Reading the Regency

Gentlemen's occupations - The Law and Medicine

There were only twelve full-time Judges in England, who sat in the three common law courts: the King's Bench, the Court of Common Pleas, and the Exchequer. Every other judge in the country was a part-time position.

"The Twelve", as they were known, were chosen from the pool of qualified Barristers, and the power to appoint a judge was split between the Lord Chancellor and the Prime Minister, so their promotion was often politically influenced.

Accepting a judgeship might mean a loss of income for a Barrister, although they would benefit from an increase in prestige. A judge received £3,000 per year plus additional income from fees, while the most senior judges enjoyed slightly higher amounts. The Lord Chief Justice had an annual income of £4,000.

A Judge was appointed for life, although from 1799 pensions were available for those who wished to retire.

In the order of Precedence, a Judge stood between the peers and the gentry, so would be below a Baron, but above a Baronet. Anyone promoted to the position of Lord Chancellor would find themselves propelled up the ranks; positioned somewhere between the Royal Family and the most senior Duke of the realm.

Medicine

"...the Medical Profession does not possess so many splendid prizes as the Church and the Bar; and on that account perhaps is rarely, if ever, pursued by young men of noble families; it is by no means barren of honours and attractions: it opens the way to reputation and wealth, and raises the Physician to a level, in the intercourse of common life, with the highest classes of society."
[An Enquiry into the Duties of Men in the higher and middle classes of Society, by Thomas Gisbourne, M.A., pub 1795]

Medicine was at the bottom of the list when it came to acceptable occupations for a gentleman's son. While there were three main sources of medical assistance available during the Regency period, the Apothecary and the Surgeon were considered tradesmen, because of the physical and retail aspects of their work, and the manner of their training.

Apart from taking a pulse or listening to a heartbeat, Physicians limited their physical contact with patients. They visually observed and questioned, then suggested a course of treatment. They were not qualified to carry out surgical operations, and did not take blood, or produce and sell drugs. Because there was no physical labour involved in being a physician, and becoming one required an expensive education, it was considered acceptable for a gentleman's son or an aspiring, well educated young man from a middle-class family.

Physicians were also the only branch of the medical profession allowed to use "Doctor" as a title, (shortened to Dr. in writing) such as in the example Dr. James Hervey. The only time when physicians did not use "Doctor" was when they had a higher title, such as Sir Henry Halford, who was Physician to the King and the Prince Regent.

At the beginning of the 19th century, physicians needed a classical education and a number of university degrees to become a doctor. Once they had obtained a Bachelor of Arts (BA) degree, then they would study for the Bachelor of Medicine (BM), followed by the Doctor of Medicine. (MD) The course of study, after achieving the BA, could take ten years.

Oxford and Cambridge were not highly regarded as medical schools. They only offered a small number of lectures in medicine, and touched on no anatomical subjects. The lectures were not even a compulsory element of their study, and a young man could obtain a degree with only a rudimentary knowledge of medicine and after the appropriate number of terms.

The Scottish Universities at Edinburgh, Glasgow and St. Andrews offered more in-depth medical curriculum; the following lectures were available in Edinburgh:

"The lectures on anatomy, practice of physic, chemistry, materia medica, theory of physic, and midwifery, commence at the latter end of October, and terminate about the 30th April in the ensuing year, in the course of which time, between one hundred and forty and one hundred and fifty lectures are delivered, of an hour each, by each of the professors of these subjects."
[A Vindication of the University of Edinburgh as a school of medicine, by Lawson Whalley, M.D. pub. 1819]

Medical study in one of the Scottish universities was cheaper than in England, and also open to non-conformists and those without a strong knowledge of Latin or Greek.

Only those who obtained their medical degrees from Oxford or Cambridge, could become a Fellow of the Royal College of Physicians. The Physicians who were granted fellowships, rather than just licences, were considered the most "gentlemanly" of their profession, and would be more likely to be called upon by the nobility and upper levels of the gentry. Graduates of other universities would only be admitted to the college as licenciates.

The Royal College of Physicians examined physicians, and until 1820 all their examinations were carried out in Latin. Only licenciates or fellows of the Royal College could offer their services within a seven mile radius of London. There were 179 licenced physicians in 1800, and by 1811 the College of Physicians listed 230 licentiates and fellows in London.

In the rest of the country, outside the seven mile radius of London, there was no single system of licencing or registration. Physicians were often registered with, and licenced by, the local Bishop. Any doctor practising medicine without a licence would incur a fine of £5 per month.

Once a Physician was qualified it could take some time to develop a good reputation and build a reasonable client base. Taking over an established practice was the easiest way, but it was still possible to set up a new practice from scratch. Because physicians needed a number of clients who could afford to pay generously, they would most often be found in large towns and cities. A physician would not charge fixed fees, but received a gratuity from his patients, based partly on their wealth; the wealthier patients subsidising those who were less well off.

Generally, a physician with a steady practice of clients would receive an income of between £300-£1,000 per year, which was sufficient to give him a gentleman's income. Fashionable doctors practising in places like Bath, Buxton, Harrogate or Royal Leamington Spa, where older patients visited looking for cures, could expect to enjoy incomes at the top end of that range.

"We met only the Bretons at Chilham Castle, besides a Mr. and Mrs. Osborne and a Miss Lee staying in the house, and were only fourteen altogether. My brother and Fanny thought it the pleasantest party they had ever known there, and I was very well entertained by bits and scraps. I had long wanted to see Dr. Breton, and his wife amuses me very much with her affected refinement and elegance."
[Letter from Jane Austen to her sister Cassandra, 6th November 1813]

Physicians were treated with a great deal of respect by their patients. Those attending someone in a gentleman's home would often be expected to stay for dinner or invited to social events.

Physician Consultants were older, more experienced fellows of the Royal College, who were often brought in as a second opinion by another physician if he was not confident in his diagnosis, or had not come across a particular illness or disease before. Hospitals around the country would employ a Physician Consultant as their head doctor. These experienced men also treated peers and the gentry in London. By cultivating the right clients and becoming fashionable among the ton they could comfortably earn over £1,000 per annum.

If a Physician serving the highest members of London society made a name for himself, he might be asked to become a Physician Extraordinary to a member of the Royal Family, which would almost guarantee him a baronetcy or knighthood.

[Image: Portrait of Henry Brougham, Barrister and Lord Chancellor, 1st Baron Brougham and Vaux, by Sir Thomas Lawrence, 1825, via Wikimedia Commons. [Public Domain]]