This article seeks to show that the usual accounts of the founding of the Edinburgh Medical Faculty in 1726 give undue prominence to John Monro, an Edinburgh surgeon, and to George Drummond, later Lord Provost of Edinburgh. They do so because their authors have ignored the ways in which patronage appointments, such as medical professorships, were and had been dispensed in the city of Edinburgh and in its university. There the Town Council was only nominally independent when it came to making professors. Medical historians have been equally cavalier in their treatment of the roles of leading politicians, especially of Archibald Campbell, first Earl of Ilay and later third Duke of Argyll, who was the most important Scottish politician working between c. 1716 and his death in 1761. A more realistic view of the history of Scottish medicine would not ignore the realities of politics and the relation of these to institutions, such as the Edinburgh Medical Faculty.