It is now, I am sorry to say, something over forty years since I began my medical studies; and, at that time, the state of affairs was extremely singular. I should think it hardly possible that it could have obtained anywhere but in such a country as England, which cherishes a fine old crusted abuse as much as it does its port wine. At that time there were twenty-one licensing bodies--that is to say, bodies whose certificate was received by the State as evidence that the persons who possessed that certificate were medical experts. How these bodies came to possess these powers is a very curious chapter in history, in which it would be out of place to enlarge. They were partly universities, partly medical guilds and corporations, partly the Archbishop of Canterbury. Those were the three sources from which the licence to practice came in that day. There was no central authority, there was nothing to prevent any one of those licensing authorities from granting a licence to any one upon any conditions it thought fit. The examination might be a sham, the curriculum might be a sham, the certificate might be bought and sold like anything in a shop; or, on the other hand, the examination might be fairly good and the diploma correspondingly valuable; but there was not the smallest guarantee, except the personal character of the people who composed the administration of each of these licensing bodies, as to what might happen. It was possible for a young man to come to London and to spend two years and six months of the time of his compulsory three years "walking the hospitals" in idleness or worse; he could then, by putting himself in the hands of a judicious "grinder" for the remaining six months, pass triumphantly through the ordeal of one hour's _vivâ voce_ examination, which was all that was absolutely necessary, to enable him to be turned loose upon the public, like death on the pale horse, "conquering and to conquer," with the full sanction of the law, as a "qualified practitioner." It is difficult to imagine, at present, such a state of things, still more difficult to depict the consequences of it, because they would appear like a gross and malignant caricature; but it may be said that there was never a system, or want of system, which was better calculated to ruin the students who came under it, or to degrade the profession as a whole. My memory goes back to a time when models from whom the Bob Sawyer of the _Pickwick Papers_ might have been drawn were anything but rare. Shortly before my student days, however, the dawn of a better state of things in England began to be visible, in consequence of the establishment of the University of London, and the comparatively very high standard which it placed before its medical graduates.