Hodgkin Remembered Cancer TX Rev 1999

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It is a great pleasure to be here this morning tocommemorate the bicentenary of the birth ofThomas Hodgkin with you. This is the third occa-sion on which Guys Hospital has honouredHodgkin and the second in which I have had thegood fortune to participate. I have been thinking agreat deal about this sustained interest in Hodgkinslife and work, trying to understand why we con-tinue to remember him. What is it that differentiateshim from the many talented men and women whosecareers were connected with this place?

As I contemplated these questions I recalled a

fantasy my late husband and I created while wewere working on our biography of Thomas Hodgkin.We called it the Dr. Hodgkin Dinner Party. Weimagined a dinner party where Hodgkin was thehonoured guest, we listed the people we wouldinvite to the party, and we anticipated the conversa-tion that would occur. Hodgkins accomplishmentsas a physician, humanitarian, and social reformerpromised that the party would be a success.

We began with the guest of honour but right awaywe ran into a problem. He might not accept our invi-tation. Hodgkin was a modest, self-effacing man. He

sought little glory for himself and did not like tostand out from the crowd. When the Royal College ofPhysicians invited him to become a Fellow, he did notaccept the honour even though the imprimaturwould have furthered his career. Hodgkin was afirmly committed Quaker, and Quakers, along withother Dissenters, were not ordinarily admitted asFellows of the College. He recognized that theCollege was making a special place for him and hedid not want to be differentiated from other qualifiednon-Anglicans. Many years later, when his colleagues

began to solicit subscriptions for a testimonial to

honour his many accomplishments, Hodgkin per-suaded them to give the money instead to an asylumfor impoverished medical men, their widows, andtheir orphaned children.

Thomas Hodgkin remembered

Amalie M.Kass

Lecturer on the History of Medicine, Harvard Medical School, Boston, Massachusetts

This article is an edited transcript of a talk given at the symposium celebrating the bicentenary of the birth of ThomasHodgkin, Guys Hospital, 2 October 1998.

CANCER TREATMENT REVIEWS 1999; 25 : 133143

Artic le No. ctrv. 1998.0108, avai lable onl ine at http:/ /www.ideal ibrary.com on

Figure 1 Thomas Hodgkin. Oil painting by Thomas Sully, 1858

(from a photograph). (Historical Society of Pennsylvania)


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Then there was the possibility that if he came tothe celebration, he would not be very sociable.Hodgkin had a tendency to be rather stiff andhumourless. And though he did not like to call atten-tion to himself, he remained dedicated to eighteenth-century Quaker customs with which many otherFriends had compromized and which today wouldseem anachronistic. He continued to use Quakerterms, thee and thou, First day and Second day, andto dress in strict Quaker-like fashion, simple darkclothing and broad-brimmed hat. On these issues hedid not mind looking and acting differently, becausehe thought sacrifice for religious principles buildscharacter. It most decidedly was part of his character.

But, assuming Hodgkin came to our party, whofrom our contemporary world would we invite? Withthis we had no problems for despite some ofHodgkins personal idiosyncrasies, his extraordinarywide range of interests in a variety of areas wouldassure us a stellar guest list. We could chose amongphysicians, scientists, medical educators, experts inpublic health, philanthropists, anthropologists, sociol-ogists, geographers and explorers, world travellers,even urban planners. We could include representa-tives of some of the people he had tried to help Liberians, Jews, Syrians, North American Indians,New Zealand Maoris, and descendants of many SouthAfrican tribes. We would most decidedly invite mem-

bers of the Hodgkin family whose pride in their illus-trious ancestor would have been equalled by hissatisfaction with their accomplishments. Hodgkinhad no children of his own, but his younger brother,

John Hodgkin, was the father of 11 children andThomas, known as Uncle Doctor by his nieces andnephews, enjoyed and reciprocated their esteem andaffection. Devotion to family was another of his fun-damental principles.

The conversation would be stimulating thoughperhaps one-sided. Hodgkin was fairly didactic inpersonal interchange and was quite certain of theimportance and righteousness of the various socialcauses in which he was engaged. But he was alsounusually knowledgeable. He had been well edu-cated. His parents had insisted on the value of learn-ing and had been his earliest teachers. His father, aschoolmaster and calligrapher, had instructed him inGreek, Latin, and English composition. He wastutored in French. He had the advantage of earlyacquaintance with scientists and social activists inthe Quaker community. His medical training was asgood as was available at the time. After an appren-ticeship to an apothecary firm in Brighton, he spent ayear walking the wards at Guys and then enrolled,in 1820, at the University of Edinburgh, by far the

best medical school in Britain. Though some of theEdinburgh faculty were already superannuated,

there were others of outstanding ability. The RoyalMedical Society provided an opportunity for stu-dents to deliver papers to a knowledgeable audienceand to discuss ideas that often challenged commonlyaccepted medical theories (Hodgkin presented apaper on the uses of the spleen, which would latercontribute to his ideas about the disease that bearshis name). Medical students flocked to Edinburghfrom other parts of the English-speaking world, andHodgkin formed important lifelong friendships withsome of them. He interrupted his studies in

Edinburgh to spend a year in Paris where the med-ical professors were demonstrating the importanceof pathological anatomy as the key to understandingdisease. In addition to attending the lectures at theEcole de Mdecin, Hodgkin spent long hours at thedissection table the availability of cadavers inFrance, in contrast to restrictions in Britain, con-tributed to French preeminence in pathology.Hodgkin was also attracted to bedside teaching inthe Paris hospitals which offered a large array of dis-eases to be observed. He became a particular favoriteof Lannec who had recently developed the stetho-

scope as a diagnostic tool providing informationabout the lungs and heart that could be correlated

134 A. M. KASS

Figure 2 John Hodgkin, Sr., c. 1800. Oil portrait attributed to John

Opie. (Friends House, London)


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with observations at autopsy. Hodgkin subsequentlyintroduced the stethoscope to London hospitals at ameeting of Guys Physical Society.

The year Hodgkin spent in Paris, plus additionalmonths in the French capital following receipt of hismedical degree from Edinburgh in 1823, and a tourof Italy and Switzerland where he met many medicalnotables, further contributed to his education andprepared him to assume a leading role in medical cir-cles when he returned to London. In 1826, he wasappointed Inspector of the Dead and Curator of theAnatomical Museum of Guys Hospital Medical

School, which had recently separated from StThomas and was exhibiting the enthusiasm andexcitement often attendant on a new enterprise.

This formal education in the classics, languages,and medicine would assure those present that ourguest of honour could hold his own in conversation.

Just as important was the process of self-educationthat marked Hodgkins entire life. He maintained avoluminous worldwide correspondence throughwhich he gathered information about his many inter-ests, medical and humanitarian. The letters were areflection of an unusually inquisitive mind and aninsatiable desire to correct social injustice. In addi-tion to his friends and associates in medicine andsocial reform, he did not hesitate to write to peoplewhom he did not know but who might supply himwith information. In the Hodgkin archive we foundletters to or from American politicians, the Chief

Justice of New Zealand, African colonists, andCanadian Indian chiefs, to name just a few.

What then might be the primary topics of conver-sation? We would probably begin with discussions ofmedicine and especially with Hodgkins medicalaccomplishments at Guys where he spent twelveyears. It was here that he delivered the first system-atic lectures in pathologic anatomy ever given inBritain. They were later published in two volumes. Itwas here that he performed, and then carefullydescribed in meticulous notes, more post-mortemexaminations than had been recorded at the hospitalto that date. It was here that he created a medicalmuseum that greatly facilitated instruction and pre-served interesting specimens found at autopsy. Heprepared many of the specimens himself and pro-moted the art of wax anatomical models. He alsopublished a catalogue to the Museum that was alandmark contribution to medical instruction andtells us much about nineteenth-century medicalknowledge. It was on the basis of his pathologicalstudies at Guys that he published many importantpapers, including a description of retroversion of theaortic valve (his paper preceded the better knownpaper by Corrigan), another on carcinoma, and stillanother on appendicitis. He assisted Joseph Lister,father of Lord Lister, in the development of theachromatic microscope and used that improvedinstrument to study and describe the biconcavestructure of erythrocytes and the striated appearanceof voluntary muscles. Not only was he unusually tal-ented, he was unusually productive.

The cholera epidemic that reached England in theautumn of 1831 would be a subject for lively conver-sation at our party. Many of Londons prominentphysicians fled the city but Hodgkin remained to carefor patients at the hospital and in the squalid neigh-

bourhoods nearby. We could assume that epidemiolo-gists, sanitary engineers, and infectious disease

physicians would want to reminisce with him aboutthe epidemic and about the essay he published in anattempt to allay the excessive fear that was gripping

THOMAS HODGKIN REMEMBERED 135

Figure 3 Stethoscope thought to have belonged to Thomas

Hodgkin. (Gordon Museum, Guys Hospital Medical School)


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the nation. Hodgkin believed that cholera was nothighly contagious, but he recognized that there wasincreased incidence among the elderly and especiallyamong the poor. To prevent further spread he urged

measures to change social conditions temporaryrelief to reduce poverty and ongoing programmescreating jobs and improving education. Our latetwentieth-century guests would undoubtedly findthese recommendations more acceptable than didmany of Hodgkins conservative colleagues.

Of course, the paper published in the Transactionsof the Medico-Chirurgical Society in 1832, describingseven cases with an unusual appearance of the lymphglands and spleen would be a compelling topic ofconversation. I would want to know what Hodgkinthought of the eponym given the disease he was thefirst to describe, since it was not until 1865, more thanthirty years later, that the term Hodgkins Diseasewas first applied. Sir Samuel Wilks, also a pathologi-cal anatomist and physician at Guys, had made simi-lar observations of a peculiar enlargement of thelymphatic glands frequently associated with enlarge-ment of the spleen, and in two papers, one pub-lished in 1856, the other in 1865, Wilks acknowledgedthat Hodgkin had preceded him in recognizing a dis-tinct disorder. In the second of his papers, Wilkssomewhat begrudgingly named the disease for hispredecessor, adding that by so doing he had savedthe profession from a name even more uncouth thanmorbus Hodgkin, that is, Wilks Disease.

136 A. M. KASS

Figure 4 Guys Hospital, 1817. Engraved by G. Cooke & H. Lekeux. (British Museum)

Figure 5 Cover page of A Catalogue of the Preparations in the

Anatomical Museum of Guys Hospital.


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Would Hodgkin have been pleased to be remem-bered in this fashion or would he have disdained thehonour? He might well be astonished that, over theyears, so many people have come to Guys to studyhis specimens, using new technologies to verify the

accuracy of his observations. He would certainly besurprised by the scientific understanding ofHodgkins Disease that has accumulated in the inter-vening years. One of the astonishing aspects ofHodgkins paper is the degree to which it confirmedhis unusual ability to recognize, without microscopicassistance, much less the use of sophisticated mod-ern day techniques, the minute changes in theappearance of lymph nodes and spleen that distin-guished them from changes that might be expectedin cases of tuberculosis or carcinoma or associatedwith drainage of inflamed tissues.

Hodgkin might be less surprised by some of thetherapeutic agents now employed against the dis-ease. In his paper, he suggested that if patients wereto come within his care, he should be inclined toendeavour as far as possible to increase the generalvigour of the system, to enjoin the utmost protectionfrom the inclemencies and vicissitudes of theweather, to employ iodine externally and to push theinternal use of caustic potash as far as circumstancesmight render allowable. Perhaps caustic potashonly sounds worse than some of the chemotherapeu-tic agents prescribed today.

During the Guys years, Hodgkin undertook sev-eral medical projects that were intertwined with his

social concerns and would surely interest the public

health specialists and social workers at our party. In1835 he delivered, and later published, a series of lec-tures titled On the Means of Promoting andPreserving Health at the Spitalfields MechanicsInstitute. Mechanics Institutes were initiated in thenineteenth century by well-meaning social reformersto provide lectures and libraries where working menhad access to information that could improve theirlives. Hodgkin recognized that it was more impor-tant to preserve health and prevent disease than tocure or alleviate actual sickness. His lectures ran thegamut from instruction about personal hygiene, diet,

ventilation, and household cleanliness to the dangersof alcohol and tobacco, and even extended to adviceon child rearing. Mechanics Institutes were not pop-ular with many well-placed men who feared theywould subvert the proper order of society.

In a lecture to the Hunterian Society, he proposeda prepayment scheme of medical care for the work-ing poor that would interest advocates of healthcarereform, which in the United States is a major contem-porary political issue.

According to Hodgkins scheme, public medicalofficers would be adequately paid to work in dispen-

saries financed by small weekly contributions fromthe subscribers. Patients could choose any physician


Figure 6 Cover page of On Some Morbid Appearances of the

Absorbent Glands and Spleen.

Figure 7 Sir Samuel Wilks. Lithograph. (Guys Hospital Medical

School)


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within the dispensary. Hodgkin himself had beenphysician to the London Dispensary and knewwhereof he spoke.

In 1836, Hodgkin was named a member of theSenate of the newly created University of London, apost that united his interests in medical educationwith his reformist proclivities and would stimulateconversation about the problems of medical educa-tion today. In the 1830s, a group of influential, lib-eral-minded Englishmen had begun agitating foruniversity degrees for non-Anglicans who, up to thattime, were excluded from higher education on reli-gious grounds. (This of course was another reasonwhy Hodgkin had gone to Edinburgh.) Eventually,London University received a charter and wasempowered to bestow degrees in medicine, law, andarts to those who qualified, without regard to reli-gious persuasion. Hodgkin was named one of 36Senators who set standards of matriculation andrequirements for degrees. Actual instruction wasgiven at the colleges and medical schools. Hodgkinsappointment coincided with his desire to eliminatediscriminatory practices and to open university edu-cation to all religious groups, as well as to improvemedical education more generally. He had delivereda stunning critique of English medical education to ameeting of the Physical Society of Guys Hospitalshortly after joining the staff, and was known toadvocate strict qualifications for admission to med-ical school, as well as increased clinical teaching as areplacement for the didactic lectures that were thehallmark of the British system.

I am sure that those familiar with the vagaries ofinstitutional politics would want to talk withHodgkin about the great tragedy of his medicalcareer: his failure to be promoted to the assistantphysicianship when the post became vacant in 1837.Many would sympathize with the injustice he suf-fered in an episode that ended badly for Guys andfor Hodgkin. He had every reason to expect theappointment after twelve years of outstanding serv-ice to the hospital and medical school. Unfortunatelyhe had not anticipated the animosity of BenjaminHarrison, the powerful Treasurer who controlledappointments. Harrison was a staunch Tory and anoutspoken Evangelical Anglican. Depth of convic-tion was the only shared aspect of their otherwisecontrasting views. A clash between the two men wasalmost inevitable, if religious and political viewshave a role in science and medicine.

In addition to Hodgkins determined espousal ofQuaker beliefs and practice, which did not sit wellwith Harrison, his participation in social reform,exemplified by the Spitalfields Lectures and Senate

of the University of London, was completely anti-thetical to Harrisons beliefs. A more politically

astute man would have taken care to moderate someof his activities but Hodgkin did just the opposite.He became a vocal spokesman on behalf of NorthAmerican Indians and other indigenous groupsthreatened by European expansionists and he testi-fied before a Select Committee of the House ofCommons that was investigating the treatment of thenatives in the British colonies. Hodgkin was espe-cially critical of the Hudsons Bay Company whichwas giving guns and alcohol to the Canadian Indiansin exchange for furs which brought large profits tothe company. Harrison was an influential director ofHudsons Bay Company and he was deeply angered

by the expos which seemed entirely appropriate toHodgkin. Added to these disagreements was the factthat Hodgkin had been absent from the hospital forseveral months, recovering from a nervous disorder.This too became a bone of contention between himand Harrison. Though Hodgkin believed he hadcompletely regained his health and could assumenew duties without difficulty, Harrison had doubts

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Figure 8 Benjamin Harrison, Jr. (Guys Hospital Medical School)


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or at least he used this as an excuse to questionHodgkins fitness.

Harrison had his own favourite for the post,Benjamin Babington. Babington was not a bad choicethough he could not equal Hodgkins past accom-plishments or future potential. Neither would hemake trouble for the Treasurer and other members ofthe establishment. At one point in the affair, Harrisonoffered to split the position between the two men,probably knowing that Hodgkin could never acceptsuch an insulting arrangement. When the Governors,who were pretty much under Harrisons thumb,voted in favour of Babington, Hodgkin resigned,thereby ending his career in medical research andteaching. There was a brief stint at St. Thomas wherehe worked hard to improve the system of medicallectures and the medical museum, but at the end of ayear he was not reappointed, another unexpected

blow to his pride. He did continue to publish ondiverse medical topics including, to demonstratethat diversity, diabetes, curvature of the spine,Abyssinian tape worm, and coronary artery disease,plus proposals for reform of the medical professionand of the medical poor laws and for a revised sys-tem of apothecary weights and measures.

While this incident was a major blow toHodgkins career, it did assure the success of ourhypothetical dinner party as he was then able todevote himself with increasing fervour to a myriadof humanitarian activities, some of which hadengaged him since boyhood. Many had their roots inthe traditional Quaker commitment to peace and

social justice. Hodgkin had been reared to take anactive role on behalf of these concerns. But he wasalso part of a broader movement among thoughtfulVictorian men and women to redress the social illsthat accompanied industrialization and urbaniza-tion. It was an era that saw a proliferation of commit-tees and societies, accompanied by a profusion ofpamphlets, speeches, and letters to the newspapers,all dedicated to one worthy cause or another. ButHodgkin put his own stamp on the causes he advo-cated. For one thing, he had an unusually strongsense of his personal obligation to redress injustice.For another, he was willing to be the instigator ofchange, to organize support for the causes in whichhe believed, and to stick with them, sometimes in theface of unpopularity, even when the cause no longerattracted interest from others. Commitment anddetermination were essential ingredients in theseactivities.

And here, of course, is where the non-medicalpeople who came to the Hodgkin Dinner Partywould take a special part in the conversation. Somewould want to explore his ideas on the colonizationof freed slaves in Africa, an idea which they mighthave difficulty understanding. Hodgkin wasopposed to slavery in the United States and in theBritish colonies but he was uncertain about theeffects of immediate and total emancipation. Insteadhe advocated a gradual end to slavery and the estab-lishment of colonies of ex-slaves in Africa where theywould be expected to introduce Christianity and theprinciples of self-improvement and self-government


Figure 9 Minute Book. British African Colonization Society. (Rhodes House, Oxford University)


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that Englishmen such as he valued. This notion ledHodgkin to be instrumental in the British AfricanColonization Society, a counterpart to the AmericanColonization Society which had established Liberiaas a refuge for freed American slaves. Most antislav-ery activists in Britain and the United States rejectedcolonization and Hodgkin was roundly criticized bymany people who would have been his allies onother social issues. Nonetheless, he persuaded theBritish Colonization Society to send money and sup-plies to Liberia during the 1830s and a decade laterhe was the first to suggest that Liberia should sepa-rate itself from the American society and become anindependent nation. When independence wasdeclared in Monrovia and the newly elected presi-dent of Liberia came to England, Hodgkin acted ashis host and facilitated British recognition of the newnation.

Though Hodgkin favoured colonization byAfrican- Americans in Africa, which he viewed as areturn to their ancestral home, he was deeply trou-

bled by the effects of European settlers on native peo-ples throughout the world. I have already mentionedhis concerns for the Canadian Indians. As a youth hehad composed a long essay criticizing the explorersand settlers whose greed, guns, diseases, and alcoholthreatened to exterminate the Indians of North andSouth America. He also criticized Christian mission-aries for their proselytizing zeal among people stillunacquainted with the material benefits of westerncivilization.

Hodgkins concerns were not exclusively humani-tarian he was also driven by his interest in socialscience and ethnology. Extermination of the nativepeople would preclude understanding the physicaland cultural history of mankind. Thus the anthropol-ogists who came to the party would find much incommon with him. His concern led Hodgkin to cre-ate the Aborigines Protection Society, a group thatclaimed to speak for all people threatened byEuropean expansionism, which at one time includednatives on just about every other continent. Hodgkinwas tireless on behalf of the Aborigines ProtectionSociety, accumulating data from correspondentsaround the world and replying with detailed recom-mendations for improved treatment of the natives.He edited the societys journal, composed memo-randa to the Colonial Office, and testified beforeParliamentary committees.

These same concerns explain Hodgkins participa-tion in the Ethnology Section of the BritishAssociation for the Advancement of Science. Herarely missed the annual meetings where he pre-sented several remarkable papers, in medicine as

well as ethnology. It explains his leadership in forma-tion of the Ethnological Society of London (which

evolved into the Royal Anthropological Institute),and his role as Honorary Secretary of the RoyalGeographical Society. In all these efforts Hodgkinvoiced the conviction that the so-called feebleraces were Gods creatures and should not beexploited by the representatives of more civilizedsocieties. Hodgkin was fighting a losing battle.Imperialism became a powerful force during the lat-ter part of the nineteenth century and Hodgkin andhis associates could not stem that tide. The social sci-entists and the humanitarians at our party might findhis ideas for the preservation and gradual improve-ment of these people rather naive, but they wouldhave the benefit of hindsight.

There were many other humanitarian enterprises,displaying the same desire to help others. Some werepersonal benefactions to North American Indians, aMaori boy, Liberian merchants, and escapedAmerican slaves, all of whom had come to Englandand needed assistance. Hodgkin was generous to afault, occasionally duped by people who took advan-tage of his trusting nature. There was the Syrian

140 A. M. KASS

Figure 10 Title Page for The Colonial Intelligencer.


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Medical Aid Association which sent British physi-cians to Beirut and Damascus where they weremeant to provide modern medical care, train localdoctors, and in time to establish a hospital. It wasanother exercise in futility which died as fundingand interest diminished, but also an example of the

breadth of Hodgkins humanitarian concerns mixedthis time with his medical interests.

And then there were the Jews. One of Hodgkinsnieces recalled that, of all his concerns, the

Aborigines and the Jews took first place in his heart.There are several explanations for this, including theanalogy between Quakers and Jews as outsiders inBritish society, the poverty of many Jews living inLondon, and the discrimination and oppressionexperienced by Jews in other parts of the world.Certainly it was Hodgkins personal friendship withSir Moses Montefiore, the outstanding leader of nine-teenth-century Anglo-Jewry, that led to many of hisefforts on behalf of the Jews. They had met in Romein 1824 when Hodgkin was briefly employed as per-sonal physician to Abraham Montefiore, Moses

younger brother, who was terminally ill with tuber-culosis. An enduring friendship ensued, largely

fuelled by their common commitment to assist theneedy in all parts of the world.

Hodgkin became physician to two Jewish friendlysocieties that provided medical care to poor Jews inthe east end of London, undoubtedly because ofMontefiores influence. He was repeatedly invited byMontefiore to accompany him and his wife on over-seas missions for the relief of persecuted Jewish com-munities. Montefiore was world renowned as

spokesman on their behalf. But it was not until 1857that Hodgkin felt he could responsibly leave Londonfor extended periods.

There followed five journeys in which Hodgkinacted as physician, companion, amanuensis, andassociate in philanthropy to Montefiore. They wenttwice to Palestine, where Montefiore was engaged inmany projects to improve the plight of the smallgroup of Jews then living in Jerusalem. They went toRome in a vain attempt to persuade the Pope torelease a Jewish boy who had been baptized as aCatholic, removed from his family, and was being

trained for the priesthood. They went toConstantinople to secure the Sultans permission to


Figure 11 Thomas Hodgkin, photograph, c. 1860. (Hodgkin family

collection) Figure 12 Sir Moses Montefiore. (Signed lithograph in Narrative of

a Journey to Morocco)


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purchase land for a hospital in Palestine (then part ofthe Turkish Empire), and they went to Moroccowhere Montefiore persuaded that Sultan to releasetwo Jews falsely accused of murder and to guarantee

better treatment for the Jews in his land. On each ofthese journeys, Hodgkin provided medical care, tooknotes of ethnological and geographical interest,developed plans for the improvement of the peoplehe saw, and dispensed personal charities of his own.Travel was difficult. The Montefiores and Hodgkinslept in tents in the deserts of Morocco and Palestine,

braved poor food and unsafe water, and endured allthe discomforts of the ships that crossed theMediterranean.

It was on the second journey to the Holy Land, in1866, that Hodgkin became fatally ill with a dysen-teric disorder. He died in Jaffa April 4th, to theintense grief of his good friend, who arranged for apermanent gravesite and commissioned the granite

obelisk that marks it today. In his final letter home,Hodgkin had written that he did not expect to liveand that he lamented the little service he had done.The grave however is more accurately inscribed to aman distinguished alike for scientific attainments,medical skill and self-sacrificing philanthropy.

This brings me back to the question I posed at the beginning of my talk. Why do we continue toremember and to honour Hodgkin, apart frominterest in the disease that bears his name?Certainly the success of our dinner party is part ofthe explanation, suggesting that he appeals to manydifferent people, each with an individual interestthat coincides with one of Hodgkins. At the end ofthe twentieth century, when specialization is afeature of our professional lives, and often of ourpersonal lives, it is refreshing, and perhaps intimi-dating, to meet a man who engaged in such a broadarray of activities.

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Figure 13 and 14 Hodgkin Grave, Jaffa, Israel (Photograph J. Seide,Janus, 48:5361, 1959)


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We remember him because he was so good, andtried so hard to do good. Not always successfully,sometimes with a limited sense of reality, but alwayswith pure motives. It is inspiring to meet a true ideal-ist, especially in an era when idealism is often eitherignored or disparaged. We admire his consistencyand his refusal to sacrifice principle for expediency.

We remember him because so many of the prob-lems he sought to remedy remain unsolved: health-care for the poor and adequate compensation for thephysicians who care for them, the relationship of sci-entific knowledge to clinical practice, even the evilsof tobacco and alcohol. Hodgkin tried to improvecare for the mentally ill, to make prisoners into use-ful citizens, to relieve poverty and unemployment.He participated in the Society for the Improvementof Factory Children and in an attempt to help thechimney sweeps. The night before departing on thefinal journey to Palestine, he completed a manuscriptOn the Dwellings of the Poor in which he enunci-ated the need for better housing.

Finally, we remember him because of the poignantquality of his life and his death. I have spoken of thefailure to be promoted at Guys. His personal life wasalso full of disappointments. The nervous disorderthat attacked him several times was discouraging.He had loved his cousin Sarah Godlee from child-hood but could not marry her because of a Quakerrule forbidding first-cousin marriages. Hodgkintried desperately to persuade the Quakers to rescindthe rule, but when he did not succeed, he acquiescedrather than leaving the Society. It was not until hewas fifty-two years old that he married a widowwhose good nature softened some of the harsh edgesof his personality and provided him with a gen-uinely happy home in Bedford Square.

His death too has a poignant quality. He became illin a foreign land, was cared for by strangers, and was

buried thousands of miles from his family. I like tothink that the epitaph on his grave makes up for thesadness of that distance Humani nihil a se alienumputabat Nothing of humankind was foreign to him.

ACKNOWLEDGEMENTS

The figures in this article are reproduced with per-mission from Perfecting the World, the life andTimes of Dr. Thomas Hodgkin 17981866, A. M.Kass and E. H. Kass; Harcourt Brace Jovanovich,1988. The Journal fully upholds the rights of theoriginal copyright holders.


Figure 15 Blue plaque at 35 Bedford Square, London.

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Hodgkin Remembered Cancer TX Rev 1999

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