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as far as ever from the discovery of specifics for and other mercantile establishments. Every phytuberculosis or cancer. Yet improved methods sician certainly will help along this movement, of treating tetanus, cholera, typhoid fever, and both through his own purchases and through enother serious diseases have been found, and our couraging his friends and patrons to invest genresearch men are pressing forward with as ardent erously. It's a good thing-push it along! a spirit as ever. If we have uncovered compara
e tively few real "cures" in the last two decades
The Schick Test for Immunity to Diphtheria. we have at least discovered many new facts, and
-Elsewhere in this number we are reproducing some tremendously significent principles. One
an editorial from the Boston Medical and Surgical discovery like diphtheria antitoxin is worth a half
Journal which gives some interesting information a century of unceasing effort—and with the tools
regarding the Schick test, which is now being used we now possess there is no reason why we should
successfully by the New York Board of Health not solve many a problem of life and death in
to determine whether or not persons exposed to the next few years. Who can tell what the next
diphtheria possess natural immunity. If they are twenty years shall bring forth? And how many
naturally immune, then it is folly to give them the of us will be here to see?
usual prophylactic injections of antitoxin. That de
this is important is made clear by the discovery “BREED BEFORE YOU DIE.”
that about half the children between five and fifDiscussing the possibility of war with France, teen are immune to the disease. The Schick test in his now-celebrated book, General von Bern- gives the information desired; and it is simple, hardi said: “It would be a war to the knife easily made, free from injury or distress to the with France, one which would, if victorious, an patient, and apparently it can be relied upon. nihilate once for all the French position as a Great Every physician should be familiar with it. Power. If France, with her falling birth-rate, determines on such a war, it is at the risk of losing her place in the first rank of European na
Successful Treatment of Bichloride Poisoning. tions, and sinking into permanent political sub
--Some months ago, Dr. Thos. A. Carter of Chi
- Some months ago, Dr. serviance. Those are the stakes.”
cago read a paper before the Chicago Medical The encouragement of rapid human reproduc
Society, in which he proposed as an antidote for tion rests upon a purely sordid and immoral basis. poisoning with bichloride tablets the use of soThe only powerful reason for urging men and
dium phosphite. This was shown to be a chemwomen to beget many children is that the nation ical antidote for the mercury salts. A clinical may be stronger than its neighbors-stronger be
trial in a number of cases convinced Doctor Carcause it has more soldiers. It can then sacrifice
ter that the remedy was an effective one. While more of its people and still survive. There is no
not all his patients recovered, the majority of intimation that reproduction run riot is going to them did, including some cases be better for the people themselves. Indeed, we
dition seemed so desperate as to offer little hope. all know that exactly the opposite is true, for
We have learned that Doctor Carter has had when a family has many mouths to feed and lit
further experience with this treatment, and that tle to feed them with, some one must go hungry.
one must go hungry. his results have generally been very satisfactory So long as the country has uncultivated land and
indeed. If the sodium phosphite will do what is undeveloped resources sufficient for all. the over- claimed for it, it should be available in every flow can be taken care of; but Europe today has drugstore for emergency use. Certainly anything no such surplus.
which promises to save the lives of individuals Looking at this matter from the standpoint of who have swallowed this deadly poison, should be the people themselves, this constant effort to where it can be used immediately whenever such breed men for destruction, either in war or in necessity arises. commerce, can have no moral justification. Were war abolished, no one would advocate it.
With the Coming of Spring.—The war is ter
rible. Yet it promises to become more terrible, EDITORIAL NOTES.
for, added to the losses of life, the suffering of Red-Cross Christmas Seals.—Have you se- the wounded, distress to troops caused by exposcured a supply? Remember that all the money ure to cold, and the starvation of the homeless derived from the sale of these seals will be used and jobless, we shall soon have to consider methto carry on the great fight against tuberculosis. ods of fighting the great plagues. If these are They can be procured at stores, news-stands, banks to come at all they will probably make their ad
vent next spring. Already cholera has appeared world, even in spite of the great war now ravagin Galicia, Turkey, Russia, and the Balkans. ing all Europe. When the snow melts, and the rivers carry the accumulations of the camps down toward the sea A New Pellagra Hypothesis.-0f making hythe cholera vibrio will almost certainly make its potheses with regard to the etiology of pellagra, appearance in every part of the continent. That there is no end. We have had the spoiled-corn the European nations realize the danger is ap- hypothesis and the simulium hypothesis, the ranparent, since we already hear that troops in east- cid-oil hypothesis, the direct infection hypothesis, ern Europe are receiving prophylactic cholera and the auto-toxemia hypothesis, and only a biblivaccination. That this may be effective is shown ographer can tell how many more. None of them by the results obtained in the Greek army during seemed to fully satisfy the profession. The latest the Balkan war. While some cases of cholera one, however, proposed by Goldberger, of the Public appeared in this army, the number attacked was Health Service, is so simple that it has much to small indeed as compared with the number of commend it to the attention of the profession. In Bulgarian soldiers who suffered. But think of the
recent numbers of Public Health Reports, he extask involved in vaccinating all Europe against presses the opinion that the disease is due to malcholera—for the women and children must be pro
nutrition, and that deficiency of proteins is the tected as well as the soldiers. Truly the burden
primary cause. He came to this opinion after a laid upon the world by this war is a titanic one. careful study of the cases of pellagra occurring
in insane asylums and other charitable instituAlcohol and Its Evil Influence.—One of the tions in the south. He uncovered the interesting most significant features of the meeting of the fact, that while hundreds of cases of the disease Alienists and Neurologists of the United States have appeared among the inmates of these instiin Chicago in July last, was the passage of a tutions, there is not a single report of an employe series of resolutions in which alcoholism was being attacked. The inference is that some differdescribed as a cause of a large proportion of the ence in environment must be responsible for the cases of insanity. As the Long Island Medical difference in the existence of the disease. That Journal says, “While physicians may be divided difference he demonstrates to his satisfaction to in their estimate of the degree of toxic power ex- be in the character of the food. The insane are erted by alcohol, they are as one in condemning poorly fed and poorly nourished. It is diffiits habitual use, and should be ready to subscribe cult to persuade them to eat such protein foods to the proposition that at best its use does little as meat, eggs, milk, and the like. Considerable good except as an occasional stimulant, and that evidence is submitted in support of his position, the economic waste resulting from the purchase and it seems to rest upon quite a strong foundaof alcoholic beverages should at least be kept tion. If he is right, then the treatment of pelwithin bounds by restrictive legislation.”
lagra, at least during its early stages, is a very It is no longer the fashion to defend the use simple thing. All that will be necessary will be of alcohol. At the last election, four states, Ari- to reduce the proportionate amount of carbohyzona, Colorado, Oregon and Washington, passed drates, including the corn products, sirup, moover into the prohibition column, and Virginia lasses and cereals generally, while increasing the voted for prohibition only two or three months proportion of fresh meat, eggs, milk, and the ago. Russia, which has been considered one of legumes. the most degraded countries in the world, from We have heard the statement made that pelthe standpoint of the use of alsohol, has at last lagrins who have been sent north for care and definitely prohibited the sale of spirits. While study, and placed under improved hygienic and the Czar's ukase was a war measure, there is dietetic conditions, have confounded and asmuch likelihood that it may be made permanent. tounded their keepers by recovering promptly. Only the other day, in the British House of Com- Perhaps the reason is that given by Doctor Goldmons the question was raised as to the desirability berger. At any rate, he has presented a hypotheof prohibiting the sale of alcoholic drinks in sis which is so simple that it can be tried out Great Britain during the war.
anywhere. These “straws” show the direction in which the wind is blowing. The world is beginning to “I see your wife has abandoned her idea of realize that there is little to be said in favor a European trip. What has happened to make of the use of alcoholic beverages as compared to her change her mind?” its disadvantages and dangers. This certainly “She heard someone say that travel broadened is another evidence of the moral awakening of the one immensely.”
THE DOCTOR'S DEVELOPMENT.
By GEORE F. BUTLER, M. D., Chicago, Illinois.
F THERE be a history of the he was an earnest student of the means at hand,
growth and development of any while most rarely he possessed such knowledge, inof the “learned” professions, any cluding that acquired from schools and books, as chapter more curious and vividly could give him rank with any town practitioner interesting than that of the med- of his time. But, first of all, he was a man of
ical professions in the United hardihood. States, it would be hard to designate its condi- Even the generation of today remembers well tions, and place, and time. The story of the the backwoods doctor, him of the saddlebags. Ten, general practitioner in America is a story of twenty, thirty miles he would come through the arduous effort, often under almost desperate cou- wood roads or by rougher ways, if need be, in ditions, and one, from the beginning, having in answer to his almost always urgent calls; for the it the elements of adventure, sometimes of ro- settler did not summon a doctor on account of mance and not infrequently of danger. It is the any trivial ailment. Night and day as well as the personal history of strong and earnest men fol- varied pathways were very much alike to him, as lowing one after another in paths first most diffi- he saw his duty; and he saw it rigorously, for the cult to perceive and, later, to pursue to the best settlers necessarily leaned on each other strongly. advantage with the best results, but never aban- To tramp in the forest through the snow of windoned until they broadened into the highways ter, to hear, perhaps, the wild cry of a panther open today.
lurking in the woods besides him or--an adventure The career of the doctor in the early days of much more serious—to be treed by some wanderJamestown or the Plymouth Colony may be imag- ing and all too hungry pack of wolves, these were ined somewhat easily. He followed the same some of the experiences of the early doctor. And course, diagnosed, in a general way, the same it is not recorded that he ever put them down in diseases, and prescribed the same medicines that his bill! He accepted the situation, appreciating he did in England. Possibly an occasional pil- more thoroughly the time when, eventually, what grim or early Virginian had more of his blood were at least apologies for roads became more let than really was good for him. But the doc- general and he could travel on horseback, protor was as the other colonists: he endured the vided, of course, that he could afford a horse. The same hardships and lived the same life with the burden of the saddlebags, when one had to carry same degree of fortitude as did they. The time his medicines with him, was in itself a thing to had not yet come when he must go out and en- be considered. And, a man on horseback had a counter vicissitudes to which the ordinary man dignity. was not subjected. The Indians were not his And what calls were his! The term "general trusting patients.
practitioner” was weak as applied to this doctor After a while, however, there came a mighty of our pioneer days. Jackson might have broken change, and the pioneer doctor had his birth. His his leg by a fall from the roof when shingling his was a new and grimly demanding heritage, and log barn; Mrs. Mason, Spartan wife of Spartan he who would accept it must be a full man. He pioneer though she might be, could possibly enappeared as he was needed. It was in the blood. dure no longer the agony of an ulcerated tooth;
The settlers were widely scattered; paths there or the malaria-smitten family of the Raffertys were none or poor ones at best, but everywhere might be out of fever-medicine. “General practo those who were in need of him the new and titioner!" The old-time doctor counted such a the original manner of the doctor somehow found title but a prefix. Surgeon, dentist, and apothehis way. He appeared always with the pioneers cary was he, as well. That to his duties was not as they forced their hewing way through the for- always added the supervision of every increase to ests and over the mountains and westward, until the population was attributable only to the fact they had overrun the Mississippi Valley. Very that the exigencies of the times had developed in learned in his profession he may not at all times almost very neighborhood some warlock dame have been, all the advantages of life had not been who presided at such function and who was credhis; but many of life's mysteries he had learned, ited by the children already in existence with the
re. Still he was buher creatures turkeys anand the ruling squirre
Still bearings but agreeable, that made the old besides all the
power and freakishness in these days attributed intervals from the nearest town. There were the to the stork. .
adventures and the enjoyments of the forest A man of parts was the doctor of the woods trail, the glory of spring and summer, the wild and farms, and it is to his credit that he recog- flowers and the birds and the barking squirrels nized the importance of his mission and felt that and the startled deer and the ruffled grouse it should be recognized by others. It is pleasant and the wild turkeys and quail, besides all the to dwell upon his varying personality, which so other creatures that made the old woods anything many still living can recall. Sometimes he was but agreeable, but which, furthermore, on occamore or less imposing and austere. Still bearing sion added not a little to the pleasures of the the trace of mud or dust or snow, according to table. More than one of the early doctors found the season, he approached the bedside. Most anx- in the abundance of game some offset to the exiously the good wife, if she herself were not the pense of living for one who had no time to clear patient, searched the face of the great man when and cultivate his land, if he possessed any, and husband or child lay in the grasp of some disease, whose income from his profession must be, under for already had the trial of all home remedies any local circumstances, limited. More than one, been made. Very grave the doctor looked and, as well, among these patient students of the woods not improbably, he shook his head; for, the shak- developed into a keen botanist or naturalist, and ing of the head means much and nothing in par- the contributions to the general knowledge, not ticular, and the good cheer of the modern physi- less than to the materia medica, of these exploitcian had not yet been understood and recognized ers of new fields have long been recognized for as a part of treatment. At the portentious look their merit and importance. and the headshake, the family fairly quaked. Then, The qualities that are in a man must count, when the medicine-case was opened there was con- 'wherever he may be or whatever his occupation, sternation, though now mingled with faith and and the early country doctors improved their ophope. Then administration of the prescription, portunities. It so happened, too, that occasionand confidence restored. The patients of those ally, their profession practically lost one of them. days had faith, and that aided mightily in the Covering a wide area the doctor, in his profescures.
sional journeys, necessarily made a host of acVaried were the prescriptions of the doctor so quaintances, and such acquaintance might be of far removed from any source of medical supplies. a character more than casual. Among his remedies were not a few whose utility Given such a man of natural force of character, had been tested before the white man had found one having a broad interest in other men and in the western hemisphere, and others the merits of affairs, and it was inevitable that he should bewhich had been learned by students, like him, of come something of a power in the community the properties of the flora of a new world.
and that it might, as a matter of course, someIt is more than possible that in our confidence times happen that he would be called upon to repin the surpassing value of modern ways we do resent his fellow citizens in framing their legislanot give due credit to the merits of the herbs and tion. Who so familiar as he with their circumsimples of the woods and fields and gardens. In stances and their public needs? So, it not infrerhubarb, the oldtime country doctor put especial quently came to pass that the country doctor betrust, and he pondered long over the differing vir- came the member of the legislature from his distues of pennyroyal, burdock-root, wild-cherry trict—that is, if he had not fallen too completely bark, and golden-seal and smartweed and lobelia, under the spell of his botanical and nature studand other products of the kindly earth, all at his ies, or, possibly, built up a practice more rehand. In many a family of today is handed down munerative than the income of a legislator, or the tradition of his liberal prescription of bone- too rheumatic from exposure to all weather at all set tea, and there are still survivals of the bone- seasons—and it often happened, as well, that his set-cult. In his softer moods, the oldfashioned career as a law maker did not end within the limdoctor prescribed infusions and decoctions of its of his own state. There have been strong men cammomile, blackberry and raspberry leaves, red among the country doctors who have been sent clover and, to induce sleep, scotch-cap tea and to congress, and the profession has reason for sometimes a hop pillow. He was a good doctor! pride in the quality of its representation in that
Yet, hard as was the pioneer doctor's life, it distinguished body. had its compensations. There was compensation Occasionally, too, the country doctor, familiar in even the sometimes arduous work involved in with the nature of the varying forests, became gathering the roots and plants whose virtues found the owner of tracts of pine land, and, so, in some an aid in the accepted remedies obtained at long instances a man of wealth; though, needless to
had become the reason horseback, for "as now the
say, these instances were not common. As a gen- hensive way. The physician himself had changed, cral rule the doctor never abandoned his profes- if not in basic personality, at least in the possession, and he very rarely changed his field of ac- sion of such knowledge as might come from tion. He was a fixed part of the developing broader acquirement. Medical colleges had come community, a notable factor in its steady progress. -great colleges, some of them, with master minds This is the idyl of a man of opportunities
in their faculties, and he who would become a But times were changing. Rarely was now the doctor now found no such preliminary hardship country doctor seen on horseback, for so passable in the way of his ambition as his predecessor had had become the roads that the gig or buckboard been forced to undergo. Opportunity was presbecame available, and there are far worse ways ent, and all depended now upon the man. Proof getting about than by gig or buckboard. In foundly educated, not in the science of medicine the old days there was much discussion as to the alone, but in the different branches of learning, relative merits of these two vehicles. The two- might be any country doctor—although now the wheeled gig was supposed to have somewhat of town, of whatever size, usually was his home a professional character about it and, besides, and his ideas and niethods were extending with could be turned about within its own length, his expanded field of thought. Some famous which was of considerable importance when nar- physicians were produced along about the middle row roads and lanes must be traversed; but the of the century, men fully deserving of the repulong, low, more swinging and easy four-wheeled tations that for them are lasting. buckboard was a practicable conveyance that Then came another change that had a tremenwould endure rough usage or carry a load.
dous effect, immediately and universally, upon Interestingly curious were some of the road the profession, and which was of a character that problems of the day, but they were rapidly dis- could not have been conceived in ordinary foreappearing as the farmers organized their school cast. The most destructive civil war in all hisdistricts and the “postmaster” began his duties tory broke out, and the doctor was drawn into the in an humble way. Already mayweed had dis- maelstrom together with his fellow citizens. As placed the fireweed on the strip between fence a private in the ranks, as an officer in command, and road, and the white clover was soon to come. he went; but it was the fact that thousands of The stumps on the fields were gradually disap- doctors became surgeons and assistaut surgeons pearing, and the Devon and the Durham some- and labored in the field throughout the vears of times appeared among the cattle. The wolves blood
bloody struggle that made its impress on the prohad been destroyed and sheep now were being
fessions as a whole, and for all future.
for reared, and in the flocks were occasionally seen,
The end of the war released to civil life a even in the 50's, the broad back of the Leicester
host of physicians whose original learning had shire or the black nose of the Southdoun. Civilization and progress were advancing all along the
been supplemented by practice in a stern school. line. Even the doctor's gig and buckboard were
They had “walked the hospitals” of battlefields; abandoned.
they had guarded the health of laboring multiA new era had opened for the doctor when he
tudes in trenches; they had fought the malaria. ceased either to compound a portion of his own
of the swamps; they had stopped the dysentery medicines or was no longer compelled to carry
of the camp; they had encountered all the harms the material for his prescriptions with him. al- and diseases to which a soldier's life subjects though in remote districts he long continued the him; and they had learned--how much they had practice by virtue of necessity. With the vil- learned and what experience did they not bring lage druggist as an ally, he now began to travel back with them! Assuredly, the civil war had about in a neat top-buggy, using two horses, turn its effect upon the medical profession in America. and turn about. His house now had porches and It tought a thousand lessons. low windows, and inside of it were comfortable To tell anything of the story of the present, furniture, books, and attractive pictures. He to attempt anything like a study of the character also sent his children to the best schools, and the of the American physician of today, is a work adolescent sons, in many instances, to college. out of the question. He is the splendid product His equipment no longer involved an attic hung of a development as natural, in its way, as it with herbs, while his place of consultation had has been phenomenal in its gradation and expanbecome a cheerful room, with all the requisite sion. But, what has not been phenomenal in ataids to diagnosis.
tainment among the important things in this new But, more than that had taken place, and some- country, and what has surpassed in advancement thing that exerted its effect in a more compre- that of the medical professions?