Journal of Human Hypertension (1997) 11, 255–261
 1997 Stockton Press. All rights reserved 0950-9240/97 $12.00
HISTORICAL REVIEW
Frederick Henry Horatio Akbar Mahomed:
‘A brave and ambitious explorer’
O Lewis
Foxcombe Hall, Boar’s Hill, Oxford OX1 5HR, UK
Keywords: Frederick Mahomed; sphygmograph; Collective Investigation Record
Frederick Henry Horatio Akbar Mahomed entered
Guys Hospital, London, as a medical student in
1869, aged 20. He already had some experience of
the medical world, having spent several months at
the Sussex County Hospital and General Sea Bathing
Infirmary in his home town of Brighton. The Hospital, which was close to the beach, had a supply of
seawater pumped to it (a practice which continued
until 1876); thus the Hospital was able to offer its
patients special seawater treatments, which the
young Mahomed may have helped to administer.
Mahomed would also have known of the work of
his grandfather, Sake (Sheikh) Dene Mahomed, who
was appointed Shampooing Surgeon to George IV
and William IV. Sheikh Mahomed established the
first Turkish baths in the country in Brighton at the
site of the present Queens Hotel on the King’s Road,
(Figure 1), and offered a ‘shampooing’ (massaging)
service which became popular after several cures
were reported, particularly of rheumatic conditions.
Sheikh Mahomed published a number of pamphlets
and booklets on the therapeutic value of his treatment, many of which were doubtless familiar to the
young student.
Although his background would have marked him
initially as an outsider in the world of traditional
medicine, Frederick Mahomed was to become a
physician of outstanding ability, with exceptional
clinical and diagnostic skills. A man of commanding
presence, with powerful intellect and unquenchable
energy, Mahomed was both practical and innovative
in his approach to problems. His untimely death left
his last initiative (the control of drugs) undeveloped,
but he had by then successfully developed the first
national survey in Britain of common diseases such
as phthisis and pneumonia, namely the Collective
Investigation Record. Although shortlived, this
novel exploration of aspects of disease attracted
great interest both at home and abroad. Today, while
the Collective Investigation is largely forgotten,
Mahomed is remembered for his work on the
relationship between vascular condition and kidney
Correspondence: Olive Lewis
Accepted 22 January 1997
disease, and for modifications which he devised
while still a student, to the sphygmograph, an
instrument which registered the rate and character
of the beats of the pulse.
That the pulse could provide valuable insight into
a patient’s condition had been recognised from
ancient times: until the 19th century, interpretation
depended heavily on the physician’s touch. The
ancient Chinese described their pulse observations
poetically ‘smooth as a flowing stream’; by the 13th
century Arabian physicians recognised 10 ‘varieties’
of pulse, recognising attributes such as the movement of the arteries and duration of the diastole and
the systole. But it was not until the 19th century that
more sophisticated methods for assessing the pulse
were possible. By the late 1860s, a variety of sphygmographs existed 1 all of which had limitations
which made them difficult to use. In England, the
model in common use was of French design by the
physiologist and inventor, Etienne-Jules Marey.2
The instrument had been brought to London in the
mid-1860s by the scientist and academic, John Burdon Sanderson.3 It was soon observed that Marey’s
sphygmograph had shortcomings: reading the tracings required considerable practice and, while it
captured the waveforms of the pulse, it did not provide a measure of pressure.4
Mahomed recognised the importance of the pulse:
. . . first amongst our guides; no surgeon can
despise its counsel, no physician shut his ears to
its appeal. Since, then, the information the pulse
affords is of so great importance and so often consulted, surely it must be to our advantage to
appreciate fully all it tells us, and to draw from
it all that it is capable of imparting.’5
But, as he was aware, not all of the vital information
on the patient which the pulse could reveal was
immediately accessible. The Marey sphygmograph
limitations were obvious,6 and the interpretation of
pulse pressure by touch, even by experienced
hands, was inexact. Mahomed began work at Guy’s
Hospital in the laboratory of the chemical pathologist, Frederick Pavy. He devised an adjustable
spring which enabled the measurement of the press-
Frederick Henry Horatio Akbar Mahomed
O Lewis
256
Figure 1 Mahomed’s baths, Brighton. (Shampooing, SD Mahomed, Brighton, 1826).
ure of the pulse, and a London instrument maker
was employed to construct the modified sphygmograph from his design (Figure 2). Mahomed was
awarded the Pupils Physical Prize at Guy’s, and an
account of the work, ‘The Physiology and Clinical
Use of the Sphygmograph’ was published in the
Medical Times and Gazette of 1872. Requests for
demonstrations followed, at which Mahomed was
able to show the practical value of the modified
instrument,7 both in the prognosis of patients with
heart disease and as a guide to the efficacy of treatments such as digitalis. Characteristic tracings of
waveforms for each known form of cardiac disease
were provided for his audience to examine.
Mahomed developed considerable skill in taking
tracings8 and in interpreting the waveforms. He was
able to identify a precise pattern or profile9 which
indicated the presence of an aneurism and, very
importantly where an operation to alleviate the condition was proposed, locate its position:
‘If all or some of these characters [from the ‘profile’] are found in the pulse on the right side and
not on the left, the aneurism is innominate; if in
the right and partly in the left, it is innominate
and transverse arch; if in the left only it is transverse or root of the subclavian; if the signs are
only partially present and equally on both sides,
it is ascending arch; if all are strongly marked and
only on one side, it is probably directly in the
course of the subclavian, and not involving the
aorta.’
Other practitioners continued to find that the taking and interpretation of readings from the sphygmograph remained difficult despite Mahomed’s
improvements. Never very popular, its use was to
decline with the introduction in the mid-1880s of
the sphygmomanometer. This new instrument measured pressure in the radial artery at the wrist, using
an aneroid device similar to a barometer10 and gave
Figure 2 Mahomed’s sphygmograph. The apparatus, modified from that of Marey was made by jeweller and watchmaker Mr A Clarke
of Forest Hill, South London, under Mahomed’s directions. (Old illustration, source unknown).
Frederick Henry Horatio Akbar Mahomed
O Lewis
an immediate quantitative measurement. The two
instruments, as Mahomed would have appreciated,
did not measure the same phenomenon. While the
sphygmomanometer measured the level of the blood
pressure (BP) in the artery at a precise moment in
time, the sphygmograph showed the duration and
features of the decline of the pressure, thus being
the more informative of the two to the skilled practitioner, such as Mahomed himself.
Soon after qualification in 1872, Mahomed was
appointed to the London Fever Hospital as resident.
Among the sick were many who displayed symptoms of Bright’s Disease, and studying sphygmographic tracings from these patients, he began to formulate a thesis about the condition. His interest in
Bright’s Disease may have been awakened by a lecture given by Sir William Gull11 to Guy’s students
in 1872; as an able and industrious student, it is
unlikely that he would have missed this event. Gull
described joint research with his colleague Dr HG
Sutton,12 which they had already presented to the
Royal Medical and Chirurgical Society,13 on chronic
Bright’s Disease. At the time, the favoured explanation for the condition remained that of Richard
Bright from whom the condition took its name, in
which the renal failure was the primary factor. Gull
and Sutton thought otherwise, proposing that the
renal aspect was secondary, and that the primary
disease was of the blood vessels, where a degenerative process occurred which they named ‘arteriocapillary fibrosis’. Their research was based on
microscopic examination of blood vessels in the
pathological laboratory and their findings were hotly
contested; some colleagues publicly expressing
doubt as to their ability to draw the correct inference
from their samples.
In his seminal paper ‘The Aetiology of Bright’s
Disease and the pre-Albuminuric Stage’14 published
in 1874, 2 years after the Gull and Sutton controversy, Mahomed described one of his earliest observations with the sphygmograph:
‘that the pulse of acute Bright’s disease closely
resembles that which had previously been
described and illustrated by the sphygmograph as
occurring in chronic Bright’s disease, or more
strictly speaking, with cirrhosis of the kidney.
Both conditions were accompanied by a pulse of
high tension. . . and especially was distinguished
by a prolongation or undue sustension of the
tidal wave.’
In a sequence of papers published in 1879,15 Mahomed described fully his clinical observations on
the condition, and set them into the context of earlier work by Burdon Sanderson, Broadbent and
others. But his paper of 1874 clearly shows he had
already recognised that high BP existed as a separate
event, and was the precursor and cause of albuminuria, rather than the reverse:
‘That previous to the commencement of any kidney change, or to the appearance of albumen in
the urine, the first condition observable is high
tension in the arterial system, due either to the
presence of a noxious material in the blood. . .
which alters the relation between the blood and
the tissues, and destroys their chemical affinity
for each other; or else to a sudden chill causing
contraction of the superficial vessels and congestion of the internal organs. If this condition of
high tension be sufficiently severe, transudation
of the characteristic crystalloids of the blood. . .
occurs before the albumen appears in the urine,
and they can be detected in that fluid by the guaiacum test for blood. If this condition be allowed
to continue, albumen is subsequently found, and,
if still unchecked or uncontrollable, Bright’s disease in one of its forms ensues.
If checked before the albumen appears, or
immediately after its appearance by a brisk purge
or other appropriate means, the condition is suddenly changed – the tension disappears from the
pulse and the crystalloids from the urine.’
As he was to put it in 1879:
‘. . . the cardio-vascular changes must be more
important and more constant than any others; and
this clinical aspect of the question would seem to
lend strong confirmation to Sir William Gull’s
and Dr Sutton’s hypothesis of arterio-capillary
fibrosis, and itself to gain strength from this
hypothesis and the evidence upon which it rests.
It appears to me that these clinical, and their
pathological observations must stand or fall
together; that one is the pathological, the other
the clinical aspect of the same condition. Of this
I feel sure, that the clinical symptoms and the
pathological changes resulting from high arterial
pressure are frequently seen in cases in which
very slight, if any disease is discoverable in the
kidney . . .’16
Thus Mahomed’s clinical observations confirmed
the findings described from post mortem data by
Gull and Sutton.17 The condition was, he recognised, difficult to diagnose, as it occurred in widely
differing conditions (such as pregnancy, high fever
and anxiety states), as well as in apparently healthy people:
‘These persons appear to pass on through life
pretty much as others do and generally do not suffer from their high blood pressures, except in
their petty ailments upon which it imprints
itself. . . As age advances the enemy gains
strength. . . . perhaps the mode of life assists
him – good living and alcoholic beverages. . . or
head work, mental anxiety, hurried meals, constant excitement. . . tend to intensify the exiting
condition, or if not previously present perhaps to
produce it. . . the individual has now passed forty
years, perhaps fifty years of age, his lungs begin
to degenerate, he has a cough in the winter time,
but by his pulse you will know him. . .. Alternatively headache, vertigo, epistaxis, a passing paralysis, a more severe apopleptic seizure, and then
the final blow.’18
This patient profile, so vividly described by Mahomed, is recognizable today.
Mahomed’s work on BP was well known to his
257
Frederick Henry Horatio Akbar Mahomed
O Lewis
258
contemporaries through frequent contributions at
meetings of professional associations, which were
widely reported in the medical press. By modern
times however, it has almost been forgotten: one reason may have been that Mahomed’s professional
career was too short to allow him time to consolidate
his work into a form which would secure a place on
the library shelf. And the significance of his work
may have been lost by careless quotation or
interpretation, notably by Clifford Allbutt,19 the
prominent Victorian physician and academic who
had become an authority on the condition of hypertension by the end of the century. The difficulty in
reproducing Mahomed’s results with the sphygmograph may also have been a factor; his skill with the
instrument was exceptional, and few could have
achieved the same degree of expertise. However,
interest in his sphygmographs has recently been
revived, and it has been acknowledged that he
anticipated, by some 100 years, modern work on BP
and the process of aging.20
In 1877, an important ambition was fulfilled for
Mahomed: he returned to Guy’s Hospital as a medical registrar, an appointment he was to hold until
his death. Soon after his appointment to Guy’s, he
decided to read for a British medical degree. One
can speculate on his reasons for taking on the heavy
burden of such study, but ambition was probably the
significant factor. Although holding an MD from
Brussels (1874), he would have known that in a
status-conscious profession, the acquisition of a
Cambridge or Oxford degree would be of inestimable value in attracting the best hospital appointments or the most wealthy and influential patients.
He chose Cambridge – a University which, under the
influence of the physiologist, Michael Foster,21 had
adopted some of the most modern ideas in the teaching of medicine from German Universities during
the 1870s. In 1881, the degree of MB was conferred
upon Mahomed for a thesis entitled ‘Chronic
Bright’s Disease without Albuminuria’. 22 For 4
years, from 1877 until 1881, he travelled between
London and Caius College, Cambridge, for formal
study and to fulfill the necessary residential requirements for a Cambridge degree. But despite the
additional burden imposed by his Cambridge studies, he continued to make contributions to discussion of medical issues of the day. The medical
press of the time testifies to his regular attendance
at professional meetings, not in a passive capacity,
but as an active contributor. He can be heard offering
factual evidence based on his own clinical experience or perceptive comment on such diverse matters
as the gynecological,23 scarlatinal convalescence,24
and tumours.25 He was willing to report on trials
with untried or relatively risky methods to treatment
where his patient was in extremis:26 for example the
unsuccessful use of direct blood transfusion for
typhoid fever, where severe haemorrhage had
occurred. 27
As his Cambridge studies neared completion,
Mahomed joined Francis Galton28 on a project on
the use of composite photography in the diagnosis
of phthisis.29 Hundreds of photographs of phthisis
sufferers were taken at Guys, Brompton and Victoria
Park Hospitals, each of which was passed rapidly
across a sensitive plate, so that one photograph was
finally formed which was a compound of all the
others. The anticipated result was that a representation of a typical phthisical patient would be
obtained, but as the published report shows the outcome was disappointing, resulting in a bland featureless face ‘every indication of individuality having been obliterated.’ But even before the
publication of the paper with Galton in 1881, Mahomed had begun work on an important new venture.
This short lived project, under the auspices of the
British Medical Association, became known as the
Collective Investigation Record. The Record was to
be the main focus of his life until his untimely death
in 1884.
In January 1880, the British Medical Journal published a paper entitled ‘Suggestions concerning the
scientific work of the association’. Here, Mahomed
set out proposals for the collection of data on disease
on a nationwide basis. As he put it:
‘There are questions which come before us every
day, apparently of the simplest nature, yet which
no man appears able, from his own individual
experience, to answer to anbody’s satisfaction;
but which would apparently readily be solved if
a single year’s experience of the members of the
Association, or of a large proportion of them,
could be obtained.’
He suggested that the British Medical Association
should conduct surveys, using standard questionnaires designed to elicit the factual rather than the
opinion on such topics as the nature of the common
cold, incubation periods or relationships between
groups of diseases. Mahomed’s suggested questionnaire covered physical characteristics including
sight testing, and sphygmographic, spirometric and
dynamometer readings. As well as providing
answers to questions which had vexed his professional colleagues for some time, he thought that
‘a deeper scientific interest would be diffused
throughout the profession. . .’ and ‘. . .it would be
brought home to each man that he owed a duty to
medicine as a science, which he was bound in honour to render in return for the privilege of using her
as a trade’. He was also interested in a more general
question concerning the predisposing factors which
caused illness within individuals. Relationship
between temperaments (in the old physical sense of
the word) and diatheses was much discussed among
the medical profession, and had been touched upon
by Mahomed himself in his papers on Bright’s Disease. It was generally accepted that race, climate,
and mode of life, affected individual mental and
physical development: this same mental and physical condition might then affect the type or class of
disease to which an individual was liable. If several
generations were subject to the same conditions,
Mahomed reasoned, the characteristics induced
would become more marked, and ‘temperaments’
formed which would then be associated with certain
types of disease. To prove or disprove this hypothesis, family medical history needed to be accurately
recorded and the proposed survey was a means of
Frederick Henry Horatio Akbar Mahomed
O Lewis
achieving this end. (Mahomed was to flesh out this
idea in a later article, in which he acknowledged the
work of Francis Galton on photographic and anthropometric records.30) This research could specifically
provide important evidence in the contemporary
debates on cell theory and Darwinian evolution;
thus Mahomed suggested that his project was ‘consonant with all the most advanced teachings of
science as to the origin of species, the differentiation
of cells and the transmission of hereditary tendencies.’31 He hoped that the information collected
would be the means of encouraging a system of permanent medical supervision, which would provide
benefits to the patient as well as to medical science.
He envisaged a ‘scientific registration of disease’
which he believed would be of immense value to
the community.32
The paper was discussed in the correspondence
columns of the British Medical Journal,33 generating
much enthusiastic, but also some negative comment.
The British Medical Association found the proposal
sufficiently attractive to set up a committee to examine it, and it was quickly recommended that Mahomed’s proposals be adopted. In April 1881 the British Medical Association formally began to organise,
through the Collective Investigation Council, the
collection of data on the lines suggested and the first
Secretary, Dr WR Smith of Cheltenham, was
appointed to the project in October 1881. Smith’s
tenure was short and from February 1882, Mahomed
took on the role of Honorary Secretary. As Professior
Humphry,34 a future Chair of the project was to
remark later, ‘Mahomed threw himself heart and
soul into the project.’35 Immediately, a new vitality
and urgency was injected into the proceedings: in
March 1882, all British Medical Association members were invited to contribute ‘his mite for the common good and for the advancement of medicine.’
The project’s Council decided that the initial investigations should concentrate on acute rheumatism,
chorea, and pneumonia, and in the case of the latter,
whether links with other diseases or with sanitary
conditions existed. At frequent intervals, memoranda outlining the objectives for research into the
chosen topics appeared in the British Medical Journal,36 a sample of standard record form for the collection of personal details was usually included
(Figure 3).
By mid-1882, local groups of the British Medical
Association across the British Isles had agreed to
participate. During the spring and early summer of
1882, Mahomed commenced an energetic campaign
to encourage further support, personally visiting a
number of branches, and writing to others. On visits
to local branches, Mahomed was careful to emphasise the practical value of the records which local
practitioners could provide, and the importance of
their contribution:
‘They had in hospitals excellent opportunities of
observing terminations of organic disease. . . but
practitioners all over England had an opportunity
of observing these people for years before their
kidneys etc became diseased. They wanted practitioners to give them the life history of patients of
259
Figure 3 Sample of a standard record form for the collection of
personal details. Published in the British Medical Journal, 16
December 1882 (Br Med J 2: 1229–1230).
this sort with regard to organic disease, and they
wanted to know what diseases prevailed in certain districts, and to put the observations to the
test. Also they wanted to know the diseases
among certain operatives in certain districts, and
to know the special diseases of every trade. Obser-
Frederick Henry Horatio Akbar Mahomed
O Lewis
260
vations from all parts of the country must tend to
benefit medical science.’37
He suggested that in the future the physician would
be paid to prevent disease, and not as at present be
called in to cure the incurable:
‘We want to teach our patients how to live to give
them healthy surroundings, and to protect them
from unhealthy habits and occupations; then to
watch and treat their minor ailments; and so ward
off, as long as possible, grave organic disease.’
Mahomed’s words reflect the changing emphasis in
late 19th century medicine towards preventative
medicine, and the beginning of the role of the family
doctor as friend and advisor to the families in his
care.
From late 1882 regular reports of numbers of completed forms were published in the British Medical
Journal. The returned questionnaires were quickly
analysed and edited by Mahomed and Professor
Humphry. Reports on pneumonia, chorea, acute
rheumatism, diphtheria, and on the communicability of phthisis were published in 1883 as Volume 1 of the Collective Investigation Record, which
received much praise and for a time was regularly
quoted in medical writings. The project achieved its
apogee at the International Medical Congress in
Copenhagen in August 1884, when discussion of the
British achievement was a prominent item on the
agenda. As the spokesman for the British delegation,
Sir William Gull put forward a proposal for an international Collective Investigation on similar lines to
the British. The Congress was receptive; similar projects were already under consideration in Russia and
France, and the Berlin Medical Association had
already set up a similar survey, but, in contrast to
the British model, had chosen to concentrate on one
topic, phthisis. The Congress endorsed the proposal
to found an International Collective Investigation,
and established a planning group, of which Mahomed was appointed a member of the British delegation along with Humphry and Isambard Owen.38
Shortly before the Congress in July 1884, Mahomed relinquished his role as working secretary to
the British Collective Investigation but retained his
honorary status. Although the new Secretary, Dr
Herringham, tried to maintain the momentum, interest had already begun to wane, as fewer completed
questionnaires were being received. The loss of
Mahomed’s immediate enthusiasm and energy must
have been keenly felt. Although its critics agreed
that useful work had been done, comments on the
scale, over-ambition and high costs of the Collective
Investigation became more frequent over the next 5
years. It was finally laid to rest by Professor
Humphry at the August 1889 Annual Meeting of the
British Medical Association in Leeds.
During the summer of 1884, Mahomed became
engaged on a new project: the effects of the growing
practice of homeopathy on drug therapeutics. Homeopathy had remained popular throughout the 19th
century among the rich and poor; for the latter, the
druggist or herbalist was often the only affordable
treatment. But Mahomed believed that patients and
medical practitioners alike were attracted by the
homeopath’s practice39 of dispensing small, elegant
doses in the form of drops or granules rather than
the grosser remedies of contemporary orthodox
medicine. Some patients attempted self-medication
with patent preparations, the content of which was
often unknown. The less scrupulous practitioners,
the ‘quacks’, were able to easily deceive patients by
bogus science, using invented terms to explain the
treatment. Respectable medical practitioners felt
deterred from using new drugs, for fear of giving the
‘quacks’ some credibility. Setting out his concerns
in a letter to The Lancet, published on 4 October
1884, Mahomed suggested that the simple repeal of
the contemporary Patent Medicines Stamp Act and
regular revision of the standard Pharmacopoeia
(introduced to Brtain in 1864) would not strike at
the heart of the problem. He put forward a novel
scheme: all medicines, including homeopathic remedies and foreign preparations, should be hallmarked by an official pharmaceutical assay department, under the aegis of the government. The
prescribing of unmarked drugs would then become
illegal. The scheme was to be funded by a charge
for testing, which Mahomed thought would result
in considerable surplus revenue for the government.
The British Medical Association again supported
Mahomed’s initiative and set up a committee to
review the scheme and to report back by January
1885; further, it was promised that the subject
would be one of the themes for the 1885 Annual
General Meeting. Mahomed also tried to enlist the
support of the Royal College of Physicians, whom
he considered had a duty under its Charter to undertake a leading role in the regulation of drugs. But
he was to be disappointed by their negative reaction
when he put his proposals to the vote at a meeting
at the Royal College on 30 October 1884.
The year 1885 was full of promise. There was
much work to be done to move the drug project forward in time for the 1885 Annual Meeting of the
British Medical Association. For Mahomed personally, there was an invitation to give the recently
established Bradshaw Lecture. But it was not to be.
On the evening of 30 October, after the disappointing meeting at the Royal College, Mahomed fell
ill. Over the next few days it became apparent that
he had contracted typhoid, probably from one of his
patients at the Fever Hospital. During the early
stages of his illness he commended cold bath treatments for himself, such as he had found useful for
his own patients, but his condition did not appear
serious enough for his physicians to take this step.
Despite the care of his friend and colleague, Dr
Broadbent, his condition deteriorated, and he died
in the early hours of 22 November 1884.
Frederick Mahomed’s professional career lasted
just 15 years. His obituarists express very poignantly
the deep sense of loss of such a promising and talented young physician. A ‘brave and ambitious
explorer in the regions beyond’ are the words of one,
using the metaphor of terrestrial exploration for
Mahomed’s pioneering work on hypertension, and
on the Collective Investigation, which was indeed
the forerunner of modern epidemiological study.
Frederick Henry Horatio Akbar Mahomed
O Lewis
References
1 Chelius’s, using mercury, Naumann’s, water, and yet
another town gas or hydrogen from a portable gasometer. A combination instrument, which measured
respiration and circulation, the stetho-sphygmograph
had also been devised by Hawksley. See The Physiology and Clinical Use of the Sphygmograph. Medical
Times and Gazette 1872; 1: 62.
2 Etienne Jules Marey (1830–1934) The sphygmograph
was the subject of his first paper, published in 1860 in
Comptes Rendues of the Academie des Sciences. Marey’s later inventions included the cine camera, and he
was the first scientific cinematographer.
3 Sir John Burdon Sanderson (1828–1905), trained at
Edinburgh, held one of the first appointments as Medical Officer of Health in Paddington, London; elected
FRS, undertook research at University College London;
later appointed Professor of Practical Physiology and
Histology at London, subsequently moved to Oxford.
4 One contemporary sphygmograph designed by Karl
Vierordt, was able to measure pulse pressure but was
a rather complex apparatus, with scale and weights.
5 The physiology and clinical use of the sphygmograph.
Medical Times and Gazette 1872; 1: 62.
6 Various improvements had been suggested: the use of
smoked glass instead of paper to improve the quality
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securely to the patient’s wrist. The Lancet 1867; 1: 499;
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7 For example, at the May meeting of the West Kent
Medico-Chirurgical Society, reported in The Lancet
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8 Some of the tracings were used by Sir William Broadbent (1835–1907), in his classic text The Pulse, 1890,
after Mahomed’s death. Broadbent, a lecturer in comparative anatomy and medicine held appointments at
London Fever and St Mary’s Hospitals.
9 Mahomed identified the following characteristics as
indicative of the presence of an aneurism: diminution
in volume of the pulse wave; a sloping upstroke;
impairment or annihiliation of percussion impulse;
partial or complete obliteration of dicrotic and other
secondary waves; generally dimunition but sometimes
increase of amount of pressure required to produce the
tracing. Report of a meeting of the Clinical Society of
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10 This in turn gave way to a sphygmanometer which
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11 William W Gull (1815–1890), clinical physician and
lecturer at Guys hospital; also appointed as physician
to members of the Royal Family.
12 Sutton, HG (1836–1891), teacher, pathologist and
physician at London Hospital.
13 Discussion reported in The Lancet dated 8 June 1872.
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15 On Chronic Bright’s Disease and its essential symptoms. The Lancet 1879; 1: pp 46, 76, 149, 261, 399,
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16 ibid, p 437.
17 Samuel Wilks, (1824 –1911), lecturer on pathology and
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18 The Lancet 1879; 1: 400.
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Case of intestinal obstruction produced by the abnormal remains of a foetal vessel. Trans Path Soc 26: 117.
A contribution to the clinical history of scarlatinal
convalescence. Practitioner 1875; 15: 21.
Primary cancer of the undescended testis, cancer of
the thymus, vacuolation of liver and kidneys. Trans
Path Soc 1883; 34: 182; Two cases of pulsatile tumour
at the root of the neck. Guys Hospital Reports 1883;
41: 83 with CH Golding-Bird.
He also tried what would now be regarded as bizarre
treatments: he is reported to have sought permission
from the hospital governors to sanction the purchase
of sheep, so that he could wrap fever patients in the
warm sheepskins, immediately on their removal by the
butcher. The idea was not implemented, as he had
already devised an improved treatment, the use of a
tent with steam supply, to provide a vapour bath.
Two cases of direct transfusion of blood for haemorrhage in typhoid fever. Trans Clin. Soc London, November 1881; 15: 50, also The Lancet, 1881; 2: 950.
A paper on Photographic Chronicles and Anthropometric Laboratories published in the Fortnightly
Review during 1882.
An enquiry into the physiognomy of phthisis by the
method of composite photography. Guys Hospital
Reports 1881; 40: 475C.
Mahomed F. On Medical Life Histories. Br Med J 1882;
2: 1296.
‘Suggestions. . .’ Br Med J 1880; 1: 31.
Mahomed’s purpose was later clarified as clinical and
not sanitary in nature, to avoid confusion with the
recently established Medical Officers of Health, whose
duties involved the compilation of statistical data, as
well as the investigation of sources of infectious disease. Br Med J 1880; 1: 74.
For example, Arthur Ransome’s paper, ‘On the Need of
Combined Medical Observation’. Br Med J 8 Oct 1864.
Humphry, Sir George (1820–1896), FRS, Professor of
Anatomy at the University of Cambridge, Surgeon to
Addenbrookes Hospital, Cambridge. Actively involved
in the work of the British Medical Association, British
Association for the Advancement of Science, The Anatomical Society of Great Britain and the Pathological
Society.
Obituary. Br Med J 1884; 2: 1099.
For example, the memorandum on Diptheria, appearing in the Br Med J 1882; 2: 1174.
Address to the South Western Branch of the British
Medical Association, in June 1882. Br Med J 2: 115.
Isambard Owen (1850–1927), Dean of St George’s
Medical School; interested in medical education;
moved into education administration after 1884.
The founder of modern homeopathy, CFS Hahnemann
(1755–1843) had conducted drug trials to ascertain
exact effects on patients, from this the homeopathic
law of infinitesimals was developed, in which the
principle that the smaller the dose, the more effective
it will be was enshrined.
261
Frederick Henry Horatio Akbar Mahomed
O Lewis
262