Chapter 1
Go Thy Way, Passenger
1806â31
Take notice, roguelings
Alfred Swaine Taylor was born on 11 December 1806, in Northfleet, Kent, the first child of Thomas and Susannah Taylor. The small town on the chalky banks of the river Thames is about 25 miles east from the centre of London, and was known in the early nineteenth century for its watercress and flint. Taylorâs maternal grandfather, Charles Badger, had been a wealthy local flint knapper, supplying the essential component for flintlock pistols. Taylorâs father was a captain in the East India Company, and perhaps moved to Northfleet from his native Norfolk when, in 1804, the company leased twelve moorings in the town for its ships.
Taylorâs middle name, Swaine, presumably harks back to an ancestor on his fatherâs side as he had several relatives with the same middle name. Just after Taylorâs second birthday, he was joined by a brother, Silas Badger Taylor. There were to be only two Taylor children; their mother died aged 37, in December 1815, three days before Taylorâs ninth birthday. Her headstone can still be found in the churchyard at Northfleet. It reads: âShe was worthy of example as a Wife a Mother and a Friend. Go thy way passenger and imitate Her whom you will some day follow.â
By 1818, Taylorâs father had become a merchant, half of Oxley and Taylor, who were based at the chalk works in Northfleet. They advertised themselves as âexporters and dealers in all sorts of flints, rough or manufactured, chalk etc, to India, and all parts of Englandâ. The company would later expand to include an office off Lombard Street in London, and Silas would grow up to continue their fatherâs business. By the 1830s, Oxley and Taylor would sell guns, and were travel agents, selling berths on ships bound for New York.
Taylor was a studious boy, not considered strong enough for the rough and tumble life of a public school. Soon after his motherâs death, he was sent to Albemarle House, the school of clergyman Dr Joseph Benson. Located in Hounslow, on a major stagecoach route to the west of London, it was a journey of about 40 miles from Northfleet. Pupils from across the country could reach the school with ease, and its semi-rural location was healthier than the city or town. Albemarle House, âa school of the first respectabilityâ, had been established at some point during the mid-eighteenth century; it was a large, imposing Georgian edifice.
The building has since disappeared, as have the gibbets that once stood very near the school by the junction of two major roads. The bodies of executed highwaymen swung there as a warning to anyone who thought to ply their trade on Hounslow Heath. They made a terrifying sight: âThe chains rattled; the iron plates barely held the gibbet together; the rags of the highwaymen displayed their horrible skeletons within.â The gibbets could be seen with ease from the school until their removal in about 1806. In the late eighteenth century, a jocular wag wrote a six-line poem, âAddressed to Two Young Gentlemen at the Hounslow Academyâ:
Take notice, roguelings, I prohibit
Your walking underneath yon Gibbet;
Have you not heard, my little ones,
Of Raw Head and Bloody Bones?
How do you know but that there fellow,
May step down quick, and up you swallow?
Although the gibbets had gone by the time Taylor attended Albemarle, their legend must have lingered on amongst the pupils at the school.
An aquatint of Albemarle House, from 1804, shows a military parade in action outside, even though it doesnât appear to have been a military academy. [Plate 2] The soldiers might have been pupils, drilled as volunteers for the war against Napoleon, or were professionals from Hounslow Camp, using space outside the school to practise. In the late 1830s, an advert for the school offered âhigh Classical and Mathematical Reading, preparatory to the Universities or the Public Schoolsâ. French was taught by a resident Parisian and instruction was given in âEnglish Literature, Commercial Science, and every subject of Education essential to the improvement of the Mind, and the refinement of the Understandingâ. All of which would stand Taylor in good stead.
âPhysiologist Taylorâ
By 1822, Taylorâs schooldays were over: in June that year, not yet 16, he was apprenticed to a surgeon. All manner of occupations could be entered by apprenticeship; Taylorâs brother would be apprenticed to a London waterman.
There were various ways to enter medicine at this period, whether one wished to be a physician, apothecary or surgeon. Unless they attended the medical schools attached to Scottish universities, British physicians trained at universities in Continental Europe, briefly studying at Oxford or Cambridge to have the degree of MD conferred on them; their knowledge came mainly from books. As surgeons and apothecaries were apprenticed, they had more practical experience with the sick. There was rivalry between the three professions in London, the Guilds and Worshipful Companies protecting the interests of their members, sometimes at the expense of the sick. But at least it meant that medical professionals were regulated to an extent, and only the best candidates were selected as apprentices.
Taylor was apprenticed to Dr Donald McRae, a surgeon in Lenham, Kent, about 25 miles south-east of Northfleet. It was the birthplace of his maternal grandmother and it is possible that Taylor still had relatives there. McRae was in his thirties, originally from Inverness in Scotland. How proficient he was as a surgeon is unknown; by 1841 he had given up medicine for banking.
The terms of Taylorâs apprenticeship stated that after a year of provincial medicine with McRae, he would become a pupil at a London hospital. In October 1823, Taylor entered the United Hospitals of Guyâs and St Thomasâs in Southwark, south London. Sometimes, provincial apprentice surgeons served part of their training in a hospital, usually spending six months to a year there. They gained invaluable experience, witnessing cases in numbers that wouldnât be seen in a rural practice, and they could perform dissections and observe operations. The studious Taylor would stay at Guyâs for the rest of his career.
St Thomasâs was an ancient hospital, founded by mediaeval monks for the treatment of the poor, on the Thamesâs south bank near London Bridge. In the early eighteenth century, one of St Thomasâs wealthy governors, Thomas Guy, was urged by a physician friend to build a new hospital. Guy was aware that many of the patients were not well enough to work once they were deemed cured and had been discharged. So he established his hospital as a place for âincurablesâ â a hospital for convalescence and rehabilitation. Guyâs opened its doors in 1726, a year after its benefactorâs death, occupying new buildings beside St Thomasâs.
A medical school of sorts was run at Guyâs from its inception. Its physicians, surgeons and apothecaries took on apprentices and pupils, and it had a surgical theatre from 1739 so that students could observe operations, even though few surgeries were performed. The hospital staff were voluntary, and were each paid ÂŁ40 a year. The sum was stipulated at the foundation of Guyâs and was only increased at the creation of the NHS. It was in the interest of staff to take on pupils and apprentices in order to increase their income.
A lecture theatre was an important lure for students, and one was built at Guyâs in 1770. A fee was paid to be enrolled as a pupil, and they followed medical practitioners on their rounds. They paid extra for classes, lectures and dissection. Lectures in anatomy and surgery were most in demand, and were taught at St Thomasâs. Guyâs provided lectures in medicine, chemistry, botany, physiology and natural physiology.
When Taylor arrived at the United Hospitals in 1823, he took great interest in his chemistry lessons, taught by William Allen and Arthur Aikin. Allen was a Fellow of the Royal Society, highly respected in his time as a man of science, but he was not a medical man. Neither was Aikin, whose focus was on geology and coalfields, but both were amongst the leading chemists of their time. It has been said that Taylor was the favourite pupil of celebrated surgeon Sir Astley Cooper. Cooper was so famous that after he died, a commemorative statue was placed in St Paulâs Cathedral, albeit with the wrong year of death on its plinth.
Taylor spent the summer of 1825 in Paris; cadavers for dissection were more easily acquired on the Continent. His trip paid off, because when he returned to London, he was awarded St Thomasâs anatomy prize. He became known for his aptitude in physiology, earning himself the nickname âPhysiologist Taylorâ. That same year, Guyâs Medical School was founded, so an anatomical theatre, a dissecting room and a museum were built.
In 1826, Taylorâs life was changed when he read Elements of Medical Jurisprudence, by American physician Theodric Romeyn Beck. Taylor later wrote, âThe subject, from the lucid manner in which it was treated by the author, fixed my attention, and induced me for the time to put aside anatomy and physiology for the sake of this new branch of medical science.â Reading Beckâs book was the deciding moment in Taylorâs career, when he chose medical jurisprudence as his âspecial object for study and practiceâ.
In 1828, aged 21, he became a licentiate of the Society of Apothecaries, and he took off on a tour of medical schools in Europe. He returned to Paris, attending lectures by eminent men of the time, such as pathologist and haematologist Gabriel Andral; surgeons Guillaume Dupuytren and Alexis Boyer; physician and embryologist Ătienne Serres; chemist and physicist Joseph Louis Gay-Lussac; and mineralogist and geologist Alexandre Brongniart. Considering Taylorâs later specialisms, perhaps the most important lectures of all were those of toxicologist Joseph Bonaventura Orfila. He had published his two-volume work TraitĂŠ des poisons from 1814 to 1815. His book explained the symptoms of poisoning, antidotes, and methods to detect poisons, as well as how to combine the postmortem with analytical chemistry, thus merging all of Taylorâs interests into one discipline.
A hollow crust spread over an abyss
Travel at this time was by ship or horse, but perhaps for reasons of economy, Taylor made much of his European journey on foot. Despite improvements in Continental travel by the late 1820s, such as better roads and fewer Italian banditti, Taylorâs progress was not only slow but fraught with danger. His ship from France to Naples was racked by storm, and he was chased off Elba by pirates. He was arrested: once for having dangerous books, and then for espionage after he sketched some fortifications in northern Italy. He was only freed when most of his artwork was destroyed, and he was sent under escort to the border. Somehow, Taylorâs sketch of Greek ruins in southern Italy survived; its careful intricacy shows his keen eye for detail.
He made his way round the medical schools and hospitals of Naples, Rome, Florence, Bologna, Milan, Heidelberg, Leiden, Amsterdam and Brussels. On his way, he travelled through the Auvergne, and hiked up the volcanic Puy de DĂ´me in central France. While in Naples, he wrote two ophthalmological articles in Italian for the Giornale Medico Napolitano; âSullâInversione degli oggetti nel fondo del Occhioâ (âOn inverting objects at the back of the eyeâ), and âSul conformarsi dellâ occhio alla distanza degli oggettiâ (âOn adapting the eye to the distance of objectsâ).
He headed to the Solfatara, near Naples, an extinct volcano where sulphur and alum were procured, and looked around the refining factory. On hearing rumbles deep underground, he was told by guides that âthe Solfatara is even now but a hollow crust spread over an abyss,â but Taylor had heard the same rumbling at the Puy de DĂ´me and in the Alps. He assigned it to crumbling in certain parts of the crater; the way the noise travelled through the hillside made it sound more terrifying than it was.
Near the Solfatara was the Grotta del Cane, a small cave in the side of a hill, where an invisible, suffocating gas lay on its sloping floor in a lake, âto about the height of the kneeâ. The gas ran up through the rocks from an extinct volcano, and was generally thought to be sulphurous. Taylor, however, had read up on it, and theorised that it was carbonic acid. Chemistry was not easy to study in Italy at the time, and with difficulty he had managed to get hold of limewater and phosphorus for his experiments. He believed that the results, including a torch extinguishing at the surface of the gas lake, proved his theory to be correct. Later experiments by others showed that it was carbon dioxide, but at least Taylor had demonstrated that the gas wasnât a compound of sulphur.
The caveâs name derived from locals showing tourists the effects of the gas lake on dogs. Standing at normal adult height, humans were unaffected. Taylor, who later in his career objected to unnecessary animal experiments, watched as a dog held down in the gas lake âmade violent attempts to escapeâ because it couldnât breathe. When released from the cave, the dog began to recover. Taylor noted that, unsurprisingly, âthere was no individual present willing to undergo the experiment, to the same extent, on his own person,â so he lowered his face to the surface of the gas and noticed how it started to affect his sinuses. When he wrote about his visit a few years later, he accompanied it with a diagram showing a man in top hat and swallowtail coat, the level of the gas coming up to mid-thigh; this is presumably his self-portrait.
He arrived back in London in the winter of 1829. In March 1830, he became a member of the Royal College of Surgeons by examination, and he returned to France again in the summer, just as revolution tore through Paris. When Parisians hurled paving slabs and flower pots at the soldiers who shot at them, Taylor was at the HĂ´pital de la PitiĂŠ. He had a chance, unusual for a British student at the time, to see gunshot wounds and their treatment on a large scale.
In London again, Taylor set up in general practice, but this stage of his career lasted only a short while. The Society of Apothecaries were demanding improved education in the neglected field of medical jurisprudence, and Taylor was ready in the wings.
Unrecognised by any
Scotland had created the first British chair in Medical Jurisprudence and Police (âpoliceâ meant âpublic healthâ) in 1807 at the University of Edinburgh. As far back as 1789, lectures had been given there on the subject by Andrew Duncan. He had tried to convince the university of the subjectâs importance âto every medical practitioner, who is liable to be called upon to illustrate any question comprehended under it before a court of justiceâ. The fate of the accused depended on the words of the medical professional, whose reputation was also on trial.
The adversarial justice system was developing, so that increasingly prosecution and defence would have counsel, and could employ expert witnesses. Counsel was usually a quick-witted barrister ready to unpick a witnessâs words or run them down with a rhetorical juggernaut: âHow cautious must, then, a medical practitioner be, when examined before such men, when it is their duty to expose his errors, and to magnify his uncertainties, till his evidence seem contradictory and absurd?â The first professor of Medical Jurisprudence at Edinburgh was Duncanâs son; it did little to advance the subject in Britain, hindered because it was only an elective part of the course.
In 1822, 25-year-old Dr Robert Christison took the chair. Like Taylor, his background was in medicine and chemistry, and he had spent some time in Paris. He had read Orfila and attended one of his lectures. In 1823, he published a paper on poisoning by oxalic acid with his colleague Jean-François Coindet, and he began to be called into court as an expert witness by defence counsels. His lectures were poorly attended, and attracted mainly lawyers rather than medical students. From an initial class size of twelve students, by 1825 numbers had dwindled down to only one. That same year, Christison petitioned the university to include his course as an optional subject in medical degrees.
Christison became well known after he was a medical witness at the 1828 trial of Burke and Hare. Helping medical students gain access to cadavers, they had avoided digging up the dead and had taken to murder instead. Christisonâs opinion was sought on wounds and bruises; had they been given before death, during the act of killing, or after death due to the rough handling of the corpse? As part of his research to find out how the body bruised after death, Christison administered blows to corpses; a practical and yet ghoulish experiment, which nearly sixty years later, another Edinburgh Medical School graduate, Sir Arthur Conan Doyle, had Sherlock Holmes carry out in A Study in Scarlet. In 1829, Christisonâs A Treatise on Poisons was published and quickly became a standard text on toxicology. It had gone through four editions by the time of its last in 1845.
The University of London caught up with the academics north of the border, establishing the first chair of medical jurisprudence in England in 1828. Demonstrating the influence that the Scottish had in the field, the first professor, John Gordon Smith, was an Edinburgh graduate. He had served as an army surgeon until 1815, when he moved to London, but restrictions prevented him from practising there because his MD was from a Scottish university. In 1821, his book The Principles of Forensic Medicine was published, and in 1825 and 1826, he lectured on the subject, which had made him an ideal candidate when the university created its chair.
But the course wasnât compulsory; few were attracted by an elective course, and it wasnât funded beyond the fees of the small number of students who attended. Smith felt that it was âunrecognised by any of the medical authorities in this kin...