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majority of the cases of septic fever fol- for the use of patent and self-prescribed lowing child-birth.
medicines. There are minor causes that J. M. HAMILTON, M. D. will be noted in their place. Old Town, Tenn.
The profession has set for itself a high
standard of education in anatomy, physiThe Patent Medicine Question.
ology, chemistry, etc., but the standard Editor MEDICAL WORLD:- In the June of therapeutics and practice is deplornumber of THE MEDICAL WORLD, page 240, ably low. Dr. Benedict presents a well-written but Here everything is a sort of scientific pessimistic article on the ever-recurring hodge-podge-a dumping ground for exsubject of patent medicines. Near the perimental garbage. I fear no successful close of his contribution the Doctor asks: contradiction when I say there is no such “Can anyone think of a better plan ?" and thing as scientific therapeutics-a system says: “If so, let us hear from you, that of therapeutics that can be measured by we may usher in the beginning of some the standards of true science. In this plan to maintain our standing before the realm everything is rank empiricism, and world.''
it is doubtful whether from the very natThat is a laudable ambition, and I ure of things it ever can be otherwise. accept the invitation, altho my view.point In every case of disease there is an unis the very antipode of that of Dr. Bene- known quantity, a dynamic force that can dict. I view this question from the point only be estimated or guest at.
Science from which I have accustomed myself to knows no guess-work. If therapeutics view all questions affecting the general is confessedly the science of guessing, why public-from the standpoint of the basal should the laity be deprived of their right principles of our government; that a free, to do some of the guessing? No one will enlightened people are capable of self-gov- deny that it is to their guess-work experiernment; that the natural force of evolu- mentation that the profession owes the tion, untrammeled by vicious legislation, great majority of its most potent remewill eventually make natural selection the dies. Witness the recent discovery, by the best selection; that the people should have profession, that lard is a good antidote to the greatest freedom in their choice of strychnin, when that knowledge was the government, their political, religious and common property of the neighborhood social affiliations; in their choice of in which the writer lived more than thirty officers, religious and medical advisers, years ago. Not only that, but in more teachers, food, clothing, medicine and all than one instance a keenly discriminating other things that pertain chiefly to the public conscience has forced the profession individual, yet do not encroach too closely to recede from some of its pseudo scientific upon the rights of others.
death-dealing positions. Witness the inThe argument that the individual should discriminate use of the lancet and the have no right in the choice of remedies in mal-administration of calomel less than a any case of disease, that the choice of half century ago. remedies is, in every case of sickness or The patent medicine men cannot in jusaccident, the “physician's prerogative, tice be accused of having ever foisted upon smacks sharply of tyranny. The tyrant is the public anything comparable with the always an egotist. The survival of the atrocious medication that has in times fittest is an inexorable law of evolution, past received the endorsement of some and if the medical profession cannot stand part of the medical profession. If we in competition with the patent medicine compare the ethical basis of patent meditrade and force it out of existence without cine with some of the present day profeslegislative aid, it deserves oblivion. If sional fads, the escutcheon of the former there is such a thing as a discriminating will, to the unprejudiced mind, appear public conscience, and medication by the several shades the brighter. No one will profession is more satisfactory than self deny that vaccination and antitoxin have medication, the profession has nothing to caused the death of innocent children and fear. To confess to fear in this matter is seriously impaired the vitality of others. to confess to inefficiency. After an ex. In the use of these things, science has not perience of more than twenty years in the demonstrated in what cases they can be professional harness, I am convinced that used without danger of deleterious or fatal inefficiency and consequent lack of confi- results. In view of these facts, what is dence in the profession is the chief cause the ethical basis for their continued use?
Simply the idea that a doctor has a moral the detestable mixtures kept in our drug and legal right to jeopardize the lives and stores for prescription use. Certainly health of an uncertain number of his pa- Pinkham's Compound is an improvement tients in order to protect others, not from over the time-honored prescriptions of the certainty, but the remote possibility savine, ergot, aloes et myrrh, etc., ad of disease or death.
nauseam, for female complaints. In view This view of the matter finds the sanc- of these prescriptions and mixtures, and tion of law in the legal maxim that “there the beastly examinations many women are is no crime where no crime is intended." subject to every time they suggest ovarian,
In Georgia, the State Board of Health uterine or vaginal symptoms, the wonder ordered a wholesale vaccination of the an- is that the demand for Pinkham's Comvaccinated; but the courts of that State pound and Pierce's Prescription is not have decided that the State cannot be held larger than it is. In my own practice responsible in the way of damages for the many cases have been cured after Pinkevil or fatal results of the practice or the ham's Compound and Pierce's Prescription use of impure vaccine by its agents. had failed to give relief. Keep ahead of Surely no crime was intended, but the the Big Bottle procession and it won't Board of Health, as agents of the State, hurt you. The formula for Piso's Conmust have known positively, if it had sumption Cure is not less scientific than carefully studied the history of vaccina- nine-tenths of the formulas for cough tion, that a number of deaths would cer- mixtures found in our text-books and tainly follow the execution of the order. medical journals. I have known several Such an order could only be executed persons cured of dyspepsia by the use of under the specious plea that the State, as Kennedy's Medical Discovery after “reguprincipal, is not responsible for the acts of lar” physicians had failed to give relief its agents when they offer human sacrifice and in some cases aggravated the disease. on the altar of science. The ethical basis In these cases Kennedy's Medical Discovof the order is the same as that of Wey- ery proved to be a "powerful alterativeler's famous reconcentrado order. The it altered the minds of these men and only difference is in the matter of expedi- their friends in regard to the ability of ency and the natural revulsion of public their doctors and the medical profession. sentiment at killing many instead of few. When a patient comes to me with the Is this the true ethical basis of all medical complaint that this or that patent medipractice? That it is the moral basis for cine did no good, I at once determine to the medical practice which many State let him know that the advice of a physilegislatures and Boards of Health are en- cian is cheaper and better than newspaper deavoring to force upon the people, under advice; and if I fail to do this, I feel that the guise of public protection, needs no I have dishonored myself and the profesargument. Many physicians insist on sion. Nover give a patient a chance to be this ethical monstrosity as a basis for cured or even benefited by a self-prescribed their own practice, but, in seeming ob- or patent medicine after your prescriptions livion to the inconsistency, clench their have failed, and there will be no trouble fists in spasms of indignation when the about "maintaining our standard before same moral code is applied to patent the world." medicine men, Christian scientists and unlicenst practitioners. Patent medicine
Pressing forward for the right.
Keep your shield and honor bright; men are certainly not fools, and there is
And if a brother chance to fall, ground for fear that they who, in compari
Do not crowd him to the wall. son, call them knaves, slightly overesti
Better lend a helping hand, mate the professional purity. There are
Than with austerity to stand doubtless knaves among patent
Seeking legislative aid
To keep him down. medicine men, but are there none skulking behind the gauzy code of professional Taken as a whole, the Doctor's article ethics ?
is little more than a confession of ignorDr. Benedict presents for our consider- ance and incompetence on the part of the ation a number of patent medicine formu- medical profession, and a piteous appeal læ. The most I have to say of them is for help to lift incompetent physicians out that in a general way they are an improve of the slough of despond. I would gladly ment over hundreds of prescriptions writ- lend a helping hand to get them out, but ten by prominent physicians and many of confess to having no sympathy with the
legislative method of curing all the ills WORLD, and I will not close without givthe body politic is heir to.
ing a word of my experience. I have Teach these medical mud-daubers that never lost a case of typhoid fever since I there is a high standard of medical edu- began using the Woodbridge tablets. I cation that they wot not of. " When the have demonstrated time and again, that blind lead the blind, both will fall into the the administration of
the administration of calcium sulph ditch," They have become so brain- is the best abortive treatment for all cases weary learning the minutiæ of anatomy, threatened with suppuration. physiology, chemistry, baeteriology, etc., Those of the profession who have not that they lack the energy to learn the es- tried the above will do well to test them sentials of therapeutics. Teach them that for themselves, and report thru THE most of their load of college cram must be WORLD.
J. G. ATKINSON. left in the slough; put the staff of com- Bristol, N. B., Can. mon-sense in their hands; teach them that a diploma or State license confers How to Manage Your Prescription Business. neither a patent right or trade-mark on Editor MEDICAL WORLD:-The average medical knowledge and skill; that legisla- man will think nothing of spending a tion is impotent to make them successful week's wages on a picnic, an excursion, or physicians ; stimulate ambition with the as a fee to some lawyer to “ make a case essence of hope, and the wail of despair against a fellow sinner; or he will lose will soon change to a shout of victory; five to ten dollars on a borse race, or a and the phantom corpse of the profession little game of “ draw;" but that same will no more rise up to frighten them. man will almost have a fit of gastralgia if Then will Science sit enthroned
he has to pay his physician two dollars for Upon the “ Rock of Ages,"
a visit. So he casts about for some less And her regal splendor fill
66 costive" method for recovery.
But he These bright and glowing pages.
loses every time, because he spends more Dr. J. W. LOCKHART. for various nostrums-so called curealls, St. John, Wash.
than the service of the physician would
have cost; and, after all, he has to call Reply to Quercus.--Experience.
in the doctor at last to save him from the Editor MEDICAL WORLD :-In your July effects of his self-medication. For the number, Quercus, Ontario, Canada, asks man who medicates himself has a fool for of your readers seven interesting ques- a doctor and an ass for a patient. tions, the fifth being as follows:
There is no one subject on which the not better (considering the work of
of people are so ignorant, and yet on which diploma mills') that each contributor they think they are so well informed, as to THE WORLD or any medical journal in that of their bodily ailments and how to the United States be required to name his
Each one has his own private alma mater for M. D. and for M. A., etc., formula handed down from father to son, etc.?"
with many additions to, and omissions My answer is, no. The name of a man's from the original, but with an assurance of alma mater is no evidence that he is com- curative qualities that would appall the petent to write intelligently for such educated physician and even stagger the journals. At best, a man's alma mater is most blatant quack. With his head full a diploma mill; it cannot furnish him of this superior knowledge, because he with brains. It was not the alma mater knows the names of the drugs in his preof the immortal Harvey, nor that of the scription, he goes shopping from drag illustrious Jenner, that gave to the world store to drug store, seeking the cheapest knowledge of the circulation of the blood price he can get. and vaccination. Nearly all of the great Many of these prescriptions come from truths known to science have been physicians. For some reason, sufficient for wrought out with brains," on the flaming themselves, they have written the common forge of life." Therefore, bearing in mind English names of the drugs, and, as a that “the Knowledge that a man can consequence, the patient knows apparently use is the only real Knowledge", let as much as the doctor. Now, when the every writer, titled or untitled, who can physician writes a prescription in plain add to the world's "real Knowledge" ap- English
English he cuts off more or less of his pear in a fair field with no favors.
legitmate income, because when the It is thirteen years since I wrote to The patient knows the names of the different
• Is it
ingredients he buys them just as he Use your own prescription blanks. Do would any sort of wares, without consult- not be the tail to any druggist's kite. ing the physician.
Blanks do not cost very much. Have the Again, the physician cuts off his legiti- printer get you up a neat tasty headline, mate income where he writes a prescrip- giving your office number and hours, and tion for some patent medicine, or nostrum. your residence. Have a line printed at A vast number of these frauds claim to the bottom reading : “Do not refill, do cure every ill that flesh is heir to. In- not give a copy of this prescription." curable diseases are cured by these greatly Any honorable druggist would respect advertised and much vaunted patent this request. If one disregarded it, see to humbugs with an ease, promptness and it that he had no more business from you. facility that completely knocks out the
Jos. R. PERRY, Ph.D., M.D. educated physician. Yet, frequently, Indianapolis, Ind. doctors will write prescriptions for some of these cheats. He loses his patient,
Ophthalmia Neonatorum, very justly, too, because the patient finds Editor MEDICAL WORLD:- Not long that he can buy the proprietary article since I was in an Eye Hospital and heard without the aid of the physician ; and the a young M. D. lecture on ophthalmia neophysician loses his reputation also, for his natorum. He said that every practitioner patient sees that the doctor is prescribing should carry a 2 per cent. solution of nifor him that thing which he is denouncing trate of silver and put it in the eyes of to the public as a humbug, a cheat and a every new-born baby, to prevent the disfraud. It has been well said that the ease. After a practice of sixteen years, I physician who prescribes a patent medi- have seen only a few cases, and could trace cine is too lazy, or too ignorant, to be a every one of them back to a specific cause. good doctor.
I believe that all the severe forms that call When a physician writes a prescription for nitrate of silver come from a special he should remember that he is putting micro-organism. The mild type, noninto it knowledge that has cost him many specific, has a tendency to recover without years of hard study and much good money invading the cornea, and will get well to secure. He should employ only tech- with a simple eye-wash, Why should we nical terms and officinal names. The carry a strong solution of nitrate of silver prescription should always be written and put it in the babies' eyes when not very plainly, for it thereby makes a good more than one in every three or four hun. impression on both the patient and the dred will need it? Wouldn't it be better druggist. One great fault with the ma- for the doctor to see that the mother has jority of physicians is the utter carelessness no discharge associated with the gonococof their chirography. Many doctors seem cus? It has been proven that inoculation to be possessed with the idea that poor with healthy lochia has failed to produce writing indicates great genius, or, possibly the disease. a profound knowledge, when really almost We should see that careless bathing of everyone else thinks that illegible scrib- the child with soiled towels and sponges bling means ignorance and illiteracy. It is avoided. frequently happens that prescriptions are The question is, are we justified in put. brought to the druggist that can hardly ting a strong solution of nitrate of silver be deciphered; it takes the combined in- in the eyes of every new-born baby? telligence of every one in the shop to
W. C. STIRLING. determine exactly what is meant. Even Sulphur Springs, Texas. then, after the customer has gone, it is [Specialists have so often witnessed the a mooted question with the dispenser sad sight of infants' eyes destroyed by whether the patient has got what the doctor neglect of the proper treatment at the ordered. Sometimes all that prevents a proper time that they feel very strongly deadly mistake is the druggist's knowl- on this subject. Hence the extreme advice edge of doses, as it is not possible to tell above mentioned. This is a very proper from the written directions just what practice among the lower classes in cities. quantity the doctor ordered.
where such danger to the babe is very freAlways write the directions plainly and quent, but in the average private practice in full on the prescription. Never, under not among the above-mentioned classes. any circumstances, say:
" Use as di- we believe the course mentioned above by rected.''
the Doctor is the proper one.—Ed.]
Mrs. W., multipara, aet 40, extremely Editor MEDICAL WORLD:-The two fol. nervous temperament. Was called to see lowing cases have proven exceedingly in- her and found abortion threatening at 8th teresting to me and to those I have had in week with excessive hemorrhage. On exconsultation, and may prove of some in- amination I found os patent and fetus preterest to your readers, and at the same senting. I emptied vagina, doucht with time teach us how exceedingly careful we creolin solution and packt with cotton must be in our prognosis of cases of simi- tampon. Returned after eight hours, relar nature.
moved tampon and with it fetus and memMrs. M., aet 33, multipara, engaged me branes intact. to confine her with her sixth child. She Two weeks after she called at my office gave a history of fairly good labors, and and directed my attention to a small painphysical examination, including urinary ful nodule immediately under the center examination, gave me sufficient encourage- of the right clavicle. The spot was painment to lead me to believe that her case ful. I prescribed cold application and would be one of plain sailing.
I called at her house two days afWhen I was called to her bedside I found terwards and found spot exceedingly painthat the os was lacerated by some previous ful, red and semi-fluctuating. The upper labor and that practically nothing was left part of right arm was swollen and there of the perineum. Head was presenting, was an edematous area about six inches R. O. A., and pains were steady, regular in diameter around the point of tenderand strong.
The child was born about ness. I diagnosed case as venous thromtwo hours after my arrival, and placenta bus, and as swelling was immediately was exprest by Crede's method about under the skin, I opened it and peeled out fifteen minutes after the birth of the child. an inky black clot the size of a walnut. Uterus contracted firmly and remained so. I packed wound with gauze. Patient re
I bandaged firmly and left patient to covered fully in four days. Swelling of rest, called the following morning and arm went down and edema disappeared. found everything progressing satisfac- Three weeks after this, patient called torily.
again at my office and declared that there In response to an extremely urgent call was another swelling on the opposite side, that evening I hastened to her and found and as she contemplated a trip to the her in a cyanotic condition with hands and West, she wanted me to immediately refeet cold, feeble, rapid pulse, respirations move it. 44 to minute, and complaining that she When I examined this side I found no was choking. Uterus was still contracted point of tenderness or swelling, but inand there was no flooding. The members stead there was a large diffuse area of of her family were extremely excited, and edema. I diagnosed thrombus, but could had not only sent for me, but also for not locate it and prescribed absolute rest nearly every doctor in the neighborhood. with arm in sling. Diagnosis was agreed on as pulmonary Had a consultation on following day embolism, and an extremely unfavorable and found patient's left arm, chest, neck prognosis given, and I was thus left alone and upper part of right arm swollen, but in my misery to shoulder the responsibility no localized swelling. Favorable progand break the news to a despondent father nosis was given. of a house full of prospective motherless This condition remained unchanged for children.
a week, when I was called and found I prescribed absolute rest and drop patient considerably worse, with dyspnea, doses of one per cent. nitroglycerin solu- cyanosis and complaining of choking. tion to be given every two hours, and left Diagnosed pulmonary embolism. Premy patient. I called early next morning scribed hot oxygen gas inhalations and and found her still alive and in a slightly nitroglycerin with very little effect. improved condition. Respirations were Patient died following day of asphyxia. reduced to 35 and pulse was slightly fuller New York City. GREGORY COSTIGAN. and less rapid. Called same evening and found still more improvement. She slowly B. D. DeKalb, M, D., of DeKalb, Iowa, and steadily improved daily. No further wishes to say to A. Jasme (see July complication appeared, and after three WORLD, page 294), that if he will anoint weeks rest in bed on a liquid diet she re- his face and hands with cedar oil, he can covered fully.
probably fish in comfort.