Original Article
SURGEONS
Thomas Paytherus (1752–1828): Entrepreneurial surgeon-apothecary and ardent Jennerian
Journal of Medical Biography 21(3) 169–179 ! The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0967772013479285 jmb.sagepub.com
Henry Connor1 and David M Clark2
Abstract Thomas Paytherus was born in Fownhope and apprenticed in Gloucester. He practised there and in Ross-on-Wye where he and Edward Jenner undertook an autopsy on a patient with angina that they linked causally to coronary artery ossification. In 1794 Paytherus moved to London and opened a highly successful pharmacy that he later sold to his partners Savory and Moore. Paytherus was among those who advised Jenner on the publication of his work on vaccination. Then he acted as an intermediary in the dispute between Jenner and Ingen-Housz and also alerted Jenner to Pearson’s claims as a pioneer of vaccination. In 1800 he published a detailed analysis of the dispute between Jenner and Woodville whose patients had developed variola-like lesions following vaccination. Their correspondence shows that Paytherus, Jenner and their families remained firm friends. Paytherus and his family moved to Abergavenny where he died in 1828.
Keywords Paytherus, Jenner, Glocestershire Medical Society, Vaccination, Medicine Chests, Herefordshire
Introduction Thomas Paytherus was born in Fownhope, Herefordshire in 1752. His father, also Thomas, came from a family of yeoman farmers who had lived in the village for at least 300 years during which time they had accumulated substantial land-holdings.1
The early years In 1769 Paytherus was apprenticed for five years, and for a fee of 200, to Richard Browne Cheston, a Surgeon at Gloucester Infirmary.2 Cheston’s father, Joseph, came from Hereford and the Cheston family owned land in Fownhope, adjacent to the Paytherus land-holdings.3 In 1723 Joseph was apprenticed to an apothecary in Gloucester.2 Richard Browne Cheston had been appointed Surgeon to the Gloucester Infirmary in 1762 and therefore was already well established by the time he took Thomas as his pupil. By 1783 Cheston had been elected a Fellow of the Royal Society and in 1787, aided by the acquisition of a Lambeth MD,4 he resigned his post as surgeon and was elected Physician to the Infirmary.5 It is likely, therefore, that Paytherus received an above-average education from his ambitious master.
At the end of his apprenticeship, Paytherus went first to London where he studied under Henry Cline (1750– 1827) and then to Edinburgh where he attended Joseph Black’s (1728–1799) lectures on chemistry.6 His choice of Cline is interesting. Cline was only two years older than Paytherus and had only just obtained his diploma from Surgeons Hall in June 1774, the year in which Paytherus went to study under him. However, he had been thought competent to teach anatomy at St Thomas’s Hospital while still an apprentice.7 Apart from his inexperience, Cline’s extremely radical political views might have led some to question his suitability as a mentor for an aspiring young doctor. He became a supporter of both Horne Tooke (1736–1812) and John Thelwall (1764–1834) and, like them, of the French Revolution. When Astley Cooper (1768–1841) became his pupil in 1784, Cooper’s mother was very concerned 1 2
Vineyard Road Hereford, HR1 1TT, UK Independent Historical Geographer, UK
Corresponding author: Henry Connor, Retired physician, Honorary Research Fellow in the History of Medicine, University of Birmingham, 1 Vineyard Road, Hereford, HR1 1TT, UK. Email: [email protected]
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that he would be influenced by Cline’s radical opinions that were, at that time, considered by many to be frankly subversive. In the event it was to be Cline’s influence with the French revolutionaries that protected Cooper when he was studying in Paris in 1792. Thereafter, Cline’s patronage would also have proved useful in England because he was appointed Surgeon to St Thomas’s Hospital and later became Master and then President of the College of Surgeons.7,8 Whether Paytherus shared Cline’s political views is not known. Black, by contrast, was already an established figure by the time Paytherus arrived in Edinburgh. He was one of the outstanding chemists of the day and an excellent lecturer whose lectures were always packed.9 Paytherus probably moved to Edinburgh during the latter part of 1775 since on 9 December he was elected a member of the Royal Medical Society in that city10 but he does not appear to have registered as a student at the university so was probably never intending to take a degree. By 1777, he had returned to London where on 3 July he received the Diploma of the Company of Surgeons.11 His father died in the same year and Paytherus promptly sold much of the family’s land in Fownhope.12 Some of the capital he raised would have enabled him to establish himself in practice as a Surgeon in Gloucester whither he then moved. The accounts of the Gloucester Infirmary for 1780 show that Paytherus was one of its subscribers.13 Of the 12 medical men listed in The Medical Register as practising in Gloucester in 1780,14 Paytherus was one of only three who subscribed to the Infirmary which might suggest he was hoping to forge closer ties with that institution. If so, he was to be disappointed because in 1783 Samuel Vaughan Cheston, the son of his former master, returned to the city15 and immediately was appointed a Surgeon to the Infirmary.5 His hopes thwarted in Gloucester, Paytherus would already have known that there was little chance of an appointment to the infirmary of his native county in Hereford. In 1783 the Hereford General Infirmary, which had been founded in temporary accommodation seven years earlier, was poised to move into its new purpose-built home on the banks of the River Wye. However, it already had a full establishment of three surgeons, none of them near retirement age; two, like one of the two physicians, were members of a local medical dynasty, the Cam family, and if one of the existing surgeons had died unexpectedly there were two other surgical members of the family waiting in the wings.16
The country surgeon With no hope of a surgical post in Gloucester or Hereford, Paytherus turned his attention to the market town of Ross-on-Wye which was only 17 miles from
friends in Gloucester and less than nine miles from his native Fownhope. While Ross did not offer the prestige of an infirmary appointment, it was increasingly establishing itself as the starting point for the fashionable Wye Tour. The river journey from Ross to Chepstow had become an essential part of the late eighteenth century Picturesque Movement and only the year before had received an additional stimulus from the publication of the influential Reverend William Gilpin’s (1724– 1804) Observations on the River Wye. The entrepreneurial spirit in Paytherus recognised the opportunities presented by a town that was attracting genteel wealth on an increasing scale and in 1783 the Medical Register recorded his arrival there, ‘removed hither from Gloucester’.15 Paytherus set up house in the fashionable riverside hamlet of Wilton, just outside the town.17 It is clear, however, that other doctors had also recognised the possibilities that Ross now offered. Faced with stiff competition, Paytherus promptly entered into partnership with a long-established apothecary, William Wood (1707–1794). At this time, Wood was already aged 77 and so Paytherus must have had a reasonable expectation of acquiring the whole practice in the not too distant future. However, when the fiveyear partnership expired, Wood was not only still alive but announced his intention of ‘continuing business as usual’ and then went on to live for a further six years.18 Paytherus enhanced his income by taking an apprentice soon after he arrived in Ross, for which he received an indenture fee of 170. The apprentice, Richard Evans, served a seven-year apprenticeship after which he joined Paytherus in partnership2,18 and was still practising in Ross until 1828 at least. As the junior partner, one of the duties Paytherus inherited from Wood was the contract for medical care of the poor in the parish of Kings Caple, some six miles from his house. He held this appointment for the 11 years in which he remained in Ross, after which the job was taken over by Richard Evans. The contract was for five guineas annually and this probably included the supply of medicines. Some midwifery and other services attracted additional fees so the total annual payment was sometimes as much as 10. In the light of the support Paytherus was later to give Edward Jenner (1749–1823) when the latter proposed the practice of vaccination in 1798, it is of some interest that the overseers of Kings Caple should have introduced free inoculation with smallpox (variolation) in 1784. This was the year after Paytherus had taken over as parish surgeon and it seems probable therefore that the practice was introduced through his prompting.19 The practice of variolation had been introduced into England from Turkey in the 1820s, amid considerable controversy, by Lady Mary Wortley Montagu (1689–1762).20
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Angina and the Glocestershire Medical Society Paytherus had established some important medical friendships while living in Gloucester. These included John Heathfield Hickes who, by 1780, was a Physician at the Infirmary, Edward Jenner who was by then at Berkeley, Caleb Hillier Parry (1755–1822) who became a physician in Bath21 and Daniel Ludlow who became a surgeon in Chipping Sodbury. In May 1788 these five men formed the Glocestershire [sic] Medical Society.22 Later, in 1799 Parry wrote ‘we were all virtually either school-fellows or fellow-students’ and that by this date he had known Paytherus and Ludlow for about 20 years and the other two for almost twice that time.23 Jenner, Hickes and Parry had all attended the Reverend Dr Washbourn’s Grammar School at Cirencester, though Jenner was two years older than Hickes and six years older than Parry. Jenner had been apprenticed to Ludlow’s father.24 It is possible that Paytherus and Hickes might also have known each other in Edinburgh where the latter obtained his doctorate in 1775. Parry also held an Edinburgh doctorate but this was not awarded until 1778.25 The five friends were the only members of the Glocestershire Medical Society. Two years before the society was founded, Paytherus had invited Hickes and Jenner to visit him in Ross to witness the post-mortem examination of a patient of Paytherus, a Mr Bellamy who had died following a history of increasing angina.23 At this time both John Fothergill (1712–1780) and William Heberden (1710– 1801) had published precise descriptions of the clinical features of angina but neither had suggested any clear aetiological hypotheses.26 Jenner had already begun to suspect it might be due to disease of the coronary arteries after finding severe calcification of these vessels in a post-mortem examination on one of his own patients a few weeks earlier. Before the examination of Paytherus’s patient therefore he offered a wager that they would find ossification of the coronary arteries. In fact, the calcification was found to be protruding into the lumen of the vessel and Paytherus showed this by performing, in effect, a post-mortem endarterectomy, the intima separating, in Jenner’s words, ‘as easily as a finger from a tight glove’.23 Paytherus did not publish details of the case although at a meeting of the Glocestershire Medical Society three years later he ‘read a case and dissection of a patient who had died of angina pectoris’.22 This must surely have been the same case. In the meantime, the Society had also heard Parry present a case of a patient with angina and severe coronary artery disease22 and when Parry published his monograph on this subject in 1799 he included a letter from Paytherus that gave full details of the latter’s case.23 The link between angina and
coronary artery disease therefore was made jointly by Parry, Jenner and Paytherus. The meetings of the Glocestershire Medical Society were held at the Fleece Inn in Rodborough, between one and four o’clock in the afternoon and were followed by dinner. Rodborough is South of Gloucester and some 30 miles from Ross on Wye which made it a significant round trip for Paytherus. He attended only four of the 12 recorded meetings between May 1788 and June 1793 and was late on one of these occasions. As members paid a fine of one guinea for every meeting they missed and 10 s 6d on every occasion when they were late,22 his membership cost him dearly but undoubtedly he put a high value on the friendships. On New Year’s Day of 1786 Paytherus married Frances Hodges at Bridstow, less than a mile from his home, thereby strengthening his links in the area. His intention of remaining in Ross seems to have been confirmed when, after the expiry of the indenture of Richard Evans in 1790, he took on another apprentice, John Evans, for five years and a fee of 205.2 The increase in the indenture fee presumably reflected his greater experience and also an increased standing within the local community. During his time in Ross Paytherus had, according to Jenner, ‘great practise as a surgeon and man midwife, but over application injured his health. He then resolved to pursue another plan in life . . .’6 and moved to London in 1794.
Druggist and surgeon in London At first Paytherus lived in Mortlake while he prepared for his new life in London.27 Then in June 1794 he took a lease on the ground floor of 136 New Bond Street (renumbered as 143 in about 1840). The premises consisted of a shop, parlour and other back rooms, cellars, a carpenter’s shop and a bedroom. The lease was to run for 11 years from Lady Day 1794 and the rental was 200 per year. Paytherus was to keep the property in good repair and was not to carry on any noxious trade.28 Here he set up the ‘Chemical, Drug, and Medicinal Warehouse’ where he manufactured and sold a great variety of proprietary medicines. To assist him in fitting out the premises he consulted the Reverend Robert Ferryman (1752–1837)27 who at this time was living in London and who was later to construct the Temple of Vaccinia in Jenner’s garden at Berkeley. It seems probable that Paytherus and Ferryman would have known each other through their Gloucester connections even though Paytherus had left Gloucester nine years before Ferryman arrived in the city.29 Paytherus advertised his proprietary medicines with great vigour in The Times and elsewhere. Among his products were ‘The Chalybeate Aperient, or true
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Cheltenham Salts’ which, when dissolved in Malvern water or any other pure water, were in ‘no respects inferior’ to the waters from the Cheltenham Spa.30 Edward Jenner, who was a great advocate of the spa water at Cheltenham, told Joseph Farington (1747–1821) that the Chalybeate Aperient made ‘a more efficient dose than the water itself does when carried from Cheltenham’. Jenner explained that Paytherus had analysed the Cheltenham water, separated its constituent salts and then re-combined the salts in the appropriate proportions to make the Chalybeate Aperient6 (Figure 1). Among his other products were an ophthalmic unguent that ‘never fails to remove those obstructions which form in the eyelids after the measles, smallpox, and other eruptive disorders’, antirachitic tablets that were ‘a certain cure’ for rickets and other disorders and, for the nursing mother, nipple liniment which was ‘a certain remedy’ for a condition ‘hitherto deemed incapable of relief’’.30 These confident claims, which fall so uncomfortably on the modern ear, were by no means exceptional for the time, even from an orthodox practitioner. For example, Edward Jenner had devised Dr Jenner’s Absorbent Digestive Lozenges’ and the friendship between Paytherus and Jenner had enabled the firm to gain exclusive manufacturing and sales rights to this product.31 Jenner clearly had no objection to being associated with the marketing methods used by Paytherus. Savory and Moore were still marketing the absorbent lozenges and chalybeate aperient in 1824. Their properties were extolled in an empirical pamphlet that produced a torrent of derisory invective from
Figure 1. The Chalybeate Aperient, as sold by Paytherus, Savory and Moore. (Reproduced by courtesy of the Smithsonian Institution.)
Richard Reece (1775–1831), editor of the Monthly Gazette of Health32 and, some years later, an equally sarcastic article in the Literary Gazette.33
Medicine chests Paytherus also advertised ‘Medicine Chests of different sizes, for Families, Officers in the Army or Navy, Gentlemen travelling to the Continent, or to the East or West Indies’.30 One such chest, made in 1804, is now in the Smithsonian Institution (Figure 2). The original owner was Ian Wilbraham Willink, originally of Amsterdam and later of 18 Wall Street, New York. The case contains more than 30 medicines together with plasters, lint, tape, a glass mortar, scales and other utensils (Figure 3). Also included was a booklet titled A companion to the medicine chest that described the medicines and their uses.34 What appears to be an identical booklet, published in 1804 (the same year as Willink’s chest), is in the Wellcome Library in London (Figure 4). It is described as being the third edition and written by a medical practitioner.35 It seems probable it was written by Paytherus who was the only medical practitioner associated with the firm, and certainly one of the later editions was written by a descendent of one of his partners.36 The business in New Bond Street was an immediate success. According to Jenner, Paytherus cleared his expenses of 800 after just one year.6 Within five years he was able to purchase the lease on the property
Figure 2. A Medicine Chest sold by Paytherus & Co. in 1804. (Reproduced by courtesy of the Smithsonian Institution.)
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Figure 3. The contents of the medicine chest. (Reproduced by courtesy of the Smithsonian Institution.)
Figure 4. The companion booklet to the medicine chest. (Reproduced by courtesy of the Wellcome Institute.)
which still had 16 years to run.28 In 1797 Paytherus had been joined in the business by Thomas Field Savory who had been apprenticed to an apothecary in Cheltenham and who might therefore have been recommended to Paytherus by Jenner. Nine years later Savory was taken into partnership, as was Thomas Moore who had practised as an apothecary in
Norfolk Street in London where, as described below, Paytherus was in practice as a surgeon.31 The business was patronised by the rich and the famous. Emma, Lady Hamilton, who lived nearby, became a lifelong customer37 and by 1806 the firm was dispensing prescriptions for the Prince Regent and other members of the Royal family.38 The Royal Patronage was probably attributable to Savory, an enthusiastic socialite and patron of the arts, who was a close friend of the Duke of Sussex, the sixth son of George III and, like Savory, a prominent Freemason.39 The Duke was often entertained to dinner in the dining room over the shop, as also was Emma.37 When Savory and Moore were taken into partnership in 1806 the partnership agreement showed that the stock-in-trade, the house with lease, utensils, furniture and fixtures were valued at 3,427. Just five years later, when Paytherus retired from the partnership, Savory and Moore had to find a further 21,700 to buy him out. In the meantime, a branch had been set up in High Street, Cheltenham in 1809 but this was not included in the buy-out.31 The firm of Savory and Moore continued trading in New Bond Street until 1981.40 The property is now a children’s outfitters but the names of Savory and Moore are still to be seen on the wrought iron portico. While Paytherus had been in charge, the day-to-day business had been in the hands of a ‘foreman’6 which allowed Paytherus time to practise as a surgeon. According to Richmond et al31 he had established a retail chemist’s business at 1 Norfolk Street, The Strand, in 1794. However, it seems more probable that this was the address of both his home and his medical practice. It is certainly the address that was given in the articles of apprenticeship when he took on Thomas Baldwin as an apprentice in 1797 and John Purchas in 1800.2 The indenture articles of 1797 described Paytherus as an apothecary and those of 1800 as a surgeon but he probably practised as a surgeon-apothecary throughout his career. The indenture fees (300 for a seven-year apprenticeship for Baldwin and 410 for a five-year term for Purchas) were considerably greater than those paid to him for his apprentices in Ross and presumably indicate both a London premium and his increased experience and status. John Purchas was probably the son of Nathaniel Purchas, a merchant in Paytherus’ home village of Fownhope. As John did not practise medicine on his return to Fownhope,1 it seems that he did not complete his apprenticeship. Just as the business in New Bond Street attracted some of the grandest clientele, Paytherus’s medical practice, which included Lady Berkeley,27 also attracted some very fashionable patients. Although Richmond et al31 gave Paytherus’s address as 1 Norfolk Street, it is also given at various times as
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number 341 and as number 13 in 1802.42 Whether these changes represent house moves or renumbering of houses has not been ascertained. By 1805 he had acquired a property at 108 Great Russell Street, near Bedford Square, in addition to the house in Norfolk Street but he seems to have left the latter by 1806.43 Fisher44 refers to Paytherus owning a property in Great Rupert Street but this almost certainly derives from a misreading by Fisher of a letter from Jenner to Paytherus45 where the word Russell is far from clear. While at Great Russell Street he was in partnership with another surgeon-apothecary, George Man Burrows (1771–1846) of Bloomsbury Square, near his home in Great Russell Street but at the far end from Bedford Square.46 This partnership was dissolved in February 180947 which may represent the date of Paytherus’s retirement from active medical practice. Burrows, who was still only 38, went on to achieve eminence as a medical reformer, as the Founding Editor of the London Medical Repository and as an expert alienist.48
Paytherus, Jenner and vaccination Paytherus must have been a busy man in the years around the turn of the century as he worked to build up both his practice and his business. Nevertheless, he devoted much time to supporting his old friend Edward Jenner as the latter strove to make vaccination an established and accepted practice. Jenner was not the first to practise vaccination. The Dorset farmer, Benjamin Jesty (1736–1816) had inoculated his wife and two elder sons with cowpox more than 20 years earlier in 1774. Although Jesty’s experiment was successful his actions met with great hostility in Dorset where he was often reviled and ostracized.49 In later years, Jesty did not always receive the recognition which his pioneering work deserved but credit for the introduction of vaccination into medical practice is deservedly given to Jenner because, as Francis Darwin was later to remark in a different context, ‘. . . in science the credit goes to the man who convinces the world, not to the man to whom the idea first occurs’.50 Even with his influential contacts, Jenner struggled to gain recognition of the benefits and safety of vaccination. Some doctors were, like Paytherus, enthusiastic supporters of the new practice but in the early years there was also considerable medical opposition. Of Paytherus’s own mentors, Henry Cline had obtained vaccine from Jenner and had carried out successful vaccinations as early as July 179851 but Richard Browne Cheston was still opposing the practice in 1801.52 It is indeed ironic that in Jenner’s home county there was still considerable opposition to vaccination as late as
1810 when a group of doctors formed the Gloucestershire Vaccine Association with the aims of promoting vaccination and of discouraging inoculation with smallpox.53 By contrast, a number of Herefordshire doctors, including a former apprentice of Paytherus, Richard Evans, had become enthusiastic converts by 1802.54 Jenner had performed his first vaccination in 1796 and, by March 1797, he had prepared a manuscript which he submitted to Sir Joseph Banks (1743–1820), presumably with a view to publication in the Philosophical Transactions of the Royal Society of which Banks was president at that time. Banks asked Everard Home (1756–1832) to give an opinion on Jenner’s manuscript. Home’s reply, written on 22 April 1797, drew attention to defects in Jenner’s work and, in consequence, Banks appears to have advised Jenner that his reputation might be compromised if he published on the basis of such weak evidence.55 Jenner then carried out further vaccinations in March and April of 1798 and his work finally appeared as a private publication56 on 17 September 1798.29,57 While preparing his manuscript Jenner had sought the advice of several of his friends and colleagues. Of particular significance was a meeting held at Rudhall Manor near Ross-on-Wye, the home of Thomas Westfaling, Esq. Also present were Dr Richard Worthington, Thomas Paytherus and John Heathfield Hickes, another fellow member of the Glocestershire Medical Society.42 Saunders and Fisher state that Edward Gardner, a wine merchant from Framptonon-Severn and another of Jenner’s friends, was also present29,58 but Gardner’s name is not mentioned by Baron42 who had assistance from both Paytherus and Hickes when writing his biography of Jenner. According to Saunders and Fisher this meeting took place in March 1797 which they thought was after Banks had turned down Jenner’s original manuscript in ‘late 1796’. However, it seems unlikely that Banks would have declined the manuscript until after he had received the opinion of Everard Home which, as already noted, was in late April 1797 and, furthermore, the chronology implied in the account given by Baron,42 who had access to all Jenner’s notes and correspondence, would suggest that the Rudhall meeting took place at a later date, after June 1797 and probably only shortly before the manuscript went to press in the Spring of 1798 by which time cowpox had re-appeared around Berkeley, thereby enabling Jenner to carry out further vaccinations.59 Three months after his work had been published Jenner asked Paytherus to act as an intermediary with his Dutch critic, Dr Jan Ingen Housz (1730–1799),60 as both Paytherus and Ingen Housz were living in London at that time. Ingen Housz claimed to have discovered several instances in
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which patients had become infected with smallpox despite having previously had an illness that had been diagnosed as cowpox.61,62 Jenner doubted whether such cases had been infected with true cowpox but Ingen Housz was adamant and Paytherus reported back to Jenner that he had found him a ‘formidable opponent’ who ‘would not hear a word in defence of your opinion’.42 Jenner evidently had complete faith in Paytherus when asking him to meet with Ingen Housz because, in an undated letter to him, he wrote ‘With respect to Mr. Housz, I can only repeat what I wrote before, do with it as if it were your own & I shall be satisfied’.45 Early in the next year, 1799 Paytherus wrote to Jenner to express his concerns about Dr George Pearson (1751–1828), a Physician at St George’s Hospital and an enthusiastic promoter of vaccination. Paytherus was concerned lest Pearson might steal some of the prestige that Paytherus believed was due to Jenner.29 Shortly afterwards Jenner’s nephew, George, wrote to Jenner to reinforce the concerns expressed by Paytherus and ‘to urge the necessity of your coming to town to wear the laurels you have gained, or to prevent them being placed on the brows of another’.42 The letter was written from Paytherus’s home in Norfolk Street and it is evident that George Jenner and Paytherus were acting in concert. In a postscript, George adds that Paytherus has just told him that a copy of Pearson’s claims had been exhibited at Sir Joseph Banks’s house the day before. The two men clearly were anxious to ensure that Jenner should come to London with all possible haste. In August 1800, almost two years after Jenner’s original publication, there was still uncertainty about the benefit and safety of vaccination. Paytherus was one of 36 physicians and surgeons who put their names to a public testimonial extolling both the efficacy of vaccination and also its safety in comparison with variolation.63 The signatories included some of the most eminent doctors in the country including Matthew Baillie (1761–1823), John Coakley Lettsom (1744– 1815), John Abernethy (1764–1831) and Astley Cooper (1768–1841). In the same year, Paytherus also investigated some unfortunate cases in Clapham where vaccination had been complicated by erysipelas due to a contaminated lancet.64 This year also saw the dispute between Jenner and William Woodville (1752–1805) of the London Smallpox and Inoculation Hospital. Many of Woodville’s vaccination cases developed pustular lesions like those of smallpox. If it were found that smallpox could be transmitted by these pustular lesions then one of the advantages of vaccination over variolation, namely that patients did not need to be isolated, would be undermined. Jenner believed that Woodville’s
cowpox vaccine must have been contaminated with smallpox but this was hotly denied by Woodville who eventually concluded that the pustular lesions must have been due to exposure to smallpox in the contaminated atmosphere of the Smallpox Hospital. The dispute between the two men was meticulously analysed by Paytherus in a work that was initially published anonymously in 180065 but Paytherus revealed himself as the author when the second edition appeared in 1801. Paytherus was fulsome in his praise for Jenner as the originator of vaccination but came down in favour of Woodville in the dispute between the two men. He emphasised the importance of obtaining vaccine material only from patients with true cowpox and not from those with smallpox and in his book he included an illustrated plate and a textual description to emphasise the different characteristics of the lesions. He also mentioned that he was supplying vaccine to doctors in London and that, in at least one instance, he had obtained the vaccine from Jenner himself. One of those who was supplied by Paytherus was John Ring (1752–1821) who had been one of the signatories to the public testimonial in 1800. Ring also described how William Wood, who had been Paytherus’s senior partner in Ross, had twice mistaken chickenpox for smallpox and had taken great offence when Paytherus had pointed out his error!66 Paytherus was an active member of the Royal Jennerian Society that had been founded to promote and encourage vaccination, especially among those who could not afford to pay for the procedure. The Society was prone to internal dissent and Paytherus represented Jenner’s views at meetings of the Society when Jenner was not able to be present in London.29 In 1806 there were still repeated allegations to the effect that vaccination was ineffective or unsafe. As a member of the Council of the Royal Jennerian Society, Paytherus was one of those who signed a vigorous rebuttal of such claims.67 Paytherus acted in various capacities as Jenner’s London agent. When the Empress Dowager of Russia sent Jenner a diamond ring in 1802, he asked that the parcel be consigned ‘to Mr. Paytherus. . . who will faithfully transmit it to me’.42 In the same year, Paytherus was elected a fellow of the Medical Society of London. Over the next five years he attended only nine out of a possible 152 of the Society’s meetings. The subject matter of the Society’s meetings was not always fully recorded but vaccination was the main of topic of discussion on at least three of the nine occasions when Paytherus attended. It seems probable therefore that his main purpose in joining the Society was to keep abreast of discussions on this subject and perhaps also to maintain a watching brief over Jenner’s interests. He is recorded as having spoken at one meeting when he described a child in whom the eruption caused
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by vaccination was modified by an attack of chickenpox that appeared six days after vaccination.68 Sometimes Jenner was distressed by the criticism that was levelled at him and disillusioned by the government’s procrastination in promoting vaccination. In reply to a letter from Paytherus in the Spring of 1808, Jenner confided to his old friend: ‘Vaccination will go on just as well when I am dead as it does during my existence, probably better, for one obstacle will die with me – Envy . . . If I could obtain a little peace and quietness, my pockets should readily restore every shilling they have gained by the cow-pox discovery. That such a thing has been discovered, I, in common with the rest of mankind, have reason to rejoice; but this also I declare, that I wish it had been the lot of some other person to have been the discoverer . . .’42
Two years later when James Moore (1762–1860), another close ally of Jenner, was collecting material for his book on The History of the Smallpox, Jenner urged him to seek out Paytherus who ‘will give you a thousand odd anecdotes’.42 At one time it was thought that Paytherus was the author of Vaccinia; or the triumph of beauty, an anonymous poem in praise of vaccination that was published in 1806. However, it was later reattributed to another friend of Jenner’s who shared the same initials as Paytherus, the Reverend Thomas Pruen69 who also published a book on vaccination.70
Family and retirement Paytherus and his wife had one son, also Thomas, and three daughters, Fanny, Emma and Mary. One of the daughters was a talented artist who was awarded a silver medal by the Society of Arts for a portrait of her sister.71 It may have been the same sister who painted a water-colour, now in the Wellcome Institute, which showed Aesculapius, the son of Apollo and the God of Medicine, sending his daughter Hygeia, the Goddess of Health, to the four corners of the earth to spread the message of vaccination. The figures in the composition spell the name of Jenner.72 It is not surprising, therefore, that Jenner should have described the Paytherus sisters as ‘those excellent young women’!42 The family certainly moved in artistic circles. In 1809 it was on the recommendation of Mr (later Sir) John Soane (1753–1837) that Paytherus was able to obtain a six-month pass ‘for his two daughters to make drawings in the Reading Room of the British Museum’.73 The family were close friends of Sir Thomas Lawrence (1769–1830) and owned many of his paintings.74
Lawrence painted the portrait of Thomas Savory38 but if he also painted Paytherus then the portrait does not appear to have survived. Paytherus was apothecary to Samuel Lysons (1763–1819), the antiquary and artist. When Lysons was suffering from ‘a bowel complaint now prevailing owing to the moist weather’, Paytherus and another doctor advised him against taking slops which only ‘further relaxed and weakened the bowels’, recommending instead that he take ‘good Roast or Baked Meats to comfort and invigorate the stomach and bowels.75 The daughters also had musical and literary contacts. Joseph Dale (1749/1750–1821) dedicated to Mary76 seven compositions for the piano and John Matthews (1755–1821), a ‘medical truant’, poet, Herefordshire landowner and member of Parliament,77 inscribed a copy of his translation of Fontaine’s Fables ‘to his kind friend Fanny Paytherus’.78 It is not always possible to trace Paytherus’s movements from the properties he owned because some of the houses were bought as investments and leased to third parties. However, an examination of London directories and other sources shows that he moved out of London sometime during or shortly after 1810 and, and as noted earlier, this date may therefore indicate the time when he retired from active medical practice. In a letter addressed to him at Great Russell Street in January 1810, Jenner wrote that he wished him well in ‘the Spot that you have fixt upon for your Family residence’ and, although Jenner did not know the area well, he felt sure it was a very pleasant one.79 This is probably a reference to a property at Blackheath where Jenner’s daughter visited the Paytherus family in December 1816.29 Jenner’s letter had begun by apologising for his tardiness in replying to one from Paytherus ‘but you know my situation, & believe me it is a very sad one, & unfits me for all kind of business’.29 This unhappy comment presumably referred to Jenner’s son, Edward, who was dying from pulmonary tuberculosis. Jenner goes on to discuss their mutual interest in gardening: ‘Anything I can add to your Gardens you may command – The White Strawberries, Catherine shall bring on her return to Town . . . I shall not let you alone till you have procured for me some of the Apple Trees that bear the transparent Apples such as you brought to your Table more than once last summer twelve month. They seem to be a Breed from the Siberian Crab, but I suppose not Mr. Knight’s’.
The reference to Mr Knight must be to Thomas Andrew Knight (1759–1838) who was the foremost horticulturalist, plant breeder and pomologist of the day.80 Paytherus must have grown a number of fruit
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trees because he reported to the Horticultural Society in 1827 that he destroyed insects on apple and cherry trees by rubbing the affected areas with the fresh green leaves of Digitalis purpurea.81 By this time he had moved back into London. The records of the Sun Fire Office show that by May 1821 he was taking out insurance at 17 Kensington Square82 but the first entry for him living at this address in Boyle’s new fashionable court and country guide is not until April 1823. It was from this address that Jenner described receiving a letter in which Miss Paytherus praised the lithographic work of his nephew Stephen. Jenner also mentioned that the artist David Wilkie (1785–1841) was a near neighbour of Paytherus in Kensington and that Sir Thomas Lawrence was a frequent visitor.29 By 1828 Paytherus and his family had moved to a house in Abergavenny Castle where he died on 5 June of that year, the death recorded by a brief notice in a local newspaper83 but not, so far as has been discovered, by any obituary in either the lay or the medical press. His Will lists interests in two copper mines in Cornwall, ownership of the tithes at Goodrich in Herefordshire, ownership of properties in Westminster, a farm in Herefordshire, a house in Hillingdon and the unexpired lease of the house in Blackheath (both of which properties were rented out), in addition to the lease on the house in Abergavenny84 where his wife died two years later.85 Insurance and census records show that all his children moved shortly afterwards to another property in Abergavenny and then to Bristol. None of the daughters married and, although the son was married briefly, there is no record of his having children.
References and notes 1. Hereford Record Office: Parish Registers AC18/1-3; Vestry Accounts AC18/17; Paytherus family deeds A9. 2. Wallis PJ and Wallis RV. Eighteenth century medics: subscriptions, licences, apprenticeships. Newcastle upon Tyne: Project for Historical Biography, 1988, pp.112, 457–458. 3. Hereford Record Office T99/11/72. 4. Wall C. The Lambeth degrees. British Medical Journal 1935; 2: 854–855. 5. Whitcombe G. The General Infirmary at Gloucester and the Gloucestershire Eye Institution: its past and present. Gloucester: [sn], 1903, pp.88–89. 6. Garlick K and Macintyre A, eds. The diary of Joseph Farington. New Haven: Yale University Press, 1984, vol. III pp.661, 664–665. 7. Bevan M. Henry Cline (1750–1827), Oxford Dictionary of National Biography. Oxford University Press, on-line edition, http://www.oxforddnb.com/view/article/5673 (2004, accessed 27 September 2010). 8. Cooper BB. Life of Sir Astley Cooper, Bart. Vol. 1, London: John W Parker, 1843, pp.95–96.
9. Doyle WP. Joseph Black (1728–1799). School of Chemistry, University of Edinburgh, http://www.chem. ed.ac.uk/about/professors/black.html (accessed 28 September 2010). 10. Laws and List of the Members of the Royal Medical Society of Edinburgh. Edinburgh: W Smellie, 1788 p.81. 11. Records of the Company of Surgeons, London: Royal College of Surgeons. 12. Hereford Record Office: (op. cit. ref. 1) Vestry Accounts AC18/17. 13. The State of the Glocester [sic] Infirmary for the year 1780. Glocester: A Raikes, 1781: 4pp. 14. The medical register for the year 1780. London: Fielding and Walker, 1780 p.95. 15. The Medical Register for the year 1783. London: J Johnson, 1783 pp.73, 219. 16. Renton C. The Story of Herefordshire’s Hospitals. Almeley, Logaston Press, 1999 pp.27–29. 17. Sun Fire insurance Policy. Guildhall Library, London entry 466709, p.139. The house was described as new, of brick and stone not exceeding 200 in value and with household goods also not exceeding 200. 18. Hereford Journal 24 July 1788 p.3 column 2; 27 Aug 1794 p.3 column 4; 17 Sept 1794 p.3 column 2. 19. Taylor E. Kings Caple in Archenfield. Almeley: Logaston Press, 1997, pp.272–273. 20. Grundy I. Montagu, Lady Mary Wortley (bap. 1689, d. 1762). Oxford Dictionary of National Biography. Oxford University Press, http://www.oxforddnb.com/ view/article/19029 (2004, accessed 4 July 2011). 21. Larner AJ. Caleb Hillier Parry (1755–1822): clinician, scientist, friend of William Jenner (1749–1823). Journal of Medical Biography 2005; 13: 189–194. 22. Royal College of Physicians of London. Regulations and Transactions of the Gloucestershire Medical Society. MS_GLOUM/736. 23. Parry CH. An inquiry into the symptoms and causes of the syncope anginosa, commonly called Angina pectoris. Bath: Crutwell, 1799, pp.2–13. 24. Proudfit WL. The Fleece Medical Society. British Heart Journal 1981; 46: 589–594. 25. List of graduates in medicine in the University of Edinburgh from 1705 to 1806. Edinburgh: University of Edinburgh, 1867. 26. Proudfit WL. Origin of the concept of ischaemic heart disease. British Heart Journal 1983; 50: 209–212. 27. House of Lords. The Sessional Papers 1801–1833, volume 46 B 1810-11:811-2. 28. Matthews LG. The Bond Street Apothecaries. Part I: Enter Thomas Paytherus. The Pharmaceutical Journal 1983; 231: 219–220. 29. Fisher RB. Edward Jenner 1749–1823. London: Andre´ Deutsch, 1991, pp.69, 71, 75, 88–89,155, 174–175, 262, 288. 30. The Times 5 November 1795 p.1 column 3. 31. Richmond L, Stevenson J and Turton A (eds) The pharmaceutical industry: a guide to historical records. Aldershot: Ashgate, 2003, pp.4, 308–311. 32. Reece R. Intuitive medicine. Monthly Gazette of Health 1824; 9: 1177–1187.
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33. Anon. How to enjoy social life. Literary Gazette, 24 June 1848, p.423. 34. Whitebread C. An interesting old medicine chest. Journal of the American Pharmaceutical Association 1936; 25: 1005–1009. 35. Anon. A companion to the medicine chest. London: J Tindal, 1804, 55pp. 36. Savory J. A companion to the medicine chest. London: John Churchill, 1836: 224pp. 37. Hardwick M. Emma, Lady Hamilton. London: Cassell, 1969, pp.155–156. 38. Hemlow J, Douglas A, Hawkins P, eds. The Journals and Letters of Fanny Burney (Madame D’Arblay), Vol. XI, Mayfair 1818–1824. Oxford: Clarendon Press, 1984, p.400. 39. Anon. Obituary. Thomas Field Savory. Freemasons Quarterly Review, 1847; 14: 334. 40. Anon. Savory and Moore to end 184 years in Bond Street. Pharmaceutical Journal 1981; 226: 172. 41. Boyle’s new fashionable court and country guide; and town visiting directory for 1798. London: Eliza Boyle and Son, 1798, p.66. 42. Baron J. The life of Edward Jenner, M.D. London: Henry Colburn, 1827, vol. 1 pp.140, 298–309, 461; Vol. 2, pp. 359–361, 373–374, 389–390. 43. Various London Directories and other sources. 44. Fisher RB (op. cit. ref. 27) pp.169 and 197. 45. Letters from Jenner to various correspondents. Wellcome Library MS. 5236. 46. Garlick K (op. cit. ref 6) volume X p.3536. 47. London Gazette 11 Feb 1809 p.197. 48. Suzuki A. George Man Burrows (1771–1846). Oxford Dictionary of National Biography. Oxford University Press, http://www.oxforddnb.com/view/article/4114 (2004, accessed 19 February 2011). 49. Smith JR. Jesty, Benjamin (bap. 1736, d. 1816). Oxford Dictionary of National Biography, Oxford University Press, http://www.oxforddnb.com/view/article/37605 (2004, accessed 4 July 2011). 50. Darwin F. Francis Galton 1822–1911. The Eugenics Review 1915; 6: 1–17. 51. Rogers WR. An examination of that part of the evidence relative to cow-pox, which was delivered to the Committee of the House of Commons by two of the Surgeons of St. Thomas’s Hospital, 2nd edn. London: J Callow, 1805, pp.9–10. 52. Thomas KB. A Jenner Letter. Journal of the History of Medicine and Allied Sciences 1957; 12: 449–458. 53. Untitled. Hereford Journal 9 May 1810 p.3 column 5. 54. Cow Pox. Hereford Journal 10 Feb 1802 p.2 column 4. 55. Baxby D. Edward Jenner’s unpublished cowpox inquiry and the Royal Society: Everard Home’s Report to Sir Joseph Banks. Medical History 1999; 43: 108–110. 56. Jenner E. An inquiry into the causes and effects of the variolae vaccinae. London: Sampson Low, 1798, p.75. 57. Baxby D. The Jenner bicentenary: the introduction and early distribution of smallpox vaccine. FEMS Immunology and Medical Microbiology 1996; 16: 1–10.
58. Saunders P. Edward Jenner, the Cheltenham years, 1795–1823. London: University Press of New England, 1982, p.57. 59. Le Fanu WR. A bio-bibliography of Edward Jenner, 1749–1823. London: Harvey and Blythe, 1951, p.24. 60. Ingen Housz JM, Beale, N and Beale E. The life of Dr Jan Ingen Housz (1730–99), private counsellor and personal physician to Emperor Joseph II of Austria. Journal of Medical Biography 2005; 13: 15–21. 61. van der Pas PW. The Ingenhousz-Jenner correspondence. Janus 1964; 51: 202–220. 62. Beale N and Beale E. Evidence-based medicine in the eighteenth century: The Ingen Housz-Jenner correspondence revisited. Medical History 2005; 49: 79–98. 63. The Monthly Magazine or British Register. 1800; 10: 1. This testimonial appeared in many other periodicals, both medical and lay. 64. Baxby D. Jenner’s smallpox vaccine. London: Heinemann Educational Books, 1981, pp.147–148. 65. Anon. A Comparative statement of facts and observations relative to the cow-pox; published by Drs Jenner and Woodville. London: Sampson Low, 1800, p.43. 66. Ring J. A treatise on the cow-pox, containing the history of vaccine inoculation. Part II. London: Carpenter and Johnson, 1803, p.636, 832. 67. Royal Jennerian Society for the Extermination of the Small-pox. Edinburgh Medical and Surgical Journal 1806; 2: 254–257. 68. Medical Society of London Archive, Wellcome Institute. SA/MSL/A/1/1; SA/MSL/D/2/1/3. 69. Le Fanu W. A Bibliography of Edward Jenner. Winchester: St. Paul’s Bibliographies, 1985, p.137. 70. Pruen T. A comparative sketch of the effects of variolous and vaccine inoculation. London: H Ruff, 1807, p.102. 71. The Gentleman’s Magazine. 1803; 93: 571. 72. Wellcome Library Images no 562352i. 73. Hamilton J. London lights: the minds that moved the city that shook the world. London: John Murray, 2007, pp.71–2, 342. 74. Fraser M. Young Mr and Mrs Hall: 1823–30. The National Library of Wales Journal 1964; 13: 29–47. 75. Garlick K (op. cit. ref 6) Volume VI p.2226. 76. Kassler M. Music entries at the Stationers Hall 1710– 1818. Aldershot: Ashgate Publishing Ltd, 2004, p.462. 77. Courtney WP. John Matthews (baptised 1755, d 1826), Reverend Claire L Nutt, Oxford Dictionary of National Biography, Oxford University Press, http://www. oxforddnb.com/view/article/18345 (2004, accessed 26 January 2011). 78. From a bookseller’s inventory, 2009. 79. Miller G (ed.) Letters of Edward Jenner, and other documents concerning the early history of vaccination. Baltimore: John Hopkins University Press, c, 1983, pp.65–67. 80. Browne J. Thomas Andrew Knight (1759–1838), Oxford Dictionary of National Biography, Oxford University Press; online edition, May 2009, http://www.oxforddnb. com/view/article/15737 (2004, accessed 26 January 2011). 81. Communications to the Horticultural Society. New Monthly Magazine 1827; 21: 210.
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82. Records of the Sun Fire Office, Guildhall Library, MS 11936/487/980393. 83. Hereford Journal 11 Jun 1828 p.3 column 4.
84. National Archives PROB 11/1744. 85. Cambrian quarterly magazine and Celtic repository 1830; 2: 259.
Author biographies Henry Connor is a retired physician who is now a volunteer guide and gardener at Hereford Cathedral. He holds an Honorary Research Fellowship in the Centre for the History of Medicine in the University of Birmingham and has a particular interest in the history of anaesthesia (Email: [email protected]). David M Clark worked as director and later as consultant to a leading rural charity and is now using his early training as a historical geographer to produce a portrait of the social and economic life of Paytherus’s home parish (Email: [email protected]).
Notes and Jottings Gabriel Garccı´ a Ma´rquez’s book ‘One Hundred Years of Solitude’ has been described as the greatest novel of the last fifty years. Other novels include ‘Love in the Time of Cholera’ in which he describes features of this disease. His medical character, Dr Urbino, is said to be reading Axel Munthe’s ‘Story of San Michele’ from where some of the description might come (page 41). Scathing of surgery, Ma´rquez’ notes ‘the scalpel is the greatest proof of the failure of medicine’ (page 10). In relation to memory he notes’, When he became aware of his first bouts of forgetfulness, he had recourse to a tactic he had heard about from one of his teachers at the Medical School: ‘‘The man who has no memory makes one out of paper’’. But this was a short-lived illusion, for he had reached the stage where he would forget what the written reminders in his pockets meant, search the entire house for the eye-glasses he was wearing, turn the key again after locking the doors, and lose the sense of what he was reading because he forgot the premise of the argument or the relationships among the characters’ (page 40). ‘Dr Juvenal Urbino never accepted the public positions that were offered to him with frequency and without conditions, and he was a pitiless critic of those physicians who used their professional prestige to attain political office’ (page 44). Penguin Books, London, 2011.
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SURGEONS
Thomas Paytherus (1752–1828): Entrepreneurial surgeon-apothecary and ardent Jennerian
Journal of Medical Biography 21(3) 169–179 ! The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0967772013479285 jmb.sagepub.com
Henry Connor1 and David M Clark2
Abstract Thomas Paytherus was born in Fownhope and apprenticed in Gloucester. He practised there and in Ross-on-Wye where he and Edward Jenner undertook an autopsy on a patient with angina that they linked causally to coronary artery ossification. In 1794 Paytherus moved to London and opened a highly successful pharmacy that he later sold to his partners Savory and Moore. Paytherus was among those who advised Jenner on the publication of his work on vaccination. Then he acted as an intermediary in the dispute between Jenner and Ingen-Housz and also alerted Jenner to Pearson’s claims as a pioneer of vaccination. In 1800 he published a detailed analysis of the dispute between Jenner and Woodville whose patients had developed variola-like lesions following vaccination. Their correspondence shows that Paytherus, Jenner and their families remained firm friends. Paytherus and his family moved to Abergavenny where he died in 1828.
Keywords Paytherus, Jenner, Glocestershire Medical Society, Vaccination, Medicine Chests, Herefordshire
Introduction Thomas Paytherus was born in Fownhope, Herefordshire in 1752. His father, also Thomas, came from a family of yeoman farmers who had lived in the village for at least 300 years during which time they had accumulated substantial land-holdings.1
The early years In 1769 Paytherus was apprenticed for five years, and for a fee of 200, to Richard Browne Cheston, a Surgeon at Gloucester Infirmary.2 Cheston’s father, Joseph, came from Hereford and the Cheston family owned land in Fownhope, adjacent to the Paytherus land-holdings.3 In 1723 Joseph was apprenticed to an apothecary in Gloucester.2 Richard Browne Cheston had been appointed Surgeon to the Gloucester Infirmary in 1762 and therefore was already well established by the time he took Thomas as his pupil. By 1783 Cheston had been elected a Fellow of the Royal Society and in 1787, aided by the acquisition of a Lambeth MD,4 he resigned his post as surgeon and was elected Physician to the Infirmary.5 It is likely, therefore, that Paytherus received an above-average education from his ambitious master.
At the end of his apprenticeship, Paytherus went first to London where he studied under Henry Cline (1750– 1827) and then to Edinburgh where he attended Joseph Black’s (1728–1799) lectures on chemistry.6 His choice of Cline is interesting. Cline was only two years older than Paytherus and had only just obtained his diploma from Surgeons Hall in June 1774, the year in which Paytherus went to study under him. However, he had been thought competent to teach anatomy at St Thomas’s Hospital while still an apprentice.7 Apart from his inexperience, Cline’s extremely radical political views might have led some to question his suitability as a mentor for an aspiring young doctor. He became a supporter of both Horne Tooke (1736–1812) and John Thelwall (1764–1834) and, like them, of the French Revolution. When Astley Cooper (1768–1841) became his pupil in 1784, Cooper’s mother was very concerned 1 2
Vineyard Road Hereford, HR1 1TT, UK Independent Historical Geographer, UK
Corresponding author: Henry Connor, Retired physician, Honorary Research Fellow in the History of Medicine, University of Birmingham, 1 Vineyard Road, Hereford, HR1 1TT, UK. Email: [email protected]
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that he would be influenced by Cline’s radical opinions that were, at that time, considered by many to be frankly subversive. In the event it was to be Cline’s influence with the French revolutionaries that protected Cooper when he was studying in Paris in 1792. Thereafter, Cline’s patronage would also have proved useful in England because he was appointed Surgeon to St Thomas’s Hospital and later became Master and then President of the College of Surgeons.7,8 Whether Paytherus shared Cline’s political views is not known. Black, by contrast, was already an established figure by the time Paytherus arrived in Edinburgh. He was one of the outstanding chemists of the day and an excellent lecturer whose lectures were always packed.9 Paytherus probably moved to Edinburgh during the latter part of 1775 since on 9 December he was elected a member of the Royal Medical Society in that city10 but he does not appear to have registered as a student at the university so was probably never intending to take a degree. By 1777, he had returned to London where on 3 July he received the Diploma of the Company of Surgeons.11 His father died in the same year and Paytherus promptly sold much of the family’s land in Fownhope.12 Some of the capital he raised would have enabled him to establish himself in practice as a Surgeon in Gloucester whither he then moved. The accounts of the Gloucester Infirmary for 1780 show that Paytherus was one of its subscribers.13 Of the 12 medical men listed in The Medical Register as practising in Gloucester in 1780,14 Paytherus was one of only three who subscribed to the Infirmary which might suggest he was hoping to forge closer ties with that institution. If so, he was to be disappointed because in 1783 Samuel Vaughan Cheston, the son of his former master, returned to the city15 and immediately was appointed a Surgeon to the Infirmary.5 His hopes thwarted in Gloucester, Paytherus would already have known that there was little chance of an appointment to the infirmary of his native county in Hereford. In 1783 the Hereford General Infirmary, which had been founded in temporary accommodation seven years earlier, was poised to move into its new purpose-built home on the banks of the River Wye. However, it already had a full establishment of three surgeons, none of them near retirement age; two, like one of the two physicians, were members of a local medical dynasty, the Cam family, and if one of the existing surgeons had died unexpectedly there were two other surgical members of the family waiting in the wings.16
The country surgeon With no hope of a surgical post in Gloucester or Hereford, Paytherus turned his attention to the market town of Ross-on-Wye which was only 17 miles from
friends in Gloucester and less than nine miles from his native Fownhope. While Ross did not offer the prestige of an infirmary appointment, it was increasingly establishing itself as the starting point for the fashionable Wye Tour. The river journey from Ross to Chepstow had become an essential part of the late eighteenth century Picturesque Movement and only the year before had received an additional stimulus from the publication of the influential Reverend William Gilpin’s (1724– 1804) Observations on the River Wye. The entrepreneurial spirit in Paytherus recognised the opportunities presented by a town that was attracting genteel wealth on an increasing scale and in 1783 the Medical Register recorded his arrival there, ‘removed hither from Gloucester’.15 Paytherus set up house in the fashionable riverside hamlet of Wilton, just outside the town.17 It is clear, however, that other doctors had also recognised the possibilities that Ross now offered. Faced with stiff competition, Paytherus promptly entered into partnership with a long-established apothecary, William Wood (1707–1794). At this time, Wood was already aged 77 and so Paytherus must have had a reasonable expectation of acquiring the whole practice in the not too distant future. However, when the fiveyear partnership expired, Wood was not only still alive but announced his intention of ‘continuing business as usual’ and then went on to live for a further six years.18 Paytherus enhanced his income by taking an apprentice soon after he arrived in Ross, for which he received an indenture fee of 170. The apprentice, Richard Evans, served a seven-year apprenticeship after which he joined Paytherus in partnership2,18 and was still practising in Ross until 1828 at least. As the junior partner, one of the duties Paytherus inherited from Wood was the contract for medical care of the poor in the parish of Kings Caple, some six miles from his house. He held this appointment for the 11 years in which he remained in Ross, after which the job was taken over by Richard Evans. The contract was for five guineas annually and this probably included the supply of medicines. Some midwifery and other services attracted additional fees so the total annual payment was sometimes as much as 10. In the light of the support Paytherus was later to give Edward Jenner (1749–1823) when the latter proposed the practice of vaccination in 1798, it is of some interest that the overseers of Kings Caple should have introduced free inoculation with smallpox (variolation) in 1784. This was the year after Paytherus had taken over as parish surgeon and it seems probable therefore that the practice was introduced through his prompting.19 The practice of variolation had been introduced into England from Turkey in the 1820s, amid considerable controversy, by Lady Mary Wortley Montagu (1689–1762).20
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Angina and the Glocestershire Medical Society Paytherus had established some important medical friendships while living in Gloucester. These included John Heathfield Hickes who, by 1780, was a Physician at the Infirmary, Edward Jenner who was by then at Berkeley, Caleb Hillier Parry (1755–1822) who became a physician in Bath21 and Daniel Ludlow who became a surgeon in Chipping Sodbury. In May 1788 these five men formed the Glocestershire [sic] Medical Society.22 Later, in 1799 Parry wrote ‘we were all virtually either school-fellows or fellow-students’ and that by this date he had known Paytherus and Ludlow for about 20 years and the other two for almost twice that time.23 Jenner, Hickes and Parry had all attended the Reverend Dr Washbourn’s Grammar School at Cirencester, though Jenner was two years older than Hickes and six years older than Parry. Jenner had been apprenticed to Ludlow’s father.24 It is possible that Paytherus and Hickes might also have known each other in Edinburgh where the latter obtained his doctorate in 1775. Parry also held an Edinburgh doctorate but this was not awarded until 1778.25 The five friends were the only members of the Glocestershire Medical Society. Two years before the society was founded, Paytherus had invited Hickes and Jenner to visit him in Ross to witness the post-mortem examination of a patient of Paytherus, a Mr Bellamy who had died following a history of increasing angina.23 At this time both John Fothergill (1712–1780) and William Heberden (1710– 1801) had published precise descriptions of the clinical features of angina but neither had suggested any clear aetiological hypotheses.26 Jenner had already begun to suspect it might be due to disease of the coronary arteries after finding severe calcification of these vessels in a post-mortem examination on one of his own patients a few weeks earlier. Before the examination of Paytherus’s patient therefore he offered a wager that they would find ossification of the coronary arteries. In fact, the calcification was found to be protruding into the lumen of the vessel and Paytherus showed this by performing, in effect, a post-mortem endarterectomy, the intima separating, in Jenner’s words, ‘as easily as a finger from a tight glove’.23 Paytherus did not publish details of the case although at a meeting of the Glocestershire Medical Society three years later he ‘read a case and dissection of a patient who had died of angina pectoris’.22 This must surely have been the same case. In the meantime, the Society had also heard Parry present a case of a patient with angina and severe coronary artery disease22 and when Parry published his monograph on this subject in 1799 he included a letter from Paytherus that gave full details of the latter’s case.23 The link between angina and
coronary artery disease therefore was made jointly by Parry, Jenner and Paytherus. The meetings of the Glocestershire Medical Society were held at the Fleece Inn in Rodborough, between one and four o’clock in the afternoon and were followed by dinner. Rodborough is South of Gloucester and some 30 miles from Ross on Wye which made it a significant round trip for Paytherus. He attended only four of the 12 recorded meetings between May 1788 and June 1793 and was late on one of these occasions. As members paid a fine of one guinea for every meeting they missed and 10 s 6d on every occasion when they were late,22 his membership cost him dearly but undoubtedly he put a high value on the friendships. On New Year’s Day of 1786 Paytherus married Frances Hodges at Bridstow, less than a mile from his home, thereby strengthening his links in the area. His intention of remaining in Ross seems to have been confirmed when, after the expiry of the indenture of Richard Evans in 1790, he took on another apprentice, John Evans, for five years and a fee of 205.2 The increase in the indenture fee presumably reflected his greater experience and also an increased standing within the local community. During his time in Ross Paytherus had, according to Jenner, ‘great practise as a surgeon and man midwife, but over application injured his health. He then resolved to pursue another plan in life . . .’6 and moved to London in 1794.
Druggist and surgeon in London At first Paytherus lived in Mortlake while he prepared for his new life in London.27 Then in June 1794 he took a lease on the ground floor of 136 New Bond Street (renumbered as 143 in about 1840). The premises consisted of a shop, parlour and other back rooms, cellars, a carpenter’s shop and a bedroom. The lease was to run for 11 years from Lady Day 1794 and the rental was 200 per year. Paytherus was to keep the property in good repair and was not to carry on any noxious trade.28 Here he set up the ‘Chemical, Drug, and Medicinal Warehouse’ where he manufactured and sold a great variety of proprietary medicines. To assist him in fitting out the premises he consulted the Reverend Robert Ferryman (1752–1837)27 who at this time was living in London and who was later to construct the Temple of Vaccinia in Jenner’s garden at Berkeley. It seems probable that Paytherus and Ferryman would have known each other through their Gloucester connections even though Paytherus had left Gloucester nine years before Ferryman arrived in the city.29 Paytherus advertised his proprietary medicines with great vigour in The Times and elsewhere. Among his products were ‘The Chalybeate Aperient, or true
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Cheltenham Salts’ which, when dissolved in Malvern water or any other pure water, were in ‘no respects inferior’ to the waters from the Cheltenham Spa.30 Edward Jenner, who was a great advocate of the spa water at Cheltenham, told Joseph Farington (1747–1821) that the Chalybeate Aperient made ‘a more efficient dose than the water itself does when carried from Cheltenham’. Jenner explained that Paytherus had analysed the Cheltenham water, separated its constituent salts and then re-combined the salts in the appropriate proportions to make the Chalybeate Aperient6 (Figure 1). Among his other products were an ophthalmic unguent that ‘never fails to remove those obstructions which form in the eyelids after the measles, smallpox, and other eruptive disorders’, antirachitic tablets that were ‘a certain cure’ for rickets and other disorders and, for the nursing mother, nipple liniment which was ‘a certain remedy’ for a condition ‘hitherto deemed incapable of relief’’.30 These confident claims, which fall so uncomfortably on the modern ear, were by no means exceptional for the time, even from an orthodox practitioner. For example, Edward Jenner had devised Dr Jenner’s Absorbent Digestive Lozenges’ and the friendship between Paytherus and Jenner had enabled the firm to gain exclusive manufacturing and sales rights to this product.31 Jenner clearly had no objection to being associated with the marketing methods used by Paytherus. Savory and Moore were still marketing the absorbent lozenges and chalybeate aperient in 1824. Their properties were extolled in an empirical pamphlet that produced a torrent of derisory invective from
Figure 1. The Chalybeate Aperient, as sold by Paytherus, Savory and Moore. (Reproduced by courtesy of the Smithsonian Institution.)
Richard Reece (1775–1831), editor of the Monthly Gazette of Health32 and, some years later, an equally sarcastic article in the Literary Gazette.33
Medicine chests Paytherus also advertised ‘Medicine Chests of different sizes, for Families, Officers in the Army or Navy, Gentlemen travelling to the Continent, or to the East or West Indies’.30 One such chest, made in 1804, is now in the Smithsonian Institution (Figure 2). The original owner was Ian Wilbraham Willink, originally of Amsterdam and later of 18 Wall Street, New York. The case contains more than 30 medicines together with plasters, lint, tape, a glass mortar, scales and other utensils (Figure 3). Also included was a booklet titled A companion to the medicine chest that described the medicines and their uses.34 What appears to be an identical booklet, published in 1804 (the same year as Willink’s chest), is in the Wellcome Library in London (Figure 4). It is described as being the third edition and written by a medical practitioner.35 It seems probable it was written by Paytherus who was the only medical practitioner associated with the firm, and certainly one of the later editions was written by a descendent of one of his partners.36 The business in New Bond Street was an immediate success. According to Jenner, Paytherus cleared his expenses of 800 after just one year.6 Within five years he was able to purchase the lease on the property
Figure 2. A Medicine Chest sold by Paytherus & Co. in 1804. (Reproduced by courtesy of the Smithsonian Institution.)
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Figure 3. The contents of the medicine chest. (Reproduced by courtesy of the Smithsonian Institution.)
Figure 4. The companion booklet to the medicine chest. (Reproduced by courtesy of the Wellcome Institute.)
which still had 16 years to run.28 In 1797 Paytherus had been joined in the business by Thomas Field Savory who had been apprenticed to an apothecary in Cheltenham and who might therefore have been recommended to Paytherus by Jenner. Nine years later Savory was taken into partnership, as was Thomas Moore who had practised as an apothecary in
Norfolk Street in London where, as described below, Paytherus was in practice as a surgeon.31 The business was patronised by the rich and the famous. Emma, Lady Hamilton, who lived nearby, became a lifelong customer37 and by 1806 the firm was dispensing prescriptions for the Prince Regent and other members of the Royal family.38 The Royal Patronage was probably attributable to Savory, an enthusiastic socialite and patron of the arts, who was a close friend of the Duke of Sussex, the sixth son of George III and, like Savory, a prominent Freemason.39 The Duke was often entertained to dinner in the dining room over the shop, as also was Emma.37 When Savory and Moore were taken into partnership in 1806 the partnership agreement showed that the stock-in-trade, the house with lease, utensils, furniture and fixtures were valued at 3,427. Just five years later, when Paytherus retired from the partnership, Savory and Moore had to find a further 21,700 to buy him out. In the meantime, a branch had been set up in High Street, Cheltenham in 1809 but this was not included in the buy-out.31 The firm of Savory and Moore continued trading in New Bond Street until 1981.40 The property is now a children’s outfitters but the names of Savory and Moore are still to be seen on the wrought iron portico. While Paytherus had been in charge, the day-to-day business had been in the hands of a ‘foreman’6 which allowed Paytherus time to practise as a surgeon. According to Richmond et al31 he had established a retail chemist’s business at 1 Norfolk Street, The Strand, in 1794. However, it seems more probable that this was the address of both his home and his medical practice. It is certainly the address that was given in the articles of apprenticeship when he took on Thomas Baldwin as an apprentice in 1797 and John Purchas in 1800.2 The indenture articles of 1797 described Paytherus as an apothecary and those of 1800 as a surgeon but he probably practised as a surgeon-apothecary throughout his career. The indenture fees (300 for a seven-year apprenticeship for Baldwin and 410 for a five-year term for Purchas) were considerably greater than those paid to him for his apprentices in Ross and presumably indicate both a London premium and his increased experience and status. John Purchas was probably the son of Nathaniel Purchas, a merchant in Paytherus’ home village of Fownhope. As John did not practise medicine on his return to Fownhope,1 it seems that he did not complete his apprenticeship. Just as the business in New Bond Street attracted some of the grandest clientele, Paytherus’s medical practice, which included Lady Berkeley,27 also attracted some very fashionable patients. Although Richmond et al31 gave Paytherus’s address as 1 Norfolk Street, it is also given at various times as
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number 341 and as number 13 in 1802.42 Whether these changes represent house moves or renumbering of houses has not been ascertained. By 1805 he had acquired a property at 108 Great Russell Street, near Bedford Square, in addition to the house in Norfolk Street but he seems to have left the latter by 1806.43 Fisher44 refers to Paytherus owning a property in Great Rupert Street but this almost certainly derives from a misreading by Fisher of a letter from Jenner to Paytherus45 where the word Russell is far from clear. While at Great Russell Street he was in partnership with another surgeon-apothecary, George Man Burrows (1771–1846) of Bloomsbury Square, near his home in Great Russell Street but at the far end from Bedford Square.46 This partnership was dissolved in February 180947 which may represent the date of Paytherus’s retirement from active medical practice. Burrows, who was still only 38, went on to achieve eminence as a medical reformer, as the Founding Editor of the London Medical Repository and as an expert alienist.48
Paytherus, Jenner and vaccination Paytherus must have been a busy man in the years around the turn of the century as he worked to build up both his practice and his business. Nevertheless, he devoted much time to supporting his old friend Edward Jenner as the latter strove to make vaccination an established and accepted practice. Jenner was not the first to practise vaccination. The Dorset farmer, Benjamin Jesty (1736–1816) had inoculated his wife and two elder sons with cowpox more than 20 years earlier in 1774. Although Jesty’s experiment was successful his actions met with great hostility in Dorset where he was often reviled and ostracized.49 In later years, Jesty did not always receive the recognition which his pioneering work deserved but credit for the introduction of vaccination into medical practice is deservedly given to Jenner because, as Francis Darwin was later to remark in a different context, ‘. . . in science the credit goes to the man who convinces the world, not to the man to whom the idea first occurs’.50 Even with his influential contacts, Jenner struggled to gain recognition of the benefits and safety of vaccination. Some doctors were, like Paytherus, enthusiastic supporters of the new practice but in the early years there was also considerable medical opposition. Of Paytherus’s own mentors, Henry Cline had obtained vaccine from Jenner and had carried out successful vaccinations as early as July 179851 but Richard Browne Cheston was still opposing the practice in 1801.52 It is indeed ironic that in Jenner’s home county there was still considerable opposition to vaccination as late as
1810 when a group of doctors formed the Gloucestershire Vaccine Association with the aims of promoting vaccination and of discouraging inoculation with smallpox.53 By contrast, a number of Herefordshire doctors, including a former apprentice of Paytherus, Richard Evans, had become enthusiastic converts by 1802.54 Jenner had performed his first vaccination in 1796 and, by March 1797, he had prepared a manuscript which he submitted to Sir Joseph Banks (1743–1820), presumably with a view to publication in the Philosophical Transactions of the Royal Society of which Banks was president at that time. Banks asked Everard Home (1756–1832) to give an opinion on Jenner’s manuscript. Home’s reply, written on 22 April 1797, drew attention to defects in Jenner’s work and, in consequence, Banks appears to have advised Jenner that his reputation might be compromised if he published on the basis of such weak evidence.55 Jenner then carried out further vaccinations in March and April of 1798 and his work finally appeared as a private publication56 on 17 September 1798.29,57 While preparing his manuscript Jenner had sought the advice of several of his friends and colleagues. Of particular significance was a meeting held at Rudhall Manor near Ross-on-Wye, the home of Thomas Westfaling, Esq. Also present were Dr Richard Worthington, Thomas Paytherus and John Heathfield Hickes, another fellow member of the Glocestershire Medical Society.42 Saunders and Fisher state that Edward Gardner, a wine merchant from Framptonon-Severn and another of Jenner’s friends, was also present29,58 but Gardner’s name is not mentioned by Baron42 who had assistance from both Paytherus and Hickes when writing his biography of Jenner. According to Saunders and Fisher this meeting took place in March 1797 which they thought was after Banks had turned down Jenner’s original manuscript in ‘late 1796’. However, it seems unlikely that Banks would have declined the manuscript until after he had received the opinion of Everard Home which, as already noted, was in late April 1797 and, furthermore, the chronology implied in the account given by Baron,42 who had access to all Jenner’s notes and correspondence, would suggest that the Rudhall meeting took place at a later date, after June 1797 and probably only shortly before the manuscript went to press in the Spring of 1798 by which time cowpox had re-appeared around Berkeley, thereby enabling Jenner to carry out further vaccinations.59 Three months after his work had been published Jenner asked Paytherus to act as an intermediary with his Dutch critic, Dr Jan Ingen Housz (1730–1799),60 as both Paytherus and Ingen Housz were living in London at that time. Ingen Housz claimed to have discovered several instances in
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which patients had become infected with smallpox despite having previously had an illness that had been diagnosed as cowpox.61,62 Jenner doubted whether such cases had been infected with true cowpox but Ingen Housz was adamant and Paytherus reported back to Jenner that he had found him a ‘formidable opponent’ who ‘would not hear a word in defence of your opinion’.42 Jenner evidently had complete faith in Paytherus when asking him to meet with Ingen Housz because, in an undated letter to him, he wrote ‘With respect to Mr. Housz, I can only repeat what I wrote before, do with it as if it were your own & I shall be satisfied’.45 Early in the next year, 1799 Paytherus wrote to Jenner to express his concerns about Dr George Pearson (1751–1828), a Physician at St George’s Hospital and an enthusiastic promoter of vaccination. Paytherus was concerned lest Pearson might steal some of the prestige that Paytherus believed was due to Jenner.29 Shortly afterwards Jenner’s nephew, George, wrote to Jenner to reinforce the concerns expressed by Paytherus and ‘to urge the necessity of your coming to town to wear the laurels you have gained, or to prevent them being placed on the brows of another’.42 The letter was written from Paytherus’s home in Norfolk Street and it is evident that George Jenner and Paytherus were acting in concert. In a postscript, George adds that Paytherus has just told him that a copy of Pearson’s claims had been exhibited at Sir Joseph Banks’s house the day before. The two men clearly were anxious to ensure that Jenner should come to London with all possible haste. In August 1800, almost two years after Jenner’s original publication, there was still uncertainty about the benefit and safety of vaccination. Paytherus was one of 36 physicians and surgeons who put their names to a public testimonial extolling both the efficacy of vaccination and also its safety in comparison with variolation.63 The signatories included some of the most eminent doctors in the country including Matthew Baillie (1761–1823), John Coakley Lettsom (1744– 1815), John Abernethy (1764–1831) and Astley Cooper (1768–1841). In the same year, Paytherus also investigated some unfortunate cases in Clapham where vaccination had been complicated by erysipelas due to a contaminated lancet.64 This year also saw the dispute between Jenner and William Woodville (1752–1805) of the London Smallpox and Inoculation Hospital. Many of Woodville’s vaccination cases developed pustular lesions like those of smallpox. If it were found that smallpox could be transmitted by these pustular lesions then one of the advantages of vaccination over variolation, namely that patients did not need to be isolated, would be undermined. Jenner believed that Woodville’s
cowpox vaccine must have been contaminated with smallpox but this was hotly denied by Woodville who eventually concluded that the pustular lesions must have been due to exposure to smallpox in the contaminated atmosphere of the Smallpox Hospital. The dispute between the two men was meticulously analysed by Paytherus in a work that was initially published anonymously in 180065 but Paytherus revealed himself as the author when the second edition appeared in 1801. Paytherus was fulsome in his praise for Jenner as the originator of vaccination but came down in favour of Woodville in the dispute between the two men. He emphasised the importance of obtaining vaccine material only from patients with true cowpox and not from those with smallpox and in his book he included an illustrated plate and a textual description to emphasise the different characteristics of the lesions. He also mentioned that he was supplying vaccine to doctors in London and that, in at least one instance, he had obtained the vaccine from Jenner himself. One of those who was supplied by Paytherus was John Ring (1752–1821) who had been one of the signatories to the public testimonial in 1800. Ring also described how William Wood, who had been Paytherus’s senior partner in Ross, had twice mistaken chickenpox for smallpox and had taken great offence when Paytherus had pointed out his error!66 Paytherus was an active member of the Royal Jennerian Society that had been founded to promote and encourage vaccination, especially among those who could not afford to pay for the procedure. The Society was prone to internal dissent and Paytherus represented Jenner’s views at meetings of the Society when Jenner was not able to be present in London.29 In 1806 there were still repeated allegations to the effect that vaccination was ineffective or unsafe. As a member of the Council of the Royal Jennerian Society, Paytherus was one of those who signed a vigorous rebuttal of such claims.67 Paytherus acted in various capacities as Jenner’s London agent. When the Empress Dowager of Russia sent Jenner a diamond ring in 1802, he asked that the parcel be consigned ‘to Mr. Paytherus. . . who will faithfully transmit it to me’.42 In the same year, Paytherus was elected a fellow of the Medical Society of London. Over the next five years he attended only nine out of a possible 152 of the Society’s meetings. The subject matter of the Society’s meetings was not always fully recorded but vaccination was the main of topic of discussion on at least three of the nine occasions when Paytherus attended. It seems probable therefore that his main purpose in joining the Society was to keep abreast of discussions on this subject and perhaps also to maintain a watching brief over Jenner’s interests. He is recorded as having spoken at one meeting when he described a child in whom the eruption caused
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by vaccination was modified by an attack of chickenpox that appeared six days after vaccination.68 Sometimes Jenner was distressed by the criticism that was levelled at him and disillusioned by the government’s procrastination in promoting vaccination. In reply to a letter from Paytherus in the Spring of 1808, Jenner confided to his old friend: ‘Vaccination will go on just as well when I am dead as it does during my existence, probably better, for one obstacle will die with me – Envy . . . If I could obtain a little peace and quietness, my pockets should readily restore every shilling they have gained by the cow-pox discovery. That such a thing has been discovered, I, in common with the rest of mankind, have reason to rejoice; but this also I declare, that I wish it had been the lot of some other person to have been the discoverer . . .’42
Two years later when James Moore (1762–1860), another close ally of Jenner, was collecting material for his book on The History of the Smallpox, Jenner urged him to seek out Paytherus who ‘will give you a thousand odd anecdotes’.42 At one time it was thought that Paytherus was the author of Vaccinia; or the triumph of beauty, an anonymous poem in praise of vaccination that was published in 1806. However, it was later reattributed to another friend of Jenner’s who shared the same initials as Paytherus, the Reverend Thomas Pruen69 who also published a book on vaccination.70
Family and retirement Paytherus and his wife had one son, also Thomas, and three daughters, Fanny, Emma and Mary. One of the daughters was a talented artist who was awarded a silver medal by the Society of Arts for a portrait of her sister.71 It may have been the same sister who painted a water-colour, now in the Wellcome Institute, which showed Aesculapius, the son of Apollo and the God of Medicine, sending his daughter Hygeia, the Goddess of Health, to the four corners of the earth to spread the message of vaccination. The figures in the composition spell the name of Jenner.72 It is not surprising, therefore, that Jenner should have described the Paytherus sisters as ‘those excellent young women’!42 The family certainly moved in artistic circles. In 1809 it was on the recommendation of Mr (later Sir) John Soane (1753–1837) that Paytherus was able to obtain a six-month pass ‘for his two daughters to make drawings in the Reading Room of the British Museum’.73 The family were close friends of Sir Thomas Lawrence (1769–1830) and owned many of his paintings.74
Lawrence painted the portrait of Thomas Savory38 but if he also painted Paytherus then the portrait does not appear to have survived. Paytherus was apothecary to Samuel Lysons (1763–1819), the antiquary and artist. When Lysons was suffering from ‘a bowel complaint now prevailing owing to the moist weather’, Paytherus and another doctor advised him against taking slops which only ‘further relaxed and weakened the bowels’, recommending instead that he take ‘good Roast or Baked Meats to comfort and invigorate the stomach and bowels.75 The daughters also had musical and literary contacts. Joseph Dale (1749/1750–1821) dedicated to Mary76 seven compositions for the piano and John Matthews (1755–1821), a ‘medical truant’, poet, Herefordshire landowner and member of Parliament,77 inscribed a copy of his translation of Fontaine’s Fables ‘to his kind friend Fanny Paytherus’.78 It is not always possible to trace Paytherus’s movements from the properties he owned because some of the houses were bought as investments and leased to third parties. However, an examination of London directories and other sources shows that he moved out of London sometime during or shortly after 1810 and, and as noted earlier, this date may therefore indicate the time when he retired from active medical practice. In a letter addressed to him at Great Russell Street in January 1810, Jenner wrote that he wished him well in ‘the Spot that you have fixt upon for your Family residence’ and, although Jenner did not know the area well, he felt sure it was a very pleasant one.79 This is probably a reference to a property at Blackheath where Jenner’s daughter visited the Paytherus family in December 1816.29 Jenner’s letter had begun by apologising for his tardiness in replying to one from Paytherus ‘but you know my situation, & believe me it is a very sad one, & unfits me for all kind of business’.29 This unhappy comment presumably referred to Jenner’s son, Edward, who was dying from pulmonary tuberculosis. Jenner goes on to discuss their mutual interest in gardening: ‘Anything I can add to your Gardens you may command – The White Strawberries, Catherine shall bring on her return to Town . . . I shall not let you alone till you have procured for me some of the Apple Trees that bear the transparent Apples such as you brought to your Table more than once last summer twelve month. They seem to be a Breed from the Siberian Crab, but I suppose not Mr. Knight’s’.
The reference to Mr Knight must be to Thomas Andrew Knight (1759–1838) who was the foremost horticulturalist, plant breeder and pomologist of the day.80 Paytherus must have grown a number of fruit
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trees because he reported to the Horticultural Society in 1827 that he destroyed insects on apple and cherry trees by rubbing the affected areas with the fresh green leaves of Digitalis purpurea.81 By this time he had moved back into London. The records of the Sun Fire Office show that by May 1821 he was taking out insurance at 17 Kensington Square82 but the first entry for him living at this address in Boyle’s new fashionable court and country guide is not until April 1823. It was from this address that Jenner described receiving a letter in which Miss Paytherus praised the lithographic work of his nephew Stephen. Jenner also mentioned that the artist David Wilkie (1785–1841) was a near neighbour of Paytherus in Kensington and that Sir Thomas Lawrence was a frequent visitor.29 By 1828 Paytherus and his family had moved to a house in Abergavenny Castle where he died on 5 June of that year, the death recorded by a brief notice in a local newspaper83 but not, so far as has been discovered, by any obituary in either the lay or the medical press. His Will lists interests in two copper mines in Cornwall, ownership of the tithes at Goodrich in Herefordshire, ownership of properties in Westminster, a farm in Herefordshire, a house in Hillingdon and the unexpired lease of the house in Blackheath (both of which properties were rented out), in addition to the lease on the house in Abergavenny84 where his wife died two years later.85 Insurance and census records show that all his children moved shortly afterwards to another property in Abergavenny and then to Bristol. None of the daughters married and, although the son was married briefly, there is no record of his having children.
References and notes 1. Hereford Record Office: Parish Registers AC18/1-3; Vestry Accounts AC18/17; Paytherus family deeds A9. 2. Wallis PJ and Wallis RV. Eighteenth century medics: subscriptions, licences, apprenticeships. Newcastle upon Tyne: Project for Historical Biography, 1988, pp.112, 457–458. 3. Hereford Record Office T99/11/72. 4. Wall C. The Lambeth degrees. British Medical Journal 1935; 2: 854–855. 5. Whitcombe G. The General Infirmary at Gloucester and the Gloucestershire Eye Institution: its past and present. Gloucester: [sn], 1903, pp.88–89. 6. Garlick K and Macintyre A, eds. The diary of Joseph Farington. New Haven: Yale University Press, 1984, vol. III pp.661, 664–665. 7. Bevan M. Henry Cline (1750–1827), Oxford Dictionary of National Biography. Oxford University Press, on-line edition, http://www.oxforddnb.com/view/article/5673 (2004, accessed 27 September 2010). 8. Cooper BB. Life of Sir Astley Cooper, Bart. Vol. 1, London: John W Parker, 1843, pp.95–96.
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Author biographies Henry Connor is a retired physician who is now a volunteer guide and gardener at Hereford Cathedral. He holds an Honorary Research Fellowship in the Centre for the History of Medicine in the University of Birmingham and has a particular interest in the history of anaesthesia (Email: [email protected]). David M Clark worked as director and later as consultant to a leading rural charity and is now using his early training as a historical geographer to produce a portrait of the social and economic life of Paytherus’s home parish (Email: [email protected]).
Notes and Jottings Gabriel Garccı´ a Ma´rquez’s book ‘One Hundred Years of Solitude’ has been described as the greatest novel of the last fifty years. Other novels include ‘Love in the Time of Cholera’ in which he describes features of this disease. His medical character, Dr Urbino, is said to be reading Axel Munthe’s ‘Story of San Michele’ from where some of the description might come (page 41). Scathing of surgery, Ma´rquez’ notes ‘the scalpel is the greatest proof of the failure of medicine’ (page 10). In relation to memory he notes’, When he became aware of his first bouts of forgetfulness, he had recourse to a tactic he had heard about from one of his teachers at the Medical School: ‘‘The man who has no memory makes one out of paper’’. But this was a short-lived illusion, for he had reached the stage where he would forget what the written reminders in his pockets meant, search the entire house for the eye-glasses he was wearing, turn the key again after locking the doors, and lose the sense of what he was reading because he forgot the premise of the argument or the relationships among the characters’ (page 40). ‘Dr Juvenal Urbino never accepted the public positions that were offered to him with frequency and without conditions, and he was a pitiless critic of those physicians who used their professional prestige to attain political office’ (page 44). Penguin Books, London, 2011.
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