Cheyne, John (1777–1836), physician, was born 3 February 1777 in Leith, Scotland, into a family of sixteen children; his father, ‘a man of great cheerfulness, benevolence, good sense, and singleness of mind’, practised medicine, and his mother was a daughter of William Edmonton, fellow of the College of Surgeons of Edinburgh. He was educated at Leith Grammar School and the High School of Edinburgh, before apprenticeship to his father, a medical practitioner, at the age of 13, and early attendance at the medical school of Edinburgh University. He obtained a medical degree (June 1795), and took a diploma at Surgeons' Hall.
Because of his height, ‘big John Cheyne’ looked older than 18. He obtained an appointment as regimental mate on 26 February 1795 and was promoted assistant surgeon to the Royal Regiment of Artillery in 1797. Posted next to Ireland, he was present at the battles with insurgents at New Ross and Vinegar Hill in June 1798. Before long he realized that he was frittering away his time in trivial leisure pursuits. He left the army in 1799, took an appointment at the ordnance hospital in Leith fort, and worked as assistant in his father's practice. He kept detailed records and whenever possible performed autopsies on fatal cases, being helped in this by Charles Bell (later knighted), from whom he learned a great deal.
His ambition was to be the leading physician in a large city. Opportunities for advancement in Edinburgh did not appear favourable, but certain comments about the situation in the Irish capital encouraged him to set up in Dublin. Towards the end of 1809 he took a house in Ely Place, moving later to 6 Merrion Square. He married Sarah Macartney, daughter of an Armagh clergyman; they had sixteen children.
Like most newcomers he was slow to attract patients, and during a six months period earned only six guineas. His appointment to the Meath Hospital (1811) brought an improvement. His fees amounted to £472 in 1812, and as if to confirm that success breeds success he was elected professor of medicine at the Royal College of Surgeons in Ireland. By then he was the author of three books published in Edinburgh: Essays on the diseases of children (1801–8); Essay on hydrocephalus acutus, or dropsy of the brain (1808); and The pathology of the membranes of the larynx and bronchia (1809).
Cheyne became physician to the House of Industry hospitals in October 1815. Many of his patients were local labourers, servants and the like, wasted by fever but basically strong. A significant number, however, were in a different category, broken and infirm from age and intemperance, or grossly disabled and diseased. After settling in, he took steps to reorganise the nursing service. His instructions, published (1817) in a new journal established by Cheyne and his colleagues, the Dublin Hospital Reports, are the first recorded attempt at education of nurses in Ireland. An article by Cheyne in the same journal (‘A case of apoplexy in which the fleshy part of the heart was converted into fat’, 1818), contained a description of disordered breathing: ‘For several days his breathing was irregular; it would cease for a quarter of a minute, then it would become perceptible, though very low, then by degrees it became heaving and quick, and then it would gradually cease again: this revolution in the state of his breathing occupied about a minute, during which there were about thirty acts of respiration.’ When William Stokes referred to a similar disorder in 1846, the eponym ‘Cheyne–Stokes breathing’ was created.
Cheyne's private practice continued to grow; he earned £1,710 in 1816, and so that this carefully cultivated success should not be at risk, he withdrew from the Meath Hospital in 1817, and from the chair of medicine in the College of Surgeons two years later. A glittering prize was still to be won: the post of physician-general to the army in Ireland, a situation that became vacant in 1820. Cheyne was appointed on 17 October to this post, which conferred the highest medical rank in Ireland. Eventually he attained an income of about £5,000.
Consumption was the commonest cause of death among soldiers serving in Ireland, and Cheyne recommended examination with the stethoscope (a recently introduced device), together with percussion of the thorax, for every army recruit whose chest was poorly developed, before his acceptance for service. His ‘Medical report of the feigned diseases of soldiers’ took the form of a letter to George Renny, MD, director-general of military hospitals in Ireland, from the physician-general (Dublin Hospital Reports, iv (1827), 123–81). He had treated sick soldiers throughout his professional life and felt entitled to speak authoritatively of malingering (a form of deceit that Cheyne pronounced to be ‘an intolerable nuisance’) and the difficulty of detecting it. From his researches he learned that factitious ophthalmia resulted from irritation with quicklime, tobacco infusion, silver nitrate, cantharides ointment, a gonorrhoeal discharge, etc. A rupture could be simulated by puncturing the scrotum with a corking pin, blowing it up with air by means of a piece of tobacco pipe, and reducing inflammation with a warm poultice. Paralysis was readily feigned.
Cheyne was affected by endogenous depression in 1825. As a therapeutic exercise he wrote Essays on partial derangement of the mind in supposed connexion with religion (1843), which contains his ‘Autobiographical sketch’. He wished to show that mental upsets ‘are invariably connected with bodily disorder’ and that the ‘moral treatment for the insane’ then favoured, was unlikely to succeed until attention was directed to the postulated physical cause. He retired in the early 1830s to Sherington in Buckinghamshire, England, where one of his sons was living, and (deciding it better to wear out than to rust out) he made his services available to the locals on three mornings in the week. On another morning patients came from distant parts. He also contributed to The cyclopaedia of practical medicine, until a cataract in his right eye prevented this occupation (1833). He died 31 January 1836, leaving explicit instructions for his burial. There was to be no tolling of church bells, but in order that the bellringers should not feel deprived, they might be given an order for bread equal to the amount due to them; they should not be given money to spend in the alehouse. Portraits of Cheyne by Sir Henry Raeburn and William Deey are in the RCSI and the RCPI respectively.