The Medical Act of 1858 was the culmination of medical, political and social wrangling for several decades before its passage. This essay looks to place the Act in its correct historical context and will specifically consider whether it brought about unity to what was a disparate and factional profession. That it was an important piece of legislation in the history of British healthcare is unquestioned, but the extent to which it directly brought about change is more uncertain. In order to understand the background, content and repercussions of the Act, one must recognize the structure of the medical system at that time. One reason for doing this, as argued by some, is that the Medical Act, like the Apothecaries Act of 1815, was the result of changes to the profession and not the cause of them. Reformists hoped that the Medical Act would unify the profession, yet significant historical, hierarchical and political barriers stood in the way of reform.