The Regulation of Medical Practice in London Under the Stuarts, 1607-1704.

Abstract

This dissertation is about the regulation of medical practice in seventeenth-century London, its causes, and consequences. Since the College of Physicians of London carried out the regulation of medical practice, the attempts of that corporation to increase and to carry out its regulatory authority from the reign of James I make up the central narrative of the dissertation; the ultimate loss of regulatory power after the "Glorious Revolution" ends the account. Had the learned physicians of the College been able to carry out their will as they and several royal governments wished, many innovations in medical practice probably would not have occurred in the ways they did. The first Chapter analyses the cause of medical regulation: why there was an attempt to regulate the practice of medicine. Through an investigation of the medical milieu, one comes to see that the learned physicians were a small and unique group of men who argued that their learning in medicine made them the most qualified practitioners. But their social and intellectual position in early modern Engl and was insecure. Medical regulation provided a mechanism through which the learned physicians could dominate the medical marketplace by gaining royal favor and the political and legal influence that allowed them to sit as a court in order to judge other practitioners for illicit practice or for malpractice. In Chapters Two to Seven, the vicissitudes in the fortunes of the College of Physicians are described. It is argued that when the Crown sought to increase its strength, the College benefited by gaining increased authority, supported by the monarchy. When the Crown's power was weak, as during the mid-century revolution, during the first part of the Restoration, and after the Glorious Revolution, the College of Physicians lost its ability to regulate medical practitioners. The temporary loss of institutional strength by the College in the mid-seventeenth century was crucial for allowing an empirical medical milieu to develop openly; this kind of medical practice eventually came to dominate, at least in part because of the ultimate failure of the learned physicians to carry out their will.