THE TWO HEBERDENS THE ELDER (1710-1801) WILLIAM HEBERDEN THE YOUNGER (1767-1845) By SIR , BART., G.C.V.O., K.C.B., M.D. HASLEMERE, SURREY, ENGLAND

(Conc lus ion ) *

(14) “A letter to Dr. Heberden con- Life of Jenner, did not reach Heberden cerning the Angina Pectoris; and Dr. who certainly never referred to the sub- Heberden’s Account of the Dissection of ject. Jenner did not publish the coronary one who had been troubled with the origin, out of consideration for Hunter disorder” (3: 1-11, 1785). Read at a who, however, was probably fully aware meeting on November 17, 1772. The of the association of coronary disease and letter dated April 16, 1772, was signed angina, and of the true nature of his own by “Unknown” who, having seen in the symptoms. For in 1776 Fothergill pub- Critical Review an abstract of Heberden’s lished a fatal case in which Hunter in paper (read in 1768 and published in 1775 had found that “the two coronary 1772), recognized his own symptoms and arteries from their origin to many of their described them in a way which the late ramifications in the heart were become Sir William Osler regarded as one of the one piece of bone.” Jenner sent his friend best on record. Realizing that he might Caleb Hillier Parry (1755-1822) a full die suddenly “the unknown” left direc- written statement of his opinion that tions that Heberden, who by this time coronary disease was the cause of angina, had seen 50 cases, should then examine pointing out that he did not wish to make his body. Three weeks later this was done it known because of his affection for John by John Hunter who found nothing Hunter. In 1788 Parry read a paper more than small areas of calcification in embodying this view to a small medical the aorta; Edward Jenner, however, who club, consisting of Jenner, Hicks of was present, wrote to Caleb Hillier Parry, Bristol, Paytheran, Ludlow and himself, “I can almost positively say that the which met three times a year, usually coronary arteries of the heart were not at the Fleece Inn, Rodborough, Glou- examined.” It may be added that in the cestershire, and is therefore sometimes spring of the following year John Hunter spoken of as “The Fleece Medical So- had his first attack of angina pectoris, ciety.” This paper was not published, but which was so graphically described by his in 1799 Parry incorporated its contents, nephew Sir Everard Home; in May, 1777 including Jenner’s statement, in “An he had a second attack, and Jenner, who Inquiry into the Symptoms and Causes soon after saw him when convalescing at of Syncope Anginosa, commonly called Bath, had in the meanwhile seen two Angina Pectoris; illustrated by Dissec- post-mortems on patients with angina tions.” There are resemblances between and coronary disease, one of them appar- Heberden and Parry; they were both ently of coronary thrombosis. In .1778 constant and copious notetakers, and left Jenner wrote a letter to Heberden giving behind them works which posthumously his diagnosis of angina and, for the first added to their already high reputations, time, stated that the underlying cause the “Commentaries,” from the senior was coronary disease. For some reason or and the “Collections from the Unpub- other this letter, reproduced in Baron’s lished Writings of the late Caleb Hillier * Part 1 appeared in the September issue, n.s. 5: 409, 1933. Parry” (3 vols., , 1825), which 80 additional cases. A parallel and contained his account of exophthalmic closely related event is the frequency goiter. with which the clinical picture of (15) “The Method of preparing the coronary thrombosis has been recog- Ginseng Root in China” (3: 34-36, nized within the last ten years. The 1785). Communicated by Heberden for John Burrow on November 11, 1773. two descriptions in 1768 and 1782 do (16) “Of the Measles” (3: 389-406, not differ in essentials, but there are a 1785). Read on August 6, 1785. This was few differences in details. Heberden the last professional paper published by regarded angina as a spasmodic and Heberden during his lifetime. not as an inflammatory affection, and in a footnote in the “Commentaries” Of these sixteen papers the out- seems to confuse with it the mountain standing are those on chicken-pox and sickness described by H. B. de Saus- angina pectoris as they give the first sure in 1779. Careful estimates of complete descriptions of these dis- Heberden’s account of angina pectoris eases. In the first of these two he have been given by Gairdner and by pointed out precisely the diagnostic Osler. points from smallpox. The last volume of Medical Obser- In the classical description entitled vations and Inquiries by a Society “Some Account of a Disorder of the of in London (6: 340-407, Breast” he wrote: “The seat of it, and 1784) contained “A Sketch of the sense of strangling and anxiety with Epidemic Disease which appeared in which it is attended may make it not London towards the End of the Year improperly called angina pectoris,” 1775” to which thirteen medical men, and he spoke of it as “a distemper including Heberden, Sir John Pringle hitherto so unnoticed, that it has not, (1707-1782), H. R. Reynolds, and as far as I know, found a place or a Sir George Baker contributed. In name in the history of disease.” his paper dated December 16, 1775, Descriptions of isolated cases, such as Heberden said that the epidemic be- those of Seneca, the Earl of Claren- gan about October 28. In this sym- don’s father, and patients of Mor- posium there was also a letter addressed gagni, F. Hoffmann (1734), and to John Fothergill (1712-1780) who Rougnon (1768) of Besangon, have stood in much the same parental since been unearthed; Huchard urged relation to these Medical Observations the claims of Rougnon (which have and Inquiries as Heberden did to been discounted as based on a case of the Medical Transactions of the Royal cardiac dilatation in emphysema), College of Physicians. Both these and the eponym “Rougnon-Heberden publications ceased after their sixth Krankheit” has been employed. In his volume, and it would seem probable “Commentaries” Heberden described that the number of years which were the disease under the heading of allowed to intervene between the Pectoris Dolor and said that he had reading and the printing of the papers seen nearly a hundred cases, so that must have led to their extinction. in the interval between the reading of The great contest between the fel- the original paper in 1768, based on 20 lows and the licentiates, who were cases, and 1782 when the “Commen- agitating for admission to the exami- taries” were finished he had seen some nation for the fellowship, of the Royal College of Physicians of London, defi- and Sir John Pringle, in favor of nitely began about 1752, “although admitting John Fothergill, arch-rebel the first mutterings of the storm were though he was, as a fellow; the heard as far back as 1746” (Chaplin), proposal was lost by 13 votes to 9. and continued with occasional ex- Another licentiate who vigorously and acerbations until the beginning of ably advocated the reform of making ’s reign. The licentiates the licentiates eligible for the fellow- were vigorous, not to say rough, in ship was W. C. Wells (1757—1817), their methods; on September 24, 1766, author of the famous “Essay on Dew” they forced their way into a Comitia (1814). He supported Dr. Christopher when Sir William Browne (1692-1774) Stanger in his action at the Court was president, and on September of King’s Bench in 1796 by a long 30 of the following year they were and spirited letter of 186 printed prevented from doing so only by pages, but not published, dated July the locked iron gates, to force which 1, 1799, to the Right Hon. Lloyd, Lord they in vain offered a smith 10 Kenyon (1732-1802), Lord Chief Jus- guineas and an indemnity of £300. tice: “Relative to some Conduct of After a number of actions at law and the College of Physicians of London much pamphlet warfare the licentiates posterior to the Decree of the Court were in the nineteenth century ad- of King’s Bench in the case of Dr. mitted to the examination for the Stanger.” In it he paid a high tribute fellowship without being doctors of to Heberden: of the Universities of Oxford or Cambridge, a requirement dating Many of our physicians have no doubt from about 1575. The anonymous received little injury from the causes of author of the “Picture of the present the corruption of character to which they State of the Royal College of Phy- were exposed; and some few have escaped sicians of London” (1817) advised their influence altogether. One of these few, Dr. William Heberden, I must con- the licentiates to concentrate and clude to have been known to your elect their own president. Times have Lordship, from the eulogy which you greatly changed since the eighteenth passed upon him during the trial of Dr. century, in the last year of which Stanger’s cause. Dr. Heberden, my Lord, there were only 45 fellows of the stands in a manner alone in his profession. College, for in 1876 the largest number No other person, I believe, either in this of fellows hailed from Edinburgh or any other country, has ever exercised closely followed by the University the art of medicine with the same dignity of London, and then came Cambridge, or has contributed so much to raise it in Oxford, and St. Andrews. In 1926 the estimation of mankind. I should there were 376 fellows, of whom think it proper to say that I had never the University of London claimed been acquainted with Dr. Heberden and consequently could neither be dazzled 149, Cambridge 97, Oxford 51, and by the splendour of his virtues, from Edinburgh 36. In 1769 John Fother- approaching them too nearly, nor in- gill, the Quaker , and others fluenced in my opinion concerning them brought an action against the College. by benefits he had already conferred A little later Heberden, with a broad upon me; and that standing as he does on and perhaps prophetic view of the the verge of this state of existence ready dispute was, with Sir William Browne to wing his flight to another glory, his ear must be closed to the voice of flattery, cheap. Thomas Cogan (1736-1818) had he ever listened to that syren, or were who took the doctorate at Leyden on I base enough to solicit his aid in the February 20, 1767, practised for some foolish expectation of receiving from him years in a restless fashion at Amster- some future reward. dam, Leyden, and Rotterdam, and On April 29, 1776, the Societe thus became acquainted with the Royale de Medecine of Paris was activities of “the Society instituted at instituted, and in August of the same Amsterdam in favour of Drowned year Heberden together with William Persons” which had been founded in Cullen, George Baker, John Pringle, 1767. He settled in London about James Lind, John Fothergill and 1772 and joined forces with Hawes others, was elected a foreign associate in founding the Royal Humane So- of the Society. He accordingly wrote ciety by each bringing fifteen friends a brief autobiographical sketch in to a meeting at the Chapter Coffee Latin to be inserted after his death House in St. Paul’s Churchyard in in the Society’s Histoire avec memoires the summer of 1774. Cogan prepared which, however, ceased to appear after the first six annual reports of the 1789. Heberden the younger enabled Society; he then handed his successful Pettigrew to reproduce this notice of obstetrical practice to John Sims his father in facsimile in his memoir. (1749-1831), m.d ., f .r .s ., a botanist Heberden’s versatility was shown in as well as physician to Princess various ways; he was a botanist of Charlotte. John Sims must not be some standing, and his activities at confused with James Sims (1741- the Royal Society were such that 1820) whose prolonged presidency of Sir (1743-1820), who the Medical Society of London (from was President from 1778 to 1820, 1786 to 1809) led in 1805 to the forma- gave the name Heberdenia to a genus tion of the Medical and Chirurgical consisting of a number of species of Society which in 1834 became the Myrsine, and one species, a Madeira Royal Medical and Chirurgical So- shrub now known as Ardisia excelsa ciety and in 1907 was transformed Ait., was for a time called Heberdenia into the Royal Society of Medicine. excelsa. He was a fellow of the Society In 1780 Cogan retired to Holland “to of Antiquaries (elected December 6, prosecute his studies in moral phi- 1770). Further, there were few public losophy.” One of the five gold medals charities which he did not support, minted for the Royal Humane Society and in this connection reference may bears an inscription to his memory. be made to the history of the Royal Hawes became the first registrar of Humane Society of which he was the Society, and wrote an account of elected a vice-president in 1789. the fatal illness in March, 1774 of William Hawes (1736-1808), who his patient Oliver Goldsmith who, like practised in the Strand, was much Heberden, was an enthusiastic sup- interested in the resuscitation of per- porter of the Society. sons taken out of the Thames, paid Heberden’s name has been attached, out of his pocket a reward to those not an uncommon fate of other dis- who brought these victims to him, tinguished Medical Fathers, to com- and in 1783 was lecturing on “Ani- paratively minor achievements. The mation” at his house in Great East- first of these is “Heberden’s nodes” described in Chapter 28 of his “Com- in pencil: “I desire this book may be mentaries” as follows: given to Mrs. Heberden for the use of any of our sons who shall study physic. Digitorum Nodi. What are these little W. H.” Underneath in the handwriting hard knobs, about the size of a small pea, of William Heberden the younger: “This which are frequently seen upon the fin- & the english (sic) copy wch. is in London gers, particularly a little below the top, have been collated, & they agree with one near the joint? They have no connection another & with the other Latin copy.” with the gout, being found in persons who A few verbal alterations and some re- never had it; they continue for life; and arrangement of the chapters were made being hardly ever attended by pain, or by the son, but the text is substantially disposed to become sores, are rather the same as that of the printed book. unsightly, than inconvenient, though they must be of some little hindrance The library of the Royal College of to the free use of the fingers. Physicians of London also contains This eponym must be distinguished manuscripts closely connected with from that of “Haygarth’s nodes” the writing of the “Commentaries”: derived from “nodosity of the joints,” (1) “Index Historiae Morborum” (Ad- a name applied by John Hay garth versaria). Small 4to bound in vellum, 564 (1740-1827) in 1805 to the swollen pages. On the fly-leaf the author wrote in joints in the disease called rheumatoid pencil “I desire that this book may be arthritis by Sir A. B. Garrod in 1858. given to any one of my sons who applies In Gould’s Medical Dictionary, edited to the study of physic. W. H.” Under- by Scott, 1931, the eponym Heberden- neath in the handwriting of W. Heberden Rosenbach nodes is given, after the younger is the following in ink: “The Ottomar Rosenbach (1851-1907), a whole is in the handwriting of Dr. Heber- hardly necessary hyphenation. den—containing the notes from which his The other eponym, “Heberden’s Commentaries were drawn up. It is particularly requested that this book may ink,” has been applied to Mistura on no account be taken out of the College, Jerri aromatica which was used by to whom it is presented by his son, W. Heberden about 1760 and remained Heberden.” in the British Pharmacopoeia until At the end of the manuscript “22 Maii 1890; it contained iron and vegetable 1784” is written in pencil. drugs, cinchona, calumba, cloves, (2) A manuscript volume, presented by cardamoms, and orange peel. LeRoy Crummer, contains many chap- His “Commentaries de Morborum ters with the same titles as those in the Historia et Curatione” (8vo, Lond., published commentaries, though the text price 7/6), completed in August, 1782, is not in the final form in the “Commen- were brought out by his son William taries.” This volume therefore shows the in 1802 who, though he did not admit process of development of the published work. it, probably translated them from Latin into English. The original manu- The “Commentaries” at once ac- script is in the library of the Royal quired a European reputation; S. T. College of Physicians of London. von Soemmering (1755-1830) pub- It is a small 4to bound in vellum, 519 lished in 1805 a Latin edition at pages, “Collectanea Spectantia ad His- Frankfurt with a preface in which toriam Morborum et Remediorum” he spoke of the author as “Medicus (Commentarii). On the fly-leaf is written vere Hippocraticus ”; J. F. Niemann brought out another edition at Leipzig in preparation for some years and in the following year; and in 1831 contained an illustration showing the Professor L. H. Friedlaender of Halle emphysematous lung of Samuel John- included it as volume 10 of the son whose necropsy Heberden at- “Scriptorum classicorum de Praxi tended in 1784. The descriptions of medica nonnullorum Opera collecta,” disease are concise clinical pictures Lipsiae, with a short life in Latin. drawn from his long experience and The fourth English edition appeared may thus be compared to composite in 1816. American editions appeared photographs. The number of single in 1818 at Boston, and in Philadelphia clinical cases recorded is not large, in 1845. and when given they are not in detail. The “Commentaries” were built The word “History” in the title up gradually from notes taken in refers to the course of the disease Latin during his active professional and not to the chronological knowl- life in the chambers of the sick, from edge and recognition of the morbid themselves or from their attendants; state. The substance contrasts with these were read over every month that of his Cambridge lectures on and expanded or modified as subse- materia medica and the Goulstonian quent events made necessary. “It lectures on poisons by the absence appeared more advisable to give such of references to, and quotations from, facts only, as were justified by the authorities, ancient and contempo- original papers, however imperfect, rary, and represents his own obser- than either to supply their defects vations. In this connection it may be from memory, except in a very few interesting to recall that instances, or than to borrow anything (1761-1815) after remarking that he from other writers.” In his preface had avoided quotations as far as Heberden goes on: possible in his “Medical History and An useful addition might have been made Reflections” (1792) appended the fol- to these papers by comparing them with lowing rather ambiguous footnote: the current doctrine of diseases and “It has smartly and justly been said, remedies, as also with what is laid down however, by Gabriel Naude (1600- in practical writers, and with accounts 1653) (who seldom ventured to hold of those who treat of the dissections of an opinion, for which he could not morbid bodies; but at my advanced age produce classical authority) that they it would be to no purpose to think of such only are adverse to quotations who an undertaking. never expect to be quoted them- While no doubt thinking of the selves.” Heberden’s style is simple, voluminous “Sepulchretum, sive Anat- clear, logical, and without any effort at omia practica ex Cadaveribus Morbo the ornate, hypotheses being rigor- donatis” (1679) °f Theophile Bonet ously excluded. On account of the and of G. B. Morgagni’s “ De Sedibus et classical purity of his Iatinity he Causis Morborum” (1761) he may also has been compared to Celsus, and have been aware of Matthew Baillie’s called by Osler the English Celsus. “Morbid Anatomy of some of the When describing the aphorisms of most important Parts of the human as the reflections of an Body” which, though it did not aged physician on the experience of appear until 1793, must have been his life, Singer says that “among modern medical writings its closest was suppurated; but I never saw a analogue is perhaps the ‘Commen- case in which it was the consequence taries’ of the great English physician, of the bite of a mad dog.” This William Heberden, the elder.” admission is at first sight rather The preface begins by quoting Plu- remarkable as a number of cases tarch’s division of a vestal virgin’s were reported in the contemporary life into three portions, in the first medical publications of the time, of which she learned the duties of including the Medical Transactions her profession, in the second practiced of the College of Physicians; but this them, and in the third taught them perhaps may be partly explained to others. This he regarded as no by the nature of Heberden’s practice bad model for the life of a physician, and by his not holding a hospital and as he had passed through the appointment. It has been said that two first of these stages he proposed he was much more interested in to employ the remainder of his days diagnosis than in treatment, and he in teaching what he knew to any of certainly examined the effect of treat- his sons who might choose the pro- ment with a critical eye; his obiter fession of physic. dictum to the effect that “new medi- There are 102 articles; the first cines, and new methods of cure, two, “Of Diet” and “Ratio Medendi” always work miracles for a while” are of a general character, and the would not now be thought an ex- remainder are arranged in alphabetical aggeration, and it has since been order, a plan of obvious convenience reasonably explained on the suppo- which did not escape Pettigrew’s sition that at first all the patients criticism that it does not possess specially subject to the effects of the value of a “philosophical classi- suggestion take the treatment with fication”; this, however, cannot but uniformly beneficial effect, and that be regarded as an ideal not yet when their number is more or less attainable. Then the short “Con- exhausted the proportion of successes clusion,” followed by the “Appendix” falls rapidly. When convinced of the containing (1) A Sketch for a preface truth he expressed it quite definitely, designed for the Medical Transac- for example in the short chapter tions 1767, (2) “Observations on the “Of the Bristol Water” which “is chronical Rheumatism,” (3) “On the celebrated for its purity and for its Pulse,” and (4) “On Opening a Vein virtues in consumption and several in Haemorrhage.” Some of the 102 weaknesses,” he remarked: “It cer- chapters are very concise, such as tainly has no claim to be thought a that on Hernia: “Ruptures require pure water; and as far as my experi- no other remedy than a proper band- ence goes, it has as little just pretence age or truss,” no mention being to any of the medicinal virtues which made of herniotomy which had been it has been thought to possess.” popularized by Ambroise Pare and The longest chapter is on that Oppro- others in the sixteenth century. A brium Medicorum, as he, like the chapter of four and a half lines reads: Rev. Richard Jackson, the founder “I have seen a considerable degree of the Cambridge Professorship of of the hydrophobia in one whose Natural Experimental Philosophy in throat had been much inflamed, and 1783, called the gout, and contains some stern remarks on the absurd The eighteenth century was prob- view popularly taken at that time ably the least satisfactory period of of a disease, which was “wished the Universities of Oxford and Cam- for by those who have it not, and bridge; according to G. M. Trevelyan boasted over by those who fancy “the slumbers of the English Univer- they have it.” Englishmen are stated sities were more scandalous than the eagerly to “resort to Bath in order lighter and more broken slumbers of to get the gout,” for the prevalent the church”; Peacock in 1841 vigor- belief was that an attack of gout ously stigmatized the corruption cleared the constitution from other which in the previous century had ailments, and was “a critical dis- disgraced the Government and filled charge of peccant humours.” There the Cambridge colleges with fellows was more fear of being cured of the who were distinguished neither by gout than of having it, and the world learning nor high principles, and Win- seemed to be content to submit to it stanley gives striking examples of the lest a worse evil should take its way in which the professors and place. The Portland powder, the rise, college tutors neglected their duties. reign, and fall of which had all This state of affairs did not pass un- occurred under his eyes, had sunk noticed at the time, and among the into a state of discredit and neglect, now forgotten pamphlets was an anon- as much below its real merit as its ymous one of 53 pages, “Strictures first praises were above it. It probably upon the Discipline of the University lost its reputation partly as a result of Cambridge, Addressed to the of the excessive doses given and Senate” (8vo, pp. 53, London, 1792), partly “by having all the natural which is ascribed by Bowes and by ill effects of gout imputed to it, Halkett and Laing to Heberden, and particularly palsies and apoplexies.” appears to be the last of his writings According to Sir A. B. Garrod it published during his lifetime. The consisted of equal parts of birthwort, Senate are approached as the gentian, germander, groundpine, and “Chirons of our future heroes, states- the tops and leaves of the lesser men and philosophers,” and their centaury. It was purchased by the attention directed to the shameful second Duke of Portland (ob. 1762) negligence of some rulers of the who was so much benefited by it University, to the absence of college that he made its composition public. tutors and fellows from the chapels, In the chapter on bronchocele there to the slovenly character of divine is not any reference to exophthalmic service there, and to “the pernicious goiter which was observed by Parry in custom of card-playing.” The author 1786 but not published until 1825. In wrote: “Since the act of Parliament in the short chapter on aneurysm, how- 1781 which gave £500 annually to ever, Heberden wrote “many tumours each of the Universities towards the of the neck, apparently of this sort, promotion of learning, Oxford has from having a strong pulsation in produced but very few learned publi- them, have after several years spon- cations from its own body, and Cam- taneously decreased, till at last they bridge, 1 believe, none.” At the pres- have almost disappeared.” ent time (1932) the Treasury grant to the University of Cambridge is St. John’s College, Cambridge, has £107,500 annually. painted on it the words: “Gul. Heber- In 1794 Thomas Percival (1740- den, Soc. Coll. 1739. Sir. W. Beechey 1804) printed for private circulation pinxit”; but there is not any record “Medical Ethics, or a Code of Insti- how it came to the College. tutes and Precepts adapted to the In 1796 when in his eighty-seventh professional Conduct of Physicians year he fell in the Chapel Royal, St. and Surgeons,” which was then added James’s, and fractured his thigh, to, amended, and published in Man- being thereby disabled from taking chester in February, 1803. It con- the considerable amount of daily tained letters from Heberden referring walking exercise to which he was to his retirement and from Sir George accustomed. His philosophical and Baker, but these were omitted in the serene temperament came to the res- second edition (1827). The “Code of cue and when nearly ninety years old Ethics” of the American Medical he remarked that though his occupa- Association, drawn up before 1849, tions and pleasures had changed he was based on Percival’s work, and did not remember to have ever passed many of the phrases in it were those a more comfortable year than the last. used in the original edition of “ Medical In the of 1800 Ethics” (Brockbank). Henry Vaughan (afterwards Halford) Sir (1753—1839) praised him in a manner otherwise painted Heberden’s portrait in 1796 reserved for fellows who have passed and, according to tradition, on arriv- beyond these voices. As in the case of ing at Windsor for this purpose found Conrad Gesner (1516-1565) and that he had forgotten to bring the William Osler (1849-1919) he had, in necessary canvas; rising to the occa- addition to ability, learning and in- sion he obtained a shirt on which he dustry, those properties of heart that proceeded to paint the portrait. endear the possessor to his generation. Peachey, however, quotes Ernest He would seem to be well described Beechey, great-grandson of the artist, as “that grave figure with the mind of to the effect that he has not any a philosopher and the heart of a knowledge of the tale of the shirt. child” (Hingston Fox). The whereabouts of the portrait, He died at his house, 79 Pall which was engraved by William Ward Mall, on May 17, 1801, being senior (1766-1826), a .r .a ., is not absolutely on the list of the fellows of the Royal certain; according to Munk’s “Roll College of Physicians and in full of the Royal College of Physicians possession of his faculties; within of London” it is that presented to the forty-eight hours of his death he College of Physicians by William quoted from an ancient Latin author Heberden the younger at the opening to the effect that “death is kinder of the present building in Pall Mall to none than those to whom it comes East on June 25, 1825, and now in the uninvoked.”* He was buried in the Censors’ room. On the other hand it * T. R. Glover, Public Orator in the Uni- has been thought to be one of the two versity of Cambridge, kindly informs me that portraits in the possession of the the following line from Publilius Syrusmost Heberden family. A portrait in the nearly corresponds to the quotation: “Mori dining-room of the Master’s Lodge of est felicis antequam mortem invocet”; that parish church at Windsor, and on his nine young children, and then the south side of the church there is a became more interested in religion monument to his memory with the than in medicine. inscription: Near this place are deposited the remains of William Heberden, m.d ., who died the 17th May, 1801, in the 91st year of his age. He practised physic, first at Cambridge, afterwards in London, with great and unsullied reputation above 50 years. His distinguished learning, his sweetness of manners, and active benevolence raised him to an uncommon height in public esteem: above all, his deep sense of religion, which he cultivated with unremitting attention, regulated his conduct through a long and busy life, and supported him to the last with unabated cheerfulness and resignation. His widow and three surviving children erected this tablet to his memory.

WILLIAM HEBERDEN (1767-1845) THE YOUNGER He was born on March 23, 1767, Though an extremely distinguished at Cecil Street, Strand, and was the classical scholar and physician the second and longest surviving son of son has not attracted the same amount William Eleberden the elder, then of historical interest as his father, in his fifty-seventh year, and his who no doubt overshadowed him. second wife Mary Wollaston. After Further, his career as a medical man education at the Charterhouse, Lon- was comparatively short; in 1812 don, from the tender age of seven when at the zenith of his professional until he left as head boy of the life he was suddenly left a widower school, he was admitted a pensioner and at once gave everything up, at St. John’s College, Cambridge, except his attendance on the King on March 30, 1784, thus following his at Windsor, in order to look after father and his half-brother Thomas. He was admitted Ducket scholar on there is also the reputed dictum of Caesar November 9, 1784, was first senior op- that the best death is the unexpected: Suetonius, “Life of Julius Caesar,” Chap. 87: time in the mathematical tripos of in'; sermone nato super Unam . . . quisnam 1788, his uncle Francis John Hyde esset finis vitae commodissimus, repentinum Wollaston (1762-1823) of Trinity inopinatumque praetulerat (the same in Hall, senior wrangler in 1783, being Plutarch’s “Caesar,” 63, 4, but that is in one of the two moderators. In the Greek); Pliny in his “Natural History,” vn, 53, 180, says “Mors repentina est summa same year he was awarded the second vitae felicitas.” None of these he considers, of the two gold (Chancellor’s) medals exactly corresponds to Heberden’s quotation. open to “commencing bachelors of Arts who having senior optimes shall years later he returned to the subject make the best appearance in classical of temperature in “An Account of learning”; his brother Charles (1772- the Heat in July, 1825, together 1796) was first Chancellor’s medallist with some Remarks upon sensible in 1793. William was admitted Platt Cold” (Phil. Trans., 116: part 2, 69, fellow of St. John’s College on March 1826). 11, 1788, and in 1790 gained the first On November 15, 1793, less than Members’ Prize, given by the Repre- five years from the date of entering sentatives in Parliament of the Uni- as a student, he was elected physi- versity for the best exercises in Latin cian, at the same time that Sir prose. In the meanwhile he had Everard Home (1756-1832), joint ex- entered the of St. ecutor with Matthew Baillie to John George’s Hospital, where he signed Hunter’s will, was elected surgeon, the pupils’ roll on December 23, to St. George’s Hospital. There were 1788. It is perhaps curious that he no assistant physicians to the hospital did not proceed to a medical degree until 1834 when James Hope (1801- at Cambridge, but incorporated m.a . 1841), the cardiologist, was appointed. at Oxford from Christ Church on Heberden’s medical colleagues were July 9, 1791, having proceeded m.a . John Robertson Barclay, f .r .s ., ap- at Cambridge in the same year, and pointed in 1799 Physician Extra- took the degrees of b .m . on June 26, ordinary to the Princess of Wales, 1792, and d .m . on April 28, 1795, at Matthew Baillie also a Balliol man, Oxford. Possibly it may have been and George Pearson an early advocate because Oxford is so much nearer of Jennerian vaccination. Heberden than Cambridge to Datchet where resigned this post in 1803, and was his father was then living, but a more succeeded by Pelham Warren (1778- probable reason is that some colleges 1835), f .r .s ., an extremely successful at Cambridge did not permit their physician, who took prodigious quan- fellows to be m.b .’s or m.d .’s , and tities of snuff, and when gazetted Heberden was a fellow of St. John’s. Physician Extra-ordinary to William On February 24, 1791, when only iv on his accession declined the ap- twenty-three years old, he was elected pointment because he had not been a fellow of the Royal Society, the previously approached. year after Matthew Baillie (1761— At the Royal College of Physicians 1823) and the same year as George of London Heberden was admitted Pearson (1751-1828), his future col- a candidate on September 30, 1795, leagues as physicians to St. George’s a fellow on September 30, 1796, was Hospital. In his first published paper a censor in 1799 and 1808, and on “On the Influence of Cold upon the November 1, 1823, an elect in the Health of the Inhabitants of London” place of Matthew Baillie deceased. (Phil. Trans., 86: 279, 1796), he In his Harveian Oration of 1809, followed his father’s and uncle’s ex- published in the following year, he ample, and handed on to other mem- gracefully eulogized his father. In bers of the family an active interest the Medical Transactions published in meteorology which, as was shown by the College of Physicians in London, by G. J. Symons, extended over to the first three volumes of which the long period 1751 to 1897. Thirty his father as the moving spirit had contributed sixteen articles, the son on March 31, 1813. It contains a drawing wrote articles in the fourth and fifth of a mattress with a hole in the middle. volumes, and indeed read two of them (5) “A Case of Water in the Head after he had retired from practice: unattended by its usual Symptoms, with Observations” (5: 173-187, 1815). Read (1) “Of a peculiar Affection of the on November 4, 1814. This described the Eyes, with Observations” (4: 56-64, necropsy of a deaf octogenarian, whose 1813). In this paper, read at the College cerebral ventricles contained 8 ounces on January 7, 1807, he recorded a case and the subarachnoid space 4 ounces of allied to nyctalopia and referred to clear fluid. It would appear to have been the case reported in the third volume an example of senile cerebral atrophy. of the Medical Transactions by his father, The article began with the following but without bringing in the family dictum: “Though I have as little respect, name. as any man, for facts merely because they (2) “Some Observations on the are extraordinary, yet when such facts Scurvy” (4: 65-84, 1813). Read on Janu- can in any way contribute to perfect our ary 7, 1807. In it he mentioned that dur- knowledge or to correct our judgement, ing the ten years (1793-1803) he was they acquire a degree of value in propor- physician to St. George’s Hospital he had tion as they perfect these ends.” seen only 3 cases of scurvy. It should be remembered that scurvy, a terrible The last volume of the Medical scourge among sailors, practically dis- Transactions was published in 1820. appeared from the Royal Navy after an After the opening of the present Admiralty order enjoining the use of house of the College in Pall Mall lemon juice was issued in November, East on June 25, 1825, evening meet- 1795. This prophylactic treatment had ings of a semi-popular character were been advocated since 1754 by James instituted under the direction of Sir Lind (1716-1794), but was neglected until (1766-1844) who was Sir Gilbert Blane (1749-1834) became one president of the College for the un- of the Commissioners of the Sick and rivalled period of twrenty-four years Wounded Sailors in 1795. (3) “The Mortality of London” (4: (1820-1844). The meetings were held 103-118, 1813). Read on February 15, monthly during the first half of the 1808. This article was on the same lines year, and lasted from 9 p.m . when tea as a previous one published in 1801 (vide and coffee were provided until 11 p.m . p. 578). He pointed out that during the The papers were first fifty years of the eighteenth century . . . on subjects peculiarly adapted to the burials exceeded the christenings in the excite interest in a mixed audience of proportion of 3 to 2, but that in the sec- gentlemen and scholars, and capable of ond half of the century this excess of being illustrated by literature, the com- burials diminished until in 1800 they were mon bond of connection of all the liberal less than the christenings in the propor- professions. The papers contributed by tion of 12 to 13. This was in part at least Sir Henry Halford, Dr. William Heberden due to greater care of infants and the fall (the younger), and some other fellows of in the death rate during the first two the College were essentially of this char- years of life. acter. (Munk.) (4) “Some Account of a Contrivance, which was found of singular Benefit in Formal discussion on the papers was stopping the Excoriation and Ulceration not allowed at these meetings which consequent upon continued Pressure in were attended by distinguished per- Bed” (5: 39-44, 1815). Read at a meeting sons, brought there by Halford’s influ- ence, such as the Duke of Wellington, the Latin edition a dedication to the Primates of England and Ireland, George in, and to the English edi- and the Lord Chancellors Lyndhurst tion a Latin index at the beginning and Brougham. and an English one at the end. Two In 1801 he published “Observations years later there appeared “Mor- on the Increase and Decrease of borum Puerilium Epitome,” 8vo, pp. different Diseases and particularly 73, London, Auctore Gulielmo Heber- of the Plague,” qto, pp. 96, London. den, which F. H. Garrison wrote This was an elaborate discussion sup- “is of such superlative excellence ported by many statistical tables and brevity that it might well be of the Bills of Mortality during the attributed to the father.” It was whole of the eighteenth century, and translated into English by J. Smyth the weekly returns for the period in 1805 with the expanded title “An 1763-1799. His “advertisement,” or Epitome of Infantile Diseases, with what would now be called the preface, their Causes, Symptoms, and Method points out that: of Cure with additional Notes and The following remarks were put to- Observations,” pp. 79. gether with the intention of subjoining On account of his own abilities them to a new edition of the Bills of and his father’s prestige he rapidly Mortality. In submitting them separately rose to a high position in the pro- to the Public, the Author is influenced fession; in 1795 when only twenty- by no vanity or self-conceit, no forward- eight years of age he was appointed ness to broach new opinions, nor any wish physician extra-ordinary to the Queen, to support a favourite system. . . . His in 1805 physician extra-ordinary to object is to direct the attention of the the King, in 1806 physician-in-ordi- medical world to a subject which has nary to the Queen, and on the death hitherto been very much neglected. of Sir George Baker in 1809 physician- The appearance of this quarto pam- in-ordinary to George 111, by whom phlet of 96 pages stimulated William he was more than once offered a Falconer (1744-1824) of Bath to bring baronetcy with a pension, distinctions out in the following year “An Exami- which his own feelings induced him nation of Dr. Heberden’s Observa- to decline. In this respect he acted tions,” in the 19 pages of which in the same manner as his senior criticism was confined to the section colleague Matthew Baillie who de- on plague. Creighton in 1894 argued clined a baronetcy. When Princess that Heberden’s statement about the Amelia (1783-1810), the youngest and well-marked diminution of dysentery favorite child of George in, was dying in London during the second half of erysipelas, the King charged Sir of the eighteenth century was vitiated Henry Halford to attend him in by the inclusion of infantile diarrhea the event of his again becoming under this heading. In 1802 Heberden insane, in case of need to call in brought out his father’s “Commenta- Heberden, and in case of further ries” (p. 570) both in the original need Matthew Baillie. The shock Latin and the English translation of the Princess’s illness brought about which he almost certainly made; to in October, 1810, the King’s fourth both editions he supplied a brief and last attack of insanity; his medical biographical sketch of his father, to attendants were Halford, Heberden, Baillie, H. R. Reynolds (1745-1811), the same year stated that the King’s and R. D. Willis (1760-1821), the bodily health was tolerably good but son of Francis Willis (1718-1807) who mental recovery was very improbable. with Reynolds had looked after the King in his attack of insanity in 1788 when the political atmosphere was much disturbed by party factions. As in 1788 so in 1810 the medical men were examined before the Privy Council and further before the Houses of Parliament. Chaplin has given a full account of the proceedings: “All the physicians were convinced that the King, although he had had three previous attacks and was in his seventy-second year, would recover and probably soon.” In reply to the direct question as to their experience about the probability of recovery in the circumstances and age of a patient like the King, Baillie and Heberden did not pretend to any special knowledge, Reynolds and Hal- ford justified their attendance on the ground of knowledge acquired in private practice. It is certainly strange that R. D. Willis was the only specialist called in. Reynolds, who had attended the King in all these attacks from 1788, was examined for two hours in the House of Lords, This prognosis was fully confirmed and in accordance with the etiquette by the outcome, for the King though was obliged to stand all the time; as lingering on till 1820 remained not a result he was so exhausted that only blind but in mental darkness. his health broke down and death Of the following well known lines: occurred on October 22, 1811. He The King employs three Doctors daily— was the grandfather of Sir John Willis, Heberden and Baillie, Russell Reynolds (1828-1896) who All extremely clever men was president of the Royal College Baillie, Willis, Heberden, But doubtful which most sure to kill is of Physicians of London from 1893 Baillie, Heberden, or Willis. to 1896. At first there was some improvement in the King’s condition, there are several slightly different but after the middle of 18 n his versions, such as the sixain beginning: mental condition deteriorated and You should send if aught should ail ye in July, 1812 he had an acute set- For Willis, Heberden, or Baillie. back; though a bulletin on August 1 The memoir of Heberden in the reported improvement, Heberden in anonymous “Picture of the Present State of the Royal College of Physi- tions” (i2mo, London, 1818 price cians of London,” pp. 64-66, 1817, 3/6, boards) and dedicated to his stated that the wording of the bulle- children, and (ii) a translation of “The tins about the King’s condition was Letters of M. T. Cicero to Titus always entrusted to him, “a task of Pomponius Atticus” with Notes (2 some difficulty when curiosity was octavo vols., 1825, £i.6s., boards). awakened on the one hand and pru- The Rev. James Cowe, Vicar of dence was necessary on the other.” In Sunbury, which is within driving reference to the distinction of the distance of Datchet, had married father and son Horace’s words “ Fortes Heberden’s cousin, Elizabeth Palmer, creantur fortibus” were quoted as only daughter of the Rev. George specially applicable, and his practice Wollaston (1738-1826), d .d ., f .r .s . is described as “rather select than Heberden was appointed Cowe’s ex- too extensive, the circles of rank ecutor and in this capacity handed being exclusively his patients.” to the Rev. the On October 1, 1795, when living manuscript of the systematic records in Dover Street, he married Elizabeth which were subsequently published Catherine (1775-1812), only daughter as “Cowe’s Meteorological Register, and heiress of Charles Miller of Shop- 1796-1839.” He is said to have com- wich, Oving, Sussex (second son of posed the inscription on the monu- Sir John Miller, fourth , of ment erected by public subscription Chichester), and niece of Sir Thomas nearly ninety years after Joseph Addi- Miller, fifth baronet. They had nine son’s (1672-1719) death and burial children, four of whom, two sons in Westminster Abbey. and two daughters, survived him; In 1826 Heberden returned to Lon- four sons, William, Charles, George, don partly in order to afford his son and Henry were educated at St. Henry (1802-1828), m.b . of Downing John’s College, Cambridge. He might 1826, who was a student at St. therefore, like his father, be quoted George’s Hospital, “the information in support of Hufeland’s contention and encouragement which he had that “a certain abundance in the himself received with so much delight power of generation is favourable to from a parent’s lips.” But evil days longevity.” His wife died after a were ahead; the death of the medical few days’ illness on May 21, 1812, son who cut his hand at a necropsy in Pall Mall; this at once altered and died in a week from pyemia, of the whole course of his life, for in another son, George, in 1829, and order to look after his young family the subsequent loss of his eldest he retired from London and, except daughter confirmed his inclination for attendance on the King, from all to devote the rest of his life to religious practice. He settled down with his research and writing. According to the children and books at Datchet near Alumni Oxonienses he was chaplain Windsor. For his children he trans- to the fellows of Exeter College from lated and had printed, but apparently 1827 to 1829, and then vicar of did not publish, (i) Plutarch’s “Broth- Broadhembury, near Honiton, Devon. erly Love,” and published “On Edu- There does not appear to be any cation, A Dialogue after the Manner other evidence that he took Holy of Cicero’s Philosophical Disserta- Orders, and this seems to be an example of two different persons with contain copies of this rather rare the same name being telescoped into engraving. one: it is almost certain that this He died on February 19, 1845, incumbent was the Rev. William at his house in Cumberland Street, Heberden (1804-1890) who was the son Marylebone, and was buried in the of Thomas Heberden, the eldest son family vault in the parish church of W. Heberden the elder, and was at Windsor where he is commemorated a fellow of Exeter College, Oxford, by the inscription: 1828-30, held this cure of souls from 1829 to 1874, and from 1837 to 1874 In memory of an excellent father, William Heberden, m.d . kept a continuous record of the rain- for many years physician to his late Majesty fall there. In 1830 William Heberden King George the Third. the younger published “Reflections He was an elegant and an accomplished upon the Gospel of St. John” (19 cm., scholar pp. 302, Lond.), in 1836 he circulated a graced by great suavity of manners, translation of “The Catholic Epistles” and influenced in all his intercourse with the world among his friends, and in 1839 at by practical and unaffected piety. their request published a “Literal To his children he was endeared by every Translation of the Apostolical Epistles claim and Revelations with concurrent Com- that love or care of self-denial mentaries” (8vo). In 1832 he pre- can make upon gratitude and affection. He was born 23 March, 1767, and died 19 sented his son William (1797-1879) February, 1845. to the vicarage of Great Bookham, In memory also of Surrey. Elizabeth Catherine, his amiable and beloved His daughter Elizabeth Catherine wife, married the Rev. Gerrard Thomas who died 21 May, 1812, in her 36th year, Andrewes, rector of St. James’s, Pic- leaving 9 children. She was the only child of Charles, son of Sir cadilly, and son of Gerrard Andrewes John Miller, Bart., formerly of Lavant, (1750-1825), dean of Canterbury, who Sussex. when offered a bishopric by the Prime Minister replied in a loud His personal property was sworn voice, “nolo.” Their daughter Eliza- under £9000. To his eldest son William beth Catherine was the grandmother he left the presentation of the benefice of H. W. Barber, physician-in-charge of Great Bookham, a moiety of the of the Skin Department of Guy’s tithes, the adjacent vicarage, and Hospital. his manuscripts on divinity. To his His portrait (Fig. 4) was painted other surviving son Charles, a bar- in his later life by Richard Roth- rister, he left the tithes of Bevington well (1800-1868), Royal Hibernian and Blisbury. Academician and Sir Thomas Law- rence’s chief assistant; it was drawn Bibliogra phy and Ref eren ces on stone by J. S. Templeton and Abb ott , T. K. Catalogue of Manuscripts in exhibited in the Royal Academy in the Library of Trinity College, Dublin, 1843. The collections of the Royal 1900; and Enquiries made Dec. 1931. Annual Register or A View of the History, College of Physicians of London, the Politics and Literature for the Year Royal Society of Medicine, and the 1763, PP- 135-147; and for the Year Wellcome Historical Medical Museum 1764, pp. 18-25. Anonymous. A Picture of the Present State Gee , S. J. 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John Rylands Library, Manchester, 203. 16: 32, 1932. (Unpublished letters of Mack enz ie , W. A Practical Treatise on Dr. Samuel Johnson.) Diseases of the Eye. Lond., 1835, P- 880. Bull er , A. C. The Life and Works of Heber- Macmic hael , W. The Gold-headed Cane. den. 8vo, Lond., 1879. Ed. 2, Lond., 1828, pp. 167-181. Chapl in , A. Medicine in England during the Moore , N. St. Bartholomew’s Hosp. J., 7: Reign of George 111: the Fitzpatrick 17-22, 1899. Lectures at the Royal College of Munk , W. Roll of the Royal College of Physi- Physicians, 1917-1918. Published by the cians of London. 1878, 2: 159-164. Author, Lond., 1919. Idem. The Gold-headed Cane. Ed. 3, Lond., Creight on , C. History of Epidemics in Brit- 1884 (Evening Meetings), p. 176. ain. Cambridge, 1894, 2: 747, 774. Nichols , J. Literary Anecdotes of the Eight- Crum mer , Le Roy . An Introduction to the eenth Century. Lond., 1812, 3: 71-3. Study of Physic (Now for the first time Osler , W. 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[Matthioli: Senensis Medici, 1570.]