William Henry Broadbent

Sir William Henry Broadbent (1835-1907) portrait

Sir William Henry Broadbent, 1st Baronet (1835-1907) was an English physician.

Broadbent was a physician, neurologist and cardiologist, and one of the leading clinical minds of late Victorian medicine. He spent almost four decades at St Mary’s Hospital, London, where he combined meticulous bedside observation with pathological correlation and developed particular expertise in diseases of the heart, nervous system, tuberculosis and typhoid. His honours included Fellowship of the Royal Society, a baronetcy (1893), the KCVO (1901), and appointment as Physician-in-Ordinary to the Prince of Wales, later King Edward VII, and to King George V.

Broadbent’s early career was strongly neurological. In 1866 he proposed “Broadbent’s hypothesis” to explain sparing of axial and bulbar muscles in hemiplegia via bilateral cortical innervation, and he went on to dissect cerebral fibre tracts, publishing The structure of the cerebral hemisphere (1870). His Lettsomian Lectures to the Medical Society of London in 1874 provided the first systematic English-language account of neurosyphilis, expanded in later papers on syphilitic brain disease.

In later years Broadbent helped professionalise neurology as a specialty, co-founding the Neurological Society of London (1885–1886) and serving as its president in 1895 and Hughlings Jackson Lecturer in 1903, while continuing major work in cardiology including studies of prognosis in heart disease, adherent pericardium and the physical signs now associated with his name. He was also active in public health, particularly in the National Association for the Prevention of Consumption and the King Edward VII Sanatorium.

Biographical Timeline
  • Born January 23, 1835 in Lindley, near Huddersfield, Yorkshire, eldest son of John Broadbent, wool manufacturer, and Esther Butterworth.
  • 1850 – Leaves Huddersfield College; briefly works in his father’s mill before persuading him to allow a medical career.
  • 1852 – Apprenticed to a surgeon in Manchester; enrolled at Owens College and the Royal School of Medicine, Manchester.
  • 1857 – Qualified MRCS and LSA; studied in Paris under Armand Trousseau (1801-1867).
  • 1858 – MB, Royal School of Medicine, Manchester with first-class honours and gold medal in obstetrics. Appointed resident obstetric officer at St Mary’s Hospital
  • 1860 – MD London; appointed pathologist and lecturer in physiology and zoology at St Mary’s.
  • 1862 – Marries Eliza Harpin of Holmfirth; the couple eventually have three sons and three daughters.
  • 1863 – First consultant appointments: physician to the London Fever Hospital and to the Western General Dispensary.
  • 1865 – Appointed outpatient physician, St Mary’s Hospital.
  • 1866 – Publishes paper on hemiplegia proposing bilateral cortical innervation of axial muscles later known as Broadbent’s hypothesis.
  • 1869 – Elected Fellow of the Royal College of Physicians (FRCP).
  • 1871 – Becomes full physician at St Mary’s Hospital and lecturer in medicine (until 1888).
  • 1874 – Delivers Lettsomian Lectures to the Medical Society of London on syphilis as a cause of nervous system disease, the first detailed English-language series on neurosyphilis.
  • 1875 – Invited to the West Riding Asylum conversazione (Wakefield); lectures on “The Theory of the Construction of the Nervous System”.
  • 1878–1884 – Publishes clinical-pathological papers on amnesia, aphasia and alcoholic spinal paralysis.
  • 1881 – President, London Medical Society.
  • 1885 – Proposes formation and becomes founding council member of the Neurological Society of London, the first dedicated neurological society in Britain.
  • 1887 – President, Clinical Society of London.
  • 1892 – Appointed Physician-in-Ordinary to the Prince of Wales after attending royal typhoid cases.
  • 1893 – Created Baronet of Brook Street and Longwood.
  • 1895 – President, Neurological Society of London; delivers presidential address on nerve force and nervous system organisation.
  • 1896 – Retires from active staff of St Mary’s Hospital after 37 years’ service.
  • 1897 – Elected Fellow of the Royal Society (FRS).
  • 1901 – Appointed Knight Commander of the Royal Victorian Order (KCVO); Physician-in-Ordinary to the new Prince of Wales (future George V).
  • 1904 – Honorary DSc, University of Leeds.
  • 1906 – Honorary LLD from Toronto and Montreal universities.
  • Died July 10, 1907 in London from influenza, aged 72; obituaries in BMJ and Lancet emphasise his diagnostic acumen, neurological work and service to royalty

Broadbent was endowed with a robustness of constitution that enabled him to tackle his numerous responsibilities without ill effect, and a Yorkshireman’s sturdiness of mind, amounting almost to stubbornness, which made him cling to his opinion once he had formed it, in face of all differences.

Brown GH

Medical Eponyms
Broadbent sign (1895)

Systolic indrawing (retraction) of the posterolateral lower ribs, classically the left 11th–12th intercostal spaces, associated with adherent pericardium.

1895 – First published by Walter Broadbent (1868–1951), who described the sign in patients with a history of pericarditis and explicitly credited his father, Sir William, with long-standing clinical recognition of the phenomenon.

…a visible retraction, synchronous with the cardiac systole, of the left back in the region of the eleventh and twelfth ribs, and in three of which there is also systolic retraction of less degree in the same region of the right back. In all the cases there is a definite history of pericarditis, and in three of them there are other conditions strongly suggesting an adherent pericardium.

This sign has long been pointed out by Sir William Broadbent in the wards of St. Mary’s Hospital, but, so far as I have heard, has not had sufficient importance attached to it elsewhere. Adherent pericardium has frequently such a serious influence on the course of valvular disease, that any aid towards the diagnosis seems worthy of attention.

Walter Broadbent 1895 (son attributing sign to his father, William)

1898 – Sir William subsequently elaborated the finding in a paper on adherent pericardium, reinforcing its diagnostic importance.

A systolic tug of the left false ribs posteriorly communicated by the diaphragm may be conspicuous. The recoil from the drag may be so distinct as to look and feel to the hand like pulsation…systolic retraction of the lower ribs on the lateral or posterior aspect of the thorax is of the greatest importance, and can scarcely be due to anything else than pericardial disease

William Broadbent 1898
Broadbent’s hypothesis in hemiplegia (1866)

In 1866, Broadbent tackled the puzzle of why hemiplegia typically paralyses the limbs and lower facial muscles on one side, yet spares the trunk, bulbar muscles and upper face. Working within Carpenter’s then-accepted framework that the pyramidal tracts arose in the corpora striata, he proposed that muscles which habitually act bilaterally (axial and bulbar groups, upper facial muscles) are governed by paired “nerve nuclei” on each side of the brain, united by commissural fibres into a functional single unit. Each half of this combined nucleus receives fibres from both corpora striata, so that even if one side of the motor apparatus is damaged, bilateral muscles can still be activated from the intact side.

John Hughlings Jackson (1835-1911) adopted this as “Broadbent’s hypothesis,” using it to interpret patterns of hemiplegia, double hemiplegia and motor seizures

Broadbent law

Broadbent later generalised the principle into what became known as Broadbent’s law regarding the relative sparing of bilaterally acting muscles in upper motor neurone lesions.

In modern paraphrase: upper motor neurone (supranuclear) lesions cause relatively less paralysis in muscles that normally act bilaterally (e.g., axial and upper facial muscles) than in muscles that act independently on each side.

1876 – Derived from Broadbent’s BMJ lecture on the construction of the nervous system, in which he generalised that paralysis is “proportionate to the independence of the muscles of the two halves” of the body, drawing on clinical observations in hemiplegia.

It will be found that throughout the body the paralysis is proportionate to the independence of the muscles of the two halves. In the face and tongue, where, as already stated, the paralysis is partial, the movements are habitually symmetrical, and independent movements, though possible, are extremely rare and exceptional. A minute analysis of this partial paralysis would further illustrate the general law, were there time for it. I will only mention the fact that, while a hemiplegic man can close both eyes together, he cannot, however accomplished in the trick previously, wink the eye of the paralysed side alone.

Broadbent WH. BMJ 1876

Later authors condensed this into the aphoristic “law” quoted in neurological and eponym dictionaries through the twentieth century.

Lesions of the supranuclear fibres — i.e., of the upper segment of the motor tract — have less paralysing effect upon those muscles which habitually produce bilateral movements than upon those which more frequently act independently of the opposite side [1907]

Lesions of the upper segment of the motor tract cause less marked paralysis of muscles that habitually produce bilateral movements than of those that commonly act independently of the opposite side. [1970]

Upper motor neurone lesions result in less paralysis in muscles concerned with bilateral contractions than those which act unilaterally [1987]

Key Medical Contributions
Neurology

Structure of the cerebral hemispheres (1870)

Stimulated by Broca’s localisation of speech to the left third frontal convolution, Broadbent dissected alcohol-hardened human brains to see whether anatomical asymmetry or distinctive fibre connections might explain left-hemisphere speech dominance. He failed to find a structural difference between the “speech area” on each side, but his work overturned the prevailing view that all brainstem tracts fanned directly to every convolution. Instead, he showed that brainstem projection fibres terminate in selected cortical areas and that there is a dense network of association fibres linking convolutions with one another, including those directly supplied from below.

These findings, published in The structure of the cerebral hemisphere and related papers on the brain of a deaf–mute woman, provided an early, influential description of cortical projection and association systems and informed his later, more elaborate schemata of language organisation.

Neurosyphilis and neurological lecturing

Broadbent delivered the Lettsomian Lectures in 1874 on syphilis of the nervous system, producing the first comprehensive English-language overview of neurosyphilis, which he expanded with illustrative cases in 1876. Though predating recognition of tabes dorsalis and general paralysis as syphilitic, his work systematised vascular, meningeal and focal syphilitic lesions of the brain and cord and helped establish neurosyphilis as a defined clinical entity in British medicine.

Founding and leadership of the Neurological Society of London (1885–1903)

On 14 November 1885 Broadbent formally proposed, seconded by John Hughlings Jackson (1835-1911), the creation of a dedicated neurological society and the Neurological Society of London was founded the following year. Broadbent served as president in 1895, opening his address by recalling that he had been “more or less a neurologist” long before the term existed, and in 1903 gave the 3rd Hughlings Jackson Lecture, including the first substantial bibliography of Jackson’s writings and a retrospective on Victorian neurology.

St Mary’s Hospital and clinical teaching

At St Mary’s Hospital (1858–1896) Broadbent progressed from resident obstetric officer to senior physician and lecturer in medicine, becoming a dominant clinical presence. Colleagues and obituarists emphasise his ability to integrate meticulous physical examination with post-mortem correlation, especially in cardiovascular and neurological disease, and his influence on generations of London clinicians through bedside teaching and formal lectures.

Public health and tuberculosis

In later life Broadbent extended his clinical interests into public health, especially tuberculosis. He helped establish and lead the National Association for the Prevention of Consumption and was heavily involved in the planning of the King Edward VII Sanatorium at Midhurst, reflecting his conviction that chronic infectious diseases required coordinated social as well as medical responses.

Major Publications
References

Biography

Eponymous Terms

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Dr Barbara Cleaver LITFL Author

MBBS (Hons) FCEM. Clinical Lead Emergency Medicine | St Mary's Hospital, Imperial College Healthcare NHS Trust

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | On Call: Principles and Protocol 4e| Eponyms | Books |

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