In 1687 the College of Physicians adopted a resolution binding all
Fellows, Candidates, and Licentiates of the College to give advice
gratis to their neighbouring sick poor when desired within the city
of London or seven miles round. But in view of the gross extortions
of the apothecaries it was asked, What was the use of the physicians’
charity if the cost of compounding the medicines was to be prohibitory?
The apothecaries, of course, denied that the examples of their
charges which were quoted were at all general, and probably they
were not. It was not to the interest of the apothecaries to destroy
free prescribing. Indeed a proposal was made to the physicians on
behalf of a numerous body of London apothecaries to accept a tariff
for medicines dispensed for the poor to be fixed by the physicians
themselves.
The relations of the two bodies had become, however, so strained that
arrangement was no longer possible. The apothecaries had in fact
obtained the upper hand. They treated many cases themselves, and
calling in the physician was largely within their discretion. At this
time (about 1700) the ordinary fee paid to a physician was 10_s._
University graduates expected more, but they too, in the majority
of cases, were only too glad to take the half sovereign, and it was
alleged that they would sometimes pay the apothecary who called them a
percentage off this.
Such was the condition of affairs when in 1696 an influential section
of the physicians, fifty-three of them, associated themselves in the
establishment of Dispensaries, where medicines should be compounded
and supplied to the poor at cost price. The fifty-three subscribed ten
pounds each, and Dispensaries were opened at the College premises in
Warwick Lane, in St. Martin’s Lane, and St. Peter’s Alley, Cornhill.
Needless to say, the war now waxed fiercer than ever. The physicians
were divided among themselves, and the anti-dispensarians refused to
meet the dispensarians in consultation. The apothecaries naturally
recommended the anti-dispensarians to their patients, and consequently
it was only the independent ones who could afford to maintain the
struggle. Scurrilous pamphlets were written on both sides, and one
long poem, Garth’s Dispensary, which was less venomous than most of
the literature on the subject, but which as a poem had no merits which
could justify the reputation it attained, complicated the struggle
from the physicians’ point of view. Johnson says that in addition to
its intrinsic merit it “co-operated with passions and prejudices then
prevalent.” His sympathies are indicated by his remark that “it was on
the side of charity against the intrigues of interest, and of regular
learning against licentious usurpation of medical authority.” One
line in the book (the last in the passage quoted below) has attained
currency in the English language. Expressing satirically the complaints
of the apothecaries, Garth says:
Our manufactures now the doctors sell,
And their intrinsic value meanly tell;
Nay, they discover too (their spite is such)
That health, than crowns more valued, costs not much;
Whilst we must shape our conduct by these rules,
To cheat as tradesmen or to fail as fools.