368 SAMUEL GARTH, PHYSICIAN AND MAN OF LETTERS DANIEL L. MCCUE, JR., PH.D. Associate Professor, Department of English Boston College Chestnut Hill, Mass. "1r HE eighteenth century, more than any other," wrote Kenneth lHopkins, was the century in which it was a commonplace to send a sheaf of verses to the press. Almost every country parson and many coun- try gentlemen did it as a matter of course, and we find doctor, solicitor, schoolmaster and soldier poets at every turn. The century in which authorship first became truly a profession was also that in which the amateur flourished most abundantly.1 Medical men in particular made remarkable contributions to English litera- ture during this century: the names of Samuel Garth, John Arbuthnot, Richard Blackmore, Mark Akenside, John Armstrong, Oliver Goldsmith, Tobias Smollett, and Erasmus Darwin echo through the pages of literary history. The reasons are not far to seek. Physicians in those days were all educated in the humanities, chiefly in classical literature, and wit or literary talent (often combined) attracted the attention of wealthy clients and frequently served as an entree into circles of influence and power. GARTH'S CAREER One of the most interesting of these doctor-authors was Samuel Garth. Born in 1661 in the county of Durham, he was the eldest son of William Garth of Bolam.2 The family belonged to the gentry3 and young Samuel received a good education. After preliminary schooling at Ingleton he entered Peterhouse College, Cambridge, in 1676 and graduated B.A. in 1679, M.A. in 1684. Perhaps influenced by the intellectual climate at Peterhouse, which was favorable to the sciences, he decided to study medicine. In 1687-the year of Isaac Newton's Principia-he went to Leyden to study clinical medicine, thereby absenting himself from the turmoil and excitement of the glorious Revolution. Leyden was one of the best-known medical schools in western Europe. Bull. N.Y. Acad. Med. SAMUEL GARTH 369 SAMUEL~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ GAT 6 Jonathan Swift's Lemuel Gulliver supposedly studied at Leyden before embarking on his famous travels; Mark Akenside and Oliver Goldsmith received their medical educations there. Garth arrived too early to come under the tutelage of Hermann Boerhaave, who started teaching at Leyden in 1701, but the atmosphere of the late 17th century Netherlands, still basking in the afterglow of the discoveries of van Leeuwenhoek and Huygens, must have been congenial. In late 1688 Garth went to France, apparently to study in the hospitals there.4 He was back in England in 1691 to take his M.D. at Cambridge, and in June 1692 became a candidate for membership in the Royal College of Physicians. Even at this early date Garth was esteemed by fellow doctors. On December 28, 1692 the College of Physicians received a letter from the Lords of the Admiralty requesting the College to name three or four physicians from whom the Lords might choose one to care for the sick and injured men at Portsmouth naval base. The College decided to re- commend only one: Samuel Garth-"he being a Doctor of Physick of Cambridge and a candidate of the College, of good learning, having spent some years in foreign hospitals."5 In 1693 Garth was elected a Fellow of the College, and in 1694 he delivered the Gulstonian lectures on the topic, De Respiratione. The lectures were admired by colleagues and Garth was urged to publish them, but he never did so. In January 1697 Garth was appointed Orator of the College and in September he delivered the annual Harveian oration in Latin. He was chosen to give the oration, not solely or primarily because of his medical knowledge, but because it was hoped that he might help reconcile oppos- ing factions within the College.6 He made use of the occasion to express two strongly held views: his firm loyalty to Whig principles and to the settlement of 1688 following the Revolution ("half of the oration," wrote one biographer, "is a panegyric of William III" 7) and his indignation at the existing quackery in the medical profession.8 A man of conscience interested in social improvement and a member of the college's important committee on medicines,9 Garth became a prime mover in the college's project to construct a dispensary to furnish prescrip- tions and drugs at cost to indigent patients. The resulting controversy called forth his earliest and most important literary work, The Dispensary (1699). The notoriety of the quarrel and Garth's witty mock-epic poem on it Vol. 53, No. 4, May 1977 370 D. L. McCUE, JR. brought him into increased prominence in the public eye. He steadily acquired a large practice and a circle of influential friends. Lords Wharton, Grantham, and Clare were among his patients.10 He was on friendly terms with the Duke and Duchess of Marlborough, Lord Peterborough, Sir John Vanbrugh, and Sir Hans Sloane, among others.11 His literary friends included John Dryden, Alexander Pope, William Congreve, Joseph Addi- son, Sir Richard Steele, John Arbuthnot, and John Gay. Few physicians who have been attracted to literature have managed to sustain a perfect balance between medical and literary activities,12 but Garth did. He "was continuously and enthusiastically engaged in the practice of medicine,'"13 yet throughout his career he moved in literary circles and continued to write and publish poems. Shortly after publication of The Dispensary Garth became a member of the Kit-Cat Club (a Whig club described later), and about 1700 he was temporarily considered for the post of Regius Professor of Physick at Cambridge.14 In 1702 he was named a Censor of the College of Physi- cians, a post which he discharged with fairness and integrity.15 In 1706 he became a Fellow of the Royal Society.16 Although a Whig, he was one of four physicians called in during the Tory administration of Queen Anne to attend Prince George of Denmark, the Royal Consort, during his last illness in 1708.17 In the early 18th century Garth took an active part in Whig politics, seemingly as a result of his relation with Sarah Churchill, Duchess of Marlborough.18 He appears to have acted as liaison between the Whig party in England and Marlborough on the Continent, having visited the latter during the military operations of 1711.19 When the Churchills were dismissed and exiled (due to the powerful opposition of Swift and the Tories) the Duchess gave Garth a diamond ring worth £ 200 as a reward for his services.20 With the death of Queen Anne and the accession of George I, Garth won other rewards. In 1714 he was knighted, and in 1715 he was appointed physician-in-ordinary to the king and physician-general to the army2 1-the culminating honors of a long and successful career. But his political activity was not yet ended. During the Jacobite uprising of 1715-1716 Garth, together with Steele, helped to keep the northern counties quiet and loyal to the king.22 In the autumn of 1716 Garth went to Paris with Addison and others to negotiate with Henry St. John Bolingbroke, the exiled Tory minister.23 Although Garth was highly respected as a medical man by his contem- Bull. N.Y. Acad. Med. SAMUEL GARTH 371 poraries, he was not innovative. He made no new discoveries in medicine, identified no new diseases, developed no new processes or cures. In the pages of such historians of medicine as John Cordy Jeaffreson, Wil- liam Munk, Benjamin Ward Richardson, and Lester S. King he is hardly ever mentioned, except in connection with the Dispensary quarrel which will be described later.24 His abilities appear to have been those of the skilled and competent practitioner, combined with a cheerful and outgoing personality which gave confidence and hope to his patients. Garth lived and practiced medicine in London, first in the Haymarket, later in St. James Street.25 He also purchased a country house at Harrow. He married Martha, daughter of Sir Henry Beaufoy, and they had one child, a daughter who later married Colonel William Boyle.26 Lady Garth died in 1717. Garth died after a brief illness on January 18, 1718/19 and is buried beside his wife at Harrow.27 THE DISPENSARY In the second half of the 17th century a long-standing rivalry between the physicians and apothecaries came to a head in London. By law, physicians wrote prescriptions and apothecaries filled them. The apothecaries, mostly uneducated men, had originally been a part of the Grocers' Livery, but they aroused such scandal by their incompetence and adulteration of commodities that in 1617 a charter separated them from the grocers and placed them under control of the College of Physicians. Since the medical practice of the day was based on empiricism, the apothecaries soon began to prescribe on their own. They found that it was not difficult to compete with the doctors, some of whom were scarcely more expert than the apothecaries.28 About 1660 the number of apothecary-doctors began to increase marked- ly in London. Moreover, during the Great Plague of 1665, when most college physicians joined the exodus from the city of their middle-class and upper-class patients, the apothecaries stayed behind to treat the sick poor-thereby consolidating their influence among the citizens and estab- lishing a precedent for their practice of medicine.29 As early as 1669 Christopher Merrett proposed having doctors not only write prescriptions for the poor, but also prepare and dispense them. Merrett's pamphlet, A Short View of the Frauds and Abuses Committed by Apothecaries; ...and of the Only Remedy Thereof by Physicians Making Their Own Medicines (London, Allestry, 1669) precipitated a controversy Vol.