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certificates, &c. &c. is it not better that they should enjoy the privileges, rather than the legislature make any infringement on the rights of a great proportion of scientific men, because, by chance diplomas have been granted to unlettered men: considering the subject in its collective sense, we are of opinion, the powers of the College ought to be abrogated and repealed, as they are found to be vexatious and oppressive; hence nothing but a radical reform can adjust the balance. In our next number we shall continue the subject "Hypothesis nonjingo."
TO SIR LUCAS PEPYS, BART. M. D.
TRffSlDENT OF THE ROYAL COLLEGE OF VHYSICIANS.
The importance of the high official situation you hold, as it respects both the interests of the profession, as well as the public welfare at larget is the motive that now induces me to address you on a subject, on which there can be but one opinion betw ixt us; the indispensable necessity for reformation.
By the present constitution of that learned body, over which you preside, you, and every gentleman in office, are, in obedience to your char' ter, constrained to act a part against those nice feelings of honour and liberality, which ought to distinguish the gentleman and physician. I may even proceed a step further, and assert, that the present constitution of the college, is equally a bar to the progress of science, the improvement of the profession, and the general interests of the community. In making this assertion, I flatter myself, I do it on no slight grounds, but that I am borne out in my statement, by the charter itself, in examining which, I hope it will appear to your conviction,
1st. That it is incompetent to support the rights and privileges the College claim.
2d. That the public are materially injured by the existence of the charter on its present footing.
The charter of the Royal College of Physicians, was originally granted by Henry VIII, at a period of society, when learning was confined solely to the church, and when physic and religion were generally dispensed by the same hand. Hence it cannot fail to partake of all that monkish illiberally and inquisitorial jealousy which characterized the churchmen in those days. It confers on the college, the exclusive privilege of granting a license for the practice of physic in London, and seven miles round; and it especially provides, that all candidates, applying for a license, shall be graduates of Oxford or Cambridge, and no where else. The want of a license it compromises by a monthly fine or mulct of 5l. sterling. The offence to be first proved .by the college* For mal-practice, it levies still a higher line, 20l. The examination of the candidates for licenses is to be in Latin, then the general language of ths church and its adherents.
Such are the leading articles of the Charter, but the first point it should have specified, and which seems wanting, is, what constitutes exclusively the practice of a physician, or where the bounds of physic end, and the other departments of the profession begin.
I have been told, that when culprits have been brought before the College, and respectfully asked directions for their proceedings on this head— that they have been answered—" The College would give none; but that they would take care to punish where they found persons offending." The necessity for a line of demarcation on this point, is certainly clear. We are told indeed, that the treatment of general diseases, forms the business of the physician; but it would be well if medical practitioners could always ascertain what are general diseases, and what are local ones. A local irritation will often arise from a general constitutional cause, and the local treatment which falls to the province of the surgeon, will have no influence without attacking the constitution by internal remedies. If the physician is to act here, he is by his province to pay no attention to the local disease, and the unfortunate sufferer must do the best he can with it. If the surgeon is to act, he is to attend only to the local disease, and to pay no attention to the constitution. So absurd has this distinction appeared in the eyes of most surgeons, that there is hardly one, but writes prescriptions, and enters upon the province of the physician, as an indispensable part of his duty.
Aware of the illiberality and purposed monopoly of the Charter granted to the College, in those days of ignorance and barbarity, the apothecaries, with a proper resentment against the intrusion, applied for a special act, by which they were permitted to practise with no difference between them and the physicians, but connecting their practice with dispensing their own medicines. By this act, the limits of the physician are certainly much circumscribed, and it was indeed tantamount to doing away altogether the exclusive privileges of the College Charter.
Then, what between the encroachments of the . surgeon and the authorized conduct of the apothecary, the real powers of the College are reduced to a very narrow compass, and it becomes a question, in what the act of infringing upon the College consists? Is it in assuming or writing up the name,
of Doctor?—This cannot be, for it is an honour conferred by universities alone, and has nothing to do with the license of the College. Neither is the possessor of it limited to any line of practice, but what he chooses himself to pursue. Is it in writing the prescription?—if so, why do the surgeons do this without molestation? In whatever the act of delinquency consists, it is perfectly clear, that if the physician interferes with medicine, in the smallest shape, the cognizance of the College is at end. He then ranks, in the eye of the College, with the apothecary, and while he takes his fee with one hand, and gives instead of a bit of paper, a little medicine with the other, he is placed beyond their jurisdiction, and can enjoy both his title and perquisite, without regard to their most violent interdict or fulmination.
This then being clear, the next point is, for what was the special purpose of the charter granted? It appears only to give a monopoly to the Graduates of Oxford and Cambridge of the practice of the metropolis and its environs. It is to be marked, that they were then the only universities, and England was at that time also a separate kingdom. But since that period, how have circumstances changed? Is medical science in either of the universities at present at its acme of perfection ?or, does England stand now as asepa
rate kingdom? In regard to the first, it is a welt