8 MAY 1886, Page 36


ADDISON slyly observes that when a nation abounds in physicians, it grows thin of people, and he adds that in our country medical men "may be described like the British army in Cwsar's time ; some of them slay in chariots, and some on foot." A hnmonrist like Addison is privileged, and in the early years of the last century such mirth at the cost of the doctors was perhaps legitimate enough. In no science has there been more rapid, we may almost say startling, progress than in that of surgery during the last half-century, and if the advance in medicine has been less striking, it is acquiring a firmer basis every day. Sixty years ago, bleeding, cupping, and leeches were the chief resources of the apothecary. The patient was bled if he was plethoric, and bled if he was aummic, bled if he had a fit, and bled if he fainted. Moreover, "almost all pain in any com- plaint, quickness of pulse, headache, intolerance of light or noise, being believed to arise from inflammation, blood flowed in torrents to subdue it." And just as operations were, to quote Mr. Bettany's words, "too often frightful alternatives or hazardous compromises," so was the treatment of disease founded less on a careful observation of Nature, than on authority and guesswork.

Yet even in the darker ages of medical science, England can boast of physicians and surgeons who have lost none of their reputation by the progress of knowledge. Linacre, whose name stands first in Mr. Bettany's list of Eminent Doctors, may be called the founder of British medicine, and to him also we are indebted for the foundation of the Royal College of Physicians. He was a man of universal knowledge, and had pupils no less famous than Sir Thomas More and Erasmus. He taught the latter Greek, and found the great Dutchman troublesome from his impecuniosity. "It has been questioned," says Linacre's biographer, Dr. J. N. Johnson, "whether he was a better Latinist or Grecian, a better grammarian or physician, a better scholar or man." Dr. Caine, whose name lives in the College which he founded, was a boy of fourteen when Linacre died. Like his great predecessor, he had travelled in Italy, and on his return introduced into the country the practice of dissection of the human body. He is said to have predicted the day of his death, and had his grave prepared accordingly in Caius College Chapel. Five years later, William Harvey was born, who ranks with the greatest discoverers of all time. Yet it is said that his Treatise on the Heart and the Circulation gave a severe check to his professional prosperity, and by the vulgar he was regarded as crack-brained. "The great Emathiau conqueror bid spare the house of Pindarus ;" but although, when the Civil War broke out, Harvey attended the King by the desire of Parliament, he states that, by the command also of Parliament, his house was not only stripped of all its furniture, "but, what is subject of far greater regret with me, my enemies abstracted from my museum the fruits of many years of toil." "Harvey," Mr. Bettany writes, "has the rare distinction of standing at the

• Botinent Doctors. By O. T. Bettany, M.L. Oamb., B.Sc. Land., F.L.S. 2 vol. London John Hogg.

head of three departments of science in England,—comparative anatomy, physiology, and medicine. When these scarcely existed, he evolved them into living form from chaos. The extent of his achievements must be gauged by the extent of the superstructure built upon his foundations." Another great physician lived in the days of the Civil War. Sydenham seems to have earned his reputation by his sagacity and sound sense. He trusted nothing to theories, but may be said to have waited on Nature, convinced that "Nature moves in a regular and orderly manner." Sydenham is well known for his faith in the benefit of horse exercise, especially for consumptive patients, and he is said to have lent a poor man one of his own horses for a journey of several days,—an agreeable prescription, truly. He was not without humour. " Now-a-days, every house has its old woman," he says, "a practitioner in an art she never learnt, to the killing of mankind ;" and he observes of a certain mode of treatment, that if it be resorted to the patient will die of his own doctor, which may have suggested the final line of Prior's epigram,—

" I died last night of my physician."

When that portentously dull epic poet, Sir Richard Blackmore, asked him what books he should study medicine in, the reply

was,—" Read Don Quixote, Sir, which is a very good book ; I read it still." So also, by the way, did Dr. Callen, the famous Edinburgh physician, who is said to have recommended this most wonderful of romances to Dugald Stewart when a boy, and to have talked over with the lad every successive incident,

scene, and character."

The difficulty of obtaining subjects for dissection was at one time no slight trouble to medical students, and in Edinburgh the violation of graves caused the surgeons to be suspected, which forced them to denounce the rumour as scandalous and malicious.

But there can be no doubt that until the passing of the Anatomy Act, body-snatching was a frequent occurrence, and it is well- known that Sir Astley Cooper, in his early years, was a constant dealer with the resurrectionists, and, as Mr. Bettany observes, not only paid large sums for the bodies, but also spent hundreds of pounds in defending the men, or providing for their families, when they got into trouble. Sir Astley, it is said, "could obtain any subject he pleased, however guarded ; and, indeed, offered to do so. No one could go further than he did before a Committee of the House of Commons, to whom he placidly avowed There is no person, be his situation in life what it may, whom, if I were disposed to dissect, I could not obtain.

The law only enhances the price, and does not prevent the ex- humation." It was not to his credit, and reads very like a political agent's boast that a constituency could not escape his skill in corrupting it. Remarkable " cases " must have felt as shy of Sir Astley as the famous Irish giant, O'Brien, who had the misfortune to be seven feet seven inches in height, was of John Hunter :—

"It appears that O'Brien had heard of and dreaded the scalpel of the famous dissector, and took special precautions to frustrate his ends. He made an Irish league with several compatriots that his body should be taken to sea and securely sunk in deep water ; but Mr. Hunter, more subtle than the giant, had made a big bargain with the undertaker, who arranged that daring the funeral progress towards the sea, the coffin should be locked up in a barn while its guardians were drinking at a tavern. The corpse was speedily extracted, and a sufficient weight of stones substituted ; and Hunter soon rejoiced in the possession of his prize, which he drove to Earl's Court in his own carriage, and quickly converted into a skeleton."

We may add that the skeleton so artfully secured is now a pro- minent object in the Museum of the Royal College of Surgeons. though it is a trophy of which, in our opinion, they ought to be ashamed. Hunter's ardour for dissection was so great, that he may be almost said to have lived for years in the dissecting-room. In the study of comparative anatomy, after dissecting all the sommoner animals, "he passed beyond the ordinary range, and made acquaintance with the keeper of the Tower menagerie that he might obtain the bodies of such animals as died there."

Even this did not suffice, for he is said to have purchased animals when alive from travelling showmen, on the understanding that their bodies should be brought to him when they died. We are not told whether people tried to sell their bodies to Hunter prospectively, but offers of this kind were made to Sir Astley Cooper, who, of course, rejected them with scorn. Like Hunter, Sir Astley dissected animals, and at one time an enormous elephant came under his knife.

The fees of great surgeons and physicians have an interest

for the public as well as for the recipients. Hunter never gained more than £6,000 a year, and for many years he gained less than £1,000. Sir Astley's profession brought him trifling sums for several years ; in the fifth year of his practice he only gained £100; but in time his income rose to £15,000 a year, and one year it reached £21,000. Sir Benjamin Brodie's receipts from first to last are stated to have far exceeded Cooper's. It was Dr. Hope, if we remember rightly, who said that no physician, he did not say no surgeon, could fairly earn more than £5,000 a year. That statement was made, however, when physicians were content with smaller fees than at the present time ; but even now there are probably not a large number of London physicians who have the choice of following Sir Henry Holland's example and confining their professional income to £5,000 a year, in order to retain leisure for study, recreation, and traveL It was vulgarly reported of Dr. Chambers, when his right hand was injured by blood-poisoning, that his fingers had become crooked from the continual habit of taking fees. Few physicians have been more popular, audit is said he could scarcely depend on one regular meal a day, so great was the demand for his services. "He literally rushed through the streets, driven post-haste at ten miles an hour." Yet his fees do not appear to have exceeded nine thousand guineas a year, a limitation that may be accounted for by frequent illnesses. Dr. Baillie, the brother of Joanna Baillie, who flourished in the early part of the century, had perhaps at that time the leading practice in London, and is said to have made £10,000 in some years. And this high remuneration was not confined to the Metropolis, for forty years ago, Sir Dominic Corrigan, of Dublin, was receiving an income of £9,000 per annum. It might be judged from these figures that the medical profession is one of the most profitable. No doubt it is so to eminent doctors, just as the Bar is profitable to distinguished barristers ; but the medical profession has, we think, this advantage over the Bar,— that any man of average ability, if his character be good and his purpose steady, is almost certain to gain a living by medi- cine, although he may fail to win an independence.

The high fame of the profession in all its branches has been nobly sustained iu our own day. Since Jenner made his great discovery, no one, perhaps, has done mankind greater service than Sir James Simpson by the application of anaesthetics in surgical cases. The frightful torture caused by some opera- tions, the impossibility of performing others which are now common, and the nervous dread of the surgeon's knife, which was itself pain of the most exquisite kind, were features belong- ing to the surgery of the past which, thanks, in the first place, to Simpson, have now almost disappeared. Suggestions with regard to anwsthetics in surgical cases had been made by Sir Humphry Davy, whose discovery of the effects of nitrous oxide may be said to have led the way to further experiments in this direction. "Simpson," says Mr. Bettany, "was in this respect not a man marvellously in advance of his age," but he was the first to bring ether and chloroform into general use in surgical practice, to the grief of some foolishly pious people, who thought that by so doing he was opposing a Divine pur- pose. In fact, as one clergyman expressed it, "chloroform was a decoy of Satan." The whole story of Simpson's life, as told by Mr. Bettany, is most interesting. He died before he was sixty, and would have been buried in Westminster Abbey bat for his own wish to be buried in Edinburgh, the city in which he had done his life's work. "His funeral was such as Edinburgh, it is said, never witnessed before, business being generally suspended." The wonderful achievements of Sir T. Speucer Wells as an operator in ovariotomy were made possible by the introduction of ananthetics. An American named McDowell performed the first modern operation of ovariotomy, in 1809, and it proved successful ; but the difficulty and danger were extreme when patients were in a conscious state, and some of the highest medical authorities condemned the operation emphatically. Sir Spencer Wells, using all the aids of medical science, has succeeded in rescuing thousands of women from death, and giving "to all future victims of a malady before inevitable in its fatality, consolation, hope, and almost certainty of cure." Truly, "Peace has her victories," and of these some of the greatest have been achieved in the field of surgery.

Mr. Bettany 's volumes are written for medical men as well as for the public, and from all readers they deserve a welcome. The progress of medical science, especially during the last ball. century, encourages a still greater hope for the future. This hope extends even to mental disease.