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Grand Rounds in Literature - Wicks Original Essay

An Authentic Life: Thomas Hodgkins (1798-1866)
by Suzanne R. Wicks

Thomas Hodgkins was born into a well-known Quaker family whose forebears had been followers of George Fox, founder of the Society of the Friends of Truth. From childhood he was steeped in the Quaker faith, and he resolved to live a life of simplicity. As did other Friends, he wore plain clothes, used the "plain" language, and was careful in his speech to speak the truth. Causing him serious trouble (abuse and ridicule) was his refusal to do "hat honor." Since he believed that he had no "betters" he removed his hat only for the Lord. Not paying his tithes to the established Church of England heaped more trouble upon him. He openly opposed the paid ministry because he believed that everyone was to be a minister, carrying out the Lord's work. His most serious trouble came when, before a court of law, he refused to take the oath, reasoning that he always spoke the truth and that there was no need to make a special case. Finally, he was allowed to "affirm" that he would speak the truth. He insisted that women were equal to men in all aspects of the law. All his life he avoided any display of ostentation.

How did one become a physician in the early 1800s? Hodgkins was an apothecary apprentice for two years and left to become a pupil at Guy's Hospital in London for six months. In 1820 he matriculated at Edinburgh Medical School, but the very next year he was in Paris engrossed in bedside rounds and autopsies. He learned how to use the stethoscope from Laemec, who had just invented it and who had published his classic Traie de l'auscultation mediate. He became skilled in percussion, so useful in the diagnosis of disease of the thorax. From France had come the revolutionary idea that the seat of disease was in organ and cellular tissues; that the use of palpation, percussion, the thermometer, and stethoscope would give more accurate diagnoses.

Returning to Edinburgh, he took his degree, traveled two years caring for a well-to-do patient, and then returned to London's Guy Hospital and Medical School. He brought the first stethoscope to an English teaching hospital, became the first lecturer of a course in pathology, and founded and became the first curator of a pathology museum (where he classified and labeled all the specimens).

His Quaker upbringing brought a keen sense of humanity to his medical practice. Beginning his life as a doctor in 1825, having qualified as a licentiate of the Royal College of Physicians, he received an appointment as physician to the London dispensary where the desperately poor of the almost one million population of London were treated. Many of the physicians were more than willing to limit their practice to the well off. The poor, living in the most squalid, crowded conditions in cellars and back alleys, amidst untreated sewage, were taken to a dispensary where they were cared for, free of charge (or for a nominal fee). These clinics were supported by private donors. For two years Hodgkins spent ten to twelve hours daily, two days a week in addition to his appointment as medical clerk in Guy's Hospital (unsalaried). As inspector of the dead and a newly created post as curator of the museum he received a salary. He found time to volunteer as physician to two clinics that cared for the sick among the poor London Jewish people. During this busy time his family expected him to attend meeting with them and he seldom missed going to Tottenham.

Although known as a pathologist, he threw himself into the prevention is diseases, lecturing and writing about the dreadful housing and living conditions of the poor. Far ahead of his time was his crusade for "wellness" through right living, good nutrition, and adequate sanitary facilities. He spoke out forcefully against the intemperate use of alcohol. He pointed out the hazards of the workplace-the cancer afflicting the small boy chimney sweeps, the lung problems of those who were forced to work under dusty conditions (he recommended face masks), and the deplorable working conditions and high rate of tuberculosis of the girls and women who earned their living sewing.

He was a longtime activist in the Peace Society and member of Meeting of Sufferings, both of which spoke out forcefully against the Crimean War, the fighting in India, and the opium trade.

Africa always absorbed his attention, and he joined with other Quakers in raising funds for the Negro and Aborigines Fund Committee as well as the British and Foreign School Society. He never lost his interest in Native Americans.

He read widely, being fluent in both modern and ancient languages. His earlier published works included the use of the stethoscope, the pathology of acute appendicitis and its complications, as well as the pathology of serous and mucous tissues. He wrote on the metric system, cancer, diabetes, and cholera. He was the first to show retroversion of the aortic valve.

It was during his first year at Guy's that he cared for and did the autopsy on a nine-year-old boy who had died of a mystifying disease of the lymph glands. This was before cellular pathology and without microscopic examination of the blood. After seeing six more cases he reported his findings.

In 1837 Hodgkins was denied promotion at Guy's This was a crushing blow. All the evidence points to political maneuvering to punish him for his outspoken opinions rooted in his Quaker faith. He was careless about collecting fees, but family money made it possible for him to spend less and less time with the practice of medicine and to devote his energies to writing, lecturing, and to his philanthropic causes. He completed a two-volume text on the pathology and serous and mucous membranes, lectured widely, and was active in the societies of ethnology, anthropology, and geography.

During his last trip to Palestine to give medical aid to Jewish settlers, Hodgkins succumbed to dysentery. He was buried in a small Protestant cemetery in Jaffa. His longtime friend and traveling companion, Sir Moses Montefiori, erected a granite obelisk that bore the inscription, "In commemoration of a friendship of more than 40 years and of many journeys together in Europe, Asia, and Africa." The Friends of Truth did not believe in ostentation, and Hodgkins would have been embarrassed to have such a splendid monument. His sorrowing widow had a small stone placed at the grave site that read, "A man distinguished alike for scientific attainments, medical skill, and self-sacrificing philanthropy. He died in the faith and hope of the Gospel."

In writing in his Jewish chronicle, Sir Montefiori wrote, "To one so guileless, so pious, so amiable in private life, so respected in his public career, and so desirous to assist in all his life in the amelioration of the condition of the human race, death could not have any terror."

SuzanneR. Wicks, a retired microbiologist, is a dual member of St. Louis (MO) and St. Petersburg (FL) meetings. This article first appeared in the August 1999 Friends Journal.