Doctor, Surgeon & Apothecary
Posted by Captain Everett on June 09, 1998 at 18:20:33:
In response to Apothecary vs. Physician, written by Peg on June 09, 1998 at 08:47:34
] I wondered about the 2 terms because in P&P, Mr. Jones is an apothecary (called in for Jane) but the sisters want to send for a physician from London. So, they just wanted someone from the city who would be more prestigious & in their eyes, more knowledgeable? The terms are not separate?
The medical practise seems to have been organized on three levels: Doctor, Surgeon and Apothecary in decending order. (This profession itself being a third behind the Church or Law as an occupation for younger sons.) The following is a very brief summery skimmed from Elie Halevy, A History of the English People in 1815.
The main role of the Physician in this period was that of diagnosis, as opposed to actually doing anything to the body. Doctors were members of the Royal College of Physcians founded in the days of Henry VIII. Members were, among other qualifications, graduates of Oxford of Cambridge. This effectively barred those of the Dissenting faiths from being a doctor, as membership in the Church of England was required for those two institutions. This allowed the students to mix freely with other future leaders of the Church and State. There were other methods of exclusion, largely used against the growing competition of doctors from Scotland. Members of the College were divided between associates, and the lesser permissi or licentiates. Their education in truly medical matters was woefully inadequate by modern standards. The study and practice of the classics, and exercises in oratory seem to have been far more important than any practical educations. Exams have been described as farcical. Indeed, the medical establishment probably did more to obstruct the advance of scientific development as anything. Despite this, England was believed to be more advanced than most of the Contintent. Once established in a practise, the physician could acquire considerable wealth and prestige in society. Halevy does not that, as a rule, the nobility did not enter this field, nor could a Doctor obtain a peerage, although they might aspire to a knighthood or a baroncy.
The small number of "Doctors" could not meet the needs of all of London, let alone the rest of the country. Thus, the next two layers provided the bulk of medical aid. The second level, Surgeons, had their own Royal College, founded in 1800. However, membership in the two organizations was mutually exclusive. They in turn, excluded the accoucheur or "chemist." The surgeon was required to attend an annual course of 24 lectures. However, like the Doctors' education, it was not entirely scientific. (Not covered by Halevy, but I recall reading that Surgeons, at least in the military, picked up a lot of their practical knowledge through assisting other Surgeons.)
The third level, chemists or apothecaries, provided the largest group. One contemporary estimate is that 9/10ths of the medical personnel fell into this group. Unlike the two other groups, they had no "professional qualifications." Education was more on an apprentiship basis. Nevertheless, they were almost the only medical help available in the country districts, or even in London. If the patient required surgery the surgeon might be called upon. In the most severe cases (or where the patient had enough money), the apothcary might consult the doctor for advice. (Halevy compares their relationship to that of the Barrister and Solicitor in the English Legal system.)
There were also the hospitals, again a far cry from what we would ever tolerate. They were fraught with abuses and mismanagement. No repectable doctor would be caught in such a place, and even the manager was only required to visit the wards once a week. Again, it fell to the apothecary to do the daily work. However, by this time things were beginnning to change. There were also a number of smaller centers for professional training for medical and surgical students, set up by forward thinking physicians and supported by wealthy sponsors.
I remain, etc.
Jason E.
- Royal Colleges Laura W 21:13:55 6/27/98
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- Thanks for the details!! (NFM) ElaineL 15:07:31 6/10/98
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- Was the barber/surgeon gone by early 1800s? *nfm* Carolyn B 22:11:13 6/09/98
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