body, is so starved by the legal fiction that
its F.R.C.P.s are the Few Really Competent
Persons practising medicine in the metropolis,
that there is not a more decrepit
corporation to be found in the three kingdoms.
Some little time ago, when a medical journal
said that a certain physician of mark had
applied for and obtained the fellowship of
the London College, that physician thought
it due to his credit to write to the medical
journal and explain that he did not ask the
college to give; but that on the part of the
college he was asked to take. The college
has nothing to rely upon but the prestige of
an old name and a reputation bolstered up
by law. It is as dead as the dead tongue in
which it carries on the farce of an
examination with its candidates. Nothing short
of the abandoning of its monopolies will
bring its blood again into free circulation.
Corporations could work under the defence
of monopolies in those old days when men
worked under the defence of helmet, breast-plate,
gauntlet, greaves, and buckler. Now-a-days,
there are many fragments of old charter
still in use, that are fit only to be exhibited at
Manchester in the same cases with the old
armour and firelocks of three centuries ago.

We are persuaded that what the medical
profession really wants in this age of its most
rapid progress, is a complete abandonment
of the dead principle of protection, and the
admission of free trade throughout its
borders. The article to be produced—as all the
bill-makers protest—is a well-educated
practitioner of medicine. We are more likely to
get this when there are fifty licensing bodies,
all dependent for their life on their good
reputation and competing for precedence of
credit, than when there is one central council
managing everything, and there are one or
two fat corporations undertaking to do all
the work in a sweet concord with the denizens
of Downing Street.

It is said that we have here a special case
to which it is not possible to apply the
principle of competition. That licensing bodies
have a tendency to underbid each other, and
to pass incompetent men for the sake of
pocketing their fees. The plan was tried by
one or two bodies, and was found so ruinous
—so perfectly analogous to the killing of the
goose which laid the golden eggs—that the
utmost pains were taken to give publicity to
the fact of its utter abandonment.

London corporations sometimes sneer at
the Scotch universities. A London practitioner
is often heard to say that a St. Andrew's
degree is good for nothing. But we
find, on inquiry, that only last May, of fifty-seven
candidates for the M.D. of St. Andrew's,
fourteen were rejected; and that, of
the fourteen, all but one had obtained licences
and diplomas of other privileged corporations,
chiefly in England. English general
practitioners every year show in many cases that
they are not up to the St. Andrew's mark,
whatever that may be. There is another fact.
Public opinion in the profession does not
regard a degree obtained at St. Andrew's
University as, by itself, a complete title to
practise physic. The consequence is that
during the last eleven years, five hundred
and seventy-three persons have obtained that
degree at Aberdeen; and, in this number,
there were only thirty-four who so much as
applied for a diploma without being already
furnished with another licence: while, even,
of the thirty-four, there can be no doubt that
the greater number afterwards presented
themselves elsewhere for examination. Does
this look as if medical licensing bodies
thought it worth while to underbid each
other, or as if medical men found their
account in getting a small licence to practise
on the easiest terms and in the cheapest
market?

Our belief is, that the thing really wanted
by the medical profession, is permission to
take freely its own manner of growth. Let
no establishment,—whether an old guild or a
new university,—claim any title to respect
that it cannot make good, and let the lead be
taken by whatever body can command it
best. Let there be no licensing to practice
within so many miles of Charing Cross, and
not beyond. Within reasonable bounds let
all licensing bodies have full play for their
best energies, and let a man declared
competent to physic his neighbour on one side of
the Tweed, physic him also on the other side.
Let no institution have about itself an
atmosphere poisonous to men licensed by any rival
body. Let every licence be a licence, full and
frank; only, whenever a man practises, let it
be known whence his licence comes, and how
much it is worth. Experience of late years
has clearly shown that the tendency of
competition among licensing bodies is to increase
the strictness of the test applied to candidates,
it being felt that this determines, more
than anything, the value of the licence and
the degree of respect paid to the body giving
it. Now, what do the manufacturers of
parliamentary bills for the doctors usually want?

They want a public registration of all
qualified practitioners, and a uniform standard
of qualification, generally determined by
some sort of professional Privy Council,
Parliament, or House of Convocation.

There can be no harm in an official register.
Private enterprise has indeed already
furnished two medical directories, published
annually, and containing the names and
qualifications of all legal practitioners of medicine.
Jealousy and self-interest keep watch,
over the accuracy of these volumes; they
are cheap, and a patient who may happen
to know so little about his medical adviser as
to wish to look his name out in a dictionary,
may as well, we think, turn to a cheap
medical directory managed by private enterprise
under the corrective influence of
competition, as to a dear article of the same sort