LIBRARY UNIVERSITY OF CALGARY HISTORICAL BULLETIN Notes and Abstracts Dealing with Medical HistOf) Issued Quarterly by the Calgary Associate Clinic as a Supplement to its monthly "H istorical Nights." VOL. 8 C AL GARY F EDRUARY, 1944 A L DERTA No. 4 . THOMAS WAKLEY (1795-1862) Medical Editor and Reformer "Hang your reforms !" said Mr. Chichely. "There's no greater humbug in the worl d. You never hear of a reform but it means some trick to put in new men. I hope you are not one of the Lancet's men, Mr. Lydgate." "I disapprove of W akley," interposed Dr. Sprague, "no man more : he is an ill-intentioned fellow, who would sacrifice the respectability of the profession, which everybody knows depends on the London Colleges for the sake of gettir;i g some notoriety for himself. There are men who don't mind being kicked blue if they can only get talked about. But Wakley is right sometimes," the Doctor added judiciously, "I could mention one or two points in which Wakley is in the right." G!loRG!l ELIOT : Middlemarch. T has been written-"Who are the· English? W hat are the Engli sh? They are Saxons who love the land, who love I their liberty, and whose .sole claim to genius is their common-sense." The subject of this sketch (to use the old tag) is an Englishman of this classic breed, a characteristic Victorian, a thorough-going reformer and a life-long fighter. He has been unaccountably slighted by history and-more surprisingly-by medical history. Few of the modern medical generation know the name of the man whose battle honors in the cause of medicine would fill a ,page. You are likely to · look in vain in the roll of the medical Valhalla for the name of the man who has done as much as any other to bring into being high standards of rpedical education and practice, and to increase the stability and dignity of ~edicine as a career. This " forgotten man" of medical history is Thomas Wakley, the founder and militant editor of The Lancet and stqrmy petrel of British medicine in the nineteenth century. His life is an exciting if not a comfortable chronicle. He is that rare phenomenon in public life-a successful reformer. Virile and vehement, dogmatic as a railway time-table, exuberant and optimistic, he is a characteristic figure of one of the great ages in British history. · Wakley was born in 1795 and his early years saw the re­ <tction to the French Revolution and the war with Napoleonic France. Then as a man he grew and flourished in the expand­ ing Victorian era, years of peace and prosperity, with the Pax Brittanica abroad and the growing application of liberal political and social principles at home. It was a time in which men were sure of certain fundamental things and the measure of their conviction was the touchstone of their character. These Victorians worked from a basis of certainty. They knew their own minds. They had a s~nse of security. With the increasing prosperity of industrial England, they had confidence in the future. At the same time a race of prophets and reformers was being bred, and there gradually took shape the measures by which Britain met the evils of the rising tide of industry-free trade, extension of the franchise, factory laws, abolition of privilege and abuses, trade unionism, the co­ operative movement. All these reforms, be it noted, were British in conception and application. They were worked out in an ordered society " \i\There freedom broadens slowlv down From precedent to precedent." · In such a scheme of things there was virtually an appointed place for the active radical reformer. And Wakley was sue}} a man. But with all this optimism and prosperity and buoyancy, it must not be supposed that the wellsprings of the Victorian age are to be found in an expanding economy and material wealth. The real strength of the age lay in the self-discipline and self-reliance of the individual Englishman. These quali­ ties were derived from many sources but to a large extent sprang from Puritan traditions which had been powerfully reinforced by the Wesleyan and ·Evangelical movements. 'Self help' was the favorite motto of the time. It is in the light of such reflections that Wakley becomes a significant figure. EARLY YEARS Thomas Wakley was born at Membury, Devonshire, July Hth, 1795, the youngest of eleven children. The name Wakley is a Saxon name and his father was a gentleman 2 THOMAS WAKLE:Y 1795 • 1862 . I farmer and de!:icendant of a long line of landowners. Our Wakley was thus what is known as a "West Country" man. They are of a tough breed, these men of Devon, Somerset and Dorset, seamen, downright and blunt men of the land, men who have known uprisings in the past. He attended grammar schools in the district but did not , excel in book learning. As a boy he wanted to go to sea but a voyage to Calcutta in an East Indiaman when he was still a lad settled this ambition. At fifteen he was apprenticed to a Taunton apothecary, then trans£ erred as apprentice to his brother-in-law, Mr. Phelps, surgeon of Beaminster, and later as pupil to Mr. Coulson at Henley-on-Thames. In 1815 he went to London and entered as student at the united schools of St. Thomas's and Guy's, known as the Borough Hospitals. He gained the most thorough part of bis medical training at the private school of anatomy in Webb Street (the Grainger School), was a pupil in the joint anatomy classes of Henry Kline and Sir Astley Cooper at Thomas's, attended Sir Astley Cooper's lectures on the prac­ tice of surgery at Guy's where he did surgical dressings and ward work. As a student be was a hard worker, energetic and hearty. A keen sportsman, he excelled in cricket, quoits and billiards. His rigorous West Country training made him a brilliant boxer and he had many bouts in the common meet­ ing-place of the students of the day-the "pubs". A very loose system of medical instruction, examination ' . and licensing prevailed at the time. The requirements for a degree were five years' study (including apprenticeship) which included two courses of lectures on anatomy, two courses of dissecting and one year's practice in the wards of the city hospitals. Wakley took the course in his stride and in 1817, now twenty-two years of age, he passed his examina­ tion for membership in the Royal College of Surgeons and walked home to Membury to announce the news. We may look at the young pedestrian as he tramps along the Dorset roads. A man of strong individuality, of great physical strength and vitality. Conversation with him will quickly reveal that he is possessed of the bluff directness of his country upbringing, that he has above all a deep sense of justice and the Englishman's love of fair play. Having grown up as the youngest among brothers who were fine jovial sportsmen and countrymen, he has few illusions and hates all shams. But what is unusual in a man destined to be a great controversialist, there is the combination of firmness and a direct manner with good-tempered courtesy. We may suppose 3 ·that this happy circumstance he owed to the influence of his five older sisters. It was to exert a powerful influence in his career in later years. The young doctor looked over the country about his home, and finding no promising location for practice, returned to London. During the year 1818 he stayed at Gerard's Hall in· Basing Street, read and studied diligently, usually rising at . 4 a.m. for this purpose. He had now to make his way I I ' unaided in the practice of medicine. How was it to be done ? · As he surveyed the profession he saw that it was firmly in the hands of the privileged classes. He noted that to be a Fellow of the Royal College of Physicians one must have a ~egr e e from Oxford or Cambridge which meant family posi­ _tion and wealth (the fellowship fees were high), one must be a member of the Church of England (no dissenter could be a Fellow). He found that all hospital appointments were made from this body of Fellows with personal influence weigh­ ing heavily. He noted further that the chief appointments in surgery were similarly made from an influential group of . Fellows in the Royal College of Surgeons and that these men . saw to it that their friends and relations were elected to all Important posts by canvassing the hospital governors. It was :thus evident that men obtained plates in the medical world by purchase and by influence and not by merit. What made matters worse, they took the salaries and fees of such posts but did not do the work,· farming it out to assistants. : · Worlds removed from this select group was the rank and ·file of the profession made up of licentiates of the Royal . College of Physicians, members of the Royal College of Surgeons and licentiates of the Society of Apothecaries. · ·These men had no prospects of advancement and their stand­ . ards of practice were for the most part deplorable. Wakley, not being of the privileged classes, found himself relegated ·to the ragtag and bobtail of the profession. This he resented, and the resentment was the spark which later kindled the fire of his reforming zeal.