by Barbara Vine
While at Vienna he indulged two of his favourite interests, walking and train travel. From the train to Salzburg he had a ‘glorious view’ of the monastery at Melk, which he describes in a letter home as ‘one of the most beautiful edifices this world has to offer’. He enjoyed a walking tour in the Austrian Tyrol and later made a trip to Lake Thun in Switzerland, taking with him his Baedeker, the famous travel guide first published some thirty years before. Whether he had an opportunity to use his newly acquired Romansch he doesn’t say. But these holidays established for him a lifelong fondness for Central Europe, its mountains and lakes.
If he also wrote to Hamilton the correspondence has been lost. In his absence his friend had become assistant physician at University College Hospital and the two men shared a set of rooms they took in Great Titchfield Street. Henry was back at Barts, lecturing on anatomy when he was only thirty-two. While there he wrote his first book: Diseases of the Blood. For many years it was regarded as the definitive authority on haemophilia and used by generations of medical students. Henry was made a Fellow of the Royal College of Physicians.
That same year he and Hamilton went together on a walking tour in Austria, staying at a pension outside Innsbruck. Both wrote home and Hamilton also wrote to Henry’s mother, no doubt appreciating the fondness she had for him. Henry’s friendship with Hamilton was genuine and deep but there may have been some element of admiration on Henry’s part for the Scotsman’s aristocratic relations. Several times in his letters to his parents he reminds them that Hamilton was related to Lord Hamilton of Luloch. He seems to have enjoyed hob-nobbing with the great. An occasional visitor to Great Titchfield Street was Richard’s sister Caroline, a few years younger than he, who was living as a companion to her aunt not far away in a gloomy house in Percy Street. Henry, in a burst of frankness unusual for him at any time, describes Caroline Hamilton in the diary as ‘a handsome young lady’. She is mentioned several times and he was evidently very attracted by her. He mentions her ‘elegant manners’ and her modesty, her affection for her brother and concern for her aunt, who was some kind of invalid. Was he in love with her? Perhaps. In a curious way he seems to have been a little in love with both brother and sister. He writes about them in more affectionate and more admiring terms than of any other characters who appear in the diary at that stage of his life. I have to add the caution here that about those who appear in later years he writes in no terms at all. Their presence, as for instance dining companions or acquaintances he called on, is merely noted.
He went from strength to strength in his profession, holding several offices, as lecturer in comparative anatomy in St Mary’s Hospital Medical School, consulting physician at the London Fever Hospital and physician to the Western General Dispensary. Somehow he found time to write another book, even longer than the first, and to revisit his beloved Alps. In 1872 he accepted a professorship of pathological anatomy at University College London, and at the same time set up in private practice in Wimpole Street.
Richard Hamilton had become consulting physician at Edinburgh Royal Infirmary and left for that city in 1869. His aunt had died the year before and Caroline had returned to the parental home. How Henry felt about this double departure from his life of the only two friends he had is recorded nowhere in the diary. He writes only, ‘Hamilton has departed for Edinburgh. I drove with him to the King’s Cross station this morning and saw him off on the train to the north.’ Trains were to play a significant part in Henry’s life and a disastrous one. But if the two tragedies, the first involving his best friend, the second the woman he was engaged to, put him off travelling by rail himself, there’s no hint of it in his writings. Though train journeys were among his pleasures, he owed his life – and I my existence – to his avoiding one of them.
By the time of her brother’s departure for Edinburgh, Caroline had been absent from the diary for a year. Had Henry asked her to marry him and been refused? This is the merest speculation. I’ve no reason to believe it. She never appears in the diary again, but he corresponded regularly with Hamilton and many of the letters he received from him were carefully dated and packed in one of the trunks.
Hamilton writes of his work, of his family, of the Miss Susannah Murray he had become engaged to, but whom he never married, and occasionally of Caroline. A letter of autumn 1874 describes her wedding to a doctor in Aberdeen. Hamilton was best man. No mention of this is made in the diary, in which by then the entries are growing shorter and more repressive. Henry does, however, record visits to Scotland in 1876 and 1879, commenting in the first entry at unusual length on the pleasures of train travel. He stayed at Hamilton’s parents’ home, he and Richard went on a tour of the Trossachs, and one glorious evening dined at Luloch Castle near Dundee with Lord and Lady Hamilton. Another time the two men spent a fortnight at Godby Hall with Henry’s mother, still apparently doting on Hamilton, and his now ailing father.
If he couldn’t replace him, Henry had found a seemingly adequate substitute for Hamilton in Barnabus Couch, another physician he appears to have met while both were working at the Western General Dispensary. Letters from Couch and copies of letters Henry wrote to Couch, were carefully preserved in the trunk. But whereas Hamilton is often referred to as ‘my friend Hamilton’ or ‘RH’ and even once as ‘dear old Hamilton’, Couch gets only his bare surname. The same applies to Lewis Fetter, another medical man Henry knew and occasionally corresponded with.
The composition of Queen Victoria’s Medical Household seems extravagant today. Three Physicians-in-Ordinary and three Surgeons-in-Ordinary were in attendance and all were both consultants to the Queen and her general practitioners, while the senior physician was styled Head of the Medical Department and the senior surgeon Sergeant Surgeon.
Ranked below them were the Physicians and Surgeons Extraordinary. If they did well and found favour with the Queen they were promoted to in-Ordinary while those among the in-Ordinary who became unfit for the task through age or ill-health reverted to Extraordinary. Besides these, the great medical army included obstetricians, ear and eye specialists and apothecaries. These last were more like general practitioners than dispensers of drugs. Some of them, Apothecaries to the Household, took care of the health of everyone outside the royal family, while Apothecaries to the Person attended the Queen and any members of the family who might be staying with her. Some of these people were at Windsor, some at Balmoral and others at Osborne. Henry’s position among them was, from the first, peculiar.
The Queen appointed him Physician Extraordinary in 1879. Most of her other doctors were in permanent residence but Henry, though sometimes staying a few days at Windsor and several times travelling with her to the Isle of Wight, retained his professorship and his London home. Though he began on the lowest rung of the royal medical ladder, he enjoyed a special position. He was the Queen’s consultant on haemophilia.
He had been in attendance only a year when he was promoted Physician-in-Ordinary to her youngest son the Prince Leopold who suffered from this disease, the blood disorder in which Henry specialized. The second essay in the notebook is about its occurrence in the royal family and Henry writes with unusual frankness. Perhaps, needless to say, none of this found its way into any letter or memoir of his or into his published works.
Since the end of the last century it has at least been adumbrated that haemophilia manifests itself in males but is carried by females. The Queen must know that it is she who carries the disease, she and she alone, and that it must have passed to her via the Reuss-Ebersdorffs, from which family her own mother came. She is well-known, of course, for her refusal to face facts and a genius at pretending that things which are so, are not so. When she mentions HRH’s disease she insists it is ‘not in the family’ and his must be an isolated case. I would not take it upon myself to tell her she is a conductor and responsible for the occurrence of the disease in this one of her sons and very probably in her grandson Frederick William of Hesse (known as Frittie) who died eight years ago
at the age of two after falling out of a window. She is fortunate that in her own case, it occurred in this son alone of the four and, as far as can be seen up until now, only one of her five daughters, but more of that later.
Telling her would do no good, I suppose, even if I could bring myself to do it. It would in any case be useless as the damage is done and in the present state of our knowledge cannot be undone. What the future will bring as regards further enlightenment no one knows, though I pray God I may be His instrument in discovering more about the disease and some kind of alleviation of its awful symptoms, if not a cure.
It is unlikely that the Princess Beatrice will ever marry, will ever be allowed to marry, she is so much the apple of the Queen’s eye, but if she does I await with a dread I am astonished to find in myself, the birth of sons to her. For some reason, I cannot tell what, perhaps an intuition deriving from my own experience, I see in the Princess’s smooth young face and handsome figure a forewarning, some kind of premonition, that she is a conductor of haemophilia like her sister Alice, Grand Duchess of Hesse.
The Queen made Prince Leopold Duke of Albany in 1881, though he still lived at Court and had no residence of his own. But if Henry believed he was unable to alleviate the symptoms of haemophilia, Queen Victoria appears to have thought otherwise. In a letter to her eldest daughter, the Princess Frederick of Prussia (later Crown Princess, later Empress), she claimed to have been ‘much struck by the improvement in dear Leo’s health since Dr Nanther began his attendance upon him’. So struck was she that in 1883 she conferred a knighthood upon Henry and he was able to have engraved on his brass plate in Wimpole Street, Sir Henry Nanther, KCB, followed by his string of degrees.
It was said that it was this improvement in the Duke of Albany’s health that persuaded the Queen to allow him to marry, something she had in the past been set against. Princess Helene, known also as Helen or Helena, of Waldeck-Pyrmont was his choice and they were married in April 1882. The bride seems to have been devoted to her semi-invalid husband. In her journal Queen Victoria wrote that at the wedding he was ‘lame and shaky’. It’s hard from this distance in time to see what Henry did to make the Queen believe Leopold was in better health. Early in 1883, at Windsor where his wife had given birth to his first child, the Princess Alice of Albany, Leopold sprained his leg. A serious hazard for haemophiliacs is bleeding into the joints as the result of external damage. Perhaps Henry was able to alleviate the pain and reassure the Queen. But how did he so win her confidence and affection that she knighted him that same year?
His famous charm perhaps. I see him as the prince of the bedside mannerists. He was tall, he was very handsome, no doubt he could be a courtier. And there was another factor in the mystifying business of his rise to eminence. John Brown died that spring and the Queen was distraught. Deeply mourning her Highland servant, she may have turned for comfort to Henry. Her recovery is usually accounted for by her conversion to spiritualism, but suppose that, though she was ‘grievously crushed and brought low’, as she wrote to the Princess Frederick, it was Henry who went some way to replacing the lost men in her life?
A little under a year later, but not before a son was on the way, Leopold died in Cannes from a haemorrhage of the brain, his death the result of what would have been a minor injury in anyone else. Far from this tragedy turning Queen Victoria away from Henry, it seems to have consolidated her faith in him and she appointed him among her personal physicians, giving him the title of Physician Royal, though he was accountable first to Sir William Jenner and then to Sir James Reid, one after the other the Queen’s Senior Physician-in-Ordinary. He was exceptional too in that he never lived at any of the royal residences but was summoned when needed.
In a letter to Couch he describes a train journey he took to Osborne in 1883.
The journey to the Isle of Wight was accomplished in about three hours. I find rail travel a most enjoyable experience, as you know. The speed and ease with which these great steam-powered horses of iron gallop through the countryside never ceases to amaze me, and gratify me also at the advance of science and the accomplishments of industry: I went up to the engine where I was invited to watch the stoking of the furnace – I am not sure here if I am using the correct terms but you will know – and was engrossed by the sight of the coal being cast in by shovel, an endless process achieved by a half-naked man, bathed from forehead to waist in perspiration. We crossed the Solent in HM’s yacht. The strait is narrow enough but the water was choppy, the craft tossed about and I confess I experienced severe nausea. All was well, of course, when we came to land and I had my first sight of this beautiful and verdant island…
Jude is home before me. It’s her turn to cook and she’s in the kitchen doing something with chicken breasts and mushrooms. I bring her a glass of wine and one for myself. She looks younger and happier than she has for a week. Hope has returned. Her cycle has begun again, this is another new beginning, and she’s off on her regimen of folic acid, ginseng, echinacea, the gynaecologist’s medication and the rest of it. When I think like this I stop laughing because I hate hope. I don’t think it should count among the virtues, it’s not in the same league as charity and faith. Whoever it was said that hope deferred makes the heart sick, is my hero.
Jude turns the gas down under the pan and sits down with her wine. She hasn’t drunk any of it and she says that perhaps she shouldn’t drink it. Somewhere or other she’s read that alcohol provokes miscarriages. That makes me angry, though I don’t think I show my anger. I see her spoiling her life for the sake of a dream child I don’t believe she’ll ever have. I tell her gently that a couple of glasses of red wine is recommended by doctors but she shakes her head.
‘If I drink wine,’ she says, ‘and I never do manage to – well, you know’ – it’s always ‘well, you know’ these days – ‘I’ll look back and think if only I hadn’t been so weak maybe I’d have…’
‘You must do whatever you think best,’ I tell her, and then she starts talking about some new manuscript she’s reading. Not that she doesn’t want to talk about conception and babies but that she’s afraid of boring me, of making me impatient. I think – I’ m almost certain – the existence of my son Paul weighs heavily on her. She likes him, she always makes him welcome when he comes here, but he’s an ever-present reminder to her that I don’t need any more children. If I never have another it won’t make me unhappy, it won’t be the end of the title, for what that’s worth, and I’ll never repine. This is what she intuits and she intuits right, though I put up some sort of a show. But a difficulty lies here too. If I seem to yearn as much as she does and no child ever comes she’s going to feel she’s let me down, she’s disappointed me as well as herself.
She asks about my Henry research and I pass her a sheaf of handwritten papers of his I’ve had blown up to readable size. She leafs through them, stops about halfway in and reads part of a lecture Henry gave to some august body, as much because she’s intrigued by what he writes as I am.
These diseases are carried by the blood. Of that we must be certain. But what is it in the blood that affects some people with haemophilia and others with purpura? A substance, of course, that is passed by way of the blood from a parent to its offspring. It is very hard to see, therefore, how a father’s blood can enter and affect the foetus in the mother’s uterus, when what he has contributed to conception is semen or seed. But it must be so. All blood looks the same but it is not the same. Medical men have been attempting to transfuse blood from one human being to another or from one animal to another since 1665. Pepys mentions such an experiment, using dogs, in his diary. In France Jean-Baptiste Denis transfused lamb’s blood into patients until a fatality occurred and he was arrested. Since then very little progress has been made, though James Blundell recorded successful tranfusions five years ago. Mostly, what occurs when red blood cells from one individual are mixed with serum from another is clumping of the red cells or in some cases bursting of the cells. Will we ever know why
?
‘Yes, we will,’ Jude says. ‘We do. When did this Blundell record successful transfusions? Once you know that you can date this paper to five years later.’
I said I’d check and Jude lays down the paper, saying dinner’s probably ready by now and would I like to drink her wine? While we’re eating we talk about this amazing novel she’s publishing by a man from what we’re now supposed to call ‘the Asian subcontinent’ and which she thinks is a front runner for the Booker Prize. It’s about marriage in India and the five big events in it are weddings. This leads her to ask me if I’ve yet done any research into Henry’s marriage, when it happened and why.
I ask her who can tell why anyone gets married and she says she knows why she did. We smile at each other across the chicken and mushrooms and I say that of course one knows oneself but can others ever know?
‘You told me he was keen on Caroline Hamilton.’
‘It looks like it, but she married someone else.’
‘And there was that woman Sargent painted,’ she says. ‘We’ve got the picture on the kitchen calendar.’
‘He didn’t marry her, either. She married someone called Caspar Raven.’
‘And Henry?’
‘He married Louisa Edith Henderson, always called Edith, who was my great-grandmother. He was Sir Henry by then, a distinguished and famous physician. It was eighteen eighty-four and Henry was forty-eight.’
‘How old was she?’
I tell her Edith was born in 1861 so she must have been twenty-three. Quite a gap, says Jude, but not unusual in the nineteenth century, and she wonders what he did for sex all those years. She’s heard London was full of prostitutes, so did he use them? Or did he visit brothels?
