THE EXPERT WITNESS AND PROPRIETARY MEDICINES.
The "Great Nerve Specialist"--The Professional Witness a Jonah--The
"Railway Spine"--Is it Lack of Fairness and Honesty or Lack of Skill
and Learning?--Destruction of Fine Herds of Cattle Without
Compensation--Koch's Dictum and Denial--Koch's Tuberculin--The Serum
Tribe--Stupendous Sale of Nostrums--Druggist's Arguments--Use of
Proprietary Medicines Stimulates Sale of Nostrums.
I wonder what the patrons of the sanitarium of the "great nerve
specialist" thought of his display of knowledge of the nervous system when
he was on the witness stand in a recent notorious case? A lawyer tangled
him up completely, and showed that the doctor had no accurate knowledge of
the anatomy of the nervous system. When asked the origin of the
all-important pneumogastric nerve, he _thought_ it originated in a certain
segment of the spinal cord! This noted "specialist" was made perfectly
contemptible, and the whole profession must have blushed in shame at the
spectacle presented. And that spectacle was not unnoticed by the
intelligent laity.
The professional witness has in most cases been a Jonah to the profession.
It is about as easy to get the kind of testimony you want from a
professional witness in a suit for damages for personal injuries as it is
to get a doctor's certificate to get out of working your poll-tax, or a
certificate of physical soundness to carry fraternal life insurance.
Let me recall the substance of a paper read a few years ago by perhaps the
greatest lawyer in Iowa (afterward governor of that State). He told of a
trial in which he had examined and cross-examined ten physicians. It was a
trial in which suit was brought to recover damages for personal injury, a
good illustration of the "railway spine." One physician testified that the
patient was afflicted with sclerosis of the spinal cord; another said it
was a plain case of congestion of the cord; another diagnosed degeneration
of the cord; yet another said it was a true combination of all the
conditions named by the first three. They all said there was atrophy of
the muscles of the left leg, and predicted that complete paralysis would
surely supervene.
On the other side five noted physicians testified as positively that
neither the spinal cord nor any nerve was injured; that there was no sign
of atrophy or loss of power in the leg; and they seemed to think the
disease afflicting the patient was due to a fixed desire to secure a
verdict for large damages from the railway company. One eminent specialist
made oath that the electrical test showed the partial reaction of
degeneration; another as famous challenged him to make the test again in
the presence of both. After it was made this second specialist went before
the jury and positively declared that there was no trace whatever of the
reaction of degeneration, and that the muscles responded to the current
precisely as healthy muscles should.
Then this eminent attorney adds: "If the instances of such diversity were
rare they might pass unnoticed, but they occur and re-occur as often as
physicians are called to the temple of justice for the expression of
opinions."
The lay mind imputes this clash of opinions either to lack of fairness and
honesty or lack of skill and learning. In either case the profession
suffers great injury in the estimation of those who should have for it
only the profoundest admiration and the most implicit faith. Again I ask,
Is it any wonder people have lost implicit faith when they read many
reports of similar cases rehashed in the various yellow journals put into
their hands?
Farmers submitted with all possible grace to the decrees of science when,
by the authority of such a great man as Koch, their fine herds of cattle
were condemned as breeders and disseminators of the great white plague and
destroyed without compensation. But how do you think these same farmers
feel when they read in yellow journals that Koch has changed his mind
about bovine and human tuberculosis being identical, and has serious
doubts about the one contracting in any way the disease of the other.
People read with renewed hope the glowing accounts of the wonderful
achievements of Dr. Koch in finding a destroyer for the germ of
consumption. Somehow time has slipped by since that renowned discovery,
with consumption still claiming its victims, and many physicians are
saying "Koch's great discovery is proving only a great disappointment."
Drugless therapy journals are continually pouring out the vials of their
wrath upon vaccination, antitoxin and all the serum tribe, and their
vituperation is even excelled by vindictive denunciations of the same
things by the individual boomer journals that flood the land.
Another bitter contention that is confusing some, and disgusting others,
is the acrimonious strife between users and non-users of proprietary
medicines. This usually develops into a sort of "rough house" affair, the
druggist mixing up as savagely as the doctors before the fight is
finished. I know nothing of the rights or wrongs of the case nor of the
merits or demerits of proprietary medicines, but I do know this, however:
The stupendous sale of nostrums that in 1907 represented a sum of money
sufficient to have provided every practitioner of medicine in the United
States with a two thousand dollar salary, has been helped by the use of
proprietary medicines. I am aware that my position is likely to be called
in question by many physicians. But they should hear druggists arguing
with people who hesitate about buying patent medicines because their
physicians tell them they should seldom take medicine unless prescribed by
a doctor. They would hear him say: "Your doctor gives you medicines that
are put up in quantities for him just as these patent medicines are put up
for us." He then produces literature and proves it--at least beyond the
refutation of the patient. Physicians would then realize, perhaps, how the
use of proprietary medicines stimulates the sale of nostrums.