Dictionary of National Biography, 1901 supplement/Paget, James

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PAGET, Sir JAMES (1814–1899), surgeon, born at Great Yarmouth on 11 Jan. 1814, was the eighth of the seventeen children of Samuel Paget and Sarah Elizabeth, his wife, daughter of Thomas Tolver of Chester. Sir George Paget [q. v.] was an elder brother. The father was a brewer and shipowner, who served the office of mayor of Great Yarmouth in 1817. James was educated at Yarmouth at a private school, and was apprenticed in 1830 to Charles Costerton, a St. Bartholomew's man, in practice as a surgeon at Yarmouth. He found time during his apprenticeship to write and publish jointly with one of his brothers a book on the natural history of Great Yarmouth. Paget came to London in the autumn of 1834 to enter as a student at St. Bartholomew's hospital, and in February 1835, while he was working in the dissecting-room, he called the attention of his teachers to some little white specks in the muscles of one of the subjects. He borrowed a microscope, showed that the specks were cysts containing worms, and read a paper on the subject before the Abernethian Societv on 6 Feb. 1835. His observations were afterwards confirmed by Professor (Sir) Richard Owen [q. v.], and the parasite has been well known ever since under the name Trichina spiralis. In 1835-1836 Paget filled the post of clinical clerk under Dr. Peter Mere Latham (1789-1875) [q. v.], because he was unable to afford the fee demanded by the surgeons of the hospital for the office of dresser. He was admitted a member of the Royal College of Surgeons of England on 13 May 1836, and, after a short visit to Paris, he settled in London, and supported himself by teaching and writing. He was sub-editor of the 'Medical Gazette' from 1837 to 1842, and in 1841 he was elected surgeon to the Finsbury dispensary. At St. Bartholomew's Hospital Paget was appointed curator of the museum in succession to W. J. Bayntin in 1837, and in 1839 he was chosen demonstrator of morbid anatomy, in which position he proved himself so good a teacher that on 30 May 1843 he was promoted to be lecturer on general anatomy and physiology. On 10 Aug. 1843 he was elected warden of the college for students, then first established at St. Bartholomew's Hospital, a post he resigned in October 1851. In 1846 he drew up a catalogue of the anatomical museum of the hospital, and on 24 Feb. 1847 he was chosen an assistant surgeon after a severe contest, the opposition being based upon the ground that he had never served the office of dresser or house-surgeon, posts which had been considered hitherto essential qualifications in every candidate for the surgical staff. He lectured on physiology in the medical school from 1859 to 1861, was promoted full surgeon in July 1861, held the lectureship on surgery from 1865 to 1869, resigned the office of surgeon in May 1871, and was immediately appointed a consulting surgeon to the hospital.

At the Royal College of Surgeons of England Paget was admitted one of the first fellows, when that order was established in 1843, and he prepared the descriptive catalogue of the pathological specimens contained in the Hunterian Museum, which appeared at intervals between 1846 and 1849. He was Arris and Gale professor of anatomy and surgery from 1847 to 1852, a member of the council from 1865 to 1889, a vice-president in 1873 and 1874, chairman of the midwifery board in 1874, president in 1875, representative of the college at the General Medical Council from 1876to 1881, Hunterian orator in 1877, the first Bradshaw lecturer 'on some new and rare diseases' in 1882, and the first Morton lecturer on cancer and cancerous diseases in 1887.

As early as 1858, and while he was still only an assistant surgeon at St. Bartholomew's Hospital, Paget was appointed surgeon-extraordinary to the queen. He attended Queen Alexandra, when princess of Wales, during a long surgical illness, and was made surgeon to King Edward VII, when prince of Wales; from 1867 to 1877 he held the post of serjeant-surgeon-extraordinary, and in 1877 he became Serjeant-surgeon to Queen Victoria on the death of Sir William Fergusson [q. v.] He was created a baronet in August 1871.

Paget was president of the three chief medical societies in London; he filled the chair of the Clinical Society in 1869, of the Royal Medical and Chirurgical Society in 1875, and of the Pathological Society of London in 1887. He was appointed a member of the senate of the university of London in 1860, and on the death of Sir George Jessel [q. v.] in 1883 Paget became vice-chancellor of the university, a post he retained until 1895. He was chosen president of the International Congress of Medicine at the meeting held in London in 1881. He was elected F.R.S. in 1851, and among many other distinctions he held the honorary degrees of D.C.L. (Oxford), LL.D. (Cambridge), F.R.C.S. (Edinburgh and Ireland), and M.D. (Dublin, Bonn, and Würzburg).

Sir James Paget died at his house, 5 Park Square West, Regent's Park, on 30 Dec. 1899, and was buried at Finchley cemetery, after a funeral service in Westminster Abbey. There is an excellent likeness of Paget in the great hall at St. Bartholomew's Hospital. It is a three-quarter-length in oils by (Sir) J. E. Millais, R.A., painted by subscription in 1873. A bust, by Sir J. Edgar Boehm, bart., R.A., stands in the Royal College of Surgeons of England; and there is a replica in the museum of St. Bartholomew's Hospital, dated 1887.

He married, in 1844, Lydia, daughter of the Rev. Henry North, domestic chaplain to the Duke of Kent, and by her had four sons and two daughters, the second son becoming successively dean of Christ Church, Oxford, and bishop of Oxford, and the third son the vicar of St. Pancras, London. Lady Paget died in 1895.

Paget was a surgeon who advanced his art by showing how pathology might be applied successfully to elucidate clinical problems, when as yet there was no science of bacteriology. He may therefore be fairly considered as one of the links connecting Hunterian surgery with the developments which have taken place during the last quarter of a century, owing to a recognition of the part played by micro-organisms in the production of disease. The position which Paget occupied as a teacher in a large medical school, his persuasive eloquence, and the classical English of his writings, gave him great authority among his contemporaries, and enabled him to exercise a much wider influence than would have been expected from his modest demeanour and somewhat retiring disposition. He was facile princeps as a teacher, not by reason of his originality, but because he was able to grasp the principle and clothe it briefly and clearly in exquisite language. Scrupulously honest and fair-minded he acquired one of the chief surgical practices in London. During the busiest period of his life he was invariably punctual, and was never outwardly in a hurry. He had strong religious convictions, which appear in many passages of his writings, and he was always careful in the religious observances of the church of England.

Paget's works are : 1. 'A Descriptive Catalogue of the Pathological Specimens contained in the Museum of the Royal College of Surgeons of England,' 4to (vol. i. 1846, vol. ii. 1847, vol. iii. 1848, vols. iv. and v. 1849). A second edition of the 'Catalogue' was published between 1882 and 1885, edited by Sir James Paget, with the assistance of J. F. Goodhart, M.D., and A. H. G. Doran, F.R.C.S. 2. 'A Descriptive Catalogue of the Anatomical Museum of St. Bartholomew's Hospital;' new edit. vol. i. 1847, vol. ii. 1852. These two catalogues laid the foundation of Paget's reputation. They made him a pathologist, trained him to be an accurate observer, and taught him to write terse English. 3. 'Lectures on Surgical Pathology,' London, 1853, 2 vols. 8vo; revised and edited by (Sir) William Turner, London, 1863, 8vo; 3rd edit, 1870; 4th edit. 1876. These volumes contain, with omissions and additions, the six courses of lectures (1847-52) delivered at the Royal College of Surgeons of England under the Arris and Gale bequests. They were the direct outcome of Paget's work in the Hunterian museum, and their publication gave a great impulse to the study of pathology, which had been flagging for some time before their appearance. 4. 'Clinical Lectures and Essays,' ed. Howard Marsh, London, 1875, 8vo; translated into French, Paris, 1877, 8vo. 5. 'Studies of Old Case Books,' London, 1891, 8vo. Paget also communicated many papers to the various medical societies and journals. He wrote the lives of eminent surgeons and physicians in the biographical division of Knight's 'Penny Cyclopædia '(London, 1833-44); he assisted Dr. William Senhouse Kirkes [q. v. Suppl.] in the first edition of the 'Handbook of Physiology' (London, 1848, 8vo; 15th edit. 1899); and he wrote an interesting introduction to South's 'Memorials of the Craft of Surgery in England' (London, 1886).

[Personal knowledge; Times, 1 Jan. 1900, p. 4; British Medical Journal, 1900, i. 49; Lancet, 1900, i. 52; St. Bartholomew's Hospital Journal, 1900, vii. 50; additional information kindly given by Stephen Paget, esq., F.R.C.S. Eng.]

D’A. P.