T

OFFENSIVE METHODS BY HEALTH BOARDS.

HE spy system has never been in much favor with Anglo-Saxon peoples. It may be necessary, in certain cases and under certain conditions, to employ it for the detection of crimes and criminals; but it is always regarded, by right-thinking persons, as being at best a sort of necessary evil, only to be made use of when all other means fail, and in which no right-feeling man or woman cares to take an active part. It is, in short, in the mind of the decent citizen, a species of dirty work, only to be employed where absolutely necessary to circumvent equally dirty work with its own weapons.

All of which we have said before, in these pages, and are led to reiterate by certain events which have recently occurred not a hundred miles from the office of this journal. The spectacle of a City Health Officer hiring paid decoys to induce a Christian Science practitioner to render advice to a presumably sick person, for which the decoy made payment with a marked bill, as though he were entrapping a suspected embezzler or forger; thereupon dragging the practitioner-a lady-to the police stations and subjecting her to the indignities of disrobing and searching her like a common thief; such a spectacle, we say, is not calculated to inspire any great respect, either in the public or the professional mind, for organized medicine. Such a procedure is justly regarded by all right-minded persons as an outrage upon common decency, and quite naturally arouses public sympathy upon the side of the victim of such brutal methods. In the case in question the prosecuting attorney declined to issue a warrant for the Christian Science healer, we think, very rightly. And we are sure that the entire medical profession repudiates with disgust and indignation the uncalled-for action on the part of the Health Officer.

Aside from the natural disgust that such third-degree methods arouse in the minds even of those who discountenance what they believe to be the mischievous activities of Christian Science and similar cults, it should be pointed out that they defeat the very ends to which they are supposed to be directed. Nothing furthers an obscure or struggling cause like persecution. It serves only to arouse public sympathy and respect, even for people and causes who are not in themselves deserving of sympathy and respect. In cases such as the one we have cited the original issue is entirely lost sight of in the overshadowing spectacle of oppression and persecution of the weak by the strong. By all means let us expose what we believe to be the fallacies and evils of these health cults, so far as they are fallacious and evil; and use our utmost efforts, in a legitimate fashion, to protect the public against their delusions. But let us confine ourselves to the limits of common decency, and avoid the foolish mistake of fanning into more vigorous life, by the

winds of persecution, the flame which it is our purpose to quench. As a general proposition, we should say, the efforts of the medical profession in this direction should be confined to educating the public. Legal prosecutions would better originate with the public who are injured by irregular and unqualified practitioners.

N°

WHERE THE HEALTH CULT ARGUMENTS ARE WEAK.

O ONE has a livelier regard than we for the principle of medical liberty; nor, we think, has anyone been more frankly outspoken in defense of that principle. Indeed, our frankness has more than once drawn upon us the criticism of some of our readers and of our contemporaries in the field of medical journalism. Hence it may well be imagined that, even while we represent the side of the medical profession in all matters between it and the public, we have a good deal of sympathy with the public standpoint, especially where questions of liberty of thought or action are at issue. We have, for example, frequently expressed our opinion that the prevailing system of State licensing of medical practitioners is neither the wisest nor the most equitable way of regulating the practice of medicine. But it does not therefore follow that we can swallow all the specious sophistry that finds utterance in the protests of the various healing cults and their followers against the legislation which provides for such licensing. We beg to point out to these enthusiasts in the cause of medical liberty that their arguments, as generally presented (and they are about the same whenever and wherever one hears them), contain two or three fundamentally erroneous premises which considerably vitiate the conclusions and appeals that are made from them.

In the first place, we are asked to consider the injustice of a legislative enactment which compels a free American citizen to seek the medical service of a certain class of medical practitioners under penalty of fine or imprisonment. So far as we are aware, there is no statute on the statute-book of any State in the Union that compels any such thing. So far as our acquaintance with the medical practice acts of the country goes, they do not refer at all to the layman who seeks medical service, but altogether to the individual who offers and renders the service. If that service be rendered by a practitioner of whatever sect or creed-who has not fulfilled the requirements of the State, there is, so far as we are aware, no penalty attaching to the person who engaged him, but only to the unqualified practitioner himself.

We are perfectly aware that the rejoinder to such a statement will be that one condition amounts to the other. If none but "regular" practitioners are permitted to practice, then the public is de facto compelled to engage the services of a "regular," or go without. Perfectly true if that were indeed the case. But that brings us to our second point, namely, that the medical practice act has nothing whatever to say about the system or school of medicine that its licensees shall practice. Its provisions relate wholly to qualification and preparation-to fitness for practice. Having satisfied these stipulations of preparation and fitness, there is nothing in the medical practice act to hinder a physician from practicing any sort of system he chooses. To be sure, there is always the possibility of having to justify one's system of treatment in a suit for malpractice or criminal carelessness, but that is a contingency which pertains under the common law, not under the medical practice act, to every practitioner, not to any particular school,

It is surely very unreasonable for our health-cult friends to object to a legislative enactment requiring that the practitioner of an art pertaining to the human

body be thoroughly educated in all that belongs to the structure and conditions of that body in health and disease, whatever system of therapy he may purpose applying to the latter. Let it be granted, for the sake of argument, that in the matter of therapeutics a regular medical course is, to say the least, opposed to the beliefs of the follower of the new creed. Well, therapeutics is a comparatively small proportion of the curriculum of a medical education, and is regarded, even by the schools themselves, as a more or less elastic subject; it becomes less and less dogmatic every year. Indeed, the legislative committee of the American Medical Association has for many years been recommending the exclusion of the subject of therapeutics from State Board examinations on the very ground of its comparative unimportance, and for the stronger reason that it will place the different schools of medicine on an equal footing and do away with this very objection of the lesser sects.

And, as stated, there is no obligation upon any practitioner to observe any special system of therapy when he has demonstrated his fitness to conduct his own practice. It is surely splitting hairs to repudiate all the rest of the important curriculum for the sake of this one branch. Such elastic phases are found in every applied science and art. A mechanical engineer, in his technical training, doubtless receives a good deal of instruction, and is required to pass an examination in certain aspects of the care and repair of engines with which he does not at all agree, and which he subsequently discards for what he considers better procedures. But neither he nor anyone else therefore questions the necessity of his technical training in order to properly equip him for the construction and care of engines. In these elective matters he is allowed individual freedom when he has demonstrated his general fitness for his vocation.

This is all that the medical practice acts of the various States demand— a general fitness to deal with the human body and its ailments, based upon a thorough knowledge of its anatomy, physiology, and pathology, and even more generic knowledge of the prevailing status of therapeutics. There is nothing in such a requirement to interfere with liberty of individual creed and practice-nothing but a reasonable protection of the public health and safety. To object to it, even admitting the slight discrepancy in the therapeutic requirement, is, to our mind, very unreasonable on the part of our irregular friends, and does not appeal to the sensible, practical mind. If they would evince a little more disposition to vie with the regular medical man in his painstaking study of the essentials of his craft, their "conscientious" differences of opinion, in the matter of treatment, would command more sincere and serious attention.

L

THE BEAM THAT IS IN thine own eye.

O, THE poor editor of the Journal of the American Medical Association! He has, as Sam Weller said about Mr. Fogg, of the celebrated law firm of Dodson & Fogg, "worked hisself into a 'igh state of excitement" over the deplorable spirit of indifference with which the vigorous campaign of so-called therapeutic reform, carried on during the past six or seven years from Dearborn Avenue, seems to have been received by the medical profession at large. He complains that some of the leading members of the profession are allowing themselves to be featured as contributors to medical journals, "whose pages fairly bristle with pharmaceutical frauds and humbugs, many of which have been exposed in The Journal of the American Medical Association," and that these distinguished names

have actually been used by the journals in question as a commercial asset to obtain subscriptions. And he plaintively asks, "In all seriousness, do the members of the American Medical Association want the propaganda for reform in proprietary medicines to be continued, or do they wish to see therapeutics slip back into the unscientific and chaotic condition that existed before the fight against fraudulent proprietaries was started?"

His wailful jeremiad concludes with this significant paragraph: "For nearly seven years the fight against proprietary frauds has been waged. What are the visible results of this campaign? The chief one is the unprecedented commercial success of those medical journals whose advertising pages are open to anything that will not debar them from the post office. In other words, the work of the Council on Pharmacy and Chemistry has resulted in driving every pharmaceutical fraud into the advertising pages of those medical journals that are published for revenue only."

We have characterized this paragraph as a significant utterance; but its true significance does not seem at all to have suggested itself to the editor of the Journal of the American Medical Association. He takes the attitude of the soldier recruit who complained that all the rest of the company were out of step. He seems to assume that, because he and his subservient Council on Pharmacy and Chemistry, have decreed certain remedies to be frauds, they must be entirely discarded by the whole profession, in spite of the fact that actual clinical experience of thousands of physicians have proven them to possess therapeutic value. Any man with a less complacent obsession of his own infallibility, coming to a startling realization that a crusade which, under his direction, had been waged with the widest publicity and almost fanatical zeal for seven years, without producing any appreciable response from the great body of men in whose interests it was supposed to be directed—so that even the "leading members of the profession" were ranged on the side of indifference any ordinarily-constituted man, we say, under such circumstances, would seriously question, not the profession, but himself, first as to whether the campaign were really the important public measure that it was alleged to be, and second whether the methods and spirit of its conduct had been such as to vitiate whatever there might be of praiseworthy intent in its purpose.

It is absurd for the editor of the Journal to accuse the entire medical profession, or even the greater part of it, including many of its leading members, with a moral turpitude to which he and his immediate associates are the bright and shining exceptions. It is equally gratuitous and insulting to characterize this same great body of physicians (which he does by implication) as a lot of ignorant fools who are blind to their own interests and casy prey to frauds and snares, which only the all-seeing eye in Dearborn Avenue detects and exposes. In short, when the fanatic fails to arouse a response in the public sentiment, it is both cheap and fatuous to blackguard the public for its shocking hardness of heart. But that is what fanatics invariably do.

If the editor of the Journal and his medico-political associates will practice a little self-scrutiny, will look carefully and honestly into their own motives and methods, laying aside, for this one occasion only, the myopic glasses of self-interest and self-esteem through which they habitually view every subject, they may find ample explanation of the state of affairs which the editor of the Journal deplores, without calling in question the intelligence and honor of an entire profession. No right-thinking, self-respecting physician, or journal, but approves and coöperates in a legitimate crusade against fraud and deception, whether it pertain to medicines or anything else.