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college even in 1618*—had the supply of physicians been in any measure equal to the necessities of the public—the medical profession of this kingdom might have held a far different position than at the present day; and might have effaced the remains of former corruptions and divisions, instead of not only perpetuating these, but creating, establishing, and at length legalising a third corruption and consequent division, unparalleled in the history of the whole civilised world. We might now have borne comparison as a “unum corpus in re et nomine "+ with any
other nations of the earth for purity, perfection, and distinction in either office. “ Dietetics” and “ Pharmaceutics” might have again joined hand in hand with “ Chirurgics,” and thus a college of pure physicians have grown with the growth and advancement of our nation, on the same basis as in the times of Herophilus and Erasistratus of old, combining all that reason and experience could combine, in opposition to all that superstition and dishonesty might advance; instead of adopting the purity of the Priest and the Barber—with that of the Apothecary superadded.
“ Union is strength ”I of the peculiar character we most require. In each section of the profession, even in spite of the hindrances existing---every * See antè,
Charter, 10 Hen. VIII. * “ Vis unita fortior' was the motto of Harvey. See · Willis's Life,' p. xxxiii.
individual who honestly pursues his course, whether as physician, surgeon, or “ general practitioner,” has such influence and power as, if united, would overcome all present difficulties ; but, we are a “house divided against itself;" we are the "bundle of sticks” divided and scattered; whereby all are not only weak and helpless for the general good, but worse--each is a weapon against the other.
The annexed table* of the relative number of physicians and apothecaries in the great nations of the earth, will speak for itself; but a short analysis may
render more evident one evil effect of this third great innovation. In those states where the number of apothecaries is limited by law, as in Germany, Sweden, Norway, Denmark, and others, they are considered too numerous, and not generally allowed,
* In order that the statements therein made, regarding the ratio of prescribing and dispensing practitioners, may not appear exag. gerated, I have taken the medical statistics for England and Wales, from the Census returns for 1851, although an analysis of the medical profession made from the 'Directory' for 1856, by Mr. G. W. Stansfield, gives the proportion of "pure " or prescribing physicians as only 397 out of 10,220 practitioners, who are there classified according to the different qualifications they possess, being derived from thirty-four different sources in the United Kingdom, and fiftyfive in Foreign States !!
The "pure” or prescribing surgeons included in the 13,470 surgeons and apothecaries” of the last census, are omitted altogether in the following comparisons; these being far more than counter-balanced by a much larger proportion of the same number (Dr. Taylor says 8000 or 9000), who keep open shops and dispense the prescriptions of other practitioners; so also, the term “druggist” in England and Wales, is viewed as synonymous with the “apothecary'' of foreign states.
* The only individuals in the Table without any required education, examination, or qualification.
+ Physicians, Surgeons, and Apothecary-Physicians are all considered as filling the office of Physician.
if they exceed the ratio of 1 to about 10,000 of the population ; but in Russia one apothecary is deemed sufficient for 86,957 inhabitants ! In other states, where no limit is placed, excepting such as the public demand imposes for the performance of the true and legitimate functions of their several professions, the number varies from 1 to 3777 in the United States, to 1 to 6660 in France; whilst in England and Wales we find that---besides the 13,470 general practitioners—there is at the least 1 apothecary (druggist) to every 1253 inhabitants.
This table may be fairly viewed in a variety of ways, by which the contrast with other states becomes still more apparent. For instance, if the 13,470 apothecary-physicians who are all ready to dispense the prescriptions of “ physicians when in attendance with themselves, be added to the 14,307 “ pure” apothecaries—we have 27,777 persons performing this office, or 1 to 645. Again, if it be true—as without doubt it is—that nine tenths of the population are nominally in the hands of the general practitioner, as their ordinary medical attendant, the same number must be excluded from the need of a “pure” apothecary, being supplied with all necessary drugs, as well as with advice, by the same individual. How then stands the proportion of apothecaries to the remaining one tenth of the population? There exists no less a number than 14,307
apothecaries to supply medicines for 1,792,760 inhabitants, or 1 to every 125 of the population.
Once more; excluding as before the general practitioners, who perform the double office—if we compare the proportion of professedly “pure” apothecaries or dispensers, 14,307, with “pure” physicians or prescribers, 1771, in England and Wales, we perceive that instead of 1 apothecary to 11 physicians, as in Russia; or 1 to 3, as in the German States, we have no less than 8 apothecaries to 1 physician, or, in other words, our ratio of apothecaries to physicians, in comparison with that of foreign states, in round numbers, stands thus :
We have 90 in the place of 1 in Russia.
1, United States. 33
1, Austria. 29
1, Prussia. 26
Finally, it may with truth be stated, that the physicians, surgeons, and apothecaries, who are educated, examined, and commissioned by law collectively to practise medicine and pharmacy in England and Wales, are ample in numbers for all classes of the public, if rightly apportioned, and if each individual be restricted to his separate and distinct duties, according to the example of all other nations; and that therefore the whole 14,307 druggists