Howard's Lectures on Medicine

Notes from lectures on medicine given by Richard Baron Howard (1807-1848) at the Manchester Royal School of Medicine. The first two lectures are numbered after which point there is some attempt at dating individual lectures to begin with but this becomes less clear as the volume progresses and it is often difficult to distinguish one lecture from another.

Some of the topics covered as you progress through the manuscript include: definition and classification of disease; division of disease into internal, structural, & functional; etiology of disease (ancients' 4 temperaments of disease or humours, nervous as 5th temperament, age, sex, debilitating causes, deficiency, exciting causes, intoxicating liquors, cold, winter deaths, winter of 1838, barometrical conditions, electrical conditions); modes of death (syncope, asthenia, violent shocks, poisoning, apoplexy [stroke], fever, anaemia, apnoea or asphyxia, coma, pestilential vapours); signs of death; definitions of types of symptoms of disease; nosology; functional disorders; irritability; tonicity; functional diseases of the nervous system; excess and deficiency of red particles; fibrin; parts of the blood; diabetes mellitus; disorders of moving powers of the blood; excess of urea; nephritis; rheumatism; pericarditis; gout; working of the heart; functional and structural disorders of the heart; angina pectoris; carditis; endocarditis; structural diseases or lesions of nutrition; origination of tissues in cells; atrophy or diminished nutrition of a part; erosion of the stomach; induration; morbid growths; hydatids [echinococcosis]; heterologous growths; effects of age; cold as an exciting cause of disease; circulatory system (description of the arteries, veins, and capillaries, and circulation of the blood, congestion, dropsy, inflammation, swelling); adhesion; suppuration; ulceration; gangrene; varieties of inflammation; structure of the brain; phrenitis [delirium] (notes that he was absent for part of the lecture); diseases and inflammation of the brain; hydrocephalus; delirium tremens [alcohol withdrawal delirium]; apoplexy [stroke]; epilepsy; hysteria; chorea (absent for part of the lecture); mercurial tremor; hydrophobia [rabies]; mental diseases (idiocy, fatuity, insanity, mania, dementia, monomania, moral insanity, insane instinct); diseases of spinal marrow (spinal meningitis, spinal irritation, spinal apoplexy); tetanus; idiopathic headaches; periodic headaches; neuralgia; diseases of respiratory organs (auscultation, respiratory murmurs, laryngitis, cynanche trachealis [croup], catarrh-absent for part of lecture, influenza, bronchitis, spasmodic asthma, pertussis or whooping cough, pneumonia, haemoptysis, phthisis [tuberculosis, pulmonary]); diseases of the abdominal viscera (stomatitis mercurialis [mercury poisoning], ulcers, mouth cancer, mumps, gastritis, carcinoma of the stomach, dyspepsia); diseases of the intestines (inflammation of mucous coat, inflammation of colon, diarrhoea, cholera with specific reference to the 1832 cholera outbreak, colic, enteralgia); diseases of the liver (inflammation, chronic hepatitis, icterus [jaundice]); the spleen; pancreas; peritonitis; diseases of the kidneys and primary organs; continued fever; fever; synochus; cerebral catarrh; exanthemata.

In their analysis of each condition the notes usually offer details on symptoms, pathology, causes, predisposing causes, diagnosis, treatment, and prognosis with information on contemporary opinions and theories and reference to the thoughts of specific physicians. There are also occasional references to contemporary events and observations on recent presentations of certain diseases, e.g. the 1832 cholera outbreak.

Inscriptions in the front cover indicate that the manuscript was donated to the Manchester Medical Society in 1882 and subsequently allocated the reference GO 5734 viz. their 1890 library catalogue.

Richard Baron Howard (1807-1848) was born in East Yorkshire on 18 October 1807 the son of Charles Howard and Mary Baron. He moved to Edinburgh in 1823 to pursue his medical studies and eventually obtained a surgeon's diploma before becoming a licentiate of the Society of Apothecaries of London in 1829 and receiving his MD from Edinburgh. Having then settled in Manchester he held a number of public roles including physician's clerk at the Manchester Royal Infirmary (1829-1833), medical officer at the Manchester Workhouse (1833-1838), physician to the Ardwick and Ancoats Dispensary (1839-1848), and honorary physician to the Manchester Royal Infirmary (1842-1848). He also served as physician to Haydock Lodge Lunatic Asylum and lectured at the Manchester Royal School of Medicine.

During his working life in Manchester Howard showed a great commitment to assisting the poor and in 1839 published An inquiry into the morbid effects of deficiency of food, chiefly with reference to their occurrence amongst the destitute poor. In 1840, on behalf of the poor law commissioners, he wrote 'A report upon the prevalence of disease arising from contagion, malaria, and certain other physical causes amongst the labouring classes in Manchester', which was published in Sanitary Inquiry in England and in 1842 printed An Address Delivered to the Pupils. Howard had suffered from illness a number of times, having himself been a patient at the Manchester Fever Hospital in 1831 and taken ill once again in 1834. He died on 9 April 1848 at his father's house in York following a painful illness. A fitting monument was erected in the chapel of the Manchester Royal Infirmary in his memory.