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Biographical entry Paget, Sir James (1814 - 1899)

Baronet, 1871; M.R.C.S., May 13th, 1836; F.R.C.S., Dec. 11th, 1843, one of the original 300 Fellows; Hon. F.R.C.S.I., 1886; Hon. M.D. Dublin, 1887; D.C.L. Oxon.; LL.D. Cantab.; F.R.S., 1851.

Born
11 January 1814
Great Yarmouth, Norfolk, UK
Died
30 December 1899
London, UK
Occupation
General surgeon

Details

Born at Great Yarmouth on Jan. 11th, 1814, the eighth of seventeen children of Samuel Paget by Sarah Elizabeth, his wife, daughter of Thomas Tolver, of Chester. Sir George Edward Paget (1809-1892), Regius Professor of Physic at Cambridge, was a brother. The father was a brewer and a shipowner who served the office of Mayor of Great Yarmouth in 1817. He got into financial difficulties when shipping fell away after the Napoleonic Wars, and incurred debts which were afterwards honourably discharged by the self-denying efforts of George and James Paget.

James Paget went to a private school in Yarmouth, and subsequently extended his education, which included a knowledge of German, by private study. He was apprenticed in 1830 to Charles Costerton, who had been educated at St. Bartholomew's Hospital, was admitted a Member of the College of Surgeons in 1810, and was Surgeon to the Yarmouth Hospital and Dispensary. During his apprenticeship James Paget found time to write, with his brother Charles, A Sketch of the Natural History of Yarmouth and its Neighbourhood, containing Catalogues of the Species of Animals, Birds, Reptiles, Fish, Insects and Plants at present known, printed by F. Skill at Yarmouth in 1834 and sold at the price of half a crown. It was written in the hope of making a little money for current expenses, but it had the good fortune of bringing the authors under the notice of Sir William Hooker, the Regius Professor of Botany in Glasgow, who had been educated in Norfolk.

Paget came to London and entered St. Bartholomew's Hospital as a medical student on Oct. 1st, 1834. Whilst dissecting on Jan. 2nd, 1835, his attention was drawn to numerous gritty specks in the muscles of the subject. He took some of the tissue to John George Children, principal Keeper of the Zoological Department at the British Museum, who sent him on to Robert Brown, Keeper of the Botanical Collection, as Children did not own a microscope. Paget made a careful study of the parasite, and his original sketches are preserved in the Library of the Royal College of Suregons. The preparation was examined by Richard Owen (q.v.), who determined the nematoid nature of the worm, named it Trichina spiralis, and took the credit.

In 1835-1836 Paget acted as Clinical Clerk to Dr. Peter Mere Latham (1789-1875), because he could not afford the 'dressing fee' payable to the Surgeons of the Hospital, and he therefore never became a house surgeon. He was admitted a Member of the Royal College of Surgeons of England in the spring of 1836, and after a short visit to Paris settled in London and supported himself by teaching and writing. He was sub-editor of The Medical Gazette from 1837-1842, and in 1841 he was elected Surgeon to the Finsbury Dispensary.

At St. Bartholomew's Hospital Paget was appointed Curator of the Museum in succession to W. J. Bayntin in 1837, and in 1839 he was chosen Demonstrator of Morbid Anatomy. He proved himself so good a teacher that on May 30th, 1843, he was promoted to be Lecturer on General Anatomy and Physiology. On Aug. 10th, 1843, he was elected Warden of the College for Resident Students, then newly established at St. Bartholomew's Hospital, a post he resigned in October, 1851.

In 1846 he drew up a catalogue of the anatomical and pathological museum of the Hospital, which showed evidence of the careful descriptions and literary excellence which marked his later work at the Royal College of Surgeons. He was elected Assistant Surgeon to the Hospital on Feb. 24th, 1847, after a severe contest. The opposition was based on the ground that he had never filled the office of dresser or house surgeon, posts which had always been considered essential qualifications in every candidate for the surgical staff. Paget, however, came out at the top of the poll with 142 votes - Andrew Melville Mcwhinnie (q.v.), who was Demonstrator of Anatomy and Lecturer on Comparative Anatomy, receiving 78, and Robert Rainey Pennington, nephew of a well-known and fashionable apothecary, 22 votes. He lectured on physiology in the medical school from 1859-1861; became full Surgeon in 1861; held the Lectureship on Surgery from 1865-1869, and resigned the office of Surgeon in May, 1871, although he gave an occasional lecture as Consulting Surgeon. He was Surgeon to the Bluecoat School (Christ's Hospital), then situated in Newgate Street, from 1862-1871.

At the Royal College of Surgeons he prepared the descriptive catalogue of the pathological specimens contained in the Hunterian Museum, which appeared at intervals between 1846 and 1849. He was Arris and Gale Professor of Anatomy and Surgery from 1847-1852; a Member of the Council from 1865-1889; a Vice-President in 1873 and 1874; Chairman of the Midwifery Board in 1874; and President in 1875. He was also the representative of the College at the General Medical Council from 1876-1881; Hunterian Orator in 1877; the first Bradshaw Lecturer in 1882, when he took as his subject "Some New and Rare Diseases"; and the first Morton Lecturer on cancer and cancerous diseases in 1887.

Paget was appointed Surgeon Extraordinary to Queen Victoria in 1858, when he was only Assistant Surgeon at his Hospital. He attended Queen Alexandra, when Princess of Wales, during a long surgical illness, and was gazetted Surgeon to King Edward VII, whom as Prince of Wales he attended during the attack of typhoid fever in 1871. From 1867-1877 he held the office of Sergeant-Surgeon Extraordinary, and in 1877 he became Sergeant-Surgeon on the death of Sir William Fergusson (q.v.). He was created a baronet in August, 1871.

He was President of the three chief medical societies of his time in London. He filled the chair of the Clinical Society in 1869, of the Royal Medico-Chirurgical Society in 1875, and of the Pathological Society in 1887. He acted as President of the International Medical Congress of Medicine held in London in 1881 with conspicuous success. In 1860 he became a member of the Senate of the University of London, and in 1883 he acted as Vice-Chancellor on the death of Sir George Jessel. He was elected F.R.S. in 1851, and held honorary degrees at Oxford, Cambridge, Edinburgh, Dublin, Bonn and W├╝rzburg.

He married in 1844 Lydia, daughter of the Rev. Henry North, domestic chaplain to the Duke of Kent and master of a private school at 1 Cornwall Terrace, Regent's Park, which was affiliated to King's College, London. She died in 1895, having made his home ideally happy. The family consisted of four sons and two daughters. The eldest son, John, was a barrister and inherited the title; the second son, Francis, was successively Dean of Christ Church and Bishop of Oxford; the third, Henry Luke, became Bishop of Chester; Stephen (q.v.) inherited much of the talent of his father as a very skilful writer and an excellent speaker. The elder daughter married the Rev. H. L. Thompson, Warden of Radley College and afterwards Vicar of St. Mary's (the University) Church, Oxford; the younger daughter, Mary Maude, remained unmarried.

Paget after leaving the Warden's house at St. Bartholomew's Hospital, where his children were born, moved to 24 Henrietta Street, Cavendish Square, in 1851, and in 1858 to 3 Harewood Place, Hanover Square, then shut off from Oxford Street by locked gates. Here he spent all his professional life, the accommodation for patients consisting of a single waiting-room which served as the dining-room, and a small consulting-room looking out on to a tiny garden; yet through these two rooms passed nearly all the interesting cases and many of the nobility of England. After he retired from practice he lived at 5 Park Square West, Regent's Park, and here he died peacefully of old age on Dec. 30th, 1899. He was buried in the Finchley Cemetery after the funeral service in Westminster Abbey. There is a tablet to his memory on the west wall of the church of St. Bartholomew-the-Less.

A bust of Paget by Sir V. Edgar Boehm, Bart., R.A., is on the College staircase. It is a good likeness and there is a replica in the Museum at St. Bartholomew's Hospital.

A three-quarter-length in oils by Sir John Everett Millais, R.A., of which there is an engraving, represents Paget lecturing at the age of 57, and hangs in the Great Hall at St. Bartholomew's Hospital. The portrait is a telling likeness, but shows signs of his recent recovery from a severe attack of blood poisoning caused by a post-mortem wound. It represents him with a sad expression, which was not usual with him. An admirable caricature by 'Spy' appeared in Vanity Fair; the likeness is poor, but the attitude is characteristic and perfect. It is reproduced in the St. Bartholomew's Hospital Journal (1925, xxxiii, frontispiece). He also appears in Jamyn Brooke's portrait group of the Council, 1884.

Paget occupied a prominent position in the surgery of his day. He founded a school which would have been larger and more influential had it not been almost immediately eclipsed by the birth of bacteriology and the teaching of Lister. It is the peculiar merit of Paget that he made use of the microscope to elucidate the true nature of morbid growths. He was a good and efficient but not a great operating surgeon; his strength lay in diagnosis, which was perfected by his robust common sense, and in later life by his unrivalled experience. His sound knowledge of morbid anatomy, gained partly in museums and partly in the more perilous field of the post-mortem room, where he twice nearly lost his life, made him a link connecting the surgery of John Hunter with that of the present day. His perfect tact, his courtesy, and his real eloquence gave him ready access to the best circles in the Victorian era. The position he occupied as a teacher at St. Bartholomew's Hospital, and the classical English of his writings, enabled him to exercise a much wider influence than would have been expected from his modest demeanour and somewhat retiring disposition. He was a great teacher because he was able to grasp principles and clothe them briefly and clearly in exquisite language. Those who will read aloud his Hunterian oration can still hear the cadences but not the actual tones of the orator.

The influence of heredity was well shown in each of his distinguished sons, who reproduced quite unconsciously his attitude, his facial appearance, and many of his traits of character. Scrupulously honest and fair-minded, he acquired the chief surgical practice in London. During the busiest period of his life he was never outwardly in a hurry nor was he ever unpunctual in keeping an appointment. He had strong religious convictions and was always careful in the religious observances of the Church of England. In person he was slightly built and a little above medium height, his face rather long, his cheeks somewhat flushed, and his eyes bright. His voice was soft and musical; he spoke quietly, fluently, and apparently extemporaneously. His public utterances were carefully prepared beforehand, and were given an air of spontaneity by slight pauses, as though hesitating for an instant in the flow of thought. They were in reality flawless and were delivered without gesture of any sort. W. E. Gladstone thought so highly of his public speaking that he said he divided people into two classes, those who had and those who had not heard Sir James Paget. It was his habit to write in his carriage short paragraphs on torn pieces of paper, which, being placed together, formed a lucid and continuous statement.

The names of Sir James Paget is associated with a chronic eczematous condition of the nipple associated with cancer of the breast, and with a chronic inflammation of the bones to which the name osteitis deformans has been given. A bibliography is given in the Index Catalogue of the Surgeon General's Library (series I and ii). The most interesting, and perhaps the most lasting, of his writings are Studies of Old Case Books, published in 1891.

Sources used to compile this entry: [Dict. Nat. Biog., xxii, Supplement, sub nomine et auct. ibi cit. Stephen Paget's Memoirs and Letters of Sir James Paget, London, 1901, with reproductions of photographs of his father and mother. MacCarmac's Address of Welcome, 1900, 172, with portrait. Brit. Jour. Surg., ii, 4, with a reproduction of Millais' portrait. Ibid., x, 1, with an illustration of Paget's disease of the breast. Ibid., x, 161, with drawings of a case of osteitis deformans. "The Life and Works of Sir James Paget," being the Wix Prize Essay of 1925 by W. R. Bett, St. Bart.'s Hosp. Jour., xxxiii, 21. Mr. Bett tells the story of the discovery and naming of the Trichina spiralis in St. Bart.'s Hosp. Jour., 1928, xxxvi, 39. Personal knowledge.].

The Royal College of Surgeons of England