Anonymous

WHY QUACKS FLOURISH.

American Public Generally Intelligent, but Densely Ignorant in Important Particulars—Cotton Mather and Witchcraft—A.B.’s, A.M.’s, M.D.’s and Ph.D.’s Espousing Christian Science, Chiropractics and Osteopathy—Gullibility of the College Bred—The Ignorant Suspicious of New Things—The Educated Man’s Creed—Dearth of Therapeutic Knowledge by the Laity—Is the Medical Profession to Blame?—Physicians’ Arguments Controvertible—Host of Incompetents Among the Regular Physicians—Report of Committee on Medical Colleges—The “Big Doctors”—Doc Booze—The “Leading Doctor”—Osler’s Drug Nihilism—The X-Ray Graft.

In spite of the apparent prevalence of graft and the seemingly unprecedented dishonesty of those who serve the public, there are not wanting signs of the coming of better things. The eminent physician who spoke of the turbidity of therapeutics thought it was only that agitation that precedes crystallization and clarification that brings purity, and not greater pollution. May the seeming bad condition not be due in part also to the fact that a larger number of our American people are becoming intelligent enough to know the sham from the genuine, and to know when they are being imposed upon?

That our American people are generally intelligent we know; but that a people may be generally intelligent and yet densely ignorant in important particulars has been demonstrated in all ages, and in no age more clearly than in our own. We wonder how the great scholar, Cotton Mather, could have believed in and taught witchcraft. What shall we think, in this enlightened age, of judges pleading for the healing (?) virtues of Christian Science, or of college professors taking treatment from a Chiropractor or magnetic healer; or of the scores of A.B.s, A.M.s, M.D.s, Ph.D.s, who espouse Osteopathy and use the powers of their supposedly superior intellect in its propagation?

We can only come to this conclusion: The college education of to-day does not necessarily make one proof against graft. In fact, it seems that when it comes to belief in “new scientific discoveries,” the educated are even more easily imposed upon than the ignorant. The ignorant man is apt to be suspicious of new things, especially things that are supposed to require scientific knowledge to comprehend. On the other hand, the man who prides himself on his learning is sure he can take care of himself, and often thinks it a proof of his superior intelligence to be one of the charter members of every scientific fad that is sprung on the people by some college professor who is striving for a medal for work done in original research.

Whatever the reason may be, the fact remains that frauds and grafts are perpetrated upon educated people to-day. In the preceding chapter I tried to tell in a general way what some of the grafts are, and something of the social conditions that help to produce the grafters. I shall now give some of the reasons why shysters find so many easy victims for their grafts.

When it comes to grafting in connection with therapeutics, the layman’s educational armor, which affords him protection against most forms of graft in business, seems utterly useless. True, it affords protection against the more vulgar nostrum grafting that claims its millions of victims among the masses; but when the educated man meets the “new discovery,” “new method” grafter he bares his bosom and welcomes him as a friend and fellow-scientist. It is the educated man’s creed to-day to accept everything that comes to him in the name of science.

The average educated man knows nothing whatever of the theory and modus operandi of therapeutics. He is perhaps possessed of some knowledge of everything on the earth, in the heaven above, and in the waters beneath. He is, however, densely ignorant of one of the most important things of all—therapeutics—the matter of possessing an intelligent conception of what are rational and competent means of caring for his body when it is attacked by disease. A man who writes A.M., D.D., or LL.D. after his name will send for a physician of “any old school,” and put his life or the life of a member of his family into his hands with no intelligent idea whatever as to whether the right thing is being done to save that life.Is this ignorance of therapeutics on the part of the otherwise educated the result of a studied policy of physicians to mystify the public and keep their theories from the laity? I don’t know. Such accusations are often made. I read in a medical magazine recently a question the editor put to his patrons. He told them he had returned money sent by a layman for a year’s subscription to his journal, and asked if such action met their approval. If the majority of the physicians who read his journal do approve his action, their motives may be based on considerations that are for the public good, for aught I know, but as a representative layman I see much more to commend in the attitude of the editor of the Journal of the A. M. A. on the question of admitting the public to the confidence of the physician. As I have quoted before, he says: “The time has passed when we can wrap ourselves in a cloak of professional dignity and assume an attitude of infallibility toward the public.” Such sentiment freely expressed would, I believe, soon change the attitude of the laity toward physicians from one which is either suspicion or open hostility to one of respect and sympathy.

The argument has been made by physicians that it would not do for the public to read all their discussions and descriptions of diseases, as their imagination would reproduce all the symptoms in themselves. Others have urged that it will not do to let the public read professional literature, for they might draw conclusions from the varied opinions they read that would not be for the good of the profession. Both arguments remind one of the arguments parents make as an excuse for not teaching their children the mysteries of reproduction. They did not want to put thoughts into the minds of their children that might do them harm. At the same time they should know that the thoughts would be, and were being, put into their children’s minds from the most harmful and corrupting sources.

So in therapeutics. Are not all symptoms of disease put before the people anyway, and from the worst possible sources? If medical men do not know this, let them read some of the ads. in the Grafter’s Herald. And are the contradictions and inconsistencies in discussions in medical journals kept from the public? If medical men think so, let them read the Osteopathic and “independent” journals. The public knows too much already, considering the sources from which the knowledge comes. Since people will be informed, why not let them get information that is authentic?

Before I studied the literature of leading medical journals I believed that the biggest and brainiest physicians were in favor of fair and frank dealing with the public. I had learned this much from observation and contact with medical men. After a careful study of the organ of the American Medical Association my respect for that organization is greatly increased by finding expressions in numbers of articles which show that my opinion was correct. In spite of all the vituperation that is heaped upon it, and in spite of the narrowness of individual members, the American Medical Association does seem to exist for the good of humanity. The strongest recommendation I have found for it lies in the character of the schools and individuals who are most bitter against it. It is usually complimentary to a man to have rascals array themselves against him.

There are many able men among physicians who feel keenly their limitations, when they have done their best, and this class would gladly have their patients understand the limitations as well as the powers of the physician. In sorrow and disgust sometimes the conscientious physician realizes that he is handicapped in his work to either prevent or cure disease, because he has to work with people who have wrong notions of his power and of the potency of agencies he employs. With shame he must acknowledge that the people hold such erroneous ideas of medicine, not because of general ignorance, but because they have been intentionally taught them by the army of quacks outside and the host of grafters and incompetents inside the regular medical profession.

Incompetent physicians, to succeed financially (and that is the only idea of success incompetents are capable of appreciating), must practice as shysters. They fully understand how necessary it is to the successful working of their grafts to keep the people in ignorance of what a physician may legitimately and conscientiously do.

Our medical brethren who preach the “all but holy” doctrine, and want to maintain the “attitude of infallibility toward the public,” will disagree with me about there being “a host” of incompetents in the regular school of medical practice. I shall not ask that they take the possibly biased opinion of an ex-Osteopath, but refer them to the report of the committee appointed by the American Medical Association to examine the medical colleges of the United States as to their ability to make competent physicians. “One-half of all the medical schools of our country are utterly unfit to turn out properly qualified physicians, and many of them are so dominated by commercialism that they are but little better than diploma mills”! That’s what the committee said.

It has been argued that the capable physician need not fear the incompetent pretender, for, like dregs, he must “settle to the bottom” and find his place. This might be true if the people had correct notions of the true theory of therapeutics. As it is, the scholarly, competent physician knows (and intelligent laymen often know) that the pretenders too often are the fellows who get the reputations of being the “big doctors.” Why? I think mainly because, being ignorant, they practice largely as quacks, and by curing (?) all kinds of dangerous (on their own diagnosis) diseases quickly, “breaking up” this and “aborting” that unbreakable and unabortable disease (by “hot air” treatment mainly), they place the whole system upon such a basis of quackery that the deluded masses often pronounce the best equipped and most conscientious physician a “poor doctor,” because he will not pretend to do all that the wind-jamming grafter claims he has done and can do.Here is a case in point which I know to be true. The farce began some years ago in a small college in Oregon. A big, awkward, harmless-looking fellow came to the college one fall and entered the preparatory department. At the end of the year, after he had failed in every examination and shown conclusively that he had no capacity to learn anything, he was told that it was a waste of time for him to go to school, and they could not admit him for another year. Was he squelched? Not he. The fires of ambition yet burned in his breast, and the next year he turned up at a medical college. I presume it had the same high educational requirements for admission that some other medical colleges have, and enforced them in about the same way. At any rate he met the requirements ($$$), and pursued his medical researches with bright visions of being a doctor to lure him on. But his inability to learn anything manifested itself again, and, presumably, his money gave out. At any rate he was sent away without a diploma. Still the fire of ambition was not extinguished in his manly bosom. Regulations were not strict in those days, so he went to a small town, wore fine clothes, a silk hat and a pompous air, and—within a short time was being called for forty miles around to “counsel little doctors” in their desperate cases. Such cases are all too common, as honest physicians know.

How humiliating to the conscientiously equipped doctor to hear people say of a man who never had more brains than he needed, and had hopelessly muddled what he had by using his own dope and stimulants: “I tell you Doc Booze is the best doctor in town yet when he’s half sober!” Strange, isn’t it, that in many communities people have an idea that an inclination on the part of a physician toward whisky or dope indicates some peculiar mental fitness for a doctor? “Poor fellow, he formed the habit of taking stimulants to keep up when he had to go night and day during the big typhoid epidemic, you know.” For what per cent. of cases of medical dipsomaniacs this constitutes a stock excuse, only medical men know. As an Osteopathic physician I was never rushed so that I felt the necessity for “keeping up on stimulants.” If I had been, to be consistent, I should have had to stimulate (?) mechanically, of course.

Not only do shysters and pretenders abuse the confidence of the masses in matters of diagnosis and medication, but of late years they are working another species of graft that is beginning to react against the profession. This graft consists in the over-use of therapeutic appliances that are all right in their place when legitimately used.

By what standard is the physician judged by the people who enter his office? It used to be the display of medical literature. Sometimes some of it was pseudo-medical literature. Did you ever know a shyster to pad his library with Congressional reports? I have. The literature used to be conspicuously placed in the waiting-room, with a ponderous volume lying open on the desk.Have you a “leading doctor” in your town? Often he is not only in the lead but has flagged all the others at the quarter post—put them all into the “has been” class. What an elegant office he has! Plush rugs and luxurious couches in the waiting-room. Double doors into the private and operating-rooms, left open when not in actual use to give impressive glimpses of glass cases filled with glittering instruments, any one of which would give the lie to Solomon’s declaration that “there is nothing new under the sun.” An X-ray machine fills a conspicuous corner. In the same room are tanks, tubes, inhalers, hot-air appliances, vibrators, etc. One full side of the room is filled with shelves that groan under a load of the medicines he “keeps and dispenses.” What are all of these hundreds of bottles for if it is true, as many of our greatest physicians say, that a comparatively few people are benefited by drugs? These numerous bottles may contain placebos. I do not know as to that, but I do know something of the impression such a display makes on the mind of an intelligent layman. The query in his mind is how much of that entire display is for its legitimate effect on the minds of the patients, and how much of it is to impress the people with the powers of this physician, with his “wonderful equipment” to cope with all manner of disease?

If there is any doubt in the minds of physicians that laymen do know and think well over the sayings of drug nihilists, let them talk with intelligent people and hear them quote from the editorial page of a great daily such sentiments as this (from the Chicago Record-Herald):

Medical men need not think, either, that the people who happened to read the editorial pages referred to are the only ones who know of that declaration from Osier. Osteopathic journals, Christian Science journals, health culture journals, and all the riff-raff of journals published as individual boosters, are ever on the watch for just such things, and when they find them they “roll them under their tongue as sweet morsels.” They chew them, as Carleton says, with “the cud of fancy,” and hand them along as latest news to tens of thousands of people who are quick to believe them.

Going back to the physician who has the well-equipped office, is he a grafter in any sense? I shall not give my opinion. Perhaps every thing he has in the office is legitimate. In the opinion of the masses of that community he is the greatest doctor that ever prescribed a pill or purloined an appendix. Taking the word of the physicians whom he has put into the “has been” class for it, he is the greatest fake that ever fooled the people. Most of those outclassed doctors will talk at any time, in any place, to any one, of the pretensions of this type of physician. They will tell how he dazzles the people with his display of apparatus “kept for show;” how he diagnoses malarial fever as typhoid, and thus gets the reputation of curing a larger per cent. of typhoid than any other doctor in town; how he gets the reputation of being a big surgeon by cutting out healthy ovaries and appendices, and how he assists with his knife women who do not desire Rooseveltian families. They point to the number of appendectomies he has performed, and recall how rare such cases were before his advent, and yet how few people died with appendicitis. Is it to be wondered that intelligent laymen sometimes lose faith in and respect for the profession of medicine and surgery?

To show that people may be imposed upon by illegitimate use of legitimate agencies I call attention to an article published recently in the Iowa Health Bulletin. The Iowa Medical Board is winning admiration from many by conducting a campaign to educate the people of the State in matters pertaining to hygienic living. In line with this work they published an article to correct the erroneous idea the laity have of the X-ray. They say:

Why do the people have such erroneous conceptions of the X-ray? Is it accidental, or the result of their innate stupidity? Certainly it is not. The people have just such conceptions of the X-ray as they receive from the faker who uses it as he uses his opiates and stimulants—to get an effect and give the people wrong ideas of his power.

A lady of a small town who was far advanced in consumption was taken to a city to be examined by a “big doctor” who possessed an X-ray. He “examined” her thoroughly by the aid of the penetrating light made by his machine, and sent them home delighted with the assurance that his wonderful instrument revealed no tuberculosis. He assured her that if she would avail herself of his superior skill she might yet be restored to health. She died within a year from the ravages of tuberculosis.

A boy of four had an aggravated attack of bronchitis. His symptoms were such that his parents thought some object might have lodged in his trachea. A noted surgeon who had come one hundred miles from a hospital to see another case was consulted. He told the parents that the boy had sucked something down his windpipe, and advised them to bring him to the hospital for an operation. They did so, and a $100 incision was made after the X-ray had located (?) an object lodged at the bifurcation of the trachea. The knife found nothing, however, and the boy still had his bronchitis, and the parents had their hospital and surgeon’s bills, and, incidentally, their faith in the X-ray somewhat shattered.

The X-rays, Finsen rays, electric light and sunlight have their place in therapy. Informed people do not doubt their efficacy. However, the history of the use of these agents is a common one. A scientist, after possibly a lifetime of research, develops a new therapeutic agent or a new application of some old agent. He gives his findings to the world. Immediately a lot of half-baked professional men seize upon it, more with the object of self-laudation and advertisement than in a true scientific spirit. Serious study in the application of the new agent is not thought of. The object is rather to have the reputation of being an up-to-snuff man. The results obtained are not what the originator claimed, which is not to be wondered at. The abuse of the remedy leads to abuse of the originator, which is entirely unfair to both.

This state of affairs has grown so bad that scientists now are beginning to restrict the application of their discoveries to their own pupils. A Berlin savant, assistant to Koch, has developed the use of tuberculin to such a point as to make it one of the most valuable remedies in tuberculosis. It is manufactured under his personal supervision, and sold only to such physicians as will study in his laboratory and show themselves competent to grasp the principles involved.