Abstract
James Paget (1814–99) was born at Yarmouth, the youngest of 17 children. While a student at St Bartholomew's Hospital in London, he identified Trichinella spiralis in muscle; his sketches are preserved in the Royal College of Surgeons. He qualified in 1836 and eventually became a surgeon at St Bartholomew's, Fellow of the Royal Society (1951), Surgeon to Queen Victoria (1858), President of the Royal College of Surgeons (1875) and baronet (1871). He died in his 85th year and was buried in Finchley Cemetery after a funeral service at Westminster Abbey.
His original descriptions of Paget's disease of bone (osteitis deformans) 1 and Paget's disease of the nipple are hailed as perfect classics in their own right, and little needs to be added to his descriptions.
The incidence of Paget's disease of bone increases with age so that per 100,000 of the population it is observed in 350 in the under-40s to 9000 in the over-80s age group. The prevalence depends upon race and heredity. Family involvement is common, suggesting a genetic factor. Osteoclasts resorb bone in chaotic fashion leading to excessive osteoblastic activity. This imbalance causes bone lysis and sclerosis in the bones of the pelvis, spine, femur, skull and tibia, causing considerable pain and deformities, fractures, osteogenic sarcoma and nerve root damage.