Eminent doctors: Their lives and their work; Vol. 2 of 2

by G. T. Bettany

On settling in Dublin, young though he was, Stokes was elected Physician to the Meath Hospital, in succession to his father. His colleague, Graves, one of the most remarkable men Dublin had produced, exercised a striking influence over him. At twenty-two Stokes was already lecturing and giving clinical instruction to a crowd of pupils. The time was one of acute distress and poverty in Ireland; fever raged in Dublin, owing to the distress caused by the failure of the potato crop in the summer of 1826. The Meath Hospital was crowded, and the young physician was taxed to the utmost, and his benevolent charity became fixed as a second nature.

During these years of activity, a powerful special object was employing his most persistent thought and observation. He was diligently storing his mind with every fact and inference bearing on diseases of the lungs. In 1837 his observations were published in the classic work on “Diseases of the Chest.” It at once placed him, says Sir Henry Acland in the memoir prefixed to the edition published by the New Sydenham Society in 1882, in the front rank of observers and thinkers. His exposition of the use of auscultation in bronchitis and the affections of the chest was most valuable.

In 1842 Stokes became Regius Professor of Physic in Dublin University, in succession to his father. From this time, though he contributed occasional papers, lectures, and cases of value to the Dublin Journal of Medical Science, and to the medical societies, he published no book till 1854, when a valuable treatise on Diseases of the Heart confirmed his reputation. In this he paid great attention to functional disturbances of the heart, where no organic disease was present. He says with great modesty, “the diagnosis of the combinations of diseases, even in so small an organ as the heart, is still to be worked out.... As the student fresh from the schools, and proud of his supposed superiority in the refinements of diagnosis, advances into the stern realities of practice, he will be taught greater modesty, and a more wholesome caution. He will find, especially in chronic disease, that important changes may exist without corresponding physical signs—that as disease advances its original special evidences may disappear—that the signs of a recent and trivial affection at one portion of the heart may altogether obscure, or prevent, those of a disease longer in standing and much more important—that functional alteration may not only cause the signs of organic lesion to vary infinitely, but even to wholly disappear—that the signs on which he has formed his opinion to-day may be wanting to-morrow; and, lastly, that to settle the simple question between the existence of functional and that of organic disease, will occasionally baffle the powers of even the most enlightened and experienced physicians.”

This treatise is acknowledged to be one of the most acute, graphic, and complete accounts of the clinical aspects of heart disease. In 1854 also he published a series of lectures on Fever in the Medical Times and Gazette, which were collected into a volume, with additions in 1874. Here he showed himself as still sceptical of the advances made by Jenner, Murchison, and others. As he wrote in one of the lectures, “there is nothing more difficult than for a man who has been educated in a particular doctrine to free himself from it, even though he has found it to be wrong,” and he could never free himself from Alison’s strong belief that fevers were essentially alike.

Very early in his career Stokes was overwhelmed with private practice. On more than one occasion he spoke and wrote strongly regarding the exertions and the mortality of Irish doctors in combating fevers and cholera, while receiving the merest pittance from Government for their services. His feelings as to everything relating to the welfare of the profession and the general culture of the student were actively displayed. “Let us emancipate the student,” he said, “and give him time and opportunity for the cultivation of his mind, so that in his pupilage he shall not be a puppet in the hands of others, but rather a self-relying and reflecting being. Let us ever foster the general education in preference to the special training, not ignoring the latter, but seeing that it be not thrust upon a mind uncultivated or degraded.”

Prevention of disease, too, engaged Stokes’s earnest attention, before sanitary science had come into fashion. “A time may come,” he said, in closing one of his addresses, “when the conqueror of disease will be more honoured than the victor in a hundred fights.”

Sir Henry Acland says of Stokes: “The study of man was with him an instinct, both on the material and on the intellectual side. On the material side; for he was a physiognomist, a great judge of character, and had a keen perception of all physical characteristics, qualities which he obtained by intense observation of men in disease, of men in health, and of persons in every class of society and every kind of occupation. On the intellectual side; for the phenomena of man’s external nature were to him only expressions of the mind working within,—mind the result of inheritance—mind formed by itself—mind the result of circumstance. The second thing to be remarked was his intense interest in every form of human character, in persons of every age, occupation, and condition. He had that which many accomplished persons have not, the keenest sense of humour, which sparkled up in a way quite indescribable. He combined with real delight in all intellectual development the most tender human interest.”

Stokes was passionately fond both of natural scenery and of landscape art; and he enjoyed the companionship and friendship of the best artists, and at the same time appreciated greatly the interests of humble life and the racy humour of the Irish peasantry. He wrote some charming descriptions of scenery, and was well acquainted with various schools of art. The antiquities and history of Ireland too, found in him an accomplished and appreciative student; and it was felt to be an appropriate tribute to his variety of taste as well as his professional skill when he was chosen President of the Royal Irish Academy in 1874.

One valuable habit Dr. Stokes ascribed to his father. “My father left me but one legacy, the blessed gift of rising early.” This often meant getting up between four and five, when he would study and write till eight. During a long day’s practice he was always exercising the most genial influence, whether over refractory students or harassed patients. At the close of the day his hospitality was as attractive as his professional manner during the earlier hours.

In 1870 Mrs. Stokes died, and from this blow her husband never fully recovered. In 1876 he found himself compelled to withdraw from his many public posts, and retire to his cottage at Carigbraig, where to the last the flights of birds which he had encouraged and trained came to seek their food at his hands. He died on January 6, 1878.