divisions-set before the medical student by the Licensing bodies, the Schools, and the Hospitals, for his choice in his passage through life. But, in order rightly to understand the connection of existing institutions with their own duties as enjoined in their original charters, and with the present divided state of the medical profession in England and Wales, we may reasonably inquire how far the ruling power in each division has failed to obtain the especial objects for which that power was appointed. Blackstone says that "The general duties of all bodies politic, considered in their corporate capacity, may, like those of natural persons, be reduced to this single one-that of acting up to the end or design, whatever it be, for which they were created by their founder." That the College of Physicians has failed in two chief purposes for which that college was created, namely, to suppress quackery, and to make of one body all who exercised the faculty of medicine,* admits of no doubt. So also, though the College of Surgeons, as well as the College of Physicians, have separated themselves from the corruption with which each branch of medicine, peculiar to these establishments, had been for so many ages united, yet has no approach been made towards effacing the division, which arose at the same time, and pro *See Charter, 10 Hen. VIII. Appendix, 16. ceeded from the same authorities.* This schism remains perhaps as complete, in some respects, between the orthodox representatives of either branch, as in the twelfth and thirteenth centuries; whilst it must be confessed that in the great mass of the profession there still persists much of that assumption on the one hand, and subordination on the other, which was then for the first time engendered. For, although a certain voluntary division of the physician's office in large towns may be, and is, productive of great advantage, yet the same, if pursued by compulsion, must be an immense evil. The encouragement given to such divisions by the law of this land, has without doubt also led to the many minor subdivisions, the wilful exaggeration of trivial diseases, and individual means of cure, as exhibited in the increasing specialities and quackeries of the present times; these being-especially if combined with a sacrifice of principle-the most profitable mode of practice.† Many other evil effects of the first great division may be adduced, but it is with the last division and corruption, as legalised by the Act of 1815, that I would especially desire to contend. 66 The failure of all previous enactments, especially of the Physicians' Charter 10 Henry VIII, and the Apothecaries Charter 13 Jac. I, was the cause of *The Priest-Physician and the Barber-Surgeon. further legislation at that time. For the purpose of ascertaining how far the law then made has succeeded, we may again inquire what were the objects of the promoters of that act; and to what extent have these objects been attained? The objects originally designed were, as described by John Mason Good, 1796, "to obtain redress against the following evils : "1. The encroachment which chemists and druggists have, of late years, made on the profession of the apothecary, by vending pharmaceutic preparations, and compounding the prescriptions of physicians.* "2. The want of a competent jurisdiction in the profession itself, to regulate its practice, and to restrain ignorant and unqualified persons from practising at all.” These and other grievances were widely canvassed by the various contending interests during the following twenty years, and were at length proposed to be remedied by the strange and anomalous Act of 1815, in which not only the hitherto exclusive powers and privileges of the College of Physicians were completely usurped, but those of the Society of "Pharmacopolites" of 1616 were as completely abrogated; inasmuch as by that act the Society of Apothecaries was authorised-after due education and examination-to grant licenses in the "science *Exclusively assigned to him by charter, 1616. See Appendix, 22. and practice of medicine," as well as that of pharmacy; whilst chemists and druggists were permitted, without either education or examination, to " buy, prepare, compound, dispense, and vend drugs, medicines, medicinal compounds, wholesale and retail,”† and, in short, to perform all the responsible and important duties for which this society was originally and solely instituted. That the effect of this Act has been far from preventing the "encroachment of chemists and druggists" is very evident that "ignorant and unqualified persons are not restrained from practising" may be as easily perceived in the unprecedented success of patent medicine vendors, and multitudes of other devices in the same direction.§ If so far the object has again failed, we may next ask, has it supplied the great desideratum refused by the College of Physicians during the three preceding centuries ? Has it provided a "competent jurisdiction in the profession of medicine," whereby a number of well-educated practitioners in "all and every its members and parts " equal to the demands * 55 Geo. III, c. 194, secs. 14 and 15. Appendix, 29a. † Ibid., sec. 28. Appendix, 296. The number of chemists and druggists throughout England and Wales in the year 1831 was about 5336; whereas by the Census of 1851 we find the number increased to 14,307, besides 13,470 general practitioners or apothecary-physicians. § Professor Holloway is said to pay £30,000 annually for advertising his especial means of cure by pills and ointment. See 'Quarterly Rev.,' June, 1855. of the public has been supplied? That this has been chiefly effected by the above society, in conjunction with the College of Surgeons, may as confidently be answered in the affirmative; thus proving that by the Act of 1815 the functions of the College of Physicians have been superseded, or vicariously performed, whilst those of the original society of apothecaries have been grossly neglected, and in their turn superseded by the voluntary establishment of the Pharmaceutical Society. The evidence of all branches of the profession, given before the "Select Committee on Medical Education" in 1834, testifies that even at that time the Apothecaries' Society came behind no examining body in England and Wales for all practical purposes. Since then their progress in every direction is extensive and unquestionable, so that in less than forty years we have 13,470 licentiates in the science and practice of medicine-the efficient attendants in ordinary on all classes of society. If this result be compared with the progress of the College of Physicians during the three preceding centuries, which first limited its number to 20, and never exceeded 260, the contrast is striking.† Had a different course been pursued by that * See Sir D. Barry's evidence, 2583-Sir H. Halford, and many others. † See antè, p. 84. |