The Belfast Medical Society was first founded in 1806 but ran into difficulties in 1814 and by 1818 had completely ceased to function. The minutes up to 1814 were available to Dr Andrew George Malcolm in 1851 as they are referred to in his History of the General Hospital but they are now missing. Our knowledge of that early society comes directly from Malcolm's History and it is to be assumed that his knowledge came directly from the minutes. He said that nineteen physicians and surgeons in Belfast were interested in mutual professional improvement and set up the society to provide a medical library. Membership was soon opened to the other practitioners in the vicinity, to apothecaries and to interested lay persons. An annual subscription of one guinea went towards the expenses of the library, a committee having been set up to select the books and journals to be purchased. The holdings were enhanced by the donation of books including valuable collections from Dr Drennan and Dr Halliday. There was an intention to form a collection of anatomical preparations but it is not known if that occurred.
Between 1806 and 1814, the position of president was successively held by Drs Halliday, Thomson, Drennan, and McCluney, while the combined position of Secretary and Treasurer was successively held by Drs McCluney, Marshall, McGee, and Thomson. Presumably each person served for two years although this is not certain. Unfortunately, disagreements arose amongst the Hospital attendants leading to the difficulties of 1814. The possessions of the society were dispersed (the donated books being returned) and after a failed attempt at recovery, it ceased to exist for a period of four years. The cause of the disagreement is not known but when it is considered that it occurred among the senior members of the society, and that when the society was revived it deliberately avoided having a president for the first twenty-eight years, it seems possible that the members fell out over the presidential succession.
The minutes record that on 8 June 1822 Dr James McDonnell, Dr Henry Forcade, Dr Robert Stephenson and Mr Moore met to consider reviving what they termed "the medical library", which is to say, the Belfast Medical Society. The annual subscription was set at one pound two and nine pence and it was agreed that a number of periodicals should be taken with books being added before long. Each new issue of a periodical was made available for one week for reading in the library before being circulated from member to member, forty-eight hours being allowed for its reading. Older issues and books could be borrowed in the usual way. The revived society had a total of twelve members by the end of the first year. In the absence of a president the chair at each meeting was taken by the fifth person who entered the room (and who also made the quorum).
It was proposed in June 1824 that a dinner be held to celebrate the revival of the Society. This became a popular annual event and one which continues to this day although the reason for the dinner is not always explicitly recalled. From May 1825 members who had paid a subscription for twenty years were excused further payment and this was said to have contributed greatly to the popularity of the Society. This custom also continues although as a result of improved life expectancy, only a reduced subscription is offered and only to those graduated forty or more years.
The minutes show that the main emphasis was always on the running of the medical library which was in its time the largest in the north of Ireland. The 1826 catalogue listed 138 books, journals and manuscripts but with the purchase of new books and the donation of old, that number had reached 1,249 titles in the 1859 catalogue. A major part of the increase was probably due to the acquisition of Dr Samuel Smith Thomson's library which he left to the Society.
A small number of medical and surgical cases were presented to the society from November 1822 to June 1823 but this practice then ceased. Malcolm himself joined the Society in 1842 and within three years the Society had agreed to accept clinical presentations at its meetings, to publish its transactions and to set up a pathological museum. In August 1845 a subcommittee was appointed to look into the latter and by 1851 nearly four hundred specimens had been collected. Malcolm was probably one of those responsible for these changes but it was Dr J M Sanders who actually proposed that the Society should receive presentations at its meetings and who presented the first case, one of Haematocele, in March 1845. The transactions of the society were recorded intermittently in the Dublin Hospital Gazette (both the original and new series) and in the Dublin Quarterly Journal of Medical Science, the latter being reprinted later in two volumes
Although the minutes from 1829 to 1843 are also now missing, we know from Malcolm that the society began to involve itself in medical politics both locally and nationally. The question of a medical school was debated as was the Medical Reform Bill. An ethical committee was established and published a set of guidelines for the conduct of practitioners towards each other (including in consultation), towards patients and in the conduct of their practice. The society also offered an arbitration service so that disputes might be settled out of the public eye.
Despite these innovations, some seem to have thought that the society was not changing far or fast enough and, largely due to Malcolm's initiative, the Belfast Clinical and Pathological Society was founded in 1853. It proved to be popular, more popular than the Belfast Medical Society which, in 1859 had only fifty-five members compared with the Belfast Clinical and Pathological Society's ninety-nine (thirty-one persons belonging to both). The Belfast Medical Society finally came to an end in 1862 with the amalgamation with the Belfast Clinical and Pathological Society and the Ulster Medical Protective Association to form the Ulster Medical Society.