Page:Hospitals, medical science and public health.djvu/15

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11
AND PUBLIC HEALTH

his assistants and his classes, would be continually enlarged, and the attention of the pathologist as continually riveted upon those signals, criterions, contingencies, interdependencies, exceptions, eccentricities, lapses, glimpses, which in the laboratory no ingenuity can forecast or reproduce, but which are coy nature's stratagems. "Οὔτε λέγει, ὄυτε κρύπτει, ἀλλὰ σημαίνει."

And what is true of the hospital is no less true for private practice. It is not fair to the pathologist, it is not fair to the patient, in cases, let us say, of biochemical disorder, of vaccinal therapeutics, of obscure toxic processes, and so forth, to pick the brains of the pathologist at second hand. The pathologist should be summoned to take his proper part in consultation with the family physican, and any other consultant, all upon equal terms. So far as circumstances and the old customs of private practice permit, it is my endeavour to bring this about; and, if expenses must be kept down, the medical consultant may be permitted to resign a few of his visits to the pathologist, who, by the way, is anything but a rapacious person.


Out-Patients.

Of the departments of a great hospital that which is most rudimentary, rudimentary almost to chaos; that in which the evil, which in this world attends upon the good, survives most manifestly, and is perhaps increasing; that which on many grounds is open to the censorious comments of medical men outside its walls and of the public, and indeed of the hospital staffs themselves, is the Out-patient Department. Physicians resent all that savours of quackery, at any rate in medicine; yet is there any custom more apt to engender and to foster quackery than to encourage mobs to wander round our halls for potions to be hugged to their bosoms as charms? In not a few cases, it is true, these herbs and salts have some virtue; but in how many are they not stock recipes, either wholly futile or at best impotent as auxiliaries against unwholesome habits and conditions of life which the physician, unable to ameliorate, gets weary of denouncing? Too soon he learns to say to himself, "Poor creatures, errant or sinful, God help them, I cannot; yet if pill or potion be a comfort to them, or a hope, by all means let them have it." And the quackery