_THE MONROS, CULLEN, THE GREGORYS, JOHN BELL, AND THE FOUNDATION OF
THE EDINBURGH SCHOOL OF MEDICINE._
Notwithstanding the early date of the foundation of the College of
Physicians of London, and the fact that the illustrious names of
Harvey and Sydenham and others adorn the rise of rational medicine
in the south, the credit of first developing a famous medical
school belongs to Edinburgh, where the Monros, Gregorys, Cullen,
Black, and Rutherford maintained during the eighteenth century
an unbroken succession of brilliant names. It cannot be allowed,
however, that the Town Council of Edinburgh, in founding medical
professorships, deserves as much of this credit as do the outside
founders of medical teaching, whose existence and success extorted
from the municipality a recognition formal and limited at first,
and certainly unremunerated. It may be questioned whether the
University of Edinburgh has not really been indebted almost as much
to the extra-academical teachers of medicine who have continually
stimulated the actual professors to their best endeavours, as to
those professors themselves.
Anatomy, the necessary foundation of medicine, had a kind of
beginning in Edinburgh in 1505, for the surgeons and barbers of the
city had procured the insertion in their charter of a clause enabling
them to obtain “once in the year a condemned man after he be dead to
make anatomy of.” But little came of this, and it was reserved for
a number of able physicians, educated abroad, in the latter part of
the seventeenth century, to set on foot some practical teaching in
medicine and the allied sciences. The names of Sir Robert Sibbald,
Sir Andrew Balfour, and Sir Archibald Stevenson must be honourably
mentioned in this connection. The first two of these were most
influential in establishing the earliest public botanic garden in
Edinburgh, a piece of ground about forty feet square, belonging
to Holyrood House. They subsequently allied to themselves James
Sutherland, who afterwards became a notable botanist, and obtained
the appointment of keeper of a much larger garden near Trinity
College Church. Many valuable collections of seeds and plants were
procured; medical students were incited to collect and send home
seeds and cuttings from places they might travel to; and so the
garden became an important starting-point for materia medica.
Professional feuds already became prominent in Edinburgh. The
surgeon-apothecaries were jealous of the physicians and doctors of
medicine. Several abortive efforts were made by the latter towards
the establishment of a College of Physicians. In 1621 King James
gave a warrant to the Scottish Parliament for this purpose; but no
action was taken. In 1630 the subject was referred to the Privy
Council. In 1656 Cromwell constituted a College of Physicians for
Scotland; but his death prevented its completion. Thus it was not
till Sibbald and Stevenson, by the aid of Sir Charles Scarborough,
Harvey’s friend, gained the ear of the Duke of York, that at last
the College of Physicians of Edinburgh was founded, in 1681,
notwithstanding the strong opposition of the surgeons and the
townsmen.
Soon after this, in 1685, the Town Council of Edinburgh appointed
three principal members of the College of Physicians to be Professors
of Medicine in what they now for the first time, at any rate in
existing documents, called “the university of this city.” Sir Robert
Sibbald was appointed Professor of Physic, and rooms were allotted to
him, but not a salary. Drs. Halket and Pitcairne were speedily added
to the list of professors, and the division of duties between the
professors was left to themselves. We have no record of any lectures
given by these professors for a long period, but we know that
Pitcairne in 1692-3 held a professorship at Leyden. On his return to
Edinburgh he became enthusiastic in promoting the medical school,
aiding Alexander Monteith in gaining permission from the Town Council
to dissect the bodies of people who died in “Paul’s Work.” “We
offer,” says Pitcairne, “to wait on these poor for nothing, and bury
them after dissection at our own charges, which now the town does;
yet there is great opposition by the chief surgeons, who neither eat
hay nor suffer the oxen to eat it. I do propose, if this be granted,
to make better improvements in anatomy than have been in Leyden these
thirty years.”
Monteith obtained a grant in October 1694 of “those bodies that
die in the correction-house,” and of “foundlings that die upon the
breast.” He was allowed to make his dissections in “any vacant
waste-room in the correction-house, or any other thereabouts
belonging to the town.” Magistrates were to be admitted if they
desired, and the apprentices of the surgeons might attend at
half-fee. However, Monteith’s scheme did not succeed, because he
had acted without concert with the other members of the Surgeons’
Corporation. These made a more successful start in the same year,
having obtained a right to “the bodies of foundlings who die betwixt
the time that they are weaned and their being put to schools or
trades, also the dead bodies of such as are stifled in the birth,
which are exposed and have none to own them; also the dead bodies of
such as are _felo do se_ and have none to own them; likewayes the
bodies of such as are put to death by sentence of the magistrate and
have none to own them.” A condition was annexed to this grant that by
Michaelmas 1697 an anatomical theatre should be built, where public
dissections should be made once a year, if opportunity offered. This
was evidently intended to extend to a course of anatomy, including
as much as could be taught on one body. The method, however, in
which anatomy was first practised in the Surgeons’ Hall was for ten
surgeons to lecture, on following days, each in succession taking a
special part. The body had to be buried within ten days.
It was in 1705 that a special appointment of one man to lecture
on anatomy was first made, and the first lecturer, Robert Elliot,
was also made Professor of Anatomy in the University, with a small
stipend. This formal appointment appears to have been directly
occasioned by the offer of some unknown teacher to give public and
private teaching in anatomy to the surgeons and their apprentices.
It is not till 1706 that we have any record of Sibbald’s lectures.
The _Edinburgh Courant_ was then made the medium whereby he
announced, in Latin, his intention to lecture on natural history and
medicine “in privatis collegiis,” or private courses of lectures. He
appears to have lectured in Latin, and to have received no pupils but
such as were skilled in Greek, Latin, mathematics, and philosophy.
About this time had settled in Edinburgh the progenitor of the long
line of distinguished Monros, John Monro, formerly an army surgeon,
who became President of the College of Surgeons in 1712. His son
Alexander, afterwards so distinguished, was born in London on the 8th
September, 1697. Being an only son, his father gave unusual attention
to his training, and early perceiving his acuteness of mind, sent him
successively to London, Paris, and Leyden to obtain the best medical
education at that time accessible. The anatomical preparations which
he made during his studentship gave such evidence of ability, that
Drummond, who then taught anatomy at Edinburgh, offered to resign
in his favour as soon as he returned home. Cheselden in London and
Boerhaave in Leyden were highly impressed by the young Scotchman’s
promise.
The year 1720 may be taken as witnessing the actual start of the
Medical School of Edinburgh, and Alexander Monro as its real founder.
Although the father did much to promote the successful start, the
son becoming actually the competent teacher, must necessarily have
the greater credit. At the age of twenty-two, Monro was appointed
Professor of Anatomy, and having announced his first course of
lectures on anatomy, to be illustrated by the preparations he had
made and sent home when abroad, his father, without his knowledge,
invited the President and Fellows of the College of Physicians and
the whole of the city surgeons to the first lecture. The surprise
caused the young lecturer to forget the discourse which he had
committed to memory, and being without notes, he had presence of
mind enough to commence talking about some of his preparations,
and soon became collected in speaking of what he was confident he
understood. Thus the surprise and temporary forgetfulness thereby
caused was a foundation of his success: he found himself applauded
as a ready speaker, and resolved throughout life to speak extempore,
being persuaded that words expressive of his meaning would always
occur in speaking on a subject which he understood. From this time
the subjects of anatomy and surgery in Monro’s hands attracted large
classes of students, the average of the first decade being 67; of the
second, 109; of the third, 147. Even during the second session his
lectures attracted students from all parts of Scotland, also from
England and Ireland. Seizing the opportunity, other professors were
persuaded to start courses of lectures, so that soon a respectable
curriculum was provided, and Monro secured in 1722 a grant of his
professorship for life. It had previously been held only at the will
of the Town Council.
Monro was now face to face with the difficulty of providing
sufficient material for the instruction of his large classes. Under
Cheselden in London he had been accustomed to a supply of subjects,
more even than he could make use of. In Edinburgh, as early as 1711,
complaints were made at Surgeons’ Hall of violation of graves in
Greyfriars’ Churchyard, “by some who most unchristianly have been
stealing, or at least attempting to carry away, the bodies of the
dead out of their graves.” But, said the surgeons, “that which
affects them most, is a scandalous report, most maliciously spread
about the town, that some of their number are accessory, which they
cannot allow themselves to think, considering that the magistrates
of Edinburgh have been always ready and willing to allow them what
dead bodies fell under their gift, and thereby plentifully supplied
their theatre for many years past.” They consequently beg that the
magistrates will seek for and punish the offenders, and resolve to
expel any of their number found accessory to the violation of graves.
The populace nevertheless continued to be excitable on the subject
of the violation of graves, and in 1721-2, surgeons’ apprentices
were especially bound “not to raise the dead.” In March 1725 Monro
was put under the stringent obligation of giving information when
he procured each dead body, and guaranteeing that it was regularly
obtained; but the mob were suspicious, and threatened to demolish his
museum and theatre at Surgeons’ Hall. Monro consequently applied for
and obtained a room in the university building, being there safer
than at Surgeons’ Hall. Here his course included dissections not
only of the human body, but also of animals. Diseases affecting the
various organs were referred to; operations upon the dead body were
performed; bandages were applied; and lastly, such physiology as was
known was treated of. This course was continued for nearly forty
years.
A great hospital was lacking, and the whole force of the medical
faculty, with the powerful aid of the far-seeing provost, George
Drummond, was engaged to secure the building of the infirmary. Monro
and Drummond were constituted a Building Committee, and Monro planned
in particular the operation-room. Dr. Moore in his Travels through
Scotland records that “the proprietors of many stone-quarries made
presents of stone, others of lime; merchants contributed timber;
carpenters and masons were not wanting in their contributions; the
neighbouring farmers agreed to carry the materials gratis; the
journeymen masons contributed their labours for a certain quantity
of hewn stones; and as this undertaking is for the relief of the
diseased, lame, and maimed poor, even the day-labourers could not
be exempted, but agreed to work a day in the month gratis toward
the erection. The ladies contributed in their way to it; for they
appointed an assembly for the benefit of the work, which was well
attended, and every one contributed bountifully.”
The completion of the hospital gave Monro the opportunity of
delivering clinical lectures on surgery, while Rutherford from 1748
gave clinical lectures on medical cases. Monro himself was present
at every _post mortem_ examination, and dictated to the students
an accurate report of the case. It was said of him “it is hardly
possible to conceive a physician more attentive to practice, or a
preceptor more anxious to communicate instruction.”
His first and perhaps best known work was his Osteology, published
in 1726, and translated into several foreign languages. A French
edition appeared in folio with excellent engravings by M. Sue,
demonstrator to the Royal Academy of Paris. A treatise on the Nerves
followed; and later, a series of Medical Essays and Observations,
many by Monro, was issued by him, as the result of meetings of the
principal medical men in Edinburgh, which flourished for some years.
Another interesting work of Monro’s was his treatise on Comparative
Anatomy, in which he proposed to illustrate the human economy by
the anatomy of such vertebrate animals as he knew. But the contrast
is astonishing between Monro’s knowledge and that of the present
day. He divides quadrupeds into carnivorous and herbivorous; fowls
into those that feed on grain and those that feed on flesh; fishes
into those that have lungs and those that have not. He remarks that
the fishes that have lungs differ very inconsiderably from an ox
or any other quadruped, and are not easily procured; consequently
he omits all account of them. Moreover, he says, “as the structure
of insects and worms is so very minute, and lends us but little
assistance for the ends proposed, we purposely omit them.” He has a
strangely unpenetrating view of the relation between an oyster and a
sensitive plant. “What difference is there betwixt an oyster, one of
the most inorganised of the animal tribe, and the sensitive plant,
the most exalted of the vegetable kingdom? They both remain fixed
to one spot, where they receive their nourishment, having no proper
motion of their own, save the shrinking from the approach of external
injuries.” Dr. Monro’s writings generally are not inviting to quote
from, being written in a plain and rather bald style, with very
little attempt at illustration.
In private life Monro, primus, was humane, liberal in sentiment,
a sincere friend, and an agreeable companion, an affectionate
husband and a kind father, having the art of making his children his
companions and friends. In 1745, after Prestonpans, he went down at
once to the battlefield to assist the sick and wounded, dressed their
wounds, and busied himself in securing them provisions and conveyance
to town. Nor did he confine his attentions to the loyal, but aided
the rebels also. He took an important share in the education of his
children, of whom Donald became a successful physician, and wrote his
life prefixed to the quarto edition of his works, 1781, to which all
subsequent biographies are much indebted.
Monro was a man of a strong muscular make, of middle height. Yet
his constitution was considerably weakened in early life owing to
his being too frequently bled. He was liable to attacks of chest
affections throughout life, but died finally of a painful ulcer of
the rectum and bladder, on July 10th, 1767. He had resigned his chair
of anatomy to his son Alexander in 1759, but continued to practise
and to attend the infirmary till the last. He bore his painful
illness with fortitude and Christian resignation, and talked of his
approaching death with the same calmness as if he were going to sleep.
“He was,” says Professor Struthers, “an able and active, and at
the same time a calm and placid man. He had family and friends
influential and plenty, but the work he had to do was of a kind
at which friends could only stand and look on. He had to do a new
thing in Edinburgh; to teach anatomy and to provide for the study
of it, in a town of then only thirty thousand inhabitants, and in a
half-civilised and politically-disturbed country; he had to gather
in students, to persuade others to join with him in teaching, and
to get an infirmary built. All this he did, and at the same time
established his fame not only as a teacher but as a man of science,
and gave a name to the Edinburgh School which benefited still more
the generation which followed him.”
Although we must depart from strict chronological order to do so,
it will be more convenient to give here an account of the second
Monro, who was born May 20th, 1733, and was early attracted to the
study of anatomy, showing great perseverance and possessing a good
memory. He soon became a very useful assistant to his father in the
dissecting-room, and when the students grew too numerous for one
lecture, his father deputed his son, at the early age of twenty, to
repeat his course in an evening lecture to those who had failed to
obtain admission in the morning. His father, seeing how successful
his son was, petitioned the Town Council to have him appointed
as his colleague and eventual successor, promising, if this were
granted, to send his son to the best medical schools in Europe, and
in every way to fit him for the post. This plan being carried out,
young Monro took his M.D. degree at Edinburgh in 1755, and set out
for a round of medical schools, London, Leyden, Paris, and Berlin;
in London he attended William Hunter; in Berlin he had the still
greater advantage of living in the house of, and sharing the intimate
instruction of, the great anatomist, Meckel—a truly good start for
a promising career. On his son’s return to Edinburgh in 1758, his
father resigned his chair to him, and the son commenced by teaching
quite novel views on the blood, controverting his father’s teaching.
“The novelty of his matter, combined with the clearness of his style,
is described by one who was present as having acted like an electric
shock on the audience. It was at once seen that he was master of the
subject, and of the art of communicating knowledge to others; his
style was lively, argumentative, and modern, compared with that of
his more venerable colleagues; and from the beginning onwards, for
half a century, his career was one of easy and triumphant success”
(Struthers). As a lecturer he was clear, earnest, and impressive,
eloquent without display, and at the same time grave and dignified.
No wonder that his classes increased in size, until they even reached
four hundred.
At the same time Monro entered into practice as a physician, and
became one of the leading practitioners in Edinburgh, so much so that
Dr. James Gregory described him as being far more than half a century
at the head of the medical school, and for a great part of that time
at the head of the profession as a practising physician. He was
also frequently called into consultation on surgical cases, though
he did not operate. His chief fame is, however, as a successful
anatomist and teacher of anatomy. In 1777 he successfully resisted
the appointment of a separate Professor of Surgery, claiming that his
office included surgery.
Monro secundus claimed, and not without good grounds, to have made
important original discoveries in regard to the lymphatic system; but
his merits as a discoverer in this department do not interfere with
the greater lustre of William Hunter and Hewson. His observations
on the structure and functions of the nervous system enjoy the
distinction of having called Sir Charles Bell’s attention to the
ganglion of the fifth pair of cranial nerves, and to important
particulars of the origin of the spinal nerves, which led in no
insignificant degree to his own great discoveries.
In 1758 Monro published at Berlin his first essay on the Lymphatics,
and Professor Black testified to having read this essay in manuscript
in 1755. It contained an account of the lymphatics as a distinct
system of vessels, having no immediate connection with the arteries
and veins, but arising in small branches from all cavities and cells
of the body into which fluids are thrown, and stating that their use
was to absorb the whole or the thinner parts of these fluids, and to
restore them to the general circulation. He showed further by medical
observation that in cases where acrid matter was applied to the pores
of the skin, or gained access to the cellular membranes, the glands
between the parts affected and the centre of the body became swollen
and painful, manifestly from being absorbed by the lymphatics.
Monro also first ascribed the absorption of bones and other solid
parts in cases of tumour to pressure. His various works on the
Nervous System, on the Muscles, on the Brain, Eye, and Ear, and on
the Structure and Physiology of Fishes, all contain observations
which were of considerable value in building up the science of
anatomy in the last century, but none of them furnish attractive
reading, such as we have found in the works of Harvey and Sydenham.
This is somewhat remarkable, considering that Monro shone as an
anecdotist, was intimate with all the celebrated Edinburgh men of his
time, and was a great admirer of the theatre, being equally attracted
by Mrs. Siddons, whom he felt the greatest pleasure in attending as a
patient, and by Foote, whose performance as President of the College
of Physicians to Weston’s Dr. Last under examination he enjoyed
extremely. It was said that Monro sent his own scarlet robe to the
theatre for the mock doctor to wear.
Another of Monro’s personal tastes was that of horticulture. He
planted and beautified several romantic hills around his estate
at Craiglockhart. Here he fitted up, says Dr. Duncan, a rural
cottage, consisting of two commodious apartments, adjoining his
head gardener’s house, whose kitchen could provide dinner for a few
select friends. He would keep no bedroom there, that he might never
be tempted to stay away from his professional duties in Edinburgh;
but in his cottage he often passed a summer day and regaled his
friends with the choicest fruits. Dr. Duncan in his Harveian Oration
relates his disappointment that the younger generation of his friends
“prefer the instrumental music of a fiddle, a flute, or an organ in a
drawing-room to that of the linnet, the thrush, or the goldfinch in
the fields;” and that the gardens of his old friends in which he had
spent such happy hours were now let out for market gardens.
Monro was very economical of his time, and carefully measured it out
to each subject which occupied him; and he worked nearly as hard
towards the end as at the beginning of his career. He did not deliver
stereotyped lectures, but continually improved them. He is to be
credited also with having favourably received Jenner’s discovery of
vaccination, and vaccinated many children himself.
In person the second Monro was of middle height, of vigorous and
athletic make. His head was large, with strongly marked features and
full forehead, light blue eyes, and somewhat large mouth. His neck
was short, and his shoulders high.
In 1798 his son, Monro, tertius, was conjoined with him in the
professorship, but for ten years more the old man continued to
give the greater part of the course. His last lecture was that
introductory to the session of 1808-9, after which he retired from
practice also, and lived on till he died of apoplexy, 2d October
1817, in his eighty-fifth year.
Born to a great name and a ready-made position, as Professor
Struthers remarks, the second Monro had every advantage which
education, friends, and place could secure. But it is to his credit
that among brilliant colleagues like Cullen, Black, Dugald Stewart,
Playfair, and others, he held his own both intellectually and
socially, even if he has not left so abiding a mark upon medical and
anatomical science as his contemporaries must have expected him to
make.
* * * * *
Notwithstanding the note which the Monros have attained for their
anatomical teaching, and the distinction won by the Gregorys as
Professors of Medicine and able physicians, they are outshone by
William Cullen, who is justly the most conspicuous figure in the
history of the Edinburgh Medical School in the eighteenth century.
WILLIAM CULLEN was born on the 15th of April, 1710, at Hamilton,
Lanarkshire, his father having been factor to the Duke of Hamilton.
Early prominent at the local grammar-school by his quick perception
and retentive memory, he was sent to the University of Glasgow in
due course, and apprenticed to a medical practitioner named Paisley,
who was both studious and possessed a good medical library, a signal
advantage to young Cullen. It became remarked by his companions
that while he took little or no part in their discussions when he
happened to be ill-informed on the subject, he always so studied
it afterwards that he could surpass the best of them if it came
up again. At the close of 1729 Cullen went to London, and first
obtained the surgeoncy to a merchant ship, commanded by a relative,
with whom he went to the West Indies, remaining six months at
Portobello. On his return to London he took a situation in an
apothecary’s shop in Henrietta Street, and studied as diligently as
ever, when not occupied in the shop. His father had died, and there
was little provision for a large family; his eldest brother’s death
compelled him to return to Scotland in the winter of 1731-2, to make
arrangements for the education of his younger brothers and sisters.
He began practice at Auchinlee near Hamilton, taking charge of the
health of a relative, and perseveringly carrying on from books those
studies which he had not money to prosecute at the seats of learning
where he longed to be.
The receipt of a small legacy was the turning-point of Cullen’s
earlier fortunes: and how small a sum a studious Scotchman can make
available in this direction is well known. Cullen resolved to devote
himself to study entirely until he should be qualified to take a
firm stand as a surgeon at Hamilton. He first went to reside with a
dissenting minister in Northumberland, for the study of literature
and philosophy, and then spent the winter sessions of 1734-5 and
1735-6 at Edinburgh Medical School, now rapidly rising into note.
On establishing himself as a surgeon at Hamilton early in 1736,
young Cullen was soon employed by the Duke and Duchess of Hamilton
and the leading families of the neighbourhood. In this comparatively
retired situation Cullen yet gained the confidence of Dr. Clerk, an
able Edinburgh physician called in to Hamilton Palace, and was the
means of influencing William Hunter to the choice of the medical
profession. William Hunter was Cullen’s resident pupil from 1737 to
1740, and declared these to have been the happiest years of his life.
Thus natural selection brings men of future note together before
the world has known them, and the lineal succession of minds is as
fruitfully carried on as that of bodies. The affection of these two
continued throughout life. Long after William Hunter refers to him as
“a man to whom I owe most, and love most of all men in the world.”
Cullen determining to devote all his time to medicine, proceeded to
the M.D. degree at Glasgow in 1740, and took a partner who was to
relieve him of surgical work. In November 1741 he married Miss Anna
Johnstone, a lady of much conversational power and charming manners,
whose companionship he enjoyed for the long period of forty-six
years. She became the mother of seven sons and four daughters. Dr.
Cullen’s name was now becoming known considerably beyond his native
locality, and in 1744 he removed to Glasgow, a step which he would
have taken previously but for the solicitations and promises of
the Duke and Duchess of Hamilton. His constant attendance on the
duke in his painful illness was ended by the death of the latter in
1743, which put an end to the project of a chemical laboratory and a
botanical garden at the palace, which had been among the inducements
by which he had been prevailed upon not to quit Hamilton. Henceforth,
in the intervals of practice and study, he began to occupy himself
vigorously with the founding of a medical school at Glasgow. He at
once began to lecture on medicine, and subsequently added to his
courses chemistry, materia medica, and botany, in all of which he
gave lectures not merely representing the knowledge of the time,
but also including original views of high value. The young school
grew, though not so rapidly as that of Edinburgh; but thus early he
was brought into contact with yet another great man, Joseph Black,
who was for some years his intimate pupil, and afterwards left
Glasgow for Edinburgh. Cullen discerned the promise of his pupil,
and carefully abstained from entering upon fields of research in
which he expected him to make a mark. Black submitted his treatise
on fixed air to Cullen, and dedicated it to him. About this time
Cullen made some important discoveries on the evolution of heat in
chemical combination, and the cooling of solutions, some of which
were not published till 1755, while others remained in manuscript,
but suggested to Black important points in his view of latent heat.
At the beginning of 1751, by the interest of the Duke of Argyll,
Dr. Cullen succeeded Dr. Johnstone as Professor of Medicine in the
University of Glasgow, at the same time that Adam Smith was appointed
to the Chair of Logic; and a friendship of great intimacy arose
between these thoughtful minds. Only a few months afterwards, Adam
Smith’s transfer to the Moral Philosophy chair led Dr. Cullen to
favour strongly the election of David Hume to the vacant chair, on an
occasion when Edmund Burke was also a candidate. Neither was elected,
strict orthodoxy carrying the day. At this period the applications
of chemistry to arts and manufactures and to agriculture engaged
Cullen’s attention considerably, and he proposed to carry out a
process for purifying common salt, but it proved too expensive.
Cullen, finding that Glasgow did not promise to build up a large
medical school at present, and being compelled to take country
practice, began to look longingly to Edinburgh, to which also his
friends were calling him. He says in a letter to William Hunter, in
August 1751, “I am quite tired of my present life; I have a good
deal of country practice, which takes up a great deal of time, and
hardly even allows me an hour’s leisure. I get but little money for
my labour; and indeed by country practice, with our payments, a man
cannot make money.” Various circumstances, however, prevented this
step being taken, until, in the beginning of 1756, he was appointed
to the professorship of chemistry at Edinburgh, and was thus fairly
launched on his notable career. In the competition for this chair,
Joseph Black had been nominated, but the two friends honourably
refused to do anything to prejudice each other, and on appointment
indeed Cullen offered Black all the fees if he would assist him.
Cullen’s first course at Edinburgh was attended by only 17 students,
his second by 59, while it rose later to 145. Practice soon came to
him, and freed him from his pecuniary struggles.
In 1757 Dr. Cullen first undertook to give clinical lectures in the
infirmary, and in this work his especial talents shone. He had now
had sufficient experience of practice, with the best knowledge of
chemistry and materia medica that the time afforded; and his skill
in observation and graphic description of disease, added to his zeal
for imparting knowledge, soon made his clinical lectures renowned.
In these lectures, for eighteen years most carefully prepared, the
first real model of what is now so familiar to medical students as
a clinical lecture was afforded. His candour may be judged from
the following expressions: “In these lectures, however, I hazard
my credit for your instruction, my first views, my conjectures, my
projects, my trials, in short, my thoughts, which I may correct and
if necessary change; and whenever you yourselves shall be above
mistakes, or can find anybody else who is, I shall allow you to rate
me as a very inferior person. In the meantime I think I am no more
liable to mistakes than my neighbours, and therefore I shall go on
in telling you of them when they occur.” Promoted by such candour,
Cullen’s reputation rapidly grew. His lectures were remarkable
for simplicity, ingenuity, and comprehensiveness of view, with
copiousness of illustration. He taught his students to observe the
course of nature in diseases, to distinguish between essential and
accidental symptoms, and to carefully discriminate the influence of
remedies from the curative operations of nature. “There is nothing,”
he said, “I desire so much as that every disease we treat here should
be a matter of experience to you, so you must not be surprised that
I use only one remedy when I might employ two or three; for in using
a multiplicity of remedies, when a cure does succeed, it is not easy
to perceive which is most effectual.” Again, he says, “Every wise
physician is a dogmatist, but a dogmatical physician is one of the
most absurd animals that lives. We say he is a dogmatist in physic
who employs his reason, and, from some acquaintance with the nature
of the human body, thinks he can throw some light upon diseases
and ascertain the proper methods of cure; and I have known none
who were not dogmatists except those who seemed to be incapable of
reasoning, or who were too lazy for it. On the other hand, I call
him a dogmatical physician who is very ready to assume opinions,
to be prejudiced in favour of them, and to retain and assert very
tenaciously, and with too much confidence, the opinions or prejudices
which he has already taken up in common life, or in the study of
the sciences.” He sought to build up rational views of medicine,
indeed, on the basis of fact and experiment. In giving his clinical
lectures he was at great pains to choose diseases of the most common
types, as most useful to the students. He adhered to great simplicity
of prescriptions, compared with the complex and barbarous nostrums
of preceding times, and he experimentally used and introduced many
new drugs of great value, such as Cream of Tartar, Henbane, James’s
Powder, and Tartar Emetic.
The novelty with which Cullen invested his subject and the boldness
of his views made many, especially conventional practitioners and
lecturers, regard him with disfavour, and decry him for not regarding
Boerhaave’s views as final, and for adopting those of Hoffmann in
conjunction with his own. Yet his lively and entertaining lectures,
combined with his pleasing treatment of patients, and “his manner, so
open, so kind, and so little regulated by pecuniary considerations,
made him win his way more and more. He was the friend of every family
he visited.” William Hunter writes in 1758, “I do assure you I have
never found anything in business so pleasing to me as to hear my
patients telling me, with approbation, what Dr. Cullen had done for
them, and to hear my pupils speaking with the reverence and esteem of
Dr. Cullen that is so natural to young minds.”
As a sign of the general mental attitude of Dr. Cullen, the following
extract from a letter to his son James, on setting out for a foreign
voyage, is of interest: “Study your trade eagerly, decline no
labour, recommend yourself by briskness and diligence, bear hardships
with patience and resolution, be obliging to everybody, whether
above or below you, and hold up your head both in a literal and
figurative sense.” While he aided his juniors in the best sense to
acquire independence of character, he “admitted them freely to his
house; conversed with them on the most familiar terms; solved their
doubts and difficulties; gave them the use of his library; and, in
every respect, treated them with the affection of a friend and the
regard of a parent. It is impossible for those who personally knew
him in this relation,” says Dr. Aikin, “ever to forget the ardour
of attachment which he inspired.” Another and not less pleasing
view of Cullen is shown in his recommendation of “Don Quixote” to
Dugald Stewart when a boy suffering from some indisposition, and the
interest he manifested in his patient’s progress in that delight. He
used to talk over with the lad every successive incident, scene, and
character, manifesting the minutest accuracy of recollection of the
master-piece.
We shall not follow the discussions which arose at Edinburgh about
the succession to Dr. Rutherford’s chair of the Practice of Physic,
nor the circumstances which led to Dr. John Gregory’s appointment.
Suffice it to say that on the death of Dr. Whytt, Cullen consented
to accept the chair of the Theory of Physic in 1766, and that
subsequently an arrangement was made by which the two professors
lectured alternately on the Theory and Practice of Physic, to
the still greater advantage of the now celebrated school. This
appointment was strongly promoted by both the Monros, and by an
address signed by 160 medical students. The arrangement now made
lasted till Dr. Gregory’s death in 1773, when Cullen became sole
Professor of the Practice of Physic. Black was brought to Edinburgh
to succeed Cullen in the Chair of Chemistry.
Cullen’s principal works are the “Nosology,” a synopsis and
classification of diseases, with definitions, which obtained wide
popularity, although only an approximation to a sound system; and
his “First Lines of the Practice of Physic,” 4 vols., 1778-85, which
went through numerous editions. One of its especial merits was that
it pointed out more clearly than preceding works the extensive and
powerful influence of the nervous system on disease. It is now held
as the defect of his system that it was too theoretical, and that its
views were not adequately supported by facts. It cannot be denied
that Cullen had but moderate anatomical and physiological knowledge,
and this has prevented him from leaving works capable of being read
with much profit by the practitioners of the present day.
It is after all on William Cullen’s personal influence on the School
of Medicine, which he did so much to maintain, that his fame will
chiefly rest. The character of this influence is honourable and
stainless. Dr. James Anderson has left in unequivocal language a
record of his bearing in his conspicuous position which does equal
honour to his intellectual energy and to his qualities of heart. Dr.
Cullen, he says, was employed five or six hours a day in visiting
patients and prescribing by letter; lecturing never less than two
hours a day, sometimes four; yet, when encountered, he never seemed
in a hurry or discomposed—always easy, cheerful, and sociably
inclined. He would play at whist before supper with as keen interest
as if a thousand pounds depended on it.
Cullen did not leave his acquaintance with his students to originate
by chance, but invited them early in their attendance, by twos,
threes, and fours, to supper, and gaining their confidence about
their studies, amusements, difficulties, hopes, and prospects. Thus
he got to know all his class, and paid especial attention to those
who were most assiduous, best disposed, or most friendless. He made
a point of finding out who among them were most hampered by poverty,
and often found some polite excuse for refusing to take a fee even
for their first course, and in many cases for their second course.
One method he adopted was to express his wish to have their opinion
on a particular part of his course which had been omitted for want of
time the previous session, and he would thereupon present them with
a ticket for the second course. After two courses he did not require
any fee for further attendance. He is credited, too, with having
introduced into Edinburgh the practice of not taking fees for medical
attendance on students of the university. This ease and generosity
about money matters was the cause of his eventually dying without any
fortune. It is said that he used to put sums of money into an open
drawer, to which he and his wife went when they wanted any.
We shall not enter here into the controversy between Dr. John Brown,
founder of the Brunonian theory of medicine, and his disciples,
and Dr. Cullen, to whom Brown had owed everything in his youth.
Brown’s system proved to be no more stable than his personal
character, although its noisy advocacy, and the abuse heaped upon him
personally, caused Dr. Cullen much pain.
Cullen continued to deliver his lectures until 1789, having
resigned his professorship on the 30th December, and he died on the
5th February 1790, almost eighty years of age. He was buried at
Kirknewton, in which parish was situated his estate of Ormiston Hill.
This latter, which he had beautified with very great care, had to be
sold after his death for the benefit of his family.
Dr. Anderson describes Dr. Cullen as having a striking and not
unpleasing aspect, although by no means elegant. His eye was
remarkably vivacious and expressive. In person he was tall and thin,
stooping very much in later life. In walking he had a contemplative
look, scarcely regarding the objects around him. When in Edinburgh
he rose before seven, and would often dictate to an amanuensis till
nine. At ten he commenced his visits to patients, proceeding in a
sedan chair through the narrow closes and wynds. He always lived,
while in Edinburgh, in a comparatively small house in the Mint, not
far from the seat of his academical duties. For them he may be said
to have lived and died.
* * * * *
The family of the Gregorys has been perhaps equally celebrated with
the Monros in connection with university life in Scotland, and has
certainly furnished it with a larger number of eminent professors.
James Gregory, the celebrated inventor of the reflecting telescope,
was the first great man of the family, and his publication of a
work on optics in 1663 marked an era in that science. His early
death in 1675, at the age of 37, deprived science of many brilliant
discoveries in prospect. His only son, James, became Professor of
Medicine in King’s College, Aberdeen, and died in 1731.
His younger son, JOHN GREGORY, the first of the medical Gregorys
who became associated with the fame of Edinburgh, was only seven
years old when his father died in 1731. After being educated at
Aberdeen, under the care of his elder brother, who had succeeded his
father, and also under the influence of his cousin, Thomas Reid,
the well-known metaphysician, young Gregory entered at Edinburgh in
1741, and studied under the elder Monro, Sinclair, and Rutherford;
and at the Medical Society commenced a warm friendship with Mark
Akenside, author of the “Pleasures of Imagination.” In 1745-6 he
studied at Leyden under Albinus, and having received the M.D.
degree from Aberdeen during his absence, he was elected to the chair
of philosophy there on his return, and lectured there for three
years on mathematics, and moral and natural philosophy. In 1749 he
resigned this chair in order to devote himself to medicine, and in
1752 he married Elizabeth, daughter of Lord Forbes, who had beauty,
intellect, and wit, and brought him a fortune.
Finding that Aberdeen afforded him no sufficient field for practice
in competition with his elder brother, Gregory went in 1754 to
London, where he had already friends such as Wilkes and Charles
Townshend, whom he had met at Leyden, and where he speedily made
other friends, of whom may be mentioned George, Lord Lyttelton,
Edward and Lady Mary Wortley Montagu. He was at once elected into
the Royal Society, and would no doubt have gained fashionable
support; but his elder brother dying in 1755, he was recalled to
Aberdeen to fill the Professorship of Medicine. Here he continued
to practise and to lecture till 1764, publishing in the latter year
“A Comparative View of the State and Faculties of Man with those
of the Animal World.” He then removed to Edinburgh with a view to
securing a professorship there. This fell to his lot in 1766, on
the death of Rutherford. In the same year he succeeded Dr. Andrew
Whytt as physician to the king in Scotland. He at first lectured on
the Practice of Physic solely, but in 1770 he agreed with Cullen
that they should lecture in alternate years on the Theory and the
Practice, and this arrangement was continued permanently. As a
lecturer he was very successful, simple and not in any way oratorical
in style. He was especially noted for some lectures on the “Duties
and Qualifications of a Physician,” which were afterwards published,
and went through several editions. He gave the profits to a poor and
deserving student. In 1772 he published “Elements of the Practice of
Physic,” a kind of syllabus of lectures; and this completes the list
of his medical works. His name was more known after his death as the
author of a little book of advice to young girls, “A Father’s Legacy
to his Daughters,” which has gone through very many editions. His
tone may be judged from the following extract:—
“Do not marry a fool; he is the most untractable of all animals; he
is led by his passions and caprices, and is incapable of hearing the
voice of reason.... But the worst circumstance that attends a fool is
his constant jealousy of his wife being thought to govern him. This
renders it impossible to lead him; and he is continually doing absurd
and disagreeable things, for no other reason but to show he dares do
them.... A rake is always a suspicious husband, because he has known
only the most worthless of your sex. He likewise entails the worst
diseases on his wife and children if he has the misfortune to have
any.”
Gregory’s predominant qualities were good sense and benevolence.
In conversation he had a warmth of tone and of gesture that were
very pleasing, united to gentleness and simplicity of manner. To his
pupils he was a friend, ever easy of access, and ready to assist them
to the utmost. His Edinburgh life was spent in intimate association
with David Hume, Lord Monboddo, Lord Kaimes, Dr. Blair, and the elder
Tytler. James Beattie loved him with enthusiastic affection, as the
closing stanzas of “The Minstrel” testify. Gregory died suddenly
on the 9th February 1773, from gout, from which he had frequently
suffered. He had thus scarcely attained the age of fifty.
JAMES GREGORY, who succeeded his father in the professorship,
was born in Aberdeen in 1753. He was educated in Edinburgh, and
also studied for a short time at Christ Church, Oxford, where his
relation, Dr. David Gregory, had been dean. He acquired a strong
taste for classics and no little classical erudition, so that he
was throughout life fond of making apposite Latin quotations, and
wrote that language easily and accurately. He was still a student
of medicine at Edinburgh when his father’s sudden death took place
in 1773. The son by a great effort completed his father’s course
of lectures, and showed so much ability that the professorship was
practically kept open for him. In 1774 he took the M.D. degree, and
spent the next two years in studying medicine on the Continent. In
1776, being then only twenty-three, he was appointed Professor of the
Institutes of Medicine, and in the following year also commenced to
give clinical lectures at the infirmary, which method of instruction
he continued for more than twenty years. His practice at first was
not extensive, until his pupils had themselves become practitioners,
and called him in as a consultant. In his later years, after Cullen’s
death, his practice increased largely, and in the ten years preceding
his death he had the leading consulting practice in Scotland.
In 1780-2 Gregory published his “Conspectus Medicinæ Theoreticæ,”
written in excellent Latin; it speedily became widely known, and
was extensively read not only in Britain but also on the Continent.
It has gone through numerous editions. Its more important and
valuable portions were those dealing with therapeutics. In 1790
he was appointed Cullen’s successor in the chair of the Practice
of Medicine, and from that time continued to lecture to large
classes down to his death in 1821 (April 2). Thus he held an almost
autocratic position for the long period of over thirty years; and
it is much to be regretted that his great talents in repartee,
quick memory for telling quotations, and fondness for a joke, led
him to take an active part in the medical controversies which
have embittered so many careers in Edinburgh. The long list of
controversial books and pamphlets by Dr. Gregory, given by Mr. John
Bell in his “Letters on Professional Controversy and Manners,” 1810,
could be considerably extended, and it affords a melancholy picture
of misplaced energy. One of these extended to 700 pages quarto, and
its tone may be judged from the following extracts from the “Memorial
to the Managers of the Royal Infirmary.”
“Let us suppose that in consequence of this memorial, every
individual member of the College of Surgeons shall, to his own share,
make forty times more noise than Orlando Furioso did at full moon
when he was maddest, and shall continue in that unparalleled state
of uproar for twenty years without ceasing. I can see no great harm
in all that noise; and no harm at all to any but those who make
it.... Ninety-nine parts in the hundred of all that noise would of
course be bestowed on me; whom it would not deprive of one hour of
my natural sleep, and to whom it would afford infinite amusement and
gratification while I am awake.”
“We are certainly a most amiable brotherhood, as every person must
acknowledge who has had the good luck to see but a dozen and a half
or two dozen of us together, especially if he saw us at dinner.
Yet, whatever the majority of us may be, I am afraid we are not
all perfect angels. Some of us at least appear to be made of the
same flesh and blood, and to be subject to the same frailties and
passions and vices as other men. The consequence is, that when two
or three of us are set down together in a little town, or fifty or
a hundred of us in a great town, and obliged to scramble for fame,
and fortune, and daily bread, we are apt to get into rivalships, and
disputes, and altercations which sometimes end in open quarrels and
implacable animosities, to the very great annoyance of those who are,
and the no less entertainment of those who are not, our patients. A
consultation among any number of such angry physicians or surgeons
in all probability will conduce as little to the benefit of their
patient as a congress of an equal number of game-cocks turned loose
in a cock-pit, for probably the good of the patient will be the last
and least object of their thoughts.”
Inasmuch as he takes occasion to say of John Bell, “any man, if
himself or his family were sick, should as soon think of calling in a
mad dog as Mr. John Bell,” we can judge of the position in which any
one found himself who had the misfortune to displease Dr. Gregory.
We must believe, however, on the testimony of many who knew him,
that he must have possessed many remarkable and excellent qualities
to have won so large a share of their attachment and esteem as he
undoubtedly did. Dr. Alison says of him (Encyc. Brit., 8th ed.),
that the boldness, originality, and strength of his intellect, and
the energy and decision of his character, were strongly marked in
his conversation, and that he showed both warm attachment to his
friends, and a generosity almost bordering on profusion. He disdained
to conciliate public favour, and often gave unrestrained vent to
a strongly irascible temper. He would not give up his point in
argument, and would overwhelm his opponents with quotations, jests,
and satire.
As a teacher Gregory was conspicuous for a sound practicality. He
highly approved of a maxim which he often brought forward: “The best
physician is he who can distinguish what he can do from what he
cannot do.” Pathology in his days was a very rudimentary science, and
hence he distrusted all theories in regard to the essential nature of
disease as premature and visionary. He was at home in the study of
diagnostic and prognostic symptoms, and paid considerable attention
to the action of remedies. He had no tendency to meddlesome medicine,
restraining and discountenancing treatment when there was no hope
or prospect of success. He believed strongly in the antiphlogistic
or lowering treatment of inflammatory diseases, and in the use of
preventive measures in warding off the attacks of chronic diseases.
Thus he presented the spectacle of an advocate of temperance, of
bodily exertion without fatigue, and of mental occupation without
anxiety, who by no means followed his own prescriptions.
As a lecturer he displayed a most ready command of language, and
an excellent memory especially for cases he had seen, the details
of which he could accurately remember from the name alone of the
patient. He gained great influence over the minds of his pupils, not
merely by the humour and the abundance of his illustrations, but
also by the outspoken exposition of his views and his commanding
energy. His frankness showed itself too in the candour with which
he communicated his opinions to the relatives or friends of his
patients. He took a genuine interest in his patients, and convinced
them of his sincerity, notwithstanding a certain roughness of manner.
Where he felt no personal antagonism he was on very cordial terms
with his professional friends, and succeeded in gaining their esteem
and regard by his manner towards them in consultation. He was, as
we have said before, the admitted autocrat of the profession in
Edinburgh in his later years, and it is much to be regretted that his
contributions to the science of medicine are so few.
Gregory used to say that while physic had been the business,
metaphysics had been the amusement of his life. Reid dedicated
jointly to him and to Dugald Stewart his “Essays on the Intellectual
Powers;” and he was an attached friend of Thomas Brown, and
interested himself greatly in securing his succession to Dugald
Stewart in the chair of Moral Philosophy. He went so far in
philology as to publish a Theory of the Moods of Verbs in the
“Edinburgh Philosophical Transactions” for 1787. His “Literary and
Philosophical Essays,” in two volumes, (1792), dealt mainly with
the old controversy as to Liberty and Necessity. However, since he
had a strong opinion that metaphysics admits of no discoveries, it
is not surprising that his contribution to the science failed to
secure a permanent place. His fourth son, William Gregory, became a
distinguished chemist, the friend of Liebig and translator of his
“Familiar Letters on Chemistry,” and Professor of Chemistry in the
University of Edinburgh.
* * * * *
JOHN BELL, who comes last to be mentioned in the list of
great Edinburgh men of the eighteenth century, is linked with
the nineteenth in part by his surgical career and posthumous
“Observations on Italy,” and still more by his relationship to his
great brother, Sir Charles Bell. Every one who reads the scattered
memorials of John Bell will be filled with regret that his career
should have been blighted by controversy and what appears even
malignant opposition, led by Dr. James Gregory. His artistic tastes
and acquirements, combined with his original views on anatomy and
surgery, made him a specimen of a new genus in Edinburgh, and it is
certain that Edinburgh did not adequately appreciate him.
John Bell, the second son of the Rev. William Bell, a clergyman of
the Scottish Episcopal Church in Edinburgh, was educated for the
medical profession by his father’s choice, in gratitude for the
relief he had received by means of a difficult surgical operation
about a month before his son’s birth, in 1763. He was apprenticed
to Alexander Wood, a well-known surgeon in 1779, for five years. He
attended the lectures of Black, Cullen, and the second Monro, and
became a fellow of the Edinburgh College of Surgeons in 1786. Monro
not being an operating surgeon, John Bell saw many defects in his
teaching as to the applications of anatomy to surgery. In fact,
surgical anatomy was never adequately taught in Edinburgh till he
himself commenced to teach, and actual dissection was little thought
of. He says, “In Dr. Monro’s class, unless there be a fortunate
succession of bloody murders, not three subjects are dissected in the
year. On the remains of a subject fished up from the bottom of a tub
of spirits are demonstrated those delicate nerves which are to be
avoided or divided in our operations; and these are demonstrated once
at the distance of one hundred feet, nerves and arteries which the
surgeon has to dissect, at the peril of his patient’s life.”[11]
Immediately after qualifying, therefore, John Bell commenced
lecturing on anatomy and surgery on his own account, an audacious
proceeding which did not fail to draw down upon him the antagonism
of all those who stood by the old lines. He was vigorous in his
denunciation of the stereotyped methods and imperfections of the old
school of Monro and Benjamin Bell. He built a house for his courses
and practical work in Surgeons’ Square, where he carried on his work
after 1790. He soon came into popularity, and this increased as his
style became more polished and formed, being in fact the most graphic
which had appeared in the Edinburgh Medical School. He was a masterly
descriptive writer, and used all the charms of style to give interest
to his subject. Consequently his opponents said that he romanced
and exaggerated. He stuck to his text that surgery must be based
upon anatomy and pathology; and unfortunately aroused the bitterest
opposition of James Gregory, who first published an anonymous
pamphlet entitled “A Guide to the Medical Students attending the
University of Edinburgh,” warning students against attending John
Bell’s lectures. The next attack was a “Review of the Writings of
John Bell, Surgeon in Edinburgh, by Jonathan Dawplucker.” This
malignant attack, says Bell, was stuck up like a playbill, in a most
conspicuous and unusual manner, on every corner of the city; on the
door of my lecture-room, on the gates of the college, where my pupils
could not but pass, and on the gates of the infirmary, where I went
to perform my operations.
Bell replied by adopting the nickname used by his opponent, at the
same time attacking his surgical ally in conventional methods,
Benjamin Bell, whose “System of Surgery,” in six volumes, afforded
him excellent sport. Bell says, “I neither mistook my bird, nor
missed my shot; and on the day in which the second number was
published, the great surgical work of Benjamin fell down dead.” At
this time it was customary for all the surgeons of Edinburgh who
cared to do so to operate in rotation at the infirmary, and Gregory
put forward a plan by which only a select and limited number of
surgeons were to be allowed this privilege. But the scheme was
especially aimed at securing the exclusion of John Bell, and this
Gregory accomplished in 1800. However, Bell had gained notoriety and
practice, though he had lost the hospital appointment, and apparently
all chance of a university professorship. He gave up teaching, and
devoted himself to practice. He had been instrumental in raising
the tone of university requirements and theories in his branch, and
it could not again sink to its former inferior condition. He became
the leading operator and consulting surgeon of his time. “He was not
only a bold and dexterous operator,” says Professor Struthers, “but
combined all the qualities, natural and acquired, of a great surgeon,
to an extraordinary degree. He was original and fearless, and a
thorough anatomist; he had intellect, nerve, and also language—was
master alike of head, hand, and tongue or pen; and he was laborious
as well as brilliant.” Generous himself and liberal to those who were
necessitous, he knew how to reprove niggardliness in the wealthy. On
one occasion a rich Lanarkshire laird gave him a cheque for £50 for
services which Bell considered to deserve much higher remuneration.
On reaching the outer door he met with the butler, and said to him,
“You have had considerable trouble opening the door to me, there is
a trifle for you,” and gave him his master’s cheque. The astonished
butler of course consulted his master about this mark of doubtful
favour, and the laird, understanding the hint, sent after the skilful
surgeon a cheque for £150.
John Bell has, however, other claims to remembrance than his teaching
and his operative skill. His anatomical and surgical writings are
still worthy of consultation, and aided materially in the progress
of the science. His principal works of this class were the “Anatomy
of the Human Body,” 3 vols. (1793-1802); “Engravings of the Bones,
Muscles, and Joints,” illustrating vol. i. of the Anatomy, 1794; “On
the Nature and Cure of Wounds,” 1795; and “Principles of Surgery,”
3 vols., 1801-8. Sir Charles Bell speaks of “the rapid improvement
in the surgery of the arteries which followed the publication of
this part of the Anatomy:” and further, that it could not easily
be surpassed for correctness and minuteness of description. The
third volume of the Anatomy was by his brother Charles, under whose
subsequent editorship the book went through numerous editions, and
was translated into German. The treatise on Wounds contained clear
expositions of the novel practice of aiming at the early union
of wounds after operations, and also emphasised the importance
of the free anastomosis of arteries in all cases where injuries
were sustained by the main arterial trunks. In his “Principles of
Surgery” he gave excellent historical views of his subject, as well
as the latest and best practice founded on anatomy and physiology.
Sir Charles Bell makes the following pointed contrast between his
brother and Sir Astley Cooper, in regard to their methods: “He (John
Bell) seems ever most happy when he can support his reasoning by
the authority of those who have preceded him, and feels that he has
conferred a double benefit when he can at the same time illustrate
the truth and vindicate the character of some excellent old surgeon,
and teach the youth of the present day to look back to the history
of the profession for their most useful lessons. Sir Astley Cooper,
on the other hand, hates all authority which interferes with
his popularity; votes that volume to be an old musty one which
is dedicated to himself; omits all mention of his respectable
contemporaries; and only varies his terms of praise and eulogy on the
young men whom he flatters, journalists and connections in business,
down to the cutler who makes his instruments.”
In 1805 John Bell married Rosina Congleton, daughter of a retired
Edinburgh physician, and in her found congeniality of tastes, an
appreciation of the artistic, literary, and musical sides of his
nature, and admirable assistance in his propensity for exercising
hospitality. His entertainments, and his own performances on the
trombone, became celebrated. His taste for art was accompanied by
remarkable skill in design and execution, in which he was only
excelled among surgeons by his own brother Charles. He never,
however, felt quite at ease after his exclusion from the infirmary.
His rivals occupying their position of authority, Dr. Gregory in
perpetual sway, could not but impress him with a sense of undeserved
failure. Early in 1816 he was thrown from his horse, and did not
recover rapidly from his injuries. In 1817 his health was so much
impaired that he went on a foreign tour with his wife, and his last
three years were spent in Italy, where his artist soul found great
delight, and where he also, had much professional practice among
English visitors to Italy.
During his residence in Italy he was well aware of the dangerous
condition of his health, but his singular degree of spirit and ardour
of character prevented his ever betraying his consciousness of it.
A few pencilled lines, written by him before leaving Paris, express
well the inmost heart of the man whose career had presented such
outward turbulence. He says: “I have seen much of the disappointments
of life. I shall not feel them long. Sickness, in an awful and sudden
form; loss of blood, in which I lay sinking for many hours, with the
feeling of death long protracted, when I felt how painful it was not
to come quite to life, yet not to die—a clamorous dream! tell that in
no long time that must happen, which was lately so near.” He died of
dropsy, at Rome, on April 15, 1820.
In Florence and Rome he visited all the principal galleries, and
took pencil notes of his observations, both from a scientific and
artistic point of view. These formed the main bulk of his posthumous
“Observations on Italy,” edited by his friend, Bishop Sandford of
Edinburgh, published in quarto form in 1825, subsequently in 2 vols.
8vo in 1835, with additional chapters on Naples. On their publication
they at once took high rank, from their singular combination of
artistic sympathies, literary expression, and scientific criticism.
The _New Monthly Review_, on its first page, described the language
of these observations as vigorous, terse and pure; his lights and
shadows as disposed with a masterly hand. His descriptions both
of landscapes and of manners in Italy are referred to as the most
fascinating that had yet appeared. As a specimen of this vivid
and picturesque style, showing how much his art was aided by that
quickness to perceive characteristic expressions and traits which was
so trained by his medical experience, we may quote his account of a
Lenten preacher whom he heard at Rome.
“A sandal-footed, bare-armed, unclothed-looking monk, young, with a
pale visage and negligent aspect, stood leaning against a pillar at
the upper end of the middle nave; his grey coarse habit, girded by
various folds of thickly-knotted cords, seemed scarcely to cover his
person; his almost naked arms hanging down by his side, while his
cowl, which had fallen back, discovered a wild pallid countenance,
and a long lean bony throat. He stood silent and motionless, like
an image or statue, as if lost in meditation, or exhausted by the
vehemence of his own overwrought feelings poured out upon his
auditors. The orator had evidently reached to an elevated strain
before my entrance, leaving, as he had suddenly paused, vivid traces
of the force of his arguments on the countenances of those he
addressed. Here the spread hands, the half-opened mouth, the strained
eye, spoke an earnest yet amazed attention, while perhaps near
him stood, with silvered hair and meek aspect, the pale anchorite,
trembling while he listened, lest perchance even he might not be
secure against the punishments of the evil-doer: while beyond him
might be seen the dark, gloomy, steady gaze of the brooding fanatic,
whose flashing eye seemed to kindle with the orator, and keep pace
with his denunciations,—perhaps contrasted by the quiet unthinking
air of contented stupidity, looking as if the sense of hearing alone
were roused, or by the speaking eye, beaming with zealous fire, as if
ready to challenge or answer each new proposition. Some stood with
downcast looks, serious and reflecting; others walked softly along,
now seen, now lost among the pillars; while the larger portion, who
had been as it were surprised by their emotion into a momentary
taciturnity, were hastily forming into groups, and beginning, in
whispered accents, to converse with that eagerness and vivacity
which so peculiarly characterise their nation. But soon, above those
murmuring sounds, the full deep-toned voice of the preacher struck
the ear, when suddenly all was again hushed to silence. Slow and
solemn he opened his discourse; but, as he proceeded, his features
became gradually more animated; his dark deep eloquent eye kindling
as he spoke, and throwing momentary radiance over his wan and
haggard countenance, while the round mellow tones of the Italian
language gave the finest energy to his expressions. With frequent
pauses, but with increasing power, he continued his discourse; his
voice now low and solemn, now grand and forcible, but still with
moderated and ever-varied accents, which worked on the feelings, at
one moment producing the chill of strong emotion, and then, as he
changed his tone, melting the heart to tenderness. The object of
his sermon and self-imposed mission was to gain votaries, and win
them to a monastic life, by portraying the dangers, the turbulence,
and the sorrows of the worldly, contrasted with the peaceful
serenity of the heaven-devoted mind. Occasionally, as if warmed by
a prophetic spirit, with an air now imploring and plaintive, now
wild and triumphant, with animated gesture and tossing of the arms,
alternately pointing to heaven and to the shades below, he seemed as
if he would seduce, persuade, or tear his victim from the world. The
powers of his voice and action gave an indescribable force to his
language, carrying away the minds of his auditors with a rapidity
that left no pause for reflection. The sombre chastened light of day
bringing forward some objects in strong relief, and leaving others
in shade, the peculiar aspect of the monk, the magic influence which
seemed to hang on his words and lend force to his eloquence, gave to
the whole scene a character at once singular and striking.”
John Bell was below middle stature, of good figure, active, with
regular features, keen penetrating eyes, and highly intellectual
expression. His widow says of him: “To a classical taste and
knowledge of drawing (many of his professional designs being finely
executed by his own hand) he joined a mind strongly alive to the
beauties of nature. He would often, in his earlier years, yield
to the enjoyment they produced, and, wandering among the wild and
grand scenery of his native land, indulge his imagination in gazing
on the rapid stream or watch the coming storm. Such habits seem
to have tended, in some measure, to form his character; training
him especially to independence in judgment, and perseverance in
investigation, that led him to seek knowledge, and boldly publish his
opinions. With warm affections and sanguine temper, he looked forward
with the hope that his labours and reputation would one day assuredly
bring independence; and meanwhile, listening only to the dictates of
an enthusiastic nature, and yielding to the impulse of feeling, he
would readily give his last guinea, his time, and his care, to any
who required them. Judging of others by himself, he was too confiding
in friendship, and too careless in matters of business; consequently
from the one he was exposed to disappointment, and from the other
involved in difficulties and embarrassments which tinged the colour
of his whole life.”
FOOTNOTES:
[11] “Letters on the Education of a Surgeon,” by John Bell, 1810.