Robert James Graves, born in 1795 or 1796, after going through a complete arts course, and such medical study as Dublin then afforded, graduated M.B. at Dublin in 1818. He then betook himself to other schools, and successively studied in London, in the most celebrated Continental schools, and in Edinburgh, being away from Dublin more than three years. He had an excellent language-faculty, and once, having forgotten his passport, was imprisoned for ten days in Austria as a German spy, the authorities insisting that no Englishman could possibly speak German as he did. During his stay in Italy, Graves, who had considerable artistic capacity, accidentally made the acquaintance of Turner, the celebrated painter, and became his companion on many journeys. An interesting notice of Graves’ intercourse with Turner has been given by Professor Stokes.[14] It appears that the two lived and travelled together for months without either of them inquiring the name of his companion.
On a voyage from Genoa to Sicily Graves’ courage and decision were strikingly put to the test when the captain and crew, in a terrific gale, were about to quit the ship in the only boat, leaving the two passengers to their fate. Graves, though ill, seized an axe, and stove in the boat, took command, repaired the pumps from the leather of his own boots, and saved the ship.
In 1821 Graves returned to Dublin, and at once took a leading position. Dr. Stokes, for a short time his pupil, and his lifelong friend, says of him at this time: “Nature had been bountiful to him: he was tall in stature, of dark complexion, and with noble and expressive features. In conversation he possessed a power rarely met with; for while he had the faculty of displaying an accurate and singularly varied knowledge without a shade of egotism, he was able to correct error without an approach to offence. He had at once a warm and a sensitive heart, and ever showed lasting and therefore genuine gratitude for the smallest kindness. Loving truth for its own sake, he held in unconcealed abhorrence all attempts to sully or distort it; and he never withheld or withdrew his friendship from any, even those below him in education and social rank, if he found in them the qualities which he loved, and which he never omitted to honour.”
“It is to be observed that as his mind was open and unsuspicious, he occasionally fell into the error of thinking aloud without considering the nature of his audience, and of letting his wit play more freely, and his sarcasm, when defending the right, cut more deeply than caution might dictate.”
During the year 1821 Graves was elected physician to the Meath Hospital, and also became one of the founders of the Park Street School of Medicine. At this time clinical investigation and clinical teaching could scarcely be said to exist, and the pathological studies of other schools were rather held in contempt. The methods in vogue in Edinburgh had not impressed Graves favourably. Students were not then regularly called upon to investigate cases for themselves, nor trained in so doing: they might obtain their degree without having ever practised diagnosis or co-operated in curing disease even to the extent of writing a prescription. “Often have I regretted,” said Graves in his introductory lecture at the Meath Hospital in 1821, “that, under the present system, experience is only to be acquired at a considerable expense of human life. There is, indeed, no concealing the truth—the melancholy truth, that numbers of lives are annually lost in consequence of maltreatment. The victims selected for this sacrifice at the shrine of experience, generally belong to the poorer classes of society, and their immolation is never long delayed when a successful candidate for a dispensary commences the discharge of his duty. The rich, however, do not always escape; nor is the possession of wealth in every instance a safeguard against the blunders of inexperience.”
After commenting on the evil effects of ignorant dogmatism in those of riper years, Dr. Graves went on to expound the plan of Continental clinical instruction. He then alluded to the coarse, harsh, and even vulgar expressions made use of towards hospital patients by Irish medical men of the day, insisting on the necessity of reform in this respect.
The plan that Graves adopted and worked so successfully, essentially consisted in giving to the advanced students charge over particular patients, requiring them to report upon the origin, progress, and present state of their diseases. At the bedside these particulars were verified or challenged by the physician; and then in the lecture-room he discussed with the class the diagnosis, prognosis, and treatment of the cases. The pupil in charge prescribed for the patient, and his prescription was revised and corrected by the physician. The advantages of this system were obvious; students being obliged to give reasons for every plan of cure, became accustomed to a rational and careful investigation of disease, and enjoyed the great benefit of the early correction of their errors.
Nevertheless the system met with much opposition, and even ridicule. As Stokes says, the student was then kept at a distance; no one cared to show him how to teach himself, to familiarise him with “the ways of the sick,” to train his mind to reason, and to inculcate the duty as well as the pleasure of original work.
Graves had both knowledge and eloquence; his style was massive, nervous, and forcible; he could command the minds of his hearers, and he showed himself thoroughly in earnest. “His active mind was ever on the search for analogies, and thus he was led to the discrimination of things apparently similar, and to the assimilation of things at the first view dissimilar, in a degree hardly surpassed by any teacher of medicine.”
Having been elected a Fellow of the King’s and Queen’s College of Physicians, Graves was subsequently appointed Professor of the Institutes of Medicine. In this capacity he gave lectures in which physiology was ably applied to the wants of medical students. In the years 1828-36 he contributed many physiological essays, chiefly to the Dublin Journal of Medical Science, of which he was one of the editors till his death, on such subjects as “The Distinctive Characters of Man,” “The Chances of Life,” “Temperament and Appetite,” “The Sense of Touch,” &c., all interesting. But it was not till 1843 that he published the work on which his reputation as an author chiefly rests, his “Clinical Lectures on the Practice of Medicine.” In relation to this one needs no higher authority in its favour than that of Trousseau, who addressed to the translator of the French edition a letter from which we make the following extracts.