VOL. XVIII JANUARY, 1912 Introductory Announcement. Our readers will observe that we have undergone a new birth. The old chrysalis, using the term in the most respectful sense, served the profession well in its time, but the times have changed and we, too, must change with them, else we die in spirit and our work is naught. No. 1 medical profession. To-day the physician must take account of the big issues of life, in so far as they are related to medicine. He bears a definite relation to public affairs. He cannot avoid the insistent call upon his attention of the economic questions of the day and their direct connection with the problems of disease. The social organism as a whole must be studied by him. While he must give better medical aid to individuals than ever before he must understand group conditions thoroly in order intelligently to apply to the individual that which only study of the complex group conditions reveals. He must, if he would see effected those alterations in our social structure which thinking men believe are to usher in an era of far greater healthfulness and happiness than the world has yet known, participate in, or at least understand the purport of, all social movements having as their objects the uplift of humanity and the improvement of conditions under which men must live and do their work. There is nothing in the world bearing directly or indirectly upon the problems of health and Copyright, 1912, by Frederic H. Robinson, Publisher. The founding of a new journal would call for an apology, in these days of literary over-production, and it would be hard to make the apology convincing. But we bespeak the interest of the profession, not in a new journal, but in an old journal which has always been representative of the best standards since its creation nearly two decades ago, and which, because of the very fact that we realize that it must really represent the profession, has been caused to experience a renascence which will bring it into accord with the most progressive tendencies of the day in the great field of modern medicine. No apology is in order here. That which changes not, dies." 66 He is blind indeed who cannot see evidences all around him of radical changes in the old viewpoints of the disease which should not be discussed in his journals. And the day has And the day has come when clinical reports and commonplace technical papers must to a considerable degree give place to the live, vital issues at present exercising the professional mind. This is not insurgency, it is simply progress. We We call our journals archives, or depositories of data which are naïvely assumed to be precious. How often are the familiar data of the journals precious? Is it going too far to characterize as graveyards the majority of our sacred depositories? Medical journalism is in a transitional state. What we may already venture to call the old-time journal reflects simple conditions both in the profession and in the editorial office. Conditions are no longer simple, yet the same compilations of papers and smug editorial utterances called medical journals continue to be issued. Our medical Henry Wattersons are still scribbling in the editorial sanctums; they are not all dead yet. No accomplished apostle of the new school of thought has appeared as yet. This is to say that no journal is justifying itself as a really responsible institution, having important duties to perform. Our journals are not fully self-conscious, morally speaking. Of what use is a journalistic body without a soul? Promising the wine of science and of truth, our journals dispense to us roof paint. a pression. Let us eliminate the case report which recites the amazing fact that the Babinski reflex was not present. Let us forswear the contribution that reveals a vast second-hand acquaintance with curious, out-of-thecommon, erudition, and is foisted upon the reader merely to amaze him, to exploit the writer, and to fill space. Let us abjure the paper that is merely "rehash" of warmed-over, eternally resurrected detritus, inductive only of intellectual ptomaine poisoning and derived from the cold-storage departments of our libraries, which institutions stand in great need of Commissions charged with the duty of consigning to vast pyres the accumulated rubbish having no permanent value and which never had any immediate justification. Let us limit our columns to material that may be read thru without the induction of strange autointoxications. This is not to set one's self an impossible task but to lighten labor and to utilize the sweetness and light now embittered and obscured. It is our design to furnish in our editorials, in our special articles, in our departments and in our cartoons what we think the profession wants and should have, and what it will read and view with real interest and profit. We call particular attention to the brilliant treatment of historical themes by that gifted writer, Victor Robinson. Wattersons may be communed Stevenson, the Belovéd, wrote the with daily; we have only one medical following in 1883: There is but one art-to omit! . . A man who knew how to omit would make an "Iliad" of a daily paper. Well, then, let us begin to omit some of the excelsior which now distends our organs of record and ex Carlyle. TRUST FUNDS IN MEDICINE AND SURGERY Every one who reads the resolutions. adopted by the New York Academy of Medicine must feel a sense of disgrace for our profession. I refer to those made imperative by division of fees among certain physicians and surgeons who altho known are unnamed. As to shame: that I shall trust was felt even by the guilty ones. Some there are among them who are more thoughtless and careless than of evil-intent, or dishonest. Their education and habits of thought and doing are not infrequently wrong. When brought to a realizing sense of what they have done, they will stop it, and not merely because of the risk and penalty which will surely follow, if they don't mend their ways immediately and radically. Alongside the division of fees, there is another evil almost as great, if not greater, at times — the taking of other physicians' patients with knowledge of the culpability or simply thru lack of thought and proper sense of justice, thus doing to and by another as they would not be done by. The first thought in every upright practitioner's mind is to serve his patients to the very best of his knowledge and ability, be they rich, or poor in private or in hospital ward, or pavilion. Now then: to-day no man is equally skilled in all ways. There are many directions in which his knowledge and experience are limited. He may not be expert in eye, ear, throat, nose, skin work, etc., but he has of them all more or less available practical knowledge and insight. At a given time, however, he wishes his patient to have the best expert advice and so guides him. Usually, he Usually, he writes a letter to the specialist telling him of essential facts in the case, also informing him why his patient has been sent. His patient does not return to him and why? Alas, the pity of it! ა Not only has the patient been treated for his special ailment, but he has been advised and treated for disease of another organ entirely foreign to the one for which treatment was requested by the family adviser. Later, the latter hears of it in some indirect manner, and sad to relate, not only has he lost a patient thru greed and lack of conscience, but also, his patient has had wrong and ignorant advice and treatment. The specialist knows it or should know it. He also should know that the family physician is far better able to counsel and control than he and that his own judgment is very limited and probably very faulty. What is the reason and what the outcome of all this wrongdoing? In three words the reason is "auri sacra fames." The outcome is clear and plain as the noon-day sun. Unless we return, and very speedily, to old ideas of nice sense of right and duty the medical profession, the noblest of all, will soon become degraded beyond recall, as I believe. "Well, honour is the subject of my story.” on the part of the victims is practically tray the confidences of their patients. impossible to control. 3rd- Opportunity would be of fered to the political and official blackmailer, whose pickings are already fat enough. 4th-Under present social conditions the victim of venereal disease would be the butt of ridicule, practically ostracised socially and treated very much as a leper might be. 5th-On account of this attitude of society toward the venereal diseases those who would suffer most severely from social suspicion, repugnance or ostracism would be those who have innocently contracted disease. 6th Physicians in general would be likely to break the laws by concealing their patients' ailments. It is my opinion that most high-minded physicians would go to jail rather than be The physician who would expose the ills of an innocent woman, or young girl especially, to public scorn and aversion, would be unworthy of his calling. Once the reporting began, however, по discrimination could justly be made by the authorities; innocently and viciously infected alike would be subject to report. 7th Patients would often go to quacks, resort to patent medicines, or do without treatment altogether, rather than consult a reputable physician who might conform to the law and report the case. Society possibly may one day be ready for the official reporting of cases of venereal disease, but the time is not yet. G. FRANK LYDSTON, M.D. THE MONTH'S CARTOON The attention of our readers will naturally be drawn to the cartoon representing "THE DOCTOR'S DILEMMA," and the doctor will be reminded of it when he faces one of those baffling clinical situations which, if he be a man of heart as well as of science, make him feel his therapeutic helplessness in a peculiarly keen way. And if he is a man of mind the needlessness of it all will press in upon his consciousness and upon his conscience, stirring him to deep consideration of the economic factors lying back of the frightful anachronism we call tuberculosis, consideration which does not stop so soon as he has passed from within the unfit habitation of the victim, but which takes the form of earnest study and ultimate action. For the co-operation of the physician is needed by the forces that are struggling to mitigate the evils of our social system. This cartoon should strike a responsive chord in the heart and mind of every physician who looks upon it, for the psychology of the doctor in the picture is, to every one of us who thinks and feels and cares, an open book. We have departed a bit from conventional medical journalism in offering this series of cartoons, a series which we have given the general title. of "The Doctor's Dilemma." These cartoons will deal with big current sociological and medical questions, and our best thought and observation, and the best endeavors of our staff artists, will go into their making. We do not doubt that they will prove one of the most inspiring features of the journal. |