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Proc (Bayl Univ Med Cent). 2010 July; 23(3): 263–265.
PMCID: PMC2900981

Samuel Wilks: the “grand old man” of British medicine

Samuel Wilks was born in Camberwell near London in 1824 and lived for 87 years (Table (Table11) (13). In 1840 he was apprenticed to a general practitioner, Richard Prior. Wilks later married Prior's widow. In 1842 Wilks became a student at Guy's Hospital in London. He received the MB degree in 1848 and his MD in 1850 from the University of London. A member of the medical staff at Guy's Hospital from 1856 to 1885, he also served as fifth curator of the museum at Guy's Hospital (4). In addition, Wilks was the editor of Guy's Hospital Reports from 1854 to 1865. 1865 marked Wilks' paper on Hodgkin's disease (5). In 1859 he published his Lectures on Pathological Anatomy (6). Wilks was elected a fellow of the Royal Society in 1870. His paper “Historical Notes on Bright's, Addison's and Hodgkin's Diseases” appeared in 1877 (7). Wilks coauthored A Biographical History of Guy's Hospital with G. T. Bettany in 1892 (8). He served as president of the Royal College of Physicians of London from 1896 to 1899 and, in 1897, he was made a baronet and appointed physician extraordinary to Queen Victoria. Figure Figure11 shows a photograph of Wilks' distinguished and commanding appearance.

Figure 1
Portrait of Sir Samuel Wilks by B. Sephton. Used with permission of the Royal College of Physicians.
Table 1
Samuel Wilks (1824–1911)

Wilks' tenure at Guy's Hospital during the latter half of the 19th century was Guy's “golden age.” Wilks labeled Thomas Addison, Richard Bright, and Thomas Hodgkin the “three great men of Guy's” (7). In 1856 Wilks published a paper on amyloidosis (lardaceous disease) and probably described the first patient with the primary type, now called AL amyloidosis (9, 10). In the same paper some of Thomas Hodgkin's original cases on enlargement of lymph nodes and spleen were unknowingly redescribed. Wilks had been unaware of Hodgkin's work on lymph nodes and spleen originally published in 1832 (1114) until he came across an 1838 citation by Richard Bright (15). Wilks followed with a second paper in 1865 describing “Hodgkin's disease” and was the first to use the eponym (5, 13, 14, 16, 17). Interestingly, neither Hodgkin nor Wilks used a microscope to examine histopathology in this disorder (14, 16). The 1865 paper was published in Guy's Hospital Reports and, by using the term “Hodgkin's disease,” Wilks immortalized his predecessor (1822). The eponym not only survives to the present, but Hodgkin's name is linked to all malignant lymphomas (Hodgkin's and non-Hodgkin's). Thus, his name echoes daily throughout the halls of every major medical center in the world (13, 14, 1623).

Wilks published a number of other important papers (Table (Table22). In 1859 he described inflammatory bowel disease some 70 years before Crohn. In the same year Wilks reported the use of bromide for the treatment of epilepsy (2, 3, 24, 25). In 1863 he described the visceral lesions of syphilis. Seven years later, Wilks reported endocarditis with systemic arterial embolism and, in 1877, he described myasthenia gravis as a clinical entity (2, 26).

Table 2
Clinicopathologic contributions of Samuel Wilks

Wilks had been a student of Thomas Addison and was distressed when, in 1872, Anton Biermer described 15 cases of “progressive pernicious anemia” making no mention of Addison's previous work. Wilks rose to defend Addison's priority, pointing out that Addison had lectured on fatal idiopathic anemia as early as 1843 and included it in his 1855 report on diseases of the suprarenal capsules (7).

Wilks was known for his outspokenness and truthfulness. He avoided the adulatory style of contemporary obituaries and once remarked laconically, “I wonder if any medical man died who was not possessed of all the virtues.” On becoming president of the Royal College of Physicians of London in 1896, Wilks inherited the tradition of annually making assessments of the character and achievements of recently deceased fellows. Wilks' reviews were more often “verum” than “bonum,” but these appraisals added to the respect for a great physician and an honest man (27, 28). Nevertheless, it was said that Wilks' assessments “added a new terror to death” (4).

William Osler was introduced to Samuel Wilks' monograph Lectures on Pathological Anatomy (6) in 1871 by Osler's clinical mentor, Palmer Howard, when Osler was a medical student (2729). Osler was so impressed that he wrote Wilks in 1875, and correspondence continued between them about interesting cases. In 1878 Osler met Wilks during rounds at Guy's Hospital. Osler then spent a delightful evening at Wilks' home. Thereafter, Osler always called on Wilks when in London. In 1907 Osler delivered his “Clinical Lecture on Erythraemia” (or polycythemia vera) at Oxford (30). Osler began by commenting on the recognition and acceptance of various diseases. He mentioned Bright, Addison, and then Hodgkin. He noted that Samuel Wilks had called attention to Hodgkin, thus naming the disease, and labeled Wilks the “grand old man today in British medicine.”

The Men and Books “snippets” were published by Osler in the Canadian Medical Association Journal in 1912, 1913, and 1914 (27). The third selection was about Wilks, which Osler wrote shortly after Wilks died. The entire series of 36 articles was collected and privately published by Dr. Earl Nation in 1959 in a limited edition of 250 copies (28). The Men and Books monograph was reissued in 1987 (1000 copies) with an introduction by Earl Nation. In the chapter on Wilks, Osler said, “He had a remarkably attractive personality, which age so adorned, that at three score and ten there was no handsomer man in London.” Between 1869 and 1914 the weekly magazine Vanity Fair featured a full-page caricature of a prominent person. Figure Figure22 shows the Vanity Fair caricature of Samuel Wilks, which appeared in 1892. The picture is signed “Spy,” a well-known caricature artist named Leslie Ward (later Sir Leslie Ward). Osler said that Wilks “had all the things that should accompany old age: fairly good health to the end, an unceasing interest in life, and the affectionate esteem of a large circle of friends” (27).

Figure 2
Caricature print of Samuel Wilks at age 68 in Vanity Fair, 1892. Photograph obtained from the National Library of Medicine (order no. B029055).

Sir Thomas Barlow, president of the Royal College of Physicians from 1910 until 1914, stated the following: “It has been said that Wilks had the genius of observation. I think he also had the genius of friendship, for he was idolised by his students, beloved by his disciples, not only of Guy's, but of every school in London, and implicitly trusted by the Fellows of the College of Physicians” (2).

Osler wrote, “With his death snaps the link between old medicine and the new, the link which united the profession with the famous clinicians of the early part of the last century, Bright, Addison, and Hodgkin” (27, 28).

Acknowledgment

I thank Shawn Guy-Pitts for expert help with preparation of the manuscript.

References

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