James Paget

Sir James Paget (1814 - 1899)

Sir James Paget (1814 – 1899) was a renowned English surgeon .

In a career spanning eight decades, with research and practice in surgery, as well as serving the royal family during Queen Victoria’s reign

He is most famous for his descriptions of Paget’s disease of the nipple (1874); Paget’s bone disease (1877); and Paget-Schroetter Syndrome (1858)

His work contributed to descriptions of multiple diseases including neurofibromatosis, hereditary multiple exostosis, painful subcutaneous tumours and viruses in relation to cancers.


Biography

  • Born 11 January 1814, Great Yarmouth, United Kingdom
  • 1834-1836 Medical school, St Bartholomew’s Hospital, London
  • 1838 – Contracted Typhoid after conducting a post-mortem
  • 1846 – Elected fellow of the Royal College of Surgeons
  • 1847 – Appointed the Aris and Gale Professor of the Royal College  where he gave lectures on nutrition, blood, repair and reproduction following injury, inflammation and tumours. These lectures formed the basis for his classical text Lectures on Surgical Pathology.
  • 1858 – Royal Surgeon Extraordinary
  • 1863 – Surgeon-in-Ordinary to His Royal Highness, the Prince of Wales
  • 1867 – Sergeant-Surgeon Extraordinary
  • 1871 – Awarded a Baronet by Queen Victoria, pronouncing him Sir James Paget
  • 1877 – Sergeant-Surgeon to Queen Victoria during her reign
  • Died 30 December 1899, London, United Kingdom

Medical Eponyms

  • Paget-Schroetter Syndrome: Axillo-subclavian vein thrombosis due to endothelial trauma, as a result of repetitive activity of the upper limbs. [Paget 1858; 1875 and Schrötter 1884. Attribution by ESR Hughes 1948]
  • Paget’s disease of the nipple. (1874)
  • Paget’s disease of bone (1877) [aka Paget’s disease; osteitis deformans]
  • Osgood-Schlatter disease (1891)
  • Carpal Tunnel syndrome (1854:42-44)
  • Paget’s Sign: A test eliciting a fluid filled mass. Two fingers are placed either side of the lump / mass in question, and when a third finger pressed on top, the two fingers move apart.
  • Paget’s Recurrent Fibroid (AKA Desmoid tumour) (1853): A fibroid-like tumour, that despite surgical removal reoccurred at the same site. His attention was drawn to this condition following repeated removal of fibroid like masses from the same site. His case series, which documents distributions all over the body described his attempts to diagnose and understand the reoccurrence.
  • Paget’s residual abscess (1869): “All abscesses formed in or about the residues of former inflammations”.  Paget described the formation of abscesses at the site of prior inflammation and suppuration. He published a series of case reports in 1869, detailing recurrent abscesses distributed across numerous anatomical sites and age groups.

Key Medical Attributions

1869 Introduced many of the approaches that underpin the foundations of the empirical study of medical education as a scientific discipline. Paget’s article initiated research in medical education, and, despite being neglected, anticipated much that eventually followed. He singularly anticipated the questions, the methods, and the approaches of future empirical research in medical education, and which deserves proper recognition. [Lancet. 2005]


Controversies

Trichinella spiralis

Whilst a first year medical student, he isolated, prepared and documented samples of Trichinella spiralis, a parasite he observed in dissection studies. However, it was his supervisor, Richard Owen who named the species and presented it to the Zoological society, taking credit for the discovery. On the discovery of the parasites in cadaver specimens, Paget stated:

All the men in the dissecting rooms, teachers included ‘saw’ the little white specks in the muscles, but I believe that I alone ‘looked at’ them and ‘observed them


Osteitis deformans

In Paget’s second paper on osteitis deformans (later termed Paget’s disease of the bone), he admits that he was not the first to use the term. He grants credit to a German physician, Professor Czerny. Paget writes:

After the publication of the paper I found that the name ostitis deformans had been given by Prof. Czerny, of Freiburg, to a disease described by him in the ‘Wiener medizinische Wochenschrift,’ September 27th, 1873. It Is mainly, as he says, “Eine locale Malacie des Unterschenkels,” a rather acute inflammation of the lower part of the tibia and fibula, inducing softening and angular bending, and then followed by hardening.


Major Publications


References

  • Turner G. The Paget tradition. New England Journal of Medicine, 1931;205: 622-629
  • Buchanan W. The contribution of Sir James Paget (1814-1894) to the study of rheumatic disease. Clin Rheumatol. 1996 Sep;15(5):461-72. [PMID 8894359]
  • Buchanan W. Sir James Paget (1814-99): surgical Osler? Proc R Coll Physicians Edinb. 1996 Jan;26(1):91-114. [PMID 11614125]
  • Colman E. Sir James Paget: the man and the eponym. Calcif Tissue Int. 2002 May;70(5):430-1. [PMID 11960206]
  • McManus IC. Sir James Paget’s research into medical education. Lancet. 2005 Aug 6-12;366(9484):506-13.
  • Paget J. The first description of carpal tunnel syndrome. J Hand Surg Eur Vol. 2007 [PMID 17296253]
  • Top 100 Ultrasound – Ultrasound Case 085

eponymictionary CTA

eponym

the person behind the name

MB BCh. UK Doctor working in Emergency medicine in Perth, Australia.

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