Gentlemanly versus Scientific Ideals: John Burdon Sanderson, Medical Education, and the Failure of the Oxford School of Physiology

Introduction

In November of 1885 John Burdon Sanderson, the Waynflete Professor of Physiology at Oxford University, received a number of letters querying his proposed changes in the requirements for an Oxford medical degree. Most of the writers were Oxford medical graduates, but one letter in particular, from a Dr. Moxon who was not a graduate of Oxford, succinctly summarized the general sentiment: Moxon ended his letter, “P.S. Don’t make [the] M.D. Oxford ‘Popular.’” ¹

The confluence of circumstances that led to this letter campaign is the focus of this paper. In short, despite the efforts of Burdon Sanderson, Henry Wentworth Acland (the Regius Professor of Medicine), and many others, the new physiology program and the related revival of preclinical medical teaching were both failures at Oxford—at least in the number of students enrolled, the main criterion by which it was judged at the time. The failure of the Oxford school of physiology in the 1880s and 1890s was due less to the opposition of clerical and classical obscurantists than to a debate within a much smaller circle of men—Oxford-educated medical practitioners and sympathetic colleagues, like Dr. Moxon.

Burdon Sanderson’s career at Oxford was carried out in the shadow of Michael Foster’s School of Physiology, as it was called by contemporaries. As I will discuss below, Burdon Sanderson was hired at Oxford to head a new physiology department that would, it was hoped, become a physiology school to rival Foster’s. The success of a research school depends on three factors: the personality of the leader; the research program itself; and support—both institutional and financial. ² In this paper I will emphasize the context of institutional and financial support, or its lack, for physiology at Oxford in the 1880s. ³ Burdon Sanderson was not successful in founding a research school, and thus my use of the term Oxford School of Physiology is somewhat ironic.

The Medical Act of 1858 had created one register of physicians legally empowered to practice medicine in the United Kingdom. In order to appear on this registry a practitioner had to have one (or more) of the various qualifications listed in a Schedule, which were the various degrees and diplomas of the licensing bodies. ⁴ The 1858 Act thus formalized the decentralized nature of British medical education, leaving intact the hodgepodge of licensing bodies and universities that had traditionally had the right to license a medical practitioner. The Act did, however, centralize some power in the hands of the General Medical Council, which published the list of qualified practitioners and also had the right to define necessary qualifications (for example, the Act did not allow for apprenticeship as a route to obtaining a license, which resulted in more would-be practitioners taking formal medical courses, thus accelerating an existing trend). ⁵

Physicians had for some time been divided between general practitioners and the elite, hospital consultants. The most common route to general practice at mid-century was still to become a Licentiate of the Society of Apothecaries, and a Member of the College of Surgeons. ⁶ Consultants tended to be academically trained, to be members of the Royal Colleges, and to practice in or close to London. ⁷ An Oxford medical degree was clearly a route to such a career.

Although my narrative is centered on the peculiar circumstances of nineteenth-century Oxford, the general problem I address is the lack of support for a move to a science-based medical curriculum in late-Victorian Britain, despite the many efforts during this era to reform medical education along these lines. The attempt at Oxford to begin a physiology program reveals that among the British medical profession generally there was far from unanimous support for making the natural sciences the basis of the medical curriculum.

The role of the basic or experimental sciences in medical education has been a particular interest of historians during the past few decades. ⁸ Several exploratory essays have discussed the issue of medical science and its...