Monday, September 12, 2016

1843: Watson lectures on principles and practice of physic

Sir Thomas Watson (1792-1882)(2, page 446)
Sir Thomas Watson gave various lectures on the principles and practice of physic (medicine), and, as though only in passing, he shared his knowledge of asthma.

His lectures were published in 1843 as "Lectures on the Principles and Practice of Physic," a book medical historian Fielding Hudson Garrison said was "the most important English treaties on the practice of medicine in the first half of the 19th century." (2, page 445)

Watson was born at Montrath, near Cullompton in Devonshire, on March 7, 1792, the eldest son of Joseph Watson. He attended grammar school at Bury St. Edmunds, and then he attended St. John's College, Cambridge, in 1811.  He began his study of medicine at the age of 27 at St. Bartholomew's Hospital, and he continued it at Cambridge, where he earned university license in medicine in 1822, was junior proctor (person who oversees an exam) from 1823-1824, and earned his M.D. in 1825. (1)(5, page 1283)

In 1827 he became physician to Middlesex Hospital which, at that time, was connected to University College.  He was professor of clinical medicine.  It was here, beginning in 1831, that he gave the lectures on cases of disease that came under his care in the wards of Middlesex Hospital.  (1)(5, page 1283)

He resigned his chair of clinical medicine at Middlesex Hospital in 1831 and accepted the job of Professor of Forensic Medicine at King's College, and in 1835 he became Professor of the Principles and Practice of Medicine. He held this office until 1840.  (1,)(5, page 1283)

He also had a flourishing private practice, and he was the physician to Sir Walter Scott on his last voyage from London to Edinburgh.  (5, page 1283)

Yet it was as professor of medicine at King's College, during the session of 1836-1837, that he delivered his famous lectures. (5, page 1283)

Through it all, however, he continued as physician at Middlesex hospital until 1844.  He ended up quitting because his private practice became so large that he could no longer do both jobs.  (1)(2, page 445)(5, page 1283)

Between September 25, 1840, and September 25, 1842, one of his lectures was published each week in the Medical Times and Gazette.  (1)(2, page 445)(5, page 1283)

These lectures were later compiled into a textbook that went through various editions over the next quarter century, the last appearing in 1871.  During this time the book served as the main text on clinical medicine in England.  (1)(2, page 445)(5, page 1283)

While he added no new medical wisdom, and nothing new about our disease asthma, his book became famous mainly because of his "attractive and elegant style and his clear presentation of his subject." (1)(2, page 445)

John Thorowgood, in his 1878 "Notes on Asthma," quoted Watson as saying the following about asthma in one of his lectures: (3, page 2)
"The bodies of asthmatics have often, on being examined after death, presented no vestige whatever of disease, either in the lungs or in the heart; evidence that the phenomena attending a fit of asthma may be the result of pure spasm." (3, page 2)
Other physicians of the era, including Dr. Henry Hyde Salter, believed that lack of physical scars in the lungs of those dying from asthma was evidence that the disease was nervous in origin. (3. page 2)

In a lecture on "Symptoms," Dr. Watson discussed difficult breathing.  He said: (4, page 130)
Dyspnoea, difficulty of respiration, is one of the most prominent of these symptoms. It may depend upon various causes. In inflammation of the lungs or pleurae there are several circumstances in operation to impede the breathing; for example, pain, which would be enough of itself; the effusion of lymph into the texture of the lung, or of serum into the cavity of the pleura, mechanically resisting the entrance of air. In dyspnoea the breathing is almost always most difficult when the patient is lying flat on his back. One reason for this is plain. In the supine horizontal posture the action of the diaphragm is obstructed by the weight and pressure of the adjacent abdominal viscera; and the erect position obviates this. Upright breathing, orthopnea, has come to be considered as a distinct modification of dyspnoea. The patient cannot be down. (4, page 130)
Sometimes, as in asthma, the difficulty of breathing comes on in separate paroxysms; the respiration becomes all at once noisy, wheezing, and laborious. A person who had never seen any cases of this kind would imagine that the patient was at the point of death—that it was all over with him; but the most frightful of these attacks are seldom attended with any immediate danger. They depend frequently upon organic disease of the lungs, heart, or aorta: sometimes they seem to be purely spasmodic; sometimes to result from transient congestion of blood in the lungs. (4, pages 130-131)
Again, Sir Thomas Watson offers nothing new to our knowledge of asthma, although he does provide an adequate picture of what medical students learned about the disease while attending medical school in the first half of the 19th century.

Interestingly, Watson's book was the main medical book referenced by Civil War physicians.

Perhaps it was partly from reading Watson's book that Dr. Henry Hyde Salter obtained his opinions on asthma, from which he used to write the most famous book on asthma in the second half of the 19th century.

Norman Moore said he retired soon after 1870, and was so respected by the medical profession that  upon attending "the comitia of the College of Physicians in March 1882.. all the fellows present rose when he entered the room, a rare mark of respect, and the highest honour which the college can bestow on one of its fellows who has ceased to hold office." (1)

He died on December 11, 1882.  His portrait, by George Richmond, hangs in the censors' room at the College of Physicians. (1)

  1. Moore, Norman, "Watson, Thomas (1792-1882)," Dictionary of National Biography, 1885-1900, volume 60,,_Thomas_(1792-1882)_(DNB00), accessed 3/16/14
  2. Garrison, Fielding Hudson, "An introduction to the history of medicine," 3rd edition, 1821, Philadelphia and London, W.B. Saunders Company
  3. Thorowgood, John Charles, "Notes on Asthma," 1878, 3rd edition, London, J and A Churchill
  4. Watson, Thomas, "Lectures on the principles and practice of physic; delivered at King's College, London, by Thomas Watson, M.D.," 1857, 4th edition, London, John W. Parker
  5. "Obituary: Sir Thomas Watson," The British Medical Journal, December 23, 1882, 2(1147), pages 1282-1285,, accessed 3/16/14
RT Cave Facebook Page
RT Cave on Twitter
Print Friendly and PDF

No comments:

Post a Comment