Alison, William Pulteney (DNB00)
ALISON, WILLIAM PULTENEY (1790–1859), physician, was born at Boroughmuirhead near Edinburgh. His father, the Rev. Archibald Alison, the author of the ‘Essay on Taste,’ was for some years incumbent of Kenley in Shropshire, and afterwards in charge of the episcopal congregation in Edinburgh. His mother was daughter of Dr. John Gregory, a member of a family distinguished in letters and science, and long connected with the university of Edinburgh. His younger brother became Sir Archibald Alison, the eminent historian. He was educated privately and entered Edinburgh College in 1803, where he studied, first arts, and afterwards medicine. In 1811 he became M.D. with a dissertation, ‘De Viribus Naturæ Medicatricibus.’ During his academical career he was an enthusiastic pupil of Dugald Stewart, then the most distinguished teacher in the university, and acquired a deep interest in philosophical questions. So considerable were his attainments in this subject that it is said Dugald Stewart at one time desired that Alison should succeed him in his chair. In 1817 he wrote an article in ‘Blackwood's Magazine’ in defence of Dugald Stewart's philosophy.
In 1815 he entered the serious work of his profession as physician to the newly-founded New Town Dispensary, and by laborious practice among the poor gained that deep sympathy with the working-classes and knowledge of their wants and sufferings which inspired the most important part of his public work in after life. The quarterly medical reports of the dispensary, published in the ‘Edinburgh Medical Journal’ (1817–19), in great part written by Alison, were important contributions to the knowledge of fevers, and still supply valuable materials for the history of epidemics, though the intricate question of the specific distinctness of different forms of fever was not at that time cleared up. These reports also contain observations on a form of small-pox as modified by vaccination, which was then a novelty.
In 1820 Dr. Alison was appointed by the crown professor of medical jurisprudence, and held this office two years. About the same time he assisted his uncle, Dr. James Gregory, in the lectures on the practice of physic. In 1822 he was appointed to the professorship called that of ‘institutes of medicine’ or physiology (but at that time including pathology also), which he held about twenty years, first as the colleague of Dr. Duncan, and afterwards alone. In virtue of this professorship he became one of the physicians to the clinical wards of the infirmary, and was thus engaged also in clinical teaching.
The substance of his lectures on physiology was given in his text-book, ‘Outlines of Physiology,’ published in 1831, afterwards expanded into ‘Outlines of Physiology and Pathology,’ 1833. Dr. Alison's physiological teaching, which is summarised in these works, produced a powerful impression on the Edinburgh school. It was not remarkable for experimental research or for novelties in detail, but was founded upon certain broad principles which the author afterwards developed in his memoirs on ‘Vital Affinity’ and elsewhere. His leading idea was that of ‘a life-force or forces, of something distinct from and superadded to the physical forces of dead matter. … These vital forces were, according to him, quite as distinct from the mind and its special endowments as from the physical forces. … Throughout the range of animated creation we find peculiar laws of being which may be termed vital, and of which organisation is the result. Two modifications of vital force are especially known to us; one in alliance with the mechanical properties of matter, giving rise to vital contraction or muscular motion; the other grafted upon its chemical properties and shown forth in vital attractions and repulsions of the ultimate molecules. These peculiar phenomena can be studied only in living beings; there is nothing analogous to them in dead matter, nor are they to be confounded together, though motion is necessarily the result of both. Vital contraction is inherent in particular tissues; vital attraction is shown forth in every part of the organism, at every moment of nutritive, secretive, absorbent change.’
The views thus expounded by a competent authority (Edinburgh Medical Journal, 1859, p. 475) were applied by Alison to explain not only physiological processes, but processes of disease, such as asphyxia and inflammation. They deal with a long-standing controversy in biology, whether life precedes organisation, or is the result of organisation, and one not yet decided. But the vortex of dispute has drifted away from the standpoint of Alison, and it would be impossible here to discuss the bearings of his views on modern controversies. These topics, and inquiries arising out of them, occupied Alison's mind and pen for many years, during which time, and indeed during the whole tenure of his professorship of institutes of medicine, he made few contributions to practical medicine.
The record of his strictly professional life will he completed by saying that in 1842 he was promoted to be professor of the practice of medicine, and held this office till 1856. In 1844 he published a text-book, ‘Outlines of Pathology and Practice of Medicine,’ which was rather intended for his own students than for general use, and is not, among text-books of medicine, very noteworthy. He was appointed first physician to her majesty for Scotland, and in 1850 received the honorary degree of D.C.L. from the university of Oxford.
His academical position and his own personal qualities gradually won for him a very large practice, especially in consultation. He performed his hospital duties with the utmost conscientiousness, visiting his patients, when necessary, several times a day. He was, besides, incessantly engaged in literary and public work, especially in connection with that great philanthropic effort which we shall speak of later. By these unremitting labours, which only great bodily as well as mental energy could have rendered possible, he had established himself as the unquestioned head of the medical profession in Scotland, when he was seized with the first attack of the malady, epilepsy, to which he was subject for the rest of his life, and to which he ultimately succumbed.
In the winter session of 1855–6 he was two or three times attacked by fits while lecturing, and in 1856 he resigned his chair, and retired almost entirely from practice. In 1858, however, he presided at the meeting of the British Medical Association at Edinburgh, but died on 22 Sept. 1859, at Colenton, near Edinburgh.
During the thirty-six years that Dr. Alison was a professor in the university of Edinburgh his influence and success deserved a higher name than popularity. Several generations of students went away impressed by his devotion to duty and grandeur of character. Such were the qualities which led him to undertake the task by which, more than by professional success, his name will be known, that of ameliorating the condition of the poor in Scotland through a reform in the system of public relief.
From the beginning of his medical experience among the poor, Alison had been penetrated with a sense of the way in which poverty and unfavourable social conditions assisted in the spread of disease. The epidemic of cholera in 1831–32, and subsequent epidemics of fever, confirmed him in the belief of the momentous importance to national health of this question. In the years 1832–40 he thought he traced an increase in the prevalence and in the mortality of fevers, which was directly connected with the spread of pauperism, especially in great towns. To attack disease it was necessary first, he thought, to attack the conditions favouring disease. Imbued with these ideas it became to his philanthropic and conscientious nature a religious duty to express them, as he did, in the pamphlet, ‘Observations on the Management of the Poor in Scotland, and its Effects on the Health of the Great Towns’ (Edinburgh. 1840).
The system for the relief of the poor in Scotland at that time differed widely from that of England, in being almost entirely dependent on voluntary benevolence, no legal claim for relief being recognised except on the part of such persons as were actually disabled, and these claims being met in most cases only by voluntary contributions. There was also, it would seem, little or no provision for the occasional distress arising from vicissitudes of trade, famine, and the like. Alison, profoundly acquainted with the terrible destitution of the lower classes in Scotland, sought a remedy in some approach to the English system, involving a legal provision for the relief of the poor by assessment. The alteration had, indeed, been proposed before, but had been opposed by those who were tenacious of the Scotch system, and had been unfavourably reported on to the general assembly so lately as 1839. Alison's pamphlet, being virtually an attack on the Scotch poor-law system, excited vehement opposition. The principles advocated were opposed to the prevalent doctrines of political economy, and extremely distasteful to Scottish national feeling. Among other eminent persons, the Rev. Dr. Chalmers offered a vigorous opposition. But Alison, or the principles he advocated, gained a considerable if not complete success. After prolonged agitation a royal commission of inquiry was issued in 1844, on the report of which an act was passed in 1845 which embodied much of that for which Alison had contended. This victory was not gained without repeated efforts. The fever of 1843 furnished Alison with fresh proof of the connection between disease and destitution; and the famine of 1846, which was severe not only in Ireland but in the highlands of Scotland, confirmed in his eyes the lesson. On the former occasion he wrote ‘Observations on the Epidemic Fever in 1843 in Scotland, and its Connection with the Destitute Condition of the Poor,’ 1844. The ultimate triumph of his cause was the more satisfactory to him, that it implied a change in public opinion, and not merely improvements in legislation.
Other public questions which engaged Alison's attention were the best methods of registration, with a view to an act for the registration of births, deaths, and marriages in Scotland, and the reclamation of waste lands, a subject on which he wrote a dissertation (Edinburgh, 1850).
Such were the public works of Dr. Alison. A few words must be said of his character. He seems to have been one of those men whose moral superiority is such as to cause their intellectual powers to appear of secondary importance. Nevertheless, these powers were in Alison very considerable. His scientific works show a firm grasp of the subjects dealt with, and were conscientiously brought up to the state of knowledge at the time. He was a vigorous writer and an acute thinker. But his moral worth was what impressed his contemporaries most profoundly. His worst fault was that in works of charity he might carry generosity to an extreme. A characteristic remark of his was, ‘If we reserve our charity until we meet with human beings exempt from sinful propensities or indulgences on whom to bestow it, we may reserve it for the next world; for assuredly we shall not find fitting subjects for it in this.’
He wrote, besides works mentioned above: 1. ‘On Vital Affinity’ (Trans. Royal Society of Edinburgh, vol. xvi.). 2. ‘Defence of the Doctrine of Vital Affinity’ (ibid. vol. xx.). 3. ‘On the History of Medicine’ (Encyclopædia of Practical Medicine, London, 1834). 4. ‘On Inflammation’ (Tweedie's Library of Medicine, vol. i. London, 1840). 5. ‘Supplement to Outlines of Physiology,’ Edinburgh, 1836. 6. ‘Reply to Dr. Chalmers's Objections to the Improvement of the Legal Provisions for the Poor in Scotland,’ 1841. 7. ‘Remarks on a Report on the Poor Law for Scotland,’ 1844; and several other pamphlets on that subject. 8. ‘Observations on the Famine of 1846–7 in Scotland and Ireland’ (Blackwood's Magazine, 1847). 9. ‘Letter to Sir John McNeill, G.C.B., on Highland Destitution,’ Edinburgh, 1851. He was likewise the author of numerous papers on Physiology, Pathology, and the Etiology of Disease, in ‘Edinburgh Medical and Chirurgical Transactions,’ ‘Edinburgh Medical and Surgical Journal,’ ‘Monthly Journal of Medicine,’ ‘London British and Foreign Medico-Chirurgical Review,’ ‘London Statistical Journal.’[Medical Directory for Scotland, 1856, &c.; Edinburgh Medical Journal, November 1859, p. 469, and January 1860, p. 597.]