There seems to be a general impression that the 17th and early 18th centuries were a bad time to get ill. But in fact, as Peter Amsden said, "All in all the history of medicine in the UK is one of immense complication". As compared with today, things were very uneven; anatomy was way ahead, perfectly adequate for most purposes. Surgical instruments had been manufactured with beautiful skill and ingenuity since at least the time of the Pompei eruption. Physiology, the function of body parts, lagged considerably. Perhaps worst of all was the lack of medical registration and accreditation - it was difficult to detect quacks. And lack of social welfare; most couldn't afford treatment. Home knowledge and treatment were good - better than today (servants performed many small operations that would today be done in a G.P.'s surgery till about 1800 -bleeding, cupping, eexcising tumours. And mothers knew incubation periods for infectious diseases until about 50 years ago, without books). Nursing, before 1850 (Nightingale) was not a serious subject. Just sentimental twaddle. Diagnostic procedures were rudimentary except for surgical lesions. Probably worst of all, was the stigma attached to surgeons and their profession, combined with a corresponding ridiculous over-valuation of physicians. Surgery was enormously hampered by lack of anaesthesia and asepsis, or blood-transfusions (which were I think still illegal after disastrous early attempts) even more than was physics by lack of present-day antibiotics and other drugs. Understandably, if there was the slightest chance that your gangrene could be cured by a tobacco-smoke enema, you would prefer that to amputation. Bleeding was no doubt a sensible way of reducing BP, but was used even for gun-shot wounds. Snail-water went out only in the 20th C. Vile and useless ingredients were common in prescriptions till around 1800; probably only about a quarter of receipts did any good at all. Deaths tended to be blamed on surgeons rather than inappropriate medication, because of the shorter time-lapse. Today, observation and auscultation skills have been almost lost due to the ready and over-used tools such as lab tests and Xrays. Many doctors who jeer at herbal remedies forget modern drugs evolved from them, and they would be lost - unlike their predecessors- if a war destroyed their hospitals. The high reputation of 17th C physicians was on the whole quite undeserved, and the low one of the surgeons they so despised, equally so. Surgeons moved with the times, always developing new skills (such as amputations in a record time), whilst physicians were conceited fops and quacks, still immersed in Galen and Hippocrates. Only in recent times do surgery and medicine unite sucessfully. Superstition dies slowly; I recall (recovering from scarlet fever 50 years ago) that health authorities had no faith in disinfectants unless they were black, evil-smelling, and toxic. Drastic meant good, like white dogs' faeces in medicine earlier on! What we call 'progress' is largely chance change of focus, in that dignosis of chest diseases (without the aid of 'cheats' such as Xrays) reached a never-surpassed peak around 1900. And even uroscopy (diagnosis of everything by urine inspection) might have reached perfection if nothing else had replaced it for six centuries. John Barton

Hello All So where does the Chirurgeon fit in and what would his part have been Were his duties simply bleeding a couple of times a year. Despite parents who could not sign their own signatures my 3ggrandfather was the local schoolmaster and chirurgeon in a small country village on the Shropshire Worcestershire border from about 1825 regards Chris Bartlett