Skae, David (DNB00)

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SKAE, DAVID (1814–1873), physician, was born in Edinburgh on 5 July 1814. His father was an architect there. Both parents died while David was a mere child, and he was educated by his maternal uncle, the Rev. W. Lothian, at St. Andrews. He attended the art classes in that university for two years, and afterwards, at an early age, spent some time as clerk in a lawyer's office in Edinburgh, where he acquired the business habits which afterwards characterised him. His bent, however, was more towards medicine than law, and, taking up that study in Edinburgh, he eventually became a fellow of the College of Surgeons there in 1836. In the same year he began to teach in the extra-academical medical school, and his lectures on medical jurisprudence soon became popular. After delivering fourteen courses of lectures on that subject, he began the teaching of anatomy, having as colleagues men who afterwards reached the first rank in the profession, like Sir J. Y. Simpson, Professor Spence, and Sir William Fergusson. In 1842 the university of St. Andrews conferred on him the honorary degree of M.D.

Meanwhile from 1836 Skae filled the office of surgeon to the Lock Hospital, and wrote several original papers on syphilis. But he soon made insanity his special study, approaching it from the point of view of a student of nervous and mental physiology. In 1846 he obtained the appointment of physician superintendent of the Royal Edinburgh Asylum at Morningside, and held the post till his death, twenty-seven years later. During his tenure of office the institution was doubled in size, and he attracted a long succession of brilliant assistant physicians, to whose training and advancement he devoted much care. In 1873 he was nominated Morisonian lecturer on insanity at the Royal College of Physicians, Edinburgh. His lectures on mental diseases were characterised by great skill and insight. Unfortunately he did not live to complete his term of office. He died at his official residence at Morningside, of cancer of the gullet, on 18 April of that year. He married Sarah, daughter of Major Macpherson of Ayr, and left issue.

Although Skae left no separate treatise, he made important and suggestive contributions to psychological medicine. He published papers on ‘The Treatment of Dipsomaniacs’ in 1858, and on ‘The Legal Relations of Insanity’ (1861 and 1867), but his most important work was directed to the ‘Classification of the Various Forms of Insanity on a Rational and Practical Basis.’ He made this topic the subject of an address which he delivered at the Royal College of Physicians, London, on the occasion of his occupying the presidential chair of the Association of Medical Officers of Asylums (9 July 1863); and he further developed it in the Morisonian lectures on insanity, 1873. These lectures were completed and published posthumously by his pupil and successor, Dr. T. S. Clouston. Skae's classification is founded upon what he called the ‘Natural History of Insanity.’ Instead of separating the insane into groups of maniacs, melancholiacs, and so on, Skae proposed that classification should be based on the underlying bodily condition of the patient—puerperal mania, traumatic mania, and so on. Skae's classification has not been generally adopted, but it recalled once for all the attention of psychiatrists to the physical basis of mental aberration; and his definition of insanity as ‘a disease of the brain affecting the mind’ is not disputable. His researches have caused clinical facts to be better understood and medical treatment to be better directed.

[Skae's papers in medical periodicals; Scotsman, April 1873; Journal of Mental Science for July 1873; personal knowledge.]

A. R. U.