December 8, 1916] 



SCIENCE 



801 



ards of admission to medical schools and 

 state licensing boards test medical gradu- 

 ates. The best intentions do not supply 

 the deficiencies due to lack of knowledge 

 and skill. It certainly can be said that in 

 the practise of medicine knowledge is a vir- 

 tue and ignorance a crime. Recognizing 

 the fact that no man, however great his in- 

 telligence and untiring his industry, can be 

 skilled in all branches of the healing art, 

 individuals select specialties in which they 

 strive to make themselves experts and these 

 so group themselves that each patient may 

 have the advice of an expert. The wisdom 

 of this procedure and its advantages to both 

 practitioner and patient must be evident to 

 all. Each individual in such a group must 

 know his specialty and must keep in touch 

 with its progress. Medicine is a progres- 

 sive science. Each year adds to its effec- 

 tiveness. Discoveries in physics, chemis- 

 try and biology find practical application 

 in the prevention or cure of disease. It fol- 

 lows that the efficient medical man must 

 continue to be a student so long as he re- 

 mains an active member of the profession. 

 In medicine there are no "papal bulls" no 

 "ipse dixits" and even "precedent" is 

 shown but scant respect. It is best com- 

 pared to a living plant constantly drawing 

 sustenance from soil and air, dropping its 

 withered leaves and branches, ever putting 

 forth buds and blossoms and bearing each 

 season better fruit. One who is not capable 

 of sustained effort should seek some other 

 calling in life. Occasionally I meet with 

 men who are still living professionally in 

 their undergraduate days, reading the same 

 old books, and writing the same old pre- 

 scriptions, both blind and deaf to the 

 changed environment. Fortunately the 

 more intelligent of the public easily recog- 

 nize these fossils and appraise them at their 

 true worth. They are interesting as relics 

 of the past, but worthless in the present. 



From the time of Hippocrates to the 

 present, wise men in the profession have 

 always advocated amity among its mem- 

 bers and I must say after many years of 

 personal experience that there is no other 

 high professional ideal so difficult in reali- 

 zation, but I am proud to add that there 

 never has been a time when the promise of 

 the realization of this ideal has been so 

 great as at present. In this matter medical 

 men have learned much from the commer- 

 cial world in which the value of coopera- 

 tion has been so abundantly demonstrated. 

 The efficiency of the individual has been in- 

 creased and the value of the product has 

 been improved. Much regret has been ex- 

 pressed concerning what is called the pass- 

 ing or the elimination of the old-time fam- 

 ily physician or general practitioner. In 

 the slow development of scientific medicine 

 he served his fellow men, often with the 

 greatest devotion and self-sacrifice. The 

 history of epidemics shows him to have 

 been often worthy of the highest honor. 

 He has faithfully served his fellow men in 

 times of dire distress. Occasionally he has 

 made contributions of the greatest value to 

 science. In the record of the slow progress 

 of man from the marshes of ignorance and 

 superstition to the uplands of knowledge 

 and science he bears a conspicuous and 

 honorable place, but in the practise of mod- 

 ern medicine his part is a subordinate one. 



In any community in which several 

 physicians are singly doing a general prac- 

 tise, cooperation, with the development into 

 skilled specialists, results in individual effi- 

 ciency among the medical men and better 

 service to their clientele. With a properly 

 equipped hospital at their service, a group 

 of village physicians may give their pa- 

 tients the same scientific and effective treat- 

 ment that they can secure in larger med- 

 ical centers. I have no sympathy with the 

 contention that our rural population de- 



