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THE SOUTHERN PRACTITIONER

AN INDEPENDENT MONTHLY JOURNAL

DEVOTED TO MEDICINE AND SURGERY

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BY WILLIAM S. CHRISTIAN, M. D., PRESIDENT OF MEDICAL SOCIETY OF VIRGINIA.

IN accordance with the time-honored and inviolable custom of your Society, I am required as the president of this splendid organization to make before you an annual address.

Before entering upon the discussion of the subject of that address it behooves me to ask why I am here in this exalted capacity? I am startled, bewildered, and embarrassed by the fact that I am here at all to-night as your chosen presiding officer. Circumstances beyond my control prevented me from attending

Reprinted from the Virginia Medical Semi-Monthly of Oct. 27, 1905. Read at the annual meeting of the Virginia Medical Society.

the session of your body last year in Richmond. I received a letter the second day of your meeting from a warm personal friend, a distinguished member of your society, telling me if I was present I could be elected president for the coming year, but that it was an unwritten law of the Society that no one could be elected to that high position unless he was present, and urging me to come, if only on Friday. I could have gone Friday, but did not like to do so with this threat hanging over me. Then to my overwhelming surprise, on Friday night I received several telegrams of congratulation, all telling me I had been unanimously elected president of this great Society. This information, I must confess, literally took my breath away, and I have been wondering from that day to this why this unmerited honor should have been bestowed upon me in this unusual manner. That it was an honor, and a distinguished honor, no one can deny. That it was unexpected, unsought, and undeserved, no one knows better than myself. That I appreciate it, and greatly appreciate it, no words of mine can adequately express.

In casting about in my mind for some reason for this exalted honor being conferred upon me by the noblest and best body of men ever assembled in Virginia, I am, as I said, embarrassed and bewildered beyond degree. It is not because of any high scientific attainment I may have been thought to have possessed, for nothing of the sort has been claimed for me. I have been the author of no medical books, have been professor in no medical college, have been conductor of no large and popular hospital, have held no important public office, have been no politician or otherwise prominent in the public eye. I have been simply an every-day, old-fashioned country doctor, probably outstripping in years of practice nearly, if not quite, every member of this body in my record of fifty-four years. I am, however, known by many of your society as a lover of my profession and of my professional brethren; and am proud of the fact that while practicing in one community for over fifty years, having been in contact and competition with some two score of doctors, they were all my warm and professional friends, and to a half score or more I was virtually their family physician. For my known

love for my profession and my brethren, and because I am a plain old country doctor, I must conclude is the reason you have thus honored me.

Therefore, to-night I shall not discuss before you any new or obscure or scientific medical subject; shall say but little about society matters. My distinguished predecessor most ably discussed these things. My theme shall be simply "The Country Doctor."

But I must first congratulate you upon the progress of your society. You come to this, thirty-sixth annual meeting, under splendid auspices, with an increased membership, with sound financial standing, with a large attendance here of representative physicians of Virginia, many distinguished physicians as your guests from other States, and your program shows an array of papers to be read before you by distinguished authors that beats all former records of your annual meetings, and are receiving a royal welcome from the profession and people of this beautiful city by the sea-a city that all Virginians are bound to love on account of its history and its traditions and its well-assured future. Greater Norfolk, we are told, will soon be a reality, which will mean in a decade or two the largest city of the South with an industrial and commercial development that will astonish the world. The rivers and the railroads that are tributary to Norfolk are to-day emptying into her lap the richest and most valuable products of our common country. All hail to Greater Norfolk - Virginia's great seaport, the South's and West's great outlet for their wonderful productions, the attractive harbor and exporting center of the commerce of half the world! She welcomes us to-night, and we accept her hospitality with unqualified delight.

But to my subject - The Country Doctor.

I am reminded at the outset of what my distinguished brother in the profession, Dr. Gordon, said in his splendid oration to the public and profession last year in Richmond (which I did not hear but read with great delight), words taken from Holy Writ— "There is no new thing under the sun." Much has been written about the country doctor- much in praise, much in slightly

veiled sarcasm, much in flippant ridicule, much in prose, and much in poetry; but I am here to say that the country doctor, if he has borne that title many years, has by training and experience, become so toughened and seasoned that he can bear all this and much more with undisturbed equanimity. He has more serious trials to face, more serious difficulties to overcome, graver duties to perform, heavier responsibilities to meet, than to be swerved from his course long enough to have his ears tickled by too fulsome praise of over-zealous, grateful friends; or his anger kindled by the assinine ridicule of flippant, witless wits. His duties and his responsibilities are those that involve the deepest interests of humanity, those that lie closest to the human heart. The city doctor and the country doctor have much in common: they both belong to the noblest of all professions; they both and together dispense more real charity than all other professions combined in all the world; they both include in their ranks many of the manliest and brainiest of men. The city physician has many advantages over the country brother. He has access to the new and improved modes of diagnosis and treatment of disease sooner than the country man; his physical energies and endurance are not taxed so much; he can easily call in a surgeon or specialist if such a one is required, and shift his graver responsibility to other shoulders. I have always honored and often envied the city doctor. The physical hardships that the country doctor has to meet and endure would be simply appalling to the average city man if he were suddenly called to experience them.

The country doctor, to be well fitted for his arduous life, must be first of all well-grounded in his profession, must be a good all-round man; when he leaves his Alma Mater he must carry with him all he has learned there and supplement all that by close application to the best books and journals; he must be careful of his habits and moral character, must be a student of human nature, must know the moral, mental, and physical characteristics of the people of his vicinage, must be gentle, patient, and sympathetic, and brave and courageous when such qualities are required; he is bound to be, if he is anything, a leading figure in his neighborhood, consulted on many subjects besides those of

his profession; he knows the inner life of the people; he knows them in their homes; he is the repository of their most important secrets; he learns to keep them, and is trusted as no other being is trusted; he knows where the closet is that contains the skeleton of the household, and his is often the hand that seizes the skeleton and tosses it out into utter darkness, where its presence will no more be felt or feared.

The country doctor must be so well grounded in his profession that he must do the work generally assigned to the specialists in the city. Every form of disease, every kind of accident or injury comes to him in his every-day career. He has to invade the field that in modern times is given up entirely to the specialist. The people know he is a doctor, and believe a doctor ought to know everything and practice surgery as well as medicine, and treat everything from a headache to an in-growing toe-nail. The human body is his field of operation; he must know it all. If in his busy life he forgets, as he usually does, the names of arteries and nerves and muscles, he must know where they are, how to avoid them and treat them. Accidents and injuries occur in the country as well as in the city. Broken heads and crushed limbs, gunshot wounds, sawmill accidents, and hundreds of other things demand the country doctor's immediate attendance as well as the legion of diseases that afflict humanity. These things occur often when he is found on the road, with but a part of his meagre armamentarium with him. Sometimes the emergency is so great that he hasn't time to get much-wished-for and much-needed help. That certainly used to be the case when doctors were further apart than at the present time.

I have more than once amputated a thigh with a small scalpel from my pocket case and sawed the bone with a carpenter's saw, and had the gratification of seeing the patient have good recovery. As a general rule the country doctor shrinks from invading the cavities of the body, and will, if possible, hurry such cases to more competent and better equipped surgeons in the city, but he is often compelled to do so against his will on account of the pressing emergency,— such cases as acute appendicitis, intussusceptions, strangulated hernia, etc. These cases cannot always