Since the physicians and surgeons did make substantial charges and
since the educated layman could buy his own books on medicine and
practice what he read or since the uneducated could turn to a neighbor
with medical knowledge or to a quack, the question arises as to why the
services of professional surgeons and physicians were in such demand.
Part of the answer lies in the professional's experience, but even in a
colony without a medical school it also lies in the education and
training received by the professional.
There were several ways in which a seventeenth-century Virginia
physician could acquire his education or training. He could have
received a medical degree in England or on the continent and then gone
to America. On the other hand, he might have learned without formal
education--perhaps by attending lectures and by experience--and then
established himself in Virginia where he was accorded professional
status. A man born in Virginia could return to the Old World for
training or formal education and then practice in Virginia. Also, a
common manner of becoming a physician or surgeon in Virginia, which was
without medical schools, was by apprenticeship. Finally, the importance
of books--imported from Europe--as a means to medical education should
not be minimized.
To be officially licensed for practice, the requirements in England
were high--those in London especially so. The following excerpt from
the statutes of the College of Physicians of London demonstrates how
demanding the educational standards for seventeenth-century English
physicians could be:
First, let them be examined in the physiologick part, and the very
rudiments of medicine, and in this examination let questions be
propounded out of the books concerning elements, temperaments, the
use of parts, anatomy, natural powers and faculties, and other
parts of natural medicine.
Secondly let him be examined in the pathologick part, or concerning
the causes, differences, symptoms and signs of diseases, which
physicians make use of to know the essence of diseases; and in this
examination let questions be proposed out of books concerning the
art of physick, of the places affected, of the differences of
diseases and symptoms, of feavers, of the pubes, of the books of
prognosticks of Hippocrates, &c.
Thirdly let him be examined concerning the use and exercise of
medicine, or the reason of healing; and let that be done out of the
books concerning preservation of health, of the method of healing,
of the reason of diet in acute diseases, of simple medicines, of
crises, of the aphorisms of Hyppocrates, and other things of that
kind, which relate to the use of healing; for example sake, what
caution to be observed in purging? in what persons? with what
medicine? and in what vein, those things ought to be done?
Likewise, what is the use of narcoticks and sleeping medicines? and
what caution is to be observed in them? what is the position and
site of the internal places? and by what passages medicines come to
there? what is the use of clysters, what kind of vomits, the
danger, kind and measure?
Under the London Company, the physicians and surgeons in Virginia had
the same education, training, and met the same standards as their
counterparts in England. This was, in part, because the Company had
good reason to supply adequate medical service, and because the men
sent were but Englishmen transplanted to America. Walter Russell, who
came to Virginia in 1608 was a "Doctour of Physicke" and Lawrence
Bohun, De la Warr's physician, had the same degree. Pott, who succeeded
Bohun as physician-general of Virginia in 1621, came recommended as a
Master of Arts well-practiced in surgery and physics.
After the Company's charter was annulled, few physicians or surgeons
with the advanced medical degrees came to Virginia. Some of the
persons, however, who practiced medicine in Virginia without medical
degrees had acquired skills and knowledge in Europe or England before
coming to the New World.
Patrick Napier who came to Virginia about 1655 as an indentured servant
and subsequently had a large medical practice, probably learned his
profession in England or on the Continent, as might have Francis
Haddon, another who came under terms of indenture and who later, also,
had a considerable medical practice. To these two examples of persons
with training and experience acquired prior to their arrival in America
might be added the similar experiences of John Williams and John Inman.
Medical knowledge and practices brought over from England were
cross-fertilized with the European even in the New World. While the
majority of newcomers were Englishmen, French, German, and other
European physicians and surgeons came to Virginia. These European
medical men appear, in general, to have prospered in Virginia and were
anxious to become naturalized "denizens to this country."
George Hacke, born in Cologne, Germany, settled in Northampton County,
Virginia, in 1653 and was known as a doctor and practitioner of
medicine. He was typical of the European-trained medical man settling
in Virginia in becoming naturalized and in leaving a considerable
estate, including thousands of acres of land. Little is known of his
medical activities and interests except that he was summoned to treat
the victim of a duel and that he left a large library which probably
included volumes on medicine.
Paul Micou, a young French physician who seems to have acquired his
education abroad, settled on the shores of the Rappahannock river, near
a place afterward called Port Micou, during the last decade of the
seventeenth century. Cultured and educated, he soon won prominence and
wealth as a physician (and surgeon), attorney, and merchant. County
records in Virginia make numerous references to suits brought by him
for nonpayment of fees, suggesting an extensive practice.
Because so many of the doctors and surgeons of seventeenth-century
Virginia are given only slight mention in the records, it is impossible
to know whether, in most cases, they had acquired their skills and
educations before coming to Virginia, or even whether they were born in
the New World. Nor is it known how many young men born in Virginia went
back to England or Europe to study medicine; a reference made by the
famous English surgeon, John Woodall, indicates that a Virginian named
Wake may have studied under him in London.
Within the Virginia county records, however, can be found evidence
indicating that a common method of learning the profession was by
apprenticeship. One interesting example of the contract between
apprentice and surgeon survives in the records of Surry County,
Virginia; made in 1657, it bound Charles Clay to Stephen Tickner,
surgeon, for a term of seven years. Clay swore to serve his master in
whatever surgical or medical duties he was assigned, and Tickner
promised to use his best skill and judgment to teach his apprentice
whatever he knew of the art. Another contract for apprenticeship was
made between Richard Townshend and the London Company's well-known Dr.
Pott. This relationship included a breach of contract that occurred not
infrequently between master and apprentice: Townshend argued in court
that Pott was not teaching him the "art & misterye" for which he was
bound.
As an apprentice, the would-be physician or surgeon could gather herbs
for his master and assist him in treating the sick. If the apprentice
could read, or if the master would teach him, then the novice could
study the medical books in the doctor's library. Not only were volumes
on medicine available, but in the libraries of the better-educated
medical men, the apprentice could also familiarize himself with other
fields of learning.
Dr. Pott had a reputation for knowing Latin, Greek, and Hebrew, and
must have imparted much of his learning to Richard Townshend, his
apprentice. Such would seem to be the case in view of the facts of
Townshend's life. He became an apprentice to Pott in 1621 and by 1636
he was a member of the colony's highest political body, the council,
and at the time of his death he possessed a considerable amount of
land. In a day when schooling was hard to come by, apprenticeship to an
educated man held great advantages.
Unfortunately catalogues of the libraries of medical men have not
survived. There is proof, however, that physicians and surgeons did not
neglect opportunities to collect volumes on medicine published in
England and Europe. If utilized, these books could have helped offset
the lack of a formal education in a university or medical school. Dr.
Henry Willoughby of Rappahannock County, Virginia, left forty-four
books on "phisick" in his estate. Dr. John Holloway, a leading
physician of Accomack County, Virginia, from 1633 until his death in
1643, left thirteen books on surgery and medicine, all in English or
Latin. Dr. Henry Andrews of York County had twenty books in Latin on
medicine.
A great number of Virginians--some of them prominent--who did not
practice medicine had, nonetheless, large collections of books on the
subject. This would indicate that many persons resorted to medical
treatment without the help of a professional. With fees high, distances
great, and well-trained doctors scarce, self-reliance is not
surprising. Many planters and their wives must have made a superficial
study of medicine; certainly the mistress of the house visiting sick
servants and slaves is a familiar historical picture.
Among the medical books in such libraries were volumes on the general
subjects of medicine (physick) and surgery, anatomy, gout, scurvy,
distillation, and natural magic. Common in the libraries of the laymen
were books recommending specific drugs for various symptoms of
diseases. The long title of one volume in a Virginia library read,
"Method of physick, containing the causes, signes, and cures of inward
diseases in man's body from the head to the foote. Whereunto is added
the forme and rule of making remedies and medicines, which our
physitions commonly use at this day, with the proportion, quantity, and
names of each medicine."
The importance of medical volumes to the lay library is indicated by
the inclusion of two in the supplies provided by a London agent for a
Virginia plantation in 1620-21. William S. Powell, in a recent study of
books in Virginia before 1624, found that the agent chose _The French
Chirurgerye_, published in English in 1597, and the _Enchiridion
Medicinae_, first published in 1573.
In spite of medical books, the apprenticeships, training in Europe or
England, and the demand for medical services despite a high fee, it is
possible to overestimate the competence of the seventeenth-century
Virginia doctor even by the standards of his own century. An
observation made by William Byrd II early in the next century tends to
reduce the stature of the medical man.
"Here be some men," Byrd wrote, "indeed that are call'd doctors; but
they are generally discarded surgeons of ships, that know nothing above
very common remedys. They are not acquainted enough with plants or
other parts of natural history, to do any service to the world...."
Byrd may have been prejudiced by his father who, although believing
himself facing death, still did not call a physician.