"Bats Rats and Barristers": The Lancet, libel and the radical stylistics of early nineteenth-century English medicine (original) (raw)
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"Bred up in the study of that faculty": licensed physicians in north-west England, 1660-1760
Medical History, 38/4, pp.398–420., 1994
There has been a tendency for historians to accept the old ideal division of labour -- of graduate physicians using their training in natural philosophy; apothecaries in their shops; surgeons using their hands -- as being a broadly accurate description of the medical professions before the supposed arrival of general practitioners in the late 18th century. No matter how often other patterns are seen, they are usually passed over as exceptional. Although medical gilds attempted to enforce the ideal, their fitful efforts rarely extended beyond their cities' limits. Much of the overlap was informal, even illegal in some circumstances, but this could not be prevented in a laisser faire society such as England. This essay explores the range of ways in which those without medical degrees could be licensed as regular practitioners of physic, thus protecting themselves from prosecution and enhancing their credibility, and the range of people so licensed.
2015
The tumultuous late Middle Ages provided the perfect conditions for the rise of the surgical craft not only in England, but Europe. This thesis shows the rise of an elite class of surgeons between the thirteenth and fifteenth century, attempting to break away from the craft status that confined them socially and professionally. Close and Patent Rolls illuminate their increased role within the military, gaining them the empirical experience to advance practice through the tactile suitability of surgical methods to the treatment of battlefield wounds. Greater practical experience led to increased employment of surgeons within the royal household, who quickly became craft elite. London and Fellowship records indicate their attempts at securing their newly-won social and professional reputation, one which was of great importance to Masters whose writings emphasised the needed for its upkeep. Through increased speculative study and the cultivation of lucrative patients, Master Surgeons of London propelled themselves up the social ladder, securing their new elite status.
Medical practice in fifteenth-century England is often seen as suffering from the low status and unregulated practice of which Thomas Linacre later complained. Unlike in many European cities, the provision of physic was uncontrolled, and while urban guilds oversaw surgery as a manual art, no comprehensive system of medical organisation or regulation existed. However, in a remarkable episode of the 1420s, a group of university-trained physicians and elite surgeons associated with Humphrey, Duke of Gloucester, briefly established just such a system. While their efforts initially secured approval for a national scheme, it was only in the City of London that they succeeded in implementing their plans. The detailed ordinances of the collegiate ‘commonalty’ they founded provide a unique insight into their attitudes. Drawing on continental models, they attempted to control all medicine within the city by establishing a hierarchy of practitioners, preventing illicit and incompetent practice, and offering treatment to even the poorest Londoners. Yet they failed to appreciate the vested interests of civic politics: achieving these aims meant curtailing the rights of the powerful Grocers and the Barbers, a fact made clear by their adjudication of a case involving two members of the Barbers’ Company, and the Barbers’ subsequent riposte—a mayoral petition that heralded the commonalty’s end. Its founder surgeons went on to revitalise their Surgeons’ Fellowship, which continued independently of the Barbers until a merger in 1540; in contrast, the physicians withdrew from civic affairs, and physic remained entirely unregulated until episcopal licensing was instituted in 1511.