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whole curriculum could be re-arranged, and the work could be better done and the more in accordance with modern requirements.

But to return to Mr Sydney Young's work:

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proach of the profession are the outcome of jealousy, that bane of medical practice. But then, what other class of professional workers is so much exposed to fierce rivalry-rivalry which not only touches the reputation, but the means of earning a living? To win their daily bread is a bitter struggle for very many competent practitioners.

It is a constant complaint that the medical profession has no court of honor, no court of appeals to adjudicate upon disputes between its members, and hence the unseemly letters which flood the medical periodicals, and which, whether they setDespite the Company and "Mastur John the ill-temper and professional rivalry of tle anything more important or not, leave Smyth," we learn by a statute of 1511 that great multitude of ignorant persons, including too many medical practitioners in no possmythes, weavers, and women, who can no sible doubt. But would a court of appeal letters on the boke" take upon them great have any advantages? We believe that cures, "in the whiche they partly use sorcerye a professional court of appeal possessing and witchcrafte, partly apply such medicines legal status and authority would be useunto the disease as be very noyous and noth- less in promoting loyalty to the profession yng metely therefor, to the highe displeasure and to the claims of the community in of God, great infamye to the facultie, and the general, though such a self-constituted grevous hurte, damage, and destruction of court of appeal might be used as a terrible many of the Kynge's liege people.' Wherefore it is enacted to the suertie and comfort engine to ostracize those young and obof all maner people," that none shall practise scure candidates for medical employment as physicians or surgeons without the license who are already sufficiently weighted in of the Bishop or the Dean of St. Paul's in the race with their seniors. Most of the London, or that of his bishop or his vicar-discreditable bickerings which are the regeneral elsewhere. The precise effect of this measure seems doubtful. It is, however, certain that the bishops occasionally gave licenses to practise down to the eighteenth century, for in 1710 the Company formally petitioned Archbishop Tenison to refrain from licensing unqualified persons. In 1540 the long rivalry between the barbers and the surgeons ended by their incorporation as a single body under the style of the Barbours and Surgeons of London.' This curious union lasted till 1745. The incorporating statute confirmed to the Company the privileges granted them by Edward IV., and granted them the bodies of four felons yearly for anatomies." Hervey was himself a dabbler in medicine, and gave substantial tokens of his favor, not only to the Company, but to many of its individual members. Chief amongst these was "Butts, the King's physician," whose memorable service to Cranmer and the cause of the Reformation at a critical moment is recorded by Shakespeare and by Strype. Doubtless the Company conformed to the King's views in his lifetime. But, in 1554, we hear of a "solempne masse or other dyvyne servyce -an accommodating phrase-at their charges; and next year of "a goodly mass" and the blessyd sacrament borne with torche-lyght about and from thens unto the Barbur-hall to dener." By 1596, however, the Court were raising money "to annoye the King of Spaine". he had confirmed their charter in 1558-and two years later they "lend" Elizabeth £100 for suppressing rebels in Ireland. In the last year of the great queen- five years after .. Henry IV." was printed wee petitioned her Majesty, and "spent the same nyghte at the bores head at supper Xs IIIjd." In 1632 the "still-vex'd Bermoothes" appears in the Company's minutes as the "Barmoothoes Lland," and in 1627-8 "a poor souldier that showed a Mandrake to this Courte " received five shillings.

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In its palmy days [says our authority] the Court was much occupied by disputes between masters and apprentices. The latter constantly "had their correction" for " "pylfering," for ". running awaye,' " and " 'going to the sea," for "pleaing at dice," and "dealing unhonestly with maydes." The "Almes of the howsse was bestowed " unto auncyent custom with roddes," but by 1603 a more elaborate implement was in use, for that year we have the item, "paid to the Goldsmythe for amending the Corrector vIIjd." The "Corrector" did not last long. In 1604-5 the Court had again to buy "2 whippes for correction xIIIjd, while a precept of 1611, issued by royal authority, and complaining of the "apparell used by manye apprentises, and "the inordynate pryde of mayde servaunts and women servaunts in their excesse of apparell and follye in variete of newe fashions," required stern enforcement. But if the Court flogged its apprentices, it saw that their masters did not "give them unlawfull correction," that they were duly trained in binge and surgery," that they were not kept "lowsie," but maintained with sufficient meate, drynck, and apparell," and that covenant servants were not "myssused in their boxe money.' Ordinances of 1556, and again of 1566, forbid the letting out of the Hall "for weddings, sportes, or games therein, or playes, or dauncinge, or for any other like entente" -perhaps a token of the incipient Puritanism

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For bookes and auntient Manuscripts in or new Library." 'Ship-money" had been paid to Elizabeth in 1596. In 1638 it is paid again with some demur. In November the Company were fined in the Star Chamber, and in April, 1639, surgeons are pressed for the King's service in Scotland. Then come forced loans by "order of the Lords and Commons," and sales of plate to meet them, the tendering of the covenant to the Company, the erasure of the oath of allegiance from the oath of admission (March 19, 1649), and of the Royal Arms from the insignia, a gift" to the Chaireman to the Committee for the Army," charges expended in procuring a Protection from the Lord General, payments for seats in church on days of humiliation and thanksgiving, and presently disbursements "when the Lord Protector was enterteined by the Citie." The Court itself became infected with the Puritan austerity. In 1647 it cut the hair of a 66 sawcy apprentice, the same, "being ondecently long," and disbursed three shillings "for mending the corrector twice."

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The change is great indeed since those days when the craft of Barbinge was actually put before that of surgery, or what was then accounted surgery-dressing gunshot wounds with boiling oil, removing limbs with black hot knives, and other enormities of which our generation has no experience, while, as for the drugs, the veriest old village crone's nostrums to-day are more scientific, less loathsome, and more useful. In those days the mortality of London stood, it is said, at eighty per thousand against the sixteen or seventeen which we have lived to look upon as the After the Restoration we find the Company, normal figure, though, of course, much of as examiners of naval surgeons, in close relathis improvement cannot be credited to tions with the Navy Office. Thus, on Auditadvances in surgery and medicine, but to day, 1664-5, there was "given to Mr. Pepis his man that day Is.," and the year previously improvements in food, hygienic surround-"Mr. Pepis" himself attended a lecture in ings, and, let us hope, in some degree to the theatre, and "had a fine dinner and good better morals and a higher religious tone. learned company,' "" many "Doctors of PhiThe Barber surgeons basked in the sique," and was "used with extraordinary refavor of the court and long kept up their spect. The terrible "visitacion " of 1665-6 connection with the royal family, as in- leaves its marks upon the Company's books, deed did other city companies of the and the great fire burnt down their hall. time. So, at any rate, Mr. Sidney Young have the surrender of their charter in 1684, tells us :after the quo warranto had issued against the city, and a somewhat fulsome address of thanks to James II. for the "Declaration of Indulgence" in 1687. Three years later the Company atoned for their servility by pressing forty surgeons' mates 'for their Majesties' service in Ireland." In 1710 a surgeon out of Lancashire refuses the oath of allegiance. In 1714 the Barbers are bidden to be in readiness "with their ornaments of triumph to welcome " our Most Gratious Lord King George upon his comeing into this kingdome." In 1735 they drink seventy-nine gal. lons of wine at a sitting. In 1741 "Sr Robt Walpole" gives them a buck, and they buy a "Punch Laddle," and we have just read in the medical journals that this grant of a buck. continued until our own generation.

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In 1603 the barbers received "the most high and mightie Prince James upon his entry into the City "in greater number and more statelie and sumtious shew" than in any former pageant. James harassed the companies for the plantation of Ulster, and under his son we have surgeons despatched "for the cureing of the wounded souldiers that come from the Isle of Rea." Still the Barbers flourished in the earlier years of Charles. They made divers contributions for the ransom of surgeons "captivated and enthrawled under the slaverye of the Turke," and at the request of "William, Lord Bishopp of London," afterwards Archbishop Laud, for "the repairs of the decayes of St. Pawles Church." In 1636 they employ "his Mat.'s Surveigher," Inigo Jones, to build them an anatomy theatre, and they celebrated the dedication thereof in 1638 by a great banquet to "the Lords of ye privye Counsell and other Lords and persons of State," many curious items for which still appear in their books. The theatre itself was built because the "Anathomyes "" were in the cook's way, 66 a great annoyance to the tables, dresser boardes, and utensills in or, upper kitchin," as a grisly minute runs. The same year (1638) they paid a long bill for brasses, rings, "swiffles," and chains for chaining up,

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For thirty years, the profession which has seen such changes has been a great favorite with the middle classes, and thousands of perplexed parents have turned to it as a fitting field for the abilities of their sons. All liberal callings are now seriously overstocked, and matters are the established Church, and at the bar the rapidly getting worse; while in the army, pressure is exceedingly great. In one important particular the popular estimate of

foundation for the belief. Let us see what explanation can be offered. Whenever a rich man is ill he sends for a practitioner of standing, and gives him much trouble, and often makes great inroads on his time for weeks and months, and when at the end of a long attendance, he receives a bill of £40, £80, £100, or, in very rare cases, £150, he jumps to the conclusion that physic is a most lucrative calling, quite overlooking the enormous amount of attention the doctor has given him — the mere visits sometimes not representing one quarter of the time needed to go and return and forgetting that not one practitioner in five has any rich patients at all, while the very man who has charged him £100 for six months' untiring care has

medicine differs toto cælo from that of
other professions, for while it is generally
recognized that the army can hardly be
said to keep those who enter in, at least
not for some years, and the bar and the
Church are little more to be depended on
as a certain and regular source of income,
it seems often to be thought that physic
provides splendid opportunities for any
number of imperfectly educated and very
ordinary lads, and the money emoluments
are enormously exaggerated. Many per-
sons frankly admit that physic is not an
agreeable calling, and that the work is
responsible and engrossing, but they
nevertheless fancy that a diploma is a
sure passport not merely to a livelihood,
but to opulence, and that good openings
are easily found in any number. The ex-perhaps only got £3 or £4 from a poorer
perience of medical practitioners does not
confirm this view. Of course, a man nec-
essarily knows the difficulties of his own
calling better than he does those of others;
and nothing is more common than to under-
estimate the drawbacks of other walks
of life. It is sometimes asserted that, in
proportion to the large pecuniary returns
expected from medical practice, doctors
are not, as a rule, equal in attainments and
training to the other professional classes,
and that an inferior man will get a larger
income as a general practitioner than in any
other liberal calling. On such a point it is
not easy to speak positively, but according
to the writer's experience a sufficiently
large and varied one-successful prac-
titioners are almost invariably able men
with a competent professional education
and great self-reliance and knowledge of
character. It has been estimated, with
much show of reason, that hardly one
medical man in forty rises to professional
eminence and social dignity. If that is
so, even moderate success must be the
exception.

client for the same amount of attention. Half a successful doctor's income is sometimes drawn from three or four families; this is especially the case in village and open country practice, but is not without its parallel in towns. For three years and a half a single wealthy family, whom we had to visit once or twice a day regularly all the time and for eighteen months we did not once sleep away from home, so as always to be within immediate call paid us several times as much as we got from all the rest of our work. One of the most disagreeable features of medical practice is that the rich are often and almost necessarily charged sums enormously in excess of any money value which the doctor's time can be supposed to have, while the poor, from their indigence, pay fees that would hardly satisfy a ploughman. No medical man can escape a vast amount of practically unpaid work; if a hospital physician or surgeon, he does it, without any pretence at remuneration, in the ordinary routine of his hospital duties, while, if a club or parish doctor, he gets his full No data exist for forming a thoroughly share of it. In our own case we have trustworthy estimate of the earnings of paid thousands of visits and gone hundoctors, and as they cannot be ascertained dreds of long journeys without always with the same precision as those of offi- getting thanks, much less any remuneracers and clergymen, the best informed tion, and as for unpaid prescriptions, they may easily go far astray. Still, facts have reached a very high figure for several enough exist to throw some light on this years past. In short, the problem how to point, and properly used, they would seem supply the masses with competent medical to demand a reconsideration of the opinion practitioners at fees not beyond the means generally held. But it may be objected: of the poor is not yet solved, and is apHow comes it, unless that opinion is cor-parently insoluble. We do not think that rect, that the wealthier classes hold such any other case could be cited of highly erroneous views? Surely if it is thought educated men, expected to live up to a and most people do think so that any certain standard and compelled to spend steady young doctor can almost infallibly large sums in carrying on their occupa get a good income at once in any part of tion, being so often in the direct employ the Three Kingdoms, there must be some of the very poor. Hence the difficulties

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of hospital, club, and parish practice; and have almost invariably had superior hence, too, the bickerings over med- advantages of education and social inter ical accounts, when the poor sufferer is course. When the doctor is moderately charged £3 or £4 for services honestly successful and well-to-do be easily holds worth five times that amount, but which the indigent invalid, accustomed to think in pence, considers enormously overcharged; hence, again, the burden of bad debts which weighs down most doctors to the ground.

Nothing is more touching than the enormous amount of trouble which medical practitioners will sometimes take on behalf of clients who never will, and sometimes never can, pay anything. When we were in London we knew a man, now a rising physician in a South Wales town, who was always ready to go to any case of emergency the moment he was called. We have sent for him in the middle of the night, and he has hurried to our assistance without a moment's delay-always coming in cheerful, full of resources, and ready to help to any extent, and as long as needed. We have known this man, though the heir of a large fortune, attend confinements in out-of-the-way Welsh villages, sometimes by himself, lighting the fire, cooking the food, making the bed, and washing the baby. Such work is not pleasant, but such kindly services as these go a long way to atone for the irritability often shown when a brother practitioner gets a well-to-do client, to whom his discarded rival considers he has a vested right.

his own in the competition of life in the liberal callings, though few even among consulting physicians are recognized as being in "the county." and not many move on terms of equality in those narrow circles which comprise the judges, the bishops, and the deans, distinguished military and naval officers, and writers of national eminence.

The discomforts of practice are always great; and, without attempting to magnify them or to underrate those of other callings, they are very acutely felt. The strain is sometimes terrible. Broken nights and frequent exposure to rain, wind, and cold, are added to regular business hours of work, that may commence at seven or eight in the morning and go on till midnight. Often, indeed, the doctor, especially in large towns, labors bravely but unsuccessfully against time, vainly trying to overtake his work, going without his meals, and starting four and even six times a day on his weary rounds. In towns of any size, indeed, he hardly pretends to have fixed hours for anything, or to go regular rounds; he is on the rush all day long. This, however, of itself, is not a matter of complaint; for it only means press of work, and he would complain still more sharply had he less to do. Were the work Before dealing with the emoluments of reasonably well remunerated, it would be successful practitioners, we will say a few bearable, but its drawbacks deserve_conwords as to the ordinary routine of a doc-sideration. In the first place, the busy tor's life, as it is well to understand ex-practitioner is always in harness actly what lies before any one entering upon it. Only a small percentage of the young men commencing medical studies are well born and affluent, so that the profession has a far smaller percentage of persons of high rank and ample means than the bar, the Church, and the army; although, even in the army, the number of these gilded sons of fortune is not very large. The rank and file, however, of medical practitioners are fully as well connected as average clergymen, lawyers, and officers, while we venture to assert that the large body of semi-educated nonuniversity men, often of very humble antecedents, which accounts for two-fifths of the clergy of the National Church, has hardly any counterpart in medicine, at any rate among the practitioners who have commer.ced practice during the past thirty years. Medical men, without including peers or sons of peers in their ranks, represent a fair grade of the middle classes,

he can

not cast his duties from him night or day. Holidays he hardly ever knows; those he has are spoiled by telegrams to return home, by pre-occupation, and worry. Only the doctor in actual practice can fully understand what the pressure of the work often is. Not a day is free, not an hour. A single case of severe illness, with its possible urgent calls, and grinding anxiety, may tie a man, very far from successful or prosperous, for weeks. There comes a most pressing invitation to lunch at a great house some way off, but the doctor must decline it, because a client is so ill that he dare not be away from home an hour longer than absolutely necessary. A week later he has an opportunity of seeing something he wants very much to see, but though his patient is now better, he dare not think of it, as it would mean being out a large part of the day. Even were he to go, and nothing went wrong, half his pleasure would be lost by the con

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viction that he ought to be at home. Yet this patient, more likely than not, never shows one particle of gratitude, and would be surprised to learn what sacrifices had been made for him. The ordinary routine is often severe enough. thousands of respectable practitioners are always busy dispensing or seeing poor patients in the early morning, at midday, and the whole evening. To this constant drudgery there is no intermission — out-door amusements, visiting, entertaining, and other relaxations are simply impossible and are unattempted. We have known men who had not left home for a single day in twenty or even thirty years, while thousands more, even in these times, when holidays are quite an institution, have one short, broken, uncomfortable holiday every third, fourth, or seventh year. We speak from knowledge and experience when we say that eight years may pass without a fortnight's holiday. The long changes of the clergy, and the vacations of the barrister, are wholly unknown; the nose is ever to the grindstone, and no one so lives in his professional duties as the ordinary doctor. This is equally true of many practitioners of the highest eminence in the largest towns; they seldom see a friend and hardly once a year go out for an evening. An eminent Dublin physician told us that in forty years he had only twice for a few days left home, while on two occasions that he invited us to dinner he was called away, and we had the dinner but not our dear old friend's society. A Birmingham surgeon of distinction had not for years been out for an evening, when his daughters, with much difficulty, persuaded him to go to a place of amusement; he had hardly reached the assembly-room when he was sent for. He was induced to take tickets several times soon after, and with the same result; he positively could not go out for an evening without being called for. Every doctor knows the irregular hours, the frequent urgent and impatient calls, and the interruptions which, if they do not make life intolerably wearisome, rob it of more than half its enjoyment. The late second visit, which he is told will only mean a few minutes, is one of the doctor's worst miseries - an hour, or even two, and sometimes three may be lost, and the weary, elderly practitioner for it is he who generally comes in for the two visits a-day patients is completely exhausted by a visit which, to the sufferer and his friends, seems a trifle hardly worth mentioning. Mainly, no doubt, as a result of this pre

occupation and worry, it is very rare to find medical men attending public gatherings in any numbers; forty clergymen may be counted for each doctor, and, still more remarkable, the disciples of physic are seldom found to have the serene manners and good humor of the more fortunate classes. The high spirits, the hearty enjoyment, which the country rector out for a holiday so often shows, are exceptional in the surgeon out for his change; the latter takes things far less easily; a glance discloses that he is weighed down by the problems of existence, that he is less urbane, sharper tempered, rougher tongued, less cultured, and less capable of unreserved enjoyment. Something may be due to the narrower resources of the doctor, who, though he may earn more, has usually a smaller private income than the rector or the colonel, and consequently takes a lower place in good society and, indeed, sees far less of it.

The difficulties of active practice are not few; the uncertainty in making out what is the matter with the sufferer is sometimes great; the symptoms are often exceedingly perplexing and the ablest practitioner can hardly form a trustworthy opinion as to their character. This uncertainty as to the nature of the complaint and the course it will run is most trying, and wears the medical attendant out. No practitioner - we care not what his eminence or ability-could truthfully say that he had not repeatedly made serious mistakes, especially as to the probable course and duration of an illness. In spite of the marvellous advances of the medical art, it must be confessed that in a consid erable percentage of cases, more than many men would care to confess, this uncertainty continues, and the doctor cannot for the life of him tell what is the matter. When this happens his hypothetical prognosis is probably wrong; or sometimes he takes a gloomy view, and prepares the sufferer for evil, of which, after months of unremitting attention, he discovers that there is no danger. At other times he takes a favorable view, and buoys up the friends, until some day he is startled and shocked by a contretemps for which he was wholly unprepared, and for which he had not been able to warn the family. The ablest men are not exempt from these disheartening and painful uncertainties. A hospital surgeon of great eminence and astuteness was hastily called to a young man of rank, the son of a very distin guished county family. The sufferer had been kicked at football, but the surgeon

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