Medicine cabinet

“ PROPOSED NATIONAL BOARD OF PUBLIC HEALTH, CONTROLLED BY ONE SCHOOL OF DOCTORS, CONDEMNED A typical instance of the dangerous tendency of the medical profession to extend its power over the people is shown in the recent scheme of the proposed National Department of Public Health, to be composed chiefly of doctors of one sect, with a head doctor having a seat in the President’s Cabinet. ”

“ First, to follow up on Daschle. What does the -- or what is your time frame for announcing a new Secretary? And will this withdrawal affect any of the appointments to other health-related areas, like the FDA and the Surgeon General?
GIBBS: We're working on nominees for both of those positions. Obviously families all over the country have -- understand the importance of getting somebody at the Food and Drug Administration who will set forth a regulatory structure that protects American families, whether it's the medicine that they take or the food that they eat. ”

“ With the view to prevent the encrease of a certain disorder, which proceeds with rapid strides in that hot climate, it is customary to appoint a committee every month, at each great station, for the inspection of such dulcineas as may be resident within the bounds of the cantonments: such as appear to be diseased, are instantly confined to a small hospital, appropriated to their reception: a salutary measure, which doubtless prevents much mischief, and is superior to our Lock Institution, which 425only offers, but does not coerce to, a proper course of medicine. ”

“ Each board is to consist of seven members appointed by the governor from the full lists of the members of the said medical societies, and is to be composed exclusively of members of the same medical society. Each appointee must be a registered physician in good standing, and shall have practised medicine or surgery under the laws of the State for not less than ten years prior to his appointment. ”

“ From what has been said, the necessity will be evident to introduce into the council those physicians who have made health, and particularly the public health, a special study; and to join with them chemists, and, above all, manufacturing chemists, because what would many of those persons, whose life has been passed in hospitals and the exclusive study of medicine, be before a steam engine? It is clear that they would often be deceived by those adroit and skilful manufacturers who would have an interest in concealing the truth. ”

“ In the closing hours of the legislative session of 1895, at the request of Governor Greenhalge, he resigned from the Senate to accept the position of secretary and executive officer of the Board of Registration in Medicine, a position he held from June 20, 1895, until April 1, 1913, when owing to continued ill health he was forced to resign as secretary, but in acordance with the request of his associates, continued a member of the board until his death. After 1895 he gave up active practice. ”

“ It may not be easy for such a committee to agree on a definite plan, but their recommendations should carry great weight with the president and the congress.
The first question appears to be as to whether a national department of health with a cabinet officer should be advocated or whether only a bureau should be recommended for the present. It is a curious fact that our cabinet is smaller and less democratic than that of any other great nation. We alone have no ministry of education. ”

“ A perusal of the Trustees’ Report, ‘Cooperation of the Pharmaceutical Houses’, is well worth the time of every member of the profession, and your committee would emphasize the statement of the Trustees: ‘The Council, constituted of scientific men, working without remuneration in the interest of scientific medicine and the medical profession expects—and rightfully—the cooperation and support of the members of that profession. What is needed, therefore, is the active sympathetic cooperation of physicians ”

“ Qualification.—The State board of health is constituted a board of public examiners ex-officio to examine and license physicians to practise medicine. Any person who is a graduate of a lawful medical college, who has attended three full courses of medical lectures of six months each, no two full courses within the same year, and who is of good moral character, and is not an habitual drunkard, shall, upon proof of such facts to the superintendent of the State board of health, as the board shall require, receive from said superintendent a license ”

“ Another of the duties of the Department of Health was to examine every person that applied to practice medicine and surgery or to engage in any professional calling. The law required a medical examination to be made of the person, who was granted a license every year, so as to keep the professions up to a high standard. ”

“ The head of the department should be a man familiar with the problems of clinical medicine, trained preferably as a pathologist, and with sufficient knowledge of the possibilities of physiology and chemistry to apply the methods of these subjects to clinical problems. I say preferably a pathologist because the pathologist is more apt to combine clinical training with a knowledge of pathology, bacteriology and the principles of immunity than is the physiologist, chemist or pharmacologist, though any one of the latter might well head such a department. ”

“ To get an idea, however, of the great variety of work undertaken by the largest hospitals, it may be well to glance at the various departments of medicine and surgery represented at St Bartholomew’s Hospital, the oldest of these London institutions. In addition to the out-patients’ rooms, and wards devoted to the treatment of ordinary medical and surgical diseases and accidents, there are the following special departments: A department for skin diseases; for diseases of the eye, ear, and throat; an orthopædic department; a dental department; a department for the special diseases of women ”

“ A separate network of polyclinics is attached to industrial mining, transport, and construction enterprises to serve their workers. Each polyclinic is divided into departments for the various specialties in medicine, and each department is staffed by one or more doctors and auxiliary personnel. Not all polyclinics, however, have departments for all the major fields of medicine; many have only sections for internal medicine, obstetrics and gynecology, pediatrics, and surgery. Patients needing consultation or treatment by other specialists are referred to the nearest hospital. ”

“ Such a center, the Committee reported, was an "urgent and immediate" need, due to the "comprehensive and global nature of modern military medicine" if the Medical Department was "to fulfill its mission of protection and care of troops, to keep pace with worldwide developments of significance to military medicine and to maintain a productive relationship with the medical profession at large * * *. The Army Institute of Pathology and medical museum are presently housed in an antiquated building which seriously limits the important functions of this institution. ”

“ In modern medicine the Department of Pathology, the laboratory of any hospital or group of hospitals, is the heart of the facility. Accurate diagnosis and consequent treatment is largely dependent upon perfection of laboratory work.
The benefits to be derived from the change of location of the contemplated building have been recognized both by the Department of Defense and the Department of the Army. The fiscal advantage of the savings made possible as well as the value of the broader improvements involved has been given Bureau of the Budget approval. ”

“ It is important that Care Committees should act in coöperation with local authorities, insurance committees, and charitable agencies, and should have representatives of these bodies on them. The medical officer of health and tuberculosis should also be ex-officio members of their committee. ”

“ There is no doubt that the commander of a hospital must be a medical practitioner, and there is no doubt that in all matters relating to his hospital his authority must be final. In the last resort he must decide whether a patient is to leave the hospital or to stay; who should be admitted, and what the treatment should be. In a good organisation he will probably be very rarely required to express an opinion respecting these matters, but in the event of a conflict of opinion between say the consulting surgeon or physician and himself, there can be but one final arbitrament. ”

“ We want independent Medical Officers of Health—appointed by the County Council, and removable only by them—men trained up for this as a profession; we want Sanitary Inspectors, with a proper qualification, appointed with the Medical Officer's approval; we want that each Medical Officer should be informed as to all approaches of dangerous disease, and bound in his turn to supply the information for other neighbouring districts ”

“ The Health Department is usurping the powers of the Legislature, which it has no authority to do. The law plainly states what the physician shall report and the Board of Health has no power to require additional matters. ”

“ The work of this department should be the investigation of clinical problems, and not of academic problems of pathology, chemistry or physiology. General practitioners, clinical assistants in the school and even those at the head of clinical departments are constantly meeting problems which demand solution, but find no adequate opportunity to investigate them in departments as now constituted. These men would find a place in the department suggested and should constitute an enthusiastic working staff which should be exceedingly productive in the advance of medical knowledge. ”

“ In the spring of 1850, the Physician-in-Chief, who, in organizing the Hospital Department, had the direction of the economical affairs of that department as well as the direction and supervision of the treatment of all patients, and who performed, besides, all surgical and obstetrical operations, except such as he could entrust to his assistant-surgeons, proposed that his senior assistants should now be appointed physicians, to have charge of departments or divisions, subject to certain regulations and restrictions, and that each should have an assistant. ”

“ When a patient is cured, he is called before a Committee of the Governors and Physicians, who examine him, and being found fit to be discharged, the Physician gives a certificate to that purpose, and then the steward of the house takes care to have him delivered to his friends.
The hospitals of Bethlem and Bridewell being made one corporation, they have the same President, Treasurer, Governors, Clerk, Physician, Surgeon, and Apothecary; yet each hospital has its proper steward and inferior officers, and a particular committee is chosen out of the Governors for each. ”

“ Despite many obstacles thrown into its path, the Council on Pharmacy and Chemistry has serenely pursued its allotted tasks, corrected its mistakes, improved its methods, and today stands as the only medium to which the honest physician may turn for information—not misinformation—regarding proprietary articles. During the war the Council and the chemical laboratory were in close cooperation with the Surgeon-General’s Office, testing and investigating every article offered to the government for the treatment of sick soldiers. ”

“ These employees of the laboratories, purveying depots and distilleries, are in a great measure expert chemists, druggists and distillers and men of professional skill, whose services are absolutely indispensable for the manufacture of medicines, hospital furniture and alcoholic stimulants. It is therefore hoped that the Honorable Secretary will see the necessity of these men being permanently attached to the Medical Department, as the practice of constantly changing these employees is productive of delay and embarrassment to the Department. ”

“ MEMBERSHIP- The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall appoint to the advisory committee under subparagraph (A) such members as deemed necessary to properly advise the Secretary, and shall include organizations and individuals with expertise in breast cancer, disease prevention, early detection, diagnosis, public health, social marketing, genetic screening and counseling, treatment, rehabilitation, palliative care, and survivorship in young women. ”

“ Whilst experience gives little promise even of inquiries from such a body as Boards of Health without responsibilities, still less of any important results from the mere representations of such bodies separated from executive authority, I would submit for consideration what appears to me a more advantageous application of medical science, viz., by uniting it with boards having executive authority. ”

“ At a second meeting, held on 13 April 1947, the Board discussed the plans for the new Institute of Pathology, its functions, and its administrative status, and recommended to The Surgeon General that facilities be provided for "research in pathology in the broadest sense," that the personnel of the Institute be "free to conduct research on an individual basis, in addition to participation in major problems of the Army Medical Department," and that the Director of the Institute "should be responsible directly to the Surgeon General." ”

“ The medical system of the future must be a national system co-ordinating all the conditions of health. At the centre we should expect to find a Minister of Health, and every doctor of the State would give his whole time to his work and be paid by salary which in the case of the higher posts would be equal to that now fixed for the higher legal offices, for the chief doctor in the State ought to be at least as important an official as the Lord Chancellor. ”