A Book About Doctors

by John Cordy Jeaffreson

"Physick lies a-bleeding" was written during the great Dispensarian War, which is touched upon in another part of these pages; and its object was to hold up physicians as models of learning and probity, and to expose the extortionate practices of the apothecaries. It must therefore be read with caution, and with due allowance for the license of satire, and the violence of a party statement. But the statement that 10s. was the customary fee is clearly one that may be accepted as truthful. Indeed, the unknown and needy doctors were glad to accept less. The author of "The Dispensarians are the Patriots of Britain," published in 1708, represents the humbler physicians being nothing better than the slaves of the opulent apothecaries, accepting half their right fee, and taking instead 25 or 50 per cent. of the amount paid for drugs to the apothecary. "They (the powerful traders)," says the writer, "offered the Physicians 5s. and 10s. in the pound, to excite their industry to prescribe the larger abundance to all the disorders."

But physicians daily received more than their ten shillings at a time. In confirmation of this, a good anecdote may be related of Sir Theodore Mayerne. Sir Theodore Mayerne, a native of Geneva, was physician to Henry IV. and Louis XIII. of France, and subsequently to James I., Charles I., and Charles II. of England. As a physician, who had the honour of attending many crowned heads, he ranks above Caius, who was physician to Edward VI., Mary, and Elizabeth—Ambrose Paré, the inventor of ligatures for severed arteries, who was physician and surgeon to Henry II., Francis II., Charles IX., and Henry III. of France—and Sir Henry Halford, who attended successively George III., George IV., William IV., and Victoria. It is told of Sir Theodore, that when a friend, after consulting him, foolishly put two broad gold pieces (six-and-thirty shillings each) on the table, he quietly pocketed them. The patient, who, as a friend, expected to have his fee refused, and therefore (deeming it well to indulge in the magnificence of generosity when it would cost him nothing) had absurdly exhibited so large a sum, did not at all relish the sight of its being netted. His countenance, if not his tongue, made his mortification manifest. "Sir," said Sir Theodore, "I made my will this morning; and if it should appear that I refused a fee, I might be deemed non compos."

The "Levamen Infirmi," published in 1700, shows that a century had not, at that date, made much difference in the scale of remuneration accorded to surgeons and physicians. "To a graduate in physick," this authority states, "his due is about ten shillings, though he commonly expects or demands twenty. Those that are only licensed physicians, their due is no more than six shillings and eight-pence, though they commonly demand ten shillings. A surgeon's fee is twelve-pence a mile, be his journey far or near; ten groats to set a bone broke, or out of joint; and for letting blood one shilling; the cutting off or amputation of any limb is five pounds, but there is no settled price for the cure." These charges are much the same as those made at the present day by country surgeons to their less wealthy patients, with the exception of a fee for setting a bone, or reducing a dislocation, which is absurdly out of proportion to the rest of the sums mentioned.

Mr William Wadd, in his very interesting "Memorabilia," states, that the physicians who attended Queen Caroline had five hundred guineas, and the surgeons three hundred guineas each; and that Dr. Willis was rewarded for his successful attendance on his Majesty King George III., by £1500 per annum for twenty years, and £650 per annum to his son for life. The other physicians, however, had only thirty guineas each visit to Windsor, and ten guineas each visit to Kew.

These large fees put us in mind of one that ought to have been paid to Dr. King for his attendance on Charles the Second. Evelyn relates—"1685, Feb. 4, I went to London, hearing his Majesty had ben, the Monday before (2 Feb.), surprised in his bed-chamber with an apoplectic fit; so that if, by God's providence, Dr King (that excellent chirurgeon as well as physitian) had not been actually present, to let his bloud (having his lancet in his pocket), his Majesty had certainly died that moment, which might have ben of direful consequence, there being nobody else present with the king save this doctor and one more, as I am assured. It was a mark of the extraordinary dexterity, resolution, and presence of mind in the Dr to let him bloud in the very paroxysm, without staying the coming of other physicians, which regularly should have ben done, and for want of which he must have a regular pardon, as they tell me." For this promptitude and courage the Privy-Council ordered £1000 to be given to Dr. King—but he never obtained the money.

In a more humourous, but not less agreeable manner, Dr. Hunter (John Hunter's brother), was disappointed of payment for his professional services. On a certain occasion he was suffering under such severe indisposition that he was compelled to keep his bed, when a lady called and implored to be admitted to his chamber for the benefit of his advice. After considerable resistance on the part of the servants, she obtained her request; and the sick physician, sitting up in his bed, attended to her case, and prescribed for it. "What is your fee, sir?" the lady asked when the work was done. The doctor, with the prudent delicacy of his order, informed his patient that it was a rule with him never to fix his fee; and, on repeated entreaty that he would depart from his custom, refused to do so. On this the lady rose from her seat, and courteously thanking the doctor, left him—not a little annoyed at the result of his squeamishness or artifice.

This puts us in mind of the manner in which an eminent surgeon not long since was defrauded of a fee, under circumstances that must rouse the indignation of every honourable man against the delinquent. Mr. —— received, in his consulting room, a gentleman of military and prepossessing exterior, who, after detailing the history of his sufferings, implored the professional man he addressed to perform for him a certain difficult and important operation. The surgeon consented, and on being asked what remuneration he would require, said that his fee was a hundred guineas.

"Sir," replied the visitor with some embarrassment, "I am very sorry to hear you say so. I feel sure my case without you will terminate fatally; but I am a poor half-pay officer, in pecuniary difficulties, and I could not, even if it were to save my soul, raise half the sum you mention."

"My dear sir," responded the surgeon frankly, and with the generosity which is more frequently found amongst medical practitioners than any other class of men, "don't then disturb yourself. I cannot take a less fee than I have stated, for my character demands that I should not have two charges, but I am at liberty to remit my fee altogether. Allow me, then, the very great pleasure of attending a retired officer of the British army gratuitously."

This kindly offer was accepted. Mr. —— not only performed the operation, but visited his patient daily for more than three weeks without ever accepting a guinea—and three months after he had restored the sick man to health, discovered that, instead of being in necessitous circumstances, he was a magistrate and deputy-lieutenant for his county, and owner of a fine landed estate.