supply of medical advice to the pauper is very far superior to that which the independent labourer could procure by his own unaided efforts. To sweep away these popular fallacies, and to revert to clear and just notions of the objects of a public sanative provision, we must get rid-first, of its Poor-Law connexion,-next, of the drug-supply by medical officers. It will then be seen, that an efficient national establishment,for visiting the sick, tending the wounded, soothing pain, and restoring health,-yet further, for preventing diseases by scientific expedients, and for instructing the people, at their houses, how to preserve health and prolong a useful life,—can no more degrade or pauperize the persons thus benefited, than enlarging their knowledge by public lectures, free libraries and museums,-training and disciplining their minds by endowed schools and colleges, instilling the truths and morals of Christianity by pastoral visits and ministrations,-protecting them from personal injury by a police force and a magistracy,—or defending them by Counsel in courts of law, when threatened with the forfeiture of liberty or life. Will any one have the boldness to affirm that the last-mentioned public provisions tend to lower the independence and self-reliance of the gratuitous recipients? Neither, then, will medical attendance and sanitary advice have such an effect when freed from their pauperizing concomitants and associations. The real cure, both for the perverted idea and for the practical evils to which it has led, is what in substance we recommended eleven years ago—namely, to connect medical duties among the poorer classes with the preventive visitation of districts, to separate the drug-provision,—and to place the renovated office under professional supervision, co-operating with highly qualified Central and Local Councils of Health. "SPERAMUS enim et cupimus futurum, ut id plurimorum bono fiat; atque ut medici nobiliores animos nonnihil erigant, neque toti sint in curarum sordibus; neque solum propter necessitatem honorentur, sed fiant demum Omnipotentiæ et Clementiæ Divinæ administri, in vitâ hominum prorogandâ et instaurandâ; presertim cùm hoc agatur per vias tutas et commodas, et civiles, licet intentatas." BACON. Hist. Vitæ et Mortis. ESSAY V. CHAPTER FIRST. OFFICERS OF HEALTH; THEIR PRIMARY DESIGN AND 1. AN Office, most beneficial in its design, yet anomalous in its relations both to the community and to the medical profession has existed for a short time in a few towns of England and Wales. In no other civilized country, nor at any former period of history-it may be safely affirmed-have similar appointments been made. § 2. The States of Ancient Greece and Asia Minor maintained famous physicians for public duties, at the public cost. Such, say some, was Hippocrates at Athens. Such, also, was Democedes successively at Ægina, Athens, and Samos.* Plato held that the Government of the commonwealth was not complete without the Esculapian element; "for," added he, "is it not necessary to provide good physicians for the State, and must not these be, for the most part, such as have been conversant with the greatest number of healthy and sick people ?"+ "It was quite common, in ancient times," says one of the most learned men of our day, "for the Asclepiade to be publicly consulted by cities and States respecting the general health of *Herod. Thalia, 125-131. + The original passage is prefixed to the Introductory Essay. 298 ANCIENT HEALTH OFFICERS. the inhabitants, and this, both for the prevention and cure of diseases."* § 3. The Romans under the Republic, on the contrary, scouted the healing art, refused to recognise its prophylactic office, expelled the Greek medical philosophers,† and reduced practitioners of medicine to a servile condition. Under the first Cæsars, however, the profession was released from its degradation,‡ and a reaction followed, as extreme in the opposite direction. The embellishment of Naples, and the fortifications of Marseilles || bore witness to the enormous wealth, not less than to the munificence and public spirit of successful Roman physicians in the first and second centuries. But another century had scarcely passed, when the people, disgusted with the venality and extortion of the private doctorsregulars and irregulars¶-and confused by the noisy pretensions of conflicting medical sects, were fain to take refuge in a municipal organization of the authorized faculty. Antoninus Pius seems to have been the first to appoint physicians to towns, the number being regulated in each place by the population.** The elder Valentinian and Valens,++ at all events, confirmed with greater privileges the colleges of Archiatri populares in Rome, Constantinople, and other chief cities.‡‡ These officers do not appear to have been debarred from private practice, although the object of their public appointment -the care of the poor-for which they received yearly stipends, was made paramount. They were not permitted by the civil law to receive specific remuneration, promised for cure during the alarm and peril of *Adams's Life of Hippocrates, p. 13. + Pliny, Hist. Nat. lib. xxix. c. 8. Sueton. Vit. Cæsar. c. 42. Pliny, Hist. Nat. lib. xxix. c. 5. See Supplementary Note F. Ibid. ** Sprengel, Geschichte der Arzneik. Theil ii. s. 218. Digest (Juris Civilis), lib. xxvii. tit. 1. De excusation. leg. vi. § 1. ++ Cod. Theod. De Medicis et Professoribus, lib. xiii. tit. 3, leg. 8, 9, 13. Frank Med. Pol. Band 6, s. 157. |