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Many have felt, at least up to the last few years, that there is less encouragement for the prosecution of scientific medicine, or at least of original research, in this than in some other countries. On the continent the philosopher has frequently occupied a high position : at any rate hospital and other medical appointments, whether civil or military, are commonly bestowed by concours, whilst with us such positions are often obtained in a somewhat objectionable way, through personal favour or family interest. A late eminent surgeon and physiologist was accustomed to observe, that every research in which he was engaged had a prejudicial effect on his practice. As a nation we look too often to present results; much of the real greatness of the first French Emperor, on the other hand, consisted in his appreciation of excellence and its effect on the future. Fortunately the pleasures of scientific pursuits constitute, themselves, their best rewards.
In this country, too, the constitution of the profession is, and always has been, anomalous; and errors in medical as well as in civil legislation have generally a bad influence on the community. The great body of those who pursue the medical art in England have no Alma Mater. A trading guild is invested with the high powers of creating the majority of the medical practitioners throughout the land, whilst its office ought rather to be the regulation of the art of the pharmacien or dispensing apothecary, and the suppression of the dangerous charlatanism and nostrums for which England is so notorious. The College of Surgeons receives large fees from its members, and yet, virtually, does not confer upon them even the power to practise surgery, for it has never prosecuted those who practise the art without its diploma, which the most illiterate quack frequently does, with less responsibility to the law in case of malpractice, than the qualified practitioner. To the College of Physicians and the two Universities, perhaps not more than a quarter of the country physicians belong, neither do they acknowledge the authority of the same, being, in fact, as far as the extant laws are concerned, unqualified practitioners.
We, however, recognise the merits of all these bodies. The first, of late years, has done more than might be expected from it; and the College has been fortunate in the acquisition of endowments for lectures and prizes, of distinguished Professors and Curators, and of the Hunterian Collection, the present state of which renders it one of the proudest possessions of science, and an amende honorable for the destruction of Hunter's folios of illustrative manuscript.* But we might have expected more from the Royal College than zootomical and microscopical pursuits, and we must not close our eyes to the fact, that a large body of intelligent men, practising one of the learned professions in a great nation, has been allowed to continue for ages in a humiliating state of unorganization.
As is generally the case, however, it is more easy to find fault than to point out a better plan; but we trust that there are a few plain indications of cure in this case, as there are in other disorders. And, perhaps, the wise physician would rather endeavour to restore the perverted functions, it may be by some unpalatable remedies, than attempt to reconstruct the body medical entirely anew.
Let the Worshipful Company properly regulate the practice of pharmacy, the College of Surgeons continue to give diplomas in surgery, and the College of Physicians descend somewhat, and take in such graduates of Medicine throughout the land as are entitled to the astute distinction of treading in the footsteps of Linacre or Harvey. Let all invidious distinctions, such as those of permissi in and extra urbem (a town patient being made of the same “stuff" as a country one) be annulled, or at least conferred according to seniority and attainments, and not by favour or an additional fee.
* A copious Synopsis of the contents of this Museum would be useful, and, together with a catalogue of the excellent library, might be presented gratuitously to each member.
But in this country, owing to the tardy progression of these bodies, another class of medical men, called general practitioners, has sprung up, which is not identical with any one of them; and, therefore, another college has become necessary, with its council, into the mode of nominating which we shall not enter ; but to which might be intrusted the power of licensing and registering, and, when needed, examining all practitioners ; of prescribing a proper qualification either as to course of study, or diplomas from other colleges ; being ready, likewise, to give advice in all matters of public Hygiene; to recommend properly qualified individuals to fill important civil or military medical offices -exercising, in fact, those necessary powers which the other Colleges, from their supineness, have allowed to lapse.
In the following pages, however, the author proposes to review the state of medicine under a scientific, rather than a political, aspect. A glance at the Table of Contents will show how he has arranged his subject. With respect to the anatomy of the nervous system, he hopes that he has, in the text and in the figures, presented some little original matter. As to the chapter on materia medica, he may observe that he has not wanted the opportunity, nor the inclination, to examine the substances described, some of them rare foreign productions. The subject of the seventh chapter, a kind of Bridgewater Essay, has long been a favourite study with him ; and in reference to the concluding one, on the various forms of pseudo-medical science, he trusts that it has not been written with more acerbity than a proper zeal for the honour of the Profession demands.
The author's principal object has been to demonstrate that considerable reliance may be placed upon the present theories and practice of medicine, bearing in mind, however, that more light remains to be shed on very many medical subjects, and that all human opinions and doctrines are liable to error. It is demonstrable enough that the foundations of Medicine must ever be the truths of Anatomy and Organic Chemistry ; and he hopes he has shown that the former has now arrived very near to perfection, and that the latter also is making rapid progress. In the various heterodox systems both these sciences are totally ignored. With respect to disease itself, he has endeavoured to elucidate, that, in many general diseases, a rational plan of cure exists in aiding or regulating the efforts of Nature herself to restore the organism to health ; but when we come, as in the Fifth Chapter, to changes of structure rather than diseased actions, or what are called organic diseases, which the disciples of other systems explicitly abandon as too unpromising, * he maintains that his art, Medical or Surgical, still shows her power—in many cases it can effect a cure ; in more, prolong life.
He next endeavours to point out a benignant Providence and dispensation even in the per
* Hahnemann's “ Organon,” Lane's “Life at the Water Cure."
mission of disease and pain, and especially in the existence of agents to cure or alleviate both. Of the last Chapter, a review of the different unfounded systems of Medicine and Physiology, he has already in the preceding paragraph sufficiently spoken.
He has written for the Profession in the first place, but also with an eye to the inquiring portion of the community—with what success he leaves to their indulgent judgment to decide.