In a 1825 article in The London Magazine aptly titled “Of Fashion in Physic,” the writer remarks how the public’s willingness to pay for what they considered “fashionable” trends in medicine and surgery left them vulnerable to ambitious practitioners or charlatans willing to exploit public faith. Speaking of aurists, the writer declared:
The people are not half deaf enough, or half the people are not deaf enough—which is the same thing. It is the business of the aurist to persuade them that they are deaf, or have been deaf, or will be deaf—or how could he exist? If they are not quite deaf enough, he makes them deafer—he persuades others that they are deaf, or will be deaf, or ought to be deaf—which answers equally well. It becomes the fashion to be an aurist—it becomes the fashion to have an aurist. Aurist sets up against aurist, their rival merits are discussed; and, in time, it is probably, no man will be able to hear without an aurist, as no man can now eat without a dentist.
What is interesting about the writer’s remark is the implication that deafness—or any hearing loss—was an ailment that could be constructed and controlled by aural surgeons, effectively removing it from any objective definition. An understanding of deafness could readily be constructed and controlled by the aurist who claimed to have found the proper methods of diagnosis and treatment. This implication was not lost on licensed practitioners, who feared the attractiveness of aural surgery would encourage the prominence of quacks and charlatans, who would in turn obliterate public trust in aural surgery and ward off licensed practitioners from venturing in the field as a speciality.
But who was a quack and how could he be recognized? William Babington, for example, lacked medical credentials, which was considered an obvious sign of the quack, and yet he was an established practitioner at Guy’s Hospital from 1795-1811 and produced work impressive enough to be honoured with presidency of the Geological Society of London and fellowship to the Royal Society in 1805. John Harrison Curtis of course was no stranger to ridicule and accusation: having only obtained minor qualifications from the College of Surgeons in order to work as a medical dispenser in the navy, Curtis’ contemporaries criticized his status as a medical practitioner (more on this later, I promise).
In Quacks: Fakers and Charlatans in English Medicine (2001), Porter claims that although “quack” was oftentimes used as an accusatory term, to convey insult and abuse towards a “bad, base doctor,” the accusations were largely issued from those who earned the reputation of being reputable practitioners. Reputable practitioners were commonly those who adhered to the standard practice of medicine at the time: mastering the requisites of a university education, setting up and maintaining a practice with a faithful client of patients, and enhancing his reputation through publishing or obtaining a position in a hospital or university. Those who dabbled in medicine without meeting the required standards were subjected to the inquisition against quackery.
However, as Porter insists, this does not mean we need to impugn the motives of the unqualified practitioner, nor deny his powers. Rather, we need to historically evaluate the social regime from which practitioners were accused of being quacks. In a society where demand for all sorts of healing combined with a literate public eager to exercise its consumerist powers, medical practitioners were forcibly aware of the success that entrepreneurialism offered.