Here's how Scotland rose to the summit of medical science

First of all, however, I have been asked again by a reader to give a viewpoint – I occasionally do so in this column when history impinges on the present – about last week’s UK Supreme Court judgment and to try and put it into historical perspective.

I will do so in 10 words, uttered by Lord Richard Keen, KC when he was advocate general appearing for the UK Government in a previous Supreme Court case: “The UK Parliament is sovereign, the Scottish Parliament is not.”

Says it all, really, and as last week’s judgment showed, he was correct in law. All those people who delude themselves that the Scottish people are sovereign may be morally and spiritually right but in law and fact they are just not accurate.

Oh, and by the way, the establishment of the UK Supreme Court by Tony Blair’s government was itself clearly a breach of the Acts of Union which guaranteed the supremacy of Scotland’s courts.

Forget law courts, the only legitimate way out of the Union is democracy. Nicola Sturgeon has set a very high bar by declaring that if the next General Election sees a simple majority of Scottish voters opt for independence-supporting parties then the Westminster Parliament must give us a second referendum.

Sorry, but she is plain wrong. History shows us that the British state will fight tooth and nail to preserve itself and even a people’s majority won’t persuade the next UK Government of whatever shade to give us a referendum they might lose. Nor will unilateral secession from the Union work, as the rUK government will simply fail to co-operate.

Fifty per cent plus one just doesn’t cut it, I’m afraid. Until the polls, including the General Election, consistently show a clear majority in favour of independence then we are stuck in the Union. That’s why I am suggesting a lesson from recent history – all polls must show that there is consistently at least 53% in favour of independence. Why 53?

Well, that’s 1% more than the percentage that voted for Brexit in 2016. Gain that 53% and any Brexit-supporting government will find it very difficult to argue against a second referendum. If they do then refuse it, recourse to the United Nations and international law will be possible because Westminster will be seen to be oppressing the Scottish people.

Remember that just a few years after the Union, Parliament came within four votes of ending it. There was no people’s democracy back then but there is now and it will be the people who will win our independence at the ballot box.

But back to other matters. Scottish medicine was already well established and highly regarded before the Union of 1707 but there is no doubt in my mind that the Union boosted the development of medical science in Scotland in the 18th and 19th centuries as more funds and more opportunities to practise their science came the way of Scottish surgeons, physicians and apothecaries – the latter being the equivalent of modern-day pharmacists.

Right at the end of the 17th century, Edinburgh Town Council had insisted that the medical “crafts” formalise their activities. The result in 1699 from the Royal College of Physicians, which incorporated the apothecaries, was a textbook that revolutionised their science – the Pharmacopoeia Collegii Regii Medicorum Edinburgensis, better known as the Edinburgh Pharmacopoeia, which took 17 years to compile. It was not the first such publication as London and Dublin already had theirs, but the Edinburgh Pharmacopoeia became a standard reference work due to the thoroughness and efficacy of its recipes for curative treatments.

THE surgeons were also told by the council to build a proper establishment for the dissection of bodies, which the council was willing to allow. Thus Surgeons’ Hall came into being and the study of anatomy in the capital became an organised business with permission to carry out dissections on the bodies of foundlings and executed criminals whose families did not claim the corpses.

In 1705 the incorporation – later the College of Surgeons – was ready to have one man in charge of their dissecting activities and, from their number, one Robert Elliot was chosen as “public dissector”. Later that year, the council appointed Elliot as its first professor of anatomy and paid him the princely sum of £15 sterling per year. Edinburgh thus had the distinction of appointing the first anatomy professor in Britain.

The limited supply of corpses led to rumours anatomists were robbing local graves of fresh bodies for their work, and a crowd soon gathered to protest at Surgeons’ Hall. The surgeons had to issue a notice that no such activity had taken place and any of their members committing that crime would be expelled.

The anatomists needed protection and they found it at the city’s university. It would be a century later that resurrectionists – and murderers Burke and Hare – would see the mob’s fears realised.

But in 1724, an incident occurred which showed the city’s anatomists were anxious for bodies.

Maggie Dickson was prosecuted for causing the death of her child, and was hanged for the crime. Surgeon apprentices claimed her corpse, but at the last minute her family came from East Lothian and counter-claimed it. A fight ensued – during which knocking was heard from the coffin in which Maggie was very much alive.

Portrait of John Monro

As the sentence of hanging had already been carried out, she could not be hanged again and “Half-hangit Maggie” lived for many more years. There’s a pub in Edinburgh Grassmarket named after her, such has been the enduring nature of her story.

By 1720, there arrived the first professor of anatomy at the university, Alexander Monro (1697-1767), known as Primus because both his son and grandson gained the same role in succession to Primus, who himself was the son of the eminent surgeon John Monro (1670-1740). To this family must be accorded the highest praise for their work in making Scotland a leading nation in medical science.

John and Alexander had a vision for a new teaching institution based on the medical academies in continental universities but they wanted it to have a distinctly Scottish science-based approach.

In 1726, Edinburgh Medical School was begun within the university with its own premises following three years later. To this day, it remains one of the best medical education facilities in the world.

Last week I quoted from Charles W Thomson’s excellent piece of propaganda Scotland’s Work and Worth: An Epitome of Scotland’s Story from Early Times to the Twentieth Century, with a Survey of the Contributions of Scotsmen in Peace and in War to the Growth of the British Empire and the Progress of the World, published in two volumes in 1909.

I have no hesitation in doing so again because Thomson was one of the first authors to compile for the general public a list of medical people who had brought distinction to Scotland.

His praise for the Monros was unequivocal and he noted that: “Dr. Monro (Primus) was succeeded by his youngest son and namesake (1733-1817), who lectured for a full half-century, and added greatly to the sum of human knowledge, especially by his investigations into the nervous and lymphatic systems of the body. He in turn was succeeded by his son, Alexander Monro tertius (1773-1859), who held the chair of anatomy for nearly 40 years.”

THE Monros were also instrumental in the establishment of a small hospital holding no more than 12 patients, all of them from the poorer quarters of Edinburgh. Such was the work that John and Alexander did there that their friend and supporter George Drummond determined to do something even better and, as the greatest of all lord provosts of Edinburgh, he did so in his first period of office, starting in 1725.

The result was the magnificent Royal Infirmary of Edinburgh which has played so vital a part in the health of this nation.

In their unbroken 126 years holding the chair, the Monros did much to advance the science of anatomy and also brought great prestige to the medical school, but developments were not confined to Edinburgh. Glasgow, Aberdeen and St Andrews also had their own medical schools, with Glasgow University’s faculty of anatomy becoming very important in the middle of the 18th century.

That is because Dr William Cullen (1710-90) moved there in 1747. A product of Glasgow University, he had been in general practice in Hamilton and Glasgow before becoming lecturer in chemistry and medicine at his alma mater.

I have written before about Cullen who, among other achievements, invented mechanical refrigeration, a feat for which he has never received true recognition. I consider him to be one of the great products of the Scottish Enlightenment and he knew and was friends with all of its major figures, such as David Hume and Adam Smith.

Charles Thomson is in no doubt about Cullen’s worth: “There was founded for him the chair of medicine in that city [Glasgow]. Cullen lectured on both physic and chemistry until 1755, when he was transferred to Edinburgh, where for 35 years he was in turn Professor of Chemistry, Institutes of Medicine, and Medicine. “He gave a new dignity to chemistry by treating it as a science in itself, helpful to art and commerce, and not as a mere appanage of medicine. In medicine he did valuable service in the classification of diseases and in his inquiries into the nervous system.

“In particular, he investigated the phenomena of reflex action, and the results established by him led not long afterwards to the discovery of the distinction between sensory and motor nerve fibres.”

Cullen’s teaching methods earned him such distinction that thousands of pupils came from all over the world to attend his lectures. The idea of modern lectures was not invented by Cullen but he popularised his technique, particularly by giving lectures “on the spot” at Edinburgh Royal Infirmary.

Two pupils and associates of Cullen were to make their family noted in medical history while being examples of the many Scottish medical people who made their name in London.

William Hunter (1718-83) from East Kilbride moved to London in the 1740s and was soon recognised as the top surgeon of his day for his expertise in anatomy and obstetrics. From 1770, he used his wealth to accumulate many items and pieces of art which were bequeathed to Glasgow University to form Scotland’s oldest public museum, the Hunterian.

According to Charles Thomson, William’s brother John Hunter (1728-93) “reached even a greater degree of eminence in his profession. At the age of 20 he joined his brother in London. With much less talent as a lecturer, John gradually outdistanced his brother as an anatomist and the study of comparative anatomy engrossed much of his attention.

“In 1776 he was appointed surgeon-extraordinary to the king, and in 1789 inspector-general of hospitals, and surgeon-general of the army. He took a prominent part in founding the London Veterinary College.

“He is now generally recognised as an original investigator of much talent, and Sir Richard Owen, the zoologist, said of his work in comparative anatomy, ‘It appears to me that he marks a new epoch’.” He, too, founded a Hunterian Museum which is in the care of the Royal College of Surgeons in London.

All these great figures flourished in the 18th century and if anything the 19th century would produce many more Scots distinguished in medical science.