William Wadd’s clinical studies and portraiture

In his time, William Wadd (1776–1829) was a well-known and well-respected surgeon and writer. One could say he was born into the profession, as his father Solomon Wadd (d. 1821) was a surgeon who ran a successful practice for over half a century in Basinghall Street, London. William Wadd entered the Merchant Taylor’s school in 1784, and by 1797 his medical studies were sufficiently advanced that he was taken on as an apprentice to Sir James Earle at Saint Bartholomew’s Hospital. By 1801 he is listed as a member of the Royal College of Surgeons of London, as it was then called, and he became a member of the College Council in 1824. When John Abernethy died the College chose Wadd, 3 August 1829, to replace him in the court of examiners. He also had the distinction of serving as one of the surgeons-extraordinary to the Prince Regent, and he was appointed surgeon-extraordinary to George IV in 1821. ¹ Wadd died on 20 August 1829, on a holiday in Ireland, when he jumped from a runaway carriage. The British statesman William Gladstone apparently knew Wadd well because his death is recorded in Gladstone’s diaries, where he writes, ‘Received the awful account of poor Mr. Wadd’s death. O May God comfort the widow & the fatherless.’ ² On 24 August Gladstone added, ‘the painful news communicated to the Wadd’s. I saw them in the evening - in very deep, but not impatient nor I trust inconsolable affliction.’ ³

Wadd’s well-placed friends and illustrious career were not sufficient though to sustain his presence in history. Very little is known of his life and very little has been written about it. ⁴ The factual skeleton of his existence is provided by the entry in the Dictionary of National Biography, which has served as the basis for all other biographies of him, including this one. ⁵ The most complete account of Wadd’s life and character can be found in his obituary in The Gentleman’s Magazine. ⁶ What interests me about Wadd are his abilities as an artist, especially as revealed in his clinical studies of patients, which are so good that they can be comfortably compared to portrait sketches made by professional artists of the era. The sketches that are the focus of this paper are particularly interesting because of the way in which they make use of the conventions of portraiture of his time.

It is in The Gentleman’s Magazine that we get our first clue about Wadd’s artistic activities and background, it is there we learn that during ‘his leisure hours he employed himself in etching numerous anatomical plates, an art in which he received the instructions of his friend Mr. Hills, “whose philosophical pursuits and eminent talents are well known”’. ⁷ Almost certainly Mr Hills is Robert Hills (1769–1844), the water-colour painter and etcher who drew the portrait of William Wadd’s father Solomon Wadd. ⁸ Hills is another figure with a limited public record. We know that he entered the Royal Academy of Arts Schools in 1788 and he exhibited at the Academy regularly from 1791 to 1824. ⁹ We also know that in 1804 he was a founding member of the Society of Painters in Water Colours (now known as the Royal Watercolour Society) and that he acted as its secretary for a number of years and regularly contributed to the society’s exhibitions. ¹⁰ Hills was a prolific artist and a vast number of his works survive (the British Museum alone has over 1200). An examination of Hills’ prints and drawings quickly reveals that he was an accomplished draughtsman and Wadd was fortunate to receive instruction from him. ¹¹ Of course, Hills would not have been the only influence on the development of his artistic abilities; Wadd received an elite education and in his era that would have included basic instruction in the appreciation and production of art. Growing up in a medical household would have also impressed upon him the importance of good draughtsmanship; in a pre-photographic era surgeons and other practitioners needed to be able to draw well in order to record and transmit information about their cases. If Wadd’s path to a medical career was set early he would have picked up these skills as a matter of course.

It appears though that he had more than a practical interest in art. In the newspaper The Morning Post, 30 March 1820, Wadd is mentioned as one of the private mourners in Benjamin West’s funeral procession. ¹² This is a revealing and important piece of information. Except for the year 1805, Benjamin West served as President of the Royal Academy from the time of Sir Joshua Reynolds’ death in 1792 to his own death in 1820. It is reasonable to assume that if Wadd was a close friend of the President of the Royal Academy his artistic interests surpassed those of a medical illustrator. This assumption is supported by his own activities as an art collector. Wadd had an extensive collection of portrait prints of medical men, which after his death was purchased by the Royal College of Surgeons for £75. ¹³ According to R W Le Fanu, a former head librarian of the college, the collection consisted of around 500 items. ¹⁴ It was an impressive collection with works by the major artists of the British tradition: Van Dyck, Kneller, Hoppner, Richardson, Reynolds, Allan and Raeburn are well represented, as are other important artists with less familiar names. The artworks are catalogued in Wadd’s Nugae Chirugicae, or a Biographical Miscellany, Illustrative of a Collection of Professional Portraits, which is probably the book he is best remembered for today, along with his Comments on Corpulency; Lineaments of Leanness, Mems on Diet and Dietetics. ¹⁵

Our knowledge that Wadd had highly developed artistic skills and a portrait print collection makes it difficult not to view his clinical studies through the framework of the fine arts. Indeed, his drawings of patients seem to rely on the portraiture conventions of his era. The strikingly empathetic depiction in Figure 1, of a woman with late stage syphilis, which was drawn in the first decade of the 19th century, is far removed from the artistically neutral and impersonal tradition of medical illustration that was then in formation and was to find its first coherent realisation in Henry Vandyke Carter’s drawings for Gray’s Anatomy. ¹⁶ Rather, Wadd’s picture of the woman provides a vivid embodiment of an injunction by the influential French art theorist Roger de Piles, ‘the attitudes are the language of portraits, and the skilful painter ought to give great attention to them’. ¹⁷ While we can be sure that Wadd, a careful draughtsman who was often praised for his visual records, made every effort to accurately depict the ravages of the disease, what strikes the viewer more forcefully is the woman’s psychological portrayal, her desolation and despair.OPEN IN VIEWER

Her frontal pose is well suited to recording her damaged face, but it is also a convention more frequently seen in portraits of women than in portraits of men. Women were thought to be more straightforward creatures, honest and open products of nature, who could communicate and be read more directly. ¹⁸ Part of what makes this drawing so arresting is its stark, implicit contrast with the tradition of frontal portraits of beautiful women with flawless skin – which are ubiquitous in British art institutions – who gaze out meaningfully to engage the viewer. The conventions of portraiture underpin the drawing’s power.

By the beginning of the 19th century portraiture had become a respectable artistic genre, though still not on a level with history painting. For most of the 18th century it had not been well regarded. Portrait painters were often referred to, somewhat disrespectfully, as ‘phiz-mongers’, vendors of meagre physiognomical resemblances rather than iron or fish. ¹⁹ Having one’s portrait painted was a common activity for Britain’s wealthier classes and, accordingly, there were hundreds of portrait painters in London. The conventions that governed these pictures were standardised and limited, and larger studios engaged in a kind of assembly line production with the master painting the face and lesser artists responsible for skies, drapery, vegetation or whatever they had a knack for representing. At the same time, print culture was growing and reproductions of famous portraits or portraits of famous people were easily available and widely displayed. ²⁰ The portrait had become central to Britain’s visual culture, and this is part of what allowed the conventions of portraiture to be carried over so easily to Wadd’s clinical studies of his patients. Another important factor was the lowly status of the genre of portrait painting itself: it is hard to imagine the lofty artistic aspirations of history painting being enlisted for the creation of patients’ records, but the modest aims of the phiz-monger, one step removed from the mechanical arts, could be turned to such a task with little dissonance. As Shaftesbury said, its practitioners are ‘mere mechanics’ as it ‘requires no liberal knowledge, genius, education, converse, moral – science, mathematics, optics, but [is] merely practical and vulgar’. ²¹

This is not to say that all portrait painters were on the same level. There was an even graduation of status that ran from the great and sought after artists of the day, such as Anthony van Dyck, to the lowly neighbourhood sign painter who occasionally knocked off a likeness for the green grocer’s daughter. The artistic elevation of portraiture as a genre, though, advanced slowly and in step with the long battle, which had begun in the Renaissance, to upgrade the status of painters and pull them from the realm of the mechanical arts into the loftier sphere of the liberal arts. The battle was fought by many artists and writers, but the figure most commonly associated with it in England is Sir Joshua Reynolds, who as President of the Royal Academy could make that case in his lectures to the Academy, which were attended by students and interested public figures. ²² It was Reynolds who argued that portrait painting could be allied with the grander subjects of history painting, and that it should move away from its limited collection of stilted poses and introduce a greater variety of them better able to capture the possibilities of human expression.

Wadd would have been familiar with these debates through Robert Hills, Benjamin West and the other artists he would have associated with. In Figure 2 he has adopted an uncommon pose that Reynolds used in his portrait of Colonel John Hayes St Leger, c. 1778. ²³ Another example of the pose is found in John Opie’s portrait of Samuel Johnson in the National Portrait Gallery. While Reynolds has St Leger quietly but seriously contemplating the realities of war, and Opie has Johnson absorbed in the act of reading, Wadd has borrowed the pose from the portraiture of the great to capture not only the damage to his patient’s head, but also to suggest an ordinary man’s reflection on the unhappy saga of his suffering. Wadd discusses the man’s case in Malformations and Diseases of the Head:

This man, about 50 years of age, received a violent blow on the eye, from the end of an oar. Great inflammation ensued, which subsided without any injury to his sight, though he was never free from pain in his head. Six months afterwards, an insect stung him in the same eye, which instantly caused great swelling, and destroyed the power of vision. Inflammation and pain were excessive, and in the course of a few weeks the eye sloughed away, leaving the orbit bare, and the eye-lids as represented in the drawing. He lingered some months in misery, and retained his faculties to the end. ²⁴ OPEN IN VIEWER

Here again the pose is well suited to depicting the man’s injury, but it is also the right ‘attitude’ from the language of portraiture for conveying his inward focus on his plight. Wadd makes a point of including details, such as his dishevelled hair and clothing, which are medically unnecessary, but useful artistic conventions that help to underline his miserable state. The viewing distance is also kept at portrait length. A closer view of the damaged area would convey more medically useful information, but it would no longer provide a larger picture – a portrait of the man who is suffering.

Many of Wadd’s clinical studies employ well established conventions of portraiture that are immediately recognisable to anyone who has walked through the National Portrait Gallery or any other major British art institution. Figure 3 provides another excellent example of how Wadd uses them. The pose, inclining slightly to a profile view, with the subject’s eyes fixed on something in the distance, is an attitude so common that that it could be the template for a considerable number of portraits of great men in business or government. The man’s thoughtful, steady expression, which gives him an air of reflecting on something of consequence, is rendered more concrete by the inclusion of his neck scarf and jacket. Once more, the viewer’s visual distance from the subject is determined by the preferences of portraiture. Of course all of this is unnecessary for the correct representation of the actual subject of the picture: the wound on the man’s forehead, which is completely incongruous with the portrait presentation. However, it must be added that Wadd used the portrait format because, like other practitioners of his time, he did not isolate the wound from the bearer of it, and he was uncertain of what to make of the wound itself.OPEN IN VIEWER

There are about two dozen clinical studies in the file of Wadd’s anatomical drawings at the Royal College of Surgeons of England that rely, to a greater or lesser extent, on the conventions of portraiture. ²⁵ Some are mere sketches and others, like the ones that have been discussed, are more finished drawings. Some made their way into Wadd’s publications. Figure 2, for example, was reproduced as an engraving in Malformations and Diseases of the Head. ²⁶ Others were never used, but that could be because of Wadd’s unexpected death in the carriage accident, or it could be that they were only made for his interest. Whatever the case, they are a testimony to Wadd’s skill as a draughtsman and observer. In an era when medical investigators were often required to be their own illustrators, they provide a striking example of how the visual arts were enlisted to serve the ends of medicine.