June 15, 1906.] 



SCIENCE. 



903 



of the triie physician and few who have 

 been burdened with wealth have reached 

 their ideal in a calling which makes no dis- 

 tinction between the rich and the poor. 



One of the demoralizing tendencies in 

 this commercial age is the money standard 

 of success. Physicians are not called or 

 chosen; accident or environment bi-ings 

 about their choice of a profession. AVhile 

 professional life broadens the mental hori- 

 zon and increases sympathy it can not 

 change man's nature, and men who are 

 unfair in business affairs are to be found 

 in our midst. 



The one crying evil, which fortunately 

 is not widespread, is the giving of commis- 

 sions, in other words, the selling of the con- 

 fidence which the patient has in his practi- 

 tioner to some specialist who will divide the 

 fee in return for reference of the case. The 

 one secretly takes money from the patient 

 without his consent, and the other, in order 

 to complete the bargain, charges more than 

 he should. This is equally harmful to the 

 one who receives and to the one who gives. 

 Such matters can not be kept secret and I 

 have personal knowledge of men of good at- 

 tainments and remunerative practise who 

 have been ruined through losing the confi- 

 dence of their communities by this perni- 

 cious traffic. Some attempts have been 

 made to justify it, but the very fact that it 

 is secret shows that both parties are 

 ashamed to have it known and is an ac- 

 knowledgment of its moral obliquity. 



Our relations with the allied profession 

 of pharmacy are not on as ethical a footing 

 as they were twenty years ago. Then the 

 druggist was the faithfiil friend of the phy- 

 sician. To-day in putting up from fifty to 

 sixty per cent, of the prescriptions sent to 

 him, the educated pharmacist cannot use 

 his skill as a chemist but simply acts as a 

 distributor of copyrighted preparations 

 which the physician calls for a few times 



only to take up with something new and 

 leave the shelves of the druggist filled with 

 the unused remnants. 



Many physicians compound their own 

 prescriptions to the detriment of the phar- 

 macist. The proprietary medicine people 

 have managed this very cleverly, to the 

 physician they are continuously calling out 

 that the druggist is 'substituting'; with 

 one hand they have given the physician 

 remedies to dispense himself, and with the 

 other furnished the druggist with patent 

 medicines with which to compete with the 

 physician, and these two natural allies have 

 drifted apart. The average pharmacist can 

 not live on physicians' prescriptions alone, 

 but he should be treated justly, and both 

 physician and druggist would profit by 

 mutual concessions to the great benefit of 

 the public. 



The higher grade of pharmaceutical 

 houses already see the danger to honest 

 pharmacy in the forced promotion of ' ethi- 

 cal ' and fake nostrums under catchy names, 

 and it is to be hoped in the future, will con- 

 fine themselves to the open compounding 

 of legitimate preparations; and these and 

 these only should be found on the advertis- 

 ing pages of reputable medical journals. 



MEDICAL PROGRESS. 



Graduation from college is merely a com- 

 mencement of a life study of medicine. 

 Therefore young men without special train- 

 ing under competent teachers should not 

 be encouraged in wanton assaults on major 

 surgical diseases unless justified by neces- 

 sity. The future will demand schools for 

 advanced training for those who desire to 

 do special work. 



The recent graduate in medicine should 

 begin in his county society by contribu- 

 tions to the newer methods which will be 

 interesting to the older men. This should 

 be his kindergarten; from there he will 

 carry his papers to the district meeting's; 



