H. EDWIN LEWIS, M. D., Managing Editor.

IRA S. WILE, M. D., Associate Editor

Medical Mobilization.-The cold shadow of war has fallen upon the nation. A chill and a shudder has brought its normal reaction of increased heat. The spirit of patriotism is aroused. Lethargy, indifference, inaction have given way to enthusiasm, application, and devoted service. A nation of many component national factors has suddenly been welded into a homogeneous mass. The expression of a truly national feeling has been manifested everywhere.

In the midst of prosperity and material success, the nation has grown careless, indolent, and wasteful. National adolescence has been characterized by bombast, temerity, and extravagance. In the presence of the frowning face of Mars there has suddenly came national realization. Action, thoughtfulness, and careful judgment are being exercised thruout the land. The ideals of civilization are threatened. The last vestiges of primitive emotion have not been thrown off. The nation, loving peace and hating war is, nevertheless, preparing to defend its honor.

Fortunately, there are those who cling to ideals with almost "impertinent" tenacity and whose belief in non-resistance and human brotherhood forces them to struggle vigorously for the avoidance of war and the maintenance of peace. The pacifists are a valuable group in the community, regardless of whether their views be accepted or not. Since our nation loves honesty, sin

cerity of purpose, and moral courage, it must recognize that those of pacific leanings are struggling to protect the nation against impulsiveness, hysteria, and hasty action. Ideals of national honor vary. The war spirit is rampant. The peace spirit is struggling for existence. On one side is the large mass of individuals who see in war the only method for preserving national honor. On the other side, a smaller group sees in the preservation of peace the best method for maintaining national honor. In a democracy, the views of the majority prevail, whether they be right or wrong, and when the die is cast, the will of the majority is accepted as the true expression of national feeling.

In this time of crisis, sober thought must be given to the various problems of international relations. The public requires careful guidance without bombastic, jingoistic utterances, and needs patriotic inspiration free from cries for blood. War has long been surrounded with panoply, blare of trumpets, and significant ceremony. If there must be war, let it be approached with grimness and determination as an unpleasant duty to be performed. Let its seriousness in terms of human life and social sacrifice be recognized. Let the best brains and brawn of the nation be marshalled, organized, drilled and trained for the performance of the various duties necessary

for the successful determination of an early and permanent peace.

The place that the medical profession occupies in times of martial life is peculiar in that it is not essentially combative in character. Its duties are protective and restorative. Its services are valuable to friend and to foe. The military surgeon does not recognize a specific uniform as the necessary card of introduction to the military hospital. Service to humanity continues to be the motive underlying medical usefulness.

From the experience of the belligerents across the sea, the nation must have learned the value and importance of a large and thoroly trained medical branch of the service. The necessity for neutral red cross units for attending to field hospitals and base hospitals is indicative of a failure to recognize the paramount importance of officially caring for the sick and the wounded. From the standpoint of the fighter, the position of the wounded, the sick, and the psychically disabled is merely that they shall be removed as quickly as possible from the active forces, in order that their presence may not embarrass military movements or hamper the morals and discipline of the sound fighting force.

An injured soldier is no soldier. He is an incubus and a parasite sapping the vitality of the active army. It is for this reason that there must be organized a group of non-combatants, who can serve the nation by saving and restoring to useful activities as many of the injured as possible. Regrettably, in the youthfulness of our nation we have been wasteful. Our lands are not intensively cultivated. Full crop production, as found in France or Germany, is scarcely known here. The tonnage of

food waste would feed a small nation. Our coal fields and mines do not yield their full possibilities. Among the cheapest commodities in America today is human life. There has been inestimable wastage thru accidents and diseases, incident to occupation and industry, but the carelessness, indifference, ignorance, and neglect which have allowed it are slowly passing away. In drugs and medicine, in hospital building and organization, there has been lacking the thoro systematization that can only be established thru efficiency, economy and thrift.

On the brink of conflict, it is time to pause and contemplate the constructive possibilities for true patriots. How can the medical profession best serve the ration? There should be not merely the development of new organizations, requiring new machinery, large funds, and scattered centers of interest, but the physicians of the nation, as a whole, should be organized, as far as possible thru the normal agencies now existent. The machinery of the American Medical Association and the State and County Medical Soceties should be placed at the service of the Government, and thru them the entire profession should mobilized for the civil and military duties which will be incumbent upon the profession in event of war.

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If universal military training is to be regarded as essential for maintaining an efficient military force, then adequate training and organization of the medical force. should be secured to raise it to a high standard of effectiveness for its particular

functions.

The type of work now being performed by the American Red Cross, the establishment of units in a number of large hospitals of the country, represents a valuable

lesson in organization under private auspices, but without direct responsibility to national authority. It is timely to consider the reorganization of the Officers' Reserve Corps which provides for volunteers who may be available for active service when war is imminent. The assignment of the Reserve Officers to various duties in the United States Medical Department of the Army on the present pro rata of medical officers would be insufficient to care for the medical and surgical phases of civil and military service, in the event of a war characterized by the exigencies and furies experienced in the titanic grip of nations across the sea.

How can the medical profession best be mobilized and trained to perform its emergency duties? How can it acquaint itself with the details necessary to enable it to fulfill its obligations to the Nation? There is no more vital question confronting organized medicine today than "how may it become fully prepared to give unstinted, intelligent and patriotic service to the Government of the United States ?"

Education Thru Autopsies.-The accuracy of clinical diagnosis has long been subject to sharp criticism. The studies of Cabot and Oertel suffice to create a reasonable suspicion in the minds of diagnosticians as to the capability of carefully trained physicians to interpret, adequately and properly, the objective phenomena upon which they base their diagnoses. The establishment of a correct diagnosis is necessarily the basic problem to be solved before rational treatment can be instituted or satisfactory prognosis can be established.

In our medical schools considerable, tho

still insufficient time is given to the determination of diagnostic accuracy. For centuries the anatomy of the human body has been regarded as the foundation of medicine. It was not, however, until pathological anatomy came into its own thru the efforts of Rokitansky and Virchow that speculative medicine gave way to the correlation of clinical observation and the pathological studies resultant from autopsies.

As is well pointed out by Winternitz (Modern Hospital, October, 1916) "The autopsy furnishes the only means of teaching the student pathological anatomy; it controls clinical diagnosis and therapy; it is the only reliable evidence on which vital. statistics may be based, and it is a constant source of problems necessary for the advancement of medicine. Naturally, therefore, the greatest benefit is derived from the autopsy in an institution where teaching is combined with clinical and research facilities."

In medical colleges, gross pathology, cellular pathology and bacteriology receive a considerable time allotment. Rarely is the opportunity afforded for the correlation of the pathological facts demonstrated and the ante mortem clinical symptoms.

From the standpoint of medical pedagogy, the time spent on human dissection is probably less important than a similar period of time devoted to autopsy work. Unfortunately, text-book descriptions of disease are so general in character that the practitioner rarely sees a patient suffering with most of the symptoms he has been taught constitute the clinical picture of specific diseases.

The study of gross pathology is more likely to be correlated with microscopic anatomical pictures than with the symptoms, clinical history, or objective signs