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By Matthew Simon
As late as 1856, of the 10,220 persons listed in the Medical Directory with some sort of qualification, only four per cent had a medical degree from an English university. Fifteen years earlier the 1841 Census had listed three times as many (33,339) as practising one or more branches of medicine.
Physicians
The Royal College of Physicians of London (of England from 1858) had been founded in 1518 and was supposed to have a monopoly in the giving of medical advice within a seven mile radius of the City of London and, from 1522, nationally, a monopoly that was challenged successfully by the apothecaries in 1703.
The four main paths of medical help
Surgeons, Dentists,and Barbers
The barbers and surgeons had been united in 1540 to form the Barber-Surgeons Company of London, but from that date the surgeons could not act as barbers, and barbers could not be involved in any form of surgery "excepting only the drawing of teeth".
The apothecaries in London were originally members of the Grocers' Company but were formed into the Society of Apothecaries by royal charter in 1617.
Apothecaries
Before The Public Health Act of 1848 established a General Board of Health to furnish guidance and aid in sanitary matters to local authorities, the hospitals were overcrowded and nasty. The
In the 18th century more than half of all practising "doctors" seem to have been men who had served an apprenticeship. Apothecaries began to train as surgeons and surgeons to take university degrees, qualifying as physicians. Many apothecaries were Members of the Royal College of Surgeons and these doubly qualified (MRCS, LSA) surgeon-apothecaries were the forerunners of general practitioners.
Towards the end of the 18th century a number of provincial medical schools were established and after about 1780 the proportion of doctors being trained at university increased. Of those who had degrees at this time about 30% had been to Edinburgh, twice as many as to any other university.
In 1511 an Act of Parliament (repealed only in 1948) had required physicians and surgeons to be licensed by the bishops of the dioceses in which they practised and both geographically and administratively this was the most comprehensive system of qualification in England and Wales, though it had fallen into disuse by 1750 and licences are rarely found after that date.
Work Cited
ENCYCLOPÆDIA BRITANNICA
https://www.britannica.com/topic/public-health/National-developments-in-the-18th-and-19th-centuries
Family Tree Magazine
https://www.familytreemagazine.com/store/index.php/catalogsearch/result/?q=Hosiptals%20Doctors%20and%20Hospitals%20during%20in%20the%20late%2018th%20and%20early%2019th%20centuries