The Irish School of Medicine
Before beginning a discussion of those trailblazing clinicians, who in the first part of the 19th century gave rise to the Irish School of Medicine, it might be interesting to review briefly the evolution of medicine in Ireland from the earliest times. Such a procedure will show that the development of that school was not an accident but rather a thing to be expected when the traditions and accomplishments of their predecessors were of such a high order in comparison with others of that same early time.
The earliest colonizers of Ireland were principally Celts and came from Southeastern Europe, sweeping upward across what are now Greece and F4rance. With them they brought all their arts and customs including the Brehon Laws, the most ancient code in Europe, concerning which we shall refer to later in a discussion of regulations pertaining to medical practice.
The first Irish physician, Capa (200 B.C.), is known by name only, all records concerning him and his work having disappeared. He was probably a member of that craft hypnotists, herbabists, priests, astrologers, etc., known as druids. It is certain, however, that most of the early physicians were and included in this lot was Diancecht (400- 500 B.C.), the first authenticated physician concerning whom we have definite evidence. He did some primitive surgery as well as healing by medicine. His greatest contribution to mankind was probably his “Elixir of Life”, described as a preservation for the dead, the living, for the want of sinews, for the tongue-tied, for swelling in the head, of wounds from iron, of burning from fire, of the bite of the hound; it prevented the lassitude of old age, cures the decline, the rupture of the blood vessels, takes away the virulence of the festering sore; the poignancy of grief, the fever of the blood, they cannot content with it, “ he to whom it shall be applied shall be made whole.” These extravagant claims remind one of the tar water mina of Bishop Berkley to which Oliver Wendell Holmes alludes in one of his works. Unfortunately for posterity, Diancecht’s formula has been misplaced.
300 B.C. is a date of considerable importance. It was then that the Irish princess, macha, established the “House of Sorrows,” one of the two earliest public hospitals in the world, the other being established at about the same time in the far east. While there were earlier organized efforts to furnish care for the sick these efforts were generally limited to members of a clan, tribe, or family, while Princess Macha’s efforts seemed to mark the beginning of the modern general public hospital. This “House of Sorrows” was in operation for many years. Later it was taken over by the Red Branch Knights and finally became the Royal Ulster Residence, continuing so until its destruction in 332 A.D. It may be of interest to some to know that these Red Branch Knights had a taste for war trophies comparable to but more terrifying than that of our American Indians. Their most prized battle souvenirs were balls composed of the brain substance of various distinguished fallen foes.
At about the time of Christ, Conner Maenessa, King of Ulster, sustained, in battle, a fracture of the skull with contusion of the brain. The ball was not removed and be recovered under palliative treatment. It is regretted that the name of his physician is not recorded since the latter’s advice for future conduct was founded on such sound principles. Conner was told “ for the future to keep his spirits cool and in proper motion and to avoid horseback riding, mental excitement, anger and all things that might disorder or ferment his blood.” He followed this advice for years but upon hearing of the crucifixion of Christ he became most angry and hew troes (symbolical of the Jews) until he dropped dead; since then he has been considered by many as “ the first man who died for the sake of Christ in Ireland.”
The Irish physicians at this time were highly regarded by the general public. Their work was usually limited to their own clan or tribe. At first the position was largely hereditary, but later pupils other than the doctors sons were admitted to study.
The laws governing medical practice were part of the previously mentioned Brehon code. Among the regulations of interest was first a division of physician into the lawful and the unlawful. The unlawful could practice but he must give notice in advance that he was not a lawful doctor or he would be held strictly liable for any unfavorable results. Secondly, the few were based on a sliding scale and were apparently fair enough. For example, the fee for curing a bishop was 42 cost, that for a prince or wealthy merchant was a year’s wages of ordinary labor, that for a slave, one-sixth as much. Further, the bill practically always paid, if not by the patient, then by the nearest relative or the clan to which he belonged; or if inflected by a transgressor the latter was required to pay. In addition to the prescribed fee the physician was allowed food for himself and as many as four students. Thirdly, there was an attempt at regulation of a statute of limitation and also a definition of responsibility. Fourthly, physicians were generally given grants of land in order that they might have time and means for an occasional period of rest and study. Fifthly, dogs, fools and female scolds were prohibited from visiting at the hospitals. As the physician’s house was generally considered a hospital, it is interesting to know that those houses were built near running water, that they had four doors, one on each side and the one facing the wind left opened and that that the custom of half doors began then, the lower half being closed for protection and the upper half open for ventilation. At any rate these door became quiet common among the peasants later and probably prevented an even higher mortality than did occur among the class living in windowless huts.
During the first 4 or 5 centuries of the Christian era, the physicians did good work as is shown of any of the other professions. There were few of any of the other professions. There were few, if any, definite scientific contributions but so far as actual practice was concerned the Irish doctors were far ahead of those of most other nations. Some of the procedures with which they were familiar were the use of heat and sweating, cupping, treatment of plagues, cauterization of wounds, control of fractures, Caesarian operation, and trephining. One trephine case resulting in the cure of amnesia was gravely reported as an operation for the removal of the organ of forgetfulness (I wonder if this is not the earliest Irishisms). Their confidence in curative medicines is well evidenced by the following cure for baldness. “With Mice fill an earthen pumpkin, stop the mouth with a lump of clay, and bury beside a fire but so that the fires too great heat reach it not.” So be it left for a year and at a years end take out whatsoever may be found therein. But it is urgent that he who shall lift it have a glove upon his hand lest at his fingers’ end the hair comes sprouting out.”
About 500 A.D. the Monastic Period in Ireland begins and one of the earliest prominent doctors was St. Brecan who died in 578. Medicine began to be taught in schools founded by St. Patrick and his successors. A Discussion of this period would be a subject in itself. In this paper it will be sufficient to say that there was continual improvement and preparation for the coming of the productive era of the first half of the 19th century when wishing that time the following contributions were among those made, the introduction of hypodermic medication, the promulgation of Colles law in regard to hereditary syphilis, the use of potassium iodide in the treatment of that disease, the advancement of clinical teaching, the description of Grave’s Disease, the description of Cheynes-Strokes Respiration, and the discovery of many heart facts, particularly in regard to aortic regurgitation and heart block. These advances were the products of the so-called Irish School of Medicine including Graves, Corrigan, Stokes, Cheyne, Adams, Wallace, Colles, and Rynd.
Three of these names, Stokes, Adams, and Cheyne immediately group themselves together in our minds because of our familiarity with the Stokes-Adams syndrome or heart block and with Cheyne-Stokes respiration.
Robert Adams was born in 1791 and died in 1875. he was a member and president of the Royal College of Surgeons and was surgeon to the Richmond, Whitmore and Nardwicke Hospitals and was one of the founders of the Richmond Hospital Medical School. His prominence as an anatomist was undoubtedly due in some measures at least to the fact that he had the advantage of being trained in that subject by Abraham Colles. Among Adams’ principal publication were “Rheumatic Gout, “ 1857, “Introductory Lecture,” 1860 addressed to beginning pupils of medicine at the above mentioned hospitals, and “Essential Heart-block,” 1862, the one which has contributed most to his fame and will be considered later in out discussion of William Stokes. His “Introductory Lecture,” sounds most modern and could well be given to day. He urged the students to defer their medical education of they had not already acquired a thorough preliminary education. He emphasized the importance of training and insisted upon daily punctuality for ward work at which time they should not be walkers merely but attentive listeners and observes. The moral side of the profession was stressed by his saying that from the moment a student enters into the profession his character comes and remains before the public, a public quick to notice even minor lapses. He assures them that while most cannot become wealthy in their work all can hope for a good living.
John Cheyne another member of this trio was born at Leith, Scotland in 1777, the son of a Dr.John Cheyne. In 1795, after graduation at Edinburgh, he entered the army and fought against the Irish. Four years later he returned to Scotland and for the next nine years worked with his father at the Leith Ordinance Hospital. He spent much of his time dissecting and was particularly interested in pathology. In 1809 he published three works on the “Disease of Children” (including an article on Group). During that same year he went to Dublin where he observed that the physicians were more interested in symptomatology than in pathology. He located in Dublin and in 1811 was appointed physician to Meath Hospital. His paper on “Acute Hydrocephalus” was published in 1815. The Dublin Hospital reports of 1818 (VII) contain Cheyne’s original observation regarding rhythmical ascending and descending periods of respiration separated from one another by short pauses. Another publication of his at that time was the “Report on the Hardwick Fever Hospital for 1818.” There were not other noteworthy publications. He died in 1836.
The most prominent of the three men was William Stokes, a contemporary and friend of Robert James Graves with whom he worked at the Meath Hospital. He was born in 1804, the son of a prominent Dublin physician. Due to the latter’s unorthodox views on methodical education and Stokes’ own inclination, his early education was not very orderly. This was largely compensated for by close contact with his father’s work and many friends distinguished in various fields of endeavor. He studied Clinical Medicine at the Meath Hospital, allied sciences at Trinity College and the Royal College of Surgeons, and then spent two years in Glasgow, principally in the chemical laboratory of a Professor Thompson. This was followed by work toward his medical degree at Edinburgh. There he became stimulated by the magnetic personality of Professor Allison and developed that rare power of original observation and research which enabled him at an early age to take so prominent and foremost a place among the pioneers of medical science. He overcame his desultory habits of his youth and began that relentless application to work that characterized him thereafter.
Before he obtained any medical qualification he saw the wonderful possibilities of Laennee’s work and published in 1825 the first systematic treatise on the use of the stethoscope. There was considerable opposition to the value of this instrument and to him is largely due its adoption among the Irish clinicians.
Shortly after this publication he received his degree at Edinburgh and returned to Dublin as Physician to the General Dispensary. The following year he succeeded to his father’s position as Physician to the Meath Hospital and his association with Graves began. At once they began to reform the methods of teaching emphasizing the clinical side and stressing observation rather than cramming. That first year found him working hard in a great typhus epidemic and in the one next year he became infected and nearly died of the disease.
In April 1828 he married Miss Mary Black. Their home life was ideal. Her death many years later were a shock from which he never recovered. He had the following inscription engraved upon the stone over her grave:
“When the ear heard her, then it blessed her,
When the eye saw her, it rejoiced,
When the poor and suffering came unto her,
They were comforted.”
Stokes in 1832 diagnosed the first case of Asiatic cholera in Ireland. During the next few years he began his voluminous contributions to medical publications. From 1835 to 1837 he prepared his famous book “The Diagnosis and Treatment of Diseases of the Chest.” This book established his reputation at once. While Laennec had concerned himself mainly with a description of various physical signs, it was Stokes who associated then with their symptoms. His descriptions are most vivid. The most important results of the researches embodied in the publication were:
Stokes continued with his teaching, writing, and traveling. Many letters were written concerning the latter and here again his keen sense of observation is quite apparent. He did not take an active part in politics but he was heartily in favor of Irish freedom.
With Graves, Colles, and Corrigan he established the Pathological Society of Dublin in 1838, which had many flourishing years.
In 1845 he succeeded his father as Professor of Medicine in the University of Dublin and the following year reported a case presenting the Stokes-Adams syndrome.
He then began his preparation of the “Diseases of the Heart and Aorta”, a book equal in importance and value to the previous one on “Disease of the Chest.” The one on the heart was published in 1854. It is the following description of “Cheyen-Stokes respiration” in connection with the fatty degeneration of the heart: “A form of respiration distress, peculiar to this affection, consisting of a period of apparently perfect apnea, succeeded by feeble and short inspirations, which gradually increase in strength and depth until the respiratory act is carried to the highest pitch of which it seeps capable, when the respirations pursuing a descendant seale, regularly diminish until the commencement of another appeal period. During the height of the paroxysm the vesicular murmur becomes intensely puerile.”
Subsequent lectures on medical education were somewhat similar to those of Graves Colles, and Corrigan.
He died in 1778 beloved as a man, revered as a teacher and honored in every way a grateful profession could show its appreciation.
Probably the name most familiar in the entire group under discussion is that of Robert James Graves. This distinguished Irish physician was born in Dublin in 1796. Though the son of a clergyman he seemed to have considerable means at his disposal for after graduation in medicine in 1818 he made a three year tour of the various European clinics and schools. His spirit of adventure was quite satisfied by his arrest as a German spy and by his experience with a mutiny on a Mediterranean ship. As this showed the resourcefulness and leadership that were to aid him in his later work it will probably be proper to tell some of the details of the latter episode.
He had embarked at Genoa for Sicily, Graves and a poor Spaniard being the passengers. In a storm the sails were blown away and the vessel began to leak. The crew was making plans to forsake the vessel when the Spaniard heard them say that that the two passengers were to be left behind. When this was reported to Graves, who was sick and lying on a couch below, he seized a heavy axe, gained the deck, and then was told by the captain that the crew intended to leave the passengers. “Then,” exclaimed Graves, if that be the case, let us all be drown together. It is a pity to part good company.” With his axe he then demolished the single lifeboat that the crew was preparing to launch, took command of the ship, furnished the leather from his own boots to repair the leaky valves and the vessel was saved.
Upon his return to Dublin in 1821 he soon became chief physician to the Meath Hospital and one of the founders of the Park Street School of Medicine. It was at these two institutions that accomplished his notable achievements. He is probably best known for his description of hyperthyroidism, a description so complete that even now that disorder is still known as “Graves Disease.” This article was published in 1835 and I am very sorry that I was unable to secure a copy of it.
He and his followers, however, apparently attached more importance to his “Clinical Lectures,” published in 1848. These lectures, taken from his clinical work, cover almost the entire field of medicine but deal principally with the various fevers. Most of the lectures are illustrated by case reports. Among original procedures described in these lectures were the recognition and significance of the pinpoint pupil and the timing of the pulse with a watch. In them we note too his familiarity with the stethoscope which had been invented only a few years before by Laennec. For example in discussing the lung finding in influenza, he states: “On applying the stethoscope over various parts of the lung you will hear at various parts a moist crepitus indicating the existence of serous infiltration. The smaller bronchial tubes and air vesicles are congested and filled with mucus; the blood cannot pass freely through the lung and consequently must be imperfectly serrated; the secreting and absorbing functions of the lung are deranged, and hence arises a state in which the pulmonary capillaries become congested, and permit the more fluid part of the blood to exude into the parenchyma of the lung, giving rise to what is termed serous infiltration. Something similar to this occurs also in general bronchitis, particularly in fever, but we very seldom have hepitization resulting from such causes. In hepitization the capillaries pour out not serum but lymph, which glues together the cells of the pulmonary tissue and forms a dense solid mass. Hence in influenza or bronchitis we seldom have true pneumonic inflammation.”
In another lecture he justifies the use of placebo early in fevers before definite medication is indicated. After telling how some men are frank enough to say that no medicine is indicated even though the family expects, he continues as follows: “Conduct like this has frequently brought down great censure on medical men. It may be said that these are mere prejudiced and above the dignity of a man of firm and consistent character; but when prejudices are intimately blended with human nature, and constitutes, and it were, a part of it, it is much better in many cases to submit to them, particularly when compliance does not involve a sacrifice of principle.” It seems to be that that is still excellent advice and probably has much to do with the success of many men in the profession who are known for their wonderful personality.
Graves’ principle scientific work was probably his fight against the various fever plagues, continuing at intervals over a period of 30 years. From his description of the tongue and other physical signs he evidently recognized the acidosis of starvation. The generalized custom before his time was to starve and purge fever patients. His treatment consisted of the administration of tonic and supportive measures. What he himself though of this contribution can be judged from what he chose for his epitaph, namely: “He fed fevers.” Other contributions he made were publications on angionerotic edema and scleraderma.
While Graves had an aggressive sarcastic exterior he had, like most really great men, a warm heart as is evidenced by his reform in the hospitals in regard to the unnecessarily rough treatment of the poor patients. However, he will probably be remembered longest by his innovations in medical education. He initiated and popularized the clinical method of teaching the elementary students. His death in 1853 removed an outstanding figure among the great clinicians of the 18th century.
William Wallace (1791- 1837) is known principally for his introduction of the use of potassium iodide in the treatment of syphilis. He was interested too in other skin diseases and in rheumatism. Chlorine as a remedy for some skin diseases was another of his suggestions.
Abraham Colles was a distinguished surgeon of that period. His great success was gained entirely by his own efforts. He was poor and had few, if any, social connections to aid him. He was, however, one of those individuals, which a single-tracked mind and that track was his profession. His birth occurred in 1773 at Milmount, two miles from Kilkerny and his early education was received at an endowed school in the latter place. In 1790 he entered the University of Dublin. Here, as later, he aimed at ultimate success in life rather than at high grades a lone although he passed creditable in all his work. Upon completing his studies there he became an apprentice to Dr. Woodroffe at that time R4esident Surgeon at Steven’s Hospital. In 1795 he received his diploma from the Royal College of Surgeons of Ireland. This was followed by two sessions at the University of Edinburgh where he received his M.D. degree. Some time was then spent visiting at the various London hospitals, and it was then that he met Sir Astly Cooper and the two developed a friendship that lasted throughout life. Sir Astly Cooper was then preparing some work on the subject of hernia and Colles helped him with his dissections. This experience led Colles to become interested in Anatomy and he began a book on Surgical Anatomy, which unfortunately was never finished. In this book he departed from the customary divisions or osteol9ogy, mycology, neurology, etc., and instead considered each part of the body as a unit and tried to show the relation of blood vessels, nerves and muscles as they acted together. The impression derived from a description of this work is that it was the forerunner of the applied anatomy textbooks of today (for example that of Davis used in our school today).
The year 1797 marks his return to Dublin where, McDonald says, he began practice with astonishing industry, excellent health, amiable temper, frank vigorous character and courage, little money and practically no friends. His first hospital work was in the Sick Dispensary at Meath Street hospital. Later he became District Visitor to the Sick and Indigent Room keepers Society. This was more of a benevolent rather than professional work but through it he made contacts that encouraged him to stand examination for resident Surgeon at Steven’s Hospital to which position he was appointed in 1799.
In 1802 he was elected president of the Royal College of Surgeons of Ireland and held this position again in 1830. In 1804 he became professor of Anatomy and Surgery of the Royal College of Surgeons of Ireland and held this position for 32 years. He published his paper “One the operation of Litholomy” in 1811. This was based largely on his textbook of anatomy. In 1813 he reported and discussed several cases where he had ligated the subclavian artery. An article followed this on “Certain Diseases of the Anus and Rectum.” This includes an excellent description of Stricture of the rectum, which he treated by dilatation with a bougie in addition to medicine internally, and also of hemorrhoids. I his operative technique for the latter he emphasized the care to be taken lest contracture occur afterward.
His famous paper “On the Fracture of the Carpal Extremity of Radius” was published in the Edinburgh Medical and Surgical Journal in 1814. His description was so accurate and thorough that that condition has since been known as Colles’ Fracture. I am sorry that time will not permit the incorporation of this entire paper. I would like, however, to quote just this much to give an idea of his excellence of description, “Then he (the surgeon) moves his fingers along the anterior surface of the radius he finds that it is more full and prominent that is natural; a similar examination of the posterior surface of this bone induces him to think that a depression is felt about an inch and a half above its carpal extremity. He now expects to find satisfactory proofs of a fracture of the radius at this spot. For this purpose he attempts to move the broken pieces of bone in opposite directions; but although the patient is by this examination subjected to considerable pain, yet neither crepitus nor a yielding of the bone at the seat of fracture, now any other positive evidence of the existence of such an injury, is thereby obtained. The patient complains of severe pain as often as any attempt is made to give to the limb the motioning of pronation and summination.” This exert will show his style of expression which was not grandiloquent but rather elegantly simple and a cute.
There was nothing of smallness or malice in his make-up. He stimulated and inspired his competitors and was loved by all. In 1800 when he began active teaching there were about 60 medical students in Dublin. This Humber had been increased to 1000 when he resigned in 1836 and no little of the credity is due him for this increase. When he began practice, surgery in Ireland was in poor repute, being considered as a sideline, and a rather despised one, of medicine. He elevated it tremendously. His home life was happy and those of his friends who knew him best loved him most.
In 1837 he published a book upon veneral diseases deciding upon this subject since he considered the confliction of opinions and lack of progress there was a discredit to the profession. A review of this book would be a subject in itself for an entire paper. Probably the most important facts he presented were these three: First, the introduction of the use of small doses of mercury in the treatment of syphilis; secondly, his solution of the question as to whether or not secondary veneral symptoms of communicating the disease, and thirdly, the observation that syphilitic babies nursed at the breast often infected wet nurses but never their own mothers. It was this last fact that led to the establishment of Colles Law in regard to the inheritance of syphilis.
In 1839 he refused an offer of a barometry because such distinction had no attraction to him personally and such a hereditary title would be an inconvenient honor in consequence of the distribution he intended to make of his property amongst his children.
He died in 1843 having been a credit not only to his profession but also to the manhood of his time.
Francis Rynd (1801-1861) another member of this group was especially interested in veneral diseases, publishing an article entitled “Stricture (pathological and practical observations.)” His chief claim to renown, however, rests upon his introduction of the hypodermic method of medication for the relief of pain. This he accomplished by the use of a small gravity device of his own invention. He possessed an extremely modest disposition and allowed a Scotchman named Wood to be given most the credit for priority in this field. Investigators have, however, clearly established since then that honor belongs to Rynd. In his description of the instrument and its use, he says, in part, “ The smaller instrument is for deep-seated nerves; for though it is not necessary to introduce the fluid into the nerve itself to ease the pain, still the nearer the seat of pain is conveyed the more surely relief is given. The fluid I have found most beneficial is a solaria of morphine in creosote, 10 grains of the former in 1 dram of the latter; six drops of this solution contain 1 grain of morphine and a grain or two may be introduce in cases of sciatica at one operation with the very best effects.” Such was the beginning of one of the greatest remedial measures used today for the benefit of mankind.
With such contemporaries as these, particularly those of the Meath Hospital group, any other physician prominent at that time would necessarily have to be accomplished to be outstanding. Such a man was Sir John Domini Corrigan. He was born in 1802 the son of moderately well to-do parents. He received a good preliminary education and then entered Maynooth College. His aptitude for physical sciences was early apparent. After serving an apprenticeship to Dr. O’Kelly, the college physician, he went to the University of Edinburgh, where he received his M.D. degree in 1825, well qualified in French, Latin and Greek as well as the purely medical sciences. Shortly afterwards he returned to Dublin and later became attached to the Jervie Street Hospital. Here he had a service of only 6 beds but by the proper selection and thorough study of those cases he derived most of the facts, which enabled him to contribute what he did to our knowledge of sortie regurgitation. According to custom he was required to aid the hospital financially for the use of those beds and he is quoted as saying later that he accomplished what he did there by trying to get value for money spent. His paper on “Aortic Regurgitation” was published in 1832 when he was 30 years of age. Its title was “ On permanent Patency of the mouth of the aorta. Or Inadequacy of the Aortic Valves.” It was most complete and even now could nearly be considered the last word on the subject. Several beautiful and clear plates enhanced the pathological description. It was in this paper that he described the water-hammer pulse now more commonly known as Corrigan’s pulse. In 1838 his other great paper was published on Cirrhosis of the lung, distinguishing that condition from tubercular phthisis. These were his outstanding original contributions to medicine and pathology. In 1843 he applied for examination to membership of the Royal College of Surgeons of England. The first and only question asked him was, “are you the author of the essay on the Potency of the Aortic Valves?” His affirmative answer admitted him to the society. His reputation and practice gained him other connections with hospitals and schools including the following _Diggs Street School, Peter Street School, Richmond Hospital, Clerk Street Hospital, and Whitworth Medical and Hardwick Fever Hospitals. As a result of this work he prepared a systematic series of lectures on “The Nature and Treatment of Fever,” which he published in 1853. In addition to the papers mentioned there were others on varied subjects. His keen interest in pathology, his bedside clinics his kind disposition and his tireless application to his work remind one of the great Osler who was to come.
Corrigan was thoroughly big man, competent in many fields of endeavor. In fact his title was the reward largely for his work as Commissioner of Education for many years. During the famine in 1846 he worked for the General Board of Health of Ireland with all his energy. Some publications at that time dealt with famine and fever. In 1847 he was appointed Honorary Physician in ordinary to Queen Victoria, a most unusual distinction for a Catholic. He became a Fellow of the Royal College of Physicians of Ireland in 1859 and was later president for several terms. In 1866 he published a cholera map of Ireland. During that same year he was created a baronet.
In 1877 at a meeting of the British Medical Association he delivered an address urging higher standards for the profession because of the dignity and breath of vision which he regarded as such vital parts of a physician’s make-up. It was in this speech that he uttered that eloquent statement “We know no difference of race, or creed, or color, for every man is our neighbor.”
From 1870-1874 he was a Member of Parliament but did not distinguish himself there as he had done in other fields. Further pursuit of that work was stopped by his defeat in 1847 brought about principally by his advocacy of the Sunday Closing Law.
Throughout his life he was a firm fighter for Irish freedom and religious equality for all. He was a follower of O’Connell and opposed to bloodshed and violence as means of acquiring these objectives. As Williamson states Corrigan was a believer in the greater freedom of thought in religion that is, the freedom to believe something and to believe much rather than that petty freedom (discussed so much today) to believe little or nothing at all. In his later years Corrigan’s comfort was disturbed by gout and in 1880 he died after several paralytic strokes. His stainless character, his kind personality, his efforts to improve the conditions of his fellowman, his devotion to his religion when such was unpopular and his scientific achievements (including in addition to those mentioned his observations of cerebral breathing typhus fever, the expansible pulsation of aneurysms? Well make him worthy of his title as one of the most famous Irish Physicians of the past.
Corrigan was the last to go and at his death the Irish School of Medicine became a part of medical history but its enviable position must be forever fresh in our memories. Until judgment day physicians will bring into this world babies born under Colles’ law and will treat some of them later with Potassium Iodide solution as advocated by Wallace when they present the expansible pulsation of aneurysm as noted by Corrigan, or the slow pulse of the Stokes-Adams syndrome if there be luetic involvement of the suriculo-ventricular bundle. These latter patients will have to be differentiated from those who may have been over digitalized in an effort to relieve the decomposition of an aortic regurgitation that presents a Corrigan or water hammer pulse. The development of Cheyne-Stokes respiration will often warn of death’s approach and the end will be more peaceful and free from pain when Rynd’s suggestion for the Hypodermic injection of medication as is followed.
“Medicine in Ancient Erin” –Borroughs Welcome 1909.
“Medical History of Meath Hospital 1888.”
“Clinical Lectures- Robert James Graves” – E. Harrington And G.D. Haswell, Philadelphia.
“Memories of John Cheyne” –T.J. Tettigrew, London, 1839.
“Historical Synopsis of the development of Hypodermic Medication” Charles A. Pfender, M.D., Washington Medical Annals – Vol. 10, pg 346.
“Cheyne-Stokes Respiratory Phenomena”- Nathan Smith Davis, Journal A.M. a., July 24, 1897.
“Wm. Stokes – His life and His Works” Wm. Stokes, Jr., London, 1898.
“Introductory Lecture Delivered on Nov. 1, 1860” Robt. Adams, (21pp. Dublin J.M. O’Tolle, 1860).
“A Treatise on the Veneral Disease –Its Varities,” Wm. Wallace – XLL 382 pp 8- London, Burgess & Hill, 1833.
“Selection from the works of Abraham Colles Consisting Chiefly of His practical observati9ns on the veneral disease and on the use of Meercury” Robt. McConnell XVI, 431, pp-post 8, London, New Sydenham Society, 1881.
“History of Medicine” –Fielding &Garrison.