Imatges de pÓgina
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appear in the printed list, and still less can he venture to sell a drug, in however small a quantity, or however insignificant its nature, without a prescription regularly signed. On both these points the medical administration is more strict even than in any other part of Europe. Not only must every prescription be signed with the name of the physician whose advice has been taken, but it must also mention the patient for whom it is written, with the day of the month and year. To the medicine a label is affixed, mentioning besides the date and hour of its delivery, its price, and the name of the "Aptékare" and his shop; but the best regulation is, that each, even the most simple medicine, must be sealed. Did such regula tions exist in full, as they exist in part, in England, and as obligatory regulations, instead of being left to the discretion of chymists, we should not hear of so many dreadful accidents and mistakes as occur every year in this country. That peculiarly English branch of the medical profession, an apothecary," is as unknown in St. Petersburgh, as it is in every other capital or city on the Continent.

It will, however, create some surprise, when I state, that although a dispenser of medicines, or chymist, as we are in the habit of terming him, cannot exercise his calling without a previous examination, and must not make up prescriptions, except under the above-mentioned restrictions, yet any person may, on payment of certain fees, deal in drugs, wholesale and retail, in St. Petersburgh. Some such defect in medical legislation exists in this country, in respect both to chymists and druggists, compared to the "apothecaries;" the latter being restricted from, and the two former allowed to supply medicines and drugs, without previous examination and legal authorization. Matters are better managed in France on this highly important subject. The sale of medicines in St. Petersburgh is

not, as in Berlin, fixed by a tariff of prices, and consequently the charges I found to be enormous. Hence it follows, that both the "Aptékare” and the dealer in drugs frequently amass considerable fortunes. The supply of medicines, in some few of the shops, seemed very respectable.

There appeared to me very little esprit de corps among the medical practitioners of St. Petersburgh. A few of the higher characters meet at each other's houses; and I recollect with satisfaction the pleasant hours I passed at the houses of Dr. Rehmann, Dr. Arendt, and Dr. Leighton, the two former of whom see a great deal of company. Dr. Arendt, in particular, receives regularly, once a week, his medical and other friends in the evening. This system of amicable intercourse among professional men, which has only lately been introduced into our own metropolis, must be productive of the very best results, if judiciously employed and properly persevered in. But, in order that private individuals may be able to do this in favour of their brethren, their professional income (supposing that they have no patrimonial fortune) ought to be considerable. In St. Petersburgh, physicians and surgeons, in great repute, may realize from 50 to 70,000 roubles a-year; and I am assured that their establishment, which on a similar scale would cost in this country fifteen or sixteen hundred pounds, is maintained there, at an expense of only from twenty to twenty-three thousand roubles, or a thousand guineas. I know that both Dr. Arendt and Dr. Leighton are in the receipt of the former sum from professional emoluments, and all those who have been at their houses know that they keep their establishments on a very respectable footing..

Medical men are rewarded in general by annual payments, and these in many instances are considerable. From six hundred to one thousand, and even fifteen hundred roubles a-year, are given to a physician to attend a whole

family, and I know more than one or two distinguished families who pay their physician two thousand roubles a-year. I am told that presents to medical men, which used to be so common, are not so much the fashion now. In a great majority of cases where a physician has been called in to attend a patient, without having been previously engaged for the family, a sum is presented to him at the termination of the complaint. Surgeons who have to perform capital operations, will afterwards attend, pay the requisite number of visits, and receive their remuneration all at once. This practice obtains likewise in England. In the case of an obstetrical practitioner, who also happens to be the physician of the family at a yearly stipend, a fee of three hundred roubles in addition is given for every accouchement. There is no instance, I believe, or such instances are very rare if they exist at all, where a medical man is feed at each visit, unless he be a stranger, and called in consultation for a few times only. Medical men of the first character have complained to me of the illiberality of part of the public towards the profession, and above all, of the caprice of the higher classes. They have informed me that even some of the first families who had been mostly benefited by their advice, and to whom their attention had been unremitting, have, notwithstanding, changed their medical attendant: all this is very possible. It is precisely what takes place occasionally in London, and I presume it is only occasionally that it occurs in St. Petersburgh. "L'ingratitude est de tous les pays."

With respect to another ground of complaint, namely, that there are families who have retained a physician as a regular medical attendant at an annual stipend, and have afterwards changed him for another, without previously discharging their obligations, even when such obligations have in some cases been of two and three years standing;

we shall find its parallel among the apothecaries of this country, who sell drugs to get paid for their skill by bills of charges generally presented annually, and discharged annually. I have heard more than one of this class of medical attendants, particularly among the most noted and most employed, complain of precisely the same thing; and at this moment, I am personally acquainted with instances of this kind, where an apothecary has been changed for another, and yet his lawful pecuniary claim remains to be settled. True it is, that this class of medical practitioners have their redress in a court of law; but what highly respectable member among them would resort to such an expedient? Parallel cases, therefore, may with truth be said to exist in both countries, of this mixture of caprice and moral turpitude on the part of patients; but in both countries, such examples must be assumed as mere exceptions, and of comparatively rare occurrence-in no wise altering the more general character of punctuality, which marks the intercourse between patients and physicians.

Indeed, it must ever be to the interest of the former to enjoy such a character among those who are to take charge of their health, a task far more important than that of undertaking the defence of mere property, if they wish to enjoy the benefit of an art which, considering the boon it confers, is entitled, perhaps, to more remuneration than any other service rendered by a particular class of individuals to the public. The correspondence between the latter and their physicians, is made up of so much manner as well as matter, feeling as well as principle, that it could never be found of the best description, except in those members of the profession whose minds have been disciplined not only by study, but by a favourable correspondence with society; not by the perusal of a few medical volumes alone, but by general reading; not by well-digested theories merely, but by

long and extensive experience. Now the acquisition of all these qualifications can only be procured by a very considerable sacrifice of time and pecuniary resources. To be able to do both, implies respectability of character and station in life; and respectability both of character and station in life demands a just and corresponding consideration. Hence the physician has a claim on the public, which it must be the interest of that public to admit, and take care that it be properly satisfied; for without remuneration, there can be no service rendered; without a punctual and superior remuneration, one cannot expect superiority of service.

This is no idle digression, as some may be inclined to think. One of the most eloquent writers on the duties of our profession, the late Dr. Gregory, proved that till within even a few years, medical ethics were yet in their infant state in England. They are still so in the capital of which I have attempted to give a description. Their discussion, therefore, in this place, in reference both to that city and my readers, cannot be said to be either ill-timed or out of place.

The great difficulty in the question of remuneration to medical men has been rather in regard to the mode of it, than to the quantity. A tradesman who gives us, at our demand, real property, has a self-evident claim upon us for a tantum pro tanto; and he receives it, and there is nothing in the transaction that shocks either the giver or the receiver. But to a person in every way our equal, (making abstraction of aristocratic distinctions,) who, at our request, deals out for the space of a few minutes certain words of advice, and confers a benefit on us, by drawing from the stores of his well-tutored mind a few cabalistical combinations, which he writes on paper,-it is not easy to offer, in the manner of the first-mentioned transaction, an equivalent for such a service. There must be, in the beginning

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