The good Dr. Gull

I’ve been trying to put the “Edmonton bureau” into more civilized order the last few weeks. This mostly involves decreasing the total entropy of my books and restoring them to shelves and boxes, which inevitably leads to the discovery of a couple dozen books I never finished and many others I’d like to read again. This in turn, tends to delay the tidying. Among the books I’ve unearthed and re-read is From Hell, Alan Moore and Eddie Campbell’s graphic novel about Jack the Ripper.

Moore’s “theory” of the case is a modification of an old Ripperologist favourite: the Ripper, goes the story, was the instrument of a royal/Masonic conspiracy to eliminate a handful of Whitechapel prostitutes who had been blackmailing the Prince of Wales’ son, Albert Victor. In a postscript that is one of the most remarkable parts of a dazzling book, Moore and Campbell, giving an overview of Ripperology and the lonely kooks who have practiced it, show exactly how crazy you’d have to be to accept this. It took an inconceivable amount of research, shuffling, and fudging on Moore’s part to contort the theory into fitting the details of the case.

"Sir William Withey Gull"But it seems unfortunate that he never stops to ease his Ripper candidate—Sir William Withey Gull (1816-1890), head of Guy’s Hospital and Physician-in-Extraordinary to the Queen—totally off the hook. Gull became a subject of interest to Ripperologists because some investigators felt the murders displayed evidence of advanced surgical knowledge; doctors and butchers alike were under a cloud of suspicion in London at the time of the killings. (Modern cops, of course, are still occasionally known to attribute “surgical skill” to cattle mutilations perpetrated by coyotes.) In Moore’s hands, Gull becomes one of the great literary monsters: a talented, ultra-bourgeois physician and teacher who is assigned an unpleasant secret task and loses control, deranged by Masonic blasphemies, mild cerebral strokes, fantasies of patriarchal vengeance, and the menacing, phallus-studded mise-en-scène of East London.

For better or worse, even if they are sensible enough not to accept Moore’s fiction as truth, future generations are likely to picture a predatory misogynist when they hear the name “William Withey Gull”. This seems a shame, one doubled by Moore’s failure to provide some apology for it: the real Gull fought for women’s right to receive a medical education, and coined the term “anorexia nervosa”. Gull seems to have been a scrupulous and gentle practitioner, one who raised himself through hard work (in the classic 19th-century manner) from childhood penury to a baronetcy. He died with what some, at the time, considered the largest personal fortune ever amassed wholly through doctoring.

From our vantage point, we can hardly help regarding most Victorian doctors as anything but striving bunglers. One shudders, for instance, reading about Gull’s stubborn insistence that diabetes mellitus was certainly a disease of the liver. But Dr. Gull probably did do some genuine good. From youth onward he was notable for a combination of amiability and trustworthiness that made a powerful impression on everyone who knew him. “Not many years ago,” one friend recalled, “we heard an old student of Guy’s [Hospital] descant on his beautiful lectures, and especially those on fever. On being questioned as to what Gull said which most struck him, he said he could not remember anything in particular, but he would come to London any day to hear Gull reiterate the words in very slow measure, ‘Now typhoid, gentlemen’.”

The friend added, “When Gull left the bedside of his patient, and said in measured tones, ‘You will get well’, it was like a message from above.” This self-consciously inspiring bedside manner, far more than anything he actually prescribed, seems to have been responsible for Gull’s success in treating the future Edward VII for typhoid, which made him a permanent royal favourite. Gull was a strong advocate of the Hippocratic principle of doing no harm—and, if possible, doing absolutely nothing at all. He was controversial in the profession for “Gull’s treatment of rheumatic fever by mint water”—that is, by means of placebo. (“Being dissatisfied with the treatment of this disease by so many remedies, he wished to try the effect of abstinence from all medicines, and to satisfy the patients’ minds he ordered mint water.”) A biographer writes:

He had the greatest hatred of the charlatanism which has a remedy for every malady, and therefore was conscientiously opposed to the homoeopathic system of affirming the existence of a medicine for every symptom. He once showed the writer a note-book in which cases were recorded, and he said how strangely this would be regarded by anyone who did not unravel its meaning.

For example, “Name, Mr. _____; disease, loss of favourite dog; treatment, Isthmus of Suez.” The explanation was, that a gentleman of no occupation came to him complaining of his wretched state of health, and Gull soon found on conversation that his mind had been much worried by the loss of his favourite dog. Gull saw that he wanted some distraction, and as just at that time all the world was hastening to Suez to inaugurate the opening of the Canal, he advised his patient to go there.

In the context of his time—or, indeed, of any earlier time in the history of Western medicine—Gull’s conservative prescribing and reassuring manner represented the best possible care a patient could expect. And one can’t help thinking that today’s MS patients who are travelling to Poland or India for venography are probably giving themselves a good strong dose of Isthmus of Suez.

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