Warfare and the launch of medical reform in Britain, 1793–1811

Abstract

AbstractUntil the beginning of the nineteenth century, registering and regulating the training of any medical practitioners in Britain had rarely been attempted, unlike in many other European countries. During the Revolutionary War with France, fevers swept through British armies, leading to numerous fatalities and crushing military defeats, especially in the disastrous expedition to St Domingo. The problem, as forcibly advocated by Robert Jackson, the leading expert on military fevers, seemed to be poor medical care due to both lack of compulsory medical training and the unsuitability of whatever training was available for army medical practitioners. With the simultaneous rapid advance of French military and civilian medical training and the threat of a French invasion, regulating British medical training and excluding the unqualified became a military necessity, and suddenly medical reform was receiving widespread attention. Emphasising the benefits to the Britain’s fighting ability, the reform effort, led by Edward Harrison, a very provincial Lincolnshire physician, under the patronage of Sir Joseph Banks, the President of the Royal Society, gained the support of leading politicians, including three Prime Ministers. For a short time, comprehensive medical reform seemed inevitable: but the opposition of the medical corporations, especially the London College of Physicians, could not be circumvented, and although Harrison persisted in his efforts for 6 years, no legislation was achieved. Nevertheless, within months, the Association of Apothecaries continued the process by pressing for a more limited reform, culminating in the 1815 Apothecaries Act. The long march towards the full regulation of doctors in Britain was started by the perceived military needs of the country during the war with France.