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Views & Reviews Between the Lines

Leave the quacks alone

BMJ 2012; 344 doi: (Published 08 February 2012) Cite this as: BMJ 2012;344:e843
  1. Theodore Dalrymple, writer and retired doctor

Joseph Sampson Gamgee (1828-1886) was one of three brothers all of whom made it into the Valhalla of British posthumous eminence, the Dictionary of National Biography. A surgeon, he is remembered today mainly for the absorbent dressing that he invented and whose use he advocated; he also had a quarrel with Joseph Lister over antisepsis. He was a contemporary of Lister’s at medical school and went on to examine Lister’s methods, which he praised though not without reservation. Lister took this badly, as if he who was not wholly for him was wholly against him. This is not a completely uncommon human trait, as anyone who has ever sat on a hospital committee will know.

Gamgee had been a surgeon in Malta during the Crimean war and was not altogether a sweet tempered man himself, at least if the tone of his pamphlet Medical Reform: a Social Question Comprehensively Studied with the Light of Philosophy, History, and Common Sense, published in 1857, is anything to go by. In the form of two open letters to the prime minister, Lord Palmerston, Gamgee attacked the Medical Reform Bill, which, once it became an act, established the General Medical Council and the medical register.

The pamphlet appears to have been written in white heat, as a last ditch attempt to avert the passing of the bill: “I hope in the few hours which elapse before the time appointed for the third reading of Mr Headlam’s bill, a resolution will be come to, if not to reject it for ever, to send it before a Select Committee . . .”

Gamgee’s objection was that the bill and act entrenched the power of what he called “the money-gorged palsied corporations,” that is to say the royal colleges of physicians and surgeons. On the latter he was particularly hard: “The ancients of the College of Surgeons have, in their dotage, been deaf to the voice of science, have struggled against popular opinion, have oppressed the Medical Profession; and at its expense, at the sacrifice of learning, and of the people’s welfare, have divided in a virtually self-elected coterie the proceeds of gain ill-gotten, by power undeserved, in a borough as rotten as old Sarum, but infinitely more disgraceful . . .”

Gamgee argued that there should be no medical monopoly and no medical orthodoxy, because it was from the free play of ideas and practices that truth and improvement emerged. He then, somewhat inconsistently, argued that the bill held doctors to a standard that did not apply to quacks but would not prevent them from practising: “The quack is a business-man, and always takes his fee before he gives his advice. And if he cannot be legally appointed surgeon to a hospital or a ship, may I ask, Has the ignorant, mischievous quack ever applied for those offices? You will say he will incur penalties if he does anything to imply that he is registered under the Act: then he will glory in his superior freedom, and have a large brass plate in his door, deeply lettered, ‘John Snooks, Herbal Doctor and water-caster, not registered.’”

Not that he thought quacks should be driven out of business: “As to the question of QUACKS, I have nothing to propose for their regulation; because I am unable to define them as to ensure their recognition by the officers of the law. Such a definition would be a real addition to the English Language and to lexicography generally.”

He then utters a cry anathema to all modern British politicians: “More reality, less tinsel, is what we want.” On the contrary, reply the politicians: more tinsel, less reality.


Cite this as: BMJ 2012;344:e843

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