§ 27. Strong grounds have been shown for the necessity of some system of control over licensed practitioners, in the exercise of their professional duties; but as this matter-although handled in recent medical-reform Bills-belongs to medical police rather than to medical education, it may be as well to suggest that matters of internal regulation would be most efficiently managed by Medical Faculties,* constituted in extensive districts, and presided over by a superintending officer of health. In cases involving irreconcilable difference of opinion, an appeal to the central council should be authorized. So again, if a general representation of the profession, in the proposed central council, be determined upon, it would, for obvious reasons, be more safely and bene.icially conducted through a district organization. § 28. Most medical Bills, also, contain a clause empowering every practitioner to recover reasonable fees for attendance. Though not strictly belonging to our present subject, it may be remarked, in passing, that such a provision would confer a much greater advantage upon the public than upon the profession, provided no right were conceded to the general practitioner to recover, in addition to his proper fee for attendance, more than the actual valuet of medicines and appliances furnished by him to the patient. With regard, however, to the consulting classes of the profession, it may well be doubted whether any parties would be gainers by the substitution of a legal claim for the customary honorarium.‡ § 29. Nothing remains to be said respecting recent projects of legislation, save on one point discussed in the commencement of * See Essay V. + Including a compensation for storing and compounding, &c. "I should be sorry to see the honorary character of fees of barristers and physicians done away with. Though it seems a shadowy distinction, I believe it to be beneficial in effect. It contributes to preserve the idea of a profession, of a class which belongs to the public, in the employment and remuneration of which no law interferes, but the citizen acts as he likes in foro conscientia."-Coleridge's Table Talk, p. 189 G 82 PENALTIES AGAINST IRREGULARS. this Essay, namely, penal clauses against unregistered practitioners and those who falsely pretend to be legally qualified. Here, I must risk unpopularity among my medical brethren, by protesting against the impolicy, to say the least, of attempting to enforce penalties against medical dissenters, until broad and comprehensive legislation shall have authorized all, without reference to their belonging to any particular medical sect, who may prove their competency to treat disease, and to promote health and longevity, by undergoing the discipline, completing the curricula, and passing the examinations (limited and regulated by a State council), which I have already presumed to recommend. Then, indeed, penalties may be fairly enforced against those who attempt to practise without the State licence and registration. And then, also, it would be quite reasonable to deal more summarily with those, who, not having obtained the licence, assume the titles, and lay claim to the privileges, of legally qualified practitioners. § 30. I should have great confidence in an appeal to the calm and deliberate judgment of the entire profession on this subject. Anomalous and irregular as its condition may be, subject as its members have been to numerous influences calculated to disturb their equanimity, I believe in the elevating effect of Medicine, as a divine calling.* Had there not been some internal correcting and renovating influence at work, the medical profession could never have so vigorously resisted the natural tendency of all institutions to deteriorate. The unconcern, the neglect, the careless repudiation of responsibility, in both its internal affairs and its relations to the State, which the constitutional government of England has ever evinced, have, indeed, depressed the social status of the * Without assenting to the noted Dr. Parr's recorded opinion of the professions of law and divinity, I quote the passage, to show his view of the medical profession:-"The practice of the law spoils a man's moral sense and philosophic spirit; the church is too bigoted and stiff-starched; but the study and practice of physic are equally favourable to a man's moral sentiments and intellectual faculties." MEDICINE AND LITERATURE. 83 medical body, cramped its usefulness, and suffered its want of regulation to injure the community; but they have not succeeded in crushing its vitality. Coleridge said "There have been three silent revolutions in England: first, when the professions fell off from the Church; secondly, when literature fell off from the professions; and thirdly, when the press fell off from literature." Whether or not counter-revolutions may be expected with regard to the first and third movements, it is clear that a counterrevolution in medicine is now silently working as to the second. And, under a sound system of medical education, we may yet appeal to the truth of our motto "MEDICINA LITERIS." |