Sir Dominic John Corrigan, Baronet, M.D.

(1802-1880)

            Dominic Corrigan was one of the first of the hitherto excluded talented Irish Catholics to come to the fore.  During his lifetime Dominic Corrigan gained an international reputation in medicine, he played a prominent part in national politics and he accumulated considerable wealth from his large practice.  These achievements are all the more remarkable when one considers that Corrigan did not have the type of patronage often thought essential for professional advancement in Victorian Ireland.  He was born in 1802 in the heart of the old city of Dublin.  His father was a merchant in Thomas Street and his house stood on a site where an Augustinian church stands today and where, in the past, Dublin’s medieval hospital of St John the Baptist was situated.  This hospital was suppressed by Henry VIII in the first wave of religious persecution.  In subsequent years the enactment of w whole range of penal laws made it virtually impossible for the native Catholic Irish to play an active part in the professional life of the country.  Towards the end of the eighteenth century these laws were relaxed and the new, more liberal approach by government opened up opportunities for young Catholics like Corrigan.

            Corrigan received his early education in a lay college which was linked with the new ecclesiastical college in Maynooth.  The local practitioner and medical attendant to the college, Dr O’Kelly, recognised Corrigan’s talent and gave him some training in medicine.  Corrigan was also influenced by one of his teachers, Dr Cornelius Denvir, who later became Bishop of Down and Connor and by whom he was taught mathematics and experimental physics.  Corrigan used this training to advantage later in his career when investigating the subject of aortic incompetence.  After leaving Maynooth he commenced the study of medicine at the School of Physic in Trinity College.  There he come under the influence of Macartney, the dynamic professor of anatomy, who had also made such a great impact on Dr Robert Graves.

            Macartney, who was from Armagh, was elected professor of anatomy and surgery at Trinity College in 1812 to succeed William Hartigan.  His great energy and enthusiasm inspired several of his students to strive for excellence and in this way he made a fundamental contribution to the development of the Irish school of medicine.  One of Macartney’s greatest difficulties in the school of anatomy was  the shortage of bodies for dissection.  In his diary he tells us that he and his demonstrator were obliged to undertake ‘the resurrection of bodies’ with very little assistance.  ‘On one occasion, I was taken prisoner and not liberated before morning and treated with the greatest indignity…’  Corrigan took an active part in body snatching when he was in Macartney’s department and in later life he published a vivid description of his experiences in The Lancet.

            Corrigan also studied in Edinburgh before he graduated MD, with William Stokes, in 1825.  When Corrigan returned to Dublin he became a physician to the Sick Poor Institution in Meath Street.  This was the largest dispensary in the city and although it was not attached to a hospital Corrigan had the satisfaction of knowing that the post had once been held by Abraham Colles.  Two years after he appointment Corrigan published papers in The Lancet on aneurysm of the aorta and on systolic heart murmurs.  They were followed by several other papers, and Corrigan’s hard work was rewarded in 1831 when he was appointed physician to the Charitable Infirmary.

            The following year Corrigan’s classic paper ‘On permanent patency of the mouth of the aorta or inadequacy of the aortic valves’ appeared in the Edinburgh Medical and Surgical Journal.  This paper contains a description of Corrigan’s Sign, that is, the visible pulsation in the neck of patients with aortic incompetence.

When a patient affected by the disease is stripped, the arterial trunks of the head, neck, and superior extremities immediately catch the eye by their singular pulsation…  The pulsations of these arteries may be observed in a healthy person through a considerable portion of their tract, and become still more marked after exercise or exertion; but in the disease now under consideration, the degree to which the vessels are thrown out is excessive.  Though a moment before unmarked, they are at each pulsation thrown out on the surface in the strongest relief.  From its singular and striking appearance, the name of visible pulsation is given to this beating of the arteries….

            Corrigan also recognised that the hypertrophy of the heart which accompanies this condition is compensatory in nature.  Although he was not the first to describe the pathology of aortic incompetence, his paper was the most lucid on the subject up to that time.  Soon physicians around the world, including Armand Trousseau in Paris, began to speak of Corrigan’s Disease, and the eponym first appeared in print in 1839 in La Lancette Française.  Corrigan made another very significant contribution to cardiology in 1838 when he published his paper ‘On aortitis, as one of the causes of angina pectoris’.

            In 1837 Corrigan was appointed physician to the Cork Street Fever Hospital and three years later he joined the staff of the House of Industry Hospitals (Richmond Hospital).  At an evening meeting of the College of Physicians in March 1838, Corrigan read a paper on ‘Cirrhosis of the lung’ during which he described a disease process whereby ‘Contraction of the fibres of the fibro-cellular tissue obliterates the small air-vesicles’.  This was published subsequently in the Dublin Journal of Medical Science and it contained a number of original observations on pulmonary fibrosis.  He described the condition as cirrhosis, preferring, he said, to add an additional fact rather than a new name to the science of medicine.  Corrigan was the first to question the generally accepted view that lung fibrosis was secondary to bronchiectasis.  He pointed out that the reverse may be the case.  He also claimed that fibrosis of the lungs could occur in patients who were not suffering from tuberculosis.  His new ideas formed the basis of subsequent work on pulmonary fibrosis and bronchial dilatation.

            Corrigan invented a number of items of equipment including an inhaler and a special bed for immobilised patients.  The bed worked on the same basic principle as the modern ripple bed.  The base of the bed was formed by a series of leather straps which could be released and tightened as required, so that one could alternate the areas of the body taking the pressure.  He designed an instrument known as Corrigan’s Button, which was a small circular metal plate with a handle.  It was heated before use, then run along the course of the sciatic nerve as a counter irritant in the treatment of sciatica.

            In 1843 Corrigan sat the examination for membership of the Royal College of Surgeons of England.  The first and only question asked of him was, ‘Are you the author of the essay on the patency of the aortic valves?’  His reply in the affirmative admitted him to the college.  Corrigan was black-balled, however, at an election for an honorary fellowship of the Royal College of Physicians of Ireland in 1847.  Around this time he had been criticised by Graves because he was a member of the government’s Board of Health.  Graves was furious over the Board’s miserly attitude to the dispensary doctors who worked in such dangerous conditions during the height of the famine epidemics.  It was an unfortunate rift between the two great men as it would appear that inadequate government measures lay at the root of the problem, and Corrigan himself had been very critical of the authorities.  However, it is almost certain that it was Graves’ censure which lost Corrigan the fellowship.

            The decision was probably regretted and in 1849 Corrigan received an honorary MD from Trinity College.  Six years later, in 1855, Corrigan submitted himself for examination to become a licentiate of the Royal College of Physicians of Ireland and he was successful.  A year after this courageous act he proceeded to the fellowship, as there was now no academic bar since he possessed a Trinity MD.  While the model of a charitable physician, his personality, ‘bold and decisive … not infrequently embroiled in public controversy and he was not in anything remarkably tolerant’, did not smooth his path.  Nevertheless, in 1859 he was elected to the office of president of the College of Physicians.  He was a dynamic president and during his five-year term of office the college acquired its fine premises in Kildare Street, where it is still based today.  Corrigan introduced legislation removing the restrictions which limited entry to the fellowship.  It became possible for the college to elect as fellows, graduates of any university in Ireland or Great Britain or any foreign university, and licentiates who might not have university degrees but who merited the fellowship by other distinction.  During his presidency the college also became the first in these islands to admit women to the licence examination, thus enabling them to be entered on the medical register.  Corrigan also promoted the interests of the Pharmaceutical Society of Ireland, of which he was the first president.  Corrigan’s reforms ushered in a new era for the College and major changes took place particularly in medical education, with the introduction of surgery and midwifery into the curriculum.  He commanded the respect of many of his colleges:

Success was obtained by him, not by the patronage of wealth or power, servility, or affectation.  He had no faith in any such wretched extrinsic influences.  The only patron he looked to for advancement was his own professional character.  Such a man naturally exercised an influence that was almost marvellous on all with whom he came in contact; and there were few subjects on which you could converse with him on which he did not throw a new ray of light, which clearly illuminated that which perhaps before had been in obscurity.

            During his early and difficult years Corrigan had been encouraged by reading The lives of British Physicians, from Linacre to Gooch.  In later years he referred to it as proving that ‘There is but one road to excellence and success in our profession and that is by steady, sturdy and hard labour’.

            Corrigan had the most lucrative private practice in Dublin.  He lived in Merrion Square and he rode every day to the Richmond on horseback.  He was very much aware of the dignity of the physician and he objected once during a domiciliary consultation when he and the patient’s practitioner were shown into a cold room without a fire after seeing the patient.  On another occasion a nervous woman with a minor gastric complaint asked her surgeon, Mr Charles Coppinger, to bring Sir Dominic Corrigan with him in consultation:

When Sir Dominic, after examining the patient and having had a short consultation with Coppinger, returned to her room, she asked him to tell her exactly what he thought was the matter with her.  ‘Oh! the matter with you, madam,’ said Sir Dominic, and having paused and looked through the window for some seconds he pointed to the region of her stomach and said: ‘You’ve got a little em-porium there.’  The lady thanked him and seemed quite satisfied.  On his way to his carriage he said to Coppinger:  ‘It is a great mistake to give that kind of person too much information.’  On going back to take farewell of his patient, Coppinger, happening to look through the window, saw a painter putting the finishing touch to the word ‘Em-porium’ on a shop front at the opposite side of the street.

            In 1862 Corrigan published a book entitled Ten Days in Athens with Notes by the Way.  It is a journal of a visit to Greece the previous year when he was accompanied by his daughter.  As well as describing the antiquities of the countryside, Corrigan took the opportunity to visit hospitals.  He was in Athens in early September and he visited the Military Hospital where he discussed therapeutic problems with the medical officers:

‘Among all the gratifications of life,’ he wrote in his diary that evening, ‘I know of none greater than learning some new mode of curing diseases or relieving pain.  It is a pleasure unalloyed by any other consideration, and sought for itself alone.’

The travellers returned through Florence and again Corrigan took the opportunity to make a detailed study of the hospital system of the city.  He was impressed by the clinical school of medicine where the salaries of some of the doctors were being defrayed by the state, thus allowing them time to concentrate on teaching.  Although the city was well provided with beds, he was critical of the care and he was not reticent about voicing his disapproval whenever he thought the situation demanded it:

A gentleman accompanied me in my visit who was connected with the government of the hospital.  He asked me was I not greatly pleased with the floors, the cleanliness, etc.  My reply was, passing my foot across a ventilator under the head of a patient’s bed, and lifting it for his inspection, with a large, thick cobweb covering my shoe.  I could not sacrifice candour to politeness.

            In 1866 Corrigan was made a baronet partly as a reward for his services as Commissioner of Education for many years, and four years later he was elected to Parliament at Westminster as a Liberal for five years after 1869 (1870-74).  He was defeated for re-election in 1874 by the liquor interest which he had antagonised by supporting the Sunday Closing Bill.  In an address to the British Medical Association in 1867, urging higher standards in medicine, he gave an insight into his own philosophy when he said. ‘And among the bonds that unite the three divisions of this our kingdom together, there are none stronger than those of our profession, soaring in its exercise above all sectarian discords.  We know no difference of race, or creed, or colour, for everyman is our neighbour.’

            As a politician he championed non-denominational education and he opposed Home Rule for Ireland.  He served as president of the Royal Zoological Society and in 1871 he became vice-chancellor of the Queen’s University in Ireland.  He devoted much of his energy to medical reform, he fought to improve the working conditions of dispensary doctors and he was an original member of the General Medical Council.

            Corrigan retired from active politics in 1873 and began to spend more time at the magnificent country residence which he had built in Dalkey, Co. Dublin, on the coast south of Dublin.  The Tudor-style house, which he called Inniscorrig, was erected right on the shore, with its own private slip-way.

            Corrigan became seriously ill at his residence in Merrion Square on 30 December 1879.  He was seen by Dr Francis Cruise who diagnosed a stroke.  Although incapacitated, Corrigan survived another month, during which time Cruise slept in an adjoining room so that he would be in a position to render immediate assistance.  Corrigan finally succumbed on 1 February 1880.  Later in the same year the surgeon Sir William Stokes gave the customary introductory address to the students in the Richmond Surgical Hospital at the opening of the teaching session.  During his address he recalled the deaths of Adams and Smith some six years earlier and then went on to say:

To-day we have another loss to deplore, one sustained more recently, that of Corrigan — three men who had all passed the line that separates eminence from greatness, who in any walk of life would have been distinguished; men who in disposition and tastes widely differed from one another, as widely as it is possible for men to differ, but, at the same time, similar in one respect, similar in having one great motive, one noble aspiration, one goal that was their ambition to reach, and that was to elevate and advance in these hospitals, by original research and philosophical eclecticism, the sciences of medicine and surgery, sciences to which almost from their very boyhood they were devoted.

(src:  Irish Master of Medicine by Davis Coakley; The Catholic Encyclopaedia; The Royal College of Physicians of Ireland)

Medical contributions – Associated eponyms:

Corrigan’s disease  –  Description:  Reflux of blood through an incompetent aortic valve into the left ventricle during ventricular diastole.  This eponymic term for aortic heart disease was introduced by the French internist Armand Trousseau (1801-1867).

Corrigan’s pulse  –  A jerky carotid pulse having a full expansion that appears to collapse and be completely empty between beats.

Description:  A jerky carotid pulse having a full expansion that appears to collapse and be completely empty between beats. An important diagnostic sign of aortic insufficiency – regurgitation and hyperkinetic circulatio – and in open ductus arteriosus Botalli. May also occur in Basedow’s disease. Usually asymptomatic for long periods of life span. Great prevalence in males. This eponymic term is hardly used any longer.  The condition was first described by Thomas Hodgkin (1798-1866).

Corrigan’s respiration  –  Description:  A shallow respiration in fever.

Corrigan’s sign  –  A clinical sign pathogonomic of chronic copper poisoning.

Description:  Purple line on the gum. A clinical sign pathogonomic of chronic copper poisoning. The term is no longer commonly used.

Hamman-Rich syndrome  –  Also known as:  Corrigan’s cirrhosis, Usual interstitial pneumonia of Liebow, Liebow’s pneumonia

Previously used term for acute diffuse idiopathic interstitial pulmonary fibrosis of unknown aetiology.

Description:  Previously used term for acute diffuse idiopathic interstitial pulmonary fibrosis of unknown aetiology. Insidious onset followed by respiratory embarrassment, fatigability, loss of weight, cyanosis, right-sided heart failure and other abnormalities. It is usually fatal. Both sexes affected; slight male predominance; onset over broad age range, but highest incidence between 40 and 70 years of age. Aetiology unknown. Familial, autosomal dominant inheritance.

First described by Sir Dominic John Corrigan (1802-1880) in 1838, in 1897 by Georg Eduard Rindfleisch (1836-1908) as «cirrhosis cystica» and in 1915 by David Paul von Hansemann (1858-1920) as «lymphangitis reticularis».

Associated persons:  Sir Dominic John Corrigan, Louis Virgil Hamman, Averill Abraham Liebow, Arnold Rice Rich