the subject chosen being Medical Reform. and bodes a fatal,

a troublesome, or a doubtful case.

It would be a stretch of politeness to say that the subject is The College of Surgeons does not forbid its members from send. ably handled, or that the Oration is likely to reflect any great ing. out medicines, (practising pharmacy,) but only pure (or con. credit on the infant society. The tone and style are indifferent suiting) surgeons are elected into the Council. The law, however, and maudlin ; the topics chosen, often narrow in themselves, and prevents it, if not effectually. A member of the College cannot treated so As to be rendered still narrower ; whilst the author is recover a bill for medicines ; and the Apothecaries Company can so injudicious as to put forward his views on politics, and his ap- proceed against him for supplying them. Surgeons, like physi- probation of the Reform Bill, on a purely scientific, or at least pro- cians, cannot recover fees for advice or prescriptions ; but they fessional occasion. The exception to this censure is the summary may for operations, even such as bleeding, or dressing wounds. of his views on medical reform ; which doubtless embody those of The amount of remuneration is for the jury to fix according to the Association, and to which we shall presently recur. Before the circumstances of the case. doing so, however, it will be well to possess the reader with a ge- 3. Apothecaries. The Apothecaries Company is governed neral view of the present state of medical matters. by a Master, Wardens, and Assistants. They derive their authority In a recognized professional sense, there are three grades of from an act passed about twenty years ago ; which renders them, medical practitioners in England ; but in a larger view, there are though the lowest in rank, the highest in privileges of all medical five or six, with frequent varieties borrowing something from two practitioners. No one unless admitted into this company can sup- or more classes. We will describe these seriatim in the order of ply his patient with medicines—an apothecary can practise physic,

rank. surgery, or what he pleases. No one is eligible even as a candi-

1. Physicians. The College of Physicians was embodied under date, unless he has been apprenticed to a member of the Company HENRY the Eighth, by royal charter. It is governed by a Pre- —the examination opens with the production of the indenture. sident, (Sir HENRY HALF0RD3 and certain officers ; and the mem- This point established, the candidate is examined in Latin, the hers consist of Fellows and Licentiates. The candidate for ad- materia medica, with botany and chemistry, anatomy, physiology, mission must have taken a medical degree at some University, and the practice of medicine ; he has also to produce certificates and be prepared, it is understood, to make a display of his Latin very similar to those of the College of Surgeons. The examination and book lore. Till very lately, no one could become a Fellow, un-

is of course more tasking, as being more various, than that of the less he had graduated at Oxford, Cambridge, or Trinity College, College ; but is said not to be so searching on any single subject Dublin ; the two first being, without exception, the worst medical

that if, on a late melancholy occasion, Sir HENRY HALFORD had quiaite, lie cannot recover for attendance.

certificates of attendance on the surgical and medical practice of a recognized hospital, or on medical practice in a dispensary.

The primary function of a surgeon is, of course, surgical te the operations they may render necessary. But besides the

as a science, the prescription of medicines for their patients netts- re‘iSed . Bentley. — the then close monopoly of the physicians — and the eon.

acquainted with the structure of the body both in health and

he must be a Doctor to be eligible. is paid by sending in as much medicine as the circumstances of the patient will permit ; for which he can recover, unless the case The function of a physician is to prescribe for disease—strictly, should be so flagrant that the jury reduce the amount of his bill, perhaps, for internal disease. He must not compound or furnish But should he do justice, and send no more medicine than is re- medicines; he must not perform the most trifling operation. So Such are the three classes of recognized legal practitioners; lancets with him, and could have used them with the dexterity he but the law is almost a dead letter as regards the respective pri- might have deemed requisite in the first medical functionary in vileges of the first two. The College of Physicians can proceed the country ; or if--as a surgeon or apothecary, bent on pleasure, against unqualified persons practising as physicians ; but as the would have done to a stranger—he had bled or tried to bleed his onus rests with them to show that the case was not in any way a friend with a penknife, he might, according to strict law, have surgical case, and other matters difficult of proof', they have gene- been turned out of the College, or at least reprimanded, for rally broken down. " We are deterred," said the President, be- saving life. Besides these restrictions, all wounds, inju- fore the Committee of the Commons, " from doing our duty, by ries from accident, whether external or internal, and diseases the powers which the Legislature has given to apothecaries and involving operations, are removed from the prescription, and of surgeons." The surgeons, we have heard, have the power to course the knowledge, of the regular physicians. They take the paint over the word surgeon if any one improperly post it up; but pas in medical precedence ; and are, at least the Fellows, a supe- before the Commons Committee, the President stated that "the nor class as regards general education and social connexion, but College of Surgeons is a body that has no power." The apothe- as a body they arc equally inferior in a medical view to other caries have a much greater protection, and proceed against the practitioners. Their education, as a matter of necessity,* is the party for penalties ; but, from the odium attaching to the elm- most superficial and theoretical : they are of necessity shut out meter of informer, and the difficulty of proving the case, many from the treatment of the most dreadful, difficult, and various persons illegally practice, especially in the country. Hence a cases ; and, though the highest, are the most useless members of variety of irregular, though it may be not ill-qualified practi- the medical profession. They are paid for their visits or advice tioners. Doctors in Scotch and German Universities practise by a fee, which is an honorarium, not recoverable by law. as physicians, or, together with members of the College of 2. Surgeons. The College of Surgeons was incorporated Surgeons, run the chance of escaping from the Apothecaries about the middle of the last century. It is governed by a Company ; or evade them by sending prescriptions to a chemist President and Council, (self-elected,) whose members take the and druggist, who supplies the medicines and may recover them Presidentship and Vice-Presidentship by rotation. Candidates as a debt. A class of hybrids, members of the Apothecaries for admission are required to show that they have been en- Compiny or the College of Surgeons, are also doctors in some gaged for four years in the acquisition of professional know- school out of England. Some of these are men of standing and high ledge, " three of which shall have been passed in a recognized

• its owner is not a member of the London College of Physicians, is a questionable matter : at best he is sailing under false colours. medic, and medical botany ; besides certi

.1. Chemists and Druggists. Their business is to vend drugs and compound prescriptions. They undergo no examination whatever as to capability—anybody may open a druggist's shop;

neither have the public any guarantee for the genuineness or Of course we do not mean to assert that a physician is of necessity incom-

petent.. Indu p. stry will educate itself, and ability will profit more upon less o purity of the articles they sell. A chemist may prescribe visits

d

pertunny than stupidity. All our remarks are to be understood generally and furnish medicines for persons in his own shop ; but if he vl formally. I them at home, and supplies medicines, he cannot recover the

amount ; and be is within the Apothecaries Act. 'He, or any one, without qualification or semblance of qualification, may practice midwifery.

5.6. Quack Doctors and Patent Medicines. Both these instru- ments of mischief flourish with impunity. The quack, vending his medicines to his dupes, cannot be touched, even if there ex- isted on the part of the legal or medical authorities any disposi- tion to check him ; and the patent medicines, decorated with a Government duty-stamp, which many fancy a sort of guarantee, can be sold by a grocer,tobacconist, or in short anybody who takes out a licence. When death has ensued from malepractices of this kind, and jurors have done their duty in convicting, the judges, swayed by a spurious humanity, have let off the convict with a penalty, which any quack would cheerfully undergo fur the mere

notoriety of the case. Besides these anomalies and evils, there are other disadvantages

springing out of what the "general practitioners " call the mono- poly of the physicians and the pure surgeons ; which, however, as being of a professional nature, may be passed over by us : only we must observe, that, resting as they do upon the opinions of society, and the advantages of wealth, station, and eminence, (whether deserved or not,) they cannot be so easily overturned as many practitioners fondly imagine. In any medical reform, the first object is the public good— to insure the advice of qualified practitioners (not to the affluent, for they may protect themselves if they please, and no law can protect folly, but) to the poor ; and to save the igno- rant from the arts of charlatans, whether an avowed and ad- vertising quack, or the more specious but not less dangerous shopman, who tampers with incipient disease, till it becomes fatal, or attains such a head as involves, in its cure, a loss of time, of money, and, what is more than either, of constitutional stamina. If willing were achieving, the plan chalked out by the Medical Association would go a long way towards this. As put forth by Dr. GRANVILLE, it is somewhat wordy ; but we will give the greater portion of it, as embracing the views of profes- sional medical reformers. It will be seen that they resolve them- selves into equality of professional rank, public examinations of

. candidates, and the regulation of chemists and druggists.

let. A maximum degree of education, theoretical as well as practical, both preliminary and professional, obtained either at the existing colleges or through authorized private teachers, for all medical students. 2dly. The same uniform, and the highest possible test of qualification,* for all who intend to practise the healing art, no matter in what branch ; the said test to consist of practical as well as theoretical demonstrations of the candidates' abilities, exhibited at one or more public examinations, to be carried on in writing as well as verbally. adly. One and the same rank and title in the profession bestowed on all who have proved themselves capable to exercise the healing art by the highest possi- ble test of qualification: whether the candidate chose afterwards to practise as physician or as surgeon, or both, or as one and the other comprising obstetricy,

and any other subdivision of the art and science of medicine. • • •

4thly. An equal enjoyment of all the privileges and benefits appertaining to the highest degree of education and qualification as certified in a diplomaby every one possessing such a testimonial, in whichever part of her .Majesty's'do- minions he may ch.sse to settle as a practitioner. [At present a Scotch practi- tioner cannot practise in Euslrind.] fithly. The establishment of one racelty in the capital of each of the three realms; to be governed by the same laws, to be similarly constituted, and to be endowed with similar powers of qualifying candidates to practise in every part

of the empire. As each of the capitals has its university for instructing and examining and granting degrees to students in every branch of educational know- ledge, their privileges and rights should be left undisturbed in every respect, except as to the right of examining and conferring degrees in the medical art— which must be surrendered to the Medical Faculty. (Ably. The Medical Faculty in each capital should consist of a certain number of eminent practitioners and public teachers, no matter to what particular branch of the profession they may liave deemed it convenient or useful to confine them. selves. * • * The members should be remunerated by a fixed salary, and not by fees dependent on the number of examinations; and to the post of member of the faculty all medical practitioners should be deemed eligible, either by open election or by competition. • * * *

Sthly. The establishment of a Board is likewise absolutely necessary, to con- sist of members of the faculty most conversant in chemistry, botany, and natu. ral history, for the purpose of examining and licensing the vendors of drugs, and compounders or dispensers of medicines. The same Board should be em- powered to fix, and from time to time to alter, the regulations by which the operations of the vending chemists and druggists might -to be governed. 9thly. A general registry of all who have been admitted to practise the heal- iog art, as well as to sell and compound drugs, should be strictly kept at the Faculty's offices, open to public inspection ; so that, in case of impostors or un- qualified persons, (whose names of course would not appear in the said registry,) being found engaged in practising medicine in any of its branches, or in admi- nistering or compounding medicines, or in vending drugs, whether simple or compounded, with any reference whatever to health or disease—a common in- fbrmer may be able to prove the fact, by a mere reference to the registry, and convict the transgressor before a Magistrate, who shall be empowered and bound to treat the case summarily, and by such pecuniary or other punishment as is awarded ih cases of misdemeanour. [It would be an improvement on this fea- ture, to compel both vendors of drugs and practitioners of medicine to exhibit conspicuously, according to a prescribed formula, the nature of their licence in their shop or receiving-room. At present, a practitioner who does this conspi- cuously seems to be making a display.] So far as all this goes, it is well ; but two points are omitted,— first, the licensed sale of quack medicines ; second, the incapa- bility under which a general practitioner labours of recovering for visits. Let us throw out a hint or two on each.

I. We see no other mode of dealing with patent medicines, than putting a stop to them for the future; if the difficulties of the case should render it necessary to allow the sale of those

• The soundness of this may be questioned. " The highest possible hst of .ralification" would cause more than nine.tenths of the young candidates to be rejected ; and more than half of the existing practitioners, if examined anew. A sufficient qualification is all that can be demanded from the average of any profession. already established by:the licensed vendors of drugs. We are aware that useful medicines, or combinations, have been dis- covered by means of quacks • but this is merely submitting to a great evil on the possibility Of a good ensuing ; and the daily im- provements in chemistry, and the ardour with which it is pursued, render such a rood much less likely to occur than formerly. Any mode of regulating patent medicines, we do not perceive. If the author conceals an ingredient or the proportions from a Board of Examiners, the stamp of their approval is mischievous ; if he fully avows its composition, his secret is gone. 2. In some disorders the medicines are expensive ; but in the majority of cases the value of the curative drug is so small as to be inappreciable; and though it requires a liquid or solid basis to be administered, yet the worth of what sick peJple in general need take, including phials, boxes, and all appliances, is often not above a few pence a day. This candid mode of practice would not, however, remunerate a gentleman for one, two, or three visits a day, or perhaps for being called up in the middle of the night. He is therefore compelled to pour in drugs disguised in simple bodies, according to the endurance and pocket of the patient, so far as observation enables him to guess at the latter. Hence the degradation of an important profession to a sordid trade, without the openness with which trade is carried on; much suspicion on the part of the patient, as to the uses of his medi- cine, and the motives of his attendant; with, often, much huck- stering as to the charges when all is over, no standard by which they can be fixed, and no means of ascertaining beforehand what they are..i. Yet if a man were to treat his patients rightly, send- ing no more medicine than they absolutely required, and charge them for his visits, however moderately,—nay, though in the case of a poor person he lumped the whole out of charity,—he is depend- ent on their honour, and can recover nothing but the were me- dicine, or any manual service. So important do we deem this point, as regards the public and the bulk of the profession, (the heads, we know, will be averse to the change,) that any reform which does not embrace it will be useless and deceptive. And this improvement is practicable, whilst we suspect many others are not. The objects of the Medical Association are all excellent ; but such is the ignorance and indifference of the public, the power of the corporate bodies whose privileges and monopolies will be destroyed, with their means of earivi,gging Ministers and Senators, who must move in and decide upon Medical Reform, that much time must elapse before the questi3n has a probability of succeeding ; whereas a short act, requiring chemists and drug- gists to pass an examination before practising, and to enable a practitioner to recover a maximum fee for visits, might probably pass at once; for though physicians and pure surgeons would be very averse to it, it is questionable whether they could infuse their views into the Members of Parliament. Besides, the bill might be limited to members of the Company, leaving physicians' and surgeons' fees still honorariums. And if it were lost at first, the subject would be mooted in a practical way, and the ground well broken in the Legislature for medical reform. Let Mr. Wsni.EY, quitting Copyrights, look to this subject.

t An apothecary's fee for a visit could be ascertained without indelicacy, but it is utterly impossible to know the amount of what his bill may he.