Graves, Robert James

Robert James Graves (1796-1853)

Clinical Descriptions (Graves Disease), and teaching methods.

Robert Graves was born in 1796, son of Richard Graves, Dean of Ardagh, He was first in the TCD Entrance Exam at 15 years, and was placed first in all his subsequent years.   After graduation in 1818, he went to London and then to the Continent for three years, especially Germany, Denmark, France, and Italy.   He was particularly impressed by the system of Bedside Teaching in Berlin.

He returned to Dublin in 1821, and was appointed to the Meath Hospital.   There he reformed medical training and introduced the system of Bedside Teaching.   Patient care was delegated to senior students under supervision.   Bedside Instruction replaced the abstract system of lectures, and ensured detailed development of clinical skills.   Graves also insisted that teachers themselves must be up to date, and led an extremely busy schedule, regularly doing rounds at 7.00 am.

In 1822 there were Typhus outbreaks in the West of Ireland.   Graves was among several volunteers, and insisted that fevered patients should be fed properly, as malnutrition often contributed to death. He once jokingly quipped to Stokes that his epitaph should read: He fed fevers.   Later, he also studied cholera outbreaks intensively, deducing that there must be an infective agent responsible, but his advice was largely ignored.  

He became Kings Professor at TCD in 1827.   He founded the Dublin Journal of Medical Science, which is still active as the Irish Journal of Medical Science.   He described hyperthyroidism in women, including the enlarged thyroid, palpitations, and protruding eyes, which is still known as Grave’s Disease.

His system spread throughout the English-speaking world, and many colleagues visited his clinics.   He was described by an American visitor as tall, slender, handsome, well-dressed, and cracking jokes with his patients and pupils.   In 1863, he published his Magnum Opus – System of Clinical Medicine, which contained many original observations.   It was highly acclaimed, and translated into French, German, and Italian.    He was made president of the Royal College of Physicians of Ireland (RCPI), and a Fellow of the Royal Society.

He had great talent for languages, and was once arrested in Austria as a suspect German spy, as his Irish origins were not believed.   He also studied history, and painting, accompanying Turner on his travels in Europe.   He was resourceful, saving a ship from sinking during a Mediterranean storm by taking command and repairing the pumps with his own shoe leather.   He invented the watch second-hand, but did not patent it; from which others profited.

He had tragedy in his personal life, losing his first two wives and 2 children very early in each marriage at childbirth.   He married a third time, and died of cancer.   His statue is among the four in the RCPI Hall.

References:

Coakley, D. (1997)   Irish Masters of Medicine,   Town House.

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