ART. XIX.- Physic and Physicians: a Medical Sketch Book, &c.: with Memoirs of Eminent Living Physicians and Surgeons. 2 Vols. London: Longman.

66

1839.

THESE Volumes neither teach the theory nor the practice of physic to her Majesty's lieges. They contain little solid information; and do not even raise in us any very high ideas of the dignity of the medical profession, nor of the right and title of those of it who generally rise to the highest station, to the distinction. Dr. Johnson has said that "A physician in a great city seems to be the mere plaything of fortune; his degree of reputation is, for the most part, totally casual; they that employ him, know not his excellence; they who reject him know not his deficiency." The Sketch Book before us would guide one to a similar conclusion. Still, says the great moralist, By an acute observer, who had looked on the transactions of the world for half a century, a very curious book might be written on the fortunes of the physicians.' This hint seems to have operated upon the author of the present work, which in certain respects resembles a publication of some notoriety, viz., "The Gold-headed Cane," containing a great variety and still greater number of particulars, chiefly of an anecdotical and amusing kind, relating to and illustrative of the most distinguished physicians, especially practitioners in this country, collected from many sources. The work is therefore essentially a compilation, the materials brought together, we are told, being scattered through four hundred volumes; these materials being thrown into divisions and distinct chapters, but not according to any clear or other than arbitrary arrangement; while many of the facts, illustrations, and stories introduced are thread-bare, from repetitions, while others of them are apocryphal.

A book, however, is to be tried according to its pretensions; and our author has been lucky or rather industrious and skilful enough to produce a series of light sketches and curious anecdotes, that will at any time entertain the general reader at whatever page the work is opened; while to medical students and practitioners many of the particulars will be interesting, some of them useful or suggestive; and this is all that he professes to do.

The title of the first chapter is the "Antiquity of Physic, and Defence of Medical Men," which like the other parts of the work contains biographical notices, along with miscellaneous matters. Next we have an account and anecdotes of "Eccentric Medical Men." Next again "Early Struggles of Eminent Medical Men," In reference to this last mentioned subject, the author tells us in the Preface that he had adduced "several instances of men who have had to contend in early life with difficulties and disappointments of no ordinary character, but who afterwards attained to very high eminence in their respective departments of medical science; and it is hoped that the perusal will encourage and elevate the drooping hopes of many who may, perhaps, at this moment be struggling nearly heart-broken, with adversity.' We may remark, however, that where there are so many aspirants and candidates, were every one of them to pluck up, take heart, and gird his loins, on reading the chapter in question, the enthusiam, and sanguine anticipations, or careering hopes of the majority, would at length be cast down for a few only can be in the first rank; there is not employment for all; or if there was, how soon would the universal prosperity of the VOL. 11. (1839). No. iv.

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living race of practitioners have treading upon its heels a host tenfold more numerous! In this as in other cases there will and must be adversity and drooping spirits; and it is good that it is so, for it acts as a salutary check, to over-production. Incentives, however, are never on this account to be withheld. Take hope from the majority of men, and what have they left? while everything that adds to its aspirations helps to elevate the general standard of a profession, and through a profession the general feeling and conduct of society.

There is value and striking truth in the following observations :-"The men who commence their career under the most favourable auspices, and with the most flattering prospects of success, do not always obtain the eminence they seek. The race is not always to the swift, nor the battle to the strong. There is a certain ordeal which all men must undergo in their passage through life; and it is very questionable whether he succeeds the best who commences under the most apparently advantageous circumstances. There is such a thing as a man depending too much upon his means, and too little upon himself-small certainties, it has been observed, are often the ruin of man." There is nothing original in these observations, but they cannot be too deeply impressed upon the mind. The saying of a celebrated English Judge, quoted by our author, puts the important truth in an aphoristic form, when answering the question-"What contributed most success at the bar?" The answer was, some succeed by great talent, some by high connexions, some by a miracle, but the majority by commencing without a shilling.".

There is a chapter on "Celebrated Medical Poets ;" and another on "Literary and Scientific Medical Men." The "Sketches and Illustrations of Medical Quackery," might have been more full and instructive, without occupying more space. But a subject which presents an over abundance of proofs and particulars is always perplexing to an illustrator. "How to get a Practice, or the Art of Rising in Physic," is meant as a "satire on the stratagems and unprofessional conduct of a certain class of practitioners, anxious to advance their interests, and not over scrupulous of the means they resort to, in order to effect their purposes." But if all be true which we find in this "Sketch-Book," or if the burden of many of its illustrations be taken as the foundation of a doctrine, stratagy as well as chance appears to have done more than talent or praiseworthy industry towards the advancement of many of our medical men.

The "Chronicles of Warwick Hall," the old College of Physicians, in Warwick Lane, and at the back of the Old Bailey," and the Medical and Surgical Luminaries of the Olden Time," make a good chapter. "MadDoctors, and Mad-Houses," affords materials for many strange and affecting anecdotes. We may instance among the particulars of this section of the work, the case of George the Third; while the notices of the life of Dr. Willis, who cured His Majesty, form one of the most interesting biographical sketches in the book.

"Medical Emigration," "Army and Navy Surgeons, and East India Company's Medical Service," are good themes, that are, considering the space afforded them, and the prevailing purpose of the author, well and instructively handled. We think that, to his own profit and to the advan

tage of many young men, he might make these points and peculiar employments the subject of fuller and closer information. In the meanwhile what is here presented ought to be well considered by many a parent and many an ingenuous youth. We quote some of the introductory paragraphs :—

We can hardly anticipate the exclamation of our gracious Queen," says the author 66 were she to visit many of the schools now established in the metropolis, for the education of medical practitioners: if she did not offer up a prayer for the safety of those over whom she has been called to reign, she would certainly be curious to know how so many doctors could find employment in her dominions.

"At a time when every body is complaining of a redundancy of medical population, when we hear lamentations from one, and sighs from another, on the present crowded state of the profession, it becomes a matter of importance and interest to inquire how far this evil, assuming its existence, admits of being removed by the adoption of the principle of emigration.

"That the medical profession is overstocked there cannot be a doubt; and that many men, highly and expensively educated, are allowed to pine, and droop, for want of public patronage, is equally self-evident. It is useless to stop to investigate the causes of the evil-they have been in operation for a considerable time, and continue to exercise their pernicious influence. The standard of medical education has been fixed too low. Every apothecary's and chemist's assistant has had facilities for entering the profession, which ought never to have been afforded; and in this way the medical ranks have been crowded with recruits; and men, who, if they had been brought up to some honest trade, would have earned a decent livelihood, are compelled, as members of a learned profession, to starve for want of patients. Every tradesman who has been able to establish himself in business, and who has laid up a few thousand pounds, must now have a son a doctor. This seems to be the mania of the age; but how little do they calculate the difficulties and vexations with which the scion of their house will have to contend!

"In one large school in the metropolis, numbering some hundreds of pupils, the principal told us that one hundred and fifty of the students were the sons of tradesmen !

"We do not object to a man, who has advanced himself in life, and acquired opulence by the means of trade, bringing up a favourite son to the profession of physic; but we do not think they would adopt this practice if they were made acquainted with the real state of the profession, and had some notion of the long and dreary journey which most men entering it have to take, before their efforts to establish themselves in anything like decent practice are crowned with success. What is the effect of this crowded condition of the profession? When a man has passed through the ordeal of his examination, unless he has capital to commence business with, he is compelled to seek an assistant's situation; to live with some hard taskmaster, and to do the drudgery of his business, for a paltry pittance of thirty pounds a-year.

"What a pleasing and gratifying prospect! sideration is, how is this evil to be remedied?

The question for our conIs there any course, which,

if adopted, would rid the profession of its superabundant numbers, and yet give each a certain amount of employment?

"The Army, the Navy, and the East India Company's service take off a certain number, and yet the evil is not obviated. The only course, then, which occurs to us to suggest, is that of emigration."

We have already alluded to the useful information that is to be found in the pages before us on these various outlets for medical labourers. As to the course of study and the preparation necessary, the pay, the condition, &c. of the Military, Naval, and the Company's Surgeons, carefully collected particulars are given. With regard to the author's hopes of the relief to be afforded by emigration, without venturing or inclining to question their grounds, it may still with good reason be anticipated and feared that our medical schools would continue to be over-crowded. The drain by which emigration would let many medical men pass off, will have its current regulated by a corresponding largeness of the streams of other classes of emigrants. Besides, so long as every profession, mechanical as well as learned, is over-stocked, the appearance of a slackening in the medical, would draw thither an extraordinary pressure. The whole frame, the various classes of the community, must be relieved with something like a contemporaneous progression, before any one section can be sensibly and favourably affected. Nevertheless it is right and proper to direct attention to any land of Promise which may afford immediate relief at home, and offer happiness and prosperity to those who go abroad. This is our author's endeavour, and to his directions and details we recommend medical aspirants and candidates for practice to look, which directions and details he thus introduces,—

"It is now our duty to point out to medical men, who find a difficulty in establishing themselves in practice in this country, those parts of the world where facilities exist for the settlement of members of the medical profession. Having been much abroad, we can speak on some points from personal observation. Our other information may be strictly relied upon, as we have been extremely careful in collecting the most authentic particulars of the countries to which allusion is made."

The two last chapters in the book have for their titles,-" Sketches of Eminent Living Physicians."- "Sketches of Eminent Living Surgeons." The author has not displayed sound judgment in the adoption of these subjects, nor good taste in his manner of treating them. His praise is offensively laid on in most of his instances; the practitioners whom he selects for adulation are, or have the appearance of being partially selected. There is invidiousness in the very fact that only a few of the living members of the profession figure in these pages, while the references to private history and personal character ought never to have been printed. Why should late rumour concerning Sir James Clark find a place in a two volumed book, which the writer of it must have intended to be something more than an ephemeral production? But our limits forbid us to say more, or to quote more than two specimens of the prevailing style and matter of the work :

ABERNETHY AND HIS PUPILS."-Mr. Abernethy had occasionally a most fearful practice of thinking aloud. On the day of one of his introductory

lectures, when the theatre of St. Bartholomew was as full as it could possibly be, and the cheering on his entrance had subsided, he was observed to cast his eyes around, seemingly insensible to the applause with which he had been greeted, and he exclaimed with great feeling and pathos, God help you all! what is to become of you?' evidently much moved by the appearance of so great a number of medical students, seeking for information to be fitted for practice."

• DR. CADOGAN.-"This physician, who was at one time in indifferent circumstances, married a rich old lady, over whose wealth he had an entire control. Like most mercantile marriages, it was not of the happiest kind. The lady had a suspicion on her mind, that the doctor would one day poison her with his physic in order to get her out of his way; and feeling ill, on one occasion, she exclaimed that she was poisoned. 'Poisoned!' said the doctor to a number of his wife's friends who were present, how can that possibly be? Whom do you accuse of the crime?' 'You,' replied the indignant wife. 'Gentlemen,' said the doctor, with considerable nonchalance, 'it is perfectly false. You are quite welcome to open her at once, and you will then discover the calumny.'".

ART. XX.

1. The Works of the Rev. Sydney Smith. In 3 Vols. London: Long

man. 1839.

2. Ballot. By the REV. SYDNEY SMITH. 8th Edition.

Longman. 1839.

London :

WHO but Sydney Smith could venture to republish a series of pamphlets, and what, in one sense, were ephemeral productions suited to and suggested by the passing occurrences of the day, extending over thirty changeful years, with the slightest hope that he should not be a heavy loser, and that the not unponderous amount of three volumes would ever be examined or read from beginning to end by the most persevering book-worm? These volumes, however, will be popular now and hereafter; and for sunday reasons. One is that the author has had the sagacity to select for his themes subjects that have a perennial interest, or he has skilfully contrived to render a temporary topic the occasion for uttering sentiments that convey first principles and that are universal in their nature. A second is, that whatever he expresses has an unwonted pith in it, going directly to the point he wishes to hit, disentangled, undiverted by any surrounding confusion. He strips himself most willingly for the contest, and then handles a smart rifle that tells at every fire. And lastly, even when most quiet, his wit is so graceful, his allusions so close, his illustrations so apt, that one might suppose the polished and keen small-sword to be held in one ready and flexible hand while the feller weapon was in the other. On these and

perhaps other accounts, it is with reluctance that one leaves off reading any one of his many separate pieces, even although he must dissent widely in opinion and conclusion from the Rev. gentleman. There is always entertainment, or clear and forcible instruction; each, whenever the subject and occasion can at all admit, striving to keep foremost.

We need not give the titles or occasions of the several contents of these