William Gladstone (Prime Minister) is reputed to have said that he divided people into two classes, "Those who had and those who had not heard of James Paget".
James Paget was slightly built, of medium weight with a long face and bright eyes. He was a gifted orator and was regarded as the finest lecturers in his area of expertise. He admired brevity and was famed for it. One of his favourite epigrams being "To be brief is to be wise". Among his many other friends of various backgrounds were John Ruskin, Cardinal Newman, Alfred Lord Tennyson, Louis Pasteur, Florence Nightingale, Thomas Henry Huxley, and Charles Darwin who were the intelligentsia of the time.
In Pathology he had mastered the major English, French, German, Dutch and Italian tests on the subject and was the equal of any man living when it came to knowledge of the subject. James Paget had a close contacts with German science and was a life-long friend of Rudolf Virchow. He and Virchow may truly be called the founders of modern pathology; they stand together. Paget's Lectures on Surgical Pathology and Virchow's Cellular-Pathologie were unrivalled. It was due to Paget that Virchow came to London to give his famous address on the importance of pathological experiments. Paget was an ardent enemy of orthodox influence in medicine, advocating the scientific approach, and fighting the antivivisectionists.
James Paget married Lydia North in 1844 and they had six children. "In May 1844, I married, and began to enjoy that happiness of domestic
life which has already lasted without a break, without a cloud, for 39 years. From this time, the "being alone" was the being alone with one
who never failed in love, in wise counsel, in prudence and in gentle care of me. With her it was easy to work and be undisturbed by anything
going-on around me; a habit I can advise everyone to learn ....... she wrote for me, copying for the press my roughly written manuscripts,
sitting with me till midnight or far into the morning."
Memoirs and Letters, Part 1, Chapter VII.
In 1851 James Paget began private practice near Cavendish Square his ultimate success resting on his charming personality as much as his anatomical-pathological knowledge and surgical skill. His reputation grew to the point where in 1858 he was appointed Surgeon Extraordinary to Queen Victoria, and in 1863 Surgeon in Ordinary to the Prince of Wales. He had for many years the largest and most arduous surgical practice in London. His day's work was seldom less than sixteen or seventeen hours. Cases reffered to him for his analysis were mainly tumours and all kinds of diseases of the bones and joints.
Despite earning £10,000 per annum from his practice James Paget continued to make notable scientific contributions as well as to write important books on surgical pathology and tumours. He never forgot his family responsibilities taking fourteen years to to help pay off his father's debts.
His fame rests on his descriptions of several diseases, the most famous of which is Osteitis Deformans, which he described in 1877. His patient was a man with progressive bone deformity whom he had first seen in 1856. Paget described enlargement of the cranium, anterior curving of the spine, which produced a Simian stance, and bowing of the legs. In 1872 the patient's vision was impaired by retinal haemorrhages and deafness developed. At autopsy the bone was so soft that it could be cut by a razor. James Paget was also one of the first to recommend surgical removal of bone marrow tumours (Myeloid Sarcoma) instead of amputating the limb which was normal procedure at the time.
Although he retired from surgery when aged sixty four, he continued to see patients in Consultations, and, as late as 1891 he travelled to Rome as an advisor. He died in London in 1899 at the age of eighty five. His burial service which was held at Westminster Abbey was conducted by his son, who was Bishop of Oxford. Another son, Stephen Paget (1855-1926), was well known for his work in experimental medicine and in 1908 founded the Research Defence Society.
Stephen Paget wrote of his father: Sir James Paget had the gift of eloquence, and was one of the most careful and most delightful speakers of his time. He had a natural and unaffected pleasure in society, and he loved music. He possessed the rare gift of ability to turn swiftly from work to play; enjoying his holidays like a schoolboy, easily moved to laughter, keen to get the maximun of happiness out of very ordinary amusements, emotional in spite of incessant self-restraint, vigorous in spite of constant overwork. In him a certain light-hearted enjoyment was combined with the utmost reserve, unfailing religious faith, and the most scrupulous honour. He was all his life profoundly indifferent toward politics, both national and medical; his ideal was the unity of science and practice in the professional life.