C. M. Appel, M. D., B. F. Alden, M. D., D. E. Barger, M. D., J. A. Black, M. D., Geo. E. Bushnell, M. D., E. R. Bryant, M. D., C. V. Cross, M. D., W. H. Crothers, M. D., C. W. Burgess, M. D., Chas. L. Field, C. L. Gregory, M. D., A. P. Hall, M. D., H. I. Jones, M. D., C. G. Kenyon, M. D., Thos. I. Janes, M. D., Thos. W. Serviss, M. D., J. H. Soper, M. D., Reginald Smith, M. D., T. B. Sutherland, M. D., A. Miles Taylor, M. D., P. M. Thomas, M. D., John Wagner, M. D. SHOULD THE PHYSICIAN PATENT HIS IDEAS. The following editorial appears in the N. Y. Med. Jour. and Phila. Med. Jour. for September 3, 1904, and deserves more than a passing notice. Dr. G. Frank Lydston is a native son of the Golden West, and a prominent writer, teacher, and practitioner at Chicago: "The opposition of the profession to the patenting of surgical instruments has been based upon the tradition which has come down from our medical forefathers that appliances and remedies used in medicine and surgery are primarily for the benefit of humanity, and that any pecuniary profit or other advantage which may accrue to the inventor is an obstacle to the application of the invention to humane ends. The fallacy of this position seems to me more than obvious. In order that the ethical principle regarding medical and surgical inventions established by our medical forefathers should be applied to the letter, certain conditions are absolutely necessary: 1. The instrument maker should furnish the appliance to the profession without profit to himself. 2. The physician or surgeon using the appliance shouid restrict its use to cases in which no fee is charged for his services. 3. Any hospital or other institution making use of a medical or surgical app liance for the relief or cure of disease should restrict the use of such inventions to pauper patients. "Whenever it can be shown that any person whosoever has made a profit, however small, out of the use of medical and surgical appliances, the strictly humane end and aim of the old-fashioned ethical principle involved are defeated. It requires very little argument to show that in practice the only individual who is made to conform to the established principle of ethics governing the patenting of medical and surgical appliances and remedies is the individual to whom we are indebted for the invention. "As matters now stand, the surgeon who invents an instrument and the physician who discovers a valuable remedy are compelled to produce them in the first instance at the expense of their own time, labor, and money, to say nothing of their brains. To add insult to injury, the instrument maker or drug manufacturer to whom he gives the profits of his ingenuity not only charges the profession, to which is entrusted the humane application of the invention, a large profit, but imposes upon the inventor himself a tax of profit on such of his own inventions or preparations as he may desire for his individual use. A bill lying upon my desk, rendered me by an instrument maker for an instrument which I invented, and which he is marketing at the usual rate of profit, serves as a case in point. "The spectacle of a hospital surgeon using an instrument invented by one of his brethren in operating in a case for which he has received or expects to receive a large fee, in a hospital which is charging high prices for lodging, nursing, and surgical dressing, is a grim satire upon the humane principle that actuated our medical forefathers in the formulation of that feature of medical ethics which covers the patenting of medical and surgical inventions. Where, as is only too often the case, the surgeon who is doing the operation with the appliance from which the inventor receives no profit, and in the invention of which he incurred great labor and expense, is paying commissions, the situation is worthy of the satire of a Smollett or a Molière. I do not hesitate to say that the humane idea, as applied to medical and surgical inventions, is an arrant humbug and an obstacle to scientific progress. Comparisons may be odious, but I believe that the humbug is much greater in America than elsewhere. "Some of the advertisements in medical journals strongly resemble those of cure alls to be found in the daily papers. If a remedy is a valuable one, why should a journal object upon ethical grounds to its mention in the reading columns? Does the fact that somebody derives a profit from the product of his ability interfere with the humane appli cation of the remedy? If the remedy is unethical, why should not a journal which objects to its appearance in the reading colums refuse to allow it to appear among its advertisements? With no desire to make invidious distinctions between journals, I feel safe in asserting that there are numerous high-toned medical journals which, while objecting to the mention of such preparations in a scientific article, without payment at advertising rates, could readily be cajoled into a change of heart as to the ethical principles involved by a satisfactory-shall we call it payment' or 'honorarium? The same medical journals that would object to the mention of a protected American preparation will blithely publish in their reading columns scientific articles in which the merits of various European preparations are extolled, without protest. Does the fact that European genius rather than American derives a profit from certain proprietary remedies make these remedies ethical' according to American standards? ་ "A very important question in connection with the subject under consideration is that of whether the deriving of a profit from medical and surgical inventions by reputable scientific men would not be more directly in the interests of humanity than the present absurd custom. Great progress in invention cannot be expected without material rewards. This is as true in medicine and surgery as elsewhere. It would be absurd for any one to say that the profit that has been derived by inventors and "middlemen" from various electrical appliances has retarded the advancement in this field or has been detrimental to the best interests of humanity. Edison's inventions, for example, have been none the less valuable because of the profit the inventor and others have derived from them. The possibility of pecuniary returns would stimulate invention in medicine and surgery quite as much as it does elsewhere, and would induce certain inventive minds in the profession to enter the paths of invention, which are at the present time closed to them for the reason that their professional position is such that the invention of a valuable instrument or preparation could in no way aggrandize themselves by the advertisement incidental thereto. The inconsistency of the medical profession in the matter |