RT Journal Article SR Electronic T1 The College of Physicians in the nineteenth century JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 234 OP 239 DO 10.7861/clinmedicine.1-3-234 VO 1 IS 3 A1 Gordon C Cook YR 2001 UL http://www.rcpjournals.org/content/1/3/234.abstract AB For much of the nineteenth century (during which there were 16 Presidents) events within the College were dominated by widespread demands for medical reform, culminating in the great Medical Reform Act of 1858. This led to major changes within the College, including an overhaul of the system(s) of elections; the old licentiates disappeared (to be replaced by the new licentiates), whilst introduction of the membership (by examination) was instituted. The style of Presidential elections was also changed. Internal College activities centred on the Library and on the London Pharmacopoeia. Early in the century, the College once again moved geographically, this time from the City to the West End of London. Regarding contemporary issues, including medical advances (notably introduction of the ‘germ-theory’ of disease causation) and important social changes (dominated by Poor Law reform), the College's input proved minimal.