Our Heritage

The Society’s first President was Dr Andrew Duncan who was, when appointed, 77 years old. He was a very vigorous septuagenarian, and, of all the great figures of Edinburgh medicine in the eighteenth and nineteenth centuries, perhaps the most amiable.The achievements of Andrew Duncan are relevant to the development and the present standing of the Med-Chi. Born and brought up in St Andrews where he was known as ‘the smiling boy’ he was a singularly benign and genuinely loved physician – one of the few to have been given the Freedom of the City of Edinburgh. Twice President of the Royal College of Physicians, for very many years Treasurer of the Royal Medical Society, he was largely instrumental in founding the Public Dispensary in Richmond Street which was the original progenitor of the Department of General Practice at Edinburgh University. His major part in setting up the Royal Edinburgh Asylum for the insane was prompted by his revulsion at the squalor of the town’s Bedlam in what is now Forest Row, where the poet Robert Ferguson spent his last days. Andrew Duncan’s pleasure in the company of colleagues and friends and his feeling for conviviality were marked by this founding of the Aesculapean Society for selected Fellows of the two Edinburgh Royal Medical Colleges, and for a wider membership the Harveian Society where ‘… the social sons of Aesculapius annually commemorate the most important of all medical discoveries, the circulation of the blood, by the circulation of the social glass’. His wider interests were illustrated by the foundation of the Caledonian Horticultural Society. All these institutions are still vigorous and active – sadly the one Society Andrew Duncan started which failed after he was no longer able to lead and encourage it was the Gymnastic Club – to promote exercise among his medical colleagues.

Sir Robert Christison said of Duncan in his old age “Little was to be learned from him. But he was so kindly and warm-hearted a man in manner, had done so much practical good in his day, and was so attentive to his students, whom he invited in succession once every week to a dull enough tea-and-talk party, that he was universally respected and respectfully listened to”.

Another of the founder members of the Society was also a noted teacher but one who attained fame of a sort in rather less savoury circumstances. He was Dr Robert Knox – a brilliant anatomist and extra-mural teacher, but the recipient – possibly in ignorance, but if so somewhat carelessly, of the victims of Burke and Hare: the scurrilous rhyme ran:

Burke the butcher, Hare the thief
Knox the man who bought the beef

The Royal Medical Society had met in its earliest days in taverns – and indeed up until the latter part of the eighteenth century a great deal of the business of Edinburgh, including medical consultations and meetings of convivial clubs was transacted in taverns. Subsequently the RMS built a Hall of its own, in Surgeon’s Square in 1775, very largely due to the exertions of the indefatigable Andrew Duncan. By 1821 however, tavern life was a good deal less ‘respectable’ – for one thing the new houses of the professional classes had dining rooms and drawing rooms and entertaining at home – previously the prerogative of the aristocracy, was beginning to be the practice of the middle classes.

The Medico-Chirugical Society of Edinburgh first met in a hotel in Register Street, then in a hotel in Waterloo Place and then in the Royal College of Physicians in its George Street home – and over the next half century in no fewer than fifteen meeting places, including other New Town hotels, Freemasons’ Hall, an auction room and a photographic salon. The Royal College of Surgeons has given the use of its meeting halls for a longer total period of time than any other institution.

The origin of the Society stems from the perception of its founding fathers that ‘it appeared to many of the practitioners and teachers of Medicine in this city, that an association among themselves similar to those which have conferred so much benefit on medical science in London and Dublin, was very desirable for their own gratification and instruction…’. The main object of the Society was “communication of facts and the interchange of opinions on medical subjects and the collection and preservation of important practical observations so frequently made by gentleman whose avocations do not permit them to undertake separate publications”.

The emphasis on publication in the early years was important. Edinburgh in this respect appears to have had something of a pioneering role. In 1731 John Monro primus was the leading light in a Society which was instrumental in compiling yearly volumes on “Medical Essays and Observations” – in 1783 this Society became the Royal Society of Edinburgh. Initially the Medico-Chirugical Society of Edinburgh published three volumes of Transactions in 1824, 1826 and 1829. These were followed by abridged reports of the Society’s proceedings which appeared in the Monthly Journal of the Medical Sciences up till 1855, and thereafter in the Edinburgh Medical Journal till 1880. The second series of Transactions was published in volume form until 1939. After the Second World War the proceedings appeared again in the Edinburgh Medical Journal until the formation of the Scottish Medical Journal in 1956, in which brief reports of the Society’s transactions were published until the Society decided about a decade ago to break with the Journal.

In the transactions, in 1855 ‘Simpson stated that he had seen a leper the day before and asked if the disease was returning again to this country. It was pointed out that the Swedes spoke of prevention by the “Scottish method”, namely castration of the males suffering from the disease. Dr Simpson hoped our Swedish friends would understand that this method of dealing with the disease is not now advocated in Scotland.

Dr Alison, Emeritus Professor of the Practice of Physic, had a paper on ‘Bleeding and its Values’, apparently one of the last struggles of the decay of faith in the value of bleeding in all cases of acute inflammation.

In 1889 there was a discussion on ‘the present epidemic of so-called influenza’. This had apparently started in St Petersburg and was thought possibly not to be influenza at all, but a form of dengue. Among other things the author of this paper suggested that ‘the working classes deserved, at the present day, to be included among the well-to-do and well nourished’. His prescription for this so-called influenza was carbonate of potash, nitrate of potash and quinine – one is struck with the happy thought that perhaps a gin and tonic might be equally effective.

In 1905, and this is an illustration of the problem which affects, usually in a cyclical manner, all Societies of this type, Sir Thomas Fraser looking back at this earlier days in the Society stated ’when I was a junior member … fifteen or twenty members … constituted an average attendance, and thirty an exceptionally large one…’.

There is no doubt that the Society took itself seriously, and did provide a measure of postgraduate education and mutual discussion and no doubt a degree of social mixing. It filled a need for hospital practitioners, but perhaps not so much for general practitioners. Papers read at the Med-Chi were becoming increasingly technical and lengthy and in 1926 the Clinical Club was formed specifically to address the needs of General Practitioners. The Clinical Club, like the Med-Chi has had its ups and downs, but it is still, like the Med-Chi, a thriving institution – both have resisted – quote properly in my view, proposals – at least two – in the past for amalgamation. There has always been at least an element of cross-membership, and for a good many years now there has been an annual joint meeting.

The other Society with which we have had a long and happy association is the Royal Glasgow Medico-Chirugical Society, and our annual joint meetings and dinners, each Society acting host in alternate years is one of the fixed points in our calendar. Their Society differs from ours in history, which is a somewhat convoluted one of resurrection of defunct institutions, and amalgamation of less thriving ones. How they got their Royal prefix is not completely clear, but in 1966 there was a move in the Edinburgh Society to make enquiries about the possibility of matching this: we were, however, informed by the Lord Lyon that there were about 70 extant Societies with similar aims and objects, and only one had been granted a Royal Charter and to pursue this aim would be difficult, probably costly and almost certainly unsuccessful, and so, sensibly, the idea was dropped.

In the 1960’s and 70’s the meetings usually took the form of lectures, discussions, or symposia and the proceedings were formal to the extent that the President and the speaker and the President’s guests at the traditional pre-meeting dinner wore dinner jackets.

The early 70’s were a difficult time for the Society and following a rise in the subscription rate there was a considerable flood of resignations, and a period of considerable introspection (leading to the inevitable setting up of a working party), with the floating of the suggestion which has come up on several occasions, of an amalgamation of all the Edinburgh Medical Societies. Better publicity and less formality won the day and the fortunes of the Society again revived. There was, however, the ongoing problem of the Scottish Medical Journal, and the eventual decision to break this tie was one which was taken only after considerable debate and soul-searching.

It was becoming clear that the proliferation of specialist postgraduate medical courses and talks were largely taking over the educational function of Medico-Chirugical Society meetings, and the emphasis shifted more and more, and with considerable success, in large measure due to the energy and enthusiasm of Hector Chawla and Jim Fowler, towards the general and the social. The Med-Chi Burns Supper has now established itself as an essential part of the Edinburgh medical/social scene as has the Harveian Festival or the Royal Medical Society Dinner. We continue to have meetings with educational content, but the education has been and is largely one of general culture. Medicine is still a learned profession, but with all life as its remit it needs to be continually refreshed, and this the Society now attempts to do.

Our predecessors from 1821 might find today’s Medico-Chirugical Society not what they would have expected. That is not a bad thing – all institutions must adapt to meet current needs in order to survive. Our first President would have approved – and would have recognised that central important objective of medical collegiality, being well fulfilled in the activities of today’s Med-Chi. He would be the first to subscribe to the doctrine that all work and no play makes Jack a dull boy and would include our interests and enjoyments in the toast to all things medical, that toast with which we are wont to end medical dinners in Edinburgh, and which is attributed to Andrew Duncan himself – Floreat Res Medica!