practise, which it behooves us to clear away. A keen criticism could doubtless disclose much of ancient error and fetishism in our materia medica and therapeutics and our pathological conceptions of obscure diseases. The entire profession does not even yet willingly and unreservedly accept the scientific element in internal medicine. The necessity and duty of thoroughly scientific methods in surgical and obstetrical practise is generally appreciated; but the obligation for equally thorough and scientific diagnosis and treatment in internal medicine is not so generally recognized. On the contrary, there is rather prevalent a spirit of disparagement and deprecation of what are called scientific methods, and insinuations are frequently made that they are not practical or useful. This spirit possibly arises not so much from frank conviction as from indisposition to keep fully abreast of the rapid developments in medicine, and a latent jealousy of those more advanced. That scientific methods in medicine (aside from those purely academic) are unpractical and useless is diametrically contrary to the reality; since it is such methods alone that have gained, and are gaining, and can gain for medicine all the real efficiency that it possesses. It is to me inconceivable that any methods in rational medicine can be other than truly scientific in their essence; sectarians, and laymen, and quacks can practise non-scientific medicine, but not true physicians. Our patients are entitled to the best possible service available, whatever be the character of any procedure that may be of use; and nothing short of this best is good enough for either the patient or the conscientious practitioner.
If a trained medical profession has only just found enlightenment, it can not be expected that the great untrained public will yet have emerged from medieval darkness in matters medical. The general public at the present time is actuated by the identical speculative spirit that for ages and until recently exercised its blighting control over the medical profession. A realization of this fact explains much that now seems anomalous and vexatious, and points the way of future betterment.
In many quarters the attitude of the public toward the medical profession is one of misunderstanding, distrust and antagonism. Fads and sects, like homeopathy, osteopathy and christian science, have a large and influential following, including the most intelligent and respectable members of the community. The hold which these (to us) irrational beliefs have on the public seems amazing and exasperating; yet the profession has only recently been emancipated from systems of precisely the same character—too recently for the public yet to have followed. Our customary attitude toward sectarianism is one of ridicule and denunciation; an attitude which produces infinitesimal results. These popular beliefs are not the product of perversity or wickedness, but result from powerful tendencies in human nature—the proneness