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.