A Portrait in History

Sir James Paget Surgeon to

Venita Jay, MD, FRCPC

orn in Yarmouth, , into a family of 17 children, B James Paget (1814–1899) rose to become the most trusted and beloved surgeon in the reign of Queen Vic- toria. Paget’s training began at the age of 16, when he was apprenticed to Charles Costerton, a general practitioner in Yarmouth. During the 4½ years he spent with Costerton, Paget learned a great deal about bones and . Paget also was a good artist and botanist. In 1834 (with his brother as a coauthor), Paget published a book entitled A Sketch of the Natural History of Yarmouth and Its Neigh- bourhood. This remarkable book contained the names of more than 700 insects and 1000 plants. At the age of 20 years, Paget entered London’s St Bar- tholomew’s Hospital as a medical student. In his first year of medical school, Paget used a microscope to visualize Trichinella in human muscle and made original sketches of the tissue parasite. Early in his medical career, he was involved in editing medical articles, teaching, and catalog- ing museum specimens as a curator. The meticulous Paget was blessed with many virtues: simplicity of character, unruffled temper, and punctuality. The consulting room and study in his small house on Harewood Place was visited by a great many historical figures. A man of highest principles and great religious convictions, Paget maintained that his profession was not a ‘‘trade,’’ and he treated rich and poor alike. He was appointed warden of St Bartholomew’s College for resident students in 1843. Paget became a professor of anatomy and surgery to the Royal College of Surgeons. Elected as Fellow of the Royal Society at 37, he was ap- pointed Surgeon-Extraordinary to Queen Victoria in 1858 and received his baronetcy in 1871. Paget served as the president of the Royal College of Surgeons in 1875 and of Sir James Paget. Illustration by Venita Jay, MD, FRCPC. the prestigious International Medical Congress in 1881. An outstanding diagnostician, surgeon, and physiolo- found the time to catalog the Hunterian collection of the gist, Paget also emerged as one of England’s finest pa- Royal College of Surgeons. thologists. He applied the microscope to his specimens Paget wrote on a variety of topics, and his skillful writ- and was irrevocably drawn to morbid anatomy. Paget also ings won him wide readership. Two conditions are named after him today. His article, ‘‘On Disease of the Mammary Areola Preceding Cancer of the Mammary Gland,’’ was Accepted for publication June 30, 1999. published in St Bartholomew’s Hospital Reports in 1874 and From the Division of , The Hospital for Sick Children, refers to Paget disease of the nipple. His 1877 paper, ‘‘On Toronto, Ontario, Canada. a Form of Chronic Inflammation of the Bones’’ (osteitis de- The author acknowledges that the general biographical overview presented does not necessarily include all of the accomplishments or formans, Paget disease) was published in the Transactions achievements associated with the person discussed. Dr Jay welcomes of the Medico-Chirurgical Society and remains a classic today. comments from readers concerning the ‘‘A Portrait in History’’ section. Paget died December 30, 1899. Before his death, Paget Reprints not available from the author. wrote his memoirs, which were edited by his son. Arch Pathol Lab Med—Vol 123, November 1999 Sir James Paget—Jay 995