William Heberden the elder (1710-1801): aspects of his London practice.

Although William Heberden was one ofthe most distinguished clinicians ofhis day, no attempt has previously been made to bring together the available material, scattered in various published works and unpublished MSS, which could throw light on his London practice. I attempt in this article to find some answers to three groups of questions: first, what were the factors that Heberden had to weigh up before exchanging the security of his life in Cambridge for the hazards of private practice in the metropolis, and what special qualifications had he acquired that contributed to his success? Second, what did his patients (and others) have to say about his ministrations and about the more general problems of health and sickness? Finally, what does Heberden himself tell us about his attitude to his patients, and how was this attitude modulated by his views on contemporary theories and procedures? Before calling our witnesses, we must summarize the facts about Heberden's background and the course of his career at Cambridge. Son of a Southwark innkeeper (who died when he was seven), he attended the parish grammar school of St Saviour-an Elizabethan foundation providing free education, heavily weighted on the side of the Classics, which might open doors for advancement in the learned professions to the brighter sons of the poor. With the backing of an imaginative headmaster and an exhibition worth £7 per annum,1 Heberden was admitted to St John's College, Cambridge, as a sizar at the age of fourteen. In 1731 (three years after obtaining his BA), he was elected Fellow of his college,2 and it was at this point that he began the study of medicine. Owing to the deficiencies ofthe medical faculty, most of Heberden's studies seem to have been self-directed; he received hisMD in 1738,3 and two years later delivered the first ofhis annual series ofpublic lectures on materia medica. In these, he demonstrated his wide reading of the literature (both ancient and modern) and-still more important-his ability to subject even the most venerated authors to searching criticism.4 If he enjoyed entertaining his audience by pricking the balloons of