Delaware State journal and statesman., 1867-09-13
nj EDIUAL.


valuable, doubtless, to the Profession, and
makes suggestions concerning the proper
classification of the several branches OF
study that would, il carried out in their
practical relations contribute more largely
to the success of the Faculty in the treat
ment OF diseases than it has yet accomplish
cd. To make this point properly under
stood by our readers, we give the following
extract from the address:
''Let us instance, for example, the neces-
sAry diagnosis of an obscure disease OF the
lungs or heart: many distinguished practi-
toner, who may be an admirable therapeu-
tist, is deficient either in the extended OPP
portuniues for pOst-mortem examinations, or
that accurate, il not musical ear, which are
both essential TO the accomplished stethos
cOpist; while, on the other hand, the very
few whose positions in great hospitals and
capitals, together with their peculiar natural
endowments, should entltle them To eminence
in the exploration OF affections of the chest,
are sometimes singularly deficient in thora-
peutical ability. In this case the exclusive
specialst-M. d. though he be-is rather
| naturalist than physician; and, should he
attempt though properly armed with tho
diplomas of many learned institutions, to
advertise himself as peculiarly devoted to
the treatment OF diseases of the lungs and
heat, his course would be clearly empirical.
AS well might the mere tuner Of piano, on
that plea alone, claim professional fellowship
with a Haydn or Handel. But are we
warranted on this account, in prohibiting
him from making known and useful his PEE
cuiar and really important powers, through
the medical journals and within the pale OF
the prolessiong Should we refuse to the
patient the advantage of his assistance, by
| declining consultation with him-not indeed
to share the responsibility of the treatment
for which he is untitled, but merely to per-
feet the diagnosis and aid in detecting the
physical changes in the progress of the
diseases If he be worthy of social respect,
as an honorable man, he will go no farther;
if not so worthy, he is ostracized on other
grounds than his devotion TO a specially.
Such are the endless varieties OF sympathies
which complicaie all morbid actions of the
more important viscera, that even partial
ly exclusive attention TO the peculiar alfec-
ton TO either of these organs, II we except
perhaps The uterine and urinary apparatus
and the brain, renders the practitioner unfit
for the treatment oil any; and he who an
nounces publicly that he claims superior
practical skill in diseases OF the lungs, the
liver, the stomach, or the bowels, proclaims
either his ignorance or his venality, and
should lie declared "hors de profession" at
once and without reserve.
"Butthe case is very different with diseases
of the eye, ear and skin; lor, while here,
also, familiarity with morbid action in
general is absolutely necessary to the proper
treatment-as il ie even in the practice of
the most isolated departments of mechanical
surgery and obstetrics-there is often re.
quisite an extent of observation on the
changes of structure in the organ specially
affected, and a practical adroitness In the
employment OF delicate and peculiar instru-
ments IN the diagnosis very seldom attain.
able by the general practitioner even in the
denscsL centres OF population, and utterly
beyond the reach OF that large majority ol
our brethren whose allotted spheres of use.
luness are confined to sparse communities
Indeed, il might be said without any outrage
upon truth, that in some directions the de-
partment Of the specialist and practitioner
At large are so widely separated, that great
emnence in either implies a corresponding
deficiency in the other; while both contri
, butte essentially to the perfection of the arI
of healing.
"The progress OF science, then, and not the
S action OF the profession, has effected divi
a sion Of labor in medicine, and we must NEE
. the inevitable consequences as VIZ may TIL,
application of the microscope in the develop
= mGnt Of the structure of tissues, and that o
the pholhalmoscope, the laryngOscope, ant
other surgical contrivances in the elucidatioI
OF morbtic conditions previously concealed
together with the modern discoveries ant
4 inventions IN chemistry and physics, hay,
il 40 enlarged our means of diagnosis, and 8,
!, changed our therapeutical treatment of
= multitude of ailments, that their frequen
u employment has become absolutely indis
u nensable. The use of these instruments can
e not become universal. The cost or thei
ia procurement, and the haOitual skill requiret
- in their application, forbid it.
= "Wlth the vast advantage derived from
l. these improvements, and tho speciaties il
ri medicine to which they have given rise, W
d, have suffered most grievously "in honor an,
II responsibility" through the unworthy con
II duct of some who have seized upon them a
s. a means of winning undeserved reputation
W with public incapable OF detecting the de
ception. Since, then, we cannot condemn
but are honestly bound TO encourage certai
II speeialtes in medicine, are we not bound i
:! selfdeiepce, aud in furtherance of the object
u of this Association, TO endeavoT to point ou
the means OF regulating themy This quel
f. tion must be answered, if not now, then q
in least at no distant day. We should not diI
courage the tyrO who is disposed to deyot
unusual attention to particular class
, diseases, provided he does not neglect tn
~ general studies which are essential to III
I'd comprehension of the nature and treatmen
/. of all disease We should not censurs hi
,s by whom the regular course of the prOfel
sion has been pursued for years under favOl
~ allie circumstances, if he see fit to retire ffoi
the general practice, to devote himself eve
exclusively to PARTICULAR branch, in whic
le he has enjoyed unusual advantages for az
IL quring skill; provided only that he bear
IN properly in mind the rapidity with whic
-, tact in tracing tho primary causes of locl
- discaseB, and determining the treatment
Id It's consequent complications, is lost In lh
le absence OF continual observation, and n
solves never 10 neglect the aid of his less @,
elusive brethren, when the interest of hi
ID patient properly demands it. But when th
young graduate, fresh from the field of hi
no elementary stpdies makes haste to lay claii
to to distinction IN the practice of any OF th
as modern specialtles, after having passed, pc
m haps, a few months in some special hospita
, lis presumption, though not unnatural I
T. youth, must be viewed by his. elders as d.
ie cidedly unwisc. Though his aptitude in Ii
use Of some comparatively Hovel lnstrumeI
OF exploration or treatment may make hil
Or very valuable to his seniors in determining
n. an exact diagnosis, in the production OF locl
v nr general anRsthesia, or the application
a remedies 10 the interior of the larynx, etc
his almost exclusive devotion to the manag,
nc ment OF IL particular class OF diseases befOi
rs his knowledge of pathology is matgred, an
le made available by years Of general obserg
oa tlOn and experience, is dangerous to IL
- character of the profession, and still MOI
so to himself Are we not bound then, by
proper iraternal feeling and charity towarl
I'd aspiring genius, to bring to bear the fu
III weight of our moral influence IN discouragln
" this unfortunate preGoCity, though less
20 censure than In pity?