HISTORY OF PATHOLOGY

Thomas Hodgkin: Social Activist

Louis Roselfeld, PhD

Thomas Hodgkin’s discovery of a lymph gland disorder is merely one event in a life
of unusually varied public activities in the social reform and humanitarian move-
ments of the mid-19th century. He wrote pamphlets on medical care for the
working-class poor, public health, housing, sanitation, and the relief of cold,
hunger, and unemployment. Hodgkin wrote about the problems arising from urban
renewal and suburban development. His contributions to geographic explorations,
anthropology, ethnology, and foreign affairs are virtually unknown today. Hodgkin’s
opposition to slavery and the slave trade involved him in the development of
settlements in Africa for freed slaves and disputes with the abolitionists in
America. He fought for social justice and human rights for native populations
being oppressed by British foreign policy in South Africa and New Zealand. His
criticism of the exploitation of Indians by the Hudson’s Bay Company’s fur trade
contributed to a professional conflict in the highly politicized environment of
Guy’s Hospital and blocked advancement of his medical career. Closer to home he
advocated reform of medical education and practice and sponsored adult educa-
tion programs. As a member of its Senate, he helped in establishing London
University, the first nonsectarian institution of higher learning in England. He
lectured to working people on the means of preserving and promoting health and
advocated prepaid medical care for the working poor. Concerned about unequal
distribution of medical care, he opposed medical contracts to the lowest bidder and
price-determined government plans for health care. He consistently maintained
that the basic problems of the poor were not medical but socioeconomic. Since
charity leaves nothing behind in exchange, Hodgkin was certain that greater
benefits would result if charitable money was used to provide jobs. He denounced
the evils of tobacco, practices of trade unions, and barbarous prize fights. On a trip
to Jerusalem with Sir Moses Montefiore in 1866, Hodgkin contracted dysentery and
died. He is buried in a protestant cemetery in Jaffa. His epitaph is fitting: “Nothing
human was alien to him.”
Ann Diagn Path01 4: 124-133,200O. Copyright 0 2000 by W.B. Saunders Company

Index Words: Thomas Hodgkin, social activist

I T WAS FAR from the best of times as the 18th

centuq. was coming to a close. Great Britain leas
Maging an unsuccessful \var \\-ith Republican France.
the mrmorics of the long struggle \vith the American
colonies. Disastrous hanyws \vcrc Ibllo\vcd 1~).lilod riots,
and rising taxation rvas follo\vcd 1~).linancial hardship
Partisans of the Revolution called themseh~cs citizens in and economic depression. In 1795, Prime Ministci
imitation of those across the Channel. For man\. British, William Pitt had been hooted and huntecl by a mob;
the dread of revolution brought panic, suspension ofckil King George III himself had been attacked in his coach.
liberties, prosecutions of the press, and mutin). in the Disaster appeared imminent. Such \vcrc the times into
fleet. Ireland \vas close to rebellion. and there rcmaincd \vhich Thomas Hodgkin MU born on August 17, 1798, in
Pcntomille, a \illagc north ol‘Lontlon.
Although Hodgkin’s Lame is gcncrall~~ associated \\ith
the clisrasc that bears his name, he had a rrmarkablc
lift on man\’ Icx.els, especialI!- in the social reform antl
humanitarian moxcmcnts of more than a ccntur?-and-a-
half ago on behalf of employment, housing, ancl health
care for the poor. His contributions to geographic
csplorations, anthropolog?., cthnoloo, foreign affairs,
and colonization of freed sla\,cs are \irtuall\, ~~nkno\rn
toda)..

124 Annals of Diagnostic Pathology, Vol 4, No 2 (April), 2000: pp 124-l 33

 Thomas Hodgkin: Social Activist 125

Hodgkin was an “activist” and a “Mlhistle-blo~ver” Oxford and Cambridge, as were all religious nonconform-
before anyone cvcr used those terms. His integrity and ists, ie, non-Anglicans. Educated privately, he acquired a
consistency in upholding human rights ran contrary to sound knowledge of the classics and natural science, and
the conventional wisdom and morality of his time. His was apparently a natural linguist. He had command of
advocacy of human rights for the native populations of French, Latin, and Greek, and picked up bits of other
British colonies and his penchant for disadvantaged and languages during his travels.
undcrprivilegcd peoples kept him from recognition and His first interest in a professional career was in
advancement in his medical career. pharmaceutical chemistry. After 2 years as an appren-
tice, he decided to pursue a medical career, not only for
Early Years, Education, Morbid Anatomist its own sake, but because he regarded medicine as the
best passport for a traveler in a foreign land and among
The adult Hodgkin was short, lean, and dark-
all races of humans. After 1 year at Guy’s Hospital and
complexioned (Figs 1 and 2). He stood straight, was VCT)’
Medical School as a physician’s pupil, Hodgkin entered
alert with bright eyes, and had a restless spirit full of
Edinburgh University as a medical student in October
purpose and action when he spoke and walked. Hodgkin’s
1820, the year in which George III died.
parents were strictly obsetvant Quakers and he re-
During the university vacation and the school year
mained faithful to his upbringing. As a dutifill member
from October 1821 to September 1822, Hodgkin trav-
of the Society, of Friends, hc accepted, although with
eled on the Continent for additional experience and
considerable protest, the decision of the Society’s elders
instruction. In Paris he learned the new art of ausculta-
opposing his marriage with a first cousin.
tion first hand from Rent Laennec (1781-1826), the
As a Quaker, Hodgkin was barred from education at
inventor of the stethoscope. Hodgkin graduated Edin-
burgh in August 1823 and in the fall accepted a position
as the personal “traveling physician” to Abraham Mon-
tefiore (1788-1824), younger brother of Moses Monte-
fiore (1784-1885), the noted philanthropist. Abraham
had tuberculosis and, planning a trip to southern France
and Italy with hopes of restoring his failing health,
wanted a physician to travel with him. The Montefiore
brothers acted for Nathan Mayer Rothschild (1777-
1836) on the London Stock Exchange and were related
to Rothschild by marriage.
How did this newly qualified and inexperienced young
physician come to be considered and eventually engaged
for such a responsible position? It wasn’t that unusual.
Senior practitioners often recommended young col-
leagues, on completion of their training, for temporary
private engagements as medical attendants to traveling
aristocratic families. A well-established practitioner could
not afford to neglect his regular practice, but for a
beginner it was an excellent opportunity. The pay was
good and the travel provided an introduction to good
society and valuable connections.
Hodgkin was recommended by Benjamin Thorpe
(1782-1870), a clerk at the Rothschild bank in Paris.
Hodgkin first met Thorpe when Hodgkin’s father trans-
ferred funds to the bank for his son’s use. They became
friends and Hodgkin treated him for a serious pulmo-
nav disorder, probably tuberculosis. Thorpe knew of
Abraham Montefiore’s traveling plans and suggested
Figure 1. Portrait of Thomas Hodgkin believed to be by
Phoebus Levin. (Courtesy of the United Medical and Dental
Thomas Hodgkin as a “compagnon de voyage.”
Sc~~ools of Guy’s and St Thomas’s Hospitals.) On September 16, 1823, they left Paris. The patient
126 Louis Rosenfeld

Figure 2. Studio photographs of Thomas Hodgkin in the later years of his life. (Courtesy of the Library Committee of the Religious
Society of Friends-London Yearly Meeting.)

and his wife rode in one carriage, their children and a At his family’s urging, he returned to London in the
governess in another, and Hodgkin with the latter or on middle of 1825 to begin the private practice of medicine.
horseback. Abraham suffered a serious relapse in Rome. While this was developing, he became associated with
Hodgkin decided to keep him comfortable and to rely on the clinical courses and museum at Guy’s Hospital. His
a strict and regular diet, but to take no aggressive interest and skill in morbid anatomy attracted the
measures. Not pleased with the cautious treatment or attention of Sir Astley Cooper (1768-1841), the re-
the lack of progress in her husband’s recovery, the wife known surgeon. In the fall of 1825, at age 27 years,
paid Hodgkin 125 guineas to cover his traveling ex- Thomas Hodgkin was appointed the first Demonstrator
penses and fired him on January 8, 1824. Despite his (Lecturer) in Morbid Anatomy and Curator of the
unsuccessful relationship with Abraham Monteliore and Museum of the new Guy’s Hospital Medical School,
his wife, and concern over the potential damage to his which began its classes in October 1825, following the
reputation, Hodgkin believed that he remained on good break of its affiliation with St Thomas’s Hospital across
terms with Moses Montefiore, who had joined them in the street. In his course of lectures, Hodgkin stressed
Rome. After several months in Italy, Sicily, and Geneva, the importance of personal acquaintance with disease
Hodgkin returned to Paris, where he joined in the by investigation at the bedside of the sick and by
intellectual and social life of the city’s salons. Early in examination of the effects of disease as revealed by
September he learned that Abraham Montefiore had cadaveric inspection.
died in Lyon on August 24. Not long afterjoining Guy’s Hospital, Hodgkin risked
 Thomas Hodgkin: Social Activist 127

the displcasurc of his more senior collcagucs by propos- criticism of the el‘fects uf civilization on indigenous
ing a raclical change in medical education. FIodgkin ovcrscas populations, especially exploitation by the Hud-
sug~gcstrcl a sharp reduction in the period ofapprcntice- son’s Bav C:ompan). ancl the destructive elect of its fur
ship \\ith an apothecary. This \V;IS a break \\ith the trade on the Indian culture and way of life. This did not
cstablishcd prxticc of spcncling 5, 6, or cvc‘n 7 \‘c’;irs in sit ~vcll \vith the all-po\verlill Benjamin Harrison, Jr
instructing the apprc’nticc in prcpariyq mrdications. (I 77 l-l 85S), treasurer ancl chief esecuti\.c officer of
Hodgkin pointed out that most of the artic.lcs in the Gu).‘s Hospital. Harrison \~as a director of the company,
apothecaries’ shops wcrc gcncrally supplied alrcad~~ which enriched its stockholders by sale of the furs
prcparcd by the \vholcsalc druggist. A fc\\. months of collectccl by the Indians and Eskimos, often in exchange
training \~~ould bc enough to acquire “the art ofcombin- for alcohol or guns. Gnsidering Harrison’s dedication
ing them in cstcml,oran~oLis prescription.” The nc\vl~. to 1hc company. and his autocratic personality, it is not
n\xilablc time should bc spt’nt in the pursuit of a liberal surprising that hc rcscntecl any criticism of company
prcliniinx?. education or cle\xAcd to other professional politics or practices. Hodgkin, to his own great misfor-
kno\vlcdgc. Hc also suggcstccl that clerks bc introduced tune, pro\idcd these criticisms in addition to advocating
into the nicdical \~artls during the clinical )‘~ars to assist social rcsponsibilit)~ 1)). the colonial powers.
the. I’h~?ki~lllS, Wml’;lr;‘h to th drCSSerS \,hJ fur SO Hodgkin had a committed interest in the al‘f‘airs 01
l011g had xsistcd the surgeons in opcratiuns ancl accom- frcccl black slaves ancl eclucatcd Indians, and enter-
panicd them in the surgical \vartls cari-\ing the boscs taincd them in his home. He bclic\.cd that missionaries,
\vith the applicatiuns lix ~\~ncls, iv, plasters, bandages, supported 1,). t hc Hudson’s Bay CIompany, were not
and dressings.’ \\.cll-suitccl as ci\ilizcrs since they tenclccl to place
con\.crsion bcforc material impro\pements. Hodgkin
Conflict and Controversy: Rejection and \\xntecl to potcct the nati\w from encroaching settle-
Resignation ments, to prrscmc those aspects of their culture that
Thomas Hodgkin held his posts as (Curator and \vcrc \\.orthy of ethnologic stud)., and to help them
Lccturcr rnltil 1837, the )xxr in \\hich Queen Vi,3oria acquire the skills and positi\‘c aspects of civilized society.
asccndecl to lhc throne. The pi\.c)tal c\‘rnt of his c;irce~ Hc fcarccl that annihilation of the “uncivilized races”
occurrccl in Scptcmbcr of that )xxr. His canditlac\~ for IVOUICIbc an irrctric\xblc loss to luture study of human
promotion to assistant physician at C;u).‘s Hospital NX physical ancl cultural history.
rcjcctcd. Thcrc MX an ~J~~Cllillg for ph!xician, the Iirst Opposition to Hodgkin nlso\vas based on his mcmber-
since 182-I. It 112s cspcctcd that Thomas Adclison ship in the So&t). of Friends, his lectures to working
( 179:3-l 860) \\ould bc proniol~d from assistant ph>xi- pcoplc on the means 01’ prcseming and promoting
&in, thercb\. creating ;I nc’~\. \xanc\~ for assistant health, and his in\ul\.cmcnt with the lbunding of the
phbxician that Hodgkin \\xntcd and cspcctcd as a IICWnonsectarian Uni\fersit!. of Lundon, \\hich was the
reward lor his man)’ !.cars of faithful and dcdicatcd lirst uni\.(.rsit). in England to grant degrees to dissenters
SCI‘\I(‘C. (nonAnglicans) and its new mcclical school ivhich com-
Hodgkin \\‘;Is one ol‘sc\~cii applicants and his medical pcttxl \vith Guy’s Hospital. Thcrc \vere other reasons,
and scicntilic crcclcntials I\‘~rc outstanding: hi had including his limitccl medical practice and his habit of
cstablishccl the lirst pathologic niuscum and compiled undercharging his patients or charging nothing at all,
thr lirst catalog at C;u>,‘s Hospital, his course in patId- cspcciall~~ the poor. His collcagucs \\.crc \‘eq. critical of
0~9. 112s the lirst s\.stcniatic scrims of Iccturcs on th( this neglect of profcssionnl fees. Hoclgkin, in keeping
subject in Great Britain, and hc introduced the stctho- \\ith his Quaker faith, did not hold back from criticizing
scope to C;u),‘s Hospital. Hou~~~cr, hc appcmd bcli)rc his associates \vhcn hc thought it \vas called for. There
the sclcction committee \vith a lot of hca\?. bqgagc. \G~S also his refusal. the pre\ious >.car, of the honor of
Hodgkin \\as in\&~ctl in the social rcli~rm ancl humani- I:cllo\\xhip in the C:ollcgc of Physicians. Hc refused on
tarian acti\itic.s of his Linic. such as health cart and conscientious grounds to accept a distinction that he
cniplo\mcnt lix the poor, colonizatic~n of l’rccd sla\~, bclic\,ed cliscriminatcd bct\vccn the Fellobvs ancl the
and rcli)rni of medical education. In\~ol\~cnicnt in thcsc lo\\x!r catcgor). of Liccntiatcs.
highI>, contro\.crsial issues \\xs not the brst crcclcntial In the linal anal!xis, the rejection of Hodgkin’s
for appearing bcliJrc ;I scl~ction conimitlcc ol‘consci-\~~i- promotion is uncloubtccll~~ rclatcd to the financial inter-
ti1.c busincssnicn.’ cst of Benjamin Harrison in the Hudson’s Bay Compa-
!n addilion . and pf-obabl~~ most troubling, \\x his n\.‘s Indian fur trade. A clircct confrontation ~vas inevi-
128 Louis Rosenfeld

table between the autocratic Harrison and the -1 days after that of Hodgkin. A bladder ailment and
independent Quaker, who felt compelled to speak out diflicult>. in urinating led to suppurati\rr inflammation
on behalf of the North American Indians whencvcr hc of the kidneys, lvhich proved fatal. Their obituarirs
learned of injustices committed against them b!. the appear on the same page of T/w Lance/ and the Brifislr
European settlers and Compan).agents. Aledical Jmmal. ’
With the approach of the election, Hodgkin came to Hodgkin’s failure is best understood in terms of his
realize that he would probably not get the position. As nonmcdical and politically contro\rcrsial activities. Fur-
he became less assertive in his o\m behalf, there \vas an thcrmorc, his indcpcndcncc and lack of dcfcrcnce to
increase in campaigning by prominent Quakers and cstablishcd authority \vcrc a hindrance to advanccmcnt.
other supporters. Possibly in response to active lobbying, Babington, who cnjoycd immcnsc popularit),, \\‘as prc-
Harrison proposed that 2 assistant physicians be ap- fcrrcd to the ccccntric champion of underdogs and
pointed, but that only one should give the clinical political and social moralist. For Hodgkin, a period 01
lectures and receive the fees. The other post \vas to bc inactivity follo\vcd that was due to depression, trouble
what Hodgkin already was, ic, curator of the museum. \+ith an intestinal disorclcr (probably. aggravated by the
Hodgkin interpreted this as a \\a) to pass him b!. dcprcssion), and then a Icngthy recuperation.
without seeming to do so. By no\v Hodgkin \vas willing to In 1842, Hodgkin joined St Thomas’s Hospital across
give up the museum to become assistant physician, but the street. After onI>. I ).car, something went lvrong
not as windowdrcssing. He told Harrison that he could there and his aff4iation \vas not renelved. He then
not in justice to himself bc a party to a dual appoint- ceased to be associated with any hospital. His practice,
ment. not being large, gradually rcccdcd into the background.
Only days before the election, Hodgkin was I-cad?. to Hodgkin still \\Totc on medical subjects, but hc \~as
drop out of the race if only his qualifications for the depri\,ed of a source of anatomic specimens. His rcla-
position were acknowledged. He also felt uncomfortable ti\rely secure financial status and lack of official duties
at being the rival of the leading candidate, Benjamin no\v permitted him to gi1.c more time and effort to
Guy Babington (1794-1866), bvhose father had treated general scientific s&jccts and nonmedical activities,
Hodgkin’s mother during her final illness. Ivhich arc rcmarkablc for their \parict)-. Before 1837, hc
The election was held September 6, 1837. Tlccnty- authored 25 papers M.ith clinical themes and 1-l that
four votes were cast. Babington received 21, Hodgkin dealt l\ith public social issues, approsimatcly a 2: I ratio
received 3, and there were 2 abstentions.’ The othcl favoring clinical thcmcs. From 1838 until his death, the
candidates had been encouraged to withdralr from the division of thcsc catcgorics 1~1s revcrscd. 17 and 59
race. Hodgkin took his loss as a personal rejection and papers, rcspccti\,cl)., for a ratio of 1:3.5, favoring social
resigned from all his positions at Guy’s Hospital the issues.
following day. No personal rivahy \vas involved in the
promotion and Hodgkin’s relationship Mith Babington
Social Reform and Other Nonmedical Interests
remained cordial. It was unlucky for Hodgkin that ~%cn
the vacant) did occur, the leading candidate was the son Thomas Hodgkin’s intcrcst in helping unci\ilizcd and
of William Babington (1756-1833), a greatly respected opprcsscd peoples first developed at an early age from
physician who was much admired for his personal the stories hc heard as a child and the reports he read of
qualities. the efTorts of the Society of Friends to ci\ilizc American
In any event, Babington’s credentials fit the rcquirc- Indians. As a Quaker, his social consciousness and
ments for the position and he was not an inappropriate concern for all opprcsscd and unclcrpri~ilcgccl pcoplcs
choice. This was aclinical appointment im.olving patient \vas cspresscd in his opposition to slaveIT and the slave
care, and Babington was known for his esperiencc with trade and by his invol\.cmcnt in many humanitarian
fevers, which constituted a large part of the admissions activities and philanthropic organizations. Hc \vas a \icc
to the hospital. He was one of the first in England to president of the American Colonization Socict), and
describe the rash that sometimes occurs with the fc\.cl \vrote 3 pamphlets on the ad\rantagcs of colonization of
following cholera. freed slaves in Africa.‘-’ Colonization was \igorou+
Babington’s professional career had several interest- opposed b>. American abolitionists M&O wanted full
ing parallels and coincidences to that of Thomas American citizenship rights for them. Hodgkin \vas
Hodgkin. However, the final parallel was the final event active in the establishment of scttlcments in Sierra
in Babington’s life. His death occurred on April 8, 1866, Leone and Liberia. When Great Britain and Liberia
 Thomas Hodgkin: Social Activist 129

cschangcd trcatics of recognition, Hodgkin, in London, care. He argurcl against medical contracts being given
rcprcscntcd the iic~4y indepcndcnt co~~tltt~~.~ to the lowest bidder bccausc he believed that business
As mc of tllc tiJ~mtlCt-s of the Aborigines’ I’rotcction techniques were not applicable to medicine. He did not
Society, Hodgkin spoke out strongI>. against the npprrs- belie\~e that the patient would obtain adequate care if
sivc mrasurrs usrd 1)). chc scttlcrs against the Indians of the lowest price was the only criterion. He questioned
CL~nacla ancl thr nati\.cs in other British scttlcmcnts in whether price sho~~lcl be considered when determining a
South Africa and Nc\v Zcalancl. Hoclgkin’s s).rnpath!. for government plan for health care.”
the Canadian Indians, IOr whom hc aclvocatcd li11l rights Hodgkin consistcntl!. maintained that the basic prob
of British citizenship,” brought him into conflict with lcms of the poor wcrc not medical, but socioeconomic,
sonic of his professional associatrs. As sccrctan. of the and that the most cffcctivc means to relieve their
Aborigines’ h-OtCCtkJn Society, his Icttrrs and petitions distress \vas to provide them \t-ith useful employment.
10 colonial go\~rnors and oflicials in t hc foreign office He pointed out that the working class is a valuable
cslxxxcd the Socict>.‘s concerns and fears of the thrcnt national rcsourcc U~~OSCunemployed status is a finan-
ofcstinctinn facccl b!, the nali\.cs of the tcrritorics being cial loss to the community and the nation. Since money
o\‘cl‘l‘Lltl by Etltqml set tlcrs. gi\.cn as charity leaves nothing behind in exchange,
Hoclgkin uxs chairman of commiltccs that cstab- Hodgkin was certain that greater benelits would result
lishccl standat-dizcd guidclincs for csplorcrs ancl Iravcl- if charitable money was used to provide jobs for those
crs to collect informntion about 1hc physical and social able to kvork. Employment instead of charit) would
structure of clistant communities. Hc \vas a fnunder of make the poor “the agents of their own deliverance” and
the Ethnology. So&t). ancl collcctcd data on the cul~urc obviate “that tendency to an abject, slothful disposition,
ancl anthropolo,~~ of priniiti\.c proplcs ancl races thrcat- \vhich the receipt of ordinar), alms is wont to produce,
cncd \vith rstinction. Hc also advncatccl thr study of and \vhich too often becomes the cause of permanent
nali\.c. African culturr and the prcsctyation of African degradation.“’ ’
latl,gLla<gcs. t” In 1851 Hodykin c bccamc thr lirst of the Although hc championed the poor and oppressed,
honorat>. sccrctarics of thr Ro!.al Geographical Socict) Hodgkin ne\rertheless reflected some of the biases of his
nfL0nclon. In I his capacit). hc rcspondcd to an inquit? in contemporaries in the educated middle class who had no
1858 from the Amcrican black activist klartin Robison s).tnpathy for the indolent of the destitute class, who
Drlan!, ( I H l2- lHH.5) for achier on an African location fnt the). felt had been brought to these circumstances b>
scttlcmcnt of freed sla\.cs. Hodgkin later introduced “their own faults and deficiencies.” A \rev great and
Dclany to other Englishmen ~410 supported coloniza- serious difficulty in relieving the poor, warned Hodgkin,
tion, ancl hc contributed funds to Dclart).‘s cspcdition of is to be found in the character of this class. “The), have
rsploration in Africa.” not the dispositions fa\rourablc for helping themselves,
and arc, consequently, not easily helped by others.” The
Public Health, Charity, and Medical Care problem lies in that “lamentable want of spirit and
for the Poor enerLg. \vhich makes all kind of continued useful exer-
Hodgkin did not ncglcct the problems of the socialI>. tion more irksome than the privations of povcrtyand the
ancl cconomicall~~disatl\.antagcd closer to hnmc. Hodgkin pinchings of hunger. When employment is provided for
adclrcssccl the issurs of mcclical cart for the \\,orking- such persons, they perfortn it slo~vly and badly,” and,
class prior, public hcnlth, housing, and sanitation in because of chronic loaling on the .job, they require
~Xttll~‘hk’tS, SLlCh ;LS ffi,ff.l f?dO/iJl<,o /O /hP C%d’JN ;!I hKkJJ7 additional supcnision, which adds considerably to the
( I H32), 011 111~MI& oJ.%lrcti~~,q md Rn~~row77/ir~~,o .\ldic-01 cspensc of their cmploynicnt.t4
Mm ,1;,r Projiwiotrnl .~lllridflnc~ 00 thr Poor ?I,/’ 0 Pnd of- Hodgkin also drew a disturbing and familiar picture
lhhid ( I X36), CiJkd, HUJf<LyI nrd I1 hrzl ~J~~/J//J/~J~JJl~,rl: 1 t i’/ll of t hc problems arising from urban renewal and subur-
sYyqcr/iom ,/i/r 7hir Rr/i<f (lH47), and a icttcr to a ban development. Hr pointed to the large increase of
nc‘\\‘spapcr on Drc,r/li,!ei,/~~r I/?PI%J). ( 1 I%(;). Hc also issurd comfortable suburban dwellings that is not matched b>
a one-pa,gc shcc1 for the Socicly for t hc Inipro~~cnirnt of an)’ incrcasc of housing units for the working class. New
the C:onclitinn ofFactot-\, CMdrcn (1832). ancl \+icler streets \verc formed and traffic greatly im-
Hodgkin acl\.ocatccl impro\~ccl \vorking conclit ions for proved \vhcn sonic of the most-crowded and unhealth)
go\,rrnmcnt-hirccl mcclical ofIiccrs and a s!stcm of chvellings of the poor were torn down, but no alternate
insurance or prepaid medical cart for t hc working poor. housing 1va.s pro\iclcd for the former occupants. The
Hc \\as cnncrrncd \vith unequal distribution of medical remaining buildings bccamc more crowded than before
130 Louis
as money-making landlords rcntcd the same li\ing
space to more than one famil~~,to the serious dctrinicnt
of health, decency, and morals.‘” “-h landlord \VhJ
seeks an income from thus providing steps to dcgrada-
tion for his poorer neighbors rnay.justly bc regarded as
an enem). to his countIT, and the public in quietl!
tolerating the c\il cannot bc regarded as \\holly blame-
less.”
In pubhcatlons \\lth rchmlcc to modern times,
Hodgkin urged that the apothecac system of \vrights
and measures be replaced b!. the metric s)stcm for the
preparation and dispensing of mcdicincs;“’ hc cmpha-
sized the importance of statistics in mcdicinc;” he
severely criticized the practices of trade unions; and he
dcnounccd the evils of tobacco. Hodgkin’s detestation of
tobacco Icd him to acti1.e participation in the British
Anti-TobaccoSociet!.. Hc attributed the cnfccblcd, sickl!
condition and chronic indigestion of many of his patients
to their use of tobacco and maintained that the British
had degenerated physically because of the grooving
consumption of tobacco. Ix Hc said that “smoking tends
to encroach on the freedom and comfort ofothcrs. . If
the smoker kept the smoke to himself, this obLjection
would be done away Mith; but the fact is, that I’or his o\\.n
useless, if not culpable gratilication, hc inllicts the
smoke of his tobacco and his smelling breath on all
indiscriminately.““’
Hodgkin was also quite pcrcepti1.c nhen it came to
athletic acti\itics. Hc rccommcnclecl cscrcisc, but not
“the barbarous prize-lights tvhich disgrace this countr?..
Their demoralizing elf‘ect is 1)).no means conlined to the
parties actually cngagcd in thcsr combats: Perhaps,
in many instances, the greatest c\il is the clltict pro-
duced upon the spectators.“”
Hodgkin had something to say about c\.cI?.thing that
interested him. Issues like tobacco, boxing, trade UIliOllS,
work relicf, food supplements and \,ouchcrs, public
health, and urban renc\val arc still \vith us. Thc)~ ha\x
remained contro\.ersial because the\, inhcrcnth. im.0h.c
opposmg social, political, and economic forces that ha\.c
become enmeshed in the fabric of socict\..
Travels with Sir Moses Montefiore, Baronet
Although Hodgkin and Moses Monteliorc sa\\. each
other frequently after Hodgkin left the rmploy of
Abraham Monteliore, there is no lirm c\idence as to
when Hodgkin became Moses Monteliorc’s physician. It
was probably sometime after 1824.
Mont&ore’s involvement in London’s financial world
and social and charitable functions brought him into
contact with upper English society. He had hxn knighted
Rosenfeld
b!. Qucrn Victoria in IX37 liJllo\\ing rkctiOll as Shcrill‘
of1~~nd0n. Victoria made him a Baronet in 18-l-6for his
hiinianitariall clli~rls after his visit to (:zar Sicholx 1 to
seek relicI‘ from go\‘crnmcnt restrict ions and harass-
nwnt OI’JCNYin Russia.
In 1857. Hodgkin accompanictl Sir hlosrs anclJudith
hlonteliorr as their personaI ph>xician on the hlontc-
liorc’s lifth trip to the Hol!. Iand to rc\ic\v the projects
sponsored during prc\ious visits and to pro\idc adcli-
tionnl linanci;tl support \vhcrc needed. Each nc\\’ visit
\\xs an occasion liar linanrial aid-his o\vIi and that
collected by others-to cxc thr gcncral miscl), and to
help the needic3t ~ascs.Rlontcliorc cndo\~ctl hospitals,
scttlrnicnts, and charitnblr institutions. When the SuL
tan in C:onstluitiiio1~lL~granted Llontcliorc ;I lirman 01
permit in 1835 allo\\ing him lo 1x1). hid in Palcstinr, hc
founded the lirst .Jc\vish rcsidcntial quarter outside t11~
\valls 01’the Old Cit!..?’ This \vas the beginning 01‘ the
,WCWC:it), ofJcrusalem. According to the. records of the
British foreign o&c. thcrc \\‘crc X.ON)Jr\\x in .Jcrusa-
Icm at that time, almost hall‘ the c.il).‘spopulation. The
rcmaindcr \\xx ,\loslcnis and (Xstians in equal num-
ber.??
Hodgkin assisted Sir ,\loscs 011 his visits to farms, ;I
girls’ school, dispcnsai?; mtl tcstile shop that the
I’hilanthropist had cslablishcd mtl ans\~crctl Ictters and
petitions, dralirtl proposals li)r nc‘\\’ undertakings, and
\vrotc reports and other docunicnts.
The tra\.c.lcrs lcli ~Jcrusalcm on June 7, 1857, and
\vcrc‘ back in Englantl in mid:Jul!. after mI abscncc of
ncarl~. 5 months. IIodgkin rcpo~~tc.tl his impressions to
thr British Association liar the Ad\xnccmcnt ol‘Sci~ncc~
about t hc proposaI IiJr ;I canal across t hr Isthmus 01‘
Suez. Hc concluded that thcrc \~oukl bc imm~nsc
physical dillicultics in t hc construction and niaiiitc-
nnncc ol‘such a c~lal. The ~lctlitcl.r~uncall side \\.;IS riot
onl~~shall0~~~ and sander, but \\xs 01‘constantl!. \x-\ing
depth ~CGNIS~of shiliing sand banks. Dredging \~scls
\vould ha\.c to operate continuousl>. to n~aintain ~1x2~
passage. Citing the enormous cost, Hodgkin cluestioncd
x\hcther the anticipated \~lunic of conimcrcial trallic
~~oukl justit). the in\~cstnicnt. C:onscqucntl>~, hi atl\.~-
catcd a railroad instead 01‘ ;I canal across the istli-
IllLls~?‘.“l
Hodgkin returned l’rom the ,\liclcll~~ICast sporting ;I
Iusuriant beard, \vhich prompted an cdilorialist I~JI
G’ql Hwpital Ga:dk to composc the l’ollo\\ing: “Hodgkin
\vcnt out \vith I\loscs [ I\lonteliorc] and rcturncd \\ith
Aaron (hair-on).“-”
Not long after, in 1859, ~Montcliorc~and Ho&kin
cmbarkcd on a politic&. scnsiti\.e trip to the Vaticarl to
 Thomas Hodgkin: Social Activist 131

rcscuc a 7-~~1l--0lcl Bolognrsc.Jc\vish child, Edgar ~Mor- used catch phrases such as “Knowledge is Power” and
tam, \vho \\x fnrcibl~~ taken from his parents b>. police of “Virtue is Happiness.‘y27
the Papal States on.Junc 24, 1858. Bologna \+XS part of Hodgkin’s account of the journey was illustrated with
the Papal States. The boy had been sccrctl~. baptized h) four lithographs prepared from his own original draw-
a teen-age Catholic srnxit ,girl \vhcn he \vas 1 !‘car- old ings. The monograph of the trip, Narra~izx qfoJoumty to
ancl clangcrously ill. The girl feared for the bo).‘s sal\x- Morocco. in 1867 and 1864, With C;eological Annotations, was
tion if hc clircl unbaptizrd. Consrq~~~tl~~, the Vatican published as a memorial to him after his death in 1866;
fklt that the child bclongcd to the Church and must be it \vas available by subscription and was dedicated to Sir
raisccl as a Catholic, c\‘cn if baptizrd in error. The Moses Montefiore, Baronet.
scnxnt’s confession to a priest led to the abduction. On his second journey to the Middle East with Sir
The kidnapping produced a ~vorlcl~\itlc outcn. from Moses, taken to distribute relief to the Jewish popula-
.Jcx\,s and ~:hristians. Protests \vcrc held throughout tion suffering from the cKccts of the previous year’s
Europe and the United States.?” Francis ,Joscph I and drought, locusts, and cholera, Hodgkin contracted dysen-
tcq’during a cholera epidemic and died on April 4, 1866.
Sapnlcon III urgecl the Pope to rclcxsc the chilcl. The
On his deathbed Hodgkin lamented “the little setice”
British lixcign secretan. csprcsscd the concern of Hct
he had done. He \vas buried in a small Protestant
Xlajcst).‘s go\~crnmcnt, but cautionrcl Sir Moses that
cemetq’ inJaffa, which is just south of Tel Aviv and is
there \\x not the slightest hope of SLI~CCSS. In his
now continuous \\ith it. The grave site is surrounded b)
o\‘crscas rcscuc missions to pro\idc financial support,
an iron railing and is marked by an impressive obelisk
cnclo~\~ hospitals ancl charitable institutions, and come to
tombstone erected by Sir Moses to commemorate their
the aicl of‘.Jc\\x being pcrsccutccl, Sir hloscs, fnrtiliccl
friendship of more than 40 years’H (Figs 3 and 4). The
\vith the approprintr cliploniatic papers from the foreign
inscription on the granite obelisk reads
oflice, met \\ith kings, cluccns, sultans, pashas, czars, an
cmpcror, and a shah. Pope Pius LX refused to see him 01 HERE RESTS THE BODY
to fret the child. Sir Moses later rcnc\\.ecl his elTorts in OF
this case. but the Church \vould not budge. Eclgar THOMA.5 HODGKIN M.D.
,\lortara \vas placed in a nionastcn. and raised as a OF BEDFORD SQUARE, LONDON,
Catholic; in 1873 he \\as ordained as a priest. A ,MAX DISTINGUISHED ALIKE
At the cncl ofOctober 1863 came an urgent appeal for FOR SCIENTIFIC ATTAINMENTS,
help from the .Je\vish congregation on Gibraltar on MEDICAL SKILL,
behalf of thcJe\vs of Tangier. Sir Moses cvas clcterminrcl AND SELF SACRIFICLVG
to gn to &rocco to seek rclcasc of in~prisnncd Jews and PHIL4iiROPY.
to scrk an auclicncc \vith the Sultan nfblorocco to obtain HE DIED AT JAFFA
a dcfinitc legal status Ir the lOO,OO(1 Jews in that THE 4TH OF APRIL 1866,
cnunt~~. Hoclgkin accompanied him and throughout the IN THE 68TH YEAR OF HIS AGE.
jnurnc). rccordcd impressions of’ c\,el-\Thing he salt. ancl IN THE FAITH s( HOPE OF THE GOSPEL.
\vrotc aii entertaining account of the journey. For “HUMAii~ NIHLL A SE ALIENUM PUTABAT”
Hodgkin, the journq. to hlorocco \vas both a pleasure
trip ancl a geological excursion. In addition to clescribing THE EPITAPH IS INSCRIBED BY HIS
the c\‘cnts and pcoplc along the \<a>. in France, Spain. DEEPLY SORROWIiiG WIDOW & BROTHER,
TO RECORD THEIR IRREPARABLE LOSS.
Gibraltar, anti North Africa, hc took notes on the
cthnolo~q. ancl geography of‘ thcsc regions and described On the rc\‘crsc side is the follouing:
the flora and fauna, antiquities, \vater systems, build-
in,qs, ancl agricultural methods cncountcrccl during t hc THIS TOMB IS ERECTED BY
nearI>. S-month journey. In his published account of-the SIR MOSES MONTEFIORE
trip, Hodgkin included geologic ancl geographic clcscrip- BART.
lions of the terrain of north-\vcstcrn Morocco; a copy of a UY COMMEMORATION OF
letter from Sir 110s~~ to the Jclvs of Morocco, urging A FRIEADSHIP OF
them to Ix lo)xl sul~jccts of their so\.crcign; and an MORE my 40 YEARS
aclclrcss 1~). Hodgkin himself to the citizens of Tangirl & OF MANY JOURNEYS
ui ging t hcni to build cduc~ationnl institutions for the TAKEN TOGETHER IN EUROPE,
!.outh of tlir city and \icinit)~. In stressing education he ASIA & AFRICA.
132 Louis Rosenfeld

footnotes or in passing as an “also-ran.” He undoubtedly

spread himself too thin by giving his time, efforts, and
writing to so many causes and activities. Hodgkin’s
epitaph, written by his brother, is appropriate: H~nzani
NihilA SeAlienum Pulabal (“Nothing human was alien to
him”).
I would like to end on a humorous note. Hodgkin read
3 papers at the annual meeting of the British Associa-
tion for the Advancement ofscience in September 1844.
Two had exotic titles: “On the Tape-Worm as Prevalent
in Abyssinia” and “On the Stature of the Guanches, the
Extinct Inhabitants of the Canary Islands.” These drew
no special notice. The third, “On the Dog as the
Associate of Man,” caught the attention of the Press and
was mentioned in Punch and the Illmtrated London News
for the moments of comic relief that it provided.“O To his
own great surprise, and no doubt that of evelyonc else
who knew him, this Quaker Englishman, serious at all
times, with hardly a charming or captivating personality
and little if any sense of humor, could be funny and
entertaining. To illustrate his presentation, Hodgkin
imitated the growl, snarl, and bark of many different
Figure 3. Thomas Hodgkin’s grave site. (Courtesy of Joshua
0. Leibowitz, Jerusalem, Israel.)

The graveyard, no longer in use, is locked, but visitors

may obtain a key at the adjoining girls’ school.
Hodgkin’s Quaker upbringing undoubtedly contrib-
uted to a narrow and unbalanced outlook on life that
made it difficult for him to compete effectively in an
imperfect world in which the rules did not conform with
his ethical standards. One obituary noted that, “In all
matters of principle he was as unyielding as granite. He
knew nothing of expediency, as separated from the
highest moral considerations.“2g This inflexible adher-
ence to truth and justice worked to his disadvantage in
the highly politicized environment of Guy’s Hospital.
Hodgkin’s life followed the advice of the ancient
adage, namely, that although one cannot solve all the
problems of the world, neither is one free to take no part
in the effort. If he seemed to stand out against the
current it was only because of his participation on so
many fronts. Touched by disappointment and failures,
Thomas Hodgkin remains one of the most interesting
and intriguing figures of mid-19th century English
medicine.
Hodgkin did not espouse new or unusual programs or
ideas, and he was not alone in trying to change the social
standards of his day. He was in the mainstream of
reform thinking, yet he made very little impact and is
rarely mentioned by historians of the social and health Figure 4. Obelisk monument. (Courtesy of Joshua 0. Leibow-
reform movements of the 19th century, and then only in itz, Jerusalem, Israel.)
 Thomas Hodgkin: Social Activist 133

kinds ofdogs and accompanied them with facial impres- 14. H”dgkin T: C:“ld, Hunger, and Want of Employment; With
sions of t hc looks of t hesc dogs with the aid of a u-ig and Suggestions Ior Their R&l’. London, England, Watts, 1847, p 7
15. Hotlgkin T: Dwellin~gs lix the Poor. The IMorning Star, April 4,
shaggy q,ebrows. PZUK/~ called his presentation “one of IXG6. p6 (Ictter)
the most succcssti~l papers that were read at the 16. Hcxlgkin T: On thr wrights to be used in medicine. BMJ
meeting.” Hodgkin was “par~icutarly t’cticitous as the 1X62:2: 197-198 (see also p 17X)
otct English hound, for which the nalural mitctness of his 17. Hxlgkin ‘1‘: Numerical method ofconducting medical inquiries.
Assoc .\lcdJ IX~4;Dccrmb~r:1090-I094
countenance admirably adapted him.““‘-‘,’
IX. Hodgkin ‘I‘: Remarks from Social Science Congress at Bradford,
Yorkshirr, 1859. Anti-TobaccuJ 1866;7-8:86
19. Hodgkin T: The Means of Promoting and Presewing Health
References (cd 2). London, England, Simpkin, Marshall, I X4 I, pp 175 I76
I. I lodgkin ‘I‘: An vssay on tnrdic;~l r&cation. rcxl b&rr the 211. Hodgkin T: The Means of Pnmoting and Preening Health
Physical Society “I&y’s Hospital at thr first mreting ol’thr srssi”n, (rd 2). London. England, Simpkin, Marshall, 1841. p 279
18”i-I 828. I.uncl~)n. England, Phillips. 182X 2 I. Rosenfrld 1~: Thomas Hodgkin and Moses Monteftorr: Europe,
2. I&s EI 1, (:arr! AH, I&s A.\l: Thwnas I Mgkin and Br+min A&, and Aliica. Bull .“J Y Acad ,\Icd I99 1;67:460-474
Harriwn: Gisis .und prwnuti~ln in xadcmia. .\Ird Hist 19X0:24: I !l7- 22. F.O. 7X/1383 (Political No. I), Januay I, 1858, James Finn tu
20X thr Earl “1‘ C:larrndon in The British CZonsulate in Jrrusalem in
Krlation lo thr Jrws of Palrstinr 183X-1914, part I (183X-1861). in
Hy~~sun ;\hl (r(l). No. 190. London, England. The Jr\%ish Historical
Swict) 01‘ Englancl. lK39, pp 257-260 (publish4 for the Society b!
GI\v;lrd C;oldst”n Ltcl)
23. Ho&kin ~1‘: On thr isthmus ul’ Sure. communicated by Dr
Nurrun Shaw. Lit C;ar. ,J Archarol Sci Art 1857;Octobrr 17, No.
2 126: I Ot 1% IO06
24. Hcxlgkin T: On the propusrd ship cnnal through the isthmus of
Surz. kp Br Assur Ad\- Sci 1X57:27: I99
2.5. \Vilks S: Hodgkin and Sir ~10~s Montefiore. C&v’s Hosp Gaz
I II 10:2-l: 1% I -I-
26. K”I-n BLV: Thr Amrrican Rraction to Thr ,\Iortara Case:
185X-1839. Cincinnati. OH, Thr AmericanJewish Archives. 1957
27. Hodgkin ?I‘: Narrative of a Journq to ~Iorocco, in 1863 and
8. I.rttrt- hrorn JJ. Robrrts I” Thomas I Mgkin, I\I+ X, IMY. 1864, uith Grolugical Annotations. London, Englancl, C:autlcy Nr\vby,
Al-chives “I‘ Kh”drs House Libl-at?. Oxlind 11s~ Brit Emp s IX. I X66
c: I ‘2/.57. 122/5X 2X. Iur\vr L (ccl): Dinrirs or Sir Aloses and Lady Montefiore.
9. Hodgkin ‘1‘: On thr pt-;wic;~bilit! of ci\&.in,y aboriginal p”pul.l- Comprising thrir Lifr and Wurk as Recorded in Their Diaries From
tions. .\I”nthl\ (:hrunirlr I839:4:3I)!l-32 I IX I”- I XX3 (~“I 2). Lonclon. England, Grillith Farran Okeden & Welsh,
II). IH”dgkin 1‘: On the imlwrt;mcc “I’sr+ing and pwscning the I X00. Farsin& p”blishrd by thr,Jr\vish Historical Society of England
Ian,gu;~gcs slx’krn I,> uncivilizrd n;Ltions. \vith thr vtr\v 01’ rlucidnting ;mcl The Jwish .\lusrum. L&don. England, 1983
t hr ph!siral hist”n VI‘ nun. Iandrm and Minhtn-gh Philosophical 29. Thr lntr Dr Hotlgkin. C:“loninl Intrlligencw; or. Aborigines’
.\I+gazinr ,mcl,j~wxd &‘%rncr 1X3.5:7:27-36. I9ClO6 F’rirnd. I X66:2:5 I!l-522
I I. K~~nfrltl I,: 11x1 in K&iwn I>cl;m) ( IX I2- I X8.5): Physician, 31). Hodgkin ‘I‘: On thr dog as the ussociatr of man. Rep Br Assoc
black srpxatist. cspI01.~1., soldier. Bull N \‘:\cucl .\lrd 198%65:801-X IX Aclv Sri I X44; 14:X I (part 2)
12. Hudgki” ‘f: On 111~ .\IIKI~. 01 Sclrcting and Kcmunrr;uing :j I. :‘a Paprr on thr “Dug.” Punch. Octobrr 12. IX-H, \.“I 7 (#170). p
.\lrdiral .\lcn liw I’r”IPssionr~i htt~ncl;uiw on thr Pour 01. a Parish o* I.59
Diet-ict: Rrad hr%w thr I luntrrian Sourt~. I.mdlirld. England. 32. A P~~ptv “n thr Dog. Ilhwatrd London SCWS. Octobrr 5, IX-H,
PI-intrd 1)) \V. Exlc .lt thr SC hwls of Inclust~~. IX36 \1ll 5 (# l27), pp “2U-221
I:~. IHcxlgkin 1‘: C:old. Hungrr. and byant (11. I-mpl~~yncnt: \Vith 33. K~wn~cltl L: Thomas Hotlgkin: 1l”rbid Anatomist and Serial
Sw+yti”ns IOI- ‘l‘hrir Krlirl’, I ~~ncl~n. E~+$ancl. \4’atts. I X47. p .5 :L.ti\.ist. 1.mh.m~. AID, .\Indiwn Books. 1983