CHAPTER IV Let me say to the younger men in connection with deriving (Part 7)

is the feeling for financial economics. A few editors and reporters take pains to give excellent medical news and information, but they are inhuman — to that extent at least. The harm which proceeds from lay press discussion of medical topics as a rule rests in the fact that wrong ideas in medicine are apt to be promptly put into practice by the people. The public is not competent to judge of the value of medical testimony. Any newspaper reference to one's personal work is ex- tremely injurious. In my early Bellevue Hospital experience, I once cheerfully gave the reporters all the information they wished about an injured man who was in the hospital at the time. Members of the visiting staff spoke to me paternally and so closely to the point that I never intentionally got into the lay press again with any reference to personal work. It is one of the things which cannot always be avoided however. A man of public importance was taken to the hospital from the street one day suffering from a sudden attack of apoplexy. I trephined at once for the purpose of allowing the blood to escape externally, believing it to be a new and desirable pro- cedure in selected cases in which the area of pressure could be determined. Reporters came to my house that evening to learn about the operation. They were offered good cigars and informed that it would be improper for me to give any TO-MORROW'S TOPICS on of the^l t into the V news beyond a mere statement of the general condition patient. One of them, however, who was admitted office, took out his notebook and pencil, and began to ask questions. I explained to him the reasons why a doctor could not speak about any individual who was under his care, or go into details of an operation which might not be accepted by surgeons after the question had been thoroughly discussed in medical societies. This reporter folded up his notebook obedi- ently, put it back into his pocket along with his pencil, and demurely said he could understand very well why a doctor should not talk for publication on such a subject. He ex- pressed a genuine personal interest in the subject, however, and asked some questions on the way to the door, which I answered directly, forgetting that he might have a concealed memory somewhere about his person. Next morning every- thing that had been kept out of his note book appeared from his memory in the form of a long personal interview relating to a new operation. When my description of the trephining operation for apo- plexy was published in the newspaper, the editor of the Medical News, Dr. Goffe, wrote a scathing editorial on the subject, in a special edition which was being sent out very widely for advertising purposes. Had Dr. Goffe known the circum- stances, or known me as he did later, he would not have written that editorial. From the facts which he assumed to be true, I would wholly agree with the main text of his remarks. One reason why I never criticize other men in their absence is because of fear that I may not know the other side of a question, and may not be just. It is such an experience as the one quoted which leads me to reserve judgment as a matter Lof habit. On another occasion a whole page in one of the Sunday papers was devoted to an "interview" with three surgeons on TO-MORROW'S TOPICS 229 a poptilar subject. A description of their instruments was illustrated by numerous cuts. I was in Europe at the time, and did not know about being one of the three "interviewed" men. When met with coolness later by a colleague who was an old acquaintance, I asked the reason, and he expressed his surprise at my appearing with personal professional matter in an interview in a Sunday paper. On hunting up the origin of the article it was found that the author of the contribution had made up a whole page of quotations from medical journal writings of the three surgeons and had sold it to the editor as an interview. He was a student at one of the medical colleges who had sought to turn an honest penny in this way. Comparatively few la)anen know where to seek for the right channels for obtaining medical help, and they are apt to accept suggestion from lay advisers. Take, for instance, a case of headache of some chronic or recurrent sort. The patient, through recommendation of friends who have been relieved from headache, may purchase a patent medicine or go to the "favorite prescription doctor," or to an oculist, or to a spa, or to an osteopath, or to a gastro-enterologist, or to a sanitarium. Now all of the friends who gave advice were no doubt relieved from their own personal headaches, because they happened by luck to get to the right man or place. Head- ache, however, is simply a sign of irritation of those branches of the fifth nerve which supply the investing membranes of the brain. The fifth nerve is connected with the sympathetic nervous system through its four ganglia, and headache is con- sequently nothing more than a report at headquarters that something is wrong somewhere about the body. Any one of fifty things may cause headache, which is a ringing of the alarm bell in the tower. Methods for removing the cause for one man's headache may have no bearing whatsoever upon headache in another man. The causes may vary from uric acid 230 TO-MORROW'S TOPICS in the circulation to an error of refraction, — from hard arteries to a soft liver. It is difficult indeed for the people to find the right physician for guiding them properly in such an ordinary matter as a headache, when the alarm bell is ringing in their towers. Wonderful tales are told by the people of miracles per- formed by healers. A simple priest, like Father Ivan of Russia, may obtain great vogue through having miracles ascribed to his healing powers, I remember particularly one tale of his being called to treat a very high church official. A certain Metropolitan when discharging a priest, under con- ditions of great stress of mind, suddenly became paralyzed in his right arm and was stricken blind. Various medical at- tendants failed to relieve him, but Father Ivan upon being called cured him promptly of his paralysis and of his blind- ness. This tale was spread widely in Russia, although an official who was associated with the Metropolitan said in private conversation with one of my friends that the story was untrue. It might just as well have been true as not, for many similar occurrences are recorded. To the alienist such an instance would represent quite an ordinarj- case of hysterical paralysis and blindness, and a cure through the influence of suggestion would be most commonplace from the point of view of those who are informed. Aside from real healing power through suggestion on the part of a priest like Father Ivan there is also a harmful side. I was told of one young man to whose bedside he was summoned. The mystic priest said to the friends and relatives, "God has called him. He must [ answer that call." The young man promptly died. My in- formant did not know the nature of the illness in that par- fticular case, but a powerful influence of suggestion might / cause death when coming from such an authoritative :e, if the patient were of a susceptible type. The death J TO-MORROW'S TOPICS 231 of such a patient wotild have the effect of enhancing the repu- tation of the prophetic power of Father Ivan, a death which he himself might have brought about. Insane mystics like the monk Heliodorus obtain royal patronage in Russia. Delusions relate to the time when our focal distance allows us to observe them, rather than to their frequency in fact at any stated time. When reading the history of delusions of people in the past, we exclaim : "Goodness ! What simpletons they were to believe in witchcraft and the evil eye!" We do not realize that precisely the same state of mind persists to-day. Even among groups of well educated people it very frequently occurs that some member of the party relates a wonderful tale about some marvellous healer who cures by supernatural powers. We hear much of "personal magnetism that almost blisters," and of remarkable cures from some strange pro- cedure on the part of a most unusual sort of individual. A Summer hotel verandah without such interesting conversa- tion is not readily to be found as yet. We often wonder why the public press takes up a position antagonistic to vivisection, for instance. A friend at the club who is editor of one of our papers gave me an explanation. He said, "Now, supposing that five thousand cranks buy the paper because of articles against vivisection, and only five hundred people drop the paper because of the articles, don't you see the balance in favor of the counting house?" The proprietor of one periodical which has much to say against vivisection and vaccination, is a great deal of a wag, and thriftily clever. His idea is that by attacking doctors on these matters a great many men become aroused in controversy, and teach the public the real truth because he wakes doctors up by throwing stones at them. He believes himself to be useful, in addition to increasing his circulation, and no doubt is useful on both bases. The good accomplished in the end 232 TO-MORROW'S TOPICS the men who know and who are awakened into speaking. really does offset what seems to be the bad effect of unmerited abuse of doctors. The time is coming when editors can obtain much more sensational matter if they wish by searching among their own advertising columns for really harmful influences. One editor who is opposed to vaccination and vivisection is, I believe, sincere. He belongs to the double rose class, and is very bright, but cannot make proper use of testimony. His periodical doubtless receives an increased circulation because of its advocacy of ideas which must be kept in a blue bottle out of the sunlight. Men who know that these particular ideas are wrong do not often drop the periodical. I buy it myself for its cleverness, and fanatics buy it for its wrong ideas. Ho ! Merry for the counting house ! From the New ^"ork Times for February 25, 1908, I cut out this letter as indicating tlie feeling of one who is filled with kindly sentiment toward animals, but who has not as yet found opportunity perhaps to make a real study of the whole subject of vivisection. To THE Editor of the New York Times: In my opinion, vivisection is the lowest form of immorality. "Below this there is no depth." The harlot, the thief, the murderer, and the degenerate of any sort may own a sense of human morality and possess their own share of the divine. Not so the vivisector. Vivisection destroys the sense of mercy I in the human heart. Therefore it is immoral. It is difficult to elieve that any lasting good can come of immorality. To me ■uelty is the one unpardonable sin, and cruelty to helpless liings is the vulgarest phase of it. The price paid for a dis- Hvisection is too great. I believe that egotism and ; desire for celebrity often give the vivisector his impetus. 5 the undersigned once wrote : : are some phases of immorality so dark that men : of them in whispers or do not speak of them at all. A TO-MORROW'S TOPICS 233 Vivisection is one of these phases of immorality. No prisons, no death cells, no obscure haimts of vice ever have sheltered beings who have so perfectly achieved the annihilation of the common sense of mercy as the vivisectors have achieved it. All cruelty to helpless things is cowardice. But to my mind the exquisite cowardice of the vivisector is the most perfect thing in immorality that the mind of man can conceive." Minnie Maddern Fiske. Mrs. Fiske simply expressed a temperament in relation to one side of a case. She is capable of speaking quite as strongly for the child who is spared from diphtheria or from infantile paralysis, — for the mother who is spared from typhoid fever and lives to care for her little flock, — for the soldier who is spared from yellow fever to fight for his country. These people are spared as a result of animal vivisection. We have seen Mrs. Fiske do wonderfully artistic work on the stage in subjects which were quite as opposite as those of vivisection and antivivisection. Were she to study the other side of the case we might be given 'fully as striking an exhibition of deep human sympathy displayed temperamentally in favor of vivi- section and the home. Vivisection stands for home and the children. Antivivisec- tion stands for Her Excellency the Barrenness de Seulchien. I would not speak of her in any spirit of disrespect. Beautiful characters and women of the finest quality of culture are found in private homes and at the hotels, who are victims of circumstances, and who make the best employment of useful lives. The Barrenness is often enough someone who has been the victim of an accident, quite as well as someone who has reached cultural limitations, and having lost the breeding instinct is devoted to a display of the delightful characteristics of higher civilization. In this group, however, we find the larger number of antivivisectionists. Comparatively few mothers or fathers are to be found among the antivivisectionists. There are probably no large stock raisers among them, because the cruelty that herds of animals formerly suffered with various infectious diseases has been so decreased through the results of vivisection, that practical animal lovers know very well what suffering has been spared their charges. Vivisection stands for home, the children and the farm. A ntivivi section stands for pet animals which bring much cheer to the childless city apartment. The leader among the antivivisectionists is at present Miss Lind- af-Hageby, whose false statements cost Coleridge twenty-five thousand dollars in his suit with Bayliss, This year she made an attempt at refuting the charge that her anti vivisection propaganda had been carried on by a systematic campaign of falsehood. A prompt verdict was rendered against her in court. It is fortunate that this type of salaried mind is not represented by the vivisectionists, who carry their data before committees of legislative bodies. Such committees are very apt to contain members with legal training, who are familiar with methods for securing the facts in a case, and who know the course and meaning of emotional movement. It is interesting to observe the way in which the public press will make up a popular diagnosis for purposes of con- venience, and doctors then follow suit. Not long ago people died largely of heart failure in the public press. Beginning to weary of this, the editors next had people dying of ptomaine poisoning. After a multitude had been swept away by ptomaine poisoning, we now have arrived at the popular diagnosis of "acute indigestion." No one can prognosticate what the next lay press diagnosis will be. This is really the fault of the doctors. Some one or two men carelessly quoted a few times, may establish a dJag- I nosis for the lay press to employ. "Heart failure" covered TO-MORROW'S TOPICS 235 an enormous range of diseases. "Ptomaine poisoning" and "acute indigestion," however, according to my observation are rather closely limited to appendicitis, ulcer of the stomach and gall-stones, although there would of course be the usual proportion of strangulated hernias, adhesion angulations, hard coronary arteries and various conditions sending a reflex impulse to the gastric ganglia. Once in a long while, to be sure, a real case of ptomaine poisoning would be included. "Acute indigestion," however, can never be a real diagnosis, as it is only a sign of something else, for which a diagnosis is in order. The ludicrousness of popular diagnoses is equalled by those which are occasionally sent in with death certificates, and the following extracts from some which were sent into the Wis- consin State Board of Health recently, found in the reports of L. W. Hotchcroft, chief statistician, are quoted : A mother 'died in infancy.' " Went to bed feeling well, but woke up dead." "Died suddenly at the age of 103. To this time he bid fair to reach a ripe old age." "Do not know the cause of death, but patient fully recovered from last illness." Deceased had never been fatally ill." Died suddenly, nothing serious." Deceased died from blood-poison, caused by a broken ankle, which is remarkable, as the automobile struck him between the lamp and the radiator." The idea of property being held in greater value than human life, by inherent instinct of the public, is shown in statistics collected by Rittenhouse of the Equitable Life Assurance Com- pany. He shows that in the year 191 1, in fifty American cities with an annual death list of 117,000 from preventible diseases, people spent an average of thirty cents per capita for H tei TO-MORROW'S TOPICS preventing life waste and $1.63 per capita for preventing fire waste. An inherent instinct demonstrated in this way is to be our guide, rather than any sentimental idea that we hold life to be of greater value than property. Life apparently is not so valuable according to nature's plan. Property is worth the most for the reason that honey is worth more than bees. The death rate from degenerative diseases of the heart, blood vessels, and kidneys, has increased more than 100 per