In the inaugural John Trust Blair Lecture, Iain Macintyre brought together the life of surgeon John Blair with the background of medical education in Scotland and the development of the study of medical history in Britain.
Iain began by stating that John Blair (1928-2023) had been a remarkable individual, a gifted man who achieved a great
deal in his lifetime in several fields and left a lasting legacy to the history of medicine. Born in the village of Wormit just next to Newport on Tay on the south shore of the Tay estuary, Blair went to school in Dundee, where his formidable intellect was first recognised. He studied medicine at St Andrews and spent his career as a consultant surgeon at Perth, a city that bestrides the River Tay.
His career was richly fulfilled across many fields of endeavour, not just surgery, but also in the military and as a sportsman – he was a keen and competent golfer- and, of course, as a medical historian. Blair’s interest in history was manifest from an early age when he took an external BA in History from the University of London in 1955. In addition to numerous papers and books, largely histories of medical institutions in Tayside and biographies of Tayside doctors, he also wrote on military medicine.
In later years his stature as a historian was recognised by his presidency of the Scottish Society of the History of Medicine, presidency of the BSHM and vice presidency of the International Society for the History of Medicine. His was appointed honorary reader in the history of medicine by St Andrews University, which further honoured him with the degree of D Litt in 1991. And, most unusually at that time for someone who was not a professional historian, in 2000 he was elected a Fellow of the Royal Historical Society.
Yet, his influence went beyond his writing. The academic and financial success of two meetings in Scotland, the BSHM and the International Society, largely organised by Blair, led to the establishment of the John Blair Trust, which sponsored the lecture at the BSHM Congress and supports medical students in attending the Congress.
Scottish universities
Iain then described how during the late18th and early19th century, Scotland produced the vast majority of university educated doctors in the UK. The university tradition in Scotland began with St Andrews, Glasgow and Kings College Aberdeen being established in the 15th century, Edinburgh in 1583 and Marischal College Aberdeen a few years later. St Andrews, where John Blair studied, began awarding MD degrees at the end of the 17th century.
The Edinburgh barbers and surgeons united as an Incorporation in July 1505 with fellowship by examination from its earliest days. The establishment of the Edinburgh University Medical School in 1726, however, was highly influential in establishing the university medical degree as a standard qualification for medical practice. Crucially, there were no religious barriers to entry, unlike Oxford and Cambridge, and the course was considerably cheaper than the residential courses in Oxford or Cambridge or the travel to a medical school in continental Europe.
The Scottish universities, particularly Edinburgh and Glasgow, began to produce large numbers of medical graduates, so that by the latter half of the 18th century only eight percent of British medical graduates graduated from Oxford or Cambridge, 6% from Europe and 85% from Scottish universities. In the first half of the 19th century the numbers were even more striking; only 3% of medical graduates came from Oxbridge, and an astonishing 96% from Scottish universities, principally Edinburgh and Glasgow. They were also in a majority in the army and in the Royal Navy and could be found everywhere throughout the British Empire.
Changing history of medicine
In the third part of his lecture, Iain turned to the Scottish influence on the sea change in the study of the history of medicine in this country from the 1960s. One of John Blair’s friends from an earlier generation was Douglas Guthrie, whose career in many ways acted as a role model for John. Guthrie too was a surgeon, and he was also a medical historian and author.
During the Second World War, while an ENT consultant to the army in Scotland, he researched and wrote his book, History of Medicine, which was published in 1945. By a remarkable piece of good fortune, the Observer newspaper sent Guthrie’s book to George Bernard Shaw for review. Known as a stern critic, Shaw, however, gave Guthrie’s book a five-star review. It went on to multiple reprints and became a global best seller. To put this in context, up to that time only a dozen or so histories of medicine had been published in English.
Guthrie developed the status of a major figure in the history of medicine, and he used that to good effect. In 1948, he founded the Scottish Society of the History of Medicine and was at first president. In 1956, he was president of the section of the history of medicine of the Royal Society of Medicine. In 1965 he was a leading light in the formation of the British Society for the History of Medicine, drawing together the four founding societies, which are represented on the presidential medal of the BSHM. Guthrie was its first president, donating this medal to the society.
Iain suggested that Guthrie’s influence went well beyond the formation of these societies, and that he influenced the history of medicine as an academic discipline, when it had been primarily the realm of amateur historians. In the 1950s Gutherie argued that the history of medicine should be more about ‘history’ than about ‘medicine’. He felt that it could only be studied properly against a background of general and social history.
His ideas led to a time of major innovation in academic history of medicine in this country, especially along with the work of his friend Noel Poynter, a co-founder of the BSHM and its first secretary. Poynter was director of the Wellcome Institute when it began to fund History of Medicine units in British universities.
Iain concluded his lecture by returning to John Blair, saying: “John Blair too left a legacy. His historiography was marked by the thoroughness of his research and his level of detail. His institutional histories are packed with insights and are authoritative. And the spirit of John Blair lives on in the work of the John Blair Trust, providing research and travel grants and prizes to further the study of history of medicine in this country for the next generation of medical historians.”
Iain Macintyre was Vice President of the Royal College of Surgeons of Edinburgh during its 500th anniversary celebration and served as surgeon to the Queen in Scotland until he retired in 2004. He now researches, writes and lectures on the history of medicine and has contributed to several books, including Surgeons’ Lives, Scottish Medicine – An Illustrated History, and Scotland’s Contribution to Naval and Military Medicine and Surgery