An ESSAY, &c.

IT is the unavoidable Fate of every Thing that makes its Appearance new in the World, to be attended with Miſrepreſentations: The malicious Genius of ſome People naturally leads them to Cenſure and Detraction, eſpecially where they have ſuch an agreeable Opportunity of exerting their beloved Talents, as is afforded to them by a⯑ny Propoſal, however juſt in it ſelf, that has not been approved of by the Practice of for⯑mer Times, in the very Place where they hap⯑pen to live, nor ſupported by the Authority of a Multitude there. Others imagine, that they have an Intereſt to oppoſe any new Scheme, and therefore are very Sanguine againſt it, al⯑tho' they are often found to be miſerably miſ⯑taken in their Opinion, even as to their own particular Concerns. A third Sort, which make up indeed by far the moſt numerous Claſs of [4]Detractors, are thoſe who go blindly in to what they hear others ſay, without giving themſelves the leaſt Trouble to examine the Caſe; they are pleaſed with the Slander, and catch the Laugh, for what Reaſon they cannot tell, and think of the Matter they don't know how, but juſt as they are put upon, and directed by the Hints ſuggeſted to them by ill natured or de⯑ſigning Perſons. Every new Project then muſt appear with great Diſadvantages; eſpecially in a narrow Place, and where the Judgments of Men are too apt to be guided by the Opini⯑ons or Examples of others, and where Reaſon is ſeldom allowed to lead any Man out of the common Road, how far ſoever that may hap⯑pen to be wrong in it ſelf. An Innovation in any of the liberal Arts or Sciences, or in the Method of exerciſing them, and rendering them uſeful to Mankind, ſince it cannot ex⯑pect to be the Darling of any one Party of Men more than of another, and conſequently can look for no Patrons out of any Party-Views, which are the Maſter-Springs of all our Actions at preſent in this unhappy Country; ſo it muſt neceſſarily meet with extraordinary Diſcou⯑ragement. Yet certain it is, that there are ſo many Errors committed in the Exerciſe of the learned Profeſſions, that the World reaps but a ſmall Part of the Advantages that naturally ought to ariſe from them. This then, if it be [5]true, (as unqueſtionably it is) muſt needs give ſome Satisfaction to the Mind of any Perſon, who, in his own Faculty, would endea⯑vour to remove thoſe Obſtacles which ſtand in the Way of his Profeſſion, and in a great Mea⯑ſure prevent the uſefulneſs of it; notwithſtand⯑ing of the forbidding Circumſtances which the Novelty of the Thing may bring along with it: And if the Project laid down by ſuch a Perſon, is of it ſelf reaſonable, it is the Propoſer's Du⯑ty to let the World know that it is ſo. And if he be able to ſatisfie the judicious Part of Mankind, who don't judge of Matters before they conſider them; and the Candid, who judge with impartiality, he may ſafely treat the O⯑pinion of all others with the utmoſt Con⯑tempt.

THE Knowledge of Medicine, which we at preſent only conſider, is undoubtedly one of the moſt valuable Bleſſings ever Heaven be⯑ſtowed upon this lower World: But as it is now exerciſed, it may ſafely be aſſerted, and can be prov'd, that the Benefit of it is but ſmall to this Nation, and eſpecially to this City of Edinburgh; and that plainly from two Rea⯑ſons: The Firſt is, the Ignorance of many of the Profeſſors of it, that is, of ſuch as actually practiſe it; and the Second, which has as bad Effects, is the Difficulty that moſt Part of Peo⯑ple find to have the Advice of thoſe who are [6]to be preſumed the beſt qualified, on Account, that their Fees are too conſiderable for the Sick Perſon's Pocket. Now the Rich amongſt us, bear but a ſmall Proportion to the poorer Sort. If many then muſt be without the Benefit of Medicine regularly apply'd, whilſt a few only can purchaſe it, certainly the Service it does to the Community is but inconſiderable.

THE natural Way to put the Practice of this Art into the moſt proper Hands, and ſo to exclude the more ignorant from it, (which was the Royal Deſign of the Sovereign, in ere⯑cting a College of Phyſicians in this Place, al⯑tho' that Deſign has not hitherto ſucceeded) would certainly be, for the Phyſicians to make ſuch a Regulation with Reſpect to their Fees, that every Perſon, when indiſpoſed, might be able to call them: If they would, for Example, accept of ſuch a ſmall Thing, at a Time, as Half a Crown, and be paid for each Viſit at the ſame Rate. And leſt it ſhould be alledged, that this were either proſtituting the Art, or ſacrificing their own Intereſt to the Good of the Publick (a Thing which, altho' noble, is not always convenient) let them conſider the following Particulars, and it is highly proba⯑ble they will change their Opinion; and per⯑haps be convinced, that they have no Manner of Intereſt to oppoſe ſuch a Scheme.

IT can be prov'd in the firſt Place, that a ſmall Fee, at a Time, to a Phyſician for his Ad⯑vice, ſatisfies the moſt Learned and Knowing Practitioners of moſt Part of Europe.

2do, THAT, were it the general Practice here to take ſuch Fees, Phyſicians would be more univerſally imploy'd than they are, ac⯑quire more Honour, and do infinitely more Service to the Lieges.

3tio, THAT the well imployed of the Fa⯑culty could loſe nothing by this Method, but rather gain; and that the leſs imployed would gain vaſtly, by ſome Part of the Buſineſs neceſ⯑ſarily falling into their Hands.

4to, THAT the Chirurgeon Apothecaries, whom it would ſeem moſtly to affect, could loſe nothing, but would gain upon ſeveral Accounts.

5to, THAT from the foregoing Conſidera⯑tions, it would be highly beneficial to the Country, that this Method were introduced, and that it would do Prejudice to no one Per⯑ſon.

As to the firſt Particular; Thoſe who know how Phyſicians are paid in Holland, where it is confeſt by every Body, there are Men of as great Learning in that Profeſſion as any where elſe at preſent; how they are paid all over Germany, Elanders, France it ſelf, and [8]every where but in Great Britain, won't diſ⯑pute, That the beſt Phyſicians are contented with ſmall Fees, and conſequently muſt think it no Diſgrace for any one of the Faculty to be ſatisfy'd with the ſame.

THE ſecond Particular is as little doubtful; For if one could have the beſt Advice about their Health for a ſmall Acknowledgment, no doubt they would call for that Advice, rather than for any other; and the leaſt Diſ⯑order would willingly make them part with Half a Crown, when perhaps, to ſave a Gui⯑nea, the Diſtemper is allowed to go on, with⯑out calling any Aſſiſtance, or at leaſt, not that of One whoſe Buſineſs it is to underſtand Diſtempers: Beſides, many a one is able to pay a ſmall Fee, who has not the Ability to pay a great one, and therefore muſt take up with what Advice he can beſt purchaſe. Theſe Conſiderations make it appear, That a more univerſal Practice muſt neceſſarily attend the lowering of the Fees.

BUT next, Phyſicians would acquire more Honour, and do more Good; becauſe by this Means they would have it in their Power, to obſerve Diſeaſes from their firſt Appearances, and by putting the Patient, from the Beginning, under a right Manage⯑ment, would, very often, effectually make [9]a Cure; when at preſent we know, they are ſeldom called (except perhaps by the richer Sort, and that not always) 'till there is imminent Danger apprehended: And then the Doctor's Buſineſs commonly is, to skreen eve⯑ry Body elſe from any Reflections about the ſick Perſon's Death, and be a Witneſs of his Exit; when he himſelf knows very well, if he be a Perſon of Ingenuity and Learning, That he now can neither underſtand nor cure the Diſtemper, ſince the Courſe of it is alrea⯑dy perverted by a bad Management, or at leaſt not rectify'd in Time by a good one. It is a certain Fact, That Phyſicians, being commonly called in the End of a Diſeaſe, or after it has made a conſiderable Progreſs, ſel⯑dom ſee any one, as God and Nature ſent it; but as it is diſguiſed and changed by Appli⯑cations made in the Beginning: And for this Reaſon they are able to do their Patients little or no Service, which has render'd the Art contemptible to ſome, and ſuſpected to be of no great Uſe, even by the moſt knowing. It would then appear to be the Buſineſs of eve⯑ry true Phyſician, to endeavour to retrieve the Honour of his own Art, by doing what he can, to bring the Practice into the Hands of the real Profeſſors of it; which can never be done 'till the Fees are made low. And is it not the utmoſt Barbarity, to deny an Advice [10]to all who have not Ability to pay Gold, and too much Modeſty to ask it for nothing?

WHAT was in the third Place aſſerted, That the well employed of the Faculty could loſe nothing, appears by conſidering, that did they keep a Liſt of every Viſit, and were paid at a certain Rate for it, it would often come to more Account than their Payments do at pre⯑ſent. People would know exactly what they expected for their Trouble, and deſire their Attendance accordingly. The Richer, who at preſent give Gold, for their own greater Satiſ⯑faction, would call them every Day, or oft⯑ner, during the Courſe of a Diſtemper. Others would call them now and then, and ſo have the Benefit of good Directions, who at pre⯑ſent languiſh without them. And from this laſt Conſideration it plainly appears, That there would be an Addition to the Gain, even of ſuch as have their Reputation the beſt eſtabliſhed: And as to the leſs employed, and younger Part of the Faculty, they muſt ne⯑ceſſarily be often in Buſineſs, whereas at pre⯑ſent they are idle, if Poor as well as Rich conſtantly ſhould call Phyſicians; becauſe in that Caſe, a few Perſons could not be ſuffici⯑ent to attend the whole who were willing to employ them.

IT may here be objected, That this is but a pretended lowering of the Fees, and that Half a Crown a Viſit lands in the ſame Thing as a Guinea now and then. But by what is ſaid a⯑bove it appears, that tho' in ſome Caſes, with Reſpect to the richer Sort, the Thing be really true, yet with Reſpect to the Generali⯑ty it is not ſo, ſince very often one Viſit or two may be ſufficient to give the Patient, or perhaps his Apothecary, ſuch Directions as be⯑ing well obſerved, will be of great Uſe to him: And even the Rich will have this Advan⯑tage by it, that they will ſooner incline to call a Phyſician to a ſlight Illneſs, than they do at preſent; and by ſo doing, often prevent the enſuing of a very ſevere One: For the firſt Attacks of a Diſeaſe are many Times deceit⯑ful. Beſides, this will be an Inducement to them to call ſeverals at a Time, where now One ſerves; and ſo they ſhall have the joynt Advice of many at a very eaſy Purchaſe.

WHAT was propoſed in the fourth Place, viz. That the Chyrurgeon-Apothecaries would loſe nothing, ſeems liable to more Objections, becauſe the Scheme it ſelf appears contriv'd with a Deſign to take the whole Practice of Me⯑dicine out of their Hands; whereas at preſent it is notourly known, that they are the Per⯑ſons who practiſe the moſt of it in this Place; [12]and therefore, that if this Project ſhould go on, it would in a Manner ruine their Buſineſs. But the thinking Part of the Gentlemen of that Incorporation (it might almoſt be aſſerted, the whole of them) are well ſatisfied, that a quite contrary Effect would enſue. For in the firſt Place, the Affair of Surgery might be put un⯑der Regulations, as well as that of Medicine, with Reſpect to the Fees; and then, when e⯑ver an external Malady required Advice, or Attendance and Applications, either by the Surgeon or his Servants, a ſtated Rule for his Payment would be found very convenient, both for the Surgeon and the Patient: Which may eaſily be deduced from what was ſaid above with Regard to Medicine, and what is clearly demonſtrated by the conſtant Cuſtom in foreign Parts.

WITH Reſpect to Pharmacy, the Surgeon-Apothecaries, who at preſent, by the Laws of this Place, have the ſole Privilege of exerci⯑ſing that Art, ſeldom make any Profit but by the ſelling of their Medicines to their Patients; and if ever they are paid for Attendance, it is commonly by the more generous Sort, who even at preſent never fail to call a Phyſician, as well as the Surgeon, to any internal Caſe. As to theſe then, the new Propoſal makes no Odds; neither does it as to the others, ſince, whether they have a Phyſician or not, the Account of [13]Medicines muſt always be paid. Thus far as to the Negative Poſition, That thoſe Gentle⯑men could not loſe: Let us next obſerve their Advantages. The moſt of them are of ſuch Candor, that they are often grieved when dealing with the poorer Sort, that the extra⯑vagant Fees of Phyſicians, entirely debar them from joyning other Advice to their own; and 'tis with Difficulty, that thoſe of middle Cir⯑cumſtances are perſwaded to conſent to it, e⯑ven where there is Danger. No doubt then, but ſince our Scheme opens a Door of having eaſily the Concurrence of a Phyſician to what⯑ever is done, the Surgeons muſt have great Sa⯑tisfaction in it; for two Advices muſt be as good as a ſingle one at leaſt, and the Character of DOCTOR will add ſome Honour to the Con⯑ſultation, and ſo be more agreeable to the Pa⯑tient. Beſides, the Perſon who furniſhes the Medicines, ſeldom has the ſame Freedom of Mind to preſcribe as another, leſt he be ſuſ⯑pected to have a View to his own Intereſt, and therefore he always wiſhes to have ano⯑ther to do it for him.

THAT the Character of DOCTOR adds little or nothing to the Matter, may be alledged, for this Reaſon, That the Surgeon-Apothecaries in this Place, are moſtly Gentlemen, conſe⯑quently have the ſame Education with our Phyſicians, as to all the Parts of Learning [14]that are commonly taught in our younger Years; That afterwards, during their Appren⯑ticeſhips, they have much Opportunity of ſeeing ſick People, and ſo, by Degrees, learn⯑ing how to Practiſe, by obſerving what is done by others; That ſome of them, after theſe Advantages, have been bred in the moſt famous medical Schools; Others again have, for a long Tract of Time, had a moſt nume⯑rous Practice in the Army or Navy, and by this Means, muſt neceſſarily have their Know⯑ledge enriched with many valuable Obſerva⯑tions of their own, which never fail to im⯑prove one better than what is learned by Hear⯑ſay; That in this Place they are not admit⯑ted to Practiſe, but after having gone through a very ſtrict and ſevere Examination, upon all Parts of Anatomy, Surgery, and Pharmacy, (which include a vaſt Part of Medicine) and which they are obliged to undergo, in about ſeven different Diets, by their preſent Rules. This ſeems, as indeed it is, to be as Auguſt a medical Trial as any in the World, altho' confin'd to ſome particular Parts of the Sci⯑ence; and they are not admitted to this Tri⯑al, 'till after Eight Years from the Beginning of their Apprenticeſhip; in which Time it is to be preſumed, that they are pretty well qua⯑lify'd, when we know that there are ſome Graduations, after a very few Months Study, [15]and perhaps without any at all. 'Tis true, there are ſome particular Perſons, who have a Right to be admitted to Trial with the Sur⯑geons ſooner than at the End of Eight Years: But as that reſpects not the Generality, it is not worth noticing; and the Abridgments that are made of this Time are commonly very ſmall. By all this then it would appear, That the Surgeon ſeems to bid fairer for be⯑ing a good Practitioner than the Doctor, and wants only the Diploma.

WITH the greateſt Regard imaginable to the Gentlemen of the honourable Profeſſion of Surgery, the moſt ancient, and ſtill the moſt certain Part of Medicine, it muſt be acknowledged, That the Facts above reci⯑ted are true; but yet it muſt be allowed, That the learned Faculty of Medicine will ſtill keep its Dignity, if the Caſe be fairly conſider'd.

A Phyſician, who juſtly merits and poſſeſ⯑ſes the Rank and Title of DOCTOR, is not one who comes inſtructed with a few Scrapes of Knowledge, taken from his own Obſervation; but brings with him, before he offers to Pra⯑ctiſe, the learned and laboriouſly acquir'd Treaſures of vaſt Numbers of Ages. The Life of one Man is extremely ſhort, and is therefore, without great Aſſiſtance, uncapa⯑ble of making any conſiderable Improve⯑ments [16]in ſo noble, and in ſome Caſes intricate, a Science as that of Medicine. There is then no poſſible Means of attaining to any Degree of Perfection in it, but by reviewing the Mo⯑numents of Antiquity, which, by a particular Providence of Heaven, have been preſerved to us. There we are inſtructed by Multi⯑tudes of Obſervations exactly taken, through a great Tract of Years, in all the Changes that appear, as the Humane Body from Health degenerates into a State of Sickneſs; as it again, by the Means of Nature, returns to its former healthful Condition; or per⯑haps continues infected by ſome Remains of the Diſeaſe; or, being overcome with the Load of the Diſtemper, periſhes. We are well advertis'd of all the ſenſible Cauſes, that have been obſerv'd to precede and produce thoſe Diſtempers, and of all the Methods that the Wit of Man has been able to diſco⯑ver, for aſſiſting Nature to overcome them; and how thoſe Methods have ſucceeded now for many Thouſands of Years. It is no ſmall Task to become well acquainted with the Obſervations and Doctrine of the Illuſtrious Ancients; and no ſmall Pleaſure, to find them daily verify'd in our own Practice. If we add to thoſe, what the Induſtry of later Times has furniſh'd to us, with reſpect to ſome new Diſeaſes, we may be allowed to be [17]well qualify'd in our Profeſſion: But yet more ſo, if we call the Aſſiſtance of Philoſophy to our Aid, under due Reſtrictions, that is, ne⯑ver ſuffering our Reaſonings to lead us a⯑way from what is undoubtedly true in Fact. If after an exact Scrutiny into all the Parts of the Animal Machine, we be able to demon⯑ſtrate the Uſes of all that various Structure, and nice Complication of Organs in every different Part of it, and to explain the Springs of all their Actions, we cannot be at a Loſs, when its Functions are put out of Order by Sickneſs, to underſtand where the Fault lies.

IF then we go further, and examin the Pro⯑perties of all the Material World, to diſcover what Parts of it may be of Service in our Art; If we ſurvey the beauteous vegetable Creation, and draw what Aid we can from the healthful Qualities of Plants; If we dive into the Receſſes of the Earth, and extort Aſſiſtance from the Mineral Kingdom; Then explore the Seas, Earth, and Air, for all the various Animals that have any Parts that can be uſeful to preſerve or repair the Body of Man: If all thoſe different Objects are care⯑fully conſidered, and their Properties enquired into, and all done with due Regard to the ſtanding practical Obſervations above mentio⯑ned, undoubtedly we muſt draw ſuch Helps from Philoſophy, as very much muſt improve [18]our Art: And we will think it but a ſmall Exaggeration in the Founder of it, who was a Heathen, when he affirms, That a Phyſi⯑cian who is a Philoſopher is equal to a God. With ſuch a Phyſician, if any ſuch there be, no Surgeon or Apothecary but will think it his Happineſs to be engaged about a Patient: For tho' he himſelf, as above, may have ſeen a great deal of Practice, and underſtand ſeve⯑ral Branches of the Art; yet the many Inter⯑ruptions to Study that commonly an Appren⯑ticeſhip brings along with it, and the over ſoon going to Practiſe at one's own Hand, will certainly make him unacquainted with many Things which a learned Phyſician knows, and has gathered from the Writings of Antiquity, whence the moſt of his Know⯑ledge comes. For really the Practice of any true Phyſician, does not ſo much furniſh him with new Obſervations, as it gives him a Fa⯑cility in repeating the old Ones, and applying them to particular Caſes: So that Study and Practice both concur to make a complete Ar⯑tiſt. But it is eaſy to obſerve, that much Stu⯑dy, with a moderate Share of Practice, makes a far greater Phyſician, than little or no Stu⯑dy, tho' with vaſt Practice: For, as above, he relies not on his own Obſervation, but on that of a great many Ages. To return to our Point, the Character of Doctor muſt add to [19]the Satisfaction both of the Patient and Apo⯑thecary in every Caſe, if he be what he ought to be, and can recommend himſelf by his Dex⯑terity, both in foretelling what is to happen in Diſeaſes, and by curing them if they are not deſperate; which will diſtinguiſh him from all Impoſtures, better than his Degree in the Univerſity, the Honour of which is often baſely proſtituted. The Wiſdom of Great Britain has erected Colleges in the different Metropolis's of the Three Kingdoms, to be a Check upon all Foreign Degrees. And it were to be wiſhed, that our own Univerſities would take Care to admit none, but who are well qua⯑lified, which would make every Doctor an Honour to the Faculty. And if at the ſame Time the Fees were ſuch as is propoſed in this Paper, the Practice would ſoon entirely come into their Hands, to the great Benefit of all, and the Loſs of no Body, not even of the Surgeons, as has been proved. Now it may be further ad⯑ded, as a Reaſon why a Phyſician ought always to be conſulted about any ſick Perſon, that as we are not here in a Place where, by the eſtabliſhed Laws, any Perſon indifferently is allowed to exerciſe what Branches of the medical Art he ſhall think fit; ſo it is a Sort of Uſurpation of other People's Rights, and a flying in the Face of Authority, for any one, not legally intitled, to preſcribe Medicines. And grant that [20]ſome who are not graduated, may have more Knowledge than others who are; yet as the Publick knows no other Teſt of one's Quali⯑fications, but the having a regular Degree, which in this City muſt be examined and ac⯑knowledged by the Royal College; and as the taking away the Neceſſity of ſuch a Teſtimo⯑ny, would have very bad Conſequences, by be⯑ing an Inlet to the very vileſt and moſt igno⯑rant of the People to practiſe without being queſtioned; ſo 'tis hoped that no Perſon, how⯑ever well accompliſhed, if he be not a Doctor, will take it amiſs to be told, that the juſt Right to give Medicines belongs to others. Let him, if he pleaſes, take his Degrees and ſatiſ⯑fy the College, or elſe keep within his own Sphere, as the Phyſicians ought to do with⯑in theirs, neither performing Chirurgical Operations, nor furniſhing Medicines to any one, unleſs they have the Privilege of ſo do⯑ing from the Board of Surgeon-Apotheca⯑ries. Neither need they pretend any Ad⯑vantage in their doing the laſt, on Account that they are ſureſt of their own Medicines, ſince the Faithfulneſs of the Chirurgeon-Apothecaries of this City, in that Particu⯑lar, is well known. The Profeſſions of Me⯑dicine and Surgery are much a Kin; to the one belongs the Cure of Internal, to the other the Cure of External Maladies: The Profeſſors [21]of them are then in that Reſpect Brethren, and on an equal Lay. If any Man will exerciſe both, let him take the neceſſary Powers from both Societies. There is no Inconſiſtency, no Diſhonour in it, that they know who have ſtudied the Hiſtory of thoſe Profeſſions, (what⯑ever the more Ignorant may object) for the greateſt Maſters were ſuch as exerciſed both. But let no Apothecary pretend to preſcribe; his Buſineſs is only to obey Preſcriptions: Let no Surgeon do the ſame, if it is not in External Caſes, which naturally come within his Pro⯑vince. Let no Phyſician perform an Operation, make External Applications, or compound and furniſh Medicines, unleſs ſuch a Perſon be ve⯑ſted with the Powers of both Societies. This would evite all Confuſion, and keep every one's Privileges diſtinct; and all Pretences for con⯑founding of them will be taken away, if every Sick Perſon may have the Advice of a Phy⯑ſician at an eaſie Rate. For we know that the Exorbitancy of the Fees was always given as a Reaſon why the Surgeons were under a Ne⯑ceſſity to preſcribe; but that it would be much better for them were it otherwiſe, 'tis hoped is is now made clear.

THE Fifth Propoſition it is needleſs now to inſiſt on, for the Advantages to the Country muſt be very great, if the poorer, as well as [22]richer Inhabitants of it be all equally admitted to reap the Benefit of ſo valuable an Art as Medicine. By this Means the Populace, by getting free Acceſs to regular Phyſicians, will have no longer their Bodies left at the Mercy of every ignorant Pretender to Phyſick, or be glad to apply for Advice to every impertinent Quack, becauſe his Fees are ſuch as they are able to afford; to which Sort of Gentlemen, we ſee they conſtantly flock wherever they offer, and of which there has been a notable Inſtance lately in this very Place. It can be prov'd, that neither Peſtilence, Famine, or War, ever have committed ſuch Ravages to the Deſtru⯑ction of Human Kind, as the unskilful Appli⯑cation of Medicine has. If ſuch wrong Ap⯑plications then, of a noble and uſeful Art, can be in a great Meaſure prevented by our Scheme, were it not an egregious Cruelty to the World, in the leaſt to oppoſe its taking Effect, eſpeci⯑ally conſidering, that no one Perſon can poſſi⯑bly loſe any Thing by it, as has been ſuffici⯑ently demonſtrated?

AFTER what has been ſaid upon this Sub⯑ject, it may appear ſomewhat ſtrange, that ſuch an important Affair has been ſo long ne⯑glected: And as it appears to be ſomething of Moment, ſo it were to be wiſhed, that a pro⯑per Method of actually putting it in Executi⯑on, [23]were fallen upon; becauſe the beſt and moſt profitable Deſigns often prove abortive, on Account of the bad Management of the Undertakers.

No doubt, ſince there is a College of Phy⯑ſicians, here, erected by Royal Authority, for the Improvement of Medicine, it is their proper Buſineſs to further this Propoſal; and it were well if they did ſo. But as Societies ſeldom do much in the like Matters, on Ac⯑count that their Members are ſeldom all a⯑greed in any one Point; and as this Project has been before them a long Time ago, and much preſſed by ſome of the moſt Noted in the Society; and as at that Time it met with Diſcouragement, (certainly, as appears by what is here advanced, without any good Reaſon) ſo in all Probability it wou'd do the ſame again; and therefore ſome ſingle Perſon, or a few, muſt ſet about it, otherwiſe ſo good a Deſign muſt for ever periſh. It is indeed a bold Undertaking for any one Man, but what inevitable Neceſſity ſeems to throw upon ſome Body. It may here perhaps be asked, Does any Man in this Place, eſpecially if he is not a very old One, think himſelf qualified as a Phyſician ought to be, according to the De⯑ſcription given of a True Phyſician above, and that therefore he can be the Perſon to undertake this Work? This may be anſwered [24]by asking another Queſtion; Pray, does any young Man think himſelf qualified for pre⯑ſcribing to Patients, in Quality of Doctor, where the Life of his Neighbour is ſo nearly concerned? Really any Perſon that is ſuffici⯑ent for the one, may be ſufficient for doing the other, and can be capable of neither, without a great deal of the Study above ſpoken of, and Practice for ſome Time. And indeed any Man can as eaſily know, whether he him⯑ſelf has made conſiderable Progreſs in the Do⯑ctrine of Hippocrates, as another can whe⯑ther he again underſtands Euclid. And it is preſumed, that no Man of common Senſe will be refuſed an Allowance to paſs a Judgment upon himſelf, whether he underſtands the laſt mentioned Author or not.

IF this then is ſo, ſome Perſon or other may, without incurring the Imputation of ex⯑traordinary Vanity, take the Burden of this whole Affair upon him, and ſet up with as good a Grace for being ready to ſerve a great many at a cheap Rate, as any other Man can to ſerve a few at a dear one. And no doubt, but that if this Method were once followed with any tolerable Succeſs, by any Perſon, the Royal College would by Degrees come into it, however unwilling they may be at the Beginning; and ſo at length the Country reap the whole Benefit propoſed by it.

THERE is one Advantage not yet taken Notice of, which is, That if ſome certain Per⯑ſons were the Undertakers, the young Stu⯑dents of Medicine might reap a great deal of Good by it.

THERE has of late been taught here, and with ſome conſiderable Succeſs, at the Surge⯑ons Hall, the whole Art of Medicine, in a Syſtematical Way; in which Courſe, with all imaginable Care of the Performers, nothing has been omitted which to them ſeem'd ne⯑ceſſary, either to demonſtrate the Theory, or illuſtrate and explain regular Practice, as drawn from certain Experience and un⯑queſtionably juſt Obſervations. This they have done, with all due Regard to the great Names of thoſe who have furniſhed the World with a vaſt Treaſure of practical Obſervati⯑ons, and of thoſe whoſe great Induſtry and accurate Genius's, have confirmed and impro⯑ved the Theory by many valuable Diſcove⯑ries; and with no leſs Deference to the Great Perſon who, from vaſt Volumes, has collected all relating to the one or the other, into ſuch an exact Order, and into ſuch Bounds, that what concerns either of them can be ex⯑plained in the Courſe of a Seven or Eight Months College; which Task they own them⯑ſelves unable to have performed, without the Aid of ſo great a Maſter.

THEY hope that they are of Service in ſeveral Reſpects to their Country. Firſt, The Money which it was formerly neceſſary for Phyſicians to beſtow on a foreign Education, may be kept at home. Next, A great many who had not Ability to go abroad to pur⯑chaſe Learning, are now taught in their own Country, which puts them to a ſmall Ex⯑pence; and by this Means a great many ac⯑quire a juſt Notion of a regular Practice, who otherwiſe would perhaps never have heard of it; and yet, may be, would have play'd the Doctor with as great Aſſurance as they ſhall do now; but under what Diſadvantages it is eaſy to tell. Beſides, the extraordinary Pains that thoſe Gentlemen have been at, in teaching in Engliſh as well as in Latin, and in inſiſting ſo minutely on every Particular, as to be un⯑derſtood by thoſe of any Capacity, will have this good Effect, that many who perhaps wanted the previous neceſſary Learning fit to accompliſh one for ſtudying Phyſick, altho' they cannot poſſibly reap the ſame Benefit from the Courſe, as others well educated will; yet they will always carry away a great deal, and ſo be much better fitted than they could have been without it, to ſerve either in the Army, or the Navy, where Medicine, as often as Surgery, is their Buſineſs; altho' a ſufficient Knowledge of the laſt is abſolutely [27]neceſſary for them, and the Whole of it, to wit of Surgery, is fully explain'd as Part of the Courſe. The hearing of it then, will make any of them, at leaſt, much ſooner good Sur⯑geons, than they can be without it. And as Edinburgh furniſhes a great many Surgeons to all the Britiſh Dominions, it is with Plea⯑ſure that theſe Gentlemen believe, if they meet with ſuitable Encouragement, they ſhall ſave many a Subject to the Nation.

TO return, after this Digreſſion, to our Point: If thoſe Gentlemen, or any of them, would undertake to give Advice, at the Rate of Half a Crown a Viſit to any Patient with⯑in the Ports of Edinburgh, or the Canongate; and for a Shilling to every Perſon, who at certain Hours ſhould conſult them at Home; and Gratis to every extremely indigent Perſon who ſhould come to them: By this Means the Students could ſee a great Deal of Practice, and have the Pleaſure of obſerving, that what was taught them in the College, was before their Eyes verify'd in Fact. Their Maſter might take one or more of them, at a Time, to ſuch Pa⯑tients as he ſhould think proper; but eſpecial⯑ly, he could make them Witneſſes of his Pra⯑ctice at Home, which 'tis believ'd (all will a⯑gree) would be a great Advantage to them; and therefore it is Needleſs to inſiſt on it. But what is their Advantage, comes in Time to [28]be the Advantage of the Publick. Now if any of the Perſons juſt mention'd, do under⯑take what we propoſe, 'tis hoped, That their daily Imployment of Teaching, puts them a⯑bove the Suſpicion of being very ignorant; and therefore the good Work may ſucceed in their Hands, as well as in that of any One whoſoever. And then the two Obſtacles that were propoſed in the Beginning, as the Hin⯑drances of the Advantages ariſing from the medical Art, that is, The Ignorance of ſome Practiſers, and the Difficulty of conſulting the Beſt on Account of their Fees, will both be al⯑moſt wholly removed, when the whole Science is to be learned in our own Country, and there⯑fore every Man made inexcuſable who learns it not, and yet deſigns to practiſe it; and then thoſe who have learned it, to be adviſed with at ſuch a Rate as every Patient can afford.

Is it then Fact, That the Method of pra⯑ctiſing Medicine at preſent, is ſubject to ma⯑ny Inconveniencies, which affect moſt Part of the Faculty, and the whole Lieges in gene⯑ral, except a very few? By the whole Tenor of the Premiſſes is it demonſtrated, That what is here propoſed would be an effectual Reme⯑dy, whereby they might all be remov'd? Is the only Way left to bring ſuch a Remedy a⯑bout, pointed out; that is, That it muſt be attempted by a ſingle Perſon, or by a few? [29]And are there ſuch Perſons, who think they have a Probability of ſucceeding in it? Are all theſe Things ſo, and nothing to ſtand in the Way of ſo good a Deſign, but the Malice or Envy of ſome People of little Souls, and mean Capacities? THEN let the Thing be in⯑ſtantly gone about. It is reaſonable in it ſelf, and the preſent Circumſtances of our Coun⯑try, where there is ſuch an extreme Scarcity of Money, neceſſarily require it, were there nothing elſe in the Matter. The more Dirt the Ignorant or Malicious endeavour to throw upon the Undertaker of a good Work, the more Honour to him, who can contemn Things of ſo much Inſignificancy, and go on to do well; and the more Ignominy and Diſ⯑grace to his Oppoſers, in the Eyes of all the knowing and candid World. The Author of this Paper is very well appriſed of the com⯑mon Methods of running down any Thing, however juſt, if a Perſon ſhall pleaſe, whoſe Talent lies that Way. He, and every Body elſe, is aware of the Backbiting Tittle-tat⯑tle, the impertinent Sneer to inſinuate a Slan⯑der, and all the little jirking villanous Arts of Detraction and Defamation, and of the wrong Conſtructions that may be put upon every Thing. He owns frankly, That if any of this Sort of Artillery be brought againſt him, he heartily deſpiſes it. If any reaſona⯑ble [30]Argument be brought againſt what is pro⯑poſed, he is willing to hear it; and if it be a good one, to be convinced by it.

IN the mean Time he thinks, after what is ſaid, it is proper to let the Publick know, That there is a Deſign, by ſome of the Faculty of Medicine, as well in Edinburgh, as in ſome of the other Royal Burghs in Scotland, actually to Practiſe in the propo⯑ſed Way, (that is, for a ſmall Fee each Conſultation) and it is hoped, That ſo lau⯑dable an Undertaking will meet with all due Encouragement. The Particulars of the Per⯑ſons Names, and the Fees they are to take, will afterwards be declared. All others are heartily invited to come into the ſame Way of doing, making ſuch Alterations in their Method of following out the Scheme, as ſhall beſt ſuit their Conveniency, and the Circum⯑ſtances of the Place they live in.

THIS ſmall ESSAY is humbly ſubmit⯑ted to the Judgment of the candid World; and the Author is perſwaded, That whether his Propoſal ſucceed at preſent, or not, that there are ſome Conſiderations which ſeem plain⯑ly to evince, That ſooner or later it muſt ne⯑ceſſarily take in this Country; and then it will be ſufficient Honour for him, to have been the firſt Mover in ſuch an important Affair.