nerated by fees in proportion to the number of attendances in the course of the patient's illness. To the apothecary or chemist, however, they wholly entrust the compounding of the medicines they prescribe, (not always forgetting to share the profit with one or the other ;) and sometimes they likewise depend upon the apothecary's observation of the progress of the malady.

This gives rise to an evident reciprocity of interests between the various professors of the healing art; a reciprocity so well understood, and so generally acted upon, that the apothecary estimates the abilities of the physician by the quantities of medicine he prescribes; and thus the honest practitioner who conscientiously confines his doses to the quantity actually necessary for the cure of the patient, passes in the drug-shops for a man of no reputation. This dishonourable traffic is so general, that the poor, who cannot afford to pay long bills for medicine, often allow their health to suffer materially before they venture upon professional advice.

Were this pernicious system abolished, as it might soon be, by separating the two professions of medicine and pharmacy, it would soon be made apparent what a very small quantity of medicine suffices for the cure of almost every

disease; and, the interests of physicians, surgeons, apothecaries, druggists, and their dependants, being thus isolated, an end would be put to the sordid association of science with trade, and the honourable scientific professor would at once be distinguished from the rapacious quack; superior science would reap its fair and just reward, instead of being disgracefully dependent on the base lucre of trade. The motives of medical men would be raised above suspicion, their characters would experience a corresponding elevation, and they would assume a rank in society, at present almost unknown to the profession.

The present mode of medical remuneration having so manifest a tendency to degrade the profession, and to fill invalids with distrust, a change is imperatively demanded; and to whom can I appeal with so much effect as to the honourable portion of that body, who so well know, that, under the present system, it is not possible for a truly upright man to practise conscientiously, without sustaining a serious pecuniary loss.

By some it may be thought, that, since I have thus drawn the attention of the public to an abuse so dangerous to the patient, and so derogatory to the physician, I should be prepared to point out a remedy; but, notwithstanding I have given it as my

decided opinion that no professional man, however high his rank, should be placed in circumstances in which his interests are immediately opposed to his duty, I do not consider the provision of a remedy precisely within my province.

As, however, every individual must feel a deep interest in the removal of this temptation to corrupt practice, since it involves a danger to which we are all subjected, I may suggest the outline of a plan which appears to me well calculated to secure the end desired, leaving more able hands to mature it. My plan is this. Let a meeting of the eminent and respectable portion of the profession be convened, and let a resolution be passed condemning the practice of making out bills for medicine, and proposing that, in lieu thereof, individuals, or heads of families, contribute to their medical attendants a sum annually, according to their circumstances in life, for which they should be entitled to medicine and advice in whatever malady they might be visited with during the year, free of any additional charge.

An eminent medical man, to whom I mentioned my view of this subject, replied, "But the public are not sufficiently liberal towards us." I would ask, where is the rational person who would hesitate his annual contribution on the ground that

to pay

he had had no occasion for either medicine or doctor? This would cure two evils at once; namely, the administration of more medicine than necessary, and the charge for it. Immediate attention would be secured to the incipient stages of disease, which, by the present system, is too often allowed to reach its height, from the dread of incurring a heavy doctor's bill; and the poor would no longer be the victims of those inferior and comparatively ignorant practitioners who now have a direct interest in the severity and duration of disorders.

GOUT.

"In vain your friends would reason down your pain."

THE prevalence of gout has quickened the diligence of medical inquirers into its causes and its cure. Many have concluded that it is incurable. This opinion, however, is false, and is not less mischievous than falsehoods usually are.

The reason why this disorder is considered by some as being beyond the reach of medical aid, is to be found in an unwillingness to believe, or at least to confess, that it is the offspring of excess. Such, however, is the case; and, consequently, the opinion of its incurability is entirely unfounded. That gout is brought on by temperance, exercise, and proper management in our living, none will venture to affirm. No; it is the offspring of repletion alone, producing an unnatural abundance of blood, which constitutes its principal predisposing cause, although morbid derangement of