THERE are many straw indications in recent years, of the medical world's scared realization of its waning supremacy over the minds of the masses. Occasionally an M.D., franker than the most, tells his colleagues—and such portion of the laity as read medical journals—that this popular defection from medical standards is due to existent abuses within their own ranks, and warns them if they would recover their lost prestige, that it will be necessary for the medical profession to clean its own house and set it in order.

    Thus the Medical Journal and Record, New York, in an editorial leader (Nov. 19, 1924), says:

    "The doctor himself has in a measure forsaken the art of medicine for the science of medicine, perhaps for the business of medicine; frequently the sick man ceases to be a patient and becomes a case—a vehicle for an interesting disease. . . . The great god Gouge is slaying his worshipers, the public is getting doctor shy."

    Edward J. Beardsley, M.D., of Philadelphia, in the "Oration in Medicine," delivered at the 158th annual meeting of the Medical Society of New Jersey, in June 1924, and published in the Journal of that Society in September, 1924, said:

    "For the past four years I have made it a part of the medical history of all patients to inquire what their experience had been with the cults, and what their reasons for consulting these instead of members of the medical profession. The results of these systematic inquiries have given me as a medical teacher and practitioner, much food for serious thought, and have been not a little disquieting. It may be well to place briefly before you the results of this inquiry.

    "Of the patients seen at my office during the past four years, 34 per cent had within three months of their coming to me, been under the care of agents of one or more of the numerous cults. During the same period, of the patients examined by me in a free dispensary connected with one of the larger Philadelphia hospitals, 26 per cent stated they had been receiving treatment through pseudo-medical agencies. It seems worth while to learn if possible, the reason for this wholesale desertion of the medical profession.

    "A careful inquiry into the chief causes of dissatisfaction, revealed that 86 per cent of the private patients and 97 per cent of dispensary patients complained that they had not been examined by their doctor, or examined so superficially that the patient considered the examination worthless. It was found that only 9 per cent of the private patients, and none at all of the dispensary patients had been completely examined by the physicians whom they had consulted.

    "The next cause for dissatisfaction—not as frankly stated, but met with too commonly to be ignored—was that the patient was impressed that the physician was more interested in receiving a fee for his services than he was in rendering full value for the fee received. Another cause for dissatisfaction, was the expense and waste of medicine ordered at successive visits, and the complaint that the medicine ordered made the patient feel worse than before taking it. A final common cause for dissatisfaction, was the inability among patients to understand why there was such a difference of opinion among physicians regarding an uncomplicated illness."

    And Dr. Beardsley freely stated on that occasion, that "the most distressing feature of such criticism is, in too many cases, its justice. That it is unfair that the entire profession should be condemned because of the failure of certain members to live up to their obligations and opportunities, is obvious; but that there should be so much ground for just complaint against the medical profession, is most unfortunate. . . . There comes a time when unpleasant truths must be faced, in order that the necessity for change and improvement become known."

    Dr. Irvin Arthur, writing in the Journal of the Indiana State Medical Association, November, 1923, said: "It is generally conceded that the medical profession is losing its grip upon the people. . . . According to statistics, there are now in the United States one-fifth as many irregular healers as there are qualified physicians, and it is my opinion that these would not exist if they did not fill a kind of need. . . . The people of this country are demanding of the medical profession something more than shaking up test tubes and looking through microscopes," says Dr. Arthur. "The thing they demand most of all when they are sick, is service, and if they cannot get it from the medical profession they will get it somewhere else."

    It is the exceptional physician, however, who faces the situation as frankly as Dr. Beardsley and Dr. Arthur. The great majority, while recognizing the decline in medical power and popularity, are disposed to put the blame on the insidious encroachments of the marauding "Cults," and to advocate organized resistance to these.

    A few pointers in medical journals will indicate the extent of popular defection from the "regulars," upon their own admission.

    Dr. Eugene S. Browning, of Grand Rapids, Mich., in the Journal of the Michigan State Medical Society, August, 1923, stated that, "Over 40,000,000 American people have deserted physicians for the various cults, religions, and health associations with all kinds of pedigrees."

    Dr. E. C. Levy, Director of Public Welfare, at Richmond, Va., in an address published in the December, 1923, number of the American Journal of Public Health, declared that, "In spite of the fact that regular medical practice to-day is incomparably superior to what it has ever been, nevertheless there has never been a time when the people had less confidence in it."

    At its 1922 meeting, the Illinois Medical Society, impelled by a desire to get at the exact facts about the rumored discontent with Regular Medicine, employed a trained newspaper reporter to interview large numbers of people and find out from as many as possible, "What did you do the last time you were sick?" and wherever it could be done gracefully, "What led you to do that?" The result was published in the July, 1923, issue of the Illinois Medical Journal, and copied by the Literary Digest. From this article, entitled "The Laity's Idea of the Physician," we quote the following:

    "Replies were grouped under general heads from 5,719 persons in Chicago, and from 1,053 persons out of Chicago—a total of 6,772. From this total only 931—less than 14 per cent—had never dabbled in any cult or pseudo-science. Of the 931 with this perfect record, only 384—not quite 6 per cent—had no curiosity about any of said cults or quackery, and no intention of experimenting just a bit with them."

    The writer's deduction from these figures was that the very small showing of those with 100 per cent loyalty to the medical profession was due to the evil machinations of "the unscientific Cults," and called for drastic action on the part of the "regulars" in combating and suppressing quackery.

    A very significant windward straw in the medical perturbation over the inroads of the "Cults" was the organization in Boston in 1923 of a layman's society called first "The Friends of Medical Progress," and later named "The American Association for Medical Progress," which should serve as a lay auxiliary to the A. M., A. meeting and thwarting "the attack on the scientific method." This is the euphemistic phrase used to designate the efforts of anti-vaccinists and anti-vivisectionists in resisting the attacks of organized and compulsory State Medicine on the rights of the individual and the compassionate claims of dumb animals.

    Thus the new "Medical Progress" organization declares in its preamble, "Although the teaching of science has gone forward at an increasing rate in the past three or four decades, we find in this country to-day a large number of persons who represent a growing dissatisfaction with the scientific school of thought. In the matter of health and disease, more and more people seem to be going over to the side of the pseudo-scientist, the chiropractor, the naturopath, the anti-vivisectionist, the anti-vaccinationist and others."

    The reason for this perverse behavior on the part of the ailing public—according to the same authorities—is "the attack on the scientific method" by these "unscientific Cults" together with the failure of scientific men to realize the necessity of defending their purpose and method against such attacks. Medical scientists are much handicapped in making laymen understand the esoteric mysteries of medicine," we are informed, "because they don't speak the language of science."

    It seems, however, that these learned and scientific gentlemen, wrapped in professional dignity and foreign nomenclature, had been much disturbed by some facts brought out at an Anti-Vivisection Convention they had attended in Boston in 1921—facts of a nature which laymen could understand. The M.D.'s "realized the menace of the unopposed propaganda of these anti-medical societies," we are told, but what to do about it?

    Still held down by their dignity, by the foreign-language gag, and by their fear of being misunderstood, the perturbed scientists finally hit upon the expedient of organizing the remnants of their lay constituency into a propagandist buffer against the onslaught of "the Cults."

    Thus sprang into being "The Friends of Medical Progress," alias "The American Association for Medical Progress." Its medical organizers were not troubled apparently by the inconsistency of expecting their lay delegates to expound medical doctrines and theories to other laymen with greater clarity than the M.D.'s themselves had been able to do.

    A bit staggering also was the alarm note sounded by Dr. George F. Vincent, of Chautauqua fame, and president of the "Rockefeller Foundation," who in a ringing speech before the newly-baptized lay missionaries of "medical progress," said: "The world has been waiting for this society, and it must be backed to the limit, or the medical profession in this country will be swamped by the cults and societies ranged against it"

    Rather extraordinary, is it not, that the bulwarks of "Science" which have been 3,000 years in building, should go down like that before the onset of a handful of chiropractors and anti-vivisectionists? One of the most profound and brilliant among modern philosophical writers, Samuel Butler, says: "Unless a matter be true enough to withstand a good deal of misrepresentation" (a stronger word than contradiction), "its truth is not of a very robust order; and if it be crushed, its overthrow is chargeable to its own inherent weakness, rather than to the strength of its opponents." Champions of "medical science" might ponder this saying to some advantage.

    The quotations from medical sources herein cited, are sufficient to show, I think, that even if "the Cults" haven't "got the M.D.'s on the run"—as is being charged in some quarters—they have at least risen to the formidable and dignified role of opponents worthy of the medical steel. In succeeding chapters we will consider some of the weapons and fighting methods of the medical combatants.