Boston University - HUB Yearbook (Boston, MA)

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24 Bosrozv UNIVERSITY YEAR Booze. until the physician is emancipated from his humiliating dependence on his patients for recognition and pecuniary support, there can never be an appropriate testing of can- didates, an unselfish professional body, nor a safe practice. The State should prescribe the most thorough education possible, and it should institute the most searching exami- nations as thc portal to practice g but, when the candidate has met all these preliminary demands of the State, it, in turn, should make him a member of the civil service, duly appoint him to a medical parish, and provide him an adequate salary. Thereafter his services, like those of a judge or general, should belong wholly to the community, and even the acceptance of the smallest present from a grateful patient should be strictly forbidden by law. All medical practice by persons other than the State-appointed physicians should also be made a punishable misdemeanor. That such a proposal should come from a country where the State has sought to give the maximum of free- dom to the citizen, both as physician and as patient, is, to say the least, significant. It is another utterance of that 'f despair of freedom which has lately led the advocates of medical reform in England to place their only hope in a prompt and thorough-going intervention of the civil power-.1 W Meanwhile, to the despondent American it should be instructive, that in France, where five years ago the State created and administered all appliances for medical educa- tion, and more entirely regulated medical practice than perhaps i11 any other country in the world, there has been complaint of sore evils in the profession, and an attempt to remedy them by authorizing the establishment of free 1 Boston University Year Book, Vol. IV. p. 20. - In what piquant contrast to this blind faith in an omnipotent State stands the delicious bitterness of this utterance of President Henri Roger at the opening of the last annual meeting of the Association Gcncrale de Prcvoyance et de Secours Mutuels des Mcdecins de France! - Aprcs lc vote de cette loi, une simple autori- sation d'un ministre incompetent et omnipotent ne suifra plus aux, xnedecins ctrangers pour exercer en France. '

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SYMPTOMS' IN JWEDICAL EDUCATION. 23 By all accounts our :American corpus 'medicorum has long been ailing. As to the fact, the experts who have been consulted in the case have all agreed. The disorder being of a very complicated nature, however, it is not surprising, that, in the diagnosis and prognosis, there has been decid- edly less'of unanimity. As to the etiology of the trouble, some, with Dr. Pepper, have laid great stress upon an alleged excess of nutrition, others, with Dr. Davis, have directed attention to the obvious defects of the mas- ticatory, digestive, and a.ssimilative apparatus of the pa- tient, others still have thought that the noxious climatic and telluric influences of our new, undrained, and poorly- aerated American society, should bear the chief burden of blame. Accordingly, when it has come to the prescrip- tion of a rational and effective therapeutic treatment, the doctors have widely and hopelessly disagreed. This has left the case largely to laymeng and this, we are strangely told,1 is the first auspicious circumstance to be noted. At first blush such an assertion would seem to involve a grave reflection upon the profession at large, but it must be remembered that nothing is more unusual, or considered more unprofessional, than for the physician, when a patient, to treat himself. n How far a physician may build his hopes of medical reform upon the non-medical public in its civil capacity has recently found a remarkable illustration in a commu- nication addressed by a New-York physician to his High- ness, Prince Bismarck, and published in the Aerztliches Vereinsblatt of last June, under the superscription, Wtum of an American Physician on the Relation of the Physician to the State. In this elaborate and forcible communica- tion the author, Dr. B. Segnitz, demands, in the interest of science and in the interest of the public, the full assump- tion of the care of health by the State. He insists, that, 1 'The non-medical public is probably the only source from ivlilch efectual reform can be expected. - The American Journal of the Medical Sciences, July, 1878, p. 186.

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SYJIPTOMS IN MEDICAL EDUCATION. 25 medical colleges under a general law prescribing the num- ber and work of the chairs, the length of the curriculum, Ste. Here is despair of the State, and a coveting of the progressive and self-helpful influences which are insepa- rable from such powerful competing institutions as the great universities of Germany! The aspiration is a wise oneg but the profession seem to have small hope of its early realization? Is Germany, then, the paradise of this profession, the land in which the ideal has been made real, the country where the medical reformer finds his occupation gone? Here is the omnipotent State, here, furthermore, the fore- most seats of learning. The State demands more rigid training than the most enthusiastic representative of American medical colleges dares suggest. The Univer- sities are ready and able to give it. Can any thing be Wanting here ? Alas! even the German physician is not happy. By recent laws the new Empire has changed his occupation from a liberal ffprofession to a mere trade CGewerbejg has substituted for the old-fashioned free honorarium a legalized tariff of prices for medical serviceg and finally, while exacting the utmost possible in the way of training from all candidates for honorable and legitimate practice, has opened to all others - so, at least, it is alleged-the widest opportunities, if not the strongest invitations, to quackery. Moreover, still further humiliations are appre- 1 Aveo nos mceurs actuelles il n'y a. rien a esperer de nouvelles loisg trop sever-es,el1es ne seront pas appliquees, trop indulgentes elles ne seront qu'un encouragement a recommencerf' M. A. Lnroua. Le Progres Medical, p. 344. Paris, 1879. - Avec1a participation future des agregcs D. Penseignement, avec Padjonction des cours cliniques spcciaux et le con- cours de Penselgnement libre, on peut afiirmer que nos facultes de maide- cine offriront des sources d'enseignement aussi abondantes que les univer- sites allemandes, xuunies de leurs professeurs ordinaix-es et extraordinaires et de leurs privat-docenten. CHAUFFABD. Revue des Deux Mondea, 1878, p. 155. - 2 Etant dormees nos habitudes, nos moanrs et nos lois contraires ln. Pinitiative individuelle, il est peu probable que, de longtemps, on essaie de fonder de pureilles soci6t6s. Le Progres Medical, Nov. 8, 1879.