Medical Fads and Fancies 33 
ist or dentist, subconsciously accentuating matters in 
his own field and knowing that each possible focus must 
be removed anyway, is prone to lay too much stress on 
the obvious infection with which he is so familiar, as 
the probable cause of the secondary disease. This often 
leads to ludicrous situations. Only a week or so ago a 
dentist specializing in the removal of teeth, urged the 
extraction of a last, not very obviously infected, molar in 
an elderly gentleman who was a patient of mine, with 
the assurance that its removal would cure his rheuma- 
tism; the previous extraction of the majority of his 
other teeth by the same exodentist having failed to do 
so. The patient had a bad chronic appendicitis and an 
infected gall-bladder containing stones. A few days 
later he—the patient, not the dentist—was sent to an 
insane asylum. His pain, his ‘‘rheumatism,’’ was really 
the premonitory expression of a severe central nervous 
system. disease, having nothing to do with joints, gall- 
bladder, appendix or teeth. 
There is another factor that makes the whole situa- 
tion difficult and that is that all of us, in a measure, are 
diseased; not only superficially through infirmities with 
which we are familiar, but internally and in numerous 
unappreciated ways. We are all rather familiar with 
the fact that as we get older, the hair turns grey, that 
we must wear glasses and the teeth need much repair. 
We also more or less consciously realize that our ca- 
pacity for bodily activity greatly diminishes. We can- 
not dance or run or do other things we did when we were 
younger. Just as surely there is a similar decadence 
of numerous internal organs and parts. We see but the 
evident surface manifestations that are expressions of 
internal deterioration. In something like 80 per cent 
of elderly people there is gall-bladder disease as shown 
