« AnteriorContinuar »
Wherefore, being not at leisure to frame Utopia's, we shall only speak of the number and salary of ministers, the time of their service, with their qualifications in general, and duties in particular, which are to be employed in this nosocomium academicum.
The nosocomium, being fitted with all manner of necessaries, shall be overseen by three or four curators, men of learning, honour, and worth, such as shall, out of charity, and goodwill to the publick, perform this trust, who are to be protectors and chancellors thereof, as also auditors of the steward's accounts.
Besides these, there shall be a mathematician for steward, a physician, surgeon, and apothecary, each well versed, both in the theory and practice, of their respective professions. A young physician, capable at least of the degree of doctor, who may be called the vicephysician, and another of about five or six years standing in the university, who may be called the student. There should be also a surgeon and an apothecary, who have served their apprenticeships in the said faculties, called the surgeon's and apothecary's mate, with two other young men, the one to serve the surgeon, and the other the apothecary, all understanding, at least, the Latin tongue, which may be called the apprentices. All these are to be chosen, at first, by the curators, but afterwards by the society itself, being such as they shall be certified are pious, ingenious, laborious, lovers of knowledge, and particularly of the faculty of physick, courteous, not covetous; and lastly, such amongst whom there may be an harmony of natures and studies, so as all fear of discords, envy, and emulation may be taken away. There ought also to be entertained as many honest, careful, ancient widows, to serve as nurses to the sick, as will be proportionable to their number, some whereof are to be ordinary, and some extraordinary, whereof the latter may be taken in, and dismissed again, as occasion of their help requires.
There should be allowed out of the revenues of the hospital to the aforenamed ministers, besides their diets, house-room, washing, firing, &c. and exemption from all taxes and employments in the commonwealth, the several sums following, viz.
To the steward
To the physician
To the vice-physician
To the surgeon & apothec. each 60 > £ per An.
To the student '"'
To the surgeon & apothec. mate
To each of the apprentices
To each ordinary nurse To an extraordinary by the week 3 shillings.
It should be granted by the state, that whosoever hath served hi* respective time in the nosocomium,-and hath a certificate thereof from the society, shall be thereby licensed to practise his profession in any place or corporation whatsoever, notwithstanding any former law to the contrary.
The steward shall not be obliged to stay any longer, than from year to year. Each of the faculty of physick may serve five years in each degree thereof, each of the surgeons and apothecaries but four.
These circumstances being premised, we now come to the very essence of the whole business; that is, to the description of each of the aforesaid ministers, their particular duty and function, which are as follow, viz.
The steward shall be a man of approved honesty, able to give order for all reparations about the house, garden, &c. to agree and bargain with workmen, and all that shall serve in any commodities into the house; he is to receive and pay all monies, and submit the accounts thereof to the whole society, and they again to the curators. For which, and other like duties, he ought to be skilled in mathematicks; chiefly in arithmetick and keeping accounts; measuring of land, timber, board, architecture, frugal contrivances, and the like. But, as to the advancement of physick, we desire he may be skilled in the best rules of judicial astrology, which he may apply to calculate the events of diseases, and prognosticate of the weather; to the end that, by his judicious and careful experiments, the wheat may be separated from the chaff in that faculty likewise; and what is good therein may be applied to good uses, and the rest exploded. He shall keep a journal of all notable changes of weather, and fertility of seasons, taking notice what fruits, &c. have abounded,and what have failed; which have been good, and which bad, with the reasons thereof, whether the same were caused by mildews, blasts, unseasonable weather, caterpillars, or other vermin; he shall take notice of the several diseases, as staggers, murrain, rot, &c. which, in each year, have infested each species of animals, and what insects have most abounded; all which particulars, with the epidemical diseases befalling man, he may compare with the aspects of the celestial bodies, and so examine the precepts delivered unto us by the professors of that art.
The physician must be a philosopher, skilled at large in the phenomena of nature; must understand the Greek tongue, be well read in good authors, and seen in the practice of all the ministrant parts of physick, willing to instruct and forward all that are under him: his work shall be twice every day deliberately to visit and examine all the sick, and, after due consideration of their condition, to prescribe them convenient medicines; and shall dictate, in Latin, to the vice-physician attending him, the history of their several diseases, excluding impertinencies; he shall see all patients in outward griefs (to whom he administreth any inward remedies) opened and dressed every now-and-then, to the end that himself and the surgeon may both have the same intention and scope in their practice. He must take care that the surgeon and student keep the history of their cures likewise, and that the apothecary and student do the same in their pharmacy and botanicks. He shall oversee the dispensation of all compound, and preparation of all chymical medicaments, giving the apothecary directions for the making of new enquiries and experiments in his way; and likewise to the surgeon and the rest, in theirs, when he seeth them not otherwise employed. In brief, he shall have an iufluence upon all the rest, and all the rest reciprocally upon him, so that he being made acquainted with all the histories taken in the hospital, laboratory, anatomical chamber, garden, &c. may give the reason of the most notable phenomena happening in either of them. All which he shall commit to writing, and, out of them, by the end of the term of his service, shall collect a system of physick, and the most approved medicinal aphorisms; taking notice by the way, where those of Hippocrates are deficient or true, and by how many several experiments he hath so found them. He shall either dissect, or overlook the dissection of bodies dying of diseases; and, lastly, shall take care that all luciferous experiments whatsoever may be carefully brought to him, and recorded for the benefit of posterity.
The vice-physician's proper charge is to see the history of the patient most exactly and constantly kept. He may now-and-then read some good author, but in all other things shall endeavour to assist, and be subordinate to the physician in all parts of his duty, still acting by his directions; but shall not prescribe any physick without the consent of the chief, nor in his absence, upon emergent occasions, without the advice of the master-surgeon. He should be always walking up and down from bed to bed, feeling the pulses, and looking on the urine and other excrements of the sick; that no considerable punctilio, in any circumstance whatsoever, escape his observation. For the compleating of the history, he shall apply himself to the making of luciferous experiments, and to take notice of such as shall be made by others.
The student shall assist the surgeon and apothecary in making the history of their practices, to the end he may have always occasions to instruct himself in these ministrant parts of physick; to read such authors as the chief physician shall appoint him, and compare all his reading with the things themselves, whereof he rcadeth, as herbs, drugs, compound medicaments, anatomy, chirurgical instruments, bandages, operations, &c. all which we call the real elements of the art. He shall, by leave from the physician, in cases of need, put his hand to help the surgeon or apothecary, and sometimes watch by night with the nurses, that the perfection of the history may by no means be hazarded on their ignorance or carelessness. He may serve the physician as an amanuensis, especially in such things, the transcribing whereof may tend much to the advancement of his own knowledge.
Of the surgeons.
The master-surgeon shall dress every patient belonging to his care the first time himself, in the presence of him to whom he shall commit the said cure afterwards, and, as it were, read him a lecture thereupon. When the other surgeons under him are dressing, he shall, accompanied with the student, go from patient to patient, to give them directions frorenatd, in their proceedings on the cure, and dictate to the student the most pertinent passages happening from time to time, that he may keep a true and uninterrupted history of them. He shall make experiments, by dissecting sundry sorts of animals; shall teach his mates anatomy, expound good authors to them; shew them the manner of making bandages, and making all manner of operations, such as are the laryngotomia, cutting for the stone, hernia, dropsy, and applying the trepan, both upon living brutes and dead carcases of men, to the end that, by practising upon these, the best places for making incision may be known, and all the dangerous parts in the way taken notice of; and upon the others, how to avoid the inconveniences of haemorrhages, strugglings, and the like.
The mate shall dress all the more difficult griefs, apply cauteries, make fontanels, practise anatomy, and manual operations; make skeletons of the sundry rare animals which he shall have the opportunity to cut up; excarnate bowels, artificially dry the muscles, tan the ventricle, guts, &c. and do what else tendeth to the perfection of anatomy; he shall also, at leisure times, transcribe the history of their practice first and originally taken by the student.
The apprentice shall serve the master in spreading plaisters, letting blood in the arm, threading pease for issues, wetting instruments, scraping lint, and sowing together bandages, which he shall also learn to apply; he shall see dissections, read good surgery, and see the practice of operations made by his superiors. He shall also see the apothecaries make all such plaisters, unguents, balsams, &c. (learning to choose and know all the gums and other ingredients going into them) as are used in their practice.
Of the apothecary.
The master-apothecary, being a most exquisite botanist, shall take care of the garden, that store of all useful plants be kept therein, and also that such as arc for beauty or rarity be not wanting. He shall give order for all experiments of grafting, transplanting, meliorating the tastes, smells, &c. of plants, accelerating of germination and maturation in them, conservation of exoticks so, as in time to make them do- mesticks, to try the effect of all artificial composts. He shall see that all herbs, roots, &c. be gathered in their due seasons, and that all the most proper courses be used for conserving them. He shall write of the sensible and evident qualities of all drugs, as of their smell, taste, ponderosity, rarity, friability, transparency, colour, hardness, &c. omitting such as are not discernible by sense, or deprensible by certain experiments, and declaring the several operations, chymical or pharmaceutical, by which these drugs are usually, or may be best prepared. He shall set down all the experiments solitary or in consort, that he meeteth with, in the mixing or preparing any of them; as that camphire will of itself evaporate; turpentine washed in water becometh white; euphorbium in the beating will cause excessive sneesing; that the seeds of cucumis (minimis will of themselves leap out with great impetuosity one after another; that spirit of vitriol, mixed with syrup.of .violets, turneth into a fair crimson colour, and others of the like nature. He shall with the student keep an exact history of all rare and unusual accidents, happening in his operations; he shall take care that all medicaments be made according to art, or the physician's particular directions: he shall ever now and then visit the apotheca, to cast out thereof all decayed drugs and compositions; shall read pharmaceutical and chymical institutions to his inferiors, and teach the plants to any of the society that shall desire to learn them.
The apothecary's mate shall transcribe the prescriptions taken by the vice-physician, and see them carefully made up; shall attend the hospital, in administring to each patient his physick according to directions, applying epithemes, cucupha's, embrocha's, fomentations, frictions, unctions, giving glysters, applying leeches, &c. He shall transcribe the history compiled by the master-apothecary, and the student, and at leisure times, when he cannot study things he may read good authors in his own art, without meddling either with physick or surgery.
The apprentice shall read some good pharmaceutical botanick and chymical institutions, shall'be much conversant in the garden to see the curing of tender and exotick plants, where he shall observe the working of nature in their growing, flowering, &c. He shall see the herbs, roots, and seeds, gathered according to directions; he shall work in beating and picking drugs, and on all other operations belonging to the preparation of medicaments.
The nurses shall be always at hand in the hospital to help the sick, that, by reason of their absence, they may not be put to strain and offend themselves by often and loud crying and calling. They shall dress their diet, and give them in quality, quantity, time, and order, according to the physician's directions; they shall see their 4innen conveniently changed, so as to prevent all annoyance to the sick. They shall in watching endeavour to observe all remarkable accidents happening in the night, as whether they raved or talked much in their sleep, snored, coughed, &c. All which they shall punctually report to the physician, shewing him the urines and other excrements, telling him the time and manner wherein they were voided, and in brief, they being the lowest members of the house, they shall be in all things obedient to their superiors.
It is hard so to assign to every minister his particular duty, as that the business, (which is the recovery of the patients, and the improvement of every man's knowledge in his proper way) cannot be done better than by this distribution: and it would be of ill consequence, if hereupon the apprentice, having done his own work, should refuse to help his fellow, being perchance at some time over-burthened; wherefore it is to be understood that this contrivance shall be no warrant to any man, not to help his fellow, in case of exigence, but chiefly to shew what we desire should be done amongst them all. For we hope that their common friendship and desire of helping the sick, and enabling themselves, will tie them enough to perform all these things in the most advantageous manner to these ends.
Having now after a fashion gone through the description of such societies and institutions, as we have thought most fit for the advance- ,ment of real learning, and among the rest, of the Ergastulum Literarium for the education of children, we now cometo speak of such books, as, being well studied and expounded in those schools, would lay a very firm foundation of learning in the scholars.
We recommend therefore in the first place (besides those books of collection, by us formerly mentioned, and Master Pell's three mathematical treatises) the compiling of a work, whose title might justly be