The 200th Anniversary of the founding of the Belfast Medical Society : From a toast at the Ulster Medical Society Presidential Dinner, in the Great Hall, Queen's University Belfast, Friday 3rd March 2006

Abstract

In 1806 Belfast was a small town at the mouth of the river Lagan, with a population of about 20,000. The population of Ireland at that time was about 5.5 million, which is very similar to the population of the whole island today, so the influence of Belfast and its citizens would have been proportionately much less than now. There was no general hospital (the small fever hospital had opened in Berry Street in 1797 with only six beds, which was the predecessor of the Royal Victoria Hospital). There was no University or Medical school. The Belfast Charitable Society in Clifton Street was the only public charity with a health aspect, providing a dispensary service from the same building that survives to this day. The only grammar school was the Belfast Royal Academy, established in 1786 in Donegall Street, which in 1806 had 120 day boys and 60 boarders. The first intimations of what was to become the Royal Belfast Academical Institution in 1810 were being voiced, but education for women would have to wait until Mrs Margaret Byers opened her school in 1859, which later became Victoria College. The social scene was set by the 2nd Marquis of Donegall, who lived in his town house at the top of what is now Donegall Place, and maintained a small country seat in Ormeau Park – he was deeply in debt, but exhibited a suitably aristocratic nonchalance and was generally popular. The industrialization of Belfast was yet to come – there were a few small dry spinning mills but most of the linen manufacture was by hand loom in the countryside. Shipbuilding had just started in Ritchie's dock, in a small way, and the Clarendon dry dock (which still survives) had just been opened, both on the other side of the river from what became Queen's Island. In political terms King George III was on the throne, and the Act of Union had been passed in 1800 so that Irish government had centralized to Westminster following the problems of 1798. The Battle of Trafalgar in 1805 had established British naval superiority, but the fear of Napoleon was still alive. The Napoleonic code of legal statutes was in process of development in France, to become the foundation of the present day European Law – perhaps in some ways Napoleon did win, in spite of Waterloo! The origins of the Belfast Medical Society have been carefully recorded by Dr Andrew Malcolm, and are worth reading in full. BELFAST MEDICAL SOCIETY “The Physicians and Surgeons of Belfast, in 1806, though only nineteen in number, were actuated by the same spirit for mutual improvement in their common profession, which has ever distinguished the most celebrated seats of medical science. We are proud to think that, at so remote a period, the practitioners of Belfast aimed at something more than independent efforts for professional distinction. When men united, as they did, for the purpose of affording to each an equal opportunity of obtaining professional information, so far as it can be obtained from a re-union, by the contributions of all, the true spirit of professional advancement is theirs. It is mentioned in the records of this date, that the most respectable physicians, surgeons and apothecaries, not merely of the town, but of the vicinity likewise, soon became enrolled under the designation of “THE BELFAST MEDICAL SOCIETY”. The annual subscription was fixed at one guinea, and the selection and purchase of books etc, were entrusted to an elected Committee. It is to be remembered, as a feature of this early institution, that among the members, were included, by an original resolution, several gentlemen not belonging to the profession, who were nevertheless, desirous of expressing their approval of its objects. It was also an original intention to form a collection of anatomical preparations, as an additional attraction to the Library. The following members formed the first Committee:- SS Thomson MD, President; William Haliday MD, William Drennan MD, Robert M'Gee MD, Robert M'Cluney, Surgeon; Andrew Marshall, Surgeon, Secretary and Treasurer. A record of this Society is preserved up till the year 1814, during which Drs Haliday, Thomson, Drennan and M'Cluney were successively Presidents; and Drs M'Cluney, A Marshall, R M'Gee and SS Thomson, in like manner, filled the united offices of Secretary and Treasurer. Subsequently, it would appear, the affairs became neglected, in consequence of serious differences of opinion among the Hospital attendants, who were then the main supporters of the Society. The demon of discord invaded its ranks, and a dissolution soon ensued. It was, at first, contemplated to dispose of the property, which chiefly comprised valuable donations from Dr Drennan and Dr William Haliday, among the members; but, this being over-ruled, the books were returned to the donors. After a little time, principally through the influence of the late Dr Stephenson, the volumes were replaced; notwithstanding, for a period of four years after the Society ceased to exist. The original spirit which prompted to the formation of the Society, did not, however, entirely expire. The name of Dr R Stephenson is here associated with the revival of the Society, in 1822, in connection with those of Dr Forcade, Mr Moore, RN and Dr M'Donnell. These four – only one of whom, as respected President, survives at the present day – met together on the 8th May of that year, and formed the nucleus of the present Ulster Medical Society. Before the year expired, the following gentlemen became enrolled as members, viz:- Mr Bryson, Mr M'Cleery, Dr Coffey, Dr M'Kibben, Dr Haliday, Dr Young and Mr Mawhinney. From this time forward there were continual accessions to its ranks, which have been gradually extending, up till the present day. The unfortunate circumstance, to which we have briefly alluded above, must certainly be deemed a blot upon our medical annals; but it is consolatory to know, that one at least of the members of the original Society heartily co-operated with the projectors of the renewed Association, to wipe away the stain. We allude to the late Dr SS Thomson, whose position among his professional brethren was ever so exalted and endearing, that we agreed, during the latter part of his active life, when his years also gave him a claim to the appellation, in designing him “the father of the profession”. AG Malcolm. The History of the General Hospital, Belfast 1851. Because the original minute book is no longer available (is it possible that Dr Malcolm did not return it after writing his history?), it is not possible to identify all of the 19 original doctors who founded the Belfast Medical Society. With the assistance of Professor Richard Clarke, some information is available for six of them, and three have portraits. These six were relatively young, and all held responsible medical positions in the fledgling town of Belfast. Five, at least received their medical education in Scotland, mostly in Edinburgh, so some thoughts on the background to Scottish medical thinking at the end of the “Scottish Enlightenment” may not be inappropriate. Dr Samuel Smith Thomson (1778-1849) came from Coleraine ( Fig 1 ), and received his MD Edinburgh in 1800 with a thesis on measles. In 1806 he was aged 28, and was the first President of the new Society. He was physician to the Belfast Fever Hospital, and subsequently to the Belfast Lying-In Hospital and the Belfast Lunatic Asylum: his broader interests included the foundation of the Anacreontic Society, subsequently the Belfast Philharmonic Society. In later life he was presented with a gold snuffbox inscribed by his colleagues, and was considered to be “the father of the profession”. His portrait still hangs in the Board Room of the Royal Victoria Hospital. His memorial in the First Presbyterian Church, Rosemary Street, Belfast records “As a physician he deservedly rose to the highest eminence and was looked to by all his brethren as their friend, their adviser and the zealous supporter of their honour and their rights. In all his charities he was generous, in all his principles liberal. Deeply impressed with religious feeling, his character was marked by faithfulness and affection in his friendships, by sincerity and candour in his opinions, and by courtesy and gentleness to all”. Dr William Haliday (1763-1836) was aged 43, and had received his MA in Glasgow followed by MD in Edinburgh in 1786, with a thesis on Electricity in Medicine. He had practised in Newry (which was then a larger town than Belfast), and was associated with his uncle, Dr Alexander Haliday, who was active in liberal politics in Belfast at the end of the 18th century, including the Volunteer conventions. In 1806 he was physician to the Belfast Poor House. Dr William Drennan (1754-1820) was the oldest founder member, ( Fig 2 ) aged 52: he had also studied in Glasgow and Edinburgh, qualifying MD Edinburgh in 1778 with a thesis on febrile convulsions. He had practised in Belfast, Newry and Dublin, and eventually retired in 1807 to live with his sister Martha McTier in the country house still called Cabin Hill, in Knock. He had been a founder member of the United Irishmen, was tried for sedition in 1794 but acquitted, and later was one of the founders of the Royal Belfast Academical Institution. Among other reminiscences is one in a letter to his mother from Edinburgh “to be a student of medicine is a term of contempt, but to be an Irish student of medicine is the very highest complication of disgrace”. The Ulster Historical Society blue plaque on the building adjacent to Rosemary Street Church tersely states “Dr William Drennan, Patriot and Radical, born in the manse on this site”. Dr Robert M'Gee (1766-1842) was age 40 in 1806: he had studied medicine at Glasgow, eventually obtaining the CM degree in 1821. He was in general practice in Lancaster Street in 1810, and later Physician to the Belfast Charitable Society. Dr Robert M'Cluney (1768-1837) was one of the founding surgeons of the Belfast Fever Hospital in 1797, and remained on the staff until 1828. He was aged 38 in 1806, and was one of those whose name is inscribed on the gold snuffbox presented to Dr SS Thomson in 1834. Dr Andrew Marshall (1779-1868) had a more unusual training, initially as a surgeon's mate in the Royal Navy, becoming a surgeon in 1802. He then took the LRCP Edin. In 1804 and in the same year the Licence of Apothecarys Hall, Dublin (LAH). Eventually he took the MD Glasgow in 1834. He practised initially as an apothecary at 98 High Street, Belfast. After return to the navy, where he was present at the capture of the island of Heligoland in 1807, he became surgeon to the Belfast Fever Hospital (1807-1828) and a moving force in the building of the new General Hospital in l817. His portrait is also in the Board Room, Royal Victoria Hospital ( Fig 3 ). An interesting sidelight on these founding fathers of the Belfast Medical Society is that most of them are buried in the Clifton Street graveyard – perhaps a necessary qualification for ultimate historical recognition. But they must all have been influenced by the Scottish enlightenment, which perhaps encouraged some of them in their more liberal views. They would have known the writings of Frances Hutcheson (1694-1746), from Drumalig and Saintfield in County Down, whose System of Moral Philosophy and doctrine of happiness underlay much of the enlightened thought: he had been Professor of Moral Philosophy in Glasgow from 1729, and is remembered now for his concept of “the greatest happiness for the greatest number”. The critical, even atheist, views of his philosophical successor in Edinburgh, David Hume, would have caused more theological concern in the Belfast of the day, but perhaps the greatest and most lasting influence was from Adam Smith (1723-1790), whose iconic writings on what became the science of economics continue to support the concept of the “free market”. We are well advanced in medicine nowadays in what he called the “division of labour” – which we call specialization. He foresaw capitalism, with all its problems; “we become buyers and sellers, customers and suppliers, eventually some people do nothing at all but think about improvements – philosophers, teachers, and professional managers of every sort”. He made his name by accurately forecasting the loss of the American colonies due to inept central government in London. Today we would agree that “the important beneficiary of the free market is not the businessman but the consumer” – that is if there still is a concept of a free market in medicine, in which case the consumer is the patient. Thirty years ago Professor DAD Montgomery had entitled his presidential address “The Ulster Medical Society – Quo Vadis”. I have begun, as he did, with the 19 Ulster doctors recorded by Malcolm who got together for their professional benefit. They had problems in working together, and perhaps their exposure to the thoughts of the Scottish enlightenment encouraged them in their individuality. Ultimately we all have become specialized, but in Desmond Montgomery's words – “if our society is to realise its potential as a unique integrating force in medicine it must continue to provide a platform where clinician and specialist can communicate with each other..... it must remain an active, integrated, eclectic society concerned with and informed of all aspects of medicine as it is practiced today. If we are truly men and women of vision..... of integrity..... of dedication, we shall not fail to hand on a Society worthy of those who will follow us. It is to them that we pledge ourselves tonight”.