National Poetry Month – Samuel Garth’s The Dispensary

Speak, Goddess! Since ‘tis Thou that best canst tell

How ancient Leagues to modern Discord fell;

And why Physicians were so cautious grown

Of others lives, and lavish of their own,

How by a Journey to th’ Elysian Plain

Peace tiumph’d, and old Time return’d again

So begins Samuel Garth’s poem The Dispensary which was first published in 1699.  Garth’s work is a satirical take on the traditional epic poem, and is perhaps one of the better examples of the “medical poetry” genre.  What better way to celebrate National Poetry Month than by taking a closer look at this work and its author?

Samuel Garth had a fairly distinguished, if unremarkable, medical career.  He was born in 1661 in County Durham in North East England, and entered Peterhouse, a constituent college of Cambridge University, in 1676.  He earned his B.A. from Cambrdige in 1679-80, his M.A. in 1684, and his M.D. in 1691, after spending some of 1688 studying in France.  In 1693 he became a member of the Royal College of Physicians, and in 1697 he delivered the College’s Harveian oration, an annual lecture that had been instituted by William Harvey.  He was made a Fellow of the Royal Society in 1706, and went on to become both physician-in-ordinary to King George I and physician-general to the army.  He died in 1719, and is buried in St. Mary’s of Harrow-on-the-Hill in London.[1]

Garth was as interested in literature as he was in medicine. He wrote several poems dedicated to various members of the English nobility, an English translation of Ovid’s Metamorphoses,[2] and humorous verses that were meant to be inscribed on the glasses used by the Kit-Cat Club, one of London’s literary societies.  But his most famous work is easily The Dispensary.  While this work is satirical in tone, it also addresses one of late seventeenth-century medical London’s most heated issues: the matter of the London Dispensary.

This particular drama had its origins in a dispute between two organizations at opposite ends of the medical spectrum: the College of Physicians and the Society of Apothecaries.  The College physicians were learned professionals who were able to write prescriptions designed to cure a specific ailment, while the apothecaries were lowly tradesmen who simply mixed ingredients together.  But from the 1660s onward, apothecaries began to venture more and more into medical practice, which drew the physicians’ ire.  Feeding into this conflict over who was qualified to practice medicine was the question of who should treat the city’s poor.  In 1687, the College passed an edict declaring that the College Fellows should give free medical advice to the indigent, and prescriptions should be filled according to the intrinsic value of the medicine.  This did not go over well with the apothecaries, who raised their prices in protest.  In response, the physicians decided to open their own laboratory for preparing medicines; however, some members saw this as a crassly commercial maneuver (or supported the apothecaries for their own financial gain), and the College split into Dispensarian and Anti-Dispensarian factions.[3]  Fuel was added to the fire in 1694 when the Society of Apothecaries petitioned the House of Commons for an exemption from municipal duties, claiming that they were already too busy with tending to the city’s poor. The College could hardly let such a claim stand, and at last, in 1696, the Dispensarians realized their goal.  Those who supported the creation of a dispensary each contributed a fee of £10 to establish a dispensary that would provide the poor with appropriately priced remedies.[4]

Samuel Garth became a College Fellow in the midst of this dispute, and fell on the side of the Dispensarians.  His mock-epic The Dispensary satirizes the conflict, both between the cliques of physicians, and between physicians and apothecaries.  In the second canto, an apothecary called Horoscope is portrayed as being concerned with profit above else (“To this bright Idol [Gold] ‘tis, alone, he bows; / And fancies, that a Thousand Pound supplies / The want of Twenty Thousand Qualities); in the fourth canto various physicians are depicted associating with the unscrupulous apothecaries, including one Mirmillo who tells them,“Tis plain, my Int’rest you’ve advanced so long, / Each Fee, tho’ I was mute, wou’d find a Tongue.”  At last, the physician Celsus[5] is led on a Dante-esque trip to the Underworld by Hygeia, the Greek goddess of health, to consult with the shade of William Harvey.  Harvey laments the subjugation of medical art to profit, and urges them to turn away from “lucre” and focus again on Science, which can be done by following the lead of William III: “To him you must your sickly State refer, / Your Charter claims him as your Visiter. / Your Wounds he’ll close, and sov’reignly restore / Your Science to the Height it had before.”[6]

While it is not well-known today, The Dispensary was quite successful upon publication, going through ten editions during Garth’s lifetime (two of which were pirated).  The biographer of the much more famous English poet Alexander Pope praised Garth, claiming that he was one of the era’s best poets.[7]  Perhaps he can become an inspiration to any aspiring medical poets working today.