_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.