George Langdown, sailor, 35 years of age, of a sanguinous temperament, in March 1813, waded up to his waist in the water, to unmoor a boat made fast to a post at a considerable distance from the shore. It was in the early part of the day; and, notwithstanding he felt cold and uncomfortable, he did not change his clothes. In a day or two he complained of pain in the head…..
Thus starts not a gothic novel, but quite possibly the first contribution to a medical journal to emanate from Poole:
Salter, T. Case of disease in the brain, with pathological observations. Edinb Med & Surg J 1815 Oct (xlv) 469-77.
The author, Thomas Salter, was a surgeon with a practice in the High Street. He was born in Somerset, though from a family with Dorset connections. He had arrived in Poole to be apprenticed to Thomas Bell, and after the requisite training at St Thomas’ Hospital in London, attending lectures in anatomy and surgery, he returned to Poole and became a partner to Bell. To cement the partnership further, he married Bell’s daughter Eliza. Salter continued to practice in Poole until the very day of his death in 1856, when he died visiting a patient on a cold February night.. His Lancet obituary colourfully described it as Death found him where life had long held him – at the laborious discharge of his duty.
Salter had become a Member of the Royal College of Surgeons in 1810 and was then elected as an Honorary Fellow (FRCS) in 1844. He was a well-known citizen and magistrate in Poole and developed a reputation beyond the town, not only as a doctor, but also as a geologist and botanist – he was also a Fellow of the Linnaean Society (FLS). His 3 sons followed him into medical practice, one dying tragically at sea but two acquiring prominence in the profession. He also trained, by taking into his practice, several other future doctors. His life and career have featured on the Poole High Street blog as well as the Royal College’s Lives of the Fellows.
Today articles written, or at least co-authored, by medical and clinical professionals based in Poole appear almost every month. Publishing has become part of the normal career path, with far more journals to write for, more research to write up, and the need for an impressive CV. But there had to be a very first article from Poole: was Thomas Salter’s article that first one?
At the time of publication in 1815 the Lancet and the British Medical Journal were not yet in existence. The Edinburgh Medical and Surgical Journal had been founded in 1805. Whilst there were some medical journals in existence by then, in the main doctors tended to correspond directly with colleagues about interesting cases or new procedures, presenting at local meetings – possibly paying for publication of a leaflet to allow a wider audience for their talk. It is quite likely that doctors and apothecaries from Poole had published well before 1815, but in the form of a treatise or pamphlet.
Salter’s journal article is clearly very different from modern literature. It is, as most such contemporary articles were, a case report, describing in some detail the clinical condition of Mr Langdown while under Salter’s care. He admits that the patient decided to leave his care and eventually, needing “parochial assistance” came under the care of a fellow practitioner. After Langdown’s death, Salter was allowed to dissect the brain, and much of the article describes in detail his pathological findings. There is also report of another similar case known to Dr Salter, and he makes reference to two other items of medical literature. Salter makes no attempt to put a definite diagnosis to the condition. He explains the decision to publish as due to the need to accurately record all instances of organic derangement affecting the brain, and the dearth of any other similar cases recorded in the literature. It should be said that Salter had a reputation of having read all important medical works. Patient confidentiality seems completely missing when the patient is named at the very start of the article, but in fact the second patient is only referred to as Mrs -.
Thomas Salter went on to publish at least another 10 journal articles. Topics covered included carditis, puerperal mania, breast cancer, use of arsenic in cure of chorea, and delirium. He was, however, not the most prolific medical author from Poole in the first half of the nineteenth century. John Wickens West seemed to be in competition with him, achieving 14 publications in that period. He practised, appropriately, in West Street, and then later in New Street. As with Salter, nearly all the articles are case reports. The two of them actually argued in print over the diagnosis of cholera. The only other Poole doctor in print 1800-1850 seems to be Alfred Crabbe. There were in total no more than 25 physicians, surgeons and apothecaries practising in Poole during the whole of the first half of the nineteen century, with no hospitals in the town.
Thomas Salter’s reputation is secure as a major figure in Poole during the first half of the nineteenth century, and as a scientist of some import. His stature is shown in the obituaries which appeared not only in local newspapers, but also in the Lancet. His funeral was widely reported, recording that hundreds of townspeople lined the streets, with shops closed as the procession passed.
Perhaps he has this further credit to his name of producing Poole’s first contribution to world medical journal literature.
Obituary: Lancet 1856 i 257.
The 1815 article can be found online via search engines.