear in mind, and assidnonslj endeavor to accomplish. 

We have made great progress ; bat mach still remains to be 
done. Many of oar county societies are still weak and inef- 
ficient, and these stand in need of all possible encouragement, 
and should be strengthened and helped in all available ways. 

Many of the doctors of the state— some hundreds of them — 
have not become members of their county societies. This state 
of affairs is unfortunate both for them and for us ; and per- 
sistent effort should be made to bring them all into the com- 
mon fold. Every doctor in the stat<e should be made to feel 
that membership in his county society is a duty not to be 
lightly neglected — an obligation, not honorably to be avoided. 
It is true that membership in a county society brings with it 
some inconvenience, some loss of time, and some expense ; but 
the aggregate of these burdens is not large ; and every physi- 
cian should claim it as a privilege to carry his share of the 
load. 

THB president's BiESSAOE. 

« 

We have carefully examined the recommendations of the 
president's message. In our judgment they are all wise and 
timely, except that which relates to the establishment of a med- 
ical journal under the auspices of the association. We believe 
it would involve an amount of expense beyond our means to 
sustain a medical periodical that in the general field of medical 
journalism would compare favorably with the great medical 
journals of the country. In the meantime we believe that it 
is very desirable that the state board of health should be able 
to issue a monthly bulletin, as a medium of communication be- 
tween the state and county health ofScials, and for the dissem- 
ination of sanitary knowledge amongst the people. Such 
monthly publications are now issued by a considerable number 
of state boards of health, and have been found to be of great 
public interest and usefulness. 

For the present, however, the funds at the disposal of the 
3tate board of hef^th of Alabama do not warrant them to un- 




82 ALABAMA STATE MEDICAL ASSOCIATION. 

dertake sach an enterprise, and its consammation must be left 
to the f atare, with the hope that the day is not very far off 
when it will become feasible. 

THB BBPOBTS OF THE YIOB-PBESroENTS. 

We have carefully considered the reports of the vice-presi- 
dents ; and are sorry to feel it to be our duty to state that they 
do not come fully up to the high standard of excellence which 
we are anxious to see established as characteristic of these re- 
ports. They are, to some extent, lacking in that fullness and 
freshness of information in regard to the status and work of 
the various county societies which should come as the natural 
results of active and unceasing supervision of the societies 
from one year's end to another. 

We do not make these strictures from any desire to censure 
the vice-presidents who have been in charge of the societies 
during the past year. But because the plan for the utiliza- 
tion of our vice-presidents is still new, and perhaps not gen- 
erally appreciated at its full value ; and we consider that it is 
very desirable that said plan should be carefully fostered, and 
developed to its fullest possible extent. 

We expect a great deal of our vice-presidents — a great deal 
more than is expected of the vice-presidents of any other med- 
ical organization. Indeed, we expect a great deal of all of our 
officers. This is the secret of our power and prosperity. We 
have a great army to discipline and train to efficiency in the 
discharge of most important public functions. Of this army 
the president of the association is the commander in chief, 
while the two vice-presidents are the commanders of its two 
grand divisions — commanders in the field — commanders on 
active duty. It is their business to make history — to look con- 
stantly after the welfare, and the efficiency, and the discipline 
of the regiments under their respective commands ; that is to 
say, it is their business to foster and encourage and direct the 
county societies in their work. This can never be accom- 
plished by waiting until near the close of the official year, and 
then, gathering such facts as can be had in response to a few 



THE REPORT OF THE BOARD OF CENSORS. 83 

hasty letters, and making these facts the basis of the annnal 
reports. 

We make these remarks in all possible kindness, and solely 
with a view to the future interests of the association. 

THE REPOBT OF THE 8E0BETABY AND THB BOOK OF THE BOLLS. 

We have examined the report of the secretary, and find it 
to be satisfactory. We therefore recommend that it be ap- 
proved by the association. 

We have also examined the Book of the Rolls and find it 
written np to date. 

THE BBFOBT OF THE PUBLISHING OOMMriTEE. 

We have examined the report of the publishing committee, 
and find it satisfactory. We therefore recommend that it be 
approved by the association. 

THE BEFOBT OF THE TBBASUBEB AND THE BOOK OF AOCOUNTS. 

We have examined the annnal report of the treasurer, with 
the accompanying vouchers. We find it to be satisfactory and 
recommend that it be approved by the association. 

We have also examined the Book of Accounts, which we find 
to.be in good condition, and written up to date. 

While, as we have said, we have found the treasurer's re- 
port satisfactory ; that is to say, an accurate record of the 
financial condition of the association — we desire to suggest 
that several of the vouchers are defective, inasmuch as they 
do not designate for what articles or services the expenditures 
were made. We do not suspect anything wrong. But it is 
best that the business of the association should be done in a 
business way ; and it is a recognized business principle that in 
all accounts the separate items should be given. For example, 
one of the vouchers we have had to consider is an account by 
the secretary for eighteen (18) dollars for '^ sundries." We do 
not know what articles are included in this word ^'sundries," 
ao4 »re, therefore^ not able to say whether the expenditure of 



84 ALABAMA STATE MEDICAL ASSOCIATION. 

this eighteen dollars was legitimate or not. We suppose that 
merely to call attention to carelessness of this sort will be suffi- 
cient to prevent its recurrence. 

The treasurer receives a salary of only one hundred dollars 
a year, and is required to give a bond of three thousand dollars 
to guarantee the faithful performance of his duties and the 
safety of the funds of the association in his keeping. The 
present treasurer has always given the required bond; but with so 
small a salary this requirement seems to be rather a heavy ex- 
action. In considering the matter we have reached the con- 
clusion that it will be better for the association to arrange with 
some guarantee company to make bond for our treasurer, and 
so to relieve him from the necessity of giving personal security. 
We therefore recommend that we be authorized to make such 
an arrangement as we have here indicated, with such guarantee 
company as we may select, and in such amount as to us may 
seem expedient, and to draw on the trea^ry of the associa- 
tion annually for such sum as may be necessary to keep such 
bond in force. 

THE BOLL OF 00BBE6F0NDENTS. 

We have duly considered the roll of the correspondents. It 
has come to our knowledge that one of our correspondents has 
died during the past year — namely, Dr. John S. Lynch of Bal- 
timore, Maryland. We recommend that his name be stricken 
from the roll of correspondents, and that a suitable expression 
of our sympathy be forwarded to his bereaved family under 
the seal of the association. 

We further recommend that the following named gentlemen 
be added to the roll of correspondents, namely : 

(1) Dr. E. D. McDaniel of Camden, Wilcox county. lie 
was for many years an honored counsellor of the association, 
and its president in 1886-7. 

(2) Dr. Nathan R. Bozeman, formerly a distinguished 
physician of this State, now of New York city. 



THE REPORT OF THE BOARD OF CENSORS. 85 

THB BBYISIOK OF THE MINUTES. 

Section 3 of article 79 of the constitntion of the association, 
provides for the revision of the minntes of the proceedings. 
We recommend that this order of business be stricken ont, and 
that it be made the duty of the board of censors to include in 
their annual reports statements of snch errors in the minntes 
as to them seem to stand in need of formal correction. 

BUSINESS BBPOBTS FROM OOUNTY SOOIETIES. 

Section 5 of article 79 of the constitntion of the association 
provides for certain business reports from the county medical 
societies. This order of business consumes a good deal of 
time. It has not heretofore entirely fulfilled its purpose. 
The business matters to which it relates have now been placed 
in charge of the vice-presidents, and should be fully discussed 
in the annual reports of said vice-presidents. For these 
reasons we recommend that this rule of order be stricken out. 

A NEW RULE OF OBDEB. 

In place of section 3 of article 79 of the constitution of the 
association, we recommend the insertion of the new order of 
business already adopted by the association in the following 
words : 

3. The reports of the vice-presidents in the order of 
seniority. 

FAST IV. OF THE 0ENS0B8 BEPOBT. 

Part IV of the Eeport of the Board of Censors has been 
devoted to special reports by the state health ofiScer. The law 
now requires the annual publication of the report of the state 
board of health, and it is in that publication that the reports 
of the state health officer find their most appropriate place. 
We therefore recommend that Part rv of the Report of the 
Board of Censors be hereafter omitted, and that Part v be 
hereafter numbered Part rv. 



86 ALABAMA STATE MEDICAL ASSOCIATION. 

OOUNSELLOBS BT OONORESBIOKAL DISTRICTS. 

At the last session of the association an agreement was adopted 
to the effect, that in the election of counsellors, they shonld 
be distribnted, as nearly as practicable, amongst the several 
congressional districts in the state, in proportion to the number 
of paying members of the association in the several districts. 
As it is a little difficult to get the number of paying members 
in the several districts at the time the elections are held, and 
also because, practically, the result will be about the same, we 
now recommend that the word ^^paying" shall be stricken out 
of this rule, and that the distribution be made on the basis of 
the number of members, whether they have paid or not. 

LIBRARY AND MUSEUM. 

We have duly considered the ordinance introduced by Dr. 
B. J. Baldwin, of Montgomery, to establish a library and 
museum for the association, and recommend its adoption. 

Be it Ordained hy the Medical Association of Alabama^ 
(1) That Drs. B. J. Baldwin, J. B. Gaston and S. D. Seelye, 
all of Montgomery, be and are hereby created a board of 
trustees, to be known as the Board of Trustees of the Library 
and Museum of the Medical Association of the State of Ala- 
bama and the State Board of Health. 

(2). That it shall be the duty of said board of trustees to 
have themselves properly incorporated under the laws of the 
state ; to issue bonds for not more than six thousand dollars ; 
to erect and furnish a building in the city of Montgomery suit- 
able for the uses of said library and museum, and also in con- 
nection therewith, to provide a residence for the state health 
officer; to solicit donations and bequests in aid of said library 
and museum, and to have the supervision and general manage- 
ment of the same ; and to report annually to the state associa- 
tion a full account of their proceedings as a board of trustees. 

(3) That the said board of trustees shall issue the said 
bonds authorized in the second section of this ordinance, in 
sums of five hundred dollars each, at not less than their par 



THE REPORT OF THE BOARD OP CENSORS. 87 

value, to run for not more than twenty years, and to bear 
interest at a rate not to exceed six per cent, per annum ; and 
that the interest on said bonds is hereby guaranteed by the 
medical association of the state of Alabama, to be paid annually 
in the city of Montgomery. 

(4) That members of the said board of trustees may be at 
any time removed from ofSce by the president and board of 
censors of the Medical Association of the State of Alabama, 
without cause assigned, and that all vacancies occuring in said 
board shall be filled by appointment of said president, by and 
with the advice and consent of the said board of censors, each 
of said trustees to hold ofiice until his death, resignation, or 
removal. 

(5) That there shall be set aside, annually, from the 
treasury of said State Medical Association such sum as may be 
recommended by the said board of censors, to constitute a 
sinking fund to redeem the said bonds, and that said sinking 
fund shall be under the control of said board of trustees, to be 
by them managed and invested as to them may seem best ; 
and said board of trustees are hereby authorized to execute 
mortgages on the real estate and buildings of said library and 
museum to secure the principal of said bonds. 

(6) The state health officer is hereby made the custodian 
of the library and museum established by this ordinance under 
the general direction and control of the board of trustees 
herein created, and in return for his i^rvices as librarian and 
curator, shall be entitled to occupy the residence connected 
with the library and museum free of rent. 

BINDING THE BOOK OF THB BULES. 

At the last session of the association we were instructed to 
publish a new edition of the Book of the Bules — an edition of 
one thousand copies — five hundred copies to be bound in cloth 
and to be sold at fifty cents per copy, and five hundred to be 
bound in paper covers and to be sold at 25 cents per copy. 
As there was to be a session of the general assembly last winter, 
we concluded it would be best not to publish the revised rules 



88 ALABAMA STATE MEDICAL ASSOCIATION, 

until after its adjournment. We now propose to attend to this 
order as speedily as possible. In the meantime it has occurred 
to tis that it will be better policy to bind the entire edition in 
cloth, and we recommend that the order be modified to this 
extent. 

THE BUTTON BADGES. 

On the first day of the present session the special committee, 
appointed a year ago to consider the case of the button badges, 
and the payment of Mr. Joel White's bill for the same, made 
their report and asked to be discharged. The report was re- 
ceived and the committee discharged. The report in question 
records the status of the case as between the secretary and the 
association, and we propose to leave that issue untouched. In 
the meantime, however, Mr. White's bill for one hundred and 
one dollars remains unpaid, a condition of affairs which we 
think should not be allowed to continue. We therefore re- 
commend that we be authorized by the association to have paid 
out of the treasury of the association and to the order of Mr. 
Joel White the sum of one hundred and one (101) dollars, as 
above mentioned. 

THE BEOBNT SESSION OF THE GENERAL ASSEMBLY. 

During the recent session of the General Assembly quite a 
number of billfi were introduced, which, to a greater or less 
extent, were intended to influence the interests represented in 
our association. We proceed to mention them separately, 
giving such attention to each as its importance seems to war- 
rant: 

(1) A bill to amend section 1298 of the Code. This was 
introduced in the house by Mr. Kyle, of Lee county, and was 
hence known as the Kyle bill. Section 1298 of the Code is 
now a dead section. It was applicable only in counties in 
which there were no boards of examiners under the jurisdic- 
tion of the State Medical Association, and as we now have 
boards in all the counties it is no longer in operation. It was 
proposed to so amend this section as to authorize all graduates 



THE REPORT OF THE BOARD OF CENSORS. 89 

of medical colleges to practice medicine in Alabama without 
examination by onr medical boards. The bill was referred to 
the committee on revision of laws, and provoked a good deal 
of discussion. Mr. Kyle, Dr. Williams, of Opelika, and Gen- 
eral Harrison, acting as attorney for the friends of the bill, 
appeared before the committee and argued the question at 
considerable length. Dr. Gaston and Dr. Cochran answered 
their arguments as well as they were able ; and the committee 
finally agreed on an adverse report, which settled the fate of 
the bill ; and which, in effect, settled the fate of all the other 
bills which were presented during the session with the same 
object in view. 

(2) A bill to prevent monopolizing the practice of medi- 
cine in this state and to provide for the appointment of boards 
of medical examiners. This bill was introduced in the senate 
by Mr. Waddell, of Bnssell county. It is believed to have 
been inspired by the friends of the Kyle bill. It is a very 
long bill, and proposed to abolish all of our boards of exami- 
ners, and all of our boards of health, both state and county, 
and to substitute for them certain mixed boards to be com- 
posed of physicians of different schools of medicine. It never 
had the slightest chance of passing, and nobody paid any 
special attention to it. 

(3) A bill of similar purport, perhaps the same bill, was in- 
troduced at the same time in the house, but was never heard 
of any more. 

(4) A bill, of which we are not able to give any details, 
to create boards of examiners, was introduced in the senate by 
Mr. Huey, but it was never reported by the committee to 
which it was referred. 

(5) Two bills were introduced in the senate by Mr. Smith, 
of Mobile, one to amend section 1302 of the Code, and one to 
amend section 1305 of the Code. The object of these two 
bills was to exempt graduates of the Medical College of Ala- 
bama from examination by the authorized boards of medical 
examiners. These bills were referred to the judiciary com- 
mittee ; they met with no favor ; and the committee promptly 



90 ALABAMA STATE MEDICAL ASSOCIATION. 

agreed on an adverse report. It affords ns special gratifica- 
tion to be able to state that these bills, although emanating 
from Mobile, were not introduced by request or with the 
knowledge of the college faculty. 

(6) A bill was introduced by Mr. Mancill, of Covington 
county, to exempt said county from the operation of the law 
to regulate practice. It died quietly in committee. 

(7) A bill was introduced by Dr. McRea, of Lowndes 
county, to fix the salary of the health officer thereof. It was 
righteously killed in committee. 

(8) The bill to authoKze the establishment of licensed grave 
yards, which was approved by the association, was not acted on 
because some of the lawyers in the house stated that the county 
commissioners of the several counties already had the powers 
which this bill proposed to confer upon them. 

(9) The bill to provide for the preliminary examination of 
students applying for beneficiary scholarships in the Medical 
College of Alabama, was under a favorable report from the 
committee of public health in the house, but was never reached 
on the calendar, and so was never put to the vote. 

(10) The bill to appropriate fifteen hundred (1500) dollars 
for clerk hire for the state board of health was reported ad- 
versely by the senate committee on finance. An effort was 
made to have it called up and put to the vote ; but the ap- 
proach of the end of the session prevented this. 

(11) A bill to amend section 4078 of the Code was intro- 
duced in the senate and passed that body with only one adverse 
vote. It then went to the house and was favorably reported 
by the committee on public health. When put to the vote in 
the house it was defeated by two votes. The friends of the 
as(K>ciation were very hopeful of its passage ; but it came up at 
an unfortunate time, and did not receive due consideration. 

(12) A bill to amend section 1305 of the Code passed both 
houses and became a law. It modifies the section in question 
so as to declare that all persons actually engaged in practice in 
any county at the time of the organization therein of a board 
of examiners shall be entitled to the pro forma certificate with- 



THE REPORT OF THE BOARD OF CENSORS. 91 

out examination. The only counties materially affected by this 
law are DeKalb and Covington. In all the other counties cer- 
tificates had already been issued to all such persons as had been 
actually engaged in practice at the time of the organization of 
the county board ; or, if there were any exceptions they were 
few. This act here follows : 

To amend section 1305 of the Code. 

Sbction 1. Be it enacted by the General Asiemhly of Alabama, That 
section 1305 of the Code be and is hereby amended so as to read as fol- 
lows: 

Certificates may in certain cases be issued without examination. 
All physicians, druggists, or dealers in drugs and medicines, having 
license as hereinbefore provided, and all physicians actually engaged 
in the practice before the organization in the county of a board of medi- 
cal examiners, are, on application to an authorized board of medical 
examiners, entitled to certificates of qualification, without examination, 
and the physician is also entitled to have his name inscribed on the 
register of licensed practitioners of medicine. 

Approved February 27th, 1889. 

(13) A bill to amend the quarantine laws of the state was 
introduced into the senate, and finally passed both houses in 
the following words : 

An Act to amend the Quarantine Laws of the State. 

Be it enacted by the General Assembly of Alabama, That the state health 
officer, under the direction and control and under the rules and regula- 
tions of the state board of health, by and with the consent and concur- 
rence of the municipal authorities and the county health officer, shall 
have the'power, and it shall be his duty, to modify the restrictions of all 
quarantines established by county and municipal authorities in this 
state ; to make them more stringent whenever in his judgment they are 
not sufficient for the protection of the people, and to lessen their strin- 
gency whenever in his judgment they interfere with travel and traffic 
to an extent beyond what is necessary for the said protection. 



92 ALABAMA STATE MEDICAL ASSOCIATION. 



PART IL THE BEPORT OF THE STATE BOARD OF MEDICAL 

EXAMINERS. 

THE WORK OF THE STATE BOABD OF EXAMINERS. 

For the year 1888 we have received from the county boards 
of medical examiners seventy-seven (77) sets of examination 
papers. Of these, four were preHminary to the study of med- 
icine, and in aH the result was the granting of the certificate. 
The examinations for the practice of medicine number seventy- 
four, of which sixty-seven (67) were successful, and seven (7), 
or 10.44 per cent, were unsuccessful. This is about half the 
usual percentage of failures. 

One examination was conducted by the state board. The 
applicant was Mr. A. T. Haley of Shelby county. His exam- 
ination was not satisfactory, and he' failed to obtain the cer- 
tificate. 

A considerable number of county boards still do their work 
in a slovenly and unsystematic way that is not at all to their 
credit, as will appear in the section of this report entitled "The 
Work of the County Boards." But, on the other hand, a con- 
siderable number of county boards are now doing admirable 
work, and the tendency all along the line is towards improve- 
ment. This is evidenced by the remarks on the examination 
papers made by several members of the state board. 

One writes as follows : 

After a careful review of these papers, it is gratifying to be able to 
say that the improvement, as compared with the papers of previous 
years, is marked, both on the part of the examiners and on the part of 
the applicants, so much so, indeed, as to impress upon me the convic- 
tion that the whole state is undergoing a medical awakening. In some 
of the examinations no special regard was paid to the new rales for ex- 
amining boards adopted at the Tuskaloosa session of 1887 ; but in a 
large majority of the cases these rules have been fairly well observed. 
The character of the questions, too, is better, though in this particular 
there is yet certainly much improvement that might be made. In the 
main, however, the questions are less elementary than heretofore, less 
numerous, and more of a character to draw out the full knowledge of 



THE REPORT OF THE BOARD OF CENSORS. 93 

the applicant. The applicants, judging from their educational attain- 
ments, were generally better prepared for the study of medicine, and 
as a consequence passed better examinations than heretofore. From 
this we infer that while the ordinance requiring preliminary examina- 
tions is not generally observed, there is still a tacit agreement on the 
part of the profession to discourage incompetent young men from be- 
ginning the study of medicine ; nor is it too much, we think, to assume 
that the colleges, impressed with what is becoming a general desire for 
a higher medical education, are doing more thorough work than they 
did a few years ago. 

Another writes : 

I must be allowed to say, that as a whole these are the best papers I 
have been called on to examine since I have been on the board, and it 
is gratifying to note the rapid improvement we are making. The rule 
to have the papers bound was well conceived and will do great good by 
giving more importance to the examinations. 

Another writes : 

It gives me very great pleasure to commend the Mobile Medical Col- 
lege for the very efficient work they are doing. Their students compare 
favorably with any in the United States. 

Another writes : 

The general character of these papers makes them the best that have 
ever been submitted to me for criticism. They show a better common 
education in the applicants They also, as a rule, are compiled and 
sent up in a better shape for the use of the association. This is a much 
desired change, inasmuch as these papers are important documents, 
which are to remain permanently in the archives of the association, 
and which ma}' become important for legal reference in the future. I 
find that in some of the examinations the questions are very defective ; 
first, in not being clearly defined ; secondly, in not being of such scope 
as to test the applicant's knowledge of the subject. This is a serious 
defect, and calls for greater care on the part of the examiners in these 
cases. But these are the exceptions, and the general verdict is alto- 
gether favorable. 

THE ADMINISTRATION OF THE LAW TO REGULATE PRAOTIOE. 

As we have already explained, there is some uncertainty 
about the conBtmction of section 4078 of the Code — the section, 
namely, which provides a penalty for the violation of the law 



94: ALABAMA STATE MEDICAL ASSOCIATION. 

to regulate the practice of medicine. There is no way to 
decide the issaes iuvolved until a case under this section is 
taken up to the supreme court of the state, and this can be 
done only on appeal. So far, whenever we have got an indict- 
ment, we have won the case, and none of the defendants have 
chosen to appeal. As we have won all the cases we have had 
no occasion to appeal. If we had lost the cases appeal would 
not be open to us as the state can not appeal when she loses a 
criminal case. The construction of this section of the Code 
must then remain doubtful until some illegal practitioner, con- 
victed under it, sees fit to take his case to the supreme court. 
The legal adviser of the state board, Col. H. C. Tompkins, is 
of the opinion that the law will hold. 

In the meantime, our duty under the law is plain. We must 
continue to enforce it, in all cases, to the best of our ability ; 
and that there may be no mistake about our intention in this 
regard, we recommend the adoption by the association of the 
following rules : 

(1) Whenever any physician, not already holding a certifi- 
cate to practice medicine, derived from some authorized board 
of medical examiners in this state, moves into any county 
with the intention of engaging in the practice of medicine 
therein, it shall be the special duty of the board of medical ex- 
aminers of said county, promptly and without delay, to serve 
on such physician the official notice as provided on page 94 of 
the Book of the Kules requiring him to conform to the law. 

(2) If, after the service of the notice aforesaid, any physi- 
cian continues to practice medicine in violation of the law, it 
shall be the duty of the county board of medical examiners to 
get up the proof against him, and to prosecute him before some 
court of competent jurisdiction promptly and without delay. 

HOW ILLEGAL DOCIORS SHOULD BE TREATED. 

In spite of all that can be done to secure the enforcement of 
the law, it sometimes happens that doctors who have not com- 
plied with the law sometimes manage to practice for longer or 
shorter periods of time. Through the indifierence of solicitors, 



THE REPORT OF THE BOARD OF CENSORS. 96 

or through the prejudices of grand juries, it may be difficult to 
secure indictments. In one case a physician was indicted 
three times, plead guilty of the charge three times, and three 
times paid costs and fines before he gave up the fight. The 
possibility of such cases makes it proper for the association to 
prescribe rules for their treatment ; and to this end we recom- 
mend the adoption of the following ordinance : 

Be it Ordained by- the Medical Association of the State of Alabama, That 
physicians engaging in the practice of medicine in this state, in viola- 
tion of law, shall be regarded as dishonorable men and unethical prac- 
titioners, and as such shall be placed under the ban of the profession, 
and denied any sort of professional recognition. 

Even if it should be found hereafter that the penalty of the 
law can not be enforced without further legislation, that does 
not at all change the requirements of the law ; and it would 
still be true that every physician practicing without a certificate 
from some authorized board of medical examiners would be an 
illegal practitioner. He would have no legal right to practice, 
and therefore no moral right. He could not collect bills by 
law. He would not be a preferred creditor for medical atten- 
tion during the last illness of decedents. He would be under 
the ban of the profession, and excluded from all professional 
recognition, and from all professional organizations. In a 
word, he would occupy a position of embarrassment and humili- 
ation that would be intolerable to any honorable and self- 
respecting man. 

BINDING KXAMINATION PAPERS. 

The sets of examination papers, sent up from the county 
boards for the year 1888, number 77 — a full annual average. 
The binding of these, at fifty cents a volume, amounts to 
$38.50. The fees sent up amount to $21. A book case for 
the filing of these papers cost $10, expressage to $4.25. The 
total expenditures are therefore $52.25, which leaves the senior 
censor out of pocket to the amount of $31.25. Of course 
this amount will be made good out of future receipts from this 
fund. 



96 ALABAMA STATE MEDICAL ASSOCIATION. 

THE WOBK OF THE OOUNTY B0ABD6. 

The county boards of medical examiners have made reports 
for 1888 as follows : 

Antauga couDty board. For the study of medicine, none. For 'the 
practice of medicine, none. 

Baldwin county board. For the study of medicine, none. For the 
practice of medicine, none. 

Barbour county board. For the study of medicine, none. For fhe 
practice of medicine, none. 

Bibb county board. For the study of medicine, none. For the prac- 
tice of medicine, none. 

Blount county board. For the study of medicine, none. For the 
practice of medicine — 

John Henry Ellison, M. D., Medical Department of University of 
Tennessee, 1888. Certificate granted. 

H. B. Martin, M. D., certificate granted. 

Luther LaFayette Wikle, M. D., medical department of the Univer- 
sity of Tennessee, 1888. Certificate granted. 

These papers came up in bad order — not properly arranged, and not 
tagged together, and written upon scraps of paper of all sizes, from the 
full length of a sheet of legal cap, down to slips not over three inches 
long. There are no applications ; no schedule of the ratings or valua- 
tion of the answers ; obstetric operations and mechanism of labor are 
improperly included under the single head of obstetrics ; and some of 
the questions, and some of the answers are missing. The questions in 
about half the branches are reasonably well chosen. In the other half 
of the branches they are very badly chosen, especially in natural his- 
tory of diseases, and in physical diagnosis, in which the questions re- 
quire little more than the definition of terms. It is evident that the 
board did not give these examinations that careful attention which is 
demanded by work of so much importance. It is also evident that tlie 
supervisors who had charge of the examinations were either incompe- 
tent or very negligent. 

On the part of the applicants. Dr. Wikle 's answers are for the most 
part very good. The answers of Dr. Martin are fairly passable. Those 
of Dr. Ellison are sometimes very faulty. 

Bullock county board. For the study of medicine, none. For the 
practice of medicine, none, 



THE REPORT OF THE BOARD OF CENSORS. 97 

Butler county board. For the study of medicine, none. For the 
practice of medicine — 

Henry Gaither Perry, M. D., Georgia College of Eclectic Medicine 
and Surgery, 1888. Certificate granted. 

Charles A. Thigpen, M. D., medical department Tulane University, 
1888. Certificate granted. 

On the part of the board these examinations were well done, and the 
papers come up in good order. The only slip made is by one of the 
examiners, Dr. J. C. Kendrick, who includes the two branches, obstet- 
ric operations, and the mechanism of labor under the single head of 
obstetrics. The supervisor did his work well. 

On the part of the applicants every thing is satisfactory. Dr. Thig- 
pen makes the perfect grade of one hundred, an exceedingly rare de- 
gree of success. Dr. Perry, it will be observed, is the graduate of an 
eclectic college. He did himself credit, and is entitled to the high grade 
of eighty-eight awarded him by the board. 

Calhoun county board. For the study of medicine, none. For the 
practice of medicine — 

Robert Lee Bowcock, M. D., University of Virginia, 1886. Certifi- 
cate granted. 

Martin Luther Emrick, M. D., Jefferson Medical College, 1888. Cer- 
tificate refused. 

Willie Newton Jones, M. D., Louisville Medical College, 1888. Cer- 
tificate refused. 

John W. Overton, M. D., medical department of the University of 
Louisville, 1887. Certificate granted. 

Walter Howard Bell, M. D., Atlanta Medical College, 1888. Certifi- 
cate granted. 

On the part of the board these examinations are of varying merit, 
sometimes good and sometimes faulty. We are sorry to have to say 
that we think the board should have been a little more careful. 

Dr. Bowcock's examination is fairly good. Except for his lament- 
able want of a more thorough knowledge of the English language. 
Dr. Overton acquitted himself fairly well. In the examination of Dr. 
Jones but little attention was paid to the rules. Even if his examina- 
tion was considered to be very imperfect the ratings should have been 
attached to the papers, and all the formalities observed. Dr. Emrick 's 
examination was hurried through in two days. He should have taken 
more time. As it was he made 73.08, and needed only two more points 
to pass successfully. The questions in Dr. Bell's examination are too 
meagre. His answers are fair. 

Chambers county board. For the study of medicine, none. For the 
practice of medicine, none. 
7 



98 ALABAMA STATE MEDICAL ASSOCIATION. 

Cherokee county board. For the stady of medicine, none. For the 
practice of medicine — 

Josiah Littleton Barge, M. D., Atlanta Medical College, 1887. Cer- 
tificate granted. 

This examination in every way yery defective, both on the part of the 
board and on the part of the applicant. As it is the first examination 
made by this board we will not push our criticism into the mention of 
details, but content ourselves with the expression of the hope that they 
will make themselves in the future more familiar with the rules, and 
conduct their examinations more carefully and systematically. 

Chilton county board. For the study of medicine, none. For the 
practice of medicine — 

Frank Hamilton Dunklin, M. D., medical department of the Univer- 
sity of Tennessee. Certificate granted. 

In this case the rules governing the examining boards were sadly 
neglected. There was no supervisor, nor do the names of any of the 
examiners appear, nor their ratings. Altogether the examination was 
exceedingly poor, with almost nothing to relieve it, either on the part 
of the board, or on the part of the examiner. 

Choctaw county board. For the study of medicine, none. For the 
practice of medicine — 

Robert Henry Coleman, Jr., M. D., Medical College of Alabama, 
1888. Certificate granted. 

Walter Jackson Coleman, M. D., Medical College of Alabama, 1888. 
Certificate granted. 

William Brantly Shamberger, M. D., Louisville Medical College, 
1884. Certificate granted. 

Qn the part of the board in these examinations the questions are 
fairly good, although some of them are too elementary. There is no 
supervisor's certificate, and none of the ratings are given. These are 
serious defects. The applicants have all acquitted themselves very 
well. 

Clarke county board. For the study of medicine, none. For the 
practice of medicine — 

Bryan William Grant, M. D., Louisville Medical College, 1888. Cer- 
tificate granted. 

This examination was conducted by the board according to the old 
schedule. There is no application, no supervisor's certificate, and no 
schedules of the ratings in the difierent branches. The questions are 
written by the examiners with spaces between them for the answers, 
thus limiting the length and completeness of the answers, instead of 
leaving the applicant free to say as much as he might want to say in 
reply to each question. Within these arbitrary limitations the appli- 
cant has acquitted himself with credit. 



THE REPORT OF THE BOARD OF CENSORS. 99 

Clay county board. For the study of medicine, none. For the prac- 
tice of medicine, none. 

Cleburne county board. For the study of medicine, none. For the 
practice of medicine, none. 

Coffee county board. For the study of medicine, none. For the 
practice of medicine — 

Abner Richard Chapman, M. D., medical department of Vanderbilt 
University, 1888. Certificate granted. 

Robert Franklin Harper, M. D., Medical College of Alabama, 1888. 
Certificate granted. 

Several objections might be named to these papers. The questions 
are too elementary and too numerous, a fault that nearly all boards at 
first fall into. On the part of the applicants, also, they are not up to the 
average standard. Still, as this is the first effort of this board we pass 
the examinations as moderately good. 

Colbert county board. For the study of medicine, none. For the 
practice of medicine — 

Hugh Walter Blair, M. D., medical department of Vanderbilt Uni- 
versity, 1885. Certificate granted. 

William Warren Prater, M. D., medical department of the University 
of Nashville, 1882. Certificate granted. 

These examinations were conducted under circumstances of some 
embarrassment that need not be mentioned here. There is no appli- 
cation, no supervisor's certificate, and no schedules of the valuation of 
the answers in the different branches, all due to negligence on the part 
of the board. On the part of the applicants the answers are usually 
correct, but are deficient in fullness. The examinations may be allowed 
to pass, but are not altogether up to the standard. 

Conecuh county board. For the study of medicine, none. For the 
practice of medicine, none. 

Coosa county board. For the study of medicine, none. For the 
practice of medicine, none. 

Coviniston county board. For the study of medicine, none. For the 
practice of medicine, none. 

Crenshaw county board. For the study of medicine, none. For the 
practice of medicine — 

William Casper Duke, M. D., Kentucky School of Medicine, 1888. 
Certificate granted. 

This examination is very defective, both on the part of the board and 
on the part of the applicant. The application, supervisor's certificate, 
summary and ratings are all missing. It is to be hoped that this board 
will be more careful in the future. 



VS%"5i 



100 ALABAMA STATE MEDICAL ASSOCIATION. 

Cullman county board. For the study of medicine, none. For the 
practice of medicine— 

Bichard Alleyn, M. D., Laval UniverBity, Quebec, Canada, 1880. 
Certificate granted. 

These papers are extremely discreditable to the Cullman county 
board. The application, the supervisor's certificate, the summary and 
ratings, and the papers on chemistry, natural history of diseases, phys- 
ical diagnosis, mechanism o(, labor, hygiene, and medical jurisprudence, 
are all missing. There can be no possible excuse for this. In the few 
branches in which he was examined the applicant does only moderately 
well. 

Dale county board. For the study of medicine, none. For the prac- 
tice of medicine, none, 

Dallas county board. For the study of medicine, none. For the prac- 
tice of medicine — 

Mimms William Coleman, M. D., medical department of the Univer- 
sity of the city of New York, 1888. Certificate granted. 

Samuel Kirkpatrick, M. D., University of Nashville, and Vanderbilt 
University, 1888. Certificate granted. 

On the part of the board these examinations, on the whole, may be 
pronounced satisfactory, but they are faulty in more ways than one. 
There seems to have been no supervisor ; anyhow there is no super- 
visor's certificate. Obstetrics is included as one of the branches in 
place of obstetric operations, and mechanism of labor as prescribed in 
the current schedule. And there is an examination on ethics, which is 
not now required. In several of the branches the questions are more 
numerous than is necessary, and many of them too elementary to serve 
the purpose of testing the qualifications of the applicants. The appli- 
cants acquitted themselves well. 

DeKalb county board. For the study of medicine, none. For the 
practice of medicine — 

George Thomas Hays, M. D., Atlanta Medical College, 1888. Certifi- 
cate granted. 

Samuel Perry Smith, M. D., Kentucky School of Medicine, 1888. 
Certificate granted. 

On the part of the board these papers are in good shape, except that 
the questions are not repeated before the answers. The questions 
would be numerous enough if they were sufiiciently comprehensive ; 
but inasmuch as in some branches they are very elementary, they are 
too few. The ratings of the answers are very high — higher, we think, 
than they were worth. On the part of the applicants the examinations 
are both barely passable. 

Elmore county board. For the study of medicine, none. For the 
practice of medicine, none. 



THE REPORT OF THE BOARD OF CENSORS, 101 

Escambia coanty board. For the study of medicine, none. For the 
practice of medicine, none. 

Etowah county board. For the study of medicine, none. For the 
practice of medicine — 

William Thomas Coggin, M. D., Medical, Cellege of South Carolina, 
1885. Certificate granted. 

John Daniel Pifer, M. D., Bellview Hospital Medical College, 1888. 
Certificate granted. 

Raphael Morgan Russell, M. D., Bellview Hospital Medical College, 
1888. Certificate granted. 

Andrew B. Small, M. D., Memphis Hospital Medical College, 1888. 
Certificate granted. 

On the part of the board these examinations come up in very good 
shape, with a fairly good selection of questions. They have been rather 
liberal in their ratings, but all the applicants were rightly passed on the 
basis of their examination papers, all of the applicants making very 
good answers. 

In one of the cases the supervisor seems to be blamable. He certifies 
that the applicant had no access to books or other helps while in his 
presence. This is not the sort of certificate the rules require from 
supervisors. The case of Dr. Coggin is the one referred to. It is now 
believed that Dr. Coggin did manage to consult books in the course of 
his examination. It is also believed that his claim to be a graduate of 
the South Carolina Medical College is false, and on this ground he has 
been expelled from the Etowah county medical society. Dr. Pifer's 
examination is a very good one ; but since the certificate was awarded 
him he has degenerated into a peripatetic and advertising doctor. Of 
course neither the Etowah county board nor his alma mater can be held 
responsible for this. 

Fayette county board. For the study of medicine, none. For the 
practice of medicine — 

Lewis Clay Harvey, M. D., medical department of the University of 
Louisiana, 1861. Certificate granted. 

On the part of the board this examination was very carelessly done, 
and with complete disregard of the rules. There is no application, no 
supervisor's certificate, no ratings for the different branches, and no 
summary of ratings ; and neither the old nor the new schedule was fol- 
lowed. The branches included in the examination are chemistry, anat- 
omy, physiology, surgery, materia medica, physical diagnosis^ practice, 
obstetrics. A good many of the questions are too elementary. The 
answers are usually correct, but too brief and summary. This is the 
first examination made by this board. We hope it will be more careful 
hereafter. 

Franklin county board. For the study of medicine, none. For the 
practice of medicinei none. 



102 ALABAMA STATE MEDICAL ASSOCIATION, 

Geneva county board. For the study of medicine, none. For the 
practice of medicine, none. 

Greene county board. For the study of medicine, none. For the 
practice of medicine, none. 

Hale county board. For the study of medicine, none. For the prac- 
tice of medicine — 

William Marie Browder, M. D., Jefferson Medical College, 1888. Cer- 
tificate granted. 

This examination on the part of the board is defective by the omission 
of the schedules of valuation of the answers in the different branches, 
and also by the omission of the final summary of values — very serious 
omissions. On the part of the applicant it is satisfactory. 

Henry county board. For the study of medicine, none. For the 
practice of medicine, none. 

Jackson county board. For the study of medicine, none. For the 
practice of medicine, none. 

Jefferson county board. For the study of medicine, none. For the 
practice of medicine — 

Thomas Johnson, M. D., University of Maryland, 1848. Certificate 
granted. 

W. W. Ransom, M. D., Vanderbilt University, 1888. Certificate 
granted. 

Robert L. Riley, M. D., medical department of Tulane University, 
1884. Certificate granted. 

Louis Audenried Salade, M. D., medical department of the Univer- 
sity of Pennsylvania, 1888. Certificate granted. 

Job N. Statum, M. D., Atlanta Southern Medical College, 1888. Cer- 
tificate granted. 

Lewis Green Woodson, M. D., medical department of the University 
of Maryland, 1887. Certificate granted. 

On the part of the board these examinations are fairly well done so 
far as the character of the questions and the general management of the 
examinations is concerned ; but in several of the cases they have dis- 
tinctly valued the answers too high, thus passing men of questionable 
qualification. This is specially so in the cases of Dr. Statum and Dr. 
Johnson. Dr. Riley's examination is only pas<»able. Dr. Salade, and 
Dr. Ransom, and Dr. Woodson acquitted themselves very well. 

Lamar county board. For the study of medicine, none. For the 
practice of medicine, none. 

Lauderdale county board. For the study of medicine, none . For the 
practice of medicine- 
William H. Acton, M. D., medical department of Vanderbilt Univer- 
sity, 1888. Certificate granted. ^ 



m^l RilPORT OP f^E BOAkb OF dEifSoks. loS 

W. A. Caldwell, M. D., medical department of Vanderbilt Univer- 
Bity, 188S. Certificate granted. 

S. 0. Panlk, M. D., medical department of Vanderbilt University, 
1888. Certificate granted. 

On the part of the board these examinations were conducted in ac- 
cordance with the old schedule. Hence there is no supervisor's cer- 
tificate, and no table of the valuation of the answers, and no final sum- 
mary. Also there is no application. The board, therefore, is not to be 
congratulated upon its work. It is under obligation to know its duty. 
On the part of the applicants the work is barely passable. 

Lawrence county board. For the study of medicine, none. For the 
practice of medicine, none. 

Lee county board. For the study of medicine, none. For the prac- 
tice of medicine — 

Tucker Henderson Frazer, M. D., Medical College of Alabama, 1888. 
Certificate granted. 

Some of the schedules of the ratings in the different branches have 
been lost ; and the paper is written on both sides. Otherwise the ex- 
aminations are satisfactory, both on the part of the board and on the 
part of the applicant. 

Limestone county board. For the study of medicine — 

Mr. Mack Moore. Certificate granted. 

This examination is creditable to everybody concerned. 

For the practice of medicine — 

John Hamilton Hansford, M. D., University of Louisville, 1888. Cer- 
tificate granted. 

Howell Beckham Gwin, M. D., University of Louisville, 1888. Cer- 
tificate granted. 

These papers came up in good shape, and the questions are well 
chosen. Dr. Hansford's examination is fairly good; Dr. Gwin's only 
moderately so. 

Lowndes county board. For the study of medicine, none. For the 
practice of medicine — 

William B. Crum, M. D., Medical College of Alabama, 1888. Cer- 
tificate granted. 

Charles W. Powell, M. D., Medical College of Alabama, 1888. Cer- 
tificate granted. 

These examinations are satisfactory both on the part of the board 
and on the part of the applicants. The only adverse criticism demanded 
is in relation to the supervisor. His part of the work is not neatly 
done, and he does not use the prescribed form of certificate. 

Macon county board. For the study of medicine, none. For the 
practice of medicine — 



104 ALABAMA STATE MEDICAL ASSOCIATION. 

John Hora Gautier, M. D., University of Louisville, 1888. Certificate 
granted. 

This examination is satisfactory both on [the part of the board and on 
the part of the applicant, except that the board is to blame for the 
omission of one of the schedale branches — namely, physical diagnosis. 

Madison county board. For the study of medicine, none. For the 
practice of medicine — 

J. A. Haggard, M. D., Kentucky School o! Medicine. Certificate re- 
fused. 

This examination is creditable to the board. The applicant was 
righteously rejected. 

Marengo county board. For the study of medicine, none. For the 
practice of medicine, none. 

Marion county board. For the study of medicine, none. For the 
practice of medicine, none. 

Marshall county board. For^the study of medicine, none. For the 
practice of medicine — 

Jefferson Bennett Haralson, M. D., Memphis Hospital Medical Col- 
lege, 1888. Certificate granted. 

In making this examination the board has exhibited very culpable 
neglect of duty. The application, the supervisor's certificate, all the 
schedules of the ratings, the paper on the mechanism of labor, the paper 
on hygiene, and the paper on medical jurisprudence, are all missing. 
The questions propounded would do well enough for an oral examina- 
tion, but are not comprehensive enough for a written examination. On 
the part of the applicant the answers are too brief, and sometimes 
incorrect. 

Mobile county board. For the study of medicine, none. For the 
practice of medicine — 

Franklin K. Beck, M. D., Medical College of Alabama, 1888. Certifi- 
cate granted. 

Angelo Festorazzi, M. D., Medical College of Alabama, 1888. Certifi- 
cate granted. 

William R. Jackson, M. D., Medical College of Alabama, 1888. Cer- 
tificate granted. 

Calvin N. Owen, M. D., Medical College of Alabama, 1888. Certifi- 
cate granted. 

Chester K. Roe, M. D., Louisville Medical College, 1871. Certificate 
refused. 

Joshua D. Terrill, M. D., Ohio Medical College, 1885. Certificate 
refused. 

On the part of the board these examinations are substantially well 



THE REPORT OF THE BOARD OF CENSORS. 105 

done. The questions, as a rule, are well chosen, but to this there are 
some exceptions, one or two of the examiners using questions that are 
too elementary, and involving only the definition of terms. The work 
of the supervisor is done in a very unsatisfactory way. The papers are 
not arranged in schedule order, except in the case of Dr. Terrill ; the 
applications, with the same exception, are not in accordance with the 
rules ; the full names are not given ; the paper is not all of the same 
size ; and he has forwarded no fees. 

The successful applicants — ^Drs. Festorazzi, Jackson, and Owen, all 
acquitted themselves with credit. Drs. Roe and Terrill were properly 
rejected . 

Monroe county board. For the study of medicine — 
T. M. McMillan, 
James L. Sowell. 

These examinations include only English grammar, United States 
history, and chemistry. They are, therefore, defective. 
For the practice of medicine, none. 

Montgomery county board. For the study of medicine, none. For 
the practice of medicine — 

Joseph Lucius Gaston, M. D., College of Physicians and Surgeons, 
New York, 1885. Certificate granted. 

Willis £d ward Sterrs (colored), M. D., University of Michigan, 1888. 
Certificate granted. 

These papers came up in perfect order. The questions on the part 
of the board are generally good ; but those in physiology should be 
more clearly expressed, and there should be more than one question in 
the mechanism of labor. Both examinations are quite voluminous. 
Dr. Gaston's answers are very good. Dr. Sterrs is very diffuse, but 
does fairly well. 

Morgan county board. For the study of medicine, none. For the 
practice of medicine — 

Samuel Lile, M. D., medical department of the University of Louis- 
ville, 1888. Certificate granted. 

Eugene Maxey Littiejohn, .M. D., Baltimore Medical College, 1886. 
Certificate granted. 

Donald Lawrence Ross, M. D., McGill University, Montreal, Canada, 
1887. Certificate granted. 

Cornelius Ritchie Taylor, M. D., Long Island College Hospital, 1887. 
Certificate refused. 

On the part of the board these examinations, while affording room 
for improvement, are fairly satisfactory — would be entirely so if a little 
more attention had been given to details. Dr. Lile's examination was 
hurried through in two days, and shows evidence of haste. Dr. Little- 
John's examination is quite satisfactory, as is also that of Dr. Rosa. 
Dr. Taylor's is very poor indeedi and he was properly rejected. 



106 ALABAMA STATE MEDICAL ASSOClATlOIf. 

Perry county board. For the study of medicine, none. For the 
practice of medicine, none. 

Pickens county board. For the study of medicine, none. For the 
practice of medicine — 

John Knox Pumell, M. D., Medical College of Alabama, 1888. Cer- 
tificate granted. 

Rufus R. Wyatt, M. D., Louisville Medical College, 1883. Certificate 
granted. 

These papers do no credit to the board of examiners. They are in 
bad order and do not conform to the schedule ; there are no valuations of 
the answers, and there seems to have been no supervisor. Dr. Purnell's 
answers are fairly good. Dr. W^att's are very poor for the most part. 

Pike county board. For the study of medicine — 
L. Hendrick. Certificate granted. 

This is an extremely good preliminary examination — so good as to 
suggest that books were consulted in the preparation of it. 
For the practice of medicine, none. 

Randolph county board. For the study of medicine, none. For the 
practice of medicine — 

Jefierson Davis Duke, M. D., Southern Medical College, Atlanta, 
1888. Certificate granted. 

Powhatan Glover Trent, M. D., Atlanta Medical College, 1888. Cer- 
tificate granted. 

On the part of the board Dr. Duke's examination is defective. There 
are no ratings, no supervisor's certificate ,!and no papers on the natural 
history and diagnosis of diseases, or on the mechanism of labor, or on 
hygiene, or on n^edical jurisprudence. The examination of Dr. Trent 
is in good shape. On the part of the applicants both examinations are 
fairly good. 

Russell county board. For the study of medicine, none. For the 
practice of medicine — 

Henry Homer Allen, M. D., Medical College of Georgia, at Augusta, 
1888. Certificate granted. 

The board has been somewhat careless in making this examination, 
which is their first. The application, supervisor's certificate, and the 
papers on mechanism of labor, and obstetric operations, are missing. 
On the other branches the questions are numerous and comprehensive. 
On the part of the applicant the examination is a good one. 

Shelby county board. For the study of medicine, none. For the 
practice of medicine, none. 

St. Clair county board. For the study of medicine, none. For the 
practice of medicine — 



TBB REPORT OF THE BOARD OP CENSORS. 107 

Luther Whitfield Sheppard, M. D., Baltimore College of Physicians 
and Surgeons, 1885. Certificate granted. 

This examination is qnite defective on the part of the board, and su- 
pervisor. The schedules of the valuation of the answers are all miss- 
ing. The questions are fairly good. On the part of the applicant the 
examination is fair, although some of the questions in anatomy are 
poorly answered. 

Sumter county board. For the study of medicine, none. For the 
practice of medicine, none. 

Talladega county board. For the study of medicine, none. For the 
practice of medicine — 

Joseph Green Powell, M. D., medical department of the University 
of Tennessee, 1888. Ceatificate refused. 

Samuel D. Rhodes, M. D., College Physicians and Surgeons, 1874. 
Certificate granted. 

Edgar Hinton Whitten, M. D., Medical College of Alabama, 1887. 
Certificate granted. 

The board, in making these examinations, has evidently been very 
anxious to discharge their duty thoroughly, and they have succeeded 
fairly well. 

Some fault could be found with some of the applicants, but on the 
whole, they have all made a fair showing. 

Tallapoosa county board. For the study of medicine, none. For the 
practice of medicine — 

Joseph Wyley McClendon, M. D., Jefferson Medical College, 1888. 
Certificate granted. 

Isaac Eugene Webb, M. D., Atlanta Medical College, 1888. Certifi- 
cate granted. 

In these examinations the board have acquitted themselves fairly 
well. But they and the supervisor are to blame for not giving the 
schedules rating the answers to the questions. Both applicants have 
done well. 

Tuskaloosa county board. For the study of medicine, none. For the 
practice of medicine — 

John Montgomery Clifton, M. D., Medical College ot Alabama, 1888. 
Certificate granted. 

William Edward Rust, M. D., University of Pennsylvana, 1842. 
Certificate granted. 

On the part of the board these examinations are fairly well done. 
Some fault might be found with the questions on anatomy and surgery. 
On the part of the applicants the answers are fairly good. 

Walker county board. For the study of medicine, none. For the 
practice of medicine, none. 



108 ALABAMA STATE MEDICAL ASSOCIATION, 

Washington county board. For the Btady of medicine, none. For 
the practice of medicine, none. 

Wilcox county board. For the study of medicine, none. For the 
practice of medicine, none. 

Winston county board. For the study of medicine, none. For the 
practice of medicine, none. 



PAKT III. THE REPOBT OF THE STATE BOABD OF HEALTH. 

THB WORK OF THE 8TATK BOABD OF HEALTH. 

At the end of another year it aflfords ns mnch gratification 
to be able to report that the work of the health department is 
still making satisfactory progress. The state health officer has 
been so much occupied with other work that he has not been 
able to give as much time and attention as usual to the details 
connected with the collection of vital statistics. Nevertheless 
there has been considerable improvement in this verj difficult 
undertaking. The returns of births and deaths in many of 
the counties have been more nearly complete than ever before. 
The monthly reports have been sent in more promptly and in 
better shape; and the same statement is true of the annual 
reports. The county health officers are more generally paid, 
and in several instances their salaries have been increased. 

The special reports of the state health officer are more 
numerous than usual, and embrace the following subjects: 

(1) Beport of a visit to southern Florida in May last. 

(2) Beport of a visit to Atlanta. 

(3) Beport on the Augusta conference. 

(4) Beport on the yellow fever epidemic at Decatur. 

(5) Beport on the Milwaukee session of the American 
Public Health Association. 

(6) Beport of visit to Jacksonville in January. 

(7) Beport on the Montgomery quarantine conference. 
All these reports will be published in the annual report of 

the State Board of Health. 



THE REPORT OF THE BOARD OF CENSORS. 109 

Experience has demonstrated, over and over again, that suc- 
cess in the collection of vital statistics depends strictly on the 
thorough organization of our work in the beats. We have 
dwelt upon this fact in all of our recent reports; but while 
great improvement has been made in this direction, a great 
deal yet remains to be done ; and we therefore desire to call 
special and emphatic attention to it again, and to urge upon all 
the county boards of health and upon all the county health 
officers the paramount importance of bending all their energies 
to the prompt and rapid development in their respective coun- 
ties of our beat system of supervision and work. The time has 
gone by when it can be claimed that this beat system is im' 
practicable. That question has been definitely settled. It 
may bo impracticable for certain county health officers, but if 
so, that should be taken as .conclusive proof that such county 
health officers are not competent for the positions they occupy. 
In this connection we deem it important that every beat officer 
should be furnished with a beat register ; and that every beat 
officer should make out the monthly beat reports in due shape 
on Form 3^. Beat registers can be had now at one dollar and 
a half each. They should be paid for by the county commis- 
sioners. In special cases they could be furnished by the 
county health officers at their individual expense. When not 
to be had in any other way, a wide awake beat officer can very 
well afford to pay for his own beat register. It may seem a 
little hard to expect beat officers to work for nothing and to 
furnish their own tools besides ; but that is in strict accordance 
with the plans and practices of the association in all the depart- 
ments of its work. We claim the privilege not only of serving 
the state without pay, but the still higher privilege of paying 
with our own money the expenses incident to such service. 
That is the secret of our strength and of our success — and we 
have a mcst abundant reward. The money so spent is sure to 
come back to us with compound interest. 

Two other points which we have discussed again and again 
in our reports, require emphatic reassertion from us, namely : 

(1) The presidents of the county societies are too often 



110 ALABAMA STATE MEDICAL ASSOCIATION. 

more or less negligent of their official duties. They are the 
captains of the companies in our organization. Each one of 
them should hold himself responsible for the discipline and 
efficiency of his company, and it is his special prerogative and 
duty to see that his committee of public health and his county 
health officer acquit themselves with credit. 

(2) The county boards of censors, acting as committees of 
public health, have not discharged their duties to the state and 
to the state association when they have elected county health 
officers. They should do much more than this ; they should 
see that these county health officers do faithful and efficient 
work, and should give them hearty cooperation and assistance 
to overcome whatever difficulties and embarrassments may 
stand in the way of success. 

DELINQUENT COUNTIES. 

While, as we have said, the work of our county boards gen- 
erally is improving, there are several of the counties inex- 
cusably delinquent in this regard. Amongst these we feel 
that it is our duty to make special mention of the counties of 
Chambers, Chilton, Henry, Lauderdale, Lee, Macon, Marengo, 
Mobile, Pickens, Bussell and Walker. In all of these counties 
the conditions are favorable for successful work. All that is 
needed is for the county boards to appoint competent county 
health officers, and to go to work in the proper spirit. We 
call upon the boards of health in thAse counties to wake up 
from the slumber of inexcusable apathy into which they have 
fallen, and to vindicate themselves from this wholesale reproach 
of inefficiency and negligence. 

The Mobile county board of health we regard as specially 
culpable. Here is one of the leading boards of the state — a 
board that ought to be a model for imitation — that persist- 
ently fall short of its duty in regard to the collection of vital 
statistics. True, they have an excuse ; they say the board of 
county commissioners will make no appropriation to pay the 
salary of a county health officer, and that they can't get any- 
body who is willing to act in that capacity without pay. The 



THE REPORT OF THE BOARD OF CENSORS. HI 

simple answer to this is that they should grapple with this 
difficnltj and overcome it. The use of an armj is to win bat- 
tles. One of the special duties of our county boards of health 
is to conquer little difficulties that obstruct their progress along 
the road to success. This board has failed long enough. 

Note. — Since this was written the Mobile board has elected 
a county health officer, and the county commissioners have 
voted him a salary. 

THE INVESTIGATION OF DELINQUENT CX)UNTY SOCIETIES. 

At the session of the association in Montgomery last year 
we were instructed to investigate the county societies of Bar- 
bour, Greene, Macon, Mobile and Montgomery, which said 
societies were reported as delinquent in the performance of 
their duties as the boards of health of their respective counties. 
This duty we have performed to the best of our ability, and 
with results that will be specially noted in the third part of 
this report under the head of The Work of the County Boards 
of Health. 

We were also instructed to investigate the Bibb county med- 
ical society, which was reported by the vice-president of the 
northern division as in a bad state of organization. This duty 
we have performed to the best of our ability, and have to state, 
after a very considerable amount of effort, this society has 
recently elected officers to fill all the vacancies, and is now, it 
is hoped, in a condition to fulfill its obligations to the state 
association. 

The Cleburne county medical society has been for some time 
almost in a state of suspended animation, and negligent of its 
duties to the association. We are glad to be able to state that 
recently this society has again entered the field of active work ; 
and we hope hereafter it will give a better account of itself. 

In this connection we desire to call the attention of the vice- 
presidents to the urgent necessity there is for them to pay 
special attention to the weaker societies in their respective 
jurisdictions, and to give them all possible counsel and encour- 
agement in keeping up their organization and work. Amongst 



112 ALABAMA STATE MEDICAL ASSOCIATION. 

these weak eocietiea we mention as in need of very careful 
attention the societies of Oovington and Washington counties. 

THE COLOR BLIND LAW. 

The examiners nnder the color blind law remain as they 
were in 1887 ; and the work entrusted to them has gone on as 
usual. 

The case intended to test the constitutionality of that part 
of the law requiring the railroads to pay for the examination 
of their employees, is still pending in the supreme court. 

In the meantime the general constitutionality of the law has 
been affirmed by the supreme court in the following case : 

Nashville, Chattanooga & St. Louis Railway Co. v. The State. From 

Jackson Circuit Court. 

[Indictment against railroad corporation employing engineer without 

certificate as to color blindness. ] 

Stone, C. J. — 1. Constitutionality of statute as to examination ofraiU 
road engineers for color blindness. — The act approved February 28th, 
1887, for the protection of the traveling public against accidents result- 
iog from color-blindness or other defective vision on the part of rail- 
road engineers (Ses8. Acts 1886-7, p. 87), is constitutional under the 
decisions of this court (McDonald v. State, 81 Ala. 279), and of the Su- 
preme Court of the United States (Smith v. State, not yet reported) ; 
and if the^provision which declares that the examinations shall be at 
the expense of the railroad corporations, or the provision which author- 
izes the state board of bealh to make alterations or additions in or to 
the rules and requirements prescribed by the statute, one or both, be 
unconstitutional, or invalid for any reason, this would not destroy the 
entire statute, nor defeat a criminal prosecution under it. 

2. Employment of railroad engineer here, under contract made else- 
where. — Although the general assembly of Alabama can not regulate or 
prescribe the conditions of contracts made in another state, it may reg- 
ulate the employment of persons here under contracts made elsewhere ; 
and this is the extent of said statute approved February 28th, 1887, in 
reference to the employment of railroad engineers who have not been 
examined as required. 

Affirmed. 

The usual tables exhibiting the results of the examinations 
made during the year, will be published in the forthcoming 
report of this board. 



THE REPORT OF THE BOARD OF CENSORS. 113 

THE QTJASANTINE OODE OF ALABAMA. 

The tliirty-three propositions which are here subjoined were 
submitted by /the state health officer to the Quarantine Con- 
ference which was held in Montgomery on the 5th, 6th and 
7th days of March. By that body some of them were adopted, 
some of them were rejected, and some were not considered at 
all for want of time. 

We have duly considered all of them. They constitute a 
harmonious and systematic quarantine code, and we recom- 
mend that they be adopted by the association. 

Quarantine propositions submitted by Dr. Jerome Cochran, 
state health officer : 

THE QUARANTINE OF BAILBOADS. 

(1) During the prevalence of yellow fever epidemics, pas- 
sengers and freights should be brought from infected localities 
only under such regulations and restrictions as may be estab- 
lished by the health authorities along the lines of the roads con- 
cerned. 

(2) The regulations and restrictions governing railroad 
transportation during yellow fever epidemics should be of such 
character as to afford all reasonable guarantees of protection to 
the communities in danger of invasion by the disease, but 
should not be more onerous than the circumstances warrant, 
and should be framed with due consideration of the extent of 
the danger in each particular case, and as affected by latitude 
and seasons of the year, and other qualifying conditions. 

(3) At all seasons of the year, and under all circumstances, 
the simple passage of railroad trains should be allowed, with- 
out obstruction, even when carrying sick refugees from in- 
fected places to healthy localities willing to receive them. 

(4) When the transfer of passengers or freights from 
infected localities from one railroad to another becomes neces- 
sary, such transfers should be done under such precautions as 
may be deemed necessary by the health authorities of the places 

8 



114 ALABAMA STATE MEDICAL ASSOCIATION. 

at which the transfers are made ; but no restrictions should be 
made that will render sach transfers impracticable, and trans- 
fers of passengers and freights from places not infected should 
not be burdened with unnecessary restrictions. Quarantines 
against all the world are illegal, mischievous, and in every way 
unwarrantable. 

(5) Quarantine inspectors on railroad trains should be under 
the control of the health authorities of the several states, rather 
than under the control of the health authorities of the com- 
munities scattered along the line of the road. In this way 
quarantine regulations may be enforced with the smallest 
amount of friction and inconvenience to the travelling public, 
and with the maximum of efficiency and economy. At the 
same time the wishes of the local authorities should be treated 
with all due consideration. 

(6) When circumstances require it the States should estab- 
lish quarantine camps at such places as may be most conven- 
ient for the detention of travellers, disinfection of baggage, and 
treatment of the sick. It is barbarous and inhuman to dump 
off travellers of any sort, and especially women and children 
and the sick, on the side of the road to take care of themselves 
the best they can. 

THE LOCAL MANAGEMENT OF YELLOW FEVER. 

(7) When one case, or a few cases of yellow fever occur in 
any community, it does not follow of necessity that the disease 
must spread and become epidemic. On the contrary, the ex- 
perience of many countries through long periods of time shows 
conclusively that in the majority of such instances, and with- 
out the observance of any special means of prophylaxis, the 
disease fails to spread. 

(8) When one case, or a few cases of yellow fever occur in 
any community, in the light of our present knowledge of the 
habits and modes of propagation of the disease, it is generally 
possible, by the employment of the proper prophylactic meas- 
ures, to prevent the development of an epidemic. 



THE REPORT OF THE BOARD OF CENSORS, 115 

NOK INTB£00UB8E. 

(9) The golden rule for the prevention of the spread of 
yellow fever is non-intercourse — isolation — the keeping of the 
well away from the sick, away from infected things, and very 
specially away from infected localities. 

(10) In the enforcement of this golden rule of non-inter- 
course two problems present themselves for solution, (a) To 
keep the people generally from coming into the infected 
houses and the infected localities ; and (b) To keep doctors 
and nurses and other attendants and the well members of sick 
families from visiting and mingling with people outside of the 
infected houses and localities. The solution of the first of 
these problems is comparatively easy. The solution of the 
second is sufiiciently difficult. But it is possible to solve them 
both. 

(11) In the densely settled sections of cities guards may be 
useful for the enforcement of non-intercourse. They are 
much less needed in sparsely settled towns. In villages and 
county neighborhoods, as a rule, they are not needed at all. 
In all cases every intelligent family should be able to take care 
of itself — should be able to keep all of its members away from 
infected houses and localities, and to guard its own premises 
from invasion by dangerous persons and things. 

(12) Non-intercourse may be practiced in the very center 
of an infected district with considerable probability of escap- 
ing the fever. Cloistered convents and prisons in infected 
cities, with yellow fever raging all around them, usually escape 
invasion ; and there are numerous instances on record in which 
private families in the midst of epidemics have passed the 
ordeal safely by the vigorous enforcement of non-intercourse. 

DISINFECTION. 

(13) Disinfection in yellow fever is based very largely on 
theoretical grounds. Nevertheless, we believe that it may be 
made a valuable agent in checking the spread of the disease. 
In the beginning of an outbreak all the resources of disinfec- 



116 ALABAMA STATE MEDICAL ASSOCIATION. 

tion should be exhausted and these efforts should be continued 
until the epidemic is fully established. After the epidemic 
has subsided disinfection is of very questionable value. 

(14) The disinfecting agents most to be trusted are heat, 
especially moist heat, cold, both artificial and natural, and 
especially cold weather and frost ; and certain chemicals, espe- 
cially the bichloride of mercury and the fumes of burning 
sulphur. To these must be added ventillation. 

(15) The disinfection of beds, bedding, clothing, and arti- 
cles of similar character, is comparatively easy. The disinfec- 
tion of single rooms, and perhaps, also, of single houses, is 
more difiScult but not entirely impracticable. The disinfection 
of yards must be regarded as very difficult, but in the begin- 
ning of an outbreak it should be attempted. The disinfection 
of a whole city, or even of a large section of a city, seems not 
to be practicable. 

, DEPOPULATION. 

(16) In the beginning of an outbreak of yellow fever there 
is no need of depopulation at all, except of infected houses, or 
infected districts ; but if people who are able to afford the ex- 
pense desire to leave they should do so quietly and deliberately, 
and no obstacles should be placed in their way ; and those who 
leave healthy districts of the city or town should go wherever 
they please, without let or hindrance. 

(17) Persons living in infected houses, or in infected dis- 
tricts should be encouraged to leave, but should be allowed to 
leave only under such restrictions as will afford reasonable 
guarantees of safety to the communities in which they find 
asylum ; and they should be sent only to such communities as 
are willing to receive them. 

(18) In the depopulation of infected houses or of special 
infected districts, the inhabitants should be removed into 
camps of probation, or into vacant houses in the adjacent 
country. After five days detention, if they remain well, and 
under proper regulations, such as disinfection of baggage, they 
should be considered free from danger, and allowed to go 
freely into any community willing to receive them. 



THE REPORT OF THE BOARD OF CENSORS. 117 

(19) The depopulation of large cities is altogether impracti- 
cable. The depopnlatioD of sparsely settled towns and villages 
is altogether unnecessary, as in them it is always possible to 
prevent any general spread of the fever. 

(20) Befnge camps, that is to say, camps for the continued 
residence of people during the prevalence of epidemics, have 
heretofore been of very small value. One reason for this is 
that it is never possible to induce any considerable proportion 
of the population of an infected city to take refuge in the 
camps. Gamps of probation, for temporary detention, may 
often be very useful. 

(21) Panics and stampedes are always without excuse, and 
at the same time excessively mischievous. At the beginning 
yellow fever always spreads slowly ; and there is always time 
for every body who desires to leave an infected place to do so 
without hurry, and under proper regulations. 

SHOT OUN QUABANTINBS. 

(22) Shot gun quarantines are barbarous, and discreditable 
to our civilization. All quarantines should be under the con- 
trol of experts. 

HEALTH 0EBTIFI0ATB8. 

(23) Health certificates should be required only in the case 
of persons leaving an infected place. They should be issued 
only by the health official in charge of the infected place. In 
each certificate the person to whom it is issued should be so 
described as to admit of his identification, and should state the 
facts of the case fully and circumstantially. And to such cer- 
tificates full credence should be given by all health authorities. 
We must have honesty and mutual confidence amongst those 
charged with the protection of the public health. 

PLACES OF REFUGE, 

(24) Under proper regulations refugees from infected places 
may be allowed to go anywhere without danger of carrying 



118 ALABAMA STATE MEDICAL ASSOCIATION. 

iDfection with them, and should generally be allowed to do so. 
Still, it is better that they should go to cooler and more north- 
erly climates, and into states and cities not ordinarily subject 
to yellow fever. In regard to this matter, a great deal depends 
on the season of the year. In June or July precautions may 
be wise that would be entirely unnecessary in September or 
October. 

WHEN BEFUGBBS MAT BETUBN. 

(25) In most of our southern communities refugees from 
an infected place may return safely after the appearance of a 
killing frost. In the present state of onr knowledge it is not 
possible to say whether or not frost kills the yellow fever 
poison, but the experience of many hundreds of epidemics 
shows beyond all controversy that it puts an end to the pre- 
valence of the fever, 

(26) Even in places where no frost is ever known, expe- 
rience teaches that after the subsidence of the fever for a reas- 
onable time there is no longer any danger. When the fever 
disappears the danger of contracting the fever disappears also. 

HIBEBNATION. 

(27) In the extreme southern parts of our country, and in 
very mild winters, it is possible for yellow fever to live through 
the winter months and to become epidemic again on the advent 
of the following summer. But in all such instances it is kept 
alive by the occasional occurrence of scattered cases — cases 
springing up here and there at intervals of only a few weeks. 
It does not hibernate in any other way than this. It never 
goes to sleep when the cold weather comes in the autumn, to 
sleep for three, four or six months, and to be awakened into 
malignant life when the hot weather comes the next summer. 

FINANCIAL BIANAGEMENT. 

(28) In yellow fever epidemics, as under other circum- 
stances, all self-respecting persons and all self-respecting com- 
munities should pay their own expenses, and take care of them- 



THE REPORT OF THE BOARD OF CENSORS. 119 

selves jast as long as they are able to do so, and the aid of 
public charity should be Invoked only in cases of real necessity. 

(29) In yellow fever epidemics physicians should make 
their regular charges, just as in the treatment of other dis- 
eases, against all persons who are able to pay ; and neither 
physicians, nor medicines, nor nurses, nor provisions, nor any 
assistance of any kind should be furnished at the public 
expense to any persons except those who are really in indigent 
circumstances. To help those who are able to help themselves 
is an abuse of public charity. 

(30) The administration of the quarantine laws should 
always be under the direction of the legally constituted health 
authorities of the community to be protected. The health 
authorities may make mistakes, but they will make fewer mis- 
takes than the political authorities will make. As quarantines 
are at present conducted in many of the states, the aggregate 
of quarantine expenses is much greater than there is any neces- 
sity for. 

(31) The quarantine of small towns is a very simple 
problem, and may be managed without much expense. As the 
population increases the problem becomes more and more diffi- 
cult ; and in very large cities it requires for its wise solution 
the highest expert skill, and abundant means. 

(32) There are two sorts of quarantine fundamentally dis- 
tinct — the police quarantine and the scientific quarantine. 
The purpose of the police quarantine is to exclude everything 
coming froitx the infected locality. The purpose of the scien- 
tific quarantine is to exclude only such things as are dangerous. 
Very of ten, especially for the protection of small communities, 
the police quarantine is the only one that is available. But as 
far as circumstances will admit of it, the scientific quarantine, 
under the management of quarantine experts, should always be 
preferred. 

(33) Local quarantines, that is to say the separate quarantine 
of towns and counties, should, as far as circumstances will war- 
rant, be superseded by state quarantines, and this on the grounds 
alike of economy, efficiency, and convenience. 



120 ALABAMA STATE MEDICAL ASSOCIATION. 

THB BXBMPTION OF THE BTATB HEALTH OFFIOEE FROM QUABAN- 

TINE BESTRicnoiirs. 

It is well known to all yellow fever experts that it is quite 
possible to transport from a place infected with yellow fever to 
any healthy community, and without placing said community 
in danger, any specified person, whether he has previously had 
yellow fever or whether he has previously not had yellow 
fever. 

In the case of a person who has not previously had yellow 
fever two precautions are necessary ; (1) detention for a suiii. 
cient length of time to cover the period of incubation of yellow 
fever ; (2) such treatment of the person, clothing and baggage 
as will relieve them from any taint of yellow fever infection. 

In the case of a person who has previously had yellow fever 
all quarantine detention may be omitted, second attacks of 
yellow fever being so extremely infrequent that for all practical 
purposes they may be left out of the account. 

While these propositions are generally true, and while they 
would dominate the policy of a strictly scientific quarantine, 
it may not always be expedient to endeavor to carry them into 
practice, regard being had to the circumstances of special cases. 

But there are cases in wLich it is desirable and expedient 
that all quarantine regulations involving detention should be 
suspended; and very specially is this true in regard to the 
state health officer. He is well known; he has had yellow 
fever ; he understands how to free himself from Infection ; and 
he has too much at stake to omit any necessary precaution. 
He could not afford to carry yellow fever into any community 
in the state ; and there may be some very urgent cause requir- 
ing him to travel for the public welfare. 

Take a few instances in illustration : There is a report of 
yellow fever in some of our towns. It is his duty to go and 
investigate the report. Suppose he finds that yellow fever 
has in fact invaded the town, is he then to be locked up there 
indefinitely? Such a policy is not necessary for the protec- 
tion of the public health, and would often be inconsistent with 



THE REPORT OF THE BOARD OF CENSORS. 121 

the public welfare. Ordinarily he would not deeire to leave 
the infected place very soon ; bnt he shoald be allowed to 
leave it if entiicient occasion should arise. Suppose while he 
is in a town known to be infected, when suspicious cases of 
fever occur in some other town in which there are no yellow 
fever experts, public apprehension is aroused, and it is 
important that the true character of the suspected cases should 
be authoritatively determined; and this to the end that if 
it is yellow fever other communities may promptly institute 
measures for their protection ; and to the end that if it is 
not yellow fever other communities may be saved from use- 
less and unnecessary expense. 

It may be said that some expert from an uninfected town 
may be sent to make the investigation. But no such physician 
can afford to go on such a mission, because, if he finds yellow 
fever he will not be allowed to return to his home and his busi- 
ness until he has undergone the usual quarantine detention. 
In 1878, Drs. Gaston and Weatherly were sent by the city of 
'Montgomery to investigate some fever in Louisville. They 
reported that it was yellow fever, and thereupon were not per- 
mitted to return until after serving a period of quarantine de- 
tention. There was no understanding of this sort when they 
left home. The detention was entirely unnecessary, as both 
gentlemen had previously had yellow fever ; and the result is 
that they could not be induced to go on another such mission, 
no matter how great the anxiety of the people of Montgomery 
to know the truth. 

Last year, 1888, Dr. O. S. Iglehart, of Vicksburg, went to 
Jackson to help determine the character of some cases of fever 
there. He notified his people that it was yellow fever. His 
reward was that he had to remain away from home for twenty 
days. Here again it was perfectly well known that Dr. Iglehart 
had had the fever. He had demonstrated by active practice 
in several epidemics that he was fever proof. His detention 
for twenty days was a piece of unmitigated folly. 

In view of the facts and principles to which we have called 
attention, we respectfully recommend the adoption of the fol- 
lowing reeolutiou : 



122 ALABAMA STATE MEDICAL ASSOCIATION. 

Beiolved, That it is the opinion of the state board of health that the 
state health officer, in the discharge of his official duties, shoald not be 
submitted to quarantine detention, but that he may be safely allowed 
to go wherever his official duties may call him after exposure to yellow 
fever, provided he travels without baggage and makes use of the usual 
precautions in regard to his person and clothing. 



EXPENDITURES. 



The State Board of Health, 

In Account with the State of Alabama, 

1888. Dr. 

May 1. To cash from Auditor % 25000 

June 4. " " 25000 

July 2. " " 25000 

Aug. 2. " " 250 00 

Sept. 1. " " 250 00 

" 30. *' ** 100 00 

Oct. 3. '* " 15000 

Nov. 7. " " 25000 

Dec. 3. " ** 250 00 

1889. 

Jan. 5, " " 25000 

Feb. 2. '* " 250 00 

Mar. 1. " ** 25000 

" 30. " " 250 00 

Total receipts to April Ist $3,000 00 

1888. CREDITS. 

April 2. By postage $ 500 

11. postage 4 00 

21. postage 6 00 

28. postage 5 00 

May 1. Health Officer's salary (April) 150 00 

1. clerk's salary for April 60 00 

1. cash paid Brown & Co 50 00 

1. box rent 50 

5. postage 5 00 

28. postage 1 00 

30. postage 1 00 

31. postage 6 00 



THE REPORT OF THE BOARD OF CENSORS. 123 

Jane 4. By Health Officer's salary (May) $ 

4. clerk's salary for May 

6. postage 

23. postage 

Jnly 2. Health Officer's salary (June) 

2. clerk's salary for Jane 

2. postage 

2. box rent, P. O 

6. cash paid Brown & Go 

11. postage 

23. postage 

30. cash to Health Officer, trip to Mobile 

30. postage 

30. telegram to J. P. Wall (Ocala) 

30. answer to same 

Aag. 2. Health Officer's salary (Jaly) 

2. clerk's salary (July) 

3. postage 

9. two telegrams 

10. two telegrams 

16. postage 

21. telegram to Calera 

21. R. R. fare to Calera 

21. supper and bed, Calera 

22. R. R. fare Calera to Montgomery 

23. telegrams — Flomaton 

Aug. 24. postage 

31. postage 

31. telegrams — Flomaton 

Sept. 1. Health Officer's salary (August) 

Sept. 1. clerk's salary for August 

6. one dozen Advertisers 

10. postage 

18. telegram 

21. telegram 

21. ' telegram 

22. telegram 

Oct. 3. postage 

3. telegram 

3. telegram 

3. telegram 

3. telegram 

6. Health Officer's salary (September) 

6. clerk's salary for September 

6. postage ^ 



150 00 


50 00 


500 


500 


150 00 


50 00 


500 


1 50 


50 00 


500 


5 00 


13 30 


500 


1 40 


1 40 


150 00 


50 00 


5 00 


50 


80 


500 


40 


1 90 


1 00 


1 90 


1 35 


500 


500 


65 


160 00 


50 00 


50 


500 


45 


1 55 


1 20 


40 


1 00 


90 


1 10 


40 


20 


150 00 


50 00 


200 



124 ALABAMA STATE MEDICAL ASSOCIATION. 

Oct. 18. By postage $ 1 00 

21. postage 2 00 

21. drayage 25 

27. postage 1 00 

Nov. 7. Health Officer's salary (October) 150 00 

7. clerk's salary for October 50 00 

7. postage 2 50 

12. express 25 

20. postage 150 

20. box rent, P. 1 50 

Dec. 1. postage 6 00 

1. two telegrams, Camden 90 

3. Health Officer's salary (November) 150 00 

3. clerk's salary for November 50 00 

7. cash paid Brown & Co 100 00 

12. postage 5 00 

17. postage 5 00 

24. postage • 5 00 

27. cash to Joel White 11 45 

£l . CaMU «0 ^L. mT. XI . A, .••••*•.•••■•.«...«••••...•. A,4 Knt 

Jan. 2. postage 5 00 

2. box rent, post-office I 50 

5. Health Officer's salary, (December) 150 00 

5. clerk's salary, (December) 50 00 

10. postage 5 00 

11. package to Camden 20 

17. postage 2 00 

21. express on yellow fever pamphlets 3 25 

21. postage 10 00 

23. postage 6 00 

Feb. 2. postage 5 00 

5. Health Officer's salary, (January) 150 00 

5. clerk's salary for January 50 00 

6. express on four packages 1 (X) 

9. postage 4 00 

13. express on three packages 75 

16. postage 5 00 

M'ch 1. Health Officer's salary, (February) 150 00 

1. clerk's salary for February 50 00 

1. postage 5 00 

8. postage 5 00 

12. postage received from Dr. Ruckel for binding 

examination papers 1 00 

20. cash paid Brown <& Co 125 00 

20. one dozen Advertisers 50 



THE REPORT OF THE BOARD OF CENSORS. 125 

Mar. 20. By postage | 6 00 

30. Health Officer's salary, (March) 150 00 

30. clerk's salary for March 50 00 

30. postage 1 60 

30. cash paid Brown <& Co 28 55 

Total credits to Aprill, 1889 $3,000 00 

RECAPITULATION OF EXPENDITURES. 

Health Officer's salary from April 1, 1888, to April 1 , 18S9. . . .$1,800 00 

Clerk's salary for same time 600 00 

Postage for same time 170 00 

Miscellaneous for same time 76 45 

Amount paid for printing 353 55 

Total $3,000 00 

GENERAL RECAPITULATION. 

To total receipts from April 1, 1888, to April J , 1889 $3,000 00 

By total expenditures j 3,000 00 

THE WOBK OF THB CX)UNTY BOARDS OF HEALTH. 

Autauga county. — ^There has been very little change in the methods 
and results of the work of collecting vital statistics in Autauga county. 
There seem to be some special difficulties in the way of establishing 
the beat system there in its integrity ; and until this can be done we 
cannot expect to get complete returns of the births and deaths. In the 
meantime it is certain that if the doctors of the county would put their 
shoulders to the wheel in good earnest all the difficulties referred to 
would soon pass away. The returns from the town of Prattville are, as 
usual, complete. Dr. S. P. Smith acted as county health officer for the 
year under review ; but has now been superceded by Dr. LeRoy J. 
Simpson, of Autauga ville. The health officer's salary is one hundred 
dollars a year. 

Baldwin county. — The woik in this county has gone on during the 
past year about as heretofore. Two of the physicians of the county 
have been habitually negligent of their duty under the law — a distinc- 
tion of which no physician can afford to be proud. It is to be hoped 
that these physicians can be induced to do better during the current 
year. Dr. E. L. Marechal is still the county health officer, and has 
manifested commendable energy in the discharge of his official duties. 
The board of county commissioners have recently voted him an annual 



126 ALABAMA STATE MEDICAL ASSOCIATION. 

salary of two handred dollars, an amount that will justify him in giT- 
ing more time to the supervision of the work, which consequently may 
now be expected to improve. 

Barbour county, — This is one of the counties to which the S(>ecial at- 
tention of the State Board was called at our last annual session, and in 
regard to which special action was taken. The result of this has been 
that the Barbour county board has elected a county health officer, and 
has again engaged in the collection of vital statistics. A tolerably com- 
plete medical directory for the county has been prepared, and the 
monthly reports have been sent in from the first of the present year. 
Dr. W. H. Robertson is the county health officer. His salary is three 
hundred dollars a year — a sum that ought to secure good work. 

Bibb county. — In regard to this county we can only repeat the sub- 
stance of what we said in our last annual report. During; the past year 
nothing at all has been done in the way of collecting vital statistics. 
The county medical society has been in a quasi state of suspended 
vitality, and all of its duties have been more or less neglected. Re- 
cently, however, the society has had a meeting and filled out its comple- 
ment of officers. We can only express the hope that they will now 
resume the discharge of their duties as a county board of health. 

Blount county, — There has been considerable improvement in our 
work in Blount county. The directory has been improved, the monthly 
reports have come in regularly, and the returns of births and deaths 
for 1888 have been fuller than for the previous year. We hope this im- 
provement will continue, and by the close of the current year this 
county will be in a satisfactory condition. Dr. Joseph F. Hendricks 
was health officer for the year just past, with an annual salary of 
seventy-five dollars — the first salary ever paid a health officer in this 
county. Recently Dr. W. M. Cole has been appointed county health 
officer. 

Bullock county,— In this county the collection of vital statistics con- 
tinues to be admirably done, and the county board of health is alive to 
all of its duties. Dr. R. H. Hays is still the county health officer. He 
receives an annual salary of one hundred and fifty dollars ; and the 
county furnishes the necessary blank books for registration and other 
uses. For the board of health, the efficient county health officer, and 
the county commissioners we have only words of praise. 

Butler county.— In this county the work of collecting vital statistics 
goes on about as heretofore. The work is tolerably well done, but it 
is not perfect. We think a little more effijrt on the part of all con- 
cerned would soon make it so, and we hope this additional effort will 
be made. Dr. Job Thigpen continues to act as county health officer. 



THE REPORT OF THE BOARD OF CENSORS. 127 

His salary last year was ninety dollars. He ought to be more liberally 
paid. 

Calhoun county. — ^During a part of last year our work in Calhoun 
county was not on a satisfactory basis. It has, however, greatly im- 
proved during the last few months, and is now moving on smoothly and 
well, and promises soon to be of such character as to place this county 
near the head of the column. Dr. Jno. M. Crook has been re-elected 
county health ofScer. His salary is one hundred and fifty dollars a 
year. So wealthy and populous a county as Calhoun should pay at 
least two hundred dollars and furnish all the needful books. 

Chambers county, — In regard to this county we are under the disagree- 
able necessity of repeating what we said in our last year's report, 
namely : '*In this county the board of health is strangely negligent of 
its duty, and there is no excuse for if The state health officer has 
exerted himself to bring about a better state of affairs, but so far with- 
out success. There are quite a number of doctors in the county, and 
they are well scattered, so that everything is favorable for efficient 
work. All that is needed is an efficient health officer, the present nom- 
inal incumbent of that position being a complete failure. The board of 
health of the county deserve s- vere censure for their failure to discharge 
their duty. 

Cherokee county, — The work of collecting vital statistics in this county 
has gone regularly on, improving slowly. There is still room for im- 
provement. Perhaps as much has been done as could have been 
reasonably expected under the circumstances, but we hope more earn- 
est efforts will be made this year. Dr. A. M. McWhorter is still the 
county health officer. 

Chilton county. — No work in our line has been done in this county 
during the past year. The county board of health has been inexcusa- 
bly negligent of their duty. There is no special difficulty in the way 
except the want of a leader. There is not a county in the state in which 
the collection of vital statistics could be more easily accomplished. The 
doctors composing the medical society should be ashamed of them- 
selves, and do penance in sack cloth and ashes. 

Choctaw county, — During the past year our work in this county has 
not improved. We have a good medical directory for the county, and 
the monthly reports come in regularly. But the returns are still de- 
fective. We would urge upon the board the imperative duty which 
rest upon them to make an earnest effort this year to overcome the dif- 
ficulties, whatever they may be, which have heretofore prevented the 
success of their work. Dr. R. B. Carr continues to act as county health 
officer. 



128 ALABAMA STATE MEDICAL ASSOCIATION. 

Clarke county. — In Clarke our work has improved very greatly, and 
is now in a very satisfactory condition. The health officer is Dr. J. W. 
Armistead. His salary is sixty dollars a year. Con8i<lering the char- 
acter of the work he is now performing the county commissioners should 
not hesitate to increase it largely. 

Clay county. — During the past year our work in Clay county has gone 
on moderately well. We have received regular monthly reports, have 
a tolerably good medical directory, and the outlook is fairly good. Dr. 
W, 0. Jenkins has been succeeded as county health officer by Dr. A. 
L. Harlan, who promises to be efficient. 

Cleburne county. — In this county, as for several years past, no effort 
was made to collect vital statistics in 188*^. Recently Dr. O. W. Shep- 
ard has been elected county health officer, and promises to use his best 
endeavors to secure success. We can not forecast the result. 

Coffee county, — In this county nothing has been done in the way of 
the collection of vital statistics since the death of Dr. J. G. Moore, some 
eighteen months ago. This furnishes a striking illustration of how 
much may depend upon one man. Dr. Moore made the work a con- 
spicuous success, and his death involved a great loss to us. There is 
no immediate prospect that this work will be renewed in this county. 

Colbert county, — Last year again, after its traditional fashion, Colbert 
county made a failure in the collection of vital statistics. Some new 
blood has got into the county society, and put a little energy into it; so 
that now the outlook is very encouraging. Dr. S. J. Cooper is still the 
county health officer. 

Conecuh county. — The collection of vital statistics in this county con- 
tinues to be well done. Dr. A. A. McKittrick continues to be the county 
health officer, and still manages to get full returns of births and deaths. 
He deserves credit for his good word. His salary has been increased 
to two hundred dollars a year— a well deserved compliment to a faith- 
ful officer. 

Coo8a county. — In Coosa very little was done in 1888. Dr. Maxwell, 
the county health officer, was away for some months and the work did 
not flourish in the hands of his locum tenens. He has now resumed his 
place, and the outlook for the current year is fairly encouraging. His 
salary is one hundred dollars a year — a fairly adequate compensation 
for the work done. 

Covington county, — This county was admitted into the association last 
year. No effort has been made in it yet for the collection of vital sta- 
tistics ; and considering the status of the county, sparsely settled, and 
with few doctors, it is not probable that much can be done in the near 
future. 



THE REPORT OF THE BOARD OF CENSORS. 129 

Crenshaw county, — In this county our work has gone on regularly, but 
not with satisfactory results. We have for it a tolerably good medical 
directory, and the monthly and annual reports have been duly received. 
But the returns are imperfect and do not improve. Dr. F. M. T. Tank- 
ersly was county health officer during the past year. He has been 
recently succeeded by Dr. S. W. May. Up to this time this county has 
failed to pay anything to the county health officer. 

CuUman county. — In this county very little was done last year. The 
county board elected Dr. M . L. Johnson .county health officer, but he 
has made no reports. 

Dale county, — The work in this county has dragged heavily, and the 
reports received have been very defective. Dr. J. 0. Holman was 
county health officer in 1888. Since the beginning of the year no re- 
ports have been received. The health officer had no salary, and got 
tired of working for nothing. We are clearly of the opinion that the 
county board should not have abandoned this work. 

Dallas county,— Better work was done in this county by far than ever 
before. This was due to the energy and tact of Dr. Jno. A. McKinnon, 
the county health officer. Dr. McKinnon has been superseded by Dr. 
M. W. Coleman. The annual salary of the county health officer is two 
hundred and forty dollars. 

DeKalh county, — Our work in this county has improved somewhat, 
but is not yet on a satisfactory basis. The monthly and annual reports 
are received regularly, but the returns are quite defective. Dr. T. J. 
Weaver is county health officer. He has no salary. 

Elmore county. — ^The work in this county has improved and the pros- 
pect is that it will continue to improve. We have for it a good medical 
directory, and the reports are regularly made. Dr. 0. S. Justice con- 
tinues to act as county health officer. He receives no salary as yet, 
but the time has now come when the county commissioners should 
award him a fair recompense for his services. 

Escambia county. — In this county during the past year the collection 
of vital statistics was very well done. The county is well organized, 
has a good medical directory, and if the county health officer is not 
mistaken the returns have been about complete. Dr. A. C. Hundley 
was county health officer until recently, when he was succeeded by Dr. 
S. G. Henderson. The health officer's salary is one hundred dollars a 
year. 

Etowah county, — In this county there was last year a decided retro- 
gression in our work under Dr. J. N. Kittrell as county health officer. 
The reports came in with tolerable regularity, but were quite defective. 
Dr. M. R. Wright was restored to the position on the first of January, 
9 



130 ALABAMA STATE MEDICAL AS80CIATT0N. 

with the result that cooBiderable improvement is already manifest. 
His salary is two handred and twenty-five dollars a year. 

Fayette county, — ^The improvement of our work in this county has 
been rapid and lasting under the energetic management of Dr. T. B. 
Woods, the county health officer, and the outlook is encouraging. The 
health officer's salary is one hundred dollars a year. 

Franklin county. — The board of health of Franklin county have 
appointed a county health officer, Dr. W. W. Cleere, but he has never 
made a report. 

Geneva county.— This county was admitted into the association last 
year. Dr. T. J. Ward has been elected county health officer. He has 
got up a pretty fair directory for his county, but as yet has made no 
reports. His salary is twenty dollars for this year. 

Qreene county, — The county of Greene, as is well known, has been 
negligent of its duties under the health laws of the state for the last 
four years. It is one of the counties that was specially complained of 
in our annual report for last year. The county board have concluded 
again to enter the field; and have elected Dr. T. W. Pierce county 
health officer. 

Hale county, — We had occasion in our last report to remark on the 
decline of our work in Hale county ; and upon the neglect of his duties 
by Dr. W. G. Avery, the county health officer. This negligence on his 
part continued and grew more fiagrant during the past year. Recently 
he has been superseded by Dr. Jacob Huggins. The annual salary of 
the health officer is one hundred and fifty dollars. 

Henry county, — It was our disagreeable duty in our last report to have 
to speak of the collapse of our work in this county. Since then a spas- 
modic effort was made to have the work resumed, but it amounted to 
nothing. In this county the collection of statistics should be well done. 
There is nothing in the way except a demoralized medical profession. 
Dr. J. I. Darby is the nominal county health officer. 

Jack%on county, — Our work in Jackson county was gradually improving 
until the beginning of last year, when the board of health elected an 
incompetent man to be county health officer, with the results that last 
year's statistics are of no value. With the beginning of this year they 
elected Dr. Andy Boyd as county health officer. Already be has put 
the collection of statistics in this county on a better footing than it ever 
had before ; and the outlook for the future is very encouraging. His 
salary is one hundred dollars a year. 

Jefferion county. — During the past year there has been a marked im- 
provement in our work in Jefferson county. It is still defective in 
some of its details, but on the whole is fairly well done. We hope that 



THE REPORT OF THE BOARD OF CENSORS. 131 

before the end of thiB year all these defects will be overcome. Dr. J. 
C. Dozier has been re-elected county health officer. His salary is six 
hundred dollars a year. 

Lamar county. — In this county the work of collecting vital statistics 
continues to be fairly well done, but it is not so complete as we would 
like to have it. Dr. Reddin^i; is still the county health officer. 

Lauderdale county. — ^This county was organized two years ago, and 
has a county health officer, but he has never made any reports. It is a 
populous county, and has a full supply of doctors, and is one of the 
counties in which the collection of statistics should not be neglected 
any longer. 

Latorenee county. — In this county our work is tolerably well done, 
but is still defective. There has been no great change in it during the 
past year. Dr. F. S. McMahon is still the county health officer. 

NoTB. — Since the above was written. Dr. F. S. McMahon has died, 
and has been succeeded by the brother Dr. W. J. McMahon. 

Lee county. — The work in Lee last year turned out a complete failure. 
Dr. Charles B. McCoy was elected county health officer, and has not 
made a single report. The Lee county society should do better than 
this. 

lAmestone county. — ^This county is not in a satisfactory condition. 
We get reports from it occasionally in the course of the year, and always 
get the annual report. The board of health has never conformed to the 
rules of the state board in regard to the beat system. Dr. W. J. Hagan 
is the county health officer. 

Lotmdes county. — Our work in Lowndes continues to be thoroughly 
well done. Dr. Shirley Bragg is still the efficient county health officer. 
His salary is six hundred dollars a year. 

Macon county. — ^This is one of the counties in regard to which the 
state board, at our last annual session, took special action. The result 
of our remonstrance was that the Macon board elected a new county 
health officer. Dr. Jno. H. Gautier ; but nothing else has been done. 
We recommend that this board be again earnestly requested to go to 
work and make some reasonable effort towards the discharge of its 
duties. 

Madison county, — ^In this county the improvement in our work has 
been marked. The situation is satisfactory, and there is good prospect 
that the improvement will continue. Dr. S. H. Lowery is the county 
health officer. His salary is two hundred dollars a year. 

Marengo county. — ^The work in this county is still in a state of col- 
lapse, Pr. Arnold Jolly is still the county health officer. He has sent in 



132 ALABAMA STATE MEDICAL ASSOCIATION. 

no report for a year and a half. This year he sent in a report for Jan- 
uary, but it was so defective it had to be sent back. This county ought 
to do better. 

Note. — Since the above notice was written Dr. G. B. Thomas has 
been elected health officer of Marengo counly. 

Marion county, — This is one of the newly organized counties. The 
county board have undertaken the collection of vital statistics, but not 
yet in a systematic way. They have no medical directory, and cannot 
be expected to succeed without it. Dr. Warren Guyton is the county 
health officer. 

Marshall county, — Our work in Marshall has never been on a satisfac- 
tory footing. We are now getting monthly reports, but they are very 
defective. Dr. W. M. Ricketts is the county health ofiicer. He gets 
no salary. 

Mobile county. — At our last annual session the State Health Officer 
was instructed to insist on monthly reports of vital statistics for the 
city of Mobile from the Mobile board of health ; and if it should be- 
come necessary, to secure legal advice, and sue out an injunction to 
compel said board to do its duty in this regard. In accordance with 
these instructions correspondence was opened with the Mobile board 
which took the matter under consideration. After much discussion 
and consultation of lawyers, the society, acting as a county board of 
health, ordered the committee of public health to make the reports de- 
manded. Monthly reports were accordingly sent in for six months — 
from July to December, both inclusive. Since the beginning of the 
present year no reports have been received. It is greatly to be regret- 
ted that this board is so persistently negligent of its duties under the 
law. It is one of the leading boards of the state, and should set a bet- 
ter example. We respectfully recommend that the instructions of last 
year in regard to this board be renewed and continued in force so that 
if it should be found necessary, the proper legal steps may be taken to 
vindicate the authority of the state board. 

NoTB. — Since the foregoing notice was written, Dr. D. G. Randle has 
been elected health officer of Mobile county, and proposes to make nil 
the re(^uired reports. His salary has been fixed at three hundred 
dollars. 

Monroe county.— Out work continues to be well done in Monroe, 
although there are still some defects in the returns from two or three 
beats. Dr. McMillan is still the county health officer, and deserves 
praise for the high degree of success he has attained. We hope he will 
not be satisfied untill he has conquered the difficulties in the two or 
three defective beats. The health officer's salary is one hundred 
dollars. 



THE REPORT OF THE BOARD OF CENSORS. 133 

Montgomery county. — In our last annual report we had occasion to 
call special attention to the delinquency of the bijard of health of this 
county, and were authorized to insist that they should comply with the 
requirements of the law. The result has been that anew health officer 
was elected, and the collection of vital statistics resumed. We have a 
partial medical directory for the county ; the monthly reports have 
been regularly made since July ; and there is now some further promise 
of improvement. Dr. P. H. Owen is the county health officer. There 
is an appropriation to defray the expenses of the office, but as yet none 
for the health officer's salary. 

Morgan county. — In this county our work has gone on about as usual. 
It is done tolerably well, but ought to be done better. It is perfectly 
possible to place this county in the front rank. Dr. B. F. Cross is still 
the county health officer. His salary is one hundred and fifty dollars. 

Perry county. — During the early part of last year our work in Perry 
county grew from bad to worse and finally collapsed entirely. A new 
county health officer. Dr. £. B. Thompson, has been elected this year. 
It remains to be seen whether he will succeed or not. 

NoTB. — Since the above was written Dr. G. A. Thigpen has been 
elected health officer of Perry county. 

Pickens county. — In our report last year we stated that the work in 
Pickens had been virtually abandoned. In May the board elected a 
new county health officer. Dr. J. C. H. Jones. He went to work very 
energetically and for a few months his success was very marked. Sud- 
denly he ceased to make his monthly reports, and, of course, the usual 
result followed. He promises to do better this year. 

Pike county. — In this county our work has steadily improved. There 
are still some defects in the organization of some of the beats, which 
we hope will be spedily overcome. This county could easily do perfect 
work. Dr. P. H. Brown is still the county health officer. 

Randolph county. — ^The hopes we expressed last year in regard to our 
work in Randolph have not been fulfilled ; Dr. Heflin went to New 
York to attend lectures, leaving the county without a health officer. 
Since the first of the current year a new health officer has been ap- 
pointed, Dr. P. G. Trent, Jr. We can only hope he will make the 
work a success. 

Russell county, — No reports have been received from this county for 
many months. It is quite possible to collect vital statistics in this 
county ; and it is to be hoped that the county board of health will soon 
resume work. 

Shelby county. — Our experience in Shelby has been unfortunate. In 
1887 Dr. Gunn, who was then county health officer, brought the work 



134 ALABAMA STATE MEDICAL ASSOCIATION. 

to a high degree of excellence. He gave up the place, and for a while 
the work languished. Dr. Geddings was then elected, and succeeded 
very well. During the course of last year he resigned, and left the 
state. Dr. J. R. Morgan was his successor, but has done nothing. It 
has been demonstrated that success is entirely feasable in this county, 
and there is no excuse for the failure that has occurred. 

SL Clair county, — In our report for 1887 we were forced to give an 
unfavorable account of our work in this county. We are glad to say 
that during the past year it has been completely redeemed ; and it is 
now in a very satisfactory condition. This is due to the efficient man- 
agement of the present county health officer. Dr. D. E. Gason. 

Sumter county, — We had in our last annual report to give an unfavor- 
able account of our work in this county. We are sorry to have to say 
that it continues to be unsatisfactory. Dr. W. H. Sledge is still the 
county health officer. His salary is one hundred dollars a year. 

Talladega county. — ^The improvement of our work in this county has 
been considerable ; and the outlook is favorable for still better work in 
the future. Dr. B. B. Simms is still the county health officer. 

Note. — Since the above was written, Dr. Simms has resigned and Dr. 
W. F. Thetford has been elected county health officer. His salary is 
two hundred dollars a year. 

Tallapoosa county, — ^There has been some improvement in this county 
but not as much as there ought to have been. Dr. J. A. Goggans is 
the county health officer. His salary is one hundred dollars. His 
great fault is his negligence and procrastination. It has proved to be 
impossible to get him to send in his reports regularly and promptly. 
It is quite possible to put this county in the front rank. 

Tuscaloosa county. — The condition of our work in this county is about 
the same as it was last year. In other words, while the reports are 
regularly made, they are quite defective, and do not improve. Dr. 0. 
H. Burton is the county health officer, and his salary is one hundred 
dollars. 

Walker county, — In this county nothing has been done for several 
years in the way of collecting vital statistics. Dr. A. M. Stovall is still 
the county health officer. His utter failure to discharge the duties of 
the office is not at all to his credit. Nor is it to the credit of his board 
that they allow this state of affairs to continue. 

Washington county, — In this county no attempt to collect vital statis- 
tics has ever been* made. Dr. John Gordon is the county health officer. 

Wilcox county, — Our work in this county goes on about as usual. We 
have a good county directory, with beat officers in all the beats, and the 



THE REPORT OP THE BOARD OF CRIfSORS. 186 

monthly reports are regularly made. Dr. Kilpatrick, the county health 
officer, seems anxious to do his whole duty, but he has succeeded only 
moderately well. His salary is one hundred dollars. 

Winston county, — ^This county was organized last year. We have for 
it a good medical directory, the monthly reports come in regularly, and 
the outlook is encouraging ; all of which is due to Dr. Thomas P. De- 
weese, the county health officer. 



PART IV. SUPPLEMENTAKY PAPERS. 

THE WORK OF THE MONTGOMBBY QUABANTINB OONFEBENOB. 

We have gathered together all the resolutions adopted by the 
Montgomery Qaarantine Conference, and herewith present 
them in the order in which they were adopted. This is by no 
means their natural order of arrangement. A natural arrange- 
ment and a little jndicions editing would have made them ap- 
pear to much better advantage. The numbering of the sec- 
tions is broken and disjointed, not because any of those passed 
have been omitted, but because some of the sections offered 
were not adopted, and hence do not appear in this collection. 

It is important to remark here that these propositions have 
not been indorsed by the Alabama state board of health, said 
board having its own well-digested code of quarantine regula- 
tions, which is not greatly different from that adopted by the 
conference. 

PB0P08ITI0K8 ADOFTED BT THE QUABANTINB OONFEBENOB. 

Resolved, That this convention urges upon all health authorities of 
states represented in it the importance of strict compliance with the 
agreement of inter- state notification adopted by the National Confer- 
ence of State Boards of Health, and the Sanitary Council of the Missis- 
sippi Valley, in regard to all communicable diseases, and especially in 
regard to yellow fever. "* 

Resolved, In the beginning of an outbreak of yellow fever there is no 
need of depopulation at all, except of infected houses, or infected dis- 
tricts ; but if people who are able to afford the expense desire to leave 
they should do so quietly and deliberately, and no obstacles should be 



136 ALABAMA STATE MEDICAL ASSOCIATION. 

placed in their way ; and those who leave healthy districts of the city 
or town should go wherever they please, without let or hindrance. 

(2) Persons living in infected houses, or in infected districts, should 
be encouraged to leave, but should be allowe d to leave only under 
such restrictions as will afford reasonable ^>uarantees of safety to the 
communities in which they find asylums ; and they should be sent only 
to such communities as are willing to receive them. 

(3) In the depopulation of infected houses or of special infected dis- 
tricts, the inhabitants should be removed into camps of probation, or 
into vacant houses in the adjacent eountry. After ten days detention, 
if they remain well, and under proper regulations, such as disinfection 
of baggage, they should be considered free from danger, and allowed to 
go freely into any community willing to receive them. 

Reaolvedf During the prevalence of yellow fever epidemics, passen- 
gers and freights should be brought from infected localities only under 
such regulations and restrictions as may be established by the state 
health authorities along the lines of roads concerned. 

(2) The regulations and restrictions governing railroad transporta- 
tion during yellow fever epidemics, should be of such a character as to 
afford all reasonable guarantees of protection to the communities in 
danger of invasion by the disease, but should not be more onerous than 
the circumstances warrant, and should be framed with due considera- 
tion of the extent and character of the danger in each particular case, 
and as affected by latitude and seasons of the year, and other qualifying 
conditions. 

(3) At all seasons of the year, and under all circumstances, the sim- 
ple passage of railroad trains should be allowed, without obstruction, 
even when carrying sick refugees from infected places to healthy locali- 
ties willing to receive them. 

Sec. 2. A well digested quarantine formula, making and promulga- 
ting the necessary rules and regulations for enforcing the same, should 
be prepared, ready to be put in force when necessary to do so, at all 
points where it is necessary to put quarantine in force. These rules 
should be published for general information, to enable all persons to 
comply with the same, and displayed by placard in every depot. 

Sec. 3. At quarantine stations accommodations should be provided 
for caring for such persons, if any, as may be detained or are not per- 
mitted to pass through such stations, while in transit, until they can be 
disposed of. 

Sec. 4. Only competent physicians, who have had experience with 
contagious and infectious diseases, should be made inspectors at quar- 
antine stations, whose duty it shall be to inspect and examine the con- 
dition of passengers, baggage and express matter. All inspectors should 
have the power to administer oaths, and to remove from the trains, and 
detain at quarantine stations such passengers, baggage or express mat' 



THE REPORT OF THE BOARD OF CENSORS. 137 

ter, &c., as may be found necessary to prevent the introduction or spread 
of infectious or contagious diseases of any kind. 

5. State boards of health should be the powers authorized to put 
quarantine in force. They should determine when, where and for what 
length of time quarantines should be maintaioed ; provide the means 
necessary for enforcing the same, and promulgate rules and regulations 
for conducting quarantines. 

Presidents and Eecretaries of state boards should be required to visit 
and inspect all quarantine stations as often as practicable, during the 
existence of such quarantines , and to make public, over their signatures 
and official positions, the general condition of the public health at the 
points where quarantines are established, and the localities affected by 
such quarantines. Local health officers, municipal or county authori- 
ties, may establish quarantine regulations, conferring with the state 
board, if deemed necessary, for co-operation. The regulations for gov- 
erning local quaranties should not be in conflict with the rules and regu- 
lations adopted by the state boards of health for enforcing quarantine 
regulations. 

Sec. 5. *The refuge stations as at present operated on the sea-coast of 
the United States are, in the opinion of this body, of infinite service, 
and we would recommend their continuance in a full equipment for all 
requirements. 

Sec. 10. Railroad agents on roads under quarantine surveillance at 
way stations should be required to refuse to sell tickets to any persons 
who can not show that they have not in twelve, days been exposed to 
any source of infection, and conductors should be required by law to 
refuse to transport passengers from way stations who are not supplied 
with tickets. 

Sec. 11. Health certificates should be required from all persons 
whenever yellow fever prevails in this country. They should be issued 
only by the health ofiicial in charge of the place, under official seal, or, 
in the absence of such seal, under the seal of the municipal or county 
court where the certificate originates. In each certificate the person to 
whom it is issued should be so described as to admit of his identifica- 
tion, and should state the facts of the case fully and circumstantially. 
And to such certificates full credence should be given by all health 
authorities. We must have honesty and mutual confidence amongst 
those charged with the protection of the public health. 

A uniform system of certificates should be adopted by boards of 
health. We would recommend the following form : 



138 AtsABAMA STATE MEDICAL ASSOCIATION. 

Health Certificate. 

, (Office of the Board of Health.) 

(Date.) 

Name 

Residence • 

How long in 

Destination 

Have you or your baggage been exposed to yellow fever infection with- 
in the past thirty days ? .V . 

I solemnly swear that the answer to the above question is true, so 
help me God. 

[Seal.] Signed, 

cName of Applicant.) 
Signed, (Official.) 

Resolved, That this conference indorse the Holt quarantine and disin- 
fection system, as at present operated at New Orleans, Louisiana, as 
the best one known for the prevention of the introduction of yellow 
fever into the ports of the United States, and recommend its uniform 
adoption. 

Resolved, 1st, When one case or a few cases of yellow fever occur in 
any community, it does not follow of necessity that the disease must 
spread and become epidemic. On the contrary, the experience of 
many countries through long periods of time shows conclusively that 
in the majority of such instances, and without the observance of any 
special means of prophylaxis, the disease fails to spread. 

2d. When one case or a few cases of yellow fever occur in any com- 
munity, in the light of our present knowledge of the habits and modes 
of propagation of the disease, it is generally possible, by the employ- 
ment of the proper prophylactic measures, to prevent the development 
of an epidemic. 

3d. The golden rule for the prevention of yellow fever is non-inter- 
course—isolation — the keeping of the well away from the sick, away 
from infected things, and very especially away from infected localities. 

4th. In the enforcement of this golden rule of non-intercourse two 
problems present themselves for solution, (a) To keep the people gen- 
erally from coming into the infected houses and the infected localities; 
and (6) to keep doctors and nurses, and other attendants, and the well 
members of sick families, from visiting and mingling with people out- 
bide of the infected houses and localities. The solution of the first 
of these problems is comparatively easy. The solution of the second 
is sufficiently difficult. But it is possible to solve them both. 

5th. In the densely settled sections of cities guards may be useful for 
the enforcement of non-intercourse. They are much less needed in 
sparsely settled towns. In villages and country neighborhoods, as a 
rule, they are not needed at all. In all cases every intelligent family 
should be able to take care of itself — should be able to keep all of its 



TBE REPORT OF TBS BOARD OF CENSORS. 139 

members away from infected house and localities, and to guard its own 
premises from invasion by dangerous persons and things. 

6th. Non-intercourse may be practiced in the very centre of an in- 
fected district with considerable probability of escaping the fever. 
Cloistered convents and persons in infected cities, with yellow fever 
raging all around them, usually escape invasion ; and there are nu- 
merous instances on record in which private families in the midst of 
epidemics have pasped the ordeal safely by the rigorous enforcement of 
non-intercourse. 

Resolved, That this conference recommend that all approved methods 
of disinfection by means of personal and municipal cleanliness, by ven- 
tilation, fumigation, chemical affusion, destruction by fire of all infected 
or suspected things used during an epidemic of yellow fever and until 
the danger of its spread shall have passed, and that all fomites should 
be disinfected after the recovery of the sick. 

We recommend as a basis of disinfection the processes as set forth 
by the committee on disinfectants of the American Public Health 
Association. 

Resolved, That it is the sense of this conference, that the best form 
of disinfectant for personal baggage is moist heat. 

Whereas, This quarantine conference has adopted the report of the 
committee on Inland Quarantine ; therefore, be it 

Resolved, That a committee of one from each state represented in 
this conference be appointed to prepare rules and regulations for gov- 
erning quarantines, when it becomes necessary to put the same in force. 
And that such rules be published when prepared for the information of 
the public, and all persons to be affected thereby. And that state 
boards of health and health officers of states be requested to furnish 
such rules to the proper officers of municipal and county authorities 
for their information. 

Be it Resolved, That the Secretary of the Treasury of the United 
States is hereby requested to increase the revenue patrol service on the 
coast of Florida to such extent as may be necessary to prevent smug- 
gling. 

Whereas, It appears by the report which Dr. Burgess has made to 
this conference, that sanitary inspection of vessels where yellow fever 
is endemic is of vital importance ; therefore belt 

Resolved, That this conference approves the plan of having medical 
inspectors attached to those consulates where yellow fever and cholera 
are endemic, with a view of securing for our protection definite infor- 
mation as to the exact sanitary condition, and the presence or absence 
of contagious diseases in such consular district. And that congress be 
urged to make the necessary appropriations to carry the plan into 
effect. 



140 ALABAMA STATE MEDICAL ASSOCIATION. 

Be it resolved, That the United States government is herehy reqaested, 
if compatible with international and constitutional law, to enter into 
negotiations with Spain with a view of investing the United States san- 
itary inspectors at Spanish ports with such legal jurisdiction as may be 
necessary for the enforcement of such rules and requirements as are 
provided. 

WHEN BEFUOEES MAY RETURN. 

] . After the occurrence of ice. 

After the occurrence of three (3) killing frosts. 

After the occurrence of no cases of fever for the period of two (2) 
weeks, and after thorough disinfection and ventilation of all localities 
infected, and bedding and such other articles as are capable of convey- 
ing germs. 

Resolved, That this conference is of the opinion that it is a duty devolv- 
ing on all nations to take measures to eradicate any plague centers from 
their territory, and that the existence of such plague centers is a men- 
ace to all other nations, and that our state department be requested to 
take measures through proper diplomatic channels for the conveyance 
of this opinion to the governments deemed obnoxious to the opinion as 
herein expressed. 

RULES PREPARED BY THE COMMITTEE. 

1. Quarantine should not be made against any place until it is offi- 
cially known that yellow fever or other infectious or contagious disease 
exists at such place. 

2. Only competent physicians should be put in charge of quarantine 
stations ; and only thoroughly qualified persons should be employed as 
inspectors on railway trains. 

3. Quarantine stations, located on railroads, should be established 
at convenient points, on one or both sides of a town or station, as may 
be deemed necessary. 

4. If an epidemic of yellow fever, or other infectious or contagious 
disease, exist at .a town or station, trains carrying passengers or freights 
should be required to pass through tlie limits of such towns or stations 
at a speed of not less than ten (10) miles per hour, without stopping at 
such towns or stations, but should stop at the quarantine station. 

6. Passengers to or from such infected point should only be received 
or delivered at the quarantine station, under the supervision of the 
quarantine officer in charge of the station. 

6. Railway tickets may be sold to persons leaving an infected place 
to any point willing to receive them. 

7. All baggage from any infected point should be properly disin- 
fected. 

8. As far as practiqfible, the same rules proposed for railroads should 



THE REPORT OF THE BOARD OF CENSORS. 141 

be applied to vessels of every kind, stage coaches, or other means of 
travel. 

9. The passage of railroad trains through any point on the line of 
road, whether infected or not, should not be prohibited by any quaran- 
tine regulations. The conductors of passenger trains should close the 
windows and ventilators and lock the doors of cars passing through any 
place where a train is not permitted to stop. 

10. All freight to any infected place should be delivered either at the 
quarantine station or the nearest railway station to such infected point, 
where it can be properly cared for. 

11. All mail matter from any infected place should be properly dis- 
infected by the United States government. And mail matter intended 
for infected points should be put off the trains at the quarantine stations. 
The United States government should instruct post-masters to receive 
and deliver mails at such quarantine stations. 

12. Railroads and express companies may receive for transportation 
from any infected place, during the time such infection exists, any mer- 
chandise or traffic consigned to places willing to receive it. 

13. State authorities should employ competent persons on passenger 
trains, as inspectors of passengers, bag<:age and express matter, as addi- 
tional precaution; but the fact of inspectors being on such trains 
should not relieve trains carrying passengers, or express matter or bag- 
gage, from stopping at quarantine stations for such inspection as the 
officer in charge may determine to be necessary. 

14. It is recommended that all quarantines, as far as practicable, 
should be uniform in their requirements and operations, which will 
greatly contribute to the prevention of panics, and tend to allay unne- 
cessary excitement and fear on the part of the people. 

15. The form of health certificate adopted by the quarantine conven- 
tion, held at Montgomery March 5, 1889, should be prepared for health 
officers to issue to such persons as may be found entitled to receive the 
same. A copy of this certificate should be printed with these rules, 
and conspicuously posted at railway stations. 

16. It is the desire and intention of health authorities, as far as prac- 
ticable, to throw every safeguard around the public health of all locali- 
ties. Municipal, county and state authorities are expected to co-operate 
in every possible way with health officers located in towns, villages and 
cities, and in charge of quarantine stations, to enable them to prevent 
the introduction or spread of yellow fever or other infectious or conta- 
gious diseases. 



142 ALABAMA STATE MEDICAL ASSOCIATION. 

AN ACT [H. B. 200. 

To amend sections one, two and eleven of an act entitled an act to reg- 
ulate the practice of pharmacy and the sale of poisons in towns and 
cities of more than one thoasaud inhabitants in tlie State of Ala- 
bama. 

Section 1. Be it enacted by the General Assembly of Alabama, That 
section one of an act entitled an act to regulate the practice of pharmacy 
and the sale of poisons in cities and towns of more than one thousand 
^ inhabitants in the State of Alabama, be amended so as to read as fol- 
lows: 

Section 1. Be it enacted by the General Assembly of Alabama, That 
from and after the passage of this act, it shall be unlawful for any per- 
son not a registered pharmacist, within the meaning of this act, to con- 
duct any pharmacy, drug store, apothecary shop or store located in any 
village, town or city in the State of Alabama, of more than nine hundred 
inhabitants, or within two miles of any incorporated city or town of 
more than nine hundred inhabitants, for the purpose of retailing, com- 
pounding or dispensing medicines or poisons for medical use, except as 
hereinafter provided. 

Section 2. Be it further enacted, That section two of an act entitled 
an act to regulate the practice of pharmacy and the sale of poisons in 
cities and towns of more than 1,000 inhabitants in the state of Alabama, 
be amended so as to read as follows : 

Section 2. Be it further enacted, That it shall be unlawful for the pro- 
prietor of any store or pharmacy in any village, town or city, in the 
state of Alabama of more than 900 inhabitants, or within two miles of 
any incorporated city or town of more than 900 inhabitants, to allow 
any person, except a registered pharmacist, to compound or dispense 
the prescriptions of physicians, or to retail or dispense poison and med- 
icines for medical use, except as an aid to and under the supervision of 
a registereed pharmacist. Any person violating the provisions of this 
section shall be deemed guilty of a misdemeanor, and on conviction 
shall be liable to a fine of not less than $25 nor more than |100 for each 
and every offense. 

Section 3. Be it further en<icted, That section 11 of an act entitled an 
act to regulate^ the practice of pharmacy and the sale of poisons in cities 
and towns of more than 1,000 inhabitants in the state of Alabama, be 
amended so as to read as follows : 

Sec. 11. Be it further enacted, That this act shall not apply tophysi- 
vians putting up their own prescriptions . 

Approved February 20th, 1889. 

C. C. Lanodon, 
Official : Secretary of State. 



ACTION ON REPORT OF THE BOARD OF CENSORS. 143 



ACTION OF THE ASSOCIATION ON THE REPORT 
OF THE BOARD OF CENSORS. 



The senior censor read the report of the board of censors and 
committee of public health by the several sections separately 
for the consideration of the Association. In this way the fol- 
lowing votes were taken : 

(1) The senior censor read the report of the board of cen- 
sors in regard to the recommendations contained in the annual 
message of the president (see ante pp. 81-82), and moved its 
approval by the Association. 

The motion was unanimously passed. 

(2) The senior censor read the report of the board of cen- 
sors in regard to the reports of the vice presidents (see ante^ 
pp. 82-83), and moved its approval by the Association. 

The motion was unanimously passed. 

(3) The senior censor read the report of the board of cen- 
sors in regard to the report of the secretary and the Book of 
the Rolls (see ante p. 83), and moved its approval by the As- 
sociation. 

The motion was unanimously passed. 

(4) The senior censor read the recommendation of the board 
of censors in regard to the report of the publishing committee 
(see ante^ p. 83), and moved its approval by the Association. 

The motion was unanimously passed. 

(5) The senior censor rdad the recommendation of the board 
of censors in regard to the report of the treasurer and the 
Book of Accounts, and also in regard to the treasurer's bond 
(see antej pp. 83-84), and moved its approval by the Associa- 
tion. 

The motion was unanimously passed. 



144 ALABAMA STATE MEDICAL ASSOCIATION. 

(6) The senior censor read the recommendations of the 
board of censors in regard to the roll of correspondents, (see 
anUj p. 84), and moved their approval by the Association. 

The motion was nnanimonslj passed. 

(7) The senior censor read the recommendation of the board 
of censors in regard to the revision of the minutes, (see antSj 
p. 85), and moved its approval by the Association. 

The motion was unanimously passed. 

(8) The senior censor read the recommendation of the board 
of censors in regard to the business reports from county socie- 
ties (see ante, p. 86), and moved its approval by the Associa- 
tion. 

The motion was unanimously passed. 

(9) The senior censor read the recommendation of the board 
of censors in regard to a new rule of order (see ante, p. 85), 
and moved its approval by the Association. 

The motion was unanimously passed. 

(10) The senior censor read the recommendation of the 
board of censors in regard to part four of the censor's report 
(see ante, p. 85), and moved its approval by the Association. 

The motion was unanimously passed. 

(11) The senior censor read the recommendation of the board 
of censors in regard to the plan for electing counsellors by 
congressional districts (see ante, p. 86), and moved its approval 
by the Association. 

The motion was unanimously passed. 

(12) The senior censor read the recommendation of the 
board of censors in regard to the ordinance creating a library 
and museum (see ante, pp. 86 87), and moved the adoption of 
the ordinance by the Association. 

The motion was unanimously passed. 

(13) The senior censor read the recommendation of the 
board of censors in regard to binding the Book of the Kules 



ACTION ON REPORT OF THE BOARD OF CENSORS. 145 

(see antSy pp. 87-88), and moved its approval by the Associa- 
tion. 
The motion was unanimously passed. 

(14) The senior censor read the recommendation of the 
board of censors in regard to paying for the batton badges 
(see ante, p. 88), and moved its approval by the Association. 

The motion was unanimonsly passed. 

(15) The senior censor read the recommendation of the 
board of censors in regard to the administration of the law to 
regulate practice (see antej pp. 93-94), and moved its approval 
by the Association. 

The motion was unanimonsly passed. 

(16) The senior censor read the recommendation of the 
board of censors in regard to the ordinance prescribing how to 
treat illegal doctors (see ante^ pp. 94-95), and moved the 
adoption of the ordinance by the Association. 

The motion was unanimously passed. 

(17) The senior censor read the recommendation of the 
board of censors in regard to the quarantine propositions sub- 
mitted by the state health officer (see cmtSj pp. 113-119), and 
moved the adoption of the propositions by the Association. 

The motion was unanimously passed. 

(18) The senior censor read the recommendation of the 
board of censors in regard to the exemption of the state health 
officer from quarantine restrictions (see cmtSy pp. 120-122), and 
moved its approval by the Association. 

The motion was unanimously passed. 

(19) The senior censor moved the adoption as a whole of 
the report of the board of censors as read. 

The motion was unanimously passed. 



10 



146 ALABAMA STATE MEDICAL ASSOCIATION. 



THE REVISION OF THE BOOK OF THE ROLLS. 

(1) The Revibon of the Roll of CouinT Societies. 

The roll of the coanty medical societies was called in order, 
and all of them being satisfactorily accounted for by annual 
reports submitted, and payment of dues, were favorably passed 
upon, except the Marion county society, which was referred to 
the board of censors for investigation. 

The roll of the county societies was here closed until the an- 
nual session of the Association, 1890. 

(2) The Revision of the College of Counbellobs. 

THE GRAND SENIOR COUNSELLORS. 

Dr. Edward D. McDaniel, of Oamden, grand senior counsel- 
lor of 1873, reported last year as having been dropped from the 
rolls for non-payment of dues, is a mistake. He should have been 
recorded as dropped for non-attendance. The necessary cor- 
rection was ordered to be made. 

Dr. Mortimer Harvey Jordan, of Birmingham, Jefferson 
county, grand senior counsellor of 1873, having died daring 
the year, his name was ordered struck from the roll. 

SENIOR counsellors. 

Dr. William Cyprian Gross, of Tuscaloosa, senior counsellor 
of 1882, tendered his resignation ; but by reason of entering 
upon a contract practice his resignation was refused and his 
name ordered struck from the roll. 

Dr. John Washington Pearce, of Oxford, senior counsellor of 
1883, tendered his resignation by reason of ill health. His 
resignation was accepted and his name ordered struck from 
the roll. 

Dr. Richard Procter Huger, of Anniston, junior counsellor 
of 1884, tendered his resignation. His resignation was accepted 
and his name struck from the roll. 



THE REVISION OF THE BOOK OF THE ROLLS. 147 

Dr. George Oalvin Norris, of Wadsworth, janior counsellor 
of 1886, having died during the year, his nafne was ordered 
struck from the roll. 

COUNSELLORS ELECT. 

The following counsellors elect having signified their accept- 
ance, signed the pledge and paid their dues, their names were 
ordered to be added to the roll of junior counsellors under date 
of 1888. 

Binfordy Peter, Somerville, Morgan county. 
Harlan, John Jefferson, Hackney ville, Tallapoosa county. 
Hill, Lather Leonidas, Montgomery, Montgomery county. 
Jones, John Culbreth Hezekiah, Stone, Pickens county. 
Wheeler, William Camp, Cherokee, Colbert county. 

Dr. Brice Martin Hughes, of Birmingham, counsellor elect 
of 1888, having died during the year, his name was not 
added to the roll. 

The secretary announced that there were six vacancies in the 
college of counsellors, whereupon the ballot was ordered and 
resulted in the following selections : 

Crook, John Martin, Jacksonville, Calhoun county. 
Goode, Rhette, Mobile, Mobile county. 
Hudson, William Henry, LaFayette, Chambers county. 
LeGrand, John Clark, Anniston, Calhoun county. 
Marechal, Edwin Lesley, Stockton, Baldwin county. 
Toole, Barclay Wallace, Talladega, Talladega county. 

The six senior counsellors whose names here follow, having 
served the Association as such for ten consecutive years, were 
ordered to be transferred to the roll of grand senior counsellors 
under date 1879 : 

Cross, Benjamin Franklin, Decatur, Morgan county. 
Gaines, Vivian Pendleton, Mobile, Mobile county. 
Herbert, Curtis Burke, Greenville, Butler county. 
Hoffman, John Richardson, Athens, Limestone county. 
Phillips, William Crawford, Selma, Dallas county. 
Thigpen, Job, Greenville, Butler county. 



148 ALABAMA STATE MEDICAL ASSOCIATION. 

The four jnnior couDBellors, whose names here follow, hav- 
ing served as snch for five consecutive years, were ordered to 
be transferred to the roll of senior coonsellors under date 
of 1884 : 

Huggins, Jacob, Newbern, Hale county. 

Jones, John Paul, Camden, Wilcox county. 

Searcy, James Thomas, Tuscaloosa, Tuscaloosa county. 

Trent, Powhatan Green, Rock Mills, Randolph county. 

The roll of the college of counsellors was here closed until 
the next annual meeting of the Association, 1890. 

(3) The Revision of the Boll of Oobrespondents. 

All the correspondents were satisfactorily accounted for and 
were ordered to be retained on the roll, except the following : 

Dr. John F. Lynch, of Baltimore, having died during the 
year, his name was ordered struck from the roll. 

The roll of correspondents was here closed until the next 
annual meeting of the Association in 1890. 

(4) The Revision of the Roll of Officers. 

The secretary announced the following vacancies in the roll 
of officers, namely : 

One president, one vice-president, two members of the board 
of censors and committee of public health for five years, one 
for two years, one orator, and one alternate orator ; whereupon 
the ballot was ordered, and resulted in the following selections, 
namely : 

President — Charles Higgs Franklin, M. D., Union Springs. 

Junior Vice-President — Shirley Bragg, M. D., Lowndes- 
boro. 

Board of Censors and Committee of Public Health— ^MA 
Scott DuBose, Columbiana, Edward Henry Shell, Birmingham, 
for five years ; Benjamin James Baldwin, Montgomery, for 
two years, to fill the unexpired term of Dr. Charles H. 
Franklin. 

Orator — Henry Tutwiler Inge, Mobile. 



THE REVISION OF THE BOOK OF THE ROLLS. 149 

AUemais Orator — William Camp Wheeler, Cherokee. 

The roll of officers was here closed until the next annual 
meeting of the Association in 1890. 

Birmingham was selected as the place for holding the next 
annual session, second Tuesday in April, 1890. 

Installation of Fbesident. 

The president elect, Charles Higgs Franklin, M. D., of 
Union Springs, was escorted to the rostrum by Drs. Jerome 
Cochran and William Henry Sanders of Mobile, and introduced 
to the Association by the retiring president, Dr. Milton C. 
Baldridge, in the following words : 

Dr. Franklin — ^It is with more than ordinary pleasure I vacate this 
chair to one so worthy to occupy it as you are. You have won this, the 
highest honor the association can bestow, by your zeal and efficiency in 
the several positions held by you since your election as counsellor in 
this city in 1882. With this record, it is safe to say you will be more 
than equal to the labor and care incident to the office. 

Dr. Franklin acknowledged the honor conferred upon him 
in his usual modest way, and promised faithfulness and hon- 
esty in the discharge of its duties. ' 

On motion of Dr. Jerome Cochran, of Mobile, the Associar 
tion adjourned without day. 



THE ANNUAL REGISTER 



OF THB 



Medical Association 



OF THB 



STATE OF ALABAMA. 



THE ANNUAL REGISTER 



OF THB 



Medical Association 



OF THB 



STATE OF ALABAMA. 



THE BOOK OF THE ROLLS OF THE MEDICAL 
ASSOCIATION OF THE STATE OF ALABAMA. 



Introduction. — ^In the transaction of last year the publishing com- 
mittee prefaced the rolls of county societies with instruction to secre- 
taries as to their records and the best method of obtaining information 
concerning them that would pass criticism, but the reports of this year 
come in with even more glaring errors than before. This should not 
be, can not be, if secretaries will only place the volume of Transactions 
before them and take their last reports as basis of reference. Remem- 
ber that, when these rolls are once complete, small errors can be readily 
seen and corrected. 

Explanation. — ^The letters mc stand for medical college. The letters 
cb stand for county board ; when the certificate is issued by the exam- 
ining board of the county in the register of which it occurs, the name 
of the county is omitted ; when the certificate was issued by the exam- 
ining board of some other county, the name of such county precedes 
the abbreviation. The first name in every list of censors is that of the 
president of the board. 



THE ROLL OF THE COUNTY MEDICAL SOCIETIES. 

Revision of 1888. 



AUTAUGA COUNTY MEDICAL SOCIETY— Selma, 1874. 

OFFICERS. 

Pr. Fletcher Pearson; V. Pr. Dudley Robinson; Sec. Eugene A. 
King; Tr. ; H. O. LeRoy J. Simpson; Censors, Charles A. Ed- 
wards, Archibald 8. McKeithen, John W. Davis, Wyatt W. Golson, 
John £• Wilkinson. 



154 THE ANNUAL REGISTER. 

NAMES OP MSaCBERS WITH TUEIB COLLEGES AND POST-OFFICES. 

DaviSi John Wilson, mc Atlanta 59, cb 80, Prattville. 
Edwards, Charles Alva, mc Memphis 49, cb 80, Prattville. 
Golson, Wyatt Washington, mc South Carolina 54, cb 80, Autaugaville- 
King, Eugene Asbury, mc Alabama 83, cb 88, Autaugaville. 
McKeithen, Archibald Smith, mc Virginia 60, cb 80, Prattville. 
Pearson, Fletcher, mc Alabama 82, cb 87, Mulberry. 
Simpson, LeRoy Johnston, mc Bellevue, 83, cb Montgomery 84, Autau- 
gaville. 
Smith, Samuel Parish, mc univ Louisiana 48, cb 84, Prattville. 
Wilkinson, John Edward, mc univ Louisiana 68, cb 80, Prattville. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Howard, Charles Campbell, mc Georgia 41, cb 80, Autaugaville. 
Sherrell, James Lewis, mc univ Pennsylvania 60, cb 80, Vineton. 

Examinations — For the practice of medicine, Eugene Asbury King, 
mc Alabama 88, cb 88, Autaugaville. Certificate awarded. 

Died — George Calvin Norris, M. D., mc Alabama 88, cb Elmore 83, 
Wadsworth, March 3, of pneumonia. 

BALDWIN COUNTY MEDICAL SOCIETY— Anniston, 1886. 

OFFICERS. 

Pr. Joseph D. Trammell ; V. Pr. William M. Lovelady ; Sec. Edwin 
L. Marechal; Tr. Edwin L. Marechal; H. O. Edwin L. Marechal; 
Censors, Edwin L. Marechal, Joseph D. Trammell, William M. Love- 
lady. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Lovelady, William Milton, cb 82, Theresa. 

Marechal, Edwin Lesley, mc Alabama 70, cb 86, Stockton. 

Trammell, Joseph Dunlap, mc univ Nashville 57, cb 86, Bay Minette. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Fowler, George Huggins, mc univ Pennsylvania 61, cb Mobile 78, 

Hemdon. 
Holmes, Origen Sibley, mc Alabama 61, cb 86, Tensaw. 
Reynolds, Samuel Kirkpatrick, mc Jefferson 57, cb Mobile 78, Battle's. 

Moved into the county — S. J. S. Cawthon, from Covington county to 
Bay Minette ; Samuel Kirkpatrick Reynolds, from Mobile to Battle's. 

Moved out of the county — S. J. S. Cawthon, from Bay Minette back 
to Covington county. 



THE ROLL OF THE COUNTY SOCIETIES. 156 

BARBOUR COUNTY MEDICAL SOCIETY— Eufaula, 1878. 

OFFICBRB. 

Pr. Joseph J. Winn ; V. Pr. Albert Goodwin ; Sec. Simon A. Holt ; 
Tr. Simon A. Holt; H. O. William H. Robertson; Censors, Simon A. 
Holt, Albert Goodwin, William P. Copeland, Joseph J. Winn, Judson 
Davie. 

NAMBS OF MBMBBBS WITH THEIR COLLBOBS AND P0BT-0FPIGB8. 

Battle, Junius Kincade, mc univ Louisiana 83, cb 83, Eufaula. 

Brannon, Hugh Lee, mc uuiv Vanderbilt 85, cb 85, Harris'. 

Clarke, James Wesley, mc S. of M. Kentucky 78, cb 81, Eufaula. 

Copeland, William Preston, mc Bellevue 70, cb 79, Eufaula. 

Davie, Judson, mc Georgia 72, cb 81, Cowikee. 

Drewry, James Wallace, mc Jefferson 49, cb 79, Eufaula.- 

Goodwin, Albert, mc univ Louisville 73, cb 79, Eufaula. 

Harper, Robert Franklin, mc Alabama 88, cb Coffee 88, Mount Andrew. 

Holt, Simon Augustus, mc univ New York 58, cb 79, Eufaula. 

Johnston, Egbert Burr, mc Alabama 83, cb 84, Eufaula. 

Mitchell, William Augustus, mc nniv Louisiana 68, cb 79, Eufaula. 

Patterson, Thomas, mc Atlanta, 69, cb 82, Louisville. 

Robertson, William Henry, mc Alabama 87, cb Pike 87, Clayton. 

Winn, Joseph Julius, mc Atlanta 68, cb 81, Clayton. 

Honorary Members. 

Bledsoe, Francis Marion, mc Jefferson 59, cb 81, Greorgetown, Ga. 
Heron, Edward Marion, mc South Carolina 32, cb 81, Louisville. 

PHYSICIANS NOT MBHBBRS OF THB SOCIBTT. 

Battle, Joseph Thomas, mc Georgia 68, cb 87, Hawkinsville. 
Blair, Henry William, mc Atlanta 80, cb 87, Louisville. 
Crews, Joseph Emmett, mc Georgia 53, cb 79, Clayton. 
Faulk, Benjamin, Elamville. 

Moye, William Robert, mc National 59, cb 82, Cla3rton. 
Pruett, James Henry, mc univ New York 68, cb 79, Harris. 
Reynolds, James Augustus, Botanic mc Ohio 45, cb 79, Pea River. 
Russell, William Arnold, Eclectic mc Ohio 45, cb 82, Batesville. 
Smart, Wilson Alexander, mc univ Louisville 85, cb 86, Clayton. 
Turner, Alexander, mc South Carolina 57, cb 79, White Oak. 
Wimberly, William Samuel, cb 87, Eufaula. 

Moved into the county — William Henry Robertson, from Brundidge, 
Pike county, to Clayton. 



156 THE ANNUAL REGISTER. 

BIBB COUNTY MEDICAL SOCIETY— Montgomery, 1876. 

OFFICERS. 

Pr. James W. Brand ; V. Pr. William J. Nicholson ; Sec. Milton C. 
Shoolar; Tr. Milton C. Shoolar; H. 0. William J. Nicholson; Cen- 
sors. James W. Brand, William C. Cross, William J. Nicholson, Oscar 
Whitfield, Milton C. Shoolar. 

NAMES OF MBHBEB8 WITH THEIR COLLEGES AND POST-OFFICES. 

Brand, James Walker, mc univ Virginia 56, cb 78, Randolph. 
Cross, William Cyprian, mc univ Vanderbilt 80, cb 81, Centreville. 
Crowe, Gratton Bradley, mc Alabama 87, cb 87, Briarfield. 
Gage, Frederick Fannin, mc univ New York 76, cb 84, Briarfield. 
Nicholson, William John, mc univ Vanderbilt 84, cb 86, Centreville. 
Shoolar, Milton Carson, mc Alabama 87, cb 87, Centreville. 
Whitfield, Oscar, mc univ Nashville 81, cb 81, Briarfield. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Hill, Allen Green, cb (old law) 55, cb Tuscaloosa 83, Green Pond. 

Jones, Benjamin Franklin, mc Miami 86, cb Jefierson 86, Blocton. 

Jones, Robert ^amuel, (Eclectic) cb 82, Six Mile. 

Handle, Hendrick Washington, mc univ Transylvania 35, cb 82, Briar- 
field. 

Ray, Jacob Virgil, cb 82, Woodstock. 

Williams, James Welford, mc Georgia 39, cb 77, River Bend. 

Wooley, Charles Lewis, Randolph. 

Meadow, Albert Eli, (Homeopath) mc Hahneman 83, cb Jefferson 83, 
Blocton. 

Monroe, Dana, Woodstock. 

Moved into the county — William Cyprian Cross, from Tuscaloosa to 
Centreville ; Dana Monroe, from Texas to Woodstock, 

BLOUNT COUNTY MEDICAL SOCIETY— Mobile, 1876. 

OFFICERS. 

Pr. Alvin S. Davidson; V. Pr. ; Sec. Milton H. Collins; 

Tr. ; H. O. William M. Cole ; Censors, Alvin S. Davidson, 

Francis N. Hudson, William B. Allgood, Henry H. Hudson, Joseph 
F. Hendrick. 

NAMSS OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Allgood, William Bamett, mc Southern 81, cb 78, Chepultepec. 
Berrier, John Henry, cb Cullman 86, Bangor. 
Cole, William Milton, cb 86, Blountsville. 



THE ROLL OF THE COUNTY SOCIETIES. 157 

Collins, Milton Homer, mc univ Tennessee 84, cb 84, Blountsville. 
Davidson, Alvin Steele, cb 78, Gurley's creek. 
Doneboo, Floyd George, mc Southern 8!, cb 81, Murphree's Valley. 
Kstelle, Samuel Henderson, cb Sumter 76, Blount Springs. 
Gillespie, Felix A., mc Alabama 89, cb 8i), Hanceville. 
Haden, Andrew Wade, mc univ Vanderbilt 82, cb 84, Summit. 
Haden, Henry Hughes, mc univ Vanderbilt 86, cb 86, Summit. 
Hendricks. Joseph Francis, mc Southern 83. cb 84, Wynnville. 
Hudson, Frank Newton, mc univ Nashville 74, cb Madison 78, Blounts- 
ville. 
Ingraham, Milton S., non -graduate, Hanceville. 
McAnally, Christopher Columbus, cb 82, Anderton. 
Moore, David Samuel, mc Atlanta 80, cb 81, Wynnville. 
Scaiff, Samuel, mc Baltimore 89, cb 89, Manningham. 
Whaley, John Peter, cb 84, Hanceville. 
Weikle, LaFayette, Anderton. 

PHYSICIANS NOT MEMBERS OF TUB SOCIETY. 

Alldridge, Patrick George, mc Atlanta 75, cb Blount 82, Brooksville. 

Clapp, William Peter, Gum Spring. 

Findley, William Marshall, mc univ Vanderbilt, Village Springs. 

Robinson, Henry Burnes, Blount Springs. 

Willoughby, John Henchia, cb 78, Grarden City. 

Examination. — Henry B. Martin, Blountsville, certificate awarded. 

BULLOCK COUNTY MEDICAL SOCIETY— Selma, 1879. 

Pr. Henry M. Hunter; V. Pr. William A. Mayes; Sec. Charles H. 
Franklin; Tr. Henry M. Hunter; H. 0. Robert H. Hayes; Censors, 
Samuel M. I^ogan, Robert H. Hayes, Nathaniel M. Bledsoe, Charles 
H. Franklin, Groves Caldwell. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Ayers, Charles James, mc univ Virginia 86, cb Dallas 86, Hector. 
Bledsoe, Nathaniel Macon, mc univ Nashville 57, cb 80, Union Springs. 
Butt, Richard, Lemuel, mc univ New York 46, cb 80, Midway. 
Caldwell, Groves, mc univ Pennsylvania 45, cb 80, James. 
Darnell, Benjamin Franklin, mc Atlanta 55, cb 83, Inverness. 
Franklin, Charles Higgs, mc univ Louisiana 66, cb 80, Union Springs. 
Haynes, Robert Hughes, mc St. Louis 79, cb 80, Union Springs. 
Hogan, Samuel Mardis, mc univ Louisville 73, cb 80, Union Springs. 
Hunter, Henry Mitchell, mc phy & surg Bailtimore 86, cb Russell 87, 

Union Springs. 
Leitner, Charles Backus, mc univ Maryland 47, cb 85, Flora. 
MayeSi William Aurelius, mc Georgia 55, cb 80, Midway, 



158 THE ANNUAL REGISTER. 

Reynolds, James Henry, mc aniv Nashville 55, cb 80, Mt. Hiiliard. 
Reynolds, William Anderson, mc Alabama 85, cb A5, Mt. Hiiliard. 
Reigler, John Olin, one course mc Atlanta 80, Perote. 
Sessions, Llewellen, mc G^rgia 43, cb 87, Union Springs. 
Thomasson, William Bartlett, mc Georgia 54, cb 80, Aberfoil. 
Walker, William Austin, mc Jefferson 54, cb 80, Perote. 

Honorary Members. 

Banks, Newton Paley, mc univ Louisville 49, Columbus, Ga, 
Harris, William Sanford, mc univ New York, Dick's Creek. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Crymes, Augustus Clayton, mc Jefferson 56, cb 80, Midway. 
Rumph, James David, mc South Carolina 36, cb 80, Perote. 
Swanson, William Schley, mc Atlanta 57, cb 80, James. 

James A. Shirley, Post Oak, practicing without authority of law. 

Moved into the county — William Boiling, from Geneva to Fitzpat rick. 

Deaths— William Boiling, M. B., Fitzpatrick, cb88, Oct. 88, of mala- 
rial fever; Clement T. Fitzpatrick, M. D., mc Memphis 49, cb 80, Fitz- 
patrick, February 4, '89, of chronic bronchitis. 

BUTLER COUNTY MEDICAL SOCIETY— Montgomery, 1875. 

OFFICERS. 

Pr. James E. Allman ; V. Pr. Joel C. Kendrick ; Sec. ; Tr. ; 

H. 0. Job Thigpen ; Censors, Curtis B. Herbert, Joel C. Kendrick, 
Job. Thigpen ; — — , . 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Allman, James E., mc Savannah 69, cb 79, Georgiana. 

Broughton, John Thomas, mc univ Pennsylvania 52, cb 79, Greenville. 

Donald, John Gordon, mc univ Louisiana 54, cb 78, Monterey. 

Herbert, Curtis Burke, state board 79, Greenville. 

Kendrick, Joel Cloud, mc univ Nashville 52, cb 78, Greenville. 

Knight, Comer John, mc New Orleans 58, cb 78, Greenville. 

Lloyd, Cary Chappelle, mc Atlanta 58, cb 78, Greenville. 

McCane, James Jordan, mc univ Louisiana 82, cb 82, Greenville. 

Murphy, Robert Neil, mc Alabama 62, cb 84, Georgiana. 

Owens, Fred Douglass, mc Atlanta 79, cb 79, Manningham. 

Simmons, William Cleveland, cb 79, Manningham. 

Smith, Robert Edward, mc Alabama 82, cb 83, Greenville. 

Smith, William Robert, mc Alabama 86, cb 86, Oakey Streak. 

Thigpen, Job, mc Georgia 56, cb 78, Greenville. 

Wall, Conrad, mc univ Nashville 59, cb 78, Forest Home. 

Webb, Owen Foster, mc Alabama 80, cb 80, Daisy. 

Wright, William Pendleton, cb 78, Boiling. 



TEE ROLL OT THE COUNTY SOCIETIES. 159 

PHYSICIAMB NOT MBBIBBBS OF THE lOCIBTY. 

Campbell, Archibald Graham, cb Elmore 84, Dunham. 

Griseett, William Paners, mc Alabama 72, cb Conecuh 84, Garland. 

Garrett, James Jefferson, mc Georgia Reform, 82. 

Harrison, Joseph, mc South Carolina 52, cb 84, Greenville. 

Perdue, James Lewis, mc Alabama 75, cb 79, Greenville. 

Perry, Henry G., mc Georgia Reform 88, Boiling. 

Steiner, Samuel Jackson, mc univ Vanderbilt 79, cb 79, Greenville. 

Stewart, Arthur S., mc univ Louisville 82, Greenville. 

Moved out of the county — Lewis Marshall McLendon, from Geor- 
giana to Bluff Springs, Florida ; Charles A. Thigpen, from Greenville 
to Marion, Perry county. 

Examinations — For the practice of medicine, Charles A. Thigpen, 
mc univ Tulane, Louisiana 88, Greenville ; Henry G. Perry, mc Reform 
88, cb 88, Boiling. Certificates awarded. 

CALHOUN COUNTY MEDICAL SOCIETY— Montgomery, 1881. 

OFFICERS. 

Pr. John W. Pearce ; V. Pr, Robert L. Bowcock ; Sec. John C. Le- 
Grand; Tr. Edward C. Anderson; H. O. John M. Crook; Censors, 
Thomas C. Hill, Thomas W. Ayers, John M. Crook, , . 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST^PFICBS. 

Anderson, Edward Clark, mc Kentucky 77, cb 84, Anniston. 
Ayers, Thomas Willborn, mc phy and surg Baltimore 86, cb 86, Jack- 
sonville. 
Bell, Walter Howard, mc Atlanta 88, cb 88, Anniston. 
Bowcock, Robert Lee, mo univ Virginia 86, cb 88, Anniston. 
Brothers, Philip Houston, cb old law 41, cb 86, Martin's Cross Roads. 
Buckalew, Annel Milbran, mc univ Louisville 70, cb86, DeArmanville. 
Bullard, Aurelius Francis, cb 82, Oxford. 
Christian, McAns Thomas William, cb 81, Oxford. 
Crook, John Martin, mc phy and surg Baltimore85, cb 86, Jacksonville. 
Davis, John Francis Marion, mc Atlanta 60, cb 81, Chocolocco. 
Davis, Thomas Asbury, mc univ Louisiana 51, cb 84, Anniston. 
Gordon, Frederick Elliott, mc Alabama 72, cb Marengo 82, Anniston. 
Hill, Thomas Calhoun, mc South Carolina 60» cb 84, Oxford. 
Huger, Richard Proctor, mc South Carolina 71, cb 84, Anniston. 
Kelley, John Baker, mc Jefferson 59, cb 84, Anniston. 
LeGrand, John Clark, mc Atlanta 80, cb 84, Anniston. 
Ligon, Anthony, Wellington, mc univ Vanderbilt 83, cb 84, Oxford. 
Mabbet, Henry, mc Savannah 76, cb 83, Anniston. 
McDarimid, John Calhoun, mc cb Clay 83, Oxford. 



160 THE ANNUAL REGISTER. 

McDuffie, James Henry, mc univ Maryland 86, cb 89, Anniston. 

McRay, Francis Marion, cb Cleburne 81, Ohatchee. 

Overton, John Wesley, mc univ Louisville 87, cb 89, Anniston. 

Stone, Sardine G., mc Alabama 87, cb 87, Jacksonville. 

Walker, James Fleming* cb 81, Anniston. 

Whiteside, John Marshall, mc univ Vanderbilt 84, cb 84, Oxford. 

Wikle, Jesse Lane, mc Greorgia 79, cb 81, Anniston. 

PHYSICIANS NOT MEMBERS OF THB SOCIETY. 

Boiling, William Elsbery, cb 81, Davisville. 

Crook, James Edward, mc univ Vanderbilt 83, cb 83, Alexandria. 

Douthit, Jackson A., cb 81, Alexandria. 

Evans, Benjamin Shumate, cb 81, White Plains. 

Hughes, John Leander, mc Georgia 51, cb 83, Piedmont. 

Kinabrew, William Henry, mc univ New York 78, cb 83, Piedmont. 

Linder, Pleasant Philips, cb 81, Jacksonville. 

Montgomery, Charles Henry, mc Washington, Baltimore 68, cb 81, 

Jacksonville. 
Sorrell, John Martin, cb 84, Anniston. 
Teague, Robert George, cb 81, Piedmont. 
White, V^irgil Lewis, cb 84, Anniston. 
Williams, George Coke, cb 81, White Plains. 
Williamson, Thomas, cb 84, Peak's Hill. 

Moved into the county — Edward D. Grimes, from Ironaton. Talladega 
county ; Fredrick Elliott Gordon, from Mobile, William Henry Blake, 
from Lineville, Clay county, John W. Sorrell, from Cleburne county to 
Anniston. 

Moved out of the county — William Henry Blake, from Anniston to 
Lineville, Clay county ; William Pace Kelly, from Oxford to Childers- 
burg, Talladega county; Thomas Northern from Oxford to Hefflin, 
Cleburne county ; Charles Richard William Wynne, from Anniston to 
London, England. 

Examinations— For the practice of medicine, Walter Howard Bell, 
mc Atlanta 88, cb 84, Anniston ; Robert Lee Bowcock, mc univ Virginia 
86, Anniston, and John W. Overton, mc univ Louisville 88, Anniston. 
Certificates awarded. Jason L. Jones, mc univ Louisville, certificate 
refused. 

CHAMBERS COUNTY MEDICAL SOCIETY— Montgomery, 1881. 

OFFICERS. 

Pr. Benjamin F. Rea, Jr.; V. Pr. Albert H. R. Frederick; Sec. 
Robert L. Gilder; Tr. Albert H. R. Frederick; H. 0. Robert L. Gil- 
der ; Censors, Benjamin F. Rea, Sr., Zachary T. Grady, Asa W. Griggs, 
William M. Gay, Albert H. R. Frederick. 



THE ROLL OF THE COUNTY SOCIETIES. 161 

NAMES OF HBMBSB8 WITH THEIR COLLEGES AND POST-OFFICES. 

Beasley, James Albert, mc Atlanta 72, cb 82, Fredonia. 

Bryce, Hilary Sanford, mc Atlanta 82, cb 82, Waverly. 

Cooper, John William, mc South Carolina 45, cb 84, Mill Town. 

DeVaughn, John Wesley, mc univ Vanderbilt 8^, cb 83, Mill Town. 

Foster, Benjamin Jesse, mc Georgia, 70, cb 82, Five Points. 

Frederick, Albert Henry Roland, mc univ New York 56, cb 82, LaFay- 

ette. 
Gay, William McCurry, mc South Carolina 81, cb 82, Mill Town. 
Gilder, Robert Lee, mc Alabama 87, cb 87, LaFayette. 
Grady, Zachary Taylor, mc Atlanta 76, cb 86, Fredonia. 
Hudson, William Henry, mc Atlanta 86, cb 86, LaFayette. 
Griggs, Asa Wesley, mc univ Nashville 55, cb 82, West Point. 
Kirby, Charles Windham, mc Georgia 84, cb 85, West Point. 
Perry, Charles Franklin, mc Atlanta 78, cb 82, LaFayette. 
Rea, Benjamin Franklin, Sr., mc Jefferson 42, cb 82, LaFayette. 
Rea, Benjamin Franklin, Jr., mc Alabama 85, cb 86, LaFayette. 
Rutland, John Blake, mc Southern 80, cb 82, Fredonia. 
Tyson, William Watson, mc Georgia 54, cb 85, West Point 

PHYSICIANS NOT MEMBEB8 OF THE SOCIETY. 

Bonner, Thomas Harrison, mc Atlanta 84, cb Randolph 84, Hickory 

Flat. 
Carmichael, Lawrence Greene, mc Graffenburg, Hickory Flat. 
Crawford, Daniel, mc Atlanta 86, cb 86, Cusseta. 
Davis, James Lawrence, mc South Carolina 45, cb 86, LaFayette. 
Hamner, Lovick Pierce, cb Randolph 82, Five Points. 
Johnson, Howard Alexander, cb Tuscaloosa 81, Mill Town. 
Pinkston, James Preston, mc Graffenburg 57, cb 82, Sharon. 
Smith, Lawrence, mc Georgia 54, cb 86, Cusseta. 
Stadghill, Robert James, mc Southern 81, cb 86, Fredonia. 
Trammell, William Monroe, mc univ Kentucky 47, cb 86, Louisville. 

Moved out of the county — Dr. Jesse Gray Palmer, from Oak Bowery 
to Opelika, Lee county. 

Died — Marcellus £. Mcintosh, M. D., mc Georgia, cb82, LaFayette. 
CHEROKEE COUNTY MEDICAL SOCIETY— Tuscaloosa, 1887. 

OFFICEES. 

Pr. Thomas N. White ; V. Pr. Norman F. Cabot ; Sec. John P. Farill ; 
Tr. Edward A. Cook; H. 0. Abbott M. McWhorter; Censors, William 
J. D. Lawrence, Thomas N. White, Norman F. Cabot, Alexander P. 
Richardson, Ellis W. Ward. 

11 



162 THE ANNUAL REGISTER. 

NAMES OF MEMBERS WITH THBIB COLLEOBB AND POST-OFFICES. 

Barge, Josiah Littleton, mc Atlanta 87, cb 88, Rock Ran. 

Bonner, Richard Ritter, mc Southern 86, cb 87, Key. 

Brown, Alexander M., cb 87, Leesburg. 

Cabot, Norman Franklin, mc univ Vanderbilt 78, cb87, Centre. 

Cook, Edward Augustus, mc univ Vanderbilt 84, cb 84, Kirk's Grove. 

Elliott, Theodoric Miles, mc Kentucky 76, cb 87, Gaylesville. 

Farill, John Paul, mc Atlanta 81, cb 87, Farill. 

Farill, John Washington, non-graduate, cb 87, Farill, 

Lawrence, George Dougherty William, mc Georgia 56, cb 87, Cedar 
Bluflf. 

Lawrence, William John Dougherty, mc univ Vanderbilt 86, cb 87, Ce- 
dar Bluff. 

McGehee, Robert Hallenus, mc Vanderbilt 87, cb 87, Round Mountain. 

McWhorter, Abbott Milton, mc Atlanta 69, cb 87, Gaylesville. 

McWhorter, Robert Lee, mc Alabama 86, cb 87, Gaylesville. 

Miller, Thomas Gideon, mc Kentucky 86, cb 87, Gaylesville. 

Richardson, Alexander P., cb 87, Key. 

Ward, Ellis William, mc phy. & surg. Baltimore 87, cb 86, Centre. 

White, Thomas Noel, mc Georgia 58, cb 87, Spring Garden. 

Wright, A. W., mc univ New York 76, Cave Springs, Ga. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Atkinson, Thomas C, Ball Flat. 

Bell, Stephen B., mc Eclectic Philadelphia, Esom's Hill, Ga. 

Gamp, Ellis James, Tecumseh. 

Carr, R. C, non-graduate. Rock Run. 

Echols, Edward D. J., cb 87, Leesburg. 

Gilder, J. M. 

Mathews, John Patrick, mc univ Nashville, cb 87, Maple Grove. 

McCurry, George Washington, system not known, Stock's Mills. 

McWhorter, George Thomas, one course in Louisville 73, state board of 

Mississippi 76, Chickasaw. 
Shamblin, Alexander, cb 87, Broom town. 
Shamblin, John Levi, mc Atlanta 88, cb 87, Broomtown. 
Sparks, Blassingame Cayton, mc Georgia 58, cb 87, Centre. 
Tate, Charles Nathaniel, cb 87, Alexis. 
White, Barnabas Pace, mc Georgia 56, cb 87, Centre. 
White, William Yancey, mc univ Nashville and Vanderbilt, 87, cb 87, 

Spring Garden. #{ 

Moved into the county — Josiah Littleton Barge, to Rock Run. 

Moved from the county — Samuel James McCurry, from Rock Run to 
Anniston. 
Benjamin Franklin Shamblin, &om Broomtown to Georgia. 



THE ROLL OF THE COUNTY SOCIETES. 163 

Examination— For the practice of medicinei Josiah Littleton Barge, 
Rock Run. Certificate awarded. 

CHILTON COUNTY MEDICAL SOCIETY— Selma, 1879. 

0FFICEB8. 

Pr. Hugh W. Caffey ; V. Pr. Joseph S. Johnson, Sr. ; Sec. Hngh T. 

Caffey; Tr. HnghT. Caffey; H. 0. ; Censors, John A. McNeill, 

William E. Stewart, Joseph S. Johnson, Sr. 

NAMES OF mCMBBBS WITH THBIB COLLBGBS AND POST-OFFICBS. 

Bivings, Albert Eugene, mc South Carolina 75, cb 82, Clanton. 
Caffey, Hugh Thomas, mc univ Tennessee 83, cb Lowndes 83, Jemison. 
Caffey, Hugh William, mc South Carolina 65, cb Lowndes 83, Verbena. 
Givhan, Joseph Phillip, mc Alabama 73, cb Dallas 78, Jemison. 
Johnson, Joseph Samuel, Sr., mc Georgia 59, cb Dallas 79, Maplesville. 
Mathews, Emmett Abram, 87, state board 86, Clanton. 
McNeill, John Archibald, mc univ Vermont 53, cb 79, Jemison, 
Stewart, William Eugene, mc univ Louisville 75, Clanton. 
Williamson, William Thomas, mc South Carolina 58, Verbena. 

PHYSICIANS NOT MBMBBBS OF THB SOCIETY. 

Callier, Thomas Eugenius, mc univ Pennsylvania 57, cb 82, Callierville. 

Dawson, James Jefferson, Kincheon. 

Johnson, Joseph Samuel, Jr., mc univ Baltimore 76, cb Clanton. 

Little, William W., Stanton. 

Pitts, John Spate, mc univ Nashville 68, cb. Verbena. 

Wise, John F., mc Graffenburg 56, cb. Cooper's. 

Moved into the county — James Jefferson Dawson, from Seddon, St. 
Clair county, to Kincheon. 

Moved out of the county — Frank Hamilton Dunklin, from Jemison to 
Gallatin, Tennessee. 

CHOCTAW COUNTY MEDICAL SOCIETY— Selma, 1879. 

OFFICBBS. 

Pr. Robert F. Moody ; V. Pr. Daniel McCall ; Sec. William H. Cun- 
ningham; Tr. William H. Cunningham; H. 0. Robert B. Carr; Cen- 
sors, Robert B. Carr, Robert F. Moody, William H. Cunningham, 
James N. McNeely, Ferdinand B. Clark. 

NAMES OF MBMBBBS WITH THBIB COLLBGBS AND POST-OFFICES. 

Carr, Robert Bryan, mc univ Louisville 82, cb 87, Pushmataha. 
Clark, Ferdinand P., mc AUbama84, cb 84i Bevil's Store. 



164 THE ANNUAL REGISTER. 

Coleman, Robert Henry, Sr., mc Jefferson 52, cb 79, Isney. 

Coleman, Robert Henry, Jr., mc Alabama 88, cb 88, Womack Hill. 

Coleman, Walter Jackson, mc Alabama 88, cb 88, Isney. 

Cunningham, William Henry, mc Alabama 86, cb 86, Mt. Sterling. 

Johnson, Samuel F., cb 81, Butler. 

Johnson, William W., mc Alabama 72, cb 79, Melvln. 

Kimbrougb, William Floyd, mc Alabama 83, cb Washington, Bladen 

Springs. 
McCall, Daniel, mc Atlanta 59, cb 79, DeCotoville. 
McNeely, John Newton, mc univ Louisiana 58, cb 79, Mt. Sterling. 
Needham, Edward W., mc univ Louisiana 68, cb 79, Lusk. 
Phillips, John P., mc Alabama 86, cb86, Yantley's Creek. . 
Turner, Mathew, mc univ Pennsylvania — , Bladen Springs. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Brown, Collin Balsam, mc univ Nashville 80, cb 83, Melvin. 
Gilmore, Abram Bessant, mc Alabama 72, cb 79, Butler. 
Harris, Edward P., mc univ Louisiana, cb 79, Rosser, Sumter county. 
Knighton, Thomas A., mc univ Louisville 88, cb 88, Pennington. 
Shamberger, William B., mc univ Louisville 83, cb 88, Yantley Creek. 
S^hoemaker, Lewis, cb 80, Womack Hill. 

Moved into the county — William F. Kimbrougb, to Bladen Springs. 

Moved out of the county — Peter Harrison Dillard. 

Examinations — For practice ;of medicine, Robert Henry Coleman, 
Jr., M. D. ; Walter Jackson Coleman, M. D. ; Thomas Abram Knighton, 
M. D. ; Wm. B. Shamberger, M. D. Certificates awarded. 

CLARKE COUNTY MEDICAL SOCIETY— Greenville, 1885. 

OFFICERS. 

Pr. Henry G. Davis; V. Pr. Green J. Jones; Sec. James W. Armi- 
stead ; Tr. John A. Gilmoe ; Censors, Benjamin S. Barnes, Bryan Bor- 
oughs, Gross S. Chapman, Green J. Jones, Henry G.Davis. 

NAMES OF MEMBERS WITH TIIEIB COLLEGES AND POST-OFFICES. 

Allen, Burrell Middleton, mc univ Louisiana 59, cb 84, Marvin. 
Arniistead, James Westwood, mc Alabama 83, cb 84, Grove Hill. 
Barnes, Benjamin Shields, mc univ Pennsylvantia 59, cb 84, Suggsville. 
Boroughs, Bryan, mc univ Louisville 70, cb 84, Vashti. 
Bush, Boaz Whitfield, mc South Carolina 53, cb 84, Choctaw Corner. 
Chapman, Gross Scruggs, mc Alabama 79, cb Conecuh 83, Jackson. 
Dahlberg, Charles James, mc Alabama 87, cb Choctaw 87, Suggsville. 
Davis, Henry George, mc Alabama 72, cb 84, Gainstown. 
Durden, Thomas Je£ferson, mc South Carolina 83, cb 87, Choctaw Cor- 
ner. 



THE ROLL OF THE COUNTY SOCIETIES. 165 

Files, Gteorge Washington, mc nniv Loaisiana 50, cb 84, Gosport. 
Fleming, John William, mc Alabama 79, cb 84, 8a1itpa. 
Gilmore, John Arcade, mc univ Louisville 86, cb 86, Rural. 
Harwood, Thomas Broadnax, mc univ Louisiana 60, cb 84, Tallahatta 

SpringH. 
Hicks, Lamartine Orlando, mc Alabama 73, cb 84, Walker Springs. 
Jones, Green Irvin, mc Atlanta 82, cb 84, Coffeeville. 
Lindsey, James Davidson, cb 86, Lower Peach Tree, Wilcox county. 
Prim, Thomas Jefferson, cb 86, Salitpa. 

PHYSICIANS NOT MBUBERS OF THE SOCIETY. 

Barefield, Henry Litman, mc Alabama 72, cb Pickens 84, Gosport 
Davis, James Madison, mc univ Louisiana 61, cb 84, Bashi. 
Findley, William Lemuel, mc s. of m. Kentucky 87, cb 87, Thomasville. 
Grant, Bryan William, mc univ Louisville 88, cb 88, Grove Hill. 
Jeffery, Grey, mc Alabama 88, cb Wilcox 88, Horeb. 
Webb, Sidney Vaughn, mc New York and Jefferson 58, cb 84, Coffee- 
ville. 

Moved into the county — Grey Jeffery, from Lower Peach Tree, Wilcox 
county, to Horeb. 

Examinations — For the practice of medicine, Bryan William Grant, 
mc univ Louisville 88, cb 8S, Grove Hill. Certificate awarded. 

CLAY COUNTY MEDICAL SOCIETY— Tuscaloosa, 1887. 

OFFICSBS. 

Pr. William O. Jenkins; V. Pr. John L. Simpson; Sec. John T. 

Manning; Tr. ; H. O. Aaron LaF. Harlan; Censors, George W. 

Bartlett, William M. Scarborough, Aaron LaF. Harlan, Angus K. Mc- 
Diarmid, William F. Irvin. 

NAMES OF MEMBBBS WITH THBIB COLLEGES AND POST-OFFICES. 

Bartlett, George Washington, undergraduate cb 87, Black's Store. 
Blake, Wyatt Hefiin, mc univ Vanderbilt 84, cb Randolph 85, Lineville. 
Conway, Magnus E., undergraduate cb Coosa 88, HoUins. 
Darby, Cunningham Wilson, undergraduate cb 87, Hatchett Creek. 
Harlan, Aaron LaFayette, mc Alabama 86, cb Tallapoosa 86, Ashland. 
Irvin, William Fletcher, mc univ Louisville 87, cb 87, Millerville. 
Jenkins, William Oliver, mc Graffenburg 60, cb 87, Lineville. 
Liles, Marion DeKalb, undergraduate cb Randolph 79, Lineville. 
Manning, John Thomas, mc univ Vanderbilt 85, cb 87, Wheelerville. 
McDiarmid, Angus Kelly, mc Alabama 72, cb 87, Hollins. 
Northen, Charles Simpson, undergraduate cb 89, Lineville. 
Owens, Seaborn Wesley, mc univ Louisville 83, cb 87, Bluff Spring. 



166 THE ANNUAL REGISTER. 

Scarborough, William Miles, undergradaate cb 87, Ashland. 
Sims, George Napoleon, mc Graffenbnrg 56, cb 87, Ashland. 
Simpson, John L. 

Stephens, Albert Russell, mc Southern 88, cb 88, Delta. 
Waits, Owen Kynyan, mc Graffenburg 66, cb 87, Lineville. 
Wiley, James Stiles, undergraduate cb 89, Mellow Valley. 

PHYSICIANS NOT MBMBEBS OF THE SOCIETY. 

David G. Harris (Botanic), Delta. 
Henry M. McClintock (Botanic), Delta. 
Bibb Simmons. 

Moved into the county — Wyatt Heflin Blake, from Blake's Ferry, 
Randolph county, to Lineville; Magnus E. Conway, from Holland, 
Coosa county, to Hollins ; Aaron L. Harlan, from Hackneyville, Talla- 
poosa county, to Ashland ; Marion DeKalb Liles, from Dwight, Ran- 
dolph county, to Lineville. 

Moved out of the county — Alpheus Clin Brooks, from Ashland to 
Eastaboga, Talladega county ; Martin James Coker, from Hillabee to 
Good water, Coosa county. 

CLEBURNE COUNTY MEDICAL SOCIETY— Selma, 1874. 

OFFICERS. 

Pr. James P. Hurst; V. Pr. ; Sec. William A. Neil ; Tr. ; 



H. O. Orlando W. Sheppard ; Censors, William M. Ligon, Orlando W. 
Sheppard, L. W. Pitchford, William A. Neil. 

NiUCBS OF MBMBEBS WITH THEIB COLLEGES AND POST-OFFICES. 

Baker. 

Hurst, James Polk, cb 84, Edwardsville. 

Johns. 

Ligon, Wilson Milton, mc Georgia 81, cb 86, Heflin. 

Neil, R. L., Heflin. 

Neil, William Alexander, mc Georgia 81, cb 86, Heflin. 

Northen, Thomas, mc Atlanta 78, cb Clay 87, Heflin. 

Pitchford, L. W., Arbacoochee. 

Sheppard, Orlando Waters, mc Graffenburg 56, cb 86, Edwardsville. 

Wood, Hiram, Chulaflnne. 

Wood, Winston Cass, mc Atlanta 81, cb Randolph 82, Arbacoochee. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Martin, Hicks, Heflin. 

Reid, Jesse T., cb 84, Wee Bee. 



THE ROLL OF THE COVNTY SOCIETIES, 167 

COFFEE COUNTY MEDICAL SOCIETY— Greenville, 1885. 



OFFICERS. 



Pr. Francis M. Rushing ; V. Pr. ; Sec. ; H. O. 



Censors, Francis M. Rushing, Josephus D. Blue, William H. Crook, 
John W. Garrett. 

NAHBS OF MSHBBBS WITH THEIR COLLEGES AND POST-OFFICES. 

Blue, Josephus Dickson, one course mc univ Louisville 85, ch 85, Elha. 
Crook, William Henry, mc Alabama 84, cb 85, Victoria. 
Garrett, John Wilkinson, mc univ Louisville 85, cb 85, Clintonville. 
Rushing, Francis Marion, mc univ Louisiana 61, cb 85, Elba. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Carter, James Peterson (Botanic), cb pro forma 88, Damascus. 
Cowart, William Augustus, cb 85, Rocky Head. 

Hill, Benjamin Augustus, Graffenburg 57, mc Alabama 60, cb 85, Elba, 
Steed, John Garrett, mc univ Nashville' 56, cb 85, Haw Ridge. 
Wilson, William Augustus, mc Georgia, cb 85, Rocky Head. 

Moved out of the county — ^Abner R. Chapman, from Elba to Geneva ; 
William Hickman Chapman, from Elba to Troy; Franklin Harper, 
from Elba to Mt. Andrew, Barbour county. 

Examinations — For the practice of medicine, Abner R. Chapman and 
Franklin Harper. Certificates awarded . 

COLBERT COUNTY MEDICAL SOCIETY— Montgomery, 1881. 

OFFICEBS . 

Pr. Edward P. Rand ; V. Pr. Hugh W. Blair ; Sec. William W. Prater ; 

Tr. ; H. 0. Samuel J. Cooper; Censors, William W. Prater, 

Hugh W. Blair, Samuel J. Cooper, William C. Wheeler, Charles W. 
Williams. 

NAMES OF MEMBERS WITH TUBIR COLLEGES AND POST-OFFICES. 

Blair, Hugh Waller, mc univ Vanderbilt 85, cb88, Sheffield. 
Cooper, Samuel Johnston, mc Memphis 71, cb 81, Tuscumbia. 
Houston, James Marshall, mc Jefferson 57, cb 81, Dickson. 
McWhorter, George Tilghman, cb Madison 81, Chickasaw. 
Morris, Charles Thomas, mc univ Louisville 75, cb Henry 80, Sheffield. 
Palmer, Charles Richard, mc univ Vanderbilt 83, cb 84, Barton. 
Prater, William Warren, mc univ Nashville 82, cb 88, Sheffield . 
Pride, .Joseph Peebles, .mc univ New York 65, cb 81, Pride's Station. 
Rand, Edward Pearsall, mc univ Louisville 72, cb 81, Tuscumbia. 
Walker, David Harris, mc univ Vanderbilt 82, cb 81, Spring Valley, 



168 THE ANNUAL REGISTER. 

Wheeler, William Camp, mc univ Vanderbilt 62, cb 81, Cherokee. 
Williams, Charles Washington, mc univ Nashville 72, cb 81, Allsboro. 
Wall, Alexander Alford, mc univ Pennsylvania 49, cb Madison 74, 

Tuscumbia. 
Brown, John Wirt, mc univ Pennsylvania 70, Sheffield. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Adams. 

Abernathy, Robert Towns, mc univ New York 49, cb 81, Tuscumbia. 

Ellis, Wiley Martin, mc univ Louisville 70 (retired), Chickasaw. 

McCloskey, James S., Dug P. O. 

Johnson, Beverly, Tuscumbia. 

Moore, Robert J., Chickasaw. 

Newsome, Benjamin Franklin, mc univ Louisville 40, cb (old law) 54, 
Tuscumbia. 

O'Riley, John Edmund, mc Alabama 74, Cherokee. 

Smith, James Clarke, mc univ Vanderbilt 85, cb Elmore 86, Tuscumbia. 

Sullivan, William Bailey, mc untv Nashville 84, cb 84, Tuscumbia. 

Turpin, Thomas James, mcuniv Louisiana 71, cb Greene 79, Sheffield. 

Watson, Charles Mc Alpine, mc univ Louisiana 81, cb Green 82, Tus- 
cumbia. 

Moved into the county — Adams, ; Charles M. Watson, from 

Florence to Tuscumbia. 

Moved out of the county — Pierce Young Driskell, from Sheffield to 
parts unknown. 

Examinations — For the practice of medicine, Hugh Walter Blair and 
William Warren Prater of Sheffield. Certificates awarded. 

CONECUH COUNTY MEDICAL SOCIETY— Selma, 1879. 

OFFICEBS. 

Pr. Andrew Jay ; V. Pr. Hugh T. Fountain ; Sec. Adam A. McKit- 

trick; Tr. ; H. O. Adam A. McKittrick; Censors, Andrew Jay, 

Plnckney M. Bruner, Francis L. Sewall, Hugh T. Fountain, Adam A. 
McKittrick. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Bruner, Pinckney McDonald, mc Alabama 61, cb Butler 79, Evergreen. 

Feagin, Aaron Pinson, mc Atlanta 60, cb 84, Brooklyn. 

Fountain, Hugh Thomas, mc Alabama 72, cb Monroe 79, Burnt Corn. 

Jay, Andrew, mc Alabama 72, cb 84, Evergreen. 

McKittrick, Adam Alexander, mc Georjsia 60, cb 84, Evergreen. • 

Shaver, William Benjamin, mc Georgia Reform 60, cb 84, Herbert. 

Taliaferro, Charles Thomas, mc Atlanta 59, cb 84, Evergreen. 



THE BOLL OT THE COUNTY SOCIETIES. 169 

PHYSICIANS NOT MBliBERS OP TUB SOCIETY. 

Bradley, Ely, mc Jefferson 57, cb 84, Bellville. 

Corbin, John A., system unknown. Without authority. 

Ferguson, W. A., system unknown. Without authority. 

Lee, Robert Augustus, mc univ Louisiana 60, cb 84, Evergreen. 

McCreary, John Absalom, mc univ Louisiana 60, cb 84, Evergreen. 

Shaw, William Ghesley, mc Alabama 85, cb 84, Bellville. 

Moved into the county — ^William Chesley Shaw, from Texas to Bell- 
ville. 

Moved out of the county — ^Francis Louis Sewall, from Bellville to 
Texas. 

COOSA COUNTY MEDICAL SOCIETY— Birmingham, 1883. 

OFFICERS. 

Pr. William J. Peddy ; V. Pr. William H. Moon ; Sec. Julius Jones ; 
Tr. Julius Jones; H. 0. William E. Maxwell; Censors, William J. 
Peddy, William H. Moon, Julius Jones, William J. Crowson, James J. 
Coker. 

NAMES OF MEMBERS WITH THEIR COLLEQES AND POST-OFFICES. 

Bailey, William, non-graduate, cb 83, Equality. 

Bryant, Alexander T., non-graduate, cb Clay 87, Goodwater. 

Coker, James Jasper, cb 83, Rockford. 

Crowson, William Jasper, mc univ Vanderbilt 82, cb 82, Weogufka. 

Humphries, Simeon Oceola, mc Jefferson 85, cb Elmore 85, Nixburg. 

Jones, Julius, mc univ Vanderbilt 84, cb 84, Rockford. 

Maxwell, William Elmore, mc Jefferson 85, cb 85, Kelleyton. 

Moon, William Henry, mc Alabama 79, cb 83, Ooodwater. 

Peddy, William Jeremiah, mc Graffenburg 55, cb 83, Rockford. 

Peterson, James Albert, mc univ Vanderbilt 89, cb 89, Hanover. 

Simpeon, John Lewis, mc Atlanta 89, cb 84, Goodwater. 

White, William Tanner, mc univ Tennessee 86, cb 86, Nixburg. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Coker, Martin James, non-graduate, cb C lay 87, Goodwater. 
Dollar, Henry Clay, mc Atlanta 75, cb 82, Marble Valley. 
Goggans, Phillip Peterson, mc univ New York 80, cb Elmore 84, Travel- 
ler's Rest. 
Mathews, John Thomas, mc univ Louisville 73, cb 84, Mount Olive. 
Pope, Chandler Mathews, mc Jefferson 57, cb 83, Goodwater. 
Parker, Eli, (botanic), Nixburg. 
Parker, Lewis Berry, (botanic) Traveller's Rest. 
Salter, Preston B., (botanic) Goodwater. 



170 THE ANNUAL REGISTER. 

Moved into the county — Alexander Thomas Bryant, from Elias, Clay 
county, to Goodwater ; Martin James Goker. from Hillabee, Clay county 
to Goodwater; John Lewis Simpson, from Gibsonville, Clay county to 
Groodwater. 

Moved out of the county — James Peterson Goggans, from Nixburg to 
Alexander City, Tallapoosa county ; Magnus £. Conway, from Hol- 
land to HoUins, Clay county. 

Examinations — James Albert Peterson, mc univ Vanderbilt, for the 
practice of medicine. Lewis M. Bruce, Graham ^haw, Fleming Cecil 
Maxwell, preparatory to the study of medicine. Certificates awarded. 

CRENSHAW COUNTY MEDICAL SOCIETY— Mobile, 1882. 

OFFICERS. 

Pr. Felix M. T. Tankersley, V. Pr. ; Sec. Andrew J. Jones ; 

Tr. ; H. 0. Samuel W. May ; Censors, James E. Kendrick, Felix 

M. T. Tankersley, Samuel W. May, Joseph R. Horn, Andrew J. 
Jones. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Burgamy, William Thomas, mc Atlanta 59, cb 83, Rutladge. 

Horn, Joseph Robert, mc Alabama 87, cb 87, New Providence. 

Jones, Andrew Jackson, mc S. of M. Kentucky 86, cb 86, Argus. 

Kendrick, James Evans, mc Alabama 69, cb 82, Leon. 

May, Samuel William, mc phy and surg Baltimore 82, cb 83, Bullock. 

Quillian, Thomas Lamar, cb 84, Honoraville. 

Tankersley, Felix Marcus Tullus, mc univ Tennessee 85, cb 85, Argus. 

Thomas, St^hen Sion, cb 84, Arcadia. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Dyer, Edward Fox, Eclectic cb 84, Rutledge. 

Horn, Richard Knox, mc Reform, cb 84, Patsburg. 

Maxwell, David Newton, Eclectic, cb Pike 60, New Providence. 

Prior, William Dayton, mc univ Nashville 79, cb Butler 81, Aiken. 

Slough, Daniel Bluford, mc S. of M. Kentucky 87, Helicon. 

Moved out of the county — Edmund Harris Johnson, from Rutledge to 
Troy, Pike county. 

Examinations — ^For the practice of medicine, William G. Duke, mc 
Kentucky 88; certificate awarded, and he left immediately for Forest 
Port, New York, to practice medicine. 



THE ROLL OF THE COUNTY SOCIETIES. 171 

COVINGTON COUNTY MEDICAL SOCIETY—Montgomery, 1888. 

0FFICEB8. 

Pr. William J. Head ; V. Pr. John F. Pendry ; Sec. John F. Pendry ; 

Tr. ; H. 0. ; Censors, William J. Head, John F. 

' Pendry, W. N. Street. 

NAMES OF MBMBBRS WITH THIBB COLLBGBS AND P08T-OFFICB8. 

Head, William J., Andalusia, college not given. 
Pendry, John F., mc Alabama 88, cb 88, Grove Hill. 
Street, William N., college and post-office not given. 

CULLMAN COUNTY MEDICAL SOCIETY— Anniston, 1886. 

OFFICBBS. 

Pr. Robert T. Searcy ; V. Pr. Marquis L. Johnson ; Sec. Francis B. 
Bamum ; Tr. Francis B. Burnum ; M. O. Marquis L. Johnson ; Cen- 
sors, Robert T. Searcy, Marquis L. Johnson, John U. Stiefelmeyer, . 
Aldo Wiess. 

NAMBS OF MBMBBBS WITH THBIR COLLBGBS AND P08T-0FFICBS. 

Burnum, Francis Bynum, one course mc univ Vanderbilt 79, cb 86, 

Cullman. 
Johnson, Marquis LaFayette, mc Alabama 75, cb 86, Cullman. 
Martin, William Henry, mc Atlanta 88, cb 86, Logan. 
Searcy, Robert Thomas, mc nniv Nashville 53, cb 86, Cullman. 
Stiefelmeyer, John Ulric, mc univ Tubingen, Germany 49, mc univ 

Toronto, Canada 74, cb 86, Cullman. 
Whorton, John Pope, mc vniv Nashville 88, cb 88, Bremen. 
Wiess, Aldo, mc univBreslau, Prussia, 52, cb 86, Cullman. 

PHYSICIANS NOT MBMBBBS OF THB SOCIBTY. 

Abbett, James W., system not known, Bremen. 

Cook, Wiley Morgan, cb Morgan 85, Cullman. 

Gieger, Marion Capers, mc Georgia Reform 86, cb 86, Bailey ton. 

Kellar, Louis, system not known, Etha. 

McDonald, William Henry, non-graduate, cb 86, Joppa. 

McPherson, George Washington, mc univ Vanderbilt 86, cb 86, Bremen. 

Reid, James, system not known, Logan. 

Walden, John, system not known, Pinacle. 

Watts, G. W., system not known. Holly Pond. 

Moved into the county— Wiley Morgan Cook, from Falkville, Mor- 
gan county, to Cullman. 



172 THE ANNUAL REQISTER. 

» 

Moved out of the county — Young Edwin Holloway, from Cullman to 
Birmingham; James H. Oden, from Cullman to Lawrence Co^e, Mor- 
gan county. 

Examinations — Richard Alleyn, Cullman; John Pope Whorton, 
Bremen. Certificates awarded. 

DALE COUNTY MEDICAL SOCIETY— Tuscaloosa, 1887. 

OFFICERS . 

Pr. Henry J. Smisson ; V. Pr. William C. Stegall ; Sec. Washington 
L. Jones; Tr. Alexander G. McLeod ; H. 0. John C. Holman ; Censors, 
Washington L. Jones, Mercer S. Davis, Erastus Byron Ard, John C. 
Holman, Richard D. Reynolds. 

NAMES OF MEMBERS WITH THEIR COLLEGES AKD POST-OFFICES. 

Ard, Erastus Byron, mc univ Vanderbilt 87, cb 87, Haw Ridge. 

Campbell, Terrell, mc Atlanta 83, cb S7, Eclio. 

Davis, Mercer Stilwell, mc Jefferson 67, cb 87, Ozark. 

Holman, John Clinton, mc Jefferson 56, cb 87, Ozark. 

Jones, Washington LaFayette, mc Louisville 75, cb 87, Ozark. 

McLeod, Alexander Gillis, mc univ Louisiana 59, cb 87, Daleville. 

Reynolds, James Wilson, mc Alabama 85, cb 87, Skipperville. 

Reynolds, Richard Davis, mc Alabama 80, cb 87, Skipperville. 

Smisson, Henry Jones, mc South Carolina 60, cb 87, Newton. 

Stegall, Albert Sidney, mc Alabama 88, cb 87, Clopton. 

Stegall, William CoUinsworth, mc South Carolina 54, cb 87, Clopton. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Baxter, Hugh C, mc Atlanta 86, cb 87, Sylvan Grove. 

Moved out of the county — Oscar Dowling, mc univ Nashville, from 
Dale to Columbia, Henry county. 

Examinations — For the practice of medicine, Oscar Dowling , mc univ 
Nashville, 88. Certificate awarded. 

DALLAS COUNTY MEDICAL SOCIETY— Montgomery, 1875. 

OFFICERS . 

Pr. Goldsby King; V. Pr. Edward B. Ward; Sec. Samuel Kirk- 
patrick ; Tr. Thomas G. Howard ; H. 0. Mimms W. Coleman ; Censors, 
John P. Furniss, John A. McKinnon, Goldsby King, Frank Tipton, 
Mimms W. Coleman. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Adams, Benjamin Clarence, mc Alabama 72, cb 78, Adams. 
Alston, Lemuel Lovatt, mc South Carolina 57, cb 78, Orrville 



THE ROLL OF THE COUNTY SOCIETIES. 173 

Clarke, Courtney James, mc Jefferson 44, cb 78, Selma. 

Cochran,. Robert McRiller, mcuniv Virginia 57, cb 78, Martin's. 

Coleman, Mimms William, rac iiniv New York 88, cb 88, Selma. 

Davidson, J. M., mcuniv Pennsylvania 49, cb 78, Selma. 

Donald, James Marion, mc Alabama 83, cb 83, Marion Junction. 

Donald, Joseph Marion, mc univ Louisiana 64, cb 78, Harreirs. 

Furniss, John Perkins, mc univ Liouisiana 54, cb 78, Selma. 

Gay, Samuel Gilbert, mc Alabama 87, cb 87, Selma. 

Gee, James Thomas, mc Jefferson 43, cb 78, Burnsville. 

Groves, Joseph Asbofy, mc South Carolina 54, cb 78, Brown's. 

Howard, Thomas Greenwood, mc Washington, Baltimore 68, cb Au- 
tauga 84, Selma. 

Jackson, Robert Dandridge, mc South Carolina 51, cb 78, Summerfield. 

Kendall, William Quinton, mc phy and surg Baltimore 80, cb 80, 
Berlin. 

King, Goldsby, mc South Carolina 80, cb 80, Selma. 

Kirkpatrick, Samuel, mc univ Vanderbilt 88, cb 88, Selma. 

McKinnon, John Alexander, mc univ Louisiana 68, cb 78, Selma. 

Phillips, William Crawford, mc univ Louisiana 73, cb 78, Selma. 

Tipton, Frank, mc univ Louisiana 70, cb 78, Selma. 

Ward, Bdward Burton, mc univ New York 82, cb Hale 82, Selma. 

West, Jett Thomas, mc univ Virginia 63, cb 78, Selma. 

Williamson, John Hancock, mc Jefferson 59, cb 78, Carlowville. 

Wilson, Isam Griffin, mc univ Louisiana 68, cb 73, Adams. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Boykin, James Owen, mc Transylvania 43, cb 78, Tilden. 

Burwell, Lincoln Laconia, (colored,) mc Leonard, North Carolina 89, cb 
89, Selma. 

Darling, .Joseph, mc univ Tulane 85, cb 86, Richmond. 

DuBose, Frank Dudley, mc South Carolina, cb 78, Orrville. 

Hall, John James, mc univ Louisiana 69, cb 78, Orrville. 

Hardy, William Robinson, mc South Carolina 61, cb 78, Pleasant Hill. 

Hudson, Herbert Sidney, mc univ Maryland 67, cb 78, Summerfield. 

Kyser, George Washington, mc univ Virginia 65, cb 78, Richmond. 

Lockwood, Frank Octavius, mc South Carolina 54, cb 78, Carlowville. 

McKinnon, Kenneth, mc univ Louisiana 52, cb 78, Pleasant Hill. 

Moore, Clement Billingslea, mc South Carolina 39, cb 78, Summerfield. 

Moseley, Elijah Bucklee, mc univ Louisiana 57, cb 78, Orrville. 

Mills, James Barnwell, mc Columbia, D. C, 52, cb 79, Orrville. 

Mixon, William, mc univ Louisiana 4<S, cb 78, Plantersville. 

Stewart, William Champney, mc South Carolina 78, cb 78, Soap Stone. 

Strong, Allen LaFayette (colored), mc Howard, D. C, 85, cb 86, Selma. 

Washington, Samuel Henry (colored), mc Howard, D, C, 85, cb Bir- 
mingham 87, Selma. 



174 THE ANNUAL REGISTER. 

Graddick, John North (Eclectic), Selma. 

Lyons, George G. Jr. ( Homeopath ist), mc Palte, Cincinnati 86, Selma. 

Moved into the county. —George G. Lyons, jr. (Homeopathist), from 
Demopolis to ^elma; J. M. Davidson, from Charlotte, N. C, to Selma; 
Lincoln Laconia Bur well (colored), mc Leonard, N. C, 89, cb Dallas 89, 
to Selma. 

DbKALB county medical society— Greenville, 1885. 

OFFICERS. 

Pr. James T. Miller ; V. Pr. William A. Elrod ; Sec. William E. Quin ; 

Tr. ; H. O. Thomas F. Weaver; Censors, William E. Quin, 

James T. Miller, Horace P. McWhorter, Thomas F. Weaver, Edward 
P. Nicholson. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Elrod, William Adison, cb 85, South Hill. 

Green, Philmon Beall, mc univ Vanderbilt 85, cb 87, Fort Payne. 
Jack, Wallace Early, mc univ Vanderbilt 89, cb 89, Collins ville. 
McWhorter, Horace Puckett, mc univ Vanderbilt 85, cb 85, CoUinsville. 
Miller, James Taylor, mc univ Vanderbilt 78, cb 85, CoUinsville. 
Nicholson, Edward Pierson, mc univ Nashville 61, cb 85, Valley Head. 
Purdon, John Edward, mc univ Dublin, Ireland, cb 85, Valley Head. 
Quin, William Everett, mc Kentucky S. of M., 81, cb 85, Fort Payne. 
Vann, Andrew Jackson, mc Georgia 55, cb 85. CoUinsville. 
Weaver, Thomas Fletcher, mc univ Nashville 71, cb 85, CoUinsville. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Allyn, Richard Phillip, mc Montreal, Canada, cb 88, Fort Payne. 

Bailey, Alfred Henry, non-graduate, cb 85, Musgrove. 

Cain, Richard Winn, mc univ Nashville 59, cb 85, Sand Mountain. 

Green, Anthony Buell, mc Transylvania 46, cb 85, Fort Payne. 

Green, William Mastin, mc univ Vanderbilt 78, cb 85, Fort Payne. 

Holiday, Abner Lark, mc Georgia 59, cb 85, Sand Mountain. 

Johnson, James Robert, mc Atlanta 77, cb 85, Lebanon. 

Johnson, John Kemper, mc univ Vanderbilt 84, cb 85, Fort Payne. 

Killian. Henry Everett, non-graduate. Porters ville. 

Lane, George Washington, non-graduate, Pea Ridge. 

Moore, William Evans, mc Atlanta 80, cb Shelby 80, Lebanon. 

Patterson, James Jefferson, cb Etowah 81, Albertville. 

Pattey, Robert James, non-graduate, Dawson. 

Redden, William, non-graduate, cb 85, Sand Mountain. 

Seibert, David Ellis, mc Vanderbilt 86, cb Marshall 86, South Hill. 

Seibert, Dolphus James> non-graduate, Grove Oak. 



THE ROLL OF THE COUNT/ SOCIETIES. 176 

Winston, John Nelson, mc univ Louisville 66, cb 85, Valley Head. 
Wooten, William (Botanic), Gheves. 

Moved into the county— Richard Phillip Allyn, from Quebec, Canada, 
to Fort Payne. 

Moved out of the county — Samuel Verderree White, from Whiton to 
Anniston, Calhoun county. 

Examinations — For the practice of medicine, Samuel Perry Smith, mc 
Kentucky 88, Wallace £. Jack, mc Vanderbilt 89, William S. DeGolia, 
mc Albany, New York, 82. Certificates awarded. 

ELMORE COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFICKRS. 

Pr. William A. Warren ; V. Pr. Allen L. Warren ; Sec. Oscar 8. Jus- 
tice ; Tr. Oscar S. Justice ; H. 0. Oscar 8. Justice ; Censors, Allen L. 
Warren, Meriwether G. Moore, James T. Rushin, Oscar S. Justice, 
William A. Huddleston. 

NAMES OP MBMBBBS WITH THEIR COLLBOBB AND P08T-OFFICB8. 

Fitzpatrick, Phillip, mc univ Louisiana 53, cb 84, Wetumpka. 
Huddleston, William Allen, mc Atlanta 80, cb 84, Wetumpka. 
Judkins, George Bernard, mc Jefferson 5d, cb Macon 79, Wetumpka. 
Justice, Oscar Suttle, mc Alabama 85, cb 85, Central Institute. 
Moore, Meriwether Gaines, mc univ Pennsylvania 46, cb 84, We- 
tumpka. 
Norton, William Abner, mc Alabama 88, cb 88, Eclectic. 
Patterson, Daniel Smith, mc South Carolina 61, cb84. Central Institute. 
Powell, Robert Emmett, cb 84, Tallassee. 
Rushin, James Knox, mc univ New York 55, cb 84, Tallassee. 
Rushin, James Thomas, mc univ Tennessee 83, cb 84, Tallassee. 
Sewell, Neil Baker, mc Jefferson 55, cb 84, Kowaliga. 
Warren, William Allen, mc Alabama 85, cb 84, Kowaliga. 

PHYSICIANS NOT MBMBBBS OF THB SOCIBTY. 

Beckett, William Francis, mc univ Louisiana 56, cb 84, Titus. 

Fielder, Martin Lucius, mc Ohio 56, cb 84, Eclectic. 

Hall, Thomas Dixon, mc univ Pennsylvania 56, cb 84, Coosada. 

Jowers, Solomon Franklin, mc Atlanta 55, cb Coosa 83, Central Insti- 
tute. 

Lamar, James Isaac, mc Georgia 52, cb 84, Deatsville. 

Lett, Harris Templeton, mc univ Louisville 75, cb 84, Good Hope. 

Nix, James Ringold, mc South Carolina 67, cb Talladega 84, Deats- 
ville. 



176 THE ANNUAL REGISTER. 

Robinson, Elias Hunt, mc univ Pennsylvania 62, cb 84, Robinson 
Springs. 

Moved into tlie county — James Ringold Nix, from Talladega to 
Deatsville ; William Abner Norton to Eclectic. 

Mbved out of the county — James John Hunter, from Wetumpka to 
Ironaton, Talladega county ; Simeon Oceola Humphries, from Oceola 
to Nixburg, Coosa county. 

ESCAMBIA COUNTY MEDICAL SOCIETY— Greenville, 1886. 

OFFICERS. 

Pr. James A. Wilkinson ; V. Pr. Henry H. Malone ; Sec. John E. 
Martin; Tr. John E. Martin; H. O. Stephen C. Henderson; Censors, 
James A. Wilkinson, James T. Packer, Stephen C. Henderson, George 
P. Henry, JohnE. Martin. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Bass, James Loraine, mc univ Louisville 87, cb 89, Brewton. 
Douglass, William, non-graduate, cb 87, Mason. 
Henderson, Stephen Cary, mc Alabama, 87, cb87, Brewton. 
Henry, George Patrick, mc univ Nashville 70, cb 89, Wallace. 
Hundley, Asbury Clark, mc univ Louisiana 66, cb87, Brewton. 
Malay, Ramsey Phelps, mc Alabama 84, cb Elmore 84, Pollard. 
Malone, Henry Holcombe, mc univ New York 60, cb 86, Brewton. 
Martin, John Elijah, mc Alabama 75, cb Bullock 79, Brewton. 
McAdory, William Robert, mc Alabama 79, cb 87, Pollard. 
Packer, James Thomas, mc Alabama 73, cb Monroe 77, Brewton. 
Wilkinson, James Anthony, mc univ Louisville 79, cb 86, Flomaton. 

Moved into the county — James Loraine Bass, from Marion, South 
Carolina, to Brewton ; George Patrick Henry, from Nashville to Wal- 
lace. 

Examinations — ^For the practice of medicine, James Loraine Bass, 
mc univ Louisville 87, cb 89, Brewton ; George Patrick Henry, mc univ 
Nashville 70, cb 89, Wallace. Certificates awarded. 

ETOWAH COUNTY MEDICAL SOCIETY— Eufaula, 1878. 

OFFICERS. 

Pr. Joseph Bevans; V, Pr. Robert F. McConnell; Sec. and Tr. Mil- 
ton R. Wright; H. O. Milton R. Wright; Censors, Milton R. Wright, 
John P. Ralls, Joseph Bevans, John P. Stewart, Andrew B. Small. 

NAMES OF MEMBERS WITH THEIR COLLBOES AND POST-OFFICES. 

Baker, Daniel Harris, mc univ Vanderbilt 82, cb 83, Gadsden. 



THE ROLL OF THE COUNTY SOCIETIES. 177 

Baskins, Walter Colquitt, mc Georgia Reform 59, cb 82, Coats' Bend. 

Bevans, Joseph, cb 78, Gadsden. 

Bynum, George Washington, mc univ Tennessee 86, cb Blount 86, Wal- 
nut Grove. 

Camp, Erasmus Taylor, mc Alabama 85, cb Cleburne 85, Gadsden. 

Ewing, William Thomas, mc 8t. Louis 49, cb 78, Gadsden. 

Funderburg, William Lewis, mc Southern 82, cb DeEalb 86, Hill. 

Landers, Franklin Pierce, mc Atlanta 73, cb 84, Hoke's Bluff. 

McConnell, Robert Franklin, mc South Carolina 81, cb St. Clair 81, At- 
talla. 

Ralls, John Perkins, mc Georgia 44, cb 78, Gadsden. 

Small, Andrew B., mc Memphis 88, cb 88, Attalla. 

Stewart, John Pope, mc Alabama 86, cb 86, Attalla. 

Wood, James William, mc univ Vanderbilt 81, cb 81, Attalla. 

Wright, Milton Roil, mc Alabama 73, cb 78, Gadsden. 

PHYSICIANS NOT MEMBBBS OF THB SOCIIBTY. 

Bevans, Edward Ganby, mc Alabama 78, cb 78, Gadsden. 

Coggan, William Thomas, Keener. 

Dowdy, Edgar Lee, mc univ Vanderbilt 76, cb 78, Keener. 

Dozier, Marshall Elias, mc Atlanta 61, cb 78, Attalla. 

Ellison, James Henry, mc univ Tennessee 88, cb Blount 88, Walnut 

Grove. 
Garlington, William Henry, mc South Carolina 56, cb 78, Walnut 

Grove. 
Liddell, Frank Apling, mc Southern 83, cb 84, Aurora. 
Liddell, John Benson, mc Atlanta 82, cb 82, Gadsden. 
Sampler, Robert Johnson, cb St. Clair 84, Gadsden. 
Stephens, Isaac Marion, mc univ Vanderbilt 81, cb 78, Gadsden. 
Teague, Frank Bowden, mc univ Tennessee 80, cb 80, Oak Hill. 

Moved into the county — James H. Ellison, from Blount county to 
Walnut Grove ; Joseph Henry Lester, from Jefferson county to Attalla ; 
Frank Apling Liddell, from Seddon, St. Clair county, to Aurora; Ralph 
Morgan Russell, from Georgia to Gadsden; Andrew B. Small, frum 
Collinsville, DeKalb county, to Attalla. 

Moved out of the county — Max James Corput, from Gadsden to Geor- 
gia ; Robert Norman Kittrell, from Gadsden to Nashville, Tennessee. 

Examinations — ^For the practice of medicine, William Thomas Cog- 
gan ; John Daniel Piper ; Ralph Morgan Russell ; Andrew B. Small. 
Certificates awarded. 



12 



178 THE ANNUAL REGISTER. 

FAYETTE COUNTY MEDICAL SOCIETY— Selma, 1884. 

OFFICERS. 

Pr. George J. Collins ; V. Pr. Jonathan 8. Hollis ; Sec. Thomas C. 
Morton ; Tr. ; H. 0. Thomas B. Woods ; CensorSi George J. Col- 
ins, Jonathan S. Hollis, Alexander W. Agnew, Thomas B. Woods, 
Abraham K. Newton. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Agnew, Alexander Washington, mc Transylvania 44, cb84, Fayette C.H. 

Collins, George Jackson, mc Alabama 74, cb 84, Pilgrim. 

Duncan, John Harvey, mc univ Vanderbilt 86, cb Pickens 86, Fayette 

C.H. 
Hocutt, Lucias Thornton, mc Atlanta 82, cb 84, Davis' Creek. 
Hollis, Jonathan Shelton, mc Alabama 84, cb 84, Brockton. 
Jones, William Wilber, cb Tuscaloosa (old law) 68, cb 84, Newtonville. 
Lane, Jesse Washington, mc Louisville 86, cb 86, New River. 
Linn, Jesse W., mc Georgia 58, cb 88, Spencer. 
Morton, Thomas Clarke, cb Lamar 71, cb 84, Erwin. 
Newton, Abraham Kilby, mc Southern 83, cb 84, Berry Station. 
Seay, Mark Rollen, cb Lamar 83, cb 86, Berry Station. 
Savage Victor, mc univ Vanderbilt 88, cb 88. 
Shelton, Henry, cb Tuscaloosa (old law) 48, cb 84, Fayette C. H. 
Smothers, Benjamin Harrison, mc Alabama 85, cb 87.. Bankston. 
Woods, Thomas Bailey, mc univ Louisville 72, cb 84, Wayside. 
Wright, Alexander W., mcuniv New York 76, cb 86, Cave Spring. 

Moved into the county — Mark Rollen Seay, from Fembank, Lawrence 
county to Berry's Station. 

Moved out of the county — Lewis Clay Harvey, from Fayette Court 
House to parts unknown ; Daniel T. Morrow, from Berry's Station to 
Walker county; Abram Virgil Ponder from Berry's Station to Law- 
rence county. 

Examinations — For the practice of medicine, Victor Savage, mc univ 
Vanderbilt 88. Certificate awarded. 

< 
FRANKLIN COUNTY MEDICAL SOCIETY— Ttscaloosa, 1887. 

OFFICERS. 

Pr. Charles P. Banks; V. Pr. Oscar Sargent; Sec. Louis W. Desprez ; 
Tr. Louis W. Desprez ; H. 0. William M. Cleere ; Censors, Charles P. 
Banks, John K. Clarke, Sr., Oscar Sargent; William W. Cleere, Louis 
W. Desprez. 



THE ROLL OF THE COUNTY SOCIETES. 179 

NAMES OF BIEBfBESS WITH THBIB GOLLBGBS AND POST-OFFICES. 

Banks, Charles Peters, mc Nashville 55, cb 88, Newberg. 

Barnes, Thomas Benton, mc Bellevue 86, cb 87, Barleson. 

Clarke, John King, Sr., mc Nashville 56, cb 88, Russellville. 

Clarke, John King, Jr., mc Vanderbilt 81, cb 88, Newberg. 

Clarke, John M., cb 88, Russellville. 

Cleere, William Watkins, mc Vanderbilt 82, cb 88, Bel Green. 

Desprez, Louis Willooghby, mc Alabama 77, cb 78, Rasseliville. 

Gill, Charles, cb 88, Newberg, 

Harris, John C, cb 88, Russellville. 

Hughes, Charles, cb 88, Pleasant Sight. 

Pike, J. H., cb 88, Pleasant Sight. 

Sargent, Oscar, mc Vanderbilt 81, cb 88, Isbell. 

White, Robert Josiah, cb 88, Burleson. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Sevier, Benjamin B., cb 87, Bel Green. 
Sevier, Daniel P., cb 87, Russell vile. 

GENEVA COUNTY MEDICAL SOCIETY— Montgomery, 1888. 

OFFICERS. 

Pr. Millard F. Fleming; V. Pr. Benjamin W. Finney; Sec. Sidney 
F. Latimer; Tr. Sidney F. Latimer; Censors, Millard F. Fleming, 
Charles W. Williams, Benjamin W. Finney. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Ard, James H., cb 88, Geneva. 

Boiling, William, cb 88, Martha. 

Finney, Benjamin W., mc New York 54, Coffee Springs. 

Fleming, Millard F., cb 88, Sanders. 

Henderson, John G., cb 88, Limestone, Fla. 

Hilliard, Charles Wesley, mc Georgia Reform 60, cb 88, Geneva. 

Howell, David D., mc South Carolina 53, cb 88, Greneva. 

Latimer, Sidney F., cb 88, Geneva. 

Mathews, James H., cb 88, Dundee. 

Powell, Samuel B., cb 88, Dundee. 

Sheets, Joseph B., cb 88, Dundee. 

Treadwell, Henry P., cb 88, Geneva. 

Ward, Thomas Jefferson, cb 88, Watford. 

PHYSICIANS NOT MEMBERS OF THE SOCIBTT. 

Clements, John M.| cb Greene — , Elton, 



180 THE ANNUAL REGISTER. 

GREENE COUNTY MEDICAL SOCIETY— Selma, 1879. 

OFFICERS. 

Pr. John J. A. Smith ; V. Pr. John S. Minor; Sec. James P. Barclay ; 
Tr. James P. Barclay; H. O. Thomas W. Pierce; Censors, Augustus 
M. Duncan, Dabney 0. McGrehee, Samuel S. Murphy, Thomas T. Byrd, 
James P. Barclay. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Barclay, James Paxton, mc univ New York, 71, cb 79, Eutaw. 
Byrd, Robert Taylor, mc univ New York 69, cb 80, Boligee. 
Duncan, Augustus Meek, mc Alabama 74, cb 79, West Greene. 
McGehee, Dabney Oswell, mc Alabama 72, cb 79, Knoxville. 
Minor, John Launcelotte, mc Alabama 83, cb 83, Mount Hebron. 
Mobley, William Americus, mc Alabama 75, cb 79, West Greene. 
Murphy, Samuel Silenus, mc Alabama 81, cb 84, Pleasant Ridge. 
Pierce, Thomas William, mc univ Virginia 57, cb 79, Knoxville. 
Smith, John James Alexander, mc Atlanta 58, cb 79, Union. 
Webb, Henry Young, mc Jefferson 46, cb 79, Eutaw. 

PHYSICIANS NOT MtEMBERS OF THE SOCIETY. 

Ashers, David Crockett, mc St. Louis 60, cb Tuscaloosa 81, Clinton. 
Byrd, Alexander Hamilton, mc univ New York 69, cb 80, Burton's Hill. 
Kimbrough, William Ellis, mc univ Louisville 83, cb Washington 86, 

Forkland. 
LaGree, Henry, mc univ New York 86, cb 87, Forkland. 
Morgan, Isaac DuBose, mc univ Pennsylvania 58, cb 79, Eutaw. 
Pumell, James Knox, cb Pickens 88, Clinton. 
Smith, Armand Pfister, mc Kentucky 75, cb 79, Knoxville. 
Snoddy, Samuel, mc Transylvania 31, cb 79, Mantua. 
Snoddy, Virgil, mc Alabama 73, eb 79, Mantua. 
White, John McElroy, mc univ Vanderbilt 79, cb 82, Pleasant Ridge- 
Moved into the county — David Crockett Asher, from Tuscaloosa to 
Clinton ; William Ellis Kimbrough to Forkland ; James Knox Pumell, 
from Pickens county to Clinton; Edward Coleman Pearson. 

Moved out of the county — William Fletcher Thetford, from Boligee 
to Talladega. 

Deaths — James Spann Boyce, M. D., mc univ Louisville 82, cb 82, 
Clinton, February 11, 89, of consumption; Joseph F. Moore, M. D., mc 
Alabama 82, cb Sumter 82, Forkland, November 8, '88, of congestion ; 
Newton Cyrus Piles, M. D., mc Jeflferson 60, cb 79, Clinton, September 
18, 1888, of heart disease; Charles Peake Sanders, M. D., Pleasant 
Ridge. 



, THE ROLL OF THE COUNTY SOCIETIES. 181 

HALE COUNTY MEDICAL SOCIETY— Montgomery, 1875. 

OFFICERS. 

Pr. Francis M. Peterson ; V. Pr. Jacob Huggins ; Sec. Richard Inge ; 
Tr. Richard Inge; H. 0. Jacob Huggins; Censors, Francis M. Peter- 
son, Elisha Young, Thomas R. Ward, Jacob Huggins, Richard Inge. 

NAMES OF MEMBERS WITH THEIB COLLEGES AND POST-OFFICES. 

Avery, William Cushman, mc univ Pennsylvania 57, cb 78, Greensboro. 
Borden, James Pennington, mc Southern 73, cb 78, Greensboro. 
Dillard, Peter Hairson, mc univ Virginia 70, cb Tuscaloosa 85, Sawyer- 

ville. 
Duggar, Reuben Henry, mc univ Pennsylvania 58, cb 78, Gallion. 
Gwinn, William Christopher, mc Louisiana 78, cb 78, Akron. 
Huggins, Jacob, mc univ Pennsylvania 60, cb 78, Newberne. 
Inge, Richard, mc univ New York 71, cb 78, Greensboro. 
Owens, William Harrison, mc univ Nashville 80, cb 81, Havana. 
Peterson, Francis Marion, mc univ New York 68, cb 78, Greensboro. 
Pickett, Joseph Martin, mc Alabama 74, cb 78, Cedarville. 
Tidmore, James Adams, mc Kansas City 84, cb 89, Havana. 
Ward, Thomas Robert, mc South Carolina 53, cb 78, Greensboro. 
Wedgeworth, William McNeil, mc phy and surg Baltimore 84, cb 85, 

Newbume. 
Young, Elisha, mc Jefferson 59, cb 78, Greensboro. 

PHYSICIANS NOT MEMBEBS OF THE SOCIETY. 

Anderson, Thomas Jefferson, mc univ Pennsylvania 52, cb 78, Akron. 

Browder, Joseph D., mc Jefferson 52, cb 78, Gallion. 

Browder, William Monroe, mc univ New York 88, cb 88, Gallion. 

Spencer, George M., cb Tuscaloosa 78, Bominick. 

Turk, William Luther, mc univ Nashville 82, cb 83, Gallion. 

Wilburn, John Calhoun, mc Jefferson 78, cb 78, Carthage. 

Moved into the county — Peter Hairson ^Dillard, from Tompkins- 
ville, Choctaw county, to Sawyerville. 

Examination — ^For the practice of medicine, William M. Browder. 
Certificate awarded. 

HENRY COUNTY MEDICAL SOCIETY— Birmingham, 1883. 

OFFICEBS : 

Pr. Fleming I. Moody; V. Pr. John I. Darby; Sec. Oscar Dowling; 
Tr. Charles F. Sporeman; H. O. John I. Darby; Censors, John P. 
Crawford, William J. Lee, Fleming I. Moody, George A. Hammond, 
John I. Darby. 



182 ^'HE ANNUAL REGISTER. 

NAMES OF IfSMBEBS WITH THEIB COLLEGES AND POST-OFFICES. 

Balkum, James Albert, me phy and surg Baltimore 85, cb 86, Dothen. 
Crawford, John Peter, me univ Louisville 61, cb 83, Columbia. 
Darby, John Isaac, mc univ Louisville 80, cb Barbour 82, Columbia. 
Dowling, Oscar, mc univ Vanderbilt 88, cb Dale 88, Columbia. 
Hammond, George Abner, mc phy. and surg. Baltimore 84, cb 84, 

Gordon. 
Hardwick, William Pleasant, mc Alabama 87, cb 88, Headland. 
Lee, William Joseph, mc univ Louisiana 60, cb 83, Abbeville. 
Minter, John Frederick, mc Georgia 78, cb 83, Columbia. 
Moody, Fleming Isaac, mc phy and surg Baltimore 76, cb 83, Dothen. 
Payne, James Washington, mc Alabama 86, cb Dale 87, Dothen. 
Price, John Edmund, mc univ Nashville 61, cb 87, Abbeville. 
Sporeman, Charles Francis, mc Alabama 87, cb 87, Headland. 

PAYSICIANS NOT MEMBEBS OF THE SOCIETY. 

Blackledge, John B., mc Alabama 89, Abbeville. 

Brooks, George Washington, mc Atlanta 58, Dothen. 

Byrd, John Simmons, mc univ Louisville 76, cb 84, Wesley. 

Carroll, Robert Daniel, one course 83, cb Geneva 88, Dothen. 

Flowers, Robert Milton, mc univ Louisville 86, cb — , Lawrenceville. 

Fowler, JohnLinsIey, mc South Carolina 51, cb 83, Shorterville. 

Fowler, John Thomas, mc South Carolina 83, cb 84, Shorterville. 

Hill, Amon, one course, Otho. 

Howell, James Richard George, one course 86, cb Dale 87, Dothen. 

Lewis, James Langston, mc Atlanta 84, cb 84, Bush. 

Long, James Benjamin, mc Louisville 81, cb 83, Abbeville. 

Gates, Wyatt Samuel, one course, Headland. 

Phillips, Benjamin, without authority, Dothen. 

Powell, Lamb G., one course, Grafton. 

Stovall, John Henry, Columbia. 

Yaughan, David Horacio, mc Atlanta 88, Gordon. 

Walden, William Preston, mc Alabama 82, cb Barbour 82, Headland. 

Williams, Henry, one course, Headland. 

Moved into the county— George W. Brooks, from Fort Gaines, 
Georgia, to Dothen; James A. Balkum, from Texas back to Dothen; 
Oscar Dowling, from Ozark, Dale county, to Columbia; John H. 
Stovall, from Florida to Columbia; David H. Yaughan, from Newton, 
Dale county, to Grordon. 

Deaths — John Thomas Stovall, M. D., Columbia, January 29, 1889 ; 
over dose of chloral. 



THE ROLL OF THE COUNTY SOCIETIES. 183 

JACKSON COUNTY MEDICAL SOCIETY— Mobile, 1882. 

OFFICERS. 

Pr. George W. Foster ; V. Pr. William C. Maples ; Sec. Andrew Boyd ; 
Tr. William C. Maples; H. 0. Andrew Boyd; Censors, William C- 
Maples, George W. Foster, James M. Dicus, James R. Tarrant, John 
H. McCord. 

NAMES OF MEMBEBS WITH THEIB COLLEGES AND POST-OFFICES. 

Allen, James Beckerel, mc univ Tennessee 87, cb 87, Stevenson. 
Blackmore, Alexander Newton, mc univ Tennessee 80, cb 82, Dodson- 

ville . 
Boyd, Andrew, mc phy. and surg. Baltimore 88, cb 88, Scottsboro. 
Boyd, James Harvey, mc univ Nashville 60, cb 82, Larkinsville. 
Brewer, Joseph Mitchell, mc univ Vanderbilt 82, cb 82, Trenton. 
Dicus, James Madison, mc Alabama 86, cb 86, Scottsboro. 
Foster, George Winfield, mc univ Nashville 82, cb 82, Stevenson. 
Hayes, George Thomas, mc Alabama 87, cb DeKalb 87, Maynard's 

Cove. 
Horton, John Jackson, mc univ Vanderbilt 81, cb 84, Stevenson. 
Knowlton, John Wiley, mc univ Vanderbilt 83, cb 84, Paint Rock. 
Maples, William Caswell, mc univ Tennessee 81, cb Madison 82, Belle- 

fonte. 
McAfee, Green Prior, cb Shelby 76, cb 82, Line Rock. 
McCord, David Blackburn, mc univ Nashville 55, cb 82, Scottsboro. 
McCord, John Harvey, cb 82, Scottsboro. 
Rorex, James Polk, mc Alabama 75, cb 82, Scottsboro. 
Tarrant, James Richard, mc Alabama 87, cb 87, Fackler. 

PHYSICIANS NOT MEMBEBS OF THE SOCIETY. 

Adkins, Charles William, mc univ Louisiana 68, cb 84, Langston. 
Allen, William Henry, mc univ Louisiana (one c) 67, cb 84, Langston. 
Clarke, John Fletchei, cb84. Garth. 
Derrick, LaFayette, cb 84, Wood ville. 
Gattis, Henry Franklin, cb 84, Woodville. 
Graham, Michael, cb 84, Stevenson. 
Grant, Felix Robertson, cb 84, Larkins' Fork. 

Harralson, Jefferson B., mc univ Vanderbilt 88, cb Marshall 88, Lang- 
ston. 
Hudson, James Madison, Tupelo. 

Lee, Elisha Lightfoot, mc univ Vanderbilt 73, cb 84, Bridgeport. 
Mason, William, mc Transylvania 46, cb 84, Fabius. 
Parks, James Weaver, cb 84, Scottsboro. 
Robertson, James Osgood, cb 84, Garth. 

Smith, Barton Brown, mc univ Nashville 67, cb 82, Larkinsville. 
Smith, William Barton, cb 86, Line Rock. 
Spiller, William Kingston, mc univ Nashville 74, cb 84, Bridgeport. 



184 THE ANNUAL REGISTER. 

Moved into the county — George Thomas Hayes, from DeKalb county 
to Maynard's Cove ; Jefferson B. Harralson, from Miltonsville, Marshall 
county, to Langston. 

JEFFERSON COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFICERS. 

Pr. James H. McCarty ; V. Pr. Wm. E. B. Davis ; Sec. George S. 
Brown; Tr. Thomas D. Parke; H. 0. John C. Dozier; Censors, 
John W. Sears, Edward H. ShoU, Henry N. Rosser, Wm. Locke Chew, 
B. Leon Wyman. 

NAMES OF MEMBBBS WITH THEIB COLLEGES AND POST-OFFICES. 

Abemethy, Jones Cadwalader, mc univ Louisiana 59, cb Marengo 78, 
Birmingham. 

Baird, William James, mc univ Maryland 82, cb 88, Birmingham. 

Barclay, John Wyethe, mc Jefferson 69, cb Madison 78, Birmingham. 

Brown, George Summers, mc Jefferson 85, cb 87, Birmingham. 

Burgamy, William Purifoy, mc Jefferson 55, cb 80, Birmingham. 

Caffee, Samuel Richmond, Miami, Ohio, 81, cb Tuscaloosa 81, Birming- 
ham. 

Carson, Shelby Chadwick, mc Louisville 74, cb Greene 79, Bessemer. 

Chew, William Locke, mc univ Louisiana 86, cb Jefferson 86, Birming- 
ham. 

Cochrane, Hardin Perkins, mc univ New York 74, cb Tuscaloosa 82, 
Birmingham. 

Coleman, Ruffin, mc univ Nashville 69, cb Limestone 78, Birmingham. 

Cooper, William Dudley, mc Jefferson 69, cb Lee 82, Birmingham. 

Culberson, John Thomas, mc univ Maryland 86, State Board 86, Bir- 
mingham. 

Curry, James B., mc Alabama 87, cb Pickens 87, Bessemer. 

Davidson, James, mc Alabama 87, cb 87, Birmingham. 

Davis, John Daniel Sinkler, mc Georgia 79, cb St. Clair 79, Birming- 
ham. 

Davis, William Elias Brownlee, mc Baltimore 84, cb 84, Birmingham. 

Douglass, Albert Gallatin, mc univ Vanderbilt 81, cb 81, Birmingham. 

Dozier, John Calhoun, mc univ Nashville 58, cb Perry 79, Birmingham. 

Drennen, Charles, mc Als^bama 72, cb Blouut 78, Birmingham. 

Drennen, Charles Travis, mc Rush, Ohio, 85, cb Cullman 85, Birming- 
ham. 

Gibson, Jefferson Davis, mc Alabama 87, cb Tuscaloosa 87, Birming- 
ham. 

Gillespie, John Sharpe, mc Miami, Ohio, 83, cb Jefferson 83,Birmingham. 

Griggs, John Gardner, mc univ Pennsylvania 63, cb Macon 86, Bir- 
mingham. 



THE ROLL OF THE COUNTY SOCIETIES. 185 

Hayes, John Monroe, mc nniv Nashville 57, cb 86, Birmingham. 

Hendley, Albert Thomas, mc nniv New York 69, cb 84, Birmingham. 

Johnston, William Henry, mc univ New York 67, cb Dallas 78, Bir- 
mingham. 

Jones, Bolivar Thomas, mc Alabama 86, cb Pickens 86, Birmingham. 

Jones, Gapers Capehart, mc univ Pennsylvania 70, cb Wilcox 79, East 
Lake. 

Ledbetter, Samuel Leonidas, mc univ Louisville 76, cb 78, Birmingham. 

Martin, James Phillip, mc Bellevue Hospital 83, cb Barbour 84, Bii^ 
mingham. 

McCarty, James Henry, mc Atlanta 80, cb 83, Birmingham. 

Morris, Edward Watts, mc univ Virginia 84, cb 87, Birmingham. 

Page, John Randolph, mc univ Virginia 50, cb 88, Birmingham. 

Park, Thomas Duke, mc univ New York 79, cb Dallas 84, Birmingham. 

Perry, Samuel, mc South Carolina 54, cb Perry 78, Birmingham. 

Pinkston, James Madison, mc phy and surg Baltimore 78, cb Marengo 
80, Birmingham. 

Prince, Francis Marion, mc Jefferson 49, cb Jefferson 78, Bessemer. 

Riggs, Edward Powell, mc phy and surg Baltimore 81, cb Dallas 78, 
Birmingham. 

Ransom, William Washington, mc univ Vanderbilt 88, cb 88, Birming- 
ham. 

Robertson, Thaddeus Lindsay, mc Jefferson 61, ct> Calhoun 87, Bir- 
mingham. 

Rosser, Henry Nollner, mc Atlanta 69, cb Shelby 69, Birmingham. 

Sears, John William, mcuniv Pennsylvania 50, cb Jefferson 78, Bir- 
mingham. 

Shoemaker, Wooten Ney, mc Columbus, Ohio, 78, cb 78, Birmingham. 

Shell, Edward Henry, mc univ Pennsylvania 56, cb Sumter 77, Bir- 
mingham. 

Sexton, Charles Richard, mc univ Louisiana 75, cb Tuscaloosa 78, Bir- 
mingham. 

Webb, Robert Dickens, mc univ Virginia 55, cb Sumter 78, Birmingham. 

Whaley, Lewis, mc Atlanta 73, cb Blount 79, Birmingham. 

Whelan, Charles, mc univ Louisiana 66, cb 78, Birmingham. 

Wilson, Cunningham, mc univ Pennsylvania 84, cb 84, Birmingham. 

Wyman, Benjamin Leon, mc univ Virginia 78, mc New York 79, cb 
Tuscaloosa 82, Birmingham, 

PHYSICIANS NOT MBMBBBS OF THB SOCIBTY. 

Abercrombie, John Patterson, mc Alabama 80, cb 82, Cedar Grove. 
Acton, Samuel Watson, mc Alabama 60, cb Marengo 78, Trussville. 
Alexander, Howard Augustus^ s. of m. Kentucky 75, cb Macon 79, Bir- 
mingham. 
Ball, John, college not given, cb Cullman 87, Avondale. 



186 THE ANNUAL REGISTER. 

Berry, Robert A., mc univ Virginia 82, cb 85, Birmingham. 

BevanSi James Madison, mc univ Louisville 72, cb Madison 71, War- 
rior. 

Blakely, Ernest Maltravers, mc Meeharry 87, cb Montgomery 87, Bir- 
mingham. 

Brewster, Andrew Jackson, mc Alabama 80, cb 87, Birmingham. 

Bh)wn, George Washington, mc Atlanta 77, cb 78, Pratt Mines. 

Brown, Thomas Jefferson, mc univ Vanderbilt 85, cb 86, Pratt Mines. 

Brown, James A., mc univ Virginia 87, cb Conecuh 87, Ensley. 

Garter, James Watkins (old law) , cb Limestone 78, Bessemer. 

Chapman, John Thomas, mc Alabama 86. cb Marengo 86, Bessemer. 

Clayton, Benjamin L , mc univ Vanderbilt 82, cb St. Clair 82, Ayres. 

Cook, William Henry, (old law) 57, cb Morgan 80, Birmingham. 

Copeland, Benjamin Grigsby, mc Jefferson 83, cb Limestone 83, Bir- 
mingham. 

Cotton, Robert, mc univ Louisiana 67, cb Jefferson 86, Ensley. 

Cross, Thomas, college and certificate not given. Warrior. 

Cross, Samuel Mardis, mc Georgia 60, cb 78, Woodlawn. 

Crow, Phillip P., mc univ Nashville 77, cb St. Clair, Coalburg. 

Crump, Henry Green (college not given), cb St. Clair 87, Birmingham. 

Cunningham, Russell McWhorter, mc Baltimore 79, cb 83, Pratt Mines. 

Curry, James C, mc Alabama 86, cb 86, Bessemer. 

Downing, John Wesley, mc Jefferson 57, cb 87, Avondale. 

Dryer, Thomas Edmund, mc Atlanta 85, cb Macon 86, Birmingham. 

Edwards, Alva Curtis, cb Coosa (old law) 57, cb 86, Birmingham. 

Edwards, Robert Smith, mc Atlanta 71, cb 78, Trussville. 

Ellis, Gideon Wesley, college not given, cb 76, Morris. 

Elsberry, J. P., mc univ Virginia 60, cb Montgomery 84, Redding. 

Finch, John, college, certificate and post-office not given. 

Foster, William Condie, mc univ Louisiana 82, cb Choctaw 84, Bir~ 
mingham. 

Gamble, John Wesley, cb Jefferson (old law), Huffman. 

Gamble, William M., college, certificate and.residence not given. 

Griffith, William, mcphy and surg Baltimore 87, Pratt Mines. 

Green, Robert Smith, mc Alabama 60, cb 87, New Castle. 

Hayes, James Simpson, college not given, cb Walker 81, Brooksville. 

Heasley, William Thomas, college not given, cb Madison, . 

Hale, William Lewis, mc Alabama 78, cb 88, Bessemer. 

Haney, Newton Bolivar, mc univ Vanderbilt 81, cb Walker 82, Birming- 
ham. 

Harwell, John T., mc Atlanta 82, cb Madison 87, Birmingham. 

Hawkins, Richard Nathaniel, mc Miami, Ohio 69, cb Shelby 80, Elyton. 

Heddleston, James Lawrence, mc South Carolina 55, cb 88, Gate City. 

Huey, John Frederick, mc Baltimore 87, cb 87, Pratt Mines. 

Jemigan, Charles Henry, mc Jefierson 54, cb Bullock 80, Birmingham. 

Jones. John Thomas, mc univ Tolane 85, cb 88| Birmingham, 



THE ROLL OT THE COUNTY SOCIETIES. 187 

Jones, Edward J., college and certificate not given, Henry Ellen. 

Klebs, Thomas A., charity hospital N. 0., cb 87, Birmingham. 

Kilbrough, J. M., college and certificate not given, Birmingham. 

Lacy, Edward Parish, mc univ Vanderbilt 83, cb Shelby 83, Dolomite. 

Lewis, Francis Porcher, mc Soath Carolina 76, cb 86, Coalburg. 

Luckie, James Buchner, mc univ Pennsylvania 55, cb 77, Birmingham. 

Oates, David Dunlap, mc univ Pennsylvania 60, cb 79, Leeds. 

Oliver, Henry F., cb 57 (old law), cb Butler 81, Woodlawn. 

Owen, William M., cb 57 (old law), cb Tuscaloosa 78, Jonesboro. 

Paine, John, mc Je£ferson 86, .cb Shelby 86, Hillman. 

Pearson, Edward Caliman, mc univ Louisville 73, cb 78, Birmingham. 

Plecker, Walter Ashbury, mc univ Maryland 85, cb 86, Morris Mines. 

Posey, William Felix, mc Alabama 51, cb 78, Mt. Pinson. 

Pouncy, John B., cb (old law) 57, cb Bullock 81, Birmingham. 

Bagsdale, Edward Socrates, mc Georgia, cb Perry 78, Bessemer. 

Bobbins, Jesse Elbert, mc South Carolina 86, cb 87, Brooksville. 

Robinson, Elisha M., mc univ Louisiana 85, cb Blount 86, Bessemer. 

Robinson, Jasper B., mc univ Vanderbilt 69, cb St. Clair 78, Bessemer. 

Robinson, John Pendance, college not given, Bessemer. 

Robinson, Thomas F., mc univ Vanderbilt 85, cb 86, Bessemer. 

Roberts, Martin, college not given, cb 79, Warrior. 

Spencer, LucianO., mc Miami, Ohio 85, cb 86, Jonesboro. 

Staggs, John B., of uncertain whereabouts, Elliott. 

Statum, Job, mc Atlanta 88, cb 88, Elliott. 

Van, James Bird, mc univ Louisiana 81, cb 82, Huffman. 

Ward, Jesse, college and certificate not given, Partridge. 

Wheeler, Samuel Harvey, mc Atlanta 73, cb Blount 78, Birmingham. 

Whissenhant, L. D., college and certificate not given, Morris. 

Wilson, Abel Robin, mc Georgia 60, cb Morgan 78, Birmingham. 

Woodson, Lewis G., mc univ Maryland 86, cb 88, Birmingham. 

Woolerton, Samuel Harvey, mc univ Pennsylvanin 86, cb 86, Oxmoor. 

Moved into the county — John Ball, from Blount county to Avondale ; 
Jno. M. Baird, to Birmingham; James A. Brown, from Virginia to 
Ensley; John T. Chapman to Bessemer; B. L. Clayton to Ayers; 
Thomas Cross to Warrior; Phillip P. Crow to Coalburg; J. P. Elsberry, 
from Montgomery county to Redding; Wm. L. Hale to Bessemer; H. 
L. .Hayes to Brookside ; James Lawrence Heddleston to Gate City ; C. 
C. Jones, from Furman, Wilcox county to Eastlake; E. J. Jones to 
Henry Ellen ; W. M. Owen to Jonesboro ; J. B. Pouncy to Birmingham ; 
Job Statum, J. B. Stagg, to Elliott; Jesse Ward to Partridge; L. D, 
Whissenhant to Morris. 

Moved out of the county— Edward P. Earle, from Birmingham to 
Cognac, France ; William Sterling Edwards, from Birmingham ; R. H. 
Hargrove to Nashville ; Robert Julien Mathews from Bryan Station ; 
Horace Lee Simpson from Birmingham. 



188 THE ANNUAL REGISTER. 

Deaths — ^Brice Martin HugheSi M. D., mc univ Louisiana 82, Bir- 
mingham, July 3, 88, suicide; Charles Calvin Gregory, M. D., cb Tus* 
caloosa, Birmingham; Mortimer Harvey Jordan, M. D., mc Miami, 
Ohio 68, cb 88, Birmingham, of fibroid phthisis. 

LAMAR COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFICERS. 

Pr. William L. Morton ; V. Pr. ; Sec. Martin W. Morton ; 

Tr. Martin W. Morton ; H. 0. Robert J. Redden ; Censors, William L. 
Morton, Martin W. Morton, Robert J. Redden, William F. Elliott. 

NAMES OF MEICBEBS WITH TUBIB COLLEGES AND POST-OFFICES. 

Box, Daniel William, mc Alabama 85, cb 85, Military Springs. 
Bums, G^rge Crothers, cb 78, Vernon. 
Collins, William James, cb 77, Kings ville. 

Elliott, William Farris, one course Louisville 57, cb 77, Beaverton. 
Hollis, Daniel Dixie, mc phy and surg Baltimore 84, cb 84, SuUigent. 
Morton, Martin Watson, mc Cincinnati, Ohio 73, cb 77, Vernon. 
Morton, William Locke, mc univ Louisiana 74, cb 77, Vernon. 
Redden, Robert James, mc univ Baltimore 73, cb 77, SuUigent. 

PHYSICIANS NOT HEHBBBS OF THE SOCIETY. 

Armstrong, William, cb 80, Detroit. 

Barksdale, James Ira, mc univ Nashville 72, cb 86, Hudson. 

Blakeney, Louis Columbus, mc Alabama 74, cb 77, Millport. 

Collins, Greorge Jackson, mc Alabama 74, cb 80, Kennedy. 

Kennedy, John Oscar, mc Alabama 82, cb 82, Kennedy. 

Kennedy, William Henderson, mc univ Nashville 51, cb 77, Kennedy. 

Seay, Thomas Jefferson, cb 77, Fembank. 

Moved out of the county — Mark Seay, from Fembank to Berry Sta- 
tion, Fayette county ; James S. Stanley, from Detroit to Mississippi. 

LAUDERDALE COUNTY MEDICAL SOCIETY— Tuscaloosa, 1887. 

OFFICERS. 

Pr. Hugh L. Ray ; V. Pr. Hiram R. Kennedy ; Sec. Percy J. Price ; 

Tr. ; H. O. Leonard W. Arnold; Censors, William M. Price, 

Henry A. Moody, Hugh L. Ray, Emmet L. Jones, Jesse A. Pate. 

NAMES OF MEMBEBS WITH THEIB COLLEGES AND POST-OFFICES. 

Arnold, Leonard Waring, mc univ New York and Vanderbilt 82, cb 87, 

Florence. 
Douglass, James Albert, mc univ Nashville OS, cb 88, Centre Star. 



THE ROLL OF THE COUNTY SOCIETIES. 189 

Duckett, Levi Fowler, mc Atlanta 56, cb 87, Florence. 
Haraway, William Epps, mc univ Nashville 56, cb 87, Florence. 
Henderson, Alexander Holmes, mc univ Nashville 76, cb 87, Bailey 

Springs. 
Jones, Emmet Lee, mc Alabama 86, cb 87, Florence. 
Kennedy, Hiram Richard, mc miiv Louisville 79, cb 87, Green Hill. 
Moody, Henry Altamont, mc univ Louisville 66, cb 87, Florence. 
Pate, Jesse Americus, mc univ Louisville 75, cb 87, Rodgersville. 
Powers, Alexander Hamilton, mc univ Louisville 71, cb 87, Waterloo. 
Price, Percy Isaac, mc univ New York and Vanderbilt 86, cb 87, 

Florence. 
Price, William Mason, mc univ New York and Vanderbilt 66, cb87, 

Florence. 
Ray, Hugh Leonidas, mc univ New York and Vanderbilt 71, cb 87, 

Florence. 
Stewart, Edward Munroe, mc univ New York and Vanderbilt 68, cb 87, 

Oakland. 
Stewart, James William, mc univ Louisiana 58, cb 87, Florence. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Hannum, Anthony Butler, mc univ Nashville 60, cb 87, Pruitton. 
Johnson, Stephen, mc univ Louisville 51, cb 87, Raw Hide. 
Kernachan, William Jones, mc univ Vanderbilt, 79, cb 88, Florence. 
Morgan, James Thomas, mc univ Nashville 61, cb 87, Florence. 
Powell, William Washington, mc univ Michigan 55, cb 88, Pruitton. 
Richardson, Wiley William, mc univ Louisville 88, cb 89, Centre Star. 
Sullivan, Oliver Brown, mc univ Louisville 47, cb 87, Waterloo. 

Moved out of the county — John Gordon Frierson, from Florence to 
Gourtland, Lawrence county ; Samuel Outison Paulk, from Raw Hide, 
to Tennessee ; Charles Mc Alpine Watson, from Florence to Tuscumbia, 
Colbert county. 

Examination — For the practice of medicine, Wiley William Richard- 
son, mc univ Louisville 88, Centre Star. Certificate awarded. 

Deaths — ^Thomas Jefferson Crittenden, M. D. (retired), Covington, of 
consumption ; Albert 0. Oliver, M. D., Rogersville. 

LAWRENCE COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFIGEBS* 

Pr. Edward C Ashford ; V. Pr. Robert M. Simpson ; Sec. William J. 
McMahon ; Tr. William J. McMahon ; H. 0. William J. McMahon ; 
Censors, Henry B. Bargett, John G. Frierson, John R. McDonald, Ed- 
gar Rand, Robert M. Simpson, 



190 THE ANNUAL REGISTER. 

NAMBS OF MBMBBRS WITH THBIR COLLBOBB AND POST-OFFIGBB. 

Ashford, Edward Clinton, mc univ Louisiana 57, cb 78, Coartland. 
Binford, Littleberry Hardeman, mc Jefferson 51, cb 78, Coartland. 
Barkett, Henry Bascomb, mc phy and surg Baltimore 78, cb 78, Hills- 

boro. 
Clarke, John McWhorter, mc univ Louisville 50, cb 78,Monlton. 
Crow, Calvin Augustus, mc Jefferson 51, cb 78, Moulton. 
Ethridge, Benjamin Franklin, mc Memphis 86, cb 86, Avoca. 
Frierson, John Gordon, mc univ Vanderbilt 86, cb 88, Courtland. 
Hodges, John Pruit, mc univ Nashville 72, cb 78, Oakville. 
Houston, Leonidas Walton, mc univ Nashville 77, cb 78, Town Creek. 
Jones, Thomas N., mc univ Louisville 78, cb 78, Mount Hope. 
Martin, John Rufus, mc univ Louisville 69, cb 78, Hatton. 
Masterson, Byron 0., mc univ Indiana 59, cb 78, Avoca. 
Masterson, John Thomas, phy and surg Philadelphia 72, cb 78, Moulton 
McDonald, John Robert, mc univ Nashville 67, cb Limestone 78, Town 

Creek. 
McMahon, William Jack, Long Island c h 60, s of m New Orleans 61, 

cb 78, Courtland. 
Rand, Edgar, mc Alabama 67, cb 78, Leighton. 

Simms, Edgar Thomas, univ m and s Philadelphia 69, cb 78, HUlsboro. 
Stanley, William Henry, mc univ Vanderbilt 87, cb 87, Brick. 
Simpson, Robert Miles, mc univ Vanderbilt 76, cb 89, Moulton. 

PHYSICIANS NOT MBMBBBB OF THB BOCIBTY. 

Carter, Parkerson Patrick, cb Lowndes '79, Brick. 
Biddle, E. J., cb Lowndes 78, Mt. Hope. 

Edwards, John Wilson, mc univ Louisville 69, cb 78, Town Creek. 
Fish, William Fletcher, mc univ New York 56, cb Limestone 78, Lan- 
ders ville. 
Howell, Rufus, mc Memphis 88, cb 78, Hatton. 
Jones, Thomas Crittenden, mc univ Louisville 76, cb 78, Mount Hope. 
King, Benjamin Rush, mc univ Pennsylvania 58, cb 78, Leighton. 
Masterson, A., mc univ Louisville 89, cb 89, Avoca. 
Masterson, Thomas, mc univ Louisville 89, cb 89, Landersville. 
Pitt, James Thomas, mc univ Nashville 86, cb 89, Hillsboro. 
Robinson, John Alexander, mc St. Louis 72, cb 89, Leighton. 
Shegog, George, mc King's, Dublin 46, cb 89, Brick. 

Moved out of the county— William L. Dinsmore, from Town Creek 
to Decatur— retired ; Reese Bowen Porter, Town Creek. 

Deaths— George Washington Bowling, M. D., Landersville; Fortuna- 
tuB Sidney McMahon, M. D., Courtland, of chronic diarrhoea. 



THE ROLL OF THE COUNTY SOCIETIES. 191 

LEE COUNTY MEDICAL SOCIETY— Hunteville, 1880. 

0FFICBB8. 

Pr. Aurelius G. Emory ; V. Pr. ; Sec. Levin W. Shepherd. 

Tr. ; H. O.Charles B. McCoy; Censors, Aurelius G. Emory, 

Levin Wilson Shepherd, Abijah B. Bennett, John H. Drake, Jesse 
G. Palmer. 

NAMES OF HEMBBRS WITH THBIB COLLBOBS AND POST-OFFICES. 

Bennett, Abijah Benjamin, mc phys and surg Baltimore 81, cb 81, 

Opelika. 
Drake, John Hodges, mc Atlanta 67, cb 81, Auburn. 
Emory, Aurelius Grigsby, mc univ Louisina 63, cb 81, Opelika. 
Griffin, William Henry Harrison, mc South Carolina 35, cb 81, Opelika. 
Love, William Joseph, mc Atlanta 84, cb 85, Waccoohee. 
McCoy, Charles Breckenridge, mc phys and surg Baltimore 82, cb 85, 

Opelika. 
Palmer, Jesse Gary, mc phys and surg Baltimore 84, cb Chambers 84, 

Opelika. 
Shepherd, Levin Wilson, mc univ New York 59, cb 81, Opelika. 

PHYSICIANS NOT MBMBEBS OF THE SOOIBTY. 

Bedell, Robert Bruce, mc univ Nashville 69, cb 81, Auburn, 

Bloodworth, Wiley Washington, mc Jefferson 53, cb 81, Lively. 

Floyd, James William Daniel, mc univ Pennsylvania 20, cb 81, Salem. 

Foreman, Arthur Levin, mc univ Louisville, cb 81, Loachapoka. 

Fowler, Andrew Jackson, mc Atlanta 85, cb 85, Roxana. 

Fuller, Isham Benjamin, cb 81, Smith Station. 

Johnson, William Henry, mc Atlanta 57, cb 81, Loachapoka. 

Lamar, William Henry, college not given, Auburn. 

Love, James Madison, mc South Carolina 54, cb 81, Salem. 

McCoy, Amos Washington, mc univ New York 53, cb 81, Opelika. 

Shelton, Marengo David, mc univ. Nashville 69, cb 81, Lively. 

Snipes, William A., college not given, Beulah. 

Terry, Early Walton, mc univ Tennessee 88, cb Elmore 88, Loachapoka. 

Williams, Daniel Bullard, college not given, Opelika. 

Williams, J. W. R., college not jdven, Opelika. 

LIMESTONE COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFICBBS. 

Pr. Theophilus Westmoreland; V. Pr. ; Sec. William J. Ha- 

gan; Tr. ; H. 0. William J. Hagan; Censors, JohnR. Hoffman, 

Theo. Westmorelandi William J. Hagan, 



192 THE ANNUAL REGISTER. 

NAMBS OF MBMBBR8 WITH THBIB COLLBGBS AND POST-OFFICBS. 

Hagan, William James, mc Jefferson 84, cb 84, Athens. 
Hoffman, John Richardson, mc Jefferson 58, cb 77, Athens. 
Houston, John Samuel, mc univ Louisville 77, cb 84, Athens. 
Pettus, Joseph Albert, mc univ Nashville 67, cb 77, Elkmount. 
Rankin, James Caffield Mitchell, mc univ Nashville 58, cb 78, Belle 

Mina. 
Westmoreland, Theopilus, mc univ Nashville 56, cb 79 Athens. 

PHYSICIANS NOT MBHBBRS OF THB SOCIETY. 

Carter, James Jackson, cb 78, Athens. 

Collins, James Marshall, cb 78, Cartwright. 

Deloney, Isaac Fox, mc univ Louisiana 53, cb Madison 78, Petty. 

Dupree, William Jefferson, cb 79, Westmoreland. 

Hill, Henry Willis, mc univ New York 49, cb 84, Mooresville. 

Hill, James Abram, mc univ Vanderbilt 84, cb 84, Mooresville. 

Moore, Elisha Dixon, cb 69, (old law), cb 78, Elk River Mills. 

Moebes, Otto, homeopathist, cb 78, Athens. 

Pettus, Thomas Coleman, cb 44, (old law), Madison, cb 77, Pettusville. 

Wallace, Nicholas Blackburn, mc Cincinnati 51, cb 78, Elkmont. 

Wilkinson, Milton Roil, mc univ Nashville 80, cb 67, (old law), cb 78, 

Westmoreland. 
Williams, George Allen, mc univ Nashville 80, cb Colbert 81, cb 82, 

Hyde Park. 
Wilson, Felix Grundy, mc univ Nashville 80, cb 65, (old law), cb 76, 

Elkmont. 
York, Seaborn Ellis, mc univ Louisville 78, cb 84, Athens. 

Examinations — For the practice of medicine, James H. Hansford, mc 
univ Louisville 88; John Crutcher, mc univ Vanderbilt 89. Certifi- 
cates awarded. 

LOWNDES COUNTY MEDICAL SOOIETY—Mobile, 1876. 

07FICEBS. 

Pr. Daniel S. Hopping; V. Pr. John P. Mushat; Sec. Shirley Bragg; 

Tr. ; H. 0. Shirley Bragg. Censors, Shirley Bragg, John 

P. Mushat, Charles T. Weatherly, John A. Pritchett, Phillip N. Cil- 
ley. 

NAMBS OF MBMBBBS WITH THBIR COLLBGBS AND P08T-0FFICBB. 

Bragg, Shirley, mc Alabama 75, cb 79, Lowndesboro. 

Bowie, Andrew, mc South Carolina 54, cb 78, Benton. 

Cilley, Philip Noble, mc univ Louisiana 48, cb 78, Lowndesboro, 



THE ROLL OF THE COUNTY SOCIETIES. 198 

Cram, William Barton, mc Alabama 87, cb 87, Farmersville. 
Dilbum, Samuel George, mc Alabama 75, cb 78, Bragg's Store. 
Hopping, Daniel Stiles, mc Jefferson 62, cb 78, Letohatchie. 
Moshat, John Patrick, mc South Carolina 56, cb 78, Hayneville. 
Pritchett, John Albert, mc univ Virginia 74, cb 78, Hayneville. 
Weatherly, Charles Taliaferro, mc Atlanta 74, cb 86, Benton. 
Weaver, William Calvin, mc univ Tennessee 83, cb 83, Fort Deposit. 

PHTSIOIANB NOT MBMBERB OF THE SOCIETY. 

Ansley, John Samuel, mc Atlanta 76, cb 78, Mt. Willing. 
Bruner, Oliver Glenn, mc Atlanta 84, cb 84, Fort Deposit. 
Buford, William Lewis, non-graduate, cb 78, Mt. Willing. 
Carr, Greorge Washington LaFayette, mc univ Pennsylvania 65, cb 78, 

Mt. Willing. 
Coleman, Aurelius Daniel, mc Alabama 86, cb 80, Mt. Willing. 
Haygood, Daniel, mc South Carolina 69, cb 78, Mt. Willing. 
Jones, Devotie Davis, mc Atlanta 73, cb 84, Fort Deposit. 
McQueen, Samuel Thomas, mc univ Pennsylvania 56, cb 78, Fort 

Deposit. 
McRea, Abram Craser, mc univ Pennsylvania 60, cb 78, Lowndesboro. 
Peake, John Samuel, mc South Carolina 64, cb 78, Farmersville. 
Peake, William, mc univ Vanderbilt 83, cb 83, Farmersville. 
Reese, Charles Edwin, mc Jefferson 65, cb 78, Lowndesboro. 
Russell, John Hamilton, cb 78, Sandy Ridge. 
Sanderson, Edmund Levi, mc Jefferson 67, cb 78, Letohatchie. 
Snow, Eugene Henry Clay, mc univ Tennessee 83, cb 86,Bragg's Store. 
Stephens, James John, cb 78, Sandy Ridge. 
Winnemore, Samuel Eggleston, mc univ New York 66, cb 78, Benton. 

Moved out of the county — L. R. Boyd, from Burkeyille to Salem, Lee 
county, Ala. 

MACON COUNTY MEDICAL SOCIETY— Selma, 1879. 

OFFICERS. 

Pr. William J. Gautier ; V. Pr. Charles L. R. Boyd ; Sec. William B. 
Arbery; Tr. John H. Gautier; H. 0. John H. Gautier. Censors, 
William I. Gautier, Fred. W. Williams, Charles L. R. Boyd, Francis 
M. Letcher, William B. Arbery. 

NAMES OF MXMBBB8 WITH THSIB COLLBGES AND POST-OFFICES. 

Arbery, William Buchanan, mc univ Vanderbilt 82, cb 82, Notasulga. 
Atkeson, Clarence Lee Crawford, mc phy and surg Baltimore 81, cb 

Lee 82, Tuskegee. 
Boyd, Charles LeRoy, mc South Carolina 66, cb 79, La Place. 
Brunson, Thaddeus Warsaw, mc univ Pennsylvania 47, cb 79, Society 

HiU. 

13 



194 THE ANNUAL REGISTER, 

Gautier, John Hora, mc univ Louisville 88, cb 88, Taskegee. 
Gautier, William James, mc univ Pennsylvania 50, cb 79, Tuskegee. 
Hodnett, Wesley Forbush, mc Transylvania 36, cb 79, Tuskegee. 
Johnson, Benjamin Franklin, mc South Carolina 43, cb 79, Notasulga. 
Letcher, Francis Marion, mc univ Louisiana 61, cb 79, Shorter's. 
Williams, Frederick William, mc univ Pennsylvania 52, cb 79, Tus- 
kegee. 

PHYSICIANS NOT MBMBBBB OF THE BOCIBTY. 

Aiken, James Gurus, mc Graffenburg 54, cb Tallapoosa 82, Notasulga. 
Ellison, James Edwin, mc Georgia 48, cb 79, Creek Stand. 
Harris, William Samuel, college and certificate not given, Dick's Store. 
Lightfoot, John Steele, mc univ Nashville 68, cb 79, Shorters. 
Reynolds, William A.lbert, college and certificate not given, Warrior 

Stand. 
Sistrunk, John, mc univ New York 58, cb 79, Society Hill. 
Wagnon, John Troup, college and certificate not given, 79, Mount Meigs. 

Examinations — Preliminary to the study of medicine, James Thomas 
May. Certificate awarded. 

MADISON COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFICERS. 

Pr. John J. Dement; V. Pr. Charles E. Blanton; Sec. Lewis C. 

Pynchon; Tr. ; H. 0. Samuel H. Lowery; Censors, Milton 0. 

Baldridge, Albert R. Erskine, Samuel H. Lowery, Richard M. Fletcher, 
David H. McLain. 

NAMES OF MSMBEBS WITH THEIR COLLEGES AND POST-OFFICES. 

Baldridge, Milton Columbus, mc Bellevue 74, cb 78, Huntsvilie. 
Blanton, Charles Edgar, mc univ Vanderbilt, 82, cb 82, New Market. 
Blanton, James Conroe, mc univ Louisville 76, cb 78, New Market. 
Brouillette, Pierre Lawrence, mc Ohio 71, cb 84, Huntsville. 
Burke, James Pickens, mc univ Pennsylvania 53, cb 78, Meridian ville . 
Dement, John Jefferson, mc univ Pennsylvania 53, cb 78, Huntsville. 
Erskine, Albert Russell, mc univ Pennsylvania 57, cb 78, Huntsville. 
Farley, John Benton, mc univ Vanderbilt 86, cb 86, Whitesburg. 
Fletcher, Richard Mathew, mc univ Pennsylvania 54, cb 78, Madison. 
Hatcher, Archer Wood, college not given, cb 82, Hazel Green. 
Hinds, Bryan William, mc univ Nashville 66, cb 81, New Hope. 
Johnson, Henry Richard, New Hope. 

Layman, Francis Marion, mc univ Nashville 70, cb 87, Mayesville. 
Lipscomb, DeKalb, college not given, cb 87, New Market. 
Lipscomb, Elias DeKalb, state board 87, New Market. 
Itowery, Samuel Hickman, mc Bellevue 73, cb 78, Huntsville. 



THE ROLL OF THE COUNTY SOCIETIES. 195 

McDonnell, Henry, mc univ Louisiana 68, cb 78, Hnntsville. 

McLain, David Hubbard, mc Alabama 75, cb 78, Mayesville. 

Pjmchon, Lewis Charlton, mc Jefferson 53, cb 78, HuntsviUe. 

Rice, Francisco, mc (botanico-med.) Memphis 57, cb 78, New Market. 

Rivers, William Edwards, cb 78, New Hope. 

Robinson, Christopher Americus, mc Jefferson 71, cb 78, Huntsville. 

Shelby, Antony Bouldin, cb 78, Huntsville. 

Sullivan, George Richard, mc Shelby 60, cb 78, Madison, 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Brazleton, John Houston, mc univ Vanderbilt 80, cb 81, Berkley. 
Glover, Antony Natalie, mc univ Nashville, cb 87, Owens Cross Roads. 
Macon, Joseph Sumter, mc Atlanta 80, cb 80, Hayes' Store. 
Petty, Robert Augustus, mc Alabama 71, cb 78, Hayes' Store. 
Ridley, James Lucas, mc Shelby 6J , cb 78, Huntsville. 
Watts, John Parks, mc univ Louisville 73, cb 78, Hayes' Store. 

Examinations — For the practice of medicine, James A. Haggard, s 
of m Kentucky 88. Certificate refused. 

MARENGO COUNTY MEDICAL SOCIETY— Birmingham, 1876. 

OFFICEBS. 

Pr. James H. Gteorge; V. Pr. George Whitfield; Sec. Charles B. 

Thomas; Tr. ; H. O. Edward H. C. Bailey; Censors, G^rge 

Whitfield, James H. George, Edward H. C. Bailey. 

NAMES OF MEMBERS WITH THBIB COLLEGES AND POST-OFFIOBS. 

Allen, William Howard, mc univ Louisville 82, cb 82, Sweetwater. 

Bailey, Edward Howe Corrie, mc univ Virginia 48, cb 78, Demopolis. 

George, James Hosea, mc South Carolina 67, cb 78, Linden. 

Jolly, Arnold, mc Alabama 85, cb 86, Faunsdale. 

Kimbrough, Wm. Leonard, mc univ Louisiana 81, cb 82, Shiloh. 

McCants, Robert Bell, mc Southern 82, cb 82, Jefferson. 

McCorkle, Thomas Samuel, mc Alabama 83, cb 83, Dayton. 

Ruffin, James Sterling, mc univ Pennsylvania 49, cb 78, Demopolis. 

Thomas, Charles Brooks, mc Southern 83, cb 83, McKinley. 

Whitfield, Bryant Watkins, mc univ Pennsylvania 63, cb 79, Demop- 
olis. 

Whitfield, Charles Boaz, mc phy and surg New York 71, cb 79, Demop- 
olis. 

Whitfield, George, mc univ Pennsylvmia 68, cb 78, Old Spring Hill. 

Whitfield, James Bryant, mc Jefferson 67, cb 82, Demopolis. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Allen, James Andrew, mc Graffenburg 63, cb 84, Shiloh. 

BettiBi Thorns Jefferson, mc univ Louisiaaa 61, cb 34, Nicbolsyill^. 



196 THE ANNUAL REGISTER. 

Dmmmond, William Fletcher, mc aniv Maryland 49, cb 78, Magnolia. 

Evans, Josiah Thomas , mc Jefferson 37, cb 79, Rembert. 

Gillespie, Robert Clements, mc univ Louisville 83, cb 83, Dixon Mills. 

Jones, Richard Augustus, mc Jefferson 55, cb 78, Dayton. 

Jones, Wade Hampton, mc South Carolina 58, cb 84, Jefferson. 

King, James Moore, mc Alabama 87, cb 87, McKinley. 

Morgan, Henry Walter, mc Alabama 73, cb 78, Dayton. 

Nixon, William Goodwin, mc univ Pennsylvania 65, cb 78, Nixonville. 

Pegram, William Henry, cb (old law) 44, cb 79, Dayton. 

Poellnit2, Benjamin Bruno, mc univ Louisiana 47, cb 81, Rembert. 

Slade, Henry, mc Alabama 72, cb 78, Magnolia. 

Smith, Seth David, mc univ Louisiana 54, cb 78, Demopolis. 

Spotswood, Norbome Dandridge, mc Kemper 44, cb 82, Linden. 

Stone, Augustus Bos worth, mc Alabama 80, cb Baldwin 86, Rembert. 

Strudwick, Edmund, mc Jefferson 57, cb 78, Dayton. 

Thomas, John, mc South Carolina 55, cb 78, Rembert. 

Webb, James, mc univ Pensylvania 42, cb 78, Faunsdale. 

Wood, John Hackworth, mc Alabama 86, cb 86, Dixon's Mills. 

Moved out of the county — ^Dr. Jno. T. Chapman, from McKinley to 
Bessemer; Dr. James Madison Pinkston, from Faunsdale to Birming- 
ham; Dr. Frank Clements Horn, from Uniontownto parts unknown. 

MARION COUNTY MEDICAL SOCIETY— Montgomery, 1888. 

OFFICERS. 

Pp. A. L. Morman; V. Pr. B. P. Ivey ; Sec. W. W. White; Tr. W. 
W. White; H. O. W. Guyton; Censors, M. H. Key, B. P. Ivey, E. L. 
Morton. 

NAMBS OF MBMBKBS WITH THBIB COLLBOBS AND POST-OFFICBS. 

Ernest, J. F., college not given, Winfield. 
Guin, Ira A., college not given, Guin. 
Guyton, William, college not given, Hamilton. 
Ivey, Benjamin P., college itot given, Winfield. 
Key, M. H., college and post-office not given. 
Martin, J. M., college not given, Hamilton. 
Morman, A. L., college not given, Bexar. 
Morton, E. L., college and post-office not given. 
White, W. W., college not given. 

PHYSICIANS NOT MBMBBR8 OF THB SOCIETY. 

Chetham, , college not given, Pearce's Mills. 

Cochran, W. J., college not given, Pearce's Mills. 

Guin, J. M., college not given, Guin. 

Howell, J. W., college not given, Pearce's Mills. 



THE ROLL OF TBE COUlfTY SOCIETIES. 197 

Martiii, M. C, college and post-office not given. 
Vaaghn, Levi, college not given, Gold Mine. 
Vaughn, G. W., college not given, GK>ld Mine. 
Whitley, J. M., college not given, Winfield. 

MARSHALL COUNTY MEDICAL SOCIETY— Anniston, 1886. 

OFFICERS. 

Pr, William May; V. Pr. Francis M. Nixon ; Sec. William L. Thom- 
ason; Tr. William L. Thomason; H. 0. William M. Ricketts; Cen- 
sors, William L. Thomason, William M. Ricketts, William May, 
Thomas S. May, Joseph J. McGahey. 

NAMBS OF MEMBBBS WITH THEIB C6LLB0ES AND POST-OFFICES. 

Hughes, William LaFayette, cb 86, Union Grove. 
Lowery, John, cb 86, Lumpkin. 

Lusk, Lorenzo David, cb Madison 69, (old law), Guntersville. 
May, Thomas Sidney, mc univ Vanderbilt 83, cb 86, Guntersville. 
May, William, mc univ Vanderbilt 82, cb 86, Warrenton. 
McGahey, Joseph Jefferson, cb Jefferson 88, Henry ville. 
Nixon, Francis Marion, cb 78, Guntersville. « 

Ricketts, William Manning, one course.Shelby, Tenn., 59, cb86. Olean- 
der. 
Thomason, William Levi, mc univ Nashville 71, cb 78, Guntersville. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Abies, William George, cb 87, Cottonville. 

Barclift, Thomas Marshall, mc univ Tennessee 85, cb 87, Red Hill. 

Hall, William Presley ,'.mc Southern 86, cb 86, Sidney. 

Jackson, James Monroe, mc South Carolina 40, cb 86, Guntersville. 

May, George Barclift, cb 84, Hilliard's Store. 

Noel, William Lewis, cb 86, Albertville. 

Patterson, Jefferson Jackson, cb Etowah 81, Marshall. 

Scott, Agrippa, mc Atlanta 85, cb 86, Albertville. 

Slaughter, Charles Jefferson, cb Etowah 81, Albertville. 

Sparks, Russell, cb 87, Red Apple. 

Moved into the county — Marcus Lumpkin Johnson, from Oleander 
to Cullman ; Charles Henry Stewart, from Collins ville to Flint, Morgan 
county. 

Deaths— William David Russell, M. D., Oleander, of cancer of the 
rectum. 



I 



198 THE ANNUAL REGISTER. 

MOBILE COUNTY MEDICAL SOCIETY— Mobile, 1876. 

OFFICERS. 

Pr. James G. Thomas ; V. Pr. Caleb Toxey ; Sec. Vivian P. Gaines ; 
Tr. Daniel E. Smith; H. O. Thomas S. Scales; Censors, George A. 
Ketchum, James F. Heustis, Goronway Owen, Caleb Toxey, Samuel 
R. Olliphant. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Cochran, Jerome, mc univ Nashville 61, cb 78, official residence Mont- 
gomery. 

Crampton, Orson Lucius, mc Bellevue 65, cb 78, Mobile. 

Edwards, William Mathews, mc Alabama 80, cb 80, Mobile. 

Festorazzi, Angelo, mc Alabama 88, cb 88, Mobile. 

Fowler, George Hug^cins, mc univ Pennsylvania 61, cb 78, Mobile. 

Gaines, Vivian Pendleton, mc Alabama 72, mc phy & surg New York 
73, cb Choctaw 79, Mobile. 

Goode, Khett, mc Alabama 71, cb 78, Mobile. 

Hendon, James Jefferson, mc Alabama 86, cb 86, Mobile. 

Heustis, James Fountain, mc univ Louisiana 48, cb 78, Mobile. 

Hirshfeld, Henry P., mc univ Pennsylvania 78, cb 78, Mobile. 

Hodgson, Samuel Holt, mc Alabama 88, cb 88, Mobile. 

Lige, Henry Tutwiler, mc univ New York 83, cb 83, Mobile. 

Ketchum, George Augustus, mc univ Pennsylvania 46, cb 78, Mobile. 

Mohr, Charles A., mc Alabama 84, cb 84, Mobile. 

Olliphant, Samuel Rutherford, mc univ Louisiana 56, cb 78, Mobile. 

Owen, Calvin Norris, mc Alabama 88, cb 88, Mobile. 

Owen, Goronway, mc univ Pennsylvania 57, cb 78. 

Pape, William Barnesmore, mc Alabama 82, cb 82, Mobile. 

Patton, William, mc Alabama 76, cb 78, Mobile. 

Randle, Dudley Crawford, mc Alabama 85, cb Pickens 79, Mobile. 

Reese, Augustus Jordan, mc univ Louisiana 49, cb 78, Mobile. 

Sanders, William Henry, mc Jefferson 62, cb 78, Mobile. 

Sawyer, William Templeton, mc univ Louisiana 60, cb 78, Whistler. 

Scales, Thomas Sidney, mc phy and surg New York 67, cb 78, Mobile. 

Smith, Daniel Edgarly, mc Alabama 61, cb 78, Mobile. 

Thomas, James Grey, mc univ Pennsylvania 56, cb 78, Mobile. 

Toxey, Caleb, mc univ Pennsylvania 60, cb 78, Mobile. 

« 

PHYSICIANS NOT MBMBEBS OF THE SOCIETY. 

Beatty, William Gibbs, mc Atlanta 69, cb 78, Whistler. 
Cooper, John Henry, mc Alabama 86, cb 86, Citronelle. 
Cox, Henry Thomas, mc univ New York 48, cb 78, Mobile. 
Hall, Alexander Rowe, mc univ Louisiana 59, cb 78, Mobile. 
Hicklin, William Crawford, mc South Carolina 38, cb 78, Mobile. 



THE ROLL OF TBE COUNTY SOCIETIES. 199 

Jackson, William Richard, mc Alabama 88, cb 88, Mobile. 

Johnson, David Ellis, mc Georgia 68, cb 78, Mobile. 

Lee, mc Alabama. 

Mastin, Claudius Henry, Sr., mc univ Pennsylvania 49, cb 78, Mobile. 

Mastin, Claudius Henry, Jr., mc univ Pennsylvania 84, cb 84, Mobile. 

Mastin, William McDowell, mc univ Pennsylvania 74, cb 78, Mobile. 

McArthur, Andrew Patterson, mc Alabama 85, cb 85, Mobile. 

McCarty, Miles Edward, mc Alabama 73, cb 78, Whistler. 

McVoy, Diego, mc univ Maryland 57, cb 78, Spring Hill. 

Meyers, Augustus (homeopathist), mc St. Louis 88, cb 88, Whistler. 

Micheal, Jacob G., mc univ Virginia 60, cb 78, Citronelle. 

Murrell, William (homeopathist;, mc New York, cb 78, Mobile. 

Pampanilla, Francis Chomeopathist), mc New York 83, cb 78, Mobile. 

Reynolds, Samuel Kirkpatrick, mc Jefferson 57, cb 78, Mobile. 

Roemer, Francis John B., mc univ Louisiana 33, cb 78, Spring Hill. 

Roe, Charles King, mc , cb , Mobile. 

Terrill, James Dixon, mc , cb , Mobile. 

Tompkins, John Edward, mc univ Vanderbilt 80, cb 81, Mobile. 
Walker, Robert Clarence, mc univ Nashville 58, cb 78, Whistler. • 

Moved into the coanty — ^William Richard Jackson, mc Alabama 88, 

cb 88, to Mobile ; Charles King Roe, mc — , cb , to Mobile ; James 

D. Terrell, mc , cb , to Mobile. 

Examinations — ^For the practice of medicine, Frank K. Beck, mc 88, 
cb 88, Mobile ; Angelo Festorazzi, mc Alabama 88, cb 88, Mobile ; Sam- 
uel Holt Hodgson, mc Alabama 88, cb 88, Mobile ; William Richard 
Jackson, mc Alabama 88, cb 88, Mobile ; Calvin Norris Owen, mc Ala- 
bama 88, cb 88, Mobile. Certificates awarded. 

James D. Terrell and Charles K. Roe, certificates refused. 

MONROE COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFICBBS. 

Pr. Samuel S. Gaillard ; V. Pr. William M. Burroughs ; Sec. George 

W. Gaillard; Tr. ; H. O. William W. McMillan. Censors, George 

W. Gaillard, William M. Burroughs, Fielden S. Dailey. 

NAMKS OF MEMBBBS WITH THBIB COLLBGBS AND P08T-0FFICBS. 

Abemethy, William Henry, mc Alabama 75, Linela. 
Bradley, Hugh, mc univ Pennsylvania 56, cb 77, River Ridge. 
Burroughs, William Monroe, mc South Carolina 57, cb 77, Newtown 

Academy. 
Dailey, Fielden Straughn, mc Alabama 71, cb 77, Kempville. 
Gaillard, George Walter, mc univ Louisville 82, cb 83, Perdue Hill. 
Gaillard, Samuel Septimus, mc South Carolina 48, cb 77, Perdue Hill. 
Hestle, William Monroe, mc Alabama 85, cb 85, Buena Vista. 



200 THE ANNUAL REGISTER. 

Jenkins, James Samuel, mc South Carolina, cb 77, Buena Vista. 
McMillan, William Wallace, mc nniv Louisiana 58, cb 79, Monroeville. 
Scott, Gladden Gorin, mc univ Louisville 85, cb 85, Mount Pleasant. 
Thomas, Joseph Weatherford, mc univ Transylvania 55. cb 77, Mount 

Pleasant. 
Wiggins, James Monroe, mc Alabama 78, cb 78, Monroeville. 

PHYSICIANS MOT MSMBBRS OF THE SOCIBTT. 

Chapman, William Robert, mc Reform, cb — , Old Texas. 
Draughn, Robert Isaac, mc South Carolina 47, cb 77, Perdue Hill. 
Hodgson, Philip Morton, Alabama 89, cb 89, Mt. Pleasant. 
Mason, William Thomas, mc Atlanta 84, cb Wilcox 84, Activity. 
Russell, James Thomas, mc Atlanta, cb 77, Monroeville. 
Whissenhant, William, mc univ Vanderbilt 81, cb 81, Buena Vista. 

Moved out of the county — William A. Smith, from Tinela to Anniston, 
Alabama. 

MONTGOMERY COUNTY MEDICAL SOCIETY— Eufaula, 1878. 

OrFICEBS. 

Pr. James R. Jordan; V. Pr. Isaac L. Watkins; Sec. Joseph L. 
Gaston ; Tr. Thos. A. Means ; H. 0. Pascal H. Owen ; Censors, John B. 
Gaston, Richard F. Michel, Samuel D. Seelye, Job S. Weatherly, 
Luther L. Hill. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Andrews, Glenn, mc univ New York 86, cb 86, Montgomery. 

Baldwin, Benjamin James, mc Bellevue 77, cb 83, Montgomery. 

Bibb, William George, mc univ Vanderbilt and Bellevue 78, cb 78, 
Montgomery. 

Blue, John Howard, mc Washington and Baltimore 70, cb 78, Mont- 
gomery. 

Douglass, James, mc South Carolina 57, cb 78, Montgomery. 

Duncan, Charles Kane, mc univ New York 58, cb 85, Montgomery. 

Gaston, John Brown, mc univ Pennsylvania 55, cb 78, Montgomery. 

Gaston, Joseph Lucius, mc pby and surg New York 85, cb 88, Mont- 
gomery. 

Hill, Luther Leonidas, mc univ New York 81, cb Jefferson 81, Mont- 
gomery. 

Howell, William Henderson, mc Atlanta 80, cb 80, Mount Carmel. 

Ivey , Bama Pitt, mc Alabama 88, cb Marion 88, Montgomery . 

Jackson, Walter Clarke, mc univ Pennsylvania 52, cb 78, Montgomery. 

Johnston, John Foot, mc South Carolina 48, cb 78, Montgomery. 

Jordan, James Reid, mc univ Maryland 84, cb 84, Montgomery. 



THE ROLL OF THE COUNTY SOCIETIES. 201 

Kendrick, William Tomlin, mc Atlanta 76, cb Butler 78, Montgomery. 

Kirk, Eben Bell, mc Alabama 85, cb Mobile 85, Montgomery. 

McDade, George Wilkins, s of m Nev Orleans 61, cb 78, Montgomery. 

Means, Thomas Alexander, mc Atlanta 57, cb 84, Montgomery. 

Michel, Kichard Fraser, mc South Carolina 47, cb 78, Montgomery. 

Owen, Pascal Harrison, mc univ New York 59, cb Lowndes 78, Mont- 
gomery. 

Pearson, Benjamin Rush, mc Alabama 81, cb 81, Montgomery. 

Pierce, Dunklin, mc univ Louisiana 58, cb Lowndes 78, Montgomery. 

Seelye, Samuel Dibble, mc univ New York 55, cb 78, Montgomery. 

Watkins, Isaac LaFayette, mc Bellevue 78, cb Bullock 86, Montgomery. 

Weatherly, Job Sobieski, mc univ New York 49, cb 78, Montgomery. 

Whipple, Henry Lawrence, mc univ New York 44, cb 78, Hope Hull . 

Wilkerson, Wopten Moore, mc univ New York 80, cb Perry 80, Mont- 
gomery. 

Williams, Robert Silas, mc Jefferson 48, cb 84, Mount Meigs. 

Wood, Milton LeGrand, mc Bellevue 77, cb 84, Montgomery. 

PHYSICIANS NOT MEKBEBS OF THE SOCIETY. 

Arnold, John B., college and post-ofSce not given. 

Galloway, Charles Wesley, mc univ Vanderbilt 86, cb 87, Snowdoun. 

Calloway, James Wesley, mc univ Vanderbilt 81, cb Lowndes 82, 
Oakley. 

Davis, LeRoy Watkins, mc Georgia 53, cb Lowndes 78, Morganville. 

Dorsett, Charles Nathaniel (colored), mc univ Buffalo 83, cb 83, Mont- 
gomery. 

Harris, Andrew Jackson, Arcadia. 

Hill, Robert Marius, mc univ New York 60, cb 78, Mt. Meigs. 

Jackson, Edward Beatty, mc Alabama 85, cb 85, Ramer. 

Ligon, Thomas Branch, mc univ New York 49, cb 84, Montgomery. 

McClane, Frank, mc univ Louisiana 66, cb 78, Hope Hull. 

McCummins, Milton H., Raif Branch. 

McDade, James, Mt. Meigs. 

McGrehee, Benjamin Ellsberry , mc univ Louisiana 72, cb 64, Pike Road. 

Mullins, James Thomas, mc Georgia 72, cb 82, Ramer. 

Naftel, Jesse Holmes, mc uxMv Alabama 87, cb 87, Pine Level. 

Naftel, St. John, mc univ Vanderbilt 79, cb 80, Naftel. 

Nicholson, John Cogburn, mc Jefferson 55, cb 78, Mt. Meigs. 

Pattx)ny Greorge Robert, mc univ Vanderbilt 69, cb 78, Montgomery. 

Rives, George, Snowdoun. 

Sankey, George, Montgomery. 

Sankey, John Thomas, cb 84, Montgomery. 

Sellers, Anthony Hamilton, mc South Carolina 82, cb 82, Oakley. 

Steers, Willis Wood (colored),mc univ Michigan 88, cb 88, Montgomery. 

Stone, Henry Lewis, mc univ Maryland 68, cb 76 (retired), Montgomery. 



202 THE ANNUAL RMOISTEE. 

Townsend, James Barnett, mc nniv Nashville 78, cb 78, Pine Level. 
Watson, VanBuren, s of m Kentucky 80, cb 78, Strata. 
Henry, John Hazzard, (homeopathist), cb Dallas 79, Montgomery. 
Landridge, John, (homeopathist), retired, Montgomery. 

Moved into the county — ^Barna Pitt Ivey, cb Marion 87, from Midway, 
Bullock county, to Montgomery; Willis Wood Steers (colored), mc 
univ Michigan 88, cb 88, to Montgomery. 

Moved out of the county — John Payne Ellsberry, from Oakley to 
Redding (contract), Jefferson county; Dudley Robinson, from Mont- 
gomery to Autaugaville. 

Examinations — ^For the practice of medicine, William A. Fowler, 
certificate refused; Willis Wood Sterrs, (colored,) certificate awarded. 

MORGAN COUNTY MEDICAL SOCIETY— Mobile, 1876. 

OFFICKBS. 

Pr. Scott L. Roundtree ; V. Pr. Andrew J. Stewart ; Sec. Philip R. 
Taylor ; Tr. Joseph Simpson Tumey ; H. 0. Benjamin F. Cross ; Cen- 
sors, Benjamin F. Cross, Scott L. Roundtree, Enoch J. Conyngton, Peter 
Binford, Richard L. Stevenson. 

NAMES OF MBMBBBS WITH THEIR COLLBOSS AND POST-OFFICES. 

Barclift, William Anderson, mc univ Nashville 77, cb 79, Hartsell. 

Barrett, Nathaniel Aldridge, mc nniv Vanderbilt 86, cb 86, Danville. 

Binford, Peter, mc New Orleans 61, cb 79, Somerville. 

Buckley, Walter Colquitt, mc phy and surg New York 85, cb 86, De- 
catur. 

Conyngton, Enoch James, mc St. Louis 83, cb 88, Decatur. 

Cross, Benjamin Franklin, mc univ Louisville 67, cb 78, Decatur. 

Dlnsmore, David Francis, mc univ Vanderbilt 81, cb Lawrence 88, De- 
catur. 

Dinsmore, William Lewis, mc univ Vanderbilt 81, cb 81, Decatur. 

Gill, Jordan Lawson, (one course) mc Louisiana 69, cb 78, Somerville. 

Gillespie, James Clark, mc univ Vanderbilt 81, cb Madison 81, De- 
catur. 

Gwin, Howell Beekham, mc univ .Louisvillf 88, cb Limestone 88, De- 
catur. 

Henry, Anslum Cicero, mc Memphis 69, cb Butler 79, Hartsell. 

Hunter, Felix Bur well, mc Alabama 86, cb Lawrence 86, Danville. 

Johnson, James Clark, mc univ Maryland 48, cb 88, Decatur. 

Minor, Lucien, mc South Carolina 49, cb 79, Trinity. 

Ross, Donald Lawrence, mc univ McGill, Montreal 87, cb 87, Decatur. 

Roundtree, Scott Lewis, mc Jefferson 68, cb 78, Hartsell. 

Sewell, John Banks, mc univ Vanderbilt 86, cb 87, Decatur. 

Stevenson, Richard Lewis (one course), mc univ Tennessee, cb 76, 
Flint. 



THE ROLL OF THE COUNTY S0C1ETE8. 203 

Taylor, Philip Richard, mc Louisville hospital 87, cb 88, Decatur. 
Tamey, Joseph Simpson, mc univ Vanderbilt 81, cb 82, Hartsell. 
Watkins, Robert Silas, mc univ Louisville 78, cb 78, Flint. 
Winston, David Mason, mc Alabama 86, cb 87, Woodland Mills. 

PHYSICIANS NOT MBIIBBBS OP TUB BOCIBTY. 

Cartwright, Oscar Bishop, mc univ Vanderbilt 75, cb 80, Decatur. 

Cook, Henry Wesley, cb (old law) 57, cb 81, Falkville. 

Gasden, James, Decatur. 

Peck, William Washington, cb 82, Fort Bluff. 

Ryan, John LaFayette, mc univ Nashville 81, cb 84, Apple Grove. 

Stevenson, Edison David, mc univ Nashville 68, cb 79, Danville. 

Smith, John Brown, mc (homeopathist) 56, cb 86, Decatur. 

Moved into the county — Howell B. Gwin, from Athens, Limestone 
county; David F. Dinsmore, from Town Greek, Lawrence county, to 
Decatur. 

Moved from the county—Deon Taylor Smith and William Lewis 
Dinsmore, from Town Creek to Anniston. 

Deaths — William B. Black, cb 78, Decatur ; George William Gill, mc 
univ Louisville 43, cb 78, Decatur; Robert Virgil Williams, mc univ 
Louisville 84, cb 88, Decatur; and William James Young, mc univ 
Nashville 72, cb 78, Decatur, all of yellow fever. 

PERRY COUNTY MEDICAL SOCIETY— Montgomery, 1875. 

OFFICBBS. 

Pr. John W.Bradfield; V. Pr. James R. Pou; Sec. Charles A. Wil- 

kerson; Tr. ; H. 0. Charles A. Thigpen; Censors, Elias B. 

Thompson, John M. Sadler, George M. Corcoran, James H. Houston, 
Charles A. Wilkerson. 

NAMBS OF SfBMBBRS WPFH THBIR COLLBGBB AND POST-OFFICBB. 

Barron, William Rowan, mc univ Virginia 61, cb 78, Marion. 
Bates, Francis Asbury, mc univ Louisiana 48, cb 78, Marion. 
Bradfield, John, mc univ South Carolina 45, cb 78, Uniontown. 
Bradfield, John Wesley, s of m Kentucky 87, cb 87, Uniontown. 
Callier, Armistead M., non-graduate, cb 87, Chad wick. 
Corcoran, George Merryman, mc univ Maryland 87, cb Marengo 87, 

Uniontown . 
Downey, William Thomas, non-graduate, cb 78, Marion. 
Houston, James Hiram, mc univ Pennsylvania 48, cb 78, Uniontown. 
Jeffries, William Bennett, mc Washington, Baltimore 65, cb 78, Perry- 

ville. 
Pou, James Rufns, mc South Carolina 54, cb 78, Uniontown. 



204 THE ANNUAL REGISTER. 

Sadler, John Milton, mc univ Louisiana 73, cb 78, Unioniown. 
Shivers, Offa Lansford, mc nniv Louisiana 73, cb 78, Marion. 
Thigpen, Charles Alston, mc univ Tulane N 88, cb Butler 88, Marion. 
Thompson, Elias Benson, mc univ Louisiana 69, cb 78, Marion. 
Wilkerson, Charles A., mc univ New York 76, cb 78, Marion. 
Wilkerson, William Washington, mc Jefferson 55, cb 78, Marion. 

PHYSICIANS NOT MBMBBR8 OF THB SOCISTY. 

Evans, Charles Albert, mc South Carolina 54, cb 78, Vilula. 
Foster, Robert, mc South Carolina 47, cb 78, Marion. 
Langhorne, John Miller, mc univ Pennsylvania 45, cb 78, Marion. 
Lawrence, James Tlnsley, non-graduate, Pinetucky. 
Mears, John Wesley Nathan, mc univ ^ew York, cb 78, Vilula. 
Mosely, David Orion, mc Washington, Baltimore 72, cb 78, Theo. 
Tncker, James Burwell, mc Vanderbilt 78, cb 79, Jerico. 
Webb, Lucius De Yampert, mc univ New York 69, cb Hale 78, Scott's 
Station. 

Moved into the county— Charles Alston Thigpen, from Greenville, 
Butler county, to Marion. 

Moved out of the county — John Robert Franklin Dominick, from 
Brush Creek to Mississippi. 

Examinations — Preliminary to the study of medicine, Edward Lock- 
hart. Certificate awarded. 

PICKENS COUNTY MEDICAL SOCIETY— Eufaula, 1878. 

OFFICERS. 

Pr. John C. H. Jones; V. Pr. ; Sec. Frank K. K. Beck; 

Tr. ; H. O. John C. H. Jones.' Censors, John C. H. Jones, 

John W. McLeod, Christopher C. Clear, Newton Hill, Samuel H. 
Hill. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Agnew, James Alexander, mc Alabama 74, cb 74, Providence. 
Beck, Frank King Kowalewski, mc Alabama 88, cb 88, CarroUton. 
Clear, Christopher Columbus, mc Alabama 85, cb 85, CarroUton. 
Cook, Thomas Henry George, mc Alabama 86, cb 86, Stone. 
Hill, Newton, mc Alabama 79, cb 85, Pickensville. 
Hill, Samuel Feuilleteau, mc South Carolina 52, cb 78, CarroUton. 
Hill, Samuel Henry, mc univ Louisville 70, cb 78, CarroUton. 
Jones, John Culbreth Hesekiah, mc univ Nashville 56, cb 78, Stone. 
McLeod, John Waters, mc univ Louisiana 82, cb 84, Bethany. 
Moody, Joseph, mc univ Louisville 71, cb 79, Franconia. 



THE ROLL OT THE COUNTY SOCIETIES. 205 

Moorehead, Henry Clay, mc univ Nashville GO, cb 79, Pickensville. 
Peebles, Jesse, mc New Orleans 48, cb 84, Stone. 
Phillips, Albert Miller, mc univ Tennessee 87, cb 87, Pickensville. 
Sterling, Samuel Johnson, mc Alabama 61, cb 78, OIney. 

PHYSICIANS NOT MBMBBBS OF THB SOCISTT. 

Baird, Duke Orleans, cb 78, Coal Fire. 

Brandon, Richard Clifford, cb 88, Grordo. 

Duncan, John Francis, mc Alabama 74, cb 78, Providence. 

Hinton, William Gaines, mc Greorgia 60, cb 79, Pickensville. 

Price, Robert Thomas, mc Alabama 74, cb 78, Lubbub. 

Quinn, James Madison, cb 80, Beard's. 

Sanders, Thomas Henry, cb 79, Garden. 

Williams, Henry Lawrence, mc Jefferson 53, cb 78, Lineburg. 

Wyatt, Rufus Roland, mc univ Nashville 84, cb 89, Memphis. 

Moved into the county — Rufus R. Wyatt, to Memphis. 

Moved out of the county— James R. Phillips, from Gordo to Millport ; 
James Knox Pumell, from Memphis to Pleasant Ridge; Thomas 
William Shockley, from Pleasant Grove to Tuscaloosa. 

Examinations — For the practice of medicine, James Knox Purnell 
and Rufus R. Wyatt. Certificates awarded. 

Deaths — George Madison Graham, M.D., cb 81, Benevola. 
PIKE COUNTY MEDICAL SOCIETY— Eufaula, 1878. 

OFFICERS. 

Pr. Edward H. Johnson; V. Pr. Josephus 8. Baird; Sec. Charles 
W. Hilliard ; Tr. William A. Crossley ; H. 0. Pugh H. Brown. Censors, 
Pugh H. Brown, Josephus S. Baird, Gustavus Hendrick, Thomas H. 
Dennis, Edward H. Johnson. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Baird, Josephus Simon, mc univ New York 76, cb 79, Troy. 
Bean, James Marion, mc Bellevue 79, cb 83, Monticello. 
Brown, Pugh H., mc univ New York 54, cb 78, Troy. 
Carlisle, Charles Mallory, non-graduate, cb 84, Milo. 
Chapman, William Hick, mc Alabama 73, cb Coffee 85, Troy. 
Crossley, William Andrew, mc South Carolina 54, cb 78, Troy. 
Dennis, Thomas Hcydenfeldt, mc Graffenburg 58. cb 78, Olustee. 
Dewberry, John Hunter, mc Jefferson 56, cb 78, Brundidge. 
Ellis, James Lewis, mc Memphis 87, cb Dale 87, Monticello. 
Ford, Elchanah Gardner, cb 78, Troy. 
Hendrick, Gustavus, mc Jefferson 56, cb 78, Brundidge. 
SilUard, Charles Wesley, mc Reform, Ga,, 61, cb 78, Troy. 



206 THE ANNUAL REGISTER. 

Johnson, Edmund Harris, mc univ Washington 69, cb Crenshaw 82, 

Troy. 
McSwain, Charles, mc South Carolina 52, cb 78, Brmdige. 
Posey, William Henry, mc Jefferson 53, cb 84, Orion. 
Sanders, William Brown, mc Atlanta 85, cb 86, Milo. 

PHYSICIANS KOT MEMBERS OF THE SOCIETY. 

Albriton, George Allen, mc univ Louisville 72, cb Crenshaw 82, Hen- 
derson. 
Aired, John Peak, cb 78, Troy. 
Bledsoe, William (botanic), cb 78, Monticello. 
Collier, James Marshall, mc univ Virginia 60, cb 78, Troy. 
Davis, Robert Huey, cb 84, Brundige. 
Davis, Thomas Jefferson, cb 84, Goshen Hill. 
Eiland, William Anderson, mc Atlanta 81, cb 84, Henderson. 
Foreman, Henry, mc Jefferson 58, cb 79, Brundige. 
Hamil, Irby Watson, mc univ Louisville 76, cb 78, Goshen Hill. 
Russell, James Thomas, mc univ New York 79, cb 84, Troy. 
Townsend, Andrew Cresswell, mc Jefferson 59, cb 82, China Grove. 
Tredwell, Lucius Marcus (botanic), cb 81, Troy. 

Moved into the county — William H. Chapman, from Elba, Coffee 
county, to Troy; Charles W. Hilliard, from Genava, Geneva county, to 
Troy ; Edmund Henry Johnson, from Rutledge, Crenshaw county, to 
Troy. 

Examinations — For the practice of medicine, James Adolphus Mc- 
Eachen, mc Alabama 89, cb 89. 

RANDOLPH COUNTY MEDICAL SOCIETY— Eufaula, 1878. 

OFFICERS. 

Pr. William E. White; V. Pr. Henry B. Disharoon; Sec. Powhatan 
Green Trent; Tr. Powhatan Green Trent; H. O. Powhatan Glover 
Trent. Censors, Powhatan Green Trent, Henry B. Disharoon, Wyatt 
Heflin, Jasper D. Liles, Frances G. Thomason. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Davis, Samuel John, mc Atlanta 82, cb 82, Rock Mills. 

Disharoon, Henry Beauregard, mc phy and surg Baltimore 85, cb 86, 

Roanoke. 
Duke, Anderson Welcome, mc Graffenburg 49, cb 79, Lamar. 
Duke, Jefferson Davis, mc Southern 87, cb 88, Lamar. 
Gauntt, Elbert Tilman, mc Atlanta 76, cb 84, Wedowee. 
Gay, Stonewall Jackson, mc Southern 88, cb 88, Almond. 
Heflin, Wilson L., mc Georgia 53, cb 85, Louina. 
Heflin, Wyatt, mc Jefferson 84, cb 84, Wedowee, 



THE ROLL OF THE COVNTY SOCIETIES. 207 

Jordan, Charles Alexander, mc Southern 84, cb 87, Blake's Ferry. 
Liles, Jasper David, mc nniv Louisville 70, cb 86, Roanoke. 
McGlendon, Edward Henry, mc Graffenburg 59, cb 79, Rock Mills. 
McManus, Michael, non-graduate, cb 79, Wedowee. 
Pool, Wyatt Heflin, mc Georgia 67, cb 79, Roanoke. 
Trent, Powhatan Green, mc Jefferson 67, cb 85, Rock Mills 
Trent, Powhatan Glover, mc Atlanta 88, cb 88, Rock Mills. 
Taylor, Cephus Blair, mc Graffenburg 49, cb 79, Rock Mills. 
White, Luther J.ieonida8, non-graduate, cb 79, Roanoke. 
White, William Elbert, mc Transylvania 40, cb 79, Roanoke. 

There are no physicians in the county not members of the society. 

Moved out of the county — Wyatt Heflin Blake, from Blake's Ferry to 
Anniston, Calhoun county. 

Examinations — ^For the practice of medicine, Jefferson Davis Duke, 
Stonewall Jackson Gay, Powhatan Glover Trent. Certificates awarded. 

RUSSELL COUNTY MEDICAL SOCIETY— Tuscaloosa, 1887. 

OFFICERS. 

Pr. Reuben A. Smith; V. Pr. George D. Pascal; Sec. James L. 
Baker; Tr. James L. Baker; H. 0. Homer A.^ Allen; Censors, Reuben 
A. Smith, George D. Pascal, James L. Baker, Benjamin W. Allen, 
Zachery W. Williams. 

NAMES OF HBMBBBS WITH THBIB COLLEOBS AND P08T-0FFICBS. 

Allen, Benjamin Washburn, mc Atlanta 84, cb 87, Jemigan. 

Allen, Henry Homer, mc Augusta 83, cb 88, Oswichee. 

Baker, James Lawrence, mc Atlanta 85, cb Jefferson 86, Seale. 

Black, Nathaniel Spragins, mc univ New York 61, cb 87, Hatche- 

chubbee . 
DeGraffenried, Edwin F., mc univ Pennsylvania 44, cb 87, Seale. 
Pascal, George Dennis, mc univ New York 72, cb 87, Hurtsboro. 
Smith, Reuben Arnold, mc univ New York 52, cb 87, Hatchechubbee. 
Williams, Zachery Walton, mc phy and surg Baltimore 82, cb 87, Glenn- 

ville. 

PHYSICIANS NOT MEMBERS OF THE SOCIBTY. 

Howard, Thomas Watson, non-graduate, cb 88, Girard. 
Jamison, William Washington, mc Georgia, cb 88, Girard. 
Scaife, Lewis Wilson, mc univ Louisiana, cb 87, Hurtsboro. 

Moved into the county— Homer H. Allen, from Chattahoochee county, 
Georgia, to Oswichee. 



208 THE ANNUAL REQISTER. 

Moved out of the county — Lucien Willis Phillips, from Crawford to 
Columbus, Greorgia; William C. Hanson, to Marengo county, Alabama; 
James G. Ingram, from Hatchechubbee to San Antonia, Texas. 

Examinations — ^For the practice of medicine. Homer H. Allen, 
Oswichee. Pharmacy, Harry Wood. Certificates awarded. 

Deaths — John K. O'Neal, M. D., of Marvyn ; abscess of the liver. 
SHELBY COUNTY MEDICAL SOCIEY— Birmingham, 1877. 

OFFICERS. 

Pr. James H. Gunn; V. Pr. ; Sec. Henry D. Geddings; Tr. 

; H. 0. Joseph R. Morgan ; Censors, Jol^eph R. Morgan, John 



H. Williams, Wilds S. DuBose, James H. Gunn, William B. Meredith. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Acker, James Wilson, cb 77, Monticello. 

Bachus, Henry, college not given, cb Dallas 53 (old law), Calera. 

Blevins, John Richardson, college not given, Calera. 

Davis, Ralph, mc Georgia 60, cb Bibb 76, Montevallo. 

DuBose, Wilds Scott, mc Atlanta 60, cb 77, Columbiana. 

Edwards, David, mc Georgia 60, cb 77, Wilsonville. 

Fields, James Guthrie, college not given, cb 77, Calera. 

Goodson, Jasper, college not given, cb Tuscaloosa (old law), 53, cb*80, 

Siluria. 
Geddings, Henry Downes, mc Pouth Carolina 80, cb 83, Shelby. 
Gunn, James Hamlin, mc Bellevue 69, cb 87, Calera. 
Mc Adams, Henry Clay, mc Alabama 83, cb 83, Shelby Iron Works. 
Meredith, William Bell, mc Alabama 72, cb 77, Montevallo. 
Morgan, Joseph ReiJ, mc univ Louisville 66, cb 77, Shelby Springs. 
Oliver, Christopher Charleton, mc Atlanta 69, cb 77, Calera. 
Tucker, Robert Milton, mc Georgia 60, cb 77, Helena. 
Williams, John Harford, mc univ Louisville 75, cb 77, Columbiana. 
Williams, Harford Isaac, mc Alabama 87, cb 87, Columbiana. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Denson, Eli Forrest, mc Vanderbilt 79, cb (old law) 60, Pelham. 
GriflSn, Alpheus J. (botanic), cb 77, Lawley, 
Johnson, Joseph Madison, mc Yanderbilt 83, cb 83, Pelham. 
Johnson, William Rufus King, mc Atlanta 80, cb 80, Pelham. 
McGraw, Allen Edward, mc univ Louisiana 73, cb 77, Harpersville. 
Singleton, William Robert, college not given, cb Tuscaloosa 56, (old 

law), Harpersville. 
Welden, Greorge Andrew, mc Atlanta 82i cb 82, Welden. 



THE ROLL OF THE COUNTY SOCIETIES. 209 

ST. CLAIR COUNTY MEDICAL SOCIETY— Euiaula, 1878. 

OFFICBBB. 

Pr. Davis £. Cason ; V. Pr. Oliver M. Steadham ; Sec. and Tr. John 
W. Ash ; H. O. Davis E. Cason ; Censors, James M. McLanghlin, John 
W. Ash ; John B. Bass. 

NAMES OF MSMBBB8 WITH THEIR COLLEGES AND POST-OFFICES. 

Ash, John Winston, mc nniv Lonisiana 80, cb 80, Springville. 
Bass, John Barrell, mc phy and surg Baltimore 70, cb 79, Ashville. 
Cason, Davis Elmore, mc oniv Nashville 70, cb 79, Ashville. 
Cason, James Calvin, mc Memphis 72, cb 83, Broken Arrow. 
Crnmp, James Wells, mc Atlanta 75, cb 80, Steele's Depot. 
Danlap, Perry Gabriel, mc univ Vanderbilt 81, cb 81, Eden. 
Garlington, Henry Spright, mc Alabama 87, cb Etowah 87, Ashville. 
Jones, George Marshall, mc Jefferson 77, cb 78, Springville. 
Jones, James Hnnter, mc Atlanta 55, cb Calhoan 78, Ragland. 
McLaughlin, James Madison, state board 80, cb 79, Springville. 
Sheppard, Luther Whitfield, mc phy and surg Baltimore 85, cb 88, 

Seddon. 
Steadham, Oliver Marshall, mc Alabama 86, cb 86, Evansville. 
Vandergrift, Washington Franklin, mc univ Louisiana 80, cb 80, 

Branchville. 

PHYSICIANS NOT MBMBEBS OF THE SOCIETY. > 

Brewster, Henry Harrison, mc not given, (old law), cb 79, Bagland. 
Crump, Henry George, mc not given, cb 79, Seddon. 
Evans, Richard Proctor, mc not given, (old law 67), cb 72, Fairview. 
Wear, John Blassingame, mc not given, cb Clay 79, Kelly's Creek. 

Moved into the county — John Blassingame Wear, from Clay county 
to Kelly's Creek. 

Moved out of the county — Sidney Parke Burnum, from Springville to 
Blount county ; Edward Parsons Chandler, [from Cropwell to Birming- 
ham; James Jefferson Dawson, to parts unknown; Barnett Linton 
Embry, from Biverside to Talladega; Frank Pierce Liddell, from Sed- 
don to parts unknown ; Robert Franklin McConnell, from Steele's De- 
pot to Attalla, Etowah county. 

Examination — Preliminary to the study of medicine, Eugene P. Ca- 
son, Ashville. Certificate awarded. 

SUMTER COUNTY MEDICAL SOCIETY— Mobile, 1876. 

OFFICEBS. 

Pr. John M. Henson; V. Pr. Mathew B. Cameron; Sec. William H. 

Sledge; Tr. ; H. 0. William H. Sledge; Censors, Jesse C. 

14 



210 THE ANNUAL REGISTER. 

I 
Houston, Mathew B. Cameron, Thomas D. Bourdeaux, John 0. Par- 
ham, William H. Sledge. 

NAMES OF MEMBBRS WITH THEIR COLLEGES AND POST-OFFICES. 

Arrington, Rohert Henry, mc univ Louisiana 50, cb 77, Livingston. 
Bickley, Thomas Jefferson, mc univ Vanderbilt 81, cb 81, Gainesville. 
Bourdeaux, Thomas Devene, mc univ Louisville 83, cb 78, York. 
Brockway, Dudley Samuel, mc Alabama 78, Jefferson 81, cb 78, Liv- 
ingston. 
Cameron, Mathew Bunyan, mc Alabama 86, cb 86, Sumterville. 
Gilmore, John Nale, mc not given, cb 78, Gaston. 
Godfrey, James Myers, mc univ Pennsylvania 55, cb 77, Sumterville. 
Hand, Samuel Patton, mc univ Louisiana 83, cb 83, Coatopa. 
Henagan, Darby, mc South Carolina 58, cb 77, Epes. 
Hearn, William Thomas, mc univ Louisville 82, cb 82, Gaston. 
Henson, John McKenzie, mc univ Pennsylvania 54, cb 80, Coatopa. 
Houston, Jesse Crawford, mc univ Louisiana 60, cb 77, Belmont. 
Marshall, James Buchanan, mc univ Nashville 72, cb 78, Warsaw. 
Parham, John Calhoun, mc s and m Kentucky 77, cb 77, Gainesville. 
Sledge, William Henry, mc Alabama 81, cb 81, Livingston. 
Vaughn, Amos Lemuel, mc univ Louisville 84, cb 84, Cuba. 
Ward, Henry Bascom, mc Alabama 78, cb 78, Cuba. 
Young, Oliver Cromwell, mc North Western 85, cb 85, Alamuchee. 

Honorary Af embers, 

Estelle, Samuel Henderson, cb (old law; 47, Blount Springs. 
Garber, Alexander Menzies, mc Transylvania 33, cb 77, Livingston. 
Giles, James Hamilton, mc univ Kentucky 57, cb 77, Cuba. 
James, William Hamilton, cb 78, York. 
Randall, Newton Fox, mc Nashville 78, cb 83, Livingston. 
Sholl, Edward Henry, mc Pennsylvania 56, cb 77, Birmingham. 
Smith, Carlos Green, mc Pennsylvania 56, cb 77, Palatka, Florida. 
Webb, Robert Dickens, mc univ Virginia 50, cb 77, Birmingham. 

PHYSICIANS KOT MBMBEBS OF THE SOCIETY. 

Allison, John Francis, mc South Carolina 50, cb 77, Curie's Station. 
Hale, Robert Hadden, mc univ Louisville 79, cb 80, York. 
Harvley, John Bunyan, mc Georgia 58, cb 78, Belmont. 
Nash, Joseph Thomas, mc univ Louisville cb 80, Livingston. 
Pinson, Hammett, mc s of m New Orleans, Burnesville, Miss. 
Sullivan, Calvin Martin, mc univ Louisiana, cb 77, Ramsey. 

Deaths — James George Foster, M. D., mc univ Louisiana 56, cb Choc- 
taw 77, Livingston, June 27, 1888, of heart trouble. 



THE ROLL OF THE COUNTY SOCIETIES. 211 

TALLADEGA COUNTY MEDICAL SOCIETY— Anniston, 1886. 

OFFICERS. 

Pr. Barclay W. Toole ; V. Pr. Benjamin B. Simms ; Sec. Henry R. 
BoBwell; Tr. Thomas J. Lee; H. 0. W. F. Thetford; Censors, John T. 
Harrison, Jason S. McCants, Barclay W. Toole, Henry R. Boswell, 
George A. Hill. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST'OFFICBS. 

Bailey, Robert Emmett, mc Atlanta 86, cb 86, Silver Ran. 

Boswell, Henry Rives, mc univ Louisville 74, cb 86, Talladega. 

Caldwell, William Drayton, mc nniv Vanderbilt 88, cb Lauderdale 88, 
Eureka. 

Castleberry, William Thomas, mc Georgia 72, cb 86, Lincoln. 

Dixon, John, mc Jefferson 56, cb 86, Fayetteville. 

Donaldson, John Thaddeus, mc South Carolina 67, cb 86, Easta Boga. 

Embry, Bamett Linton, mc Atlanta 78, cb 86, Riverside. 

Gist, Paul, mc Atlanta 86, cb 86, Talladega. 

Harrison, John Tinsley, mc Atlanta 81, cb 86, Munford. 

Heacock, John William, mc univ Louisiana 68, cb 86, Alpine. 

Hill, George Armstrong, mc Jefferson 70, cb 86, Syllacauga. 

Keller, David Carleton, mc univ Pennsylvania 47, cb 86, Syllacauga. 

Lee, Thomas Jefferson, mc univ Vanderbilt 86, cb 87, Talladega. 

McCants, Jason Samuel, mc Atlanta 66, cb 86, Talladega. 

Morton, Hartwell Fisk, cb Fayette 84, Childersburg. 

Moseley, Robert Alexander, mc South Carolina 38, cb 86, Talladega. 

Rhodes, Edward Davis, mc Georgia 60, cb 86, Alpine. 

Sims, Albert Gallatin, mc univ Nashville 69, cb 86, Renfro. 

Simms, Benjamin Birt, mc Jefferson 85, cb Coosa 85, Talladega. 

Thetford, William Fletcher, mc univ Louisiana 67, New York Poly- 
clinic 84, cb Greene 79, Talladega. 

Toole, Barclay Wallace, mc univ Nashville 60, cb 86, Talladega. 

Honorary Members. 

Johnson, Joseph Henry, mc Jefferson 56, Talladega. 
Taylor, William, mc univ Louisville 52, Talladega. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Brooks, Alpheus Olin, mc Southern 87, cb Clay 87, Ashland. 
Gorman, Harrison Clayton, mc Georgia 56, cb 86, Alpine. 
Groce, Benton Walton, mc Georgia 42, cb 86, Munford. 
Hamilton, William Thomas, mc Alabama 80, cb Coosa 80, Jenifer. 
Hunter, John James, mc Alabama 80, cb Coosa 83, Ironaton. 
Keller, William Carleton, mc univ Vanderbilt 87, cb 87, Syllacauga, 
Mays, Lorenzo, mc Gr^ffenburg 56, cb 86, Chandler Springy. 



212 THE ANNVAL REGISTER. 

McAlpin, Sumner Mandevillei mc Jefferson 57, cb 86, Alpine. 
Pearson, James E., mc Alabama 88, cb 88, Syllacauga. 
Powell, Thomas Jefferson, mc Baltimore 66, cb 86, Childersbarg. 
Bay, Lorenzo Ellis, mc univ Loaisville 88, cb Clay 87, Hightower's 

MUl. 
Rowell, William Henry, cb Tallapoosa 82, cb 86, Childersbarg. 
Stockdale, John Locke, mc Sonth Carolina 54, cb 86, Talladega. 

Moved into the county — William Thomas Hamilton, from Rockford, 
Coosa county, to Jenifer ; John James Hunter, from Wetumpka, Elmore 
county, to Ironaton; William Pace Kelly, to Childersburg ; William 
Fletcher Thetford, from Boligee, Greene county, to Talladega. 

Moved out of the county — Miles Jefferson Greene, from Alpine, to 
Montgomery ; Edward D. Grimes, from Ironaton to Anniston ; Joseph 
Powell, from Childersburg to Texas ; James D. Rhodes, from Alpine 
to parts unknown ; Edward Hinton Whitten, from Ironaton. 

Examinations— Samuel D. Rhodes, mc phy and surg New York, cer- 
tificate awarded to practice medicine. Joseph Powell, mc univ Van- 
derbilt, certificate refused. 

TALLAPOOSA COUNTY MEDICAL SOCIETY— Selma, 1879. 

OFFICERS. 

Pr. Abner J. Nolen ; V. Pr. William G. Carleton ; Sec. James A. Gog- 
gans; Tr. John W. Hooper; H. 0. James A. Groggans; Censors, 
Greorge W. Vines, James A. Goggans, Andrew J. Coley, John M. 
Watkins, Robert V. Salmon. 

NAMES OF MEMBERS WITH THEIR COLLKOBS AND POST-OFFICES. 

Banks, Wilson Lumpkin, mc Graffenburg 52, cb 82, Jackson's Gap. 
Carleton, William George, mc univ Vanderbilt 82, cb Chambers 82, 

Dudleyville. 
Coley, Andrew Jackson, mc Jefferson 80, cb 82, Alexander City. 
Freeman, Jeremiah Summerfield, cb 82, Alexander City. 
Goggans, Jamea Adrian, mc univ New York 77, cb 82, Alexander City. 
Harlan, John Jefferson, mc Alabama 72, cb 82, Hackney ville. 
Hooper, John Wilson, mc Jefferson 74, cb 74, New Site. 
Johnston, John Young, mc Graffenburg 54, cb 82, Walnut Hill. 
Lightfoot, Robert Wilson, mc South Carolma 62, cb 82, Alexander City. 
Nolen, Abner Jackson, mc univ Louisville 80, cb 82, New Site. 
Pharr, Edward Miller, mc univ Vanderbilt 82, cb 82, Daviston. 
Radford, George Clements, cb Clay 87, Bulger's Mills. 
Reagan, Onslow, cb 82, Alexander City. 
Salmon, Robert Virgil, mc Alabama 75, cb 82, Dadeville. 
Shepard, Jackson Joseph, mc Graffenburg 64, cb 82, Dadeville. 



t^B ROIL OP THE COVNTY SOCIETIES. 213 

Shepard, Orlando Taylor, mc Graffenburg 54, cb 82, Tohopeka. 
Smith, Watt Francis, mc Grafifenbarg 54, cb 82, Thaddeus. 
Tucker, Adolphiis Orlando, cb 82, Dadeville. 
Vines, Greorge Washington, mc nniv Louisiana 71, cb 82, Dadeville. 
Watkins, John Milton, mc univ Louisiana 71, cb 82, Camp Hill. 

PHYSICIANS NOT MBMBBB8 OF iks BOCIBTY. 

Bloodworth, Hiram Watkins, cb Randolph 84, Dadeville. 

Croggans, James Peterson, cb (old law) 51, cb Coosa 82, Alexander City. 

Gray, Thomas Marshall, cb 82, DadeviUe. 

McLendon, Joseph, mc Jefierson 88, cb 88, Jackson's Gap. 

Motley, Joseph Parker, mc Atlanta 86, cb 86, Daviston. 

Rowe, Andrew Thomas, mc Georgia 50, cb Lee 82, Dadeville. 

Shepard, Phillip Madison, mc Graffenburg 54, cb 82, Dadeville. 

Ward, Lucius Cincinnatus, cb 82 Daviston. 

Webb, Isaac Eugene, mc Atlanta 88, cb 88, Camp Hill. 

Moved into the county — James Peterson Goggans, from Nixburg, 
Coosa county, to Alexander City. 

Moved out of the county — Aaron LaFayette Harlan, from Hackney- 
ville, to Ashland, Clay county. 

Examinations—To practice, Joseph McLendon, mc Jefferson 88, 
Jackson's Gap. Certificate awarded. 

TUSCALOOSA COUNTY MEDICAL SOCIETY— Birmingham, 1877. 

OFFICERS. 

Pr. James L. Fant; V. Pr. Alfred S. Allen; Sec. Oliver H. Burton; 
Tr. Oliver H. Burton ; H. O. Oliver H. Burton ; Censors, James T. 
Searcy, Peter Bryce, James L. Fant, Robert Neilson, Frank H. Sims. 

NAMES OF MBMBBRS WITH THSIB COLLBGSS AND POST-OFFIGBS. 

Allen, Alfred Sidney, mc Alabama 81, cb 81, Cottondale. 
Bondurant, Eugene DuBose, mc univ Virginia 83, cb Hale 83, Tusca- 
loosa. 
Bryce, Peter, mc univ New York 59, cb 78, Tuscaloosa. 
Burton, Oliver Heame, mc univ Tulane, Louisiana 87, cb 87, Tuscaloosa. 
Clifton, James M., mc Alabama 88, cb 88, Cottondale. 
Cochrane, William Allen, mc univ Pennsylvania 39, cb 78, Tuscaloosa. 
Ellis, Robert Austin, mc univ Louisiana 71, cb Pickens 81, Tuscaloosa. 
Fant, James Louis, mc South Carolina 76, cb Marengo 78, Tuscaloosa. 
Foster, David Lawrence, mc Jefferson 57, cb 78, Tuscaloosa. 
Guild, James, mc Jefferson 55, cb 84, Tuscaloosa. 
Hester, Williams, mc univ New York 67, cb 78, Tuscaloosa. 



214 TBE ANNUAL REOtSTEtt. 

Little, James, mc Atlanta 76, cb 80, Tuscaloosa. 

Little, John, jr., mc nniv Louisiana 69, cb 78, Tuscaloosa. 

Lucius, Bichard DeKalb, mc Alabama 71, cb 78, Hickman. 

Marlow, Nicholas Perkins, mc Jefferson 69, cb 78, Tuscaloosa. 

Neilson, Robert, mc Georgia 54, cb 78, North Port. 

Nichols, Andrew Barry Crook, mc Philadelphia 69, cb 78, Tuscaloosa. 

Read, John Braham, mc univ Louisiana 46, cb 78, Tuscaloosa. 

Searcy, James Thomas, mc univ New York 67, cb 78, Tuscaloosa. 

Sims, Frank Hemdon, mc Southern 83, cb 84, Tuscaloosa. 

Trigg, Arthur Warren, mc Alabama 81, cb 81, Samantha. 

Trimm, James, mc Alabama 81, cb 78, North Port. 

Williamson, Jameb Louis, mc Alabama 81, cb 81, North Port 

PHYSICIANS NOT M£MBERS OF THS SOCIETY. 

Beck, F. K., mc Alabama 88, cb 88, Gottondale. 

Oaldwell, Washington Jackson, cb 84, Hull. 

Clements, Alsey, cb 78, Cottondale. 

Clifton, M., mc Alabama 88, Cottondale. 

Crump, William, cb 79, Marcumville. 

Elrod, William Washington, cb 78, Sipsey Turnpike. 

Foster, E., college not given, Hayes. 

Gibson, Robert Franklin, mc univ Transylvania, cb 78, Tuscaloosa. 

McCord, Charles Richard, cb 80, Marcumville. 

Oliver, George W., college not piven, . 

Parker, William Thomas, mc s of m New Orleans 60, cb 84, Sylvan. 
Shockley, Thomas Washington, mc Alabama 85, cb 86, Coker. 
Smothers, William Jonas, mc Alabama 80, cb Pickens 80, Coker. 
Toomy, Mark Antony, cb 78, Hagler. 
Thompson, J. M., college not given, Tuscaloosa. 

Moved into the county — ^Thomas Washington Shockley, from Pleas- 
ant Grove, Pickens county, to Coker. 

Moved out of the county — ^David Samuel Asher, from Tuscaloosa to 
Greene county ; Douglass Pearson Beatty, from Hull's Station to Hale 
county ; William Cyprian Cross, from Tuscaloosa to Centreville, Bibb 
county ; Jefferson Davis Gibson, from Tuscaloosa to Greene county ; 
Marcellus Shipp, from North Port to Walker county ; James R. Johnson, 
from Romulus to Pickens county ; Robert James Walker, from Vance 
to Jefferson county ; William Ellis Rust, from Vance to parts unknown. 

Examinations — For the practice of medicine, James M. Clifton, mc 
Alabama 88, Cottondale; James J. Harris, Jr., Tuscaloosa, and Louis 
Lichtschein . Certificates awarded . 



TBE nOLL OT THE COUNTY SOCIETIES. 215 

WALKER COUNTY MEDICAL SOCIETY— Mobile, 1876. 

OFFICBRS. 

Pr. William C. Rosamond ; V. Pr. Richard P. Griffin ; Sec. Andrew 
M. Stovall; Tr. John M. Miller; H. O. Giles S. Bryan ; Censors, James 
A. Groodwin, William C. Rosamond, Andrew M. Stovall, Richard P. 
Griffin, William L. Gravlee. 

NAMES OP ICEMBBBS .WITH THEIR COLLEGES AND POST-OFFICE^. 

Bryan, Giles Samuel, mc Memphis 87, cb 88, Jasper. 
Camack, David Hubbard, cb (old law) 72, cb 81, Jasper. 
Cunningham, William M., mc univ Vanderbilt 84, cb 84, Corona. 
Goodwin, Joseph Anderson, mc Alabama 74, cb 81, Jasper. 
Gravlee, William Lewis, mc univ Vanderbilt 82, cb 82, Day's Gap. 
Griffin, Richard Parker, cb (old law) 72, cb 81, Day's Gap. 
Guilder, James Lester, cb (old law) 72, cb 81, Eldridge. 
Hayes, James Simpson, cb (old law) 72, cb 81, Horse Creek. 
Hendon, Albert Dixon, cb (old law) 74, cb 81, Gamble Mines. 
Jackson, Charles Beaufort, mc Atlanta 85, cb Tuscaloosa 85, Horse 

Creek. 
Manasco, John, cb (old law) 76, cb 81, Townley. 
Miller, John Melville, mc univ Vanderbilt 85, cb 85, Cordova. 
Miller, Virgil Martin, mc univ Vanderbilt 80, cb 81, Townley. 
Rosamond, William Crawford, cb Tuscaloosa (old law) 54, cb 81, 

Jasper. 
Stovall, Andrew McAdams, mc univ Louisville 80, cb81, Jasper. 

PHYSICIANS NOT MEMBERS OF THE SOCIETY. 

Little, David Hubbard, cb Jefferson 80, Eldridge. 
Stephenson, William Henry, mc Atlanta, Day's Gap. 
Woodson, Patton. 

Moved out of the county — ^Thomas Jefferson Springfield, from Town- 
ley to Winfield, Marion county. 

Examinations — For the practice ef medicine, Giles Samuel Bryan, 
mc Memphis 87, Jasper ; Gaines, mc Belle vue 83, residence, Tennessee. 
Certificates awarded. 

WASHINGTON COUNTY MEDICAL SOCIETY— Tuscaloosa, 1887. 

OFFICERS. 

Pr. John W. Wood; V. Pr. ; Sec. ; Tr. ; H. 0. 

John Gordon ; Censors, John Gordon, John W. Wood, William H. 
Boykin. 



216 TEE ANNUAL REGISTER. 

NAMES OF MSMBBB8 WITH THEIR COLLEGES AVB POST-OFFICES. 

Boykiiiy William Henry, mc Alabama 87, cb 88, Escatawpa. 
Gordon, John, mc Ohio 66, cb 87, Healing Springs. 
Wood, John Wesley, mc univ Virginia 80, cb 87, Koenton. 

PHYSICIANS NOT MEMBBB8 OP THE SOCIETY. 

Lyons, Oliver, system not known, Washington Mills. 

Moved out of the county — John Henry Cooper, from Citronelle to 
Louisiana; William Ellis Kimbrongh, from St. Stephens to Forkland, 
Greene county. 

WILCOX COUNTY MEDICAL SOCIETY— Eufaula, 1878. 

OFFICERS. 

Pr. Lucius E. Starr ; V . P. Samuel R. Bonner ; Sec. John P. Jones ; 
Tr. John P. Jones ; H. O. Rufus H. Eilpatrick ; Censors, Lucius E. 
Starr, Rufus H. Kilpatrick, Samuel R. Bonner, Thomas G. Jenkins, 
Edward D. McDaniel. 

NAMES OF MEMBERS WITH THEIR COLLEGES AND POST-OFFICES. 

Adams, Blakenship, mc Atlanta 84, cb 84, Pine Apple. 

Adams, David, mc Georgia 68, cb 81, Pine Apple. 

Benson, James Cook, mc Alabama 87, cb 87, Sedan. 

Bonner, James Isaac, mc Alabama 78, cb 79, Rose Bud. 

Bonner, Samuel Robert, mc phy and surg Baltimore 87, cb 87, Cam- 
den. 

Oram, Floyd Edward, mc univ Louisiana 73, cb 79, Arlington. 

Curtis, Alonzo Bittle, mc Alabama 82, cb 79, Lower Peach Tree. 

Curtis, Christopher Columbus, mc Alabama 82, cb 82, Lower Peach 
Tree. 

Dale, William Bonner, mc univ Louisiana 61, cb 79, Allenton. 

Dansby, Daniel McAdams, mc Georgia 35, cb 80, Rehoboth. 

Dansby, John Quincy, mc Alabama 74, cb 80, Rehoboth. 

Gaillard, Edmund, mc South Carolina 30, cb 79, Camden. 

Gaston, David Finis, mc univ Louisiana 82, cb 82, Boiling Springs. 

Gibson, Albert Madison, mc Alabahia 85, cb 85, Lower Peach Tree. 

Godbold, John Calhoun, mc Alabama 79, cb 79, Nellie. 

Haddox, William Thomas, mc univ Louisiana 58, cb 79, Pine Hill. 

Harris, Albert Duggett, mc South Carolina 57, cb 79, Pine Apple. 

Jenkins, Thomas Griffin, mc univ Louisiana 48, cb 79, Camden. 

Jones, John Paul, mc s of m New Orleans 61, cb 79, Camden. 

Jones, Joseph Harvey, mc univ Louisville 80, cb 80, Allenton. 

Kilpatrick, Rufus Hall, mc Alabama 88, cb 88, Camden. 

Lee, Thomas, mc South Carolina 57, cb 80, Furman. 

McDaniel, Edward Davies, mc South Carolina 57, cb 79, Camden. 

Palmer, Ransom Dabney, mc univ Louisiana 86, cb 86, Furman. 



THE ttOLL OF TBE COUNTY SOCIETIES. 217 

Pniifoy, John Howard, mc Jefferson 59, cb81, Furman. 
Pornell, William Thomas, mc Alabama 76, cb 79, Prairie Bluff. 
Ransom, David Wardiaw, mc univ Louisiana 70, cb 78, Pine Apple. 
Starr, Lucius tlrnest, mc Alabama 61, cb 79, Camden. 

PHYSICIANS NOT MEMBBBS OF TUB SOCIETY. 

Cole, WilUam, Snow Hill. 

Cook, Samuel Benjamin Alexander, cb 85, Bethel. 

King, Samuel S., mc univ Louisiana, Catherine. 

Lee, John Frederick, cb 83, Allenton. 

Sonthall, James (retired), cb 79, Lower Peach Tree. 

Moved into the county — Samuel S. King to Catherine. 

Moved out of the county — ^Thomas Samuel Roach, from Rehoboth to 
Texas ; Robert Grordon Southall, from Lower Peach Tree to Greenville, 
Mississippi ; Capers Capehart Jones, from Furman to East Lake, Jef- 
ferson county. James Henry Weir, to Dallas county. 

Examinations — For the practice of medicine, Rufus Hall Kilpatrick, 
mc Alabama 88, Camden. Certificate awarded. 

Deaths — Lucky Walker Jenkins, M. D., mc univ Louisiana 49, cb 79, 
Camden, June 27, 1888. 

WINSTON COUNTY MEDICAL SOCIETY— Montgomery, 1888. 

OFFICBBS. 

Pr. Thomas P. Deweese ; V. Pr. William R. Adkins ; Sec. C. Harvey 
Johnson ; Tr. C. Harvey Johnson ; H. 0. Thomas P. Deweese ; Cen- 
sors, Thomas P. Deweese, William R. Adkins, C. Harvey Johnson, Da- 
vid Carroll, William J. Painter. 

NAMES OF MBMBBBS WITH THEIB COLLEGES AND POST-OFFICBS. 

Adkins, William Riley, cb Tuscaloosa 77, Double Springs. 

Carroll, David, cb Blount 71, Double Springs. 

Deweese, Thomas P., mc univ Louisville 85, cb Walker 85, Nauvoo. 

Ford, David Benjamin, cb 85, South Lowell. 

Johnson, Calaway Harvey, mc Alabama*85, cb 85, Houston. 

Painter, William James, non-graduate, cb 85, Double Springs. 

PHYSICIANS NOT MBMBBBS OF THE SOCIETY. 

Wilson, John, cb (old law) 86. 

Taylor, John C, cb (old law) 80, Ark. 

Bailey, James W. (homeopathist), cb 85, Houston. 

Roden, Benjamin W. (botanic), cb |Marioa 87, Ark. 

Moved out of the county — David Henry Little, from Ark to Eldridge, 
Walker county ; William Lewis Hughes, from Ark to Oleander, Mar- 
shall county. 



218 TBE ANNUAL REOISTEH. 



THE ROLL OF THE COLLEGE OF COUNSELLORS. 

Revision of 1889. 



THB GRAND SENIOB OOUNSELLOBS. 

Abernethy, William Henry, Tinela — Tascaloosa session 1873 

Baldridge, Milton Columbus, Huntsville — Birmingham session 1877 

Bryce, Peter, Tuscaloosa — ^Tuscaloosa session 1873 

Cochran, Jerome, Mobile — ^Tuscaloosa session 1873 

Cross, Benjamin Franklin, Decatur — Selma session 1879 

Dement, John Jefferson, Huntsville — ^Tuscaloosa session 1873 

Furniss, John Perkins, Selma — ^Mobile session 1876 

Gaines, Vivian Pendleton, Mobile — Selma session 1879 

Gaston, John Brown, Montgomery — Montgomery session 1875 

Godfrey, James Myers, Sumterville — ^Tuscaloosa session 1873 

Herbert, Curtis Burke, Greenville — Selma session 1879 

Hoffman, John Richardson, Athens — Selma session 1879 

Hogan, Samuel Mardis, Union Springs — Montgomery session 1875 

Hopping, Daniel Stiles, Letohatchie — Birmingham session 1877 

Jackson, Robert Dandridge, Summerfield — ^Tuscaloosa session 1873 

Jackson, Walter Clarke, Montgomery — Tuscaloosa session 1873 

Johnston, William Henry, Birmingham — Montgomery session 1875 

Ketchum, George Augustus, Mobile — Tuscaloosa session 1873 

Luckie, James Buchner, Birmingham — Mobile session 1882 

McKinnon, John Alexander, Selma — Mobile session 1876 

McKittrick, Adam Alexander, Evergreen — ^Tuscaloosa session 1873 

Means, Thomas Alexander, Montgomery — Eufaula session 1878 

Michel, Richard Fraser, Montgomery — Tuscaloosa session 1873 

Mitchell, William Augustus, Eufaula — Birmingham session 1877 

Phillips, William Crawford, Selma — Selma session 1879 

Prince, Francis Marion, Bessemer — Birmingham session 1877 

Pritchett, John Albert, Hayneville — Mobile session 1876 

Reese, Augustus Jordan, Mobile — Tuscaloosa session 1873 

Sanders, William Henry, Mobile — Eufaula session* 1878 

Sears, John William, Birmingham — Birmingham session 1877 

Seelye, Samuel Dibble, Montgomery — Montgomery session 1875 

Starr, Lucius Ernest, Camden — Selma session 1874 

Thigpen, Job, Greenville — Selma session 1879 

Weatherly, Job Sobieski, Montgomery — Tuscaloosa session 1873 

Webb, Robert Dickens, Birmingham — ^Tuscaloosa session 1873 



MOLL OF TBE COLLEGE OF COUNSELLORS. 319 

THE BSNIOB OOUNSELLOBS. 

Barclay, James Paxton, Eutaw— Huntsville session 1880 

Brockway, Dadley Samuel, Livingston — Mobile session 1882 

Brown, Pagh H., Troy— Huntsville session 1880 

Cason, Davis Elmore, Ashville — Selma session 1880 

DuBose, Wilds Scott, Columbiana— Montgomery session 1881 

Emory, Aurelius Grigsby , Opelika — Birmingham session 1883 

Fletcher, William Mathew, Madison Station— Montgomery session.. 1881 

Franklin, Charles Higgs, Union Springs— Mobile session 1882 

Goggans, James Adrian, Alexander City — Birmingham session 1883 

Goodwin, Joseph Anderson, Jasper — Mobile session 1882 

Hayes, Robert Hughes, Union Springs — Huntsville session 1880 

Hendrick, Gustavus, Brundidge — Montgomery session 1881 

Hill, Samuel Henry, Carroll ton— Mobile session 1882 

Huggins, Jacob, New Berne — Selma session 1884 

Jay, Andrew, Evergreen — Mobile session 1882 

Jones, Capers Capehart, East Lake, Montgomery session 1881 

Jones, John Paul, Camden — Solma session 1884 

Kendrick, Joel Cloud, Greenville — Mobile session 1882 

Kendrick, William Tomlin, Montgomery — Montgomery session 1881 

Moody, Joseph, Franconia — Mobile session 1882 

Mushatt, John Patrick, Hayneville, Montgomery session 1881 

Peterson, Francis Marion, Greensboro— Selma session 1880 

Robertson, Tbaddeus Lindlay, Birmingham— Montgomery session.. 1881 

Rorex, James Polk, Scottsboro — Selma session 1880 

Searcy, James Thomas, Tuscaloosa — Selma session 1884 

Sholl, Edward Henry, Birmingham — Selma session 1880 

Sledge, William Henry, Livingston— Mobile session 1882 

Smith, Daniel Edgarly, Mobile— Mobile session 1882 

Stovall, Andrew Mc Adams, Jasper — Mobile session 1882 

Thetford, William Fletcher, Talladega — Montgomery session 1881 

Thomas, James Grey, Mobile — Selma session 1880 

Tipton, Frank, Selma — Mobile session 1882 

Trent, Powhatan Green, Rock Mills — Selma session 1884 

Wall, Conrad, Forest Home — Selma session 1880 

Ward, Henry Bascom, Cuba — Birmingham session 1883 

Wilkerson, Wooten Moore, Montgomery — Birmingham session 1883 

Wright, Milton Roil, Gadsden — Selma session 1880 

THE JUKIOB OOUNSELLOBS. 

Baldwin, Benjamin James, Montgomery — ^Anniston session 1886 

Binford, Peter, Somerville — Montgomery session 1888 

Bragg, Shirley, Lowndesboro — Greenville session 1885 

Darby, John Isaac, Columbia — Tuscaloosa session 1887 



S20 TBE ANNUAL HSOISTMR. 

Croodwin, Albert, Eufaula — Greenville session 1885 

Harlan, John Jefferson, Hackney vi He — Montgomery session 1888 

Heacock, John William, Alpine — ^Tnscaloosa session 1887 

Hill, Lather Leonidas, Montgomery — Montgomery session 1888 

Inge, Henry Tntwiler, Mobile — Greenville session 1885 

Jones, John Culbreth Hezekiah, Stone — Montgomery session 1888 

Eendrick, Joel Beder, Greenville — Greenville session 1885 

Lowery, Samuel Hickman, Huntsville — Greenville session 1885 

McWhorter, Abbott Milton, Gaylesville — Tuscaloosa session 1887 

Nicholson, Edward Pierson, Valley Head — Greenville session 1885 

Nolen, Abner Jackson, New Site — Anniston session 1886 

Northen, Thomas, Ashland — Tuscaloosa session 1887 

Redden, Robert James, Sulligent — ^Tuscaloosa session 1887 

Rushing, Francis Marion, Elba — Anniston session 1886 

Whaley, Lewis, Birmingham — Anniston session 1886 

Wheeler, William Gamp, Cherokee — Montgomery session 1888 

Whelan, Charles, Birmingham — Greenville session 1885 

Wilkinson, James Anthony, Flomaton — Anniston session 1886 

THB 00UNSELL0B8 ELEOT. 

Crook, John Martin, Jacksonville, Calhoun county. 
Goode, Rhett, Mobile, Mobile county. 
Hudson, William Henry, LaFayette, Chambers county. 
LeGrand, John Clark, Anniston, Calhoun county. 
Marechal, Edwin Lesley, Stockton, Baldwin county. 
Toole, Barclay Wallace, Talladega, Talladega county. 

Grand senior counsellors 35. 

Senior counsellors 37 

Junior counsellors 22 

Counsellors elect 6 — 100 



ROLL OF COUNSELLORS BY DISTRICTS. 221 



THE ROLL OF COUNSELLORS BY CONGRESSIONAL 

DISTRICTS, 



On this roll the names of the counsellors are given by congressional 
districts. It is intended to serve as a guide in the election of new 
counsellors with a view to the distribution of them in approximate 
proportion to the number of members in the several districts. It is not 
considered to be good policy, and it is not considered to be fair and 
right to give to a few large towns greatly more than their pro rata share 
of counsellors. The calculations are made to the nearest whole num- 
bers. 

THE FIRST DISTRICT. 

Names of Counsellors — W. H. Abernethy, Jerome Cochran, Rhett 
Goode, H. T. Inge, Vivian P. Gaines, George A.Ketchum, A. J. Reese, 
W. H. Sanders, D. E. Smith, J. G. Thomas. 

Clarke, members 17 counsellors 



Choctaw, " 14 

Marengo, " 13 

Mobile, " 27 

Monroe, " 12 

Washington, " 3 





9 
1 




Totals 86 10 

One counsellor to every nine members. 

THE SECOND DISTRICT. 

Names of Counsellors — B. J. Baldwin, Pugh H. Brown, J. B. Gaston, 
Gustavus Hendrick, C. B. Herbert, L. L. Hill, W. C. Jackson, Andrew 
Jay, J. C. Kendrick, W. T. Eendrick, E. L. Marechal, A. A. McKit- 
trick, T. A. Means, R. F. Michel, S. D. Seelye, Job Thigpen, J. 8. 
Weatherly, Conrad Wall, W. M. Wilkerson, J. A. Wilkinson. 

Baldwin, members 3 

Butler, 

Conecuh, 

Crenshaw, 

Covington, 

Escambia, 

Montgomery, 

Pike, 



(( 
tt 
tt 
tt 
tt 
ft 
tt 



Totals 94 

0^6 counsellor to every five members. 



3 


counsellors 


••«•••• X 


17 




4 


7 




2 


8 







3 


V • • « • • • 





11 




1 


29 




10 


16 




2 


94. 




20 



323 THE ANNUAL REGISTER. 

THE THIBD DISTRICT. 

Names of Counsellors — ^John I. Darby, A. G. Emory, C. H. Franklin, 
Albert Goodwin, Robert H. Hayes, S. M. Hogan, Wm. A. Mitchell, F. 
M. Rushing. 

Barbour, members 14 counsellors 2 

17 ** 3 

4 *' 1 

11 " 

13 " 

12 ** 1 

9 ** 1 

8 . " 



Bullock, 




Coffee, 




Dale, 




Geneva, 




Henry, 




Lee, 




Russell, 





Totals 88 8 

One counsellor to every eleven members. 

THE FOURTH DISTRICT. 

Names o/ CourweKor«— Shirley Bragg, Jno. P. Fumiss, D. S. Hopping, 
Jacob Huggins, R. D. Jackson, J. Paul Jones, Jno. A. McKinnon, Jno. 
P. Mushatt, F. M. Peterson, W. C. Phillips, Jno. A. Pritchett, L. E. 
Starr, Frank Tipton. 

Dallas, 

Hale, 

Lowndes, 

Perry, 

Wilcox, 



members 


24 


counsellors 


4 


<( 


14 


<( 


2 


(( 


10 


it 


4 


(< 


16 


tt 





a 


28 

92. 


it 


2 


i( 




12 



Totals. 

One counsellor to every eight members. 

THE FIFTH DISTRICT. 

Names of Counsellors — James A. Goggans, W. H. Hudson, A. J. Nolen, 
Thomas Northen, J. J. Harlan. 

Autauga, members 9 counsellors 



1 





1 





3 



Bibb, 




Chambers, 




Chilton, 




Coosa, 




Clay, 




Elmore, 




Macon, 




Tallapoosa, 





7 




17 




9 




12 




18 




12 




10 




20 





Totals. " 114 

One counsellor to every twenty-three members. 



ROLL OF COUNSELLORS BY DISTRICTS. 223 

THE SIXTH DIBTBICT. 

Names of Counsellors — J. P. Barclay, D. S. Brockway, Peter Bryce, 
J. M. Godfrey, J. A. Goodwyn, 8. H. Hill, W. H. Johnston, 0. 0. 
Jones, J. G.H. Jones, J. B. Kendrick, J. B. Luckie, Joseph Moody, F. M. 
Prince, T. L. Robertson, J. R. Redden, J. T. Searcy, J. W. Sears, E. H. 
Sholl, W. H. Sledge, A. M. Ctovall, H. B. Ward, R. D. Webb, Chas. 
Whelan, Lewis Whaley. 

Fayette, members 16 counsellors 

Greene, " 10 " 1 

Jefferson. " 50 " 11 

Marion, *' 9 " 

Pickens, " 14 " 3 

Lamar, *• 8 " 1 

Sumter, " 18 " 4 

Tuscaloosa, '* 23 ** 2 

Walker, " 15 " 2 

Winston, " 6 " 

Totals 169 24 

One counsellor to every seven members. 

THE SEVENTH DISTRICT. 

Names of Counsellors — D. E. Cason, W. S. DuBose, Jno. M. Crook, 
J. W. Heacock, J. 0. LeGrand, A. M. McWhorter, E. P. Nicholson, P. 
G. Trent, B. W. Toole, M. R. Wright, W. F. Thetford. 

Blount, members 18 counsellors 

26 " 2 

18 " 1 

11 " 

7 " 

10 " 1 

14 " 1 

9 " 

18 " 1 

13 ** 1 

21 " 3 

17 " 1 



Calhoun, 


(( 


Cherokee, 


(( 


Cleburne, 


(< 


Cullman, 


(1 


DeKalb, 


ti 


Etowah, 


ti 


Marshall, 


<i 


Randolph, 


tt 


St. Clair, 


tt 


Talladega, 


a 


Shelby, 


n 



Totals 182 11 

One counsellor to every seventeen members. 



THE EIGHTH DISTBICT. 



Names of Counsellors—M, C. Baldridge, Peter Binford, B. F. Cross, 
J. J. Dement, R. M. Fletcher, J. R. Hoffman, 8. H. Lowry, J. P. Rorez, 
W. 0. Wheeler. 



224 THE ANNUAL RE0I8TER. 

Colbert, members 14 counBellors 1 



1 





1 

4 

2 



Franklin, " 13 

Jackson, " 16 

Lauderdale, ** 15 

Lawrence, '* 19 

Limestone, ** 6 

Madison, ** 24 

Morgan, " 23 



Totals 130 9 

One counsellor to every fourteen members. 

GENERAL SUMMARY. 

The whole number of members in the State is 955, and the whole 
number of counsellors 100. This gives one counsellor for every 9.55 
members ; for convenience, we may say, one counsellor to every 10 
members, about. 

The first district, with 86 members and 10 counsellors, has one coun- 
sellor more than it is entitled to. 

The second district, with 94 members and 20 counsellors, has ten 
counsellors more than it is entitled to. 

The third district, with 88 members and 8 counsellors, has one coun- 
sellor less than it is entitled to. 

The fourth district, with 92 members and 12 counsellors, has nearly 
two counsellors more than it is entitled to. 

The fifth district, with 114 members and 5 counsellors, has six coun- 
sellors less than it is entitled to. 

The sixth district, with 169 members and 24 counsellors, has seven 
counsellors more than it is entitled to. 

The seventh district, with 182 members and 11 counsellors, has seven 
counsellors less than it is entitled to. 

The eighth district, with 130 members and 9 counsellors, has four 
counsellors less than it is entitled to. 



THE ROLL OF OFFICERS. 225 

THE EOLL OF COERESPONDENTS. 

Revision of 1889. 



Bizzell, William David, M. D., Atlanta, Georgia 1881 

Bozeman, Nathan, M. D., New York 1889 

Gamett, A. F., M. D., Hot Springs, Arkansas 1876 

McDaniel, Edward Davies, M. D., Camden, Alabama 1889 

Moses, Gratz A., M. D., St. Loa]3, Missouri 1874 

Osborn, Thomas Childress, M. D., Clebome, Texas 1885 

Phillips, N. D., M. D., Gainesville, Florida 1876 

Richardson, Nicholas Davis, M. D., Nashville, Tennessee 1882 

Summers, Thomas 0., M. D,, Jacksonville, Florida 1875 

Toxey, Caleb, M. D., Mobile^ Alabama 1885 



THE EOLL OF OFFICEES. 

Revision of 1889. 



PRESIDENT: 

Chablbs Higgs Fbanklin, M. D Union Springs. 

VICE-PRESIDENTS : 

Senior — ^Benjamin Franklin Cboss, M. D Decatur. 

Junior — Shiblby Bbagg, M. D Lowndesboro. 

SECRETARY : 

Thomas Albxandbb Mbans, M. D Montgomery. 

Term expires, 1893. 

TREASURER : 

Waltbb Clabkb Jackson, M. D Montgomery. 

Term expires, 1893. 

THE BOARD OF CENSORS AND COMMITTEE OF PUBLIC 

HEALTH. 

ShoU, Edward Henry, Birmingham 1889-1894 

DuBose, Wilds Scott, Columbiana 1889-1894 

Cochran, Jerome (Senior Censor). Mobile 1888-1893 



226 THE ANNUAL REGISTER. 

Gaston, John Brown, Montgomery 188S-1893 

Seelye, Samuel Dibble, Montgomery 1887-1892 

Weatherly, Job Sobieeki, Montgomery 1887-1892 

Baldwin, Benjamin James, Montgomery 1886-1891 

Sanders, William Henry, Mobile 1886-1891 

Dement, John Jefferson, Huntsville 1886-1890 

Ketchum, George Augustus, Mobile 1885-1890 

OE ATOE : 

Hbnbt Tdtwilbb Inqe, M. D Mobile. 

ALTERNATE ORATOR : 
WiLUAM Camp Whbblbb, M. D Cherokee. 

STATE HEALTH OFFICER: 

Jbbomb Cochban, M. D Mobile. 

Term expires, 1893. 
(Official residence, Montgomery, Alabama.) 

PLACE OF MEETING— BIRMINGHAM. 
Time of meeting, the second Tuesday in April, 1890. 



THE SCHEDULE OF THE REGULAR REPORTERS. 

Session of 1890. 



Bbnjamin Jambs Baldwin, M. D., Montgomery — 

Headache and Neuralgia, Resulting from Refractive 
Errors. 

William Lockb Chbw, M. D., Birmingham — 

The Value of Amputation of the Scrotum as an Aid to 
the Radical Cure of Varicocele. 

Enoch Jambs Conynoton, M. D., Decatur — 

Perineal Lacerations and their Treatment. 

William Elias Brownlbb Davis, M. D., Birmingham— 

A study of the Treatment of Local and General Peri- 
tonitis. 

John Bbown Gaston, M. D., Montgomery— 

Cerebio-spinal Fever. 



SCHEDULE OF THE ANNUAL SESSIONS. 227 

Sahubl Mabdis Hoqan, M. D., IlDion Springs — 

CoDgenital Club-foot, and its Early Treatment. 

BoLiyAR Thomas Jonbs, M. D., Birmingham — 

Social Amusements as Exercise, and their Relation 
to Health. 

Cbisto Ahbbicus Robinson, M. D., Hnntsville — 

Antisepsis in Surgery. 

Edwabd HsinKY Sholl, M.D., Birmingham — 

The Practical Relation of the Physician to Life In- 
surance. 

Jambs Gbby Thomas, M. D., Mobile — 

Subject left to choice. 

Isaac LaFayettb Watkins, M. D., Montgomery — 

The Therapeutics of the Endometrium. 

Jambs Anthony Wilkinson, M. D., Flomaton — 

Some Thoughts on our Modem Therapeutics. 



THE SCHEDULE OF SPECIAL COMMITTEES. 

The committee on the establishment of a permanent home for the 
widows and orphans of physicians, and superannuated physicians, 
asked for and were granted further time in which to make their final 
report. 



SCHEDULE OF THE ANNUAL SESSIONS SINCE 

THE ORGANIZATION IN 1868. 

Selma— Albert Gallatin Mabry 1868 

Mobile— Albert Gallatin Mabry 1869 

Montgomery— Richard Eraser Michel 1870 

Mobile — Francis Armstrong Ross 1871 

Huntsville— Thomas Childress Osborn 1872 

Tuscaloosa— George Ernest Kumpe 1873 

Selma — George Augustus Ketchum 1874 

Montgomery— Job Sobieski Weatherly 1875 

Mobile — ^John Jefferson Dement 1876 

Birmingham — Edward Davies McDaniel 1877 

Eufaula— Peter Bryce. 1878 

Selma— Robert Dickens Webb 1879 



228 THE ANNUAL REGISTER. 

Huntsville— Edward Pendleton Gaines 1880 

Montgomery — William Henry Anderson 1881 

Mobile— John Brown Gaston 1882 

Birmingham— Cliflford Daniel Parke. 1883 

Selma — Mortimer Harvey Jordan 1884 

Greenville — Benjamin Hogan Riggs 1885 

Anniston — ^Frances Marion Peterson 1886 

Toscaloosa— Samuel Dibble Seelye 1887 

Montgomery— Edward Henry ShoU 1888 

Mobile — Milton Columbus Baldridge 1889 



SCHEDULE OF THE ANNUAL ORATORS. 

Gaston, John Brown— Mobile session 1869 

Ketchum, George Augustus — Montgomery session 1870 

Anderson, William Henry — Mobile session 1871 

Weatherly, Job Sobieski — ^Montgomery session 1872 

Jordan, Mortimer Harvey — ^Tuscaloosa session 1873 

Seelye, Samuel Dibble — Selma session 1874 

Ketchum, Greorge Augustus — Montgomery session 1875 

Michel, Richard Fraser — ^Mobile session 1876 

Fournier, Edmund Henry — Birmingham session 1877 

Riggs, Benjamin Hogan — Eufaula session 1878 

Mitchell, William Augustus — Selma session 1879 

Baker, Paul DeLacy — Huntsville session 1880 

Baldridge, Milton Columbus— Montgomery session 1881 

Bryce, Peter — Mobile session 1882 

Sholl, Edward Henry— Birmingham session 1883 

Sanders, William Henry — Selma session 1884 

Searcy, James Thomas— Greenville session 1886 

No oration delivered — ^Anniston session 1886 

Huger, Richard Proctor— Tuscaloosa session 1887 

Baldwin, Benjamin James — Montgomery session 1888 

Coleman, Ruffin — Mobile session 1889 



THE OBITUARY RECORD. 229 



THE OBITUARY RECORD. 



AuTAUOA County — Qeorge Calvin Norris, M. D., medical college of 
Alabama, 1883, and junior counsellor of the state medical associ- 
ation, on the 3d of March, of pneumonia. 

Bollock County — ^William Bowling, M. D., of malarial fever. Clem- 
ent T. Fitzpatrick, M. D., Memphis medical college, 1849, of 
chronic bronchitis. 

Chambbbs County — Marcellus E. Mcintosh, M. D., medical college of 
Georgia. 

» 

Grebnb County — James Span Boyce, M. D., medical department of 
the University of Louisville, 1882, on the 11th of February, 1889, 
of consumption. Joseph F. Moore, M. D., medical college of 
Alabama, 1882, on the 8th of November, 1888, of congestion. 
Newton Cyrus Piles, M. D., Jefferson medical college, 1860, on 
the 18th of September, 1888, of heart disease. Charles Peake 
Sanders, M. D., Transylvania university, 1842. Disease not 
stated. 

Hsnby County— -John Thomas Stovall, M. D., on the 8th of January, 
1889, of an over-dose of chloral. 

Jbffbbson County — ^Mortimer Harvey Jordan, M. D., Miami medical 
college, 1868; grand senior counsellor, and ex-censor, and ex- 
president of the state medical association, of fibroid phthisis. 
Brice Martin Hughes, M. D. , medical department of the Univer- 
sity of Louisiana, 1882, on the 3d of July, 1888, of suicide. 
Charles Calvin Gregory, M. D. Disease not stated. 

Laudbbdalb County — Thomas Jefferson Crittenden, M. D., of con- 
sumption. Albert 0. Oliver, M. D. ; disease not stated. 

Lawbbncb County — George Washington, M. D., Louisville medical 
college, 1878 ; disease not stated. Fortunatus Sidney McMahon, 
M. D., university of Pennsylvania, 1857, of chronic diarrhoea. 

Marshall County — William David Russell, M. D., Cincinnati college 
of physicians and surgeons, 1884, of cancer of the rectum. 



230 THE ANNUAL REGISTER. 

Morgan County— William B. Black, county board 1877 ; George Wil- 
liam Gill, M. D., university of Louisville, 1843; Robert Virgil 
Williams, M. D., university of LouiJBville, 1884; William James 
Young, M. D., university of Nashville, 1872; all of yellow fever. 

PiCKBNs County — George Madison Graham, cb ; disease not stated. 

BusssLL County — ^John K. O'Neal, M. D., of abscess of the liver. 

Sumter County— James George Foster, M. D., university of Louisiana, 
1856, of heart disease. 



THE APPENDIX 



or 



MEDICAL AND SANITARY DISSERTATIONS 



AND REPORTS. 



THE ANNUAL ORATION. 



BT BUFFIN OOLSMAN, M. D., OF BIRMINGHAM. 

Member of the Medical ABSociation of the State of Alabama. 



Ladies and OenUemen: 

It is with no ordinary pride that I appear before you this 
evening as the orator of our association; but this pleasure is not 
entirely unalloyed, for, as yon well know, I stand here, by a 
sad dispensation of providence, in the stead of one whom you 
justly honored with your first choice for the duties of the 
hour. Yes, but for inexorable fate, Brice Martin Hughes 
would have charmed us at this moment with his gentle voice 
and winning manners ; and for the love we bore him, I know 
you will bear with me while I drop a modest flower in tribute 
upon his grave. Our profession lost a brilliant promise, and 
many a heart its brightest light when this young man passed 
from us to that country from whose bourne no traveller 
returns. He was an able and brilliant physician, and was 
endowed with that happy combination of traits which some 
great man has declared to constitute and mark the surgeon, 
^'the heart of a lion, and the hand of a woman." 

He was a most winning friend. In disposition he was bold, 
without being aggressive ; proud, but not arrogant ; dignified, 
but not austere ; genial, but not frivolous ; fixed in his convic- 
tions, but neither bigoted nor dogmatic. He was everything 
that gave the world assurance of a man. But, alas ! the curtain 
fell, and in the heyday of youth, in the flush of his young man- 
hood, he passed from off our stage to take his chamber in the 
silent halls of death. As Longfellow says of Young Evan- 
geline, we may say of him : 



234 THE APPENDIX OF MEDICAL PAPERS. 

"Something there was in his life incomplete, imperfect, unfinished, 
As if a morning in June, with all its music and sunshine, 
Suddenly paused in the sky, and, fading, slowly descended 
Into the east again, from whence it late had arisen." 

With a fond adieu, we turn to brighter themes. 

And, in the first place, fellow-members of the association, I 
congratulate jou that kind fortune has cast our lines in such 
pleasant places ; and I confess to a feeling of worthy pride as 
I raise my voice in this classic city that sits like a queen beside 
the blue waves and golden sands of the southern gulf. Yes, 
we stand upon. historic ground ; we stand within the pale of a 
city that echoed to the shots and shouts of DeSoto and his cav- 
aliers ; a city that saw the first dawn of civilization in the 
howling wilderness of Alabama ; a city whose name has been 
not only co-extensive with, but frequently known beyond the 
name of her mother state ; a city around whose hearthstones 
hover the shades of distinguished men and illustrious women. 
Here lived the erudite and patriotic Oampbell ; the gallant and 
loyal Bragg; the daring and heroic Semmes; the great and 
honored Knott ; the witty and scholarly Anderson ; the bril- 
liant and lamented Gilmore ; the generous and noble Gaines. 
Here lived the accomplished and elegant Madame LeYert, 
whose name filled two hemispheres, and here still lives the 
foremost novelist within American borders, the gifted author 
of St. Elmo and Beulah — books which have perhaps been more 
widely read than any published in America. We are, indeed, 
on consecrated ground, and surely no inspiration is lacking to 
raise me to the height of the argument of the theme which I 
have chosen to present you this evening — 

^ Voman's relations to the higher education and professions, 
as viewed from physiological, and other stand-points." 

I see a smile flit over the faces of you venerable fathers, as 
I, a young, unmated excelsior, rush into the conflict, bearing 
aloft my banner with its strange device. But, my hearers, 
though I stand here to-day as lonely as a solitary pine upon 
the dry Tortugas ; though — 



THE ANNUAL ORATION. 235 

"For me no blazing hearth shall bum 
Or busy housewife ply her evening care, 

Nor children run to lisp their sire's return, 
Or climb his knee the envied kiss to share ;" 

Though desolate be my lot, yet when it comes to the 
question of woman's ability, I speak not as the scribes or 
pharisees, but even as one with authority. Since a tender 
youth, when I climbed the hillside to pluck the first ripe 
grapes for that bright-haired maiden (gone, alas! I know not 
where), I have pursued after the fair beings — whether amid 
the fragrance of orange groves, western blizzards or northern 
snows, I have followed the brilliant ignis fatuuSy ^^that, like 
the circle bounding: earth and skies, allures from far, yet as I 
follow flies." and no man, however much married, Is a more 
competent witness to the power and prowess of woman. 

I am aware that there is much opposition to the views I 
shall lay before you as to woman's claims to all the riehts, 
privileis and immnnities of higher mental development, and 
the common benefits that will arise therefrom. Public opinion 
generally is against me, and our profession has ever been in an 
attitude of persistent hostility to the admission of woman into 
the higher learning and professions. Conservatism is a good 
trait in human character ; it is well enough that many people 
shall iterate ^^whatever is, is right ; what was good enough for 
our forefathers is good enough for us." I shall not, therefore, 
be awry with any one who repudiates my views. Best assured, 
too, that it is not from any defect in my esteem of my honored 
profession that I deem woman worthy to enter its sacred pre- 
cincts. I yield to no one in reverence to our high calling, and 
its noble followers. I know that it is a science affording 
unbounded scope to the most enlightened and far-reaching 
mind ; that it is a career of work and worry ; that it demands 
uncomplaining devotion to duty seldom equalled in any liberal 
calling. ^^Its ordeals are singularly trying ; the first introduc- 
tion into the dissecting room ; the first lessons in the operating 
theatre ; the first performance of post-mortem operation ; the 
first visit in case of infection ; the early struggle for practice 
when youth is the certain preventiye to progress ; the night 



236 THE APPENDIX OF MEDICAL PAPERS. 

and day of toil ; the intimate conversance with human mifiery, 
mental and physical, in all its most terrible forms ; the implicit 
trusts and confidences that have to be received and maintained 
with a watchfulness that knows no limit — these constitute, I 
say, a trying ordeal." And, alas, too frequently, broken rest 
and querulous complaints are the only rewards, and the poor 
Samaritan must be prompted onward by the highest sense of 
charity and benevolence, and sustained and soothed by that 
unfaltering trust that leads the missionary to the poisonous 
swamps and jungles of the tropics. Still, despite all these hard 
prerequisites, I maintain that woman is easily able to bear the 
burden even on to the highest point of success, not only in 
our profession, but in all spheres of intellectual endeavor. 

Now, to my judgment this question is not a chimerical one, 
nor one foreign to the atmosphere of this association ; on the 
contrary, both as to its determining principles and its ultimate 
bearings, it lies entirely within the domain of science, and es- 
pecially within the province of hygiene and physiology ; and 
the verdict upon its merits should be rendered, not according 
to prejudice and ^^a priori?^ judgments, but rather according 
to the methods of modem science — a careful and unbiased in- 
vestigation of the principles and facts. 

Then, as Antony begged of the Boman mob, I ask that you 
"lend me your ears," as I briefly and dispassionately review 
the objections urged against the Amazons carrying war into 
man's Africa. 

These objections are of two kinds — scientific and aesthetic. 
Primarily, it is argued that a wide disparity exists between 
woman's physical strength and endurance on the one hand, and 
on the other, the intense strain and outlay of nervous energy 
requisite for the higher walks of scientific and professional 
life ; it is gravely assumed that the higher intellectuality can 
be won only by the sacrifice of physical robustness, and upon 
the premise of such untoward results, most dire consequences 
are foreboded touching the perpetuation and character of the 
human race. Far from it ; any change from the present state 
of woman's health and vigor would be an improvement de- 



THE ANNUAL ORATION. 237 

vontlj to be wished. Countenances sicklied o'er with the pale 
cast of ill health are to be seen, alas I mach of tener than the 
roseate flash of robnstness. Nerroasness, lassitude, listless- 
ness, headaches, yea, hysteria, are not altogether unknown in 
the consultation room. And surely these are not all to be 
laid at the door of violent brain culture. Oh, no, there are 
other reasons more guilty. One bright woman suggests that a 
girl strong enough to live an idle and frivolous life, has done 
the hardest work ever found to be done, and that the life that 
many girls lead after leaving school could be exchanged for a 
carpenter's with advantage to nerve and brain. Yes, the 
amount of exercise indulged in by most of our women, espe- 
cially at the south, is about equal to that of the model woman 
described by Socrates, who filled her desires in this direction 
by folding up and putting away her clothes. Now in view of 
the extent of some wardrobes this would be considerable labor, 
but only consider the cramping style of those clothes. We 
laugh at the Pagan Chinee for compressing the feet of their 
fair ones into wooden shoes, but, reverend doctors, we nine- 
teenth century people, in the blaze of the sun of western civ- 
ilization, inflict, by our social customs and requirements, in 
style, torture and deformity a thousand fold more intense than 
did ever Ah Sing upon his almond eyed lady. ^'So cribbed, 
cabined, and confined," with attenuated waist, and contorted 
feet, our noble Anglo Saxon women are growing more and 
more a prey to all the ills that flesh is heir to. Why whoever 
saw a lady run — the very idea is a sacrilege. And even when 
children, how stands the case? While the boy pursues the 
flying ball, chases the hoop, or scours the plain, the tender ship 
of a sister is berigged in ribbons, flounces and things, and put 
into a straight jacket of ponderous decorum and inactivity. 
And in spite of the girl's physical inferiority, by a strange per- 
version of common sense, it is deemed a wise thing that she 
should have completed her mental training, entered society, 
and hooked her fish, at an age when her more robust brother 
is still kept pounding at his roots and his theorems, hammering 
out the solid metal of a sure and abiding culture. 



238 THE APPENDIX OF MEDICAL PAPERS. 

The illogical attitude of the medical profession upon this 
point is summed up gingerly by a brilliant lady. She says the 
physicians cry : "Women beware ! beware ! ! You are on the 
brink of destruction ; you have hitherto been engaged only in 
crushing your waists; now you are attempting to cultivate 
your mind ! You have been merely dancing all night in the 
foul air of the ball-room ; now you are beginning to spend 
your mornings in study. You have been incessantly stimu- 
lating your emotions with concerts and operas, with French 
plays, and French novels ; now you are exerting your under- 
standing to learn Greek, and solve propositions in Euclid. 
Beware ! oh beware ! ! science pronounces that the woman 
who studies is lost." A hundred times no ! I exclaim. . 

A large per cent, of the disorders of the nervous system now 
so prevalent among women I believe due to ennui, which 
would be all dissipated in the light and pleasure of a well- 
stored intelligence. "A sound mind in a sound body," is a 
true saying, and the reverse is frequently as true, "a sound 
body from a sound mind." The interaction is mutual. The 
experience of to-day of all the leading centres of higher female 
education fully demonstrates that health and close study under 
salutary regulations are not at all sworn foes ; and, further, 
that the students of these institutions are much more eager 
after healthful and robust sports of every kind than is the 
Martha-like sister who kitchenward plods her weary way ; or 
the fairer belle, who trips the "light fantastic" until the dap- 
pled dawn doth rise. For one case of breakdown from over- 
work among women, there are a score from ennui, and sheer 
inanition of doing nothing. It can not be denied that mental 
and physical collapse will sometimes occur in the higher work 
from overstrain, and lack of hygienic regulations. For the 
matter of that, it is not an unknown sight to see a youth 
whose mind jangles, and is out of tune, and whose body is 
become but a frail weed from suicidal over-work. Cautious 
medical regulations are requisite for the welfare of both 
sexes, and a more enlightened policy and oversight is loudly 
demanded for the prevention of the many maladies incident 



TEE ANNUAL ORATION. 239 

to onr entire Bystem of edacation, which are dae, doubtless, to 
overpressnre, wretched ventilation, and a general infringement 
of the simplest principles of good health as known to our pro- 
fession. Eventually this medical supervision will prevail, and 
all these objections on the score of physical disabilities will be 
eliminated. But after all, we must not forget the fact that it 
is especially true in the silent realm of thought that the battle 
is not to the strong, nor the race to the swift. Alexander 
Pope was not a Hercules, George Washington was no miracle 
of strength, Alexander Stephens, one of the foremost men in 
the annals of the south, was an emaciated dwarf. Ah ! exclaims 
some aesthetic physiologist, all this storm and stress will make 
for the advanced woman a brutalized physique ; such a figure 
as will banish the soft folds and graceful draperies that now 
characterize female dress and give such elegance and fascinar 
tion to woman. In other words, that all lady doctors will 
dress a la Dr. Mary Walker. Furthermore, the beauty lover 
contends that woman's lovely face will be all spoiled. The 
frontal bone, the forehead, he says, will grow too large from 
study, and thus lose that coy beauty with which it now nestles 
below the bramble of blowsy bangs. Juno and Venus, he 
prophecies, will vanish from the face of the land, leaving only 
a howling race of spectacled Minervas ranging about seeking 
whom they may devour. Ood forbid ! The sesthetic turn of 
the argument, however, is contrived to affright the ladies 
themselves, who have some weakness in this direction, but it 
is only a man of straw. The three goddesses will rather be 
blended in one, and to the soft outline and mantling color of 
the lovely Helen, will be added that more subtle and finer 
beauty which the lofty soul silently chisels into the roughest 
features ; that tender and refined air which Baphael gives to 
his ethereal master-pieces, and that grows alone from high and 
noble thoughts seated in a mind of gentlest culture. 

When we come to the second question as to woman's ability 
to grasp the broad and complex truths lying in the profounder 
sciences, we are again confronted with much skepticism. Kor 
is the fact amazing. A few years ago woman was caged in 



240 TEE APPENDIX OF MEDICAL PAPERS. 

behind castle-bars as man's unworthy plaything, instead of 
his noble and equal helpmeet. Before this spirit of tyranny, 
not yet dead, her intellectual capacities have been most grudg- 
ingly admitted, and the means for their development set at the 
minimum. Unquestionably, there is a wide sexual divergence in 
the mental attributes of the two sexes. May be, as Tennyson 
sings, ''Woman is unto man as water unto wine.'^ She doubtless 
is more emotional ; she depends more upon intuition ; but, this, 
after all, may be only instantaneous logic, with man's cumber- 
some machinery of premise and syllogism omitted — 

''Man owns her logic of the heart 

And wisdom of unreason, 

Supplying, while he doubts and weighs, 

The needed word in season." 

• 

But, however weak they are, is it not better to develop 
these faculties, to inform them, to train them to a noble self- 
reliance than to leave them to lean at chance upon any broken 
reed that is offered ? But how stands the matter ? With a 
great many is it not thought enough if a woman is on speak- 
ing terms with the three E's ; or as Mrs. Malaprop puts it to 
Lydia Languish : " Enough geography to know the contiguous 
counties, and enough arithmetic to subdue a column of com- 
mon household expenses ? And, in more polite walks, where 
ciphering is vulgar, what is the case ? Some superficial refine- 
ment of manners, and knowledge of the forms of society ; a 
small stock of ordinary phrases, a slight attendance on the play, 
and above all, a fashionable taste for dress." A dish of intel- 
lectual pabulum that would more fit the brain of a chicken. 
And what are necessarily the pernicious results of this system 
of repression ? Of what art, is one thus trained, a mistress by 
which she might earn a living, if alone, in the struggle for ex- 
istence into which this world is plunged ? Oan such a one aid 
in the care of a father or mother, should misfortune fling them 
upon her some day ? Or how fitted is she, when her labors of 
indolence are ended, to aid some poor worthy fellow, be he a 
doctor, or what, on up to nobler ends, and star-eyed aspirations? 
In those hours when gloom gathers upon the brightest beavenS| 



THE ANNUAL ORATION. 241 

when adversities and restless feelings come, is she one for a 
counsellor, to sustain by tier purpose and character, and soothe 
by her thoughtful care ? I see her as an impediment rather, a 
weight to every stroke of the brave swimmer's arm. Fudge, 
says some one, ^4t is unwomanly for a woman to do other than 
household work ; she is unsexed by any occupation beyond the 
pale of home ; she is altogether too lovely, too pure, too ethe- 
real, to alight upon the dust of the arena." Far be it from me 
to do violence to the tenderest ideal of womanly loveliness, 
purity, modesty, sanctity. May no winds ever visit the least 
of them too roughly ; may the snows that rest on Mount Wash- 
ington be no purer than she ; may she ever be regarded with 
the sentiments of highest chivalry, yea, may ten thousand 
swords leap from their scabbards at a rough look upon her. 
Still, I do not appreciate that one hair's breadth of this fair- 
ness will be yielded by a little wholesome labor, or a little men- 
tal elevation. I have yet to see a lady, less a lady for earning 
money ; she forfeits not a whit of esteem, but rather gains in 
worthiness by earning a state of independence and self-support 
instead of dangling as a pensioner upon another's bounty. 
Such a woman must carry herself with a self-respect that no 
sneer can cover, or rusty dress conceal. To equal man, she 
need not ape him, nor necessarily grow manish. In a larger 
and more public sphere, her truth will grow stronger with 
strength ; her purity grow positive, instead of negative, and 
her gentleness be purged of its weakness. 

It sounds most gallant to contend that woman should do no 
work in the every-day walks of life, but it cannot be denied 
that this idea has had its issue in many women being neither 
bread-winners nor bread-makers ; and degenerating into crea- 
tures of the world, whose aspirations are mere yearnings for 
social eclat, and dazzling robes of purple, and fine linen ; in 
short, whose prototypes are the Biblical lilies, toiling nor spin- 
ning not, yet outrivaling Solomon in all his glory. Of course, 
it is not always so. Indeed, this slavery of woman to purely 
domestic duties, and on the other hand, this worship of her, 
98 if she were from a brighter realm, fostered generations of 
15 



242 THE APPENDIX OF MEDICAL PAPERS. 

housewives and social qneens in onr southern coantry, the boast 
of its citizens, and the admiration of strangers. Bat with en- 
vironments changed, customs must change. To-day is not as a 
day in 1860. From many families the besom of war swept 
every vestige of property, and it cannot be denied that the 
problem of life for man or woman, single or married, grows 
more and more complex, the battle for survival more and more 
desperate. Whether as wife, or as antiquated maids, women 
must put their hand to the wheel in the ever more grinding 
strife. 

Some one asks what is the good of all this higher mental 
training, if as soon as a woman is thus trained, she marries ? Her 
mission, he goes on to say, is to bake my bread, broil my chops, 
look to my children, and see to me in sickness. I wish, as my 
companion, no bhie-stocking, or female martyr, no St. Agnes, 
nor Catherine Leyburn. Is it, dear sir, that your own intellect- 
ual fire is such a rush light, that you prefer darkness rather 
than light ? Well, there are yet many after your heart's liking. 
But we must know that as a man's intellectual standard ad- 
vances, so must woman's. Ah ! those were good old days for 
silly women when the mixing of a julep made them virtuous, 
and skill in roast pig an ornament to their sex ; when the mil- 
iner and rogue pot paved the way to man's heart, and the 
kitchen to his esteem. But the days of John Falstaff are gone ; 
and while true that '^A civilized man can not live without 
dining," man can not live by "bread alone." Is love to be an 
appetite, or a sentiment? Is woman to be a help-meet or a 
hinder-meet ? A bauble or a companion ? And are learning 
and housewifery any more incompatible than learning and any 
of man's drudgery ? Chemistry and cooking, mathematics and 
matrimony, may go hand in hand. It is possible that one 
should at the same time contemplate lofty ideals, and not for- 
get lowly realities. Grant, too, at most, that woman can only 
pass her culture to her children. However high her accom- 
plishments, can they serve, according to a physician's view, any 
better end? The highest social and physiological benefits 
needs must accrue from such results. No men know better 



THE ANNUAL ORATION. 243 

than we the powerful influence of heredity, and the admirable 
work of the great English scientist, Mr. Galton, is a powerful 
tribute to this parental influence that silently, but surely shifts 
the shuttle, and weaves the web of many a mortal in colors, 
bright it may be, but more often of a sombre hue. 

It is an old saying — and a true one — ^That the hand that 
rocks the cradle, rocks the world." Its basis is in the well- 
established law that of the two parents, the mother exerts by 
far the strongest influence upon children, whether directly, or 
indirectly. In nearly every instance of great historic fame, it 
is possible to discover in the mother, the basis of the man's 
sterling worth, inflexible character, brilliant intellect, or what- 
ever other trait that marks him. Shakspeare, Pope, Napoleon, 
Lee, and a host of others, bear witness to this truth. Though 
clever fathers seldom have clever sons, almost all great men 
have had superior women for their mothers. Nor does the in- 
fluence cease with the child, but woman governs men ; and as 
the wife, so generally is the husband. 1 firmly believe that if 
that higher evolution of humanity for which men are strug- 
gling, praying, evangelizing, is ever to be, it will come only by 
a development of woman, jpaW/?a«*w, with theadvance of man.' 
A higher domestic tone will be inaugurated, life will be ren- 
dered richer in all that constitutes higher attractiveness, and 
the end of complete and wise being more nearly reached in 
manifold' ways. 

But let us not forget that this implied concession that every 
lassie will have her laddie, alas ! will not be true. Strive how- 
soever stoutly as some of us may to bring about this desirable 
end, we can not change the statistics. Woman to day is con- 
fronted by an environment different from that of many periods 
of history. The numerical proportion of the sexes has changed, 
and to-day the women outnumber the men in the ratio of 21 to 
20. Only to think of it. "Now, polygamy and female infanti- 
cide can not be reverted to, in order to reduce the surplus. 
Nor can we reverse the Sabine story, and allow women to 
pounce down upon other lands for stray superfluous males." 
After creation's lords have selected the best of creation's 



244 THE APPENDIX OF MEDICAL PAPERS. 

ladies, there is still a dreary residue that are left either to go 
through the anwomanly act of earning a livelihood, or the 
womanly act of perishing. There are three million snch in 
these United States, in these hard straits. Mnst they be turned 
without arms, or equipment into the battle that is raging about 
our ears ; be cast into the raging sea without belt, plank, or 
contrivance whatsoever, whereby to keep their heads above 
water ? It is a cruel respect that demands of a woman to 
starve merely for conformity to a false standard of feminine 
deportment established by society under circumstances and 
environments entirely at variance with the condition that con- 
fronts woman to-day. 

Finally, I ask if the achievements standing to the credit of 
woman in the past, are not an adequate earnest of her grand 
possibilities, should all hampering restraints of prejudice and 
tradition be removed ; and do they not cry aloud that the 
golden day of this emancipation should be hastened on? An 
ounce of experience is worth a ship load of theory. A glance 
at history reveals a glorious array of illustrious women in every 
walk of life that brands the imputation of her imbecility as a 
vile slander. 

Would you behold patriotism of the highest type. See the 
self-devotion to her country of the young maid of Orleans as 
she offers herself, like Iphigenia of old, a living sacrifice on 
the altar of La Belle France, now inciting the recreant soldiery 
to do or die; now leading them with consummate strategy and 
skill to victory ; or, now in prison, still unconquered, and un- 
conquerable, or at the stake giving up her pure spirit, with a 
smile parting her innocent lips. 

Is it philanthropy you wish? Behold yon figure in the 
somber habiliments of a plain Quaker Friend, Elizabeth Fry, 
walking the wards of a pestilential prison house, and I ask if 
any man — not excepting John Howard — has ever done more 
for the amelioration of the horrors of prison life, for the per- 
manent betterment of those unfortunates doomed to suffer the 
penalty of the law. Or see in the flash of that cannon, a tall 
figure in black, moving under that sulphurous canopy of smoke 



TQE ANNUAL ORATtOHf. 248 

from prostrate form to postrate form, staunching this wonnd, 
or offering to those parched lips, a cup of water — it is Flor- 
ence Nightingale at Balaklava — and no mortal is more worthy 
to be called blessed : 

O, watcher, worn and pale, 

Good Florence Nightingale, 

Thanks, loving thanks, for thy large work and will ! 

England is glad of thee, 

Christ, for thy charity. 

Take thee to joy, when hand and heart are still ! 

Religion, too, has her St. Agnes, her Catherine of Sienna, 
and her latter day heroine who turn their backs upon luxurious 
homes to carry the light of Bethlehem's Star to their sisters 
sitting beneath the shadows of the Dark Continent. 

In medicine woman has made her way through the trials of 
ward and dissecting room to honorable distinction, and several, 
like Drs. Mary Putnam Jacobi and Grace Peckham have added 
lustre to our profession. And we even see American Portias 
called to the bar, and Dinahs warning the world of judgment 
to come. No one can deny that the touch of her hand is 
softer than man's, and as for her powers of language, who dare 
deny. She has made her way through school and college up 
to some of the foremost educational posts. In the leading 
schools of England and of this country, when admitted to com- 
petition with men, woman makes as fair progress, and often 
bears away the honors. The most creditable portions of our 
magazines are productions of her pen ; and she stands forth as 
the most successful administrators of colleges, the peers of any 
man in learning and control. 

Some of the most magnificent work of this century in art 
stands to the credit of Rosa Bonnheur. Oeorge Elliot is one 
of the foremost modern thinkers ; and the recent planet that 
has swung into the literary firmament, Robert Elsmere, would 
seem to prophesy that George Elliot's mantle of masterly accu- 
racy and sweep, has fallen on the shoulders of another woman. 
And there, too, is that poet whose words sink into the heart 
as dew into the flower, Mrs. Browning. In a word, the pages 



246 THE APPENDIX OF MEDICAL PAPERS. 

of history are all the brighter with immortal deeds, and the 
world all the" richer that a host of women have lived, the 
equals of any man in statesmanship, heroism, and all that de- 
pends on largeness of brain and magnanimity of sonl. 

Now, gentlemen of the association, the greatest advance in 
the medical science of onr generation is the dearer and more 
general recognition that the power of the physician to cnre 
disease is extremely limited, and that the aim of the enlightened 
doctor, shonld be prevention. Now woman, as we have seen, 
is the great moulding influence of society, of humanity, and as 
the die, so the casting. In all the world, there is no more 
potent factor for injury ; nor, on the other hand, a more potent 
factor for all that is good, beautiful and true. 

Would we rear a hardier and more robust manhood ; would 
we elevate the intellectual and moral tone of each succeeding 
generation — woman holds the key. But whether or not, the 
portal shall be opened upon this roseate future, which we all 
must earnestly wish for, will be determined in a large part by 
the attitude of the medical profession, both in its advice, and 
in its supervision. Our endeavors, of course, primarily con- 
cern the health of the body ; and may the day be hastened 
when we again may see in the flesh the counterparts of the 
Greeks' Venus de Medici, or Diana the Huntress; but we 
also are to minister to a mind diseased ; and to eradicate false 
ideas of womanhood ; to insist upon brain as well as body 
culture, seems to me one of the highest offices of the physician* 
The good that will accrue to the human race, from such a con- 
summation, will far outreach all the benefits of pills and 
potions, though they be stacked like Pelion on Ossa, or flow as 
free as the mighty Nile. In justice, then, to woman's inalien- 
able rights to freedom of choice ; and in justice to her many 
intellectual triumphs of the past ; in behalf of her own physi- 
cal and mental elevation, and in behalf of the infinite good 
that will ensue for the entire human family from this eleva- 
tion, I hold that woman should be admitted to all the higher 
privileges of academic and professional life. 



THE ANNUAL ORATION. 247 

The medical profession can bestow upon onr race no larger 
boon than the cure of all the infirmities, and the eradication of 
all the popnlar fallacies concerning woman's strength and 
ability, that now obstruct the path to this great reformation. 



248 TS^ APPENDIX OF MEDICAL PAPERS. 



ELECTRICITY IN GYNECOLOGY. 



BY W. E. B. DAVIS, M. D., BIBMINGnAM, ALA., 

Member of the Medical ABSOciation of the State of Alabama. 



It is not my purpose to endeavor to show that electricity is a 
panacea for all the ills of womankind, bnt to present the sub- 
ject as one who has given it considerable study, and who has 
had some experience in its use. No doubt ultra-enthusiasm has 
led to frequent failure ; but while, by some, perhaps too much 
has been claimed, by others it has not received the considera- 
tion it deserves. Too many are attempting to use electricity, 
however, before learning something of the indications for its 
application, and of its physics and physiology, and often fail to 
get satisfactory results, and do much harm — but this should not 
argue against its proper use. In the hands of gynecologists, 
who have familiarized themselves with its actions, and learned 
how to keep an outfit in proper condition for work, the agent 
has accomplished all that could be expected, and complaints 
have not come from this class; while others, with no experi- 
ence whatever in the practice of electricity as recommended 
by Apostoli, have condemned it in the most emphatic language. 
Bnt when Sir Spencer Wells, the Keiths, Engelmann,Lapthom 
Smith, and a host of other competent observers, state that they 
have been gratified with the results they have seen accom- 
plished, there should be no question as to its value as a thera- 
peutic agent in gynecology. 

In this paper I will confine my remarks to faradism and 
galvanism (the electrolytic current), the forms of electricity 
used by Apostoli, and with which I have had experience. 

While faradism and the mild galvanic currents had been 
used before Tripier's and Apostoli's investigations, yet but 



ELECTRICITY IN GYNECOLOGY. 249 

little was accomplished nntil they placed their application upon 
a scientific basis ; and especially does Apostoli deserve credit 
for pointing out the limit of^Tripier's treatment in chronic in- 
flammations of the Qterns. ' 

Faradism being a stimulant and tonic to enfeebled and re- 
lazed muscular and nerve fibers, it has proven a very valuable 
agent in relaxation of the uterus, vagina, uterine ligaments, 
and for dilated blood vessels, and, too, in relieving pain. 

The application of strong galvanic currents is in its infancy, 
and to Apostoli is due the credit for its popularity. He has 
been enable by the use of his abdominal electrode of clay, a 
good galvanometer, a strong electrolytic battery, and an inat- 
tackable sound or needle, to concentrate the current of one 
pole, without danger, render the other passive, and administer 
very high intensities without pain to the patient. lie thus 
utilizes the chemical properties of each pole in a "precise and 
dosable manner." When absorption and disintegration are 
desirable, the negative, alkaline, or absorbent pole is used ; 
when hemorrhage is to be controlled the positive, or acid, 
coagulating pole. The inter-polar effects are also increased 
with the intensity of the current — rendered bearable at such 
high doses, by him. 

I employ a 50-cell Diamond Carbon battery, thirty cells of 
which will furnish a sufiicient current, without a rheostat, for 
all gynecological work. This battery was constructed under 
my supervision by Woodruff & Harris, of Birmingham, and 
is^ a model for office work. Instead of this, I have recently 
adopted the Edison circuit, direct from the dynamo. This 
current is preferred to that furnished by cells, since the annoy- 
ances and inconveniences of a battery are avoided. Doubt- 
less the dynamo, recommended by Franklin Martin, will soon 
be adopted in places where the Edison light is not used. 

I have several sizes of cutaneous electrodes, and use each ac- 
cording to the intensity of the current administered. The 
electrode of potter's clay is only used with doses of more than 
100 milliamperes, since it is so unpleasant to the patient. 
Martin's surface electrode— TVon^. Inter. Med. Cong. ^87 — 



250 THE APPENDIX OP MEDICAL PAPERS. 

ie the best yet suggested, and will, doubtless, be generally 
adopted, except with very high intoneities, when the large clay 
electrode is preferable. Masacy's cnrrent controller — ^Uo- 
tricity in Diaeaaesof Women — meets all the indications for a 



[Maaaey'a Current Controller.] 
rheostat, and the cnrrent can be varied at will by its nee. with 
scarcely any shock. "It conaiBte of a ground glass plate, pro- 
vided with a tapering area of soft pencil- mark, broadening 
into thick graphite, embedded in the glass, where it is joined 
to lead, over which a brass contact, attadied to a crank, can be 
made to pass." When the crank is placed to the right of a 
hard robber button tite contact rests entirely on the glass and 
the circuit is broken. Moving it to the right the resistance to 
the circuit gradually grows leas until the desired intensity is 
reached. The increase and decrease is very gradnal. With 
. this instrnmcDt we are enabled to admin later an incaDdescent 
light cnrrent for all strengths of galvanic work. It is pre- 



ELECTRICITY IN GYNECOLOGY. 



251 



ferred to Bailey's rheostat, used by Apostoli, since it does not 
leave any resistance in the circait, when desired, and because 
it is simpler and avoids shock better. 



o 



o 



0> 

g 
a> 



HH O 

J; « 

aU 
o fl 

'S'o 

P CQ 



Gaiffe's galvanometer has been used in all 
applications of the current. It registers as high 
as 250 milliamp^res. A good meter is indis- 
pensable for every application. In addition to 
the apparatus mentioned, I have a number of 
different forms of uterine electrodes, such as 
recommended by Apostoli and Martin, and also 
a portable galvanic battery, but find it almost 
useless in the administration of high intensities ; 
hence I have been forced to confine my work 
principally to ofiice practice. 



The faradic apparatus which I use, is the 
one recommended by Apostoli, and consists of 
his bi-polar vaginal and uterine exciters, and 
a Gaiffe battery, which has a bobbin of very 
££. thick, short wire, and another of very fine, 
long wire, both of which can be used with 
the same primary coil. The former furnishes 
the current of quantity, so highly recommend- 
ed by Apostoli for relaxed muscle, and the 
latter the current of tension, the remedy par 
exceOence for pelvic painj « Apostoli claims the 
following advantages over the uni-polar elec- 
trodes, for his bi-polar uterine and vaginal 
exciters, in which the two poles terminate in about an inch 



a 

a 

OQ 

a 




[Apostoli's Bi-polar Intra-TJterine Electrode for Faradic Carrent.] 
from each other at the end of the instrument : 



252 TSE APPENDIX OP MEDICAL PAPERS. 

'^1. Doing away with the cntaneons pole. 

^'2. Concentrating on the nterns and its h'gaments the 
whole of the electrical action. 

'^3. The operation is easier and does not require the assist- 
ance of the patient nor any one else to hold the tampons. 

^'4. The operation is less painful on account of the current 
not passing through the skin. 

''5. The operation is stronger and more effective on account 
of the possible increase of the uterine contractility, the facil- 
ity being given by employing, although with less pain, a much 
stronger current, with the result that it is more curative." 

Since it is to the condition of the uterus following parturi- 
tion, that we must look for the explanation of nearly all the 
inflammatory troubles of this organ presented to the gynecol- 
ogist for treatment ; and since these processes give rise to 
displacements of the uterus and cause so many pelvic diseases, 
any agent which promises to prevent or relieve subnivolution 
of the uterus should receive a very hearty welcome. And just 
here, I will state, that faradism is given so prominent a place 
in this paper, not so much for the number of diseases which it 
is capable of curing, as for its power as a preventive. To 
my mind, no physician who does any obstetrical practice what- 
ever, should be without a suitable faradic outfit. The appli- 
cation of this current is so simple that it can be used by any 
member of the profession ; and I am thoroughly convinced, 
that by its proper use, the majority of the troubles with which 
women arCxafflicted, after an abortion or delivery at full term, 
could be prevented. My experience has convinced me, beyond 
question, of the correctness of Tripier's conclusion, "that the 
faradic current is capable of relieving engorgement of the 
uterus ;" (restricted to the enlarged, soft, hypcrsBinic uterus, 
which so often results from an abortion, etc.), and as such, an 
invaluable preventive against the pathological conditions which 
so often arise from this cause. 

I do not use the remedy immediately after every delivery, 
as recommended by Apostoli — AnncUs of Ch/nec,^ 1881 — but 
wait until the uterus has had time for involution to be com- 



ELECTRICITY IN YNECOLOO Y. 253 

pleted. As joa know, he applies the cnrrent of qnaDtity at 
once in the nterus of a woman, who has been delivered at term, 
or sooner, and repeats the operation eight or nine times within 
six days after confinement at full term, and fifteen to twenty 
times after an abortion. His object is — Apostoli Annah de 
Crynec, — to help and hasten nterine involution; "to shorten 
convalesence and to prevent the complications which result 
from its stoppage or slowness." This effect has been demon- 
strated by clinical experience, and can be practiced witli profit 
in the hospital. Inasmuch, however, as <?very woman who is 
confined or has an abortion does not suffer from subinvolution 
of the uterus, and since the expense required for this system of 
treatment could not, or would not be afforded except by a very 
small class, unless it were certain that the uterus would not 
return to its normal size, it has, therefore, seemed the wiser 
plan in my own practice, to prescribe ergot, which — Apostoli^ 
Chronic Metritis — acts very much as faradization on the smooth 
muscular fibre of the uterus, "although not by any means so 
prompt, energetic or reliable," after every confinement or 
abortion, and to use it more freely in cases of laceration of the 
cervix. 

I examine all cases at the expiration of six weeks, and if I 
find the uterus enlarged — subinvoluted — I begin at once to 
apply the bi polar uterine exciter of Apostoli and repeat the 
operation every second or third day, for ten to fifteen minutes 
at a time, until the organ has returned to its proper size, 
which can be counted on with almost mathematical certainty. 

I have used the current of quantity, as recommended by 
Apostoli, in a large number of cases with the most satisfactory 
results, but having found by the use of the current of tension — 
the current from the long, fine wire— for pain in an enlarged, 
hypersemic uterus, that the organ would be reduced in size the 
same as when the current of quantity was administered, re- 
cently I have adopted the current of tension in a large pro- 
portion of the cases of enlargement and in relaxation of 
muscle, as well as for pain. The current of tension is much bet- 
ter borne by the patient, and I have been unable to recognize 



264 THE APPENDIX OF MEDICAL PAPERS. 

any difference in the results. The enrrent should be used as 
strong as the patient can stand comfortably — this being the 
guide as to dose. I practice strict antisepsis, and after the 
operation support the nteras with tampons of wool and cotton, 
and I desire to insist upon the importance of this ; for, by sup- 
porting the organ we relieve the passive congestion resulting 
from the lengthening of the veins, which have no valves, and 
thus bring to bear a very important factor in the treatment. 
The patient rarely suffers any inconvenience after the opera- 
tion and can retarn to her household duties as if nothing had 
occurred. She generally feels relieved of the fullness in the 
pelvis, and always sleeps better on the night following the 
treatment. 

Contrary to the instructions of Apostoli, I generally intro- 
duce the uterine exciter through a bi-valve speculum, as op- 
portunity is afforded of cleansing the cervix beyond that had 
by a simple vaginal injection, given before the introduction of 
the instrument. There is seldom any pain from hooking down 
the anterior lip of the cervix and the passage of the sound. I 
always rest the handle of the electrode on a large wad of ab- 
sorbent cotton, which prevents any traumatism to the endome- 
trium. 

While, as stated, the woman rarely suffers after the opera- 
tion, yet it is better to itiBist that she remain in bed till the 
next day, as should be done after the passage of the uterine 
sound for any purpose. 

In cases coming to the physician after subinvolution has 
existed for a greater or less time, when it is not possible to say 
whether the condition is one of incomplete retrograde meta- 
morphosis or chronic metritis, in the stage of hyperplasia — 
when the muscular structure of the uterus has been supplanted 
by the formation of new tissue, the faradic current proves a 
very valuable diagnostic measure; for if the organ is not 
reduced perceptibly after eight or ten applications of the cur- 
rent — Apostolij Chronic Metritis — this is proof that the condi- 
tion is not that of retrograde metamorphosis — ^simple subinvo- 
lution — but a condition which always results from this when 



ELECTRICITY IN YNECOLOO Y, 255 

not relieved — hyperplasia — the treatment of which is not a 
mechanical one, as taught by Tripier, for it is not an engorge- 
ment as he believed, but a new formation — Apo8tol% Chronic 
Metritis. For this and the inflammation which is always asso- 
ciated with it — endomitritisj in one of its forms — Apostoli 
has taught us that the electrolytic current is indicated, '^by 
which we can attack the lining of the organ," and at the same 
time procure the trophic effects of the current — thus modify 
the nutrition of the organ, and procure absorption and retro- 
grade metamorphosis of the areolar structure. Should there be 
hemorrhage or profuse leucorrhoea, the positive would be 
indicated, and the current should be applied for five minutes, 
with from 100 to 150 miliamperes, twice a week. In cases 
where there is no hemorrhage, and no leucorrhoea, the nega- 
tive pole should be applied, on account of its more powerful 
effects in restoring the circulation and producing absorption. 
About twenty applications will generally be required in this 
class of cases. 

In chronic inflammation in the last stage — a fibrous condi- 
tion — the negative current should be used as in the case just 
described, and in addition, negative punctures of the cervix, with 
from 100 to 200 milliamp&res — Apostoli, Chronic Metritis. As 
the conditions of the uterus, of which we have just spoken, 
are the most frequent cause of displacement, and since these 
can be relieved by faradism and galvanism, what could be more 
rational than to place electricity as the agent above all others 
for the prevention and treatment of displacements o/ the uterus f 
Ton say the treatment recommended by Tripier has been dis- 
appointing ; and you are correct, for he did not recognize the 
chronic inflammations of the uterus as different from simple 
subinvolution — Apostoli, Chronic Metritis — and hence thought 
that faradism was indicated for all cases. 

The electrical treatment of uterine displacements is based 
upon anatomical and pathological facts, which have been very 
ably discussed by Dr. A. Lapthorn Smith — American Journal 
Obstetrics, June, 1888 — and since the uterus is a muscular 
organ, supported and held in position by muscles, it is rational 



266 THE APPENDIX OF MEDICAL PAPERS. 

to conclude with him ^'that the mnecle of the organ itself pre- 
vents it from being flexed, that the muscles of the ligaments 
prevent it from being verted, and that the muscles of the 
vagina and perineum prevent it from being prolapsed." It 
matters not whether the flexion be due to want of "tone in 
the muscle;" be due to "defective nutrition or innervation, 
owing to the poor quality of the blood supply," or the "want 
of nervous fluid," by the failure of the sympathetic to supply 
this sufficiently, or to hyperemia, we have a reliable and effec- 
tive remedy in the faradic current. 

My experience in cases of retroflexion, when there was no 
hyperplasia, has been most gratifying. Some patients have 
been relieved with as few as six applications. The following 
report of a case will serve to illustrate : 

Was consulted June 1, 1888, by Anne G., colored, aged 23; 
had an abortion four months previously, at third month; was 
suffering with pain in back and over both ovaries, and could 
scarcely walk owing to severe "backache." The uterus meas- 
ured 3J inches, and was retroflexed. After cleansing the 
vagina and cervix with a five per cent, solution of carbolic 
acid, the bi-polar excitor of Apostoli was introduced into the 
uterus, and the current of quantity administered for ten min- 
utes; patient stood very strong current, and felt better after 
the application. A dry tampon was introduced to support 
uterus. After six applications, made every third day, the 
uterus remained in position, and she was relieved of all symp- 
toms. This case was cured in a shorter time than we usually 
expect, for even in the early stages of engorgement from ten 
to twenty applications are required. 

When the displacement is accompanied with chronic inflam- 
mation, and the organ enlarged from that cause, it is necessary 
to apply the galvanic current to reduce the size of the organ, 
as has been recommended, alternating with the faradic, in order 
to strengthen the muscle, as the hypergenetic tissues are 
absorbed. 

In "fixed flexions," when the displacement is associated with 
the last stage of chronic inflammation, in which there is a hard 



ELECTRICITY IN YNECOLOO Y. 257 

cartilaginoas-like cervix, the same treatment shoald be adopted 
as for chronic inflammation of the uterus in the last stage, 
which has been described. Of course the cure of displace- 
ments will depend altogether on the causes and to the patho- 
logical condition of the organ, and hence, while an engorged 
uterus can be reduced in size and restored to position in a few 
weeks, very chronic processes will require as many months. 
Displacements of the uterus, associated with adhesions, find a 
very valuable remedy in the mild applications of the galvanic 
current. 

The following case is reported to illustrate the effects of the 
faradic current on the perineum, vagina and uterine ligaments 
in prolapsus of the uterus, and also the effects of the current 
in relieving pain : 

Mrs. P., age 35 years, had last child four years ago (four 
years before consulting me), since which time she had suffered 
almost the entire time, from pelvic pains, insomnia, and very 
marked nervous symptoms. The pain was so severe at her 
menstrual periods that she had been advised by her physician 
to have her ovaries removed, and it was for this purpose that I 
was consulted. Her uterus was normal in size, and prolapsed 
to a marked degree, which was due to its relaxed supports. 
The bi-polar vaginal exciter, with strong current, was used 
every second or third day, for two weeks, and at the next pe- 
riod she did not know when the flow appeared. In eight weeks 
her uterus remained in proper position ; she was relieved of 
insomnia, and her nervous symptoms improved. Two months 
after the treatment was stopped she became pregnant. Both 
the currents of quantity and of ],tension were used at each 
consultation in this case. 

The effects of the faradic current in strengthening the ute- 
rine supports were very forcibly demonstrated to me, by its 
application in a case where the uterus protruded from the vulva, 
after the cervix had been amputated, even before I had be- 
gun the use of electrolysis, and when I was in the habit of 
amputating the cervix to dimish the size of the uterus, by set- 
ting up a process of retro-grade metamorphosis, and afterwards 

17 



258 THE APPENDIX OF MEDICAL PAPERS. 

of applying faradism to strengthen the supports of the organ, 
in order to keep it in position, instead of narrowing the vagina 
by surgical methods. 

Yon have observed that in treating displacements by elec- 
tricity that I have recommended supports to hold uterus in 
position, which is not in accord with the practice of Dr. Smith 
and others. I generally use the dry tampons of cotton and 
wool, but do not object to any form of support, properly used, 
which will hold the organ in place. These supports can not 
cure the condition, it is true, but by restoring the circulation 
and preventing hypersemia, aid the stimulatingand tonic effects 
of electricity, and these combined afford the ideal treatment 
Hewitt says : 

^'A flexion of the uterus to a certain extent ligates the ves- 
sels and interferes with the circulation directly and indirectly. 
The incompressible arteries'still carry blood to the body, but 
the compressed veins fail to return it to the general circulation, 
and the consequences are congestions, oedema, and, in time, hy- 
pergenesis of tissue." 

Dr. Emmett, in a paper read before the American Gyne- 
cological Society, says, "the degree of prolapse below or eleva- 
tion of the uterus above a certain plane, causes the symptoms 
usually attributed to version alone." In other words, it is the 
effect that the displacement has on the circulation and the 
pessary by restoring the circulation, by relieving the pressure 
which straightens out the tortuous veins of the pelvic tissue 
and restoring them, thus relieves symptoms, and prevents hy- 
persemi^." The pessary does not cause atrophy of the muscles, 
as claimed by some, but strengthens them by sustaining the 
circulation. I do not say that electricity can do away with 
such surgical procedures as shortening the round ligaments- 
Alexander's operation — or attaching the corneu of the organ to 
the abdominal wall, or the narrowing of the vagina by the 
many methods at present in vogue, but I do know that many 
cases can be relieved by this method of treatment which would 
otherwise be condemned to the knife. Circumstances, of 
course, will frequently modify our course in treating a casei 



ELECTRICITY IN QXNECOLOQY. 259 

and a surgical method has to be accepted for the want of 
time to use other treatment — and so, for many other reasons 
which might be mentioned. However, when electricity is 
tried, if it should fail, nothing would be lost, as surgical pro- 
cedures could then be resorted to. 

Ohronic inflammatory exudations, which so often follow par- 
turition, have in negative galvano-puncture, according to 
Apostoli, Engelmann and others, a very reliable remedy. The 
deposits should be punctured from once to twice a week and 
from one hundred to one hundred and fifty milliamp^res ad- 
ministered. My experience with these cases does not warrant 
me in giving an opinion, but judging from my results with the 
mild currents and strong intra-uterine applications, I can not 
question their statements. 

The faradic current has given good results in the so-called 
chronic pelvic inflammations, where there is a thickening of 
one or both broad ligaments, which results from the collection 
of blood in the distended veins, where the organ is displaced. 
{Hardony Trans. S, S. c& O. Asso.) Of course the lacerated 
cervix which usually causes this condition should be repaired 
without waiting for the disappearance of the swellings, and then 
faradism and dry tampons used to support the uterus and to 
strengthen its supports. 

Electricity benefits so many of the pathological processes, 
which give rise to disorders of menstruation, that it is but 
natural to expect it to afford relief in many cases of amen- 
orrhoea, menorrhagia and dysmenorrhoea. 

Amenorrhoea and menorrhagia, due to a chlorotic condition 
have, for a long time, been treated with success by the general 
application of faradism. Amenorrhoea due to atrophy of the 
uterus, and menorrhagia from relaxtion or from engorgement of 
the organ, are both capable of relief by the proper local appli- 
cation of the current. The bi-polar intra-uterine exciter 
should be used every second or third day, for about ten 
minutes at a time, as has been described. 

I could report cases of both classes, but time will not permit, 
I have seen patients who menstruated eight* or nine days at each 



260 THE APPENEIX OF MEDICAL PAPERS. 

period before treatment, after a few applications of the faradic 
current, whose menses would continue, at the next period, for 
only four or five days. Of course, when the hemorrhage is 
due to disease of the mucous membrane, this treatment would 
be powerless, but instead should be administered the positive, 
galvanic current, which has advantages over the curette, liquid 
injections, etc., as there is no pain or danger. 

In neuralgic dysraenorrhoea I have been very successful 
with the faradic current of tension, and can speak positively of 
its efficacy. In women of a hysterical temperament, in whom 
the slightest excitement or worry will cause to sufl^er greatly — in 
those cases where there is no apparent pathological lesion — I 
have succeeded with this remedy as with no other. The 
current is administered about three times weekly, with the 
bi-polar vaginal, or uterine exciter. The positive, continuous 
current has also produced similar results in my hands. For 
apparent reasons the negative, galvanic current has been recom- 
mended when the dysmenorrhoea is due to mechanical causes, 
that is, ^^when the nerve filaments are pressed upon by inflam- 
matory exudations, or the canal occluded by chronic inflamma- 
tory swellings."— J^njr^ZmflTin, Trans, Amer. G. So(fy^ 1888, 
I agree with Franklin Martin, that by no means should we 
recommend the removal of an organ for pain until galvanism 
has been thoroughly tried, when the pain is due to ^^chronic 
ovaritis, either with or without hypertrophy, or when inflam* 
matory deposits, either with or without adhesions, surround 
both organs. Galvanism can never take the place of the 
removal of the ovaries and tubes ; for each has fts place, but 
many patients can be cured or permanently relieved by elec- 
tricity as quickly, "and sometimes more surely," than by the 
removal of these organs. 

I have a case, now under observation, upon whom I operated 
about eight months ago, removing the ovaries and tubes, for 
the relief of the very grave symptoms caused by inflammatory 
deposits and adhesions around both ovaries, one of which was 
atrophied, the other hypertrophied. I insisted on using elec- 
tricity in this case, but my patient had suffered so long, and 



ULECTRtCITy IN TNECOLOO Y. 26l 

been treated so mnch, that she was nnwilling to sabmit to any- 
thing short of an operation for the removal of the ovaries. I 
consented. to the operation because I thought it possible that 
she had a pus-tube, having had two pelvic abscesses, which 
opened into the vagina. There was no pus, however, at the 
operation. It has failed to afPect her menstrual periods, and 
there is no relief so far from her former condition. 

I now propose to use both galvanism and the current of 
tension, and believe the treatment will be rewarded with suc- 
cess ; and promise, whatever the result, it shall be reported. 

While I have had no experience with electricity in extra- 
uterine pregnancy, yet from a study of the actions of the agent 
and its results in the hands of others, there can be no doubt 
but that it should be used in the early stages of this condition, 
and should there be a mistake in diagnosis, there could be no 
harm done, as this is the remedy (galvaniam) for the patholog- 
ical processes which are liable to be mistaken for extra-uterine 
gestation. But when the pregnancy has lasted for more than 
three months, and when it can be positively diagnosed, it is a 
question in my mind whether laparotomy should not be re- 
sorted to at once. 

The subject which has concerned the profession most, by far, 

in connection with the use of electricity in the diseases of wo- 
men, is, the treatment qfjibraid tumorSj and since the experi- 
ences of Apostoli, the Keiths, Engelmann, Lapthorn Smith, and 
others, have demonstrated most conclusively the value of this 
remedy in the symptomatic cure of these growths, ^^ such as 
offer probabilities of healthy retrograde metamorphosis," I 
shall not offer my own experience, which has been limited, to 
prove what should not be questioned. If a tumor is undergo- 
ing cystic, suppurative or malignant degeneration, this can not 
be revolutionized and the tumor reduced in size, but on the 
contrary, the process will be hastened. — Engdmomn^ Trans. 
Amer. Oynl. 8oc.y ^88 / also Apostdiy Appendix of Chronic 
Metritis. Much, then, depends on the selection- of cases for 
the use of galvanism, in order to be successful. And since it 
can not be determined in all cases whether or not there is a 



^62 TBE APPENDIX OF MEDtCAt PAPERS. 

process of degeneration in existence, this will explain some 
cases of failure, as pointed out by Engelmann — Trcma. Amer, 
Oyrd. Society^ ^88 — "in which it is not the fault of the opera- 
tor or the remedy." 

Martin, of Berlin, in a paper read before the Gynecological 
Society, in which he reported his observations on 205 cases of 
myomata of the corpus, said that thirty-eight — 20.4-10 per 
cent. — "showed changes which certainly represented the oppo- 
site of that which is called benign." 

From this report of Dr. Martin another lesson is taught, 
and that is, the importance of beginning the treatment early, 
before a malignant process has been established, thereby, not 
only preventing this process of degeneration, but at the same 
time, establishing a process of retrograde metamorphosis, 
which results in a cure. In no other section of country is 
there better opportunity afforded for the study of the effects of 
this treatment than in the south ; for it is well known that the 
negro race is peculiarly susceptible to this class of tv/mor. 

Apostoli claims for this treatment : 

"First — An anatomical diminution which does not advance 
so far as to complete dispersal. 

"Second — The quick and lasting cessation of hemorrhage. 

"Third — The disappearance of all the symptoms of com- 
pression. 

"Fourth— The symptomatic restoration of the patient." 

As stated, while speaking of the treatment of chronic in- 
flamation of the uterus, he uses the poles of the battery accord- 
ing to the result desired. If hemorrhage is to be controlled, 
the positive intra-uterine applications, otherwise, the negative 
current, which can be introduced by needles into the sub- 
stances of the tumor, or by a sound into the uterine cavity. 
The inter-polar action of the current, which is the most im- 
portant effect, is thus explained by Apostoli : 

''In the organic substance intermediate between the two poles, the 
inter-polar region, as it is called, through which the current spreads in 
rendering itself from the point of entrance to that where it is discharged, 
there is a twofold action. The one is contemporaneous with the current 
itself, the other is posthumous. 



ELSCTttlCITY ID OYNJSCOtOOlt. 263 

The contemporary ciciion consists in an exaggerated vital and circula- 
tory activity favorable to the rapidity of nutritive changes. This will 
explain the absorption of certain effusions, either interstitial or intra- 
articular, under the influence of a current directed through them. 

The posthwnouB cLciionf enduring after the cessation of the current, 
occasions that condition known as the polarization of the organic tis- 
sues. This is an accepted fact. The organic region, thus occupied by 
the circuit of the current, is, in effect, charged as a second battery. It 
is consequently endowed with a supplementary electro-motive force or 
tension, which in its discharge prolongs the topical and trophic effects 
that the preliminary current had begun ; and it still further advances 
the retrograde metamorphoses which we see in non-malignant neo- 
plasms.*' 

AH who have had experience, agree with Apostoli, that the 
diminntion in the size of a tnmor will vary according to its 
strnctnre, viz : that a soft one will nndergo the process of re- 
trograde much faster than the hard one ; a snb-peritoneal can 
not be diminished as the intra-mnral. Yet, that nearly all can 
be reduced snfficiently to relieve symptoms of pressure. The 
hemorrhage will be more difficult to control in the snb-macns 
and interstitial forms, and less difficult according to the length 
and size of the uterine canal. That is, the smaller the surface 
of the uterine canal the less difficulty in stopping the hemor- 
rhage. It must not be inferred from this, however, that the 
current has all of its haemostatic power in its application to 
the mucous membrane of the uterine canal ; for the same re- 
sult can be had, in a longer time, as shown by Apostoli, by 
puncturing the tumor with positive needles. In severe hemor- 
rhages, when it is desired to administer higher intensities with- 
out pain, Martin and Apostoli have devised intra-uterine elec- 
trodes, "reduced to a very trifling length," to be passed from 
one extremity to the other of the uterine canal, so as to at- 
tack the entire surface — different portions separately. "To 
properly appreciate the value of this treatment," says Apostoli, 
" the powerlessness of purely medical therapeutics must be 
borne in mind, and too, the mortality of hysterectomy." 

In the removal of the ovaries to produce an artificial meno. 
pause, as has been pointed out by others, we submit the woman 
to a dangerous operation without sufficient hope for improve- 



364 THS APPENDIX OF MEDICAL PAPEHS. 

ment, as tumors have been known to take on new activity, and 
give rise to most alarming symptoms after the menopause; and 
too, the operation does not always stop menstruation. On the 
other hand, electricity, properly used, is devoid of danger, gives 
satisfactory results, and requires only from three to twelve 
months for a symptomatic cure. I emphasize symptomatic / 
for all who have used the agent agree that pain, hemorrhage, 
and more or less reduction in the size of the tumor can be 
expected — sufficient reduction for the patient not to suffer from 
its size. 

With these facts, there can be no question as to the proper 
course to pursue in the treatment. Certainly, hysterectomy 
should never be resorted to before electrolysis has been used. 



KCLAMPSIA on AV It) ARUM, 625 



ECLAMPSIA GRAVID AKUM. 



BY RICHARD MATHEW FLETCHER, M. D., OF MADISON. 

Ex-Vice-President and Senior Counsellor of the Medical Association of 

the State of Alabama. 



DI80U8SBD BY 

Jambs Myers Godfrey, M. D., of Samterville. 
Edwin Lesley Marbchal, M. D., of Stockton. 
Edward H. Sholl, M. D., of Birmingham. 



In the stady of spasmologj, we find that eclampsia is char- 
acterized by irregular convnlsive motions with alternate relax- 
ations in contradistinction to tonic spasm, which signifies a 
constant rigidity or contraction. In the pnerperal state and 
its management, convulsions stand first in importance to the 
practitioner of midwifery. 

It is a trouble that we do not meet with very often in 
obstetrical practice. To show the relative frequency of the 
attacks in a given number of labors, Collins says that in 16,414 
labors there were only 30 cases of puerperal convulsions, show- 
ing that one woman out of every 547 was attacked with the 
disease. The celebrated Madam Boivin, in her practice at the 
Maternite Hospital, Paris, says that out of 20,357 labors, that 
19 women were attacked with eclampsia, making the number 
attacked about one in 1,000. Dr. Churchill, in his tables, of 
96,903 labors, only 159 occurred, giving one in 609. I give 
these statistical results simply to show how extraordinary is the 
fact that, in a limited private practice, that within the last 
twelve months that I should have been confronted with four 
cases of this disease. Primiparous women are most liable to be 



266 ^S£ APPENDIX OP MEDtCAl PAPERS. 

attacked, bat all partarient women are subject to invaBion. 
Women advanced in pregnancy, or a woman in the first of her 
lying in, as a rule, are mostly affected with the malady. Three 
of the above mentioned cases were primiparse, and came under 
my care after labor had commenced and convulsions had 
ensued. The fourth case «was a multiparous woman in 
labor with her fourth child. I attended this woman in her 
first confinement ; she then suffered greatly with convulsions, 
but gave birth to a living child and made a good recovery. I 
was called, as stated above, to see her in her fourth labor, and 
found her in convulsions. She again passed through a terrible 
ordeal the second time and gave birth to a living child. After 
the child was born the convulsions ceased and she recovered 
without further trouble. This woman was a stout, healthy 
negress, always apparently in good health before and after her 
labors. Two of my other cases were also negressos, aged 14 and 
15 respectively ; both had short necks, were fat, and possessed 
considerable muscular strength. The fourteen year old girl 
had been in labor twenty-four hours when I first saw her, had 
had numerous convulsions beginning with her labor; she soon 
gave birth to a dead child, the convulsions, however, continued 
and in about twelve hours after delivery she died in profound 
coma. The fifteen year old woman had been in labor also 
some hours before I L her; she died undelivered in the third 
spasm after my arrival. My fourth case was a white woman 
eighteen years old, in labor with her first child ; she was short, 
with tissues firm and solid, hard and unyielding ; had been in 
labor some time, and had convulsions from the beginning. I 
soon delivered her of a large male child ; the child was unin- 
jured and did well ; the mother continued to have spasms after 
parturition all night ; the intervals grew longer and the fits 
lighter, and stopped finally early the next morning. She made 
a good and rapid recovery. The treatment used in these cases 
was veratrum in decided doses, both by the mouth and per 
rectum, also bromide potassium and chloral. I gave to each 
case cathartics. The cases all occurred in the country, and I 
used such remedies as I had at my command. I know of no 



MCLAMPStA QkAVlDAttVM. 26? 

sonrce of anxiety to which the practitioner of midwifery is 
exposed greater than the fear that his parturient patient may 
be attacked with convalsions. When in our power to do so, 
we should closely observe and protect onr patients against an 
attack of eclampsia, for it is much easier to avert it than to 
control and cure it when once established, no matter how 
wise, sagacious and prudent we may be in the use of the means 
employed to give relief. We may even be masters in the 
guiding principles that should control onr actions, and bring 
all our resources to our aid, yet the knowledge of the fact con- 
fronts us that we may, in any paroxysm, see our patient die 
writhing in convulsions. There is nothing so horrible in 
appearance, so deadly in tendency, and so embarrassing in 
treatment, as puerperal eclampsia. There is something so 
touching to see a woman in child birth die from any cause, 
particularly a young woman, with all of her cherished hopes 
of maternity blasted. Doctor Meigs said it was a sort of dese- 
cration for an acouche to die. I would be glad to know that I 
would be spared in the future from witnessing some of the 
scenes through which I have passed ; they go to the heart of 
both friends and physician, and leave the doctor reminiscences 
that he would be willing never to recall. 

Dr. Meigs very beautifully and graphically describes this 
disorder. He says the organs of the woman that are inner- 
vated principally by the pneumogastric nerves suffer most. 
The powers of the hemisphere of the brain and tnbercula 
quadrigemina experience a temporary oblivion, or rather sus- 
pension of power, quelling into a sort of temporary death or 
oblivion these important parts of the brain, while the spinal 
cord and the cerebellum, which are the sources and directors of 
the motions, and also the medulla oblongata, which gives origin 
to the respiratory nerves, should be the seats of that intense, 
though irregular evolution of power, whose effects we witness 
in the writhings, contortions and agonies of the eclampsic fit. 
There are other facts and circumstances worthy of our observa- 
tion and attention, the most prominent of which is the carbon, 
izing of the blood, or its conversion into venus blood by the 
interruption of the respiratory or oxygenating function. 



268 TffE APPENDIX OF itEDtCAl PAPERS. 

Dr. Meigs says it ie a carious circumstance that the above 
means should have been designed and provided by Providence 
for the cure of the paroxysm. He explains in this way: He 
says, when the whole sanguine mass has become carbonated the 
brain and spinal cord must cease to innervate the muscles con- 
vulsively, and that the speedy relaxation of every rigid muscle 
permits the restoration to the longs of their oxygenating 
power. He further says, that while the system is convalsed in 
the spasm the movements of the mass of the blood is greatly 
modified by the alternate violent contraction and relaxation of 
the mnscles, a modification that ceases as soon as the muscles 
come to a state of rest, so that in a few moments after the 
countenance has been black and deformed in every feature, 
you have the pleasure to see it recover its whiteness, though 
ghastly pale, while the whole brain wakes up to the renewed 
performance of its organic, as well as its intellectual offices. If 
this exposition of the phenomena be correct, it is of good 
omen, says this original thinker and remarkable man, to see 
the face of our patient growing darker and darker, as it is a 
hopeful announcement of a speedy close of the distressing ex- 
hibition. Along this line of thought much more conld be said, 
but I cannot, in a paper like this, be more elaborate, without 
consuming too much of your time. I will state, however, that I 
am chiefly « indebted to Dr. Meigs' book for the foregoing 
thoughts and conclusions, a book full of information on this 
important subject. 

With the light that more recent investigation has afforded 
us, I wish now, particularly, to call your attention to the 
etiology, pathology, and treatment of this disorder. 

There is no better established principle in the domain of 
medicine, than that which lays down the imperative necessity 
of initiating all curative procedures with the view of the re- 
moval of the cause. All experience and observation prove 
that there are numerous factors in the production of eclampsia 
gravidarum. We have causes predisposing and exciting too 
numerous to mention here. The foetus in utero is an etiological 
cause which stands alone and distinct from all other removable 
causes. 



ECLAMPSIA GRAVIDARUM. 269 

A grave and important qnestion for our consideration is, 
whether or not the induction of premature labor is ever justi- 
fiable, with the view of preventing eclampsia. The authorities 
are not agreed on this point, and the rules of practice are 
therefore conflicting. I would be slow to induce abortion 
with the view of avoiding puerperal convulsion, even in 
albuminuric women. In reviewing the history of all the cases 
that have fallen under my care, and from the clinical facts pre- 
sented by others who have given the benefit of their experience? 
I find that a minority of pregnant albuminuric women have 
eclampsia. It is only within a comparatively recent date, that 
the complication of pregnancy with nephritis and albuminuria 
was brought to light. Kayer was the first to announce the 
fact, and Lever, in Grey's hospital reports, was tlfe first to 
trace the causal relation between the epileptiform attacks, 
long known to accoucheurs, and the morbid condition occur- 
ing in the kidneys during pregnancy, supposed to be an acute 
parenchymatous inflammation of those organs. Lever gives 
the opinion that the pressure of the pregnant uterus upon the 
renal vessels, is the cause of the affection of the kidneys. 
Bosenstein and others hold the same opinion. 

This theory is not sustained by more enlightened views, as 
to the true nature of the morbid condition of the kidneys. It 
is claimed that mechanical pressure upon the renal vessels is a 
mere assumption, as neither the anatomical facts, nor the 
clinical symptoms uphold the theory. It is an admitted fact 
that parenchymatous inflammation of the kidneys is developed 
during pregnancy, but the real cause of the nephritis is not 
well settled. 

I will now give the views of different writers bearing on 
this subject : The London Lancet thus refers to Dr. King's 
explanation of this cause of puerperal eclampsia. King enun- 
ciates the theory, that pressure on the aorta and venacava 
inferior is the cause of the renal trouble in pregnancy and 
labor, and is due to the abnormal position of the foetus in the 
latter part of pregnancy. The normal position, he says, is the 
dorso-anterior of an oblique presentation. He says the head, 



270 TEE APPENDIX OF MEDICAL PAPERS. 

normally, does not lie in the brim of the pelvis, but in the 
iliac fossa. He claims that the shape of the foetus, in this 
position, is such as to avoid pressure on the great vessels. He 
denies that, in primiparsd, that the head of the child is normally 
lower at the end of pregnancy than in multiparas, and he 
attributes its frequent low position to vanity, leading to tight 
lacing. This pressure on the great vessels, he claims, leads to 
pressure in the renal and cerebral arteries, thus accounting for 
the renal trouble, as well as the nervous condition. The 
Lancet comments on this paper, and says, though it is the 
result of much thought, it fails to convince us, and will 
probably fail to convince others. Dr. Parviij concludes that 
the judgment of the Lancet will meet with very general 
acceptance. 

Dr. A. A. Browne, of Montreal, reports a very thoughtful 
paper upon this subject, presented to the Medico- Chirurgical 
Society of that city, by Dr. Lapthorn Smith In this paper, 
Dr. Smith makes the following statements as to the relation 
of albuminuria, urcemia, puerperal convulsions and puerperal 
mania. According to Smith, a moderate amount of renal con- 
gestion causes albumen to appear in the urine, a greater amount 
causes increase of albumen, diminution of urea, and the urea 
retained in the blood affects nerve centers, causes headache, 
disordered vision, &c. A still greater amount of albumen in 
the urine, and of urea in the blood, poisons, and at the same 
time starves nerve centers, and causes dropsy of the brain to 
such an extent that irritation is set up, and convulsions ensue. 
The guiding principle in treatment, according to Dr. Smith, 
is that, without grave reasons for the contrary, we should 
induce premature labor at any time after the seventh month, 
at which time we find the urine of the pregnant woman loaded 
with albumen, or considerably deficient in urea. Dr. Parvin 
takes issue with Dr. Smith, and says that it has not yet been 
demonstrated that urea in the blood causes eclampsia. He 
further makes the important statement that usually there is a 
remarkable difference between the effects of retention of urea 
in certain other diseases, and the latter, in that the temperature 



ECLAMPSIA GRAVIDARUM. 271 

rises in eclampsia and falls in nrsemic poisoning. He further 
states that only a minority of pregnant albuminuric women 
have eclampsia. Finally, he says, an increasing number of 
cases of eclampsia is known, in which there was no proof of 
renal disease before the eclampsic seizures. 

Dr. Malcolm Black, in a paper read before the Glasgow 
Obstetrical and Gynecological Society, attributed the disease 
to toxasmia, but thought nervous erethism, mental distress, and 
relaxed abdominal walls predisposed. He also thought the 
foetus was an irritant and advocated speedy delivery in the 
treatment. Cameron, in the treatment of the convulsions, 
advised chloroform, but had little faith in venesection. Reid 
advocated speedy delivery, preferring manual dilatation of the 
OS. In cases that had been in labor some time, he recommended 
amyl nitrate. Parvin says the trials made with this drug do 
not justify its use. It was first suggested by Dn Weir Mitchell. 
Dr. Chambrelent reports a case of grave eclampsia at the 
eighth month of pregnancy ; labor was induced, a dead child 
was born, the mother recovered. Leonard reports a case of 
eclampsia at the seventh month of pregnancy. The convul- 
sions were controlled by chloroform and chloral, the patient 
was put on milk diet, and the pregnancy ended at term with 
the birth of a living child. 

Dr. Pope narrates two cases of eclampsia occurring during 
labor which were successfully treated by chloral and potassium 
bromide. The women were delivered of living children, but 
one died in twenty-four hours after birth. He attributes the 
beneficial results of the medicines to diaphoresis — one patient 
had 480 grains of the bromide and 120 of chloral given in 
eight doses. 

Bompiana reports two cases of eclampsia occurring in preg- 
nant albuminuric women, treated by inhalation of oxygen. In 
one, before the oxygen was given, the patient had been unsuc- 
cessfully treated with bromide of potassium, chloral, bleeding 
and subcutaneously injected morphia. When the oxygen was 
used there was slight improvement, but she soon died. The 
other woman, he says, was cured. 



272 THE APPENDIX OF MEDICAL PAPERS. 

It occurs to rae that in the use of oxygen it would be prefer- 
able to give it by the rectum. Inhalation is difficult and some- 
times impracticable. Dr. McOord reports a patient seven 
months pregnant when seized with eclampsia, to whom he gave 
bromide of potassium, chloral, morphia and chloroform. He also 
bled. He then used, hypodermically, 12 drops of Norwood's 
tincture of veratrnm, and 10 grains of chloral, repeating the 
dose in forty minutes — patient had no more fits and was de- 
livered of a dead child. Dr. Oatman, in a paper read before 
the section on obstetrics — Ninth International Congress — advo- 
cates veratrum viride. After controlling the convulsions by 
chloroform, morphia, chloral and the bromides, he exhibits 
eight drops of the saturated tincture by the mouth, or 15 drops 
by the rectum, the dose to be repeated every fifteen or twenty 
minutes, until the frequency of the pulse is reduced to forty 
beats per minute. Bushmore, in a paper read before the King's 
county New York medical society, advocates this remedy, and 
in his paper gives the statistics of 76 cases, both ante and post- 
partrmij with a mortality of about 30 per cent, under the vera- 
trnm treatment. He further makes this remarkable statement, 
that in every case in which he used the veratrum before the 
eighth or tenth convulsion the patient recovered. Osborne 
reports a posi-partum case of eclampsia successfully treated 
with hypodermic injections of veratrum. On the other hand, 
Dr. W. Ellison reports a case occurring after delivery, which 
was first treated unsuccessfully by heroic doses of veratrum, 
and then by chloral. The chloral was given by himself, the 
veratrum by a physician who saw the case before him. He 
states also that he found the bladder greatly distended, intro- 
duced a catheter and drew off more than a gallon of urine — 
the patient recovered. Dr. Parvin says that such abundant 
secretion of urine is not the rule in eclampsia, and that this 
symptom indicated decidedly a hysterical element in the dis- 
ease. LaMotte records a case in which he attributed the con- 
vulsions solely to retention of urine — artificial evacuation of 
the bladder cured the patient. Lovejoy and Allen strongly 
advocate venesection. In fifteen cases thus treated all recov- 



ECLAMPSIA GRAVIDARUM. 278 

ered. Id albnminnric women threatened with convalfiions 
Bitter gives three to five grains of benzo salicylate of lithia, 
in conjanction with fresh hydrangia, thirty grains every four 
honrs. He has the bowels moved two or three times a day 
with confection of senna. Dnjardin Beanmetz relies npon 
chloral in eclampsia, and regards it as the most valuable of all 
remedies in this disease. Eggleson speaks well of the morphia 
and chloral treatment. He says he has not had a case of 
eclampsia in his own practice for five years. He attributes 
the fact to his directing his patients to nse bitartrate of potassium 
as soon as there is the slightest swelling of the feet or legs. 
He gives two teaspoonfuls in water every morning. He also 
makes a most remarkable statement when he says that in an 
experience of thirty-six years that he treated thirty cases with 
thirty recoveries. He winds np by saying, I have found noth- 
ing equal to morphia and chloral. Shizover, Squance, Evoff, 
and Bertrand are all advocates of pilocarpine hypodermically 
employed. Dr. J. W. McLane cautions against the use of 
jaborandi or pilocarpine; says they frequently cause intense 
salivation and bronchorrhcea, sometimes ending in death. He 
is a strong advocate of preventive treatment. When albumen 
is found in the urine he gives saline cathartics, such as citrate 
of magnesia. When the face is turgid, the pulse bounding 
and full, the urine smoky and scanty, with dizziness and rush 
of blood to the head, he bleeds to the amount of fifteen or six- 
teen ounces before giving the cathartic. He then directs the 
patient to drink plenty of water and to take mild diuretics. 
If the kidneys remain inactive he applies dry cups and gives 
diaphoretics. Dr. McLane considers albuminuria as properly 
a symptom, a condition, not a disease, although he treats it as 
such. His object is to relieve the congested condition of the 
kidneys. He puts the patient on milk diet, small quantities 
frequently repeated, amounting to three or four quarts daily. 
If convulsions are imminent he advises speedy delivery. 

Dr. Wm. T. Lusk believes that the shortest way to manage 
these cases is to administer anaesthetics, and empty the uterus 
fts speedily as possible. Dr. H. J, Oarrigues claims that 



274 TffE APPENDIX OF MEDICAL PAPERS. 

daring pregnancy we find tetanoid contractions or convnleions. 
He also says that we find convulsions simulating hysteria. In 
the treatment of such cases he believes strongly in the 
therapeutic value of chloral hydrate. The late Dr. B. H. 
Biggs thought the necessity of inducing abortion to relieve 
puerperal convulsions was a very rare occurrence. He held 
that all puerperal convulsions were, in character, epileptiform. 
He differed from those who attributed them to uraemia, cerebral 
anaemia, hyperaemia, or darned up effete matter in the blood. 
He claimed that the condition which results in eclampsia is 
essentially a neurosis ; that the disease was neurotic in char- 
acter, and not due to pressure of the gravid uterus, or acute 
nephritis. He held that the pathological state was due to 
peripheral irritation acting on the excito motor centres, and 
that the admonitions of the eclampsic outbreak, such as double 
vision, &c., were but the result of this central nervous derange- 
ment. He employed the usual remedies, but claimed that 
they did good by calming the excito-motor centres, acting 
directly on them. 

Dr. Ketchum holds that parenchymatous nephritis is the 
pathological condition of the kidneys, and a potent factor in 
the production of eclampsia. Dr. Peterson says that pressure 
produces congestion, or in some way interferes with the func- 
tions of the kidneys, frequently causing the trouble. Dr. 
Fournier said, why the pregnant female should be liable to paren- 
chymatous nephritis, has not yet been determined, and no 
theory has yet explained the vaoduB operandi^ but the fact 
must be accepted that it is incident to the pregnant state. 

My aim, in the preparation of this paper, was to present to 
the profession the practical experiences and investigations of 
the eminent gynaecologists and specialists of the present day 
upon this important subject. The many recent advances 
which have been made in the pathology of this, as well as 
most of the diseases peculiar to women, have led to numerous 
important changes, and to the expression of new views and 
new methods, as well as new remedies in the manner of treat- 
ment I will offer a few remarks on the claims wbob obloirf^l 



ECLAMPSIA ORAVIDAEUM. 275 

has for its advantages over other remedies in the treatment 
of the disease under consideration. According to Liebreich it 
is a quick anaesthetic, non-excitant, leaves no bad after-effects 
and interferes but slightly with the cardiac nervous power. 
He claims that its advantages over chloroform must therefore 
be at once apparent, for not only is it a quick ansssthetic, and 
is followed by no bad effects, but is easily administered. By 
repeated doses at regular intervals, patients are kept perfectly 
under control. Again, its superiority over chloroform is 
evident, when the practitioner happens to be single-handed, 
instances of which are of every-day occurrence in country 
practice, where doctors are few and far between. The medi- 
cal attendant would find it no easy task, both to give chloroform 
and deliver his patient under such circumstances. Chloroform 
is also often followed by sickness, and, with the tongue in the 
condition which it usually is in eclampsia, would prevent any- 
thing that might come up into the throat from being got rid 
of, thereby favoring asphyxia. Not only can chloral be admin- 
istered simply per rectum, but also in combination with nour- 
ishment — such as milk, eggs, &c., thus saving the disturbance 
of the patient as well as keeping up her vitality. 

Much is known, and there is yet a great deal to be learned 
about eclampsia. In the puerperal woman we see physiologi- 
cal processes and pathological conditions that we do not find in 
the more gravid female. We have morbid manifestations of 
both the arterial and nervous systems. I have quoted many 
authorities, noted for their high standing as writers and teach- 
ers, men of acknowledged ability and great repute, yet they 
differ, both as to the pathology nnd treatment of eclampsia. 

The conclusion of the whole matter, reasoning from my 
stand- point, is this : The foetus in utero is the prime cause in 
all cases of spasm ; the peculiar constitution of the woman gives 
the form or type to the spasm ; a predisposing or apoplectic 
habit of body in a woman will result in the apoplectic fit ; the 
habit or predisposition of the woman will determine the nature 
of the convulsions. They may be apoplectic, epileptiform, 
tetanoid^ hysterical, nephritic or reflex in qliaracter, Taking 



376 THE APPENDIX OF MEDICAL PAPERS. 

this view of the subject, we can readily see why it is there 
should be such variety in the selection of remedial measures in 
the management of this disease. In treating the apoplectic 
and nephritic forms, arterial sedatives, such as venesection, 
veratrum, and kindred remedies, would best fulfil the indica- 
tions in such cases, particularly in robust and plethoric women. 
In the highly organized, nervous cases, the nervous sedatives 
should be preferred. In the ansemic, tonics and restoratives 
would be indicated. It is our privilege as well as our duty, in 
all cases of disease committed to our care, to investigate pa- 
tiently, observe closely, and think profoundly, in order that we 
may be able to draw sensible deductions and prescribe with 
prudence and wisdom. 

Our profession is one of great responsibility, and we have 
grave and important duties to perform. We should strive to 
be men of independent thought, individuality of character, of 
sound and discriminating judgment. Our highest ambition 
should be to merit and deserve the confidence and respect of 
those who employ us as medical advisers and counsellors. 
There is no royal road to success in the medical profession ; 
eminence and distinction can only be achieved by patient toil 
and persistent effort. The Medical Association of Alabama 
has done much to elevate the profession in the State. Let us 
carry on the good work, and speed the day when there will be 
few incompetent and disqualified men in Alabama. 



Da. Jambs M. Godfrey. 

Whilst approving, in the main, the paper just read, I do not 
think sufficient stress was laid on the efficacy of venesection in 
the treatment of eclampsia gravidarum. It is true that the 
remedy is an old fashioned one, but having had considerable ex- 
perience in the management of the affection, I do not hesitate 
to say that, in my opinion, a decided bleeding, in time, will do 
more for its relief than anything else. The use of venesection 
does not preclude the use of other remedies commonly advised 
and used in such cases, but render them more efficacious. It9 



ECLAMPSIA ORAVIDARVM. 277 

nse, too, is of decided benefit in getting rid of the dropsy, 
which is generally albnminnric. We may not be able to bleed 
women in an asthenic condition, bnt I am satisfied that the 
vast majority of cases are amenable to this treatment. 



Dr. Edwin Lesley Mabschal. 

The treatment of any disease withont reference to its causa- 
tion is at once unsatisfactory and unscientific. ^'A knowledge 
of the specific element in disease" is the only basis upon which 
rational treatment can be founded, and it should be our earnest 
effort, in every case, to discover the nature of that specific 
element, in order that the treatment instituted should reflect 
creditably upon our intelligence, and inure to the benefit of 
our patients. In conformity with this principle, I hold that 
in puerperal eclampsia the first duty that devolves upon the 
physician is to ascertain the cause of the eclamptic seizure, and 
to adapt his remedies in accordance therewith ; for all admit 
that these cases are due to a diversity of causes. In one class 
of cases we find, as the principal causative factor, irritation of 
the peripheries of the uterine nerves, indicating the necessity 
of agents that lessen nerve conductivity, or that obtused nerve 
sensibility ; hence, the value of chloroform, chloral, &c. 

But where, from either functional or organic trouble about 
the kidneys, there is retention of azatized matter exerting a 
toxic effect upon the nerve centres, and convulsions ensue, the 
necessity of speedy elimination is at once apparent. This can 
be secured either by the use of hydrogogue* cathartics, diuret- 
ics, or of agents that promote cutaneous transpiration. Where 
elimination by the kidneys or bowels is impossible, I have de- 
rived benefit from the hypodermic use of pilocarpine. In 
cases where there is extensive oedema, and the urinary secretion 
small, and convulsions occur, no agent has given me such good 
results. It produces profuse sweating, and accomplishes that 
which is BO desirable — vicarious elimination. Its depressant 
action upon the heart, so much dreaded by many, has, I think, 
been greatly magnified, since in a large experience with it I 



278 fHM APPENDIX OP MEDICAL PAPERS. 

have, as yet, seen do untoward effect. I wonld not, however, 
be understood as advocating its ose except in those cases where 
elimination by the skin is desirable. My experience in puer- 
peral eclampsia, while not large, has been sufficiently extensive 
to induce me to assert that the mortality, to both mother and 
child, is frightful. 



Db. Sholl. 

Dr. Sholl, in commending Dr. Fletcher's carefully prepared 
and excellent paper on puerperal convulsions, made some few 
remarks on his experience for more than thirty years in the 
treatment of this alarming condition. He recalled two fatal 
cases ; one in his early practice, when he depended upon anses- 
thetics and anodynes ; another where the approved remedies of 
later days were used, and failing to give any relief, bleeding 
was resorted to late in the attack. 

In all his cases save these he had bled, with one exception, 
as freely as the occasion seemed to require ; in one furious case, 
five pints in forty-five minutes. Experience and observation 
had taught him that while the use of opium, veratrum, chloro- 
form, chloral, might in many instances be adequate to the relief 
of the suffering woman, the practitioner who bled these cases 
gave them whatever else might be used secondarily, the great- 
est possible chance for recovery. To this the wisdom of past 
ages bears attest, and as yet he had never regretted bleeding. 
He had also found in the condition of the pregnant woman, 
precedent to full time, where all other means failed to relieve 
the threatening symptoms, prompt and happy and continuous 
relief from the timely use of the lancet, so clearly demonstrated 
that there could be no shadow of doubt as to what was the 
curative agent. 



TkEATMENT OP PVLMOlfARy PHTHISIS. 279 



CURABILITY AND TREATMENT OF PULMONARY 

PHTHISIS. 



BY VIVIAN PENDLETON GAINES, M.D., OF MOBILE. 
Senior Counsellor Medical Association of the State of Alabama. 



DISOUSSED BY 

William Henry Abbbnbthy, M. D., of Bell's Landing. 

Edward Henry Sholl, M. D., of Birmingham. 

George Wilkins McDadb, M. D., of Montgomery. 

John Pope Stewart, M. D., of Attalla. 

William Gamp Wheeler, M. D., of Cherokee. 

Anoelo Festorazzi, M. D., of Mobile. 

Adam Alexander McKittrick, M. D., of Evergreen. 



Palmonary consamption is the commonest and most fatal 
malady to which the human race is snbject; occarring at every 
age and in every rank of life, it selects the most beantifnl and 
most gifted as its victims, and entails months or years of weary 
suffering. What need, then, for further incentive to a careful 
and diligent inquiry as to whether something may not be done 
to prevent its occurrence, retard its development, or arrest its 
progress. 

I have little that is absolutely new to bring forward — at 
least that is new to those who keep pace with the literature on 
the subject; but I believe that I have important testimony to 
give in favor of modern science, as my experience powerfully 
corroborates modern views with reference to the treatment of 
pulmonary consumption. 

The great fact to which I have to testify is, that pulmonary 
consumption is a curable disease — indeed, in the early stages of 
a catarrhal consumption, it is often a very curable disease. 



280 tme appendix of medical papers. 

There is frequently found on post-mortems^ in the lungs of 
many persons who had died in advanced life from other dis- 
eases, large cretaceous deposits and puckered cartilaginous cica- 
trices, which proved emphatically that they had consumption 
at some antecedent period of life, but had recovered, dying 
at last of other disease. 

The same pathological evidences of the curability of pul- 
monary consumption have been found by all who have had 
special opportunity of making post-mortem observations in the 
aged. Many persons have argued against the absorption of 
tubercle, and have boldly asserted that its absorption is impos- 
sible. But there are no valid grounds for this statement. 
True it is that the general health and tone of the system rarely 
improve so far as to render absorption of tubercles probable, 
and it is equally true that, from its nature and position, tubercle 
does not easily admit of absorption ; but experience at the bed- 
side and observation in the dead-house leave little room for 
doubt that its absorption may take place under favorable cir- 
cumstances. 

While I consider phthisis a curable malady, I must admit 
that we can not count our complete recoveries by large num- 
bers ; and, if phthisis is to be cured, it must be taken at an 
early period of its existence, before the lungs are so disor- 
ganized as to be unable to discharge their physiological func- 
tions, and persistently treated. 

Many a case has been benefitted for a time, the disease has 
been apparently subdued, when a return to old habits and 
exposure has lead to a reappearance of the affection in a severe 
form, antl to a fatal issue ; so we can not boast too soon of our 
cures, and insist on the importance not only of prolonged treat- 
ment in all cases of consumption, but of the patients leading 
such a life as will enable them, if possible, to avoid the causes 
which are likely to bring their latent disease into activity. 

I shall not enter into any discussion as to what tubercle is, 
or whether the tubercle-bacilli is a cause or result of consump- 
tion ; neither shall I describe the varieties of phthisis. Whilst, 
however, I abstain from the consideration of these subjects^ 



TRBA TMENT OF PULMONAJt Y PHTmsiS. 281 

we mast admit that recent experiments on the artificial inocn- 
lation of tubercle, has given a fresh aspect to tlie subject of 
the contagion of phthisis, and have rendered it possible that 
the inhalation of the tnbercle-bacilli from the dried spata of 
phthisical patients, is probably a fraitfnl source of propagation 
of the dread disease. We shonld therefore advise great clean- 
liness and antiseptic precautions, lest by any possibility some 
worthy person fall a victim in the zealous discharge of duty to 
the patient. To some extent disinfectants ought to be used in 
the vessel which receives the expectorations from such patients, 
and in the room occupied by them. 

The well should not sleep in the same room with advanced 
cases of the disease. 

TBBATMBNT. 

As a general rule, I think that it is best to let the patient 
know enough of the disease to regard it as something not to 
be trifled with or neglected, and that every attention and every 
sacrifice that can be to health should be perseveringly made. 
Patients should wear flannel next the body at all times, and 
enough clothing to keep them comfortable, but not enough to 
be a burden to them and keep up an undue action of the' skin 
as to paralyze the peripheral nerves and render the patient a 
more easy prey to sudden changes of temperature and slight 
draughts. When going out of doors in cold weather it is a 
very good plan to wear a protector over the chest, but this 
should be taken off on re-entering the house. 

The neck and shoulders should be bathed every morning in 
moderately cold water, and well rubbed afterward ; and when 
the disease is only moderately advanced, the patient should 
have a sponge bath at least once a day. This serves to keep 
the skin in good condition and it also has a general tonic effect. 
With regard to the temperature of the water, it should be 
governed largely by the sensations of the patient. 

Let your patient adopt a mild but nutritious diet, and pre- 
serve carefully the tone and healthy condition of the digestive 
organs. Begarding climate — when the case is not too far ad- 



282 THE APPENDIX OP MEDICAL PAPERS. 

vanced, other things being condacive, the removal of the 
patient to a suitable climate is a thing most desirable. For 
being in a warm climate in the winter, thorough ventilation 
can be kept up all the while if the patient be not able to get 
about. A certain amount of out door exercise can be taken 
daily generally. 

The climate of Mobile and vicinity, is highly beneficial in 
cases in the early stages (especially the catarrhal form) before 
breaking down of pulmonary structures has taken place, and 
when catarrhal inflammation of the mucous membrane is 
chronic or intense, the cough not accompanied by much expec- 
toration, and the general condition of the patient tolerably 
good. 

There are two very healthy winter resorts near Mobile, if a 
person prefers the country — Citronelle, 30 miles north of 
Mobile, on the M. & O. B. B., and Spring Hill, six miles west 
of Mobile. Both points are very accessible, high and dry, and 
noted for their healthfulness. Many remain in the city and do 
well. 

If the disease is in its early stage; if it is limited to one 
lung, and to a small portion of that lung; if the disease is not 
hereditary; if no local complications exist, and if the progress 
of the case has been slow and with occasional interruptions; if 
the patient has still considerable vigor of constitution, the case 
may be looked upon as a favorable one. 

If, on the other hand, the disease has advanced steadily and 
rapidly, both lungs are affected, or if the tuberculous deposit 
is very extensive in one lung, if cavities exist, and the usual 
train of secondary complications have ensued, then the case is 
unfavorable. The earlier, then, the period of the disease, the 
slower its progress ; and the more simple and limited it is, the 
better are the chances of improvement from a change of cli- 
mate. Parties from colder climates, who come here to spend 
the winter, by avoiding the damp and chilling influence of 
their winter and spring months, often find that a residence in 
our southern climate at a season when malarial disease is not 
prevalent, and when the heat is not oppressive, escape in a de- 



TkEA TMENT OP POLMOIfARY PltTmSIS. 283 

gree both dangers, and thns materially improve the chances of 
life. There is no donbt of this. If proper cases are selected, 
and proper management is adopted, great good will be experi- 
enced — life will be prolonged, and cases, I believe, permanently 
cnred. 

But the good effects of a whole winter's residence is some- 
times lost by a too early retnrn to the chilly and variable 
weather of the north. 

Of the many cases that are decidedly benefitted by a change 
of climate, but few, comparatively, are so far restored to health 
by remaining here a single winter, that they can safely remain 
at home the next winter. Many are obliged to return winter 
after winter, and finally get rid of the disease, or keep it so 
much in check that it makes but little progress ; at any rate, 
it gives the patient the best chance of ultimate recovery, or it 
prolongs life even when it does not effect a perfect cure. 

Patients in returning to their northern homes in the spring, 
should make a stop for several days every few hundred miles, 
so as to prevent a too sadden transition from a warm to a cold 
climate, and thus avoid setting up a bronchial inflammation. 

The climate of Colorado is desirable for those in the early 
stage of the disease, frequently effecting a permanent cure, 
provided they remain in that climate ; but to leave that rarified 
air is apt to cause a return of the disease, so that a patient 
should go there with the view of remaining permanently. 

When the digestive organs are in a healthy condition, and a 
mildness of the constitutional symptoms, and an absence of 
complications in other organs, adds very much to the prospec- 
tive advantages of a change of climate, especially a sea voyage. 

Let your patient adopt a mild but nutritious diet, and pre- 
serve carefully the tone and healthy condition of the digestive 
organs. 

Use as little medicine as possible, so as not to disorder the 
stomach. If the powers of digestion fail, they may require 
the support of tonics and stimulants, but stimulants should not 
be taken only with food, and not alone at odd times between 
meals, as is done by many persons — a custom more sociable than 



284 TBE APPENDIX OF MEDICAL PAPERS. 

wholesome, and especially injurious to the stomach ; for the 
gastric juice is thus stimulated to secretion, and having no food 
to digest, acts on the walls of the viscus, giving rise to flatu- 
lence and loss of appetite ; when the meal time comes the food 
is not thoroughly relished, and, on account of the waste of the 
gastric juice, imperfectly digested. Ext. malt taken during 
meals will frequently aid digestion, and give tone to the 
stomach. 

Dr# Loomis thus formulates the dietetic of phthisis : ^^Take 
food not less than six times in twenty-four hours. Three full 
meals at intervals of six hours, with light lunches between. 
No more food at one time than can be easily digested. Take 
no food when suffering from fatigue, worry or excitement. 
The articles of any one meal should be such as are digested in 
either the stomach or intestines alone ; ^. 6., the fats, starches 
and sugars should not be mixed with the albuminoids, and the 
meals should alternate in this respect." 

Food should be to a certain extent oily, consisting of meat, 
milk, cream, or cod-liver oil ; and when cod-liver oil is digested, 
it should be pushed almost to the full extent of digestion. 

Whea there is vomiting. Dr. Loomis recommends, ''from a 
half to a teaspoonf ul of raw scraped beef, made into a sand- 
wich, and given every half hour ; this to be continued for forty- 
eight hours, during which the patient must be kept quiet and 
in the recumbent position." 

When the nausea is intense and protracted, the stomach may 
be washed out by the flexible stomach syphon. 

You can by this method feed the patient, and practice what 
Debove calls super-alimentation. The various meat powders 
may be used with good results in this forced alimentation. 

Under the influence of these powders of meat, you will see 
stomachs the most inactive and feeble recover their functions, 
the appetite return, the bodily weight increase, and the strength 
come back. This treatment is applicable in all cases where 
nutrition is at fault, and especially to tuberculosis. The opera- 
tion is very simple, and the patients soon become so accus- 
tomed to the introduction of the tube that they can use it 
themselves. 



TREA TMENT OF PULMONA R Y PHTHISIS. 285 

In regard to cod- liver oil, Dr. Loomis advises that it be com- 
bined with an alkali, avoiding stimulants if possible. Ood-liver 
oil and the bjpophosphites are to be looked to as the great 
anti-phthisical remedies, yet vanons tonic medicines are highly 
beneficial. 

Strychnia is by far the best tonic for strengthening the stom- 
ach and preventing nausea from the oil. It is very important 
to persevere in giving cod-liver oil regularly, and for a suffi- 
cient length of time to obtain the greatest benefit from it. It 
should be given immediately after meals, as it becomes thor- 
ourghly mixed with the food and is less likely to rise by eruc- 
tation than when taken into an empty stomach. 

Friction over the chest with a crash towel night and morn- 
ing is of benefit in relieving the neuralgic pains, which are 
frequently very annoying. 

In young women of phthisical tendency, where there is a 
condition of ansBmia and chlorosis. Dr. A. H. Smith prescribes 
the following tonic : 

9 — Corrosive sublimate, one to two grains ; solution of chlo- 
ride of arsenic, one fluid drachm ; tincture chloride of iron and 
dilute hydrochloric acid, each four fluid drachms ; simple syrup, 
three fluid ounces ; water suflicient to make six ounces —mix. 
Dose, dessert spoonful in a wine glass of w^ter after each meal. 

This often affords the greatest benefit, the general condition 
and body-weight of the patient improving in a remarkable 
manner. 

It should not be given for a longer period than two weeks 
at a time. 

In young women of phthisical developments, when there is 
a condition of marked emaciation, ansemia, chronic diarrhoea, 
and generally weakened constitutions, Drs. Alonzo Clark and 
Francis Delafield, considers the immediate indication is to 
build up the general system by the use of iron, combined with 
the inhalation of oxygen properly diluted. 

Diarrhoea may be controlled by subnitrate of bismuth, mild 
astringents, aided by opium if necessary. Night sweats may 
be controlled by belladonna or atropia, the oxide or sulphate of 



286 THE APPENDIX OF MEDICAL PAPERS, 

m 

zinc, gallic acid, acetate of lead, and aromatic Bnlphnric acid, 
as internal remedies. Hot vinegar, with capsicum, is an effi- 
cient application. 

I do not advise the application of liniments or plasters 
applied upon the chest of phthisical patients, as they have a 
tendency to interrupt the cutaneous exhalation. 

Counter irritation, by means of the cup or tincture of iodine, 
is employed when local plurisies occur. As to expectorant reme- 
dies in phthisis, I think they should be banished almost alto- 
gether from the treatment of the disease. Cough mixtures, 
as a rule, contain opiates, which will quiet the cough for a 
time, and thus deceive a hopeful patient with the idea that his 
condition is really improving. But the long continued use of 
these remedies is sure to impair and disturb the digestive func- 
tions, without actually benefitting the lungs. I always try to 
defer the use of opiates as long as possible, and use it in the 
smallest possible doses, but most of the other sedatives should 
first be exhausted. 

The following is recommended to relieve the cough where 
it is desirable to avoid the use of opium : 

9;. — Spirits of chloroform and dilute hydrocyanic acid, of 
each one and a half fluid drachuis ; tincture hyoscyamus, half 
fluid ounce; camphor water sufiicicnt to make four fluid 
ounces ; mix — dose, a teaspoonf ul in water. 

The inhalation of a few drops of chloroform often gives 
complete relief to the cough. When hsemoptysis is present, 
ergot of ergotine may be employed internally and subcutane- 
ously with good effect; acetate lead, gallic acid, and the astrin- 
gent preparations of iron, are sometimes of benefit. 

Oil of origanum, in five drop doses, on sugar, every three or 
four hours, frequently gives good results in checking the hse- 
- moptysis. 

When fever proves very troublesome, antifebrine is pre- 
scribed, in many instances with the best effect — the tempera- 
ture falls, the pulse becomes more natural, and the accompany- 
ing symptoms are temporarily alleviated. 

The daily paroxysms of fever are frequently prevented or 



TREA TMENT OF PULMONAR Y PHTHISIS. 287 

much modified by giving antifebrine in advance^ of the 
paroxysm ; and, given dnring the fever, its anti pyretic power 
is marked. 

I have used creosote for the past three years, both internally 
and by inhalation, atid I consider it of great value, usually 
administering n nnnninir three times a day, after meals. The 
experience of Dr. Beverly Bobinson with creosote in the treat- 
ment of phthisis is very encouraging. He gives it both inter- 
nally and by inhalation, and says ^Hhe frequent or prolonged 
topical application of creosote vapors to the respiratory tract, 
in a considerable area, is of undoubted utility." 

He recommends the following formula for internal adminis- 
tration : 

Pj.- -Creosote (beechwood), six minims ; glycerine, one ounce ; 
whisky, two ounces. Mix, and use as directed. 

The daily amount of creosote prescribed by him for adults 
has varied usually from three to six minims, and continued 
frequently many months without increase or interruption, or 
any evidence of intolerance. 

The following inhalents he uses by means of the perforated 
zinc inhaler, to be worn during fifteen to twenty minutes every 
three hours, and from ten to twenty drops of the inhaling 
fluid, poured on the sponge of the inhaler three or four ^irnos 
during the day : 

Jl. — Iodoform, twenty-four grains; creosote, four minims; 
oil of eucalyptus, eight minims ; chloroform, forty-eight 
minims; alcohol and ether, of each half ounce — mix. 

9. — Etherial tincture of iodine and carbolic acid, of each 
two drachms; creosote, one drachm ; rectified spirits of wine, 
one ounce — mix. 

9;. — Creosote, one drachm ; alcohol, half ounce — mix. 

He says that he is convinced, from his experience, that we 
have in beechwood creosote a remedy of great value in the 
treatment of pulmonary phthisis, particularly during the first 
stage. Not only does it lessen or cause the cough to diminish, 
favorably change, and occasionally stop sputa, relieve dyspnoea 



i^- 



288 THE APPENEIX OF MEDICAL PAPERS. 

in very many instances ; it also often increases appetite, pro- 
motes nutrition, and arrests night sweats. It does not occasion 
hfemoptysis, and rarely canses disturbance of the stomach or 
bowels, except in cases in which it is given in too large doses. 
He says : "It is certainly an unobjectionable medicament from 
any point of view. It is easy of administration ; it is adapted 
to the majority of sufferers from pulmonary phthisis every- 
where ; it may be used with some advantage at all stages of 
this disease, even the most advanced, and in my experience it 
has proven itself superior to any other medicinal treatment 
with which I am familiar." 

Reuss does not hesitate to say that so high a percentage as 
nearly one-half of his cases, when taken in season — yet bearing 
the unequivocal symptoms of phthisis — are rendered cured, 
not relieved temporarily, but lapse of time, with disappearance 
of evidences, indicate a cure. 

Under the system of treatment which is now being exten- 
sively used, the disease runs a less rapid course, and recovery 
from it is far more frequent than was formerly the case. I 
can bear strong testimony to the value of the mode of treat- 
ment, which has of late years gained favor with the profession, 
as a most valuable adjunct to the treatment of phthisis, namely, 
the pneumatic cabinet. Many lives have undoubtedly been 
saved, and, in a still greater number of persons, life has been 
prolonged by this measure. Much, however, remains to be 
done, for as yet we can only confess to a small measure of suc- 
cess — a measure which, nevertheless, holds out hopes of greater 
success in the future. 

Direct medication in diseases of the air-passages is now 
attracting the attention of physicians, as a field to be worked 
with advantage. It is evident that much good might result 
from the judicious use of local applications to diseased surfaces, 
if these could be used with anything like the degree of defi- 
niteness that attends their employment elsewhere, and I be- 
lieve this can be done with the pneumatic cabinet as now em- 
ployed. 

Antiseptic inhalations is a valuable adjunct in the treatment 



TREA TMENT OP PULMONARY PHTHISIS. 289 

of phthisis, which of course most be combined with a judicious 
general treatment. Such treatment will, many times, relieve 
certain symptoms and cure certain structural diseases that stand 
in the way of the patient's recovery. 

Dr. Everett Smith, in his brochure on the pneumatic cabi- 
net, says : ^'The peculiar value of this treatment lies in the 
combination of the medicated spray with the increased strength 
of the respiratory movements, a much fuller expansion of the 
chest is produced than is possible by an ordinary full inspira- 
tion ; and at the same time the medicated spray being carried 
to the very deepest and most remote portions of the lungs with 
much greater force than by a natural inspiration, is deposited 
upon the bronchial tubes, even the smallest of them, as well 
as in cavities and inflamed portions of the lungs. 

''The materials, moreover, which have been found most use- 
ful as antiseptic inhalations, are not mere gases which are min- 
gled with the inspired air and then pass out with it,. but they 
are vapors of solid bodies which are deposited upon lung tissue. 
Upon every moist bronchial tube, upon the walls of cavities 
and around, if not within, the areas of inflammation, the inhaled 
vapor is condensed to render the soil barren for germ growth, 
to impregnate lung cells and bronchial mucous membranes with 
antiseptic material, which we know renders them less fitted for 
the cultivation of germs, so that finally we may be able to 
supply the vital activity which is lacking in these parts, and 
prevent the progress of disease. This treatment is especially 
good in the early stage of the disease, on account of its bene- 
cial effects upon chest capacity. It expands and strengthens 
not only the diseased, but even the healthy, although undevel- 
oped chest, and which is beneficial from a mere hygienic stand- 
point. Careful tests before and after a course of treatment, 
have demonstrated an increase in the capacity of the chest of 
from twenty-five to one hundred per cent, and a corresponding 
development both of chest measurement and chest expansion. 
This calisthenic exercise is not solely beneficial in developing 
the muscles of the chest walls ; but it is the mucous membrane 

19 



290 THE APPENDIX OF MEDICAL PAPERS, 

of the bronchial tubes and of the Inng-cells that is strength- 
ened and invigorated, while the Inng-cells themselves are ex- 
panded and stimulated into a more vigorous and healthful ac- 
tivity. 

'^The effect of the inhalations upon the cough and expectora- 
tion depends not only upon the progress that disease has made 
upon the lungs, but also upon the choice of remedies that are 
to be used. In nearly every case, however, there has been no- 
ticed a marked decrease of both of these symptoms, although 
at first the expectoration may be somewhat increased. This 
increase is due to the fact that the removal of the external 
pressure has caused such an expansion of air in the bronchial 
tubes as forcibly to expel secretions, which may have so ac- 
cumulated as seriously to impede the proper expansion of the 
air cells." 

These inhalations correct the viscidity and fetor of the ex- 
pectoration, adding very much to the patient's comfort, and 
improves his constitutional state. 

Good results are evidently obtained by the antiseptic action 
upon the diseased and suppurating surfaces ; but while great 
results have been gained, there seems to be but slight diminu- 
tion in the number of bacilli to be found in the sputa. 

The treatment gives good results in controlling the suppu- 
rative proce^es and in healing the diseased surface, so it must 
prove of value in the treatment of phthisis; even if it does not 
destroy the bacilli, it adds greatly to the comfort of our pa" 
tients and prolongs their lives, and is, therefore, a valuable 
acquisition in the treatment ; for any means of treatment which 
promises relief for such a terrible disease as phthisis is cer- 
tainly worthy of the fullest attention of the profession. It 
does not interfere with any of the medicinal and nutritive meas- 
ures that have proved already to be of value, but may be used 
only in connection with, and as an adjunct to these other meth- 
ods of treatment ; as such, it has taken a legitimate place in 
therapeutics, and claims a careful and unprejudiced trial and 
investigation. 

Dr. Holman S. Humphrey says : '^In consumption there is 



TREA TMENT OF PULMONAR Y PHTHISIS. • 291 

present, from the incipiency of the disease, a marked inability 
to receive a normal quantity of oxygen by respiration. This 
may be due to defective structure, nervous debility, confine- 
ment in ill-ventilated quarters, or to catarrhal disease of the 
mucous membrane of the air passages, in which the ciliated 
epithelium are impaired in activity and the bronchi loaded 
with mucous— thus preventing the normal quantity of oxygen 
from reaching the blood and tissues, the digestive and assimi- 
lative powers fail, followed by impaired circulation of the blood 
and mal-nutrition. The earliest defect in digestion is in the 
direction of fatty matters, for the reason that suflScient oxygen 
is not present to utilize them, as two hundred and ninety- 
five parts of oxygen are required for every one hundred parts 
of fat, and failure to get oxygen means want of power to digest 
fatty food, and a wasting of tissue must follow with all its 
attendant evils. 

^^This is not alone true of carbonaceous food, but of all foods, 
as the quantity of oxygen present determines the capacity to 
digest any and every kind of food known ; and the ^stuffing 
plan' of feeding the sick beyond their capacity to oxidize is a 
slow but certain method of poisoning them. Alimentary sub- 
stance is food when the forces stored therein are given to the 
body by oxidation, and not otherwise. This being true, it 
seems that the physician's first duty towards his patient suffer- 
ing with that class of malady, rendering a sufficiency of these 
elements impossible to obtain without artificial assistance, is to 
see that such assistance is promptly rendered by supplying in 
some manner the necessary running power so essential to the 
well being of each and every function in life." 

He supplies this deficiency by rectal injection of oxygen gas. 

It has been my experience with the pneumatic cabinet treat- 
ment, that patients to whom cod-liver oil had been intolerable, 
have taken it without difficulty when exhibited in conjunction 
with this special method of local treatment, proving that the 
increased amount of atmospheric air with its quota of oxygen 
was received to digest the oil. 

The Burgeon metbo4 of treatment, the rectal injection of 



292 THE APPENDIX OF MEDICAL PAPERS. 

carbonic acid, impregnated with sulphurated hydrogen, seems 
to have had undue value attached to it, and it is seldom of real 
benefit, though it may prove serviceable in occasional cases. 

Dr. Solis Cohen says 'Hhat he does not hesitate to express 
his opinion of its value as a therapeutic measure." 

Dr. Bruen says "that he considers the treatment chiefly val- 
uable in those cases of pulmonary diseases attended with 
bronchial catarrh." 

So that while the method can not be expected to fulfil the 
hopes which it first aroused, it is not to be regarded as worth- 
less. It seems to have some slight effect in checking the pro- 
fuse catarrh of the bronchial tubes, and thereby relieving 
somewhat the patient's cough. 

Surgical treatment of pulmonary cavities has lately received 
a good deal of attention. The intra-pulmonary injection of 
antiseptics into the cavity has been used to some extent with 
apparent success. In cases of phthisis, with localized cavities, 
direct opening into them has been practiced. With a bistoury 
an incision is made through the skin of half an inch or so 
in length at the most favorable point, and, with a galvano or 
thermo-cantqry instrument, this opening is extended down to 
the pulmonary cavity beneath. The object of using the cau- 
tery is to seal the blood vessels along the opening to prevent 
hemorrhage. A drainage tube is then inserted, and the cavity 
carefully treated by syringing at first with a warm solution of 
carbolic acid, or small quantity of salt and water. Afterwards 
astringents or stimulating solutions may be introduced, begin- 
ning with the milder ones, watching the effects, finally using a 
solution of iodine or permanganate of potassium. This mode 
of treatment has been practiced and ably advocated by Drs. 
Pepper and Eobinson, and their efforts have been attended 
with fair success in well selected cases, and seems promising 
enough to warrant further attempts, but it should be consid- 
ered too dangerous an operation to warrant general adoption. 



TREA TMENT OF PULMONAR Y PffTHISIS. 293 

Db. William Henby Abbrnethy. 

I cau not divest myself of the coDviction that consnmption 
is in some waj contagious — that it may be, and is sometimes 
commnnicated to the healthy by the diseased. Whether this 
is so by tubercular bacilli entering the alimentary canal or the 
respiratory tract and thus infecting the body, I do not know, 
but my limited observation is in support of that theory, for I 
have witnessed a number of instances of the non-consumptive 
contracting the disease after living and sleeping in the same 
apartment with a consumptive wife or husband. If it is 
finally settled that phthisis is in any sense contagions, then may 
we hope that preventive medicine will do much to lower its 
present high mortuary record. 

Another fact with regard to phthisis that deserves more 
than passing notice is its increased frequency among negroes. 
Forty years ago it was almost unknown with them, where, as 
now the percentage of cases is atleast double that of the whites; 
especially is this so in the malarial borders of the Alabama 
river. It is also more rapid in its course than in the white 
race, terminating usually in three to six months. Why it is 
that the negro is more susceptible of consumption since than 
he was before his emancipation is a grave and curious question. 
Some of the causes, I think, are bad food badly cooked, 
irregular habits of eating and sleeping, and insu£Scient and 
filthy clothing. To all these I may add his stormy emotional 
religious exercises (for he is a very religious being), and his 
sexual indulgence, which are inseparable habits, and amount 
to little less than continued debauch. The depravity of con- 
stitution resulting from all this renders him an easy prey to 
phthisis in whatever manner it may enter his body. 



Db. Edwabd Hekby Sholl. 

In the discussion of the paper on consumption by Dr. 
Gaines, Dr. Sholl asked the members of the Association to offer 
suggestions for the relief of a patient of his. The gentleman 



294 THE APPENDIX OF MEDICAL PAPERS. 

had tubercular laryngitis, and suffered intense pain in swallow- 
ing. So far all remedies had failed. Dr. Gaines then sug- 
gested the use of a cocaine spray.* (This, since that time, has 
been faithfully tried without any permanent benefit, but 
followed by a solution of twenty grains to the ounce of nitrate 
of silver, directly applied every other day, has afforded great 
relief.) 

A question had often risen in his mind of late years as to 
the cause of the greatly increased death rate among the strictly 
black population by consumption. His years of practice having 
bridged over from the time of the old regime, he was practi- 
cally enabled to see the great difference in thirty years ago and 
now. Then, on the large plantations where he practiced, a 
death by consumption was very rare; of late years the tables of 
vital statistics tell of a different state of things. Pulmonary 
diseases find many more victims. In fact, during one year of 
the years he was acting as assistant health officer of Sumter 
county, for Dr. R. D. Webb, the percentage of deaths among 
the negroes of the entire number was nearly one-half; forty- 
three per cent, by pneumonia alone. Now, it is a well known 
fact that the lung of the negro is smaller and weighs less than 
that of the white man. This was largely demonstrated by Dr. 
A. W. McDowell, at Benton Barracks, during the war, where 
he had remarkable opportunities for post-mortem investigations, 
as he had ten thousand of them under his care. This will 
account for the possibility of greater fatality in pulmonary 
troubles, but not for the great discrepancy in the rate. Nor 
can you find in the external surroundings a plausible explana- 
tion. Where, then, gentlemen, will you find the solution of 
this problem, with its startling figures? It is worthy of our 
most attentive consideration and careful investigation. 



Dr. Geo. W. MoDade. 

In 1882 I wrote Dr. J. Marion Sims the following letter: 
"It is very remarkable how few cases of secondary syphilis, 
scrofula and consumption existed in those days among the 



TREATMENT OF PULMONARY PHTHISIS. 296 

slaves, compared with what we now find. The two latter 
were then almost unknown among the negroes, bat since eman- 
cipation they are very common. 

^^Is secondary syphilis the parent of scrofula and consump- 
tion? Certainly these were rarely seen among the negroes 
while in slavery, whereas they are now encountered every day. 
Secondary syphilis was then less frequent among them than 
now, because their masters took every precaution for their 
early treatment and cure. But now they are free to contract 
this loathsome disease and to spread it as they may." 

Dr. Sims wrote : "Professor Samuel D. Gross read an ex- 
haustive paper on the connection between syphilis, scrofula 
and consumption before the American Medical Association in 
1875, advocating the view that the two latter were the offspring 
of syphilis. It would now appear from the history of these, 
in the negro, in slavery and in freedom, goes far to establish 
the correctness of the views so forcibly set forth by my dis- 
tinguished countryman." 

Dr. Gross was a firm believer in the doctrine that tubercular 
consumption is the offspring of syphilis. I am prepared to 
accept him as authority on this subject. 



Dr. John Popb Stewabt. 

I am glad this subject has been brought up. I have noticed 
the great ihcrease of this disease in the colored race, in both 
the young and old, as well as the middle aged ; and, like the 
several gentlemen who have preceded me, I am at a loss 
to know the cause. I have attributed it to many causes, and 
have found it difficult to prove. It is my opinion — and I base 
it upon the observation of a life time, having been bom and 
reared among them, my father being a slave owner— that it is 
due to their irregular life, I have no doubt. They are gre^at 
nocturnal ramblers, constantly exposing themselves to all kinds 
of weather night after night. Both sexes do this. I have em- 
ployed many servante, and it is with difficnlty that we can keep 
them awake and at work, because of this diposition to ramble 
about at night. I have known them to work hard all day and 



296 THE APPENDIX OF MEDICAL PAPERS. 

go five or six miles at night to a frolic, or "death watch," re- 
tarning late and getting only a short nap before they would 
have to go to work the next day. This will break the greatest 
constitation, and it is to this habit that I have at last attributed 
the cause of the increase of consumption in the negro. 

It can not be because they lack sufficient nutrition. The 
negroes in my section have plenty; they do not lack for clothmg, 
and are housed well. 

I have tried to find a taint of syphilis in some cases of con- 
sumption that have come under my observation, but have failed 
in not a few. So this can not be set up as the cause. Yet there 
is some definite reason, some subtle factor at work in this race 
of people that is bringing down upon them this dread destroyer, 
this incurable disease, consumption. I do hope that, at the 
next meeting of the Association, one or more gentlemen will 
come forward and throw more light on this subject ; for it is 
our duty to look after this people, as providence has placed 
them in our hands, and as they are mentally incapable of appre- 
ciating the danger with which they are threatened, or in work- 
ing out the cause or effecting a remedy. 



Db. William Camp Whbbler. 

In reference to the very able and well prepared paper just 
read by Dr. Gaines, I must say that I am somewhat surprised 
to note that he said nothing about consumption in the negro. 

Prior to the war, tuberculosis among the slaves was a very 
rare disease ; in fact, many of us never saw it at all then. Some 
fifteen years since it was evidently on the increase, and the per- 
centage has steadily grown larger year by year ever since. In 
fact, for the past few years in the northern part of this state, 
at least in some localities, almost half the deaths among the 
negroes are from consumption. 

Dr. Wall, the senior member of our county society, who has 
kept some statistics, told me recently that in his practice the 
death rate has increased fully seventy-five per cent within the 
last twenty years. I have collected no statistics, but there is 



TREATMENT OF PULMONARY PHTHISIS, 297 

one very noticeable fact in all negro consumptives — the marked 
progress of the disease and the rapid decline of all cases. I 
have never seen the disease stayed or arrested in a single case, 
and I have never known a negro to live exceeding two months 
after the establishment of the disease. The smallness of the 
chest, and the consequent reduced breathing capacity, far below 
that of the Caucassian race, may account for this ; but why so 
many more cases now, than years ago, is the problem I wish to 
see solved. 

Our profession yet stands, as it has for generations back, 
as the guardians of this helpless people in a sanitary sense ; 
and we are morally bound to investigate this scourge which is 
almost daily claiming its victims, and if possible avert the cause 
leading to such ravages. It may be, Mr. President, that the 
negroes in towns and cities are not so liable to this disease as 
in the country, but on this point I am not advised ; however, I 
deem the matter of sufficient importance to demand our atten- 
tion at once, and I would respectfully suggest that, before the 
close of our present session, the chair appoint two or three gen- 
tlemen, whose duty it shall be to gather such data and facts as 
may be obtainable, and report thereon at the next session of 
this Association. 



Dr. Angelo Festobazzi. 

One point against which we must battle is fever, and for this 
purpose I think sulphate of quinine the most reliable of all 
antipyretics; but with this, perfect rest must be enforced. 
One- tenth of a grain of morphine increases its power and acts 
charmingly. Aconite, gelseminnm and veratrum are objection- 
able to me on account of their bad effects on the digestive or- 
gans. Cod-liver oil pure, or combined with the hypophos- 
phites, in my opinion is indispensable in certain stages. I agree 
with Dr. Oaines in stating that cough mixtures are more inju- 
rious than beneficial, because the opium in them only gives 
temporary relief. I prefer the administration of stramonium 
and belladonna to opium in cases where symptoms become suf- 
ficiently distressing to demand relief. 



298 THE APPENDIX OP MEDICAL PAPERS. 

I have noticed in the wards of Charity Hospital, BlackwelPs 
Island, N. Y., that when a stimulant expectorant is demanded a 
mixture containing carbonate of ammonia in the infusion of 
wild cherry acts nicely. It is one of my pet prescriptions now, 
because it docs not nauseate. For the hemoptysis I find tur- 
pentine and argotin indispensable. Raw scraped beef in the 
shape of sandwiches, as the doctor states, is the most nutritious 
food that can be given. I am no believer in the anti- 
septic treatment of phthisis. The phthisical patient can never 
imbibe too much fresh air. His apartments must be large and 
airy. 

For night sweats I find atropia the most effectual, although 
I 'find oxide of zinc, gallic or sulphuric acid and arsenate of 
iron useful. Change of climate should always be enforced to 
those who will not suffer financially, and should go to a mild 
and temperate climate. In this country, California is very 
good. 



Db. Adam A. McKittriok. 

It is notorious that since the rebellion many negroes have 
died of a disease resembling phthisis. Prior to the iVar it was 
not known to occur, and I am not now prepared to give an 
opinion of the etiology, but hope to obtain more data in the 
future and write something definite about it. From the his- 
tory of the cases observed, I am not inclined to attribute its 
origin to syphylis. 



DYSMENORRHCEA ; ITS CAUSE AND TREATMENT. 299 



DYSMENORRHCEA; ITS CAUSE AND TREATMENT. 



BY EDWARD POWELL RIGGS, M. D., BIRMINGHAM, ALA., 
Member of the Medical ARsociation of the State of Alabama. 



9 



That we may properly nnderstand the natare of this painfnl 
affection, and as preparatory to its successf al treatment, it be- 
comes expedient that we briefly survey the physiological phe- 
nomena of normal menstruation. In every child-bearing, 
healthy female, the nterns becomes the seat of periodically re- 
curring functional disturbance. 

For the space of a week preceding the catamenial epoch 
there is an increase in the quantity of blood in the venous 
sinuses of the pelvis. This vascular tension gradually increases 
until the drain from the uterus is established. Under the influ- 
ence of this hypersemia, the uterus and tubes undergo a true 
erection. The volume of the uterus increases to such an ex- 
tent that it can be easily felt through the walls of the abdomen ; 
its flbres become redder, softer, and more spongy, the cervix 
softens, enlarges, and seems to lengthen, and is more easily 
reached by the finger of the investigator. Its color changes to 
a dark purple. The os opens to permit the discharge from 
the body of the uterus. 

The mucous lining of the body of the womb thickens and be- 
comes folded and mammillated, its color changes into a reddish 
brown. The glands show marked enlargement and their 
secretion is abundantly increased; the sub-epithelial vascular 
net work becomes apparent and surrounds the enlarged orifice 
of the glands, thus giving a porous appearance to the inside of 
the womb. The epithilial covering soon loosens and the 
capillaries, now deprived of their support, yield to the pressure 
of the blood, and rupture in innumerable small crevices in a 



300 THE APPBNEIX OF MEDICAL PAPERS. 

manner that might be fitly compared to the barsting of the 
pitaitary body in epistaxis. Through these microscopical 
openings the blood passes into the cavity of the uterns. 

In addition to the peculiar anatomical arrangement of the 
veins of the female pelvis, which favors the stasis of the blood, it 
has been shown that these vessels, along with the ovaries, tubes 
and uterus, is supplied with a system of muscular fibers 
which, under the influence of the ovarian nisus, contract, and 
comprising the venous sinuses retard the flow of blood. The 
stasis in the uterine tissues increase the capillary tension, causing 
them to rupture, and hence the appearance of the menstrual 
flow. 

It has been generally determined that the mucous lining of 
the body of the uterus is the source of the hemorrhage. The 
votaries of the denudation theory allege that every menstrual 
period is anticipated by a fatty degeneration of the mucous 
membrane; blood is extra visated into its substance, the whole 
disintergrates, exfoliates, and is washed away with the discharge 
and a new membrane generated by the inner layer of the 
muscular lining. If the mucous membrane is cast off with 
each flow, it must be capable of completing the cycle of dis- 
integration, exfoliation and re-integration in an incredible 
space of time. 

There are many menstrual irregularities which preclude 
the acceptance of such an hypothesis. Until quite recently 
the theory of ovulation being the determining cause of men- 
struation was accepted as classical doctrine; but since menstru- 
ation has been found to continue with regularity in many cases 
after complete removal of both ovaries, the correlation between 
ovulation and menstruation has been denied by some writers. 
Cases have been cited where there was a congenital absence 
of the uterus with the ovaries intact; there was ovulation and 
corpus luteum; also, cases of married women who became preg- 
nant before the climax of sextual development had occurred, 
and continued to bear children without the appearance of men- 
struation, and the rarest cases of conception after the menopause. 
These facts are indisputable, and warrant the conclusion that 



DYSMENORRHCEA ; ITS CAUSE AND TREATMENT. 301 

ovniation and menstruation may occnr independent of each 
other; but, admitting these inferences to be true, does it prove 
that the Graafian folicle is not the starting point of menstrna- 
tion? It has been wisely said that ''habit is the memory 
of the body." We know how difficult it is, even by the 
force of our will, to quit a custom that has once become estab- 
lished. Therefore it is quite conceivable that an organ formed 
by nature and disciplined by habit, may continue for a time to 
perform after its function and source of stimulation has 
been removed. The ovaries are not infrequently found well 
developed when the uterus was rudimentary or absent. But 
the uterus is never fully matured when the ovaries are absent or 
rudimentary. Again, if from any cause the ovaries atrcfpAy^ the 
uterus likewise deteriorates in size and structure. It has also been 
definitely settled that menstrual life does not begin until the 
ovaries have attained their final and complete development; 
until their growth has advanced as far as the vital force of the 
individual will permit. Those instances of conception without 
menstruation might be explained by the possibility of a follicle 
rupturing at a time when some condition of the nervous 
system would prevent the reflex phenomina of menstruation. 
Those cases that are constantly pregnant or nursing have no 
need of or time for menstruation. In these cases the uterus is 
kept functionally active and its structural integrity is main- 
tained by pregnancy and the degenerative changes after labor. 
Lawson Tait, who is a pronounced skeptic on the ovular 
theory, now maintains that it is the tube and not the ovary 
that influences the flow. He alleges that it is the effort of the 
tubes to grasp the ovary, but adduces no reason for such action 
in the tubes. There is good reason for believing that the 
tubes are active about the time of menstruation ; but that they 
are not the prime factors, we think has been satisfactorily estab- 
lished. Mr. Tait strikes the key-note when he says that men- 
struation is under the control of some special nerve centre, 
situated high up in the cord. There is but little doubt that 
this function is presided over by some centre that is excited 
into action by an apparent impulse generated by the stimulous 



802 THE APPENDIX OF MEDICAL PAPERS. 

of the enlarged OraafiaD follicle. This fact is exemplified by 
the infln^nces that mental emotions exert over this as over 
the functions of other organs of the body. It is not nnusnal 
to observe the flow delayed for a time or suppressed when 
established by any canse that excites the emotions. This infla- 
ence is probably exerted by some molecular change in the 
arrangement of the nerve cells, which interferes with the reflex 
eqnillibrium of the centres, and hence it fails to respond to the 
impress conveyed to it from the ovary. It is not diflScnlt to 
believe that the stimulus of an enlarged Graafian follicle may 
excite vascular changes in the uterus just as the presence of 
food in the stomach produces those vascular and nutritive 
changes in the salivary glands and pancreas that constitute 
the secretion. 

The purpose of menstruation is still conjectural. It is 
nature's unalterable law that inaction in organic structures 
wilU in time, lead to atrophy and decay. Therefore, it is most 
probable that those changes which occur in the uterus during 
menstruation is intended to compensate for the want of use that 
civilization necessarily produces. It seems to conserve the 
structural integrity of the womb and keeps it in a proper 
condition to receive and nourish the impregnated ovule. 

It is a peculiarity of the organs of the human body that 
when normal they perform their functions without pain. 
Structural integrity and functional activity proceed together, 
go hand in hand. The uterus is no exception to this rule. 
We have seen that the catamenial flow is caused by changes 
that take place in the mucous lining of the uterus, so when 
the epoch is attended with pain its cause is to be sought in the 
endometrium and its underlying tissues. In a large majority of 
cases the pain is induced by spasms of the muscles of the 
uterus, brought on by a hyperesthetic condition of the endo- 
metrium, which is the result of an incomplete development of 
the organ from defective nutrition. 

I do not include, under the term dysmenorrhoBa, those cases 
of pelvic pain that have progressively grown worse for several 



DYSMENORRH(EA ; ITS CAUSE AND TREATMENT. 803 

days preceding the flow, and almost entirely disappearing when 
the discharge is well established. The pain in snch cases is 
evidently the result of pressure from vascular engorgement 
on some diseased peri-uterine tissue, and is relieved as soon as 
the drain from the uterus removes the tension of the blood 
vessels. 

Diseases of the tubes and ovary may unmistakeably be asso- 
ciated with dysmenorrhoea, and structural changes in either 
tube or ovary may produce pathological changes in the endome- 
trium that will ultimately result in dysmenorrhcea. I am of 
the conviction, however, that dysmenorrhcea, properly speak- 
ing, can not be caused by diseases of the appendages, inde- 
pendent of some abnormal condition of the uterus. It is pos- 
sible that cases with some pathological condition outside of the 
womb may suffer with this malady, but the searching scrutiny 
of a careful analysis will, in most instances, disclose some con- 
dition of the uterus that will explain the pain. 

It is worthy of observation that a large proportion of the 
worst cases of dysmenorrhcea occur in young women during 
sexual development, and is especially common among those 
who impose upon themselves, or have imposed upon them, the 
intellectual strain of overtaxing mental exertion. These cases 
consume their vital force in developing their intellects at a time 
when the sexual organs make the greatest demands for proper 
nutrition. 

It is not uncommon to see girls enter puberty in blooming 
health, without an ache or a pain, overtask themselves at school, 
and their health soon begins to fail ; they lose their appetite, 
look pale and ansemic, and become an easy prey to emotional 
disturbances. Her menses, hitherto painless, now begin to 
worry her, and unless promptly relieved, she soon becomes the 
victim of the most obstinate type of dysmenorrhcea. 

The proper interpretation of these cases is, that the vital 
force of the economy is exhausted by intellectual overwork. 
The sexual organs being last to develop, bear the brunt of the 
disturbance, consequently they are the first to yield when the 
nutrition of the body is impoverished. The uterus not receiv- 



304 THE APPENDIX OF MEDICAL PAPERS. 

ing sufficient natriment, becomes highly sensitive and irritable, 
the afflux of blood produces reflex irritation and causes spasms 
of the uterus ; hence the pain. Any cause, either local or con- 
stitutional, that interferes with the nutrition of the uterus may 
indirectly cause dysmenorrhoea. 

There is an abundance of evidence to show the greater preva- 
lence of dysmenorrhoea among the higher classes than among 
the lower ; indeed, it is very unusual to observe a case of dys- 
menorrhoea among the southern laborers. This is wholly due 
to the environments of the lower classes, which render them 
comparatively exempt from those influences that tend to depress 
the vital powers. 

The upper classes are compelled by custom to lead passive 
and indolent lives ; these habits retard the development of the 
sexual organs and produces a condition of the nervous system 
that is highly productive of the neuroses, of which hyperses- 
thesia of the endometrium is a manifestation. 

I am not in accord with those who believe that obstruction 
by stenosis, flexion or conical cervix, is a direct cause of men- 
struation. The blood normally does not pour, but oozes drop 
by drop from the walls of the uterus ; and hence it is difficult 
to conceive that such a contraction of the cervical canal as will 
not permit of the escape of this small quantity of fluid can 
often exist. Again, it is a significant fact that the flow gener- 
ally bears an inverse relation to the amount of pain ; in many 
cases the pain is excruciating when only a few drops of fluid 
is passed. Instances are not wanting where the cervical canal 
was well nigh totally occluded from caustic applications, and yet 
we do not often flnd painful menstruation the result of this 
condition. 

From the scantiness of the discharge, it is reasonable to sup- 
pose that the obstruction occurs in the endometrium and the 
underlying walls of the uterus, and may be due to the firmness 
and rigidity of imperfect development, or spasm of the mus- 
cular walls may prohibit the capillary oozing that naturally 
takes place. Stricture of the cervical canal may produce reflex 
irritation in the uterus, just as strictures of the urethra will ex- 
cite irritation in the bladder and kidneys. 



DY8MEN0RRHCEA ; ITS CAUSE AND TREATMENT. 305 

DjsmenorrhcBa is important because of its frequency, and 
because it is not relegated to the domain of gynecology alone, 
but comes not infrequently under the care of the general prac- 
titioner. 

There are many young females afflicted with this malady, 
whose future happiness hangs upon slender threads that may 
be rudely broken by careless hands, or gently gathered up by 
intelligent and careful management at the proper time. 

It is a vulgar error to suppose that this ailment in the girl 
will invariably cease when full maturity has been attained and 
the highest functions of the sexual organs are brought into 
play. We do not deny that conception and labor will, in some 
instances, bring about this desirable result. But there is far 
greater reason to fear that the girl who suffers from dysmenor- 
rhcea will have her pain greatly intensified after marriage. 

It should be remembered that an organ that performs its 
functions with difficulty is, from that fact, predisposed to struc- 
tural deterioration ; consequently these cases do not often con- 
ceive. The same condition of the uterus that produces the 
hypersesthesia likewise determines the subsequent sterility. 

Should these cases, however, become pregnant, the extreme 
sensitiveness of their sexual organs render them very liable to 
abort. If the ovum is carried to the full term, their preg- 
nancy and labor will be attended with far more than the usual 
amount of suffering. 

Again : there is always great danger of the attacks becom- 
ing habitual, jeopardizing the patient's health and rendering 
future life miserable. Therefore, it will be conceived how co- 
gent the reasons are for treating dysmenorrhcea with greater 
care than at first seems necessary. When called to a case dur- 
ing the paroxyism, our first duty is to alleviate pain. Of the 
remedies at our command for this purpose, opium is of course 
the most potent ; but there are many objections to its use. It 
deranges the digestive organs, and leaves very unpleasant 
sensations about the head in nearly all cases. The most 
serioQS objection to its use, however, is the extreme dan- 
20 



306 THE APPENDIX OF MEDICAL PAPERS. 

ger of fostering the opiam habit. A patient who has once 
drowned her snfiering with this drug is feebly able to resist the 
imperious cravings induced by its use, and throwing herself 
into the same treacherous oblivion on each return of the pain, 
she soon loses the precious gift of self-control, and pursues a 
course that almost infallibly ends in moral annihilation — 
compared with which, the original malady dwindles into 
insignificance. Opium should, for these reasons, be excluded, 
except in those cases of extreme pain, where immediate relief 
is imperatively demanded, and where other remedies have been 
tried and found inefficacious; even then I would strongly 
advise that the question be well weighed, whether it is not 
better to allow the pain some latitude than to relieve it at the 
risk of destroying the patient's inherent power of resisting a 
recourse to opium as a domestic remedy for the relief of dys- 
menorrhcea. Antipyrine has been found to possess marked value 
for the relief of pain in dysmenorrhoea. I have used it in 
some cases and believe it justly merits a high rank as a remedy 
in the treatment of this affection. The fact that it in no way 
disturbs the digestive functions, and that it leaves no disagree- 
able after results, render it far preferable to any of the nar- 
cotics. It may be given in 12^ grain doses, combined with 
pot. bromide, and repeated every hour until three doses 
have been given. It will rarely, if ever, be found necessary 
to give the third dose. Given in this manner it is devoid of 
danger, and is invaluable for mitigating pain. 

The cure of dysmenorrhoea is to be accomplished by judi- 
cious treatment during the interval of menstruation. 

If we are correct in assuming that dysmenorrhoea is chiefly 
due to the higher aesthetic condition of the endometrium, asso- 
ciated with spasms of the muscles and walls of the uterus, and 
that this condition is the result of imperfect development, or 
of degeneration and atrophy, from local disease, the indication 
for treatment is made plain. We should make careful inquiry 
into the history, from the time that sexual life began, especially 
as to her mode of life and mental strain since that time ; we 
should attempt to repair any constitutional invasion by enforc^ 



; 



DYSMENORRHCEA ; ITS CAUSE AND TREATMENT. 307 

iDg a strict obedience to the laws of hygiene. If the faulty 
natritive is due to mental overwork at school, she should be 
required to leave off her studies and spend her time among 
cheerful and healthy associates, spending a few hours every 
day in the open air, exposed to the rays of the sun. If she is 
ansBmic, iron and strychnia, with the hypophosphites may be 
given. If constipated, some of tl\e bitter mineral waters may 
be ordered. A glass of Hunyadi or Carlsbad taken before 
breakfast will produce one or two evacuations in most 
instances. 

If this plan of general treatment, after a fair trial, fails to 
steadily improve the patient and lessen the pain, it becomes 
necessary to make a vaginal examination. The vagina may be ^ 
so contracted and sensitive as to necessitate an anesthetic for 
an examination even with one finger. It is wise to thoroughly 
expand the vagina, while the patient is under the influence of 
an anesthetic, so as to lessen the pain of subsequent treatment. 

In typical cases of dysmenorrhoea the cervix will be found 
contracted, inelastic and very sensitive. Any attempt to pass 
an instrument into the cavity of the uterus will be attended 
with intense pain, not unlike that of dysmenorrhcea. Hot 
water vaginal douches used night and morning will, in the 
course of a few weeks, lessen the sensitiveness, soften the cer- 
vix and improve the circulation of the sexual organs. After 
the preparatory treatment, and satisfying ourselves that no peri- 
uterine inflammation exists, we may proceed to dilate the cervi- 
cal canal. This operation cures dysmenorrhoea in a manner 
widely different from the generally accepted theory. It does 
not act as is commonly supposed, by merely opening the canal 
for the escape of the menstrual fluid, but affords relief by 
overstretching the tissues about the neck of the womb, para- 
lyzing the muscles and thus preventing spasm; just as ex- 
panding the sphincter ani will relieve the spasms caused by 
a fissure, or a forcible striding of the ostium vaginse, will cure 
vaginismus. 

The success of the operation depends upon the thoroughness 
with whiqb tbe os internum is dilated. . The operation should 



308 THE APPENDIX OF MEDICAL PAPERS. 

always be performed with the patient under the inflnence of 
an anesthetic, and mast be carried to the point of overstretch- 
ing to accomplish the desired results. The rigid condition of 
the cervix renders it very difficalt to pass the dilator into the 
nterns, bnt by inserting the instrument as far as it will go 
without force, holding the organ steady with a self- retaining 
tenaculum, and pressing the blades slightly open, the canal 
above will yield so that the instrument can be closed and 
passed further up. By repeating this manoeuvre the blades 
can be carried by the inner os with comparative ease. When 
the instrument is in a proper position the blades should be 
made to expand by gradually turning the thumb screw at the 
handle so as to stretch and not tear the tissues of the cervix. 
It is best to operate at the patient's house, and it is important 
that she should be required to remain perfectly quiet in bed 
for forty-eight hours after the operation, in order to avoid any 
inflammation that might be set up. If proper precautions are 
taken the operation is comparatively devoid of danger. Dr. 
Goodell states that he has performed it quite a number of 
times without a single evil result. 

To bum up the points that I wish to emphasize in this brief 
presentation of my subject are, that the immediate cause of 
dysmenorrhoea is spasm of the uterus, induced by the press- 
ure of vascular engorgement on a hyperesthetic endometrium; 
that hyperesthesia is the result of incomplete development or 
deterioration from local or constitutional disease, and that if 
proper attention to the general health fails to give relief in 
reasonable space of time, the cervix should be fully and 
thoroughly dilated. 



DENTITION. 309 



DENTITION. 



BY WILLIAM CAMP WHEELER, OF CHEROKEE. 
Junior Counsellor of the Medical Association of the State of Alabama. 



Of the Bnbject nnder consideratioD, I shall have nothing to 
say regarding its anatomical or physiological aspect ; these, as 
practitioners, concern ns least. I will further declare, in the 
ontset, that the object of this paper is not so much to intro- 
duce to the profession new and potent remedies to meet the 
ills of dentition as to attract the attention and arouse the con- 
science of the profession to a higher claim than in many 
instances these little sufferers are wont to engage. 

In the short period of dentition, which does not comprise 
more than one sixteenth of the average human life, we find 
the startling fact, according to the most accurate statistics 
obtainable, that folly one-half the deaths occnr. 

In this age of advanced thought, of wonderful scientific 
achievements, of purer morals, and with all the facilities for 
cheaper and more comfortable living, many will ask, is not 
the death rate among children decreasmg? We answer not so, 
bat rather on the increase. 

The period of dentition has always been regarded (and 
justly so,) as a very critical time in the history of every child, 
and a time when the child's health is more easily affected or 
impaired than any other. 

The very delicate mncns and follicalar lining of the stomach 
and intestines of the young child, while yet in a state of rapid 
growth and development, is very impressible, and highly sus- 
ceptible to the influences of irritation and the varying changes 
of heat and cold. The rapid development, j?er ««, is a fruitful 
source of many difficulties ; and these are further intensified by 



310 TItE APPENDIX OF MEDICAL PAPERS. 

the wonderf al sympathy existing between the skin and bowels. 
And in its entire organism nothing can possibly play a more 
important part than the nervous system, which is more impres- 
sible in the young child for the first three years than at any 
time thereafter. And it is a common practice among mothers 
and narses, and, I reget to say, many practitioners too, who 
attribute almost every ailment at this period to the child's 
teething. This amounts, on the one hand, to a matter of habit ; 
and on the other, to a gross and unpardonable negligence. The 
early management of children has much to do with their health 
during the evolution of their milk teeth ; and to this end they 
should be clad in good flannels, and these should not be removed 
in summer, nor until after the expiration of the third year. If 
you would preserve the integrity of the bowels, and thereby 
prepare the child well for the first and second summers, never 
feed it except in cases of actual necessity ; and only then, after 
having ascertained what is best adapted to its special case. In 
the matter of feeding, and in the articles of diet, many mothers 
and nuraes commit grievous mistakes, and as a rule the profes- 
sion regards too lightly this very important feature. The de- 
mands of fashion, impelled by foolish pride, has sent many 
thousands of sweet little innocents to the nursery, there to draw 
a vicious sustenance from the nursing bottle, and ultimately 
sicken and die, that could have been kept healthy and strong at 
the maternal breast. God speed the day when all mothers shall 
realize the importance, the completeness of their mission. No 
substitute has yet been discovered or manufactured that com- 
pares favorably with the mother's milk as a food for children, 
and, according to the Divine order of things, there never will 
be. The best general food, in the absence of maternal support, 
is the milk of a healthy young cow; and to secure the best and 
most uniform results she should be kept on an enclosed pas- 
ture, fed regularly on sound wholesome food, and milked three 
times daily. Meal, hay and a few of the best grasses should 
constitute her entire food. The milk from cows roaming at 
large on the commons and devouring all manner of vegetation 
should never be given to young children. It often becomes 
objectionable and even disagreeable to adults. 



DENTITION. 311 

As those children are healthier and thrive best who receive 
their sustenance from maternal source, so should those being 
fed receive the milk from the same cow daily. Frequent 
changes in diet always work to the detriment of the child, and 
this is one great reason why so many children are unhealthy 
who are fed mainly on cow's milk ; and this is especially ap- 
plicable to children reared in towns and cities. 

Observation teaches that but few mothers give buttermilk to 
young children, and yet with many it is the most wholesome 
and agreeable diet they can take. By way of parenthesis, I will 
add that one of the most vigorous and healthy children in the 
family of the writer was raised almost exclusively on butter- 
milk. And in this connection I make the assertion, without 
fear of a successful contradiction, that during early life, and 
during dentition especially, when there is present a greater or 
less degree of pyrexia, that nine children out of every ten are 
fed too often and too much. In this particular there is great 
need of reformation. 

The fact that thousands of children are annually cast off by 
their mothers to obtain sustenance from other and more haz- 
ardous sources, has led to a wholesale and very extensive man- 
ufacture of divers kinds of infant foods, the most of which 
only merit condemnation. While some of these preparations 
possess more or less merit, yet, until we obtain more satisfac- 
tory results from this class of foods, the profession should be 
very slow in giving them endorsement. 

Of all the ills incident to dentition, pyrexia is the most com- 
mon; in fact, its absence is a grand exception to the rule. 
This ranges from 99^ to about 104^, and in its milder type, 
having its origin in irritation alone, needs no special attention ; 
but when the mercury registers 102° or more, we are advised 
it is time for some remedial interference ; and to meet this, 
chemistry has given us no better or more reliable agent than 
antipyrine. It is probably to be preferred to antifebrine, for 
the reason that it is more easily administered, and possesses de- 
cidedly greater anodyne properties — a desideratum in most 
teething children. In point of frequency probably no other 



312 THE APPENDIX OF MEDICAL PAPERS. 

complication in dentition is so common as diarrhoea and vom- 
iting ; in fact, very few children get through this trying ordeal 
without these in greater or less degree. These may be induced 
by many causes, viz : diet, change of clothing, catarrh, etc., 
but the most fruitful source is irritation and sympathy. 

All will agree that organs so closely related in their physio- 
logical action as the mouth, stomach and bowels, may be, and 
are usually sympathetically disturbed in pathological condi- 
tions ; and no condition of the entire organism more clearly 
illustrates this than a teething child. By this irritation, and 
sympathy by continuity, the stomach fails to convert the in- 
gesta into healthful chyme, often rejecting it altogether; the 
liver fails in its office both as to quality and quantity for a per- 
fect chylification, and the bowels with this morbific condition 
can not possibly remain in a normal condition* When much 
difficulty exists, and the gums become tense and full, lance 
them, and do it freely ; go down through the gum proper, and 
be sure to cut through the dens ligamentum. This will always 
afford some relief, and if the tooth does not follow promptly, 
do not hesitate to cut again, and even the third time. A few 
drops of blood from the gum and the incision of the ligament 
will always eventuate in some comfort, and the idea of a tough 
cicatrix advocated by some is only imaginary. I am aware 
that many of our latter-day disciples of Escnlapius take bold 
ground against this procedure, but I have yet to see the first 
case where free incisions have proven detrimental ; but on the 
other hand have seen indubitable evidence of great good — even 
to the relieving of convulsions, with the lancet alone. 

For the bicuspids and molars, I make the crucial incision. 
By some this is opposed, under the plea that "it is ancient, old 
fogy, and not practiced by the medical gentlemen of today;" 
but — 

''Old customs, oh 1 1 love tlie sound, 
However simple they may be ; 
Whatever with time hath sanction found. 
Is welcome, and is dear to me." 

In the diarrhoea of children teething, no medicine is of so 



DENTITION. 313 

mnch value as mercury. It should be given as an alterative 
and always in very minute doses ; never give more than one- 
sixth and frequently as little as one twenty-fourth gr. of the sub- 
chloride as a potion, and at intervals of about £hree hours, till its 
alterative effect is manifest, when generally most of the difficul- 
ties for the time will disappear. With a good normal hepatic se- 
cretion, little trouble will remain to be overcome in the manage- 
ment of the case. In this connection the bichloride of mer- 
cury is one of our best agents, and deserves a prominent place 
in this class of remedies. I give from one-sixtieth to one-one 
hundred and sixtieth gr. dissolved in water ; this is a fine cor- 
rective, and can be given for days, if necessary, without deplet- 
ing your patient. With proper dietetic measures nine cases 
out of every ten will need little or no medicines after securing 
the alterative effect of either of these remedies. 

For voniiting, with little children, I have never found any- 
thing superior to the above in addition to lime-water and pep- 
sin ; and of the many forms of the latter I prefer the saccha- 
rated. 

Where children suffer long, or the mucus coat becomes 
involved either by engorgement or inflammation, we have an 
annoying and often grave form of bowel trouble, and for this, 
above all others, I prefer creosote, fluid extract ergot and 
McMunn's elixir ; the latter I regard as the best opiate for 
children, for obvious reasons. Astringents, without a due 
regard to alteratives and correctives, amount to little worse 
than no medication. 

Most of us are given to ascribing the neuroses of little 
children to their teething, and, doubtless, in so doing, some- 
times commit great blunders. A careful investigation of the 
spine, a rigid examination of the genitalia, and a correct 
information as to idiosyncracies, syphilization, etc., might 
sometimes save our little patients from death and ourselves of 
many regrets. Countless numbers of little children suffer, 
and often unto death, by the neglect of mothers in duly caring, 
for the genitalia. Much of this arises from a want of proper 
knowledge of this important duty, and to this end almost 



314 TffE APPENDIX OF MEDICAL PAPERS. 

every physician has opportnnities for rendering valuable 
advice. 

Cutaneous eruptions are very freqaent complications in 
dentition, and, while I would not favor them, yet seldom 
attempt to cure them until dentition is accomplished. The late 
Dr. Parrish generally regarded ornptions, especially eczematous 
sores, aB a salutary process, and insisted on favoring rather than 
discouraging them ; and in many obstinate cases, he would 
even imitate this by blisters. 

It is an undisputed and settled fact that, daring dentition, 
all other diseases assume a more scrioas aspect, and at this 
period cerebral complications are far more frequent than at 
any other period of life. We must remember that many com- 
plications may arise during this period that are often entirely 
independent of any connection whatever with the evolution 
of the teeth. In many instances children could be saved much 
annoyance and unpleasantness by administering the remedies 
indicated to the mother ; this very easy method is too often 
disregarded or overlooked, and in some cases it seems really to 
be the most effectual of all means. 

Another method, which is very desirable in many cases, is 
bat seldom resorted to — I refer to external applications. 
When we consider the delicate structure of the derma, and the 
activity of the absorbents at this age, we are assured the prompt 
and rapid application of many remedial agents. For general 
debility, and especially if the case have chronic intermittent 
fever, I know nothing superior to a flannel jacket containing 
pulverized camphor and powdered cinchona. I have seen 
this prove effectual in a short time where the patient had been 
steadily declining under remedies given per orem. 

Now Mr. President, and fellow-practitioners, before closing 
this very imperfect paper, I beg to call your attention to one 
matter especially. As a rule, we devote too little time and 
study to our small patients, and particularly if we consider 
them teething. If we have but a given time for a specific 
number of cases, in the name of suffering humanity give an 
equitable portion of it to the little children ; to those who 



DENTITION, 315 

have not even one word to express their desires ; to those who 
can by no means locate their affliction ; to those who are dnmb 
to every emotion ; to those whoso future lies ont before them 
and who may reward yonr snccessfnl efforts by years of use- 
fulness and honor ; and, finally, to those whose mute helpless- 
ness can not protest against yonr neglect or indifference. 

On this line we might learn a grand lesson from the example 
of our Divine Lord, who, when he would restore the adult, 
laid his hands on him or spake, and he was made whole; but 
when the little children were brought into his presence, he 
took them in his arms, pressed them to his warm, sympathic 
heart and blessed them. 

Gentlemen, we must cultivate the children ; we must study 
how to win them to us, and thereby gain their love and confi- 
dence. Each child's case needs to be studied as critically as 
that of its father or mother, and every practitioner of medicine 
who is true to his calling, will feel this important duty devolv- 
ing upon him. Wo are too apt to judge the value of our pro- 
fessional work by the status of our patient, and the renown 
which rewards and crowns our successful efforts. 

Dr. McKenzie opening the larynx of the Emperor Frederic, 
while all Europe and the world awaited with anxious solicitude 
the result ; Sir Henry Thompson thrusting a scalpel into the 
bladder of Napoleon III ; Dr. Bliss searching for the missing 
bullet of the assassin Guiteau, are striking and dramatic figures, 
and well deserve the keen and eager interest and attention 
which clings to their evecj act in connection with their illus- ' 
trions patients; but who can say that the painstaking practi- 
tioner who brought William of Orange through a dentition so 
perilous that the life of the breathing skeleton was wholly 
despaired of ; or that the able and conscientious physician who 
nursed Alexander Stephens through the ills of childhood, 
keeping alive the vital spark in his frail anatomy, has not done 
as great a work for hnmanity ae those renowned physicians 
whose professional skill was exhibited in the '^glare and fierce 
light which beats upon a throne ?" True, it is, no hourly bul- 
letins proclaimed to the world the varying conditions of their 



316 THE APPENDIX OF MEDICAL PAPERS. 

little patients ; no eager mnltitndes read with anxioas hope or 
fear their gaarded reports ; no enterprising reporters haunted 
the street corners, eager to catch a harried interview. They 
worked in comparative obscurity, and nnrsed the tender germ 
of life and greatness in its feeble tenement ; they had not the 
prompt applause of nations to stimulate and reward them ; 
their humanity and devotion to professional duty (coupled 
with profound sagacity) prompted them to bestow upon the 
little sufferers committed to their care that intelligent attention 
which those who strive for the world's recognition alone might 
wholly fail to give. No man can be truly great in his pro- 
fession who "dances attendance'^ at the gates of power and 
neglects the cry of suffering innocence and weakness. The 
pathology of the peasant's child demands your attention as 
sternly as the ruler's indisposition. I would gladly impress 
upon every practitioner of medicine the inexorable demands 
upon him by that class of his patients whose present helpless- 
ness and future promise constitute their greatest claim. The 
physician who devotes a fair share of his time and talents to 
the wants of his little patients, has the pleasing assurance that 
he is accomplishing more far-reaching good than if his practice 
were confined to jurists, statesmen or rulers. 



THE RADICAL CURE OF HERNIA. 317 



RECENT ADVANCES IN THE RADICAL CUR5 OF 

HERNIA. 



BY BENJAMIN LEON WYMAN, M. D., OF BIRMINGHAM, ALA., 
Member of the Medical Association of the State of Alabama. 



DISOUSSED BY 

Dr. John D. S. Davis, of Birmingham, Ala. 



There has been so much writteD daring tlie past two years 
npon the operative treatment of hernia, and the remarkable 
success which has followed the methods proposed by Czerny, 
Michell, Banks, McEwen, McBurney and others, that I have 
thought it might not prove uninteresting for us to take a short 
review of some of the reeent advances in this department of 
operative surgery. When I consider the various procedures 
which have been practiced by different surgeons for the relief 
of this common, and always dangerous condition, I feel some 
hesitation in asking your attention to this subject ; and espe- 
cially so, when I realize the fact that my experience in the 
operative treatment of hernia is very limited, being confined 
to only a few cases. I trust, however, that the importance of 
the subject, and a desire upon my part to arrive at the truth, is 
sufficient apology. 

The object of this paper, then, is not so much to record my 
own personal experience, but rather to call your attention to 
the recent modern advances in operative procedure, so that we 
may interchange views, and if possible solve some of the diffi- 
cult problems involved. 

To aseptic and antiseptic surgery we are indebted in a large 
measure for the good results which have followed the improved 



318 THE APPENEIX OF MEDICAL PAPERS. 

methods. While it can not be denied that there ie always some 
danger attending any operation in which the sac is opened, it 
has been shown that the modern operation is one accompa- 
nied with very little risk to life, and hence we find many sur- 
geons undertaking to make a radical cure who, in former times, 
resorted to palliative measures. 

The chief dangers to be apprehended from the operation are 
sepsis and hemorrhage. The former can be prevented by 
proper antiseptic precautions, the latter by care in the proper 
h'gation of the omental pedicle. The operation for radical 
cure in cases of strangulated and non strangulated hernia is still 
in the experimental stage, and to decide what is the best and 
safest procedure of the many methods proposed, is no easy 
task. Surgeons have given up all the old methods as totally 
unreliable. In cases of reducible hernia, the subcutaneous wire 
operation of Wood is still practiced, and is popular with some 
surgeons ; but it is admitted that twenty to twenty-five per 
cent in favorable cases, and forty per cent in unfavorable cases, 
result in failure, so far as permanent and complete relief is 
concerned. The old method of invaginating the skin, and 
passing the subcutaneous sutures, has been entirely discarded. 
Heaton's method, which consists in injecting irritating fluid 
into the connective tissues outside the canal, is rapidly passing 
into disrepute, the percentage of failures being acknowledged 
to be about seventy per cent. 

Some surgeons have been content, and still practice the 
method of removing that portion of the sac below the superfi- 
cial ring, and completing the operation by suturing the pillars 
of the external ring. This plan, it has been shown, is defect- 
ive, from the fact that there still remains a depression in the 
peritoneal surfaee at the mouth of the hernial opening, and 
also that portion of the canal which lies between the superfi- 
cial and deep rings. The hernial protrusion coming down into 
the canal, and meeting with little resistance at the external 
ring, soon makes its way out by breaking down any tissues or 
sutures which lie below it. In these cases an incomplete her- 
nia results, which gives the patient much inconvenience. 



THE RADICAL CURE OF HERNIA, 319 

Id my first case I mot with this same difficulty. It was an 
operation done for the relief of strangulation. After opening 
the sac as high as the external ring, and dividing the constric- 
tion and retnrning the intestine, I did not remove the sac, but 
left it in sitn, and completed the operation by passing deep 
SQtares through the neck of the sac and the pillars of the ex- 
ternal ring. My patient made an excellent recovery from the 
operation, and was up on the 9th day. The last time I saw 
him he informed me that he had to wear his truss to prevent 
the descent of the hernia. Upon examination, I found a pro- 
trusion in the abdominal wall near the superficial ring, which 
proved very conclusively to my mind that the operation was a 
failure so far as complete and permanent cure was concerned. 
This experience accords with that of many others who have 
undertaken to obliterate the canal by approximating the walls 
of the canal, and leaving the sac in situ. 

It was on account of these radical defects in all the old 
methods which led to the adoption of the modern operation, 
and in consequence the operative procedure has been com- 
pletely revolutionized. The whole question of radical cure 
hinges upon the proper answers to the following questions: 

1st. What disposition should be made of the sac? 

2nd. How can the peritoneal laxity at the deep ring be re- 
moved, and what is the best means for furnishing support to 
the peritoneum at this point? 

Upon the question of the treatment of the sac, the majority 
of surgeons agree, that to make a radical cure it is necessary to 
ligate the sac high up in the canal close to the deep ring, and 
completely remove it. As to the best means of obliterating the 
canal, and supporting the peritoneum at the deep ring, there is 
much difference of opinion ; the modern operation has in view 
the closure of the sac, and the complete obliteration of the 
hernial canal. Czerny, Michell, Banks, Weir and others ad- 
vocate the plan of de-ligating the sac high up in the canal near 
the internal ring, cutting it off, and completing the operation 
by passing deep sutures through the abdominal wall, and by 
this means approximating the sides of the canal and obliterat- 



a20 THE APPENDIX OF MEDICAL PAPERS. 

ing its cavity. The operation first proposed and practiced ex- 
tensively by McEwen of Glasgow, consists in dissecting out 
the sac, and then retaining it by means of a straight cat-got 
sature passed longitudinally several times throagh the sac, and 
through the abdominal wall, about one inch from the outer side 
of the deep ring. When traction is made, the sac is puckered 
and folded and drawn completely into the abdominal cavity, 
where it is'said to act as a "bulwark on the peritoneal aspect of 
the internal ring," and prevents the descent of the hernia. 
After disposing of the sac, McEwen strengthens the weakened 
abdominal wall by passing deep catgut sutures through the 
conjoined tendon outwards towards pourparts ligament, and 
thus unites the transversalis and internal oblique muscles with 
pourpart ligament. These sutures are passed deeply through 
the abdominal wall near the internal ring, and the walls of the 
canal are thus brought into direct contact. The objection 
urged against this operation is, that it makes no provision 
against the peritoneal laxity around the internal orifice of the 
canal, and that it does not produce what is most to be desired, 
and that is a smooth peritoneal surface. It is also urged that 
this method is difiicult of application, and often impracticable 
in many cases. In congenital hernia, it is impossible to sepa- 
rate the sac from the cord ; frequently it is so thin that it can 
not be thrown into folds; then again in cases where the sac is 
diseased or injured, and ie unfit to be replaced. 

One of the latest operations proposed, is what is known as 
the open method. While not original, it has been extensively 
practiced by Dr. Chas. McBurney of New York, and bids fair, 
I think, to be generally adopted by the profession. In a late 
paper read before the Now York Academy of Medicine, he 
reports thirty-six operations with only one death, and that due 
to alcoholic delirium, and not connected with operation. Out 
of thirty one cases under observation, he reports only one 
relapse, but says that some of the cases are of recent date, and 
can not yet be called permanently cured. McBurney's opera- 
tion accomplishes the complete obliteration and closure of the 
hernial canal by means of cicitricial tissue, which is formed by 



THE RADICAL CURE OF HERNIA. 321 

allowing the wonDd to remain open and granulate from the 
bottom. 

To those who are interested in the subject, I would refer to 
the original article published in the Medical Becord of March 
23d. It is understood that the operation is done under the 
strictest antiseptic precautions, special attention being paid to 
cleaning the regions about the field of operation. A free 
incision is made, beginning opposite and a little to* the outer- 
side of the internal ring, and extended well to the lower end 
of the sac. The incision is rapidly deepened until the concave 
border of the superficial ring is exposed to view as well as the 
anterior wall of the sac. The superficial and deep layers of 
fascia being cut through, one blade of blunt scissors is inserted 
under the border of the ring, and the anterior wall of the 
canal is split up to outer border of the internal ring ; the sac 
is dissected up to its lowest end, and carefully separated from 
its attachment to the cord ; this is most easily done with the 
finger or handle of the scalpel, by beginning at the upper part 
of the sac above the superficial ring. The cord being separated 
from the sac as high as the peritoneum, the sac can be lifted 
out and ligated at the junction of the sac and general peri- 
toneum. 

Dr. McBurney directs that the sac should always be opened 
before applying the ligature. The hernia is now reduced, and 
if omentum be present it should be ligated and cut off, the 
stump being returned to the abdominal cavity. If the 
omentum be adherent, it must be detached from the sac and 
carefully ligated before it is cut away by the knife. In ligating 
the sac, the following plan is recommended : 

The sac being held in a vertical position, the operator's finger 

is introduced into the neck of the sac, and the sac drawn down 

by the right hand. The ligature is now placed around the 

highest point of the sac and tightened by an assistant upon the 

operator's hand. It will be readily understood that this plan 

insures against the danger of including a loop intestine or 

omentum in the ligature ; a pedicle of sufficient size is left to 

prevent slipping of the ligature, the rest of the sac is cot away. 
21 



822 THE APPENDIX OF MEDICAL PAPERS. 

Id coDgenital hernia, it is often impossible to separate the 
sac from the cord, and it is necessary to cnt off the sac by 
piece-meal, and, instead of the ligature, carefully stitch the 
neck. We have now reached a very important step in the 
operation ; we have a large gaping wonnd which includes the 
whole length of the canal, and the circumference of the inter- 
nal ring. 

Dr. McBurney describes the anatomical boundaries and floor 
of the wound in the following language : "The posterior wall 
is formed by the fascia transversalis in its inner aspect, and by 
the peritoneum in its outer part ; the peritoneum in its inner sur- 
face is smooth, and the sac completely obliterated. The upper 
wall of the wound is formed by the edges of the skin, superfi- 
cial fascia, external oblique, aponuerosis and conjoined tendon; 
the lower wall by skin, superficial fascia, and a strip of apo- 
nuerosis, or practically, pourparts ligament, including the outer 
pillar of the external ring." 

In passing the sutures, an effort should be made to bring 
down the lax edge of the conjoined tendon. The sutures 
should be of stout cat-gut or silk, and placed according io 
McBurney as follows : "From four to eight, according to the 
size of the wound, bind together the tissues which form the 
npper wall of the wound, that is, the conjoined tendon, the 
aponuerosis of the external oblique (including the inner pillar 
of external ring), the skin is carefully and deeply inverted 
while each stitch is tied tightly, as many more sutures bind 
together the lower wall, that is, the skin and pourparts liga- 
ment, including the lower part of the outer pillar of the 
external ring." It is clear that this plan of suturing leaves an 
open wound and allows it to granulate from the bottom. To 
prevent too much gaping of the wound, McBurney passes 
what he calls tension sutures; two or more are passed deeply 
through the skin and superficial fascia across the wound. 
These stitches relieve the tension on the edge sutures, and have 
a tendency to narrow the wound. They should be tied over 
pledgets of iodoform gauze to prevent them from ulcerating 
through. The whole floor of the wound should be dusted 



THE RADICAL CURE OF HERNIA. 323 

with iodoform, and closely packed with iodoform gauze 
throughout the whole canal, particular care being taken that 
the outer angle around the circumference of the internal ring 
and over the etump of the sac is thoroughly packed. The 
wound in the scrotum is sewed up, a drainage tube placed 
at the lower end if necessary ; the operation is completed by 
enveloping the parts in abundant layers of bi-chloride gauze 
and cotton, and over this a piece of thin rubber tissue to pre- 
vent soiling of the dressings with urine ; a spica bandage is 
applied and the patient put to bed ; the dressings are not dis- 
turbed for five or six days, when the packing should be 
renewed, and it will be found that the wound has begun to 
granulate. The dressings should be changed every four or 
five days. The time required for complete healing of wound 
and formation of cicatrix is said to be five or six weeks, and 
during this period the patient must remain in bed. McBurney 
claims for this operation the following advantage over all other 
methods : 

1. It is the only method in which the sac is completely 
obliterated. 

2. That the walls of the canal are very firmly united 
throughout its whole length by strong cicatricial tissues. 

3. That the wound being open the risk of abscess and septic 
infection complications is reduced to a minimum. 

4. That it is applicable to every form of hernia. 

These are certainly very decided advantages, and the author 
is a man of large experience, and has had abundant opportunity 
to test the value of all the other methods. 

When we consider the question of radical cure in connection 
with the operation for strangulation or hemiotomy, I think the 
experience of modern surgery teaches very clearly that an 
attempt should be made to bring about not only relief to the 
strangulation, but, also, a radical cure. It has been shown 
that the mortality, after the radical operation, is not increased, 
but rather diminished. There are several causes to account for 
these good results. To aseptic precautions, and to the greater 
care in the ^neral technique of the operation, much of the sue- 



324 THE APPENDIX OF MEDICAL PAPERS. 

ceBB is dne, and also to the fact that enrgeons do not now delay 
after strangulation has occarred, and hence the strangulated 
gut is usually found in a healthier condition, the success of a 
herniotomy depending, in the main, upon the condition of the 
intestine at the time of the operation. We have already dis- 
cussed the different methods of treating the sac. 

In cases where the operation is done for strangulation, the 
same general principles obtain. The rule was in the old opera- 
tion of herniotomy, for the hernia to return, the surgeon being 
satisfied if he succeeded in saving the life of the patient. With 
the present lights before us, unless the surgeon affects a radical 
cure, he falls far short of his duty. 

In concluding these fragmentary remarks, it appears that 
while there has been great advance made in operative treat- 
ment of hernia, we have not yet reached a perfected operation, 
and one easily and safely performed by any physician of ordi- 
nary skill. 

It is impossible to say which procedure of all those proposed 
is best and safest, as it must be confessed that all operations for 
the cure of hernia are difficult, and more or less complicated, 
depending upon the varying conditions found in different indi- 
viduals. 

Those of us who live away from the large metropolitan cen- 
ters, and do not have an opportunity to become expert in 
operative procedure, must be content to adopt whatever 
method seems simplest and is accompanied with least danger. 

Eelapses sometimes occur after all the different methods, 
and time alone must decide as to the relative merits of each. 



Dr. John D. S. Davis. 

I do not think a patient who is obliged to wear a truss after 
herniotomy can be properly called cured. That procedure, 
which is worthy of the name of radical, should secure to the 
patient permanent relief from his malady, and freedom from 
mechanical appliances used to prevent a return of the hernia. 



THE RADICAL CURE OF HERNIA. 325 

It has been my experience, that the ruiQed sac, after the 
method of McEwen, will not only soon open up and again 
allow the gat to protade, bnt it makes no immediate primary 
provision at all against the great laxity of the peritoneum which 
exists in all large hernias, around the internal orifice of the 
canal. 

McBumey has attempted to restore to the peritoneum, at the 
internal ring, the natural smooth surface that exists where no 
rupture has occurred, by tying off the sac as high up, as in case 
of femoral hernia, as Gimbernat's ligament, and allowing the 
open wound to heal by granulation. He mats all the tissues 
together on each side of the wound by sewing together all the 
layers forming the abdominal wall except the transversalis and 
peritoneum, from the internal ring to the spine of the pubis. 
The stitches keep the wound potent throughout its entire depth 
and provides against the possible formation of a feeble union 
between any two layers on opposite sides of the wound. The 
wound is dressed open and allowed to .fill up by granulations 
from the bottom, formed by the transversalis, with 4;he peri- 
toneum behind it. At the end of five or six weeks, a firm cica- 
trix will be formed sufficient to secure strong repair. 

The preventable dangers of the operation are immediate and 
remote— immediate from hemorrhage, which will be of rare 
occurrence when care is taken in the ligations of omental 
pedicles — remote from sepsis, which will seldom be seen un- 
der proper antiseptic precautions. 

The advantages maintained for the open method of wound 
treatment, which I desire to emphasize as the result of my own 
experience in corroboration of Dr. McBurney, are : 

(1) ^'That, in inguinal hernia one is able, after laying 
open the canal, to very evenly and completely tie off the sac. 

(2) "That the wound, being open, no drainage is required, 
and the risk of abscess and septic complications are reduced to 
a minimum. 

(3) "That the walls of the canal are united throughout by 
strong cicatricial tissue." 



326 THE APPENDIX OF MEDICAL PAPERS. 



EPICYSTIC SURGICAL FISTULA FOR C YSTOSCOPIO 
EXPLORATION ; INTRAVESICAL TREAT- 
MENT AND DRAINAGE. 



BY JOHN D. 8. DAVIS, M. D., OF BIRMINGHAM, ALA., 
Member of the Medical Association of the State of Alabama. 



Epicystotomj has become an established and frequently prac- 
ticed procedure, and the dangers incident to opening the blad- 
der through the abdominal wall are so slight that patients saf- 
fering from almost any vesical trouble are encouraged to have 
the bladder opened for diagnostic purposes and treatment at a 
time when the general health remains unimpaired ; a practice 
which, a few years ago, would not have been resorted to by the 
most aggressive surgeon. 

Catarrh of the bladder, irrespective of its cause, is always 
followed by a series of consecutive pathological changes, which, 
independently of the partial or complete interruption of the 
passage of the urine, tend to destroy life. A dilatation of the 
bladder and ureters by retention of urine may give rise to such 
a degree of distention, as to destroy life from suspension of 
important functions by mechanical pressure. During the stage 
of inflammation a paretic condition may occur, the blood ves- 
sels in the vesical wall lose their support, and transudation and 
exudation take place into the paravascular tissue, which, com- 
bined with capillary stasis attending this stage of the disease, 
results in sloughing, infiltration, pysemia, peritonitis and death. 
The damming up of the urine may, and does often cause sur- 
gical-kidney, epididymitis and tetanus. 

The treatment of chronic vesical catarrh resolves itself into a 
consideration of the causes producing the disease, many of 
which, the presence in excess of certain inorganic constituents 



TREATMENT AND DRAINAGE OF FISTULA. 327 

of the urine, stone, strictare and hypertrophy, are capable of 
correction ; whilst others — sach as malignant tumors and cer- 
tain conditions of the prostate — may only admit of a pallia- 
tion of the symptoms to which they give rise, and the removal 
of which must be the first object in the treatment. But when a 
paretic condition of the bladder exists, provision must be made 
for the complete continuous emptying of the viscus ; its thor- 
ough cleansing by frequent irrigation with hot sterilized water ; 
and the promotion of a healthy tone in the mucus membrane 
and muscular structure of the bladder. The frequent intro- 
duction of catheters for drawing off residual urine and washing 
out the bladder has been productive of much harm; and, 
instead of giving relief, proved to be, by reason of their fre- 
quent introdaction into the inflamed bladder to draw off the 
urine two or three times a day, a source of immediate and 
alarming symptoms. These facts are cogent reasons for adopt- 
ing surgical means in all cases of intra-vesical troubles as soon 
as a diganosis can be made, and often when it can not other- 
wise be made, for the complete emptying of the bladder, 
thorough cleansing, diagnosis, and intra-vesical treatment. 

The epicystic surgical fistula is deigned for drainage, intra- 
vesical treatment and cystoscopic exploration, and may be di- 
vided for consideration under the following heads : 

I. Definition of epicystic surgical fistula. 

U. Surgical resources in the formation of the epicystic 
snrgical fistula. 

1. Preparation for the operation. 

2. Anaesthesia. 

3. Position. 

4. Incision and opening bladder. 

5. Intra-vesical exploration and treatment 

6. Toilette and after-treatment. 

III. Advantages of the epicystic surgical fistula. 

1. Cystoscopic exploration. 

2. Intra-vesical treatment. 

3. Drainage. 



328 THE APPENDIX OF MEDICAL PAPERS. 

I. — Definition of Epicystio Surgical Fistula. 

Epicystic Surgical Fistula is the title here give to a supra- 
pubic fistula into the bladder created by the surgeon for explo- 
ration, intra-vesical treatment and drainage. A fistula, which, 
acting as an artificial urethra, is capable of giving free access 
to the inside of the bladder for cystoscopic exploration, to pro- 
vide a ready, convenient and comfortable means of emptying 
the bladder at will, and gives the surgeon a competent opening 
into the viscus for intra-vesical applications. 

It constitutes an essential element in the speedy and com- 
plete evacuation of the contents of the bladder in all epicystic 
operations, and imitates nature in the restoration of its own 
continuity and repair as the pathological changes within the 
bladder subsides. 

II.— SUBOIOAL ReSOUBCBS IN THE FORMATION OF THE EpICYS- 

Tio Surgical Fistula. 

(1). Preparation for the Operation. — The presence of two 
assistants, though not necessary, may be of valuable aid. A 
temperature of 80^ or 85° Fah. should be maintained in the 
operating room from the beginning to the end of the opera- 
tion. All hair is to be shaved from the pubis, and all the de- 
tails of antiseptic surgery are to be carried out so far as clean- 
ing the pubis and abdomen. The bladder is emptied and thor- 
oughly washed with warm water. When the water returns 
clean, the bladder is slowly distended with warm sterilized 
water thrown into the bladder by means of a fountain syringe, 
with nozzle in urethra — a degree of pressure sufficient to dis- 
tend the bladder to its utmost capacity — which can never be 
too great for the resistance of the bladder. It is better to fail 
in filling the bladder than to distend the bladder beyond the 
limit of competency. Indeed, it is not necessary to fill tlie 
bladder to any degree of resistance. I have operated when the 
bladder was in an irritable condition and would not tolerate 
distention greater than the capacity of two ounces, and had no 
difficulty in avoiding the pre-vesical fold of peritoneum or find- 



TREATMENT AND DRIANAQE OF FISTULA. 329 

ing the bladder. The water is secured in the bladder by tying 
the penis at the base with a rubber tnbe. 

A colpeurjnter is next to be well oiled and inserted into the 
rectam — the rectum having been previously emptied by 
enema, and filled with warm water.^iThis distention brings 
the bladder into view above the pubis. 

(2). An(B8thesia. — My preference for chloroform is the re- 
sult of my own personal experience with it. It is not free 
from objections, as its depressing effect on the heart is well 
known. The operation usually occupies fifteen minutes ; and 
hence, its prolonged use would be unnecessary and uncalled 
for. The objections to ether are, the suppression of the excre- 
tions and the frequency with which bronchitis is produced 
when administered to persons advanced in years. The best 
course to pursue, when the operation is prolonged, is to follow 
the use of the chloroform by ether. The patient must be kept 
profoundly under the influence of the ansesthetic from the first 
incision until the superficial wound is closed. 

(3). Position, — The patient is placed on the back on an 
ordinary operating table with the legs extended as if in a posi- 
tion for perfect comfort and rest. Many surgeons claim ad- 
vantages in the position recommended by Trendelenburg. Eig- 
enbrodt emphasizes the fact^ that the elevation of the pelvis 
in Trendelenburg's positionf helps the surgeon to avoid the 
prevesical peritoneal fold at the time of the incision of the 
bladder. 

I have employed this posture for intra-vesical operation by 
means of the supra-pubic incision with no advantage over the 
ordinary flat-back position. With two openings in the bladder 
for a continuous stream of clear water, I have no trouble in 
illuminating every part of the bladder with the electric surgi- 
cal light, and thus am enabled to examine the entire intra-ves- 

*L. c.,p. 72. Cf. Lang, Med, News, Dec. 4, 1886. 

fin Trendelenburg's position the patient's legs are held over the 
shoulders of an assistant with the body resting on an incline table, 
much in the position which hogs are swung for spaying. 



330 THE APPENEIX OF MEDICAL PAPERS. 

ical wall. Undoabtedly the position recommended bj Trendel- 
enbnrg poesefises advantages, which to the author more than 
myself, make it highly ideal. As for myself, I prefer and 
recommend tlie flat-back position; 

(4). Incision and opening bladder. — A perpendicular incis- 
ion three or four inches long is made in the median line above 
the symphysis pubis. The recti muscles are separated to sym- 
physis. If the pyramidalis are in the way, the fibres should 
be cut The transversalis fascia is divided on a grooved direc- 
tor from symphysis to within one inch of upper margin of su- 
perficial wound. Instead of following Guyon's manoeuvre, I 
catch the bladder with a tenaculum on a line with the symphy- 
sis, through the prevesical- fat, and cut through with a bladder 
knife into the bladder with one smooth, clean incision, to pre- 
vent undue disturbance of the cellulo-adipose tissue between 
the bladder and pubis and avoid infiltration. I have never 
seen a case where it was necessary to put up the prevesical fat, 
and with it the peritoneal cul-de-sac. If the bladder is caught 
on a line with the symphysis and cut downwards, no fears need 
be had for the peritoneum. Cutting this prevesical fat pre- 
vents its after dropping down over the opening into the blad- 
der, and acting as a valve to prevent easy escape of urine and 
causing infiltration. And, too, such a procedure gives a smooth 
incision throughout, and it is almost impossible to have infil- 
tration, even when no drainage tube is left in the bladder, and 
the urine is left to flow out through the fistulous track and 
taken up by a layer of absorbent cotton. In makiag the incis- 
ion into the bladder, no attention is to be paid to any vein or 
veins which are sometimes met with. If cut, they will stop 
bleeding when the bladder is dropped back and the rectal bag 
removed. The operation is usually bloodless in the sense of 
hemorrhage. I have operated without the patient losing more 
than one drachm of blood. 

(5). Int/rorVesicaL exploration amd treatment — The finger is 
carried into the bladder and a thorough search made for any 
tumors, villous growths, or foreign bodies. The bladder is 



TREATMENT AND DRAINAGE OF FISTULA. 331 

now emptied and the rubber aronnd the penis untied and the blad- 
der well washed out with hot sterilized water. The bladder can 
now be examined with the cjstoscope and surgeon's electric 
light. If tumors be founds if practicable they should be re- 
moved ; villous growths and any foreign body found should be 
removed. If nothing is found in the bladder, the surgical fis- 
tula, in the absence of malignancy, will be all that is required 
to relieve the cystitis. 

(6). Toilette and after treatTnent — The bladder is allowed 
to drop back into the pelvis and the superficial wound so closed 
by two sutures (including the skin and superficial facia only), 
in the lower portion of the incision and one in the upper 
portion of the incision, as to leave a fistulous track of equal 
size from bladder to juncture of upper third and middle third 
of the superficial incision. A large rubber catheter is now to 
be introduced into the bladder through the opening and its 
distal extremity allowed to enter a urinal placed in the bed 
between the patient's thighs, or {/i*eferably at the patient's side. 
Professor F. Trendelenburg, director of the surgical clinic of 
the University of Bonn, proposed, for draining the bladder in 
supra-pubic lithotomy, the T-tube in lateroabdominal position 
and open wound treatment as the simplest, safest and best. 
He makes an antiseptic dressing of iodoform gauze around the 
T-tube. There can be no real necessity for a tube of any kind 
to be introduced into the bladder for the purpose of conveying 
the urine from the bladder to prevent infiltration, irritation of 
superficial fascia and soiling of dressings. 

If the urine is kept acid by the administration of citric acid 
or some other more palatable acid drink, no better antiseptic 
than the acid urine can be secured for the constant bath of 
the parts. It should be allowed to flow out through the 
wound and absorbed by a pad of absorbent cotton placed 
loosely over the wound, and removed as often as soiled by the 
outflowing urine. By this method of emptying the bladder, 
no possible small amount of urine can be impeded in its out- 
flow, which is the case around and outside of the tube, when 
catheter or tube is left in for any length of time — a source of 



832 THE APPENDIX OF MEDICAL PAPERS. 

no little annoyance at timee. This little collected or retained 
nrine, around the outside of the tube alone, I have Been pro- 
duce a hard chill and elevation of temperature, and become for 
the time an immediate, alarming and aggravating source of 
trouble. I never have seen the skin made sore or chafed by 
the outflowing urine in epicystotomj, or from its after escape 
through the surgical fistula. 

The bladder should be washed out twice daily with hot ster- 
ilized water, by means of a fountain syringe, with its nozzle 
introduced into the urethra, the water escaping through the 
epicystic fistula and guided into a bed-pan under the patient. 
The superficial stitches are taken out at the end of a week, and 
intermittent catheterization by the fistula is then resorted to 
for the sole purpose of training the fistula and prevent its 
rapid closure. It is not necessary to catheterize for the pur- 
pose solely of drawing off the urine. In one case I never 
drew the urine save for the purpose of analysis, but occasion- 
ally introduced a rubber bougie to prevent the closure of the 
fistula. The drainage by the fistula alone is admirable, and the 
fistula will be well formed in twenty or thirty days, competent 
to retain urine without dripping and to allow its escape in a 
good projecting stream at will. With no tearing of the tissues, 
and, with a clean cut, the drainage is perfect and the dangers 
are nil, 

III. Advantages of the Epioystio Subqioal Fistula, 

(1). Cyatoscopio JSx^loration--Nitze has, by means of the 
cystoscope, been enabled to diagnosticate tumors of the bladder 
in nine cases in which rectal palpation, the sound and other 
means had furnished negative results. One of the great diffi- 
culties in the cystoscopic exploration of the bladder is the 
presence of pus, mucus, and sometimes blood, which renders 
it exceedingly difficult to 'maintain a translucency of the fluid 
used to distend the bladder. By means of a simple fountain 
syringe a constant current of clear water may be kept within 
the bladder so essential to a complete observation of the trigo- 
num Lieutaudii, the most interesting part of the viscus, the 



TREATMENT AND DRAINAGE OP FISTULA. 333 

nretere; and to examine any affection of that viscus. The 
fistula may be made for temporary purposes of cystoscopy by 
the Petorson-Guyon-Perier operation ; but I can see great 
advantages from a different operation, by Dr. Hunter McGuire, 
the object of which tends to detect as well as eliminate the 
trouble within the viscus ; and, too, in the final construction of 
a permanent fistula, gives an easy after-method of exploration, 
and makes a better arti^cial method by reason of its length 
and extension upwards of two to three inches. Diagnostic 
purposes are met by the possibility of immediate detection of 
all local conditions, such as tumors, calculi, foreign bodies, 
neoplasms, the collection of fluids from the ureters, etc. 

(2). Intra- Vesical Treatment — Having by means of the 
epicystic exploration revealed the true nature of the intra- 
versical trouble, the treatment resolves itself into the immediate 
necessities of the case. For instance, prostatectomy may be 
necessary, villus papilloma may be found and should be reme- 
died ; pedunculated growths may be found which should be 
removed by the scissors or Paquelin's cautery, etc. In such 
cases, the opening in the bladder sufficient to introduce the 
finger, should be enlarged downwards under the symphysis 
pubis and the operation indicated should at once be performed. 
The object of the formation of the permanent surgical fistula 
is to meet the after indications in such operations, the details 
of which do not properly come within the province of this 
discussion. However, it is sufficient to state, what is reasonable 
and practicable, that a better means by which the intra-vesical 
wall can be reached and treated therapeutically has not yet 
been devised. 

(3). Drainage. — Permanent after-drainage in all intra- versi- 
cal operations can not be necessary ; but is highly essential to 
secure good and sufficient drainage until the paravascular 
tissue is disingorged, the cystitis is relieved and the urine 
becomes normal and passes per urethra unobstructed. And 
until this end is attained complete artificial arrangement for 
the escape of the contents of the viscus must be made. In 



334 THE APPENDIX OF MEDICAL PAPERS. 

snch caeee of prostatic hypertrophy, or malignant growths, 
when removal of the obstruction is impossible or contra indi- 
cated, the epicystic surgical fistula is clearly indicated and 
essentially necessary. It meets every possible indication for 
local treatment and gives the only controllable, ready and free 
drainage to viscus and kidneys. Urinary back pressure, as the 
result of the incompetency of the uretha, fiom the various 
immovable prostatic troubles, is often an immediate and 
remote cause of surgical kidney, which can only be removed or 
relieved by supra-pubic drainage. It is also indicated in con- 
ditions of the bladder of long standing cystitis, as in the case 
reported by me in the Virginia Medical Monthly,* in which 
the urethra, though made competent by cutting, was not 
sufficient to keep the bladder emptied withont catheterization — 
a procedure which kept up a constant vesical inflammation, 
which, combined With capillary stasis, attending the inflamma- 
tory process, resulted in paresis. 

I now have the pleasure of introducing that case (Mr. T. A. 
Nixon's,) to you fifty-eight days after the operation. His condi- 
tion to-day is sufficient guarantee for all I have said in favoring 
the formation of an epycistic surgical fistula for the relief of 
chronic vesical catarrh. The result in this case is more than I 
promised. He can retain his urine several hours and withont 
dripping of urine or pain to bladder. Urine completely under 
control and bladder relieved of pain. Present capacity of 
bladder is sixteen ounces. The fistula here is well formed and 
competent in every respect for which it was formed. 

I now draw his urine with a catheter, not that it is necessary 
to introduce the catheter, but to guide the urine into the 
bottle and prevent a projected stream from going on the floor. 

De. Gborgb W, MoDadb. 

There are no specifics known to the medical profession. The 
knife fails in the hands of the most skillful surgeon ; also, all 

♦Virginia Medical Monthly, April, 1889. 
Alabama Medical and^Surgical Age, April, 1889. 
New York Medical Journal, April 13, 1889, 



TREATMENT AND DRAINAGE OF FISTULA. 835 

remedies in the hands of the practitioner. There are many in 
the profession who are nnable to perform so grave an operation 
as epicystotomy ; many patients who will not snbmit to the 
operation, and very many who are unable to pay the surgeon 
for his services. Hence, we must have recourse to remedial 
agents which act directly through the uninary system for the 
cure. This remedy I believe we have in the philadelphus coro- 
narius, known by the common name of mock orange, and wild 
syringa. It is not truly a syringa, that name being more prop- 
erly applied to the lilac family. I can find no literature on the 
philadelphus coronarins as to its medical properties, it being 
simply mentioned in botanical lists. It is indiginous to this 
country, growing in the rich alluvial soils of our sloughs, creeks 
and river bottoms, flowering in April and May. 

Case I. E. 8., a mulatto man aged 62, has suffered for 
seven years with chronic cystitis and enlarged prostate, gradu- 
ally growing from bad to worse. He had been under the care 
of two prominent physicians without benefit. He called to 
see me in March, 1880. His appearance indicated he was a 
great sufferer, careworn, emaciated and weary. He complained 
of having to void his urine very often, as often as every hour 
or two. Each passage — no matter how small in quantity — was 
attended with severe pains, and for several months previous a 
desire to defecate at the same time. He was so frequently dis- 
turbed at night as to prevent his sleeping, except at short inter- 
vals. He had no fever; appetite only tolerably good. The 
urine had an acid reaction, color dark, containing large quanti- 
ties of muco-purnlent matter, often streaked with blood, and 
when allowed to remain in the vessel for a short while, became 
very offensive. He was forced to use a catheter, being unable 
to pass his water without it. I had very little hope of benefit- 
ting my patient. In such unpromising cases physicians gen- 
erally prescribe tonics, anodynes, and some one of the many 
mineral waters, trusting, by their assistance, that nature may 
come in to aid them, as the sufferer perchance is being restored 
to health. 

I have consulted several physicians older than myself, hoping 



336 THE APPENDIX OF MEDICAL PAPERS. 

to find some remedy for relief in suck cases, bat found them 
in the same dilemma as myself, all preferring not to be called on 
to treat them. Suffice it to say, I was as unsuccessful as my 
confreres. My treatment, like theirs, gave only temporary 
relief ; and after continuing it for three or four months, I told 
my patient frankly that I could do him no good, and that it 
was a useless expenditure of his money to have any more of 
my prescriptions filled. I confidently expected that he would, 
in the course of three or four months, succumb to his suffering 
and be numbered amongst the dead. Several weeks after this, 
I was called to visit him. I found he had quite a hemorrhage 
from the bladder. I noticed as I entered the yard a bush of 
the wild philadelphns coronarius which he had transplanted 
from the woods hard by. I said to him, here you have the 
remedy for your disease growing in reach of you. I ordered 
him at once to have a lot of the roots dug and instructed him 
h^w to make a decoction, and to take of it a wineglassful every 
four to six hours. 

I had no confidence in anything I had prescribed doing him 
any good ; still, I left my patient encouraging him to persevere 
in taking the decoction. He said he had given up all hope of 
getting well. Soon after beginning with the medicine he be- 
gan to improve, and in the course of three months was cured. 
At the end of six months his health was excellent ; had gained 
in fiesh, and, instead of looking upon a man once — in all ap- 
pearance — a cadaver, I saw one in perfect health. 

Nine years have since passed away. He still continues well 
of the diuresis and chronic cystitis. The enlargement of the 
prostate and stricture of the urethra prevent him from passing 
his urine without a catheter ; passes his water four or five times 
during the day ; gets up once only in the night, just before 
daylight. His sleep is undisturbed and refreshing. 

Case II. Mr. T. M. White, aged 73, has been declining 
in health and growing more and more feeble as his years ad- 
vance. I called to see him in 1886. He complained of fre- 
quent desire to void his urine, day as well as night. It had 
become such a source of annoyance to him be has long since 



TREATMENT AND DRAINAGE OF FISTULA. 337 

ceased to visit his neighbors, ''being ashamed to trot out to 
make water.'' His sleep is very often distnrbed and nnref resh- 
ing, he having to void his urine ten or twelve times daring the 
night. As he knew the history and treatment in case nnmber 
one, I soon persaaded him to make the decoction of philadel- 
phns coronarins root and take it. In the coarse of a month 
his condition was so mnch improved, he neglected taking the 
medicine. Hence, when I saw him again he stated that he had 
very much improved in every way. He was not disturbed 
of tener than three or four times daring the night, and thought 
he would have been entirely cured if he had taken the decoc- 
tion regularly. He experienced so much relief from the medi- 
cine, he prescribed it for his son who was afflicted in the same 
manner. His son's trouble was brought on by the intemperate 
use of common whisky. The decoction cured him. 

Case III. Mr. B. B. White, planter, aged 31, was in perfect 
health and was attacked very suddenly in June, 1885, after 
having been chilled by a shower of rain. Soon thereafter he 
was seized with a desire to pass his water, accompanied with a 
burning sensation in the region of the prostate and extending 
along to the meatus ; the paroxysms of heat continuing from 
five to'ten minutes, then intermissions of ease would occur at 
about the same intervals of time ; then the strangury and de- 
sire to pass urine would be repeated and a disposition to defe- 
cate, when the paroxysms came on. He continued to suffer in 
this way for three years with occasional intermissions of relief, 
never exceeding a few hours. Every day and night for weeks, 
months and years, he suffered until he became emaciated and 
so enfeebled he could scarcely walk. During these three years 
of worry and suffering, he employed at different times three 
physicians, but obtained only temporary relief. 

In the month of October, 1888, I was called to see him and 
found him lean, feeble and with some fever. He repeated his 
story o£ suffering, and was then passing his water as often as 
once every hour or two, day and night. His appetite was poor, 
bis bowels regular. Examination of bis urine when in repose, 
93 



838 THE APPENDIX OF MEDICAL PAPERS. 

disclosed a large mnco-purnlent deposit which, when allowed 
to stand, in a few hoars became very offensive ; that voided 
during the night was especially so, had acid reaction of a dark 
straw color and free of albumen. I prescribed for him Wheel- 
er's elixir and Chapman's mixture, with double the quantity of 
compound spirits of lavender and the decoction of philadelphus 
coronarius. The tonic to be taken before meals, the Chapman's 
mixture every three or four hours, when suffering from stran- 
gury, and the decoction in wineglassful doses three times a day 
in the intervals between the other medicines. He began to 
improve immediately ; suffered one night only for an hour. I 
soon left off the tonic, and directed the Chapman's mixture to 
be taken only when he had the slightest indications of stran- 
gury, and the decoction to be kept up in daily doses. Two 
months since he began this treatment he has gained fifteen or 
twenty pounds ; his complexion is good, his appetite excellent, 
his digestion perfect, sleeps well, mucous in the urine has dis- 
appeared, and, but for occasional symptoms of his old trouble, 
he feels perfectly well. In a recent letter he reports himself 
cured, and thinks with proper care there will never be a return 
of his disease. 

I have now three cases under treatment ; two of whom are 
old men, one a young married woman. The former have been 
materially benefitted, and strong hopes are entertained of cure 
in both cases. 

In the case of the young woman, I prescribed for her several 
months agoj the Chapman's Mixture and compound spirits of 
lavender and Wheeler's Elixer. As long as she took the mix- 
tures the distress and diuresis was relieved, but would return as 
soon as it was left off. One month ago she called at my office 
with her husband. I ordered the decoction, of philadelphus 
coronarius with the happiest relief from her suffering, and I 
am satisfied that a cure will be effected in her case. She has 
been a sufferer from this painful distress for three years. I 
made no test of her urine as she lives in the country, and I 
had no facilities at hand to make it. 

We all know how unsatisfactory this class of patients are to 



TREA TMENT AND DRA IN A OE OF FISTULA . 839 

treat. A remedy that will give almost immediate relief and a 
cure, will fill a vacancy in our list of therapeutic agents, long 
felt, and will prove a blessing to human sufferers. This 
remedy, I believe, we have found in the one I now present to 
you. My success has been so uniform and the relief so decided, 
I have every confidence in recommending it to you and through 
you to your patients. 

I am of the opinion that it will be found on trial equally as 
efficacious in other diseases of the urinary organs, as nephritis, 
gonorrhoea, gleet, etc. I am very anxious to have the assistance 
of the profession in making other experiments with it; would 
like to see it tried in cases of diabetes and albuminuria. I am 
encouraged, at least, to hope it will prove beneficial on the 
principal, that, if you restore any organ to its normal condition, 
the disease will be cured. 

I have formulated a recipe and made arrangements with 
Messrs. Eli, Lilly & Co., of Indianapolis, Ind., who are noted 
throughout our country for the purity of their pharmaceutical 
preparations, to manufacture it for the use of the profession. 

Dr. John D. S. Davis. 

I regret that I was called from the hall during the reading 
of Dr. McDade's paper, and heard but little of it. I desire to 
emphasize the fact that accurate observation of all my cases of 
cystitis has taught me to expect but little from therapeutic 
treatment. I value cleanliness above everything elem in any 
inflammation of the bladder, and to get cleanliness in the 
inflamed bladder, there must necessarily be a competent open- 
ing into the bladder to allow a continuous stream of water to 
pass in and out, for washing out the bladder. Even when the 
urethra is competent to admit a double canula catheter for a 
continuous stream of water, I claim that the irritation to the 
prostate is so great — from the frequent passage of the cathe- 
ter — that the good effects produced by the work are antago- 
nized by the irritation to the prostrate. I have made the 
perineal incision into the bladder through the prostate gland 
for ()r^Dage in cystitis p^iiet^p tim^9 with good, immediate 



840 THE APPENDIX OF MEDICAL PAPERS. 

results. I found in almost every case, the perineal fistula 
closed, before the pathological conditions within the bladder 
were controlled ; and when I attempted to keep the perineal 
fistula open by passing a sound or ^perineal plug, my efforts to 
relieve would be met with increased irritation of the prostate 
and neck of the bladder. By reason of the epicystic fistula, 
I have observed that any amount of cathertization through the 
fistula produced no increased irritation, and gives a much better 
opening for the outflowing urine and washing out the bladder 
at will. The bladder may be washed out by means of a double 
tube introduced into the epicystic surgical fistula, or by intro- 
ducing the water into the bladder per urethra and out through 
the fistula without instrumental disturbance to the prostate. 
My experience alone confirms my opinion of the great ad- 
vantages of the epicystic surgical fistula, and in no other way. 
Accurate observation of my patients has led me to the con- 
clusion that medication does but little good and is, at best, ex- 
ceptional paliation. 



Complications of diseases, 341 



COMPLICATIONS OF DISEASES. 



BY HOWELL BECKHAM GWIN, M. D., DECATUR, ALA. 
Member of the Medical Association of the State of Alabama, 



Addressing especially my younger brethren in the medical 
profession, my purpose is to briefly insist upon the early, 
thorongh, and habitual study of the complications of diseases. 
Confronting and perplexing us so frequently, they are to us, as 
to a traveler ^'the hill-difficulty," and to the geometrician ^'the 
Pons Asinorum." 

''A complication, in medicine, means the presence of several 
diseases, or of several adventitious circumstances foreign 
to the primary disease." — Dunglison. They must be dis- 
tinguished from sequellse which are '^morbid phenomena left 
as the result of a disease" — though a sequel may lead to a com- 
plication, as the perforation of the intestine in typhoid fever 
gives rise to peritonitis. To distinguish a complication from an 
essential part of the disease requires the most exact diagnosis 
e. g., chronic catarrhal gastritis is less a complication than a part 
of gastric cancer. In some diseases it is a difficult matter to 
dissociate the complications from the sequellse, as in measles 
where the sequellsa may be looked upon as the complications 
which have continued after the subsidence of the exanthem ; 
but it is customary to include under sequellse certain affections 
that are the result of the derangement of the system by the 
morbillous process. Complications of measles consist, as a rule, 
in the exaggerated morbid action of organs or parts that are 
essentially implicated in the disease ; therefore, we are apt to 
encounter such affections as laryngitis, bronchitis, pneumonia, 
eta The most common accompaniment of a disease will soon 
be anticipated and treated as laryngitis with measles, and peri- 



342 THE APPENEIX OF MEDICAL PAPERS. 

tonitis with typhoid fever and inflammatorj Inng-troable with 
from five to ten per cent, of influenza cases. Bat when not so 
common or arising in a remote region it requires the most 
thorough diganosis and the most skillful therapeutics. When 
studying a case complications should always be within our per- 
spective. For example, pancreatic disease is often accom- 
panied by jaundice, andl as pancreatic disease is often at the 
bottom of diabetes, it will account for the jaundice, while the 
presence of the jaundice may also suggest a pancreatic diabetes. 
Some complications may have a very obscure clinical history, 
as pneumonia with gastric cancer. A disease may appear at 
different stages in the progress of the primary disease, and may 
sometimes be overlooked, as lobular pneumonia in typhoid fe- 
ver; the heart's action may be so weakened in typhoid fever that 
venous thrombosis may be the result. Certain complications 
may be very rare, as peritonitis found by Dr. Howard once as 
a complication of acute rheumatism. 

Dsraeli has said, "it is the unexpected which happens." 
The effects of chloroform upon some constitutions may sur- 
prise and often alarm us. The outburst of a latent or heredi- 
tary affection or taint, or the lesion of some weak organ or 
tissue may seriously complicate the disease and disturb its 
treatment. The diagnostician must thread everv fact, and, de- 
ducing a true theory, must proceed with a slow or rapid, but 
always with a firm step. If the morbid organism illustrates 
the maxim, "in union there is strength," the physician, too, 
must do the same with his remedies. All his powers of ob- 
servation and reasoning, and all his scientific resources, must be 
brought into vigorous exercise, in search of any appreciable 
lesion which may increase danger to the patient, or difficulty 
to the practitioner. 

We are apt, if not sure, to meet with complications where 
diseases have a wide range of symptoms, where, febrile in na- 
ture they have a remarkable course of temperature, when spe- 
cific poisons affect the patient, as before or immediately after 
child-birth, when a common cause like malaria attacks several 
organs simultaneously or successively. Of this we may usually 



COMPLICATIONS OF DISEASES. 348 

be assured, that we will rarely find the case in the body to cor- 
respond in every respect with the case in the books. As noth- 
ing has so contributed to the advancement of knowledge as 
comparative science, comparative anatomy, comparative biol- 
ogy, comparative grammar, etc., so nothing will so surely make 
a true and successful physician as comparative study of com- 
plicated diseases, and their co-ordinat%i treatment, and hence 
his accurate differential diganosis will often prove the key to 
his action. 

It must be assumed, I think, that even a slight complication 
makes the prognosis less favorable. To nip this in the bud, 
to hold it in check, to control it in its pari passu course or in 
its closer alliance with the primary disease, this reveals one's 
having "risen to the height of the great argument and of the 
greater responsibility." Complications that make the prognosis 
unfavorable, as visceral complications with gout, will awaken 
the deepest concern, and put our skill to the utmost test. 

As complications may sometimes mask themselves as 
sequellsB, so sequellse may sometimes mask themselves as 
complications; for instance, intense bronchitis occurring in 
severe forms of influenza are not strictly speaking complica- 
tions, but an essential process of the disease, while capillary 
bronchitis is a complication. The symptoms of the complica- 
tions often attach themselves to the original disease, thus 
obscuring them. Causal conditions deserve profound consider- 
ation, as when attacks of recurrent, remittent, or intermittent 
fever arise from malarial influence to which intestinal catarrh 
is due. Lead-poisoning, malaria, and wrong or insufficient diet 
may cause both dysentery and paralysis. Constipation may 
be either a symptom or a primary affection. Constipation is 
almost a universal accompaniment of dyspepsia, sustaining to 
it not infrequently a causative relation. The circulatory and 
nervous systems, so intimately related to some affections,, are 
often impressed independently, by a common cause, so as to 
produce perplexing or dangerous complications. Even a 
natural condition, like pregnancy, often proves a serious com- 
plication. 



344 THE APPENDIX OF MEDICAL PAPERS. 

The question of treatment — ah, here onr objective work 
begins. To define the limits between health and disease, be- 
tween canse and effect, is very difficult, aye, often eludes onr 
capacity. When a complication occars, the treatment appro- 
priate to the idiopathic disease is first suggested, and of course 
shonld be well in hand. Standing ready with as full knowledge 
as possible of the patient's constitution, we are to study all that 
pertains to the wise administration of remedies, their compati- 
bility or non-compatibility, their simplicity, and the avail- 
ability of a common remedy to reach a common canse. 
In some cases no direct' remedy beyond simple alleviation 
need be used, as with rheumatic symptoms in scarlet fever, 
requiring a simple liniment composed of carbolic acid, tinct. of 
belladonna and camphor. If internal medicine be indicated, 
then, in the face of the above suggested problems, while 
striving to harmonize all the morbid phenomena, our duty is to 
strive to harmonize our complex treatment. A consideration 
of certain correlated morbid conditions justifies the inference 
that they have a common origin, as in cases of gout pointing 
to a perverted nutrition, and this in turn suggests the treat- 
ment. Here I cannot be specific. 

My object in this article is gained if young physicians 
would value more truly the importance of this theme and 
make it a prime study. It is so generic that its appreciation 
will lead us to the more thorough study of single diseases, and 
so practical that we shall through life find constant use for the 
fruits of our knowledge, as they relate both to separate and 
allied diseases. 



SEPTICJSMTA. 345 



SEPTICEMIA; IMPORTANCE OF EARLY DIAG- 

NQSIS. 



BY JOHN POPE STEWART, OF ATT ALL A, 
Member of the Medical Association of the State of Alabama. 



This fever differs from any other symptomatically and 
pathologically; it stands alone in cause and e£Eect; there is no 
use to confound it with other fevers, its symptoms are so 
peculiarly its own — and yet it is so confounded. There are a 
great many more deaths from septic fever throughout the 
country than are shown by the certificates sent up. Over 
four-fifths of the deaths from parturition is due to septicemia, 
though thought to be, and is so called, puerperal and peritoneal 
fevers. Nearly all those who die of wounds, that is, if they 
recover from the shock, die of septicsemia. 

Burns, scalds, bruises and other injuries can be added to 
this list. I have seen cases where salivation had caused sepsis, 
a knife wound, a mashed finger, a stumped toe, and last, but 
by no means least, because through it I have lost a dear friend, 
and that has caused this paper to have been written, the pulling 
of a tooth. 

The first question to settle is the difference between sep- 
ticaemia and pyeemia. I make none; there are the two, so 
called, but they are always coupled together. Some authors 
give differential symptoms, but I could never get them so 
arranged as to tell what I had before me, septicaemia or 
pysBmia, and as the cause and effect are the same, and the treat- 
ment identical, I never have but one disease which, to the 
profession, I call septicaemia, and to the laity blood poison. 
We are not sufiiciently well informed as to the etiology of 
either disease if there are two, to justify the drawing of a 



346 THE APPENDIX OF MEDtCAL PAPERS. 

line of diBtinction between them, therefore why try to do so? 
Others may sncceed, but I treat both as one, and while I write 
of septicsemia, I write of traumatic fever and pysemia as well. 
Septicsemia literally is blood poison caused by traumatic injury 
of greater or less extent, at least in the majority of cases, 
but some writers claim that septic fever can be set up by 
spontaneous formation of pus in the blood without traumatism, 
calling such cases ^^purulent diathesis." But to this theory I 
do not attach belief, because it is not substantiated except 
by post-mortem examinations, which show abscess formations 
in the lungs, liver, etc., that might have been the cause, in- 
stead of the effect of the disease, with the exception perhaps of 
hectic fever in phthisis, cancers and internal abscesses, all of 
which I class as septic. I have never seen septicaemia where 
there had been no injury; yet, in regard to the prevalent 
diathesis, I will say that I believe, and in fact have seen cases 
where I thought the patient was easily poisoned from an in- 
jury, owing to an impoverished condition of the blood. 

This is as far as my idea of purulent diathesis goes. 
Most of the experiments that have been made to elucidate the 
nature of septicaemia, by Panum, Yirchow and others, go to 
show that it is due to infection with some poison contained in 
putrefyiujg matter or substances. Since Pasteur has rendered it 
probable that the ferment of decomposition either consists of, 
oris generated by bacteria, much labor has been expended 
to determine whether the poisonous principle in experimental 
septicaemia is a chemical substance dissolved in decomposed 
fluids or living germs. According to Panum, however, it is a 
chemical substance which he claims to have extracted and 
isolated, to which he has given the name of sepsin. Panum, 
however, admits that this poisonous material is produced by 
bacteria, yet he does not regard the bacteriae as the active 
agents of infection. 

Be this as it may, we always find in the pus of suppurating 
wounds micrococci in large numbers, and it is maintained by 
the great Lister that, while the products of the growth of cer- 
tain bacteria act locally on a wound, giving rise to inflamma- 



SEPTICJEMIA. 347 

tion and snpparation, it aSecte at the same time the general 
Bjatem, giving rise to traumatic fever and septic intoxication. 

This is jret a mooted question. Accepting the germ theory, 
are these minute organisms ever present in the healthy living 
body, and must they inevitably lead to septic deoompoaiftioD 
when present? Innumerable experiments, however, go to show 
that normal blood and tissue do not contain, nor even favor the 
development of these germs. The greatest proof of this we 
owe to Chanveau, in his operation of ^'Bistourage." This is 
performed by rupturing the spermatic cord, sub-cutaneously by 
tortion ; the testicle is thus cut off from its source of nutrition and 
therefore dies. Being in a closed sack (the tunica vaginalis), 
it is protected from the air, and as a fact it atrophies. Now, 
if the blood contained the putrifactive germs, it would break 
down and suppurate. This it does not do, but simply disap- 
pears by absorption. 

To prove that the germs come from external sources, Chan- 
veau injects into the blood of rams septic organisms, and 
then performs ^^bistourage." The result was, that the testicle 
broke down and suppurated. And to prove that it was bacteria 
that caused the putrifaction, he filtered the fluid and then 
injected it, but had no similar result ; and to prove that it was 
the result of traumatism, he injected two rams and performed 
bistourage on one only, and that one alone suffered putrifac- 
tion of the- testicle. 

So, we have two theories as to how the septic poison is de- 
veloped in the body — both verified by a host of learned 
men — one side headed by the great Lister, and the other by 
Panum ; but whether we accept the one or the other, matters 
not materially ; it is a serious disease, and so often fatal, there- 
fore should be guarded against with every precaution; and 
I am glad to see that the profession are generally alive to the 
importance of antiseptic methods in everything. It is when 
we have a case of septicaemia of obscure origin comes the great- 
est importance of an early diagnosis ; and in all injuries, no 
matter how slight, we should ever be on the alert for this fever. 

Antisepsis has reached such a high state of perfection that 



848 T^E APPENDIX OF MEDICAL PAPERlS. 

Burgical operations however grave, and almost impossible, are 
done now by amateurs with as much success as great openir 
tors ; and the method is so simple and cheap, and the resolts 
so satisfactory, that it should be accounted criminal to practice 
without it. In this case, the ounce of preventive is worth far 
more than the pound of cure. 

Septicemia is invariably ushered in by a chill, a peculiar 
convulsive rigor; the patient complains of being cold only a 
moment or two before he or she will be shuddering with rigors. 
In this it differs from malaria ; in a malarial chill the patient 
feels pains in the back and head and through all the joints; has 
a creepy feeling up the spine, stretches and gapes for a consid- 
erable time ere the chill comes on ; so it can not be confounded 
with malaria. After the chill there is, as a rule, a continuous, 
usually high fever without distinct type ; the skin is dry and 
hot at times, and then there may be again profuse perspiration, 
with hot or cold skin ; or again, the ekin may be cool and no 
sweating. The condition of the skin, therefore, is no guide ; 
there is usually a yellowish hue of the skin, but not invariably, 
and the icterus is never great or intense ; the pulse is small, 
frequent and constant; the tongue and lips are dry, the 
urine is scanty and high colored, and may contain albumen, the 
bowels may be costive or an uncontrollable diarrhoaa may exist, 
the patient may be apathetic and sleepy or wakeful and restless. 
The chills recur. The foregoing symptoms exaggerate ; the 
face assumes a peculiar emaciated look, a certain cadaverous 
expression that I have never seen in any other disease, except 
in one who died of starvation ; the temperature runs very high, 
from 102 to 107 ; the pulse is a bare thread, the respiration is 
quick and shallow, delirium sets in about the fourth or fifth 
day, and lasts till the patient becomes comatose and dies with 
a thread-like pulse, h'gh temperature and labored respiration. 
This outlines the symptoms that I have seen in several cases. 
There is generally affection of the lungs, the patient complains 
of pain, which is soon followed by a cough and the spitting up 
of a frothy sputa that consists of muco-purulent matter mixed 
with blood, showing inflammation and suppuration in the lung 
tissue with probable abscess formation. 



SEPTICEMIA. 349 

The symptoms of importance, and those that are invariably 
present, are the introdactory chill, the facial expression, and the 
pnlse; and as they are of snch great importance, I will recall your 
attention to them. The chill comes on suddenly, a convulsive 
shudder that may last from five to forty minutes ; it may be 
sometimes so short and slight as to be overlooked, but I have 
never found it lacking. The facial expression I can hardly 
describe ; it is a distressed, death-like look ; an expression pecu- 
liar to this fever alone, and has more the look of a person that, 
when you see them, you don't know why, but you feel that 
that man is going to die. This expression is constant, and 
comes early in the disease, even in those who recover. The 
pulse is always thready and fast, running from one hundred and 
twenty to one hundred and eighty per minute, hardly thick 
enough to count ; the temperature varies. 

If you will indulge me, I will now give three cases of this 
disease, each differing from the other in origin and general 
symptoms; one treated successfully, one unsuccessfully, the 
other not treated at all. 

Case 1. Mrs. S., aged 22, multipera. Two children living, 
three dead. Counting the case in which I was called, the three 
dead were all prematurely bom about the beginning of the 
seventh month, living only an hour or so. In this, the third 
and last case to which I was called, the placenta was retained, 
being closely adherent, so that it was impossible to break it up 
and bring it away whole. I waited ten hours, tried again and 
failed; so, taking the lesser of two evils, I tore it up and 
brought it away by bits until I could get no more. Taking a 
Davidson syringe, I attached a silver male catheter to it, irri- 
gated the womb with warm carbolized water, gave a quieting 
dose and left. 

Kext day, on my^ return, she said she felt well enough. I 
ordered a dose of castor oil for her bowels, and again washed 
out the womb ; gave another dose of morphine and left. The 
next day she complained of the horrible odor and an uneasy 
feeling in and about the womb. I gave her a little quinine 
with the morphine, and washed the uterine cavity out thor- 



350 THE APPENDIX OF MEDICAL PAPERS. 

OQghly. I was sent for in the night, saying she had had a chill. 
I went immediately; found her suffering intense agony. I 
gave her a hypodermic of morphine first thing ; examined, 
found the pulse fast and thready, the temperature 105 F., the 
facial expression septic, I washed the womb, and as be- 
fore shreds of foul, decomposing placenta would be washed 
away. I gave her digitalis and whisky and left. Next day, 
temperature same, pulse a little better, facial expression as 
before. I gave antipyrine, quinine, digitalis, whisky, verar 
trum, etc.; washed the womb out regularly; easing pain with 
morphine, promoting sleep with bromides and chloral for five 
consecutive days without effect. On the 6th day the pulse ran 
up to 107 ; patient began to have a more deathly look. I took 
some bichloride of mercury from my pocket case, sprinkling a 
good lot in a bowl of hot water and irrigated the womb witli it. 
Next day she had no fever at all, nor had she any more. I con- 
tinued with the corrosive snbl. solution. The day following (the 
8th) she had considerable uterine pain, which opiates would not 
ease. I then blew about \ oz. of iodoform into the uterine 
cavity, which eased her in a few minutes, and that was my last 
treatment. She fully recovered. Throughout this attack the 
appetite was fair, the bowels regular, the skin dry and hot, no 
icterus, the urine scanty, but not very high colored, thirst not 
great ; there was no delirium and no apathy; respiration nor- 
mal. 

Casb 2. — Boy, aged 17, of a consumptive family; right leg 
was broken by an ore car, great laceration of the soft parts, 
bone laid bare for six or eight inches, some flesh gone. I in- 
sisted on immediate amputation. Parents and patient both 
objected. I then dressed it, using thorough antiseptic precau- 
tion. Suppuration and pus formation set in early second day; 
great quantities of pus were discharged. On third day patient 
had a chill, followed with a thread-like pulse and high fever. 
Amputated 5th day, just below the knee. Operation was con- 
ducted with every precaution. Patient came out of anaesthesia 
all right. The 6th day he died of septiceeraia. In this case 
there was a diarrhoea, a cough with muco purulnet sputa, a eool 



SEPTICEMIA. 351 

skin, no perspiration, urine normal, respiration qnick and shal- 
low, facial expression the most deathly I ever saw. 

Case No. 3. — A. H., aged 28. This being the case that 
has caused me to write this paper, I must beg pardon for the 
time I shall take in its description. In January last (17th) the 
patient came in my office complaining of a terrible neuralgia of 
the jaw and face, stating that he had been to a dentist to have 
a tooth extracted. It was the wisdom tooth, right side, lower 
jaw. The dentist in extracting the tooth broke it off. Patient 
insisted that the root be taken out. Attempt was made to do 
so ; a great many instruments were used, and violent efforts 
made. The gums were badly lacerated and torn, the alveolar 
process broken, and jaw bone bruised, no doubt. The root 
remained. I prescribed an acid solution of quinine and mor- 
phine. The next day (Friday) he was able to be out and down 
town ; had his jaw tied Up ; said it bothered him a little, felt 
bad and feverish ; asked me for a purgative. I gave him a 
dose of calomel to take at bed-time, and told him to follow it 
with quinine next morning. He remained at home, next day 
was able to be up, but not out ; jaw still hurt some, had to , 
keep up the quinine and morphine. I examined his jaw, saw 
that it was greatly inflamed, involving the tonsils and throat. 
I gave a gargle of Listerine glycerine and hydrastis canadensis, 
and, as his tongae was coated I repeated the calomel 
and directed him to take quinine next morning (as there was 
febrile movement 10 grain doses at intervals of two hours until 
three doses were taken.) He had a cold stage that night and 
next day (Sunday) his symptoms were a grade worse ; fever, 
however, not very high; pain in the jaw still persisted. I gave 
him antipyrine through the day and directed quinine again for 
the next morning until fifty grains were taken. I gave no 
more purgatives, as my calomel had acted nicely. Monday 
evening, 21st, 5th day after the tooth had been pulled at, he 
had a regular rigor, at four o'clock; it came on suddenly lasting 
thirty or forty minutes and resembled greatly, convulsions. I 
happened to be with him, and had every opportunity to see 
and know the character of the chill Up to this time I had 



362 THE APPENDIX OF MEDICAL PAPERS. 

not dreamed of septic poison, but this chill, coming on as it 
did, and following it, a temperature that qnickly run nptol04, 
with a rapid thready pulse, I told his mother my opinion. She 
immediately desired consultation, and Drs. E. and W. of Grads- 
den were sent for. They examined ; we consulted and agreed 
to disagree. E. and W. diagnosed malatia, to which I dis- 
agreed. Dr. E. suggested more calomel with opium and Do- 
ver's powders, to which Dr. W. disagreed. So we informed 
the family, and Dr. E. was retained. Being a personal friend 
^ of the family, I continued to visit the patient as such onlyj and 
seeing the treatment. This was a great trial to me, for I was 
as certain that he would die as I was that my diagnosis was 
correct. I watched the symptoms throughout. Bigor would 
follow rigor at intervals of 24 to 36 hours ; the pulse continued 
weak and thready, the temperature would vary 102 to 105^, 
the bowels persisted inactive, the urine was scanty, high col- 
ored and albuminous, the skin cool and bathed in sweat ; the 
affected jaw was greatly swollen, as was the throat and muscles 
of the neck ; an abscess pointed upon the external surface just 
below the seat of trouble ; the pain about the injured tooth was 
a source of constant complaint; the facial expression septic. 
For five days these symptoms run on unabated. I could see 
the great emaciation of the face and neck grow greater day by 
day; the peculiar facial expression grew more marked hour by 
hour, and the mind became delirious, and more delirious as 
time rolled by ; he ate nothing, slept none, rolled and tossed 
day and night without opiates or stimulants. 

On the 6th day (Saturday) his mother asked me what I 
thought of him. I told her that he would die. She tele- 
graphed for Dr. Todd of Atlanta, Ga. That night coma set 
in and I thought he was gone ; however, he rallied and lived 
long enough for Dr. Todd to see him and confirm my diagno- 
sis. On Sunday the 27th, at 3 o'clock, he became comatose, 
and died at 9 p. m. There was no post-mortem. Whether the 
septic poison in this case resulted from an abscess at the root of 
that tooth, or whether the instruments of the dentist held the 
deadly toxic, will ever remain a mystery; but that be died of 



SEPTICEMIA. 858 

septice^mia there can be no doubt, and how well it notight have 
been for him if Dr. E. could have recognized it in time ; be- 
cause to cure one of this disease at all, one must know what 
they are fighting at the outset; for the treatment must be 
thoroughly antiseptic and stimulating, and of course one would 
not use antiseptics if they had not realized the trouble. Hence, 
the importance of early diagnosis. . 

After reading the works of the great Lister, and the statisti- 
cal results from the profession on antiseptic surgery, antiseptic 
dentistry and antiseptic midwifery, I feel like calling that man 
in error who will practice otherwise. The risk is so little on 
the one hand and so great on the other, that it would seem that 
every doctor would take it up ; but to-day you will find physi- 
cians that will go whacking and slashing along, hit or miss, and 
not bother with antiseptics. 

I will here lay down a few rules that I have adopted, which 
will be beneficial to those who have no better ones. 

In case of an operation, I lay out all the instruments I 
intend to use, sponges, thread, &c. I dip my instruments into 
a sol. of carbolic acid, 1 to 20, and wash my hands and sponges 
in a sol. of hydrg. bichlo., 1 to 1500 ; my thread I get already 
prepared; I wax it, however, with carbolized wax. I then 
work from beginning to end under a spray of listerine, thrown 
by an assistant, through one of Eeall & Co.'s atomizers, on to 
the parts under the operation. After the operation, I having 
dressed the wound antiseptically, I wash my instruments per- 
fectly clean, dip them in alcohol and hold them over a spirit 
lamp, burning away anything that might have adhered to their 
surface. They are then ready to be put away. 

In dressing a wound, I use either the iodoform gauze or 
cloths dipped in a sol. of bichlo. hydrg. in glycerine. I pre- 
pare these myself, following Dr. J. Lister's method. I get me 
a lot of clean rags, which are as good or better than wool or 
absorbent cotton, cut them in squares of two, four, six, eight 
and ten inches, and dip them in my sol. which I make as fol- 
lows : bichlo. hydrg. 1 part^ glycerine 4 parts, water 200 parts ; 

23 



354 THE APPENDIX OF MEDICAL PAPERS. 

• 

disBolve the bichlo. in the glycerine, and add the water After 
dipping the rags in this Bolntion I hang them np to dry, and 
they are ready for use. 

For the gauze I use absorbent cotton, with the following 
formula : 

^ — Iodoform, one ounce ; sulphuric ether, six ounces ; acohol, 
one pint — mix. 

In this solution I dip the cotton, one ounce at a time, and 
wring loosely and lay aside to dry, and continuing thus until 
all of the solution is utilized. 

The proper method of dressing wounds, such as those left 
after operations in the mouth, throat, rectum, vagina, etc., is 
with this iodoform gauze ; care should be taken that it be snugly 
packed into all the corners of the wound, filling as near as pos- 
sible all pouches and sinuses. Thus packed, it can be left six 
or eight days ; it is non-irritating and keeps a wound thoroughly 
antiseptic, no matter how much saliva, pus, urine or fserces may 
pass over it. 

By following this plan of operation and this method of sur- 
gical dressing, I have no fears of septicaemia; for having 
adopted some similar method in all my cases, ray patients have 
thus far escaped this dread disease. 

In cases of labor I adopt antiseptic measures as follows : I 
always carry in my obstetrical case a bottle of carbolic acid, 
sol. of bichlo. in glycerine, ergot, chloroform, and carbolized 
oil, two large bath sponges already prepared, a piece of carbolic 
soap, my forceps and other instruments. I first call for a basin 
of warm water ; to this I add a little of my sol. bichlo., wash 
my hands well, using the carbolic soap and a nail brush, then 
soaping my fiands well with my own soap, which is the best 
lubricator I know, I make my examination early. I ascertain 
if my patient's bed and clothing are clean ; if the bowels have 
not moved in some time, and I have time, I give an enema of 
soap-suds. I now make a fresh solution of bichlo. with rain 
water, and taking a bath sponge I bathe the vulva and surround- 
ing parts, taking care to clean the hairs. I now see that the 
clothing is jrell up towards the shoulders out of the way ; hav* 



SEPTICEMIA. 355 

ing my right hand well soaped, I use it in examinations and 
pressure on the perinseam, my left hand on the abdomen to assist 
the bearing down efforts. When I rupture the bag of waters 
or they break of themselves, I am ready with my sponges to 
catch all the discharge I can. After the child is born and re- 
moved, I sponge away all the blood and water ; then, after de- 
livering the after-birth, I sponge again — this time thoroughly, 
removing the cloths beneath my patient and bringing her 
clothes down. I now grease her well with the carbol. oil, put 
a guard of absorbent cotton over the vulva, and I am done. 

Since I have adopted this plan I have had no septic nor puer- 
peral fevers. But if, after all these precautions, septicsBmia 
should come on, I would advise irrigation of the uterine cavity 
with a solution of hydrg. bichlo., 1 to 2000, or stronger, owing 
to the amount of retained placenta and secondines. 

In dentistry, that is such] dentistry as we doctors in small 
towns and the country have to practice, we should use still 
greater precaution ; for the mucus lining of the mouth is very 
vascular and poison is very quickly absorbed, and when there 
is a solution of continuity, how much quicker? A friend of 
mine told me the other day that he inoculated a man with 
syphilis by pulling a tooth twenty or thirty minutes after he 
had pulled one for a man who had the disease, by using the 
same instrument. Other poisons can be and are transmitted 
into the system in the same manner; so, it is exceedingly im- 
portant that antiseptic precautions be observed in pulling a 
tooth. The method I have adopted is simple, yet perfect. I 
hit my lancet a lick or two over an oil-stone greased with carbol. 
oil, wipe it, dip in alcohol and hold over a spirit-lamp a mo- 
ment, and cut around the affected tooth. I then dip my for- 
ceps in the alcohol and hold them a little longer in the flame 
to warm them as well as disinfect them, as warm forceps hurt 
less than cold ; and after the operation I of course wash both 
lancet and forceps clean before putting them away. I then 
give my patient listerine as a mouth wash ; and following 
this plan I feel no uneasiness but what that patient will do 
well, no ms^tter how u^l^ an s^bscQss may be at the root of the 



366 TEE APPENDIX OF MEDICAL PAPERS. 

tooth or how violent the methods I have to adopt to get the 
tooth out. 

These are the prophylactic measures. Treatment proper for 
this disease, after all preventive measures have failed, 
or in cases of septicsemia where yon are called after 
the trouble has begun, is to support the patients strength, 
stimulants and nutritious diet are indicated; as a stimulant I 
use alcohol, in the form of whisky, brandy and wine, and £ 
give it in large quantities like I would in snake-bites. Quinine 
digitalis and opiates are also beneficial, the first to control the 
fever and convulsions, the second to control the hearts action 
and the pulse,' the latter to ease pain and give rest. Mercuric 
bichoride is also indicated with a view to its germicidal effect 
constitutionally, for if this poison is produced by living germs 
infecting the curculatory fluid, which we have every reason to 
believe, why should we not give the germicide internally, as 
well as apply it locally, to arrest the poison? I do, and where 
the symptoms have become alarming, I would advise the 
bichloride given hypodermically in from one-sixteenth to one- 
eighth grain doses, at intervals of say from three to five hours. 
This can be safely done in a solution of one to five hundred 
water, without any trouble locally at point of insertion. For 
diet I would prescribe milk, milk punch, milk shakes, eggs, 
soft boiled, egg nog, chicken broth,'beef tea, oat meal parridge, 
wild game, fowls and coffee. 

Bromide and iodide potash I have found beneficial, the first 
to relieve the brain and quiet the nervous excitement, the latter 
as an absorbent. 

For local treatment at point of infection, the antiseptic 
methods already described should be redoubled, turn out the 
pus, remove diseased bone and flesh, if any, and thoroughly 
cleanse and disinfect and guard against further invasion of the 
toxic agents. 

As to the pathology of this disease, I have never had the 
opportunity to investigate, having never been at nor conducted 
a post-mortem examination in septicemia, so what I might say 
in regard to the appearance of the different parts of the human 



SEPTICEMIA. 35t 

orgaDism, the blood and other fluids, wonid simply be a recapit- 
ulation of what the books say, with which do donbt yon are all 
familiar. Yet to make a finish of my subject, which I hope 
has giv^n some entertainment, I will briefly as possible men- 
tion some of the post-mortem appearances as given by Billroth, 
to whom we owe no little, as he devotes pages to this subject, 
in his work on pathological surgery. 

^'On autopsy," he says, "you find nothing pathological in the 
skull, heart and pericardium, normal in the right auricle and 
ventricle, a firmly coagulated white fibrinous clot, both pleural 
cavities are filled with a cloudy serous fluid, the surface of the 
lungs are covered with jaundiced layer of net like fibrin, re- 
moving this we find just beneath the surface of the lung, and 
especially in the lower tubes, a lot of fine nodules, the size of 
a chestnut, bisecting them; they are discovered to be abscesses, 
at least the greater number; a few are blood red, somewhat 
granular, and in their midst spots of pus varying in size, some 
of these lie so near the surface they implicate the pleura, and 
pluritis is secondary. 

The liver is very vascular and friable and filled with abscesses 
like those of the lungs, especially if the injury is one of the 
head, the spleen is somewhat enlarged and one section shows 
firm wedge shaped nodules, pointing inward, their broad ends 
being at or near the surface, these nodules are found to be 
partly broken down with pus. 

The intestines are usually normal. Abscesses are found in 
the kidneys and articulations. 

In the blood of the veins pus is found and in more or less 

« 

quantity in nearly all the parts of the body. 

These are the principle pathological features as laid down by 
Billroth, as you see they are separate and distinct from the 
pathology of any other diseases, and show undoubtedly that 
the circulation of pus in the blood absorbed from wounds as 
pus, or as bacteria that quickly change to pus, causes general 
infection of the whole system, and sets up this dread disease. 



358 THE APPENDIX OF MEDICAL PAPERS. 



OVARIAN TUMORS. 



BY M. J. THOMPSON, OF MERIDIAN, MISS. 



I desire to present to yon, for your inspection, a variety of 
ovarian tnmors, which will donbtless interest yon. The stndy 
of this class of tnmors is comparatively recent, and at present 
is attracting more of the attention of the snrgeon and gynecol- 
ogist than any other morbid condition of the hnman body that 
is remediable by snrgical measures, and the saccesses of Tait, 
Hewitt, Wiley, Thomas, Polk and many others, in this partic- 
ular branch of surgery, has elevated the operation to the first 
rank among surgical operations. 

The first of these specimens is an ovarian polycist, some of 
which are as yet unruptured. You will observe that it is a 
perfect cyst. The most interesting of its history is that it was 
taken from a pure negress. Many gynecologists, among whom 
was the famous Atlee, claim that a pure negress can never 
have a pure cystic tumor of the ovary, but that all tumors in 
that class of our population are necessarily either fibroid or 
fibro-myomatous in their character. I am satisfied that this is 
a mistaken idea. The cyst was removed by my partner. Dr. 
W. F. Hyer, formerly of Holly Springs, Miss. The next pair 
of tumors that I show you were removed by myself on the 
nineteenth of last month, with a perfect recovery. You will 
notice that they are perfect fibroids the largest, somewhat 
kidney shaped, and weighing about two pounds, the smallest 
about two ounces. In this case the menstruation was regular 
in point of time, very profuse, painful, and lasting from six to 
ten days. The pedicle was broad, thick and short, so vascular 
that the hemorrhage could not be controlled by silk ligature, and 
we were compelled to controle the hemorrhage with the elastic 
ligature, fixing the stump in the lower part of the incision. 



OVARtAN TMORS. 3Sd 

The third specimen is a pair of tnmors removed from a woman 
on acconnt of continaons pain at all times, but agonizing dur- 
ing the meustmal period. Yon will notice that the larger one 
is a perfect cyst, and that a portion of the smaller had become 
cystic and was undergoing the process of degeneration. This 
latter operation yon will find about the biggest operation you 
ever attempted when you try it on, provided firm adhesives 
have fastened it to the posterior surface of the broad ligament 
It is not necessary to describe the details of these operations 
as they are found in all works on surgical gynecology, but they 
are presented only as objects which may perhaps interest you. 



360 THE APPENDIX OF MEDICAL PAPERS. 



ASCITES. 



BY CHARLES WHELAN M. D., OF BIRMJ/TGHAM. 
Junior Counsellor of the Medical Association of the State of Alabama. 



The limited time 'allotted me between the request of onr 
president that I should prepare a volnnteer paper, for the pres- 
ent meeting of the association, and my resolution of fulfilment, 
prevents me from doing more than offering for your consid- 
eration, an anomalous case of ascites occurring in my practice. 

I purpose, then, to make this paper as brief as it is possible, 
consistent with the objects of inquiry, and I trust that it may 
invite such discussion as the importance of the subject de- 
mands. 

The questions which chiefly concern me in my case are : 
1st, on what cause was the dropsy dependent ; 2d, have we 
scientific methods sufficiently correct, approximately, to deter- 
mine in all cases, and 3d, if not, is laparotomy ever justifiable 
and under what circumstances ? Before I pass in review the 
several questions involved, I will briefly introduce the patient, 
with such antecedent history as I obtained from her own lips. 

In the month of September, 1888, I was summoned pro- 
fessionally to prescribe for Miss L., a young lady in her 19th 
year. I found her with every indication of good health, cheeks 
carnation glow, nutrition perfect, and with no symptom that 
she was a victim of organic disease. The pulse, however, was 
accelerated and the breathing quickened, which were not de- 
pendent, as the sequel will show, either on lung or heart com- 
plication, but purely the efiEect of pressure. 

I did not at this visit make an accurate examination, as it 
was disclosed during the conversation that she had been for 
three or four months before, an inmate of the infirmary of a 



ASCITES. 361 

distingnished Bpecialist in a distant state. I, therefore, pre- 
ferred to correspond with him before expressing an opinion. 

I accordingly addressed him a letter of inquiry, from which 
I elicited the following history of his connection with the case : 

NoYBMBEB 19th, 1888. 
Dr, Charles Whelan, Birmingham^ Alabama: 

Deab Doctor : Your letter is received. I found in the case of Miss 
L. some endometritis, for which I made application. I did not find 
any heart disease. The enlargement of the abdomen, I think, is gas- 
eous and hysterical. 

The amenorrhcBa, seems to me, due to atony of the ovaries, and I 
would suggest to you, what I did not try in her case, electricity. This 
seems to me a very promising resource now." 

It is proper I should state here, that six months inter- 
vened between the time she left his infirmary and became my 
patient; yet it would seem from the doctor's letter, that her 
abdomen was abnormal when he saw her, a fact patent to the 
young lady herself, as she informed me ; but she placed no 
emphasis on it during her residence there, and never alluded to 
it, to the doctor. 

I make this explanation in courtesy to the justly distin- 
guished position of a distant specialist, and suggest the proba- 
bility, that when he saw her, there was no accumulation, and 
that she required only such treatment as he addressed. Par- 
don this digression. A second but more accurate examination 
of her history and symptoms, revealed the fact that she had 
been irregular in her menstrual function from its establishment; 
the discharges, however, were unaccompanied by pain, but 
scant, and light colored, and further that she had passed four 
years in its history with complete suppression, and has not from 
this date menstruated in two years. 

Ko monthly constitutional disturbance or other reminders 
occurred in the history of this function to emphasize the fact 
that one of nature's laws in the life of every normal woman 
was being disregarded. The closest scrutiny for vicanous 
hemorrhages, were answered in the negative, and I was thus 
left to my own resources to answer an anxious patient and 
solicitous parent, ''what can the matter be?" I proceeded now 



362 THE APPENDIX OF MEBtCAL PAPERS. 

to subject my patient to the recognized methods known to onr 
art to ascertain as far as possible to what the enlargement of 
her abdomen might be dae. 

For differential points of diagnosis, I carefally interrogated 
her, 1st, as to retained menstrual fluid, 2d, ovarium cyst proper 
or extra, 3d, ascites, dependent on cirrrhosis, 4th, effusions due 
to heart, spleen and kidneys, 5th, extra peritonial dropsy as 
described by Gross, 6th, those occurring as result of peritonitis, 
whether acute or chronic, cancerous or tuberculous, and inde- 
pendent of obstructive causes. Through this method of exclu- 
sion I narrowed the investigation to that of a diagnosis between 
ovarian dropsy and ascites dependent on cirrhosis. 

The differential points emphasized by our writers for pur- 
poses of clinical distinction, were not to my mind sufficiently 
clear for a positive opinion. 

As I before remarked, the nutrition of my patient, the absence 
of the characteristic facies ovarina, together with the objective 
signs, satisfied me that it was not a case of ovarian dropsy; and 
yet when I percussed over the right ovarian region, there was 
a considerable area of dullness, with the patient on the le/i 
aide. 

The extreme distension of the abdomen with the fluid, ob- 
scured the boundaries of the liver, so that if I had been an ex- 
pert physical diagnostician, I was prevented from ascertaining 
the question of ascites dependent on cirrhosis. 

From prudential considerations I refrained from aspirating 
the abdomen, remembering the teaching of Goodell and others^ 
that even the thrust of a hyperdermic needle in an ovarian cyst 
for purpose of diagnosis, might produce peritonitis and death. 

It here occurred to me, that the Southern Gynecological As- 
sociation would meet in Birmingham early in December, when 
I believed that whatever doubts remained with me surely 
would be adjusted by some specialist in that body. 

I^communicated with my patient, overruling her importunate 
demands of me for an opinion, until that auspicious occasion. 
I accordingly visited that body and inquired for one of its 
most distinguished members, and was introduced to one of the 
visiting number from the State of Kentucky. 



ASCITES. 363 

I explained my difficulty, read the published letter to him 
quoted in this paper, gave him my own views of the case, and 
begged that he would equip himself with the numerous imple- 
ments of modern gynecological warfare, and proceed to her 
chamber. 

He courteously acceeded to my wishes, remained over an 
hour, examined her with the greatest particularity digitally 
and with speculum, propounding every question necessary for 
purposes of ascertaining the history of her case. 

I sat patiently by, and after he had finished, I asked him if 
he had satisfactorially to his own mind, arrived at a diagnosis, 
that he would oblige me by introducing a sound into the womb, 
and a trocar into the abdomen, both of which he declined. 

He was summoned home that night by telegram, and I was 
still in doubt. 

The next day, determined to exhaust the further talent of 
that distinguished body, I requested Drs. Hardon and Bizzell, 
of Atlanta, to visit her with me, who concurred in ray opin- 
ion that the containing fluid was in the peritonseum, indepen- 
dent of ovarian cysts. With this opinion, a trocar was intro- 
duced, and over two gallons of ascitic fluid was drawn from 
her abdomen, with greatly relief to her respiration and circu- 
lation. 

It was now possible to interrogate the liver, ovaries and ab- 
dominal viscera; but these gentlemen, like myself, could 
assign no satisfactory, pathological reason for cause and effect. 

At their request I sent the fluid by express to Atlanta which 
they examined chemically and microscopically, showing the 
absence of Dnysdale's cell, frequently present in cystic degen- 
eration of the ovaries, but an abundance of albumen character- 
istic always of ascites. 

She represented that she felt better than she had for the 
last two years, remained in bed only one day, her breathing 
and pulse became normal, she went about wherever and when- 
ever she pleased without embarrassment. 

I prescribed, tentatively, the old pill of blue mass, digitalis 
and squills, with hydragogue cathartics, until I became con- 



864 THE APPENDIX OP MEDICAL PAPERS. 

vlDoed that £ was draining her system, without any correspoud- 
ing good to my patient. 

I therefore concluded, with the lights before me, that it was 
the purest empiricism to be daily drugging a woman, the very 
picture of good health ; and I at once made up my mind to 
rely exclusively on paracentesis, which since December the 3d 
has been done five times, with no diminution of recurring quan- 
tity of fluid, or so far as I can determine, with either sensible 
effect on her constitution, or with any promise that the tapping 
will ultimately relieve her. I have relied, as I before remarked, 
on paracentesis, purely in an empirical way, as I have been on- 
able to trace the dropsy in this case to its causative morbid 
condition. 

I have searched the literature of this subject through the 
pages of every reliable standard authority to justify me in the 
hope, that my case might not belong to none of those rare 
ones, where the hydroperitoneum might occur as a functional 
affection. 

In support of this bare hope, I find in Ziemssen's Encyclopae- 
dia, vol. 8, in discussing ascites, the following language : "For- 
merly, in addition to these secondary effusions into the abdom- 
inal cavity, the existence of an idiopathic ascites was believed 
in, and even nowadays the possibility of such an occurrence is 
upheld by many observers." 

That such an idea is not purely chimerical, in forty-six cases 
(I quote from Flint, and analyzed by him), in one case only 
was the history consistent with the supposition that the affec- 
tion was purely functional. 

I can now remember one case in my own practice, and in 
conversations with our local physicians, they cite other cases, 
in which the operation was resorted to alone, with permanent 
relief to the patient only after several tappings. 

I then must admit that I am fostering rather a forlorn hope, 
that either tapping or hydragogne- cathartics will ultimately 
benefit my patient; but with the objective and subjective 
symptoms I am quite confident in the assertion, that between 
a choice of remedies, paracentesis offers the speediest method 



ASCITES. 866 

of temporary relief, and with the least danger of depressing 
the vital powers. 

Flint emphasizes this idea in very forcible language, when 
he says, owing to the disturbance and prostration caused by 
prolonged use of hydragogues, they are liable to do harm, and 
should not enter largely into the treatment. 

Little dependence, he further says, is to be placed on diuret- 
ics, but recommends them in a negative way, as they do not 
cause so much disorder or prostration. 

In the Year Book of Treatment of 1889, Dr. Duckworth 
writes : '^It seems highly unscientific (and I most cordially en- 
dorse the writer), to attempt to remove large quantities of as- 
citic fluid by purgatives and diuretics, when so ready and rapid 
a means of evacuation are at hand in the form of paracentesis." 

It is to be remembered, that the circulation in the intestines 
and kidneys is already much interfered with by the pressure of 
the fluid, and yet these organs are often called upon by the 
physician to do extra work in their disabled state. 

It would then seem, from all the evidence, that whether a 
diacrnosis be made or not, tapping offers the most favorable 
temporary relief for the patient, even in organic forms of the 
disease. But let us briefly recur to the propositions laid down 
for discussion at the outset of this paper, and dispose of them 
in their order. 

As to the first, on what cause is the dropsy dependent? I 
must answer that I am in cimmcrian darkness. 

Second : Have we scientific methods, sufficiently correct even 
approximately, to determine in all cases? 

I reply, that I believe, in the form dependent on cirrhosis, 
which is recognized to be one of the most prolific causes, that 
very few men, if any, are competent to pronounce ez-cathedra, 
on this question, especially since there are so many sources, 
which Dr. Loomis justly states may lead to error in the con- 
clusion, that the liver is the seat of the disease. 

Every student leaves his college with a definite, or, if you 
please, an indefinite knowledge of the normal boundaries of 
the liver, and I have no doubt that he can give you its topo- 



n 



866 THE APPENDIX OF MEDICAL PAPERS. 

graphical anatomy by metes and bounds as accurately as the 
average real estate man in Birmingham can those of a corner 
lot. But what an immense advantage the latter, with his the- 
odolite and unobstructed field of vision, possesses over the for- 
mer, with his pleximeter (percussion and palpation, forsooth), 
with an abdominal wall cutting off his vision. 

I intend no reflection on physical diagnosis as an art or sci- 
ence, if you please, in some of the more pronounced forms of 
hepatic disease, and regard it as a valuable resource ; but how 
many difficulties could be suggested for purposes of accurate 
diagnosis, that would humiliate even a Loomisora DeCosta in 
clinical differentiation of some of the obscurer forms ? 

Does^not cirrhosis very often exist, with no positive means 
of ascertaining it with the methods in vogue, as taught in our 
text books, or as solved by a brother of an experience of even 
a quarter of a century. 

In proof of this position, no very extended argument will be 
demanded of me by this body ; and I shall therefore declare it 
to be almost an axiomatic truth. 

The received doctrine in the pathology of cirrhosis is, that it 
is a connective tissue leision. 

In the first stage, the liver is somewhat increased in size ; 
then as Glisson^s capsule thickens more and more, the bulk be- 
comes reduced. In this connection, DeCosta very truthfully 
records his views on this question in the following lan- 
guage: "It is, however, very doubtful whether the stage 
of enlargement invariably precedes that of shrinking; proba- 
bly the process of reduction constitutes at times the first mor- 
bid change. 

"But without entering into this question, we may state that 
there are no symptoms by which we can recognize the disease 
at an early period, whether or not the liver be augmented in 
volume; for the symptoms at first are the same as those of 
chronic congestion or chronic inflammation of the organ, nor 
can we say even after the stage of contraction is fairly devel- 
oped, that the diagnosis of the affection is easy, or indeed pos- 
Bible." 



ASCITES. 867 

I note that this writer cites other manifestations to assist in 
diagnosis of cirrhosis as the disease progresses, symptoms not 
necessary to embody in this paper, as they are familiar to yon 
all ; and after reciting them in detail, he concludes not one of 

THESE SYMPTOMS ARE REALLY 0HARA0TEBI8TI0. 

In farther corroboration, Dr. Adolph Strampell, in his Text 
Book of Medicine, in discussing the diagnosis of cirrhosis, em- 
ploys this language : "We must be cautious, for portal ob- 
struction, with precisely similar results, may be due to other 
causes like the external pressure of tumors or portal throm- 
bosis.' Many forms of hepatic syphilis can not be differentiated 
from cirrhosis by mere clinical observation of the hepatic dis- 
order." 

I hope that I have satisfactorily disposed of two of the prop- 
ositions announced in the early part of this paper, and if I 
have, the third proposition would follow in logical sequence, 
viz : that laparotomy is a justifiable procedure, under just such 
circumstances as complicate my case of ascites. 

With a view of inviting discussion, I introduce the question 
of laparotomy, as often the only means left the physician in 
solving the many difficult questions surrounding abdominal 
dropsy. 

I am informed by Dr. Ashby of Baltimore that opening the 
abdomen for ascites is not a new idea. He states that Sir Spen- 
ser Wells, in 1862, made an exploratory incision in a case of as- 
cites, dependent on tuberculosis of the peritonseum. The pa- 
tient was twenty-two years old and unmarried, suffering from 
ascites, and as his diagnosis was uncertain, an exploratory inci- 
sion disclosed myriads of tubercles studding the peritonseum. 

The patient recovered and was still living in 1884. The 
same writer records two operations in America in 1887; in one 
case the exploration revealed nothing. The result, however, in 
all, was stated to be satisfactory. Whilst the literature of this 
subject is meagre and unsatisfactory for statistical value, it 
furnishes valuable evidence, and authorizes this procedure for 
diagnostic purposes, notwithstanding the seeming gravity of 
the operation. 



868 THE APPENDIX OF MEDICAL PAPERS. 

In stadying the subject of ascites from the standpoint of my 
patient, in whose case I feel more than ordinary interest, I 
frequently asked myself the question, how long should I con- 
tent myself with hydragogue cathartics, diuretics and the 
trocar? Is there to be no limit to this unscientific method of 
treatment, even for temporary relief? When am I to discon- 
tinue such profitless therapy, and invoke the 'aid of the 
surgeon? I do not think I can answer these questions so well 
as Dr. T. A. Ashby, of Baltimore, has done, in the January 
number, 1889, of the American Journal of Obstestrics, in his 
paper on ^Maparatomy for ascites,'' an operation bold in concep- 
tion; nevertheless his case is certainly a most significant one, 
and sustains the proposition I started out with: how great 
difficulty encompasses the diagnosis of ascites, and in fact, how 
impossible often it is, to do so, or remove the cause, if remedi- 
able, by the methods hitherto employed. 

I consider myself fortunate in discovering the able paper 
above referred to, and if my own remarks point no moral other 
than emphasizing and giving circulation to that of Dr. Ashby's 
paper, I shall feel that I have not written in vain. 

With the permission of the association I will quote what Dr. 
Ashby states, with reference to the question of "laparotomy 
for ascites," and give his case in as condensed a form as I can, 
consistent with a clear understanding of it. 

"The question will arise, does the risk involved in an explor- 
atory incision overbalance the probable advantages which may 
result from the information it is likely to impart? 

I shall not call in the aid of a long list of statistics to guide 
us to the answer of this question, but relying upon the growing 
experience of the profession, axiomatically assert that explora- 
tory laparotomy carefully aseptically performed, is compara- 
tively speaking free from danger, and should be undertaken in 
all cases in which the surgeon has a reasonable hope of render- 
ing a service commensurate with the risks it imposes. 

In abdominal accumulations the peritonseum is more tolerant 
of interference than in other conditions, and septic processes 



ASCITES. 369 

are less likely to resnlt, hence we approach a laparotomy under 
conditions more favorable than those usually found. 

Peritonitis is an infrequent result of abdominal paracentesis. 
When aroused in the wake of this procedure an explanation 
will readily be found in the methods employed. 

Mere opening of the abdominal walls with the knife has become 
one of the safest procedures in abdominal surgery, and gives 
such results, that a growing experience has demonstrated it to 
be admissible as an invaluable aid to diagnosis. 

If it be strictly within the province of scientific work to ex- 
plore the abdominal cavity for the elucidation of such symptoms 
as pain, reflex disturbances, and other intra-abdominal condi- 
tions, an equal claim should be established for the practice of 
a procedure, which may enable the surgeon to remove the 
cause of such a symptom as ascites." 

I regret that he omits in his paper to inform us what partic- 
ular blood vessel was encroached by the tumor, obstructing the 
circulation, and pronouncing the ascites. 

The following is a condensed statement of the case as re- 
ported, at length, by Dr. Ashby, in the Journal of Obstetrics 
of January, 1889: Miss H., age nineteen, Baltimore, Md.; both 
sides of family tuberculous; had a cough for past few months, 
disappearing; well nourished, plump, healthy; in February and 
March, periods were shorter than usual; in April and May, be- 
came continuous and health suffered; May 1st, abdomen began 
to enlarge, and by the 23d was alarmingly distended with 
fluid; examination of lungs, heart, kidneys, liver, spleen, etc., 
appeared normal; vaginal examination showed tenderness over 
either ovary; on June 1st, paracentesis abdominalis, withdrawal 
of two gallons of ascitic fluid; examination as to causation, 
negative; June 5th, cavity of peritoneum again filled, second 
pelvic examination revealed nothing; the trocar, hydragogue 
cathartics and diuretics offered little or nothing; the diagnosis 
was, therefore, undetermined, but supposed to be ascites, due 
to band compressing abdominal vessels; exploratory laparotomy 
was advised and accepted; median^ incision, escape of three 

gallons of fiuid; hand pressed in, showed right ovary cystic, 
24 



870 THE APPENDIX OF MEDICAL PAPERS. 

Bize of billiard ball, removed, with its tabe. Further examina. 
tion show fibro-mjoma of left broad ligament as large as a 
hens egg, this was removed with the finger; it making pressure 
on the broad ligament, plexas was supposed to be the cause of 
the ascetes; recovery with cure. 



The next Annual Meeting of the Medical Association of the 
State of Alabama, will be held in the city of Birmingham on 
the second Tuesday in April, 1890, at 12 o'clock noon, and 
continuing four days. 

Each county is entitled to send two Delegates. The assess- 
ment upon the Oonnty Societies is onb dollar for each mem- 
ber, exclusive of Counsellors and Delegates, the former of 
whom pay a fee of ten dollabs and the latter five dollabs. 
Further particulars will be found in the Annual Circular 
Letter of the Secretary, to be issued March Ist, 1890. 



INDEX. 



PAGE. 

PUBLISHING COMMITTEE 2 

MINUTES OF THE PROCEEDINGS— First day 7 

Grand Senior Counsellors ; Senior Counsellors 7 

Junior Counsellors ; delegates 8 

Health Officers present 10 

Members of county societies visiting ; Fraternal Messengers 10 

Address of welcome 12-13 

Annual message of the President 15-28 

Quarantine 19 

Public sanitation 20 

Biographical sketch of Dr. M. H. Jordan 29 

Report of the Senior Vice-President 32-39 

Report of the Junior Vice President 40-46 

Revision of the minutes of last session 47 

The annual report of the secretary 48-56 

Exchanges received 48 

Rolls and Records 49 

Correspondence 51 

Duties of County Societies 52 

Vital statistics ; the omnibus discussion 53 

Reports in relation to diseases 53 

Annual Report of the Publishing Committee 55 

Classified list of exchanges 55 

Medical journals 56 

Annual report of the Treasurer 57-63 

Dues from counsellors 57 

elect ; from delegates 59 

county societies 61 

Statement; credits 62 

Business Reports of County Societies 64-69 

Schedule of special committees 70 

Excursion ; Evening session 71 

PROCEEDINGS OF THE SECOND DAY 73 

Schedule of the Regular Reporters ; Volunteer papers 74 

Evening session 75 



374 INDEX. 

PAOB. 

PROCEEDINGS OF THE THIRD DAY 76 

PROCEEDINGS OF THE FOURTH DAY— Vote of thanks 77 

Sixteenth Annual Report of the Board of Censors, inclading 
reports of the State Board of Medical Examiners and Com- 
mittee of Public Health 79-142 

Part I — ^The Report of the Board of Censors 80 

The work of the State Association 80 

The President's Message 81 

The Report of the Vice-Presidents 82 

The Report of the Publishing Committee S3 

The Report of the Treasurer and book of accounts. . 83 

The Roll of Correspondents 84 

The Revision of the Minutes 85 

Business Reports of County Societies ; new rule of 

order 86 

Part IV of the Censor's Report 85 

Counsellors by Congressional Districts 86 

Library and Museum 86 

Binding the Book of the Rules ^ 87 

The Button Badges 88 

The recent session of the General Assembly 88 

Part II — The Report of the State Medical Examiners 92 

The work of the State Board of Examiners 92 

The administration of the law to regulate practice. 93 

How illegal doctors should be treated 94 

Binding Examination papers 95 

The work of the County Boards 96-108 

Part III— The Report of the State Board of Health 108 

The work of the State Board of Health 108 

Delinquent counties 110 

The investigation of delinquent county societies 111 

The Color Blind Law 112 

The Quarantine Code of Alabama 113 

The Quarantine of Railroads 113 

The local management of yellow fever .... 114 

Non-interference ; disinfection 116 

Depopulation. 116 

Shot-gun Quarantine ; Health certificates 117 

Place of refuge 117 

When refugees may return 118 

Hibernation ; financial management 118 

The exemption of the State Health Officer from 

quarantine restrictions 120 

Expenditures ; credits 122 

The work of the County Boards of Health 126-135 



INDEX. 875 

PROCEEDINGS OF THE FOURTH DAY— Continued. page. 

Part IV — Supplementary Pai>ers 135 

The work of the Montgomery Quarantine Confer- 
ence; Propositions adopted by the Quarantine 

Conference 135 

When physicians may return 140 

Rules prepared by the committee 140 

An act 142 

The action of the Association on the Report of the 

Board of Censors 143 

The Revision of the Book of the Rolls 143 

Roll of County Societies 143 

College of Counsellors 143 
The Grand Senior Counsellorg ; Senior Counsellors 143 

Counsellors elect 147 

The Revision of the Roll of Correspondents 148 

Officers 148 

Installation of president 149 

The Annual Rbgistbb 150 

The Book of the Rolls ; introduction 153 

The Roll of the County Societies 153 

The Roll of the College of Counsellors 218 

The Grand Senior Counsellors 218 

The Senior Counsellors ; junior Counsellors 219 

The Counsellors elect 220 

The Roll of Counsellors by Congressional Districts 221 

The Roll of Correspondents 225 

Officers 225 

Board of Censors and Committee of Public Health 225 

The Schedule of Regular Reporters 226 

special committees^ 227 

annual sessions 227 

annual orators 228 

The Obituary Record 229 

THE APPENDIX OF MEDICAL AND SANITARY DISSERTA- 
TIONS AND REPORTS 231 

The Annual Oration 233-247 

Electricity in Gynecology 248-264 

Eclampsia Gravidarum 265-276 

Dr. James M. Godfrey 276 

Dr. Edwin L. Marechal 277 

Dr.E. H. ShoU 278 

Curability and Treatment of Pulmonary Phthisis 279-298 

Treatment 281 



876 INDEX. 

PROCEEDINGS OF THE FOURTH DAY— Continued. page. 

Dr.W. H. Abernethy 293 

Dr. Edward H. Sholl 293 

Dr. George W. McDade 294 

Dr. John P. Stewart 295 

Dr. William A. Wheeler 296 

Ar. Angelo Festdrazii 297 

Dr. A. A. McKittrick 298 

Dysmenorrhoea ; Its Cause and Treatment 299-308 

Dentition 309-316 

Recent Advances in the Radical Care of Hernia 317-324 

Dr. John D. 8. Davis { 324 

Epicystic Sargical Fistula for Cystoscopic Exploration ; Intra- 
vesical Treatment and Drainage 326-340 

(I) Definition of Epicystic Surgical Fistula 328 

(II) Surgical Resources in the Formation of the Epicystic 
Surgical Fistula 328 

(1) Preparation for the Operation 328 

(2) Anaesthesia, (3) Position 329 

(4) Incision and opening of bladder 330 

(5) Intra-Vesical Exploration and Treatment 330 

(6) Toilette and after Treatment 331 

(III) Advantages of the Epicystic Surgical Fistula, (I) Cys- 

toscopic Exploration : 332 

(2) Intra-Vesical Treatment 333 

(3) Drainage 333 

Dr. George W. McDade 534 

Complication of Diseases 341 

Septicscmiii ; Importance of Early Diagnosis 345-^3 

Ascites 360-370 



/ 



i