It may be that the poet means to convey the idea that doctors of the fourteenth century, like some of those of the nineteenth, were prone to talk “shop.”

Astrology at this time was an essential part of medicine, and the simplest remedies were not applied without consulting the stars, so that to be “grounded in astronomye” was most essential.

Here we have reference to mystical modes of treatment which were then much in vogue. Amulets and charms were constantly prescribed; the doctrine of signatures—i.e., the giving of those plants having some slight resemblance to parts of the human body or to some prominent symptom of disease, for the relief of the organs or diseases which they resembled—was in every-day use; and the treating of images in order to affect the original of the image was a constant practice among witches, and was probably used by the profession.

Here we have allusion to the Hippocratic humoral pathology as developed by Galen.

Quick diagnosis and prompt treatment.

It would seem that even in Chaucer’s time the advertising druggist was as pushing as at present.

Our friend’s library was tolerably complete, for here we have a list of the medical “scriptures,” Greek, Roman, and Arabian, an acquaintance with which was the whole duty of a physician, and which to doubt was heresy. The last two names on the list refer to John of Gaddesden and Gilbert, both English writers, of whom I shall have a few words to say presently.

Doubtless there were many things then which took the place of pancreatic emulsion and extract of malt.

This line is frequently quoted to show that the scepticism with which doctors are often charged is of no modern growth. The point of the line is, however, to be found in the fact that Chaucer’s doctor was certainly a priest, as were all the physicians of his time, and that the practice of medicine had drawn him away, somewhat unduly perhaps, from the clerical profession, to which he also belonged.

A robe of scarlet and sky-blue, lined with silk. Equally gorgeous doctors may be seen at the present time by those who attend at Burlington Gardens on “Presentation Day.”

The priest-physician was fully as fond of his fees as are any of his successors. But to come to particular instances which prove the truth of Chaucer’s graphic picture.

EARLIEST LONDON PRACTITIONERS.

The “Gilbertyn” of Chaucer’s doctor was Gilbertus Anglicus, an Englishman who wrote a work on medicine about the year 1290, and it is remarkable from the fact that it gave the first description of leprosy written by western writers, leprosy being a disease which has long ceased to exist in this country. He treated apoplexy with ants’ eggs, scorpions’ oil, and the flesh of lions; but where he obtained this latter commodity it is hard to tell. For urinary calculi he advised the administration of the blood of a he-goat fed upon parsley and saxifrage.

John of Gaddesden was a graduate of Merton College, Oxford, and wrote his famous medical treatise, “Rosa Anglica,” about 1305. He is said to have been greedy of money, and he recommends his contemporaries to make arrangements about fees before undertaking a case. He was an ecclesiastic, and was court physician to Edward II. and Edward III. He tells us that bleeding is hurtful at the time of the feasts of St. John and St. Stephen, but necessary at Christmas because of the custom of overloading the stomach with cakes at that season. Pigs’ dung was his favourite hæmostatic; and when the son of the King had small-pox, he was careful that everything about his couch should be red.

In South’s “Craft of Surgery” is a most interesting and full account of John of Arderne, one of the earliest English writers on surgery. This worthy was a specialist for the cure of fistula, and dwelt at Newark between 1349 and 1370, when he moved to London. His work “Praxis Medica” is among the Sloane Manuscripts in the British Museum. He made his great reputation by curing Sir Adam Everyngham of fistula after he had been pronounced incurable by the chief doctors in France. He relates the cases (some of them with details) of other patients. The most interesting of the writings of John of Arderne is that entitled “Of ye Manere of ye Leche,” because it throws a flood of light on professional manners and ethics in the fourteenth century. The following paragraphs (taken from South) are well worth quoting; but in doing so I think it advisable to (in some degree) modernise the spelling and the expressions:—“First, it behoveth him that will profit in this craft that he set God ever before him in all his works, and evermore call meekly with heart and mouth his help, and occasionally, according to his power, give of his earnings to the poor, that they by their prayers may get him grace of the Holy Ghost. Let him not be found rash or boastful in his words or deeds. And let him abstein from much speaking, especially among the great. And let him answer questions warily, lest he be overtaken by his words.... Also be a leche not much laughing nor much playing, and let him as much as may be fly the fellowship of knaves and disreputable persons. And be he evermore occupied in things beholding to his craft, whether he read or study, write or pray, for the exercise of books whorshippeth a leche.... And above all this, it profiteth to him that he be found evermore sober, for drunkenness destroyeth all virtue, and bringeth it to nought, as sayth a wise man. Be he content in strange places with the meat and drink there found, using measure in all things.... Scorn he no man.... And if there be made speech to him of any leche, neither set him at nought, nor praise him too much, nor commend him, but thus may he courteously answer: ‘I have not any knowledge of him, but I have neither learned nor heard of him but good and honest.’... Consider he not over openly the lady or the daughters, or other fair women in great men’s houses, ‘ne profre them not to kisse, ... that he come not in to the indignacion of the lord ne of noon of his.’... When such men come to the leche to ask help or counsel, it speedeth that he make seeming excuses, that he may not incline to their asking without harming or without indignation of some great man or friend, or for necessary occupation; or feign he him hurt, or for to be sick, or some other convenient cause by which he may likely be excused. Therefore if he will favour to any man’s asking, make he covenant for his travail and take it beforehand.... And if he see the patient, pursue busily the cure then, and ask he boldly more or less, but ever be he warre of scarce askings, for over scarce askings setteth at nought both the market and the thing. Therefore for the cure of fistula in ano, when it is curable, ask he competently of a worthy man and a great an hundred marks or forty pounds, with robez and feez of an hundred shillyns terme of life, by year. And take he not less than an hundred shillyns, for never in als my life took I less than an hundred shillyns for cure of that sekeness.” John of Arderne advises that prognosis should be very guarded, and that as to the time of recovery it is good to say double what you think, and if the patient ask “why he putte him so long a time of curying, sithe that he heled him by the halfe? Answer he, that it was for that the patient was strong hearted and suffered well sharp things, and that he was of good complexion and had able flesh to heal, and feign he other causes pleasable to the patient, for patients of such words are proud and delighted.” The leech is further advised to dress like a clerk (i.e., a priest), “for why it seemeth any discrete man clad with clerk’s clothing to occupy gentlemen’s boards.” “Have the leche also clean hands and well shapen nails, cleansed from all blackness and filth.” There are many other directions for conduct given in this remarkable document, and sundry extracts from Scripture are given as suitable for quotation by the bedside: “And it speedeth that a leech can talk of good tales and of honest that may make the patient to laugh, as well of the biblee as of other tragediez.” Finally, he is charged to most scrupulously observe all professional confidences. It is evident that John of Arderne was a consummate man of the world, and knew all the tricks of his trade. His fees seem to have been enormous, and, indeed, he is only one out of many examples among our early professional forerunners who made very large professional incomes.

Whether Gilbert, Gaddesden, and John of Arderne were associated with any guild which took upon itself the duty of protecting the interests of physicians and surgeons is not known. Certainly they belonged to no association of which we have any trace remaining. I shall now endeavour to show how the medical corporations of London had their origin, and it is necessary to make a few preliminary remarks.

THE SEVERANCE OF MEDICINE AND SURGERY.

The physicians and surgeons were originally very different orders of men. Medicine is in most Christian countries an offshoot of the clerical profession. So profitable was the practice of medicine, that not only monks, but many of the higher clergy, devoted themselves to it. The union of the two professions of medicine and divinity existed up to the middle of the seventeenth century, and evidence of it is still found in the “Lambeth M.D.,” a degree which the Archbishop of Canterbury still has the right to confer, but only upon a legally qualified practitioner. It was thought necessary by Pope Innocent III. (1198–1216) to forbid the clergy to undertake any operation involving the shedding of blood, and by decrees of other popes in the thirteenth and fourteenth centuries they were forbidden to practise surgery in any form. In this way medicine and surgery became divorced, and this forcible and arbitrary separation of two branches of the same subject served undoubtedly to hinder the progress of medical knowledge to an enormous extent. Medicine was thus left mainly in the hands of scholars, of men who at that time stood alone in the possession of scholastic learning, while surgery was handed over to men who had little or no scholarship, but who amassed a considerable amount of practical wisdom in the daily struggle with the difficulties of their craft.

The early physicians, like Chaucer’s “Doctour of Phisik,” often had an extensive knowledge of the writings of the Greek, Latin, and Arabian writers, who may be considered as the medical “fathers.” These were their scriptures, which to doubt was heresy. They knew nothing beyond them, and it is not surprising that priestly medicine, divorced as it was from those practical matters in overcoming which we alone get wisdom, was absolutely unprogressive and unproductive. If the early clerical physicians did little for medicine as a science, they did a great deal for it as a profession. They were men of learning and high culture; they had had a university training; and we shall see that many of them were well born and had been brought up amongst high-minded gentlemen; and undoubtedly it is due to the College of Physicians, and largely to some of its earlier members, that the profession of medicine has been practised in this country in a manner which is mainly creditable. Glaring exceptions, of course, have occurred; but, as a rule, the men who have neglected to conduct themselves as gentlemen have met with no encouragement from the College of Physicians, and I believe it would be difficult to over-estimate the influence for good which the College has had in this direction.

The early surgeons were many of them illiterate and rough. Some of them—perhaps most of them—were, in this country and in France, evolved from the barbers; and this is not surprising, for the man who can shave with dexterity has acquired no small skill in handling sharp instruments, and must be often called upon to treat wounds of his own making. It is not surprising that these men should have been called in to attend to cases of injury, and we know that they very early added tooth-drawing and bleeding to their tonsorial art, and practised all three till a comparatively recent date. War with its wounds must have made surgery a necessity in every country, from the time of the siege of Troy downwards; and Mr. South gives an interesting account of Thomas Morstede, who was chief surgeon to Henry V.’s army at Agincourt. Again, many doubtless acquired their first knowledge by practising on animals, and it must be remembered that there are now throughout this country scores of illiterate men who operate with consummate skill on the lower animals. It appears that as early as 1308 the barbers of London were incorporated into a guild, and there appears to have been a gradual separation of them into those which practised surgery and those which practised barbery, and in 1460 the Guild of the Barber-Surgeons was one of the livery companies of the City. Outside this body there was an Association of Surgeons, and also an Association of Physicians, and, according to Mr. South, there appears to have been in 1423–24 a veritable Conjoint Board of Physicians and Surgeons, which, however, survived its birth only a few months. At the time of the accession of Henry VIII. it appears that public opinion was getting ripe for legislation.

THE EARLIEST MEDICAL ACT.

In the third year of the reign of that monarch (1511–12) an “Act for the Appointing of Physicians and Surgeons” was passed, the preamble of which was as follows: “Forasmuch as the science and cunning of physick and surgery (to the perfect knowledge whereof be requisite both great knowledge and ripe experience) is daily within this realm exercised by a great multitude of ignorant persons, of whom the greater part have no manner of insight into the same, nor in any other kind of learning; some also can no letters on the book, so far forth that common artificers, as smiths, weavers, and women, boldly and accustomably take upon them great cures and things of great difficulty, in the which they partly use scorcery and witchcraft, partly apply such medicines unto the disease as be very noxious and nothing meet therefore; to the high displeasure of God, great infamy to the faculty, and the grievous hurt, damage, and destruction of many of the King’s liege people; most especially of them that cannot discern the uncunning from the cunning. Now therefore ... be it enacted,” &c. And the Act goes on to provide that all who practise medicine and surgery (except graduates of the University) shall be previously examined, approved, and admitted by the Bishop of London or the Dean of St. Paul’s, or (for the country) by the bishop of the diocese, who shall call to his aid for this purpose four doctors of physick, “and for surgery other expert persons in that faculty.” The penalty for evading the Act was £5 for each month of illegal practice. Two years later an Act was passed giving to the members of the Guild of Barber-Surgeons (not exceeding twelve) exemption from bearing arms or serving on inquests.

THE COLLEGE OF PHYSICIANS.

The time was now at hand when the first step was to be taken to give the profession a position of independence, and to allow it to regulate its own affairs without reference to ecclesiastical dignitaries. We owe this in all probability to Thomas Linacre, who possessed the confidence of Cardinal Wolsey, and probably also of the king. Be that as it may, on September 23rd, 1518, letters patent were granted constituting the Royal College of Physicians. By this instrument the College was given the control of all medical practitioners in London and within seven miles of it, and none were to be allowed to practise unless previously examined by the College. Four years later these powers were extended to the whole of England, except in the case of University graduates. The charter and subsequent Act gave ample power to the College to regulate its affairs, and accorded privileges and exemptions to the physicians similar to those previously accorded to the surgeons. The great fact, however, was the power of controlling the profession, and it must be remembered that the censors had power to fine and imprison delinquents. In Henry’s charter six persons were named—viz., John Chambre, Thomas Linacre, Ferdinand de Victoria, Nicholas Halsewell, John Francis, and Robert Yaxley, and it will be interesting to consider the personality of some of these founders of the Royal College. The real founder and first president was Thomas Linacre, who was born in 1460. Having graduated at Oxford, and become a Fellow of All Souls in 1484, he went abroad in 1485, and visited Bologna, Florence (where he enjoyed the friendship of Lorenzo de Medici), Rome, Venice, and the famous school of Padua (where he took the degree of M.D.). In 1501 he was appointed physician and preceptor to Prince Arthur, and also physician to Henry VII. He was also physician to Henry VIII., and it is recorded that he was consulted by many men of note, notably Cardinal Wolsey and Erasmus. He took holy orders in 1509, and the same year was presented to the rectory of Merstham, then became prebend of Wells (1510), rector of Hawkhurst (1510), canon of St. Stephen’s, Westminster, prebend of York (1517), precentor of York (1519), rector of Holsworthy, Devon (1518), and rector of Wigan, Lancashire (1520). This list of eight clerical benefices in almost as many years—benefices which were probably given as professional fees, and which were probably passed on, as soon as given, to a successor “for a consideration”—throws a curious light on the state of the Church, and helps us to understand the crash which was so soon to come. It is interesting, as showing the origin of the medical within the clerical profession, to remember that the first President of the College of Physicians was the rector of four parishes, the occupant of two prebendal stalls, a canon, and a precentor. We all owe a debt of gratitude to Linacre. He not only obtained the charter for the College, but gave his house in Knightrider Street (which is a street running parallel to part of Queen Victoria Street, E.C.) as a meeting-place for the new corporation. All who are competent to judge seem agreed in stating that Linacre was one of the greatest scholars of his age, and possessed a knowledge of Latin and Greek which for that time was quite exceptionally great. He founded lectureships at Oxford and Cambridge. He died in 1524, six years after the foundation of the College, and was buried in Old St. Paul’s, where in 1557 Caius erected a monument with an epitaph of his own composing. Of John Chambre, the first person named in the charter, we know little; but it is interesting to note that he was a Fellow of Merton College, Oxford; that he studied at Padua; that he was physician to the king; that he was censor of the College in 1523; that he was doubly a vicar, doubly an archdeacon, a prebend, a canon, and a dean, and the treasurer of Bath Cathedral. He died in 1549. Of the other four persons named in the charter we know very little, and they need not detain us. Linacre’s house, which was given by its owner, was the first home of the College of Physicians, was occupied by the College until 1614, and remained the property of the College until 1860, when it was taken for the Crown by an Act of Parliament. Only the front part of the house was given by Linacre, the back part belonging to Merton College, Oxford, which is one of the many connexions between Merton College and the College of Physicians. The house represented at p. 61 was certainly not Linacre’s original dwelling.

We have thus seen the science of medicine in London beginning with the clergy, then organised under the supervision of bishops and deans, and finally with an independent controlling body, of which the early members were many of them in holy orders. It will now be convenient to trace the subsequent history of the College of Physicians, and I shall endeavour to bring before the mind’s eye some of its most remarkable early Fellows, and in so doing I shall hope to give some idea of the condition of medicine in London in the days of the Tudor and Stuart sovereigns. My information on these points is mainly drawn from Dr. Munk’s learned work, entitled “The Roll of the Royal College of Physicians of London.”

A very prominent figure in the early history of medicine in London is John Kaye, or Caius, as he called himself, well known, by name at least, in connexion with Gonville and Caius College, Cambridge, which he enlarged and endowed. Caius was born in 1510, and studied at Gonville Hall, Cambridge, which was ultimately to be better known by his own name. He went to Padua in 1539, and lived in the same house with the celebrated anatomist, Vesalius. He became professor of Greek at Padua, and took the M.D. there in 1541. He became F.R.C.P. in 1547, and settled in London in 1552. He was president of the College in 1555. He was physician to Edward VI., Mary, and Elizabeth, but he is said to have been removed from the latter position because of his Romish tendencies. He died in 1573 at his house in Bartholomew Close, and was buried in the chapel of Caius College, with the epitaph “Fui Caius.” Caius was certainly rich, as is shown by his splendid munificence at Cambridge. Although he was much occupied at Cambridge in the latter years of his life, he was frequently re-elected to the presidency of the College, the last time being in 1571. The frequent re-election of a president, who was latterly much of an absentee, may have been from the hope that the College would ultimately obtain some of his great wealth, but, if this were so, (of which indeed there is no evidence), the College was doomed to disappointment. Caius appears to have had great regard for form and order. He was the inventor of the insignia of office—the silver wand, the Book of Statutes, and the cushion—which are still used by the president of the College. On the occasion of the funeral of Dr. Bartlot, in 1556, we learn that the College attended in state, and that the Book of Statutes, adorned with silver, was carried before the president. Caius was very punctilious about the respect to be paid to the dead, and we find it laid down in the statutes of Caius College that the president, fellows, and students are to attend the funerals of subjects used for dissection with as much reverence and pomp as though it were the corpse of some more worthy person, because of the advantage which they had derived from it. Caius kept the accounts of the College with great accuracy, and in 1560, on the termination of his first six years of office, handed over the whole of the funds to his successor, amounting to £55 13s. 3d. He wrote out the annals of the College with his own hand, and thus did much to establish order in the proceedings. His love of what we should call “ritual” seems to have led him into trouble in his later years, and a large amount of material connected with religious ceremonial, which was found in Caius College, was burnt by order of the vice-chancellor. Caius was a profound scholar, and edited many of the writings of Galen, Celsus, and Hippocrates. He was also a naturalist, and wrote a treatise on British Dogs. His only original medical work was a “Boke or Counsel against the Sweat”—a treatise, in fact, on the sweating sickness. Strangely enough, the first edition was in English, but its ultimate appearance was in orthodox Latin. He was much concerned about the faulty pronunciation of Latin in this country, and tried to introduce the continental method of pronouncing the vowels, to which he had become accustomed during his long residence abroad. He was something of an antiquary, and proved to his own satisfaction that the University of Cambridge was founded by “Cantaber,” B.C. 394. He defended the privileges of the College, and in a case tried before the Lord Mayor in the reign of Elizabeth as to the right of surgeons to give internal remedies for the sciatica, &c., the evidence of President Caius seems to have convinced the Court that they had no such right. The name of Caius is inseparably connected with the teaching of anatomy in this country. When King Henry VIII. in 1540 gave the charter to the Barber-Surgeons (of which I shall have more to say hereafter), the following important clause formed part of the charter: “The said masters or governors of the mystery and commonalty of barbers and surgeons of London and their successors yearly for ever, after their said discretions, at their free liberty and pleasure, shall and may, have and take without contradiction, four persons condemned, adjudged and put to death for felony by the due order of the King’s laws of this realm, for anatomies, without any further suit or labour to be made to the King’s Highness, his heirs and successors for the same.” When the first anatomy lectures were given at Barber-Surgeons’ Hall is not quite clear; but according to South it was before 1563, and according to Sir George Baker, Dr. Caius was the first lecturer appointed, and this appointment was made shortly after his return from Italy, which was in 1547. It was during Caius’s lifetime, and while he was taking an active interest in the College, although not actually president (namely, in 1565), that Queen Elizabeth accorded to the physicians facilities with regard to anatomy similar to those enjoyed by the Barber-Surgeons; and it is evident from the statute of Caius College which I just now read, and which has been kindly brought to my notice by Mr. Ransom, that Caius made proper arrangements for the teaching of anatomy in connexion with his Cambridge foundation. Anatomy is the very groundwork of medicine, and without it it can have no existence as a branch of science. Undoubtedly we owe a deep debt of gratitude to the Barber-Surgeons, to the College of Physicians, and to Dr. Caius. I cannot dismiss this remarkable man without further illustrating his character by recalling three events which took place at the College during the time that Caius was president. In 1558, Christopher Langton, M.D., F.R.C.P., was expelled from the College for “rashness, levity, and foolish contentions with his colleagues at consultations, as well as for incontinency.” Five years later, for this latter failing, this worthy “was carted through London in a ridiculous attire.” In 1559, John Geynes, M.D., F.R.C.P., was cited before the College for impugning the infallibility of Galen. On his acknowledgment of error and humble recantation he was received into the College. In 1556 the College objected to the admission by the University of Oxford of one David Laughton, an illiterate coppersmith. The College laid before Cardinal Pole and the visitors the following instance of his illiteracy: “Cujus infantia, cum suggessit ut quomodo corpus declinaretur, exigeremus, respondit hic, hæc, et hoc corpus accusativo corporem,” adding “egregius certe ex universitate medicus cui humana vita committeretur.” This objection was successful. Clearly formal President Caius was not the man to countenance loose morals, heterodoxy, or bad grammar. We must not dismiss Caius without alluding to the Dr. Caius of Shakspeare, as drawn in the “Merry Wives of Windsor.” Shakspeare’s Caius is described as a French physician, and throughout the play he is made to speak broken English. Caius died in 1573, when the poet was ten years old, and it is very probable that Shakspeare borrowed the name without thinking of the man. On the other hand, it must be remembered that Caius probably spoke Latin like a Frenchman and that he lost favour at the court of Elizabeth, and it is possible that Shakspeare may have heard him held up to ridicule.

But to proceed with the history of the College and its relations to medical education. In 1581, Dr. Caldwell and Lord Lumley founded the Lumleian Lectures on Anatomy and Surgery, and the importance of this foundation will be appreciated when it is stated that Harvey was Lumleian lecturer from 1615 to 1656, and that it was in these lectures that the great fact of the circulation was first demonstrated. In 1587, we find the College renting a garden for forty marks a year, and engaging John Gerard, the author of the well-known “Herbal,” to keep it stocked for them with rare plants. Gerard himself had a garden in Holborn, where among other things he propagated the potato.

William Gilbert, who was president of the College in 1600, was the first really scientific Fellow. He was physician to Elizabeth and James I., and his great work on magnetism, “De Magnete Magneticisque Corporibus et de Magno Magnete Telluræ, Physiologia Nova,” commanded the admiration of Bacon and Galileo, and of many succeeding generations of scientists. It is a work worthy of being placed alongside of Harvey’s work on the Circulation, and the College of Physicians is honoured to have reckoned him among its presidents. The importance of Gilbert’s investigations to a great naval Power seems to have been recognised by Queen Elizabeth, who, to her great honour, assisted him with a pension. He died in 1603, aged sixty-three, and was buried at Colchester. He was the contemporary of Shakespeare and Bacon, and was one of those who helped to make the Elizabethan era the wonder of all subsequent generations.

The post-mortem examination made on the body of James I. is an interesting record of the state of pathology in 1625. It is recorded “that the head was found so full of brains that they could not keep them from spilling—a great mark of his infinite judgment; but his blood was wonderfully tainted with melancholy, and the corruption thereof was the supposed cause of his death.”

I have now to mention the man who, above all others, has tended by his work to make medicine a science, and who probably did much by his lectures at the College to disseminate a knowledge of anatomy and physiology. Harvey was the first English physiologist, and lectured for forty-one years at the Royal College of Physicians on anatomy and surgery. William Harvey (1578–1657) went to Padua in 1598, and studied under Fabricius, Minadous, and Casserius, and took his M.D. in 1602. He came to London in 1604, became F.R.C.P. in 1607, and succeeded Dr. Wilkinson at St. Bartholomew’s in 1609. He was Lumleian lecturer in 1615. He expounded, as is supposed, the doctrine of the circulation in 1616, and finally published his views in 1628. He was physician to James I. in 1618 (?). In 1638 he was appointed physician in ordinary to Charles I., and there is a curious order in the letter-book of the Lord Steward’s office for the settling a “diett of three dishes of meat and meale with all incidents thereunto belonging upon the said Dr. Harvey,” which daily “diett” was subsequently commuted for £200 a year. Harvey followed the fortunes of the King, and was at the Battle of Edgehill in 1642. Meanwhile his house in London was plundered of goods and anatomical records. He became warden of Merton College, Oxford, in 1645, from which post he was ousted by the Parliament in 1646. By the solicitation of Sir George Ent he was induced to publish his work on Generation in 1651. He gave a new library and museum to the College of Physicians in 1653, whereupon the Fellows placed his statue in their hall, and, in his absence, elected him president in 1654, which honour, however, he gracefully declined, and recommended the College to elect Dr. Prujean instead. He remained Lumleian lecturer until 1656, when he resigned, and presented the College with his patrimonial estate at Burmarsh, Kent. He died of the gout in 1657 in his eightieth year. In his will he says: “I give to the College of Physicians all my bookes and papers, and my best Persia long carpet, and my blue satin embroyedyed cushion, one pair of brass and irons, with fireshovell and tongues of brass, for the ornament of the meeting-room I have erected for the purpose. Item, I give my velvet gown to my loving friend Mr. Doctor Scarborough, desiring him and my loving friend Mr. Doctor Ent to looke over those scattered remnants of my poore librarieie, and what bookes, papers, or rare collections they shall think fit to present to the College, and the rest to be sold, and with the money buy better.” Thus, it will be seen that Harvey is not only the greatest ornament of the College, but also its greatest benefactor. He was the second in order of time of the great lights of science connected with the College, Gilbert being the first. His will is interesting from the choice of his executors, who were both Fellows of the Royal Society and leaders of science; and, secondly, by the mention of the velvet gown, which possibly is the one represented as worn by Sir C. Scarborough in the picture at Barbers’ Hall. I abstain from any mention of Harvey’s great discovery, because we all know it and appreciate it, and no words of mine could increase your admiration.

I may here mention that in 1614 the house in Knightrider Street had become too small for the business of the College, and accordingly new premises were taken on lease from the Dean and Chapter of St. Paul’s at Amen Corner, at the end of Paternoster Row. A botanical garden was planted and a theatre was built, and here it was that Harvey made the College a present of a great parlour and a museum, which he erected at his own cost. The garden extended from the Old Bailey to the Church of St. Martin, Ludgate, and included the site of the present Stationers’ Hall. The museum and library soon became enriched by many contributions, the greater part of which were, however, unhappily destroyed by the fire in 1666.

Dr. Goulston (F.R.C.P. 1611) founded by will the Gulstonian Lectures, to be read “between Michaelmas and Easter by one of the four youngest doctors of the College.” Sir Theodore Mayerne (F.R.C.P. 1616), was by birth a Swiss Protestant, and after serving as physician to Henry IV. of France, settled in London, where he became physician to James I. and his Queen, and subsequently to Charles I. He was the fashionable physician of his day, and was one of the first to use chemical medicines, which was looked upon as heretical by the strict Galenists, who used only “simples,” drawn from organic nature. He introduced calomel and blackwash, wrote the dedication to the first edition of the Pharmacopœia Londinensis (1618), accumulated great wealth, and died at Chelsea in 1655.

Sir Charles Scarborough succeeded Harvey as Lumleian lecturer, and was lecturer on anatomy to the Barber-Surgeons. He was physician to Charles II., James II., and William III., and was a great mathematician.

Baldwin Hamey, jun. (F.R.C.P. 1634), a devoted Royalist and Churchman, enjoyed a lucrative practice among amorous Parliamentary Puritans. He presented the lease of the College in Amen Corner to his colleagues (1651), contributed largely to its rebuilding after the fire, and left it a considerable landed estate near Ongar, in Essex.

Francis Glisson (F.R.C.P. 1635), Regius Professor of Physic at Cambridge, was president of the College in 1667–8-9. He wrote a treatise on Rickets, was a serious anatomist, wrote a treatise on the Anatomy of the Liver, and has given us “Glisson’s Capsule” as a record of his industry and talent. He was one of the original members of the Royal Society, and one of the few of the Fellows of the College who stopped in London during the plague. He was a friend of Anthony Ashley, Earl of Shaftesbury. We are indebted to Dr. Glisson for positive additions to our knowledge of the human body, and he is to be regarded as the third in order of time of the scientific Fellows.

Thomas Wharton (F.R.C.P. 1650), Thomas Willis (F.R.C.P. 1664), and Richard Lower (F.R.C.P. 1675) were three earnest and distinguished anatomists, who added new facts to medicine, and whose names are still enshrined in our anatomical nomenclature.

THE PLAGUE.

We now approach the year 1665, so notable for the terrible pestilence which afflicted London, and we may well take the opportunity of seeing what was the practice of physicians at this time. The best account of the plague is that written by Dr. Nathaniel Hodges, under the title “Loimologia.” This treatise, originally written in Latin and published by the author in 1672, was translated by Dr. John Quincy in 1720. From this valuable work we gain some insight into the moral and physical conditions of the population, and of other causes which tended to increase the virulence of the epidemic. It was at the close of the year 1664 that cases of plague—a disease which had previously committed extensive ravages in London—began to occur, and the fears of the inhabitants were fomented by astrologers and others, who tormented the ignorant with prophecies as to the evils which would occur from the “conjunction of Saturn and Jupiter in Sagittarius” and the like. Again, the action of the magistrates, who ordered that infected houses should be marked with a red cross and the legend “Lord, have mercy upon us,” and who further set a guard upon such houses to prevent either ingress or egress, was probably most mischievous, as tending to spread the infection amongst all the inhabitants of a house, and to keep it alive within the confined area of the city. Hodges truly remarks that the proper course would have been to immediately remove the infected to proper lodgings provided without the walls. He continues: “But what greatly contributed to the loss of people thus shut up was the wicked practice of nurses (for they are not to be mentioned but in the most bitter terms). These wretches, out of greediness to plunder the dead, would strangle their patients and charge it to the distemper in their throats; others would secretly convey the pestilential taint from sores of the infected to those who were well,” &c. If we are to receive the statement seriously (and Hodges is a temperate writer), it throws considerable light on the moral condition of the lower orders.

The first symptom of the plague appears to have been, as a rule, a violent shivering or rigor, lasting from half an hour to four or five hours. This was followed or accompanied by vomiting. Upon this delirium quickly supervened, and if not restrained the infected would run “wildly about the streets.” Vertigo, headache, and coma were also common. The signs of fever were strongly marked, such as “extreme inquietude, a most intense heat outwardly, attended by unquenchable thirst within, dryness, blackness of the tongue, intolerable heat of the præcordia, and all other usual concomitants of a fever’s accession.” In many cases there seem to have been well-marked exacerbations and remissions, but this was not constantly observed. Insomnia was occasionally troublesome, and palpitation of the heart appears to have been often strongly marked. Sweating was a common feature, and seems often to have been “critical,” the plague subsiding at once by crisis. Pustules upon the skin, varying in size from a pea to a nutmeg, and called blains, as well as buboes affecting the lymphatic glands, were among the ordinary symptoms. Further, in addition to these, carbuncles seem to have been very usual, and also a petechial eruption; and, further, Hodges describes (in addition to the foregoing pustules, buboes, carbuncles, and petechiæ) certain prominent spots with pyramidal heads, which were called “plague tokens” by the vulgar.

The treatment adopted was very far from being of the so-called “expectant” form which is now so much followed in the management of patients suffering from infective disorders. They were put to bed between the blankets, and the patient was addressed by his physician “with cheerfulness.” Hodges seems to have discouraged phlebotomy, but he states that many “let blood largely.” If the patient did not vomit he was given an emetic, and this in many cases was followed by an expulsive cathartic. In all cases were strong diaphoretics administered, and sweating was encouraged to the utmost. A marvellous assortment of drugs was poured into the patient. Those used by Hodges were mostly fresh indigenous herbs, and he mentions angelica, rue, sage, veronica, centaury, scabious, pimpernel, marygold, scorzonera, ivy berries, balm, valerian, garlic, gentian, elder berries, juniper berries, and dozens of others; but he speaks scornfully of the Oriental bezoar, powdered unicorn’s horn, and powder of toads, which many thought very efficacious. “To all who sweat,” he says, “change of clothes is to be denied, for the patient takes harm by clean coverings, not so much from any prejudicial quality of the soap abounding in them, as from a dampness which is inseparable from them, and the approach of air which is unavoidable in the shifting, both of which will check the sweating.” Sleep was industriously kept off, although sometimes, through sheer weariness, the patient would drop into a doze. The diet given was light and generous—eggs, strong broths, and good wines; but of the usefulness of gold boiled in the broths Hodges has “nothing to say.” The patient was most rigidly kept in his bed, and those who were delirious were tied in them. During the sweats “the patients were forcibly kept awake,” and if later in the disease a little sleep was allowed, they were roused every four hours to take medicine. Scents were used in the room, and odorous gum resins, such as styrax, were burnt upon live coals. Blisters were applied to several parts, such as the nape of the neck and the insides of the arms and thighs. These blister plasters were made of pitch, galbanum, wax, cantharides, yeast, euphorbium, and vinegar of squills, worked into a mass. The parts thus blistered were not suffered to heal till the malignity of the disease was spent. “Besides epispasticks, it is not lost labour to apply proper things to the feet. I commonly used a plaster made of the compound betony plaster, adding to it some euphorbium, saffron, and London treacle, and I found this to do more good than cataplasms, which some, however, liked better to use, and were made of bryony root steeped in vinegar, the flesh of pickled herrings, black soap, rue, scordium, and arum, with a sufficient quantity of vinegar; sometimes also pidgeons were applied to the feet.” Similar applications were also made to the wrists. The buboes were treated with cataplasms and discutients, and were often opened by the surgeon and subsequently washed with a “Lixivium of ashes, scordium, betony, bugloss, sanicle,” &c., in which also was dissolved some London treacle. Carbuncles were treated in a similar way, but when the eschar did not fall off the actual cautery was liberally applied. In order to prevent the necessity of using a hot iron, it was suggested that “sometimes the pestilential venom is to be drawn out by cupping or scarrification or epispasticks; sometimes also for the same purpose is applied the bare rump of a fowl, repeated until these creatures appear not to be hurt by it; for this natural warmth soothes the vital heat of the part it is applied to, and entices away the morbifick venom through the pores; pidgeons, used alive, and warm sheep’s lights have likewise been observed thus to asswage the acrimony of this pestilential virulence.”

Hodges is by no means silent on the important subject of prevention, and he justly says: “When the nature and peculiar qualities of this disease are known and reported by physicians, such laws should be provided as might best conduce to prevent its spreading, if not to its utter extirpation.” The punishment of those who frighten the populace by prophecies and the like; the timely separation of the sick from the well; house-to-house visitation (which was actually carried out); the disinfection of the air by fumigations; the daily cleansing of streets, sinks, and canals (“because stench and nastiness are justily reckoned the entertainers of infection”); the burning of pastilles; the killing of “dogs, cats, and other domestic brutes,” which carry the infection from place to place; and great attention to personal health, are among the measures which he advocates. He has no belief in the benefit to be derived from taking excrement and urine, which were given as antidotes by some old nurses; but, on the other hand, he had implicit faith in liberal potations of sack (“middle-aged, neat, fine, bright, racy, and of a walnut flavour”). With regard to the use of tobacco, he says: “I must confess myself at uncertainties about it, though as to myself I am its professed enemy, and was accustomed to supply its place as an antidote with sack.” He did not believe in amulets, which were then much in vogue; some being alleged to have a diffusive magnetic value; others drawing the poison out of the body “as amber attracts straws,” some serving to invigorate nature. Walnut shells filled with mercury, arsenic mixed with wax and a variety of other drugs, and dried toads seem to have been the amulets most generally worn.

Among the physicians who stayed in London to minister to the sick, Hodges mentions “Dr. Glisson, Regius Professor at Cambridge, Dr. Nath. Paget, Dr. Wharton, Dr. Berwick, Dr. Brookes, and many others.” And he further states that of these, eight or nine died. Hodges, however, survived, and he says: “I think it not amiss to recite the means which I used to preserve myself from the infection during the continual course of my business among the sick. As soon as I rose in the morning early, I took the quantity of a nutmeg of the antipestilential electuary; then, after the dispatch of private concerns in my family, I entered into a large room, where crowds of citizens used to be in waiting for me; and there I commonly spent two or three hours, as in an hospital, examining the several conditions and circumstances of all who came thither; some of which had ulcers yet uncured, and others to be advised under the first symptoms of seizure; all which I endeavoured to dispatch with all possible care to their various exigencies. As soon as this crowd could be discharged, I judged it not proper to go abroad fasting, and therefore got my breakfast. After which, till dinner-time, I visited the sick at their houses.... After some hours visiting in this manner I returned home. Before dinner I always drank a glass of sack, to warm the stomach, refresh the spirits, and dissipate any beginning lodgement of the infection. I chose meats for my table that yielded an easy and generous nourishment, roasted before boiled, and pickles, not only suitable to the meats but the nature of the distemper (and, indeed, in this melancholy time, the city greatly abounded with variety of all good things of that nature). I seldom likewise rose from dinner without drinking more wine. After this I had always many persons come for advice, and as soon as I could dispatch them I again visited till eight or nine at night, and then concluded the evening by drinking to cheerfulness of my old favourite liquor, which encouraged sleep and an easy breathing through the pores all night. But if in the daytime I found the least approaches of the infection upon me, as giddiness, loathing at stomach, and faintness, I immediately had recourse to a glass of this wine, which easily drove these beginning disorders away by transpiration. Yet in the whole course of the infection I found myself ill but twice; but was soon again cleared of its approaches by these means, and the help of such antidotes as I kept always by me.” It should be mentioned that during the infection Dr. Hodges wore an “issue” as a preventive measure, and he says: “Whenever I was most beset with pestilential fumes I could then immediately perceive a shooting pain in my issue, and had a great deal of ill-conditioned matter discharge therefrom; and this I always looked upon as a sure warning to have timely recourse to alexipharmicks.” The facts given by Dr. Munk concerning Hodges are the following: Nathaniel Hodges, son of the vicar of Kensington, was born in 1629, educated at Westminster, Cambridge, and Oxford, and appears to have been a Parliamentarian; M.D., 1659; F.R.C.P., 1672; censor, 1682; Harveian orator, 1683. During the latter part of his life he received a pension from the City on account of his services during the plague. He fell into debt, and died in Ludgate Prison in 1688. There is a tablet to his memory in St. Stephen’s, Walbrook. Let us not be hard on this brave man. He did his duty nobly. True, he was fond of sack and got into debt. Perhaps had his nature been less generous, and had he been less full of the milk of human kindness, he might have amassed a large fortune. He is a noble exception to Chaucer’s doctrine that “gold in physick is a cordial,” and it would ill become us to sit in judgment on one who in an important respect affords us an example of noble conduct.