Samuel Wilks
Sir Samuel Wilks (1824–1911) was an was an influential English physician and neurologist
Wilks was central to the clinicopathological tradition at Guy’s Hospital and one of the most philosophical medical minds of the Victorian era. A contemporary and successor to the “three great men of Guy’s” – Richard Bright (1789–1858), Thomas Addison (1793–1860), and Thomas Hodgkin (1798–1866) – Wilks solidified the foundation of scientific pathology in Britain.
He served as President of the Royal College of Physicians, was elected a Fellow of the Royal Society, and became a baronet and physician extraordinary to Queen Victoria. Wilks was noted for his clinical acuity, humanism, and his ability to correlate clinical findings with pathological anatomy, producing influential works across neurology, infectious diseases, and gastroenterology.
Biography
- 1824 – Born June 2 in Camberwell, London
- 1842 – Entered medical training at Guy’s Hospital
- 1848 – Graduated MB; held resident posts at Guy’s
- 1850 – Awarded MD with gold medal
- 1851 – Passed MRCP examination
- 1853 – Physician at Surrey Dispensary; distinguished typhoid from typhus
- 1854–1865 – Editor of Guy’s Hospital Reports
- 1856 – Elected FRCP; appointed assistant physician at Guy’s
- 1859 – Published Lectures on Pathological Anatomy based on 4,500 autopsies
- 1865 – Proposed the eponymous term “Hodgkin’s Disease“
- 1867 – Appointed full physician at Guy’s, succeeding Sir William Gull
- 1868 – Published on alcoholic paraplegia and early description of Korsakoff’s psychosis
- 1870 – Elected Fellow of the Royal Society (FRS); published early description of bacterial endocarditis (Capillary embolism or arterial pyaemia)
- 1874–1878 – Published Lectures on Specific Fevers, Diseases of the Chest, and Diseases of the Nervous System
- 1877 – First probable description of myasthenia gravis
- 1881–1883 – President, Pathological Society
- 1884 – Awarded LLD, University of Edinburgh
- 1896 – President, Royal College of Physicians; appointed baronet and physician extraordinary to Queen Victoria
- 1897 – Received Moxon Medal
- 1911 – Died November 8 in Hampstead, aged 88
Key Medical Contributions
Clinicopathological Method
Wilks pioneered the systematic correlation of clinical symptoms with post-mortem findings, performing and publishing over 4500 autopsies. His Lectures on Pathological Anatomy (1859, 1875, 1889) provided a foundational text in English pathology, emphasising observation and verification over theory…and he had a few words to say to those not as progressive [Assertion versus argument: a few letters to an anti-vivisectionist]
Hodgkin Disease
In 1856, Wilks rediscovered generalised lymphadenopathy with enlarged spleen, confirming the earlier report published by Thomas Hodgkin in 1832. Wilks had investigated many more cases than Hodgkin and provided a more perfect description but acknowledged Hodgkin’s priority, and proposed the eponym in his 1865 report Cases of enlargement of the lymphatic glands and spleen (or Hodgkin’s disease)
I refer to a disease where the lymphatic glands are increased in size, and associated with a deposit of a morbid kind in the internal viscera, more especially in the spleen. Although my own observations were at the time original (1856), I had been forestalled by Dr. Hodgkin, who was the first, as far as I am aware, to call attention to this peculiar form of disease.
Epilepsy and Cortical Theory
Contrary to prevailing views that epilepsy originated in the medulla, Wilks proposed a cortical origin, anticipating Hughlings Jackson’s later formalization of epileptogenic foci. He distinguished between idiopathic epilepsy and epileptiform seizures from lesions, promoting potassium bromide as the first effective anticonvulsant.
… being in the habit of using the iodide in epilepsy. I substituted the bromide for it. I was at first under the impression that it was acting as an absorbent, and was picking out for its operations those cases where the disease had a syphilitic or local origin; but when the cures came to be numerous, the explanation would not apply, and it was evident that a very valuable specific remedy had been obtained…
It is a great question whether this remedy which has so powerful an influence in checking the fits is really curative; whether indeed it has a permanent effect on the brain to render it less unstable
Inflammatory Bowel Disease
In 1859, Wilks gave an early description of what would later be recognised as inflammatory bowel disease, predating the publication of Burrill Bernard Crohn (1884-1983) by over 70 years. His autopsy findings detailed ulcerative colitis and terminal ileitis, establishing idiopathic colitis as distinct from dysentery.
…we have seen a case attended by discharge of mucus and blood where, after death, the whole internal surface of colon presented a highly vascular, soft, red surface, covered with tenacious mucus or adherent lymph, and here and there a few minute points of ulceration ; and the coats, also, much swollen by exudation into the mucous and submucous tissues.
In the small intestine nothing remarkable was observed until the lower end of the ileum was reached, when at about three feet from its termination in the caecum, the mucous membrane commenced to exhibit an inflammatory response. In the caecum, inflammation of the most acute and violent character was observed…
Syphilitic Visceral Disease
In 1863, Wilks published landmark descriptions of gummatous lesions in internal organs (On the syphilitic affections of internal organs), significantly advancing knowledge of tertiary syphilis and earning election to the Royal Society.
Myasthenia Gravis
In 1877, Wilks reported what is now considered the first probable case of myasthenia gravis – a woman with fluctuating ptosis, squint, and dysphagia – now interpreted as the earliest detailed account of myasthenia gravis, though at the time thought to be hysterical in nature.
Case – Mary B age 30, was sent in as a sufferer from paralysis of one side of her body. She was a governess, and said that two years ago her left hand became numb, afterwards weak, and at the end of three months her whole arm was helpless. Subsequently the left leg became affected in a similar way, and after this the left eyelid drooped so that she was unable to raise it. She said also she had a fit, and after this was unable to open her mouth, and lived in consequence on liquid food. On admission she was found unable to move her left arm and leg ; the arm when raised dropped lifeless at her side. She had ptosis of the left eye, but the eye was natural and movable. She was unable to open her mouth beyond half an inch. The tongue protruded straight. It was evident that these symptoms did not correspond to any which would arise from a known special lesion, and therefore the case was regarded as one of “ideal” paralysis. She was cured in five weeks by moral treatment.
Major Publications
- Wilks S. Cases of a peculiar enlargement of the lymphatic glands frequently associated with
disease of the spleen In: Cases of lardaceous disease and affections, Guy’s Hospital Reports, 1856; 2: 114-132 [Hodgkin disease] - Wilks S. Lectures on Pathological Anatomy Delivered at Guy’s Hospital. London, Longman, 1859
- Wilks S. Catalogue of the pathological preparations in the Museum of Guy’s Hospital. 1863
- Wilks S. On the syphilitic affections of internal organs. Guy’s Hospital Reports, 1863; 9: 1-64
- Wilks S. Cases of enlargement of the lymphatic glands and spleen (or Hodgkin’s disease). Guy’s Hospital Reports, 1865; 11: 56–67.
- Wilks S. Observations on the pathology of some of the diseases of the nervous system. Guy’s Hospital reports 1866; 12: 152–244.
- Wilks S. Drunkard’s or Alcoholic Paraplegia In: Paraplegia. Lectures on diseases in the nervous system. Medical Times and Gazette 1868; 37(2): 467–472
- Wilks S. Capillary embolism or arterial pyaemia. Guy’s Hospital Reports 1870; 15: 29–35.
- Wilks S. Alcoholic paraplegia. Lancet. 1872; 99(2532): 320–321
- Wilks S. Lectures on Pathological Anatomy. 1875, (3e 1889)
- Wilks S. Lectures on the specific fevers and diseases of the chest. 1875
- Wilks S. On cerebritis, hysteria and bulbar paralysis. Guy’s Hospital Reports, 1877; 22: 7-56.
- Wilks S. Lectures on diseases of the nervous system. 1878 (2e 1883)
- Wilks S. Assertion versus argument: a few letters to an anti-vivisectionist. 1882
- Wilks S. On the pupil in emotional states. Brain 1883; 6: 1–6.
- Wilks S. How the blind dream. Brain 1885; 8: 272–273.
- Wilks S. On falling. Brain 1886; 9: 207–217.
- Wilks S. Lectures on pathological anatomy. 1889
- Wilks S. Biographical reminiscences. 1911
References
Biography
- Sir Samuel Wilks, Bart., F.R.S. . Nature 1911; 88: 83 (1911)
- Banerjee AK. Sir Samuel Wilks: a founding father of clinical science. J R Soc Med. 1991 Jan;84(1):44-5.
- Eadie MJ. Samuel Wilks (1824-1911): neurologist and generalist of the Mid-Victorian Era. J Med Biogr. 2008 Nov;16(4):215-20.
- Stone MJ. Samuel Wilks: the “grand old man” of British medicine. Proc (Bayl Univ Med Cent). 2010 Jul;23(3):263-5.
- Pearce JM. Sir Samuel Wilks (1824-1911): ‘the most philosophical of english physicians’. Eur Neurol. 2009;61(2):119-23.
- Dunea G. Sir Samuel Wilks (1824–1911). Hektoen International
Eponym
the person behind the name
