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Anatomising ‘Athens’: Architecture, Medicine, and the Lieux de Savoir in Early Modern Edinburgh

Ann-Marie Akehurst

Abstracts

This paper contends that Edinburgh’s international reputation as a centre for intellectual excellence rested on a unique context which favoured the spread of ideas and research. Crucially, strands which coalesced were its excellence in medicine, related to other scientific enquiry; its topography, which dictated a mutual proximity in the parts of the city concerned with the advancement of such knowledge; and buildings, both ancient and modern. By using Christian Jacob’s notion of lieux de savoir, I argue Edinburgh’s identity emerged from the entanglement of lieux de mémoire and lieux de savoir. By focusing on the spaces and social activities of Edinburgh’s medical lieux de savoir this paper traces how the epistemic fields of new medicine and science influenced Edinburgh’s international reputation as an Enlightenment city. I argue that in the potting sheds of the botanical gardens, on the benches of the anatomy theatres, within the walls of Royal Colleges and the University, and between the pages of books, Ancient and Modern learning and culture was hotly debated, and the application and management of new knowledge was negotiated. Edinburgh’s lieux de savoir was a crucible forging the Enlightenment city that was projected across academic departments, and through its publications and influential alumni including surgeons on British ships, to imperial contact zones across the world.

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Introduction: Lieux de Mémoire and Lieux de Savoir

1In a monograph on nationalism, Benedict Anderson (1983) argues the importance of an “imagined community” in the construction of a collective identity. For Anderson, the development of print culture permitted the formation of a consciousness based on a sense of shared values across communities. The literary historian Martin Willis has recently drawn on poetic and medical writing, and specifically travel guides from the 1860s to 1890s, to suggest that Edinburgh was widely characterised as a city by its “medical pre-eminence” (2017: 359-60). Almost all guides identified “medical sites at the Royal Infirmary (both old and new), the Royal College of Surgeons, Edinburgh University’s medical school, and various other charitable organizations associated with medical practice. Written and graphic representations are undoubtedly useful indicators of projected and received local identities and I argue here that Edinburgh’s international reputation was, in addition to these, a reflection of the creation of built forms and their associated social activity. 

2This paper – that addresses the complex construction of urban identity – proposes that by the mid-nineteenth century Edinburgh was internationally characterised as a place of urban civility, gentility, and improvement due to a unique combination of development of ideas through research, promulgation, and debate and the architecture framing that activity. Crucially, strands which coalesced were its excellence in medicine, related to other scientific enquiry; its topography, which dictated a mutual proximity in the parts of the city concerned with the advancement of such knowledge; and buildings, both ancient and modern. From the perspective of an architectural historian, I aim to extend Willis’ work: by arguing that the proximity of dedicated architectural spaces contributed to shaping civic character; by extending Anglo-centric British narratives by relating Scotland directly to Continental Europe; and by acknowledging that medico-scientific knowledge and practice was also developed outwith exclusive Royal Colleges. Nineteenth-century Edinburgh was physically remarkable. The city which initially occupied a constrained site, now extended north with magnificent institutional and domestic architecture. The presence of the New Town, and the scale of the Royal Infirmary in Lauriston Place (1872-79), in the Old Town’s Southside, masks, however, the earlier compression of space which enabled the emergence of medical lieux de savoir in early modern Edinburgh.

3Edinburgh’s status as Scotland’s capital city, its ancient significance, and jurisdictional complexity generated a legacy of city maps which now enable historians to recover traces of the historic built environment in a city that was later subject to heroic engineering. Visitors – charmed by the pleasing regularity of the New Town that was developed from the mid-eighteenth century – may be unaware of the density of the city before its construction. The multiple perspectives of James Gordon of Rothiemay’s magnificent 1647 map captures the compaction of Edinburgh’s distinctive crag and tail geology: a city confined to a geological ridge, constrained by the Nor’ Loch to the north and within fortified walls to the south (Figure 1).

Figure 1. Plan of Edinburgh, ca. 1710

Figure 1. Plan of Edinburgh, ca. 1710

‘The Plan of Edinburgh, exactly done ...’ Originally engraved ca. 1710, from a survey of Edinburgh by James Gordon of Rothiemay & Frederik de Wit in 1647. 

Johnston, Andrew. The Plan of Edinburgh, exactly done... ca. 1710, National Library of Scotland, Edinburgh.

4Its complicated topography is best understood as a prominent East-West ridge, flanked by undulating valleys to the south and a mostly flat plain to the north. Reading from left to right, Edinburgh Castle tops the craggy volcanic rock; down the central spine of the volcanic ridge, Lawnmarket bisects the densely populated borough of Edinburgh, its narrow streets and wynds appearing as teeth on a comb in plan, while the distinctive tall tenements are minutely rendered in birdseye view – a space economy that saw residents of all classes living in close proximity. By contrast, on the eastern edge, stands the independent and spacious borough of the Canongate, terminating at Holyrood Palace. Here, the houses and mansions fronting the thoroughfare conceal extensive airy gardens to the rear. To the south of the Castle, occupying a steep-sided valley, Cowgate runs parallel to Lawnmarket and the High Street and where, as Giovanna Guidicini’s plan shows, there were a concentration of craft guilds (Figure 2). 

Figure 2. Plan of Edinburgh Southside

Figure 2. Plan of Edinburgh Southside

Guidicini, Giovanna, after Geoffrey W. Barrow’s 2005 Plan of Edinburgh Southside showing traditional occupational groupings and vacant site of the former Blackfriars Friary, south of Cowgate.

Barrow, Geoffrey. Plan of Edinburgh Southside. 2005. Triumphal Entries and Festivals in Early Modern Scotland: Performing Spaces, by Giovanna Guidicini, Brepols, 2020, 152.

5Long before the eighteenth-century creation of the New Town and draining of the Nor’ Loch, on Edinburgh’s Southside – between the Cowgate and Drummond Street, west of the Pleasance and at the east end of what is now Infirmary Street – lay an extensive Dominican Friary reading as an empty space on the plan. It had been destroyed by 1571 when its lands and possessions were given by the Crown to the magistrates and Town Council. In the seventeenth century, on this formerly undeveloped site next to the Flodden Wall, buildings dedicated to science and medicine were built adjacent to the Tounis College (Town’s College), an institution which offered a classical higher education from 1583. The site enjoyed city patronage and became the nucleus of Edinburgh University and Britain’s first established teaching hospital. This development of the formerly empty space is clearly apparent on a city plan of 1765 (Dingwall 1995: 21; Figure 3). 

Figure 3. Plan of Edinburgh, 1765

Figure 3. Plan of Edinburgh, 1765

Plan of Edinburgh in 1765 showing Southside with the medical spaces in Comrie, John D. History of Scottish Medicine, London, published for the Wellcome Historical Medical Museum by Baillière, Tindall & Cox, 1927.

Comrie, John D. Plan of Edinburgh in 1765. 1927, Wellcome Historical Medical Museum by Baillière, Tindall & Cox, London.

6Edinburgh’s authority as a seat of learning was established from the sixteenth century. Analysing the interrelation between architectural spaces, material objects, and social behaviour, architectural historian Giovanna Guidicini demonstrates how choreographed royal processions drew on site-specific evocations of Edinburgh’s real and imaginary histories, and shared events (2020: 99-140, 166). She describes Edinburgh as punctuated by lieux de memoire – enduring places where the accretion of historical associations anchored memory and permitted ambiguous interpretations of the past, and shaped collective identity (Guidicini 1989: 7-24). Architecture constructs collective identity by denoting both shared and personal meaning. The shifting relationship between social activity and material culture – such as the construction of spaces – is encapsulated in entanglement theory that has been defined by archaeologist Ian Hodder as “weav[ing] together the relationships of humans and things by following the threads and the dependencies […] views structures and systems as the products of these threads and webs, of the links between humans and things” (2011: 182). Pertinent to the creation of innovative knowledge and praxis, Hodder emphasises that complex human entanglement with material objects has necessarily a forward momentum with interrelations generating new activities. This concept usefully expresses the complex, varied, and unrecoverable interactions between the numerous scholars who contributed to Edinburgh’s eighteenth-century civic improvement connected to science and medicine (Elliott 2010: 229). The notion of entanglement helps understand that anatomy theatres, physic gardens, and hospitals were more than buildings per se; they were arenas where existing orthodoxies were challenged and made part of the shifting civic character. While complex to describe, the entanglements of medical spaces that responded to, and were a platform for, international engagement, drew together an actual and imagined global community that complemented Edinburgh’s ancient reputation.

7While entanglement addresses interaction between people, objects, and spaces, in the specific context of medico-scientific spaces, the French historian Christian Jacob’s (2014) characterisation of lieux de savoir shapes socio-spatial analysis as related to information exchange. Jacob’s twenty-first-century examples range from smartphones and books to libraries and places of intellectual exchange, whether material, virtual, or social (2014, 312-33/1967). Jacob’s formulation embraces the material and mental, the concrete and abstract, activities and the spaces in which they are conducted, and this nexus definition of human activity is helpful in describing early modern Edinburgh’s Southside:

They [lieux de savoir] are established by living interactions, during a course, a seminar, a conference, a discussion, a thesis defence, a controversy, but also by a research path. They are also the material, built or natural places, where these activities that they shelter are deployed: classrooms, laboratories, libraries, botanical gardens, museums, workshops. They are also the instruments, the tools, the samples, the machines, which accompany the gestures of the hand and open up new dimensions to human perception and thought. Finally, they are the artefacts which make it possible to materialize and register knowledge or which play a role in its very construction: drawings, diagrams, written texts, speeches carried by the voice. They are the inscriptions carried on these supports, the signs or the assemblies. (2014: 179/1967)

8Jacob discriminates between lieux de mémoire and lieux de savoir because the field of knowledge, he contends, is wider, more divided and layered than that of collective memory (2014: 967/1967). This article claims that Edinburgh’s civic identity was partly an emergent property of the entanglement of lieux de mémoire and lieux de savoir through the epistemic teaching of science (or natural philosophy) (Levine 1999: 23). What follows then is a discussion of Edinburgh’s varied fields of scientific enquiry, separated by discipline for ease of reading, but ultimately articulated by these notions regarding the social complexity of identity construction, for it is to Edinburgh’s character as a medical centre of excellence that we now turn.

Between Antiquity and Modernity: Early Modern Medicine

9We can best grasp Edinburgh’s dedicated spaces and activities that comprised its medical lieux de savoir by looking at a 1765 Plan of Edinburgh (Figure 3) where the proximity of institutions is made apparent. These spaces framed the intellectual battleground between antiquity and modernity that was pivotal in the evolution of medical practice from largely religious and palliative to ‘scientific’ therapeutics. Historically, medicine had been shaped by the classical humoral theories of Hippocrates and Galen. Put simply, since antiquity, the body was understood to be governed by the equilibrium of four humours – blood, black bile, yellow bile, and phlegm. Disease was attributed to an upset in the balance of the humours and ascribed to non-naturals: diet, environment, sleep, emissions and secretions, exercise, and mental outlook (Barnett 2008: 36-7). Disease was not only localised in the dis-ease of the body but related to wider, cosmic, and elemental forces. Treatment aimed to restore equilibrium through therapies as purging and bleeding administered by lower status apothecaries or surgeons who were trained in apprenticeships akin to craftsmen. University educated physicians advised on diet, habit, and lifestyle, often remotely. This medicine was taught at the Universities of Oxford and Cambridge in Britain and, since the Protestant Reformation, dissenters, Roman Catholics, and Jews – who could not affirm the authority of the Anglican Church – had been forced to attend teaching in Continental Europe or in Scotland.

10For centuries, Roman Catholicism had shaped Western European attitudes towards sickness and disease, and hospitals largely administered care rather than cure. Renaissance humanists pivoted away from acceptance of illness but strove to validate the assertions of antiquity. In northern Europe, alongside the Protestant Reformation, the reformation of science and medicine generated a growing sensory engagement with the working of the body and its systems (Porter 1997: 210-44). Natural philosophers observed the natural world and gradually the sceptical and experimental method, proposed by Francis Bacon, inspired challenging ancient beliefs. Crucially for this examination of Edinburgh, the processes of knowledge construction were being established during the seventeenth and eighteenth centuries when tenets of Galenic medicine were gradually repudiated in favour of growing understandings of the body and its workings as systems. Disease became regarded as a physical entity with identifiable causes. New interpretive frameworks generated fresh understandings of physics and chemistry; anatomical dissection challenged Galenic orthodoxies, and innovative microscopes enabled fine-grained corporal scrutiny. Engagement with the haptic elements of these emerging disciplines partly shaped Enlightenment medicine. Indeed, the historian of science John V. Pickstone argues that early modern science was a mix of natural history and craft (2000: 89), and Richard Sennett has sketched the increasingly important necessity of craft skill in generating new understandings (2008: 196-201).

11The rise of physical engagement created demand for dedicated spaces that were necessarily close to one another in Edinburgh as we have seen. Knowledge was garnered through a sensory methodology Pickstone itemises as: “describing and collecting, identifying and classifying, utilising and displaying” (2000: 60). Experimental philosophy aiming to illuminate the processes of natural phenomena later supplemented this taxonomical activity. Historians of science Steven Shapin and Simon Schaffer detailed technologies essential for epistemologically validating early modern science – the material, literal, and social (1985: 25-6). They required spaces for experimental inquiry, debate, and publication. The proximity of these spaces – what Jacob would call lieux de savoir – comprised an embryonic medical campus. Anatomy theatres, laboratories, wards, colleges, specimen collections, and libraries all facilitated group witnessing, knowledge transfer, and intellectual networking through publication and teaching, fuelling the eighteenth-century Scottish Enlightenment (Dingwall 1995: 27).

12By 1750, chemistry, botany, and anatomy were formally included in any physician’s education (Pickstone 2000: 68). The construction of purpose-built spaces created and facilitated the coalescing of a local medico-scientific culture. The early maps reveal the proximity of these spaces that enabled a growing community in restricted precincts through the interaction of professors and students alike. Edinburgh medicine and civic culture was a product of that distinctive topography by throwing together an increasingly entangled network of personalities and new spaces. Before the New Town was built, Edinburgh’s medical buildings were confined to the Southside. Institutional re-location has disguised that proximity of the earlier structures, but in the early eighteenth century, the Scots spy John Macky and sometime Edinburgh resident, the journalist Daniel Defoe, identified Edinburgh’s medical spaces there (Macky 1723: Letter 5; Defoe 1724-6: Letter 3; Alsop 2004).

13The most architecturally conspicuous building was William Adam’s Royal Edinburgh Infirmary of 1741 (Figure 4), described in the plans as: “Open to all the Curable distressed from whatever Corner of the world they come without restriction”.

Figure 4. The Old Infirmary, Edinburgh

Figure 4. The Old Infirmary, Edinburgh

Inglis, Francis Carid. The Old Infirmary, Edinburgh. Ca. 1920, Wellcome Collection, London.

14That global ambition was not just an architect’s hyperbole but reflected the international reputation of Edinburgh medicine. In 1759, the American co-founder of the Medical College at the University of Pennsylvania, John Morgan, wrote Edinburgh medical school “surpasses that of every school in Europe” (quoted in Dingwall 2010: 306). While travel writing was no doubt internationally publicised, Edinburgh’s elites had always benefited from strong European links. Diplomats and merchants travelled, and exiles as the Earl of Mar in Paris, maintained contacts, while the Royal Society and Republic of Letters fostered international corresponding memberships (Stewart 2016; Ehrenstein 2004). The strong architectural influence of Hendrik de Keyser is manifest on the Tron Kirk (Colvin 2008: 718) and, in this context, the Dutch city of Leiden was important (Dingwall 2010: 308). Internationalism had long been integrated into medical education through the perigrinatio medica – a kind of Grand Tour of Europe’s principal medical centres (Cunningham 2010: 3-4).

Anatomy’s Spaces of Display

15From the Renaissance, public dissections of human bodies illustrated Galenic and Aristotelian understandings focussing on the liver, lungs, and blood system. Centres for anatomy had developed at Padua, Bologna, Rome, Paris, Montpellier, and Leiden, where anatomy theatres were constructed. Despite London’s size and having anatomy theatres at the Company of Barber-Surgeons and College of Physicians, the metropolis’ lack of a university, and failure to establish one clear medical authority, hampered its development as a medical centre of excellence until the mid-eighteenth century, and many English physicians and surgeons were educated in Scottish or Continental universities (Brockliss 2010: 17-8, 40; Elliott 2010: 194).

16The terms of enquiry changed especially due to the work of Antwerp anatomist Andreas Vesal (Vesalius) whose monumental, lavishly illustrated Seven Books on the Fabric of the Human Body (1543), generally known as the Fabrica, shifted emphasis to the human body and its systems (Cunningham 2010b: 23-4; 28-9). As in Leiden, where many Edinburgh doctors had been educated, anatomical understanding underpinned the surgical profession and autopsies were performed in theatres based on European models. Essentially, space was created, either within an existing building, as a chapel, or a purpose-built centrally planned structure. Large un-obstructed windows illuminated the space: and the light focused on a central table on which the cadaver would be placed. Tiers of steeply raked seating enabled a clear view of the proceedings as in Leiden’s anatomy theatre that was lit by tall gothic lancets and presided over by animated skeletons as represented in engravings of the period (Figure 5).

Figure 5. The Anatomy Theatre, Leiden, the Netherlands 

Figure 5. The Anatomy Theatre, Leiden, the Netherlands 

Line engraving of the Leiden Anatomy Theatre showing tiered seating, anatomical specimens, and prominent windows. 

Swanenburgh, Willem. De Anatomie te Leiden. 1610, Wellcome Collection, London.

17Edinburgh was part of the elite group of medical cities with its first established medical institution, the Royal College of Surgeons of Edinburgh, founded in 1505 by Royal Charter granted from King James IV (Williams 2012: 51). The College occupied several sites until a 1696 Town Council decree directed constructing a purpose-built Surgeons’ Hall with a dissection theatre accommodating more cadavers (Williams 2012: 51; Dingwall 1995: 59). It was designed by James Smith, the Surveyor of the Royal Works in Scotland, who had first-hand knowledge of classical building in Rome (Colvin 2008: 949-53). Surgeons’ Hall was completed the following year near High School Yards, adjacent to what would become the Royal Infirmary (Figure 6).

Figure 6. A Perspective View of the Surgeons’ Hall, Edinburgh

Figure 6. A Perspective View of the Surgeons’ Hall, Edinburgh

Eighteenth-century engraving by Paul Fourdrinier and Paul Sandby.

Fourdrinier, Paul and Paul Sandby. A Perspective View of the Surgeons Hall, Edinburgh. 1753, Wellcome Collection, London.

18Though no plans survive, we know it contained three ground-floor chemical rooms, a laboratorie [sic.], Edinburgh’s first of many Physic Gardens, and a bagnio to generate income from elite citizens wishing to derive health benefits (Dingwall 1995: 59-60; Williams 2012: 51-62). Surgeons’ Hall’s symmetrical façade and detailing demonstrate restrained classicism, but it was not baldly utilitarian: it was decorated with Dutch marble and French glass. Though Matthew Williams has recently compared the structure to a country villa (2012: 54) the anatomy theatre with its prominent windows functioned mainly for illuminating public and private anatomies. 

19Many Edinburgh professors had been educated in Leiden and when the internationally famous Alexander Monro, a key figure in the establishment of the Edinburgh Infirmary, was appointed Professor of Anatomy in 1720 he transferred teaching to the nascent University where another purposely designed theatre was created (Guerrini 2004a).While not wishing to reinforce the numerous Great Man histories of Edinburgh medicine, one characteristic was consistency in attracting and fostering exceptional individuals. Monro was the first of three generations of Edinburgh anatomists: Alexander Monro secundus, and Alexander Monro tertius, sequentially occupied Edinburgh’s Chair of Anatomy for 126 years. Monro primus’ career embodied Shapin and Schaffer’s three technologies: his syllabus, method, and objective critical stance towards competing anatomical theories – accessibly delivered in English not Latin – was influenced by natural philosophy lecturers in London, Paris, and Leiden (Passmore 2001: 15-6). He started with a history of anatomy but proceeded to a strong emphasis on the haptic, with practical anatomy using one or two cadavers, then comparative anatomy, physiology, and surgical operations. He was technically gifted and ingeniously employed animals, waxes, and anatomical preparations. Monro’s commentary on his practice, The Anatomy of the Humane Bones (1726), went through eight editions in his lifetime and a further three after his death. It was translated into most European languages and in 1759 a French folio edition was published with elegant engravings by Joseph Sue, Professor of Anatomy to the Royal Schools of Surgery and to the Royal Academy of Painting and Sculpture in Paris. Writing at the end of the eighteenth century, a pseudonymous J. Johnson highlighted the importance to medical students of close observation:

For the benefit of those who wish to acquire a perfect knowledge of anatomy, private demonstrations of the subjects of Dr Monro’s lectures on the structure of the body are given at an evening hour by Mr Fyfe [sic.]. Every gentleman should attend this course the first season he attends Dr Monroe [sic.], for by doing so he will see every part more distinctly than the crowd at the doctor’s class will allow and besides he is entitled to witness the preparation of the various parts of the dead body, which is necessary for illustrating lectures (1792: 221).

20An 1850 map of Edinburgh shows Surgeon’s Square that was by then the location of several anatomical schools (Dingwall 2010: 319-20). In accounting for the relative decline in the Medical School’s reputation towards the end of the eighteenth century, Dingwall notes the proliferation of extramural spaces and institutions, such as private anatomy schools and royal colleges, in which medical education was conducted, outwith the university.

21Edinburgh’s College of Physicians had received a Royal Charter in 1681 and its anatomy theatre was subsequently built in 1697. Its founders were physician, botanist, and geographer Robert Sibbald, and physiologist Archibald Pitcairne, who championed the iatromechanical theory of physiology and endorsed Harvey’s theory of blood circulation rather than that of the Ancient Greeks in his Solutio Problematis de Historicis (1688) (Guerrini 2004c; Keary 2022). They established a base in 1704 in Fountain Close that expanded over the next decade to include a bath house. Defoe recorded, “a fine Musæum, or Chamber of Rarities” that he later itemised as “several skeletons of strange creatures, a mummy, and other curious things” (1724–6: 583; Backscheider 2004). Specimen collections aided understanding of the body and indeed the space was praised for “all the usual methods of academic learning in their full perfection” (Defoe 1724-6: 583). By the late eighteenth century, both Physicians’ halls were abandoned, and the physicians moved north to the New Town (Dingwall 1995: 123). 

22Nearby the Town’s College (in the historical Southside) was the embryonic university, and the creation of the Chair of Chemistry in 1713 was vital in establishing Edinburgh’s Faculty of Medicine in 1726. Distinctively, such academic appointments were generally made under the aegis of the Town Council that had the right to appoint two Professors of the Theory and Practice of Medicine and two Professors of Medicine and Chemistry, along with the Chair of Anatomy. The Chair of Botany was included in 1738, paving the way for Edinburgh’s international reputation for a broad scientific education, as well as medical teaching and research (Foundation Faculty Medicine 2015). By the later eighteenth century, the naturalist Thomas Pennant recorded “twenty-two professors of different sciences” (1776: 63). The medical school united – though not always harmoniously – the activities of separate disciplines with large numbers of patients to observe, concretising the medico-scientific lieux de savoir.

Botanical Gardens and Sensory Observation

23It is in the evolution of the Botanical Gardens that Edinburgh’s sensory and haptic methodology took root. The discipline of botany instilled transferable skills and knowledge: it generated a supply of plant-based remedies while its teaching reinforced pedagogical practices. Additional to the Surgeons’ and Physicians’ gardens, in July 1675, botanist James Sutherland took over the Edinburgh Physic Garden, established by Sibbald and fellow physician Andrew Balfour near Holyrood Palace to supply them with materia medica (the animal, mineral and plant materials from which medical preparations were made) and as a display collection (Guerrini 2004b). Such academic botanic gardens featured in centres of medical learning at Pisa, Padua, Leiden, and Montpellier from the sixteenth century, and in Uppsala, Oxford, and Paris during the seventeenth, when they became an expected feature of a high-status scholarly institution (Hickman 2021: 24-5). 

24In 1676, the Edinburgh Town Council had leased Sutherland the garden near Trinity Hospital that he laid out to supply the needs of Edinburgh physicians, supporting the Faculty of Medicine and establishing Edinburgh's international reputation (Royal Edinburgh Botanic Garden, 2015; Guerrini 2004b). Sutherland’s Hortus Medicus Edinburgensis (1683), a catalogue of plants by number and rarity, was the first of its kind in Scotland. Sutherland was subsequently appointed Professor of Botany in 1695 when the Incorporation of Surgeon-Apothecaries engaged him to teach botany and to lead the masters four times a year in a “publick herbarizing” (Guerrini 2004b).

25Garden historian Clare Hickman has recently described eighteenth-century herborizing excursions for apprentices as important events for professional advancement (2021: 16-9). As Edinburgh expanded northwards, the Physic Gardens were relocated. In the 1770s, John Hope, Regius Keeper of the Royal Botanic Gardens Edinburgh, developed the five-acre Leith Walk gardens – described by Hickman as ‘state of the art’ – as the venue for teaching his students (Creation Edinburgh Botanic Garden 2015). There, hot houses, conservatories, and a teaching room complemented vast collections of native and overseas specimens (Creation Edinburgh Botanic Garden 2015). A plan of 1777, held by the Edinburgh Royal Botanic Gardens, reveals the layout. The Botanic Cottage comprised domestic apartments on the ground floor for the head gardener, with a lecture theatre on the first floor. Influenced by the Jardin du Roi in Paris, it was a research and experimentation space (Hickman 2021: 34). Part of the garden – the Schola Botanica – was laid in straight lines for teaching purposes, resembling Continental botanic gardens as that at Leiden, though most of the space reflected the current picturesque taste for naturalistic planting (Hickman 2021: 26, fig. 1.4 and pl.3). As in Europe, these pedagogic spaces facilitated the education of doctors in plant identification and the use of ‘simples’ (remedies). The Physic Garden occupied the same epistemic space as a museum: botanical collections – that incorporated specimens introduced by travellers – disseminated knowledge of the plant world and substituted for some difficult, costly international travel.

26Innovatively, Hope asserted that practical and sensory engagement with materia medica was crucial to wider medical understanding, and Lectures on the Materia Medica, as Delivered by William Cullen, M.D (1775) was published to meet student demand for this novel teaching practice. Hickman emphasises multisensory engagement in the construction of medical knowledge more broadly than botany. From 1777, botany formed a compulsory element of medical teaching, alongside materia medica, chemistry, anatomy, surgery, pharmacy, clinical practice, and theory. First-hand encounter with materials, close observation, drawing, note making and discussion were methods shared across disciplines (Hickman 2021: 38-43). Hope employed diagrams to depict physiological experiments on plants (Eddy 2016: 109) and drew on the skills of the technical illustrator Andrew Fife who included in his portfolio of roles, that of anatomical dissector. The interdisciplinarity was particularly manifest in the fact that Edinburgh surgeons retained the right to act as dispensing pharmacists resulting in a Fraternity of Surgeon-Apothecaries (Dingwall 1995: 187).

27Hope’s activities also extended to international engagement where he shaped networks in the construction of medico-pharmacological knowledge. The American physician and Edinburgh alumnus Benjamin Rush directed his students that “in a sick room, we should endeavor [sic.] to be all touch, all taste, all smell, all eye, all ear, in order that we may be all mind: for our minds, as I shall say presently, are the products of impressions upon our senses” (quoted in Hickman 2021: 24). Some of Hope’s students, working for the East India Company, were instrumental in introducing Himalayan flora to Europe. Meanwhile, the Indian Botanic Garden near Kolkata (now Acharya Jagadish Chandra Bose Indian Botanic Garden) was founded by alumnus William Roxburgh in 1786 (Passmore 2001: 58). This physical and sensory engagement with materia medica that became central to medical teaching, coupled with the engagement with international ideas and teaching methods, placed eighteenth-century Edinburgh (a rival to Paris) at the forefront of scientific pedagogy and empirical enquiry in the nineteenth century. So, while Leith Walk gardens were a little removed from Edinburgh’s Southside, the study conducted there was epistemologically at the heart of medical knowledge construction. These activities associated with botany – whether close scrutiny or correspondence – extended the ambit of Edinburgh’s lieux de savoir across the world.

The Royal Infirmary of Edinburgh and Bedside Teaching

28As time passed, students flocked to Edinburgh because it was the only English-speaking university which provided a full range of medical education and offered bedside teaching (Passmore 2001: 80). Edinburgh’s international reputation, as discussed above, was enhanced by advanced clinical practice that was extended by bedside teaching conducted in the Infirmary. The first Infirmary opened in 1729 and was paid for by public funds after an appeal led by Lord Provost George Drummond and the Royal College of Physicians. Its six beds, based in the “Little House” at the head of Robertson’s Close, off Cowgate, in what is today, Infirmary Street, provided the opportunity for clinical training, influenced by Monro primus’ time with Herman Boerhaave in Leiden (Hull 1997: 512-4; Underwood 1977). 

29While eighteenth-century British voluntary hospitals – of which this was the first to be established outside London – claimed to address the needs of the labouring poor, Edinburgh’s proposal also aimed to create a place to instruct surgical apprentices and medical students. The architectural historian Christine Stevenson argued Monro primus ghost authored the fundraising literature for the second infirmary, together with Scotland’s preeminent architect William Adam, revealing an ambition that the “building was to work in a way unique in the genre” (Stevenson 1996: 53). Drummond ensured the economic motivation was to attract international students whose fees would augment the hospital’s coffers (Stevenson 1996: 54). The education was economical compared to other schools, which reinforced its unique reputation.

30In 1736, King George II’s Royal Charter endowed the hospital with patronage and legal rights and the surgeons joined the Physicians in the Royal Infirmary in 1738, commissioning Adam to design it. The Royal Infirmary, located at High School Yards, opened in 1741, offering 228 beds and an additional five cells at basement level for those suffering from mental illness (Figure 7).

Figure 7. The Royal Infirmary of Edinburgh

Figure 7. The Royal Infirmary of Edinburgh

Plan of the Floors of the Infirmary designed and drawn by William Adam, and engraved by R. Cooper from The History and Statutes of the Royal Infirmary of Edinburgh, 1778.

Adam, William and R. Cooper. Plan of the Ground Floor of the Royal Infirmary at Edinburgh. 1778, Wellcome Collection, London.

31Stevenson observes the Infirmary was the first of Edinburgh’s many eighteenth-century monumental buildings. Adam’s spectacular Infirmary – that no longer exists – embraced European ideas. Its u-plan, that was derived from sanitary French models, permitting cross-ventilation, reducing the risk of miasmata from ‘vitiated’ (spent) air, became a model for British provincial hospitals throughout the eighteenth century. Contemporary accounts suggested that little was spent on architectural ornament apart from an applied classical order on the centre of the façade underneath the baroque scrolls that designated the College apartments as opposed to wards, still apparent in the early twentieth-century photograph (Figure 4). The blocks of wards, reminiscent of tenement housing, reinforce the Infirmary’s austere presence and serious purpose.

32The hospital plan, published long after construction, makes apparent the separation of spaces for discrete purposes (Figure 7). Above the ground floor administration offices were two floors of medical wards and a surgical floor close to the operating theatre illuminated by a French style octagonal lantern surmounted by a square dome. The space also served as a chapel, an anatomy theatre and lecture hall seating over two hundred (Stevenson 1996: 59). In the 1770s, the naturalist Thomas Pennant proclaimed: “The operation-room is particularly convenient, the council-room elegant, with a good picture in it of Provost Drummond. From the cupola of this building is a fine prospect, and a full view of the city” (1776: 63). And as if to underline Edinburgh’s multi-use economy of space, it also served as an astronomical observatory.

33The Infirmary’s central façade dignified the professionals and their callings inside the hospital but was planned with lucrative medical education in mind by facilitating the separation of the potentially offensive noises from the medical school – especially regarding the witnessing of surgery – from the wings housing patients (Stevenson 1996: 53-62). That proximity of the wards – initially with ten patients demonstrating a curated collection of cases – enabled the development of the ward round as a feature of clinical teaching where students practiced their observational and deductive skills developed in anatomy and botany. In 1748, physician John Rutherford secured consent to use the surgical amphitheatre for clinical lectures supplementing the informal bedside teaching (Risse 2010: 243). Until the late eighteenth century, physical examination was restricted to inspection of the skin, tongue, throat, eyes, and the pulse, supplemented by observations of bodily fluids and excreta (Passmore 2001: 82-3). The number of beds in the teaching ward gradually increased to 50 by the 1770s, which enabled students to observe patients and transcribe the clinical records into their own case books (Passmore 2001: 80). The infirmary gradually expanded, occupying much of the adjacent land including the old Surgical Hospital, which opened in 1832, and the new Surgical Hospital in 1853.

34In the grand narratives of Edinburgh medicine, women featured solely in the field of midwifery, and then exclusively as patients. As J. Johnson observes: “When the practice of midwifery was principally confined to women, it might be deemed merely a mechanical art […] As midwives are almost exclusively employed in low life, in Edinburgh; and as many of them are very ignorant; difficult cases occur in a great proportion” (1792: 26, 32). This marginalisation of traditional embodied knowledge was shot through with class snobbery and evidences the black boxing of medical knowledge and practices reinforced and policed by medical institutions. Johnson continues: “Since gentlemen began to be employed in that line, it has become very different; for the treatment of the diseases of women, in almost every stage of life, has by common consent, consigned to the charge of male practitioners of midwifery” (1792: 26). Childhood diseases were also grouped under midwifery and despite the proportion of women and children in the population, Johnson notices: “it is the only medical class which candidates for degrees are not obliged to attend” (1792: 26).

Chemistry: Understanding the Properties of Materials

35Whereas anatomy, microscopy, and botany were observational, descriptive but necessarily destructive, chemistry offered the potential for material innovation. As the theories, equipment and practices of late-fifteenth- to seventeenth-century “chymistrie” evolved into chemistry, the conceptual and methodological skills of the analysis of the composition and properties of substances became increasingly important for diagnosis and therapeutic preparations. Professor Hermann Boerhaave of Leiden University, who shaped the careers of so many of Edinburgh’s early medical teachers and who held a Chair in Chemistry, was innovative in his use of instruments as Farenheit’s thermometer and introduced such practices into his teaching (Eddy 2014: 13). 

36As we have seen, three chemical rooms and a laboratorie [sic.] were included in Edinburgh’s Surgeons’ Hall (Williams 2012: 51-62). The historian of science, Simon Werrett, has recovered how many early laboratories were constructed from domestic spaces – a discovery that underlines the significance of such purpose-built laboratories (Werrett 2013: 627-46). The activities conducted in such spaces can be appreciated from visitors’ accounts to Oxford’s early School of Natural History (Bennett, Johnston, and Simcock 2000: 17-24), the Philosophical Transactions of the Royal Society from 1665, and Nehemiah Grew’s Catalogue and Description of the Natural and Artificial Rarities for the Royal Society (Grew 1681). The historian and epistemologist, Henning Schmidgen (2018) observed “laboratorium” primarily denoted workshops of alchemists, apothecaries, and metallurgists, and subsequently came to refer to all accommodation in which natural phenomena and processes were explored by means of tools and instruments. Such instruments can be seen in a print of a chemical laboratory from Encyclopédie, ou Dictionnaire Raisonné des Sciences, des Arts et des Métiers, Planches, Neuchatel (1765) held in the Wellcome Collections. Recent studies of student notebooks discussed below revealed sketches of “customised retorts, Florentine flasks, funnels and other specialised ‘vessels’ exhibited in notebooks based on the Edinburgh lectures of [Joseph] Black and [William] Cullen” (Eddy 2016: 108). Such apparatus confirms the centrality to chemistry of the application of heat and the mixing of fluids to substances for observation and analysis of their properties and change. This is confirmed, for instance, by the 1752 University of Edinburgh thesis of the eminent chemist, Joseph Black that necessitated heating the alkali magnesia alba, noting the subsequent weight, and hypothesising the air driven off – that he called “fixed air”. Black’s work resulted in the first chemical identification of a gas (Anderson 2004). Of course, not all chemistry was associated with medicine, and much was to have commercial and particularly industrial influence.

37Schmidgen (2018) is correct in his observation of the epistemological closeness of early modern laboratories to anatomical theatres, cabinets of curiosities, botanical gardens, observatories and “other knowledge spaces”. While these spaces taken together comprise lieux de savoir, laboratories were also qualitatively different since early modern chemical experimentation involved accurate quantification, analysis, and distinctively, synthesis (Pickstone 2000: 139-41). Understanding chemical changes informed bodily processes and materials acting upon them. This skill set was crucial in constructing medico-scientific knowledge that would shape increasingly effective therapeutics. Meanwhile, the inclusion of these varied disciplines in the medical syllabus ensured movement between specialisms and their dedicated spaces, helping medical identity to cohere.

38Like their colleagues, Edinburgh chemists too embraced innovative teaching: Black used diagrams to aid visualising of the concept of chemical attraction and repulsion (Eddy 2014: 14) and Black and Cullen (1710-90) used schematic diagrams “to represent how furnaces and mineshafts worked” (Eddy 2016: 107). Indeed, the career of William Cullen embodied the interdisciplinarity, practical engagement, and international networking that was becoming characteristic of Edinburgh medicine (Passmore 2001: 23-36; Jordan and Watson 2004). In 1757, within two years of moving to Edinburgh, Cullen was lecturing at the Royal Infirmary on materia medica, the notes for which became the basis of the unauthorised published edition. Cullen also taught botany, physiology, and medical practice (Passmore 2001: 31). His dedication to the construction and application of scientific knowledge, and his preoccupation with the natural philosophical principles underlying the material world which he illustrated with experiments, meant his clinical lectures were immensely popular and were disseminated informally by the circulation of students’ notes throughout Europe and the American colonies (Passmore 2001: 95).

39As with botany then, Edinburgh’s international reputation as a centre of excellence for medical education was propelled across the globe through personal networks and the written word. As well as ward teaching, Cullen conducted postal consultations with patients in France, Belgium, Italy, Prussia, the United States, and Madeira. Many of his protégés gained influential positions within the late Enlightenment medical world. Additionally, many served the British Empire, particularly through the Royal Navy – such as Thomas Trotter and Gilbert Blane. Cullen’s American students John Morgan, William Shippen jun., and Benjamin Rush exported the Edinburgh ethos to America, establishing the University of Pennsylvania Medical School in Philadelphia. Indeed, the copy of Cullen’s Lectures on the Materia Medica held by the Wellcome Collection was published in Philadelphia. Subsequently, during Joseph Black’s eminent career teaching chemistry, he corresponded with Lavoisier – evidence of international collaboration and of the esteem in which Black was held (Passmore 2001: 105). International networks as these reflect an outward-looking ethos: Edinburgh University and its medical school was public; its campus occupied the mercantile section of the city burgh rather than exclusive Royal Canongate; its professors were appointed and paid by the Town Council. Its scientific training, often in English, attracted students from home and abroad, while its diaspora of alumni published internationally. Non-conformist English students sought a Scots medical education. Students from Oxford, Cambridge, and the American eastern seaboard, extended theoretical knowledge with practical training and benefited from a broad scientific education (Dingwall 2010: 312). The university innovated in what we would now call interdisciplinarity, in the anatomy process, taking clinical histories, pioneering physiological and psychological patient inspection, and establishing teaching wards. Writing at the end of his life, the French mathematician and Enlightenment philosopher the Marquis de Condorcet reflected on the utility of what we now call “science”, and the interrelatedness of these fields of knowledge:

How much of the discovery of microscopes, and of meteorological instruments, contributed to the perfection of natural history? How great is this science indebted to chemistry, which, alone, has been sufficient to lead to more profound knowledge of the objects it considers, by displaying their most intimate nature, and most essential properties – by showing the composition and elements; why natural history offers to chemistry so many operations to execute, such a numerous set of combinations formed by nature, the true elements of which required to be separated, and sometimes discovered, an imitation of the natural processes; and, lastly, how great is the mutual assistance afforded to each other by chemistry and natural philosophy; and how greatly have anatomy and natural history been already benefited by the sciences. (1795: xxx).

Dissemination: Scots’ Culture of Writing and Sharing 

40Throughout his history of human knowledge Condorcet stresses the benefits of the press in disseminating “the progress of the human mind”, and it is to the culture of dissemination we must now turn, for, as he observed:

To the press we owe those continuing discussions which alone can enlighten doubtful questions; and fix upon an immovable basis, truths too abstract, too subtle, too remote for the prejudices of the people, the common opinion of the learners, not to be sued and forgotten and lost. (1794: 147-8)

41Edinburgh’s success was partly due to the proximity of scientific spaces and the social networks and cultural practices they allowed, but its international reputation was concretised in print. This article has aimed to consider Scotland’s relation to Continental Europe on its own terms, especially as its legal framework differed substantially from that in its southern neighbour. While rule of the Kingdoms of Scotland and England were united in the person of King James I and VI from 1603 and while there were some institutional parallels between the countries, during the seventeenth century significant differences regarding print culture encouraged the flowering of academic dissemination. From the publication of Scotland’s first medical work, Gilbert Skene’s Ane Breve Descriptioun of the Pest (1568), it was clear that medical matters would be a concern (Mann 2001: 187). Notably, it was written in the vernacular, an imperative asserted by the Protestant reformer John Knox and his followers (Mann 2001: 186). Indeed, Knox had just called for a national system of education in his Book of Discipline (1560) that was fully realised when the Scots Parliament reinforced Knox’s wishes through the 1696 Schools Act that established a school in every parish and facilitated a high Scots literacy rate (Herman 2001: 22-6). 

42In 1556, just before Knox published his Book of Discipline, the Company of Stationers of London received its Royal Charter that reserved the right to establish a press to members of that Company or those in receipt of a royal charter (Davis 1988: 29). The Stationers’ Company was a protectionist livery company that restricted entry into the trade, limited the number of presses per printer, and had the right to seize illegal and pirated works. In the English provinces, only Oxford, Cambridge, and eventually York, were permitted to print. Tying authority to commerce, in 1603 a royal patent supported the Stationers in becoming a joint stock company. By contrast, Scots printers experienced no government or centralised limitation; town councils were authorised to licence the activity of the press within the burghs. As the historian of printing Alistair Mann observes, “the relative liberalisation of trade in Scotland encouraged growth within and without Edinburgh while the larger scale of the English book trade made it feasible for it to flourish in a more close to commercial environment” (2001: 193). Crucially, copyright law differed between the two polities. Copyright registered with the Stationers’ Company was issued in perpetuity whereas in Scotland copyright for individual books originated directly from patents granted by the Crown. Individual book licences were granted for a specific period, usually 19 years, or the lifetime of the licence holder (Mann 2010: 53). Scots’ authorities’ belief that perpetual copyright was unreasonable has been characterised as resembling that in France, Spain, and the Low Countries, but unlike England (Mann 2010: 53). Moreover, Scots’ attitudes to intellectual property differed: while a manuscript or a printed book were legal property, the text or ideas were not (Mann 2001: 196). Scotland’s absence of centralised and commercialised control of presses; the burghs’ authority to licence publishing; the custom of overseas education; and embrace of practices and craftspeople from France, Spain, and the Low Countries as well as England, reflects an openness aiding the success of Scots publishing (Mann 2001: 199). The Stationers’ Company had unsuccessfully tried to extend its control to Scotland and abandoned that ambition in 1670 (Mann 2001: 194). This further stimulated flourishing Scottish book culture. As Mann observes:

From the 1670s a new secular livre universel proliferated on subjects such as medicine, science, law, current affairs, practical guides and polite belle-lettres. For the first time in Scottish book history secular works out number the religious as seen in the output of the Scottish press and the inventories of booksellers. (2001: 195)

43An “Act of Parliament for settling the right of copies […] made provision for a constant supply of modern books” (Defoe 1724-6: 583) and a flourishing of bookselling, printing, and paper manufacture served this large literate and numerate public. Edinburgh’s reputation expanded outside university precincts to wider audiences. Between 1720 and 1840, Scotland’s college population tripled; fees were affordable for the middle classes, and public lectures were attended by women and men. Public education and a culture of empiricism generated scientific knowledge by testing hypotheses through experimental trial and error (Dingwall 2010: 306).

44Dingwall attributes the success of the medical school partly to the publication of texts within the university by Edinburgh scholars as we have seen. One notable example is the case of the Pharmacopeia. The notion of a botanical encyclopaedia was originated by the Greek physician Pedanius Dioscorides (ca. 40-90 AD), whose De Materia Medica was widely read for over a millennium and formed the core of the European pharmacopeia until the nineteenth century. Soon after the foundation of the College in 1681, the decision was made to produce Edinburgh’s own Pharmacopeia to abolish the practice of secret remedies, as was attempted in London decades before. A committee of eight was formed with the president in the chair and it took them 18 years to complete the task. This long delay was due to many contentions with surgeons opposed to any Edinburgh Pharmacopeia and to fellows opposed to its style and structure. When eventually published such was its success that it was pirated in 1732 by a London publisher, and, as its historian observes, its vast reach was aided “through the legion of conspectuses, compendiums, and dispensatories which included it” (Cowen 2012: 134). Its publication and immediate success were largely due to the energies and wide interests of Robert Sibbald (Passmore 2001: 87). Publication of such pharmacopoeias shaped how the public understood and managed chemical knowledge (Eddy 2014: 13). This is just one of many early books now held in the libraries of Edinburgh’s Colleges of Surgeons, and of Physicians, and the University. 

45But it was not only published works that disseminated Edinburgh’s medical and scientific reputation. Recent research on student note keeping reveals much about the transmission of knowledge within Edinburgh and further afield. Matthew Eddy analysed manuscript textbooks and rough notes; commonplace books, and edited notebooks where students recorded intellectual content (2016: 88). Innovative diagrams, tables, and figures used in the natural sciences and medicine proved very difficult to capture; for instance, Professor Alexander Monro II was concerned his anatomy diagrams were not being reproduced. Eddy suggests students paid detailed attention when visualisations were relatively uncommon: extraordinarily, one Carmichael Smyth could still recall those anatomy figures decades after seeing them (2016: 99). In the anatomy theatre, botanical gardens, and patients’ bedsides, rough notetaking was essential. Copying rough notes into blank notebooks resulted in more organised collections. Printed syllabi helped organisation as illustrated by one student who cross-referenced Cullen’s chemistry lectures: “vide syllabus page 9” (Eddy 2016: 100). Similarly, botanists edited field notes in a process Eddy calls “writing after the fact” as a way of digesting information practised in the observational skills and recording new objects (2016: 101).

46Sharing information between disciplines and across generations bolstered medical culture. Professors occasionally annotated lecture notebooks purchased from students reinforcing graphic culture (Eddy 2016: 112-3). Significantly, many notebooks entered personal or professional libraries across Britain and the Empire – disseminating knowledge across generations and across space. Eddy highlights the contribution of these previously overlooked activities to epistemic culture:

in many ways the chorus of student notetakers. transcribers and draughtsman operating in Scottish universities resembled a group of editors, compositors, and pressman who worked collectively to produce books on the shopfloor of printing houses […] Scottish students lived within a graphic community centred around the universities that specialised in the packaging and replication of scholarly knowledge. The skill of classroom observation played a pivotal role, particularly when students took rough notes and when they expanded their jottings and thoughts, individually or collectively into recopied notebooks. Crucially, while students did much of the scribal work, professors were part of the community as well, especially since they distributed outlines and lecture headings designed to help students structure their notes.…In addition to the immediate role played by notebooks in Scotland’s university towns, they also circulated scholarly knowledge across Britain and its colonies. (2016: 119- 21)

Conclusion

47The Lord Provost of Edinburgh, George Drummond was both the founder of the Royal Infirmary and a key figure in the development of the New Town in 1752 – a major physical change in the city reflecting the innovative mindset of the contemporaries (Youngson 1967: 3; Guidicini 2019: 106; Lewis 2019: 84). I have suggested that the city’s identity was poised between its engagement with classical learning and those lieux de mémoire on the one hand, and the blossoming of science that fused long held medical theories, classical architectural detail, and traditional garden layouts, with novelty in scientific lieux de savoir on the other. Each discovery entailed sceptical debate, challenging and supplanting orthodoxies with new strategies of medical intervention that accepted or modified traditional behaviours. The medical school provided doctors and students with opportunities to encounter patients whose conditions they might observe, and upon whom they might occasionally experiment with innovative treatments. In this way they concretised Edinburgh’s lieux de savoir where knowledge was constructed and transmitted. Physical proximity of institutions was initially important because it ignited immediate and extended human interactions, while Edinburgh’s print culture supported production and consumption of innovation. The Royal Colleges, Botanical Gardens, and the University conferred and policed professional status and enabled networks in a world where religion, class, and nationality traditionally defined personal identity. They were platforms enabling group identity to coalesce by developing new codes of social behaviour. The plain black suit, white shirt and cravat uniform worn by the medical profession, and which shows in the eighteenth- and nineteenth-century portraits held at the Royal College of Physicians of Edinburgh, came to denote the serious professional training of doctors (Clothing Made Man 2022).

48This article has consciously avoided the political arena, but it would be remiss completely to overlook the significance of the 1707 Act of Union that constitutionally absorbed the formerly independent Scotland into Great Britain. John Lowrey reminds us that after 1707 in the search for a new identity, history was co-opted to shore up ideas of national progress and development (2001: 136-57). Some Scottish institutions also sought independence from England, and the university was a conspicuous example. Before the 1871 abolition of the English Universities’ Tests Act, incoming students had to swear allegiance to the Church of England. Edinburgh’s accessible, publicly funded, inclusive institution was not Oxford or Cambridge, and despite its Royal Colleges and private practitioners, London had no university to organise clinical teaching (Passmore 2001: 79-83). One extraordinary statistic underlines the contrast: in the century following 1750, England educated only 500 doctors whereas 10,000 were educated in Scotland (Colley 1996: 129). Additionally, Edinburgh’s broad, generalist – even European-style – teaching, in the vernacular, widened access, and it has been suggested that more than anywhere else in Europe, the practical approach to science and medicine resembled those other Enlightenment practitioners – engineers.

49By the late eighteenth century, confident Edinburgh medics required new premises. Large scale urban classicising began in the Old Town and in 1832 the Royal College of Surgeons enjoyed their meeting hall, museum, lecture room, and library in William Henry Playfair’s Greek-Revival Ionic temple on Nicholson Street, across the road from Robert Adam’s monumental Roman Doric university buildings of 1789. Edinburgh’s ancient institutions sat alongside new ones, occasionally in competition, sometimes as partners. The Royal College of Physicians was relocated to a purpose-built hall on George Street in 1781 designed by James Craig, and in 1844 it changed premises again and moved to Queen Street, to a building designed by Thomas Hamilton where it remains. By 1842, Edinburgh stood for civility, gentility, and improvement. Tourists’ accounts and published guides affirming its medical reputation that had been constructed over the previous two centuries, amplified its importance. Its medico-scientific lieux de savoir continued as a crucible helping forge the Enlightenment city as a centre of medical excellence, that was from the outset projected across academic departments, across generations, and, through its publications, influential alumni, and surgeons in British armed forces, to imperial contact zones across the world.

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List of illustrations

Title Figure 1. Plan of Edinburgh, ca. 1710
Caption ‘The Plan of Edinburgh, exactly done ...’ Originally engraved ca. 1710, from a survey of Edinburgh by James Gordon of Rothiemay & Frederik de Wit in 1647. 
Credits Johnston, Andrew. The Plan of Edinburgh, exactly done... ca. 1710, National Library of Scotland, Edinburgh.
URL http://0-journals-openedition-org.catalogue.libraries.london.ac.uk/angles/docannexe/image/6526/img-1.jpg
File image/jpeg, 428k
Title Figure 2. Plan of Edinburgh Southside
Caption Guidicini, Giovanna, after Geoffrey W. Barrow’s 2005 Plan of Edinburgh Southside showing traditional occupational groupings and vacant site of the former Blackfriars Friary, south of Cowgate.
Credits Barrow, Geoffrey. Plan of Edinburgh Southside. 2005. Triumphal Entries and Festivals in Early Modern Scotland: Performing Spaces, by Giovanna Guidicini, Brepols, 2020, 152.
URL http://0-journals-openedition-org.catalogue.libraries.london.ac.uk/angles/docannexe/image/6526/img-2.jpg
File image/jpeg, 90k
Title Figure 3. Plan of Edinburgh, 1765
Caption Plan of Edinburgh in 1765 showing Southside with the medical spaces in Comrie, John D. History of Scottish Medicine, London, published for the Wellcome Historical Medical Museum by Baillière, Tindall & Cox, 1927.
Credits Comrie, John D. Plan of Edinburgh in 1765. 1927, Wellcome Historical Medical Museum by Baillière, Tindall & Cox, London.
URL http://0-journals-openedition-org.catalogue.libraries.london.ac.uk/angles/docannexe/image/6526/img-3.jpg
File image/jpeg, 128k
Title Figure 4. The Old Infirmary, Edinburgh
Credits Inglis, Francis Carid. The Old Infirmary, Edinburgh. Ca. 1920, Wellcome Collection, London.
URL http://0-journals-openedition-org.catalogue.libraries.london.ac.uk/angles/docannexe/image/6526/img-4.jpg
File image/jpeg, 148k
Title Figure 5. The Anatomy Theatre, Leiden, the Netherlands 
Caption Line engraving of the Leiden Anatomy Theatre showing tiered seating, anatomical specimens, and prominent windows. 
Credits Swanenburgh, Willem. De Anatomie te Leiden. 1610, Wellcome Collection, London.
URL http://0-journals-openedition-org.catalogue.libraries.london.ac.uk/angles/docannexe/image/6526/img-5.jpg
File image/jpeg, 301k
Title Figure 6. A Perspective View of the Surgeons’ Hall, Edinburgh
Caption Eighteenth-century engraving by Paul Fourdrinier and Paul Sandby.
Credits Fourdrinier, Paul and Paul Sandby. A Perspective View of the Surgeons Hall, Edinburgh. 1753, Wellcome Collection, London.
URL http://0-journals-openedition-org.catalogue.libraries.london.ac.uk/angles/docannexe/image/6526/img-6.jpg
File image/jpeg, 285k
Title Figure 7. The Royal Infirmary of Edinburgh
Caption Plan of the Floors of the Infirmary designed and drawn by William Adam, and engraved by R. Cooper from The History and Statutes of the Royal Infirmary of Edinburgh, 1778.
Credits Adam, William and R. Cooper. Plan of the Ground Floor of the Royal Infirmary at Edinburgh. 1778, Wellcome Collection, London.
URL http://0-journals-openedition-org.catalogue.libraries.london.ac.uk/angles/docannexe/image/6526/img-7.jpg
File image/jpeg, 117k
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References

Electronic reference

Ann-Marie Akehurst, “Anatomising ‘Athens’: Architecture, Medicine, and the Lieux de Savoir in Early Modern Edinburgh”Angles [Online], 16 | 2023, Online since 01 June 2023, connection on 21 June 2024. URL: http://0-journals-openedition-org.catalogue.libraries.london.ac.uk/angles/6526; DOI: https://0-doi-org.catalogue.libraries.london.ac.uk/10.4000/angles.6526

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About the author

Ann-Marie Akehurst

Independent Art and Architectural Historian and Fellow of the Society of Antiquaries of London. Ann-Marie Akehurst has published on early modern spaces of health and wellbeing, sacred space, and urban identity. She is currently co-editing a volume on the Art of Contagion with Marsha Morton for Routledge. Contact: ann-marie.akehurst[at]alumni.york.ac.uk

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Copyright

CC-BY-4.0

The text only may be used under licence CC BY 4.0. All other elements (illustrations, imported files) are “All rights reserved”, unless otherwise stated.

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