and dislocations, to say nothing of the quacks known as "bonesetters," whose success, as has been confessed to me by a surgeon, is often greater than that of men belonging to his own authorized class.
In conformity with the normal order of evolution, integration has accompanied this differentiation. From the beginning have been shown tendencies toward unions of those who practiced the healing art. There have arisen institutions giving a certain common education to them; associations of those whose kinds of practice were similar; and, in later times, certain general, though less close, associations of all medical men. In Alexandria—
In Rome, along with the imported worship of Æsculapius, there went the communication of knowledge in the places devoted to him. During early mediæval times the monasteries, serving as centers of instruction, gave some embodiment to the medical profession, like that which our colleges give. In Italy there later arose institutions for educating physicians, as the medical school of Salerno in 1140. In France before the end of the thirteenth century the surgeons had become incorporated into a distinct college, following, in this way, the incorporated medical faculty; and while thus integrating themselves they excluded from their class the barbers who, forbidden to perform operations, were allowed only to dress wounds, etc. In our own country there have been successive consolidations. The barber-surgeons of London were incorporated by Edward IV, and in the fifteenth century the College of Physicians was founded, and "received power to grant licenses to practice medicine—a power which had previously been confined to the bishops" Progress in definiteness of integration was shown when, in Charles I's time, persons were forbidden to exercise surgery in London and within seven miles, until they had been examined by the company of barbers and surgeons; and also when, by the 18th of George II, excluding the barbers, the Royal College of Surgeons was formed. At the same time there have grown up medical schools in various places which prepare students for examination by these incorporated medical bodies: further integrations being implied. Hospitals, too, scattered throughout the kingdom, have become places of clinical instruction, some united to colleges and some not. Another species of integration has been achieved by medical journals, weekly and quarterly, which serve to bring into communication educational institutions, incorporated bodies, and the whole profession.
