A Study of the Development of General Practice in the Scottish Islands

This study traces the development of General Practice in the Scottish islands from the earliest times up until the present day. The earliest evidence of medical practice is trephination carried out in the Bronze Age. In the Dark Ages, and succeeding centuries, medical practice was in the hands of the Columban missionaries, for whom medical cures demonstrated the superior power of monotheism over pagan gods. There was also a rich body of folk-beliefs, based on witchcraft, evil-eye etc., with healing by means of incantations, charm-stones and well-rituals In the twelfth century, the island chiefs employed well-educated hereditary clan physicians, but their influence declined in the early eighteenth century. For those less highly placed in the clan hierarchy, recourse was still made to folk-medicine. Increasingly, from the seventeenth century, readily recognisable medical practitioners were to be found in the islands. Medical practice was most unsatisfactory in the Scottish islands until the middle of the nineteenth century, when the Poor Law Amendment Act was passed. Although this Act improved medical practice considerably, the structure of landownership in the islands delayed its full benefits. A significant development was the Highlands & Islands Medical Service of 1912, which was practically unchanged by the advent of the National Health Service. It is second in importance only to the coming of air-service to the islands, which largely removed the geographical truism of remoteness and isolation.