A previous blog described a case of crim. con. “Crim. con.” is short for criminal conversation or adultery. The accused adulterer or defendant in the case was a member of the clergy, one Rev. Mr. Bate Dudley. I read the case only because Mr. W. Musgrave’s signature, inscribed on the inside of the book, had attracted my eye.1 This post describes what I learned when I Googled the name inscribed in another Regency-era book.
The Interesting Signature
In Dr. Robert Willan’s book on the history of measles, scarlet fever and smallpox, published in 1821, I found an interesting signature for William Thomas Gallimore, a surgeon in Chesterfield.2 Mr. Gallimore might have acquired the book from a friend or by purchasing it from a colleague’s estate or even buying it from the publisher. The date 1830 might represent the year he bought it.
NOTE: In Jane Austen’s day a doctor was addressed as “Doctor”—for example, Dr. Baillie, Dr. Clutterbuck—while surgeons were addressed as “Mister”—Mr. Guthrie, Mr. Bell. The tradition continues today.3
The Charge against the Surgeon
The prisoner, Mr. Gallimore, “surgeon,” was charged with the manslaughter of Ann Warwick, who lived at Hollymoorside near Chesterfield in Derbyshire. The specific charge was gross neglect. If the jury found the prisoner acted ignorantly and without the expected proper skill and care, their duty was to return a verdict of guilty.4
The Case Presented to the Jury
The patient was a 26-year-old pregnant woman who complained of being unwell. Mr. Gallimore was called at 9 o’clock p.m. He examined her, agreed to send some medicines to help her sleep, and promised to return later. At about 2 o’clock the next morning, the surgeon returned and learned that she had suffered a miscarriage. After half an hour’s rest, he re-examined her and forcibly withdrew what he thought was the placenta, which had already come away with the child. Unfortunately, it was not the placenta he extracted, but the womb itself, which resulted in the woman’s death.
Evidence Regarding the Surgeon’s Skill
The prisoner was described as a “kind and attentive man” who practiced extensively as a man-midwife. There were hints, however, that he was under the influence of liquor when he showed up at 2 a.m.
Mr. Gallimore was found guilty of manslaughter in the death of Mrs. Warwick by either gross ignorance or inattention. Since there was no evidence of criminal intent, he was sentenced to prison for six months.
Surgical Training during the Regency Era
Medical training for surgeons in the late 18th and early 19th centuries was nothing like today’s rigorous curriculum. Indeed, the English approach to medical education two hundred years ago was quite entrepreneurial, with students organizing their own course of study.5 A Regency surgeon may have begun his training as an apprentice to an apothecary or surgeon. He may have taken a course or two in anatomy along the way to learn how to dissect and stitch up wounds. He may have studied chemistry and pharmacy and physiology. A man training to become a surgeon was required to spend at least six months in the surgical practice of a surgeon at one of London’s large hospitals.5 He was not required to pass an examination to qualify him to practice.6
Most English villages had only one medical man to serve a diverse population. Even though he might have trained as an apothecary, this medical practitioner was required by necessity to serve as an apothecary, a doctor, a surgeon, and sometimes a midwife. In fact, an inquiry into the state of medicine in England, published in 1814, reached this conclusion:7
The number of uneducated persons, who exercise the profession of Medicine and Surgery in its various departments, is almost incredible to those who have not investigated the subject.
In an 1804 study of medical practitioners in the county of Lincolnshire, for example, the following statistics were reported: 5 men practiced as physicians (all graduates of a Scottish university); 11 served as surgeon-apothecaries (the forerunner to today’s general practitioner); 25 worked as Druggists (along with 40 “irregulars” working as Druggists), and 63 were midwives. The incredible statistic is this: none of the midwives had received any instructions in midwifery. All told, only one in nine of these practitioners had been educated for the medical profession.7
Given these statistics, perhaps it is not too surprising that Mr. Gallimore lacked sufficient training to carry out his duties properly—no comfort to Mrs. Warwick’s family. But only think how he would marvel at the years of training required to produce today’s neurosurgeon or cardiovascular surgeon or surgeon specializing in plastic surgery. How very lucky we are.
1Anon. Adultery Trial, in the Court of King’s Bench, before Lord Kenyon, and a Special Jury, between Edward Dodwell, Esq., Plaintiff, and The Rev. Henry Bate Dudley, Defendant, for Crim. Con. (London, 1789).
2Smith, Ashby. Miscellaneous Works of the Late Robert Willan, M.D., F.R.S., F.A.S., Comprising an Inquiry into the Antiquity of the Small-pox, Measles, and Scarlet Fever. (London, 1821).
3Loudon, I. Why are (male) surgeons still addressed as Mr? BMJ. 2000;321(Dec. 23-30):1589-1591. [BMJ stands for British Medical Journal.]
4Anon. Midland Circuit: Forcible inversion of the womb, by an accoucheur. The Lancet. 1844; October, Vol. I (1):267-268.
5Palluault, Florent. Medical Students in England and France 1815-1858: A Comparative Study (thesis). University of Oxford, 2003.
6Clarke, J.F. Autobiographical Recollections of the Medical Profession. (London, 1874), p. 5 (PDF p. 26).
7Kerrison, Robert Masters. An Inquiry into the Present State of the Medical Profession in England. (London, 1814), pp. 37-38 (PDF pp. 58-59).