Robert Graves Lecture 1974_Dr. Ciaran F McCarthy
10/09/1974 in Royal College of Physicians of Ireland, 6, Kildare Street, Dublin 2
Ciaran F McCarthy, Department of Gastroenterology, Regional Hospital, and University College, Galway.
Coeliac Disease : The Irish Dimension
Perhaps the only advantage of Oliver Cromwell’s invasion of Ireland was that his staff included a Colonel Graves from whom Dr. Robert Graves descended. Dr. Graves first literary venture was the editing of a school magazine which was published weekly. Following that, he published widely in the medical literature. His first paper on medical research is of particular interest to me and describes an outbreak of fever in Galway in the early 19th century (Graves, 1824). Even now, the paper makes interesting reading as many localities in Galway are mentioned. The Claddagh area is recorded as an area of the city which did not suffer too badly from the fever. Graves suggested that the sea-faring nature of the people living in the Claddagh enabled them to obtain adequate supplies of fish and so avoid at least to some extent the effects of famine and malnutrition. To the discredit of the Claddagh people, he comments that more people died in the streets of the Claddagh area than in the streets of the remainder of the town. This he attributed to the unfriendly nature of the Claddagh people who did not take strangers into their houses as was customary in other parts of the city and so they died in the streets. This early experience of Graves stimulated his interest in fevers and, indeed, his observation that famine and hunger preceded outbreaks of fever may have been responsible for his pronouncement that patients with fever should be fed, not starved as was the practice at the time. Graves rapidly built up a large private practice in Dublin, but contemporaries comment that his practice was not as large as that of some of his fellow physicians. This may, in par[, have been due to his definite opinions on many aspects of the medical scene at his time. He was keenly interested in medical education and approved of the apprentice system of medical training in which groups of students are attached for a period of time to a particular doctor. His private practice may have suffered because of devoting his energies to both teaching and private practice. He worked hard and one of the duties of his assistants in the hospitals he was attached to was to meet him at 7 a.m. and accompany him, carrying a candle, to light his way to the patients. One wonders, nowadays, how many junior staff would carry a candle for their consultants. He comments on the value of medicine as practised in hospitals as compared to private practice in the learning of medicine. He considered that hospital practice offered unsurpassed opportunities to study aspects of pathology and morbid anatomy, but that it was in private practice that the opportunities existed for seeing the effect of disease on patients in their natural environment.
Irish J Med Sci December 1975, 144:1
This being the fourteenth Graves Lecture since its beginnings in 1961.