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Biographical entry Hutchinson, Sir Jonathan (1828 - 1913)

Knight Bachelor, 1908; M.R.C.S., Aug. 2nd, 1850; F.R.C.S., Dec. 11th, 1862; L.S.A., 1850; F.R.S., 1882; LL.D. Glasgow, 1887; LL.D. Cantab., 1890; D.C.L. Oxford; LL.D. Edin.; Hon. M.D. Dublin; D.Sc. Leeds.

Born
23 July 1828
Selby, Yorkshire, UK
Died
23 June 1913
Haslemere, Surrey, UK
Occupation
Dermatologist, Ophthalmologist, Pathologist and Venereologist

Details

Born on July 23rd, 1828, the second son of Jonathan Hutchinson and Elizabeth Massey, both members of the Society of Friends, at Selby, Yorkshire. Hutchinson continued throughout life to exhibit some of the external characteristics of a Quaker. After an education at Selby, he was early apprenticed to Caleb Williams (q.v.), Lecturer on Materia Medica and Therapeutics in the York School of Medicine, and he attended the York Hospital. At this very small York School of Medicine he received individual instruction from Dr. Thomas Laycock - later Professor of Medicine in Edinburgh - which made a life-long impression, on the importance of heredity, and of physiognomy in diagnosis. He passed on to St. Bartholomew's Hospital, where Sir James Page's influence was dominant; he studied under him, including the subject of syphilis, and qualified M.R.C.S. in 1850. He then pursued the post-graduate study of which he became afterwards such a strong advocate. He acted as Assistant Physician at the City of London Hospital for Diseases of the Chest; Surgeon to the Metropolitan Free Hospital; Surgeon to the Royal Ophthalmic Hospital, Moorfields (1862-1878), where he had Edward Nettleship (q.v.) as Assistant; Surgeon to the Blackfriars Hospital for Diseases of the Skin; and Assistant Surgeon to the Lock Hospital for a while from 1862. He continued Surgeon to the Moorfields and Blackfriars Hospitals for many years. He was appointed Assistant Surgeon to the London Hospital in 1860; and after passing the F.R.C.S. examination in 1862 became Surgeon until 1883, then Consulting Surgeon. From 1862 he lectured on the principles and practice of surgery, from 1863 on medical ophthalmology, and in that year gained the Guy's Hospital Astley Cooper Prize for his essay "On Injuries of the Head". After 1883 he gave an annual course of lectures as Emeritus Professor of Surgery. A Triennial Prize for an essay was instituted to commemorate his services and teaching.

He was an active member of various London medical societies and served as the President of five of the most important. At the meeting called to wind up the old Sydenham Society he proposed a continuation as the New Sydenham Society, of which he was Secretary from 1859-1907. The translations from the chief writings of Continental authorities constitute an extraordinarily well-selected collection. The publications especially due to him in the New Sydenham Society were the Atlas of Skin Diseases and The Atlas of Drug Eruptions.

At the Royal College of Surgeons he was Hunterian Professor of Surgery and Pathology, 1879-1883; Member of Council, 1879-1895; Member of the Court of Examiners, 1880-1887; Bradshaw Lecturer, 1888; President, 1889 (returning to the previous custom of holding office for one year, broken by the four years' tenure of his predecessor, W. S. Savory); Hunterian Orator, 1891; Trustee of the Hunterian Collection, 1897. He sat on the Royal Commission on Small-pox and Fever Hospitals, 1881, and that on Vaccination, 1890-1896; his demonstration of vaccino-syphilis as a possible consequent of arm-to-arm vaccination put a stop to that method of vaccinating. As Hunterian Professor he gave six lectures on "Neuropathogenesis, chiefly with reference to Diseases of the Eye, Skin, Joints, etc.", four lectures "On Some of the Surgical Aspects of Gout and Rheumatism", and two lectures "On the Etiology of True Leprosy". His Bradshaw Lecture dealt with "Museums in reference to Medical Education and the Advance of Knowledge".

Jonathan Hutchinson, as a clinical diagnostician by naked-eye observations, was one of the great medical geniuses of his time, and there is no one superior in the history of medicine, whether in the diagnosis of cases in surgery, ophthalmology, dermatology, or syphilology. This was conjoined with a peculiar strain of philosophy. He was a colleague of another extraordinary genius in neurology and philosophy - Hughlings Jackson - and the interest of the two met over the ophthalmic side of neurology, and the general use of the ophthalmoscope as an instrument of diagnosis. His remarkable talent was exhibited in the discovery of syndromes; his audience supposed he was exhibiting a rare case, but after listening to him they discovered that they were able to recognize such cases, and his syndromes have now become commonplaces in the text-books. Examples are his 'triad' in inherited syphilis - deformity and notching of the teeth, labyrinthine deafness, and interstitial keratitis; defects in children's teeth, associated with infantile convulsion and lamellar cataract; the peculiar physiognomy in ophthalmoplegia and tabes dorsalis; the inequality of the pupils in cerebral compression; gout and haemorrhages; tobacco amblyopia; and idiosyncrasies of many kinds.

He had, too, a remarkable fund of illustration and simple comparison - the 'apple-jelly' appearance of some forms of lupus; the imitative characteristics of the superficial appearances of syphilis. He had a slow and precise delivery, with eyes turned to the ground. An endless series of cases were stored in his memory, recalled by the initial of the patient's name and the outstanding feature presented. His broad-minded philosophy made him hold, as to his rare cases, that they afforded clues to the pathology of the class, links between some one already recognized group and another. His crowded audiences listened intently as he passed, by some ingenious connection, from one subject to another - a custom defended by him on the plea that, for the attention of his audience, a 'mixed diet' was needed. At the hospital one lecture had as title, "On Fairy Rings and Allied Phenomena". From fairy rings in fields, he passed on to ringworms and herpes, phenomena he held to be allied. One lecture at Haslemere commenced with the earth's crust, passed to elephants, and ended on John Wesley; another, on whales, tailed off to Wordsworth's poetry, and then to social questions relating to tuberculosis and leprosy. No one of his colleagues equalled him in a 'spotting diagnosis', for he was nearly always right, very exceptionally wrong. A young surgeon who had married and was beginning surgery broke out into a rash all over, which rapidly became nodular. Several who saw him murmured, "Syphilis, however acquired", until 'Jonathan' at once said, "General sarcomatosis", and this was confirmed in a few weeks. In another case, however, he diagnosed syphilis, in spite of the patient's protests that he had not undergone exposure, and in a couple of days small-pox was evident.

His genius in diagnosis and his philosophy were remarkably combined in all he wrote and said on syphilis. At the discussions on the pathology of syphilis at the London Pathological Society in 1876 (Pathol. Soc. Trans., 1876, xxvii, 341) he held that the condition was due to a specific and living microbe, contagious and transmissible only so long as the microbe retained its vitality. "Someone will see it one day, for it is beyond doubt that it must be there" (p. 446). With this should be compared Moxon's sarcasms whilst avoiding question of causation (pp. 403-410), the gibe by Gull - "Well, I think syphilis is a flesh and blood disease" (p. 415). He taught the treatment of early syphilis by long persistence in the administration of metallic mercury by the mouth, very finely divided as 'grey powder', the course being interrupted at increasing intervals, for two to three years, but always short of salivation. He made but little use of arsenic, for he was impressed by it as a cause of cancer.

In 1855 he began to observe cases of leprosy from the East End in the London Hospital, and thus called attention to a number of instances wandering about and mixing with the general populace in many cities of the world. He took up the view that in Norway and elsewhere lepers persisted owing to the custom of eating stale fish. Until he stirred up inquiry the subject leprosy was in a state of stagnation. After the discovery of the bacillus he made further observations in South Africa and India, in which he grafted to his first theory the transference of the bacillus by contact and contamination of food - but it continued until the end of his life a non-proven thesis. In 1868 he suggested that a museum illustrating the progress of medicine and surgery during the past year should be instituted at the Annual Meetings of the British Medical Association; this came into force.

His houses at Nos. 14 and 4 in Finsbury Circus and in Cavendish Square, one after the other, became filled by a vast collection of specimens, coloured drawings, and charts used by him for his clinical lectures and demonstrations, until he collected them in the clinical museum attached to his son's house, 1 Park Crescent, Regent's Park. For years he was making provision for post-graduate instruction, and in 1899 he instituted a Medical Graduates' College and Policlinic at 22 Chenies Street, of which he was at once the life, the soul and the financier. He made exhibitions for short periods of illustrations he had collected on various subjects, and, through his persuasion, lectures and demonstrations were given by a great number of members of staff of hospitals, and by special practitioners. The history of Hutchinson's Policlinic will form an important chapter when systematic post-graduate instruction becomes definitely established in London; it came to an end after his death and the outbreak of the War. All that is of special and permanent value has been collected and preserved in the Museum of the College of Surgeons, including MSS., such as his research on the arthritic diathesis. The abundance of his collections was so great that duplicates of illustrative material were dispersed and in part taken over to the United States.

There was yet another remarkable endeavour. At his country house at Haslemere, Surrey, he set up an educational museum and library, a miniature of the Natural History Museum in London, and a library providing an outline of history, for the benefit of the population of the locality. The museum displayed rocks, fossils, plants, flowers, preserved as well as freshly gathered, birds' eggs, an aviary and vivarium exhibiting natural objects of the neighbourhood, including the common viper. The library contained charts of figures tabulating events from antiquity to the present day. King Edward VII knew of him as the surgeon who had a hospital for animals on his farm. Lectures and addresses were given - including Sunday afternoon addresses - on the potato, tuberculosis, poetry, the inner life, and new birth. This 'home university' published a monthly journal, which includes features of a school book, encyclopaedia, and a journal of science and literature. After his death the executors handed it over, pruned of its diffuseness, to Haslemere. Hutchinson also started a somewhat similar museum at his birthplace, Selby, but that did not excite so much local interest. The object of the museum was to establish evolution as a motive for right living in place of personal immortality as usually taught. Throughout his life he jealously retained his membership of the Society of Friends, although he accepted 'evolution' as a renaissance of religion.

Hutchinson was a good walker, fond of shooting and riding; he swam in a cold-water pool in his grounds until nearly the end of his life. He died at his house, The Library, Inval, Haslemere, on June 23rd, 1913, and was buried at Haslemere. By his orders there was inscribed on his gravestone, "A Man of Hope and Forward Looking Mind". Portraits accompany his obituary notices, and there are several in the College Collection. He figures in the Jamyn Brookes portrait group of the Council, 1884. His wife died in 1886; their family included six sons and four daughters. One son, Jonathan, F.R.C.S., followed his father as Surgeon to the London Hospital; another, Proctor, a laryngologist, died early ; Roger Jackson was in practice at Haselemere; and H. Hutchinson became an architect.

PUBLICATIONS: -
Hutchinson's publications were very numerous; the chief works are: -
The Archives of Surgery, 10 vols., 1889-1900. His archives include what Hutchinson deemed of importance from among his previous publications, together with notes and additions.
"Syphilis, the Discussion at the London Pathological Society, 1876." - Trans. Path. Soc., 1876, xxvii, 341.
Notes about Syphilis, 1887; new. ed., 1909.
The introduction to the System of Syphilis, by D'Arcy Power and J. Keogh Murphy, in 6 vols., 1908, pp. xvii-xxxv.
Hutchinson Collection in the Museum of the Royal College of Surgeons. Illustrations, notes and MSS.

Sources used to compile this entry: [Brit. Med. Jour., 1913, i, 1398, with elderly portrait. Lancet, 1913, i, 1832, with a similar portrait. Brit. Jour. Ophthalmol., 1925, ix, 257, with a middle-age portrait, by Sir Rickman Godlee. Brit. Jour. Dermatol., 1913, xxv, 225. London Hosp. Gaz., 1913, xx, 1, by Sir Frederick Treves. Ibid., 1918, xxii, 93, by Dr. S. C. Clippingdale. Proc. Roy. Soc., 1920, ser. B, xci, obit. xli, by T. B. Brit. Jour. Surg., 1926-7, xiv, 1, with an excellent portrait. Treacher Collins's The History and Traditions of the Moorfields Eye Hospital, London, 1929, with portrait.].

The Royal College of Surgeons of England