THE ELIMINATION OF DISEASE The prevention of disease has been thought to be the special concern of the medical profession. This is, how ever, no more the case than that the improvement of housing conditions concerns only architects, or that the improvement of morals is of interest only to the clergy. There is a distinct mutuality of interest between physicians and those who labor for the improvement of social condi tions. The struggle which physicians and health boards and sanitarians maintain, with greater or less success, to reduce the death-rate is, after all, only one phase of the warfare against bad social conditions. The death-rate is only a concrete sign of the existing state of the conflict with poverty, injustice, and crime : with the causes of human misery. " Social salvation," remarks C. Hanford Henderson, " must come about by changing men's ideas and bodies and homes, not separately, but contempora neously." To lower the death-rate, involving as that does, under existing conditions, the decrease of needless suffering, the improvement of our physical bodies, and the elevation of our ideas, is, therefore, an integral part of social reform, and is an essential part of any comprehen sive relief policy.
In the reduction of the death-rate the first place is given instinctively to the services of the physician and the surgeon in their treatment of individual cases, and this is as it should be. The maintenance of a high professional standard in the practice of medicine is of the utmost social importance. It is not a matter which concerns primarily the individual practitioner. For him the only thing nec essary to his reputation and his pecuniary emoluments is that he shall be a little more skilful and successful than 47 his fellow-practitioners. But for the community as a whole it is the general level of the efficiency and knowl edge and skill of those who are to be intrusted with the health and lives of the people that is of concern. Medical education, therefore, and laboratory research are properly charges upon the community as a whole, and although their guidance necessarily remains in the hands of doctors of medicine, there should be quick public appreciation of every public-spirited act which makes the hospital of greater utility for purposes of instruction and the medical col lege of increasing breadth and efficiency.
On the other hand, physicians might take that part of the general public which has shown an interest in social welfare increasingly into their confidence, and might wel come more emphatically than heretofore the cooperation of the public press, of charitable agencies and public officials, including not only health boards, but those who from any point of view come into contact officially with the living conditions of the mass of the people. Such increased confidence and cooperation might profitably extend to clergymen, to 'employers of labor, to labor leaders, and to many others whom we do not think of primarily as interested in the problems of medical science, but upon whose aid the community must rely if the conclusions of investigators and those who practise medicine are to be made the basis of universal public policy.
A friend of the author once wrote in a personal letter that in his opinion physicians are, on the whole, the most bigoted body of men that he knew, with a single excep tion. Possibly the force of this severe and undeserved reflection will be somewhat mitigated by the explanation that he was interested in the manufacture and sale of a proprietary remedy. But whatever basis there is for the charge that some physicians continue the guild spirit in an age to which it is ill adapted should surely be re moved. There are everywhere indications that the air of mystery surrounding the treatment of disease is clearing away, that the individual patient is frankly told much more than formerly of the nature of his disease, of the rea son for this and that course of treatment.