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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 patient, as the phrase is, for all he was worth, and gave him visible medicine out of good old saddle-bags–how much faith we used to have in those saddle-bags–and not a prescription in a dead language to be put up by a dead-head clerk who occasionally mistakes arsenic for carbonate of soda. I do not mean, however, to say there is no sense in the retention of the hieroglyphics which the doctors use to communicate their ideas to a druggist, for I had a prescription made in Hartford put up in Naples, and that could not have happened if it had been written in English. And I am not sure but the mysterious symbols have some effect on the patient.

The mention of the intimate knowledge of family and constitutional conditions possessed by the old-fashioned country doctor, whose main strength lay in this and in his common-sense, reminds me of another great advance in the modern practice, in the attempt to understand nature better by the scientific study of psychology and the occult relations of mind and body. It is in the study of temper, temperament, hereditary predispositions, that we may expect the most brilliant results in preventive medicine.

As a layman, I cannot but notice another great advance in the medical profession. It is not alone in it. It is rather expected that the lawyers will divide the oyster between them and leave the shell to the contestants. I suppose that doctors, almost without exception, give more of their time and skill in the way of charity than almost any other profession. But somebody must pay, and fees have increased with the general cost of living and dying. If fees continue to increase as they have done in the past ten years in the great cities, like New York, nobody not a millionaire can afford to be sick. The fees will soon be a prohibitive tax. I cannot say that this will be altogether an evil, for the cost of calling medical aid may force people to take better care of themselves. Still, the excessive charges are rather hard on people in moderate circumstances who are compelled to seek surgical aid. And here we touch one of the regrettable symptoms of the times, which is not by any means most conspicuous in the medical profession. I mean the tendency to subordinate the old notion of professional duty to the greed for money. The lawyers are almost universally accused of it; even the clergymen are often suspected of being influenced by it. The young man is apt to choose a profession on calculation of its profit. It will be a bad day for science and for the progress of the usefulness of the medical profession when the love of money in its practice becomes stronger than professional enthusiasm, than the noble ambition of distinction for advancing the science, and the devotion to human welfare.

I do not prophesy it. Rather I expect interest in humanity, love of science for itself, sympathy with suffering, self-sacrifice for others, to increase in the world, and be stronger in the end than sordid love of gain and the low ambition of rivalry in materialistic display. To this higher life the physician is called. I often wonder that there are so many men, brilliant men, able men, with so many talents for success in any calling, willing to devote their lives to a profession which demands so much self-sacrifice, so much hardship, so much contact with suffering, subject to the call of all the world at any hour of the day or night, involving so much personal risk, carrying so much heart-breaking responsibility, responded to by so much constant heroism, a heroism requiring the risk of life in a service the only glory of which is a good name and the approval of one’s conscience.

To the members of such a profession, in spite of their human infirmities and limitations and unworthy hangers-on, I bow with admiration and the respect which we feel for that which is best in this world.