Tyranny of Treatment

This web exhibition is an adapted version of a lunchtime gallery talk given at Dr Johnson’s House Museum on Tuesday 25 November 2003 to coincide with the temporary exhibition on 'The Tyranny of Treatment, Samuel Johnson, his friends and Georgian Medicine'.

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Johnson Exhibition poster 2003

The exhibition poster

The exhibition poster

According to the exhibition caption this picture (painted by Sir Joshua Reynolds in 1769) shows ‘Dr Johnson Arguing’. The caption does not mention his eyes but this is a particularly interesting portrait to the ophthalmic historian since it may show evidence of his childhood scrofula (tuberculosis of the lymph glands which can cause long-term visual impairment).

Johnson contracted scrofula, aged about 2, probably from cow’s milk. He may also have had a non-specific ophthalmia neonatorum or conjunctivitis and blepharitis at the age of just 10 weeks, but if so this infant blindness was not the same as that from which he suffered in later life. (One theory is that he contracted it from his wet nurse’s milk).

A quick glossary:

• Ophthalmia = inflammation
• Conjunctivitis = pink eye, bacterial or viral infection. It can spread from one to the other eye but rarely affects vision and is uncomfortable rather than painful
• Blepharitis = inflammation of the eye lids

Gonorrhoeal ophthalmia - eye model

Gonorrhoeal ophthalmia

This is a 19th century model of Gonorrhoeal ophthalmia showing untreated venereal disease with a purulent discharge. Newborn babies can get this when passing through the birth canal (and thus almost always suffer in both eyes). Could this be what Johnson had at the age of ten weeks, and if so what does it say about the reputation of his mother?

Johnson's diaries record a childhood visit to a Wolverhampton relative, so that a young Worcester physician, Dr Thomas Attwood (who trained at Leiden under Hermann Boerhaave) could examine his bad eyes. Attwood's treatment was to bleed the young boy's left arm!!!! This was to release the ill 'humours' still thought to be the cause of most disease. Whilst the bleeding was taking place, his attention was distracted by a custard pie.

Scrofula left Johnson with possible blindness in one (the left) eye as a consequence. The resultant corneal scarring would have distorted his central vision but left the peripheral vision intact, meaning that Johnson could keep his eyes in alignment such that no observer would spot any problem (his friend Boswell didn’t).

For centuries it had been believed that the monarch could 'touch' for scrofula. It was one of the most useful services a ruler could deliver directly to his subjects. Johnson received a gold 'touchpiece' from Queen Anne, c. 1711 at one of last royal touching occasions. This was worn around his neck for the rest of his life. The event was also signficant as an early encounter with London for the sickly boy from Lichfield.

Johnson's friend Boswell

Johnson did not allow his visual disability to affect him unduly. As James Boswell observed:

His sight had always been somewhat weak; yet, so much does mind govern and even supply the deficiency of organs that his perceptions were uncommonly quick and accurate

Boswell was Dr Johnson's biographer, and lived a life of only slightly less literary achievement but considerably more destructive conduct.

Johnson told Boswell to keep his mind active and shun drinking at night. The effect of ignoring this advice may be gleaned from the definition of the verb 'see' in Johnson's Dictionary. In this Johnson included a quotation from John Locke:

It was a right answer of the physician to his patient, that had sore eyes: If you have more pleasure in the taste of wine than in the use of your sight, wine is good for you; but if the pleasure of seeing be greater to you than that of drinking, wine is naught.

Print of Joshua Reynolds

Johnson's friend Reynolds

Sir Joshua Reynolds was a close friend of Johnson and portrayed him several times on canvas. Reynolds too had his own eyesight problems:

• In 1783 he experienced inflammation of eyes in conjunction with several other ailments
• In July 1789 he felt his eyesight dimming whilst painting
• 2 months later he was blind in one (left) eye, later reporting this to be swollen and painful
• He described his predicament as the falling of a curtain. This is consistent with retinal detachment, accompanied by haemorrhage

The medical men of the day felt it better not to intervene in any way. On 3 September 1789 the Morning Post reported:

Sir Joshua Reynolds has found some improvement in the eye supposed to have been totally lost. The only medical opinion he has taken, has been from his old friend Sir George Baker, to whose experience he fortunately resorted, for in such cases, perhaps the less that is done the better, as the eye in general is oftener destroyed by unskilful treatment than by diseases that usually affect it.

• In 1791 Boswell visited Reynolds and spoke of the artist's ‘dismal apprehension of becoming quite blind’

Today we think that Reynolds probably experienced a malignant tumour in the left eye, which eventually caused the detached retina. What we cannot be sure of is whether this tumour spread to his liver and hence proved the cause of his death in 1792, or whether his eye problem was secondary to a main tumour in the liver.

In the eighteenth century most spectacle frames were of steel or iron with ring ends and were designed for wearing with a wig. Particularly popular were the short double-hinged 'Ayscough sides' (post 1752) and the rimmed 'Martins Margins' (post 1756). Reynolds’ type of frame can be seen on his self-portrait. There is a copy c.1788 on view in the downstairs parlour of the Dr Johnson House Museum, but our museum has a better quality version.

Detail of Reynolds self portrait
Detail of Reynolds Self Portrait
from the version at the College
of Optometrists

Note that this was initially a private image, only copied later, as well as the only portrait by Reynolds to show a sitter wearing spectacles. Reynolds' actual spectacles are at the Royal Academy and are of the turnpin variety with an optical correction of, -4.00 Dioptres, suitable for 'medium' (significant) myopia - a condition often associated with retinal detachment.

There is also a strong likelihood that he would have benefited from bifocal lenses, prompting at least one historian to ascribe their invention to him.

Johnson's Housekeeper, Anna Williams

Anna developed cataracts in both eyes aged 30. This is an early age for this to happen; the possibility that she had congenital cataracts cannot be ruled out.

Morgagnian cataract

The eye model shows a Hypermature Morgagnian cataract, revealing an opaque residue of damaged proteins on the lens. Note also the dense brown nucleus. G.V. Morgagni (1682-1771) was a Paduan anatomist working (in old age) at around the same time as Johnson. He spread the German ‘new teaching’ on cataract to Italy i.e. dismissing the old idea that cataracts were caused by catarrh seeping from the brain. The Dictionary defines CATARACT primarily as a cascade of water! But he includes a second definition: [in medicine] "little clouds, motes and flies seem to float about in the air", (quoting Quincy).

A couching needle was used to pierce the cornea and detach the cataract. The cornea reflects light onto the lens (which then focuses light onto the retina). It is very sensitive to pain but contains no blood vessels. The operation had to be carried out quickly in this pre-anaesthetic era. Anna knew Samuel Sharp (1700-78), the Senior Surgeon at Guys Hospital from 1751 and Johnson knew him too, quoting him in the Dictionary for example in the statement that glaucoma is cataract!

Unfortunately, Anna's cataract operation, perfomed in 1753, failed. Possibly it was too soft for successful surgery. This was the same year as the first use of a knife for corneal incision.

Bow porcelain eyebath

Bow porcelain eyebath

This rare Bow porcelain eyebath from 1765 illustrates the theme of optical hygiene, at least amongst the wealthier classes of Johnson's time. Other products available would have been preparations such as 'Eyebright' and various ophthalmic ointments. For instance Singleton’s eye ointment (red mercuric oxide) was one of the earliest brand name medicines, and was manufactured in Lambeth from the late 16th century right through to the 1970s.

'Doctor' Johnson fancied himself as a bit of medical expert and mixed with many medical practitioner friends. Not only could he write prescriptions for himself in apothecaries characters but he died not long after attempting self-administered surgery. Boswell referred to him as a ‘dabbler in physick’.

Did Johnson wear spectacles?

• Johnson was heavily critical of Reynolds for depicting the 'imperfections' of people in the portraits he painted. Determined not to suffer a similar fate Johnson told Hester Thrale that ‘I will not be blinking Sam’.
• But...Johnson’s Life of Swift mocks the ‘ridiculous resolution or mad vow’ that Swift made never to wear spectacles.
• And Johnson can be shown to have thought that spectacles were a great invention: George Steevens collaborated with Johnson on the revisions to his edition of Shakespeare and wrote in his Miscellanies II (p.254) that ‘he never made use of glasses to assist his sight’, yet, ‘He mentioned the name of the original inventor of spectacles with reverence and expressed his wonder that not an individual out of the multitudes who had profited by them, had, through gratitude, written the life of so great a benefactor to Society’ (in the context of Johnson's time this probably means Roger Bacon).

If visitors to Johnson's House go to the ‘Anna Williams Room’ they will see a picture of Johnson (c.1766?) not wearing spectacles but struggling to manage without them, holding a manuscript close to his face. He was not alone in his bad practice. (See the picture of Joseph Baretti in the Withdrawing Room!) No pictures of Johnson survive of him wearing corrective eyewear.

Dr Johnson's spectacles

Nevertheless, since the 1950s the BOA Museum has possessed a pair of spectacles alleged to be those of the great man.

They have unusual right-angled short sides, but can in other respects be dated stylistically to circa 1790. Remember that Johnson died in 1784. Did he come to use them in extreme old age? Or did he obtain a pair from one his many friends but choose never to wear them, or only secretly?

The lenses are spherical biconvex with a power of +2.75 D. this is consistent with the old age theory, though in dealing with antique spectacles one can never be sure if the lenses have been replaced in a more recent phase of the frame's life.

The main reason for the attribution to Johnson is twofold. Firstly they are contained within a case (obviously Victorian) on which is inscribed in gold-coloured lettering 'Dr Johnson's Spectacles'. It is not unreasonable to suppose that a personal memento of such a key figure should subsequently have had a special container provided and that this should be labelled to identify it.

Secondly the antiques dealer assured the museum's representative that the inscription related to THE Dr (Samuel) Johnson and not any other. Any additional knowledge that may have been available to that dealer is now lost.

Dr Johnson's Dictionary definitions:

• SIGHT = ‘Perception by the eye; the sense of seeing’
• To SEE = ‘To perceive by the eye’ [Quote from Locke: on drinking - see above -  also a quote from Bacon’s Natural History: ‘Air hath some secret degree of light; otherwise cats and owls could not see in the night’]
• VISION = ‘Sight, the faculty of seeing’ [Includes 2 quotations from Newton’s Opticks]
• OPTICIAN = ‘one skilled in opticks’
• SPECTACLE (in the plural) = ‘Glasses to assist the sight’ c.f. EYEGLASS. N.B. there is no entry for any of the spectacle parts e.g. ‘bridge’ or ‘temple’
• EYE = ‘The Organ of Vision; the medium of the sense of sight’
• EYEBALL = ‘The apple of the eye; the pupil’
• EYEDROP = ‘Tear’  

Samuel Johnson trade card
Samuel Johnson Trade Card

And finally, a little speculation....

Supposing the spectacles were named after their maker on account of their unusual design. We do know of an 18th century optician called Samuel Johnson (who was apprenticed in 1738 but died in 1772 - perhaps a bit too early). His trade card reads:

(THE OLDEST SHOP.) / SAMUEL JOHNSON, / OPTICIAN, / (Successor to the late Mr. MANN) / At the Sign of Sir ISAAC NEWTON and Two Pair of Golden Spectacles, near the West End of St. Paul's, LONDON; [etc.]

It would be easy to see how a pair of spectacles made by one Samuel Johnson, could be confused for those owned by Dr Johnson the literary figure living a very short distance down the road. We shall probably never know the truth.

Further study:

For more information on Johnson's medical history, see:

Wiltshire, John, Samuel Johnson in the Medical World, The Doctor and the Patient (Cambridge: CUP, 1991).

Follow the link to Eighteenth Century Spectacles where you can learn more about eyewear in the age of Dr Johnson, or go to our Art Gallery pages to have a better look at our portrait of Joshua Reynolds.