601 



PHYSICIANS, ROYAL COLLEGE OF. 



PHYSICIANS, ROYAL COLLEGE OF. 



603 



passing of the medical act the College of Physicians of London had 

 repudiated the granting their diploma to those who sent out their 

 medicines or practised surgery. But on the passing of this act, those 

 who were registered as physicians by the diplomas of the Colleges of 

 Physicians of Edinburgh or Dublin, were entitled to practise iu all 

 parts of the United Kingdom. This, accompanied with the lowering 

 of the fee for admission by the College of Physicians of Edinburgh, 

 led a large number of general practitioners to seek admission to that 

 College. Shortly after the passing of the act, the College of Physi- 

 cians in London instituted a year of grace, in which they admitted to 

 the membership of the College also at a reduced fee, the graduates of 

 universities and others practising medicine, who did not send out their 

 medicines. This has led greatly to the increase of the number of 

 members of the medical profession, who practise under the style and 

 title of physician. 



Some idea of the amount of fees paid to physicians in the middle 

 ages may be gained by what we are told of Petrus de Abano, one of 

 the most eminent physicians of the 13th century. For visiting a 

 patient out of his own city he charged one hundred and fifty francs 

 (or about six pounds) per day ; and that when sent for by Pope 

 Honorius IV., he demanded four hundred ducats per day, or about 

 seventy pounds. (Bayle's ' Diet.,' art ' Apone.') It should, however, 

 be noticed that these charges were considered very enormous. 



PHYSICIANS, HOYAL COLLEGE OF, the principal chartered 

 medical body in England, was founded through the instrumentality of 

 Linacre, who obtained, by his interest with Cardinal Wolsey, letters 

 patent from Henry VIII., dated in the year 1518. This charter 

 granted to John C'hambre, Thomas Linacre, Ferdinand de Victoria, 

 Nicholas Halsewell, John Francis, and Robert Yaxley, that they and 

 all men of the game faculty of and in the city of London, should be in 

 fact and name one body and perpetual community or college; and 

 that the same community or college might yearly and for ever elect 

 and make some prudent man of that community expert in the faculty 

 of medicine, president of the same college or community, to supervise, 

 observe, and govern for that year the said college or community, and 

 all men of the same faculty, and their affairs, and also that the 

 president and college of the same community might elect four every 

 year, who should have the supervision and scrutiny, &c., of all phy- 

 tiei.ins within the precinct of London. The statute 14 Henry VIII. 

 confirmed this charter, and further ordained that the six persona above 

 named, choosing to themselves two more of the said commonalty, 

 should from henceforth be called and cleaped elects ; and that the 

 same elects should yearly choose one of them to be president of the 

 said commonalty; and then provided for the election of others to 

 supply the rooms and places of such elects as should in future be void 

 by death or otherwise, which was to be made by the survivors of the 

 game elects. The statute 32 Henry VIII. provides that from thence- 

 forth the President. Commons, and Fellows might yearly, at inch time 

 as they should think fit, elect and choose four persons of the said 

 Commons and Fellows, of the best learned, wisest, and most discreet, 

 such a* they should think convenient, and have experience in the 

 faculty of physio, to search and examine apothecaries' wares, Ac. This 

 last appointment is independent of the constitution of the body, the 

 persons so appointed being officers for a special purpose ; and it has 

 been usual to select for this office the same four persons in whom the 

 government of the physicians is reposed by the charter and statute of 

 the 14th of that king. 



The constituted oin'eera then of this corporation are the eight elects, 

 of whom one is to be president, and four governors, who have generally 

 borne the name of censors. There is nothing to be gathered from the 

 charter or statutes in any way tending to exclude any of the elects, 

 except the president, from the office of censor ; and as no duties are 

 assigned to the elects, except those of filling up their own number, 

 electing one of themselves to be president, and granting testimonials 

 to country practitioners, they may be rather regarded as candidates 

 for the office of president than as active officers of the corporation. 

 The college Is bound to choose four censors, for the purpose of dis- 

 charging the duties confided in it, which are to be executed by these 

 officers. It is also incumbent on the elects to preserve their number, 

 BO that there may at no time be less than fire, including the pre- 

 sident, as they would not, after a further reduction, be capable either 

 of electing a president or choosing others to fill the vacancies In their 

 own body. (Willcock ' On the Laws of the Medical Profession,' p. 32.) 

 It is evident that the charter so far incorporated all persons of the 

 same faculty, of and near London, that every person on the 23rd of 

 September, in the 10th year of the reign of Henry VIII., falling within 

 that description, was entitled to be admitted into the association. 

 Such of them as had availed themselves of this privilege, and 

 others subsequently admitted, are the persons described by statute 

 82 Henry VIII., as " Commons and Fellows " (quutcd in Willcock, 

 p. 13). But as to the persons who should afterwards enjoy that 

 distinction, the original charter and all subsequent statutes are silent. 

 James I. and Charles II. granted charters to this body. The first 

 is silent as to the mode of continuing it ; but the charter of 

 Charles, after limiting the number of fellows to forty, directed that 

 when a vacancy should occur in that number, the remainder should 

 elect one of the most learned and able persons skilled and experienced 

 in physic, then of the commonalty of members of the college. Each 



of these charters seems to have been granted with the view to the 

 enactment of a bill to the same ett'ect, as the kings respectively 

 pledged themselves to give it the royal assent. No statute has been 

 at any time passed in pursuance of this purpose; and it is very 

 doubtful how far and in what manner the charters have been 

 accepted by the college, though they have certainly been several 

 times acted upon. (Willcock, p. 34.) 



The licentiates of the college wbo may practise within the precincts 

 of London and seven miles round it were (until 1836) of three orders, 

 namely, fellows, candidates, and mere licentiates. The last of these 

 classes, generally denominated licentiates, are those who have only a 

 licence to practise physic within the precincts above described. The 

 second class was abolished in ] 836. The first class are those who have 

 received that licence, but whose licence also shows that they are 

 admitted to the order of fellows. This licence has often been called 

 a dijiloma, but as it confers no degrees, the word is not properly 

 applied, according to its more strict signification. 



The order of licentiates was created by the following clause of the 

 charter of Henry VIII. : " We have granted also to the same president 

 and college or community, and their successors, that no one within the 

 said city or within seven miles around may practise iu the said faculty 

 until admitted to this by the said president and community, or their 

 successors for the time being, by the letters of the same president and 

 college, sealed with their common seal, under the penalty of one 

 hundred .'hillings for every month for which, unadmitted, he may have 

 practised in the same faculty, half to be applied for us and our heirs, 

 and half for the same president and college." Now the common law 

 having given every man a right to practise in any profession or business 

 in which he is competent, the effect of 14 Henry YIII. must be taken 

 to be this, namely, it has left to every man his common law right of 

 practising in the profession of physic, as in any other profession, if 

 competent, and has appointed the president and college to be judges of 

 this competency. (WiUcuck, p. 8.) The mode of examination is 

 wholly in the discretion of the college, which has confided tbe imme- 

 diate direction of it to the censors. It has, however, also appointed 

 that tbe doors of the censors' chamber shall be open to all fellows 

 who may think proper to be present, and that they may take part iu 

 the examination, should they think tit ; and that the fellows may have 

 an opportunity of availing themselves of this right, it is appointed that 

 all examinations shall take place at a court held at certain regular 

 intervals. (Ibid., p. 41.) 



The order of Candidates was abolished in 1836, as above stated, but 

 there were reserved to students then in the universities of Oxford and 

 Cambridge their inchoate rights. 



The order of Fellows comprises those who are admitted into the 

 fellowship, community, commonalty, or society of the college. The 

 charter incorporated all physicians then legally practising in London, 

 so that each of them who thought proper to accept it became if to facto 

 a member or fellow ; but as all future practitioners, within the pro- 

 cincta of and seven miles round that city, were required to obtain the 

 licence of the college, there soon arose two orders of the profession. 

 The fellows attempted by various bye-laws to limit their own number, 

 but seem to have considered the licentiates as members of the college, 

 or the commons, and themselves as forming a select body for the pur- 

 pose of government. To this state of the society, the statute 32 

 Henry VIII. seems to allude in speaking of the " commons and 

 fellows." The charter of Charles II. expressly notices these orders as 

 forming the body of the society, inasmuch as it directed that new 

 fellows should be elected from among the commons of the society. 

 Ibid., p. 44.) 



Up to a very recent period the College confined it election of Fellows 

 to graduate* of the universities of Oxford and Cambridge. This was 

 done under the direction of certain bye-laws, which it appeared the 

 College had not by iu charters the power to enforce. The.ic bye-laws 

 have been now modified, and graduates of all British and other uni- 

 versities, being licentiates of the College, are open to election for the 

 fellowship. 



There is a third class of members of the College, called extra- 

 licentiates, or licentiates extra urbem. They are examined by the 

 president and elects of the College, by virtue of an Act of Parliament 

 passed previously to the granting of the present charter of the College. 

 By this Act, power was given to the president and elects to examine 

 person* desiring to practice physic throughout England and Wales. 

 After the College of Physicians obtained their charter this Act fell 

 into desuetude ; but the president and elects having made known their 

 power at the beginning of the present century, the list of extra- 

 licentiates gradually increased, till in 1851 they nearly equalled in 

 number the licentiates of the College. By the charter of the College, 

 they were held to have no right to practice their profession within 

 seven miles of London ; and in case any of the extra-licentiates 

 came to reside within that distance of London, they were cited to 

 appear and be examined before the censors for their licence to 

 practise in London. This was not a mere formal examination, as 

 instances have been known in which the censors have rejected 

 candidates who had been admitted to practise by the elects The 

 revival of the class of extra-licentiates by the elects, and the jealousy 

 of the censors of this body of physicians, was one of the causes 

 which led to the passing of the Medical Act of 18S8, by which the 



