Imatges de pàgina
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his private patients. Sir Alexander Crichton, who has left a great reputation behind him at St. Petersburgh, established his nephew there, Sir W. Crichton, who acts in the capacity of physician to the Emperor and Empress. But this gentleman, of whom I was sorry I could not see more while I remained in that capital, being obliged to attend their Majesties wherever they go, cannot be said to form a member of the professional corps of St. Petersburgh. I might make the same observation with regard to another English physician, Dr. Leighton, who, in consequence of his situation of physician-in-chief of the navy, and physician to the Empress, is necessarily obliged to abandon great part of his practice. This gentleman, however, uniting the branch of midwifery to his other occupations, has formed a more extensive prac tice than any other, and much of it remains by him, notwithstanding his occasional and long absence from the capital. Though advanced in years, he is still very active, and goes through his fatiguing duties with as much ease as his son, a young physician, educated at Edinburgh, and just settled at St. Petersburgh, does in his more limited circle of practice. Dr. Leighton practises a great deal among the English, and shares with Dr. Walker, a highly respectable English physician, the confidence and good opinion of the merchants and members of the English Factory. Of the abilities of the latter gentleman, I can speak from personal experience, having met him more than once in consultation: of the former, report speaks favourably. My intercourse with him, which was entirely the result of his kindness and hospitality, tends to confirm his public estimation. There is another accoucheur, in great vogue, whom I also met in consultation, and who was kind enough to show me his obstetrical establishment-I mean Dr. Southoff, a German practitioner, who is at the head of the obstetrical department of the Foundling, and professor of midwifery for the female

students. I have also had the pleasure of forming the acquaintance of Dr. Reinhold, another of the Emperor's physicians, a German by birth, who has a respectable practice.

All these individuals, with one or two exceptions, certainly form the principal part of the medical profession in St. Petersburgh; but, as I observed before, they are too much otherwise engaged to attend to private practice, and cannot, therefore, be comprehended in that body of practitioners from whom my observations were derived, and to whom my reflections applied. If I turn to the surgeons, I find that Dr. Arendt; Mr. Hrubi, and M. Savenko, both eminent oculists; Messrs. Galloway, Salmon, Gibbs, and Beverley; with one or two others, whom I have known but little, are deserving of equal commendation with the beforementioned physicians, particularly the first, Dr. Arendt, who may, with great justice, be ranked with Cooper, Brodie, Dupuytren, and other very able operators of the present day. Now, with respect to private practice, the case with these gentlemen is different. They are all, indeed, connected with some branch or other of the public service; but their private practice is not thereby injured or impeded. They may, therefore, be said to form an integral part of the body of medical practitioners in St. Petersburgh; and as such they are certainly calculated to raise its character. But the rest of that body is much more numerous, and composed multifariously, as I before remarked; and it is from a knowledge of their medical proceedings, and surgical operations, in the aggregate, that I deduced those conclusions which I advanced at the beginning of this chapter. There is a class of physicians in St. Petersburgh, which, for their number and peculiarity of situation, must be considered apart; and it is probably owing to the existence of such a class, that the mass of medical practitioners in that city does not stand quite on that uniform, homogeneous, and exalted

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footing, at all times so desirable, which it holds in other great capitals. I allude to the resident domestic physicians in the families of the great, whose whole time and attention are devoted to their employers, thereby excluding the more regular physician from many sources of practice and emolument, and being themselves practically excluded from the benefit of a more general practice. There are several families who give from 400l. to 5007. sterling per annum to their resident domestic physicians. I am myself acquainted with more than one instance of this description.

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It was observed to me, while I was at St. Petersburgh, that however respectably constituted the medical corps of that capital may be, there are not among them any very marquant and tranchant characters;" no such men as a Baillie and a Halford of London; a Portal and a Recamier, of Paris; a Heimes and Hufeland, of Berlin; a Rasori and Brera, of the North of Italy; to whom one might look up in case of need for a last appeal, when all common aid has failed; and whose European reputation not being confined to the spot in which they practise, would consequently afford a surer guarantee to the patient that, their advice once taken, every thing that art and skill can effect on this side of the grave has been procured. It has been urged, moreover, that not one of the present leading medical characters in St. Petersburgh has had his name attached to any important work, or to any of those many discoveries and improvements which mark the present medical age in every other great country; and that so far St. Petersburgh is very differently supplied with medical talent from London, Paris, Berlin, Vienna, and one or two of the principal cities in Italy. I am not competent either to admit or to deny the truth of such allegations. It is true, that with the exception of the work already mentioned, from the pen of Sir J. Wylie, which I have read, and one or two in

teresting memoirs of Dr. Ruhl, Dr. Arendt, and one or two others of which I have some knowledge, I am not acquainted with any addition made either to medical literature or medical practice, by any of the professional individuals I have enumerated; and that so far none of them may be said to have a tranchant, or European character. But in admitting thus much, I mean not to accede to the inference, that because they have not composed works, or made discoveries, they may not be considered as able practitioners.

The police of the medical profession appeared to me to be placed upon a very judicious footing in St. Petersburgh. No medical man, let his rank be what it may, can settle and practise in that city without having undergone a proper examination. Regularity of education is thus, at all events, ensured in all those who appear there in the character of medical practitioners. A list of all persons authorized to practise is printed yearly, and to judge from its extent, it would appear that our brethren of all degrees are very numerous in St. Petersburgh. The surveillance of the medical profession, and of its rights and privileges, is confided in a particular manner to the Minister of the Home Department, who is assisted by a council of medical men, generally selected from the most eminent practitioners in the city. One of the attributes of this council is, to inquire into the rights to practise claimed by individuals, and to report to the Minister any infraction of the established law respecting the regulation of the practice of medicine, as well as the existence of any empirical impostor. Professed quacks are not tolerated, and the laws against them are generally put in force with great strictness. A recent example in illustration of this has occurred, in which a person was, by an ukase of the Emperor, banished from the territory of Russia, for having persevered in sell

ing nostrums after he had been warned by the proper authorities from so doing. This happened a few weeks after my leaving the capital. A man of the name of Ditrich, who had been authorized to practise as a veterinary sur geon, took upon himself the more difficult task of professing medicine in general, notwithstanding the repeated warnings he had received from the Medical Direction of St. Petersburgh, against his illegal proceedings. He was therefore declared to be an impostor, on legal proof having been produced of that fact, and banished as such from the country, the Government publishing its sentence, and the motives which led to it. "Afin qu'elle serve d'avertissement à d'autres charlatans et imposteurs, car il est de la volonté de S. M. L'Empereur que tout delit semblable soit puni de la même manière."* Had the College of Physicians in London such a power, they might soon get rid of the stigma which adheres to them, but ought to attach to Government, of suffering hundreds of pretended doctors and declared quacks to play off their tricks on the health and purse of His Majesty's liege subjects. There is no marked difference of rank, nor any very definite division of province, between medicine and surgery in St. Petersburgh. I have known both practised by the same persons whether surgeons or physicians; and in the military as well as civil hospitals, the distinction, with one or two exceptions, is completely abolished. In general, most of those who settle in St. Petersburgh, try to attain the honour of Doctor of Medicine; for, by an ukase of the late Emperor, who wished to encourage the higher branches of education in medicine, persons who have obtained the degree of M. D. are at once admitted into one of the thirteen classes of nobility.

A pharmacien, or "Aptékare," dares not make up a prescription of any practitioner whose name does not Journal de St. Petersburgh, No. 3, 1828.

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