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.; V J

LETTERS

■ a.

MEDICAL EDUCATION,

(ORIGINAUT PUBLI3HKD IN THE MONTREAL

GAZETTE,)

addhessed to the

MEMBERS

OF THE

PROVINCIAL LEGISLATURE OF CANADA.

W3 iaia©KiaS(ai® KJ^atio fisi.. ©»

MONTREAL :

ARMOUR & RAMSAY.

KINGSTON:

RAMSAY, ARMOUR, fo^ C o ,

iat2.

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MEDICAL EDUCATION.

LETTER I.

to the honourable, the members of the legislative council,
and of the house of assembly.

Gentlemen,

With the termination of the first Provincial Parliament of United
Canada, has closed one of the most important Sessions which it has,
probablj', ever been the lot of British North America to witness — im-
portant, as well in reference to the number of Bills which have been
submitted to your deliberations, as to the nature of the Bills themselves ;
and it is the earnest desire of every true patriot, that He who dis-
poseth all things for the good of his creatures, will, by his providential
care, so overrule these, the result of your counsels, that they may work
together for the happiness and prosperity of this country, the brightest
gem in Her Majesty's diadem.

Numerous and highly Important as were the measures which were
perfected, that, I am happy to say, of education was not neglected: it
received at your hands that attention which its extrenie importance
demanded ; satisfied that knowledge is power, and that for elevating
and dignifying the character of a nation, all that is requisite is to cul-
tivate the moral attributes and mental faculties of the rising generation,
as the foundation of a moral and intellectual superstructure. That a
necessity existed for such a measure, no one denied ; of the manner,
however, in which it was to be carried into effect, some discrepancies

of opinion existed, a virtual demonstrallon of n familiarity or acquain-
tance with the subject, on the part of all, manifesting itself according
to the habits of thought oftlie individual's mind.

Closely allied to this subject, is another, which was also brought
undei your consideration, namely, Medical Education. To establish
this highly important object on a proper foundation, a Bill was intro-
duced by the Honourable Member for the County of Terrebonne, em-
bodying in its detail a plan, which, it was thought, would have been
acceptable to the medical profession generally. Having been referrred
to a Committee, it was so essentially altered in its features, as, to a
great extent, to negative any useful results which might have been
anticipated from it. In this modified shape, however, from some
want of technical formality, the Bill was, subsequently, thrown out by
the House of Assembly : and hero the matter meanwhile rests. We
cannot but congratulate the profession generally, and even the public,
also, on such a result ; for while, on the one hand, the interests of the
British medical profession here have been materially served by the re-
jection, on the other, it has given time for a maturer consideration
of the points involved in its details, and, in either case, will have been
productive of good.

The interests of the medical profession, being of a special char-
acter, can scarcely be expected to be understood by the Members
of the House generally; consequently, the writer of the present, and
succeeding series of letters, hopes that he will not be accused either of
vanity or presumption, in laying before you an impartial account of
the present state of the medical profession in this country, its wishes,
and its wants ; fully persuaded, that with you, and you alone, as the
only legally constituted authority, rests the power, and, he also feels
satisfied, the inclination, to rectify abuses, where these are shown to
exist, and to ameliorate and to improve, when circumstances de-
mand it-
It is with extreme diffidence that the writer thua ventures before
you and the public. The subject, however, is one of such immense
importance, that the task, though an exceedingly invidious one, must

I %

be executed by somebody. He has patiently waited for Rome abler
pen to take the field, but has been disappointed. Under the firm im-
pression, that anotlier Bill for the regulation of medical education will
be introduced at the next Session of the Provincial Parliament, he
conceives that at no more propitious time than the present, when the
hurry and pressure of business is temporarily suspended, when you
arc enjoying a relaxation from private, as well as Provincial duties,
could your attention be more properly directed to a subject like the
present. The health and happiness of thousands are at issue, afibrding
the most ample apology for the loss of time it may occasion you in
perusing tlic^e letters.

I subscribe myself, in the meantime,
Gentlemen,

Your most obedient, humble servant,

MEDICUS.

Montreal, January 13, 1842.

CfLa'iW'il'V*"!'"

LETTER II.

; I

Gentlemen,

In continuation of the subject which I proposed in my last letter to
introduce to your notice, the train of argument which I am required
to adopt compcis me to take a short glance at the history of medicine
in the early ages of the world, and to observe the manner in which it3
study was, in those days, prosecuted. On this subject, however,
I do not intend to occupy i,.uch of your time.

Perhaps nothing is more strongly corroborative of the necessity of
a proper medical education lliun the fact, that in all newly discovered
countries, how uncivilized or savage soever the inhabitants may have
been, some traces of an application to medicine have been discovered —
thus demonstrating its importance and its essentiality to their happi-
ness ; the same remark equally applies to the early ages of the world.
It appears, in fact, to be a natural and inevitable sequence to society
of all kinds, that attempts should be made to alleviate pain, to heal
wounds, and to repair the injuries to which the body is constantly
incident ; and however rude or imperfect the first attempts may have
been, yet we always find them keeping strict progress with the advance
of civilization and the march of science. In the first instances, the
remedies may have been few, their application simple, and the requi-
site knowledge for their proper employment easily obtained j but with
the progressive increase of population, and the multiplication of reme-
dies and diseases, and the developement of fresh resources, some degree
of preparation or study became requisite, not only for the proper
discrimination of diseases, but also for the correct appreciation of the
principles which ought to guide the practitioners in the application of
their remedies.

t letter to
required
medicine
which its
however,

icessity of
liscovered
may have
severed —
eir happi-
he world,
to society
n, to heal
constantly
may have
3 advance
nces, the
the reqiii-
but with
1 of reme-
ime degree
lie proper
ion of the
ilication of

As far back in the hiHtury of the world as authentic record carircs
us, we liavo constant proof of a devotion, more or lcs8 energetic, to the
practice of medicine. In those early days, the Priests were the
depositories of medical lore, a circumstance which originated among
the Jews from Divine command, but which was perpetuated among
them, as well as the other contemporary nations, by the superior
education which this particular class received, and the consequent
superior knowledge on all other subjects which they evinced. This
association of Priest and Physician was by no means favourable to
the advance of medicine, as a science ; the one was prostituted from
its legitimate aims to secure and maintain the ascendancy of the other,
and the treatment of diseases was cloaked under the most super-
stitious rites and ceremonies. Hitherto but little system was practised
in the pursuit of medical knowledge. Attempts, indeed, were fre-
quently and successfully made to disunite the two offices just' alluded to,
and, although we find in these early periods of medical history, a name,
here'and there, who struck out a new path for himself, yet «he mass of
practitioners blindly followed in the footsteps of their predecessors —
gleaning their information as best they could. About 300 years B. C.
the importance of studying medicine, on a proper system, was acknow-
ledged in the foundation of the first school at Alexandria, through the
munificence of the Ptolemies. Here it was taught in its various bran-
ches, and here some of the most illustrious men, whose names adorn
the pages of medical literature, received their elementary instruction.
We have not, at the present day, any means of ascertaining the exact
nature of the curricula which the students had to undergo ; but we do
know, that the greatest attention was paid to the study of anatomy,
physiology, pathology, the materia medica, and the practice of medi-
cine and surgery. Antecedently to this period, the structure of the
human body was only known from analogy — from dissections of the
lower animals. It was nov/ prosecuted in its only legitimate way, the
bodies of executed criminals being assigned by the Government for
that purpose. As the natural result of this improved system of me-

km ■

(licnl tiiitiun, atui the other branclica of pliilottopliy tauglit in tliJH
scIiu'jI, a cIdhlt system of investigation vvns opplicil to the principles
of mcilical science, — nunicrous Hccts, from time to time, nprang up,
which, in enforcing their own peculiar tenets, directeil general atten-
tion to the subject, and, disclosing the fallacies of their opponents, ele-
vated, to a higli degree, the medical art. For several centuries afler
this period, medicine was prosecuted with equal ardour in the Arabian
and Saracenic schools, and, imitating the example set by Alexandria,
we have the namea of the Neapolitan Colleges of Monte Cassino and
Salerno, both of which acquired some degree of eminence. From the
twelfth to the fifteenth centuries, what have been emphatically called
the dark age?, set in— a period in which, to use the language of a cele-
brated writer of the present day, " ignorance, superstition, and bar-
barism tyrannised over learning and genius, — in which knowledge of
any kind was to be sought for only among the ruins of old churches
and monasteries, — in which fabulous legends supplied the place of
truth, and the arts of a crafty priesthood debased, vvhile they enslaved,
the minds of men." Aided, in the first instance, by the Crusades,
then by the Reformation, but, above all, by the discovery of the art of
printing, an art " which derides the havoc of time and barbarism,"
medicine, together with the other branches of knowledge, revived from
the flagging state in which it had lately existed, and a re-action, more
than proportionate to its previous depression, took place,— schools
were established in most of the principal cities, among ethers in
Montpelicr, Bologna, Vienna, Padua, Pavia, Milan, Rome, Naples,
Paris, and last, and by no means least, in Oxford, Cambridge, Edin-
burgh, and Dublin.

I seek not, Gentlemen, to draw any unfair inference from the
facts just adduced ; but I must fearlessly record my firm conviction, that
it is to these schools, and these only, with the perpetuation of this mode
of teaching medicine, that we must attribute the present exalted state
of medical science. Their beneficial elTects were soon apparent.
Tlie rivalry which quickly manifested itself, — the fame which each
was desirous of acquiring, instigated to close invoatigation of the nature

Iff

;lit in tliJM
principles
sprang up,
oral Qtten-
nenta, ele-
lurios after
lie Arabian
Uoxandria,
lassino and
From the
cally called
B of a cele-
n, and bar-
lowledge of
J churches
le place of
y enslaved,
I Crusades,
)f tlie art of
barbarism,"
evived from
ction, more
e,— schools
g ethers in
ne, Naples,
ridge, Edin-

and treatment of discoses ; a rcHult, which, in its turn, tended to a
fuller and more exact dcvclopement of medical principles, — to its con-
solidation, as a science, — and to a removal of the numerous errors
which entrammclled it.

Medicine, as a science, nt the present day, is by no means what it
was even a few centuries ago, and it is, consequently, by no means ne-
cessary to the object which we have in view, to incjuire into the nature,
degree, or extent, of the initiatory studies requisite for its successful
practice in those days. But if proper initiatory instruction was then
required, on the part of all who wished to enter upon its duties, as is
proved by the establishment of schools, it is even still more so now,
when the requisite attainments are of a much higher order. What
these are, will be seen by in8i)ecting the curricula of the principal
schools of Europe, which I reserve as the material for my next letter.

I remain.

Gentlemen,

Your most obedient, humble servant,

MEDICUS.

Montreal, January li), 18'1'2.

;e from the
viction,that
of this mode
xalted state
n apparent,
which each
)f the nature

LETTER III.

Gentlemen,

The importance of pursuing the study of medicine, on a proper system,
being established in the foundation of schools, where its principles may
be taught and its doctrines inculcated, and this from early ages of the
world, we shall conclude this part of our subject, by inquiring into the
nature of the curricula required of young men entering into that prO'
fession, in some of the principal Colleges of Europe, namely, Edin-
burgh, London, Dublin, Paris, Oxford, Cambridge, Glasgow, Aber-
deen, and St. Andrews. I would willingly have extended this sketch
to the German schools of medicine, but having no certain data at my
command, with respect to them, I am disposed to pass them over. I
must, however, state, that the curricula demanded at any of these, do
not differ materially from those of Edinburgh or London, and where
differences do exist, they will be found in the requirement of in-
creased qualifications.

Independently of classical knowledge, and hospital attendance,
varying in time from one to three years, the candidates for degrees are
expected to give satisfactory evidence of knowledge on the following
subjects, namely :—

Anatomy, Chemistry,

Materia Medica, Pharmacy,

Therapeutics, Physiology,

Theory and Practice of Meilicine,

The Principles and Practice of Surgery,

Midvvlicry, and Diseases of Women an J Children,

Pathology, Botany, Natural History,

Medical Jurisprudence and Police,

Military Surgery,

Mathematics, Natural and Moral Philosophy.

r system,
pies may
B of the
I into the
that pro-
ly, Edin-
w, Aber-
tiis sketch
ata at my
I over. I
these, do
md where
ent of in-

ttendance,

egrees are

following

He is also obliged to furnish tickets on Practical Anatomy, Practical
Chemistry, Clinical Medicine, and Clinical Surgery. Som« of these
classes are dispensed with in some of the Colleges, especially those
not immediately bearing on the practical parts of the profession, such
as Botany, Natural History, and Mechanical Philosophy ; but the list
above given, may be taken as a sample of the curriculum, and the
amount of knowledge required.

The least time during which the students are permitted to acquire
this information, is four years, — that is, four winter sessions, of six
months each, during which lectures on these various branches are de-
livered, at least five times in the week. The longest period oi study
enjoined is twelve years ; at the expiration of either of which periods
or terms, according to the respective Colleges which enjoin them, the
candidates are admitted to the highest degree in medicine, M.D., on
satisfactory examination of their qualifications, and the writing of a
Thesis, which is made to undergo a public defence, on the part of its
author.

At the University of Oxford, the preliminary degrees of B.A.,
M.A., and M.B., are first required, before the degree of M.D. can be
obtained. The degree of B.A. (Bachelor of Arts) requires a four
years' study ; in the course of two years afterwards, that of M.A.
(Master of Arts) is obtained ; at the expiration of another year's study,
the candidate is admitted as M.B. (Bachelor of Medicine) ; and not
until three years are completed, is the degree of M.D. (Doctor of Me-
dicine) conferred, and these after four separate examinations for the
respective degrees.

At the University of Cambridge, a somewhat similar plan is pur-
sued, a ten years' term of study being also requisite.

In the University of Dublin, the preliminary degrees of A.B. and
A.M. are not requisite, though the possessors of these degrees enjoy
superior advan<^ges. The previous possession of the degree of M.B.,
however, is imperative, before that of M.D. can be obtained ; those
who hold the degree of A.M., can obtain that of M.D, after six years'
study ; those holding that of A.B., not until after seven ; while thoso

who hold neither, are obliged to prosccuto their studies for twelve
years.

At the Marischal College and University of Aberdeen, the pos-
session of the preliminary degree of A.M. is imperative ; while in that
of St. Andrews, its possession is recommended, though not absolutely
enjoined.

At Paris, the degree of Bachelor of Letters ia enjoined, before that
of Doctor in Medicine, or Doctor in Surgery, can be conferred.

In the other Colleges, or schools of medicine, to which reference
has been made, although the possession of the degrees of A.M. or
A.B. is not demanded, yet it is obvious, on inspecting the curricula
required of the students, that the object has been to compel on them
as extensively diversified attainments as possible, and to enforce an
acquaintance with the collateral l)ranches of medical science, which,
though they may prove of but little value at the bedsides of the sick,
yet elevate and adorn the medical character.

Leaving the Eastern, let us now direct our attention to the West-
ern I misphere, and, taking, as our guide, the curricula required at
any of the respectable medical schools of the Union (for they are not
all so), we shall find them closely following in the footsteps, and imi-
tating the example, of their British ancestors. From three to four
years' study is required, and collegiate instruction rendered imperaiive.
The nature of the studies is more purely medical, and, except in one
or two instances, an acquaintance with Natural Pliilosophy, Botany,
or any other collateral branch, is not enjoined. Although graduation
does not permit the holder of the degree to enter into immediate prac-
tice, yet in the greater number of the States, its previous possession is
imperative, before the license "ad practicandum" is granted, as it is
& prima facie evidence of the fitness of the individual for the duties in
which he is to engage.

Some of you. Gentlemen, are members of the medical profe-'sion,
and are, consequently, familiar with the nature and extent of the preli-
minary studies requisite for practising it in a proper manner. The
greater portion are not acquainted with these facts, and to these the

s for twelve

en, the pos-
while in that
lot absolutely

(], before that
ferred.

ich reference
1 of A.M. or
the curricula
npel on thetn

enforce an
ence, which,
B of the sick,

to theWest-
ila required at
)r they are not
eps, and imi-
(1 three to four
ed imperative,
except in one
lophy, Botany,
]gh graduation
imediate prac-
s possession is
anted, as it is
ir the duties in

cal profusion,
nt of the preli-
Tianner. The

1 to these the

statements which have been made, may appear novel, but if so, not
tlie less true. Accustomed, as we all are, from our very infancy, to
see ignorant pretenders, of all classes, sexes, and ages, tampering vviili
diseases, and employing remedies of various descriptions, according as
their own whims or fancies may direct, occasionally innocuous, gen-
erally dangerous in such hands, for " fools rush in where angels fear
to tread," the mass of mankind are prone to regard medical know-
ledge as a thing easily acquired, requiring no particular skill in the
application of its remedies, and a smaller quantum of brains for its ac-
quisition, th?.n probably any other profession. The deception, let me
assure you, is an exceedingly gross one, and involves in its conse-
quences the most alarming, the most pernicious, effects. We have
seen that years of arduous, laborious study are necessary for the ac-
quisition of its principles ; and when we reflect for one moment on the
multiplicity of diseases to which the human frame is incident, the
Protean variety of their symptoms, and the frequent calls which are
made upon the sound judgment, and prompt suggestions of the Phy-
sician, whose mind must be prepared for every emergency, no other
arguments, I feel convinced, are necessary to prove the extreme im-
portance of a proper elementary instruction. We acknowledge the
necessity of due preparatory instruction in the other two professions,
and descending from these, in the various mechanical pursuits which
give occupation to so many thousands of our tradesmen and others,
and yet in the medical profession, the practice of which is so closely
interwoven with our dearest interests, and which involves a greater
amount of human happiness or misery than any, or the whole of these
put together, the preliminary acquisition of its principles has hitherto
appeared in this country, to be a matter of no consequence whatever.
But I am anticipating.

I remain,

Gentlemen,

Your most obedient, humble servant,

MEDIC US.

Montreal, January 24, 1842.

LETTER IV.

Gentlemen,

11;,^

The course of my subject brings me now to tiie consideration of the
present state of medicine in this country, by far the most ungracious
part of the task, which may lay me open to imputations of various
kinds; and although tiie circumstances, which, in illustration of my
position, I am compelled to state, may prove unpalatable to a myriad
of demi-Doctors, the outpourings of whose wrath it is no difRcult
matter to predict, yet the cause in which I am writing — a cause in-
volving the sacred interests of humanity — urges me to the duty. I
shall, however, make no assertions, but shall appeal to facts, and shall
state the truth, irrespective of persons, and fearless of consequences.

We have seen, in the last two letters, the care which has been
evinced, from very early ages of the world, to secure to young men
that knowledge of their profession, which would enable them to un-
dertake the practical duties of it, with credit and honour to them-
selves, and benefit to the sick entrusted to their charge. Scholastic
education ha3 been shewn to possess the sanction of antiquity, a fact
which is, at the same time, virtually demonstrative of the insufficiency
or inadequacy of all other modes of imparting the requisite degree of
initiatory instruction. We have seen the system practised in England,
Scotland, Ireland, France, and the United States, and, in fact, in every
other civilized nation under the sun. Let us now look homewards,
and see how far we keep up with this spirit of improvement, in incul-
cating the principles of the medical profession, in the only manner the
utility of which has received the confirmation of the experience
of ages.

tration of the
t ungracious
3 of various
ition of my
to a myriad
s no difficult
-a cause in-
the duty. I
cts, and shall
sequences.
;h has been
) young men

them to un-
our to them-
Scholastic
uity, a fact
insufficiency
site degree of

in England,
fact, in every

homewards,
!nt, in incul-
r manner the
experience

Tiic Ordinance which at present regulates the practice (there is
none regulating the study) of medicine in this Province, is the 28tli
Geo. III. cap. 8, the object of which is, " to prevent persons prac-
tising Physic or Surgery within the Province of Quebec, or Midwifery
in the towns of Quebec or Montreal, without a license." It prescribes
an examination, before a Medical Board, of all, except those who hold
a degree from "any Universitjr," which, according to the opinion of
the Attorney-General, refers exclusively to British diplomas, or have
been commissioned or warranted as Surgeons in Her Majesty's Army
or Navy, and exempts altogether from the necessity of obtaining a
license, the Physicians or Surgeons of Her Majesty's Army or Navy,
on active service within the Province. L prescribes no particular
time, nor does it indicate any particular course of study ; in fine, ac-
cording to the Ordinance, the time of study may be either six days or
six years, — the candidate for license may be either six years old, or
sixty ; its whole requirements being, that he present himself before one
of the Medical Boards of the Province, and if he replies to the few
questions proposed to him, which chance may so direct as to be on
subjects with which he may be, to a certain extent, familiar, he must
be received.*

But the working of this system is best seen by those who compose
the Medical Boards of the Province. To them it is notorious, that the
candidates come before them with the minimum quantity of knowledge,
requisite to enable them to pass. There have been a (ew honourable
exceptions to this statement, but they are so few, as to corroborate the
fact, rather than invalidate it. Nor is it at all surprising. Appren-
ticed, as I grant they usually are, a circumstance the result of custom,
more than of necessity, they are admitted to the privilege of compounding

* This is so literally true, that presenting before the Medical Boards, has been,
1 by students, proverbially termed, " taking their chance."

The stigma ■)( passing improperly educated persons, might, by some, be at-
i tached to the Boards of the Province ; but, we must observe, that these Boards have
j not tlie power of either elevating or demanding a high standard of medical acquire-
i ments. They may demand, but whence are these attainments to be derived l The
I faulty system of education, compels the reception of inferior qualifications, which,
1 though the Boards may regret, for many and obvious reasons, ihcy cannot prevent.

furmulse, which is the Houice of all tltcii' knowledge in Pharmacy
and the Materia Medica ;' their linovvlcdge of Chemistry, gleaned from
books, and practically exemplified, to a certain extent, in the way just
specified, is as meagre as can possibly be, in most cases, amounting to
the grossest ignorance of its simplest principles ; their knowledge of
Anatomy, studied from books, aided by a few plates, as old and antique
as may well be iniagined, serves them to know, at best, the carotid
artery from the femoral, and is utterly unfit for assisting them in the
performance of any, the most trifling, operation in Surgery. Their
knowledge of Medicine and Surgery, derived from the same source,
however well stored with theory their minds may be, readers them
worse than useless at the bedsides of the sick, from a deficiency of
practical information, and serves to confuse, more than enlighten, as to
the nature and proper treatment of the disease before them. The other
branches of medicine, as Therapeutics, Physiology, Pathology, Sic.,
are laid aside, as requirements by no means necessary to enable them
to pass, and as fit subjects for study at future periods, which very fre-
quently never arrive.

Such, Gentlemen, in a few words, is by no means an over<drawn

picture of the present standard of medical knowledge in this country.

So far as regards the mass of medical men who receive students,

auch a result is not commom. Here and there, however, it

must be confessed, one is to be found, who endeavours to remedy

these defects in the tuition of his apprentice or student ; but it would

require more time than the very best of this second class can afford,

to bestow even an approach to what would be considered, even by

himself, as a proper medical education. What facilities can he have

for Dissection 1 what, for tlic illustration of Chemistry 1 what, in fact,

for any other of even the least important branches of the science ?

None, none whatever. His whole time is engrossed in his own private

practice. If he can bestow any on his student, it is but a fraction, too

trifling to notice, and, as is far too frequently the case, the students pursue

their studies, and glean their information, according to the dictates of

their own judgment or inclination. This, I luust observe, in no fauJi

)

n Pharmacy
gleaned from
the way just
amounting to
nowleilge of
1 and antique
, the carotid
them in the
•gery. Their
same source,
renders them
deficiency of
nlighten, as to
n. The other
ithology, &c.,
I enable them
lich very fre-

,n over*drawn

this country.

sive students,

however, it

urs to remedy

but it would

iss can afford,

ered, even by

s can he have

what, in fact,

the science ?

lis own private

a fraction, too

students pursue

the dictates ot

vCi in no fauU

ofeither master or pupil, but it resides in the deficiency of proper legis-
lative enactments, which, while they ought to regulate the studies pre-
liminary to the practice of one of the most important professions which
exists, a profession which involves in the prosecution of its duties, a
greater amount uf human happiness than any other, should, at the
same time, put it out of the power of every one to usurp, or undertake,
an initiatory instruction, which he has not the means, or the power, of
completing as it ought to be.

But on whom do the evils which are thus necessarily attendant
on this imperfect system of education, devolve 1 The answer is a
plain one. There is no class of society, however elevated it may bo,
which may not, does not, feel its influence. Its pernicious effects are
rampant through the land, throughout its length and its breadth ; and
though by no means unfelt in the cities, in the country it commits its
direst ravages. Humanity sickens at the accounts sometimes brought
from these quarters. At one time, we hear of a man literally bleeding
to death unaided, (a medical man having been actually called in !) from
a wound in the leg, by a scythe, a result which the timely exhibition
of the slightest surgical skill, mi^lit have prevented ! At another, we
hear of an amputation at the thigh, for the cure of an aneurism in the
ham, and this in lieu of the more delicate operation of tying the femoral
artery a little above it, an operation which might have saved the unfor-
tunate individual's limb ! At another, we hear of a blister having
been applied to a strangulated inguinal hernia, for the relief of the in-
flammatory symptoms which had set in, as the inevitable result of the
strangulation. This individual died in the course of twelve hours
afterwards ! And more lately still, of an operation to remove a tumour
of the abdomen, which was caused by an enlarged stomach, fro m
organic disease. The abdomen was actually cut into, and the mistake
was not discovered, until the shining peritoneal coat of the stomach
presented itself to view ! ! This cost the poor woman her life, and is
now furnishing the groundwork for a legal prosecution. But what pe-
cuniary consideration can recompense for the loss of those who are
near, and dear, to us ? Can our affections be bought for silver or gold ?

or can these afford the slightest consolation to our wounded, lacerated
feelings 1 We shudder, Gentlemen — our best feelings revolt, at the
cruelties which we see so frequently inflicted on the poor dumb, de-
fenceless creatures which surround us ; cruelties which are literally
nothing, to the wholesale licenRcd murder of our own species, toler-
ated in this country.

I subscribe myself,

Gentlemen,

Your most obedient, humble servant.

MEDICUS.

Montreal, January 27, 1842.

LETTER V.

Gentlemen,

In my last letter, I exhibited a plain, unvarnished picture of the pre*
sent state of medicine in this country, and showed up the system, of
which it is the practical working, in its naked deformity. Much more
might have been written ; but the subject is one so revolting to all the
finer feelings of our nature, that enough, and probably more than
enough, has been said to prove the object which I had in view)
namely, the present extremely degraded state of medicine in this
country.

But has there never been an attempt made to ameliorate this me-
lancholy state of things, — to diffuse abroad a spirit more congenial to
improvement, — to rescue medicine from the low state into which it
had sunk,— and to lessen the evils consequent upon a worse than im-
perfect system of education 1 Yes, Gentlemen, such an attempt was
made. About fiileen or twenty years ago, a few medical gentlemen
of this city, aware of the unfortunate occurrences which were daily
taking place, and recognising the source whence they originated, deeply
impressed with the necessity of causing the study of medicine to be
prosecuted in its only legitimate manner, the utility of which had been
tested by nearly twenty-two centuries' experience, and of the benefits
of which they had themselves been participators, associated them-
selves together, under the name of the << Medical Institution," and
publicly delivered lectures on the various branches of medical edu-
cation. Far from meeting with that support which was so justly their
due, — far from being, in the slightest degree, assisted in their arduous
undertaking, an undertaking involving an immensity of labour, and no

profit whatever (their receipts being frequently, at the end of the year,
insufficient to cover their expenses), they have been stigmatised as ex-
clusives, and have encountered the most untiring opposition. Into the
causes of this opposition, causes which would willingly, at the time,
have sacrificed at the shrine of their gratification the \)cm and most
beneficent intentions, I wish not now to enquire ; I desire not to rako
up the smouldering embers of political animosity, and re-kindle a fire,
which, I fain hope, has now nearly, if not altogether, expired. The
Medical Institution, however, merged eventually into the M'Gill Col-
lege, — still holds its ground, — and must, at Inst, triumph over the
countless obstacles, which have hitherto, but ineifectually, attempted to
oppose its prosperity. It may be here not irrelevant to mention the
curriculum required by the rules of this College, as it is the only
chartered Institution in British North America, which professedly im-
parts a medical education.

The candidate for the degree, which is that of Doctor of Medicine
and Surgery, must have attained the age of twenty-one years, and
afford satisfactory proof of classical attainments, and must furnish tes-
timonials of having attended, during at least three years, courses on
the following branches of medical education : —

Anatomy and Physiology ; Chemistry and Pharmacy ; Theory
and Practice of Medicine ; Midwifery, and Diseases of Wo-
men and Children ; Surgery ; Materia Medica, and Thera-
peutics J Clinical Medicine and Surgery — Two six-month
courses each.
Institutes of Medicine ; Practical Anatomy — One six-month course

each.
Hospital Attendance — During^ at least, two years.
He is also required to compose a Thesis on some medical subject,
at his own option, which is publicly defended, on a day set apart for
that especial purpose.

It will be observed, on examining this curriculum, that the nature
of the required studies \s purely medical, none of the collateral branch-
es, which swell out the curricula of the principal Colleges of Great

il of the year,
natised na ex-
on. Into the
r, at the lime,
beut and most
e not to rake
fkindle a fire,
:pired. Tlie
> M'GiU Col-
iph over the
', attempted to
mention the
is the only
ofessedly im-

r of Medicine
ne years, and
it furnish tes-
f courses on

acy ; Theory

ases of Wo-

and Thera-

vo six-month

month course

dical subject,
set apart for

at the nature
teral branch-
ges of Great

Britain, and of Aonie in the United States, being enjoined, while all
those classes arc rendered imperative, the principles of which are
called into every day operation. In a young and rising Colony, no
more than this can, or oiighl, to l)e demanded ; but this much should
ho. The object sought for, is to elevate the standard of medical know-
ledge, — to impart useful, not ornamental, education,— to unfold the
principles of medical science to all who feel disposed to take advantage
of the opportunity thus oflTered, — and to aflbrd no longer a plea, or an
excuse, for the criminal ignorance of them, which was so conspicuous
every where. But although the means of acquiring a rudimentary
knowledge of their profession was thus placed within the reach of all,
cxperienco has amply proved the lamentable fact, that although a few
do avail themselves of the privileges thus opened to ihem, yet the
mass of young men entering the profession, prefer the imperfect system
prescribed by the law, to collegiate education, which vvould entail the
trifling outlay of a (ew pounds. As long as collegiate education is
not rendered imperative, so long will this system he persevered in, a
system which perpetuates a degree of ignorance more befitting the un-
tutored savages of a newly discovered clime, or the semi-barbarism of
antideluvian periods, than the vaunted civilization of a Christian
country, in the nineteenth century.

But, Gentlemen, in 1831, the Provincial Legislature of Lower Ca-
nada, took the matter up ; and let us now see what they made of it. In
that year, an Act was passed — 27th Will. IV. Cap. 1— entituled " An
Act to repeal a certain Act therein mentioned, and to provide more
effectual regulations concernifig the practice of Physic, Surgery, and
Midwifery." One would altnost have supposed, that a modern Legis-
lature, careful of the interests of the constituents, by whom they were
returned as Members, and necessarily cognizant of the innumerable
evils which flowed from the deficient state of medical education,
would, in proposing a remedy for a disease, pregnant with such disas-
trous consequences, have devised the means of at once eradicating ihe
complaint, by enforcing a strict compliance with a proper preparatory
instruction, on the part of all who wished to enter upon its duties. In

roaJing over tho Act, however, the most caroleis observer cannot but
be struck with tho culpable inJiflerence dlsployed on this point.
While the greatest care seems to have been taken to make the Me-
dical Boards of the Provihcc elective (than which no method could
possibly have been selected more open to abuse, especially with re-
spect to talent, and that, too, in a situation where it is so much needed) ;
while it takes especial care to impose penalties on all persons prac-
tJHing without a licenso, and in this manner protects their own ignorant
pretenders from the encroachments of their, too frequently, more skil-
ful, but unlicensed, opponents ; while tho most stringent regulations
ore made in reference to the poor apothecaries, and ample care is
taken that they receive a proper preliminary education (of the same
nature as that for the physician !— the only diilerence in the education
of the two being, that the former has to serve a three years*, the
latter a fivo years', apprenticeship) ; the very object which ought to
have been steadily kept in view, — the all-important subject, which
should to have constituted the main feature of the Bill, a proper system
of initiatory instruction, is studiously avoided.

Nor, Gentlemen, can we be at the slightest loss in assigning a rea-
son for this seeming negligence, for it is only seeming. The Legis-
lature well knew, that in rendering collegiate instruction imperative,
they would have been directly advancing the interests of tb? M'Gill
College ; but they, at the same time, forgot, or rather affected not to
remember, the long-established commercial axiom, (and education may,
in this senRe, be viewed in a commercial light,) that where the demand
is created, the supply speedily follows, and, consequently, that where
one medical school existed, there, in no long time, might fifty have been
rearing their heads. Narrow-visioned policy ! which strained at a
gnat, and swallowed a camel, — which, while withholding a proper
preliminary education, perpetuated, through its neglect, the direst con-
sequences upon a hapless community.

To you. Gentlemen, the medical profession generally, for their
own honour, and the public, also, for their own interest, anxiously
look for an amelioration of this state of things. The middle of the

ir cannot but
I this point,
lako the Me-
lethoU could
»Ily with re-
ich needed) ;
eraons prac-
Dwn ignorant
r, more skil-
t regulations
imple care is
of the same
he education
) years', the
hich ought to
ibject, which
>roper system

nineteenth, finds the standard of medical knowledge in this country,
no higher than it was in the middle of the eighteenth, century : no im-
provememt has taken place,— not the slightest change. The attempt
has been made, but, unsupported by Legislative authority, it hoa
proved almost abortive.

The provisions of a Medical Bill, regulating the interests y * the
medical profession, shall form the materials of my next and last
letter.

In the meantime.

Gentlemen,
I remain your most obc liont, humble servant,

MEDIC US.
Montreal, February 3, W,2.

signing a rea-
The Legis*
n imperative,
.f the M'Gill
fTected not to
iucation may,
B the demand
, that where
fly have been
strained at a
ing a proper
le direst con-

■ ;t

dly, for their
>st, anxiously
liddle of the

LET'»^ER VI.

Gentlemen,

The conclusion of my subject, brings me now to the consideration of
the details c " a Medical Bill, such a one as would accord with the
feelings and necessities of the medical profession generally, and, at the
same time, tend to elevate the standard of medical knowledge through-
out the Province. Both the Canadas labour under similar disadvan-
tages in this respect; consequently, the provisions of the Bill should be
such as to affect both ; and its title should be the following : " An Act
to Regulate the Study and Practice of Physic, Surgery, and Midwifery,
within tht Province of Canada."

The preamble should repeal all existing laws or Acts which at pre-
sent affect the study or practice of the same within the Province, espe-
cially 28th Geo. III. cap. 8, which bears on the practice in Lower
Canada, and 59th Geo. III. cap. 13, 59th Geo. III. cap. 2, and 8th
Geo. IV. cap. 3, which influence it in Upper Canada.

Sec. 2. — A competent classical education to be imperative on every
one desiring to practice as a Physician^ Surgeon, Man-Midwife, or
Apothecary. *

Sec. 3. — No person to be admitt*: 1 to examination for license to
practice as a Physician, Surgeon, Man-Midwife, or Apothecary, unless
he has attained the age of twenty-one years.

Sec. 4<. — All persons desiring to practice as Phys'sians, Surgeons,
or Man-Midvvives, must submit to an examination, before a Medical
Board, on the following subjects : Anatomy, Physiology, Chemistry,
Pharmacy, Materia Medica, Therapeutics, Theory and Practice of
Medicine, Principles and Practice of Surgery, Midwifery, and Di-
seases of Woiaen and Children.

Sec. 5.— All persons desiring to practice as an Apotliccary, must
submit to an examination before a Medical Board on the following
subjects : Materia Medica, Pharmacy, and the Principles of Che-
mistry.

Sec. 6. — For the provisions of this Act, Medical Boards to be
appointed by the Governor-Grenoral, or person administering the Go*
vernment for the time being, in the cities of Toronto, Kingston, Mont-
real, and Quebec.

Sec. 7. — The Medical Boards to consist of, at least, nine Medical
practitioners, five of whom shall constitute a quorum. To meet, at
least, once every three months, after a fortnight's . yiification of the
same, in, at least, two papers published in the respective cities. Their
duties shall be to examine the testimonials and qualifications of every
pereon wishin<r to practice within the Province as a Physician, Sur-
geon, or Man-Midwife, every person desiring to practice as an Apo-
thecary, and all women desiring to practice as Midwives ; and if, on
examination, they shall be found duly qualified for the discharge of
the duties of the respective offices which they wish to practice, a cer-
tificate to that effect shall be granted to them, to be confirmed as a
license by the Governor-General, under his hand and seal.

Sec. 8. — Successful candidates shall pay a fee of £1, to the Se-
cretary of the Board, to assist in defraying the incidental expenses of
the Board.

Sec. 9. — Exempts from examination by the Medical Boards, all
persons holding a diploma or degree from any British University or
College ; all persons holding a diploma or warrant in Her Majesty's
Army or Navy ; and all Army and Navy Physicians or Surgeons on
active duty within the Province.

Sec. 10. — All persons wishing to practice as a Physician, Surgeon,
or Man-Midwife, shall serve an apprenticeship of, at least, three years,
with some licensed medical practitioner^ and shall adduce testimonials
of attendance on the following branches of medical study, the courses
of which shall have endured for, at least, four months, and the num-
l)er of iectuies, at least, five du'ing the week : Two courses, of Ana^

I ! •

m,-

tomj anJ Physiology, two of Chemistry and Pharmacy, two of Mate-
ria Medica and Therapeutics, two of Surgery, two of Theory and Prac-
tice of Medicine, two of Obstetrics, and two of Practical Anatomy,
with Hospital attendance during, at least, two Academic years, the
Hospital containing, at least, forty beds.

Sec. 11. — All persons wishing to practice as Apothecary, shall
serve an apprenticeship of, at least, three years, ^vith dome licensed
Medical practitioner or Apothecary, and shall adduce testimonials of
attendance on the following classes, the duration being, at least, four
months, aid the number of weekly lectures, at least, Ave : One course
of Chemistry and Pharmacy, one course of Materia Medica.

Sec. 12. — No person to practice Physic, Surgery, or Midwifery,
within the Province, without a license, under a penalty of XIO for the
first offence, and JS20 for every succeeding one.

Sec. 13.— No person to vend medicine as an Apothecary, with-
out license, except in the instance of patent medicines, under a pen-
alty of £10 fer the first offence, and jE15 for every subsequent one.

Sec. 14<. — No female to practice as a Midwife, without a license,
under a penalty of JC5 for the first offence, and JS7 10s. for every sub-
sequent one.

Sec. 15. — No Apothecary to vend any adulterated medicines, or
medicines which ehall not be genuine, under a penalty of £5 for the
first offence, and jGlO for every subsequent one.

Sec 16. — No Apothecary to vend any poisonouf ubstances, such
as corrosive sublimate, arsenic, laudanum, and the like, unless the
person requiring the same, produce, from a Clergyman, Physician, or
other respectable iniiabitant of the place in which he resides, a certi-
ficate, stating the name, residence, and occupation, of the person re-
quiring it, under a penalty of £2 lOs. for the first offence, and £5 for
every subsequent one.

Sec. 17. — All Apothecaries to keep poisonous substances in co-
lou>v,d bottles, with the word "Poison," in large letters, ij»arked
thereon, r.nuer a penalty of £2 IDs. for the Cwat offence, and JE5 for
every subsequent one.

wo of Mate-
)ry and Prac-
lal Anatomy,
nic years, the

liecary, shall
)me licensed
3stimonials of
at least, four
: One course
lica.

r Midwifery,
f JBIO for the

iecary, with-
under a pen-
iquent one.
out a license,
br every sub-
medicines, or
jBS for the

stances, such
ie, unless the
hysician, or
sides, a certi-
le person re-
, and £5 for

ances in ce-
tera, n.arked
, and JE5 for

Sec. 18. — No person whatever, under any pretence, to inoculate
any child or adult with the natural virus of the small-pox, unless af\er
previous vaccination with cow-pox virus, under a penalty of JS5 for
the first offence, and £1 lOs. for every subsequent one.

Sec. 19. — To facilitate the study of Anatomy, all dead bodien
unclaimed by friends or relatives, within three days, from the month of
November to May, and within two days, from the month of May to
November, whether dying in Hospitals, Jails, or other public Institu-
tions, or found dead, publicly exposed, to be given up to a public lec-
turer on Anatomy, for the purposes of dissection ; and that a warrant,
signed by a Justice of the Peace, in favour of the applicant for the
same, addressed to the Coroner of the District, or chief officer of the
Hospital, Juil, or public Institution, be sufficient to obtain it.

Sec. 20. — The penalties imposed in this Act to be recovered by the
deposition of, at least, two witnesses, before any of Her Majesty's
Justices of the Peace, within, at least, three months after the commis-
sion of the offence, with imprisonment until the fine is paid ; one
moiety of the fine to be given to the informants, the other moiety to
be the property of Her Majesty, her heirs, and successors.

Sec. 21. — This Act to remain in force, until repealed by a subse-
quent Act of the Legislature.

A few comments on some of the sections of this proposed Bill, and
I shall conclude.

Section 9. — I should scarcely has c deemed it necessary to make the
slightest allusion to this section, had not the proposal been seriously
entertained by several Members, to admit American diplomas into tnis
country on a par with British ones, — that is, without subjecting the
parties holding them to an examination. The impropriety and the im-
policy of snch a measure, could be clearly demonstrated to every un-
biassed mind, did not the already too great length of this letter warn
me to be brief. I may, however, advance several arguments, with-
out entering into explanatory details. In the first place : Although a
few American Colleges do impart a complete system of medical in-

■aPT"

28 I

struction, yet the generality of them do not, and this remark especially
applies to all the Border Universities (1), those which would most cer-
tainly be visited by our students, from their proximity and cheapness.
A number of graduates from these Universities, as they style them-
selves, have applied for license to the Montreal Medical Board, and the
records shew the rejection of a large numerical majority, from utter
ignorance of the simplest principles of the profession, and consequent
incompetency. Secondly : A chartered College exists within the
Colony, fully capable of imparling the requis-ile degree of elementary
knowledge ; and in no long time, others would be established also. It
has been objected to the M'Glll Collogo, that the lectures are in the
English language, and, consequently, are not comprehended by the
Canadians. To expose tlic frivolousness of this objection, it is, I
think, sufficient to observe, that tlie classes this winter shew a large
majority of Canadians among the gentlemen attending them, who have
thus voluniarily come forward. Thirdly : The protective arm of the Le-
gislature, which ought to foster their own Institutions, and hold out no in-
ducement to seek that instruction in a foreign country, which their own
is fully capable of imparting to, at least, an equal, if not a superior,
degree. Fourthly : The usage of almost all Governments, which re-
cognise as valid no diplomas but their own. Three gentlemen holding
the M'Gill College diploma, are now practising in Louisiana, United
States, and all the three had not only to take the oath of allegiance, but
to submit to an examination before the Medical Board in that
State ; and, in 1838, five English Physicians were put on their uial at
Boulogne, for practising without a license, and condemned to the pay-
ment of a trifling fine, equivalent to an interdiction. According to
this decision, no foreign Physician can practice in France at all/anless
he undergoes an examination before the Facultv of Phvsicians at
Paris.

Section 18. — The best directed efforts to suppress this loathsome
and fatal disease, will be utterly unavailing, as long as the practice o^
inoculating is permitted to continue, ft has been made the subject of

^f"

Legislative interference in the Imperial Parliament ; and the penalties
of the Statute were actually imposed on one medical man, who con-
travened its enactments.

Section 19. — It surely requires little to be sold to prove the impor-
tance of such a step as is here indicated on the part of the Legislature.
If a knowledge of the functions and structure of the human frame is
demanded from the Physician and Surgeon, and if an intimate ac-
quaintance with these can only be obtained by means of dissection,
measures should be adopted to secure this end, in the least offensi"
way possible. Such a method is adopted in Great Britain ; and,whiiu
it has been found there to subserve well the end for which it was in-
tended, it would, if introduced into this country, also tend to obviate
the disngroeable and dangerous practice, by which an imperious ne-
cessity now compels the student to acquire the material for this impor-
tant branch of his studies.

I have now. Gentlemen, brought these letters to a conclusion, and
leave the whole matter in your hands, under the full persuasion, that
it will meet with that attention which its extreme importance demands.
I have, I believe, fully demonstrated the urgent necessity of Legislative
interference in establishing a higher standard of acquirements, on the
part of those who intend to engage in the important duties of the me-
dical profession. You alone, Gentlemen, have the power, and, after
the arguments which have been advanced, I doubt not, the inclination.
This end will be amply attained in the sketch of the Bill which I have
just submitted to your calm and deliberate judgment.

In establishing some of the positions which I had to assume in the
course of my argument, I was compelled to make some painful dis-
closures ; but, in doing so, however much I regretted the necessity, I
sedulously endeavoured to appeal to facts ; and have now the satis-
faction of adding, that, although nearly a fortnight has elapsed since
my last two letters were publicly laid before you, not a single state-
ment has been, either directly or indirectly, impugned. This tr jit
acquiescence on the part of the medical profession, in the statement:

which have been made, and the inferences which have been deduced
from them, cannot surely be regarded as unimportant. It has invested
my feeble efTurts in the cause which I have undertaken, with a corro-
borative influence and weight, which I scarcely permitted myself to
hope they would so readily have acquired.

It reniaini) to me, Gentlemen, to subscril)e myself,

Your most obedient, humble servant,

MEDICUS.

Montreal, January 17, 1842.

a B B iA "U" ifta :_^'

Page 11, line 24, for " not until three years are cok.:pleted," read, " not until three
additional years are completed:"

Page 16, line 22, for "fdr such a result is not commom," read, "such a result is
not uncommon."

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