3 - The Corporations, licensing, and reform, 1700–1815

Summary

No degree of discipline, nor any kind of examination, can ensure the public against having a certain number of persons who are indifferently qualified included in the list of well-qualified practitioners. Young men may be compelled to have opportunities of study, but they cannot be compelled to learn.

Quarterly Review, 1840

The history of medical education in London seen through official records, from the minute books of the Surgeons' Company to Acts of Parliament, is a patchwork of regulations and traditions that hides as much as it reveals about medical organization and practice. From the bureaucratic perspective that such documents offer, London medical men were separated into the familiar tripartite division of physicians, surgeons, and apothecaries, each with its own corporate body, public voice, and standards of appropriate medical training. Entry into the Royal College of Physicians, the Surgeons' Company, or the Worshipful Society of Apothecaries certainly marked professional status and acceptance into the mainstream of metropolitan practice. Yet, as much recent work has shown, defining the medical profession(s) according to these corporations' claims flies in the face of contemporary understanding of who could and should practice medicine. The lines between “quacks” and “regulars,” so bitterly drawn by medical men threatened for their livelihoods and so frequently ignored by their potential patients, are more realistically cast as the shades of gray between regular and irregular practitioners. Community acceptance and length of experience could matter as much as – or more than – formal licensing, university degrees, or corporate membership in establishing a full-time medical career in much of eighteenth-century Britain.