The Herbalist: Nicholas Culpeper and the Fight for Medical Freedom. Benjamin Woolley

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СКАЧАТЬ in October 1609. At around the same time he was admitted as a full Fellow of the College of Physicians, confirmed with the publication in the College Annals of the list of Fellows according to ‘seniority and position’, which placed him twenty-third.³¹

      As well as providing a regular salary, the position at St Bart’s proved fruitful in introducing new clients, as influential courtiers often found it convenient to call upon the hospital’s medical staff when they were ill. In early 1612, the most powerful politician of them all, Robert Cecil, was laid low ‘by reason of the weakness of his body’, a reference to a deformity described unflatteringly by one enemy as a ‘wry neck, a crooked back and a splay foot’. According to the courtier John Chamberlain, ‘a whole college of physicians’ eagerly crowded around Cecil’s sick-bed, Sir Theodore de Mayerne, James I’s personal physician, being ‘very confident’ of success, ‘though he failed as often in judgement as any of the rest’. Treatment was hampered by a disagreement over diagnosis, which within a fortnight changed ‘twice or thrice, for first it was held the scorbut [scurvy], then the dropsy, and now it hath got another Greek name that I have forgotten’. Harvey and his surgeon, Joseph Fenton, were then summoned from St Bart’s and were deemed to have done ‘most good’ in treating the condition, Fenton particularly, though neither managed a cure, as Cecil died two months later – probably of the disease originally diagnosed, scurvy.³²

      In 1613, Harvey took a further step towards the summit of his profession by offering himself for election as a Censor, one of the key positions in the College hierarchy. He attended his first session on 19 October and made an immediate impact. He and his three colleagues, Mark Ridley, Thomas Davies, and Richard Andrews, examined the case of one Edward Clarke, who had given ‘some mercury pills to a certain man named Becket, which caused his throat to become inflamed and even spitting ensued’. Dr Ridley, a veteran Fellow and serving his sixth term as a Censor, demanded a fine of £8, much higher than usual (apothecaries and other medical tradesmen were typically fined around forty shillings; fines of £5 or more were usually reserved for foreign physicians who set up practice in London without a licence). The distinguished scholarly physician Dr Davies, less active in College affairs and serving his third term as a Censor, objected that this was too severe a punishment for a first offence. Then Harvey, uninhibited by his lack of experience, intervened. He backed Ridley, arguing that such ‘ill practice’ demanded an exemplary punishment. However, he conceded Clarke’s fine should be ‘remitted’, reduced, on account of his ‘submission’ to the College, though he should be imprisoned if he failed to pay it. In November, Harvey further demonstrated his zest for discipline and standards by apparently insisting that an applicant for a licence to practise be examined three times on the same day.

      And so the meetings continued, week after week, considering case after case, imposing fine upon fine. In December, a Mr Clapham, an apothecary of Fenchurch Street, was brought before the Censors, charged with, among other things, selling an unauthorized medicine ‘for the stone’. Kidney stones were one of the most common complaints physicians had to deal with, and many doctors, including Harvey, had their own secret and lucrative remedies for treating them. Mr Clapham omitted to mention that he sold his own formula and, being ‘reminded’ of it by the Censors, ‘confessed that he often accepted five shillings for this’. In response to questions about its recipe, he was oddly specific about the absence of ‘distilled goats’ milk’, possibly because this would reveal the origin of his recipe and open him to further charges. As well as Mr Clapham, another apothecary, Peter Watson of St John’s Street, was asked to produce copies of four prescriptions he had made up, two of which had not been written by a physician.

      The records are sketchy but suggest that, in the year Harvey served his first term as a Censor, he enthusiastically enforced, if he did not actually initiate, one of the most comprehensive crackdowns on unlicensed practitioners to date. The main target was the apothecaries, whose combination of medical experience and knowledge of medicines made them a particularly potent threat to the physicians’ monopoly. During this period, as many as one in ten of the capital’s hundred and twenty or so practising apothecaries were summoned before the Censors, to receive a reprimand if they were lucky, a heavy fine and threat of imprisonment if they were not.³³ They seemed to lurk everywhere, down every alley, on every corner, in every backroom. The Censors heard their mocking laughter at the College’s impotence echo through the streets.

      As well as threatening the health of the capital’s citizens, these insolent quacks undermined the dignity of the College, at a time when it was preparing to move from its cramped rooms in Knightrider Street to prestigious headquarters next to St Paul’s Cathedral, at Amen Corner – a fitting address for an institution that considered itself the last word in medical expertise. From their grand new premises, they decided it was time to step up their campaign by making a direct appeal to the sovereign.

      Harvey was still too junior a member of the King’s household to take on this role, so it was entrusted to a more senior royal physician, Dr Henry Atkins. In early 1614 Atkins was enlisted to whisper the College’s grievances into King James’s ear during one of their routine consultations. On 23 May 1614, the College called an emergency Comitia so that Atkins ‘might inform them what he had done on our behalf before the most serene King’. He ‘reported much’ about his discussions, but did not want to have his words recorded in the Annals, presumably because he felt it might compromise royal confidentiality. His unrecorded remarks encouraged the Fellows, Harvey among them, to draft a letter to the King, entreating James, ‘the founder of the health of the citizens’, to ‘cure this distress of ours, and deign to understand the paroxysms and symptoms of this our infirmity’. The letter reminded the King that under ‘royal edicts … the audacity of the quacks, and the wickedness of the degraded were committed to our senate for correction and punishment’. But the writ of the College was now routinely flouted. ‘They fling scorn and all things are condemned’, particularly by the apothecaries, who ‘ought to be corrected: for as we minister to the universe so they are the attendants of the physicians’.³⁴

      Their proposed remedy was to support a move to separate the apothecaries from the Grocers’ Company – the reverse of the manoeuvre used to control the surgeons. The College had little influence over the Grocers, but might have over a company of apothecaries, as long as its founding charter established the physicians’ superiority, which existing legislation only ambiguously supported. Their wish was to be granted, despite the protests of the grocers themselves and of the City authorities, who feared the new apothecaries’ company would, like the College, fall outside their influence.

      The new Society of Apothecaries was granted its charter on 6 December 1617, after a great deal of wrangling between the College, the Grocers, the City, and the royal court’s law officers. As a sop to the City, it was agreed that the Society should operate as a guild, with the same organization as other livery companies, having powers to bind apprentices to masters, and free them once they had completed their apprenticeship, and to police the practice of its trade. The doctors also agreed to observe the Society’s monopoly by refraining from making and selling medicines themselves. However, unlike the other guilds, it was not to be regulated by the City fathers. Instead, it fell under the supervision of the College, which was given powers to intervene in crucial aspects of the Society’s business: the passing of by-laws, the ‘freeing’ of apprentices when they completed their term, and the searching of shops.

      Another important provision was that apothecaries would have to make their medicines according to a standard set of recipes set out in a ‘London Antidotary’ or dispensatory, drawn up by the College: a bible of medicine.

      Bergamo in Italy and Nuremberg in Germany had long used official dispensatories that prescribed exactly how medicines were to be made by apothecaries trading within their borders. Now that the apothecaries of London were to be constituted as a separate body, the College СКАЧАТЬ