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been more or less completely effaced, by the reunion, in one and the same individual, of medicine “ in all and every its members and parts.

Sir G. Lefevre thus writes of Russia in 1837 :* “It is now generally allowed that there is no essential distinction between medicine and surgery, although practitioners of medicine may be divided into different ranks and classes. Perhaps there is no country where this indivisibility, as regards the practice of the profession, is more strictly maintained than in Russia : a physician embraces all the branches of the healing art, and acts as physician, surgeon, and accoucheur; if he does not do so, there is nothing to prevent him using his own discretion in such matters. The physician in Russia is, in fact, identical with the general practitioner in England, save and except that in no instance does he dispense his own medicines.

Apothecaries are mere vendors of drugs and licensed preparers of physicians' prescriptions ; in no case are they allowed to compound medicines, or even sell the most innocent drug, without a written order from a medical practitioner.

“ This combination of medical duties is not now a matter of choice, it is one of necessity, inasmuch as the interests of the mass of the community are to be considered of more importance than the ideas which a few individuals may form to themselves


* · British and Foreign Med. Rev.,' vol. iv, p.


of medical orthodoxy; and in the present day all the English physicians residing in Russia are, as already stated, de facto, general practitioners.

Apothecaries' shops are licensed by government, and limited in number: their proprietors are fully qualified for the important and exclusive duties assigned to them, and a high tariff is fixed on all medicines.

In Prussia, and the German states generally, there are many ranks and divisions in the medical profession; there are surgeons of first and second class, country doctors, and others. There are also two classes of graduated physicians—a first class, who profess and practise both medicine and surgery ; a second class, who practise medicine only: all are compelled to pass through a surgical as well as medical education and examination, before practising in either division—the only difference is the omission of operative surgery by the latter.

The graduated physicians are the only members of the profession eligible for all offices, but to qualify for the highest medical appointments from that of “ district-doctor" to that of “High-Medical-PrivyCounsellor,” in addition to the five ordinary examinations, to which all are subjected, (viz., 1, the Anatomical ; 2, the Chirurgical ; 3, the ClinicoMedical ; 4, the Clinico-Surgical ; and 5, the final or vica-voce examination, there are two others

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required of him-an Obstetrical and a Forensic or Jurisprudential.*.

In the United States of America every candidate for graduation is “compelled to exhibit his qualifications for practising both medicine and surgery; for although some may devote themselves more especially to the latter branch, their medical education does not differ from that of the practitioner who confines himself to medicine. They are all educated, in other words, for the general exercise of the duties of the profession.”+

In Denmark, Professor Otto says, 6. From what has been stated of the qualifications requisite for admission to the examination of the medical faculty at the universities and at the College of Surgeons, and of the extent of knowledge, required at both in all the different branches of medicine and surgery, it is evident that the state has done everything in its power to secure the aid of able and enlightened men in an art, upon which depend the health and life of its subjects." In no country are the harmony and unity of the medical profession so well preserved. I

In Norway, there is no distinction in name even of the two divisions, physician and surgeon-the functions of both being always understood to be

* Professor Hecker, of Berlin, ‘Br. and For. Med. Rev.,' vol. i, pp. 289, 300, &c.

+ ‘Med. in the United States,' by R. Dunglison, M.D., ib., vol. ii,

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p. 293.

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combined, the same name expresses either or both ; therefore it is, in the translation of a report of Professor Holst, the word “ Læge" is sometimes rendered “ Physician” and sometimes “Surgeon.

In France, also, the unity of medicine is essentially restored. There are three faculties of medicine--those of Paris, Montpellier, and Strasbourg—besides preparatory schools of medicine in various provincial towns. These are the only portals to the profession, and all who pass through them must give full proof of their knowledge, in the use of all the acknowledged means of cure, as well as in the treatment of all diseases and injuries, though they may afterwards select or exclude any or either from their practice. Paris was the chief seat of that warfare which continued for so many centuries between physicians and surgeons, as the representatives of the priests and barbers in successive periods. Here it was that disputes commenced between the Faculty of Paris and the College of Surgery founded by Lanfranc, on the one hand—and between this College and the barbers, on the other.

The principal cause of this great jealousy, and the support given by the faculty to the latter, was the extending practice of the surgeons of St. Como, and the patronage bestowed on them by the Academy.

Philippe-le-Bel passed a law, A.D. 1311, obliging

* Op. cit., vol. iv, p. 54. So also for other cognate languages. See “ Lace » • Bosworth’s Anglo-Saxon Dictionary.'

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all French surgeons to be examined by this College. The Faculty of Medicine, fearing the effect of this patronage, established the rule of not granting a license to Bachelors unless they took an oath never to practise surgery.

Notwithstanding the bitter animosity thus. fostered for so many ages in France, and subsequently the compulsory union of surgeons and barbers, in subordination to the physicians, yet the truth of this degradation was at length acknowledged, by the separation of "

of “surgery” from barbery,” in the year 1732, and the foundation of the Royal Academy of Surgery.

Since that day the rank of this deposed branch has been fully realised, and the unity of medicine proclaimed, by the restoration of Surgery to the Faculty of Medicine—or rather, that of the latter to the former. 1 The walls that now encircle both, assert the merit of those men who struggled for its existence through the ages of separation and degradation to which it had been subjected. Five medallions grace that building, each surrounded with a garland of oak, containing portraits of the great champions of surgery during this periodnamely, Pitard, Paré, Maréchal, La Peyronie, and Petit.

Ireland and Scotland also, in spite of Collegiate

* Sprengel, vol. ii, p. 458.

+ The building now devoted to the Faculty was formerly the “ Ecole de Chirurgie.”

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