mething like this line that the
greatest advance has been made in medical practice; I mean in the
direction of prevention. This involves, of course, the exclusion of the
evil, that is, of suppressing the causes that produce disease, as well as
in cultivating the resistant power of the human system. In sanitation,
diet, and exercise are the great fields of medical enterprise and
advance. I need not say that the physician who, in the case of those
under his charge, or who may possibly require his aid, contents himself
with waiting for developed disease, is like the soldier in a besieged
city who opens the gates and then attempts to repel the invader who has
effected a lodgment. I hope the time will come when the chief practice of
the physician will be, first, in oversight of the sanitary condition of
his neighborhood, and, next, in preventive attendance on people who think
they are well, and are all unconscious of the insidious approach of some
concealed malady.
Another great change in modern practice is specialization. Perhaps it has
not yet reached the delicate particularity of the practice in ancient
Egypt, where every minute part of the human economy had its exclusive
doctor. This is inevitable in a scientific age, and the result has been
on the whole an advance of knowledge, and improved treatment of specific
ailments. The danger is apparent. It is that of the moral specialist, who
has only one hobby and traces every human ill to strong liquor or
tobacco, or the corset, or taxation of personal property, or denial of
universal suffrage, or the eating of meat, or the want of the
centralization of nearly all initiative and interest and property in the
state. The tendency of the accomplished specialist in medicine is to
refer all physical trouble to the ill conduct of the organ he presides
over. He can often trace every disease to want of width in the nostrils,
to a defective eye, to a sensitive throat, to shut-up pores, to an
irritated stomach, to auricular defect. I suppose he is generally right,
but I have a perhaps natural fear that if I happened to consult an
amputationist about catarrh he would want to cut off my leg. I confess to
an affection for the old-fashioned, all-round country doctor, who took a
general view of his patient, knew his family, his constitution, all the
gossip about his mental or business troubles, his affairs of the heart,
disappointments in love, incompatibilities of temper, and treated the
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