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382 Journal of the Royal Society of Medicine Volume 72 May 1979

Dr Thomas Hodgkin and Sir Moses Montefiore Bart -


the friendship of two remarkable men'

Alex Sakula MD FRCP


Redhill General Hospital, Redhill, Surrey, RHI 6LA

Dr Thomas Hodgkin earned himself a sure place in the history of medicine by his original
description in 1832 of the disease which bears his name. Less well known about Hodgkin are
his wide humanitarian interests, in some of which he was joined by another great
philanthropist, his friend and patient, Sir Moses Montefiore. The story of the association of
these two very different men, one a Quaker physician and the other a Jewish financier, remains
of great interest, especially their journey together on a mission of mercy to the Holy Land,
which ended with the death of Hodgkin.
Sir Moses Montefiore Bart FRS (1784-1885)
Moses Montefiore was born on 28 October 1784 in Livorno. He came of an ancient Sephardi
Jewish family of merchants who settled in Italy in the seventeenth century. His grandparents
moved to London in the mid-eighteenth century and had seventeen children, one of whom,

Figure 1. Sir Moses Montefiore: from an oil


painting by H Weigall, 1881. (Courtesy of
0110687/538--6$O.OO©
National Portrait Gallery, London) 99Te oa oceyo Mdcn

Joseph Elias Montefiore, married Rachel, daughter of Abraham Lambroso de Mattos


Mocatta. She and her husband were on a visit to Livorno when she gave birth to her son
Moses. On their return to London the family lived in Kennington, where Moses went to school.
Later, he and his brother Abraham entered the Stock Exchange.
In 1812, Moses Montefiore married Judith, the daughter of an Ashkenazi Jew, Levi Barent
Cohen; they had no children. He lived in New Court, St Swithin's Lane in the City of London,
next door to his friend, the famous financier Nathan Mayer Rothschild, who had married his
wife's sister. The brothers Montefiore acted as brokers to Rothschild, and they both rapidly
1dAccepted 9 May 1978
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Journal of the Royal Society ofMedicine Volume 72 May 1979 383

became very wealthy. Moses Montefiore was able to retire from the Stock Exchange in 1824, at
the age of 40 (Goodman 1925).
In 1837, Montefiore was elected FRS - the first Jewish member of the Society. In the same
year he was elected Sheriff of the City of London, and later he was Deputy Lieutenant of Kent
and Lieutenant of the City of London. He had purchased in 1831 a splendid house and gardens
at East Cliff Lodge, near Ramsgate, and it was there that he became acquainted in 1834 with
the future Queen Victoria, when she was staying in Broadstairs with her mother, the Duchess
of Kent. Montefiore placed his secluded grounds at East Cliff Lodge at the disposal of the
Royal ladies. On her accession in 1837, Queen Victoria knighted him, and in 1846 Sir Robert
Peel made him a Baronet.
Montefiore was an observant orthodox Jew and was President of the Board of Deputies of
British Jews for forty years. After his retirement from the City, he devoted the remainder of his
life to social and humanitarian work and to helping the victims of persecution (Nahon 1965).
He made seven visits to the Holy Land: in 1827, 1839, 1848, 1856, 1857, 1866 and 1875. His
wife accompanied him on these journeys until her death in 1962. On his last journey to the Holy
Land in 1875, he was aged 91. In the Holy Land, he laid the foundations of the New City of
Jerusalem, endowed hospitals and almshouses, and commenced agricultural enterprises (e.g.
the first orange grove near Jaffa). These journeys were described by him and his wife in their
Diaries; some of these were destroyed, but extracts from others were later published (Loewe
1890).
Montefiore's work on behalf of the persecuted was facilitated by his great diplomatic skill in
gaining access to the appropriate sovereign. In 1840 he obtained from the Sultan of the
Ottoman Empire a firman denouncing the inveterate false charge of ritual murder brought
against the Jews. In 1846, he managed to persuade Czar Nicholas I to withdraw the 1844 ukase
which ordered all Jews to retire from the western frontiers of Russia. In 1863 Montefiore (then
aged 79) made a journey to the Sultan of Morocco to counter an outbreak of violence against
Christians and Jews. He contributed handsomely to any worthwhile charity, such as the
provision of medical help for the 1837 cholera epidemic in Naples.
Sir Moses Montefiore was undoubtedly a most remarkable nineteenth-century English
figure. All who met him were soon made aware of his magnetic personality and of his great
goodness of heart and bountiful charity. He lived to a very ripe old age, and his 100th birthday
was publicly celebrated at his home in Ramsgate. He died there in his 101st year on 25 July
1885. He was buried at Ramsgate near the synagogue which he had founded in his grounds,
and he lies side by side with his wife in the mausoleum which was designed as a copy of the
Tomb of Rachel which lies between Jerusalem and Bethlehem. In his will, he endowed the
Judith Lady Montefiore College and Library at Ramsgate, which he had first established in
1865 in memory of his wife, and this became a centre of religious observance and theological
research.
Dr Thomas Hodgkin MD (1798-1866)
Thomas Hodgkin was born at 14 Penton Street, Pentonville, London on 17 August 1798, the
third of four children of John and Elizabeth Hodgkin. The family were strict Quakers and John
Hodgkin earned his living as a private tutor. In 1815, the Hodgkins moved to Tottenham.
The young Thomas Hodgkin was a keen scholar, especially proficient in languages. After a
brief apprenticeship with a Brighton chemist, Hodgkin was for a short time in 1819 a
physician's pupil at Guy's Hospital, and then in 1820 he entered Edinburgh University and
graduated MD in 1823. While still a student, he spent his vacations visiting European medical
centres - including the Necker Hospital in Paris, where he met Laennec and was introduced to
careful physical examination, including the use of the stethoscope. On his return, he read a
paper to Guy's Physical Society on the use of the stethoscope.
In 1825, Hodgkin became a Licentiate of the Royal College of Physicians, London and was
then invited to be the first lecturer in morbid anatomy and curator of the museum at Guy's
Hospital. Richard Bright and Thomas Addison - also Edinburgh graduates - were already on
the staff of Guy's. All three - 'the great triumvirate' (Cameron 1954) - were keen on
384 Journal of the Royal Society of Medicine Volume 72 May 1979

correlating clinical and pathological findings. By 1829, Hodgkin had produced a catalogue of
the Guy's Museum, listing 1677 specimens. Between 1826 and 1836 he recorded all his
autopsies in thirteen volumes of 'The Green Inspection Book'. In addition, Hodgkin wrote an
important series of original descriptions of morbid anatomy; the most important of these was
in 1832, 'On some morbid appearances of the absorbent glands and the spleen', in which he
described six cases of enlarged lymph glands and the spleen, not of infective origin. This paper
did not attract attention at the time, but in 1838, Bright quoted it in his paper on tumours of the
spleen. However, it was not until 1865 that Sir Samuel Wilks drew attention to Hodgkin's
original observations, and labelled the condition 'Hodgkin's disease'.
-In 1836 Hodgkin was offered the Fellowship of the Royal College of Physicians but, because
he objected to the method of election of Fellows, he refused it. In 1837, a vacancy as assistant
physician at Guy's arose, and Hodgkin was keen to be appointed. However, owing to a
personality clash, he was rejected in favour of Dr Benjamin Guy Babbington. Hodgkin was
very disappointed, resigned his post as lecturer and curator at Guy's, and went through a
severe depressive phase.

Figure 2. Dr Thomas Hodgkin. From an oil


painting in Gordon Museum, Guy's Hospital.
(Courtesy of Royal College of Physicians,
London)

Between 1837 and 1842, he engaged in some medical practice, but not very successfully. In
1842, he took up an appointment as lecturer in medicine at St Thomas's Hospital, where he was
required to reorganize the Medical School. However, after less than a year, he gave up this post
too - the exact reason was obscure. It would appear that Hodgkin had some difficulty in
cooperating with medical colleagues, and as Hancock suggested in his Fitzpatrick Lecture
(1968), Hodgkin 'may have suffered the great social disadvantage of a lack of sense of humour'
(Figure 2).
Although he continued to write papers on medical subjects, the time that he spent on medical
practice dwindled while he became more and more involved in other matters, of an
ethnological, philosophical and philanthropic nature. This related to his strong Quaker belief
and his concern for the underprivileged. He showed a great interest in the treatment of African
negroes, North American negroes and Indians, and Australian aborigines. He supported the
infant Republic of Liberia, as well as the North in the American Civil War, and he made a
Journal of the Royal Society of Medicine Volume 72 May 1979 385

point of associating in public with coloured people. In addition, he served eleven years (1851-
1862) as Honorary Secretary of the Royal Geographical Society.
Many years earlier he had fallen in love with his cousin Sara Gooder, but the Society of
Friends forbade the marriage (Hodgkin 1840). In 1850, at the age of 52, he married Frances
Sara Scaife, a widow from Nottingham, and he lived happily with her at 35 Bedford Square;
they had no children.
Hodgkin's association with Montefiore
It was on one of Hodgkin's travels as a medical student in Southern Europe in 1823, that he
accompanied Abraham Montefiore and his wife. Hodgkin did not get on too well with
Abraham, but he was introduced to Abraham's brother, Sir Moses Montefiore, and the two
men took an immediate liking to each other. They became very close friends and thereafter
Hodgkin remained Montefiore's personal physician (Stern 1967). They often travelled together
in Europe, and in 1860 when Lady Montefiore's health was failing they journeyed to the
Mediterranean in the hope that this would benefit her. In 1863, Hodgkin accompanied
Montefiore on his journey to North Africa, as Christians and Jews in Morocco were suffering
at the hands of the Moslems. The party travelled in a Royal Navy gunboat HMS Magicienne
via Gibraltar to Morocco, and crossed the Atlas desert to intercede with the Sultan. On his
return, Hodgkin described this in his 'Narrative of a Journey to Morocco in 1863 and 1864 ...
with geological annotations'. The book was not ready for publication in his lifetime, but was
published posthumously shortly after his death in 1866, by subscriptions as a memorial to him.
The book was illustrated by plates from Hodgkin's own water-colour drawings.
Hodgkin's last voyage and death (1866)
In 1865 bad news reached Montefiore from the Holy Land. There had that year been a plague
of locusts which had ruined the harvest. This had been followed by an outbreak of cholera in
Jerusalem, where one out of six of the population died (Plashkes 1957). The Jewish Board of
Deputies together with Montefiore started a Holy Land Relief Fund and £3000 was collected
and sent out.
Early in 1866, Montefiore decided to go to Jerusalem to apply the balance of the Fund
personally. On this, his sixth, visit to the Holy Land he was accompanied by Thomas Hodgkin,
Captain Henry Moore (brother of the British Consul in Jerusalem), his relatives, Mr and Mrs
Sebag, and his old friend and literary executor, the renowned orientalist, Dr L Loewe (Wolf
1884). Montefiore later wrote a report to the Jewish Board of Deputies, in which he described
the journey to Egypt and the voyage from Alexandria to Jaffa, where they were ceremoniously
received by the Governor of the town, judges, commander of the troops and representatives of
various religious denominations. He described how he saw locusts clinging to the windows
(Loewe 1890). Hodgkin had been ailing even before the voyage from Alexandria to Jaffa, but at
Jaffa he became more seriously ill with acute diarrhoea - probably dysentery, or possibly
cholera. The party was due to proceed from Jaffa to Jerusalem, which was the destination of
this mission of mercy. Arrangements were therefore made for the care of Hodgkin, while the
rest of the party moved on. Montefiore's dilemma at Jaffa was poignantly described in his
Report:
'Being most reluctant to leave him [Thomas Hodgkin] in Jaffa, I remained with him up to the last
moment until it became absolutely necessary to depart for Jerusalem in order to arrive there in time for
the Passover holidays.
'While at Jaffa I had frequently expressed my strong desire either to remain there with my lamented
friend, take him with me to Jerusalem, or to relinquish my journey thither and return with him to
Europe; but all my friends assured me that it would be most imprudent for Dr Hodgkin to travel at that
time and that the best and only advisable course was to let him remain in the house of Mr Kyat, the
British Consular Agent, under the most kind and watchful attendance of that gentleman and his
family with whom he had been staying since our arrival at Jaffa. Advice so earnestly urged I could not
but follow. Accordingly, on Sunday, 25th March, having previously secured the professional services
of Dr Sozzi, the physician of the Lazaretto, and left my own English servant, and likewise engaged
386 Journal of the Royal Society ofMedicine Volume 72 May 1979

another, in the hope of being soon rejoined by him; and having for this purpose left for his convenience
the takhteerawan (sedan chair) which the Govenor of Jerusalem had kindly sent to Jaffa for my own
use. Unfortunately the state of health of my lamented friend had not been, previous to his departure
from England, as satisfactory as his friends could have wished, and indeed he left home to accompany
me on my journey, in the hope and belief that the voyage and change of air would prove beneficial to
him. I have at least much consolation in reflecting that all that could be done was made available for the
preservation of his valuable life' (Loewe 1890).
Hodgkin died on 4 April 1866, aged 68. Captain Moore, a member of the party, wrote to
John Hodgkin (Thomas's brother) a few days after the death. He described how, on hearing
from Dr Sozzi that Hodgkin's illness had taken a turn for the worse, he left Jerusalem and
reached Jaffa to find Hodgkin in extremis.
'The poor Doctor seemed glad to see us, and although I did all in my power to reassure and
encourage him, he would not admit that he was not in a dying state. The doctor, although fully aware of
the gravity of his case, did not give up all hope.
'During this time, his sufferings were often most acute. I feel sure that you will rejoice that he bore
them with the utmost fortitude and resignation, praying that the will of the Lord might be done, and
saying that "He has given and He has taken away" and "Blessed be his name".
'I myself cannot find words to express my profound admiration at the calm attitude of this most
excellent man and Christian in the hour of trial and suffering. His last thoughts were of his Maker and
the eternity opening before him. He prayed to be allowed a few hours respite from pain before the final
struggle, a request which I have every reason to believe was granted. He passed away calmly.
'Dr Hodgkin expired at a quarter past five in the evening of the 4th of April, and was buried in the
English Cemetery, near the city walls, outside the new gate, and nearly opposite the British Consul's
house. The funeral was attended by the few Protestants residing at Jaffa, the officiating Consul, and the
people attached to his office, with the two doctors and myself, and the two European attendants left
with him by Sir Moses.
'It was a lovely morning, but most sad and mournful was the group which stood around the grave of
your dear brother and their lamented friend. A strong wooden railing has been put around the grave to
mark the spot for the present, till a suitable monument can be sent from Europe.'
This letter is included in the introduction to Hodgkin's posthumously published 'Narrative
of a Journey to Morocco in 1863 and 1864' (1866).
Montefiore was heartbroken on the loss of one who had been his personal friend as well as
his beloved physician for forty years. In his Report, he wrote further:
'It has pleased the Almighty to take him [Thomas Hodgkin] from us, and that he should not again
behold his loving consort and beloved relations; he breathed his last in a land endeared to him by
hallowed reminiscences. To one so guileless, so pious, so amiable in private life, so respected in his
public career, and so desirous to assist, with all his heart, in the amelioration of the condition of the
human race, death could not have had any terror.
'His soul has ascended to appear before the throne of glory, there to receive the heavenly recompense
which is awarded to the good and righteous of all nations.
'I trust that I may be pardoned for this heartfelt but inadequate tribute to the memory of my late
friend. His long and intimate association with me and my late dearly-beloved wife, his companionship
on our travels, and the vivid recollection of his many virtues, make me anxious to blend his name, and
the record of his virtue, with the narratives of these events'.

Hodgkin's memorial
On his return to England, Montefiore arranged for a memorial, in the form of a granite pillar,
to be erected over the grave. The inscription on one face reads:
'Here rests the body of Thomas Hodgkin, M.D., of Bedford Square, London, a man distinguished alike
for scientific attainment, medical skill and self-sacrificing philanthropy. He died in Jaffa, the 4th of
April, 1866, in the faith and hope of the Gospel. HUMANI NIHIL A SE ALIENUM PUTABAT. The
epitaph is inscribed by his deeply sorrowing widow and brother to record their irreparable loss.'
Journal of the Royal Society of Medicine Volume 72 May 1979 387

On the obverse of the memorial is inscribed:


'This tomb is erected by Sir Moses Montefiore, Bart, in commemoration of a friendship of more than
forty years and of many journeys taken together in Europe, Asia and Africa'.
On his last visit to the Holy Land in 1875, Montefiore visited Hodgkin's grave and memorial
(Montefiore 1875). The small cemetery which is situated near the Tabetha Girls School
(Church of Scotland) has become neglected and overgrown by vegetation, although in 1966,
Dr Chas F Izsak, Chief Surgeon at the Israeli Government Hospital at Jaffa, and his wife
personally cleared the area around Hodgkin's grave. The year 1966 being the centenary of the
death of Hodgkin, a conference on Hodgkin's disease was held in Israel. On 15 December 1966,
before the conference commenced, a memorial ceremony alongside Hodgkin's grave was held
and was attended by the Israeli Minister of Health and His Excellency, the Ambassador of
Great Britain (Leibowitz 1967).
Conclusion
No doubt there were many factors drawing together these two outstanding men of such
different origins and backgrounds, but foremost must have been their mutual recognition of
the other's strong religious faith and their common love of their fellow men, especially the
down-trodden. It would perhaps have been more appropriate if Montefiore had found his final
resting place in the Holy Land. Yet, by Hodgkin lying buried there, it is as though this has put
the final seal on their profound friendship. Hodgkin is the only great non-Jewish physician of
the past whose grave is preserved there. Although his remains lie in a foreign land, he is
nevertheless among friends and his memory is dear to the medical profession in Israel.
References
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Cameron H (1954) Mr Guy's Hospital. Longmans Green, London
Goodman P (1925) Moses Montefiore. Routledge, London
Hancock P E T (1968) Journal of the Royal College ofPhysicians of London 2, 404
Hodgkin T (1832) Medico-Chirurgical Transactions 17, 68
Hodgkin T (1840) On the Rule of the Society of Friends which forbids the Marriage of First Cousins. R Watts, London
Hodgkin T (1866) Narrative of a Journey to Morocco in 1863 and 1864. T C Newby, London
Leibowitz J P (1967) Israel Journal of Medical Science 3, 501
Loewe L (ed) (1890) Diaries of Sir Moses and Lady Montefiore comprising their life and works as recorded in their
diaries 1812-1883. Griffith Farrow Okeden & Welsh, London
Montefiore M (1875) Narrative of a forty day's sojourn in the Holy Land. Wertheimer, Lea, London
Nahon S U (1965) Sir Moses Montefiore. Jewish Agency, Jerusalem
Plaschkes S J (1957) Acta Medica Orientalia 16, 136
Stern ES (1967) Medical History 11, 182
Wilks S (1865) Guy's Hospital Reports 26, 56
Wolf L (1884) Sir Moses Montefiore: a centennal biography, with extracts from letters and journals. Murray, London