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Home , County corporate, Edward Alston, Henry Atkins (physician), Humphry Rolleston, Thomas Coxe, Thomas Linacre

[From Fabricios ab Aquapendente: Opere chirurgiche. Padova, 1684]

ANNALS OF MEDICAL HISTORY Third Series, Volume III January, 1941 Number 1

HISTORY OF IN THE CITY OF

By SIR , BT., G.C.V.O., K.C.B.

HASLEMERE,

HET “City” of London who analysed Bald’s “Leech Book” (ca. (Llyn-din = town on 890), the oldest medical work in Eng­ the lake) lies on the lish and the textbook of Anglo-Saxon north bank of the leeches; the most bulky of the Anglo- I h a m e s a n d Saxon leechdoms is the “Herbarium” stretches north to of that mysterious personality (pseudo-) Finsbury, and east Apuleius Platonicus, who must not be to west from the confused with Lucius Apuleius of Ma- l ower to Temple Bar. The “city” is daura (ca. a.d. 125), the author of “The now one of the smallest of the twenty- Golden Ass.” Payne deprecated the un­ nine municipal divisions of the admin­ due and, relative to the state of opin­ istrative of London, and is a ion in other countries, exaggerated County corporate, whereas the other references to the imperfections (super­ twenty-eight divisions are metropolitan stitions, magic, exorcisms, charms) of . Measuring 678 acres, it is Anglo-Saxon medicine, as judged by therefore a much restricted part of the present-day standards, and pointed out present greater London, but its medical that the Anglo-Saxons were long in ad­ history is long and of special interest. vance of other Western nations in the Of Saxon medicine in England there attempt to construct a medical litera­ is not any evidence before the intro­ ture in their own language. The Anglo- duction of Christianity by Augus­ Saxon leeches were not necessarily ec­ tine in 597 (Payne); but on Anglo-Saxon clesiastics, as at a somewhat later date medical books light has been thrown so often were. As another by T. (). Cockayne in his “Leechdoms, high authority, Sir D’Arcy Power, con­ Wortcunning, and Starcraft” (1864), cluded, little is known about actual and in 1904 by J. F. Payne (1840-1910) medical practice before the Norman conquest. The Anglo-Norman period sions of those practicing medicine, the did not bring about any immediate evolution of which will now be briefly suppression of old English medicine, traced: but introduced the influence of the medical schools of Salerno and later of I. Barbers and Apothecaries Montpellier. Those corresponding to modern gen­ In the thirteenth century those prac­ eral practitioners, though spoken of as ticing medicine are now rather shadowy leeches (Anglo-Saxon laece = healer) personalities from confusion with and later apothecaries, included: others of the same or much the same (a) The Barbers (those who shave the name; for example there appear to beard), originally a religious guild which have been two contemporary Johns of came into being in 1308. They had a St. Giles. This is shown by Russell’s recognized status and so were not irreg­ article on medical writers of thirteenth­ ular practitioners, empirics, or quacks. century England. They were often The Barbers received their charter as a clerics and resident away from the City City Company on February 24, 1461-2, of London. and were described as the “Freemen of the Mistery of Barbers of the City of Among the prominent British-born London Using the Mistery or Faculty medical authors in this century some were much abroad, especially at Montpellier, of .” Thus the word mistery the adjective “anglicus” signifying not (from the middle English mistere = a only that they were Englishmen but were craft) is quite different from mystery well known or lived abroad. Gilbertus (Latin mysterium = something con­ Anglicus (?i 180-1230) practiced at Mont­ cealed or obscure); there has been some pellier, and expressed a poor opinion of confusion between them: the “mystery charms and other similar methods. Gil­ plays” were so called because they were bert was a common name, especially acted by members of a craft. The Bar­ among bishops, and the Gilbert described bers were a close body, being largely on as Chancellor of Montpellier was some­ hereditary lines; they took and taught one else (Payne). Bernard of Gordon cer­ apprentices, and were of two categories: tainly taught medicine from about 1285 the subordinate grade was mainly en­ to 1307 at Montpellier, when there were at least two physicians called Ricardus gaged in barbery, the administration of Anglicus or Richard of Wendover, the enemas, extraction of teeth, minor sur­ senior, also called Ricardus Salernitanus, gery, and bleeding, though they were was the teacher of Gilbert; and the junior not allowed to advertise this by expos­ (d. 1252), at Montpellier and to ing a cupful of blood in the window. Pope Gregory IX (1142-1241), later be­ The other grade aspired to surgical came a canon of St. Paul’s when he might practice. This division was accentuated have taken part in the medical practice after 1540 when the Barbers Company at the near-by St. Bartholomew’s hos­ united with the small Fellowship of Sur­ pital; he must be distinguished from an­ geons (there were then twelve members other Richard of Wendover (d. 1250), only) to form the Barber-Surgeons Com­ Bishop of Rochester, and from Ricardus pany. The subordinate group, now Anglicus (fl. 1196-1226), a famous jurist of more strictly controlled in their prac­ . tice, corresponded to “the gentlemen In the fourteenth century there were of the short robe” in the College of St. in the three main divi­ Come in Paris, founded by the Sur­ geons early in the fourteenth century; the City companies, after the Societa the surgeons in the Barber-Surgeons scientifica of Naples founded in 1540. Company were in the same position as The new charter restrained the Grocers the “gentlemen of the long robe” of and other City companies from the sale the Paris college. The long and short of drugs in, and within a radius of seven robes were imitations of the graduate miles of, the City of London, and con­ and undergraduate gowns of univer­ ferred on the Society the power of sities. search, seizure, and destruction over the (b) The Apothecaries, literally those contents of apothecaries’ shops. James I in charge of a storehouse (a.7ro0r]KT], aivo felt strongly that steps, which appar­ = away, = place; low Latin ently the Grocers had neglected, should apotheca) for various non-perishable be taken to prevent the activities of commodities, drugs as well as spices “very many empiricks and unskilful and other groceries. These apothecaries and ignorant men” in spite of regula­ belonged to the guild of Spicers of tions to the contrary. The Society Cheap Ward in the City, which on St. bought its present site inside the City Anthony’s day (May 9), 1345. united walls, and after the destruction of its with the Pepperers, “the good folks Hall in the Great Fire of London, the of Soper Lane,” the members of present Hall was built there. both being chiefly foreigners, to form The Act of 1511 (3 Henry VI11, cap. the Fraternity of St. Anthony “to the iii) made it unlawful for any one to honour of God, the Virgin Mary, St. practice medicine or surgery in, and for Anthony and All Saints”; eventually, seven miles around, London without in 1373, this Fraternity was merged in having first been examined and ap­ the Grocers Company which received proved by four doctors of medicine or the parent charter on February 16, surgeons acting under the Bishop of 1428-9. From 1386 the Grocers had London or the Dean of St. Paul’s; out­ been entrusted with the inspection of side the seven mile area similar arrange­ shops where drugs were sold, and on ments were enforced under the bishop April 9, 1606, the Grocers''-' Company of the diocese or his vicar general. The and the Apothecaries were united by original charter of the Royal College charter into one company as “the Free­ of Physicians of London in 1518 and men of the Mistery of the Grocers and the modified charter in 1522 (14-15 Apothecaries of the City of London.” Henry VIII, cap. v) were on much the This union, however, was short-lived; same lines, an exception being made in for, in spite of opposition by the Gro­ favor of graduates of and Cam­ cers, James I of England, petitioned by bridge resident outside London and Gideon Delaune (?i 565-1659), who has the seven mile area. therefore been regarded as the founder The apothecaries early began to treat of the Society (Wall, 1932), and forti­ patients; for example, in 1345 Coursus fied by the advice of his physicians— de Gangeland, a London apothecary, (1558-1635), president of was granted a pension of sixpence a day the Royal College of Physicians, and Sir for attendance on Edward III during Theodore Turquet de Mayerne (1573- his illness in Scotland, and Gideon Dc- 1655)—granted on December 6, 1617, laune was apothecary to Anne of Den­ a separate charter to the Apothecaries mark, the wife of James I; the Court with the name Society, unique among appointments of Apothecary still re- main. The long quarrel between the caries, butchers, cookes, and coffin­ members of the Society of Apothecaries makers,” probably applied with even who practiced medicine and the Royal more force in 1665.

College of Physicians extended over Among the apothecaries and physicians most of the seventeenth century, reach­ who rendered good service during the ing its acme at the end of the century plague and deserved reward, was Francis as was immortalized in the mock heroic Bernard (1627-1698); he was apothecary poem of the “Dispensary” (1699) by to St. Bartholomew’s Hospital during the Sir Samuel Garth (1661-1719). During plague and in 1678 was created m.d. by the Archbishop of Canterbury, incorpo­ the great plague of London (1665) the rated at Cambridge, and elected assistant president, Sir (1595- physician to St. Bartholomew’s hospital. 1669), and most of the fellows of the Later he became physician to James II Royal College of Physicians followed the and physician to St. Bartholomew’s hospi­ Court and their well-to-do patients into tal. William Boghurst (1631-1685), an the country so that the College was de­ apothecary, prescribing and selling medi­ serted, and Christopher Merrett (1614- cines at the “White Hart,” St. Giles-in-the- 1695), the first Harveian Librarian, resi­ Fields, saw from 40 to 60 plague patients a dent in the College was left alone, but day and left a manuscript “Loimographia: an account of the great plague of London joined his colleagues before the end in 1665,” ready for press. It, however, re­ of June when the College was robbed. posed in the British Museum, Sloane MS. The statement made in the “Rod for 349, until 1894 when it was edited by J. F. Run-Awayes” by Thomas Dekker Payne and printed. According to Payne it (? 1570-1641) about the plague of 1625, is undoubtedly the best contemporary namely that “none thrive but apothe- medical description of the epidemic. Bog­ hurst contested the general opinion at the (? 1620-1679?), who also remained in Lon­ time that it was air-borne, and argued that don. made the only necropsy on a case of it was due to an old poison lurking in the plague, of which there is any record in this soil. With regard to the question whether epidemic, and after doing so had symptoms or not to take flight from the plague, he for which he applied a dried toad to his thought that only those with definite du­ chest to draw out the poison, then a popu­ ties, such as physicians, apothecaries, and lar prophylactic. He wrote “Loimotomia: surgeons, should stay. But he added, or, the pest anatomized” (1666) and criti­ though not acting upon it, that those cized the fellows of the Royal College of apothecaries having their work from phy­ Physicians for leaving London; he also ar­ sicians are “not obliged to stay behind gued against excessive bleeding. Corfe from when their masters lead the way; for who personal experience described a somewhat shall direct them?’’ similar departure of physicians during a Nathaniel Hodges (1629-1688), d.m. cholera epidemic in London, and paid a oxon. (1659), a candidate (member) in tribute to Frederick Wood (1820-1906), 1659 and a fellow (1672) of the Royal Col­ m.r.c.s., l.s.a. 1841, the last apothecary lege of Physicians, practicing in Walbrook, (1847-1867) to St. Bartholomew’s Hospital a plague-stricken area of the City, was un­ who in 1849 followed the example of his remitting in his care of the sick. He was predecessor Francis Bernard by remaining appointed by the Corporation of the City at his post during the epidemic. for special plague duty in the City with (Sir) (d. 1694) m.d. can- The apothecaries were left to look tab. (1653), president of the Royal College after the sick poor and others who of Physicians (1684-1687) and physician in stayed in the City, and so strengthened ordinary to Charles II (1677). Hodges wrote their position as medical men. As a an account of the epidemic in Loimologia result some of the fellows of the Royal (1672) and had implicit faith in sack as an College of Physicians on their return antidote to infection by plague and was to London suffered severely from loss convinced that he had thus twice aborted of practice. In “Physick lies a-bleeding, attacks of the plague in his own person. or the Apothecary turned Doctor: a This was probably the cause of his later downfall, for, after considerable success Comedy acted every day in most Apoth­ both in practice and at the Royal College ecaries shops, in London” (1697), by of Physicians, his practice melted away the satiric Tom Brown (1663-1704), the and he died in the Ludgate Debtors’ hero of the incident: prison. Defoe in his “ Journal of the Plague Year 1665” (published in 1722) has been I do not like you, I)r. Fell The reason why I cannot tell thought to have drawn from Hodges the character of “Dr. Heath,” one of whose a character complained, “I have been a patients was a victim to the late results of physician in London about 40 years, the habit of drinking sack contracted dur­ and I never knew so little business to ing the plague (W. G. Bell). Thomas in all my lifetime.” This was a progres­ Wharton (1614-1673), who in 1656 de­ scribed and named the thyroid, stayed in sive change, for according to Mason London throughout the plague and was Good (1764-1827) in 1795, for every promised the next appointment as physi­ patient seen by a physician, twenty were cian in ordinary to Charles II but when attended by an apothecary . . . who the vacancy came was passed over and “only has the opportunity of stifling given instead an honorable augmentation the contagion in its birth.” In the vig­ to his paternal arms. George Thomson orous paper warfare some pamphlets were anonymous, especially those for Royal College of Physicians of London the apothecaries, for example “Belluni (1871-76). The efforts of the Associa­ medicinale, or the present state of Doc­ tion, after the two Royal Colleges of tors and Apothecaries in London” Physicians and of Surgeons had stood (1701). Prominent on the side of the aside, resulted in the passage of the physicians were Christopher Merrett in Apothecaries Act 1815 which has been 1670, Jonathan Goddard (1617-75), described as having “changed the trade and Charles Goodall (1642-1712); and of the apothecary into a profession rec­ to (1615-85) who, like ognized by the State” (Wall, 1932). It (1619-1707), was empowered the Society of Apothecaries president of the College (1682) and to appoint a Court of Examiners to ex­ later fell on evil days financially, has amine prospective apothecaries, and for­ been ascribed the anonymous “Dis­ bade anyone to practice as an apothe­ course wherein the interest of the pa­ cary in London, England and tient in reference to physick and phy­ unless thus examined successfully and sicians is soberly debated, many abuses thereby qualified. Between 1815 and of the apothecaries . . . are detected, 1882 the diploma L.S.A. (licentiate of and their unfitness for practice discov­ the Society of Apothecaries) was con­ ered” (1669). ferred on nearly 31,000 persons (Hor­ The apothecaries finally won the day ner); during the greater part of the as regards the practice of medicine; in nineteenth century the qualifications 1721 the House of Lords made it legal L.S.A. and M.R.C.S. (member of the for them to prescribe as well as to dis­ Royal College of Surgeons of England) pense for patients, but did were the most frequent among general not permit any charge for visits or ad­ practitioners. Since the Medical Act vice, payment being made for medicines 1886, which led to the formation of the only; this restriction was not lifted until Conjoint Examining Board of the Royal 1811. About the end of the eighteenth Colleges of Physicians and of Surgeons, century the evolution of the apothecary the diploma L.R.C.P. (licentiate of the into the general practitioner passed into Royal College of Physicians of London) the phase of the surgeon-apothecary, a largely took the place of the L.S.A. combination of the barber-surgeon and (since 1907 L.M.S.S.A., licentiate in the apothecary; this has been regarded Medicine and Surgery of the Society of as a repair of the ancient and artificial Apothecaries) in the double qualifica­ schism of medicine and surgery (Hor­ tion for general practitioners in Eng­ ner). In 1795 Mason Good advocated land and Wales. The Society of Apothe­ improvements in the education of the caries in 1827 again took the initiative apothecaries, and in 1812 an Association by establishing an examination in mid­ of Apothecaries and Surgeon-Apothe­ wifery as part of that for their license. caries of England and Wales with the A late sign of the transformation of the object of “improving the education and apothecary in name into the general rendering more respectable their own practitioner in being may perhaps be body” was organized and presided over found in the following events: in 1847 by George Man Burrows (1771-1846) F. Wood, apothecary to St. Bartholo­ who was the father of Sir George Bur­ mew’s hospital, a post dating back to rows (1801 -87) president of the General 1567 (N. Moore, 1918) was given the Medical Council (1864-69) and of the additional duty of visiting daily all the patients in the physicians’ wards. to the wars, they were accompanied by Twenty years later this work teas under­ assistants; thus in 1415 when Henry V taken by four house-physicians. invaded France he took with him

II. The Surgeons of the City of London According to J. F. Payne (1904) it is clear that there were surgeons in Eng­ land from the seventh century onwards, though they had no special name to dis­ tinguish them from leeches in general. The starting point of this schism affect­ ing two forms of treatment has been ascribed to Papal edicts, especially the Council of Tours (1163), which were originally aimed to obviate the incom­ petence of priests (Garrison), forbid­ ding them to take part in any procedure involving bloodshed and so including surgical operations. This principle of ecclesia abhorret a sanguine was made absolute by the medical Faculty of Paris. In these days of increasing spe­ cialism the separation of surgery from medicine was opposed on broad grounds by and Har­ Thomas Morstede and twelve assistants. vey Cushing. Master John of Arderne (1307-90), the Master-Surgeons. Starting as a small best known of the early master-surgeons guild, the Fellowship of Surgeons, never in London, was a well read man who, more than twenty, dating from 1324, though an operator, employed not only the Master-Surgeons gained their train­ herbs, but charms. He wrote much, in ing and experience chiefly in the rough his later life, from about 1370, when schools of the wars. When at home, resident in London. His works, espe­ they were the consulting surgeons of cially the lesser treatises, written in London, but they often took charge of Latin, have been dutifully rescued patients in the country and were away from oblivion by D’Arcy Power. Ar- from London until their cases were derne’s “De cura oculorum,” which ex­ complete, and were thus a nomadic set tols the value of human urine as an of men. A close body, they appear to eye-wash was reproduced by James. have co-opted their members who thus The sixteenth century saw the union became entitled to be called “masters.” of the Company of the Barbers with the Unlike the physicians, whom they met unchartered guild of the Master-Sur­ on terms of fair equality, they were not geons, on July 25, 1540, to form the clerics or graduates of Oxford, Cam­ Barber-Surgeons Company. In this bridge or necessarily of continental uni­ union the crafts of barbery and surgery versities. They did not teach or have were kept distinct, the barbers confin­ apprentices, though when they went ing their activities to barbery, the ex­ traction of teeth and other minor serv­ to take heed and not to commit them­ ices, and being debarred from bleeding selves into the hands of every blind which they had previously practiced; buzzard that will take upon them to let this subsequently proved very lucrative blood, yes, to the utter undoing of a to the surgeons who would hardly have number.” With an ethical standard objected to their exclusion from bar­ high for that time when remedies were bery. After this a vigorous effort was kept secret, Clowes made public a styp­ made to improve the status of surgery tic powder he employed to check by Thomas Vicary (1490-1561), who haemorrhage at amputations. had played an influential part in bring­ ing about the union of the Barbers with John Woodall (? 1556-1643), surgeon to the East India Company and a colleague the Master-Surgeons, by Thomas Gale of William Harvey (1578-1657) at St. (1507-87), John Halle (1529-68), and Bartholomew’s Hospital, was the author William Clowes (1540-1604). They sys­ of “The Surgion’s Mate, or a Treatise dis­ tematically taught their apprentices covering faithfully the due contents of the and examined them for a license with­ Surgion’s Chest” (1617), and the “Viati­ out which no one could practice sur­ cum,” being the “Path-Way to the Sur­ gery in the City of London and within geon’s Mate” (1628), two textbooks much seven miles. They also established a used by naval surgeons. He recommended higher form of license—“the grand lemon juice to prevent and cure scurvy diploma”—which was occasionally which, however, had been successfully em­ granted, and has been likened to the ployed in 1593 by Sir Richard Hawkins fellowship of the Royal College of Sur­ (?1562-1622) in the “Dainty” and in 1600 by Sir James Lancaster (d. 1618). Subse­ geons of England, instituted in 1843. quently it was advocated in 1754 by James In connection with the granting of a Lind (1716-94), but it was not until 1796 license it should be added that until that the use of lemon juice was officially 1713 the final authority was vested in introduced into the Royal Navy. I11 1639 the Bishop of London and the Dean of Woodall brought out as an expanded edi­ St. Paul’s, acting for the Archbishop of tion “The Surgeons Mate; or, military Canterbury, who fulfilled some of the and domestique Surgery . . . with a trea­ functions of General Medical Council tise of ye cure of ye plague”; he had much (Wall. 1937). experience during the London plagues of Further, a very active campaign was 1603, 1625, 1636 and epidemics in France, launched against irregular practi­ Germany and Poland, had recovered from tioners. Gale said of their “cures” that two attacks, and advocated his pill aurum they “maketh the Devil in Hell dance vitae of secret composition, one dose of which was followed by cure (MacArthur). for joy to see the poor members of Jesus He would thus appear to have acted in Christ so miserably tormented.” Halle, conformity with the modification in 1908 a friend of Vicary, practicing at Maid­ of Terence’s maxim, namely to the effect stone, and the only one of these not at­ “Chirunmso sum! nihil medicum a me tached to St. Bartholomew’s Hospital, alienuni puto” (Dent). was the author of “The historicall ex­ postulation against the Beastlye Abusers After the Restoration (1660) the sur­ both of Chyrurgerie and Physick in geons openly showed their dislike of oure tyme” (1565); and Clowes among the association with the barbers; this, a number of eloquent expressions of though contentious, was not so violent opinion advised “the friendly readers as the quarrels of the physicians with the apothecaries. Eventually, largely as 22, 1800. In the meanwhile, in 1796, the result of the influence of John the Surgeons’ Hall had been sold, and a Ranby (1703-73), Sergeant-Surgeon to house bought in Lincoln's Inn Fields, George II. and in spite of the protest outside the City, where the Court of of the Barbers, the Barber-Surgeons’ the moribund Company first met in Company was dissolved, and the Sur­ January 1797. Charles Hawkins (1750- geons' Company was created in 1745. 1816) was, like his father Sir Caesar This separation of the Surgeons from Hawkins (171 1-86), Sergeant-Surgeon to the Barbers exerted a very important the King and Surgeon (1774-92, and influence on , by 1798-1800) to St. George’s Hospital; he abolishing the monopoly of anatomical was the first master of the College, hav­ and surgical teaching in London pos­ ing been the last master of the Com­ sessed by the Barber-Surgeons’ Com­ pany. In 1822 the title President was pany. As the result there sprung up a substituted for that of Master, and in number of private proprietary medical 1835-36 the College was practically schools, the most famous of which was rebuilt. the Hunterian or Great Windmill Street School. These private undertak­ III. Physicians ings gradually became transformed into In medieval times there were few the medical schools attached to the physicians in London; the earliest re­ large general hospitals and made them corded residence of a physician in the teaching hospitals. City appears to have been in the first From the time that the Barbers be­ third of the twelfth century in Alder- came a City Company in 1461-62 and manbury, close to the Guildhall and even before, anatomical teaching had Wood Street, namely of John the phy­ been given in their hall in Monkwell sician (N. Moore). The physicians in Street. To the united Barber-Surgeons’ those early times were usually clerics, Company was granted in 1540 the mo­ monks, or scholars who took all knowl­ nopoly of teaching anatomy and sur­ edge as their province; others were the gery in London, and the bodies of four personal medical attendants of Royalty; executed felons every year. In 1546 of eight physicians known to be prac­ John Gaius (1510-73) began his twenty ticing in or near London in the reign years’ tenure of the Readership in anat­ of Henry III (1216-72), two were phy­ omy at the Barber-Surgeons’ Hall. The sicians to Queens, two were canons of new Surgeons’ Company built the Sur­ St. Paul’s, two priests at St. Albans, and geons’ Hall in the old Bailey, just in­ that great and alternatively named per­ side the City, and it was completed sonality, John of St. Albans, from his about 1753. Inattention to business and birthplace, John of St. Giles, Joannes the defalcation of the clerk, Joseph Anglicus, and Joannis de Sancto Cruttenden, in 1780, after thirty-five Aegidio (fl. 1230), who lectured at Mont­ years’ service, who absconded with pellier on medicine and at Paris on £800 or £900 led to financial failure medicine and philosophy, was a doctor and to dissolution of the Company in of divinity, law, and medicine, was phy­ 1796. Ebe transformation of the Com­ sician to Philip Augustus, King of pany into the Royal College of Sur­ France in 1209, and attended Robert geons in London was then planned and Grosseteste or Greathead (1175-1253), a Royal Charter was granted on March Bishop of Lincoln; the bishop had been the teacher of Roger Bacon (1214- Wars of the Roses put a stop to this 1294), was an authority on optics with union, which was not realized until the reputation as one of the most 1886, and then only in part as the Con­ learned men of all times; and had also joint Examining Board of the Royal acquired sufficient medical knowledge College of Physicians of London and at Oxford to be physician to a previous the Royal College of Surgeons of Eng­ Bishop of Lincoln (Cholmeley). land. John of Gaddesden (? 1280-1361) was The Royal College of Physicians of the author of a textbook of medicine London was founded on the lines of the “Rosa Medicinae” (1314), often called Italian by Letters Patent, “Rosa Anglica,” in which he quoted a Charter of 10 Henry vm on Septem­ large number of authorities, which ber 23, 1518, as a result of the solicita­ were analyzed in detail by Cholmeley; tions of (1460-1524), among them were the “Compendium physician to Henry vm and a medical Medicinae,” also called “Lilium” or graduate of , and on the advice of “Laurea medicinae” (1303) of Gilbert Cardinal Wolsey. For more than three the Englishman, and the “Lilium medi­ centuries it remained within the bound­ cinae” of Bernard of Gordon professor aries of the City of London, and for at Montpellier. John of Gaddesden nearly a hundred years it occupied gave the name “Rosa Medicinae” to his rooms, given to it by Linacre in his book “on account of five appendages house, the “Stone-House,” in Knight (sepals) which belong to the rose, as it Rider Street. In 1614 it moved to Amen were five fingers holding it, concerning Corner, and when this was destroyed in which it is written”; but he may also the Great Fire of London (1666) a new have been influenced in the choice of a College was built in Warwick Lane, title by his seniors. Though largely a and was finally completed in 1679. compilation from Greek, Arabian and Here the College remained until in Jewish writers, it contains many per­ 1825 followed the march of fashion sonal observations. He was educated westward to its present site in Pall Mall (m.a., 1303; d.m., 1309; b.d.) at Merton East. College, Oxford, then the chosen alma A number of consulting physicians and mater of intending physicians. He was surgeons remained in the City; in the the first Englishman known to be phy­ eighties of the last century there were sician to an English monarch and had some members of the staffs of the London an extensive practice in London, being and Guy’s Hospitals living in Finsbury esteemed as a gynecologist. Like many Square. In those pre-telephone days Guy’s early physicians he was also a cleric, Hospital found it advisable that members being a canon of St. Paul’s, and like of the assistant staff should live within a John of Ardenne, the surgeon, wrote in mile of the hospital. Latin and was an outstanding figure in When first started and for a long these early days. time the College was the sole guardian In 1423 an attempt was made to es­ of medical learning in England; for Ox­ tablish a college of physicians and sur­ ford and Cambridge, though recogniz­ geons in London and a well planned ing medicine as a branch of learned scheme was prepared, but in 1428 war knowledge, did not take an active part again broke out with France, the sur­ in its progress. All the fellows of the geons left London, and in 1455 the Royal College of Physicians were either medical graduates of Oxford or Cam­ scriber of the maxillary antrum and of bridge, or incorporated as such from the mediastinum testis (mediastinum continental universities. Linacre thus Highmorianum). Several of the older brought physicians together for the first hospitals were originally priories, the time in England with the object of care of the sick being a later form of improving their learning and status active charity, and some hospitals re­ and. it is said, fostering a contempt mained so in the old sense of the word, for the mere accumulation of riches namely as workhouses or alms-houses; (N. Moore). Ebe original Charter gave thus ttvo of the five Royal hospitals, the College the control of all practicing Bridewell and Christ’s, never served the as physicians in. and for seven miles sick in body. round, London. Four years later it was enacted that no one. except graduates st. Bartholomew’s hospital of Oxford or Cambridge, should prac­ The oldest British hospital, St. Bar­ tice physic in any part of England with­ tholomew’s, was founded in Smithfield out the approval of the College. In 1534 in 1123 by Rahere (d. 1144), described the power to grant degrees and licences by Stow as “a pleasant witted gentle­ was conferred by Act of Parliament on man, and therefore in his time called the Archbishop of Canterbury, and the the Kings minstrell,” and by others as power to give the m.d. Lambeth, still Jester to Henry 1. Tired of Court life persists. According to Wall (1935), a he went as a penitent pilgrim to Rome well known homeopath, Edward where being attacked by fever, prob­ Cronin, received the degree in 1858, ably malaria, he had a vision and as a just before the Medical Act came into result made a vow to St. Bartholomew force and thus secured admission to the that he would found a priory and hos­ Register, and since then the degree has pital in Smithfield. Returning to Lon­ been given occasionally (he gave four don he became an Augustinian canon instances), but as a decoration only, the and the first master of the hospital, last being a medical practitioner, James which he held for life. He made pro­ Rogers, Mayor of Swansea, when the vision for brethren and sisters and for Church Congress met there in 1880. sick persons and pregnant women. It was, however, long before special wards IV. The Hospitals of the City of and hospitals for lying-in women came London into being (see p. 15). From very small The five Royal hospitals of the City beginnings the number of beds in St. —St. Bartholomew’s, Bethlem, Bride­ Bartholomew’s hospital during pre­ well, Christ’s and St. Thomas’s—were Reformation times touched 80, and at constituted as such, though dating its second foundation by Henry vm much further back, in the middle of the in 1547 it had nominally 100 beds; but sixteenth century, after the suppression at one time there were only three in­ of the monasteries by Henry vm. patients and a little later ten. In 1923, Much information about the early his­ the eight hundredth anniversary of its tory of hospitals in London was made foundation, there was full equipment available in 1810 by Anthony High- for 748 beds (D’Arcy Power, 1923). more (1758-1829), a solicitor in Ely At a very early date there were at­ Place and a descendant of Nathaniel tached to the hospital six “outhouses” Highmore (1613-85), physician and de­ at some distance, such as Highgate Road, and the Old Kent Road. These 1590 he gave up medicine for the were probably at first for lepers, but church. His successors were Thomas with the appearance of syphilis were D’Oyly (?i548-1603), a Spanish scholar used for venereal disease, the word who died while in office in the Hospi­ Lock (hospital) being said to be de­ tal; Ralph Wilkinson (d. 1609), and rived from Loke, a house for lepers William Harvey (1578-1657) whose ap­ (Highmore). Four of the outhouses dis­ pointment on October 14, 1609 so appeared, and in 1760 the two remain­ greatly added to the fame of the Hos­ ing—that for men in the Old Kent pital. Road, and that for women in Kingsland The first book on medicine in any Road—were closed. In the seventeenth way connected with St. Bartholomew’s and eighteenth centuries they were Hospital was the great treatise “Brevi- under the care of the two junior assist­ arium Bartholomei” (ca. 1387) by John ant surgeons. Mirfield (fl. 1393), an Augustinian Until the middle of the sixteenth Canon, resident in the Priory of St. century St. Bartholomew’s Hospital Bartholomew, also founded by Rahere. was without a surgical staff; Thomas Norman Moore (1908) exhaustively ex­ Vicary, the author of the earliest amined two manuscript copies of the printed book in England to be solely “Breviarium,” in the British Museum devoted to anatomy, “A Treasure for and Pembroke College, Oxford, and Englishmen containing the Anatomie quoted much from its contents; it con­ of Mans Body” (1548),* became the demned the separation in the twelfth first Medical Officer and chief surgeon century of surgery from medicine, as in 1548. Two other surgeons were ap­ indeed Lanfranchi (? 1250-1315) had pointed at this time. Less fortunate was done earlier. the first appointment of a resident phy­ The of the hospital sician in 1567, Roderigo Lopez, a grew up gradually and was formally Portuguese Jew, physician to Oueen recognized in 1791. It was mainly due Elizabeth, who was hanged, drawn and to the teaching of John Abernethy quartered at Tyburn in 1594 for con­ (1764-1831) who was elected assistant spiring to poison her, and was consid­ surgeon in 1787. On the medical side ered by to have been the David Pitcairn (1749-1809) was a prom­ original of “Shylock’’ in the “Merchant inent teacher; from 1788 he taught at of .” He had been succeeded the hospital, but never published, the about 1580 by Peter Turner (1542- causation of heart disease by acute rheu­ 1614) who held office until 1585 and matism; that he did so was pointed out was followed by Timothy Bright P1551- by Matthew Baillie (1761-1823) in 1615) , “father of modern shorthand” 1797, and by W. C. Wells (1757-1817) (of his book Characterie, 1588, one copy in 1812; the association of the two con­ only exists) who also brought out an ditions was described in 1836 by J. B. abridgment of John Foxe’s “Acts and Bouillaud (1796-1881) of Paris whence monuments of the church,” in 1581; in it has been called “maladie de Bouil­ laud.” * No copy of this book is now known, and its existence has been doubted, but that there BETHLEM ROYAL HOSPITAL (“BEDLAM”) was such a work, though mainly a compila­ tion, out of date when it appeared, was Like other ancient hospitals in the shown by D'Arcy Power. City of London, Bethlem Hospital arose out of a priory. In 1247 Simon to force and compel the idle strumpet FitzMary, a of London, founded and burly vagabond to honest and vir­ the Order of the Knights of the Blessed tuous exercise.” All the bedding and Mary of Bethlehem with a priory in other furniture of the hospital of the Bishopsgate. It did not flourish, and in Savoy was given for the maintenance of 1547 after the suppression of the mon­ Bridewell and the hospital of St. asteries in 1539 by Henry vm (1491- Thomas in Southwark (Stow). If ill, the 1547), it was in 1553 given, as a Royal occupants were to be treated at St. hospital for the reception and mainte­ 'Thomas’s Hospital, and their children, nance of lunatics, to the Corporation of if of good capacity, were to be brought London by Edward vi. It was not. how­ up at Christ’s Hospital. These three ever, included with the four other Royal hospitals were thus linked to­ Royal hospitals in the Order of the Hos- gether. Bridewell after being largely pitalls of K. Henry VIII. and K. Ed­ destroyed in the Great Fire of London ward VI., 1557. The accommodation in (1666) was rebuilt, but was demolished the priory was inadequate and accord­ in 1 863. ingly it was removed in 1676 to the south side of Lower Moorfields. The Christ’s hospital design of the new building was mod­ The site of this future famous school elled on that of the Chateau de Tui­ for poor, fatherless children was occu­ leries in Paris; that this should be pied by a small convent of Grey Friars, adopted for a hospital for the insane so mendicants of the Franciscan order. exasperated Louis xiv that he “or­ “The Grey Friars” described by Thack­ dered a plan of St. James’s Palace, Lon­ eray was the Charterhouse, then on the don to be copied for offices of a very other side of Smithfield. The blue-coat inferior character” (Highmore). For school for 300 children dates from its more than 200 years one of the sights of Charter conferred by Edward vi in London was to go to see the lunatics at 1552. It was largely destroyed by the Moorfields for a small charge for the fire of London (1666), but was rebuilt, upkeep of the hospital. In 1815 the hos­ and in 1674 Charles 11 founded a math­ pital was removed to St. George’s Fields, ematical school to qualify forty boys for Lambeth, and in July 1930 to Eden Park, near Beckenham, Kent. the sea. In 1902 the school moved to Horsham in Sussex. BRIDEWELL st. Thomas’s hospital Bridewell, a City parish near the Fleet ditch and Blackfriars, contained a St. Thomas’s Hospital in Southwark palace of King John, within the walls was outside the City of London as it of which was a well, dedicated to St. was on the south side of the Thames. Bridget or St. Bride and reputed to The present difficulties about its earli­ possess healing properties. This palace est origin have been discussed at length was in 1553 given to the City by Ed­ by F. G. Parsons. From the twelfth cen­ ward vi as a house of occupation or tury there was a priory of St. Mary the workhouse, where trades could be Virgin or St. Mary Overie (according !learnt, and as a prison for the “disor­ to Stow, over the river; others have re­ derly and those addicted to idleness, the garded the word as a fusion of the enemy of all virtue . . . and last of all Saxon words of er = a bank and eye = an island). From 1106 part of this Au­ Farre’s house. In 1808 its title was al­ gustinian priory was known as the in- tered to the “London Infirmary for firmarium of St. Mary the Virgin (Par­ Curing Diseases of the Eye,” the aims sons), and in 1173 when Thomas a of the Charity being thus restricted to Becket (?i 118-70) was canonized, be­ the ocular diseases. When the founda­ came known as “Becket’s spital.” The tion stone of the new hospital, in the priory was abolished by Henry vm in northeast corner of Lower Moorfields 1538, and in 1552 the Mayor and Citi­ and to the north of the old City wall, zens of London bought the Manor of was laid on May 2, 1821, its name was Southwark, containing the site of the changed, for the third time, to the Lon­ Priory from Edward vi, repaired it, don Ophthalmic Infirmary; finally in and opened it as a hospital for 260 sick 1837 it became the Royal London Oph­ poor and helpless. In 1553 the King in­ thalmic Hospital, and in 1899 moved, corporated it as one of the Royal hospi­ for the third time, to its present site in tals. It was not, however, included with the City road. It must not, as it easily the other four Royal hospitals in “The might, be confused with (a) the Royal Order of the Hospitalls,” 1557 (D’Arcy Infirmary for the Eye which opened in Power, 1923). It was rebuilt in 1693; in 1804 in Street and came to an end 1 862 the site of the hospital was sold to in 1872 when its funds, after settling all make room for London Bridge railway liabilities, amounting to £200 only, station, and the patients were accom­ were handed over to the Moorfields Eye modated in the Surrey music hall until Hospital; or (b) the Infirmary for Dis­ on June 21, 1871, the present hospital eases of the Eye, largely established by in Lambeth was declared opened by G. J. Guthrie (1785-1856) in 1816, long Queen Victoria. known as the Royal Westminster Oph­ thalmic Hospital in King William OTHER HOSPITALS Street, next to Charing Cross Hospital; Owing to somewhat similar names in 1928 it moved to 178 High Holborn, which sometimes underwent changes, W.C.i. for example in the ophthalmic and ma­ St. Luke’s Hospital for Lunatics. The ternity hospitals, which also moved original Hospital opened in 1737 on from one to another part of London, the north side of the Upper Moorfields; confusion may occur. but, as it did not contain accommoda­ The Royal London Ophthalmic Hos­ tion for more than 110 patients, a new pital (Moorfields) was established by hospital was erected in Old Street and J. C. Saunders (1773-1810), J. R. Farre opened in 1787, for 300 patients, 200 of (1775-1862), and Richard Battley (1770- 1856), an apothecary in St. Paul's whom were regarded as curable and 100 Churchyard, who was the secretary as incurable. Patients considered to from 1804 to 1818, with the assistance have been insane for a year were not of the physicians and surgeons of St. eligible for admission, and it was Thomas’s and Guy’s Hospitals, espe­ thought proper to state that “the pa­ cially Sir Astley Paston Cooper (1768- tients are not exposed to view” (see 1841) who suggested its establishment. p. 13). The permanent Pest-House of It was first known as the “London Dis­ the City erected after the plague of pensary for Curing Diseases of the Eye 1592 had been close to, and to the west and Ear” and was opened on March 25, of that subsequently occupied by St. 1805 in Charterhouse Square close to Luke’s Hospital. The position of this pest-house was indicated by Pest-House and parts adjacent, and also for sick and Row built there in 1737. lame out-patients in Physic and Sur­ gery” was started in hired apartments in MATERNITY HOSPITALS London House. AldersgatcStreet,and in Fhe first approach to a lying-in hos­ the following year moved to Shaftesbury pital in London was not in the City but House in the same street and adopted in the West End. In 1739 Sir Richard the new title “The City of London Ly­ Manningham (1690-1759), a leading ing-in Hospital for Married Women,” mail-midwife of his day, and also de­ the out-patient department being dis­ scribed as “an ugly old gentleman in a continued. In 1773 a specially built hos­ grate blak wig” (vide Spencer), estab­ pital was opened at the corner of Old lished the first wards for 25 parturient Street, near St. Luke’s Hospital for lu­ women in a house adjoining his own in natics and the Eox and Goose ale-house. Jermyn Street (G. C. Peachey) and not, A list of the maternity hospitals in as often stated, in the parochial Infir­ London and elsewhere between 1650 mary, St. James’s, Westminster, both and 1800 is given by Spencer. being outside the City. These Wards became in 1752 the General Lying-in DISPENSARIES Hospital which after several migrations From these charities, the forerunners at the West End came under the patron­ of the out-patient departments of pres­ age of Queen Charlotte in 1791, and ent day hospitals, the patients received was spoken of as the Queen’s Lying-in advice and medicines gratis or for a Hospital; it was then stated that it was small charge and, if necessary, were for “poor pregnant women, as well mar­ visited in their own homes. In 1688 the ried as unmarried” thus differing from Royal College of Physicians of London, other lying-in hospitals which excluded then in Warwick Lane, opened a dis­ the unmarried. Later the hospital took pensary in its house with branches in the name of Queen Charlotte’s Hospi­ St. Peter’s Alley, Cornhill and in St. tal, and in 1813 moved to the Old Martin’s Lane, the last being outside Manor House, Lisson Green, and was the City boundaries, where the sick rebuilt on that site in 1856. The Mid­ poor within and for seven miles round dlesex Hospital in Berners Street in the City could obtain advice gratui­ 1747, two years after its foundation, tously and the medicines prescribed at provided a ward for married lying-in cost price; this continued until the end women. of 1724. There was then an interval The British Lying-in Hospital in without any dispensary in the City of Brownlow Street (E) was opened in London until in 1770 the General 1749 under the name “The Lying-in Dispensary in Aldersgatc Street was Hospital-’ for married women, the ad­ opened, this was followed by the Fins­ jective “British” was added to the title bury Dispensary in 1780. Both of these in 1756. William Hunter (1718-83) was owed much to the energy of the philan­ on the original staff. It is now the “Brit­ thropic Quaker physician John Coak­ ish Hospital for Mothers and Babies,” ley Lettsom (1744-1815). Woolwich. The City Dispensary in Grocers’ The City of London Maternity Hos­ Hall Court, Poultry, was opened in pital and Midwifery Training School, 1789 for the relief of the diseased poor City Road. In 1750 the “Hospital for “requiring medical and surgical assist­ married women in the City of London ance, and for inoculation.” The London Electrical Dispensary in sicians in London which, stimulated by City Road was established in 1793. John Fothergill (1712-80), published That this followed the vogue of Mes­ “Medical Observations and Inquiries” mer (1734-1815) in the last twenty years (1757-84) dealing especially with unsuc­ of the eighteenth century in Paris may cessful cases and errors of diagnosis and be significant. Of 3,274 patients treated treatment. Fothergill was never a fellow from Michaelmas 1793 to Christmas of the present Medical Society, but Lett­ 1802 it was claimed that 1,401 were som, his fellow Quaker and devoted cured, 1,232 relieved, 557 discharged, admirer, endowed the Fothergillian and 84 remaining under cure. One of Memorial which might naturally sug­ the regulations for patients is perhaps gest that Fothergill had been promi­ worth quotation: nent in originating the Society. The patients, when cured, shall apply Hunterian Society. There were sev­ at the dispensary for letters of thanks, eral small but active medical societies which are, within three days, to be deliv­ in the Hunterian era of the eighteenth ered to the governors who recommended century; but the two chief medical so­ them; or, in neglect thereof, are not to be cieties in London during the first quar­ admitted to any future benefit from this ter of the nineteenth century were the charity. present Medical Society of London, and The Dispensary was apparently in the Royal Medical and Chirurgical So­ existence in 1810 when Highmore’s ciety (1805-1907) now continued in the book, from which the above is taken, Royal Society of Medicine of London, was published. and then meeting in Verulam Build­ ings, Gray’s Inn. These were thought to MEDICAL SOCIETIES IN THE CITY be too far from Finsbury Square and The present Medical Society of Lon­ Circus, then the chief “Harley Street” don was founded in 1773, largely as a district; at any rate the need for a Medi­ result of the energy of J. C. Lettsom cal society nearer Finsbury was in 1819 and his “Hints for the establishment of voiced, especially by William Cocke, a Medical Society in London’’ pub­ the author of a brief memoir of Blizard lished in that year. The Society first who was the first president and sug­ met in Lettsom’s house in Sambrook gested the name Hunterian Society. Court, Basinghall Street, then in Crane From 1821 to 1866 the Society had Court, and in 1788 in a house, number premises at 18 Aldermanbury, but oth­ 6 Bolt Court, Fleet Street, which Lett­ erwise led a nomadic existence. som left to the Society so long as the The Medical and Philosophical So­ number of fellows did not fall below ciety of St. Bartholomew’s Hospital was ten. A library was started there by Lett­ founded in 1795 by John Abernethy som. At first the membership was lim­ who utilized the Society for part of his ited to 30 physicians, 30 surgeons, and teaching. It had six presidents, and the 30 apothecaries, as general practitioners physicians and surgeons of the hospital were then called. But in 1789 there took a considerable share in the Socie­ were 250 fellows and in 1939 the num­ ty’s activities. In 1830, owing to Aber­ ber was 566. In 1850 the Society moved nethy’s illness, meetings ceased entirely; to George Street, Hanover Square, and but on November 23, 1832 it was re­ in 1871 to 11 Chandos Street, Caven­ solved “that a society of the medical dish Square. pupils of this hospital be founded, to There was an earlier Society of Phy­ be called the Abernethian Society, and that the gentlemen present be enrolled infection by the Trichinella spiralis was as the founders of the same.” This so­ given before the Society by James Paget ciety inherited the records and tradi­ (1814-99), then dissecting as a first year tions of its predecessor, and had six student at the hospital, who in 1845 presidents, one for each of the six win­ gave an address at the Jubilee and at­ ter months of the year. In February tended its centenary meeting in 1895 1835 the original description of human when Norman Moore gave the address.

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