Aortic Arch Manifestations-Thos. McCrae, Associate Professor of Medicine, Johns Hopkins, Baltimore. Muscle Manifestations-Harry C. Buswell, Associate Pro- Visceral Manifestations-J. H. Bauer, Hamilton. Evening Smoking concert at the Yacht Club, Burlington Beach. WEDNESDAY, MAY 27TH. Surgical Section-9 A. M. J. P. Morton, Hamilton-(Title to be sent.) G. T. McKeough, Chatham-"Mechanical Ileus, Operation, Recovery, Remarks on the Treatment." W. E. Olmsted, Niagara Falls-"Ulcer of the Stomach." Medical Section G. S. Glassco, Hamilton-(Title to be sent.) J. R. Stanley, St. Mary's-(Title to be sent.) R. J. Dwyer, Toronto-(Title to be sent.) D. Dunton, Paris-(Title to be sent.) F. Fenton, Toronto-(Title to be sent.) George Hodge, London-"The Treatment of Pneumonia." K. C. McIlwraith, Toronto-(Title to be sent.) R. Ferguson, London-(Title to be sent.) General Session-Afternoon. Address in Surgery-Charles L. Scudder, Surgeon to the G. E. Armstrong, Professor of Surgery, McGill University. Evening Session-Dinner at the Royal Hotel. Surgical Section THURSDAY, MAY 28TH. H. Sinclair, Walkerton-(Title to be sent.) Medical Section D. King Smith, Toronto-(Title to be sent.) J. T. Fotheringham, Toronto "Malignant Endocarditis." Campbell Howard, Assistant in Medicine, McGill University. York-"Rheumatism." General Session-Afternoon. Address in Medicine-Charles G. Stockton, Professor of Medicine, University of Buffalo. L. G. Cole, Radiographer to the Roosevelt Hospital, New York— Illustrated Lecture. C. K. Clarke, Toronto "Psychiatry in Relation to General Medicine." Published on the 15th of each month. Address all Communications and make all Cheques, Post Office Orders and Postal Notes payable to the Publisher, GEORGE ELLIOTT, 203 Beverley St., Toronto, Canada VOL. XXX. TORONTO, MARCH, 1908. No. 3. COMMENT FROM MONTH TO MONTH. The Re-organization of the Visiting Staff of the Toronto General Hospital article, the responsibility for which rests alone on the managing editor, as the editors or the associate editor knew nothing about it whatever, was not intended to give offence to anyone. The language used has been characterized as altogether too strenuous. The article desired to set forth that the Hospital Board had been unfair to some who had served it faithfully. It said nothing about the capability of the new staff; it was not intended to. It condemned wire-pulling. As it has been intimated there was none, then it was an error to refer to wire-pulling in the same article. It cannot be offensive to state wire-pulling is distasteful; nor to assert that, in the opinion of the writer of the article, every doctor licensed to practice should not be debarred from doing same. in hospitals receiving governmental and municipal grants. A Commission on Tuberculosis in Ontario is advocated by Dr. Forbes Godfrey, M. L. A. According to Dr. Godfrey a commission of three persons should be appointed to investigate the conditions in the Province and report as to the advisability of establishing a Provincial Sanatorium. We fully agree with him as to the need of such commission. In fact four years ago in March, 1904, we advocated this commission, pointing out at that time. "That matters in connection with the prevention and treatment of tuberculosis are practically in chaos in this Province of Ontario." From the newspaper reports of the recent meeting of the Ontario Board of Health, we learn that there have been 36,700 deaths in Ontario from tuberculosis in the last decade, set out as follows: 1897, 3,164; 1898, 3,291; 1899, 3,405; 1900, 3,484; 1901, 3,284; 1902, 2,694; 1903, 2,723; 1904, 2,877; 1905, 2,667; 1906, 2,911. These statistics show that in the last pentad there has been a satisfactory and encouraging decrease in the death roll. This must be due to the education of the public and the good work being done by existing sanatoria. But why so single out tuberculosis? What about cancer, pneumonia, la grippe, and all preventable diseases? Why concentrate fighting forces all along one line? Unless, indeed, it may be expert tactics to do away with one disease and then tackle another, and so on until all are done to death. The strange thing about fighting preventable diseases is that the most strenuous work is done by the doctor. The public cannot see eye to eye with his disinterestedness. The doctors or the medical associations or the medical press, point out the way long before the laity lose their "lackadaisy." The remedy to medical men seems quite clear. There should be a directing hand in fighting all sorts of diseases, a hand untrammelled by political influences of any sort or description. In fact, in the government of every province there should be a Minister of Public Health, just as well as there is a Minister of Agriculture or of Finance. Surely the former takes precedence over the latter. It would in individual life. Why not in state life? How can any government better concern itself than by first looking after and conserving the health of its constituent parts? For without a strong, virile, robust manhood, we cannot expect much towards nationality. The Establishment of a Department of Public Health has been debated in the Canadian House of Commons; every doctor in the House favored the project. In connection with this very vital and very important question, we published last month a strong article on "The Appointment of Ministers of Public Health" from the pen of Dr. Bushnell, of England, who has made a special study of the entire subject. Year after year the Canadian Medical Association has urged upon the Federal Government the urgency and necessity of this step, but although that association voices the sentiment of the Canadian profession, nothing has come of it. It is well known that public health matters in Ottawa are scattered over five or six departments of the public service. How business men who are always preening themselves upon their superb knowledge of doing business, or how parliamentarians, many of whom are almost statesmen, can drift along in such a very important matter of business and executive proficiency, staggers the susceptibility of us poor professional men, who are so often sneered at for being such poor business men. What have we got to do with business? The fact is we are professional men and wish to be professional men, while business men throw some small sneers now and again at us for not being proficient at both. If professional men of the medical stripe had all to do with this question of a Department of Health, it would be mighty soon decided. And so with Hospital Management if these institutions so far as the medical aspects of same go, were handed over entirely to the care of medical men, and so-called business men stepped down and out, and stayed out, hospitals would be far better managed than they are at the present day. Will somebody tell us why hospital boards should choose the poor man's physician for him? Flatly, is not that the right of every man to do for himself? We heartily concur in the statement of The Canada Lancet that every doctor should follow his patient into whatever hospital he goes, irrespective of his being a private, a semi-private, or a public or semi-public patient. When the patient is paying per diem what the hospital demands of him, he has the right to have the physician he wants to attend him. Very few will deny this. But there is still another class of patient who is admitted on a city order. His hospital maintenance is paid for by the municipality. All physicians as other citizens contribute to that patient's maintenance. It is said that it is right that some member of the "staff" should attend this patient, as the hospital is responsible for him. We deny this point blank. The hospital or the "staff" or even an outside physician (if any such condition in any hospital exists), has no right whatever to treat a city order patient for nothing at all. It is the duty of the municipality, which can always raise money by taxes, to pay for the treatment of this class of patient, just as much as it is its duty to pay towards the maintenance account. Municipalities should have health officers or assistants to treat their patients in whatever hospital they send that patient to. |