MEDICAL EDUCATION OF THE PEO

PLE THEIR BEST SAFEGUARD.

BY T. N. REYNOLDS, M. D., of DETROIT.

In view of the fact that there is still in the world the most extraordinary misconception with regard to the true functions of medicines and medical men, it may not seem wholly unfit that we should somewhat briefly advert to it here.

As it existed among the people in earlier times, it amuses us now perhaps more than it surprises us; and when we recognize it still here and there among those in lowly favored circumstances of life, it usually makes little or no impression upon us; but when we so often see it among the refined and cultured of our time we are sometimes led to inquire why it is. But this misconception is not confined entirely to the laity or to the crude charlatan, but more or less pervades the educated and legitimate medical fraternity itself; and it is no uncommon thing to see among the younger members of our profession men confidently attributing to medicines particular cures that they never produced. And even the older practitioners, with quite an abiding faith, sometimes prescribe remedies that serve little more than to mutually satisfy the mind of the patient and the doctor that the necessary and essential thing has been done in the premises.

This undue credit to the effect of the drugs prescribed, when it occurs among medical men, probably arises mostly from the habit and routine of always prescribing in certain approved manners in certain kinds of cases; and when improvement takes place, forgetting to allow sufficiently for the healing power of time and nature herself.

As it occurs in the masses of the laity, however, when they throw themselves unreservedly upon the mercies of some of the many artful impostors of the day, or, almost regardless of the man, cling to some of the schools of medicine or forms of treatment with an ardor that often amounts to fanaticism, it seems to arise from the fact that there is still in man an inherent tendency to rely alone on some mysterious or super

natural intervention in behalf of his physical as well as his spiritual welfare. Men in a great measure seem not ready to act upon the idea that while there may occur at times special and supernatural intervention in behalf of our spiritual welfare, it is nevertheless probable that the greatest amount of mental enjoyment is only obtained by the greatest amount of willing obedience to those social and moral laws of life which produceit. So with regard to our physical being, men largely rely upon medical aid and supernatural protection, and neglect to observe and conform to those natural laws which regulate and govern the functions of our organism in health and in disease. With medical men the hope to at last hit upon the lucky remedy or successful plan has in all ages led to the adoption, at times, of many absurd modes of treatment that have been discarded after more careful observation and riper experience; sometimes to excessive dosing and too heroic treatment; and sometimes to the other extreme, as in the high dilutions once generally endorsed and still sometimes used by some of thosewho pursue what is called the homeopathic plan.

When, then, there are in the minds of those who devote themselves specially to the science and practice of medicine so many absurd notions with regard to it, and so much faith in much of it that is not warranted in fact, it is not a wonder that the masses, and even the educated portions of the laity, should treat us now and then, as they do, to such sublime exhibitions of their faith in some particular drug, plan of treatment, or school of medicine, while they evince often only very little knowledge or concern as to the proficiency or character of the man himself prescribing it.

As nothing but hard-learned experience and frequently dis-appointed hopes in his scientific prescriptions will ever thoroughly convince the young practitioner of their frequent inutility, so nothing but the proper kind of education on these matters will ever convince the people of their frequent too great confidence in the efficacy of drugs alone.

To this end, the study of anatomy, physiology, hygiene, and. particularly the laws of life, with the influence thereon of habits, conditions, and surroundings, should enter largely into, and be assiduously carried all the way through the education of the young, even if it be to the exclusion of almost no matter what other branch besides. And if the use of drugs be referred to at all in their education, it should be with an especial care that they be taught the facts as they are; that the essential and useful drugs are really few and their administration rarely necessary; that in the aggregate in the world it is probable enough.

that more harm is being yearly done by their indiscriminate and unskilled use than there is good by their timely and judicious employment.

Physicians can do much more than is usually done in this direction by their individual influence in practice. Each physician should constantly endeavor to establish in the minds of his patrons the fact that they should seek intelligent opinions and skilled advice more than prescriptions. And even at an occasional risk of losing patronage, when medicine is not required at all, he should dare to say so, and give the right advice instead. Doctors should be educators more than physicmongers. Whatever time the occasion demands should be taken to fully explain the trouble for which persons present themselves, and the best regulation of living to be adopted under the circumstances; and for this opinion and advice alone, when kindly given, they should and generally will expect to pay. Physicians should endeavor at all times to divest their practice of every appearance of mystery; and in this connection they should certainly abolish the common practice of retiring from the family and holding private conversation after having seen a patient in consultation. They should rather insist on some members of the family or persons most concerned being present when conversation may not advantageously be had with the patient; otherwise such mysterious movements and awe-inspiring manners tend not at all to enlighten, but very much to becloud the minds of many people, and leave them a more ready prey to the quack, who can as well, and always does with effect imitate those and all kindred mysterious ceremonies.

Physicians can with the utmost politeness to each other and the very kindest consideration for the opinions of each, discuss conditions and agree on treatment in the presence of some of those concerned; and it is the people's right to see and know exactly what their physician thinks and does in their case either alone or in consultation.

If imposition and quackery is ever removed or lessened at all it will be in exact proportion to the amount of correct information and thorough enlightenment the people may obtain on this entire subject, for it can never avail very much that a few educated and honorable practitioners labor to bring the comparative few whom they reach up to a reasonable and correct estimation of the practice of medicine, while the masses remain unable to discriminate between the imaginary and what is real in it, or between the artful and unscrupulous pretender and the genuine medical man. As long as there is a general and popular demand for the different forms of quackery, there will

always be found an ample supply; and legislation, though necessary and good as far as it goes, can never entirely prevent it. The early and continued education of each individual on the subject is the only successful remedy.

And since none can see and feel so well as physicians the need of the people with regard to it, it becomes us and would seem our direct and humane duty to interfere, and move to the extent of our opportunity in establishing if possible somewhat of a medical education in all the common schools throughout the country. This is perfectly practicable, and probably would be nowhere unfavorably received.

Let the people become properly and generally enlightened on the medical subject and we will not see them cajoled and carried away with extravagant advertisements and pretentious modes of cure, nor even hear them ask much more concerning a physician, "is he a homeopath or an allopath?" but only hear them inquire of him as they should of one assuming that capacity, "is he simply an educated, trained, ingenious, industrions, and in every way competent and upright medical man?"

SMALL-POX EPIDEMIC AT DEAR

BORNVILLE.

BY S. P. DUFFIELD, M. D.

On Sunday, the 28th of January, 1878, I was called to see a young man by the name of Charles Hall, who had been working with a sawing gang on the Michigan Central Railroad for a few days, having come from Detroit. He was in great pain in his left lung with high fever, temperature ranging first day I saw him 102° on the thermometer; pulse 120. I enquired if he had been exposed to any of the contagious diseases, and his mother informed me a baby sister of his was taken with the measles in the city of Detroit and died. The pain in the left lung grew more and more intense; had the cough which we all notice in pleurisy, and when called again in the afternoon, finding the pain of such a character, and fearing measles complicated with pleurisy, I applied mustard plaster and watched him for an hour; no relief, in spite of anodynes, etc., etc. I applied cups over the region of the pain, taking about four ounces of blood. This relieved him and he sank into a gentle sleep and seemed better. I bandaged the ribs and put him upon a preparation of ipecac, opium, capsicum and quinia, hoping to drive, with warm teas and clothing, the exanthem out, for I expected it might be malignant measles or some malignant exanthem. Word came to me in three hours that he was bleeding from the places where he was cupped and that they could not stop it. I pressed sponge into the places, but nothing short of cauterization by nitrate of silver checked the hemorrhage. He rested well that evening, but toward morning became delirious, temperature 103. The morning of the second day when I called I found him rapidly sinking from hæmaturia, which had set in strongly. I put him on ergot and persulphate iron, but the urine became almost pure blood and I saw my patient was doomed. No rash had appeared upon his face, his hands, or his body, and next day he continued in the same condition, pulse 103, delirious, with hæmaturia. On the morning of the fifth day he died. No rash upon his face