Note on Chronic Functional Disorders

W. G. Webber
1921 Boston Medical and Surgical Journal  
\OL. CiXXx IN'. -No. 1I5)] BUSTO.\ MEDICAL AND SURGICAL JOURNAL 399 -rhe fenifininq quality of wanting sometlling ne,w and a clange, does not always stop to reasonl as to the So0undness of wvhat has previously been done, and practiced. Women have their part in insistinlg uponi progress and must be given credit for it. Their work, tiowever, is supplemental to that of men. Woman mlust be, as she alvays has been, a coo,perative Worker witlh man. She can never supplant him. Woman has come into the
more » ... has come into the field very effectively in Matters relating to public health promotion, district Visi.ting aiid social 1welfalre. She is a nurse by nature, anld the backbone of the hospital, but how well she tits as a diagnostdciani, or into the rOle of general or SPecial prsaetitioner, may be open to question. The fact remainis that she is advancing materially the field and opportunities of medical service. The city and large towins lhave lhad, for the most. part, the beimefit of these niew professions. The doctor aind medical maan has been gradually sucked away from the rural districts and small towns by the lure of hospital attractions, clinical facilities and education, and be-Muse he appreciated the value of trainied woimen wvorlkers inl the field. The problem of medical service in the back counitry grows more and more seriouis. 1 Wih81 to quote from a recent letter: "rFranklini Ooulnty Farlnm Bireau, "Gr-eejnfleld, Muss.. March 1i, 1921. "rr. P l1 W. Goldsbury, bear sir:-"In thinlkiing over the matter of lheailtlh in our ,rural commuinities, I lhave become more and more 1lpressed witlh the great loss which has comie to thbe in the disappearance of the old country doctor. ITe practically no longer exists in this Colnty. rormerly. lie was a tower of strength nl the communi,ty, being interested In everyone fromn hirth to the grave, and was not only a Counselor In health. but ani adviser in edue-tliO and community policies. The fact that many Or thle people of the country towns mire iiiany' imiles froma a physician annd that our towni physicilans dliSllke to go long distances in a(lverse wveather COnditions whlen most needed. operates to shut thelil away from medical service in many cases. "The not result is that the navorne couintry commlunity does not have as good medical ser-VCees afl it did 50 years ago, while othler classes n1W receiving superior nladvantages. The exarmna-'t(>n Of eomllt.ry l>ys dtirinig the dlraft pertod fAored the result of this condition. a condition olr Which the country community Is not to blame. As there seems to be very little chance th 11t yong doctors v1ill settle in country districts.°o lolngt athere Is a cliance of practieing In the Centres there seemns to be no hope for improved colJtions from this souree and we must look to°e nsatjion, or movement, to give the opport fitNfor suieh medieal attendance ns is neede(d 'I the eolinitry districts. This problem is one Wh!ich 9ha a great influence on the futuhre det(1 flt of ouir agricuiltuire. and one in which uliklin Countv lxtension Service for Agrieul-tillr% and IThne Making is muieh interested and 'Willinlg to CopeVralte triu ilorgang serov q are seeking to exten(d dis- "lmi nring prvice and social welfare work into a5n ds Rtricts. That will be a mobilizing of suhel que.qio, 'OVer th)e hills and into -the back regions. The tjtate4 (ot dbistribIltion of health eentres is being treatrn ", t,hat distanw to clinics for spedalized ast 08In the case of tubercular and venereal diseases, will not be so great and so costly. The writer believes that hospital and clinical educational facilities should be within 20 miles of every general practitioner, and that provisions should be made so that lhe can get ,to such, at least once a week. The writer also believes that su-ch health centers and the best kind of cooperation from physicians cannot be brought into being by mere legislative enactment, org31izatioii and financial support. The program and survey which can be adapted, to the city and large towni fits almost not at all to the rural (listrict and each district has such a distinctive topography andl individuality that standardizing makes a ticklish or l)recarious foundaton and framework. Rural life in thfiis part of the country is an unknowin book, es,senitially, to the welfare worker and district nurse. They have Inot lived backthere enoughl to know and sense elemiienital conditions, the temperamenit and(I prejudices Kof the poople, history and character of the land, etc., etc. The present rural practitioner holds the key to the initial development of a public healtlh program lor this back region and he must be souglht out and his influience brought to bear for any permaneryt plan of iiphufilding. A real Tappreciaition of what he was in the past and a faith 'in his capacity to help solv;3
doi:10.1056/nejm192104141841517 fatcat:acevogix7vcgrgx2g32b7zjpre