Biography of the so-called “great men” of medicine has frequently been disparaged by academic historians—especially when the author is a retired clinician. This has often been justified, as some of the works are mere collections of readily available facts with no synthesis and little understanding. Whiggish hagiography is easy to write. But good biography is important. Those who would try to understand the fundamental trends of the past and interpret them for today must know about the protagonists and be able to rely on accurate scholarship about them. The skills that the experienced clinician biographer brings to the work are very similar to those he used with his patients. The collection of primary source material (clinical examination, x-rays and pathology results), formulating the hypothesis (diagnosis) and then testing it (the treatment and follow up) is little different to the technique of a trained historian.
Haygarth was a “great man”. A true child of the Enlightenment, he had a wide circle of correspondents and friends including William Cullen, John Fothergill, Sir Joseph Banks, William Heberden and, across the Atlantic, Benjamin Waterhouse. He became an extremely busy physician in Chester, where he demonstrated that it was easier to put ideas into practice than in London. Thus he formulated a plan, which was in a great measure successful, to eradicate smallpox in the town by inoculation. Later, he wanted to extend the plan nationwide, but nothing came of it, and shortly afterwards vaccination was promoted. On the basis of his own experiments, he believed that fever was contagious. He set up fever wards for the poor in the local infirmary, and this work laid the conceptual foundations for isolation hospitals.
At the age of fifty-eight he retired from clinical practice and went to Bath, the city of Jane Austen, Edward Jenner and Caleb Hiller Parry. For some years the Bath Philosophical Society met in his house. He turned his attention to literary work based on the mass of clinical notes he had made. This led to further publications on fever, rheumatism, and, possibly unwisely, he entered into the virulent controversy in Philadelphia as to whether what we now call yellow fever was endemic or imported from the Caribbean.
Perkins' Tractors had become the fashionable cure-all among the valetudinarians in the town, and Haygarth exposed Perkins as a fraud and made sure that the deception was widely exposed.
True to the spirit of the age, he engaged in philanthropy. A devout Anglican, he was always interested in education for the poor and, having been a governor of the Blue Coat School in Chester, he proposed that a similar scheme could be introduced in every parish in England at very little cost. In his later years his other great interest was in devising and setting up the Bath Provident Institution as a savings bank for the benefit of the thrifty and industrious.
This study is not only a delight to read, but it will be of great value to many researchers. Anybody looking at the genesis of the understanding of fever, medicine in small town Georgian England, the history of smallpox, the transatlantic passage of medical knowledge, education for the poor and the start of the Friendly Society Movement will find something of value. Those interested in Booth's previous work on the medical connections of the Yorkshire Dales will not be disappointed.
The book is well produced and impeccably referenced. Booth, a true clinical historian, has made his case that Haygarth's name should be placed “alongside the great pioneering philanthropists of the age”.
