Doctors
In the early 19th century, medical training was diverse. Although the view that an examination must be undertaken as a mark of preparedness to practise was long established, the quality of the examinations was variable. The Fellows of the Royal College of Physicians of Edinburgh and the Royal College of Surgeons of Edinburgh were the licensing bodies. Physicians were permitted to examine patients, diagnose disease, and prescribe medications. Surgeons performed operations, set broken bones, and treated accident cases and skin disorders.
The University of Edinburgh Medical School had a two-tiered education model which allowed a great number of students to matriculate, but allowed few to graduate as Physicians. Students had to attend all lectures with the exception of midwifery (although it was strongly encouraged nonetheless), they had to study for at minimum 3 years, had to write a series of oral and written examinations in Latin and had to compose a Latin thesis and defend it before the whole faculty. Consequently, the majority of students attended Edinburgh with the intention of learning medicine for just one year before leaving due to the costs of a degree and the fact that a MD degree was not required to practice medicine. Between 1765 and 1825, only 20% of Edinburgh students graduated with an MD. In 1825, the years of medical education increased from three to four years and in 1833, English replaced Latin as the language of examination. Although the Edinburgh University Medical School was considered one of the leading training bodies, and employed some of the most notable teachers of the time, as the century progressed, some of the teaching methods were seen increasingly as old-fashioned and no longer appropriate, and this contributed to the flourishing of the extra-mural schools.
Training to be a surgeon was done by apprenticeship. In the early years of the century, successful completion of an apprenticeship was all that was needed for entry into 'regular' medical practice, although, later, it was required that students pass the licentiate exams of the Royal College of Surgeons.
The Medical Act of 1858 sought to provide a standardised system which would render the proof equally worthy, whatever the entry portal. Although the University of Edinburgh admitted the first female medical students in 1869, the University refused to award them degrees. Edinburgh’s medical school remained closed to women until 1894.
One of the outstanding surgeons of his day was Dr William Ferguson (portrait by unknown artist) who lived at Number 22. For most of his career, he worked at the Royal Infirmary of Edinburgh. Ferguson's reputation was that of a great ‘conservative’ surgeon: a term he used to describe operations that ensured the preservation of parts of the body which would otherwise have been sacrificed. Among operations with which his name is specially identified are those for harelip and cleft palate, and amputations of limbs. In 1840 he was appointed Professor of Surgery at King's College London and later became surgeon to Queen Victoria. He was one of the leading medical practitioners in London and was elected President of the British Medical Association. He was created a baronet in 1866. He also was a good violinist, an expert fly-fisher, and very fond of drama. Like Ferguson, Dr John Campbell (Number 17), was a Fellow of the Royal College of Surgeons. The first formal association of doctors specialising in surgery was The Barber Surgeons of Edinburgh which was formally incorporated as a Craft Guild in 1505. In 1647 the Guild acquired a permanent meeting place in rented rooms of a tenement in Dickson's Close. In the 18th century The University of Edinburgh Medical School (established in 1726) and The Royal Infirmary of Edinburgh were responsible for the rapid development of systematic medical teaching on a sound scientific basis. With surgery still perceived by many to be simply a manual craft, rather than an intellectual discipline, members of the Incorporation of Surgeons undertook the task of education and did much to establish Edinburgh's reputation as a centre of surgical teaching. By the beginning of the 19th century there was an urgent need to provide suitable accommodation for the large collection of anatomical and surgical specimens which had been presented to the College and William Henry Playfair was commissioned to design the Surgeon’s Hall, containing a Meeting Hall, Museum, Lecture Room and Library. Campbell served as President Royal College of Surgeons around the time of the opening of the new building.
It is possible that Dr William Russell (photo) who lived at Number 46 may yet find major fame from work he carried out when working as a pathologist in the School of Medicine at the Royal Infirmary in Edinburgh. In 1890, he gave an address to the Pathological Society of London outlining his discovery of ‘a characteristic organism of cancer’ that he observed microscopically in tissue sections from all forms of cancer, as well as in certain cases of tuberculosis, syphilis and skin infection. His discovery quickly became known to pathologists as ‘Russell bodies’ and these continue to fascinate researchers and doctors to this day. There are some who believe that Russell’s findings are still of importance in an as-yet-to- be-discovered link between cancers and microbes. Only time will tell if his discovery relates to a ‘cancer germ.’ As Russell was not a microbiologist, he ended his investigations into a possible cancer parasite and wrote: ‘It seems almost needless to add that there remains abundant work to be done in this important and attractive field.’ When Russell died at the age of 89, the British Medical Journal published a large obituary noting that he was universally respected and imbued with the dignity and highest ideals of his profession, and that he had served at one time as President of the Royal College of Physicians. However, there was almost no mention of his discovery in the field of cancer. Dr James Begbie (Number 18), was also at the forefront of research. He was among the first physicians to give a detailed description of Grave’s disease [at one time called Begbie's disease], an autoimmune disease that most commonly affects the thyroid, and also was a key figure in the study of other diseases. After 1863 Begbie gave up his teaching and hospital appointments, to concentrate on his consulting practice, becoming one of the most popular and highly esteemed physicians in Scotland. For forty years, he acted as the physician to the Scottish Widow’s Fund and Life Assurance Society. One of his sons, Warburton, also became a doctor.
In 1832 there was severe outbreak of cholera in Edinburgh. Dr John Mackintosh (Number 31), who earlier had served as a medical officer in the Royal Artillery in South America and in France in the aftermath of the Battle of Waterloo, was working at the Edinburgh Cholera Hospital in Drummond Street. During the outbreak Mackintosh's workload was demanding. He reported that he felt compelled to make frequent night visits because of ‘the young medical gentlemen being worn out, and also from the drunkenness that too often prevailed among the nurses.’
One of the other doctors was Dr Thomas Latta, and the two doctors were the first to use intravenous therapy, this being at the time a remarkable attempt to correct the catastrophic loss of body fluids which is the main cause of death in cholera. Mackintosh reported that the saline treatment they had given to patients had enabled a fair number to survive. Although Dr Latta reported his findings in a letter to The Lancet in May 1832, many decades were to pass before fluid replacement became recognised as the standard treatment that is in use today. Mackintosh said of Latta following his death: ‘Although Dr Latta's exertions and fate must have been known to a number of influential men, his grave does not exhibit any monument of public gratitude.’
Dr Robert Thin (portrait by Henry Wright Kerr - collection Royal College of Physicians, Edinburgh) lived at Number 6,. He qualified in Midwifery Practice from the Edinburgh Royal Maternity and Simpson Memorial Hospital but became a general practitioner, the first to be appointed President of the Edinburgh Royal College of Surgeons. When he died, a ‘Grateful Patient’ wrote: ‘In his visits, while he never gave the impression that he was hurried in his examination and advice, he never wasted his time. And how could he afford to, when during an epidemic of influenza he would have over eighty visits to pay in one day, besides a consulting room full for one or two hours. His patients were patients, suffering human beings, whom he would help to the uttermost of medical resources. He was generous for he had many patients to whom he gave his service free. To the last days of his practice his eye was bright and his step light, although he must have climbed many thousands of stairs.’
Dr John Brown (Number 51) perhaps best summed up the prime qualifications of a physician: ‘Let me tell you, my young doctor friends, that a cheerful face and step, and neckcloth and kindly joke, a power of exciting, a setting a-going, a good laugh, are stock in our trade not to be despised. The hearty heart does good like a medicine.’