Vol. 60, 1909 - University of North Carolina at Chapel Hill

146
THE CHARLOTTE MEDICAL JOURNAL.
and helpful, and not dogmatic, nor deroga- This is especially true of surgical results,
tory. for it is imt sufficient, nor, in fact, is it war-
The sole purpose is to aid the profession ranted, that a case be simply determined to
as a whole, in the proper extension and de- be mainly surgical, to be operated upon,
velopment of medical and surgical science Much more is necessary; for while it is
as practiced today. usually easy, for instance, to differentiate
In former days, the science of medicine the organically diseased from the nervously
embraced the science of the practice of medi- diseased, yet it is, in my experience, quite
cine as well as that of the practice of sur- another matter to differentiate the organicgery,
but in the advancement of that science ally diseased patient, who, because of this
in recent years, it appears to me that, un- condition, becomes nervously upset, from
fortunately, there has not been that close the neurotic individual who becomes orunion,
that intimate sympathy and co-oper- ganically diseased, and still all these facation
between the practitioners of the two tors are of most vital importance, and rebranches
of the profession that are for the quire the best thought and experience of
best interests of the development of the both physician and surgeon acting conscience
of medicine in toto, and for the pa- jointly, and in perfect imion.
tients resultantly. This harmonious cooperation would
In their enthusiastic endeavors to obtain throw a much-welcomed light on the postbrilliant
results, both medical and surgical operative statistics of the surgeon's long
practitioners have been more or less un- list of tabulated statistics of abdominal
mindful of obligation to their patients' cases of such and such a disease with a
rights, and each has acted more or less in- given mortality, which are now well-nigh
dividually and separately. valueless, and show us more clearly the re-
As a result of this competition, so to mote, as v.ell as the immediate effects obspeak,
the surgeon has achieved the most tained. It would also, as some writer has
substantial standing for his branch of the said, probably light up that twilight zone
profession, and by his audacity, as well as between the so-called organic and funcby
his skill, he has magnified his branch of tional affections, embracing the neurasthe
science to the temporary disadvantage thenic class of disorders, as well as illumof
his co-worker in the field of medicine, ine the Stygian darkness of that purely
and by degrees, modern medicine and sur- neurotic zone, in which neurologist, phygery
have become estranged, and appar- sician and surgeon often grope aimlessly,
ently divorced. helplessly and hopelessly.
This would be eminently proper if all In the next place, in regard to the quali-^
cases of disease could be separated into fications of physicians and surgeons, there: i
only two classes, namely, medical and sur- are distinctively two classes, the agnostic^V
gical, and, further, especially if all sur- and the diagnostics. .
geons, as well as physicians, could be de- The agnostic physician is the one who i
nominated as wholly capable and elEcient, reveals his knowledge, or the lack of it .
but this classification cannot be justly rather, by drugs, dopes and demeanor. He i
claimed, nor approved by competent judges, looks wise, drugs every symptom, and doses i
In regard to the first proposition, the every patient. This type is ea.sily recognizclassification
of diseases, it is important in able.
order to properly treat a case, whether med- The agnostic surgeon is the operating i
ical or surgical, and especially if surgical, surgeon, who operates first, last, and all
not only to consider the symptomatic part the time. He no sooner discovers some deof
the equation in evidence at the time, but parture from the normal in structure, thaa i
also to estimate candidly the future possible he rushes to the rescue. His type is familiar, :
developmental features of each case, and to us all.
this is no easy task for the skilled physician The results of both of these classes of 1
or surgeon, much less the tyro in either practitioners are notable—they frequently i
branch of the science. score, but they more usually fail.
And yet this is done every day, and the On the other hand, the diagnostic phy- j
patient mercilessly relegated to the one or sician, just as the diagnostic surgeon, ap- I
the other, acting separately and independ- proaches each case with caution and care, \
ently, just as the case is determined to be calling to his aid every facility furnished
one either of surgery or medicine. by his skill and experience, both in prac- i
The results are often obvious, for while a tice and in the laboratory,
symptomatic cure in medical cases, or an But just here, to my mind, comes the :
anatomical cure in surgical cases may be fatal error to the patient and the profession
secured temporarily, yet a disability fre- alike; for, while they work enthusiastically
quently remains which vitiates the most and scientifically, still they work single- ;
successful life-saving result. handed and unaided. i
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