HOW TO ELEVATE THE MEDICAL PROFESSION.

READ BEFORE THE R. I. HOMOEOPATHIC SOCIETY BY T. H. MANN, M. D.

THE question is constantly rising before the minds of physicians as to the best means to suppress the illegitimate practice of medicine, which is especially prevalent in this country, and to control the enormous sale of so-called patent medicines.

It is a well-known fact that a very large class of the diseases to which we are called to minister are caused by, or much aggravated by, self-administered medicines, purchased from the grocer or druggist, or taken under the advice of irresponsible persons.

The number of persons made sick by so-called medicines would make a very respectable proportion by the side of the number of those injured at the present time by malaria, crowded tenement-houses, and defective drainage; and, while the popular press as well as the medical press throughout the country is just now alive to the discussion of sanitary science pertaining to the last-mentioned detriments to health, it utters not one word of warning to the millions who swallow patent pills and mixtures with unaccountable recklessness.

It was a far-reaching truth which our famous American showman uttered and reiterated, that "The American people love to be humbugged." Its import strikes one as comparatively harmless when applied to the results of his particular profession, but when applied to the results of the thousands of mixtures palmed upon the public, and taken as medicines, its harmlessness is not so apparent.

It is too much to expect of the popular press of the country, except the medical profession take the initiatory step, that they will conscientiously discuss and represent to the public, through their columns, the great amount of harm done by this great traffic in medicines, when we know that many of the periodical publications of the country would be obliged to discontinue their daily and weekly issues if their medicinal and questionable professional advertisements were discontinued.

With the exception of the advent of, and popularizing of, the new school of medicine, the daily and hourly bulletins from the bedside of our late lamented President Garfield did more towards popularizing the advancement of the science of medicine and surgery than anything else in this country during the present century. Not because the bulletins were so explicit, truthful, and full of the eagerly sought information, but because they set the masses to inquiring into medicine and surgery. Herein lies our hint towards the only course which can be taken by the medical profession, if it would minister to the health of the community

by the suppression of illegitimate doctors and patent nostrums, the public and popular discussion of medical art and science through the popular press of the country, in the same manner, and by the same means used by the professors of other sciences. The study of the arts and sciences by the masses is becoming popular; and, if we propose to retain the dignity of our profession, we must make educated medicine popular with the masses through free discussion; by it we must educate the people to that degree in the science of medicine that will take them out of the reach of its unscientific practice and sale. We must insist upon the thorough teaching of anatomy, physiology, and hygiene in our public schools with the same persistency that is now applied to English grammar, - and its study should commence with the grammar schools.

Physicians, as a class, are remarkably reticent in relation to their science. Their reasons, so far as their pockets are concerned, have been good. To illustrate, let me give the following incident, which occurred not very long ago:

I chanced to meet a smart, brisk genius of a Yankee pedler, who was driving a very one pair of matched horses and elegantly illuminated carriage. He was peddling throughout the country a well-known patent medicine. After an introduction he remarked, "Doctor, I suppose I injure your business some here in town, for I believe I have sold over a thousand dollars' worth of my medicine during the past week." The above remark was made for the benefit of those who were standing by, at my expense. My reply stopped any further conversation upon that subject: "I beg your pardon, sir, but you are mistaken; your business increases mine."

The legitimate physician, like the legitimate priest, has the good of his people at heart, and does not wish to swell his business at the expense of their health.

The reticence of the physician in relation to his science does not add to his dignity, but really causes the masses to class him with the humbugs. The medical profession are to blame for the medical humbugs of the day and of the past centuries. Its members were the first to practise it, continued its practice for several hundred years, and the masses of the people have taken the cue from them.

Every important truth in medical science for the past three hundred years, when proclaimed, was ridiculed by the profession, its discussion interdicted, and, in many instances, its discoverers banished. Need we wonder that the people care so little for the science of medicine, but will seek that which promises most? They can obtain no real information of the science, so they try the art.

Our doctors, for the past few years, are waking up to their losing dignity, and, as a result, our medical journals and societies are discussing legislative enactments; committees are lobbying with the legislators to induce them to pass laws which shall restrict the practice of medicine. Through their urging, in some of the States, laws regulating the practice of medicine have been passed, all of which does not and will not amount to a row of pins in value, towards the suppression of quackery, or help raise the dignity of the profession.

That profession which commands the most dignity, the largest fees, and the greatest popularity is that of law. The principles of law are discussed by the masses more than any other science, its precepts and practices are better known. When medicine is as well and popularly diffused among the people as it should be, and eventually will be, its educated and deserving practitioners will be as well paid, protected, and popular.

An exclusiveness has been thrown about the medical profession by its own practitioners, so that no truth may enter except it be ex cathedra. The old-time physician entered the sick-room, with life and death in his saddle-bags, with the awful, mysterious air which the musty lore of ages conferred upon him, giving the impression that he knew all about it, but, by law, was forbidden to tell. Instead of intelligently discussing the disease, its causes and means of remedy, with the patient or his friends, he now leaves a nauseous compound, the more sickening and disagreeable the better, which will puke or purge, or a few cabalistic hieroglyphics.

Medicine, with its different schools and practices, principles and claims, should be freely discussed throughout the popular press of the country, as freely discussed as politics or religion, for that is the genius of our free institutions; then the people will soon learn who are the quacks, and the dignity of the profession will find a level equal to its attainments.

Steps in the right direction have already been taken by the advanced members of the profession, and quite a number of our popular periodical publications contain weekly and monthly articles, from their pens, of great value. The new school has led the van for the past twenty-five years, and will continue to lead until some more scientific practice arises.

The old school of medicine, as it existed twenty-five years ago, and as it still exists in some places, is the class that fear public discussion. They fear their trade will vanish if regular, intelligent, scientific medicine is made popular. Not all of this class are included among the so-called old school, but some of them are found in the ranks of the new school. It is a small mind that fears for his practice and professional standing because the

popular mind is being educated towards the science and art which he professes.

A physician of this State has made the remark many times within the past four years, that "the physician who had preceded him for four years had spoiled the practice." The physician that he referred to had done all in his power to educate the people above the use of quack and patent medicines, and to observe the well-known sanitary laws which govern health. True, he had reduced the practice from $4,000 to $2,000 per year, but he had stamped typhoid fever out of his practice, and reduced the sale of medicines by the grocery stores two thirds.

Suppose the same results could be accomplished all over our country, would it lower the dignity of the profession, or raise the illegitimate professional to greater prominence?

As the doctors were thinned out by that kind of practice, who would be the first to leave the ranks?

PLACENTA PRÆVIA: CASE.

REPORTED TO THE RHODE ISLAND HOMEOPATHIC SOCIETY BY ROBERT HALL, M.D.

WAS called about the 8th of July last to see Mrs. S―, aged thirty-six years, six months advanced in her second pregnancy. She had been married twelve years, and her first child was ten years old. I found her suffering from an "aching" in the pelvic region, which had troubled her more or less for some days previous. On the 10th, the membranes ruptured, but other conditions remained unchanged until the morning of the 15th, when there was quite a profuse hemorrhage. Digital examination made at this time showed no dilatation had occurred. I prescribed rest and Secale 1*.

Early on the morning of the 16th I was informed that several hemorrhages had occurred since my previous visit, but she had scarcely experienced any labor pains. Examination revealed an os, sufficiently dilated to allow the finger to pass through with difficulty, and thus the placenta was discovered lying across the internal os. The nature of the case was now made known to the husband of the patient. I immediately called on my friend, Dr. I. W. Sawin, to whom I related the symptoms, and of whom requested assistance in escaping from the difficulty in which I had found myself; for, if anything is horrible to me, it is to discover in the commencement of labor a presenting placenta, and life-blood flowing rapidly away.

We were soon at the bedside, when his examination confirmed my diagnosis, and it was at once decided to use Barnes's dilators, and await results. After six or eight hours, the os was sufficiently

dilated to enable Dr. Sawin's very delicate hand to pass, and he accordingly delivered. As the breech presented he was not obliged to turn. When the hand entered the uterus, it went by the left margin of the placenta, which was thereby partially turned to the right, affording a comparatively free passage for the infant. After delivery, there was but slight hemorrhage, and the placenta was removed with usual ease. The uterus was immediately irrigated with warm water, for the purpose of preventing further serious hemorrhage. The mother's convalescence was propitious; the child lived five days.

TABES DORSALIS.

Treated by Nerve Stretching, in the General Hospital at Prague,
Wards of Prof. Süssenbaum.

REPORTED BY E. M. CURRIER, M. D.

ANNA MÜLLER; age, forty-six; married. The patient, in her tenth year, had small-pox; since which time the cornea of the left eye remained clouded, the result of a corneal ulcer which she had at that time. In her fifteenth year the patient had typhus fever, and was sick for six weeks; and again, in her nineteenth year, she is said to have had typhus fever, remaining with it in the hospital seven weeks. In her twenty-second year, she miscarried in the sixth month of pregnancy, and has not been pregnant since. The present affliction began twelve years ago, and is said to have been caused by repeatedly taking cold in washing and carrying water. At first, pain in the right hypochondrium was noticed spreading toward the middle line, and afterward extending toward the shoulder; later, the pain spread to the left side, and appeared at last in the lower extremities. Burning and stinging pains appeared alternately in the right and left side, often lasting for twenty-four hours. The bones were said to be the principal seat of these pains. During the period of pain, the patient had to be either sitting or lying down; yet when free from pain she could walk about again. Finally, the pains appeared in the whole body, especially in the upper extremities (decided statements of time were not made by the patient). The head is said to have been always free from pain. The pain increased from year to year, so that walking, and even putting the feet on the ground, became very difficult, as the legs seemed to slip. During the last two years all the symptoms have been greatly aggravated: the violent pain becoming almost continuous, and the power of walking gradually diminishing. In walking, the legs were thrown to and fro, trembled and slipped easily, so that