James Paget - Works

Works

No famous surgeon, not even John Hunter (1728–1793), was likely to have founded his practice deeper in science than Paget did, or waited longer for his work to come back to him. In physiology, he had mastered the chief English, French, German, Dutch and Italian literature of the subject, and by incessant study and microscope work had put himself level with the most advanced knowledge of his time, so that it was said of him by Robert Owen, in 1851, that he had his choice, either to be the first physiologist in Europe, or to have the first surgical practice in London, with a baronetcy. His physiological lectures at St Bartholomew's Hospital were the chief cause of the rise in the fortunes of its school, which in 1843 had gone down to a low point.

His work in pathology was even more important. He filled the place in pathology left empty by Hunter's death in 1793; this was the time of transition from Hunter's teaching, which for all its greatness was hindered by want of the modern microscope, to the pathology and bacteriology of the present day. Paget's greatest achievement was that he made pathology dependent, in everything, on the use of the microscope, especially the pathology of tumours. He and Virchow may truly be called the founders of modern pathology; they stand together, Paget's Lectures on Surgical Pathology and Virchow's Cellulär-Pathologie.

When Paget, in 1851, began practice near Cavendish Square, he had still to wait a few years more for success in professional life. The turn of the tide came about 1854 or 1855; and in 1858 he was appointed surgeon extraordinary to Queen Victoria, and in 1863 surgeon in ordinary to Albert Edward, Prince of Wales. He had for many years the largest and most arduous surgical practice in London. His day's work was seldom less than 16 or 17 hours. Cases sent to him for final judgment, with especial frequency, were those of tumours, and of all kinds of disease of the bones and joints, and all neurotic cases having symptoms of surgical disease. His supremacy lay rather in the science than in the art of surgery, but his name is also associated with certain great practical advances. He discovered the Paget's disease of the breast and the Paget's disease of the bones (osteitis deformans), which are named after him; he was the first to urge removal of the tumour, instead of amputation of the limb, in cases of myeloid sarcoma. In 1869 he was elected President of the Clinical Society of London. . In 1870, he was elected a foreign member of the Royal Swedish Academy of Sciences.

In 1871, he nearly died from infection at a post mortem examination, and, to lighten the weight of his work, was obliged to resign his surgeoncy to the hospital. In this same year, he received the honour of the baronetcy of Harewood Place (Middlesex). He received an honorary degree from the University of Cambridge in 1874. In 1875, he was president of the Royal College of Surgeons, and delivered the Hunterian oration in 1877. Also in 1875, he was elected as president of the Medical and Chirurgical Society of London. In 1878, he gave up operating, but for eight or 10 years longer, he still had a very heavy consulting practice. In 1880, he gave, at Cambridge, a memorable address on Elemental Pathology, setting forth the likeness of certain diseases of plants and trees to those of the human body. The next year, he was president of the International Medical Congress held in London. In 1887 he was elected President of the Pathological Society of London

Besides shorter writings, he also published Clinical Lectures and Essays (1st ed. 1875) and Studies of Old Case-books (1891). In 1883, on the death of Sir George Jessel, he was appointed vice-chancellor of the University of London. In 1889, he was appointed a member of the Royal Commission on Vaccination.

In May 1886, he treated Edward Crowley, father of Aleister Crowley for tongue cancer. An operation was advised, but Crowley declined and died the following year.

He died in London on 30 December 1899, at the age of 85.

Sir James Paget had the gift of eloquence, and was one of the most careful and most delightful speakers of his time. He had a natural and unaffected pleasure in society, and he loved music. He possessed the rare gift of the ability to turn swiftly from work to play, enjoying his holidays like a schoolboy, easily moved to laughter, keen to get the maximum of happiness out of very ordinary amusements, emotional in spite of incessant self-restraint, and vigorous in spite of constant overwork. In him a certain light-hearted enjoyment was combined with the utmost reserve, unfailing religious faith, and the most scrupulous honour. He was all his life profoundly indifferent toward politics, both national and medical; his ideal was the unity of science and practice in the professional life.

Sir James's reputation remains high due to his work as a surgeon and medical research and work, but he also had an apparent interest in criminal matters. In 1886, he followed the poisoning trial of Adelaide Bartlett for the murder of her husband Edwin. After a spirited defense by Sir Edward Clarke, Bartlett was acquitted. The key problem of the trial was that Edwin was poisoned by liquid chloroform, which was found in his stomach, but liquid chloroform burns the throat if swallowed, and the drinker would be screaming. Edwin Bartlett never screamed the night he died. As a result, an alternative theory of suicide was considered and helped get the acquittal, but it left the public unsatisfied. Paget, upon hearing the result, made the comment for which he is best remembered: "Now that she has been acquitted for murder and cannot be tried again, she should tell us in the interest of science how she did it!" Paget's interests in crime were shared by his son John Paget, who wrote a book Puzzles and Paradoxes about several famous historical mysteries.