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The Life and Work of Thomas LAYCOCK 1812-1876 Frederick The Life and Work of ThOMAS LAYCOCK 1812-1876 Frederick Ernest James University College London A thesis presented to the University of London in candidature for the degree of Doctor of Philosophy. 3 ABSTRACT Following an introduction giving the reasons for writing on Thomas Laycock, there are two chapters of personal biography making use of his unpublished personal Journal. An account is then given of his papers on hysteria and the thinking which led from hysteria to reflex brain function. Next a chapter is devoted to Laycock's writings on public health and his involvement with Edwin Chadwick in the preparation for the City of York of The Report on the state of Large Towns and Populous Districts. Laycock always had a special interest in medical psychology and extended reflex action to explain some of the phenomena of mental illness and memory. An account is also given of his various other writings related to psychiatry. He was aware that extending reflex function to the brain would result in various philosophical and theological problems and Laycock's opinions are given on these issues together with a brief account of his classical work Mind and Brain. Having a great interest in medical psychology, also being a lecturer at the York Medical School and later Professor of the Practice of Physic at Edinburgh, it was natural he should be a pioneer in the teaching of the subject. Many fascinating ideas are to be found in Laycock's writings on general medicine, especially his use of neurology to explain oedema and certain types of pulmonary disease. A trophic nervous system was thought to cause tissue pathology which was a reversion to a lower evolutionary type. In his last decade Laycock wrote consolidating many of his previous ideas but attempted to bring these into line with then current scientific advances. A selection of his unpublished writings is examined in the same chapter. 2 In his lifetime Laycock was not an influential person but he impressed a few of his more able students, several of whom were to become professionally distinguished. The careers of these are described. After some conclusions a bibliography, with notes. is provided of published and unpublished works used in this thesis. 3 ACKNOWLEDGEMENTS It is a pleasure to acknowledge help received from many, without which this work would not have been possible. Dr Michael Barfoot has very generously shared with me his extensive knowledge of nineteenth century Edinburgh medical affairs, his wide knowledge of Thomas Laycock and has given encouragement to finalise this thesis. Dr. Kathleen Webb has provided much information relating to nineteenth century York and Dr Joyce Gaibraith details of Laycock's involvement with the York Medical Society. Dr Louise Yeoman of the National Library of Scotland has supplied ihotocopies of the correspondence between George Combe and Thomas Laycock together with related information. Joy Pitman, archivist to the Royal College of Physicians of Edinburgh, has supplied photocopies of manuscript material in the Thomas Laycock Collection at the College, a complete list of the collection and other information. Sue Gold has given great assistance in finding and maldng available relevant books and Sally Bragg has kindly facilitated various administrative arrangements. The Weilcome Trust kindly made a grant towards two visits to Edinburgh and many journeys to London. Finally my thanks are due to Professor W.F.Bynum who has guided my reading, supervised my studies and suffered my inept word processing in many earlier drafts. 4 CHAPTERS 1. Introduction Reasons for writing on Thomas Laycock: Structure of Thesis. 2. Biography, Earlier years Family background and school days: Profession and professional training: London visit and examinations: Medical students in Laycock's time: Qualifications: Radical Politics and Medicine: Appointment to York County Hospital: Laycock starts his medical writing: The Göttingen visit: Laycock's views on M.Ds: The York Medical Society: The York Dispensary: York Medical Schoc British Association for the Advancement of Science. 3. Biography, Later years A vacancy at the York County Hospital: The Edinburgh Appointment: A family disease: Anne Laycock' s death: Last days: Thomas Laycock's character and reputation. 4. Birth of a new concept. Laycock's Hysteria Papers: Observations on the hysteria papers: Mesmerism: Reflex function of the brain and the birth of neuropsychiatry: Laycock, George Combe and Phrenology: William Carpenter and Cerebral Reflexes: Other writers on Cerebral Reflexes. 5 5. Political Medicine Background of the public or State health movement of 1848: Thomas Laycock's association with public health: Public health and the City of York: Fevers: Epidemiology: The British Medical Association: Medical Act 1858. 6. Psychiatry Administrative Psychiatry: Forensic Psychiatry: Classification: Treatment: Memory and its organic defects: Religious insanity: Alcoholism: Statistics and insanity: The Unconscious. 7. Psychology, Philosophy, Religion and Ethics Psychology: Philosophy: Laycock examines the consequences of brain reflexes: Religion and Thomas Laycock: Ethics: Mind and Brain. 8. Thomas Laycock and Medical Education Apprenticeship and hospital bases training: Combined training in medicine and surgery: Lectures at York: Teaching at Edinburgh: Psychiatric Education: Laycock as a teacher: Laycock, the Medico Psychological Association: Training and education. 9. General Medicine. Proleptics or periodic illness: Medical textbooks: Pulmonary disease: Dropsies: Nervous dropsies of centric origin involving the trunk and limbs: Reflex dropsies involving the so called sympathies: Tissue pathology and therapeutics: Clinical (3astro- intestinal disease: Haematology: Dermatology: Scurvy: Laycock and Bennett. 6 10. The Last Decade and Unfinished Works. New thoughts in physiology: Can a body and mind relationship be investigated?: Laycock and Carpenter: Some unpublished writings. 11. Some Famous Students and Thomas Laycock's influence. John Hughlings Jackson: Sir David Ferrier: Sir James Crichton- Browne: Sir Thomas Clouston: Sir Jonathan Hutchinson: Sir Byrom Bramwell: Sir Thomas Lauder Brunton: Thomas William McDowall: John Mimer Fothergill: The sequelae to Thomas Laycock's ideas and works. 12. Conclusions Personal character: Public Health: Reflex Brain Function Neurology: General and Psychological Medicine: Medical Education: Thomas Laycock's influence. Bibliography. 7 CHAPTER 1 INTRODUCTION This is a biographical study of Thomas Laycock, physician, and examines his life and writings in the changing medical and social scene of the mid-nineteenth century. Reasons for writing on Laycock As a doctor he had an extraordinary career. Starting life as an apprentice in a small Yorkshire town, he rose, without wealth or patronage, to be Professor of Medicine in the University of Edinburgh. At the time Edinburgh was the premier clinical teaching school in the United Kingdom and Laycock's rise was a typical Samuel Smiles self help story, a story well worth telling in its own right. There can be few medical men of the period who wrote and contributed to such diverse fields of medical endeavour. Although not a topic for which he is widely known, Laycock was very active in the early days of public health, the City of York especially benefiting from his work. It was an issue on which he wrote and co-operated with that legendary figure of public health, Edwin Chadwick. Intimately related to public health is statistics and it was therefore appropriate that Laycock should publish on that subject and, at one time, be secretary of the Statistical Section of the British Association for the Advancement of Science. For Laycock public health embraced many matters of medical administration such as the registration of all medical practitioners and coroners' Courts. 8 The single most important work for 'hich Thomas Laycock is remembered is the extension of reflex action from the spinal cord to the cerebral hemispheres, thereby initiating the movement of medical psychology. Beveridge (1) writes: Laycock was the first to argue that a science of mental life was possible, that mind could be studied using the principles of medical psychology... .he sought to develop a scientific cerebral psychology which would unite philosophy and physiology. It is this which has led in recent years to a revival of interest in Laycock by those authors dealing with nineteenth century neurophysiological concepts (2 and 3). The development of reflex brain tfunction and unconscious cerebration had profound implications for philosophy and theology; implications which were not neglected by Laycock, for many of his writings relate to these matters. Controversies about the nature of the will, consciousness and the precise relationship between body, mind and spirit were to continue throughout Laycock's life, matters to which he gave considerable thought. Reflex brain function was used to explain many obscure phenomena, hysteria, mesmerism, somnambulism, dreaming and much of psychiatry especially hallucinations. Insanity was a subject in which Laycock had a special interest, not only in its theory and practice but in its teaching. He was well acquainted with the asylum situation, he promoted the interests of asylum medical officers, was an early member of the Medico- Psychological Association and eventually its President. As a lecturer at the York Medical School and then as Professor of Medicine at Edinburgh Laycock was a pioneer in psychiatric teaching to medical students.
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