The History of the Royal Society of Medicine

In 1773, Dr John Coakley Lettsom and a small number of friends inaugurated the Medical Society of London. Soon, however—possibly because Lettsom's attention was diverted towards the promotion of the Royal Humane Society and the Royal Sea Bathing Infirmary at Margate—the Medical Society of London lost momentum. The number of submitted papers declined, and disputes almost led to its dissolution. Under a new president, Dr James Sims, the society rallied temporarily, and benefited from the gift of the freehold property at Bolt Court, Fleet Street, and a library of six thousand books. However, increasing frustration at the oligarchic presidency of Dr Sims and the need for reform led in 1804 to proposals for new laws to put the society on a more democratic basis. After a struggle during which the activities of the society practically ceased, the reformers resigned and in 1805 formed the Medical and Chirurgical Society of London. One of the regulations of the new society restricted the term of the president to two years, a clear reference to the difficulties with the leadership of the Medical Society of London. Membership was not cheap—six guineas admission fee and an annual subscription of three guineas. The aims of the new society included the formation of a library and a union of the various branches of the profession. Admission to membership was by personal nomination, followed by a ballot (three-quarters of votes in favour were required for election), although to help the establishment of the society the founders bypassed this system to elect some leading figures such as James Parkinson (who described his eponymous disease in 1817). A special category of honorary members was created for distinguished non-medical scientists such as Humphry Davy, who became famous for his invention of the miner's safety lamp, first used in 1816. Initially the strength of the newly founded society derived mainly from the staff of Guy's Hospital and from those associated with the Great Windmill Street School, and a smaller group was drawn from the London Hospital and its medical school. It was not until the 1840s that a substantial number of members came from other institutions. The Medical and Chirurgical Society meetings were held at 2 Verulam Buildings, Gray's Inn Road (Figure 1) from 1805 to 1810, at which point the owner evicted the society so that the building could be sold. After a period of cohabitation with the Geological Society at 3 Holborn Row, the Medical and Chirurgical Society moved to 30 and then 57 Lincoln's Inn Fields, and finally in 1834 to 53 Berners Street (Figure 2). The removal of the society to 20 Hanover Square in 1889 was mainly prompted by the growth of the library. Figure 1 Gray's Inn looking south. The Medical and Chirurgical Society's first house was at the south end of the terrace in the left foreground Figure 2 53 Berners Street, London W1 In 1809, important papers that had been presented at meetings began to appear in the society's journal, Medico-Chirurgical Transactions. The decision whether or not to publish a paper in the Transactions was the prerogative of the Council, and the reasons for acceptance were not given. Those assembled at the Council meeting were balloted and the outcome was final. It appears that some of the most interesting material was rejected. For example, Council decided against publication of Doucet's experiment in which tetanus was said to have been cured by regularly pouring between 15 and 26 buckets of cold water over the patient. Examples of more important rejected works include a paper in 1824 reporting removal of one side of the jaw for osteosarcoma and the first description of the worm Trichina spiralis in 1833; Dr Thomas Addison's paper, describing the disease that was named after him, was rejected repeatedly. In 1843, referees were introduced, to assist the Council in evaluating manuscripts. One of the more important items to survive the ancient peer review process was Dr Thomas Hodgkin's paper in 1832 describing the disease that was to take his name. The Transactions faced many early difficulties, which included criticism of the large number of single case reports, frequent typographical errors, and the expense of printing. No volumes were published at all in some years. The journal was nevertheless to develop greatly, and survived until 1907. Despite early tribulations, the Medical and Chirurgical Society and its Transactions flourished, and in 1812, with the support of the then president and King's Physician Sir Henry Halford, the society petitioned for a Royal charter of incorporation. This was fiercely opposed by the Royal College of Physicians, who set up a committee to take whatever measures necessary. The College sent a memorial to the Privy Council opposing the society's petition as injurious to the College and altogether unnecessary, and within months the society's bid was rejected by the law officers of the Crown. A supplementary petition and counter-attack swiftly followed, pointing to the lethargy of the Royal College, which had failed to print a library catalogue for 55 years, restricted the use of its library to a small number of fellows, failed to publish anything since 1786, and allegedly held no useful meetings. A bitter dispute followed, the supplementary petition failed, and the society appealed to the Lords of the Committee of the Privy Council. Lawyers for the society and for the College of Physicians presented their opposing views in the Cockpit at Whitehall in 1814, the outcome being that the Royal College of Physicians succeeded in thwarting the ambitions of the society. Unsurprisingly, this outcome caused lingering resentment. In fact the Royal Charter was sanctioned only in 1834, the year of the move to Berners Street. Under its new name of the Royal Medical and Chirurgical Society of London (RMCS), the society achieved maturity and status and flourished as an academic institution. Originally, reporters from other medical journals were banned from admission to meetings, but this rule began to be relaxed in 1842, and gradually others became free to print all or part of the society's proceedings. This led to the official publication of the Proceedings of the society from 1856, and initially authors could specify whether they wished their work to be published in the Proceedings only or in the Transactions with an abstract in the Proceedings. Later Council withdrew this choice and made their own decisions. Failed attempts in 1860-1861 and 1868-1870 to amalgamate the RMCS with the Pathological Society, the Obstetrical Society, and several other specialist societies left the RMCS divided and weak at the very time that specialization was at a peak. Whereas in 1800 there were twelve specialist charity hospitals and dispensaries, by 1890 there were a hundred. New specialist societies multiplied and defied amalgamation, which introduced an element of antagonism and competition for material to be presented at meetings. However, during the final decade of the century support for amalgamation developed, which resulted in a firm proposal in 1905, and twenty-six London medical societies were approached to see if they would be willing to amalgamate. Some welcomed the proposal whereas others hesitated. In 1907 it was agreed to name the new society the Royal Society of Medicine (RSM), and fifteen medical societies including the RMCS agreed to unite under this name. The history of developments up to 1907 is covered in the first five chapters of Penelope Hunting's magnificent and beautifully illustrated history of the RSM1. Subsequent events occupy the remaining five chapters, about two-thirds of the book, where the development and notable achievements of the individual Sections and Forums are set out, Dr Hunting's examination of the records having been enhanced by information from many senior Fellows. Although her book will be of special interest to Fellows, it also provides a gripping account of many of the most important medical developments in the past 200 years, with much material to engross any reader with an interest in medical history. It is profusely illustrated. For pure fascination it is hard to beat the radiograph of Dr John Hall-Edwards' hand, taken a few days before the hand and arm had to be amputated because of radiation damage. Hall-Edwards, a radiologist and so-called X-ray and radium martyr, presented his own case to the Section of Electro-therapeutics (latterly the Section of Radiology) in November 1908. But wherever you open the book you are sure to find something interesting and absorbing, whether it is the first report of cases of smallpox communicated to the fetus (reported by Dr Edward Jenner), the first description of hay fever (by Dr John Bostock), or the fierce controversy over whether or not rickets was the result of a lack of a vitamin (Dr Edward Mellanby), the importance of vitamins having been dismissed by some as merely ‘the latest dietetic stunt’.