The Project Gutenberg eBook of Eminent doctors: Their lives and their work; Vol. 1 of 2
    
This ebook is for the use of anyone anywhere in the United States and
most other parts of the world at no cost and with almost no restrictions
whatsoever. You may copy it, give it away or re-use it under the terms
of the Project Gutenberg License included with this ebook or online
at www.gutenberg.org. If you are not located in the United States,
you will have to check the laws of the country where you are located
before using this eBook.

Title: Eminent doctors: Their lives and their work; Vol. 1 of 2

Author: G. T. Bettany

Release date: November 22, 2022 [eBook #69406]

Language: English

Original publication: United Kingdom: John Hogg, 1885

Credits: Bob Taylor, Emmanuel Ackerman and the Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive)


*** START OF THE PROJECT GUTENBERG EBOOK EMINENT DOCTORS: THEIR LIVES AND THEIR WORK; VOL. 1 OF 2 ***





  Transcriber’s Note

  Italic text displayed as: _text_




                          EMINENT DOCTORS.




                          Ballantyne Press
                     BALLANTYNE, HANSON AND CO.
                        EDINBURGH AND LONDON




                          EMINENT DOCTORS:

                     Their Lives and their Work.

                                 BY

         G. T. BETTANY, M.A. (CAMB.), B.Sc. (LOND.), F.L.S.

           AUTHOR OF “FIRST LESSONS IN PRACTICAL BOTANY,”
                    “ELEMENTARY PHYSIOLOGY,” ETC.
      AND LECTURER ON BOTANY IN GUY’S HOSPITAL MEDICAL SCHOOL.

  “There is to me an inexpressible charm in the lives of the good,
   brave, learned men, whose only objects have been, and are, to
                  alleviate pain and to save life.”

                            —G. A. SALA.

                          _IN TWO VOLUMES._

                               VOL. I.

                  [Illustration: Bookmaker’s Mark]

                               LONDON:
                     JOHN HOGG, PATERNOSTER ROW.

                      [_All rights reserved._]




                              PREFACE.


Medical Biography has not taken its due place in the thoughts of our
countrymen, nor has it received deserved attention from literary
men. Anecdotes of big fees, brilliant operations, brusque actions,
or suave politeness, have too exclusively contributed to form the
popular idea of eminent physicians and surgeons. Aikin’s incomplete
“Biographical Memoirs of Medicine,” Macmichael’s “Lives of British
Physicians,” and Pettigrew’s “Medical Portrait Gallery,” have been
the chief collective records of British medical men; and the latter,
owing to its expensive form, was inaccessible to most persons.
Munk’s “Roll of the College of Physicians” is a mine of information
about members of that College, and a similar record of members of
the College of Surgeons would be invaluable. In 1865 Dr. Herbert
Barker commenced, and after his lamented death Dr. Tindal Robertson
continued, a series of memoirs of living medical men, accompanied by
photographs. The _Midland Medical Miscellany_ commenced to publish
a somewhat similar series of memoirs, with portraits, in 1882. The
medical press has been distinguished for the ability and general
fidelity of its biographical notices of deceased members of the
profession.

There is no book, however, in current literature which supplies
medical men or the general public with biographical accounts of the
most notable men who in this kingdom have contributed to make the
medicine and surgery of to-day what they are. It is the aim of the
present book to occupy this vacant place. It is hoped that this has
been done in a form neither too technical for the general reader, nor
unsuitable for the busy practitioner, who has very little time to
read elaborate biographies, but would fain store his mind with the
principal facts and lessons of the lives of his great predecessors
and teachers.

The difficulty of selection has been great. It was felt that sure
ground would be occupied by taking the foundation of the London
College of Physicians as a starting-point, and giving a place only
to those celebrated men in the seventeenth and eighteenth centuries
whose title to fame none would deny. Paucity of biographical
materials has prevented the introduction of some names; others have
been excluded because they were rather notorious for their fees,
their _bonmots_, or their fantastic behaviour, than for their solid
contributions to medicine.

In regard to men of the present century, the task of selection
has been still more difficult. For the most part distinguished
physiologists, zoologists, &c., do not find a place in these pages,
unless they have also won distinction in medical practice. It cannot
be expected that the list of living names will satisfy everybody.
Others as worthy might have been included. If in refraining from
commenting on the career of his present colleagues at Guy’s Hospital,
the author may appear to have done injustice to their great merits,
he is convinced that he has thereby best steered clear of the dangers
of partiality. The utmost care has been taken to avoid giving details
which should be private during a man’s life, and to state only those
facts about living men which have already for the most part been
made generally accessible.

The task of reading hundreds of biographical memoirs, medical
treatises, scattered pamphlets and papers, has been exceedingly
heavy. All those named in the following pages have been consulted;
and where details are not given of controversies or incidents which
some may be surprised to see passed over, this has been the result
of careful deliberation. The author desires specially to acknowledge
his great obligations to the _Lancet_ and other medical journals. He
trusts he has contributed to the object which they, like himself,
have at heart, of elevating the medical profession in the public
estimation.


  DULWICH, _September 1885_.




                         CONTENTS OF VOL. I.


                                                                  PAGE

  PREFACE                                                            v

  CHAP.

  I. LINACRE, CAIUS, AND THE FOUNDATION OF BRITISH
  MEDICINE                                                           1

  II. WILLIAM HARVEY AND THE CIRCULATION OF THE
  BLOOD                                                             25

  III. THOMAS SYDENHAM, THE BRITISH HIPPOCRATES                     52

  IV. THE MONROS, CULLEN, THE GREGORYS, JOHN BELL,
  AND THE FOUNDATION OF THE EDINBURGH SCHOOL
  OF MEDICINE                                                       71

  V. WILLIAM AND JOHN HUNTER AND THE APPLICATIONS
  OF ANATOMY AND PHYSIOLOGY TO SURGERY                             119

  VI. EDWARD JENNER AND VACCINATION                                169

  VII. SIR ASTLEY COOPER AND ABERNETHY: THE KNIFE
  _versus_ REGIMEN                                                 202

  VIII. SIR CHARLES BELL AND THE FUNCTIONS OF THE
  NERVOUS SYSTEM                                                   242

  IX. MARSHALL HALL AND THE DISCOVERY OF REFLEX
  ACTION                                                           264

  X. SIR BENJAMIN BRODIE AND SIR WILLIAM LAWRENCE,
  TWO GREAT PRACTICAL SURGEONS                                     286




EMINENT DOCTORS.




CHAPTER I.

_LINACRE, CAIUS, AND THE FOUNDATION OF BRITISH MEDICINE._


The name of THOMAS LINACRE must stand at the head of any account of
the history of British medicine, for before his accession to the
office of tutor and physician to Prince Arthur, eldest son of Henry
VII., in 1501, no physician of such ability as to have left works
of permanent value had arisen in this country. To him belongs the
honour of having founded the Royal College of Physicians of London,
the earliest of the British medical corporations; and by that one act
he may be said to have constituted medicine a distinct profession.
The slightness of the emphasis which can be laid upon the medical
profession up to Linacre’s time may be recognised from the fact that
he was both tutor and medical attendant to a prince, and that he
subsequently became a not undistinguished ecclesiastic.

Canterbury gave birth to this founder of British medicine about
1460. He derived his descent, however, from a Derbyshire family
of Saxon blood flourishing before the Conquest at Linacre, near
Chesterfield. His school-days were passed under the superintendence
of William Selling, at the monastic school of Christchurch in
Canterbury. Selling was an enlightened man for his time, and had
travelled in Italy, where he studied Greek with one of the most
eager students of the time, Politian, and had brought home with him
numerous valuable manuscripts. A fellow of All Souls’ himself, he
doubtless had some influence in securing the election of his pupil to
a fellowship there at an early age, in 1484. At Oxford Linacre was a
pupil of Cornelio Vitelli, an Italian, one of the earliest teachers
who brought Greek learning into this country.

Before long Linacre himself took charge of pupils, the most famous of
whom afterwards became Sir Thomas More. Linacre accompanied Selling
to Italy when Henry VII. appointed the latter on a mission to the
Roman pontiff. In Italy he received the benefit of introductions
to, and instructions from, Politian and others, and formed an
acquaintance with Aldus Manutius, the celebrated printer, at Venice.
At Florence he was introduced to Lorenzo de Medici, who specially
approved of his companionship with his sons both in their studies
and their amusements. After taking the degree of Doctor of Medicine
in the University of Padua with great applause, owing to the skill
with which he defended the positions of his thesis, he returned to
England. He apparently betook himself at once to Oxford, where he was
incorporated M.D. It is presumed that he was still most concerned
in academical pursuits; and he was the first Englishman to publish
a correct rendering of a Greek author after the revival of letters,
namely, the “Sphere” of Proclus, printed by Aldus at Venice in 1499.
Whether he was also incorporated at Cambridge, as Dr. Caius relates,
cannot now be proved, but it is rendered probable by the fact of his
subsequent foundation of a lectureship in medicine at that university.

At this period of his life Linacre had the good fortune to be the
instructor, especially in Greek, of no less a person than Erasmus.
The latter was evidently a most appreciative admirer of our erudite
doctor, as well as of the facilities for classical study afforded
in England. “In Colet,” says he, writing to Robert Fisher, “I hear
Plato himself. Who does not admire the perfect compass of science
in Grocyn? Is aught more acute, more exalted, or more refined than
the judgment of Linacre? Has nature framed anything either milder,
sweeter, or happier than the disposition of More? It is wonderful
how universally copious is here the harvest of ancient learning,
wherefore you should hasten your return.”

With the beginning of the sixteenth century, however, a new era in
Linacre’s life dawns. Whether or not he was introduced to court in
1501 in connection with the visit of Prince Arthur to Oxford, it is
certain that about the period when the prince was contracted in
marriage to Catherine of Arragon, his health and further education
were intrusted to Dr. Linacre; and it is believed, though without
sure grounds, that he also became one of the king’s domestic
physicians.

The death of the young prince, however, relieving Linacre of his
tutorial duties, appears to have had the effect of throwing him with
ardent zeal into the practice of the medical profession. Erasmus had
availed himself of his skill, as is testified by a letter of his from
Paris in 1506, giving an account of his complaints, and lamenting the
want of his accustomed advice and prescriptions. His friends even
found that he was too devoted to his studies and practice, and begged
him to relax so far as to write to them occasionally. Probably the
economical disposition of Henry VII. prevented Linacre from reaping
too great a reward from his connection with the court, and he would
hail with hopeful feelings the accession of Henry VIII. with his more
liberal tendencies. His position was soon assured by his appointment
as one of the king’s physicians, apparently the principal one; and
his estimation at court was higher than his office alone would have
occasioned, in consequence of his learning and social qualities. His
other patients included Cardinal Wolsey, Archbishop Warham, and Fox,
Bishop of Winchester.

About the commencement of Henry VIII.’s reign Linacre took up the
study of theology, which he had previously neglected in his zeal for
the revival of letters; and, in accordance with the practice of the
age, on becoming convinced of the importance of Christian doctrines,
he sought ordination. In October 1509 the Primate gave him the
rectory of Merstham, in Kent, which he held only a month, receiving
in December a prebendal stall in the cathedral of Wells, and in 1510
the cure of Hawkhurst, in Kent, which he held till 1524. Still higher
preferment, however, awaited him, for he became canon and prebend
of Westminster in 1517. Numerous other appointments followed, which
we will not particularise. It does not appear certain that Linacre
gained any conspicuous distinction in theology, but his preferments
were rather acknowledgments of his general learning and merit, being
the most convenient form in which such recognition could at that time
be given.

Linacre’s intercourse with Erasmus continued, but was somewhat
embarrassed by reason of the latter’s constant demand for pecuniary
aid. We gain a glimpse of the prudence which Linacre had attained,
from a letter of Erasmus in 1521, complaining of the unfavourable
reception of his applications for money, mentioning that though
his health was infirm, and though he possessed only six angels, he
had been advised to curtail his expenses and bear his poverty with
fortitude, rather than apply further to the Primate and Lord Mountjoy.

We have now to recur to Linacre’s medical pursuits, which were not
interrupted to any serious extent by his clerical preferments. Early
in Henry VIII.’s reign, he read before the University of Oxford a
“Shagglyng” lecture, of which nothing but the name is preserved.
His renewed connection with Oxford occasioned it to be bruited
abroad that he had a special design of making benefactions to the
university, and the authorities bethought themselves that they had
somewhat neglected their distinguished alumnus. Consequently they
presented him with an address, in which they seem to have been
actuated by that kind of gratitude which consists in a lively sense
of favours to come. Part of it runs thus (translated from Latin),
showing how much dignity a learned university then possessed:—

  “To Thomas Linacre, the most skilful physician of the king.”

“We are not a little troubled, excellent sir (to mention nothing
besides), and most learned of physicians, since till now we
have never greeted your pre-eminence by letter (let us confess
the truth), how we may readily devise the means by which we may
handsomely remove from ourselves the stain of ingratitude which we
have incurred, were we otherwise than assured that you are rather
displeased at the greater goodwill, nay the more ardent affection,
which your courtesy has entertained towards our university,
than at any negligence, not to say sluggishness of our own. How
excellent the mind, how liberal the devotion of him, who, whilst
he is the most eminent, is indisputably the most eloquent of his
contemporaries, towards the university of Oxford, is a secret
to none. How well you think of us, and how generously you have
resolved to provide for our interests, we have fully learned from
the report of our colleagues, who have discoursed with you.... But
that we have yet made no returns for your extraordinary bounty
towards us (to repay, alas! accords not with our poverty), which
we can only do with our whole hearts ... we give you truly our
fullest thanks, resting our chief hope in you, whose reputation
stands so high with the king’s majesty, that we may with good
reason commemorate you amongst the most active leaders and foremost
patrons of our academical host.”


The form which very many attempts to promote the progress of medicine
in that age took was that of translations of and commentaries on the
works of Galen, which in the original Greek were inaccessible to
nearly every one.

After spending much time on executing his share of a scheme for
translating Aristotle’s entire works into Latin, in conjunction
with Grocyn and Thomas Latimer, and which unfortunately never was
published, Dr. Linacre betook himself to the congenial task of
translating into Latin Galen’s works, the first portion of which,
on the Preservation of Health, was published at Paris in 1517, and
dedicated to Henry VIII. The feelings which moved him to this act
arose, as he declares to the king, from finding himself wanting in
the means of vying with those who, allured by the renown and glory
of his name, daily contended in the number and variety of their
gifts. For this reason he knew nothing more becoming his duty or his
calling, than the dedication of some memorial of his studies, that
he might satisfactorily account for the leisure which, by the royal
indulgence, he sometimes stole from his appointed attendance, and at
the same time show that he not only spent the hours of office, but
even of recreation from its duties, in accomplishing, to the best of
his ability, what he thought would be acceptable to him. A copy of
this work on vellum, and magnificently embellished, was presented to
Wolsey, with an adulatory letter. These are still preserved in the
British Museum.

This translation was followed by several others from Galen, including
the Method of Healing, 1519, dedicated to the king; the treatise on
Temperaments, 1521, dedicated to Leo X.; on the Natural Functions,
1523, dedicated to Warham; on the Pulse, 1523, dedicated to Wolsey.
Other treatises left complete at Linacre’s death were printed by
Pynson in 1524. Of the treatises on grammar and language, compiled by
Linacre, we need not here attempt to give an account.

Most important of all Linacre’s achievements towards the advancement
of medicine was undoubtedly his securing the foundation of the
Royal College of Physicians. “The practice of medicine,” says his
biographer, Dr. J. N. Johnson, “when this scheme was carried into
effect, was scarcely elevated above that of the mechanical arts;
nor were the majority of its practitioners better educated than
mechanics. No society as yet existed, independent of the monastic and
ecclesiastical, which could at all be considered learned.”

Linacre was at the sole expense of founding the college, for the
crown merely granted the letters patent. These were issued in 1518,
incorporating all physicians in London as one faculty and college,
with power to elect a president, to use a common seal, and to hold
lands not exceeding the annual value of £12. They were to hold
assemblies and govern their faculty in London and within seven miles,
all persons being interdicted from practice who did not hold their
license. Four censors were to be chosen yearly, for the correction
and government of physic and its professors, the examination of
medicines, and the punishment of offenders; and physicians were to be
exempt from attendance at assizes, inquests, and juries. The power
of correction by fine or imprisonment occasioned some embarrassment
at a subsequent period, for when some offenders were committed
by the college, the gaolers would not receive them into prison,
considering the college must charge itself with the custody of its
own culprits. To obviate this difficulty a statute (I Mary, sess.
2, c. 9) was passed, requiring gaolers to receive persons committed
by the college, and also enjoining all justices, mayors, &c., in
London to assist the President of the college in searching for faulty
apothecary wares.

Various defects having been found in the original letters patent,
they were confirmed by a statute, 14 Henry VIII. (1523), which
provided among other things that no person except graduates of Oxford
or Cambridge should be permitted to practise physic throughout
England, unless examined and approved by the President of the College
of Physicians of London, and at least three other selected members.
Previous to Linacre’s time, the bishops or their vicars-general
were the persons who could grant licences to practise medicine (in
addition to the universities), and this power was long after this
retained by them, although they called in physicians to assist them
in determining to whom licences should be granted.

As was but natural, Linacre was the first President of the college
which owed its existence to himself, and he held that office till his
death. His residence, the Stone House, in Knight-Rider Street, Paul’s
Wharf, convenient for access to the Court, then kept up at Bridewell,
was also the meeting-place of the college. The front portion of the
house, a parlour below, and a council room and library above, were
given to the college during his lifetime, and remained the property
of the college until 1860.

In considering the import of Linacre’s endeavours to promote the
study of medicine at Oxford and Cambridge, it must be remembered that
the idea of establishing lectureships or professorships for public
instruction was quite a novel one in England, and that Fox, Bishop
of Winchester, appears to have been the first, in 1517, to endow
lectures in Greek and Latin. And Linacre unquestionably has the merit
of first applying such an idea to the improvement of instruction in
medicine. His foundations did not take full effect till 1524. Again,
we have a letter from the University of Oxford “to the renowned
Dr. Linacre,” couched in the most exaggerated style of panegyric,
thanking him for his proposition to endow “splendid lectures” in
medicine, lauding his “sober gravity and erudite judgment,” “his
greatness,” “the transcendency of his gifts.” The letters patent
founding the lectures were dated on the 12th of October, 1524, only
eight days before his death. Two of the lectureships were to be
founded at Oxford and one at Cambridge, and to be named Linacre’s
Lectures. Thirty pounds a year, a considerable sum then, was to be
devoted to this purpose by his trustees, out of the proceeds of two
manors at Newington, near Sittingbourne. But although the trustees,
Sir Thomas More, Tonstal, Stokesley, Tonstal’s successor, and John
Shelley, were men who might have been expected to pay attention to
Linacre’s desires, yet, probably owing to the busy occupations in
which they were engaged, they failed to carry them into full effect;
and it was not till the third year of Edward VI. that Tonstal, the
surviving trustee, assigned two of the lecturers to Merton College,
Oxford, and one to St. John’s College, Cambridge. Their office was
to expound publicly certain parts of Hippocrates or Galen. That his
lectures failed to become what Linacre would have wished, was due to
the common defect of that age in not foreseeing the revolutions in
learning that were to come, and not providing any elasticity in their
foundations. Thus these lectureships, which might have powerfully
aided the development of medicine, remained of little use till modern
times, when they have been placed on an improved footing.

“It has been questioned,” writes his biographer, “whether he was
a better Latinist or Grecian, a better grammarian or physician, a
better scholar or man. That Linacre was of a great natural sagacity,
and of a discerning judgment in his own profession, we have the
concurrent testimony of the most knowing of his contemporaries.
In many cases which were considered desperate, his practice was
successful. In the case of his friend Lilye, he foretold his certain
death if he submitted to the opinion of some rash persons who advised
him and prevailed with him to have a malignant strumous tumour in his
hip cut off, and his prognostic was justified by the event.

“In private life he had an utter detestation of everything that was
dishonourable; he was a faithful friend, and was valued and beloved
by all ranks in life. He showed a remarkable kindness to young
students in his profession; and those whom he found distinguished for
ingenuity, modesty, learning, good manners, or a desire to excel, he
assisted with his advice, his interest, and his purse.”

Linacre had suffered for years from stone in the bladder, which had
limited his usefulness and the perfection of several of his designs;
and he died of ulceration of the bladder, on the 20th October, 1524,
having made his will four months previously. He was buried in St.
Paul’s Cathedral, in a spot chosen by himself, and expressly named
in his will. No memorial was erected over his grave until 1557, when
Dr. Caius, one of his successors, reared a monument with a suitable
inscription, ending with a favourite expression which he afterwards
placed on his own tomb, “Vivit post funera virtus.”

The will of Dr. Linacre includes annuities to his two sisters, a
bequest to his brother, and other legacies. To his nieces Alice and
Margaret he bequeathed each a bed, Margaret to have the better; and
to William Dancaster, a priest who witnessed the will, a feather-bed
and two Irish blankets were left. The simplicity of these details
shows that a man of high distinction in many ways at that time
counted as important possessions articles now universal.[1]

       *       *       *       *       *

JOHN KAYE or KEY, better known by the Latinised form CAIUS, which
retains nevertheless the pronunciation derived from the English
original, Keys, was born at Norwich on the 6th of October, 1510,
being thus fourteen years old at Linacre’s death. He entered
Gonville Hall, Cambridge, on the 12th September, 1529, and here he
early distinguished himself by translating from Greek into Latin two
treatises—one by Chrysostom—and by making an abridgment of Erasmus’s
“De Verâ Theologiâ.” He took the degree of B.A. in 1532-3, and was
appointed principal of Physwick Hostel on the 12th November, 1533,
being elected to a fellowship of Gonville Hall on December 6th
following. Proceeding M.A. in 1535, he is recorded as subscribing,
with the master and fellows of Gonville Hall, the submission to Henry
VIII.’s injunctions.

In 1539 he went to Italy, and studied medicine at Padua under
Montanus, lodging in the same house with Vesalius, who became the
most distinguished anatomist of his time. In 1541 the degree of
Doctor of Medicine was conferred upon him at Padua, where in the
next year we find him delivering public lectures on the Greek text
of Aristotle, in conjunction with Realdus Columbus, the stipend for
which was provided by some Venetian nobles. The next year, 1543, he
largely occupied in visiting all the most celebrated libraries of
Italy, collating manuscripts, principally with a view to publishing
correct editions of Galen and Celsus.

Returning to England after further travels in France and Germany,
he was incorporated M.D. at Cambridge, and practised apparently at
Cambridge, Norwich, and Shrewsbury, with such success that he was
appointed physician to Edward VI., an appointment he continued to
hold under Queens Mary and Elizabeth. On the 22d December, 1547,
he was admitted a Fellow of the College of Physicians, and in 1550
became an Elect, in 1552 Censor. In the latter year appeared his
English treatise on the Sweating Sickness, which had broken out at
Shrewsbury in 1551. This was afterwards enlarged and published in
Latin.

“The Boke or Counseill against the Sweatyng Sicknesse,” was dedicated
by Dr. Caius to William, Earl of Pembroke. The dedication begins
thus: “In the fearful time of the sweat, many resorted unto me for
counsel, among whom some being my friends and acquaintance, desired
me to write unto them some little counsel how to govern themselves
therein.... At whose request at that time, I wrote divers counsels
so shortly as I could for the present necessity, which they both
used and did give abroad to many others, and further appointed in
myself to fulfil the other part of their honest request for the time
to come. The which the better to execute and bring to pass, I spared
not to go to all those that sent for me, both poor and rich, day and
night. And that not only to do them that ease that I could, and to
instruct them for their recovery; but to note also thoroughly the
cases and circumstances of the disease in divers persons, and to
understand the nature and causes of the same fully, for so much as
might be.”

A certain conceit is evident throughout the brief treatise, as when
he describes his early translations from Latin into English, and
partially apologises for writing in English, then gives an account
of the life and writings of his friend, William Framingham, a
fellow-townsman of his who died young. The description of the disease
which he gives indicates a very acute rheumatic affection, inasmuch
as perspirations of disagreeable odour, acute pains in the limbs,
delirium, quick and irritable pulse, &c., were prominent among them.

It is notable how little medical science was progressing beyond
Galenic principles. Dr. Caius says, “This disease is not a sweat
only, but a fever in the spirits by putrefaction venomous, with a
fight, travail, and labour of nature against the infection received
in the spirits, whereupon by chance followeth a sweat, or issueth an
humour, compelled by nature, as also chanceth in other sicknesses
which consist in humours.” Still, a glimpse of truth is shown in
the view expressed that “our bodies can not suffer anything or hurt
by corrupt and infective causes, except there be in them a certain
matter prepared, apt and like to receive it, else if one were sick,
all should be sick.”

Dr. Caius showed himself notably before his age also in his censures
of excess in eating and drinking, his commendation of the bath, and
of muscular exercise. His advice to his readers to have recourse
to a good physician, and to be at least as good to their bodies
as to their hose or their shoes, is followed by a picture of the
army of quacks who in default of science preyed upon the masses.
“Simple-women, carpenters, pewterers, braziers, soapball-sellers,
apothecaries, avaunters themselves to come from Pole,
Constantinople, Italy, Almaine, Spain, France, Greece, Turkey, India,
Egypt or Jury; from the service of emperors, kings, and queens,
promising help of all diseases, yea incurable, with one or two
drinks, by drinks of great and high prices, as though they were made
of the sun, moon, or stars, by blessings and blowings, hypocritical
prayings, and foolish smokings of shirts, smocks, and kerchiefs, with
such others, their phantasies and mockeries, meaning nothing else but
to abuse your light belief, and scorn you behind your backs, with
their medicines (so filthy, that I am ashamed to name them), for your
single wit and simple belief, in trusting them most, which you know
not at all, and understand least; like to them which think far fowls
have fair feathers, although they be never so evil favoured and foul;
as though there could not be so cunning an Englishman, as a foolish
running stranger, or so perfect health by honest learning, as by
deceitful ignorance.” From all which the reader may judge whether
somewhat similar remarks might not be applicable to the last century,
and even to a great part of the present, in its credulity of the
efficacy of quack medicines and the powers of audacious empirics.

In 1555 Dr. Caius was elected President of the College of Physicians,
an office which he continued to hold until 1561. He applied himself
with devoted energy to promoting the interests of the college,
commencing to record its annals, till then unpreserved, procuring
the copying and binding in grand style of the college statutes,
designing the insignia, the cushion of crimson velvet edged with
gold on which the statutes were laid, the silver staff ornamented
with the college arms borne by the President, to remind him,
according to Caius, by its material (silver), to govern with patience
and courtesy, and by its symbols (the serpents), with judgment
and wisdom. His zeal further exhibited itself in protecting the
privileges of the college, as when he appeared successfully, in
Elizabeth’s reign, against the barber surgeons, who were claiming the
right to prescribe medicines for internal administration in cases
where their operative assistance was called in.

One of the most striking innovations which Dr. Caius introduced into
this country was unquestionably the practice of dissection of the
human body. He had actually taught practical anatomy in the Barber
Surgeons’ Hall, not long after his return from Italy; and he further
provided for the development of that science by procuring from Queen
Elizabeth, about 1564, a grant to the College of Physicians to take
annually the bodies of two criminals after execution, for dissection,
and the fellows were required, under penalty of a fine for refusing,
to give demonstrations and lectures on anatomy in turn. He left a
fund for defraying the expenses attending these dissections.

Dr. Caius had never wavered in his attachment to learning, and
to his alma mater, Cambridge. Notwithstanding his numerous public
interests, the court, the college, and private practice, he developed
fully and had the pleasure of carrying into execution a design for
improving and enlarging Gonville Hall, which under his auspices
became a college, with the addition of his name to its title. He
added to its resources very considerably, founded three fellowships
and twenty scholarships, and enlarged it by building an entirely
new court, known as Caius Court. Together with this enlargement he
pleased his taste by erecting three new gates, two on its external
boundaries, and one within it. The first, severely simple, was
inscribed “Humilitatis;” the second, more lofty, and surmounted
by several rooms, was on one side inscribed “Virtutis,” on the
other “Jo. Caius posuit Sapientiæ.” The last, smaller, but highly
decorated, leading to the Senate House and the Schools, bore the
word “Honoris;” and thus the worthy doctor signified that by way of
humility we attain to virtue and honour.

By the authority of letters patent granted by Philip and Mary, 4th
September, 1557, Dr. Caius was authorised to frame new statutes
for Gonville and Caius College. It was not till 1558 that he
was incorporated M.D. at Cambridge, and the next January he
was reluctantly induced to accept the dignity of master of the
college, which then fell vacant. He made this a further occasion of
benefaction by refusing the stipend and emoluments of the office,
which he held till one month before his death. For one year he
resigned the presidency of the College of Physicians, that he might
more uninterruptedly superintend the erection of his new court at
Cambridge; but he returned to the presidency for 1562-3, and again in
1571.

A man of Dr. Caius’s incessant activity and zeal for his own opinions
could not hope to remain without enemies. In 1565 three fellows of
his college, whom he had expelled, charged him with atheism and
opposition to professors of the Gospel. His maintenance of his
post at court under sovereigns of opposite religious professions,
notwithstanding his attachment to Romanism, was made a subject of
accusation of unsteadiness in his religious principles. Fuller
remarks that “his being a reputed papist was no great crime to such
who consider the time when he was born, and foreign places wherein
he was bred. However, this I dare say in his just defence: he never
mentioneth Protestants but with due respect, and sometimes doth
occasionally condemn the superstitious credulity of popish miracles.”
Nevertheless, he retained in his college certain books and vestments
formerly used in the Roman Catholic service, and Bishop Sandys
having written to the vice-chancellor, Dr. Byng, complaining of
this, they were collected and burnt in 1572 (Dec. 13), much to Dr.
Caius’s vexation, who considered Dr. Byng’s action most arbitrary,
and inveighed strongly against the conduct of certain fellows of his
college in the matter.

Previous to this time, in 1570, Dr. Caius had published an account
of British dogs, which is the earliest scientific description of the
kind of dogs then occurring in this country. It had been the result
of a request by the celebrated naturalist, Gesner, whose death in
1565 prevented its earlier publication. Numerous other accounts of
British natural history had been furnished by Dr. Caius to Gesner,
and were inserted in his works. To give an idea of our doctor’s
ability in descriptive natural history, we subjoin his account “Of
the dog called a Bloodhound.”

“The greater sort which serve to hunt, having lips of a large size,
and ears of no small length, do not only chase the beast while it
liveth, but being dead also by any manner of casualty, make recourse
to the place where it lieth, having in this point an assured and
infallible guide, namely the scent and savour of the blood sprinkled
here and there upon the ground. For whether the beast being wounded,
doth notwithstanding enjoy life, and escapeth the hands of the
huntsman, or whether the said beast being slain is conveyed cleanly
out of the park (so that there be some signification of blood shed),
these dogs with no less facility and easiness than avidity and
greediness, can disclose and bewray the same by smelling, applying
to their pursuit agility and nimbleness without tediousness. And
albeit peradventure it may chance that a piece of flesh be subtilly
stolen and cunningly conveyed away with such provisos and precaveats
as thereby all appearance of blood is either prevented, excluded,
or concealed, yet these kind of dogs by a certain direction of an
inward assured notice and privy mark, pursue the deed-doers, through
long lanes, crooked reaches, and weary ways, without wandering awry
out of the limits of the land whereon those desperate purloiners
prepared their speedy passage. Yea, the nature of these dogs is such,
and so effectual is their foresight, that they can bewray, separate,
and pick them out from among an infinite multitude and an innumerable
company—creep they never so far into the thickest throng, they will
find him out notwithstanding he lie hidden in wild woods, in close
and overgrown groves, and lurk in hollow holes apt to harbour such
ungracious guests. Moreover, although they should pass over the
water, thinking thereby to avoid the pursuit of the hounds, yet will
not these dogs give over their attempt, but presuming to swim through
the stream, persevere in their pursuit, and when they be arrived and
gotten the furthen bank, they hunt up and down, to and fro run they,
from place to place shift they, until they have attained to that plot
of ground where they passed over.”

This treatise was so highly esteemed by Pennant that he inserted it
in his British Zoology; and it was reprinted in a very neat form in
1880.[2]

We need not particularise the very numerous editions and translations
from Galen, Celsus, Hippocrates, which Dr. Caius published or left
in manuscript. His own original medical works were the Method of
Healing, based however upon Galen and Montanus, and the account of
the sweating sickness, concerning which Hecker remarks, “Although,
judged according to a modern standard, it is far from satisfactory,
yet it contains an abundance of valuable matter, and proves its
author to be a good observer.”[3]

Dr. Caius is credited with having predicted the very day of his
death. He had his own grave prepared in Caius College Chapel, on the
2d, 3d, and 4th of July, 1573, and died at his London house on the
29th of the same month, aged sixty-three. His body being removed
to Cambridge as he had directed, the master and fellows of his
college and the principal members of the university in procession
met it at Trumpington. The inscription on his tomb in Caius Chapel
is characteristic of the man, in whose eyes his own works and
achievements, undoubtedly considerable, loomed large. “Vivit post
funera virtus,” as he had recorded on Linacre’s monument. “Fui
Caius,” he adds, as a pithy if egotistic comment.

       *       *       *       *       *

Among other notable men of the sixteenth century must be mentioned
WILLIAM GILBERT, M.D., a native of Colchester, who was born in 1540,
and became senior fellow of St. John’s College, Cambridge, in 1569.
Having settled in London in 1573, his distinction was such that he
became physician to Queen Elizabeth. But he was one of the first
of the illustrious series of English physicians who employed their
leisure in philosophical research. By his book, “On the Magnet, on
Magnetic Bodies, and the Great Magnet the Earth,” published in 1600,
he had the good fortune to become the stimulator of Galileo himself
to the study of magnetism, and that master described him as “great to
a degree which might be envied.” Queen Elizabeth added to her titles
to regard by conferring a pension on Gilbert, which aided him in
prosecuting his experiments. Gilbert was in fact a great originator
in science, having discovered the earth’s magnetism, and that to this
is due both the direction of the magnetic needle north and south,
and the variation and dipping of the needle. Thus he stands as the
discoverer of the facts on which the science of magnetism was based.
He is said to have been no less exact in chemistry, but unfortunately
nothing of his is extant on that subject. Fuller says of him in the
“Worthies”—“Mahomet’s tomb at Mecca is said strangely to hang up,
attracted by some invisible loadstone; but the memory of this doctor
will never fall to the ground, which his incomparable book, ‘_De
Magnete_,’ will support to eternity.” Gilbert died in 1603, shortly
after being appointed physician to James I.


FOOTNOTES:

[1] Life of Thomas Linacre. By J. Noble Johnson, M.D. London, 1835.

[2] “Of Englishe Dogges:” 170 Strand, W.C.

[3] “Epidemics of the Middle Ages.” Sydenham Soc. Publ. London 1844.




CHAPTER II.

_WILLIAM HARVEY AND THE CIRCULATION OF THE BLOOD._

  “Oft have I seen a timely-parted ghost,
  Of ashy semblance, meagre, pale, and bloodless,
  Being all descended to the labouring heart,
  Who in the conflict that he holds with death,
  Attracts the same for aidance ’gainst the enemy;
  Which with the heart there cools, and ne’er returneth
  To blush and beautify the cheek again.”

If the man who discovered a new material world deserves immortality,
equally meritorious is he who revealed a new world of activity, and
promulgated the first true conception of the ceaseless round of vital
processes. As Dr. Parkes says in his Harveian Oration, 1876, “When
any one examines into this discovery of Harvey’s, and gradually
recognises its extraordinary importance, he cannot but be seized with
an urgent wish to know how the mind which solved so great a problem
was constituted; how it worked and how it reached, not merely the
probability, but the certainty, of a grand natural law.... There
was no accident about it—no help from what we call chance; it was
worked out and thought out, point after point, until all was clear as
sunshine in midsummer. Nor had it been anticipated.”

WILLIAM HARVEY, eldest son of Thomas Harvey and Joan Halke, was
born at Folkestone in Kent, on the 1st of April, 1578, and that
his parents were in easy circumstances may be judged by the fact
that five of his brothers became substantial London merchants. Of
his mother it is recorded on her monumental tablet that she was “a
careful, tender-hearted mother, dear to her husband, reverenced of
her children, beloved of her neighbours.” Her eldest son, after
some years’ education at Canterbury, was entered at Gonville and
Caius College in 1593, where he remained till 1597, when he left the
university with the B.A. degree, and betook himself to Padua. This
renowned university then boasted among its professors Fabricius, the
anatomist, whose influence upon Harvey was evidently remarkable.
After five years, Harvey obtained his doctorate in medicine, couched
in terms of the utmost praise of his astonishing ability, memory,
and knowledge, and returned to England. He was admitted to the same
degree at Cambridge, and settled in practice in London, marrying the
daughter of Dr. Launcelot Browne in his twenty-sixth year—a union
which proved childless.

Having become a candidate for the Fellowship of the College of
Physicians in 1604, he was admitted in 1607 after due probation; and
we find him in 1609 seeking the reversion of the physiciancy to St.
Bartholomew’s Hospital, gaining the king’s letters recommendatory,
and producing such testimonials from the President of the College of
Physicians and others that he was chosen before the vacancy occurred,
and on the death of Dr. Wilkinson was appointed to the office,
October 14, 1609.

Harvey now rapidly advanced in general favour as a physician, and in
1615 was appointed Lumleian Lecturer at the College of Physicians,
an office then held for life. His first lectures were given in April
1616, and in this and subsequent years he gradually unfolded the
novel views on the heart and the circulation of the blood which he
was acquiring, and which he published in 1628. The novelty of his
views does not, however, consist in the idea that the blood actually
moves in the vessels. This was known before, and Shakespeare gives
expression to a current conception in the passage at the head of
this chapter. Servetus, in 1553,[4] had asserted that the blood
finds access from the right side of the heart to the left through
the lungs, thus explaining the intermixture in the heart of the two
kinds of blood appropriate to arteries and veins respectively. For
a long time the partition between the ventricles was believed to be
perforated like a sieve, so that a mixture of venous and arterial
blood could take place. But this had been completely disproved by
Berengarius and Vesalius. Consequently the two kinds of blood,
according to this view, after meeting in the head, thorax, and
abdomen, returned to the heart by the way they came, for a fresh
supply of the exhausted or enfeebled spirits on which the principal
functions of the body depended. Servetus, it is true, asserts
a communication between the pulmonary artery and veins; but he
particularly declares that “the vital spirit has its origin in the
left ventricle, the lungs assisting especially in its generation,”
and that “it is engendered from the mixture that takes place in the
lungs of the inspired air with the elaborated subtile blood which the
right ventricle of the heart communicates to the left.” The extent of
his knowledge is further shown by his statement that “the blood is
mixed in the pulmonary vein with the inspired air, and by the act of
expiration is purified from fuliginous vapours, when having become
the fit recipient of the vital spirit, it is at length attracted by
the diastole.” Still very great credit is due to the man who first
declared that “the crimson colour is imparted to the spirituous blood
by the lungs, not the heart.”

Servetus was, however, ignorant of the force by which the blood is
impelled into the arteries, and the contractile functions of the
heart were unknown. The ventricle was believed to dilate from some
undiscovered cause, and thus to suck in the purified “spiritus
vitalis.” But Servetus’s explanation, whatever it was worth, occurred
in a theological work, the issue of which led to the author’s death
at Calvin’s persecuting hands, and the work remained unknown—for
Calvin carefully burnt every copy possible—until 1694, when Sir Henry
Wotton disinterred it.

Realdus Columbus, the associate of Dr. Caius at Padua, had in 1559
published a treatise containing some advanced views, showing that the
blood once having entered the right ventricle from the vena cava,
cannot return in consequence of the opposition of the tricuspid
valves, and he further perceived the effect of the pulmonary valves;
but he still held the idea that the blood had to be converted in
the lungs into a kind of spirit, and looked upon the liver as the
fountain-head of the blood. Finally, he denied the muscular structure
of the heart.

Cæsalpinus added to this some more complete idea of the greater
circulation, but he knew nothing of the valves in the veins, and held
to the belief that there were two kinds of blood, one for the growth,
another for the nourishment of the body. He imagined that it was only
during sleep that the veins become distended while the pulsations
of the arteries become moderated. He had no idea of the connection
between the emptying of the arteries and the filling of the veins,
nor of the heart being the cause of the blood’s movement.

Fabricius, Harvey’s teacher of anatomy, had made such a distinct step
in advance in discovering the valves of the veins and the effect
they must have, that it is quite astonishing that he should not have
proceeded farther. But the fact is, that without the microscope as
developed in after years,[5] it was impossible to solve a multitude
of questions satisfactorily, and we may rather marvel that Harvey was
able to achieve so much with the means at his disposal. The principal
means he employed to this end was undoubtedly the vivisection of
animals.

Chapter i. of his celebrated treatise on the Motion of the Heart
and the Blood (Frankfort, 1628) begins emphatically, “When I first
gave my mind to vivisections, as a means of discovering the motions
and uses of the heart, and sought to discover these from actual
inspection, and not from the writings of others, I found the task so
truly arduous, so full of difficulties, that I was almost tempted to
think, with Fracastorius, that the motion of the heart was only to be
comprehended by God.[6]

“At length, and by using greater and daily diligence, having frequent
recourse to vivisections, employing a variety of animals for the
purpose, ... I thought ... that I had discovered what I so much
desired, with the motion and the use of the heart and arteries....

“These views, as usual, pleased some more, others less; some chid
and calumniated me, and laid it to me as a crime that I had dared
to depart from the precepts and opinions of all anatomists.... At
length, yielding to the requests of my friends, that all might be
made participators in my labours, and partly moved by the envy of
others, who, receiving my views with uncandid minds and understanding
them indifferently, have essayed to traduce me publicly, I have been
moved to commit these things to the press.... Finally, if any use or
benefit to this department of the republic of letters should accrue
from my labours, it will perhaps be allowed that I have not lived
idly, and, as the old man in the comedy says:—

  ‘For never yet hath any one attained
  To such perfection, but that time, and place,
  And use, have brought addition to his knowledge;
  Or made correction, or admonished him,
  That he was ignorant of much which he
  Had thought he knew; or led him to reject
  What he had once esteemed of highest price.’

“So will it, perchance, be found with reference to the heart at this
time; or others, at least, starting from hence, the way pointed out
to them, advancing under the guidance of a happier genius, may make
occasion to proceed more fortunately, and to inquire more accurately.”

In the second chapter, after a vivid description of the behaviour of
the heart, he thus declares its muscular nature. “The motion of the
heart consists in a certain universal tension—both contraction in
the line of its fibres, and constriction in every sense. It becomes
erect, hard, and of diminished size during its action; the motion is
plainly of the same nature as that of the muscles when they contract
in the line of their sinews and fibres; for the muscles, when in
action, acquire vigour and tenseness, and from soft become hard,
prominent, and thickened: in the same manner the heart.”...

“These things, therefore, happen together or at the same instant:
the tension of the heart, the pulse of its apex, which is felt
externally by its striking against the chest, the thickening of its
parietes, and the forcible expulsion of the blood it contains by the
constriction of its ventricles.”

In further chapters he establishes separately, and in a masterly
manner, the facts that the pulse in the arteries depends on the
contraction of the ventricles; that when the left ventricle ceases
to contract, the pulse in the arteries also ceases; that the two
auricles contract together, and also the two ventricles together,
but the ventricles following the auricles in a certain rhythm; that
the heart accomplishes a transfusion of the blood from the veins to
the arteries; and that the blood sent into the lungs from the right
ventricle passes through the porous structure of the lungs and back
to the left ventricle.

In his eighth chapter, Harvey feels himself to be bringing forward
considerations of so novel a character, that “I tremble,” he says,
“lest I have mankind at large for my enemies, so much doth wont and
custom, that become as another nature, and doctrine once sown and
that hath struck deep root, and respect for antiquity influence all
men: _still the die is cast, and my trust is in my love of truth,
and the candour that inheres in cultivated minds_.” He found it
impossible to account for the constant influx of blood into the
arteries, and the return of blood to the heart, unless there was “a
motion, as it were, in a circle.” And he shows by calculations of
the quantity passing through the heart in an hour, that it is much
more than the whole body contains, and that there is no way except
by communications taking place from arteries to veins in every part
of the body. Finally, he clearly shows how the valves in the veins
promote the return of blood to the heart.

Throughout the whole of this treatise considerations from comparative
anatomy, from the phenomena of human diseases, and from natural
philosophy, are thickly interspersed, and imagery of the most
suggestive character is called into requisition; the whole forming
a treatise that every scientific man might well read, and that
no doctor should consider himself fully educated without having
attentively perused. In a subsequent letter to John Riolan the
younger, Professor of Anatomy in the University of Paris, Harvey lays
down—in opposition to those who repudiate the circulation because
they cannot see the efficient nor final cause of it, and who exclaim,
_Cui bono?_—the fundamental scientific axiom, “Our first duty is to
inquire whether the thing be or not, before asking wherefore it is.”
Again, “He who truly desires to be informed of the question in hand,
and whether the facts alleged be sensible, visible, or not, must
be held bound, either to look for himself, or to take on trust the
conclusions to which they have come who have looked; and indeed there
is no higher method of attaining to assurance and certainty.”

Everything that Harvey wrote shows him to have been pre-eminently an
example of the scientific mind, that which submits everything to the
test of experiment and observation. Anatomy he professed to learn and
teach, not from books, but from dissections, not from the positions
of philosophers, but from the fabric of Nature. In the introduction
to his Treatise on Generation he praises the “more excellent way”
of those “who, following the traces of nature with their own eyes,
pursued her through devious but most assured ways till they reached
her in the citadel of truth. And truly in such pursuits,” he goes
on, “it is sweet not merely to toil, but even to grow weary, when
the pains of discovering are amply compensated by the pleasures
of discovery. Eager for novelty, we are wont to travel far into
unknown countries, that with our own eyes we may witness what we
have heard reported as having been seen by others, where, however,
we for the most part find that the presence lessens the repute. It
were disgraceful, therefore, with this most spacious and admirable
realm of nature before us, and where the reward ever exceeds the
promise, did we take the reports of others upon trust, and go on
coining crude problems out of these, and on them hanging knotty and
captious and petty disputations. Nature is herself to be addressed;
the paths she shows us are to be boldly trodden; for thus, and whilst
we consult our proper senses, from inferior advancing to superior
levels, shall we penetrate at length into the heart of her mystery.”

True and scientific as the Treatise on the Heart and the Circulation
was, or rather because it was so true and scientific, its
publication gave a decided and severe check to Harvey’s professional
prosperity. It was believed by the vulgar, says Aubrey, that he was
crack-brained. Writing many years after the publication, Aubrey says
that though he was allowed to be an excellent anatomist, nobody
admired his therapeutic methods. It was said by practitioners that
they could not tell by his prescriptions what he aimed at. Yet he
continued well in favour with the court, and with numerous persons
of distinction. Having become Physician Extraordinary to James I.
in 1618 or earlier, he was in 1623 promised the reversion of the
office of Physician in Ordinary when a vacancy should occur. But his
accession to this post only took place in 1630 under Charles I.[7]

Harvey became Treasurer of the College of Physicians in 1628, but
resigned this office and also procured the appointment of a deputy
at St. Bartholomew’s Hospital in 1630, when he was commanded by
the King to attend the young Duke of Lennox in his travels on the
Continent. Having returned from this expedition, in 1632 he was sworn
in Physician in Ordinary for his Majesty’s household, and in 1639
we find a letter in the Lord Steward’s office, giving orders for
settling a diet of three dishes of meat a meal with all incidents
thereunto belonging upon Dr. Harvey. But later on, in 1640, the
King when at York makes another arrangement, devoting £200 a year
to Dr. Harvey, the three dishes of meat probably not having been
readily forthcoming just then. In 1632-3 a deputy had again to be
appointed at St. Bartholomew’s; in 1636 he was required to accompany
the Earl of Arundel on his embassy to the Emperor of Germany. This
gave him an opportunity of personally explaining the circulation to
various eminent physicians in the principal German cities. On one
of these occasions, at Nuremberg, we find it recorded that Harvey
gave a public demonstration of the circulation, which satisfied all
except Caspar Hofmann.[8] Returning to England, Harvey accompanied
Charles I. in his expeditions, such as that to Scotland in 1639;
and we may remark that, being in such close proximity to the royal
person, he contrived very skilfully not to become involved in court
intrigues, his best protection being his devotion to his medical and
physiological investigations.[9] Even when war had broken out, Harvey
became in no way obnoxious to the Parliament, for he tells us himself
that he attended the King not only with the consent but by the desire
of Parliament. In this way Harvey was present on the very field at
the battle of Edgehill.

“During the fight,” says Aubrey, “the Prince and Duke of York were
committed to his care. He told me that he withdrew with them under
a hedge, and took out of his pocket a book and read. But he had not
read very long before a bullet of a great gun grazed on the ground
near him, which made him remove his station.” We cannot but admire
the coolness and serenity of mind which could thus occupy itself with
reading in the midst of carnage, having evidently no sort of belief
in, or vocation for, the employment of force in the arbitrament
between opposing opinions. Accompanying Charles to Oxford, he found
congenial society, and was incorporated Doctor of Medicine on the
7th December, 1642. “I first saw him at Oxford,” says Aubrey, “1642,
after Edgehill fight; but was then too young to be acquainted with
so great a doctor. I remember he came several times to our college
(Trinity) to George Bathurst, B.D., who had a hen to hatch eggs in
his chamber, which they opened daily to see the progress and way of
generation.”

Thus we see Harvey continuing engaged in that study of the mysteries
of reproduction and development to which he devoted so many years and
so many toils. He must have commenced his studies on this subject at
least early in Charles’s reign.

In 1645, while the King and his physician still remained at Oxford,
Sir Nathaniel Brent having quitted Merton College, of which he was
Warden, and taken the Covenant, Harvey was appointed Warden in his
place by virtue of a royal mandate. He had indeed lost more than
his time in following the royal fortunes, and deserved any reward
the King could bestow upon him. At the close of the sixty-eighth
section of his treatise on Generation Harvey says, “Let gentle minds
forgive me if, recalling the irreparable injuries I have suffered,
I here give vent to a sigh. This is the cause of my sorrow: whilst
in attendance on his Majesty during our late troubles and more than
civil wars, not only with the permission but by the command of the
Parliament, certain rapacious hands stripped not only my house of all
its furniture, but what is subject of far greater regret with me, my
enemies abstracted from my museum the fruits of many years of toil.
Whence it has come to pass that many observations, particularly on
the generation of insects, have perished, with detriment, I venture
to say, to the republic of letters.”[10]

The Wardenship of Merton was not long Dr. Harvey’s, for when Oxford
surrendered to the Parliamentary forces in July 1646, he quitted
the university and returned to London, and Sir Nathaniel Brent was
reinstated in his former position. Nothing has been ascertained of
the reason for Harvey’s cessation of personal attendance on the King
at this period, but it is certain that he took refuge in the homes
of his brothers, each of whom, whether in the City, at Lambeth, at
Roehampton, or at Combe, kept special apartments reserved for him.
It is most pleasing, indeed, to note the great brotherly affection
existing in this family. The earliest of them to die, Thomas Harvey,
in 1622, has the following inscription on his monumental tablet.
“As in a Sheaf of Arrows. _Vis unita fortior._ The Band of Love
the Uniter of Brethren.” Thus, leaving his financial concerns in
charge of his brother Eliab, William devoted himself, at the age of
sixty-eight, more fully to his researches on Generation, which his
friend Dr. Ent extracted from him at Christmas 1650.

Dr. Ent, addressing the President and Fellows of the College of
Physicians, writes an introduction to this work, in which he gives
us a pleasing view of Harvey in his retirement. He says: “Harassed
with anxious, and in the end not much availing cares, about Christmas
last, I sought to rid my spirit of the cloud which oppressed it by
a visit to that great man, the chief honour and ornament of our
college, Dr. William Harvey, then dwelling not far from the city. I
found him, Democritus like, busy with the study of natural things,
his countenance cheerful, his mind serene, embracing all within
its sphere. I forthwith saluted him, and asked if all were well
with him. ‘How can it,’ said he, ‘while the Commonwealth is full of
distractions, and I myself am still in the open sea? And truly,’ he
continued, ‘did I not find solace in my studies, and a balm for my
spirit in the memory of my observations of former years, I should
feel little desire for longer life. But so it has been, that this
life of obscurity, this vacation from public business, which causes
tedium and disgust to so many, has proved a sovereign remedy to me.’”
An extended conversation is recorded, in which Harvey discourses
in his wisest vein on the value of the interrogation of nature in
every possible way. Dr. Ent informed him that the learned world were
eagerly looking for his further experiments. Harvey rejoined, “You
know full well what a storm my former lucubrations raised. Much
better is it oftentimes to grow wise at home and in private, than by
publishing what you have amassed with infinite labour, to stir up
tempests that may rob you of peace and quiet for the rest of your
days.” He at last produced the treatise on generation of animals,
and Dr. Ent urging him to publish it both in consideration of his
own fame, and the public benefit, and offering to see it through
the press, the author consented to its publication at once or at
some future time. Dr. Ent was exultant, feeling, like another Jason,
laden with the golden fleece. “Our Harvey,” he says, “rather seems as
though discovery were natural to him, a thing of ease and of course,
a matter of ordinary business; though he may nevertheless have
expended infinite labour and study on his works. And we have evidence
of his singular candour in this, that he never hostilely attacks any
previous writer, but ever courteously sets down and comments upon the
opinions of each; and indeed he is wont to say, that it is argument
of an indifferent cause when it is contended for with violence and
distemper, and that truth scarce wants an advocate.”

This great work, published in 1651, begins by describing the hen’s
egg and its development, the doctrine being enunciated that all
animals as well as plants are produced from ova. Incidentally, as
well as subsequently, observations of great merit and value on
reproduction in all kinds of animals are given, and it is clearly
shown that instead of containing, from the first, excessively
minute but complete animals, eggs at first include extremely simple
structures, which by successive and gradual changes come to be like
the adults from which they have sprung. It is true that Harvey, with
Aristotle, believed that the germs of lower animals could arise out
of non-living matter; but it is only in the most recent days that
the most elaborate microscopical investigations seem finally to have
disposed of this view. The doctrine that the simply constructed germ
grows by feeding on non-living matter, converting it into living
matter, and gradually transforming it into the form characterising
the parent, was a great innovation in Harvey’s age, and it hung fire
till Caspar Wolff, in 1759, securely established it. But this has
remained till the present century to be made fruitful.

Throughout Harvey’s treatise it is evident how greatly the lack
of powers such as those of the microscope crippled the entire
investigation, although it is truly wonderful how much was
accomplished without its aid. Incidental remarks show the acute mind
everywhere tending towards sound procedure, as in tying the main
artery of a tumour he wished to destroy; arriving on the brink of
a discovery even when its full perception did not come, as when in
regard to the lungs he says, “Air is given neither for the cooling
nor the nutrition of animals,” contrary to the prevailing notion. But
the absence of chemical knowledge in that age prevented his going
farther.

His published works only represent a portion of Harvey’s life-work.
We find allusions to his “Medical Observations” and “Medical
Anatomy,” which, if written, were probably destroyed in the College
of Physicians at the Great Fire. In one place Harvey states that in
his medical anatomy he meant, “from the many dissections he had made
of the bodies of persons worn out by serious and strange affections,
to relate how and in what way the internal organs were changed in
their situation, size, structure, figure, consistency, and other
sensible qualities, from their natural forms and appearances, such
as they are usually described by anatomists, and in what various
and remarkable ways they were affected. For even as the dissection
of healthy and well-constituted bodies contributes essentially to
the advancement of philosophy and sound physiology, so does the
inspection of diseased and cachectic subjects powerfully assist
philosophical pathology.” Thus it appears that, had we possessed
Harvey’s pathological observations, he would also have merited the
title of founder of pathology.

About the time of the publication of the Treatise on Generation,
Harvey’s work on the Heart and Circulation was gaining continued and
widespread adhesion on the Continent. In Italy, Trullius, a Roman
professor; in France, John Pecquet of Dieppe; in Leyden, Thomas
Bartholin, were occupied in promulgating Harvey’s views. A notable
convert was Plempius of Louvain, who, having given himself up to the
refutation of Harvey, found himself compelled to retract when he
himself made some experiments on living dogs.

Harvey was constantly solicitous for the welfare of the College
of Physicians, before which he continued to deliver the Lumleian
Lectures up to 1656. At an extraordinary meeting held on 4th July,
1651, Dr. Prujean, the President, read to the Fellows the following
anonymous proposal: “If I can procure one that will build us a
library, and a repository for simples and rarities, such a one as
shall be suitable and honourable to the college, will you assent
to have it done or no?” The offer was of course unanimously and
gratefully accepted, but it does not appear at what period it
transpired that Harvey was the munificent donor. However, on 22d
December, 1652, the college decreed a statue to him, which was
executed in his doctor’s cap and gown, inscribed “Viro monumentis
suis immortali.” It was not, however, till the 2d of February,
1653-4, that the new building was opened, consisting, as Aubrey
tells us, of a noble building of Roman architecture (of rustic work
with Corinthian pilasters), comprising a great parlour, a kind of
convocation-room for the Fellows to meet in below, and a library
above. Harvey was present on the opening occasion, having provided a
handsome entertainment, and formally handed over the title-deeds and
entire interest in the building in a speech of the utmost benevolence
and goodwill. He had contributed not merely the building, but also a
considerable library, and many surgical instruments and objects of
interest to the museum.

On the 30th September, 1654, Harvey was elected in his absence to the
presidency of the college, which, however, he declined on the next
day, owing to his age and growing infirmities, and recommending the
continuance in office of Dr. Prujean, who nominated him as one of the
council, which office he did not refuse. He continued to lecture,
although his strength was diminished by severe attacks of gout, but
in July 1656 he resigned his lectureship. In taking leave of the
college, at a grand banquet which he gave, he presented it with his
patrimonial estate at Burmarsh in Kent. One special provision settled
a salary for a librarian, and another established what has since been
known as the Harveian Oration, delivered yearly in commemoration of
benefactors to the college, and now extended to those who have added
to medical science during the year.

The long and truly fortunate career of Harvey—for fortunate he must
be deemed, who, like Darwin, having enunciated an epoch-making
discovery, lived to see it inculcated as a canon—was now drawing to
a close. In several of his later letters he expresses his feelings
of infirmity. Writing in 1655 to Dr. Horst, at Hesse-Darmstadt, he
speaks of “advanced age, which unfits us for the investigation of
novel subtleties, and the mind which inclines to repose after the
fatigues of lengthened labours.” Later, on the 24th April, 1657,
writing to Dr. Vlackveld, at Harlem, he says: “It is in vain that
you apply the spur to urge me, at my present age—not mature merely,
but declining—to gird myself for any new investigation. For I now
consider myself entitled to my discharge from duty.”

Harvey died on the 3d of June, 1657, in the eightieth year of his
age, and the Fellows of his college followed his remains far out of
the city towards Hempstead, in Essex, where his brother Eliab had a
vault. His will is a characteristic document. He thus expresses his
Christian faith: “I do most humbly render my soul to Him that gave
it, and to my blessed Lord and Saviour Christ Jesus.” Making his
brother Eliab executor and residuary legatee, he bequeaths legacies
to all his relations with most affectionate expressions: we do not
know the date of his wife’s death (she was still living in 1645), but
she is here mentioned as “my dear deceased loving wife.” “I give to
the College of Physicians all my books and papers, and my best Persia
long carpet, and my blue satin embroidered cushion, one pair of brass
andirons, with fireshovel and tongs of brass, for the ornament of the
meeting-room I have erected.” It seems very probable that these books
and papers included some much-regretted observations of Harvey’s,
which were destroyed, with the building which he erected and the
statue to his memory, in the great fire of 1666. He left £10 to his
friend Hobbes of Malmesbury, who describes Harvey as the only one
that he knew who conquered envy and established a new doctrine in his
lifetime.

“The private character of this great man,” says Aikin, in his
Biographical Memoirs of Medicine in Great Britain, “appears to have
been in every respect worthy of his public reputation. Cheerful,
candid, and upright, he was not the prey of any mean or ungentle
passion. He was as little disposed by nature to detract from the
merits of others, or make an ostentatious display of his own, as
necessitated to use such methods for advancing his fame. The many
antagonists whom his renown and the novelty of his opinions excited
were, in general, treated by him with modest and temperate language,
frequently very different from their own; and while he refuted
their arguments, he decorated them with all due praises. He lived
on terms of perfect harmony and friendship with his brethren of the
college; and seems to have been very little ambitious of engrossing
a disproportionate share of medical practice. In extreme old age,
pain and sickness were said to have rendered him somewhat irritable
in his temper.... It is certain that the profoundest veneration
for the great Cause of all those wonders he was so well acquainted
with appears eminently conspicuous in every part of his works. He
was used to say, that he never dissected the body of any animal
without discovering something which he had not expected or conceived
of, and in which he recognised the hand of an all-wise Creator. To
His particular agency, and not to the operation of general laws,
he ascribed all the phenomena of nature. In familiar conversation
Harvey was easy and unassuming, and singularly clear in expressing
his ideas. His mind was furnished with an ample store of knowledge,
not only in matters connected with his profession, but in most of the
objects of liberal inquiry, especially in ancient and modern history,
and the science of politics. He took great delight in reading the
ancient poets, Virgil in particular, with whose divine productions he
is said to have been sometimes so transported as to throw the book
from him with exclamations of rapture. To complete his character, he
did not want that polish and courtly address which are necessary to
the scholar who would also appear as a gentleman.”

According to Aubrey, who knew him well, Harvey was not tall, but
of the lowest stature; round-faced, olivaster in complexion, with
little round eyes, very black and full of spirit, his hair black
as a raven, but quite white twenty years before he died. His
portrait in the College of Physicians corresponds with this account,
indicating a nervous, bilious temperament, and showing a compact,
square, wide forehead. The general expression is highly intellectual,
contemplative, and manly.

Harvey has the rare distinction of standing at the head of three
departments of science in England—comparative anatomy, physiology,
and medicine. When these scarcely existed, he evolved them into
living form from chaos. The extent of his achievements must be gauged
by the extent of the superstructure built upon his foundations. He
laid the foundations broad and firm, and practised the true method of
science. Notwithstanding Harvey’s infirmities, his mind in old age
was characterised by an abiding youthfulness and desire to learn,
so that Aubrey found him studying Oughtred’s “Clavis Mathematica,”
and working problems not long before he died. He was equally pleased
to communicate his knowledge to others, and, as Aubrey relates, “to
instruct any that were modest and respectful to him. In order to
my journey (I was at that time bound for Italy), he dictated to me
what to see, what company to keep, what books to read, how to manage
my studies—in short, he bid me go to the fountain-head and read
Aristotle, Cicero, Avicenna.” He was always very contemplative, and
was wont to frequent the leads of Cockaine House, which his brother
Eliab had bought, having there his several stations in regard to
the sun and the wind, for the indulgence of his fancy. At the house
at Combe, in Surrey, he had caves made in the ground, in which he
delighted in the summer-time to meditate. He also loved darkness, as
he could then best contemplate. The activity of his mind would often
deprive him of sleep, when he would rise and walk about in his shirt,
until he was cooled and could gain sleep. Similarly he treated his
attacks of gout; he would sit with his legs bare, even in frost, on
the leads of Cockaine House, and put them into a pail of water until
he was almost dead with cold, and thus he found his attacks could be
moderated.

His great works were, according to the custom of the age, written in
Latin; and Dr. Willis, who has translated all of them into English,
describes his Latin as generally easy, often elegant, and not
unfrequently copious and imaginative—he never seems to feel in the
least fettered by the language he is using.

The College of Physicians, says Dr. Munk, possesses some interesting
memorials of Harvey, two of which may be mentioned. One the whalebone
probe or rod, tipped with silver, with which he demonstrated
the parts in his Lumleian Lectures at the college. The other,
consisting of six tables of wood, upon which are spread the different
blood-vessels and nerves of the human body, carefully dissected out,
probably prepared by Harvey himself, and presumed to have been
used by him in his lectures. They were presented to the college by
the Earl of Winchelsea, one of whose ancestors, the Lord-Chancellor
Nottingham, had married the niece of Harvey.


FOOTNOTES:

[4] Restitutio Christianismi.

[5] Malpighi first saw the blood circulating. In 1661 he records his
having seen the circulation of the blood in the frog’s lungs. Later
he saw it also in the frog’s mesentery.

[6] Dr. Willis’s Translation of Harvey’s Works. Sydenham Soc. 1847.

[7] Harvey’s personal history is comparatively little concerned
with the controversy which arose in establishing the truth of
his discovery. His lectures and demonstrations at the College of
Physicians were so convincing that he met with but slight opposition
from capable critics in England. Continental professors, however,
were slower to accept his teaching. “The Circulation of the Blood,”
he says in his first answer to Riolan in 1649, “has now been before
the world for many years, illustrated by proofs cognizable to the
senses, and confirmed by numerous experiments; but no one has yet
attempted opposition to it on the ground of ocular testimony. Empty
assertions, baseless arguments, captious cavillings, and contumelious
epithets are all that have been levelled against the doctrine and its
author.” We need not, therefore, follow here the history of the final
and full triumph of Harvey’s views on the Continent.

[8] That Harvey’s scientific ardour was in full operation during
this journey we also learn from a remark of Hollar the artist, who
accompanied the ambassador: “He would still be making of excursions
into the wood, making observations of strange trees, plants, earths,
&c., and sometimes like to be lost; so that my lord ambassador would
be really angry with him, for there was not only danger of wild
beasts, but of thieves.”

In a letter written on this journey, Harvey says: “By the way we
could scarce see a dog, crow, kite, raven, or any bird, or anything
to anatomize; only some few miserable people, the reliques of the war
and the plague, whom famine had made anatomies before I came.”

[9] There is every reason to believe that by this course of conduct
Harvey lost nothing of the King’s favour and regard. Harvey records
that on several occasions the King had exhibited to him the beating
heart of the chick in the shell. We learn that he placed at Harvey’s
disposal several does for his experiments, and was present on various
occasions at his dissections. Though it is not definitely recorded,
Harvey appears to have accompanied Charles on at least one of his
journeys to Scotland, and to have visited the Bass Rock. In his work
on Generation he incidentally describes the seabirds which he found
so abundant there.

[10] It is in reference to this that Cowley says:—

  “O cursed war! who can forgive thee this?
    Houses and towns may rise again,
      And ten times easier ’tis
  To rebuild Paul’s than any work of his.”




CHAPTER III.

_THOMAS SYDENHAM, THE BRITISH HIPPOCRATES._


In the front rank of practical physicians in England stands THOMAS
SYDENHAM, descended from an ancient Somersetshire family, one branch
of which migrated into Dorsetshire in the reign of Henry VIII., and
settled at Winford Eagle. Here he was born in 1624. We know nothing
of his early years till we find him entered at Magdalen Hall, Oxford,
in 1642. His studies were interrupted by Charles I.’s residence
there, and it is very probable that he took arms on the side of the
Parliament, while it is certain that his brothers did so—one of
them, William Sydenham, having been a well-known Parliamentarian
commissioner, and Governor of the Isle of Wight. His mother, too,
was in some way, of which we have no account, “killed in the civil
wars” in 1644, so that there is sufficient reason why Thomas Sydenham
should have withdrawn from Oxford at this time. Sir Richard Blackmore
indeed describes him as a disbanded officer, and this appears
possible from what Sydenham himself states.

In his letter dedicatory to Dr. John Mapletoft of the third edition
of his “Medical Observations,” Sydenham says: “It is now thirty
years since I had the good fortune to fall in with the learned
and ingenuous Master Thomas Coxe, Doctor.... I myself was on my
way to London, with the intention of going thence to Oxford, the
breaking out of the war having kept me away for some years. With
his well-known kindness and condescension, Dr. Coxe asked me what
pursuit I was prepared to make my profession.... Upon this point my
mind was unfixed, whilst I had not so much as dreamed of medicine.
Stimulated, however, by the recommendation and encouragement of so
high an authority, I prepared myself seriously for that pursuit.
Hence all the little merit that my works may have earned in the eyes
of the public is to be thankfully referred to him who was the patron
and promoter of my first endeavours.”

Dr. Lettsom in 1801 communicated to the _Gentleman’s Magazine_ a
MS. anecdote which has since been found to be derived from “The
Vindicatory Schedule,” by Dr. Andrew Brown, published two years after
Sydenham’s death. “Dr. Thos. Sydenham was an actor in the late civil
war, and discharged the office of captain. He being in his lodgings
in London, and going to bed at night with his clothes loosed, a mad
drunken fellow, a soldier, likewise in the same lodging, entered his
room, with one hand gripping him by the breast of his shirt, with the
other discharged a loaded pistol into his bosom; yet, oh strange!
without any hurt to him.” The story then goes on to relate how the
bullet happened to be discharged in the line of all the bones of the
palm of the hand edgeways, so that it lost its force and was spent
without doing any harm to Sydenham.

When Oxford surrendered to the Parliament, Sydenham returned to
Magdalen Hall, and was soon afterwards elected a fellow of All Souls’
in place of an expelled Royalist. The degree of M.B. he took in 1648,
without taking a degree in arts; and he appears to have resided
at Oxford for some years, with possibly an interval spent at the
Montpellier School of Medicine. Soon after taking his degree he began
to suffer from gout and symptoms of stone, to which he was a martyr
more or less for the rest of his life.

We do not know in what year Sydenham finally quitted Oxford and went
to London. He gives an account of the epidemics of 1661 in London,
where he must then have been settled. In 1663 he became a licentiate
of the College of Physicians, but could not proceed further without
a doctor’s degree, which he did not take till comparatively late in
life, in 1676.

In 1666 appeared Sydenham’s first work, the first edition of the
“Method of Curing Fevers,” dealing with continued and intermittent
fevers, and with smallpox.

This first edition was dedicated to Robert Boyle, whom Sydenham
describes as “truly and wholly noble,” and to whom he ascribes
transcendent parts, such as to raise him to the level of the most
famous names of foregone ages. He acknowledges many and great
favours conferred upon him by his friend; and he states soberly that
it was on Boyle’s persuasion and recommendation that he undertook to
write the book, and by his experience that some portions of it had
been tested. Boyle occasionally accompanied Sydenham in his visits
to the sick. The physician hopes his book will not find less favour
for being “neither vast in bulk, nor stuffed out with the spoils of
former authors.” “I have no wish to disturb their ashes,” he remarks.

The preface to the first edition begins thus: “Whoever takes up
medicine should seriously consider the following points: firstly,
that he must one day render to the Supreme Judge an account of
the lives of those sick men who have been intrusted to his care.
Secondly, that such skill and science as, by the blessing of God,
he has attained, are to be specially directed towards the honour of
his Maker and the welfare of his fellow-creatures, since it is a
base thing for the great gifts of heaven to become the servants of
avarice or ambition. Thirdly, he must remember that it is no mean
ignoble animal that he deals with. We may ascertain the worth of
the human race, since for its sake God’s only-begotten Son became
man, and thereby ennobled the nature that He took upon Him. Lastly,
he must remember that he himself hath no exemption from the common
lot, but that he is bound by the same laws of mortality, and liable
to the same ailments and afflictions with his fellows. For these
and like reasons let him strive to render aid to the distressed with
the greater care, with the kindlier spirit, and with the stronger
fellow-feeling.”

The candid and philosophic temperament of the man is also well
exemplified in the conclusion of the same preface. He foresees
that “even where my practice has been tried, and its results been
recognised, it will be asserted that my statements are anything but
new, and that the world has long known them. I have, notwithstanding,
never allowed myself to be deterred from communicating the following
pages to those of my fellow-creatures who unite the love of truth
with the love of their kind. It is my temper and disposition to be
careless both of the sayings and the doings of the over-proud and the
over-critical. To the wise, however, and the honest, I wish to say
this much:—I have in no wise distorted either fact or experiment;
I told the truth, the whole truth, and nothing but the truth....
In the meanwhile I ask the pardon, and submit to the arguments, of
better judges than myself, for all errors of theory. Perhaps I may
myself hereafter on many points change my mind of my own accord. As I
have no lack of charity for the errors of others, I have no love of
obstinately persisting in my own.”

At the outset of his treatise he asserts that a disease is an effort
of nature which strives with might and main to restore the health
of the patient by the elimination of the morbific matter. Yet he is
so far in accord with modern discovery of bacterial germs, that
he refers the specific differences between fevers to some unknown
constitution of the atmosphere. His wisdom is conspicuous when
he says he prefers nothing, on the outbreak of a new fever, to a
little delay, and diligently observes the character and cause of the
disease, and what kinds of treatment do good or harm. He discerns
thoroughly that the scientific working out of the characteristics
and phenomena of each disease must be accomplished before it can be
asserted that any good work worthy of mention has been got through.
It would be difficult to exhibit a more modest and a more truly
philosophical spirit than that shown in the following lines at the
close of his second chapter: “One thing most especially do I aim
at. It is my wish to state how things have gone lately; how they
have been in this the city which we live in. The observations of
some years form my groundwork. It is thus that I would add my mite,
such as it is, towards the foundation of a work that, in my humble
judgment, shall be beneficial to the human race. Posterity will
complete it, since to them it shall be given to take the full view of
the whole cycle of epidemics in their mutual sequences for years yet
to come.”

A signal instance of his philosophic moderation is given in the
following extract: “For my own part, I am not ambitious of the name
of a philosopher, and those who think themselves so, may perhaps
consider me blameable on the score of my not having attempted to
pierce into those penetralia. Now, writers like these I would just
recommend, before they blame others, to try their hand upon some
common phenomena of nature that meet us at every turn. For instance,
I would fain know why a horse attains its prime at seven, and a man
at one-and-twenty years? Why, in the vegetable kingdom, some plants
blow in May and others in June? There are numberless questions of
this sort. Hence, if many men of consummate wisdom are not ashamed to
proclaim their ignorance in these matters, I cannot see why I am to
be called in question for doing the same. Etiology is a difficult,
and, perhaps, an inexplicable affair; and I choose to keep my
hands clear of it. _I am convinced, however, that Nature here, as
elsewhere, moves in a regular and orderly manner._”

In how wise and firm a tone does Sydenham denounce and demolish the
quacks and patent medicine vendors! He considers that any man who
can, by any sure line of treatment, or by the application of any
specific remedy, control the course of diseases or cut them short,
is bound by every possible bond to reveal to the world in general so
great a blessing to his race. If he withheld it, he pronounced him a
bad citizen and an unwise man; for no good citizen would monopolise
for himself a general benefit for his kind, and no wise man would
divest himself of the blessing he might reasonably expect from his
Maker in contributing to the welfare of the world.

Sydenham stands out as a great advocate and champion of Peruvian
bark, which, in its modern form of quinine, has justified all that he
claimed for it. He is also the founder of the “expectant” treatment.
“My chief care,” he says, “in the midst of so much darkness and
ignorance, is to wait a little, and proceed very slowly, especially
in the use of powerful remedies, in the meantime observing its nature
and procedure, and by what means the patient was relieved or injured.”

The new treatise at once attracted attention, and was reviewed in
the Philosophical Transactions for 1666. In the same year there
appeared a Dutch edition of the Method. The value and the effect of
this treatise we can scarcely fully appreciate at the present time,
but its pith is well given by Dr. John Brown, author of the “Horæ
Subsecivæ.” “Besides their broad, accurate, vivid delineations of
disease—portraits drawn to the life, and by a great master—and their
wise, simple, rational rules for treatment, active and negative,
general and specific—there are two great principles continually
referred to as supreme in the art of medicine. The first is that
nature cures diseases; that there is a recuperative and curative
power, the _vis medicatrix_, in every living organism, implanted in
it by the Almighty, and that it is by careful reverential scrutiny
of this law of restoration that all our attempts at cure are to be
guided; that we are its ministers and interpreters, and neither
more nor less; and the second, that symptoms are the language of a
suffering and disordered and endangered body, which it is the duty
of the physician to listen to, and as far as he can to explain and
satisfy, and that, like all other languages, it must be studied. This
is what he calls the natural history of diseases.... What Locke did
for the science of mind, what Harvey and Newton did for the sciences
of organic and inorganic matter, Sydenham did for the art of healing
and of keeping men whole: he made it in the main observational; he
founded it upon what he himself calls downright matter of fact,
and did this not by unfolding a system of doctrines or raising up
a scaffolding of theory, but by pointing to a road, by exhibiting
a method—and moreover teaching this by example, not less than by
precept—walking in the road, not acting merely as a finger-post, and
showing himself to be throughout a true artsman and master of his
tools. The value he puts upon sheer, steady, honest observation, as
the one initial act and process of all true science of nature, is
most remarkable; and he gives himself, in his descriptions of disease
in general and of particular cases, proofs quite exquisite of his own
powers of persevering, minute, truthful scrutiny.”

In 1668 a second edition of the Method was published, with additions,
especially a chapter on the Plague, and prefaced by a eulogistic
address in Latin verse, extending to fifty-four lines, by the
illustrious Locke. In 1676 appeared the third edition of the Method,
so much enlarged that it is better regarded as the first edition of
the “Medical Observations.” In the same year Sydenham proceeded to
the degree of Doctor of Medicine, not at Oxford, but at Cambridge,
this choice being probably due to the fact that his son had entered
at Pembroke College, Cambridge, two years before.

From the preface to his treatise on gout and dropsy, published in
1683, we find that Sydenham was compelled to lay aside his project of
a complete book on chronic diseases by the extreme attacks of gout
which his labours brought on. “Whenever I returned to my studies,”
he says, “my gout returned to me.” A few years before, in 1677, he
had been prevented from practising by a severe attack of gout, and
he was compelled to spend another three months in the country to
restore his health. He continued his labours, however, it is to be
believed, beyond his strength, and several editions of his works,
with fresh observations, were issued in the later years of his life.
He died at his house in Pall Mall on the 29th of December, 1689,
aged sixty-five, being buried at St. James’s, Westminster. The truly
appropriate description, “Medicus in omne ævum nobilis,” was given
of him by the College of Physicians in 1810, when a mural tablet was
raised to his memory near his place of burial.

Sydenham’s will shows that he had three sons—William, Henry, and
James—the eldest of whom received entailed estates in Hertfordshire
and Leicestershire. He bequeathed £30 for the professional education
of his nephew James, afterwards Sir James Thornhill, Hogarth’s
father-in-law. Sydenham’s executor was Mr. Malthus, an apothecary of
Pall Mall (great-grandfather of Professor Malthus), whom he enjoins
to bury him with a careful abstinence from all ostentatious funeral
pomp.

It is perhaps not necessary to regret so acutely the lack of
biographical details regarding Dr. Sydenham, as many have done, for
we think that his character stands out clearly in his writings. In
his letter to Dr. Mapletoft, already referred to, he says:—

“After a few years spent in the arena of the university, I returned
to London for the practice of medicine. The more I observed the facts
of this science with an attentive eye, and the more I studied them
with due and proper diligence, the more I became confirmed in the
opinion which I have held up to the present hour, viz., _that the art
of medicine was to be properly learnt only from its practice and its
exercise_; and that, in all probability, he would be the best skilled
in the detection of the true and genuine indications of treatment
who had the most diligently and the most accurately attended to the
natural phenomena of disease.”

The same preface contains Sydenham’s opinion of a great contemporary
and valued friend of his. “You know also how thoroughly an intimate
and common friend, and one who has closely and exhaustively examined
the question, agrees with me as to the method I am speaking of—a man
who, in the acuteness of his intellect, in the steadiness of his
judgment, in the simplicity (and by _simplicity_ I mean _excellence_)
of his manners, has amongst the present generation few equals and
no superiors. This praise I may confidently attach to the name of
John Locke.” Dugald Stewart, commenting on this, says: “The merit of
the Method therefore may be presumed to have belonged in part to Mr.
Locke.” There is no reason, however, in the co-operation of these
great minds, for detracting from the praise of either.

Sydenham’s idea of a satisfactory method of curing was a line of
practice based upon a sufficient number of experiments. His business
was, he says, to support his own observations, not to discuss the
opinions of others. The facts would speak for themselves, and would
alone show whether he acted with truth and honesty, or, like a
profligate and immoral man, was to be a murderer even when in his
grave. In the preface to the third edition he says, “The breath of
life would have been to me a vain gift, unless I contributed my mite
to the treasury of physic.” He considered that medicine was to be
advanced in two main ways—by a history of diseases, by descriptions
at once graphic and natural, and by formulating a praxis or method
of treating them. The most modern thought could produce no sounder
principle for describing disease than the following: “In writing
the history of a disease, every philosophical hypothesis whatsoever
that has previously occupied the mind of the author should lie in
abeyance. This being done, the clear and natural phenomena of the
disease should be noted—these and these only. These should be noted
accurately and in all their minuteness.” He wittily remarks that
it often happens that the character of the complaint varies with
the nature of the remedies, and that symptoms may be referred less
to the disease than to the doctor. He traces the lack of accurate
descriptions of diseases to an idea that disease was but a confused
and disordered effort of nature defending herself in vain, so that
men had classed the attempts at a just description with the attempts
to wash blackamoors white.

Sydenham conceived the idea, too, of paying some attention to the
wishes and tastes of the patient. “A person in a burning fever
desires to drink freely of some small liquor; but the rules of art,
built upon some hypothesis, having a different design in view,
thwart the desire, and instead thereof order a cordial. In the
meantime the patient, not being suffered to drink what he wishes,
nauseates all kinds of food, but art commands him to eat. Another,
after a long illness, begs hard, it may be, for something odd or
questionable; here, again, impertinent art thwarts him and threatens
him with death. How much more excellent the aphorism of Hippocrates:
‘Such food as is most grateful, though not so wholesome, is to be
preferred to that which is better, but distasteful.’” He has nothing
of the meddlesome practitioner about him. “Indeed, if I may speak my
mind freely, I have been long of opinion that I act the part of an
honest man and a good physician as often as I refrain entirely from
medicines, when, upon visiting the patient, I find him no worse
to-day than he was yesterday; whereas, if I attempt to cure the
patient by a method of which I am uncertain, he will be endangered
both by the experiment I am going to make on him and by the disease
itself; nor will he so easily escape two dangers as one.”

A fine description of one aspect of hysteria and hypochondria may
here be given as an example of his power in the delineation of
disease: “The patients believe that they have to suffer all the
evils that can befall humanity, all the troubles that the world can
supply. They have melancholy forebodings, they brood over trifles,
cherishing them in their anxious and unquiet bosoms. Fear, anger,
jealousy, suspicion, and the worst passions of the mind arise without
cause. Joy, hope, cheerfulness, if they find place at all in their
spirits, find it at intervals ‘few and far between,’ and then take
leave quickly. In these, as in the painful feelings, there is no
moderation. All is caprice. They love without measure those whom they
will soon hate without reason. Now they will do this, now that—ever
receding from their purpose.... All that they see in their dreams are
funerals and the shadows of departed friends.”

The great physician has nowhere described his own character more
clearly than in the following passage: “In all points of theory where
the reader finds me in error, I ask his pardon. In all points of
practice I state that I speak nothing but the truth; and that I have
propounded nothing except what I have properly tried. Verily, I am
sure that, when the last day of my life shall have come upon me, I
shall carry in my heart a willing witness that shall speak, not only
to the care and honesty with which I have laboured for the health of
both rich and poor who have intrusted themselves to my care, but also
to those efforts which I have made to the best of my power, and with
all the energies of my mind, to give certainty to the treatment of
diseases even after my death, if such may be. In the first place, no
patient has been treated by me otherwise than I would myself wish to
be treated under the same complaint. In the second, I have ever held
that any accession whatever to the art of healing, even if it went no
further than the cutting of corns or the curing of toothaches, was of
far higher value than all the knowledge of fine points, and all the
pomp of subtle speculations—matters which are as useful to physicians
in driving away diseases, as music is to masons in laying bricks.”

The last comparison leads us to note that a vein of humour runs
through Sydenham’s works, as when he quotes

  “Tua res agitur paries quum proximus ardet,”

as a reason for his leaving London in the height of the plague.

In another passage, he is referring to the want of opportunity of
the poor to injure themselves by unsuitable diet in smallpox, owing
to the “res augusta domi.” Yet even among the poor, he says, since
they learnt the use of certain cordials, many more have died than in
previous ages less learned but more wise. “Nowadays every house has
its old woman,” he says, “a practitioner in an art she never learnt,
to the killing of mankind.”

In one place he grimly remarks, that if a certain mode of treatment
be resorted to, the patient will die of his own doctor, an end which
in that age must have too frequently resulted, though not specified
in the catalogue of diseases.

Here is a specimen of Sydenham’s witty apophthegms: “A man who finds
a treasure lying on the ground before him, is a fool if he do not
stoop and pick it up; but he is a greater one who, on the strength
of such a single piece of luck, wastes labour and risks life for the
chance of another.”

Again, “The usual pomp of medicine exhibited over dying patients is
like the garlands of a beast at the sacrifice.” Elsewhere he refers
to some persons “to whom nature has given just wit enough to traduce
her with.” We must also refer to Sydenham’s humour his answer to Sir
Richard Blackmore, who asked him what books he should study medicine
in: “Read Don Quixote, sir, which is a very good book: I read it
still.”

We notice as an instance of Sydenham’s kind-heartedness, a case
in which he lent a poor man one of his horses for a several days’
journey, believing continuous horse-exercise to be the best cure for
his disease.

Another characteristic touch is the following: “I have always thought
that to have published for the benefit of afflicted mortals any
certain method of subduing even the slightest disease, was a matter
of greater felicity than the riches of a Tantalus or a Crœsus.” To
Dr. Brady he remarks: “To you that undeserved abuse wherewith I am
harassed by many, is a vexation and sorrow; whilst, of those who
utter it this I may safely say, that if a harmless life, hurting
none by word or deed, had been sufficient to protect me from their
tongues, they never would have thundered against me. Since, then, it
is from no fault of mine that these calumnies have fallen on me, this
is my resolution, viz., that I will not afflict myself because other
men have done wrong.”

Again he says: “My fame is in the hands of others. I have weighed in
a nice and scrupulous balance, whether it be better to serve men,
or to be praised by them, and I prefer the former. It does more
to tranquillise the mind; whereas fame, and the breath of popular
applause, is but a bubble, a feather, and a dream. Such wealth as
such fame gives, those who have scraped it together, and those who
value it highly, are fully free to enjoy, only let them remember that
the mechanical arts (and sometimes the meanest of them) bring greater
gains, and make richer heirs.”

He addressed to Dr. Thomas Short his treatise on Gout and Dropsy,
because “although others despised the observations which I previously
published, you had no hesitation in attributing to them some
utility.”... “It is my nature to think where others read; to ask less
whether the world agrees with me than whether I agree with the truth;
and to hold cheap the rumour and applause of the multitude.”

We have yet to note a remarkable fragment entitled “Theologia
Rationalis, by Dr. Thomas Sydenham,” in manuscript in the Cambridge
University Library. It appears to coincide very closely with other
indications of his views, and it has been said of it, “There is much
in it of the spirit both of Locke and Butler—of Locke in the spirit
of observation and geniality; of Butler in the clear utterances as to
the supremacy of reason, and the necessity of living according to our
own true nature.” The general principles of his regard of the Divine
Being may be judged from the following extract: “Wherefore, to this
eternal, infinitely good, wise, and powerful Being, as I am to pay
all that adoration, thanks, and worship which I can raise up my mind
unto; so to Him, from the consideration of His providence, whereby
He doth govern the world, myself and all things in it, I am to pray
for all that good which is necessary for my mind and body, and for
diverting all those evils which are contrary to their nature; above
all desiring that my mind may be endowed with all manner of virtue.
But in requesting things relating to my body and its concerns, having
always a deference to the will of the Supreme Being, who knows what
is best for me better than I do myself. And though my requests to
these bodily concerns of mine are not answered, nevertheless, herein
I worship Him, by declaring my dependence upon Him; and forasmuch as
that, in many respects, I have transgressed His divine laws written
upon my nature, I am humbly to implore His pardon, it being as
natural for me to do it, as it is to implore the pardon of a man whom
I know I have offended. In all which requests of mine, and all His
creatures, how many soever they be in number, and how distant soever
they be in place, He being infinite, is as ready at hand to hear and
to help as any man who is but finite is at hand to administer food to
his child that craves it.”

Thus we take leave of Sydenham, denominated by Locke “one of the
master-builders at this time in the commonwealth of learning;”
reckoned by the masters in his own and the next age as second to
Hippocrates alone—the man whom Boerhaave never mentioned to his class
without lifting his hat, describing him as “Angliæ lumen, artis
Phœbum, veram Hippocratici viri speciem.”




CHAPTER IV.

_THE MONROS, CULLEN, THE GREGORYS, JOHN BELL, AND THE FOUNDATION OF
THE EDINBURGH SCHOOL OF MEDICINE._


Notwithstanding the early date of the foundation of the College of
Physicians of London, and the fact that the illustrious names of
Harvey and Sydenham and others adorn the rise of rational medicine
in the south, the credit of first developing a famous medical
school belongs to Edinburgh, where the Monros, Gregorys, Cullen,
Black, and Rutherford maintained during the eighteenth century
an unbroken succession of brilliant names. It cannot be allowed,
however, that the Town Council of Edinburgh, in founding medical
professorships, deserves as much of this credit as do the outside
founders of medical teaching, whose existence and success extorted
from the municipality a recognition formal and limited at first,
and certainly unremunerated. It may be questioned whether the
University of Edinburgh has not really been indebted almost as much
to the extra-academical teachers of medicine who have continually
stimulated the actual professors to their best endeavours, as to
those professors themselves.

Anatomy, the necessary foundation of medicine, had a kind of
beginning in Edinburgh in 1505, for the surgeons and barbers of the
city had procured the insertion in their charter of a clause enabling
them to obtain “once in the year a condemned man after he be dead to
make anatomy of.” But little came of this, and it was reserved for
a number of able physicians, educated abroad, in the latter part of
the seventeenth century, to set on foot some practical teaching in
medicine and the allied sciences. The names of Sir Robert Sibbald,
Sir Andrew Balfour, and Sir Archibald Stevenson must be honourably
mentioned in this connection. The first two of these were most
influential in establishing the earliest public botanic garden in
Edinburgh, a piece of ground about forty feet square, belonging
to Holyrood House. They subsequently allied to themselves James
Sutherland, who afterwards became a notable botanist, and obtained
the appointment of keeper of a much larger garden near Trinity
College Church. Many valuable collections of seeds and plants were
procured; medical students were incited to collect and send home
seeds and cuttings from places they might travel to; and so the
garden became an important starting-point for materia medica.

Professional feuds already became prominent in Edinburgh. The
surgeon-apothecaries were jealous of the physicians and doctors of
medicine. Several abortive efforts were made by the latter towards
the establishment of a College of Physicians. In 1621 King James
gave a warrant to the Scottish Parliament for this purpose; but no
action was taken. In 1630 the subject was referred to the Privy
Council. In 1656 Cromwell constituted a College of Physicians for
Scotland; but his death prevented its completion. Thus it was not
till Sibbald and Stevenson, by the aid of Sir Charles Scarborough,
Harvey’s friend, gained the ear of the Duke of York, that at last
the College of Physicians of Edinburgh was founded, in 1681,
notwithstanding the strong opposition of the surgeons and the
townsmen.

Soon after this, in 1685, the Town Council of Edinburgh appointed
three principal members of the College of Physicians to be Professors
of Medicine in what they now for the first time, at any rate in
existing documents, called “the university of this city.” Sir Robert
Sibbald was appointed Professor of Physic, and rooms were allotted to
him, but not a salary. Drs. Halket and Pitcairne were speedily added
to the list of professors, and the division of duties between the
professors was left to themselves. We have no record of any lectures
given by these professors for a long period, but we know that
Pitcairne in 1692-3 held a professorship at Leyden. On his return to
Edinburgh he became enthusiastic in promoting the medical school,
aiding Alexander Monteith in gaining permission from the Town Council
to dissect the bodies of people who died in “Paul’s Work.” “We
offer,” says Pitcairne, “to wait on these poor for nothing, and bury
them after dissection at our own charges, which now the town does;
yet there is great opposition by the chief surgeons, who neither eat
hay nor suffer the oxen to eat it. I do propose, if this be granted,
to make better improvements in anatomy than have been in Leyden these
thirty years.”

Monteith obtained a grant in October 1694 of “those bodies that
die in the correction-house,” and of “foundlings that die upon the
breast.” He was allowed to make his dissections in “any vacant
waste-room in the correction-house, or any other thereabouts
belonging to the town.” Magistrates were to be admitted if they
desired, and the apprentices of the surgeons might attend at
half-fee. However, Monteith’s scheme did not succeed, because he
had acted without concert with the other members of the Surgeons’
Corporation. These made a more successful start in the same year,
having obtained a right to “the bodies of foundlings who die betwixt
the time that they are weaned and their being put to schools or
trades, also the dead bodies of such as are stifled in the birth,
which are exposed and have none to own them; also the dead bodies of
such as are _felo do se_ and have none to own them; likewayes the
bodies of such as are put to death by sentence of the magistrate and
have none to own them.” A condition was annexed to this grant that by
Michaelmas 1697 an anatomical theatre should be built, where public
dissections should be made once a year, if opportunity offered. This
was evidently intended to extend to a course of anatomy, including
as much as could be taught on one body. The method, however, in
which anatomy was first practised in the Surgeons’ Hall was for ten
surgeons to lecture, on following days, each in succession taking a
special part. The body had to be buried within ten days.

It was in 1705 that a special appointment of one man to lecture
on anatomy was first made, and the first lecturer, Robert Elliot,
was also made Professor of Anatomy in the University, with a small
stipend. This formal appointment appears to have been directly
occasioned by the offer of some unknown teacher to give public and
private teaching in anatomy to the surgeons and their apprentices.

It is not till 1706 that we have any record of Sibbald’s lectures.
The _Edinburgh Courant_ was then made the medium whereby he
announced, in Latin, his intention to lecture on natural history and
medicine “in privatis collegiis,” or private courses of lectures. He
appears to have lectured in Latin, and to have received no pupils but
such as were skilled in Greek, Latin, mathematics, and philosophy.

About this time had settled in Edinburgh the progenitor of the long
line of distinguished Monros, John Monro, formerly an army surgeon,
who became President of the College of Surgeons in 1712. His son
Alexander, afterwards so distinguished, was born in London on the 8th
September, 1697. Being an only son, his father gave unusual attention
to his training, and early perceiving his acuteness of mind, sent him
successively to London, Paris, and Leyden to obtain the best medical
education at that time accessible. The anatomical preparations which
he made during his studentship gave such evidence of ability, that
Drummond, who then taught anatomy at Edinburgh, offered to resign
in his favour as soon as he returned home. Cheselden in London and
Boerhaave in Leyden were highly impressed by the young Scotchman’s
promise.

The year 1720 may be taken as witnessing the actual start of the
Medical School of Edinburgh, and Alexander Monro as its real founder.
Although the father did much to promote the successful start, the
son becoming actually the competent teacher, must necessarily have
the greater credit. At the age of twenty-two, Monro was appointed
Professor of Anatomy, and having announced his first course of
lectures on anatomy, to be illustrated by the preparations he had
made and sent home when abroad, his father, without his knowledge,
invited the President and Fellows of the College of Physicians and
the whole of the city surgeons to the first lecture. The surprise
caused the young lecturer to forget the discourse which he had
committed to memory, and being without notes, he had presence of
mind enough to commence talking about some of his preparations,
and soon became collected in speaking of what he was confident he
understood. Thus the surprise and temporary forgetfulness thereby
caused was a foundation of his success: he found himself applauded
as a ready speaker, and resolved throughout life to speak extempore,
being persuaded that words expressive of his meaning would always
occur in speaking on a subject which he understood. From this time
the subjects of anatomy and surgery in Monro’s hands attracted large
classes of students, the average of the first decade being 67; of the
second, 109; of the third, 147. Even during the second session his
lectures attracted students from all parts of Scotland, also from
England and Ireland. Seizing the opportunity, other professors were
persuaded to start courses of lectures, so that soon a respectable
curriculum was provided, and Monro secured in 1722 a grant of his
professorship for life. It had previously been held only at the will
of the Town Council.

Monro was now face to face with the difficulty of providing
sufficient material for the instruction of his large classes. Under
Cheselden in London he had been accustomed to a supply of subjects,
more even than he could make use of. In Edinburgh, as early as 1711,
complaints were made at Surgeons’ Hall of violation of graves in
Greyfriars’ Churchyard, “by some who most unchristianly have been
stealing, or at least attempting to carry away, the bodies of the
dead out of their graves.” But, said the surgeons, “that which
affects them most, is a scandalous report, most maliciously spread
about the town, that some of their number are accessory, which they
cannot allow themselves to think, considering that the magistrates
of Edinburgh have been always ready and willing to allow them what
dead bodies fell under their gift, and thereby plentifully supplied
their theatre for many years past.” They consequently beg that the
magistrates will seek for and punish the offenders, and resolve to
expel any of their number found accessory to the violation of graves.
The populace nevertheless continued to be excitable on the subject
of the violation of graves, and in 1721-2, surgeons’ apprentices
were especially bound “not to raise the dead.” In March 1725 Monro
was put under the stringent obligation of giving information when
he procured each dead body, and guaranteeing that it was regularly
obtained; but the mob were suspicious, and threatened to demolish his
museum and theatre at Surgeons’ Hall. Monro consequently applied for
and obtained a room in the university building, being there safer
than at Surgeons’ Hall. Here his course included dissections not
only of the human body, but also of animals. Diseases affecting the
various organs were referred to; operations upon the dead body were
performed; bandages were applied; and lastly, such physiology as was
known was treated of. This course was continued for nearly forty
years.

A great hospital was lacking, and the whole force of the medical
faculty, with the powerful aid of the far-seeing provost, George
Drummond, was engaged to secure the building of the infirmary. Monro
and Drummond were constituted a Building Committee, and Monro planned
in particular the operation-room. Dr. Moore in his Travels through
Scotland records that “the proprietors of many stone-quarries made
presents of stone, others of lime; merchants contributed timber;
carpenters and masons were not wanting in their contributions; the
neighbouring farmers agreed to carry the materials gratis; the
journeymen masons contributed their labours for a certain quantity
of hewn stones; and as this undertaking is for the relief of the
diseased, lame, and maimed poor, even the day-labourers could not
be exempted, but agreed to work a day in the month gratis toward
the erection. The ladies contributed in their way to it; for they
appointed an assembly for the benefit of the work, which was well
attended, and every one contributed bountifully.”

The completion of the hospital gave Monro the opportunity of
delivering clinical lectures on surgery, while Rutherford from 1748
gave clinical lectures on medical cases. Monro himself was present
at every _post mortem_ examination, and dictated to the students
an accurate report of the case. It was said of him “it is hardly
possible to conceive a physician more attentive to practice, or a
preceptor more anxious to communicate instruction.”

His first and perhaps best known work was his Osteology, published
in 1726, and translated into several foreign languages. A French
edition appeared in folio with excellent engravings by M. Sue,
demonstrator to the Royal Academy of Paris. A treatise on the Nerves
followed; and later, a series of Medical Essays and Observations,
many by Monro, was issued by him, as the result of meetings of the
principal medical men in Edinburgh, which flourished for some years.
Another interesting work of Monro’s was his treatise on Comparative
Anatomy, in which he proposed to illustrate the human economy by
the anatomy of such vertebrate animals as he knew. But the contrast
is astonishing between Monro’s knowledge and that of the present
day. He divides quadrupeds into carnivorous and herbivorous; fowls
into those that feed on grain and those that feed on flesh; fishes
into those that have lungs and those that have not. He remarks that
the fishes that have lungs differ very inconsiderably from an ox
or any other quadruped, and are not easily procured; consequently
he omits all account of them. Moreover, he says, “as the structure
of insects and worms is so very minute, and lends us but little
assistance for the ends proposed, we purposely omit them.” He has a
strangely unpenetrating view of the relation between an oyster and a
sensitive plant. “What difference is there betwixt an oyster, one of
the most inorganised of the animal tribe, and the sensitive plant,
the most exalted of the vegetable kingdom? They both remain fixed
to one spot, where they receive their nourishment, having no proper
motion of their own, save the shrinking from the approach of external
injuries.” Dr. Monro’s writings generally are not inviting to quote
from, being written in a plain and rather bald style, with very
little attempt at illustration.

In private life Monro, primus, was humane, liberal in sentiment,
a sincere friend, and an agreeable companion, an affectionate
husband and a kind father, having the art of making his children his
companions and friends. In 1745, after Prestonpans, he went down at
once to the battlefield to assist the sick and wounded, dressed their
wounds, and busied himself in securing them provisions and conveyance
to town. Nor did he confine his attentions to the loyal, but aided
the rebels also. He took an important share in the education of his
children, of whom Donald became a successful physician, and wrote his
life prefixed to the quarto edition of his works, 1781, to which all
subsequent biographies are much indebted.

Monro was a man of a strong muscular make, of middle height. Yet
his constitution was considerably weakened in early life owing to
his being too frequently bled. He was liable to attacks of chest
affections throughout life, but died finally of a painful ulcer of
the rectum and bladder, on July 10th, 1767. He had resigned his chair
of anatomy to his son Alexander in 1759, but continued to practise
and to attend the infirmary till the last. He bore his painful
illness with fortitude and Christian resignation, and talked of his
approaching death with the same calmness as if he were going to sleep.

“He was,” says Professor Struthers, “an able and active, and at
the same time a calm and placid man. He had family and friends
influential and plenty, but the work he had to do was of a kind
at which friends could only stand and look on. He had to do a new
thing in Edinburgh; to teach anatomy and to provide for the study
of it, in a town of then only thirty thousand inhabitants, and in a
half-civilised and politically-disturbed country; he had to gather
in students, to persuade others to join with him in teaching, and
to get an infirmary built. All this he did, and at the same time
established his fame not only as a teacher but as a man of science,
and gave a name to the Edinburgh School which benefited still more
the generation which followed him.”

Although we must depart from strict chronological order to do so,
it will be more convenient to give here an account of the second
Monro, who was born May 20th, 1733, and was early attracted to the
study of anatomy, showing great perseverance and possessing a good
memory. He soon became a very useful assistant to his father in the
dissecting-room, and when the students grew too numerous for one
lecture, his father deputed his son, at the early age of twenty, to
repeat his course in an evening lecture to those who had failed to
obtain admission in the morning. His father, seeing how successful
his son was, petitioned the Town Council to have him appointed
as his colleague and eventual successor, promising, if this were
granted, to send his son to the best medical schools in Europe, and
in every way to fit him for the post. This plan being carried out,
young Monro took his M.D. degree at Edinburgh in 1755, and set out
for a round of medical schools, London, Leyden, Paris, and Berlin;
in London he attended William Hunter; in Berlin he had the still
greater advantage of living in the house of, and sharing the intimate
instruction of, the great anatomist, Meckel—a truly good start for
a promising career. On his son’s return to Edinburgh in 1758, his
father resigned his chair to him, and the son commenced by teaching
quite novel views on the blood, controverting his father’s teaching.
“The novelty of his matter, combined with the clearness of his style,
is described by one who was present as having acted like an electric
shock on the audience. It was at once seen that he was master of the
subject, and of the art of communicating knowledge to others; his
style was lively, argumentative, and modern, compared with that of
his more venerable colleagues; and from the beginning onwards, for
half a century, his career was one of easy and triumphant success”
(Struthers). As a lecturer he was clear, earnest, and impressive,
eloquent without display, and at the same time grave and dignified.
No wonder that his classes increased in size, until they even reached
four hundred.

At the same time Monro entered into practice as a physician, and
became one of the leading practitioners in Edinburgh, so much so that
Dr. James Gregory described him as being far more than half a century
at the head of the medical school, and for a great part of that time
at the head of the profession as a practising physician. He was
also frequently called into consultation on surgical cases, though
he did not operate. His chief fame is, however, as a successful
anatomist and teacher of anatomy. In 1777 he successfully resisted
the appointment of a separate Professor of Surgery, claiming that his
office included surgery.

Monro secundus claimed, and not without good grounds, to have made
important original discoveries in regard to the lymphatic system; but
his merits as a discoverer in this department do not interfere with
the greater lustre of William Hunter and Hewson. His observations
on the structure and functions of the nervous system enjoy the
distinction of having called Sir Charles Bell’s attention to the
ganglion of the fifth pair of cranial nerves, and to important
particulars of the origin of the spinal nerves, which led in no
insignificant degree to his own great discoveries.

In 1758 Monro published at Berlin his first essay on the Lymphatics,
and Professor Black testified to having read this essay in manuscript
in 1755. It contained an account of the lymphatics as a distinct
system of vessels, having no immediate connection with the arteries
and veins, but arising in small branches from all cavities and cells
of the body into which fluids are thrown, and stating that their use
was to absorb the whole or the thinner parts of these fluids, and to
restore them to the general circulation. He showed further by medical
observation that in cases where acrid matter was applied to the pores
of the skin, or gained access to the cellular membranes, the glands
between the parts affected and the centre of the body became swollen
and painful, manifestly from being absorbed by the lymphatics.

Monro also first ascribed the absorption of bones and other solid
parts in cases of tumour to pressure. His various works on the
Nervous System, on the Muscles, on the Brain, Eye, and Ear, and on
the Structure and Physiology of Fishes, all contain observations
which were of considerable value in building up the science of
anatomy in the last century, but none of them furnish attractive
reading, such as we have found in the works of Harvey and Sydenham.
This is somewhat remarkable, considering that Monro shone as an
anecdotist, was intimate with all the celebrated Edinburgh men of his
time, and was a great admirer of the theatre, being equally attracted
by Mrs. Siddons, whom he felt the greatest pleasure in attending as a
patient, and by Foote, whose performance as President of the College
of Physicians to Weston’s Dr. Last under examination he enjoyed
extremely. It was said that Monro sent his own scarlet robe to the
theatre for the mock doctor to wear.

Another of Monro’s personal tastes was that of horticulture. He
planted and beautified several romantic hills around his estate
at Craiglockhart. Here he fitted up, says Dr. Duncan, a rural
cottage, consisting of two commodious apartments, adjoining his
head gardener’s house, whose kitchen could provide dinner for a few
select friends. He would keep no bedroom there, that he might never
be tempted to stay away from his professional duties in Edinburgh;
but in his cottage he often passed a summer day and regaled his
friends with the choicest fruits. Dr. Duncan in his Harveian Oration
relates his disappointment that the younger generation of his friends
“prefer the instrumental music of a fiddle, a flute, or an organ in a
drawing-room to that of the linnet, the thrush, or the goldfinch in
the fields;” and that the gardens of his old friends in which he had
spent such happy hours were now let out for market gardens.

Monro was very economical of his time, and carefully measured it out
to each subject which occupied him; and he worked nearly as hard
towards the end as at the beginning of his career. He did not deliver
stereotyped lectures, but continually improved them. He is to be
credited also with having favourably received Jenner’s discovery of
vaccination, and vaccinated many children himself.

In person the second Monro was of middle height, of vigorous and
athletic make. His head was large, with strongly marked features and
full forehead, light blue eyes, and somewhat large mouth. His neck
was short, and his shoulders high.

In 1798 his son, Monro, tertius, was conjoined with him in the
professorship, but for ten years more the old man continued to
give the greater part of the course. His last lecture was that
introductory to the session of 1808-9, after which he retired from
practice also, and lived on till he died of apoplexy, 2d October
1817, in his eighty-fifth year.

Born to a great name and a ready-made position, as Professor
Struthers remarks, the second Monro had every advantage which
education, friends, and place could secure. But it is to his credit
that among brilliant colleagues like Cullen, Black, Dugald Stewart,
Playfair, and others, he held his own both intellectually and
socially, even if he has not left so abiding a mark upon medical and
anatomical science as his contemporaries must have expected him to
make.

       *       *       *       *       *

Notwithstanding the note which the Monros have attained for their
anatomical teaching, and the distinction won by the Gregorys as
Professors of Medicine and able physicians, they are outshone by
William Cullen, who is justly the most conspicuous figure in the
history of the Edinburgh Medical School in the eighteenth century.
WILLIAM CULLEN was born on the 15th of April, 1710, at Hamilton,
Lanarkshire, his father having been factor to the Duke of Hamilton.
Early prominent at the local grammar-school by his quick perception
and retentive memory, he was sent to the University of Glasgow in
due course, and apprenticed to a medical practitioner named Paisley,
who was both studious and possessed a good medical library, a signal
advantage to young Cullen. It became remarked by his companions
that while he took little or no part in their discussions when he
happened to be ill-informed on the subject, he always so studied
it afterwards that he could surpass the best of them if it came
up again. At the close of 1729 Cullen went to London, and first
obtained the surgeoncy to a merchant ship, commanded by a relative,
with whom he went to the West Indies, remaining six months at
Portobello. On his return to London he took a situation in an
apothecary’s shop in Henrietta Street, and studied as diligently as
ever, when not occupied in the shop. His father had died, and there
was little provision for a large family; his eldest brother’s death
compelled him to return to Scotland in the winter of 1731-2, to make
arrangements for the education of his younger brothers and sisters.
He began practice at Auchinlee near Hamilton, taking charge of the
health of a relative, and perseveringly carrying on from books those
studies which he had not money to prosecute at the seats of learning
where he longed to be.

The receipt of a small legacy was the turning-point of Cullen’s
earlier fortunes: and how small a sum a studious Scotchman can make
available in this direction is well known. Cullen resolved to devote
himself to study entirely until he should be qualified to take a
firm stand as a surgeon at Hamilton. He first went to reside with a
dissenting minister in Northumberland, for the study of literature
and philosophy, and then spent the winter sessions of 1734-5 and
1735-6 at Edinburgh Medical School, now rapidly rising into note.
On establishing himself as a surgeon at Hamilton early in 1736,
young Cullen was soon employed by the Duke and Duchess of Hamilton
and the leading families of the neighbourhood. In this comparatively
retired situation Cullen yet gained the confidence of Dr. Clerk, an
able Edinburgh physician called in to Hamilton Palace, and was the
means of influencing William Hunter to the choice of the medical
profession. William Hunter was Cullen’s resident pupil from 1737 to
1740, and declared these to have been the happiest years of his life.
Thus natural selection brings men of future note together before
the world has known them, and the lineal succession of minds is as
fruitfully carried on as that of bodies. The affection of these two
continued throughout life. Long after William Hunter refers to him as
“a man to whom I owe most, and love most of all men in the world.”

Cullen determining to devote all his time to medicine, proceeded to
the M.D. degree at Glasgow in 1740, and took a partner who was to
relieve him of surgical work. In November 1741 he married Miss Anna
Johnstone, a lady of much conversational power and charming manners,
whose companionship he enjoyed for the long period of forty-six
years. She became the mother of seven sons and four daughters. Dr.
Cullen’s name was now becoming known considerably beyond his native
locality, and in 1744 he removed to Glasgow, a step which he would
have taken previously but for the solicitations and promises of
the Duke and Duchess of Hamilton. His constant attendance on the
duke in his painful illness was ended by the death of the latter in
1743, which put an end to the project of a chemical laboratory and a
botanical garden at the palace, which had been among the inducements
by which he had been prevailed upon not to quit Hamilton. Henceforth,
in the intervals of practice and study, he began to occupy himself
vigorously with the founding of a medical school at Glasgow. He at
once began to lecture on medicine, and subsequently added to his
courses chemistry, materia medica, and botany, in all of which he
gave lectures not merely representing the knowledge of the time,
but also including original views of high value. The young school
grew, though not so rapidly as that of Edinburgh; but thus early he
was brought into contact with yet another great man, Joseph Black,
who was for some years his intimate pupil, and afterwards left
Glasgow for Edinburgh. Cullen discerned the promise of his pupil,
and carefully abstained from entering upon fields of research in
which he expected him to make a mark. Black submitted his treatise
on fixed air to Cullen, and dedicated it to him. About this time
Cullen made some important discoveries on the evolution of heat in
chemical combination, and the cooling of solutions, some of which
were not published till 1755, while others remained in manuscript,
but suggested to Black important points in his view of latent heat.

At the beginning of 1751, by the interest of the Duke of Argyll,
Dr. Cullen succeeded Dr. Johnstone as Professor of Medicine in the
University of Glasgow, at the same time that Adam Smith was appointed
to the Chair of Logic; and a friendship of great intimacy arose
between these thoughtful minds. Only a few months afterwards, Adam
Smith’s transfer to the Moral Philosophy chair led Dr. Cullen to
favour strongly the election of David Hume to the vacant chair, on an
occasion when Edmund Burke was also a candidate. Neither was elected,
strict orthodoxy carrying the day. At this period the applications
of chemistry to arts and manufactures and to agriculture engaged
Cullen’s attention considerably, and he proposed to carry out a
process for purifying common salt, but it proved too expensive.

Cullen, finding that Glasgow did not promise to build up a large
medical school at present, and being compelled to take country
practice, began to look longingly to Edinburgh, to which also his
friends were calling him. He says in a letter to William Hunter, in
August 1751, “I am quite tired of my present life; I have a good
deal of country practice, which takes up a great deal of time, and
hardly even allows me an hour’s leisure. I get but little money for
my labour; and indeed by country practice, with our payments, a man
cannot make money.” Various circumstances, however, prevented this
step being taken, until, in the beginning of 1756, he was appointed
to the professorship of chemistry at Edinburgh, and was thus fairly
launched on his notable career. In the competition for this chair,
Joseph Black had been nominated, but the two friends honourably
refused to do anything to prejudice each other, and on appointment
indeed Cullen offered Black all the fees if he would assist him.
Cullen’s first course at Edinburgh was attended by only 17 students,
his second by 59, while it rose later to 145. Practice soon came to
him, and freed him from his pecuniary struggles.

In 1757 Dr. Cullen first undertook to give clinical lectures in the
infirmary, and in this work his especial talents shone. He had now
had sufficient experience of practice, with the best knowledge of
chemistry and materia medica that the time afforded; and his skill
in observation and graphic description of disease, added to his zeal
for imparting knowledge, soon made his clinical lectures renowned.
In these lectures, for eighteen years most carefully prepared, the
first real model of what is now so familiar to medical students as
a clinical lecture was afforded. His candour may be judged from
the following expressions: “In these lectures, however, I hazard
my credit for your instruction, my first views, my conjectures, my
projects, my trials, in short, my thoughts, which I may correct and
if necessary change; and whenever you yourselves shall be above
mistakes, or can find anybody else who is, I shall allow you to rate
me as a very inferior person. In the meantime I think I am no more
liable to mistakes than my neighbours, and therefore I shall go on
in telling you of them when they occur.” Promoted by such candour,
Cullen’s reputation rapidly grew. His lectures were remarkable
for simplicity, ingenuity, and comprehensiveness of view, with
copiousness of illustration. He taught his students to observe the
course of nature in diseases, to distinguish between essential and
accidental symptoms, and to carefully discriminate the influence of
remedies from the curative operations of nature. “There is nothing,”
he said, “I desire so much as that every disease we treat here should
be a matter of experience to you, so you must not be surprised that
I use only one remedy when I might employ two or three; for in using
a multiplicity of remedies, when a cure does succeed, it is not easy
to perceive which is most effectual.” Again, he says, “Every wise
physician is a dogmatist, but a dogmatical physician is one of the
most absurd animals that lives. We say he is a dogmatist in physic
who employs his reason, and, from some acquaintance with the nature
of the human body, thinks he can throw some light upon diseases
and ascertain the proper methods of cure; and I have known none
who were not dogmatists except those who seemed to be incapable of
reasoning, or who were too lazy for it. On the other hand, I call
him a dogmatical physician who is very ready to assume opinions,
to be prejudiced in favour of them, and to retain and assert very
tenaciously, and with too much confidence, the opinions or prejudices
which he has already taken up in common life, or in the study of
the sciences.” He sought to build up rational views of medicine,
indeed, on the basis of fact and experiment. In giving his clinical
lectures he was at great pains to choose diseases of the most common
types, as most useful to the students. He adhered to great simplicity
of prescriptions, compared with the complex and barbarous nostrums
of preceding times, and he experimentally used and introduced many
new drugs of great value, such as Cream of Tartar, Henbane, James’s
Powder, and Tartar Emetic.

The novelty with which Cullen invested his subject and the boldness
of his views made many, especially conventional practitioners and
lecturers, regard him with disfavour, and decry him for not regarding
Boerhaave’s views as final, and for adopting those of Hoffmann in
conjunction with his own. Yet his lively and entertaining lectures,
combined with his pleasing treatment of patients, and “his manner, so
open, so kind, and so little regulated by pecuniary considerations,
made him win his way more and more. He was the friend of every family
he visited.” William Hunter writes in 1758, “I do assure you I have
never found anything in business so pleasing to me as to hear my
patients telling me, with approbation, what Dr. Cullen had done for
them, and to hear my pupils speaking with the reverence and esteem of
Dr. Cullen that is so natural to young minds.”

As a sign of the general mental attitude of Dr. Cullen, the following
extract from a letter to his son James, on setting out for a foreign
voyage, is of interest: “Study your trade eagerly, decline no
labour, recommend yourself by briskness and diligence, bear hardships
with patience and resolution, be obliging to everybody, whether
above or below you, and hold up your head both in a literal and
figurative sense.” While he aided his juniors in the best sense to
acquire independence of character, he “admitted them freely to his
house; conversed with them on the most familiar terms; solved their
doubts and difficulties; gave them the use of his library; and, in
every respect, treated them with the affection of a friend and the
regard of a parent. It is impossible for those who personally knew
him in this relation,” says Dr. Aikin, “ever to forget the ardour
of attachment which he inspired.” Another and not less pleasing
view of Cullen is shown in his recommendation of “Don Quixote” to
Dugald Stewart when a boy suffering from some indisposition, and the
interest he manifested in his patient’s progress in that delight. He
used to talk over with the lad every successive incident, scene, and
character, manifesting the minutest accuracy of recollection of the
master-piece.

We shall not follow the discussions which arose at Edinburgh about
the succession to Dr. Rutherford’s chair of the Practice of Physic,
nor the circumstances which led to Dr. John Gregory’s appointment.
Suffice it to say that on the death of Dr. Whytt, Cullen consented
to accept the chair of the Theory of Physic in 1766, and that
subsequently an arrangement was made by which the two professors
lectured alternately on the Theory and Practice of Physic, to
the still greater advantage of the now celebrated school. This
appointment was strongly promoted by both the Monros, and by an
address signed by 160 medical students. The arrangement now made
lasted till Dr. Gregory’s death in 1773, when Cullen became sole
Professor of the Practice of Physic. Black was brought to Edinburgh
to succeed Cullen in the Chair of Chemistry.

Cullen’s principal works are the “Nosology,” a synopsis and
classification of diseases, with definitions, which obtained wide
popularity, although only an approximation to a sound system; and
his “First Lines of the Practice of Physic,” 4 vols., 1778-85, which
went through numerous editions. One of its especial merits was that
it pointed out more clearly than preceding works the extensive and
powerful influence of the nervous system on disease. It is now held
as the defect of his system that it was too theoretical, and that its
views were not adequately supported by facts. It cannot be denied
that Cullen had but moderate anatomical and physiological knowledge,
and this has prevented him from leaving works capable of being read
with much profit by the practitioners of the present day.

It is after all on William Cullen’s personal influence on the School
of Medicine, which he did so much to maintain, that his fame will
chiefly rest. The character of this influence is honourable and
stainless. Dr. James Anderson has left in unequivocal language a
record of his bearing in his conspicuous position which does equal
honour to his intellectual energy and to his qualities of heart. Dr.
Cullen, he says, was employed five or six hours a day in visiting
patients and prescribing by letter; lecturing never less than two
hours a day, sometimes four; yet, when encountered, he never seemed
in a hurry or discomposed—always easy, cheerful, and sociably
inclined. He would play at whist before supper with as keen interest
as if a thousand pounds depended on it.

Cullen did not leave his acquaintance with his students to originate
by chance, but invited them early in their attendance, by twos,
threes, and fours, to supper, and gaining their confidence about
their studies, amusements, difficulties, hopes, and prospects. Thus
he got to know all his class, and paid especial attention to those
who were most assiduous, best disposed, or most friendless. He made
a point of finding out who among them were most hampered by poverty,
and often found some polite excuse for refusing to take a fee even
for their first course, and in many cases for their second course.
One method he adopted was to express his wish to have their opinion
on a particular part of his course which had been omitted for want of
time the previous session, and he would thereupon present them with
a ticket for the second course. After two courses he did not require
any fee for further attendance. He is credited, too, with having
introduced into Edinburgh the practice of not taking fees for medical
attendance on students of the university. This ease and generosity
about money matters was the cause of his eventually dying without any
fortune. It is said that he used to put sums of money into an open
drawer, to which he and his wife went when they wanted any.

We shall not enter here into the controversy between Dr. John Brown,
founder of the Brunonian theory of medicine, and his disciples,
and Dr. Cullen, to whom Brown had owed everything in his youth.
Brown’s system proved to be no more stable than his personal
character, although its noisy advocacy, and the abuse heaped upon him
personally, caused Dr. Cullen much pain.

Cullen continued to deliver his lectures until 1789, having
resigned his professorship on the 30th December, and he died on the
5th February 1790, almost eighty years of age. He was buried at
Kirknewton, in which parish was situated his estate of Ormiston Hill.
This latter, which he had beautified with very great care, had to be
sold after his death for the benefit of his family.

Dr. Anderson describes Dr. Cullen as having a striking and not
unpleasing aspect, although by no means elegant. His eye was
remarkably vivacious and expressive. In person he was tall and thin,
stooping very much in later life. In walking he had a contemplative
look, scarcely regarding the objects around him. When in Edinburgh
he rose before seven, and would often dictate to an amanuensis till
nine. At ten he commenced his visits to patients, proceeding in a
sedan chair through the narrow closes and wynds. He always lived,
while in Edinburgh, in a comparatively small house in the Mint, not
far from the seat of his academical duties. For them he may be said
to have lived and died.

       *       *       *       *       *

The family of the Gregorys has been perhaps equally celebrated with
the Monros in connection with university life in Scotland, and has
certainly furnished it with a larger number of eminent professors.
James Gregory, the celebrated inventor of the reflecting telescope,
was the first great man of the family, and his publication of a
work on optics in 1663 marked an era in that science. His early
death in 1675, at the age of 37, deprived science of many brilliant
discoveries in prospect. His only son, James, became Professor of
Medicine in King’s College, Aberdeen, and died in 1731.

His younger son, JOHN GREGORY, the first of the medical Gregorys
who became associated with the fame of Edinburgh, was only seven
years old when his father died in 1731. After being educated at
Aberdeen, under the care of his elder brother, who had succeeded his
father, and also under the influence of his cousin, Thomas Reid,
the well-known metaphysician, young Gregory entered at Edinburgh in
1741, and studied under the elder Monro, Sinclair, and Rutherford;
and at the Medical Society commenced a warm friendship with Mark
Akenside, author of the “Pleasures of Imagination.” In 1745-6 he
studied at Leyden under Albinus, and having received the M.D.
degree from Aberdeen during his absence, he was elected to the chair
of philosophy there on his return, and lectured there for three
years on mathematics, and moral and natural philosophy. In 1749 he
resigned this chair in order to devote himself to medicine, and in
1752 he married Elizabeth, daughter of Lord Forbes, who had beauty,
intellect, and wit, and brought him a fortune.

Finding that Aberdeen afforded him no sufficient field for practice
in competition with his elder brother, Gregory went in 1754 to
London, where he had already friends such as Wilkes and Charles
Townshend, whom he had met at Leyden, and where he speedily made
other friends, of whom may be mentioned George, Lord Lyttelton,
Edward and Lady Mary Wortley Montagu. He was at once elected into
the Royal Society, and would no doubt have gained fashionable
support; but his elder brother dying in 1755, he was recalled to
Aberdeen to fill the Professorship of Medicine. Here he continued
to practise and to lecture till 1764, publishing in the latter year
“A Comparative View of the State and Faculties of Man with those
of the Animal World.” He then removed to Edinburgh with a view to
securing a professorship there. This fell to his lot in 1766, on
the death of Rutherford. In the same year he succeeded Dr. Andrew
Whytt as physician to the king in Scotland. He at first lectured on
the Practice of Physic solely, but in 1770 he agreed with Cullen
that they should lecture in alternate years on the Theory and the
Practice, and this arrangement was continued permanently. As a
lecturer he was very successful, simple and not in any way oratorical
in style. He was especially noted for some lectures on the “Duties
and Qualifications of a Physician,” which were afterwards published,
and went through several editions. He gave the profits to a poor and
deserving student. In 1772 he published “Elements of the Practice of
Physic,” a kind of syllabus of lectures; and this completes the list
of his medical works. His name was more known after his death as the
author of a little book of advice to young girls, “A Father’s Legacy
to his Daughters,” which has gone through very many editions. His
tone may be judged from the following extract:—

“Do not marry a fool; he is the most untractable of all animals; he
is led by his passions and caprices, and is incapable of hearing the
voice of reason.... But the worst circumstance that attends a fool is
his constant jealousy of his wife being thought to govern him. This
renders it impossible to lead him; and he is continually doing absurd
and disagreeable things, for no other reason but to show he dares do
them.... A rake is always a suspicious husband, because he has known
only the most worthless of your sex. He likewise entails the worst
diseases on his wife and children if he has the misfortune to have
any.”

Gregory’s predominant qualities were good sense and benevolence.
In conversation he had a warmth of tone and of gesture that were
very pleasing, united to gentleness and simplicity of manner. To his
pupils he was a friend, ever easy of access, and ready to assist them
to the utmost. His Edinburgh life was spent in intimate association
with David Hume, Lord Monboddo, Lord Kaimes, Dr. Blair, and the elder
Tytler. James Beattie loved him with enthusiastic affection, as the
closing stanzas of “The Minstrel” testify. Gregory died suddenly
on the 9th February 1773, from gout, from which he had frequently
suffered. He had thus scarcely attained the age of fifty.

JAMES GREGORY, who succeeded his father in the professorship,
was born in Aberdeen in 1753. He was educated in Edinburgh, and
also studied for a short time at Christ Church, Oxford, where his
relation, Dr. David Gregory, had been dean. He acquired a strong
taste for classics and no little classical erudition, so that he
was throughout life fond of making apposite Latin quotations, and
wrote that language easily and accurately. He was still a student
of medicine at Edinburgh when his father’s sudden death took place
in 1773. The son by a great effort completed his father’s course
of lectures, and showed so much ability that the professorship was
practically kept open for him. In 1774 he took the M.D. degree, and
spent the next two years in studying medicine on the Continent. In
1776, being then only twenty-three, he was appointed Professor of the
Institutes of Medicine, and in the following year also commenced to
give clinical lectures at the infirmary, which method of instruction
he continued for more than twenty years. His practice at first was
not extensive, until his pupils had themselves become practitioners,
and called him in as a consultant. In his later years, after Cullen’s
death, his practice increased largely, and in the ten years preceding
his death he had the leading consulting practice in Scotland.

In 1780-2 Gregory published his “Conspectus Medicinæ Theoreticæ,”
written in excellent Latin; it speedily became widely known, and
was extensively read not only in Britain but also on the Continent.
It has gone through numerous editions. Its more important and
valuable portions were those dealing with therapeutics. In 1790
he was appointed Cullen’s successor in the chair of the Practice
of Medicine, and from that time continued to lecture to large
classes down to his death in 1821 (April 2). Thus he held an almost
autocratic position for the long period of over thirty years; and
it is much to be regretted that his great talents in repartee,
quick memory for telling quotations, and fondness for a joke, led
him to take an active part in the medical controversies which
have embittered so many careers in Edinburgh. The long list of
controversial books and pamphlets by Dr. Gregory, given by Mr. John
Bell in his “Letters on Professional Controversy and Manners,” 1810,
could be considerably extended, and it affords a melancholy picture
of misplaced energy. One of these extended to 700 pages quarto, and
its tone may be judged from the following extracts from the “Memorial
to the Managers of the Royal Infirmary.”

“Let us suppose that in consequence of this memorial, every
individual member of the College of Surgeons shall, to his own share,
make forty times more noise than Orlando Furioso did at full moon
when he was maddest, and shall continue in that unparalleled state
of uproar for twenty years without ceasing. I can see no great harm
in all that noise; and no harm at all to any but those who make
it.... Ninety-nine parts in the hundred of all that noise would of
course be bestowed on me; whom it would not deprive of one hour of
my natural sleep, and to whom it would afford infinite amusement and
gratification while I am awake.”

“We are certainly a most amiable brotherhood, as every person must
acknowledge who has had the good luck to see but a dozen and a half
or two dozen of us together, especially if he saw us at dinner.
Yet, whatever the majority of us may be, I am afraid we are not
all perfect angels. Some of us at least appear to be made of the
same flesh and blood, and to be subject to the same frailties and
passions and vices as other men. The consequence is, that when two
or three of us are set down together in a little town, or fifty or
a hundred of us in a great town, and obliged to scramble for fame,
and fortune, and daily bread, we are apt to get into rivalships, and
disputes, and altercations which sometimes end in open quarrels and
implacable animosities, to the very great annoyance of those who are,
and the no less entertainment of those who are not, our patients. A
consultation among any number of such angry physicians or surgeons
in all probability will conduce as little to the benefit of their
patient as a congress of an equal number of game-cocks turned loose
in a cock-pit, for probably the good of the patient will be the last
and least object of their thoughts.”

Inasmuch as he takes occasion to say of John Bell, “any man, if
himself or his family were sick, should as soon think of calling in a
mad dog as Mr. John Bell,” we can judge of the position in which any
one found himself who had the misfortune to displease Dr. Gregory.
We must believe, however, on the testimony of many who knew him,
that he must have possessed many remarkable and excellent qualities
to have won so large a share of their attachment and esteem as he
undoubtedly did. Dr. Alison says of him (Encyc. Brit., 8th ed.),
that the boldness, originality, and strength of his intellect, and
the energy and decision of his character, were strongly marked in
his conversation, and that he showed both warm attachment to his
friends, and a generosity almost bordering on profusion. He disdained
to conciliate public favour, and often gave unrestrained vent to
a strongly irascible temper. He would not give up his point in
argument, and would overwhelm his opponents with quotations, jests,
and satire.

As a teacher Gregory was conspicuous for a sound practicality. He
highly approved of a maxim which he often brought forward: “The best
physician is he who can distinguish what he can do from what he
cannot do.” Pathology in his days was a very rudimentary science, and
hence he distrusted all theories in regard to the essential nature of
disease as premature and visionary. He was at home in the study of
diagnostic and prognostic symptoms, and paid considerable attention
to the action of remedies. He had no tendency to meddlesome medicine,
restraining and discountenancing treatment when there was no hope
or prospect of success. He believed strongly in the antiphlogistic
or lowering treatment of inflammatory diseases, and in the use of
preventive measures in warding off the attacks of chronic diseases.
Thus he presented the spectacle of an advocate of temperance, of
bodily exertion without fatigue, and of mental occupation without
anxiety, who by no means followed his own prescriptions.

As a lecturer he displayed a most ready command of language, and
an excellent memory especially for cases he had seen, the details
of which he could accurately remember from the name alone of the
patient. He gained great influence over the minds of his pupils, not
merely by the humour and the abundance of his illustrations, but
also by the outspoken exposition of his views and his commanding
energy. His frankness showed itself too in the candour with which
he communicated his opinions to the relatives or friends of his
patients. He took a genuine interest in his patients, and convinced
them of his sincerity, notwithstanding a certain roughness of manner.
Where he felt no personal antagonism he was on very cordial terms
with his professional friends, and succeeded in gaining their esteem
and regard by his manner towards them in consultation. He was, as
we have said before, the admitted autocrat of the profession in
Edinburgh in his later years, and it is much to be regretted that his
contributions to the science of medicine are so few.

Gregory used to say that while physic had been the business,
metaphysics had been the amusement of his life. Reid dedicated
jointly to him and to Dugald Stewart his “Essays on the Intellectual
Powers;” and he was an attached friend of Thomas Brown, and
interested himself greatly in securing his succession to Dugald
Stewart in the chair of Moral Philosophy. He went so far in
philology as to publish a Theory of the Moods of Verbs in the
“Edinburgh Philosophical Transactions” for 1787. His “Literary and
Philosophical Essays,” in two volumes, (1792), dealt mainly with
the old controversy as to Liberty and Necessity. However, since he
had a strong opinion that metaphysics admits of no discoveries, it
is not surprising that his contribution to the science failed to
secure a permanent place. His fourth son, William Gregory, became a
distinguished chemist, the friend of Liebig and translator of his
“Familiar Letters on Chemistry,” and Professor of Chemistry in the
University of Edinburgh.

       *       *       *       *       *

JOHN BELL, who comes last to be mentioned in the list of
great Edinburgh men of the eighteenth century, is linked with
the nineteenth in part by his surgical career and posthumous
“Observations on Italy,” and still more by his relationship to his
great brother, Sir Charles Bell. Every one who reads the scattered
memorials of John Bell will be filled with regret that his career
should have been blighted by controversy and what appears even
malignant opposition, led by Dr. James Gregory. His artistic tastes
and acquirements, combined with his original views on anatomy and
surgery, made him a specimen of a new genus in Edinburgh, and it is
certain that Edinburgh did not adequately appreciate him.

John Bell, the second son of the Rev. William Bell, a clergyman of
the Scottish Episcopal Church in Edinburgh, was educated for the
medical profession by his father’s choice, in gratitude for the
relief he had received by means of a difficult surgical operation
about a month before his son’s birth, in 1763. He was apprenticed
to Alexander Wood, a well-known surgeon in 1779, for five years. He
attended the lectures of Black, Cullen, and the second Monro, and
became a fellow of the Edinburgh College of Surgeons in 1786. Monro
not being an operating surgeon, John Bell saw many defects in his
teaching as to the applications of anatomy to surgery. In fact,
surgical anatomy was never adequately taught in Edinburgh till he
himself commenced to teach, and actual dissection was little thought
of. He says, “In Dr. Monro’s class, unless there be a fortunate
succession of bloody murders, not three subjects are dissected in the
year. On the remains of a subject fished up from the bottom of a tub
of spirits are demonstrated those delicate nerves which are to be
avoided or divided in our operations; and these are demonstrated once
at the distance of one hundred feet, nerves and arteries which the
surgeon has to dissect, at the peril of his patient’s life.”[11]

Immediately after qualifying, therefore, John Bell commenced
lecturing on anatomy and surgery on his own account, an audacious
proceeding which did not fail to draw down upon him the antagonism
of all those who stood by the old lines. He was vigorous in his
denunciation of the stereotyped methods and imperfections of the old
school of Monro and Benjamin Bell. He built a house for his courses
and practical work in Surgeons’ Square, where he carried on his work
after 1790. He soon came into popularity, and this increased as his
style became more polished and formed, being in fact the most graphic
which had appeared in the Edinburgh Medical School. He was a masterly
descriptive writer, and used all the charms of style to give interest
to his subject. Consequently his opponents said that he romanced
and exaggerated. He stuck to his text that surgery must be based
upon anatomy and pathology; and unfortunately aroused the bitterest
opposition of James Gregory, who first published an anonymous
pamphlet entitled “A Guide to the Medical Students attending the
University of Edinburgh,” warning students against attending John
Bell’s lectures. The next attack was a “Review of the Writings of
John Bell, Surgeon in Edinburgh, by Jonathan Dawplucker.” This
malignant attack, says Bell, was stuck up like a playbill, in a most
conspicuous and unusual manner, on every corner of the city; on the
door of my lecture-room, on the gates of the college, where my pupils
could not but pass, and on the gates of the infirmary, where I went
to perform my operations.

Bell replied by adopting the nickname used by his opponent, at the
same time attacking his surgical ally in conventional methods,
Benjamin Bell, whose “System of Surgery,” in six volumes, afforded
him excellent sport. Bell says, “I neither mistook my bird, nor
missed my shot; and on the day in which the second number was
published, the great surgical work of Benjamin fell down dead.” At
this time it was customary for all the surgeons of Edinburgh who
cared to do so to operate in rotation at the infirmary, and Gregory
put forward a plan by which only a select and limited number of
surgeons were to be allowed this privilege. But the scheme was
especially aimed at securing the exclusion of John Bell, and this
Gregory accomplished in 1800. However, Bell had gained notoriety and
practice, though he had lost the hospital appointment, and apparently
all chance of a university professorship. He gave up teaching, and
devoted himself to practice. He had been instrumental in raising
the tone of university requirements and theories in his branch, and
it could not again sink to its former inferior condition. He became
the leading operator and consulting surgeon of his time. “He was not
only a bold and dexterous operator,” says Professor Struthers, “but
combined all the qualities, natural and acquired, of a great surgeon,
to an extraordinary degree. He was original and fearless, and a
thorough anatomist; he had intellect, nerve, and also language—was
master alike of head, hand, and tongue or pen; and he was laborious
as well as brilliant.” Generous himself and liberal to those who were
necessitous, he knew how to reprove niggardliness in the wealthy. On
one occasion a rich Lanarkshire laird gave him a cheque for £50 for
services which Bell considered to deserve much higher remuneration.
On reaching the outer door he met with the butler, and said to him,
“You have had considerable trouble opening the door to me, there is
a trifle for you,” and gave him his master’s cheque. The astonished
butler of course consulted his master about this mark of doubtful
favour, and the laird, understanding the hint, sent after the skilful
surgeon a cheque for £150.

John Bell has, however, other claims to remembrance than his teaching
and his operative skill. His anatomical and surgical writings are
still worthy of consultation, and aided materially in the progress
of the science. His principal works of this class were the “Anatomy
of the Human Body,” 3 vols. (1793-1802); “Engravings of the Bones,
Muscles, and Joints,” illustrating vol. i. of the Anatomy, 1794; “On
the Nature and Cure of Wounds,” 1795; and “Principles of Surgery,”
3 vols., 1801-8. Sir Charles Bell speaks of “the rapid improvement
in the surgery of the arteries which followed the publication of
this part of the Anatomy:” and further, that it could not easily
be surpassed for correctness and minuteness of description. The
third volume of the Anatomy was by his brother Charles, under whose
subsequent editorship the book went through numerous editions, and
was translated into German. The treatise on Wounds contained clear
expositions of the novel practice of aiming at the early union
of wounds after operations, and also emphasised the importance
of the free anastomosis of arteries in all cases where injuries
were sustained by the main arterial trunks. In his “Principles of
Surgery” he gave excellent historical views of his subject, as well
as the latest and best practice founded on anatomy and physiology.
Sir Charles Bell makes the following pointed contrast between his
brother and Sir Astley Cooper, in regard to their methods: “He (John
Bell) seems ever most happy when he can support his reasoning by
the authority of those who have preceded him, and feels that he has
conferred a double benefit when he can at the same time illustrate
the truth and vindicate the character of some excellent old surgeon,
and teach the youth of the present day to look back to the history
of the profession for their most useful lessons. Sir Astley Cooper,
on the other hand, hates all authority which interferes with
his popularity; votes that volume to be an old musty one which
is dedicated to himself; omits all mention of his respectable
contemporaries; and only varies his terms of praise and eulogy on the
young men whom he flatters, journalists and connections in business,
down to the cutler who makes his instruments.”

In 1805 John Bell married Rosina Congleton, daughter of a retired
Edinburgh physician, and in her found congeniality of tastes, an
appreciation of the artistic, literary, and musical sides of his
nature, and admirable assistance in his propensity for exercising
hospitality. His entertainments, and his own performances on the
trombone, became celebrated. His taste for art was accompanied by
remarkable skill in design and execution, in which he was only
excelled among surgeons by his own brother Charles. He never,
however, felt quite at ease after his exclusion from the infirmary.
His rivals occupying their position of authority, Dr. Gregory in
perpetual sway, could not but impress him with a sense of undeserved
failure. Early in 1816 he was thrown from his horse, and did not
recover rapidly from his injuries. In 1817 his health was so much
impaired that he went on a foreign tour with his wife, and his last
three years were spent in Italy, where his artist soul found great
delight, and where he also, had much professional practice among
English visitors to Italy.

During his residence in Italy he was well aware of the dangerous
condition of his health, but his singular degree of spirit and ardour
of character prevented his ever betraying his consciousness of it.
A few pencilled lines, written by him before leaving Paris, express
well the inmost heart of the man whose career had presented such
outward turbulence. He says: “I have seen much of the disappointments
of life. I shall not feel them long. Sickness, in an awful and sudden
form; loss of blood, in which I lay sinking for many hours, with the
feeling of death long protracted, when I felt how painful it was not
to come quite to life, yet not to die—a clamorous dream! tell that in
no long time that must happen, which was lately so near.” He died of
dropsy, at Rome, on April 15, 1820.

In Florence and Rome he visited all the principal galleries, and
took pencil notes of his observations, both from a scientific and
artistic point of view. These formed the main bulk of his posthumous
“Observations on Italy,” edited by his friend, Bishop Sandford of
Edinburgh, published in quarto form in 1825, subsequently in 2 vols.
8vo in 1835, with additional chapters on Naples. On their publication
they at once took high rank, from their singular combination of
artistic sympathies, literary expression, and scientific criticism.
The _New Monthly Review_, on its first page, described the language
of these observations as vigorous, terse and pure; his lights and
shadows as disposed with a masterly hand. His descriptions both
of landscapes and of manners in Italy are referred to as the most
fascinating that had yet appeared. As a specimen of this vivid
and picturesque style, showing how much his art was aided by that
quickness to perceive characteristic expressions and traits which was
so trained by his medical experience, we may quote his account of a
Lenten preacher whom he heard at Rome.

“A sandal-footed, bare-armed, unclothed-looking monk, young, with a
pale visage and negligent aspect, stood leaning against a pillar at
the upper end of the middle nave; his grey coarse habit, girded by
various folds of thickly-knotted cords, seemed scarcely to cover his
person; his almost naked arms hanging down by his side, while his
cowl, which had fallen back, discovered a wild pallid countenance,
and a long lean bony throat. He stood silent and motionless, like
an image or statue, as if lost in meditation, or exhausted by the
vehemence of his own overwrought feelings poured out upon his
auditors. The orator had evidently reached to an elevated strain
before my entrance, leaving, as he had suddenly paused, vivid traces
of the force of his arguments on the countenances of those he
addressed. Here the spread hands, the half-opened mouth, the strained
eye, spoke an earnest yet amazed attention, while perhaps near
him stood, with silvered hair and meek aspect, the pale anchorite,
trembling while he listened, lest perchance even he might not be
secure against the punishments of the evil-doer: while beyond him
might be seen the dark, gloomy, steady gaze of the brooding fanatic,
whose flashing eye seemed to kindle with the orator, and keep pace
with his denunciations,—perhaps contrasted by the quiet unthinking
air of contented stupidity, looking as if the sense of hearing alone
were roused, or by the speaking eye, beaming with zealous fire, as if
ready to challenge or answer each new proposition. Some stood with
downcast looks, serious and reflecting; others walked softly along,
now seen, now lost among the pillars; while the larger portion, who
had been as it were surprised by their emotion into a momentary
taciturnity, were hastily forming into groups, and beginning, in
whispered accents, to converse with that eagerness and vivacity
which so peculiarly characterise their nation. But soon, above those
murmuring sounds, the full deep-toned voice of the preacher struck
the ear, when suddenly all was again hushed to silence. Slow and
solemn he opened his discourse; but, as he proceeded, his features
became gradually more animated; his dark deep eloquent eye kindling
as he spoke, and throwing momentary radiance over his wan and
haggard countenance, while the round mellow tones of the Italian
language gave the finest energy to his expressions. With frequent
pauses, but with increasing power, he continued his discourse; his
voice now low and solemn, now grand and forcible, but still with
moderated and ever-varied accents, which worked on the feelings, at
one moment producing the chill of strong emotion, and then, as he
changed his tone, melting the heart to tenderness. The object of
his sermon and self-imposed mission was to gain votaries, and win
them to a monastic life, by portraying the dangers, the turbulence,
and the sorrows of the worldly, contrasted with the peaceful
serenity of the heaven-devoted mind. Occasionally, as if warmed by
a prophetic spirit, with an air now imploring and plaintive, now
wild and triumphant, with animated gesture and tossing of the arms,
alternately pointing to heaven and to the shades below, he seemed as
if he would seduce, persuade, or tear his victim from the world. The
powers of his voice and action gave an indescribable force to his
language, carrying away the minds of his auditors with a rapidity
that left no pause for reflection. The sombre chastened light of day
bringing forward some objects in strong relief, and leaving others
in shade, the peculiar aspect of the monk, the magic influence which
seemed to hang on his words and lend force to his eloquence, gave to
the whole scene a character at once singular and striking.”

John Bell was below middle stature, of good figure, active, with
regular features, keen penetrating eyes, and highly intellectual
expression. His widow says of him: “To a classical taste and
knowledge of drawing (many of his professional designs being finely
executed by his own hand) he joined a mind strongly alive to the
beauties of nature. He would often, in his earlier years, yield
to the enjoyment they produced, and, wandering among the wild and
grand scenery of his native land, indulge his imagination in gazing
on the rapid stream or watch the coming storm. Such habits seem
to have tended, in some measure, to form his character; training
him especially to independence in judgment, and perseverance in
investigation, that led him to seek knowledge, and boldly publish his
opinions. With warm affections and sanguine temper, he looked forward
with the hope that his labours and reputation would one day assuredly
bring independence; and meanwhile, listening only to the dictates of
an enthusiastic nature, and yielding to the impulse of feeling, he
would readily give his last guinea, his time, and his care, to any
who required them. Judging of others by himself, he was too confiding
in friendship, and too careless in matters of business; consequently
from the one he was exposed to disappointment, and from the other
involved in difficulties and embarrassments which tinged the colour
of his whole life.”


FOOTNOTES:

[11] “Letters on the Education of a Surgeon,” by John Bell, 1810.




CHAPTER V.

_WILLIAM AND JOHN HUNTER AND THE APPLICATIONS OF ANATOMY AND
PHYSIOLOGY TO SURGERY._


It is somewhat surprising that anatomy, the necessary basis of a
sound treatment of the human body in disease, should have so long
remained comparatively uncultivated in this country as a practical
art, after Harvey had led the way and shown how brilliant discoveries
might be made by dissection. Continental schools certainly put to
shame early English efforts in anatomy: and it would appear not easy
to establish in England any new study, unless the subject is one from
which large pecuniary profits may immediately be anticipated—in which
enterprise there can be no sort of merit. When a man has attained
some reputation as an anatomist or physiologist, all the efforts of
British society seem to be directed towards taking him away from that
pursuit of which he has proved himself an ornament, and converting
him into a man whose business it is to cure private ailments, thereby
preventing him but too successfully, in most instances, from
pursuing that for which he has shown conspicuous talent. Thus we find
Cheselden, whose publication of an Anatomy of the Human Body, in
1713, and Osteography in 1733, had shown great anatomical ability,
was carried into a large private practice. And William Hunter, the
founder of the first great anatomical museum, was diverted from his
proper studies to become an obstetrician, in order to obtain money
for his special objects.

WILLIAM HUNTER, whose name has been previously mentioned in
our account of Cullen, was born on May 23, 1718, at Kilbride,
Lanarkshire, being the seventh of ten children of John and Agnes
Hunter. At fourteen he was sent to Glasgow for his education,
remaining there five years, it being his father’s wish that he should
enter the Church. Imbibing liberal opinions, he soon became averse
to this proposal, and his intimacy with Dr. Cullen determined his
thoughts towards medicine. In 1737 he became Cullen’s resident pupil
at Hamilton, and remained with him three years. It was then agreed
that he should go and study medicine at Edinburgh and London, and
afterwards return to Hamilton to a partnership with his master. Their
mutual attachment was lifelong.

The winter of 1740-1 was spent by William Hunter at Edinburgh, where
Monro primus was then teaching anatomy. The following summer he went
to London, and obtained the position of assistant to Dr. Douglas, who
was then engaged on a great book on osteology, which he did not live
to complete, the education of Dr. Douglas’s son being also placed in
his charge. He considered this offer so inviting that he remained
in London, although it was contrary to the wishes of his now aged
father, who thought the arrangement with Dr. Cullen preferable. The
father died on the 30th October following, aged 78.

The young man soon became expert in dissection, and he entered as a
surgeon’s pupil at St. George’s Hospital. His prospects were soon
after clouded by the death of Dr. Douglas, but his residence in the
family was not interrupted. As early as 1743 he communicated to the
Royal Society a paper on the Structure and Diseases of Articulating
Cartilages; and thereafter was occupied in preparing to commence
teaching anatomy. His opportunity came in 1746, when Mr. Samuel
Sharpe gave up a course of lectures on surgery, which he had been
delivering to a society of navy surgeons in Covent Garden, and
recommended William Hunter in his place. His lectures were found so
satisfactory that they asked him to extend his course to anatomy. He
had great timidity in lecturing at first, but soon gained confidence.
One of his pupils who accompanied him home after his introductory
lecture, relates that he carried his fees for the course, amounting
to seventy guineas, in a bag under his cloak, and that he remarked
that it was a larger sum than he had ever been master of before. The
profits of these courses he expended in no niggardly spirit, to a
large extent in befriending others, and he was consequently unable
to begin his next season’s lectures at the proper time, owing to lack
of means to advertise their commencement. He learnt a salutary lesson
by this delay, for he found that by so far straining his resources
he had only encouraged the idleness of his friends. This made him
for the future cautious of lending money, and more economical than
before, and may be said to have laid the foundation of his fortune.

In 1747 William Hunter was admitted a member of the College of
Surgeons, and in the spring took a continental journey, in which
he met Albinus at Leyden. Although he commenced practice as a
surgeon, he gradually discontinued it when he began to succeed as an
accoucheur, being appointed surgeon-accoucheur to both the Middlesex
Hospital and the British Lying-in Hospital. His conciliating manners
and pleasing address contributed to make him popular in this branch
of practice. In 1750 he obtained the degree of M.D. from the
University of Glasgow, and about the same time ceased to reside
with Mrs. Douglas, and went to Jermyn Street, so long associated
with the Hunters. In 1751 he visited his home at Long Calderwood,
Kilbride, and gratified his affection for Dr. Cullen, who had now
become established at Glasgow. As Cullen was one day riding with him,
he pointed out to Hunter how conspicuous Long Calderwood was from a
distance, when the latter replied with energy, “Well, if I live, I
shall make it still more conspicuous.” This, however, was his only
visit to his native place after his settling in London.

William Hunter joined the College of Physicians in 1755, and the
Medical Society about the same time. His “History of an Aneurism of
the Aorta,” appears in the first volume published by that Society, in
1757. In regard to aneurisms he had made many original observations,
such as to place the subject in a totally new aspect. Several papers
he contributed to this Society bear directly on problems of interest
in midwifery and the diseases of women.

It was in 1762 that the first edition of the “Medical Commentaries”
appeared, in which Monro secundus was severely attacked for having
claimed as his own discoveries which William Hunter had, years
before, promulgated at his lectures. It is to be regretted that in
regard to these very matters, as well as others, disputes afterwards
arose between William Hunter and his brother John, who it appears
had made at least some of these discoveries, while engaged as
assistant to his brother. In respect of a number of these, the elder
brother gave credit to his junior both when lecturing and in his
publications; in regard to others, the elder gave no credit at all
when John conceived himself entitled to much, or all, of the praise
of originality. Both brothers were strikingly sensitive as to their
claims to originality, and William Hunter on several occasions
seems to have regarded a new demonstration as his property because
made in his dissecting-room, though not by himself. Yet we find it
recorded that in the winter 1762-3, when the brothers had separated,
William Hunter would frequently say in his lectures: “In this I am
only my brother’s interpreter”—“I am simply the demonstrator of
this discovery; it was my brother’s.” We must recur to this subject
later, merely mentioning now, that John Hunter acted as his brother’s
assistant and dissected for him from 1748, and that from 1755 to 1760
a certain portion of the lectures was delivered by him; in 1760 they
separated.

There is no question that in general education, in manners, in
delivery, in all that makes the successful lecturer and the
attractive practitioner, William Hunter greatly excelled his
brother. Dr. Baillie has said of him, “No one ever possessed more
enthusiasm for his art, more persevering industry, more acuteness of
investigation, more perspicuity of expression, or indeed, a greater
share of natural eloquence. He excelled very much any lecturer whom I
have ever heard in the clearness of his arrangements, the aptness of
his illustrations, and the elegance of his diction.” If it were not
for the tenacity with which he pursued controversial topics, and his
unfortunate disagreement with his brother, there would be nothing to
mar the pleasurable nature of the picture of William Hunter. The way
in which he himself viewed this side of his character may be gathered
from the following extract from the Supplement to his Medical
Commentaries, published in 1777.

“It is remarkable, that there is scarce a considerable character in
anatomy, that is not connected with some warm controversy. Anatomists
have ever been engaged in contention. And indeed, if a man has not
such a decree of enthusiasm, and love of the art, as will make him
impatient of unreasonable opposition, and of encroachments upon his
discoveries and his reputation, he will hardly become considerable in
anatomy, or in any other branch of natural knowledge.

“These reflections afford some comfort to me, who unfortunately
have been already engaged in two public disputes. I have imitated
some of the greatest characters, in what is commonly reckoned their
worst part: but I have also endeavoured to be useful; to improve and
diffuse the knowledge of anatomy: and surely it will be allowed here,
that if I have not been serviceable to the public in this way, it has
not been for want of diligence, or love of the service.

“It has likewise been observed of anatomists, that they are all
liable to the error of being severe on each other in their disputes.
Perhaps from being in the habit of examining objects with care and
precision, they may be more disgusted with rash assertions, and
false reasoning. From the habit of guarding against being deceived
by appearances, and of finding out truth, they may be more than
ordinarily provoked by any attempt to impose upon them; and for
anything that we know, the passive submission of dead bodies, their
common objects, may render them less able to bear contradiction.”

It would have been pleasing if we could have related that William
Hunter allowed supreme merit to any one anatomist or physiologist
who preceded him. But we find him saying about Harvey: “In merit,
Harvey’s rank must be comparatively low indeed. So much had been
discovered by others, that little more was left for him to do, than
to dress it up into a system; and that, every judge on such matters
will allow, required no extraordinary talents. Yet, easy as it was,
it made him immortal. But none of his writings show him to have been
a man of uncommon abilities.” Dr. Hunter must surely have been aware
that this was carping criticism, for on a preceding page he had
spoken of Harvey as a first-rate genius for sagacity and application.

The years after his brother’s secession brought Dr. Hunter to the
summit of professional success. His obstetric knowledge and skill
were known to be so great that he was called in to consultation
respecting the Queen in 1762. Two years later he was appointed
physician extraordinary to her majesty. His increasing engagements
soon left him little time for his dissecting-room and lectures,
and he engaged as assistant one of his pupils, William Hewson, and
afterwards took him into partnership in his lectures. But this
connection was severed, owing to disputes, in 1770, and Hewson
commenced lecturing on his own account, and achieved great success,
which was cut short, however by his early death from fever in 1774.
Cruickshank was his successor with Dr. Hunter, and continued his
partner till the death of the latter.

In 1768, the year after his election into the Royal Society,
William Hunter was appointed the first Professor of Anatomy to the
newly-founded Royal Academy, and he entered upon this field of work
with great vigour, applying his anatomical knowledge to painting and
sculpture with his usual success. On the death of Dr. Fothergill he
was elected President of the Society of Physicians, now the Medical
Society of London.

The most remarkable work which William Hunter published was a great
series of folio plates of the Human Gravid Uterus, begun in 1751,
and published in 1775. In the dedication of this work to the King he
acknowledged that in most of the dissections he had been assisted
by his brother, “whose accuracy in anatomical researches is so well
known,” he says, “that to omit this opportunity of thanking him for
that assistance would be in some measure to disregard the future
reputation of the work itself.” But this acknowledgment did not
content John Hunter, who claimed the original merit of most of the
discoveries his brother announced, and communicated a full account to
the Royal Society in 1780, five years after his brother’s work was
published. At the next meeting of the Society William Hunter replied
to his brother’s claims, and John rejoined. The consequence was that
the Society published nothing on the subject, but retained the papers
of both in manuscript. The anatomical description of William Hunter’s
plates was completed by his nephew, Dr. Baillie, and published in
1794.

A still more important work, as regarded costliness, was the
formation of the museum, which still remains for the benefit of
students as the Hunterian Museum in Glasgow University. Economical
from the first, as regarded his personal expenses, William Hunter,
after laying aside a sufficient sum to provide for old age or
sickness, applied his thoughts to the foundation of an anatomical
school in London. During Mr. Grenville’s administration, in 1765, he
petitioned him for the grant of a piece of ground on which to build
an anatomical theatre, undertaking to spend £7000 on the building,
and to endow a permanent professorship of anatomy. It can hardly
be believed that such a munificent offer was rejected; but it was
the middle of the eighteenth century, and the government pension to
Dr. Johnson was probably considered the utmost stretch of public
countenance to learning and science. Lord Shelburne, it is true,
expressed a wish that Dr. Hunter’s proposal might be carried out by
means of a general subscription, and offered himself to contribute a
thousand guineas. But William Hunter was not the man to depend for
the execution of his projects upon an appeal of this kind, and he
consequently purchased a plot of ground in Great Windmill Street,
near the Haymarket, where he built a suitable house for his own
residence, with a lecture-theatre, dissecting-rooms, and a handsome
room for a museum. To this he removed in 1770 from Jermyn Street.
He had already a very large collection of human, comparative, and
morbid anatomy, which he continued to augment. He purchased all the
best collections of morbid and other anatomical specimens that were
offered for sale, such as those of Sandys, Falconer (which included
Hewson’s), and Blackall. To these were added numerous specimens of
rare diseases, presented to him by medical friends and pupils. We
discern the light in which he viewed these gifts by the following
statement in one of his publications: “I look upon everything of
this kind which is given to me as a present to the public, and
consider myself as thereby called upon to serve the public with more
diligence.” And the museum was always open to the many visitors who
were attracted by its fame.

Dr. Hunter’s tastes expanded. He collected fossils, rare books,
and coins. Dr. Harwood described his library as including the
most magnificent treasure of Greek and Latin books that had
been accumulated by any person then living. The anatomist even
discovered a bibliographical novelty in comparing two copies of the
Aldine edition of Theocritus, which he found to present material
differences, though representing the same edition. The collection
of coins in this museum was of such value and importance that an
illustrated quarto was devoted to the description of a portion of
them by William Combe. The preface gives an account of the progress
of the collection, which had now cost no less than twenty thousand
pounds.

Another important addition was made to the museum in 1781 in the
shape of Dr. Fothergill’s collection of shells, corals, and other
natural history specimens. Dr. Fothergill’s will directed that
William Hunter should have the first refusal of the museum at five
hundred pounds less than its value as ascertained by appraisement,
and Dr. Hunter eventually made the purchase for twelve hundred pounds.

This noble museum was left by his will, not to his brother John,
but to his nephew Dr. Baillie, and in case of his death to Mr.
Cruickshank, for thirty years, at the end of which time the
collection was to go to the University of Glasgow. Dr. Baillie,
however, handed it over to Glasgow before the time specified. Eight
thousand pounds was also left to keep up and increase the collection.

Dr. Hunter never retired from practice, although much tormented
by gout in his later years. He thought at one time of settling
down somewhere in Scotland, when suffering more than usual from
ill-health, but having found the title of an estate offered him
to be defective, and also having to provide for his constantly
increasing museum expenses, he laid aside his intention. He continued
most persevering both in his practice and in his lectures,
notwithstanding his augmented sufferings, until on the 15th of
March 1783 he was almost prostrated. On the 20th, however, he would
deliver his lecture introductory to the operations of surgery,
notwithstanding the dissuasions of his friends. Towards the end of
his lecture he fainted, and had to be carried to bed by two servants.
In the following night he had an attack of partial paralysis, from
which he did not rally. During his illness he said to his friend,
Mr. Combe, “If I had strength enough to hold a pen, I would write
how easy and pleasant a thing it is to die.” His brother John was
admitted to see and attend him on his deathbed, and no hint of
disagreement on these occasions is given. William Hunter died on
the 30th March 1783, in his sixty-fifth year, and was buried at St.
James’s Church, Piccadilly.

William Hunter was of an elegant figure, slender, and rather below
the middle height. The portrait of him by Sir Joshua Reynolds adorns
the Hunterian Museum at Glasgow. An unfinished painting by Zoffany
represents him in the attitude of lecturing on the muscles at the
Royal Academy, surrounded by academicians. Hunter’s portrait is the
only completed part. It was presented to the College of Physicians by
Mr. Bransby Cooper in 1829.

We hear of no matrimonial projects at any time on William Hunter’s
part. He was wedded to his museum, his profession, his lectures. He
lived a frugal life, eating little food, and that plainly prepared;
rising early, and being always at work. When he invited friends to
dine with him, he seldom provided more than two courses, and he
often said, “A man who cannot dine on one dish deserves to have no
dinner.” A single glass of wine was handed after dinner to each
guest. Some accused him of parsimony. The truth is that he did not
relish the amusements and luxuries in which most people indulge, but
he was by no means parsimonious as to the pursuits in which he found
real pleasure. His biographer, Dr. Foart Simmons, says: “There was
something very engaging in his manner and address, and he had such
an appearance of attention to his patients when he was making his
inquiries as could hardly fail to conciliate their confidence and
esteem. In consultation with his medical brethren, he delivered his
opinions with diffidence and candour. In familiar conversation he was
cheerful and unassuming. All who knew him allow that he possessed
an excellent understanding, great readiness of perception, a good
memory, and a sound judgment.”

Dr. Hunter made no bequest to his brother John; but he knew that the
latter was well established and successful. Still, his bequest of the
family estate at Long Calderwood to his nephew, Dr. Baillie, appears
not to have been altogether satisfactory to the latter, who handed
it over to his uncle John. Dr. Hunter left an annuity of £100 to his
sister, Mrs. Baillie, for life, and £2000 to each of her daughters.
Dr. Baillie was his residuary legatee.

       *       *       *       *       *

The name of JOHN HUNTER recalls the glories of a great medical
school, the labours of an indefatigable dissector, the skill of a
brilliant operating surgeon, and the formation of the noblest of the
Hunterian museums, that of Lincoln’s-Inn-Fields, the richest heritage
of the London College of Surgeons. The youngest son of the same
parents as William Hunter, John was the child of his father’s old
age, the latter approaching seventy at John’s birth on February 13th,
1728. The father died when John was ten years old, and his mother
appears to have been extremely indulgent to her youngest child,
and so little controlled his desires for amusements that he left
the local grammar-school almost destitute of classical knowledge,
which formed, of course, the staple instruction there imparted. The
imperfection of his general early education was a painful drawback to
John Hunter all his life.

There is no doubt that when about seventeen John went to Glasgow on a
visit to his sister, Mrs. Buchanan, whose husband, a cabinet-maker,
was failing to get on in business, owing to his musical and social
qualities. How far John took part in the business is not recorded,
but it is likely that he owed much of his mechanical skill to what
he learnt at the shop, which seemed to stick to him much more
closely than any book-learning. Finding his efforts to relieve his
sister from her difficulties ineffectual, he returned home to Long
Calderwood. Mrs. Buchanan died in 1749.

We have extremely little knowledge of the workings of John Hunter’s
mind in his youth, or how far he was conscious of the great talents
that were awaiting the appropriate incentive. His being much given
to country amusements is all that we know. At length he tired of
having no profession, and his brother William’s success attracted
him to London. He begged that he might pay a visit to him, and be
his assistant in anatomy, if possible. The request being acceded
to, John arrived in London in September 1748, was at once set to
work upon a dissection of the muscles of the arm to illustrate his
brother’s lectures, and succeeded beyond expectation. He was now
established in his brother’s dissecting-room in the winter, and in
the summer attended Chelsea Hospital under Cheselden. It was evident
that John had found an occupation suited to his capabilities, and
in his second season he was placed in full charge of the pupils in
the dissecting-room, while Dr. Hunter almost confined himself to his
lectures. In 1751 John became a pupil at St. Bartholomew’s Hospital,
where Percival Pott was then a leading surgeon. In 1754 he was
entered as a surgeon’s pupil at St. George’s Hospital, where a chance
of a surgeoncy was more likely than at St. Bartholomew’s. In 1756 he
was for some months house-surgeon at St. George’s.

Between these two last dates he became temporarily resident at
Oxford, where his name was put down at St. Mary’s Hall, June 5, 1755.
Probably the idea was that he should become a physician, taking an
Oxford degree in medicine; but he was in no humour “to stuff Latin
and Greek at the University;” and he never conquered his aversion to
classics. Long afterwards he wrote: “Jesse Foot[12] accuses me of
not understanding the dead languages; but I could teach him that on
the dead body which he never knew in any language dead or living.”
The last entry of charges for battels against John’s name in the
buttery-book of St. Mary’s Hall occurs on July 25, 1755, so that
he probably resided less than two months. His name was kept on the
books, however, till December 10, 1756.

The only variation we hear of in his constant round of work was a
visit John paid to his home in 1752. In 1755 John was admitted to
a certain degree of partnership in Dr. Hunter’s lectures; besides
undertaking a definite part of the course, he was to supply his
brother’s place when absent on professional engagements. This was
a serious source of discomfort; the younger Hunter’s defective
education here became prominent. We may take a description of his
style of lecturing at a later period from his avowed enemy, Foot,
but it will be well to deduct one half from it as the product of
animosity. “In the beginning, these lectures were written on detached
pieces of paper; and such was the natural confusion of his mind,
that he would be frequently found incapable of explaining his own
opinions, from his notes; and after having in vain tried to recall
the transitory ideas, now no longer floating in the mind, nor
obedient to the will—after having in vain rubbed up his face, and
shut his eyes, to invite disobedient recollection—he would throw the
subject by, and take up another.”

Meanwhile, passing laborious days in the dissecting-room, John was
becoming a more perfect anatomist than his brother, and began making
discoveries on his own account, some of which William demurred to
at first, but usually accepted and brought forward in his lectures,
giving John credit for them. Among other discoveries of this time
may be mentioned that of the ramifications of the nerves of smell in
the nose, the unravelling of branches of the fifth nerve, previously
unknown, the tracing of the arteries in the gravid uterus, and the
existence of lymphatic vessels in birds. Other discoveries made by
John Hunter are described in William Hunter’s Medical Commentaries.
But it soon appeared that the younger brother felt he did not receive
a due share of praise and acknowledgment of his labours, while the
elder considered every discovery made in his dissecting-room as more
or less his property. John continued to dissect “with an ardour
and perseverance of which there is hardly any example. His labours
were so useful to his brother’s collection, and so gratifying to
his disposition, that although in many other respects they did not
agree, this simple tie kept them together for many years” (Sir E.
Home).

John gradually became led into the study of comparative anatomy, from
finding that structures which were complex in the human subject were
simpler in animals, or different in plan, in both cases throwing
light on human anatomy and physiology. Thus he made dissections
of all the commoner animals, and always preserved the parts which
interested him. He soon passed beyond the ordinary range, and made
acquaintance with the keeper of the Tower menagerie, that he might
obtain the bodies of such animals as died there. Similarly he even
would purchase animals when alive, from travelling showmen, simply
requiring them to bring him their bodies whenever they happened to
die. He bought all rare animals that came in his way: others were
presented to him by friends, and thus an ample supply of material was
secured.

There is some obscurity about the reasons which induced the younger
brother in 1760 to accept an appointment as staff-surgeon in the
army, joining the expedition to Belleisle in 1761. There is not much
doubt, however, that his health had suffered, and that a foreign
voyage and residence were calculated to restore him. In 1762 he was
employed with the army in Portugal, and in this experience laid
the foundation of his knowledge of military surgery. During this
expedition he neglected no opportunity of forwarding his studies in
comparative anatomy and physiology. Thus when at Belleisle, in order
to discover whether animals in a state of hibernation could digest
food, he introduced worms and pieces of meat into the stomachs of
lizards, and kept them under observation in a cool place. He found
the substances so introduced remained perfectly undigested. So in
1762, near Lisbon, he tested the hearing of fishes by observing the
effect of the report of a gun upon the inhabitants of a nobleman’s
fish-pond.

Retiring from the army after the peace of 1763, John Hunter found
his place in his brother’s dissecting-room occupied by Mr. Hewson, a
most capable dissector and lecturer. Hence he had no option but to
depend on his own exertions, and he started in London practice as a
surgeon in Golden Square. He found that practice came but slowly, and
formed a class for the study of anatomy and practical surgery to add
to his income. This, too, never proved nearly so remunerative as his
brother’s lectures, owing to John’s defects of style and expression
already mentioned. His success in practice was also retarded by his
refusal or failure to employ any of the arts or tact needed to gain
personal popularity. Although he was a good convivial companion,
at any rate in his earlier days, any festive enjoyment was always
subordinated to his zeal for a new specimen or a rare case, from
which he could learn something. He would take any trouble, or go
any distance, with these ends in view; while his feeling about an
ordinary case may be gathered from a remark to his attached friend,
Lynn, as he laid aside his dissecting instruments—“Well, Lynn, I
must go and earn this d——d guinea, or I shall be sure to want it
to-morrow.” Mere fashionableness Hunter could not tolerate. Dr.
Garthshore, a physician of the old school, always formal, polite,
and well dressed, accosting him one day in his dissecting-room with
his usual _empressement_, “My d-e-a-r John Hunter,”—was astonished
to hear the mocking reply, “My d-e-a-r Tom Fool.” The busy dissector
was not likely to value highly the formalities of the courtly doctor,
who as a contemporary remarks, “occasionally looked in, wound up his
watch, and fell asleep.”

Finding his collection of live animals grow beyond his means of
providing for them in town, Hunter purchased a considerable piece
of ground at Earl’s Court, then about two miles outside London,
and built upon it a house with a lawn behind it, upon and around
which he kept a collection of curious variety, and sometimes under
comparatively slight control, in order that their habits might the
more readily be watched. On one occasion two leopards got loose, and
one was scaling the boundary wall, while the other was engaged in
combat with dogs, when Mr. Hunter, unarmed, went out and seized them
both and replaced them in their outhouse; an act of courage which,
when it was over, nearly caused him to faint.

In 1767 an accident by which Mr. Hunter ruptured his tendo Achillis,
whether while dancing, or in getting up from the dissecting-table
after being cramped by long sitting, is not certain, occasioned
him to study carefully the process by which ruptured tendons are
healed. His method of treating himself was to keep the heel raised,
and to compress the muscle gently with a roller, thus preventing
any spasmodic contraction. He divided the same tendon in several
dogs, killing them subsequently at different periods to examine the
progress and nature of the repair; and his experiments and specimens
were the origin of the present practice of cutting through tendons
for the relief of distorted and contracted joints.

In the same year, 1767, Mr. Hunter was elected into the Royal
Society, before his brother—an evidence that his eager investigations
were already making him well known to men of inquiring minds.
At a later period he was one of the originators of meetings at
a coffee-house to discuss papers before their submission to the
Society generally. In 1768 he became a member of the Royal College of
Surgeons, and in the same year, supported by his brother’s interest,
he was elected surgeon to St. George’s Hospital by 114 to 42 votes.
He was now in a position in which more patients were at his disposal
for experimental or novel modes of treatment, and in which he could
take resident pupils on advantageous terms. In 1770 his brother’s
removal to his new premises in Great Windmill Street, led to John’s
transfer to his brother’s late house in Jermyn Street, where he
found much more ample accommodation for his work than he had hitherto
possessed. Here among his earliest pupils was Dr. Jenner, who was
an enthusiastic disciple, and whom Mr. Hunter would gladly have
permanently associated with him. He kept up a continual and intimate
correspondence with him throughout life, often asking Dr. Jenner for
information on questions of natural history.

Soon after his removal to Jermyn Street, namely, in July 1771,
Mr. Hunter married Anne, eldest daughter of Mr. Robert Home, an
army surgeon, father of his subsequent pupil and associate, Sir
Everard Home. He had been engaged to Miss Home for some years, but
financial reasons had hitherto postponed the marriage. Mrs. Hunter
had artistic, literary, and musical tastes, which to some extent,
by their expense, trenched on her husband’s scientific objects. She
is remembered as the author of the words of a number of Haydn’s
English canzonets, including the celebrated one, “My mother bids me
bind my hair.” Mr. Hunter sometimes found that his wife’s friends
were too fashionable or frivolous for his taste, and occasionally
his irritation got the better of his manners. It is related that
once, returning late in the evening after a wearisome day’s work, he
unexpectedly found his drawing-room filled with gay company, walked
straight into the room, and addressed the assembly in these terms:
“I knew nothing of this kick-up, and I ought to have been informed
of it beforehand; but as I am now returned home to study, I hope the
present company will now retire:” a hope speedily realised. Hunter
much preferred the weekly social assemblies at which his scientific
friends were welcomed, and where the conversation was pointed and
informing. Still there is no ground for reflecting on the general
happiness of Mr. Hunter’s married life. Of his two children who
survived infancy, he often said that if he had been allowed to
bespeak a pair of children, they should have been those with which
Providence had favoured him. His wife survived him till 1821, when
she died in her 79th year.

Early in 1771 Mr. Hunter published his first work of any magnitude,
the first part of his “Treatise on the Natural History of the Human
Teeth,” which long continued a standard work, largely appropriated
by subsequent writers. The second part, treating of the diseases of
the teeth, did not appear till 1778. In 1772 he made his mark at
the Royal Society by his celebrated paper on the digestion of the
stomach after death, which he attributed to the action of the gastric
juice upon the dead tissues. His stores of knowledge and learning
were afterwards made evident by many papers in the “Philosophical
Transactions,” of which the principal were those on the torpedo
(1773), on the air receptacles of birds, and on the Gillaroo trout,
1774; the production of heat by animals and vegetables, 1775; the
recovery of persons apparently drowned, 1776; the communication of
smallpox to the fœtus in utero, 1780; the organ of hearing in fishes,
1782; the specific identity of the wolf, jackal, and dog, and on the
structure and economy of whales, 1787; observations on bees, 1793;
and on some remarkable caves in Bayreuth, and fossil bones found
therein, 1794. The titles of these papers, however, convey but a
very imperfect idea of the wide range of subjects treated in them.
When he described a structure, he made it the starting-point of a
dissertation, in the course of which he brought to bear all his vast
stores of knowledge to establish general principles or to illustrate
important points of physiology.

In the autumn of 1772 his brother-in-law, Everard Home, became his
pupil. He describes Hunter’s museum at this time as already having
an imposing magnitude. All the best rooms in the house were devoted
to it, and it was continually being enlarged by his unremitting
toil. From six, or earlier, till nine, when he breakfasted, Hunter
dissected; after breakfast till twelve he was at home to patients.
Punctuality he observed to a fault. He would leave patients at home
in order to start punctually to his outside consultations, “for,”
said he, “these people can take their chance another day, and I
have no right to waste the valuable time of other practitioners by
keeping them waiting for me.” He kept one book at home in which to
enter these, and had an exact copy of it always in his waistcoat
pocket: thus those at home by referring to the book could invariably
find him. Once his former pupil, Cline, having to meet Hunter in
consultation, made a second arrangement, unknown to Hunter, to
take him to see another patient of his immediately after. Hunter’s
outburst of passion at this unjustifiable disturbance of his
arrangements for the afternoon was with difficulty appeased. His
punctuality at dinner, at four, was equally settled, but he strictly
ordered that dinner should be served whether he were at home or
not. For many years he drank no wine, and sat but a short time at
table, except when he had company; but he nevertheless pressed the
guests to disregard his example. “Come, fellow,” said he, in his
usual blunt way, to Mr., afterwards Sir William, Blizard, “why don’t
you drink your wine?” The guest pleaded in excuse a whitlow, which
caused him much pain. Hunter would not allow the validity of the
plea, but continued to urge him and ridicule his excuse. “Come, come,
John,” said Mrs. Hunter, “you will please to remember that you were
delirious for two days when you had a boil on your finger some time
ago.” This turned the laugh against Hunter, who ceased to importune
his guest.

In addition to his own pre-eminent industry, Hunter was not without
the most important talent of making others’ labours advance his ends.
Thus for fourteen years he employed a very capable young artist
named Bell, keeping him resident in his house, occupied in making
drawings, and anatomical preparations, and generally in museum work.
Bell was frequently called in also to act as Hunter’s amanuensis.
After he left Mr. Hunter, in 1789, he became an assistant-surgeon
under the East India Company, settling at Bencoolen, where his
zoological studies were continued with much promise of great
achievement; but, unfortunately for science, he died of fever in 1792.

In 1772 Hunter began to lecture on the theory and practice of
surgery, at first to his pupils and a few friends admitted
gratuitously, but afterwards on payment of a fee of four guineas.
This may be accounted the first introduction into this country,
perhaps to any, of the idea of principles of surgery, and the
necessity of a rational explanation of processes of repair, and of
a scientific basis for operations. Instead of a study of anatomy
alone being required by a surgeon, he elevated pathology into its
true position, and brought in all the aids with which physiology and
comparative anatomy could at that time illuminate the subject. But
in advance of any of these aids was his own clear insight, which
penetrated to the core of a question, and often brought out truth
which he could not himself explain, or only imperfectly. He never
overcame his difficulty in lecturing; at the commencement of each
course he always composed himself by a draught of laudanum. His
lectures, delivered on alternate evenings from October to April,
were given from seven to eight o’clock. His class was usually
comparatively small, never exceeding thirty; but the quality of his
audience was good, as may be gathered from its having included Astley
Cooper, Cline, Abernethy, Carlisle, Chevalier, and Macartney. He
never became an attractive lecturer; from deficiency in extempore
speaking, he was compelled to read his lectures, and seldom raised
his eyes from his manuscript. His manner was frequently ungraceful,
but his matter was for the most part highly intelligible and luminous
to those of his hearers who came prepared by thought and attainments
to be really edified, while he was often unintelligible to those
who had no practice in thinking for themselves and desired to keep
clear of that odious pain. In his lectures he was equally unsparing
towards his own and others’ errors, and he never clung to his own
past opinions. “Never ask me,” he replied to a question, “what I have
said or what I have written; but if you will ask me what my present
opinions are, I will tell you.”

The following extract from Ottley[13] gives an interesting view
of Hunter’s after-dinner habits. “After dinner he was accustomed
to sleep for about an hour, and his evenings were spent either in
preparing or delivering lectures, in dictating to an amanuensis the
records of particular cases, of which he kept a regular entry, or
in a similar manner committing to paper the substance of any work on
which he chanced to be engaged. When employed in the latter way, Mr.
Bell and he used to retire to the study, the former carrying with
him from the museum such preparations as related to the subject on
which Hunter was engaged: these were placed on the table before him,
and at the other end sat Mr. Bell, writing from Hunter’s dictation.
The manuscript was then looked over, and the grammatical blunders,
for Bell was an uneducated man, corrected by Hunter. At twelve the
family went to bed, and the butler, before retiring to rest, used to
bring in a fresh Argand lamp, by the light of which Hunter continued
his labours until one or two in the morning, or even later in winter.
Thus he left only about four hours for sleep, which, with the hour
after dinner, was all the time that he devoted to the refreshment of
his body. He had no home amusements for the relaxation of his mind,
and the only indulgence of this kind he enjoyed consisted in an
evening’s ramble amongst the various denizens of earth and air which
he had congregated at Earl’s Court.”

In January 1776 Mr. Hunter attained a court position, being
appointed surgeon-extraordinary to the king. In the same year he
became interested in the efforts of the Humane Society, and at its
request drew up a paper for the Royal Society on the recovery of
the apparently-drowned. Herein he makes a just distinction between
absolute death and suspended animation, illustrates different modes
of dying, and describes many signs of life and death. This year was
also the first in which he delivered the Croonian lecture to the
Royal Society, on muscular motion, a subject which he continued in
successive years till 1782 (omitting 1777); but the lectures were
never published, being, he said, too incomplete.

In the year 1773 Mr. Hunter suffered the first open onset of the
disease which occasioned him such acute pain and distress for many
years, in an attack of spasm accompanied by cessation of the heart’s
action apparently for three quarters of an hour. During the attack,
however, sensation and voluntary actions were kept up, and he was
able to continue respiring by voluntary effort. In the next few
years the attacks were somewhat rare; but from 1783 onwards he was
subject to severe angina pectoris whenever mentally agitated. In 1777
a constant giddiness or vertigo seized him on account of his being
called upon to pay a large sum of money for a friend for whom he
had become security, at a time when it was exceedingly inconvenient
to do so. This illness led him to visit Bath in the autumn, leaving
Mr. Bell and Mr. Home to catalogue his museum. At Bath Dr. Jenner
visited him and was surprised at his altered appearance, and here
first diagnosed his case as dependent upon an organic affection of
the heart: but he did not tell Hunter his diagnosis, fearing an
injurious effect. Returning to town, and soon recovering his usual
health and vigour, Mr. Hunter published in 1778 the second part of
his Treatise on the Teeth, dealing with their diseases. In 1779 a
paper contributed to the Royal Society on the hermaphrodite black
cattle or free martin gave him occasion to describe hermaphroditism
in general. In 1780 occurred the unfortunate controversy with
his brother, in regard to the discovery of the utero-placental
circulation, to which we have already referred. The estrangement
which followed was extreme, and protracted till the elder brother lay
on his deathbed. After his brother’s death, however, which occurred
just at the conclusion of John Hunter’s course of lectures, when he
had finished his lecture, he still seemed to have more to say; and at
length, appearing as if he had just recollected something, he began,
“Ho! gentlemen, one thing more: I need not remind you of ——: you all
know the loss anatomy has lately sustained.” He was obliged to pause
and turn his face from his hearers. At length recovering himself, he
stated that Mr. Cruickshank would occupy the place of Dr. Hunter.
This, and a few words more, were not spoken without great emotion,
nor with dry eyes. The scene was so pathetic, that a general sympathy
pervaded the class; and though all had been preparing to leave, they
stood or sat motionless for several minutes.

The eagerness with which Mr. Hunter sought and appropriated all
rarities is amusingly illustrated by his own remarks to Dr. Clarke,
who had a preparation illustrating extra-uterine pregnancy, which Mr.
Hunter often viewed with longing eyes. “Come, Doctor,” said he, “I
positively must have that preparation.” “No, John Hunter,” was the
reply, “you positively shall not.” “You will not give it me, then?”
“No.” “Will you sell it?” “No.” “Well, then, take care I don’t meet
you with it in some dark lane at night, for if I do, I’ll murder you
to get it.” It is reported that a specimen which remains one of the
most valued in the Hunterian Museum cost Mr. Hunter no less than £500
in 1783, namely, the skeleton of O’Brien, the Irish giant, seven feet
seven inches high. It appears that O’Brien had heard of and dreaded
the scalpel of the famous dissector, and took special precautions to
frustrate his ends. He made an Irish league with several compatriots
that his body should be taken to sea, and securely sunk in deep
water; but Mr. Hunter, more subtle than the giant, had made a big
bargain with the undertaker, who arranged that during the funeral
progress towards the sea the coffin should be locked up in a barn
while its guardians were drinking at a tavern. The corpse was
speedily extracted, and a sufficient weight of stones substituted;
and Hunter soon rejoiced in the possession of his prize, which he
drove to Earl’s Court in his own carriage, and quickly converted into
a skeleton.

In 1781 Mr. Hunter was called by the defence as a witness in the
trial of Captain Donellan at Warwick Assizes for the murder of his
brother-in-law, Sir Theodosius Boughton. In his evidence Mr. Hunter
gave all that could justly be deduced from the facts known to him,
but refused to speak positively as to the cause of death. Under
cross-examination he became confused and hesitating, as was certain
to be the case. This rather aroused the wrath of Mr. Justice Buller,
who in his charge said, “I can hardly say what his opinion is, for he
does not seem to have formed any opinion at all of the matter.” But
Hunter’s caution was undoubtedly justifiable.

In 1783 the lease of the Jermyn Street house expired, and finding
it difficult to accommodate his museum in any premises he could
obtain, Mr. Hunter purchased the remainder of the lease, extending
to twenty-four years only, of a house on the east side of Leicester
Square, with ground extending on the rear to Castle Street, where
there was a second smaller house. On the vacant ground Mr. Hunter
determined to build a museum for his collection, including a large
upper room fifty-two feet by twenty-eight, lighted from above, and
having a gallery running round it. A lecture-room and other rooms
were beneath. By the spring of 1785 this considerable undertaking
was complete, absorbing all Hunter’s spare cash and costing him more
than £3,000. But the museum, which was removed to it in April 1785,
had by 1782 cost him £10,000 in addition to valuable presents, so
that it cannot be said that the casket cost more than the jewels
although being on so short a lease it was doubtless expensive. The
museum in its new home became continually more celebrated, and
was visited by many foreign anatomists of distinction, including
Blumenbach, Camper, Scarpa, and Poli. At this period Hunter was at
the height of his career; his mind and body were in full vigour; “his
hands,” says Home, “were capable of performing whatever was suggested
by his mind; and his judgment was matured by former experience.”
There were diverse opinions about his skill as an operator, however;
Astley Cooper did not consider him especially dexterous or elegant.
Nevertheless his anatomical knowledge and great experience stood him
in good stead, and he was almost always successful in completing his
operations. It must be recollected, however, that special importance
was, in pre-chloroform days, attached to speed, and in this Hunter
did not excel. Indeed, to him, operating was a distasteful element
in a surgeon’s curative efforts. “To perform an operation,” he would
say, “is to mutilate a patient we cannot cure; it should therefore be
considered as an acknowledgment of the imperfection of our art.”

The year of greatest success, however, was marked by a period of
grave illness, with attacks of violent spasms of the heart, followed
by syncope. These recurred on occasions of extra exertion, anxiety
of mind, fits of temper, or even the fear lest an animal which he
wished to secure might escape before a gun could be brought to shoot
it. To this year (1785) we are indebted for the celebrated portrait
of Hunter by Sir Joshua Reynolds, in the possession of the Royal
College of Surgeons. He was a bad sitter, but Reynolds, dissatisfied
with his progress, one day was gratified by seeing Hunter in deep
reverie, with his head supported by his left hand. He at once turned
his canvas upside down, and began to record that life-like face,
which shows Hunter the philosopher in the true profundity of his
nature. Sharp engraved this portrait, and it was one of his greatest
successes.

The year 1785 was that in which Hunter first tied the femoral artery
in a case of popliteal aneurism, and thus initiated one of the
greatest modern improvements in surgery, relying upon the enlargement
of the smaller communicating or collateral vessels to make up for the
cessation of circulation through the principal vessel. This appears
to have been suggested to him by an experiment on the mode of growth
of deer’s antlers. Having been granted by the king the privilege
of experimenting with the deer in Richmond Park, he tied one of
the external carotid arteries supplying (_inter alia_) one of the
half-grown antlers. The antler became cold, but after a week or two
Hunter, to his astonishment, found that it had again become warm and
was growing again. On a _post mortem_ examination he discovered that
this continued growth was due to the enlargement of small branches
of the carotid above and below the wound, to an extent sufficient to
restore the blood-supply in the antler. And by a stroke of genius
Hunter saw that a similar process might be expected to occur in
cases of aneurism, and supersede the then generally fatal methods
of operating by means of amputation, or by directly evacuating the
sac of the aneurism. The fourth patient Hunter performed the new
operation upon lived for fifty years; a specimen illustrating the
case is preserved in the Hunterian Museum.

In 1786, on the death of Middleton, Hunter received the appointment
of deputy surgeon-general to the army; becoming in 1790, on the death
of Mr. Adair, surgeon-general and inspector of hospitals. In 1786
he published his long-deferred work on the Venereal Disease, which,
though printed and sold in his own house, met with a rapid sale, and
proved a very valuable work. In the same year he collected a large
number of his papers contributed to the Royal Society, together with
others not previously published, into a quarto volume entitled,
“Observations on certain Parts of the Animal Œconomy,” and thus
placed his researches in imposing bulk before the general public. The
Copley Medal of the Royal Society was awarded to Hunter in 1787 for
his discoveries in natural history.

About this time Mr. Hunter was allowed to nominate Home as his
assistant at St. George’s, and in 1792 Home undertook a further
portion of his work, by delivering the surgical lectures, for which
purpose he was intrusted with Mr. Hunter’s manuscripts. This enabled
Mr. Hunter to give more time to the preparation of his great
treatise on the Blood, Inflammation, and Gunshot Wounds, which,
however, remained to be published by his executors in 1794. Death
was about to claim him, and the immediate cause which led to his end
was a dispute with his colleagues and the governors of St. George’s
Hospital about pupils’ fees. In his treatment of pupils personally
Hunter was always generous, especially when they showed ability and
zeal. Thus he gave Carlisle a perpetual ticket to his lectures,
having been much pleased with a preparation he brought for his
acceptance, showing the internal ear very excellently. He would often
also send valuable patients to young men starting in practice, and
struggling with pecuniary difficulties. He never concealed from his
pupils the hard work he had done to attain his position: “I’ve been
here a great many years, and have worked hard too, and yet I don’t
know the principles of the art,” he remarked to one. He did not,
however, get on so well with his fellow-surgeons at the hospital. He
so constantly insisted on the importance of studying physiology for
the benefit of surgical practice, while they had been educated with
little or no physiology, that his manner, as well as his pursuits,
procured him the stigma of being an innovator and enthusiast.
Early in 1792 one of his colleagues, Charles Hawkins, resigned the
surgeoncy, and Keate, then assistant to Gunning, the senior surgeon,
was elected his successor by a considerable majority, in opposition
to Home, who was, of course, Hunter’s candidate. The acrimony of the
contest appears to have led Hunter to announce his intention of no
longer dividing with them the fees received for the surgeons’ pupils,
owing, as he alleged, to his desire that the other surgeons should
pay more attention to their pupils, instead of neglecting them, as
he asserted they did. His right to do this was warmly contested,
and the question was referred to the subscribers to the hospital.
Hunter addressed them a long letter before the day of meeting, in
March 1793, detailing the efforts he had made since his connection
with the hospital to induce his colleagues to improve the system of
instruction, which efforts had proved ineffectual: one man “did not
choose to hazard his reputation by giving lectures;” another “did
not see where the art could be improved.” Consequently Hunter had
slackened his own efforts, causing a great falling off in the numbers
of students. The other surgeons replied that they had continued the
usual plan, and that if students had neglected their hospital duties
to pursue physiological studies, it was not their fault. If they had
given lectures, copies of them might have been taken by the pupils
and might get abroad. Mr. Hunter’s connection with the Windmill
Street Anatomical School, and his power of conferring posts in the
army, not his superior attention to his pupils, were the cause of a
larger number of pupils entering under him. They were able to show
that it would be a manifest disadvantage that only one surgeon should
instruct a pupil and not all four. The governors decided against
Hunter, for his plan must have produced confusion and discord. A
committee drew up rules for the admission and regulation of pupils,
and these were adopted without any consultation with Mr. Hunter. One
of them, which seemed specially directed against him, forbade the
entry of any pupil who had not had previous medical instruction.
Young men frequently came up to London from Scotland, recommended
to Mr. Hunter, and were entered by him at the hospital without
having had any previous medical instruction. A case in point arose
in the succeeding autumn. Two young men came up in the usual way,
and ignorant of the new rule, Hunter undertook to press for their
admission at the next Board meeting, on the 16th October 1793. On the
morning of the day he expressed his anxiety to a friend lest some
dispute might occur, as he was convinced such an occurrence would
be fatal to him. His life, he used to say, “was in the hands of any
rascal who chose to annoy and tease him.” Leaving home at the usual
hour, he forgot, strange to say, to take his list of appointments
with him, and Mr. Clift hastened after him with it. Later, arriving
at the hospital, he found the Board already assembled, and presented
and supported his memorial. During his speech one of his colleagues
flatly contradicted him, and Hunter immediately ceased speaking,
retired from the table, and, struggling to suppress his passion,
hurried into an adjoining room, which he had scarcely reached when,
with a deep groan, he fell lifeless into the arms of Dr. Robertson,
one of the hospital physicians. Dr. Baillie his nephew, and Home,
who was present, made every effort to restore him, but in vain. Thus
were cut short at once the meeting of the St. George’s Board, and the
life of the greatest surgeon they had had. He was buried in a simple
manner on October 22d, at St Martin’s in the Fields. A _post mortem_
examination had shown that his heart was wasted and diseased, and
his coronary arteries, mitral valves, and aorta much ossified and
diseased, thus justifying Dr. Jenner’s diagnosis.

In person Hunter was of about middle height, vigorous and robust,
with high shoulders and short neck, strongly marked features,
projecting eyebrows, light-coloured eyes, and high cheeks. He
always dressed plainly, with his hair curled behind; this had been
reddish-yellow in early life, but white latterly.

Mr. Hunter left little but his museum, which he wished the nation
to purchase and provide for. After years of effort, in the course
of which Mr. Pitt, on being appealed to, replied: “What! buy
preparations! why, I have not money enough to purchase gunpowder,”
Parliament in 1799 voted £15,000 for his museum (it had cost Hunter
over £70,000), and its guardianship was offered to the College of
Physicians, which declined it, and then to the College of Surgeons,
which accepted it, gaining at the same time a new charter and the
title of Royal. Hours during which the collection might be open for
professional men and others to study, and a keeper to explain the
collection, were stipulated for, and at least twenty-four lectures
were to be given annually on comparative anatomy and other subjects
by members of the college. These are the well-known Hunterian
lectures made illustrious by Owen, Huxley, Parker, and Flower. The
collection was placed in a temporary habitation in Lincoln’s Inn
Fields in 1806, and Parliament has granted in all £42,500 at various
dates for the building of a suitable museum. The present building,
however, has cost very much more than the sum mentioned, the expense
being defrayed out of the college revenues for diplomas.

During the weary years of waiting for the government consent to
purchase the museum, Hunter’s family had to be maintained by the
sale of his furniture and library, and his miscellaneous collection
of objects of _virtu_, coats of mail, weapons, &c.; and the mere
conservation of the museum was a matter of considerable expense.
His papers fell into the hands of Mr., afterwards Sir Everard Home,
who detained them without publishing them for many years, during
which time he himself published a vast variety of papers under
his own name in the Philosophical Transactions. It is generally
believed that many of these were largely derived from Mr. Hunter’s
manuscripts; and this the more, that, when at last, after many years
of evasion, his co-trustees of the museum pressed him to deliver up
the manuscripts as they were, he secretly burnt almost the whole of
them. In fact, Mr. Clift, who became keeper of the museum, and had
been long the assistant and friend of Sir Everard, when questioned by
the Commission on Medical Education, replied that all his life he had
been employed by Sir Everard in transcribing portions of Mr. Hunter’s
manuscripts, and in copying drawings from his portfolios, which Sir
Everard issued to the public as his own. It was in 1823, when Sir
Everard had received from the printer the final proof of his last
volume on Comparative Anatomy, that he disgraced his name for ever by
this great and irreparable destruction. Mr. Clift’s list of what he
remembers of the burnt papers fills more than a page of the memoir of
John Hunter prefixed to vol. x. of Jardine’s Naturalists’ Library.
And the bare enumeration and contents would give but little idea of
the labour expended in its production. “I have many times,” says Mr.
Clift, his assistant and amanuensis during the last twenty months of
his life, “written the same page at least half a dozen times over,
with corrections and transpositions almost without end,” so great was
the difficulty Hunter felt in adequately expressing his ideas. But
this only serves to increase our regret that these valuable originals
should have been destroyed. He generally wrote his first thoughts
or memoranda on all subjects on the slips torn off from the ends,
and the blank pages and envelopes of letters. He appeared to have no
desire of preserving his own hand-writing, but when they had been
copied, usually folded them up, and put them on the chimney-piece to
light the candle with; and the rough or waste copies on all subjects,
when copied out fair, were taken into his private dissecting-room, as
waste paper to dissect upon.

Sir Everard Home[14] describes his brother-in-law as “very warm and
impatient, readily provoked, and when irritated, not easily soothed.
His disposition was candid and free from reserve, even to a fault.
He hated deceit, and was above every kind of artifice; he detested
it in others, and too openly avowed his sentiments. In conversation
he spoke too freely, and sometimes harshly of his contemporaries;
but if he did not do justice to their undoubted merit, it arose not
from envy, but from a thorough conviction that surgery was yet in its
infancy, and he himself a novice in his own art; and his anxiety to
have it carried to perfection made him think meanly and ill of every
one whose exertions in this respect did not equal his own.” He was
called the Cerberus of the Royal Society, and certainly it appears
easier to admire and estimate him correctly now than it would have
been to live in comfort with him. Yet, when advanced in practice
and honours, he paid more instead of less attention to those whom
he had known earlier. Mr. Gough, who had charge of a menagerie in
Piccadilly, related that when he called on Mr. Hunter, if the house
was full of patients, and carriages waiting at the door, he was
always admitted. “You have no time to spare,” said he, “as you live
by it. Most of these can wait, as they have little to do when they go
home.” It is certain that Hunter only valued money as it enabled him
to carry on his researches. He introduces a patient to his brother
thus: “He has no money, and you have plenty, so you are well met;”
and he would never take fees from curates, authors, and artists.
With his lack of courtliness and evident zeal for dissection, it can
be no wonder that his income never reached £1000 before 1774. Yet
afterwards it increased to £5000 for some years, and had reached to
£6000 when he died. But all he could spare, throughout, went to his
museum.

Hunter’s sense of his own importance was evident, and often very
ingenuously expressed. “Ah, John Hunter, what! still hard at work!”
said Dr. Garthshore to him, finding him in the dissecting-room late
in life. “Yes, doctor,” replied Hunter, “still hard at work; and
you’ll find it difficult to meet with another John Hunter when I am
gone.” To Abernethy he said, “I know I am but a pigmy in knowledge,
yet I feel as a giant when compared with these men.” He could not
be described as a good conversationalist, yet his remarks, slowly
brought out, were often wonderfully pointed and forcible. In politics
he was a strenuous Tory, and “wished all the rascals who were
dissatisfied with their country would be good enough to leave it.” He
hated all public ceremony or display, and when begged to go to Sir
Joshua Reynolds’s funeral, fairly wished Sir Joshua and his friends
at the d——l.

He was undeviatingly honest, eminently a lover of truth, humane
and generous in disposition, warm and disinterested as a friend,
a kind affectionate husband and father. Some have called him a
materialist or even an atheist, but he appears to have had no doubt
of the existence of a First Cause. His study of religion was no
doubt limited by natural tendencies in his mind, and by his habitual
concentration on his work, and the evidence of revelation did not
make, so far as can be ascertained, a deep impression on his mind. As
to death, his view was, “’tis poor work when it comes to that.”

Hunter’s remains lay undisturbed in St. Martin’s Church, till
on March 28, 1859, they were removed, mainly through Mr. Frank
Buckland’s intervention, to Abbot Islip’s Chapel in Westminster
Abbey and deposited in the north aisle of the nave, close to Ben
Jonson’s tomb. His name and achievements are annually commemorated by
orations such as those from which the subsequent extracts are made,
but most of all by the Hunterian Museum and the lectures delivered in
connection therewith.

To expound Hunter’s views of life, and the results of his other
philosophical and practical studies, would lead us far beyond our
limits. Life he regarded as a principle independent of structure;
as a great chemist; as a sort of animal fire. “Mere composition of
matter,” he said, “does not give life; for the dead body has all the
composition it ever had. Life is a property we do not understand; we
can only see the necessary steps leading towards it.” He imagined
that life might either be something superadded to matter, or consist
in a peculiar arrangement of particles of matter, which being thus
disposed acquired the properties of life. As to equivocal generation,
he believed—and here he coincides with the best results of modern
sciences—that all we could have was negative proofs of its not taking
place. As to geological changes, he had strikingly original views,
regarding water as the chief agent, and pointing out that the popular
view by which the Deluge was supposed to account for finding marine
organisms in rocks was untenable. He could discern that in the long
past great oscillations of level and climatic variations had taken
place. In regard to development and evolution, he had very luminous
ideas pointing to modern discoveries. Thus he remarks “if we were
to take a series of animals from the more imperfect to the perfect,
we should probably find an imperfect animal corresponding with some
stage of the most perfect.”

We cannot more clearly emphasise the character of Hunter’s intellect
and work than in the words of two distinguished men of our own time,
both eminent pathologists, and qualified as few can be for estimating
such a man.

Dr. Moxon[15] says:—

“If we ask what gave him that most valuable power of estimating what
was worth doing, and what could be done—the power which Bacon calls
the ‘mathematics of the mind’—we find the reply, I believe, in these
great facts of his history. Firstly, that he was a man who had a
free youth, not over-taught, nor over-strained; and, secondly, that
in his manhood he worked with an eye to usefulness and duty, and not
only to notoriety, nor to the mere cry of ‘who will show us something
new?’ Indeed, the main and distinctive feature of his noble life
was his resolute pursuit of the practical aim of his profession, to
establish sound laws for scientific surgery and medicine. I have said
that the wonderful store of facts he collected constituted answers
to questions: Hunter the physiologist answering the questions of
Hunter the surgeon. He did not so follow physiology as to turn it
away from usefulness. And the results of his work he puts up in
his museum. And he will gladly have anything for his collection.
But always putting things by in their physiological order, mark,
so that in due time they shall answer to his further questions. He
will lecture on surgical principles,—true ones they must be,—if he
changes them yearly in accordance with his observations. But he
will not, he cannot, lecture on comparative anatomy or zoology. Why
not? It does not conform enough with his main bent to surgery, to
practical aim, to a duty. He believes in a vital principle, therefore
he must have an aim before him. He succeeds in his aim; and by the
masterly introduction of the operation on aneurism which bears his
name he saves thousands from a painful death. Led further by the
same enthusiasm for the true purpose of his life as a surgeon, he
inoculates his frame with a loathsome disease that he may have it
always by him to study it, regardless of danger and of pain.”

Sir James Paget’s views[16] are thus expressed:—

“The range of Hunter’s work matched with the time devoted to it.
Never before or since—I think I am safe in saying this—was any one
a thorough investigator and student in so wide a range of science.
He was an enthusiastic naturalist; as a comparative anatomist
and physiologist he was unequalled in his time; among the few
pathologists he was the best; among the still fewer geologists and
students of vegetable physiology, he was one, if not the chief; and
he was a great practical surgeon. He was surgeon to a large hospital
in London, and for many years held the largest practice in the
metropolis. In all these things at one time no one but Hunter ever
was eminent and successful.... There is not one of them in which he
did not make investigations wholly original—not one of them of which
he did not enlarge the area very far beyond that which had been
covered by his predecessors—not one of them in which he did not leave
facts and principles on record which it is impossible to count and
very hard to estimate.

“In all these characters of Hunter’s works we see that which was the
dominant character of his mind—massiveness and grandeur of design
were indicated in all to which he applied himself. And in perfect
harmony with this was the simplicity of his ordinary method of
work. It consisted mainly in the orderly accumulation of facts from
every source, of every kind, and building them up in the simplest
inductions. If he had been an architect, he would have built huge
pyramids, and every stone would have borne its own inscription. He
knew nothing of logic or the science of thought. He used his mental
power as with a natural instinct. He worked with all his might, but
without art. I know no instance so striking as in him of the living
force which there is in facts when they are stored in a thoughtful
mind.

“But Hunter was not only a great observer, he was a very acute one.
I think it would be difficult to find in all the masses of facts
which he has recorded any one which was either observed or recorded
erroneously. If there are errors in his works, they are the errors
of reasoning, not of observation. And it may be noted, as a singular
example of his accuracy, that when he tells his inferences it is
generally with expressions implying that he regarded them as only
probable: a fact he tells without conditions; when he generalises, it
is with ‘I suspect,’ ‘I believe,’ ‘I am disposed to think,’ or the
like.... He seems to have thought he had never reached farther than
the nearest approach to truth, which was at that time attainable,
and that a year or more of investigation would bring him nearer to
the truth, and then that which now seemed right would be surpassed or
set aside. He used to say to his pupils in his lectures, ‘Do not take
notes of this; I daresay I shall change it all next year.’”

Abernethy, who knew him well, says: “It is scarcely credible with
what pains Mr. Hunter examined the lower kinds of animals,” and he
quotes Mr. Clift as saying that “he would stand for hours motionless
as a statue, except that with a pair of forceps in either hand he
was picking asunder the connecting fibres of some structure” that he
was examining: ... “patient and watchful as a prophet, sure that the
truth would come: it might be in the unveiling of some new structure,
or in the clearing up of some mental cloud; or it might be as in a
flash, in which, as with inspiration, intellectual darkness becomes
light.”


FOOTNOTES:

[12] Author of the defamatory so-called Life of John Hunter, 1794.

[13] “Life of John Hunter,” by Drewry Ottley, 1835.

[14] Life of John Hunter, prefixed to the treatise on the Blood,
Inflammation, &c.

[15] _Medical Times and Gazette_, March 3, 1877.

[16] _Medical Times and Gazette_, Feb. 17, 1877.




CHAPTER VI.

_EDWARD JENNER AND VACCINATION._


Modern preventive medicine may be said to date from the introduction
of inoculation for smallpox in the early part of the eighteenth
century. It is much more profitable to dwell on the history of the
second step in this direction, a far greater one, due to the genius
of one man, Edward Jenner, whose Life by Dr. Baron, though not a
biographical masterpiece, is the source of much valuable information.

The name of Stephen Jenner had been handed down from generation to
generation in Gloucestershire, and the Rev. Stephen Jenner, father
of Edward, was vicar of Berkeley when his famous son was born,
on May 17, 1749. The father, however, died in 1754, and an elder
son, another Stephen Jenner, Fellow of Magdalen College, Oxford,
is credited with some attention to his education. But his school
life was not prolonged, for about the thirteenth year of his age
he commenced preparation for a medical career by entering upon
apprenticeship to Mr. Daniel Ludlow, a medical practitioner at
Sodbury near Bristol, with whom he remained six years.

Young Edward, when a fine ruddy boy of eight, was, with many others,
put under a preparatory process for inoculation for smallpox. This
was indeed a formidable proceeding, lasting six weeks. He was first
bled, to ascertain whether his blood was “fine;” was then purged
repeatedly till the ruddy youth became emaciated and feeble; and all
the while was kept on a low diet, and dosed with some drink which
was supposed to sweeten the blood. This is appropriately termed a
“barbarism of human veterinary practice,” but it was followed by
exposure to contagion from others in a state of severe disease. By
good luck the boy got off with a mild attack; but we may well ascribe
to the lowering preparatory treatment he had undergone, that he
never could as a child enjoy sleep, and was constantly haunted by
imaginary noises. All his life long he was too acutely alive to these
impressions and to any sudden jar.

It is perhaps more interesting, it is certainly more important,
to notice the influence exerted upon one mind by another, than to
examine the influences of any material objects upon human nature.
In this light we may view with pleasure the relations which existed
between Jenner, his elder brother already mentioned, and the great
anatomist, John Hunter. The ties of affection and esteem must have
been strong which drew the young doctor from the attractions of
London, from constant association with his admired friend in his
studies, from opportunities to inquire such as those afforded
by the arrangement of Sir Joseph Banks’s collection made during
Captain Cook’s celebrated voyage, from prospects of gain and worldly
advancement, to the retirement of a country village, the isolation
and the simplicity of rural existence. We can hardly overestimate
the benefits derived by the developing mind of the young doctor
from his daily intercourse for two years with such a preceptor as
John Hunter. The impression was mutual, for we find Hunter years
afterwards writing to Jenner, “I do not know any one I would sooner
write to than you: I do not know anybody I am so much obliged to.”
A correspondence full of interest on subjects of natural history
was kept up between them. Hunter’s appreciation of his friend’s
attainments was shown markedly when he formed the plan of a school of
natural history and human and comparative anatomy, and asked Jenner
to come and be his partner in the undertaking. Very many particulars
of experiments and inquiries in natural history by Jenner were
communicated to Hunter, and were of essential service to him. His
most important published paper in natural history was that on the
Cuckoo, published in the “Philosophical Transactions” for 1788.

Jenner’s name has been so exclusively connected in the popular mind
with the subject of vaccination, that his ability as a practitioner
and his originality in many departments of medicine and surgery have
been somewhat lost sight of. No doubt this was much aided by his own
modesty; but in the treatment of many diseases his views, founded on
the improved anatomy and physiology he had learned from Hunter and
his own acute observation, were far in advance of his time.

It was perhaps, however, by his sympathetic qualities of heart that
Jenner most of all obtained and maintained the influence which he
possessed. He could truly rejoice with those that rejoiced, and weep
with those that wept. In him uncommon delicacy of feeling co-existed
with a joyous and lively disposition; and his gentlemanly manners
made him welcome everywhere. He was ever observant of natural
phenomena, and loved nothing better than to persuade some friend to
ride with him during his long journeys through the countryside. Those
who enjoyed the pleasure have described the vivid and imaginative
fervour which characterised his conversation, whether in reference
to his own feelings or the beauties of the scenery around, and
the captivating simplicity and ingenuity with which he explained
phenomena of animal and vegetable life which came under notice. In
fact he never met any one without endeavouring to gain or to impart
instruction.

Among the many proofs of Jenner’s sagacity and acuteness in matters
outside medicine should be mentioned the following, recorded by Sir
Humphry Davy, showing that Jenner anticipated the late Charles Darwin
in his views of the important effects produced by earthworms upon
the soil. “He said the earthworms, particularly about the time of
the vernal equinox, were much under and along the surface of our
moist meadow-lands; and wherever they move, they leave a train of
mucus behind them, which becomes manure to the plant. In this respect
they act, as the slug does, in furnishing materials for food to the
vegetable kingdom; and under the surface, they break the stiff clods
in pieces and finally divide the soil.”

His appearance and manner in this early portion of his life are thus
described by his intimate friend, Edward Gardner: “His height was
rather under the middle size, his person was robust, but active and
well formed. In his dress he was peculiarly neat, and everything
about him showed the man intent and serious, and well prepared to
meet the duties of his calling. When I first saw him it was on
Frampton Green. I was somewhat his junior in years, and had heard
so much of Mr. Jenner of Berkeley that I had no small curiosity
to see him. He was dressed in a blue coat and yellow buttons,
buckskins, well-polished jockey-boots, with handsome silver spurs,
and he carried a smart whip with a silver handle. His hair, after
the fashion of the times, was done up in a club, and he wore a
broad-brimmed hat. We were introduced on that occasion, and I was
delighted and astonished. I was prepared to find an accomplished
man, and all the country spoke of him as a skilful surgeon and a
great naturalist; but I did not expect to find him so much at home
on other matters. I who had been spending my time in cultivating my
judgment by abstract study, and smit from my boyhood with the love of
song, had sought my amusement in the rosy fields of imagination, was
not less surprised than gratified to find that the ancient affinity
between Apollo and Esculapius was so well maintained in his person.”

So informing and yet witty, so full of life, so true to life was his
conversation that the chance of sharing it was eagerly embraced,
and his friends rode many miles to accompany him on his way home
from their houses, even at midnight. His poetical fancy occasionally
vented itself in little pieces of verse, one of which, entitled
“Signs of Rain,” beginning—


  “The hollow winds begin to blow,”


will probably long prove of interest in children’s collections of
verse.

Some of his epigrams are very apt, as this on the death of a miser—


  “Tom at last has laid by his old niggardly forms,
  And now gives good dinners; to whom, pray? the worms.”


Singing and violin and flute playing were favourite amusements of
his; and in his later years he would lay aside all cares for a time
and sing one of his own ballads with all the mirth and gaiety of his
youthful days.

Science and social intercourse were combined in two societies of
which Jenner was the soul—one he called the Medico-convivial,
which met usually at Radborough, the other the Convivio-medical,
assembling at Alveston.

At the meetings of these societies Jenner would often bring forward
the reported prophylactic virtues of cowpox, and earnestly recommend
his medical friends to inquire into the matter. All his efforts,
however, failed to induce them to take it up; and the subject became
so distasteful to them that they at one time threatened to expel him
if he continued to harass them with so unprofitable a subject.

Dr. Jenner did not marry till March 6, 1788, when Miss Catherine
Kingscote, a lady belonging to a well-known Gloucestershire family
frequently furnishing representatives to Parliament, became his wife.
The union was very happy, but Mrs. Jenner’s delicate health for many
years caused great anxiety and needed constant attention.

In 1792 Jenner became M.D. of St. Andrews, with the view of giving
up much of his fatiguing general practice. In 1794, at the age of
forty-five, he suffered from a severe attack of typhus fever, which
threatened to prove fatal. At this time the experiments in proof of
vaccination had not been made, and if he had died, the world in all
probability might have waited long for the introduction of this great
novelty.

Many who learn that vaccination was made known to the world in 1798,
when Jenner was forty-nine years old, do not know that the subject
attracted his attention in his youthful days as a country surgeon’s
apprentice, and that his faculties were ever after engaged upon the
matter at every convenient opportunity. He repeatedly mentioned the
subject of cowpox to his great teacher, John Hunter, when studying
with him in London. Hunter never damped the ardour of a pupil by
suggesting doubts or difficulties; but it does not appear that he
was specially impressed by what he heard. Yet he made known Jenner’s
information and opinions both in his lectures and to his friends.
But for many years Jenner’s ideas were poohpoohed by medical and
other authorities whom he met in his country practice. They believed
many had had smallpox after cowpox, and that the supposed protective
influence of the latter was due to something in the constitution of
the individual.

Not till 1780 did Jenner fully disclose to his devoted friend Edward
Gardner his hopes and fears about what he felt to be his great
life-work. He then described to him the various diseases which
attacked milkers when they handled diseased cows, and especially that
form which afforded protection against smallpox; and with deep and
anxious emotion expressed his hopes of being able to propagate this
latter form from one human being to another, so as to bring about the
total extinction of smallpox.

The exceeding simplicity of the ultimate discovery makes it difficult
for us nowadays to imagine the circumstances under which Jenner had
to grope his way in the imperfect twilight, and the perplexities
by which he was beset in arriving at true conclusions. Both his
own observation and that of other medical men of his acquaintance
proved to him that what was commonly called cowpox was not a certain
preventive of smallpox. But he ascertained by assiduous inquiry
and personal investigation that cows were liable to various kinds
of eruptions on their teats, all capable of being communicated to
the hands of the milkers; and that such sores when so communicated
were all called cowpox. But when he had traced out the nature of
these various diseases, and ascertained which of them possessed the
protective virtue against smallpox, he was again foiled by learning
that in some cases when what he now called the true cowpox broke out
among the cattle on a dairy farm, and had been communicated to the
milkers, they subsequently had smallpox.

It was this repeated failure to arrive at a perfect result which
perhaps gave the stimulus that led Jenner to ultimate triumph. The
fact that he was on the scent of a discovery which in some form had
a promise of indefinite blessing, made him redouble his efforts
when most perplexed. He conceived the idea that the virus of the
cowpox itself might undergo changes sufficient to deprive it of its
protective power, and yet enable it to communicate a disease to the
milker. Thus he at last came on the track of the discovery that it
was only in a certain condition of the pustule that the virus was
capable of imparting its protective power to the human constitution.

Having thus steered his way safely through all the pitfalls which
might have destroyed the accuracy of his results, Jenner was able to
go on to the next stage, that of putting his theory to the test. It
is singular how long he was before he had an opportunity of further
experiment. In 1788 he showed a drawing of the cowpox as it occurred
in milkers to Sir Everard Home and others in London. Various eminent
medical men, Cline, Adams, Haygarth, heard of and discussed the
matter, and encouraged Jenner’s inquiries. But it was not till May
14, 1796, that he had an opportunity of transferring cowpox from
one human being to another. Sarah Nelmes, a dairymaid who had been
infected from her master’s cows, afforded the matter, and it was
inserted by two surperficial incisions into the arms of James Phipps,
a healthy boy about eight years old. The cowpox ran an ordinary
course with no ill effect, and in July Jenner writes to Gardner: “The
boy has since been inoculated for the smallpox, which, as I ventured
to predict, produced no effect. I shall now pursue my experiments
with redoubled ardour.”

Jenner did not, even now that he had attained to certainty in his
own mind, rush precipitately into publicity, although his benevolent
desires to avert the scourge of smallpox from humanity strongly urged
him to do so. Still less did he yield to the temptation to establish
himself as a practitioner with a specialty for warding off smallpox,
which might have led him speedily to fortune. He was as if forearmed
against the stringent requirements which would be made as to the
proofs of such a discovery if made gratuitously public. At this time
he says: “While the vaccine discovery was progressive, the joy I felt
at the prospect before me of being the instrument destined to take
away from the world one of its greatest calamities, blended with the
fond hope of enjoying independence and domestic peace and happiness,
was often so excessive that, in pursuing my favourite subject among
the meadows, I have sometimes found myself in a kind of reverie. It
is pleasant to me to recollect that these reflections always ended
in devout acknowledgments to that Being from whom this and all other
mercies flow.”

Until the spring of 1798 Jenner had no further opportunity of
pursuing his inquiries, for the cowpox disappeared from the
neighbouring dairies. At last he had matured his research, and it
was ready for publication. Before sending it to the printers it was
most carefully scrutinised by a number of friends at Rudhall, near
Ross, in Herefordshire, the seat of Mr. Thomas Westfaling. Their
sympathy encouraged him and their judgment approved of his work,
which none who read Jenner’s modest and now classic recital, “An
Inquiry into the Causes and Effects of the Variolæ Vaccinæ,” bearing
date June 21, 1798, can wonder at. Previous to this date, however,
Dr. and Mrs. Jenner had been two months in London, experiencing
much mortification from the fact that no one in London could be
obtained as a patient to be inoculated with cowpox. Dr. Jenner often
stated that his patience had been exhausted on that occasion: and it
remained for Henry Cline to perform the first successful vaccination
in London. Finding that subsequent inoculation with smallpox failed
to give his patient any disease, Cline expressed his opinion that
this promised to be one of the greatest improvements ever made in
medicine; and he begged Jenner to remove to London, promising him a
practice of ten thousand a year. Jenner’s sentiments on this matter
are characteristically expressed in the following extract: “Shall I,
who even in the morning of my days sought the lowly and sequestered
paths of life—the valley, and not the mountain; shall I, now my
evening is fast approaching, hold myself up as an object for fortune
and for fame? Admitting it as a certainty that I obtain both, what
stock should I add to my little fund of happiness? My fortune, with
what flows in from my profession, is sufficient to gratify my wishes;
indeed, so limited is my ambition and that of my nearest connexions,
that were I precluded from future practice I should be enabled to
obtain all I want. And as for fame, what is it? a gilded butt, for
ever pierced with the arrows of malignancy.”

The first lady of rank who had her child vaccinated was Lady Frances
Morton (afterwards Lady Ducie). The Countess of Berkeley very early
promoted Jenner’s success and ardently advocated vaccination.

A certain Dr. Woodville, eager to rank among the vaccinators,
discovered cowpox in a dairy in Gray’s Inn Lane, in January 1799,
found that the milkers became infected, and took from them matter
with which he vaccinated a number of persons; but contrary to
Jenner’s practice, he proceeded to insert smallpox matter in their
arms on the third and fifth days after vaccination, as if that could
afford a fair trial of the new method. No wonder that the patients
exhibited pustules like those of smallpox, and this was the first of
the many disasters that arose from the injudicious zeal of Jenner’s
first followers. This same Dr. Woodville, in an interview with Jenner
in March of the same year, showed himself so little acquainted
with the real character of cowpox, that he described it as having
been communicated by effluvia; and that the patient had it in the
confluent way. Jenner remarked on this: “Might not the disease have
been the confluent smallpox communicated by Dr. Woodville, as he is
always full of the infection?”

Notwithstanding the mistakes of injudicious friends vaccination
began to spread in 1799, largely through the aid of those friends of
Jenner who themselves became inoculators—including many who were not
medical practitioners. In the same year it came into notice on the
continent, the “Inquiry” having become known in Vienna, Hanover, and
Geneva. In particular Dr. de Carro in Vienna became its most zealous
and judicious advocate, and greatly contributed to the striking
diminution in the ravages of smallpox which soon became evident in
that city through the introduction and wide spread of vaccination. A
little later, vaccine matter was first sent to Berlin. The same year
vaccination became known in the United States, Professor Waterhouse
of Cambridge, Mass., being the first to appreciate its importance. He
as soon as possible vaccinated his own children, and then had one of
them publicly inoculated with smallpox; and no infection following,
the practice became at once established in the United States. Some
contamination with smallpox having taken place by injudicious
action as in England, matter was obtained direct from Jenner, and
President Jefferson, with his sons-in-law, in 1801, set the example
of vaccinating in their own families and those of their neighbours,
nearly 200 persons. France and Spain had also followed in the wake,
and almost all Europe was now being vaccinated.

We cannot follow the details of the successful introduction of
vaccination as by a triumphal progress all over the world, proving
its efficacy on men of all colour, of all civilisations, of all
climates. Sir Ralph Abercrombie’s expedition to Egypt was the first
armed force submitted to vaccination, and its good effects were
most evident. At Palermo it was not unusual to see on the mornings
of public inoculation at the hospital a procession of men, women,
and children, conducted through the streets by a priest carrying
a cross, on the way to be inoculated. The medical officers of the
British navy in 1801 presented Dr. Jenner with a gold medal in honour
of his discovery.

Smallpox was still committing great ravages in India and Ceylon, and
Jenner exerted himself to the utmost to transmit vaccine matter to
the East. The early attempts all failed, some from accident, such
as the loss of an East Indiaman at sea, others from inexperience in
sending the virus so great a distance, exposed to such vicissitudes
of climate. Dr. Jenner proposed to the Secretary of State to send in
some ship to India a number of soldiers who had not had smallpox, and
to vaccinate them in succession by appointing a skilled surgeon to
accompany the vessel; but those in office could not see the wisdom of
this plan. Consequently the noble discoverer resolved himself to do
what was so needful, and while seeking to defray part of the cost by
a public subscription, he headed it with a subscription of a thousand
guineas. But before the project could be matured, news arrived of the
successful introduction of vaccine matter into Bombay, in consequence
of its successive transfer to Constantinople, to Bagdad, to Bussora,
and thence by sea to Bombay. The self-denying enthusiasm of Dr.
Jenner is, however, as conspicuous as if his expedition had been
fitted out as he intended.

The simple narrative which the great man himself gave in 1801 in a
pamphlet only extending to eight pages, deserves reproducing in
every account of the discovery. Its simplicity is more forceful than
any decorative treatment could have rendered it. “My inquiry into the
nature of the cowpox commenced upwards of twenty-five years ago. My
attention to this singular disease was first excited by observing,
that among those whom in the country I was frequently called upon
to inoculate, many resisted every effort to give them the smallpox.
These patients I found had undergone a disease they called the
cowpox, contracted by milking cows affected with a peculiar eruption
on their teats. On inquiry, it appeared that it had been known among
the dairies time immemorial, and that a vague opinion prevailed
that it was a preventive of the smallpox. This opinion I found was
comparatively new among them, for all the older families declared
they had no such idea in their early days.”

       *       *       *       *       *

“During the investigation of the casual cowpox, I was struck with
the idea that it might be practicable to propagate the disease by
inoculation, after the manner of the smallpox, first from the cow,
and finally from one human being to another. I anxiously waited
some time for an opportunity of putting this theory to the test. At
length the period arrived, and the first experiment was made upon
a lad of the name of Phipps, in whose arm a little vaccine virus
was inserted, taken from the hand of a young woman who had been
accidentally infected by a cow. Notwithstanding the resemblance
which the pustule, thus excited on the boy’s arm, bore to variolous
inoculation, yet as the indisposition attending it was barely
perceptible, I could scarcely persuade myself the patient was secure
from the smallpox. However, on his being inoculated some months
afterwards, it proved that he was secure. This case inspired me with
confidence; and as soon as I could again furnish myself with virus
from the cow, I made an arrangement for a series of inoculations.
A number of children were inoculated in succession, one from the
other; and after several months had elapsed, they were exposed to
the infection of smallpox—some by inoculation, others by variolous
effluvia, and some in both ways, but they all resisted it. The result
of these trials gradually led me into a wider field of experiment,
which I went over not only with great attention, but with painful
solicitude.”

The great revolution effected by vaccination can scarcely be
appreciated in our days, and some testimonies from the past are
continually needed. The Rev. Dr. Booker, of Dudley, which in his time
contained fourteen thousand inhabitants, testified thus respecting
vaccination and its striking effects: “I have, previous to the
knowledge of the vaccine inoculation, frequently buried, day after
day, several (and once as many as eight) victims of the smallpox.
But since the parish has been blessed with this invaluable boon of
Divine Providence (cowpock), introduced among us nearly four years
ago, only two victims have fallen a prey to the above ravaging
disorder (smallpox). In the surrounding villages, like an insatiable
Moloch, it has lately been devouring vast numbers, where obstinacy
and prejudice have precluded the Jennerian protective blessing, and
not a few of the infected victims have been brought for interment in
our cemeteries; yet, though thousands have thus fallen beside us, the
fatal pestilence has not hitherto again come nigh our dwelling. The
spirit of Jenner hath stood between the dead and the living, and the
plague has been stayed.”

Many ladies took up the practice of vaccination with zeal and skill.
Thus, up to November 1805, Miss Bayley, of Hope, near Manchester,
had vaccinated two thousand six hundred persons, and a female friend
of hers had vaccinated two thousand. Miss Bayley is related to
have carried on her extensive vaccinations with great judgment and
precision. She commenced by offering five shillings to any one who
could produce an instance of the occurrence of smallpox in any person
vaccinated by her. Out of the whole number of cases above mentioned,
however, only one claim was made; and on referring to her books, it
was found that a mark had been made against the name, indicating a
suspicion that the vaccination had not been effective.

Dr. Jenner has often been reproached for encouraging unprofessional
persons to practise vaccination: but it should be noted that he never
did so unless the person concerned had carefully studied the subject,
and could be relied on to follow his directions implicitly. In
fact, some of the non-professional vaccinators were more efficient
than many professional ones, for these frequently disdained to be
instructed by him, and by no means followed the rules he laid down.
Thus discredit came to vaccination to a great extent by the mistakes
of its professional advocates.

The most extraordinary attacks were made upon vaccination and its
promoters, including, of course, most virulent denunciations of
its supposed anti-religious tendencies. Opposing doctors detected
resemblances to ox-faces, produced in children, as they alleged, by
vaccination. A lady complained that since her daughter was vaccinated
she coughed like a cow, and had grown hairy all over her body; and
in one country district it was stated that vaccination had been
discontinued there, because those who had been inoculated in that
manner bellowed like bulls.

One mode in which some doctors suffered at the time of the
introduction of smallpox is not often remembered. Inoculation with
smallpox was largely practised, and some medical men derived a
considerable proportion of their income from this branch of their
profession. It was stated on good authority that Dr. Woodville,
at one time Physician to the Smallpox Hospital, having given up
inoculation and largely practised vaccination, his income sank in
one year from £1000 to £100; and others who refused to discontinue
inoculation and advocate vaccination were more than suspected of
interested motives.

The antagonism of vaccination to the so-called designs of Providence
was loudly asserted. One Dr. Squirrel on this head maintained that
“Providence never intended that the vaccine disease should affect
the human race, else why had it not, before this time, visited the
inhabitants of the globe? Notwithstanding this, the vaccine virus
has been forced into the blood by the manufacturing hand of man, and
supported not by science or reason, but by conjecture and folly only,
with a pretence of its exterminating the smallpox from the face of
the earth.” Again, he denounces “the puerility and the impropriety
of such a conduct, viz., of introducing vaccination with a boasted
intention not only to supplant, but also to change and alter, and,
in short, to prevent the established law of nature. The law of God
prohibits the practice; the law of man, and the law of nature, loudly
exclaim against it.” Inoculation had been just as bitterly denounced
as “dangerous,” “sinful,” “diabolical,” in numerous sermons and
medical treatises, when it was introduced, less than a century before
this.

No more striking evidence of the beneficial results which attended
vaccination, even in Jenner’s lifetime, could be given than those
which attended its introduction into Vienna, where smallpox had
prevailed severely for centuries. The average number of persons who
died at Vienna in each of the first five years of this century was
about 14,600: of these eight hundred and thirty-five died of smallpox
in the year 1800. Vaccination being introduced and extensively
adopted, the number of deaths from smallpox fell to one hundred and
sixty-four in 1801, to sixty-one in 1802, to twenty-seven in 1803,
while in 1804 only two persons died, and these deaths were not
occasioned in Vienna, one being that of a boatman’s child who caught
the disease on the Danube, and the other a child sent to Vienna
from a distant part of the empire already infected. Yet so long was
the practice of vaccination before it spread to an equal extent in
England, that nine hundred and fifty deaths occurred from smallpox in
London in the last three months only of 1805.

Wherever he might happen to be, Jenner offered to vaccinate
gratuitously all poor persons who applied to him at fixed times. The
people of one parish, in the neighbourhood of Cheltenham, held back,
while the adjacent parishes accepted the new practice to a large
extent. But in one particular year the people of the reluctant parish
arrived in large numbers to claim vaccination for their children.
On inquiry it appeared that smallpox had been among them, causing
many deaths, while those of their neighbours who had been vaccinated
escaped. Yet it was not this potent argument which had been most
influential, but the fact that the cost of coffins and burial
for those who had died of smallpox became alarming to the parish
officials, and they were moved to urge the people authoritatively to
be vaccinated, and so save the parish expenses.

From this time forward for a number of years Jenner paid annual
visits to London, remaining there a great part of the season,
incessantly occupied in vaccinating, in giving information and
instruction on the subject verbally to many medical men, in writing
to a vast number of persons who corresponded with him from all parts
of the world, for every one who heard of the discovery and wanted
to know more about it applied to the discoverer, and in social
intercourse with people of note, whom he never failed to impress
by his eloquence and perspicuity. We cannot follow here the many
incidents which marked these years, his intercourse with royal
personages, the addresses of congratulation and gratitude which he
received from all kinds of localities and bodies of people, the
foundation of the Royal Jennerian Society, and the like. A few,
however, must find a place.

A Dr. Pearson, to whom we shall have to refer again, distinguished
himself at first as an ardent vaccinator, but subsequently he seems
to have imagined himself entitled to much of the distinction which
belonged to Dr. Jenner, and in order to secure this, set about
forming a public “vaccine board,” in which the chief official status
was assigned to himself. He succeeded in obtaining the patronage of
the Duke of York and other notable persons. Addressing Jenner on
the subject, in December 1799, Pearson says: “It occurs to me that
it might not be disagreeable to you to be an extra-corresponding
physician.... No expense is to be attached to your situation except
a guinea a year as a subscriber, and indeed I think you ought to be
exempt from that, as you cannot send any patients.” This was pretty
well, one might think, to be addressed to Jenner: in one year after
the full publication of his discovery, he was to be shunted off as an
“extra-corresponding physician.” Jenner’s answer showed the sense in
which he regarded it. “It appears to me somewhat extraordinary that,
an institution formed upon so large a scale, and that has for its
object the inoculation of the cowpox, should have been set on foot
and almost completely organized without my receiving the most distant
intimation of it.... For the present I must beg leave to decline the
_honour_ intended me.” After some discussion, most of the royal and
influential personages who had promised to support Dr. Pearson’s
institution withdrew their names from it.

At Brunn in Moravia, where Count Francis de Salm introduced and
widely diffused vaccination, the people erected a temple dedicated to
Jenner, and annually held a festival on his birthday.

The Dowager Empress of Russia first promoted vaccination in that
empire, gave the name Vaccinoff to the first child vaccinated, had
the child taken to St. Petersburg in one of her own coaches, placed
in the Foundling Hospital, with a provision settled on her for life.
In 1802 the Empress sent Dr. Jenner a letter signed with her own
hand, with a valuable diamond ring. In fact in all foreign countries
vaccination was accepted with more enthusiasm than in England. The
proof of this may readily be seen in Dr. Baron’s Life of Jenner.

Meanwhile Jenner had expended a large amount of money out of his
fortune, in visiting London, distributing information, giving up
to a very large extent his practice at Berkeley, and being by no
means recouped by profits of practice in London. His friends at
length, seeing that he was now debarred from obtaining from practice
an adequate reward for his great discovery, urged him to apply to
Parliament for some reward. This was at last done in 1802, and the
petition was recommended very strongly by the king, and considered by
a committee of the House of Commons. This committee received evidence
which unanimously affirmed the importance and practical value of the
discovery, and almost as unanimously agreed in Jenner’s originality.
Admiral Berkeley, chairman of the committee, said that Jenner’s was
unquestionably the greatest discovery ever made for the preservation
of the human species. A grant of £10,000 was proposed on June 2,
1802, and after a considerable discussion was carried, as against an
amendment proposing to grant £20,000.

It soon appeared, however, that the House of Commons had failed to
satisfy the sense of justice of the mass of people as well as of
the more eminent members of the medical profession in its grant to
Jenner. Sir Gilbert Blane, in an address he drew up on the subject,
said: “It is the universal voice of this as well as other nations
that the remuneration given to Dr. Jenner is greatly inadequate to
his deserts, and to the magnitude of the benefit his discovery has
conferred on mankind.”

In January 1803 was founded the Royal Jennerian Institution,
under royal patronage, and with Jenner as president, to propagate
vaccination in London and elsewhere. This continued its operations
for some years with distinguished success; but Dr. Walker, who had
been appointed resident inoculator, soon began to deviate from
Jenner’s instructions, and to adopt methods calculated in Jenner’s
view to bring the practice into disrepute. Consequently the dismissal
of Walker was called for, but was negatived in one division, to which
Walker had brought in as voters twenty persons who only paid their
subscription on the day of voting. By such absurd possibilities
are the steps of benefactors to their race frequently beset. The
resignation of Dr. Walker took place soon afterwards, but the
Jennerian Institution did not fully recover from the effects of
the dissension, and on the establishment of the National Vaccine
Institution in 1808 it became practically extinct.

Will it be credited that, after the decisive parliamentary vote, for
more than two years the Treasury delayed to pay the money, on one
pretence and another; and when at last it was paid, nearly £1000 was
deducted on account of fees. Akin to this, though the amount was
trifling, was a demand made upon Jenner for five pounds admission
fees, when the corporation of Dublin conferred upon him the freedom
of that city.

Among the multitude of testimonies of appreciation which Jenner
received, not the least interesting is one which proceeded from the
chiefs of the “Five Nations” of Canadian Indians, the Mohawks, the
Onondagas, the Senecas, the Oneidas, and the Coyongas. Their address
to him ran as follows: “Brother! our Father has delivered to us the
book you sent to instruct us how to use the discovery which the Great
Spirit made to you, whereby the smallpox, that fatal enemy of our
tribes, may be driven from the earth. We have deposited your book in
the hands of the man of skill whom our Great Father employs to attend
us when sick or wounded. We shall not fail to teach our children to
speak the name of Jenner; and to thank the Great Spirit for bestowing
upon him so much wisdom and so much benevolence. We send with this
a belt and string of wampum, in token of our acceptance of your
precious gift; and we beseech the Great Spirit to take care of you in
this world, and in the land of spirits.”

In 1804 one of the most beautiful of the Napoleon series of medals
was struck in commemoration of the Emperor’s estimate of the value of
vaccination. He was so sensible of Jenner’s claims, that he allowed
his petitions for the liberation of British subjects to prevail.
Napoleon was about to reject one petition, but when Josephine uttered
the name of Jenner, he paused and exclaimed, “Jenner! ah, we can
refuse nothing to that man.” Perhaps no more striking example of the
extent to which Jenner’s influence extended outside England could be
given, than the fact that numbers of persons travelled abroad or on
shipboard bearing with them, in preference to a passport, a simple
certificate signed “Edward Jenner,” testifying that the persons were
known to him and were travelling in pursuit of health, or science, or
other affairs unconnected with war. When the great war was over, and
the allied sovereigns visited London, Jenner was introduced, among
others, to the Emperor of Russia and the King of Prussia, by their
special request.

But in Great Britain there were many things calculated to detract
from Jenner’s perfect enjoyment. On various occasions the British
government were by no means eager to show him a respect and honour
equal to that paid to him abroad. When various government officials
combined to launch a national vaccine establishment, it was at first
stated that Jenner was to be director, with the stipulation that
no one was to take any part in the vaccinating department who was
not either nominated or approved by him. Yet soon afterwards, out
of eight persons nominated by Jenner, six were rejected. Jenner
himself was not admitted a member of the Board, which was composed
exclusively of the four censors of the College of Physicians and
the master, and two senior wardens of the College of Surgeons. In
consequence of this treatment, occurring in 1808, when vaccination
was so universally recognised, Dr. Jenner resigned the post of
director, but was succeeded by his friend, Mr. Moore, who was
thoroughly in his confidence.

A picture of Jenner’s inward life at this period, when the subject
of a second parliamentary grant was being considered, may here be
given from a letter of his:—“As for myself, I bear the fatigues and
worries of a public character better by far than those who know the
acuteness of my feelings could have anticipated. Happy should I be to
give up my laurels for the repose of retirement, did I not feel it to
be my duty to be in the world. I certainly derive the most soothing
consolation from my labours, the benefits of which are felt the world
over; but less appreciated, perhaps, in this island than in any other
part of the civilised world.... Cheltenham is much improved since
you saw it. It is too gay for me. I still like my rustic haunt, old
Berkeley, best; where we are all going in about a fortnight. Edward
is growing tall, and has long looked over my head. Catherine, now
eleven years old, is a promising girl; and Robert, eight years old,
is just a chip of the old block.”

In July 1806 Lord Henry Petty, who had succeeded Mr. Pitt as
Chancellor of the Exchequer, carried a motion in the Commons, that
the Royal College of Physicians should be requested to inquire into
the progress of vaccine inoculation. The College made an inquiry,
giving the fullest scope to the opponents of vaccination, and
finally reported that, considering the number, respectability,
disinterestedness, and extensive experience of its advocates,
compared with the feeble and imperfect testimonies of its few
opposers, the value of the practice seemed established as firmly as
possible. In July 1807 the subject was again debated in Parliament,
and a proposal to grant £10,000 was rejected in favour of one moved
by Mr. Edward Morris that £20,000 be granted to Dr. Jenner.

The European inhabitants of India were from the first among the most
earnest in recognising Jenner’s merits, and afforded him in many
ways practical testimonies of their gratitude. About £4000 were
transmitted to him from Calcutta in 1806 and following years; from
Bombay £2000, and from Madras nearly £1400.

The effects of incessant labours were beginning seriously to tell
on Jenner’s health, when in 1810 he lost his eldest son from
consumption, in his 21st year. This event preyed much on his mind,
and left him in a state occasioning great anxiety to his friends. In
the same year he lost his firm friend the Earl of Berkeley, and his
beloved sister, Mrs. Black. Under these troubles he felt the more
acutely the calumnious attacks to which he was constantly subjected.
Dr. Parry of Bath, writing to him about this time, says—“For
Heaven’s sake, think no more of these wasps, who hum and buzz about
you, and whom your indifference and silence will freeze into utter
oblivion. Let me again entreat you not to give them one moment’s
consideration, _opus exegisti ære perennius_. The great business is
accomplished, and the blessing is ready for those who choose to avail
themselves of it; and with regard to those who reject it, the evil
will be on their own heads.”

In 1811 occurred the first well-authenticated case of smallpox in
a boy vaccinated by Jenner, the Hon. Robert Grosvenor. The disease
became severe and threatened death, when all at once the later stages
were passed through rapidly, and a good recovery was made. Other
vaccinated children in this family were exposed to the contagion, and
did not suffer. There seemed every reason, as Jenner explained, to
ascribe the failure of protection in the first case to a peculiarity
of constitution which would probably have exposed the patient to
a second attack of smallpox. In fact, Dr. Jenner had vaccinated
the child when in weak health at a month old. Lady Grosvenor was
timid, and prevailed on him, contrary to his usual practice, to
make one puncture only; and the pustule that resulted was deranged
in its progress by being rubbed by the nurse. Nevertheless the
case created much alarm and excitement, and greatly exhilarated
the anti-vaccinists. Jenner’s simple answer was to admit the fact,
alleging that if ten, fifty, or a hundred such events should occur,
they would be balanced a hundred times over by cases of second
attacks of smallpox. “I have ever considered the variolous and the
vaccine radically and essentially the same. As the inoculation of the
former has been known to fail in instances so numerous, it would
be very extraordinary if the latter should always be exempt from
failure. It would tend to invalidate my early doctrine on this point.”

A letter of Jenner to Dr. Baron on this subject, exhibits perhaps the
utmost degree of irritation that he showed. “The Town is a fool—an
idiot,” he remarks, “and will continue in this red-hot, hissing-hot
state about this affair, till something else starts up to draw aside
its attention. I am determined to lock up my brains and think no more
_pro bono publico_.... It is my intention to collect all the cases I
can of smallpox, after supposed security from that disease.”

In 1813 the degree of M.D. was voted to Jenner by the University of
Oxford. It was expected that the London College of Physicians would
have followed suit by admitting him to membership, but they exacted a
full examination, which Jenner at his age, and with his reputation,
could not be expected to submit to. In the summer of 1814 Jenner
visited London for the last time, being presented to the Czar, and
having numerous interviews with his sister, the Grand Duchess of
Oldenburg. On the 13th September, 1815, Mrs. Jenner died, a calamity
which most deeply afflicted Dr. Jenner, and seemed to mark his
retirement from active public life. It is much to be regretted that
he did not live to complete and publish his own final account, and
matured convictions, as to the suitable conditions of vaccination,
and the modifications and imperfections to which it was liable. This
engaged much of his attention in his later years, but his inquiries
were interrupted by illness and by family affliction. His later
years were made painful by extreme nervous sensitiveness, and he had
several attacks which foreboded death by apoplexy, which ultimately
occurred on 26th January, 1823. He was buried at Berkeley, by the
side of his wife, on 3d February.

Jenner’s nature, says his biographer, was mild, unobtrusive,
unambitious; the singleness of his heart and his genuine modesty
graced and adorned his splendid reputation. Had those who opposed him
known how little of selfishness, vanity, or pride entered into his
composition! He made no answer to aspersions.

“All the friends who watched him longest, and have seen most of his
mind and of his conduct, with one voice declare that there was a
something about him which they never witnessed in any other man. The
first things that a stranger would remark were the gentleness, the
simplicity, the artlessness of his manner. There was a total absence
of all ostentation or display; so much so, that in the ordinary
intercourse of society he appeared as a person who had no claims to
notice. He was perfectly unreserved, and free from all guile. He
carried his heart and his mind so openly, so undisguisedly, that
all might read them. You could not converse with him, you could not
enter his house nor his study, without seeing what sort of man dwelt
there.”

“The objects of his studies generally lay scattered around him; and,
as he used often to say himself, seemingly in chaotic confusion.
Fossils, and other specimens of natural history, anatomical
preparations, books, papers, letters—all presented themselves in
strange disorder; but every article bore the impress of the genius
that presided there. The fossils were marked by small pieces of
paper pasted on them, having their names and the places where they
were found inscribed in his own plain and distinct hand-writing....
He seemed to have no secrets of any kind: and, notwithstanding a
long experience with the world, he acted to the last as if all
mankind were trustworthy, and free from selfishness as himself.
He had a working head, being never idle, and accumulated a great
store of original observations. These treasures he imparted most
generously and liberally. Indeed, his chief pleasure seemed to be in
pouring out the ample riches of his mind to every one who enjoyed
his acquaintance. He had often reason to lament this unbounded
confidence; but such ungrateful returns neither chilled his ardour
nor ruffled his temper.”

Such was the man to whom the world was indebted for vaccination; no
court or metropolitan physician, no university student, but a country
doctor, a man of science and of benevolence, whose name is undying.




CHAPTER VII.

_SIR ASTLEY COOPER AND ABERNETHY: THE KNIFE_ VERSUS _REGIMEN._


Few men have been more renowned in their day than the great “Sir
Astley.”

ASTLEY COOPER was the grandson of a surgeon at Norwich. His father
was a very estimable clergyman in Norfolk; his mother wrote novels
of some repute, and was noted for her benevolence and unselfishness.
Astley, the fourth son of a numerous family, was born on August 23,
1768. His youth was marked by a succession of hairbreadth escapes
and exploits, demanding coolness and audacity. He had no great taste
for classics or literature in youth or through life. As a youth he
had a handsome and expressive countenance, with much openness of
manner and liveliness of conversation, so that he often charmed
those who disapproved of his wild freaks. Like John Hunter, he had a
free youth, and if unimproved was likewise unspoiled by systematic
training.

Both the grandfather and the uncle of Astley Cooper, the latter
a lecturer at Guy’s, are credited with some share in exciting a
surgical bias in the boy’s mind. Visiting the Norwich hospital one
day, and seeing a striking operation, he was strongly impressed with
the utility of surgery. In 1784 a visit from his uncle, the London
surgeon, led to the nephew being articled to him; but his progress
here was limited, owing to the attraction which a free town-life had
for him at first. One day he was met by his uncle disguised in the
uniform of an officer, and the former recognising his nephew, the
latter denied all knowledge of him. The detection of this escapade
was soon followed by his transfer as a pupil from his uncle to Mr.
Cline, who then shared with Abernethy the next honours as a surgeon
to John Hunter. Under Cline, young Cooper imbibed the spirit of
Hunter’s teaching from one of his most enthusiastic pupils: for
Cline’s judgment about Hunter was that there seemed no comparison
between his great mind and all who had preceded him.

Sir Astley Cooper at a later period thus depicts his old master: “Mr.
Cline was a man of excellent judgment, of great caution, of accurate
knowledge; particularly taciturn abroad, yet open, friendly, and
very conversationable at home. In surgery cool, safe, judicious; in
anatomy sufficiently informed. In politics a Democrat, living in
friendship with Horne Tooke. In morals thoroughly honest; in religion
a Deist. A good husband, son, and father. As a friend sincere, but
not active; as an enemy most inveterate.”

Young Cooper was soon actively engaged in dissection, and his
adventurous nature found scope in many a night-expedition with the
body-snatchers or resurrectionists in their search for “subjects.”

He spent one winter session (1787-8) at Edinburgh, having already
made considerable progress in anatomy and surgery. He greatly
appreciated Cullen, Black, and Fyfe. Having returned from Edinburgh,
he attended John Hunter and other celebrated lecturers, and in 1789,
being only 21, he was appointed demonstrator at St. Thomas’s. Two
years later Mr. Cline obtained for him the joint lectureship with
himself in anatomy and surgery. In December 1791 he married Miss
Anne Cock. The wedding was perfectly quiet owing to the recent death
of the lady’s father, and on the evening of the same day Astley
Cooper lectured on surgery with his usual composure, without any of
his pupils becoming aware of his marriage. In June 1792 the young
surgeon and his bride visited Paris, and were there during the three
terrible months which followed. Cooper spent much time in studying
Parisian methods of surgery and in attending the debates of the
National Assembly. His safety was secured by a democratic badge, and
by friendship with leading revolutionists in England to whom Cline
adhered.

In addition to his income from his hospital lectures, Mr. Cooper
came into possession by his marriage of a fortune of fourteen
thousand pounds, so that he was at once placed beyond any pecuniary
anxiety. He consequently was enable to devote himself mainly to
study and teaching. He went to the hospital before breakfast to
dissect for lecture, and he also demonstrated to students before the
lecture-hour. He injected their subjects, lectured from two till
half-past three, and three evenings a week lectured on surgery.
Further, he persevered in visiting the interesting cases in the
hospital and making notes of them. His lectures on surgery, which
he was the first in the Borough hospitals to separate from anatomy
and physiology, were not at the beginning a conspicuous success. He
found that he had been too theoretical, but soon changed his plan,
and selected cases in the hospital as the basis of his lectures. From
this moment his class increased and became interested. He himself
acquired a facility in recalling cases and circumstances illustrative
of the disease under consideration which greatly added to the
attractiveness of his style. The fact is, he was not the intellectual
successor of John Hunter, and could not succeed by similar methods.
Yet the influence of Hunter upon him was unmixedly beneficial; he had
the wit to perceive that Hunter was not “an imaginative speculator,
and any one who believed in him a blockhead and a blacksheep in the
profession.” The improved lectures on surgery attracted twice as
many entries in 1793 as in 1792, and Mr. Cooper was besides selected
as lecturer on anatomy at the College of Surgeons. A chief part of
his duties in this latter capacity was to lecture on and dissect the
bodies of executed criminals. The lectures were most successfully
given to crowded audiences. In 1797 the now rising surgeon removed
from his early residence in Jeffries Square, St. Mary Axe, to 12
St. Mary Axe, long occupied by Mr. Cline, who now moved westward.
In the next year he had a severe accident, being thrown from his
horse on his head, and his life was in considerable danger for some
time. The extent of Mr. Cline’s consolatory sympathy, when Cooper
was lamenting the risk to his life because of its interference with
some professional inquiry likely to be of public benefit, was thus
expressed: “Make yourself quite easy, my friend; the result of your
disorder, whether fatal or otherwise, will not be thought of the
least consequence by mankind.”

An early pupil, Dr. William Roots, however, gives a very different
account of Cooper’s “consequence to mankind.” “From the period of
Astley’s appointment to Guy’s until the moment of his latest breath,
he was everything and all to the suffering and afflicted; his name
was a host, but his presence brought confidence and comfort; and I
have often observed that on an operating day, should anything occur
of an untoward character in the theatre, the moment Astley Cooper
entered, and the instrument was in his hand, every difficulty was
overcome, and safety generally ensued.” No doubt reference is here
made to the fact recorded by Sir Astley himself as follows: “I was
always of opinion that Mr. Cline and I gained more reputation at the
hospitals by assisting our colleagues than by our own operations, for
they were always in scrapes, and we were obliged to help them out of
them.”

Mr. Travers, who became Astley Cooper’s articled pupil in 1800,
says at that time he was the handsomest, most intelligent-looking
and finely formed man he ever saw. According to the custom of his
time, he wore his hair powdered, with a queue, and had always a
glow of colour in his cheeks. In his daily ride he wore a blue
coat and yellow buckskin breeches and top-boots. He was remarkably
upright, and moved with grace, vigour, and elasticity, and would not
unfrequently throw his well-shaped leg upon the table at lecture,
to illustrate some injury or operation on the lower extremity.
Cheerfulness of temper amounting to vivacity, and a relish for the
ludicrous, never deserted him, and his chuckling laugh, scarce
smothered while he told his story, his mirthful look and manner,
and his punning habit, were well known. His personal habits were
very simple; he drank water at dinner, and took two glasses of
port after. A good digestion never forsook him; as he said, “he
could digest anything but sawdust.” He was remarkable for requiring
little amusement or company beyond what he found in his professional
pursuits; and he read comparatively little medical literature.

It has often been alleged that Astley Cooper was somewhat unfeeling
in nature; and it must be admitted that he had not a deep sympathy
with bodily pain, for his own insusceptibility was equalled by his
physical endurance. Yet he always sympathised deeply with mental
suffering, and Mr. Travers, who saw him read a posthumous letter
from a favourite pupil who had committed suicide, relates that
his utterance was choked with sobs, and he wept as for the loss of
an only child. That his affection was not restricted to his own
immediate family is shown by the fact that on the deeply regretted
death of his little daughter he adopted into his family a little girl
who was no relative, but whose mother died early; and subsequently he
himself brought from Yarmouth in the coach, a twenty hours’ journey,
his little nephew, Astley, then two years old, who subsequently
became his successor in the baronetcy.

More widely known than the nephew during Sir Astley’s life was his
servant, Charles Osbaldeston—a name which in practice softened down
into Balderson. He was keenly alive to his master’s interest, and had
much tact and disposition for manœuvre; he boasted that in twenty-six
years he never lost a patient for his master whom it was possible to
retain. Wherever Mr. Cooper was, Charles would start after him, if
urgently required, and at any cost of post-horses track him out and
bring him triumphantly to the fore.

Mr. Cooper in his earlier years, when anatomy formed a great
part of his work, was of necessity largely concerned with the
resurrectionists, and was one of the main supporters, it may be
equally conceded, of their practices, the details of which he was
not unfrequently made acquainted with. But the state of the law,
which almost made it impossible to gain possession of subjects for
dissection legally, must be accepted as the apology for much that
would now as then be regarded as shocking. It cannot be strictly
germane to Sir Astley Cooper’s life to describe the procedure of
the body-snatchers, as Mr. Bransby Cooper has done;[17] but it may
be remarked that on occasions when public notice was threatened,
Astley Cooper took prompt steps to obviate injurious publicity of
his name. For a time the men of ill-fame reigned supreme, exacting
almost what prices they chose. If any demur was made, they stopped
the supplies, and then the medical students became angry, held
indignation meetings, sent deputations to their teachers, sometimes
asserting that their lecturers were not as active or as liberal as
those of some rival school, and threatening to leave _en masse_.
Thus the lecturers were in a manner forced to pay more for their
subjects than they could receive from their pupils for dissecting
them. Another disagreeable consequence was, that when the regular
“resurrectionists” got into trouble, the surgeons had to make great
exertions in their behalf, and often advanced large sums to defend
them, or to keep them and their families during imprisonment. Sir
Astley Cooper spent hundreds of pounds in this way. One of his
accounts includes £14, 7s. for half the expenses of going down
and bailing Vaughan at Yarmouth, £13 for Vaughan’s support during
twenty-six weeks’ imprisonment, £50, 8s. for four subjects, paid to
Murphy, and six guineas “finishing money” to three men, a douceur at
the end of a session.

The high prices paid led some people to offer their bodies before
death; but of course this was illegal. Sir Astley’s brief answer
to one offer from a third party asking to know the truth, was—“The
_truth_ is that you deserve to be hanged for making such an unfeeling
offer.” But under other circumstances, when the obtaining of the
corpse of a person who had died after an operation interesting to
the surgeon was in question, Sir Astley paid large sums, and was
thus enabled to add many valuable specimens of surgical results to
his museum. Thus his accounts for 1820 show the following entries
in regard to obtaining the body of a man on whom he had operated
twenty-four years before: “Coach for two there and back, £3, 12s.;
guards and coachmen, 6s.; expenses for two days, £1, 14s. 6d;
carriage of subject, and porter, 12s. 6d.; subject, £7, 7s.; total,
£13, 12s.”

This subject was to be obtained, we read, “cost what it may.” It is
no wonder, then, that of Sir Astley it might be said that no man knew
so much of the habits, the crimes, and the few good qualities of the
resurrectionists. He could obtain any subject he pleased, however
guarded: and indeed offered to do so. No one could go further than he
did before a Committee of the House of Commons, to whom he plainly
avowed: “There is no person, let his situation in life be what it
may, whom, if I were disposed to dissect, I could not obtain. The law
only enhances the price, and does not prevent the exhumation.” At
last the dreadful disclosures about the practices of “burking” in
Edinburgh in 1829 led to the passing of the Anatomy Act, legalising
dissection under proper regulations.

Nor were human bodies the only ones laid under contribution by Astley
Cooper. When animals were wanted for some physiological illustration
or investigation, his man Charles could always procure them, and
he had at one time as many as thirty dogs, besides other animals,
shut up in the hayloft. Half-a-crown a piece was paid by Charles on
receipt of the dogs, however obtained, and no doubt dog-stealing
was one source. The menagerie at the Tower was to Mr. Cooper, as
it had been to John Hunter, a considerable resource for specimens
for dissection. In 1801 an enormous elephant came under his knife,
and being too unwieldy to be got into the dissecting-room, it had
to be cut up in the courtyard, where, assisted by several students,
Mr. Cooper gave himself no rest till all the interesting parts were
preserved and deposited in St. Thomas’s Museum. Bird-stuffers,
fishmongers, and poultry merchants were also among the sources of
supply for his unwearying knife.

To Astley Cooper, as to most men who rise to eminence, remunerative
practice came but slowly. “My receipt,” says he, “for the first
year was £5, 5s; the second, £26; the third, £54; the fourth, £96;
the fifth, £100; the sixth, £200; the seventh, £400; the eighth,
£610; the ninth (the year in which he was appointed surgeon to the
hospital), £1100.” This was in 1800, when his uncle, William Cooper,
resigned the surgeoncy. It might have been supposed that the uncle
would favour his nephew’s succession in every way possible; but
he rather supported Mr. Morris, the strongest competitor. For the
rising star made the elder jealous of his brilliancy, and moreover
always regarded Cline, at St. Thomas’s, as his uncle’s superior. Thus
Astley Cooper’s success was by no means certain, as his political
associations with Horne Tooke and Thelwall were strenuously alleged
against him. But Astley, ever preferring success to politics,
resolved on giving up the latter and on being neutral for the future,
at any rate as to all open proceedings. This resolve secured his
appointment by Mr. Harrison, the well-known treasurer of Guy’s, who
with Sir Astley shares the highest credit in the establishment of its
medical school. He now absented himself from Mr. Cline’s political
parties, and always advised young surgeons not to attach themselves
to particular parties, as their duties must extend to persons of all
views. He also, to leave no stone unturned, personally canvassed each
of the seventy-two governors.

In 1800 Astley made his first communication to the Royal Society, on
the effects of destruction of the tympanic membrane of the ear. He
had found that considerable openings might be made in the membrane
without impairing the hearing power. He consequently applied this
operation to certain kinds of deafness resulting from disease or
obstruction in the Eustachian tube, and in 1801 sent in another
paper detailing the results of twenty cases. Although his success in
restoring lost hearing was much less than he had anticipated, the
operation has since been frequently performed, and the Royal Society
in 1802 awarded him the Copley Medal for these papers. In the same
year he was elected F.R.S.

Astley Cooper’s activities were at this time strongly directed
towards the improvement of his profession by intercourse and
discussion at societies, of several of which he was the life and
soul. The Physical Society at Guy’s Hospital afforded his earliest
opportunity of this kind, and long retained his active interest.
During his short stay at Edinburgh his predominance was so evident
that he was chosen president of a society to protect students’
rights against usurpations by the professors. Here also he joined a
Speculative Society, and read a paper in favour of the Berkeleian
theory of matter. One of the debates which he opened was on the
subject “Is man a free agent?” He would have been a president of
the Royal Medical Society at Edinburgh had he returned for a second
winter, so much did he distinguish himself in debate. At a later
period the strength of his association with Edinburgh was attested by
his forming the Edinburgh Club in London for former Edinburgh medical
students. The most important society, however, with the foundation
of which he was connected, was the Royal Medical Chirurgical
Society, which originated in a secession from the Medical Society
of London. Dr. Yelloly, who was intimately connected with the new
foundation, says of Mr. Cooper at this time: “I never saw any one
more open-hearted as a companion, more unreserved in his remarks,
with always a large store of information at his command, and who was
at the same time more kindly disposed, and abounding in all sorts
of material for the gratification of those with whom he associated.
He was not a reading man; but he contrived to get the most valuable
information of every description, whether professional or general,
and always to use it in the best, the most attractive, and the
readiest way.” The treasurer of the society was Astley Cooper, and he
rendered essential service. The earliest volume of its Transactions,
published in 1809, contained a paper recording his first operation
for the relief of aneurism of the carotid artery by tying it below
the aneurism—a method now established. But he had previously
published (part 1 in 1804, part 2 in 1807) a work which largely
contributed to his reputation, namely, on Hernia or Rupture. A second
edition was published in 1827. The anatomical structures concerned
were excellently expounded and illustrated, and the experience gained
in frequently and successfully operating in cases of this disease
gave Mr. Cooper a position of the highest authority. As so often
happens to medical men, his attention was especially called to this
disease from the fact that he had been subject to it from early life.
The anatomical study he undertook in order to perfect his knowledge
of this matter was immense. “I have related no case,” he says, “and
given no remark, for the truth of which I cannot vouch.” When his
pupils showed him some interesting appearance in a dissection, he
would say; “That is the way, sir, to learn your profession. Look
for yourself; never mind what other people may say, no opinion or
theories can interfere with information derived from dissection.”
The expense of the illustrations to this work was so great that Mr.
Cooper was loser of a thousand pounds by it when every copy had been
sold.

In 1806 Mr. Cooper left St. Mary Axe to occupy the house in New Broad
Street which for nine years was crowded by his patients, during
the most remunerative years of his life. In those years he rose at
six, dissected privately till eight, and from half-past eight saw
large numbers of gratuitous patients. At breakfast he ate only two
well-buttered hot rolls, drank his tea, cool, at a draught, read his
paper a few minutes, and then was off to his consulting-room, turning
round with a sweet benign smile as he left the room. Patients crowded
his rooms and besieged “Charles,” using manifold devices to get the
earliest interview possible. At one o’clock he would scarcely see
another patient, even if the house was full; but if detained half
an hour later, would fly into a rage, abuse Charles, and jump into
his carriage, leaving Charles to appease the disappointed patients.
Sometimes the people in the hall and ante-room were so importunate
that Mr. Cooper was driven to escape through his stables and into
a passage by Bishopsgate Church. At Guy’s he was awaited by a crowd
of pupils on the steps, and at once went into the wards, addressing
the patients with such tenderness of voice and expression that he at
once gained their confidence. His few pertinent questions and quick
diagnosis were of themselves remarkable, no less than the judicious
calm manner in which he enforced the necessity for operations when
required. At two the pupils would suddenly leave the ward, run across
the street to the old St. Thomas’s Hospital, and seat themselves
in the anatomical theatre. After the lecture, which was often so
crowded that men stood in the gangways and passages near to gain
such portions of his lecture as they might fortunately pick up, he
went round the dissecting-room, and afterwards left the hospital to
visit patients, or to operate privately, returning home at half-past
six or seven. Every spare minute in his carriage was occupied with
dictating to his assistants notes or remarks on cases or other
subjects on which he was engaged. At dinner he ate rapidly and not
very elegantly, talking and joking; after dinner he slept for ten
minutes at will, and then started to his surgical lecture, if it were
a lecture night. In the evening he was usually again on a round of
visits till midnight.

Dr. Pettigrew, in his “Medical Portrait Gallery,” thus vividly
describes the overpowering influence Sir Astley had upon his pupils:
“I can never forget the enthusiasm with which he entered upon the
performance of any duty calculated to abridge human suffering. This
enthusiasm, by the generosity of his character, his familiar manner,
and the excellence of his temper, he imparted to all around him;
and the extent of the obligations of the present and of after ages
to Sir Astley Cooper, in thus forming able and spirited surgeons,
can never be accurately estimated. He was the idol of the Borough
School. The pupils followed him in troops; and, like to Linnæus,
who has been described as proceeding upon his botanical excursions
accompanied by hundreds of students, so may Sir Astley be depicted
traversing the wards of the hospital with an equal number of pupils,
listening with almost breathless anxiety to catch the observations
which fell from his lips. But on the days of operation this feeling
was wound up to the highest pitch. The sight was altogether deeply
interesting; the large theatre of Guy’s crowded to the ceiling—the
profound silence obtained upon his entry—that person so manly
and so truly imposing—and the awful feeling connected with the
occasion—can never be forgotten by any of his pupils. The elegance
of his operation, without the slightest affectation, all ease, all
kindness to the patients, and equally solicitous that nothing should
be hidden from the observation of the pupils; rapid in execution,
masterly in manner; no hurry, no disorder, the most trifling minutiæ
attended to, the dressings generally applied by his own hand. The
light and elegant manner in which Sir Astley employed his various
instruments always astonished me, and I could not refrain from
making some remarks upon it to my late master, Mr. Chandler, one of
the surgeons to St. Thomas’s Hospital. I observed to him, that Sir
Astley’s operations appeared like the graceful efforts of an artist
in making a drawing. Mr. C. replied, ‘Sir, it is of no consequence
what instrument Mr. Cooper uses, they are all alike to him; and I
verily believe he could operate as easily with an oyster-knife as
the best bit of cutlery in Laundy’s shop.’ There was great truth in
this observation. Sir Astley was, at that time, decidedly one of the
first operators of the day, and this must be taken in its widest
sense, for it is intended to include the planning of the operation,
the precision and dexterity in the mode of its performance, and the
readiness with which all difficulties were met and overcome.”

Mr. Cooper, notwithstanding his persevering industry in dissection,
would not have found time to acquire all the knowledge he did, but
for employing several assistants either to dissect the specimens he
obtained from operations or from _post mortem_ examinations, or as
artists and modellers, amanuenses, &c. He was very peremptory in his
orders to his assistants to obtain for him any specimen he required,
and would not listen to suggestions of difficulties. “So and so must
be done,” he said, and his tone did not admit of the possibility
of failure. Thus he accumulated the large collection of morbid
specimens which he contributed to St. Thomas’s Hospital, at a time
when such collections were poohpoohed, and so little regarded, that
he could readily obtain any specimen he desired which was at the
disposal of his colleagues. With regard to his proceedings in these
matters the utmost secrecy was observed, entrance to his private
dissecting-rooms being jealously restricted to himself and his paid
assistants. When it was difficult to obtain leave to make a _post
mortem_ examination in private practice, he would spend a long time
in arguing most strenuously upon the matter with the relatives,
pointing out the reasons which rendered it desirable in the interests
of science. His only child was examined by his express wish by a
friend; and he left strict injunctions and directions for the _post
mortem_ on his own body. In very few cases was his determination ever
frustrated.

Astley Cooper reached his zenith in Broad Street. In one year his
income reached £21,000; for many years it was £15,000. One merchant
prince paid him £600 a year; the story of another, who tossed him a
cheque for a thousand guineas in his night-cap, after a successful
operation for stone, is well known. Many of his patients wrote a
cheque for their fee when they consulted him, and never made it less
than five guineas. It is amusing to contrast with his reputation as
a surgeon and operator, the extremely limited pharmacopœia to which
he trusted. “Give me,” he would say, “opium, tartarized antimony,
sulphate of magnesia, calomel and bark, and I would ask for little
else:” and from five or six formulæ he gave his poorer patients a
constant stock of medicine.

Mr. Cooper was appointed Professor of Comparative Anatomy at the
Royal College of Surgeons in 1813, being the first appointment after
Sir Everard Home retired. He lectured during only two seasons, in
1814 and 1815. Not being deeply read in his subject, he resolved to
see what industry could do, and restricted himself to three or four
hours’ sleep, that he might gain additional time for the dissection
of animals. He also employed several assistants to dissect for him,
and the result was that his specimens came by coach-loads to each
lecture. Mr. Clift remarks of one lecture, “This was an overpowering
discourse, and highly perfumed, the preparations being chiefly recent
and half-dried and varnished.” His lectures were very successful,
though he would have preferred lecturing on surgery, which was
allotted to Abernethy. In the year last mentioned he resigned the
professorship and also moved to New Street, W., hoping thereby to
diminish the fatigue occasioned by the numerous visits which he had
to pay westward. In the following May he signalised his skill by his
celebrated operation of tying the aorta or principal artery of the
body, for aneurism, in a case in which life was in the extremest
peril. The ease with which he prepared for the operation and the
masterly skill and success with which he completed it—without the aid
of chloroform, be it remembered—excited admiration throughout the
profession, who could best judge of the difficulties which had to be
overcome. The patient died of incurable disease, but the success of
the operation was undoubted.

After having for some years attended Lord Liverpool, Mr. Cooper was
in 1820 called in to George IV., who afterwards insisted on his
performing a small operation upon him, although he then held no court
appointment. He was very reluctant, fearing erysipelas, and only at
length yielded to command. His success in this was followed by the
conferment of a baronetcy, which was hailed with acclamation by all
his friends both professional and public.

In 1822 Sir Astley first became an Examiner at the College of
Surgeons. In this capacity he was very conscientious and considerate,
never asking catch-questions, or making abstract inquiries, but
invariably dwelling upon practical matters, and putting his questions
in simple and straightforward language. In the same year appeared
perhaps his most important work, that on Dislocations and Fractures
of the Joints, and as was his fixed principle, he published it at
a price just sufficient to cover the cost of the letterpress and
engravings.

In January 1825 Sir Astley resigned his lectureship at St. Thomas’s,
owing to the impairment of his health. Mr. Key had previously been
delivering part of his surgical course, and his nephew Bransby
Cooper had undertaken the anatomical lectures; and Sir Astley was
determined to secure their succession to his appointments. He had
only resigned in the firm conviction that this was generally agreed
upon. His astonishment may be imagined when he learnt that Mr. South
had been appointed anatomical lecturer. Sir Astley, desiring to
withdraw his resignation, was informed that it was too late. Mr.
Harrison, however, the then spirited treasurer of Guy’s, came to
the rescue, and offered to establish a school of medicine at Guy’s,
totally independent of St. Thomas’s, and to appoint Mr. Key and Mr.
Bransby Cooper to the chairs of surgery and anatomy. This was at
once agreed to, and a lecture theatre and other premises hastily
built during the summer, so that the new school of Guy’s was opened
in the succeeding October. A large proportion of the old pupils of
the united schools of St. Thomas’s and Guy’s entered at Guy’s, and a
considerable number of new pupils coming up, the now famous school
was prosperously floated. Sir Astley did not lecture much for the
new school, though he gave a few occasional lectures on anatomy
and surgery, which of course were crowded to excess. He now became
consulting surgeon to Guy’s, and evidenced his zeal by commencing the
formation of a museum like that which he had already deposited at St.
Thomas’s, and which he would have removed thence had it been in his
power. In 1827 he was elected President of the College of Surgeons.

By this time Sir Astley had adopted the habit of spending as much
of his time as possible on his estate at Gadesbridge, near Hemel
Hempstead. Here he became a rural character, shooting and “making
shoot” with eagerness and joviality. Lady Cooper, having lost
her adopted daughter, Mrs. Parmenter, and having had no second
child, could not endure living in London. In 1825, Sir Astley took
his home-farm upon his hands, and kept it in consummate order,
at considerable expense, it must be owned. He was always either
experimenting or trying to carry out some new plan he had heard of
or observed. He again and again became violently angry, as he grew
older, when he found that his ideal farm only produced substantial
loss: and used repeatedly to vow he would never allow such passion
to overcome him again. One of his experiments in farming was the
purchase of lame or ill-fed horses at Smithfield at from five
to seven pounds apiece, feeding and doctoring them himself at
Gadesbridge, and turning them into much better animals. He sometimes
made a good profit in this way, and for years drove in his own
carriage horses that had only cost him twelve pounds ten. If they
were past cure, he would experiment upon them according to what
investigation he might have in progress at the time.

Lady Cooper’s death in June 1827 was a heavy blow to Sir Astley, and
he was so much affected by it that he resolved to retire altogether
from practice. Before the end of the year, however, he found the
_ennui_ of retirement insupportable, and returned to town and full
practice again. He was married a second time to Miss C. Jones in July
1828. The same year he was appointed Sergeant-Surgeon to the King,
an appointment in which he was continued at William IV.’s accession.
Having no lectures, he still dissected, and occupied himself largely
with completing his various works for the press. His “Illustrations
of Diseases of the Breast” appeared in 1829, and was followed by
“Diseases of the Testis,” 1830, “The Anatomy of the Thymus Gland,”
1832. He was for a second time President of the Royal College of
Surgeons in 1836.

In his old age, even when travelling about, Sir Astley never lost his
passion for dissecting, and always visited every hospital and surgeon
of note on his travels. He never liked staying more than a few days
in one place; he soon began to pine after his accustomed pursuits. On
several occasions, when detained longer than he liked in one place,
he would get up early and leave by coach for London, without giving
any warning of his intention.

On a visit which he made to Edinburgh in 1837, the freedom of the
city was conferred upon him and the honorary LL.D. He had previously
been made D.C.L. of Oxford. He continued his anatomical and surgical
investigations to the last, publishing a splendid work on the
Anatomy of the Breast in 1840, preliminary to a complete account
of the diseases to which it is liable, which was never completed.
He died on the 12th of October 1841, in the seventy-third year of
his age, at Conduit Street, where he had practised latterly. He was
buried, by his own particular request, beneath the chapel of Guy’s
Hospital. A statue of him, by Baily, was erected, chiefly by the
members of the medical profession, in St. Paul’s Cathedral, near
the southern entrance. An admirable portrait of him by Sir Thomas
Lawrence exists. Sir Astley’s name is commemorated by the triennial
prize essay of three hundred pounds for the best original prize essay
on a professional subject, to be adjudicated by the physicians and
surgeons of Guy’s, who may not themselves compete.

A criticism on Sir Astley during his life accorded to him a great
share in establishing pure induction as the only sure means of just
diagnosis, and in introducing a simplicity of treatment in accordance
with the processes of nature. Before his time, operations were too
often frightful alternatives or hazardous compromises; he always made
them follow, as it were, in the natural course of treatment; and he
succeeded in a great degree in divesting them of their terrors by
performing them unostentatiously, confidently, and cheerfully. He
stated an opinion and fact to the Committee on Medical Education,
which might well have been borne in mind by some examiners since his
day: “Whenever a man is too old to study, he is too old to be an
examiner; and if I laid my head upon my pillow at night, without
having dissected something in the day, I should think I had lost
that day.” Sir Astley left among his private papers an estimate of
himself, written in the third person, which is worth quoting. “Sir
Astley Cooper was a good anatomist, but never was a good operator
where delicacy was required. He felt too much before he began ever to
make a perfect operator.... Quickness of perception was his forte,
for he saw the nature of disease in an instant, and often gave
offence by pouncing at once upon his opinion. The same faculty made
his prognosis good. He was a good anatomist of morbid, as well as of
natural structure. He had an excellent and useful memory. In judgment
he was very inferior to Mr. Cline in all the affairs of life.... His
imagination was vivid, and always _ready_ to run away with him if he
did not control it.”

“His principle in practice was, never to suffer any who consulted him
to quit him without giving them satisfaction on the nature and proper
treatment of their case.”

Finally, he says, what is a fitting close to this narrative of his
career, “My own success depended upon my zeal and industry; but for
this I take no credit, as it was given to me from above.”

       *       *       *       *       *

Another pupil of John Hunter, a man of very different mould, in
several respects more akin to the master than Sir Astley, now claims
our attention. Unlike many of the great men whose achievements we
have recorded, JOHN ABERNETHY was born in London, in the parish
of St. Stephen’s, Coleman Street, on the 3d of April 1764. He was
the second son of John Abernethy, merchant, descended from an
Irish-Scotch family which had furnished more than one noted man to
the Protestant dissenting ministry in Ireland. While very young he
was sent to the Wolverhampton Grammar School under Dr. Robertson.
Here he was reputed studious and clever, but was evidently passionate
as well as humorous. The severe discipline common at that time does
not seem to have worked very well with Abernethy, for he came out
of it more excitable and impatient than he had been previously.
School days were over at fourteen, however, and at fifteen the
youth was apprenticed to Mr., afterwards Sir Charles, Blicke,
his father’s neighbour in Mildred’s Court, one of the surgeons
to St. Bartholomew’s Hospital. His own desire was to enter the
legal profession, in which his fine memory would have rendered him
important service; but his father did not agree with this choice,
and the medical profession was selected. His master was an empiric;
but Abernethy early determined to get to the bottom of things as far
as possible, and engaged in investigations on his own account. The
bent of his mind towards treatment by diet is shown by the following
statement. “When I was a boy,” he said, “I half ruined myself in
buying oranges and other things, to ascertain the effects of
different kinds of diet in this disease” (of the kidney).

Abernethy’s interest in anatomy and surgery was first effectively
stimulated by Sir William Blizard, who lectured at the London
Hospital, and he warmly acknowledged this in his introductory lecture
at the College of Surgeons in 1814, when he succeeded Sir William
as professor. He was soon selected to dissect for Sir William’s
lectures; he derived much benefit from Pott’s surgical lectures at
St. Bartholomew’s, and from Dr. Marshall’s lectures in Holborn;
but was most powerfully influenced by John Hunter, who noted him
among his most intelligent pupils. The opportunity of becoming an
assistant-surgeon, being reserved to apprentices of the surgeons
to St. Bartholomew’s, came early to Abernethy, for his master’s
promotion to the surgeoncy led to his election as assistant-surgeon
in July 15, 1787, when only twenty-three years old, by a majority of
fifty-three to twenty-nine votes. But he was under the necessity,
owing to his senior’s remaining so long in office, of continuing as
assistant-surgeon for the long period of twenty-eight years.

The young surgeon soon began to put his original powers in evidence
by starting as a lecturer. Mr. Pott had for years given a course of
lectures on surgery, but no other lectures had been delivered, and
the medical school of St. Bartholomew’s must be regarded as owing its
establishment to Abernethy. To be the life and soul of a new school
is enough for any man in his maturest years; it was more than enough
for Abernethy, beginning at twenty-three, when everything was new,
and precedents were few, and when his own faculties and studies still
lacked much. To this we must largely attribute the worn-out look
which began to settle upon his face from the age of fifty. He was
not content in his lecturing with any dry and orderly narration, but
combined with his descriptive account the purposes of a structure,
the diseases and accidents to which it is liable, and illustrations
from comparative anatomy. He for a long time included in his courses
at once anatomy, physiology, pathology, and surgery; at the same time
he kept up his attendance on John Hunter’s lectures, and diligently
studied in the wards of the hospital. His industry at this period
was such that he rose at four, and sometimes went into the country
that he might read with less interruption. It may seem strange, in
connection with the well-known brusqueness of his manner, to read
that he had an unconquerable shyness in his early years of lecturing,
which often made him retire from the theatre to regain his composure
before being able to commence his lecture. But this shyness is often
a concomitant of real talent and originality before it has found
means to display itself effectively; and brusqueness is in not a few
instances the cloak of timidity. When his dramatic instincts had
led him into his true path, he soon gained in ease, and his classes
increased so rapidly that in 1790 the governors of St. Bartholomew’s
resolved to build him a theatre, which was opened in October 1791.

Abernethy’s style in lecturing is described by those who heard him
as unique both in communicating his ideas and in interesting his
pupils. When his style had fully developed, it was spoken of as
“Abernethy at Home.” His mode of entering the lecture-room, says
Pettigrew, was often irresistibly droll; his hands buried deep in
his breeches-pockets, his body bent slouchingly forward, blowing or
whistling, his eyes twinkling beneath their arches, and his lower jaw
thrown considerably beneath the upper. Then he would cast himself
into a chair, swing one of his legs over an arm of it, and commence
his lecture in the most _outré_ manner. The abruptness, however,
never failed to command silence, and rivet attention.

“‘The count was wounded in the arm—the bullet had sunk deep into
the flesh—it was, however, extracted—and he is now in a fair way of
recovery.’ That will do very well for a novel, but it won’t do for
us, gentlemen: for ‘Sir Ralph Abercromby received a ball in the thick
part of his thigh, and it buried itself deep, deep: and it got among
important parts, and it couldn’t be felt; but the surgeons, nothing
daunted, groped, and groped, and groped,—and Sir Ralph died.’”
Thus he would introduce an admirable discourse on gunshot wounds,
reprobating in the strongest language the perilous and painful
practice of making prolonged searches for bullets in important
organs. He always illustrated his subject by telling anecdotes,
frequently of a side-splitting character, and so compelled his pupils
to remember his doctrines.

His mental abstraction was not unfrequently manifested strikingly in
the lecture-theatre. On one occasion it is related of him that at an
introductory lecture at St. Bartholomew’s, when he had been received,
as usual, with great applause, he appeared utterly indifferent to it,
but quietly casting his eyes over the assemblage, burst forth in a
tone of deep feeling, “God help you all! what is to become of you!”

His dramatic power was much employed in imitating his patients’
peculiarities, with a mixture of the serious and the humorous which
was most effective. Many of his stories were most apt in their
bearing on some important fact or principle. One of these we may be
allowed to quote from Macilwain.[18]

“Ah, there is no saying too much on the importance of recollecting
the course of large arteries; but I will tell you a case. There was
an officer in the navy, and as brave a fellow as ever stepped, who
in a sea-fight received a severe wound in the shoulder, which opened
his axillary artery. He lost a large quantity of blood, but the wound
was staunched for the moment, and he was taken below. As he was an
officer, the surgeon, who saw he was wounded severely, was about
to attend to him, before a seaman who had been just brought down.
But the officer, though evidently in great pain said: ‘Attend to
that man, sir, if you please, I can wait.’ Well, his turn came; the
surgeon made up his mind that a large artery had been wounded; but
as there was no bleeding, dressed the wound, and went on with his
business. The officer lay very faint and exhausted for some time,
and at length began to rally again, when the bleeding returned; the
surgeon was immediately called, and not knowing where to find the
artery, or what else to do, told the officer he must amputate his arm
at the shoulder-joint. The officer at once calmly submitted to the
additional but unnecessary suffering; and as the operator proceeded,
asked if it would be long; the surgeon replied that it would be soon
over; the officer rejoined: ‘Sir, I thank God for it!’ but he never
spake more.”

Amidst death-like stillness, Abernethy quietly concluded: “I hope you
will never forget the course of the axillary artery.”

It has been, we believe, a somewhat general impression, that
Abernethy as a lecturer indulged in tricks or extraordinary
gesticulations. But this is by no means correct. There was a method
in every item of his procedure, and all he aimed at was to impress
upon the students’ minds in the most forcible and abiding way the
ideas he wished to convey. He gained, it is said, the appearance
of perfect ease without the slightest presumption; and had no
offensive tricks. Macilwain, who was his pupil at his best period,
says: “The expression of his countenance was in the highest degree
clear, penetrative, and intellectual; and his long but not neglected
powdered hair, which covered both ears, gave altogether a philosophic
calmness to his whole expression that was peculiarly pleasing. Then
came a sort of little smile, which mantled over the whole face,
and lighted it up with something which we cannot define, but which
seemed a compound of mirth, archness, and benevolence.... There was a
sort of running metaphor in his language, which, aided by a certain
quaintness of manner, made common things go very amusingly. Muscles
which pursued the same course to a certain point, were said to travel
sociably together, and then to _part company_. Blood-vessels and
nerves had certain habits in their mode of distribution, contrasted
in this way; arteries were said to _creep_ along the sides of
or between muscles: nerves, on the contrary, were represented
as penetrating their substance _without ceremony_.... He was
particularly happy in a kind of cosiness or friendliness of manner
which seemed to identify him with his audience; as if we were all
about to investigate something interesting _together_, and not as if
we were going to be ‘lectured’ at at all. He spoke as if addressing
each individual, and his discourse, like a happy portrait, always
seemed to be looking you in the face.”

In consultation or in ordinary practice, Abernethy was only rough and
hasty when something annoyed him. Towards his fellow-practitioners
who could give a reason for their opinions or their treatment, he
was polite and even deferential. He never recommended interference
with judicious plans of cure in order to gain _éclat_ for himself,
nor unless some important end were to be obtained. He was no party
to concealments or deceptions being practised on the friends of
patients, and in many cases told the plainest of plain truths to
patients themselves. “Pray, Mr. Abernethy, what is a cure for gout?”
was the question of an indolent and luxurious citizen. “Live upon
sixpence a day—and earn it,” was the cogent reply. He is reported to
have been consulted by the Duke of York; and to have stood before
him, as usual, whistling, with his hands in his breeches-pockets. The
astonished Duke remonstrated: “I suppose you know who I am.” “Suppose
I do,” replied Abernethy, “what of that?” And he advised the Duke,
in reference to his complaint: “Cut off the supplies, as the Duke
of Wellington did in his campaigns, and the enemy will leave the
citadel.” A barrister came to Mr. Abernethy with a small ulcer on his
leg, which had proved difficult to heal. Having heard much of his
impatience and peculiar manners, he began to pull down his stocking
as soon as he entered his consulting-room. “Holloa! holloa! what the
devil are you at?” exclaimed the surgeon. “I don’t want to see your
leg; that will do, put it up, put it up.” The patient did so, but
marked his displeasure by placing only a shilling upon the table when
he left. “What is this?” asked Abernethy. “Oh,” replied his patient,
“that will do, put it up, put it up,” and coolly retired.

It is said that Abernethy’s impatience frequently arose from
his anxiety to be at his hospital duties; and that instead of
representing this in a proper manner, he would sometimes almost push
patients from his door. Sir Astley Cooper received many a fee from
those who had quitted Abernethy, or would not venture to encounter
his rudeness. To his hospital patients, especially those who were in
great distress, he was all kindness. Their gratitude was sometimes
amusingly demonstrated. Mr. Stowe relates one example of this: “It
was on his first going through the wards after a visit to Bath,
that, passing up between the rows of beds, with an immense crowd of
pupils after him, myself among the rest—the apparition of a poor
Irishman, with the scantiest shirt I ever saw, jumping out of bed,
and literally throwing himself on his knees at Abernethy’s feet,
presented itself. For some moments everybody was bewildered; but the
poor fellow, with all his country’s eloquence, poured out such a
torrent of thanks, prayers, and blessings, and made such pantomimic
displays of his leg, that we were not long left in doubt. ‘That’s the
leg, yer honnor! Glory be to God! Yer honnor’s the boy to do it! May
the heavens be your bed! Long life to your honnor! To the divole with
the spalpeens that said your honnor would cut it off!’ &c. The man
had come into the hospital about three months before, with diseased
ankle, and it had been at once condemned to amputation. Something,
however, induced Abernethy to try what rest and constitutional
treatment would do for it, and with the happiest result. With some
difficulty the patient was got into bed, and Abernethy took the
opportunity of giving us a clinical lecture about diseases and their
constitutional treatment. And now commenced the fun. Every sentence
Abernethy uttered Pat confirmed. ‘Thrue, yer honnor, divole a lie in
it. His honnor’s the grate dochter entirely!’ While at the slightest
allusion to his case, off went the bed-clothes, and up went the
leg, as if he were taking aim at the ceiling with it. ‘That’s it,
by gorra! and a bitther leg than the villin’s that wanted to cut it
off!’ This was soon after I went to London, and I was much struck
with Abernethy’s manner in the midst of the laughter. Stooping down
to the patient, he said with much earnestness: ‘I am glad your leg is
doing well; but never kneel, except to your Maker.’”

Many are the stories in which Abernethy’s name appears; many have
been exaggerated; many are falsely connected with his name. Sometimes
he would, instead of crushing a victim, become sufficiently the
victim himself. A lady once said to him: “I had heard of your
rudeness before, but I did not expect this.” When he handed her his
prescription, she asked: “What am I to do with this?” The rough reply
was, “Anything you like. Put it in the fire if you please.” The lady
took him at his word, laid down her fee, threw the prescription
into the fire, and left the room; nor could Abernethy persuade her
to receive her fee again, or a fresh prescription. Notwithstanding
all stories to his disadvantage, there is no doubt that Abernethy’s
intentions were most kind, and that he never took a fee from a
patient who might possibly be unable to afford it comfortably. For
these two reasons, his not unfrequent roughness, and his leniency
about fees, he certainly had a much smaller income than he might have
secured. Yet his income was very considerable, but not carefully
managed. One day calling to pay his wine merchant for a pipe of wine,
he threw down a handful of notes, and pieces of paper with fees. On
being asked to wait till all were accurately counted, as some of the
fees might be more than he thought. “Never mind,” said he, “I can’t
stop; you have them as I took them,” and hurried away.

It is now time to refer to some of Abernethy’s principal
publications. In 1793 he published his first volume of Surgical
and Physiological Essays, including his celebrated essay on lumbar
abscess, in which he details a simple and beautiful method of cure
which has since been largely followed. In the second volume of these
essays, a paper on the functions of the skin details some careful
experiments upon the air in which the hand or foot had been confined
for some time. He detected some carbonic acid in such air, and
founded upon the experiments important views as to the necessity of
keeping the skin cleansed and in healthy action. The third part of
these essays, published in 1797, contained an important paper on
injuries of the head, deprecating among other things all unnecessary
interference, and so preventing many a fruitless operation. In 1806
appeared Abernethy’s Surgical Observations, including an account of
the disorders of health in general, and of the digestive organs in
particular, which accompany local diseases, and obstruct their cure.
Whenever he wished to impress upon a patient or a practitioner the
importance of attending to the general health, and the stomach in
particular, if some local disease was to be cured, he always referred
to his book, so that his phrase “read my book” was expected as a
certainty. But it appeared sometimes as if he perceived disorder
of the digestive organs in every case. A lady who had an affection
outside the knee-joint occasioned by a blow against the edge of a
step, went to Mr. Abernethy, and was about to show the affected part,
when he rudely exclaimed, “I don’t want to see your knee, ma’am!
allow me,” and pressed his fist with force against her stomach. She
of course cried out, and he of course attributed her disorder to her
stomach. Nevertheless she recovered without medicine, by strictly
local treatment of the knee, under Dr. Pettigrew.

In all Abernethy’s writings there was manifested a lack of good
arrangement which contrasts strikingly with his excellence as a
lecturer: but in the latter capacity his audience was always before
him, and he could see and test the suitability of his matter.
Education had not furnished him with real literary training, and his
aptness of expression and his wit do not appear to striking advantage
in his written works.

Abernethy was married on the 9th January 1800 to Miss Anne Threlfall,
whom he had met at a house to which he had been professionally called
in. His courtship was brief; his proposals were made by letter; he
characteristically deprecated too much “dangling,” gave the lady a
fortnight to consider her reply; and was successful. Not for one day
did he interrupt his hospital lectures.

In 1815, after twenty-eight years’ tenure of the office of
assistant-surgeon, Abernethy became full surgeon on the retirement
of his old master, Sir Charles Blicke. He made the appointment
the occasion for publishing a pamphlet on the evils attending the
prolonged tenure of office by old surgeons. He himself had lectured
for twenty-eight years, and been largely influential in filling the
hospital with students, from whose hospital fees he received nothing
whatever. About the time of his succession to the surgeoncy he took a
house at Enfield, to which he resorted on Saturdays, gladly quitting
his own house in Bedford Row for a quiet country ride. In the summer
he would retire to Enfield on most evenings. This tended very much to
the benefit of his fidgety nervous system. From early life his heart
had been particularly irritable, causing him frequent suffering. A
wound which he accidentally gave himself in dissecting at one time
caused him such a severe illness that it was three years before he
had recovered from its effects, which appeared in very varied forms.
It must be acknowledged, too, that he was not as moderate in eating
as he exhorted his patients to be. He frequently was attacked by
inflammatory sore-throat, terminating in abscess.

Abernethy resigned his professorship at the College of Surgeons in
1817, and was gratified by a resolution sent to him, thanking him
for the distinguished energy and perspicuity which had characterised
his lectures. This resignation, however, was not sufficient relief
to his overstrained system, which was now often tormented with
rheumatism. He took insufficient care of himself, would walk down
from Bedford Row to the hospital in knee-breeches and silk stockings
when it was raining, without a thought of protecting himself from
a drenching. With very cold feet he would stand opposite one of
the flue openings in the museum, and this with other imprudences
gradually sapped his strength. At the age of sixty, according to
the plan he had suggested and strongly advocated, he resigned his
appointment as surgeon, but the governors would not accept it. He was
persuaded to remain in office some time longer, but finally resigned
on July 24, 1827. The succeeding winter was the last in which he
lectured, and in 1829 he gave up his examinership at the College of
Surgeons. He had now become very lame, thin and old-looking. His eye
retained its expressiveness, but showed evidences of the continual
pain he suffered. He died on the 20th April 1831, quite worn out, but
conscious to the last: he was buried in the parish church of Enfield.
Thus early, like John Hunter, died one of his pupils, who, in the
words of the Duke of Sussex at the anniversary meeting of the Royal
Society in 1831, appears the most completely to have caught the bold
and philosophical spirit of his great master.


FOOTNOTES:

[17] Life of Sir Astley Cooper, i. 334-448.

[18] Memoirs of John Abernethy.




CHAPTER VIII.

_SIR CHARLES BELL AND THE FUNCTIONS OF THE NERVOUS SYSTEM._


It will have been gathered that scientific medicine and surgery were
as yet scarcely in a condition to begin. After the discovery of the
circulation of the blood physiological research seemed to halt,
waiting on anatomy. It now took an immense and decided leap forward.

CHARLES BELL was descended from a family long settled in Glasgow; but
his grandfather becoming a minister of the Scotch Church, settled in
Gladsmuir, Haddingtonshire, and died young; and his father, William
Bell, born 1704, was a minister of the Scottish Episcopal Church
in Edinburgh. Here he suffered from all the persecution inflicted
on Episcopalians in Scotland after the Young Pretender’s rising in
1745. Episcopal ministers were forbidden to officiate to more than
four besides the family; and later, an Act was passed to forbid any
one in holy orders to officiate in a house of which he was not the
master. William Bell’s first wife dying in 1750, leaving no surviving
children, he married in 1757 Margaret Morice, grand-daughter of
Bishop White, who became the mother of Robert Bell, author of the
Scotch Law Dictionary; John Bell, the celebrated surgeon; George
Joseph Bell, Professor of the Law of Scotland in the University of
Edinburgh, and author of the Commentaries on the Law of Scotland; and
Sir Charles Bell. The father of these four eminent sons died in 1779,
when Charles was but five years old.

The straitened circumstances in which the family were left at
the father’s death resulted in knitting them closely together in
their common struggle. The affection which existed through life
between George Joseph Bell and Charles, four years younger, is one
of the most delightful on record. Much of the brothers’ education
was the result of their own efforts. George relates that although
his schooling cost but five shillings a quarter, it had to be
discontinued when he was eleven years old. Mrs. Bell aided her
children with French and drawing, and had a considerable share in
bringing forth that talent for drawing which afterwards was of such
advantage both to John and Charles.

Although Charles was some time at the High School at Edinburgh, he
most emphatically declares that he received no education but from his
mother, and the example set him by his brothers, all of whom showed
a true independence and self-reliance. He says: “For twenty years of
my life I had but one wish—to gratify my mother and to do something
to alleviate what I saw her suffer.” When she died, the blank and
indifference produced in his whole nature were so great, that all
ambition seemed to die out of him for a long time.

His brothers made a plaything of him in childhood, but yet appeared
confident of his future. They were wont to say: “Oh, never mind,
Charlie will do very well. No fear for Charlie.” Yet in after life
he greatly regretted that his early education was limited, and he
took very great pains to improve what was deficient. Even within the
last few years of his life he engaged French and Italian masters to
read with him, although he could read both languages before he left
Edinburgh.

Taking up the study of medicine under the guidance and tuition
of his elder brother John, who was already becoming notable as a
lecturer, he very rapidly found his true vocation, and gained such
proficiency that before he was twenty-one he was able to take part
of his brother’s lectures. In 1799 he published the first part of
his “System of Dissections.” Edinburgh, then embittered by the
controversy between his brother and Dr. Gregory, and other untoward
occurrences, did not give him fair scope for his talents; and it
was decided that Charles should adventure himself in London. This
was an enterprise of hardihood at that time, for Scotchmen were
still looked upon with suspicion; yet he had already become known
in London by his association with John Bell in the “Human Anatomy,”
by the first two volumes of his “System of Dissections,” and by his
engravings of the arteries, brain, and nerves. The impression made
upon him by his first experience of London, on a Sunday in November,
was thus expressed: “If this be the season that John Bull selects
for cutting his throat, Sunday must be the day, for then London is
in all its ugliness, all its naked deformity; the houses are like
ruins, the streets deserted.” He was soon rather unceremoniously
told by a hospital surgeon that they could manufacture their own raw
material, and if he had difficulties in Edinburgh, he would have more
in London. Some of his early friends in London were cautioned that he
was a sharp insinuating young man, who would drive them out of their
hospitals. His friend Lynn answered such an innuendo thus: “I liked
his brother, and I like himself. He is no humbug. His conversation
is open and free.” Lynn indeed discerned that a worthy successor of
William Hunter was among them.

Charles Bell gained considerable notice by his criticisms on artistic
anatomy, and by the profound knowledge of the human body which he
made evident. The manuscript of his “Anatomy of Expression” being in
a forward state, it was shown to many persons of influence, including
Sir Joseph Banks (President of the Royal Society), Benjamin West,
Sydney Smith, &c., and the general opinion was that he would make a
great name. But Charles did not deceive himself into the idea that
his path into situations of importance would be easy. “I can make a
few good friends,” he says, “but cannot engage the multitude.”

After many discouragements, having at one time resolved to return
to Edinburgh, Mr. Bell took a house, formerly Speaker Onslow’s, in
Leicester Street, Leicester Square, and fitted up a lecture-room in
it. Here he started as a public lecturer on anatomy and surgery, with
an attendance of forty, but only three paying pupils, on January 20,
1806; and the second lecture was delivered to an audience of ten. In
February he lectured to a dozen artists, much to their delight. On
the 10th February 1806, after nearly fifteen months in London, he
received his first fee in consultation.

Many years afterwards, looking back upon this period of severe
struggle, he wrote: “When I consider the few introductions I then
had—to men who could be of no assistance to me—I look back with a
renewal of the despair I then felt.... These days of unhappiness and
suffering tended greatly to fortify me, so that nothing afterwards
could come amiss, nothing but death could bring me to a condition
of suffering such as I then endured.... I could not help regretting
the noble fields that were everywhere around me for exertion in my
profession, and which I found closed against me.” Meanwhile youthful
acquaintances in Edinburgh, Horner and Brougham, were getting places
in the ministry.

This year his “Anatomy of Expression” was published, and was at
once received with high favour, many painters adopting it as their
text-book. Flaxman declared he considered Mr. Bell had done more for
the arts than any one of that age. Fuseli called it truly valuable.

Charles Bell had more than an ordinary measure of liveliness,
good-humour, and geniality. One day he writes: “A band of Pandæans
are playing before my window. They make me frisk it. Last night I had
a little supper here, with some good flute-playing. It was intended
to make Horner know Wilkie, the Scotch Teniers.” All through life he
retained this sensibility to lively music. The sound of a familiar
Scotch air would start him whistling, and laying aside work, he would
take his wife by the hand, and make her dance with him through room
after room.

By the autumn of 1807, his note as a surgeon had grown, and
patients became numerous. His lectures on surgery, too, became
an unqualified success, though the number of paying pupils was
small. In 1808, however, he had thirty-six pupils. His studies for
his lectures were most faithfully and zealously prosecuted. His
lectures were most original: his discoveries were given step by
step to his class-pupils. The first record of his results in regard
to the nervous system is in a letter of 26th November 1807, when
he writes: “I have done a more interesting _nova anatomia cerebri
humani_ than it is possible to conceive.” This developed gradually
into an introduction to the Nervous System, which was shown to many
in manuscript. Meanwhile the Professorship of Anatomy at the Royal
Academy was about to become vacant, and Mr. Bell’s candidature was
warmly advocated by many of the most eminent surgeons and artists.
Abernethy desisted from the idea of candidature in his favour. Wilson
was dissuaded from competing. Sir Astley Cooper wrote a letter
stating that he beyond all comparison merited the post, and would
be an invaluable acquisition to the Royal Academy. But in the end,
Mr., afterward Sir Anthony, Carlisle was elected, and lectured to but
four pupils in his first course. It is to be remembered that even
at hospitals, lectures were by no means common things at this time.
Several of the most eminent hospital surgeons did not lecture at all,
or only lectured occasionally. So that Bell’s class of thirty-six was
really a first-rate one.

A mark of his original and painstaking mode of making progress was
seen in the visit he paid to Haslar Hospital, when the wounded
soldiers from Corunna arrived home, in January 1809. The scene was
a most striking and impressive one to his feeling nature. “I have
stooped,” he says, “over hundreds of wretches in the most striking
variety of woe and misery, picking out the wounded. Each day as I
awake, still I see the long line of sick and lame slowly moving
from the beach: it seems to have no end. There is something in the
interrupted and very slow motion of these distant objects singularly
affecting.” From the cases he saw he gained much; and laid the
foundation of his essay on Gunshot Wounds, appended to the second
edition of his “Operative Surgery.”

In 1810 Charles Bell became engaged to his future wife, Marion Shaw,
whose sister Barbara had for some years been married to his brother
George. Their brothers, John and Alexander, became Charles Bell’s
pupils and assistants. In writing to Miss Shaw at one time Mr. Bell
revealed to her much of the sadness and melancholy of his first years
in London, oppressed by the consciousness of not occupying a position
corresponding to his talents, and finding everywhere difficulties.
“Many and many a time in the prosecution of my plans of life have I
wished that I were with the armies, to rid myself of the load of life
without discredit.” He was married on the 3d of June, 1811.

The next year was another important landmark in Charles Bell’s
life. He accepted an offer of partnership with Mr. Wilson in the
Great Windmill Street School of Medicine. His own preparations and
drawings, &c., were added to the museum already there, and his joy at
seeing the two united was great and unmixed. His first lecture in the
school was to a class of 80 to 100 pupils. He was at the height of
his ambition in being connected with the celebrated Windmill Street
School. Mr., afterwards Sir Benjamin, Brodie, Dr. Roget, and Dr.
Brande were among his associates in lecturing. His new house (34 Soho
Square) had as many resident pupils as he could accommodate; and he
was not yet forty years old.

In 1813 he was admitted into the Royal College of Surgeons. A formal
examination being necessary, he records with amusement that the
facetious dogs asked him of what disease he thought Buonaparte
would die. In 1814 he was elected by a large majority surgeon to
Middlesex Hospital, and immediately began to make great use of
his new opportunities. His operations and clinical lectures soon
became attended by large numbers of students, and even eminent
practitioners. A Russian General, Baron Driesen, having a ball in his
thigh, was placed under his care, and especially commended to him
by the Czar Alexander. A fee of £200 and two silver cups were his
reward, as well as great personal regard from both the General and
his aide-de-camp.

When the stirring news of Waterloo arrived in London, the same
spirit which had animated him after Corunna, impelled Mr. Bell
to start off, accompanied by John Shaw, to render assistance to
the wounded. The amount of work was appalling. Nothing was ready,
to cope with the mass of misery suddenly accumulated. Mr. Bell,
finding after an inspection of the situation that he could do most
by taking in hand the needful operations upon the French wounded,
commenced his operations at six one morning and continued incessantly
operating till seven in the evening, and so on for three consecutive
days. While he amputated one man’s thigh, there lay at one time
thirteen others waiting, all begging to be taken next. “It was a
strange thing,” he says, “to feel my clothes stiff with blood, and
my arms powerless with the exertion of using the knife; and more
extraordinary still, to find my mind calm amidst such variety of
suffering; but to give one of these objects access to your feelings
was to allow yourself to be unmanned for the performance of a duty.”

It appears strange that a man who in 1807 had commenced what proved
to be such an epoch-making series of discoveries in regard to the
nervous system should have so long allowed them to lack general
publicity. His manuscript was first shown to his brother and other
friends in 1808. But it is to be noted, that when in 1811 he
privately circulated a pamphlet under the title of “An Idea of a New
Anatomy of the Brain,” submitted for the observation of the author’s
friends, they received it with but scant appreciation, and either
failed to regard it as remarkably novel, or considered the views it
put forth incredible. At this period, while the brain was believed
to be the organ of thought, it was also supposed to discharge some
nervous fluid through the spinal cord to the nerves. Little was
accurately known about the functions of the nerves: even John Bell
and Astley Cooper had advised the section of the facial nerve to cure
tic, thus paralysing the muscles of the face instead of relieving the
pain. Microscopy had not yet revealed the multitudinous fibres of
which nerves are composed, and experimental evidence was confined to
comparatively coarse forms. Thus on cutting across the main trunk of
a nerve, both sensation and motion were lost in the parts supplied
by the nerve. Bell first disentangled the functions of sensation
and motion, and found that they were carried on through distinct
nerve fibres. He noticed the distinct properties of the nerves of the
senses, for instance the fact that a prick of the optic nerve in an
operation caused a flash of light to be perceived, not a sensation of
pain: when the pricking of certain papillæ of the tongue gave rise
to a sensation of taste, not of pain, and when a blow upon the ear
occasioned the hearing of noises. Thus he acquired the conception
that in the brain the powers of the nerves were distinct and
peculiar, and due to the portion of the brain from which they started.

Seeing that in the vast number of the nerves of the body the
functions of sensation and motion were evidently combined, Bell
imagined that these nerves consisted of different portions tied
together, and he sought for a method of determining how they were
combined. The separate portions in which the spinal nerves enter the
spinal cord, forming two roots, anterior and posterior, occurred
to him as furnishing a possibility of experimental inquiry. He
now resolved to make crucial experiments on living animals, which
should settle the question by a well-devised plan of procedure.
No man was more averse to giving unnecessary pain than Charles
Bell; no man felt more keenly the sufferings of his patients. The
first brief record of the results is as follows: “Experiment 1. I
opened the spine and pricked and injured the posterior filaments of
the nerves—no motion of the muscles followed. I then touched the
anterior division—immediately the parts were convulsed. Experiment 2.
I now destroyed the posterior part of the spinal marrow by the point
of a needle—no convulsive movement followed. I injured the anterior
part, and the animal was convulsed.” It was at once inferred that the
anterior root of the spinal nerves was motor in its functions, the
posterior root sensory.

This simple fact revolutionised the physiology of the whole subject.
We cannot now realise the novelty which there was in attaining this
extent of knowledge of the nervous system, or how valuable this firm
basis was in commencing to unravel the nervous mechanism. We cannot
here detail the experiments and trains of reasoning by which it was
shown that the fifth cranial nerve was similar in its general plan
to the spinal nerves, including distinct sensory and motor portions;
and by which the knowledge of the cranial nerves generally was
widely extended. We note now that Bell’s first paper on the Nervous
System was read before the Royal Society on the 21st July 1821, and
was received with great approbation. It soon became generally known
throughout Great Britain and on the Continent, being by almost every
one acknowledged as strikingly original. The dispute which afterwards
arose as to his perfect originality and independence having been
so conclusively settled in Mr. Bell’s favour by the production of
his original pamphlet, manuscript and letters, no account of the
controversy need here be given. He himself fully felt the importance
of his discoveries: “I have made a greater discovery than ever was
made by any one man in anatomy,” he says, not vaingloriously, but as
a simple perception of the fact.

The application of the new knowledge to the elucidation of many
obscure diseases, where the nervous system was affected, engaged
Charles Bell’s zealous attention. He speedily classified and
arranged cases illustrative of the action of the motor and sensory
nerves, cases where the muscles of the face were paralysed, as well
as various kinds of paralysis throughout the body. Instances of
partial or local pain were explained in their relation to the nerves
concerned; disorders of the eye, tongue, muscles of respiration, &c.,
all received new illumination from his researches.

A further discovery was that of the muscular sense, by which we
perceive many of the qualities of objects surrounding us, and which
even enables us to stand upright. The sensation of the degree of
muscular effort put forth in every action, in every resistance,
to a large extent builds up our judgments about external objects,
and determines our actions; and the recognition of the fact that
we perceive this by a sense distinct from touch is due to Bell.
The study of the eye entered very largely into this question, as
the muscular movements of the eye are of such extreme import in
our perceptions. In 1818 he wrote: “I think I have made out that
squinting depends on the over-action of one of the oblique muscles,
and that it may be cured by an operation. I am looking out for a
patient to try this upon.” But for want of a squinting monkey to
make the first trial upon, the thought was not carried to practical
results, and it remained for others to mature the operation for the
cure of squinting.

As a specimen of Bell’s style in popular writing, to which he devoted
great pains, we quote from his Bridgewater Treatise on “The Hand”
a passage dealing with the movements of the eye. “On coming into a
room, we see the whole side of it at once—the mirror, the pictures,
the cornice, the chairs; but we are deceived: being unconscious
of the motions of the eye, and that each object is rapidly, but
successively, presented to it. It is easy to show that if the eye
were steady, vision would be quickly lost; that all these objects,
which are distinct and brilliant, are so from the motion of the eye:
that they would disappear if it were otherwise. For example, let
us fix the eye on one point, a thing difficult to do, owing to the
very disposition to motion in the eye: but by repeated attempts we
may at length acquire the power of fixing the eye to a point. When
we have done so, we shall find that the whole scene becomes more
and more obscure, and finally vanishes. Let us fix the eye on the
corner of the frame of the principal picture in the room. At first,
everything around it is distinct; in a very little time, however, the
impression becomes weaker, objects appear dim, and then the eye has
an almost incontrollable desire to wander; if this be resisted, the
impressions of the figures in the picture first fade: for a time, we
see the gilded frame; but this also becomes dim. When we have thus
far ascertained the fact, if we change the direction of the eye but
ever so little, at once the whole scene will be again perfect before
us. These phenomena are consequent upon the retina being subject to
exhaustion.”

Considering the warmth with which the originality of Charles Bell’s
views was contested, it is indeed striking to notice how early he
composed himself to answer only by silence. “This must be,” he says,
“the mode in which my opinions shall come to be acknowledged: without
some agitation and controversy they would never be propagated. I am
satisfied I have a secure ground.”

In 1821 Wilson died, and Bell’s assumption of the chief
responsibility for the Windmill Street School, with heavy pecuniary
liabilities, followed. In 1824 he was appointed to the Professorship
of Anatomy and Surgery at the Royal College of Surgeons. So he set
himself with renewed energy to make his lectures of the utmost
value to practising surgeons. His first lecture was given to an
audience crowded to suffocation. The crowding continued at subsequent
lectures, many being unable to get admission.

On the 19th July 1827 his beloved brother-in-law and assistant,
John Shaw, died. His suffering from this loss was intense. In his
discoveries, his first great object had always been “to convince
Johnnie.” This faithful brother-in-law was fortunately replaced
by another, Alexander Shaw, afterwards surgeon to the Middlesex
Hospital, notable in after times as a defender of his fame and
expounder of his doctrines. In the same year was matured the project
long incubating, of a new London University (now University College),
in which Charles Bell was to be the head of the Medical School. He
delivered the inaugural lecture, and for some years took an active
part in its organisation. The arrangements, however, which were made
by the governing body were in many respects inconsistent with the
high ideal of teaching which Charles Bell had, and with the freedom
of procedure to which he had been for so many years accustomed at
the Windmill Street School. Consequently in 1830 he finally retired
from the new College, and felt in some respects stranded, for
discovery and teaching were his very life. Practice was to him an
irksome necessity. Thus a time of life in which practical success
might have made him wealthy was characterised by depression and
sadness, principally relieved by a very unusual recreation for a
hard-worked London practitioner, namely, fly-fishing. He was first
attracted to this sport by spending a day at Panshanger with his
bosom friend, John Richardson. The evident delight of his friend in
this occupation, and the freshness and relaxation which it afforded,
convinced him that he had found the thing he wanted to sweep from
his mind the cobwebs of professional life. Lady Bell says, “He was
often on the waterside before sunrise—indeed, before he could see his
flies; and he did enjoy these morning hours. I came down with his
breakfast, bringing books and arrangements for passing the whole day,
even with cloaks and umbrellas, for no weather deterred us. He liked
me to see him land his fish, and waved his hat for me to come.” In
the intervals of angling many of the best parts of his popular works
on the Hand and on Animal Mechanics were written.

In spite of the feelings of disappointment which oppressed him
severely on some occasions, it must not be imagined that he was
predominantly unhappy. Lord Jeffrey described him as “happy Charlie
Bell;” Lord Cockburn wrote: “If I ever knew a generally and
practically happy man, it was Sir Charles Bell.” Alexander Shaw said
of him: “His mind was a garden of flowers and a forest of hardy
trees. Its exercise in profound thought gave him high enjoyment;
yet he would often avow his pleasure in being still a boy, and he
did love life and nature with the freshness of youth. I therefore
repeat—if ever I knew a happy man, it was Sir Charles Bell.” Yet,
seeing that he was convinced, “that the place of a professor who
_fills his place_ is the most respectable in life,” we may believe
that a painful sense of ungratified desire was largely present if not
continually expressed. In 1835 he writes: “My hands are better for
operation than any I have seen at work; but an operating surgeon’s
life has no equivalent reward in this world... I must be the teacher
and consulting surgeon to be happy.”

In 1831, in connection with the accession of William IV., the
Guelphic order of knighthood was conferred on several distinguished
men of science, among whom Charles Bell was included. His association
with Herschel and Brewster in this honour was gratifying and
appropriate. A complete school of medicine was now projected in
connection with the Middlesex Hospital, in which he was to take a
prominent part. It had not, however, passed through three complete
months of its history, when the Town Council of Edinburgh elected Sir
Charles[19] to the Chair of Surgery in the University, and the offer
proved attractive enough to induce him to leave London. He had always
cherished the idea of a return to Edinburgh at some future time, and
it appeared to him that there was a possibility of a sphere of more
elevated usefulness there, than he could now hope for in London.
Moreover, his heart was in Scotland, in the streets of Edinburgh—in
the theatre where Monro had lectured to him—in the society of his old
friends Jeffrey, Cockburn, William Clerk, Adam Ferguson, and most of
all his brother George. “London is a place to live in, but not to
die in,” he said. “My comfort has ever been to labour for some great
purpose, and my great object of study has been attained.... There is
but one place where I can hope to fulfil the object of my scientific
labour, and that is Edinburgh; and that is an experiment.”

Successful as his classes were in Edinburgh, and influential as his
position speedily became, it must be acknowledged that the experiment
was a failure, for it did not give him the satisfaction he had hoped.
Practice in Edinburgh could not possibly yield what London did,
and the emoluments of the University chair did not counterbalance
this. Some coldness, too, was shown him on the part of his
fellow-professors. It was an old case of Scotch undemonstrativeness.
“I have had a German professor to breakfast,” he writes, “who brings
me a volume from Paris—they make me greater than Harvey. I wish to
heaven the folks at home would make something of me. I thought, in
addressing the new-made doctors at the conclusion of the session,
that I had done well; but not one word of approbation from any
professor, nor has one of them in all this time called me in to
consultation, except when forced by the desire of the patient.”
His income, never very considerable in Edinburgh, diminished
considerably. “I put down my carriage with as little feeling as I
throw off my shoes,” he says; but when in 1842 a Government proposal
appeared likely to end in the extinction of the privileges of his
beloved University, his excitement was unbounded. He set off for
London as soon as he could. But he was attacked by a spasm of the
stomach so severe as to threaten his life. He hastened on towards
London, but while at Manchester, assisting at an operation, he
thought he should have been obliged to lie and roll on the carpet, or
leave the room in the midst of it. On Wednesday April 27, 1842, Sir
Charles and Lady Bell reached Hallow Park, the seat of Mrs. Holland,
near Worcester. Looking on the winding Severn and the distant hills,
he said to his wife: “This is a novel spot; here I fain would rest
till they come to take me away.” Here he sketched an old yew-tree,
some sheep, and the river; then two children and a donkey. As he
went back he looked with his observant eye at every shrub, commented
on the birds’ notes, and gathered up their feathers for his flies.
After dinner the same evening he gave graphic sketches of medical
celebrities he had known, admired and discussed an engraving of
Leonardo da Vinci’s Last Supper, and was altogether so happy in mood
that he said to his wife: “Did you ever see me happier or better
than I have been all this forenoon?” yet he had been several times
that day in imminent danger of death from the dread malady that John
Hunter had, angina pectoris. We cannot refrain from quoting the
account of his end (Letters, p. 400): “The evening reading that night
was the 23d Psalm; the last prayer, that beautiful one, ‘For that
peace which the world cannot give,’ and then he sank into a deep and
quiet sleep. In the morning he awoke with a spasm, which he said was
caused by changing his position. His wife was rising to drop his
laudanum for him, but calling her to him, he laid his head on her
shoulder, and there ‘rested.’”

No more appropriate tribute has been paid to Sir Charles Bell than
that in the _Edinburgh Review_ for April 1872. The writer says (p.
429): “Never passed away a gentler, truer, or finer spirit. His
genius was great, and has left a legacy to mankind which will keep
his name fresh in many generations. But the story of his life has a
more potent moral. It is the story of one who kept his affections
young, and his love of the pure and the refined unsullied, while
fighting bravely the battle of life; whose heart was as tender as his
intellect was vigorous and original who, while he gained a foremost
place among his fellows, turned with undiminished zest to his home
and his friends, and found there the object, the reward, and the
solace of his life.”

He was buried near the yew-tree he had so lately sketched in Hallow
Churchyard. A plain stone, with his name, dates of birth and death,
and the line, “The pure in heart shall see God,” marked the spot. A
tablet was afterwards placed in the churchyard, with an inscription
written by his lifelong friend Francis (Lord) Jeffrey. Part of it
runs thus: “Sacred to the memory of Sir Charles Bell, who, after
unfolding with unrivalled sagacity, patience, and success, the
wonderful structure of our mortal bodies, esteemed lightly of his
greatest discoveries, except only as they tended to impress himself
and others with a deeper sense of the infinite wisdom and ineffable
goodness of the Almighty Creator.” His letters, edited by his widow
(1870), are a lasting memorial of his beautiful and noble nature.


FOOTNOTES:

[19] In December 1835.




CHAPTER IX.

_MARSHALL HALL, AND THE DISCOVERY OF REFLEX ACTION._


The character of MARSHALL HALL, who divides with Sir Charles Bell the
principal honours of discovery as to the nervous system, presents
a contrast to his in that it displays a mind more minutely active,
and more distinctly medical in its tone, combined with a marvellous
degree of detailed benevolence. Thus Hall’s reputation has, like
Harvey’s and John Hunter’s, grown largely since his death. Marshall
Hall was born at Basford near Nottingham on February 18, 1790,
his father, Robert Hall, having been a cotton manufacturer and
bleacher of ingenuity and originality. He first employed chlorine
as a bleaching agent on a large scale, his earliest attempts having
procured for his establishment the epithet of “Bedlam.” He was of
a very religious turn, too, being one of the early Wesleyans. The
strict but benevolent piety of his father, and the sweet and gentle
disposition of his mother, were favourable to the growth of high
morality, strict conscientiousness, and amiability of character in
their family, while the inventive ability of the father reproduced
itself in his second son, Samuel Hall, a prolific inventor, and no
less in his sixth son, Marshall. It is not often that a typically
good and inoffensive son has turned out so conspicuously original in
his work. But he had a saving fondness for boyish literature such
as Robinson Crusoe, and was full of fun and playfulness. He was
early sent to Nottingham to school with the Rev. J. Blanchard, the
instructor of Kirke White. Here he did not even learn Latin, although
his elder brothers had had classical instruction. French appears to
have been his only linguistic attainment: and the chief fact recorded
of his school-days is his thrashing a tyrannical “big boy” in the
school. But school was over for him at the age of 14, and he was
placed with a chemist at Newark. Soon finding his position irksome,
his friendship with a youth who was preparing for a medical career
led him to long for a similar course, and ultimately his father was
induced to send him to Edinburgh, whither he went in October 1809.
He had already indicated his future eminence by rising very early
to study medicine and chemistry, and giving as his reason: “I am
determined to be a great man.”

At Edinburgh he quickly distinguished himself by his diligent study
of anatomy; he was recognised as a student of the first rank, and
was chosen senior president of the Royal Medical Society in 1811.
Dr. Bigsby says of him: “Few men have changed during their progress
through life so little as Marshall Hall. As he began, so he ended,
delighting in the labour—the labour itself—of investigation.... All
the stores of knowledge which his predecessors had either gathered
or created, Marshall Hall was eager to acquire; a hardy, enduring
constitution seconding all his efforts.... All his energies were
directed to the formation of the skilful bedside physician, that is,
to the alleviation and cure of disease.” It was said of him, “Hall
never tires.” During his three years’ studentship he never once
missed a lecture. He graduated in June 1812, and was almost at once
appointed resident house physician to the Edinburgh Royal Infirmary.
Here his love of order, his zeal, and spirit of inquiry found full
scope, and he took extreme pains in the study of diagnosis. He gave
a voluntary course of lectures on the principles of diagnosis in
1813, which were the basis of his well-known work, first published in
1817. His usefulness to the younger students in the hospital was very
great, and equally striking was his good example of purity of life
and conversation, and constant cheerfulness. His puremindedness was
characteristic through life; Marshall Hall never attached himself to
any man of coarse mind or manners.

During his last year at Edinburgh the young physician, attracted
towards London practice, was prudently weighing the cost and risk of
such an enterprise. He decided in favour of a more modest course of
provincial practice, waiting till his book on Diagnosis should be
matured. As in later life, so now he was “strong in hope, inflexible
for truth and justice, but inexperienced in the ways of the world,
and unable to cope with the cunning, or to dissemble with the false.”
After a visit to Paris for some months he proceeded to Göttingen
and on to Berlin to visit the medical schools, walking alone and
on foot from Paris to Göttingen, more than six hundred miles, in
November 1814. After a brief period of practice in Bridgewater
he commenced practice at Nottingham in February 1817, and with
remarkable rapidity attained a leading position. In 1817 his work
on the Diagnosis of Diseases appeared, and at once marked him out
as a man of the highest originality, applying accurate observation
and classification of symptoms to the detection and distinction of
diseases. Of this book the _Lancet_ of August 15, 1857, remarked:
“Comprehensive, lucid, exact, and reliable, this work has, in the
main, stood the test of forty years’ trial. A better has not been
produced.” When Dr. Baillie, nephew of John Hunter and President of
the College of Physicians, first saw Marshall Hall, he complimented
him on being the son of the author of so extraordinary a work as that
on Diagnosis. Being modestly told that he himself was the author,
Baillie exclaimed: “Impossible! it would have done credit to the
greyest-headed philosopher in our profession.”

In 1818 Hall published a work on the affections usually denominated
Bilious, Nervous, &c., and in 1820 an essay in which the prevalent
custom of bleeding was attacked, especially in certain affections
occurring after childbirth, which under that treatment almost
invariably proved fatal. In 1822 this was followed by a small volume
on the Symptoms and History of Diseases, which was especially
valuable in treating of the detection of internal diseases. In 1824
appeared his important paper On the Effects of the Loss of Blood in
the “Medico-Chirurgical Transactions,” published also in an expanded
form in his “Medical Essays” in the same year. Before this time the
lancet was in hourly use, and Marshall Hall termed it “a minute
instrument of mighty mischief.” Almost all pain in any complaint,
quickness of pulse, headache, intolerance of light or noise, being
believed to arise from inflammation, blood flowed in torrents to
subdue it. It was by his various papers bearing on this question that
Dr. Hall became prominently known; for the dropping of the lancet
was an evident change of procedure which the public as well as the
profession could lay hold of. In 1825 the young enemy of the lancet
was elected Physician to the Nottingham Hospital by a large majority
of votes, and the best practice of the neighbouring counties was his.
He was unremittingly employed: in his walks and rides almost heedless
of external occurrences, absorbed in contemplation; at home ever busy
in his library or his laboratory, making chemical experiments from
which numerous valuable memoirs arose; never accepting invitations of
pleasure; unwearied in his attentions to the sick poor whom he saw
gratuitously. He economised time by riding, being a good horseman,
riding through the country on pitch-dark nights without accidents. He
treated his horses well and earned their affection. “How is it that
your horses never fall?” a friend inquired. “I never give them time
to fall,” was the reply. The Bible constantly at his side was another
mark of Marshall Hall, and he was ever ready to discourse on the
wisdom and benevolence of God, as shown in the structure of the human
body.

London continued to attract the popular Nottingham physician. Dr.
Baillie had predicted that if he came to London, he would be the
leading physician in five years; Sir Henry Halford, who succeeded
him as President of the College of Physicians, termed Marshall
Hall, a few years afterwards, “the rising sun of the profession.”
We cannot wonder that a visit to London in August 1826 resulted in
his remaining there. His Nottingham patients, deeply regretting his
removal, continued to consult him by letter; and his first year in
town produced £800, a remarkable instance of quick success.

In 1828 he published “Commentaries on Diseases of Females,” with
graphic plates depicting conditions of parts such as the tongue,
lips, nails, &c., which he first associated with various disorders
of women. He continued his series of careful papers on subjects
connected with blood-letting. His writings on these two subjects
produced him a considerable portion of his early practice.

Meantime Marshall Hall married, in 1829, and soon afterwards settled
in Manchester Square, where he lived for twenty years. Desiring to
become a Fellow of the Royal Society, he entered upon a special
research on the circulation of the blood, the results of which he
might communicate to the Society. After carefully inspecting under
the microscope the blood-flow in the transparent parts of frogs,
toads, newts, &c., he arrived at the conclusion that all the blood
changes, and all nutrition and absorption by the material tissues are
effected in the minute or capillary channels between the arteries and
the veins. The paper founded upon this research was read before the
Royal Society in 1831, but was refused a place in the “Philosophical
Transactions;” yet an equally great man, Johannes Müller, the leading
German physiologist, pronounced his paper one of extraordinary
interest. It was separately published in 1832. The Royal Society,
however, did not reject Marshall Hall’s next paper, “On the Inverse
Ratio between Respiration and Irritability in the Animal Kingdom,”
which has been pronounced “one of the most beautiful examples of
widely extended observations, and previously disjointed facts, all
brought together and rendered harmonious by the insight and genius of
a master-mind.”[20]

From the latter subject the investigator passed to that of
hybernation, his views on which also found acceptance with the
Royal Society. One feature in his experiments on this subject was
an ingenious apparatus for ascertaining the temperature of the bat
without disturbing its winter sleep. By this time Marshall Hall had
quite a little menagerie in his house, of animals whose physiology
he was investigating; mice, hedgehogs, bats, birds, snakes, frogs,
toads, newts, fishes were in turn laid under contribution. Abhorring
cruelty as utterly as a man could, he yet saw the absolute necessity
of discovering in the first instance, by experiments on animals,
truths which were of vital importance both to men and brutes. Mr.
Henry Smith of Torrington Square was his diligent associate in these
inquiries. Dr. Hall said of him: “I never knew a person so accurate
in his information and so devoid of selfishness. His interest in my
researches never flagged. He was true to his appointments as the
clock itself.”

While the papers refused a place in the “Philosophical Transactions”
were going through the press, to appear as a “Critical and
Experimental Essay on the Circulation of the Blood,” a serious
accident happened to a portion of the manuscript. It was sent from
time to time by stage-coach to Messrs. Seeley, printers, at Thames
Ditton, and on the evening of William IV.’s coronation a packet
containing the only record of a considerable series of experiments
was stolen from the coach. This most serious loss could only be
repaired by a repetition of the experiments, which Dr. Hall at once
set about with most Christian equanimity.

Early in 1832 Marshall Hall was elected a Fellow of the Royal
Society, and in the same year he published another paper on the
Effects of Loss of Blood, in the “Medico-Chirurgical Transactions.”
The original papers on practical medicine which he produced during
this period are too numerous to be mentioned here. We must hasten to
give an account of Marshall Hall’s great researches on the reflex
functions of the spinal cord.

It was while he was examining the circulation of the blood in the
newt’s lung that Marshall Hall noted the fact from which his great
discoveries arose. The newt’s head had been cut off; thus its life,
in the ordinary acceptation, was destroyed. The tail was afterwards
separated. “I now touched the external integument with the point of
a needle; it moved with energy, assuming various curvilinear forms!
What was the nature of this phenomenon? I had not touched a muscle;
I had not touched a muscular nerve; I had not touched the spinal
marrow. I had touched a cutaneous nerve. That the influence of this
touch was exerted through the spinal marrow was demonstrated by the
fact that the phenomenon ceased when the spinal marrow was destroyed.
It was obvious that the same influence was reflected along the
muscular nerve to the muscles, for the phenomenon again ceased when
these nerves were divided. And thus we had the most perfect evidence
of a reflex, or diastaltic, or diacentric action.”

The importance of this discovery may be gathered from the fact, that
but few considerable advances in the physiology of the nervous
system had hitherto been made, the most important being that of
Sir Charles Bell, proving that there were separate nerve fibres of
motion and of sensation, and that they entered different portions
of the spinal cord and brain. Dr. Andrew Whytt of Edinburgh had
published in 1751 a work in which he detailed the movements which a
frog’s trunk was able to execute after its head had been cut off,
and had naturally referred these movements to the spinal cord; but
the import of such actions was not understood, nor the mechanism
by which they were executed. Somehow these observations led to
no new principles. But the truly original mind of Marshall Hall
travelled beyond the first facts to trace the process, and he at
last comprehended the nature of such acts as the involuntary closure
of the eyelids, independent of will, for the purpose of preventing
the admission of injurious matter, or of protecting the eye against
injury. The processes of swallowing, choking, vomiting, coughing
were now for the first time explained. Further, in pursuance of
Marshall Hall’s practicality of object, many cases of injury to the
nervous system became more or less intelligible. In paralysis of the
brain, where the medulla oblongata and spinal cord were uninjured,
it was understood how the animal functions could be maintained,
and how in cases where the patient was unable by any exercise of
the will to clench his hand, yet the stimulus of a rough stick
on the sensory nerves of the palm of the hand was sufficient to
bring about a forcible grasp, this being a simple reflex act in
which the spinal cord was concerned. The first breath of a new-born
infant, the spasmodic closure of the larynx in convulsions, fits of
spasmodic asthma, &c., were seen to be reflex in their nature; and
in many disorders which had hitherto baffled curative efforts, they
became possible, because the first great step had been taken, the
understanding of the phenomena.

These discoveries proved so far-reaching in their bearing that
their establishment and following out were the work of years of
almost constant toil. It is estimated that from the period of
his first experiments to the close of his life no fewer than
thirty-five thousand hours were occupied by Dr. Hall in work strictly
connected with the subject. The discovery was first made known to
the Zoological Society on November 27, 1832: a fuller and further
account was given to the Royal Society in 1833, and published in the
Transactions. It was immediately translated into German and inserted
in Müller’s Archiv. Yet most of the leading authorities in England,
with the fatality which attends discoveries in proportion to their
greatness, made Marshall Hall the object of obloquy, and denounced
him as the propagator of absurd and idle theories. In 1837 a second
memoir was read before the Royal Society, but was rejected from its
Transactions; and in a most unscientific spirit, Dr. Hall’s offer to
show his experiments before a committee was not acceded to. Even
his proposal to withdraw from practice for five years, in order
to study the subject without interruption, secured him no better
reception. Moreover, the medical press, with the exception of the
_Lancet_ and a very few others, denounced Marshall Hall virulently.
In one number of a quarterly journal no fewer than four articles
attacked the discovery, one denying its originality while allowing
it to be true, another denouncing Dr. Hall’s views as new but not
true. The long persistence of this opposition was almost incredible;
for years one journal kept it up through every number; each step was
disputed, and what was indisputable was depreciated. “Ancient works
were disinterred in the vain hope of robbing him of his originality.
‘Complete anticipations’ were exultingly announced. On the one hand,
he was accused of stealing his ideas from old writers; on the other,
contemporaries started up and claimed the discovery as theirs; while
some combated its truth, and never ceased cavilling.”

While the Royal Society refused him any honours, and in 1847, ten
years after the last paper, rejected another which he sent in,
detailing an experimental research on the relation of galvanism
to the nervous and muscular tissues, Marshall Hall never ceased
his investigations. He did not, however, like some few men of
originality, disdain to reply to attacks. He was even anxious to
refute any and every mis-statement made about him and his work,
his view being: “It would not be truthful in me; and why should
I fear to declare the truth?” “I appeal from the first half of
the nineteenth century to the second.” “I am as certain of the
truth of what I have advanced, as I am of my own existence.” But
while his opponents denounced him as irritable and thin-skinned,
it is testified of him that his temper was never affected; neither
petulance nor gloom clouded his life; he never wrote an anonymous
unfavourable review. “Nothing delighted his benevolent heart,” says
his widow, “more than to praise others, when he could conscientiously
do so; and never can I forget the sparkle of his eye and his pleasant
smile when he had written something in favour of any professional
brother.”

Practice now flowed in upon Dr. Hall. His researches gave him an
insight into diseases and disorders of the nervous system which
no one had as yet approached. Large numbers of patients came to
consult him personally, or sent for him without the intervention
of a general practitioner. Dr. Russell Reynolds says that his “New
Memoir on the Nervous System,” 1843, described with remarkable
ingenuity the mechanism of the convulsive paroxysm, and of many
other affections assuming a paroxysmal type. “To Dr. Marshall Hall
is due the merit of having rescued the obscure class of convulsive
affections from a region of utter unintelligibility. The action of
strychnia as a spinal excitant, or, in small doses, as a spinal
tonic; the direction—general, regiminal, and medical—of the epileptic
patient, in order to avoid all the excitants of convulsive action;
the recommendation of tracheotomy in laryngismal epilepsy; and the
simple but beautiful ‘Ready Method in Asphyxia,’ were among the later
efforts of Dr. Hall’s great genius.... The two prominent features of
his treatment were simplicity and perseverance. We have seen numerous
cases in which his administration of simple aperients, together with
strictly regiminal measures, had wrought extraordinary cures; and we
know of previously paraplegic men, now well, who under his direction
took strychnia for much longer than a year; and of so-called
epileptics who slowly recovered from the most frightful combination
of symptoms, while kept by Dr. Hall for sixteen or eighteen months
under the influence of mercury.” Even under the heaviest strain of
practice he found time to continue his researches, and to publish his
experience. In 1845 and 1846 appeared two small volumes of “Practical
Observations and Suggestions in Medicine,” in which a great number of
medical subjects were treated in so concise and telling a way that
they were immediately welcomed by a large class of readers. A chapter
on the use of the Alcoholic Lotion in Phthisis Pulmonalis is said
to have been the means of saving many lives; another on “the Temper
Disease” is most interesting to the student of human nature as well
as of medicine.

A friend, Mr. Henry Gregory, of Herne Hill, who had much professional
and friendly intercourse with Dr. Hall, says of him: “In debate or
conversational argument nothing seemed to escape his penetration.
His minuteness in bringing out little things which others thought
not of, was remarkable; with one little atom, so to speak, a light
would shine forth from him so brilliantly that I could only sit
and admire his remarkable mental gifts. He was a great man and a
genius, and, like all the truly great, made no parade.... He was the
educator of the intellect; his domain was pure scientific research.
The earnest activity of his mind made him proceed, and every
advance he made was a clearing away of error and an establishment
of truth.... In emergencies he was both prompt and cautious; when
anxious excitement surrounded him, it did not disturb his judgment.
In dangerous and difficult cases he was always calm. His deep sense
of duty and responsibility was unbending.” There is a universal
concurrence of testimony as to his great success in gaining his
patients’ confidence; young and old looked with delight for his
visits. He would always direct the responsible nurse most precisely,
and endeavour by every possible device to secure that his special
treatment should be carried out. His searching and pointed questions
not unfrequently discovered “hidden seizures,” as he called them,
which had been totally unsuspected or uncomprehended by patients or
friends. His power of devising a remedy is amusingly illustrated
by his prescription to an indolent lady that she was to walk daily
to the Serpentine from her home, and dip her finger in it. The
desirability of healthy mental occupation, and the encouragement of
happiness and pleasing customs generally, were favourite subjects
of his injunctions. Sympathy and kindliness shone through his whole
manner. A Scotch minister said to him: “You place your soul in the
stead of your patient’s soul.” But he abhorred all coaxing and
wheedling; he hated cant. He would not lower his own lofty sense of
independence by anything approaching to it. One might have supposed
so sympathetic a nature would have been compliant; but his spirit and
dignity were consistent with and equal to his sympathy. It was but
another phase of his noble character that he could attend the poor
and the needy middle-class without allowing or causing them to feel
the slightest difference between themselves and the rich.

This was the great physician who could never find a post as
physician in any London hospital. His medical teaching was almost
entirely confined to the schools that were outside the close circle
of the hospital schools. In 1834-6 he lectured on medicine at the
Aldersgate School, and then joined the Webb Street School (that of
the Graingers), taking a similar post. He also gave lectures for two
years at “Sydenham College,” established near University College.
But the exertion of lecturing concurrently at these two was too much
for his voice, and he could not complete his course in 1839. In
1842-6 he gave lectures on nervous diseases, at St. Thomas’s Hospital
Medical School. In these he illustrated many points by remarkable
diagram portraits of paralytic patients. His lectures were given
extemporaneously after careful preparation, and delivered extremely
clearly, without any showiness. When lecturing at a school unattached
to a hospital he would invite his pupils by turns to breakfast at
his house, that they might then see some of his poorer patients, and
go over their cases with him. One instance of his thoughtfulness for
his pupils is enough to mark out any man from among his fellows. A
student was confined to his room for three or four weeks by illness,
and Dr. Hall came regularly to his lodgings to give him a _resumé_ of
his lecture, and of what followed it. No wonder that an affectionate
feeling bound his class to him, and that no lecturer ever was more
attentively followed. The instances of the affection and regard
displayed in various ways between him and his pupils are among the
most interesting records in medical biography.[21]

Though he had been denied the Fellowship of the College of Physicians
until 1841, Marshall Hall was at last fully recognised by the College
in being appointed to deliver the Gulstonian lectures in 1842, and
the Croonian in 1850, 1, and 2. In these courses, which were largely
attended, he fully explained his views and discoveries on the
nervous system and nervous diseases, as well as on general medical
treatment. They were published later, in the form of “Synopses” of
each course, in quarto.

Notwithstanding his aversion to anything like strife in medical
politics, Marshall Hall took a prominent part in the formation of
the British Medical Association, and was at once elected on its
Council, and delivered the oration on Medical Reform in 1840. He
was in his true place in every philanthropic scheme that needed
medical advocacy. The open railway carriages were doomed when he
denounced them as dangerous to health; inhuman flogging of soldiers
was evidently condemned when he expounded the character of the
injuries inflicted on the cutaneous nerves, and the decree of shock
to the heart. He even wrote on the Higher Powers of Numbers, in the
_Mechanics’ Magazine_, and took an interest in devising new forms of
conjugation for Greek nouns and verbs. He strongly advocated a new
Pharmacopœia, based on the decimal system. He suggested in a pamphlet
as early as 1850 new works for the sewerage of the Thames, developing
his ideas more elaborately in 1852 and 1856. Many of his views and
plans have since been adopted: others must and will still be carried
out if London is to be properly and healthily drained.

It is not to be imagined that Hall was so absorbed in study and
practice that he could not take recreation. No one enjoyed more than
he the pleasure of travelling, the tonic of the open air, the change
to the Continent, a tour to America; and he rigorously took these,
and enjoyed himself with the _abandon_ of a child. His delight in
splendid scenery was extreme; and he gratified his taste, in season,
by tours extending very widely over Europe. His visit to America was
specially undertaken in 1853 with the object of studying slavery by
personal observation. In New York and other cities he gave lectures
by request illustrative of his discoveries. From Quebec to New
Orleans, and even the Havana, his fame had preceded him, and he was
feted and listened to with as much ceremony and enthusiasm as his
retiring nature could be prevailed upon to endure. At the Havana
he lectured in French for two hours, and the medical students of
the city visited him again and again, thirsting for information at
first hand. Dr. and Mrs. Hall returned to England in April 1854;
and very soon after he published his little volume on “The Two-fold
Slavery of the United States.” The subject was one which most deeply
interested Marshall Hall’s philosophical and religious mind; and it
is significant of the depth of his philosophy that he was far-seeing
enough to be certain that unprepared abolition would be far from a
perfect boon for the slave, while yet he regarded the continuation
of slavery as wicked and degrading, financially ruinous, and tending
to generate wars. His remedies were first, education; second, the
appointment of fair task-work; third, the privilege of over-work,
to be paid for, and the payments accumulated till freedom could be
purchased with the aid of proportionate additions by the Federal and
States’ Governments. Whether his plan could ever have been worked
out will now never be known. That many of the evils he foresaw have
followed persistence in slavery and sudden abolition is matter of
certainty.

Marshall Hall’s physical frame had been overtaxed by his exertions
and struggles, and he became increasingly liable to severe
laryngitis. Taking another continental trip in the winter of 1854-5,
he showed his vivid intellectual energy by applying himself at Rome
to the study of Hebrew. He engaged a Rabbi to teach him, and when
awake at night or at early dawn, he worked at his new study with
the zeal of a tripos candidate, and never did a pupil make more
rapid progress. He ascended Vesuvius during the eruption of May
1855, a serious undertaking for a man of sixty-five. At Paris, in
the summer, he wrote in three months a work in French, detailing
his investigations on the spinal system, dedicated to M. Flourens,
who had always shown the most generous appreciation of his labours
as constituting a great epoch in physiology. Louis, the great
physician, and his wife, were equally warm in their appreciation of
and attachment to him. On December 5, 1855, Marshall Hall was elected
a corresponding member of the French Academy of Science, by 39 votes
out of 41.

On returning to England towards the end of 1855, Marshall Hall’s mind
fastened with characteristic eagerness on a new subject, suggested
by reading the Humane Society’s “Rules to Restore the Apparently
Drowned.” He remarked: “There is nothing in the treatment to restore
respiration.” He at once thought out the question in the light of his
researches on the physiology of respiration, and when he had mentally
devised his system of restoration, proceeded to make experiments
to test them. Hitherto it had been believed that it was useless to
attempt to restore those who had been immersed three or four minutes.
He said to the Secretary of the Humane Society: “If we take this for
granted, we shall do nothing; surely it is worth while to make the
effort to restore after a longer period.” His plan for producing
artificial respiration, by turning the body first on the face, then
on the side, and repeating the motion for a quarter of an hour,
making equable pressure on the back of the chest when in the prone
position, removing it when rotating on to the side, is known all over
the world as the Marshall Hall method, and has saved thousands of
lives. Numerous details are added to increase the efficiency of the
treatment. But the Humane Society looked coldly on the novel plan,
and long persisted in ignoring it. The National Lifeboat Institution
wisely adopted it; the medical profession received it with
acclamation; it was applied to the revival of still-born infants,
and the restoration of those in danger of dying from asphyxia from
other causes than drowning. At the same time when Palmer’s trial for
poisoning was occurring, Dr. Hall drew attention to the facility
with which the presence of strychnia could be proved by administering
any suspected matter to young frogs, which would be affected by the
five-thousandth part of a grain of strychnia.

But he now began to succumb to the effects of his long-continued
malady in the throat. Expectoration of blood became more frequent,
difficulty of swallowing increased; at times he was near absolute
starvation, and his sufferings were horrible, but his patience and
resignation marvellous. After months of terrible illness, during
which his cheerfulness never left him, he died on the 11th August
1857, of ulceration of the upper part of the gullet and windpipe.
During his illness his mind was as active as ever, he wrote
continually his new ideas, and worked out to fuller ends his former
discoveries. Throughout he was especially bright and affectionate to
all little children; the manner in which he entered into children’s
delights was most exquisite to witness. His Christian faith was
unclouded; as he said, religion was to him the principal thing. In
the simplicity, beauty, and happiness of his character he resembled
Sir Charles Bell, of whom he was the true successor.


FOOTNOTES:

[20] _Medical Times and Gazette_ August 29, 1857.

[21] Memorials of Marshall Hall, by his widow, 1861.




CHAPTER X.

_SIR BENJAMIN BRODIE AND SIR WILLIAM LAWRENCE, TWO GREAT PRACTICAL
SURGEONS._


The influence of heredity and of association and connexion with
talented persons is well illustrated in the case of Sir Benjamin
Brodie. His paternal grandfather, Alexander Brodie, was a native of
Banffshire, who came to London as a humble adventurer and almost
as a Jacobite refugee. He married a daughter of a physician named
Shaw, of similar Jacobite family and connexions. Brodie became an
army clothier, and one of his daughters, who married Dr. Denman, the
eminent obstetric physician, was the mother of Lord Denman. Margaret
and Sophia, the twin daughters of Dr. Denman, married—the former
Sir Richard Croft, who attended the Princess Charlotte at her death
in 1817, the latter Dr. Matthew Baillie, the eminent physician, and
nephew of John Hunter. The army clothier’s wife was herself a woman
of considerable abilities, and it was said that there was royal blood
in the family.

The father of Sir Benjamin was educated at Charterhouse and at
Oxford. As a boy he was patronised by the first Lord Holland, and
spent much time at Holland House. A warm attachment existed between
them, in which Charles James Fox shared. When Lord Holland died in
1774, he directed by will that Mr. Brodie, who had taken holy orders,
should have the next presentation to whichever of his livings first
became vacant. This desire was soon fulfilled, and Winterslow in
Wiltshire became the home of the Brodies. The Rev. Mr. Brodie married
in 1775 a daughter of Mr. Collins, a banker at Salisbury; and of this
marriage Benjamin Collins Brodie was the third son, having been born
in 1783.

Sir Benjamin in his “Autobiography” gives a pleasing picture of his
father, a man of sound classical knowledge, great energy, minute
acquaintance with parishioners, and devotion to his parochial duties.
Notwithstanding his wife’s considerable fortune, Mr. Brodie found
he could not afford to send all his sons to public schools, and he
consequently determined to educate them himself. An elder sister
who joined the brothers at lessons became no mean proficient in
classics. Under the strict discipline of their father the children
grew up in the habit of methodical study, and Sir Benjamin records
that idleness even for a day was always irksome to him in after
life, and he had little inclination for any pursuit without a
definite ulterior object. Seven miles distant from Salisbury, the
family learned to be self-dependent for interest of all kinds, and
their solitude was little varied except by occasional visits of
cousins, such as Lord Denman, who was for a year a resident pupil
with Mr. Brodie after leaving Eton, and a few others, one of whom
was afterwards Dr. Maton, a well-known London physician, and (Sir)
John Stoddart, afterwards Chief Justice at Malta. Vigour of character
was shown markedly when in 1798 the brothers raised a company of
volunteers on the alarm of a French invasion. The eldest at nineteen
received a commission as captain, while Benjamin, only fourteen, was
appointed ensign. Great pains were bestowed on the drill of this
company, and the officers expended their pay in entertaining the men
in a great barn; and the influence already possessed by the youths
was evident in the maintenance and increase of the numbers of the
corps and the attention paid to drill. The eldest brother, Peter,
became a distinguished conveyancing barrister. The second was a local
banker, proprietor of a newspaper, and represented Salisbury in three
Parliaments.

As he drew towards adult age, Brodie read extensively in science and
philosophy and general literature. In the autumn of 1801, the medical
profession having been chosen for him, he went to London without any
special bent towards the occupation in which he was destined to shine
so conspicuously. He gives it as his opinion, in after years, that
those who succeed best in professions are those who have embarked
in them not from irresistible prepossession but perhaps from some
accidental circumstance, and persevere in their course as a matter
of duty, or because they have nothing better to do. “They often
feel their new pursuit to be unattractive enough in the beginning;
but as they go on, and acquire knowledge, and find that they obtain
some degree of credit, the case is altered; and from that time they
become every day more interested in what they are about:”—a great
encouragement to the vast majority of students who do not feel the
stimulus and inspiration of genius.

During his first season in London, young Brodie attended Abernethy’s
course on Anatomy, and to his influence may be attributed the choice
of surgery as his special vocation. “He kept up our attention,” says
Brodie, “so that it never flagged, and what he told us could not be
forgotten.” One of his earliest friendships was that which he formed
with William Lawrence as a fellow-student. This continued unbroken
throughout life, and though they might be regarded as rivals, no
jealousy ever arose between them. But Brodie was more at home with
his non-medical friends, his elder brother with whom he lodged,
Denman, Merivale, Wray, Stoddart, Gifford (afterwards Lord Gifford),
and Maton. The latter had established in London the Academical
Society, as a sort of transplant from Oxford, and Brodie was here
introduced to Lord Glenelg and his brother Robert Grant, Francis
Horner, Dr. Bateman, and “a young Scotchman of uncouth appearance,”
afterwards Lord Campbell. Before this Society Brodie read papers on
metaphysical enquiries and on the principles of science, showing
his philosophical bent. Berkeley was the author who influenced him
most powerfully, from his clear reasoning and simple unaffected
perspicuous style, terms which are specially appropriate to Brodie’s
own writing.

In 1802 Wilson’s lectures on anatomy at Great Windmill Street were
Brodie’s main professional pabulum. “I was naturally very clumsy in
the use of my hands,” he says, “and it was only by taking great pains
with myself that I became at all otherwise.” In the spring of 1803
he became a pupil of Home (afterwards Sir Everard) at St. George’s
Hospital, continuing also his anatomical studies. He ultimately
became Sir Everard’s assistant both in the hospital and in private
practice. From this connection, however, he derived little pecuniary
profit, but by aiding Home in his researches in comparative anatomy
and physiology he gained decided benefit. In 1805, however, Brodie
became demonstrator in Wilson’s anatomical school. He was introduced
to Sir Joseph Banks, and through him to the best scientific men of
the day. Could there be more favourable conditions for progress, or
circumstances more unlike these of chilling seclusion and neglect
which have so often hindered and overshadowed men of merit?

Brodie continued to demonstrate, and from 1809 to lecture at Great
Windmill Street, until in 1812 (Sir) Charles Bell became principal
lecturer there. In 1808 he was appointed assistant surgeon at St.
George’s Hospital, by Home’s influence, and in reality did the work
of a full surgeon almost from that date. Private practice he scarcely
attempted, his hands being full of anatomical and hospital work.
Robert Keate and Brodie were at the hospital daily, and superintended
everything; there was never an urgent case that they did not visit
in the evening. This surgical experience was at once turned to
advantage by Wilson, who asked Brodie to join him in lecturing on
surgery. From 1809 onward for nearly twenty years, Brodie gave this
course of lectures, and had a good attendance of students; besides
which he lectured on surgery at St. George’s Hospital till 1840. In
1809 he took a house in Sackville Street and received three private
pupils, and in 1810 felt justified, from the increase of his means,
in engaging in physiological enquiries, stimulated by Bichat’s
researches. He was elected into the Royal Society in 1810; and in the
same and following winter communicated to the Society two valuable
papers, one “On the Influence of the Brain on the Action of the Heart
and the Generation of Animal Heat;” and the other “On the Effects
produced by certain Vegetable Poisons.” The former was given as the
Croonian Lecture in 1810. These papers, though largely superseded by
recent investigations, were quite remarkable for their time, and for
the first he was awarded the Copley Medal in 1811, which had never
before been given to so young a man.

It is worth noting that a medal was awarded by the Royal Society to
the second Sir Benjamin Brodie in 1850, for his investigations “on
the chemical nature of wax.” With the exception of the two Herschels,
this is the only instance in which father and son have received this
honour. The most noted, perhaps, of Brodie’s physiological papers
was one on the influence of the nervous system on the production of
animal heat, published in 1812. He concluded that an animal with
the nervous centres removed, or with their functions suspended by
narcotic poison, lost its power of generating heat, even though the
action of the lungs was kept up by artificial respiration. Brodie
used the then little known woorara poison brought by Dr. Bancroft
from Guiana, to produce suspension of the nervous action. In after
life increase of practice left little time for further physiological
research.

At length Brodie married (in 1816) Ann, the third daughter of
Serjeant Sellon, his bride being only nineteen. This was in every
way a happy marriage; and Sir Benjamin always warmly recognised his
wife’s excellent moral training of their children. In the year of
their marriage Brodie’s professional income from fees and lectures
amounted to £1530. For some years he had paid special attention to
diseases of the joints, which were then very ill understood; and in
1819 he published his classical work “On the Pathology and Surgery of
Diseases of the Joints.” He clearly distinguished between diseases of
the various tissues of which joints are composed; and also between
hysterical, neuralgic, and merely local diseases. Many limbs, in
which no disease could be found after removal, were at that time
removed merely because pain was felt in them. A story told in the
_Lancet_ on this subject is worth reproducing.

“Late one evening a person came into our office, and asked to see
the Editor of the _Lancet_. On being introduced to our sanctum,
he placed a bundle upon the table, from which he proceeded to
extract a very fair and symmetrical lower extremity, and which had
evidently belonged to a woman. ‘There!’ said he, ‘is there anything
the matter with that leg? Did you ever see a handsomer? What ought
the man to be done with who cut it off?’ On having the meaning of
those interrogatories put before us, we found that it was the leg of
the wife of our evening visitor. He had been accustomed to admire
the lady’s leg and foot, of the perfection of which she was, it
appeared, fully conscious. A few days before, he had excited her
anger, and they had quarrelled violently, upon which she left the
house, declaring she would be revenged on him, and that he should
never see the objects of his admiration again. The next thing he
heard of her was that she was a patient in —— Hospital, and had
had her leg amputated. She had declared to the surgeons that she
suffered intolerable pain in the knee, and had begged to have the
limb removed—a petition the surgeons complied with, and thus became
the instrument of her absurd and self-torturing revenge upon her
husband.”

Brodie may now be regarded as firmly established in public favour.
His income in 1819 exceeded that of the preceding year by £1000. He
enjoyed the intimate acquaintance of Lord and Lady Holland, and the
sunshine of their friendship had its strong influence on practice.
In 1819 Brodie removed to Savile Row, and in the same year was
appointed to succeed Lawrence as Professor of Comparative Anatomy and
Physiology at the College of Surgeons. In this capacity he lectured
for four years, delivering new and original matter each time.
They constituted a frightful addition to his labours, and he only
completed them by taking many hours from needed sleep. He records,
however, that few things contributed more to his improvement than the
composition of his lectures, and the habit of recording his knowledge
and thoughts. It enabled him to detect his own deficiencies, and to
avoid hasty conclusions, and taught him to be less conceited of his
own opinions.

An important branch of modern surgery may be said to have had its
rise in an operation first performed by Brodie. Nowadays subcutaneous
operations, in which the slightest possible opening is made in the
skin, and frequently considerable incisions or other interferences
are made beneath it, are very common, and the procedure is of the
greatest importance in orthopædic surgery and the relief of muscular
and tendinous contractions of various kinds. Brodie first performed
a subcutaneous operation for the relief of varicose veins of the
legs in 1814, and several similar cases were published by him in the
seventh volume of the “Medico-Chirurgical Transactions.” If no other
operative improvement of great moment is associated with Brodie’s
name, it is not that he has not left his mark on that department of
practice, but rather that he has been the introducer of innumerable
minor improvements. In particular, he was notable in devising
improvements in surgical instruments and apparatus.

In 1821, Brodie was called in to attend George IV., who very much
wished him to perform the operation which in deference to Lord
Liverpool was entrusted to Sir Astley Cooper. Brodie remained ever
after a favourite with George IV. and attended him frequently during
his last illness, going to Windsor every evening, and visiting the
King at six in the morning and remaining with him for an hour or two
before returning to London. When William IV. came to the throne,
Brodie was appointed Serjeant Surgeon, and soon after received
a baronetcy. He had now for some years been at the head of his
profession, having succeeded to Sir Astley’s place on his retirement
in 1828. In 1823 his income was already £6500; for many years his
practice brought him £10,000 and sometimes £11,000 a year. This was
a very remarkable income considering the small proportion of it that
was derived from operations. Much the greatest part he took in single
guinea fees, and thus it is seen how much his opinion was valued in
surgical cases. Indeed he often, especially after his retirement
from St. George’s Hospital in 1840, refused to perform important
operations to which he felt no special attraction. But his abiding
popularity and influence is shown by the fact that his total receipts
from fees, from first to last, considerably exceeded Sir Astley’s.
He used to say that he had always kept in mind the saying of William
Scott (afterwards Lord Stowell) to his brother John (subsequently
Lord Eldon), “John, always keep the Lord Chancellorship in view,
and you will be sure to get it in the end:” and a similar aim and
distinction were Brodie’s.

Meanwhile, the public interest was by no means lost sight of in
private practice. To Brodie is largely due the merit of having put
a stop to the career of St. John Long, the fashionable medical
impostor. Sir Benjamin was one afternoon on his way to visit a friend
at Hampstead, when he was called in to see a Miss Cashin. Finding
an enormous slough on her back, caused by Long’s treatment, he
exclaimed, “Why, this is no better than murder!” The lady died, and
on the strength of Sir Benjamin’s expressions, an inquest was held,
followed by the trial and condemnation of Long. Yet such was the
strength of the fashionable partisanship in favour of the impostor,
that the judge, Mr. Justice Park, merely fined him £250, which he at
once paid. A second trial in another case, where death had ensued
upon his treatment, ended in a verdict of acquittal.

In 1834 Sir Benjamin succeeded to the first vacancy that occurred,
after his appointment as Serjeant Surgeon, in the Court of Examiners
of the College of Surgeons; this was by prescription due to his court
office. He found this duty very irksome, and he resigned it when a
new charter, which he had been largely instrumental in obtaining, no
longer granted this privilege to the Serjeant Surgeon.

In 1839 and ’40 Sir Benjamin was President of the Royal Medical
and Chirurgical Society, and here again he shone. In addition to
his own most valuable contributions, he excelled in drawing out
others. His attendance was most diligent; his mind was never at a
loss for something interesting to say; he stimulated discussion
when an opposite precedent had been established; and to him a very
large share of the Society’s prosperity was due. Of course the
Presidency of the Royal College of Surgeons fell to his lot. When
the General Medical Council was established, Sir Benjamin was by
common consent called to the Presidency; and in 1858 he received
a still more remarkable honour in being called to the Presidency
of the Royal Society, which office he held with dignity and wisdom
till 1861. It is impossible for us here to record all the important
offices Brodie filled, nor all the valuable communications he made
to learned societies and various journals. Fortunately his charming
autobiography is very accessible, being published separately as well
as in the excellent collection of works, in three vols., 1865, edited
by Mr. Charles Hawkins.

It is easily imagined that Brodie’s long course of labour could only
have been sustained by a strong constitution. He was not altogether
robust, but by careful management succeeded in preserving excellent
health. In 1834, while in the Isle of Wight, he fell from a pony
and dislocated his right shoulder joint, which long after became
diseased. In July 1860 his sight became impaired, and he ultimately
submitted to excision of the iris of both eyes by Mr. (now Sir
William) Bowman. Later, he was operated on for cataract; but all
efforts to preserve good sight were futile. In July 1862 he began to
suffer in his right shoulder, and finally died of cancerous disease
in that joint on October 21st, 1862. He was buried at Betchworth,
Surrey, in which parish the estate, Broome Park, which he had
purchased, is situated.

The _Lancet_ said of him, “It is true praise of Sir Benjamin Brodie
to say, that he was more distinguished as a physician-surgeon than
as an operating-surgeon. His vocation was more to heal limbs than to
remove them. His imagination had never been dazzled by the brilliancy
of the knife, to any great operative display. He was, however, always
a most steady and successful operator: lightness of hand, caution
without timidity, never-failing coolness, and fertility of resources,
were his distinguishing characteristics. He made no secret of his
opinion, that the operative part of surgery was not its highest part.
Diagnosis had always been his great strength, and his opinion was,
therefore, always deeply valued by the profession and the public. We
believe his heart was with hospital, rather than private practice,
but in almost all cases men are more fond of their early occupations
than of those which come afterwards. As a teacher, he was always
distinguished for the value of the matter he had to communicate.
Those who heard him in the early part of his career say that he was
then energetic rather than polished; that he appeared to struggle
with the weight and mass of facts he had stored up in his mind. But,
in later years, his delivery was fluent and perfect. No man in his
profession could deliver himself more readily or more elegantly than
Sir Benjamin Brodie.”

Dr. Babington, President of the Royal Medical and Chirurgical
Society, thus characterised Brodie:—“As a practical surgeon Sir
Benjamin Brodie attained a success far beyond that of most of his
contemporaries, and this he seems to have owed, not to personal
appearance or manner, not to eccentricity, not to an unusual degree
of courtesy on the one hand, or of bluntness or brusquery on the
other, but to the legitimate influence of a high order of intellect,
thoroughly devoted to the practical application of the stores of
surgical knowledge acquired by his assiduity and experience—to the
sound, well-considered, and decided opinions which his patients
were sure to obtain from him, and to the confidence which his high
religious principles and his strict morality inspired.... For
myself, I can only say that I never knew a more single-minded and
upright character, one more free from affectation or presumption,
who expected less deference or deserved more, or who more completely
impressed me with a belief that the main object of his efforts, that
which was always uppermost on his mind, was, wholly irrespective of
self, to benefit those by whom he was consulted.”

Dr. (now Sir Henry) Acland has given in the Proceedings of the
Royal Society perhaps the best survey of Brodie’s character and
work:—“Neither as scientific man, nor as surgeon, nor as author was
he so remarkable as he appears when viewed as he was—a complete man
necessarily engaged in various callings. It was impossible to see
him acting in any capacity without instinctively feeling that there
he would do his duty, and do it well. Nor could he be imagined in a
false position. A gentleman, according to his own definition of that
word, he did to others that which he would desire to be done to him,
respecting them as he respected himself. Simple in his manners, he
gained confidence at once; accustomed to mix with the poorest in the
hospital and with the noblest in their private abodes, he sympathised
with the better qualities of each,—valued all, and despised nothing
but moral meanness. Though as a boy he was retiring and modest, he
was happy in the company of older persons, and, as he grew older,
loved in his turn to help the young. ‘I hear you are ill,’ he wrote
once in the zenith of his life to a hospital student of whom he did
not then know much; ‘no one will take better care of you than I;
come to my country house till you are well;’ and the student stayed
there two months. He was thought by some reserved—he was modest;
by others hasty—he valued time, and could not give to trifles that
which belonged to real suffering; he was sometimes thought impatient,
when his quick glance had already told him more than the patient
could either describe or understand. Unconscious of self, of strong
common-sense, confident of his ground or not entering thereon, seeing
in every direction, modest, just, sympathetic, he lived for one
great end, the lessening of disease. For this object no labour was
too great, no patience too long, no science too difficult. He felt
indeed his happiness to be in a life of exertion. As a professional
man he valued science because it so often points the way to that
which is practically useful to many; but as a scientific man his
one object was the truth, which he pursued for its own sake, wholly
irrespective of any other reward which might or might not follow on
discovery. He had not the common faults of common men, for he had not
their objects, nor their instinct for ease, nor their prejudices;
though he became rich, he had not unduly sought riches; though he
was greatly distinguished, he had not desired fame; he was beloved,
not having courted popularity. What he was himself, that he allowed
other men to be, till he found them otherwise. He saw weak points
in his profession, but he saw them as the débris from the mountains
of knowledge and wisdom, of benevolence and of self-denial, of old
traditional skill ever growing and always purifying,—those eternal
structures on which are founded true surgery and medicine. If ever he
was bitter in society, it was when they were under-valued; if ever
sarcastic, it was when the ignorant dared presume to judge them.

“A light is thus thrown on his even career of uniform progress.
Training his powers from youth upwards, by linguistic and literary
studies, by scientific pursuits, by the diligent practice of his
art, by mixing with men, he brought to bear on the multifarious
questions which come before a great master of healing, a mind alike
accustomed to acquire and to communicate, a temper made gentle by
considerate kindness, a tact that became all but unerring from his
perfect integrity. He saw that every material science conduces to the
well-being of man; he would countenance all, and yet be distracted by
none. He knew the value of worldly influence, of rank, of station,
when rightly used; he sought none, deferred excessively to none; but
he respected all who, having them, used them wisely, and accepted
what came to himself unasked, gave his own freely to all who needed,
and sought help from no one but for public ends.... Those who knew
him only as a man of business, would little suspect the playful
humour which sparkled by his fireside, the fund of anecdote—the
harmless wit, the simple pleasures of his country walk.

“In the quality of his mind he was not unlike the most eminent of
his contemporaries, Arthur Duke of Wellington. Those who did not
know him, and who do not appreciate the power requisite to make such
a master in medicine as he was, may be surprised at the comparison.
Yet our great soldier might have accepted the illustration without
dissatisfaction. Whatever art Brodie undertook, if he has been
correctly drawn, he would have entirely mastered. The self-discipline
of the strongest man can effect no more. The care with which the
two men compassed every detail, and surveyed every bearing of a
large question, the quiet good sense, the steadiness of purpose, the
readiness of wide professional knowledge in critical emergencies,
were in each alike. The public and his profession esteemed Brodie as
the first in his art.”

       *       *       *       *       *

WILLIAM LAWRENCE was born at Cirencester in July 1783, his father
having practised as a surgeon in that town for many years. After
being educated at a classical school near Gloucester, young Lawrence
was apprenticed in February 1799 to the celebrated Abernethy, in
whose house he went to reside. In after years, when lecturing
before the College of Surgeons for the first time, Lawrence spoke
thus eloquently of his teacher:—“Having had the good fortune to be
initiated in the profession by Mr. Abernethy, and to have lived
for many years under his roof, I can assure you, with the greatest
sincerity, that however highly the public may estimate the surgeon
and the philosopher, I have reason to speak still more highly of
the man and the friend; of the invariable kindness which directed my
early studies and pursuits, of the disinterested friendship which
has assisted every step of my progress in life, and the benevolent
and honourable feelings, the independent spirit and the liberal
conduct, which, while they dignify our profession, win our love,
and command our respect for genius and knowledge, converting those
precious gifts into instruments of the most extensive public good.”
Lawrence proved himself so zealous a pupil that in the third year of
his apprenticeship, Abernethy appointed him to be his demonstrator
of anatomy, a post which he filled for twelve years. Becoming
a member of the College of Surgeons in 1805, he was appointed
Assistant Surgeon to St. Bartholomew’s Hospital in 1813, and in
the same year was elected F.R.S. Already in 1801 he had published
a translation from the Latin of a Description of the Arteries, by
Murray, Professor at Uppsala. In 1806 he won a prize offered by the
College of Surgeons, for an essay on the Treatment of Hernia. This
essay when printed gained immediate acceptance, and numerous editions
were published. Lawrence’s contributions to anatomy and surgery now
followed rapidly, several appearing in the _Edinburgh Medical and
Physical Journal_. His observations on Lithotomy showed the way to a
revival of the true system of operating laterally with the knife. In
1814 Lawrence was chosen surgeon to the Eye Hospital at Moorfields,
and in 1815 to the Royal Hospitals of Bridewell and Bethlehem. In
the latter year he was selected for the Professorship of Anatomy and
Physiology at the College of Surgeons, and hence arose one of the
bitterest controversial tempests of the early part of this century.

Lawrence took occasion, in his first lectures in 1816, to criticise
Abernethy’s exposition of Hunter’s theory of life, and to unfold
views which seriously scandalised those who regarded life as a
mysterious entity entirely separate from and above the material
organism with which it is associated. These views were criticised
by Abernethy in his “Physiological Lectures” in 1817, and Lawrence
replied in 1818, in terms of sarcasm which made a serious breach
between the master and his former pupil. Lawrence’s lectures were
published as “An Introduction to Comparative Anatomy and Physiology,”
1816, and “Lectures on Physiology, Zoology, and the Natural History
of Man,” 1819. Having been accused by Abernethy and others “of
perverting the honourable office intrusted to him, by the College
of Surgeons, to the very unworthy design of propagating opinions
detrimental to society, and of endeavouring to enforce them for
the purpose of loosening those restraints on which the welfare of
mankind depends,” he used his eloquence unsparingly both to defend
his position, and to repel the attacks made upon him. He was not
more heretical than many of his predecessors, nor than a great many
enlightened biologists of the present day. He regarded life as “the
assemblage of all the functions, and the general result of their
exercise. Thus organisation, vital properties, functions and life,
are expressions related to each other; in which organisation is the
instrument, vital properties the acting power, function the mode
of action, and life the result.” Again, “we find that the motion
proper to living bodies, or in one word, Life, has its origin in
that of their parents. From their parents they have received the
vital impulse, and hence it is evident, that in the present state of
things, life proceeds only from life; and there exists no other but
that which has been transmitted from one living body to another by an
uninterrupted succession.”

Lawrence was virulently attacked, and his name associated with Tom
Paine and Lord Byron as arch-heretics. A pamphlet of the year 1820
has the following title: “The Radical Triumvirate; or, Infidel Paine,
Lord Byron, and Surgeon Lawrence colleaguing with the Patriotic
Radicals to emancipate Mankind from all laws Human and Divine, with a
plate engraved for their instruction: a Letter to John Bull from an
Oxonian resident in London.” The Christian Advocate in the University
of Cambridge, the Rev. Thomas Rennell, among others, took up the task
of controverting Lawrence’s supposed materialism. The lectures on
the comparative anatomy of man certainly put forward in a striking
light many of Blumenbach’s views, and showed that the literal
accuracy of the early parts of Genesis was inconsistent with the
facts of zoology and comparative anatomy. We might proceed further
on this subject, but Lawrence himself prevented his successors from
espousing his personal cause with ardour, for, being called upon to
resign his position at Bridewell and Bethlehem, “he did not resign,
but recanted; bought up all the copies of his work ‘On the History
of Man,’ and sent them over to America.”[22] Numerous modified and
also spurious editions were sold. This conduct deprives him of a
large share of our sympathy and respect. Had Lawrence, like Darwin or
Huxley, maintained his opinions when most unpopular, he might have
won a victory for sound science years before it actually was gained.
If he had been the original discoverer of the truths he enunciated,
and had bought them with his life’s energy, he would scarcely have
dropped them at the raging of a storm. But the glory was not to be
his. He was tried in the balance and found wanting.

The early symptoms of disagreement between Abernethy and Lawrence
extended to other members of the staff, and led to the establishment
of the Aldersgate Street School of Medicine, where Lawrence lectured
on surgery till 1828, when he succeeded to Abernethy’s lectures on
surgery at St. Bartholomew’s. The Aldersgate School included able
teachers, such as Tweedie, Clutterbuck, Roget, Tyrrell, and Davis,
and had much success. Lawrence’s connection with the Eye Infirmary
led him to become an authority on the surgery of the eye. He
published in 1830 a treatise on the venereal diseases of the eye, in
1833 a treatise on diseases of the eye, besides other papers on this
branch of practice. Late in life he published, in 1863, his valuable
“Lectures on Surgery.” His smaller works and papers are too numerous
to mention.

As a student, Sir Benjamin Brodie describes William Lawrence
as already remarkable for his great powers of acquirement, his
industrious habits, and his immense stores of information. In later
life he characterised him as possessed of considerable powers of
conversation, abounding in happy illustrations and not ill-natured
sarcasm. “In public speaking,” says Brodie, “he is collected, has
great command of language, and uses it correctly. In writing,
his style is pure, free from all affectation, yet in general not
sufficiently concise.... That he is thoroughly acquainted with his
profession cannot be doubted.” But Sir Benjamin does not attribute to
him so much originality as erudition and industry.

It is in his relations to medical politics that the conduct of
William Lawrence is most open to question. When the College of
Surgeons was a close corporation, he put himself at the head of
a great agitation to liberalise it. An eloquent speech at the
Freemasons’ Tavern in 1826 was one of the marked features of the
campaign, in which he joined heartily with the _Lancet_ in attacking
the old-world system of the College. “But,” says the _Lancet_, “the
Council feared him, and elected him into their body. From that moment
Mr. Lawrence became a conservative and an obstructive, and maintained
that character to the close of his life. He not only deserted his
former friends, but lost no opportunity of reviling them.... Mr.
Lawrence, during the long period that he was a member of the Council,
and of the Court of Examiners, resolutely and consistently opposed
every attempt that was made to improve the education and the status
of the surgeon in general practice.”

Lawrence was twice President of the College, and more than once
delivered the Hunterian Oration. On the last of these occasions, in
1846, when a new charter had lately been obtained which failed to
gratify the just aspirations of the members of the College, no one,
it is said, could be persuaded to deliver the Hunterian Oration, till
Lawrence, with characteristic polemic zeal, threw himself into the
breach. A crowded audience, for the most part hostile, assembled;
and Lawrence, instead of avoiding controversy, both defended and
commended the action of the Council. A storm of indignation was
excited, especially among those who had listened to his contrary
deliverances twenty years before. But “the orator was imperturbable
in the fiercest of the storm. He certainly displayed on that occasion
his most extraordinary talents as an orator. When he had allowed his
audience to exhaust their dissatisfaction at the sentiments which
he had uttered, he concluded his address in a most masterly and
eloquent peroration, which called forth the plaudits of the assembly.”

“In arriving at a just estimation of the character of Sir W.
Lawrence, it must be admitted,” says the _Lancet_, “that in most
of the higher qualities of the mind he was entitled to admiration.
His talents were of the highest order, seldom surpassed in our
profession. As a writer, his style was vigorous, clear, and
convincing. As a lecturer, in manner, substance, and expression,
he had no superior in the profession of our time, if we except
Joseph Henry Green. As an operator, if not among the greatest, he is
entitled to hold a high position. But it must be acknowledged that
‘his principles were somewhat lax, his heart was somewhat hard.’
We speak of him now merely in a public capacity, for in all the
relations of private life he was most estimable and affectionate.
Notwithstanding the low estimation in which he held surgeons in
general practice, it is probable no pure surgeon of modern times
ever had so large a general practice as himself. If they were only
competent for the ‘common exigencies of surgery,’ he at all events
thought himself able to treat every class of disease, whether medical
or surgical.”

In physical frame Lawrence was well developed and vigorous, above
middle height, with a high forehead, a cold but keen blue eye, a
classic nose, a large expressive mouth, and a firm chin of some size.
He was always somewhat liable to loss of nerve power in the face or
in the lower limbs. In 1865 he began to become enfeebled, and finally
hemiplegia supervened, and a second attack, at the Council Chamber
of the College of Surgeons, laid him by completely. But he remained
conscious till the last, dying on the 5th July 1867. A bust of him
adorns the rooms of the Medico-Chirurgical Society, and another is
in the College of Surgeons. A baronetcy was only conferred on him in
the March before his death. He had long been Surgeon Extraordinary to
the Queen, and finally Serjeant Surgeon. It has been said of him that
he kept his appointments as long as possible; but it may be answered
that he was full of vitality, and died in harness.


END OF VOL. I.

PRINTED BY BALLANTYNE, HANSON AND CO. EDINBURGH AND LONDON.


FOOTNOTES:

[22] _Lancet_, July 13, 1867. It has been since shown that Lawrence
had nothing to do with the American speculation.




INDEX.


  Abercrombie’s, Sir Ralph, Expedition, i. 182.

  Aberdeen University, i. 100, ii. 246.

  ABERNETHY, JOHN (1764-1831), i. 146, 162, 168;
    early years, 227;
    apprenticeship, 227;
    pupil of Pott and John Hunter, 228;
    appointed assistant-surgeon to St. Bartholomew’s, 228;
    his lectures, 229;
    dramatic style, 230, 231;
    his method, 232;
    apt phrases, 233;
    roughness and eccentricity, 233, 234;
    impatience, 235;
    gratitude of an Irishman, 235, 236;
    anecdotes, 236, 237;
    surgical and physiological essays, 237;
    “read my book,” 238;
    marriage, 239;
    becomes full surgeon, 239;
    failing health, 240;
    resigns appointments, 240;
    death, 241;
    Abernethy and Brodie, 289;
    and Lawrence, 303-305, 307.

  Academy of Science, French, i. 283.

  Acland, Sir H., on Brodie, i. 300-303;
    on Stokes, ii. 189, 192.

  Acupressure, ii. 102.

  Addison Family, the, ii. 1, 2.

  ADDISON, THOMAS (1793-1860), education, ii. 2;
    at Edinburgh, 2;
    settles in London, 3;
    dislike of specialism, 3;
    appointments at Guy’s, 4, 5;
    early works, 4;
    writes on practice of medicine, &c., 5;
    on disease of supra-renal capsules (Addison’s disease), 6, 7;
    clinical teaching, 7;
    his practicality, 8;
    Dr. Wilks on, 8-10, 11;
    bluntness and shyness, 10, 11;
    Continental reputation, 11;
    Dr. Lonsdale on, 12;
    marriage, 12, 13;
    death, 13;
    Addison Ward, 13;
    association with Dr. Bright, 17, 21.

  Aikin, John, on Harvey, i. 47;
    on Cullen, 95.

  Akenside, Mark, i. 99.

  Aldersgate School of Medicine, i. 279, ii. 241.

  Aldus Manutius, i. 2, 3.

  Alison, Dr. W. P., i. 105, ii. 180, 188.

  Anæsthetics, ii. 95-100.

  Anatomical Lectures, i. 18, 75-79, 84, 109, 121, 135, 138, 204, 205,
        229, 246, 289, ii. 25, 26, 36, 37, 48, 49, 73, 226.

  Anatomists, William Hunter on, i. 125.

  Anatomy in London, i. 18;
    in Edinburgh, 72, 73;
    stealing corpses for, 77;
    the resurrectionists, 208-211;
    at Royal Academy, 247.

  —— Comparative. See Comparative Anatomy.

  Anderson, Dr. James, on Cullen, i. 96, 98.

  Aneurism, i. 153, 214, ii. 44.

  Antiseptic Surgery, ii. 46, 114, 141-147.

  Arthur, Prince, i. 3.

  Aubrey on Harvey, i. 35, 38, 48, 49.


  Babington, Dr., on Brodie, i. 299.

  BAILLIE, Dr. MATTHEW (1761-1823) on William Hunter, i. 124;
    completes his uncle’s work, 128;
    his uncle’s bequests to him, 130, 132;
    at John Hunter’s death, 158;
    and Marshall Hall, 267, 269;
    his practicality, ii. 51;
    education, 52;
    assists William Hunter, 53;
    writes on morbid anatomy, 53;
    physician to St. George’s Hospital, 53;
    physician to George III., 54;
    manners and generosity, 54, 55;
    death, 55;
    bequest to College of Physicians, 55.

  Balderson, Charles, i. 208, 211, 215.

  Balfour, Sir A., i. 72.

  Barber Surgeons, i. 18, 72.

  Barclay, Dr. (anatomical lecturer), ii. 25, 35.

  Bark, Peruvian, i. 59.

  Barlow, Dr. H. C., ii. 120.

  Barlow, Dr., on Dr. Bright, ii. 14.

  Baron, Dr., Life of E. Jenner, i. 169, 200, 201.

  Bayley, Miss, i. 186.

  Bell, Benjamin, i. 109, 110.

  Bell, George Joseph, i. 243, 259.

  Bell (John Hunter’s artist), i. 145, 147, 148.

  Bell, Lady; i. 249, 258, 261-263.

  BELL, JOHN (1763-1820), and Dr. Gregory, i. 103, 105, 110;
    early years, 108;
    attacks Monro and Benjamin Bell, 109, 110:
    excluded from Infirmary, 110;
    success in practice, 111;
    operative skill, 111;
    works on anatomy and surgery, 112;
    marriage, 113;
    artistic tastes; 113;
    illness and foreign travel, 113;
    death, 114;
    Observations on Italy, 114;
    personal character, 117, 118;
    and Charles Bell, 243, 244, ii. 48, 107.

  BELL, Sir CHARLES (1774-1842), i. 108, 112, 113;
    birth and education, 243;
    medical study in Edinburgh, 244;
    early works, 244;
    goes to London, 245;
    artistic anatomy, 245;
    lectures and early struggles, 246;
    anatomy of expression, 246;
    his lively temperament, 247;
    first idea of new anatomy of brain, 247;
    disappointment of Academy professorship, 248
    visit to Haslar Hospital, 248;
    marriage, 249;
    partnership in Windmill Street School, 249;
    elected surgeon to Middlesex Hospital, 250;
    goes to Waterloo, 250;
    pamphlet on Brain, 251;
    crucial experiments on spinal cord, 252;
    publishes his discoveries on the nervous system, 253;
    elucidates obscure diseases, 254;
    muscular sense, 254;
    Bridgewater Treatise on the Hand, 255;
    becomes professor at College of Surgeons, 256;
    at London University, 257;
    retires from latter, 257;
    fly-fishing, 257;
    his happy temperament, 258;
    knighted, 259;
    elected Professor at Edinburgh, 259;
    coldness of fellow-professors, 260;
    excitement at proposed changes, 260;
    journey to London, 260, 261;
    his last day, 261;
    _Edinburgh Review_ on, 262;
    Jeffrey’s Epitaph on, 262.

  Bell, William, i. 242.

  BENNETT, JOHN HUGHES (1812-1875);
    early training, ii. 209;
    studies at Edinburgh, 210;
    studies in Paris and in Germany, 210;
    treatise on cod-liver oil, 210;
    lectures in Edinburgh, 211;
    polyclinical course, 211, 212;
    literary work, 212;
    elected Professor, 212;
    clinical teaching, 213;
    and Leucocythæmia, 213;
    views on pneumonia, 214;
    principal works, 214, 215;
    character, 215, 216;
    illness, operation, and death, 216.

  Berkeley, Admiral, and vaccination, i. 192.

  Bishops’ licenses to practise medicine, i. 10.

  Blackhall, Dr., ii. 19.

  Black, Joseph, i. 84, 90, 92, 96.

  Blane, Sir Gilbert, i. 192.

  Blicke, Sir C., i. 227.

  Blizard, Sir W., i. 144, 228.

  Booker, Rev. Dr., i. 185.

  Botany at Edinburgh, i. 72.

  Bowman, J. Eddowes, ii. 261.

  BOWMAN, Sir W. (_b._ 1816);
    early life, ii. 261;
    studies medicine at Birmingham, 261;
    at Dublin and King’s College, London, 261;
    becomes demonstrator and curator, 262;
    Continental studies, 262;
    physiological papers, 262;
    scientific writing, 263;
    appointed to Ophthalmic Hospital, 263;
    eye practice, 264;
    professorship of physiology, 264;
    baronetcy, 265;
    St. John’s House, 265;
    assist Miss Nightingale’s work, 265;
    supports physiological experiments, 265;
    lofty view of surgery, 266.

  Boyle, Robert, i. 54.

  Bridgewater Treatises, i. 255.

  BRIGHT, RICHARD (1789-1858), ii. 5;
    birth, 14;
    studies at Edinburgh and Guy’s, 15;
    journey through Iceland, 15;
    enters at Cambridge, 16;
    travels on Continent, 16, 17;
    at Waterloo, 16;
    appointments at Fever Hospital and at Guy’s, 17;
    Dr. Wilks on, 18;
    writes on kidney diseases, 18-20;
    on pneumonia, 20;
    on cerebral and spinal diseases, 21;
    practice, and death, 21;
    character, 22, 23;
    and Holland, 63, 64.

  Bristol Medical School, ii. 127.

  British Association, ii. 183.

  British Medical Association, i. 281, ii. 162, 177.

  _British Medical Journal_, ii. 154, 248, 265.

  Brodie, Alexander, i. 286.

  Brodie, Peter, i. 288.

  Brodie, Rev. Mr., i. 287.

  BRODIE, Sir BENJAMIN (1783-1862);
    ancestry, i. 286;
    birth, 287;
    early years and education, 288;
    an ensign at fourteen, 288;
    medical study in London, 288, 290;
    non-medical friends, 289;
    the Academical Society, 289;
    becomes demonstrator at Windmill Street, 290;
    appointed Assistant-Surgeon to St. George’s, 290;
    lectures on Surgery, 291;
    physiological studies, 291, 292;
    marriage, 292;
    work on Diseases of Joints, 292;
    professional success, 294;
    professorship at College of Surgeons, 294;
    subcutaneous surgery, 294;
    court appointments, and baronetcy, 295;
    opposition to impostors, 296;
    his numerous presidencies, 297;
    autobiography, 297;
    operations on his eyes, 298;
    death, 298;
    character of, 298-303;
    character of Lawrence, 308.

  Brougham, Lord, i. 246, ii. 34, 43.

  Brown, Baker, ii. 110, 111.

  Brown, Dr. John (Horæ Subsecivæ), on Sydenham, i. 59.

  Brown, Dr. John (founder of Brownian System), i. 98.

  Brown Square School, ii. 36, 37.

  Buckland, F., and John Hunter’s remains, i. 163.

  Budd, George, ii. 125.

  Budd, Samuel, ii. 125.

  BUDD, WILLIAM (1811-1880);
    early life, ii. 125;
    medical studies, 125;
    investigates typhoid fever at North Tawton, 125-126;
    germ theory, 126-128;
    removes to Clifton, 127;
    opposition to his views, 128;
    measures against cholera, 128, 129;
    against rinderpest, 129;
    his writings, 129;
    incessant work, 130;
    views on pulmonary consumption, 130;
    death, 130;
    Murchison and, 132.

  Buller, Justice, and John Hunter, i. 151.

  Burke, Edmund, i. 91.

  Byng, Dr., and Caius, i. 20.


  Cæsalpinus, i. 29.

  Caius College. See Gonville and Caius, also Caius, John.

  CAIUS, JOHN (1510-1573), builds Linacre’s monument, i. 13;
    birth, 13;
    at Cambridge, 14;
    elected fellow of Gonville Hall, 14;
    studies at Padua, and travels in Italy, France, and Germany, 14;
    practises medicine, 14;
    appointed physician to Edward VI., 14;
    writes on Sweating Sickness, 15;
    denounces quacks, 16, 17;
    elected President of College of Physicians, 17, 20;
    introduces dissection, 18;
    enlarges Gonville Hall and builds gates, 19;
    obtains statutes for Gonville and Caius College, and becomes Master,
        19;
    charged with atheism and Romanism, 20;
    books and vestments burnt, 20;
    writes on British Dogs, 21;
    account of Bloodhound, 21, 22;
    writes Method of Healing, 22;
    death and burial, 23;
    inscription on tomb, 23.

  Calvin, i. 28.

  Cambridge University, and Linacre, i. 3, 11;
    and Caius, 14, 19, 20, 23;
    and Sydenham, 60;
    and Chambers, ii. 59;
    and Watson, 149.

  Canadian Indians and Jenner, i. 194.

  Carlisle, Sir Anthony, i. 146, 155, 248, ii. 32.

  Caroline, Princess (wife of George IV.), ii. 65.

  Carro, Dr. De, i. 182.

  Carter, Elizabeth, ii. 267.

  CARTER, R. BRUDENELL (_b._ 1828);
    education, 268;
    early works, 268;
    Crimean service, 268;
    country practice, 269;
    connection with journalism, 269;
    ophthalmic specialism, 269;
    Treatise on Eye Diseases, 270;
    later writings, 270, 271.

  Celsus, i. 14.

  CHAMBERS, WILLIAM FREDERIC (1786-1855);
    education, ii. 59;
    physician to St. George’s Hospital, 59;
    physician to William IV., 60;
    death, 60;
    character and habits, 61.

  Chandler, Mr., on Astley Cooper, i. 218.

  Charles I., i. 35-39.

  Charlesworth and Lunacy, ii. 220.

  Cheselden, i. 76, 77, 120, 134.

  Cholera, ii. 128.

  CHRISTISON, Sir R. (1797-1882), ii. 42;
    education at Edinburgh, 286;
    studies in London and Paris, 286;
    appointed Professor of Medical Jurisprudence at Edinburgh, 286;
    his success in lecturing, 287;
    success as scientific witness, 287;
    dangerous experiments, 288;
    work on poisons, 288;
    appointed Professor of Materia Medica, 289;
    influence in Edinburgh University, 289;
    honours, 290;
    death, 290;
    personal characteristics, 290.

  Circulation of the blood, i. 27-36.

  Civiale’s operation, ii. 196.

  Clarke, Dr., and J. Hunter, i. 150.

  Clark, Sir James, ii. 181.

  Clay, Dr. C., ii. 109, 110.

  Clay, John, ii. 112.

  Cleopatra’s Needle, ii. 247.

  Clerke, Dr., i. 89.

  Clift, W., i. 157, 160, 168, 220.

  Cline, Henry, i. 144, 146, 180, 203, 204, 206, 212, 226.

  Clinical lectures, i. 92, 93, 103, 250, ii. 38, 172, 206, 213.

  —— medicine, ii. 162.

  COBBOLD, T. SPENCER (_b._ 1828);
    early life, ii. 255;
    studies at Edinburgh, 255;
    geological studies, 255, 256;
    appointments in London, 256;
    dissections at Zoological Gardens, 256;
    practice as a specialist, 257;
    connection with Veterinary College, 257;
    lectures on parasites, 258, 259.

  Cod-liver oil, ii. 186, 187, 210, 211.

  Colet, i. 3.

  Collyer, Robert, and anæsthetics, ii. 96, 97.

  Columbus, Realdus, i. 14, 29.

  Combe, William, i. 130, 131.

  Comparative anatomy, i. 80.

  CONOLLY, JOHN (1794-1867), ii. 160, 217;
    early life, 221;
    enters militia, 221;
    studies at Edinburgh, 222;
    practises at Chichester, 222;
    at Stratford, 222;
    appointed Professor at London University, 222;
    settles at Warwick, 222;
    studies insanity, 222, 223;
    work on Indications of Insanity, 223;
    appointed to Hanwell, 225;
    abolishes mechanical restraint, 226;
    clinical lectures, 227;
    interest in patients, 228;
    retirement from Hanwell, 228;
    at Earlswood Asylum, 229, 230;
    private practice, 230;
    writings and lectures, 231;
    writes on Hamlet, 231;
    death, 231.

  Conservative surgery, ii. 47, 71-81.

  Consumption Hospital, ii. 185.

  _Contemporary Review_, ii. 197, 198.

  Cooper, Bransby, i. 209, 221, 222.

  Cooper family, the, i. 202.

  COOPER, Sir ASTLEY (1768-1841), i. 113, 146, 152;
    early life, 202;
    escapades, 203;
    pupilage with Cline, 203;
    studies at Edinburgh, 204;
    becomes lecturer, 204;
    visit to Paris, 204;
    his style of lecturing, 205;
    a severe accident, 206;
    his personal influence, 206;
    appearance and habits, 207;
    sympathy with mental suffering, 207;
    his servant Charles, 208;
    Cooper and the resurrectionists, 208;
    their extortions, 209;
    his determination to have specimens, 210;
    dissection of dogs, 211;
    of an elephant, 211;
    income, 211;
    gives up politics on appointment to Guy’s surgeoncy, 212;
    operates on tympanic membrane, 212;
    membership of societies, 213;
    his store of information, 214;
    operations for aneurism, 214;
    work on Hernia, 214;
    life in New Broad Street, 215;
    in the hospital and lecture-room, 216;
    his overpowering influence, 217;
    graceful operations, 218;
    peremptory orders, 218;
    a big fee, 219;
    his limited pharmacopœia, 219;
    lectures at College of Surgeons, 220;
    ties the aorta, 220;
    operates on George IV., 221;
    Sir Astley as an examiner, 221;
    foundation of Guy’s separate medical school, 222;
    Presidency of the College of Surgeons, 222;
    life in the country, 223;
    horse-keeping, 223;
    temporary retirement, 223;
    later works, 224;
    rapid movements, 224;
    death, monument and portrait, 225;
    estimate of Cooper, 225;
    his own character of himself, 226;
    and Abernethy, 235;
    and Charles Bell, 248;
    and Brodie, 295, 296.

  Cooper, William, i. 203, 212.

  Cornelio Vitelli, i. 2.

  CORRIGAN, Sir DOMINIC (1802-1880);
    education and medical studies, ii. 155;
    papers on heart diseases, 156, 157;
    Corrigan’s pulse, 156, 157;
    appointments, 158;
    becomes M.P. for Dublin, 159;
    death, 159.

  Coulton, ii. 97.

  Cowley on Harvey, i. 39.

  Coxe, Dr. Thomas, i. 53.

  Cremation, ii. 116, 117, 194, 198, 199.

  Cromwell, i. 73.

  Cruickshank, i. 127, 130, 149.

  CULLEN, WILLIAM (1710-1790);
    birth, i. 87;
    education at Glasgow, 87;
    apprenticeship, 88;
    goes to West Indies as ship’s surgeon, 88;
    assists in a London shop, 88;
    begins practice, 88;
    receives a legacy, 88;
    further studies at Edinburgh, 88;
    friendship of Duke of Hamilton, 89;
    influences William Hunter, 89;
    marriage, 89;
    removal to Glasgow, 89;
    founds medical school there, 90;
    his lectures and discoveries, 90, 91;
    becomes Professor of Medicine at Glasgow, 91;
    friendship with Adam Smith and David Hume, 91;
    appointed Professor of Chemistry at Edinburgh, 91;
    his clinical lectures, 92;
    his candour, 92, 93;
    letter to his son, 94, 95;
    appointed to Chair of Physic, 95;
    his works, 96;
    personal influence, 96, 97;
    kindness to students, 97;
    Cullen and John Brown, 98;
    death, 98;
    personal aspect and habits, 98;
    agreement with Gregory, 100;
    friendship with William Hunter, 91, 94, 120, 122.

  Czermak, ii. 251.


  Dancaster, William, i. 13.

  Darwin, Charles, anticipation of, i. 172.

  Davy, Sir Humphrey, i. 172, ii. 95, 96.

  Dogs, Caius on, i. 21.

  Donders, ii. 260.

  Donellan, Captain, trial of, i. 150.

  Douglas, Dr., i. 120, 121.

  Down, Dr. Langdon, on Conolly, ii. 229.

  Drummond, George, i. 78.

  Dublin Medical School, ii. 105, 155, 189-191, 201-208.

  Duncan, Dr., on Monro _secundus_, i. 85, 86.


  Edinburgh University and Medical School, i. 71-118, 204, 213, 224,
        259, 260; ii. 2, 15, 25-28, 35-50, 56, 59, 63, 64, 73, 85-94,
        99-103, 125, 130, 131, 138, 149, 155, 204, 210-216, 221, 222,
        286, 289.

  Edward VI., i. 14.

  Elizabeth, Queen, i. 14, 18, 23.

  Elliot, Robert, Professor of Anatomy at Edinburgh, i. 75.

  Ent, Sir G., i. 40, 41.

  Erasmus, i. 3, 4, 5.

  Esquirol and lunacy, ii. 220.

  Expectant treatment, i. 59.


  Fabricius, i. 26, 29.

  Faraday, ii. 96, 181.

  FERGUSON, Sir WILLIAM (1808-1877), and conservative surgery, ii. 71,
        72;
    early years, 72;
    studies anatomy under Knox, 72, 73;
    assists Knox, 73;
    his Edinburgh appointments, 73;
    removal to London, 74;
    operative skill, 74, 75;
    conservation of limbs, 75;
    lithotomy, 76;
    excision of joints, 76, 77;
    hare-lip and cleft-palate, 77;
    invents instruments, 78;
    careful planning of operations, 78, 79;
    “Practical Surgery,” 79;
    social character and manners, 80-82;
    appointments, 81;
    President of College of Surgeons, 81;
    death, 82.

  Fever Hospital, London, ii. 118, 119, 124, 131, 132.

  Fevers, Sydenham’s method of curing, i. 54;
    treatment of, 64.

  Fisher, Robert, i. 3.

  Flogging of Soldiers, i. 281.

  Flourens, i. 283.

  Foot, Jesse, on John Hunter, i. 135.

  _Fortnightly Review_, ii. 240, 253.

  Fothergill’s, Dr., collection, i. 130.

  Fox, Bishop of Winchester, i. 4, 11.

  Framingham, William, i. 16.

  French Academy of Sciences, i. 283.

  Fuller, on Caius, i. 20.


  Galen, i. 7, 8, 14.

  Gardner, E., i. 173, 176, 178.

  Garthshore, Dr., i. 139, 162.

  Generation, Harvey on, i. 34, 39-43.

  George III., i. 127, ii. 54, 57.

  George IV., i. 221, 295, ii. 57.

  Gerhard, Dr., of Philadelphia, ii. 120.

  Germ Theory of Typhoid, ii. 126, 127.

  Gesner and Caius, i. 21.

  GILBERT, WILLIAM (1540-1603), i. 23, 24;
    physician to Queen Elizabeth, 23;
    writes on the magnet, 24.

  Glasgow University, i. 87, 89, 120, 122, 128.

  Gonville and Caius College, i. 19, 26.

  Gonville Hall, i. 14, 19.

  Goodsir, John, ii. 47, 255.

  GRAVES, R. J. (1795-1853), ii. 189;
    studies at Dublin, London, and Edinburgh, 202;
    travels on Continent, 202;
    intercourse with Turner, 202;
    decision when in danger, 203;
    description of, by Stokes, 203;
    appointments in Dublin, 204, 206;
    introductory lecture, 204;
    his clinical method, 205;
    lectures on physiology, 206;
    clinical lectures, 206;
    Trousseau’s opinion, 206, 207;
    views on fevers, 208;
    on cholera, 208;
    death, 209.

  Gregory family, i. 87, 99-108.

  Gregory, Henry, on Marshall Hall, i. 277.

  GREGORY, JAMES, Dr. (1753-1821), on Monro _secundus_, i. 83;
    early years, 102;
    completes his father’s lectures, 102;
    studies on the Continent, 102;
    practice, 103;
    Gregory’s “Conspectus,” 103;
    succeeds to Cullen’s chair, 103;
    controversies, 103-105;
    Gregory and John Bell, 105, 110, 112;
    as a teacher and lecturer, 106;
    autocracy, 103-107;
    philosophical writings, 107.

  GREGORY, JOHN (1724-1773), i. 95;
    early years, 99;
    studies at Edinburgh, 99;
    at Leyden, 99;
    elected professor at Aberdeen, 100;
    marriage, 100;
    settles in London, 100;
    recalled to Aberdeen, 100;
    removes to Edinburgh, 100;
    works, 101;
    death, 102.

  Gregory, William, i. 107.

  Grocyn, i. 3, 7.

  GULL, Sir W. W. (_b._ 1816);
    studies at Guy’s Hospital, ii. 159;
    appointments at Guy’s, 160;
    writings, 161;
    protest against specialism, 161;
    address to British Medical Association, 162;
    Harveian oration, 162, 163;
    honours, 163, 164;
    evidence on intemperance, 164;
    view of vivisection, 165, 166.

  Guy, William, ii. 302.

  GUY, W. A. (_b._ 1810);
    education, ii. 302;
    studies at Guy’s, Cambridge, and on the Continent, 303;
    appointed professor at King’s College, London, 303;
    studies statistics, 303;
    sanitary reforms, 303;
    works, 303.

  Guy’s Hospital, i. 202-222, 225, ii. 3-13, 15-21, 159-161, 282, 291.

  Guy’s Hospital Reports, ii. 10, 18, 20, 21, 161, 294.


  HALFORD, Sir HENRY (1766-1844);
    on Baillie, ii. 51;
    education, 56;
    physician to Middlesex Hospital, 56;
    physician to George III., 57;
    change of name, 57;
    president of College of Physicians, 58;
    writings, 58.

  HALL, MARSHALL (1790-1857);
    birth, i. 264;
    education and apprenticeship, 265;
    study at Edinburgh, 265;
    lectures on diagnosis, 266;
    Continental study, 267;
    practice in Nottingham, 267;
    work on Diagnosis, 267;
    on Symptoms and History of Diseases, 268;
    on Loss of Blood, 268;
    antagonism to bleeding, 268;
    removes to London, 269;
    rapid success, 269;
    research on circulation refused by Royal Society, 270;
    other papers accepted, 270;
    study of hybernation, 271;
    accident to a manuscript, 271;
    research on reflex actions, 272-276;
    application to nervous diseases, 273, 274, 276, 277;
    persistent attacks on, 274, 275;
    second paper rejected by Royal Society, 274;
    researches on galvanism and nervous tissues, 275;
    replies to mis-statements, 275, 276;
    new memoir on Nervous System, 276;
    Ready Method in Asphyxia, 277;
    his demeanour in practice, 278, 279;
    lectures, 279;
    at College of Physicians, 280;
    British Medical Association, 281;
    philanthropic schemes, 281;
    visit to America, 282;
    writes on Slavery, 282;
    Continental tour, and reception in Paris, 283;
    suggestions for restoring the apparently drowned, 284;
    painful illness and death, 285.

  Hall, Mrs. Marshall, i. 276.

  Hall, Robert, father of Marshall, i. 264.

  Hall, Samuel, brother of Marshall, i. 265.

  Hamilton, Duke of, i. 87, 89, 90.

  Harrison, Treasurer of Guy’s, i. 212, 222, ii. 3.

  Harveian Oration, i. 25, 45, 86, ii. 162.

  HARVEY, WILLIAM (1578-1657);
    birth, i. 26;
    at Cambridge and Padua, 26;
    settles in London, 26;
    physician to St. Bartholomew’s, 27;
    Lumleian lecturer, 27;
    expounds new views on heart and circulation, 27;
    Treatise on Motion of Heart and Blood, 30-33;
    Harvey called crack-brained, 35;
    physician to James I. and Charles I., 35;
    travels on the Continent, 36;
    attendance on Charles I., 36, 37;
    at Edgehill, 37, 38;
    at Oxford, 38;
    studies hatching of eggs, 38;
    appointed Warden of Merton College, 38;
    his museum destroyed, 39;
    leaves Oxford, 39;
    lives with his brothers, 40;
    entrusts Treatise on Generation to Dr. Ent, 41;
    its publication, 42;
    Harvey’s lost medical works, 43;
    benefactions to College of Physicians, 44-47;
    declines Presidency, 45;
    infirmity in old age, 46;
    death and burial, 46;
    will, 46, 47;
    personal character, 47;
    personal appearance, 47, 48;
    lofty intellectual position, 49;
    habits, 49, 50;
    Latinity, 50;
    memorials in College of Physicians, 50;
    William Hunter on, 126;
    records of, in St. Bartholomew’s Hospital, ii. 169.

  Harvey’s brothers, i. 26, 40, 46, 50.

  Harwood, Dr., on William Hunter’s library, i. 129.

  Hawkins, Cæsar, ii. 110.

  Hazelwood School, ii. 261.

  Healing, Caius’ Method of, i. 22.

  Helmholtz, ii. 260.

  Henry VII., i. 1, 2, 4.

  Henry VIII., i. 4, 7, 10, 14.

  Herbert, Sidney, ii. 298.

  Hewson, William, i. 84, 126, 138.

  Hill, Gardiner, and Lunacy, ii. 220, 221.

  HINTON, JAMES (1822-1875);
    early history, ii. 278, 279;
    studies at St. Bartholomew’s Hospital, 280;
    foreign voyages, 280;
    residence in Jamaica, 280;
    intercourse with Toynbee, 281;
    early writings, 281;
    aural practice, 282;
    charm of conversation, 283;
    later publications, 284;
    death, 284.

  Hinton, J. H., ii. 278.

  Hippocrates, the British, i. 52-70.

  Hobbes of Malmesbury, i. 47.

  Hodgson, Joseph, ii. 261.

  Holland, Lord and Lady, i. 294, ii. 65.

  HOLLAND, Sir HENRY (1788-1873), ii. 15;
    early life, 62;
    at Glasgow University, 63;
    draws up Report on Agriculture of Cheshire, 63;
    at Edinburgh, 64;
    in society, 64;
    travels, 64, 65, 68, 69;
    becomes medical attendant to Princess Caroline, 65;
    success and moderation, 66;
    his great energy, 67;
    marriages, 67;
    physician to Queen Victoria, 67, 68;
    death, 68;
    writings, 69;
    Recollections of Past Life, 70.

  Home, Sir Everard, i. 141, 143, 148, 152, 154, 158-161, 178, 290,
        291.

  Houstoun, R., ii. 109.

  Humane Society, i. 147, 284.

  Hume, David, i. 91, 102.

  Hunterian Museums. See Museums.

  Hunterian Oration, i. 309.

  HUNTER, JOHN (1728-1793), i. 123, 124, 127, 131;
    birth and early years, 133;
    visit to Glasgow, 133;
    goes to London and assists his brother, 134;
    his hospital studies, 134;
    short residence at Oxford, 135;
    shares his brother’s lectures, 135;
    his style of lecturing, 136;
    early discoveries, 136;
    dissection of animals, 137;
    becomes staff-surgeon in army, and goes to Belleisle and Portugal,
        137;
    returns home and practises in Golden Square, 138;
    want of tact, 138;
    his brusqueness, 139;
    builds a house at Earl’s Court, and keeps a private menagerie,
        139;
    his encounter with leopards, 139;
    ruptures his _tendo Achillis_, and studies mode of cure, 140;
    elected Fellow of Royal Society, and surgeon to St. George’s
        Hospital, 140;
    takes a house in Jermyn Street, and receives Jenner as pupil, 141;
    marries Miss Home, 141;
    his dislike of fashionable parties, 141;
    writes on the Teeth, and on digestion of stomach after death, 142;
    his principal contributions to the Royal Society, 142, 143;
    his indefatigable industry, 143;
    punctuality and order, 144;
    blunt hospitality, 144;
    employs an artist named Bell, 144, 145;
    lectures on surgery, 145;
    after-dinner habits, 146, 147;
    appointed surgeon to the King, 147;
    Croonian lectures, 148;
    suffers from angina pectoris, 148;
    visit to Bath, 148;
    emotion at his brother’s death, 149;
    his eagerness for specimens, 150;
    obtains skeleton of O’Brien, the Irish giant, 150;
    evidence on murder of Sir T. Boughton, 150;
    Justice Buller’s strictures, 151;
    builds museum in Leicester Square, 151;
    renewed illness, 152;
    portrait by Sir Joshua Reynolds, 153;
    ties femoral artery, 153;
    experiments on deer’s antlers, 153;
    appointed surgeon-general to the army, 154;
    Copley medal awarded, 154;
    Home assists him, 154;
    Hunter writes treatise on Blood, Inflammation, &c., 155;
    dispute with hospital governors and surgeons, 155-157;
    aid to young students, 155;
    discussion at board meeting, and sudden death, 157;
    personal appearance, 158;
    national vote for his museum, 158;
    declined by Physicians, accepted by Surgeons, 158;
    Home and Hunter’s papers, 159;
    Home burns them, 160;
    Hunter the Cerberus of the Royal Society, 161;
    his generosity, 162;
    his income, 162;
    his sense of his own importance, 162;
    religious views, 162;
    removal of remains to Westminster Abbey, 163;
    views on life, 163, 164;
    Dr. Moxon on, 165;
    Sir James Paget on, 166-168;
    Abernethy on, 168;
    Clift on, 168;
    and Edward Jenner, 170, 171, 176;
    and Cline, 203;
    and Astley Cooper, 204, 205;
    and Abernethy, 228, 241;
    and Baillie, ii. 53;
    and ovariotomy, 106.

  HUNTER, WILLIAM (1718-1783), i. 84;
    becomes Cullen’s pupil, 89;
    subsequent friendship with Cullen, 91, 94, 120, 122;
    studies at Edinburgh, 120;
    goes to London, 120;
    studies at St. George’s Hospital, 121;
    lectures on anatomy, 121;
    lack of means, 122;
    enters on obstetric practice, 122;
    visits home, 122;
    Medical Commentaries and other writings, 123;
    disputes as to originality, 123, 127;
    is assisted by John Hunter, 124;
    excellence as a teacher, 124;
    on anatomical controversy, 125;
    on Harvey, 126;
    called in to the Queen, 126;
    chosen professor to the Royal Academy, 127;
    Hunter and the Royal Society, 127, 128;
    Hunterian Museum (now at Glasgow), 128;
    founds anatomical school in Great Windmill Street, 129;
    cost and extent of his collection, 129, 130;
    leaves it to Baillie, with reversion to Glasgow University, 130;
    intends to retire, 130;
    dies, 131;
    portraits of Hunter, 131;
    personal habits and manners, 132;
    bequeaths estate to Baillie, 132;
    and John Hunter, 134;
    and Baillie, ii. 53;
    and ovariotomy, 106.

  Hypochondria, Description of, i. 65.


  India and Jenner, i. 183, 197.

  Infirmary at Edinburgh, i. 78, ii. 26-28, 36-39, 45, 49, 73.

  Jackson, C., ii. 98.

  James I., i. 24, 35.

  Jefferson, President, i. 182.

  Jeffrey, Francis, i. 257, 258, 262.

  JENNER, EDWARD (1749-1823), i. 141, 148;
    apprenticeship, 169;
    inoculation for small-pox, 170;
    becomes John Hunter’s pupil, 170;
    their mutual influence, 171;
    Jenner’s sympathetic qualities, 172;
    suggestion about earthworms, 172;
    his personal appearance, 173;
    wit, poetry, and accomplishments, 174;
    convivial societies, 174, 175;
    studies cow-pox, 176-180;
    publishes discovery of vaccination, 179;
    refuses London practice, 180;
    Jenner and Dr. Woodville, 181;
    discovery made known on Continent, 181;
    in United States, 182;
    in the East, 183;
    Jenner’s patriotic offer, 183;
    publishes brief narrative, 184-186;
    vaccination by non-professionals, 186;
    vaccination attacked, 187;
    gratuitous vaccination, 189;
    public vaccine Board, 190;
    a temple to Jenner, 191;
    the Empress of Russia and Jenner, 191;
    Parliamentary grant, 192;
    Royal Jennerian Institution, 193;
    Treasury delays, 193;
    testimony of Canadian Indians, 194;
    Napoleon and Jenner, 194;
    National Vaccine Establishment, 195;
    Jenner’s inward life, 196;
    second Parliamentary grant, 196, 197;
    gratitude of Europeans in India, 197;
    bereavements, 197;
    death from small-pox after vaccination, 198;
    Jenner’s account, 198;
    presentation to the Czar, 199;
    death of Mrs. Jenner, 199;
    death, 200;
    Dr. Baron on, 200, 201.

  Jennerian Society, Royal, i. 190, 193.

  JENNER, Sir WILLIAM (_b._ 1815);
    studies and early successes, ii. 118;
    papers on Typhoid and Typhus Fevers, 119, 123;
    later appointments and writings, 124, 125;
    on Parkes, 296, 301.

  Jenner, Stephen, i. 169.


  Kaye. See Caius.

  Keate, i. 155.

  Keith, T., ii. 102.

  Key. See Caius.

  King’s College, London, ii. 74, 76, 77, 147, 149, 150, 262-264, 304.

  Knox, Robert, ii. 72, 73.


  Laennec, ii. 5, 181.

  _Lancet, The_, i. 267, 275, 293, 298, 307, 309, 310, ii. 97, 133, 134,
        142, 214, 243, 244, 295.

  Latimer, i. 7.

  LAWRENCE, Sir WILLIAM (1783-1867),
    and Brodie, i. 289;
    education, 303;
    apprenticed
    to Abernethy, 303;
    appointments at St. Bartholomew’s, 304;
    early works, 304;
    professor at College of Surgeons, 305;
    criticism of Abernethy, 305;
    lectures on Man, and controversy thereon, 305-307;
    Lawrence yields to the storm, 307;
    establishes Aldersgate Medical School, 307;
    ophthalmic works, 308;
    relations with College of Surgeons, 308;
    delivers Hunterian oration, 309;
    character of, 310;
    death, 311.

  Lenten preacher at Rome, a, i. 115-117.

  Lifeboat Institution, National, and Marshall Hall, i. 284.

  Lilye, i. 12.

  LINACRE, THOMAS (1460-1524), birth, i. 1;
    descent, 2;
    school-days, 2;
    elected fellow of All Souls’, 2;
    takes pupils, 2;
    travels in Italy, 2;
    graduates M.D. at Oxford, 3;
    translates the “Sphere” of Proclus, 3;
    teaches Erasmus Greek, 3;
    becomes Prince Arthur’s tutor, 3;
    appointed physician to Henry VIII, 4;
    studies theology, 4;
    gains preferments, 5;
    advises Erasmus, 5;
    lectures at Oxford, 6;
    receives a flattering address, 6;
    translates Aristotle and Galen, 7, 8;
    writes on grammar and language, 8;
    founds College of Physicians, 8-10;
    benefactions to it, 10;
    founds lectureships at Oxford and Cambridge, 10-12;
    his practical skill, 12;
    his personal character, 12;
    death, 13;
    buried in St. Paul’s, 13;
    memorial erected by Caius, 13;
    will, 13.

  Lister, Joseph Jackson, F.R.S., ii. 135-137.

  LISTER, Sir JOSEPH (_b_. 1828), ii. 46, 47, 114;
    studies, 137;
    physiological researches, 137;
    professorship at Glasgow, 138;
    unhealthy wards, 138-140;
    carbolic acid and germs, 141;
    the antiseptic system, 141-147;
    diminution of pyæmia, 143, 146;
    experiment on a calf, 143, 144;
    antiseptic gauze, 145;
    carbolic spray, 146;
    corrosive sublimate, 146;
    distinctions conferred upon, 147.

  Liston, Rev. Harry, ii. 24.

  LISTON, ROBERT (1794-1847), education and early years, ii. 24;
    medical study in Edinburgh, 25;
    in London, 25;
    assists Barclay, 25;
    lectures on anatomy and surgery, 26;
    dissensions at the Royal Infirmary, 26-28;
    removes to London, 28;
    works on surgery, 28;
    as an operator, 29, 30;
    his great strength, 30, 31;
    his decision, 31;
    and the College of Surgeons, 32;
    the _Times_ on, 32, 33;
    and Syme, 33, 34, 35-37, 39-41;
    death, 34;
    and Sir J. Simpson, 85;
    and chloroform, 98.

  Lizars, Alexander, ii. 49.

  Lizars, John, ii. 39, 48-50, 74, 109.

  Locke, John, i. 62, 63, 70.

  Lombard, Dr. H. C., ii. 119.

  London Hospital, ii. 250-252.

  London University, i. 257, ii. 163, 176, 301.

  Long, St. John, i. 296.

  Lonsdale, Dr., on Dr. Addison, ii. 3, 12, 13.

  Lorenzo de Medici, i. 2.

  Louis, i. 283, ii. 120.

  Lumleian lectures, i. 27, 35, 44.

  Lunacy, ii. 217-235.

  Lymphatics, i. 84.


  Macilwain on Abernethy, i. 231-233.

  M’Dowell, Ephraim, ii. 107-109.

  M’Kendrick, Dr., on Hughes Bennett, ii. 215, 216.

  MACKENZIE, MORELL (_b._ 1837), on specialism, ii. 240;
    early life, 249, 250;
    medical study, 250, 251;
    Continental studies, 251;
    acquaintance with Czermak, 251;
    appointments at London Hospital, 251, 252;
    work with laryngoscope, 251-254;
    becomes a specialist in diseases of the throat, 252;
    his various works, 253;
    extension of specialism, 253, 254.

  Mackenzie, Stephen, ii. 249, 250, 268.

  Mackenzie’s Travels in Iceland, ii. 15, 64.

  Malpighi, i. 30, note.

  Malthus, i. 61.

  Manchester, Bishop of, on cremation, ii. 117.

  Manutius, Aldus, i. 2, 3.

  Mapletoft, Dr. J., i. 52, 62.

  Mary, Queen, i. 14.

  Materialism, i. 306.

  MAUDSLEY, HENRY (_b._ 1835);
    studies in London, ii. 232;
    appointed Professor at University College, 233;
    writes on Theory of Vitality and on Physiology and Pathology of
        Mind, 233;
    Gulstonian Lectures on Body and Mind, 234;
    case of Victor Townley, 235;
    on Responsibility in Mental Disease, 235;
    on Pathology of Mind, 235;
    on Body and Will, 237, 238.

  Meckel, i. 83.

  Medical and Chirurgical Society, Royal, i. 213, 268, 295, 297, 299,
        ii. 11, 123, 187.

  Medical Association, British, i. 281, ii. 45, 81, 124, 290.

  Medical Council, ii. 159, 164, 289.

  Medical Lectures, i. 75, 90, 92, 95, 96, 97, 100, 103, 106, ii. 5,
        17, 133, 150, 158, 160, 183, 189.

  Medical Society, Royal, of Edinburgh, i. 213, 265, ii. 2, 88, 209,
        222.

  _Medical Times_, ii. 77, 293, 294, 297.

  Medicine, British, Foundation of, i. 1-24.

  Menagerie, Tower, i. 137, 211.

  Merton College, Oxford, i. 38, 39.

  Middlesex Hospital, i. 250, 259, ii. 56, 131, 149, 256.

  Minto House Hospital, ii. 38, 39.

  MONRO, ALEXANDER (_primus_) (1697-1767);
    birth, i. 75;
    education, 75, 76;
    appointed Professor of Anatomy, 76;
    first lecture, 76;
    large classes, 77;
    difficulty of obtaining subjects, 77;
    building of the infirmary, 78;
    clinical lectures, 79;
    post mortem examinations, 79;
    “Osteology,” 79;
    other works, 79;
    Comparative Anatomy, 80;
    private life, 80;
    dresses wounds after Prestonpans, 81;
    death, 81;
    Professor Struthers on, 81.

  MONRO, ALEXANDER (_secundus_) (1733-1817);
    birth, i. 82;
    lectures for his father, 82;
    Continental travels, 82;
    taught by Meckel, 83;
    becomes professor, 83;
    medical practice, 83;
    discoveries on the lymphatic system, 84;
    other works, 85;
    fondness for the stage, 85;
    and for horticulture, 85;
    economy of time, 86;
    favours vaccination, 86;
    death, 87;
    John Bell and, 108, 109.

  MONRO, ALEXANDER (_tertius_), i. 86.

  Monro, John, i. 75, 76.

  Montagu, Lady Mary, i. 100.

  Montanus, i. 14.

  Monteith, Alex., i. 73, 74.

  More, Hannah, ii. 178.

  More, Sir T., i. 2, 3, 11.

  Morris, Edward, i. 197.

  Morton, W. T. G., ii. 98.

  Moxon, Dr., on John Hunter, i. 165, 166.

  Müller, Johannes, and Marshall Hall, i. 270.

  MURCHISON, CHARLES (1830-1879), ii. 119;
    medical studies, 130, 131;
    work in Calcutta and Burmah, 131;
    returns to London, 131;
    appointments, 131;
    work on Continued Fevers, 131-133;
    other writings, 133;
    his teaching powers, 133;
    character, 134.

  Museums, Hunterian, i. 128-130, 151, 158, 159, 163.


  Napoleon I. and Jenner, i. 194.

  National Vaccine Institution, i. 193, 195.

  Nélaton, ii. 11.

  Nightingale, Miss Florence, ii. 265.


  O’Brien, skeleton of, i. 150.

  Orfila, ii. 285, 286, 291.

  Ottley, D., on John Hunter, i. 146.

  Ovariotomy, ii. 106-114.

  Oxford University, Linacre and, i. 2, 3, 6, 7, 11;
    Harvey and, 38, 39;
    Sydenham at, 52-54;
    John Hunter at, 135;
    and Jenner, 199;
    and Baillie, ii. 52;
    and Halford, 56.

  Padua, Linacre at, i. 2;
    Caius at, 14;
    Harvey at, 26.

  PAGET, Sir JAMES (b. 1814), i. 166-168, ii. 72, 114, 143;
    early studies, 167;
    report on results of use of microscope, 168;
    address to students, 168, 169;
    professorship at College of Surgeons, 169:
    publication of lectures, 170;
    conditions of healthy nutrition, 170, 171;
    lecture on Study of Physiology, 172;
    clinical lectures, 172;
    attention to detail, 173;
    serious illness, 173, 174;
    on Theology and Science, 174;
    on alcohol, 175;
    appointments, 176;
    on the College of Surgeons’ Museum, 176;
    on exceptions to types, 177;
    on Study of Science, 177.

  Palmer, trial of, i. 284, ii. 287, 288, 294.

  Palmerston, Lord, ii. 66.

  PARKES, E. A. (1819-1875);
    Harveian oration, i. 25;
    early influences, ii. 296;
    studies at University College, 296;
    goes to Madras and Moulmein, 297;
    practice in London, 297;
    journalistic work, 297;
    physician to University College Hospital, 297;
    serves in Crimean war, 298;
    appointed professor at Army Medical School, 298;
    Manual of Practical Hygiene, 299;
    Army Medical Reports, 300;
    Sir W. Jenner on, 301;
    death, 302.

  Parry, Dr., and Jenner, i. 197.

  Paterson, Dr., Life of Syme by, ii. 31.

  Pathological Society, ii. 185.

  Pathology, i. 145.

  Pearson, Dr., and vaccination, i. 190, 191.

  Pembroke, Earl of, i. 15.

  Pennock, Dr., of Philadelphia, ii. 120.

  Peruvian bark, i. 59.

  Pettigrew, Dr., on Astley Cooper, i. 216-218;
    on Abernethy, 230.

  Petty, Lord H., and vaccination, i. 196.

  Physical Society of Guy’s, i. 213, ii. 6.

  Physicians (Edinburgh), College of, i. 72-73, 76, ii. 289.

  Physicians (Irish), College of, ii. 158, 206.

  Physicians (London), College of, foundation of, i. 1, 8;
    letters patent, 9;
    new statutes, 10;
    Caius and, 15;
    insignia of, 17;
    dissection, 18;
    Harvey Lumleian lecturer at, 27, 35;
    declines presidency, 45;
    Sydenham and, 61;
    and John Hunter’s Museum, 158;
    E. Jenner and, 195, 199;
    Marshall Hall and, 280;
    Bright and, ii. 21;
    Baillie and, 53, 55;
    Halford and, 56, 58;
    W. Jenner and, 124;
    Murchison and, 133;
    Watson and, 151;
    Williams and, 184, 187;
    Maudsley and, 234, 238;
    Parkes and, 298;
    Guy and, 303.

  Pinel, ii. 218, 219.

  Piozzi, Mrs., on Henry Holland, ii. 64.

  Pitcairne, i. 73.

  Pitt, William, i. 158.

  Plempius of Louvain, i. 44.

  Poisons, ii. 4.

  Politian, i. 2.

  Pott, Percival, i. 134, 228.

  Prayer for the sick, ii. 197.

  Prestonpans, i. 81.

  Priestley, Dr., ii. 95.


  Quacks, i. 16, 17, 58.

  Quain, Jones, ii. 241, 242.

  Queen’s University, Ireland, ii. 158.


  Reflex action, i. 272-277.

  Reid, John, ii. 85.

  Reid, Thomas, i. 99, 107.

  Resurrectionists, i. 208-211.

  Reynolds, Dr. Russell, i. 276, 295.

  Reynolds’, Sir Joshua, portrait of William Hunter, i. 131;
    of John Hunter, 153, 163.

  Richardson, John, i. 257.

  Rinderpest, ii. 129.

  Riolan, John, the younger, i. 33, 36, note.

  Roots, Dr. W., and Astley Cooper, 206.

  Royal Institution, ii. 66, 172.

  Royal Society and William Hunter, i. 127;
    and John Hunter, 140, 142, 143, 147, 148, 149, 154;
    and Astley Cooper, 212, 213;
    and Charles Bell, 253;
    and Marshall Hall, 270, 272, 274, 275;
    and Brodie, 291, 292, 297, 300;
    and Lister, ii. 138, 147;
    and Wilson, 244;
    and Bowman, 262;
    and Toynbee, 273, 275;
    and Parkes, 301.

  Russia, Emperor of, i. 195, 199.

  —— Empress of, i. 191.


  Salm, Count de, and vaccination, i. 191.

  Sandford, Bishop, i. 114.

  Sandys, Bishop, i. 20.

  Scott, Sir Walter, ii. 150.

  Selling, William, fellow of All Souls’, i. 2.

  Servetus, i. 27, 28.

  Shagglyng Lecture, i. 6.

  Sharpe, Samuel, i. 121.

  Shaw, Alexander, i. 249, 257, 258.

  Shaw, John, i. 249, 250, 256.

  Shelburne, Lord, i. 128.

  Short, Dr. T., i. 68.

  Sibbald, Sir R., i. 72, 73, 75.

  Siddons, Mrs., i. 85.

  Simmons, Dr. Foart, on William Hunter, i. 132.

  SIMON, JOHN (_b._ 1816);
    student at King’s College, 304;
    appointed lecturer at St. Thomas’s Hospital, 304;
    medical officer to City of London, 304;
    to Board of Health and Privy Council, 304;
    Reports to Privy Council, 305;
    honours, 306.

  Simpson, Alexander, ii. 84, 86, 89, 104.

  SIMPSON, Sir JAMES Y. (1811-1870);
    birth and early years, ii. 83, 84;
    student life in Edinburgh, 85;
    his father’s death, 86;
    disappointed of a parish surgeoncy, 86;
    becomes assistant to Professor Thomson, 87;
    his first original paper, 88;
    description of, when presiding over Medical Society, 88, 89;
    visits London and the Continent, 89;
    his habits of plain speech, 90;
    candidature for professorship of midwifery, 90, 91;
    his success, 91, 92;
    antiquarian paper on Leprosy, 92;
    success in practice, 92, 93;
    complaints of neglect, 93;
    controversies, 94;
    experiments with sulphuric ether, 98;
    introduces chloroform, 99;
    description of Simpson’s parties, 101;
    introduces acupressure, 102;
    attacks hospital system, 102;
    honours, 103;
    bereavements, 103;
    death, 104.

  Slavery, Marshall Hall on, i. 282.

  Smith, Adam, i. 91.

  Smith, Henry, and Marshall Hall, i. 271.

  Smith, Henry, and Sir W. Fergusson, ii. 79, 80, 82.

  Smith, Sydney, and Holland, ii. 67, 68.

  Specialism, ii. 161, 239, 240.

  Squirrel, Dr., and vaccination, i. 188.

  St. Andrews University, i. 175.

  St. Bartholomew’s Hospital, i. 27, 36, 134, 304, 307, ii. 149,
        167-169, 176, 286.

  St. George’s Hospital, i. 134, 140, 154-158, 290, 291, ii. 25, 53,
        59, 269, 273.

  St. Mary’s Hospital, ii. 131, 257, 275.

  St. Thomas’s Hospital, i. 204, 205, 211, 212, 216, 218, 219, 221,
        222, 279, ii. 105, 133, 291, 304.

  Stethoscope, the, ii. 5, 60.

  Stewart, Dr. A. P., ii. 120.

  Stewart, Dugald, i. 63, 95.

  STOKES, WILLIAM (1804-1878);
    studies in Glasgow and Edinburgh, ii. 188;
    writes on the stethoscope, 188;
    early success, 189;
    work on Diseases of the Chest, 189;
    appointed Professor in Dublin University, 189;
    work on Diseases of the Heart, 190;
    lectures on fever, 191;
    on student’s culture, 191;
    on prevention of disease, 192;
    character by Sir H. Acland, 192;
    early rising and geniality, 193;
    death, 193;
    on Graves, 203, 205.

  Struthers, Professor, on Monro _primus_, i. 81;
    on Monro _secundus_, 83, 87;
    on John Bell, 111.

  Surgeons, College of, Edinburgh, i. 72, 75, 77, 208, ii. 44, 49, 73

  Surgeons, College of, London, i. 220, 221, 240, 250, 256, 294, 297,
        304-311, ii. 32, 79, 81, 115, 167, 169, 176, 246, 249, 271,
        305.

  Surgical Lectures, i. 79, 109, 131, 138, 145, 154, 156, 205, 229,
        246, 247, 291, ii. 25, 28, 36, 37, 48, 49, 79.

  Sutherland, James, i. 72.

  Sweating Sickness, i. 15.

  Sydenham College, i. 279, ii. 242.

  —— Society, New, ii. 187, 189.

  SYDENHAM, THOMAS (1624-1689);
    birth, i. 52;
    at Oxford, 52;
    led to choose medicine by Dr. Coxe, 53;
    escapes when shot at in London, 53;
    returns to Oxford, 54;
    removes to London, 54;
    publishes method of curing fevers, 54;
    his principles, 55;
    philosophic views, 56;
    ideas of disease, 57;
    views on nature’s order, 58;
    on quacks and culpable secrecy, 58;
    on Peruvian bark, 59;
    Dr. J. Brown on the “Method,” 59, 60;
    subsequent editions, 60;
    becomes M.D., 61;
    treatise on gout and dropsy, 61;
    death, 61;
    will, 61;
    medicine learnt by practice, 62;
    his opinion of Locke, 62;
    experimental medicine, 63;
    attention to wishes of patients, 64;
    on hysteria and hypochondria, 65;
    Sydenham’s character of himself, 66;
    his humour, 66, 67;
    kindheartedness, 67;
    calumnies on, 68;
    his Rational Theology, 69;
    his religious feelings, 69, 70.

  Sydenham, William, i. 52.

  SYME, JAMES (1799-1870);
    and Liston, ii. 25-27, 31, 33, 34;
    education and early years, 35;
    discovers waterproofing process, 35;
    assists Liston, 36;
    amputation at the hip-joint, 36;
    studies in Germany, 36;
    Brown Square Medical School, 36;
    surgical lectures, 37;
    starts Minto House Hospital, 38;
    clinical lectures, 38;
    Liston’s jealousy, 39;
    gains professorship of surgery, 39;
    reconciliation with Liston, 40;
    Syme’s controversies, 40;
    writings, 41, 44, 45;
    brief removal to London, 41-43;
    great operations, 44;
    Principles of Surgery, 44;
    address to British Medical Association, 45;
    Battle of the Sites, 45;
    private life, 46;
    on antiseptic method, 46;
    testimonial dinner, 47;
    Professor Lister on, 48;
    and Fergusson, 73, 75, 76.


  TAYLOR, A. SWAINE (1806-1880);
    education, ii. 291;
    medical studies, 291;
    studies chemistry and medical jurisprudence, 291;
    appointed to lecture at Guy’s, 292;
    papers and writings, 292, 293;
    appearance as witness, 294;
    the Palmer trial, 294;
    death, 294.

  Theology, Sydenham’s Rational, i. 69.

  THOMPSON, Sir HENRY (_b._ 1820);
    studies in London and Paris, ii. 195;
    twice wins Jacksonian prize, 195;
    appointments at University College, 195, 196;
    Clinical Lectures, 195;
    Practical Lithotomy and Lithotrity, 195;
    Civiale’s operation, 196;
    attends King of the Belgians, 196;
    controversy on Prayer for the Sick, 197;
    on cremation, 198, 199;
    on use of intoxicants, 200;
    on Food and Feeding, 200;
    artistic tastes, 200.

  Thomson, Prof. A. T., ii. 296, 297.

  Thomson, Prof. John, ii. 87, 90.

  Thornhill, Sir James, i. 61.

  _Times, The_, on Liston, ii. 32, 33.

  Todd, R. B., ii. 262-264.

  Tonstal, i. 11.

  Tower Menagerie and John Hunter, i. 137;
    and Astley Cooper, 211.

  TOYNBEE, JOSEPH (1815-1866);
    education, 273;
    medical study, 273;
    researches on the eye, 273;
    aural practice, 274;
    Asylum for Deaf and Dumb, 274;
    researches and dissections, 275;
    appointment to St. Mary’s Hospital, 275;
    ventilation hobby, 275, 276;
    Hints on Local Museums, 276;
    artificial tympanic membrane, 276;
    melancholy death, 277;
    intercourse with Hinton, 281.

  Travers, Mr., on Astley Cooper, 207.

  Treatment, expectant, i. 59.

  Trousseau, ii. 6, 11;
    on Graves, 206, 207.

  Tuke family and lunacy, ii. 219, 220, 231.

  Turner, J. M. W., ii. 202.

  Typhoid and Typhus Fevers, ii. 119-133.


  University College, London, i. 257, ii. 28, 41-43, 118, 124, 137,
        149, 183, 195, 196, 222, 232, 233, 273, 296-298.


  Vaccination, i. 178-200.

  Vaccine Institution, National, i. 193, 195.

  Vaughan family, the, ii. 55, 56.

  Vaughan, Henry. See Halford, Sir Henry.

  Vesalius, i. 14.

  Victoria, Queen, i. 311, ii. 57, 60, 67, 68, 81, 124, 151, 158, 164,
        176, 188, 196.

  Vitelli, Cornelio, i. 2.

  Vivisection, i. 252, 271-275, 292, ii. 143, 165, 265.


  Wakley, Thomas, ii. 243, 245.

  Walker, Dr., and vaccination, i. 193.

  Wallis, John, ii. 267.

  Warren, Dr. J. C., and anæsthetics, ii. 98.

  Waterhouse, Prof., i. 182.

  Waterloo, Charles Bell at, i. 250.

  WATSON, Sir THOMAS (1792-1882), ii. 128;
    education, 148;
    elected fellow of St. John’s, Cambridge, 149;
    medical studies in Edinburgh and London, 149;
    becomes proctor at Cambridge, 149;
    removes to London, 149;
    appointments, 149, 150;
    and Sir Walter Scott, 150;
    lectures published, 150;
    honours, 151;
    Introductory Lecture, 151-153;
    Dr. West on, 153;
    British Medical Journal on, 154;
    death, 155.

  Webb Street School of Medicine, i. 279.

  Wells, Horace, ii. 97.

  West, Dr. C., on Sir T. Watson, ii. 153.

  Westfaling, Thomas, i. 179.

  WELLS, Sir T. SPENCER (_b._ 1818),
    on Sir W. Fergusson, ii. 72;
    student life in Leeds, Dublin, and London, 105;
    joins Samaritan Hospital, 106;
    experience in Crimean war, 110;
    early experiences in ovariotomy, 111, 112;
    stringent precautions, 113;
    great successes, 113, 114;
    adopts antiseptic system, 114;
    on surgery as salvaging, 115;
    municipal and state questions, 116;
    on cremation, 117.

  Whytt, Andrew, i. 95, 100, 273.

  Wilkes, John, i. 100.

  Wilks, Dr., on Dr. Addison, ii. 8-11;
    on Dr. Bright, 18.

  William IV., i. 224, 259, 295, ii. 57, 60.

  WILLIAMS, CHARLES J. B. (_b._ about 1800);
    early education, ii. 178;
    scientific experiments, 179;
    studies at Edinburgh, 179;
    chemical researches, 180;
    studies in London and Paris, 180;
    work on Stethoscope, 181;
    settles in London, 181;
    early writings, 182;
    sounds of heart, 182;
    Lectures at Kinnerton Street, 183;
    reports to British Association, 183;
    becomes Professor at University College, 183;
    Gulstonian lectures, 184;
    physician to Hospital for Consumption, 185;
    Principles of Medicine, 185;
    first president of Pathological Society, 185;
    work on Cod-Liver Oil, 186, 187;
    presidency of New Sydenham Society, and of Medical and Chirurgical
      Society, 187;
    studies in retirement, 188.

  WILSON, ERASMUS (1809-1884);
    early life, ii. 240, 241;
    studies under Abernethy, and in Paris, 241;
    pupil of Langstaff, 241;
    joins Aldersgate School of Medicine, 241;
    assists Quain at University College, 242;
    establishes Sydenham College, 242;
    writes the Dissector’s Manual and Anatomist’s Vade Mecum, 242;
    acquaintance with Thomas Wakley, and appointment on _The Lancet_,
        243;
    becomes a specialist in skin diseases, 243;
    portraits of diseases of skin, 244;
    Continental studies, 244;
    character in practice, 244, 245;
    the case of flogging at Hounslow, 245;
    various works, 246;
    founds professorship of dermatology, 246;
    and of pathology, 246;
    becomes President of College of Surgeons, 247;
    pays for bringing Cleopatra’s Needle to London, 247;
    his great munificence, 248;
    bequest to College of Surgeons, 249;
    death, 249.

  Wilson, i. 249, 256, 290, 291.

  Windmill Street School, i. 129, 140, 156, 249, 256, 290, 291, ii. 59.

  Wolsey, Cardinal, i. 4, 8.

  Wood, Alexander, i. 108.

  Woodville, Dr., and vaccination, i. 181, 187.


  Yelloly, Dr., on Astley Cooper, i. 214.

  York, Duke of, and Abernethy, i. 234.


  Zoological Society, i. 274.




  Transcriber’s Note

  pg viii (table of contents) Preface page should be v not vii
  pg 2 Changed His schooldays were passed to: school-days
  pg 16 added period to end of sentence: and of muscular exercise
  pg 42 changed comma to period at: from which they have sprung
  pg 163 added semicolon to: as a great chemist
  pg 163 changed but be appears to: but he appears
  pg 228 changed spelling of St. Batholomew’s to: St. Bartholomew’s
  pg 233 changed double quotes around lectured to single quotes: going
         to be lectured
  pg 294 Changed Now-a-days subcutaneous operations to: Nowadays
  pg 304 changed spelling of Upsala to: Professor at Uppsala
  Added Index from volume 2.



*** END OF THE PROJECT GUTENBERG EBOOK EMINENT DOCTORS: THEIR LIVES AND THEIR WORK; VOL. 1 OF 2 ***


    

Updated editions will replace the previous one—the old editions will
be renamed.

Creating the works from print editions not protected by U.S. copyright
law means that no one owns a United States copyright in these works,
so the Foundation (and you!) can copy and distribute it in the United
States without permission and without paying copyright
royalties. Special rules, set forth in the General Terms of Use part
of this license, apply to copying and distributing Project
Gutenberg™ electronic works to protect the PROJECT GUTENBERG™
concept and trademark. Project Gutenberg is a registered trademark,
and may not be used if you charge for an eBook, except by following
the terms of the trademark license, including paying royalties for use
of the Project Gutenberg trademark. If you do not charge anything for
copies of this eBook, complying with the trademark license is very
easy. You may use this eBook for nearly any purpose such as creation
of derivative works, reports, performances and research. Project
Gutenberg eBooks may be modified and printed and given away—you may
do practically ANYTHING in the United States with eBooks not protected
by U.S. copyright law. Redistribution is subject to the trademark
license, especially commercial redistribution.


START: FULL LICENSE

THE FULL PROJECT GUTENBERG LICENSE

PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK

To protect the Project Gutenberg™ mission of promoting the free
distribution of electronic works, by using or distributing this work
(or any other work associated in any way with the phrase “Project
Gutenberg”), you agree to comply with all the terms of the Full
Project Gutenberg™ License available with this file or online at
www.gutenberg.org/license.

Section 1. General Terms of Use and Redistributing Project Gutenberg™
electronic works

1.A. By reading or using any part of this Project Gutenberg™
electronic work, you indicate that you have read, understand, agree to
and accept all the terms of this license and intellectual property
(trademark/copyright) agreement. If you do not agree to abide by all
the terms of this agreement, you must cease using and return or
destroy all copies of Project Gutenberg™ electronic works in your
possession. If you paid a fee for obtaining a copy of or access to a
Project Gutenberg™ electronic work and you do not agree to be bound
by the terms of this agreement, you may obtain a refund from the person
or entity to whom you paid the fee as set forth in paragraph 1.E.8.

1.B. “Project Gutenberg” is a registered trademark. It may only be
used on or associated in any way with an electronic work by people who
agree to be bound by the terms of this agreement. There are a few
things that you can do with most Project Gutenberg™ electronic works
even without complying with the full terms of this agreement. See
paragraph 1.C below. There are a lot of things you can do with Project
Gutenberg™ electronic works if you follow the terms of this
agreement and help preserve free future access to Project Gutenberg™
electronic works. See paragraph 1.E below.

1.C. The Project Gutenberg Literary Archive Foundation (“the
Foundation” or PGLAF), owns a compilation copyright in the collection
of Project Gutenberg™ electronic works. Nearly all the individual
works in the collection are in the public domain in the United
States. If an individual work is unprotected by copyright law in the
United States and you are located in the United States, we do not
claim a right to prevent you from copying, distributing, performing,
displaying or creating derivative works based on the work as long as
all references to Project Gutenberg are removed. Of course, we hope
that you will support the Project Gutenberg™ mission of promoting
free access to electronic works by freely sharing Project Gutenberg™
works in compliance with the terms of this agreement for keeping the
Project Gutenberg™ name associated with the work. You can easily
comply with the terms of this agreement by keeping this work in the
same format with its attached full Project Gutenberg™ License when
you share it without charge with others.

1.D. The copyright laws of the place where you are located also govern
what you can do with this work. Copyright laws in most countries are
in a constant state of change. If you are outside the United States,
check the laws of your country in addition to the terms of this
agreement before downloading, copying, displaying, performing,
distributing or creating derivative works based on this work or any
other Project Gutenberg™ work. The Foundation makes no
representations concerning the copyright status of any work in any
country other than the United States.

1.E. Unless you have removed all references to Project Gutenberg:

1.E.1. The following sentence, with active links to, or other
immediate access to, the full Project Gutenberg™ License must appear
prominently whenever any copy of a Project Gutenberg™ work (any work
on which the phrase “Project Gutenberg” appears, or with which the
phrase “Project Gutenberg” is associated) is accessed, displayed,
performed, viewed, copied or distributed:

    This eBook is for the use of anyone anywhere in the United States and most
    other parts of the world at no cost and with almost no restrictions
    whatsoever. You may copy it, give it away or re-use it under the terms
    of the Project Gutenberg License included with this eBook or online
    at www.gutenberg.org. If you
    are not located in the United States, you will have to check the laws
    of the country where you are located before using this eBook.
  
1.E.2. If an individual Project Gutenberg™ electronic work is
derived from texts not protected by U.S. copyright law (does not
contain a notice indicating that it is posted with permission of the
copyright holder), the work can be copied and distributed to anyone in
the United States without paying any fees or charges. If you are
redistributing or providing access to a work with the phrase “Project
Gutenberg” associated with or appearing on the work, you must comply
either with the requirements of paragraphs 1.E.1 through 1.E.7 or
obtain permission for the use of the work and the Project Gutenberg™
trademark as set forth in paragraphs 1.E.8 or 1.E.9.

1.E.3. If an individual Project Gutenberg™ electronic work is posted
with the permission of the copyright holder, your use and distribution
must comply with both paragraphs 1.E.1 through 1.E.7 and any
additional terms imposed by the copyright holder. Additional terms
will be linked to the Project Gutenberg™ License for all works
posted with the permission of the copyright holder found at the
beginning of this work.

1.E.4. Do not unlink or detach or remove the full Project Gutenberg™
License terms from this work, or any files containing a part of this
work or any other work associated with Project Gutenberg™.

1.E.5. Do not copy, display, perform, distribute or redistribute this
electronic work, or any part of this electronic work, without
prominently displaying the sentence set forth in paragraph 1.E.1 with
active links or immediate access to the full terms of the Project
Gutenberg™ License.

1.E.6. You may convert to and distribute this work in any binary,
compressed, marked up, nonproprietary or proprietary form, including
any word processing or hypertext form. However, if you provide access
to or distribute copies of a Project Gutenberg™ work in a format
other than “Plain Vanilla ASCII” or other format used in the official
version posted on the official Project Gutenberg™ website
(www.gutenberg.org), you must, at no additional cost, fee or expense
to the user, provide a copy, a means of exporting a copy, or a means
of obtaining a copy upon request, of the work in its original “Plain
Vanilla ASCII” or other form. Any alternate format must include the
full Project Gutenberg™ License as specified in paragraph 1.E.1.

1.E.7. Do not charge a fee for access to, viewing, displaying,
performing, copying or distributing any Project Gutenberg™ works
unless you comply with paragraph 1.E.8 or 1.E.9.

1.E.8. You may charge a reasonable fee for copies of or providing
access to or distributing Project Gutenberg™ electronic works
provided that:

    • You pay a royalty fee of 20% of the gross profits you derive from
        the use of Project Gutenberg™ works calculated using the method
        you already use to calculate your applicable taxes. The fee is owed
        to the owner of the Project Gutenberg™ trademark, but he has
        agreed to donate royalties under this paragraph to the Project
        Gutenberg Literary Archive Foundation. Royalty payments must be paid
        within 60 days following each date on which you prepare (or are
        legally required to prepare) your periodic tax returns. Royalty
        payments should be clearly marked as such and sent to the Project
        Gutenberg Literary Archive Foundation at the address specified in
        Section 4, “Information about donations to the Project Gutenberg
        Literary Archive Foundation.”
    
    • You provide a full refund of any money paid by a user who notifies
        you in writing (or by e-mail) within 30 days of receipt that s/he
        does not agree to the terms of the full Project Gutenberg™
        License. You must require such a user to return or destroy all
        copies of the works possessed in a physical medium and discontinue
        all use of and all access to other copies of Project Gutenberg™
        works.
    
    • You provide, in accordance with paragraph 1.F.3, a full refund of
        any money paid for a work or a replacement copy, if a defect in the
        electronic work is discovered and reported to you within 90 days of
        receipt of the work.
    
    • You comply with all other terms of this agreement for free
        distribution of Project Gutenberg™ works.
    

1.E.9. If you wish to charge a fee or distribute a Project
Gutenberg™ electronic work or group of works on different terms than
are set forth in this agreement, you must obtain permission in writing
from the Project Gutenberg Literary Archive Foundation, the manager of
the Project Gutenberg™ trademark. Contact the Foundation as set
forth in Section 3 below.

1.F.

1.F.1. Project Gutenberg volunteers and employees expend considerable
effort to identify, do copyright research on, transcribe and proofread
works not protected by U.S. copyright law in creating the Project
Gutenberg™ collection. Despite these efforts, Project Gutenberg™
electronic works, and the medium on which they may be stored, may
contain “Defects,” such as, but not limited to, incomplete, inaccurate
or corrupt data, transcription errors, a copyright or other
intellectual property infringement, a defective or damaged disk or
other medium, a computer virus, or computer codes that damage or
cannot be read by your equipment.

1.F.2. LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the “Right
of Replacement or Refund” described in paragraph 1.F.3, the Project
Gutenberg Literary Archive Foundation, the owner of the Project
Gutenberg™ trademark, and any other party distributing a Project
Gutenberg™ electronic work under this agreement, disclaim all
liability to you for damages, costs and expenses, including legal
fees. YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT
LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE
PROVIDED IN PARAGRAPH 1.F.3. YOU AGREE THAT THE FOUNDATION, THE
TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE
LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR
INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH
DAMAGE.

1.F.3. LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a
defect in this electronic work within 90 days of receiving it, you can
receive a refund of the money (if any) you paid for it by sending a
written explanation to the person you received the work from. If you
received the work on a physical medium, you must return the medium
with your written explanation. The person or entity that provided you
with the defective work may elect to provide a replacement copy in
lieu of a refund. If you received the work electronically, the person
or entity providing it to you may choose to give you a second
opportunity to receive the work electronically in lieu of a refund. If
the second copy is also defective, you may demand a refund in writing
without further opportunities to fix the problem.

1.F.4. Except for the limited right of replacement or refund set forth
in paragraph 1.F.3, this work is provided to you ‘AS-IS’, WITH NO
OTHER WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT
LIMITED TO WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PURPOSE.

1.F.5. Some states do not allow disclaimers of certain implied
warranties or the exclusion or limitation of certain types of
damages. If any disclaimer or limitation set forth in this agreement
violates the law of the state applicable to this agreement, the
agreement shall be interpreted to make the maximum disclaimer or
limitation permitted by the applicable state law. The invalidity or
unenforceability of any provision of this agreement shall not void the
remaining provisions.

1.F.6. INDEMNITY - You agree to indemnify and hold the Foundation, the
trademark owner, any agent or employee of the Foundation, anyone
providing copies of Project Gutenberg™ electronic works in
accordance with this agreement, and any volunteers associated with the
production, promotion and distribution of Project Gutenberg™
electronic works, harmless from all liability, costs and expenses,
including legal fees, that arise directly or indirectly from any of
the following which you do or cause to occur: (a) distribution of this
or any Project Gutenberg™ work, (b) alteration, modification, or
additions or deletions to any Project Gutenberg™ work, and (c) any
Defect you cause.

Section 2. Information about the Mission of Project Gutenberg™

Project Gutenberg™ is synonymous with the free distribution of
electronic works in formats readable by the widest variety of
computers including obsolete, old, middle-aged and new computers. It
exists because of the efforts of hundreds of volunteers and donations
from people in all walks of life.

Volunteers and financial support to provide volunteers with the
assistance they need are critical to reaching Project Gutenberg™’s
goals and ensuring that the Project Gutenberg™ collection will
remain freely available for generations to come. In 2001, the Project
Gutenberg Literary Archive Foundation was created to provide a secure
and permanent future for Project Gutenberg™ and future
generations. To learn more about the Project Gutenberg Literary
Archive Foundation and how your efforts and donations can help, see
Sections 3 and 4 and the Foundation information page at www.gutenberg.org.

Section 3. Information about the Project Gutenberg Literary Archive Foundation

The Project Gutenberg Literary Archive Foundation is a non-profit
501(c)(3) educational corporation organized under the laws of the
state of Mississippi and granted tax exempt status by the Internal
Revenue Service. The Foundation’s EIN or federal tax identification
number is 64-6221541. Contributions to the Project Gutenberg Literary
Archive Foundation are tax deductible to the full extent permitted by
U.S. federal laws and your state’s laws.

The Foundation’s business office is located at 809 North 1500 West,
Salt Lake City, UT 84116, (801) 596-1887. Email contact links and up
to date contact information can be found at the Foundation’s website
and official page at www.gutenberg.org/contact

Section 4. Information about Donations to the Project Gutenberg
Literary Archive Foundation

Project Gutenberg™ depends upon and cannot survive without widespread
public support and donations to carry out its mission of
increasing the number of public domain and licensed works that can be
freely distributed in machine-readable form accessible by the widest
array of equipment including outdated equipment. Many small donations
($1 to $5,000) are particularly important to maintaining tax exempt
status with the IRS.

The Foundation is committed to complying with the laws regulating
charities and charitable donations in all 50 states of the United
States. Compliance requirements are not uniform and it takes a
considerable effort, much paperwork and many fees to meet and keep up
with these requirements. We do not solicit donations in locations
where we have not received written confirmation of compliance. To SEND
DONATIONS or determine the status of compliance for any particular state
visit www.gutenberg.org/donate.

While we cannot and do not solicit contributions from states where we
have not met the solicitation requirements, we know of no prohibition
against accepting unsolicited donations from donors in such states who
approach us with offers to donate.

International donations are gratefully accepted, but we cannot make
any statements concerning tax treatment of donations received from
outside the United States. U.S. laws alone swamp our small staff.

Please check the Project Gutenberg web pages for current donation
methods and addresses. Donations are accepted in a number of other
ways including checks, online payments and credit card donations. To
donate, please visit: www.gutenberg.org/donate.

Section 5. General Information About Project Gutenberg™ electronic works

Professor Michael S. Hart was the originator of the Project
Gutenberg™ concept of a library of electronic works that could be
freely shared with anyone. For forty years, he produced and
distributed Project Gutenberg™ eBooks with only a loose network of
volunteer support.

Project Gutenberg™ eBooks are often created from several printed
editions, all of which are confirmed as not protected by copyright in
the U.S. unless a copyright notice is included. Thus, we do not
necessarily keep eBooks in compliance with any particular paper
edition.

Most people start at our website which has the main PG search
facility: www.gutenberg.org.

This website includes information about Project Gutenberg™,
including how to make donations to the Project Gutenberg Literary
Archive Foundation, how to help produce our new eBooks, and how to
subscribe to our email newsletter to hear about new eBooks.