Practice
Medicine was practiced in a wide array of settings. It was practiced by one of a multitude of different practitioners, wielding a variety of licenses. Social class delineated between one practitioner and the next; professional standards were as obscure as female practitioners. Fees ranged from a mere token to a handsome sum wrapped in paper and placed on a nearby table, to allow for discreet collection later. Despite common notions, the Victorian Age was full of medical practitioners, the possible wealth, rank, and social status that were associated with the practice of medicine appealed to many. (Mitchell, Victorian Britain 491)
Doctors and physicians occupied the highest rung on the social ladder. Such citizens were considered gentleman because 1) their training did not include apprenticeship and 2) the profession excluded, supposedly, manual labor. Doctors were permitted to dine with the family during home visits, while other practitioners took dinner with the servants. A physician's fee was wrapped and placed nearby, for theoretically gentleman did not accept money for their work. The prestige originated in their education: most often a higher degree from an esteemed school such as Cambridge, Oxford, or Edinborough. A medical degree, however, did not require any clinical experience. Students studied Greek and Latin theory, but they were not obligated to 'walk the wards'. Not all 'doctors', however, attended a medical school. For the majority of the Victorian era no official licensing requirements existed, but the practice did become more professionalized and organized. (Mitchell, Daily Life 196) The doctor that was called in to deal with Mrs. Yeobright's snake bite knew nothing but the old wives tale to neutralize the poison. This doctor most likely had no license, but just practiced the profession based on information handed down from a family member, most likely his father. (268)
Most doctors maintained a room in their residence for treatment and care. This room, dubbed the surgery (even when the practitioner was not a surgeon), was open to patients without appointment during specific hours. (Mitchell, Daily Life 196) Physicians and doctors did not deal with external injuries. They did not set bones, examine patients, or perform surgery. Doctors primarily administered 'physic', or drugs, utilizing a detailed case history provided by another medical practitioner. Doctors were chiefly concentrated in London where they were guaranteed a host of upper class patients. (Pool 249)
Elizabeth Blackwell became the first fully accredited woman doctor in the United States and Great Britain. Accepted as a joke, she diligently acquired all the major qualifications needed to practice medicine. Elizabeth eventually opened her own women's medical training school and an infirmary.
The normal price for a Doctor's home visit near the turn of the century was five shillings, although most doctors charged only 1s. 6d. when they were aware of a patient's inability to pay. Many physicians saved one morning a week to work charity cases, otherwise, the gentleman charged a guinea per visit. (Mitchell, Daily Life 179) Highly successful medical establishments were known to take in more than 10,000 pounds a year. Even moderate success netted at least 700 pounds. (Mitchell, Victorian Britain 489)
Surgeons represented the next step down from doctors in the social hierarchy. The paramount difference between physicians and surgeons is training. Surgeons were apprenticed in their middle teens; their parents paid for the boy to watch a surgeon in his practice, read his books, and later act as the surgeon's assistant. Such pupils were infamous for their rowdiness. Surgeons set bones, stitched wounds, and pulled teeth. (Mitchell, Daily Life 204) Surgeons were often qualified as apothecaries as well. An apothecary typically sold drugs, advice, and performed basic medical tasks such as initially examining a sick patient. (Mitchell, Victorian Britain 774) The title apothecary-surgeon came into use when the trade was regulated. In 1815 the apothecaries act provided for licenses for those practitioners who first 'walked the wards' of a medical establishment for six months. As time wore on, however, the line separating apothecary-surgeons and doctors became less distinct, until finally the professions merged into one, general practitioner. (Pool 250)
Nursing was first popularized by Florence Nightingale; she portrayed it as I dignified and glamorous profession. Nightingale led the first women nurses, ten of them, into the Crimea, and afterwards, British society awarder her with enough funding to found a nursing school. Despite the glorious connotations, however, nursing required perpetual work and care. Nurses cooked meals for patients, cleaned, were on call day and night. The pay, a shilling per day, was fairly good for the times, and the women earning it were well respected. Often a year as a probationer, a position between maid and nurse, was required of nurses before they received their qualifications. Typical shifts ran from 7:00 am until 9:00 pm, with two hours of recreational and mealtime breaks in between. Qualified nurses were able to earn up to 50 pounds per year, with free meals and board. (Mitchell, Daily Life 199)
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