COLLEGE OF PHYSICIANS, WARWICK LANE. ENTRANCE.
COLLEGE OF PHYSICIANS, WARWICK LANE. ENTRANCE.
The year 1665 and 1666 were eventful ones for the College of Physicians. At that time the president was Sir Edward Alston, who had managed to repair the financial ruin caused by the civil wars by the expedient of admitting honorary Fellows, and making them pay for the honour. It was in this year that Charles II. attended one of the anatomy lectures, and knighted the lecturer (Sir George Ent) at its termination. Misfortunes, however, were in store, and we can hardly say they were undeserved. When the plague appeared, the president and most of the Fellows fled from town, and during their absence the treasure chest of the College was emptied by thieves. After the plague came the great fire, and in it the College at Amen Corner was destroyed. When the College was rebuilt, a new site, not far from the old one, was chosen. This was in Warwick Lane, Newgate Street, on a piece of ground purchased from Mr. Hollier, a surgeon, for £1,200. The new College was designed by Wren. It was in the form of a quadrangle, with a botanical garden behind it, running down to the City walls. The entrance was through a fine gate, and over this Sir Christopher Wren built a magnificent theatre, forty feet in diameter, with an octagonal-domed roof. This theatre was said to be a model of what a theatre should be. There were, in addition, fine rooms for transacting the College business, and a good library. Only about 140 books had been saved from the fire, but the new College was soon furnished with books by the library of the Marquis of Dorchester, which that noblemanbequeathed to it. He appears to have been a learned and somewhat eccentric man, who studied “all manner of learning, both divine and human.” He became a Fellow of the College in 1658, and shortly before had been made a Bencher of Gray’s Inn. It is impossible not to regret the fine old College, with its spacious courtyard and physic garden and its historic associations. But it would seem as if no purely educational establishmentcan flourish in the City of London. The Royal Society, the College of Physicians, and the College of Surgeons have all moved away, and Gresham College alone is left, as if to show the impossibility of flourishing in the richest city of the day. Much as one may regretthe old College, it is probable that Sir Henry Halford did right in advising in 1824 a move to Pall-Mall, notwithstanding that the present house is much smaller than the old one, and by no means remarkable for the convenience of its arrangement.
COLLEGE OF PHYSICIANS, WARWICK LANE. QUADRANGLE.
COLLEGE OF PHYSICIANS, WARWICK LANE. QUADRANGLE.
Of the London physicians of the seventeenth century none is better known thanThomas Sydenham. He was born in 1624, joined the Parliamentary army in 1643, and became M.B. Oxon. in 1648. In what his medical education consisted is not clear. It is very doubtful if he was ever at Montpellier or any foreign school. He was a great friend of John Locke. He came to London in 1660, and was a licentiate of the College of Physicians in 1663. Like the rest of the world, he ran away from the plague; but, as he lived in Westminster, he did not probably suffer from the fire. He died in 1689. His “Medical Observations concerning the History and Cure of Acute Diseases” was published in 1666, and was dedicated to Robert Boyle. In the preface of this work he strongly advocates an attempt at a scientific classification of disease by a careful comparison of the phenomena observed in different cases. Accurate diagnosis was the necessary preliminary to finding a reliablemethodus medendi. His own descriptions of disease are excellent. Perhaps his account of the gout, from which he suffered, is more often quoted than any other. He was never a Fellow of the College of Physicians. There is no evidence that he ever applied to be made a Fellow. Expressions are frequent in his writings which seem to show that he was not on the best of terms with some of his contemporaries. Sydenham was undoubtedly a man who could think for himself, and perhaps his chief merit lies in the fact that he appreciated much of the medical writing of his time at its true value. It is recorded of him by Dr. Johnson that, “when Sir Richard Blackmorefirst engaged in the study of physic, he inquired of Dr. Sydenham what authors he should read, and was directed by Dr. Sydenham to “Don Quixote,” “which,” said he, “is a very good book; I read it still.” In this answer of Sydenham’s we perhaps get a clue to his attitude towards the profession. He was one of the first to use Peruvian bark in the treatment of ague, and this must have done much to advance his practice at a time when London was scourged by malarious fever. One of my objects is to bring before you personal facts with regard to some of our professional ancestors, and we get a good idea of Sydenham in that chapter of his “Schedula Monitoria” in which he details his own sufferings. It was in 1660 that he first suffered from the gout, and shortly afterwards symptoms of renal calculus developed, and in 1676 he began to suffer from hæmaturia. “This became,” he says, “afterwards habitual, as often as I either went along a way on foot, or drove in a carriage, no matter how slowly, over the paved streets. On an unpaved road, however, I might drive as far as I chose, and no such harm would occur.” He tried various remedies for this trouble without success. “I therefore made up my mind to try no further, and only guarded against the affection by avoiding as much as I could all motion of the body.” When his urine became bloody he was bled, and he took frequent doses of manna dissolved in whey as a laxative, and sixteen drops of laudanum in small beer at bedtime as a hypnotic. As to the regimen he observed, he says: “On getting out of bed I drink a dish or two of tea, and ride in my coach till noon, when I return home and moderately refresh myself (for moderation is well in all) with some sort of easily digestible meat that I like. Immediately after dinner, I drink rather more than a quarter of a pint of Canary wine to promote the concoction of the food inthe stomach, and to drive away the gout from the bowels. After dinner I ride in my coach again, and (unless prevented by business) am driven out for two or three miles in the country for change of air. A draught of thin small beer serves for supper, and I repeat this even after I have gone to bed and am about to compose myself to sleep. I hope by this julep to cool and dilute the hot and acrid juices lodged in the kidneys, whereby the stone is occasioned.” He goes on to state that he prefers the “hopped small beer,” and “to prevent bloody urine I take care as often as I drive any distance over the stones to drink a free draught of this small beer upon getting into my coach, and also, if I am out long, before my return, a precaution which has always been sufficient.” Occasionally he suffered from what may be called a gastric crisis, and “in this case I drench myself with more than a gallon of posset, or else of this small beer: and, as soon as I have got rid of the whole by vomiting, take a small draught of canary wine with eighteen drops of the liquid laudanum, and, going to bed, compose myself to sleep. By this method I have escaped imminent death more than once.” In an attack of nephritic colic occurring in a patient of sanguine temperament, Sydenham took ten ounces of blood from the arm on the same side with the kidney affected. “After this a gallon of posset drink, wherein two ounces of marsh-mallow roots have been boiled, must be taken without loss of time, followed by the injection of the following enema: Marsh-mallow roots and lily-roots, of each one ounce; mallow-leaves, pellitory, bears’ breech, and chamomile flowers, of each a handful; linseed and fennugreek, of each half an ounce; water in sufficient quantity. Boil down to half a pint; strain; dissolve in the clear liquor two ounces each of kitchen sugar and syrup of marsh-mallow; mix and make into a clyster. After the patienthas vomited and been purged, a full dose of twenty drops of liquid laudanum is to be given, or else fifteen or sixteen grains of Matthew’s pills.” Sydenham lived in Pall-Mall, and Cunningham in his Handbook of London has the following anecdote, which is of interest in connexion with his small beer and canary: “Mr. Fox told Mr. Rogers that Sydenham was sitting at his window looking on the Mall with his pipe in his mouth and a silver tankard before him, when a fellow made a snatch at the tankard and ran off with it. Nor was he overtaken, says Fox, before he got among the bushes in Bond Street, and there they lost him.” Sydenham lived in Pall-Mall from 1664 to 1689, and was buried in St. James’s Church. A near neighbour of his was Madame Elinor Gwynne, over whose garden wall King Charles II. used often to look as he walked in the Mall in St. James’s Park. Sydenham, I have said, was a licentiate of the College of Physicians, and was never a Fellow. In Chamberlayne’s “Present State of England” for 1682 I find a list of the Fellows, candidates, honorary Fellows, and licentiates of the College of Physicians. The name of Thomas Sydenham does not occur in this list, although it contains the name of his son, Dr. William Sydenham. In 1684 Dr. Hans Sloane, a young physician afterwards to be very famous, took up his abode with Sydenham. It was not till after Sydenham’s death that his reputation reached the exalted position in which it has been held.
In the lives of many of the early physicians are interesting facts which throw considerable light on the progress of medicine, both as a branch of knowledge and a profession; but the exigencies of time and space compel me to be brief.
Samuel Collins, who was president of the College in 1695, was one of the earliest comparative anatomists, and wrote a work entitled “A System of Anatomy treating ofthe Body of Man, Beasts, Birds, Fishes, Insects, and Plants.” I am not acquainted with the work, but the title seems to indicate that he had enlarged views on the question of biology.Nehemiah Grew, who was secretary to the Royal Society in 1677, and an honorary Fellow of the College in 1682 (and possibly earlier), is said to have been the first who saw the analogy between animals and plants, and to establish the fact of sex in plants. In medicine he introduced Epsom salts, which he obtained by evaporating Epsom water, so that we owe him a great debt, and undoubtedly he is one of the greatest men who has been connected with the College.Sir Edmund Kingwas surgeon to Charles II., and was made an honorary F.R.C.P. by command of His Majesty. Charles II. being seized with apoplexy on Feb. 2nd, 1684, King promptly bled His Majesty without consultation. His act was subsequently approved by his colleagues, and he was ordered £1,000 by the Privy Council, which was never paid.Francis Bernardwas apothecary to St. Bartholomew’s Hospital, and when the staff of that institution ran away from the plague, Bernard stopped at his post and ministered to the wants of the patients. For this he was rewarded by being made assistant physician to the hospital, and became honorary F.R.C.P. in 1680. He died in 1697, and is buried in St. Botolph’s, Aldersgate.
Two centuries ago, and even later than this, it was not thought unprofessional for a physician to have secret remedies. Thus Dr. Goddard, who was much trusted by Oliver Cromwell, who was one of the original members of the Royal Society, professor at Gresham College, the friend of Sydenham, and a Fellow of the College in 1646, was the inventor of “Goddard’s drops.” The most notable instance of “professional secrets,” however, isthat of the midwifery forceps. This was the secret of the Chamberlen family, of whom I will mention two.Peter Chamberlen(M.D. Padua, F.R.C.P. 1628) was probably the first fashionable obstetrician, and is supposed to have been the inventor of the forceps. He made an attempt to organise the monthly nurses, was much employed about the English court, and had eighteen children by his two wives.Hugh Chamberlen, the son of Hugh Chamberlen and the nephew of Peter Chamberlen (F.R.C.P. 1694), was the most celebrated man-midwife of his day. He published a translation of Mauriceau’s Midwifery, and in the preface to that book he says: “I will now take leave to offer an apology for not publishing the secret I mention we have to extract children without hooks where other artists use them; viz., there being my father and two brothers living that practise this art, I cannot esteem it my own to dispose of nor publish it without injury to them, and I think I have not been unserviceable to my own country, although I do but inform them that the forementioned three persons of our family and myself can serve them in these extremities with greater safety than others.” This is a very pretty specimen of medical ethics on the part of one who was a censor of the College as late as 1721. What are probably the original forceps were accidentally discovered, in 1815, at Woodham Mortimer Hall, Essex, formerly the residence of Peter Chamberlen. “They were found under a trap-door in the floor of the uppermost of a series of closets, built over the entrance porch,” and may now be seen in the library of the Royal Medico-Chirurgical Society. Hugh Chamberlen is buried in Westminster Abbey, where a Latin epitaph of seventy-two lines, by Bishop Atterbury, adorns his tomb.
I feel tempted to mention two or three more of the early physicians who are deservedly famous, but in doingso I must limit myself to those who flourished mainly in the seventeenth century.
John Radcliffe, who became F.R.C.P. in 1687, appears to have been a blustering, kindly, and successful practitioner. He spoke his mind freely, even to monarchs, and seems to have made his way more by push than courtesy. His chief claim to be remembered is as a public benefactor. He accumulated a large fortune, and founded at Oxford the Radcliffe Library, Radcliffe Infirmary, Radcliffe Observatory, and Radcliffe Travelling Fellowship, and also left £500 a year to St. Bartholomew’s Hospital, London, for improving the diets of the patients. Radcliffe was only one of many London doctors who have been great public benefactors. I have already alluded to Linacre, Caius, Harvey, Baldwin Hamey, Caldwell, and Croon, and the list may be enlarged by mentioning Sir Hans Sloane (who founded the British Museum and gave the Chelsea Garden to the Apothecaries’ Society), William and John Hunter, Erasmus Wilson, and Richard Quain—the last and the most munificent benefactor of this (University) College.
Sir Hans Sloanewas born in 1660, became F.R.C.P. in 1687, was president from 1719 to 1735, and died in 1753 in his ninety-fourth year. He was president of the Royal Society from 1727 (succeeding Sir Isaac Newton), and retired to Chelsea in 1740, where his name still lives in Sloane Street and Hans Place. In his youth he accompanied the Duke of Albemarle to Jamaica, and returned home with a valuable botanical collection. He was a great accumulator of archæological and natural curiosities, and his collection was by his will offered to the nation at a nominal sum, and thus was founded the British Museum. Sir Hans Sloane was born in the last days of the Commonwealth, only three years after the death of Harvey. In Evelyn’s Diary we read how, onApril 16th, 1691, he (Evelyn) “went to see Dr. Sloane’s curiosities, being an universal collection of the natural productions of Jamaica,” &c. He lived in the reign of Charles II., James II., Anne, William III., George I., and George II., and died five years after the birth of Jeremy Bentham, who was so active in the foundation of University College.
Perhaps the main object held in view by those who were instrumental in establishing the medical corporations was “protection,” and certain it is that the monopoly of medical licensing enjoyed by the physicians and the barber-surgeons in London and seven miles round was very great. No small amount of the energies of the College of Physicians was in its earlier days devoted to the fighting of irregular practitioners, but this was and is a hopeless battle. We have seen how Henry VIII. protected the rights of physicians and surgeons, but then, as now, there was a great deal of public sympathy for irregular practitioners, and accordingly we find that in the thirty-fourth and thirty-fifth year of the reign of Henry VIII. an Act was passed, the chief clauses of which were to the following effect:—That the surgeons, “mindful onely of their own lucres, and nothing the profit or ease of the diseased or patient, have sued, troubled, and vexed divers honest persons, as well men as women, whom God hath endued with the knowledge of the nature, kind, and operation of certain herbs, roots, and waters, and the using and ministring of them to such as be pained with customable diseases, as women’s breasts being sore, a pin and a web in the eye, uncomes of hands, scaldings, burnings, sore mouths, the stone, strangury, saucelin, and morphew, and such other like diseases, &c. &c. Therefore it shall be lawful forany person to cure outward sores, notwithstanding the statute of the 3rd of Henry VIII.” The public did not like being deprived of their favourite quacks and wise women; and the same feeling undoubtedly obtains at present in this country, where hundreds of newspapers are kept afloat almost entirely by quack advertisements, and the proprietor of a pill and ointment has recently died possessed of wealth probably greater than that of all the Fellows of both the Royal Colleges collectively. These are significant facts, and ought to warn us not to waste our energies in attempting to oppose human nature.
Dr. Goodall, in his account of the College of Physicians, published in 1684, gives many curious details of the conflicts of the College with quacks and empirics. The College possessed magisterial power, and, on conviction, the president and censors had power to fine and imprison. For instance, in 1632 Francis Roes,aliasVinter, was accused of undertaking to cure a woman of a tympany, for which he had made exorbitant charges: “Being asked what medicines he gave, at first he refused to discover them, saying he had them noted in his books; but after long expostulation he named jalap and elatorium (as he pronounced the word), and, being questioned what elatorium was made of, he said it was composed of three or four things, whereof diagridium was one. He was censured for giving elatorium (a medicine he knew not), and particularly to a woman at his own house, whom he afterwards sent home through the open streets, telling her it was a cordial. He was fined £10 and committed to prison.” Again, we find one Richard Hammond, a surgeon, fined £5 and committed to prison for undertaking to cure a child of the dropsy. It appears that he administered a clyster composed of molasses, white hellebore, and red mercury, “which wrought soviolently that the boy died therewith.” John Hope, an apothecary’s apprentice, gets into trouble for giving a man two apples of coloquintida boiled in white wine, with cinnamon and nutmeg. “The medicine wrought both upwards and downwards; upward he vomited a fatty matter, and downward he voided a pottle of bloud,” and ultimately died. This case was remitted to the higher courts of justice. In 1637 an order was sent from the Star Chamber “to examine the pretended cures of one Leverett, who said that he was a seventh son, and undertook the cure of several diseases by stroaking.” The investigation of this case lasted over a month, and finally the College reported that Leverett was an impostor. “In the fourth year of King Edward VI., one Grig, a poulterer, of Surrey (taken among the people for a prophet in curing divers diseases by words and prayers, and saying he would take no money, &c.), was, by command of the Earl of Warwick and others and the Council, set on a scaffold in the town of Croidon in Surrey with a paper on his breast whereon was written his deceitful and hypocritical dealings; and after that on the 8th of September set on a pillory in Southwark, being then Our Lady Fair then kept, and the Mayor of London with his brethren the aldermen riding through the fair, the saidGrigasked them and all the citizens forgiveness. Of the like counterfeit physician (saith Stow) have I noted to be set on horse-back, his face to the horse-tail, the same tail in his hand for a bridle, a collar of jordans about his neck, a whetstone on his breast, and so led through the city of London, with ringing of basons, and banished.” The above are samples of dozens of similar cases; and it is interesting to note that many of these irregular practitioners had powerful friends, and we find Ministers of State writing on behalf of some of them, praying that the punishment may be remitted.
In order to complete the picture of the profession in the seventeenth century, I have abstracted from the Diary of truthful Samuel Pepys a few facts having a bearing on medicine. These seem to me to throw no little light upon the science, practice, and ethics of medicine at his time:—“March 26th, 1660: This day it is two years since it pleased God that I was cut for the stone at Mrs. Turner’s in Salisbury-court. And did resolve while I live to keep it a festival, as I did the last year at my house, and for ever to have Mrs. Turner and her company with me. But now it pleased God that I am prevented to do it openly: Only within my soul I can and do rejoice, and bless God, being at this time, blessed be His holy name, in as good health as ever I was in my life.—Oct. 19th, 1663: Coming to St. James’s, I hear that the Queen did sleep five hours pretty well to-night, and that she waked and gargled her mouth, and to sleep again; but that her pulse beats fast, beating twenty to the King’s or my Lady Suffolk’s eleven. It seems she was so ill as to be shaved and pidgeons put to her feet, and to have the extreme unction given her by the priests, who were so long about it that the doctors were angry. The King they all say is most fondly disconsolate for her, and weeps by her, which makes her weep; which one this day told me he reckons a good sign, for that it carries away some rheume from the head.—Oct. 20th: Mrs. Sarah —— tells us that the Queen’s sickness is the spotted fever, and that she is as full of spots as a leopard.—22nd: This morning, hearing that the Queen grows worse again, I sent to stop the making of my velvet cloak till I see whether she lives or dies.—24th: The Queen is in a good way to recovery; and Sir Francis Pridgeon [Prujean, President of the Royal College of Physicians] hath got great honour by it, itbeing all imputed to his cordiall.—Jan. 16th, 1667: Prince Rupert, I hear, is very ill; yesterday given over, but better to-day.—28th: Prince Rupert is very bad still, and so bad that he do now yield to be trepanned.—Feb. 3rd: To White Hall.... Talking, and among other things, of the Prince’s being trepanned, which was in doing just as we passed through the Stone Gallery, we asking at the door of his lodgings, and were told so. We are full of wishes for the good success, though I dare say but few do really concern ourselves for him in our hearts. With others into the House, and there hear that the work is done to the Prince in a few minutes without any pain at all to him, he not knowing when it was done. It was performed by Moulins. Having cut the outward table, as they call it, they find the inner all corrupted, so as to come out without any force; and the fear is that the whole inside of his head is corrupted like that, which do yet make them afraid of him; but no ill accident appeared in all the doing of the thing, but with all imaginable success, as Sir Alexander Frazier did tell me himself, I asking him, who is very kind to me.—April 3rd: This day I saw Prince Rupert abroad in the Vane room, pretty well as he used to be, and looks as well, only something appears to be under his periwigg on the crown of his head.—4th: (At the Duke of Albemarle’s.) One at the table told an odd passage in the late plague, that at Petersfield (I think he said) one side of the street had every house almost infected through the town, and the other not one shut up.—June 28th, 1667: Home, and there find my wife making of tea, a drink which Mr. Pelling, the potticary, tells her is good for her cold and defluxions.—Nov. 21st: With Creed to a tavern, where Dean Wilkins and others; and a good discourse; among the rest of a man that is a little frantic, and that is poor and a debauched man, that the College have hired for20s. to have some of the blood of a sheep let into his body, and it is to be done on Saturday next. They purpose to let in about twelve ounces, which they compute is what will be let in in a minute’s time by a watch. On this occasion Dr. Whistler [President of the Royal College of Physicians] told a pretty story, related by Muffet, a good author, of Dr. Caius, that built Caius College, that being very old, and living only at that time upon woman’s milk, he, while he fed upon the milk of an angry, fretful woman, was so himself; and then being advised to take it of a good-natured, patient woman, he did become so beyond the common temper of his age.—30th: I was pleased to see the person who had his blood taken out ... saying he finds himself much better since, and as a new man. But he is cracked a little in his head, though he speaks very reasonably, and very well. He had but 20s. for his suffering it, and is to have the same again tried upon him; the first sound man that ever had it tried on him in England, and but one that we hear of in France.—June 23rd, 1668: To Dr. Turberville about my eyes, whom I met with, and he did discourse, I thought, learnedly about them, and takes time before he did prescribe me anything, to think of it.—29th: To Dr. Turberville’s, and there did receive a direction for some physick, and also a glass of something to drop into my eyes; he gives me hope that I may do well.—July 3rd: To an alehouse; met Mr. Pierce, the surgeon, and Dr. Clarke, Waldron, Turberville, my physician for the eyes, and Lowre, to dissect several eyes of sheep and oxen, with great pleasure, and to my great information. But strange that this Turberville should be so great a man, and yet to this day has seen no eyes dissected, or but once, but desired this Dr. Lowre to give him the opportunity to see him dissect some.—13th: This morning I was let blood, and did bleed about fourteen ouncestowards curing my eye.—31st: The month ends sadly with me, my eyes being now past all use almost, and I am mighty hot about trying the late printed experiment of paper tubes.—Aug. 11th: Mighty pleased with a trial I have made of the use of a tube spectacall of paper, tried with my right eye.”
Cesare Morelli (a music master) wrote thus to Mr. Pepys on April 11th, 1681: “Honoured Sir,—I did receive your last letter, dated the ninth of this month, with much grief, having an account of your painful fever. I pray God it will not vex your body too much; and if by chance it should vex you longer, there is here a man that can cure it with simpathetical powder, if you please to send me down the pearinghs of the nailes of both your hands and your foots, and three locks of hair of the top of your crown. I hope with the grace of God it will cure you,” &c.
BARBER-SURGEONS’ HALL.
BARBER-SURGEONS’ HALL.
Much as we owe to the College of Physicians, we owe even more to the early surgeons, and there is certainly no spot in this city which has a greater interest for us as students of medicine than the hall of the Barbers’ Company in Monkwell Street, a street not far from the General Post Office. The house in Knightrider Street, the original home of the College of Physicians, is gone. The house in Amen Corner, the second home of the College, was burnt. The Grand College in Warwick Lane was deserted and sold, and has now completely disappeared. The Barbers’ Hall remains and commands our respect as being on the original spot, though not the original building where the study of anatomy took its rise in this country. The barbers and surgeons have occupied premises in Monkwell Street certainly since their first incorporationin 1460, possibly earlier. The present hall was built by Inigo Jones, and having partially escaped the fire in 1666, much of the original building remains, and certainly the present court-room and the elaborately carved shell canopy over the front door are both works which do credit to this famous architect. Originally, the hall stood detached from other buildings, and seems to have had a fair-sized piece of ground round it, and a garden at the back; and its theatre, one of Inigo Jones’s best works, rested on one of the bastions of the old city wall. With land at its present enormous value, it is not to be wondered at, though much to be regretted, that the Company has turned every available inch to account; and the medical antiquary who now goes in search of this, to us, almost sacred edifice, will need to be warned that it is hemmed in and hidden by warehouses. It was in 1540that Henry VIII. gave a charter to the Barber-Surgeons, and Holbein’s famous picture of this event is the chief treasure of the Barbers’ Hall, which contains many other relics of medical interest. In this picture, which has been often engraved, and is doubtless familiar to many of you, there are certain points which merit our attention. It is a group of nineteen people, and it is probable that the portraits of all are faithful. The portrait of Henry VIII. was said by King James I. to be reported “very like him and well done,” and it is probable that the portraits of the others are equally good. The king is seated, and the eighteen persons receiving the charter are on their knees. These eighteen are arranged in two groups—a group of three on the right hand of the king, and a group of fifteen on the left. Those on the right are probably entitled to take precedence of the others, they are all members of the king’s household—viz., John Chambre, the king’s physician, who was, as we have seen, one of the six persons named in the charter of the College of Physicians; Sir William Butts, physician to Henry VIII., and one of the characters in Shakspeare’s play of that name; and Master J. Alsop, the Royal apothecary. The fifteen on the left are all surgeons or barbers. The chief, to whom the king is handing the charter, is Thomas Vicary, the king’s sergeant-surgeon, and the first medical officer appointed to St. Bartholomew’s Hospital; of the others, Ayliffe, Mumford, and Ferris were king’s surgeons, and Symson, Harman, and Penn were king’s barbers; of the remaining eight little is known.
HOLBEIN’S PICTURE: HENRY VIII. GIVING A CHARTER TO THE BARBER-SURGEONS.[To face p.97.
HOLBEIN’S PICTURE: HENRY VIII. GIVING A CHARTER TO THE BARBER-SURGEONS.
[To face p.97.
The original charter to the Barber-Surgeons provided that the two mysteries of barbery and surgery should be kept distinct, and it gave facilities for obtaining the bodies of executed felons for purposes of anatomicalstudy. There is no doubt that the anatomy lectures at the Barber-Surgeons’ Hall preceded those given by the physicians. The necessity of a knowledge of anatomy must have been felt daily by these early surgeons, and, like practical men, they took steps to supply their wants. The giving of these lectures, a physician being appointed lecturer, was the chief work of the Company. Some of the particulars collected by Mr. South are of interest, as showing how this first London School of Anatomy was worked. Every member of the Company was bound to attend the anatomy demonstrations, a fine of fourpence being imposed upon those freemen who were late, and sixpence upon those who were absent. For each summons to “an anatomy” the sum of 3s. 4d. was charged, whether present or absent, and the members of the Company were bound to come “decently appareyled, for their own honestye, and also for the worshippe of the Company.” The anatomical demonstrations appear to have been public, and their occurrence was a solemn festival—in fact, in the early days of the Company “private anatomies” were disallowed, except by special licence from the court. There were two masters of anatomy appointed yearly, and two stewards of anatomy to look after the creature comforts of those who attended the demonstration. It was also the duty of the masters and stewards to fetch the body from the place of execution, which was not always an enviable duty. The actual lecture and demonstration was given by a fifth officer, a “reader” specially chosen, who was generally a physician. The masters of anatomy had to make due provision for the comfort of the “Dr.,” and they were specially charged to provide a “matte about the harthe in the hall,” in order that he might not suffer from cold feet. They also had to provide two fine white rods for demonstrating, a wax candle to look into the body, necessaryinstruments, and clean white sleeves and aprons for each day for themselves as well as for the reader. A fine of 40s. was imposed for inattention to these necessary details. The greatest formality was observed. The notices of the forthcoming demonstration were issued according to a regulated formula, which differed according to the rank in the Company of the person bidden, and, after assembling in the parlour, a procession to the theatre was marshalled by the clerk in due form. There were two demonstrations daily, at noon and at five, and between the morning and afternoon lecture the court and officials were “plentifully regaled,” the doctor or reader “pulling off his own robes and putting on the clerk’s, which has always been usual for him to dine in.” These demonstrations went on for three consecutive days, and at their close the clerk “attends the doctor in the cloathing room, where he presents him, folded up in a piece of paper, the sum of ten pounds, and where afterwards he waits on the masters of anatomy and presents each of them in the like manner with the sum of three pounds.” After each public demonstration the lecturer was allowed to give a private demonstration to his own pupils for three days, after which the body was decently interred, and the expenses incurred by the masters of anatomy (£3 7s. 6d.) were reimbursed. Seats were provided in the theatre, and the body was surrounded by a curtain until the demonstration actually began. Among the curiosities in Barbers’ Hall is a portrait of Sir Charles Scarborough, the physician to Charles II., in the act of giving an anatomical lecture with a “subject” before him, and Alderman Arris at his side assisting him. Scarborough, who was a good anatomist and distinguished mathematician, is represented as seated, dressed in full robes of scarlet and ermine, wearing a velvet hat with jewelled band and withlace cuffs, and Alderman Arris is scarcely less gorgeous. Alderman Arris, together with Dr. Gale, endowed those lectures, which are still given at the College of Surgeons, and which are known as the Arris and Gale Lectures. This Dr. Gale is not to be confounded with Thomas Gale, sergeant-surgeon to Queen Elizabeth, one of the earliest English writers on surgery.
It was on Feb. 27, 1662, that Samuel Pepys records that “about 11 o’clock Commissioner Pett and I walked to Chyrurgeon’s Hall (we being all invited thither, and promised to dine there), where we were led into the theatre; and by-and-by comes the reader, Dr. Tearne, with the master and company, in a very handsome manner; and, all being settled, he began his lecture, and his discourse being ended, we had a fine dinner and good learned company, many doctors of Physique, and we used with extraordinary great respect. Among other observables we drunk the King’s health out of a gilt cup given by King Henry VIII. to this Company, with bells hanging on it, which every man is to ring by shaking after he hath drunk up the whole cup.... Dr. Scarborough took some of his friends, and I went with them, to see the body of a lusty fellow, a seaman, that was hanged for robbery.” The cup to which Pepys alludes, and other interesting pieces of plate, are still in the possession of the Company, and they also have an excellent picture of Inigo Jones by Vandyke, and many other pictures of interest. There are also to be seen four silver wreaths worn by the master and wardens on state occasions, and upstairs is a massive oak table said to be the original table used for anatomical purposes.
The apprentices of the Company were kept in order. For example, they were not allowed to wear a beard of more than fifteen days’ growth, and in case of offence in this particular the master was fined 6s. 8d. Apprenticeswere bound to be able to read and write, and those that intended practising in London passed what appear to have been preliminary examinations. “How he knoweth what ys surgery and also what an anatomy ys, and how many parts it is; of what the iiij elements and the xij signes be, which is the first part of examynacion for a prentyce.” The apprentice was then bound to read to the court every half-year an epistle, in order that the court might judge of his progress; and he first became a probationer and was licensed for so many years, at the end of which time, subject to good behaviour and adequate knowledge, he was admitted a master of surgery and anatomy. The fee for the apprentice’s examination appears to have been a silver spoon, with his name upon it, weighing one ounce; and 7d. to the clerk for writing and seal. The examination fee for the great diploma appears to have been £6 6s.
We have seen that the physicians were an offshoot from the priests and the surgeons an offshoot from the barbers. In the same way, the apothecaries were originally linked with the grocers; and it was not till 1617 that James I. gave to the Apothecaries’ Company an independent charter. The apothecaries were originally druggists pure and simple, but they took to prescribing, and this brought them into conflict with the physicians. In the end the apothecaries were victorious; and finally, in 1815, they acquired the rights of examining and licensing, which are practically the same as they now possess.
In considering the growth of medical knowledge in London, we should do very wrong to omit mentioningthe Royal Society, in the establishment of which Charles II. seems to have taken a lively interest. The first informal meetings of those who afterwards formed the nucleus of this important Society were held at Wadham College, Oxford; and after the Restoration, at Gresham College, London. Among those mentioned by Chamberlayne as the founders are Robert Boyle, Sir W. Petty, the Bishop of Salisbury, the Dean of Wells, Dr. Wallis, Dr. Goddard, Dr. Willis, Sir Christopher Wren, Lord Brouncker, John Evelyn, Thomas Henshaw, Sir George Ent, and Dr. Croone. The actual foundation of the Royal Society by charter from the King took place on April 22nd, 1663, and amongst the powers granted to the Society by their charter was that of taking and anatomising the dead bodies of persons put to death by order of the law. Their recognised place of meeting was Gresham College, but after the fire they met for a time at Arundel House. “In their discoursings,” we are told, “they lay aside all set speeches, and eloquent harangues (as fit to be banished out of all civil assemblies, as a thing found by woeful experience, especially in England, fatal to peace and good manners), and everyone endeavours to express his opinion or desire in the plainest and most concise manner.” Even at the present day there are not wanting those who sneer at the “ologies,” and it is therefore not surprising that in 1682 it should have been necessary to meet criticism by putting forward a defence of this Society. “But what advantage and benefit,” says Chamberlayne, “appears after so many meetings? It is true they have made many experiments ofLight(as the excellent Lord Bacon calls them), and perhaps not so many experiments of fruit and profit; yet without doubt some may hereafter find out no small use and benefit even in those Luciferous experiments which now seem only curious and delightful; but it is also as true that the Royal Society hath made agreat number of experiments and inventions very profitable and advantageous to mankind. They have mightily improved the naval, civil, and military architecture. They have advanced the art, conduct, and security of navigation. They have not only put this kingdom upon planting woods, groves, orchards, vineyards, evergreens, but also Ireland, Scotland, New England, Virginia, Jamaica, Barbadoes, all our plantations, begin to feel the influence of this Society.” At Gresham College they had a library, the gift of the Duke of Norfolk, and a repository or museum, filled with natural curiosities.
This allusion to the Royal Society has brought to our notice Gresham College, the first home of the Society. Pepys often alludes to “The College,” meaning thereby the meetings of the Royal Society in Gresham College. This College, which ought to have been the nucleus of a university of London, was founded by Sir Thomas Gresham, who was born in 1519, and flourished in the reigns of Edward VI., Mary, and Elizabeth. He was himself a university man, having been at Caius College, Cambridge, and he amassed great wealth as a merchant and financier. He died in 1579, and by his will he left the bulk of his property to his widow, with the stipulation that at her death his house in Bishopsgate Street should be converted into a college, and that it should have for its endowment the rents arising from the shops in the Royal Exchange, which in Gresham’s time amounted to £700 a year. The Corporation and the Mercers’ Company were the trustees of this fund. There were seven endowed professorships—viz., astronomy, physic, law, geometry, divinity, rhetoric, and music. Gresham’s house in Bishopsgate Street appears to have been admirably adapted for a college. It wasquadrangular, and had a garden and planted walks, so that the quiet and seclusion which are essential to study might have been obtained there. Be the cause what it may, the College, which escaped the fire, did not flourish.
GRESHAM COLLEGE.
GRESHAM COLLEGE.
The Royal Society left it in 1710, and in 1768 Gresham House was pulled down to make way for an Excise Office, the Government granting £500 a year in exchange for the house and land. After this date the lectures were given in a room of the Royal Exchange, and in 1843 the present Gresham College was built at the corner of Basinghall Street, the house being outwardly not to be distinguished from the mercantile houses which abound in the city. The cause of the failure of Gresham College is doubtful. Dr. Johnson was of opinion that it was due to the fact that the students paid no fees, and therefore a powerful stimulus to the professors was wanting. The condition that the lectures were to be given in Latin as well as English, a condition reasonable enough in Gresham’s time, has served as a clog; but probably the chief cause is to be found in the physical and moral atmosphere of the city. The corner of Basinghall Street is a very different place from those “groves of the Academy where Plato taught the truth.” Here every creature you meet appears to be in a hurry—certainly in too great a hurry to get wisdom, which, says the son of Sirach, “cometh by opportunities of leisure.”
If universities, in the proper sense, have languished in London, the same cannot be said of learned societies. London, the great exchange and mart of the world, has assisted by its numerous and flourishing societies in the exchange of knowledge and ideas among learned men. The Medical Society of London was founded in 1773 in Bolt Court, Fleet Street. The Royal Medico-Chirurgical Society was founded in 1805. The other medical societies are all recent creations.
Thus it appears that the College of Physicians and the Company of Barbers and Surgeons, and also Gresham College, were the earliest schools of medicine in London, the only places where anything approaching to systematic instruction was given.
It was scarcely before the beginning of the eighteenth century that the hospitals of London began to be of any importance in the teaching of medicine. The earliest hospitals in London were leper hospitals, for at one time leprosy abounded in this city. St. James’s Palace is built on the site of a hospital for “maidens that were leprous;” the name Spitalfields reminds us that at one time there was a “spittle” here for lepers. There were other hospitals of a similar kind in Southwark and Kingsland. The next hospitals were mostly institutions founded by the religious houses, and were very much of the nature of almshouses, where the wretched, unfortunate, and diseased were received for a time. The two most important of these were St. Bartholomew’s Hospital and St. Thomas’s Hospital, and a few words as to their origin will not, I think, be uninteresting.
As regards St. Bartholomew’s Hospital, Mr. Morrant Baker has written a most interesting monograph, entitled “The Two Foundations,” to which I am indebted for much that I have to say under this head. This hospital owes its origin to Rahere, who is said to have been a minstrel jester at the court of Henry I. Concerning this pious founder, an aged chronicler (one of the monks of the Priory of St. Bartholomew) tells us: “Man born and sprung of low kynage, and when he attained the flower of youth he began to haunt the households of noblemen and the palaces of princes; where under every elbow of them, he spread their cushions with japes and flatterings,delectably anointing their eyes, by this manner to draw to him their friendships. And still he was not content with this, but often haunted the king’s palace (Henry I.), and, among the noiseful press of that tumultuous court, informed himself with polity and cardinal suavity, by that which he might draw to him the hearts of many a one.” It does not seem at all likely that Rahere ever wore a cap and bells as a professional jester; but that he was rather apersona grataabout the court, alike for his merry tongue and his handsome presence, concerning which his effigy in the church of St. Bartholomew the Great speaks clearly enough. Dr. Norman Moore, by reference to an early manuscript, has clearly shown that Rahere was no professional jester. He was early in life a Canon of St. Paul’s, and Dr. Moore thinks that he was possibly famous for his wit, just as Sydney Smith was famous. His fashionable and giddy life seems to have told upon Rahere, and he ultimately turned serious, made a pilgrimage to Rome, fell ill there, saw visions, notably one of St. Bartholomew the Apostle, who commanded him to go home and build a church and asylum for the sick and weary in Smithfield. Rahere’s persuasive powers were effectual in obtaining a site in the King’s Market, Smithfield, and the foundation of the church and hospital took place in 1123. As to Smithfield, the monk’s manuscript continues: “Right unclean it was; and, as a marsh, dungy, and fenny, with water almost every time abounding and that that was eminent above the water, dry, was deputed and ordained to the jubeit or gallows of thieves, and to the torment of other that were condemned by judicial authority.” Rahere seems to have brought his histrionic talents to bear on his good work, for the chronicler records that by feigning idiocy he attracted the reverence of the superstitious, and “drew to him the fellowship of children and servants, assembling himself as one of them; and with their use and help, stones andother things profitable to the building lightly he gathered together.” It is needless to say that many miracles were performed in the early days of the Priory and Hospital of St. Bartholomew. It was distinctly a monastic institution, and more resembled, as Mr. Baker suggests, the sick and lying-in ward of a modern workhouse than a hospital as we understand the term. Mr. Baker further suggests that the jousts and tournaments of Smithfield, as well as the horse and cattle fair which had been held there from time immemorial, may have provided the monks with not a few surgical casualties.
For the following facts concerning St. Thomas’s Hospital I am indebted to a paper by Mr. Rendle, read in 1882 before the Royal Society ofLiterature:—
Those who have travelled from London Bridge to Cannon Street by the railway, must have noticed the fine Church of St. Saviour’s, Southwark. This church marks the site of the ancient Priory of St. Mary Overy, which was the original home of St. Thomas’s Hospital. Southwark, in ancient times, was largely occupied by the clergy. Not far from the Priory of St. Mary was the Abbey of Bermondsey, and the palatial residences of the Bishops of Winchester and Rochester. In 1207 the Priory of St. Mary was burnt down, and with it the Hospital of St. Mary. At Winchester House was living at that time Peter de Rupibus, Bishop of Winchester. This prelate decided to rebuild the hospital in a better form and on a better site, and accordingly set to work to obtain funds by means of the usual Charter of Indulgences addressed to the faithful in 1228. “Behold,” says Bishop Peter, “at Southwark an ancient hospital, built of old to entertain the poor, has been entirely reduced to cinders and ashes by a lamentable fire; moreover, the place wherein the old hospital has been founded was less suitable, less appropriate for entertainment and habitation,both by reason of the straitness of the place and by reason of the lack of water and many other conveniences; according to the advice of us, and of wise men, it is transferred and transplanted to another more commodious site, where the air is more pure and calm, and the supply of water more plentiful. But whereas the building of the new hospital calls for many and manifold outlays, and cannot be crowned with its due consummation without the aid of the faithful, we request, advise, and earnestly exhort you all, and with a view to the remission of your sins enjoin you according to your abilities, from the goods bestowed on you by God, to stretch forth the hand of pity to the building of this new hospital, and out of your feelings of charity to receive the messengers of the same hospital coming to you for the needs of the poor to be therein entertained, that for these and other works of piety you shall do you may after the course of this life reap the reward of eternal felicity from him who is the recompenser of all good deeds and the loving and compassionate God. Now we, by the mercy of God, and trusting in the merits of the glorious Virgin Mary and the apostles Peter and Paul, and St. Thomas the Martyr and St. Swithin, to all the believers in Christ who shall look with the eye of piety on the gifts of their alms—that is to say, having confessed, contrite in heart and truly penitent—we remit to such twenty days of the penance enjoined on them, and grant it to them to share in the prayers and benefactions made in the church of Winchester and other churches erected by the grace of the Lord in the diocese of Winchester. Ever in the Lord. Farewell.” The Prior of St. Mary Overy assisted in the good work, and several popes confirmed the acts of their subordinates, and thus St. Thomas’s Hospital was founded on the site now occupied by part of the London Bridge Railway Station—a site which was its home from1228 to 1862. In 1535 there were forty beds at St. Thomas’s Hospital. In 1507 the hospital was enlarged and repaired, “the void ground,” called the “Faucon,” and afterwards the “Tenys Place” and “Closshbane” (probably connected with the game of skittles), was acquired, and the following was the bill: “Paid to Mr. Scott of Kent, and Ann, his wife, for the land forty marks, and for a gown cloth of damask for the said Ann £3 16s. 8d.—in all £31 13s. 4d.” When this land, or very nearly the same, was sold to the South-Eastern Railway Company in 1862 it fetched £296,000. The total cost of land and buildings erected in 1507, with the legal expenses, was £311 6s. 1½d. About the year 1527, James Nycolson, of “St. Thomas’s Spyttell in Southwark,” had a printing press within the precincts of the hospital, and among other notable books produced the Bible known as “Nycolson’s Coverdale.”
When the religious houses were suppressed by Henry VIII., these hospitals and asylums, which were part and parcel of them, were suppressed also, and for a time the poor found themselves deprived of much assistance to which they had become accustomed. It was therefore found necessary to re-establish these institutions on a new footing. This was done by Henry VIII. and Edward VI., and when we speak of these monarchs as founders we must remember that they refounded in a better form that which Henry had previously destroyed. St. Bartholomew’s was refounded in 1548, and St. Thomas’s in 1553; and in 1557 the four Royal hospitals—St. Bartholomew’s, St. Thomas’s, Christ’s Hospital, and Bridewell—were, in a sense, incorporated together for purposes of management. Dr. Payne has kindly permitted me to inspect a little book bearing the date 1557,and entitled “The Order of the Hospitalls of K. Henry the viii.th and King Edward the vi.th—viz., St. Bartholomew’s, Christ’s, Bridewell, St. Thomas’s. By the Mayor, Cominaltie, and Citizens of London, Governours of the Possessions, Revenues and Goods of the sayd Hospitals.” From this it appears that “one Hospital, called St. Bartholomew’s the little,” was founded by King Henry VIII., and the other three by his successor. The governors were to be sixty-six at least, fourteen aldermen and fifty-two grave commoners, whereof four were to be scriveners, “to the intent that in every house may be one or more.” Two of the aldermen were “governors-general,” one to be called controller and the other surveyor, while the remaining sixty-four were divided equally among the four hospitals, three aldermen and thirteen commoners to each, whereof one was to be their treasurer. The governors were appointed at a general court held on St. Matthew’s Day (Sept. 21st), and held office for two years from Michaelmas Day (Sept. 29th). On appointment a solemn charge was read to them, in which the objects of the four hospitals are thus set forth: “Idelnes, the enemie of all vertue, is suppressed and banished; the tender youth of the nedy and idle beggars vertuously brought up; the number of sick, sore, and miserable people refreshed, harbored, and cured of their maladies; and the vile and sturdy strumpet compelled to labour and travaile in profitable exercises.” The latter paragraph refers especially to Bridewell, which was originally established as a house of correction “for the strumpet and idle person, for the rioter that consumeth all, and for the vagabond that will abide in no place.” Bridewell has been rendered immortal by Hogarth’s fourth plate of the “Harlot’s Progress,” but as an institution it disappeared in 1863. Among the officers of the Royal Hospitals were “scruteners,” who performedthe duties of “collectors” of legacies and other gifts. The charge to these officers concluded as follows: “And finally, when you shall hapen to be in the company of good, vertuous, and welthy men, you shall to the best and uttermost of your wits and powers, advance, commend, and set forth the order of the said Hospital and the notable commodities that ensue to the whole realme of England, and chiefly to the citie of London, by erection of the same; and also how faithfully and truly the goods geven to their uses are by the Governours thereof ministered and bestowed.” They were also enjoined to exhort scriveners to remind testators of the hospital when making their wills, and to provide the said scriveners with prospectuses for their information. They were further enjoined to exhort the bishop and clergy, and especially the preachers at “Pawles Crosse”: “That they twise or thrise in the quarter at the leaste, do move and exhort the people to further the said work.” The officers attached to each hospital were “the clerke, the matron, the nurses and keepers of wards, the steward, the officer appointed to warne the collectors and church wardens, the cooke, the butler, the porter, the shoemaker, the chirurgian, the barbour, the bedles.” Another institution having a similar origin to the Royal Hospitals is Bethlehem Hospital, or Bedlam. This was founded by Henry VIII., on the site of the suppressed Priory of our Lady of Bethlehem. At the end of the seventeenth century it was moved to a new building in Moorfields, and finally, at the beginning of the present century, it was established where it now is, in St. George’s Fields, Southwark.
We get an insight into the methods of practice in the London hospitals in the sixteenth and seventeenth centuries from a series of papers in the St. Bartholomew’sHospital Reports, written by Sir James Paget, Dr. Church, and Dr. Norman Moore. In the eighteenth volume of St. Bartholomew’s Hospital Reports Dr. Norman Moore gives some interesting facts with regard to the first medical officer, Thomas Vicary, who was appointed somewhere near the year 1550. He lived in the hospital, wore a smart livery which cost fifty-three shillings, was sergeant-surgeon to Henry VIII. and his three successors, and wrote a book on anatomy. Thomas Vicary is represented in Holbein’s picture of Henry VIII. granting a charter to the Barber-Surgeons. He appears to have served abroad with the army, and to have been a person of considerable experience, and to have had a proper sense of his duty as a professional man and a citizen. Not so much is to be said for the first physician to St. Bartholomew’s, Dr. Lopus, a Portuguese Jew, appointed in 1561, whose main object in this world appears to have been to get money. He was convicted of conspiring with the Spaniards to compass Queen Elizabeth’s death by poison, and in 1594 was hanged at Tyburn. Dr. Norman Moore gives another graphic picture of an Elizabethan surgeon in William Clowes, a man who was an army surgeon attached to the Earl of Leicester, and who in the intervals of foreign service was attached to St. Bartholomew’s. Clowes appears to have been a man of learning and experience, devoted to his art, and well able to do battle with irregular practitioners. Of these encounters he doubtless had many, and he gives a lively description of an interview with a quack vendor of a balm and plaster. “Then riseth out of his chayre, flering and gering, this myraculous surgeon, gloriously glittering like the man in the moon, with his bracelets about his armes, therein many precious jewels and stones of St. Vincent his Rockes, his fingers full of rings, a silver case with instruments hanging at his girdle, and a gilt spatulasticking in his hat, with a rose and crown fixed on the same.” Clowes was surgeon to Christ’s Hospital, and we learn the interesting fact that in his day twenty or thirty children had the scurvy at a time—a fact due to a diet largely composed of fish and other salted provisions, with a scanty allowance of vegetables and a total absence of potatoes.
Sir James Paget, in an interesting paper (written in 1846 while he was filling the offices of Warden to St. Bartholomew’s and Lecturer on Physiology) entitled “Records of Harvey,” gives us some facts regarding this very great man, which help us to understand London “hospital practice” as carried on during the reigns of James I. and Charles I. Harvey was appointed physician to the hospital in 1609, seven years after taking his degree at Padua, and seven years before he imparted his great discovery of the circulation to the College of Physicians. He was appointed during the lifetime of his predecessor, Dr. Wilkinson, and was to succeed on the death or retirement of the latter, and, like candidates for hospital appointments of the present day, he came furnished with testimonials, one from the King, and another from the President of the College of Physicians; and it is almost needless to say that his application was granted. On his appointment after the death of Dr. Wilkinson, the following “charge” was read to him:—“Physician,—You are here elected and admitted to be the physician of the poor of this hospital to perform the charge following—that is to say, one day at the least through the year, or oftener as need shall require, you shall come to this hospital and cause the hospitaller, matron, or porter to call before you in the hall of this hospital such and so many of the poor harboured in this hospital as shall need the counsel and advice of the physician. And you are here required and desired byus in God His most holy Name, that you endeavour yourself to use the best of your knowledge in the profession of physic to the poor then present or any other of the poor at any time of the week which shall be sent home unto you by the hospitaller or matron for your counsel, writing in a book appointed for that purpose such medicines with their compounds and necessaries as appertaineth to the apothecary of this house, to be provided and made ready for to be administered unto the poor, every one in particular according to his disease. You shall not for favour, lucre, or gain, appoint or write anything for the poor, but such good and wholesome things as you shall think, with your best advice, will do the poor good, without any affection or respect to be had to the apothecary. And you shall not take gift or reward of any of the poor of this house for your counsel.”
In 1626 Harvey’s stipend, which had been £25 per annum, was raised to £33 6s. 8d., on condition that he relinquished his claim to one of the hospital houses. In 1630 he obtained leave of absence from his hospital duties, having been commanded by the King to travel with James Stuart, Duke of Lenox. Harvey was at this time physician extraordinary to the King, and in the year following was appointed physician in ordinary. Dr. Andrewes appears to have been appointed as Harvey’s substitute during his absence, the governors showing themselves somewhat unwilling to accept Dr. Smith, who was Harvey’s nominee. It appears that the work of the hospital increasing, and Harvey being much occupied at court, Dr. Andrewes was definitely appointed Harvey’s coadjutor, or, as we should say, “assistant physician,” with the yearly stipend of £33 6s. 8d. A set of rules was drawn up by Harvey and accepted by the governors, which are interesting in two particulars: first, as showingthat Harvey was impressed with the necessity of limiting the relief afforded by the hospital, and that he foresaw the inconvenience likely to arise from a press of what we should call “out-patients;” and secondly, that in the matter of prescribing internal remedies the chirurgeons were unable to act independently of the physicians. It further appears that there were “lock” hospitals in connection with St. Bartholomew’s, established in Southwark and Kingsland, in the disused Leper Hospitals (leprosy having then disappeared from London), for the reception of venereal cases. That venereal disease had long been very rife in London appears from the statement of William Clowes in 1596, that within five years over 1,000 cases had been cured at St. Bartholomew’s, and he adds, “I speak nothing of St. Thomas Hospitall, and other houses about the city, wherein an infinite multitude are daily cured.” Harvey retired from St. Bartholomew’s in 1643. In Harvey’s time the staff consisted of two physicians, three surgeons, one of whom, John Woodhall, was the author of the “Surgeon’s Mate,” and in his twenty-four years’ service amputated “many more than 100 of legges and armes,” with a mortality of 20 per cent., one surgeon for the stone, two surgeons or “guides” for the lock hospitals, an apothecary, and “a curer of scald heads.” This latter functionary appears to have been a woman, and the salary paid to her for her services varied from £27 in 1623 to £126 in 1642, and there is evidence to show that she received three or four shillings for each scald head cured. According to Dr. Church, at St. Bartholomew’s Hospital, where the diet, owing to the munificence of Dr. Radcliffe, has, since his time at least, been exceptionally good, so late as 1767 potatoes do not seem to have been introduced into any of the diets; greens were given on certain days of the week, but no other vegetables are mentioned.
Dr. Church, in an article in St. Bartholomew’s Hospital Reports (vol. xx.), called “Our Hospital Pharmacopœia,” gives many interesting facts. The surgeons found their own drugs in 1549, and they were allowed £18 a year “because things pertaining to their faculty be very dear.” In a note appended to an old formula in the St. Bartholomew’s Pharmacopœia for a poultice, of which cow-dung was one ingredient, Dr. Church says: “Those who have not had the curiosity to look back at the old Pharmacopœias of the London Colleges of the sixteenth and seventeenth centuries, can hardly imagine the disgusting nature of the substances they contained. In the catalogue of the official simples of our own London College for the year 1689 occur—‘Homo Vivens: Capilli, ungues, saliva, cerumen, sordes, sudor, urina, stercus, sanguis, calculi, semen, lac, menses, secundinæ. Homo mortuus: Cadaver caro, cutis, pinguedo, ossa, cranium, cerebrum, cor, fel, manus.’ And this at a time when R. Morton, Edward Tyson, Hans Sloane, and Richard Blackmore were Fellows of our College and Sydenham a Licentiate.... It is not until the fifth edition of the Pharmacopœia of our London College that we get rid of the old traditions handed down from the earliest periods of medicine. The 1746 Pharmacopœia may be said to mark a perfect revolution, or rather, I should say, reformation in the annals of pharmacy.” This purging of the Pharmacopœia of disgusting things, “for the most part superstitiously and doatingly derived from oracles, dreams, and astrological fancies,” was largely due to Dr. Plumptre, who was president of the College from 1740 to 1746, and the extent of it may be gained from the fact that the “simples,” which numbered 645 in the fourth edition, had, in the fifth, dwindled to 208. Many of the formulæ previously in use had been derived fromthe East, and notably from a learned pharmacologist called John of Damascus, concerning the date of whom authorities agree to differ.
The complexity of some of the old formulæ was prodigious. The antidote of Matthiolus against poisons and plague contained 131 ingredients, and Venice treacle, which was largely prescribed by Sydenham and even later physicians, contained over sixty. In the sixth (1788) edition of the Pharmacopœia, sixty-three articles which appeared in the fifth edition were discontinued.
Among those who stayed at his post during the plague must be mentioned Dr. Francis Bernard, apothecary, and subsequently physician (1678) to St. Bartholomew’s Hospital. To rightly estimate his conduct we must remember that the governors of the hospital, as well as the physicians had deserted it. Dr. Church gives the following extracts from the minutes of the Court: “Held at the ‘Green Man,’ near Laieton, in the county of Essex, Sept. 28th, 1665. Forasmuch as it was now understood that the two doctors were remiss to officiate or procure their business to be done as it ought to be. It was therefore thought fit for Dr. Bernard, the apothecary, whose ability is so well approved, should prescribe at the present for the patients in the said doctors’ stead, until further orders thereon.” At the same Court the salaries of the two doctors, Dr. Micklethwaite and Dr. Tearne, were ordered not to be paid.
The treatment of the patients in the early days of the hospitals was occasionally a little severe. Thus Dr. Steele of Guy’s has kindly furnished me with a few extracts made from one of the old committee books of St. Thomas’s: “1567. Patients were ordered to be whipped at the cross for misdemeanour. 1573. A hand-mill was ordered to grind corn to keep patients from idleness. 1598. Foul patients (i.e., venereal),notoriously lewd livers, were ordered when cured to be punished at the cross before being discharged.” This reads like great severity, but severity was probably necessary in Southwark, which was rather a rough suburb of London. Thus an old map of Southwark given in Mr. Rendle’s paper shows that in the year 1542 there were some eighteen large inns, of which the “Tabard” or “Talbot” was one. Here also in later times was Paris Garden, bull rings, bear rings, the Globe Theatre, and lastly, the brothels or stews which were under the control of the Bishop of Winchester, the denizens being known as Winchester geese. Perhaps, therefore, it is not surprising that in this map are shown two sets of pillories and cages, and that the governors of the hospital found strong measures to be necessary to maintain discipline.