Such is the perversity of our nature, that the remuneration given with the greatest reluctance is the reward of those who restore us, or who conscientiously endeavour to restore us to health. The daily fees, it is true, are not handed with regret, for the patient is still suffering; but if they were to be allowed to accumulate to a considerable amount, they would be parted with, with a lingering look. The lawyer’s charges for a ruinous litigation, the architect’s demands for an uncomfortable house, are freely disbursed, though if exorbitant they may be taxed; but the doctor’s—a guinea a visit!—is sheer extortion. ‘Send for the apothecary: the physician merely gives me advice; the apothecary will send me plenty of physic: at any rate I shall have something for my money.’

To what can this unjust, this illiberal feeling be attributed? Simply to vanity and pride. Illness and death level all mankind. The haughty nobleman, who conceives himself contaminated by vulgar touch, can scarcely bring himself to believe that he is placed upon the same footing as a shoe-black. All prestiges of grandeur and worldly pomp vanish round the bed of sickness; and the suffering peer would kneel before the humblest peasant for relief. Then it is that money would be cheerfully lavished to mitigate his sufferings. But how soon the scene is changed! The patient is well, thrown once more in the busy vortex of business or of pleasure. He had been slightly indisposed; his natural constitution is excellent: the doctors mistook his case; thought him very ill, forsooth; but nature cured him.

Could the ambitious mother admit for one moment that her daughter had been seriously ill?—a sick wife is an expensive article! If her medical attendant unfortunately hinted that the young lady had been in danger, he is considered a busy old woman, exaggerating the most trifling ailment to obtain increase of business; in fact, a dangerous man in a family where there are young persons—to be provided for. Nor can we marvel at this. No one likes to be considered morally or physically weak, excepting hypochondriacs, who live upon groans, and feel offended if you tell them that they do not look miserable. The soldier will describe the slightest wound he received in battle as most severe and dangerous; a feeling of pride is associated with the relation. The bold hunter will boast of a fractured limb; the accident showed that he was a daring horseman. Nay, the agonizing gout is a fashionable disease, which seems to proclaim good living, good fellowship, and luxury: it is, in short, a gentlemanly disease. But the slow ravages of hereditary ailments, transmitted from generation to generation with armorial bearings, the development of which may be averted by proper care, or hurried on by fashionable imprudence! how difficult even to hint to a family the presence of the scourge, when, through the transparent bloom of youth and beauty, our experienced eye reads the fierce characters of death in the prime of years. The aerial coronet floats in fond visions before the doting mother’s ambitious eyes. A man would be a barbarian, nay, a very brute, to deprive the darling girl of the chances of Almacks, the delights of the pestiferous ball-room, or the galaxy of court or opera!

To attend the great is deemed the first stepping-stone to fortune, and patronage is considered as more than an equivalent of remuneration. Too frequently does the physician placed in that desirable situation forget what Hippocrates said of the profession. “The physician stands before his patient in the light of a demi-god, since life and death are in his hands.”

Curious anecdotes are related of this unbecoming subserviency. A courtly doctor, when attending one of the princesses, was asked by George III. if he did not think a little ice might benefit her. “Your majesty is right,” was the reply; “I shall order some forthwith.” “But perhaps it might be too cold,” added the kind monarch. “Perhaps your majesty is right again; therefore her royal highness had better get it warmed.”

This absurd deference to rank and etiquette by a physician who at the moment is superior to all around him, reminds one of an account given by Champfort of a fashionable doctor. “D’Alembert was spending the evening at Madame Du Deffand’s, where were also President HÉnault and M. Pont de Vesle. On this flexible physician’s entering the room, he bowed to the lady with the formal salutation, ‘Madame, je vous prÉsente mes trÈs humbles respects.’ Then, addressing M. HÉnault, ‘J’ai bien l’honneur de vous saluer.’ Turning round to M. de Vesle he obsequiously said, ‘Monsieur, je suis votre trÈs humble serviteur;’ and at last, condescending to speak to D’Alembert, he nodded to him with a ‘Bonjour, Monsieur!’” On such occasions a condescending smile from power is considered a fee.

Reluctance in remunerating medical attendants was also manifested by the ancients; and Seneca has treated the subject at some length. The difficulty in obtaining remuneration has unfortunately rendered many physicians somewhat sordid, and loth to give an opinion unless paid for. In this they are unquestionably right, as gratuitous advice is seldom heeded; and one of the most distinguished practitioners used to say, that he considered a fee so necessary to give weight to an opinion, that, when he looked at his own tongue in the glass, he slipped a guinea from one pocket into another.

To consider themselves in proper hands, patients must incur expenses, and as much physic as possible be poured down. Malouin, physician to the Queen of France, was so fond of drugging, that it is told of him, that once having a most patient patient, who diligently and punctually swallowed all the stuff he ordered, he was so delighted in seeing all the phials and pill-boxes cleaned out, that he shook him cordially by the hand, exclaiming, “My dear sir, it really affords me pleasure to attend you, and you deserve to be ill.” Our apothecaries must surely meet with incessant delight!

The most extraordinary remuneration was that received by Levett, Dr. Johnson’s friend and frequent companion. It was observed of him that he was the only man who ever became intoxicated from motives of prudence. His patients, knowing his irregular habits, used frequently to substitute a glass of spirits for a fee; and Levett reflected that if he did not accept the gin or brandy offered to him, he could have been no gainer by their cure, as they most probably had nothing else to give him. Dr. Johnson says “that this habit of taking a fee in whatever shape it was exhibited, could not be put off by advice or admonition of any kind. He would swallow what he did not like, nay, what he knew would injure him, rather than go home with an idea that his skill had been exerted without recompence; and had his patients,” continues Johnson, “maliciously combined to reward him with meat and strong liquors, instead of money, he would either have burst, like the dragon in the Apocrypha, through repletion, or been scorched up, like Portia, by swallowing fire.” But though this worthy was thus rapacious, he never demanded any thing from the poor, and was remarked for his charitable conduct towards them.

Various professional persons have sometimes endeavoured to remunerate their medical attendants by reciprocal services: thus an opera-dancer offered to give lessons to a physician’s daughters for their father’s attendance upon him; and a dentist has been known to propose to take care of the jaws of a whole family to liquidate his wine bill. One of the wealthiest merchants of Bordeaux wanted to reduce the price of a drawing-master’s lessons, on the score of his taking his children’s daubs with him to sell them on account. This arrangement, however, did not suit the indignant artist, who left the Croesus in disgust.

A singular charge for medical attendance was lately brought before the court of requests of Calcutta, by a native practitioner. He demanded 314 rupees for medicine alone, and in the items of drugs appeared pearls, gold leaf, and monkeys’ navels!

In one of the old French farces there is an absurd scene between Harlequin and his physician. The motley hero had been cured, but refused to remunerate his Esculapius, who brought an action for his fees, when Harlequin declares to the judge that he would rather be sick again; and he therefore offers to return his health to the doctor, provided he would give him back his ailments, that each party might thus recover their own property. This incident was perhaps founded on an ancient opinion of Hippocrates, who frequently mentioned salutary diseases. In 1729, a Dr. Villars supported a thesis on this subject, entitled “Dantur-ne morbi salutares?” and Theodore Van Ween has also written a learned dissertation on the same subject.

A celebrated Dublin surgeon was once known to give a lesson of economy to a wealthy and fashionable young man remarkably fond of his handsome face and person. He was sent for, and found the patient seated by a table, resting his cheek upon his hand, whilst before him was displayed a five-pound note. After some little hesitation he removed his hand, and displayed a small mole on the cheek. “Do you observe this mark, doctor?”—“Yes, sir, I do.”—“I wish to have it removed.”—“Does it inconvenience you?”—“Not in the least.”—“Then why wish for its extirpation?”—“I do not like the look of it.”—“Sir,” replied the surgeon, “I am not in the habit of being disturbed for such trifles; moreover, I think that that little excrescence had better remain untouched, since it gives you no uneasiness; and I make it a rule only to take from my patients what is troublesome to them.” So saying, he took the five-pound note, slipped it into his pocket, and walked out of the room, leaving the patient in a state of perfect astonishment.

It is related of a physician who received his daily fee from a rich old miser, who had it clenched in his fist when he arrived, and turned his head away when he opened his hand for the doctor to take it, that, on being informed his patient had died in the morning, not in the least disconcerted he walked up to the dead man’s chamber, and found his clenched fist stretched out as usual; presuming that it still grasped the accustomed remuneration, with some difficulty he opened the fingers, took out the guinea, and departed.

The Egyptian physicians of old were paid by the state, but they were not prevented from accepting remuneration from individuals, and they were allowed to make demands for their attendance except on a foreign journey, and during military services.

When we compare the value of money it appears probable that the fees of olden practitioners were more considerable than the remuneration of the present day. Attendance upon royalty and the court seems also to have been more profitable. Dr. Radcliffe says, that he received from King William 200l. a year more than any other physician in ordinary—this monarch upon his appointment, gave him moreover, 500 guineas out of the privy purse for his attendance on the Earl of Portland, and the Earl of Rochford. When the same physician went to Hanau to attend Lord Albemarle, he received 1200l. from the king, with 400 guineas from his patient, besides a valuable diamond ring.

Dr. Radcliffe’s fortune must have been considerable, as appears from his legacies, bequeathing 5000l. for the improvements of University College—4000l. for the building of a library at Oxford—and 500l. yearly for the amelioration of the diet of St. Bartholomew’s hospital. Radcliffe had not been a year in London when he received 20 guineas daily, and he mentions that his fee for a visit from Bloomsbury Square to Bow, was five guineas.

We do not exactly know what was the exact honorarium of Doctors in former days, yet Baldwin Hammey informs us that in 1644, Dr. Robert Wright who had only been settled three years in London, was in the habit of receiving a thousand broad pieces (22 shillings) in the course of the year.

The following is a curious account of a puritan’s consultation with Dr. Hammey.

“It was in the time of the civil wars when it pleased God to visit him with a severe fit of sickness, or peripneumonia, which confined him a great while to his chamber, and to the more than ordinary care of his tender spouse. During this time he was disabled from practice; but the very first time he dined in his parlour afterwards, a certain great man in high station came to consult him on an indisposition—(ratione vagi sui amoris,) and he was one of the godly ones too of those times. After the doctor had received him in his study, and modestly attended to his long religious preface, with which he introduced his ignominious circumstances, and Dr. Hammey had assured him of his fidelity, and gave him hopes of success in his affair, the generous soldier (for such he was) drew out of his pocket a bag of gold and offered it all at a lump to his physician. Dr. Hammey, surprised at so extraordinary a fee, modestly declined the acceptance of it; upon which the great man, dipping his hand into the bag himself, grasped up as much of his coin as his fist could hold, and generously put it into the doctor’s coat-pocket, and so took his leave. Dr. Hammey, returned into his parlour to dinner, which had waited for him all that time, and smiling (whilst his lady was discomposed at his being absent so long), emptied his pocket into her lap. This soon altered the features of her countenance, who telling the money over, found it to be thirty-six broad pieces of gold: at which she being greatly surprised, confessed to the doctor that surely this was the most providential fee he ever received; and declared to him that during the height of his severe illness, she had paid away (unknown to him) on a state levy towards a public supply, the like sum in number and value of pieces of gold; lest under the lowness of his spirits, it should have proved a matter of vexation, unequal to his strength at that time to bear; which being thus so remarkably reimbursed to him by Providence, it was the properest juncture she could lay hold on to let him into the truth of it.” It has been supposed, that the sanctimonious sufferer was no other than Ireton, Cromwell’s son-in-law.

During the imprisonment of Dr. Friend in the tower, Dr. Head attended his patients, and on his liberation he presented him with 5000l. the amount of the fees received on his account. Dr. Meade’s practice averaged from 5000l. to 6000l. per annum. It is somewhat strange, that this celebrated physician whose evenings were generally spent in convivial meetings at Batson’s Coffee-house, used in the forenoon to receive consulting apothecaries at a tavern near Covent-garden, prescribing for the patients without seeing them at half-a-crown fee.