RECOLLECTIONS OF A DOCTOR'S LIFE.

Auckland Star, Volume XXXVI, Issue 201, 23 August 1905, Page 9

RECOLLECTIONS OF A DOCTOR'S LIFE.

Ife» (By R. H. BAKEWELL, M.D.) i

jG i T I *.iTt seems to mc that the recollections Wtf scenes and incident* in the professional life of a medical practitioner 5 iriio ha? practised in all the four quar--iers of the world for iifty-seven years will be °f some interest to the public. I I have practised in London, in manuiac- ! \ tmicc district-, in country towns, and j j,, rural districts of Knjrland, in the I sfes' Indies, both Spanish and English,-! ! in South America, in Turkey. j n Russia i ■. (jn the Crimea), in Australia for a short j | in South Africa, and for thirty- ! two years in New Zealand. I have ' been twice a medical officer in the army, ' ; I have been a medical officer in the Co- , • lonia! Department in Trinidad. 8.W.1., I ; and in my last official position I was j I snroeon-superintondenl of a New Zea- ; ' land Government emigrant ship. 1 have j ieen a medical officer of no than I eleven hospitals of all sorts and sizes, j ; from a cottage hospital of twenty heds , l to the general hospital of Scutari. '' | yhieh contained eight hundred bed- , (SOOi. I I only mention these details to show : the reader that I have ample materials to draw upon- and although for obvious \ reasons many of tlie- most thrilling ; scenes or incidents cannot be narrated. | . T thiuk I may venture to promise that • these papers will not lack interest. j Born in the year 1831. 1 was just six- ; teen years and a-half «dd when I en- j tered the medical profession as articled j •pupil, or, legally speaking, apprentice. \ to a general practitioner in YValtham j Abbey. Essex. It was in -May. IS4S, : that 1 first went to him- and after a j month's trial I was articled for five years in June. At that time, and for j ten years afterwards, the medical pro- , fession in England was divided into j three grades, physicians, pure surgeons. : and general practitioners, who were in • the large majority of cases apothecaries ; as well as members of the Koyal Col- j 5 lege of Surgeons. ; At that time no one was recognised as a physician in England who was not a licentiate, member, or fellow of the London College of Physicians. To obtain even the Ik-en-e a man was rcquir- I ed to be a graduate (M-B. or M.D.I of ' a British University. Tiie fellows, j who were elected from the body of mem- j bers were all Oxford or Cambridge men. Physicians wore not allowed to ; perform, any surgical operation, however trifling: they could not even bleed. . however urgent the case, or open an ; abscess: they were obliged to send for . 2 ?urgeon or apothecary to do any ope- i ration. Of course, they never supplied j - Eedk-ine. but only prescribed. In 134S | and for some year.-.previously they had j been allowed to practise midwifery, bnt j this was a comparatively recent inno- I ration. In the old days the College I left that work to those who ought to j .practise it invariably —to women. From the ranks of the College of Phy- j sicians were chosen all the physicians of hospitals, whether in Loudon or the country, , Physicians were paid entirely by fees in cash—they never seat out any bills, j and were debarred by the terms of their j charter from ever suing for payment of I ices. They are still, under the Medical Act of IS.")S- by their own particular j irish. deprived of the power, which be- | long- to all other registered medical j practitioners, of suing for their fees. Pure surgeons, as they called themselves, were members or fellows of the Eoyal College of Surgeons, who treated only surgical diseases and performed operations. They were not suppo-ed to I

__„,.--.__.. . ----. rr- -•- attend midwifery cases, or medical cases j such as levers, inflammations of the in- j tcrnal organs, nervous diseases nr the '• like. In reality they, for the mosi part, practised medicine whenever they had : tbe chance. It was only those at the Ten - top of the tree, who had plenty : to do with hospital and private prac- ; tice. who really refused medical cases, | . especially of a chronic character, that j 'did not require frequent visiting. All the hospital surgeons in London and the large towns were supposed to ! "be pure surgeons. At any rate, none [ were appointed who were apothecaries ' or sent out their own medicines. In ■the smaller towns the infirmaries or "hospitals were frequently officered by general practitioners. Hospital sur- j geons never sent out bills, but were \ " paid by fees. , They had, however, the : right to recover in a court of law "for : work and labour done."' as the legal I phrase wasBelow the pure physicians and surgeons, professionally and in social position, were the vast majority of the. .profession—the general practitioners j j 'or apothecaries. They almost invari-j' ably attended both surgical, medical,, and midwifery cases: they were the doctors of the" poor law unions, attending the workhouses and the outdoor pauper?; they w-fr? the club or lodge doctors, and they were, except in very ' severe or dangerous cases, the usual ~ medical and surgical attendants of all the middle classes and working classes •*"ho were not in clubs. -4 ? . in order to be employed under *»" Poor Law Board, a m.-.n bad to h<Md ' the double qualirir-ation. that is to he "* member of the College of Surgeons as "*"eU as a graduate in medicine, nr a heentiate of the Apothecaries' Society. : ] nineteen one of twenty of the general !' Practitioners whn had commenced prac- I ( free subsequently to the passing of the . ' £ew Poor Law held two qualifications. 1 ■some of the o!der men held only one—j t '% apothecaries" license. A very few ! W the seniors who were in practise be- | : "Te the passing of the Apothecaries' , !-*<t in 181.-.. still were legally qualified \\ »s'"having been in practise before 1815." ! Most of these had had no regular mcdi- j °al education, hut bad been si nip Iv ' * chemists and druggists. They occupied : «c very lowest posiiion in Tlie proles- . s °on, although they hud to be reco_:ni.<- ~

cd. - - ■ previous to 1 ■$.">■>. the l'cen-e of I "™* Apothecaries" Company in England ' ,*a* the only way by which a man could ; jeeover a debt due for visits or advice I . an y ease, it had become n common i Fac-tise for general practitioners to I only for the medicines they sup- j pue_. and nothing for advise at the or for visits in the town. Visits I ft .j"'tne country, or at such a distance) . could not be easily accomplished <".n j ™°* were charged " for. But ready ! was rarely" paid, and both mcdi- j -tof ana visits were booked, and long I "JP« of details sent out half-yearly. J '■^V" a term I pre'f erred to that of ap- j "Egltics—to make out these odious j *^ 9r - For some weeks before midsmn- I Wc_lfl nd Christmas all my leisure time j

"Mr Smith, 1848 I>r ' *° J " Pm S arlick « July I. Packet of powders (baby) If Mixture (baby) ' 3 / 6 •2. Ditto (baby) ...* ]/6 Lotion °/fi 3, Box of pills (Mrs S.) \\\\ 2/ Box of ointment (Master ... 1/6 Mixture (Mrs S.) ......._.. 2/6 and so on. Every separate article was separately charged for. Of course the bills for families ran to a prodigious length. The wealthier patients \ho could afford to pay. instead of recefcr-. lug their medicine in a bottle of mix* tare, would get a packet of four or six draughts, one to be taken three times a (.lay or every four hours, according to the severity of the ea-e. These bottles contained each one fluid ounce and a-ha]f. and were charged eighteen pence each! So the bill mounted merrily up for a few weeks" iltnc-s. There is no doubt about it. that this, practise of charging for medicine was far more profitable to the doctor than the present system of charging for Visit* or advice. I never got "such bills in my life as my old governor used to get. And the people liked it too. The public are such fools—they want to see something for their money, and they do see it when they have shelves full of empty bottles and pill boxes. They cannot >cc why They should pay anything for inerp words, although to he able to utter those words has cost yeats ot study and practise. My first duty as an articled pupil was to learn to dispense. My governor, as I used to call him, had a dispensir.es- assistant, who stopped for a month or two after I came, in order to teach mc dispensing. Fortunately for myself, and for Mr Priest (ray master) I had bad a course of practical chemistry in the laboratory cf a first-class analytical chemist, so that I knew the elements of chemistry, and also a considerable number of the chemicals used in a pharmacy. I made mistakes, but. fortunately, none of them were fatal.. I gave a small baby half a dozen powders—one to be taken every four hours, each powder containing two grains of tartarised antimony. The governor had not written any prescription, but just hurriedly said, as he passed in the gig. ".Send Mrs "#baby six powders with two grains of antimony in each; one every four hours " Now. I had frequently made up mixtures containing antimony, that is tartar emetic, or turtarised antimony, hefore: not in doses of two grains, certainly, but I thought little of that. 1 r ■ eordingly made up the powders and sent them by the errand-boy to the patient's house. Some time before I expected him the governor come hack. and hurriedly asked mc whether 1 had sent the powders to Mr? "s child.. [ said '"Yes." "What did you put in them";" "Two grains of antimony, sir." ">how mc the bottle you toox iv from.' 7 I took out the bottle of tartar emetic. "Good heavens!" he said and jumped into the gig aud set off instantly. When he returned, with the packet of powders, he explained to mc that he had intended to give what was called then in the London Pharmacopeia, the Pulvis Anlimouii Co. —a preparation imitating James' fever powders, and containing a very mild preparation of antimony, but no tartar emetic. He had suddenly remembered that he had never explained to mc about this preparation, and fearing that I might have given the tartarised antimony, he had driven home with all speed. Fortunately, the child had not taken any of the powders. This was. I think, the only serious mistake I ever made in dispensing, and the fault was not mine. (To be continued.)