The History of the Royal College of Physicians and Surgeons of Glasgow: The Shaping of the Medical Profession, 1858-1999 (review)

The story of the Royal College of Physicians and Surgeons of Glasgow begins in 1599 when King James VI of Scotland granted to Peter Lowe, "our Surgeon and chief Surgeon to Our dearest Son the Prince," and Robert Hamilton, "Professor of Medicine," the authority to regulate the practice of medicine and surgery within the counties of the diocese of Glasgow.

Glasgow was then a small university city of some 7000 inhabitants. In the following centuries it grew to a city of over a million people at the heart of perhaps the greatest industrial conurbation in the British empire. Over these same centuries, the industrial urbanization and the subsequent growing prosperity of the people changed the pattern of disease in Scotland. From early in the nineteenth century, increasing intervention by the government in the prevention of disease and the promotion of health, together with changing expectations of the people, made new demands on the medical profession. Then, in the twentieth century, advances in medical science transformed the scope and the effectiveness of services that the medical profession was able to provide. In addition to responding to this dramatically changing scene at home, fellows of the college played a prominent role in providing medical services in what was for a time the greatest empire the world had ever known; the faculty (college since 1962) now has some 6000 fellows and members practicing in countries across the world. After 400 years, the fellows decided that the time had come to commission a history of their college. The book reviewed here is the second volume of that history, covering the period from 1858 to 1999.

However, the authors have not produced, as one might have hoped, a judicious account of the college's interaction with society and its contribution to medicine and surgery over these years of spectacular change. Instead, they turn inward and present a history of the internal affairs of the college drawn principally from the minutes of meetings of the College Council.

Because a diligent council must inevitably devote more time and attention to overcoming pressing difficulties than to celebrating even great achievements, such reliance on their minutes has tended to disturb the balance of this history. For example, from 1886 to 1930, the college lost out to Glasgow University after a long struggle to maintain its position in the training and licensing of undergraduates. The inordinate time spent by the council on this one issue led the authors to present this period as one of "The Faculty in Decline," although this was also a period in which College Hall had to be enlarged, new seminar rooms had to be added, the library quadrupled in size, the college became home to Glasgow's many medical and surgical societies, and fellows of the college made major contributions to surgery (Lister, Macewen), medicine (Gairdner), public health (M'Vail), and physiology (Noel Paton, Cathcart). Similarly, the chapter on 1930-50 is given over to the college's internal problems of "Reorientation and Revival." Little attention is given to other more public achievements, such as the leading part played by the college in the 1930s in easing the way for German and Austrian medical refugees to practice in Britain, while the English colleges and the British Medical Association created what barriers they could against them.

This imbalance is present throughout the book. There are also factual errors, especially when the authors stray from their principal source, the College Minutes (for example, on the teaching of medical students at Glasgow University). Even such illustrious men as Sir William Macewen are inaccurately identified, and the identification of others is misleading (for example, Dr. John C. M'Vail—not "Mr. John C. McVail"—was president of the British Society of Medical Officers of Health and never simultaneously "physician at Kilmarnock Infirmary and MOH for the Counties...