Wednesday, 12 October 2016
The amazing work of Thomas Hodgkin
The title page didn't offer any particular excitement either, though it confirmed that the volume was in a very clean condition:
A little bit of further research revealed that the Medical and Chirurgical Society of London - an inelegantly named body if ever there was one - was to become the Royal Society of Medicine in 1907, but at this point was meeting in small rooms in Lincoln's Inn Fields. This does pique the historical interest a little, but what really causes jaws to drop and eyes to bulge is the contents of the volume.
On pages 68 - 114, nestled in amongst other medical tracts, is a short paper that, on its presentation in 1832, caused little remark, Thomas Hodgkin's "On some morbid appearances of the absorbent glands and spleen". One might find that to be a rather macabre title, and indeed it is, for the paper deals with Hodgkin's observations of seven patients with tumours on their lymph nodes, spleens and livers. He was at this point lecturer of morbid anatomy and curator of the museum at Guy's Hospital, and this type of medical observation was nothing new to him. This might be why he missed the significance of his own conclusion that " this enlargement of the glands appeared to be a primitive affection of those bodies, rather than the result of an irritation propagated to them from some ulcerated surface or other inflamed texture". In other words, these patients were suffering something other than a normal inflammatory infection.
Hodgkin more or less left it at that. It was his successor at Guy's, Samuel Wilks, who realised the importance of Hodgkin's discovery. In 1856, Wilks observed patients with the same symptoms and recognised them from Hodgkin's work. In 1865 he published his own paper in which he dubbed the condition Hodgkin's disease, which we now know as Hodgkin's lymphoma. Since then, the crucial importance of Hodgkin's discovery has come to be appreciated: ""The 1832 paper is the beginning of our understanding of the lymphoreticular malignancies and can be regarded as the first step in our recognition of the immune system and its disorders"(Stephen A. Geller, Comments on the anniversary of the description of Hodgkin's disease, Journal of the National Medical Association, Vol. 76 (1984), pp. 815-817.) This paper is one of the founding texts of immunology with ramifications in the present day - Hodgkin's lymphoma is often associated with AIDS - and an important work in the history of oncology.
Like Hodgkin himself - Quaker, social reformer, anti-slavery campaigner - the volume that carries this work looks rather humble, but is really a brilliant gem. It exists in medical libraries throughout the world, and yet it is surprisingly rare on the open market. Only one copy appears in the auction records, the Meyer Friedman copy which sold at Sotheby's New York in November 2001. That copy sold for over $20,000. The past is another country, alas, and that was a hugely subscribed sale at which many things went for eye-watering prices. Nevertheless, our price of £4000 for this ground-breaking work seems as modest as the author himself.
Posted by Chris Saunders