A Book About Doctors

by John Cordy Jeaffreson

"Then Criticism the Muse's handmaid proved,
To dress her charms and make her more beloved:
But following wits from that intention stray'd.
Who could not win the mistress, woo'd the maid;
Against the poets their own arms they turn'd,
Sure to hate most the men from whom they learn'd.
So modern 'Pothecaries, taught the art
By Doctors' bills to play the Doctor's part,
Bold in the practice of mistaken rules,
Prescribe, apply, and call their masters fools."

The origin of the memorable Dispensarian Campaign between the College of Physicians and the Company of Apothecaries is a story that can be briefly told. The younger physicians, impatient at beholding the prosperity and influence of the apothecaries, and the older ones indignant at seeing a class of men they despised creeping into their quarters and craftily laying hold of a portion of their monopoly, concocted a scheme to reinstate themselves in public favour. Without a doubt many of the physicians who countenanced this scheme gave it their support from purely charitable motives; but it cannot be questioned that as a body the dispensarians were actuated in their humanitarian exertions by a desire to lower the apothecaries, and raise themselves in the eyes of the world. With all its genuine and sterling benevolence, the medical profession, by the unworthy and silly conduct of its obscure members, has repeatedly laid itself open to the charge of trading on its reputation for humanity. In Smollett's time, as his novels show, the recognized mode employed by unknown doctors to puff themselves into notoriety and practice, was to get up little hospitals and infirmaries, and advertise to the charitable for aid in the good task of ameliorating the condition of the poor. And half the peddling little charitable institutions, infirmaries, dispensaries, or hospitals, that at the present time rob the rich and do harm to the poor in every quarter of London, originated in "the friends" of young physicians and surgeons conspiring together to get them "the position of being attached to an hospital staff." In 1687, the physicians at a college-meeting, voted "that all members of the College, whether Fellows, Candidates, or Licentiates, should give their advice gratis to all their sick neighbouring poor, when desired, within the city of London, or seven miles round."

To give prescriptions to the very poor, unaccompanied with the means of getting them dispensed, is of little use. Sir Astley Cooper used to see in the vicinity of his residence the slips of paper, marked with his pen, which it was his wont to distribute gratuitously to indigent applicants. The fact was, the poor people, finding it beyond their means to pay the druggist for dispensing them, threw them away in disgust. It was just the same in 1687. The poor folk carried their prescriptions to the apothecaries, to learn that the trade charge for dispensing them was beyond their means. The physicians asserted that the demands of the drug-venders were extortionate, and were not reduced to meet the finances of the applicants, to the end that the undertakings of benevolence might prove abortive. This was of course absurd. The apothecaries knew their own interests better than so to oppose a system which at least rendered drug-consuming fashionable with the lower orders. Perhaps they regarded the poor as their peculiar field of practice, and felt insulted at having the same humble people—for whom they had pompously prescribed and put up boluses at two-pence apiece—now entering their shops with papers dictating what the two-penny bolus was to be composed of. But the charge preferred against them was groundless. Indeed, a numerous body of the apothecaries expressly offered to sell medicines "to the poor within their respective parishes, at such rates as the committee of physicians should think reasonable."

But this would not suit the game of the physicians. "A proposal was started by a committee of the College, that the College should furnish the medicines of the poor, and perfect alone that charity which the apothecaries refused to concur in; and after divers methods ineffectually tried, and much time wasted in endeavouring to bring the Apothecaries to terms of reason in relation to the poor, an instrument was subscribed by divers charitably disposed members of the College, now in number about fifty, wherein they obliged themselves to pay ten pounds apiece towards the preparing and delivering medicines at their intrinsic value." Such was the version of the affair given by the College apologists. The plan was acted upon; and a dispensary was eventually established (some nine years after the vote of 1687) in the College of Physicians, Warwick Lane, where medicines were vended to the poor at cost price.

This measure of the College was impolitic and unjustifiable. It was unjust to that important division of the trade who were ready to vend the medicines at rates to be fixed by the College authorities—for it took altogether out of their hands the small amount of profit which they, as dealers, could have realized on those terms. It was also an eminently unwise course. The College sank to the level of the Apothecaries' Hall, becoming an emporium for the sale of medicines. It was all very well to say that no profit was made on such sale—the censorious world would not believe it. The apothecaries and their friends denied that such was the fact, and avowed that the benevolent dispensarians were bent only on underselling and ruining them.

Again, the movement introduced dissension within the walls of the College. Many of the first physicians, with the conservatism of success, did not care to offend the apothecaries, who were continually calling them in, and paying them fees. They therefore joined in the cry against the dispensary. The profession was split up into dispensarians and anti-dispensarians. The apothecaries combined and agreed not to recommend the dispensarians. The anti-dispensarians repaid this ill service by refusing to meet dispensarians in consultation. Sir Thomas Millington, the president of the College, Edward Hulse, Hans Sloane, John Woodward, Sir Edmund King, and Samuel Garth were amongst the latter. Of them the last-named was the man who rendered the most efficient service to his party.

Garth is perhaps the most cherished by the present generation of all the physicians of Pope's time. He was a Whig without rancour, and a bon-vivant without selfishness. Full of jest and amiability, he did more to create merriment at the Kit-Kat club than either Swift or Arbuthnot. He loved wine to excess; but then wine loved him too, ripening and warming his wit, and leaving no sluggish humour behind. His practice was a good one, but his numerous patients prized his bon-mots more than his prescriptions. His enemies averred that he was not only an epicure, but a profligate voluptuary and an infidel. Pope, however, wrote of him after his death, "If ever there was a good Christian, without knowing himself to be so, it was Dr. Garth." Pope had honoured him when alive by dedicating his second pastoral to him.

"Accept, O Garth, the muse's early lays,
That adds this wreath of ivy to thy bays;
Hear what from love unpractised hearts endure,
From love, the sole disease thou canst not cure."

A good picture of Garth the politician is found in the "Journal to Stella." "London, Nov. 17, 1711," writes Swift—"This is Queen Elizabeth's birthday, usually kept in this town by apprentices, &c.; but the Whigs designed a mighty procession by midnight, and had laid out a thousand pounds to dress up the pope, devil, cardinals, Sacheverel, &c., and carry them with torches about and burn them. They did it by contribution. Garth gave five guineas; Dr. Garth I mean, if ever you heard of him. But they were seized last night by order from the Secretary.... The figures are now at the Secretary's Office at Whitehall. I design to see them if I can."

A Whig, but the friend of Tories, Garth cordially disliked Sir Richard Blackmore, a member of his own profession and political party. Blackmore was an anti-dispensarian, a bad poet, and a pure and rigid moralist. Naturally Garth abominated him, and sneered at him for his pomposity and bad scholarship. It is to be regretted that Garth, with the vulgarity of the age, twitted him with his early poverty, and with having been—a schoolmaster. To ridicule his enemy Garth composed the following verses:—