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_):
"Prof. William Osier, the distinguished teacher of medicine, who was
taken from this country a few years ago to occupy the most important
medical chair in Great Britain, has shocked his profession repeatedly
by his pronouncements against the use of drugs and medicines of almost
every kind. Only a few days ago he made an address in which he
declared that even though most physicians will be deprived of their
livelihood, the time must soon come when sound hygienic advice for the
prevention of disease will take the place of the present system of
prescription and _pretense of cure_. The most able physicians agree
with him, even when they are not frank enough to express themselves to
the same effect."
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:
"The people think that with the X-ray the doctor can look right into
the body and examine any part or organ and tell just what is the
matter with it, when the fact is all that is ever seen is a lot of dim
shadows that even the expert often fails to understand or recognize."
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.