“'On which side?' I asked him, for I could not be sure there was anything different on one side from what I saw on the other.
“'Under the left eye. I called it a pimple; the specialist called it acne. Now look at this photograph. It was taken after my acne had been three months under treatment. It shows a little more distinctly than in the first photograph, does n't it?'
“'I think it does,' I answered. 'It does n't seem to me that you gained a great deal by leaving your customary adviser for the specialist.'
“'Well,' my friend continued, 'following my wife's urgent counsel, I kept on, as I told you, for a whole year with my specialists, going from head to foot, and tapering off with a chiropodist. I got a deal of amusement out of their contrivances and experiments. Some of them lighted up my internal surfaces with electrical or other illuminating apparatus. Thermometers, dynamometers, exploring-tubes, little mirrors that went half-way down to my stomach, tuning-forks, ophthalmoscopes, percussion-hammers, single and double stethoscopes, speculums, sphygmometers,—such a battery of detective instruments I had never imagined. All useful, I don't doubt; but at the end of the year I began to question whether I should n't have done about as well to stick to my long tried practitioner. When the bills for 'professional services' came in, and the new carpet had to be given up, and the old bonnet trimmed over again, and the sealskin sack remained a vision, we both agreed, my wife and I, that we would try to get along without consulting specialists, except in such cases as our family physician considered to be beyond his skill.'”
The Counsellor's story of his friend's experiences seemed to please the young Doctor very much. It “stirred him up,” but in an agreeable way; for, as he said, he meant to devote himself to family practice, and not to adopt any limited class of cases as a specialty. I liked his views so well that I should have been ready to adopt them as my own, if they had been challenged.
The young Doctor discourses.
“I am very glad,” he said, “that we have a number of practitioners among us who confine themselves to the care of single organs and their functions. I want to be able to consult an oculist who has done nothing but attend to eyes long enough to know all that is known about their diseases and their treatment,—skilful enough to be trusted with the manipulation of that delicate and most precious organ. I want an aurist who knows all about the ear and what can be done for its disorders. The maladies of the larynx are very ticklish things to handle, and nobody should be trusted to go behind the epiglottis who has not the tactus eruditus. And so of certain other particular classes of complaints. A great city must have a limited number of experts, each a final authority, to be appealed to in cases where the family physician finds himself in doubt. There are operations which no surgeon should be willing to undertake unless he has paid a particular, if not an exclusive, attention to the cases demanding such operations. All this I willingly grant.
“But it must not be supposed that we can return to the methods of the old Egyptians—who, if my memory serves me correctly, had a special physician for every part of the body—without falling into certain errors and incurring certain liabilities.
“The specialist is much like other people engaged in lucrative business. He is apt to magnify his calling, to make much of any symptom which will bring a patient within range of his battery of remedies. I found a case in one of our medical journals, a couple of years ago, which illustrates what I mean. Dr. __________ of Philadelphia, had a female patient with a crooked nose,—deviated septum, if our young scholars like that better. She was suffering from what the doctor called reflex headache. She had been to an oculist, who found that the trouble was in her eyes. She went from him to a gynecologist, who considered her headache as owing to causes for which his specialty had the remedies. How many more specialists would have appropriated her, if she had gone the rounds of them all, I dare not guess; but you remember the old story of the siege, in which each artisan proposed means of defence which he himself was ready to furnish. Then a shoemaker said, 'Hang your walls with new boots.'
“Human nature is the same with medical specialists as it was with ancient cordwainers, and it is too possible that a hungry practitioner may be warped by his interest in fastening on a patient who, as he persuades himself, comes under his medical jurisdiction. The specialist has but one fang with which to seize and bold his prey, but that fang is a fearfully long and sharp canine. Being confined to a narrow field of observation and practice, he is apt to give much of his time to curious study, which may be magnifique, but is not exactly la guerre against the patient's malady. He divides and subdivides, and gets many varieties of diseases, in most respects similar. These he equips with new names, and thus we have those terrific nomenclatures which are enough to frighten the medical student, to say nothing of the sufferers staggering under this long catalogue of local infirmities. The 'old-fogy' doctor, who knows the family tendencies of his patient, who 'understands his constitution,' will often treat him better than the famous specialist, who sees him for the first time, and has to guess at many things 'the old doctor' knows from his previous experience with the same patient and the family to which he belongs.