The Clinique. Dr. Cornelia Stettler of the Hahnemann College, Chicago, has a unique article on False Prophecy in Obstetrics. The doctor puts into writing what physicians of experience must have thought about many times. It is a common experience of obstetricians to have their patients tell of being told by some medical adviser that they could never conceive, or could never carry a baby through, or could never give birth to a live baby if they should become pregnant. In the article she says; "Married women may be divided into two classes: (1) those who do not wish to become mothers and (2) those who do." "These two classes are very differently affected by the dictum of a doctor who says it is impossible for them to become pregnant. In the first case, if the woman, believing that the doctor knows it all, takes no precaution against it, finds that he was mistaken, she will alway question his honesty and his ability as an obstetrician, as well as a general practitioner." Prophecies are made that conception cannot occur, or if it should occur, that the child could not be born alive. Such false alarms naturally create an untold amount of anxiety and sorrow. The pregnant woman becomes wretched indeed when told by a physician in whom she has confidence, that she cannot go to term It is still worse when she is made to believe the child can never be born alive. What physician of experience does not know of many cases where prophecies of this kind had been made, but where all went well when the day of parturition came. It would seem as if physicians would have more respect for their own reputation than to make so many unwarranted prophecies. The doctor presents the following propositions. (1) Whether a woman desires to have children or not, it is wrong for the physician to tell her that such a result is impossible. (2) Nature has thrown such safeguards about the foetus in utero and has so many resources which tend to its safety, that the most unpromising cases will often be carried to term, especially if we do not discourage the patient beforehand, or despair of a good result ourselves. (3) Since premature delivery, the Cæsarean section, Porro's operation and symphysiotomy under anæthesia have taken the place of the horrible old obstetric operations that murdered the child and mutilated the mother. The doctor and the nurse and everybody who is interested in a pregnant woman, should cheerfully and joyfully encourage her to hope for a safe and speedy delivery when the time arrives. (4) An intelligent patient can be made to understand that the resources of aseptic midwifery are almost always sufficient to ward off the threatened dangers of the lying in. The statistics that will prove most conclusively the remarkable exemption from puerperal disorders under the newer methods of treatment as compared with the old are available and should be familiar to all who engage in the practice of obstetrics. These facts should not only keep the doctors from prophesying evil for their patients, but should dispel the fear and the apprehension of the patient herself. Free Dispen saries vs. Club Doctors. North American Journal of Homeopathy. The CRITIQUE has already made a deliverance on the Corporation Doctor published in the Jan- ation doctors bode more evil to the profession than the much talked against free dispensary. The North American makes a deliverance under the caption "An Impending Danger" and says this of the club doctor in England: The club doctor usually receives $1 a year from each member, furnishing all required services. One man reports tkat in three years' work for a club of male adults he made 974 calls and 1,400 consultations, for which he received $700, an average of 30 cents per treatment. Small as this seems, he confesses that the same services at regular rates would only have brought twice as much. When women and children belong to the club the calls are more numerous, but the compensation remains the When we note that the club doctor is not usually the struggling beginner, but the wealthy and long-established practitioner, whose underpaid and overworked assistant does all the club work; and that the club membership is not restricted to the deserving, except in rare instances, the evil of the system becomes more manifest. same. The North American warns the profession in America against these evils and urges the inauguration of effective measures against them before they become so thoroughly intrenched as they already are in England. The CRITIQUE is in thorough spmpathy with all efforts to bring about needed reforms. We insist, however, that the contract doctor is a greater menace to the profession than is the free dispensary. Let us briefly consider the differential diagnosis of the two "Impending Dangers" and let the readers of the CRITIQUE make up there own prognosis. College Free Dispensary. Takes patients from the general profession; Treats those unable to pay; Does not affect the general fees; Does not tend to make classes in the profession; Affords most useful clinical instruc tion to medical students; Leaves every patient free to have Homeopathic or any other treatment he may wish; A few patients well able to pay, get treatment for nothing; Is in the way of charity and a relief to the Medical profession. Club or Corporation Doctor. The same; Treats for a pittance those well able to pay; Tends to lower the fees; Tends to make a few rich physicians, who employ "cheap Johns" to do the work for a meagre subsistence. Creates in the minds of his patients contempt for the medical profession; In many cases the patient must pay for a system of practice he does not indorse; Many patients, well able to pay full price, get treatment for a pittance; Violates medical ethics and diverts the natural resources of the profession into personal channels. MEDICAL OPINION. It seems to me of the utmost importance that at the very beginning of his course a medical student be made acquainted with the principle of medicine-all the principles upon which beneficial practice is based.-Chas. S. Mack, M. D., in Principles of Medicine. An eminent physician once said there are three diseases he makes no pretensions to cure, and they all commence with "C" namely, cholera, consumption and clap. This about tells the story. Dr. C. E. Fisher in Medical Century. I do not see how any conscientious physician would dare to use it (antitoxin) as a prophylactic. I am of the firm conviction that it has done a thousand times more harm than it has done good, and I do not believe it has prevented the disease in a single case.--Prof. R. N. Tooker, M. D., Chicago. As to the terrible after result (of anti toxin) I have not had the least possible after result. I have used it in consultation and my own practice since beginning its use in something like forty eight cases, and I am sure that of these forty-eight only three died. I am speaking of malignant cases.--Dr. C. B. Kinyon, Rock Island, Ill. Virchow "believed the final secret of-i, e., how to preserve life alive and protect it against the assaults of disease, resulting in an extension of life rivalling that of the patriarchs of oldwould be discovered within the lifetime of many of his hearers. -W. C. Goodno, M. D. TREATMENT OF CHOREA BY MASSAGE. FEDOROW (ibid., p. 713) reports five cases in girls seven to fourteen years of age treated satisfactorily with massage and gymnastics. The etiology was unknown in three cases, in another fright, and in psychic infection from a sister, were demonstrated as causes. All the patients were anemic, badly nourished, but had previously been healthy. Internal organs were normal. The treatment consisted in tub-baths of 27° R.; in some cases iron and arsenic was administered, and with this a general massage of the whole body. In three to four days the choreic movements become weaker; in one severe case only was improvement delayed for four weeks. After the symptoms began to improve, passive gymnastics-flexion and extension of the extremities and of the head-were practised. Recovery took place within two to six weeks; in more severe cases after two and a half months. Contraindications to this method of treatment are acute polyarthritis, great valvular disease of the heart, etc. The good effects of massage can probably be referred to a lowering of the irritability of the cortex of the brain, by the slight irritation of the peripheral nerves. In chorea following infectious diseases it may be due to an improvement of the circulation, and an increase of metabolism with resulting rapid excretion of the toxines circulating in the system.-Pediatrics. THE CRITIQUE. Formerly THE DENVER JOURNAL OF HOMEOPATHY. SAMUEL S. SMYTHE, M. D., Editor. W. A. BURR, M. D., Associate Editor. J. WYLIE ANDERSON, M. D., Managing Editor. All books for review, magazines, exchanges, correspondence and articles for publication in this Journal should henceforth be sent to Dr. S. S. Smythe, Editor, 403 California Building, Denver, Colorado. All business communications should be addressed to Dr. J. Wylie Anderson, 16 Steele Block, Denver, Colorado. FORTY CENT RAILROAD SURGEONS. At first glance it is difficult to comprehend the indifference which has prevailed in the medical profession regarding the employment of a few contract doctors to care for large numbers of employes at merely nominal rates. No one has seemed to realize to what extent this system has drawn from the legitimate rescources of the profession, or how great an injustice has been done. The explanation lies in the fact that the whole scheme has been cunningly carried on under the guise of a sort of charity for the laboring classes, and medical men have been completely deceived by this phase of the question. The truth is that the present cheap fee system originated in selfishness aud avarice for the sole benefit of the promotors. Real charity has no part or parcel in it. The men who are assessed to provide large incomes for a few favored physicians, are in no sense objects of charity and would resent the appellation as an insult. Such an impression is carefully guarded against. They are not consulted at all. The sum is simply deducted from their wages, and their desires are not considered. While the individual assessments are small, the aggregate amount which goes into the pockets of the doctor, is immense. |