LONDON FROM THE MEDICAL POINT OF VIEW.
It is impossible to appreciate the causes of the insanitary condition
of Old London without a knowledge of the state of medical education at
the time. This chapter will show clearly that scientific medicine is
of comparatively modern growth, and it will not need any professional
training to distinguish between the superstitious dogmas of the
past and those scientific principles which have resulted from the
systematic study of medicine by strictly scientific methods. If the
scientific study of medicine should from any cause be checked, there
can be no doubt that we should soon again make acquaintance with those
pestilences which wrought such fearful havoc in the Middle Ages.
CHAUCER’S DOCTOR.
In giving an account of the profession of medicine as seen in London,
both in ancient and modern times, one cannot do better than begin with
that “Doctour of Phisik” described by Chaucer as setting out from the
“Tabard” in Southwark with the other pilgrims bound for the shrine of
St. Thomas of Canterbury about the year 1380. Chaucer’s lines have been
often quoted, but I make no apology for giving them once more, because
the description of the “doctour” bears the stamp of truth and is
sufficiently minute to bring the individual before us:--
“There was also a Doctour of Phisik,
In al this world ne was ther non him lyk
To speke of Phisic and of Surgerye.”
It may be that the poet means to convey the idea that doctors of the
fourteenth century, like some of those of the nineteenth, were prone to
talk “shop.”
“For he was grounded in astronomye.”
Astrology at this time was an essential part of medicine, and the
simplest remedies were not applied without consulting the stars, so
that to be “grounded in astronomye” was most essential.
“He kept his pacient wondurly wel
In houres by his magik naturel.
Wel cowde he fortune the ascendent
Of his ymages for his pacient.”
Here we have reference to mystical modes of treatment which were then
much in vogue. Amulets and charms were constantly prescribed; the
doctrine of signatures--_i.e._, the giving of those plants having some
slight resemblance to parts of the human body or to some prominent
symptom of disease, for the relief of the organs or diseases which they
resembled--was in every-day use; and the treating of images in order to
affect the original of the image was a constant practice among witches,
and was probably used by the profession.
“He knew the cause of every maladye
Were it of cold or hete or moyst or drye,
And where thei engendrid, and of what humour.”
Here we have allusion to the Hippocratic humoral pathology as developed
by Galen.
“He was a verrey parfight practisour,
The cause i-knowe, and of his harm the roote
Anon he yaf the syke man his boote” (remedy).
Quick diagnosis and prompt treatment.
“Ful redy hadde he his apotecaries
To sende him dragges, and his letuaries,
For eche of hem made othur for to wynne.
Here frendschipe was not newe to begynne.”
It would seem that even in Chaucer’s time the advertising druggist was
as pushing as at present.
“Wel knew he the olde Esculapius,
And Deiscorides, and eeke Rufus,
Old Ypocras, Haly and Galien;
Serapyon, Razis and Avycen;
Averrois, Damascen and Constantyn,
Bernard and Gatisden, and Gilbertyn.”
Our friend’s library was tolerably complete, for here we have a list of
the medical “scriptures,” Greek, Roman, and Arabian, an acquaintance
with which was the whole duty of a physician, and which to doubt was
heresy. The last two names on the list refer to John of Gaddesden and
Gilbert, both English writers, of whom I shall have a few words to say
presently.
“Of his diete mesurable was he,
For it was of no superfluité,
But of gret norisching and digestible.”
Doubtless there were many things then which took the place of
pancreatic emulsion and extract of malt.
“His studie was but litel on the Bible.”
This line is frequently quoted to show that the scepticism with which
doctors are often charged is of no modern growth. The point of the
line is, however, to be found in the fact that Chaucer’s doctor was
certainly a priest, as were all the physicians of his time, and that
the practice of medicine had drawn him away, somewhat unduly perhaps,
from the clerical profession, to which he also belonged.
“In sangwyn and in pers he clad was al,
Lyned with taffata and with sendal.”
A robe of scarlet and sky-blue, lined with silk. Equally gorgeous
doctors may be seen at the present time by those who attend at
Burlington Gardens on “Presentation Day.”
“And yit he was but esy in dispence;
He kepte that he wan in pestilence.
For gold in phisik is a cordial;
Therefore he lovede gold in special.”
The priest-physician was fully as fond of his fees as are any of his
successors. But to come to particular instances which prove the truth
of Chaucer’s graphic picture.
EARLIEST LONDON PRACTITIONERS.
The “Gilbertyn” of Chaucer’s doctor was =Gilbertus Anglicus=, an
Englishman who wrote a work on medicine about the year 1290, and it is
remarkable from the fact that it gave the first description of leprosy
written by western writers, leprosy being a disease which has long
ceased to exist in this country. He treated apoplexy with ants’ eggs,
scorpions’ oil, and the flesh of lions; but where he obtained this
latter commodity it is hard to tell. For urinary calculi he advised the
administration of the blood of a he-goat fed upon parsley and saxifrage.
=John of Gaddesden= was a graduate of Merton College, Oxford, and wrote
his famous medical treatise, “Rosa Anglica,” about 1305. He is said
to have been greedy of money, and he recommends his contemporaries
to make arrangements about fees before undertaking a case. He was an
ecclesiastic, and was court physician to Edward II. and Edward III. He
tells us that bleeding is hurtful at the time of the feasts of St. John
and St. Stephen, but necessary at Christmas because of the custom of
overloading the stomach with cakes at that season. Pigs’ dung was his
favourite hæmostatic; and when the son of the King had small-pox, he
was careful that everything about his couch should be red.
In South’s “Craft of Surgery” is a most interesting and full account
of =John of Arderne=, one of the earliest English writers on surgery.
This worthy was a specialist for the cure of fistula, and dwelt at
Newark between 1349 and 1370, when he moved to London. His work “Praxis
Medica” is among the Sloane Manuscripts in the British Museum. He
made his great reputation by curing Sir Adam Everyngham of fistula
after he had been pronounced incurable by the chief doctors in France.
He relates the cases (some of them with details) of other patients.
The most interesting of the writings of John of Arderne is that
entitled “Of ye Manere of ye Leche,” because it throws a flood of
light on professional manners and ethics in the fourteenth century.
The following paragraphs (taken from South) are well worth quoting;
but in doing so I think it advisable to (in some degree) modernise
the spelling and the expressions:--“First, it behoveth him that will
profit in this craft that he set God ever before him in all his
works, and evermore call meekly with heart and mouth his help, and
occasionally, according to his power, give of his earnings to the poor,
that they by their prayers may get him grace of the Holy Ghost. Let
him not be found rash or boastful in his words or deeds. And let him
abstein from much speaking, especially among the great. And let him
answer questions warily, lest he be overtaken by his words.... Also
be a leche not much laughing nor much playing, and let him as much
as may be fly the fellowship of knaves and disreputable persons. And
be he evermore occupied in things beholding to his craft, whether he
read or study, write or pray, for the exercise of books whorshippeth
a leche.... And above all this, it profiteth to him that he be found
evermore sober, for drunkenness destroyeth all virtue, and bringeth
it to nought, as sayth a wise man. Be he content in strange places
with the meat and drink there found, using measure in all things....
Scorn he no man.... And if there be made speech to him of any leche,
neither set him at nought, nor praise him too much, nor commend him,
but thus may he courteously answer: ‘I have not any knowledge of him,
but I have neither learned nor heard of him but good and honest.’...
Consider he not over openly the lady or the daughters, or other fair
women in great men’s houses, ‘ne profre them not to kisse, ... that he
come not in to the indignacion of the lord ne of noon of his.’... When
such men come to the leche to ask help or counsel, it speedeth that he
make seeming excuses, that he may not incline to their asking without
harming or without indignation of some great man or friend, or for
necessary occupation; or feign he him hurt, or for to be sick, or some
other convenient cause by which he may likely be excused. Therefore if
he will favour to any man’s asking, make he covenant for his travail
and take it beforehand.... And if he see the patient, pursue busily
the cure then, and ask he boldly more or less, but ever be he warre
of scarce askings, for over scarce askings setteth at nought both the
market and the thing. Therefore for the cure of fistula in ano, when it
is curable, ask he competently of a worthy man and a great an hundred
marks or forty pounds, with robez and feez of an hundred shillyns terme
of life, by year. And take he not less than an hundred shillyns, for
never in als my life took I less than an hundred shillyns for cure of
that sekeness.” John of Arderne advises that prognosis should be very
guarded, and that as to the time of recovery it is good to say double
what you think, and if the patient ask “why he putte him so long a time
of curying, sithe that he heled him by the halfe? Answer he, that it
was for that the patient was strong hearted and suffered well sharp
things, and that he was of good complexion and had able flesh to heal,
and feign he other causes pleasable to the patient, for patients of
such words are proud and delighted.” The leech is further advised to
dress like a clerk (_i.e._, a priest), “for why it seemeth any discrete
man clad with clerk’s clothing to occupy gentlemen’s boards.” “Have
the leche also clean hands and well shapen nails, cleansed from all
blackness and filth.” There are many other directions for conduct given
in this remarkable document, and sundry extracts from Scripture are
given as suitable for quotation by the bedside: “And it speedeth that
a leech can talk of good tales and of honest that may make the patient
to laugh, as well of the biblee as of other tragediez.” Finally, he is
charged to most scrupulously observe all professional confidences. It
is evident that John of Arderne was a consummate man of the world, and
knew all the tricks of his trade. His fees seem to have been enormous,
and, indeed, he is only one out of many examples among our early
professional forerunners who made very large professional incomes.
Whether Gilbert, Gaddesden, and John of Arderne were associated with
any guild which took upon itself the duty of protecting the interests
of physicians and surgeons is not known. Certainly they belonged to no
association of which we have any trace remaining. I shall now endeavour
to show how the medical corporations of London had their origin, and it
is necessary to make a few preliminary remarks.
THE SEVERANCE OF MEDICINE AND SURGERY.
The physicians and surgeons were originally very different orders
of men. Medicine is in most Christian countries an offshoot of the
clerical profession. So profitable was the practice of medicine, that
not only monks, but many of the higher clergy, devoted themselves to
it. The union of the two professions of medicine and divinity existed
up to the middle of the seventeenth century, and evidence of it is
still found in the “Lambeth M.D.,” a degree which the Archbishop of
Canterbury still has the right to confer, but only upon a legally
qualified practitioner. It was thought necessary by Pope Innocent III.
(1198-1216) to forbid the clergy to undertake any operation involving
the shedding of blood, and by decrees of other popes in the thirteenth
and fourteenth centuries they were forbidden to practise surgery in
any form. In this way medicine and surgery became divorced, and this
forcible and arbitrary separation of two branches of the same subject
served undoubtedly to hinder the progress of medical knowledge to
an enormous extent. Medicine was thus left mainly in the hands of
scholars, of men who at that time stood alone in the possession of
scholastic learning, while surgery was handed over to men who had
little or no scholarship, but who amassed a considerable amount of
practical wisdom in the daily struggle with the difficulties of their
craft.
The early physicians, like Chaucer’s “Doctour of Phisik,” often had an
extensive knowledge of the writings of the Greek, Latin, and Arabian
writers, who may be considered as the medical “fathers.” These were
their scriptures, which to doubt was heresy. They knew nothing beyond
them, and it is not surprising that priestly medicine, divorced as
it was from those practical matters in overcoming which we alone get
wisdom, was absolutely unprogressive and unproductive. If the early
clerical physicians did little for medicine as a science, they did a
great deal for it as a profession. They were men of learning and high
culture; they had had a university training; and we shall see that many
of them were well born and had been brought up amongst high-minded
gentlemen; and undoubtedly it is due to the College of Physicians,
and largely to some of its earlier members, that the profession of
medicine has been practised in this country in a manner which is mainly
creditable. Glaring exceptions, of course, have occurred; but, as a
rule, the men who have neglected to conduct themselves as gentlemen
have met with no encouragement from the College of Physicians, and I
believe it would be difficult to over-estimate the influence for good
which the College has had in this direction.
The early surgeons were many of them illiterate and rough. Some of
them--perhaps most of them--were, in this country and in France,
evolved from the barbers; and this is not surprising, for the man who
can shave with dexterity has acquired no small skill in handling sharp
instruments, and must be often called upon to treat wounds of his own
making. It is not surprising that these men should have been called in
to attend to cases of injury, and we know that they very early added
tooth-drawing and bleeding to their tonsorial art, and practised all
three till a comparatively recent date. War with its wounds must have
made surgery a necessity in every country, from the time of the siege
of Troy downwards; and Mr. South gives an interesting account of Thomas
Morstede, who was chief surgeon to Henry V.’s army at Agincourt. Again,
many doubtless acquired their first knowledge by practising on animals,
and it must be remembered that there are now throughout this country
scores of illiterate men who operate with consummate skill on the lower
animals. It appears that as early as 1308 the barbers of London were
incorporated into a guild, and there appears to have been a gradual
separation of them into those which practised surgery and those which
practised barbery, and in 1460 the Guild of the Barber-Surgeons was
one of the livery companies of the City. Outside this body there was
an Association of Surgeons, and also an Association of Physicians,
and, according to Mr. South, there appears to have been in 1423-24 a
veritable Conjoint Board of Physicians and Surgeons, which, however,
survived its birth only a few months. At the time of the accession
of Henry VIII. it appears that public opinion was getting ripe for
legislation.
THE EARLIEST MEDICAL ACT.
In the third year of the reign of that monarch (1511-12) an “Act for
the Appointing of Physicians and Surgeons” was passed, the preamble of
which was as follows: “Forasmuch as the science and cunning of physick
and surgery (to the perfect knowledge whereof be requisite both great
knowledge and ripe experience) is daily within this realm exercised by
a great multitude of ignorant persons, of whom the greater part have
no manner of insight into the same, nor in any other kind of learning;
some also can no letters on the book, so far forth that common
artificers, as smiths, weavers, and women, boldly and accustomably take
upon them great cures and things of great difficulty, in the which
they partly use scorcery and witchcraft, partly apply such medicines
unto the disease as be very noxious and nothing meet therefore; to the
high displeasure of God, great infamy to the faculty, and the grievous
hurt, damage, and destruction of many of the King’s liege people; most
especially of them that cannot discern the uncunning from the cunning.
Now therefore ... be it enacted,” &c. And the Act goes on to provide
that all who practise medicine and surgery (except graduates of the
University) shall be previously examined, approved, and admitted by the
Bishop of London or the Dean of St. Paul’s, or (for the country) by
the bishop of the diocese, who shall call to his aid for this purpose
four doctors of physick, “and for surgery other expert persons in
that faculty.” The penalty for evading the Act was £5 for each month
of illegal practice. Two years later an Act was passed giving to
the members of the Guild of Barber-Surgeons (not exceeding twelve)
exemption from bearing arms or serving on inquests.
THE COLLEGE OF PHYSICIANS.
The time was now at hand when the first step was to be taken to give
the profession a position of independence, and to allow it to regulate
its own affairs without reference to ecclesiastical dignitaries. We owe
this in all probability to Thomas Linacre, who possessed the confidence
of Cardinal Wolsey, and probably also of the king. Be that as it may,
on September 23rd, 1518, letters patent were granted constituting the
Royal College of Physicians. By this instrument the College was given
the control of all medical practitioners in London and within seven
miles of it, and none were to be allowed to practise unless previously
examined by the College. Four years later these powers were extended to
the whole of England, except in the case of University graduates. The
charter and subsequent Act gave ample power to the College to regulate
its affairs, and accorded privileges and exemptions to the physicians
similar to those previously accorded to the surgeons. The great fact,
however, was the power of controlling the profession, and it must be
remembered that the censors had power to fine and imprison delinquents.
In Henry’s charter six persons were named--viz., John Chambre, Thomas
Linacre, Ferdinand de Victoria, Nicholas Halsewell, John Francis, and
Robert Yaxley, and it will be interesting to consider the personality
of some of these founders of the Royal College. The real founder and
first president was =Thomas Linacre=, who was born in 1460. Having
graduated at Oxford, and become a Fellow of All Souls in 1484, he
went abroad in 1485, and visited Bologna, Florence (where he enjoyed
the friendship of Lorenzo de Medici), Rome, Venice, and the famous
school of Padua (where he took the degree of M.D.). In 1501 he was
appointed physician and preceptor to Prince Arthur, and also physician
to Henry VII. He was also physician to Henry VIII., and it is recorded
that he was consulted by many men of note, notably Cardinal Wolsey and
Erasmus. He took holy orders in 1509, and the same year was presented
to the rectory of Merstham, then became prebend of Wells (1510), rector
of Hawkhurst (1510), canon of St. Stephen’s, Westminster, prebend of
York (1517), precentor of York (1519), rector of Holsworthy, Devon
(1518), and rector of Wigan, Lancashire (1520). This list of eight
clerical benefices in almost as many years--benefices which were
probably given as professional fees, and which were probably passed
on, as soon as given, to a successor “for a consideration”--throws a
curious light on the state of the Church, and helps us to understand
the crash which was so soon to come. It is interesting, as showing
the origin of the medical within the clerical profession, to remember
that the first President of the College of Physicians was the rector
of four parishes, the occupant of two prebendal stalls, a canon, and
a precentor. We all owe a debt of gratitude to Linacre. He not only
obtained the charter for the College, but gave his house in Knightrider
Street (which is a street running parallel to part of Queen Victoria
Street, E.C.) as a meeting-place for the new corporation. All who are
competent to judge seem agreed in stating that Linacre was one of the
greatest scholars of his age, and possessed a knowledge of Latin and
Greek which for that time was quite exceptionally great. He founded
lectureships at Oxford and Cambridge. He died in 1524, six years after
the foundation of the College, and was buried in Old St. Paul’s, where
in 1557 Caius erected a monument with an epitaph of his own composing.
Of =John Chambre=, the first person named in the charter, we know
little; but it is interesting to note that he was a Fellow of Merton
College, Oxford; that he studied at Padua; that he was physician to the
king; that he was censor of the College in 1523; that he was doubly a
vicar, doubly an archdeacon, a prebend, a canon, and a dean, and the
treasurer of Bath Cathedral. He died in 1549. Of the other four persons
named in the charter we know very little, and they need not detain us.
Linacre’s house, which was given by its owner, was the first home of
the College of Physicians, was occupied by the College until 1614, and
remained the property of the College until 1860, when it was taken for
the Crown by an Act of Parliament. Only the front part of the house was
given by Linacre, the back part belonging to Merton College, Oxford,
which is one of the many connexions between Merton College and the
College of Physicians. The house represented at p. 61 was certainly not
Linacre’s original dwelling.
[Illustration: LINACRE’S HOUSE. (_From a Print in the “Gold-Headed
Cane.”_)]
We have thus seen the science of medicine in London beginning with the
clergy, then organised under the supervision of bishops and deans,
and finally with an independent controlling body, of which the early
members were many of them in holy orders. It will now be convenient to
trace the subsequent history of the College of Physicians, and I shall
endeavour to bring before the mind’s eye some of its most remarkable
early Fellows, and in so doing I shall hope to give some idea of the
condition of medicine in London in the days of the Tudor and Stuart
sovereigns. My information on these points is mainly drawn from Dr.
Munk’s learned work, entitled “The Roll of the Royal College of
Physicians of London.”
A very prominent figure in the early history of medicine in London is
=John Kaye=, or =Caius=, as he called himself, well known, by name
at least, in connexion with Gonville and Caius College, Cambridge,
which he enlarged and endowed. Caius was born in 1510, and studied at
Gonville Hall, Cambridge, which was ultimately to be better known by
his own name. He went to Padua in 1539, and lived in the same house
with the celebrated anatomist, Vesalius. He became professor of Greek
at Padua, and took the M.D. there in 1541. He became F.R.C.P. in 1547,
and settled in London in 1552. He was president of the College in 1555.
He was physician to Edward VI., Mary, and Elizabeth, but he is said
to have been removed from the latter position because of his Romish
tendencies. He died in 1573 at his house in Bartholomew Close, and was
buried in the chapel of Caius College, with the epitaph “Fui Caius.”
Caius was certainly rich, as is shown by his splendid munificence at
Cambridge. Although he was much occupied at Cambridge in the latter
years of his life, he was frequently re-elected to the presidency of
the College, the last time being in 1571. The frequent re-election of
a president, who was latterly much of an absentee, may have been from
the hope that the College would ultimately obtain some of his great
wealth, but, if this were so, (of which indeed there is no evidence),
the College was doomed to disappointment. Caius appears to have had
great regard for form and order. He was the inventor of the insignia of
office--the silver wand, the Book of Statutes, and the cushion--which
are still used by the president of the College. On the occasion of the
funeral of Dr. Bartlot, in 1556, we learn that the College attended in
state, and that the Book of Statutes, adorned with silver, was carried
before the president. Caius was very punctilious about the respect
to be paid to the dead, and we find it laid down in the statutes of
Caius College that the president, fellows, and students are to attend
the funerals of subjects used for dissection with as much reverence
and pomp as though it were the corpse of some more worthy person,
because of the advantage which they had derived from it. Caius kept
the accounts of the College with great accuracy, and in 1560, on the
termination of his first six years of office, handed over the whole
of the funds to his successor, amounting to £55 13s. 3d. He wrote out
the annals of the College with his own hand, and thus did much to
establish order in the proceedings. His love of what we should call
“ritual” seems to have led him into trouble in his later years, and a
large amount of material connected with religious ceremonial, which
was found in Caius College, was burnt by order of the vice-chancellor.
Caius was a profound scholar, and edited many of the writings of
Galen, Celsus, and Hippocrates. He was also a naturalist, and wrote a
treatise on British Dogs. His only original medical work was a “Boke
or Counsel against the Sweat”--a treatise, in fact, on the sweating
sickness. Strangely enough, the first edition was in English, but
its ultimate appearance was in orthodox Latin. He was much concerned
about the faulty pronunciation of Latin in this country, and tried to
introduce the continental method of pronouncing the vowels, to which
he had become accustomed during his long residence abroad. He was
something of an antiquary, and proved to his own satisfaction that
the University of Cambridge was founded by “Cantaber,” B.C. 394. He
defended the privileges of the College, and in a case tried before the
Lord Mayor in the reign of Elizabeth as to the right of surgeons to
give internal remedies for the sciatica, &c., the evidence of President
Caius seems to have convinced the Court that they had no such right.
The name of Caius is inseparably connected with the teaching of anatomy
in this country. When King Henry VIII. in 1540 gave the charter to
the Barber-Surgeons (of which I shall have more to say hereafter),
the following important clause formed part of the charter: “The said
masters or governors of the mystery and commonalty of barbers and
surgeons of London and their successors yearly for ever, after their
said discretions, at their free liberty and pleasure, shall and may,
have and take without contradiction, four persons condemned, adjudged
and put to death for felony by the due order of the King’s laws of this
realm, for anatomies, without any further suit or labour to be made
to the King’s Highness, his heirs and successors for the same.” When
the first anatomy lectures were given at Barber-Surgeons’ Hall is not
quite clear; but according to South it was before 1563, and according
to Sir George Baker, Dr. Caius was the first lecturer appointed, and
this appointment was made shortly after his return from Italy, which
was in 1547. It was during Caius’s lifetime, and while he was taking
an active interest in the College, although not actually president
(namely, in 1565), that Queen Elizabeth accorded to the physicians
facilities with regard to anatomy similar to those enjoyed by the
Barber-Surgeons; and it is evident from the statute of Caius College
which I just now read, and which has been kindly brought to my notice
by Mr. Ransom, that Caius made proper arrangements for the teaching
of anatomy in connexion with his Cambridge foundation. Anatomy is the
very groundwork of medicine, and without it it can have no existence
as a branch of science. Undoubtedly we owe a deep debt of gratitude to
the Barber-Surgeons, to the College of Physicians, and to Dr. Caius.
I cannot dismiss this remarkable man without further illustrating his
character by recalling three events which took place at the College
during the time that Caius was president. In 1558, Christopher Langton,
M.D., F.R.C.P., was expelled from the College for “rashness, levity,
and foolish contentions with his colleagues at consultations, as well
as for incontinency.” Five years later, for this latter failing, this
worthy “was carted through London in a ridiculous attire.” In 1559,
John Geynes, M.D., F.R.C.P., was cited before the College for impugning
the infallibility of Galen. On his acknowledgment of error and humble
recantation he was received into the College. In 1556 the College
objected to the admission by the University of Oxford of one David
Laughton, an illiterate coppersmith. The College laid before Cardinal
Pole and the visitors the following instance of his illiteracy: “Cujus
infantia, cum suggessit ut quomodo _corpus_ declinaretur, exigeremus,
respondit _hic_, _hæc_, et _hoc corpus_ accusativo _corporem_,” adding
“egregius certe ex universitate medicus cui humana vita committeretur.”
This objection was successful. Clearly formal President Caius was not
the man to countenance loose morals, heterodoxy, or bad grammar. We
must not dismiss Caius without alluding to the Dr. Caius of Shakspeare,
as drawn in the “Merry Wives of Windsor.” Shakspeare’s Caius is
described as a French physician, and throughout the play he is made to
speak broken English. Caius died in 1573, when the poet was ten years
old, and it is very probable that Shakspeare borrowed the name without
thinking of the man. On the other hand, it must be remembered that
Caius probably spoke Latin like a Frenchman and that he lost favour at
the court of Elizabeth, and it is possible that Shakspeare may have
heard him held up to ridicule.
But to proceed with the history of the College and its relations to
medical education. In 1581, Dr. Caldwell and Lord Lumley founded the
_Lumleian Lectures on Anatomy and Surgery_, and the importance of this
foundation will be appreciated when it is stated that Harvey was
Lumleian lecturer from 1615 to 1656, and that it was in these lectures
that the great fact of the circulation was first demonstrated. In
1587, we find the College renting a garden for forty marks a year, and
engaging John Gerard, the author of the well-known “Herbal,” to keep
it stocked for them with rare plants. Gerard himself had a garden in
Holborn, where among other things he propagated the potato.
=William Gilbert=, who was president of the College in 1600, was the
first really scientific Fellow. He was physician to Elizabeth and
James I., and his great work on magnetism, “De Magnete Magneticisque
Corporibus et de Magno Magnete Telluræ, Physiologia Nova,” commanded
the admiration of Bacon and Galileo, and of many succeeding generations
of scientists. It is a work worthy of being placed alongside of
Harvey’s work on the Circulation, and the College of Physicians is
honoured to have reckoned him among its presidents. The importance of
Gilbert’s investigations to a great naval Power seems to have been
recognised by Queen Elizabeth, who, to her great honour, assisted him
with a pension. He died in 1603, aged sixty-three, and was buried at
Colchester. He was the contemporary of Shakespeare and Bacon, and was
one of those who helped to make the Elizabethan era the wonder of all
subsequent generations.
The post-mortem examination made on the body of James I. is an
interesting record of the state of pathology in 1625. It is recorded
“that the head was found so full of brains that they could not keep
them from spilling--a great mark of his infinite judgment; but his
blood was wonderfully tainted with melancholy, and the corruption
thereof was the supposed cause of his death.”
I have now to mention the man who, above all others, has tended by
his work to make medicine a science, and who probably did much by
his lectures at the College to disseminate a knowledge of anatomy and
physiology. Harvey was the first English physiologist, and lectured
for forty-one years at the Royal College of Physicians on anatomy
and surgery. =William Harvey= (1578-1657) went to Padua in 1598, and
studied under Fabricius, Minadous, and Casserius, and took his M.D. in
1602. He came to London in 1604, became F.R.C.P. in 1607, and succeeded
Dr. Wilkinson at St. Bartholomew’s in 1609. He was Lumleian lecturer
in 1615. He expounded, as is supposed, the doctrine of the circulation
in 1616, and finally published his views in 1628. He was physician to
James I. in 1618 (?). In 1638 he was appointed physician in ordinary
to Charles I., and there is a curious order in the letter-book of the
Lord Steward’s office for the settling a “diett of three dishes of meat
and meale with all incidents thereunto belonging upon the said Dr.
Harvey,” which daily “diett” was subsequently commuted for £200 a year.
Harvey followed the fortunes of the King, and was at the Battle of
Edgehill in 1642. Meanwhile his house in London was plundered of goods
and anatomical records. He became warden of Merton College, Oxford, in
1645, from which post he was ousted by the Parliament in 1646. By the
solicitation of Sir George Ent he was induced to publish his work on
Generation in 1651. He gave a new library and museum to the College of
Physicians in 1653, whereupon the Fellows placed his statue in their
hall, and, in his absence, elected him president in 1654, which honour,
however, he gracefully declined, and recommended the College to elect
Dr. Prujean instead. He remained Lumleian lecturer until 1656, when
he resigned, and presented the College with his patrimonial estate at
Burmarsh, Kent. He died of the gout in 1657 in his eightieth year.
In his will he says: “I give to the College of Physicians all my
bookes and papers, and my best Persia long carpet, and my blue satin
embroyedyed cushion, one pair of brass and irons, with fireshovell and
tongues of brass, for the ornament of the meeting-room I have erected
for the purpose. Item, I give my velvet gown to my loving friend Mr.
Doctor Scarborough, desiring him and my loving friend Mr. Doctor Ent to
looke over those scattered remnants of my poore librarieie, and what
bookes, papers, or rare collections they shall think fit to present to
the College, and the rest to be sold, and with the money buy better.”
Thus, it will be seen that Harvey is not only the greatest ornament
of the College, but also its greatest benefactor. He was the second
in order of time of the great lights of science connected with the
College, Gilbert being the first. His will is interesting from the
choice of his executors, who were both Fellows of the Royal Society and
leaders of science; and, secondly, by the mention of the velvet gown,
which possibly is the one represented as worn by Sir C. Scarborough in
the picture at Barbers’ Hall. I abstain from any mention of Harvey’s
great discovery, because we all know it and appreciate it, and no words
of mine could increase your admiration.
I may here mention that in 1614 the house in Knightrider Street had
become too small for the business of the College, and accordingly new
premises were taken on lease from the Dean and Chapter of St. Paul’s
at Amen Corner, at the end of Paternoster Row. A botanical garden was
planted and a theatre was built, and here it was that Harvey made the
College a present of a great parlour and a museum, which he erected
at his own cost. The garden extended from the Old Bailey to the
Church of St. Martin, Ludgate, and included the site of the present
Stationers’ Hall. The museum and library soon became enriched by many
contributions, the greater part of which were, however, unhappily
destroyed by the fire in 1666.
=Dr. Goulston= (F.R.C.P. 1611) founded by will the _Gulstonian
Lectures_, to be read “between Michaelmas and Easter by one of the four
youngest doctors of the College.” =Sir Theodore Mayerne= (F.R.C.P.
1616), was by birth a Swiss Protestant, and after serving as physician
to Henry IV. of France, settled in London, where he became physician
to James I. and his Queen, and subsequently to Charles I. He was the
fashionable physician of his day, and was one of the first to use
chemical medicines, which was looked upon as heretical by the strict
Galenists, who used only “simples,” drawn from organic nature. He
introduced calomel and blackwash, wrote the dedication to the first
edition of the Pharmacopœia Londinensis (1618), accumulated great
wealth, and died at Chelsea in 1655.
=Sir Charles Scarborough= succeeded Harvey as Lumleian lecturer, and
was lecturer on anatomy to the Barber-Surgeons. He was physician to
Charles II., James II., and William III., and was a great mathematician.
=Baldwin Hamey=, jun. (F.R.C.P. 1634), a devoted Royalist and
Churchman, enjoyed a lucrative practice among amorous Parliamentary
Puritans. He presented the lease of the College in Amen Corner to his
colleagues (1651), contributed largely to its rebuilding after the
fire, and left it a considerable landed estate near Ongar, in Essex.
=Francis Glisson= (F.R.C.P. 1635), Regius Professor of Physic at
Cambridge, was president of the College in 1667-8-9. He wrote a
treatise on Rickets, was a serious anatomist, wrote a treatise on the
Anatomy of the Liver, and has given us “Glisson’s Capsule” as a record
of his industry and talent. He was one of the original members of the
Royal Society, and one of the few of the Fellows of the College who
stopped in London during the plague. He was a friend of Anthony Ashley,
Earl of Shaftesbury. We are indebted to Dr. Glisson for positive
additions to our knowledge of the human body, and he is to be regarded
as the third in order of time of the scientific Fellows.
=Thomas Wharton= (F.R.C.P. 1650), =Thomas Willis= (F.R.C.P. 1664), and
=Richard Lower= (F.R.C.P. 1675) were three earnest and distinguished
anatomists, who added new facts to medicine, and whose names are still
enshrined in our anatomical nomenclature.
THE PLAGUE.
We now approach the year 1665, so notable for the terrible pestilence
which afflicted London, and we may well take the opportunity of seeing
what was the practice of physicians at this time. The best account
of the plague is that written by =Dr. Nathaniel Hodges=, under the
title “Loimologia.” This treatise, originally written in Latin and
published by the author in 1672, was translated by Dr. John Quincy
in 1720. From this valuable work we gain some insight into the moral
and physical conditions of the population, and of other causes which
tended to increase the virulence of the epidemic. It was at the close
of the year 1664 that cases of plague--a disease which had previously
committed extensive ravages in London--began to occur, and the fears of
the inhabitants were fomented by astrologers and others, who tormented
the ignorant with prophecies as to the evils which would occur from
the “conjunction of Saturn and Jupiter in Sagittarius” and the like.
Again, the action of the magistrates, who ordered that infected houses
should be marked with a red cross and the legend “Lord, have mercy upon
us,” and who further set a guard upon such houses to prevent either
ingress or egress, was probably most mischievous, as tending to spread
the infection amongst all the inhabitants of a house, and to keep it
alive within the confined area of the city. Hodges truly remarks that
the proper course would have been to immediately remove the infected
to proper lodgings provided without the walls. He continues: “But what
greatly contributed to the loss of people thus shut up was the wicked
practice of nurses (for they are not to be mentioned but in the most
bitter terms). These wretches, out of greediness to plunder the dead,
would strangle their patients and charge it to the distemper in their
throats; others would secretly convey the pestilential taint from sores
of the infected to those who were well,” &c. If we are to receive the
statement seriously (and Hodges is a temperate writer), it throws
considerable light on the moral condition of the lower orders.
The first symptom of the plague appears to have been, as a rule, a
violent shivering or rigor, lasting from half an hour to four or
five hours. This was followed or accompanied by vomiting. Upon this
delirium quickly supervened, and if not restrained the infected would
run “wildly about the streets.” Vertigo, headache, and coma were also
common. The signs of fever were strongly marked, such as “extreme
inquietude, a most intense heat outwardly, attended by unquenchable
thirst within, dryness, blackness of the tongue, intolerable heat
of the præcordia, and all other usual concomitants of a fever’s
accession.” In many cases there seem to have been well-marked
exacerbations and remissions, but this was not constantly observed.
Insomnia was occasionally troublesome, and palpitation of the heart
appears to have been often strongly marked. Sweating was a common
feature, and seems often to have been “critical,” the plague subsiding
at once by crisis. Pustules upon the skin, varying in size from
a pea to a nutmeg, and called blains, as well as buboes affecting
the lymphatic glands, were among the ordinary symptoms. Further, in
addition to these, carbuncles seem to have been very usual, and also a
petechial eruption; and, further, Hodges describes (in addition to the
foregoing pustules, buboes, carbuncles, and petechiæ) certain prominent
spots with pyramidal heads, which were called “plague tokens” by the
vulgar.
The treatment adopted was very far from being of the so-called
“expectant” form which is now so much followed in the management of
patients suffering from infective disorders. They were put to bed
between the blankets, and the patient was addressed by his physician
“with cheerfulness.” Hodges seems to have discouraged phlebotomy,
but he states that many “let blood largely.” If the patient did not
vomit he was given an emetic, and this in many cases was followed
by an expulsive cathartic. In all cases were strong diaphoretics
administered, and sweating was encouraged to the utmost. A marvellous
assortment of drugs was poured into the patient. Those used by Hodges
were mostly fresh indigenous herbs, and he mentions angelica, rue,
sage, veronica, centaury, scabious, pimpernel, marygold, scorzonera,
ivy berries, balm, valerian, garlic, gentian, elder berries, juniper
berries, and dozens of others; but he speaks scornfully of the Oriental
bezoar, powdered unicorn’s horn, and powder of toads, which many
thought very efficacious. “To all who sweat,” he says, “change of
clothes is to be denied, for the patient takes harm by clean coverings,
not so much from any prejudicial quality of the soap abounding in them,
as from a dampness which is inseparable from them, and the approach
of air which is unavoidable in the shifting, both of which will check
the sweating.” Sleep was industriously kept off, although sometimes,
through sheer weariness, the patient would drop into a doze. The diet
given was light and generous--eggs, strong broths, and good wines; but
of the usefulness of gold boiled in the broths Hodges has “nothing
to say.” The patient was most rigidly kept in his bed, and those who
were delirious were tied in them. During the sweats “the patients were
forcibly kept awake,” and if later in the disease a little sleep was
allowed, they were roused every four hours to take medicine. Scents
were used in the room, and odorous gum resins, such as styrax, were
burnt upon live coals. Blisters were applied to several parts, such
as the nape of the neck and the insides of the arms and thighs. These
blister plasters were made of pitch, galbanum, wax, cantharides, yeast,
euphorbium, and vinegar of squills, worked into a mass. The parts thus
blistered were not suffered to heal till the malignity of the disease
was spent. “Besides epispasticks, it is not lost labour to apply proper
things to the feet. I commonly used a plaster made of the compound
betony plaster, adding to it some euphorbium, saffron, and London
treacle, and I found this to do more good than cataplasms, which some,
however, liked better to use, and were made of bryony root steeped in
vinegar, the flesh of pickled herrings, black soap, rue, scordium, and
arum, with a sufficient quantity of vinegar; sometimes also pidgeons
were applied to the feet.” Similar applications were also made to
the wrists. The buboes were treated with cataplasms and discutients,
and were often opened by the surgeon and subsequently washed with a
“Lixivium of ashes, scordium, betony, bugloss, sanicle,” &c., in which
also was dissolved some London treacle. Carbuncles were treated in a
similar way, but when the eschar did not fall off the actual cautery
was liberally applied. In order to prevent the necessity of using a hot
iron, it was suggested that “sometimes the pestilential venom is to be
drawn out by cupping or scarrification or epispasticks; sometimes also
for the same purpose is applied the bare rump of a fowl, repeated until
these creatures appear not to be hurt by it; for this natural warmth
soothes the vital heat of the part it is applied to, and entices away
the morbifick venom through the pores; pidgeons, used alive, and warm
sheep’s lights have likewise been observed thus to asswage the acrimony
of this pestilential virulence.”
Hodges is by no means silent on the important subject of prevention,
and he justly says: “When the nature and peculiar qualities of this
disease are known and reported by physicians, such laws should be
provided as might best conduce to prevent its spreading, if not to its
utter extirpation.” The punishment of those who frighten the populace
by prophecies and the like; the timely separation of the sick from the
well; house-to-house visitation (which was actually carried out); the
disinfection of the air by fumigations; the daily cleansing of streets,
sinks, and canals (“because stench and nastiness are justily reckoned
the entertainers of infection”); the burning of pastilles; the killing
of “dogs, cats, and other domestic brutes,” which carry the infection
from place to place; and great attention to personal health, are among
the measures which he advocates. He has no belief in the benefit to be
derived from taking excrement and urine, which were given as antidotes
by some old nurses; but, on the other hand, he had implicit faith in
liberal potations of sack (“middle-aged, neat, fine, bright, racy, and
of a walnut flavour”). With regard to the use of tobacco, he says: “I
must confess myself at uncertainties about it, though as to myself I
am its professed enemy, and was accustomed to supply its place as an
antidote with sack.” He did not believe in amulets, which were then
much in vogue; some being alleged to have a diffusive magnetic value;
others drawing the poison out of the body “as amber attracts straws,”
some serving to invigorate nature. Walnut shells filled with mercury,
arsenic mixed with wax and a variety of other drugs, and dried toads
seem to have been the amulets most generally worn.
Among the physicians who stayed in London to minister to the sick,
Hodges mentions “Dr. Glisson, Regius Professor at Cambridge, Dr. Nath.
Paget, Dr. Wharton, Dr. Berwick, Dr. Brookes, and many others.” And
he further states that of these, eight or nine died. Hodges, however,
survived, and he says: “I think it not amiss to recite the means which
I used to preserve myself from the infection during the continual
course of my business among the sick. As soon as I rose in the morning
early, I took the quantity of a nutmeg of the antipestilential
electuary; then, after the dispatch of private concerns in my family,
I entered into a large room, where crowds of citizens used to be in
waiting for me; and there I commonly spent two or three hours, as in
an hospital, examining the several conditions and circumstances of all
who came thither; some of which had ulcers yet uncured, and others to
be advised under the first symptoms of seizure; all which I endeavoured
to dispatch with all possible care to their various exigencies. As soon
as this crowd could be discharged, I judged it not proper to go abroad
fasting, and therefore got my breakfast. After which, till dinner-time,
I visited the sick at their houses.... After some hours visiting in
this manner I returned home. Before dinner I always drank a glass of
sack, to warm the stomach, refresh the spirits, and dissipate any
beginning lodgement of the infection. I chose meats for my table that
yielded an easy and generous nourishment, roasted before boiled, and
pickles, not only suitable to the meats but the nature of the distemper
(and, indeed, in this melancholy time, the city greatly abounded with
variety of all good things of that nature). I seldom likewise rose from
dinner without drinking more wine. After this I had always many persons
come for advice, and as soon as I could dispatch them I again visited
till eight or nine at night, and then concluded the evening by drinking
to cheerfulness of my old favourite liquor, which encouraged sleep and
an easy breathing through the pores all night. But if in the daytime
I found the least approaches of the infection upon me, as giddiness,
loathing at stomach, and faintness, I immediately had recourse to a
glass of this wine, which easily drove these beginning disorders away
by transpiration. Yet in the whole course of the infection I found
myself ill but twice; but was soon again cleared of its approaches by
these means, and the help of such antidotes as I kept always by me.”
It should be mentioned that during the infection Dr. Hodges wore an
“issue” as a preventive measure, and he says: “Whenever I was most
beset with pestilential fumes I could then immediately perceive a
shooting pain in my issue, and had a great deal of ill-conditioned
matter discharge therefrom; and this I always looked upon as a sure
warning to have timely recourse to alexipharmicks.” The facts given by
Dr. Munk concerning Hodges are the following: Nathaniel Hodges, son of
the vicar of Kensington, was born in 1629, educated at Westminster,
Cambridge, and Oxford, and appears to have been a Parliamentarian;
M.D., 1659; F.R.C.P., 1672; censor, 1682; Harveian orator, 1683.
During the latter part of his life he received a pension from the City
on account of his services during the plague. He fell into debt, and
died in Ludgate Prison in 1688. There is a tablet to his memory in
St. Stephen’s, Walbrook. Let us not be hard on this brave man. He did
his duty nobly. True, he was fond of sack and got into debt. Perhaps
had his nature been less generous, and had he been less full of the
milk of human kindness, he might have amassed a large fortune. He is
a noble exception to Chaucer’s doctrine that “gold in physick is a
cordial,” and it would ill become us to sit in judgment on one who in
an important respect affords us an example of noble conduct.
[Illustration: 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 nobleman bequeathed
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
establishment can 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 regret the 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.
[Illustration: COLLEGE OF PHYSICIANS, WARWICK LANE. QUADRANGLE.]
Of the London physicians of the seventeenth century none is better
known than =Thomas 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 reliable _methodus 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 Blackmore first 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 in the 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
patient has 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 of the 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 King= was 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 Bernard= was 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.
SECRET REMEDIES.
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, is that 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 doing so 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 Sloane= was 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, on
April 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.
THE CRUSADE AGAINST QUACKERY.