ADMINISTRATIVE HISTORY
The Faculty Office was established by the 'Peter's Pence Act', 25 Henry VIII, c.21 (1533). This act gave the Archbishop of Canterbury and his successors the power and the authority, by themselves or by their 'sufficient and substantiel [sic] Commissary or Deputy' to grant instruments under the name and seal of the Archbishop. The faculties to be issued were restricted to those 'accustomed to be had at the See of Rome, or by the aurthority [sic] thereof', other instruments to be granted only by the order of King or Council. A faculty is a dispensation, or a licence, granted to a clergyman or layman applying to be dispensed from existing laws; for example for a clerk to hold more than one living, for marriage without banns or for a physician, midwife, or public notary to be allowed to practise. These dispensations and licences were previously issued by the Pope or papal legates, subject to their confirmation or registration in chancery. The machinery designed to expedite this addition to the Archbishop's jurisdiction was the Faculty Office, headed by the master of the faculties.
Henry VIII as head of Church and State ensured that the link between the two was maintained in the Faculty Office. The Faculty Office officials were to direct the process of application and issue, and grant the faculty, while the Clerk of Dispensations and Faculties in Chancery was entrusted with the issue, under the Great Seal, of confirmations of commendams, dispensations and doctorates, and enrolling these, with M.A.s and public notaryships, on the Dispensation Rolls (Guiseppi, Guide to the Public Records, I (London, 1963), pp. 9, 19). The officials of the office were to be responsible to the Archbishop alone, but the laws governing procedure have been made by successive acts of Parliament, as in the case of issuing marriage licences or appointing public notaries. As created in 1533 the Faculty Office continues its work today.
MASTER OF THE FACULTIES [from Melanie Barber's 'Directory of medical licences issued by the archbishop of Canterbury, 1535-1775, in Lambeth Palace Library, part 2: Faculty Office Series Licences, 1535-1764' (typescript, 2000)]:
The dates relate to the tenure of the office of the master of the faculties.
BERKENHEAD (BIRKENHEAD) (Sir John), (1660-1679)
THOMPSON (Robert), (1679-1683)
PAMAN (Henry), (1683-1689)
HEDGES (Sir Charles), (1689-1714)
JOHNSON (James), (1714-1727)
CHICHELEY (Richard), (1727-1738)
ANDREW (John), (1738-1747)
POTTER (John), (1747)
BETTESWORTH (John), (1747)
TOPHAM (Sir Francis), (1747-1770)
SURROGATES [from Melanie Barber's 'Directory of medical licences issued by the archbishop of Canterbury, 1535-1775, in Lambeth Palace Library, part 2: Faculty Office Series Licences, 1535-1764' (typescript, 2000)]:
The dates refer to the fiats, and not to the covering dates of their tenure as surrogates of the master of the faculties.
BETTESWORTH (John), (1727)
BRAMSTON (William), (1732)
BRICE (Stephen), (1687)
CLEMENT (William), (1713)
DUCAREL (Andrew Coltee), (1764)
EXTON (John), (1710)
EXTON (Thomas), (1683)
FAUCONBERGE (Henry), (1693)
KING (William), (1698)
LLOYD (Nathaniel), (1701-2)
PAUL (George), (1715-33)
PINFOLD (Charles), (1729)
WALKER (Thomas), (1736)
WOOD (Robert), (1705-1712)
FACULTY OFFICE MEDICAL LICENCES
Following the Henrician statute of 1511, the Archbishop of Canterbury, like other bishops, became responsible for the licensing of physicians and surgeons. However there are no records in Lambeth Palace Library which throw light on his exercise of this aspect of his jurisdiction until 1576, the date of the first medical licence entered in Archbishop Grindal's register. Thereafter the registers record the provincial licences issued by the vicar general on behalf of the Archbishop of Canterbury. The vicar general became the principal official for the licensing of medical practitioners by the Archbishop of Canterbury. Another office through which the Archbishop exercised jurisdiction over 'clerical' physicians was the Faculty Office. As regards medicine and surgery, the Faculty Office grants were more in the nature of dispensations and initially differed from the episcopal licensing envisaged by the Henrician statute of 1511.
Before the Reformation, papal dispensations were granted to the regular and secular clergy to study medicine or practise surgery, subject to certain restrictions, and evidence for these relatively rare grants is recorded in the papal registers. For instance in 1512, John Chambre, treasurer of Wells and royal physician, was granted a licence and faculty for life to practise medicine 'with the exception of cautery and surgery', the latter being prohibited by the Fourth Lateran Council of 1215. The canonical requirement for a dispensation may not have been frequently observed, as seems to be suggested by the fact that papal nuncios visiting England were authorised to 'absolve those, secular or regular, who have studied in civil law or medicine without licence of the apostolic see'. From 1534 the Faculty Office was vested with this jurisdiction over clerical physicians and surgeons, and this complemented the Archbishop's existing authority derived from the 1511 Act. The dispensatory character of the papal jurisdiction shaped the early Faculty Office grants.
Between 1535 to 1547, the Faculty Office issued six dispensations to practise medicine, and with the exception of John Dale for whom the information is not available, all the recipients were members of the regular or secular clergy. They were dispensed to practise 'in spite of their holy orders'. No medical dispensations were recorded in the late 16th century muniment book covering the years 1567-93, but the lack of surviving records for the years 1549-1567, and for the first half of the 17th century means that it is not possible to prove that the Faculty Office stopped granting medical dispensations after 1547.
Following the Restoration, the Faculty Office was again involved with authorising physicians to practise, and from this date, the grants consist of licences, rather than dispensations, and they were no longer confined to clerical practitioners. These were similar to the licences issued by the Archbishop's vicar general. During the primacy of William Juxon (1660-1663), the Faculty Office granted considerably more licences than the vicar general's office. Thereafter the situation was reversed, possibly mirroring a rationalisation of the responsibilities or areas of jurisdiction of the various archiepiscopal officials.
From 1661 until 1764, the Faculty Office granted about 114 medical licences. This figure needs to be treated with caution. In the absence of a muniment book for the years, 1680-1691, the fiats are often the sole evidence of licensing. In some cases, the information given in these records is not conclusive. In addition, immediately after the Restoration, the practice of registration seems to have been a little erratic. If the fiat of either the Archbishop or the master of the faculties is accepted as the necessary authority for the subsequent issue of the licence, one would expect there to be a record of the licence in the muniment book, but this does not always hold true. The majority of the licences date to the late 17th century; only 22 post-date 1700, with none issued between 1739 and 1763. The last medical licence was granted to James Ford, L.C.P., in January 1764, just eight months before he was awarded a Lambeth M.D. The same letters testimonial were adapted for both grants, and there is some evidence that Archbishop Secker had originally intended the master of the faculties to issue a Lambeth M.D., rather than a licence.
Although there are similarities between the licences issued by the vicar general and the Faculty Office, there are significant differences. The Faculty Office licence betrayed the dual nature of the office's origin. The former papal powers of dispensation were not vested solely in the Archbishop; they were subject to confirmation by the crown in chancery. Depending on their level of importance and consequently their cost, dispensations issued by the master of the faculties were either registered by the chancery clerk of the faculties or were sealed with the royal seal. From the Restoration onwards, all Faculty Office medical licences concluded with the clause (in Latin until 1733): 'provided always that these presents do not avail you anything unless registered and subscribed by the clerk of his majesty for faculties in chancery'. The registration should be recorded on the dispensation rolls of chancery in the Public Record Office. This joint machinery was cumbersome and the need for chancery confirmation would have added to the cost of the grant.
The medical licences issued by the vicar general of the Archbishop were limited to the province of Canterbury. But as the Faculty Office jurisdiction extended throughout England and Wales, medical licences issued by this office sometimes authorised the recipient to practise in the northern province of York as well. The mid-16th century dispensations authorised physicians to practise anywhere. After the Restoration, Edmund Freeman appears to have been the first candidate to have been licenced to practise 'throughout the entire kingdom of England', 1 June 1663. Thereafter until 1737, another eighteen licences were granted which embraced all or part of the province of York, sometimes in combination with the province of Canterbury. In one case, the candidate, Nathaniel Edward, was licensed to practise in the diocese of Chester and the county of Nottingham. The rest of the licensees were confined to the southern province either in general, or to a number of specified dioceses or counties. On a few occasions, the licence was restricted to one diocese, as for example, Henry Jackson and Miles Middleton, who were licensed to practise in the sees of Canterbury and Winchester in 1662 and 1736 respectively. Their reasons for applying to the Faculty Office for such a restricted licence are unclear. The last licence granted by the Faculty Office, to James Ford in 1764, did not define the area in which he could exercise his profession.
As a general rule, the Faculty Office licences, like those issued by the vicar general, excluded the licensees from practising within the city of London and a seven-mile radius around it. This area came within the jurisdiction of other licensing authorities, notably the College of Physicians and the Company of Barber-Surgeons. Nevertheless, in 1664, Didier Fowcault, a London apothecary, requested a licence 'whereby he may be enabled to exercise and practise the facultie and profession of a physitian within the city of London and elswhere throughout your Graces province of Canterbury'. Archbishop Sheldon personally authorised the grant with his fiat, but there is no record in the muniment book of the issue of the actual licence.
All candidates were required to swear to the various oaths of allegiance, abjuration or supremacy specified by statute. The majority also subscribed to the articles of religion, usually to articles one to three of the 39 Articles. Unlike the vicar general's office, the Faculty Office does not appear to have kept separate subscription books in which the candidates who personally appeared at the office subscribed. Where applicants were inaccessible to London, commissions were issued to three local clergymen of the candidates' choice, authorising any one of them to secure the appropriate oaths and subscriptions. The licence was usually issued on the return of the commission, though occasionally it accompanied the latter. Evidence of licentiates swearing an oath of office is provided in only a couple of cases. In 1737-8, Francis Penrose and Richard Marriner were required to swear 'to the best of my skill and judgement, I will diligently use and exercise the arts of physick and chirurgery indifferently both to poor and rich. So help me God.' The licence of James Ford included a specific reference to his having taken the oath of office.
Applicants were expected to provide evidence of their medical or surgical expertise, such as letters testimonial. Where the candidate was recommended by local clergy, physicians, or parishioners, or a mixture of these, the Faculty Office insisted on the countersigning or examination by two fellows of the College of Physicians. The chance survival of a letter from the incumbent of Norton sub Hamdon in Somerset relating to the licensing of Timothy Boyce of Wantage in 1679 shows the lengths to which some officials went to secure information on the qualifications of candidates. The brief notes of caveats against the licensing of four individuals without the knowledge of particular local physicians indicates the need for applicants to secure support from those already practising within their neighbourhood.
During the 1660's and 1670's, the licence normally recorded the names of the leading physicians on whose testimony the grant was made. Thereafter a more general recommendation was included, noting that the licensee was 'recommended by the credible testimony of diverse discrete persons skilful in the art'. If the applicant was well known to the master of the faculties, the requirement for written proof of his medical skills seems to have been waived, as for instance for Peter Mark Sparck, a royal physician, described as 'Mr. Speakers Friend'.
The letters testimonial also certified that the candidate was sound in doctrine and manners, and conformable to the government in both church and state. Until the Act of Toleration of 1689, conformity was looked upon as a requirement. Yet the Rev. James Stevenson, who had recently refused to comply with the provisions of the 1662 Act of Conformity and was in process of being ejected from the vicarage of Martock in Somerset, was licensed to practise medicine on 15 Nov. 1662. After 1689, there was less emphasis on conformity, but except in the case of the one Quaker, Jonathan Cadwalladar, who affirmed instead of swearing the oath of allegiance in 1733, their religious non-conformity is not self-evident from the records.
Where a physician already held a diocesan licence, he was expected to show this or at least provide a copy of it. However not all Faculty Office licentiates had previously been licensed by any episcopal authority. In 1679, Timothy Boyce's patron states this to be the case even though he had practised medicine and surgery for about thirteen years.
The letters testimonial were normally annotated with the fiat of the master of the faculties authorising one of his subordinates to draw up the licence or commission for the taking of oaths. Hence the name associated with this class of Faculty Office material - fiats. In addition, the series of 'Fiats' (F II) includes commissions and other related papers, such as a copy of an episcopal licence, record of admission as a fellow of the Society of Apothecaries, or appointment as a royal surgeon at the Tower of London. The series begins in 1660, but the first medical fiat dates to 1661.
The Faculty Office muniment books (F I) comprise the other principal source of information on medical licences. From the Restoration, these volumes include copies of the licences, often in full, with the exception of abbreviated common form provisos. The series is lacking the volume for 1680-91, and the gaps can only be filled by information drawn from the fiats. For the earlier period, there are muniment books covering the years 1534-1549, and these provide brief details of the dispensations, together with a note of costs, and registration or sealing in chancery.
The Faculty Office issued considerably fewer licences than the vicar general. In the early 17th century, the vicar general may have been in practise the sole archiepiscopal licensing authority. After the Restoration, both offices exercised jurisdiction over medical licensing, but the vicar general was the principal channel. In view of a number of gaps in registration, it is not possible to give precise figures. However on the basis of the surviving records, the ratio was almost 6 to 1 in favour of the vicar general's office (630 vicar general as against 114 Faculty Office). Nevertheless the Faculty Office licence was regarded by male physicians and surgeons as a significant means of extending and enhancing their authority to practice. No women were licensed by the Faculty Office.
Although a number of the Faculty Office licentiates can be identified in Wallis's 18th century medics, many of them were unknown to the editors if only because the Faculty Office records were not viewed as a source for medical licensing. Melanie Barber's directory provided the first list of all the medical licenses issued by the Faculty Office extracted from the records in Lambeth Palace Library. The dispensation rolls in the Public Record Office may possibly provide details of a few additional licences, but an examination of these rolls was beyond the scope of the Library's project.
Select Bibliography:
J.H. Bloom and R.R. James, Medical practitioners licensed under the Act of 3 Henry VIII, in the diocese of London (1935).
D.S. Chambers, Faculty Office Registers 1534-1549 (1966).
Harold J. Cook, The decline of the old medical regime in Stuart London (1986).
Joseph Foster, Alumni Oxonienses. 1500-1886 (1888-1892) (8 vols.).
J.G. Galt, 'The letters testimonial of the English bishops and the London M.D.', History of medicine, vol. 6 no. 2 (1975). [Lambeth Palace Library W131.A1]
J.R. Guy, 'The episcopal licensing of physicians, surgeons, and midwives,', Bulletin of the History of Medicine, 56 (1982), pp. 528-42.
David Harley, '"Bred up in the study of that faculty." Licensed physicians in the north-west of England 1660-1760', Medical History, 38 (1994), pp. 398-420.
R.R. James, 'Licences to practise medicine and surgery issued by the Archbishops of Canterbury 1558-1775', Janus, 41 (1937), pp. 97-106. [Lambeth Palace Library Z664.L2 2.01]
Susan C. Lawrence, Charitable knowledge, hospital pupils and practitioners in eighteenth century London, (1995).
William Munk, The roll of the Royal College of Physicians. Vol. 1 (1878); vol. 2 (1878).
Margaret Pelling and Charles Webster, 'Medical practitioners' in C. Webster, ed., Health, medicine and mortality in the sixteenth century, (1978), pp.165-235.
Margaret Pelling, 'Tradition and diversity: medical practice in Norwich 1550-1640,' in Scienze, credenze occulte, livelli di cultura, Convegno internazionale di Studi, Florence (1982), pp.159-71.
John H. Raach, A directory of English country physicians, 1603-1643 (1962).
J.H. Raach, 'English medical licensing in the early seventeenth century', Yale Journal of biology and medicine, 16 (1944), 286 and ff.
R.S. Roberts, 'The personnel and practice of medicine in Tudor and Stuart England', Medical History, 6 (1962), pp.363-82; 8 (1964), pp.217-34.
John Venn and J.A. Venn, Alumni Cantabrigienses: part 1: From the earliest times to 1751 (1922-4) (4 vols.).
P.J. & R.V. Wallis, 18th century medics, Project for historical biobibliography, Newcastle, 2nd edition, 1988.
