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AN UNBROKEN RECORD The College’s fascinating Minute Books dating back to the 16th century
An unbroken written record
A fascinating set of College archives charting the evolution of medical professions in the capital since the 16th century is now available online, writes Jacqueline Cahif
he Royal College of
TSurgeons of Edinburgh was founded in 1505 as a craft guild when the surgeons formally united with the city’s barbers as the ‘Incorporation of Surgeons and Barbers of Edinburgh’, receiving Royal Charter in 1778.
We are very fortunate that the College archives are as old as our organisation, and we can safely lay claim to being the custodians of one of the oldest and most complete institutional medical archives in Scotland, and possibly the world.
Although the earliest manuscript in the College Archive dates to 1466, we hold an uninterrupted record of all Council meetings held from 1581 to the present day; it is possible the minutes between 1505 and 1581 were lost, destroyed or simply did not exist.
The RCSEd Minute Books are some of our most heavily accessed archives. They have unquestionably informed the greater part of our knowledge on the esteemed history of the College, and are a treasure trove for staff, Members and Fellows, as well as the huge number of academic researchers interested in our heritage and the history of medicine and surgery more broadly.
It is also due to these resources that we have a record of all the men and women who have qualified with our institution since the 16th century, enabling us to deliver a very popular genealogical enquiry service.
Taken together with our early manuscript collection, the Minute Books offer a fascinating insight into how medical practitioners in Edinburgh organised and evolved into medical ‘professions’ hundreds of years ago, enabling historians to unravel this complex history. This has particular significance given that Edinburgh had emerged as the world-leading centre for medical teaching by the mid-18th century.
We are delighted to announce that these remarkable Minute Books – all 25 volumes covering the years 1581 to 1922 – have now been digitised and are freely available to read online.
CONTINUITY IS KEY When considering how to best describe these precious historical records, I was initially stumped. How do you summarise five centuries of Council meetings from these hefty volumes in so few pages?
To give you an idea of the sheer breadth of subjects covered, they include business affairs and activities; litigation and disputes; financial transactions; educational and social events; exams and teaching; presentation of new Members and Fellows; disciplinary matters; reactions to wider social, economic and political change, particularly with implications on medical education; and, importantly, the development of anatomical and surgical education.
However, there is a thread that weaves through the collection of Minute Books, which has supported the aims of our original founders, ensuring our longevity into the 21st
The College achieves its ‘highest standards’ through training and supporting surgeons for the entirety of their career
Jacqueline Cahif College Archivist, RCSEd Above: One of the College’s Minute Books from 1581 century: continuity. Therefore, I thought I would look more closely at this theme and also illustrate the measures taken by the College when individuals have subverted the original principles of the Incorporation. Continuity can be found in so many areas of our work, most notably and obviously through education, training, examination and membership. Our original 1505 Charter, or ‘Seal of Cause’ to give its formal title, was explicit that the Incorporation should exist as a formal examining body, and one of the earliest meetings, held in 1582, registers a William Bisset who was examined and “fund qualifit” to practise.
Above: Old Surgeons’ Hall, High School Yards, Edinburgh
Left: Interior of a Surgery by Matthijs Naiveu, showing a surgeon treating a man’s arm wound in the 18th century THE ‘HIGHEST STANDARDS’ The structure of teaching and qualification has obviously changed markedly since our inception. The decline of the Triple Qualification (TQ) examination in the 1960s, which was comparable to an undergraduate university medical degree, transformed our remit, and the College now functions as a centre of higher surgical education and examination. The current RCSEd mission statement reads:
“With our interest in professional standards, the College’s primary role – and the main concern of our Fellows and Members – is to ensure the safety of our patients… We do this by championing the highest standards of surgical and dental practice.”
The College achieves its ‘highest standards’ through the provision of training beyond initial qualification and supporting surgeons for the entirety of their career. This idea
of extended education existed in our organisation centuries ago, thus a minute from 1647 notes that, once qualified, a surgeon should “continue his examinations”.
The theme of continuity can also be seen in centuries-old customs still upheld by the College. The 16thcentury minutes disclose the regulations applied to RCSEd Office Bearers, including several that have endured. Like today, they were elected, and a minute from 1582 identifies the first recorded election of the Deacon (President), Boxmaster (Treasurer), ‘Keeper of the Kist’ (Secretary) and quartermasters. Unlike today, the election itself took place in the (outgoing) Deacon’s house.
Discussions that have taken place in meetings during turbulent and uncertain times in our history give a flavour of the practical steps taken by the College to meet challenges, such as public health emergencies. I recently came across a fascinating entry from the 17th century with particular contemporary relevance that draws a direct parallel with the recent COVID-19 pandemic, whereby the RCSEd Presidential term was extended by one year.
In order to provide a sense of stability during a particularly severe outbreak of plague in Edinburgh in 1604, the Office-Bearer elections were cancelled and the Deacon and “four maisteris, box maisteris and keipar of the key of the kist, ar continewit in thair offices for this yeir to cum [during] the continewing of the plague of pestilence”.
BREAKING THE RULES In order to promote the highest standards of surgical practice the College requires its membership to adhere to professional codes of conduct. The RCSEd Laws from 2021 state: “Fellows and Members are expected to conduct themselves personally and professionally with integrity and honesty”.
Much of our success and prolific reputation lies in this aspect of our organisation’s overall objectives, and the College has consistently promoted professional and correct behaviour through its entire history.
Today, surgeons found to have participated in disreputable behaviour will likely have their membership rescinded. The minutes show surgeons and trainees in the past frequently engaged in rule-breaking and misconduct, and at times this was a real concern to the College. What is particularly notable, however, is the unwavering consistency in stamping out incorrect or perceived immoral behaviour.
Rule-breaking most commonly involved pre-qualification apprentice surgeons usurping the privileges of qualified ‘mastersurgeons’, or unauthorised medical practitioners who had crossed occupational boundaries. The medical marketplace of the early modern period was marked by great fluidity between different groups – many amateur – and the Incorporation took steps to suppress their activities with great regularity.
In 1585, for example, it was reported that an unqualified “simple barber” [as opposed to a licensed barber-surgeon] was punished for practising surgical procedures, being made to “hummell himself on his kneis” and beg for forgiveness in front of the full Incorporation. There are numerous similar incidents in the minutes and these individuals were a persistent source of irritation to the surgeons.
CRIME AND PUNISHMENT However, more serious crimes were laid out before Council meetings, some of which brought the College into serious disrepute, the most well-known concerning the practice of bodysnatching, which was particularly rampant in Edinburgh.
Unsurprisingly, whenever cases of bodysnatching came to light, public attention turned to the surgeons. This became a recurring thorn in the side of the College from the early-18th century and continued well into the 19th century as the demand for cadaveric teaching material intensified.
The minutes expose the lengths the College went to in order to dissociate themselves from this gruesome practice – in short, the surgeons had to be seen to be taking action. During a meeting in 1742 Office Bearers ordered the placement of notices on “Church Doors, City-Gates, Coffee-houses or other public places” to “show the World the sentiments of this
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Above: The and correct behaviour through its entire history '' Anatomist Overtaken by the Watch (1773), by William Austin. Some anatomists in the 18th century turned to crime to obtain cadavers
Society” in their opposition to “this Monstrous Crime”. Several decades later, in October 1771, a meeting was held to discuss the offer of a financial reward “to discover who took the dead body out of the Grave… some days since”.
The College minutes also record professional quarrels and on occasion disputes appear to have played out in public, seemingly when the offenders had participated in one drink too many. In 1670, for instance, two Members brought shame on the College after an altercation in the town when one threatened the other with violence and that he would “break his heid”.
A notable (and extreme) example from 1679 involved a master-surgeon who displayed violence towards his apprentice, to the extent that he beat him and drew blood “in great quantity and to the hazard of his lyfe”. The roles were reversed in 1818 when a student assaulted a College examiner, surgeon John Gairdner (later PRCSEd). A young man, the son of an Ayrshire minister, had turned up at Gairdner’s home the evening following an examination held at the College where the examiner had rejected him. As revenge, the student attacked the surgeon with a whip in order to punish him. Consequently, he was taken into custody and tried by the Sheriff under the ancient Scots law of “hamesucken” (striking a person in their home).
We also get a glimpse into some of the more turbulent meetings themselves. During one 17thcentury meeting an Office Bearer offended the Deacon with “injurious” speech. His penalty? A spell in Edinburgh’s Tollbooth Jail.
A 500-YEAR RECORD In 1699 a Library was officially established by the Incorporation after a public appeal for “physicall, anatomicall, chururgicall & other Curious Books”. However, the preservation of the Minute Books as well as the thousands of early modern manuscripts suggests the Incorporation was assiduously collecting its business papers from the 16th century. This not only demonstrates the surgeons’ meticulous recordkeeping, but suggests that the Secretary (‘Keeper of the Kist’) most likely acted as the Incorporation’s archivist, managing not just the College Minutes, but also what we refer to today as the ‘Chirurgians’ Business Papers’. Possibly a stretch, but I do like to think that my current position as College Archivist is the continuation of a role that stretches back 500 years.
Overall, the College Minute Books are testament to the success of the world’s oldest surgical institution remaining faithful to its original aims, while demonstrating continuity in its efforts to consistently promote the highest standards of professional integrity among its membership.
Above: Resurrectionists (1847) by Hablot Knight Browne, depicting bodysnatching in London. The crime was also rife in Edinburgh and the College was keen to distance itself from this practice
That is not to say the College has been unchanging or inflexible. The minutes leave a paper trail on how the College has adapted to transformations in surgical knowledge, education and practice – including the Anatomy Act (1832), Medical Act (1858), introduction of the NHS in 1945, or even more recently by embracing technological innovation to accommodate distance learning for its overseas membership.
