Royal College of Surgeons of Edinburgh 
                      

The 1897 stained glass window
which features the College's armorial bearings
overlooks the College's main staircase

Seven years from now, the Royal College of Surgeons of
Edinburgh will celebrate its Quincentennial. Having
enjoyed a continuous existence as a corporate body since
1505 AD, it may justly claim to be one of the oldest
surgical corporations in the world.

       1. The first 100 years, the Sixteenth Century and
          the Barber Surgeons
       2. The 1600s : the first permanent meeting place
       3. The 1700s : the growth of scientific medicine in
          Edinburgh
       4. The 1800s : a new meeting place, the Playfair
          Building
       5. Into the 20th Century: a period of expansion

The first 100 years, the Sixteenth Century and the Barber
Surgeons

In 1505, the Barber Surgeons of Edinburgh were formally
incorporated as a Craft Guild of the city and this
recognition is embodied in the Seal of Cause or Charter of
Privileges which was granted to the Barber Surgeons by the
Town Council of Edinburgh on 1st July 1505. The Seal of
Cause is a remarkable document. It clearly established the
role of the Incorporation of Barber Surgeons as a body
concerned with the maintenance and promotion of the
highest standards of surgical practice and this remains
the prime purpose of the great international surgical
brotherhood of The Royal College which has developed from
the Incorporation. The Seal of Cause conferred various
privileges upon the Incorporation, including the exclusive
right of its members to practise surgery in Edinburgh and
surrounding districts, but in return for these privileges,
it imposed certain crucially important duties and
obligations. The most important of these, which remains
entirely appropriate to this day, is stated very clearly
in the Seal of Cause. "... that no manner of person occupy
or practise any points of our said craft of surgery...
unless he be worthy and expert in all points belonging to
the said craft, diligently and expertly examined and
admitted by the Maisters of the said craft and that he
know Anatomy and the nature and complexion of every member
of the human body... for every man ocht to know the nature
and substance of everything that he works or else he is
negligent." From its earliest origins the College has been
an examining body principally concerned with the setting
and maintenance of professional standards. Another vitally
important obligation laid upon the Barber Surgeons was
that of ensuring that all who practise the craft should be
able to read and write and this literacy requirement is
the earliest of any comparable professional body.

The Seal of Cause recognised the importance of a thorough
knowledge of Anatomy for the practice of surgery and in
order that the Incorporation might maintain a high
standard of anatomical knowledge amongst its members it
was granted the right to have the body of one executed
criminal per annum for the purposes of anatomical
dissection. Having regard to the very strong religious,
cultural and social prejudices against dissection of the
human body, this was indeed an extraordinary dispensation.
The Seal of Cause was confirmed on the 13th of October
1506 by a Royal Charter granted by King James IV of
Scotland, arguably the most interesting and attractive
figure of the entire Stuart dynasty.

[arjames4.jpg (4377 bytes)] A man of many diverse
                            accomplishments, his long and
stable reign was for Scotland a brief golden age. King
James was particularly fascinated by medical science and
we have clear evidence that he was a skilled and
enthusiastic practical surgeon and dentist.

During the 16th Century the Incorporation met in the house
of its Deacon but meetings were occasionally held in one
of the aisles of St. Giles Kirk and because of this the
Deacon was sometimes referred to as the `Kirk Maister'.
The early records of the Incorporation are somewhat
fragmented but the names of most of its early Office
Bearers are recorded in minutes of the Town Council. From
1581 onwards, its records are complete. One of the most
important landmarks in the early history of the Barber
Surgeons is the Royal Charter granted to them by Mary
Queen of Scots, the grand-daughter of James IV, on 11th
May 1567. This notable document - which is often referred
to as the " Barber Surgeons' letter of exemption ",
formally relieved members of the Incorporation from the
obligation to bear arms in defence of the realm but
obliged them to treat sick and wounded soldiers in the
Queen's armies - is the first formal statement anywhere of
the non-combatant role of the army doctor.

Gilbert Primrose, who was elected Deacon of the Barber
Surgeons on three separate occasions, was appointed
Surgeon to King James VI of Scotland and when the King
succeeded to the English throne, in 1603, Primrose went
south with him and became Chief Surgeon to the Royal
Household in London. Because of Primrose's prestige and
the force of his personality, the status of the
Incorporation of Barber Surgeons became progressively
enhanced and, in 1583, it was formally recognised by the
Town Council as the premier craft guild. Several members
of the Incorporation gained wide experience of military
surgery through service with various European armies
during the Thirty Years War and many others later served
in the Scottish Covenanting Armies of the 1640's.

The 1600's : the first permanent meeting place

By the end of the 16th Century, a distinction had
developed between the Barbers, who simply cut and shaved
hair, and the Barber Surgeons, who also practised the more
skilled craft of blood letting and other forms of surgery.
The Surgeons gradually abandoned hair cutting and shaving,
but frequent disputes arose between the two branches of
the Incorporation concerning the rightful scope of their
work.


        In 1647 the Incorporation acquired for the first
time a permanent meeting place by renting three rooms of a
tenement in Dickson's Close. Later, after joining forces
with the Apothecaries, the Incorporation laid out in their
grounds at Curriehill the first Edinburgh Physic Garden.
In this were grown all kinds of medicinal herbs which
enabled the Surgeon/Apothecaries to train their
apprentices in the recognition of the plants which formed
the basis of Materia Medica at that time.

By the end of the 17th Century, an increasing number of
Edinburgh Surgeons had acquired a formal academic training
in medicine and certain Physicians had begun also to
practise surgery. The most notable of these was Archibald
Pitcairne, who became Professor of Medicine in the
University of Leiden where amongst his students were many
Scots. He returned to Edinburgh in 1693 and joined the
Incorporation of Barber Surgeons in 1701. The admission of
Pitcairne and other `Doctors' to the Incorporation did
much to enhance its prestige and to establish surgery
clearly as a reputable branch of medicine.

In 1695, the Incorporation was granted a new charter by
King William III and Queen Mary, which confirmed the
jurisdiction of the Surgeon-Apothecaries over the practice
of surgery in Edinburgh and the south-east of Scotland.
The charter also confirmed the Incorporation's
responsibility for anatomical teaching and this prompted
it to apply to the Town Council for more bodies for
dissection. The Council approved this application on the
condition that the Incorporation provided an anatomical
theatre. Work on what is now known as " Old Surgeons' Hall
" , in High School Yards, was started and by 1697 was
completed and occupied. The first public dissections were
conducted there in 1703.


Old Surgeons' Hall

The 1700's : the growth of scientific medicine in
Edinburgh

The Faculty of Medicine in the University of Edinburgh was
established in 1726 and no one did more to achieve this
than John Monro, who was Deacon of the Incorporation of
Surgeons from 1712 to 1713. Monro's son, Alexander Monro
(Primus), became Professor of Anatomy in the University in
1719 and his brilliance as a teacher attracted students
from all over the British Isles and even from the North
American Colonies. He also played a notable part in the
establishment of the Edinburgh Royal Infirmary. The
University Faculty of Medicine and The Royal Infirmary
were responsible for the rapid development in Edinburgh of
systematic medical teaching on a sound scientific basis.
Surgery, however, suffered from the effects of a lingering
academic prejudice against what was perceived to be a
manual craft rather than an intellectual discipline.
Formal surgical teaching consisted of only a few lectures
grudgingly appended to the University course in Anatomy.
These surgical lectures were delivered by two successive
Professors of Anatomy, Alexander Monro (Secundus) and
Alexander Monro (Tertius), the son and grandson of
Alexander Monro (Primus), who were physicians without any
surgical training. This was bitterly resented by the
Incorporation of Surgeons and prompted certain of its
members to exercise their historical right to teach
surgery independently within the city. The energy and
enthusiasm of these teachers more than compensated for the
surgical deficiencies of the University Medical Course and
certain of them, most notably Benjamin Bell and the
brothers, John and Charles Bell (to whom he was not
related) did much to establish Edinburgh's reputation as a
centre of surgical teaching.

The College agitated strongly for the establishment of a
Chair of Clinical Surgery in Edinburgh University and this
was eventually approved in 1803. The College also pressed
for the establishment of a University Chair of Systematic
Surgery and, when this proposal was rejected, a Chair of
Surgery within the College was set up in 1804. In 1831,
surgical teaching within the academic curriculum was
finally separated from Anatomy by the institution in the
University of a Chair of Systematic Surgery and, as a
result of this, the College Chair of Surgery was allowed
to lapse in 1833.

On 22nd May 1778, King George III granted a new Charter
whereby the Surgeons were incorporated anew under the
title " Royal College of Surgeons of the City of Edinburgh
" . This did not completely separate the College from its
connection with the Town Council. A further Charter,
granted by Queen Victoria in 1851, completed the severance
of the College from the Town Council and changed its title
to its present form. Her Majesty Queen Elizabeth II was
graciously pleased in 1979 to grant the College its sixth
Royal Charter.

The 1800's : a new meeting place, the Playfair Building

By the beginning of the 19th Century, the Old Surgeons'
Hall had become inadequate for the College and there was
an urgent need to provide suitable accommodation for the
large collection of anatomical and surgical specimens
which had been presented to the College by Dr John
Barclay. A site for this was acquired by the purchase of
the Riding School in Nicolson Street. William Henry
Playfair, 1790-1857, the foremost Scottish architect of
that era, was commissioned to design a building containing
a meeting hall, Museum, Lecture Room and Library as its
principal apartments. The original plans are preserved in
the College archives and the handsome furniture, designed
by him for the College building, is still in use to this
day.

Into the 20th Century: a period of expansion

In July 1905, the College celebrated the fourth centenary
of its Incorporation and the most important occasion was
the conferment of the Honorary Fellowship upon 36 of the
world's most distinguished surgeons. These included Lord
Lister, the acknowledged " Father of Modern Surgery " who
had become a Fellow in 1855 and he is the only Fellow of
the College ever to be awarded its Honorary Fellowship. In
1955, on the 450th Anniversary of the foundation of the
College, the Honorary Fellowship was conferred upon His
Royal Highness, the Duke of Edinburgh, who had graciously
consented to become Patron of the College earlier in that
year.

The same year marked the advent of the Journal of the
Royal College of Surgeons of Edinburgh, which, under the
Editorship of Sir John Bruce, rapidly achieved world-wide
recognition. The Annual Clinical Meeting of Fellows has
developed into an important scientific occasion, in which
distinguished surgeons from all over the world
participate. The first College meeting outwith Edinburgh
was held in 1960. This has been repeated every year since
then. Some years later, certain senior Egyptian Fellows
invited the College to visit Egypt and, in 1976, the first
full scale College meeting to be held outwith the British
Isles took place in Cairo and Alexandria. Further overseas
meetings have been held in Jamaica, Sri Lanka, Singapore,
Kenya, India and Malaysia and the next overseas meeting is
due to take place in Hong Kong in October 1996.

During the first two centuries of its existence, the
Incorporation of Surgeons admitted to membership those
apprentices who had been trained for six years by master
surgeons and who had given satisfactory service. A
statutory fee had to be paid and the aspiring surgeon was
required to produce his `ticket' as a Burgess of the City
of Edinburgh, but the most important condition of entry
was the passing of an examination, conducted by the senior
members of the Incorporation.

In 1851, it was decided that admission to the Fellowship
of the College should be purely by election. It was not
until 1884 that the Fellowship Examination was
re-introduced. From its inception, the examination
flourished and the recruitment of candidates increased
steadily during the early years of the 20th Century. A
considerable number of those were from overseas and soon
many Fellows of the College were to be found in senior
surgical posts in Australia, Canada, New Zealand, South
Africa, India and in all other parts of what was then the
British Empire.

During the 20th Century, the form and content of the
Fellowship Examination has been progressively adapted to
changes in surgical science and practice and in accordance
with changing patterns of surgical training. The College
has always been prompt to recognise the need for such
adaptation, which it has managed to achieve without any
diminution of standards.

At the end of the 20th Century, the College has nearly
13,000 Fellows of whom some 6,300 live in the British
Isles. The others are to be found in all parts of the
world, but whatever their location, the Fellows are
concerned to fulfil the prime purpose of the College which
is, quite simply, the maintenance and promotion of the
highest standards of surgical practice and surgical
training. Until very recently, the College has been
concerned almost entirely with the setting of standards
and the conduct of examinations designed to ensure that
these standards are being maintained, but as we approach
the 21st Century and our Quincentennial, the College will
increasingly be concerned with the provision of surgical
education and training in addition to maintaining and
enhancing its historic role. Dr Helen Dingwall has
commenced work on the production, for the Quincentennial,
of a new History of the College and this will be a record
of how a local Craft Guild in the capital city of a small,
poor nation on the fringe of Europe developed over 500
years into a large international organisation of high
repute. It will be a record of notable service to Humanity
of which all Fellows of the College can be justly proud.