THE SEVERANCE OF MEDICINE AND SURGERY.
The physicians and surgeons were originally very different orders of men. Medicine is in most Christian countries an offshoot of the clerical profession. So profitable was the practice of medicine, that not only monks, but many of the higher clergy, devoted themselves to it. The union of the two professions of medicine and divinity existed up to the middle of the seventeenth century, and evidence of it is still found in the “Lambeth M.D.,” a degree which the Archbishop of Canterbury still has the right to confer, but only upon a legally qualified practitioner. It was thought necessary by Pope Innocent III. (1198–1216) to forbid the clergy to undertake any operation involving the shedding of blood, and by decrees of other popes in the thirteenth and fourteenth centuries they were forbidden to practise surgery in any form. In this way medicine and surgery became divorced, and this forcible and arbitrary separation of two branches of the same subject served undoubtedly to hinder the progress of medical knowledge to an enormous extent. Medicine was thus left mainly in the hands of scholars, of men who at that time stood alone in the possession of scholastic learning, while surgery was handed over to men who had little or no scholarship, but who amassed a considerable amount of practical wisdom in the daily struggle with the difficulties of their craft.
The early physicians, like Chaucer’s “Doctour of Phisik,” often had an extensive knowledge of the writings of the Greek, Latin, and Arabian writers, who may be considered as the medical “fathers.” These were their scriptures, which to doubt was heresy. They knew nothing beyond them, and it is not surprising that priestly medicine, divorced as it was from those practical matters in overcoming which we alone get wisdom, was absolutely unprogressive and unproductive. If the early clerical physicians did little for medicine as a science, they did a great deal for it as a profession. They were men of learning and high culture; they had had a university training; and we shall see that many of them were well born and had been brought up amongst high-minded gentlemen; and undoubtedly it is due to the College of Physicians, and largely to some of its earlier members, that the profession of medicine has been practised in this country in a manner which is mainly creditable. Glaring exceptions, of course, have occurred; but, as a rule, the men who have neglected to conduct themselves as gentlemen have met with no encouragement from the College of Physicians, and I believe it would be difficult to over-estimate the influence for good which the College has had in this direction.
The early surgeons were many of them illiterate and rough. Some of them—perhaps most of them—were, in this country and in France, evolved from the barbers; and this is not surprising, for the man who can shave with dexterity has acquired no small skill in handling sharp instruments, and must be often called upon to treat wounds of his own making. It is not surprising that these men should have been called in to attend to cases of injury, and we know that they very early added tooth-drawing and bleeding to their tonsorial art, and practised all three till a comparatively recent date. War with its wounds must have made surgery a necessity in every country, from the time of the siege of Troy downwards; and Mr. South gives an interesting account of Thomas Morstede, who was chief surgeon to Henry V.’s army at Agincourt. Again, many doubtless acquired their first knowledge by practising on animals, and it must be remembered that there are now throughout this country scores of illiterate men who operate with consummate skill on the lower animals. It appears that as early as 1308 the barbers of London were incorporated into a guild, and there appears to have been a gradual separation of them into those which practised surgery and those which practised barbery, and in 1460 the Guild of the Barber-Surgeons was one of the livery companies of the City. Outside this body there was an Association of Surgeons, and also an Association of Physicians, and, according to Mr. South, there appears to have been in 1423–24 a veritable Conjoint Board of Physicians and Surgeons, which, however, survived its birth only a few months. At the time of the accession of Henry VIII. it appears that public opinion was getting ripe for legislation.