President's Address

BY W. C. CHAPMAN, M. D., TOLEDO

We have come this year to the fifty-eighth annual meeting of our Association, the first after the reorganization. So radical a change in methods of legislation and scientific procedure must seem strange, and perhaps distasteful to many, who, by long acquaintance with the old, have grown to believe that no improvements could be inaugurated by which the medical profession could be induced to take an advanced stand and so become more powerful for good in cur great commonwealth.

It had become an apparent, oft-discussed fact that there must be strong reason why, with seven thousand or more doctors eligible to membership, there should be less than one thousand names upon the roll of the Association, rarely half of that number attending the annual meetings, hence a change to overturn well-established regulations in any body of associated persons requires careful and long-continued investigation. The danger is that for want of such investigation prejudice may prevent the acceptance of not fully understood procedures. The adoption of the new order of things at Toledo was, in my opinion, a step forward. Time may, as it likely will, demonstrate necessity for amendment, but the whole will stand an everlasting monument to the committee of our parent society, the American Medical Association, which, after great labor, evolved a plan whereby all physicians of our land will eventually come together a harmonious whole. With considerable experience gained from personal observation, or learned from the councilors, I trust you will bear with me in my endeavor to show the difficulties encountered in pursuance of the work of reorganization, with the hope that I may assist in overcoming them. The purpose of this Association, as shown by Article II of our Constitution, "Shall be to federate and bring into one compact organization the entire medical profession of the

State of Ohio, and to unite with similar associations in other States to form the American Medical Association, with a view to the extension of medical knowledge, and to the advancement of medical science; to the elevation of the standard of medical education and to the enactment and enforcement of just medical laws; to the promotion of friendly intercourse among physicians and to the guarding and fostering of their material interest; and to the enlightenment and direction of public opinion in regard to the great problems of State medicine; so that the profession shall become more capable and honorable within itself, and more useful to the public in the prevention and cure of disease and in prolonging and adding comfort to life."

It does not seem possible that any one would oppose or indifferently consider such plain and persuasive statements of possibilities. Yet such is the case, evidenced by the discouraging attempts made by your councilors to organize local societies. In this age of organization it is necessary to combine all elements of strength that the whole be strengthened. No one can afford to hold himself aloof from his fellows. Interchange of thought and experience broadens and cultivates. It has been frequently urged that membership in medical societies profits nothing. What recompense is there for time and money expended in society work? These questions have been asked over and over again. As our medical societies have for the most part been constituted, they were rightfully asked. In view of the immense possibilities in the federated organization of the medical profession, the handful of doctors composing the societies have had little to encourage them in their endeavors to elevate and strengthen the entire profession, thereby benefiting themselves as well as the people.

It was with the desire to bring about new and better organization that a few enthusiastic and determined society workers, after many discouragements, were finally able to present to the American Medical Association a plan which was adopted, and sent to the States, that they might modify

their organic laws so as to conform to its requirements, and thus become auxiliary to the parent body. Eighteen State societies have already taken this step, and it is hoped that the rest will soon be added to the list.

Many individuals object to the new order of things, or, in fact, to anything which has for its object the bringing together of all, thus forming a compact whole. Without referring to the objections in detail, I will briefly present to you some of the advantages to be gained by closer companionship, thus hoping to overcome antagonism and prejudice.

It is a deplorable fact that at this time last year about half the counties had no medical societies. The doctors were scattered as "sheep without a shepherd." There was no way whereby any medical question, however important, could be brought to the attention of a body of the profession in many localities. The federation and compact organization of the entire medical profession would remedy this, and is made possible by several wise provisions of the new constitution not yet well understood. The foundation of all government is in the individual. Exactly so is the wise provision for the formation of the American Medical and State Association vested in the membership of the county society. The county society is the portal through which membership in either of the others can be gained. As such it judges of the qualifications of those who desire recognition as physicians. A favorable vote of admission at once makes such person a member of the State Association, with privilege, not compulsory, of uniting with the American Medical Association without further credentials. The result of this wise provision will be that the county society will become a power for good in every community. To remain outside the fold will demonstrate either incompetency or a desire to keep aloof from brother practicians. With nothing to add to, he refuses to take from the wealth of knowledge brought to the society meeting of his locality. I cannot understand such men. They are willing to stand back and not offer to assist in

attempts made by their brothers for a betterment of the profession; they are willing to receive the "gifts the gods give," whilst the active society workers must "bear the heat and the burden of the day." Efforts made to elevate the standard of medical education, or to procure the enactment and enforcement of just medical laws, must be strenuous and persistent if the desired result is to be obtained. For this reason, among so many others, we as an Association want your help; as a State organization an unbroken front must be presented, pushing forward with steady tread to a decisive victory. Men do not know each other until they have often come in contact; to know your brethren there must be friendly intercourse. The interchange of experience, the story of victory or defeat, will ameliorate the trials and troubles met daily. Touch elbows in drill, then when the battle comes you will have faith in your comrades. There never was man so skilled in his profession who did not some day need a friend to stand with him. Go to your medical society and choose the one whose worth you have learned from your meetings with him there. The promotion of friendly intercourse and the guarding of material interest urge to the frequent coming together of neighboring physicians.

Above and beyond all that has been urged in the preceding, medical societies should undertake "the enlightenment and direction of public opinion in regard to the great problem of State medicine, so that the profession shall become more capable and honorable within itself, and more useful to the public in the prevention and cure of disease, and in prolonging and adding comfort to life."

There never was a time when the profession of medicine stood higher in the estimation of the people than it does today. I say this candidly, fully believing it to be true. Onslaughts are made by isms, cults and pathies, but today to whom does this same public turn in troublous time for enlightenment and relief? Is it not to the scientific medical society man? Whom do the State boards of health depend

upon for assistance but the known competent doctor? Great questions are now before us to be settled in the near future, questions which require the united experience of all. The people now expect much, and if we would embrace the opportunity and perform our duty as we should we must come up to the work as one man, through knowledge gained by organized effort.

There are many diseases known to be preventable which demand investigation by united effort. I desire to call attention to several of these in the concluding portion of this address. I do this for the reason that the people are lamentably ignorant of all questions pertaining thereto, and it is the duty of the profession to enlighten them as to causation and prevention. To do this wisely, frequent discussions are necessary in all our societies. Without such information it is difficult to enforce sanitary or other preventive procedures, especially if the expenditure of large amounts of money becomes necessary. So, too, physicians of little experience in special forms of disease should learn from others who presumably know from observation of many cases the disease they are called upon to treat. If this knowledge could be gained through discussion in medical societies much good would follow. All conflict upon the diagnosis of smallpox would in such event be overcome, and the present scourge of that dread disease would have been ended long ago. Every one knows that this disease is highly contagious and can be avoided only by isolation and strict quarantine of the person affected with it, and still for several years past our State, as well as other parts of our country, 'have been afflicted with it. It is a disgrace that it has been allowed to remain so long with us. If a united profession had been well informed as to the clinical aspects of the disease, and skilled in the employment of prophylactic measures, there would be little of the scourge remaining. Smallpox today is present in more than one-half of the counties of the State, making its appearance in unexpected localities and surprising the public and the doctors. Many times the ob