AN ESSAY FOR Reforming the Modern Way of Practising MEDICINE IN
EDINBURGH:
Wherein it is proved, That the
Foreign Method
of paying
Physicians
with small FEES at a Time, would be of great
Benefit
to the NATION, if it were followed in EDINBURGH, and in the other
Royal Burghs
in SCOTLAND, and do no Hurt to
Physicians
themselves.
EDINBURGH,
Printed. Sold by Mr.
James Davidson,
Mr.
Thomas Heriot,
and Mr.
Alexander Symmers,
Booksellers in
Edinburgh.
1727. (Price Six Pence.)
An ESSAY,
&c.
I T is the unavoidable Fate of every Thing that makes its Appearance new in the World, to be attended with Misrepresentations: The malicious Genius of some People naturally leads them to Censure and Detraction, especially where they have such an agreeable Opportunity of exerting their beloved Talents, as is afforded to them by any Proposal, however just in it self, that has not been approved of by the Practice of former Times, in the very Place where they happen to live, nor supported by the Authority of a Multitude there. Others imagine, that they have an Interest to oppose any new Scheme, and therefore are very Sanguine against it, altho' they are often found to be miserably mistaken in their Opinion, even as to their own particular Concerns. A third Sort, which make up indeed by far the most numerous Class of Detractors, are those who go blindly in to what they hear others say, without giving themselves the least Trouble to examine the Case; they are pleased with the Slander, and catch the Laugh, for what Reason they cannot tell, and think of the Matter they don't know how, but just as they are put upon, and directed by the Hints suggested to them by ill natured or designing Persons. Every new Project then must appear with great Disadvantages; especially in a narrow Place, and where the Judgments of Men are too apt to be guided by the Opinions or Examples of others, and where Reason is seldom allowed to lead any Man out of the common Road, how far soever that may happen to be wrong in it self. An Innovation in any of the liberal Arts or Sciences, or in the Method of exercising them, and rendering them useful to Mankind, since it cannot expect to be the Darling of any one Party of Men more than of another, and consequently can look for no Patrons out of any Party-Views, which are the Master-Springs of all our Actions at present in this unhappy Country; so it must necessarily meet with extraordinary Discouragement. Yet certain it is, that there are so many Errors committed in the Exercise of the learned Professions, that the World reaps but a small Part of the Advantages that naturally ought to arise from them. This then, if it be true, (as unquestionably it is) must needs give some Satisfaction to the Mind of any Person, who, in his own Faculty, would endeavour to remove those Obstacles which stand in the Way of his Profession, and in a great Measure prevent the usefulness of it; notwithstanding of the forbidding Circumstances which the Novelty of the Thing may bring along with it: And if the Project laid down by such a Person, is of it self reasonable, it is the Proposer's Duty to let the World know that it is so. And if he be able to satisfie the judicious Part of Mankind, who don't judge of Matters before they consider them; and the Candid, who judge with impartiality, he may safely treat the Opinion of all others with the utmost Contempt.
THE Knowledge of Medicine, which we at present only consider, is undoubtedly one of the most valuable Blessings ever Heaven bestowed upon this lower World: But as it is now exercised, it may safely be asserted, and can be prov'd, that the Benefit of it is but small to this Nation, and especially to this City of
Edinburgh;
and that plainly from two Reasons: The First is, the Ignorance of many of the Professors of it, that is, of such as actually practise it; and the Second, which has as bad Effects, is the Difficulty that most Part of People find to have the Advice of those who are to be presumed the best qualified, on Account, that their Fees are too considerable for the Sick Person's Pocket. Now the Rich amongst us, bear but a small Proportion to the poorer Sort. If many then must be without the Benefit of Medicine regularly apply'd, whilst a few only can purchase it, certainly the Service it does to the Community is but inconsiderable.
THE natural Way to put the Practice of this Art into the most proper Hands, and so to exclude the more ignorant from it, (which was the Royal Design of the Sovereign, in erecting a College of Physicians in this Place, altho' that Design has not hitherto succeeded) would certainly be, for the Physicians to make such a Regulation with Respect to their Fees, that every Person, when indisposed, might be able to call them: If they would, for Example, accept of such a small Thing, at a Time, as Half a Crown, and be paid for each Visit at the same Rate. And lest it should be alledged, that this were either prostituting the Art, or sacrificing their own Interest to the Good of the Publick (a Thing which, altho' noble, is not always convenient) let them consider the following Particulars, and it is highly probable they will change their Opinion; and perhaps be convinced, that they have no Manner of Interest to oppose such a Scheme.
IT can be prov'd in the first Place, that a small Fee, at a Time, to a Physician for his Advice, satisfies the most Learned and Knowing Practitioners of most Part of
Europe.
2do, THAT, were it the general Practice here to take such Fees, Physicians would be more universally imploy'd than they are, acquire more Honour, and do infinitely more Service to the Lieges.
3tio, THAT the well imployed of the Faculty could lose nothing by this Method, but rather gain; and that the less imployed would gain vastly, by some Part of the Business necessarily falling into their Hands.
4to, THAT the Chirurgeon Apothecaries, whom it would seem mostly to affect, could lose nothing, but would gain upon several Accounts.
5to, THAT from the foregoing Considerations, it would be highly beneficial to the Country, that this Method were introduced, and that it would do Prejudice to no one Person.
As to the first Particular; Those who know how Physicians are paid in
Holland,
where it is confest by every Body, there are Men of as great Learning in that Profession as any where else at present; how they are paid all over
Germany, Elanders, France
it self, and every where but in
Great Britain,
won't dispute, That the best Physicians are contented with small Fees, and consequently must think it no Disgrace for any one of the Faculty to be satisfy'd with the same.
THE second Particular is as little doubtful; For if one could have the best Advice about their Health for a small Acknowledgment, no doubt they would call for that Advice, rather than for any other; and the least Disorder would willingly make them part with Half a Crown, when perhaps, to save a Guinea, the Distemper is allowed to go on, without calling any Assistance, or at least, not that of One whose Business it is to understand Distempers: Besides, many a one is able to pay a small Fee, who has not the Ability to pay a great one, and therefore must take up with what Advice he can best purchase. These Considerations make it appear, That a more universal Practice must necessarily attend the lowering of the Fees.
BUT next, Physicians would acquire more Honour, and do more Good; because by this Means they would have it in their Power, to observe Diseases from their first Appearances, and by putting the Patient, from the Beginning, under a right Management, would, very often, effectually make a Cure; when at present we know, they are seldom called (except perhaps by the richer Sort, and that not always) 'till there is imminent Danger apprehended: And then the Doctor's Business commonly is, to skreen every Body else from any Reflections about the sick Person's Death, and be a Witness of his Exit; when he himself knows very well, if he be a Person of Ingenuity and Learning, That he now can neither understand nor cure the Distemper, since the Course of it is already perverted by a bad Management, or at least not rectify'd in Time by a good one. It is a certain Fact, That Physicians, being commonly called in the End of a Disease, or after it has made a considerable Progress, seldom see any one, as God and Nature sent it; but as it is disguised and changed by Applications made in the Beginning: And for this Reason they are able to do their Patients little or no Service, which has render'd the Art contemptible to some, and suspected to be of no great Use, even by the most knowing. It would then appear to be the Business of every true Physician, to endeavour to retrieve the Honour of his own Art, by doing what he can, to bring the Practice into the Hands of the real Professors of it; which can never be done 'till the Fees are made low. And is it not the utmost Barbarity, to deny an Advice to all who have not Ability to pay Gold, and too much Modesty to ask it for nothing?
WHAT was in the third Place asserted,
That the well employed of the Faculty could lose nothing,
appears by considering, that did they keep a List of every Visit, and were paid at a certain Rate for it, it would often come to more Account than their Payments do at present. People would know exactly what they expected for their Trouble, and desire their Attendance accordingly. The Richer, who at present give Gold, for their own greater Satisfaction, would call them every Day, or oftner, during the Course of a Distemper. Others would call them now and then, and so have the Benefit of good Directions, who at present languish without them. And from this last Consideration it plainly appears, That there would be an Addition to the Gain, even of such as have their Reputation the best established: And as to the less employed, and younger Part of the Faculty, they must necessarily be often in Business, whereas at present they are idle, if Poor as well as Rich constantly should call Physicians; because in that Case, a few Persons could not be sufficient to attend the whole who were willing to employ them.
IT may here be objected, That this is but a pretended lowering of the Fees, and that Half a Crown a Visit lands in the same Thing as a Guinea now and then. But by what is said above it appears, that tho' in some Cases, with Respect to the richer Sort, the Thing be really true, yet with Respect to the Generality it is not so, since very often one Visit or two may be sufficient to give the Patient, or perhaps his Apothecary, such Directions as being well observed, will be of great Use to him: And even the Rich will have this Advantage by it, that they will sooner incline to call a Physician to a slight Illness, than they do at present; and by so doing, often prevent the ensuing of a very severe One: For the first Attacks of a Disease are many Times deceitful. Besides, this will be an Inducement to them to call severals at a Time, where now One serves; and so they shall have the joynt Advice of many at a very easy Purchase.
WHAT was proposed in the fourth Place,
viz. That the Chyrurgeon-Apothecaries would lose nothing,
seems liable to more Objections, because the Scheme it self appears contriv'd with a Design to take the whole Practice of Medicine out of their Hands; whereas at present it is notourly known, that they are the Persons who practise the most of it in this Place; and therefore, that if this Project should go on, it would in a Manner ruine their Business. But the thinking Part of the Gentlemen of that Incorporation (it might almost be asserted, the whole of them) are well satisfied, that a quite contrary Effect would ensue. For in the first Place, the Affair of Surgery might be put under Regulations, as well as that of Medicine, with Respect to the Fees; and then, when ever an external Malady required Advice, or Attendance and Applications, either by the Surgeon or his Servants, a stated Rule for his Payment would be found very convenient, both for the Surgeon and the Patient: Which may easily be deduced from what was said above with Regard to Medicine, and what is clearly demonstrated by the constant Custom in foreign Parts.
WITH Respect to Pharmacy, the Surgeon-Apothecaries, who at present, by the Laws of this Place, have the sole Privilege of exercising that Art, seldom make any Profit but by the selling of their Medicines to their Patients; and if ever they are paid for Attendance, it is commonly by the more generous Sort, who even at present never fail to call a Physician, as well as the Surgeon, to any internal Case. As to these then, the new Proposal makes no Odds; neither does it as to the others, since, whether they have a Physician or not, the Account of Medicines must always be paid. Thus far as to the Negative Position, That those Gentlemen could not lose: Let us next observe their Advantages. The most of them are of such Candor, that they are often grieved when dealing with the poorer Sort, that the extravagant Fees of Physicians, entirely debar them from joyning other Advice to their own; and 'tis with Difficulty, that those of middle Circumstances are perswaded to consent to it, even where there is Danger. No doubt then, but since our Scheme opens a Door of having easily the Concurrence of a Physician to whatever is done, the Surgeons must have great Satisfaction in it; for two Advices must be as good as a single one at least, and the Character of DOCTOR will add some Honour to the Consultation, and so be more agreeable to the Patient. Besides, the Person who furnishes the Medicines, seldom has the same Freedom of Mind to prescribe as another, lest he be suspected to have a View to his own Interest, and therefore he always wishes to have another to do it for him.
THAT the Character of DOCTOR adds little or nothing to the Matter, may be alledged, for this Reason, That the Surgeon-Apothecaries in this Place, are mostly Gentlemen, consequently have the same Education with our Physicians, as to all the Parts of Learning that are commonly taught in our younger Years; That afterwards, during their Apprenticeships, they have much Opportunity of seeing sick People, and so, by Degrees, learning how to Practise, by observing what is done by others; That some of them, after these Advantages, have been bred in the most famous medical Schools; Others again have, for a long Tract of Time, had a most numerous Practice in the Army or Navy, and by this Means, must necessarily have their Knowledge enriched with many valuable Observations of their own, which never fail to improve one better than what is learned by Hearsay; That in this Place they are not admitted to Practise, but after having gone through a very strict and severe Examination, upon all Parts of Anatomy, Surgery, and Pharmacy, (which include a vast Part of Medicine) and which they are obliged to undergo, in about seven different Diets, by their present Rules. This seems, as indeed it is, to be as August a medical Trial as any in the World, altho' confin'd to some particular Parts of the Science; and they are not admitted to this Trial, 'till after Eight Years from the Beginning of their Apprenticeship; in which Time it is to be presumed, that they are pretty well qualify'd, when we know that there are some Graduations, after a very few Months Study, and perhaps without any at all. 'Tis true, there are some particular Persons, who have a Right to be admitted to Trial with the Surgeons sooner than at the End of Eight Years: But as that respects not the Generality, it is not worth noticing; and the Abridgments that are made of this Time are commonly very small. By all this then it would appear, That the Surgeon seems to bid fairer for being a good Practitioner than the Doctor, and wants only the
Diploma.
WITH the greatest Regard imaginable to the Gentlemen of the honourable Profession of Surgery, the most ancient, and still the most certain Part of Medicine, it must be acknowledged, That the Facts above recited are true; but yet it must be allowed, That the learned Faculty of Medicine will still keep its Dignity, if the Case be fairly consider'd.
A Physician, who justly merits and possesses the Rank and Title of DOCTOR, is not one who comes instructed with a few Scrapes of Knowledge, taken from his own Observation; but brings with him, before he offers to Practise, the learned and laboriously acquir'd Treasures of vast Numbers of Ages. The Life of one Man is extremely short, and is therefore, without great Assistance, uncapable of making any considerable Improvements in so noble, and in some Cases intricate, a Science as that of Medicine. There is then no possible Means of attaining to any Degree of Perfection in it, but by reviewing the Monuments of Antiquity, which, by a particular Providence of Heaven, have been preserved to us. There we are instructed by Multitudes of Observations exactly taken, through a great Tract of Years, in all the Changes that appear, as the Humane Body from Health degenerates into a State of Sickness; as it again, by the Means of Nature, returns to its former healthful Condition; or perhaps continues infected by some Remains of the Disease; or, being overcome with the Load of the Distemper, perishes. We are well advertis'd of all the sensible Causes, that have been observ'd to precede and produce those Distempers, and of all the Methods that the Wit of Man has been able to discover, for assisting Nature to overcome them; and how those Methods have succeeded now for many Thousands of Years. It is no small Task to become well acquainted with the Observations and Doctrine of the Illustrious Ancients; and no small Pleasure, to find them daily verify'd in our own Practice. If we add to those, what the Industry of later Times has furnish'd to us, with respect to some new Diseases, we may be allowed to be well qualify'd in our Profession: But yet more so, if we call the Assistance of Philosophy to our Aid, under due Restrictions, that is, never suffering our Reasonings to lead us away from what is undoubtedly true in Fact. If after an exact Scrutiny into all the Parts of the Animal Machine, we be able to demonstrate the Uses of all that various Structure, and nice Complication of Organs in every different Part of it, and to explain the Springs of all their Actions, we cannot be at a Loss, when its Functions are put out of Order by Sickness, to understand where the Fault lies.
IF then we go further, and examin the Properties of all the Material World, to discover what Parts of it may be of Service in our Art; If we survey the beauteous vegetable Creation, and draw what Aid we can from the healthful Qualities of Plants; If we dive into the Recesses of the Earth, and extort Assistance from the Mineral Kingdom; Then explore the Seas, Earth, and Air, for all the various Animals that have any Parts that can be useful to preserve or repair the Body of Man: If all those different Objects are carefully considered, and their Properties enquired into, and all done with due Regard to the standing practical Observations above mentioned, undoubtedly we must draw such Helps from Philosophy, as very much must improve our Art: And we will think it but a small Exaggeration in the Founder of it, who was a Heathen, when he affirms,
That a Physician who is a Philosopher is equal to a God.
With such a Physician, if any such there be, no Surgeon or Apothecary but will think it his Happiness to be engaged about a Patient: For tho' he himself, as above, may have seen a great deal of Practice, and understand several Branches of the Art; yet the many Interruptions to Study that commonly an Apprenticeship brings along with it, and the over soon going to Practise at one's own Hand, will certainly make him unacquainted with many Things which a learned Physician knows, and has gathered from the Writings of Antiquity, whence the most of his Knowledge comes. For really the Practice of any true Physician, does not so much furnish him with new Observations, as it gives him a Facility in repeating the old Ones, and applying them to particular Cases: So that Study and Practice both concur to make a complete Artist. But it is easy to observe, that much Study, with a moderate Share of Practice, makes a far greater Physician, than little or no Study, tho' with vast Practice: For, as above, he relies not on his own Observation, but on that of a great many Ages. To return to our Point, the Character of
Doctor
must add to the Satisfaction both of the Patient and Apothecary in every Case, if he be what he ought to be, and can recommend himself by his Dexterity, both in foretelling what is to happen in Diseases, and by curing them if they are not desperate; which will distinguish him from all Impostures, better than his Degree in the University, the Honour of which is often basely prostituted. The Wisdom of
Great Britain
has erected Colleges in the different Metropolis's of the Three Kingdoms, to be a Check upon all Foreign Degrees. And it were to be wished, that our own Universities would take Care to admit none, but who are well qualified, which would make every Doctor an Honour to the Faculty. And if at the same Time the Fees were such as is proposed in this Paper, the Practice would soon entirely come into their Hands, to the great Benefit of all, and the Loss of no Body, not even of the Surgeons, as has been proved. Now it may be further added, as a Reason why a Physician ought always to be consulted about any sick Person, that as we are not here in a Place where, by the established Laws, any Person indifferently is allowed to exercise what Branches of the medical Art he shall think fit; so it is a Sort of Usurpation of other People's Rights, and a flying in the Face of Authority, for any one, not legally intitled, to prescribe Medicines. And grant that some who are not graduated, may have more Knowledge than others who are; yet as the Publick knows no other Test of one's Qualifications, but the having a regular Degree, which in this City must be examined and acknowledged by the Royal College; and as the taking away the Necessity of such a Testimony, would have very bad Consequences, by being an Inlet to the very vilest and most ignorant of the People to practise without being questioned; so 'tis hoped that no Person, however well accomplished, if he be not a
Doctor,
will take it amiss to be told, that the just Right to give Medicines belongs to others. Let him, if he pleases, take his Degrees and satisfy the College, or else keep within his own Sphere, as the Physicians ought to do within theirs, neither performing Chirurgical Operations, nor furnishing Medicines to any one, unless they have the Privilege of so doing from the Board of Surgeon-Apothecaries. Neither need they pretend any Advantage in their doing the last, on Account that they are surest of their own Medicines, since the Faithfulness of the Chirurgeon-Apothecaries of this City, in that Particular, is well known. The Professions of Medicine and Surgery are much a Kin; to the one belongs the Cure of Internal, to the other the Cure of External Maladies: The Professors of them are then in that Respect Brethren, and on an equal Lay. If any Man will exercise both, let him take the necessary Powers from both Societies. There is no Inconsistency, no Dishonour in it, that they know who have studied the History of those Professions, (whatever the more Ignorant may object) for the greatest Masters were such as exercised both. But let no Apothecary pretend to prescribe; his Business is only to obey Prescriptions: Let no Surgeon do the same, if it is not in External Cases, which naturally come within his Province. Let no Physician perform an Operation, make External Applications, or compound and furnish Medicines, unless such a Person be vested with the Powers of both Societies. This would evite all Confusion, and keep every one's Privileges distinct; and all Pretences for confounding of them will be taken away, if every Sick Person may have the Advice of a Physician at an easie Rate. For we know that the Exorbitancy of the Fees was always given as a Reason why the Surgeons were under a Necessity to prescribe; but that it would be much better for them were it otherwise, 'tis hoped is is now made clear.
THE Fifth Proposition it is needless now to insist on, for the Advantages to the Country must be very great, if the poorer, as well as richer Inhabitants of it be all equally admitted to reap the Benefit of so valuable an Art as Medicine. By this Means the Populace, by getting free Access to regular Physicians, will have no longer their Bodies left at the Mercy of every ignorant Pretender to Physick, or be glad to apply for Advice to every impertinent Quack, because his Fees are such as they are able to afford; to which Sort of Gentlemen, we see they constantly flock wherever they offer, and of which there has been a notable Instance lately in this very Place. It can be prov'd, that neither Pestilence, Famine, or War, ever have committed such Ravages to the Destruction of Human Kind, as the unskilful Application of Medicine has. If such wrong Applications then, of a noble and useful Art, can be in a great Measure prevented by our Scheme, were it not an egregious Cruelty to the World, in the least to oppose its taking Effect, especially considering, that no one Person can possibly lose any Thing by it, as has been sufficiently demonstrated?
AFTER what has been said upon this Subject, it may appear somewhat strange, that such an important Affair has been so long neglected: And as it appears to be something of Moment, so it were to be wished, that a proper Method of actually putting it in Execution, were fallen upon; because the best and most profitable Designs often prove abortive, on Account of the bad Management of the Undertakers.
No doubt, since there is a College of Physicians, here, erected by Royal Authority, for the Improvement of Medicine, it is their proper Business to further this
Proposal;
and it were well if they did so. But as Societies seldom do much in the like Matters, on Account that their Members are seldom all agreed in any one Point; and as this Project has been before them a long Time ago, and much pressed by some of the most Noted in the Society; and as at that Time it met with Discouragement, (certainly, as appears by what is here advanced, without any good Reason) so in all Probability it wou'd do the same again; and therefore some single Person, or a few, must set about it, otherwise so good a Design must for ever perish. It is indeed a bold Undertaking for any one Man, but what inevitable Necessity seems to throw upon some Body. It may here perhaps be asked, Does any Man in this Place, especially if he is not a very old One, think himself qualified as a Physician ought to be, according to the Description given of a
True Physician
above, and that therefore he can be the Person to undertake this Work? This may be answered by asking another Question; Pray, does any young Man think himself qualified for prescribing to Patients, in Quality of
Doctor,
where the Life of his Neighbour is so nearly concerned? Really any Person that is sufficient for the one, may be sufficient for doing the other, and can be capable of neither, without a great deal of the Study above spoken of, and Practice for some Time. And indeed any Man can as easily know, whether he himself has made considerable Progress in the Doctrine of
Hippocrates,
as another can whether he again understands
Euclid.
And it is presumed, that no Man of common Sense will be refused an Allowance to pass a Judgment upon himself, whether he understands the last mentioned
Author
or not.
IF this then is so, some Person or other may, without incurring the Imputation of extraordinary Vanity, take the Burden of this whole Affair upon him, and set up with as good a Grace for being ready to serve a great many at a cheap Rate, as any other Man can to serve a few at a dear one. And no doubt, but that if this Method were once followed with any tolerable Success, by any Person, the Royal College would by Degrees come into it, however unwilling they may be at the Beginning; and so at length the Country reap the whole Benefit proposed by it.
THERE is one Advantage not yet taken Notice of, which is, That if some certain Persons were the Undertakers, the young Students of Medicine might reap a great deal of Good by it.
THERE has of late been taught here, and with some considerable Success, at the
Surgeons Hall,
the whole Art of Medicine, in a Systematical Way; in which Course, with all imaginable Care of the Performers, nothing has been omitted which to them seem'd necessary, either to demonstrate the Theory, or illustrate and explain regular Practice, as drawn from certain Experience and unquestionably just Observations. This they have done, with all due Regard to the great Names of those who have furnished the World with a vast Treasure of practical Observations, and of those whose great Industry and accurate Genius's, have confirmed and improved the Theory by many valuable Discoveries; and with no less Deference to the Great Person who, from vast Volumes, has collected all relating to the one or the other, into such an exact Order, and into such Bounds, that what concerns either of them can be explained in the Course of a Seven or Eight Months College; which Task they own themselves unable to have performed, without the Aid of so great a Master.
THEY hope that they are of Service in several Respects to their Country.
First,
The Money which it was formerly necessary for Physicians to bestow on a foreign Education, may be kept at home.
Next,
A great many who had not Ability to go abroad to purchase Learning, are now taught in their own Country, which puts them to a small Expence; and by this Means a great many acquire a just Notion of a regular Practice, who otherwise would perhaps never have heard of it; and yet, may be, would have play'd the
Doctor
with as great Assurance as they shall do now; but under what Disadvantages it is easy to tell. Besides, the extraordinary Pains that those Gentlemen have been at, in teaching in
English
as well as in
Latin,
and in insisting so minutely on every Particular, as to be understood by those of any Capacity, will have this good Effect, that many who perhaps wanted the previous necessary Learning fit to accomplish one for studying Physick, altho' they cannot possibly reap the same Benefit from the Course, as others well educated will; yet they will always carry away a great deal, and so be much better fitted than they could have been without it, to serve either in the Army, or the Navy, where Medicine, as often as Surgery, is their Business; altho' a sufficient Knowledge of the last is absolutely necessary for them, and the Whole of it, to wit of Surgery, is fully explain'd as Part of the Course. The hearing of it then, will make any of them, at least, much sooner good Surgeons, than they can be without it. And as
Edinburgh
furnishes a great many Surgeons to all the
British
Dominions, it is with Pleasure that these Gentlemen believe, if they meet with suitable Encouragement, they shall save many a Subject to the Nation.
TO return, after this Digression, to our Point: If those Gentlemen, or any of them, would undertake to give Advice, at the Rate of Half a Crown a Visit to any Patient within the Ports of
Edinburgh,
or the
Canongate;
and for a Shilling to every Person, who at certain Hours should consult them at Home; and
Gratis
to every extremely indigent Person who should come to them: By this Means the Students could see a great Deal of Practice, and have the Pleasure of observing, that what was taught them in the College, was before their Eyes verify'd in Fact. Their Master might take one or more of them, at a Time, to such Patients as he should think proper; but especially, he could make them Witnesses of his Practice at Home, which 'tis believ'd (all will agree) would be a great Advantage to them; and therefore it is Needless to insist on it. But what is their Advantage, comes in Time to be the Advantage of the Publick. Now if any of the Persons just mention'd, do undertake what we propose, 'tis hoped, That their daily Imployment of Teaching, puts them above the Suspicion of being very ignorant; and therefore the good Work may succeed in their Hands, as well as in that of any One whosoever. And then the two Obstacles that were proposed in the Beginning, as the Hindrances of the Advantages arising from the medical Art, that is, The Ignorance of some Practisers, and the Difficulty of consulting the Best on Account of their Fees, will both be almost wholly removed, when the whole Science is to be learned in our own Country, and therefore every Man made inexcusable who learns it not, and yet designs to practise it; and then those who have learned it, to be advised with at such a Rate as every Patient can afford.
Is it then Fact, That the Method of practising Medicine at present, is subject to many Inconveniencies, which affect most Part of the Faculty, and the whole Lieges in general, except a very few? By the whole Tenor of the Premisses is it demonstrated, That what is here proposed would be an effectual Remedy, whereby they might all be remov'd? Is the only Way left to bring such a Remedy about, pointed out; that is, That it must be attempted by a single Person, or by a few? And are there such Persons, who think they have a Probability of succeeding in it? Are all these Things so, and nothing to stand in the Way of so good a Design, but the Malice or Envy of some People of little Souls, and mean Capacities? THEN let the Thing be instantly gone about. It is reasonable in it self, and the present Circumstances of our Country, where there is such an extreme Scarcity of Money, necessarily require it, were there nothing else in the Matter. The more Dirt the Ignorant or Malicious endeavour to throw upon the Undertaker of a good Work, the more Honour to him, who can contemn Things of so much Insignificancy, and go on to do well; and the more Ignominy and Disgrace to his Opposers, in the Eyes of all the knowing and candid World. The Author of this Paper is very well apprised of the common Methods of running down any Thing, however just, if a Person shall please, whose Talent lies that Way. He, and every Body else, is aware of the Backbiting Tittle-tattle, the impertinent Sneer to insinuate a Slander, and all the little jirking villanous Arts of Detraction and Defamation, and of the wrong Constructions that may be put upon every Thing. He owns frankly, That if any of this Sort of Artillery be brought against him, he heartily despises it. If any reasonable Argument be brought against what is proposed, he is willing to hear it; and if it be a good one, to be convinced by it.
IN the mean Time he thinks, after what is said, it is proper to let the Publick know, That there is a Design, by some of the Faculty of Medicine, as well in
Edinburgh,
as in some of the other Royal Burghs in
Scotland,
actually to Practise in the proposed Way, (that is, for a small Fee each Consultation) and it is hoped, That so laudable an Undertaking will meet with all due Encouragement. The Particulars of the Persons Names, and the Fees they are to take, will afterwards be declared. All others are heartily invited to come into the same Way of doing, making such Alterations in their Method of following out the Scheme, as shall best suit their Conveniency, and the Circumstances of the Place they live in.
THIS small ESSAY is humbly submitted to the Judgment of the candid World; and the Author is perswaded, That whether his Proposal succeed at present, or not, that there are some Considerations which seem plainly to evince, That sooner or later it must necessarily take in this Country; and then it will be sufficient Honour for him, to have been the first Mover in such an important Affair.
FINIS.