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All these doors and more are standing invitingly open, competing for candidates to enter, pay fees, and receive in exchange for their cash, any of the above combination of letters that may suit their purpose, or tickle their vanity; in virtue of which they can then authoritatively knock at the door of the General Medical Council, and demand to be placed on the Register as "duly qualified practitioners," legally licensed to commit manslaughter with impunity! And yet they may be, and as a rule are, profoundly ignorant as Anatomists, miserably unacquainted with the organs of the human body, and their functions as Physiologists, completely destitute of even a smattering of rational Hygiene, or of natural Therapeutics, while they may be so disgracefully illiterate as to be unable to "stand on the same platform as the pupil teachers in the village schools of Scotland," as Dr. Alexander Wood affirmed, or as Sir Dominic Corrigan said, that they "could not pass an examination for the place of a letter-carrier!"

Nay more, these "duly qualified practitioners" need know comparatively nothing of Surgery even as a mechanical art, let alone possess a knowledge of it as a high and noble science! To possess one or all of the above enumerated alphabetical distinctions, a Surgical Education or Examination is not necessary! Hence the awful maltreatment of disease that is perpetually taking place, such as Professor Syme gave an illustration of symptoms are mistaken for disease, patients are cruelly and needlessly tortured, and a multitude of valuable lives are annually consigned remorselessly to premature graves.

But it may be asked-Cannot medicine be safely practised without a knowledge of Anatomy, Surgery, Physiology, and Therapeutics?-without, in fact, thorough education in the Science of Medicine? Sir William Lawrence, one of the most eminent men of his age, has fully answered the question put

*

* Sir William Lawrence, who, as a Surgeon, Anatomist, Lecturer and Writer, was unrivalled, died July, 1867. "His talents were of the highest order; his acquirements seldom surpassed in our profession."--Lancet, July, 13, 1867.

in this way-"Is all this knowledge necessary for a practitioner ? is it required that a physician or a surgeon should know anatomy, natural and morbid, physiology, and pathology? To the science of Medicine, and to its rational improvement and extension, it is necessary; but by no means so to the mere routine of practice, and the successful prosecution of the trade. Perhaps, indeed, a firm faith in drugs and plasters, and a liberal administration of them, may be a surer road to popular success, if the remark addressed by a veteran practitioner to a young enthusiast in science be well grounded-Juvenis, tua doctrina non promittit opes; plebs amat remedia!"t-which may be freely rendered, young man thy scientific doctrine, though true to nature, will never, if carried out in practice, permit of your success in life, because the ordinary run of mankind love to be cheated with the destructive delusions of Drug Medication!

What, then, need a practitioner have-what knowledge must he possess? Well, he could not get on cleverly without some knowledge of the Materia Medica, but it will be sufficient if he possesses just enough to enable him to prescribe liberally "drugs and plasters," and this any three-and-sixpenny companion to the "British Pharmacopoeia" will put him in possession of. Hudibras says—

-"all a rhetorician's rules

Teach nothing but to name his tools."

So with Drug practitioners. There is no absolute necessity that their whole stock of medical knowledge should extend much beyond the nomenclature of the Pharmacopoeia, and a companion at three-and-sixpence will place its whole poisonous contents, with the formulæ for prescribing them, within the circumference of the most illiterate capacity. With such valuable "learning" at command, portentiously and dexterously handled, thousands of such practitioners are enabled to pass respectably"-nay, profitably-through life, without their path of practice having been illumined by a solitary ray of medical science! And this will continue to be the case as long as public

* Lectures on Comparative Anatomy, &c., seventh edition, p. 45.

ignorance and credulity support and reward practitioners of the kind, and consequently uphold and preserve the false systems of Physic by which they prosper.

But is it not truly shameful that such a state of things should exist in this nineteenth century, as medical authorities themselves admit? Surely if the "educated classes" were alive to their own interests the Medical Profession could not continue to be so unworthily composed as it confessedly is? In this case, however, there is action and reaction. The supinity of the public tends to lower the qualifications and character of the profession to swarm the country with practitioners of such gross incapacity as to be unfitted to hold an Army or Navy appointment; but, as they must live, of course the reaction is on the public at large, and thus deplorable evils are caused. What but disaster and calamity can be expected to arise from practitioners incapable of treating disease scientifically or rationally? Hence fatal mistakes are constantly occurring. Life is often endangered and frequently sacrificed; but it is seldom, save among the profession, that such things ooze out, for, no matter how gross and palpable the blundering may be, practitioners are found on this point to make common cause, and thus the relatives and friends of the victims immolated are consoled with the assurance, that the resources of Science and Art had been skilfully employed to effect a cure, or at least to procrastinate the fatal issue! "It was God's will!"-"His time had come"and that is all can be said about it!

In this way, observes an eminent and candid authority, Dr. Frank, "thousands are annually slaughtered in the quiet sick room!" Contemplating the havoc thus made by professional incapacity, Dr. Ramage of London placed this denunciatory opinion on record :— "I fearlessly assert that in most cases the sufferer would be safer without a Physician than with one. have seen enough of the mal-practice of my professional brethren to warrant the strong language I employ." And Dr. John Johnston, editor for many years of the Medico-Chirurgical Review, has given his independent testimony thus:-"I declare,

as my conscientious conviction, founded on long experience and reflection, that, if there was not a single physician, surgeon, man-midwife, chemist, apothecary, druggist, nor drug on the face of the earth, there would be less sickness and less mortality than now prevails!"

SECTION IV.-Medical Schools and Colleges-Special Hospitals -General incapacity of teachers-Reaction on the Profession -Opinions of Medical authorities on the subject.

Ir is, perhaps, a pardonable delusion for the general public to entertain that teachers and professors in Medical Schools and Colleges are men of high capacity, admirably qualified to im part sound instruction, and train the student-mind in the ways of science and truth. The evidence of fact, however, is of a very different character. Such appointments are, indeed, seldom made with exclusive reference-or scarcely any reference at all—to distinguished merit, or approved capacity for conveying instruction. Private influences, intrigues, personal or party considerations, for the most part regulate such offices, and the mere interests of students or of science are rarely consulted.

Then, Medical Schools have been multiplied far beyond the real wants of the profession, and practitioners assume the office of teacher, who are deplorably ignorant themselves. A connection with a School or an Hospital is rarely valued, save as a means of obtaining notoriety-of getting into a position for trading profitably on public credulity. When Examining Boards have been induced to recognize the certificate of any school, that is all that is required. The lectures are for the most part pretentious imperfections, and clinical instruction, which is the really valuable part of a student's practical education, is seldom in the hands of men who are earnest, and capable, and conscientious in the discharge of their duty,

In the same way, also, Special Hospitals have been increased

to a most mischievous extent. Almost every part of the human body has now its Special Hospital, just as in ancient times the Egyptian Priest-Physicians had a special deity to preside over some thirty-two divisions of the body, in order to multiply rites, and increase the flow of offerings into their coffers. For practitioners to club together and get up a Special Hospital is regarded as a certain passport to public favour. Their own friends of course aid them, and blow their trumpets, the charitable are wheedled out of subscriptions, and thus while there is unity in disease, there is no unity in teaching or treatment, and the time of students really desirous of learning their profession is frittered away in attending illusory instruction.

This is all caused by the delusion of a silly public, prone to believe that practitioners, because they are attached to some School, Hospital, or College, must necessarily be a grade beyond the common. True, some men of rare genius and distinguished teaching capacity are occasionally found in such situations, but as a rule, mediocre intellect and very common-place acquirements, a prejudiced adherence to preconceived opinions, a contentedness to continue plodding on in a dull routine of duties slovenly discharged, and an invincible hostility to the uncomfortable innovations of new truths are, unhappily, the acknowledged characteristics of the medical teaching power generally of the United Kingdom.

Many years ago the eminent Surgeon Carmichael of Dublin, when presiding over the Medical Association of Ireland, pointed out the evils that had then arisen from the systematic exclusion of highly-qualified men from Hospitals, Schools, and Colleges, and the appointment of the nominees of intrigue and favourit ism

!

"Those who want talent," said he, "resort to cunning and underhand dealing; therefore we usually find stupidity and trickery go hand in hand." He complained of "those subtle seniors of the profession upholding, by every means in their power, their aspiring but inefficient allies in the situations which they ought to possess, heedless alike of the injury inflicted on the members of their own profession, and upon society at large." He denounced the "most baneful system," by which highly educated prac

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