Quacks and Grafters Part 4

"'All surgeons are liable to error, not only in diagnosis, but in the performance of operations based on diagnosis. Such errors must always be expected and included in the contingencies of the practice of medicine and surgery. Doubtless many of my hearers can recall cases of their own in which useless--or worse than useless--operations have been performed. If, however, serious operations are in the hands of men of large experience, such errors will be reduced to a minimum.

"'Many physicians send patients for diagnosis and opinion as to the advisability of operation without telling the consultant that they themselves are to perform the operation. The diagnosis is made and the operation perhaps recommended, when it appears that the operation is to be in incompetent hands. His advice should be conditional that it be carried out only by the competent. Many operations, like the removal of the vermiform appendix in the period of health, the removal of fibroids which are not seriously offending, the removal of gall-stones that are not causing symptoms, are operations of choice rather than of necessity; they are operations which should never be advised unless they are to be performed by men of the greatest skill. Furthermore, many emergency operations, such as the removal of an inflamed appendix and other operations for lesions which are not necessarily fatal--should be forbidden and the patient left to the chances of spontaneous recovery, if the operation proposed is to be performed by an incompetent.

"'And is not the surgeon, appreciating his own unfitness in spite of years of devotion, in the position to condemn those who lightly take up such burdens without preparation and too often without conscience?

"'In view of these facts, who should perform surgery? How shall the surgeon be best fitted for these grave duties? As a matter of right and wrong, who shall, in the opinion of the medical profession, advise and perform these responsible acts and who shall not? Surgical operations should be performed only by those who are educated for that special purpose.

"'I have no hesitation in saying that the proper fitting of a man for surgical practice requires a much longer experience as a student and a.s.sistant than the most exacting schools demand. A man should serve four, five or six years as a.s.sistant to an active surgeon. During this period of preparation, as it were, as much time as possible should be given to observing the work of the masters of surgery throughout the world.'

"While Dr. Richardson's ideal may seem almost utopian, there being so wide a difference between the standard he would erect and the one generally established, we must all agree that however impossible of attainment under present conditions, such an ideal is none too high and its future realization not too much to hope for.

"While there is being done enough poor surgery that is honest and well intended, there is much being done that is useless, conscienceless, and done for purely commercial ends. This is truly a disagreeable and painful topic and one that I would gladly pa.s.s by, did I not feel that its importance demands some word of condemnation coming through such representative surgical organizations as this.

"The spirit of graft that has pervaded our ranks, especially here in the West, is doing much to lower the standard and undermine the morals and ethics of the profession. When fee-splitting and the paying of commissions for surgical work began to be heard of something like a decade ago, it seemed so palpably dishonest and wrong that it was believed that it would soon die out, or be at least confined to the few in whom the inherited commercial instinct was so strong that they could not get away from it. But it did not die; on the other hand, it has grown and flourished.

"In looking for an explanation for the existence of this evil, I think several factors must be taken into account, among them being certain changes in our social and economic conditions. This is an age of commercialism. We are known to the world as a nation of "dollar chasers," where nearly everything that should contribute to right living is sacrificed to the Moloch of money. The mad rush for wealth which has characterized the business world, has in a way induced some medical men, whether rightfully or wrongfully, to adopt the same measures in self-protection. The patient or his friends too often insist on measuring the value of our services with a commercial yard-stick, the fee to be paid being the chief consideration. In this way the public must come in for its share of responsibility for existing conditions. So long as there are people who care so little who operates on them, just so long will there be cheap surgeons, cheap in every respect, to supply the demand. The demand for better physicians and surgeons must come in part from those who employ their services.

"Another source of the graft evil is the existence of low-grade, irregular and stock-company medical schools. In many of these schools the entrance requirements are not in evidence outside of their catalogues. With no standard of character or ethics, these schools turn out men who have gotten the little learning they possess in the very atmosphere of graft. The existence of these schools seems less excusable when we consider that our leading medical colleges rank with the best in the world and are ample for the needs of all who should enter the profession. Their constant aim is to still further elevate the standard and to admit as students only those who give unmistakable evidence of being morally and intellectually fit to become members of the profession.

"Enough men of character, however, are entering the field through these better schools to ensure the upholding of those lofty ideals that have characterized the profession in the past and which are essential to our continued progress. I think, therefore, that we may take a hopeful view of the future. The demand for better prepared physicians will eventually close many avenues that are now open to students, greatly to the benefit of all. With the curtailing of the number of students and a less fierce compet.i.tion which this will bring, there will be less temptation, less necessity, if you will, on the part of general pract.i.tioners to ask for a division of fees. He will come to see that honest dealing on his part with the patient requiring special skill will in the long run be the best policy. He will make a just, open charge for the services he has rendered and not attempt to collect a surrept.i.tious fee through a dishonest surgeon for services he has not rendered and could not render. Then, too, there will be less inducement and less opportunity for incompetent and conscienceless men to disgrace the art of surgery.

"The public mind is becoming especially active just at this time in combating graft in all forms, and is ready to aid in its destruction.

The intelligent portion of the laity is becoming alive to the patent medicine evil. It is only a question of time when the people will demand that the secular papers which go into our homes shall not contain the vile, disgusting and suggestive quack advertis.e.m.e.nts that are found to-day. A campaign of reform is being inst.i.tuted against dishonest politicians, financiers, railroad and insurance magnates, showing that their methods will be no longer tolerated. The moral standards set for professional men and men in public life are going to be higher in the future, and with the limelight of public opinion turned on the medical and surgical grafter, the evil will cease to exist. Hand in hand with this reform let us hope that there will come to be established a legal and moral standard of qualification for those who a.s.sume to do surgery.

"I feel sure that it is the wish of every member of this a.s.sociation to do everything possible to hasten the coming of this day and to aid in the uplifting of the art of surgery. Our individual effort in this direction must lie largely through the influence we exert over those who seek our advice before beginning the study of medicine, and over those who, having entered the work, are to follow in our immediate footsteps. To the young man who seeks our counsel as to the advisability of commencing the study of medicine, it is our duty to make a plain statement of what would be expected of him, of the cost in time and money, and an estimate of what he might reasonably expect as a reward for a life devoted to ceaseless study, toil and responsibility. If, from our knowledge of the character, attainments and qualifications of the young man we feel that at best he could make but a modic.u.m of success in the work, we should endeavor to divert his ambition into some other channel.

"We should advise the 'expectant surgeon' in his preparation to follow as nearly as possible the line of study suggested by Richardson. Then I would add the advice of Senn, viz: 'To do general practice for several years, return to laboratory work and surgical anatomy, attend the clinics of different operators, and never cease to be a physician.

If this advice is followed there will be less unnecessary operating done in the future than has been the case in the past.' The young man who enters special work without having had experience as a general pract.i.tioner, is seriously handicapped. In this age, when we have so frequently to deal with the so-called border-line cases, it is especially well never to cease being a physician.

"We would next have the young man a.s.sure himself that he is the possessor of a well-developed, healthy, working 'surgical conscience.'

No matter how well qualified he may be, his enthusiasm in the earlier years of his work will lead him to do operations that he would refrain from in later life. This will be especially true of malignant disease.

He knows that early and thorough radical measures alone hold out hope, and only by repeated unsuccessful efforts will he learn to temper his ambition by the judgment that comes of experience. Pirogoff, the noted surgeon, suffered from a malignant growth. Billroth refused to operate or advise operation. In writing to another surgeon friend he said: 'I am not the bold operator whom you knew years ago in Zurich. Before deciding on the necessity of an operation, I always propose to myself this question: Would you permit such an operation as you intend performing on your patient to be done on yourself? Years and experience bring in their train a certain degree of hesitancy.' This, coming from one who in his day was the most brilliant operator in the world, should be remembered by every surgeon, young and old."

Oh, surgery! Modern aseptic surgery! In the hands of the skilled, conscientious surgeon how great are thy powers for good to suffering humanity! In the hands of shysters "what crimes are committed in thy name!"

With his own school full of shysters and incompetents, and grafters of "new schools" and "systems" to compete with on every hand, the conscientious physician seems to be "between the devil and the deep sea!"

With quacks to the right of him, quacks to the left of him, quacks in front of him, all volleying and thundering with their literature to prove that the old schools, and all schools other than theirs, are frauds, impostors and poisoners, about all that is left for the layman to do when sick is to take to the woods.

PART TWO

OSTEOPATHY

CHAPTER VII.

SOME DEFINITIONS AND HISTORIES.

Romantic Story of Osteopathy's Origin--An Asthma Cure--Headache Cured by Plowlines--Log Rolling to Relieve Dysentery--Osteopathy is Drugless Healing--Osteopathy is Manual Treatment--Liberty of Blood, Nerves and Arteries--Perfect Skeletal Alignment and Tonic, Ligamentous, Muscular and Facial Relaxation--Andrew T. Still in 1874--Kirksville, Mo., as a Mecca--American School of Osteopathy--The Promised Golden Stream of Prosperity--Shams and Pretenses--The "Mossbacks"--"Who's Who in Osteopathy."

The story of the origin of Osteopathy is romantic enough to appeal to the fancy of impressionists. It is almost as romantic as the finding of the mysterious stones by the immortal Joe Smith. In this story is embodied the life history of an old-time doctor and pioneer hero in his restless migrations about the frontiers of Kansas and Missouri. His thrilling experiences in the days of border wars and through the Civil War are narrated, and how the germ of the idea of the true cause and cure of disease was planted in his mind by the remark of a comrade as the two lay concealed in a thicket for days to escape border ruffians. Then, later, how the almost simultaneous death of two or three beloved children, whom all his medical learning and that of other doctors he had summoned had been powerless to save, had caused him to renounce forever the belief that drugs could cure disease. He believed Nature had a true system, and for this he began a patient search. He wandered here and there, almost in the condition of the religious reformers of old, who "wandered up and down clad in sheep-skins and goat-hides, of whom the world was not worthy." In the name of suffering humanity he desecrated the grave of poor Lo, that he might read from his red bones some clue to the secret.

One Osteopathic journal claims to tell authentically how Still was led to the discovery of the "great truth." It states that by accidentally curing a case of asthma by "fooling with the bones of the chest," he was led to the belief that bones out of normal position cause disease.

Still himself tells a rather different story in a popular magazine posing of late years as a public educator in matters of therapeutics. In this magazine Still tells how he discovered the principles of Osteopathy by curing a terrible headache resting the back of his neck across a swing made of his father's plowlines, and next by writhing on his back across a log to relieve the pain of dysentery. Accidentally the "lesion" was corrected, or the proper center "inhibited," and his headache and flux immediately cured.

You can take your choice of these various versions of the wonderful discovery.

Ever since Osteopathy began to attract attention, and people began to inquire "What is it?" its leading promoters have vied with each other in trying to construct a good definition for their "great new science."

Here are some of the definitions:

"Osteopathy is the science of drugless healing." For a genuine "lesion"

Osteopath that would not do at all. It is too broad and gives too much scope to the physicians who would do more than "pull bones."

"Osteopathy is practical anatomy and physiology skillfully and scientifically applied as _manual_ treatment of disease." That definition suits better, because of the "manual treatment." If you are a true Osteopath you must do it _all_ with your hands. It will not do to use any mechanical appliances, for if you do you cannot keep up the impression that you are "handling the body with the skilled touch of a master who knows every part of his machine."

"The human body is a machine run by the unseen force called life, and that it may run harmoniously it is necessary that there be liberty of blood, nerves, and arteries from the generating point to destination." This definition may be impressive to the popular mind, but, upon a.n.a.lysis, we wonder if any other string of big words might not have had the same effect. "Liberty of blood" is a proposition even a stupid medical man must admit. Of course, there must be free circulation of blood, and ma.s.sage, or hot and cold applications, or exercise, or anything that will stimulate circulation, is rational. But when "liberty of blood" is mentioned, what is meant by "liberty of arteries"?

"Osteopathy seeks to obtain perfect skeletal alignment and tonic ligamentous, muscular and facial relaxation." Some Osteopaths and other therapeutic reformers (?) have contended that medical men purposely used "big words" and Latin names to confound the laity. What must we think of the one just given as a popular definition?

A good many Osteopaths are becoming disgusted with the big words, technical terms and "high-sounding nothings" used by so many Osteopathic writers. The limit of this was never reached, however, until an A.B., Ph.D., D.O. wrote an article to elucidate Osteopathy for the general public in an American encyclopedia. It takes scholarly wisdom to simplify great truths and bring them to the comprehension of ordinary minds. If writers for the medical profession want a lesson in the art of simplifying and popularizing therapeutic science, they should study this article on Osteopathy in the encyclopedia.

A brief history of Osteopathy is perhaps in place. The following summary is taken from leading Osteopathic journals. As to the personality and motives of its founders I know but little; of the motives of its leading promoters a candid public must be the judge. But judgment should be withheld until all the truth is known.

The principles of Osteopathy were discovered by Dr. Andrew T. Still in 1874. He was at that time a physician of the old school practicing in Kansas. His father, brothers and uncles were all medical pract.i.tioners. He was at one time scout surgeon under General Fremont. During the Civil War he was surgeon in the Union army in a volunteer corps. It was during the war that he began to lose faith in drugs, and to search for something natural in combating disease.

Then began a long struggle with poverty and abuse. He was obstructed by his profession and ridiculed by his friends. Fifteen years after the discovery of Osteopathy found Dr. Still located in the little town of Kirksville, Mo., where he had gradually attracted a following who had implicit faith in his power to heal by what to them seemed mysterious movements.

His fame spread beyond the town, and chronic sufferers began to turn toward Kirksville as a Mecca of healing. Others began to desire Still's healing powers. In 1892 the American School of Osteopathy was founded, which from a small beginning has grown until the present buildings and equipment cost more than $100,000. Hundreds of students are graduated yearly from this school, and large, well-equipped schools have been founded in Des Moines, Philadelphia, Boston and California, with a number of schools of greater or less magnitude scattered in other parts of the country. More than four thousand Osteopaths were in the field in 1907, and this number is being augmented every year by a larger number of physicians than are graduated from Homeopathic colleges, according to Osteopathic reports.

About thirty-five States have given Osteopathy more or less favorable legal recognition.

The discussion of the subject of Osteopathy is of very grave importance.

Important to pract.i.tioners of the old schools of medicine for reasons I shall give further on, and of vital importance to the thousands of men and women who have chosen Osteopathy as their life work. It is even of greater importance in another sense to the people who are called upon to decide which system is right, and which school they ought to rely upon when their lives are at stake.

I shall try to speak advisedly and conservatively, as I wish to do no one injustice. I should be sorry indeed to speak a word that might hinder the cause of truth and progress. I started out to tell of all that prevents the sway of truth and honesty in therapeutics. I should come far short of telling all if I omitted the inconsistencies of this "new science" of healing that dares to a.s.sume the responsibility for human life, and makes bold to charge that time-tried systems, with their tens of thousands of pract.i.tioners, are wrong, and that the right remedy, or the best remedy for disease has been unknown through all these years until the coming of Osteopathy. And further dares to make the still more serious charge that since the truth has been brought to light, the majority of medical men are so blinded by prejudice or ignorance that they _will_ not see.

This is not the first time I have spoken about inconsistencies in the practice of Osteopathy. I saw so much of it in a leading Osteopathic college that when I had finished I could not conscientiously proclaim myself as an exponent of a "complete and well-rounded system of healing, adequate for every emergency," as Osteopathy is heralded to be by the journals published for "Osteopathic physicians" to scatter broadcast among the people. I practiced Osteopathy for three years, but only as an Osteopathic specialist. I never during that time accepted responsibility for human life when I did not feel sure that I could do as much for the case as any other might do with other means or some other system.

Because I practiced as a specialist and would not claim that Osteopathy would cure everything that any other means might cure, I have never been called a good disciple of the new science by my brethren. I would not practice as a grafter, find bones dislocated and "subluxated," and tell people that they must take two or three months' treatment at twenty-five dollars per month, to have one or two "subluxations" corrected. In consequence I was never overwhelmed by the golden stream of prosperity the literature that made me a convert had a.s.sured me would be forthcoming to all "Osteopathic physicians" of even ordinary ability.

As I said, this is not the first time I have spoken of the inconsistencies of Osteopathy. While yet in active practice I became so disgusted with some of the shams and pretences that I wrote a long letter to the editor of an Osteopathic journal published for the good of the profession. This editor, a bright and capable man, wrote me a nice letter in reply, in which he agreed with me about quackery and incompetency in our profession.