Intended for healthcare professionals

Feature Christmas 2017: The Lives of Doctors

George Man Burrows and the anguished birth of general practice

BMJ 2017; 359 doi: (Published 14 December 2017) Cite this as: BMJ 2017;359:j5713

Stephen Gillam delves into the history of a man sometimes revered as the father of general practice

“And it is the business of the judges (the Court of Assistants), so to construe the Act, as to suppress the mischief and advance the remedy.” Thus, quoting Judge Blackstone and with a characteristic flourish, did George Man Burrows conclude A Statement of Circumstances Connected with the Apothecaries’ Act, and its Administration.1 Published in 1817, this intriguing document provides insights into the history of general practice that resonate today.

Burrows is now chiefly remembered as an expert on insanity. He has been strangely neglected for someone revered as the “father of general practice.”2 Why does he merit such claims? To what mischief does he refer, and what were his remedies?

Rise of the surgeon-apothecary

Before 1800, there was not one medical profession but three. The physicians, members of a learned profession, dealt with internal disorders. Surgeons were craftsmen whose sphere was still largely external. Apothecaries were tradesmen who dispensed physician’s prescriptions until they won the right to visit, advise, and prescribe.3 This well known tripartite division conceals the extent to which their respective practices overlapped with each other—and those of many untrained “irregulars.”

The rise of the surgeon-apothecary in the 18th century was in large measure driven by economic expediency. Most surgeons practised physic and pharmacy to survive, whereas apothecaries frequently undertook simple surgical procedures. Across the country in small towns and villages, most medical men—however they styled themselves—were undertaking much the same kind of general practice, involving all branches of medicine.

Burrows was born at Chalk, near Gravesend, in 1771. Educated at the King’s School, Canterbury, he was then apprenticed …

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