J is for Robert Jackson MD

artist unknown – Wikipedia

Robert Jackson (1750-1827) got his MD in Leyden in 1786. He had every right to be proud of his doctorate which he achieved at the age of thirty five after many vicissitudes. If you go the old Dictionary of National Biography you’ll read, “After a good schooling at Wandon and Crawford he was apprenticed for three years to a surgeon at Biggar, and in 1768 joined the medical classes at Edinburgh. Supporting himself by going twice on a whaling voyage as surgeon, he finished his studies without graduating, and went to Jamaica, where he acted as assistant to a doctor at Savanna-la-mer from 1774 to 1780.” All very circumstantial. It’s only when you look at the small print that you realise this is Jackson on Jackson. Almost all the information in Charles Creighton’s article for the DNB comes from a memoir added to the 1845 third edition of Jackson’s Systematic View of the Formation, Discipline, and Economy of Armies by its editor, Dr Borland, who based it on recollections of conversations with his old friend. Creighton’s other sources, for example an obituary by Dr Barnes in The Transactions of the Provincial Medical and Surgical Association, are equally anecdotal.

Barnes says Jackson’s “parents were in poor circumstances” but that is not an adequate explanation for their failure to support him through university. The clue, I think, lies in his apprenticeship. Believe it or not, in those days, a career in medicine wasn’t the answer to parental dreams. Jackson’s departure for Jamaica was rapid, but not so rapid as to suggest a shot gun lay behind it. In Jamaica it’s possible he wrongly called himself a doctor, though it’s just as likely the term was used by other people as an honorific. None of this is sinister. Jackson said slightly different things to different people at different times. And there are no records to substantiate one or other version of events. Thus Barnes has him acting as “medical superintendent” to a detachment of the 1st Battalion of the 60th Foot (not mentioned in the regimental history though this is no surprise since the battalion was split up into penny packets all over the West Indies) and then going to New York in 1778, while Borden has him in Jamaica until 1780.

Sir Archibald Campbell by Romney

Jackson’s career from 1780 is well authenticated. He enlisted into the 71st Regiment. This was the second regiment in the British Army to be called Fraser’s Highlanders. The earlier Fraser’s Highlanders was numbered 78 and disbanded in 1763. The second Fraser’s Highlanders was disbanded in 1786. Neither is related to the 71st (later Highland Light Infantry) which was numbered 73 in the American War of Independence. Jackson caught the eye of the colonel of the 71st, Lt Colonel Sir Archibald Campbell, shown above in a painting by George Romney now at the National Gallery of Art in Washington. Campbell granted Jackson an ensigncy. Then – to the great good fortune of British Army medicine – Jackson took up a vacancy as surgeon’s mate in the regiment. He was captured with the rest of the regiment at Yorktown, paroled and returned to England where he had only the half pay of an ensign to sustain him.

In a 1972 lecture – which you can read in full at https://journals.sagepub.com/doi/pdf/10.1177/003591577206501233 – Lieutenant General Sir Neil Cantlie states “his penurious circumstances were solved when he married an accomplished Edinburgh lady of considerable fortune and he at once went to Paris and thence to Brussels and Leyden where he took the degree of Doctor of Medicine by examination.” Cantlie, by the way, was a man whose standing in the army owed much to Jackson’s insistence that those responsible for the army’s health “should be so constituted as to maintain and honourable and respectable rank in the military fabric.” But I digress. Cantlie’s explanation, while tidy, begs the questions, how Jackson met the lady and why he left immediately for Leyden. Once again – no scandal. The lady was the niece of a brother officer and he appears to have met her father, Dr Stephenson, while walking in Scotland. She went off with him overseas. The Jacksons returned to England in 1787 where he settled down into general practice in Stockton. In 1791 he published the first of many really important books, this one based on his experiences in Jamaica.

This is a dog of a copy of the first American edition which is very much more common than the 1791 London edition. In a brief digression I’m going to show you all the things that are wrong with it. First (see above) wrong edition.

Second (also see above) the titlepage is soiled (left in a barn for a decade or two).

Third (see above) it has new endpapers (the new violently clashing with the old).

Fourth (see above) it has been rebound (by an amateur who hasn’t heard of title labels).

Fifth (see above) the text is browned (or more than a little foxed).

Sixth (see above) some of its gatherings are working loose (the book is broken in two).

No matter its defects. This is a snip at £25. And, as a bookseller who shall remain nameless, once told me on the phone, “I hope I look that good when I’m 225.”

Back to Jackson and his Treatise on the Fevers of Jamaica. Apart from beginning a taxonomy on the various diseases of the West Indies, the book contains useful remarks on military hygiene and sensible suggestions about how clothing and equipment could be varied in hot and cold climates. This sounds blindingly obvious now. It was very far from that at the end of the 18th Century.

Jackson’s book should have been a best seller as Britain geared up for war with France. The obvious way for Britain with a small army to fight France on land was to invade her empire overseas. But everybody knew that British soldiers dropped like flies when serving in the West Indies. And so it proved. Roger N Buckley in Journal of the Society for Army Historical Research Number 226 – he’s written a full length book since then – while discussing “the steady and relentless destruction of the British army in the West Indies” calculates that British military casualties there between 1793 and 1815 amounted to 424,000 of whom 75,000 died. By way of comparison Dumas and Vedel-Petersen in Losses of Life Caused by War give a grand total of 35,600 deaths in the British Army in the whole of the Peninsular War between 1808 and 1814.

In America, where ‘Carolina fever’ was a concern, Jackson sold better. His 1791 London edition is really quite hard to find, his 1795 Philadelphia edition is commonplace.

In 1793 Jackson went back to the army. There is no need to assume he found general practice in Stockport to be insufficiently remunerative or that there was any other ulterior reason for his going. Simply, as an ensign on half pay, he was called to the colours. As an MD with seven years general practice behind him, he expected to be appointed an army physician. A problem arose: having never belonged to The Royal College of Physicians, he was technically ineligible, and the Physician General, Sir Lucas Pepys, refused to bend the rules. Jackson had to accept a lower position and was duly gazetted “Mr Robert Jackson from half pay of Ensign 71st Foot to be surgeon to the Buffs.” This was the beginning of a long feud between Jackson and the Royal College.

In Holland Jackson established a regimental hospital that had dramatically fewer deaths per admission than any other medical establishment in the army. Jackson’s startling success attracted the attention of the Commander in Chief, HRH the Duke of York, who appointed him Physician by his own authority.

After the conclusion of the Holland campaign, Jackson went with The Buffs (3rd Foot) to the West Indies. His experiences there led to An Outline of the History and Cure of Fever, Epidemic and Contagious published in Edinburgh in 1798. This book, which was a milestone in the identification and treatment of yellow fever, is still cited today. It must have gratified Jackson when it earned – albeit rather late – a respectful 31 page review in The Medical and Physical Journal.

Jackson went on to write many more books. The most famous is A Systematic View of the Formation, Discipline, and Economy of Armies first published in 1804 and recently described by Neil Ramsey in Command at a Distance as “the first fully scientific treatment of a modern disciplinary regime.”

Jackson’s second stay in the West Indies gave him an insight into the scale of corruption commonplace in the administration of the army overseas. His pamphlets exposing maladminstration in the Army Medical Department revived his feud with the College of Physicians. As the old DNB records “in the course of the contest he wrote seven pamphlets (from 1803 to 1809), was obliged to retire from active service, and committed an assault on Keate, the surgeon-general (by striking him across the shoulders with his gold-headed cane), for which he suffered six months’ imprisonment.” Here is an account of the ‘assault’:

Most likely Keate wanted an apology which Jackson wouldn’t give. Thomas Keate, who was then Surgeon General, had plenty of reasons to be peeved with Jackson, who had been one of the principal whistle blowers when The Commissioners of Military Enquiry, in their fifth report, took a look at the Army Medical Board. Below is Keate’s outraged response. Jackson’s name is mentioned many times in the index:

Keate survived his paper war with Jackson largely because the Commissioners of Military Enquiry had bigger fish to fry. Their ninth report on the ‘….more effectual examination of accounts for His Majesty’s forces in the West Indies’ exposed an astonishing story of corruption by which Valentine Jones, when Commissary General in the West Indies, entered into an agreement with a contractor, Matthew Higgins, allowing Higgins to supply vessels and equipment at his own price in return for a share of the excess profit. Jones’ share of the proceeds between April 1796 and May 1797 amounted to over £87,000. By these standards the malfeasance of the Army Medical Department was negligible.

Keate and the Army Medical Board met their Waterloo with the Walcheren Enquiry. The best book on the medical aspects of the campaign is Martin R Howard’s Walcheren 1809 which is subtitled the scandalous destruction of a British Army. It wasn’t the French who destroyed the British army at Walcheren, it was disease. This Rowlandson cartoon expresses the public outrage about the actions or rather inactions of the Army Medical Board and the physicians who comprised it.

The two men pilloried are Thomas Keates and Lucas Pepys. Robert Jackson sits on the jackass below. All around are the stores on one side and emoluments “for home consumption” on the other. The “champaign chest” is a reference to Keates’ reputation as a toper. This is grotesquely unfair because whatever else Keates was, he was a brilliant surgeon with a notably steady hand, who was the first man to tie a subclavian artery. But that’s satire.

In 1811 Jackson was recalled from retirement and made Medical Director in the West Indies. This represented a conclusive defeat for the College of Physicians. He wrote several other well regarded books. He retired from his final post as Inspector General of Hospitals in 1819 and immediately set out to investigate an outbreak of fever in Spain. I conclude with the conclusion of Jackson’s obituary in Gentleman’s Magazine for 1827.

And – before you ask – I have tried to find the names of Jackson’s two wives and the date of death of the first. Without success. It’s not that women are air-brushed out of history, it’s that most of them never had a place in history in the first place.

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