A brief historical overview of the regulation of medical practice: from Rome to Ferdinand VII.

The medical profession is probably the oldest, or at least as old as the other profession that has the reputation of being the oldest in the world. And the fact is that, if the natural ferocity of primitive man created certain biological instantiations, it is no less true that the diseases that soon afflicted him created that other job, that other character: that of the healer, the doctor. Created an inevitable need. However, it was not until the time of ancient Mesopotamia, 1,500 years ago, that the figure of the practical physician, the ‘asu, emerged, who used both plant remedies and surgical intervention, sometimes prophylactically, when He used to castrate animals. Slaves in the service of the chief women. The Sumerian Code of Hammurabi is the first law that deals with malpractice, setting out sanctions that apply to doctors. For example: “…if a doctor has caused the death of a sick person, his hands will be cut off…”. Then it was the oath of Hippocrates that forced many classes of doctors to swear by Apollo and Aesculapius on the ethical principles of their profession. In ancient Rome, the image of the patriarch as caretaker of the health of the family community was replaced by the medic, who was almost always an immigrant from nearby Greece, whether a vulnarius (healer of wounds) or Be a carnifex (butcher). Failure to intervene was the common end. Whether the Roman Medici belonged to the atomistic or Methodist conceptions, or were dogmatic or empiricist in their conduct, their education and qualifications were not officially established until the reign of the emperor Severus Alexander (222–235), of whom it can be said that That they had made regulations for it. first time. Time of medical profession. In the case we are discussing, nothing new occurs, except for the medical certificates (ichazas) that Arab medical students received after studying with a teacher of recognized solvency. Doctor positions do not include the practice of gynecology, which is almost exclusively reserved for midwives. And in this circuitous journey of history there is no novelty in the generalization of the practice of medicine until Medieval Europe, where in 1140 Roger II of Sicily legislated a final examination to be able to practice, thus pleasing the magistrate of Salerno. Did school. This regulation was consolidated with Frederick II in 1224, within an intellectual environment inspired by Latin Averroism. It was legislated that all aspiring doctors should be publicly examined by the professors of Salerno, who, after passing the test, would give the new Master of Medicine a ring, a laurel branch, a book, and the kiss of peace. It is three centuries later when we find another official provision worthy of mention: the Practical Provisions promulgated by Philip II in 1558, which is a legal model of professional organization of the time. Some excerpts from such rule will suffice by reference: “(…) They shall appoint two examiners to the General Hospital (…);” And there they will order the person being examined to take the pulse of four or five patients; And they will ask you what you have understood about each patient and the quality (…) and causes (…) of their illness and what medications and treatments you plan to use (…) “. (Seventh Practical Law of 1558, which creates the Protomedicato Court). In the 16th century, medicine studies (theories of Hippocrates and Galen) were studied at the universities of Barcelona, ​​Salamanca, Valencia, Alcalá and Granada, following a practical curriculum. , received the title of Bachelor of Medicine. I would not like to conclude this legislative list without mentioning the contents of the official medical degree issued in the name of HM Fernando VII by the Chamber Physicians-Surgeons in the year 1831. After the title, The obligations and privileges are described in detail. Regarding the possessor of the title of Bachelor of Medicine, where religious reasons and political circumstances are not mentioned. In any case, it is a curious document that provides an important part of the history of our profession. In short, I copy some excerpts: “(…) We grant the license so that you can practice freely in the above mentioned Faculty of Medicine. And on behalf of the King, our Lord, we request that all judges do not impose any hindrance on him, nor molest or oppress him, causing him to pay any kind of tribute on account of his faculty. We declare that you have sworn to protect forever the secret of the Most Pure Conception of the Virgin Mary; Keep secrets in appropriate cases; Not to belong to secret societies, or to recognize the absurd doctrine that the people are the arbiters of altering the established form of government; Ignore all risks and infections when public health demands it; Advise those who are in danger of dying on the arrangement of their spiritual and temporal affairs; “To not recommend abortion or infanticide (…) is the basis on which we issue this title.”