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William Drennan, His Medical Life Presidential Address to Ulster Medical Society Delivered on 15 October 1998 Randal Hayes, MD, Bsc, FRCP, FRCPI

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William Drennan, His Medical Life Presidential Address to Ulster Medical Society Delivered on 15 October 1998 Randal Hayes, MD, Bsc, FRCP, FRCPI The Ulster Medical Journal, Volume 68, No. 1, pp. 4-11, May 1999. William Drennan, his Medical Life Presidential Address to Ulster Medical Society delivered on 15 October 1998 Randal Hayes, MD, BSc, FRCP, FRCPI Across the country this year many groups are involved in commemorating the bicentenary of the Rebellion of 1798. It seems appropriate that 11h____..._iI. :n_I.I we recall the life of Dr William Drennan, one of the founders of the United Irishmen and in 1808 the third president ofthe Belfast Medical Society, a forerunner of this organisation. William Drennan (Fig 1) was born in Belfast in 1754, the youngest ofnine children ofwhom only three survived. His father, Thomas Drennan, was then Minister of the First Presbyterian Church in Rosemary Street. Although only 12 when his father died, the ideas of Thomas Drennan and his contemporaries had a considerable influence on the development of William's political thought. Thomas Drennan was one of a number of dissenting ministers, educated in Glasgow, who formed a distinct group and through which political ideas were developed and articulated. Drennan was related by marriage to Francis Hutcheson and went in 1720 to assist him in a Dissenting school in Dublin. It was Hutcheson, who returned to Glasgow as Professor of Moral Philosophy, who was to provide the basis for the teaching espoused by this group and which was to influence the development ofWilliam Drennan' s political thinking. Hutcheson believed that Figure 1 political and social questions were ultimately moral ones and that the system which provided University. One of the areas which I have found for "the greatest happiness for the greatest interesting is to try to look at the concepts which number" was the moral framework within which supported medical thinking at that time and it is all relationships were to operate. It was his view these which I shall share with you in this next that in every sort of government, the people section. The seventeenth century had seen the governed had the right of defending themselves beginning of observation and experimentation, against the abuse of power. This thinking, taken the work of Harvey, Willis and Sydenham, the by a generation of emigrants to the American results of which were to challenge the traditional colonies, was to provide the impetus for that view handed down from Galen and Hippocrates. struggle for independence and was subsequently It was said that the "ancient practitioners existed through William Drennan and his colleagues to in an unenlightened state and all was mere stimulate the formation of the United Irishmen. conjecture". In the eighteenth century during that In 1769 at the age of 15 Drennan went to Glasgow movement of the mind we have come to call the University, graduating MA in 177 1; subsequently enlightenment reason was to create a better future. he enrolled in the Medical School of Edinburgh Science would give man control over nature and © The Ulster Medical Society, 1999. Presidential Address 5 the conquest of disease would follow. For some, later rival John Brown who insisted that there the application of mathematics and physics to was only one disease and that its manifestations physiology saw human activity as a series of depended on whether irritability was exaggerated mechanical chain reactions. This reductionist or decreased. A disease was sthenic ifexcitement philosophy was challenged by others who felt was increased and asthenic if diminished. The that the body was more than the sum of its parts advantage of this view was that it offered a and that purposive human activity required the therapeutic rationale, treatment being the guidance of something else, the soul, which was provision of either sedatives or stimulants both the controller of physiological processes depending on where on the "excitement" scale and the agent ofconsciousness. Herman Boerhave you judged your patient to be. who occupied a series of chairs in Leiden in the Brown seemed to be a popular lecturer and early eighteenth century was ofthe view that man developed an excited and rowdy following among possessed a physical body, analysable in terms of the Edinburgh students. Before starting his mathematics and physics, and an immortal soul. lectures he would take laudanum mixed into a It was in Leiden that Alexander Monroe, the first glass of whiskey and would repeat this several of three generations to be professors of anatomy times during the lecture. He became addicted to in Edinburgh trained, and the philosophy both and eventually died in 1788 in London promoted by the early Edinburgh school and its having taken too large a dose of laudanum before emphasis on clinical teaching owes much to that going to bed. Drennan by temperament was much background. more a follower of Cullen than of Brown and his Drennan had as teachers some eminentphysicians. respect for the former is shown in the fact that he Included among them were Black and Cullen. brought his sister Matty to see him in St Andrews Black had moved to Edinburgh from Glasgow as in 1782. It was in Edinburgh that he began to Professor ofChemistry where he had a reputation write to his sister Matty and it is through this as an experimenter. He identified "fixed air" correspondence, some 1400 letters now in the which was later shown to be carbon dioxide, Public Records Office in Belfast that we know so established that it was present in expired air and much of Drennan and his time. It is through these that although non-toxic would not support life. letters that I would like to provide insights into Cullen also came to Edinburgh from Glasgow but the life of a medical student and subsequently on had little aptitude for experimentation. He some aspects of medical practice. gathered together new medical knowledge, tried In the latter half of the eighteenth century to evaluate its worth and to incorporate it into his Edinburgh was attracting approximately 200 medical thinking. While many of his views medical students per year ofwhich one third were paralleled those of Boerhave he differed in that from Ireland. Relations between town and gown his belief was that the nervous system and not the were not good. Drennan writes "a student of vascular system was the key physiological medicine is a term of contempt but an Irish regulator. The origin of life lay in the response of student of medicine is the very highest the nervous system to environmental stimuli. complication of disgrace". Indeed on one These provoked sensations, some conscious, occasion, the populace believing that an outbreak through actions on irritable tissue in the organism. offever arose from the Infirmary attacked several This nervous power, the provider oflife, was also students and one of them died. The letters betray the basis ofheat, light, electricity and magnetism. the usual student preoccupation with money. "My Cullen also believed that progress in medicine expenses have been great as usual - I'm not had lagged behind that of other sciences through certain whether I have received the worth of the lack of a classification of disease. He produced money but I hope you have not utterly thrown it his own classification ofdiseases and with typical away on me". However Drennan seems to have Scottish parsimony reduced them to four. Cullen been a diligent and abstemious student. "I rise a believed most diseases were due to external little after six in the morning. After preparing for influences and that these same factors were classes, at about 8.00 o'clock if it be a good capable ofcausing different diseases, the different morning I will give stretch to my legs for half an manifestations in individuals being dependent on hour in the meadow which lies near my lodgings the state of excitement of the nervous system. - I return to take my breakfast of bread and milk These theories were extended by his pupil and and then issue out to the labours of the day. From C) The Ulster Medical Society, 1999. 6 The Ulster Medical Journal nine until one I am tossed about with the wind of Drennan seemed well aware of the consequences doctrine through different parts ofthe University; of excessive withdrawal of blood. He describes from nine till ten at the practice; from ten till fainting, the development of oedema with ascites eleven at the University; from eleven till twelve and pleural effusion and in addition recognised Materia Medica, a class which treats on medicines, that there was sometimes excessive exudation of their use and application; from twelve to one at fluid into the bronchi which resulted in the sudden the Infirmary. From one till three I make it a rule death of the patient. His dilemma was to provide to walk and chew on what I have heard. After a rationale for a therapy which he recognised as dinner I seldom have more than one hour's dangerous but which was also promoted by his attendance at College. Then I idle away an hour teachers. He struggled to find criteria by which at a coffee house, call on my friends and in the the method could be used to assist natural evenings have some select friends whom I make mechanisms. There seemed to be a reasonable as drunk as they can be on tea and warm water". rationale in what he described as inflammatory As the end of his studies approaches he describes fevers which from the characteristics of the pulse himself as "neither very nervy nor very grave on described we might recognise as high output the matter of the examination, but just in that states. With regard to other situations he was golden mean which will secure me a kind of generally cautious but recognised that in some bashful assurance, an appearance I would imagine situations it was better to bleed unnecessarily the most recommending of all others, to my than to refrain deliberately.
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