This state of matters has prevailed for many centuries, and, taking the different value of money into account, notwithstanding the advance of medical science, there is but little change in the scale of remuneration, whether as to large fees paid by Royal or t.i.tled personages, fees by the middle cla.s.ses, or by the rural or working population.
It has been well said, that "the theory and practice of medicine is the n.o.blest and most difficult science in the world; and that there is no other art for the practice of which the most thorough education is so essential."
Whittier observes:--"It is the special vocation of the doctor to grow familiar with suffering--to look upon humanity disrobed of its pride and glory--robbed of all its fict.i.tious ornaments--weak, hopeless, naked--and undergoing the last fearful metempsychosis, from its erect and G.o.d-like image, the living temple of an enshrined divinity, to the loathsome clod and the inanimate dust! Of what ghastly secrets of moral and physical disease is he the depository!"
Sir Thomas Browne, in his "Religio Medici," says:--"Men, that look no further than their outsides, think health an appurtenance unto life, and quarrel with their const.i.tutions for being sick; but I, that have examined the parts of man, and know upon what tender filaments that fabrick hangs, do wonder that we are not always so; and, considering the thousand doors that lead to death, do thank my G.o.d that we can die but once."
This model physician, who said, "I cannot go to cure the body of my patient, but I forget my profession and call unto G.o.d for his soul," in the same work, finely says of charity:--"Divinity hath wisely divided the act thereof into many branches, and hath taught us, in this narrow way, many paths unto goodness; as many ways as we may do good, so many ways we may be charitable. There are infirmities not only of the body, but of soul and fortunes, which do require the merciful hand of our abilities. I cannot contemn a man for ignorance, but behold him with as much pity as I do Lazarus. It is no greater charity to clothe his body than apparel the nakedness of his soul."
His distinguished position, as a physician and an author, demands very special and reverential mention in these pages.
Sir Thomas Browne was born in London on the 19th of October, 1605. He died at Norwich on the 19th of October, 1682, having reached exactly the age of seventy-seven. His father was a wealthy merchant, of a good Cheshire family, but died when his more ill.u.s.trious son was a boy, and his mother shortly afterwards married Sir Thomas Dutton. After travelling on the Continent, he settled as a practising physician at Shipley Hall, near Halifax, for a time, and then moved to Norwich, where the remaining forty-two years of his life were spent. His library contained vast stores of learned works on antiquities, languages, and the curiosities of erudition. He corresponded with the best men of his day, and was often able to a.s.sist them in their various investigations. His friend Evelyn, alluding to Browne"s home, at Norwich, tells us "His whole house and garden being a paradise and cabinet of rarities, and that of the best collections, especially medals, books, plants, and natural things." He was knighted by Charles II. in 1671.
Throughout the troublous times of the Civil War, the Commonwealth, and the Restoration, he led a quiet studious life, issuing volume after volume full of profound, penetrating, and far-reaching thought, set forth in stately, sonorous, and musical language, the perfect form or style of which, at times, is only equalled but not excelled by the best cadenced prose of Milton or Jeremy Taylor.
His "Religio Medici," "Hydrotaphia or Urn Burial," and "The Garden of Cyrus," have been my favourites for more than half a century. Of the latter work, John Addington Symonds has finely and truly said, that "the rarer qualities of Sir Thomas Browne"s style (are) here displayed in rich maturity and heavy-scented blossom. The opening phrase of his dedication to Sir Thomas Le Gros--"When the funeral pyre was out, and the last valediction over, men took a lasting adieu of their interred friends, little expecting the curiosity of future ages should comment on their ashes;"--this phrase strikes a key-note to the sombre harmonies which follow, connecting the ossuaries of the dead, the tears quenched in the dust of countless generations, with the vivid sympathy and scrutinizing sagacity of the living writer.... I will only call attention to the unique feeling for verbal tone, for what may be called the musical colour of words, for crumbling cadences, and the reverberation of stationary sounds in cavernous recesses, which is discernable at large throughout the dissertation. How simple, for example, seems the collocation of vocables in this phrase--"Under the drums and tramplings of three conquests!" And yet with what impeccable instinct the vowels are arranged; how naturally, how artfully, the rhythm falls! Take another, and this time a complete sentence,--"But the iniquity of oblivion blindly scattereth her poppy, and deals with the memory of men, without distinction to merit of perpetuity."
Take yet another--"The brother of death daily haunts us with dying mementoes.""
I take leave of this, the most notable of English Physicians, by transcribing the following grand, suggestive, and characteristic pa.s.sage from his "Fragment on Mummies":--"Yet in these huge structures and pyramidial immensities of the builders, whereof so little is known, they seemed not so much to raise sepulchres or temples to death, as to contemn and disdain it, astonishing heaven with their audacities, and looking forward with delight to their interment in those eternal piles. Of their living habitations they made little account, conceiving of them but as _hospitia_, or inns, while they adorned the sepulchres of the dead, and planting them on lasting basis, defied the crumbling touches of time and the misty vaporousness of oblivion. Yet all were but Babel vanities. Time sadly overcometh all things, and is now dominant, and sitteth upon a sphinx, and looketh unto Memphis and old Thebes, while his sister Oblivion reclineth semisomnous on a pyramid, gloriously triumphing, making puzzles of t.i.tanian erections, and turning old glories into dreams. History sinketh beneath her cloud. The traveller, as he paceth amazedly through those deserts, asketh of her, who builded them? and she mumbleth something, but what it is he heareth not."
The medical profession is a n.o.ble and pleasant one, though laborious and often full of anxiety, straining mind and body. The good physician is the sympathizing, confidential, and comforting _friend_ of the family. He values the humble gifts and testimonials of grat.i.tude from the poor, even more than the costly presents of the rich.
The virtuous poor are always grateful. It can truly be said of the physician"s kind and often gratuitous services to them, in the language of scripture:--
"When the ear heard me, then it blessed me; and when the eye saw me it gave witness to me; because I delivered the poor that cried, and the fatherless, and him that had none to help him. The blessing of him that was ready to perish came upon me; and I caused the widow"s heart to sing for joy."
Among savages, sorcerers, and magicians, are the medicine men; these are still represented, in civilisation, by impostors and quacks. Members of the profession, as a rule, keep themselves posted up in the medical science of the day, honestly and unselfishly do everything that can be done for their patients, and rejoice in being the means of their recovery, far more than in their fee.
Burton, in his "Anatomy of Melancholy," treating of "Physician, Patient, and Physick," when astrology, ignorance, and queer nostrums, were then more in vogue than practical science, says:--"I would require Honesty in every Physician, that he be not over careless or covetous, Harpylike to make a prey of his patient, or, as an hungry Chirurgeon, often produce and wire-draw his cure, so long as there is any hope of pay. Many of them, to get a fee, will give physic to every one that comes, when there is no cause, thus, as it often falleth out, stirring up a silent disease, and making a strong body weak." Burton then quotes the following sensible Aphorism from Arnoldus:--"A wise physician will not give physick, but upon necessity, and first try medicinal diet, before he proceedeth to medicinal cure."
Latimer thus severely censured the mercenary physicians of his day:--"Ye see by the example of Hezekiah that it is lawful to use physick. But now in our days physick is a remedy prepared only for rich folks, and not for the poor, for the poor man is not able to wage the Physician. G.o.d indeed hath made physick for rich and poor, but Physicians in our time seek only their own profits, how to get money, not how they might do good unto their poor neighbour. Whereby it appeareth that they be for the most part without charity, and so consequently not the children of G.o.d; and no doubt but the heavy judgment of G.o.d hangeth over their heads, for they are commonly very wealthy, and ready to purchase lands, but to help their neighbour, that they cannot do. But G.o.d will find them out one day I doubt not."
"Empirics and charlatans are the excrescences of the medical profession; they have obtained in all ages, yet the healing art is not necessarily the occasion for deception; nor the operations of witchcraft, charms, amulets, astrology, alchemy, necromancy, or magic; although it has its mysteries like other branches of occult science."
Paracelsus, the prince of charlatans, styled himself "King of Physic,"
but, though he professed to have discovered the _elixir of life_, he humbly died at the early age of forty-eight years.
We are told of a patient who, instead of the medicine prescribed, swallowed the prescription! and _Punch_ records an extraordinary case of a voracious individual who bolted a door, and threw up a window!
Sydney Smith, on being told by his doctor to take a walk on an empty stomach, asked--"Upon whose!" But a truce to stories suggested by the queer nostrums of quacks.
Empirics, however, often believed in their nostrums, and were, sometimes, amiable and unselfish.
In the year 1776, we are told, there lived a German doctor, who styled himself, or was called, "the Rain-water doctor;" all the diseases to which flesh is heir he professed to cure by this simple agent. Some wonderful cures were, it is said, achieved by means of his application of this fluid, and his reputation spread far and wide; crowds of maimed and sickly folk flocked to him, seeking relief at his hands. What is yet more remarkable still, he declined to accept any fee from his patients!
Dr. Haygarth, of Bath, had a pair of wooden tractors made in precisely the same shape and appearance as Perkin"s metallic ones; and the same results followed as when the others, which cost five guineas a pair, were used.
The story is well known of the condemned criminal in Paris, who was laid on a dissecting table, strapped down, with his eyes bandaged, and slightly p.r.i.c.ked, when streamlets of water set a-trickling made him think, as he had been told, that he was being bled to death. His strength gradually ebbed away, and he actually died, although he did not lose a drop of blood.
I knew of a gentleman who, when pills to procure sleep were ordered to be discontinued, lay awake. The doctor made up a box of bread pills, which were administered as the others had been, and the patient slept, and recovered rapidly.
A young medical man fell in love with a young lady patient, and, when he had no longer any pretext for continuing his visits, he sent her a present of a pair of spring ducks. Not reciprocating his attentions, she did not acknowledge the present, upon which he ventured to call, asking if the birds had reached her. Her reply was--"Quack, quack!"
Dr. Lettsom, a quaker in the time of George III., near the close of the last century, had such an extensive practice that his receipts in some years were as much as 12,000; and this although half his services were entirely gratuitous, and rendered with unusual solicitude and care to necessitous clergymen and literary men. Generosity was the ruling feature of his life. On one occasion he attended an old American merchant whose affairs had gone wrong, and who grieved over leaving the trees he had planted. The kind hearted doctor purchased the place from the creditors, and presented it to his patient for life.
Pope, a few days before his decease, bore the following cordial testimony to the urbanity and courtesy of his medical friends:--"There is no end of my kind treatment from the Faculty; they are in general the most amiable companions, and the best friends, as well as the most learned men I know."
And Dryden, in the postscript to his translation of Virgil, speaks in the same way of the profession. "That I have recovered," says he, "in some measure the health which I had lost by too much application to this work, is owing, next to G.o.d"s mercy, to the skill and care of Dr. Guibbons and Dr. Hobbs, the two ornaments of their profession, whom I can only pay by this acknowledgment."
When Dr. Dimsdale, a Hertford physician and member of Parliament, went over to Russia to inoculate the Empress Catherine and her son, in the year 1768, he received a fee of 12,000, a pension for life of 500 per annum, and the rank of Baron of the Empire.
Dr. Henry Atkins was sent for to Scotland by James the Sixth to attend Charles the First (then an infant), ill of a dangerous fever. The King gave him a fee of 6000, with which he purchased the manor of Clapham.
Louis XIV. after undergoing an operation, gave his physician and his surgeon 75,000 crowns each.
Dr. Glynn once attended the only son of a poor peasant woman, ministering to his wants with port wine, bark, and delicacies. After the lad"s recovery, his mother waited on the doctor, bringing a large wicker basket with an enormous magpie, which was her son"s pet, as a fee to show their grat.i.tude.
A thousand pounds were ordered to be paid to Sir Edmund King for promptly bleeding Charles the Second, but he never received this fee.
Dr. Mead, in the time of George the First, was generous to a degree, and like many of his brethren, would not accept fees from curates, half-pay officers, and men of letters. At home his fee was a guinea. When he visited patients of means, in consultation or otherwise, he expected two guineas or more. But to the apothecaries who waited on him at his coffee houses of call he charged only half a guinea for prescriptions, written without his having seen the patient. He had an income one year of 7,000, and for several years received between 5,000 and 6,000, which, considering the value of money at that time, is as much as that of any living physician.
The physicians who attended Queen Caroline had five hundred guineas, and the surgeons three hundred guineas each; Dr. Willis was rewarded for his attendance on George III. by 1,500 per annum for twenty years, and 650 per annum to his son for life. The other physicians, however, had only thirty guineas each visit to Windsor, and ten guineas each visit to Kew.
Dr. Abernethy was annoyed by a lady needlessly consulting him about her tongue. One morning she came, as he was descending the steps from his door and putting on his gloves. She said:--"Doctor, I"m so glad I have caught you!" The doctor asked if it were the old trouble. On her saying "Yes," he told her to put out her tongue. She did so, and he said, "Stand there till I come," and left her so, in the street, setting out on his round of visits.
Once when prescribing nutritious and expensive diet for a young man in consumption, he observed the look of despair on the young wife"s face, and the evidence of straitened circ.u.mstances around; when the lady appealed to him, asking if there was really nothing else he could suggest for her husband. He replied:--"When I think of it, I"ll send along a box of pills in the afternoon!" A messenger brought the box. On the lid was written "One every day," and, on being opened, it was found to contain twenty guineas!
He once bluntly told a _bon-vivant_ gentleman to "Live on sixpence a day, and earn it!"
Long ago, a friend told me of a lady in Devonshire, belonging to a family she knew, who read medical books, and at length imagined she had every disease under the sun. Whenever she discovered what she believed to be a new symptom, she at once went off to consult different medical men regarding it, spending several hundreds a year in this way, and all quite needlessly. At length she confided to her friends that since doctors differed so widely, and she could obtain no satisfaction as to what ailed her, she had resolved to go to town and consult one of the Queen"s physicians.
A consultation was held in the family, and her nephew was sent to explain matters to the physician, in the hope of his being able to cure her hypochondria. When she reached town, the street in which the physician lived was blocked with the carriages of patients. After waiting hours, her turn at last came. The physician examined her, asked a few questions, then enquired if she had any friends in town, as he would rather call to see her when under their roof, and there tell her what he had got to say. She protested that she was quite prepared to hear the worst--that she had for long years looked death in the face--that the notices of her death were lying in her desk, all written out and addressed, only requiring the date to be filled in, etc. The physician said he was busy--more than twenty patients were still waiting in the street--he was averse to scenes, and would much prefer to see her at her friend"s house. She still persisted, and begged of him to tell her all, there and then, on which he said:--"Madam, it is my melancholy duty to inform you--that there is nothing whatever the matter with you!"
This interview fortunately effected her cure, to the great delight of her friends, who paid the physician a handsome fee.
Sir Astley Cooper one year received in fees 21,000. This sum was exceptional, but for many years his income was over 15,000. His great success was achieved very gradually. "His earnings for the first nine years of his professional career progressed thus:--In the first year he netted five guineas; in the second, twenty-six pounds; in the third, sixty-four pounds; in the fourth, ninety-six pounds; in the fifth, a hundred pounds; in the sixth, two hundred pounds; in the seventh, four hundred pounds; in the eighth, six hundred and ten pounds; and in the ninth--the year in which he secured his hospital appointment--eleven hundred pounds."
On one occasion when he had performed a perilous surgical operation on a rich West Indian merchant, the two physicians who were present were paid three hundred guineas each; but the patient, addressing Sir Astley, said:--"But you, sir, shall have something better. There, sir, take _that_," upon which he flung his nightcap at the skilful operator. "Sir,"
replied Sir Astley, picking up the cap, "I"ll pocket the affront." On reaching home, he found in the cap a draft for a thousand guineas from the grateful but eccentric old man.
A cynical lawyer once advised a young doctor to collect his fees as he went along, quoting the following verse to back his recommendation:--
"G.o.d and the doctor we alike adore, But only when in danger, not before; The danger o"er, both are alike requited-- G.o.d is forgotten, and the doctor slighted."
The following story ill.u.s.trates the too frequent weary waiting, when hope makes the heart sick, and also shows on what curious casual incidents the success of a career may sometimes turn. It has been told in different ways, and attributed to different men, such as to Dr. Freind, and others; but, quite possibly, the same or a similar incident may have repeatedly occurred. I simply give it as it was narrated to me. A young doctor having graduated with honours, took a house at a high rent in Harley Street, London. The bra.s.s plate attracted no patients; months pa.s.sed idly and drearily, and the poor fellow took to drink. One night the door-bell rang--a servant man, from a lady of t.i.tle round the corner, begged him to come at once, as his mistress was dangerously ill, lying on the floor; her own doctor was out, and he was sent to fetch the first doctor he could find. The young doctor regretfully thought what a fool he was, for here was his chance, when he could not avail himself of it; but he would go, and try hard to pull himself together.
When he reached the room, he had enough conscience or sense left to know that he was not in a fit state to prescribe, and exclaiming, "Drunk, by George!" took his hat and bolted from the house. Next morning he received a scented note from the lady, entreating him not to expose her, inviting him to call, and offering to introduce him professionally to her circle!
Before the season was ended, his practice was yielding him at the rate of some 1500 a year!