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Review of REVIEWS
Peace and Occupational Diseases
We hear much in these days of the benefits of peace and the horrors of war. People like Mr. Carnegie complacently address us on the subject of peace and donate large sums toward its attainment, while we listen to them with no acute realization of the incongruity of their performances. Carnegie's career in the industrial world. was warfare of the grimmest kind, in which brigades succumbed to disease and injury. The warfare of the industrial world never ceases, and a million men are injured annually in our mines and on our railroads. The peace that means the cessation of political war, carried on by military forces, does not compare in moment with the peace that is needed in the industrial world. For some reason we lose sight of the seriousness of our daily social warfare and cry for peace when there is no peace, and can be no peace, so long as the industrial holocaust goes on. For it is entirely true that the sordid considerations that determine the one kind of war determine the other kind as well, and the cure of one is the cure of both. If we would put our social and economic houses in
order, there would be an uplift that would necessarily lead to the growth of healthful ideas of all sorts, and particularly to an improvement in ethical standards. This would necessarily affect international relations and tend to make war remote. Peace, like charity, should begin at home.
Mr. Carnegie and others of his ilk fatuously attempt to tinker with endresults. They would put the cart before the horse. They want to order political peace by a kind of fiat from The Hague. This sort of thing is useless so long as men cannot live and work under decent sanitary, hygienic and economic conditions. The human spirit must become sweeter and kindlier, if war is to cease; man's intellectual development must be accorded a freer scope; industrial slavery must give way to economic cooperation, if peace is to come upon the world, and these things cannot be so long as the special genius of the Carnegies, Rockefellers and Garys is not commandeered, so to say, by the people, and put to work for the benefit of all instead of a few. The State now calls to its service in special fields men
of superior attainments or special genius in certain departments of constructive work and administration. Why should it not call into its service our economic generals, and why should not this service be regarded by those called as the highest honor that can come to them? Why should not this Republic have a Legion of Honor, membership in which would depend, not upon the founding of libraries, not upon the construction of homes for the defective, not upon the disbursement of charity funds, but upon constructive service relating to basic changes in the social and economic order that would mean greater human efficiency (not greater slavery). Would not a larger human happiness, a development of ethical standards on the part of the whole people rather than a few, and better health result from such service rendered to the Commonwealth? And not only should those possessed of constructive genius be expected to serve the State-they should be penalized for failure so to do. What would this be but an extension of a method already in force?
Only one thing is necessary before these things can be. The people must really want them. When they refuse to sweat any longer for the money kings and begin to make the money kings sweat a little for them, things will improve mightily.
These things have a tremendous relation to the great problem of disease. We know what the slave methods of the corporations cause in the case of their own employees, and we also know the results in terms of disease on the part of the exploited people. We know the results of our system of permitting the pirates who stand between the producer and the consumer to control, as Mr. Lindberg, of Minne
sota, has pointed out in the House, the system of credits and debits, and thru it money, thus controlling, in turn, the commodities themselves by paying the producers the least and charging the consumers the most they can stand. We know what will happen if what Mr. Lindberg calls the money trust succeeds in getting the public to swallow the Aldrich plan and to stand much longer for the syndicate which absolutely controls the reserve funds in American banks, thus dominating the financial world. We know that from these things are flowing human hardship, degeneration, tuberculosis and a long list of physical ills that are economic ills.
Mr. Gary, of the steel trust, gave his wife a Christmas present of a pearl necklace costing half a million dollars. This price represents just a little loose change out of Mr. Gary's profit pocket. Every pearl in that necklace symbolizes an industrial disease.
Peace, forsooth! Let us understand what is meant by peace and by war. Then let us found a Hague Tribunal, not of marble, and not in Europe, but in every man's heart; therein to be arbitrated the cause of human rights versus property rights, of health, moral, mental and physical, versus disease.
PROFESSION OR TRADE-WHICH?
Early this morning one of my most beloved patients died. With him at the time of his death was "one of my boys," distinguished among many by reason of his shining talents. During two days and nights this physician had scarcely a moment to himself for rest. Even his meals were taken hurriedly and with the feeling that he should not
give himself any but the barest, necessary moments for bodily sustenance. This story, literally true, speaks for itself.
Would a mere tradesman do such noble work? Could he do it? He neither would, nor could.
This was practical idealism of the noblest sort and there is nothing comparable to it in this world of ours at present, except it be with a few devoted nurses; and I am happy to write such an one was also in charge of my patient.
I have tried in this brief way to show the difference between a profession and a trade.
Ours is the noblest of all professions, in my belief, when practised "Heart within and God o'erhead!" Otherwise, it is the meanest of all trades.
BEVERLEY ROBINSON, M.D.
The matter of fee-splitting has been much discussed of late and our ethical conclusions well defined. This subject has brought to our minds another. We have not infrequently heard general practitioners complain in this wise: A physician is called upon to treat a serious fracture, say of the leg or thigh. He in turn calls in a surgeon to put the fracture up, after which he takes care of the case, the surgeon making an occasional visit. When the case is concluded the surgeon, without a word to the practitioner as to the patient's financial circumstances, or the circumstances of the family, or the practitioner's own prospects as to remuneration, sends in an exorbitant bill-exorbitant at least in the sense that if he be paid the practitioner cannot, even tho his bill be
pitifully small considered in relation to that of the surgeon.
Now it may be said by some that it is small business for the surgeon deliberately to take the practitioner into. consideration in such a situation; that he is under no obligation whatever to look out for the physician; that it would smack of the same evils as does fee-splitting if he did, et cetera, et
We know where fraternity begins, but where does it end? In small, inconsequential matters, in matters pertaining to what may be called superficial professional graces, the indications are clear and our practices above reproach. But there are, or ought to be, a fraternity and a red-blooded kindliness between practitioners and their consultants that should go as far as a decent consideration for each other's welfare. It seems to us that any man who imagines that his blessed dignity or his ethical standards would be damaged by merely friendly consideration of his co-workers is not a very human sort of creature. It is safe to say that the general practitioner as a rule takes the interests of the consultant into consideration, "cracks him up" to the family, and is anxious that he be properly reimbursed. Why should he not, if there is anything in this thing we call fraternity? To him it is not merely a word. And why should not the consultant reciprocate? It is our belief that he does, as a rule, and we are discussing only the exceptional man.
We should not tolerate fake standards, relied upon by some people to cover their selfish greed. Let us choose consultants who are not only able advisers but fraternal spirits as well-men first and scientists afterward. But it is safe to say that our
advice is not needed in this connection, for no man of unattractive traits can hope to command the love or the patronage of his fellow practitioners who reveals such traits.
There need be no fear of our precious ethics suffering because of a display of kindly consideration, even tho it be displayed in connection with such sordid details as fees. None of the rotten elements pertaining to fee-splitting enter into such subjects as the one under consideration. We must not taboo as unethical frank understandings as to common interests
-the interests of the patient first and the interests of practitioner and con
sultant, together, second. No one should be scotched; the maintenance of a high standard of ethics does not require that anyone be scotched.
If there are sermons in stones, what lessons there are in a cartoon like that which we publish this month; and what food for thought!
There is but little check on reproduction among those most unfit to reproduce. Research workers connected with the Galton Laboratory have shown that the feeble-minded, for example, are especially fertile. The less the power of reasoning the larger the family, bad economic conditions notwithstanding. Indeed, where conditions are bad and the womb continues to house a new arrival every year or two, we may consider that a prima facie case is set up, tending to prove feeble-mindedness.
PILLS AND THE PEERAGE Dr. William Osler is no longer alone his baronetic glory. James Beecham, whose famous pills have traveled thru so many alimentary canals, has likewise been created a baronet. The rejuvenation of the British aristocracy is now complete, and the eminent Sir James has satisfied all his ambitions but one: to be buried in Westminster Abbey.
THE MONTH'S CARTOON
"Multiply and Replenish the Earth"
poor mother may be a better parent than the rich one, and we also believe that women should be so situated as to enjoy the fruits of marriage to the full, but none of these things, in the face of the outrageous fate that awaits most of the children born under bad conditions, justify themselves save as merely academic arguments. Were conditions decent, the world could not see too many happy children, with wholesome and endurable lives awaiting them.
The influences that are behind the advocacy of large families to-day are sentimental, pseudo-religious, political (in the worst sense), economic (exploitative), military (we are still making war one of our chief occupations and needing men to settle with their blood and lives the quarrels and mistakes of statesmen) and fanatical, not to say criminal, perpetuation of our smug, middle-class morality (so
When in addition to bad economic conditions we observe deplorable physical conditions, not to speak of worse things, and find the Niagara of babies augmented still more, thinking men feel oppressed.
We are quite well aware that the called).