Rose v Royal College of Physicians

Hungerford Market, London, engraved by R.C. West, 1805[4]

Seale was a poor butcher in Hungerford Market, London, during the winter of 1699-1700.[1] He lived near to Rose and according to Rose, was suffering from venereal disease and was not trustworthy; he "hath been a very loose liver, and very much addicted to women, the effects of which fell sorely upon him the last years."[5]

An eighteenth-century apothecary's shop recreated for the Deutsches Museum in Nürnberg[6]

During the trial, Rose was an influential and high ranking liveryman of the Society of Apothecaries, associating with London's wealthiest citizens. His brothers included Thomas Rose and Francis Rose who patented land in Jamaica, and John Rose, a London merchant, who traded with Jamaica and transported labourers there on his ships.[7] Another brother, Fulke Rose, was an early colonist of Jamaica whose widow eventually married Sir Hans Sloane.[8]

Meeting of the College of Physicians as imagined by Rowlandson and Pugin. Aquatint by J. Bluck, 1808.[9]

Throughout the 17th century, the College actively controlled medical licensing in London by punishing those involved in "malapraxa".[10] The founding RCP charter of 1518 had established the duty of the censor as to "enquire about all practitioners of medicine ... to examine, correct and govern them, if necessary to prosecute them".[11]

The RCP, in addition, was unable to stop a Bill (law) in 1694, which gave the Society of Apothecaries certain exemptions and recognition that apothecaries were caring for an increasing number of Londoners, many more than physicians.[5]

Apothecaries Hall, Pilgrim St Engraved by John James Hinchliff from a drawing by Thomas Hosmer Shepherd, c. 1850.[12]

Apothecaries originated in the supply of medicinal spices and herbs, gained a separate identity from grocers in 1617, and established a right to treat the sick during the plague of 1665, when many physicians and their rich patients fled London.[13] By the time of the trial, apothecaries were appearing increasingly on the list of highest tax payers and the Society of Apothecaries was also “one of the most considerable corporations of London" and "politically powerful".[5]

Only College members could practise ‘physick’, but the question of what constituted practise of physick was debated. Seale was angry enough to speak to a committee of censors at the College in Warwick lane, accusing Rose of giving him 'physick' from 5 December 1699 to January 1700.[5]

Sir John Holt by Richard van Bleeck, oil on canvas, c. 1700. National Portrait Gallery, London.[15]

Whether Rose stood in his own defence or was even summoned was not documented, but it was the College’s intention to put him before judge and jury. The College annals stated their decision: “that Mr Swift, the attorney of the College prosecute the said William Rose forthwith”.[13] In the meantime, Seale had accused Rose of returning to him with rage against the allegations. Mr Swift, with the support of the King’s Bench subsequently ensured that the jury found Rose guilty of compounding several medicines and selling them to Seale – infringing on the privileges of the physicians as set in the College's charter and endorsed by the Privileges and Authority of Physicians in London Act 1523. Sir John Holt, leading Whig judge, made his judgement and fined Rose £5, equivalent to one month’s practice (about £817 in 2019).[3][13]

The Society of Apothecaries were represented by Thomas Powys and Samuel Dodd[13][14] and indicated that the consequences of prosecuting him would be devastating not only to Rose but to all apothecaries, who would not be able to practise their profession without the licence of a physician. They also emphasised outdated laws and charters.[5][20] Dodd also stated “I am not only for the apothecaries but for all the poor people of England”.[13] The trial record showed that Rose had merely made up the medicines and there was no evidence that he advised or sold Seale medicines. In addition, Seale was deemed to be suffering from a minor ailment, one that an apothecary would be attending to.[13] Their statement confirmed that the apothecary had always gone about their work this way and it “may not be deemed unlawful”[1] if they advise common medicines for common conditions or if they practised as a physician without fee. They accused the physicians of monopolising “physick”, which if continued, would be a burden and damaging to people who when slightly ill would not be able to obtain medicines without consulting and giving a fee to member of the College. In addition, it would prejudice those who suddenly became unwell at night and would usually call for the apothecary.[5][20]

The College argued that the appeal was unfounded and contrary to the Society’s account, College members were directed to give advice to the poor and visit them at home as necessary. They accused apothecaries of having high charges for medicines, which frequently made people feel worse. As a result they had been compelled to open dispensaries in London so that the poor could see a physician for free and pay for medicines at a lesser cost. They disputed that apothecaries were needed to deal with common complaints – neighbours and family could deal with these lesser minor ailments, or better still, they could self-care. That the apothecary was necessary was doubtful in the eyes of the College and they continued to reiterate that physicians were just as easily accessible in the city. They were adamant that apothecaries should not “judge” a disease and then advocate a medicine – not only would this be dangerous but likely to be further chargeable. A particular note on assessing diseases in its early stage was made, with the College saying that diseases are often difficult to decipher early on and that apothecaries were not qualified and therefore it was unsafe: “the management thereof ought not to be left to their judgement”.[14] They concluded that should the apothecary make a mistake, eventually, the physician would be needed to correct it.[14]

After the hearing, the House of Lords stated: “That the said judgement given in Queen’s Bench…against the said William Rose, shall be, and is hereby, reversed."[3] This was the crucial moment of the legal recognition of apothecaries as the “medico-pharmaceutical practitioner” or doctors.[3][13][21]

The decision established the right of apothecaries to give advice as well as to dispense medicines.[22][23]