This blog post from the British Library showcases a 15th-century manuscript (Harley MS 1760) containing a fascinating early example of medical licensing. The document grants "Master Nicholao" permission to practice medicine in the diocese of Norwich, specifically allowing him to treat internal ailments. Issued by the Bishop of Norwich, it highlights the Church's historical role in regulating medical practice and reveals contemporary understanding of medical specializations, differentiating between treating internal diseases and surgical procedures. The manuscript exemplifies the intersection of religious authority and healthcare in medieval England.
This blog post, entitled "Permission to Practise Medicine," hosted on the British Library's Digitised Manuscripts blog, delves into the fascinating historical context surrounding the regulation of medical practice, specifically focusing on a particular manuscript held within the library's extensive collection. This manuscript, dating back to the 15th century, specifically the year 1421, provides a tangible example of the early mechanisms employed to authorize individuals to engage in the practice of medicine. The document itself is a license, granted by the Bishop of London, to one John Somerset, permitting him to administer medical care. The post meticulously details the intricacies of the license, explaining that it granted Somerset permission to practice across the Diocese of London, a geographically significant area encompassing not only the city of London itself, but also extending into parts of Essex, Middlesex, and Hertfordshire. The author emphasizes the importance of such licensure within the medieval context, highlighting the Church's role in overseeing various aspects of societal life, including healthcare. Furthermore, the post underscores the distinction between physicians, trained at universities, and surgeons and other medical practitioners who typically lacked formal university education. It suggests that individuals like John Somerset, while licensed by the Bishop, likely fell into the latter category, serving a vital role in providing medical care to the populace despite not holding a university degree in medicine. The post concludes by observing the historical significance of this document as a testament to the long-standing concern for regulating the practice of medicine, ensuring some level of competency and oversight in a profession deeply impactful on public health and well-being. The inclusion of the specific date, 28th of January, further enhances the tangible connection to this historical event and allows for a more vivid imagining of this pivotal moment in the life of John Somerset and the history of medical licensing.
Summary of Comments ( 13 )
https://news.ycombinator.com/item?id=42832114
HN users discuss the historical context of medical licensing, highlighting how it served to protect established physicians and potentially stifle innovation. Some point out the inherent difficulty in assessing medical competence in earlier eras, lacking the standardized testing and scientific understanding we have today. Others draw parallels to modern regulatory hurdles faced by startups and new technologies, suggesting that licensing, while intended to protect the public, can also create barriers to entry and limit progress. The elitism and gatekeeping aspects of early licensing are also mentioned, with some arguing that similar dynamics still exist in modern healthcare systems. A few users express skepticism about the overall efficacy of medical licensing throughout history, questioning whether it has truly improved patient outcomes.
The Hacker News post titled "Permission to Practise Medicine," linking to a British Library blog post about a medieval physician's license, generated several interesting comments.
One commenter highlighted the striking similarities between the historical licensing process and modern medical regulation, noting the continued importance of established authorities granting permission to practice. They found it fascinating that core elements of professional certification have persisted across centuries.
Another commenter pointed out the irony of the physician, John of Burgundy, being licensed to practice in London despite apparently not being English. They connected this to the broader historical context of migration and the movement of skilled individuals across borders, suggesting that even in the Middle Ages, cities recognized and sought out expertise regardless of nationality.
A further comment focused on the text of the license itself, specifically the phrase granting permission "in the city and suburbs of London." This commenter questioned the geographical extent of the suburbs at that time and speculated on the challenges of defining the boundaries of the city's jurisdiction.
Someone else expressed surprise at the apparent lack of a requirement for formal medical education, contrasting it with modern stringent educational pathways for physicians. They wondered about the prevailing medical knowledge and practices of the period and how competency was assessed in the absence of standardized training.
The discussion also touched upon the role of the Bishop of London in granting the license, prompting a commenter to discuss the historical intertwining of religious authority and secular governance, particularly in matters of public health and welfare.
Finally, a commenter reflected on the broader historical context of the Black Death, suggesting that the licensing of physicians might have been partly a response to the devastating plague and a desire to regulate medical practices in a time of crisis. They pondered whether this period saw an increased emphasis on formalizing medical authority.
These comments collectively offer various perspectives on the historical license, touching on themes of professional regulation, migration, urban geography, medical education, religious authority, and the impact of historical events. They provide a richer understanding of the context surrounding the document and raise intriguing questions about the evolution of medical practice.