John Forbes

This article is about the doctor. For other uses of the term John Forbes, please see John Forbes (disambiguation).

John Forbes (1787-1861), physician and medical journalist, was born on 17 December 1787 at Cuttlebrae in Banffshire, North-East Scotland. He was the fourth son of a tenant farmer, Alexander Forbes and Cicilia Wilkie.

Life

Between 1803 and 1805, Forbes attended the Arts course of Marischal College, Aberdeen, and then went to Edinburgh to obtain the diploma of the Royal College of Surgeons, passing the examination in February 1806. The following year he entered the naval medical service as a temporary assistant surgeon. Between 1807 and 1816 his time was spent mostly at sea. He was promoted to full surgeon on 27 January 1809, after serving on the 'Royal George', the 100-gun flagship of the Channel Fleet. He later saw action against the French in the Caribbean (1809-10) and in the North Sea squadron blockading the Dutch coast and attacking ports on the river Elbe (1811-13).

In 1816, Forbes enrolled in the medical school at Edinburgh University, graduating with an MD in August 1817 on the same day as his old schoolfriend, James Clark. During his medical studies. Forbes had attended geology lectures given by Professor Robert Jamieson. When, fortuitously, Professor Jamieson asked to recommend an Edinburgh physician with an interest in geology for a medical practice in Penzance, Cornwall, he recommended Forbes, who duly moved to Penzance in September 1817.

On 19 May 1820, Forbes married Eliza Mary Burgh (1787-1851). He took a keen interest in local Cornish academic activities, contributing papers to the Royal Geological Society of Cornwall, of which he was secretary. One of his papers was on the health of Cornish tin and copper miners, including studies of their working conditions and the stethoscopic signs of pulmonary tuberculosis.

John Forbes and his wife moved to Chichester in 1822, where their only child, Alexander Clark Forbes, was born on 18 April 1824. At Chichester, Forbes wrote his major medical work Original Cases with Dissections and Observations illustrating the use of the Stethoscope and Percussion in the diagnosis of Diseases of the Chest (1824). Original Cases was favourably reviewed by The Lancet (Anon 1824).

On 15 October 1840, John Forbes resigned as senior physician at Chichester Infirmary in order to take up residence at 12 Old Burlington Street, Westminster. On 15 February 1841, Forbes was appointed as court physician to Prince Albert (1819-1861) and the royal household. He was elected a Fellow of the Royal College of Physicians in 1844 and as an honorary fellow of the Imperial Society of Physicians in Vienna in 1845. In 1852 he was awarded the honorary degree of Doctor of Civil Law by the University of Oxford, and he was knighted by Queen Victoria in 1853.

On homeopathy "If they adduce no other proof than the fact of diseases ceasing on or after employment of their medicines, the fact, though repeated ad infinitum, if standing simply by itself, must go for nothing in the way of proof.... "To be called on to believe that the decillionth of a grain of charcoal or oystershell, is capable of producing hundreds of the most formidable symptom, and of curing, as if ny magic, the most inveterate diseases - while we can take ounces, nay pounds, of the same substance into our stomachs with no other inconvenience than its mechanical bulk - seemss so gratuitous an outrage to human reason that the mind instinctively recoils from the propositio." On allopathy "The principlal of these inferences are... "1. That in a large proportion of the cases treated by allopathic physicians, the disease is cured by nature, not by them "2. That in a lesser, but still not a small proportion of cases, the disease is cured by nature in spite of them... "3. That consequently in a considerable proportion of diseases it would fare as well or better with patients ... if all remedies, at least all active remedies, especially drugs, were abandoned." Forbes J (1846). Homoeopathy, allopathy and “young physic”. British and Foreign Medical Review, 225-265.

Medical Journalism

In 1818 Clark had brought back from Paris an early model of the newly invented stethoscope of René Laënnec (1781-1826). Clark was enthusiastic about the French physician’s teaching as expressed in De L’Auscultation Médiate (1819), and, prompted Forbes to translate this into English. His first translation, A Treatise on Diseases of the Chest (1821) helped to spread Laënnec’s teachings to the English-speaking world.

At Chichester, Forbes combined private medical practice with his hospital work at the new Chichester Infirmary for fourteen years. During this time, in collaboration with two other Edinburgh graduates, John Conolly (1794-1866), and Alexander Tweedie (1794-1884), Forbes launched a Cyclopaedia of Practical Medicine in four volumes (Forbes et al. 1832-35). In 1836, Forbes and Conolly started a new publication in 1836: the British and Foreign Medical Review, or, A Quarterly Journal of Practical Medicine. This became known as the "Forbes Review" and was widely read throughout Europe.

Forbes' interests included animal magnetism, based on the ideas of the Austrian physician Franz Anton Mesmer (1734-1815), whose ideas were discredited by a royal commission in 1784 (Commission Royale 1784). In 1846, he published an article, in German, on ‘Sleepwalking, clairvoyance and animal magnetism’. In 1845, he ridiculed clairvoyance in an article in a London literary journal and was congratulated by a reviewer for trying to establish whether the demonstrations of clairvoyance and mesmerism were genuine or fraudulent by personally witnessing them.

Forbes was also interested in phrenology and homeopathy; Forbes admired much about the founder of homeopathy, Samuel Hahnemann, declaring that it was ‘but simple justice to admit that Hahnemann was a man of profound learning and perfect integrity, and that many of his disciples were sincere, honest and learned men". He kept an open mind on Hahnemann’s principle of ‘like cures like’, but had no time for medical quackery, whether by unorthodox practitioners or by mainstream doctors. In January 1846, he published an anonymous commentary in the British and Foreign Medical Review entitled ‘Homeopathy, Allopathy and the “Young Physic” (featured in the James Lind Library). Forbes approached the subject by examining the evidential basis for medicine; he believed that drugs were often prescribed prematurely and in too large amounts without waiting to see whether 'masterly inactivity' (the vis medicatrix naturae) would be effective. He felt that this was particularly true for inexperienced doctors, fresh from medical school.

In 1857, in Of Nature and Art in the Cure of Disease, Forbes makes it clear that his views had changed from scepticism to outright condemnation of the unorthodox doctrines of mesmerism and homeopathy, while still advocating the benefits of the curative properties of Nature. Forbes says that “a large proportion of cases of disease [which] recover under homeopathy…recover by means of the curative powers of Nature alone.” He concluded that homeopathy is “one of the greatest delusions…of the healing art” and the only good that ensues from its practice is the reduction in “the monstrous polypharmacy which has always been the disgrace of our art – by at once diminishing the frequency of administration of drugs and lessening their dose.” (Chapter VII, pp 162-63).

"Before his [Sir Astley Cooper's] time, operations were too often frightful alternatives or hazardous compromises; and they were not seldom considered rather as the resource of despair than as a means of remedy; he always made them follow, as it were, in the natural course of treatment; he gave them a scientific character; and he moreover, succeeded, in a great degree, in divesting them of their terrors, by performing them unostentatiously, simply, confidently, and cheerfully, and thereby inspiring the patient with hope of relief, where previously resignation under misfortune had too often been all that could be expected from the sufferer." John Forbes (Ed.), British and Foreign Medical Review (July 1840, vol. 10, No. 19, 104 writing in appreciation of the anatomisy and surgeon Sir Astley Cooper (1768-1841) who had famously declared that "The science of medicine is founded on conjecture, and improved by murder."

The London medical establishment considered his views iconoclastic, as was reflected in his obituary in The Lancet, which referred to his “obnoxious articles” published in the British and Foreign Medical Review (Anon 1861), and an article entitled 'Medical Errors' written by a Fellow of the Royal College of Physicians of London (Barclay 1864, pp 3-4) questioned his claim that Nature was often the chief cause of success in the treatment of disease.

John Forbes’ general reputation was unharmed, however, as, in 1846, he was appointed as one of the first two consulting physicians to the Brompton Hospital for Consumption and Diseases of the Chest. He resigned as editor of the British and Foreign Medical Review in 1847.

In 1858, one of his colleagues at the Brompton Hospital dedicated a textbook on pulmonary tuberculosis to him, describing Forbes as

“one who, through his long life, has exerted no inconsiderable influence over his profession, and who, amongst his other distinguishing qualities, has had the courage to question the groundwork of some of the principles of his art, and with a view to their correction has boldly expressed his convictions” (Smith 1858).