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The next thing which needs to be done for the medical schools is to procure scholarship funds and endowments for its professorships, or a large permanent fund, the income of which shall be applicable to salaries. So long as medical schools are conducted as private ventures for the benefit of a few physicians and surgeons who have united to form a corporation or a faculty, the community ought not to endow them; for it is contrary to the best interests of the public that medical education should be conducted in that way. The experience of the past hundred years in this country proves that such medical schools will not be endowed. While several millions of dollars are yearly devoted to education in arts and in theology by intelligent and public-spirited men and women, hardly anything is given for education in medicine, because almost all American medical schools are organized and carried on as commercial adventures. In 1871, the Harvard Medical School ceased to be in any sense a private venture, and became a constituent department of the University, devoted, like the other departments, to the advancement of science and learning, and to the amelioration of the conditions of human life. Since that year, it has received by gift and bequest $270,000 ; but this sum, though considerable, is not one-third of the endowment which it urgently needs. The objects of endowment in medical education are precisely the same as in other departments of education; namely, to provide permanent means of securing the most competent persons for its professorial chairs, of helping poor students of rare capacity, and of advancing knowledge by new researches. It is the primary object of medical science and art to defend and improve the life that now is, - the life of the individual, of the family, and of society; but, since it is impossible to separate physical from mental and moral well being, the domain of medical science is really coextensive with human nature. Whatever notions influence benevolent persons to endow institutions which teach the humanities or theology should also avail for the endowment of medical education. The seed and the fruit, the planting and the harvesting, may be different in kind; but these various cultures all have in view a common end, - namely, the improvement of man's high estate.
It is hardly worth while to attempt by illustration to show what schools are very good and which are worse than bad. That there is a large number of men practising medicine to-day with whom contact is demeaning to the educated practitioner, and whose very existence is a danger and menace to the community, must be conceded. These ignorant fellows have the same legal qualifications as the most educated and skilful physicians, and in many cases also the confidence of the community in which they exist. A broader and better education would command a much greater respect from the masses. How often you hear a doctor say the
mind-cure is a humbug and Christian scientists are worse than charlatans, dismissing the subject with but this explanation ! Hence the public says: “Doctors are fools. Mary Jane of our town walked for the first time in years after Mrs. Smith had prayed with her, and Deacon Jones's dyspepsia only vanished after the mind-cure invaded the village.” Every physician hears of these marvels daily, but to the educated man they admit of an explanation as easy as the laws of light or sound.
Have any of you ever walked through the Salpétrière Hospital in Paris, beside that great chief of neurologists, Charcot? Have you seen him, by the exercise of his tremendous will power, convert the frail hysteric female into a giantess of strength? Have you seen him hypnotize his patients, and render them oblivious to pain? Here we may truly wonder at the power of man, and compare his modern miracles to those of the great Master. Yet Charcot will explain the power, which seems given him from above, to be but the exercise of a superior physical and mental force over a diseased nervous condition. Well might the reverend gentleman in Chicago say that he could cure many diseases by the faith-cure, but he never could remove the cinder from his son's eye by that agency,- for which heresy he was promptly expelled from the Faith Convention. I will not trespass further upon the half-hour, for there are other speakers whom I know you wish to hear during the time remaining for the debate on the resolution as read.
DEBATE ON DR. CURTIS'S ADDRESS. Rev. Dr. J. ANDERSON, Waterbury, Conn.- While I was listening to the suggestions of Dr. Curtis, I was reminded of a remark made by Dr. Leonard Bacon, who was closely connected with Yale College, in reference to the mutual relation and duties of the different professions. The question of the relation of the ministry to the medical profession came up in some way. In old times, the physician used to bring in no charge against the clergy for professional attendance; but a change is taking place in that respect. Upon my making this remark, Dr. Bacon came to the defence of the medical profession, and said that so long as the clergy were as willing as other people to run after any quack they must expect the medical profession to treat them accordingly, and make no distinction between them, as members of a profession, and other persons.
I have been surprised at the apparent ignorance of even intelligent men — and I suppose the clergy may be considered intelligent men as a rule — in regard to the value of professional knowledge in other professions. I suppose it is paralleled by the ignorance of intelligent men in regard to the value of authorities
in any department with which they are not familiar. During a recent discussion in which I took part, in the newspaper press, with Mr. Neal Dow, of Maine-law fame, I ventured the opinion that all scholars to-day must reject the "I wo-wine theory” of the Scriptures; namely, that whenever the Scriptures praise wine they refer to unfermented grape juice, and that whenever they condemn wine they refer to what we call wine. That theory was prevalent among temperance people at one time, but I said that no scholar of any repute to-day would advocate that theory. That was putting a meaning upon the word "scholar” which Mr. Neal Dow would not perhaps accept. I recognized certain scholars as authorities and other so-called scholars as non-authorities, and so the question of the value of authorities came up as a matter of course. It is so in all departments of life. The great mass of the people, and a good many intelligent people, fail to recognize the difference between a real authority and one that has no authority, in the department of medicine as well as elsewhere. In the city of Waterbury, I have observed that every time a wandering physician comes round, and puts out his sign at the chief hotel, the people flock to him to receive medical treatment. They do not inquire whether he is an educated physician or not. They do not know the difference. That is why there may be intelligent physicians in any community, and yet people be victims to these wandering quacks. Of the twenty, thirty, or forty physicians in our city, there are several who hold no medical degree and who have no thorough medical education ; yet among their patients are sonne quite intelligent people. It seems to require special training, special knowledge of scientific matters, to appreciate these distinctions. The great difficulty perhaps lies in this direction. As long as people do not know the difference, they will make no difference in selecting their physicians. Social considerations may come in, financial considerations will come in ; but considerations of scholarship and learning in the professions will come in to a very slight extent. This difficulty is hard to reach. We cannot make a proclamation which will reach the masses of the people, and we cannot have any legislation to reach the difficulty.
And yet there is a place for legislation. It seems to me that our law-givers can do something in elevating the standard ; and if there are medical colleges, so called, that are graduating men and throwing them out on the community when they are not fit to be physicians,— men who gravitate into the position of quacks as soon as they get to work, - it seems to me that something ought to be done to prevent it. If this Association can do anything in that direction, it ought to be done. One of the great changes that is taking place at the present day is a tendency to abolish the old ideas concerning the three learned professions, - medicine, law, theology. For centuries these professions stood out pre-eminently,—there were no others. But to-day there are many professions or semi-professions, and the lines are not drawn so distinctly as they were; and there are tendencies at work in all these to lower them, to deprofessionalize the men who belong to them. I remember some years ago a change took place in the ecclesiastical relations of the town to which I belong. A conference of churches was organized. We had had an association of ministers, – I think the oldest one organized in the United States, - organized in 1708. An effort was made to abolish that and substitute for it this conference of churches, in which the lay element should be prominent. I took the ground at that time, in opposition to President Woolsey, that we ought to cherish the Association and make the most of it, because of its bearing upon the clergy as a profession; that we ought to emphasize our professionalism; that in this country, where there was so much drawing away from the purely professional characteristics of the ministry, we ought to cherish our professionalism, not in the sense of wearing a straight coat and white cravat, but in giving opportunity for training and for learning. What is wanted in the ministry is wanted in the medical and legal professions; and it seems to me that we should co-operate with one another in that matter. I, for one, wish to emphasize the value of the medical profession as such, and to stand up for the regular school.
Prof. WAYLAND. - The hopelessness of it is the feeling that weighs upon me. Every word you have said, Mr. Chairman, is perfectly true, flagrantly true ; and yet what are you going to do about it? People will go on selling themselves to quacks to the end of time; and, as one species of quackery decomposes, from the residuum will rise another species, with more devils than the first. Now it seems to me impossible to get the public sufficiently interested in this to make a public opinion strong enough to control the evil. In the first place, you cannot get medical men to take hold of it with any zeal or earnestness. If I may be pardoned a personal allusion, a few years ago I made a great effort to secure the passage of a better law, intended to cover precisely the evil to which Dr. Anderson has alluded; that is, to prevent med cal tramps writing M.D. after their name. I secured the assent of the leading physicians of the regular school, of the homeopathic school, and of the eclectic school or, as one of my acquaintances, with quaint innocence, calls it, the “epileptic” school. It was not a narrow bill, it was simply a provision that no men, who had not a degree from some of those three schools, should be allowed to practise. It had the unanimous assent of the judiciary committee of the Connecticut legislature, but a quack from our city succeeded in laughing it out of the legislature; and it did not get a corporal's guard of votes, though there was not a man who, if you had got him in a corner and talked with him, would not have said that it was a perfectly just and fair bill. The community did not care anything about it. So much for legislation. In some States there has been more stringent legislation; but, after a few cases have been disposed of, the jury will usually acquit, as there is a popular supposition that the law is the result of a desire to persecute on the part of the medical profession.
As to the improvement of medical schools. The great trouble is that a competent medical man can earn by his profession in large city an income far beyond what he would receive for teaching. Such a physician earns from $25,000 to $30,000 a year. How can you ask him to give the cream of his time to teaching men hardly up to average intelligence, - certainly not above it, many of whom come into the profession not for the humanity they may exercise, but for the ducats they may accumulate? To endow a professor's chair and get a teacher, before he is too old to have any vital love or enthusiasm for the work, would require an endowment that wouid yield $12,000 or $15,000 a year. What is the chance of doing that? The same is true, to a considerable extent, of a law school ; but the legal profession is not — to use a term that expresses exactly what I mean so rasping. It does not involve so much wear and tear of the nerves. But the successful law schools could be counted on the fingers of one hand. I am sorry to indulge in this Jeremiad.
Dr. Curtis.— I was brought up very near Waterbury, and I know to what Dr. Anderson refers. But the trouble is that these travelling doctors have degrees. They cannot go from State to State because there have been rather stringent laws passed in certain States,- in nineteen out of the thirty-eight, I believe, - which make it impossible for a man to practise without a degree; but it is easy to get a degree in many States. A legitimate physician of the regular school, if he belongs to any institution like a county association, is not allowed to advertise in any way, or to have his name in the paper as being interviewed with regard to public health. This is the unwritten law. There is a man in New York who made an enormous reputation for curing rheumatism and gout. The members of the Stock Exchange flocked to him. He had his parlors in a tenement house district, where he showed a petition signed by the people in that neighborhood, begging him not to leave them. The street where this house stood would be filled with carriages. The secret of his success was that in every one of his prescriptions sulphate of morphia was combined, which made every one happy for the time being. In the end, however, the expected result occurred: the renown is now passing away, and in two more years he will not be heard from. Every physician in New York knew his methods, because his prescriptions filled the books of the apothecaries. I should not wonder if he made $75,000 a year; but there was no way of stopping him, — nothing that the profession could do to prevent it. Still, I do not think the “hopelessness” is as bad as Prof. Wayland puts it. Public opinion must change, and able physicians will be recog. nized. He says that educated men are not going to give up $25,000 or $30,000 a year to teach in medical schools. I think it is true, however, that the enthusiast, the man who wishes to