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Very much more often, though, the amateur falls into error, making mistakes born of his own ignorance of the fundamental things everybody must learn who takes a regular course of instruction-but still the crowd sympathizes with him, because "he couldn't be expected to know." True, but this self-same amateur should have realized his own ignorance before he proceeded to interfere.

A costly machine may be ruined by an ignorant interferer-and there is little consolation to the owner to be told that the rash one's intentions were good. What piece of machinery is as complicated and delicate as the human body? Nevertheless the rule holds good here.

A Pennsylvanian took his daughter to a quack, who diagnosed "a cancer humor in the blood." To bring out the "humor," he applied a strong solution of corrosive sublimate to her skin. The result needs no description at our hands, but patient as well as quack saw in the angry appearance of the skin the confirmation of the diagnosis. Again the caustic was applied, and it bit deeply into the the tissues. A third application followed, and the girl died in the torments of the inferno, slowly burned to the bone.

At the trial the pretender to medical skill swore he really believed the destruction was the cancer humor coming out, and that he did not know the effects of the caustic he was applying; on which plea he was acquitted. The judge ruled that it was the father's duty to satisfy himself of a doctor's qualifications before entrusting his child to him; and that, when so accepted, if the doctor did his best so far as his knowledge and skill went, no more could be expected. The deception due to his claim of skill he did not possess seemed to be out of consideration.

This shocking catastrophe is by no means a solitary example of its kind; every community could furnish others, some quite as bad or worse.

There was that case of the man with the anchylosed knees. The doctors had refused to make any attempt to straighten the crooked legs, but there was in the vicinity one of those "natural geniuses"

to whom such matters "come easily", and this fellow undertook to accomplish the cure. Finding the victim's limbs resisting his utmost strength, the man applied his homely, everyday common sense to the problem in a way that commended itself to all present. He had the barn-door taken off its hinges and brought to the sickroom, laid the patient on the floor, put the door on top of him, and the "doctor," with two others, got on the door and “tramped"! Yes, and they actually straightened the crooked legs, so that three days later the man fitted into an ordinary-shaped coffin without any difficulty whatever.

Of a piece with this was an incident related not long ago in a drug journal. A woman applied for treatment, saying her child had swallowed some foreign body. The clerk replied that he did not know what to recommend, and she turned to leave; when another clerk, who, the journal remarked exultantly, was a salesman, stepped forward and advised a bottle of magnesium citrate. The sale was made, and the clerk was commended for his astuteness.

Neither the druggist nor the editor in this case seemed to have a glimmering suspicion that the patient's life was imperiled by thus liquefying the stools that otherwise might have enveloped the foreign body and conducted it harmlessly through the intestinal tract. Had death followed, the clerk might have truthfully plead that, as he was not a doctor, he should not be expected to know the danger following his treatment. The public would generally have accepted this plea and the court sustained it; although to us it seems that, since the woman applied for advice on the assumption that the clerk was qualified to give it and the latter accepted that assumption and gave the advice that resulted in death, both moral and legal responsibility should attack.

To impersonate an officer is sure to be followed by penalties if trouble results and the impersonator is caught. Is it less reprehensible to impersonate a doctor?

The remedy is the education of the people by ourselves. It does not take long to convince men that a costly watch should not be handed over to "just anyone" to tinker


at, but must be entrusted only to an expert, known to be such.

If each of us were to do his individual part of this general duty, we should soon find the public realizing that there are experts in detecting and remedying defects in the working of the human machinery. We should hear less of dormant hipjoint disease aroused to activity by imprudent "osteopathy"; of children dying of easily curable disease because their parents were "science"; of people passing along to the incurable stages of maladies because they were exhorted to "forget it" when the first warnings of nature were given; of women's lives wrecked because the husbandto-be had entrusted the treatment of his gonorrhea to the corner druggist; or of the innumerable instances where neglect and ignorance aid the enemies of human life.

It's our own fault that these things are so why not change them?

"There are two classes of people who through their calling work habitually against each other: the first are the cooks, who work toward the production of disease; the second are the physicians, who strain every effort for the cure of disease."-Tissot.



Every once in a while we get a letter something like this:

"DEAR DOCTOR ABBOTT: I have been a subscriber to your journal for almost fifteen years, and I have always admired your independence, your fearlessness and your fairness. I stood with you when you put up that big fight a few years ago, and wrote you privately to that effect at the time. I use some of the 'alkaloids' in my practice, and have occasionally contributed to THE CLINIC. But I am through! Last month you had an article on "The Etiologic Relationship of Pumpernickel and Pip," by Dr. Septimus Sextus, M. D., of Pumphreyville. I know Dr. Sextus, and I know that he is physically bow-legged and cross-eyed, morally perverse and mentally twisted. His article is twaddle, an insult to every self-respecting home. I am surprised that you should publish in your previously excellent journal anything that


goes so decidedly counter to all the opinions of the best authorities. Take my name off your list at once. I beg to remain, sir, Indignantly yours,


There are many men who admire you as long as you agree with them, but who are intolerant of anyone who sees things in a different way from what they do. Such men often talk loudly of freedom of thought and the glories of an untrammeled press, but give them a free hand, and a Servetus would be burned or a Priestley stoned in every hamlet of the Nation. Do you know Dr. Dixit?

O, Lord, give us courage this day to ask for a profit on our work.-"Ben Franklin Messenger."


The readers of CLINICAL MEDICINE CONstitute a great big family, and undoubtedly one reason for its popularity is that every individual in this "family" feels a personal interest in every other member. We talk things over in these pages without restraint, in a most "heart-to-heart" sort of way, and if anything appears in the journal's pages which interests us very much, some one is pretty sure to write to the author and tell him about it. It is a frequent occurrence that we hear from those who have contributed that they have received hundreds of letters as a result of one short article. That's right. This is exactly what every one of us who writes. needs to keep us "up to the mark."

So, if we see anything in THE CLINIC that we like, or that we do not like, let's write and tell the author just how we feel about it. Won't you all do so? There is nothing that cheers a man more, when he has labored hard to bring his ideas to the attention of others, than to feel that his work is appreciated. Of course, every man Jack of us wants praise, but we― most of us-would far rather be criticized than have no attention paid to us at all.

So I hope that every time you go through the pages of this journal you will mark carefully the things that you approve or disapprove, and then write the "culprits"

and tell them just exactly how you feel about their articles.

The same as to the advertisers. We could not get out CLINICAL MEDICINE for twice the money it costs you if it were not for the support afforded by the income. from the advertising pages. And, do you know, those same pages are of immeasurable importance to all of us. They constitute the current record of all that is new and best on the commercial side of medicine and the allied industries of interest to physicians.

The man engaged in business who does not read the advertising pages is going to become a back number; in fact, I believe that in a large number of the current periodicals published the advertising section is the most valuable part. Anyhow, scan these pages of THE CLINIC closely, and if you see anything there which interests you or about which you believe you ought to have more knowledge, sit down at once and write the advertiser and ask him to give you the information desired. It will pay you.

Take our advice, and you will simply be surprised and astounded at the amount of helpfulness you will get out of such correspondence, both with the professional brethren in the field who are writing and with the commercial men who are also working for your benefit in making and selling things they believe you ought to possess.

It would be a good plan for you to go through this journal every month with pencil in hand, marking this point here and that argument there, making note of this advertiser's name and of that man's product. If you do this and write these people, it will not be long before you will build up a correspondence that will not only be personal and friendly in character, but of immense educational value. Try it, by all means!


It does not seem surprising to us that there are therapeutic nihilists. It would be amazing if there were none.

The nihilist is generally a man with brains. When he does something he wants

to see some result of his efforts. He is the original "man from Missouri." If he has given tincture of aconite repeatedly and there has been no pharmacologic response; if he has been time and again equally unfortunate with digitalis, with belladonna, hyoscyamus, and other medicinal preparations, he certainly has good excuse for becoming a nihilist. If he has failed absolutely, unquestionably, with these remedies, which are "official," which have the stamp of authority, and possibly are furnished on his prescriptions as "standardized"; if in spite of all he can do they fail to produce the expected remedial results, what can he conclude but that the whole materia medica is useless-yes, and dangerous?

It is the do-nothing drug which makes the do-nothing doctor. Therapeutic nihilism is the legitimate offspring of the galenic system.

The factors of uncertainty, of variability in the quantity and proportions of the proximate principles, of decomposition due to age, heat and climatic conditions, and of "natural" polypharmacy, are constantly present in these preparations, which accordingly are never twice alike and rarely give identical results. How could a carpenter build a house if he depended on a foot-rule which was 13 inches long today and only 3 inches long tomorrow? How can a physician secure success with a drug which is too strong today, tomorrow absolutely inert?

The men who employ the alkaloidal and active-principle remedies, which are uniform in dose, always potent, always capable of producing effect, do not question the utility of drugs. These men do not guess at drug action, they know, and knowing, they achieve success.

Where the nihilist makes his mistake is in closing his eyes to everything except his own failures. Strong men are the most prone to conclude that because they have fallen short of success, every other man must do the same: As Prof. Reynold Webb Wilcox says: "The nihilist impedes progress by his captious criticisms of methods which do not appeal to his limited understanding and imformation, and by the


his own

loud asseverations based upon failures."

The therapeutic nihilist is an intense man, a man who has learned to concentrate his efforts upon his own field, too often a narrow one. He should learn to broaden out, to look beyond his limited understanding into the experiences of others, and there seek the secrets of mastery.

We venture this prediction, that when the masterly analytic and constructive minds of some of our great "nihilists" are concentrated upon the possibilities of active-principle medication, this foolish talk about the slight value of drugs will cease to come from within the medical profession. The reform is at our very doors. When the nihilist becomes sufficiently imbued with the spirit of progress to turn aside from his "captious criticisms" and really begins to study and work with us for the betterment of therapeutics, abandoning the outlived and the outworn, he will become an enthusiast, an optimist, and most important of all, a better doctor.

No, we don't blame the nihilist-except for clinging to antiquity, for tying his efforts to paleozoic pharmacy. But we do wish that he might awake from this sleep of the centuries-awake to the possibilities of this wonderful twentieth century.

Cheer up! Look forward! Boost! Do these and you can speedily put Cosmos on your pay-roll.


In view of the peculiar local complications, political and otherwise, confronting Mayor Harrison, the appointment of Dr. George B. Young as Health Commissioner of Chicago strikes us as an excellent solution of the problem, and as one which could not have been improved upon.

The fact that Mayor Harrison has gone to the U. S. Public-Health and MarineHospital Service for a man to fill this highly important position is not only a well-merited compliment to the Service, but it is also an exceedingly wise move in the interest of a city of the importance of

Chicago, because the personnel of the U. S. Medical Service consists of the most highly trained and efficient sanitarians in the world. It is not in a spirit of boasting that this assertion is made, but a simple statement of a well-known fact when we claim that the physicians connected with the U. S. Public Health and Marine Hospital Service yield to none in their scientific and practical attainments.


Another fortunate feature in the selection of Dr. Young as Health Commissioner is that it has taken the position out of the field of political wire-pulling, out of politics altogether and this is as it should be. The head of the Chicago Health office should be selected entirely for his scientific attainments and his knowledge in matters sanitary and hygienic, for his efficiency in dealing with the large problems that are submitted to his decision, and the service should not be jeoparded by any consideration of political pull or political gratitude.

We heartily congratulate Chicago on her new Health Commissioner; we congratulate Mayor Harrison on the wisdom of his selection, and Dr. Young on his appointment. We also congratulate the U. S. Public-Health and Marine-Hospital Service on this acknowledgment of its high standing.

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While CLINICAL MEDICINE does not intend to enter the lists in defense of any of these institutions, it does seem significant that the wonderful improvement in teaching facilities and material equipment as well as in the personnel of the instructors in these Chicago institutions receive no word of commendation from the committee. We are proud of great institutions like Rush, Northwestern, and the College of Physicians and Surgeons, but we are also gratified with the progress made by other schools. Every one of the institutions attacked is superior, in almost every respect, to the Rush College of ten or twenty years ago, of which some of us are proud to be graduates. We should encourage them to keep on growing better.

In our opinion, the cause of better medical education in this city is not advanced by attacking the characters, or questioning the motives of the profession in Chicago, or that part of it engaged in medical instruction. Any man who knows local conditions can tell you that some of the brightest minds of this country are connected with the colleges which Percy and his associates have gone out of the way to assail. An assault by men of his caliber upon The Chicago College of Medicine and Surgery, Bennett Medical College, and Hahnemann Medical College, including in this assault aspersions upon the student body, the faculty and every one associated with them, is a blatant example of medical Phariseeism and bad taste.

A man who dares waste an hour of time has not learned the value of life.-Charles Darwin.


How true is it? According to the constitution of the United States, every man in the world is born free and equal. Since the days of the French Revolution this grand generalization has been accepted as truth itself. In America it is true de jure but not de facto. Politically, it is perhaps true in the fact that to every individual is guaranteed, by the laws of the land, equal rights, and he gets these provided he is wise enough and strong enough; but anthropoligically, the truth is nearer the opposite,

that is to say, that no two individuals are born with equal possibilities.

Woods Hutchinson has recently said that all are born equal, and that the difference in men is simply one of training or environment; but, then, we all know Woods, and how dearly he loves to say things.

No educator who ever endeavored to study the pupils under his care would for a moment admit even a close similarity in their mental endowments. Those who have studied this question most discriminatingly are almost unanimous in the assertion that between the various races of men there is a radical difference, and that, whereas a certain education is a possibility to the Caucasian, it does not by any means follow that the same education is a possibility to members of other races without a mixture of Caucasian blood.

Some of us know that to us music is an unlearned thing. To the scion of a line of learned forefathers the acquisition of booklore comes like the recollection of forgotten knowledge. To others the same task is a demand upon neurons unpossessed of inherited aptness for such work. Note the helpless way with which such persons gaze at the problems which to the inheritor of learning seem so easy, and then say there is nothing in the heredity of brain culture.

It takes keen observation, sometimes, to discriminate between the leader, the advanced thinker, and the beneficent iconoclast, and the poseur. Some men are unfortunate in having once said something worth while and henceforth feel they must work to sustain their reputation as

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