Simon Bowman 500 years of RCP_1

500 Years of the Royal College of Physicians Professor Simon Bowman Harveian Librarian (with particular thanks to Kristin Hussey, Julie Beckwith, Louella Vaughan and other colleagues) th 16 Century The Founding of the College 1518 1510 - 1500-1535 Church of England 1534 Cast list Thomas Linacre 1460-1524 1st PRCP B: Derby Educ: Canterbury, Oxford, Florence, Padua Tutor to: Prince Arthur Royal Physician Cardinal Wolsey 1470-1530 King Henry VIII 1491-1547 (age 27 in 1518) Medical Marketplace • Extremely vigorous and varied • Array of people jostling for custom - surgeons/barbers - Apothecaries/grocers/spicers - ‘illiterate Monks and Empiricks’ - assorted other quacks, blood-letters and charlatans… • Plague, influenza, smallpox, dysentery, syphilis Physicianly Medicine c1518 • Hippocrates, Galen, Avicenna: 460-370 BC 129-200 AD 980-1037 AD • Four Humors: blood, phlegm, choler (yellow bile), melancholy (black bile) • Treatments – Bloodletting & Purging – Astrology – Uroscopy – Herbs & Medicines Founding of the College • • • • Founded in 1518 Linacre=PRCP Bulwark against ‘quacks & charlatans’ Based on Padua? ‘Humanism’ Right to ‘make Statutes … most expedient for publick Service’ • ‘With regard to their own dignity, the good of the people, and in particular to the honour of the Universities (Oxbridge)’ • 1st home=Knightrider Street The 1518 Charter • Granted same rights as previously given to the Church to regulate medical practice within miles of the City of London • Rights to examine, admit and appoint • President elected for year at a time • Censors; Founding members; Circa 16-20 physicians in London in 1518 • 1523 Act of Parliament The Earliest College • Regulation of medical practice - examination to grant licences - prosecution of irregular practitioners - oversight of apothecaries and surgeons • ‘Publick Health’ • ‘Enlist themselves in the service of the ‘English realm’ The Licentiates • New breed of medical men • Often Scottish and/or non-conformist • Therefore not Oxbridge, which is in relative decline at this time • Often enthusiastic about ‘new philosophy’ • Often ‘middling class’ Siege of Warwick Lane • Tensions between Fellows and Licentiates reach breaking point in 1767 • Case of Dr Letch – left open as to whether Licentiates were members • College stormed by Licentiates and take seat at the table William Browne PRCP • Multiple court cases Lord Mansfield • contemporary issues on religion, inclusion and franchise The End of the Eighteenth Century • Relative end to aggressive regulatory stance of the College • College does the right thing and allows certain Licentiates to become Fellows • Overhaul of statutes and eventual reform • ‘Other functions’ (publishing, promotion of vaccination, asylums, study of epidemics) come to predominate – end of Galen • Better relationships with Apothecaries & Surgeons William Heberden 19th Century Professonalism and Standardisation 19th Century Pall Mall 1825 Sir Henry Halford Addison Hodgkin Bham 1825 UCL 1827 KCL 1830 BMA 1832 GMC 1860 Q 1837-1901 Munk Public Health: reports on Leprosy and vaccination Bright GPs Prelude to Real Change • Massive expansion in the number of doctors • Changes to medical education – the ‘proto-GP’ • The extension of franchise • Repeal of Test and Corporation Act • The machinery of Empire • External campaigns esp the Lancet The Medical Act of l858 • Founding of the General Medical Council • First instance of state oversight of a profession • Licensing and regulation of ALL doctors • College retained: - the right to examine - the right to charge fees - the right to recommend names to the register 20th Century • • • • • • • • • The NHS Public Health Smoking Alcohol, Obesity, Air Pollution Women in Medicine Diversity International Training & Education Policy The College’s Six Homes • • • • • • Knightrider Street Amen Corner Knightrider Street 1518 Warwick Lane Pall Mall East Regents Park Warwick Lane 1667 Knowledge Quarter, Liverpool St Andrew’s Place 1964 Amen Corner 1614 Pall Mall East 1825 RCP North Liverpool 2017/ 2020 Historical Collections • Pharmacopoeia • • • • • • • • • • • Portrait collection: Zoffany, Hoyland, Lawrence, Epstein, Frink, Annigoni Rare books/manuscripts: Vesalius (1543), Chaucer (1440), Wilton Psalter (1250), Caxton (1473) Anatomical Tables & Prujean chest Silver & other collections Matthew Baillie th th 16 c Caduceus, 17 c Mace, William Harvey’s rod, 1761-1823 John Radcliffe’s cane Symons collection William Harvey: Ceaseless Motion RCP500 Charter The RCP500 Charter reaffirms the commitment made by physicians to: • provide the highest standards of patient care • train, develop and support doctors • act as leaders • promote good health and prevention of ill health • no regulation or licensing 21st Century Thank you ... Creation of social and then religious divisions - clear deviation from intent of Charter The Odd Social Position of the Doctor • Sit outside of norms of medieval life no structure • Manners of a... esp the Lancet The Medical Act of l858 • Founding of the General Medical Council • First instance of state oversight of a profession • Licensing and regulation of ALL doctors • College retained:... • New breed of medical men • Often Scottish and/or non-conformist • Therefore not Oxbridge, which is in relative decline at this time • Often enthusiastic about ‘new philosophy’ • Often ‘middling