In the same lecture Sir James clearly showed the value of studying cases not agreeing with the ordinary types. “We should study all exceptions to rules; never thinking of them as unmeaning or accidental. Especially, we should never use, in its popular but wrong translation, the expression, ‘exceptio probat regulam;’ as if an exception to a rule could be evidence that the rule is right. If we use it, let this be in its real meaning; translating it, as surgeons should, that an exception probes the rule, tests it, searches it—as the Bible says we should ‘prove all things’—to its very boundary.”
Finally we may quote some sentences from Sir James Paget’s lecture on “Elemental Pathology,” delivered before the British Medical Association in 1880, as expressing his philosophy of life. “I hold it to be very desirable that every one of us should, all his life long, study some science in a scientific manner. There seems to be no equally good method for maintaining the temper and the habits, which by making us always good students, will make us as good practitioners as we can be. There is no method so good for maintaining a constant habit of inquiry, with accuracy and perseverance in research, the power of weighing evidence, of calmly judging, and of accurately speaking; none better for cultivating the love of truth, the contempt for fallacies, whether others’ or our own, the gentleness and courtesy which are appropriate to the consciousness of the imperfection of our knowledge.”
[CHAPTER XXI.]
WILLIAMS, STOKES, AND DISEASES OF THE CHEST.
Although this country has not enjoyed the distinction of introducing that invaluable instrument, the stethoscope, to medical science, great interest naturally attaches to those who first used the stethoscope in this country. And among these the name of Charles John Blasius Williams is prominent.
Charles Williams, the son of a clergyman of a Cardiganshire family, was born early in the present century at Heytesbury in Wiltshire, where his father was perpetual curate, and custos of the Hungerford almshouse, in which he resided. He was educated at home by his father. His early liking for natural science and medicine may be considered to have come through his mother, who was the daughter of a surgeon, also named Williams, at Chepstow, and had been educated by Hannah More’s sisters, and received instruction in reading from Hannah More herself. Before the age of fourteen, having access to some good books on natural philosophy, he had made for himself two electrifying machines, a battery of Leyden jars, a voltaic pile, and several little telescopes, microscopes, kaleidoscopes, and æolian harps. Thomson’s Chemistry enabled him to carry on extended chemical experiments, and to start well at Edinburgh subsequently.
Astronomy, a lifelong hobby, was cultivated in the family after the reading of Chalmers’s astronomical discourses; they bought a telescope and did some really good observing. Active games were not lost sight of: and the young Charles excelled all his neighhours in leaping and running. Stilt-walking was a favourite pursuit; and the youth once made a pair of stilts with a footing twelve feet from the ground, mounted on which he could walk well, and look into the upper windows of the house. Natural history tastes were further carried out in a somewhat unusual direction. Poultry and all kinds of domestic animals were studied so minutely, and their cries imitated so closely, that Charles could influence their behaviour towards himself just as if he had been one of themselves.[13]
In the autumn of 1820 Charles Williams entered at Edinburgh University, attending Hope’s interesting lectures on Chemistry and the dry prelections of Monro tertius on Anatomy, alternated with Barclay’s extra-academical class. Later he diligently attended W. P. Alison’s courses of lectures, and had much personal instruction from him. He had not proceeded far in his medical studies before he became absorbed in chemical physiology, and especially in relation to respiration and animal heat. Carefully studying all the most recent chemical discoveries, he made new experiments showing that the change of colour between venous and arterial blood could take place when the blood was enclosed in an animal membrane out of the body, and surrounded by atmospheric air. Thus in 1823 he anticipated what Professor Graham so largely developed in relation to the general permeability of animal membranes. He further discussed the origin of animal heat, and suggested various developments of the theory of combustion. The paper, later amplified into a thesis for graduation in 1824, attracted Alison’s high commendation, although Hope had returned the paper with the remark that the subject was quite proper for a young gentleman’s thesis, but that he declined to enter into the subject.
In 1824-5 the young doctor heard Charles Bell’s lectures on the Nervous System at the London College of Surgeons, and attended the surgical practice of several of the London hospitals. At midsummer 1825 he went to Paris, and in addition to French literature studied painting, becoming a good amateur landscape-painter both in water-colours and oils. In the winter he attended Majendie’s lectures on Physiology and the practice of Dupuytren, Laennec, and many others. But Laennec, the great auscultator, then in his last year of life, gained his most ardent devotion. It was surprising, says Dr. Williams, how little he was valued by French students. Those who attended his clinique were chiefly foreigners. M. G. Andral’s post mortem examinations also he found invaluable.
The chief discoveries relating to auscultation were undoubtedly Laennec’s; yet his knowledge of acoustics was by no means profound, and he was often not successful in explaining rationally the sounds that he heard in the chest. Dr. Williams soon started in the path of applying acoustic laws in this field, and in 1828 he produced his valuable “Rational Exposition of the Physical Signs of Diseases of the Chest,” suggesting various improvements in the construction and use of stethoscopes. Returning to London, Dr. Williams derived great benefits through an introduction to Dr. (afterwards Sir James) Clark, so long attached as physician to the Queen, and from the family acquaintance with Lord Heytesbury. His work above mentioned was favourably reviewed, and soon made its way; and many of his explanations are accepted to the present day. After various travels with patients, he settled in Half Moon Street, Piccadilly, in 1830, having married his cousin, Miss Harriett Jenkins, of Chepstow.
Becoming a member of the Royal Institution, Dr. Williams was introduced to Faraday, and was soon engaged to write for the “Cyclopædia of Practical Medicine,” to which he contributed numerous valuable articles on auscultation and diseases of the chest. In these articles he recommended strongly the cure of catarrh by the heroic process of reducing the supply of fluid. The remedial uses of counter-irritation were carefully expounded: and dyspnœa, difficult or distressed breathing, was clearly described.