president's address — SECTION I. 221 



With this gradual development cf accuracy in medical science, 

 one would think that the art cf medicine would be showing an 

 increasing application of exact methods for the beueiit of sick 

 humanity. To a certain exte^nt this is the case, but it is not 

 so nearly to the extent that it should be. There are various 

 reasons for this. There is an inadequate appreciation by the 

 public of the delicate balance of evidence necessary to an honest 

 diagnosis, or of the complexity of modem methods necessary for 

 this ; there is the difficulty of providing the necessary equipment 

 accessible to all medical men ; there is the real practical difficulty 

 CI insuring that all medical men are able to use the apparatus 

 when it is provided, or able to keep tliemselves abreast of modern 

 developments; and, finally, there is the inertia and conservatism 

 of the public to be overcome in many ways. 



The jiublic estimate of the medical man is redolent of the 

 middle ages. To many of the public, even to-day, the dis}>eusing 

 chemist is as sl'illed a therapeutist as the best of the specialists 

 while the optician is even recognised in law as almost, if not 

 quite, the equal of the trained oculist. To the whole of the public, 

 with the exception of a few, a very few, more enlightened people, 

 one dcctcr is as good as another. The possession of a medical 

 diploma of any kind is accepted bv the public, and even by many 

 public authorities, as sufficient evidence that a doctor, without 

 any special experience, can be in turn a specialist in surgery, in 

 venereal diseases, in hospital administration, in children's 

 diseases, or even in questions of public health. Maiiy men who 

 recognise the distinctic-a between a carpenter and a joiner, a 

 bricklayer and a mason, or who readilv agree that a builder's 

 labourer is not worth the same wages as the builder himself, will 

 accept anv medical diploma as evidence cf the medical man's 

 ability to give an opinion in any oaie of the several branches of 

 medicine, each cf which requires, not only a life-long study, but, 

 to a certain extent, a special temperament. Thei mechanical 

 dexterity, the capacity for rapid decision ex})ressed by appropriate 

 action, combined with the sound diagnostic judgment which dis- 

 tinguish the first-rank surgeon, are personal qualities quit© 

 different from those which make a, doctor successful in the adminis- 

 tration of a large hospital, an asylum, or a Health Department. 



Yet, the public to-day, as Mr. Syme recently said, " still regard 

 the ' doctor,' as they call him, as a kind of wizard, who can tell 

 intuitively what is the matter with a patient and then prescribe 

 a drug which will act like a charm and drive the disease away." 

 Their idea of medical practice is, as Osier said, — " a traffic be- 

 tween individuals, the sale of a cui'e." 



This public estimatei of medical art as a j>iercing glance by the 

 eagle eye of the inspired doctor readintr the innermost secrets of 

 the patient's soul, followed by the administration of a mysterious 



