Graves, Robert James (1796–1853), physician and teacher, was born 28 March 1796 in Dublin, youngest of three sons and seventh among ten children of Richard Graves (1763–1829), author, professor of divinity at TCD, and dean of Ardagh, and his wife Elizabeth Mary, daughter of James Drought (c.1737–1820), professor of divinity at TCD. Educated at Downpatrick Diocesan School, Co. Down, and TCD, he became proficient in anatomy and pathology under the influence of James Macartney (qv), graduated BA with gold medal (1815), MB (1818), and MD (1841) (Dubl.), and was admitted licentiate of the (R)K&QCPI (1820). He studied in London, Edinburgh, and several European medical schools (1818–c.1820) and kept abreast of medical developments throughout his life. In Europe he had several adventures: he was imprisoned in Austria for ten days as a suspected spy, the authorities being sceptical that an Irishman could speak German so fluently; he also spoke fluent French and Italian.
Returning to Dublin, he became a leading figure in the celebrated Dublin school of medicine. Appointed physician at the Meath Hospital (1821–43), he immediately pioneered radical changes in medical care. He introduced the stethoscope to Ireland, which greatly aided the diagnosis of diseases. A dedicated and lively teacher, he transformed clinical instruction by the introduction of bedside teaching, which he had first encountered in Germany, impressing on his students the importance of practical knowledge rather than relying solely on medical theory. Under the supervision of a physician, the care of patients became the responsibility of senior students, who were taught to sympathise, communicate clearly with their patients, and treat rich and poor equally; they examined them, discussed diagnoses, suggested treatment, and made daily progress reports, a system that influenced clinical teaching throughout the English-speaking world, and which, together with the contribution of his colleague and friend Dr William Stokes (qv), attracted foreign students and doctors to the Meath Hospital, which became a renowned teaching centre.
Responding to a government appeal in September 1822, Graves led a team of volunteer doctors to the famine- and fever-stricken people of Galway and published a vivid account of his experiences in his ‘Report of the fever lately prevalent in Galway’ (Transactions of the Association of the Fellows and Licentiates of the King and Queen's College of Physicians, iv (1824), 408–38). He subsequently wrote frequently on the subject of fever, and revolutionised its treatment by advocating porter, wine, and a nutritious diet rather than the fasting previously prescribed. Delighting in the beneficial effects of this treatment, he suggested to his students that a suitable epitaph for himself would be ‘He fed fevers’ (Stokes, lix). Conscious of the way in which poverty and malnutrition contributed to the incidence of disease, he felt he owed it to his country to proclaim aloud the existence of this evil. Acutely aware too, of the sacrifice made by doctors in treating fever patients during the great famine (nearly 7 per cent of Irish doctors died in 1847), he published ‘A letter . . . relative to the proceedings of the Central Board of Health of Ireland’ (Dublin Quarterly Journal of Medical Science, iv (1847), 513–44), castigating the board, which included such eminent figures as Sir Philip Crampton (qv), Sir Robert Kane (qv), and Dominic Corrigan (qv), for mismanagement on many fronts, not least ‘for the gross neglect . . . and the paltry economy everywhere observable in the care of the sick’ (518) and for its derisory payment of an extra five shillings a day to doctors enlisted to fight the typhus epidemic, comparing it with the guinea charged by Crampton for a half-hour's consultation. He subsequently fulminated against the board for its failure to appreciate the contagious nature of cholera (which appeared in Ireland in 1849) and provide appropriate hospital accommodation for its victims.
Considered one of the most eminent teachers of clinical medicine of the nineteenth century, Graves was co-founder of the Park Street School of Medicine (1824), which became one of the most successful private schools in Dublin He lectured on medical jurisprudence, pathological anatomy, and the practice of physic, and was subsequently appointed king's professor of the institutes of medicine in TCD (1827–41), which embraced physiology, pathology, and therapeutics. A founding president of the Pathological Society of Dublin, he chaired its first meeting (1838). Established to promote the study of pathology and develop the diagnosis and treatment of diseases by relating pre-mortem symptoms to post-mortem findings, it was the first society of its kind and attracted visiting doctors: similar societies were quickly established in Europe and North America.
A prolific writer on many subjects, Graves contributed to the Dublin Hospital Reports and edited the fifth and last volume (1830). In 1832 he and Robert Kane co-founded the Dublin Journal of Medical and Chemical Science (subsequently the Irish Journal of Medical Science); Graves was subsequently co-editor and a regular contributor. It became important as a forum for Irish medical research, and brought international recognition to developments in Irish medicine. He was the first Irish doctor to publish regularly his lectures in the London Medical and Surgical Journal (1832–4) and in the London Medical Gazette (1837–8); collected and published as Clinical lectures (Philadelphia, 1838), they significantly influenced clinical teaching and practice in the English-speaking world. In the same year, one of Germany's most prestigious journals, Zeitschrift für die Gesamte Medizin, was dedicated to Graves.
When the cholera epidemic spread from India across Europe, reaching Ireland in 1832, the infectious nature of the disease was disputed; but Graves meticulously traced the progress of the epidemic along the chief lines of communication, clearly demonstrated its infectious nature, and was responsible for the widespread use of lead acetate in Ireland in treating cholera. He recommended the establishment of medical observatories to study the onset and symptoms of epidemics and endemic diseases to prevent further propagation. He is most famous for his identification of exophthalmic goitre, ‘Newly observed affection of the thyroid gland in females’ (London Medical and Surgical Journal, vii, pt 2 (1835), 516–17), which became known as ‘Graves’ disease'; though it had been first described in 1786 by Caleb Hillier Parry (1755–1822), Graves's description was classically comprehensive. He was the first to practise pulse-taking and relate it to clinical conditions. His description of angioneurotic oedema, ‘Quincke's disease’, pre-dated Heinrich Quincke's by many years. In his great work A system of clinical medicine (1843; later editions were entitled Clinical lectures on the practice of medicine) he made original clinical observations on many conditions, including descriptions of peripheral neuritis, scleroderma, and erythromelalgia. Translated into German, Italian, and French, it became a standard work in Europe and North America. In his preface to the French edition (1862) the eminent physician Armand Trousseau (1801–67) acknowledged that ‘of all the practical works published in our time, none [is] more useful . . . I have incessantly read and re-read the work of Graves; I have become inspired with it in my teaching’ (Stokes, lxii–lxiii).
Graves was elected fellow (1823) and president of the (R)K&QCPI (1843–5), MRIA (1826), FRS (1849), and honorary and corresponding member of many European medical societies. In 1843 he resigned from the Meath Hospital, but continued in private practice and remained consultant physician to the Adelaide and Coombe Hospitals, and Peter's Parish Dispensary.
Graves rarely engaged in politics, and had little sympathy with catholicism, catholic emancipation, or nationalist aspirations. A very private, deeply religious man with strong evangelical beliefs, he believed that ‘to create life is the attribute of God; to preserve life is the noblest gift man has received from his creator’ (Graves, 513). Tall, distinguished, scholarly and a well travelled man of wide interests, he was an able draughtsman, and as a young man travelled and sketched with J. M. W. Turner (1775–1851) in Italy. He also contributed erudite articles to the press, writing anonymously on the Hungarian revolution and the first Afghan war. During his last years he suffered from depression and for a period was estranged from his wife. He lived at 4 Merrion Square, Dublin; in 1852 he bought a country mansion, Cloghan Castle near Banagher, King's Co. (Offaly). He died 20 March 1853 at his home from cancer of the liver and was buried in Mount Jerome cemetery, Dublin.
Graves married first (1821) Matilda Jane Eustace (d. 1825); and secondly (1826) Sarah Jane (d. 1827), daughter of John Brinkley (qv), astronomer royal of Ireland; each of his first two wives bore him a daughter who died young. He married thirdly (1830) Anna Grogan (d. 1873); they had two sons – Richard Graves (1832–71), cleric, and William Graves, lieutenant-colonel in the 82nd Regiment – and four daughters. The youngest daughter, Florence, married Lt.-gen. Sir Lawrence Worthington Parsons (qv). His brother Richard Hastings Graves (1791–1877) was the rector of Brigtown, Co. Cork, and a theological writer; he published a complete edition of his father's works, The whole works of Richard Graves with a memoir (1840).
In 1863 William Stokes wrote a memoir of Graves, selected and edited many of his writings, and published Studies in physiology and medicine. Graves is honoured by a statue by Albert Bruce Joy (qv) in the RCPI, unveiled in 1877; a bust by John Hogan (qv) in the RCPI; and a portrait by Charles Grey (c.1808–1892), which hangs in the NGI. A bibliography of his writings is published in Selwyn Taylor, Robert Graves: the golden years of Irish medicine (1989).