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American Medical Biographies/Jackson, James (1777–1867)

Jackson, James (1777–1867)

James Jackson was born in Newburyport, Oct. 3, 1777, and died in Boston, August 17, 1867. His ninety years of busy life stretched from the middle of the war of the Revolution to the close of the Civil War, a notable figure in the New England of his day, and one who played a significant part in the medical history of the Commonwealth of Massachusetts during its formative period. At the time of his birth medical practice was emerging from a crude infancy, in which the functions of the doctor and clergyman were often united; before he died the modern era had become fairly inaugurated. While a young physician he rendered conspicuous service in the founding of the Harvard Medical School and the Massachusetts General Hospital whose histories have been so notable, and he set up a standard of ideals in medical practice not to be surpassed. His volume of "Letters to a Young Physician," 1855, are still profitable to the student who sees not only his patient but the man and fellow-citizen as well. This small book deserves a place on every doctor's shelf.

The founder of the Jackson family in America was Edward Jackson, who, with his older brother John, came from London to Cambridge, Massachusetts, in 1643, as a pioneer settler in New Cambridge, known as Newtown or Newton. He represented his town in the General Court for many years and was active in behalf of the commonwealth and of his community. Thirty-eight of his descendants fought in the War of the Revolution, and, fourteen of the descendants of his great-grandson Jonathan Jackson, the father of our subject James, fought in the Civil War of 1861.

James Jackson's grandfather married Dorothy Quincy, and lived in Quincy until his death in 1757. Their son Jonathan graduated from Harvard College in 1761 and removed to Newburyport to be near his intimate friend John Lowell. This friendship proved eventful for the later history of the family in many ways. In 1772 Jonathan Jackson married Hannah Tracy, daughter of Patrick Tracy, a prominent public-spirited merchant of Newburyport; they had nine children, of whom James Jackson was the fifth.

Industry and enterprise were the fashion in those stirring times, and the five sons of Jonathan and Hannah early established themselves in professional life or business. The three brothers, Charles, James and Patrick, who long survived the other two, occupied an important place in the life of their community.

Jonathan Jackson was unable to do more than was absolutely essential toward the education of his sons. James went to Harvard College where he met Dr. John Collins Warren (q. v.), and became the warm friend of John Pickering of Salem, the son of Timothy, Secretary of State under Washington, later a remarkable scholar and jurist. He graduated from College in 1796 at the age of nineteen, and taught for two quarters in Leicester Academy, where he would have stayed longer but for a call from his father, the Supervisor of Internal Revenue for the District of Massachusetts, to take a place as clerk in his office. His fixed purpose, however, was to study medicine, and even to borrow money to carry out his plan.

The young Medical Institution of Harvard University (founded 1783) was still grappling with its problems when Jackson attended its courses in 1796. There were no clinical advantages and the teaching was supplemented by an association with some practitioner outside called a preceptor. The small faculty was a good one for its day; there were Benjamin Waterhouse (q. v.), professor of the theory and practise of physic, John Warren (q. v.), Aaron Dexter (q. v.) and J. Gorman (q. v.), professors of anatomy, physiology, chemistry and materia medica respectively.

Whatever wisdom Jackson got from this institution, his enrollment was important from the fact that it brought him into closer connection with the Warren family, and with Dr. John Collins Warren, who graduated from Harvard in the class next below his, as well as with the Warrens' father, John Warren, (q. v.), the fine, public-spirited patriot of the Revolutionary War, the teacher of human anatomy in the "Medical Institution."

Jackson's first step in his medical education was his enrollment in December, 1797, as a pupil of Dr. E. A. Holyoke (q. v.) of Salem, son of President Holyoke of Harvard College. This remarkable teacher (centenarian) was then the foremost physician in New England; Dr. Jackson ever called him his "glorious old master," who instilled into him accuracy of observation and moderation in treatment. To him he dedicated his graduation thesis on the "Brunonian System" (1809).

The substitution of experience for theory, now a commonplace, was new in those days, and Dr. Jackson's acceptance of this guiding principle enabled him to welcome cordially and critically the methods of clinical research to which Louis, his son's instructor a quarter of a century later, gave so powerful an impulse.

The joint lives of Dr. Holyoke and Dr. Jackson, stretched from 1728 to 1867, over nearly a century and a half, and witnessed a revolution in medical standards, hopes, and aims,—even the transition from superstitution to substantial achievement.

Jackson spent part of a year in England towards the close of his medical studies where John Hunter, Abernethy and Astley Cooper were leaders. Jenner's discovery of the protecting value of vaccine took definite form while he was abroad, and although Jackson was not the first to herald this discovery in America, yet he was active in spreading the knowledge and use of the new method in New England.

In 1799 Jackson received a free passage to London in a ship with his brother Henry as captain. While in London he was a "dresser" at St. Thomas's, and studied anatomy with Cline at that hospital, and with Astley Cooper at Guy's, and vaccination at the St. Pancras Hospital under Woodville, besides attending the regular medical lectures. St. Saviour's Church yard, where he had his rooms, was only a block removed from the Hospital, then near the south end of the old London Bridge. Guy's Hospital nearby was opened for patients in 1725; and from 1768 until 1825 the two institutions were closely united for teaching as the "United Hospitals," and students were at liberty to attend operations and lectures in both.

In August, 1800, he sailed for Boston in the Superb, "a large ship for that period," and reached home in forty-nine days. Two days later he began practice, depending for his first success on vaccination coming into vogue. In his "Reminiscenses," published in old age, he writes:—

"On Oct. 1, 1800, I began business. Vaccination had been introduced about the time that I commenced my studies, but the practice had not been extensively adopted at that day, even in England. Dr. Woodville of London was physician of the Pancras Smallpox and Inoculation Hospital, where he had attended to the subject of vaccination more carefully and more extensively than any other, not exceptting Dr. Jenner. I placed myself under his care (for ten guineas, I believe), and learned all then known about that business. The practice of vaccination had just been introduced here, and Boston was full of it—so far as talking went.

"My friends took me up on that account, so that in that October I derived $150 from that source. I also derived just as much from other business, that made my fees amount to $300 the first month.

"In the remaining 11 months of my first year I earned $500, or nearly $50 a month, or $800 for the year. I must say that everybody talked to me of vaccination, so that I got to fear that people would think I could talk of nothing else, and therefore, before my first winter was over, I rather avoided the subject. However, the cox-pox gave me notoriety, and that is a great advantage to a young man if it comes to him fairly, without any tricks."

On October 3, 1801, his twenty-fourth birthday, he married Elizabeth Cabot, at a time when he was $3,000 in debt, the sum borrowed for his education. This step proved a wise one and they lived together "for seventeen happy years"; they had nine children, three dying in infancy or early childhood. The oldest of Dr. Jackson's sons surviving childhood, James Jr. (q. v.), a remarkable young fellow, graduated at Harvard College, studied medicine, and went abroad where he became a favorite pupil of Louis in Paris, under whom he did original work in the early diagnosis of tuberculosis of the lungs. He also made observation in the clinical history and pathology of cholera during the serious Paris epidemic. A few months after returning to America, in 1834, this promising young man died of typhoid fever; the shock of this loss led Dr. Jackson soon to resign his positions in the hospital and in the medical school. He wrote a memoir of his son published in 1836.

After his wife's death he married her sister, Sarah Cabot, who lived until shortly before his own demise.

In 1802 Dr. Jackson was physician to the Boston Dispensary, serving in the "middle" district, extending from "the north side of Summer and Winter streets to the Mill pond and Creek."

Next came the joint labor with Warren of reorganizing the Massachusetts Medical Society, as the representative body of the entire medical community of the Commonwealth, following the scheme of Dr. John D. Treadwell(q. v.) of Salem, "one of the best physicians of that day."

Meantime, plans for removing the Medical School to Boston, where clinical facilities were more adequate, and for the founding of the Massachusetts General Hospital, constantly occupied the thoughts of Warren and Jackson. The removed Medical School was opened in Boston in 1810, and it became possible to utilize the Leverett Street Almshouse with about fifty sick or infirm persons for clinical instruction.

In 1812 Dr. Jackson was appointed Hersey Professor of the Theory and Practice of Physic, in place of Dr. Waterhouse, and with this move the Medical School was fairly launched in its new form. Dr. Jackson's lectures were didactic, according to the fashion of the day, and his notes, which were printed and are still extant, reveal much thoughtful study.

In 1811 the New England Journal of Medicine and Surgery was established, and up to 1825 Dr. Jackson was its largest contributor.

In 1810 the plans for the establishment of the Massachusetts General Hospital took definite shape, through the appointment of an able Board of Trustees, and in the same year Jackson and Warren drew up an appeal for subscriptions which went far toward assuring success. The carrying out of these plans was interrupted by the War of 1812, and the Hospital was not opened for patients until 1821; at first the applicants came in one by one as the notion of a hospital was a strange one. Dr. Jackson's distinguishing characteristic during his hospital service was a reverential fidelity in observation.

He was a man of medium height, dignified and courtly in bearing. His features were regular, the nose aquiline, the upper lip markedly long and the mouth wide. There is a good bust in the Massachusetts General Hospital.

He continued well into the new century to cling to the older customs which were rapidly disappearing. He wore knee-breeches, and after giving these up he still dressed in a long-tailed coat like the evening coat of today. The stock and the white neck-cloth, a regular part of the dress of a man of his position, always seemed peculiarly appropriate. His hat hung always on the same peg in the hatrack and no one would have been so presumptuous as to remove it. He was an early riser, and when as an old man he went to his dressing-room for his morning bath, his long-time faithful attendant had his foot tub and pitcher respectively placed always on the same pattern of the flowered carpet. A similar impulse made him scrupulously punctual in his professional engagements, and to avoid the chance of being late he carried two watches! As he grew older and largely withdrew from active practice, he continued to call each morning at a certain hour and minute on all of his children within his reach. The writer of this sketch well remembers that the clocks could be set by Dr. Jackson's ring at the front door, when he often found the family at breakfast.

Dr. Samuel A. Green (q. v.), the medical historian of his day, says of him, "He is perhaps the most conspicuous character in the medical annals of Massachusetts . . . No physician in the State ever exerted so large and lasting an influence over his professional brethren or his patients." O. W. Holmes (q. v.), one of the most affectionate and delightful of his biographers, has left this out of a number of tributes:

"Thoughtful in youth, but not austere in age
Calm, but not cold, and cheerful though a sage;
Too true to flatter, and too kind to sneer,
And only just when seemingly severe;
So gently blending courtesy and art,
That wisdom's lips seemed borrowing friendship's heart.
Taught by the sorrows that his age had known
In others' trials to forget his own,
As hour by hour his lengthened day declined,
A sweeter radiance lingered o'er his mind.
Cold were the lips that spoke his early praise,
And hushed the voices of his morning days,
Yet the same accents dwelt on every tongue,
And love renewing kept him ever young."