A measure of the elite : a history of medical practitioners in Harley Street, 1845-1914

摘要

Though Harley Street has been viewed as the provenance of the medical elite in Britain, no attempt has been made to systematically examine this elite in its historical context or to consider the veracity of this view. Hence, this thesis reconstructs the totality of all the male (n = 657) and female (n = 24) medical practitioners who arrived in Harley Street from 1845-1914 by undertaking a prosopographical analysis and contextualising the historical background in which they lived and worked. Over the course of the nineteenth century, Harley Street became a progressively more fashionable choice for medical practitioners wishing to establish a practice in London and in most cases, this address represented the pinnacle of their career trajectory. It is argued here that an elite medical enclave did, indeed, establish itself in this geographical area during the period. The group's reputation was assessed through their medical qualifications, scholarships, prizes, teaching and hospital posts, publications, public lectures and their role in medical societies. Harley Street medical practitioners differed from other London medical practitioners because they published more material (85 of the cohort in general and 93 percent of the cohort who qualified MD published their work, in contrast to up to 50 per cent of London medical practitioners), had more prestigious qualifications (86 per cent were qualified MD, MB, FRCP, FRCS or MRCP in contrast to approximately 25 per cent in Greater London), were members of medical societies (almost 90 per cent of the cohort in contrast to between 40 and 50 per cent of GPs in Britain), created new medical specialities, established specialist hospitals, took prominent roles in medical societies and delivered renowned public lectures that were published in the main medical journals. Moreover, this group wielded considerable collective editorial control in a wide range of medical publications. Hence, their efforts greatly facilitated the professionalisation of medicine in the late nineteenth and early twentieth centuries. Through their senior hospital and teaching posts the cohort had an important influence on the next generation of medical practitioners, as these connections were crucial in attracting new medical practitioners to the Street. This thesis, therefore, determines whether Harley Street can be regarded as a measure of the medical elite.