MEDICAL PROFESSION. 



651 



which the circumstances and habits of their pro- 

 fession have entailed upon them, they may well be 

 allowed as an offset against their mortification, 

 some pride in their cheerful compliance with the 

 benevolent customs which they have inherited 

 with it. 



In England, the chief reliance for the regulation 

 of the profession, is upon the direct provisions of 

 the laws, enforced by penalties, which, in some 

 instances, are severe. The design of the chartered 

 privileges is to secure the community against the 

 ignorance and impositions of empirics. But in at- 

 tempting this, they have in effect established a dif- 

 ference of rank and of privileges in the profession 

 itself; and this is not always conformed to the dis- 

 tinctions of scientific and professional merit. The 

 London college of physicians, for example, whose 

 powers and privileges, as granted by charter, are 

 exceedingly ample, have established it as a by-law, 

 which no force either of persuasion or compulsion 

 has been sufficient to induce them to relax, that no 

 physician shall be elected a fellow of the college, 

 who has not taken a doctor's degree at one of the 

 English universities, Oxford or Cambridge. This 

 same college has the power (a power which it has 

 on several occasions shown itself sufficiently dis- 

 posed to exercise) to punish by fine and imprison- 

 ment, any man who shall attempt to practise medi- 

 cine in London, or within seven miles of it, with- 

 out a license from its own board of censors. The 

 law, however, compels them to grant the license 

 upon receiving proof of a sufficient education, at 

 whatever school it may have been obtained. The 

 advantages for a medical education at the univer- 

 sities are incomparably less than they are in Lon- 

 don and Edinburgh, and in some of the schools on 

 the continent, to which many English students 

 resort. As those who have the greatest portion 

 of enterprise and ambition will resort to those 

 schools which offer the greatest advantages, it fol- 

 lows, that a large proportion of the licentiates in prac- 

 tice, must be men of a higher character and a bet- 

 ter education than those who hold the higher 

 title, and enjoy the extended privileges of fellows. 

 Still more inevitably does it follow, that there 

 must be perpetual jealousies and collisions be- 

 tween the two classes of physicians. But this is 

 net all. There is still another class of practition- 

 ers more numerous than either of these. By the 

 charter of the college of physicians, as we have 

 said, none but a licentiate of that college is per- 

 mitted to practise medicine. More than a hundred 

 years ago, the college attempted to enforce the 

 law against an apothecary, who had visited a sick 

 man, and given him medicine, by which he was 

 cured, without charging a fee. The house of 

 lords, on an appeal from the king's bench, de- 

 cided that this was not practising physic, within 

 the meaning of the charter, and thus opened the 

 door for all apothecaries to follow the example. 

 They were of course not slow to avail themselves 

 of the privilege; and in a short time, a very large 

 proportion of the medical practice passed into their 

 hands, while that of the regular physicians de- 

 clined to little more than consultation. 



The whole history of this change is curious 

 and instructive; and singularly illustrates the 

 effect of relying upon legal protection in disregard 

 to the influence of public opinion. It needs no 

 ill-tailed history of the transaction, to show, that 

 at the time when it took place, there was H de- 

 mand on the part of the community for a more 



popular class of practitioners, which the law itself 

 could not resist. Whether it was, that the num- 

 ber of physicians was too small, or what is more 

 probable, that relying upon their legal privileges 

 they demanded more compensation or deference in 

 return for the exercise of their profession, than 

 the public were willing to concede, is of little 

 moment. Nothing but such a necessity as we have 

 supposed could have induced the house of lords, by its 

 decision, and the public by submitting to it, to do 

 away by a mere fiction of law, with the express sti- 

 pulations of the royal charter, sanctioned as they were 

 by an act of parliament. That it was no better than 

 a fiction, is shown both by the nature of the ques- 

 tion, and by the subsequent events. For more 

 than a hundred years, the apothecaries in England 

 have performed the duties, which in other coun- 

 tries are performed by physicians. The apothe- 

 cary visits the patient, and determines what his 

 case requires ; and the only real distinction between 

 him and the physician is, that instead of writing 

 his presciption and sending it to a shop, he sup- 

 plies the medicine himself, and then, by a degrad- 

 ing subterfuge, evades the law, by charging for 

 medicine only, and obtains compensation for his 

 personal attendance, either by an enormous charge 

 for his medicines, or by a sort of voluntary contri- 

 bution, which custom has rendered legal. Even 

 this yoke of humiliation is now taken from the 

 necks of the apothecaries. As they have provided 

 for the education of the members of their company, 

 the court in 1830 decided, that it is absurd to 

 regard them as mere mechanists, and that they 

 have the right to demand a fee for the mental 

 labour of prescribing the medicine, as well as for 

 the mechanical labour of preparing it. 



What are the precise distinctions in the It- gal 

 rights of this department of the profession, we do 

 not exactly know. But it will readily appear, 

 that here is a third rank in the profession, entitled 

 to, and aiming at, and not unfrequently obtaining, 

 general confidence and employment, as practition- 

 ers of medicine. It is sometimes not a little 

 amusing, to witness the struggle between them 

 and their more privileged and higher-titled bre- 

 thren. While the physicians uniformly speak of 

 them as an inferior class, they seemed disposed to 

 forget their origin. They have dropped the name 

 of apothecaries, and commonly style themselves 

 general practitioners. Although they have thus 

 brought themselves into notice and favour, not 

 only without, but in defiance of, the provisions of 

 charters and statutes, we find them no less than 

 their older brethren, relying upon such provisions, 

 for the defence of the privileges they have obtained. 

 They, too, have now their chartered company ; 

 and we find by some of the journals, that the com- 

 plaint is already made, that druggists are presum- 

 ing to prescribe in contravention of the rights and 

 privileges of the apothecaries. In twenty years, 

 we shall probably see these same druggists tread- 

 ing in the steps of their predecessors, and exalted 

 by some new legal fiction into acknowledged, if 

 not privileged practitioners.^ In the ultimate result 

 they, too, may become educated and competent 

 physicians. But in the interim, while the process 

 of transformation is going on, the kingdom is rilled 

 with ignorant and unskilful practitioners, and new 

 elements of discord and discussion are introduced 

 into a profession already sufficiently divided. 



Let us now suppose, that instead of the im- 

 mense powers conferred on the college of physi- 



