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whole curriculum could be re-arranged, It is a constant complaint that the med. and the work could be better done and ical profession has no court of honor, no the more in accordance with modern re- court of appeals to adjudicate upon disquirements.
putes between its members, and hence the But to return to Mr Sydney Young's unseemly letters which flood the medical work:
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
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 bickerinys which are the re. general elsewhere. The precise effect of this proach of the profession are the outcome measure seems doubtful. It is, however, cer- of jealousy, that bane of medical practice. tain that the bishops occasionaily gave licenses. But then, what other class of professional to practise down to the eighteenth century, workers is so much exposed to fierce for in 1710 the Company formally petitioned Archbishop Tenison to refrain from licensing rivalry - rivalry whteh not only touches unqualified persons. In 1540 the long rivalry
the reputation, but the means of earning a between the barbers and the surgeons ended living? To win their daily bread is a by their incorporation as a single body under bitter struggle for very many competent the style of "the Barbours and Surgeons of practitioners. London." This curious union lasted till 1745. The incorporating statute confirmed to In its palmy days [says our authority] tha the Company the privileges granted them by Court was much occupied by disputes between Edward IV., and granted them the bodies of masters and apprentices. The latter confour felons yearly " for anatomies." Hervey stantly “had their correction” for “pylferwas himself a dabbler in medicine, and gave ing,” for “ running awaye,” and “
going to substantial tokens of his favor, not only to the the sea,” for “ pleaing at dice,” and “ dealing Company, but to many of its individual mem- unhonestly with maydes.” The “Almes of bers. Chief amongst these was “Butts, the the howsse” was bestowed “unto auncyent King's physician,” whose memorable service custom with roddes,” but by 1603 a more to Cranmer and the cause of the Reformation elaborate implement was in use, for that year at a critical moment is recorded by Shake we have the item, “paid to the Goldsmythe speare and by Strype. Doubtless the Com- for amending the Corrector viljd.” The pany conformed to the King's views in his “ Corrector" did not last long. In 1604-5 lifetime. But, in 1554, we hear of a “sol- the Court had again to buy “2 whippes for empne masse or other dyvyne servyce - an correction xIlljd, while a precept of 1611, accommodating phrase — at their charges; issued by royal authority, and complaining of and next year of “a goodly mass” and the the “apparell used by manye apprentises,” “ blessyd sacrament borne with torche-lyght and “the inordynate pryde of mayde serabout and from thens unto the Barbur-hall to vaunts and women servaunts in their excesse dener." By 1596, however, the Court were of apparell and foliye in variete of newe fashraising money, “to annoye the King of ions,” required stern enforcement. But if the Spaine - he had confirmed their charter in Court flogged its apprentices, it saw that their 1558 — and two years later they “lend ” Eliz masters did not “give them unlawfull correcabeth £100 for suppressing rebels in Ireland. tion,” that they were duly trained in " barIn the last year of the great queen — five years binge and surgery,'' that they were not kept after “ Henry IV.” was printed peti- "lowsie,” but maintained “with sufficient tioned her Majesty, and “ 'spent the same meate, drynck, and apparell,” and that coveryghte at the bores head at supper Xs IIIjd.” | nant servants were not " myssused in their In 1632 the “still-vex'd Bermoothes" appears boxe money. Ordinances of 1556, and again in the Company's minutes as the “ Barmoo- of 1566, forbid the letting out of the Hall • for thoes Lland,” and in 1627-8 “a poor soul weddings, sportes, or games therein, or playes, dier that showed a Mandrake to this Courte” or dauncinge, or for any other like entente" received five shillings.
– perhaps a token of the incipient Puritanism
of the City. Nevertheless, there were occa-1" or bookes and auntient Manuscripts in or sional dispensations, as on October 10, 1570, new Library." “Ship-money had been “when Margaret yt was Mr. Vaughan his paid to Elizabeth in 1596. In 1638 it is paid mayde is graunted to kepe one Sonday her again with some demur. In November the wedyng in the hall and no more. The prac- Company were fined in the Star Chamber, and tice was not extinct in 1708, as the clerk was in April, 1639, surgeons are pressed for the then entitled to a fee of £1"for the use of King's service in Scotland. Then come the Hall for funeralls, country feasts, or wed- forced loans by "order of the Lords and dings.'
Commons," and sales of plate to meet them,
the tendering of the covenant to the Company, The change is great indeed since those the erasure of the oath of allegiance from the days when the craft of Barbinge was actu- oath of admission (March 19, 1649), and of ally put before that of surgery, or what the Royal Arms from the insignia, a
gift" was then accounted surgery dressing to the .. Chaireman to the Committee for the gunshot wounds with boiling oil, removing Army,” charges expended in procuring a Prolimbs with black hot knives, and other tection from the Lord General, payments for enormities of which our generation has no
seats in church on days of humiliation and
thanksgiving, and presently disbursements experience, while, as for the drugs, the
“when the Lord Protector was enterteined by veriest old village crone's nostrums to-day the Citie.” The Court itself became infected are more scientific, less loathsome, and with the Puritan austerity. In 1647 it cut the more useful. In those days the mortality hair of a “sawcy” apprentice, the same, of London stood, it is said, at eighty per “ being ondecently long," and disbursed three thousand against the sixteen or seventeen shillings for mending the corrector twice." 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 his man that day is.," and the year previously
day, 1664-5, there was given to Mr. Pepis improvements in food, hygienic şurround-“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 Phi. The 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. We 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 In 1603 the barbers received “the most thanks to James II. for the “Declaration of high and mightie Prince James " upon his Indulgence” in 1687. Three years later the entry into the City “in greater number and Company atoned for their servility by pressmore statelie and sumtious shew"than in any ing forty surgeons' mates “for their Majesformer pageant. James harassed the com- ties' service in Ireland.”
In 1710 a surgeon panies for the plantation of Ulster, and under out of Lancashire refuses the oath of allegihis son we have surgeons despatched “for the ance. In 1714 the Barbers are bidden to be cureing of the wounded souldiers that come in readiness with their ornaments of trifrom the Isle of Rea." Still the Barbers umpli to welcome " our Most Gratious Lord flourished in the earlier years of Charles.. King George upon his comeing into this kingThey made divers contributions for the ran- dome.” In 1735 they drink seventy-nine gal. som of surgeons “captivated and enthrawled lons of wine at a sitting. In 1741“ Sr Robe under the slaverye of the Turke,” and at the Walpole” gives them a buck, and they buy a request of “William, Lord Bishopp of Lon- “ Punch Laddle," and we have just read in don,” afterwards Archbishop Laud, for “the the medical journals that this grant of a buck repairs of the decayes of St. Pawles Church.” continued until our own generation. In 1636 they employ“his Mat.'s Surveigher," Inigo Jones, to build them an anatomy theatre, For thirty years, the profession which and they celebrated the dedication thereof in has seen such changes has been a great 1638 by a great banquet to “the Lords of ye favorite with the middle classes, and thouprivye Counsell and other Lords and persons sands of perplexed parents have turned of State," many curious items for which still to it as a 'fitting field for the abilities of appear in their books. The theatre itself was
their sons. Alī liberal callings are now built because the " Anathomyes
were in the a great annoyance to the tables, seriously overstocked, and matters are dresser boardes, and utensills in of upper the established Church, and at the bar the
rapidly getting worse ; while in the army, kitchin," as a grisly minute runs. The same year (1638) they paid a long bill for brasses, pressure is exceedingly great. In one imrings, "swiftles," and chains for chaining up, portant particular the popular estimate of
medicine differs toto cælo from that of | foundation for the belief. Let us see what other professions, for while it is generally explanation can be offered. Whenever a recognized that the army can hardly be rich man is ill he sends for a practitioner said to keep those who enter in, at least of standing, and gives him much trouble, not for some years, and the bar and the and often makes great inroads on his time Church are little more to be depended on for weeks and months, and when at the as a certain and regular source of income, end of a long attendance, he receives a bill it seems often to be thought that physic of £40, £80, £100, or, in very rare cases, provides splendid opportunities for any £150, he jumps to the conclusion that number of imperfectly educated and very physic is a most lucrative calling, quite ordinary lads, and the money emoluments overlooking the enormous amount of at. are enormously exaggerated. Many per- tention the doctor has given him — the sons frankly admit that physic is not an mere visits sometimes not representing agreeable calling, and that the work is one quarter of the time needed to go and responsible and engrossing, but they return - and forgetting that not one pracnevertheless fancy that a diploma is a titioner in five has any rich patients at all, sure passport not merely to a livelihood, while the very man who has charged him but to opulence, and that good openings £100 for six months' untiring care has are easily found in any number. The ex- perhaps only got £3 or £4 from a poorer perience of medical practitioners does not client for the same amount of attention, confirm this view. Of course, a man nec- Half a successful doctor's income is someessarily knows the difficulties of his own times drawn from three or four families; calling better than he does those of others; this is especially the case in village and and nothing is more common than to under- open country practice, but is not without estimate the drawbacks of other walks its parallel in towns. For three years and of life. It is sometimes asserted that, in a half a single wealthy family, whom we proportion to the large pecuniary returns had to visit once or twice a day regularly expected from medical practice, doctors all the time - and for eighteen months we are not, as a rule, equal in attainments and did not once sleep away from home, so as training to the other professional classes, always to be within immediate call — paid and that an inferior man will get a larger us several times as much as we got from income as a general practitioner than in any all the rest of our work. One of the most other liberal calling. On such a point it is disagreeable features of medical practice not easy to speak positively, but according is that the rich are often and almost necesto the writer's experience - a sufficiently sarily charged sums enormously in excess large and varied one — successful prac- of any money value which the doctor's titioners are almost invariably able men time can be supposed to have, while the with a competent professional education poor, from their indigence, pay fees that and great self-reliance and knowledge of would hardly satisfy a ploughman. No character. It has been estimated, with medical man can escape a vast amount of much show of reason, that hardly one practically unpaid work; if a hospital medical man in forty rises to professional physician or surgeor., he does it, without eminence and social dignity. If that is any pretence at remuneration, in the ordiso, even moderate success must be the nary routine of his hospital duties, while, exception.
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 remunera. cers 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 io throw some light on this years past. In short, ihe problem how to point, and properly used, they would seem supply the masses with competent medical io 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
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 his own in the competition of life in the the indigent invalid, accustomed to think liberal callings, though few even among in pence, considers enormously over- consulting physicians are recognized as charged; hen again, the burden of bad being in “the county," and not many debts which weighs down most doctors to move on terms of equality in those naro the ground.
row circles which comprise the judges, Nothing is more touching than the enor- the bishops, and the deaps, distinguished mous amount of trouble which medical military and naval officers, and writers of practitioners will sometimes take on behalf national eminence. of clients who never will, and sometimes The discomforts of practice are always never can, pay anything. When we were great; and, without attempting to magnity in London we knew a man, now a rising them or to underrate those of other callphysician in a South Wales town, who was ings, they are very acutely felt. The strain always ready to go to any case of emer-is sometimes terrible. Broken nights and gency the moment he was called. We have frequent exposure to rain, wiod, and cold, sent for him in the middle of the night, are added to regular business hours of and he has hurried to our assistance with work, that may commence at seven or eight out a moment's delay – always coming in in the morning and go on till midnight. cheerful, full of resources, and ready to Often, indeed, the doctor, especially in help to any extent, and as long as needed. large towns, labors bravely but unsuccessWe have known this man, though the heir fully against time, vainly trying to overof a large fortune, attend confinements in take his work, going without his meals, out-of-the-way Welsh villages, sometimes and starting four and even six times a day by himself, lighting the fire, cooking the on his weary rounds. In towns of any food, making the bed, and washing the size, indeed, he hardly pretends to have baby. Such work is not pleasant, but such fixed hours for anything, or to go regular kindly services as these go a long way to rounds; he is on the rush all day long, atone for theirritability often shown when This, however, of itself, is not a matter of a brother practitioner gets a well-to-do complaint; for it only means press of client, to whom his discarded rival consid- work, and he would complain still more ers he has a vested right.
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
he canactly what lies before any one entering not cast his duties from him night or day. upon it. Only a small percentage of the Holidays he hardly ever knows; those le young men commencing medical studies has are spoiled by telegrams to return are well born and affluent, so that the home, by pre-occupation, and worry. Only profession has a far smaller percentage of the doctor in actual practice can fully un. persons of high rank and ample means derstand what the pressure of the work than the bar, the Church, and the army; often is. Not a day is free, not an hour. although, even in the army, the number of A single case of severe illness, with its these gilded sons of fortune is not very possible urgent calls, and grinding anx. large. The rank and file, however, of iety, may tie a man, very far from sucmedical practitioners are fully as well con. cessful or prosperous, for weeks. There nected as average clergymen, lawyers, comes a most pressing invitation to lunch and officers, while we venture to assert at a great house some way off, but the that the large body of semi-educated non doctor must decline it, because a client is university men, often of very humble an- so ill that he dare not be away from home tecedents, which accounts for two-fifths an hour longer than absolutely necessary, of the clergy of the National Church, has A week later he has an opportunity of hardly any counterpart in inedicine, at any seeing something be wants very much to rate among the practitioners who have see, but though his patient is now better, commerced practice during the past thirty be dare not think of it, as it would mean years. Medical men, without including being out a large part of the day. Even peers or sons of peers in their ranks, rep- were he to go, and nothing went wrong, resent a fair grade of the middle ciasses, half his pleasure would be lost by the con
viction that he ought to be at home. Yet occupation and worry, it is very rare to this patient, more likely than noi, never find medical men attending public gathershows one particle of gratitude, and would ings in any numbers; forty clergymen be surprised to learn what sacrifices had may be counted for each doctor, and, still been made for him. The ordinary routine more remarkable, the disciples of physic is often severe enough — thousands of re- are seldom found to have the serene manspectable practitioners are always busy pers and good humor of the more fortunate dispensing or seeing poor patients in the classes. The high spirits, the hearty enearly morning, at midday, and the whole joyment, which the country rector out for evening. To this constant drudgery there a holiday so often shows, are exceptional is intermission -out-door ainuse in the surgeon out for his change; the ments, visiting, entertaining, and other latter takes things far less easily; a glance relaxations are simply impossible and are discloses that he is weighed down by the unattempted. We have known men who problems of existence, that he is less urhad not left home for a single day in bane, sharper tempered, rougher tongued, twenty or even thirty years, while thou- less cultured, and less capable of unre. sands more, even in these times, when served enjoyment. Something may be holidays are quite an institution, have one due to the narrower resources of the short, broken, uncomfortable holiday every doctor, who, though he may earn more, third, fourth, or seventh year. We speak has usually a smaller private income than from knowledge and experience when we the rector or the colonel, and consequently say that eight years may pass without a takes a lower place in good society and, fortnight's holiday. The long changes of indeed, sees far less of it. the clergy, and the vacations of the bar- The difficulties of active practice are rister, are wholly unknown; the nose is not few; the uncertainty in making out ever to the grindstone, and no one so lives what is the matter with the sufferer is in his professional duties as the ordinary sometimes great; the symptoms are often doctor. This is equally true of many exceedingly perplexing and the ablest practitioners of the highest eminence in practitioner can hardly form a trustworthy the largest towns; they seldom see a opinion as to their character. This unifriend and hardly once a year go out for certainty as to the nature of the complaint an evening. An eminent Dublin physi- and the course it will run is most trying, cian told us that in forty years he had only and wears the medical attendant out. No twice for a few days left home, while on practitioner — we care not what his emi. two occasions that he invited us to dinner nence or ability — could truthfully say he was called away, and we had the dinner that he had not repeatedly made serious but not our dear old friend's society. A mistakes, especially as to the probable Birmingham surgeon of distinction had course and duration of an illness. In spite not for years been out for an evening, of the marvellous advances of the medical when his daughters, with much difficulty, art, it must be confessed that in a consid. persuaded him to go to a place of amuse- erable percentage of cases, more than ment; he had hardly reached the assem- many men would care to confess, this unbly-room when he was sent for. He was certainty continues, and the doctor cannot induced to take tickets several times soon for the life of him tell what is the matter. after, and with the same result; he posi- When this happens his hypothetical prog. tively could not go out for an evening nosis is probably wrong; or sometimes he without being called for. Every doctor takes a gloomy view, and prepares the knows the irregular hours, the frequent sufferer for evil, of which, after months of urgent and impatient calls, and the inter- unremitting attention, he discovers that ruptions which, if they do not make life there is no danger. At other times he iniolerably wearisome, rob it of more than takes a favorable view, and buoys up the half its enjoyment. The late second visit, friends, until some day he is startled and which he is told will only mean a few min- shocked by a contretemps for which he utes, is one of the doctor's worst miseries was wholly unprepared, and for which he - an hour, or even two, and sometimes had not been able to warn the family. three may be lost, and the weary, elderly The ablest men are not exempt from these practitioner for it is he who generally disheartening and painful uncertain.ies. comes in for the two visits a-day patients A hospital surgeon of great eminence and - is completely exhausted by a visit astuteness was hastily called to a young which, to the sufferer and his friends, man of rank, the son of a very distin. seems a trifle hardly worth mentioning. guished county family. The sufferer bad Mainly, no doubt, as a result of this pre- / been kicked at football, but the surgeon