VOL. X. [NEW SERIES.]

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than any thing else.-RUSKIN.

Original Articles.

SOME OF THE ADVANTAGES OF ATTENDING MEDICAL SOCIETIES AND READING MEDICAL JOURNALS.*

BY T. B. GREENLEY, M. D.

In response to a toast, "The Kentucky State Medical Society," at Henderson, the president, Dr. Ouchterlony, remarked that "no one not a member of some society had ever in this or any other State attained any honorable distinction in the profession; that all the creditable work done in the State for thirty years past has been accomplished by members of the State Society."

When we have the history of advances in medicine thus set before us as being accomplished only by members of medical societies we should be induced to become members. There are advantages to be derived by society membership outside of the knowledge we may gain. It brings us together annually, whereby all the amenities of social intercourse and friendship may be cultivated, and thus aid greatly in binding us together as one great brotherhood.

In a paper I read several years ago I had occasion to remark that I believed the fraternal feelings existing between the profession of the two great sections of this country, together with that of the Masonic order, hastened the closure of the late unhappy war. Had we all been medical men or all Masons there would have been no war.

Read at the meeting of the Mississippi Valley Medical Association, October, 1890.

No. 9.

Then the cultivation of sociability and friendship on the part of the profession is of the utmost importance, both as it respects our interest and pleasure, and there is no more pleasant way of enjoying such sociable intercourse than at the meetings of medical societies. It af fords us a short vacation from active work, which is, as a rule, demanded in order to afford us both physical and mental relaxation from overtension. It is a kind of holiday that every hard-worked doctor should take advantage of whenever a favorable opportunity offers. We are thereby enabled to meet old friends and form new acquaintances every year, which frequently result in pleasant and lasting friendship. It has been the good fortune of your humble speaker to make the acquaintance of many medical brethren at meetings of various medical societies, whose friendships form some of the most pleasant episodes of his memory. In fact, if there were no other inducements to be members of medical associations, the social element is of sufficient importance to cause us to become such. What greater boon can men enjoy than that of true and genuine friendship? And when I meet a member of our loved profession I take it for granted he is a gentleman, and grasp his hand as I would that of a friend. There should exist no jealousies among our fraternity, but, on the other hand, with hearts and hands, let us meet as brothers should meet brothers; for really we are in a certain sense brethren. I am aware it is too often the case that unpleasant feelings are engendered among medical men, especially in small towns where competition is more palpable than it is in cities. This is wrong, and should be discouraged. If our competitors act honorably in their intercourse with us we should not complain. If they violate the code of ethics, the society to which you belong is the place in which to

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have the correction made. But I hardly think any member of the profession who is also a member of a medical society will act dishonorably toward his fellow member. There is or should exist a tie of friendship between all members of the profession, and especially between members of a medical society, that binds us together as effectually as that mystic tie which bound David and Jonathan in indissoluble and undying friendship.

But there are other reasons which should induce us to belong to medical societies. It is here that we meet our greatest and best men, and have the opportunity of hearing their words of wisdom. It is here that the experience and observations of our best men are given in detail. It is here that intricate problems in our science are ably discussed and elucidated. Can we well afford to absent ourselves from such a mental feast? I think not. A great deal of knowledge can be acquired by attending medical societies; in fact, they are efficient schools for the instruction of their members; and it may be remarked that no one returns home without a modicum of knowledge more than when he left.

Were it not for medical societies the sanitary condition of the country would receive but little attention. It is through their influence and agency that laws are enacted establishing health boards for the protection of the people by sanitary means. It is through the influence of medical societies that laws are enacted to protect the people against the baleful effects of pretenders and medical charlatanry of all kinds; but much in this particular remains to be accomplished. Public opinion in this respect is to be schooled, and until many of the isms and nonsensical fads of the day, such as Christian science or faith cure, spiritualism with its necromancy, et id omnia, are obliterated from public belief, scientific medicine will continue to struggle in behalf of the public welfare.

In connection with medical societies, medical literature serves greatly as an educator of the medical man. To a toast, "The Medical Press," at the late meeting of Kentucky Medical Society at Henderson, Dr. Dudley S. Reynolds made a happy response. It is very evident that a practitioner of medicine who fails

to attend medical societies and to read medical literature soon falls behind his compeers who avail themselves of these advantages. He soon drops into a routine practice, and drags along entirely ignorant of the great advances made in medicine every few years. In fact, in a single decade he is left far in the rear of his more enterprising and studious competitor. One may tell you he has no time to attend medical societies or to read medical journals; that attention to his patients demands all his time. Now it would seem better for his patients and more creditable to himself if he wonld take time to post himself as to what is best for their wel fare. He no doubt has fallen into a certain groove or routine practice, which he pursues, no difference what may be the character of the malady of his patient. Or, on the other hand, he may be an experimenter, which perhaps is more dangerous to his patients than the routine plan.

I saw a prescription, a few years ago, by a medical man in practice with fourteen different ingredients or medicinal agents. We have frequently heard of shot-gun prescriptions, but this might be called a double barreled shot-gun load. Unfortunately many of the ingredients were incompatible with each other, or perhaps it was fortunate that this was the case, as the chemical reactions may have modified the action of some of the more active substances. I am happy, however, to say that this brother was not a member of any medical society, nor was he a reader of medical journals.

Further, to show how a member of the profession may get far in the rear in the way of knowledge, not long since a brother who does not live a hundred miles away advised the friends of a patient who died of phthisis pulmonalis to sue the attendant for malpractice, on the ground that he used creosote in treating the case. He informed the friends that it was never used in the treatment of consumption. This brother, of course, was not a member of a medical society nor a reader of medical journals.

Many years ago I was acquainted with a brother practitioner-in fact, hal met him in consultation more than once-who was anxious to bleed a woman who was nearly dead from

metrorrhagia. He contended that she had inflammation of the bowels, and that venesection was the only remedy to save her. In fact, he had made several attempts to bleed her before my arrival, but fortunately missed the vein. His excuse for failure was that his lancet was dull. When I entered the house he informed me that he had me sent for to bleed the patient, as that was all that was necessary to be done. After examining the patient, he was astonished when I told him I would not bleed her, as she was already nearly dead from loss of blood.

This man also claimed to be familiar with veterinary surgery. He claimed to cure footail in sheep by extracting a worm from the foot. His worm, however, proved to be a tendon. Of course you will all say this brother was not a member of a medical society, nor did he read medical journals.

Also, many years ago, I was called to a case of labor with a breech presentation, the child being delivered except the head. The patient had been in this condition over nine hours. The doctor had used all his force to extract the head by pulling on the body, and, becoming disgusted, left the patient in the hands of a couple of midwives to finish the case. They in turn had tried their strength, but also failed, and as a last resort sent for me ten miles distant. I found one midwife present, the other having also retired in disgust. It was an anterior buttock presentation. The efforts at extraction had extended the head so as to lock the occiput behind the symphysis pubis and the chin behind the coccyx. Fortunately the womb was still acting, and, raising the child with one hand, I introduced two fingers behind, and getting them on the upper jaw, in the absence of pain flexed the head, and the next pain expelled it. The midwife was astonished at my getting the head away without pulling on the body.

Now you all can guess that this brother was not a member of a medical society, nor much addicted to reading medical journals. But these things occurred in the old days, and it is greatly to be hoped that much improvement has taken place since among our brothers who are non-members of medical societies.

There are many able members of the profession, men of cultured intellects, who unfortunately are not members of medical societies. But how can we expect them to keep up with their profession unless they are and also read medical journals? The association with medical men tends greatly to stimulate them to greater efforts in their profession, and excites their ambition to keep pace with their confrères. The science of medicine is advancing in many particulars, and, as before remarked, he that stands still is soon left in the rear; and any one, no difference how intellectual he may be and how well he may have been educated, both collegiate and medical, must read in order to keep up, or he is liable at any time, when among advanced medical men, to feel abashed at what might be termed his ignorance of late discoveries in his profession.

In speaking of what medical societies have done to benefit the public as well as themselves, I omitted to remark that in my opinion they should discountenance the encouragement of malpractice suits by medical men. I believe nearly all such suits grow out of some word or insinuation of some doctor, who claims to be a friend to the family, that the patient was not treated properly; that he ought to have gotten well, etc. Now this is quite wrong. If' we think any mistake has been made in the management of the case we should not speak of it to the patient's friends. A suit of this kind is a two-edged sword, and should be handled carefully, for we are just as liable to be troubled that way as is our neighbor.

Another thing I think is wrong, but it might be righted to some extent by the influence of medical societies if properly exerted. I allude to certain dogmatic assertions made by some members of the profession who are well up on the ladder of fame. It is asserted by some that all wound infection ensues from contact of the surgeon's hands, and that no case of puerperal fever could occur independent of contagion from the accoucheur's contact. These are broad and dogmatic assertions which are calculated to involve both surgeons and obstetricians in malpractice or damage suits. These assertions are made in order to support certain theories, and not with the intention to involve