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Biographical entry Page, Herbert William (1845 - 1926)

MRCS Nov 16th 1869; FRCS Dec 14th 1871; LSA 1872; MB Cantab 1870; MA 1871; MCh 1872; Boylston Medical Prize Harvard University 1881; JP for the County of Surrey.

Born
22 December 1845
Died
9 September 1926
Farnham
Occupation
General surgeon

Details

Born on Dec 22nd, 1845, the eldest son of William Bousfield Page (qv), of Carlisle. He entered the University of Edinburgh in 1864; then went to Christ's College, Cambridge, where he graduated in Arts, and later received his medical education at the London Hospital, under the guidance of Hughlings Jackson, Gawen Sutton, and Jonathan Hutchinson. The influence which these inspiring teachers had upon Page is illustrated by the fact that, whilst he decided early to follow the career of a consulting surgeon, in all his institutional and public and private work he displayed general familiarity with the problems of medicine. He served as House Surgeon to Jonathan Hutchinson, and on the outbreak of the Franco-Prussian War obtained a commission in the German Army and acted as an Assistant Surgeon all through the campaign, being attached to the Hessian Division and located at the Princess Alice Hospital at Darmstadt. After the war he joined his father in practice at Carlisle in 1872, but soon made up his mind to practise surgery in London. He was later Consulting Surgeon to the Cumberland Infirmary.

He was appointed Surgical Registrar at the London Hospital in 1875, and in 1876 became Assistant Surgeon to St Mary's Hospital, on the staff of which he served as Surgeon and teacher for thirty years, until he was elected Consulting Surgeon.

As a surgeon Page was earnestly conscientious and very cautious. He was the first surgeon at St Mary's to rely on instruments and dressings sterilized by heat rather than by antiseptics, and while he was essentially conservative, he was not reactionary; indeed, in 1887 he performed for the first time at his hospital the operation of gastro-enterostomy. The patient was a man of 48 who had suffered from malignant obstruction of the pylorus for several months; the operation gave much relief and the patient lived for seventy-two days. In a paper read at the Royal Medico-Chirurgical Society Page reviewed the results of thirty-eight cases in which the operation had been done. It was, he said, an operation distinctly justifiable and to be recommended, for it was capable of bringing relief to the distressing symptoms caused by pyloric obstruction and was thereby in all probability the means of prolonging life. Such arguments were greatly in advance of the time at which they were put forward.

As a teacher Page was seen at his best in his informal clinical lectures. His formal lectures, scholarly, profound, and stated in polished phrase, did not arrest the attention of students as did these models of clear thinking and of lucid exposition, which remained in the memory and were acted upon in after-practice. He possessed great power of speech. A wonderful choice of words, a clear diction, and a melodious voice gave to his speeches a distinction which was still further enhanced by his clarity of thought and by a touch of whimsical humour. A speech from Page decorated any occasion, however prosaic.

Possessed of these qualities, Page made his mark as a railway witness at a time when the railway companies considered it necessary to contest excessive claims against them for damages as the result of accidents. Lord Chief Justice Coleridge, summing up in the case of Milsom v the London and North-Western Railway Company in 1879, remarked:-

"This I will say, that whereas it is most difficult very often to follow the reasons and to apply the ordinary rules of common sense to the evidence given by Dr R and Mr G, I do not think any man of the most ordinary common sense would have the least difficulty in following the evidence of Mr Page and in ascertaining exactly and definitely what Mr Page meant to say. Whether you believe Mr. Page is another matter, but he is such a comprehensible and intelligible witness as I very seldom have heard in the witness box. A child might understand him, and he gave his evidence with lucidity and firmness; a more cool and intelligent man, a person who seemed to estimate the value of the words he is using, it has seldom been my good fortune to see before a judge and jury."

Suave but accurate, Page, in fact, was soon busy maintaining a new position in regard to the so-called injuries due to railway accidents. In his work on Injuries of the Spine (1883) he was able to account for many of the symptoms following such accidents, which had been previously regarded as of a particularly malign character, inasmuch as they were thought to illustrate degeneration of the spinal cord following traumatism to bones or muscles. Having no such sinister expectations, Page consequently came into conflict with Erichsen's followers, who had evolved a complete pathology for the condition named 'concussion of the spine'. Page's position regarding 'railway' spine was that it was a mental condition caused partly by the pain due to a definite injury to ligamentous and muscular structures of the spinal column, and partly by the apprehension of the unknown consequences which might flow from this. He held that the condition was maintained and augmented by auto-suggestion and by the fear that all this suffering would not be sufficiently compensated. He was careful not to use the word 'malingering'. His conception displaced the view that the symptoms of which the sufferers complained were due to a 'concussion of the spinal cord' analogous to the condition known as 'concussion of the brain'. Page set forth these views in his Boylston Prize Essay and showed high courage in doing so, for he ran counter to the authority of his seniors.

His connection with the Royal College of Surgeons was a close one. He was a Member of the Council from 1899-1907, and a Member of the Court of Examiners from 1894-1902. He was also an Examiner in Surgery at the Universities of Oxford, Cambridge, and Birmingham.

After the first publication of his chief work in 1883 he served as President of the Neurological Society, an office which had rarely been held by a surgeon. At the Carlisle Meeting of the British Medical Association in 1896 he was Vice-President of the Section of Surgery, having been Hon. Secretary to this Section at the Ryde Meeting in 1881. His main activity as a railway case expert occurred whilst he was Surgeon to the London and North-Western and Great Western Railways.

Retiring as long before his death as 1906, and living for twenty years at his country seat, Sedgecombe House, The Bourne, Farnham, he had become an unfamiliar figure at the Royal College of Surgeons, when, a very few years before his death, he called there, bringing with him a medallion portrait of himself executed by Lady Harris, in 1920; it is not a striking likeness.

He died, after a long illness, at Sedgecombe House, on Sept 9th, 1926, being survived by his widow (m 1905), daughter of Canon Houghton, and by two daughters by his first marriage to a daughter of the Rev Christopher Parker, of Skirwith Abbey, Cumberland. One of his brothers was the Recorder of Carlisle, and another became the Dean of Peterborough. After his death Mr V Warren Low, as executor, gave two silver cups to the College early in 1927. The cups had been presented to Page when he left St Mary's Hospital, and were bequeathed "in happy remembrance of my one-time connection with the College as a Member of Council and also of the Court of Examiners, to be used as loving-cups at College banquets, the same to be suitably engraved."

Publications:-
Injuries of the Spine and Spinal Cord without Apparent Mechanical Lesions and Nervous Shock, in their Medico-legal Aspects, 8vo, London, 1883; 2nd ed., Philadelphia, 1885.
Railway Injuries: with Special Reference to those of the Back and Nervous System, in their Medico-legal and Clinical Aspects, with bibliography, 8vo, London, 1891.
"Abdominal Section for Intussusception" (with C HANDFIELD JONES). - Med-Chir Trans, 1878, lxi, 301.
"Subperiosteal Haemorrhage." - Ibid, 1883, lxvi, 221.
"Case of Tabetic Arthropathy." - Clin Soc Trans, 1882-3, xvi, 158.
"On the Abuse of Bromide of Potassium in the Treatment of Traumatic Neurasthenia". - A Clinical Lecture, 12mo, London, 1885; reprinted from Med Times, 1885, i, 437.
Clinical Papers on Surgical Subjects, 12mo, London, 1897.
Contributions to Lancet, Brit Med Jour, Brain, etc.
In 1881 the Boylston Prize was awarded to Page by Harvard University for his Essay on "Injuries to the Back, without apparent Mechanical Lesion, in their Surgical and Medico-legal Aspects". This was embodied by him in his other important works on spinal and railway injuries.

Sources used to compile this entry: [Lancet, 1926, ii, 626, with a good portrait and an account of his views on railway injuries].

The Royal College of Surgeons of England