Martin Duke, MD, FACP 

Mystic, Connecticut, United States 

Every generation seems to produce its share of physicians and surgeons who are remembered for their literary accomplishments—Avicenna and Maimonides in the middle ages, Rabelais during the French Renaissance, Thomas Browne in the 17th century and Keats and Goldsmith in the 18th century.  Anton Chekhov, Arthur Conan Doyle, Axel Munthe, Somerset Maugham and William Carlos Williams made their marks in the 19th and 20th centuries as did Lewis Thomas, Richard Selzer and Oliver Sacks in more recent years, to name but a few.  Not to be overlooked for inclusion in this select group is Tobias Smollett (1721-1771), an 18th century novelist, playwright, poet, writer of travel and history books, satirist, essayist, book reviewer and editor.  Early in his career he engaged in the practice of medicine but never, it seems, with great success in building a practice.  Ultimately, this failure may have been a blessing in disguise.  For in turning from a medical to a literary career, as one observer wrote, “it is pleasing to think that his [Smollett’s] training and early experience in medicine may have played their part in developing his faculty for accurate observation and graphic description—the essential backbone of his prose.”1  Medicine’s loss became the literary world’s gain.

 

This article reviews what is known about Smollett’s medical education, experiences and achievements. Descended from a prominent Scottish family, Smollett was baptized in the parish church of Cardross, Dumbartonshire, Scotland on March 19, 1721.  He was the youngest of Archibald and Elizabeth Smollett’s three children. After attending the Dumbarton grammar school, Tobias went to Glasgow University (although his name does not appear on its matriculation or graduation records).2 Other than brief comments noting that “he formed an intimacy with some students of medicine, which, more than any predilection for the study, determined him to embrace the profession of physic”3 and that “he attended the anatomical and medical lectures in the University,”4 little is known about his medical studies.

  

Fig. 1. Excerpt from examination records of the Company of Barber-Surgeons, December 4th, 1739 showing entry of Tobias Smollett (Courtesy of The Worshipful Company of Barbers, London)

 

At the age of fifteen, an apprenticeship with two well-known surgeons in Glasgow was “booked” in the Faculty Records on May 30, 1736. As cited by Duncan, “The which Day Tobias Smollett, son of the deceased Mr. Archd. Smollett in Dumbarton, is booked apprentice with Mr. William Stirling and John Gordon, freeman, for five years from the date of the Indenture produced, dated the Sixteenth and Nineteenth days of Aprill [sic] last, and he payed the Collector ten shillings ster. of Booking money with the Clerk and Officer their dues [sic].”5 Few details are available about this period of his training, although according to Fulton, “one place Smollett certainly visited in his apprenticeship was the Touns [sic] Hospital, founded in 1733 to house and work the city’s indigent.”6  Three years into his apprenticeship in mid 1739, Smollett left Glasgow for London, taking with him a copy of a play he had written—The Regicide—which he hoped to have performed there.  It would be, however, several years before this actually happened.  In the meantime, he entered the next phase of his medical career.

Fig. 2. Mid 19th century letter offering Smollett’s medical diploma for sale. (Courtesy of Bernard Quaritch Ltd., London)

 

Whether it was a need to support himself, a desire to serve in the war against Spain, or the adventuresome spirit of an eighteen-year-old youth wishing to see the world, Smollett decided to put his medical training and knowledge to good use in the navy.  To this end, he took an examination at Barber-Surgeons’ Hall in London where on December 4, 1739, the entry of his name, his suitability as a “second mate of a third rate,” and the identities of his examiners were recorded in Rough minutes of the Courts of Assistants and Examiners from May 1738 to July 17427 (Figure 1).  Included among those who examined him was the well-known William Cheselden (1688-1752), Surgeon to St. Thomas’ Hospital, surgical innovator and Fellow of the Royal Society.

 

From 1740 to 1741, Smollett served aboard the HMS Chichester and participated in the attack on Carthagena (Cartagena), South America.  Years later, he wrote in both his fictional and nonfictional works about the hardships endured on these vessels and the sicknesses and diseases he encountered on this voyage.  After leaving the navy sometime between 1742 and 1744, he met his future wife in Jamaica and returned to England to establish a medical practice.

 

On May 22, 1744, Smollett, then 23 years old and living in London, sent a letter to Mr. Barclay of Glasgow in which he identified himself as a surgeon.  Smollett wrote, “I have moved into the house where the late John Douglas, surgeon, died, and you may henceforth direct for Mr. Smollett, surgeon, in Downing Street, West [Westminster].”8  Between 1746 and 1750, he frequently changed residences in the city in search of opportunities to build his practice, first moving to less expensive quarters on Chapel Street in Mayfair and then, with the birth of his daughter, to larger quarters in the Beaufort Building, Beaufort Street, near the Strand and Somerset House.  He finally settled in Monmouth House on Lawrence Street, Chelsea (formerly the home of the Duchess of Monmouth) where he lived for around 12 to 13 years while becoming increasingly more committed to his literary career.2  In 1950, the London County Council erected on this street a commemorative blue plaque that read: “Chelsea China was manufactured in a house at the north end of Lawrence Street 1745-1784.  Tobias Smollett novelist also lived in part of the house from 1750 to 1762.”

 

Fig. 3. Title page of Tobias Smollett’s “An Essay on the External Use of Water”, 1752. (With permission of the Historical Medical Library of The College of Physicians of Philadelphia)

In an effort to improve his medical image, Smollett “evidently felt that he would be the better of a degree [sic], so he sent a fee of £28 Scots and certificates [of recommendation] from two sponsors to Marischal College, Aberdeen, and received a diploma creating him Doctor of Medicine,”9 a procedure that was not unusual at the time.  It is doubtful that he traveled from London to Aberdeen to obtain the degree but instead was awarded it in absentia.10  The date was recorded as June 1750, with the diploma signed in all likelihood by Dr. James Gordon, then the Professor of Medicine.11,12

 

What happened to Smollett’s diploma during the years that followed?  Knapp indicated that it was preserved with Smollett’s papers in Italy.13  The artist Hugh William Williams (1773-1829) wrote that while travelling in Europe from 1816-1818 he went to Leghorn, Italy where “a gentleman, on visiting a lady here the other day, saw, among some papers on her table, the diploma granted to Dr. Smollett by the University of Aberdeen. Wishing to obtain the curious document, he waited on the lady a second time, but, upon inquiry, he discovered that she had cut it down for thread paper.”14  This apparent destruction of the diploma would seem to have settled its fate.  Recently, however, a letter dated from the mid 19th century was found in which its author claimed that he had Smollett’s medical diploma and was offering it for sale15 (Figure 2), thus raising the question of whether the diploma, despite the earlier report of its destruction, might still have existed many years later.  Further research into this incident is needed. 

 

Two publications by the then Dr. Smollett can be considered contributions to the medical literature.  The first, "An Essay on the External Use of Water" (1752), was a critical discussion of the poor hygienic conditions that existed when administering mineral water treatments and “a plan for rendering them more safe, agreeable, and efficacious”16 (Figure 3).  The second was a case report entitled “Separation of the Pubic Joint” that Smollett sent to his friend and teacher, the Scottish obstetrician William Smellie (1697-1763), for inclusion in the latter’s well-known Treatise on the Theory and Practice of Midwifery.17 

 

When Smollett stopped seeing patients, he did not stop writing about medicine.  Throughout his works—essays, novels, books, letters and reviews—are frequent passages about medicine, medical treatments and diseases (including his own ailments), still as fascinating to read today as they probably were two and half centuries ago. 

 

References

  1. Underwood EA.  Medicine and science in the writings of Smollett.  Proc R Soc Med 1937; 30: 961-74.
  2. Knapp LM.  Tobias Smollett, Doctor of Medicine and Manners.  Princeton, New Jersey: Princeton University Press, 1949.
  3. Anderson R.  The Life of Tobias Smollett, M.D. with Critical Observations on his Works.  Edinburgh: Mundell and Son, 1803; p. 20.
  4. Ibid., p. 24.
  5. Duncan A.  Memorials of the Faculty of Physicians and Surgeons of Glasgow, 1599-1850.  Glasgow: James Maclehose and Sons, 1896; p. 120.
  6. Fulton HL.  Smollett’s Apprenticeship in Glasgow, 1736-1739.  Studies in Scottish Literature.  1980; 15 (issue 1): 175-186.
  7. Archive ref: B/2/5.  Held by the Barbers’ Company, London.  Entry date - December 4th 1739 in Rough minutes of the Çourts of Assistants and Examiners, May 1738-July 1742.  (Courtesy of The Worshipful Company of Barbers’).
  8. Noyes ES (editor).  The Letters of Tobias Smollett, M.D.  Cambridge: Harvard University Press, 1926; p. 6.
  9. Taylor WD.  Tobias Smollett, M.D., Aberdeen, 1750.  Aberdeen University Review 1939; 26: 125-35.
  10. Knapp LM, op. cit., p. 144.
  11. Register of MD’s 1736-1756 kept by Professor James Gordon.  MSM 27. Aberdeen University, Special Collections Centre.
  12. Anderson PJ (editor).  Fasti Academiae Mariscallanae Aberdonensis: Selections from the records of the Marischal College and University, MDXCIII-MDCCCLX [1593-1860] Volume 2.  Aberdeen: New Spaulding Club, 1898; pp. 111,116.
  13. Knapp LM, op. cit., pp. 144-5.
  14. Williams HW.  Travels in Italy, Greece, and the Ionian Islands Volume 1.  Edinburgh: Archibald Constable and Co. 1820; p. 198.
  15. Autographed letter, Charles Young, c. 1850.  (Courtesy of Bernard Quaritch Ltd, London).
  16.  Knapp LM, op. cit., p. 146.
  17. McClintock AH (editor).  Smellie’s Treatise on the Theory and Practice of Midwifery Volume 2.  London: The New Sydenham Society, 1877; pp. 7-8.

 

Martin Duke, MD, FACP graduated in 1954 from the New York University School of Medicine.  Following postgraduate training in medicine, pathology and cardiology, he was in private practice in Manchester, Connecticut from 1963-1993.  During this period he served as Director of Medical Education and Chief of Cardiology at the Manchester Memorial Hospital and held a teaching position at the University of Connecticut School of Medicine.  He is the author of two books, over one hundred medical articles, and is on the editorial board of the state medical journal.