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The French and American medical professions share similar historical bases for strong political and economic market positions. As professions, the attributes of common education, ethics, and mission tend to keep physicians together in their political organization. But the medical professions in both France and the United States are also subject to intraprofessional forces of division, such as the conflicts which often oppose generalists to specialists. Although organized medicine in France and the United States shares these commonalities, there is a very important difference between the two countries. The French profession tends toward organizational particularism, both ideologically and nonideologically, which serves to splinter it in ways inimical to the interests of the medical profession. By contrast, the American medical profession tends to organize universally-that is, its organizational base is much more often one of unity and accommodation toward the divergent interests of physicians. Thus, organized medicine in the United States has more easily fought off political and economic pressures coming from government and the private sector-but by no means with total success. On the other hand, highly fragmented organized medicine in France has experienced an almost linear decline in the face of pressures coming from a determined and strong state.

The 100 most-cited JAMA articles were identified using the 1955 through 1983 Science Citation Index of the Institute for Scientific Information. The most-cited article received 705 citations, while the least-cited article received 158. The oldest was published in 1910 and the most recent in 1976. These articles describe important medical advances in areas such as asbestos exposure, smoking, and oral contraceptives. Most of the 285 JAMA authors are Americans and include Baruch S. Blumberg and Edward A. Doisy, both Nobel laureates. Thirteen of the articles were included in JAMA's original landmark series; the editorial committee used a combination of peer review and citation frequency to select 51 articles.

They are unalike and far apart, these 13 past editors of The Journal. Between Nathan S. Davis's first issue and William R. Barclay's retirement, there was almost a century of change in medicine, society, the American Medical Association, prose style, and editorial needs. During these years, the editors ranged from the brilliant organizers John B. Hamilton and George H. Simmons to the diligent John H. Hollister and the devoted Johnson F. Hammond. There were editors with the hot determination of James C. Culbertson, John H. Talbott, and Robert H. Moser, and there were those with the cool precision of Austin Smith and Hugh H. Hussey. They varied from Morris Fishbein, who wrote and spoke "with the grade of an eagle in its unhindered soar," to Truman W. Miller, who wrote scarcely a word. Here, briefly, they are together.

In the last half of the 19th century, medicine was becoming organized. In Washington, DC, in 1870, the attempt by black physicians to join the local medical society met with fierce and successful resistance. Ultimately, a separate, racially integrated medical society was formed. One hundred years ago, it became the still-vital Medico-Chirurgical Society of the District of Columbia, the local branch of the National Medical Society.

Little has been written recently about the obligations of lay people in professional relationships. Yet the Code of Medical Ethics adopted by the American Medical Association in 1847 included an extensive statement on "Obligations of patients to their physicians'. After critically examining the philosophical foundations of this statement, I provide an alternative account of lay obligations in professional relationships. Based on a hypothetical social contract and included in a full specification of professional as well as lay obligations, this account requires lay people to honor commitments and disclose relevant information. Ethically, the account assumes that all parties in lay-professional relationships should be given equal consideration and respect in determining rights and obligations. Factually, it assumes that the treatment of many illnesses and injuries required collaboration and cooperation among lay persons and health professionals, that medical resources and personnel are limited, and that medicine, nursing, and related health professions, are, in MacIntyre's sense, practices.

From the introduction of the "Gallinger-DC" bill in 1896 to the passage of the Laboratory Animal Welfare Act in 1966, organized medicine and the American physician have been active in promoting the humane and appropriate use of research animals and explaining to the public and legislators the importance of research using animals to medical progress. The role of organized medicine and science in events leading to passage of federal legislation is discussed. Past efforts of the American Medical Association and the American physician have been critical in numerous successful efforts at the local, state, and national level to prevent the passage of laws which restricted animal use for health research and impeded medical progress. This article demonstrates that current initiatives by physicians to preserve biomedical research are a reaffirmation of their traditional role.

The following address was given at the Gold-Headed Cane Ceremony, University of California School of Medicine, on 3 June 1966. At this event on the eve of Commencement Day, the senior student who has been chosen by his classmates and professors in the Department of Medicine as the one who best exemplifies the qualities of a true physician is given a gold-headed cane. This carries on the English tradition of a cane which was passed from physician to physician from 1689 to 1825, and was carried successively by Drs. John Radcliffe, Richard Mead, Anthony Askew, David Pitcairn and Matthew Baillie. The original cane now rests in the Hall of the Royal College of Physicians in London.