ability and perhaps is inferior to the average physician. The laity is always ready to "swallow" this kind of talk, marvel over alleged professional standing, and admire seeming greatness. I admit that there are factors besides those of scientific or professional ability that are legitimate or ethical, which stand as an adjunct to a physician's success; such as courtesy, affability, neatness, cleanliness, morality, temperance, and honesty; but these latter virtues are often very little appreciated on the frontier where we so often find our patrons are of inferior moral and intellectual standing. It consequently falls to the lot of the physician to educate the public. To accomplish this he needs the co-operation of his fellow-practitioners. Unity and concord are absolutely necessary, as much so as in the system of teaching pupils in the graded schools. The sooner the physicians in a community come to realize that by considering each others welfare they further their own interests and correspondingly prosper, the better it is for them. The physicians in a town, county, district or state, should by all means organize themselves in such a way as to make themselves useful to each other so as to better their mutual, professional, social, and financial positions. No man who prefers to stand alone, who ignores the opinions of his colleagues, can ever become a useful and great man. In unity there is strength, and in wide-awake organizations there is enlightenment and progress. At the present stage of civilization we find a tendency towards organization in all lines of business or enterprise for the general betterment of conditions. We also notice and must acknowledge that great strides have been made and that marked improvements have resulted. No man standing alone on his own resources can accomplish what an organization can. Therefore I will say-let the physicians fall in line, and by combined effort bring their individual as well as mutual standing to a higher level. To my mind there is no vocation or business on earth where this factor plays a more important part than in the medical profession. The most sacred and wonderful thing on earth is human life and to the physician is entrusted the keeping watch and care of it. The physician's duties are the most responsible, the most serious, and the most noble of all duties given to a human being to discharge. Let us therefore be mindful of the high character of our mission, and unite heartily, sincerely, and conscientiously to elevate the standard of the profession, both in the art as well as in ethics, that the individual physician and the county, district, and state societies may prosper and be the means of doing good, helping each other over difficulties and do our best in fulfilling our noble and sacred trust. Rickets. J. W. Cockenower, Des Moines, Ia. (Journal A. M. A., November 4), says that rickets is a disease of defective nutrition from mal-assimilation, augmented by the absence of sunshine and fresh air. The scrutinizing diagnostician will readily see that it is much more common than is usually supposed, especially in the crowded, unhygienic quarters of large cities. The bone changes are specially noticeable, most frequently about the age of 6 months, and the age limit of the disease is usually between 6 months and 3 years. But before the osseous changes occur or are very marked some other symptoms may appear, gastro-intestinal disorders, night sweats, debility, fever, rapid dentition and decay, enlarged abdomen, as well as large head and large and tender epiphyses. All of these may not be present, but enough to recognize the condition and start early treatment. This should be constitutional in the fullest sense, with dietetic and hygienic measures as well as mechanical and operative ones. Medicines are of less importance than food, sunlight and fresh air, but iron, arsenic, phosphorus, etc., are often of advantage. During the stage of bone softening, weight bearing on the tender bones, spine or limbs should be avoided and the child kept on its back until the condition can be tided over. Frequently the case is seen too late for this, but prompt orthopedic treatment may still be available. THAT OLD "OAKEN BUCKET.” The old oaken bucket, Don't hang in the well. At any rate, the old song's dead; WESTERN MEDICAL REVIEW A JOURNAL OF MEDICINE AND SURGERY Publshed Monthly by Western Medical Review Company, Omaha, Nebr. Per Annum, $2.00 The Western Medical Review is the journal of the Nebraska State Medical Association and is sent by order of the Association to each of its members. Entered as second-class matter at the Postoffice of Omaha, Nebraska, under the act of Congress of March 3, 1879. Every member of our State Medical association is entitled to the privilege of helping swell the numbers of our membership and in increasing the usefulness and efficiency of our organization. Let us, each one, put in his best licks from now till our next annual meeting in May. "In union there is strength; in organiaztion there is perfection.' To non-members: We want you. You need us. You need our organization, our influence and association. Tekamah, Neb., March 14, 1912. NESBIT. The Making of a Physician. A good physician cannot be made from poor material any more than a whistle can be made from the tail of a pig. The raw material should possess certain essential qualities to insure success and one of the frequent causes of failure is lack of the physical, mental or moral qualities necessary. The physical qualifications are no less important than the mental and moral, but are too frequently overlooked. The possession of good health is as essential to a physician as to any other individual. The services required, especially in general practice, are such as test the endurance of even the most robust. Th varying character of professional duties, the loss of sleep, and irregularity of meals are only a small part of the physical difficulties the physician has to contend with. Frequent and intimate contact with infectious diseases and unsanitary conditions exposes him to greater danger than anyone else, even the nurse not excepted, for the nurse has only one patient at a time. The pressing necessity for rapid transit is another element of danger which has been considerably increased by the advent of the automobile in recent years. Not only should the physician possess good general health, but a fairly normal condition of the special senses is also a necessity. The senses of sight, hearing and touch are essential to the proper investigation of abnormal conditions of the patient and are also of value in giving timely warning of danger. The possession of a good memory is not the only or even the most important mental requirement. Success in the practice of medicine requires well developed powers of reasoning and arriving at correct conclusions. Rational therapeutics is the result of correct reasoning from accurate information, while empiricism is the result of mere memorizing in acquiring medical knowledge. Good judgment, known also as common sense, is another important qualification. It means the ability to distinguish between the trivial and the important, between the incidental and the essential in matters pertaining to injury or disease. The man lacking good judgment will treat symptoms apparent in a given case, the man possessing it will find and treat the underlying cause. Perhaps the most essential of all qualifications is that of thoroughness and it is one very frequently lacking. The majority of medical students have more desire "to pass" than to master the various branches of the medical curriculum, and later on as physicians, they have more ambition to treat or operate cases and collect fees than to permanently benefit their patients. A very large percentage of physicians fail to achieve lasting success for want of the essential moral qualities. Moral shipwrecks are altogether too common among medical men. The temptations which always assail a young man on leaving the home atmosphere and those peculiar to a medical college, require firm moral stamina to enable a young man to maintain his moral integrity.. Later on the temptations and vicissitudes incidental to medical practice require still greater moral firmness and wholesomeness to avoid the many pitfalls. It is sad, but doubtless true, than sanatoria for the treatment of drug addictions have more medical men as patients (in proportion to the number in that profession), than any other class. The cause is not want of knowledge of the danger of drug addiction but want of moral strength and conviction. Simple honesty, is another important quality essential to true success and too often lightly esteemed. The student who cribs or cheats in recitations and examinations will likely make use of questionable or dishonest methods for self advencement when he becomes a physician. He will misrepresent the condition of his patient to secure a larger fee; he will operate or recommend operation whenever consent can be secured, regardless of pathology or ultimate consequences, and, as for fee splitting, he will consider it a sacred right whether he be the splitter or splittee. Sympathy and tact are two qualities, whether mental or moral, which have much to do with professional success in medicine. Many a man of broad sympathy and ready tact has succeeded where another of far greater technical skill, but lacking |