The Milan exchange. (Milan, Gibson County, Tenn.) 1874-1978, 1874-08-20
London Physicians.

The London correspondent of the Gin
cinuati Clinic writes: The readers of the
Clinic may be interested in details regard
ing the figure cut in the world by Lon
don doctor.
The dining-room-thef first room entered |
from the hall on the ground floor of
London hOuse-iS universally, believe,
used as a reception room for patients, and
a smaller room at the end of the hall. as a
consultation apartment. All London
physicians have butler or fOOlman in
livery, in attendance. Some of the SER
wants occupy very confidential position,
and make engagements for the doctor.
DIR. Gull'S man is said to be especially ex-
pert in pressing visitors with the great inn
pOrtance of his master, and he makes tn
engagements for the visits days and weeks
in advance. The anxious patient may ap-
peal for an immediate interview, for an
earlier appointment, but the memorable
attendant says it is impossible. that Sn
William cannot be disturbed, that the
time named is the earliest period at which
he can be seen. Sir William Gull's man is
said TO be well trained, and it is even hint
ed that anxious patients are sent labori-
Ously away, when Sir William Gull is
only taking his morning cigar or Willing
away tedious hour with the last new
novel; but this is obviously a SANDER,
originating with enViOus and less success
ful doctors. But it is certainly true, that
the difficulty of seeing Sir William Gull
only enhances the desire of his patients to
procure his serviceS-an illustration of the
social law, that men prize most that which
is most difficult of attainment.
A successful London doctor observes
the same state on his rounds through the
city as in his office. Driving wretched
horse i'll a perishing buggy, or trundling
along in an omnibus, or aiding his strength
with an occasional pull in hanson or
cub, does not suffice for the needs of
London consultant. He rides in
brOugham or clarence carriage, his coach
man in livery, his fOOtman on the box.
The great man is rolled up to the door OF |
the mansion, he sits majestic until the
Mercury on the box has dismOunted and /
opened the door of the carriage, and then, /
without haste or any impairment of dig .
niied demeanOr, he steps on the pavement. /
All this, which may appear unmeaning /
parade, is perfectly consistent with |
English notions of the fitness Of
things, and is in entire harmony with the |
social uSages of London. The younger |
men ride in brOugham drawn by one /
horse and driven by a liveried cOachman, /
but unattended by the fOOtman. 1t was /
recently made serious charge by a Lon /
don medical journal, that DemOnstr tor /
of Anatomy in one of the London medical |
schools was seen riding in his brougham |
with kid gloves on at noon. Such eccen /
trIc conduct as this was supposed to be the /
reason who so many candidates for the re-
cent fellowship examination of the Royal |
College of surgeons had been plucked or |
failed to pass.
The state which must be observed by the |
London doctor cannot be maintained with |
out a certain income. Hence it is that for |
years his life is one of continual toll and /
anxiety. The number of people who Can /
afford to pay guinea fee is not very large /
relatively, even in so rich a city as Lon
don; and Englishmen are educated TO a
keen sense of values. The ordinary con-
sulting fee is guinea-equal TO six dol |
lars. nearly and for a visit twice that |
sum. Sir VIM. Gull, Sir VIM. Jenner, and |
probably a few Others, have advanced their /
fees recently, and now charge two guineas /
for the office consultation. As the money /
is paid at the time, and as there are no |
losses and commissions for collection, it Is /
obvious that a very satisfactory income /
may be made from a few patients each |
day. OF course, the surgeons get, very |
often, much larger fees than those named .
above, which are the rates for ordinary |
consultation visits. Important operations |
Justify, as is the rule everywhere, very |
much larger fees-the amount being de-
pendent on the circumstances OF the pa
tent and the time and skill involved. As |
Sir Benjamin Brodie once remarked. the |
large professional income is not made
from large fees, which are in the nature OF |
things exceptional, but from the continue d |
dropping into the purse OF small ones. L
have been informed by those who are in a |
position to know that few London pro-
fessiOnal incomes reach 100000 (abOuI
500, 000). The latter figure is rarely ex-
ceeded, even in London. There is no |
doubt the great physicians and surgeons |
of New York make much larger incomes. |
An illustration of this fact was /
afforded me very recently in the expe |
rience of gentleman who had |
consulted DR.. Austin Flint, Sr., in New |
York and Sir James Paget, in London. |
The fee of the former was twenty-five dol |
lars, and of the latter tive guine;ls, or about
twelve dollars There is little doubt that |
DIR. Flint also sees a much larger number
OF patients than Sir James Paget.
L alluded in my last letter 10 the fact that
the creation of Sir William Gull a Baronet
was well received by the aristOcracy. Bul
the medical Baronets are, as a rule, looked
on with cOldness and not unfrequently
with derision by the privileged classes.
They smell of the shop. They are also
compelled to stick to the shop TO build up
the fortune necessary TO maintain the dig
nity of their descendants in their hereditary
rank. One may see Oh their doors the title
duly engraved on a brass plate; for exam
pie: Sir William Jenner, Bart. This is a
very important stock of trade, and not only
brings griSt TO The mill. but furnishes a
reason for massive fees. 1t requires sever
al generations for the baronets of medical
| origin to be purified of the odors emana-
ting from the shop.
was curious TO know the history of
some of the sons of medical baronets Gre
ated during this century. The present Sir
Ashley Cooper, son ut the great surgeon,
makes no figure in the world, and indeed
cannot, for his only occupation consists in
maintaining the family dignity on the
/ gains Of his father. Very different has
been the career of the present Sir Benjamin
| Brodie, son of the surgeon with whose
name and surgical achievements we are all
/ so familiar After a very distinguished
career at the University, the present Sir
/ Benjamin Brodie was appointed Professor
of Chemistry at Oxford. in which science
I he has made important researches. Owing
/ TO impaired health he has lately retired
/ from his professional duties, and is now
living quite eunostentatiouslya at his country
I seat
/ The notifications to which new-made
| baronets are exposed, and the social re
straints which so interfere with the intel
/ lectual activity of the privileged classes,
/ have rendered many eminent medical men
/ quite Indifferent or indeed opposed to en-
! tering the tilted ranks when the Opportun-
| ity has been offered them.