MEDICAL PRACTICE AMONG THE
POOR.

A COMPLAINT lies before me of the difficulty
that the poor often find in obtaining
medical attendance; of the neglect and sometimes
oppression that they suffer at the
hands of medical practitioners. Such a
complaint on the part of the public is not
altogether just. The whole mass of the poor in
this country is thrown upon the almost
unassisted charity of the medical profession; a
charity to the support of which the public
contributes scarcely a tithe. No burden in
any degree resembling it is sustained by any
other profession, or by any trade. From the
working clergy, indeed, in many places, even
a greater measure of gratuitous toil is
extracted; but their case, in several respects,
differs greatly from that of the surgeon; who
gives time which is of money value to him,
drugs which are costly, the services of an
assistant whom he must pay; and often is
compelled, also, to keep a horse at the
disposal of the poor. He is obliged not seldom
to turn from the door of the rich man who
would pay him for his visit, to fulfil his
duty to a poor man in more urgent need;
and for all such labour he receives nominal
payment, with few thanks from boards of
guardians; some of whom behave to him with
autocratic condescension or with inflated
incivility, as if surgeons were slaves, and
they assemblies of three-tailed bashaws.

The public knows little of the real position
in which the sick poor stand with regard to
their medical attendants; because medical
men as a body bear their burden manfully,
and accept the charge of the poor as an
incident of their calling: rarely expressing
discontent, and then oftener at want of thanks
than at want of money. They know that
the time has not come when ratepayers will
take a fair share of the charitable work, and
contribute more than odd pence for attendance
on the needy in their time of greatest
need. The members of the medical profession
respond freely therefore to the appeal
made to their own humanity; striving quietly
and heartily to do their duty, and to make
the best of their position.

I trust that I shall not be thought wanting
in humanity, if I suggest in this paper little
more than a business view of the relations
that subsist between the sick poor and the
main body of the doctors. Mr. Souchong, who
supplies tea to the poor in ounce packets at
an enhanced price, and not always in the
state in which it left China; Mr. Sirloin, who
sells them the chips and fragments of
his meat at a good profit; Mr. Wick, who
gets the halfpenny out of the poor man's
penny candle, may hold up their hands at
the hardheartedness of an apothecary who
meanly connects thoughts of the sick poor
with thoughts of his own day-book and
ledger. Be it so. Many a night, when Mr.
Souchong was snoring soundly with his cash-box
on the chair at his bedside, I and thousands
of my brethren, in town cellars and garrets,
or in country cottages by lonely hill-sides,
have sat sleepless by the bed of a poor man
or woman tossing with pain, have had our
hands grasped firmly by sufferers who held
to us as to dear life; and, forgetting our own
wearinesses, have laboured to be strong in
help, and strong in sympathy, to cheer the
downcast, and to comfort those that mourned.
Of course we are hardhearted. Mr. Souchong,
who happens to be a poor law guardian, and
who knows it, says so.

Let it be conceded, as regards men of the
pestle—and I don't mind owning myself one
of the brotherhood—that we have among us
our fair share of black sheep, in the shape of
peccant individuals, and that there are some
stains also upon our body corporate. But,
with all our faults, we are not an affluent
body. I saw the average profits of all
English qualified surgeons and apothecaries,
calculated some little time ago; and, if I
recollect rightly, they did not come to so much
as eighty pounds per man. Many starve in
secret, many live upon their friends or upon
private means, until their turn may come
to earn a bit of pudding. The profession
looks to an undiscerning public for
patronage which is much too unwisely and
unequally distributed. It is full of struggling
men whose competition with each other would
be fierce if it were not restrained by gentlemanly
feeling, and a rigid code of etiquette.
In such a profession jealousies and morbid
sensitiveness must—as they surely do—
exist. The folly of the ignorant among the
public opens many a profitable path to
meanness. Worldly advantages are offered