Part 14

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 gratitude.

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 L7,000, and for several years received between L5,000 and L6,000, 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 L1,500 per annum for twenty years, and L650 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 circumstances 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 L21,000. This sum was exceptional, but for many years his income was over L15,000. 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:--

"God and the doctor we alike adore, But only when in danger, not before; The danger o'er, both are alike requited-- God is forgotten, and the doctor slighted."

The following story illustrates 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 brass plate attracted no patients; months passed idly and drearily, and the poor fellow took to drink. One night the door-bell rang--a servant man, from a lady of title 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 L1500 a year!

Curiously enough, it is recorded of a British doctor that he once actually took a fee from a _dead_ patient. Entering the bedroom immediately after death had taken place, he observed the right hand tightly clenched. Opening the fingers, he found in them a guinea. "Ah, that was clearly for me," said the doctor, putting the gold into his pocket.

It may be remembered here, that the Royal College of Physicians, London, was founded by Thomas Linacre, physician to Henry VIII., in 1518; and that the Royal College of Physicians of Edinburgh was incorporated by Charter of Charles II., November 20th, 1681.

As to the fees paid to physicians, we find that Dr. Edward Browne, the son of Sir Thomas Browne, who became a distinguished physician in London, in his Journal, under the date of February 16th, 1664, records: "I went to visit Mr. Edward Ward, an old man in a feaver, when Mrs. Anne Ward gave me my first fee, 10 shillings."

In a work entitled "Levamen Infirmi," published in the year 1700, we find that the scale of remuneration to surgeons and physicians was as follows:--"To a graduate in physic, his due is about ten shillings, though he commonly expects or demands twenty. Those that are only licenced physicians, their due is no more than six shillings and eightpence, though they commonly demand ten shillings. A surgeon's fee is twelvepence a mile, be his journey far or near; ten groats to set a bone broke or out of joint; and for letting blood one shilling; the cutting off or amputation of any limb is five pounds, but there is no settled price for the cure."

Till recent times neither barristers nor physicians could recover their fees by legal proceedings against their clients or patients unless a special contract had been made. In the case of lawyers this custom can be traced back to the days of ancient Rome. Their services were regarded as being gratuitously rendered in the interests of friendship and justice, and of a value no money could buy. The acknowledgment given them by clients was regarded as an _honorarium_, and paid in advance, so that all pecuniary interest in the issue of the suit was removed, thus preserving the independence and respectability of the bar.

Equity draftsmen, conveyancers, and such like, however, could recover reasonable charges for work done.

So in the medical profession, surgeons, dentists, cuppers, and the like were always entitled to sue for their fees; but the valuable services of a consulting physician were of a different kind, not rendered for payment but acknowledged by the gratitude and honour of his patients.

But this code of honour was modified when all medical practitioners were relieved by the Act of 21 and 22 Vict. 90, which applied to the United Kingdom, and enabled them to recover in any court of law their reasonable charges as well as costs of medicines and medical appliances used. This rule applies to physicians, surgeons, and apothecaries as defined by the statute.

The following information is taken from "Everybody's Pocket Cyclopaedia" (Saxon & Co.).

LONDON MEDICAL FEES.

"Patients are charged according to their supposed income, the income being indicated by the rental of the house in which they reside. The following are the charges usually made by medical practitioners:--

| Rentals. |------------------------------------------------ | L10 to L25 | L25 to L50 | L50 to L100 ----------------------|----------------|----------------|-------------- Ordinary Visit | 2s 6d to 3s 6d | 3s 6d to 5s | 5s to 7s 6d Night Visit | Double an | Ordinary | Visit Mileage beyond two | | | miles from home | 1s 6d | 2s | 2s 6d Detention per hour | 2s 6d to 3s 6d | 3s 6d to 5s | 5s to 7s 6d Letters of Advice | Same charge as | for an Or- | dinary Visit Attendance on Servants| 2s 6d | 2s 6d to 3s 6d | 3s 6d to 5s Midwifery | 21s | 21s to 30s | 42s to 105s | | | CONSULTANTS. | | | | | | Advice or visit alone | 21s | 21s | 21s Advice or visit with | | | another Practitioner| 21s | 21s to 42s | 21s to 42s Mileage beyond two | | | miles from home | 10s 6d | 10s 6d | 10s 6d -----------------------------------------------------------------------

"Special visits, _i.e._, of which due notice has not been given before the practitioner starts on his daily round, are charged at the rate of a visit and a half. Patients calling on the doctor are charged at the same rate as if visited by him.

"There are about 23,000 physicians and surgeons in the United Kingdom, or one to every 1,600 inhabitants."

It has been my privilege to know several doctors intimately. Our family doctor when I was a boy in Paisley, was Dr. Kerr, a man far in advance of his day. He was the means of introducing a pure water supply to the town of Paisley, always strenuously urging the importance of sanitary matters and good drainage, when such things were then but little understood, and greatly neglected. Shortly after the water had been introduced to the houses, from Stanley, an old man--who had been accustomed to purchase water from a cart which went through the streets selling it from a barrel--on being asked how he liked the new water, replied indignantly, "Wha's going to pay good siller for water that has neither smell nor taste?"

On one occasion, an elderly gentleman, who was slightly hypochondriac, consulted Dr. Kerr about his clothing, saying that he regulated the thickness of his flannels by the thermometer. Dr. Kerr, losing patience, said, "Can you not use the thermometer your Maker has put in your inside, and put on clothes when you are cold?"

Dr. Kerr's son and assistant, whom we then called "the young doctor," died a few years ago in Canada, over eighty years of age. No man could possibly have been more considerately kind, gentle, and tender-hearted. On one occasion, in 1841, when, in typhus fever, I was struggling for my life, he sat up with me for three whole consecutive nights, and brought me through. He ever kept himself abreast of the science of the day, and devoted his abilities and energies, _con amore_, to the benefitting of men's souls as well as their bodies.

Another model village and country doctor, also an intimate friend of my parents, Dr. Campbell of Largs, I knew very well. Good, genial, and accomplished, he was a perfect gentleman, and equally at home dining with Sir Thomas Brisbane, or drinking a cup of tea at some old woman's kitchen fireside. He read the _Lancet_, and tried all new medicines, and repeatedly, when going to London, at his request I procured the most recent instruments for him. He was intimate with Dr. Chalmers, Lord Jeffrey, Lord Moncrieff, Lord Cardwell, etc. In telling me of experiments with Perkin's metallic tractors, and that the same results were obtained with wooden ones, showing the power of imagination, he gave me a recent curious illustration. He had lately had the old fashioned little panes of glass taken out of the windows of his house, and plate glass inserted. His mother, who did not know of the change, calling one afternoon, sat on an easy chair, close by the gable window, knitting. On suddenly looking round she said, "Oh John, I've been sitting all this time by an _open_ window," and forthwith she began to sneeze! She actually took cold, and even afterwards could scarcely be persuaded that it had _not_ been an open window, for she said she felt the cold! The doctor told me of an old maiden lady who consulted him, and who, when he prescribed in a general way, insisted on knowing exactly what ailed her. He said she was only slightly nervous, and would soon be all right. This did not at all please her, and she at once loudly protested--"Me nervous! There is not a nerve in my whole body!"

A West India merchant, one of his patients whom I knew, he also told me, one day said to him, "Doctor, for forty years I never knew I had a stomach, and now I can think of nothing else!"

At the cholera time Dr. Campbell was laid down by the disease. The fact spread like wildfire over the village, and, at once, prayer-meetings for his recovery were called by the public bellman, meetings of _all_ the different denominations, including the Roman Catholics (Dr. Campbell was a Free Church Elder), and there were truly heartfelt rejoicings in the whole district over his recovery.

I once asked him how he managed to get in his fees, since he never refused to visit when sent for. He said that one year, from curiosity, he kept an account of his gratuitous visits, and it ran into three figures; but he never took the trouble to note them again, as it served no purpose.

Many years ago he went to his rest, and, at his request, during his last illness, I paid him a farewell visit.

There are few finer descriptions of the country doctor than that contained in Ian Maclaren's "Beside the Bonnie Brier Bush," a book which speaks directly home to every true Scottish heart.

Dr. Campbell, in his large-hearted and genial Christian charity, scientific research, and philosophical acquirements, always reminded me of Sir Thomas Browne, "the beloved physician" of Norwich.

The following pleasing incident, relating to a medical man, came under my own notice. I often visited a country minister, an intimate friend, a learned man, and a genius, the quaint originality of whose observations often reminded me of Fuller, the Church historian, or Charles Lamb. Although of limited means, the Rev. Robert Winning, of Eaglesham, was ever hospitable; if he knew of any poor student, he would invite him to the manse for a month, on the plea that he would help to prepare him for his examination in Hebrew and Greek. The old manse servant, also an original, was paid a sum of money as compensation for refusing tips from visitors. One day, seeing an advertisement of a new book in a magazine I was reading, Mr. Winning remarked to me, "Andrew, I wish you would buy that book, _cut the leaves_, and lend it to me to read!"

One evening a message reached him from the village inn, saying that a doctor had come to an urgent case, which required him to stay over night, that there was no room in the inn, and asking if the minister could give him a bed. His wife, knowing the house was full, asked her husband what they should do. His reply was, "Be not forgetful to entertain strangers, for thereby some have entertained angels unawares. Give him a room, though we have to sleep on the floor." He was accordingly hospitably entertained.

Some time after, the minister took ill. The medical guest heard of it, went to see the local doctor, and, with his consent, visited the minister twice a week, from a distance of nine miles, and for a period of some four months, till his death. When the widow afterwards sent for his account, he said there was none, for it had been more than discharged on the first evening he had spent at the manse.

Dr. Stark, of Glasgow, who attended my family for years, was a skilful practitioner, but eccentric. He generally made light of trifling ailments, but was most energetic when aroused by any appearance of danger. I knew of his being suddenly called in to see an old lady who was far gone in an advanced stage of cholera. He at once asked to be shown over the house, looked at the different fireplaces, but as none of them suited his purpose, he went to the kitchen, threw off his coat, took out the range, made a fire in the recess that would have roasted an ox, had the old lady carried down in blankets and placed before it, worked energetically with her the whole night, and brought her through. In a similar way he once stayed over night and saved the life of one of my boys. One day I called at his house, and, finding him with a bad cold, eyes red and watery, throat husky, said, "Doctor, if you found me so, you would prescribe placing the feet in hot water and mustard, warm gruel, medicine, and going to bed! Physician, heal thyself!" The doctor's Shakespearian reply was, "Do you think I am such a fool as to take physic?"

Once when accompanying me to the coast to visit one of my children, there was a heavy sea on, and the steamer, on approaching the pier, rolled alarmingly, and was close on a lee shore. A strange lady on board, in terror, laid hold of the doctor, a tall, stalwart man, saying, "Oh! sir, are we going to the bottom?" On which he said, dryly, "Behave yourself, if you are going there, you are going in good company!" which odd answer reassured and caused her to laugh.

In speaking of a Greek gem representing Cupid and Pysche, one day, when driving in Wigtonshire with the late Dr. David Easton, a medical friend, he said I had not given the correct pronunciation of the names. Always willing to learn, I asked to be put right; whereupon, the doctor gravely informed me that I ought to have said--Cupped and Physic!

I have spoken of the kindness of medical men, such as Dr. Garth Wilkinson, to clergymen, artists, and literary men. I add one more expression of gratitude, which is a good modern instance:--

When at St. Helens, in Jersey, during his last illness, my friend Samuel Lover, the genial poet and artist, wrote the following lines to Dr. Dixon, his friend and physician. I first copied them some years ago from Lover's MS. note-book, kindly lent me by his widow when I was engaged in the preparation of his life. Such cordial tributes are a good physician's most highly-valued fees:--

"Whene'er your vitality Is feeble in quality, And you fear a fatality May end the strife, Then Dr. Joe Dickson Is the man I would fix on For putting new wicks on The lamp of life."

From the many varied facts and incidents adduced in these pages, it will be seen that, in anxiety or sorrow, the good family doctor is a true and sympathetic friend, whose services can never be paid by gold.

Next to religion, nothing is more precious or comforting than the sympathy of those who know and fully understand our sufferings, for, as my old favourite, Sir Thomas Browne, to whom I ever revert with renewed pleasure, truly and beautifully says:--"It is not the tears of our own eyes only, but of our friends also, that do exhaust the current of our sorrows, which, falling into many streams, runs more peaceably, and is contented with a narrower channel."

Ye Ende

Index.

Abernethy, John, 206-208, 266

Advertisements, Curious, 155-159

Ague, Charms for, 240-241

Akenside, Mark, 109-111

Andrews, William, Barber-Surgeons, 1-7; Touching for King's Evil, 8-23; Assaying Meat and Drink, 24-31

Anne, Queen, 18-19

Assay Cups, 30-31

Assaying Meat and Drink, 24-31

Atkins, Dr. H., 264

Axon, W. E. A., The Doctor in the time of Pestilence, 125-139

Banks, Mrs. G. Linnaeus, Some Old Doctors, 192-208

Barber-Surgeons, 1-7

Barber's Pole, 6, 35

Bicycle, 23

Birmingham town's book, 15

Bisley, 15

Bishop, hanged, 167

Bishop and Williams, body-snatchers, 171-177

Blackmore, R. D., 118

Blackmore, Dr., 111-113

Black Art, 45

Bleeding, 7, 216

Blood, Circulation of the, 195

Blood in windows, 2

Boke of Jhon Caius, 127

Booker, Rev. Dr., on small-pox, 163-164

Bossy, a quack, 149

Brown, Dr. John, 115

Brown, Sir Thomas, 123, 124, 253-258, 278, 283

Bruce, King Robert the, 209

Buddhism, 67-68

Bulleyn, Dr., quoted, 219

Burke and Hare, 168

Burkers and Body-Snatchers, 167-180

Burning for disease, 46

Burton's "Anatomy of Melancholy," 259-260

Byron quoted, 187

Campbell, Dr., 276, 278

Cancer, Curious treatment for, 222

Carriages, 22-23

Celestials and medicine, 58-61

Chalmers, John, M.D., 115

Charms, 43-44, 52

Chaucer's Doctor of Physic, 70-75

Chester in plague time, 133-135; Touching at, 17

Cholera, Reminiscences of, 181-191

Circulation of the blood, 195

Colic, Charm for, 248

Cooper, Sir Astley, 170, 179, 268

Coryat, 141

Cramp, Charm, 52; Strange cure for, 249

Croydon, Cholera at, 185-186, 190

Crusade, 209

Cumming, Dr. W. F., 114-115

Cupping, 217