Note: When Dalrymple’s long-running BMJ column ended in 2012, he had a backlog of about 60 unpublished pieces, and he kindly gave them to us to post here at Skeptical Doctor. We are posting them on Wednesdays to coincide with the schedule of his old BMJ column. We hope you enjoy them.
Of late I have observed my pension fund shrink as my Heberden’s nodes have grown. I should have preferred, of course, if it had been the other way round; but there is nevertheless a certain fascination, and indeed a strange consolation, in watching the progress of pathology in oneself, if it is not too serious of course.
My nodes have given me an interest in William Heberden (1710 – 1801) who – apart from being the first to describe such nodes – wrote one of the best early descriptions of angina. When I found a little book by Austin Dobson (1840 – 1921) called Later Essays, which was published in the year of the author’s death and which contained an essay about Heberden titled An 18th Century Hippocrates, I knew I should have to buy it.
Dobson was only a spare-time litterateur, working for 45 years at the Board of Trade. His first book other than some poems was The Civil Service Handbook of English Literature, not exactly a title to set the heart racing. It is strange how many clerks in such offices were men of letters: Sir Edmund Gosse, by far the most eminent critic of his day was Dobson’s contemporary at the Board of Trade, and of course Charles Lamb worked as a clerk for the East India Company. Lamb was not an enthusiastic bureaucrat, and when his boss complained that he always arrived late at work, lamb replied, “Yes, sir, but to make up for it I always leave early.”
The Dictionary of National Biography says rather unkindly of Dobson’s writing that “his mastery of artificial rhythms was excellent, but at his lightest he lacked gaiety; at his gravest he lacked weight; as a poet he lacked personality.” But his knowledge of the Eighteenth Century was unparalleled. He knew everybody who was anybody, and quite a few beside.
His essay on Heberden is more concerned with the latter’s literary pursuits than with his medical ones. Heberden, he tells us, was a classical scholar of great accomplishment, and when a young man contributed a chapter to a book called Athenian Letters which was long considered the finest commentary on Thucydides ever written. He was also a learned Hebraist, and assisted the eminent bishop, William Newcome, in the production of his An Attempt towards an Improved Version and a Metrical Arrangement, and an Explanation of the Twelve Minor Prophets.
Heberden was not only physician to George III, but to the leading literary figures of his day. He attended Doctor Johnson during his last illness, who called him “the last Roman” though he also called him “the most timid of the timid” when it came to treating dropsy (Johnson eventually sliced the skin of his legs to let some of the fluid out). Although Johnson had a high regard for Heberden, he quoted lines from Jonathan Swift’s Verses on His Own Death with Heberden ironically in mind:
The doctors, tender of their fame,
Wisely on me lay all the blame:
‘We must confess, his case was nice;
But he would never take advice.
Had he been ruled, for aught appears,
He might have lived these twenty years,
For when we opened him we found
That all his vital parts were sound.’
Heberden treated, among other literary figures, the poet William Cowper. He recommended that Cowper, who suffered bouts of madness, remove to Margate, but this was not altogether a success. Heberden’s description of my nodes, however, was very accurate.