Medicine: To Throw at the Cat

The world of medicine boasts some 6,000 medical journals, almost a tenth of them in the U. S. A major requirement for scientific publication is dullness. All articles in British and U. S. journals are cut to the same hidebound pattern: The problem is stated, its history reviewed (often from the time of Hippocrates), the experiments or clinical notes baldly recorded, briefly "discussed." Finally the whole structure is crowned with conclusions—if there are any.

Medical editors frown upon literary graces as Puritans frowned upon dancing. Almost all medical reports are warty with Greek and Latin jargon: "Etiologic factors" for "causes," "acute coryza" for "the common cold," "osseous structures" for "bones." Yet the modern physician's bible, Sir William Osier's Principles and Practice of Medicine, is a model of warm and lucid prose—human language conveying the fears and torments of sick human beings.*

Most outstanding among the handful of U. S. doctors who show some compassion for the English language is Editor Morris Fishbein of the Journal of the American Medical Association. Editor Fishbein has a wit which he likes to sharpen at the expense of quacks and of others who displease him. Only attempt at humor in the whole spate of U. S. medical journals is the collection of stale, smutty jokes which have trailed with dismal repetition through the Journal's "Tonics and Sedatives" column for the past 20 years.

Last fortnight Scotland's famed physiologist, 68-year-old Sir Robert Hutchison, made some remarks on the style of British and American medical literature. Occasion: A David Lloyd Roberts (famed obstetrician who died in 1920) memorial lecture before the London Medical Society. The average time before papers get into print in scientific journals is around 12 months, but last week's issue of the British Lancet gave Sir Robert's speech front-page billing. Excerpts:

"The great majority of us are snowed under by an avalanche of medical journals. Too many doctors choke their offices with unopened magazines 'useful to throw at the cat,' and the only way a busy physician can keep up with his field is to clip and catalogue practical articles. Facts may be said to be buried rather than recorded."

To check the avalanche, control the "verbal diarrhea," "mental exhibitionism," and "itch for advertising" of many medical writers, Sir Robert suggested: 1) "strict birth control in regard to new journals," strict "suppression" of many old ones; 2) tougher editing ("almost everything is too long"). Above all, he said, there should be no publication of "memorial lectures, such as this one. . . . There are surely better ways of remembering the dead than by boring the living."

As for the literary quality of medical writing, Sir Robert continued, "Many papers on medical psychology, biochemistry or iatromathematical [medico-mathematical] subjects might . . . just as well be written in Chinese. . . . American medical literature . . . exhibits only too often an absence of any sense of style or even of grammar. . . . We are not yet so bad as that here. . . .