January 2011 Q3
In what ways did the training of doctors change during the period c1350–
c1900?
You may use the following in your answer and any other information of
your own.
􀀃 􀀃􀀃 Vesalius carried out dissections during the Renaissance period.
􀀃 􀀃􀀃 1815: The Society of Apothecaries and the Royal College of
Surgeons introduced examinations.
􀀃 􀀃􀀃 1884: Edinburgh University opened a new medical school,
containing research laboratories.
Task
Read pages 26 – 27 of Edexcel book and make notes. Use the additional
slides too.
Then answer the question above.
Society of Apothecaries of London
ORIGINS & HISTORY
The word 'apothecary' is derived from apotheca, meaning a place where wine, spices and herbs were stored. During the thirteenth century it
came into use in this country to describe a person who kept a stock of these commodities, which he sold from his shop or street stall.
London apothecaries were originally members of another livery company, the Grocers', and together these tradesmen can be traced back to the
Guild of Pepperers, an association formed in the City in 1180. By 1316, the Pepperers had been joined by the Spicers.
The Pepperers subsequently became wholesale merchant traders dealing en gros (hence the word 'grocer') and in
1428 were incorporated as the Worshipful Company of Grocers. The trade in spicery and the development of
pharmacy, on the other hand, became interdependent and led to the emergence of spicer-apothecaries. These
members of the Grocers' Company had their shops in Bucklersbury where they stored and sold spices, confectionery,
perfumes, spiced wines, herbs and drugs which they compounded and dispensed to the public.
By the mid-sixteenth century apothecaries had become the equivalent of today's community pharmacists, dealing
mainly with the preparation and sale of substances for medicinal purposes. Authority over medical practice, however,
lay with the College of Physicians.
The London apothecaries with their specialist pharmacy skills petitioned for several years to secede from the Grocers'
Company. Gideon de Laune, a wealthy and influential Huguenot, led the separatists. He was Apothecary to Anne of
Denmark, wife of James I, which may have helped them gain the king's approval. The Worshipful Society of
Apothecaries of London was incorporated by royal charter on 6 December 1617.
King James justified his decision in the House of Commons in 1624: "I myself did devise that corporation and do allow it. The grocers, who
complain of it, are but merchants; the mystery of these apothecaries were belonging to apothecaries, wherein the grocers are unskilful; and
therefore I think it is fitting they should be a corporation of themselves."
The Society is No. 58 in the order of precedence of the City Livery Companies.
The Society's Hall in Blackfriars, formerly the guesthouse of the Dominican Priory of the Black Friars, was acquired in 1632. Destroyed in the
Great Fire of London, it was re-built by 1672 on the same site, where it still stands.
From 1672 until 1922, the Society of Apothecaries manufactured and sold medicinal and pharmaceutical products at the Hall, and in 1673 it
founded the Chelsea Physic Garden, only relinquishing managerial control in 1899.
In 1704 the Society won a key legal suit (known as the Rose Case) against the Royal College of Physicians in the House of Lords, which ruled
that apothecaries could both prescribe and dispense medicines. This led directly to the evolution of the apothecary into today's general
practitioner of medicine.
Just over a century later, as a result of the Apothecaries' Act of 1815, the Society was given the statutory right to conduct examinations and to
grant licences to practise Medicine throughout England and Wales, as well as the duty of regulating such practice.
MEDICAL REFORM AND EDUCATION AND PHARMACY TRAINING
Apothecaries frequently flouted the authority of the Physicians by dispensing medicines without a
prescription. The College of Physicians countered this by asserting its right to inspect apothecaries'
shops and by imposing stringent quality controls on raw drugs and medicinal preparations.
The Society and the College were at bitter variance over these issues for many years until a test case
went to appeal in the House of Lords in 1704. William Rose, a freeman of the Society, was
prosecuted by the Physicians for visiting a sick man in his home, prescribing medicines for him and
dispensing them.
Bowing to recognised common practice, the Lords ruled in favour of the Apothecary, for Physicians
were relatively few in number and most people could not afford their fees. This judgment ratified their
status as members of the medical profession, and thus apothecaries evolved into general
practitioners of medicine (today's GPs).
Medical reform and regulation of the profession, especially with regard to education and training,
became a major concern at the close of the eighteenth century. Members of the Society were at the
forefront of the movement which gathered momentum between 1810 and 1814 and resulted in the
Apothecaries' Act of 1815.
History of the Royal College of Surgeons
The College is descended from the Fellowship of Surgeons, which was already over a
century old when it was awarded a 'cognizance' (similar to a coat of arms) in 1492. Under
Henry VIII, the Fellowship united with the Company of Barbers to form the Company of
Barber-Surgeons in 1540. They maintained a somewhat uneasy partnership in the 16th
and 17th centuries when the degree of surgical intervention was limited.
The 18th century, however, saw the rise of private anatomy schools and the development of an academic basis for
surgical practice through the teaching and publications of the leading European surgeons. As a consequence, the
number and importance of surgeons increased, along with a firm desire for independent professional recognition.
Thus, in 1745, the surgeons broke away from the barbers to form a separate Company of Surgeons, with its own hall
close to the Old Bailey and Newgate Prison. In 1797, the surgeons moved away from the City to property purchased in
Lincoln's Inn Fields. This coincided with the government placing into the care of the College the writings and specimen
collection of John Hunter (1728-1793), a surgeon regarded as one of the most distinguished scientists of his day.
In 1800, the Company of Surgeons was granted a Royal Charter to become The Royal College of Surgeons in London,
later of England.
A new College building was built to provide lecture theatres, meeting rooms and accommodation for the Hunterian
Collection. Although the buildings have been replaced, the College occupies the same site today.
Further charters over the years have modified the constitution to reflect changing needs, including the foundation of the
Faculties of Anaesthetists (now a separate Royal College), Dental Surgery, General Dental Practice and Accident &
Emergency Medicine.
The College is governed by a President and Council of elected Fellows and invited representatives. A separate Court of
Examiners conducts examinations. The College participates in The Forum of Surgery of Great Britain and Ireland which
co-ordinates certain professional activities and national bodies.
Edinburgh Medical School
The College of Medicine and Veterinary Medicine has a long history as one of the best medical institutions in the world.
The eight original faculties formed four Faculty Groups in August 1992. Medicine and Veterinary Medicine became one
of these, and in September 2002, became the smallest of three Colleges in the University.
The University of Edinburgh was founded in 1583 by the Town Council of Edinburgh as the first civic university in Britain.
Although the Medical School can trace its origins back to the barber surgeons of Edinburgh in the early part of the 16th
century, the Faculty of Medicine did not gain formal recognition within the University until 1726.
Edinburgh’s Faculty of Medicine was founded on the models established at the University of Padua in the 16th century
and at Leiden in the 17th.
It was in part a deliberate policy to boost the economy of the city by attracting foreign students to study in Scotland
rather than send young Scots at great expense to the Continent.
By the middle of the 18th century, the success of the School came from teaching both Medicine and Surgery in a university
setting, but with a clinical base in a teaching hospital.
The establishment of the Medical Faculty was soon followed by the founding of a public hospital, originally in temporary
accommodation in 1729, but after 1741 in the purpose-built Royal Infirmary of Edinburgh close to the University.
The physicians had already established a botanic garden for the study of medicinal plants and this gave the base for the
development of studies in Materia Medica (Pharmacology) and Chemistry.
By 1764 the numbers of medical students were so great that a new 200-seat anatomy theatre was built in the College
Garden.
Edinburgh’s fame was enhanced later by a succession of brilliant teachers, such as William Cullen, James Gregory and
Joseph Black (discoverer of carbon dioxide and of latent heat).
The School attracted many students from Ireland, America and the Colonies, and Edinburgh graduates were closely
involved in the founding of several of the first Medical Schools in the US and Canada.
Edinburgh Medical School in the 19th Century
The Edinburgh Medical School retained its place as one of the most prestigious in the world during the 19th century.
Midwifery was finally admitted as an essential part of the compulsory medical curriculum. James Young Simpson
revolutionised obstetric and surgical practice with the introduction of chloroform anaesthesia in 1847.
There were enormous advances in surgery, under great names such as Robert Liston, James Syme and Joseph Lister,
particularly with Lister’s introduction of antiseptic and aseptic techniques in the 1870s.
Edinburgh also played a part in the battle for admission of women into medicine with the reluctant acceptance of Sophia
Jex Blake to some classes in 1869, though the eventual concession of full equality with men was not achieved till 1889.
New facilities
Old College, 1837
By the 1860s the development of Edinburgh medicine was constrained by its existing premises, with the Royal Infirmary
in ageing buildings around Infirmary Street and the Medical Faculty still squeezed into the University quadrangle on
South Bridge (now known as Old College).
A fine new building at Lauriston Place was finished in 1880. New premises were also required for the Medical Faculty as
modern teaching demanded proper facilities for scientific research and practical laboratories. A site was selected just
across from the new Royal Infirmary and a new Medical School was opened in 1884.