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in business takes the widest range has the best basis for success. This fact is eminently true in medicine. The general surgeon, physician, or obstetrician, will prove a better practitioner in any particular disease than the specialist. The most successful surgeon is the man who has also a thorough knowledge of practical medicine. The relations of diseases are intimate, often obscure, and frequently all-controlling. The practitioner who fails to detect these relations will certainly not be thoroughly qualified, whatever may be his pecuniary success. He will treat diseases in his specialty from the most narrow stand-point, and too frequently fail to comprehend those remote influences and widely extended sympathies which most seriously modify their progress. These peculiarities the general practitioner anticipates and readily recognizes, and promptly meets every manifestation with proper remedies. It has been remarked by an accurate observer of the progressive changes in the medical profession, that the older physicians often much excel the younger in methods of treatment, because they take a much wider range of symptoms, and do not narrow their view to single organs and individual diseases. There is much truth in the remark. The recent graduate has his mind pre-occupied with scholastic divisions and subdivisions of diseases of individual parts, and in his analysis he becomes more and more restricted, until the attention is fixed upon a

limited, perhaps an insignificant part of the subject under investigation. The same is true of the pure specialist, as the term is now employed. In general, he is necessarily a poor practitioner, and though he may more correctly interpret the purport of pathological changes than others who have studied the special forms of disease less minutely, he will show but little skill in employing remedies. If we contrast also the usefulness and the rank in the profession of the general practitioner with that of the specialist, we shall see clearly that the studies of the former tend much more to enlarge the mind, to strengthen its grasp, and increase its powers of correct analysis. Every force acting upon or within the human organism is investigated, and its near or remote influence carefully weighed or measured. It is a matter of historical record that the great practical men of the profession, in all times, have been students of medicine, in the largest sense; they have embraced within the scope of their studies the circle of its sciences, and have made each department contribute to their success. Hunter, Abernethy, Brodie, Simpson, Hosack, Mott, Warren, are a few of the recent names which occur to us as examples of that large and liberal culture, which embraced the widest field of scientific research, and subsidized every available fact. They limited their specialties in practice to the three grand natural divisions, viz. : Medicine, Surgery, Obstetrics.

XLVI.

GRATUITOUS SERVICES.

THE

HE medical profession has the reputation, at least among its own members, of being greatly overworked and miserably underpaid. It is true, even of those services for which medical men are promptly and fully paid, that the physician receives a smaller compensation than any person who brings to the discharge of duties special knowledge; he ranks below many classes of artisans. And we must add the fact that much of the time his services are confessedly rendered gratuitously. All the poor are his patrons, and by far the most exacting patrons that he can claim. Their demands upon his time are constant, and their calls are always imperative. Finally, if there is a public institution which requires a medical attendant, this service must also be gratuitous, though the governors or commissioners who control its affairs receive large salaries. It is not our intention now to pass in review the instances of extortion practiced upon our profession, but to notice one in particular where reform is needed, and which medical men should unite to obtain. Life Insurance Companies are wealthy organizations which re

ceive large incomes from their business. Many of these corporations have amassed immense wealth, and all are in a greater or less degree prosperous. These societies are actually dependent upon medical officers for protection and success. The medical examiner is indeed the most important officer in the organization, for the prosecution of the business calls for his daily examination of applicants. The success of the whole business of Life Insurance may be said to rest most unequivocally upon the professional knowledge of the medical examiners. No Life Insurance Company would for a moment employ a medical officer of recognized incompetency. On the contrary, every such association seeks out the best educated and most reputable physician for this office, and to his professional knowledge intrusts its future success. Here is a marked instance in which the prominent medical men of any given community are placed in a position to command full and ample remuneration for their services. Their patrons are wealthy and powerful, and bestow large salaries on other important officers. The medical examiner ranks among the first in point of real consequence, and brings to the discharge of his duties a higher qualification than any other officer, viz. the education of a scientific expert. scientific expert. Such services in every other department of business command respect and the most liberal reward. Why do they not in a Life Insurance Company? There is

but one reason, and that is apparent on the most superficial examination of the subject. It is that medical men do not place a proper estimate upon their own services. There are found in this and every community physicians in large practice taking high rank in their profession, who are willing to travel several miles at mid-day to attend at the offices of Life Insurances, and, after making as critical medical examinations as would be required in most obscure diseases, they accept with gratitude the paltry fee of three, two, or even one dollar per head. Indeed, the passion for serving these great monopolies almost gratuitously, is so strong among our leading physicians, that they struggle for the vacancies which occur with all the desperation of politicians. Instead of rejecting with scorn the miserable pittance which these companies dole out to them in the way of fees, they pocket it with an air of the most intense satisfaction. We might forgive such greed in a young man who has to struggle hard to obtain a livelihood; but in older members, enjoying sufficient incomes from their legitimate business, it is reprehensible and unpardonable. A great reform is needed in this matter. The profession should unite in requiring that every medical examiner in a Life Insurance Company shall demand an adequate payment for his services. Instead of three dollars for each examination let him require seven or ten dollars, or still better

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