University home |A-Z|

Centre for the History of Science, Technology and Medicine

The making of the medical profession

Thomas Wakley (1795-1862), editor and founder of the Lancet, and one of the leading early nineteenth-century British campaigners for medical reform.

When we go to see our GP or visit a hospital, we generally assume that we are in 'safe hands', and that those who treat us have passed through a course of education, and have been subject to formal examinations and other such tests of their knowledge and ability.  But things were not always like this.  Before the nineteenth century, there was very little regulation of who could practice medicine or even what sort of education and training made a 'doctor'.  Early modern medicine was a diverse and pluralistic world of 'quacks', 'orthodox' practitioners, 'sham' doctors, informal interpersonal care and self-help.

The 'professionalization' of medicine in the nineteenth century has long been a subject of interest for medical historians. They have shown how this period saw the creation of new institutions and formal mechanisms for regulating medical practice, and for distinguishing the 'qualified' practitioner from the 'quack'.  In Britain, a key development was the Medical Act of 1858 which established the General Medical Council and the Medical Register, a public list of all recognised medical practitioners. 

But, as research by CHSTM staff members has shown, there was more to the creation of the medical profession than this. Not only were the structures of medicine changing: so too were its cultures and values. In the eighteenth century, most physicians and surgeons thought of themselves as learned gentlemen who entertained a variety of intellectual interests. During the early nineteenth century, however, a number of practitioners elaborated different ideas of what it meant to be a doctor. Inspired by the ideologies of the so-called 'Age of Reform', they configured medicine as a body of knowledge of unique social utility. Not only did they take an ever greater role in the public sphere (in the field of sanitary medicine, for example), but they also sought to reconfigure the relations between medicine, the public and the state, demanding legislative protection from 'unqualified' practitioners and positioning themselves as experts within a variety of fields.

Ian Burney's work shows how Victorian practitioners sought to construct the coroner's inquest and murder trial as an arena for medical expertise, while that of Michael Brown considers how medical reformers imagined and presented themselves as public servants, dedicated to the health and wellbeing of the nation.  Meanwhile, Stephanie Snow's research on anaesthesia demonstrates how the ability of perform pain-free operations enhanced the social and cultural authority of surgeons.  However, this work also seeks to counteract narratives of professional 'triumph' by showing how such claims to authority often ran counter to social, cultural and political convention. Thus, attempts to medicalize the coroner’s inquest were mediated by established notions of popular justice, demands for the outlawing of ‘quackery’ by the dictates of the free market, and the assertion of clinical expertise by the values of charitable benevolence. Likewise, the reception of anaesthesia was not as straightforward as we might imagine, challenging as it did the social, cultural and spiritual meanings of pain.

Recent publications by CHSTM staff and students

Michael Brown. Performing medicine: medical culture and identity in provincial England, c. 1760-1850.  Manchester: Manchester University Press, forthcoming 2010.

Michael Brown. "'Like a devoted army': medicine, heroic masculinity and the military paradigm in Victorian Britain". Journal of British Studies, forthcoming 2010.

Michael Brown. "Medicine, Reform and the 'end' of charity in early nineteenth-century England". English Historical Review, forthcoming 2009.

Stephanie J Snow. Blessed days of anaesthesia: how anaesthetics changed the world.  Oxford: Oxford University Press, 2008.

Michael Brown. "Medicine, quackery and the free market: the 'war' against Morison's Pills and the construction of the medical profession, c.1830–c.1850”, in M. S. R. Jenner and P. Wallis, eds, Medicine and the Market in England and its Colonies, c.1450-1850.  Basingstoke: Palgrave Macmillan, 2007.

Ian A Burney. "The politics of particularism: medicalization and medical reform in nineteenth-century Britain", in Roberta E. Bivins and John V. Pickstone, eds, Medicine, madness and social history: essays in honour of Roy Porter.  Basingstoke: Palgrave Macmillan, 2007.

Stephanie J Snow. Operations without pain: the practice and science of anaesthesia in Victorian Britain.  Basingstoke: Palgrave Macmillan, 2006.

Ian A Burney. Poison, detection and the Victorian imagination. Manchester: Manchester University Press, 2006.

Ian A Burney. “Medicine in the Age of Reform”, in Arthur R. Burns and Joanna Innes, eds, Rethinking the Age of Reform: Britain, 1780-1850.  Cambridge: Cambridge University Press 2003.

Ian A Burney. Bodies of evidence: medicine and the politics of the English inquest, 1830-1926. Baltimore: Johns Hopkins University Press 2000.

Top of page

Disclaimer | Privacy | Copyright notice | Accessibility | Freedom of information |