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Medical Students in England and France, 1815-1858

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Medical Students in England and France, 1815-1858 FLORENT PALLUAULT D.E.A., archiviste paléographe MEDICAL STUDENTS IN ENGLAND AND FRANCE 1815-1858 A COMPARATIVE STUDY University of Oxford Faculty of Modern History - History of Science Thesis submitted for the degree of Doctor in Philosophy Trinity 2003 ACKNOWLEDGMENTS In the first instance, my most sincere gratitude goes to Dr Ruth Harris and Dr Margaret Pelling who have supervised this thesis. Despite my slow progress, they have supported my efforts and believed in my capacities to carry out this comparative study. I hope that, despite its defects, it will prove worthy of their trust. I would like to thank Louella Vaughan for providing an interesting eighteenth-century perspective on English medical education, sharing her ideas on my subject and removing some of my misconceptions. Similarly, I thank Christelle Rabier for her support and for our discussions regarding her forthcoming thesis on surgery in England and France. My thanks naturally go to the staff of the various establishments in which my research has taken me, and particularly to the librarians at the Wellcome Library for the History and Understanding of Medicine in London, the librarians in the History of Science Room at the Bibliothèque nationale de France in Paris, and to Bernadette Molitor and Henry Ferreira-Lopes at the Bibliothèque Inter-Universitaire de Médecine in Paris. I am grateful to Patricia Gillet from the Association d’entraide des Anciens élèves de l’École des Chartes for the financial support that the Association has given me and to Wes Cordeau at Texas Supreme Mortgage, Inc. for the scholarship that his company awarded me. I would also like to thank Xavier Bahuaud for his help every time computer troubles arose. Finally, I would also like to thank my family in France, England and in the United States for their unremitting support. In particular, this thesis would have never been completed without the daily encouragements and unfailing assistance of my wife, Elisabeth. 2 TABLE OF CONTENTS ABBREVIATIONS....................................................................................................................5 TABLE OF APPENDICES.........................................................................................................6 TABLE OF ILLUSTRATIONS ....................................................................................................7 INTRODUCTION ....................................................................................................................8 1. TOWARDS MEDICAL STUDIES ...........................................................................................30 Degree, career and school...............................................................................................................32 Motives and family circumstances.................................................................................................41 Nature of medical studies and practice.........................................................................................46 Fitness and preparation...................................................................................................................51 Selection of a school........................................................................................................................54 2. DURING MEDICAL STUDIES: FIRST STEPS TOWARDS INSTRUCTION.................................62 Matriculation and opening day.......................................................................................................63 Clinical detachment..........................................................................................................................71 Timetables .........................................................................................................................................74 Requirements....................................................................................................................................77 Curricula ............................................................................................................................................90 Examinations ....................................................................................................................................93 3. DURING MEDICAL STUDIES: LEARNING MEDICINE.........................................................98 Lectures .............................................................................................................................................99 Practical anatomy ...........................................................................................................................105 Clinical training...............................................................................................................................116 Therapeutics and science ..............................................................................................................131 Laboratories and botanic gardens................................................................................................139 The adoption of innovations........................................................................................................142 3 4. DURING MEDICAL STUDIES: BEYOND THE CURRICULUM ............................................. 146 Satisfaction and complaints of students .....................................................................................147 The views of medical reformers...................................................................................................149 Shaping one’s own instruction .....................................................................................................155 Relationships with professors ......................................................................................................169 Discipline.........................................................................................................................................171 5. OUTSIDE THE MEDICAL SCHOOL: STUDENTS IN A SOCIAL CONTEXT ............................ 175 Public perception of medical students........................................................................................176 Living conditions............................................................................................................................186 Activities outside the medical school ..........................................................................................203 6. TOWARDS MEDICAL PRACTICE ...................................................................................... 223 Shaping a career..............................................................................................................................224 Differentiation and distinction.....................................................................................................232 Examinations ..................................................................................................................................245 Settling in practice..........................................................................................................................255 CONCLUSION .................................................................................................................... 261 APPENDICES ..................................................................................................................... 271 ILLUSTRATIONS ................................................................................................................ 283 BIBLIOGRAPHY ................................................................................................................. 304 Manuscript and archival sources..................................................................................................304 Printed primary sources ................................................................................................................306 Printed secondary works...............................................................................................................340 Unpublished theses........................................................................................................................372 4 ABBREVIATIONS Throughout this thesis the following abbreviations are used : AN: Archives nationales (Paris). BIUM: Bibliothèque Inter-Universitaire de Médecine (Paris). FRCP : Fellowship of the Royal College of Physicians. LSA: Licence of the Society of Apothecaries. MB: Bachelor in Medicine. MD: Doctor in Medicine (or Docteur en Médecine). MRCP: Membership of the Royal College of Physicians. MRCS: Membership of the Royal College of Surgeons (of London, 1800-1843; of England, from 1843). RSCME: [England. Parliament. House of Commons], Report from the Select Committee on Medical Education and Practice of the Medical Profession in the United Kingdom, with the Minutes of Evidence, Appendices and Indices (London, 1834). UCL: University College, London. WLHUM: Wellcome Library for the History and Understanding of Medicine (London). Translations All translations from French are my own. 5 TABLE OF APPENDICES Figure 1. Origin of the certificates of attendance at medical practice presented by candidates to the Licence of the Society of Apothecaries in 1820 and 1840 ................................................272 Figure 2. Fees for attendance at all courses required by the College of Surgeons and Society of Apothecaries in various London medical schools, 1854..........................................................272
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