CHAPTER IX.
FEES.
From the earliest times the Leech (Leighis), or healer, has found, in the exercise of his art, not only a pleasant sense of being a public benefactor, but also the means of private advancement. The use the churchmen made of their medical position throughout Christendom (both before and after that decree of the council of Tours, A.D. 1163, which forbade priests and deacons to perform surgical operations in which cauteries and incisions were employed), is attested by the broad acres they extracted, for their religious corporations, as much from the gratitude as from the superstition of their patients. And since the Reformation, from which period the vocations of the spiritual and the bodily physician have been almost entirely kept apart, the practitioners of medicine have had cause to bless the powers of sickness. A good story is told of Arbuthnot. When he was a young man (ere he had won the patronage of Queen Anne, and the friendship of Swift and Pope), he settled at Dorchester, and endeavoured to get practice in that salubrious town. Nature obviated his good intentions: he wished to minister to the afflicted, if they were rich enough to pay for his ministrations, but the place was so healthy that it contained scarce half-a-dozen sick inhabitants. Arbuthnot determined to quit a field so ill-adapted for a display of his philanthropy. "Where are you off to?" cried a friend, who met him riding post towards London. "To leave your confounded place," was the answer, "for a man can neither live nor die there." But to arrive at wealth was not amongst Arbuthnot's faculties; he was unable to use his profession as a trade; and only a few weeks before his death he wrote, "I am as well as a man can be who is gasping for breath, and has a house full of men and women unprovided for."
Arbuthnot's ill-luck, however, was quite out of the ordinary rule. Fuller says (1662), "Physic hath promoted many more, and that since the reign of King Henry VIII. Indeed, before his time, I find a doctor of physic, father to Reginald, first and last Lord Bray. But this faculty hath flourished much the three last fifty years; it being true of physic, what is said of Sylla, 'suos divitiis explevit.' Sir William Butts, physician to King Henry VIII., Doctor Thomas Wendy, and Doctor Hatcher, Queen Elizabeth's physician, raised worshipful families in Norfolk, Cambridge, and Lincolnshire, having borne the office of Sheriff in this county." Sir William Butts was rewarded for his professional services by Henry VIII. with the honour of Knighthood, and he attended that sovereign when the royal confirmation was given, in 1512, to the charter of the barber-surgeons of London. Another eminent physician of the same period, who also arrived at the dignity of knighthood, was John Ayliffe, a sheriff of London, and merchant of Blackwell-Hall. His epitaph records:—
"In surgery brought up in youth,
A knight here lieth dead;
A knight and eke a surgeon, such
As England seld' hath bred.
"For which so sovereign gift of God,
Wherein he did excell,
King Henry VIII. called him to court,
Who loved him dearly well.
"King Edward, for his service sake,
Bade him rise up a knight;
A name of praise, and ever since
He Sir John Ayliffe hight."
This mode of rewarding medical services was not unfrequent in those days, and long before. Ignorance as to the true position of the barber in the middle ages has induced the popular and erroneous belief that the barber-surgeon had in olden times a contemptible social status. Unquestionably his art has been elevated during late generations to a dignity it did not possess in feudal life; but it might be argued with much force, that the reverse has been the case with regard to his rank. Surgery and medicine were arts that nobles were proud to practise for honour, and not unfrequently for emolument. The reigns of Elizabeth and her three predecessors in sovereign power abounded in medical and surgical amateurs. Amongst the fashionable empirics Bulleyn mentions Sir Thomas Elliot, Sir Philip Paris, Sir William Gasgoyne, Lady Taylor and Lady Darrel, and especially that "goodly hurtlesse Gentleman, Sir Andrew Haveningham, who learned water to kill a canker of his own mother." Even an Earl of Derby, about this time, was celebrated for his skill in chirurgerie and bone-setting, as also was the Earl of Herfurth. The Scots nobility were enthusiastic dabblers in such matters; and we have the evidence of Buchanan and Lindsay as to James IV. of Scotland, "quod vulnera scientissime tractaret," to use the former authority's words, and in the language of the latter, that he was "such a cunning chirurgeon, that none in his realm who used that craft but would take his counsel in all their proceedings." The only art which fashionable people now-a-days care much to meddle with is literature. In estimating the difference between the position of an eminent surgeon now, and that which he would have occupied in earlier times, we must remember that life and hereditary knighthood are the highest dignities to which he is now permitted to aspire; although since this honour was first accorded to him it has so fallen in public estimation, that it has almost ceased to be an honour at all. It can scarcely be questioned that if Sir Benjamin Brodie were to be elevated to the rank of a Baron of the realm, he would still not occupy a better position, in regard to the rest of society, than that which Sir William Butts and Sir John Ayliffe did after they were knighted. A fact that definitely fixes the high esteem in which Edward III. held his medical officers, is one of his grants—"Quod Willielmus Holme Sirurgicus Regis pro vitâ suâ possit, fugare, capere, et asportare omnimodas feras in quibuscunque forestis, chaccis parcis et warrennis regis." Indeed, at a time when the highest dignitaries of the Church, the proudest bishops and the wealthiest abbots, practised as physicians, it followed, as a matter of course, that everything pertaining to their profession was respected.
From remote antiquity the fee of the healer has been regarded as a voluntary offering for services gratuitously rendered. The pretender to the art always stuck out for a price, and in some form or other made the demand which was imprinted on the pillboxes of Lilly's successor, John Case,