London (Ancient And Modern) From The Sanitary And Medical Point Of View — Ditto: Secret Remedies; The Crusade Against Quackery; Medicine In The Days Of Pepys; The Barber Surgeons; The First Anatomy Lectures; The Apothecaries

SECRET REMEDIES.

Two centuries ago, and even later than this, it was not thought unprofessional for a physician to have secret remedies.

Thus Dr. Goddard, who was much trusted by Oliver Cromwell, who was one of the original members of the Royal Society, professor at Gresham College, the friend of Sydenham, and a Fellow of the College in 1646, was the inventor of “Goddard’s drops.

” The most notable instance of “professional secrets,” however, is that of the midwifery forceps.

This was the secret of the Chamberlen family, of whom I will mention two.

=Peter Chamberlen= (M. D.

Padua, F. R.

C. P.

1628) was probably the first fashionable obstetrician, and is supposed to have been the inventor of the forceps.

He made an attempt to organise the monthly nurses, was much employed about the English court, and had eighteen children by his two wives.

=Hugh Chamberlen=, the son of Hugh Chamberlen and the nephew of Peter Chamberlen (F. R.

C. P.

1694), was the most celebrated man-midwife of his day.

He published a translation of Mauriceau’s Midwifery, and in the preface to that book he says: “I will now take leave to offer an apology for not publishing the secret I mention we have to extract children without hooks where other artists use them; viz.

, there being my father and two brothers living that practise this art, I cannot esteem it my own to dispose of nor publish it without injury to them, and I think I have not been unserviceable to my own country, although I do but inform them that the forementioned three persons of our family and myself can serve them in these extremities with greater safety than others.

” This is a very pretty specimen of medical ethics on the part of one who was a censor of the College as late as 1721. What are probably the original forceps were accidentally discovered, in 1815, at Woodham Mortimer Hall, Essex, formerly the residence of Peter Chamberlen.

“They were found under a trap-door in the floor of the uppermost of a series of closets, built over the entrance porch,” and may now be seen in the library of the Royal Medico-Chirurgical Society.

Hugh Chamberlen is buried in Westminster Abbey, where a Latin epitaph of seventy-two lines, by Bishop Atterbury, adorns his tomb.

I feel tempted to mention two or three more of the early physicians who are deservedly famous, but in doing so I must limit myself to those who flourished mainly in the seventeenth century.

=John Radcliffe=, who became F. R.

C. P.

in 1687, appears to have been a blustering, kindly, and successful practitioner.

He spoke his mind freely, even to monarchs, and seems to have made his way more by push than courtesy.

His chief claim to be remembered is as a public benefactor.

He accumulated a large fortune, and founded at Oxford the Radcliffe Library, Radcliffe Infirmary, Radcliffe Observatory, and Radcliffe Travelling Fellowship, and also left £500 a year to St. Bartholomew’s Hospital, London, for improving the diets of the patients.

Radcliffe was only one of many London doctors who have been great public benefactors.

I have already alluded to Linacre, Caius, Harvey, Baldwin Hamey, Caldwell, and Croon, and the list may be enlarged by mentioning Sir Hans Sloane (who founded the British Museum and gave the Chelsea Garden to the Apothecaries’ Society), William and John Hunter, Erasmus Wilson, and Richard Quain--the last and the most munificent benefactor of this (University) College.

=Sir Hans Sloane= was born in 1660, became F. R.

C. P.

in 1687, was president from 1719 to 1735, and died in 1753 in his ninety-fourth year.

He was president of the Royal Society from 1727 (succeeding Sir Isaac Newton), and retired to Chelsea in 1740, where his name still lives in Sloane Street and Hans Place.

In his youth he accompanied the Duke of Albemarle to Jamaica, and returned home with a valuable botanical collection.

He was a great accumulator of archæological and natural curiosities, and his collection was by his will offered to the nation at a nominal sum, and thus was founded the British Museum.

Sir Hans Sloane was born in the last days of the Commonwealth, only three years after the death of Harvey.

In Evelyn’s Diary we read how, on April 16th, 1691, he (Evelyn) “went to see Dr. Sloane’s curiosities, being an universal collection of the natural productions of Jamaica,” &c. He lived in the reign of Charles II.

, James II.

, Anne, William III.

, George I. , and George II.

, and died five years after the birth of Jeremy Bentham, who was so active in the foundation of University College.

THE CRUSADE AGAINST QUACKERY.

Perhaps the main object held in view by those who were instrumental in establishing the medical corporations was “protection,” and certain it is that the monopoly of medical licensing enjoyed by the physicians and the barber-surgeons in London and seven miles round was very great.

No small amount of the energies of the College of Physicians was in its earlier days devoted to the fighting of irregular practitioners, but this was and is a hopeless battle.

We have seen how Henry VIII.

protected the rights of physicians and surgeons, but then, as now, there was a great deal of public sympathy for irregular practitioners, and accordingly we find that in the thirty-fourth and thirty-fifth year of the reign of Henry VIII.

an Act was passed, the chief clauses of which were to the following effect:--That the surgeons, “mindful onely of their own lucres, and nothing the profit or ease of the diseased or patient, have sued, troubled, and vexed divers honest persons, as well men as women, whom God hath endued with the knowledge of the nature, kind, and operation of certain herbs, roots, and waters, and the using and ministring of them to such as be pained with customable diseases, as women’s breasts being sore, a pin and a web in the eye, uncomes of hands, scaldings, burnings, sore mouths, the stone, strangury, saucelin, and morphew, and such other like diseases, &c. &c. Therefore it shall be lawful for any person to cure outward sores, notwithstanding the statute of the 3rd of Henry VIII.

” The public did not like being deprived of their favourite quacks and wise women;

and the same feeling undoubtedly obtains at present in this country, where hundreds of newspapers are kept afloat almost entirely by quack advertisements, and the proprietor of a pill and ointment has recently died possessed of wealth probably greater than that of all the Fellows of both the Royal Colleges collectively.

These are significant facts, and ought to warn us not to waste our energies in attempting to oppose human nature.

Dr. Goodall, in his account of the College of Physicians, published in 1684, gives many curious details of the conflicts of the College with quacks and empirics.

The College possessed magisterial power, and, on conviction, the president and censors had power to fine and imprison.

For instance, in 1632 Francis Roes, _alias_ Vinter, was accused of undertaking to cure a woman of a tympany, for which he had made exorbitant charges: “Being asked what medicines he gave, at first he refused to discover them, saying he had them noted in his books; but after long expostulation he named jalap and elatorium (as he pronounced the word), and, being questioned what elatorium was made of, he said it was composed of three or four things, whereof diagridium was one.

He was censured for giving elatorium (a medicine he knew not), and particularly to a woman at his own house, whom he afterwards sent home through the open streets, telling her it was a cordial.

He was fined £10 and committed to prison.

” Again, we find one Richard Hammond, a surgeon, fined £5 and committed to prison for undertaking to cure a child of the dropsy.

It appears that he administered a clyster composed of molasses, white hellebore, and red mercury, “which wrought so violently that the boy died therewith.

” John Hope, an apothecary’s apprentice, gets into trouble for giving a man two apples of coloquintida boiled in white wine, with cinnamon and nutmeg.

“The medicine wrought both upwards and downwards; upward he vomited a fatty matter, and downward he voided a pottle of bloud,” and ultimately died.

This case was remitted to the higher courts of justice.

In 1637 an order was sent from the Star Chamber “to examine the pretended cures of one Leverett, who said that he was a seventh son, and undertook the cure of several diseases by stroaking.

” The investigation of this case lasted over a month, and finally the College reported that Leverett was an impostor.

“In the fourth year of King Edward VI.

, one Grig, a poulterer, of Surrey (taken among the people for a prophet in curing divers diseases by words and prayers, and saying he would take no money, &c. ), was, by command of the Earl of Warwick and others and the Council, set on a scaffold in the town of Croidon in Surrey with a paper on his breast whereon was written his deceitful and hypocritical dealings; and after that on the 8th of September set on a pillory in Southwark, being then Our Lady Fair then kept, and the Mayor of London with his brethren the aldermen riding through the fair, the said _Grig_ asked them and all the citizens forgiveness.

Of the like counterfeit physician (saith Stow) have I noted to be set on horse-back, his face to the horse-tail, the same tail in his hand for a bridle, a collar of jordans about his neck, a whetstone on his breast, and so led through the city of London, with ringing of basons, and banished.

” The above are samples of dozens of similar cases; and it is interesting to note that many of these irregular practitioners had powerful friends, and we find Ministers of State writing on behalf of some of them, praying that the punishment may be remitted.

MEDICINE IN THE DAYS OF PEPYS.

In order to complete the picture of the profession in the seventeenth century, I have abstracted from the Diary of truthful Samuel Pepys a few facts having a bearing on medicine.

These seem to me to throw no little light upon the science, practice, and ethics of medicine at his time:--“March 26th, 1660: This day it is two years since it pleased God that I was cut for the stone at Mrs. Turner’s in Salisbury-court.

And did resolve while I live to keep it a festival, as I did the last year at my house, and for ever to have Mrs. Turner and her company with me.

But now it pleased God that I am prevented to do it openly: Only within my soul I can and do rejoice, and bless God, being at this time, blessed be His holy name, in as good health as ever I was in my life.

--Oct.

19th, 1663: Coming to St. James’s, I hear that the Queen did sleep five hours pretty well to-night, and that she waked and gargled her mouth, and to sleep again; but that her pulse beats fast, beating twenty to the King’s or my Lady Suffolk’s eleven.

It seems she was so ill as to be shaved and pidgeons put to her feet, and to have the extreme unction given her by the priests, who were so long about it that the doctors were angry.

The King they all say is most fondly disconsolate for her, and weeps by her, which makes her weep; which one this day told me he reckons a good sign, for that it carries away some rheume from the head.

--Oct.

20th: Mrs. Sarah ---- tells us that the Queen’s sickness is the spotted fever, and that she is as full of spots as a leopard.

--22nd: This morning, hearing that the Queen grows worse again, I sent to stop the making of my velvet cloak till I see whether she lives or dies.

--24th: The Queen is in a good way to recovery;

and Sir Francis Pridgeon [Prujean, President of the Royal College of Physicians] hath got great honour by it, it being all imputed to his cordiall.

--Jan.

16th, 1667: Prince Rupert, I hear, is very ill;

yesterday given over, but better to-day.

--28th: Prince Rupert is very bad still, and so bad that he do now yield to be trepanned.

--Feb.

3rd: To White Hall....

Talking, and among other things, of the Prince’s being trepanned, which was in doing just as we passed through the Stone Gallery, we asking at the door of his lodgings, and were told so.

We are full of wishes for the good success, though I dare say but few do really concern ourselves for him in our hearts.

With others into the House, and there hear that the work is done to the Prince in a few minutes without any pain at all to him, he not knowing when it was done.

It was performed by Moulins.

Having cut the outward table, as they call it, they find the inner all corrupted, so as to come out without any force; and the fear is that the whole inside of his head is corrupted like that, which do yet make them afraid of him; but no ill accident appeared in all the doing of the thing, but with all imaginable success, as Sir Alexander Frazier did tell me himself, I asking him, who is very kind to me.

--April 3rd: This day I saw Prince Rupert abroad in the Vane room, pretty well as he used to be, and looks as well, only something appears to be under his periwigg on the crown of his head.

--4th: (At the Duke of Albemarle’s. ) One at the table told an odd passage in the late plague, that at Petersfield (I think he said) one side of the street had every house almost infected through the town, and the other not one shut up.

--June 28th, 1667: Home, and there find my wife making of tea, a drink which Mr. Pelling, the potticary, tells her is good for her cold and defluxions.

--Nov.

21st: With Creed to a tavern, where Dean Wilkins and others; and a good discourse; among the rest of a man that is a little frantic, and that is poor and a debauched man, that the College have hired for 20s.

to have some of the blood of a sheep let into his body, and it is to be done on Saturday next.

They purpose to let in about twelve ounces, which they compute is what will be let in in a minute’s time by a watch.

On this occasion Dr. Whistler [President of the Royal College of Physicians] told a pretty story, related by Muffet, a good author, of Dr. Caius, that built Caius College, that being very old, and living only at that time upon woman’s milk, he, while he fed upon the milk of an angry, fretful woman, was so himself; and then being advised to take it of a good-natured, patient woman, he did become so beyond the common temper of his age.

--30th: I was pleased to see the person who had his blood taken out ...

saying he finds himself much better since, and as a new man.

But he is cracked a little in his head, though he speaks very reasonably, and very well.

He had but 20s.

for his suffering it, and is to have the same again tried upon him; the first sound man that ever had it tried on him in England, and but one that we hear of in France.

--June 23rd, 1668: To Dr. Turberville about my eyes, whom I met with, and he did discourse, I thought, learnedly about them, and takes time before he did prescribe me anything, to think of it.

--29th: To Dr. Turberville’s, and there did receive a direction for some physick, and also a glass of something to drop into my eyes; he gives me hope that I may do well.

--July 3rd: To an alehouse; met Mr. Pierce, the surgeon, and Dr. Clarke, Waldron, Turberville, my physician for the eyes, and Lowre, to dissect several eyes of sheep and oxen, with great pleasure, and to my great information.

But strange that this Turberville should be so great a man, and yet to this day has seen no eyes dissected, or but once, but desired this Dr. Lowre to give him the opportunity to see him dissect some.

--13th: This morning I was let blood, and did bleed about fourteen ounces towards curing my eye.

--31st: The month ends sadly with me, my eyes being now past all use almost, and I am mighty hot about trying the late printed experiment of paper tubes.

--Aug.

11th: Mighty pleased with a trial I have made of the use of a tube spectacall of paper, tried with my right eye.

” Cesare Morelli (a music master) wrote thus to Mr. Pepys on April 11th, 1681: “Honoured Sir,--I did receive your last letter, dated the ninth of this month, with much grief, having an account of your painful fever.

I pray God it will not vex your body too much; and if by chance it should vex you longer, there is here a man that can cure it with simpathetical powder, if you please to send me down the pearinghs of the nailes of both your hands and your foots, and three locks of hair of the top of your crown.

I hope with the grace of God it will cure you,” &c. THE BARBER-SURGEONS.

[Illustration: BARBER-SURGEONS’ HALL.

] Much as we owe to the College of Physicians, we owe even more to the early surgeons, and there is certainly no spot in this city which has a greater interest for us as students of medicine than the hall of the Barbers’ Company in Monkwell Street, a street not far from the General Post Office.

The house in Knightrider Street, the original home of the College of Physicians, is gone.

The house in Amen Corner, the second home of the College, was burnt.

The Grand College in Warwick Lane was deserted and sold, and has now completely disappeared.

The Barbers’ Hall remains and commands our respect as being on the original spot, though not the original building where the study of anatomy took its rise in this country.

The barbers and surgeons have occupied premises in Monkwell Street certainly since their first incorporation in 1460, possibly earlier.

The present hall was built by Inigo Jones, and having partially escaped the fire in 1666, much of the original building remains, and certainly the present court-room and the elaborately carved shell canopy over the front door are both works which do credit to this famous architect.

Originally, the hall stood detached from other buildings, and seems to have had a fair-sized piece of ground round it, and a garden at the back; and its theatre, one of Inigo Jones’s best works, rested on one of the bastions of the old city wall.

With land at its present enormous value, it is not to be wondered at, though much to be regretted, that the Company has turned every available inch to account; and the medical antiquary who now goes in search of this, to us, almost sacred edifice, will need to be warned that it is hemmed in and hidden by warehouses.

It was in 1540 that Henry VIII.

gave a charter to the Barber-Surgeons, and Holbein’s famous picture of this event is the chief treasure of the Barbers’ Hall, which contains many other relics of medical interest.

In this picture, which has been often engraved, and is doubtless familiar to many of you, there are certain points which merit our attention.

It is a group of nineteen people, and it is probable that the portraits of all are faithful.

The portrait of Henry VIII.

was said by King James I. to be reported “very like him and well done,” and it is probable that the portraits of the others are equally good.

The king is seated, and the eighteen persons receiving the charter are on their knees.

These eighteen are arranged in two groups--a group of three on the right hand of the king, and a group of fifteen on the left.

Those on the right are probably entitled to take precedence of the others, they are all members of the king’s household--viz.

, John Chambre, the king’s physician, who was, as we have seen, one of the six persons named in the charter of the College of Physicians; Sir William Butts, physician to Henry VIII.

, and one of the characters in Shakspeare’s play of that name; and Master J. Alsop, the Royal apothecary.

The fifteen on the left are all surgeons or barbers.

The chief, to whom the king is handing the charter, is Thomas Vicary, the king’s sergeant-surgeon, and the first medical officer appointed to St. Bartholomew’s Hospital;

of the others, Ayliffe, Mumford, and Ferris were king’s surgeons, and Symson, Harman, and Penn were king’s barbers; of the remaining eight little is known.

[Illustration: HOLBEIN’S PICTURE: HENRY VIII.

GIVING A CHARTER TO THE

BARBER-SURGEONS.

[_To face p. 97. _ ] THE FIRST ANATOMY LECTURES.

The original charter to the Barber-Surgeons provided that the two mysteries of barbery and surgery should be kept distinct, and it gave facilities for obtaining the bodies of executed felons for purposes of anatomical study.

There is no doubt that the anatomy lectures at the Barber-Surgeons’ Hall preceded those given by the physicians.

The necessity of a knowledge of anatomy must have been felt daily by these early surgeons, and, like practical men, they took steps to supply their wants.

The giving of these lectures, a physician being appointed lecturer, was the chief work of the Company.

Some of the particulars collected by Mr. South are of interest, as showing how this first London School of Anatomy was worked.

Every member of the Company was bound to attend the anatomy demonstrations, a fine of fourpence being imposed upon those freemen who were late, and sixpence upon those who were absent.

For each summons to “an anatomy” the sum of 3s.

4d.

was charged, whether present or absent, and the members of the Company were bound to come “decently appareyled, for their own honestye, and also for the worshippe of the Company.

” The anatomical demonstrations appear to have been public, and their occurrence was a solemn festival--in fact, in the early days of the Company “private anatomies” were disallowed, except by special licence from the court.

There were two masters of anatomy appointed yearly, and two stewards of anatomy to look after the creature comforts of those who attended the demonstration.

It was also the duty of the masters and stewards to fetch the body from the place of execution, which was not always an enviable duty.

The actual lecture and demonstration was given by a fifth officer, a “reader” specially chosen, who was generally a physician.

The masters of anatomy had to make due provision for the comfort of the “Dr. ,” and they were specially charged to provide a “matte about the harthe in the hall,” in order that he might not suffer from cold feet.

They also had to provide two fine white rods for demonstrating, a wax candle to look into the body, necessary instruments, and clean white sleeves and aprons for each day for themselves as well as for the reader.

A fine of 40s.

was imposed for inattention to these necessary details.

The greatest formality was observed.

The notices of the forthcoming demonstration were issued according to a regulated formula, which differed according to the rank in the Company of the person bidden, and, after assembling in the parlour, a procession to the theatre was marshalled by the clerk in due form.

There were two demonstrations daily, at noon and at five, and between the morning and afternoon lecture the court and officials were “plentifully regaled,” the doctor or reader “pulling off his own robes and putting on the clerk’s, which has always been usual for him to dine in.

” These demonstrations went on for three consecutive days, and at their close the clerk “attends the doctor in the cloathing room, where he presents him, folded up in a piece of paper, the sum of ten pounds, and where afterwards he waits on the masters of anatomy and presents each of them in the like manner with the sum of three pounds.

” After each public demonstration the lecturer was allowed to give a private demonstration to his own pupils for three days, after which the body was decently interred, and the expenses incurred by the masters of anatomy (£3 7s.

6d.

) were reimbursed.

Seats were provided in the theatre, and the body was surrounded by a curtain until the demonstration actually began.

Among the curiosities in Barbers’ Hall is a portrait of Sir Charles Scarborough, the physician to Charles II.

, in the act of giving an anatomical lecture with a “subject” before him, and Alderman Arris at his side assisting him.

Scarborough, who was a good anatomist and distinguished mathematician, is represented as seated, dressed in full robes of scarlet and ermine, wearing a velvet hat with jewelled band and with lace cuffs, and Alderman Arris is scarcely less gorgeous.

Alderman Arris, together with Dr. Gale, endowed those lectures, which are still given at the College of Surgeons, and which are known as the Arris and Gale Lectures.

This Dr. Gale is not to be confounded with Thomas Gale, sergeant-surgeon to Queen Elizabeth, one of the earliest English writers on surgery.

It was on Feb.

27, 1662, that Samuel Pepys records that “about 11 o’clock Commissioner Pett and I walked to Chyrurgeon’s Hall (we being all invited thither, and promised to dine there), where we were led into the theatre; and by-and-by comes the reader, Dr. Tearne, with the master and company, in a very handsome manner; and, all being settled, he began his lecture, and his discourse being ended, we had a fine dinner and good learned company, many doctors of Physique, and we used with extraordinary great respect.

Among other observables we drunk the King’s health out of a gilt cup given by King Henry VIII.

to this Company, with bells hanging on it, which every man is to ring by shaking after he hath drunk up the whole cup....

Dr. Scarborough took some of his friends, and I went with them, to see the body of a lusty fellow, a seaman, that was hanged for robbery.

” The cup to which Pepys alludes, and other interesting pieces of plate, are still in the possession of the Company, and they also have an excellent picture of Inigo Jones by Vandyke, and many other pictures of interest.

There are also to be seen four silver wreaths worn by the master and wardens on state occasions, and upstairs is a massive oak table said to be the original table used for anatomical purposes.

The apprentices of the Company were kept in order.

For example, they were not allowed to wear a beard of more than fifteen days’ growth, and in case of offence in this particular the master was fined 6s.

8d.

Apprentices were bound to be able to read and write, and those that intended practising in London passed what appear to have been preliminary examinations.

“How he knoweth what ys surgery and also what an anatomy ys, and how many parts it is; of what the iiij elements and the xij signes be, which is the first part of examynacion for a prentyce.

” The apprentice was then bound to read to the court every half-year an epistle, in order that the court might judge of his progress; and he first became a probationer and was licensed for so many years, at the end of which time, subject to good behaviour and adequate knowledge, he was admitted a master of surgery and anatomy.

The fee for the apprentice’s examination appears to have been a silver spoon, with his name upon it, weighing one ounce; and 7d.

to the clerk for writing and seal.

The examination fee for the great diploma appears to have been £6 6s.

THE APOTHECARIES.

We have seen that the physicians were an offshoot from the priests and the surgeons an offshoot from the barbers.

In the same way, the apothecaries were originally linked with the grocers; and it was not till 1617 that James I. gave to the Apothecaries’ Company an independent charter.

The apothecaries were originally druggists pure and simple, but they took to prescribing, and this brought them into conflict with the physicians.

In the end the apothecaries were victorious; and finally, in 1815, they acquired the rights of examining and licensing, which are practically the same as they now possess.