A Question to Society: “Whether the Art of Medicine As It Has Been Usually Practiced Has Contributed to the Advancement of Mankind” Kayla Wiles | Furman University

A Question to Society: “Whether the Art of Medicine as it Has Been Usually Practiced Has Contributed to the Advancement of Mankind” Kayla Wiles | Furman University

Prior to the medical and public health revolutions of the nineteenth century, Scotland’s rudimentary healthcare system consisted of little more than corrupted physicians, overcrowded hospitals, and ineffective treatments for a small percentage of the population. In his written abstract to the Aberdeen Philosophical Society, Dr. John Gregory attributes these problems to a flawed Scottish medical education. This abstract formed the basis of Gregory’s larger publications which introduced the concept of bioethics to Britain. My study analyzes how Gregory uses a rhetoric of sensibility to characterize the proponents and barriers to medical advancement. Analyzing Gregory’s abstract contributes to our understanding of how the Scottish Enlightenment provided venues for medical professionals to critique society and define rhetoric of the era.

It is November 8, 1763. John Gregory rises this question to the Society on July 12, 1762, from his seat at the Red Lion1 and gazes but would not present his written response casually at a handful of colleagues, all of until almost a year and a half later (Ulman whom have put their drinks aside so as to 119, 193). give their undivided attention to the Whether anyone spoke after Gregory on speaker. Gregory then voices a question to November 8 is unclear in the Society’s min- be considered just for that meeting of utes, which only note that Gregory inserted Aberdeen’s Philosophical Society: “Whether his abstract in the “Question Book” on the art of medicine as it has been usually December 13, 1763 (Ulman, Table A-7). That practiced has contributed to the advance- abstract, though incomplete, survives as a ment of mankind.” reprinted copy in Laurence McCullough’s As a former medical student within the John Gregory’s Writings on Medical Ethics and Royal Infirmary teaching ward and then Philosophy of Medicine. Throughout this “Professor of the Practice of Physic” at King’s paper I will analyze Question 59 as pre- College in Aberdeen, Gregory had witnessed sented in McCullough’s book. the flaws of a Scottish physician’s education Even though the Question 59 abstract and how they related to Scotland’s medical remained sealed in the Society’s Question issues of the time (McCullough, Writings, 3). Book until salvaged by the Aberdeen He expressed these thoughts as to “Whether University Library in 1892,2 the content the art of medicine as it has been usually found its way almost entirely into Gregory’s practiced has contributed to the advance- A Comparative View of the State and Faculties ment of mankind,” known as “Question 59,” of Man with those of the Animal World (1764), in his written abstract to the Aberdeen Observations on the Duties and Offices of a Philosophical Society. Gregory had proposed Physician and on the Method of Prosecuting

44 | Young Scholars in Writing Enquiries in Philosophy (1770), and Lectures Scottish Enlightenment were societies in on the Duties and Qualifications of a which men and women would openly dis- Physician (1772) (McCullough, Invention, cuss issues of the time and propose solutions. 103). Lectures, based on the classes Gregory The Aberdeen Philosophical Society was taught at the University of Edinburgh fol- one such environment, leading to “the com- lowing his membership in the Society, was positions of some of the most influential translated into German, French, and Italian philosophical works published in Scotland within 20 years of its publication (Maio 182). during the latter half of the eighteenth cen- Scholars have therefore analyzed Gregory’s tury” (Ulman 12). John Gregory’s fellow writing within the context of these three members of the Aberdeen Philosophical larger publications, rather than as the Society included Thomas Reid (An Inquiry Question 59 abstract presented to the into the Human Mind, On the Principles of Aberdeen Philosophical Society. Common Sense, 1764), James Beattie (An This paper analyzes the Question 59 Essay on the Nature and Immutability of the abstract as a currently unpopular precursor Truth, 1770), Alexander Gerald (Essay on to the works which later deemed Gregory Genius, 1774), and James Dunbar (Essays on as “the father of bioethics in the English the History of Mankind in Rude and language” (McCullough, Writings, 1). Cultivated Ages, 1780), to name a few. Question 59 not only serves as a foundation According to Lewis Ulman’s The Minutes for Gregory’s more prominent publications, of the Aberdeen Philosophical Society, 1758– but also exemplifies a “rhetoric of sensibility” 1773, question proposals, discussions, and the used by scientists in eighteenth-century insertions of abstracts in response to those Britain. A rhetoric of sensibility, based in a questions followed a very specific format. culture of bodily communication and grow- The Society member who proposed the ques- ing discoveries in human physiology, can be tion for discussion would speak first, “then applied to bioethics and patient-physician each member in his turn, with no one relationships. This study contributes to allowed to speak to that question more analyses of how the Scottish Enlightenment than twice without permission from the provided venues for medical professionals president” (Ulman 47). The Aberdeen to critique society and help define the rhet- Philosophical Society met on the second and oric of the era. I specifically discuss how fourth Wednesdays of each month for Gregory uses a rhetoric of sensibility to approximately five hours in the evening, compare and personify medicinal practice with some of that time devoted to in the eighteenth century and how his cri- “entertainment” (Ulman 45). Despite its tique of the profession applies to other seemingly rigid structure, the Society only Western nations. had two officers (a secretary and a president) and conducted meetings fairly informally. Historical Context Members were encouraged to be inquisitive The Aberdeen Philosophical Society and collaborative—analyzing the world cre- As Gregory posed Question 59, Aberdeen atively and presenting discourse in a way that was in the midst of the Scottish Enlighten- would encourage discussion (Ulman 44–45). ment and would continue to be for another This environment might have been deter- 27 years (Daiches 1). At the heart of the mined by Gregory, who along with Thomas

Wiles | 45 Reid is considered the founder of the A Culture of Sensibility Aberdeen Philosophical Society (Ulman 44). One characteristic of eighteenth-century British culture is an emphasis on the human Medical and Public Health Issues of the body—how it both communicates with Eighteenth Century others and functions as a network of sys- Gregory is credited as the founder of bio- tems. This “bodily rhetoric,” or a rhetoric of ethics in the English language. The need for sensibility, arose out of three main contrib- bioethics arose out of the nonexistent utors to British society during the healthcare system of Gregory’s time and the eighteenth century: the growing bourgeoi- consequently corrupted physicians who sie class, the Romantic movement, and would pursue self-interest at the patient’s scientists’ improving understanding of expense and often abuse patient confidenti- human physiology (Goring ix; Menely 120; ality (Bastron et al. 20). Physicians were Gaukroger 390). also guilty of leaving dying, “incurable” Following the Glorious Revolution of patients to the clergy, who would then help 1688, power in Britain shifted from the the patient to achieve eternal salvation courts and landed aristocrats to the urban (McCullough, Writings, 22). bourgeoisie (Goring 22). Members of the Those who mistrusted physicians would bourgeoisie often congregated in salons, often resort to “self-physicking”—a method clubs, or coffee houses to discuss current that failed in more severe cases and demon- events and issues. Out of these meeting strated the need for a more permanent places grew an expectation for the British establishment, which arrived in 1726: the gentleman to demonstrate good oratory Royal Infirmary (Buchan 277; Lobban 10). (Goring 10). This “language of politeness” While the Infirmary improved physi- emerged as a “social currency” which cian-patient relationships, the facilities only involved cohesiveness between words and treated the narrow “working poor” demo- bodily expression (Goring 21). Soon a gen- graphic (McCullough, Writings, 23). The tleman’s “social body”—one that is defined mortality rate also increased within 30 years by status and mannerisms—modified his of the Infirmary’s construction, and physi- “physical body” into a particular view that is cal examinations consisted of little more compatible, or “sensible,” with society’s than taking a patient’s pulse and tempera- expectations (Goring 19–20). ture (Buchan 284).3 These flaws were a The Romantic movement’s emphasis on disappointing and ironic testament to emotion and individualism heightened Scottish medicine, known for its superior Britain’s fascination with the human “close clinical observation, hands-on diagno- body. Romanticism encouraged dramatic sis, and thinking of…the human body as a expression through words, music, painting, system” (Herman 309). Gregory’s Question and gestures to establish identity (Menely 59 abstract identifies some faults in the 120–121). A stronger sense of identity fur- Scottish medical education system which ther engrained the British gentleman’s might have contributed to the nation’s pub- connection to society through oratory. lic health shortcomings. During the eighteenth century, members of the British bourgeoisie who were doctors or professors of science were beginning to

46 | Young Scholars in Writing understand the human body in terms of its that every person is aware of self-existence, functional parts. Prior centuries had viewed other tangible objects, and sound moral or fundamental processes mechanically, deter- religious beliefs (Krolikowski 145). Wild mining that chemical reactants balance explains that this philosophy feeds into phy- with chemical products, but not apprehend- sician-patient relationships, with the patient ing why muscles contract “with a force expecting the doctor to do his job well and much greater than the original cause,” or the doctor expecting the patient to follow “insensibly” (Gaukroger 394). Human phys- through with treatments (53). Moral Sense iology required a much less mechanical philosophy teaches that one’s sense of mor- thinking, as homeostasis occurs in bodily als should be considered just as intuitive as systems that are not necessarily stable and the other five physical senses, contributing some regulatory mechanisms operate inde- to a desire for harmony (Wild 53). pendently of one another (Gaukroger Wild hypothesizes that these “various 394–6). Eighteenth-century scientists even- philosophical strands” made sense to doc- tually came to the conclusion that while tors such as Gregory because they organs sometimes work against each other collectively emphasize “sensibility” and (exhibiting “irritability”), they collectively “sympathy”—both of which are characteris- contribute to the life of the organisms, tics of the nervous system (54). The nervous demonstrating “sensibility” (Gaukroger system is “sensible” because it sends signals 399–400). This understanding of compati- that help “man” survive and accommodate bility in human physiology made bodily varying physical and social environments. rhetoric especially appealing to scientists as These neurons are “sympathetic” because they conversed in philosophical societies. they regulate communication between solid organs in the body to generate specific Rhetorical Analysis responses. The blend of Christian theories Rhetoric of Sensibility and classical philosophies therefore pro- Wayne Wild characterizes Gregory as not duced a rhetoric of sensibility understood only a starting point for modern medical by eighteenth century medical professionals ethics, but also as a “practitioner of sensibil- in terms of human physiology. In this study, ity” (48). According to Wild, the rhetoric of I explore how Gregory uses rhetoric of sensibility made popular by Britain’s bour- sensibility as an overarching strategy to geoisie derives from a combination of compare and personify the most important Protestant natural law theory, Common components of a medical advancement. Sense philosophy, and Moral Sense philosophy (52–53). Protestant natural law theory Influence of Bacon, Hume, and Smith on states that a “man” is in charge of his own Question 59 morals—he does not need an “external code Gregory’s approach to Question 59 and his from guild, professional college, or higher later essays was inspired by more than divine authority” (Wild 52). He should, Scotland’s healthcare issues. McCullough however, be cognizant of a moral responsi- and several other scholars have observed bility to whom his profession serves. that John Gregory melded the ideas of Common Sense philosophy (also known as Francis Bacon,4 David Hume,5 and Adam Scottish Common Sense Realism) states Smith6 in almost all of his publications.

Wiles | 47 According to McCullough, “Gregory had machine there is no power analogous to this” learned very well indeed all of the major les- (60). (All of Gregory’s quotations are spelled sons of the Baconian experimental method as they appear in McCullough’s John and its chief implication for medicine: med- Gregory's Writings on Medical Ethics and icine must be improved and Baconian Philosophy of Medicine.) Because humans are method provides the means for doing so” not machines, doctors should not be diag- (Writings 27). Hume and Smith’s philoso- nosing or treating them as such. phies influenced Gregory’s support of Gregory next compares “synthetic” edu- sympathy for a successful physician-patient cation with “analytical” education. He gives relationship (Bastron et al. 20; Wild 50). Scottish medical education a particularly Some scholars have noted Gregory’s ten- harsh critique: “Universities, where medi- dency to use imagery in his arguments. cine is usually taught, seem not to be well The Critical Review wrote in its July 1801 calculated for the advancement of any issue that Gregory’s work “in reality, [was] kind of science” (61). Gregory claims that just a series of independent essays, con- universities encourage students to think nected by very slight links. If there be any synthetically, or deductively, “for the con- band which unites the whole, it is an veiency of teaching.” He believes that in inquiry how far the boasted superiority of order for medicine to advance, students man, and his more extensive powers, con- should be taught how to think analytically, tribute to his happiness” (318). Question 59 or inductively, “where the mind proceeds ponders if “man” has really advanced medi- from particular facts to established general cine for the sake of well-being. If he has not principles.” Gregory concludes this compar- done so up until the eighteenth century, ison with the comment that it might not then why not yet? matter how universities teach students if they assume that there is nothing else to Comparisons learn about medicine as physicians (61–62). Gregory uses comparisons to exemplify the The previous comment leads Gregory to “art of medicine” that Scotland’s physicians discuss his third comparison between an have not yet perfected. The first comparison “assuming & dogmatical” physician and a made in the Question 59 abstract is “modest & sceptical” one. The first type of “between an animal and an inanimate physician is the one who graduates from a machine” (Gregory 60). Gregory explains medical school complacent with all the that unlike a machine, an animal (or knowledge he has learned. “His mind is at human) has the inherent mechanisms to ease in having allways sure and fixed princi- fight disease. “There is a certain internal pro- ples to rest upon—in the mean time the art cess carried on by nature, the principles of [of medicine] can receive no improvement which we are in a great measure strangers to, from him, as he does not imagine it stands by which they endeavour to remove the dis- in need of any,” Gregory explains. His next order or to suppress any want occasioned by thought in this syllogism is particularly it,” he says. “We have instances of this in the foreboding for Scottish medicine: cases of fractured bones, the incarnation of wounds, and the inlargement of one kidney If a patient dies [the physician] is quite when the other is destroyed—in a common satisfied everything was done for him,

48 | Young Scholars in Writing that art could do—It is difficult for men relief—These facts which cannot be to give up favourite opinions, the disguised lay the foundation for the art children of our youth, to sink from a of medicine. (60, emphasis added) state of security & confidence, into one of suspence and scepticism— This simultaneous parallelism and per- Accordingly, few physicians change their sonified description (italicized above) principles and very seldom their communicates that humans cannot rely on practice—These vary like other fashions nature to treat themselves. While nature is and like them are universally adopted, not entirely a barrier to medical advance- while they do prevail (62). ment, it is too fickle and unreliable for most injuries or illnesses. Gregory gives the The danger of an all-assuming physician example of a broken bone—would anyone is no desire to find other ways to cure really leave a dislocated arm to nature with- patients because he has too much faith in out seeing a doctor for help? “We have not the dominant “fashion” of other physicians. one instance of a nation where the art is not With this attitude, medicine does not practiced,” he answers. advance at all. The “modest & scpetical” Gregory next personifies the medical pro- physician, on the other hand, “never loses a fession—a group of people who should be patient but he secretly laments his igno- proponents of medical advancement but rance of the proper means of having saved have instead been barriers: him, which he blames rather than the disease being incurable in itself.” This We find no profession which has physician’s love of science, humility, and watched with so jealous an eye over good conscience, says Gregory, are what intruders or which has treated them with naturally stimulate the “improvement of so much abuse & ridicule even when it knowledge” (62). was apparent the intrusion was only owed to motives of humanity… Personification Enlarged knowledge produces a liberal Gregory has three major instances of per- & unsuspicious spirit & there is no sonification in his abstract to Question 59. profession that can boast of more men of He utilizes personification to characterize learning, ingenuity, & genteel education the proponents and barriers of medical than physic – There is however some advancement. The first instance is nature: reason to suspect that the way in which Physic has been practiced has not been But the efforts of nature tocure a disease so beneficial to mankind nor or relieve a patient may in some cases contributed so much to the advance of without the assistance of Art, be art, as if it had been left more open & inefficient and in some cases pernicious… not confined to a particular set of men The efforts of nature are sometimes so who lived by it as a profession. (61, violent as a require a check & sometimes so emphasis added) feeble as to stand in need of cordials & an additional stimulus—In some cases The italicized words indicate that the nature makes no sensible effort for her medical profession is proud and exclusive.

Wiles | 49 While Gregory believes that medicine keep his proper distance behind & he will would not advance without the medical wish him very well,” says Gregory. Medical profession to practice the art, the “system” school professors and doctors want to see has defined a rigid way to diagnose and their students succeed, but only if their suc- treat patients. Any proposals for new diag- cess does not surpass their own. The system noses or treatments do not generally pass is therefore a barrier to medical advance- through this system very well, which is ment, as well. Gregory’s third instance of personification: Who, then, is a true proponent of scientific progress? A physician, when he sets out in life, quickly perceives that the knowledge An Incomplete Abstract most necessary to procure him a Gregory sits back down after reading his subsistence, is not the knowledge of his abstract, waiting for the next member to profession, what he finds most essential comment on the importance of medicine to to that purpose are the arts of deceiving “mankind.” His discussion might have con- mankind…views very different from the tinued beyond stating that human life is too pursuit of genius & science—He can short to understand every branch of science, expect no patrons to his real merit, but the surviving manuscript of Question 59 because none are judges of it, but a few ends midsentence with a mysterious, brack- of his profession, whose interest it is to eted “13r” (McCullough, Writings, 66). No have it concealed—If he attempts to surviving manuscript tells the twenty-first show the weakness of the fashionable century exactly what Gregory’s colleagues system or to introduce an alternative in said on that day, either, but the books pub- the practice, the whole faculty are lished beyond the Aberdeen Philosophical alarmed, their vanity is piqued in having Society indicate a mutual consent for the their opinions, which they thought improvement of medical practice. Gregory perfectly well established, brought into later wrote in his book A Comparative View question & exposed by a young man & of the State and Faculties of Man with those of their interest is evidently concerned to the Animal World that the physician who crush him as fast as possible (63). learns science through observation and understands the human heart is one who The system—a network of other doctors advances medicine: and medical school professors—allows no new medical discoveries to challenge its There are, indeed, many obstacles of authority. Gregory explains that if the different kinds, which concur to render young physician continues to press for dif- any improvement in the practice of ferent medical practices to treat his patients Physic a matter of the utmost difficulty, or alternative remedies, the system will find at least while the profession rests on its ways to blackmail him through “his pre- present narrow foundation. Almost all scriptions in the apothecarys file” and every physicians who have been Men of “miscarriage the outcry is raised” (63). “A ingenuity, have amused themselves in man does not hate another because he is forming theories, which gave exercise to engaged in the same race but let him only their invention, and at the same time

50 | Young Scholars in Writing contributed to their reputation. Instead and serves as a precursor to medical of being at the trouble of making advancements and public health initiatives observations themselves, they culled out taken throughout Scottish cities in the of the promiscuous multitude already nineteenth century (Lobban 31–32). The made, such as best suited their purpose, Edinburgh Medical School, a university and dressed them up in the way their Gregory had critiqued in his Question 59 system required. In consequence of this, abstract for teaching “synthetically,” even- the history of medicine does not so tually expanded its curriculum to include a much exhibit the history of a progressive wider array of courses (Lobban 42). These art, as a history of opinions, which courses included pathology (due to a grow- prevailed perhaps for twenty or thirty ing concern with the causes of disease) and years, and then sunk in to contempt and hygiene and public health (to provide medi- oblivion…Nothing is required, but cal evidence to law courts about how to assiduous and accurate observation, and reduce disease transmission in cities). The a good understanding to direct the British Medical Association (BMA), estab- proper application of such observation. lished in 1832, pressed for proper regulations But to cure the diseases of the Mind, and more effective training of doctors so there is required that intimate that they would be more adequately quali- knowledge of the Human Heart, which fied to practice medicine (Lobban 42). must be drawn from life itself, and British doctors and professors also eventu- which books can never teach. (269–71) ally either adopted medical advancements from other countries or made their own, Monthly Review explains the significance such as using chloroform to put patients to of Gregory’s work in its August 1789 issue: sleep during long operations and carbolic acid to sterilize wounds (Lobban 20–24). Dr. Gregory’s chief view, in his various Like Britain, the U.S. incorporated other writings, was not confined to the mere ideals of the Western world into medical improvement of his readers in scientific education and practice. The medical field, knowledge. In some of his compositions, however, still does not completely satisfy he [1] points out the proper use of Gregory’s criteria for the advancement of philosophy, by shewing its application to “mankind.” Gregory had called for an educa- the duties of common life; in others, he tion that would encourage physicians to [2] has successfully endeavoured to think analytically so that they would be inculcate virtuous principles; in one work more open to alternative diagnoses and he [3] has delineated that propriety of treatment for their patients. Since the conduct which is necessary in the Scottish Enlightenment, both Europe and practice of the noblest art; and in another the U.S. developed Continuing Medical he [4] has exhibited the elementary Education (CME) programs to keep physi- principles of science which he possessed. cians informed on scientific advancements (162, bracketed numbers added) and how these discoveries impact patients. Even though its development is evi- Gregory’s response to Question 59 con- dence-based, CME lacks “scientifically tains the basis for each of these four areas based methodology for educating patients,…

Wiles | 51 meeting the regulatory requirements for cancer (Levitz and Kamp). Even though licensure, but not on practice improvement the U.S. Food and Drug Administration or enhancement of patient outcomes” had issued a warning about the morcella- (Nissen 1813). CME is also poorly funded in tors, some doctors thought that the FDA Europe and the U.S., even though spon- had “overreached,” had faith in the com- sored by pharmaceutical companies and pany that produced them, and continued to government agencies (Sandars 680). use the device on their patients (Levitz and Because pharmaceutical companies fund Kamp). The Western medical profession CME programs, course objectives have therefore still has blind spots in the “system” been colored by commercial interests in the described by Gregory. past—motivating the U.S. Senate Finance Despite the gaps in physician oversight, Committee to develop new guidelines that most Western countries have developed relieve CME of bias (Partin 156). Until codes of ethics and malpractice laws that these guidelines go into effect and theCME incorporate Gregory’s ideals. The American curriculum incorporates more “prac- Medical Association (AMA), for example, tice-based learning” than “didactic-based outlines standards of conduct for physicians, learning” in a variety of healthcare settings, asking them to “continue to study, apply, and physicians are still advancing medicine at a advance scientific knowledge” along with slow rate (Nissen 1813). “maintaining a commitment to medical edu- In comparison to Gregory’s time, phar- cation” (AMA 1). Because these standards are maceuticals and government regulations not laws, however, many physicians are not play a much larger role in the medical pro- held accountable for their actions until a mal- fession “system.” Most U.S. states, for practice suit ensues (Bal 339). Medical school example, have prescription databases that bioethics courses and CME programs should enable physicians to better understand their better include real-life scenarios to prevent patients’ medical history but also be held incidents of malpractice. accountable for improperly prescribing medications. In recent years, the system has Conclusions identified physicians overprescribing pain- The twenty-first century is still approaching killers that contributed to the opioid what Gregory claimed in his later books epidemic (Calvert and Campo-Flores). would advance medicine: the physician who While government regulations have a is not only curious and open-minded, but more symbiotic relationship with the medi- also well-mannered and concerned for the cal profession than during the Scottish well-being of his patients (Maio 184). Enlightenment, commercial interests and Gregory uses a rhetoric of sensibility in his physician pride still do interfere with a Question 59 abstract to explain why the dif- patient receiving the best possible diagnosis ferent players of a medical advancement or treatment. In 2013, Johnson & Johnson must be compatible. He first defines the art halted sales of a laparoscopic power of medicine by making comparisons: medi- morcellator used for hysterectomies. The cine treats humans rather than machines; morcellator, a tool used to cut up and analytical education better prepares doctors remove a uterus, left behind malignant tis- for treating patients than a synthetic educa- sue in several female patients, resulting in tion; and the modest physician is more

52 | Young Scholars in Writing likely to care about improving medicine protagonist nor an antagonist but should than the dogmatic physician. Gregory next serve as a reason why human beings need personifies the protagonists and antagonists the existence of medicine. The surviving of medical advancement. The antagonists, Question 59 abstract ends before Gregory says Gregory, should be proponents of scien- can explain the true protagonist of medical tific progress but have instead served as advancement, but within the following 100 barriers. These include the medical profes- years Scotland achieves the mindset for sion and the overall “system” which defines progress and reform for which he had advo- how medicine should be practiced. Gregory cated. The Western world continues to build also personifies nature, which is neither a on this progress.

Acknowledgments I conducted this study while studying abroad in Edinburgh, UK through Furman University during the Spring 2016 semester. I thank my then-professor, Dr. Sean O’Rourke, for accepting me into this program, encouraging his students to produce publication-quality papers, and helping me find the grave of Dr. John Gregory (right next to Adam Smith’s!). I appreciate the time and effort undertaken by the National Library of Scotland and the Aberdeen University Library to track down Gregory’s unfinished manuscript in a form I could analyze, and faculty at the University of Edinburgh for answering my questions about Gregory’s student days at the Royal Infirmary. I also thank myYSW faculty advising editor, Dr. David Elder, for helping me shape the paper into its final product.

Notes 1The Red Lion is a tavern located in Fochabers, a town close by to Old Aberdeen. Gregory had taught at King’s College in Old Aberdeen before the campus joined the University of Aberdeen. According to Laurence McCullough, this tavern might have been one of the Aberdeen Philosophical Society’s meeting locations (Writings, 10). 2The Aberdeen University Library obtained manuscripts of the Aberdeen Philosophical Society’s minutes and question book (MS 145, MS 539/1, and MS 539/2) between 1892 and 1957. The library’s records indicate that MS 539/1, the formal minute book for the Society, had multiple owners until donated to the University of Aberdeen in 1892. The son of the last owner stated that his father, Dr. John Webster of Edgehill, had bought the Society’s minutes at a book auction. The Aberdeen University Library has been unsuccessful in tracing the ownership of MS 145 and MS 539/2, only determining that the university’s Special Collections possessed all three manuscript sets before 1957 (Minutes of the Aberdeen Philosophical Society; University of Aberdeen). 3 Nurses were known to measure body temperature with inaccurate equipment. 4Francis Bacon is credited for the invention of the scientific method in Britain (Walzer 15). 5David Hume, a British philosopher and historian, is known for works such as A Treatise of Human Nature: Being an Attempt to Introduce the Experimental Method of Reasoning into Moral Subjects (Buchan 76-78). 6Adam Smith is known as the founder of modern economics through published works such as The Wealth of Nations (Buchan 122-26).

Wiles | 53 Works Cited American Medical Association (AMA). AMA Code of Ethics. American Medical Association, 2016. “Art. IX. - Literary and Characteristical Lives of John Gregory, M.D., Henry Home, Lord Kames, David Hume, Esq. and Adam Smith, LL.D.” The Critical Review, July 1801, 32nd ed., Smellie’s Literary Lives sec., pp. 317–22. “Art. XVII. - The Works of the Late John Gregory, M.D.” Monthly Review, Aug. 1789, 81st ed., Dr. Gregory's Works sec., pp. 162–65. Bal, Sonny. “An Introduction to Medical Malpractice in the United States.” Clinical Orthopaedics and Related Research, vol 467, 2009, pp. 339–47. Bastron, Dennis, and Laurence McCullough. “What Goes Around, Comes Around: John Gregory, MD, and the Profession of Medicine.” Proceedings (Baylor University: Medical Center), vol 20, no. 1, 2007, pp. 18–21. Buchan, James. Capital of the Mind: How Edinburgh Changed the World. Birlinn Limited, 2007. Calvert, Scott and Arian Campo-Flores. “States Fight Opioid Epidemic with Prescription Databases.” The Wall Street Journal, 2 Sept. 2016. www.wsj.com/articles/ states-fight-opioid-epidemic-with-prescription-databases-1472854536 Daiches, David. The Scottish Enlightenment, 1730–1730: A Hotbed of Genius:. U of Edinburgh Press, 1986. Gaukroger, Stephen. “The Realm of Sensibility.” The Collapse of Mechanism and the Rise of Sensibility: Science and Shaping of Modernity, 1680–1760. Oxford UP, 2015. Goring, Paul. The Rhetoric of Sensibility in Eighteenth-Century Culture. Cambridge UP, 2005. Gregory, John. A Comparative View of the State and Faculties of Man with Those of the Animal World. T. Cadell, Jun. and W. Davies, Strand, 1798. Gregory, John. “Whether the Art of Medicine as It Has Been Usually Practiced Has Contributed to the Advancement of Mankind.” Question 59. Aberdeen Philosophical Society, Aberdeen. John Gregory's Writings on Medical Ethics and Philosophy of Medicine, Vol. 57, edited by Laurence B. McCullough, Kluwer Academic, 1995, pp. 59–66. Herman, Arthur. The Scottish Enlightenment: The Scots’ Invention of the Modern World. Harper Perennial, 2001. Krolikowski, Walter. “The Starting Point in Scottish Common-Sense Realism.” The Modern Schoolman vol. 33, no. 3, 1956, pp. 139–52. Levitz, Jennifer and John Kamp. “Medical Device Sidelined Too Late to Save Someone.” The Wall Street Journal, 22 Nov. 2014. www.wsj.com/ articles/a-medical-device-is-sidelined-but-too-late-for-one-woman-1416600067 Lobban, Robert. Edinburgh and the Medical Revolution. Cambridge UP, 1980. Maio, Giovanni. “Is Etiquette Relevant to Medical Ethics? Ethics and Aesthetics in the Works of John Gregory (1724-1773).” Medicine, Health Care and Philosophy, vol. 2, 1999, pp. 181–87. Menely, Tobias. “Returning to Emotion, via the Age of Sensibility.” Eighteenth-Century Life vol. 34, no.1, 2010, pp. 114–24. McCullough, Laurence, ed. John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine. Philosophy and Medicine. Vol. 56. Kluwer Academic, 1998.

54 | Young Scholars in Writing McCullough, Laurence, ed. John Gregory’s Writings on Medical Ethics and Philosophy of Medicine. Philosophy and Medicine. Vol. 57. Kluwer Academic, 1998. Minutes of the Aberdeen Philosophical Society. 1773. MS 145; 539, GB 0231 University of Aberdeen, Special Collections. University of Aberdeen, Aberdeen. Nissen, Steven. “Reforming the Continuing Medical Education System.” Journal of the American Medical Association (JAMA), vol. 313, no. 18, 12 May 2015, pp. 1813–14. Partin, Clyde, Howard Kushner, and Mary E. Kollmer Horton. “A Tale of Congress, Continuing Medical Education, and the History of Medicine.” Proceedings (Baylor University Medical Center), vol. 27, no. 2, 2014, pp. 156–60. Sandars, John. “Continuing Medical Education Across Europe: Demonstrating Cost Effectiveness and Impact on Patient Care May Be Difficult.”British Medical Journal (BMJ), vol 341, 24 Sept. 2010, pp. 680–81. Ulman, Lewis, ed. The Minutes of the Aberdeen Philosophical Society, 1758–1773. Aberdeen UP, 1990. University of Aberdeen. “Aberdeen Philosophical Society Records.” Primo.abdn.ac.uk. n.d. Walzer, Arthur. George Campbell: Rhetoric in the Age of Enlightenment. SUNY Press, 2002. Wild, Wayne. “The Origins of a Modern Medical Ethics in Enlightenment Scotland: Cheyne, Gregory and Cullen as Practitioners of Sensibility.” Scottish Medicine and Literary Culture, 1726–1832, edited by Megan J. Coyer and David E. Shuttleton, Brill, 2014, pp. 48–73. Wood, P. B. “The Natural History of Man in the Scottish Enlightenment.” History of Science, vol. 28, no .1, 1990, pp. 89–123.

Wiles | 55