MEDICAL JOURNALISM. 
BY 
MR. ERNEST HART, 
EDITOR OF THE " BRITISH MEDICAL JOURNAL," ETC. 
EROM 
THE MEDICAL NEWS, 
June 17,1893. [Reprinted from The Medical News, June 17, 1893.] 
MEDICAL JOURNALISM.1 
By MR. ERNEST HART, 
EDITOR OF THE "BRITISH MEDICAL JOURNAL," ETC. 
I left England at a moment of great pressure of pub- 
lic business in order to have the pleasure of fulfilling this 
engagement. So great, indeed, was the pressure that a 
few days before starting I telegraphed Dr. Culbertson 
that, to my great sorrow, I feared that it would be im- 
possible for me to leave uncompleted Parliamentary 
work which I had in hand, as Chairman of the Parlia- 
mentary Committee of the British Medical Association 
on behalf of the Army Medical Department and of the 
Medical Officers of Scotland. However, it is not only 
faith that will remove mountains, but the heart's desire 
is almost as potent. I have come because you wished 
me to come, and because I wanted to meet you ; I came 
to exchange that hand shake which is a simple and 
moving expression of friendship between English- 
speaking men of the old country and the new. 
Now that I am here, I feel how little it is, beyond the 
expression of good-will, friendship, and esteem, which I 
have to say. But presence is more than words, and, 
under such circumstances, is in itself a message-one of 
which I ask you to accept the dumb eloquence and to 
make that the apology for imperfections of my desultory 
1 An address delivered before the American Medical Editors' 
Association, at its meeting in Milwaukee, June 5, 1893. Special 
stenographic report kindly revised by Mr. Hart for The Medical 
News. 2 
and hesitating words, for Englishmen are dumb dogs, 
and I am no orator, as every born American is. In vain 
extenuation of our verbal deficiencies, we try to remem- 
ber the injunction, facta non verba, and I would again 
ask you to accept the fact of my presence as an excuse 
for the poorness of my words. 
Speaking as a journalist to journalists, I have chosen 
as my theme " Medical Journalism."' I have had now 
some thirty years' experience of it, and it is of the les- 
sons learned and to be learned that I shall endeavor to 
take counsel with you. 
During those thirty years a great change has come 
over the world of literature, science, and politics. In 
that change, which journalists have largely helped to 
bring about, their functions, their power, and their duties 
have been largely transformed and inevitably magnified. 
The mission of the medical journalist is a great one; it 
is no longer an accidental function of an otherwise busy 
man's life. Even the ablest men who have taken that 
view of journalism have failed to make much mark in 
that calling. I refer to men of such capacity and stand- 
ing as Jenner, Quain, Spencer Wells, Barnes, and Jona- 
than Hutchinson-all of our later time. It offers a 
career that repays and requires undivided devotion; one 
that may fulfil high ambitions and subserve large useful- 
ness. I speak of it as a mission ; for no man can reach 
the ideal of medical journalism who only writes to live; 
he must live to write. 
JOURNALISM AS A CAREER. 
THE IDEAL QUALITIES OF THE JOURNALIST. 
The ideal journalist needs to cultivate many qualities 
which it is not always easy to combine. He should have 
rapidity of initiative and promptness of decision, for 
slow deliberation is the grave of opportunity. He needs 
quick and catholic sympathy ; for this is a great source 3 
of power; but a corresponding capacity for just indigna- 
tion is its necessary correlative and qualification. Mag- 
nanimity is a necessary editorial quality, for often the 
best way to remedy injuries is to forget them. An 
editor must know what to pass over as well as what to 
note, and must be able and willing, often graciously and 
tenderly, to ignore what others know. He must be acces- 
sible to all; and while appreciating the personal acquaint- 
ance and justifying the confidence of the leaders among 
whom he lives and ranks, he needs to be in daily touch 
and constant sympathy with the professional masses, 
whose requirements and rights it is his especial function 
to voice and to champion. 
To be really useful and to be really powerful, two 
things which are almost synonymous, the editor of a 
medical paper must, in his public capacity, even more 
than other men in their special spheres, always govern 
his course and be prepared to justify it, by referring each 
individual case to a recognized basis, and a logically 
defensible principle. He is a leader militant; he must 
be a standard-bearer, and must have always a motto 
inscribed upon his flag. I long since chose mine. It is 
one to which many thousands of our profession in Great 
Britain have rallied, and I do not see any prospect of 
needing to change it for many years to come ; my guid- 
ing principle has been and is " The government of the 
profession by the profession for the profession." You 
will recognize in this formula the altered words of one of 
your greatest statesmen. Of the medical press, even 
more than of the general press, may be used the words 
of one of the ablest of modern editors, that it should be 
at once the eye, the ear, and the voice of its readers, and 
especially of the lowly among them. It should be the 
visible speech-the phonograph of all ranks. It confers 
a chieftaincy which arises out of its being the servant of 
GUIDING PRINCIPLES. 4 
all. Among its great powers must be counted that not 
only has it the casting vote in many decisions-great 
and small-but it has also both initiative and power of 
closure. It can declare urgency, or shut down discus- 
sions. It is a Parliament always open, and of which 
the editor is not only chief orator, but he is also speaker 
and chairman of committee. 
With its privileges and responsibilities come many 
pains. Journalism entails much sacrifice. 
An editor needs, and must have, many enemies; he 
cannot do without them. Woe be unto the journalist of 
whom all men say good things. A man, says Oliver 
Wendell Holmes, whose opinions are never attacked is 
beneath contempt. For every real thought on every 
real subject knocks the wind out of somebody. Com- 
pesce mentem ; durum sed tcevius fit patientia quieqtiid 
corrigere est nefas; which, freely translated, may be 
summed up in a few words: Bide your time, keep a 
cool head and quiet mind. Time cures all things, and 
patience softens hardships. Editorial work, like all 
other good work, is largely one of self-sacrifice. It is 
the grave of literary reputations and the despair of liter- 
ary ambition. In writing leading articles, as Washing- 
ton Irving found in voluminous correspondence, " your 
mind is torn from you in strips and ribbons," which are 
scattered to the wind, and your thoughts leak out in 
driblets which barely moisten the earth. Where is there 
a literary memorial of any, even the greatest among 
editors ? Perhaps Addison might have survived by his 
Spectator alone, but he was an essayist rather than a 
journalist. St. Beuve has left a monument of literary 
criticism, but not, it is to be feared, " more lasting than 
brass " ; but Delane, wise and great editor as he was, the 
brilliant Fonblanque, Hutton, philosopher and moralist, 
have but written, I fear, their names in sand, and that is 
POWERS, PRIVILEGES, AND PAINS. 5 
the common lot of all journalists as such. In their works 
they shall live, but their names, hardly known even in 
their own day, shall speedily be forgotten. That is at once 
their glory and the penalty in which they must rejoice. 
Their influence, far-spreading and enduring, their unseen 
power in the shaping of events, is the reward of their 
self effacement. 
An editor must quickly form opinions, and firmly ex- 
press them, but he does well not to enter into controversy. 
" For controversy," it has been well said by Dr. Oliver 
Wendell Holmes, "equalizes fools and wise men in the 
same way-and the fools know it." It is a prudent thing 
to refuse to be drawn into controversy, especially in the 
pages of one's own journal. Don't lose time in alterca- 
tion, for in much altercation truth is lost. Let every 
man have his say, let him contradict you', let him attack, 
provided he does so in the limits of courtesy and of good 
temper. Learn from him, and let others learn. Do not 
answer him or put tags to his letter, unless some rectifi- 
cation of facts is necessary. Among the earliest lessons 
for an editor to learn, and it is one also which must last 
him during all his life, is to be slow to think evil, and to 
be hard of hearing for personal accusation. The accused 
so often turns out to be whiter than the accuser. 
If now we may, in passing, linger for a moment in 
the field of technical details to speak of some special 
editorial difficulties, I will select as not the least trying 
that of the fair and kindly conduct of the department of 
reviewing. It is an obvious truism, often clothed in the 
millinery of epigram, that the auther who sends a book 
for the candid opinion of the reviewer, as he says and 
believes, almost invariably expects it to be praised. 
Anything cooler than a warm shower of eulogy chills 
him ; a lukewarm mixture of praise and blame makes 
him shiver; a rain of cold criticism is apt to make his 
REVIEWS AND REVIEWERS. 6 
teeth chatter-with rage ; and for this there is great ex- 
cuse. Of a book, even more than a child, the author is 
apt to say to himself: " It is a poor thing, but mine 
own." The condemnation outrages not only a man's 
self-esteem but his parental affection. It is well, then, 
to advise the younger reviewers, who are apt to be arro- 
gant and satirical on small provocation, to temper jus- 
tice with kindness ; to seek out merits as wells as defects; 
to endeavor to portray the character of a book when 
passing judgment, and to forego the savage joy of cut- 
ting up the product of the feebly well-intentioned. Rather 
pass their work over in silence. But there is a tribe of 
books, wares of the self-advertiser and the vulgar noto- 
riety-hunter, flags of the unscrupulous privateer who 
flies, without a warrant, the colors of the specialist; sign- 
boards of the masquerading quack. Of these it must 
still be said: " When the culprit escapes, the judge is 
condemned." But it is of literary quackery in high 
places, of the empty platitudes, of the ill-written inani- 
ties, of orations, discourses, and lectures by men who, 
having attained professional distinction, fail to set aside 
time for continuous intellectual culture-it is of these 
that it becomes the medical journalist to harden his 
heart to the unforgiving judge. He alone can venture 
fearlessly to do so, and he ought to do so, for they not 
only disappoint but they mislead. They lower the lit- 
erary standard of medicine,which is already inadequate. 
LITERARY STYLE. 
That brings us to the subject of literary style in medi- 
cal journalism, which may be dismissed, however, in 
very few words. An editor is often asked by young 
writers: ''What style would you recommend me to 
adopt ? and what advice can you give me for writing 
in your journal?" I don't know what your view may 
be, but it has always seemed to me desirable to recom- 
mend the avoidance of style, and to advise those who 7 
seek counsel on style, consciously to avoid it and to try 
chiefly to say what they have to say as clearly as pos- 
sible, and to seek mainly the accurate expression of pre- 
cisely the shade of meaning which it is intended to depict. 
It is a golden rule to think out clearly and precisely what 
there is to say, and to say it shortly and without ambi- 
guity. People who are anxious about style are generally 
those who have little or nothing to say, and they are 
precisely those who take longest in saying it. It is gen- 
erally difficult to say nothing without saying it at great 
length, and medical stylists are among the bores of the 
profession and the terrors of the medical journalist. 
On the other hand, nothing will compensate for the want 
of clear and grammatic expression; nor is there any 
department of journalism in which pompous rhetoric 
and the straining after jocosity is less graceful than 
in medical journalism. 
ORGANIZATION OF THE MEDICAL JOURNAL. 
I have nothing to tell you which you probably do not 
know better and from more modern sources, and from 
your own experience on this subject; but I can, in a few 
words, lay bare to you one or two secrets of our press- 
room, and leave you to value or to cast them away. 
Many of us here were educated in the old school of 
journalism, which relied chiefly on the permanent staff 
of leading article-writers and reviewers, to whom were 
allotted, from week to week, everything in their respec- 
tive departments. When a very young man, and while 
still residing in hospital, I wrote the editorial " Notes of 
the Week" for a leading journal. Three columns a week 
was the allotted tale. To another member of the staff 
was intrusted three columns of''Answers to Correspond- 
ents," and so on from cover to cover. In some high 
places I believe that system still survives ; it seems to me 
effete. At any rate, I have abolished it for the last twenty 
years. The only system that seems to me adequate to 8 
the real needs of professional readers is that in which 
every unsigned editorial paragraph is written by a speci- 
ally selected expert. That is the principle on which I 
have modelled the journal I have the honor to conduct. 
Every letter received, every paragraph, every cutting 
editorially dealt with, is referred to an expert having 
special knowledge and being a recognized authority in 
the matter. The recent examination of our books shows 
that to fulfil the requirements of the comparatively few 
pages of our journal devoted to unsigned editorial mat- 
ter, we need and employ the services of an effective staff 
of nearly two hundred and fifty editorial writers. Of 
these upward of forty contribute on an average to our 
pages every week-often only a few lines each; for our 
object is authoritative accuracy; our literary aim is 
brevity and fulness ; and our difficulty is condensation. 
It is a laborious and difficult method, involving heavy 
daily correspondence and constant vigilance to guard 
against personal eccentricity or prejudice or-that bug- 
bear of journalism-unjustifiable censure. But that 
method may, I venture to think, be recommended as 
one that gives authoritative accuracy, reality, and trust- 
worthiness to journalism. A medical journal, in order 
to rise to the height of extended usefulness, needs to be 
written from end to end by experts; and so far as the 
Journal of the British Medical Association may be con- 
sidered to have been a success, that success has, I believe, 
largely been due to the fact that no pains or necessary 
outlay has been spared to provide that every line in 
every department shall be written by persons who are 
themselves trustworthy experts ; that it shall be free from 
padding, and in its smallest details real and true; worthy 
of confidence in statement of fact, and free from the re- 
hash of second-rate opinions gathered from second-rate 
sources. 
I may venture also to suggest that it is a great ad- 
vantage to a journal and to the profession which it 9 
represents that it should be connected with living organ- 
izations, local or general. Energy becomes in itself a 
merit when otherwise it would be a fault; when there is 
an organization that underlies and is capable of over- 
ruling it; when the journal is not only a voice-vox et 
preterea nihil-but also an undisguised personality and 
associated with influential standing committees. A 
journal becomes thus an active, permanent, and ever- 
living power in the State, and it is from the combination 
of a journal with an association that the highest develop- 
ment of this form of professional and social influence, I 
believe, may be fairly demanded and expected. And 
our experience has shown that it is not always expected 
in vain. 
MEDICAL ETIQUET. 
A class of questions which give an editor frequent 
occupation for thought, and sometimes some passing 
trouble, are those known as questions of medical eti- 
quet. The value, the uses, and the meaning of medi- 
cal etiquet are very variously estimated. There are 
those to whom it is fetich, and those to whom it is tabu ; 
to some it is a name of terror, to others a term of 
derision ; some assume to hold themselves above its 
reach, others are obviously below it, and some outside 
of it; but consciously or unconsciously all are affected 
by it. The philosophers hold it to be unnecessary be- 
cause superfluous ; but it is perhaps true, however para- 
doxic, to say that in our complex modernity of civiliza- 
tion it is often, and sometimes chiefly, the superfluous 
that is felt to be essential. At any rate, it is chiefly our 
superfluities that become indispensable. The philoso- 
phers are apt to predict that medical ethics have no 
separate existence, apart from or antagonistic to the 
rules of general ethics. Far from being a reproach or a 
ground of detraction or a reason for abolition, that is one 
of its highest claims to respect, and a fair measure of its 
usefulness. Medical ethics are particular cases of gen- 
* 10 
eral ethics. They constitute the bulwarks and the outer 
fortification of the central fortress. Do unto others as 
you would have them do unto you, is the golden rule 
which is enclosed within the casket of general as of med- 
ical ethics. But society has found it necessary to formu- 
late a vast number of accepted laws of conduct which are 
none the less necessary for daily use because they may 
all be found inscribed in the Ten Commandments. The 
two hundred and forty Levitic commandments, the Gos- 
pel rules of conduct for life, and the whole code of 
modern legislation for the regulation of social relations, 
are not superfluous, because they may be traced to the 
simple Mosaic tablets, and to the Sermon on the Mount. 
In the complex relations of medical life questions daily 
arise involving principles upon which every man might, 
after due thought, decide for himself. They include 
applications of principle which every man might work 
out if his intellect were always keen, his judgment well 
balanced, his interests calmly self-judged and easily put 
aside when they conflict with the general interest. So 
perfect a being might be content to be a law unto himself; 
but for others less perfect it has been found in every 
walk of life that it is well to have at hand, stored in the 
memory or laid down for reference, decisions and rules 
already settled by the wisdom, the experience, and the 
judgment of the wisest and best of our predecessors and 
our contemporaries-that is, the code of medical ethics, 
and wise men will not despise it. Let me say in one brief 
sentence that many of us in Great Britain think it one 
of the highest and greatest claims to sympathy and 
respect of the American Medical Association, as a rep- 
resentative body, that it has framed and promulgated 
such a code and that it has made great sacrifices to 
uphold it. Securus judicat orbis terarrum. 
There is one question that has from time to time 
cropped up in relation to medical etiquet, and that has 
long since been thoroughly settled with us, but as to 11 
which there is, I hear, still some difference of opinion 
among various sections of the profession here. It may 
be worth while to refer to it in passing, as an illustration 
of the view that I have just expressed, as to the conveni- 
ence of having the particular cases of medical ethics 
that involve some complications, carefully thought out 
and authorititavely settled. I am thinking, in saying this, 
of the question of 
-CONSULTATIONS WITH HOMEOPATHS. 
Some ingenuity has been exerted in endeavoring to show 
or to suggest that the rule that prevails everywhere, and 
unquestioned throughout Great Britain, forbidding such 
consultations, is a selfish rule and contrary to the public 
welfare. If it were so, it would be self-condemned, for 
we are probably all of us here well agreed that the funda- 
mental principle of medical ethics is that all rules laid 
down as part of the code are, and must be, as much for the 
welfare of the whole community as for the good guidance 
and advantage of the medical profession as a class. 
The arguments that are sometimes used to indicate that 
the refusal of a practitioner of good standing to consult 
professionally with a homeopathic practitioner is con- 
trary to the public good and a mark of illiberality and intol- 
erance amongst regular practitioners, are a false, fabri- 
cated, specious, and worthless plea. On what is the 
demand for such a consultation based ? The only cor- 
rect and forcible basis is that it should be for the benefit 
of the patient. It is sometimes said that, at any rate, 
the regular practitioner can and ought to give his assist- 
ance in determining the diagnosis of the case. But the 
answer to that is plain as noon-day. We are not here, 
nor do we enter the sanctuary of the sick-room to solve 
conundrums. The medical mission is to heal the sick. 
The physician fulfils his function of the tarpon only when 
his diagnosis is to be followed by an effective treatment. 
Now, we all of us have the conviction that the treatment 12 
so called, instituted by homeopaths as such, is absolutely 
ineffective, and does not and cannot, if faithfully carried 
out in accordance with what is known as the home- 
opathic doctrine and method, be of any avail whatever. 
Of course, it is said that very often the so-called home- 
opathic treatment is not carried out by homeopaths. In 
that case the nomenclature is itself a fraud, and we are 
not called upon to soil our hands by taking part in any 
such imposture. But we treat homeopathy and are will- 
ing to regard it as an honest delusion. The physician 
however, can take no part in such delusion. If he were 
to accept the position of a mere solver of riddles, he would 
lose all that makes medicine dignified and that ennobles 
its functions. He would be doing worse than this in 
entering into a consultation with a homeopath. We are 
entitled to assume that the homeopathic practitioner 
himself believes that his treatment of infinitesimals may 
be of some benefit to the patient. At any rate, we may 
feel sure that the patient entertains that delusion, and by 
entering into -consultation over the sick-bed, the physi- 
cian would ratify by his presence that understanding. 
The public could not understand that fine-drawn, arti- 
ficial, and unholy distinction which would allow a con- 
scientious practitioner to stand by the bedside of a man 
smitten with disease, trembling, perhaps, on the thresh- 
old of death, and on the paltry pretence of assisting to 
clear up the diagnostic difficulties of the case, to examine 
the patient and leave him to the tender mercies of one 
who, in his heart, he believes, and who, with all his 
intelligence, he is convinced, is a person carrying out a 
system of medicine, so called, which is absolutely incapa- 
ble of affording to the patient such chances of life as the 
advancing inroads of disease may leave. Consultation 
with a homeopath, regarded from this point of view (and 
I know of no other from which it can fairly and worthily 
be regarded), is worse than a sham, worse than an im- 
posture. It is a crime. On this head of conduct there 13 
is, I have said, no division of opinion throughout Great 
Britain, and any physician who should break that now 
well-established rule would be regarded as putting him- 
self beyond the pale of ordinary professional intercourse 
with his brethren; and men would refuse, and before 
now have refused, to consult with any practitioner who 
thus misinterprets the true ethics of consultation. 
No ingenuity, no special pleading can set aside, so far as 
I have ever been able to understand the matter, the pre- 
vailing ethical rule that underlies the decision of this 
particular case ; and it affords, I think, a very good ex- 
ample of the importance of not leaving every man to 
draw his own conclusions and to work out his own de- 
ductions from the few central principles, but of having 
at hand decisions made deliberately and in general con- 
sultation on thorny points, which it requires some firm- 
ness of purpose and an immovable moral determination 
rightly to solve, without being misled by side issues. 
One or two eminent men, as I can recall in my early ex- 
perience of journalism, allowed themselves to be misled 
by the specious cry of intolerance, and for a moment 
declared the intention of accepting, under the flag of 
liberality, the false position that I have indicated. It 
was but for a moment, and it would be unfair now to 
recall the name of the greatest among them, who quickly 
saw the error of his ways and drew back in time to save 
his great reputation and his spotless honor. I only refer to 
the matter thus briefly as indicating that for the wisest 
and greatest among us it is true that the honor and the 
esteem of the mass of the profession are likely to be 
surer guides than the acute intelligence of a few, although 
among these there may be those whom we delight to 
honor as leaders of the profession. 
A strict adherence to the rules of etiquet is sometimes, 
with shallow scorn, stigmatized as trades-unionism. We 
can be well content to leave that phrase as it stands, but let 
us translate it into its proper language. Medicine is not a trade; it is a profession. And unions such as ours, such as 
yours, unions which are called the Association of Medical 
Journalists, or which are called the American Medical 
Association or the British Medical Association, typify 
and embody professional union. We accept and con- 
vert to our own honor and dignity and to the welfare of 
the public, the very phrase which is hurled at us as if it 
were a reproach. Yes, we here are all for medical union. 
Our duty as medical journalists is to promote profes- 
sional union, and it is one of the great titles of the 
American Medical Association to honor, one of its great 
titles to the respect and the esteem of the profession in 
this country and in Great Britain, that on this matter of 
consultation with homeopaths it has chosen the straight 
and narrow path-that it has declined to be drawn off 
by the blandishments of those who offer a crown of lib- 
erality which looks flowery enough, but which is quickly 
shown, when it is handled, to be a crown of crackling 
thorns-one which, however decorated with the blossom 
of public applause, pierces the very substance of pro- 
fessional honor and duty. It is the liberality of a Gallio 
which we are invited to accept as our ensign, but which 
the American Medical Association and the British Medi- 
cal Association are unanimous in scornfully rejecting. 
The voice of the profession has been and is in the 
end the surest judge of right. In all such questions of 
general conduct and universal rights, it is the rank and 
file of the profession with whom lie the duty, the power, 
and the privilege of decision ; even in the face of oppo- 
sition from those whom we delight with the title of 
leaders of the profession. That brings me to my final 
topic: 
14 
LEADERS OF THE PROFESSION. 
No man attains that position nowadays without having 
earned it. No one should reflectively and consciously 
speak slightingly of the leaders ; least of all could I. I 15 
have enjoyed the friendship and frequent opportunities of 
communication with men such as Austin Flint, Van 
Buren, Gross, Fordyce Barker, Marion Sims, Agnew, to 
speak only of a few of those of your leaders whose per- 
sonality was best known to us in Britain, but who have, 
alas I gone over to the majority. No one could have 
known them without recognizing the signs of nobility of 
mind and strength of character. So with us, it has been 
a liberal education to have spent a life in frequent com- 
munication at successive periods, and on many great 
and small occasions with men such as the sagacious 
Brodie ; Sir Henry Holland, a philosopher and traveller 
and a pioneer by intellect ; Owen, the Cuvier of Great 
Britain ; Watson, the Nestor of the last generation of 
medicine, and still a classic ; Ferguson, lion-hearted and 
woman-handed; Syme, sturdily original and uncom- 
promising ; Simpson, a pathmaker in obstetric medicine 
and surgery ; Christison, the type of prudence and candid 
research ; Stokes, brimful of sagacity and humor ; Cor- 
rigan and Porter, masters of the great Dublin school; 
and our own eminent leaders, such as Jenner, Lister, 
Andrew Clark, Paget, Quain, Spencer Wells, Henry 
Thompson, Hutchinson, all men who have risen by 
their own individual merits, and are known by their 
works. They have fruit as well as leaf. 
It is not, therefore, in a cynical mood or snarling 
temper that I say : " Except in clinical scientific re- 
search-a great and never-to-be-forgotten exception- 
put not your trust in leaders. Lucus a non lucendo. 
They are called leaders, but so far as modern history 
shows and so far as my experience of thirty-five years 
teaches they are mostly led. 
In the great social movement of medicine; in its 
human progress; in the development of the newer and 
wider functions of medicine ; its relation to public life ; 
its organization for the prevention of diseases, for the 
care of the sick poor by the State; for the organization 16 
of out-relief of hospitals in such manner as to prevent 
abuse; in most of the great movements of our day we 
have for the most part found them lagging, cold, or 
indifferent; feeling little enthusiasm for such movements 
in Great Britain as those that resulted in the appoint- 
ment of the sanitary commissions, and in that organi- 
zation of a public health system which laid the founda- 
tion of the new science and practice of diseases. It was 
Rumsey, Farr, W. H. Michael, who led the way and 
whom I found the most active promoters of a system 
that since then has furnished the model for the civilized 
world. They were general practitioners, without hospital 
appointment. The General Medical Council of Educa- 
tion and Registration was created at the instance of the 
British Medical Association, led by Hastings, its founder; 
Bottomly, of Croydon ; Waters, of Chester. Provincial 
practitioners were the founders of that Council which has 
rendered such vast service for the cause of education, 
which was created and has been remodelled in the teeth 
of the active opposition and subsequent indifference 
of the leaders of medicine, ordinarily so called, who have, 
however, stepped into the leading places on it in virtue 
of their official positions. 
So was it with the reformation of the workhouse hos- 
pitals and infirmaries, which are, with us, the hospitals 
of the State. That was, in its inception, the work of a 
medical journal, the Lancet, with which I was then 
editorially associated. It was carried out by Rogers, 
Carr, Anstie, and myself, with the aid of a vast body of 
lay support which we conciliated. 
So has it been with the removal of the grievances of 
the army and navy medical officers. Until lately the 
whole of that great reform has been left in the hands of 
the Parliamentary Committee of the British Medical 
Association. The battle has been successfully fought by 
that representative body of general practitioners, and by 
them alone, until last year, when the Royal colleges united 17 
to secure the adoption of the recommendations of a War 
Office Committee, which, however, they had up to that 
date done little or nothing to obtain. I repeat, then : Rest 
not your hopes of any but purely scientific progress upon 
leaders, for the maintenance of growth in your organiza- 
tions, and of your relations to the State and the people. 
When you have made up your minds, by preliminary 
discussion and in general session, as to what is needful, 
right, and wise, and when your cause is well advanced 
and winning all along the line, the leaders of the profes- 
sion will generally follow. Don't mistake me that it is 
in the order of things. The leaders are always apt to 
resemble the conservative old world squire described by 
Washington Irving, who went religiously to church and 
sat in the front pew and joined boldly in the responses, 
because it seemed to be to him an excellent example to 
the lower orders to show that, though he was great and 
wealthy, he was not above being religious. The leading 
men are apt to join reluctantly in any new movement. 
The rails must be laid first and the roadway made se- 
cure, and then they are commonly willing to board the 
train and come along in the first car, with the flags fly- 
ing and the music sounding, to receive the sympathy 
and the applause of the admiring crowd. This is not 
surprising. Difficilis glories custodia. They have, for 
the most part, a great practice to attend to, which keeps 
them busy, and a great reputation to maintain, and to 
make a mistake might be a terrible thing. They are 
apt to be thinking ex necessitate of where they stand. 
Their tendency is to stand in the old ways, with which 
they have good reason to be satisfied. It is for us to 
take larger thought of where we are going. 
We journalists need.not be so much afraid of making a 
mistake from time to time. As your ambassador said not 
long since, at the Mansion House, London, to the great de- 
light of his hearers : " The man who never made a mis- 
take never made anything." We can all try to make as 18 
few as possible, but it has been truly said, that genius 
consists not in never making a mistake, but in never 
making the same mistake twice over. We journalists 
need not be so much afraid of unpopularity. It is very 
often the case, and, as I suppose all of us have found it 
out in the course of our career, that it is not infrequently 
the forerunner of success. You cannot, if you would, 
avoid hatred, but you can take care that no man justly 
hates you. In the fulfilment of our public duties- it is 
necessary to base opinions and policies upon a logical 
principle, and to hold personal interests and private pre- 
possessions as of comparatively little account. We have 
all a natural love for friends and friendship, but private 
friendships which will not bear the strain of public 
differences must give way. Time will often happily 
repair ruptures which have given much pain, yet these 
are among the greatest pains and griefs of responsible 
journalism. But- 
They are slaves who fear to speak 
For the fallen and the weak; 
They are slaves who will not choose 
Hatred, scoffing, and abuse 
Rather than in silence shrink 
From the truth they needs must think; 
They are slaves who dare not be 
In the right with two or three. The Medical News. 
Established in 1843. 
A WEEKL Y MEDICAL NEWSPAPER. 
Subscription, $4 00per Anmim. 
The American Journal 
OF THE 
Medical Sciences. 
Established in 1820. 
A MONTHL YMEDICAL MAGAZINE. 
Subscription, $4.00 per Annum. 
COMMUTA TION RA TE, $7.50 PER ANNUM. 
LEA BROTHERS Sa CO. 
PHILADELPHIA.