At Edinburgh he quickly distinguished himself by his diligent study of anatomy; he was recognised as a student of the first rank, and was chosen senior president of the Royal Medical Society in 1811. Dr. Bigsby says of him: “Few men have changed during their progress through life so little as Marshall Hall. As he began, so he ended, delighting in the labour—the labour itself—of investigation.... All the stores of knowledge which his predecessors had either gathered or created, Marshall Hall was eager to acquire; a hardy, enduring constitution seconding all his efforts.... All his energies were directed to the formation of the skilful bedside physician, that is, to the alleviation and cure of disease.” It was said of him, “Hall never tires.” During his three years’ studentship he never once missed a lecture. He graduated in June 1812, and was almost at once appointed resident house physician to the Edinburgh Royal Infirmary. Here his love of order, his zeal, and spirit of inquiry found full scope, and he took extreme pains in the study of diagnosis. He gave a voluntary course of lectures on the principles of diagnosis in 1813, which were the basis of his well-known work, first published in 1817. His usefulness to the younger students in the hospital was very great, and equally striking was his good example of purity of life and conversation, and constant cheerfulness. His puremindedness was characteristic through life; Marshall Hall never attached himself to any man of coarse mind or manners.
During his last year at Edinburgh the young physician, attracted towards London practice, was prudently weighing the cost and risk of such an enterprise. He decided in favour of a more modest course of provincial practice, waiting till his book on Diagnosis should be matured. As in later life, so now he was “strong in hope, inflexible for truth and justice, but inexperienced in the ways of the world, and unable to cope with the cunning, or to dissemble with the false.” After a visit to Paris for some months he proceeded to Göttingen and on to Berlin to visit the medical schools, walking alone and on foot from Paris to Göttingen, more than six hundred miles, in November 1814. After a brief period of practice in Bridgewater he commenced practice at Nottingham in February 1817, and with remarkable rapidity attained a leading position. In 1817 his work on the Diagnosis of Diseases appeared, and at once marked him out as a man of the highest originality, applying accurate observation and classification of symptoms to the detection and distinction of diseases. Of this book the Lancet of August 15, 1857, remarked: “Comprehensive, lucid, exact, and reliable, this work has, in the main, stood the test of forty years’ trial. A better has not been produced.” When Dr. Baillie, nephew of John Hunter and President of the College of Physicians, first saw Marshall Hall, he complimented him on being the son of the author of so extraordinary a work as that on Diagnosis. Being modestly told that he himself was the author, Baillie exclaimed: “Impossible! it would have done credit to the greyest-headed philosopher in our profession.”
In 1818 Hall published a work on the affections usually denominated Bilious, Nervous, &c., and in 1820 an essay in which the prevalent custom of bleeding was attacked, especially in certain affections occurring after childbirth, which under that treatment almost invariably proved fatal. In 1822 this was followed by a small volume on the Symptoms and History of Diseases, which was especially valuable in treating of the detection of internal diseases. In 1824 appeared his important paper On the Effects of the Loss of Blood in the “Medico-Chirurgical Transactions,” published also in an expanded form in his “Medical Essays” in the same year. Before this time the lancet was in hourly use, and Marshall Hall termed it “a minute instrument of mighty mischief.” Almost all pain in any complaint, quickness of pulse, headache, intolerance of light or noise, being believed to arise from inflammation, blood flowed in torrents to subdue it. It was by his various papers bearing on this question that Dr. Hall became prominently known; for the dropping of the lancet was an evident change of procedure which the public as well as the profession could lay hold of. In 1825 the young enemy of the lancet was elected Physician to the Nottingham Hospital by a large majority of votes, and the best practice of the neighbouring counties was his. He was unremittingly employed: in his walks and rides almost heedless of external occurrences, absorbed in contemplation; at home ever busy in his library or his laboratory, making chemical experiments from which numerous valuable memoirs arose; never accepting invitations of pleasure; unwearied in his attentions to the sick poor whom he saw gratuitously. He economised time by riding, being a good horseman, riding through the country on pitch-dark nights without accidents. He treated his horses well and earned their affection. “How is it that your horses never fall?” a friend inquired. “I never give them time to fall,” was the reply. The Bible constantly at his side was another mark of Marshall Hall, and he was ever ready to discourse on the wisdom and benevolence of God, as shown in the structure of the human body.
London continued to attract the popular Nottingham physician. Dr. Baillie had predicted that if he came to London, he would be the leading physician in five years; Sir Henry Halford, who succeeded him as President of the College of Physicians, termed Marshall Hall, a few years afterwards, “the rising sun of the profession.” We cannot wonder that a visit to London in August 1826 resulted in his remaining there. His Nottingham patients, deeply regretting his removal, continued to consult him by letter; and his first year in town produced £800, a remarkable instance of quick success.
In 1828 he published “Commentaries on Diseases of Females,” with graphic plates depicting conditions of parts such as the tongue, lips, nails, &c., which he first associated with various disorders of women. He continued his series of careful papers on subjects connected with blood-letting. His writings on these two subjects produced him a considerable portion of his early practice.
Meantime Marshall Hall married, in 1829, and soon afterwards settled in Manchester Square, where he lived for twenty years. Desiring to become a Fellow of the Royal Society, he entered upon a special research on the circulation of the blood, the results of which he might communicate to the Society. After carefully inspecting under the microscope the blood-flow in the transparent parts of frogs, toads, newts, &c., he arrived at the conclusion that all the blood changes, and all nutrition and absorption by the material tissues are effected in the minute or capillary channels between the arteries and the veins. The paper founded upon this research was read before the Royal Society in 1831, but was refused a place in the “Philosophical Transactions;” yet an equally great man, Johannes Müller, the leading German physiologist, pronounced his paper one of extraordinary interest. It was separately published in 1832. The Royal Society, however, did not reject Marshall Hall’s next paper, “On the Inverse Ratio between Respiration and Irritability in the Animal Kingdom,” which has been pronounced “one of the most beautiful examples of widely extended observations, and previously disjointed facts, all brought together and rendered harmonious by the insight and genius of a master-mind.”[20]
From the latter subject the investigator passed to that of hybernation, his views on which also found acceptance with the Royal Society. One feature in his experiments on this subject was an ingenious apparatus for ascertaining the temperature of the bat without disturbing its winter sleep. By this time Marshall Hall had quite a little menagerie in his house, of animals whose physiology he was investigating; mice, hedgehogs, bats, birds, snakes, frogs, toads, newts, fishes were in turn laid under contribution. Abhorring cruelty as utterly as a man could, he yet saw the absolute necessity of discovering in the first instance, by experiments on animals, truths which were of vital importance both to men and brutes. Mr. Henry Smith of Torrington Square was his diligent associate in these inquiries. Dr. Hall said of him: “I never knew a person so accurate in his information and so devoid of selfishness. His interest in my researches never flagged. He was true to his appointments as the clock itself.”
While the papers refused a place in the “Philosophical Transactions” were going through the press, to appear as a “Critical and Experimental Essay on the Circulation of the Blood,” a serious accident happened to a portion of the manuscript. It was sent from time to time by stage-coach to Messrs. Seeley, printers, at Thames Ditton, and on the evening of William IV.’s coronation a packet containing the only record of a considerable series of experiments was stolen from the coach. This most serious loss could only be repaired by a repetition of the experiments, which Dr. Hall at once set about with most Christian equanimity.
Early in 1832 Marshall Hall was elected a Fellow of the Royal Society, and in the same year he published another paper on the Effects of Loss of Blood, in the “Medico-Chirurgical Transactions.” The original papers on practical medicine which he produced during this period are too numerous to be mentioned here. We must hasten to give an account of Marshall Hall’s great researches on the reflex functions of the spinal cord.
It was while he was examining the circulation of the blood in the newt’s lung that Marshall Hall noted the fact from which his great discoveries arose. The newt’s head had been cut off; thus its life, in the ordinary acceptation, was destroyed. The tail was afterwards separated. “I now touched the external integument with the point of a needle; it moved with energy, assuming various curvilinear forms! What was the nature of this phenomenon? I had not touched a muscle; I had not touched a muscular nerve; I had not touched the spinal marrow. I had touched a cutaneous nerve. That the influence of this touch was exerted through the spinal marrow was demonstrated by the fact that the phenomenon ceased when the spinal marrow was destroyed. It was obvious that the same influence was reflected along the muscular nerve to the muscles, for the phenomenon again ceased when these nerves were divided. And thus we had the most perfect evidence of a reflex, or diastaltic, or diacentric action.”