American Public Generally Intelligent, but Densely Ignorant in Important Particulars—Cotton Mather and Witchcraft—A.B.’s, A.M.’s, M.D.’s and Ph.D.’s Espousing Christian Science, Chiropractics and Osteopathy—Gullibility of the College Bred—The Ignorant Suspicious of New Things—The Educated Man’s Creed—Dearth of Therapeutic Knowledge by the Laity—Is the Medical Profession to Blame?—Physicians’ Arguments Controvertible—Host of Incompetents Among the Regular Physicians—Report of Committee on Medical Colleges—The “Big Doctors”—Doc Booze—The “Leading Doctor”—Osler’s Drug Nihilism—The X-Ray Graft.
American Public Generally Intelligent, but Densely Ignorant in Important Particulars—Cotton Mather and Witchcraft—A.B.’s, A.M.’s, M.D.’s and Ph.D.’s Espousing Christian Science, Chiropractics and Osteopathy—Gullibility of the College Bred—The Ignorant Suspicious of New Things—The Educated Man’s Creed—Dearth of Therapeutic Knowledge by the Laity—Is the Medical Profession to Blame?—Physicians’ Arguments Controvertible—Host of Incompetents Among the Regular Physicians—Report of Committee on Medical Colleges—The “Big Doctors”—Doc Booze—The “Leading Doctor”—Osler’s Drug Nihilism—The X-Ray Graft.
In spiteof the apparent prevalence of graft and the seemingly unprecedented dishonesty of those who serve the public, there are not wanting signs of the coming of better things. The eminent physician who spoke of the turbidity of therapeutics thought it was only that agitation that precedes crystallization and clarification that brings purity, and not greater pollution. May the seeming bad condition not be due in part also to the fact that a larger number of our American people are becoming intelligent enough to know the sham from the genuine, and to know when they are being imposed upon?
That our American people are generally intelligentwe know; but that a people may be generally intelligent and yet densely ignorant in important particulars has been demonstrated in all ages, and in no age more clearly than in our own. We wonder how the great scholar, Cotton Mather, could have believed in and taught witchcraft. What shall we think, in this enlightened age, of judges pleading for the healing (?) virtues of Christian Science, or of college professors taking treatment from a Chiropractor or magnetic healer; or of the scores of A.B.s, A.M.s, M.D.s, Ph.D.s, who espouse Osteopathy and use the powers of their supposedly superior intellect in its propagation?
We can only come to this conclusion: The college education of to-day does not necessarily make one proof against graft. In fact, it seems that when it comes to belief in “new scientific discoveries,” the educated are even more easily imposed upon than the ignorant. The ignorant man is apt to be suspicious of new things, especially things that are supposed to require scientific knowledge to comprehend. On the other hand, the man who prides himself on his learning is sure he can take care of himself, and often thinks it a proof of his superior intelligence to be one of the charter members of every scientific fad that is sprung on the people by some college professor who is striving for a medal for work done in original research.
Whatever the reason may be, the fact remains that frauds and grafts are perpetrated upon educated people to-day. In the preceding chapter I triedto tell in a general way what some of the grafts are, and something of the social conditions that help to produce the grafters. I shall now give some of the reasons why shysters find so many easy victims for their grafts.
When it comes to grafting in connection with therapeutics, the layman’s educational armor, which affords him protection against most forms of graft in business, seems utterly useless. True, it affords protection against the more vulgar nostrum grafting that claims its millions of victims among the masses; but when the educated man meets the “new discovery,” “new method” grafter he bares his bosom and welcomes him as a friend and fellow-scientist. It is the educated man’s creed to-day to accept everything that comes to him in the name of science.
The average educated man knows nothing whatever of the theory andmodus operandiof therapeutics. He is perhaps possessed of some knowledge of everything on the earth, in the heaven above, and in the waters beneath. He is, however, densely ignorant of one of the most important things of all—therapeutics—the matter of possessing an intelligent conception of what are rational and competent means of caring for his body when it is attacked by disease. A man who writes A.M., D.D., or LL.D. after his name will send for a physician of “any old school,” and put his life or the life of a member of his family into his hands with no intelligent idea whatever as to whether the right thing is being done to save that life.
Is this ignorance of therapeutics on the part of the otherwise educated the result of a studied policy of physicians to mystify the public and keep their theories from the laity? I don’t know. Such accusations are often made. I read in a medical magazine recently a question the editor put to his patrons. He told them he had returned money sent by a layman for a year’s subscription to his journal, and asked if such action met their approval. If the majority of the physicians who read his journal do approve his action, their motivesmaybe based on considerations that are for the public good, for aught I know, but as a representative layman I see much more to commend in the attitude of the editor of theJournal of the A. M. A.on the question of admitting the public to the confidence of the physician. As I have quoted before, he says: “The time has passed when we can wrap ourselves in a cloak of professional dignity and assume an attitude of infallibility toward the public.” Such sentiment freely expressed would, I believe, soon change the attitude of the laity toward physicians from one which is either suspicion or open hostility to one of respect and sympathy.
The argument has been made by physicians that it would not do for the public to read all their discussions and descriptions of diseases, as their imagination would reproduce all the symptoms in themselves. Others have urged that it will not do to let the public read professional literature, for they might draw conclusions from the varied opinions they read that would not be for the good of theprofession. Both arguments remind one of the arguments parents make as an excuse for not teaching their children the mysteries of reproduction. They did not want to put thoughts into the minds of their children that might do them harm. At the same time they should know that the thoughts would be, and were being, put into their children’s minds from the most harmful and corrupting sources.
So in therapeutics. Are not all symptoms of disease put before the people anyway, and from the worst possible sources? If medical men do not know this, let them read some of the ads. in theGrafter’s Herald. And are the contradictions and inconsistencies in discussions in medical journals kept from the public? If medical men think so, let them read the Osteopathic and “independent” journals. The public knows too much already, considering the sources from which the knowledge comes. Since people will be informed, why not let them get information that is authentic?
Before I studied the literature of leading medical journals I believed that the biggest and brainiest physicians were in favor of fair and frank dealing with the public. I had learned this much from observation and contact with medical men. After a careful study of the organ of the American Medical Association my respect for that organization is greatly increased by finding expressions in numbers of articles which show that my opinion was correct. In spite of all the vituperation that is heaped upon it, and in spite of the narrowness of individualmembers, the American Medical Association does seem to exist for the good of humanity. The strongest recommendation I have found for it lies in the character of the schools and individuals who are most bitter against it. It is usually complimentary to a man to have rascals array themselves against him.
There are many able men among physicians who feel keenly their limitations, when they have done their best, and this class would gladly have their patients understand the limitations as well as the powers of the physician. In sorrow and disgust sometimes the conscientious physician realizes that he is handicapped in his work to either prevent or cure disease, because he has to work with people who have wrong notions of his power and of the potency of agencies he employs. With shame he must acknowledge that the people hold such erroneous ideas of medicine, not because of general ignorance, but because they have been intentionally taught them by the army of quacks outside and the host of grafters and incompetentsinsidethe regular medical profession.
Incompetent physicians, to succeed financially (and that is the only idea of success incompetents are capable of appreciating), must practice as shysters. They fully understand how necessary it is to the successful working of their grafts to keep the people in ignorance of what a physician may legitimately and conscientiously do.
Our medical brethren who preach the “all but holy” doctrine, and want to maintain the “attitude of infallibility toward the public,” will disagree withme about there being “a host” of incompetents in the regular school of medical practice. I shall not ask that they take the possibly biased opinion of an ex-Osteopath, but refer them to the report of the committee appointed by the American Medical Association to examine the medical colleges of the United States as to their ability to make competent physicians. “One-half of all the medical schools of our country are utterly unfit to turn out properly qualified physicians, and many of them are so dominated by commercialism that they are but little better than diploma mills”! That’s what the committee said.
It has been argued that the capable physician need not fear the incompetent pretender, for, like dregs, he must “settle to the bottom” and find his place. This might be true if the people had correct notions of the true theory of therapeutics. As it is, the scholarly, competent physician knows (and intelligent laymen often know) that the pretenders too often are the fellows who get the reputations of being the “big doctors.” Why? I think mainly because, being ignorant, they practice largely as quacks, and by curing (?) all kinds of dangerous (on their own diagnosis) diseases quickly, “breaking up” this and “aborting” that unbreakable and unabortable disease (by “hot air” treatment mainly), they place the whole system upon such a basis of quackery that the deluded masses often pronounce the best equipped and most conscientious physician a “poor doctor,” because he will not pretend to do all that the wind-jamming grafter claimshe hasdone andcando.
Here is a case in point which I know to be true. The farce began some years ago in a small college in Oregon. A big, awkward, harmless-looking fellow came to the college one fall and entered the preparatory department. At the end of the year, after he had failed in every examination and shown conclusively that he had no capacity to learn anything, he was told that it was a waste of time for him to go to school, and they could not admit him for another year. Was he squelched? Not he. The fires of ambition yet burned in his breast, and the next year he turned up at a medical college. I presume it had the same high educational requirements for admission that some other medical colleges have, and enforced them in about the same way. At any rate he met the requirements ($$$), and pursued his medical researches with bright visions of being a doctor to lure him on. But his inability to learn anything manifested itself again, and, presumably, his money gave out. At any rate he was sent away without a diploma. Still the fire of ambition was not extinguished in his manly bosom. Regulations were not strict in those days, so he went to a small town, wore fine clothes, a silk hat and a pompous air, and—within a short time was being called for forty miles around to “counsel little doctors” in their desperate cases. Such cases are all too common, as honest physicians know.
How humiliating to the conscientiously equipped doctor to hear people say of a man who never had more brains than he needed, and had hopelesslymuddled what he had by using his own dope and stimulants: “I tell you Doc Booze is the best doctor in town yet when he’s half sober!” Strange, isn’t it, that in many communities people have an idea that an inclination on the part of a physician toward whisky or dope indicates some peculiar mental fitness for a doctor? “Poor fellow, he formed the habit of taking stimulants to keep up when he had to go night and day during the big typhoid epidemic, you know.” For what per cent. of cases of medical dipsomaniacs this constitutes a stock excuse, only medical men know. As an Osteopathic physician I was never rushed so that I felt the necessity for “keeping up on stimulants.” If I had been, to be consistent, I should have had to stimulate (?) mechanically, of course.
Not only do shysters and pretenders abuse the confidence of the masses in matters of diagnosis and medication, but of late years they are working another species of graft that is beginning to react against the profession. This graft consists in the over-use of therapeutic appliances that are all right in their place when legitimately used.
By what standard is the physician judged by the people who enter his office? It used to be the display of medical literature. Sometimes some of it was pseudo-medical literature. Did you ever know a shyster to pad his library with Congressional reports? I have. The literature used to be conspicuously placed in the waiting-room, with a ponderous volume lying open on the desk.
Have you a “leading doctor” in your town? Often he is not only in the lead but has flagged all the others at the quarter post—put them all into the “has been” class. What an elegant office he has! Plush rugs and luxurious couches in the waiting-room. Double doors into the private and operating-rooms, left open when not in actual use to give impressive glimpses of glass cases filled with glittering instruments, any one of which would give the lie to Solomon’s declaration that “there is nothing new under the sun.” An X-ray machine fills a conspicuous corner. In the same room are tanks, tubes, inhalers, hot-air appliances, vibrators, etc. One full side of the room is filled with shelves that groan under a load of the medicines he “keeps and dispenses.” What are all of these hundreds of bottles for if it is true, as many of our greatest physicians say, that a comparatively few people are benefited by drugs? These numerous bottles may contain placebos. I do not know as to that, but I do know something of the impression such a display makes on the mind of an intelligent layman. The query in his mind is how much of that entire display is for its legitimate effect on the minds of the patients, and how much of it is to impress the people with the powers of this physician, with his “wonderful equipment” to cope with all manner of disease?
If there is any doubt in the minds of physicians that laymen do know and think well over the sayings of drug nihilists, let them talk with intelligent people and hear them quote from the editorial page of agreat daily such sentiments as this (from the ChicagoRecord-Herald):
“Prof. William Osier, the distinguished teacher of medicine, who was taken from this country a few years ago to occupy the most important medical chair in Great Britain, has shocked his profession repeatedly by his pronouncements against the use of drugs and medicines of almost every kind. Only a few days ago he made an address in which he declared that even though most physicians will be deprived of their livelihood, the time must soon come when sound hygienic advice for the prevention of disease will take the place of the present system of prescription andpretense of cure. The most able physicians agree with him, even when they are not frank enough to express themselves to the same effect.”
“Prof. William Osier, the distinguished teacher of medicine, who was taken from this country a few years ago to occupy the most important medical chair in Great Britain, has shocked his profession repeatedly by his pronouncements against the use of drugs and medicines of almost every kind. Only a few days ago he made an address in which he declared that even though most physicians will be deprived of their livelihood, the time must soon come when sound hygienic advice for the prevention of disease will take the place of the present system of prescription andpretense of cure. The most able physicians agree with him, even when they are not frank enough to express themselves to the same effect.”
Medical men need not think, either, that the people who happened to read the editorial pages referred to are the only ones who know of that declaration from Osier. Osteopathic journals, Christian Science journals, health culture journals, and all the riff-raff of journals published as individual boosters, are ever on the watch for just such things, and when they find them they “roll them under their tongue as sweet morsels.” They chew them, as Carleton says, with “the cud of fancy,” and hand them along as latest news to tens of thousands of people who are quick to believe them.
Going back to the physician who has the well-equipped office, is he a grafter in any sense? I shall not give my opinion. Perhaps every thing he has inthe office is legitimate. In the opinion of the masses of that community he is the greatest doctor that ever prescribed a pill or purloined an appendix. Taking the word of the physicians whom he has put into the “has been” class for it, he is the greatest fake that ever fooled the people. Most of those outclassed doctors will talk at any time, in any place, to any one, of the pretensions of this type of physician. They will tell how he dazzles the people with his display of apparatus “kept for show;” how he diagnoses malarial fever as typhoid, and thus gets the reputation of curing a larger per cent. of typhoid than any other doctor in town; how he gets the reputation of being a big surgeon by cutting out healthy ovaries and appendices, and how he assists with his knife women who do not desire Rooseveltian families. They point to the number of appendectomies he has performed, and recall how rare such cases were before his advent, and yet how few people died with appendicitis. Is it to be wondered that intelligent laymen sometimes lose faith in and respect for the profession of medicine and surgery?
To show that people may be imposed upon by illegitimate use of legitimate agencies I call attention to an article published recently in theIowa Health Bulletin. The Iowa Medical Board is winning admiration from many by conducting a campaign to educate the people of the State in matters pertaining to hygienic living. In line with this work they published an article to correct the erroneous idea the laity have of the X-ray. They say:
“The people think that with the X-ray the doctor can look right into the body and examine any part or organ and tell just what is the matter with it, when the fact is all that is ever seen is a lot of dim shadows that even the expert often fails to understand or recognize.”
“The people think that with the X-ray the doctor can look right into the body and examine any part or organ and tell just what is the matter with it, when the fact is all that is ever seen is a lot of dim shadows that even the expert often fails to understand or recognize.”
Why do the people have such erroneous conceptions of the X-ray? Is it accidental, or the result of their innate stupidity? Certainly it is not. The people have just such conceptions of the X-ray as they receive from the faker who uses it as he uses his opiates and stimulants—to get an effect and give the people wrong ideas of his power.
A lady of a small town who was far advanced in consumption was taken to a city to be examined by a “big doctor” who possessed an X-ray. He “examined” her thoroughly by the aid of the penetrating light made by his machine, and sent them home delighted with the assurance that his wonderful instrument revealed no tuberculosis. He assured her that if she would avail herself of his superior skill she might yet be restored to health. She died within a year from the ravages of tuberculosis.
A boy of four had an aggravated attack of bronchitis. His symptoms were such that his parents thought some object might have lodged in his trachea. A noted surgeon who had come one hundred miles from a hospital to see another case was consulted. He told the parents that the boy had sucked something down his windpipe, and advised them to bring him to the hospital for an operation. They did so, anda $100 incision was made after the X-ray had located (?) an object lodged at the bifurcation of the trachea. The knife found nothing, however, and the boy still had his bronchitis, and the parents had their hospital and surgeon’s bills, and, incidentally, their faith in the X-ray somewhat shattered.
The X-rays, Finsen rays, electric light and sunlight have their place in therapy. Informed people do not doubt their efficacy. However, the history of the use of these agents is a common one. A scientist, after possibly a lifetime of research, develops a new therapeutic agent or a new application of some old agent. He gives his findings to the world. Immediately a lot of half-baked professional men seize upon it, more with the object of self-laudation and advertisement than in a true scientific spirit. Serious study in the application of the new agent is not thought of. The object is rather to have the reputation of being an up-to-snuff man. The results obtained are not what the originator claimed, which is not to be wondered at. The abuse of the remedy leads to abuse of the originator, which is entirely unfair to both.
This state of affairs has grown so bad that scientists now are beginning to restrict the application of their discoveries to their own pupils. A Berlinsavant, assistant to Koch, has developed the use of tuberculin to such a point as to make it one of the most valuable remedies in tuberculosis. It is manufactured under his personal supervision, and sold only to such physicians as will study in his laboratory and show themselves competent to grasp the principles involved.
TURBID THERAPEUTICS.
An Astounding Array of Therapeutic Systems—Diet—Water—Optics—Hemotherapy—Consumption Cures—Placebos—Inconsistencies and Contradictions—Osler’s Opinion of Appendicitis—Fair Statement of Limitations in Medicine Desirable.
An Astounding Array of Therapeutic Systems—Diet—Water—Optics—Hemotherapy—Consumption Cures—Placebos—Inconsistencies and Contradictions—Osler’s Opinion of Appendicitis—Fair Statement of Limitations in Medicine Desirable.
To beconvinced that therapeutics are turbid, note the increasing numbers of diametrically opposed schools springing up and claiming to advocate the only true system of healing. Look at the astounding array:
Allopathy, Homeopathy, Eclecticism, Osteopathy, Electrotherapy, Christian Science, Emmanuel movement, Hydrotherapy, Chiropractics, Viteopathy, Magnetic Healing, Suggestive Therapeutics, Naturopathy, Massotherapy, Physio-Therapy, and a host of minor fads that are rainbow-hued bubbles for a day. They come and go as Byron said some therapeutic fads came and went in his day. He spoke of the new things that astounded the people for a day, and then, as it has been with
“Cowpox, tractors, galvanism and gas,The bubble bursts and all is air at last.”
One says he has found that fasting is a panacea.Another says: “He is a fool; you must feed the body if you expect it to be built up.”
One says drinking floods of water is a cure-all. Another says the water is all right, but you must use it for the “internal bath.” Still another agrees that water is the thing, but it must be used in hot and cold applications.
One faker sayshehas found that most diseases are caused by defective eyes, and proposes to cure anything from consumption to ingrown toe-nails with glasses. Another agrees that the predisposing cause of diseases is eye strain, but the first fellow is irrational in his treatment. Glasses are unnatural and therefore all wrong. To cure the eyes use his wonderful nature-assisting ointment; that goes right to the optic nerve and makes old eyes young, weak eyes strong, relieves nerve strain and thereby makes sick people well.
Another has found that “infused” blood is the real elixir of life. He reports 100 per cent. of twenty cases of tuberculosis cured by his beneficent discovery. I wonder why we have a “Great White Plague” at all; or why we have international conventions to discuss means of staying the ravages of this terrible disease; or why State medical boards are devoting so much space in their bulletins to warn and educate the people against the awful fatality of consumption, when to cure it is so easy if doctors will only use blood?
Even if the hemotherapist does claim a little too much, there is yet no cause for terror. A leadingOsteopathic journal proclaims in large letters that the Osteopath can remove the obstruction so that nature will cure consumption.
Christian Scientists and Magnetic Healers have not yet admitted their defeat, and there are many regulars who have not surrendered to the plague. So the poor consumptive may hope on (while his money lasts). Our most conscientious physicians not only admit limitations in curing tuberculosis, but try to teach the people that they must not rely on being “cured” if they are attacked, but must work with the physician to prevent its contagion. The intelligent layman can say “Amen” to that doctrine.
The question may be fairly put: “Why not have more of such frankness from the physician?” The manner in which the admissions of doctors that they are unable to control tuberculosis with medicine or surgery alone has been received by intelligent people should encourage the profession. It would seem more fair to take the stand of Professor Osler when he says that sound hygienic advice for the prevention of diseases must largely take the place of present medication and pretence of cure.
As a member of the American Medical Association recently said, “The placebo will not fool intelligent people always.” And when it is generally known that most of a physician’s medicines are given as placebos, do you wonder that the claims of “drugless healers” receive such serious consideration?
The absurd, conflicting claims of quack pretenders are bad enough to muddle the situation and add to theturbidity of therapeutics; but all this is not doing the medical profession nearly as much harm, nor driving as many people into the ranks of fad followers, as the inconsistencies and contradictions among the so-called regulars.
This was my opinion before I made any special study of therapeutics, and while studying I found numbers of prominent medical men who agree with me. One of them says that the “criticisms,” quarrels, contradictions, and inconsistencies of medical men are doing more to lower the profession in the estimation of the intelligent laity and to cause people to follow the fads of “new schools” than all else combined.
Think for a moment of some of these inconsistencies and contradictions. One doctor in a town tells the people that he “breaks up” typhoid fever. His rival, perhaps from the same college, tells the people that typhoid must “run its course” and cannot be broken up, and that any man who claims the contrary is a liar and a shyster. One surgeon makes a portion of the people believe he has saved dozens of lives in that community by surgical operations; the other physicians of the town tell the people openly, or at least hint, that there has been a great deal of needless butchery performed in that community in the name of surgery. And then the people see editorials in the daily press about the fad of having operations performed, and read in their health culture or Osteopathic journals from articles by the greatest M.D.s, in which it is admitted that surgery is practiced toolargely as a graft. Professor Osler is quoted as saying:
“Surgeons are finding altogether too many cases of appendicitis these days. Appendicitis is becoming so common and so easily detected that the physician’s wife can diagnose a case of it over the telephone.”
“Surgeons are finding altogether too many cases of appendicitis these days. Appendicitis is becoming so common and so easily detected that the physician’s wife can diagnose a case of it over the telephone.”
One leading physician says medical treatment has little beneficial effect on pneumonia; another claims to be able to cure it, and lets the friends of his patient rely entirely on his medicine in the most desperate cases. Another says the main reliance should be heat. Another says ice-packs. Another says Antiphlogistine. Another says, “All those clay preparations are frauds, and the only safe way to treat pneumonia is by blood letting.” Thus it goes, and this is only a sample of contradictions that arise in the treatment of diseases.
Nor is the above an overdrawn picture. Most of it was from the journal of the editor who said he refused to send it to a layman who had sent his money in advance. But all that same stuff has been hashed and rehashed to the people through the sources I have already mentioned. There are not only these evidences of inconsistencies to edify (?) the people, but constantly recurring examples of incompetency and pretensions.
There is no doubt a middle ground in all this, but it is not evident to the casual observer. If the true physician would honestly admit his limitations to the intelligent laity, much of this muddle would beavoided. While by such a course he may occasionally temporarily lose a patient, in the end both the public and profession would gain. The time has gone by to “assume an air of infallibility toward the public.”
THE EXPERT WITNESS AND PROPRIETARY MEDICINES.
The “Great Nerve Specialist”—The Professional Witness a Jonah—The “Railway Spine”—Is it Lack of Fairness and Honesty or Lack of Skill and Learning?—Destruction of Fine Herds of Cattle Without Compensation—Koch’s Dictum and Denial—Koch’s Tuberculin—The Serum Tribe—Stupendous Sale of Nostrums—Druggist’s Arguments—Use of Proprietary Medicines Stimulates Sale of Nostrums.
The “Great Nerve Specialist”—The Professional Witness a Jonah—The “Railway Spine”—Is it Lack of Fairness and Honesty or Lack of Skill and Learning?—Destruction of Fine Herds of Cattle Without Compensation—Koch’s Dictum and Denial—Koch’s Tuberculin—The Serum Tribe—Stupendous Sale of Nostrums—Druggist’s Arguments—Use of Proprietary Medicines Stimulates Sale of Nostrums.
I wonderwhat the patrons of the sanitarium of the “great nerve specialist” thought of his display of knowledge of the nervous system when he was on the witness stand in a recent notorious case? A lawyer tangled him up completely, and showed that the doctor had no accurate knowledge of the anatomy of the nervous system. When asked the origin of the all-important pneumogastric nerve, hethoughtit originated in a certain segment of the spinal cord! This noted “specialist” was made perfectly contemptible, and the whole profession must have blushed in shame at the spectacle presented. And that spectacle was not unnoticed by the intelligent laity.
The professional witness has in most cases been a Jonah to the profession. It is about as easy to get the kind of testimony you want from a professionalwitness in a suit for damages for personal injuries as it is to get a doctor’s certificate to get out of working your poll-tax, or a certificate of physical soundness to carry fraternal life insurance.
Let me recall the substance of a paper read a few years ago by perhaps the greatest lawyer in Iowa (afterward governor of that State). He told of a trial in which he had examined and cross-examined ten physicians. It was a trial in which suit was brought to recover damages for personal injury, a good illustration of the “railway spine.” One physician testified that the patient was afflicted with sclerosis of the spinal cord; another said it was a plain case of congestion of the cord; another diagnosed degeneration of the cord; yet another said it was a true combination of all the conditions named by the first three. They all said there was atrophy of the muscles of the left leg, and predicted that complete paralysis would surely supervene.
On the other side five noted physicians testified as positively that neither the spinal cord nor any nerve was injured; that there was no sign of atrophy or loss of power in the leg; and they seemed to think the disease afflicting the patient was due to a fixed desire to secure a verdict for large damages from the railway company. One eminent specialist made oath that the electrical test showed the partial reaction of degeneration; another as famous challenged him to make the test again in the presence of both. After it was made this second specialist went before the jury and positively declared that there was no tracewhatever of the reaction of degeneration, and that the muscles responded to the current precisely as healthy muscles should.
Then this eminent attorney adds: “If the instances of such diversity were rare they might pass unnoticed, but they occur and re-occur as often as physicians are called to the temple of justice for the expression of opinions.”
The lay mind imputes this clash of opinions either to lack of fairness and honesty or lack of skill and learning. In either case the profession suffers great injury in the estimation of those who should have for it only the profoundest admiration and the most implicit faith. Again I ask, Is it any wonder people have lost implicit faith when they read many reports of similar cases rehashed in the various yellow journals put into their hands?
Farmers submitted with all possible grace to the decrees of science when, by the authority of such a great man as Koch, their fine herds of cattle were condemned as breeders and disseminators of the great white plague and destroyed without compensation. But how do you think these same farmers feel when they read in yellow journals that Koch has changed his mind about bovine and human tuberculosis being identical, and has serious doubts about the one contracting in any way the disease of the other. People read with renewed hope the glowing accounts of the wonderful achievements of Dr. Koch in finding a destroyer for the germ of consumption. Somehow time has slipped by since that renowned discovery, withconsumption still claiming its victims, and many physicians are saying “Koch’s great discovery is proving only a great disappointment.”
Drugless therapy journals are continually pouring out the vials of their wrath upon vaccination, antitoxin and all the serum tribe, and their vituperation is even excelled by vindictive denunciations of the same things by the individual boomer journals that flood the land.
Another bitter contention that is confusing some, and disgusting others, is the acrimonious strife between users and non-users of proprietary medicines. This usually develops into a sort of “rough house” affair, the druggist mixing up as savagely as the doctors before the fight is finished. I know nothing of the rights or wrongs of the case nor of the merits or demerits of proprietary medicines, but I do know this, however: The stupendous sale of nostrums that in 1907 represented a sum of money sufficient to have provided every practitioner of medicine in the United States with a two thousand dollar salary, has been helped by the use of proprietary medicines. I am aware that my position is likely to be called in question by many physicians. But they should hear druggists arguing with people who hesitate about buying patent medicines because their physicians tell them they should seldom take medicine unless prescribed by a doctor. They would hear him say: “Your doctor gives you medicines that are put up in quantities for him just as these patent medicines are put up for us.” He then produces literature and proves it—at leastbeyond the refutation of the patient. Physicians would then realize, perhaps, how the use of proprietary medicines stimulates the sale of nostrums.
FAITH CURE AND GRAFT IN SURGERY.
Suggestive Therapeutics Chief Stock in Trade—Advice of a Medical College President—Disease Prevention Rather than Cure—Hygienic Living—The Medical Pretender—“Dangerous Diagnosis” Graft—Great Flourish of Trumpets—No “Starving Time” for Him—“Big Operations”—Mutilating the Human Body—Dr. C. W. Oviatt’s Views—Dr. Maurice H. Richardson’s Incisive Statements—Crying Need for Reform—Surgery that is Useless, Conscienceless and for Purely Commercial Ends—Spirit of Surgical Graft, Especially in the West—Fee-Splitting and Commissions—A Nation of “Dollar-Chasers”—The Public’s Share of Responsibility—Senn’s Advice—The “Surgical Conscience.”
Suggestive Therapeutics Chief Stock in Trade—Advice of a Medical College President—Disease Prevention Rather than Cure—Hygienic Living—The Medical Pretender—“Dangerous Diagnosis” Graft—Great Flourish of Trumpets—No “Starving Time” for Him—“Big Operations”—Mutilating the Human Body—Dr. C. W. Oviatt’s Views—Dr. Maurice H. Richardson’s Incisive Statements—Crying Need for Reform—Surgery that is Useless, Conscienceless and for Purely Commercial Ends—Spirit of Surgical Graft, Especially in the West—Fee-Splitting and Commissions—A Nation of “Dollar-Chasers”—The Public’s Share of Responsibility—Senn’s Advice—The “Surgical Conscience.”
I thinkwe have enough before us to show why intelligent people become followers of fads. Seeing so many impositions and frauds, they forget all the patient research and beneficent discoveries of noble men who have devoted their lives to the work of giving humanity better health and longer life. They are ready at once to denounce the whole medical system as a fraud, and become victims of the first “new system” or healing fad that is plausibly presented to them.
And here a question arises that is puzzling to many. If these systems are fads and frauds, whydo they so rapidly get and retain so large a following among intelligent people? The answer is not hard to find. The quacks of these fad schools get their cures, as every intelligent doctor of the old schools knows, in the same way and upon the same principle that is so important a factor in medical practice,i. e.,faith cure—the psychic effect of the thing done, whether it be the giving of a dose of medicine, a Christian Science pow-wow, the laying on of hands, the “removal of a lesion” by an Osteopath, the “adjustment” of the spine by a Chiropractor, or what not.
The principles of mind or faith cure are legitimately used by the honest physician. Suggestive therapeutics is being systematically studied by many who want to use it with honesty and intelligence. They realize fully that abuse of this principle figures largely in the maintenance of the shysters in their own school, and it is the very foundation of all new schools and healing fads. The people must be made to know this, or fads will continue to flourish.
The honest physician would be glad to have the people know more than this. He would be glad to have them know enough about symptoms of diseases to have some idea when they really need the help of a physician. For he knows that if the people knew this much all quacks would be speedily put out of business.
I wonder how many doctors know that observing people are beginning to suspect that many physicians regulate the number of calls they make on a patient by motives other than the condition of thepatient—size of pocketbook and the condition of the roads, for instance. I am aware that such imputation is an insult to any physician worthy of the name, but the sad fact is that there are so many, when we count the quacks of all schools, unworthy of the name.
The president of a St. Louis medical college once said to a large graduating class: “Young men, don’t go to your work with timidity and doubts of your ability to succeed. Look and act your part as physicians, and when you have doubts concerning your power over diseaseremember this, ninety-five out of every hundred people who send for you would get well just the same if they never took a drop of your medicine.” I have never mentioned this to a doctor who did not admit that it is perhaps true. If so, is there not enough in it alone to explain the apparent success of quacks?
Again I say there are many noble and brainy physicians, and these have made practically all the great discoveries, invented all the useful appliances, written all the great books for other schools to study, and they should have credit from the people for all this, and not be misrepresented by little pretenders. Their teachings should be applied as they gave them. The best of them to-day would have the people taught that a physician’s greatest work may be done in preventing rather than in curing disease. Physicians of the Osler type would like to have the people understand how little potency drugs have to cure many dangerous diseases when they have a firm hold onthe system. They would have some of the responsibility removed from the shoulders of the physician by having the people understand how much they may do by hygienic living and common-sense use of natural remedies.
But the conscientious doctor too often has to compete with the pretender who wants the people to believe thatheis their hope and their salvation, and in him they must trust. He wants them to believe that he has a specific remedy for every disease that will go “right to the spot” and have the desired effect. People who believe this, and believe that without doctoring the patient could never get well, will sometimes try, or see their neighbors try, a doctor of a “new school.” When they see about the same proportion of sick recover, they conclude, of course, that the doctor of the “new school” cured them, and is worthy to be forever after intrusted with every case of disease that may arise in their families.
This is often brought about by the shyster M.D. overreaching himself by diagnosing some simple affection as something very dangerous, in order to have the greater credit in curing it. But he at times overestimates the confidence of the family in his ability. They are ready to believe that the patient’s condition is critical, and in terror, wanting the help of everything that promises help, call in a doctor of some “new school” because neighbors told how he performed wonderful cures in their families. When the patient recovers speedily, as he would have done with no treatment of any kind, and just as the shysterM.D. thought he would, the glory and credit of curing a “bad case” of a “dangerous disease” go to the new system instead of redounding to the glory of Dr. Shyster, as he planned it would.
Is it any wonder true physicians sometimes get disgusted with their profession when they see a shyster come into the town where they have worked for years, patiently and conscientiously building up a legitimate practice that begins to promise a decent living, and by such quack methods as diagnosing cases of simple fever, such as might come from acute indigestion or too much play in children, as something dangerous, typhoid or “threatened typhoid,” or cases of congestion of the lungs as “lung fever,” and by “aborting” or “curing” these terrible diseases in short order and having his patients out in a few days, jumps into fame and (financial) success at a bound? Because the typhoid (real typhoid) patients of the honest doctor lingered for weeks and sometimes died, and because frequently he lost a case of real pneumonia, he made but a poor showing in comparison with the new doctor. “He’s just fresh from school, you know, from a post-graduate course in the East.” Or, “He’s been to the old country andknowssomething.” Just as if any physician, though he may have been out of school for many years, does not, or may not, know of all the curative agencies of demonstrated merit!
Would a medical journal fail to keep its readers posted concerning any new discovery in medicine, or helpful appliance that promises real good to theprofession? Yet people speak of one doctor’s superior knowledge of the best treatment of a particular disease as if that doctor had access to some mysterious source of therapeutic knowledge unknown to other physicians. It is becoming less easy to work the “dangerous diagnosis” graft than formerly, for many people are learning that certain diseases must “run their course,” and that there are no medicines that have specific curative effects on them.
There is another graft now that is taking the place of the one just mentioned, to some extent at least. In the hands of a fellow with lots of nerve and little conscience it is the greatest of them all. This is the graft of the smart young fellow direct from a post-graduate course in the clinics of some great surgeon.
He comes to town with a great flourish of trumpets. Of course, he observes the ethics of the profession! The long accounts of his superior education and unusual experience with operative surgery are only legitimate items of news for the local papers. Certainly! It is only right that such an unusual doctor should have so much attention.
There is no “starving time” for him. No weary wait of years for patients to come. At one bound he leaps into fame and fortune by performing “big operations” right and left, when before his coming such cases were only occasionally found, and then taken to surgeons of known ability and experience. The reputable physician respects surgery, and would respect the bright young fellow fresh from contact with the latest approved methods who has nerve toundertake the responsibility of a dangerous operation when such an operation is really indicated. But when it comes to mutilating the human body by cutting away an appendix or an ovary because it is known that to remove them when neither they nor the victim are much diseased is a comparatively safe and veryquickway to get a big reputation—that is the limit of quackery. And no wonder such a man is so cordially hated by his brethren. He not always hated because he mutilates humanity so much, as because his spectacular graft in surgery is sure to be taken as proof conclusive that he is superior in all other departments of therapeutics.
And it puzzles observing laymen sometimes to know why all the successful (?) operations are considered such desirable items of news, while the cases that are not flattering in their outcome pass unmentioned.
I find most complete corroboration of my contention in the president’s address, delivered before the Western Surgical and Gynecological Association at St. Louis, in 1907, by Charles W. Oviatt, M.D. This address was published in theJournal of the American Medical Association, and I herewith reprint it in part: