The Canadian Journal of Medicine and Surgerv A JOURNAL PUBLISHED MONTHLY IN THE INTEREST OF VOL. XVI. TORONTO, JULY, 1904. Original Contributions. PRESIDENT'S ADDRESS.*. BY J. F. W. ROSS, M.D., TORONTO. NO. I. Gentlemen,―There are pinnacles to which we reach, only to be hurled down from the dizzy height into the valley below, to be hidden from the rude storms of the world where peace and quiet and easy-going hum-drum pervades the spot, while the green grass grows under the feet. This is the well-known valley of the "Have-beens." Ifills have only two sides, one going up and the other going down, and when one has reached such honor as you have conferred upon me, he has climbed the up-side and must begin to descend. One is elated with the honor, but grieved with a retrospect of all that led up to it; one is pleased with the evidence of the good-will of his fellows and a better lot of fellows never lived in any profession-but subdued with that soul-shaking feeling that youth is fleeting and age approaching. Each man naturally looks forward to the day upon which he may occupy the presidential chair, but when the day comes he would give much to be able to postpone the honor for another ten years. And now it is time for the past-presidents to move up and make room for me; but I do not intend to be placed upon the shelf, if health and strength remain. We all like to mingle with youth, but unfortunately youth and age were never meant to mix. Charles Kingsley has aptly put it: "When all the world is old, lad, And all the sport is stale, lad, * Delivered at meeting of Ontario Medical Association, June, 1904. Creep home and take your place there The spent and maimed among ; You loved, when all was young." It is a satisfaction, in dealing with the awful miseries of life, to know that others suffer, that suffering and death are the accompaniments of life, and from this springs much of the beautiful sympathy that is witnessed by our profession. We have a grand work to do. Charles Dickens has put it in the words of the doctor's wife, where she says, "We are not rich in the bank, but we have always prospered, and we have quite enough. I never walk with my husband but I hear the people bless him. I never go into a house of any degree but I hear his praises or see them in grateful eyes. I never lie down at night but I know that in the course of that day he has alleviated pain and soothed some fellow-creature in the time of need. I know that from the beds of those who were past recovery, thanks have often gone up in the last hour for his patient ministration. Is not this to be rich ?" The young doctor must have as his main master faculty-sensecommon-sense, and he must have a real turn for the profession. A great divine has said, "The grace of God can do much, but it canna gie a man common-sense." The danger of the present day is that the mind gets too much of too many things. A young medical student may have, as one author puts it, zeal, knowledge, ingenuity, attention, a good eye, a steady hand; he may be an accomplished anatomist, histologist, analyst, and yet with all the lectures and all the books and other helps of his teachers, he mav be beaten in treating a whitlow or a colic by the nurse in the wards, or the old country doctor who was present at his birth. The prime qualifications for a doctor have been given by Dr. Brown in the words, Capax, Perspicax, Sagax, Efficax. Capax— room for the reception and proper arrangement of knowledge. Perspicax-a keen and accurate perception. Sagax-the power of judging, ability to choose and reject. Efficax the will to do and a knowledge of the way to do it; the power to use the other three qualities. The doctor must have a discerning spirit. There is a nick of time, or in other words, a presence of mind, and this he must have, or as Dr. Chalmers has said, "Power and promptitude." "Has he wecht, he has promptitude, has he power. He has power, has he promptitude, and moreover has he a discerning spirit." The doctor must be as a general in the field or the pilot in a storm. I often think he belongs to no one in particular, but is public property. His time is never his own. His children see little of him, and he leads a sort of Bohemian life-restless, active, thoughtful, worried, much beloved and occasionally cordially hated. He should be Bohemian in his tastes if he wishes for refinement to soften his manners and make him less of a wild beast. Art and literature, however, help to make noble only what is already noble, but such hobbies elevate and improve the mind and lift it above the rut of every-day life. A good education is a first. essential. It is not necessary that everybody should know everything, but it is more to the purpose that every man when his turn comes should be able to do some one thing. "The boy who teaches himself natural history by actual bird nesting is healthier and happier, better equipped in body and mind for the battle of life, than the nervous, interesting, feverish boy with the big head and thin legs-the wonder of his class." It is well to have a pursuit as well as a study. The doctor should marry, but his wife should be kept out of his work. Goldsmith said, "I was ever of opinion that the honest man, who married and brought up a large family, did more service than he who continued single and only talked of population.' By marriage a man's sympathies are extended and his views of life are broadened. A touching picture of the refining influence of sorrow has been given us by Dr. Brown, the author of "Rab and His Friends," in speaking of his father. He says: "A child, the image of himself, lovely, pensive, and yet ready for any fun, with a keenness of affection, that perilled everything on being loved, who must cling to some one, and be clasped, made for a garden, not for the rough world, the child of his old age. This peculiar meeting of opposites was very marked. She was stricken with sudden illness. Her mother was gone, and so she was to her father the flower he had the sole keeping of, and his joy in her wild mirth, watching her childish moods of sadness, as if a shadow came over her young heaven, were themselves something to watch. She sunk at once and without pain, her soul quick and unclouded, and her little forefinger playing to the last with her father's curls, her eyes trying in vain to brighten his. The anguish, the distress, was intense; in its essence, permanent. He went mourning and looking for her all his days." But the affection, we learn, softened and refined him and made him better fitted for his work. His son tells us further, that "his affectionate ways with his students were often very curious. He contrived to get at their hearts and find out all their family and local specialities in a sort of shorthand way, and he never forgot them in after life." And such attentions are valued throughout life, and the clay is moulded and figured, and ornamented, enriched and burned in the fire. and fitted for the battle of life. And the defective articles must be rejected, and the broken articles may, perhaps, be mended, but they are never the same again, and perhaps we would be better without them. Our ranks must be kept clean. We must have a good, healthy professional growth, and in Ontario, I am glad to say, that such exists. The regular who adopts the methods of the quack, is a much more dangerous individual than the quack himself. But we have others, who are by no means quacks, who unfortunately lack discernment, and who do not mean to do the harm that they certainly occasion. Our duty is to relieve and not to cause suffering. Some surgical procedures of the present day require severe criticism. Surgeons may be too conservative or not conservative enough. A few years ago we had an epidemic of the former, and now we are suffering from a plague of the latter. We are able to do so much that we are apt to do more than we should. I hope that the few dangerous individuals will soon be quarantined, so that the death rate and the cripple rate may diminish, and the epidemic be checked. The epidemic has been spreading and has assumed large proportions, and seems to affect chiefly young and middle-aged, nervous women. Men with exposed organs appear to be fairly free from its ravages. But as a profession in general we have been making great strides. The State is being saved from the enormous losses incident to great epidemics, and the medical profession is out of pocket, as a consequence. It does not appear that proper efforts have been made to reimburse the doctors. We are asked to do what our friends the lawyers would take good care not to do, without a proper arrangement for the payment of a proper fee. We are asked to register births, to register deaths, to notify regarding infectious diseases, and to attend to the poor without remuneration. These are not charities. We are assisting and defending the commonwealth, and the commonwealth should pay us, and we should organize and agitate with this end in view. Unless such matters are attended to and a new method of payment of members of the profession is adopted, the numbers entering must be considerably reduced. In China the doctor is paid for keeping the family in good health. In Canada, we, as a profession, protect the people from dangerous diseases, but the services are not paid for, and are scarcely recognized. A few officials take all the fees. Our real charity is not among the really needy, but among the apparently well-to-do. A proper revision of the relations of medical and surgical fees to one another is much needed, and a ruling of the Association on the ethics of commissions is required. A special committee of this Association should be appointed to investigate these matters and submit a report at our next meeting. It has been said that knowledge is no barren cold essence, but it is alive with the colors of the earth and sky and is radiant with light and stars. "If we endeavor to follow along the lines of experimental investigation of natural phenomena, we must obtain a fondness for the impartiality and truth which such a study in |