most freely to all medical men who will be
humbugs. Some surely must be too weak to
withstand temptation of this kind; and, indeed,
it is well known that so far as we could
do so with honour we have all sought to satisfy
the public by including a very considerable
mass of humbug in the routine of our daily
practice. We are not to blame for this, any
more than we are to blame for the heart-
burnings that arise among ourselves out of
the generally impoverished state of the profession;
called upon as it is to give its services
gratuitously to three-fourths of the population
of the country. We accept cheerfully, I
say again, that last-mentioned necessity; but
it is not requisite that we should work, as we
so generally do work, unthanked.

A parish doctor, who does not physic the
poor wholly on pump water, Epsom salts, and
gentian; who treats them just as he would
treat the rich, administering large and
long-continued doses even of such medicines as
may cost him sixteen shillings an ounce; not
denying them quinine, and not afraid, if he
thinks it of any service, to let a pauper consume
pint after pint of sarsaparilla,—such a man
spends the whole pittance which the parish
allows him upon drugs that he supplies for
parish use. He also runs up a bill at his
instrument maker's for tools used in
performing various small operations that arise
out of his parish practice; although the same
may not always be operations recognised as
such by boards of guardians. He further
pays eighty or a hundred pounds a-year
to a qualified assistant, to help in the parish
work; or, if he cannot afford that, he
performs the parish work himself, to the great
damage and hindrance of whatever private
practice he may have.

Apart from a sense of duty done, the sole
profit that a medical man gets out of
attendance on the sick poor, is experience. But he
gets that out of the sick rich who pay him
for his cares; yet he is content to take it as
his only profit from the poor. His need of
experience is great. He acquires it first in
hospitals; in which poor men, women, or
children are collected for gratuitous treatment
by the foremost men of the profession;
who in that way bear their share of the
general burden (no payment being attached
to hospital appointments); and, at the same
time, impart much of their own practical
knowledge to their juniors. Then the juniors,
when they have received their diplomas, begin
practice by the acquisition of some more
experience among the poor; and, with that
view, seek small salaried positions as house
surgeons in provincial infirmaries, or as
assistants—doers of the parish work—in the
pay of established surgeons.

These are the young men entitled
whippersnappers; to whom the poor are said by
Messieurs Souchong, Sirloin, and Wick,
to be shamefully and neglectfully handed
over. Mr. Souchong, Sirloin, and their
friends refuse on their own parts to take
counsel of a whippersnapper; so do their
betters with considerable unanimity. They
wait until he has more experience; that is to
say, until he has tried his prentice hand
sufficiently among the poor. He would be happy
enough to attend viscounts and bankers; but
he is bidden by society to try his hand first
among beggars. He does so in all good faith
and earnestness; whereupon cries virtuous
society, it is a shame to entrust to
whippersnappers poor men's lives! Now, I believe
that, as the world of physic goes, the poor
are not in this respect much to be pitied; and
that on the whole, they perhaps get more
true help in the way of medical attendance
than several of the classes next above them;
including nearly all the poorer half of what
are called the middle classes. The poor man
in any town, if dangerously ill, may go into a
hospital, where he not only gets the help of
such professional advice as, except himself,
only the wealthy can afford to summon to
their cases, but he gets the advice carried out
for him by a system of skilled watching and
tending such as many a duke is unable to
secure. In every town, almost every surgeon,
or physician famous for his skill in treating
any given form of disease, sits at some hospital
or dispensary at certain hours to prescribe
gratuitously for the poor who come to him;
securing himself the opportunity of watching
and comparing a great number of cases, and,
on the other hand, giving to the poor
opportunities that very seldom can be compassed
by a tradesman's purse. Even the out-door
visiting by whippersnappers is rather a gain
to the sick poor than not. The young
practitioner, fresh from his studies and his hospital
training, has not, indeed, independent experience;
but he has the best and latest knowledge
fresh in his head, and the experience of
first-rate practice that he has been witnessing,
still at his fingers' ends. This is not
the case with men in active practice, who
cannot keep pace with the growth of scientific
knowledge in their own profession. Thus
the whippersnapper may know more than the
old established man; whose very success
makes him a man of routine and leaves him
no time for study. Perhaps, however, this
youth is a fool who has lost time and
misused his opportunities. Granted. Perhaps
the old man, too, was such a fool in his
youth; and, if he was, assuredly he never had
it in his power afterwards to conquer the
ignorance with which he started. He has
learned only to hide it: to find a substitute
for knowledge sometimes in assumption—
sometimes in gruffness or in some assumed
eccentricity of manner. But the young fool
who, distrusting himself, is not bound by
any delicacies of position to abstain from
seeking information of his seniors, is a much
safer counsellor to a poor man—or even to a
rich man—than the old fool who is pledged to
maintain a character for wisdom.