Sbc Indian SU&ical (gazette. ?
?
AUGUST 1, 1882.
MEDICAL
PRACTICE IN CALCUTTA.
A proposal has been made to the Government of the Principal of the Grant Medical College
Bombay by to enact
portion
a Medical .Registration Law similar to that of the English Act which provides for the rc-
THE INDIAN MEDICAL GAZETTE.
214
[August 1,
1882.
is but their aid is also largely sought for purposes of conat present under the consideration of the Government sultation by the practitioners and inhabitants of the town of India. What is good for Bombay in this behalf at large. The annual contract system is almost uniwould also be good for Calcutta and Madras, and per- versally resorted to in family practice ; the contract fee to the station and wealth of the haps for India generally ; and if a law of this sort is varying according The smaller fees, from lis. 100 to Rs. 1,000. patient, or necessary desirable, it ought plainly to be imperial rather than provincial. With a view to discussing in a say below Rs. 300, are paid by bachelors and persons future number the grounds on which the registration of limited means, poor but proud, to whom a special These fees constitute debts of medical qualifications in India generally, or its prin- concession is often made. of honour, and no interchange of bills or formal docuwe be considered advantageous, cipal towns, might ments of any kind passes between doctor and patient. propose now to jot down a few notes regarding the mode in which medical practice is carried on in As debts of honour they are almost invariably promptly For casual services?single visits, Calcutta. It must be that this and fully adjusted.
gistration
of medical
qualifications.
This
proposal
understood, however, apply to India generally.
consultations, &c., the gold mohur (Rs. 16) is the basis less is never accepted, and in special circumstances? doubt in many large towns and centres of population severe illnesses, operations, &c., a liberal honorarium conditions exist very closely resembling those of and given. We Calcutta ; but the capital town is more advanced in founded on this basis is expected men need add that medical to this hardly belonging side of India. this respect than any other place on this
description
The
does not
proportion
of
qualified practitioners
of medicine
class
of
customs
is
?
No
have
interest,
no
direct
or
indirect,
in the sale
drugs,
approximate larger, and their professional A second section of qualified practitioners consists closely to the European type. A rough and of medical men possessing English qualifications who ready classification of medical practitioners into qualihave settled as private practitioners in Calcutta. fied and unqualified at once suggests itself. The records of the Municipal Office indicate that, in These belong to various nationalities, European, Asian, and mixed, and their practice is of a varied description. 1881, 81 of the former and 43 of the latter applied for with medical officers licenses to practise. These figures probably fall consi- Some few practise on a level labour among and on The similar terms. majority derably short of the actual number of practitioners of and less liberal in classes less in circumstances easy each class ; and as the unqualified are more likely to obtains also in evade taxation than the qualified, the proportion is also ideas. The annual contract system contract fee is smaller, the of but this not be far from sphere practice, in all probability wrong. It would 300. The Rs. Rs. to 50 from single fee for the mark to reckon one hundred as the probable num- ranging more
ber of each class. one
medical
This would
practitioner
to
give
proportion
a
every thousand
of
inhabitants,
The qualified practiwhich appears a liberal supply. tioners are divisible into three categories. 1st, Officers of the Indian medical service stationed at the
presidenThe cy who enjoy the privilege of private practice. number of these does not undergo much change, nor is there much probability of an increase of them in the future. The policy of Government has been rather to diminish
they and
than
add
to
their
number.
There
8 of this class stationed in Calcutta.
now
are are
attached to hospitals and medical schools, available for attendance on Government who
servants
for such
are
Officially
public
are
entitled to
duties
as
their
services,
and
members of committees and
boards, visitors of public institutions, &c., as may be assigned to them. As a body, selected from the whole
service for
special and important medical enjoying special advantages in the way of gaining knowledge, experience and skill, they have work,
always
and
constituted
the leaders of the
profession
in
Their practice lies mostly among the European inhabitants, official and non-official, of the town ; Calcutta.
is
casual services
also
more
moderate, perhaps
on
the average one-half of what is paid to the first class. Practitioners of this class lead very laborious lives. Depending entirely on their earnings in prac-
tice, subject often to groundless or fanciful calls, undergoing a large amount of ill requited or unrequited toil, their time never their own, they find their profession a very exacting and not very liberal task master. Still with clcse attention to work and steadiness a competence if not a moderate fortune can
comfortable be made
by
the
unofficial medical practitioner, and
that this class of medical men is not Few of this section have a direct more numerous. interest in the sale of drugs, but many of them
the wonder is
attend
in the
shops
of
share of the
profit
on
comers a
the
of practitioners includes men
"
advice gratis" to all give the guerdon being ts, druggis
at stated hours to
who,
as
far in
as
a
we
prescriptions.
limited are
This section
number of medical
aware, have
English practice.
no
exact
We allude
to representative salaried some of the by English Surgeons qualified leading European firms of druggists whose duty it is to see, examine and prescribe for all persons applying
August
or
medical relief of
being
MEDICAL PRACTICE IN CALCUTTA.
1, 1882.]
constitutes
the
on
premises
;
the
prescriptions
made up in the establishment.
course
This
superior kind of counter practice, and really a private dispensary ministered
a
the institution is to
qualified and often skilful doctor. The public largely of this system, and in simple cases, requiring deep and close study or prolonged treat-
by
a
215
conceded. The doctor consulted examines the case* writes his prescription or delivers his opinion, and receives his fee. In wealthy families this consultation maybe repeated daily or oftener for a long period if the one consultant may be or more than case is
avails itself
urgent, summoned ; sometimes
not
The selection of the consultant may
ment, the system is convenient, safe and efficient. The medical men employed in this way are of good stamp, and when a case cannot be done justice to at
speak, they do not hesitate to advise the hospital or consulting room. The objecadvice gratis" tionable feature in the matter is the element which robs the higher medical talent required for diagnosis, prognosis, and prescription of value, and makes remuneration depend on the material sold in the shop. No doubt the price charged is a fancy one, and includes the advice as well as the drug, but the subthe
counter,
so
to
ordination of
professional
purely
purposes of trade
so
overtly
men
is
and work
objectionable
to
The
system also must interfere with the .practice of the general practitioner. The charging for medicines instead of medical attendance is
one
blots of
of the
system has been established in a much more pronounced form. Still it is right to add that the Calcutta public would not willingly lose this source of medical aid in small
English practice.
Here the
same
emergencies. The third section of
qualified
medical
men
comprises
as
many
four
depend
or
on
five.
previ-
acquaintance, more frequently on the nature of 'the professor of medicine being called to a medical case, of surgery to a surgical, of obstetrics, to
ous
the case, a
midwifery. In most cases the
resort to
"
as
scrupulously,
m
pi an
some it
of treatment is followed out not
is
different consultant is called
accepted, and a new and in, or perhaps the aid of a
trial made of some quack heed given to the advice of The fee usually paid to a an old woman or a fnkeer. Some man is lis. 2 per visit. medical native qualified demand and receive Rs. 4, and a very few lis. 8. A a small operation or night visit entitles to double fee. rJbe fgQ system encourages fickleness on the pait of men is not an infrequent clients. A change of medical a consultation is either sugevent. In serious cases a
homoeopath is invoked, or or or irregular practitioner,
the doctor or demanded by the patient or his friends. The consultant may be asked to see the case once or oftener, or several consultants may be summoned together or separately, or both doctor and consultant may be changed, and this may occur or In serepeatedly until the patient recovers dies.
gested by
like to divide the
possessing Indian qualifications,?graduates of the Calcutta Medical College, and licentiates and graduates of the Calcutta University. The municipal returns indicate 64 of this class, but that is certainly an under * estimate. These men are the product of the higher education in medicine resulting from the organization of the Medical College in 1835 by Lord George Bentinck. Many have been in Government employ, and have
rious
retired
of them charges aud receives lis. 1G a visit. We know little of this sphere of practice, but we suspect that a good deal of quacking goes on. Quacking is We have in occult agencies. inseparable from dealing which underin homoeopaths instances two met with
men
or
holding
resigned
offices
; some
at the
are
presidency
still in the ;
the
service,
majority
are
private practitioners pure and simple. All but a tew are Hindus, and they practise almost exclusively among their countrymen. There is keen competition among this class, and there is not much compunction among them about supplanting or superseding each other. Their manner and extent of practice vary immensely. Family practice is here the exception and fee practice the rule. Family practice is mostly confined to wealthy and permanent residents in
medical annum.
with
by
no
means
light.
In serious
or severe
family attendant suggests a consultation European doctoi", which ig in mogt cages readily
the a
a
fee of from Us. 100 to Rs. 300 per When the family is a large one, the work
to be done is cases
Calcutta who engage the services of
man on a
cases
native
ponsibility, a
medical
men
res-
and in cases requiring operation the aid of is almost always sought. There
European Surgeon
homoeopaths among this class. The myshomoeopathy rather commends itself to the
several
are
tery of native mind, and the medicines?save the mark !? cheaper. There are homoeopaths are tasteless and amateur. Some of the quaqualified, unqualified and a do sect large business, and one lified members of the
took, and
on
prepayment of a substantial fee, by infinitesimals. Some practice to
cancer
cure
cataract
homoeo-
conviction. Its refinements and illusions pathy commend themselves -to imaginative and unpractical minds. Others practice it because it pays better than so-called orthodox medicine, and there are a few qualified men who profess both allopathy and homoeopathy, either according to the whim of themselves and from
practice
exceptional, and it is pleasant to record that they prefer the realities and imperfections of rational medicine to the delusions and preor
to
their
patients.
These
cases
the honour of native medical
are
men
THE INDIAN MEDICAL GAZETTE.
216
tended
Still there is not
finality of infinitesimals. practitioners of rational
among abhorrence of transcendental ?with in
medicine
empiricism
tlie
same
Europe America, phases of irregular practice are tolerated in a manner unknown elsewhere. The transitionary state of India as regards medical science and practice is probably accountable for this peculiarity, and perhaps also the milder and more passive nature of the Hindoo. Most of the practitioners of whom we now write have kind
some
of connection with
dispensaries.
They
have a share in their profits, or attend at stated hours to give " advice gratis" to all either
own
them
or
This comers, sharing the profit on the prescriptions. direct or indirect interest in the sale of medicine is prone to abase the profession to the level of a trade, It also and apt also to lead to over medication. encourages the vice of specifics, of which presently. The
qualified
native
practitioners
of Calcutta
are as
body a highly meritorious class. They practice honorably for the good of their patients and scorn deception or extortion. We have found them to be free of the hideous vice of trading on the infirmities and anxieties of humanity, and they accordingly coma
mand the respect and confidence and sometimes the affection of the community. They lead laborious and useful lives.
reputation are
Some of them
and reached
few who do not
earn
livelihood, though here practice may be a period
have
deservedly
and
success
wealth,
a
sufficient and
as
elsewhere the
of strait
earned
and there
comfortable
starting in and struggle. The
frequently called into consultation by the juniors, and though jealousies and enmities exist, there is on the whole a friendly sense of fellowship senior and leaders
are
very numerous, and
not
to their
which is met
and this and other
and
are
[August 1,
Another "
variety
of
our
has
who
student"
failed
nothing
sojourn in Calcutta. unqualified medical practitioner
discredit during
is the
have heard
we
1882-
succeeded
not
has been University examinations, res augustice to discontinue the compelled through
in
the
passing
or
Some men of this class who have gone full curriculum and possess natural ability through Others who and tact, succeed very well in practice. have been careless and idle, neglected hospital work but one or two Sessions in College, and are
his studies. a
spent lacking in intelligence and penetration, are little better than impostors. Many of these men profess homeois more easily learnt and pays better^ pathy, which where and mistakes, if they are possible, are not so readily detected. Regarding the practice of the failed student wo are not in a position to give much information. It is probably very irregular as regards principles and Men of this class
remuneration.
they get.
and not be very
get,
can
Some medical students do
their College
career.
are
apt
to
take what
to how
particular as
little practice
a
The small fees are ready in any
they
they
during
receive
are
difficulty to call in more skilled assistance, they probably do not commit much mischief, though here as in England a
help,
and
as
they
their teachers and to
practise
hakims and
do
seniors who
kobirajs,
not
close
under
unless
encourage them supervision. Tlie
very -wise in
are
interpreting
symptoms, very fluent with traditionary rules and maxims, and very expert in the compounding of strange messes, mineral and
vegetable,
obtain consider-
employment among the more conservative of the Some of them acquire great reputations for natives. able
cholera,
among them.
the treatment of
We now come to the unqualfied practitioners, and of these there is a variety almost defying classification. The term native doctor" i? an elastic one, and may
disease, and amass wealth, Ihey are the surviving representatives of the ancient medical creeds of Hindustan, and are doomed to early extinction ; they are honest and humble in their way, and do not come
include
city
of
men
who have served Government in the capaor who have studied in a
hospital assistant,
vernacular medical vernacular licentiate.
school and
obtained
a
license
as
Both have
undergone systematic instruction in medicine of a limited kind, been examined and furnished with diplomas. They are therefore in a sense qualified, though not according to a very high standard of education or exami-
nation. Many of them are intelligent men, skilful in the management of minor ailments. They practice in a lower sphere than the holders of university degrees and
receive
lower
fees.
Some
of them
have
or
attend small
dispensaries. They frequently act in subordination to superior practitioners, carrying out their directions, applying dressings, &c. They are
unpretending useful class of men, and considerable service to the humbler classes,
an
are
of
They
fevers
or
the
much into contact with whose
medicine in
nothing Finally,
guished rapacity,
manner
common
there
of
or
some
practitioners
thought
and
special
of rational work has
with theirs.
are
the
in Calcutta
quacks
as
and
impostors
distin-
elsewhere by ignorance
and who find in the
credulity
of the
and un-
educated native too easy a field for the exercise of A mong these there is in trickery and extortion. Wellesley Street a curious colony of Madrassees who vaunt themselves by means of glaring signboards as u Professors of piles and fistula." Their treatment consists in the application of strong caustics to the anal verge. The cure is painful but efficacious ; but ugly cicatrices and sometimes atresia are left behind. Such is a rough and superficial sketch of the state of medical practice in Calcutta in the year of grace 1882.
August
There craze
two blemishes which demand
are
namely,
1st?the
for
tendency specifics.
Advertising honourable
or
some
to
advertise,
special notice, and 2nd.?The
does not appear to be accounted disderogatory, and the columns of native
and sometimes
puffs
CURRENT MEDICAL TOPICS.
1, 1882.]
English
papers contain
"
cards" and
of the most
unblushing kind. Unfortunately English practitioners show a bad example in this
respect, and the
that advertising of any sort is not appear to have taken deep hold of the medical profession in India. Perhaps the
feeling
unprofessional does
close association with the drug trade to which we have alluded is responsible for this failure to understand
that what is necessary and becoming in trade is beneath the dignity of a profession. In this respect an elevation of professional tone is desirable. The practice of inventing and proclaiming
is
a more
of
specifics
"
specifics"
serious fault, because it involves in most cases a palpable untruth and partakes of the quack spirit which imposes secret remedies on the public to the advantage of the discoverer and advertiser. No honourable medical man is justified in resorting to the trick these
and secret cures, and the
imposture,
spirit
that
inspires
which are mostly the expedients of is deserving of nothing but the most un-
expedients,
qualified condemnation.
217
?
AUGUST 1, 1882.
MEDICAL
PRACTICE IN CALCUTTA.
A proposal has been made to the Government of the Principal of the Grant Medical College
Bombay by to enact
portion
a Medical .Registration Law similar to that of the English Act which provides for the rc-
THE INDIAN MEDICAL GAZETTE.
214
[August 1,
1882.
is but their aid is also largely sought for purposes of conat present under the consideration of the Government sultation by the practitioners and inhabitants of the town of India. What is good for Bombay in this behalf at large. The annual contract system is almost uniwould also be good for Calcutta and Madras, and per- versally resorted to in family practice ; the contract fee to the station and wealth of the haps for India generally ; and if a law of this sort is varying according The smaller fees, from lis. 100 to Rs. 1,000. patient, or necessary desirable, it ought plainly to be imperial rather than provincial. With a view to discussing in a say below Rs. 300, are paid by bachelors and persons future number the grounds on which the registration of limited means, poor but proud, to whom a special These fees constitute debts of medical qualifications in India generally, or its prin- concession is often made. of honour, and no interchange of bills or formal docuwe be considered advantageous, cipal towns, might ments of any kind passes between doctor and patient. propose now to jot down a few notes regarding the mode in which medical practice is carried on in As debts of honour they are almost invariably promptly For casual services?single visits, Calcutta. It must be that this and fully adjusted.
gistration
of medical
qualifications.
This
proposal
understood, however, apply to India generally.
consultations, &c., the gold mohur (Rs. 16) is the basis less is never accepted, and in special circumstances? doubt in many large towns and centres of population severe illnesses, operations, &c., a liberal honorarium conditions exist very closely resembling those of and given. We Calcutta ; but the capital town is more advanced in founded on this basis is expected men need add that medical to this hardly belonging side of India. this respect than any other place on this
description
The
does not
proportion
of
qualified practitioners
of medicine
class
of
customs
is
?
No
have
interest,
no
direct
or
indirect,
in the sale
drugs,
approximate larger, and their professional A second section of qualified practitioners consists closely to the European type. A rough and of medical men possessing English qualifications who ready classification of medical practitioners into qualihave settled as private practitioners in Calcutta. fied and unqualified at once suggests itself. The records of the Municipal Office indicate that, in These belong to various nationalities, European, Asian, and mixed, and their practice is of a varied description. 1881, 81 of the former and 43 of the latter applied for with medical officers licenses to practise. These figures probably fall consi- Some few practise on a level labour among and on The similar terms. majority derably short of the actual number of practitioners of and less liberal in classes less in circumstances easy each class ; and as the unqualified are more likely to obtains also in evade taxation than the qualified, the proportion is also ideas. The annual contract system contract fee is smaller, the of but this not be far from sphere practice, in all probability wrong. It would 300. The Rs. Rs. to 50 from single fee for the mark to reckon one hundred as the probable num- ranging more
ber of each class. one
medical
This would
practitioner
to
give
proportion
a
every thousand
of
inhabitants,
The qualified practiwhich appears a liberal supply. tioners are divisible into three categories. 1st, Officers of the Indian medical service stationed at the
presidenThe cy who enjoy the privilege of private practice. number of these does not undergo much change, nor is there much probability of an increase of them in the future. The policy of Government has been rather to diminish
they and
than
add
to
their
number.
There
8 of this class stationed in Calcutta.
now
are are
attached to hospitals and medical schools, available for attendance on Government who
servants
for such
are
Officially
public
are
entitled to
duties
as
their
services,
and
members of committees and
boards, visitors of public institutions, &c., as may be assigned to them. As a body, selected from the whole
service for
special and important medical enjoying special advantages in the way of gaining knowledge, experience and skill, they have work,
always
and
constituted
the leaders of the
profession
in
Their practice lies mostly among the European inhabitants, official and non-official, of the town ; Calcutta.
is
casual services
also
more
moderate, perhaps
on
the average one-half of what is paid to the first class. Practitioners of this class lead very laborious lives. Depending entirely on their earnings in prac-
tice, subject often to groundless or fanciful calls, undergoing a large amount of ill requited or unrequited toil, their time never their own, they find their profession a very exacting and not very liberal task master. Still with clcse attention to work and steadiness a competence if not a moderate fortune can
comfortable be made
by
the
unofficial medical practitioner, and
that this class of medical men is not Few of this section have a direct more numerous. interest in the sale of drugs, but many of them
the wonder is
attend
in the
shops
of
share of the
profit
on
comers a
the
of practitioners includes men
"
advice gratis" to all give the guerdon being ts, druggis
at stated hours to
who,
as
far in
as
a
we
prescriptions.
limited are
This section
number of medical
aware, have
English practice.
no
exact
We allude
to representative salaried some of the by English Surgeons qualified leading European firms of druggists whose duty it is to see, examine and prescribe for all persons applying
August
or
medical relief of
being
MEDICAL PRACTICE IN CALCUTTA.
1, 1882.]
constitutes
the
on
premises
;
the
prescriptions
made up in the establishment.
course
This
superior kind of counter practice, and really a private dispensary ministered
a
the institution is to
qualified and often skilful doctor. The public largely of this system, and in simple cases, requiring deep and close study or prolonged treat-
by
a
215
conceded. The doctor consulted examines the case* writes his prescription or delivers his opinion, and receives his fee. In wealthy families this consultation maybe repeated daily or oftener for a long period if the one consultant may be or more than case is
avails itself
urgent, summoned ; sometimes
not
The selection of the consultant may
ment, the system is convenient, safe and efficient. The medical men employed in this way are of good stamp, and when a case cannot be done justice to at
speak, they do not hesitate to advise the hospital or consulting room. The objecadvice gratis" tionable feature in the matter is the element which robs the higher medical talent required for diagnosis, prognosis, and prescription of value, and makes remuneration depend on the material sold in the shop. No doubt the price charged is a fancy one, and includes the advice as well as the drug, but the subthe
counter,
so
to
ordination of
professional
purely
purposes of trade
so
overtly
men
is
and work
objectionable
to
The
system also must interfere with the .practice of the general practitioner. The charging for medicines instead of medical attendance is
one
blots of
of the
system has been established in a much more pronounced form. Still it is right to add that the Calcutta public would not willingly lose this source of medical aid in small
English practice.
Here the
same
emergencies. The third section of
qualified
medical
men
comprises
as
many
four
depend
or
on
five.
previ-
acquaintance, more frequently on the nature of 'the professor of medicine being called to a medical case, of surgery to a surgical, of obstetrics, to
ous
the case, a
midwifery. In most cases the
resort to
"
as
scrupulously,
m
pi an
some it
of treatment is followed out not
is
different consultant is called
accepted, and a new and in, or perhaps the aid of a
trial made of some quack heed given to the advice of The fee usually paid to a an old woman or a fnkeer. Some man is lis. 2 per visit. medical native qualified demand and receive Rs. 4, and a very few lis. 8. A a small operation or night visit entitles to double fee. rJbe fgQ system encourages fickleness on the pait of men is not an infrequent clients. A change of medical a consultation is either sugevent. In serious cases a
homoeopath is invoked, or or or irregular practitioner,
the doctor or demanded by the patient or his friends. The consultant may be asked to see the case once or oftener, or several consultants may be summoned together or separately, or both doctor and consultant may be changed, and this may occur or In serepeatedly until the patient recovers dies.
gested by
like to divide the
possessing Indian qualifications,?graduates of the Calcutta Medical College, and licentiates and graduates of the Calcutta University. The municipal returns indicate 64 of this class, but that is certainly an under * estimate. These men are the product of the higher education in medicine resulting from the organization of the Medical College in 1835 by Lord George Bentinck. Many have been in Government employ, and have
rious
retired
of them charges aud receives lis. 1G a visit. We know little of this sphere of practice, but we suspect that a good deal of quacking goes on. Quacking is We have in occult agencies. inseparable from dealing which underin homoeopaths instances two met with
men
or
holding
resigned
offices
; some
at the
are
presidency
still in the ;
the
service,
majority
are
private practitioners pure and simple. All but a tew are Hindus, and they practise almost exclusively among their countrymen. There is keen competition among this class, and there is not much compunction among them about supplanting or superseding each other. Their manner and extent of practice vary immensely. Family practice is here the exception and fee practice the rule. Family practice is mostly confined to wealthy and permanent residents in
medical annum.
with
by
no
means
light.
In serious
or severe
family attendant suggests a consultation European doctoi", which ig in mogt cages readily
the a
a
fee of from Us. 100 to Rs. 300 per When the family is a large one, the work
to be done is cases
Calcutta who engage the services of
man on a
cases
native
ponsibility, a
medical
men
res-
and in cases requiring operation the aid of is almost always sought. There
European Surgeon
homoeopaths among this class. The myshomoeopathy rather commends itself to the
several
are
tery of native mind, and the medicines?save the mark !? cheaper. There are homoeopaths are tasteless and amateur. Some of the quaqualified, unqualified and a do sect large business, and one lified members of the
took, and
on
prepayment of a substantial fee, by infinitesimals. Some practice to
cancer
cure
cataract
homoeo-
conviction. Its refinements and illusions pathy commend themselves -to imaginative and unpractical minds. Others practice it because it pays better than so-called orthodox medicine, and there are a few qualified men who profess both allopathy and homoeopathy, either according to the whim of themselves and from
practice
exceptional, and it is pleasant to record that they prefer the realities and imperfections of rational medicine to the delusions and preor
to
their
patients.
These
cases
the honour of native medical
are
men
THE INDIAN MEDICAL GAZETTE.
216
tended
Still there is not
finality of infinitesimals. practitioners of rational
among abhorrence of transcendental ?with in
medicine
empiricism
tlie
same
Europe America, phases of irregular practice are tolerated in a manner unknown elsewhere. The transitionary state of India as regards medical science and practice is probably accountable for this peculiarity, and perhaps also the milder and more passive nature of the Hindoo. Most of the practitioners of whom we now write have kind
some
of connection with
dispensaries.
They
have a share in their profits, or attend at stated hours to give " advice gratis" to all either
own
them
or
This comers, sharing the profit on the prescriptions. direct or indirect interest in the sale of medicine is prone to abase the profession to the level of a trade, It also and apt also to lead to over medication. encourages the vice of specifics, of which presently. The
qualified
native
practitioners
of Calcutta
are as
body a highly meritorious class. They practice honorably for the good of their patients and scorn deception or extortion. We have found them to be free of the hideous vice of trading on the infirmities and anxieties of humanity, and they accordingly coma
mand the respect and confidence and sometimes the affection of the community. They lead laborious and useful lives.
reputation are
Some of them
and reached
few who do not
earn
livelihood, though here practice may be a period
have
deservedly
and
success
wealth,
a
sufficient and
as
elsewhere the
of strait
earned
and there
comfortable
starting in and struggle. The
frequently called into consultation by the juniors, and though jealousies and enmities exist, there is on the whole a friendly sense of fellowship senior and leaders
are
very numerous, and
not
to their
which is met
and this and other
and
are
[August 1,
Another "
variety
of
our
has
who
student"
failed
nothing
sojourn in Calcutta. unqualified medical practitioner
discredit during
is the
have heard
we
1882-
succeeded
not
has been University examinations, res augustice to discontinue the compelled through
in
the
passing
or
Some men of this class who have gone full curriculum and possess natural ability through Others who and tact, succeed very well in practice. have been careless and idle, neglected hospital work but one or two Sessions in College, and are
his studies. a
spent lacking in intelligence and penetration, are little better than impostors. Many of these men profess homeois more easily learnt and pays better^ pathy, which where and mistakes, if they are possible, are not so readily detected. Regarding the practice of the failed student wo are not in a position to give much information. It is probably very irregular as regards principles and Men of this class
remuneration.
they get.
and not be very
get,
can
Some medical students do
their College
career.
are
apt
to
take what
to how
particular as
little practice
a
The small fees are ready in any
they
they
during
receive
are
difficulty to call in more skilled assistance, they probably do not commit much mischief, though here as in England a
help,
and
as
they
their teachers and to
practise
hakims and
do
seniors who
kobirajs,
not
close
under
unless
encourage them supervision. Tlie
very -wise in
are
interpreting
symptoms, very fluent with traditionary rules and maxims, and very expert in the compounding of strange messes, mineral and
vegetable,
obtain consider-
employment among the more conservative of the Some of them acquire great reputations for natives. able
cholera,
among them.
the treatment of
We now come to the unqualfied practitioners, and of these there is a variety almost defying classification. The term native doctor" i? an elastic one, and may
disease, and amass wealth, Ihey are the surviving representatives of the ancient medical creeds of Hindustan, and are doomed to early extinction ; they are honest and humble in their way, and do not come
include
city
of
men
who have served Government in the capaor who have studied in a
hospital assistant,
vernacular medical vernacular licentiate.
school and
obtained
a
license
as
Both have
undergone systematic instruction in medicine of a limited kind, been examined and furnished with diplomas. They are therefore in a sense qualified, though not according to a very high standard of education or exami-
nation. Many of them are intelligent men, skilful in the management of minor ailments. They practice in a lower sphere than the holders of university degrees and
receive
lower
fees.
Some
of them
have
or
attend small
dispensaries. They frequently act in subordination to superior practitioners, carrying out their directions, applying dressings, &c. They are
unpretending useful class of men, and considerable service to the humbler classes,
an
are
of
They
fevers
or
the
much into contact with whose
medicine in
nothing Finally,
guished rapacity,
manner
common
there
of
or
some
practitioners
thought
and
special
of rational work has
with theirs.
are
the
in Calcutta
quacks
as
and
impostors
distin-
elsewhere by ignorance
and who find in the
credulity
of the
and un-
educated native too easy a field for the exercise of A mong these there is in trickery and extortion. Wellesley Street a curious colony of Madrassees who vaunt themselves by means of glaring signboards as u Professors of piles and fistula." Their treatment consists in the application of strong caustics to the anal verge. The cure is painful but efficacious ; but ugly cicatrices and sometimes atresia are left behind. Such is a rough and superficial sketch of the state of medical practice in Calcutta in the year of grace 1882.
August
There craze
two blemishes which demand
are
namely,
1st?the
for
tendency specifics.
Advertising honourable
or
some
to
advertise,
special notice, and 2nd.?The
does not appear to be accounted disderogatory, and the columns of native
and sometimes
puffs
CURRENT MEDICAL TOPICS.
1, 1882.]
English
papers contain
"
cards" and
of the most
unblushing kind. Unfortunately English practitioners show a bad example in this
respect, and the
that advertising of any sort is not appear to have taken deep hold of the medical profession in India. Perhaps the
feeling
unprofessional does
close association with the drug trade to which we have alluded is responsible for this failure to understand
that what is necessary and becoming in trade is beneath the dignity of a profession. In this respect an elevation of professional tone is desirable. The practice of inventing and proclaiming
is
a more
of
specifics
"
specifics"
serious fault, because it involves in most cases a palpable untruth and partakes of the quack spirit which imposes secret remedies on the public to the advantage of the discoverer and advertiser. No honourable medical man is justified in resorting to the trick these
and secret cures, and the
imposture,
spirit
that
inspires
which are mostly the expedients of is deserving of nothing but the most un-
expedients,
qualified condemnation.
217
