Gotowa bibliografia na temat „Great Britain Politics and government 1800-1837”

This concluding chapter reflects on the events at New Geneva and the political context of Europe at large. There was more than a hint of irony in the fact that members of the United Irishmen were put to death at New Geneva. This was one of the most significant outcomes of the Waterford experiment. The intention had never of course been to create a military base for soldiers. The buildings were made for republicans. Yet it was at the site of New Geneva that the British troops and loyalist volunteers employed dreadful violence against the United Irishmen. New Geneva Barracks passed into folklore because of the bloody treatment of the rebels. The British government, still at war with revolutionary France, used the example of what happened in 1798 to justify a ‘Scottish solution’ to the Irish problem: the Acts of Union of 1800, which created the Kingdom of Great Britain and Ireland from 1801.

There was no more turbulent yet creative time in the history of medical study than the latter years of the eighteenth century. During this troubled era, familiar landmarks in medicine were fast disappearing; new ideas about medical training were gaining favor; the sites of medical education were rapidly expanding; and the variety of healers was growing in every country. Student populations, too, were undergoing important changes; governments were shifting their role in medicine, especially in the continental nations; and national differences in educating doctors were becoming more pronounced. These transformations are the subject of the opening chapters of this book. These changes in medical education were a reflection of the general transformation of European society, education, and politics. By the century’s end, the whole transatlantic world was in the grip of profound social and political movement. Like other institutions, universities and medical schools were caught up in a “period of major institutional restructuring” as new expectations were placed on teachers and students. Contemporaries spoke of an apocalyptic sense of an older order falling and new institutions fighting for birth, and inevitably the practice of healing was also affected. From the middle of the century, the nations of Europe and their New World offspring had undergone a quickening transformation in their economic activity, educational ideas, and political outlook. By 1800, in the island kingdom of Great Britain, the unprecedented advance of agricultural and industrial change had pushed that nation into world leadership in manufacturing, agricultural productivity, trade, and shipping. Its population growth exceeded that of any continental state, and in addition, nearly three-fourths of all new urban growth in Europe was occurring in the British Isles. The effects on higher education were to create a demand for more practical subjects, modern languages, and increased attention to the needs of the thriving middle classes. Although Oxford and Cambridge, the only universities in England, were largely untouched by the currents of change, the Scottish universities, by contrast, were beginning to teach modern subjects, to bring practical experience into the medical curriculum, and to open their doors to a wider spectrum of students.

As the previous chapters have suggested, striking changes in medical education had occurred by 1800 in nearly every Western country. In particular, the movement toward practical training in medical teaching had gathered momentum toward the end of the eighteenth century. Not only in Vienna, Paris, Edinburgh, and Leyden but also in scores of universities, hospitals, military schools, dispensaries, lying-in clinics, and private courses spread across Europe and North America, students were finding new opportunities to practice dissection; see patients at the bedside; take case histories; practice surgical, obstetrical, and other procedures; and even diagnose and treat patients under a teacher’s supervision. It is this sea change in attitudes toward practical training that we explore in this chapter. Spurred by Enlightenment concerns for public health and utilitarian concepts of practical training, new clinical experiences were becoming available in many places. Although in some countries, notably France and Germany, the state played a decisive role in fostering the new development, in others, especially Britain and America, students were left largely on their own to gather practical experience, choosing from a variety of lecture-demonstration courses, hospital training, apprenticeship opportunities, experience in outpatient dispensaries, and private classes. National differences in social and political development channeled the strong pressures for utilitarian education into new forms of clinical training. Differing concepts of what constituted a “teaching clinic” came to exist side by side, especially in Europe. In unsettled France, the clinical impulse, which had early centered on surgical practice in urban hospitals and was now promoted by an all-powerful revolutionary government, found its primary outlet in large hospitals. In the German states, on the other hand, politically divided and lacking large hospitals in most university towns, clinics developed largely as small appendages to university programs in medicine. British clinical training, as described in earlier chapters, was centered haphazardly in the London hospitals away from the nation’s universities and was growing also in provincial hospitals and dispensaries. In North America, the search for clinical experience was spread over a great variety of small infirmaries, dispensaries, and private courses, and apprenticeship training remained the dominant mode of getting hands-on practice.