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diff --git a/old/69392-0.txt b/old/69392-0.txt deleted file mode 100644 index ff09834..0000000 --- a/old/69392-0.txt +++ /dev/null @@ -1,12212 +0,0 @@ -The Project Gutenberg eBook of Eminent doctors, by George Thomas -Bettany - -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. 2 of 2 - -Author: George Thomas Bettany - -Release Date: November 20, 2022 [eBook #69392] - -Language: English - -Produced by: 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 *** - - - - - - Transcriber’s Note - - Italic text displayed as: _text_ - Bold 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. II. - - [Illustration: Bookmaker’s Mark] - - LONDON: - JOHN HOGG, PATERNOSTER ROW. - - [_All rights reserved._] - - - - - CONTENTS OF VOL. II. - - CHAP. PAGE - - XI. ADDISON, BRIGHT, AND THE DISEASES WHICH BEAR - THEIR NAMES 1 - - XII. LISTON, SYME, LIZARS, AND THE NEWER SURGERY 24 - - XIII. BAILLIE, HALFORD, CHAMBERS, AND HOLLAND, THE - FASHIONABLE AND COURTLY PHYSICIANS 51 - - XIV. SIR WILLIAM FERGUSSON AND CONSERVATIVE SURGERY 71 - - XV. SIR JAMES SIMPSON AND ANÆSTHETICS 83 - - XVI. SIR SPENCER WELLS AND OVARIOTOMY 105 - - XVII. SIR WILLIAM JENNER, BUDD, MURCHISON, AND - TYPHOID FEVER 118 - - XVIII. SIR JOSEPH LISTER AND ANTISEPTIC SURGERY 135 - - XIX. SIR THOMAS WATSON, SIR DOMINIC CORRIGAN, SIR - WILLIAM GULL, AND CLINICAL MEDICINE 148 - - XX. SIR JAMES PAGET AND SURGICAL PATHOLOGY 167 - - XXI. WILLIAMS, STOKES, AND DISEASES OF THE CHEST 178 - - XXII. SIR HENRY THOMPSON AND CREMATION 194 - - XXIII. GRAVES, HUGHES BENNETT, AND CLINICAL TEACHING 201 - - XXIV. CONOLLY, MAUDSLEY, AND MENTAL DISEASES 217 - - XXV. EMINENT SPECIALISTS: SIR ERASMUS WILSON AND - SKIN DISEASES; MORELL MACKENZIE AND THROAT - DISEASES; COBBOLD AND INTERNAL PARASITES 239 - - XXVI. EMINENT SPECIALISTS—_continued_: SIR W. BOWMAN, - BRUDENELL CARTER, AND EYE DISEASES; TOYNBEE, - HINTON, AND EAR DISEASES 260 - - XXVII. SIR R. CHRISTISON, SWAINE TAYLOR, AND POISON - DETECTION 285 - - XXVIII. PARKES, GUY, SIMON, AND PUBLIC HEALTH 295 - - INDEX 307 - - - - -EMINENT DOCTORS. - - - - -CHAPTER XI. - -_ADDISON, BRIGHT, AND THE DISEASES WHICH BEAR THEIR NAMES._ - - -Operative dexterity, as was natural, arrived more quickly at -perfection than did medical treatment. In fact, no one will pretend -that medicine has yet travelled far, in comparison with its future -achievements, when physiology, pathology, and therapeutics shall -have become more complete. THOMAS ADDISON is a specimen of the -physicians of genius who have adorned this century. He is known as -the discoverer of a disease which bears his name; but his true fame -rests upon his practical talent in diagnosing disease. - -Dr. Lonsdale, in his volume of “Worthies of Cumberland,” issued in -1873, shows that Addison sprang from the ranks of the yeomanry of -Cumberland, and that his forefathers resided during the Commonwealth -at “The Banks,” in the parish of Lanercost. Thomas Addison, born -in 1636, and Mary his wife, have left their initials carved on an -old oaken settle still preserved at The Banks, inscribed with -the injunction, “When God doth thee in store, remember thou the -poor.” One of his descendants was a Samuel Addison, who became a -doctor of medicine, but died at the age of thirty-four. Thomas -Addison, a nephew of his, was born in April 1793, at Longbenton, -near Newcastle-on-Tyne, where his father was in business, though he -retained his farm at The Banks, where his wife lived for the most -part. Young Addison clung greatly to the ancestral home, and many -years afterwards assembled his wedding guests there. It is on the -very site where the Romans encamped during the building of the wall -to the Solway Firth; it overlooks the medieval Priory of Lanercost; -near by is Naworth, the old Border castle of “Belted Will Howard.” - -Thomas Addison was educated at the Newcastle grammar-school under -the Rev. E. Moises, and there became a masterly Latin scholar, so -that he afterwards took his lecture notes in Latin at Edinburgh. -He went direct from school to Edinburgh University, declining to -enter as a pupil with an Edinburgh doctor, as his father desired. He -was no ordinary student. Independent in thought and action, he was -soon recognised by the Royal Medical Society, and made one of its -presidents in 1814, an honour which Marshall Hall, and Richard Bright -his subsequent colleague, also attained about that time. A striking -fact it is that three of the first names of great English physicians -of this century should be Edinburgh students, and Presidents of the -same Medical Society there. But as yet the London medical schools -were only in embryo. - -Addison took his M.D. degree in 1815, and afterwards, it is believed, -visited the Continental schools; but of this there is no certain -evidence. He soon settled in London, in Skinner Street, Snow Hill, -in one of the so-called haunted houses. He knew but one man, an old -fellow-student, in London. Yet he received nearly sixty guineas -in his first year of practice, a very considerable success. He -became House Surgeon to the Lock Hospital; then Physician to the -General Dispensary, where he studied skin diseases with Bateman. -This appointment he held for eight years, and it was of essential -service to him. He manifested a keen eye for generic distinctions and -individual varieties, and might probably have succeeded to Bateman’s -position in regard to skin diseases. But he was not to be made into -a specialist. As Dr. Lonsdale says, “with Addison the investigation -of any disease meant the full exercise of his abilities till he had -mastered it, and having done this, he could not rest till he broke -up fresh ground for tillage.” He dreaded becoming a specialist; it -savoured of quackery. He always held that the true physician must -understand surgery well; and that the good surgeon must know the -principles of medicine. - -In 1819 or 1820 commenced Addison’s association with Guy’s. He early -attracted the attention of the energetic and discerning treasurer, -Mr. Harrison, then the beneficent despot of Guy’s, and was by -him appointed Assistant-Physician in 1824. This was a victory for -unconventional procedure, for it had always been the custom to -appoint men at Guy’s who had been original pupils, and not to receive -men who were already qualified and in practice into the charmed -circle. It was soon evident that a great practical physician had -joined the hospital staff, and he was further recognised in 1827 by -receiving the lectureship of Materia Medica. Here his attractive -powers were made evident by the large classes he drew around him, -at a period when medical students entered for individual courses of -lectures, and did not as a rule take the whole of their instruction -at one school. He must have received between £700 and £800 from these -lectures in some years. Men felt that he was the man to sustain and -increase the fame of Guy’s. - -In 1829 Dr. Addison published, in conjunction with John Morgan, -Surgeon to Guy’s, an essay on “The Operation of Poisonous Agents -on the Living Body.” Strange to say, this was the first serious -investigation in England into the phenomena of general poisoning. -The authors believed that a direct influence on the nerve filaments -distributed to the blood-vessels accounts for the rapid effects of -some of them. In 1830, Addison published a pamphlet on some disorders -of females, vigorously combating some received notions, and objecting -to the system of depletion. In concluding a lengthy lecture to his -class on this subject, he showed the sentiments which animated him -by the following remarks: “Gentlemen, if you require an apology for -detaining you so long, I find ample material for that apology in -the lively interest in which we must all feel in the comfort and -happiness of the other sex, doomed as they are, both by the decrees -of Providence and by human institutions, to drink deep of the bitter -cup of suffering. Whatever may be her lot in this world, we, as men, -must at least acknowledge that, whilst Infinite Power gave us being, -Infinite Mercy gave us women.” - -In 1837 Addison was elected full Physician to the Hospital, and was -appointed joint-lecturer with Dr. Bright on Medicine. About this time -he commenced with his colleague the “Elements of the Practice of -Medicine,” of which the first volume only appeared, chiefly written -by Addison. It was most highly valued, but neither author could be -induced to complete it. Valuable monographs in number came from his -rich experience: two on Pneumonia in 1837 and 1843; Observations on -the Anatomy of the Lungs in 1840; the Pathology of Phthisis, 1845, in -which he laid down the principle that inflammation constitutes the -first instrument of destruction in every form of phthisis. This early -advocacy of a doctrine which has thrown much light on this disease -was strongly opposed by the physicians of his day, and stamped -Addison as a powerful innovator. He was much impressed by Laennec’s -views, and acquired very great power of diagnosing from auscultation -of the chest. Yet, candid ever in confessing ignorance, he read a -paper before Guy’s Physical Society in 1846, “On the Difficulties and -Fallacies attending Physical Diagnosis of Diseases of the Chest.” -Among other subjects, he dealt with Diseases of the Liver, Affections -of the Skin, Disorders of the Brain connected with Diseased Kidneys, -and “the Influence of Electricity as a Remedy in certain Convulsive -and Spasmodic Diseases,” in every case bringing together facts -hitherto disconnected, and contributing markedly to advance medicine -as a science. - -The achievement of Dr. Addison, however, which has attracted most -general notice, is his discovery of a disease of the supra-renal -capsules, the small organs adjacent to the kidneys, whose function -has not yet been satisfactorily ascertained. We are told that in -one case, which had baffled all investigation, Addison was called -in, and after careful enquiry, stated positively that the patient -suffered from a disease of these organs, which would before long -prove fatal. This opinion was received with polite incredulity, -but it was justified by the result, and the supra-renal capsules -were the only organs that were found diseased. This extraordinary -diagnosis was soon noised abroad, and on the Continent brought -Addison more honour than in England. Trousseau in France was -cordially supported in naming it “la Maladie d’Addison” (Addison’s -disease), a name which it will long retain. But the disease was not -discovered in this apparently sudden and striking manner, but was -the result of observations carried on for many years, in which -his powers of deduction from a few cases and imperfect data were -most strikingly evidenced. The disease occurs rarely, and very few -hints or materials for comparison were available. A form of wasting -disease without any apparent organic injury had been again and again -observed—bloodlessness, extreme prostration, and various shades of -alteration in the colour of the skin, being prominent symptoms. A -certain bronzing of the integument was, and still is, an inexplicable -concomitant, and no light was thrown upon it till Addison, carefully -examining the organs of a deceased patient, when no other disease -could be detected, discovered signs of malady in the supra-renal -capsules. He identified the disease, and though he did not absolutely -mark it out from all others, he gave a very perfect account of the -symptoms in the cases which he had met with, and showed that no other -disease could be connected with them—indeed no other disease of these -capsules has been discovered. - -As a teacher Addison was impressive and popular. His interest in -his class was genuine and unfeigned; he was eager to draw out the -talents of his students. Among his pupils were Dr. Golding Bird, -too early called from his brilliant career, Sir William Gull, Dr. -Wilks, and many others of note. His clinical teaching in the wards -was especially superior. He could most vividly illustrate on the -patient, and most clearly define and demonstrate his disease. He -disliked anything like interference with his methods by others, -and sometimes showed it somewhat brusquely. Once when he had been -away from his wards for a few days, a colleague had seen reason to -change his treatment of a case of pleurisy. On Addison’s return, -he at once inquired the reason, and was told that the physician in -charge believed the case to be one of pneumonia and solidification -of the lung. “Ah indeed!” said Addison, “give me a trocar;” and he -immediately plunged the little instrument into the chest, and drew -off a few ounces of fluid, proving the accuracy of his own diagnosis. -He wasted no time in considering or discussing probabilities; he was -certain, and he proved that he was right. - -Dr. Wilks’ view of Addison’s character, in the collected edition -of his works published by the New Sydenham Society, 1868, is so -pertinent that it must find a place in any adequate account of -Addison:— - -“His strong, positive, and perpetual insistence upon the term -‘practical,’ in reference to disease, constitutes, indeed, the -key to Addison’s character and professional career. He was always -ready to discuss newly-started theories, but he never for a moment -allowed them to interfere with the results of his matured experience. -Possessing unusually vigorous perceptive powers, being shrewd and -sagacious beyond the average of men, the patient before him was -scanned with a penetrating glance, from which few diseases could -escape detection. He never reasoned from a half-discovered fact, but -would remain at the bedside, with a dogged determination to track -out the disease to its very source, for a period which constantly -wearied his class and his attendant friends. So severely did he tax -his mind with the minutest details bearing upon the exact exposition -of a case, that he has been known to startle the ‘sister’ of the -ward in the middle of the night by his presence; after going to bed -with the case present to his mind, some point of what he considered -important detail in reference to it occurred to him, and he could -not rest till he had cleared it up. He has also been known, after -seeing a patient within the radius of eight or ten miles, to have -remembered on his near approach to London, thinking over the case -on his way, that he had omitted some seemingly important inquiry, -and to have posted back some miles for the purpose of satisfying -his mind on the doubt which had occurred to it. If at last he could -lay his finger on the disease, his victory was attained, and his -painstaking satisfactorily rewarded. For with him accurate diagnosis -was the great, and too often the ultimate object of an industry of -search, a correlation of facts deduced from scientific observation, -and a concentration of thought rarely combined in the individual -physician. To those who knew him best, his power of searching into -the complex framework of the body, and dragging the hidden malady to -light, appeared unrivalled; but we fear that the one great object -being accomplished, the same energetic power was not devoted to -its alleviation or cure. Without accusing Addison of a meditated -neglect of therapeutics, we fancy that we can trace the dallying with -remedies which has been the characteristic of more recent times. -‘I have worked out the disease; if it be remediable, nature, with -fair play, will remedy it. I do not clearly see my way to the direct -agency of special medicaments, but I must prescribe something for -the patient, at least, to satisfy his or her friends,’ seems to have -been a part of the habit of mind which can deal satisfactorily only -with the observable and proven, and shrinks from the uncertain and -questionable.” - -Addison did not seek to push himself into notoriety. Indeed he seems -to have studiously kept himself in the background as regards public -life. He took little pains to seek publication of his researches in -the medical journals, and for the most part his excellent papers -appear in Guy’s Hospital Reports. Thus his practice was not equal -to his great merits, though he died worth £60,000. In professional -intercourse he appeared blunt, and even at times rude, giving -the idea of hauteur and assumption of superiority. The general -practitioner was liable to find him unapproachable, and to conceive -of him as a man of large self-esteem. Yet underneath this outward -semblance lay a most acute nervousness of temperament. This powerful, -well-built, energetic, emphatic man concealed a physical nervousness -and susceptibility which most deeply affected him in circumstances -of trial. He often said, “I never rose to address the Guy’s Junior -Physical Society without feeling nervous;” and yet at the same -time he appeared to his audience to be speaking in a tone akin -even to bluster. His apparent discourtesy was as far as possible -from representing his real sentiments. “Viewed in its professional -aspect,” says Dr. Wilks, “no character on record has presented in -a higher degree the sterling hard qualities of true professional -honesty. We have never heard a single instance in which a word of -disparagement of a professional brother escaped him. He would always -strenuously, and with all his natural vigour, maintain what he -believed to be the truth, but never for the purpose of underrating -the opinions of others. His whole bearing in the profession was to -the last degree honourable, and anything like jealousy or ill-will -against another professional man never entered his mind.” - -The chief honour outside his school that fell to Addison was the -Presidency of the Royal Medical and Chirurgical Society. But court -favour did not shine on him, though none would have more worthily -received it. On the Continent, as we have before said, Addison was -treated with the utmost distinction. When he visited Paris, Nélaton, -Trousseau and the élite of the profession entertained him at a public -dinner, and gave him the warmest reception. Addison made an eloquent -speech in excellent French. He was a zealous Tory, not approving -of Disraeli’s modernised policy, but equally removed from Eldon’s -tyrannical rule. - -Guy’s Museum of Pathology, adorned by an admirable bust of him -by Joseph Towne, bears large testimony to Addison’s energy and -discernment. He added to it very largely, and his early study of -skin diseases led him to suggest and superintend in execution a plan -for illustrating skin diseases by wax models, and carefully coloured -drawings from life—a process afterwards extended widely through the -range of pathology. - -“Every feature of Addison’s face,” says Dr. Lonsdale, “was well -defined, and comported well with his finely-proportioned massive -head. He had dark hair, large eyebrows, and eyes of deep hazel -colour; his nose was pronounced, his lips full and voluble, and -rather special in action, and his chin firm and broad; and his -general physiognomy was stamped with vigour and unmistakable -character throughout. He had a deep penetrating eye, that became full -of life and light when engaged in debate. Of commanding presence -and firm significant step, he possessed a keen penetrativeness, -indeed a special discernment that never failed him in private life, -and but rarely at the bedside of the sick. He stood before you the -impersonation of power and dignity and independence.” Some persons -who knew him well believed that he would have had equal success -at the bar, in the senate, in the navy or the Church. Whatever he -attempted, he would have mastered, and would have carried out, -undisturbed by opposition, undeviating in principle. - -Dr. Addison did not marry till he was some years over fifty. His wife -was the widow of W. W. Hanxwell, Esq. The wedding, in September -1847, took place in Lanercost Church, and was attended by an unusual -incident. Just before the ceremony, and unknown to the party, a storm -had blown part of the roof of the church on to the altar table. When -he saw the wreckage, Addison exclaimed to his biographer, nervously -clutching his arm, “Good God, Lonsdale! is this not ominous?” But -his friend, suggesting that any part of the building would do for -the ceremony, and the bride smilingly showing no diminution of -cheerfulness, reassured the doctor, and all went off well. Mrs. -Addison, who had two children by her first husband, but none by -the second, survived Dr. Addison twelve years. She is described as -extremely amiable, and an excellent wife. - -In the spring of 1860 Addison was compelled to retire from his -hospital duties by a threatening of brain-disease. He settled at -Brighton; but his disease progressed, and ended in his death on -29th June 1860. He was buried at Lanercost on the 5th of July. A -marble tablet in the chapel of Guy’s Hospital records that he won -the admiration and the confidence of the students of the Hospital -by his profound knowledge and earnest eloquence: and that he was -beloved by the patients for his unwearied attention and kindness to -them. One of the medical wards in the new buildings of Guy’s is named -after him “Addison Ward.” It is worthy of note that Addison, like -John Bell, was a musician, and ready at learning a new instrument. -Being slightly deaf in one ear, he was correspondingly acute with the -other. This ear he used with surpassing skill in auscultation of the -heart and lungs. - - * * * * * - -In the preface to an edition of Dr. Bright’s “Clinical Memoirs on -Abdominal Tumours,” published by the Sydenham Society in 1861, Dr. -Barlow well remarks, “There has been no English physician—perhaps it -may be said none of any country—since the time of Harvey, who has -effected, not only so great an advance in the knowledge of particular -diseases, but also so great a revolution in our habits of thought, -and methods of investigating morbid phenomena and tracing the -etiology of disease, as has the late Dr. Richard Bright. To those who -have received the knowledge of the connections of dropsy, albuminous -urine, and disease of the kidney, among the first rudiments of -medicine, the facts which establish that connection may appear -so simple and easily ascertained, that the amount of labour, the -accuracy of the observation and the rigid adherence to the inductive -method which characterised the whole of Bright’s researches, may -hardly have been suspected, still less adequately appreciated.” - -RICHARD BRIGHT was born at Bristol in September 1789, his father -being a member of the wealthy banking firm of Ames, Bright, & Cave, -and his elder brother subsequently representing Bristol in three -parliaments. His early education was conducted by Dr. Estlin, and -later by Dr. Carpenter, both names of note in Bristol. In 1808 he -entered at Edinburgh University, at first attending Dugald Stewart, -Playfair, and Leslie, in whose mathematical class he gained a prize -in 1809, commencing the study of medicine under Monro tertius, Hope, -and Duncan. - -In 1810 Dr. Bright, with Dr. (afterwards Sir Henry) Holland, -accompanied Sir George Mackenzie in his journey through Iceland, and -contributed notes on botany and zoology, as well as other portions, -to “Mackenzie’s Travels in Iceland” (Edinburgh, 1811). Mackenzie -acknowledges Bright’s cheerful and ready exertion and undeviating -good-humour in the many cross accidents that befel the party. Several -times the two medical friends were in imminent danger, and we cannot -but be thankful that these lights of medicine were spared to do their -life-work. - -Returning from Iceland, Bright’s clinical hospital work was commenced -at Guy’s Hospital, London, where he lived in the house of a resident -officer for two years, a foretaste of the forty years’ residence -which he practically made within its walls. Astley Cooper was then in -his best form, and young Bright was at once attracted to pathology -and _post mortem_ observation. At this early date he made a drawing -of a granular kidney, one of the morbid conditions which he was -afterwards to do so much to elucidate. In 1812-13 Bright was again -a student at Edinburgh, where Gregory was still in full vigour: and -he graduated on the 13th September 1813, producing a thesis on -Contagious Erysipelas. With the idea of graduating at Cambridge, -he entered at Peterhouse, where his brother was a lay-fellow, but -he only resided two terms, finding his studies impeded by college -discipline. In 1814 Bright was one of the crowd of English voyagers -upon the Continent, and made himself conversant with French and -German, attending professional lectures especially at Berlin and -Vienna. In the spring of 1815 he travelled considerably in Hungary, -and the result of his observations, for he was emphatically an -observer, was given to the world in his large quarto volume of -“Travels from Vienna through Lower Hungary, with Remarks on the State -of Vienna during the Congress of 1814,” published at Edinburgh, -1818. This was a most valuable contribution on the social condition, -statistics, and natural history of that country, then so little known -in England. In all this it is evident how much Dr. Bright’s career -was facilitated by the comfortable circumstances in which he was -placed pecuniarily: not that money gave him his talent, but that it -prevented him from suffering from the obstacles and disadvantages -which have attended the career of so many physicians. - -Meanwhile, Dr. Bright, in the winter of 1814, had been studying -cutaneous diseases under Dr. Bateman at the Dispensary. On his return -home through Belgium, about a fortnight after Waterloo, he saw many -interesting cases of disease among the sick and wounded from the late -contending armies. In December 1816 he was admitted a Licentiate -of the London College of Physicians, and was soon after elected -assistant-physician to the London Fever Hospital, paying the frequent -price of a severe attack of fever, which almost cost him his life. -In the summer and autumn of 1818 he again visited the Continent, -spending a considerable time in Germany and Italy, and returning -through Switzerland and France. - -From 1820 we may date Bright’s full entry upon his professional -career; for he now took a house in Bloomsbury Square for private -practice. His election the same year to the assistant-physiciancy to -Guy’s Hospital led him to give up the Fever Hospital and concentrate -his attention on the work at Guy’s. He became speedily noted for his -diligent attendance in the wards, and for tracing the causes of his -patients’ symptoms in the _post mortem_ room when they unhappily -arrived there. For many years he spent six hours a day in his beloved -scene of investigation; and long afterwards, when private practice -absorbed more of his time, he longingly looked back upon the past -years of cheerful research and successful toil. His progress, well -prepared for, was now rapid. In 1821 he was elected F.R.S.; in 1822 -he began to lecture on Botany and Materia Medica; and in 1824 he -lectured on Medicine, in conjunction at first with Dr. Cholmeley, -later taking the whole course alone. Some years afterwards Dr. -Addison became associated in this lectureship, and the two famous -men for many years upheld and raised the fame of Guy’s by their -copartnership. - -Bright was not a theorist, was devoid of special doctrines and -“views,” but as Dr. Wilks[1] well puts it, “he could see, and we -are struck with astonishment at his powers of observation, as he -photographed pictures of disease for the study of posterity.” From -this Dr. Wilks infers that he did not thoroughly perceive the value -of his own work, and that he attached no more importance to diseases -of the kidney than to those of the liver and brain, which he also -described. Dr. Wilks even regards many observations of Bright as -more novel and original when they were published than those relating -to the kidney, but the latter were of more value, and their greater -significance was at once recognised. It should be distinctly -understood that Bright was not simply a specialist in kidney disease, -but a clinical physician of rare excellence, who followed his cases -into the _post mortem_ room, and carefully observed not only the -changes which had taken place in the organ whose disease had caused -death, but also the state of all the other organs of the body. He was -one of the first, if not the first, to describe acute yellow atrophy -of the liver, pigmentation of the brain in melanæmia (or pigmented -blood) due to miasma, condensation of the lung in whooping-cough, -unilateral convulsion without loss of consciousness in local brain -diseases, the bruit of the heart in chorea, the small echinococci on -the interior of hydatid cysts, &c. - -It is strange indeed that dropsy should have existed so long and -its cause have been undiscovered; and that renal disease, as we now -understand it, should have been almost unknown. For more than a -century before Bright’s work was published the occurrence of albumen -in the urine of dropsical persons had been known; and cases had been -noted where convulsions and blood-poisoning had occurred when the -kidneys had been found small and granular after death. Dr. Blackhall -had written a treatise on dropsy in 1813; but though he found the -urine albuminous, he rarely went to the _post mortem_ room and -examined the kidneys, which indeed might often at that time remain -untouched. But until Bright’s first quarto volume of “Reports of -Medical Cases,” 1827, appeared, renal disease had not been recognised -as an important malady; he was at once hailed as a discoverer, and -the malady called after his name. He first showed how to recognise -a common form of disease, and systematised what was known about it, -and he further demonstrated that there were three or four varieties -of it, a view which subsequent investigation has most fully confirmed -and developed in most important directions. He proved that not only -was there a continual withdrawal from the blood of most important -albuminous constituents, but that this was frequently attended with -a failure to remove by the kidneys that natural product of waste, -namely urea, which remaining in the blood in excess became poisonous, -and often produced convulsions and inflammations at a distance -from the kidneys. This latter view of the consequences of retained -secretion was not adopted without considerable opposition, but fuller -inquiry only made its truth more evident. And the adoption of a new -truth had its reflex effects in other departments of investigation. -Diseases of other excretory organs might possibly be caused in -the same way; and so the effects of diseased liver in causing -retention of the bile and its circulation in the tissues became anew -illuminated; and bile-poisoning and blood-poisoning were placed on a -new footing. - -Although a large amount of time for many years was given to the -investigation of renal cases, many other departments of research -were the objects of Dr. Bright’s careful attention. We have already -referred to some of these. Perhaps one series of phenomena that he -was as much interested in as any was the various tumours of the -abdomen, and the means of diagnosing between them. He published -in Guy’s Hospital Reports an extended set of monographs on these -subjects, which have been published in a collected form by the -New Sydenham Society. They are chiefly clinical, illustrated by -well-grouped cases, observed and recorded with great care and -accuracy, and abounding in important suggestions as to diagnosis and -function. - -The second volume of “Reports of Medical Cases” appeared, in two -parts, in 1831, and contained principally narrations of cases of -cerebral and spinal diseases, including paralysis, epilepsy, -tetanus, hydrophobia, and hysteria, with observations on their nature -and pathology. The many coloured plates in both volumes are of great -excellence and authority, being executed under Dr. Bright’s own -superintendence. He was afterwards associated with Dr. Addison in -the production of the first volume of the “Elements of the Practice -of Medicine.” The first volume of Guy’s Hospital Reports, published -in 1836, contains no fewer than eight papers from Bright’s own pen. -In 1832 Dr. Bright was elected a Fellow of the Royal College of -Physicians, and in 1833 gave the Gulstonian lectures at the College, -on the Functions of the Abdominal Viscera, with observations on the -diagnostic marks of the diseases to which the viscera are subject. -In 1836 he was censor, and in 1837 gave the Lumleian lectures on -Disorders of the Brain. - -In his early years Dr. Bright’s practice was not very extensive. He -was disinclined to use any adventitious aids to popular reputation, -and was content to pursue his tireless investigations. His -publications on renal disease gradually attracted general attention, -and the profession found him a most reliable and valuable consultant, -so that in his later years he commanded a first-class practice. A -few years before his death he resigned his post at Guy’s Hospital, -and was made Honorary Consulting Physician. He died on the 11th -December 1858, from the consequences of extensive and long-standing -ossification of the aortic valves of the heart, the exit for the -blood being reduced to a mere chink. He had long suffered very -considerably, but was never thoroughly examined in life. However, -he believed considerably in the value of medicine, and took large -quantities of some kinds. He was buried at Kensal Green. - -Bright is described as having had “a remarkably even temper and -cheerful disposition: he was most considerate towards the failings -of others, but severe in the discipline of his own mind. He was -sincerely religious, both in doctrine and practice, and of so pure -a mind that he never was heard to utter a sentiment or to relate an -anecdote that was not fit to be heard by the merest child or the -most refined female. He was an affectionate husband and an excellent -father, not only taking the most lively interest in the welfare of -his children, and in their pursuits, but never so happy as when he -had them around him; so that half the pleasure of the long vacation -was lost, unless he had as many members of his family as possible -for his companions.” He married, first, the third daughter of Dr. -Babington, senior; and secondly a sister of Sir William Follett, by -whom he left surviving three sons, one being Dr. Bright of Cannes, -and another the Rev. James Franck Bright, the well-known historian, -and Master of University College, Oxford. - -It is said of Bright that he was perhaps better known abroad than -any other British physician of his time. The confidence reposed -in him by his professional brethren was dependent largely upon the -minute attention he bestowed upon every case. He always took careful -notes, and often made drawings, being a good draughtsman and rather a -connoisseur in etchings and engravings. - - -FOOTNOTES: - -[1] Historical Notes on Bright’s Disease, Addison’s Disease, and -Hodgkin’s Disease, in Guy’s Hospital Reports, 3d series, vol. xxii. - - - - -CHAPTER XII. - -_LISTON, SYME, LIZARS, AND THE NEWER SURGERY._ - - -Among operating surgeons few names take higher rank than those of -Liston and Syme, at one time close associates in private medical -teaching at Edinburgh, at a later period jealous rivals and even -antagonists, but happily again warm friends before the sudden end -of the elder. ROBERT LISTON was born on the 28th October 1794, -his father being the Rev. Henry Liston, minister of Ecclesmachan, -Linlithgow, whose accomplishments included a considerable -acquaintance with the theory of music, and who wrote a treatise on -Perfect Intonation in addition to inventing an organ calculated to -produce the desired intonation. He was educated chiefly by his father -up to the age of fourteen, and afterwards attended classical and -mathematical lectures in Edinburgh University during two sessions, -obtaining a prize for Latin composition in the second. At this period -of his life he exhibited great fondness for the sea, and was only -induced to give up his desire to become a sailor by a promise that if -he would study medicine he should eventually be a naval surgeon if he -wished. His taste for a seafaring life never forsook him; and one -of the relaxations which he most enjoyed up to within a few weeks of -his death, was sailing in a yacht which he kept on the Thames. He was -also very fond of field-sports. - -In 1810 Liston commenced medical study as the pupil of Dr. Barclay, -the well-known anatomical lecturer. He soon became noted by his -instructor for his zeal and untiring assiduity, and he eventually -chose him as his assistant and prosector, an office he retained -until 1815. It was thus that Liston acquired the foundation of his -remarkable knowledge of surgical anatomy, which his later experience -strengthened, and to which he added a dexterity in the use of -surgical instruments, and especially the knife, which was unsurpassed -in his time. - -In 1815 Liston became surgeon’s clerk or house-surgeon in the -Royal Infirmary of Edinburgh, in which capacity he availed himself -fully of the opportunities for making _post mortem_ examinations, -which were then performed by the house-surgeons. In 1816 he went -to London, and studied several months at St. George’s Hospital, -and also attended some of Abernethy’s lectures. In 1817, having -taken the diplomas of the College of Surgeons both in London and -Edinburgh, he began practice in Edinburgh, and again assisted Dr. -Barclay in his anatomical teaching. But misunderstandings arising -between them, Liston left Barclay and commenced to lecture on his own -account at the beginning of the session 1818-19, James Syme becoming -his assistant. In 1823 Liston gave up teaching anatomy in favour -of Syme, in order to devote himself entirely to surgical teaching; -but Liston retained a large share of the proceeds of the anatomical -lectures, as the originator and more important proprietor of the -joint school. This arrangement did not last long, Syme withdrawing to -Brown Square in 1824: and it appears that Liston is, at least equally -with Syme, open to the charge of having displayed serious jealousy in -this matter. They were unavoidably serious rivals, too nearly equals -in power, and perhaps too conscious of their own individual claims, -to be able to view with equanimity each other’s proceedings and -advancement. - -Liston had published a little book on the Surgical Anatomy of Crural -Hernia (1819), and soon acquired fame by performing several brilliant -operations, difficult amputations, ligatures of arteries, lithotomy, -&c. At that time there were many defects in the management of the -Royal Infirmary, and Liston set to work, young as he was, to agitate -for their removal. Unfortunately he did not make any attempts to -conciliate the managers in so doing, and his outspoken complaints -were met with bitter opposition from some of the surgeons as well as -managers. He entered into the spirit of controversy which Dr. Gregory -had done so much to foment, and in which so much of the talent and -time of Edinburgh men was then wasted. In 1821 Liston records that -he was almost daily applied to by patients from the Infirmary who -had failed to secure relief from the surgeons, and he was exposed -to the charge of decoying patients thence. It was even demanded -of him, on pain of perpetual exclusion from the surgeoncy to the -Infirmary, that he should refuse his professional assistance to any -person who had been a patient there. He naturally refused to comply -with any such condition, nor would he absent himself from attendance -on the Infirmary practice, as was also suggested. It is fair to say -that Liston courted the fullest investigation of his actions, and -denied that he had ever directly or indirectly insinuated to any -patient of the Infirmary that the practice followed there was bad, -or that he himself knew better, or had in any way tried to entice -patients away. But he did complain of the tedious and often injurious -delay which took place before patients were operated upon, and the -unsatisfactory result of many of the operations; while he himself -had undoubtedly cured many discharged as incurable, or imperfectly -relieved. The young surgeon showed so vigorous a front that great -efforts were made to make the most of any imprudences he committed, -and to deter students from attending his classes, especially by hints -that they would come off very badly before the College of Surgeons -if they did. Strange that he who now maintained so bold an attack -upon convention and authority, should have shown such jealousy of -his former demonstrator, Syme, and have endeavoured by manner, and -more than manner, to repress and depreciate a still younger man’s -skill. This was but one of the many inconsistencies and difficulties -that Liston’s consciousness of his own powers and his abrupt and -somewhat rough manner of dealing with differences of opinion led him -into. Nevertheless the scathing charges of incompetency which Liston -brought against some of the surgeons then in office, and supported in -detail, were sufficient to prove to the managers that Liston was no -ordinary young man, but must be allowed a full field for his talents; -and consequently gaining increasing fame as a lecturer on surgery, -and attracting large classes of students, Liston in 1828 became one -of the surgeons to the Royal Infirmary. - -But Liston’s interest was insufficient to gain him the Professorship -of Surgery in the University when it fell vacant, and he gladly -accepted the offer of the Surgeoncy to the North London Hospital -with the Professorship of Clinical Surgery in University College in -1834. His transfer to London was a striking success. He had already -published, in 1833, his “Principles of Surgery,” which went through -several editions. Its clearness, simplicity, and homeliness of style -made it popular, and well calculated to widen his fame. Unornamental -almost to a fault, and perhaps deficient in illustration, he gave -much practical information, and definitely elucidated his subject. -His “Practical Surgery,” published in 1837, chiefly giving the -results of his own experiences, was still more popular. His brilliant -talents, however, were those of an operator. It was said of him that -he possessed every qualification for success in this department, -great physical strength and activity, coolness, promptitude, energy, -and unflinching courage, a steady hand and a quick eye, a resolution -which rose with the difficulties he encountered, and rested on a just -reliance on his complete knowledge of anatomy and pathology. Yet the -brilliant operator was not over anxious to exhibit his talents; he -was often considered remarkably cautious. His deliberation was as -marked before undertaking an operation as was his fearlessness when -it was undertaken. His readiness and resource under the most varied -and difficult combinations of circumstances were surprising. He -excelled in irregular operations in which no well established mode of -procedure could be followed, but he had to depend on the decision of -the moment as to the particular case. He knew exactly what he meant -to do and how to do it, and this without delay or hesitation. Thus he -won the reputation of being the most dexterous operator of his day. - -In addition to his “Surgery” Liston published numerous valuable -papers on amputation, difficult cases of aneurism, tracheotomy, -lithotomy, and lithotrity. He left his impress on a very large -number of operations, either devising new methods of meeting old -difficulties, or improving the accepted modes of dealing with them. -He invented an improved shoe for the treatment of club-foot, and -was great at reducing dislocations. He once succeeded in reducing a -dislocated hip-joint after the dislocation had continued no less -than two years. He introduced the method of reducing dislocated -phalanges, especially of the thumb, by passing the ring of a -door-key over the part and hitching it against the projecting end -of the bone, so that extension and pressure could be brought to -bear simultaneously. After dislocation of the thigh backwards, he -several times took advantage of the immediate powerlessness of the -muscles from shock, and reduced the limb on the spot without the -use of pulleys or even without the aid of an assistant. He invented -or modified splints for broken limbs. His methods of performing -amputations by flaps became very largely adopted. He had great -success in what are known as plastic operations, such as restoring -a nose by taking a flap from the upper lip. His name is scarcely -more associated with amputations, however, than with lithotomy and -lithotrity, to which he devoted great attention. Many of his lectures -on those subjects were published in the _Lancet_ and were widely read. - -Much importance has been assigned to Liston’s personal strength as -constituting a large element in his operative successes. His hand and -arm, it was said, might have furnished models for a Hercules, and -their power was not unfrequently shown in operations requiring great -muscular exertion. But he was equally successful in those in which -the most delicate manipulation was demanded. His decision and force -of character were equal to the accurate control over his powerful -yet adaptable muscles. He would amputate the thigh single-handed, -compress the artery with the left hand, using no tourniquet, and do -all the cutting and sawing with the right, with only the aid of a -house-surgeon to hold the limb and tie the ligatures on the arteries. -He did not need time for reflection; his actions were prompted by -a kind of intuition akin to genius; he seemed to comprehend at a -glance the requirements of any particular case. Yet he never gave up -his habit of studying anatomy, spending as many hours as possible in -actual dissection. - -One of Liston’s striking exhibitions of decision and invention -occurred during an amputation of the thigh by Russell, then Professor -of Clinical Surgery at Edinburgh. An artery in the cut bone bled -profusely, and in consequence of its bony surroundings could not be -tied in the ordinary way. Liston with the amputating-knife at once -cut off a chip of wood from the operating table, formed it into -a cone, and drove it into the bleeding orifice, and in this way -immediately arrested the bleeding.[2] - -Liston’s general principles of treatment are also worthy of note, -as he exercised by their means a considerable influence on the -profession. He early became alive to the unwisdom of over-treatment, -and tended more and more to trust to natural recuperative powers. He -was thus enabled to dispense with the multitudinous paraphernalia -which surrounded the operating surgeon, the repeated poulticing, -strapping, bandaging, anointing, which often rendered a stay in a -surgical ward almost intolerable. - -On the death of Sir Anthony Carlisle in 1840, Liston was elected to -the Council of the Royal College of Surgeons, but did not become one -of the Examiners until March 1846. There is little doubt that he -would before long have attained the Presidency of the College, had -not his career been cut short. His practice became very large, and -there is no doubt that he undertook an amount of work which many men -would have found impossible. Yet he was noted for his consideration -of the poor and necessitous. It was remarked in the _Times_ after -his death that “his nature abhorred everything sordid, and no man -ever was more strongly impressed with the feelings of an honourable, -generous, and independent practitioner. In whatever rank of life the -‘case’ occurred, if it was one of difficulty or interest, this master -of his art was ready with the potent spell of his unerring bistoury, -and his reward was in the consciousness of his own power, and in the -noble pride of having been ministrant to the relief of suffering -humanity. His manner in ordinary society was sometimes complained of -as harsh or abrupt, and he certainly was occasionally neglectful -of the mere trifling courtesies of life, and sometimes careless of -refinement or punctilio. He was a man of thought more than of show. -He could not bear triflers, and he did not always avoid showing -his distaste. He was a fervid lover of truth and sincerity, and -sometimes, perhaps, expressed himself too strongly when he thought -there lurked any meanness or deceit or affectation. But in the proper -and trying scene of the labours of the medical man—in the chamber of -the sick—he was gentle as he was resolute. He never had a patient who -was not anxious to become a friend, and the voice which was sometimes -discordant amid the petty annoyances of daily life was music to the -sick man’s ear. Into the scene of suffering he never brought a harsh -word or an unkind look, and the hand which was hard as iron and true -as steel in the theatre of operation was soft as thistle-down to the -throbbing pulse and aching brow. It may also be added, with perfect -truth, that in the exercise of his arduous duties, among persons of -the highest rank and most fastidious sympathies, his delicacy and -forbearance were as remarkable as the sound sense which regulated all -his professional conduct. His heart was in his business.” - -Liston was warm in his friendships though strong in his dislikes. He -did not readily take to strangers. It is to be noted that he became -frankly reconciled to Syme after their serious divergence. He took -the initiative finally in 1839, and a genial correspondence took -place between them. They met once more in the autumn of 1847, when -Liston visited Edinburgh, and were often together. Liston dined with -Syme at Millbank the day after his arrival in Edinburgh, and again -the day before he left for London. Before very long, however, Liston -was carried off by aneurism of the aorta, which must have existed -for years, and been fostered by his great physical exertions, which -characterised his recreation as well as his work. It had been found -impossible to diagnose his ailment with certainty till some little -time before his death, which came with startling suddenness upon -the medical world and the public generally. He died on December 7, -1847, aged 53, and was buried at Highgate Cemetery. A body of 400 -students and a large number of medical men attended his funeral. He -left a widow and a family of six children, two of whom were sons. -One of these, however, died very soon after his father. In the -following May Lord Brougham delivered a glowing eulogy on Liston at -the distribution of prizes at University College. A sum of about -£700 was subscribed for a memorial, which took the form of a marble -statue—placed in the College—and a gold medal called the Liston -Medal, which is awarded annually for surgery at the same institution. - - * * * * * - -JAMES SYME, another of the great Scotch surgeons of this century, -was born in Edinburgh on the 7th November 1799. His father, a -Writer to the Signet, was of good family, but owing to unsuccessful -speculations was involved in difficulties, and left nothing behind -him. Young Syme was educated at the High School of Edinburgh, -and soon showed characteristic patience and perseverance without -brilliant parts. A certain thickness of speech, almost amounting to -an impediment, strengthened the impression of shyness that he gave. -Instead of country sports, he was fond of botanising, and of making -skeletons of small animals. A similar tendency manifested itself in -his attachment to chemistry and his fondness for making chemical -experiments. Thus he was equipped with a sufficient bent towards -studies connected with medicine to render it not surprising when he -adopted the medical profession. - -From 1815 onward Syme attended the University of Edinburgh, taking -both Arts and Science lectures at first. Incidentally, in the -course of his chemical pursuits, he made an original discovery of -the waterproofing process, and having first dissolved indiarubber, -was able to construct flexible tubes of it, and to render various -substances waterproof by brushing a thin solution of it into their -interstices. Not to be diverted from his medical work, Syme declined -to take out a patent, but published his method. Mr. Mackintosh of -Glasgow soon after patented a process, and Syme gained no advantage -from his discovery. - -Syme’s early friendship with Liston led him to enter Barclay’s -Extra-Academical classes in the winter of 1817-18. In the next -winter, however, Syme followed Liston when he started on his own -account, and assisted him in demonstrating from the beginning. He -perseveringly continued studying, and in 1822 went to Paris to -improve himself both in anatomy and operative surgery, gaining -especial advantage from Lisfranc’s and from Dupuytren’s operations -and instructions. - -While demonstrating for Liston, Syme was pursuing his medical studies -at the Royal Infirmary and elsewhere, and became impressed with the -unwisdom of the repeated and severe blood-letting then in vogue. In -1823, having become a qualified surgeon, and entering into practice -in Edinburgh, Syme performed his first striking operation—one -which he himself designated as “the greatest and bloodiest in -surgery”—namely, amputation at the hip-joint. Its success was an -earnest of his future triumphs. In the same year Liston retired from -teaching anatomy to devote himself entirely to surgery, and Syme -occupied his place. The summer of 1824 was spent in studying surgery -as practised in Germany. The same year a coldness which had been -growing between Liston and Syme caused the withdrawal of the latter -from association with Liston, and his starting a new school in Brown -Square in partnership with Dr. Mackintosh. Here Syme taught anatomy -and surgery, Dr. Mackintosh medicine and midwifery, and Dr. Fletcher -physiology. The class in surgery numbered as many as fifty students. -But the difficulties and scandals attending the due supply of -subjects for dissection gradually disgusted Syme with the anatomical -part of his work, and a quarrel with Dr. Mackintosh finally led -to his quitting the Brown Square school, and devoting himself -entirely to surgery. This was a bold stroke, seeing that he had -four or five formidable competitors in Edinburgh, including Liston, -Lizars, and Fergusson (afterwards Sir William). Yet so strikingly -was he justified by the event, that in 1828-9 his class increased -to 250, the largest ever assembled by any teacher of pure surgery -in Edinburgh. Practice had been flowing in upon him, stimulated in -1826 by an important paper on the treatment of wounds, in which -he insisted on the importance of providing a free outlet for all -discharges instead of almost hermetically sealing them up, as was so -frequently done. In 1827 he gave another evidence of his remarkable -operative skill by successfully removing a huge tumour involving part -of the lower-jaw bone, an operation which no other surgeon would -undertake. Sixteen years afterwards the patient was met with, having -his deformity well covered by a vigorous beard. - -It was natural that the lack of a hospital appointment should be -keenly felt by Mr. Syme, and that he should apply for one when a -vacancy occurred at the Royal Infirmary; but his action when this -was refused to him, in view of the rivalry existing between himself -and Liston, was eminently energetic and commendable. He started a -small hospital for twenty-four patients at Minto House on his own -responsibility; but although he fortified himself with an influential -committee and received a certain amount of annual subscriptions, the -principal part of the expense throughout fell upon himself. Thus -in the first year the public subscribed £217 and Mr. Syme £779, -including £400 which he received in students’ fees. About this time, -too, he married a sister of his old schoolfellow Robert Willis, -afterwards the biographer of Sydenham, and set up a carriage. These -expenses led him into pecuniary difficulties, which were not easily -surmounted at first, but in a few years his circumstances became easy -through the rapid increase of his practice. - -Syme’s clinical lectures became remarkable from the novelty of -the method he employed. It had been customary in Edinburgh to -lecture on a certain number of cases somewhat resembling each -other, without the patients’ presence or anything to emphasise the -instruction. The young innovator brought the patients one by one -into the lecture-room, questioned them, demonstrated the principal -features of their complaint, and then explained the principle of his -treatment, in the presence or absence of the patient, according to -circumstances, and finally operated, when necessary, in the presence -of the pupils. Syme was a man of few words and earnest manner; he -illustrated his remarks by few but well-chosen personal experiences, -but gave nothing superfluous; and it is not to be wondered at that -his success was marked. - -Liston’s jealousy increased as the success of Minto House became -assured. In 1830 Liston wrote in the subscription book of his rival’s -hospital, “Don’t support quackery and humbug.” This led Syme to bring -an action for libel against Liston, which the latter had to settle -by apologising. In 1831, however, his exertions were successful -in gaining the professorship of surgery at the Edinburgh College -of Surgeons for his friend Lizars by a majority of one vote over -Syme. In 1832, when Liston’s practical treatise “The Elements of -Surgery” appeared, Syme also came forward with his more theoretical -“Principles of Surgery.” In 1833 Syme took advantage of a chance -which he longed for, and agreed with the retiring professor of -clinical surgery in the University (Russell) to allow him £300 a -year for life if he became his successor. This was after Liston had -refused to come to any such arrangement. When it was carried into -effect in 1833 the managers of the Infirmary felt that they must -allow the new clinical professor to have wards for clinical teaching, -notwithstanding Liston’s active opposition. - -Syme’s success as a teacher followed him to the Infirmary, and pupils -crowded his wards. He was regularly present when Liston operated, -but never took any part with him. Syme’s appearance often, it is -said, excited the evident scorn of Liston, though no open hostilities -took place. The strained condition of affairs was alleviated by the -removal of Liston to London in 1835. It is satisfactory to find that -the quarrel was finally healed in 1839, when Liston wrote to Syme, -“Will you allow me to send you a copy of my last book? Write and tell -me that you wish to have our grievances and sores not plastered up, -but firmly cicatrised.” A genial correspondence followed. - -We wish it could be said of Syme that all his disputes were as -happily concluded. His intimate friend Dr. Belfrage, minister of -Slateford, whom he consulted in all his difficulties, told him “he -was always right in the matter, but often wrong in the manner, of his -quarrels;” and this must be held to account in part for the number -and seriousness of the controversies in which he became involved, few -of which, however, need be referred to here. It may be questioned -whether, on numerous occasions when Mr. Syme defended himself against -attacks or brought actions for damages, he would not have done better -to content himself with appealing to his well-known character and -attainments, and living down aspersions. But Gregory and others in -Edinburgh had left an evil habit of controversy in the air; and -though Syme was more moderate than his predecessors, he often had his -hands full. Although he was himself a great improver of professional -practice, he was really a conservative in his attitude towards -other men and new methods. His opposition to Simpson’s discovery of -anæsthetics, and to his introduction of acupressure for closing cut -blood-vessels without the use of a ligature, is an example of this. -It is to be noted, however, that Syme’s numerous controversies left -no detrimental impression on the public, and did not detract from -the warmth of affection which a host of friends testified towards him. - -Liston’s removal to London left Syme practically in possession of -the leading surgical practice in Scotland at the age of thirty-five. -So marked was his progress that soon after the Queen’s accession -he was appointed Surgeon in Ordinary to the Queen for Scotland. A -little later a considerable fortune was left him by an uncle, and -thenceforward he enjoyed an ease of circumstances which, while it -rendered his actions independent, was not at all detrimental to his -professional success. The good work which, in addition to operative -successes, he was accomplishing may be judged by the titles of -the papers contained in a selection from his published writings, -published in 1848. These “Contributions to the Pathology and Practice -of Surgery” included, among others, papers on senile gangrene, on -the power of periosteum to form new bone, on ulcers of the leg, -on amputation at the ankle-joint, on the treatment of popliteal -aneurism, on excision of the ankle-joint, on the contractile or -irritable stricture of the urethra, and on lithotomy. In all these -he introduced new modes of treatment or operation or propounded -new views, and many of his improvements are generally adopted. In -1847 Liston’s sudden death led to his chair at University College, -London, being offered to Syme. After anxious weighing of the question -he decided to accept the post. On his quitting Edinburgh he was -entertained at dinner by more than a hundred members of the medical -profession. Dr. (afterwards Sir Robert) Christison, who presided, -said no man had ever obtained so early in life as Syme the position -of consulting surgeon for a whole nation; and this he owed entirely -to his intrinsic merits. He referred to the collateral pursuits -with which many doctors had recreated themselves. Dr. Cullen had -his rural retreat; Dr. Gregory his Latin and polemics; Sir Charles -Bell his pencil and his rod; Mr. Liston his hunter; Mr. John Bell -his trombone. Mr. Syme had rendered his garden and conservatories -conspicuous in a land of gardeners. - -Mr. Syme arrived in London in February 1848, and settled in Bruton -Street. An amusing incident occurred in connection with his first -lecture at University College. Having been accustomed to give -clinical lectures in the operating theatre at Edinburgh, which was -provided with seats, he supposed a similar arrangement obtained in -London, and announced his intention of lecturing in the operating -theatre without having previously visited it. On entering the room to -deliver his lecture, he found the students were seated inelegantly -on the rails which rise behind one another in the amphitheatre. This -attitude shocked him at first, but was soon exchanged for a more -befitting one. - -Difficulties, however, arose in connection with the chair of -systematic surgery, which he was asked to undertake with that of -clinical surgery. This he felt would occupy too much time, and -require a devotion to theoretical surgery and to pathology which -did not accord with his bent. On the 7th of May some discourteous -demonstrations at the College prize distribution towards two of his -colleagues deeply wounded him; and he wrote “that the slightest -approach to any insult of the kind, whether offered in the -comparative retirement of the lecture-room or inflicted publicly with -the silent sanction of the presiding authority of the College (Lord -Brougham), would effectually incapacitate him from ever addressing -his pupils with satisfaction to himself or benefit to them.” In -three days afterwards, having declined the fresh post offered him, -he resigned that for which he had quitted Edinburgh. Fortunately -his old position at Edinburgh had not yet been filled up, and he -returned with alacrity to his familiar theatre and beloved home, his -experiment having cost him £2000. He had been well received by the -heads of the profession in London, and was rapidly gaining practice. -His own brief comment on the change from Edinburgh to London was, -that ambition made him sacrifice happiness, and that he found such a -spirit of dispeace in University College as to forbid any reasonable -prospect of comfort. - -The succeeding years furnish a multitude of records of honours paid -to Professor Syme, and of distinguished successes in operating. In -1848-9 he was elected president of the Medico-Chirurgical Society of -Edinburgh, and greatly elevated the character of its proceedings; -in 1850-1 he was president of the Edinburgh College of Surgeons. For -years few numbers of the _Monthly Medical Journal_ appeared without -a lecture, case, or observation of importance from him. One of his -most striking operations was the removal of the entire upper-jaw bone -by making one incision in the cheek, with perfect success; the wound -healed without a drop of matter, and it was difficult subsequently to -trace the line of incision. The patient’s articulation remained quite -distinct. Two of his most difficult operations in 1857 were connected -with the tying of arteries for cure of aneurisms—one of the carotid, -the other of the iliac, artery. The frightful risks and the excellent -procedure by which they were successfully encountered still further -enhanced Mr. Syme’s great reputation. In 1856-7 his “Principles -of Surgery” reached a fourth edition. Its terse style and clear -exposition had rendered it a great favourite with practical surgeons. -A striking feature in it is the constant reference to fundamental -principles. It was said of him at this period, “Mr. Syme is never at -fault. Something unforeseen or unexpected may occur, but its import -is at once understood and the contingency provided for.” - -At the Great Exhibition of 1862 Syme was chosen chairman of the -jury on surgical instruments. In 1863 he visited Dublin once more, -and expounded his principles before the leading surgeons, being -received there as a man of European reputation. His operations for -the relief of axillary and carotid aneurisms, as well as his bold -excision of the whole scapula for tumour, with safety and without -much loss of blood, were continually increasing his fame. In 1864 -he published his work on the Excision of the Scapula, and proved -that the wound might heal quickly and soundly, and the arm remain -strong and useful. A great operation for relief of a distressing -disease by excision of a large part of the tongue was wonderfully -successful in November 1864. This was the last case Syme had time -to publish. In August 1865 he gave the address in surgery at the -meeting of the British Medical Association in Leamington. In it he -gave a graphic account of modern improvements in surgery, in which -he had himself a large share, and contrasted it with the state of -things at the beginning of his professional career. It constituted a -most valuable review of the history of surgery during the century. -Syme was the first representative at the Medical Council of the -Universities of Edinburgh and Aberdeen, and might not improbably -have been its president but for his illness and death. His last -great controversy was that known at Edinburgh as the “Battle of the -Sites.” A new hospital was required, and at first, in 1866, Syme was -strongly in favour of a new building on the old site. But further -experience of erysipelas and pyæmia in the old hospital convinced him -of the necessity of having an entirely new building in which the old -disadvantages would be absent. He consequently changed his view, -and strongly advocated the new plan, which was ultimately, in 1869, -accepted. But he did not live to see the new work begun. - -In private life Syme was genial and happy, throwing off all -professional cares, quarrels, and anxieties in the home circle. His -unobtrusive religion was an essential feature of his character. He -was devoted to truth and earnest in its advocacy, and hence sprang -many of his controversies; but he had no love for controversy as -such. His domestic life was very happy, though broken at various -times by death. His first wife died in 1846: of her numerous family -two daughters only survived to adult age, one of them being now the -wife of Sir Joseph Lister. His second wife was the sister of Burn, -the architect: this union was equally happy with the former; but the -second Mrs. Syme also died before him. Her youngest child was Mr. -James Syme, the present proprietor of Millbank. This house and estate -Professor Syme decorated and improved with all that horticulture and -excellent taste could devise, and it was under his sway one of the -most charming resorts near Edinburgh. His social gatherings of eight, -ten, or twelve choice spirits were delightful, and his hospitality -was both large and discriminating. - -It is pleasing to record that Mr. Syme welcomed the greatest surgical -improvement of modern times, that brought forward by Professor -Lister, his son-in-law. In 1868 he contributed a valuable paper -to the _British Medical Journal_ “On the Antiseptic Method of -Treatment in Surgery,” by which he greatly aided its progress. This -was his last year of full practice. In April 1869 he was seized with -paralysis, resigned his professorship and surgeoncy soon after, but -recovered sufficiently in the autumn to receive a testimonial in St. -James’s Hall, London (November 10, 1869), at a public dinner in which -the leaders of the profession vied with one another in honouring -him. The testimonial took the form of the endowment of a surgical -fellowship in the University of Edinburgh, in addition to the placing -of a marble bust in the Infirmary or University library. A bust was -subsequently placed in both of these situations. Syme at length died, -after repeated attacks of paralysis, on the 20th of June 1870. - -It has been well said by Professor Goodsir, that few men come to -their principles at such an early age as Mr. Syme. His terseness of -writing aided greatly in their propagation, and his practice was -extended far and wide by the assurance that “he never wasted a word, -nor a drop of ink, nor a drop of blood.” He was great too in his -conservation of all parts which might by any dexterity and patience -be made useful. His revival of operations for the excision of joints -rather than the amputation of limbs is an instance of this. Syme’s -operation of amputation at the ankle-joint will always remain in -vogue as the least fatal and most useful in surgery. - -Professor Lister has thus summed up Syme’s character as a surgeon—“A -practical surgeon, Mr. Syme presented a remarkable combination of -qualities; and we have not known whether to admire most the soundness -of his pathological knowledge, his skill in diagnosis, resembling -intuition, though in reality the result of acute and accurate -observation and laborious experience, well stored and methodised; the -rapidity and soundness of his judgment, his fertility in resources -as an operator, combined with simplicity of the means employed, -his skill and celerity of execution, his fearless courage, or the -singleness of purpose with which all his proceedings were directed to -the good of his patients.” - - * * * * * - -Though his fame has been overshadowed by the greater distinction -of Liston and Syme, John Lizars deserves mention, not only as a -brilliant operator, but also as a teacher, lecturer, and author. He -was fortunate in his instructor, having been the pupil and apprentice -of John Bell. After obtaining his qualification in 1808 Lizars -became a naval surgeon, and saw good service on the Spanish and -Portuguese coasts in Lord Exmouth’s fleet. He left the navy in 1815, -and settled in Edinburgh, joining Allan, who lectured on surgery, -and taking himself the departments of anatomy and surgery. Later, -when this partnership was dissolved, Lizars continued to lecture, -adding surgery before long to his programme, and hence being almost -incessantly engaged during the prolonged winter session with his -daily lectures on each subject. His zeal and method attracted, and -retained for years, classes frequently numbering one hundred and -fifty. He was obliged after a time to limit his labours when the -Edinburgh College of Surgeons decided to recognise lectures in -one department only from any given lecturer; and he resigned his -anatomical lectures to his brother Alexander, afterwards Professor of -Anatomy in the University of Edinburgh, and thenceforward lectured -on surgery alone. In 1831 John Lizars was appointed Professor of -Surgery to the College of Surgeons, a post which he held for eight -years. He had previously become surgeon in the Infirmary, and was -considerably senior to Liston. The two were not unworthy compeers as -regarded brilliancy in operating. Lizars’ ease and coolness under -circumstances of difficulty were remarkable. He is said to have been -the first who performed the operation for the removal of the lower -jaw. - -Lizars published a “System of Practical Surgery”; but is perhaps best -known for his great folio series of coloured “Anatomical Plates” -with companion (octavo) volume of text. The engravings of the plates -were for the most part made from original dissections by himself. -They formed an immense series of illustrations, occupying 110 folio -plates, and some of them, especially those on the brain and nervous -system, can scarcely be surpassed for artistic excellence. It was -really a magnificent work for its day, and had a very large sale; -and as regards a great portion of the contents, since they show -actual facts, they cannot be superseded. After his retirement from -teaching, Lizars devoted himself to private practice, both surgical -and general. He died at Edinburgh, May 21, 1860. - - -FOOTNOTES: - -[2] The writer is indebted for this anecdote to Dr. Paterson’s -“Memorials of the Life of James Syme,” in which a number of incidents -relating to Liston are given, with an interesting parallel between -the careers of the two great surgeons (chapter xii., p. 210-216). It -is much to be regretted that no biography of Robert Liston has yet -been written. - - - - -CHAPTER XIII. - -_BAILLIE, HALFORD, CHAMBERS, AND HOLLAND, THE FASHIONABLE AND COURTLY -PHYSICIANS._ - - -One cannot more strikingly emphasise the change which has taken place -during the present century in the views and practice of medical men -than by quoting from Sir Henry Halford’s biographical notice of -Baillie, the nephew of William and John Hunter, and brother of Joanna -Baillie. Here we have Halford acknowledging a current sentiment -against physical examination of the patient. “He (Baillie) appeared -to lay a great stress upon the information which he might derive from -the external examination of his patient, and to be much influenced -in the formation of his opinion of the nature of the complaint -by this practice. He had originally adopted this habit from the -peculiar turn of his early studies,—and assuredly such a method, not -indiscriminately but judiciously employed, as he employed it, is a -valuable auxiliary to the other ordinary means used by a physician, -of obtaining the knowledge of a disease submitted to him. But it is -equally true that, notwithstanding its air of mechanical precision, -such examination is not to be depended upon beyond a certain point. -Great disordered action may prevail in a part without having yet -produced such disorganisation as may be sensibly felt; and to doubt -of the existence of a disease because it is not discoverable to -the touch, is not only unphilosophical, but must surely, in many -instances, lead to unfounded and erroneous conclusions. One of the -inevitable consequences of such a system is frequent disappointment -in foretelling the issue of the malady, that most important of all -points to the reputation of a physician, and though such a mode of -investigation might not prove unsuccessful in the skilful hands -of Dr. Baillie, it must be allowed to be an example of dangerous -tendency to those who have not had his means of acquiring knowledge, -nor enjoyed the advantages of his great experience, nor have learned -by the previous steps of education and good discipline to reason and -judge correctly.” Halford then refers to the quickness with which a -good physician makes up his mind on the nature of a disease; at that -time it was oftener a guess than a process of reasoning. Baillie -was one of the first to study pathology, and to bring into practice -physical examination. - -MATTHEW BAILLIE was born on the 27th October 1761, in the manse of -Shotts, Lanarkshire, his father having been Professor of Divinity -in Glasgow University, his mother, Dorothea, sister of William and -John Hunter. After two sessions at Glasgow, Baillie entered, in 1779, -at Balliol College, Oxford, where he completed his M.D. in 1789. -Residing during vacations with William Hunter, he became almost -like a son to him, and assisted him much in making his anatomical -preparations and superintending his dissecting-room. On the death of -his uncle in 1783, he and Cruickshank continued the lectures with -great success. Baillie lectured till 1799. One of his pupils said -of him that his style, though not eloquent, irresistibly commanded -attention; he appeared completely master of his subject, was -exceedingly clear, concise, and condensed, and never at a loss for an -appropriate word. He was always modest and unostentatious. When left -sole heir of his uncle William, he at once transferred to John Hunter -the family estate of Long Calderwood, to which he regarded him as -entitled. - -Baillie’s principal work is pathological. In 1793 he published “The -Morbid Anatomy of some of the most Important Parts of the Human -Body,” and although pathology is now very different from what it was -in his day, and his classification is not now useful, his facts, when -properly interpreted, are still found excellent. The work met with -very great success, and was translated into many European languages, -besides going through five English editions in the author’s lifetime. - -Baillie gradually got into good practice, being appointed physician -to St. George’s Hospital in 1787, elected Fellow of the College -of Physicians in 1790, Censor in 1791 and 1796, and Fellow of the -Royal Society in 1789. On the retirement of Dr. Pitcairn from -practice in 1798, Baillie succeeded to a great part of it, and -his practice was still further benefited by his marriage with the -daughter of Dr. Denman, whose great obstetric practice enabled him -to recommend Baillie very frequently. He resigned his hospital work -in 1799, and from that time had perhaps the leading practice in -London, making ten thousand pounds in some years. He was consulted -about George III.’s case, and in 1810 was made Physician to the -King and offered a baronetcy, which he declined. In 1814 he was -also appointed Physician-in-Ordinary to the Princess Charlotte, and -attended many members of the royal family. His manner towards his -fellow-practitioners was as pleasing as his conduct to patients. To -both he would carefully explain, as far as possible, his views of the -nature of the case and the treatment required, and he was exceedingly -successful in tranquillising the apprehensions of his patients. -His modesty was transparent. He would say to his friends: “I know -better perhaps than another man, from my knowledge of anatomy, how -to discover a disease, but when I have done so, I do not know better -how to cure it.” From this one is not surprised to learn that he -was not fertile in expedients, but if the simplest means failed, he -was often at a loss what to do next, and was not apt at varying his -prescriptions. - -Baillie was not without an irritability of temper, in which we see -some resemblance to John Hunter; but his heart was at bottom most -kindly. He would often say after an outbreak, “I have spoken roughly -to that poor man; I must go and see him, be it ever so late;” “that -patient is in better health than I am myself, but I have been too -hard with him, I must make him amends.” There were many instances of -his great and delicate generosity to his patients. Overwork, to the -extent of devoting sixteen hours a day to practice, enfeebled his -constitution, and before the age of sixty he was compelled to retire -in a large measure from practice. He died at his seat, Duntisbourne -House, near Cirencester, on the 23d September 1823, leaving a fortune -of £80,000. He bequeathed a considerable sum to the College of -Physicians, with his manuscripts and other interesting curiosities, -such as the gold-headed cane used by Radcliffe, Mead, and others, -whose arms are engraved on it. He was buried in Duntisbourne Church, -but his memory was commemorated by his professional friends by a -fine bust by Chantrey in Westminster Abbey. His excellent qualities -and his strong religious principle were well set forth by Sir Henry -Halford in an address to the College of Physicians. - - * * * * * - -Sir HENRY HALFORD was long a contemporary of Baillie, but -survived him more than twenty years. He was the second son of -Dr. James Vaughan, a successful physician at Leicester, whose -third son became a judge of the Court of Common Pleas; the fourth -son was Dean of Chester and Warden of Merton College, Oxford; -the fifth, Envoy-extraordinary to the United States; and the -sixth was the father of Dean Vaughan, the well-known Master of -the Temple. The eldest son died in his twenty-third year. The -distinction which Vaughan’s sons attained shows that his judgment -was admirably exercised in their education. In fact, he spent his -whole professional income in providing for them the best possible -educational aids. Henry, like the others, was sent from Rugby to -Oxford (the youngest only going to Cambridge); and he records, in -eulogising his father’s treatment of them, that not one of them -asked or received further pecuniary assistance from him after he had -finished his education, and commenced his own efforts to provide for -himself. - -Henry Vaughan was born on October 2d, 1766. Entering at Christchurch, -Oxford, he graduated B.A. in 1788, M.D. 1791. He studied medicine -for some months at Edinburgh, and also practised for a time with his -father at Leicester. About 1792 he came to London, and having a good -opening through his Oxford friends, had courage enough to borrow -£1000 on his own security in order to establish himself in London -practice. Here his good manners and evident learning stood him in -good stead, and he was elected physician to the Middlesex Hospital -in 1793, becoming a Fellow of the College of Physicians in 1794. In -March 1795 he still further promoted his advancement by his marriage -with the third daughter of Lord St. John, and rapidly rose into note. -With all his talents, however, it looks like one of fortune’s freaks -that Vaughan should have been appointed Physician-Extraordinary to -the King in 1793, at the age of twenty-seven; and that his practice -should have so increased that in 1800 he was compelled to give up his -hospital appointment. But fortune had more favours in store for him. -He inherited a large property on the death of Lady Denbigh, widow of -his mother’s cousin, Sir Charles Halford; and he consequently changed -his name in 1809 by Act of Parliament from Vaughan to Halford. George -III. created him a baronet in the same year. - -The King had indeed a strong preference for Sir Henry Halford, as -he now became. He secured Sir Henry’s promise, before the onset of -his last long derangement, that he would not leave him, and that if -necessary he would call in also Dr. Heberden and Dr. Baillie. To -recite the number of royal personages to whom Sir Henry was physician -would be tedious; suffice it to mention that he attended, besides -George III., George IV., William IV., and Queen Victoria, having thus -been the physician of four English sovereigns. - -There is no doubt that Halford possessed talents of a high order. He -is said to have been inferior to Baillie in accuracy of diagnosis, -but superior in the cure and alleviation of disease. He had quick -perception, sound judgment, and great knowledge of the powers of -medicines. For many years after Baillie’s illness and death he was -undisputedly at the head of London practice. At the College of -Physicians his rule continued unchecked, if not unquestioned, for -more than twenty years, he having been President from 1820 till -his death on the 9th of March 1844. He was largely instrumental in -securing the removal of the College from Warwick Lane in the city -to the present commodious building in Pall Mall East. His bust by -Chantrey was presented to the College by a number of Fellows. His -portrait by Sir Thomas Lawrence is at Wistow, Leicestershire, where -he was buried in the parish church. - -Halford’s early success was not favourable to his prosecuting -original research nor to his publishing much that is important. His -chief publications were first given as addresses to meetings of -the College of Physicians. In these he showed skill and pleasing -literary art. He wrote on the Climacteric Disease, on the Necessity -of Caution in the Estimation of Symptoms in the Last Stages of some -Diseases, on the Tic Douloureux, on Shakespeare’s Test of Insanity -(Hamlet, Act iii. Sc. 4), on the Influence of some of the Diseases -of the Body on the Mind, on Gout, on Phlegmasia Dolens, on the -Treatment of Insanity, and on the Deaths of some Illustrious Persons -of Antiquity—and again, on the Deaths of some Eminent Persons of -Modern Times. It is to be regretted perhaps that a man of such -accomplishments should have left so little behind him; but he was -of use to his day and generation; and as to the knowledge he had -attained, it served him only to affix the term “conjectural” to -medicine, when speaking of the confidence Baillie inspired. At least -he did not seem to have hidden from himself how little the medicine -of his days could lay claim to being completely informed. - - * * * * * - -WILLIAM FREDRIC CHAMBERS, the son of an East Indian civil servant, -whose family belonged to Northumberland, was born in India in -1786. Brought to England in 1793 in consequence of his father’s -death, he was educated at Bath, Westminster, and Trinity College, -Cambridge, where he graduated B.A. in 1808. He had hoped for a -fellowship, intending to take orders; but being disappointed, he -turned to medicine, and entered at the Great Windmill Street School, -subsequently spending a year at Edinburgh, and returning to study -at St. George’s Hospital, the Eye Infirmary at Moorfields, and at -Bateman’s celebrated Dispensary. His diligence, both in practical -medical study and in dissections, attracted the attention of the St. -George’s physicians, and on the resignation of Dr. Pelham Warren, -then one of the leaders of London practice, he was brought forward -and elected physician to the Hospital in 1816 when only thirty years -of age. His East Indian connection secured him, in 1819, the post -of examining physician to the East India Company, after being some -time assistant-physician. Notwithstanding his early prominence, his -professional income rose but slowly, showing that neither ability -nor patronage will avail greatly in competition with the established -favourites. It was 1825 before Chambers’s practice amounted to -£2000; and his pre-eminence was not marked till the death of Dr. -Maton in 1835, and the great age of Sir Henry Halford (who died -in 1844), left him in indisputed possession of the leading London -practice. From 1836 to about 1851 he received in fees between seven -and nine thousand guineas a year. In 1836 he was consulted by Queen -Adelaide, and in 1837 was made Physician-in-Ordinary to William IV., -declining knighthood, though made Commander of the Guelphic order. -He was continued as Physician-in-Ordinary to Queen Victoria, and -his successful career was uninterrupted, except by rather frequent -ill-health. About 1851, owing to the failure of his health, he -retired from practice, and settled near Lymington, where he died on -the 17th December 1855. - -Chambers did not win his success either by writing, teaching, or -discovering. In addition to a tall commanding figure, and the most -agreeable, yet straightforward manners, he possessed striking -decision, and pursued bold and successful plans of treatment in -acute diseases. He kept himself well acquainted with the advances of -others, and was early distinguished by his adopting the stethoscope. -Like many men of great eminence, he was at heart exceedingly -diffident, and felt acutely the responsibilities which he undertook. -He was continually in fear of doing something wrong or making a -mistake. Thus he undoubtedly was a most conscientious physician, -and it is to be feared that he gave himself much suffering by the -minutely painstaking system that he adopted. Both at the hospital -and in private practice, he personally recorded the particulars -of every case that he saw, together with all his prescriptions—an -astounding instance of laborious effort. In this way his private -practice furnished sixty-seven large quarto volumes of notes, which -were every day completely written up, and carefully indexed, so -that he could refer with the utmost ease to any case he had ever -seen. Moreover, he made in very many instances sketch maps of the -diseased organs, side by side with the description. So persistent was -he in this conscientious toil, that he often continued it far into -the night and even till daylight, resuming work again before nine -o’clock. Ill-health was a necessary consequence, but his reliability -was certain to tell in practice. He could scarcely depend on a single -regular meal a day, so great was the demand for his services. He -literally rushed through the streets driven post-haste at ten miles -an hour. After a serious illness in 1834, through having absorbed -poisonous matter from a patient who had died of pleurisy, his right -hand was distorted by the results of abscesses; and it was hence -vulgarly reported that his fingers had become crooked from the -continual habit of taking fees. The regard he won from others may be -evidenced by the fact that Sir Benjamin Brodie for some weeks visited -him daily during this illness at Tunbridge Wells, when this entailed -much greater loss of time than now. His liberality was well known, -and this, with his frequent illnesses, caused him to accumulate no -great fortune. - - * * * * * - -With regard to Sir HENRY HOLLAND, it is with regret that we own -how comparatively slight are his claims to a place in the gallery -of great medical men. He was accomplished beyond most men, but -one is compelled to ask, what did he accomplish with his great -opportunities? Whom did he teach? what did he teach? what did he -discover? His travelling excursions extended over almost the whole -globe except Australia. He was intimate for more than half a century -with many men and women of mark on both Continents. He knew well -the Presidents and statesmen of the United States; prescribed for -six Prime Ministers of England, as well as for its sovereigns and -princes. But even in regard to information of moment which he might -justifiably have given concerning them, he has been strikingly -reticent in his “Recollections of Past Life.” - -Henry Holland, the son of Peter Holland, a much-respected medical -practitioner, was born at Knutsford in Cheshire, on October 27, -1788. His maternal grandmother was a sister of Josiah Wedgwood, the -eminent potter, and grandfather of Charles Darwin. Holland was also a -cousin of Mrs. Gaskell, the author of “Mary Barton,” and biographer -of Charlotte Brontë. He was educated first at Newcastle-on-Tyne -under the Rev. W. Turner, and early showed his predilection for -travel by making long pedestrian excursions in the neighbourhood. -In 1803, he went for a year to Dr. Estlin’s school, near Bristol, -where he succeeded at once to the position of head boy, left vacant -by John Cam Hobhouse, afterwards Lord Broughton, and where he also -commenced his long friendship with Richard Bright, who has already -been mentioned in this work. His classical and literary tastes here -developed, and were further fostered by a vacation passed at Dr. -Aikin’s at Stoke Newington, and in the society of his sister Mrs. -Barbauld and his daughter Lucy Aikin. Still, young Holland leaned -towards a commercial life, and entered a Liverpool merchant’s -office, with the stipulation that he was to spend two sessions at -Glasgow University. These saved him from being bound to a merchant’s -desk; for after his second session, 1805-6, he sought and obtained -release, and took up medicine. At Glasgow he had become intimate with -William Hamilton (afterwards Sir William), his discussions with whom -had doubtless a considerable influence on his mental development. -Holland’s literary talent already began to show itself, for he was -selected at the age of eighteen to draw up a Statistical Report on -the Agriculture of Cheshire for Government, and received for it £200, -double the sum proposed. - -In October 1806, Holland entered at the Edinburgh Medical School; -but he did not confine himself exclusively to one school, for he -spent two succeeding winters in the Borough Schools of London, Guy’s -and St. Thomas’s, and in private study. Resuming at Edinburgh, he -took his degree in 1811. Travel had already found him apt; in 1810 -he went to Iceland with Sir George Mackenzie and Richard Bright, and -contributed considerable portions to the narrative of the expedition. -Holland early became associated with the Whig section of Edinburgh -society, but he saw much of its general aspects, and he knew Walter -Scott, Dugald Stewart, Francis Jeffrey, Henry Erskine, and many -others known to fame. He had already made the acquaintance of Maria -Edgeworth during a visit to Ireland; and her letters to him would in -themselves fill a volume. Everywhere the bright pleasing intelligent -youth was welcomed. As he could not yet be admitted by the College of -Physicians owing to his lack of years, he undertook extensive travels -on the Continent, venturing into little-known regions, and published -his “Travels in Portugal, Sicily, the Ionian Islands, and Greece,” -in 1815, a work which yet further increased his fashionable repute. -Mrs. Piozzi, writing from Bath in 1815, says, “We have had a fine Dr. -Holland here. He has seen and written about the Ionian Islands, and -means now to practise as a physician—exchanging the Cyclades, say we -wits and wags, for the sick ladies. We made quite a lion of the man. -I was invited to every house he visited at for the last three days. -So I got the _queue du lion_, despairing of _le cœur_.” - -Holland had spent much time in the military hospitals in Portugal -during his travels, and gained valuable experience. In Turkey he came -into contact with Ali Pasha, through whom he was deprived of most of -his papers relating to Albania, a mortifying loss at the time. After -his return home he speedily formed friendships with Lords Lansdowne, -Aberdeen, and Holland, which continued uninterrupted save by death, -and of course led to his intimacy with many other persons of note, -traits in whose characters are recorded in the “Recollections.” We -cannot here follow the incidents of the brilliant social life into -which Henry Holland entered with so much zest. Suffice it to mention -that he was elected to the Royal Society in 1816, and admitted on the -same day as Lord Byron, who on that occasion made his only visit. -Henry Holland was an almost constant guest at Holland House. In the -summer of 1814 he became domestic medical attendant on the Princess -(afterwards Queen) Caroline, to accompany her during her first year -of travel on the Continent. This situation became one of extreme -delicacy, and its importance was very manifest at her trial years -afterwards, where Dr. Holland’s evidence, declaring that he had never -seen anything improper or derogatory in her behaviour to Bergami or -any other person, proved of extreme weight in her behalf. - -A man of such connections could not fail to gain almost as much -practice as he liked. His visits to Spa for four successive years, -after the London season, strengthened his professional prospects, -and his fourth year’s practice brought him over £1200. In a few -years he was able to resolve that his professional income should -never exceed £5000, and that he would give to study, recreation, -or travel all his surplus time. Thus happily placed, Henry Holland -became the friend of every man of note, the patron of science at -the Royal Institution, of which he was long president—but not the -hospital physician, the clinical teacher, the original writer, the -promoter of medical reform, or the habitué of the medical societies. -He dined out, and never reproved his patients for the lapses from -physiological prudence which he observed at the table. The “frequent -half hour of genial conversation” was what he bestowed and was most -capable of bestowing on his patients. Perhaps he thereby solaced -their days of tedium or hypochondria as well as others who might have -sought to root up their habits or impart tone to their minds with -more ruthless energy. “When Lady Palmerston was suffering from an -illness that occasioned some alarm to her friends,” said the _Times_, -in its obituary notice of Holland, “one of them, meeting the late Dr. -Fergusson, asked anxiously how she was. ‘I can’t give you a better -notion of her recovery,’ was the reply, ‘than by telling you that I -have just received my last fee, and that she is now left entirely to -Holland.’” On this being repeated to Lord Palmerston his lordship -mused a little, and then said, “Ah! I see what he means. When you -trust yourself to Holland, you should have a superfluous stock of -health for him to work upon.” Holland himself had this superfluous -stock of health. When over eighty he writes: “A frequent source of -amusement to myself is my incapacity for walking slowly; and the -sort of compulsion I even now feel to pass those immediately before -me in the street, and to take the diagonal instead of the two sides -of a square, whenever this is the alternative. When I cease to take -the diagonal (often a dirty one) instead of the side pavements, I -shall consider that I have gone a step downwards in the path of -life.” His excursions were almost all taken alone; but he evidently -seldom put himself out of the reach of general society, as good -as the neighbourhood afforded. He was no recluse, yet apparently -not a man of a few warm strong personal friendships. If he was we -find no record of it. From his utter reticence about his medical -contemporaries, we should judge that he did not at bottom appreciate -them as they deserved. - -To give briefly a few of the more notable dates in Holland’s life, he -married first, in 1822, a Miss Caldwell, who died in 1830, leaving -two sons, the present Sir Henry Holland and the Rev. F. J. Holland; -and secondly, in 1834, Saba, daughter of Sydney Smith. He was made -Physician-Extraordinary to the Queen in 1837; Physician-in-Ordinary -to the Prince-Consort in 1840; was offered, but declined, a -baronetcy by Lord Melbourne in 1841; was made Physician-in-Ordinary -to the Queen in 1852, and accepted a baronetcy in 1853. In later -years he withdrew altogether from practice, but continued active in -society and persevering in travel. In his last journey, to Russia, he -was accompanied by his son, the Rev. F. J. Holland; on his way back -he attended the trial of Marshal Bazaine at Versailles on the 24th -October 1873, dined the same day at the British Embassy, returned -to London the next day, did not go out on Sunday the 26th, and died -quietly in bed on the 27th, on the 85th anniversary of his birth. - -To this extraordinary age lived the man who had been seen in all -climates, in the Arctic Circle or in the Tropics, on the Prairies or -the Pyramids, in the same black dress coat in which he almost ran -from house to house at home. Sydney Smith said of him that he started -off for two months at a time with a box of pills in one pocket and -a clean shirt in the other—occasionally forgetting the shirt. Let -Sir Henry tell his own tale of his enjoyment. “The Danube I have -followed, with scarcely an interruption, from its assumed sources at -Donau-Eschingen to the Black Sea—the Rhine, now become so familiar to -common travel, from the infant stream in the Alps. The St. Lawrence -I have pursued uninterruptedly for nearly two thousand miles of its -lake and river course. The waters of the Upper Mississippi I have -recently navigated for some hundred miles below the falls of St. -Anthony. The Ohio, Susquehanna, Potomac, and Connecticut rivers I -have followed far towards their sources; and the Ottawa, grand in -its scenery of waterfalls, lakes, forests, and mountain gorges, for -three hundred miles above Montreal. There has been pleasure to me -also in touching upon some single point of a river, and watching the -flow of waters which come from unknown springs or find their issue in -some remote ocean or sea. I have felt this on the Nile at its time of -highest inundation, in crossing the Volga when scarcely wider than -the Thames at Oxford, and still more when near the sources of the -streams that feed the Euphrates, south of Trebizond.” Altogether Sir -Henry estimated that he had spent twelve years of his life in foreign -travel. - -Literary work was a pastime with Holland, and both in the Quarterly -and the Edinburgh Reviews he delighted to show his extensive -reading, and his enlightened yet very unrevolutionary views. His -more interesting reviews have been published as “Scientific Essays,” -and “Chapters on Mental Physiology;” while his “Medical Notes and -Reflections” constitutes almost all his practical contribution to -medical science. Interesting “Fragmentary Papers” were published -posthumously. In the “Medical Notes” certain current questions -were philosophically discussed in a most pleasing style, and some -questions of practice treated with some originality if not with -boldness. Two chapters may be especially alluded to as valuable, -namely, those “On the Abuse of Purgative Medicines,” and “On -Bleeding in Affections of the Brain.” Many of his chapters on -Mental Physiology show wide observation and kindly insight into the -relations of mind and body. But after all it is by his “Recollections -of Past Life” that Holland will be most known, his sketches of the -leading personages, politicians, wits, and scientific and literary -men having a charming vividness and truthfulness about them, making -every one regret that so many limitations were imposed by the author -upon himself when he might have easily furnished so much more -material for history. - -Holland was of the middle height, spare in appearance, but very -active; with a countenance not indicative of the highest mental -power. - - - - -CHAPTER XIV. - -_SIR WILLIAM FERGUSSON AND CONSERVATIVE SURGERY._ - - -The association of the word “conservative” with operative surgery, so -strongly identified in the popular mind with the removal of portions -of the body, needs some explanation to the non-professional reader. -In former times inflammation with denudation of bone was commonly -believed to necessitate amputation; and diseased joints, especially -the elbow, knee and ankle, with ulceration of cartilages, were -generally considered incurable, except by removal of the limb. As -Fergusson said, the ways of surgery get grooved; they are hallowed in -the estimation of some. The man who steps from the groove is held to -be rash and is called to account. How much this was the case will be -seen by the reception accorded to conservative surgery, which aspired -to do away with many of the radical proceedings of the past. - -The term “conservative surgery,” as first used by Sir W. Fergusson -in 1852, meant operations for the preservation of some part of the -body, which would otherwise have been unnecessarily sacrificed. A -smaller and more limited operation was undertaken to remove simply -the incurably disorganised portion of the body, such as a diseased -joint, and not an entire limb. Thus Fergusson said, “a compromise -may be made, whereby the original constitution and frame, as from -the Maker’s hand, may be kept as nearly as possible in its normal -state of integrity.” “No one can more thoroughly appreciate a -well-performed amputation than I do, but I certainly appreciate -more highly the operation which sets aside the necessity for that -mutilation.” - - * * * * * - -Two great surgeons thus bear testimony to Fergusson: “The -improvements which he introduced in lithotrity and in the cure of -cleft-palate may almost be considered typical,” says Sir Spencer -Wells,[3] “of the school of modern conservative surgery, and will -long be acknowledged as triumphs of British surgery in the reign of -Victoria.” He was, in the words of Sir James Paget, “the greatest -master of the art, the greatest practical surgeon of our time.” - -WILLIAM FERGUSSON was born on March 20th, 1808, at Prestonpans, -East Lothian, and was educated first at Lochmaben in Dumfriesshire -and afterwards at the High School of Edinburgh. At fifteen he -entered a lawyer’s office, by his own desire, but soon found that -law did not suit him, and at seventeen exchanged law for medicine, -which profession his father had wished him to adopt. He was -early attracted by the teaching of Robert Knox, the celebrated -anatomist, who quickly discerned the stuff his pupil was made of. -Fergusson would often spend from twelve to sixteen hours a day in -the dissecting-room. One of his dissections of the nerves of the -face, preserved in the museum of the Edinburgh College of Surgeons, -remains an admirable example of manipulative skill and dexterity, and -the stand on which it is placed is also a specimen of his work. At -twenty Knox made him demonstrator to his class, which then numbered -four hundred. He had previously assisted John Turner, Professor of -Surgery at the College of Surgeons. At the early age of twenty-one -Fergusson became Fellow of the College of Surgeons by examination. -Knox then promoted him to a share in his lectures on general anatomy, -and the young lecturer also gave demonstrations on surgical anatomy, -which proved highly valuable. He soon began to manifest his skill -in operative surgery, and in 1831 he was elected surgeon to the -Edinburgh Royal Dispensary, and showed his boldness by performing -the important operation of tying the subclavian artery, which as -yet had only been twice done in Scotland. In 1833 he married Miss -Ranken, heiress of the estate of Spittlehaugh in Peeblesshire. This -marriage, while it placed him beyond pecuniary difficulty, had no -effect in diminishing his industry. In 1839 he became surgeon to the -Royal Infirmary, and Fellow of the Royal Society of Edinburgh, and -already shared the highest surgical practice with Syme. In fact there -was hardly room for two such men in Edinburgh. Liston had betaken -himself to London. In 1840 Fergusson followed his example, accepting -an invitation to King’s College, which was now establishing its -hospital. At a farewell presentation, Lizars said that he had seen no -one, not even Liston himself, surpass Fergusson in the most trying -and critical operations. The man of whom this could be said at the -age of thirty-two had every chance of success in London, even though -he came thither with scarcely any personal friends to back him. -Professor Partridge, his old friend, gave him a cordial introduction, -and he established himself in Dover Street, Piccadilly, only to find -that his first year’s private practice did not exceed £100. Yet -it cannot be denied that Fergusson came to London at a fortunate -period. Within a few years death or retirement withdrew from practice -many of the most capable operators, such as Liston, Aston Key, and -Astley Cooper. Thus his success was really rapid, for his third year -brought him £1000, and in 1847 he removed to a large house in George -Street, Hanover Square. His style of operating soon attracted general -attention both among students and practitioners, and King’s College -operating theatre became the resort of all the medical students and -practitioners who could cram into it. - -As an operator Fergusson was most peculiarly skilled, and he appears -to have had a natural manipulative dexterity, which he assiduously -cultivated. Like Sir Charles Bell and other eminent surgeons, he was -a splendid fly-fisher; and his manipulation served him in good stead -in acquiring skill on that most difficult of instruments, the violin. -Carpentering and metal-working came easily to him, and gave him -great readiness in improvising splints or other apparatus desirable -for his patients’ special circumstances. Yet having such power and -dexterity, he did not choose to display it on all possible occasions, -but rather was conspicuous for his frequent abstinence from operative -interference, counting it a greater glory to save a limb than to -cut one off, and taking endless trouble to preserve a portion when -amputation would have been much easier. - -Although the rivalry between Fergusson and Syme frequently led to -open dissensions, yet no man more freely, fully, and repeatedly -acknowledged Syme’s great services than Fergusson. Thus he always -ascribed the chief merit of the revival of the “conservative” -operation of excision of the elbow-joint to Syme. Originally -suggested by Park, and first performed by Moreau, it was not until -the operation was taken up by Syme that it attracted serious -attention. Fergusson followed in his wake, and extended the same -principles till there was scarcely a part which could be conserved -which he had not laid hands on with that object. To take an -instance from parts of small size. A gentleman of active habits, in -charge of a large establishment, to whom the use of a pen was of -vast importance, had a bad whitlow at the end of his right thumb. -An abscess was opened in due time, and the bone was found bare. -Amputation was urged, but the patient objected, and on consulting -Fergusson, he was advised to wait, and then a few weeks afterwards -the portion of bone that died was removed through the original -opening for the abscess. Before long, the thumb, apparently entire, -was as useful as ever. “Opinions may differ,” says Fergusson, “but -for my own part, I deem it a grand thing when by prescience even the -tip of a thumb can be saved.” - -To Liston’s boldness and rapidity Fergusson added greater caution -and self-control. In lithotomy both were equally distinguished, -and attained their end with the simplest instruments. An anecdote -recorded in the _Medical Times and Gazette_ (Feb. 17, 1877) -illustrates this. Some practitioners were discussing the relative -merits of some leading hospital surgeons, and introduced the subject -of lithotomy. “I saw Mr. —— perform lithotomy to-day in half a -minute.” “Oh,” replied B, “I saw —— once extract the stone in twenty -seconds.” “Have you ever seen Fergusson perform lithotomy?” “No.” -“Well then, go; and, look out sharp, for if you only even wink, -you’ll miss the operation altogether.” - -In 1845 Fergusson revived the plan of excising the head of the femur -for incurable disease of the hip-joint, and it became established -as a valuable operation, in spite of Syme’s violent opposition. In -1847 Mr. Fergusson excised the entire scapula, where the whole -arm would otherwise have been sacrificed. In 1850 his attention -became concentrated on diseases of the knee-joint, and before -long he excised the joint for severe disease. Although the result -was unfavourable, Fergusson, undismayed, repeated the operation -successfully, and in spite of strong criticism and opposition, -continued for at least fifteen years, it has become established. -The strength of the feeling aroused on this subject was so great -that once when Fergusson was about to excise a knee-joint at King’s -College Hospital, a surgeon, once a colleague, publicly protested -against the performance of the operation. Fergusson’s earlier -cases were not always well selected for the operation, and he had -many disheartening failures. But he persevered and improved in his -selection of cases, and achieved what he regarded as the greatest -triumph of conservative surgery. - -Some of Fergusson’s greatest triumphs were in connection with -hare-lip and cleft-palate. His first formal operation in surgery -was for hare-lip in 1828. Up to 1864 he had operated on nearly four -hundred cases with only three deaths. The adoption in 1850 of a -spring or truss to push the sides of the lips forwards, invented -by Jem Hainsby (the old dissecting-room attendant at Guy’s), and -the father of a child-patient, was of great value in preserving the -mobile parts of children from undesirable movements. In regard to -cleft-palate Fergusson’s labours were of even greater value, for -he discovered by careful dissection the reason why the edges of -the wound were so often prevented from uniting, and by dividing the -muscles concerned, in addition to other valuable improvements in -practice, he enabled many patients to gain an excellent undivided -palate. Up to 1864 he had operated on 134 cases, of which 129 were -successful, and only two failed entirely. It is unnecessary to go -through the long list of successes won by Fergusson; but it is well -to mention that when he found the existing instruments unsuitable for -his purpose, he never rested till he had invented better ones. The -bull-dog forceps, the mouth-gag for operations on the palate, various -bent knives, and many other instruments and apparatus bear the stamp -of his inventive skill. - -With all his operative brilliancy, that did not constitute -Fergusson’s chief claim to admiration, nor was it the principal cause -of his success. The perfect planning of the operation beforehand -from beginning to end, down to the smallest detail, and being ready -for every possible emergency with the precise method for meeting it, -distinguished him most. Consequently he neither hurried, wearied, -nor hesitated when he began. Things were so perfectly planned, his -assistants so well drilled, that not a word needed to be spoken, and -this produced a curious appearance at times, so that it was often -remarked that he must be on bad terms with his assistants. He left no -detail unsupervised, and completed the operation entirely himself, -even applying bandages and plasters. His coolness under difficulty -was probably connected with his forethought; he could often cover -his own or others’ mistakes in the coolest manner, and this put him -in the best position for remedying them. It was his pride never -to be late. He hated unnecessary waste of time, and once when a -friend intending to tie a large artery had laid it bare by a fine -dissection, and was showing it with natural gratification, Fergusson -called him to the point by remarking, “Jist put a thread round it.” -So when a large artery had been wounded, and an assistant eagerly -tried to stop the bleeding with his finger, Fergusson said: “Jist -get your finger out of the way, mon, and let’s see what it is,” and -satisfactorily tied the vessel.[4] He was remarkably neat too in his -completion of an operation, and could not bear to leave any traces -behind, either in hospital or private house. - -In the subjects which he had thoroughly studied and on which he had -practical experience Fergusson was a master. This is seen in his -“Practical Surgery,” which reached a fifth edition in 1870, and -in his lectures on the Progress of Anatomy and Surgery delivered -at the College of Surgeons in 1864 and 1865. But as a systematic -lecturer he did not achieve great success, nor was he conspicuous as -a bedside teacher owing to his reticent manner. It was in operating -that he shone most, and in his remarks on operations; to see him -operate was for the student or practitioner already instructed what -to observe a lesson full of practical value. On some important -questions he was imperfectly informed, and this was proved when he -opposed the movement for securing a pure water supply to large towns, -and favoured the anti-vivisectionists in some remarks and evidence -which showed considerable ignorance of physiological discovery and -progress. Again, his attitude towards homœopathic practitioners -largely compromised his influence at one time. - -Fergusson’s social instincts as well as his personal sympathies won -him favour from all classes, and his male as well as his female -patients felt deeply his kindly attentions, while children simply -worshipped him. His practice was always to treat a hospital patient -with exactly the same consideration as one in private. Mr. Henry -Smith records the profound impression made upon him as a young -student by his remarkable kindness and gentleness towards a little -lame boy. It is not to be wondered at that he inspired his patients -with the utmost confidence, an art that many equally clever have -lacked. A gentleman who came to London to have an enormous tumour -of the lower jaw removed, saw several eminent surgeons, but chose -Fergusson as the operator without hesitation. “Directly he put -his hands upon me,” said this gentleman, “to examine my jaw, I -felt that he was the man who should do the operation for me; the -contrast between his examination and that of others was so great.” -As Mr. Henry Smith says, “Fergusson not only shone pre-eminently -as an operator, but he possessed a profound knowledge of his art, -and wielded all its resources with consummate skill. His powers of -observation were remarkable; his memory was most tenacious; his -shrewdness, sound common-sense, tact and knowledge of men, and how -to deal with them, were acknowledged by all; and conspicuous amongst -them was that facility of resource in all trying emergencies, which, -added to his extraordinary mechanical skill, made him what he was, -and brought about a success which has seldom been vouchsafed to any -surgeon.” - -Fergusson became M.R.C.S., Eng., in 1840, and Fellow in 1844. -He was appointed Surgeon to the Prince-Consort in 1849, and -Surgeon-Extraordinary to the Queen in 1855, and Sergeant-Surgeon -in 1867. In 1861 and again in 1868 he was elected to the Council -of the College of Surgeons, notwithstanding the strong opposition -of the existing council on the first occasion. In 1867 he became -an examiner in surgery, and in 1870 President of the College. His -lectures as Professor have already been mentioned. We may add that he -was President of the Pathological Society in 1859 and ’60, and of the -British Medical Association at its brilliant London meeting in 1873. -His many other appointments and distinctions must be passed over, -with the exception of the baronetcy, which he received in 1866. - -Fergusson never tired of work. His fine energies kept him ever -fresh. He could sing, or dance a Highland reel, with energy long -after middle age, and when just returned from a prolonged and tiring -journey. He was a munificent patron of literature and the drama; -attended many an author without fee, and would not unfrequently pay -for their lodging near him in cases where that was desirable. His -spirit of hospitality was lavish, whether in London or at his seat -at Spittlehaugh in Peeblesshire. He was ever ready to show kindly -feeling towards even those who censured him most severely, and his -forgiving nature was many times most conspicuously evident. Whenever -he had any consciousness of having done or said anything calculated -to wound another’s feelings, old or young, he never rested until he -had made reparation in some way. He held a truly modest estimate -of himself, was unspoiled by popularity, and never became at all -overbearing. He was a staunch friend, to old pupils especially, -and a liberal helper of members of the profession generally. Many -a surgeon who has risen has owed to him essential help. Indeed, he -displayed the best Christian characteristics, and was, in Mr. Henry -Smith’s words, “the true type of a Christian gentleman.” He died in -London, after an exhausting illness, of Bright’s disease, on February -10th, 1877, and was buried at West Linton, Peeblesshire, where his -wife had already, in 1860, been buried. A portrait of him by Lehmann -was presented by subscription to the London College of Surgeons in -1874, and a replica is in the Edinburgh College of Surgeons. His best -monument is in the life and work of the multitude of his pupils, whom -he influenced and stimulated as few have ever done. - - -FOOTNOTES: - -[3] Surgery, Past, Present and Future, 1877. - -[4] Henry Smith, Biographical Sketch of Sir W. Fergusson. - - - - -CHAPTER XV. - -_SIR JAMES SIMPSON AND ANÆSTHETICS._ - - -Future ages will perceive in the history of medicine and surgery in -the nineteenth century no more remarkable event than the discovery -and the introduction of means for relieving and temporarily -abolishing pain. And although the name of Simpson is by no means the -only one honourably associated with this discovery, his achievement -in the introduction of chloroform places him on an enviable pinnacle -of greatness. - -JAMES YOUNG SIMPSON, the seventh son and eighth child of a small -baker, was born at Bathgate, Linlithgowshire, on the 7th of June -1811. His birth took place when his father’s circumstances were -at the lowest ebb. Several of the family, including his mother, -had but just recovered from fever. The mother had to rise from her -maternal pain to take an active part in business, which she did most -energetically and successfully. Her religious character and her -thrifty habits deeply impressed the little boy, and he pleasingly -recalled in after years her injunction, when she had just darned a -big hole in his stocking, “My Jamie, when your mother’s away, you -will mind that she was a grand darner.” She died when James was but -nine years old, leaving him in the care of his only sister Mary, -eleven years older, who proved a tender foster mother. Already as -a child James Simpson became known as “the wise wean,” “the young -philosopher,” and his voice was sweet and silvery. His industry and -retentiveness of memory early gave promise of distinction, which -all the family were persuaded would fall to his lot. And he would -readily, book in hand, keep the shop for a time, or run with rolls -to the laird’s house. “I remember,” says his brother Alexander,[5] -“finding him sitting in the street on a very dusty day, sobbing -bitterly, the tears running down his cheeks covered with dust. ‘What -ails you, Jamie?’ I said, and he answered, sobbing as if his heart -would break, ‘I’ve broken the pony’s knees.’” It turned out that -Alexander himself had overridden the pony, so that it could not help -stumbling. - -The father of the family trusted his children in a peculiar way. All -were regarded as equally concerned in the family prosperity, and the -shop till was unfastened, and free to all; each habitually thought -of the general good first. In this way the household prospered ever -after James’s birth, and he personally received unremitting attention. - -At the age of fourteen James Simpson entered -Edinburgh University, “a very very young and very solitary, very poor -and almost friendless student,” as he himself said forty years after. -For two years he pursued classical and mathematical studies, gaining -a small bursary before his second session. One of his earliest -purchases was a little book on “The Economy of Human Life,” for which -he gave ninepence. An extract from it which he wrote in his cash-book -is significant of his temper of mind: “Let not thy recreations be -expensive, lest the pain of purchasing them exceed the pleasure thou -hast in their enjoyment.” Though an economical student, however, -his literary tastes were wide, as he early bought Byron’s Giaour -and Childe Harold, and Paley’s Natural Theology. He lodged with Dr. -Macarthur, a former usher in the Bathgate School, together with John -Reid, an old schoolfellow, afterwards Professor of Anatomy at St. -Andrews, in the upper flat of a tall house in Adam Street. Reid’s -enthusiasm for anatomy seem to have first inspired Simpson to choose -medicine as a profession. - -In the winter of 1827 James Simpson entered as a medical student -in the University, and, attending Liston’s class on surgery, soon -became conspicuous. He took full notes of lectures, and was freely -critical of his teachers. He became a dresser under Liston, and -received excellent testimonials from him. But he shrank from surgery, -having an exquisite tenderness of heart which almost drove him from -the profession. After witnessing on one occasion a poor woman’s -agony under amputation of the breast, he started off directly to -seek employment as a writer’s (or lawyer’s) clerk. He soon returned, -however, deeply imbued with the desire to do something to render -operations less painful. Simpson’s summer vacations were passed at -Bathgate, natural history and antiquarian pursuits occupying his -spare time. In January 1830, just before he was going up for his -license to practise, his father died after some weeks’ illness, -during which James constantly watched at his bedside. Such an -interruption to study at a critical moment might have upset so -sensitive a mind. But Simpson went in for his examination in April, -and became a member of the Edinburgh College of Surgeons before he -was nineteen years of age. His brother Alexander, who, with the -rest of the family, furnished faithful and persevering help to the -young brother of whom so much was expected, gave him a home while -he looked out for some post to occupy him while waiting for his -Edinburgh degree, which his youth prevented him from taking as yet. -One of the situations which he sought was that of parish surgeon in -a little village named Inverkip, on the Clyde. “When not selected,” -he writes long after, “I felt perhaps a deeper amount of chagrin -and disappointment than I have ever experienced since that date. If -chosen, I would probably have been working there as a village doctor -still.” - -In 1831 Simpson returned to his university studies, his brother -David having commenced business in Stockbridge, Edinburgh, and being -able to accommodate the young doctor. He assisted in maintaining -himself by becoming assistant to Dr. Gairdner. Thus he was enabled -to complete his university course and take his M.D. degree in 1832, -giving as his inaugural thesis an essay on “Death from Inflammation.” -This attracted much attention, especially from Dr. John Thomson, -Professor of Pathology, who at once requested him to act as his -assistant with a salary of £50, which the young man made sufficient -for all his necessities. In this capacity he prepared a catalogue -of the museum of the pathological department. His first experience -of obstetric study in attending Professor Hamilton’s lectures had -not left his mind under a compulsion to pursue the subject deeply, -but Dr. Thomson saw that his assistant, soft-mannered but full of -decisive activity, was the very man to succeed in midwifery practice, -and he therefore advised him to devote himself specially to it. -Another great characteristic was his power of winning the confidence -of others, and especially of getting his patients to tell him what it -was most important that he should know. But he went immediately to -work to become learned in his subject, and then to turn over in his -mind everything that he had learnt, until it assumed a new aspect. He -always sought new and better ways, and if any department of practice -or theory appeared to him defective, he restlessly applied his mind -to invent or imagine some improvement. And he had an absorbing -desire to gratify his family by achieving success. When his sister -Mary told him in 1834 he was injuring his health by overwork, he -replied, seriously, “Well, I am sure it’s just to please you all.” - -Simpson’s first important paper, on the Diseases of the Placenta, -delivered before the Royal Medical Society in 1835, at once showed a -master hand. It was translated into French, German, and Italian. He -began by exhaustively studying the previous history of every subject -he took up, and then tested others’ opinions and facts by his own -observation. One of his earliest papers includes nearly one hundred -references to previous literature, including many authorities, -showing an unusual range of reading. If he could not read the -language of an author he got some one who could to do so, and give -him the material bearing on his point of inquiry. But while no man -regarded more highly than he the patient achievements of the past, no -man sat more loosely to tradition and convention. - -In 1833 Simpson became a member of the Royal Medical and Physical -Societies of Edinburgh. Of the former he was soon President. A writer -in the _Scotsman_ for May 10, 1870, thus described his appearance -in that capacity. After speaking of his long tangled hair, and very -large head, he says: “A poet has since described him as one of -‘leonine aspect.’ Not such do we remember him. A pale, large, rather -flattish face, massive, brent brows, from under which shone eyes -now piercing as it were to your inmost soul, now melting into almost -feminine tenderness, and coarsish nose, with dilated nostrils, a -finely-chiselled mouth, which seemed the most expressive feature of -the face, and capable of being made at will the exponent of every -passion and emotion. Who could describe that smile? When even the sun -has tried it he has failed, and yet who can recall those features and -not realise it as it played round the delicate lines of the upper -lip, where firmness was strangely blended with other and apparently -opposing qualities? Then his peculiar, rounded, soft body and limbs, -as if he had retained the infantile form in adolescence, presented -a _tout ensemble_ which even had we never seen it again would have -remained indelibly impressed on our memory.” - -In 1832 Alexander and Mary Simpson both married. Alexander’s wife, -however, became as attached as his sister to James, and there was -no interruption to the family helpfulness. When cholera appeared -in Bathgate, Alexander made a will securing a provision for James -if he died. “I trust,” wrote this true brother, “every one of you -will look to him. But I dare say every one of you has a pleasure -in doing him good by stealth, as I have had myself.” The brothers -Alexander and John enabled James to visit London and the Continent -in 1835 to see a variety of practice; his travelling companion was -Dr. Douglas Maclagan, afterwards Professor of Medical Jurisprudence -at Edinburgh. On his return Simpson gained some practice, but -chiefly among those who could pay him little or nothing. In May -1836 he obtained the situation of house-surgeon to the Lying-in -Hospital, which he held for a year. This soon led to an increase of -practice among better-paying patients. He now gave some courses of -lectures on Midwifery in the Extra-Academical School, which were well -received, besides being appointed interim lecturer on Pathology, when -his friend Dr. Thomson had resigned. He gave great labour to the -preparation of his lectures, besides continuing to publish original -papers on Midwifery. At this time he rose repeatedly at three in the -morning, when he did not sit up all night. But with all his work he -found time for social enjoyment, for family interests, for messages -to old schoolfellows in humble life. - -Neither now nor at any time did Simpson lose his habit of plain -speech. He did not always conciliate others by his outspoken -expressions, and he did not care to wrap up unpleasant truths in -honeyed words. In 1839 some hasty words which passed between Simpson -and Dr. Lewins of Leith in reference to an anonymous letter written -by the latter, nearly led to a duel; but, fortunately, friends were -able to persuade them that both were to blame, and an amicable -reconciliation was effected. In the same year, that in which also -he had commenced housekeeping on his own account, Simpson became -a candidate for the Chair of Midwifery, vacated by Dr. Hamilton’s -resignation. The contest was a very severe one, Dr. Evory Kennedy of -Dublin having strong claims. Simpson strained every nerve to secure -testimonials and to influence electors, publishing an octavo volume -of testimonials, extending to more than 200 pages. He was finally -elected Professor on the 4th February 1840 by a majority of one -vote only, at the age of twenty-eight, with no advantages of social -position or long experience to back him. A few weeks previously -(December 26, 1839) he had married his second cousin, Miss Jessie -Grindlay, of Liverpool, to whom he had long been attached. - -But difficulties were not over when the election had taken place. The -pecuniary cost of the canvass was about £500, chiefly in printing -and postage; and Simpson had less than no money; he was considerably -in debt to his relatives. His new colleagues had to a large extent -opposed him, preferring Dr. Kennedy; they continued to oppose him, -not fancying their association with a small baker’s son. Practice -began to flow in, but it necessitated taking a larger house, keeping -a carriage, and much greater expenditure; and it was some time before -the young couple could make both ends meet. Demands from old friends -or from poor people for help, crowded on Simpson faster than fees; -and his kindly heart did more for them than sober judgment would -warrant. He frequently sat up all night writing for the press. He was -beset remarkably early by philanthropic projectors, self-interested -promoters, young aspirants to fame, and men anxious to bring forward -a pill calculated to make people live to the age of Methusaleh, or -desirous of the Doctor’s interest to get them permission to fish in -one of his patients’ streams. Nervous headaches and acute pains began -to cast their horrible shadows over his life; but work was scarcely -ever remitted. His lectures were immediately a great success; he -had the largest class in the University. Additional seats had to be -supplied, and then there was not room for all to sit. His cares had -meanwhile been increased by the birth of a daughter, a fortnight -before the session began. - -Simpson’s untiring activity could not content itself, however, with -strictly professional subjects. Before the end of his first session -of professional lectures, he began to work at a memoir which received -the title of “Antiquarian Notices of Leprosy and Leper-Houses in -Scotland and England.” In it he makes nearly five hundred references -to out-of-the-way authorities, and in the appendix is a list and -notices of one hundred and nineteen leper-houses which he had traced -in Britain. The memoir is a mine of valuable antiquarian information. - -By the end of 1842 his pecuniary position was assured beyond all -doubt, although his benevolence would have made this difficult -had not his skill become so famed. His success when little over -thirty years of age was marvellous; the hotels were filled with his -patients, and his practice was said to be worth many thousands of -pounds a year to these establishments. His house had to be enlarged -to receive some who insisted on remaining in the closest proximity -to the great doctor. But in the whirl of practice one fault became -prominent. Methodical and exhaustive in his literary researches, and -possessed of a powerful memory, he could not be persuaded to make -systematic notes of his appointments, and seemed to be incapable of -so planning out his time as to spend it to the greatest advantage -for his patients. He not unfrequently forgot a definite appointment, -and was sometimes overpersuaded by pushing people or by professional -friends to attend to cases out of their proper turn. That he ever -consciously did any one an injustice either for pay or without it -is quite untrue. But he was blamed as if he had. He was indeed only -too careless about money, and frequently too regardless of his own -interest to demand a proper fee. His receipts were stuffed at once -into his pockets, which were emptied at night, he knowing nothing -of their contents before. Sometimes a fee was received in a letter, -and neither taken out nor acknowledged. Once he received £10 thus, -when a much larger fee might have been expected, and several notes -of expostulation followed on his neglect to acknowledge its receipt. -One stormy night Simpson was much disturbed in sleep by the rattling -of a window. He got up, felt in his pocket for a bit of paper, and -lighted on the £10 note, which was devoted to the tightening of the -window-frame. On Mrs. Simpson discovering the nature of the bit of -paper in the morning, he merely replied, “Oh, it’s _that_ £10.” -A sample of ridiculous expostulations is the case where repeated -letters asked Dr. Simpson’s opinion whether three leeches should not -be applied to a hip-joint, instead of two, which the family medical -man recommended. - -In the midst of practice and lectures, he found time to write or -dictate many a brief or lengthy article on obstetric practice or -diseases of women, always practical, always exhausting previous -authorities. It was in this direction especially that his mind was -ever at work. Then when he had come to a conclusion, he withheld no -item of it. “Keen to perceive the truth,” says the _Scotsman_,[6] -he was equally vigorous in his announcement of it, and cared little -to what cherished opinion his statements might run counter. Hence -came contests where little quarter was given or received. He was a -dangerous antagonist to meet at a joust, and though he could use the -keen edge of steel, he oftener despatched his antagonist with a heavy -mace of facts or figures, which those who had neither his industry -nor his powers of memory could neither refute nor set aside. Hence -he made many enemies, for he had run counter to many prejudices, and -the old spirit which had opposed his election to the professorial -chair cropped out ever and anon, showing that it was smothered, not -extinguished. - -It should ever be remembered that Simpson’s greatness was established -before he had introduced chloroform, and depended on his unsurpassed -skill in obstetrics and diseases of women, while yet he was a most -accomplished general physician. Already, in January 1847, when he -was only just beginning to study anæsthetics, he was made one of the -Queen’s Physicians for Scotland. We cannot here attempt a history -of previous efforts to secure immunity or relief from pain, but it -is evident Simpson was in this respect not a man marvellously in -advance of his age; the subject was in the air; unceasing efforts -at improvement were being made. Before the end of the last century -the brilliant chemical discoveries of Priestley had led to his -suggestion that drugs might be administered in definite quantities by -inhalation through the lungs. Oxygen was the first gas inhaled for -medicinal purposes; and in 1795 Dr. Pearson of Birmingham prescribed -the inhalation of ether in cases of consumption, being followed ten -years later by Dr. Warren of Boston, U.S.A. In 1800 Sir Humphry -Davy, when superintending Beddoes’ Pneumatic Institution at Bristol, -founded principally for the medicinal inhalation of oxygen, began to -study the effects of nitrous oxide, which he employed, after he had -become familiar with its intoxicating effects, to relieve the pain of -a severe inflammation of his own gums. In publishing his account of -its successful inhalation he said, “As nitrous oxide in its extensive -operation seems capable of destroying physical pain, it may probably -be used with advantage during surgical operations in which no great -effusion of blood takes place.”[7] Thus we must credit Sir Humphry -Davy with the most original observation and experiment on the subject -of anæsthetics: another instance in which the investigator seeking -to advance science has made an observation and suggestion bearing -on the welfare of the whole of mankind. His pupil and successor, -Faraday, in 1818 announced that sulphuric ether vapour, when inhaled, -produced similar effects to nitrous oxide. Here closes the record of -anæsthetics for many years, practically we believe because medicine -and surgery had not yet become sufficiently scientific to discern -their value. - -In 1835 Robert Collyer, an American medical student, inhaled ether at -a chemical lecture by Professor Turner at University College, London, -being himself made insensible, in company with other students; he -noted that his fellow-students under its influence became insensible -to pain. In December 1839, Collyer, near New Orleans, reduced a -dislocation of the hip for one of his father’s negroes who had fallen -down in insensibility on inhaling the fumes of rum. The negro showed -no sign of pain. Collyer soon after identified this narcotic state -with that produced by mesmerism, under which also some operations -were painlessly performed. Collyer lectured on these subjects in 1840 -and subsequent years in Philadelphia, Boston, Liverpool, and other -places. He made mesmeric and narcotising experiments, the latter -with a mixture in which the vapour of alcohol with poppy seeds and -coriander steeped in it was inhaled, and in 1842 he states that he -administered his alcoholic mixture to a patient in Philadelphia, -during tooth-drawing, with a painless result. In 1844 an American -chemical lecturer named Coulton exhibited the properties of nitrous -oxide at a lecture given at Hartford, Connecticut, at which Horace -Wells, a dentist practising there, was present. Having a tooth -which he himself wished to get extracted, Wells invited Coulton to -administer nitrous oxide to him. This was successfully done, and -during Wells’ insensibility his tooth was removed by a friend, Dr. -Riggs. Wells on recovering consciousness exclaimed, “A new era in -tooth-pulling!” and at once attempted to introduce the practice at -Hartford and at Boston; but not using the gas in purity, and not -being sufficiently skilful in its administration, his attempts often -failed, and at Boston he was hissed, and gave up his efforts in -despair. Later, when anæsthetics had become firmly established, he -again sought unsuccessfully to introduce nitrous oxide, and at last -put an end to his life. It is sad to think of this fate for a man -who, with a little more education and a little more perseverance, -might have reaped a great harvest of fame.[8] - -We cannot go into the controversy as to which American has the -greatest merit in the introduction of sulphuric ether as an -anæsthetic. Suffice it to mention that Charles Jackson, a chemist -of Boston, who had been present at Wells’ demonstration in 1840, -first experimented on himself by inhaling pure sulphuric ether, and -having produced insensibility, communicated his discovery to W. T. G. -Morton, a dentist who had been present at Wells’ demonstration, and -prevailed on him to employ it. Morton afterwards alleged that this -step was taken independently on his part. - -On September 30, 1846, Morton administered ether to Eben Frost -for tooth-drawing with complete success, and in October following -it was used in an important operation by Dr. J. C. Warren at the -Massachusetts General Hospital. The news arrived in England before -the end of 1846, and on December 19th, James Robinson, a dentist of -Gower Street, London, was the first to operate under ether in this -country for the removal of a tooth. On December 21 Robert Liston -employed it most successfully at University College Hospital in an -amputation of the thigh and in the removal of a great toe-nail, one -of the most exquisitely painful operations. Its general adoption -followed in the first few months of 1847. Dr. Simpson, as early as -January 9, 1847, after previously inhaling it himself, used it in -order to relieve pain in childbirth, and found that its anæsthetic -effects produced no stoppage or perceptible alteration in the -muscular contractions of the womb. This and other cases of his were -quickly published, and justify his claim to having introduced ether -in its application to midwifery practice. - -The inconveniences occasioned by the smell of sulphuric ether, the -considerable doses required to be given, and its tendency to irritate -the bronchial tubes, led Simpson to inquire for and to try other -analogous liquids. He was recommended, among others by Dr. Gregory, -to try chloroform, discovered by Soubeiran in 1831 and Liebig in -1832, and accurately investigated by Dumas in 1835. He concluded -after much labour, and the expenditure of some hundreds of pounds, -that chloroform, without the unpleasant smell of ether, produced -more rapid effects with a smaller dose, and he very soon began to -use it in midwifery and to introduce it to his surgical friends for -operations. It was brought before the Edinburgh Medico-Chirurgical -Society on the 10th November 1847; and so well-known and favoured did -it become that in a very short time Simpson’s Edinburgh chemists were -manufacturing 7000 doses a day. Here we might almost stop in this -record, but for two things, one the controversies Simpson had as to -the impropriety and irreligiousness of removing pain, supposed to be -one of the Creator’s ordinances which ought not to be mitigated; and -the other, the deaths that began to occur under the administration of -chloroform. As to the first, a specimen of the objectors is furnished -by a clergyman, who wrote “that chloroform was a decoy of Satan, -apparently offering itself to bless woman; but in the end it will -harden society, and rob God of the deep earnest cries which arise -in time of trouble for help.” Even the relief of pain in surgical -operations was held by many to be unwarrantable. But a powerful -counter-argument was found, in the much greater ease and certainty of -success with which surgeons could now perform their operations when -the cries and writhings of the patient were removed. The controversy -that ensued, however, would fill a volume, and Simpson in it proved -himself, as ever, a hard hitter. - -For many years scarcely anything but chloroform was used for -producing anæsthesia; but gradually numerous unexpected deaths under -its administration led many to think that it had too depressing an -effect on the action of the heart, in some cases at least, and led -to the trial of other agents, including bichloride of methylene, the -reintroduction of ether, and nitrous oxide. The two latter are very -largely used at present, and so also is a mixture composed of one -part by measure of alcohol to two of chloroform and three of ether, -also known as the A.C.E. mixture, from the first letters of the -three constituents. This is now considered by many to be safer than -chloroform. What will be the judgment of future experience we can -have no pretensions to decide. - -We cannot give in detail the subsequent events of Dr. Simpson’s life. -It became more busy and active, more benevolent, and more distinctly -religious as years went on. He refused advantageous offers to settle -in London, and instead patients came from all parts of the world -to consult him in Edinburgh. His hospitality was unbounded. His -daily breakfasts and luncheons have been graphically described by -a well-known poet. “Assembled unceremoniously in a moderate-sized -room, with little in common save the wish to meet their host, you -found a company drawn together from every latitude and longitude, -social and geographical. Of all this motley party there is probably -hardly one who is not notable, and the grades and classes of eminence -run through the whole gamut of social distinction from duchesses, -poets, and earls, down to the author of the last successful book on -cookery, the inventor of the oddest new patent, a Greek courtier, a -Russian gentleman, or a German count. At your elbow the last survivor -of some terrible shipwreck is telling his story to the wife of that -northern ambassador, who is meeting, with the softest Scandinavian -dialect, the strong maritime Danish of the clever State secretary -opposite. Behind you a knot of American physicians, just arrived, are -discussing in a loud voice, a speech in Congress, or agreeing, _sotto -voce_, on the particular professional topic upon which they have come -to consult the great authority. Turn for a moment from this sculptor, -who is waiting to ask the opinion of the many-sided professor on the -sketches which he is now showing to that portrait-painter, and to -learn which of them shall be done in marble for the nobleman whose -attention the doctor has found time to direct to the rising young -artist, and you may catch something of yonder violent discussion -between those arrivals from Australia, who have come from the land of -gold in search of what gold cannot buy.” - -But it is by no means only in connection with ether and chloroform -that Simpson introduced a new practice. Besides numberless -suggestions and novel ideas in midwifery, he brought forward (in -1859, after some years of study) a totally new method of closing -arteries after operations and in substitution for ligatures, so often -the cause of inflammation. Long before John Hunter had pointed out -that needles and pins when passed into and embedded in the living -body seldom or never produced any inflammatory action. Simpson was -struck with the idea that slender sharp-pointed needles or pins of -non-oxidisable iron, somewhat like hare-lip needles, might be used to -close together the walls or flaps of wounds, at the same time keeping -the blood-vessels closed. These pins could be withdrawn very early, -and would greatly favour healing at the earliest possible moment. The -new method, called acupressure, of course met with much opposition, -and Simpson was severely censured for meddling in a preserve strictly -limited to the surgeon. But the help of the Aberdeen surgeons, Keith -and Pirrie, was of great service in promoting the fair trial of the -practice. His attack on the prevailing hospital system in 1869 was -one of his later crusades, and he certainly accumulated a great store -of facts showing the unhealthiness of the existing conditions of -aggregation in crowded hospitals. His advocacy of a separate system -in hospital construction, and of limiting the number of patients -close together, of course drew on him further fierce opposition. -We cannot here refer to his strong exposure of the fallacies of -homœopathy, his vigorous actions in connection with the University -of Edinburgh, or the numerous antiquarian papers which his prolific -pen gave forth. Every year had crowded into it three times as much -research as a very industrious man could manage, ten times as much -controversy, and twice as much practice. Honours came thick upon him. -In 1856 he was greatly gratified by the French Academy’s award of the -Monthyon Prize of 2000 francs for “most important benefits done to -humanity.” At the beginning of 1866 he was created a baronet. In 1869 -the freedom of Edinburgh was presented to him. - -Heavy affliction came now and again to embitter his life. Several -children were taken from him in the prime of their life, including -his eldest son, who showed great promise of a brilliant medical -future, but was cut off within a fortnight after his father was -made a baronet. In later life he became an ardent church worker, -having joined the Free Church of Scotland when the Disruption -took place. 1870 found the vital machine much out of order. Heart -pain—_angina pectoris_—so often the scourge of medical men, came more -frequently with its terrible strain. But he never relaxed his work -in the intervals, until absolutely compelled. In one of his later -conversations he said, “How old am I? Fifty-nine. Well, I have done -some work. _I wish I had been busier._” One of his expressions showed -his distaste for theology. “I like the plain simple Gospel truth, -and don’t care to go into questions beyond that.” During almost his -last night he was inexpressibly comforted by having with him his -brother Alexander, who had watched over him with such tenderness -from childhood. He sat on the pillow with Sir James’s head on his -knee, and the sufferer again and again slowly uttered the words, “Oh, -Sandy, Sandy!” He died on May 6, 1870. He would have been buried -in Westminster Abbey but for his own express wish to be buried in -Warriston Cemetery, Edinburgh. His funeral was such as Edinburgh -had, it is said, never witnessed before, business being generally -suspended. His widow survived him but a few weeks, dying on the 17th -June following. His eldest surviving son, Walter Grindlay, succeeded -him in the baronetcy. - - -FOOTNOTES: - -[5] Memoir of Sir James Y. Simpson, by J. Duns. Edinburgh, 1873. - -[6] _Scotsman_, May 9, 1870. - -[7] Researches, Chemical and Philosophical, chiefly concerning -Nitrous Oxide and its Respiration. By Humphry Davy. London, 1800. - -[8] _Lancet_, 1870, History of Anæsthetic Discovery. - - - - -CHAPTER XVI. - -_SIR SPENCER WELLS AND OVARIOTOMY._ - - -Thomas Spencer Wells, whose career in the revival of the operation -of ovariotomy has attracted very widespread attention and interest, -was born in 1818, being the eldest son of Mr. William Wells of St. -Alban’s, Herts. - -Without being formally apprenticed, he enjoyed many of the advantages -of the old apprenticeship system, under an able country practitioner, -Michael Thomas Sadler, of Barnsley, Yorkshire. Subsequently he spent -a year with a parish doctor in Leeds, attending the Leeds Infirmary, -and Hey’s and Teale’s lectures. The session 1837-8 was passed in -Dublin, and there Graves and Stokes largely influenced the young -surgeon. Continuing his course of culture in varied fields, he went -to St. Thomas’s, London, and was a zealous pupil of J. H. Green, -Travers, and Tyrrell. Here he obtained a prize for the best reports -of _post mortem_ examinations. Becoming a member of the College of -Surgeons in 1841, he entered the navy as assistant-surgeon, and spent -six years in the Naval Hospital at Malta. - -In 1853 Sir Spencer Wells settled in practice in London, and in 1854 -became attached to the Samaritan Hospital, then a dispensary for the -diseases of women. At this time Sir Spencer states he knew less of -this branch of the profession than of any other. In his younger days -he had attended an unusual number of midwifery cases, but latterly -his practice had been almost exclusively surgical, with a strong -tendency towards ophthalmic surgery. It was at this time that he -first became interested in the subject that has made his name so -widely known. - -From time immemorial the ovaries of women have been subject to -diseased growths and fluid accumulations, for which there was -scarcely a remedy, except when fluid could be drawn off through one -or more punctures, and fatal results were the almost inevitable -sequel of these diseases. Towards the end of the seventeenth and -beginning of the eighteenth centuries, several medical men proposed -to remove the diseased organ by an incision in the front wall -of the abdomen. William Hunter in 1762 put forward a method by -which this operation, otherwise full of danger, might be rendered -feasible; and John Hunter, lecturing in 1785, favoured the idea -of removal, considering that the opening would not necessarily -constitute a highly dangerous wound. In 1798 Chambon, in a book on -diseases of women, published at Paris, strongly argued in favour -of the operation. Although it does not appear that he ever himself -performed it, he says, “I am convinced that a time will come when -this operation will be considered practicable in more cases than I -have enumerated, and that the objections against its performance will -cease.” John Bell also has a share of credit in this matter, for in -his lectures on surgery at Edinburgh in 1794 he dwelt with much force -on the practicability of removing ovarian tumours by operation. It -was reserved, however, for a pupil of his, Ephraim M’Dowell, from -Virginia, to perform the first modern operation of ovariotomy for -disease. He settled in practice in Kentucky in 1795, and in 1809 -carried into effect this novel operation upon a middle-aged woman, -who survived to complete her seventy-eighth year in 1841. Thus an -American had the glory of first boldly starting in the new path. - -It was difficult to give the new operation a start in England. “It -must be remembered,” says Sir Spencer Wells, “that, at that time of -day, the mortality from all operations was much greater than it is -now; that the sick and diseased were more passively quiescent under -their maladies and less tolerant of any surgical suggestions, just -as we ourselves find to be the case among the unroused population -of an outlying agricultural district; that they were not buoyed -up, as modern women are, by the histories and promises of painless -extirpations under chloroform or methylene; and that, without any -mawkish sentimentalism, surgeons themselves had to encounter the -_peine forte et dure_ of their suppressed sympathy, and nerve -themselves up to the infliction of the most deliberate and tedious -eviscerative vivisection. The disease was looked upon as a mystery, -and its ending in death as a matter of course; and, instead of being -accompanied, as we now see it, by fretful resistance and chafings to -escape, it only led to stolid endurance or religious submission; and -on the part of the profession, to pity and endeavours to alleviate -the inevitable misery. But M’Dowell was a free man, in a new country, -clear from the conventional trammels of old-world practice, found -his patients in the most favourable conditions of animal life, seems -to have had one of those incomprehensible runs of luck upon which -a man’s fate and reputation so often turn if he has the sagacity -and energy to put such fortunate accidents to good account, and was -happy, as those usually are who can afford or constrain themselves -to wait, in finding suitable time, place, persons, and opportunity -for working into fact the notions of his tutor, Bell. He lost only -the last of his first five cases of ovariotomy, and thus, as it -were, established at the outset what until recently was complacently -regarded as a satisfactory standard of mortality for so serious an -operation.”[9] - -As a surgeon M’Dowell was “cautious, calm, and firm, paying great -attention to the details of his operations and treatment, and -selecting and drilling his assistants with great care.” In 1879 a -granite obelisk was raised to his memory in the cemetery where he -was buried, near his home, in commemoration of his courageous and -important work. - -Long after M’Dowell’s operations became known, a case was discovered -as far back as August 1701, in which Robert Houstoun, a Glasgow -surgeon, operated on a woman for a large tumour in a fashion somewhat -anticipatory of modern ovariotomy. She recovered, and lived sixteen -years afterwards. So often are anticipations of great improvements -to be found, that it appears that the merit, like the difficulty of -actually making a thing practicable and practised, is as great as, or -greater than, that of discovery. - -Several American surgeons followed M’Dowell, but the operation did -not come rapidly into vogue, partly because anæsthetics had not yet -been introduced. Lizars of Edinburgh had one successful and one -unsuccessful case in 1825. Dr. Granville attempted it in London in -1827, but the operation was abandoned on account of the difficulties -met with: fortunately the patient recovered. In 1836 Dr. Jeaffreson -of Framlingham first operated successfully by means of the short -incision recommended by William Hunter; the patient recovered and -bore a family afterwards. In the same year several other provincial -surgeons were equally successful. In 1840 Mr. Benjamin Phillips -operated unsuccessfully at the Marylebone Infirmary. In 1842 Dr. -Charles Clay of Manchester commenced a long series of operations, -operating four times in the year, three times successfully. The -first successful case in London was by Mr. Walne in November 1842. -From this time operations were not infrequent. In September 1846 Mr. -Cæsar Hawkins proved for the first time that success was possible -in a London hospital; his precautions and his directions were most -excellent. In June 1848 Dr. Charles Clay published a series of 32 -cases with only 10 deaths, and he continued to operate for many years -until he had performed 395 operations with only 101 deaths, slightly -above 25 per cent. He used long ligatures. In 1850 Mr. Duffin, in -London, employed an important improvement in procedure. - -Sir Spencer Wells’s medical education and study in all these years -had not led to his paying any attention to the subject. It was -evidently outside the prevailing ideas of most of the medical -schools. His opinion in 1848 was certainly against the justifiability -of the operation. In 1853 or 1854 he became acquainted with Mr. Baker -Brown, and in the latter year assisted him at the Middlesex Hospital -in his eighth case of ovariotomy. This was the first time he had seen -the operation attempted, but the patient died. Several unsuccessful -cases led Brown to give up his attempts entirely from March 1856 to -October 1858. - -When the Crimean War broke out, Sir Spencer Wells betook himself -to the army in the East. There he learnt much of the freedom with -which the abdomen might be injured and yet recovery take place if -the constitution was good and other things were favourable. He saw -frightful cases of laceration by fragments of shell recover after -careful cleansing and accurate closure of the wounds. He returned to -London much less afraid than before of abdominal wounds. Renewing -his work at the Samaritan Hospital, he at first saw very little of -ovarian disease, and it was not till December 1857 that he made his -first attempt to perform ovariotomy, which, however, on Baker Brown’s -advice, he did not carry to completion. His second attempt was -completed, with Brown’s assistance; but the latter did not recommence -to operate himself until after an interval of more than two years and -a half. - -Sir Spencer Wells has given a graphic account of his early -experiences.[10] “It would be difficult to imagine,” he says, “a -position more disheartening than that in which I was placed when -making my first trials of ovariotomy. The first attempt, as I have -said, was a complete failure, and strengthened not only in the minds -of others, but in my own mind, the fear that I might be entering -upon a path which would lead rather to an unenviable notoriety than -to a sound professional reputation. And if I had not seen increasing -numbers of poor women hopelessly suffering, almost longing for death, -anxious for relief at any risk, I should probably have acquiesced in -the general conviction—have been content with palliative tapping, -or making some further trials of incision and drainage, or of -iodine-injection, or of pressure, rather than have hazarded anything -more in the way of ovariotomy. It may be forgotten now, but it is -true, that at that time everything was against the venture. The -medical press had denounced the operation, both in principle and -practice, in the strongest terms. At the medical societies the -speakers of the highest authority had condemned it most emphatically. -The example of the men who had practised it was not followed; some of -them had given it up. Only once had a successful result been obtained -in any of our large metropolitan hospitals, that by Cæsar Hawkins, at -St. George’s Hospital, in 1846, and he never undertook it a second -time. Every other attempt—at Guy’s Hospital by Morgan, Key, and -Bransby Cooper, at St. Thomas’s by Solly—had ended in death.” In 1858 -three cases were undertaken, and all with success, which did much to -confirm Mr. Wells in his new practice. The fourth he lost, and to -explain the cause he made some experiments upon animals, which led to -important improvements in methods, yet during 1859 five out of eleven -operations had fatal results. - -The translation in 1860, by Mr. John Clay of Birmingham, of Kiwisch’s -“Diseases of the Ovaries,” with its valuable tables showing the -results of all recorded cases, was of great importance to the -progress of ovariotomy. Since then vast improvements have been -introduced, the mistakes of earlier operators corrected, bichloride -of methylene has been used with gratifying results instead of -chloroform, precautions have been taken to prevent the access of -any taint of infectious disease, every medical man present at the -operation has been put under strict inquiry as to his not having -recently been in a dissecting or _post mortem_ room, and the utmost -possible purification of house, room, bedding, clothing, and -instruments has been practised. Indeed some precautions have been so -stringently insisted on as to give considerable offence at times. The -old vegetable material for ligatures and sutures, coarse whipcord -or twine, has been given up, and after many trials of metallic -wires pure silk has been settled upon as the most trustworthy. -In fact it is entirely absorbed without needing to be pulled out -again. The multitude of intricate details involved precludes our -giving an account of the stages by which the present perfection has -been reached. In 1864 Mr. Wells, in pursuance of a pledge he had -given to record and publish his entire experience, favourable and -unfavourable, published a full account of his first 114 cases. Since -then two extended records, one in 1872 giving an account of 500 -cases, and a second in 1882 with 1071 cases, have been published. The -most remarkable thing in the history is the gradual diminution in -mortality. In the first hundred cases the deaths were thirty-four; -in the last they diminished to eleven; in the seventy-one cases -following the first thousand only four died, while sixty-seven -recovered. This is notwithstanding the fact that Sir Spencer Wells -is often called upon to treat patients rejected by other surgeons as -unfavourable cases. A recent record by Thomas Keith, an Aberdeen -surgeon, in which a mortality of only three and a half per cent. -has occurred, even outdoes this astonishing result. It is needless -to relate how the operation has been adopted by most Continental -surgeons of mark, and with excellent results. - -We may note that already in 1864 Mr. Wells had treated of hospital -atmosphere, organic germs as causes of excessive mortality, and -commented on the researches of Polli with sulphur and the sulphites, -before as yet the antiseptic treatment had come prominently forward. -When Mr. Lister’s system became established, Mr. Wells gladly adopted -all its essentials in his operations—the spray, carbolised sponges, -instruments, &c. He is convinced that by these precautions those -patients who have recovered have suffered much less from fever, while -convalescence has been more rapid than it used to be. In fact, the -general result of the ovariotomy of the past twenty-five years is -“thousands of perishing women have been rescued from death; many more -thousands of years of human life, health, enjoyment, and usefulness -have been given to the race, and to all future victims of a malady -before inevitable in its fatality, consolation, hope, and almost -certainty of cure.” - -The good influence of this success has, Sir James Paget says, -extended to every department of operative surgery, and will always -continue to be felt. It has led to an extension of the whole domain -of peritoneal surgery, leading surgeons to attempt and persevere -until successful in many operations formerly considered quite out of -reach. - -Sir Spencer Wells is by no means content with promoting the progress -of operative surgery; he looks forward to prevention with the -greatest hope, and advocates measures calculated to promote accurate -research in pathology. He is a strong supporter of any possible -action by the College of Surgeons in this direction. He says: “While -we modern surgeons congratulate our science on its liberation from -the trammels of tradition; upon its working in an atmosphere cleared -of the mist of superstition; upon the changing of its mode of action -from a blind grappling with the phantom entities of a disease to a -study and manipulation of overnourished or degenerating tissues; upon -its having laws which can be understood and rules of practice which -can be followed, we ought not to overlook one fact, which perhaps -is more evident to outsiders than to ourselves, standing as we do -in the dust and turmoil of the arena of our work. I mean that that -work, good and useful as it is, has too much the character of what is -technically called ‘salvaging’—is too much in correlation with what -is done by the lifeboat service.” - -Mr. Wells had long been a member of the Council of the College of -Surgeons when in 1882-3 he became its President. In 1882 he was -created a baronet. He has by no means limited himself to questions -of operative surgery. His public efforts have been frequently -directed towards important subjects of state and municipal polity, -sanitary matters, the abatement of the smoke nuisance, the securing -of the health of passengers on board ship, the hygienic condition of -hospitals, and perhaps most important of all, the mode of disposal of -the dead. His views on the evils of the present system are well set -forth in a letter he addressed to the _Times_ on March 3, 1885, from -which we make the following extract:— - -“In this metropolitan district in the twenty-five years 1859-1883, -the deaths registered number 1,896,314. Of course, the dead have -been buried, and with scarcely an exception, in and around London. -Grant that in ten years a body may become harmless—although I do not -at all believe that it does so within twenty years in our soil and -climate—can any imagination conceive the enormous mass of decaying -animal matter by which we are surrounded? Could any one be surprised -at the outbreak of some devastating pestilence a hundredfold more -destructive than the plague or black death of the Middle Ages? And -ought not every sanitary reformer to aid the revival of the ancient -practice which would convert the existing cemeteries, so rapidly -becoming sources of danger to the public health, into permanently -beautiful gardens, receptacles for vases and cinerary urns, which -would encourage sculpture, mural decoration, and coloured glass-work; -while in our country churches the ashes of the people might again -repose in death near the scene of their work in life perfectly -harmless, instead of polluting the earth of the church-yard and the -water drunk by the surviving people, or being carried far from their -homes and places of worship to some distant cemetery, which before -long must become overcrowded and pestilential. Public sentiment may -for a time revolt at an innovation, but a very little reflection will -bring most people to agree with part of the Bishop of Manchester’s -address on consecrating a new cemetery. He said:— - -“‘Here is another hundred acres of land withdrawn from the -food-producing area of the country for ever.... In the same sense in -which the “Sabbath was made for man, and not man for the Sabbath,” I -hold that the earth was made, not for the dead, but for the living. -No intelligent faith can suppose that any Christian doctrine is -affected by the manner in which, or the time in which, this mortal -body of ours crumbles into dust.’” - -Sir Spencer Wells in his frequent communications on the subject lays -much stress on the fact that such undoubted proofs of natural death -are required by the Cremation Society before cremating a body that no -murderer or poisoner would think of getting the forms filled up. At -the Milan Crematorium a death from poison was actually discovered in -this way, when natural death only was believed to have taken place. - - -FOOTNOTES: - -[9] Ovarian and Uterine Tumours: 1882. - -[10] Address to Midland Medical Society, Birmingham, November 5, -1884. - - - - -CHAPTER XVII. - -_SIR WILLIAM JENNER, BUDD, MURCHISON, AND TYPHOID FEVER._ - - -In no department of medical knowledge has recent progress been more -marked than in the discrimination and the tracing of the natural -history of the diseases known as zymotic: and no man takes higher -rank in this department of investigation than Sir WILLIAM JENNER. -He was born at Chatham, January 30, 1815, being the son of Mr. John -Jenner, and educated at University College, London. After qualifying -as a general practitioner, he commenced practice and obtained the -appointment of Surgeon-Accoucheur to the Royal Maternity Charity. -Before long he graduated M.D. at London University (1844), and -retired from general practice. His studies in pathology became more -and more extensive, and his merits were so far recognised that in -1849 he was elected Professor of Pathological Anatomy to University -College, and Assistant-Physician to University College Hospital. - -For some years Dr. Jenner had been assiduously studying in the London -Fever Hospital, seeking to make a straight path through the many -knotty questions then, in debate. In April 1849 he commenced the -publication, in the _Monthly Journal of Medical Science_, of his -classic paper on “Typhoid and Typhus Fevers, an attempt to determine -the question of their identity or non-identity, by an analysis of -the symptoms, and of the appearances found after death in sixty-six -fatal cases of continued fever, observed at the London Fever Hospital -from January 1847 to February 1849.” In this he states that “with -few exceptions, British physicians have laboured to prove that -typhoid and typhus fevers are identical. The results obtained by this -analysis justify the assertion that they are essentially distinct -diseases.... For two years, in distinguishing the two diseases by -the eruption alone not a single error has been made, so far as could -be proved by examination after death of the fatal cases, or by the -progress of the non-fatal cases after their diagnosis was recorded.” - -The history of previous investigations and the fluctuations of -opinion are excellently given by Dr. Murchison in his great work on -the “Continued Fevers of Great Britain,” 1862, 2d ed. 1873. Dr. H. C. -Lombard of Geneva appears to have been the first to state positively -(in 1836) that “there were two distinct and separate fevers in Great -Britain; one of them identical with the contagious typhus, the other -a sporadic disease, identical with the typhoid fever of the French.” -He failed, however, to point out the distinctive eruptions and other -characteristics of the two fevers. At the same period Drs. Gerhard -and Pennock in Philadelphia arrived at more definite conclusions, and -distinguished the typhus of Philadelphia as being the same as British -typhus, the old gaol, camp, and ship fever, so direfully contagious -and fatal; while certain intestinal phenomena were invariably -found in the other or typhoid fever, which was rarely contagious. -The characteristic eruptions and many of the symptoms were also -accurately discriminated. These observers were followed by others who -with more or less success and emphasis insisted on the same views. -Among these were Drs. H. C. Barlow and A. P. Stewart, both of whom -read important papers on the subject before the Parisian Medical -Society in 1840. In 1841 the celebrated Louis in the second edition -of his great work on typhoid fever accepted the view that the English -typhus was very distinct from the fever which he had so largely -elucidated. Nevertheless many physicians of authority strongly -maintained their identity, and the majority of the medical schools -taught this doctrine, which could not fail to retard progress. It is -obvious how much uncertain and injurious treatment must have existed -for a long period owing to the confusion of these two diseases. - -In his series of papers published in 1849 and 1850 Dr. Jenner -confirmed and extended the distinctions between the symptoms of the -two fevers, comparing the selected cases most minutely as regarded -previous health, complexion, sex, age, mode of attack, duration, -eruption, expression during disease, manner, hue of face, presence -of headache, delirium, loss of muscular power, sensation, appearance -of the tongue, suffering of pain, appetite, thirst, pulse, cough, -and lung symptoms, and many other particulars, and detailed most -carefully the _post mortem_ appearances of the diseased action in -every organ. - -As regards the age of patients, he showed by calculation that typhoid -usually attacked much younger patients than typhus, the average -age of his cases of the one being 22 years, of the other 42 years. -In typhus, death took place on the average on the fourteenth day, -while in typhoid the average was the thirty-second day of residence -in the hospital. The rose rash of typhoid, disappearing completely -on pressure, resuming the original appearance on the withdrawal of -pressure, was clearly discriminated from the mulberry rash of typhus. -His _post mortem_ observations may be considered to have given the -death-blow to the idea that typhoid was merely typhus fever with -abdominal complications. In closing the series of papers (April -1850) Dr. Jenner remarked, as to the suggestion that he had drawn -general conclusions from a too limited number of facts, “A few facts, -impartially observed, minutely recorded, and carefully analysed, -are, I believe, more likely to give correct results than a multitude -of general observations; and moreover, I believe most men would be -astonished if they had in numbers all the cases of any given disease -they had ever seen, yet concerning which they have generalised. The -method I have adopted—however prolix it may be, however difficult -to conform to, however tedious the details into which it leads—has -this advantage, that if the observer be honest, and capable of noting -what is before him, thinking men may judge of the value of his facts, -the force of his reasoning, and the correctness of his conclusion; -whereas general observations, while they are totally incapable of -proving anything, are exposed to all the fallacies of definite -statements, because the one, like the other, rests ultimately on the -accuracy of the facts observed. If the observations on which any -reasoning is founded be erroneous, no cloaking of those observations -in general terms can render the conclusions correct. It has been -objected to definite numerical statements that they mislead the -reader by an _appearance_ of accuracy in cases where there has been -great inaccuracy in observation. This objection appears to me to -lie against the condition of the reader’s mind, and not against the -method.... The more complicated the problem to be solved, the more -careful ought we to be that _every_ step in its solution is made -correctly. How complex questions, such as arise in medicine, are to -be determined mentally—_i.e._, without the aid of figures—by ordinary -men, I am at a loss to conceive. Yet physicians think to solve, by -mental reveries, problems in comparison with which the most difficult -that the most renowned calculators ever answered were child’s play; -and not only do they think to solve these problems, but to carry in -their minds for years the complicated materials by which they are to -be solved.” - -Another important branch of Dr. Jenner’s inquiry dealt with the -question as to whether the specific cause of these diseases is -distinct or the same, the latter being then the preponderant -opinion. In a paper on this subject communicated to the Royal -Medical and Chirurgical Society, on December 11, 1849, he showed -that in 1847-8-9, on analysing all the cases in which two or more -fever patients came from the same house, scarcely a single instance -occurred where typhus and typhoid came at the same period from the -same house. In nearly all cases the two diseases came from quite -distinct localities. No transitional cases occurred between the two; -the rash of typhoid did not graduate into that of typhus. It was -several times observed that when a succession of cases came from the -same locality, or arose apparently from the same cause, they agreed -remarkably in symptoms or other features. Thus Dr. Jenner considered -he had definitely proved that typhus and typhoid proceeded from -perfectly distinct causes, a result which recent medical science -accepts without reserve. - -Although the contributions of this distinguished physician have been -of such high worth, and his subsequent success so great in practice, -he is far from being wedded to the view that any great step forward -in medicine has been the direct result of the labours of a single -man. Long after his early papers, in addressing the British Medical -Association in 1869, Sir William Jenner said: “The silent workers -render most efficient aid, the results of their unspoken experience -confirming or refuting the published assertions of the few.” He -believes that no science has advanced more during the present epoch -than medicine, and that it has progressed equally as a practical art. - -Dr. Jenner’s appointments include, among a crowd of others, those -of Physician to University College Hospital (1854), Professor -of Clinical Medicine (1857) and of the Principles and Practice -of Medicine (1862), Physician to the Hospital for Sick Children -(1852), Assistant-Physician to the Fever Hospital (1853). In 1864 -he was elected Fellow of the Royal Society, and became President -of the College of Physicians in 1881. In 1861 he was appointed -Physician-Extraordinary to the Queen, and attended the Prince-Consort -in his last illness. In 1862 he became Physician-in-Ordinary to the -Queen, and has frequently attended her Majesty. He was made a baronet -in 1868, and further advanced to the dignity of a K.C.B. in 1872 for -his services during the Prince of Wales’s illness from typhoid fever. - -Sir William Jenner has published eminently valuable clinical -systematic lectures in the medical journals, and a small treatise on -Diphtheria (1861). His addresses to the British Medical Association -(1869), and to the Epidemiological Society (1866), published -together, are most excellent as summaries of the modern progress of -medicine, and as pointing out the directions in which future advances -may be made. He insists most strongly on and desires most ardently -the prevention of disease, and shows a striking readiness to welcome -new discoveries. - - * * * * * - -Few more striking individualities have been seen among the provincial -physicians of our day than that of WILLIAM BUDD, of Clifton. He -was one of the younger sons of Mr. Samuel Budd, a successful -medical practitioner at North Tawton in Devonshire, who having -very considerable culture and foresightedness, brought up most of -his large family at home, and was ultimately enabled to introduce -seven out of nine sons to the medical profession, sending seven to -Cambridge, where five became wranglers. One of the elder brothers, -George Budd, was long Professor of Medicine at King’s College, -London, the author of an excellent treatise on Diseases of the -Liver, and a most successful London physician. William Budd was -born in September 1811; his medical studies were pursued in London, -Edinburgh, and Paris, in the latter of which cities he spent four -years. Graduating M.D. in 1838 at Edinburgh, he for some time -afterwards assisted his father in his practice at North Tawton, and -here in 1839 commenced his lifelong studies on typhoid fever, having -himself been already a sufferer by that malady. He had peculiar -advantages in this study, for he was personally acquainted with -every inhabitant of the village, and being as medical practitioner in -almost exclusive possession of the field, nearly every one who fell -ill, not only in the village itself, but over a large area around -it, came immediately under his care. At the date of the outbreak -the population of eleven or twelve hundred had been extremely -exempt from fevers. Yet there was no sewerage system; cesspools -prevailed; pig styes were close to the houses; and all conditions -of decomposition were to be found;—but fever did not arise till it -had been specifically introduced. In July 1839 the first case of -typhoid occurred, and before the beginning of November over eighty -of the inhabitants had suffered from it. Young Budd kept an accurate -and detailed record of every essential fact, and spared no pains in -tracing out all extraneous facts that he required to know. He was -extremely struck by the fact that three persons left North Tawton -after they had been infected, and all three communicated the disease -to one or more of the persons by whom they were surrounded. The -narrative which Dr. Budd gave many years afterwards, in his “Typhoid -Fever: its Nature, Mode of Spreading, and Prevention” (1873), is like -a romance for its interesting detail, though melancholy with its -tale of pain and death. He shows that there is evidently a specific -poison which breeds and multiplies in the living human body, and -that this process of breeding and multiplying constitutes the fever -itself. This essentially is its contagiousness, the communication -from body to body of the specific matter or germ, which when bred -and multiplied produces the fever. This he called the master-fact -in its history. He further believed that all the emanations from -the typhoid patient are in a certain degree infectious, but that -what is cast off from the intestine is incomparably more virulent -than anything else. Wherever no sufficient provision was made for -preventing such material from contaminating the soil and air of the -inhabited area around, notwithstanding the most spacious rooms, the -freest ventilation, and careful nursing, he found there was no real -security against the spread of the fever. The fact alleged against -Dr. Budd’s views, that typhoid is seldom taken by attendants on the -sick, does not at all militate against his teaching, for unless they -received into their system through milk, water, food, or air, some of -the specific poison of typhoid, they would certainly not suffer. - -In 1842 Dr. Budd settled in Clifton, and was in 1847 elected -Physician to the Bristol Royal Infirmary. He lectured for a number -of years in the Bristol Medical School, and worked incessantly -at maturing and propagating his views on the nature and mode of -propagation of zymotic disease. He was no mere theorist, but in all -his pursuits had most practical objects in view, seeking to enforce -on his medical brethren, public authorities as well as private -persons, the urgent necessity of the most careful, well-advised, -and continuous methods of disinfection. He was in effect a great -sanitarian and champion of preventive medicine. Pure water was one of -his great panaceas. The Bristol Waterworks were among his cherished -objects of promotion and watchfulness. His remarkable clearness of -vision and strength of conviction made him somewhat impatient of -the strenuous opposition with which his views were met. For a long -period he was almost alone in his uphill fight. He did not fully put -his views before the profession till 1857-60, when he published a -series of papers in the _Lancet_, afterwards embodied in his work -on typhoid fever; but he had long before taught them in the Bristol -Medical School, and practically acted upon them himself. During the -depressing period of opposition which he encountered, almost the only -sympathy he could count on was that of the late Sir Thomas Watson, -who encouraged him greatly, believing his investigations to be of -priceless value. Cheered in this way, Budd continued to promulgate -his views, dogmatically it is true, but in a manner singularly -attractive, for he had a natural kindliness of disposition and -freedom from all jealousy. His impressive eloquence was not more -striking than his logical power, which is evident in all his works. - -Asiatic cholera, when it broke out in Bristol in 1866, found William -Budd and Bristol prepared. The deaths from this destroyer in 1849 -had been 1979, in 1866 they were but 29, notwithstanding that the -disease broke out very severely, and occurred in twenty-six different -localities. Budd’s preventive measures, and his stringent plans of -disinfection, proved victorious. He made the contagious diseases -of animals subjects of special study; and his conclusion was that -several of them could only be adequately dealt with by immediately -slaughtering the infected animals. This view he took in regard to the -terrible rinderpest of 1866: and his advice of “a poleaxe and a pit -of quicklime,” though at first ridiculed, had to be followed, after -great loss had taken place through not following it earlier. - -Dr. Budd was elected a Fellow of the Royal Society in 1870. Besides -his famous work on typhoid fever, and many scattered contributions -to medical journals and societies, Dr. Budd was the author of the -following works, many of which are of very great value:—“Malignant -Cholera: its Mode of Propagation and its Prevention” (1849); -“Scarlet Fever and its Prevention” (1869); “The Siberian Cattle -Plague, or the Typhoid Fever of the Ox” (1865); “On Diseases which -affect Corresponding Parts of the Body in a Symmetrical Manner” -(1842); “Researches on Gout” (1855); “Cholera and Disinfection, or -Asiatic Cholera in Bristol in 1866” (1871); “Variola Ovina—Sheep’s -Smallpox—or the Laws of Contagious Epidemics Illustrated by an -Experimental Type” (1863). He was an accomplished draughtsman and -an excellent photographer, and made great use of these arts in his -researches. He was well skilled in French, German, and Italian, -and kept himself well up in Continental as well as English medical -literature. He worked with untiring energy and industry, having -a large practice extending far beyond Bristol: but the attempt to -combine this with so much original research proved too much for his -constitution. He had been originally strong, but was weakened by two -attacks of fever, and finally in 1873 his health broke down, and this -led to his finally retiring from practice and settling at Clevedon, -where he died January 9, 1880. Just previously to his retirement he -had committed to his friend Dr. Paget of Cambridge a brief summary -of the results of many years’ study of pulmonary consumption, as to -its communicability from person to person by organic germs. This was -published in the _Lancet_ at the time, but unfortunately the fuller -researches therein referred to have never been given to the public. -But in connection with typhoid and other zymotic fevers he has left -on the subject the indelible impression of his great genius. - - * * * * * - -The exertions of CHARLES MURCHISON, who died before Budd, though -much younger, were largely devoted to controverting Budd’s views -on the germ theory of zymotic diseases. He belonged to the same -Aberdeenshire family from which Sir Roderick Murchison the geologist -sprang, and was born in Jamaica in 1830. His father, himself a -physician, spent his latter days in Elgin, where his son Charles was -at first educated. As early as 1845 he entered Aberdeen University, -but in 1847-8 he commenced medical study at Edinburgh, and in -successive years gained numerous distinctions and considerable -note as a diligent and successful student. In 1850 he was Syme’s -house-surgeon. In August 1857, when he graduated, he received the -gold medal for his thesis on the Pathology of Morbid Growths. He -further studied at the Rotunda, Dublin, and in Paris, whence he went -to India, being appointed Professor of Chemistry to the Medical -College, Calcutta. In this office he was both successful as an -experimenter and as an expositor. Later, he went with the army on -the British Expedition against Burmah, and utilised the opportunity -to make valuable observations on the climate and diseases of Burmah, -which he afterwards published. - -Returning to England in 1855, Murchison became a member of the -London College of Physicians, Physician to the Westminster General -Dispensary, and Demonstrator of Anatomy at St. Mary’s Hospital. -In 1856 he was appointed Assistant-Physician to King’s College -Hospital, which office he resigned in 1860, and joined the staff -of the Middlesex Hospital. He further held from 1856 the post of -Assistant-Physician to the London Fever Hospital, steadily pursuing -there as elsewhere his investigations into the nature and causes of -zymotic diseases, from which he himself twice suffered in the form of -typhus fever, which left in him heart-mischief that ultimately caused -his death. - -In 1862 appeared Murchison’s work on “The Continued Fevers of Great -Britain,” dealing especially with typhus, typhoid, and relapsing -fevers. In this he treats exhaustively the history, geographical -range, causation, symptoms, treatment, and many other questions -connected with fevers, and endeavours especially to reduce his -observations to a numerical expression. His strong conviction -was that these diseases are preventable, and that they originate -in certain unhealthy and impure conditions capable of generating -specific poisons in each case. But as he commenced his work at the -London Fever Hospital believing that typhus and typhoid fever were -mere varieties of one disease, in spite of Stewart’s and Jenner’s -publications, so he maintained to the last that Budd’s view as to the -germ origin of typhoid fever was erroneous, and that even if typhoid -were communicable by germs, it could arise anew when favouring -conditions of decomposition occurred. He regarded it as proved that -typhoid fever is constantly appearing where decomposing sewage is -present, but where every effort fails to detect contamination from a -previous typhoid patient. - -Murchison’s work was at once recognised as a standard one. The first -edition was rapidly sold, and it was translated into German. The -publication of a second edition was, however, delayed till 1873, -owing to Murchison’s strong desire to make his book as complete -statistically as possible. The first edition was based on 6703 -cases of continued fever admitted into the London Fever Hospital -in the years 1848-57, but the second included the results of a far -larger number, 28,863, admitted during 1848-70, thus giving the -entire medical history of the fever hospital from the time that the -different continued fevers were first distinguished in 1848. Energy -and resolution of the most intense description are indicated by -such a labour. This work had to be done in the intervals of growing -practice and hospital teaching. By the time he was forty years old -Murchison was one of the leading London physicians, and continued in -full work till his death. - -It was not only in regard to fevers that Murchison held a conspicuous -place and published works of great value. In 1868 he published an -excellent series of “Clinical Lectures on Diseases of the Liver,” -which reached a second edition in 1877, when he added to them -the Croonian Lectures on “Functional Derangements of the Liver,” -delivered at the College of Physicians in 1874. In 1871, when St. -Thomas’s new hospital was opened, Murchison was invited to join -its staff as full physician and joint-lecturer on medicine. In -this growing school he found full scope for his great talent as -a clinical teacher. Of his success in this capacity the _Lancet_ -said[11]—“His teaching was a reflex of his singular lucidity of -thought and expression, which not only attracted the student with its -distinctness and brilliancy, but furnished him with a method on which -to found his own facts and observations.” His inaugural address as -President of the Pathological Society in 1877 gave further proof of -his marked originality of thought. - -Murchison’s accomplishments and personal attractiveness were as -remarkable as his professional talents and industry. In botany, -zoology, chemistry, and geology he had very wide knowledge, and he -edited the palæontological memoirs of his friend Hugh Falconer, the -explorer of the Miocene fauna of the Siwalik Hills. Fly-fishing -was his favourite recreation. “In personal appearance,” says the -_Lancet_, “Dr. Murchison was slightly below middle stature, and -before the commencement of his fatal illness, of sturdy robust -build, with the appearance of one well fitted to bear the trials -and struggles of life. His head was large, the forehead high and -full, the hair black, and eyes of surprising brilliancy and power of -expression. In manner he was reserved, sparing of speech, and free -from that impulsiveness which hails the ordinary acquaintances of -life as esteemed friends. To those who knew him intimately, however, -his full character was revealed, and they found in him a depth -of love, tenderness, and sympathy, together with a constancy and -devotion in friendship, rarely found in more demonstrative natures.” -He attached himself particularly to the younger members of his -profession, and never spared time or trouble in assisting them with -his counsel and sympathy. He suffered severely from heart disease -for several years before his death, which took place suddenly in the -interval between the departure of one patient and the announcement of -another, on the 23d April 1879. - - -FOOTNOTES: - -[11] Obituary notice, May 3, 1879, p. 645. - - - - -CHAPTER XVIII. - -_SIR JOSEPH LISTER AND ANTISEPTIC SURGERY._ - - -Again and again in these pages the hereditary succession of -scientific powers has been illustrated. Not the least eminent example -is to be found in the case of Sir Joseph Lister, who is the son of -Mr. Joseph Jackson Lister, F.R.S., of Upton House, Essex, who in the -words of the Rev. J. B. Reade, F.R.S., in his presidential address -to the Royal Microscopical Society in 1870, “raised the compound -microscope from its primitive and almost useless condition to that -of being the most important instrument ever yet bestowed by art upon -the investigator of nature.” Mr. J. J. Lister was born in London -on January 11, 1786, his parents being members of the Society of -Friends. At fourteen years of age he left school to assist his father -in the wine trade: but though for many years closely occupied in -business, he contrived by early rising and otherwise to supplement -his plain school education, and to make himself accomplished in -mathematics, as well as generally acquainted with most subjects -in literature, science, and art. His predilection for optics was -early shown. As a little child with shortsighted eyes, he enjoyed -looking through air bubbles in the window-pane, enabling him to see -distant objects more clearly. At school he was the only boy who -possessed a telescope. He soon became addicted to microscopical -study; but it was not till 1824, when he was 38 years old, that he -thought of improving the object-glass of the compound microscope, -and made suggestions to W. Tulley, the optician, which resulted in -the production of a new object-glass much less thick and clumsy, -which speedily became the favourite. On January 21st, 1830, he read -a paper before the Royal Society “On the Improvement of Compound -Microscopes,” announcing the remarkable discovery of the existence of -two aplanatic foci in a double achromatic object-glass. This formed -a basis for subsequent important improvements. In 1837 he gave to -Andrew Ross the construction for a ⅛-inch objective of three compound -lenses, by which that maker’s fame was largely increased, and it -became the standard form for high power for many years. He also made -some notable researches “On the Structure and Functions of Tubular -Polypi and Ascidiæ” (Phil. Trans. 1834), and independently came to -the same conclusions as Sir George Airy, the late Astronomer-Royal, -on the limits of human vision as determined by the nature of light -and of the eye; but his paper on this subject was never published, -owing to the publication of Sir George Airy’s researches. He survived -in vigorous health to see his son Joseph in secure possession of -fame, dying on October 24, 1869. His son records[12] that “he was -most unselfish, and scrupulously tender of hurting the feelings of -others, and extremely generous in the pecuniary support of public -philanthropic objects, as well as in secret acts of charity. Though -warmly attached to the religious Society of Friends, to which he -belonged, he was a man of very liberal views and catholic sympathies. -But the crowning grace of this beautiful character, though it might -veil his rich gifts from those not intimate with him, was a most rare -modesty and Christian humility.” - -JOSEPH LISTER was born in 1828, and took the B.A. degree at -London University in 1847. Pursuing a course of medical study at -University College, London, he gained the M.B. degree in 1852, being -awarded gold medals in anatomy and in botany at the first M.B. -examination, and the scholarship and gold medal in surgery at the -final examination. He became Fellow of the Royal College of Surgeons -in 1852, and took a similar qualification at Edinburgh in 1855. He -married a daughter of Mr. Syme, then Professor of Surgery in the -University of Edinburgh. - -Devoting himself to physiological research on matters having a wide -bearing on practical medicine and surgery, Mr. Lister attained wide -repute as an original investigator at a comparatively early age, and -his position in physiology was assured by a series of papers which -would suffice to make his career memorable, if he had never applied -antiseptic measures to the treatment of disease. Beginning with some -observations on the contractile tissue of the iris in 1853, he went -on to study the muscular tissue of the skin, the flow of the lacteal -fluid, and the minute structure of involuntary muscular fibre, on -all of which subjects his papers are published in the “Journal -of Microscopical Science.” In 1857 he commenced his series of -contributions to the Royal Society, the first being on the functions -of the visceral nerves, with special reference to the inhibitory -system. This was further developed in “An Inquiry regarding the -Parts of the Nervous System which regulate the Contractions of the -Arteries” (Phil. Trans. 1858). But his two most important papers at -this period are those on the Early Stages of Inflammation (1857), and -on the Coagulation of the Blood, delivered as the Croonian Lecture -for 1863. - -For some years Mr. Lister was a lecturer on surgery in the Edinburgh -Extra-Academical School. He was afterwards elected Professor of -Surgery in Glasgow University, and Surgeon to the Glasgow Royal -Infirmary. - -While Mr. Lister held these appointments, circumstances occurred -which were calculated to stimulate to the highest degree the effort -to discover some method of dressing wounds which should obviate the -dangers of putrefactive changes. About 1860 a new surgical hospital -was erected as part of this infirmary, and although many of the -most approved principles of hospital construction had been adopted, -the building proved extremely unhealthy. Pyæmia, erysipelas, and -hospital gangrene soon showed themselves, affecting on the average -most severely those parts of the building nearest to the ground. For -several years Mr. Lister found that in his male accident ward, which -was on the ground-floor, when nearly all the beds contained patients -with open sores, the diseases which result from hospital atmosphere -were sure to be present in an aggravated form; whereas, when a large -proportion of the cases had no external wound, these evils were -greatly mitigated or entirely absent. At this period the managers -were very desirous of introducing additional beds into the wards, -to supply accommodation for the rapidly increasing population of -Glasgow; and Mr. Lister strongly and firmly resisted such increase in -his wards. Some of the wards indeed at times became subject to such -severe mortality that they had to be closed for various periods. One -particular visitation was so serious that it was resolved to make an -investigation to discover if possible the cause of the evil, which -might, one would think, have been done at an earlier period. Great -was the shock of every one concerned to find that a few inches below -the surface of the ground behind the two lowest male accident wards, -with only the basement area, four feet wide, intervening, there was -the uppermost tier of a multitude of coffins, which had been placed -there at the time of the cholera epidemic of 1849. The corpses had -undergone so little change in the interval that the clothes they had -on at the time of their hurried burial were plainly distinguishable. -The wonder was, not that these wards on the ground-floor had been -unhealthy, but that they had not been absolutely pestilential. Yet -at the very time when this shocking disclosure was made, Mr. Lister -was able to state, in an address which he delivered to the British -Medical Association at Dublin in 1867, that during the previous nine -months, in which his new antiseptic plans of treatment had been in -operation in his wards, not a single case of pyæmia, erysipelas, or -hospital gangrene had occurred in them. - -The managers of the infirmary of course did all in their power -to remedy this insalubrious state of things. They poured large -quantities of carbolic acid and quicklime upon the ground, -considering this a less dangerous proceeding than to attempt the -removal of the putrefying mass; they covered the ground with an -additional thickness of earth, and adopted other measures. The -hospital itself was far from being well situated in other respects. -It abutted against the old Cathedral Churchyard, much used for the -“pit burial” of paupers in a most deleterious state of aggregation. -Yet during the two years and a quarter intervening between the Dublin -address and Mr. Lister’s leaving Glasgow for Edinburgh, his new -antiseptic system continued in the main as successful as before. - -In the course of the year 1864 Professor Lister had been much struck -with an account of the remarkable effects produced by carbolic -acid upon the sewage of the town of Carlisle, the admixture of a -very small proportion not only preventing all odour from the lands -irrigated with the refuse material, but also destroying the entozoa -which usually infest cattle fed upon such pastures. His attention -having been for several years greatly directed, as we have seen -above, to the subject of suppuration, especially in its relation to -decomposition, he saw that such a powerful antiseptic was peculiarly -adapted for experiments with a view to elucidating that subject, and -thus the applicability of carbolic acid to the treatment of compound -fractures occurred to him. - -The antiseptic system was put into practice in the Glasgow Infirmary -in March 1865, but at first applied almost exclusively in compound -fractures (or those in which there is an external wound) and -abscesses. From 1867 it was employed for almost all surgical cases. -It arose out of Mr. Lister’s study of Schwann and Pasteur’s germ -theory and the experiments connected with them. He repeated many of -the experiments, and devised new methods calculated to test whether -they were capable of explaining the phenomena of putrefaction. These -sufficed to prove definitely that in putrefaction the development of -such organisms as the microscope could detect, and the concomitant -putrefactive changes, were occasioned by minute germs suspended in -the atmosphere. Professor Tyndall’s beautiful experiments, by which -he demonstrated the perfect manner in which cotton wool filters the -air of its suspended particles, led to the idea (suggested by Dr. -Meredith of the Indian service to Mr. Lister) that cotton wool might -be used with advantage as an antiseptic dressing. The cotton wool -must itself be rendered pure of germs by some antiseptic agency, for -by the theory the air within it must contain germs. But the main -feature upon which Mr. Lister for a long time relied was the copious -use of carbolic acid in such a form as to prevent the occurrence of -putrefaction in the part concerned. - -Mr. Lister’s first paper on the subject, published in the _Lancet_ -for 1867, struck a chord which the editor of that journal emphasised -as follows on August 24 of that year (p. 234): “If Professor Lister’s -conclusions with regard to the power of carbolic acid in compound -fractures should be confirmed by further experiment and observation, -it will be difficult to overrate the importance of what we may -really call his discovery. For although he bases his surgical use -of carbolic acid upon the researches of M. Pasteur, the application -of these researches to the case of compound fractures, opened -abscesses, and other recent wounds, is all his own.” The risk of -blood-poisoning after operations in themselves slight, was declared -to be the one great opprobrium of surgery. There was no limit to -the operative skill of surgeons, but a miserable and serious risk of -fatal after-consequences against which the surgeon had no defence. -Mr. (now Sir James) Paget had in 1862 given forth an idea of which -we can now more clearly see the bearing, when he said that the best -results he had seen in cases of pyæmia were with patients kept night -and day in a current of wind. We now see that this in fact amounted -to continually passing over the patient air less charged with germs -than that of the room or ward in which he was placed. Mr. Lister -contemplated the destruction of these germs at the seat of the wound, -and the prevention of the access of fresh germs. - -An example will perhaps illustrate the matter better than a -theoretical account. An experiment was performed on the 31st December -1868 on a young calf a few days old, under chloroform, namely, the -tying of the carotid artery on the antiseptic system, with threads -composed of animal tissue. The threads employed had all been soaked -for four hours in a saturated watery solution of carbolic acid, which -swelled and softened them. The hair near the wound was cut short, -and a solution of carbolic acid in linseed oil rubbed well into the -skin to destroy any putrefactive organisms lying amongst the roots -of the hair. The sponges employed in the operation were wrung out of -a watery solution of the acid, and all the instruments introduced -into the wound, together with the fingers of the operator’s left -hand and the copper wire used for sutures, were treated with the -same lotion, some of which was poured into the wound after the -introduction of the last stitch, at one of the intervals left for -the escape of discharge, to provide against the chance of any fresh -blood which might have oozed out during the process of stitching -having passed back and taken fresh germs in with it. The external -dressing was a towel saturated with the oily solution of carbolic -acid, folded as broad as the length of the neck, wrapped so as to -extend freely beyond the wound, and prevented by several contrivances -from slipping. A sheet of gutta-percha tissue was applied outside to -prevent contamination of the antiseptic towel from without. A few -ounces of the oily solution were poured daily over the towel for the -first week, after which the dressings were left untouched for three -days and then entirely removed. The wound was found quite dry, and -free from tenderness. When the animal was subsequently killed, the -ligatures were seen to be converted into living tissue; and such -experiments proved how valuable animal fibres might be as ligatures -under the antiseptic system. - -Again, a portion of cotton wool was impregnated with about one -two-hundredth part of its weight of carbolic-acid vapour, and the -surface of a granulating sore and surrounding skin was washed with -a dilute solution of the acid. A piece of oiled silk of the size of -the sore was then applied, to prevent the dressings from sticking -through becoming dry. Over this was placed a piece of folded linen -rag of rather larger size, and similarly impregnated with carbolic -acid vapour to the cotton wool; this being intended to absorb any -discharge from the sore. Lastly, an overlapping mass of carbolised -cotton wool was securely fixed over all. The result was that although -all chemical antiseptic virtue left the dressing by evaporation of -the volatile carbolic acid in a day or two, yet putrefaction was -practically excluded by the cotton wool for any length of time. - -Subsequently another variety of protective material was adopted, -namely antiseptic gauze, a loose cotton fabric, the fibres of which -were impregnated with carbolic acid lodged in insoluble resin. The -interstices between the fibres were kept free from these ingredients, -so that the porous fabric might readily absorb discharges. By -arranging this in a sufficient number of layers and covering the -whole with a layer of mackintosh, the discharge was compelled to -pass through the whole length of the antiseptic dressing. Thus it -was almost certain that if no putrefactive mischief were left in a -wound or abscess, none would enter it, however profuse might be the -discharge. - -If a wound was presented for treatment, inflicted by some other -than the surgeon, some dust was sure to have been introduced, which -probably contained putrefactive germs. The energy of these had -first to be destroyed by washing the raw surface with some strong -antiseptic agent. But in operating upon a previously unbroken skin, -Mr. Lister considered that he could prevent the septic particles -from entering at all, by operating in an antiseptic atmosphere. This -was provided by producing a shower of spray of carbolic acid of the -finest character. This answered exceedingly well when the solution -producing the spray consisted only of one part of carbolic acid to -100 parts of water. - -Here we must limit our detailed account of the antiseptic system. -Under it large abscesses are opened, the matter pressed out, and -fresh matter does not form, and cures are effected in severe cases -which scarcely ever used to be cured. Arteries are tied with a -security before unknown. Amputations and excisions are effected with -a safety and diminished mortality quite surprising. Even senile -gangrene shows hopeful results which were previously quite out -of question. Pyæmia, hospital gangrene, and erysipelas have been -almost banished from wards where the system is properly carried -out. Recently a modification has been introduced, in which there -is employed, not a volatile material as in the case of carbolic -acid, but a dilute solution of corrosive sublimate combined with -albumen. Gauze is now prepared for Sir Joseph Lister steeped in -this substance, and it may become generally adopted; but it does -not appear likely to supersede carbolic acid for the purification -of instruments, sponges, the skin, or as a substitute for the -carbolic spray. The particular form of antiseptic is a matter of -detail, on which improvement may long continue to be made; but -the development of the essential idea of preventing the access of -germs which can cause putrefactive changes by one method or another, -and the destruction of them as far as possible when they have -obtained access, will remain connected with Sir Joseph Lister as -an achievement of the highest force; indeed his name seems likely -to give a new word to our language, namely Listerism, by which the -essential features of his system are understood. - -Professor Lister was awarded a Royal Medal by the Royal Society of -London in 1880, having previously received the high distinction of -the MacDougall Brisbane Prize from the Royal Society of Edinburgh -in 1875, for a remarkable paper on the Germ Theory of Fermentative -Changes. He was created a baronet in December 1883. The universities -of Cambridge, Edinburgh, and Glasgow had conferred upon him the -honorary degree of LL.D., and Oxford that of D.C.L. He has been for -some years Surgeon to King’s College Hospital, having succeeded Sir -William Fergusson. - - -FOOTNOTES: - -[12] _Monthly Microscopical Journal_, 1870, iii. p. 143. - - - - -CHAPTER XIX. - -_SIR THOMAS WATSON, SIR DOMINIC CORRIGAN, SIR WILLIAM GULL, AND -CLINICAL MEDICINE._ - - -The Nestor of the medical profession, Sir Thomas Watson, died in -1882, at the great age of ninety, universally beloved and honoured. -Yet he had written but one extended work, the “Lectures on the -Principles and Practice of Physic,” and had made no striking -discovery. But to have written a book which every cultivated -practitioner reads, and reads with delight and satisfaction, is an -achievement given to few, many though there be who aim at it. And Sir -Thomas Watson’s personal character was as unique as his advice was -valuable. - -THOMAS WATSON was born on March 7th, 1792, at Montrath (now Dulford) -House, near Cullompton, Devonshire, where his father, Joseph -Watson, a Northumbrian by family, was then living. He was educated -at Bury St. Edmund’s Grammar School, where he was a schoolfellow -with Blomfield, afterwards Bishop of London, and a great friend of -Watson’s. In 1811 he entered at St. John’s College, Cambridge, -and became tenth wrangler and fellow of his college. At that time -only two fellows of St. John’s could retain their fellowships -without taking orders, and one of these must study medicine. This -circumstance availed to turn Watson’s attention to medicine in 1819 -at the age of 27, when he entered St. Bartholomew’s Hospital, and -came under the powerful influence of Abernethy. During the session -1820-1 he attended medical lectures at Edinburgh University, and in -1822 received his licence to practise from Cambridge. But academical -pursuits were continued, and Watson took private pupils, among whom -was Lord Auckland, afterwards Bishop of Bath and Wells, and served -the office of proctor in 1823-4. In 1825 he took his M.D. degree, -and married Miss Jones, niece of Turner, Dean of Norwich and Master -of Pembroke College. Soon afterwards he established himself as a -physician in Henrietta Street, Cavendish Square, London, in which -street he continued to live for fifty-seven years. His wife died, to -his lasting regret, five years later, leaving him with one son and -daughter, to whom he was devotedly attached. - -Watson was recognised from the commencement of his London career as -a man of mark, and in 1827 he was elected Physician to the Middlesex -Hospital. In 1828, on the opening of the University College, he was -appointed Professor of Clinical Medicine, retaining his post at the -Middlesex Hospital; but he transferred his services as lecturer to -King’s College in 1831, becoming Professor of Forensic Medicine. -Practice had come but slowly in these years. In 1831 he made his -first contribution to medical literature, in the shape of “Remarks -on the Dissection of Bishop, and the Phenomena attending Death by -Strangulation” (_Medical Gazette_). Bishop had murdered an Italian -organ-boy, and brought the body to King’s College for sale: Bishop -was hanged, and his body, like that of his victim, came to King’s -College for dissection. From this time Dr. Watson made numerous -contributions to the _Medical Gazette_, largely embodied in his -subsequent great work. In July 1832 he was chosen to accompany Sir -Walter Scott from London to Edinburgh when he was returning from -Italy to Abbotsford for the last time. - -In 1836 Dr. Watson was appointed to the chair of the Principles and -Practice of Medicine at King’s College, and in the ensuing winter -delivered the first draught of those lectures on which his fame -rests. They soon became well known, and they were printed weekly -in the _Medical Gazette_ in 1840-2. Finally they were published in -two volumes by Parker in 1844, and became acknowledged as medical -classics. Mr. Parker showed a righteous liberality when their great -sale had brought in a large sum, in granting the author two-thirds -of the profits instead of one-half, as had been agreed, and handing -him twelve hundred pounds as a first payment. Watson had already, -in 1840, resigned his chair at King’s College rather than leave his -old post at Middlesex Hospital, but in 1843 he was compelled by -the increase of private practice to resign even this. Henceforward, -especially after the retirement of Dr. Chambers in 1848, he was at -the head of London practice for many years. He was not, however, -appointed one of the Queen’s Physicians-Extraordinary till 1859; -in 1861 he was called in to attend the Prince-Consort in his fatal -illness, and in 1866 he was created a baronet, receiving in 1870 -the further appointment of Physician-in-Ordinary to the Queen. The -College of Physicians elected him President in 1862, an office he -held for five years. From 1858 to 1860 he represented the College -on the General Medical Council. In 1857-8 he was President of the -Pathological Society, and he was in 1868 the first President of -the Clinical Society. In 1859 he was elected a Fellow of the Royal -Society. - -Two quotations from Watson’s Introductory Lecture to his course will -serve to indicate some of the qualities which have given his book -such popularity. Referring to the study of anatomy and physiology, he -says; “Do not think that I am wandering from my proper subject when -I bid you to remember how profoundly interesting, how almost awful, -is the study in itself and for its own sake, revealing, as it surely -does, the inimitable workmanship of a Hand that is Divine. Do not -lose or disregard that grand and astonishing lesson. Do not listen -to those who may tell you not to look for the evidence of purpose in -this field of study, that the visible mechanism of that intricate -but marvellously perfect and harmonious work, the animal body—the -numberless examples of means suited to ends, of fitness for a use, -of even prospective arrangements to meet future needs, of direct -provisions for happiness and enjoyment—that all these have no force -at all, in true philosophy, as evidences of design. For my own part, -I declare that I can no more avoid perceiving, with my mental vision, -the evidential marks of purpose in the structure of the body, than -I can help seeing with my open eyes, in broad daylight, the objects -that stand before my face.” - -Again, he characterises the profession of medicine in noble terms. -“The profession of medicine having for its end the common good of -mankind, knows nothing of national enmities, of political strife, -of sectarian divisions. Disease and pain the sole conditions of its -ministry, it is disquieted by no misgivings about the justice or the -honesty of its client’s cause; but dispenses its peculiar benefits, -without stint or scruple, to men of every country or party, and rank -and religion, and to men of no religion at all. And like the quality -of mercy, of which it is the favourite handmaid, it “blesses him that -gives and him that takes,” reading continually to our own hearts -and understandings the most impressive lessons, the most solemn -warnings. It is ours to know in how many instances, forming indeed -a vast majority of the whole, bodily suffering and sickness are the -natural fruits of evil courses—of the sins of our fathers, of our -own unbridled passions, of the malevolent spirit of others. We see, -too, the uses of these judgments, which are mercifully designed to -recall men from the strong allurements of sense, and the slumber of -temporal prosperity, teaching that it is good for us to be sometimes -afflicted. Familiar with death in its manifold shapes, witnessing -from day to day its sudden stroke, its slow but open siege, its -secret and insidious approaches, we are not permitted to be unmindful -that our own stay also is brief and uncertain, our opportunities -fleeting, and our time, even when longest, very short, if measured by -our moral wants and intellectual cravings.” - -These lectures had the largest sale of any similar work in the -author’s lifetime. Five large editions were published under his -own revision. He most unsparingly altered his previous views with -the advance of science, and showed rare modesty in his expressions -thereupon. Dr. Charles West has admirably sketched his friend’s -character (_Medical Times and Gazette_, Dec. 16, 1882): “He laid -no claim to genius; he made no great discovery. Though a scholar -he was not more learned, though a good speaker he was not more -eloquent, than many of his contemporaries whose names are now -well-nigh forgotten; and yet he was by universal consent regarded as -the completest illustration of the highest type of the physician. -His moral as well as his intellectual qualities had much to do with -the estimate which all formed of his character. His faculties were -remarkably well balanced, his mind was eminently fair. He had that -gift—the attribute and the reward of truth—the power intuitively -to detect all specious error. Hence, while the added experience of -each year gave increased value to his teachings and his writings, it -brought but little for him to unlearn or to unsay. He took a wide -view of every question.... He availed himself of knowledge from all -sources, and for all purposes except vain display; he used theories -to illustrate his facts and to point their meaning, but no further, -conscious that, with imperfect knowledge, it would be idle to attempt -to build up correct theory.... Take him in his teaching, all in all, -he seems to me, more than any one I ever knew, to be the undoubted -heir of England’s greatest practical physician, Thomas Sydenham.” - -Another writer in the _British Medical Journal_, Dec. 23, 1882, -speaks of his serene and gentle temper, his modest dignity, his -benevolent kindness, his unfailing clearness of judgment. “Nothing -that happened in the professional world, of human or scientific -importance, was alien to him; and there are few men among his -contemporaries who have not at one time or another come to him for -advice and guidance. Conciliatory to the utmost bounds of kindness, -he was never open to the charge of favouring compromise.... It is -rare indeed to find any man of whom it may be said as of him, that -there is not one man in the profession who would at any time have -declined to accept Sir Thomas Watson’s judgment on any personal or -professional question as final. His sense of justice, his habitual -reference of all questions of detail to unassailable principle, his -flexibility of mind, and his quick perception of character, gave -him a rare but well-justified ascendancy over even the ablest of -his contemporaries.” After a long old age spent in retirement from -practice, but in continued vigorous professional study, of which he -gave evidence in a little book on the Abolition of Zymotic Diseases, -published as late as 1879, the venerable man died of old age at his -son’s residence at Reigate, in Surrey, on December 11, 1882. - - * * * * * - -Born about ten years after the last-mentioned eminent physician, -DOMINIC JOHN CORRIGAN for many years held a position in Dublin -somewhat parallel to that of Watson in London. He was a native of -Dublin, born on December 1st, 1802, his father having been a merchant -in Thomas Street. Educated first at the lay college of St. Patrick’s -at Maynooth, he entered upon medical study as the pupil of Dr. -O’Kelly of Maynooth, who had foresight to discern that his pupil was -capable of rising to the highest position in the profession, and -advised his being sent to the Edinburgh Medical School. Part of his -medical study was, however, pursued in Dublin, where he attended -clinical lectures at Sir Patrick Dun’s Hospital. His Edinburgh degree -dates from 1825. - -The rising science of pathology had deeply impressed young -Corrigan’s mind, and he devoted himself, after settling in Dublin -as physician to the Meath Street Dispensary, to original study. One -of the principal fruits of his inquiries was his classic paper on -“Permanent Patency of the Mouth of the Aorta, or Inadequacy of the -Aortic Valves,” published in the _Edinburgh Medical and Surgical -Journal_, April 1832. This paper commenced with the following -statement, “The disease to which the above name is given has not, so -far as I am aware, been described in any of the works on diseases -of the heart. The object of the present paper is to supply that -deficiency. The disease is not uncommon. It supplies a considerable -proportion of cases of deranged action of the heart, and it deserves -attention from its peculiar signs, its progress, and its treatment. -The pathological essence of the disease consists in inefficiency of -the valvular apparatus at the mouth of the aorta, in consequence of -which the blood sent into the mouth regurgitates into the ventricle. -This regurgitation, and the signs by which it is denoted, are not -necessarily connected with one particular change of structure in the -valvular apparatus.” One particular feature attending these cases, -which Corrigan was the first fully to describe, was the extraordinary -character of the pulse, since known very generally as “Corrigan’s -pulse.” The strong visible pulsation in the arteries of the head, -neck, and arms, bounding into a new position with each beat of the -heart, and becoming prominent under the skin, has since proved -the means whereby aortic valvular disease of the heart has been -recognised in multitudes of cases. The full pulse, followed by almost -complete collapse, has since been termed “jerking, splashing, or -collapsing,” or the “water-hammer pulse.” The peculiar rushing thrill -felt by the finger in the large superior arteries was also dwelt -upon, as well as the “bruit de souffle” heard as an accompaniment of -the heart-sounds. Corrigan had corrected Laennec’s erroneous view of -the cause of this bruit, in a previous paper in the _Lancet_ of vol. -ii., 1829, p. 1. - -Dr. Corrigan continued for some years zealously to investigate -the functions of the heart, and he experimented largely upon the -hearts of fishes and reptiles. He published an important paper -“On the Motions and Sounds of the Heart,” in the _Dublin Medical -Transactions_, 1830, part i. At this period of his career, when -practice as yet was but scanty, he was much encouraged by reading -“The Lives of British Physicians, from Linacre to Gooch,” published -in 1830, and he referred to it afterwards as showing that “there is -but one road to excellence and success in our profession, and that is -by steady study and hard labour; and you will at least always have -this consolation in your dreariest hour of labour, that no proud -man’s contumely, no insolence of office, nor ‘spurns that patient -merit of the unworthy takes,’ can bar your way.” - -Resigning his post at the Meath Street Dispensary, Corrigan became -successively attached to the Cork Street Fever Hospital, and to -the Jervis Street Hospital. Yet the Irish College of Physicians -failed to discern his great merits, and blackballed him when he was -first proposed for the fellowship, a mistake which they subsequently -atoned for in some measure by electing him their president for five -successive years, and by commissioning a statue of him, by Foley, at -the conclusion of his term of office. In 1833 he began to lecture -on the practice of medicine in the Carmichael School of Medicine, -and practice grew rapidly. In 1840 he was appointed physician to the -House of Industry Hospitals, which post he held till 1866. Here he -delivered a noteworthy course of lectures on the Nature and Treatment -of Fever, which were published in 1853. He accepted and enforced the -modern views as to the distinctness of typhoid from typhus fever. - -In 1841 Dr. Corrigan became a member of the Senate of the new -Queen’s University, of which after thirty years he was appointed -Vice-Chancellor. In 1849 Dublin University gave him the honorary -M.D. He was assiduously devoted to the onerous duties of a -Commissionership of National Education. As to practice, he became the -most popular and highly remunerated physician Dublin had ever seen, -having for many years more calls upon him than he could possibly -attend to, and receiving in several years as much as £9000 per -annum in fees. In 1866 he was made a baronet in consideration both -of his medical position and of his important services to national -education. He was also Physician-in-Ordinary to the Queen in Ireland. - -As member of the General Medical Council from 1858 till his death, -Sir Dominic Corrigan exercised a strong influence in favour of -elevating the standard of professional education. He was an eloquent -and lively debater and not at all averse to a display of verbal -pugnacity, but he was much and generally beloved. In 1868 Sir Dominic -was induced to come forward as an advanced Liberal candidate for -the representation of the city of Dublin in Parliament; but on that -occasion, however, he was defeated. In 1870 he was elected by a -majority of over a thousand votes, and sat in Parliament till 1874. -Originally of a fine constitution, he suffered severely from gout in -his later years, and died after an attack of paralysis on Feb. 1, -1880. - - * * * * * - -The succession of clinical physicians is well sustained at the -present day in the person of Sir WILLIAM WITHEY GULL, Baronet. Born -on the last day of December 1816, at Thorpe-le-soken, Essex, William -Gull was educated privately, and early became a student of Guy’s -Hospital, London. To this establishment he was so attached that for -fifteen years he resided within its walls or immediately adjacent. -In 1841 he became M.B. of London University, and in 1846 M.D. He was -elected Fellow of the College of Physicians in 1846, and Fullerian -Professor of Physiology at the Royal Institution in 1847, which -office he held till 1849. - -Very early after his graduation as M.B., Dr. Gull was appointed to -assist the pupils at Guy’s in their studies, or in other words, -he became medical tutor. In 1843 he began to lecture on natural -philosophy. In 1846 he undertook the important lectureships of -physiology and comparative anatomy in Guy’s Medical School. Meanwhile -about 1843 Dr. Gull had been appointed resident superintendent of -the asylum for twenty female lunatics which Guy had ordered to be -maintained. He formed a close acquaintance with Dr. Conolly, whose -name will ever be connected with the rational treatment of the -insane in this country, and by adopting improved methods Dr. Gull -was finally so successful that the patients were all discharged -cured, and the wards occupied by them devoted to the treatment of -acute cases more properly coming under care in a general hospital. -Meanwhile Dr. Gull was appointed assistant-physician to Guy’s, and in -due course succeeded to the full physiciancy. In this capacity his -clinical teaching was long one of the important features at Guy’s. In -1856 he became joint-lecturer on medicine, which office he held till -1867 with great distinction. At this date he was compelled by the -increasing claims of practice to resign his appointment; but he is -still attached to Guy’s as consulting physician. - -Practice, indeed, came upon Dr. Gull all too soon for medical -science to reap the highest advantage from his original research. -But whatever he has written has been of high value and worthy -of deep consideration. Among his writings may be mentioned the -Gulstonian Lectures on Paralysis (_Medical Gazette_, 1849), essays -on Hypochondriasis and Abscess of the Brain, in Reynolds’ “System -of Medicine,” and Guy’s Hospital Reports, 1857; on Paraplegia, in -Guy’s Hospital Reports for 1856, 1858, and 1861; on Anorexia Nervosa, -and on a Cretinoid State, in the _Transactions of the Clinical -Society_, vol. vii. His Report on Cholera, with Dr. Baly, for the -College of Physicians (1854), and his paper, with Dr. Sutton, on -Arterio-Capillary Fibrosis (_Med. Chir. Transactions_, vol. lv.), -rank high as original contributions, which must always be consulted -by writers on those subjects. - -In an oration delivered before the Hunterian Society in 1861 Dr. -Gull took occasion to utter a protest against the popular prejudice -for specialists. “Who can treat as a speciality,” he asks, “the -derangements and diseases of the stomach, whilst its relations and -sympathies are so universal? How can there be a special ‘brain -doctor,’ whilst the functions of the brain are so dependent upon -parts the most distant, and influences the most various? A tumour in -the brain may tell of its presence only through disturbance in the -stomach, and a disorder of the stomach and its appendages may have -for its most prominent symptoms only various disturbances of the -brain.” - -In his address on “Clinical Observation in Relation to Medicine,” -before the British Medical Association in 1868, Dr. Gull thus -expressed his impartial attitude in medicine: “We have no system -to satisfy; no dogmatic opinions to enforce. We have no ignorance -to cloak, for we confess it.” “Medicine is a specialism; but of no -narrow kind. We have to dissect nature; which, for practice, is -better than to abstract it.” “To clinical medicine the body becomes a -pathological museum. In every part we recognise certain proclivities -to morbid action; and the purpose of our study is to trace these -tendencies to their source on the one hand, and to their effects on -the other.” “The effects of disease may be for a third or fourth -generation, but the laws of health are for a thousand.” “Happily, -at this day, hygiene has gained strength enough to maintain an -independent position in science. To know and counteract the causes of -disease before they become effective is evidently the triumph of our -art; but it will be long before mankind will be wise enough to accept -the aid we could give them in this direction. Ignorance of the laws -of health, and intemperance of all kinds, are too powerful for us. -Still we shall continue to wage an undying crusade; and truly we may -congratulate ourselves that no crusade ever called forth more able -and devoted warriors than are thus engaged.” - -In 1870 Dr. Gull delivered the Harveian Oration before the Royal -College of Physicians, and expressed himself forcibly as to the duty -of preventing disease. Indeed, it is a strong article of faith with -him that at some future time the office of the physician will be -gone. “I cannot doubt it is on all sides imperative on us to limit, -and if possible to blot out, all diseases of whatever kind. Who would -assume the responsibility of letting a preventable evil fester in -society, on a pretence of a knowledge of the divine purposes, or -under the pretext that public morality would be thereby promoted? -The duty which lies nearest to us must ever have the first claim; -and it cannot but be admitted that the nearest duty each man has to -his fellow is to save him as far as possible from all injury, even -though that injury may arise as the consequence of his own fault. Nor -will it be questioned that the cause of morality is more advanced -by beneficent interference than by permitting ourselves to stand -passively by whilst intemperance and vice work ruin and infect the -very fountains of life.” - -Meanwhile Dr. Gull had attained many of the highest honours of the -profession. He was one of the first graduates of London University -to attain a seat on its Senate, which he continues to occupy. He was -Censor of the College of Physicians in 1859-61 and in 1872-3, and -Councillor in 1863-4. Oxford conferred on him the degree of D.C.L. -in 1868, the Royal Society elected him to its Fellowship in 1869, -Cambridge followed suit with the LL.D, in 1880, and Edinburgh in -1884. He was appointed a Crown Member of the General Medical Council -in 1871, holding office till 1883, when he resigned. His successful -attendance on the Prince of Wales in 1871, in conjunction with Sir W. -Jenner, became the occasion of his receiving a baronetcy in 1872, and -being made Physician-Extraordinary to the Queen. - -The evidence given by Sir William Gull before the Lords’ committee -on intemperance, in 1877, has often been referred to as one of the -most valuable aids to temperance that a medical man has rendered. He -distinctly assigned a subordinate value to alcohol as a medicine, and -expressed his belief that its value lay chiefly in its action on the -nervous system as a sedative, not as a stimulant. He further stated -that a very large number of people in society are dying, day by day, -poisoned by alcohol, but not supposed to be poisoned by it. In the -case of inebriates, with most patients he would not be afraid to stop -the use of alcohol altogether. He sees no good in leaving off drink -by degrees. “If you are taking poison into the blood, I do not see -the advantage of diminishing the degrees of it from day to day.... I -should say, from my experience, that alcohol is the most destructive -agent that we are aware of in this country.” - -His own example is powerfully instructive. “If I am fatigued with -overwork, personally, my food is very simple. I eat the raisins -instead of drinking the wine.... I should join issue at once with -those people who believe that intellectual work cannot be so well -done without wine or alcohol. I should deny that proposition and hold -the very opposite.” In the life of James Hinton, by Ellice Hopkins, -to which Sir William Gull has contributed a preface, we learn another -secret of a popular physician’s endurance in the record of early -constitutionals in the parks and remote suburbs, from six to eight in -the morning. - -In 1882, in the controversy on Vivisection, Sir William Gull, writing -in the _Nineteenth Century_, showed that his sympathy with the -struggles of physiologists for their science was combined with a -fully answering appreciation of the value of physiological research -to medicine. “Yearly in this country,” he says, “more than twenty -thousand persons, children and others—mostly children—die of scarlet -fever; and nearly twenty thousand more of typhoid fever; and one -of the chief causes of this mortality is the high temperature of -the blood, which results from the disturbance due to the fever -process. No wonder therefore that physiologists and physicians have -anxiously and laboriously occupied themselves in investigating that -mechanism of the living body which in health maintains so constant a -temperature under varying circumstances, both internal and external, -and which becomes so easily and fatally deranged in disease.... The -febrile state must have arrested attention from the infancy of man. -The mothers of a palæolithic age must have watched their children -consumed to death in it, as do the mothers of to-day. The name of -this fiery state is as old as literature.... This fiery furnace, -with its uncounted millions of victims, science hopes to close.” - -“There is no doubt that physiological experiments are useful, useful -for animals as well as for man. They are therefore justifiable.... -Nothing is so cruel as ignorance. For how many centuries had human -sufferers to bear pain which is now preventable by better knowledge? -How many thousands festered to death in small-pox before the -discovery of vaccination? How many are now dying of tubercle and -scrofula whom a better knowledge of their conditions might rescue? -Yet the pursuit of this knowledge is hindered in England by the -outcry of cruelty—the cruelty being no more than the inoculation of -some of the lower animals with tubercular and scrofulous matter, in -order to study the course of the disease and the modes of prevention. -The cruelty obviously lies, not in performing these experiments, but -in the hindering of progressive knowledge.” - - - - -CHAPTER XX. - -_SIR JAMES PAGET AND SURGICAL PATHOLOGY._ - - -The foremost surgical philosopher and orator of his day, Sir -JAMES PAGET was called to occupy the presidential chair of the -International Medical Congress which met in London in August 1881. -This was the culmination of a long career of scientific usefulness -and successful practice. Sir James is a younger brother of Dr. G. E. -Paget, Regius Professor of Medicine in the University of Cambridge, -and was born at Yarmouth in Norfolk in 1814. After a course of -professional study at St. Bartholomew’s Hospital, London, Mr. Paget -qualified as a member of the London College of Surgeons in 1836. His -energy and acuteness were soon made manifest to the authorities, and -he was selected to catalogue and describe the Pathological Museums of -St. Bartholomew and also of the College of Surgeons, in conjunction -with Mr. Stanley. These important works contributed not a little to -establish Mr. Paget’s scientific reputation. - -In July 1842 Mr. Paget, while Demonstrator of Morbid Anatomy at -St. Bartholomew’s, published in the _British and Foreign Medical -Review_ an exhaustive report on the chief results obtained by the -use of the microscope in the study of human anatomy and physiology; -it was afterwards issued separately. Being derived from the original -authorities, and full references being given, it was of great value -at a critical period in the growth of the knowledge of minute -anatomy. For some years Mr. Paget drew up valuable reports on the -progress of human anatomy and physiology. - -Forty years ago Mr. Paget was already Warden of St. Bartholomew’s -College and Lecturer on Physiology in the Hospital. At the opening -of the session of 1846 he addressed the students in an eloquent and -practical way on “The Motives to Industry in the Study of Medicine.” -His appeals to the highest motives were most forceful, and very -indicative of the spirit which was to animate himself throughout -life. “Do not imagine,” he said, “that your responsibilities will -be limited to the events of life or death. As you visit the wards -of this hospital, mark some of the hardly less portentous questions -which, before a few years are past, you may be permitted to -determine. In one, you will find it a doubt whether the remainder of -the patient’s life is to be spent in misery, or in ease and comfort; -in another, whether he and those who depend upon his labours are -to live in hopeless destitution, or in comparative abundance. One -who used to help his fellow-men finds ground to fear that he may -be a heavy burthen on their charity. Another counts the days of -sickness, not more by pain and weariness, than by the sufferings and -confusion of those who are left at home without a guide, and, it may -be, starving. Oh, gentlemen! I can imagine no boldness greater than -his would be, who would neglect the study of his profession, and yet -venture on the charge of interests like these; and I can imagine no -ambition more honourable, no envy so praiseworthy, as that which -strives to emulate the acquirements of those who are daily occupied -in giving safe guidance through the perilous passages of disease, and -who, in all these various difficulties and dangers, can act with the -energy and calmness that are the just property of knowledge.” - -About the same time Mr. Paget published an interesting pamphlet -containing all the records of Harvey preserved in the Journals of -St. Bartholomew’s, with notes elucidating them. Meanwhile, having -been appointed Professor of Anatomy and Surgery to the College of -Surgeons, an office which he held from 1847 till 1852, the lectures -which he delivered being reported in the medical journals, as well -as listened to with delight by large audiences, were recognised as -among the most masterly modern contributions to surgical science. -His prolonged study of the pathological collections belonging to the -College and to St. Bartholomew’s in preparing the catalogues, enabled -him to illustrate his lectures in a most interesting and valuable -manner. The lectures were collected and published in 1853, and have -ever since occupied a similar lofty position to the lectures on -medicine by Sir Thomas Watson. They illustrate the general pathology -of the principal surgical diseases, in conformity with modern -advances in physiology. In several recent editions a distinguished -pupil of Sir James Paget, Professor Turner of Edinburgh, has revised -the lectures from the pathological point of view, while the author -has continued to revise them in their clinical aspect. - -The leading topics under which these famous lectures are comprised -are: Nutrition, Hypertrophy, Atrophy, Repair, Inflammation, -Mortification, Specific Diseases, and Tumours. The concluding passage -of the second lecture, on “The Conditions Necessary to Healthy -Nutrition,” is a fine exposition of a view of the relation between -the mind and a changing brain. “In all these things, as in the -phenomena of symmetrical disease, we have proofs of the surpassing -precision of the formative process, a precision so exact that, as -we may say, a mark once made upon a particle of blood or tissue is -not for years effaced from its successors. And this seems to be a -truth of widest application; and I can hardly doubt that herein is -the solution of what has been made a hindrance to the reception of -the whole truth concerning the connection of an immaterial mind with -the brain. When the brain is said to be essential, as the organ or -instrument of the mind in its relations with the external world, -not only to the perception of sensations, but to the subsequent -intellectual acts, and especially to the memory, of things which have -been the objects of sense—it is asked, how can the brain be the organ -of memory when you suppose its substance to be ever changing? or how -is it that your assumed nutritive change of all the particles of the -brain is not as destructive of all memory and knowledge of sensuous -things as the sudden destruction by some great injury is? The answer -is—because of the exactness of assimilation accomplished in the -formative process; the effect once produced by an impression upon -the brain, whether in perception or in intellectual act, is fixed -and there retained; because the part, be it what it may, which has -been thereby changed, is exactly represented in the part which, in -the course of nutrition, succeeds to it. Thus, in the recollection of -sensuous things, the mind refers to a brain in which are retained the -effects, or rather the likenesses of changes that past impressions -and intellectual acts had made. As, in some way passing far our -knowledge, the mind perceived and took cognisance of the change made -by the first impression of an object, acting through the sense organs -on the brain; so afterwards, it perceives and recognises the likeness -of that change in the parts inserted in the process of nutrition. - -“Yet here also the tendency to revert to the former condition, or -to change with advancing years, may interfere. The impress may be -gradually lost or superseded, and the mind, in its own immortal -nature unchanged, and immutable by anything of earth, no longer finds -in the brain the traces of the past.” - -In 1854 Mr. Paget gave one of the series of lectures on Education -at the Royal Institution, in which Whewell, Faraday, and others -took part. His lecture on the Importance of the Study of Physiology -as a branch of education for all classes, was marked by elevation -of thought and practicality of aim. One interesting point that he -dwelt on was that a wider scheme of education would be more likely -to discover men fitted for particular work. “It has seemed like -a chance,” he said, “that has led nearly every one of our best -physiologists to his appropriate work; like a chance, the loss -of which might have consigned him to a life of failures, in some -occupation for which he had neither capacity nor love.” The value -of physiological instruction is now generally admitted, but the -practical application is almost as generally neglected. - -Sir James Paget has published but too few of his thoughts to the -public and the profession; but all that have been given to the world -have been of sterling worth. His Clinical Lectures and Essays, -collected in 1875, include some of the most interesting reading -imaginable. He deals among other subjects with the various risks of -operations, the calamities of surgery, stammering with other organs -than those of speech, cases that bone-setters cure, dissection -poisons, and constitutional diseases. Some of the most instructive -of the series are those which describe forms of nervous mimicry of -serious diseases. An extract from “The Calamities of Surgery” gives -clear expression to Sir James Paget’s views on preparation for -operating:— - -“Look very carefully to your apparatus. I have no doubt that you -will look very carefully to the edges of your knives and your saws -and all things that are mighty to handle; but look to the plaster, -look to the ligatures and the sutures, and all the things which are -commonly called minor. When I have seen Sir William Fergusson and -Sir Spencer Wells operate, I have never known which to admire most; -the complete knowledge of the things to be done, the skill of hand, -or the exceeding care with which all the apparatus is adjusted and -prepared beforehand. The most perfect plaster, the most perfect silk, -not one trivial thing left short of the most complete perfection -it is capable of. I have no doubt that the final success of their -operations has been due just as much to these smaller things as to -those greater things of which they are masters.” - -The lecture on Dissection Poisons was especially called forth by an -illness from which he suffered for three months in 1871, caught from -attending the _post mortem_ examination of a patient who had died -of pyæmia. Yet he had no wound or crack of the skin of any kind. In -closing the lecture Sir James remarked: “Sir William Lawrence used -to say that he had not known any one recover on whose case more than -seven had been consulted. Our art has improved. I had the happiness -of being attended by ten: Sir Thomas Watson, Sir George Burrows, Sir -William Jenner, Sir William Gull, Dr. Andrew, Dr. Gee, Mr. Cæsar -Hawkins, Mr. Savory, Mr. Thomas Smith, Mr. Karkeek. In this multitude -of counsellors was safety. The gratitude I owe to them is more than I -can tell—more than all the evidences of my esteem can ever prove.” - -In an address on Theology and Science, delivered to students at the -Clergy School at Leeds, in December 1880, Sir James Paget remarks -that “in theology, and in the Christian faith which it expounds, -there are not only clear evidences which, in their accumulated force, -cannot, I think, be reasonably resisted by those who will fairly -collect and try them; but there are convictions of religious faith, -not always based on knowledge, or on other evidence than the faith -which is ‘the evidence of things unseen,’ which may justly be held -as unalterable, because they are consistent with revelation, and -have been sustained by the testimony of clouds of witnesses, and, -I believe, have in many minds the testimony of God’s indwelling -Spirit.” He expresses the belief that the truths and highest -probabilities of science and religion may justly be held together, -though on different grounds, and that they are not within reach of -direct mutual attack. He advises clerical students, if they touch -upon such questions, to undertake some real study in science, by -observation, by experiment, by collecting, as well as by reading. -“And let your reading be in the works of the best masters, that -you may learn their true spirit, their strength, their methods of -observing and thinking, their accuracy in describing.” - -Sir James Paget appears as a champion of moderation in the -_Contemporary_ controversy on the Alcohol Question. He says that the -presumption in favour of moderation is strengthened by comparing -those of our race who do not and those who do habitually use -alcoholic drinks. “As to working power, whether bodily or mental, -there can be no question that the advantage is on the side of those -who use alcoholic drinks. And it is advantage of this kind which is -most to be desired. Longevity is not the only or the best test of -the value of the things on which we live. It may be only a long old -age, or a long course of years of idleness or dulness, useless alike -to the individual and the race. That which is most to be desired is -a national power and will for good working and good thinking, and a -long duration of the period of life fittest for these; and facts show -that these are more nearly attained by the people that drink alcohol -than by those who do not.” - -Sir James Paget holds or has held appointments too numerous to -mention. After a long and honourable career as Assistant-Surgeon and -Surgeon to St. Bartholomew’s, he became Consulting Surgeon. As a -member of the Council of the College of Surgeons and for some years -President, and also as a member of the Senate, and for some years -Vice-Chancellor of London University, he has exercised powerful -influence on the improvement of medical education and on medical -politics generally. He is Surgeon to the Prince of Wales and Serjeant -Surgeon-Extraordinary to the Queen. A baronetcy was conferred upon -him in August 1871, and he has received honorary distinctions in -abundance from both British and foreign universities. - -In 1882 in his Bradshawe lecture, “On some Rare and New Diseases,” -Sir James Paget remarked on the increase in the number of real -students, which he has had a large share in creating. “I have been -often made happy by the contrast which I have seen while working at -the new edition of the catalogue of the pathological specimens in the -College of Surgeons’ museum. While I was writing the last edition, -between thirty and forty years ago, scarcely a student ever entered -the museum. Hour after hour I sat alone; I seemed to be working for -no one but myself, or for nothing but the general propriety that a -museum ought to have a catalogue, though no one might ever care to -study with it. Now, and for some years past, a day rarely passes -without many pupils and others being at work in every part of the -museum.” - -In the same lecture Sir James clearly showed the value of studying -cases not agreeing with the ordinary types. “We should study -all exceptions to rules; never thinking of them as unmeaning or -accidental. Especially, we should never use, in its popular but wrong -translation, the expression, ‘exceptio probat regulam;’ as if an -exception to a rule could be evidence that the rule is right. If we -use it, let this be in its real meaning; translating it, as surgeons -should, that an exception probes the rule, tests it, searches it—as -the Bible says we should ‘prove all things’—to its very boundary.” - -Finally we may quote some sentences from Sir James Paget’s lecture -on “Elemental Pathology,” delivered before the British Medical -Association in 1880, as expressing his philosophy of life. “I hold -it to be very desirable that every one of us should, all his life -long, study some science in a scientific manner. There seems to be no -equally good method for maintaining the temper and the habits, which -by making us always good students, will make us as good practitioners -as we can be. There is no method so good for maintaining a constant -habit of inquiry, with accuracy and perseverance in research, the -power of weighing evidence, of calmly judging, and of accurately -speaking; none better for cultivating the love of truth, the -contempt for fallacies, whether others’ or our own, the gentleness -and courtesy which are appropriate to the consciousness of the -imperfection of our knowledge.” - - - - -CHAPTER XXI. - -_WILLIAMS, STOKES, AND DISEASES OF THE CHEST._ - - -Although this country has not enjoyed the distinction of introducing -that invaluable instrument, the stethoscope, to medical science, -great interest naturally attaches to those who first used the -stethoscope in this country. And among these the name of Charles John -Blasius Williams is prominent. - -CHARLES WILLIAMS, the son of a clergyman of a Cardiganshire family, -was born early in the present century at Heytesbury in Wiltshire, -where his father was perpetual curate, and custos of the Hungerford -almshouse, in which he resided. He was educated at home by his -father. His early liking for natural science and medicine may be -considered to have come through his mother, who was the daughter of -a surgeon, also named Williams, at Chepstow, and had been educated -by Hannah More’s sisters, and received instruction in reading from -Hannah More herself. Before the age of fourteen, having access to -some good books on natural philosophy, he had made for himself two -electrifying machines, a battery of Leyden jars, a voltaic pile, and -several little telescopes, microscopes, kaleidoscopes, and æolian -harps. Thomson’s Chemistry enabled him to carry on extended chemical -experiments, and to start well at Edinburgh subsequently. - -Astronomy, a lifelong hobby, was cultivated in the family after -the reading of Chalmers’s astronomical discourses; they bought a -telescope and did some really good observing. Active games were not -lost sight of: and the young Charles excelled all his neighhours in -leaping and running. Stilt-walking was a favourite pursuit; and the -youth once made a pair of stilts with a footing twelve feet from the -ground, mounted on which he could walk well, and look into the upper -windows of the house. Natural history tastes were further carried out -in a somewhat unusual direction. Poultry and all kinds of domestic -animals were studied so minutely, and their cries imitated so -closely, that Charles could influence their behaviour towards himself -just as if he had been one of themselves.[13] - -In the autumn of 1820 Charles Williams entered at Edinburgh -University, attending Hope’s interesting lectures on Chemistry and -the dry prelections of Monro tertius on Anatomy, alternated with -Barclay’s extra-academical class. Later he diligently attended W. -P. Alison’s courses of lectures, and had much personal instruction -from him. He had not proceeded far in his medical studies before he -became absorbed in chemical physiology, and especially in relation -to respiration and animal heat. Carefully studying all the most -recent chemical discoveries, he made new experiments showing that the -change of colour between venous and arterial blood could take place -when the blood was enclosed in an animal membrane out of the body, -and surrounded by atmospheric air. Thus in 1823 he anticipated what -Professor Graham so largely developed in relation to the general -permeability of animal membranes. He further discussed the origin -of animal heat, and suggested various developments of the theory of -combustion. The paper, later amplified into a thesis for graduation -in 1824, attracted Alison’s high commendation, although Hope had -returned the paper with the remark that the subject was quite proper -for a young gentleman’s thesis, but that he declined to enter into -the subject. - -In 1824-5 the young doctor heard Charles Bell’s lectures on the -Nervous System at the London College of Surgeons, and attended the -surgical practice of several of the London hospitals. At midsummer -1825 he went to Paris, and in addition to French literature studied -painting, becoming a good amateur landscape-painter both in -water-colours and oils. In the winter he attended Majendie’s lectures -on Physiology and the practice of Dupuytren, Laennec, and many -others. But Laennec, the great auscultator, then in his last year -of life, gained his most ardent devotion. It was surprising, says -Dr. Williams, how little he was valued by French students. Those who -attended his clinique were chiefly foreigners. M. G. Andral’s _post -mortem_ examinations also he found invaluable. - -The chief discoveries relating to auscultation were undoubtedly -Laennec’s; yet his knowledge of acoustics was by no means profound, -and he was often not successful in explaining rationally the sounds -that he heard in the chest. Dr. Williams soon started in the path -of applying acoustic laws in this field, and in 1828 he produced -his valuable “Rational Exposition of the Physical Signs of Diseases -of the Chest,” suggesting various improvements in the construction -and use of stethoscopes. Returning to London, Dr. Williams derived -great benefits through an introduction to Dr. (afterwards Sir James) -Clark, so long attached as physician to the Queen, and from the -family acquaintance with Lord Heytesbury. His work above mentioned -was favourably reviewed, and soon made its way; and many of his -explanations are accepted to the present day. After various travels -with patients, he settled in Half Moon Street, Piccadilly, in 1830, -having married his cousin, Miss Harriett Jenkins, of Chepstow. - -Becoming a member of the Royal Institution, Dr. Williams was -introduced to Faraday, and was soon engaged to write for the -“Cyclopædia of Practical Medicine,” to which he contributed numerous -valuable articles on auscultation and diseases of the chest. In -these articles he recommended strongly the cure of catarrh by the -heroic process of reducing the supply of fluid. The remedial uses of -counter-irritation were carefully expounded: and dyspnœa, difficult -or distressed breathing, was clearly described. - -In 1833, while practice grew but slowly, the second edition of the -Rational Exposition was brought out, containing an enlarged section -on the sounds of the heart in health and disease. For some years Dr. -Williams had considered the questions involved, and by experimental -inquiries in 1835 he established that several causes to which they -had hitherto been ascribed could not be the cause of the sounds of -the heart, and that the first sound was produced by the muscular -contraction of the ventricles, and the second by the reaction of the -arterial blood tightening the semilunar valves. His anticipation -by Rouanet in 1832 in the latter point has, however, been more -recently made evident. A third edition of his book, now of increased -importance, was published in 1835, under the title of “The Pathology -and Diagnosis of Diseases of the Chest, illustrated especially by a -Rational Exposition of their Physical Signs.” It was reprinted in -America, and translated into German and Swedish. The same year he was -elected F.R.S. - -In 1836 Dr. Williams was asked to give lectures on Diseases of the -Chest at the Anatomical School in Kinnerton Street, connected with -St. George’s Hospital. In 1836-7 he was president of the Harveian -and the Westminster Medical Societies. In the summer of 1837 he -worked to prepare for the second Report of the British Association -Committee on the sounds of the Heart, in which were brought forward -important experimental results in regard to morbid murmurs associated -therewith. In 1835 he had shown that the true ground of distinction -between different forms of disease of the heart’s valves lay in the -different direction in which the sonorous currents spread the sounds, -and imparted them to the chest walls. Thus he first established the -distinction between basic and apex murmurs, developing his views more -fully in 1836-7-8. - -In 1839 Dr. Williams was elected Professor of Medicine to University -College, and physician to its hospital on Elliotson’s retirement. -Work now crowded upon him; in the first winter session he gave 150 -lectures and examinations in six months, visited the hospital almost -every day, and gave a weekly clinical lecture. Up to this period -_post mortem_ examinations at the hospital had been made in a mere -open shed, with a wooden shelf, scarcely screened, and without a -table or a supply of water. Dr. Williams himself planned a proper -_post mortem_ theatre; and with the plan he offered £50 towards the -cost,—a munificent mode of action which speedily secured the building -of the required theatre. Dr. Williams’s practical teaching and -luminous lectures caused the Medical School to increase still more -rapidly. He had a class of over two hundred. In 1840 an experimental -research in which Dr. Williams was assisted by Prof. Sharpey proved -the muscular contractility of the bronchial tubes, and confirmed the -great influence of belladonna and stramonium as remedies in asthma, -in suspending this contractility. - -The winter of 1840-1 was occupied largely with original experiments -on congestion, determination of blood, and inflammation, which Dr. -Williams treated of in the Gulstonian Lectures at the College of -Physicians in 1841. His results and views were, as acknowledged by -eminent men recently, twenty-five years in advance of his time. Both -Virchow and Burdon-Sanderson have acknowledged their great value. Dr. -Williams claims that he first pointed to enlargement of the arteries -leading to a part as the direct physical cause of determination -of blood to that part. “When the web of a frog’s foot is gently -irritated by an aromatic water, the arteries may be seen through -the microscope to become enlarged, and to supply a fuller and more -impulsive flow of blood to the capillaries and veins, which then all -become enlarged too: the whole vascular plexus, including vessels -which before scarcely admitted red corpuscles, then becomes the seat -of a largely increased current” (_London Medical Gazette_, July 1841). - -The year 1841 was marked by the first public steps taken to -establish the Hospital for Consumption and Diseases of the Chest, -which originated with Mr. (afterwards Sir) Philip Rose. A clerk in -his firm suffering consumption found no hospital willing to admit -him, on the plea of the lingering and incurable nature of the -disease. This started the idea of a special hospital, which Dr. -Williams cordially supported, and to which he became consulting -physician. The history and great success of the Brompton Hospital -cannot be followed here; in 1882 it had 331 beds. The great Virchow, -when he visited it in 1881, said, “Here _everything_ is done for the -sick.” - -In 1843 Dr. Williams published the “Principles of Medicine,” a work -in which physiology and pathology were largely employed to form a -basis for scientific medicine. It was received with high approval, -and became a standard work in America. New editions appeared in 1848 -and in 1856. Sir James Paget and Sir James Simpson among others have -given it the stamp of their marked approbation. The _Lancet_ gave it -almost unqualified praise. In 1846 the Pathological Society of London -was established, and Dr. Williams was chosen its first president. -Its objects were the exhibition, description, and classification -of morbid specimens, and the promotion of pathological research by -systematic observation and experiments. In his opening address, Dr. -Williams answered the sceptical question, “What is the use of opening -bodies? We never find what we expected:” by describing a _post -mortem_ examination of a remarkable case of pulmonary disease. The -examination had been concluded before Dr. Williams arrived, and he -was told that there was enlargement of the heart, which the physician -in charge expected, and was satisfied. Dr. Williams insisted -on careful inspection of the lungs, which disclosed extensive -consolidation, and in addition an unexpected general dilatation of -the bronchial tubes. This was the case in which he first discovered -the connection between that change and pleuro-pneumonia. The very -appropriate motto of the Society, “Nec silet mors,” was suggested by -Dr. Williams. - -At the end of the winter session of 1849 Dr. Williams resigned his -professorship and physiciancy, his health having severely suffered -from overwork, and private practice increasing rapidly. He removed -to Upper Brook Street, and here continued for twenty-four years in -full practice. In January 1849 Dr. Williams published his first -account in the _London Journal of Medicine_, on Cod-Liver Oil in -Pulmonary Consumption. He had been studying its application for -three years, but of course the priority in recommending it belongs -to Dr. Hughes Bennett. It was only in 1846, when a purified oil had -been prepared from the fresh livers of the fish, that Dr. Williams -found patients willing to take the oil, and in 1848 he wrote that -he had prescribed the oil in 400 cases of tubercular disease of the -lungs, and in 206 out of 234 recorded cases its use was followed by -marked improvement. The administration of cod-liver oil is such a -commonplace of the present day that it can scarcely be realised that -it is a novelty almost exclusively belonging to the present half of -the nineteenth century. And to Dr. Williams very much of the credit, -and of the proof of its efficacy, is due. A lady first visited on -September 3, 1847, appeared at the verge of death. Cod-liver oil -restored her in a few weeks, and she lived many years after. This was -a sample of the experience which, after many years’ testing, led Dr. -Williams to say, in the great work on pulmonary consumption published -by himself and his son, Dr. C. T. Williams, in 1871, that the average -duration of life in phthisis had been at least quadrupled. Of 1000 -cases tabulated, 802 were still living at the last report, and many -were expected to live for years. - -The New Sydenham Society, started in 1858, also found an apt first -president in Dr. Williams. Its usefulness in improving medical -literature by translations and republications has been and is very -great. The Lumleian Lectures at the College of Physicians followed -in 1862, and were entitled “Successes and Failures in Medicine.” -They were not published till 1871, when they appeared in the -_Medical Times and Gazette_. Great attention was directed in them -to the hopes and prospects of prevention of disease. In 1873 Dr. -Williams was elected to the Presidency of the Royal Medical and -Chirurgical Society, which he held for two years, though suffering -from gradually increasing deafness. In 1874 he was appointed -Physician-Extraordinary to the Queen. In 1875 he retired to Cannes, -where he has since renewed his earlier astronomical studies, and -made some important observations on sun spots. So in scientific -recreations, and in Biblical studies in which he has long been deeply -interested, the veteran physician whom Dr. Quain describes as “the -principal founder of our modern school of pathology,” passes the -closing years of a protracted life. - - * * * * * - -The Irish Schools of Medicine have had a briefer history than those -of Edinburgh and London, but have produced men whose character and -labours rank among the highest. WILLIAM STOKES, born in July 1804 in -Dublin, was the son of Whitley Stokes, Regius Professor of Medicine -in the University, a man of lofty aims and untiring energy, and -a very successful teacher of medicine. Father and son alike were -students of the Edinburgh Medical School; but the son owed much -to personal companionship with his father. After a few months at -Glasgow, young Stokes entered at Edinburgh early in 1823, and soon -came in contact with Dr. Alison, who exercised a profound influence -upon him; “the best man I ever knew,” he declared. Such striking -progress did he make, that before he left Edinburgh, in 1825, he had -written and published a little book on “The Use of the Stethoscope,” -which he was fortunate enough to sell for £70. - -On settling in Dublin, young though he was, Stokes was elected -Physician to the Meath Hospital, in succession to his father. -His colleague, Graves, one of the most remarkable men Dublin had -produced, exercised a striking influence over him. At twenty-two -Stokes was already lecturing and giving clinical instruction to a -crowd of pupils. The time was one of acute distress and poverty in -Ireland; fever raged in Dublin, owing to the distress caused by the -failure of the potato crop in the summer of 1826. The Meath Hospital -was crowded, and the young physician was taxed to the utmost, and his -benevolent charity became fixed as a second nature. - -During these years of activity, a powerful special object was -employing his most persistent thought and observation. He was -diligently storing his mind with every fact and inference bearing on -diseases of the lungs. In 1837 his observations were published in the -classic work on “Diseases of the Chest.” It at once placed him, says -Sir Henry Acland in the memoir prefixed to the edition published by -the New Sydenham Society in 1882, in the front rank of observers and -thinkers. His exposition of the use of auscultation in bronchitis and -the affections of the chest was most valuable. - -In 1842 Stokes became Regius Professor of Physic in Dublin -University, in succession to his father. From this time, though he -contributed occasional papers, lectures, and cases of value to the -_Dublin Journal of Medical Science_, and to the medical societies, -he published no book till 1854, when a valuable treatise on -Diseases of the Heart confirmed his reputation. In this he paid -great attention to functional disturbances of the heart, where -no organic disease was present. He says with great modesty, “the -diagnosis of the combinations of diseases, even in so small an -organ as the heart, is still to be worked out.... As the student -fresh from the schools, and proud of his supposed superiority in -the refinements of diagnosis, advances into the stern realities of -practice, he will be taught greater modesty, and a more wholesome -caution. He will find, especially in chronic disease, that important -changes may exist without corresponding physical signs—that as -disease advances its original special evidences may disappear—that -the signs of a recent and trivial affection at one portion of the -heart may altogether obscure, or prevent, those of a disease longer -in standing and much more important—that functional alteration may -not only cause the signs of organic lesion to vary infinitely, but -even to wholly disappear—that the signs on which he has formed his -opinion to-day may be wanting to-morrow; and, lastly, that to settle -the simple question between the existence of functional and that of -organic disease, will occasionally baffle the powers of even the most -enlightened and experienced physicians.” - -This treatise is acknowledged to be one of the most acute, graphic, -and complete accounts of the clinical aspects of heart disease. -In 1854 also he published a series of lectures on Fever in the -_Medical Times and Gazette_, which were collected into a volume, with -additions in 1874. Here he showed himself as still sceptical of the -advances made by Jenner, Murchison, and others. As he wrote in one of -the lectures, “there is nothing more difficult than for a man who has -been educated in a particular doctrine to free himself from it, even -though he has found it to be wrong,” and he could never free himself -from Alison’s strong belief that fevers were essentially alike. - -Very early in his career Stokes was overwhelmed with private -practice. On more than one occasion he spoke and wrote strongly -regarding the exertions and the mortality of Irish doctors in -combating fevers and cholera, while receiving the merest pittance -from Government for their services. His feelings as to everything -relating to the welfare of the profession and the general culture of -the student were actively displayed. “Let us emancipate the student,” -he said, “and give him time and opportunity for the cultivation of -his mind, so that in his pupilage he shall not be a puppet in the -hands of others, but rather a self-relying and reflecting being. Let -us ever foster the general education in preference to the special -training, not ignoring the latter, but seeing that it be not thrust -upon a mind uncultivated or degraded.” - -Prevention of disease, too, engaged Stokes’s earnest attention, -before sanitary science had come into fashion. “A time may come,” -he said, in closing one of his addresses, “when the conqueror of -disease will be more honoured than the victor in a hundred fights.” - -Sir Henry Acland says of Stokes: “The study of man was with him an -instinct, both on the material and on the intellectual side. On -the material side; for he was a physiognomist, a great judge of -character, and had a keen perception of all physical characteristics, -qualities which he obtained by intense observation of men in -disease, of men in health, and of persons in every class of society -and every kind of occupation. On the intellectual side; for the -phenomena of man’s external nature were to him only expressions of -the mind working within,—mind the result of inheritance—mind formed -by itself—mind the result of circumstance. The second thing to be -remarked was his intense interest in every form of human character, -in persons of every age, occupation, and condition. He had that which -many accomplished persons have not, the keenest sense of humour, -which sparkled up in a way quite indescribable. He combined with -real delight in all intellectual development the most tender human -interest.” - -Stokes was passionately fond both of natural scenery and of landscape -art; and he enjoyed the companionship and friendship of the best -artists, and at the same time appreciated greatly the interests of -humble life and the racy humour of the Irish peasantry. He wrote -some charming descriptions of scenery, and was well acquainted with -various schools of art. The antiquities and history of Ireland too, -found in him an accomplished and appreciative student; and it was -felt to be an appropriate tribute to his variety of taste as well -as his professional skill when he was chosen President of the Royal -Irish Academy in 1874. - -One valuable habit Dr. Stokes ascribed to his father. “My father left -me but one legacy, the blessed gift of rising early.” This often -meant getting up between four and five, when he would study and write -till eight. During a long day’s practice he was always exercising the -most genial influence, whether over refractory students or harassed -patients. At the close of the day his hospitality was as attractive -as his professional manner during the earlier hours. - -In 1870 Mrs. Stokes died, and from this blow her husband never fully -recovered. In 1876 he found himself compelled to withdraw from his -many public posts, and retire to his cottage at Carigbraig, where to -the last the flights of birds which he had encouraged and trained -came to seek their food at his hands. He died on January 6, 1878. - - -FOOTNOTES: - -[13] A most entertaining account of his encounters with a game-cock -is given in Dr. Williams’s “Memoirs of Life and Work,” 1885, from -which most of these particulars are derived. - - - - -CHAPTER XXII. - -_SIR HENRY THOMPSON AND CREMATION._ - - -The mode of disposing of the remains of the dead is naturally one -upon which doctors may be expected to have a good deal to say. As -guardians of the health of the living, the dangers and diseases -which the material remnants of our deceased friends may occasion the -living must concern the medical profession. The increasingly dense -aggregation of human beings in great towns has impressed the last -two generations with the necessity of doing something to prevent -disease from spreading through delay in burial, and the use of -unsuitable burial-places. But for the most part the efforts which -have been made have only taken the form of pushing the evil a little -further off; and a little mathematical calculation will show that the -present cemeteries must soon be surrounded by habitations, and some -fresh arrangements will have to be made. To cope with these evils -the practice of cremation has been vigorously advocated, as a more -rational and healthy mode of disposing of the dead, by the Cremation -Society, of which Sir HENRY THOMPSON is the President. - -This distinguished surgeon is the son of Mr. Henry Thompson of -Framlingham, Suffolk, having been born on August 6, 1820. It is -stated that Mr. Thompson objected to his son’s studying medicine, -believing that the profession had a sceptical tendency. Thus it was -not till he had reached the age of twenty-one, and became entitled -to some property in his own right, that the subject of this chapter -was free to pursue his chosen profession. He studied chiefly at -University College, London, and also in Paris. He obtained the M.B. -degree at London University in 1851, and the Fellowship of the -College of Surgeons in 1853, and in the same year was appointed -assistant-surgeon at University College Hospital. In 1852 and again -in 1860 he won the Jacksonian Prize at the College of Surgeons for -essays on subjects to which he had devoted much of his life-work. - -The two works on which Sir Henry Thompson’s reputation among the -medical profession chiefly rests are his “Clinical Lectures on -Diseases of the Urinary Organs,” and his “Practical Lithotomy and -Lithotrity,” both of which have gone through numerous editions; -but he has also written many smaller treatises on allied subjects, -and his articles in Holmes’s “System of Surgery” almost reach the -dimensions of separate works. His practice has grown to large -dimensions in this department, and in 1877 he was able to publish -a list with particulars of 500 cases in which he had performed -operations for stone in the bladder, being he believed the largest -ever published by an operator. The unrivalled extent, also, to which -he was enabled to utilise the experience of other surgeons, by their -communication of their cases to him, made his book on lithotomy and -lithotrity of unique value. - -Sir Henry Thompson is known to have made very large use of the -operation devised by Civiale of Paris, in 1817, for crushing -stones into powder or gravel, rendering it unnecessary to perform -the serious operation of lithotomy. Civiale’s first operations of -this kind were performed in 1824, and to him the introduction and -successful application of the method is due. The operation has been -largely improved of late years, and much of this is due to Sir -Henry Thompson. Owing to his well-known skill in this department -of practice, he was called in to the late King of the Belgians in -1863, and succeeded in affording him relief by operation, when the -most distinguished Continental surgeons had failed. The honour of -knighthood was subsequently conferred upon Mr. Thompson by Queen -Victoria in recognition of his great services to her uncle. About -this time Sir Henry became full surgeon to University College -Hospital. He has since relinquished active work at the hospital, -becoming Consulting Surgeon and Emeritus Professor. - -Sir Henry has become known to the public in connection with several -important social and religious questions. One which excited much -controversy was his letter to Professor Tyndall in regard to prayer -for the sick, which appeared in the _Contemporary Review_ in 1872. -After classifying the various objects of prayer, and considering -the possibility of testing the actual results of prayer, he says: -“There appears to be one source from a study of which the absolute -calculable value of prayer (I speak with the utmost reverence) can -almost certainly be ascertained. I mean its influence in affecting -the course of a malady, or in averting the fatal termination. For -it must be admitted that such an important influence manifestly -either does, or does not exist. If it does, a careful investigation -of diseased persons by good pathologists, working with this end -seriously in view, must determine the fact. The fact determined, -it is simply a matter of further careful clinical observation to -estimate the extent or degree in which prayer is effective. And -the next step would be to consider how far it is practicable to -extend this benefit among the sick and dying. And I can conceive few -inquiries which are more pregnant with good to humanity when this -stage has been arrived at.” - -The practical method proposed for testing the question was that -a single ward or hospital, under the care of first-rate doctors, -containing patients suffering from diseases best understood, -should be made a subject of special prayer by the whole body of -the faithful for three or five years, and that at the end of that -time the mortality should be compared with the past rates, and also -with that of other leading hospitals during the same period. But -the experiment was never tried, owing to the storm of obloquy and -controversy with which the proposal was greeted, in which scant -regard was paid to the evident good faith of the proposer. - -Sir Henry Thompson soon came before the public in a new light. Having -failed to get people to pray systematically for the sick, he next -attempted to induce them to burn their dead, a proceeding which, -as it appeared, was little less shocking to many than the former -proposition had proved. The first paragraph of his first article in -the _Contemporary Review_ (January 1874), since reprinted, with a -second on the same subject, struck a sensational key. - -“After death! The last faint breath had been noted, and another -watched for so long, but in vain. The body lies there, pale and -motionless, except only that the jaw sinks slowly but perceptibly. -The pallor visibly increases, becomes more leaden in hue, and the -profound tranquil sleep of death reigns where just now were life and -movement. Here then begins the eternal rest. - -“Rest! no, not for an instant. Never was there greater activity -than at this moment exists in that still corpse. Activity, but of a -different kind to that which was before. Already a thousand changes -have commenced. Forces innumerable have attacked the dead. The -rapidity of the vulture, with its keen scent for animal decay, is -nothing to that of nature’s ceaseless agents now at full work before -us.” - -After explaining the process of animal decomposition, and describing -the various modes of disposing of the dead between which it is -necessary to choose, the writer went on to insist that our present -mode of burial is certainly injurious to health either now or in -the future, and constitutes in reality a social sin of no small -magnitude. A curious aspect of this question was brought to light by -the mention of the large annual importation of bones for manuring -the soil, while we bury a vast quantity of human bones annually, too -deep in the earth to be useful agriculturally. The evils of burial -customs and expenditure were also dwelt upon, and then the new, yet -old plan of cremation was advocated, practically following nature’s -indication, and hastening the process so as to make it safe, without -unpleasantness. It was suggested that funeral rites could be most -appropriately associated with cremation. “Ashes to ashes, dust to -dust” would express a literal and evident fact. The condition of many -churchyards, past and present, has given conclusive evidence that the -present mode of burial consigns moist remains to water or damp, and -generates loathsome effluvia, too often causing severe disease in -those living near. - -This subject is still one of controversy, though it has emerged into -“practical politics” by reason of a decision by Mr. Justice Stephen -that cremation is not illegal under the present law. Sir Henry -Thompson continues his vigorous efforts in favour of cremation. - -Sir Henry has also distinguished himself as an advocate for great -moderation and even total abstinence in the use of intoxicating -liquors, stating that without them he can do his work better and with -more zest, and that his constitution has improved under abstinence. -Among his lighter works, “Food and Feeding” is pleasant and popular; -while a still later display of varied literary tastes is seen in -a medical novel, “Charley Kingston’s Aunt,” published under the -pseudonym of Pen Oliver. - -The artistic tastes and attainments of Sir Henry Thompson are -well known. He studied painting under Elmore and Alma Tadema, -and has frequently exhibited at the Royal Academy. He has a very -fine collection of blue and white Nankin china, of which a quarto -catalogue has been published. - - - - -CHAPTER XXIII. - -_GRAVES, HUGHES BENNETT, AND CLINICAL TEACHING._ - - -The subjects of this chapter, both men of great influence, left a -decisive mark on the systems of clinical teaching in their respective -schools of medicine, besides rendering great services to physiology -and to medicine. - -In Dublin University a Regius Professorship of Physic dates from the -time of the Restoration, and other chairs were subsequently founded. -The Irish College of Surgeons was established as late as 1784, but -nothing great came of it for many years. A Scotchman, Cheyne, settled -in Dublin, published in 1817 the first volume of the Dublin Hospital -Reports, and by the excellence of his own clinical reports on cases -of fever, gave a good tone to the work of the Irish school. But the -elevation of the Dublin Medical School to the high rank which it has -ever since maintained was the work emphatically of Robert Graves and -of William Stokes. - -The Graves family, descended from a colonel in Cromwell’s cavalry, -who had acquired considerable estates in Limerick county after -Cromwell’s subjugation of the country, was represented at the close -of the last century by the Regius Professor of Divinity in Dublin -University, and one of the senior Fellows of Trinity College, Richard -Graves, D.D. His three sons, Richard, Hercules, and Robert obtained -at the degree examinations of three successive years the gold medal -in science and in classics. - -ROBERT JAMES GRAVES, born in 1795 or 1796, after going through -a complete arts course, and such medical study as Dublin then -afforded, graduated M.B. at Dublin in 1818. He then betook himself -to other schools, and successively studied in London, in the most -celebrated Continental schools, and in Edinburgh, being away from -Dublin more than three years. He had an excellent language-faculty, -and once, having forgotten his passport, was imprisoned for ten -days in Austria as a German spy, the authorities insisting that no -Englishman could possibly speak German as he did. During his stay in -Italy, Graves, who had considerable artistic capacity, accidentally -made the acquaintance of Turner, the celebrated painter, and became -his companion on many journeys. An interesting notice of Graves’ -intercourse with Turner has been given by Professor Stokes.[14] It -appears that the two lived and travelled together for months without -either of them inquiring the name of his companion. - -On a voyage from Genoa to Sicily Graves’ courage and decision were -strikingly put to the test when the captain and crew, in a terrific -gale, were about to quit the ship in the only boat, leaving the two -passengers to their fate. Graves, though ill, seized an axe, and -stove in the boat, took command, repaired the pumps from the leather -of his own boots, and saved the ship. - -In 1821 Graves returned to Dublin, and at once took a leading -position. Dr. Stokes, for a short time his pupil, and his lifelong -friend, says of him at this time: “Nature had been bountiful to -him: he was tall in stature, of dark complexion, and with noble and -expressive features. In conversation he possessed a power rarely met -with; for while he had the faculty of displaying an accurate and -singularly varied knowledge without a shade of egotism, he was able -to correct error without an approach to offence. He had at once a -warm and a sensitive heart, and ever showed lasting and therefore -genuine gratitude for the smallest kindness. Loving truth for its -own sake, he held in unconcealed abhorrence all attempts to sully or -distort it; and he never withheld or withdrew his friendship from -any, even those below him in education and social rank, if he found -in them the qualities which he loved, and which he never omitted to -honour.” - -“It is to be observed that as his mind was open and unsuspicious, -he occasionally fell into the error of thinking aloud without -considering the nature of his audience, and of letting his wit play -more freely, and his sarcasm, when defending the right, cut more -deeply than caution might dictate.” - -During the year 1821 Graves was elected physician to the Meath -Hospital, and also became one of the founders of the Park Street -School of Medicine. At this time clinical investigation and clinical -teaching could scarcely be said to exist, and the pathological -studies of other schools were rather held in contempt. The methods -in vogue in Edinburgh had not impressed Graves favourably. Students -were not then regularly called upon to investigate cases for -themselves, nor trained in so doing: they might obtain their degree -without having ever practised diagnosis or co-operated in curing -disease even to the extent of writing a prescription. “Often have -I regretted,” said Graves in his introductory lecture at the Meath -Hospital in 1821, “that, under the present system, experience is only -to be acquired at a considerable expense of human life. There is, -indeed, no concealing the truth—the melancholy truth, that numbers of -lives are annually lost in consequence of maltreatment. The victims -selected for this sacrifice at the shrine of experience, generally -belong to the poorer classes of society, and their immolation is -never long delayed when a successful candidate for a dispensary -commences the discharge of his duty. The rich, however, do not always -escape; nor is the possession of wealth in every instance a safeguard -against the blunders of inexperience.” - -After commenting on the evil effects of ignorant dogmatism in those -of riper years, Dr. Graves went on to expound the plan of Continental -clinical instruction. He then alluded to the coarse, harsh, and even -vulgar expressions made use of towards hospital patients by Irish -medical men of the day, insisting on the necessity of reform in this -respect. - -The plan that Graves adopted and worked so successfully, essentially -consisted in giving to the advanced students charge over particular -patients, requiring them to report upon the origin, progress, and -present state of their diseases. At the bedside these particulars -were verified or challenged by the physician; and then in the -lecture-room he discussed with the class the diagnosis, prognosis, -and treatment of the cases. The pupil in charge prescribed for the -patient, and his prescription was revised and corrected by the -physician. The advantages of this system were obvious; students being -obliged to give reasons for every plan of cure, became accustomed -to a rational and careful investigation of disease, and enjoyed the -great benefit of the early correction of their errors. - -Nevertheless the system met with much opposition, and even ridicule. -As Stokes says, the student was then kept at a distance; no one cared -to show him how to teach himself, to familiarise him with “the ways -of the sick,” to train his mind to reason, and to inculcate the duty -as well as the pleasure of original work. - -Graves had both knowledge and eloquence; his style was massive, -nervous, and forcible; he could command the minds of his hearers, -and he showed himself thoroughly in earnest. “His active mind -was ever on the search for analogies, and thus he was led to the -discrimination of things apparently similar, and to the assimilation -of things at the first view dissimilar, in a degree hardly surpassed -by any teacher of medicine.” - -Having been elected a Fellow of the King’s and Queen’s College of -Physicians, Graves was subsequently appointed Professor of the -Institutes of Medicine. In this capacity he gave lectures in which -physiology was ably applied to the wants of medical students. In -the years 1828-36 he contributed many physiological essays, chiefly -to the _Dublin Journal of Medical Science_, of which he was one of -the editors till his death, on such subjects as “The Distinctive -Characters of Man,” “The Chances of Life,” “Temperament and -Appetite,” “The Sense of Touch,” &c., all interesting. But it was -not till 1843 that he published the work on which his reputation as -an author chiefly rests, his “Clinical Lectures on the Practice of -Medicine.” In relation to this one needs no higher authority in its -favour than that of Trousseau, who addressed to the translator of the -French edition a letter from which we make the following extracts. - -“I have constantly read and re-read the work of Graves; I have become -inspired with it in my teaching.... The lectures on scarlatina, -paralysis, pulmonary affections, cough, headache, have acquired -an European reputation.... When he inculcated the necessity of -giving nourishment in long-continued pyrexias, the Dublin physician, -single-handed, assailed an opinion which appeared to be justified -by the practice of all ages, for low diet was then regarded as an -indispensable condition in the treatment of fevers. Had he rendered -no other service than that of completely reversing medical practice -upon this point, Graves would by that act alone have acquired an -indefeasible claim to our gratitude.” - -“On the other hand, I cannot sufficiently recommend the perusal -of the lectures which treat of paralysis; they contain a complete -doctrine, and this doctrine has decisively triumphed. The sympathetic -paralyses of Whytt and Prochaska have now their place assigned in -science, under the much more physiological name of reflex paralyses.” - -“Graves is a therapeutist full of resources.... There is not a day -that I do not in my practice employ some of the modes of treatment -which Graves excels in describing with the minuteness of the true -practitioner, and not a day that I do not, from the bottom of my -heart, thank the Dublin physician for the information he has given -me.” - -“Graves is in my acceptation of the term a perfect clinical teacher. -An attentive observer, a profound philosopher, an ingenious artist, -an able therapeutist, he commends to our admiration the art whose -domain he enlarges, and the practice of which he renders more useful -and more fertile.” - -In 1843 and 1844 Graves was President of the Irish College of -Physicians, and was elected a Fellow of the Royal Society in 1849. He -was led by his experience to hold strongly the belief that typhus and -typhoid were not distinct fevers. His great service to the treatment -of fevers is however independent of this. He recognised the ill -effects of a lowering system upon fever patients, and steadily set -himself to maintain the patient’s strength by food and stimulants. -One day he was going round the hospital, when on entering the -convalescent ward he began to expatiate on the healthy appearance of -some who had recovered from severe typhus. “This is all the effect -of our good feeding,” he exclaimed; “and lest, when I am gone, you -may be at a loss for an epitaph for me, let me give you one, in three -words:— - - “HE FED FEVERS.” - -Graves’s papers on Cholera embodied in his Clinical Lectures give -an able history of the progress of that disease, and his researches -led him to urge the foundation of a complete network of medical -observatories to record especially the rise, progress, and character -of disease, whether endemic or epidemic. Had he lived he might have -done much to promote this object, only now and partially being -attempted in the collective scheme for the investigation of disease -under the auspices of the International Scientific Congress. But his -labours shortened his life. He constantly corresponded with pupils -all over the world; wrote much for periodical literature on subjects -outside medicine, even doing the literary work of a patient whose -family were in straitened circumstances. A disease of the liver -finally cut him off, after a protracted illness borne with Christian -fortitude and faith, on March 20, 1853. - - * * * * * - -Having been a leading teacher at Edinburgh for many years, JOHN -HUGHES BENNETT impressed his individuality upon a larger number of -students, and has been more generally recognised than Graves as a -man of conspicuous merit. As a clinical teacher, as a physiologist, -as a pathologist, as a therapeutist, he had high claims. He reformed -the treatment both of pneumonia and of phthisis, and identified -a disease, leucocythæmia, whose characters have proved the -starting-point for most fruitful investigations. - -Bennett was born in London on August 31, 1812, and educated at the -Grammar and Mount Radford Schools, Exeter. He was fortunate in having -a cultivated mother, a lady of independent thought and spirit, and -to her he owed the development of his marked literary and artistic -tastes. As a boy she trained him in elocution, in which he afterwards -excelled, and widened his thoughts by taking him again and again to -the Continent. - -Deciding to study medicine, young Bennett was apprenticed to a -Mr. Sedgwick of Maidstone, and for a short time attended St. -Bartholomew’s Hospital. A little later, however, he decided to -enter at Edinburgh University, and soon showed himself an assiduous -student. He made the acquaintance of Edward Forbes, J. H. Balfour, -John Reid, and others, who afterwards distinguished themselves, -and became one of the Presidents of the Royal Medical Society. In -1837 he took the M.D. degree, being awarded a gold medal, on Syme’s -recommendation, for the best surgical report, and being mentioned as -worthy of a second medal by Sir Charles Bell. - -Bennett next studied for two years in Paris, founding the Parisian -Medical Society, of which he was the first president. Other two years -he devoted to study in German medical schools. The microscope and the -stethoscope became in his hands familiar implements of research, and -he already began to give forth the results of his study, contributing -to Tweedie’s “Library of Medicine” a large proportion of the second -volume dealing with diseases of the nervous system. - -Bennett returned to Edinburgh in 1841, and on the 1st October -published “Treatise on the Oleum Jecoris Aselli, or Cod-liver Oil, -as a Therapeutic Agent in certain Forms of Gout, Rheumatism, and -Scrofula, with Cases.” His knowledge of this remedy had been acquired -in Germany, where cod-liver oil was being used in the treatment -of these diseases. Its use had however long been known among the -Scotch fishing folk, and Drs. Kay and Bardsley had many years -before prescribed it in the Manchester Infirmary. The publication, -however, stagnated, and there was added in 1847 to the remaining -copies an appendix of cases benefited by cod-liver oil. By this time -its administration was decidedly on the increase, and one firm of -druggists in Edinburgh had sold six hundred gallons in the preceding -year, as compared with one gallon in 1841. At the same time Dr. C. J. -B. Williams was introducing purer forms of the oil in London, as we -have already related, and by his writings and practice and study of -cases of pulmonary consumption did very much to promote its general -use. - -In November 1841 Bennett started a course of lectures on histology -at Edinburgh, in which he illustrated physiology and pathology by -microscopical preparations: he also formed classes for private -instruction in microscopical manipulation. At that time minute -changes in structure were generally overlooked, and to Bennett -belongs the credit of first giving such instruction in a systematic -form. He strongly desired to gain the chair of General Pathology at -Edinburgh, which was vacant in 1842, but he was unsuccessful. - -When he was soon afterwards appointed physician to the Royal -Dispensary, Bennett had an opportunity of putting into practice -what he had learnt in Germany, by establishing what he called a -polyclinical course, his students being taught practically, under -the eye of the teacher, to examine and prescribe for patients. It -must not be forgotten, however, that Syme had previously introduced -a somewhat similar procedure at his Minto House (Surgical) -Hospital. As Pathologist to the Royal Infirmary, Bennett had great -opportunities of studying morbid specimens, and he got together a -large pathological collection. He further gave courses of lectures on -pathology. - -For many years Bennett took a large part in maintaining the literary -activity of the Edinburgh School. Many papers by him appeared in the -_London and Edinburgh Monthly Journal of Medical Science_, of which -he subsequently was part and sole proprietor two or three times, -being so lucky as to make a profit on each of his transactions. - -In 1848 Dr. Bennett was unanimously elected Professor of the -Institutes of Medicine (_i.e._, Physiology) at Edinburgh. In this new -work he was soon conspicuous for the practicality of his teaching, -and for his continual introduction of matters bearing on pathology -and medicine. He made every lecture a complete study, enriching -it with all the appliances, material and artistic, that he could -command, and embellishing it by finished elocution. He would now -and again lay aside his manuscript to comment upon, and frequently -to denounce, the opinions of others, by which course he made -enemies, for he was not sufficiently measured in his treatment of -opponents. Yet it might safely be said that he was not actuated by -personal hostility, but only by antagonism of view. Still he was too -favourable to his own work, and did not adequately appreciate other -men. The general student enjoyed those peculiarities of Dr. Bennett -of which he did not himself feel the brunt, but in the clinical -class or in the examination hall his unsparing logical acumen tasked -the student mind somewhat severely, and he was a generally dreaded -examiner. - -From the peculiar organisation of Edinburgh work Bennett was expected -to be a clinical teacher of medicine as well as a professor of -physiology; thus the importance of his work in the infirmary was as -great as that in the lecture-room. He was a clinical teacher of the -highest order—nothing was suffered to pass unnoticed. All methods -of inquiry into the patient’s case were diligently taught to the -students, who were led to observe precisely and methodically for -themselves. He would test and stimulate his pupils[15] most acutely -by disputation, questioning, and argument; and he thus trained a body -of men who carry his impress into all their work. - -In 1845 Dr. Bennett published a case of “Hypertrophy of the -Spleen and Liver,” which is the first recorded case of a disease -characterised by a great abundance of white corpuscles in the blood, -now known as leucocythæmia. Although Bennett did not at first -recognise its true nature, his description and subsequent labours -did much to elucidate the disease, and his name must be honourably -associated with the subject. - -Perhaps, however, the greatest service Bennett rendered to medicine, -independently of his promotion of the use of cod-liver oil in -phthisis, is his strong protest against the lowering treatment in -pneumonia and other inflammatory diseases. On this point the _Lancet_ -(October 9, 1875) says: “He reduced the mortality of uncomplicated -pneumonia to _nil_. He demonstrated, not only the dispensableness, -but the injuriousness, of the antiphlogistic treatment which had -ruled the best minds of the civilised world for ages. Doubtless other -physicians were working in the same direction even before Bennett, -but he devised a treatment of his own which has given most brilliant -results, and he adhered to it and to the pathological views on which -it was based so steadily and over so long a series of years as to -establish its truth, and so largely revolutionise the practice of -medicine in acute diseases.” Dr. Bennett’s later attacks on the -mercurial treatment of liver diseases were almost equally strong with -that on bleeding and the antiphlogistic methods, but being undertaken -late in life did not leave such an impression. - -Dr. M’Kendrick gives in the _British Medical Journal_, October 9, -1875, a list of no fewer than 105 papers and memoirs by Bennett. -Among his larger works were “An Introduction to Clinical Medicine;” -“Lectures on Clinical Medicine,” 1850-6, which were entitled in -later editions “Clinical Lectures on the Principles and Practice -of Medicine.” Of this his principal work, six editions were -published during his lifetime in the United States, and the book -has been translated into French, Russian, and Hindoo. “Outlines -of Physiology” appeared in 1858, and a Text-book of Physiology in -1871-2. His works on Cancerous and Cancroid Growths, on the Pathology -and Treatment of Pulmonary Tuberculosis, and on the Restorative -Treatment of Pneumonia, will of course be consulted as containing -authoritative statements of his views on these important subjects. -He wrote the article on Phthisis in Reynolds’ “System of Medicine,” -Reports on the Action of Mercury on the Liver, and Researches on -the Antagonism of Medicines, as reports to the British Medical -Association, 1867-1875. - -Dr. M’Kendrick, some time Bennett’s assistant and deputy, says of -him:[16] “Professor Bennett was a man of clear and logical intellect. -What he wanted in breadth of view he gained in penetrative power. Few -could grasp more quickly the essentials of a subject, or perceive -sooner or more accurately the real point at issue. _Method_ was the -prevailing quality of his mind which guided him as a teacher.... -He wanted patience with details, the power of positive scientific -expression, and the faculty of taking a wide view of all the facts -bearing on what was immediately under discussion. He assumed an -attitude of scepticism to all questions until fairly convinced.” - -“His tendency to indulge freely in critical and sarcastic remarks -upon the works of others did not make him a general favourite with -some of his professional brethren, consequently he never attained -a large practice as a consulting physician, which was from other -considerations his due. He was too much a reformer, too pronounced -and outspoken in his opinions; he had too much identified himself -with certain lines of thought; and it must be confessed that he did -not possess that indefinable manner which inspires confidence both in -patient and in practitioner alike.” - -“By those who knew him best Dr. Bennett was much beloved. He shone -in the social circle, where his love of music and power of brilliant -conversation cast a radiance through the room.” - -In 1855 Bennett unsuccessfully competed for the chair of the Practice -of Physic at Edinburgh, and he felt his non-success very much. For -the next ten years he continued in active work, but in 1865 began -to suffer severely from a bronchial and throat affection. Later he -was attacked by diabetes, and had to spend several winters on the -Continent. In 1874 he resigned his professorship. In August 1875 he -was gratified by receiving from Edinburgh the LL.D. degree, his bust -by Brodie being presented to the University by former pupils. He -was operated on for stone in September following at Norwich, by Mr. -Cadge, and died on September 25th, being buried at Dean Cemetery, -Edinburgh, by the side of his friends, Goodsir and Edward Forbes. His -wife, son, and four daughters survived him. - - -FOOTNOTES: - -[14] Biographical Notice, prefixed to Graves’ “Studies in Physiology -and Medicine,” 1863. - -[15] _Edinburgh Medical Journal_, October 1, 1845. - -[16] _Edinburgh Medical Journal_, November 1875, p. 473. See also -_British Medical Journal_, October 9th, 1875. - - - - -CHAPTER XXIV. - -_CONOLLY, MAUDSLEY, AND MENTAL DISEASES._ - - -The modern realisation of the association of mental with physical -health, the annexation to the sphere of biology of the phenomena of -mind, and the concurrent comprehension of the true attitude of the -physician towards mental diseases, have doubtless put into the shade -achievements less than a century old, and some of them dating from -only fifty years ago. Yet the simple discontinuance of the system of -restraint practised from time immemorial on almost all lunatics was -perhaps a greater practical revolution than the biological one just -referred to; and England stands in the forefront of this revolution. - -The old lunatic asylums of this country were objects of dread and -repulsion. Severity was considered to be an absolute necessity in -their management. “The affrighted visitors,” says Conolly,[17] -“saw that many were furious ... and it never occurred to them that -habitual severity was the real cause of the habitual fury.” New -Bethlem in Moorfields two centuries ago was a place of chains, -manacles, and stocks. Down to 1770 the inmates were exhibited to the -public at a charge of twopence, afterwards reduced to one penny. - -The medical profession had become accustomed to neglect mental -diseases, and to acquiesce in severe treatment. Cruelty became -developed in ingenious forms. In some Continental asylums patients -were terrified by the gradual ascent of water in a well in which -they were chained. Machines were imagined by which a newly arrived -lunatic could suddenly be raised to the top of a tower, and as -suddenly lowered into a deep dark cavern; “if the patient could be -made to alight among snakes and serpents, it would be better still.” -A revolving chair was invented, in which the victim could be strapped -and made to gyrate at the rate of one hundred revolutions per minute. -This was eulogised as a potent means of quieting the unmanageable, -and was supposed to induce the melancholy to take “a natural interest -in the affairs of life.” We can only make this passing allusion to -the way in which ingenuity was exhausted in devising methods of -restraint and torture. - -Nothing could have been worse than the condition of the Bicêtre and -the Salpêtrière, the two large asylums of Paris, when Pinel was in -1793 appointed to the former by Cousin, Thouret, and Cabanis, then -newly appointed administrators of the Parisian hospitals. Damp, -dark cells, infested by rats, contained dirt-coated beings whose -only comfort was a little straw, chained, brutally ill-treated, -and attended by brutal criminals. For nearly ten years previously -Pinel’s attention had been directed to the treatment of the insane, -and now, in spite of difficulties which officials threw in his way, -he succeeded in loosening the chains and ameliorating the treatment -of the majority of the patients. Yet his reforms nearly cost him -his life. Rumours were spread accusing him of some evil motive in -unchaining dangerous lunatics, and a mob one day seized him, and -uttered the well-known terrible cry “_à la lanterne!_” An old soldier -of the French Guard, once a lunatic, whom he had released from -chains, cured, and employed in his own service, was appropriately the -means of his rescue. Thus was philanthropy once more justified of her -children. - -At this very period English public opinion had been excited by -revelations of cruelty and consequent deaths in the old York Asylum. -In 1791 a lady belonging to the Society of Friends was placed in -this asylum; her friends were refused admission to visit her, and in -a few weeks she died. Inquiries that were made showed great grounds -for suspicion, although full details could not be obtained.[18] But -with great promptitude William Tuke, a prominent Friend at York, -whose family has continued famous for attention to the affairs of the -insane, proposed early in 1792 the establishment of a “Retreat” at -York for insane patients, in which sympathy should be substituted -for unkindness, severity, and stripes. The account given by Samuel -Tuke in 1813 of its management is still a model in many respects.[19] - -Neither Pinel nor the Tukes were however bold enough entirely to -dispense with mechanical coercion. In 1818 Esquirol, the true -successor of Pinel in France, found maltreatment still generally -prevalent in the provincial asylums of France. In England mechanical -restraint continued to be largely employed till Conolly’s time, -and survives in some private asylums to the present day. We cannot -give further details on this head, but hasten to mention the names -of two men, Dr. Charlesworth and Mr. Gardiner Hill, who must ever -be remembered as the first to give up mechanical coercion entirely -in the small asylum of Lincoln. Dr. Charlesworth, physician to -the asylum, had for many years diligently watched the effects of -mechanical coercion, and gradually lessened the number of instruments -of restraint in the asylum. Finally, the total disuse of mechanical -restraints was decided on, and put in practice by Mr. Gardiner Hill -in 1836 in concert with Dr. Charlesworth, with the most gratifying -results. - - * * * * * - -We now come to the man who more than any other in England may be -said to have established the non-restraint system so firmly that -it will never be upset. JOHN CONOLLY was born at Market Rasen in -Lincolnshire, in 1794. His father, a member of a good Irish family, -died young, and the care of a young family fell on his widow, whose -maiden name was Tennyson, and whose patience and self-sacrifice -her son ever affectionately acknowledged as the main influence -which led to his own success. When his mother ultimately married a -French gentleman, a political emigré, the latter taught his stepson -French, and imbued him with a genuine taste for and knowledge of -the language. Condillac’s essay “On the Origin of Human Knowledge” -influenced his mental life. While in his teens his attention was -first called to the subject of lunacy by an inspection of the Glasgow -Asylum, and he never afterwards ceased to take the deepest interest -in it. - -At eighteen young Conolly became an officer in a militia regiment, -in which capacity he served several years. While still young, he -married in 1816 the daughter of Sir John Collins and went to reside -in France, on the banks of the Loire. A year later he had decided -to enter the medical profession, and in 1817 became a student at -Edinburgh University. After a diligent career, in the course of -which he was one of the presidents of the Royal Medical Society, he -graduated M.D., and settled in practice as a physician at Chichester. -Here he became intimately acquainted with Dr. (afterwards Sir John) -Forbes, with whom he was afterwards much connected in literary -matters. - -Dr. Conolly did not remain very long at Chichester, but removed in -1823 to Stratford-on-Avon, where he wrote many contributions to and -took part in editing the “Cyclopædia of Practical Medicine,” and the -_British and Foreign Medical Review_. At Stratford he became alderman -and mayor, established a public dispensary, and studied Shakespeare -with enthusiasm. This occasioned him afterwards, while practising at -Warwick in 1835, to take an active part as chairman of the committee -formed for securing the preservation of Shakespeare’s tomb, and the -restoration of the chancel of the church. - -In 1827 Dr. Conolly was appointed Professor of the Practice of -Medicine in London University, which appointment he only held four -years, finding life as a London physician unsuitable to his tastes. -In 1831 he again resorted to the country, establishing himself in -Warwick. - -The subject of insanity had long engaged Dr. Conolly’s attention. He -had studied the question both abroad and at home, and had been for -five years, (while residing at Stratford) inspecting physician to the -Lunatic Houses for the County of Warwick, an office which he resumed -when he settled in Warwick. He had unsuccessfully proposed to the -council of the University that he should give his pupils clinical -instruction on insanity in one of the lunatic asylums in London. -“Thus,” says Sir James Clark,[20] “clinical instruction in mental -diseases was thrown back for thirty years in this country.” - -In 1830 Conolly published his valuable work, “An Inquiry concerning -the Indications of Insanity, with Suggestions for the better -Protection and Care of the Insane.” His objects were to render -the recognition of insanity less difficult, by showing in what it -differed from those varieties of mind which approached nearest to it; -and to point out those circumstances which, even in persons decidedly -insane, could alone justify various degrees of restraint. He lamented -that during a student’s career he only saw cases of insanity by -some rare accident. Every lunatic asylum was closed to him, and -yet when qualified he might any day have to decide on a patient’s -insanity. In view of some recent revelations a quotation from the -introduction to this work (p. 3) is not inappropriate. “The timidity -or ignorance, or it may be, a dishonest motive, of relatives, leads -to exaggerated representations; and the great profit accruing from -a part of practice almost separated from general medicine, cannot -but now and then operate against proper caution in admitting such -representations. When men’s interests depend upon an opinion, it is -too much to expect that opinion always to be cautiously formed, or -even in all cases honestly given. The most respectable practitioners -in this department openly justify the authorising of restraint before -the patient is seen, and on the mere report of others; and it seems -that depositions to the insanity of individuals have been received -in courts of law, concerning persons with whom the deponents have -never had an interview; and that on these depositions proceedings -have been partly founded, of which the results were the imprisonment -of lunatics, and restraint over their property. When the affair is -conducted with more formality, and the suspected person is visited -before being imprisoned, those who visit him are often very little -acquainted with mental disorders, and come rather to find proofs of -his insanity, which, to minds pre-possessed, are seldom wanting, than -cautiously to examine the state of his mind.” - -“If a person of sound mind were so visited, and knew of the visit -beforehand, it would not be quite easy for him to comport himself, -so as to avoid _conviction_ that he was _not_ of sound mind. His -indignation would pass for raving; his moderation for the proverbial -cunning of a lunatic.” - -After describing the condition of asylums and lunatics at that time, -the author considers the constitution of the human understanding and -the inequalities, weaknesses, and peculiarities of mind which do not -amount to understanding, and the influence of stimuli, of age, and -of disease on the mind, and then discusses the phenomena of insanity -and the questions of treatment and protection. He insists on the -necessity of the most scrutinising watchfulness over the servants -employed in their care. In cases where patients would do themselves -or others an injury he insists on watching, instead of mechanical -means of restraint. He proposes a complete scheme for the care of all -lunatics by the State, providing for perfect publicity of procedure. -He finally points out the increasing liability of the nervous system -to disorganisation owing to the increased pressure and more varied -anxieties of modern life, an observation most fully justified by what -has been established since his day. - -This work, a most readable and interesting one, both to medical men -and to general readers, was not received with nearly sufficient -warmth. Too many were wedded to the old systems of treatment; too -many knew nothing about the diseases of the mind, and their sympathy -could not be aroused in favour of lunatics. So Conolly was left -to his country work at Warwick, varied by one year’s residence at -Birmingham, till 1839, when he was appointed Resident Physician to -the Middlesex County Asylum at Hanwell, at that time the largest in -England. He had taken the opportunity of visiting the Lincoln Asylum -and gaining all the advantages possible from its experience. He was -now satisfied that mechanical restraint was not only unnecessary, but -possibly injurious. On few others had the non-restraint system gained -a hold. Hanwell had the reputation of being one of the best-managed -asylums in England, many patients being occupied in agricultural and -other pursuits. Yet one year after Sir William Ellis’s resignation, -when Conolly took office, “instruments of mechanical restraint of -one kind or other were so abundant in the wards as to amount, when -collected together, to about six hundred, about half of them being -handcuffs and leg-locks.” - -Conolly entered upon his duties on the 1st June 1839. The asylum -then contained 800 patients, and he found forty under continuous -mechanical restraint. In his first report to the Quarter Sessions, -he informed the Justices that since the 21st of September not one -patient had been under restraint. “No form of strait waistcoat, no -handcuffs, no leg-locks, nor any contrivance confining the trunk, or -limbs, or any of the muscles, is now in use. The coercion chairs, -about forty in number, have been altogether removed from the wards.” -In fact, they had been cut up to make a floor for the carpenter’s -shop. - -This was not accomplished without some trouble and anxiety. It took -time to indoctrinate the officers and attendants with the principles -of the new system, in which they were deprived of their old prop. The -aid which he received from Miss Powell the matron was most valuable. -In ten years not one case was admitted to Hanwell in which mechanical -restraint was deemed necessary, although many suicidal patients were -among them. In fact, the removal of restraint tended directly and -powerfully to promote the recovery of these, by taking away the sense -of degradation occasioned by such restraint, by bringing them within -the sphere of medical remedial agents and of cheerful influences. The -only substitutes allowed were in some cases seclusion of a patient in -an ordinary sleeping apartment, and, in extreme cases, in a padded -room in which the floor was a bed; such seclusion being immediately -reported to the medical officers, and recorded, even when continued -only for a few minutes. This was found sufficient to protect the -other patients, to calm the refractory one, and act as a tonic and -remedial influence. The shower-bath was rarely resorted to except -for medical reasons; window-guards, clothing, and bedding of strong -materials to prevent tearing, were only required in a few cases. “The -great and only real substitute for restraint is invariable kindness,” -says Dr. Conolly. “This feeling must animate every person employed in -every duty to be performed.” - -Dr. Conolly published the main results of his experience in his -Clinical Lectures in the _Lancet_ in 1846, and in a work on the -Construction and Government of Asylums, in 1847. His annual reports -to the Justices detailed the progress of his system, and he -afterwards summarised them and published them collectively. At the -end of ten years, finding the non-restraint system in no danger -of being abandoned at Hanwell, Dr. Conolly ceased to be resident -physician, and became visiting physician, attending at the asylum -twice a week, and spending the greater portion of the day there. His -interest in the patients, says Dr. Hitchman, seemed never to flag. -He would always look out for something to commend in a patient, the -hair better kept, clothes more neatly worn, &c., and addressing the -patients in the most gentle, affectionate tones, he made his visits -always a matter of longing. The old attendants at the hospital in -after years spoke of Dr. Conolly’s untiring watchfulness in the first -years of his experiment. He would visit the wards at all hours of the -night to see that his orders were being obeyed, walking noiselessly -along the corridors. He was kept up in his arduous duties by an -elevated religious principle. “I feel grateful to God,” he wrote, -“who has intrusted duties to me which angels might stoop to perform.” -He suffered greatly from an affection of the skin, which kept him -awake at night and ill at ease during the day; and hence was liable -to fits of depression and irritability which sometimes made him -appear impatient. - -In 1852, on his resignation of the appointment of visiting physician, -Conolly’s connection with Hanwell practically ceased, and a piece -of plate and his own portrait by Sir W. Gordon were presented to -him at a public meeting by Lord Shaftesbury. In his reply on this -occasion Dr. Conolly said: “Those who know me well will believe me -when I say there never was an occasion when the sense of merit was -less reflected from the breast of the recipient of a public honour, -than it is from me at this moment.” He further stated that when he -had first heard of the establishment of Hanwell Asylum, he was seized -with a restless desire to become one day its head. - -Many objects of philanthropy had Dr. Conolly’s untiring advocacy, -both before and after his retirement from Hanwell. Public -middle-class lunatic asylums, the education of medical men in mental -diseases, the establishment of idiot asylums, especially that at -Earlswood, were among these. He was the first doctor applied to -by Mrs. Plumbe in regard to the foundation of Earlswood, and his -co-operation with Dr. Andrew Reed was of the most essential service -to the enterprise. - -Dr. Langdon Down, formerly Medical Superintendent at Earlswood, wrote -in regard to Conolly: “His visits were the most refreshing incident -of my recollection in connection with the asylum. Entering on my -work (in 1858) as an untried man, and finding myself allied to an -institution which had become unpopular at the Lunacy Board, I was -mainly decided on holding a position which had so much to overwhelm -one by the influence of Dr. Conolly. That influence was magical. The -humility of his character was only equalled by the real love he -manifested for the mentally afflicted. - -“At the visits of the Board of Management, he would steal away from -his colleagues, and was to be found holding loving intercourse -with the little members of my charge in a way that one has never -seen before or since. Moreover, he so encouraged every official -in his or her work, that the savour of his visit lasted till -he again returned.... For myself, I have often had to seek his -counsel, and never without being struck with his judgment and the -fascination of his influence, the high resolve he inspired in one, -and what willingness he exhibited to maintain, co-equally with the -responsibility, the power of the Medical Superintendent, and thus -to prevent a repetition of those evils which he had so bitterly to -lament in his own experience.” - -The years after Conolly left Hanwell were busily occupied with a -large practice, especially in mental cases. In a few years his -unceasing labour told on him, and he suffered much from chronic -rheumatism and neuralgia. Finally he was compelled to retire from -practice, when he took up his residence at Lawn House, Hanwell, -whence he could see the asylum in which he had spent so many -anxious hours. He finally lost mental energy, and was unable to -complete several treatises and records of experience which he -was contemplating. He, however, left an enduring memorial of his -life-work in “The Treatment of the Insane without Mechanical -Restraints,” 1856, written in a most readable style. We must not -omit to mention his courses of lectures on Insanity at the College -of Physicians and at the Royal Institution, his papers on Infantile -Insanity, and finally “A Study of Hamlet,” in which he brings the -most skilfully marshalled arguments to prove that Hamlet’s was a -real and not a feigned madness. As to Hamlet’s treatment of Ophelia -in Act II., Scene 1, and more especially in the scene where Hamlet -and Laertes met over her grave, he remarked; “The picture of madness -here is too minutely true, its lights and shades are too close to -nature to have been painted as a mere illustration of feigning, -and of feigning without intelligible purpose.” Both Sir Theodore -and Lady Martin (Miss Helen Faucit) considered his exposition most -satisfactory, and that it settled the question finally. - -Conolly was carried off, after years of weakness, by an attack of -paralysis with convulsions, which was fatal in a few hours, on March -5, 1867. Few have left behind them a brighter record as physician and -philanthropist. - - * * * * * - -Improvement in the treatment of the insane and the knowledge of -mental diseases has progressed rapidly in late years, owing to the -efforts and studies of many workers, among whom Drs. Bucknill, -Tuke, Hood, Lockhart Robinson, and Forbes Winslow are conspicuous. -The record of their work would lead us into too wide a field. -But the life-work of one of the sons-in-law of Dr. Conolly, HENRY -MAUDSLEY, is of a character which for good or ill has exerted, and is -exerting, a powerful influence on younger minds. We come here into -a region of work influenced by the philosophy of Darwin and Herbert -Spencer, applied to the physiology and pathology of mind, and to the -relationship between body and mind. The time is not yet come for -an impartial estimate of the striking works which Dr. Maudsley has -brought forth in fertile succession, in addition to his extensive -labours as one of the editors of the _Journal of Mental Science_. But -it is certain that every one who would place himself in a position -to estimate the strength of the so-called “materialistic” school, -whether he be a metaphysician, a doctor, or a person of average -culture, must read Dr. Maudsley’s works. They are written fearlessly, -and for the most part with admirable lucidity, displaying a knowledge -of literature and philosophy not often met with, combined with great -practical experience in mental phenomena. - -Henry Maudsley was born near Giggleswick, in Yorkshire, on February -5, 1835. After receiving his early education at Giggleswick School, -he proceeded to University College, London, and took the M.B. degree -at London University in 1856, with the distinction of University -Scholar in Medicine. He proceeded to the M.D. degree in 1857. During -the years 1859-1862 he was Resident Physician to the Manchester -Royal Lunatic Hospital. Returning later to London he became for a -time Professor of Medical Jurisprudence at his old college, and later -Consulting Physician to the West London Hospital. - -In an article on “The Theory of Vitality,” which Dr. Maudsley -published in the _British and Foreign Medico-Chirurgical Review_ in -1863 (republished in “Body and Mind,” 1870), he showed remarkable -power for a young man of twenty-eight. His conclusion was that -the conscious mind of man blends in unity of development with the -unconscious life of nature. He looked for the harmonisation of the -idealism of Plato and the realism of Bacon as the expressions of the -same truths. - -In 1867 Dr. Maudsley published an important work on the Physiology -and Pathology of Mind. It was intended to treat of mental phenomena -from a physiological rather than from a metaphysical point of view -and secondly, to bring the manifold instructive instances presented -by the unsound mind to bear upon the interpretation of the obscure -problems of mental science, and to do what he could to put an end to -the inauspicious divorce between the two branches of his subject. -He energetically exposed the shortcomings of psychologists and -metaphysicians, and naturally encountered severe criticism, and it -may be allowed that some of his expressions were those of youthful -enthusiasm rather than of matured wisdom. But the book had such -merits, that a second edition was called for in the next year, and -before long exhausted, after which the book was out of print for some -years. - -At length Dr. Maudsley republished in a modified form the “Physiology -of Mind” in a separate volume of 550 pages (1876), putting it -forward as a disquisition, by the light of existing knowledge, -concerning the nervous structures and functions which are the -probable physical foundations of those natural phenomena, which -appear in consciousness, or feelings, and thoughts. In this work he -says (p. 47) “that the subjective method—the method of interrogating -self-consciousness—is not adequate to the construction of a true -mental science has now seemingly been sufficiently established. That -is not to say that it is worthless; for when not strained beyond its -capabilities, its results must, in the hands of competent men, be as -useful as they are indispensable.... That which a just reflection -teaches incontestably, the present state of physiology illustrates -practically. Though very imperfect as a science, physiology has made -sufficient progress to prove that no psychology can endure except it -be based upon its investigations.” - -Meanwhile Dr. Maudsley had been called upon in 1870 to deliver the -Gulstonian Lectures at the College of Physicians, and these were -published in a small book under the title “Body and Mind: an Inquiry -into their Connection and Mutual Influence, specially in Reference -to Mental Disorders.” The first lecture expounded the physical -conditions of mental function in health; the second described some -forms of mental degeneracy which showed prominently the operation of -physical causes from generation to generation, and the relationship -of mental disorders to other diseases of the nervous system. The -third included a general survey of the pathology of the mind, and the -relations of morbid states of body to disordered mental function. - -Meanwhile some important medico-legal cases had brought into -prominence Dr. Maudsley’s belief that there are many forms of -mental disease in which a patient ought not to be held criminally -responsible for his actions, although he might be fully cognisant of -their nature. This was definitely expressed as far back as 1864 in a -pamphlet entitled “Insanity and Crime,” a medico-legal commentary on -the case of George Victor Townley, by the editors of the _Journal of -Mental Science_. It was in 1872 more fully developed by Dr. Maudsley -in his “Responsibility in Mental Disease,” which has gone through -numerous editions. - -In 1879 the “Pathology of Mind” appeared in a separate and enlarged -form, and contains a systematic exposition of the subject, introduced -by an account of sleep, dreaming, somnambulism, and allied states. -He then proceeds to deal with the causation of insanity, both social -and material, and then further expounds the symptoms of insanity, -treating it as one disease with varied manifestations, and then -delineating the clinical groups of mental disorders met with in -practice and which the physician has to deal with. One great merit -of the book is, that the clinical pictures it contains are drawn from -life. An extract from chapter iv., dealing with the influence of -conditions of life on the production of insanity, will show how at -every step Dr. Maudsley introduces considerations bearing on morality. - -“The maxims of morality which were proclaimed by holy men of old as -lessons of religion indispensable to the well-being and stability of -families and nations, are not really wild dreams of inspired fancy, -nor the empty words which preachers make them; founded on a sincere -recognition of the laws of nature working in human events, they -were visions of eternal truths of human evolution. Assuredly the -‘everlasting arms’ are beneath the upright man who dealeth uprightly, -but they are the everlasting laws of nature which sustain him who, -doing that which is lawful and right, leads a life that is in -faithful harmony with the laws of nature’s progress; the destruction -which falls upon him who dealeth treacherously and doeth iniquity, -‘observing not the commandments of the Lord to obey them,’ are the -avenging consequences of broken natural laws. How long will it be -before men perceive and acknowledge the eternity of action, good -or ill, and feel the keen sense of responsibility, and the strong -sentiment of duty which so awful a reflection is fitted to engender? -How long before they realise vividly that under the reign of law on -earth sin or error is inexorably avenged, as virtue is indicated, -in its consequences, and take to heart the lesson that they are -determining in their generation what shall be predetermined in the -constitution of the generation after them?” - -A later important work is “Body and Will,” 1883. “Its justification -from my standpoint,” says Dr. Maudsley, “is, that I have been engaged -all my life in dealing with mind in its concrete human embodiments, -and that in order to find out why individuals feel, think, and do -differently, and in what way best to deal with them so as to do one’s -duty to oneself and to them, I have had no choice but to leave the -barren heights of speculation for the plains on which men live and -move and have their being. It is not enough to think and talk about -abstract minds and their qualities when you have to do with concrete -minds that must be observed, and studied, and managed.” - -This work deals with questions too vast to be summarily discussed; -but one aspect of Dr. Maudsley’s mind is well expounded in the -following extract:— - -“In nature, as we see it, we seem to see a conflict of warring -opposites; gravitation opposed, or rather indeed complemented, by -repulsion; chemical affinities by chemical repulsions; magnetic -attraction by electric repulsion; evolution by dissolution; -conservation by revolution, quiet or catastrophic; love by hate; -self-love by love of kind; heaven by hell. Certain it is that hate -and destruction are just as necessary agents as love and production -in nature, which could no more be, or be conceived to be, without -the one than without the other; and to call the one good more than -the other, however necessary from the standpoint of human egoism, -is just as if one were to call gravitation good and repulsion bad, -as gravitation, had it self-consciousness, would no doubt do. In -order to have a theory of cosmogony that shall cover all the facts, -it has always been necessary to supplement a good principle by a -bad principle, a God of love and creation by a God of hate and -destruction. And it must always be so. We may, agreeably to the logic -of our wishes, comfort ourselves in our pilgrimage by entertaining -the hope and belief of the working out of good through evil and of -the permanence of good after the disappearance of evil, just as, if -it were useful and pleasing to us to cherish the illusion, we might -persuade ourselves that repulsion will one day be annihilated and -gravitation endure, or that evolution will continue and dissolution -cease to be; but if we look at the matter in the cold spirit of -strictly rational inquiry we shall always find abundant reason to -believe that the sum of the respective energies of good and evil -remains a constant quantity, the respective distribution only -varying, and that we might as well try to increase the height of the -mountain without increasing the depth of the valley, as to increase -the good in the world by purging it of its so-called evil.” - -Dr. Maudsley became a Fellow of the College of Physicians in 1869, -has been President of the Medico-Psychological Association, and -received the LL.D. degree from Edinburgh University in 1884. - - -FOOTNOTES: - -[17] “Treatment of the Insane without Mechanical Restraints,” 1856. - -[18] For details of the exposure of 1813 and 1814, see “A History of -the York Asylum,” York, 1815. - -[19] For a description of the state of Bethlem Hospital in 1815, see -Conolly’s work above cited, pp. 26-29. In making this record Conolly -says, “Nothing can more forcibly illustrate the hardening effect of -being habitual witnesses of cruelty, and the process which the heart -of man undergoes when allowed to exercise irresponsible power. Partly -from custom, and partly from indifference, and partly from fear, even -physicians not particularly chargeable with inhumanity used formerly -to see patients in every form of irritating restraint, and leave them -as they found them. _Such facts justify the extremest jealousy of -admitting the slightest occasional appliance of mechanical restraints -in any asylum. Once admitted, under whatever pretext, and every abuse -will follow in time._” - -[20] Memoir of John Conolly, M.D., D.C.L., by Sir James Clark, -Bart., 1869; very ill-arranged. - - - - -CHAPTER XXV. - -_EMINENT SPECIALISTS._ - - _SIR ERASMUS WILSON AND SKIN DISEASES; MORELL MACKENZIE AND THROAT - DISEASES; COBBOLD AND INTERNAL PARASITES._ - - -Specialisation is decreed by the will of the public as much as by -that of the practitioner. This is true of many professions besides -those of medicine. Although the general discernment has always -recognised the ability of men with powers of the universal type, -these men are rare, and there is a strong tendency to believe that a -man cannot be master of the whole field of a science, but may more -probably be master of a portion of it. Again, with hawk eye the -people who want to be cured of disease mark and then swoop down upon -men who appear to them specially capable in one department of medical -practice, and no denunciation of specialism, no drawing back on the -part of the physician, will avail against this natural selection. The -man to whom crowds of patients of one kind flock naturally becomes -specially skilled in dealing with them: and it is impossible to stem -the tide by saying that such ought not to be the case. - -Specialism has been carried to a surprising extent in America, when -Dr. Morell Mackenzie informs us, in his article on “Specialism in -Medicine,”[21] it would be almost impossible to find a city with -ten thousand inhabitants in which there are not three or four -specialists; whilst in a city of one hundred and thirty thousand -inhabitants, thirteen specialists were found exclusively engaged in -treating throat diseases. - -The days of encyclopædic knowledge may be past, but the need of -a broad, general, scientific, and professional education for the -medical man, even a specialist, will never cease. If, as Dr. -Mackenzie says, the leviathans of omniscience loom dim and gigantic, -like the megatherium and mastodon of remote geological periods, and -if the type is as utterly extinct as he believes, it is all the -more incumbent on the guides of medical instruction to see that -their pupils pass through a broad course of study which shall fairly -represent the achievements of the past and the main features of the -knowledge of the present. ERASMUS WILSON was a man who undoubtedly -gained a good record in general professional knowledge, and knew well -the anatomy and physiology of his student days. - -William James Erasmus Wilson, son of William Wilson, surgeon, a -native of Aberdeen, in early life a naval surgeon, who later settled -at Dartford and Greenhithe in Kent, was born on November 25, 1809, -in High Street, Marylebone, where his maternal grandfather, Erasmus -Bronsdorph, a Norwegian by birth, resided. He was educated at -Dartford Grammar School and at Swanscombe, but very soon commenced -practical medical work under his father in the parish infirmary. -At the early age of sixteen he was sent to London to enter John -Abernethy’s anatomical class, and there is no doubt that his -teacher’s individuality powerfully impressed him. But among his -friends were some who led his tastes also somewhat deeply into botany -and zoology, entomological facts then learnt being destined to bear -fruit in his Commentary on Diseases of the Skin. - -Wilson was enabled to extend his studies to Paris in 1828 and -in 1830, where he attended Cuvier’s and Geoffroy St. Hilaire’s -lectures, and among others saw the practice of Dupuytren, Orfila, and -Lisfranc. He became noted for his neat dissections, insomuch that -he was nicknamed the “piocheur,” or “sap” in English slang. To his -excellence in dissection young Wilson joined an equal faculty for -drawing, derived from his mother. - -In 1826 young Wilson had become a resident pupil with Mr. Langstaff, -father of a fellow-student, surgeon to the parish infirmary of -Cripplegate. Here in Langstaff’s dissecting-room, where many -pathological researches were carried on, Wilson made the acquaintance -of numerous men of mark who resorted thither, including Jones Quain -and William Lawrence. On the establishment of the Aldersgate School -of Medicine under Lawrence’s régime, Wilson joined it as student, and -in 1829-30 won both the surgical and the midwifery prizes. On the -day when he attained his majority, November 25, 1830, Wilson took the -Apothecaries’ Hall diploma. - -Having become a member of the London College of Surgeons in 1831, -Wilson was asked by Dr. Jones Quain, then Professor of Anatomy and -Physiology at University College, London, to be his assistant, and -he soon after was appointed Demonstrator of Anatomy under Richard -Quain. Wilson was a capital teacher of anatomy, and his private -museum of dissections prepared by his own hands fully illustrated -his manipulative capacity. He superintended the execution of the -illustrations to the celebrated Quain’s Anatomy, and also those to -Liston’s Practical Surgery (1837). - -When Dr. Jones Quain retired from University College Hospital in -1838, Wilson resigned his appointments also, and established a school -of anatomy under the title of Sydenham College, which however did not -prove ultimately successful. He then devoted himself to such private -practice as he could obtain in Charlotte Street, Fitzroy Square, -eking out his income by taking pupils, and by literary work. In 1838 -he appeared as an author with “The Dissector’s Manual of Practical -and Surgical Anatomy,” subsequently producing the “Anatomist’s Vade -Mecum” (1840), of which many editions have been called for. In -the same year he became Lecturer on Anatomy and Physiology at the -Middlesex Hospital. - -Meanwhile Wilson had made the acquaintance of a man who was destined -to turn his thoughts in the direction which became permanent. His -father, after retiring from the navy, had taken a mansion at Deham, -Bucks, and set up a private lunatic asylum; and in connection with -this establishment Wilson met Mr. Thomas Wakley, M.P., the founder of -the _Lancet_, and coroner for Middlesex. Mr. Wakley appointed Wilson -sub-editor of the _Lancet_ in 1840, a post which he held for several -years, continuing to write for that journal after resigning the more -onerous post when his private practice increased. About this time he -became Consulting Surgeon to the Marylebone Infirmary, and gained a -very extensive experience of every department of hospital surgery. In -fact, it appeared at first that Wilson would probably make his mark -as a pure surgeon. - -No more certain path, however, opening in this direction, Mr. Wakley -considerably influenced Wilson towards choosing a special line of -practice as a means of success. There was much open opposition -at that time among medical men to the idea of specialisation, -and Mr. Wakley succeeded in overcoming Wilson’s fear of sinking -under the dreaded name of quack. The choice of a specialty was not -difficult, as skin diseases or dermatology then constituted an almost -uncultivated field. “I have never regretted my choice,” he remarked -on one occasion;[22] “there is only one more beautiful thing in the -world than a fine healthy skin, and that is a rare skin disease.” - -In 1842 Wilson brought out his extended systematic work on Diseases -of the Skin, and subsequently produced twelve fasciculi of folio -“Portraits of Diseases of the Skin.” In connection with these we may -mention that he took a large share in the well-known five volumes -of Anatomical Plates, issued jointly by Dr. Quain and himself. In -1843 he was elected a Fellow of the College of Surgeons, and in 1844 -a Fellow of the Royal Society, having contributed to the latter -a memoir on a newly-discovered parasite on the human skin, the -_Entozoon folliculorum_. He made himself familiar with varieties -of skin diseases by extensive vacation rambles—in Switzerland and -the Valais studying goitre, in Italy searching out ringworm cases -among the peasantry, in the East making leprosy a special object of -inquiry. He wrote the article “Skin” in Cooper’s Surgical Dictionary, -a Report on Leprosy, and many articles on various subjects connected -with the specialty. - -Thus Wilson became a specialist of great merit as well as profitable -practice, and, says the _Lancet_ (August 16, 1884), “knew more about -skin diseases than any man of his time. He cured when others had -failed to cure; and his works on dermatology, though they met with -pretty searching criticism at the time of their appearance, have -nearly all maintained their position as text-books. The horrible -cases of scrofula, anæmia, and blood-poisoning which he witnessed -among the poor of London—they are happily rarer now than they were -half a century ago—enlisted his warm sympathies. But he had to deal -with rich patients as well as poor, and over these the masterful -stamp of his mind enabled him to exercise despotism in matters of -diet. Wilson was not only a consummate dietician, but he knew how to -make his patients submit to have their bodies placed under martial -law.” He in fact largely viewed skin diseases as expressions of -internal derangement and constitutional defects. He was continually -on the look out for deficiency of nutrition in children and remedying -it. - -Wilson was much pleased to be the means of bringing forward a little -work on “Infant Life: its Nurture and Care,” written anonymously by -a lady, and first published in his “Journal of Cutaneous Medicine.” -In the preface which he wrote to it he expresses his strong beliefs -that hygiene is the first necessity of a scholastic institution, -that with proper nurture almost all the diseases of infants would be -extinguished, that illness following vaccination properly performed -can only occur owing to neglect of proper nurture and care, and that -“healthy children never suffer, never die from vaccination.” - -An incident which brought Erasmus Wilson prominently before the -public was the inquest held at Hounslow on a soldier who had died -after a regimental flogging. Mr. Wakley held the inquest, which -lasted eleven days. It was in a great measure owing to Mr. Wilson’s -decided evidence that a verdict was returned declaring that the -flogging had been the cause of death. The public feeling was aroused, -a Parliamentary inquiry was subsequently held, and the punishment of -flogging was at last removed from the regimental code. - -Several works of considerable merit made Wilson’s name very widely -known. One of the most popular of these was entitled “Healthy Skin,” -first published in 1845. It strongly advocated that constant use of -the bath which has become far more prevalent than when it was first -issued. A translation of Hufeland’s “Art of Prolonging Life,” which -he edited, appeared in 1853. In “The Eastern or Turkish Bath,” in -1861, Wilson gave a powerful impetus to the establishment and spread -of the Turkish bath in England, and laid down principles and plans -of procedure calculated to make this bath safe for persons of very -varied constitutions. - -In 1869 Erasmus Wilson founded at his own cost a museum and -professorship of dermatology at the College of Surgeons, with an -endowment of £5000, and was appointed the first professor. In this -capacity he lectured for nearly ten years. Several successive series -of lectures were published, as well as a catalogue of the museum. -He was also the founder of the Chair of Pathology in Aberdeen -University. He also endowed a pathological curatorship at the College -of Surgeons. He was elected on the Council of the College in 1870, -and was President in 1881. A special grant of an honorary gold medal -was made to him by the College in 1884, just before his death. - -His early Eastern travels had particularly interested Wilson in -Egyptology, and he became by wide reading and study very competent -in Egyptian lore, as is evidenced by his “Egypt of the Past,” -published in 1881. His munificence in connection with the bringing -of the obelisk known as “Cleopatra’s Needle” to London in 1877-8 is -a familiar story. Many abortive proposals had been made to secure -its being brought to England, but Government had always failed to -make any arrangement. General Sir James Alexander was the means of -starting the idea in Erasmus Wilson’s mind, by speaking to him of -a project for raising sufficient money by a general subscription. -Wilson, who was greatly interested, thought the sum needed, £10,000, -would not be forthcoming, and undertook to pay the entire sum -himself, Mr. John Dixon, C.E., having undertaken its successful -transport. Thus Britons will ever owe to him the possession of this -choice treasure of Egyptian antiquity. The book entitled “Cleopatra’s -Needle: with Brief Notes on Egypt and Egyptian Obelisks,” which -Wilson brought out in 1877, went through several editions. - -But these were only a few of the public objects to which Erasmus -Wilson devoted his wealth, which had been vastly increased by -singularly skilful investments in gas and railway companies’ shares. -He restored Swanscombe Church, near his birthplace, in 1873. He -founded, at a cost of £2500, a scholarship at the Royal College of -Music, besides contributing considerably to its general funds. He was -a large subscriber to the Royal Medical Benevolent College at Epsom, -and built at his own cost a house for the head-master; further, he -built at a cost of £30,000 a new wing and chapel for the Sea-Bathing -Infirmary at Margate, in which skin diseases are largely treated. He -was a strong Freemason, and contributed liberally to various Masonic -charities. In recognition of his many public benefactions he was -knighted in 1881. - -“From his earliest life,” says the _British Medical Journal_ (August -16, 1884), “he was characterised particularly by his kindliness and -gentleness of manner, which made him many friends; indeed, to know -him was to love him. His generosity to poor patients who came to -consult him was very great, not only prescribing for them gratis, -but supplying the means for carrying out the treatment, and that -not only after he became wealthy, but even at a time when he could -ill afford to be generous. The amount of good he did privately will -probably never be known, as he was one of whom it may truly be said, -that he never let his left hand know what his right hand did—so -unostentatious was he in regard to his charity.” - -Sir Erasmus Wilson had been in ill-health for two years before his -death, and for a year was quite blind, yet never lost cheerfulness. -On July 23, 1884, he was at the consecration of St. Saviour’s Church -at Westgate on Sea, of which he had laid the foundation-stone a year -before. Within three days he became seriously ill, and died on August -7th. He had married in 1841 a Miss Doherty, who survived him. He left -no family, and the bulk of his property, something like £180,000, -reverts on Lady Wilson’s death to the College of Surgeons, without -any restriction as to the disposal of the fund. Other legacies of -£5000 each he bequeathed to the Sea-Bathing Infirmary at Margate, the -Medical Benevolent College, and the Society for the Relief of the -Widows and Orphans of Medical Men. Such bequests alone would place a -man among great public benefactors. Wilson had not waited till death -came before he became beneficent, and if his gifts are used in the -spirit in which he gave them, he will rank with John Hunter as to the -material if not the intellectual legacy he has bequeathed to mankind. - - * * * * * - -Descended from an old Scotch family (the Mackenzies of Scutwell), -Dr. MORELL MACKENZIE is the son of the late Mr. Stephen Mackenzie, -surgeon, of Leytonstone, by his wife Margaret, daughter of Mr. Adam -Harvey of Lewes. Morell Mackenzie was born at Leytonstone, on the -borders of Epping Forest, on the 7th July 1837. His father was a man -of exceptional intellectual power, whose studies took the direction -of metaphysics and mental diseases; hence he acquired great skill in -treating nervous affections which border on insanity. His ability -was testified to by Mr. Brudenell Carter in his valuable essay on -Hysteria (see p. 268). Mrs. Mackenzie was a clever woman of a highly -practical tendency. The untimely death of Stephen Mackenzie in 1851, -when he was thrown out of his gig and killed on the spot, left his -widow with nine children very slenderly provided for. - -Morell Mackenzie was educated by Dr. Greig of Walthamstow, many of -whose pupils entered the service of the East India Company. Mackenzie -always took a great interest in natural history, in which he was -largely encouraged by his mother, and from an early period greatly -desired to enter the medical profession. But a medical education -being then beyond the means of the family so suddenly bereaved, he -was placed at the age of sixteen in the office of the Union Assurance -Company in Cornhill. Here he got on very well, but never abandoned -the hope of becoming a doctor. Fortunately, by the kind aid of a -relative, he was enabled to gratify this desire, and he accordingly -resigned his clerkship, and became a student at the London Hospital. - -On commencing his medical studies Mackenzie determined to take his -degree at the University of London, combining with his hospital work -the preparation for matriculation. Having become a member of the -College of Surgeons in 1858, he subsequently took the M.B. degree -with high honours in three subjects. At the London Hospital he -obtained the senior gold medal for surgery, and the gold medal for -zeal, talent, and humanity to the patients, awarded by the governors. -On leaving the hospital he went to Paris, where he studied for a -year under Trousseau, Nélaton, Ricord, and others. He spent another -year in Vienna, where he studied pathology under Rokitansky, chest -diseases under Skoda, skin affections under Hebra, and diseases of -the eye under Arlt and Jäger. During his stay at Vienna Mackenzie -made an expedition to Pesth in order to become acquainted with -the laryngoscope, an instrument invented by Manuel Garcia, which -Czermak was then beginning to use. A friendship sprang up between -these two men which only terminated with Czermak’s lamented death. -Czermak was very desirous that Mackenzie should translate some of -his papers and publish them in the English medical journals, but he -had determined to study for a few months in Italy, and before he -returned home Czermak had himself come over to London and introduced -the laryngoscope into England. On arriving in London Mackenzie was -at once appointed Resident Medical Officer at the London Hospital, -and shortly afterwards Registrar to that institution. He now began to -make daily studies with the laryngoscope, and soon published cases in -the medical journals which had been treated by its aid. In 1862 he -completed the M.D. degree at London University. - -In 1863 the Jacksonian prize for an essay on the Diseases of the -Larynx was awarded to Mackenzie by the Royal College of Surgeons, -and on the urgent advice of many of his medical friends, especially -that of the late Dr. Herbert Davies, he determined to make throat -diseases a specialty, and having established himself in practice in -the West End, he was largely instrumental in founding the Throat -Hospital in King Street, Golden Square, in the same year. In 1866 Dr. -Mackenzie was appointed Assistant-Physician to the London Hospital, -and his colleagues subsequently offered to recommend to the committee -of that institution that a department for throat diseases should be -established under his supervision. This however he declined, on the -ground that he wished to treat diseases of every kind whilst attached -to the London Hospital. He, however, gave a course of lectures on -Throat Diseases at the London Hospital Medical College, whilst he -also lectured on Physiology for three years. Dr. Mackenzie was -afterwards obliged, owing to his increasing practice, to resign his -connection with the London Hospital. - -Dr. Mackenzie has for many years occupied a prominent position -not only as a specialist but as a champion of specialism, and has -exhibited considerable persistence in his advocacy of any cause with -which the interests of specialism were connected. Some years ago, -when most of the special hospitals were excluded from participation -in the London Hospital Sunday Fund, Dr. Morell Mackenzie led the -attack upon the position taken up by the committee, with the result -that the treasurer of the Fund resigned, and a modification of -procedure took place. Dr. Mackenzie, among the other honorary -memberships of foreign societies which have been conferred upon him, -is one of the two honorary Fellows of the American Laryngological -Association, Signor Garcia being the other. He has invented a number -of instruments or modifications of instruments for the treatment -of throat diseases, and has written copiously on the subject. His -principal works are entitled “On the Use of the Laryngoscope in -Diseases of the Throat,” “Essays on Throat Diseases,” “Diphtheria,” -“Hay Fever,” and “Diseases of the Throat and Nose.” He has also -written the article on Diseases of the Larynx in Reynolds’s “System -of Medicine.” - -Dr. Morell Mackenzie claims that his experience as to diseases of the -throat amply justifies and necessitates specialism. “The scientific -literature relating to these,” he says (_Fortnightly Review_, June -1885), “dates from little more than twenty-five years back, and -already it has grown to a bulk that would surfeit the voracity of the -most persevering bookworm, and it goes on increasing and multiplying -in a manner that makes one long for a Malthus to preach some degree -of moderation to its producers. Every week, every day brings one -books, pamphlets, articles, lectures, reprints about all sorts of -uncomfortable things in _itis_ and _osis_, as seen in the throats of -Englishmen, Frenchmen, Germans, Italians, Danes, Russians, Americans, -and all the other offspring of Babel. A certain proportion of these, -no doubt, are of great value, but not a few might be consigned to -the wastepaper basket without serious loss to science; all must be -read, however, lest some grains of wheat should be thrown away with -the chaff. Several periodicals dealing exclusively with diseases of -the throat appear with praiseworthy regularity; and there are also -societies, associations, &c., founded for the same purpose, each of -which, of course, issues its yearly volume of Transactions.... This -may give some faint idea of the herculean labour which the specialist -who wishes to keep abreast of the progress of knowledge in his own -subject from the literary point of view alone has to undergo; and -it must be remembered that in medicine reading is after all only -subsidiary to the practical work by which skill is perfected and -experience gathered and extended.” - - * * * * * - -The subject of animal parasites upon and in the human body, while -certainly not one of the most attractive on a superficial view, has -yet been found to yield scientific material of the highest interest, -and has required great energy and care to produce satisfactory -results. Among British workers in this field none is more widely -known than Dr. THOMAS SPENCER COBBOLD, F.R.S. - -Dr. Cobbold is the third son of the late Rev. Richard Cobbold, -rector of Wortham, Suffolk, the author of the striking “History of -Margaret Catchpole,” and his grandmother, Mrs. Cobbold, was a zealous -geological collector in the early days of geology, having a fossil -species of mollusc (_Nucula Cobboldiæ_) named in her honour. The -subject of this notice was born at Ipswich in 1828, and educated for -some years by the Rev. H. Burrows, at Yarmouth, and afterwards at the -Charterhouse. - -Young Cobbold entered upon the study of medicine at the Norfolk -and Norwich Hospital in 1844, as pupil of Mr. Crosse, F.R.S. Later -he proceeded to Edinburgh, and became class-assistant to Professor -Hughes Bennett, and prosector to Professor Goodsir, then at the -height of his career. Such men, and especially Goodsir, exercised a -great awakening influence on young Cobbold, and deepened his strong -tendencies towards anatomical research. In 1851 Dr. Cobbold graduated -on the same day as Dr. Burdon-Sanderson, now Waynflete Professor -of Physiology at Oxford, and the late Dr. Charles Murchison, all -three being gold-medallists. After studying for some time in Paris, -Dr. Cobbold on his return to Edinburgh was appointed curator of -the Anatomical Museum, and became active in dissecting specimens -of animals received at the museum. Among others his memoir on -the giraffe and other ruminants formed the basis of his article -Ruminantia, contributed to Todd and Bowman’s Cyclopædia of Anatomy -and Physiology. When the lamented Edward Forbes was elected to the -chair of Natural History, Dr. Cobbold’s attention was powerfully -attached to geology, and for some years he made excursions with -his class, and collected large numbers of fossils. More distant -excursions to Arran, the Yorkshire and Devonshire coasts, the Isle of -Wight, &c., supplied Dr. Cobbold with specimens of great service in -illustrating the Swiney Lectures, which he afterwards delivered for -five years with marked success at the British Museum and at the Royal -School of Mines (1868-72). So popular did these lectures become that -towards the close of the last course many of the visitors could not -find seats. - -After the death of Edward Forbes, Dr. Cobbold resigned his -appointments in Edinburgh, and became Lecturer on Botany at St. -Mary’s Hospital. Two years later he transferred his services to the -Middlesex Hospital, lecturing there for thirteen years on Zoology -and Comparative Anatomy. During his connection with the Middlesex -Hospital he took up the branch of zoology and medicine with which his -name will be most distinctively associated. During three successive -years he examined the bodies of animals dying at the Zoological -Gardens, especially with a view to discovering the presence of -parasitic worms in them. Many papers were contributed by him to the -Linnean and Zoological Transactions and Proceedings, among which we -may call attention to “Remarks on all the Human Entozoa” (Zool. Soc. -Proc., 1862). - -In 1864 Dr. Cobbold was elected F.R.S., and in the same year -published his “Introductory Treatise on the Entozoa,” which -established his reputation, the _Lancet_ declaring that it formed a -noble contribution to medical science and a credit to our national -literature. Up to the year 1865 Dr. Cobbold persevered in the -pursuit of pure science, refusing all inducements to practice; but -finding that after his twenty years of zealous labour, no suitable -scientific post opened for him, he at length commenced practice in -Wimpole Street, removing later to Harley Street. Here his great -knowledge of the habits and treatment of internal worm parasites -became available for professional purposes, and his services were -largely sought. But scientific pursuits and public lecturing still -claimed his attention, and among the achievements of his later years -are his book on Tapeworms, which has gone through several editions; -his lectures on practical helminthology, entitled “Worms;” a manual -of the “Parasites of the Domesticated Animals,” a larger treatise -on Parasites, a smaller supplementary work on Human Parasites. In -1873 Dr. Cobbold received the appointment of Professor of Botany at -the Royal Veterinary College, and soon afterwards a special chair -of helminthology was established for him at the College, for giving -instruction on the parasites and parasitic diseases of domesticated -animals to veterinary students. In connection with this work. Dr. -Cobbold went still more deeply into the parasitic diseases of -domestic animals, such as those which caused grouse disease, ostrich -and pigeon epidemics, gapes in chickens, &c. He delivered a course -of lectures on the “Parasites of Animals employed as Food” at the -Society of Arts. He has been the first to describe many new species -of internal worms from elephants, horses, cattle, sheep, and dogs. -One of the most elaborate of his special memoirs is that in which he -has described the parasites of elephants, in the Linnean Society’s -Transactions. With these extensive researches in comparative anatomy, -Dr. Cobbold has not neglected human parasites of late years, and -various papers and lectures of his have commanded much attention and -elucidated important points. He contributed fifty short articles on -these subjects to Quain’s “Dictionary of Medicine.” As a lecturer -Dr. Cobbold’s style is highly popular and pleasing. He possesses to -a great degree the power of putting himself on good terms with his -audience and keeping them interested. His position in regard to the -investigations with which his life has been chiefly occupied has been -quite unique. - -An extract from his work on Entozoa is an interesting example of a -very successful mode of treating this subject. “The happiest, and -perhaps after all the most truly philosophic, way of studying the -entozoa, is to regard them as a peculiar fauna, destined to occupy an -equally peculiar territory. That territory is the widespread domain -of the interior of the bodies of man and animals. Each animal or -“host” may be regarded as a continent, and each part or viscus of -his body may be noted as a district. Each district has its special -attractions for particular parasitic forms; yet, at the same time, -neither the district nor the continent are suitable localities as -a permanent resting-place for the invader. None of the internal -parasites ‘continue in one stay;’ all have a tendency to roam; -migration is the very soul of their prosperity; change of residence -the _sine quâ non_ of their existence, whilst a blockade in the -interior, prolonged beyond the proper period, terminates only in -cretification and death.” - - -FOOTNOTES: - -[21] _Fortnightly Review_, June 1885, p. 775. - -[22] _World_, September 18, 1878. - - - - -CHAPTER XXVI. - -_EMINENT SPECIALISTS—continued._ - -_SIR W. BOWMAN, BRUDENELL CARTER, AND EYE DISEASES; TOYNBEE, HINTON, -AND EAR DISEASES._ - - -The eye, the organ of light, was, till recent times, practically -a dark chamber. Only its grosser movements and the effects of its -lenses upon the rays of light were understood. Its minute structure, -its relationship to the brain, and the real nature of the morbid -changes occurring in it, were hidden. To-day its microscopic elements -are unravelled, and very much is known of their connexion with the -great nerve-centres behind them. Experiment and calculation have -gone far to settle the precise mode in which light gives rise to -sight, and affects our perception and judgment of external objects, -and the condition of the eye during life and health or disease has -been brought into view by the ophthalmoscope. The names of Helmholtz -and of Donders are inseparably connected with modern advances in the -physiology of the eye, while no English name is more conspicuous in -regard to the surgery of the eye than that with which we commence -this chapter. - -WILLIAM BOWMAN, the third son of Mr. J. Eddowes Bowman, banker, -of Nantwich, and afterwards of Welshpool and Wrexham, was born at -Nantwich on July 20, 1816. He was early surrounded by scientific -associations, for his father was a botanist and geologist of wide -cultivation, having formed a very complete herbarium of British -plants, and having furnished to Sir Roderick Murchison valuable -original matter for his “Silurian System.” - -Mr. Bowman placed his son at Hazelwood School, Birmingham, which -Sir Rowland Hill’s father was conducting on the principle of -the abolition of corporal punishment. The boys largely governed -themselves, printing a magazine of their own. They were taught -natural science too, a very unusual thing in those days. In such a -congenial atmosphere young Bowman flourished, and in time became head -boy. - -An accident to one of his hands, about the close of his school -course, seems to have led to Mr. Bowman’s choice of surgery as a -profession. For some months he saw country practice with Mr. T. T. -Griffith, of Wrexham, seeing a good deal of cholera, which was then -prevailing, and spending his leisure in copying anatomical drawings -of the human bones and muscles. He then became, through the interest -of Mr. Joseph Hodgson, F.R.S., afterwards President of the College of -Surgeons, who had attended to his injured hand, a resident pupil at -the General Hospital, Birmingham, where he continued for five years. - -These early years were fruitful in microscopical observations of both -healthy and diseased tissues, and even in experimental physiology, -for Mr. Bowman was one of those whose advancement in science has been -considerably due to experiments upon animals. In 1837, after a brief -visit to the Dublin medical schools, he became a student at King’s -College, London, where Robert Bentley Todd had been lately appointed -Professor of Physiology. Mr. Bowman’s skill and extensive knowledge -were soon made use of by Todd, and he was successively appointed -prosector and demonstrator of anatomy and curator of the anatomical -museum. - -In 1838 Mr. Bowman visited the hospitals and museums of Holland, -Germany, and Vienna, and made a considerable stay in Paris in 1841. -Meanwhile his original studies were bearing fruit in important -papers contributed to the Royal Society, “On the Minute Structure -and Movements of Voluntary Muscle” (1840), “On the Contraction of -Voluntary Muscle in the Living Body” (1841), and, “On the Structure -and Use of the Malpighian Bodies of the Kidney” (1842). The latter -marked a conspicuous advance in the physiology of the kidney, and Mr. -Bowman was distinguished by receiving a royal medal for it, having -been elected F.R.S. in the previous year. Professor Michael Foster, -in his address on Physiology to the International Medical Congress of -1881, referred to these memoirs on muscle and the kidney as “classic -works, known and read of all instructed physiologists.” - -In 1840 Mr. Bowman, at the early age of twenty-four, was appointed -Assistant-Surgeon to King’s College Hospital. His scientific writing -became much in demand. He wrote on Surgery in the “Encyclopædia -Metropolitana,” on Muscle, Motion, and Mucous Membrane in Todd’s -“Cyclopædia of Anatomy and Physiology,” and took a large share with -Dr. Todd in writing and illustrating the “Physiological Anatomy -and Physiology of Man,” which was brought out in parts. The desire -to render this book as far as possible accurate and original by -repeating most of the observations of others and making new ones -where necessary, led to successive delays in the appearance of the -parts. Finally the closing part was written by Dr. Lionel Beale, and -published in 1856. - -Having become a Fellow of the College of Surgeons in 1844, Mr. Bowman -in 1846 joined the staff of the Royal London Ophthalmic Hospital, -Moorfields, as assistant-surgeon, having already made extensive -researches into the minute structure of all the organs of special -sense. His advent to the Moorfields Hospital was marked by the -delivery, in 1847, of a series of lectures on the “Parts Concerned in -Operations on the Eye,” which were afterwards separately published. -It was evident that ophthalmic surgery had gained a distinguished -recruit. Mr. Bowman had, independently of Brücke, discovered the -ciliary muscle, and his work brought forward numerous other facts -of structure for the first time. His paper “On the Structure of the -Vitreous Body,” contributed to the _Dublin Quarterly Journal of -Medical Science_, also attracted good attention. His suggestions on -operations for artificial pupil in the _Medical Times and Gazette_ -also showed conspicuous capacity for ophthalmic surgery. - -Although much urged to devote himself exclusively to this branch -of practice, Mr. Bowman preferred to continue in general surgical -practice for many years, attaining the surgeoncy to King’s College -Hospital in 1856, two years after he had reached the full surgeoncy -at Moorfields. In 1848 he had been conjoined with Dr. Todd in the -professorship of physiology and general and morbid anatomy in King’s -College, retaining the professorship, after Dr. Todd’s retirement, in -conjunction with Dr. Beale. But by 1855 Mr. Bowman found himself so -fully occupied that he finally resigned the professorship. He held -the surgeoncy to King’s College Hospital till 1862. - -From this period Mr. Bowman has been the acknowledged leader -of ophthalmic practice. He was one of the first to employ the -ophthalmoscope. His numerous papers in the Ophthalmic Hospital -Reports and in the Medico-Chirurgical Transactions have given -particulars of many improvements in operations on the eye, which -he has adopted, introduced, or improved. Lachrymal obstructions, -glaucoma, conical cornea, and cataract are among the subjects he -has specially dealt with; and he has by his clinical teaching and -operative example contributed not a little to the building up of -modern ophthalmic surgery. The well-earned honour of a baronetcy was -conferred upon him in 1884. - -The breadth of Sir William Bowman’s sympathies is shown on the one -hand by the active part he took in the establishment in 1848 of -the St. John’s House Sisterhood for training nurses for hospitals, -families, and the poor, having joined its council from the beginning, -and having materially assisted Miss Florence Nightingale in her -various philanthropic nursing enterprises; and, on the other hand, -by his consistent advocacy of physiological experiment. He considers -that every step forwards in our knowledge of the healthy body must -lead to a better understanding of disease and an improvement of -our power of counteracting it, whether in the way of prevention, -alleviation, or cure. - -In his address to the British Medical Association at Chester in -1866,[23] this eminent authority took occasion to protest forcibly -against the imputation of cruelty to animals sometimes made against -medical men in respect of physiological experiments. He insisted -both on the excessive difficulty of these original inquiries and -the high motives which actuate physiologists and the higher class -of scientific inquirers. “There should be no doubt,” said he, “as -to the free allowance of dissections of living creatures for the -advancement, and also for the communication, of a knowledge so -indispensable for our race, and for every generation of it.” He -practically charged the opponents of vivisection with stopping the -gates of knowledge, neither going in themselves nor suffering those -that were entering to go in. - -The lofty view which Sir William Bowman takes of the surgeon’s -function may be gathered from an extract from the above-mentioned -address. “I see no reason to doubt that future ages will still accept -the pious saying of one of old, that surgery is the _Hands of God_; -the Human Hands, apt images and reflex of man’s whole being, from his -morning hour of puling helplessness, when the - - “... tender palm is prest - Against the circle of the breast;” - -through all his working day of time, until they shall be upraised -once more at last in joy and adoration, to hail a brighter and an -eternal dawning; the Human Hands, permitted now, through insight into -God’s laws, to be His instruments of succour to that earthly life and -organisation which His power, wisdom, and love have first brought -into being, still alone both sustain and cause to perish when their -part is played; to that material organisation which dies every hour -it lives, which indeed dies by living, and lives by dying, and which -wondrously transmits ever its own prerogatives and dark secrets to a -succeeding life, destined apparently to remain a marvel and a mystery -impenetrable to all generations.” - - * * * * * - -The career of Mr. R. BRUDENELL CARTER is of special interest, owing -to the fact that he was a general practitioner in the country till -the age of forty, and came to London in 1868 without friends or -connection, intending to establish himself as a specialist in eye -diseases, and in a few years attained to eminence. But Mr. Carter’s -life had been previously marked by energy and success of no common -order; and his literary tastes and accomplishments ranked in the -forefront of the causes of his success. - -A reference to Mr. Carter’s ancestry will show that good hereditary -influences met and combined in him. His father was a major in the -royal marines; his grandfather, rector of Little Wittenham in -Berkshire, was a younger brother of Elizabeth Carter, the well-known -poetess and translator of Epictetus, whose portrait by Lawrence is -in the National Portrait Gallery. The rector was entirely educated -by his learned sister till he went to Cambridge. The rector’s wife -was a granddaughter of John Wallis, the mathematician and astronomer, -one of the founders of the Royal Society. The Carters belonged to the -younger branch of a family which had held the manor of St. Columb -Major in Cornwall from the time of Henry VII. - -Mr. Carter was born, at Little Wittenham on October 2, 1828. After -being at private schools he commenced his professional education by -apprenticeship to a general practitioner, and afterwards entered -at the London Hospital. After becoming a member of the College of -Surgeons in 1851 he practised for a short time at Leytonstone and at -Putney. - -At this period Mr. Carter published his first work “On the Pathology -and Treatment of Hysteria” (1853). This was avowedly based to a -considerable extent upon the opinions and practice of Mr. Stephen -Mackenzie, then recently deceased, who was extensively known by his -successful treatment of the most inveterate hysterical disorders. -This work in itself sufficiently indicated the presence of a writer -possessing both clearness of view and moderation of statement. - -This was followed by a much more extensive treatise “On the Influence -of Education and Training in Preventing Diseases of the Nervous -System” (1855). Mr. Carter was led to write it by observing the -frequent connection between faulty education and nervous or mental -disorders. It is divided into three parts, dealing respectively -with the Nervous System, Physical Education, and Moral Education. -The latter was that for the sake of which the book was written; -it displays a thoughtful moderation and breadth of view, without, -however, forecasting the author’s future eminence. - -Immediately upon the completion of this book Mr. Carter started -for the Crimea, where he served with the army as staff-surgeon. -Returning home when peace was concluded, he settled in -Nottinghamshire, and soon moving into the town of Nottingham, took an -active part in the establishment of an eye hospital there. In 1862 -he removed to Stroud in Gloucestershire, and founded an eye hospital -in Gloucester. In 1864 Mr. Carter became Fellow of the College of -Surgeons by examination. - -In 1868 Mr. Carter took the important step of removing to London, -resolving to rely upon medical and other literary work mainly until -practice should come. Thus Mr. Carter has been the writer of very -voluminous contributions to journalism, and has shown great ease and -lucidity of style. In 1869 he was appointed Surgeon to the Royal -South London Ophthalmic Hospital, and in 1870 Ophthalmic Surgeon to -St. George’s Hospital. He has persevered in commenting severely upon -errors of modern education, and has especially dealt with evils done -in various ways to the eyes in modern life. One pamphlet of his, “On -the Artificial Production of Stupidity in Schools,” has been often -reprinted. In an address at the opening of the Medical Session at St. -George’s in 1873 Mr. Carter thus spoke of cramming: “The show pupils, -who furnish marvellous answers to a multiplicity of questions, on -a multiplicity of subjects, in response to the demands of various -preliminary or matriculation examinations, remind me of nothing so -much as of the wooden cannon which artillerymen call ‘Quakers,’ which -require for their production in unlimited numbers, besides the -blocks of wood, nothing but a turning-lathe and a paint-brush; and -which are mounted, to deceive the enemy, in embrasures that would -otherwise be vacant.... But our ‘competition wallahs,’ instead of -being used to deceive an enemy, have been used chiefly to deceive -ourselves.” - -In 1875 Mr. Carter published an extended and important “Practical -Treatise on Diseases of the Eye.” In this he distinctly states that -in its normal condition the eye has faults which would condemn a -telescope or microscope to be thrown aside as useless, but which in -the living organ are neutralised by the conditions under which it -is exerted. He recommends any one who would operate upon the eye to -take a great deal of preliminary trouble, and to train his hands to -especial delicacy of action, so that he shall be indifferent which he -uses. “It has more than once been my lot,” he says, “to see attempts -to operate upon the human eye made by a surgeon who did not even -know how to hold the instruments he was about to misuse; and I can -conceive few things more painful than such a spectacle.” “In all -ages and countries the bad workman has complained of his tools, and -the good workman has produced the most varied results by the most -simple means. A man who is very awkward, and whose awkwardness is -perpetually bringing him to grief, hits upon a contrivance by which -he hopes that this natural result may in some degree be obviated. He -calls his contrivance an invention; and, like those persons of whom -it is said that their glory is in their shame, he is often somewhat -proud of it. Many surgeons of great and deserved repute have invented -each a single instrument, such as Beer’s knife or Tyrrell’s hook; and -some have invented more than one, chiefly because they have struck -out some new procedure for which new appliances were indispensable. -But as a rule the invention of many instruments by a surgeon may be -accepted as a sufficient proof of his clumsiness; and when, without -valid reason, any single operator has his peculiar scissors, and his -peculiar hook, and his peculiar forceps, and his peculiar scoop, all -called after his name, it is more than probable that the gift of -fingers has not been bestowed upon him.” - -Mr. Carter in 1877 gave a course of lectures “on Defects of Vision -which are Remediable by Optical Appliances,” as Hunterian Professor -of Pathology and Surgery at the College of Surgeons. These were -published in the same year. He has since issued a more popular work, -“Eyesight—Good and Bad: a Treatise on the Exercise and Preservation -of Vision,” 1880. The following extract has to do with a very -injurious form of prejudice due to ignorance. - -“The persons who suffer most from popular prejudice and ignorance -on the subject of spectacles are men of the superior artisan class, -who are engaged on work which requires good eyesight, and who, at -the age of fifty or sixty, find their power of accomplishing such -work is diminishing. It is a rule in many workshops that spectacles -are altogether prohibited, the masters ignorantly supposing them -to be evidences of bad sight; whereas the truth is that they are -not evidences of bad sight at all, but only of the occurrence of a -natural and inevitable change, the effects of which they entirely -obviate, leaving the sight as good for all purposes as it ever was.” -His general interest in education and its effects is abundantly -manifested as in the description of the late Mr. C. Paget’s half-time -experiment at Ruddington near Nottingham, where garden work was -substituted for about half the ordinary school hours of a portion of -the scholars. The children so treated were found after a short period -altogether to outstrip in their schoolwork those who devoted, or were -supposed to devote, twice as much time to it. - -Mr. Carter has translated two valuable works bearing on his -specialty: viz., Zander on the Ophthalmoscope, and Scheffler on -Ocular Defects. He has contributed to “Our Homes, and How to Make -them Healthy,” to the Sydenham Society’s _Biennial Retrospect of -Medicine_, and to many other publications. - - * * * * * - -Aural surgery has not long been raised to the rank of an honoured -specialty. JOSEPH TOYNBEE was told on one occasion by an eminent -member of the profession that he would make nothing of aural surgery. -He replied, “I will work at it for ten years, and then if nothing can -be made of it, I will tell you why.” On another occasion he said, -“I’ll rescue aural surgery from the hands of the quacks” (_Medical -Times_, July 14, 1866). Prematurely cut off though he was, he added -largely to the scientific knowledge of the ear and its maladies, and -vastly improved their treatment. - -JOSEPH TOYNBEE was born in 1815, at Heckington, in Lincolnshire, -his father having been a large farmer. After being for some years -under a private tutor at home, he went to King’s Lynn Grammar -School. At seventeen he was apprenticed to Mr. William Wade of the -Westminster General Dispensary, Soho, and studied anatomy under Mr. -Dermott. His assiduous and careful dissections were of essential -benefit in preparing him for his lifelong minute dissections of -the ear in health and disease. He further studied at St. George’s -and at University College hospitals. Even during his student life -aural studies powerfully attracted him, and as early as 1836 several -letters of his under the initials J. T. appeared in the _Lancet_. -In 1838 he became a member of the College of Surgeons, and was -selected as assistant-curator of its museum under Professor Owen. He -obtained the Fellowship of the Royal Society in 1842 for researches -demonstrating the non-vascularity of articular cartilage, the cornea, -crystalline lens, vitreous humour, and epidermoid appendages, which -were published in the Philosophical Transactions for 1841. - -Toynbee early entered upon aural practice in Argyll Place, -becoming also one of the surgeons to the St. James’s and St. -George’s Dispensary. He was included in the first list of Fellows -of the College of Surgeons on the issue of its new charter. At -the Dispensary he founded a Samaritan Fund for supplying the sick -poor with necessaries of life and warmth. All sanitary matters -were subjects of his profound interest, and he spent much time -in improving the condition of things in the parishes around him, -especially promoting means of securing adequate ventilation, and the -erection of model lodging-houses near Broad Street, Golden Square. - -Toynbee’s practice gradually became very large, but he continued to -dissect, and also to support administratively as well as pecuniarily -many benevolent societies. He found that so little was really known -of the diseases of the ear from actual dissection, that his only hope -of framing a system of aural surgery was by personal and persevering -examination and record of morbid specimens. This was carried on for -more than twenty years, until he had dissected about 2000 human ears. -Many of these were derived from his patients in the large Asylum for -the Deaf and Dumb, whose condition he had examined previously to -their death. Many medical men also supplied him with specimens of -diseased ears, as well as notes of cases. He further inquired closely -into the history of very many cases of patients with diseased ears. - -In 1860 Toynbee published an extended work on “The Diseases of the -Ear,” which placed the subject on a firm basis, and will always -remain of great value from the interesting details of cases and -treatment which it contains. The list of his own published papers -on which it is based, about sixty in number, testifies to Toynbee’s -great industry in research. They include papers on the structure and -functions of the tympanic membrane, on the muscles which open the -Eustachian tube, and on the mode of conduction of sound from the -tympanic membrane to the labyrinth of the ear, contributed to the -Royal Society, many researches on the diseases of the ear in the -Medico-Chirurgical Transactions, and a crowd of series of cases or -special memoirs contributed to the Pathological Society and medical -journals. In 1857 he had published a descriptive catalogue of the -preparations illustrating diseases of the ear contained in his own -museum. - -On the establishment of St. Mary’s Hospital, Mr. Toynbee was elected -aural surgeon and lecturer on diseases of the ear; and he published -in 1855 and 1856 courses of clinical lectures, which he delivered -there. He took a deep interest in the condition of idiots, and of the -deaf and dumb, and in many cases, to his great delight, devised plans -by which those who were not totally deaf were taught to speak when -their case had been regarded as hopeless, causing a corresponding -improvement in their mental faculties. - -Two of his most zealously pursued hobbies were ventilation, and -the formation of local museums. It was said that patients who went -to him for the benefit of their hearing, whether they improved in -that respect or not, came away full of the most advanced views -on ventilation. At Wimbledon, where he took a country-house, he -was indefatigable in developing a village club, and in forming an -educative and recreative museum. He published valuable “Hints on the -Formation of Local Museums” (1863), as well as “Wimbledon Museum -Notes.” His enthusiastic advocacy was actively engaged in furthering -the establishment of similar clubs and museums in various parts of -the kingdom. He continued through life an active microscopist and -zoologist, and was elected just before his death President of the -Quekett (Microscopical) Club. At the same time he was treasurer of -the Medical Benevolent Club, to which he himself largely contributed. - -One of Toynbee’s most valuable contributions to the treatment of -deafness was his invention of a method of forming an artificial -tympanic membrane when that part had been destroyed or perforated. -This is fully described in his pamphlet on the subject, which went -through many editions, as well as in his general treatise. He first -demonstrated the existence of many osseous and other tumours of the -parts of the ear and of the ossicles of the tympanum, and also the -fact that the Eustachian tube leading from the back of the throat -into the tympanum remains always closed except during the momentary -act of swallowing. - -A premature end came to Toynbee’s energetic and benevolent life. -Always active in experimental research, and much concerned in -aural therapeutics, he experimented on himself with chloroform, -and it is believed, prussic acid vapour, which he wished to cause -to enter by the Eustachian tube into the tympanum for the relief -of tinnitus aurium or noises in the ears. He unfortunately pursued -his experiments while alone, and was found dead on July 7, 1866, in -his consulting room at Savile Row, with a pad of cotton wool over -his face, and chloroform and prussic acid bottles, his open watch, -and various memoranda of experiments near him. His death excited -universal sympathy for Mr. Toynbee’s widow and nine children, with -whom he had lived most happily. - - * * * * * - -If one great aural surgeon became a martyr of science, another was no -less a martyr of philanthropy. The name of JAMES HINTON, which gained -wide celebrity during his lifetime, has been progressively elevated -since his death by the publication of his “Life and Letters,” by Miss -Ellice Hopkins, and of his works on “The Art of Thinking,” 1879, -“Philosophy and Religion,” 1881, and “The Law-Breaker, and the Coming -of the Law,” 1884. Even yet, fortunately, much more may be hoped for, -in the shape more especially of an autobiography, and of a work on -Ethics. - -It has become increasingly evident that James Hinton was, if not -a true genius, a man who approached very nearly to that altitude -of nature. As Mr. Shadworth Hodgson remarks in the introduction to -the “Chapters on the Art of Thinking,” Hinton is a hander-on of -Coleridge’s torch, with less of systematic theology and more of -emotional spiritualism. It is quite impossible to attempt here to -sketch his various philosophical contributions. Indeed the time has -not yet fully come to estimate them, their influence, or the man who -gave birth to them. As an aural surgeon he perhaps scarcely rose to -Toynbee’s level, but this was rather because the greatness of his -mind and soul in vaster fields overpowered him, than from defect of -ability. An outline of his life and work only can here be given. - -James Hinton was the third child (of eleven) of the well-known -Baptist minister, John Howard Hinton, having been born at Reading in -1822. His father’s mother was aunt to Isaac Taylor, the author of -the “Natural History of Enthusiasm.” It was from his mother, Eliza -Birt, however, that James Hinton derived most. She is described as a -fervent, lofty-souled woman, full of enthusiasm and compassion, yet -dignified and able to rule others with mild but irresistible sway. - -As a little child, James Hinton, though sweet-tempered, showed a -strong tendency to investigate everything, and to rearrange the -elder children’s games “as they ought to be.” The father taught the -children to be keenly observant of natural history. The mother bred -them up to have an instinctive feeling for religion, especially in -its aspect of love to God. An elder brother, Howard, died when James -was but twelve, and this bereavement made such an impression upon him -that he soon after was baptized and publicly received as a member of -the Baptist Church. - -At school James Hinton did not show special ability, though he had -a remarkable verbal memory until a certain period, when he suddenly -lost it without any special cause. In 1838 his father left Reading -for London, becoming minister of the Devonshire Square Chapel. -Feeling some pressure of circumstances with his large family, Mr. -Hinton placed James in the first situation which presented itself, -viz., that of cashier at a wholesale woollen-draper’s shop in -Whitechapel. This temporary immersion in proximity to some of the -coarsest scenes imaginable had a very deep influence in educing the -thoroughgoing altruism which afterwards characterised him. - -After holding the Whitechapel situation about a year, and spending -some time in search of a more suitable occupation, Hinton became a -clerk in an insurance office in the city. Here, while not becoming -an adept at book-keeping, he sat up at night and gave himself a -miscellaneous education. At this time he has been described as -“an abstract idea untidily expressed;” he was wholly indifferent -to appearances, and his clothes could never be made to fit him; -and he was often guilty of lapses from politeness. He was full of -argumentativeness, and determined to get to the bottom of everything. - -A little later his intense intellectual labours, combined with the -deep sense he now and ever after entertained of the wrongs to which -women were subjected, brought him into a state of mind in which he -resolved to run away to sea. His intention being discovered, his -father consulted a doctor about him, who wisely advised that he -should enter the medical profession, as being more fitted to give -scope for his mental powers. He was consequently entered at St. -Bartholomew’s Hospital at the age of twenty. He was able to perform -his entire course of medical study with very great rapidity, and -before taking his diploma went on a voyage to China and back as -surgeon of a passenger ship. On his return in 1847 be became a member -of the College of Surgeons, and settled for a time as a surgeon’s -assistant at Newport in Essex. - -He did not remain here long, but in the autumn of 1847 took the -position of surgeon to a shipload of freed slaves who were to be -shipped by voluntary agreement from Sierra Leone to Jamaica. He -remained for more than a year after this in Jamaica, taking the -practice of a medical man in ill-health, and looking after the -progress of his late charges. In 1849-50 he travelled homewards by -way of New Orleans, where he gained further insight into the slavery -question. In 1850 he entered into partnership with a Mr. Fisher, a -surgeon in general practice in Bartholomew Close; and became engaged -to Miss Margaret Haddon, after an attachment of ten years. - -In August 1850 we find the first note of his success in aural -surgery; he cured his mother’s deafness by a syringing properly -performed. Some other cases of success followed this, and were very -cheering. Soon after this he was introduced to Mr. Toynbee, and spent -much time with him both at St. Mary’s Hospital and privately. Yet -he did not find anything in practice large enough to satisfy his -aspirations. “Too many things crowd upon me; none _commands_ me,” -he writes March 1851. “The thing which shall fill my heart must be -not for myself but for others. To be contented I must toil not for -comfort, nor money, nor for fame, nor for love, but for truth and -righteousness.” - -In 1852 Hinton’s marriage with Miss Haddon took place, one of -singularly deep affection. He was now in practice for himself, -finding general practice not very profitable, especially as he -would not condescend to use arts to obtain success. He continued -his study of aural surgery, and assisted Mr. Toynbee largely in the -classification of his museum, already alluded to. - -In 1856 Hinton published his earliest papers on physiology and ethics -in the _Christian Spectator_. In 1858 he contributed an essay to the -_Medico-Chirurgical Review_ on “Physical Morphology,” suggesting that -organic growth takes place in the direction of least resistance—a -conception utilised by Mr. Herbert Spencer in his “First Principles.” -In 1859 “Man and his Dwelling-place” was published and favourably -received. Its success encouraged him to lay aside practice, reduce -his expenses to a minimum, and take to writing as a profession. He -settled in a little house at Tottenham, where his sitting-room was of -such dimensions that he used to say he could open the door with one -hand, poke the fire with the other, and had nature given him a third, -open the window with it, without rising from his seat. - -At first success attended the venture. Thackeray accepted for the -_Cornhill Magazine_ the series of “Physiological Riddles,” with the -remark “Whatever else this fellow can do, he can write!” These were -afterwards published, with others, under the title “Life in Nature.” -“Thoughts on Health” were also contributed to the _Cornhill_. But his -mind continued in such activity of growth, ever full, ever changing, -that he had not time to write his thoughts in form for publication, -and he was forced back into practice, which he had not quite -renounced, continuing to see a few aural patients twice a week at -his father’s house. In 1863 he was appointed aural surgeon to Guy’s -Hospital, and took a house in George Street, Hanover Square, for the -purpose of aural practice. With heroic and costly resolution, knowing -he could not adequately do his work as an aural surgeon and devote -himself to philosophy, he locked his manuscripts away from his sight. - -Henceforward he rapidly succeeded in practice. In 1866 he took the -place vacated by the death of his valued friend Toynbee, removing to -his house in Savile Row. When in full practice, and not allowing -himself to write, his chief life was in conversation. A few lines may -be here quoted from Miss Hopkins’ Life of Hinton. “It is difficult to -give any adequate idea of the charms of Mr. Hinton’s conversation to -a mind at all in harmony with his own. His most marked peculiarity -was the intensely emotional character of his intellect. Nature to him -was no cold abstraction, no cunningly contrived machine made up of -matter and force, but a mighty spiritual presence, a living being, -tenderly and passionately beloved. The laws of nature were to him the -habits of a dear and intimate friend.... But keen as was his delight -in purely intellectual operations, he valued everything chiefly, -if not only, in its relation to the moral.... How often, from some -comparatively remote region of thought, or of art, would he flash -down a light upon some practical matter, showing perhaps a neglected -duty in its vital relations, or revealing an order in what looked -like moral waste and confusion. Owing to this strong recognition of -the spiritual unity of all life, never was there a man in whom the -barrier between the religious and the secular was more completely -effaced.” - -In 1869 his success in aural surgery was so assured, that an eminent -surgeon suggested to Mr. Hinton that he might justifiably resume his -philosophy as an evening recreation. So after six years’ abstinence -he resumed his writing. But his thoughts, allowed once more to spring -into full activity, were certain to master him. “Wherever he was, at -a friend’s house, in the street, at church, at a concert, he jotted -down his notes on scraps of paper, backs of envelopes, bills, and -programmes, writing them out in full in the evening.” Finally, these -thoughts were printed for his own private use, and from them a great -portion of his posthumous works is derived. - -At last he had made money enough by practice to retire. His parting -gift to his profession was contained in “The Questions of Aural -Surgery,” a work of standard value; and his “Atlas of Diseases -of the Membrana Tympani.” In March 1874 he retired, but with a -constitution deeply injured by overwork and excess of feeling and -thought. His father had died the year before; his mother died in -1874. He continued incessantly working, writing, thinking, studying -mankind in the streets and alleys of London, or in the colliers’ -cottages in South Wales, and came to suffer much from sleeplessness. -When he set sail in the autumn of 1875 for the Azores, where Mrs. -Hinton had preceded him, he was already seriously ill. At last he -was seized with inflammation of the brain, and died on December 16, -1875, a martyr to his intense passion for the good of mankind. Of -his intellectual, ethical, and religious views this is not the place -to speak at large; his books must be left to explain themselves to -kindred spirits. - - -FOOTNOTES: - -[23] Reprinted by the Association for the Advancement of Medicine by -Research, 1882. - - - - -CHAPTER XXVII. - -_SIR R. CHRISTISON, SWAINE TAYLOR, AND POISON DETECTION._ - - -Although the detection of crimes of poisoning is but one of the -departments of service which the medical profession is able to render -to the law, yet it is one which has very largely attracted public -attention, owing to the many awful aspects of death by poisoning, -and the helplessness which mankind has always felt in regard to -these crimes. Latterly the skill displayed in the detection of the -existence of poisons after the death of the victims has set at -rest many of the doubts as to the certainty of judgment in regard -to poisoning, and the discovery of antidotes to many poisons has -supplied a means of remedy in numerous cases before it is too late. -It is obvious that these results could only begin to be realised when -chemistry had made considerable progress; and consequently it was not -till 1813 that a young doctor, the celebrated Orfila, published in -Paris the first part of a treatise on Poisons, which was subsequently -merged in his “Legal Medicine,” 1821-3. The names most conspicuous in -founding this new department of investigation in Great Britain are -those which stand at the head of this chapter. - - * * * * * - -ROBERT CHRISTISON, one of the twin sons of Alexander Christison, -many years Professor of Humanity in Edinburgh University, was born -at Edinburgh in July 18, 1797. After a complete education, in arts -at the University, he finally chose the medical profession, and was -for two years and a half resident assistant in the Royal Infirmary. -Taking his M.D. degree in 1819, he spent the next eighteen months at -St. Bartholomew’s Hospital, London, and in Paris, where he worked -in the laboratory of Robiquet at practical chemistry, and studied -toxicology with Orfila himself. - -When Dr. Christison was about to leave Paris, Dr. Gregory’s death -led to a vacancy in the Chair of Medical Jurisprudence at Edinburgh, -and Christison was proposed to fill it while still absent. It is -significant of the state of knowledge that not one of the candidates -besides Christison had any practical knowledge of chemistry. The -influence of Lord Melville, however, who had been his father’s -resident pupil when young Christison was born, was the determining -cause of his success in the election. - -At first students were very few, not half-a-dozen attending the -earliest course. Christison devoted himself with characteristic -energy to make his chair a real influence in the university. And here -we may remark briefly on the extraordinary vigour of constitution -which the new professor possessed, and retained almost till death. He -could walk, run, or row better and with more endurance than any man -of his time in Edinburgh, and that is saying a great deal. He made -his new chair his primary object. Being an extremely neat and clean -worker in the laboratory, his investigations soon became noted, and -it was found, when he was called in to give evidence on matters of -medical jurisprudence, especially in poisoning cases, that his mind -was equally clear and accurate, and that he could give reasons for -his beliefs which rendered his statements unimpeachable. From the -famous trial of Burke and Hare in 1829 down to 1866 Dr. Christison -appeared as a scientific witness in almost every case of medico-legal -importance in Scotland, and in many in England. - -“As a witness,” says the _Scotsman_ (Jan. 28, 1882), “he was -remarkable for a lucid precision of statement, which left no shadow -of doubt in the mind of court, counsel, or jury as to his views. -Another noteworthy characteristic was the candour and impartiality he -invariably displayed, and which, backed as it was by the confidence -that came of mature deliberation, rendered him almost impregnable to -cross-examination. This was notably illustrated in the celebrated -Palmer trial. Some of the medical witnesses for the Crown had got so -severely handled by the prisoner’s counsel that the case seemed in -danger of breaking down, but Christison had not been long in the box -when the lawyers found they had at last met one who was a match for -the subtlest of them: and so complete was the failure of all their -efforts to discredit his evidence, that the case, by the time he -finished, had assumed the gravest possible complexion.” - -As a persevering experimentalist, Christison was daring even to -rashness in making trials on himself. He thus tested the taste of -arsenious acid, which was held by Orfila and most others to be rough -and acrid, and which he proved to be rather sweet. He ate an ounce -of the root of _Œnanthe crocata_, which had stood most poisonous in -England and on the Continent; but the Scotch specimen at any rate did -not poison Dr. Christison. A most striking risk was run in the case -of the Calabar bean. He took a dose before going to bed, and found -its effects resembled those of opium. Not satisfied, he took a larger -dose next morning on rising, with the result of almost paralysing -him. But he fortunately had a good emetic close at hand, a bowl of -shaving water, and administering a large quantity, he was partially -relieved. But much prostration remained, and medical assistance had -to be summoned. - -Christison’s principal services to the literature of his subject -consisted in his work on Poisons, which was first published in 1829, -and went through several successive editions, and in numerous memoirs -and papers contributed to medical and scientific journals, some of -which detailed improved chemical processes and tests for poisons, -as those on “The Detection of Minute Quantities of Arsenic in Mixed -Fluids,” “On the Taste of Arsenic, and on its Property of Preserving -the Bodies of Persons who have been Poisoned with it,” and on the -poisonous properties of numerous vegetable alkaloids. - -In 1832 Christison, having raised his class to no fewer than ninety -students, resigned his chair on appointment to that of Materia -Medica, intending to become, in addition to a clinical teacher of -medicine, an original investigator on the therapeutical action of -remedies. But before he had got fully afloat in this, practice, for -which he had not specially laid himself out, flowed in upon him, and -prevented the realisation of his desire. He accumulated a fine museum -of materia medica, and his lectures were very popular. But it cannot -be said that he left his mark on medicine or therapeutics to the same -extent that he did on toxicology. - -Christison was eminently a lover of his university, and exceedingly -conscious of its great merits. In numerous matters he was very -conservative, and strongly resisted some modern views of pneumonia -and fevers. He wielded great influence for many years in the -administration of university matters. In 1838 and in 1846 he was -President of the Edinburgh College of Physicians. From 1868 to 1873 -he was President of the Royal Society of Edinburgh. From 1857 to 1873 -he occupied a seat at the General Medical Council. After having been -for many years Physician-in-Ordinary to the Queen in Scotland, Dr. -Christison received a baronetcy in 1871, on the recommendation of Mr. -Gladstone. In the same year his bust by Brodie was presented to the -university, by general subscription among the medical profession. - -In 1872 Sir Robert Christison completed his fiftieth year of active -service as professor in the university, the only case of the kind -that had ever occurred; and a large and enthusiastic assembly -entertained him at dinner. Further honours still awaited him; he was -in 1875 elected President of the British Medical Association at its -Edinburgh meeting; and in 1876 he was selected for the Presidency -of the British Association, a distinction which however he declined -on the ground of his advanced age. He soon afterwards retired from -active duty; but lived in considerable vigour till about Christmas -1881. He died on January 23, 1882, in his eighty-fifth year. - -“As regards his personal characteristics,” says the _Scotsman_, “Sir -Robert was perhaps liable to be somewhat misunderstood by those who -did not know him. Dogmatic and positive in his opinions, he was -inclined to lay down the law in a way that might not always be quite -agreeable.... On the other hand, friends who had the good fortune to -know him intimately found in his nature a fund of geniality such as -the casual observer could never have dreamt of. Warmth of heart and -simple unaffected kindness would seem to have been distinguishing -qualities of his private and social demeanour.” He was a strong -Churchman and Tory. He married in 1827 a Miss Brown, who died in -1849, leaving three sons. - - * * * * * - -Some years younger than Christison, ALFRED SWAINE TAYLOR was -contemporary through life with him, and occupied for many years a -quite exceptional position in the English mind in connection with the -detection of cases of poisoning. He was born at Northfleet in 1806, -and educated at Hounslow. At the early age of sixteen he became the -pupil of a surgeon near Maidstone, and in October 1823 entered as a -student at Guy’s and St. Thomas’s Hospitals, then forming a united -medical school. Later on he was exclusively connected with Guy’s as -pupil and lecturer until his retirement in 1878. - -From the year 1826 Taylor gave much attention to medical -jurisprudence, although his diligence was such as to win for -him a prize for anatomy at Guy’s. Chemistry proved a congenial -subject to him under the instruction of Allen and Aikin, and he -was further stimulated in the same direction by frequent visits to -Paris and all the principal Continental medical schools. At Paris -he heard among others Orfila and Gay-Lussac. Geology, mineralogy, -and physiology likewise engaged his attention, and so was formed a -mind singularly broad in its views of natural phenomena, and well -calculated to expound their laws. Taylor passed his examinations -at the Apothecaries’ Hall in 1828 and at the College of Surgeons in -1830, and entered upon practice, continuing, however, to study in the -chemical laboratory of Guy’s Hospital. - -In 1831, when the Apothecaries’ Society first required candidates for -their diploma to attend lectures on Medical Jurisprudence, Mr. Taylor -was appointed to lecture on the subject at Guy’s Hospital, a post -which he continued to hold for forty-seven years. In the next year he -succeeded Mr. Barry as co-lecturer on chemistry with Mr. Aikin, whose -colleague he continued till 1851, after which he was sole lecturer -on chemistry till 1870, when he resigned this lectureship. In these -important functions Dr. Taylor acquitted himself admirably. He was -exceedingly clear in his statements, exact and successful in his -experiments, while yet very undemonstrative in manner. - -In 1832 the new lecturer commenced his long series of memoirs bearing -on poisoning, by publishing an account of the Grotto del Cane, near -Naples, with remarks on suffocation by carbonic acid. This appeared -in the _London Medical and Physical Journal_. In subsequent years -he contributed important papers to Guy’s Hospital Reports, on the -action of water on lead, on poisoning by strychnia, on the tests -for arsenic and antimony, &c., and was soon a recognised authority -on medico-legal questions. He contributed to the _London Medical -and Physical Journal_ valuable memoirs on poisoning, child-murder, -&c. In 1836 he published the first volume of a work on medical -jurisprudence which was not completed at that time. In 1842 he -brought out his well-known “Manual of Medical Jurisprudence,” which -reached its tenth large English edition in 1879, in the author’s -lifetime, in addition to numerous American editions. The Swiney Prize -of 100 guineas, together with a valuable silver vase for a work on -Jurisprudence, were also awarded to him. - -In 1848, when he became a member of the College of Physicians, Dr. -Taylor published a work on Poisons which was at once accepted as -standard, and has gone through several editions. In 1865 his large -work entitled “The Principles and Practice of Medical Jurisprudence” -appeared, including much matter for which there was not space in his -manuals. This work attained its third edition in 1883, having been -edited by Dr. Thomas Stevenson, his distinguished successor at Guy’s -Hospital. - -But this represents only a portion of the literary labours of Dr. -Taylor. From 1844 to 1851 he was the editor of the _London Medical -Gazette_, afterwards incorporated with the _Medical Times_. He -largely co-operated in editing various editions of Pereira’s Materia -Medica. He brought out in conjunction with Professor Brande a Manual -of Chemistry in 1863, and in 1876 edited Dr. Neil Arnott’s celebrated -work on Physics. He was elected in 1853 Fellow of the College of -Physicians, having had previously conferred upon him the honorary -M.D. of St. Andrews University. He was elected a Fellow of the Royal -Society in 1845. He married in 1834 a Miss Cancellor. - -It was as a medical witness in important legal cases that Dr. Swaine -Taylor was most widely known. If a case of unusual character was -before the courts, it came to be expected that he should be called -as a witness, and for many years he was retained by the Treasury as -their medical adviser on such cases. It is impossible here to refer -to the numerous important cases of this character in which Dr. Taylor -figured. A writer in the _Medical Times_ for June 12 and 19, 1880 -(pp. 642, 671), enters into this question from full knowledge, and -describes him thus: “Personally Taylor was of a tall and imposing -figure, gracious to friends and bitter to foes, and, as the lawyers -found, a superb witness, not to be shaken by any light word of -doctrine.... There was a thoroughness about Taylor’s work which was -always satisfactory.” - -In regard to the celebrated Palmer trial, Dr. Taylor was severely -cross-examined, and was contradicted in important points by experts -called for the defence. In fact, it is possible that the case would -have gone in favour of the prisoner but for the strong confirmation -of the view of the prosecution given by Dr. Christison, to which we -have already referred. Dr. Taylor expressed his strong views on this -question in an extended pamphlet “On Poisoning by Strychnia,” most of -which appeared in Guy’s Hospital Reports for 1856. He died on May 27, -1880. - - - - -CHAPTER XXVIII. - -_PARKES, GUY, SIMON, AND PUBLIC HEALTH._ - - -“Prevention is better than cure” is the homely proverb which -marks out a large proportion of the work of sanitary science. The -prevention of disease and of its spread, and the promotion of the -general healthiness of the people—these are objects which modern -progress has brought into view. When they are completely attained we -shall all die of old age unless cut off by accidents or violence; and -this is a goal which many sanitarians of the present day have vividly -before their mind. - -The public health and the public welfare have been sought by no man -more earnestly than by EDMUND ALEXANDER PARKES. Of him Dr. Russell -Reynolds said:[24] “In the combination of moral, mental, and physical -beauty, Dr. Parkes was to my knowledge never equalled, to my belief -cannot be surpassed. Pure as a sunbeam, strong as a man, tender as a -woman, keen as any scientist to unravel the hidden mysteries of life -in its minutest detail of chemical and physiological research, yet -practical in the application of his knowledge to the cleansing of a -drain or the lightening of a knapsack; he made the world much richer -by his life, much poorer by his death.” - -Parkes was born on March 29, 1819, in the village of Bloxam, -Oxfordshire, his father being Mr. William Parkes, of the Marble-yard, -Warwick, “a man of superior mind, remarkable alike for industry, -firmness, and nobility of character.”[25] His mother, Frances Byerly, -daughter of Mr. Thomas Byerly of Etruria, Staffordshire, was much -occupied in literature, and her sister, wife of Professor A. T. -Thomson of University College, London, was a well-known biographer -and novelist. - -Under such favouring influences young Parkes grew up a gentle -but unusually merry and happy boy. After being educated at the -Charterhouse, he entered as a medical student at University -College, and spent much time in his uncle’s laboratory, becoming an -excellent manipulator, and already showing a fondness for research. -At the first M.B. examination at London University in 1840 he was -exhibitioner and medallist in anatomy, physiology, and chemistry, -and medallist in materia medica. In 1841 at the final M.B. he was -medallist in physiology and comparative anatomy, and gained honours -in medicine. He had taken the College of Surgeons’ diploma in 1840. - -Of this period of Parkes’s life Sir William Jenner, an intimate -fellow-student at University College, says: - -“As a student he was distinguished by brightness and cheerfulness, -amiability, unselfish willingness to help others at any cost of -trouble to himself, energy in work, diligence in the using of each -hour for the studies of that hour, the high moral tone that pervaded -his converse, and above all, and crowning all, by the real living -purity of his being.” - -Early in 1842 Parkes entered the army medical service, and went as -assistant-surgeon to the 84th regiment to Madras and Moulmein. Here -he prosecuted inquiries which bore fruit in two small publications -on the Dysentery and Hepatitis of India (1846), and on Asiatic -and Algide Cholera (1847). But before this period he had retired -from the army and entered upon practice in Upper Seymour Street, -Portman Square, becoming further known as a physician by editing and -completing Dr. Thomson’s work on Diseases of the Skin (1850). This -was only a portion of his literary and original work at this time, -during which he contributed largely to the _Medical Times_, and from -1852 to 1855 edited the _British and Foreign Medico-Chirurgical -Review_, for which difficult task he was exceedingly well fitted. - -Having been appointed one of the physicians to University College -Hospital, his influence was very marked, both on his students and his -colleagues. One of his pupils, afterwards a distinguished physician, -said that he never went round the wards with him without feeling an -intense wish to become better, and at the same time feeling that he -could become so. In 1855 Parkes delivered the Gulstonian Lectures -at the College of Physicians, taking the subject of Pyrexia, or the -State of Fever. - -During the Crimean War, when great pressure existed upon the -hospitals at Scutari, Dr. Parkes was selected by Government to -proceed to the seat of war to establish an additional large hospital. -He fixed upon Rankioi on the Dardanelles, and his choice proved -excellent. He worked most zealously to make everything as perfect as -possible, and he accomplished much in spite of the red-tape which was -so disastrously prominent in the war administration of that time. He -did not in any way spare himself, though his constitution had shown -serious signs of weakness in London, when he had had severe attacks -of pneumonia and phlebitis. His report on the work of his hospital at -the conclusion of the war was a most valuable one, and he gained the -high esteem of Mr. Sidney Herbert, afterwards Lord Herbert of Lea. - -One result of the Royal Commission of Investigation into the -administration of the war was the foundation of the Army Medical -School, and Mr. Herbert never showed better judgment than in -selecting Dr. Parkes to be Professor of Military Hygiene in -connection with it. Consequently he gave up in 1860 his post at -University College; he was appointed Emeritus Professor, and a marble -bust of him was placed in the College museum. - -Parkes found that in order adequately to teach the subjects involved -in preserving and promoting the health of the army, he must not only -study the special features of army life and the peculiar liabilities -attaching thereto, but also the general science of hygiene, then -almost new. He organised at the cost of immense labour a detailed -system of instruction, based on the principle of making the student -apply practically what he taught. All the special questions which -came up relating to air, water, food, temperature, clothing, house -construction, drainage, &c., were as far as possible illustrated in -the laboratory, and individual instruction was most carefully given. - -In 1864 was published the first edition of Parkes’s “Manual of -Practical Hygiene,” a masterly book, accurate, learned, clear, full, -and of the highest interest to the thoughtful mind. The introduction -to this work opens with a clear definition of the subject. “Hygiene -is the art of preserving health; that is, of obtaining the most -perfect action of body and mind during as long a period as is -consistent with the laws of life. In other words, it aims at -rendering growth more perfect, decay less rapid, life more vigorous, -death more remote.” - -Later he says: “It is undoubtedly true that we can, even now, -literally choose between health and disease; not, perhaps, always -individually, for the sins of our fathers may be visited upon us, -or the customs of our life and the chains of our civilisation and -social customs may gall us, or even our fellow-men may deny us -health, or the knowledge which leads to health. But, as a race, man -holds his own destiny, and can choose between good and evil; and as -time unrolls the scheme of the world, it is not too much to hope -that the choice will be for good.” He further powerfully indicates -the basis of state medicine, to secure for all individuals the -conditions of health which they often cannot secure for themselves. -He shows too that self-interest, state-benefit, and pecuniary profit -are at one in these matters when rightly understood. “It is but too -commonly forgotten,” he says, “that the whole nation is interested -in the proper treatment of every one of its members, and in its own -interest has a right to see that the relations between individuals -are not such as in any way to injure the well-being of the community -at large.” It is almost needless to add that numerous editions of -Parkes’s Practical Hygiene have been called for; it has also been -translated into several foreign languages. - -We have enumerated, however, but a small portion of the subjects -upon which Parkes’s unceasing philanthropic activity was exercised. -For many years he wrote an annual review of the Progress of Hygiene, -contributed to the Army Medical Reports. He served on many public -inquiries relating to matters of health, and did more for the -diminution of mortality in the army than any other man. He carried -on many protracted and difficult physiological investigations, such -as those on the effects of diet and exercise, on the elimination of -nitrogen, on the effects of alcohol on the human body, on the effects -of coffee, extract of meat, and alcohol on men marching, chiefly -contributed to the Royal Society. As a member of the Senate of London -University, and of the General Medical Council, and as Secretary to -the Senate of the Army Medical School, he performed detailed work of -the highest value, and all in spite of delicate health. - -“With increase of years,” says Sir William Jenner,[26] “his mind -ripened, his sphere of action widened, his influence over others -operated in new and perhaps more important ways; but in all moral -and intellectual essentials Dr. Parkes was as a man what he was -as a youth—he was animated by the same principles and stimulated -by the same faith. As years went on his mind proved itself to be -singularly well balanced; he possessed an extraordinary power of -acquiring information; his memory was very retentive; he was the -best-informed man in the medical literature of the century I ever -met; he was unprejudiced as he was learned; he could use with ease -the information he acquired, and could express his ideas clearly and -simply; his language was always elegant, and on occasions eloquent. -His powers of observation, of perception, of reasoning, and of -judgment were all good, and equally good. But as in his youth, -so in his manhood, the beauty of his moral nature, his unselfish -loving-kindness, his power of inoculating others with his own love -of truth, with his own sense of the necessity of searching for the -truth, of questioning nature till she yield up the truth, of earnest -work, were his most striking characteristics.” - -At last the seeds of weakness which were constitutional in Parkes -developed into acute tuberculosis, and he died on March 15, 1875, -after an illness of four months. His domestic life had been a very -happy one, but his wife, a Miss Chattock, whom he married in 1851, -had died in 1873, and he was much broken by her loss. He left no -children. His monument is in the Parkes Museum of Hygiene, which -enforces eloquently the lessons of his life. - - * * * * * - -Dr. WILLIAM AUGUSTUS GUY, F.R.S., is one of the most eminent of -modern promoters of the public health. He was born at Chichester -in the year 1810, his ancestors for three generations having been -medical practitioners there. His grandfather, William Guy, was a -pupil of John Hunter, and in Hayley’s life of Romney it is stated -that “Cowper said of him that he won his heart at first sight, and -Romney (who painted his portrait) declared that he had never examined -any manly features which he would sooner choose for a model if he had -occasion to represent the compassionate benignity of the Saviour.”[27] - -After a childhood spent with this estimable grandfather, young Guy -was educated at Christ’s Hospital, and later studied for five years -at Guy’s Hospital. Winning the Fothergillian medal of the Medical -Society of London for the best essay on Asthma, in 1831, at the early -age of twenty-one, he was encouraged to enter at Cambridge, where, -after a further period of two years spent at Heidelberg and Paris, he -took his M.B. degree in 1837. - -In 1838 Dr. Guy became Professor of Forensic Medicine in King’s -College, London, and later Assistant-Physician to King’s College -Hospital. He early directed his attention to statistics, and joined -the Statistical Society in 1839, and became one of its honorary -secretaries in 1843. 1844 he contributed important evidence -before the Health of Towns Commission, on the state of the London -printing-offices, and the consequent development of pulmonary -consumption among printers. He co-operated in founding the Health -of Towns Association, and has been incessantly occupied in public -lectures, investigations, and writings, in calling attention to -questions of sanitary reform. He has been notably concerned in the -improvement of ventilation, the utilisation of sewage, the health -of bakers and soldiers, hospital mortality, and many other like -subjects. In 1873 he was President of the Statistical Society, and he -has successively been Croonian, Lumleian, and Harveian Lecturer at -the College of Physicians. His various publications and papers are -too numerous to recount. We may, however, mention the “Principles of -Forensic Medicine,” and successive editions of Hooper’s “Physicians’ -Vade Mecum.” - - * * * * * - -Mr. JOHN SIMON, C.B., F.R.S., is one of the veterans of the present -day in matters of public health, besides having the highest -reputation as a surgeon and pathologist. Born in 1816, Mr. Simon was -a student of King’s College, London, and was elected a fellow of the -College of Surgeons in 1844. He was appointed in 1847 lecturer on -Pathology at St. Thomas’s Hospital. His subsequent researches and -writings, especially those on Inflammation, have proved his great -fitness for the post. In 1850 he published a very original course of -lectures on General Pathology, as conducive to the establishment of -Rational Principles for the Diagnosis and Treatment of Disease. - -Mr. Simon’s career in connection with public health began with his -being appointed the first Medical Officer of Health to the City of -London. He was before long selected as medical adviser to the General -Board of Health, and was thence transferred to the important post of -medical officer to the Privy Council. In this capacity his labours, -ably seconded by a crowd of zealous workers, have been of priceless -value to the nation at large. The successive annual reports published -by the Privy Council sufficiently attest this. - -In his first report to the Privy Council, Mr. Simon stated “that -more than half of our annual mortality results from diseases which -prevail with a very great range of difference in proportion as -sanitary circumstances are bad or good; that, according to the latest -available evidence, some of these diseases prevail twice or thrice, -some of them ten or twenty times, some of them even forty or fifty -times, as fatally in some districts as in other districts of England; -that the result of their excessive partial development is to render -the mortality of certain districts from 50 to 100 per cent. higher -than the mortality of other districts, and to raise the death-rate of -the whole country 33 per cent. above the death-rate of its healthiest -parts.” - -In his eleventh report Mr. Simon was able to write as follows: “It -would, I think, be difficult to over-estimate, in one most important -point of view, the progress which, during the last few years, has -been made in sanitary legislation. The principles now affirmed in -our statute-book are such as, if carried into full effect, would -soon reduce to quite an insignificant amount our present very large -proportions of preventable disease.... Large powers have been given -to local authorities, and obligation expressly imposed on them, -as regards their respective districts, to suppress all kinds of -nuisance, and to provide all such works and establishments as the -public health primarily requires; while auxiliary powers have been -given for more or less optional exercise in matters deemed of less -than primary importance to health.... The State ... has interfered -between parent and child ... between employer and employed ... -between vendor and purchaser; has put restrictions on the sale -and purchase of poisons; has prohibited in certain cases certain -commercial supplies of water; and has made it a public offence to -sell adulterated food, or drink, or medicine, or to offer for sale -any meat unfit for human food.... Its care for the treatment of -disease has not been unconditionally limited to treating at the -public expense such sickness as may accompany destitution; it has -provided that in any sort of epidemic emergency, organised medical -assistance, not peculiarly for paupers, may be required of local -authorities; and in the same spirit requires that vaccination at the -public cost shall be given gratuitously to every claimant.” - -Mr. Simon has been a distinguished surgeon to St. Thomas’s Hospital, -and attained some years ago the Presidency of the College of -Surgeons. He is also a member of the General Medical Council. In 1878 -his bust in marble was presented to the College of Surgeons by public -subscription, in recognition of his eminent services in sanitary -science. - - -FOOTNOTES: - -[24] See the _Lancet_, March 25, 1876, p. 481. - -[25] _Medical Times and Gazette_, March 25, 1876, p. 348. - -[26] _Lancet_, July 8, 1876, p. 41, supplement to Harveian Oration. - -[27] See Photographs of Eminent Medical Men, ii, 59. - - - - -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. - - - - - PRINTED BY BALLANTYNE, HANSON AND CO. - EDINBURGH AND LONDON. - - - - -List of Books - - _SEASON_] :Published by [1885-1886. - -JOHN HOGG, 13, Paternoster Row, London, E.C. - -In two vols., crown 8vo., cloth, price 21s. - - - =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. - - CHAP. - - 1. LINACRE, CAIUS, and the Foundation of British Medicine. - 2. WILLIAM HARVEY and the Circulation of the Blood. - 3. THOMAS SYDENHAM, the British Hippocrates. - 4. The MONROS, CULLEN, The GREGORYS, JOHN BELL, and - the Foundation of the Edinburgh School. - 5. The HUNTERS and the Applications of Anatomy and Physiology to - Surgery. - 6. EDWARD JENNER and Vaccination. - 7. SIR ASTLEY COOPER and ABERNETHY: the Knife _versus_ Regimen. - 8. SIR CHARLES BELL and the Functions of the Nervous System. - 9. MARSHALL HALL and Reflex Action. - 10. SIR B. BRODIE and SIR WM. LAWRENCE: two Great Practical Surgeons. - 11. ADDISON and BRIGHT, and the Diseases which bear their Names. - 12. LISTON, SYME, LIZARS, and the Newer Surgery. - 13. BAILLIE, HALFORD, CHAMBERS, and HOLLAND: - Fashionable and Courtly Physicians. - 14. SIR WM. FERGUSSON and Conservative Surgery. - 15. SIR JAMES SIMPSON and Anæsthetics. - 16. SIR SPENCER WELLS and Ovariotomy. - 17. SIR WILLIAM JENNER, BUDD, MURCHISON, and Typhoid Fever. - 18. SIR JOSEPH LISTER and Antiseptic Surgery. - 19. SIR F. WATSON, SIR DOMINIC CORRIGAN, SIR W. GULL, - and Clinical Medicine. - 20. SIR JAMES PAGET and Surgical Pathology. - 21. DR. WILLIAMS, STOKES, and Diseases of the Chest. - 22. SIR HENRY THOMPSON and Cremation. - 23. GRAVES, HUGHES BENNETT, and Clinical Teaching. - 24. CONOLLY, MAUDSLEY, and Mental Diseases. - 25. EMINENT SPECIALISTS: SIR ERASMUS WILSON and Skin Diseases; - MORELL MACKENZIE and Throat Diseases; COBBOLD - and Internal Parasites. - 26. EMINENT SPECIALISTS, _continued_:—SIR WILLIAM - BOWMAN, BRUDENELL CARTER, and Eye Diseases; - TOYNBEE, HINTON, and Ear Diseases. - 27. SIR R. CHRISTISON, DR. A. SWAYNE TAYLOR, and Poison Detection. - 28. PARKES, ANSTIE, ED. SMITH, SIMON, - BUCHANAN, and Public Health. - -[Illustration: Bookmaker’s Mark] - - - - -CLASSIFIED CONTENTS OF CATALOGUE - - -Books @ 1s. and 1s. 6d. - - PAGE - - Toothsome Dishes: The New Shilling Cookery Book 6 - Self-Help for Women: A Guide to Business 9 - The Band of Mercy Guide to Natural History 21 - The Dictionary of 1,000 Christian Names 17 - - -Books @ 2s. 6d. - - Every Cloud has its Silver Lining, and other Proverb Stories. First - Series 5 - One Thing at a Time, and other Proverb Stories. Second Series 5 - Plodding On; or, The Jog-trot to Fame and Fortune 17 - Facts and Phases of Animal Life 20 - Andersen’s Shoes of Fortune and other Fairy Tales 22 - Far-famed Tales from the Arabian Nights 21 - Wonderful Animals: Working, Domestic, and Wild 20 - Mottoes and Aphorisms from Shakespeare 23 - Hood’s Guide to English Versification 23 - Fortunate Men: How they made Money and won Renown 22 - - -Books @ 3s. 6d. - - The Secret of Success; or, How to get on in the World 10 - Our Redcoats and Bluejackets: War Pictures on Land and Sea 10 - The Parlour Menagerie. Woodcuts by Bewick and others 11 - Boys and their Ways: A Book for and about Boys 12 - Plain Living and High Thinking; or, Practical Self-Culture 12 - The Glass of Fashion. Etiquette and Home Culture 13 - Girls and their Ways: A Book for and about Girls 13 - The Pilgrim’s Progress. Life by Southey, and Harvey’s Illustrations 14 - The Church Seasons, Historically and Poetically Illustrated 14 - Exemplary Women: Feminine Virtues and Achievements 15 - The Ocean Wave: Voyages, Seamen, Discoveries, Shipwrecks, and - Mutinies 16 - The Life and Adventures of Robinson Crusoe 16 - Our Homemade Stories } { 18 - Stories of Young Adventurers } { 18 - Evenings away from Home } By ASCOTT R. HOPE { 19 - A Book of Boyhoods } { 18 - Stories out of School-time } { 19 - Young Days of Authors } { 3 - The Adventures of Maurice Drummore (Royal Marines) by Land and Sea 15 - Your Luck’s in your Hand; or, The Science of Modern Palmistry 8 - Dainty Dishes. By Lady Harriet St. Clair 6 - Landmarks of English Literature 7 - Great Movements, and Those who Achieved Them 7 - Blakely’s Popular Technical Dictionary of Commercial and General - Information 3 - - -Books @ 4s. 6d., 6s., 6s. 6d., and 7s. 6d. - - The Birthday-Book of Art and Artists 9 - “In Perils Oft.” Romantic Biographies Illustrative of the Adventurous - Life 3 - Woman’s Work and Worth in Girlhood, Maidenhood, and Wifehood 7 - The Manuale Clericorum. Abridged from “The Directorium Anglicanum” 23 - - -Edition de Luxe; price 7s. 6d. - - Robinson Crusoe. Stothard’s Illustrations, engraved by Heath 4 - - -Books @ 21s. - - Eminent Doctors: Their Lives and their Work. Two Vols. 1 - The Directorium Anglicanum 23 - - -Libraries for Young Readers. - - Ascott Hope’s Anchor Library of Fact and Fiction. Six Illustrated - Volumes, in Elegant Illustrated Metal Case. Price 21s. 24 - - The Boys’ and Girls’ Treasury of Natural History, Fairy Tales, - Biography, and Proverb Stories. Seven Illustrated Volumes, in Elegant - Illustrated Metal Case. Price 17s. 6d. 24 - - - - -_PUBLISHING SEASON_, 1885-6. - - -MR. ASCOTT R. HOPE’S NEW BOOK. - -WITH EIGHT ILLUSTRATIONS ON TONED PAPER. - -Small crown 8vo., 384 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =Young Days of Authors.= By ASCOTT R. HOPE, Author of “Stories of - Young Adventurers,” “Stories out of School-time,” etc. - - -CONTENTS: - - 1. BOYS IN ARMS. - 2. A POET’S BOYHOOD. - 3. A MIDSHIPMAN OF THE OLD SCHOOL. - 4. A YOUTH OF FAME AND FORTUNE. - 5. A WORKING BOY. - 6. A SCOTCH LASSIE IN AMERICA. - 7. A STORY-TELLER’S OWN STORY. - 8. A RUSSIAN CADET. - - -_Dedicated by permission to Sir RICHARD TEMPLE, Bart., G.C.S.I., -etc., late Governor of Bombay._ - -WITH SIXTEEN ILLUSTRATIONS ON TONED PAPER. - -Crown 8vo., 544 pp., cloth, bevelled boards, price 6s.; gilt edges, -6s. 6d. - - “=In Perils Oft.=” =Romantic Biographies= Illustrative of the - Adventurous Life. By W. H. DAVENPORT ADAMS, Author of “Plain Living - and High Thinking,” “Secret of Success,” “Woman’s Work and Worth,” - etc. - -“We are a wonderful people; it was never our Government which -made us a great nation.... England was made by Adventurers, not -by its Government; and I believe it will only hold its place by -Adventurers.”—_Journals of Major-General C. G. Gordon, C.B., at -Khartoum._ - -“Adventures are to the Adventurous.” - - -CONTENTS: - - CHAP. - - 1. THE HERO OF ST. JEAN D’ACRE. - 2. THE LAST OF THE SEA-KINGS. - 3. A HUNGARIAN DERVISH. - 4. THE MODERN WANDERING JEW. - 5. ARCTIC ADVENTURE. - 6. DISCOVERY OF THE ALBERT NYANZA. - 7. THE RAJA OF SARAWAK. - 8. ADVENTURES IN THE ARABIAN DESERT. - 9. THE WONDERFUL RIDE TO MERV. - 10. THE ENGLISH “SHEIKH.” - 11. THE HERO OF KHARTOUM. - - -Second edition, small crown 8vo., 384 pp., cloth, price 3s. 6d.; gilt -edges, 4s. - - =A Popular Technical Dictionary of= Commercial and General - Information. By EDWARD T. BLAKELY, F.S.A. (of the Board of Trade). - -“To young people destined for business, this Manual supplies a -variety of Technical Information such as no other book in the -language offers so compactly.”—_Extract from the Author’s Preface._ - - -EDITION DE LUXE. - -WITH STOTHARD’S ILLUSTRATIONS, ENGRAVED BY HEATH. - -_Richly bound in blue, black, and gold, gilt edges._ - -In one volume, demy 8vo., cloth, price 7s. 6d.; half morocco extra, -12s. 6d. - - =The Life and Adventures of Robinson= Crusoe, with a Sketch of - Defoe, by HENRY J. NICOLL. (Printed from a new font of old-faced - type.) - - NOTE.—This is a complete, unabridged edition of Defoe’s - masterpiece, with all the 22 beautiful Illustrations from the - Drawings by THOMAS STOTHARD, R.A., engraved by CHARLES HEATH. - These Illustrations are now printed from the Original Copper - Plates, which were produced at great cost, and are still in perfect - condition, having been steel-faced to preserve them. Copies of - the Original Edition with these same plates, published by Messrs. - Cadell and Davis in 1820, now fetch a high price. - - -“Mr. Hogg is to be thanked for re-issuing the ‘Life and Adventures -of Robinson Crusoe,’ with Stothard’s twenty-two designs engraved -on copper by Charles Heath. Their charm is irresistible, and as -book prints they rank among the classics of English art. They are -delightful works. The text before us is complete, and well printed in -a clear type. This edition is, therefore, excellent.”—_Athenæum._ - -“It was a happy idea of Mr. Hogg to secure the original -copper-plates, and to present his handsome edition of Defoe’s -masterpiece with the most appropriate illustrations that it ever -received. The whole of the twenty-two engravings are given, and we -can congratulate the admirers of the immortal tale, which has been -more truthfully and tenderly illustrated by Stothard than by any -other artist.”—_Queen._ - -“This is truly an _edition de luxe_ of Defoe’s masterpiece. It is -beautifully printed and enriched with twenty-two full-page engravings -from the drawings of Thomas Stothard, R.A., and altogether is a book -to please the eye and delight the heart of all who have ‘a weak side’ -to our sterling old British classics.”—_North British Daily Mail._ - -“An admirable edition of the immortal ‘Robinson Crusoe,’ adorned with -engravings from Stothard’s celebrated designs, forming a sumptuous -present.”—_Truth._ - -“The plates come out in this edition with the sharpness of their -earliest days, and are full of force and grace. Those who get this -copy of Defoe’s great work will indeed have a pleasure.”—_Scotsman._ - -“A book which many would desire to have on their shelves in -common with other English classics. Small editions are numerous -enough, but Mr. John Hogg now supplies us with a handsome library -volume, which, moreover, has the advantage of Stothard’s exquisite -designs engraved by Heath. The volume, a full-size 8vo., finely -printed with wide margins, has a critical introduction by Henry J. -Nicoll.”—_Bookseller._ - -“An edition printed in fine bold type, and containing reproductions -of Stothard’s well-known illustrations. And, what is more, -it contains not only the ‘Adventures’ but also the ‘Further -Adventures’ of Robinson Crusoe, which are often omitted from popular -editions.”—_St. James’s Gazette._ - -“This is one of the handsomest editions of Defoe’s immortal work -which we have seen an _edition de luxe_, indeed. It is a trite, -but in this case a perfectly fitting statement, that Mr. Hogg has -spared no expense in the production of what is at once a beautiful -gift-book, and an equally beautiful volume for the drawing-room -table.”—_Manchester Weekly Post._ - -“_Editions de luxe_ of standard works being in constant demand, -Mr. Hogg has done well to add to the list this handsome edition of -Defoe’s masterpiece. Stothard’s designs, it need scarcely be said, -are greatly superior to the ordinary run of book engravings, being -admirable alike as illustrations and on account of their intrinsic -merits. Altogether the book may be confidently recommended to those -who desire to possess a library edition of a work which seems -likely to maintain its proud pre-eminence, and it would not be easy -to find a work better adapted in all respects for presentation -purposes.”—_Aberdeen Free Press._ - -“Everybody may not be aware of this latest and most beautiful edition -of the adventures of the old York mariner. We may say then, without -qualification, that this volume is one of the most elegant that has -come out of the press this season. The sketch of Defoe is very well -done.”—_Yorkshire Gazette._ - -“Few of the many reprints of works of acknowledged excellence that -have been recently published will surpass the one now under notice in -intrinsic worth.”—_Glasgow Herald._ - - - - -_PROVERB STORIES FOR BOYS AND GIRLS._ - - -I. - -Small crown 8vo., cloth, 256 pp., with 36 Illustrations, price 2s. -6d.; gilt edges, 3s. - - =Every Cloud has its Silver Lining=, and other Proverb Stories - for Boys and Girls. First Series. By MRS. J. H. RIDDELL, MRS. - M. DOUGLAS, MARIA J. GREER, and other Authors. With Thirty-six - Illustrations by A. W. COOPER, A. CHASEMORE, ADELAIDE CLAXTON, and - other Artists. - - -CONTENTS. - - STOCKTON MANOR; OR, EVERY CLOUD HAS ITS SILVER LINING. BY CONSTANCE - BURNET. - - THE CURATE OF LOWOOD; OR, EVERY MAN HAS HIS GOLDEN CHANCE. BY MRS. - J. H. RIDDELL. - - THE ORPHANS; OR, NO HAND NEED BE EMPTY WHILE THERE IS SEED TO BE - SOWN. BY CONWAY EDLESTON. - - LADY MADALENA; OR, NEVER MAKE A MOUNTAIN OF A MOLE-HILL. BY THE - AUTHOR OF “MY MOTHER’S DIAMONDS.” - - JULIET PERCY; OR, HANDSOME IS AS HANDSOME DOES. BY MARY COMPTON. - - THE ROMANCE OF THE TERRACE; OR, NEVER WADE IN UNKNOWN WATERS. BY - MARIA J. GREER. - - ROVER AND HIS FRIENDS; OR, A FRIEND IN NEED IS A FRIEND INDEED. - FROM THE FRENCH OF MADAME COLOMB. - - THE YOUNG ENGINEER; OR, SOMETIMES WORDS WOUND MORE THAN SWORDS. BY - MRS. M. DOUGLAS. - - -II. - -Small crown 8vo., cloth, 256 pp., with 33 Illustrations, price 2s. -6d.; gilt edges, 3s. - - =One Thing at a Time, and other= Proverb Stories for Boys and - Girls. Second Series. By ETHEL COXON, MRS. DOUGLAS, MADAME COLOMB, - and other Authors. With Thirty-three Illustrations by A. CHANTREY - CORBOULD, A. W. COOPER, HARRIET BENNETT, and other Artists. - - -CONTENTS. - - A RULE OF CONDUCT; OR, ONE THING AT A TIME. BY MADAME COLOMB. - - A BRAVE BOY’S TRIALS; OR, SAY WELL IS A GOOD WORD, BUT DO WELL IS A - BETTER. BY ETHEL COXON. - - COUSIN FLORENCE; OR, BEAUTY IS BUT SKIN DEEP. BY CONWAY EDLESTON. - - THE QUIET DAUGHTER; OR, WHEN THE SUN HAS SET THE LITTLE STARS MAY - SHINE. BY MRS. M. DOUGLAS. - - THE LITTLE MODEL; OR, ’TIS A LONG DAY WHICH HAS NO NIGHT. FROM THE - FRENCH. - - A DAZZLING ACQUAINTANCE; OR, FAIR WORDS BUTTER NO PARSNIPS. BY MRS. - M. DOUGLAS. - - THE BEST SUIT; OR, ONE DOES NOT DO WHAT ONE OUGHT UNLESS ONE DOES - WHAT ONE CAN. BY WALTER CLINTON. - - -THE NEW SHILLING COOKERY-BOOK. - -In crown 8vo., 160 pp., price 1s. - - =Toothsome Dishes: Fish, Flesh, and= Fowl; Soups, Sauces, and - Sweets. With Household Hints and other Useful Information. Edited - by CARRIE DAVENPORT. - - INTRODUCTION:—1. Foods in Season; 2. Tables of Weights and - Measures; 3. A Ready Reckoner to check Bills; 4. Cooking Requisites - and Utensils; 5. Condiments, etc., to keep in Stock. - - SOUPS:—How to make Soups. Recipes. - - SAUCES:—How to make Good Sauces. Recipes. - - FISH:—How to choose Fish. Recipes. - - MEAT:—1. How Meat is cut up; 2. Joints (how used); 3. How to choose - Meat; 4. Modes of Cooking (how to roast, boil, broil, stew, etc.); - 5. Recipes. - - POULTRY AND GAME:—How to choose. Recipes. - - ECONOMICAL COOKERY:—How to utilize Cold Meat, Scraps, etc. - - VEGETABLES:—Including Salads, Pickling, etc. Recipes. - - SWEETS, ETC.:—Pastry, Puddings, Cakes, Biscuits, Scones, etc. - Recipes. - - PICKLES, PRESERVES, FORCEMEAT, ETC.:—Recipes. - - EGGS, CHEESE, ETC.:—How to choose and preserve. Recipes. - - COOKERY FOR INVALIDS:—Recipes for the Sick and Convalescent. - - MISCELLANEA:—Various Odds and Ends, including Tea, Coffee, etc. - - APPENDIX:—Various Household Hints. - - -“=A most attractive general cookery-book.=”—_Examiner._ - -_Tenth edition, small crown 8vo., 392 pp., cloth, price 3s. 6d._ - - =Dainty Dishes. Receipts collected by= LADY HARRIET ST. CLAIR (late - Countess Münster). - -“In spite of the number of cookery-books in existence, Lady Harriet -St. Clair’s volume is well worth buying, especially by that class of -persons who, though their incomes are small, enjoy out-of-the way and -_recherché_ delicacies.”—_Times._ - -“It is true to its title, but shows that ‘dishes’ may be ‘dainty’ -without being costly or elaborate, with nothing but wholesome -ingredients to begin with, and delicate management in the -cooking.”—_Examiner._ - -“It is a capital cookery-book. All the recipes are clear and well -conveyed, and they will enable anyone who chooses to follow them to -produce capital cookery.”—_Scotsman._ - -“The contents of the volume are varied, much attention being -bestowed on Scotch dishes, and it is something to say in this age -of many cookery-books, that the recipes given are not fanciful, but -practical. They can really be cooked, a recommendation that cannot be -given to many of our cookery-books.”—_Glasgow Herald._ - -“A design so excellent, and an accomplishment so complete, may well -recommend this volume to the consideration of the ladies of this -kingdom. If economy can be combined with an agreeable and nutritious -diet, by all means let the fact be well known.”—_British Mail._ - -“Those house-wives who wish to improve in the now fashionable art of -cookery, will find a storehouse of plain, practical teaching in this -book.”—_Literary Churchman._ - -“The late Countess Münster has not only laid English and French -kitchens under contribution, but takes us to Italy, Germany, Russia, -and even to Poland, in search of any dish that may be toothsome, -wholesome, and made easily and cheaply.”—_Bookseller._ - -“A book of gastronomic delicacies enough to make the mouth -water.”—_Surrey Comet._ - -“Here is a cookery-book unique in character, and well worth -studying.”—_Educational Times._ - - -_Second and Cheap Edition, with Twelve Portraits._ - -Small crown 8vo., 472 pp., cloth, price 3s. 6d.; gilt edges, 4s. - -Landmarks of English Literature. - -By HENRY J. NICOLL, Author of “Great Movements,” etc. - - -CONTENTS: - - INTRODUCTION: Explains the Plan of the Book, and gives some Hints - on the Study of Literature. - - THE DAWN OF ENGLISH LITERATURE. - - THE ELIZABETHAN ERA. - - THE SUCCESSORS OF THE ELIZABETHANS. - - THE LITERATURE OF THE RESTORATION. - - THE WITS OF QUEEN ANNE’S TIME. - - OUR FIRST GREAT NOVELISTS. - - JOHNSON AND HIS CONTEMPORARIES. - - THE NEW ERA IN POETRY. - - SIR WALTER SCOTT AND THE PROSE LITERATURE OF THE EARLY PART OF THE - NINETEENTH CENTURY. - - OUR OWN TIMES. - - PERIODICALS, REVIEWS, AND ENCYCLOPÆDIAS. - -“We can warmly commend this excellent manual. Mr. Nicoll is a fair -and sensible critic himself, and knows how to use with skill and -judgment the opinions of other critics. His book has many competitors -to contend with, but will be found to hold its own with the best of -them.”—_St. James’s Gazette._ - -“Mr. Nicoll’s facts are commendably accurate, and his style is -perfectly devoid of pretentiousness, tawdriness, and mannerism, for -which relief in the present day an author always deserves much thanks -from his critics.”—_Saturday Review._ - -“Mr. Nicoll has performed his task with great tact, much literary -skill, and with great critical insight. No better book could be put -into the hands of one who wishes to know something of our great -writers, but who has not time to read their works himself; and no -better guide to the man of leisure who desires to know the best -works of our best writers and to study these in a thorough manner. -Mr. Nicoll’s literary estimates are judicious, wise, and just in an -eminent degree.”—_Edinburgh Daily Review._ - -“Mr. Nicoll’s well-arranged volume will be of service to the student -and interesting to the general reader. Biography and history are -combined with criticism, so that the men are seen as well as their -works.... The copious and careful table of chronology gives a -distinct value to the book as a work of reference. The volume is -without pretension, and deserves praise for simplicity of purpose, as -well as for careful workmanship.”—_Spectator._ - - -_Second and Cheap Edition._ - -WITH EIGHT PORTRAITS, 464 pp., crown 8vo., cloth, price 3s. 6d.; gilt -edges, 4s. - - =Great Movements and those who= Achieved Them. By HENRY J. NICOLL, - Author of “Landmarks of English Literature,” etc. - -“A useful book.... Such work ... should always find its reward in an -age too busy or too careless to search out for itself the sources of -the great streams of modern civilization.”—_Times._ - -“An excellent series of biographies.... It has the merit of -bespeaking our sympathies, not as books of this class are rather apt -to do, on the ground of mere success, but rather on the higher plea -of adherence to a lofty standard of duty.”—_Daily News._ - -“Immense benefit might be done by adopting it as a prize book for -young people in the upper classes of most sorts of schools.”—_School -Board Chronicle._ - - -Crown 8vo., 576 pp., cloth, price 6s. 6d.; gilt edges, 7s. - - =Woman’s Work and Worth in Girlhood,= Maidenhood, and Wifehood. - With Hints on Self-Culture and Chapters on the Higher Education and - Employment of Women. By W. H. DAVENPORT ADAMS. - -“It is a small thing to say that it is excellent, and it is only -justice to add that this all-important subject is dealt with in a -style at once masterly, erudite, charming.”—_Social Notes._ - -“As an aid and incitement to self-culture in girls, and pure -and unexceptionable in tone, this book may be very thoroughly -recommended, and deserves a wide circulation.”—_English-woman’s -Review._ - -“It is a noble record of the work of woman ... and one of the very -best books which can be placed in the hands of a girl.”—_Scholastic -World._ - - -WITH FIVE WOOD-CUTS, ILLUSTRATING “THE HAND OF GOOD FORTUNE,” ETC. - -Crown 8vo., 304 pp., cloth, price 3s. 6d. - - =Your Luck’s in Your Hand; or, The= Science of Modern Palmistry, - chiefly according to the Systems of D’Arpentigny and Desbarrolles, - with some Account of the Gipsies. By A. R. CRAIG, M.A., Author of - “The Philosophy of Training,” etc. Third Edition. - - CHAP. - - 1. PALMISTRY AS A SCIENCE. - 2. ANCIENT PALMISTRY. - 3. THE MODERN SCIENCE AND ITS HIGH PRIEST. - 4. SIGNS ATTACHED TO THE PALM OF THE HAND. - 5. THE THUMB. - 6. HARD AND SOFT HANDS. - 7. THE HAND IN CHILDREN. - 8. SPATULED HAND. - 9. THE ENGLISH HAND. - 10. THE NORTH AMERICAN HAND. - 11. THE ARTIST HAND. - 12. THE USEFUL HAND. - 13. CHINESE HANDS. - 14. THE HAND OF THE PHILOSOPHER. - 15. THE HAND PSYCHICAL. - 16. MIXED HANDS. - 17. THE FEMALE HAND. - 18. M. DESBARROLLES AND THE ADVANCED SCHOOL. - 19. PALMISTRY IN RELATION TO THE FUTURE. - 20. THE THREE WORLDS OF CHIROMANCY. - 21. THE MOUNTS AND LINES. - 22. THE LINE OF THE HEAD. - 23. THE LINE OF LIFE—OF SATURN—OF THE LIVER—OF VENUS. - 24. THE LINE OF THE SUN. - 25. THE RASCETTE. - 26. THE SEVEN CAPITAL SINS. - 27. POWER OF INTERPRETATION. - 28. THE ASTRAL FLUID. - 29. THE CHILDREN OF THE RULING PLANETS: THEIR CHARACTERS. - 30. READINGS OF THE HANDS OF CELEBRATED MEN AND WOMEN. - 31. M. D’ARPENTIGNY AND THE GIPSIES—MR. BORROW’S RESEARCHES. - 32. GIPSY CHIROMANTS. - 33. THE HAND AS AFFECTED BY MARRIAGE. - 34. CONCLUSION. - -“The glove-makers ought to present the author with a service of gold -plate. He will be a rash man who lets anybody see his bare hands -after this. We are anxious to find a lost pair of gloves before we go -out for a breath of fresh air after such an exhausting study as this -book has furnished us.”—_Sheffield and Rotherham Independent._ - -“Palmistry, chiromancy, and their kindred studies, may be mystical, -indeed, but never unworthy. There is more in them than the mass -imagine, and to those who care to wade into them. Mr. Craig will -prove himself a capital guide.”—_Manchester Weekly Post._ - -“The illustrations are curious. Those whose care to study the matter -of hands, fortunate or unfortunate, will find abundant materials -here.”—_Literary World._ - -“It is certainly a ‘handy book,’ for hands of every class are so -carefully described that all the signs of the palms may be readily -‘got up’ by those who wish to deal in this simplest of the dark -sciences.”—_Publishers’ Circular._ - -“The work is of surpassing interest.”—_Aberdeen Journal._ - -“Gives the fullest rules for interpreting the lines and marks on -the hands, fingers, and wrists, as well as the points of character -indicated by their shape. We can imagine this little book, which is -illustrated by five diagrams, being a source of a large amount of -amusement.”—_Bookseller._ - - - =Manuals of Self-Culture for Young= Men and Women. - - 1. =The Secret of Success.= See page 10. - 2. =Plain Living and High Thinking.= See page 12. - 3. =Woman’s Work and Worth.= See page 7. - 4. =Hood’s Guide to English Versification.= See page 23. - 5. =Landmarks of English Literature.= See page 7. - - -_Dedicated, by express permission, to Sir FREDERICK LEIGHTON, P.R.A._ - -PRINTED IN BROWN INK, WITH TWELVE FLORAL ILLUSTRATIONS, AND THE -BINDING DESIGNED BY “LUKE LIMNER,” F.S.A. - -Imperial 16mo., cloth, bevelled boards, interleaved, 432 pages, price -4s. 6d. gilt edges. - - =The Birthday-Book of Art and Artists.= Compiled and Edited by - ESTELLE DAVENPORT ADAMS, Editor of “Rose Leaves,” “Flower and - Leaf,” etc. - - “Mrs. Adams’ pleasant _Birthday Book_ you eagerly will - con.”—_Punch._ - - “Birthday books we have seen in abundance, but this bears away the - palm.”—_Guernsey Mail._ - - “Estelle Davenport Adams has bestowed infinite trouble on her - ‘Birthday Book of Art and Artists,’ which is quite an artistic - encyclopædia on a small scale.”—_Graphic._ - - “Few of the infinite variety of birthday books have been planned - more ingeniously, or to more useful purpose, than this, which ought - to secure a large share of the popularity lavished on these pretty - manuals.”—_Glasgow Herald._ - - “A handy little book for those persons who take note of birthdays, - either for the giving or taking of presents.”—_Athenæum._ - - “Altogether it is a birthday book to be coveted.”—_Scotsman._ - - “The book may really be very useful, and concludes with an - excellent index.”—_Saturday Review._ - - “Mrs. Davenport Adams has combined in miniature something of a - catalogue of art, a biographical dictionary of artists, and a - dictionary of artistic criticism, and has thereby done a thing - which may be of some service.”—_World._ - - “Quite a dictionary of dates as to the birthdays of eminent - artists, for, besides those whose names are allotted to the days of - the year, there is a supplementary list. The quotations are well - made. The book itself is a work of art.”—_Sword and Trowel._ - - -120 pp., small crown 8vo., boards, price 1s.; or bound in cloth, 1s. -6d. - - =Self-Help for Women: A Guide to= Business. With Practical - Directions for Establishing and Conducting Remunerative Trades and - Business Occupations suitable for Women and Girls. By A WOMAN OF - BUSINESS. - - 1. CELEBRATED WOMEN OF BUSINESS. - 2. SELECTING A BUSINESS. - 3. CONDUCTING A BUSINESS. - 4. THE BERLIN-WOOL BUSINESS. - 5. THE BOOT AND SHOE TRADE. - 6. CONFECTIONERY BUSINESS. - (_With Confectioners’ Receipts._) - 7. CORSET-MAKING BUSINESS. - 8. THE DRESS-MAKING BUSINESS. - 9. THE FANCY TRADE. - 10. FISH AND GAME TRADE. - 11. GLASS AND CHINA BUSINESS. - 12. THE JEWELLERY TRADE. - 13. LADIES’ UNDERCLOTHING AND BABY LINEN WAREHOUSE. - 14. THE MUSIC TRADE. - 15. SERVANTS’ REGISTRY BUSINESS. - 16. SHEFFIELD AND BIRMINGHAM GOODS TRADE. - 17. STATIONERY AND BOOKSELLING. - 18. THE TOY TRADE. - 19. MISCELLANEOUS TRADES. - 20. HOTEL MANAGING. - 21. THE LADY HOUSEKEEPER AND THE LADY HELP. - 22. HOME OCCUPATIONS. - 23. THE PLEASURES OF WORK. - - “The writer is evidently well informed, and her shrewd, practical - hints cannot fail to be of value to an increasing class of the - community, the women who are left to fight their own way in the - world.”—_Echo._ - - “This volume will be useful and cheering to many a woman thrown - upon her own resources, by showing her what other women have done, - and enabling her to discover in what direction she can best make - use of her abilities.”—_Bristol Mercury._ - - “Before going into any trade or profession women should consult - this little work.”—_Sheffield Independent._ - - “Claims our most marked attention.”—_Punch._ - - “A shilling laid out in the purchase of this little book will - prove a far better investment than the waste of postage stamps in - replying to letters.”—_Stationer._ - - “This is not a trumpery talk about business suitable for women, but - a serious production, in which specific trades and occupations are - dealt with in an intelligent and candid manner.”—_Manchester Weekly - Post._ - - “To those who find it needful to leave home and to enter upon - the struggles of the world, the little book which ‘A Woman of - Business’ has prepared will be found at once a guide and an - encouragement.”—_Manchester Courier._ - - “It fully fulfils its object in clearly showing the variety of - businesses and lucrative employment which women may follow, as well - as giving useful information as to how to start.”—_Weldon’s Ladies’ - Journal._ - - “A volume which every woman who is at a loss to know how she may - earn honourable livelihood should purchase.”—_Dundee Courier._ - - -WITH EIGHT ILLUSTRATIONS ON TONED PAPER. - -Fifth Edition, small crown 8vo., 384 pp., cloth, price 3s. 6d; gilt -edges, 4s. - - =The Secret of Success; or, How to= Get on in the World. With some - Remarks upon True and False Success, and the Art of making the Best - Use of Life. Interspersed with Numerous Examples and Anecdotes. By - W. H. DAVENPORT ADAMS, Author of “Plain Living and High Thinking,” - etc. - - “Mr. Adams’s work is in some respects more practical than Mr. - Smiles’s. He takes the illustrations more from the world of - business and commerce, and their application is unmistakable.... - There is much originality and power displayed in the manner in - which he impresses his advice on his readers.”—_Aberdeen Journal._ - - “There is a healthy, honest ring in its advice, and a wise - discrimination between true and false success.... Many a story of - success and failure helps to point its moral.”—_Bradford Observer._ - - “The field which Mr. Adams traverses is so rich, extensive, and - interesting, that his book is calculated to impart much sound - moral philosophy of a kind and in a form that will be appreciated - by a large number of readers.... The book is otherwise a mine of - anecdote relating to men who have not only got on in the world, but - whose names are illustrious as benefactors to their kind.”—_Dundee - Advertiser._ - - -WITH TWO COLOURED PLATES AND EIGHT PAGE ILLUSTRATIONS. - -Third edition, small crown 8vo., 400 pp., cloth, price 3s. 6d.; gilt -edges, 4s. - - =Our Redcoats and Bluejackets: War= Pictures on Land and Sea. - Forming a Continuous Narrative of the Naval and Military History - of England from the year 1793 to the Present Time, including the - Afghan and Zulu Campaigns, Interspersed with Anecdotes and Accounts - of Personal Service. By HENRY STEWART, Author of “The Ocean Wave,” - etc. With a Chronological List of England’s Naval and Military - Engagements. - - “A capital collection of graphic sketches of plucky and brilliant - achievements afloat and ashore, and has, moreover, the advantage of - being a succinct narrative of historical events. It is, in fact, - the naval and military history of England told in a series of - effective tableaux.”—_World._ - - “It is not a mere collection of scraps and anecdotes about our - soldiers and sailors, but a history of their principal achievements - since the beginning of the war in 1793. The book has charms for - others than lads.”—_Scotsman._ - - “Besides being a work of thrilling interest as a mere story-book, - it will also be most valuable as a historical work for the young, - who are far more likely to remember such interesting historical - pictures than the dry lists of dates and battles which they find in - their school-books.... Possesses such a genuine interest as no work - of fiction could surpass.”—_Aberdeen Journal._ - - * * * * * - -“_Among the multitude of publishers who issue books suitable -for presents, Mr. Hogg holds a high place. A catalogue of his -publications, samples of which lie before us, contains a number of -useful and interesting works eminently suitable for presentation to -young people of both sexes, and they contain as much reading at as -low a price as any books in the market._”—PALL MALL GAZETTE. - - -WITH UPWARDS OF 300 ENGRAVINGS BY BEWICK AND OTHERS. - -FIFTH AND CHEAP EDITION. - -Large crown 8vo., 520 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =The Parlour Menagerie=: Wherein are exhibited, in a Descriptive - and Anecdotical form, the Habits, Resources, and Mysterious - Instincts of the more Interesting Portions of the Animal - Creation. Dedicated by permission to the Right Hon. the Baroness - Burdett-Coutts (President) and the Members of the Ladies’ Committee - of the Royal Society for the Prevention of Cruelty to Animals. - - [Illustration: WHITE EYELID MANGABEY. - - _Specimen of the 66 Wood Engravings by Thomas Bewick in the - “Parlour Menagerie.”_] - -From Professor OWEN, C.B., F.R.S., &c. - -(Director, Natural History Dep., British Museum). - -To the Editor of the _Parlour Menagerie_. - - “The early love of Nature, especially as manifested by the Habits - and Instincts of Animals to which you refer, in your own case, is - so common to a healthy boy’s nature, that the _Parlour Menagerie_, - a work so singularly full of interesting examples culled from so - wide a range of Zoology, and so fully and beautifully illustrated - cannot fail to be a favourite with the rising generation—and - many succeeding ones—of Juvenile Naturalists. When I recall the - ‘Description of 300 Animals’ (including the Cockatrice and all - Pliny’s monsters) which fed my early appetite for Natural History, - I can congratulate my grandchildren on being provided with so much - more wholesome food through your persevering and discriminating - labours.—RICHARD OWEN.” - - -From the Right Hon. JOHN BRIGHT, M.P. - -To the Editor, _Parlour Menagerie_. - - “I doubt not the _Parlour Menagerie_ will prove very interesting, - as indeed it has already been found to be by those of my family - who have read it. I hope one of the effects of our better public - education will be to create among our population a more humane - disposition towards what we call the inferior animals. Much may be - done by impressing on the minds of children the duty of kindness in - their treatment of animals, and I hope this will not be neglected - by the teachers of our schools.... I feel sure what you have done - will bear good fruit.—JOHN BRIGHT.” - - “The _Parlour Menagerie_ is well named. Full as an egg of - information and most agreeable reading and engravings, where before - was there such a menagerie?”—_Animal World._ - - “We have never seen a better collection of anecdotes and - descriptions of animals than this, and it has the great advantage - of numerous and admirable woodcuts. Pictorial illustrations form - an important and valuable addition to any such collection. Those - in the book before us are of remarkable excellence.... We highly - commend the spirit which pervades the book, a spirit intensely - alien to cruelty of every kind. On the whole, it is one of the - very best of its kind, and we warrant both its usefulness and - acceptability.”—_Literary World._ - -“_Mr. Hogg is, without question, a specialist in the art of catering -for the literary tastes of the young._”—SHROPSHIRE GUARDIAN. - - -WITH EIGHT ILLUSTRATIONS ON TONED PAPER. - -Second edition, small crown 8vo., 352 pp., cloth, price 3s. 6d.; gilt -edges, 4s. - - =Boys and their Ways: A Book for and= about Boys. By ONE WHO KNOWS - THEM. - - -CONTENTS. - - Chaps. 1. The Boy at Home.—2. The Boy at School.—3. The Boy in - the Playground.—4. The Boy in his Leisure Hours.—5. Bad Boys.—6. - Friendships of Boys.—7. The Boy in the Country.—8. How and What to - Read.—9. Boyhood of Famous Men.—10. The Ideal Boy. - - “The table of contents gives such a bill of fare as will render - the boy into whose hands this book falls eager to enjoy the feast - prepared for him. We venture to predict for this charming book a - popularity equal to ‘Self-Help.’... No better gift could be put - into a boy’s hands, and it will become a standard work for the - school library.”—_Scholastic World._ - - “Who the author of the book is, has been kept a secret, and - the anonymity we regret, because the work is one with which - no writer need be ashamed to identify his name and stake his - reputation.”—_Edinburgh Daily Review._ - - “It is a boy’s book of the best style.”—_Aberdeen Journal._ - - -WITH EIGHT PORTRAITS ON TONED PAPER. - -_Dedicated by permission to the Rt. Hon. W. E. GLADSTONE, M.P., &c._ - -Third edition, small crown 8vo., 384 pp., cloth, price 3s. 6d.; gilt -edges, 4s. - - =Plain Living and High Thinking; or=, Practical Self-Culture: - Moral, Mental, and Physical. By W. H. DAVENPORT ADAMS, Author of - “The Secret of Success,” etc. - - -PART I.—MORAL SELF-CULTURE. - - Chap. 1. At Home. - ” 2. Life Abroad. - ” 3. Character. - ” 4. Conduct. - - -PART II.—MENTAL SELF-CULTURE. - -Chap. 1. How to Read. - - Chaps. 2 to 9. Courses of Reading in English Poetry, History, - Biography, Fiction, Travel and Discovery, Theology, Philosophy and - Metaphysics, Miscellaneous Science and Scientific Text-Books. Chap. - 10. How to Write: English Composition. - - -PART III.—PHYSICAL SELF-CULTURE. - -“Mens sana in corpore sano.” - - “We like the thorough way in which Mr. Adams deals with - ‘Self-Culture: Moral, Mental, and Physical.’ His chapter on the - courtesies of home life, and the true relation between parent - and child, is specially valuable nowadays. He certainly answers - the question, ‘Is life worth living?’ in a most triumphant - affirmative.”—_Graphic._ - - “Books for young men are constantly appearing—some of them - genuine, earnest, and useful, and many of them mere products of - the art of book-making. We have pleasure in saying that this - volume by Mr. Adams deserves to take its place among the best - of the first-mentioned class. It is fresh, interesting, varied, - and, above all, full of common sense, manliness, and right - principle.”—_Inverness Courier._ - - “Young men who wish to make something of themselves should invest - seven sixpences in this most valuable volume.”—_Sword and Trowel._ - - “A better book of the class in all respects we have seldom had the - pleasure to notice.... We cannot too strongly recommend it to young - men.”—_Young Men’s Christian Association Monthly Notes._ - -“_A glimpse through Mr. Hogg’s catalogue shows how admirably he -caters for the young of both sexes._”—WOLVERHAMPTON CHRONICLE. - - - “The best book of the kind.” } - “A complete Society Encyclopædia.” } _Vide Critical Notices._ - -With Frontispiece, small crown 8vo., 352 pp., handsomely bound in -cloth price 3s. 6d.; gilt edges, 4s. - - =The Glass of Fashion: A Universal= Handbook of Social Etiquette - and Home Culture for Ladies and Gentlemen. With Copious and - Practical Hints upon the Manners and Ceremonies of every Relation - in Life—at Home, in Society, and at Court. Interspersed with - Numerous Anecdotes. By the LOUNGER IN SOCIETY. - - CHAP. - 1. AT HOME. - 2. ABROAD. - 3. THE PHILOSOPHY OF DINNERS. - 4. THE BALL. - 5. THE PHILOSOPHY OF DRESS. - 6. THE ART OF CONVERSATION. - 7. THE ETIQUETTE OF WEDDINGS. - 8. AT COURT. - 9. HINTS ABOUT TITLES. - 10. A HEALTHY LIFE. - 11. TWO CENTURIES OF MAXIMS UPON MANNERS. - 12. THE HOUSEHOLD. - - “The most sensible book on etiquette that we remember to have - seen.”—_Pall Mall Gazette._ - - “This book may be considered a new departure in the class of works - to which it belongs. It treats etiquette ‘from a liberal point of - view,’ and amply fulfils its purpose.”—_Cassell’s Papers._ - - “Useful, sensibly written, and full of amusing illustrative - anecdotes.”—_Morning Post._ - - “Creditable to the good sense and taste, as well as to the special - information of its author.”—_Telegraph._ - - “The book is the best of the kind yet produced, and no purchaser of - it will regret his investment.”—_Bristol Mercury._ - - “Those who live in dread lest they should not do the ‘correct - thing’ should procure the book, which is a complete society - encyclopædia.”—_Glasgow News._ - - -WITH EIGHT ILLUSTRATIONS ON TONED PAPER. - -Second edition, small crown 8vo., 352 pp., cloth, price 3s. 6d.; gilt -edges, 4s. - - =Girls and their Ways: A Book for and= about Girls. By ONE WHO - KNOWS THEM. - - CHAP. - - 1. THE GIRL AT HOME. - - 2. THE GIRL IN HER LEISURE HOURS. - - 3. THE GIRL AT SCHOOL—THE GIRL AND HER FRIENDS. - - 4. THE GIRL ABROAD: CHARACTER SKETCHES. - - 5. A GIRL’S GARDEN; IN PROSE AND POETRY. - - 6. THE GIRL’S AMATEUR GARDENER’S CALENDAR; OR, ALL THE YEAR ROUND - IN THE GIRL’S GARDEN. - - 7. THE GIRL’S LIBRARY—WHAT TO READ. - - 8. THE GIRL IN THE COUNTRY—PASTIME FOR LEISURE HOURS THROUGHOUT THE - YEAR. - - 9. WHAT THE GIRL MIGHT AND SHOULD BE: EXAMPLES OF NOBLE GIRLS FROM - THE LIVES OF NOBLE WOMEN. - - “It aims high, and it hits the mark.”—_Literary World_. - - “Books prepared for girls are too often so weak and twaddly as to - be an insult to the intellect of girlhood. This new work is an - exception.”—_Daily Review_ (_Edinburgh_). - - “Worthy of a somewhat longer analysis than we shall be able to give - it.... Parents will be benefited by its perusal as well as their - daughters ... the more so that it is not written in a dry homiletic - style, but with a living kindness and sympathy.”—_Queen._ - - “A long list of books is given both for study and amusement. This - list is selected with care and without prejudice, and should prove - a great assistance to girls in doubt what to read.... It is a - sensible and well-written book, full of information and wholesome - thoughts for and about girls.”—_St. James’s Budget._ - - “Home duties, amusement, social claims and appropriate literature, - are subjects successively treated, and treated with both knowledge - and sound judgment.”—_Pall Mall Gazette._ - -“_A wide field of variety, and some of the strongest elements -of romantic interest, are covered by and comprised in the books -published by Mr. Hogg._”—SCHOOL BOARD CHRONICLE. - - -Southey’s Edition, with Life of Bunyan, &c. - -Illustrated with the Original Wood Blocks, by W. HARVEY. - -Large crown 8vo., 402 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =The Pilgrim’s Progress. In Two= Parts. By JOHN BUNYAN. With - Bibliographical Notes, and a Life of the Author, by ROBERT SOUTHEY; - Portrait and Autograph of BUNYAN, and Thirty Wood Engravings by W. - HARVEY, from the Original Blocks. The Text in large type (Small - Pica). This is a reprint (with additional notes) of the edition - published by John Major, London, 1830, at 21s., which was highly - eulogized by Sir Walter Scott and Lord Macaulay. - - “This reprint, at a very moderate price, may be regarded as a - popular boon.”—_Daily Telegraph._ - - “An excellent edition of the great allegory. It contains Southey’s - ‘Life,’ which certainly stands first for literary merit.”—_Pall - Mall Gazette._ - - “Costlier editions are on sale, but none produced with more taste - than this one.”—_Dispatch._ - - “A real service has been rendered for those who want a thoroughly - readable copy of ‘The Pilgrim’s Progress.’”—_Literary World._ - - “The whole book is reproduced in excellent fashion.”—_Scotsman._ - - “This edition has exceptional claims upon public favour. The late - poet laureate’s biography is in his best manner, while Harvey’s - effective woodcuts are in themselves a feature of very considerable - interest to lovers of British art. In the matter of typography and - general get-up the reprint is in every respect superior to the - original edition, and the low price at which the book is published - should tempt many to obtain a copy. The binding and decorations are - very effective, and the volume is fitted to grace any drawing-room - table.”—_Oxford Times._ - - -Second Edition, with Eight Engravings after Celebrated Painters. - -Small crown 8vo., 392 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =The Church Seasons. Historically= and Poetically Illustrated. By - ALEXANDER H. GRANT, M.A., Author of “Half-Hours with our Sacred - Poets.” - - ☞ The aim has been to trace the origin and history of the Festivals - and Fasts of the Ecclesiastical Year, and to illustrate in - poetry the circumstances under which they began and continue to - be celebrated, and the principal ideas and doctrines which they - severally incorporate. - - “Our festival year is a bulwark of orthodoxy as real as our - confessions of faith.”—PROFESSOR ARCHER BUTLER. - - “Mr. Grant’s scholarship is endorsed by authorities; his method - is good, his style clear, and his treatment so impartial that - his work has been praised alike by _Church Times_, _Record_, - _Watchman_, _Freeman_, and _Nonconformist_. No words of ours could - better prove the catholicity of a most instructive and valuable - work.”—_Peterborough Advertiser._ - - “The work shows very plainly that much care and judgment has been - used in its compilation.... The intrinsic worth of its contents - and their lasting usefulness admirably adapt it for a present. The - eight engravings have been chosen so as to give examples of the - highest samples of sacred art.”—_Oxford Times._ - - “A very delightful volume for Sunday reading, the devotional - character of the hymns giving an especial charm to the work. The - historical information will be proved full of interest to young - Churchmen, and young ladies especially will find the work to be - one well adapted to inform the mind and gladden the heart.”—_Bible - Christian Magazine._ - - “Mr. Grant’s volume is worthy of high praise, alike for its careful - research and its discriminative quotations. There is so much - religious literature which is below the level of criticism, that we - cannot but welcome a volume which commends itself to a cultivated - Christian audience.”—_Echo._ - -“_Mr. John Hogg is always successful in producing an attractive array -of books for youthful readers, ... and we ought to add, that all his -publications are prettily got up._”—BRISTOL MERCURY. - - -WITH EIGHT ILLUSTRATIONS BY FRANK ABELL, PRINTED ON TONED PAPER. - -Large crown 8vo., 422 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =The Adventures of Maurice Drummore= (Royal Marines), by Land and - Sea. By LINDON MEADOWS, Author of “Whittlings from the West,” - “College Recollections and Church Experiences,” “Jailbirds, or the - Secrets of the Cells,” etc. - - “Every boy who is lucky enough to get these adventures once into - his hands will be slow in parting with them until he has brought - the hero safely home through them all.”—_British Mail._ - - “A very good sort of story it is, with more of flavour than - most.”—_World._ - - “We have seen nothing in this book to contradict at least - the latter part of an opinion quoted in the preface from a - correspondent, that it is one of the cleverest, and one of - the healthiest, tales for boys with which the writer was - acquainted.”—_Spectator._ - - “It is almost equal to Robinson Crusoe.”—_Sheffield Independent._ - - “A capital story. The adventures are excellently told. Many of such - books are mere imitations, and have no originality. Lindon Meadows’ - story has originality, and it is well worth reading.”—_Scotsman._ - - “It has a distinct literary flavour, and is realistic in the best - sense.”—_Athenæum._ - - “Such works do much to stimulate a healthy chivalrous feeling in - the breasts of a rising generation, and tend to make them both - patriotic and full of endurance, under the many difficulties which - they encounter in life.”—_Shrewsbury Chronicle._ - - “We are inclined, after much deliberation, to call it the best - book for boys ever written. Whoever wishes to give to a boy a book - that will charm and enthral him, while imparting the noblest and - healthiest impulses, let him choose ‘The Adventures of Maurice - Drummore.’”—_Christian Leader._ - - “It is thoroughly healthy, not ‘goody’ in the least; in short, - just such a book as one would wish to place in the hands of a - pure-minded, high-spirited boy.”—_Nottingham Guardian._ - - “A thorough boy’s book, and the hero’s doings at school and in the - Royal Marines are told with much vivacity, his adventures being - many.”—_Glasgow Herald._ - - “The book is simply crammed with adventures, frolic, and - fun, depicted in racy style, and pervaded by a healthy tone, - while its attractiveness is increased by some spirited - illustrations.”—_Guernsey Mail and Telegraph._ - - “A book that men will read with interest, and boys with an avidity - which will probably not be awarded to any other book of the season. - It would be a pity if the merits of such a story were lost in the - crowd, and we trust it will receive the recognition which is its - due.”—_Aberdeen Daily Free Press._ - - -WITH EIGHT ILLUSTRATIONS ON TONED PAPER. - -Small crown 8vo., 384 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =Exemplary Women: A Record of= Feminine Virtues and Achievements - (abridged from “Woman’s Work and Worth”). By W. H. DAVENPORT ADAMS. - - CHAP. - I. WOMAN AS MOTHER. - II. WOMAN AS WIFE. - III. WOMAN AS MAIDEN. - IV. WOMAN IN THE WORLD OF LETTERS. - V. WOMAN IN THE WORLD OF ART. - VI. WOMAN AS THE HEROINE, ENTHUSIAST, AND SOCIAL REFORMER. - - “The qualifications and influence of women in different spheres of - life are detailed and illustrated by notices of the lives of many - who have been distinguished in various positions.”—_Bazaar._ - -“_The youth of both sexes are under deep obligations by the -publication of Mr. Hogg’s very interesting and attractive volumes. -It is a great object to attract the young to the habitual practice -of reading. That can only be accomplished by putting into their -hands books which will interest and amuse them, and at the same time -furnish them with useful knowledge, and with sound lessons of a -moral, judicious, and sensible character, calculated to be useful to -them as they advance in years._”—DUNDEE COURIER AND ARGUS. - - -WITH EIGHT ILLUSTRATIONS ON TONED PAPER. - -Small crown 8vo., 384 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =The Ocean Wave: Narratives of some= of the Greatest Voyages, - Seamen, Discoveries, Shipwrecks, and Mutinies of the World. By - HENRY STEWART, Author of “Our Redcoats and Bluejackets,” etc. - - “Mr. Stewart’s new work comprises a selection of stories of the - sea told in his best style and being historically accurate, ranks - high among popular volumes intended to combine entertainment - with instruction. To young and old alike the book ought to be - profitable, for from it a very lucid account may be obtained of - many of those momentous occurrences which have served to swell - the history of England, and to afford an example to succeeding - generations.”—_Bazaar._ - - “A delightful volume of adventure. Rebellions and mutinies come - jostling up against hair-breadth escapes and mournful disasters; - while the south seas and the north, the equator and the poles, are - all brought to notice by the judicious and able editor, MR. HENRY - STEWART.”—_Bedfordshire Mercury._ - - “It may fairly claim to be a popular volume, combining - entertainment with instruction. The book is well written, the - accounts of naval engagements are graphic and inspiring, and if no - attempts have been made to write a systematic history of maritime - enterprise, there is at all events presented a vast mass of - information in an attractive form.”—_Athenæum._ - - “A flight through the air on the enchanted prayer-carpet would not - surpass in interest the movement of these narratives from ‘summer - isles of Eden lying in dark purple spheres of sea’ to the iron - coast of Nova Zembla.”—_Sheffield Independent._ - - “A singularly interesting volume. The narratives are well told, - and the illustrations plentiful; young people will be sure to like - it, and will pick up from it, in a pleasant way, a good deal of - historical information.”—_Guardian._ - - “‘The Ocean Wave’ is far more interesting than nine-tenths of the - story books. Coming down to more modern times, Mr. Stewart gives us - some stirring episodes in the last American War, the moving tale - of Arctic Exploration, from the time of Cabot to the Jeannette - Expedition, and concludes a most interesting and useful volume with - an account of the famous shipwrecks in recent times.”—_Literary - Churchman._ - - -WITH TWELVE ILLUSTRATIONS BY THOMAS STOTHARD, R.A., AND A PORTRAIT OF -DEFOE. - -In one volume, 512 pp., large crown 8vo., cloth, price 3s. 6d.; gilt -edges, 4s. - - =The Life and Adventures of Robinson= Crusoe, of York, Mariner. - With an Account of his Travels round Three Parts of the Globe. - - ☞ _A complete, unabridged Edition of both Parts, with no - curtailment of the “Further Adventures.”_ - - “A complete, unabridged edition of ‘Robinson Crusoe,’ in which - something of the old tone, which has been to a great extent - sacrificed in modern versions of this boy’s classic, has been - revived. Twelve of the quaint illustrations by Thomas Stothard, - engraved by Heath, are given, and are in themselves a sufficient - reason for giving a specially hearty welcome to this edition of - Defoe’s masterpiece. But the publication will, in the eyes of - its young readers at all events, find a higher recommendation in - the fact that the ‘Further Adventures’ have not been subject to - their usual curtailment. A short biographical sketch of Defoe and - Bernard Barton’s ‘Memorial’ of Robinson Crusoe are given by way of - introduction, and add appreciably to the value of the edition. The - book is excellently printed and bound.”—_Nottingham Daily Guardian._ - - “It has every feature for becoming the boy’s favourite edition of - ‘Robinson Crusoe.’”—_School Board Chronicle._ - - “This handsome volume cannot fail to command an extensive sale; - it contains both parts of the immortal hero’s adventures, and is - therefore properly styled a ‘complete edition.’ A portrait and - brief Memoir of Defoe precedes his tale.”—_Manchester Weekly Post._ - - “This edition of ‘boyhood’s classic’ will take rank among the best. - It contains twelve illustrations by Thomas Stothard, R.A., which - are all good, and a portrait of Daniel Defoe, with a well written - sketch of his life. Every boy should read ‘Robinson Crusoe,’ and - will if he has the chance, and no better copy could be provided - than the one published by Mr. Hogg.”—_Wesleyan Methodist Sunday - School Magazine._ - - “In no more complete or attractive style could it be presented - than as issued the other day by Mr. Hogg. The volume makes fully - 500 pages, one half of the whole being taken up with the ‘Further - Adventures,’ frequently abridged or omitted altogether from this - ever fresh triumph of the story teller’s art. Printed on good - paper, with large clear type, and radiant outwardly in purple and - gold, this new edition is also illustrated with copies of a dozen - drawings by Stothard and engraved by the elder Heath.”—_Glasgow - Herald._ - - -WITH SIX PORTRAITS PRINTED ON TONED PAPER. - -Second edition, small crown 8vo., cloth, 288 pp., price 2s. 6d.; gilt -edges, 3s. - - =Plodding On: or, The Jog-trot to= Fame and Fortune. Illustrated by - the Life-Stories of - - GEORGE PEABODY, - JOHN KITTO, - ROBERT CHAMBERS, - CHARLES KNIGHT, - HUGH MILLER, - GEORGE ROMNEY, - M. W. WATSON, - THOMAS BRASSEY, - ABRAHAM LINCOLN. - -By HENRY CURWEN, Author of “A History of Booksellers,” etc. - - “We are glad to meet with a book of this kind, which has left the - well worn tracks pursued by writers of similar works. There is a - great variety in the characters of the different men whose lives - are chronicled, and in the circumstances which surrounded them, but - there is the common tie of a brave heart, a single purpose, and an - indomitable will. The book is written in a manly, honest spirit, - and should find a place in the library of every home.”—_Guernsey - Mail._ - - “A splendid book for boys and young men, illustrating, by the best - method of all, life-histories, the way in which successful men have - triumphed over early disadvantages, and have arrived at a great and - good name and ample wealth by quiet perseverance in the path of - duty.”—_Dundee Courier._ - - “The biographical sketches are so presented as to bring out in a - salient manner the great faculty these remarkable men have for hard - and indomitable work. It is made evident that the greatness of a - country and the progress of civilization grow out of the labour of - such men.”—_School Board Chronicle._ - - “These men are not idolized by Mr. Curwen, who does his work in - sincerity and love. The former prevents the false hero-regarding - which is too much the fashion, the latter imparts the author’s - enthusiasm. Portraits add to the value of the half-crown - volume.”—_Derbyshire Mercury._ - - -HINTS FOR THE SELECTION OF CHRISTIAN NAMES. - -Second edition, 176 pp., cloth, price 1s. 6d. - - =The Pocket Dictionary of One= Thousand Christian Names (Masculine - and Feminine): with their Meanings Explained and Arranged in Four - different Ways for ready Reference. With an Historical Introduction. - - 1. MASCULINE NAMES, with their Meanings attached. - 2. FEMININE NAMES, with their Meanings attached. - 3. DICTIONARY OF MEANINGS—MASCULINE NAMES. - 4. DICTIONARY OF MEANINGS—FEMININE NAMES. - - ☞ _Every Parent should consult this Dictionary before deciding on a - Child’s Name._ - - “This will be a useful and interesting book for those who like to - learn the meaning of their own and their friends’ appellations. - Parents should purchase it, as it might help them to name their - children a little more originally than they do.”—_Glasgow Herald._ - - “A useful little etymological book. We observe that the compiler - has gone to the best sources and authorities, and we recommend a - perusal of his thoughtful preface as being full of suggestions for - those who desire to study deeply his subject.”—_Manchester Weekly - Post._ - - “The idea is a good one, and well carried out, and the book should - prove well worth its price to any parent in search of a suitable - baptismal name.”—_Guernsey Mail._ - - -“_A series of excellent books for boys is published by Mr. John Hogg, -London._”—SCOTSMAN. - - -_MR. ASCOTT R. HOPE’S NEW BOOKS._ - -“Mr. Ascott R. Hope now occupies the foremost place as a writer of -fiction for the schoolboy, and as he never produces a weak book, -and never disappoints his clients, his name is always a sufficient -passport.”—_School Board Chronicle._ - - -WITH EIGHT ILLUSTRATIONS ON TONED PAPER. - -Second edition, small crown 8vo., 384 pp., cloth, price 3s. 6d.; gilt -edges, 4s. - - =Stories of Young Adventurers. By= ASCOTT R. HOPE, Author of - “Stories of Whitminster,” etc., etc. - - A YOUNG TURK. - A WHITE INDIAN. - A SLAVE BOY’S STORY. - A SOLDIER BOY’S STORY. - A SAILOR BOY’S STORY. - A YOUNG YANKEE ON THE WAR PATH. - FOUR SONS OF ALBION. - A GIRL’S STORY. - AN ADVENTURER AT THE ANTIPODES. - AN ADVENTURER AT HOME. - -“Mr. Hope is one of the best of living writers of boys’ books, and -we do not think we over-estimate the merits of the book before us if -we say it is one of his best. The idea is a happy one.... The result -is altogether as successful as the idea is happy.”—_Birmingham Daily -Post._ - -“Good, wholesome, stirring reading for boys of all ages. The scenes -of these adventures are laid in every quarter of the globe, and they -include every variety of peril.”—_World._ - -“Mr. Ascott Hope has hit upon a really excellent idea in his ‘Stories -of Young Adventurers,’ and carried it out with admirable success.... -It would be difficult to pick out a better book of its kind; young -readers will hang over every page with an absorbing interest, and -all the time will be imbibing some useful historical information. We -should like to think that so thoroughly good a book will be in the -hands of a great many boyish readers.”—_Guardian._ - -“Sure to make the eyes of our boys gleam.... The tone is healthy and -robust, and for its kind the book is one of the best we know.”—_Sword -and Trowel._ - -“A debt of gratitude is due to Mr. Hope.... The work is as good as -the design.”—_Athenæum._ - - -WITH EIGHT ILLUSTRATIONS ON TONED PAPER. - -Small crown 8vo., 384 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =A Book of Boyhoods. By Ascott R.= HOPE, Author of “Our Homemade - Stories,” etc. - - A NEW ENGLAND BOY. - A BRAVE BOY. - A FRENCH SCHOOLBOY. - A SCHOOLBOY OF THE OLDEN TIME. - A BLUECOAT BOY. - A STABLE BOY. - A REBEL BOY. - A MYSTERIOUS BOY. - A BLIND BOY. - - “Well planned, well written, and well named.... Mr. Hope has told - these stories with much dramatic power and effect, and has produced - a book which will delight all healthy-minded lads.”—_Scotsman._ - - “Stories of all sorts of boys, who in different countries and - circumstances, in peace or in war, at school or at work, at home or - out in the world, by land or by sea, have gone through experiences - worth relating.... The work is just such a volume as we would - like to see in the hands of our schoolboys, and of those who are - emerging into the busy haunts of business and anxiety.”—_Yorkshire - Gazette._ - - “Essentially of an attractive character to the youthful reader, - and is, perhaps, as likely to interest the sisters as the - brothers.”—_Bedford Mercury._ - - -WITH EIGHT ILLUSTRATIONS ON TONED PAPER. - -Small crown 8vo., 352 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =Our Homemade Stories. By Ascott= R. HOPE, Author of “Stories of - Young Adventurers,” etc. - - “Mr. Hope throws himself instinctively into his most dramatic - incidents from the boys point of view, and is humorous within the - limits of their easy appreciation. We own to having laughed aloud - over some of his drolleries; nor can anything be much better in - this way than the dialogue in ‘My Desert Island.’”—_Times._ - - “Mr. Hope understands boy nature through and through, and can get - hold of their attention in a way entirely his own.... All manner of - adventures at school, at home, and at sea, are narrated with equal - vivacity and good sense.”—_Bookseller._ - - “There is great variety in this volume, ... and the heroes are not - model characters, but real boys.... There is a pleasant vein of - humour running through the book that is unfortunately rare in tales - for the young of the present day.”—_Manchester Examiner._ - - “Romances of the kind which boys—yes, and girls too—will greatly - enjoy.”—_Post._ - - -WITH NINETEEN ILLUSTRATIONS BY GORDON BROWNE, - -Small crown 8vo., 352 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =Evenings away from Home: A= Modern Miscellany of Entertainment for - Young Masters and Misses. By ASCOTT R. HOPE, Author of “A Book of - Boyhoods,” etc., etc. - - “No writer for boys surpasses Mr. Hope, and to tell boys he - is here in strong force is to ensure the sale of a large - edition.”—_Bedfordshire Mercury._ - - “A _bonne bouche_ for boys. A right merry collection of short tales - and sketches by Mr. Ascott R. Hope.”—_Daily Chronicle._ - - “Just the kind of story to please the intelligent schoolboy or - schoolgirl on the outlook for a little wholesome nonsense. The - book is well got up, and the fantastical illustrations are likely - to enhance it in the eye of the laughter-loving public.”—_School - Newspaper._ - - “Intended for young readers, and deserves the attention of those - who provide prizes and replenish school libraries.”—_Wesleyan - Methodist Sunday School Magazine._ - - “A merrier book, with merrier pictures, one could not well - imagine.”—_Newcastle Chronicle._ - - “The glorious fun in these stories is quite irresistible. The - illustrations are sure to set the table in a roar. The tales are - supposed to be told by the boys themselves, and are amazingly well - told. Mr. Hope’s name is already a household word.”—_Sheffield - Independent._ - - -WITH EIGHT ILLUSTRATIONS ON TONED PAPER. - -Small crown 8vo., 352 pp., cloth, price 3s. 6d.; gilt edges, 4s. - - =Stories out of School-time. By Ascott= R. HOPE, Author of - “Evenings away from Home,” etc. - -CONTENTS: - - CHAP. - 1. FIDDLE-DE-DEE! A STORY OF HISTORY AND MYSTERY. - 2. VICTOR’S PONY: A STORY OF THE FRANCO-GERMAN WAR. - 3. ‘TO-MORROW’: A STORY OF THE HOLIDAYS. - 4. ALL BY HIMSELF: A STORY OF THE HIGHLANDS. - 5. OLD SCORES: A STORY OF THE CRIMEA. - 6. CHARLEY: A STORY OF MEMORY. - 7. BLACK AND WHITE: A STORY OF THE FIFTH OF NOVEMBER. - 8. THE WATCH: A STORY OF CHRISTMAS TIME. - 9. OUR SUNDAY AT HOME: A GIRL’S STORY. - - “Mr. Hope is a scholar, and his wide knowledge and culture give his - books a _cache_ of their own.”—_Journal of Education._ - - “We like Mr. Hope’s stories. They are fresh and healthy and - vigorous. They can inspire no evil thought; they must encourage - to good efforts; they are never dull; they are always amusing. A - volume of stories of which this can be truthfully said needs no - further commendation.”—_Scotsman._ - - “If we must choose one story as being particularly good, it will be - ‘Victor’s Pony.’ It is very clever and dramatic.”—_Saturday Review._ - - “There is an old saying, that we must not tell tales out of school, - but no schoolboy will quarrel with Mr. Ascott Hope for having - broken the rule.”—_Literary Churchman._ - - “No school library can be complete while Mr. Ascott Hope’s books - are not in circulation.”—_Derbyshire Mercury._ - - “The nine stories which make up this volume, without being of the - too-goody sort, have one and all an instructive tendency which - does not in the least diminish the interest both boys and girls - will take in perusing them. Though these tales are more especially - written for boys, not a few girls would read them with unmixed - pleasure.”—_British Mail._ - - “Excellent samples of what this ready writer can achieve. Not a - story in this collection of nine drags or ends tediously. This is - just the book for boys.”—_Christian World._ - - “Mr. Hope thoroughly understands what kind of stories boys - want, and what will please them. The various stories recounted - in this new volume are all related in Mr. Hope’s inimitable - way.”—_Nonconformist._ - - -☞ _For Mr. Hope’s “Young Days of Authors,” see page 3._ - - -_MR. MORWOOD’S NATURAL HISTORY BOOKS._ - -From the Royal Society for the Prevention of Cruelty to Animals. - - “I am directed by the Literature Committee to inform you that Mr. - Morwood’s books (‘Facts and Phases of Animal Life’ and ‘Wonderful - Animals’) are calculated greatly to promote the objects of this - Society, and, therefore, it is our earnest hope that they will be - purchased by all lovers of animals for circulation among young - persons, and in public institutions.—JOHN COLAM, Secretary.” - - -WITH SEVENTY-FIVE WOOD ENGRAVINGS. - -Small crown 8vo., 288 pp., cloth, price 2s. 6d.; gilt edges, 3s. - - =Facts and Phases of Animal Life, and the= Claims of Animals to - Humane Treatment. With Original and Amusing Anecdotes. By VERNON - S. MORWOOD, Lecturer to the Royal Society for the Prevention of - Cruelty to Animals. - -CHAP. - - 1. WONDERFUL FACTS ABOUT ANIMALS. - 2. AT THE BOTTOM OF THE SEA. - 3. A HUNT IN OUR DITCHES AND HORSE-PONDS. - 4. BUZZINGS FROM A BEEHIVE. - 5. SPINNERS AND WEAVERS. - 6. BLACK LODGERS AND MINIATURE SCAVENGERS. - 7. INSECTS IN LIVERY, AND BOAT-BUILDERS. - 8. OUR BIRDS OF FREEDOM. - 9. OUR FEATHERED LABOURERS. - 10. IN THE BUILDING LINE. - 11. BIRD SINGERS IN NATURE’S TEMPLE. - 12. CHANTICLEER AND HIS FAMILY. - 13. MINERS OF THE SOIL. - 14. ACTIVE WORKERS, WITH LONG TAILS AND PRICKLY COATS. - 15. NOCTURNAL RAMBLERS ON THE LOOK-OUT. - 16. QUAINT NEIGHBOURS AND THEIR SHAGGY RELATIONS. - 17. OUR FURRY FRIENDS AND THEIR ANCESTORS. - 18. OUR CANINE COMPANIONS AND TENANTS OF THE KENNEL. - 19. RELATIONSHIP OF MAN AND ANIMALS. - 20. CAN ANIMALS TALK AND REASON? - 21. USEFUL LINKS IN NATURE’S CHAIN. - 22. CLIENTS WORTH PLEADING FOR. CLASSIFICATION, GLOSSARY, AND INDEX. - - “We have read parts of this work with great pleasure, and intend - to go through it page by page for our own personal delectation. - Two-and-sixpence will be well spent upon a book which teaches - humanity to animals while it amuses the youthful reader.”—_Sword - and Trowel._ - - “A capital natural history book.”—_Graphic._ - - “Crammed with good stories.”—_Sheffield Independent._ - - -WITH EIGHTY-ONE ILLUSTRATIONS. - -Small crown 8vo., 288 pp., cloth, price 2s. 6d.; gilt edges, 3s. - - =Wonderful Animals: Working, Domestic=, and Wild. Their Structure, - Habits, Homes, and Uses—Descriptive, Anecdotical, and Amusing. By - VERNON S. MORWOOD. - -CHAP. - - 1. CURIOUS ODDS AND ENDS ABOUT ANIMALS. - 2. PEEPS DOWN A MICROSCOPE. - 3. LILLIPUTIAN SUBJECTS OF THE ANIMAL KINGDOM. - 4. INSECT ARMIES, AND HOW RECRUITED. - 5. AN UNDERGROUND CITY OF LITTLE PEOPLE. - 6. FISH IN ARMOUR. - 7. FIRST COUSINS, OR OUR BIRDS IN BLACK. - 8. FEATHERED FEEDERS ON FISH, FLESH, AND FOWL. - 9. PEACEFUL MONARCHS OF THE LAKE. - 10. BIPED TENANTS OF THE FARMYARD. - 11. FOREST ACROBATS, LITTLE MARAUDERS, AND FLYING ODDITIES. - 12. FEEBLE FOLK, FISHERS, AND POACHERS. - 13. BRISTLY PACHYDERMS, WILD AND TAME. - 14. ARISTOCRACY OF ANIMALS. - 15. AN ANCIENT FAMILY. - 16. LOWINGS FROM THE FIELD AND SHED. - 17. FOUR-FOOTED HYBRIDS. - 18. OUR DONKEYS AND THEIR KINDRED. - 19. EVERYBODY’S FRIEND. - 20. ANECDOTES OF EVERYBODY’S FRIEND. - 21 AND 22. FOES AND FRIENDS OF ANIMALS. - - “This book is as full of anecdotes as a Christmas pudding is full - of plums. Most of them are quite new. He is a poor fellow who does - not regard all dumb creatures with a kindlier feeling after reading - this entertaining book. It is worth a score detectives in the - interests of humanity.”—_Sheffield Independent._ - -“_Mr. Hogg is a famous caterer in the way of books for youth. All his -books are excellent of their class; they are amply illustrated, and -it seems as though Mr. Hogg had resolved to be the special caterer in -healthy literature for the youngsters, and his publications are well -adapted to the various stages of youth of both sexes._”—INDIAN DAILY -NEWS. - - -_Dedicated by permission to the Royal Society for the Prevention of -Cruelty to Animals._ - -WITH FIFTY-NINE ILLUSTRATIONS. - -128 pp., small crown 8vo., boards, price 1s.; or bound in cloth, 1s. -6d. - - =The Band of Mercy Guide to Natural= History. An Elementary Book - on Zoology: Instructive, Amusing, and Anecdotical. By VERNON S. - MORWOOD, Author of “Facts and Phases of Animal Life,” “Wonderful - Animals,” etc., and Lecturer to the Royal Society for the - Prevention of Cruelty to Animals. - - “It is an excellent idea to connect the knowledge of Nature with - the thought of kindness and tenderness to dependent creatures. We - welcome this volume as a means towards this end.”—_Spectator._ - - “Its accurate statement of facts is combined with a number of - amusing anecdotes, which are sure to rivet the attention of the - juvenile reader.... We know of no better book of its class on this - most interesting branch of study.”—_Guernsey Mail and Telegraph._ - - “Satisfies a need which has been felt for some elementary work - on natural history to interest the young folks who belong to the - Band of Mercy. Plentiful engravings and popular lessons on birds, - beasts and reptiles, with some anecdotes, make up this pleasant - book.”—_Christian World._ - - “Any book which advocates kindness to animals ought to find a - warm welcome in the school and household. The book before us - would form a good reading book for the upper standards in our - Schools.”—_Literary Churchman._ - - “One of the best shilling’s-worth in the market. It will teach our - youngsters to be kind to all things that live.”—_Sword and Trowel._ - - “A useful little book on natural history, simple and unpretentious - in style, and copiously illustrated. There is no better - preventative of cruelty to animals than a knowledge of their - habits and characteristics, and books of this sort, therefore, can - scarcely be multiplied too much.”—_Aberdeen Free Press._ - - -WITH SEVENTY-EIGHT ILLUSTRATIONS. - -Small crown 8vo., 288 pp., cloth, price 2s. 6d.; gilt edges, 3s. - - =Far-Famed Tales from the Arabian Nights’= Entertainments. - Illustrated with Seventy-eight wood Engravings, and carefully - revised for Young Readers. - - THE FISHERMAN AND THE GENIE. - THE GREEK KING AND DAUBAN THE PHYSICIAN. - THE VIZIER WHO WAS PUNISHED. - THE STORY OF THE KING OF THE BLACK ISLES. - THE STORY OF SINDBAD THE SAILOR; OR, THE OLD MAN OF THE SEA. - THE SLEEPER AWAKENED. - THE STORY OF ALADDIN; OR, THE WONDERFUL LAMP. - THE ADVENTURES OF THE CALIPH HAROUN ALRASCHID. - THE STORY OF BABA ABDALLA. - THE STORY OF COGIA HASSAN ALHABBAL. - ALI BABA AND THE FORTY THIEVES. - - “The print is good, there is a profusion of good illustrations, - and the volume may be thoroughly recommended as well supplying - an acknowledged want of a selection of the most familiar of the - stories from the ‘Arabian Nights,’ in a form fit for childish - reading.”—_Guardian._ - - “A capital arrangement of some of the ‘Arabian Night’ Tales. Clear - print, suggestive woodcuts and plenty of them, carefully edited - versions—what more could be wanted?”—_Bedfordshire Mercury._ - - “A selection of the best stories in the ‘Arabian Nights’ - Entertainments, illustrated with seventy-eight wood engravings. - The compiler has executed his task with taste and skill, all - objectionable passages having been removed without any loss of - spirit.”—_Bristol Mercury._ - - “There is nothing in this selection from the far-famed tales which - young people may not be permitted to read. We envy the child who - reads this book. Who is there, indeed, that can forget the time - when he first read the adventures of Sindbad the Sailor, and the - story of Ali Baba and the Forty Thieves? It is pleasant still to - watch the dilating eyes of the youngsters as they pore over the - old fictions, of which the volume before us contains a well-chosen - selection.”—_Sheffield Independent._ - -“_The peculiarity of Mr. Hogg is that all his publications have a -healthy, moral tone, whilst most of them are eminently calculated -beneficially to impress the minds of both sexes. Commercially, the -publisher attaches to them a very modest value; mentally and morally, -the value cannot be estimated._”—LINCOLNSHIRE FREE PRESS. - - -WITH TWENTY-EIGHT ILLUSTRATIONS. - -Small crown 8vo., 288 pp., cloth, price 2s. 6d.; gilt edges, 3s. - - =The Shoes of Fortune, and other Fairy= Tales. By HANS CHRISTIAN - ANDERSEN. With a Biographical Sketch of the Author, a Portrait, and - Twenty-seven Illustrations by OTTO SPECKTER and others. - - BIOGRAPHICAL SKETCH: HANS CHRISTIAN ANDERSEN, HIS LIFE AND GENIUS. - THE SHOES OF FORTUNE. - THE FIR-TREE. - FIVE FROM A POD. - THE STEADY TIN SOLDIER. - TWELVE BY THE POST. - THE FEARSOME UGLY DUCKLING. - THE SHEPHERDESS AND THE CHIMNEY-SWEEP. - THE SNOW-QUEEN, IN SEVEN STORIES. - THE LITTLE OCEAN-MAID. - THE ELFIN MOUND. - OLD WINK, WINK, WINK. - THE LEAP-FROG. - THE ELDER BUSH. - THE BELL. - HOLGER DANSKE. - THE EMPEROR FREDERICK BARBAROSSA. - - “The popularity of the fairy tales of Hans Andersen can never - wane, and new editions of some of them can scarcely fail to be - successful. Here is one published by Mr. John Hogg, with a very - readable biographical sketch of the author by Dr. Kenneth Mackenzie - (the original English edition of Andersen’s ‘In Sweden’), and a - variety of illustrations, including a portrait.”—_St. James’s - Gazette._ - - “A volume which will be popular with young people. The stories are - well selected, and there are some excellent illustrations in the - book.”—_Scotsman._ - - “This beautifully illustrated edition of Andersen’s exquisite - stories is sure to be a favourite with all young people who become - its fortunate possessors. The biographical sketch is admirably - written.”—_Sheffield Independent._ - - “We recommend all boys and girls who have not read about the - wonderful Shoes of Fortune, and the Ugly Duckling and the Snow - Queen, to get this book as soon as possible.”—_Literary Churchman._ - - “The tales, of course, we need not criticise; but we may say that - the illustrations are not unworthy of them. They show something - of the same graceful fancy which guided Andersen’s pen. Of the - singular personality of Andersen himself we get a really valuable - sketch. Dr. Mackenzie estimates him justly, we think, but not - unkindly.”—_The Spectator._ - - -WITH PORTRAIT OF NATHAN MEYER DE ROTHSCHILD. - -Second edition, crown 8vo., cloth, bevelled boards, price 2s. 6d. - - =Fortunate Men: How they made Money= and Won Renown. A Curious - Collection of Rich Men’s Mottoes and Great Men’s Watchwords; their - Financial Tests and Secrets; their Favourite Sayings and Guiding - Rules in Business, with Droll and Pithy Remarks on the Conduct of - Life, mostly taken down in their own words. To which is added many - New and Authentic Sayings of “Poor Richard,” with Sundry Pieces of - Useful Advice to Persons Entering the World, and Practical Hints - for those Desirous of Improving their Position in it. - - “A chronicle of rank, and fame, and gold.”—_Punch._ - - “The real value of its contents consists in its asserting the - claims to respect of virtues, such as perseverance, method, and - punctuality, which are often contemptuously treated, but which - are invaluable, whether for making money or, which is much more - important, for formation of character. With regard to the latter - object, there is no question of substantial reward to the student, - and we therefore wish the book success.”—_Glasgow Herald._ - - “There is encouragement for others in its anecdotes, and its advice - is dictated by morality and common-sense. To carry out its maxims - might not ensure the making of a fortune during the present times - of depression, but would secure an honourable business reputation - under any circumstances.”—_Christian World._ - - “He will be a dull and stupid boy indeed, who, whether fifty - or fifteen years of age, does not learn something that will be - valuable from ‘Fortunate Men.’”—_Manchester Weekly Post._ - - “There are passages among these selections which are worthy to - be inscribed in brass in every place of business. Of worldly - wisdom we have here huge nuggets, and in the mingled mass much of - pure gold may be seen. Every young man may read this book with - profit.”—_Sword and Trowel._ - -“_As in every book which Mr. Hogg has sent us, so in this; we have to -praise the typography, the paper, and the strong but also ornamental -binding._”—MANCHESTER WEEKLY POST. - - -A HANDBOOK OF REFERENCE AND QUOTATION. - -Second edition, fcap. 8vo., cloth, price 2s. 6d. - - =Mottoes and Aphorisms from Shakespeare=: Alphabetically arranged; - with a Copious Index of 9,000 References to the infinitely varied - Words and Ideas of the Mottoes. Any word or idea can be traced at - once, and the correct quotation (with name of play, act, and scene) - had without going further. - - “The collection is, we believe, unique of its kind.... It solves - in a moment the often difficult question of where a proverb, or - aphorism, or quotation from Shakespeare can be found.”—_Oxford - Times._ - - “As neat a casket of Shakespearian gems as we ever remember having - met with.”—_Public Opinion._ - - “The writer who delights now and then to embellish his productions - by some of the well-pointed and telling mottoes and aphorisms from - Shakespeare has here a most valuable book of reference.”—_Yorkshire - Gazette._ - - “Everything, in these cases, depends on the index, and the index - here seems to have been carefully made.”—_Sheffield Independent._ - - -New and enlarged edition, fcap. 8vo., cloth, price 2s. 6d. - - =A Practical Guide to English Versification=, with a Compendious - Dictionary of Rhymes, an Examination of Classical Measures, and - Comments upon Burlesque and Comic Verse, Vers de Société, and Song - Writing. By TOM HOOD. A new and enlarged edition, to which are - added Bysshe’s “RULES FOR MAKING ENGLISH VERSE,” etc. - - “We do not hesitate to say, that Mr. Hood’s volume is deserving of - a place on the shelves of all who take an interest in the structure - of verse.”—_Daily News._ - - “The book is compiled with great care, and will serve the purpose - for which it is designed.... We may add that it contains a good - deal of information which will be useful to students who have no - wish to be numbered amongst verse-makers.”—_Pall Mall Gazette._ - - “A dainty little book on English verse-making. The Dictionary of - Rhymes will be found one of the most complete and practical in our - language.”—_Freeman._ - - “Alike to the tyro in versifying, the student of literature, - and the general reader, this guide can be confidently - recommended.”—_Scotsman._ - - -Crown 8vo., cloth extra, bevelled boards, price 7s. 6d. - - =The Manuale Clericorum: A Guide for= the Reverent and Decent - Celebration of Divine Service, the Holy Sacrament, and other - Offices, according to the Rites, Ceremonies, and Ancient Use - of the United Church of England and Ireland. Abridged from the - “Directorium Anglicanum.” With Additions of Special Value in the - Practical Rendering of the Services of the Church. Edited by the - Rev. F. G. LEE. - - -Red Line Edition (the Fourth), with Illustrations, quarto, price 21s. - -CAREFULLY REVISED, WITH NUMEROUS EMENDATIONS. - - =The Directorium Anglicanum: Being a= Manual of Directions for the - Right Celebration of the Holy Communion, for the saying of Matins - and Evensong, and for the Performance of other Rites and Ceremonies - of the Church, according to ancient uses of the Church of England. - Edited by the Rev. FREDERICK GEORGE LEE, D.C.L., F.S.A. - - “The existence of one such work of credit and reputation must - do something to diminish the varieties of Ritualism into which - the tastes or studies of independent explorers might lead - them.”—_Guardian._ - - - - -_PUBLISHING SEASON, 1885-6._ - -LIBRARIES FOR YOUNG READERS. - - -ASCOTT HOPE’S ANCHOR LIBRARY. - -STORIES OF FACT AND FICTION. - -[Illustration: Book Box] - -TITLES OF THE VOLUMES. - - 1. Our Homemade Stories. - 2. Stories of Young Adventurers. - 3. Evenings away from Home. - 4. A Book of Boyhoods. - 5. Stories out of School-time. - 6. Young Days of Authors. - -☞ _Six Illustrated Volumes, price 3s. 6d. each; gilt edges, 4s. each._ - -_Or the whole in an Elegant Illustrated Metal Box, price 21s._ - - -THE BOYS’ AND GIRLS’ TREASURY - -Of Natural History, Fairy Tales, Biography, & Proverb Stories. - -_BY POPULAR AUTHORS._ - -[Illustration: Book Box] - -TITLES OF THE VOLUMES. - - =1. Facts and Phases of Animal Life, and the Claims of Animals to - Humane Treatment.= By VERNON S. MORWOOD. - - =2. The Shoes of Fortune and other Fairy Tales.= By HANS C. - ANDERSEN. - - =3. Wonderful Animals: Working, Domestic, and Wild.= By VERNON S. - MORWOOD. - - =4. Far-famed Tales from the Arabian Nights.= Revised for Young - Readers. - - =5. Plodding on; or, The Jog-trot to Fame and Fortune.= By HENRY - CURWEN. - - =6 and 7. Proverb Stories for Boys and Girls.= Two Series. By - VARIOUS AUTHORS. - - ☞ _Seven Illustrated Volumes, price 2s. 6d. each; gilt edges, 3s. - each. Or the whole in an Elegant Illustrated Metal Box, price 17s. - 6d._ - -London: John Hogg, 13, Paternoster Row, E.C. - - - - - Transcriber’s Notes - pg 15 Changed spared to do their life work to: life-work - pg 36 changed Dupuytreu’s to Dupuytren’s operations and instructions. - pg 54 Changed he was also appointed Physician in Ordinary to: - Physician-in-Ordinary - pg 57 Changed have been appointed Physician Extraordinary to: - Physician-Extraordinary - pg 59 Changed being some time assistant physician to: - assistant-physician - pg 60 Changed in 1837 was made Physician in Ordinary to: - Physician-in-Ordinary (2 places) - pg 67 Changed He was made Physician Extraordinary to: - Physician-Extraordinary - pg 67 Changed Physician in Ordinary to the Prince Consort to: - Physician-in-Ordinary to the Prince-Consort - pg 68 Changed was made Physician in Ordinary to: Physician-in-Ordinary - pg 94 unneeded quote after not extinguished. - pg 137 changed Dovoting to Devoting himself to physiological - pg 151 Changed called in to attend the Prince Consort to: - Prince-Consort - pg 166 changed smallpox to small-pox before the discovery (2 instances - of small-pox) - pg 174 changed double to single quotes around the evidence of things - unseen, - pg 203 changed life-long to lifelong friend, say of him (3 instances - of lifelong) - pg 224 Added quote after state of his mind. - pg 252 Changed Mackenzie was appointed Assistant Physician to: - Assistant-Physician - pg 261 fixed spelling of William Bowman, the third son - pg 280 added “on” to taking his diploma went on a voyage - pg 284 changed over-work to overwork and excess of feeling... - (3 instances of overwork) - pg 286 added . to Dr Gregory’s death... - pg 298 changed spelling of phebitis to phlebitis. His report on... - pg 308 Changed appointed Assistant Surgeon to St. George’s to: - Assistant-Surgeon - pg 310 changed spelling of Cruikshank to Cruickshank to match pg 53 - pg 310 changed ear years to early years, 72; under Ferguson, Sir - William - - - Advertisement pages - pg 4 added missing quote after Robinson Crusoe,’ with Stothard’s - pg 4 added missing quote after ‘a weak side’ to our sterling - pg 9 changed single quote to double after may be of some service.” - pg 11 changed word o to of, end of line I hope one of - pg 13 changed single quote to double after special information of its - author.” - pg 14 changed principa to principal ideas and doctrines - pg 14 changed ncorporate to: which they severally incorporate. - pg 18 added period after “Mr. Hope throws himself - pg 19 added ” after not in circulation. - pg 20 added . after 9. our feathered labourers - -*** END OF THE PROJECT GUTENBERG EBOOK EMINENT DOCTORS *** - -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. 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