The humane society movement and the transnational exchange of medical knowledge in the late eighteenth and early nineteenth centuries

Introduction

Humane societies were charities whose focus was the recovery of apparently dead persons, through the use of resuscitation techniques. As charitable societies, their founders and managing committees were typically middle-class men who gave their time and energy in a voluntary capacity, and the funding of the organisations derived from voluntary sources of income – subscriptions, donations, bequests and charity sermons. Humane societies embraced advances in technological and medical knowledge, and pioneered the use of life-saving equipment and techniques. By far the majority of cases that came to the attention of the societies were drownings or near drownings, with societies’ published reports often carrying illustrations of devices, such as life buoys, ice ladders and designs for lifeboats. Yet, these charities also devoted attention to the recovery of persons apparently dead through hanging and other forms of asphyxiation.

Humane societies were established throughout Europe and North America in the late eighteenth and early nineteenth centuries: the first in Amsterdam (1767), followed by similar initiatives in Milan, Venice, Hamburg and Paris in the following 4 years.1 The translation by Thomas Cogan into English of the Amsterdam society’s Memoirs in 1771 influenced the foundation of the London association, the Royal Humane Society (RHS), 3 years later.2 By the turn of the nineteenth century, there were humane societies operating throughout Britain, Ireland, Europe and North America, constituting just one part of the expanding associational world, which, as James Kelly and Martin Powell have asserted,3 ‘created the foundations for the emergence of what is now denominated civil society’ (p. 11). The historian Amanda Moniz4 has identified more than 40 humane societies in existence throughout the Atlantic world between 1784 and 1805 (p. 152). In addition to the main continental cities wherein these life-saving initiatives were established, societies were to be found in Edinburgh, Aberdeen and Glasgow, as well as London, Bath, Bristol, Falmouth, Hull, Liverpool and Suffolk, to name but a few locations. In Ireland, at least six societies were established in a 20-year period, reflecting the ‘strengthening philanthropic impulse’ that historians have identified in late eighteenth- and early nineteenth-century urban centres,5–7 as well as mirroring philanthropic trends among the middle classes internationally. The Irish societies were located in Cork (founded in 1787), Dublin (1788), Limerick (c. 1793), Lisburn (1808), Derry and Newry.

Numerous ‘movements’, whose members were actively concerned with improving the moral and temporal state of the population, especially the lower classes, spread throughout the Atlantic world in this period. The increased zeal for moral reform was driven by, among other factors, the expanding associational culture of the urban middle classes, the rise in religious evangelicalism, fears of the spread of political discord from revolutionary France and Malthusian predictions of unsustainable demographic growth among the labouring classes. The movements for social and moral reform that flourished at this time included Sunday schools,8 fever hospitals,6,9 mendicity societies10 and Strangers’ Friend Societies.11,12 Each of these networks of societies constituted a transnational ‘movement’, in that institutions sharing mutual objectives, worldviews and strategies, founded by persons from similar social backgrounds, corresponded with each other, exchanging ideas, advice and items of material culture, such as printed reports. This transnational correspondence allowed for the promotion and drawing upon of precedent-setting methodologies and the development of a common approach to the societies’ respective challenges. The tackling of social and moral ills through associational means was also influenced by the prevailing religious sentiment of the time. Religious revivals had been witnessed throughout much of Europe and North America, especially in Protestant regions, and the increasing zeal placed on the importance of saving souls, most notably in regard to the prevention of attempted suicide by drowning, manifested itself in the emerging humane society movement. Humane societies’ successes in reviving apparently drowned persons drew an obvious parallel with the resurrection of Christ and the redemption of mankind, and this sentiment is reflected in the RHS’s 1786 report: ‘It may be proper to observe that the Humane Society has extended its views beyond the grave: for in giving new life to the expiring corpse, they have likewise endeavoured to re-animate the mind, and awaken it to a sense of reverential gratitude to the Great Giver and preserve of Life’. While the RHS set out stringent guidelines on the manner in which the near-drowned person’s body was to be treated upon rescue, the saved person’s soul was also attended to, through the gifting of a bible and devotional texts, reminding these individuals ‘of the obligations they owe to the Supreme Being’ (p. 218).13

Among the most active contributors to transnational discourses on social and moral improvement in this period were medical practitioners, especially physicians and surgeons. Medical gentlemen were typical of the increasingly powerful middle classes who took an active role in civic affairs and embraced the prevailing associational culture of the period through active membership of voluntary organisations, ranging from intellectual societies to charities. There are a number of reasons for medical practitioners’ prominence in the establishment of humane societies. On the one hand, these men wished simply to dedicate time and resources to the saving of lives; instances of drowning also provided physicians and surgeons with opportunities to administer the latest resuscitation techniques and use the most innovative equipment, thus expanding their skillset and professional standing. What also cannot be denied is that for medical gentlemen, eager to stress their enlightened middle-class notions of sensibility, an appointment to or involvement with a medical charity ‘enhanced professional reputations and advanced career and social prospects’ (p. 5).6 Practitioners’ work with charities was typically carried out on a voluntary basis, carrying no salary, but raising one’s standing within his community and his profession, and exposing him, through the society’s officers and subscribers, to prospective clientele for their private practice. Laurence Geary has noted that medical charity was both social lubrication and social obligation,2,6,14 while Richard Bell, writing about late eighteenth-century America, has observed:15 ‘doing good not only felt good, it also looked good. The business of benevolence was performative: participation [with humane societies] allowed the ostentatious display of humanitarian concern and financial largesse for the purposes of concentrating authority and calibrating status’ (p. 89). Wherever humane societies were located, medical men were invariably among the founders. The RHS was established by the physicians Thomas Cogan and William Hawes (p. 5),16 while the physicians and surgeons of the Dublin General Dispensary were founding members of the city’s humane society, undertaking to treat any case of apparent death by drowning or other accident at the dispensary’s premises in Temple Bar, a short distance from the River Liffey quays (pp. 8–12).17 The Lisburn Humane Society was established in 1808 by ‘the medical men, and a number of other active persons in that town and neighbourhood’.18,19 It was common for dispensaries to be attached to humane societies, as seen in Dublin, Lisburn and Cork, and this was the case also in Edinburgh, where the Edinburgh and Leith Humane Society was instituted in 1784, to which a separate dispensary was added in 1816 before both institutions were united in 1825.20

The transnational movement

Founded in 1774 as the Society for the Recovery of Persons Apparently Drowned, changing its name to the Humane Society and later to the RHS, the London organisation publicised ‘skills in rescue techniques, especially in accidents with water, though in other sorts of apparent sudden death too … the Society supplied equipment, awarded prizes, and published pamphlets, advocating mouth-to-mouth resuscitation, tobacco clysters, electric stimulation and the importance of rubbing and keeping warm’ (p. 97).21 The RHS served as a parent body within the Irish and British manifestation of this transnational movement. Dr Joshua Dixon, the leading figure behind the humane society in the north-western English coastal town of Whitehaven, observed of the London organisation:

‘Your HUMANE SOCIETY, from which originates every similar institution, may be justly deemed their PARENT; or rather as the centre of exalted Philosophy, whose rays, with genial energy, are directed to a boundless circumstance. EUROPE has long gratefully attested its benignant exertions, and AMERICA, &c. experienced its beneficent and revivifying influence’. (p. 38)22

The RHS grew into one of the most successful and influential charitable societies in Britain, and its influence can be identified through the succession of published letters from individuals throughout the English-speaking world, describing instances of successful revivals of apparently drowned persons using the means adopted by the London society. Many figures in the humane society movement throughout Ireland, Britain and further afield corresponded with their counterparts in other countries, and it was this correspondence that constituted the foundation rock of a transnational humane society movement. This correspondence, much of which contained accounts of successful interventions in cases of near drowning, shaped the members’ sense of belonging to a wider movement in which similar motivations, methods, experiences and setbacks were discussed in a mutually supportive intellectual and associational environment.

British and Irish societies took their lead, in terms of founding principles and resuscitation techniques, from the London pioneers: for instance, the founders of the Suffolk Humane Society23 in 1806 resolved that ‘in consequence of the numerous accidents to which the eastern coast is particularly exposed, it is highly expedient to form a Society on the principle of the Royal Humane Society of London’ (pp. 7–8). Many societies in Britain and Ireland mirrored the RHS’s practice, itself based on initiatives undertaken in Amsterdam, Venice, Paris and Mainz,24,25 of distributing printed instructions as well as ‘animation boxes’ of equipment to ‘danger spots’, known for their high incidence of accidents and suicide attempts. The founding resolutions of the Dublin Humane Society included a declaration ‘that twelve Sets of necessary Apparatus be procured as speedily as possible, and that the Places where they are kept to be published, with the Name of such Gentlemen of the Faculty as are willing to attend the Objects of this Charity, when called upon’.26 In Dublin city the boxes were typically kept at public houses, apothecary shops and a hotel located along the quays, all places to which the public had easy access in the event of an emergency. In county Dublin boxes were to be found in Clontarf and Lucan, a seaside and riverside town, respectively, and were kept at the homes of prominent gentlemen. The RHS provided direct assistance in this respect to the Lisburn humane society upon its establishment in 1808, when the Ulster founders – the medical men of the town – acquired resuscitation apparatus from the London organisation, as well as copies of the RHS’s annual reports and other published works on the topic of suspended respiration.18

These boxes typically contained basic medical instruments, blankets and alcoholic spirits, as well as, crucially, printed instructions advising on the proper use of the apparatus and a list of rewards payable to rescuers. The inclusion of these items reflects the fact that the ‘animation boxes’ were intended for the use not solely of medical practitioners but also members of the general public (pp. 4–5).26 The equipment comprised easy-to-use items essential to life saving, the application of which was within the ability of most nonmedical persons, thus emphasising the humane society movement’s zeal to not limit this innovative medical knowledge, and associated material items, to the medical elite (p. 46).27 An interesting aspect of the work of humane societies was the universal reach of its endeavours – as Amanda Moniz28 has observed, ‘Anyone might drown, so all humanity was the object of the [humane society] movement’s concern’ (p. 637) – not only in the rescuing of all persons apparently drowned but in its goal to educate people of all social classes in the most innovative techniques in resuscitation. These methods were not intended to be the preserve of medical gentlemen, although the involvement of these practitioners was essential for the efficient running of these institutions. An early commentator29 on the work of the pioneering Amsterdam society praised the institution’s ‘principal objects … [as being] to instruct those, who happen to be present when persons, supposed to be drowned, are taken out of the water, in the best means that can be used for their recovery, and to excite them to make the attempt’ (p. 512). In its early existence the Amsterdam society reported that 150 persons had been saved within a 4-year period,30 ‘many of whom owed their preservation to peasants and people of no medical knowledge’ (p. 631). This theme of a universal duty to be able and willing to assist one’s fellow man was embraced by the physician Alexander Johnson (c. 1716–99), who was largely responsible for introducing the methods of the Amsterdam society into England. Writing in his 1784 work Relief from accidental death, Johnson asserted:

Those therefore, who neglect or decline giving such aid, will not only be considered deficient in an essential point of humanity, but in some measure as accessary to the patient’s death, by allowing the last spark of his life to extinguish: a reproach which no man can, upon the least reflection, allow to be laid to his charge; even under the prejudice than none but medical men can administer relief in such critical situations, as it is a sad apology for the loss of a life, that the medical assistant came too late. (p. 5)31

Instances of direct personal contact between members of humane societies strengthened the bond felt amongst these social improvers. One such instance of cooperation and exchange of ideas is revealed in the minute book of the Leith (Edinburgh) Humane Society, relating to a representation received by the London society from a gentleman attached to the Leith body:

Mr Coldstream laid before the meeting Remarks made by his son Mr John when in London upon the Receiving House and apparatus of the Royal Humane Society of London in Hyde Park which were read to the meeting. The meeting were highly gratified for the communication and requested Mr Coldstream to convey to his son their thanks therefore, and they directed these remarks to be put up with the other papers connected with the Humane Society.32

The pioneering Amsterdam society’s methods for resuscitation were cited in the influential medical guide, Domestic Medicine, first published in 1769 by William Buchan (1728/9–1805), a fellow of the Royal College of Physicians of Edinburgh, and republished in more than 140 separate editions, proving particularly popular in the USA.30,33 Members of humane societies typified the transnational nature of the middle classes’ associational culture and the key figure within this movement, in terms of the dissemination of information throughout Europe and the transatlantic world, was Dr John Coakley Lettsom (1744–1815), a founding member of the RHS (Figure 1). Lettsom was a Quaker physician who by the age of 40 years was operating perhaps the most lucrative private medical practice in London. As befitting a man of his education, social position and professional ambitions, Lettsom was involved in numerous philanthropic initiatives and corresponded with like-minded individuals throughout Britain, Europe and America, regularly enclosing copies of the RHS’s annual reports with letters to his friends and correspondents.33–35 For example, in the 1780s Lettsom was thanked by the newly formed Cork Dispensary and Humane Society for advice proffered to the nascent charity, and was described by the southern Irish city’s institution as ‘our corresponding physician in London’, as well as being enrolled as an honorary member.13,36 Lettsom’s exchange of these reports was not limited to like-minded colleagues in Ireland and Britain. In June 1797, Dr Struve of Görlitz in Saxony wrote to the English doctor, requesting the latest RHS reports as well as copies of English-language medical works:35 ‘I beg the favour of your sending me not only the second volume of the Transactions of the Royal Humane Society, but if it is possible, some of the newest English medical books, in order that I may translate them into German, to communicate in this way to my countrymen the literary treasures of Great Britain’ (p. 272).In the same decade Lettsom informed one correspondent:34 ‘Several Humane Societies are established in America, the West and East Indies, with which we correspond’ (pp. 23–6). Among Lettsom’s regular correspondents was the physician, philanthropist and member of the Philadelphia Humane Society Benjamin Rush (1746–1813), considered to be one of the ‘Founding Fathers’ of the USA, and their exchange of letters further reveals the transnational, and in this case the transatlantic, exchange of information and printed media (in the form of published reports) among medical men concerned with the rescue of persons apparently drowned.15,33,35 The importance of transnational networks between medical men at this time, especially those actively engaged with voluntary associations, such as the humane societies, was demonstrated in 1792 when Lettsom, along with Anthony Fothergill, was elected a foreign member of the American Philosophical Society; Fothergill later ceased his medical practice in Bath and moved to Philadelphia, becoming an active member of the Philosophical Society.33

The proliferation of humane societies represented a ‘movement’, in that institutions with common objectives were formed by individuals with shared social backgrounds, and driven by similar motivations. The evidence for the history of this movement supports Robert Morris’s description37 of voluntary societies as ‘networks of people in similar situations solving like problems and fulfilling like needs in an independent manner but conscious of each others’ existence’ (p. 104). Developing Morris’s point, we see that humane societies, while operating as autonomous charities, existed within an intellectual environment wherein the work of similar organisations was increasingly accessible and widely exchanged. The founding reports of these charities cited the influenced derived from earlier humane societies. As Richard Bell15 has observed of humane societies in the USA, ‘corresponding secretaries communicated constantly with sister societies throughout the Atlantic world, exchanging information that helped managers refine, perfect, and promote their life-saving techniques’ (p. 86). Societies included in their published annual reports case studies of specific instances and experiences, which served as widely distributed and frequently updated guides to best practice. These vignettes, together with accounts of income and expenditure, and statistical tables recording the numbers of persons relieved, ‘provided the public with a distinct impression of effectively targeted relief’.5,37

News of the work of existing organisations drove others into action and the precedent established by the early pioneers of this movement was noted by those lamenting the absence of a similar society in their own town or city. In March 1787 a meeting of the citizens of Cork bemoaned the absence of a humane society in the city, especially given the prevalence of uniquely local factors that highlighted the benefit of such an initiative:38 ‘so many lives have been saved by the exertions of these Societies in other places, that it is to be regretted, we have been so long without one in this City, where the number of quays without parapets, leaves the inhabitants so much exposed to these melancholy accidents’ (p. 3). In the same year a newspaper report of a death by drowning in Dublin city speculated: ‘Probably if proper methods were taken, the man might have been recovered; but as no body of men are formed here, similar to the Humane Society in London, all the advantages are lost of such an [sic] useful institution’.39 Two years later, the same newspaper, in an article highlighting the work of physicians in Liverpool in rescuing apparently drowned people using the means recommended by the London society, reminded its readers of the continued absence of a similar Dublin entity:

As accidents of the same nature frequently occur in this city, it were much to be wished that an association was formed on the benevolent plan of the several institutions of the kind in England. There are many persons of surgical skill and humanity who interest themselves on those occasions when they happen here; but the stimulus required to produce other immediate exertions in such cases is wanting, and we could wish was supplied by subscriptions of the affluent.40

The proliferation of printed media in the eighteenth century facilitated the rapid dissemination of ideas across national boundaries. Among the most popular and widely read works were medical texts, owing to the greater number of medical practitioners writing and publishing, as well as a growing appetite among the literate classes for knowledge on the natural world, especially the workings of the human body (p. 23).41 This period generated an expanding body of medical knowledge on the efficient treatment of drowning victims, as physicians throughout the Atlantic world contributed to a vibrant discourse on resuscitation techniques. Methods of restoring life to the apparently drowned that had been attempted by preceding generations of practitioners were now being subjected to systematic experimentation and, upon successful outcomes, widespread application (pp. 98–107).42 In 1792 the Irish-born physician James Curry (d. 1819), who served at Guy’s Hospital in London and was a member of the Royal Medical Society of Edinburgh, observed:43 ‘inflating the lungs has been long spoken of as one of the means that may be tried; but it is only within these few years, that it’s mode of operation has been clearly shewn, and the necessity for it’s assiduous employment properly insisted on’ (p. ix). Among the key contributors to this discourse on life saving and resuscitation was the aforementioned Anthony Fothergill, a physician who studied as a medical student at the University of Edinburgh, and who authored An essay on the preservation of shipwrecked mariners (London, 1799). This pioneering work on shipwrecks and methods for saving lives in such situations was awarded a gold prize by the RHS and established his expertise in this field, a fact marked by the granting to him of honorary membership by the Massachusetts Humane Society.33,44 Other influential figures were Alexander Johnson (c. 1716–99), a physician trained at King’s College, Aberdeen, who was largely responsible for promoting the work of the pioneering Amsterdam society in England33 and Charles Kite (c. 1760–1811), a surgeon who was a member of the Company of Surgeons in London and who published An essay on the recovery of the apparently dead (1788), for which he was awarded the RHS’s silver medal.33

Within a short number of years the RHS’s methods were being practiced by life-saving organisations throughout the Atlantic world, as well as by medical practitioners and lay people; they were promoted not only by members of the humane society movement but also in medical directories and handbooks. For instance, Butler’s medicine chest directory, published for Charles Butler MD of Sackville Street in Dublin, included a section on appropriate treatments for cases of suspended animation, based on the recommendations of the RHS.45 By the 1780s newspaper reports from across Britain and Ireland of rescues of drowned persons almost invariably make reference to the application of resuscitation techniques in line with the methods of the RHS.46–48

By highlighting the practices that were deemed to be without merit as life-saving techniques, humane societies were distinguishing between their own methods, which they saw as being grounded in rationality and science, and the irrational life-saving practices so commonly adopted by the general populace. The language used by humane societies in emphasising this distinction is illustrative of this conscious effort to demonstrate the efficacy of the societies’ methods. For instance, the Dublin Humane Society published accounts of drowning incidents in the summer and autumn of 1777 in which the ‘vulgar’ and ‘fruitless’ practices of the general public were reported, so as to highlight their inefficacy, as well as their danger to the victim. The society recalled the drowning on 22 July of a 3-year-old boy from Marrowbone Lane in the south inner city.26 Attempts to revive the boy, who had spent 45 min under water, continued for 2 hours before a medical practitioner was called upon and in that time, ‘all the Vulgar methods were used, such as rolling, shaking violently, with the Head downwards, &c. sufficient to destroy any Remains of Life’ (p. 14). Medical gentlemen eventually attended the scene but were not successful in resuscitating the boy. The report26 implicitly identified the ‘vulgar methods’ as contributing to the prevention of the victim’s revival (pp. 14–15). When 40-year-old Patrick Boyle was taken from the water on 9 August 1777, having been submerged for 1.75 hours, ‘the Populace treated him in their usual Manner’, proving ultimately unsuccessful (p. 14).26 The following day, a young sailor, who had spent 40 min in the River Liffey, was subjected to a litany of harmful practices by the supposedly ignorant public:

When the Populace had a Vein open in each Arm, thinking there appeared some Signs of Life in him, and performed several Experiments on him, such as searing him with a hot Iron, rolling him, &c. and when they had spent Half an Hour in these injurious and fruitless Attempts, they then brought him to the Baths, when (as was expected) all Endeavours for his Recovery were ineffectual. (p. 14)26

Such resuscitation methods contrasted sharply with those promoted by the Dublin Humane Society, drawing upon the well-publicised methods of the London organisation. When 45-year-old Richard Develin fell into the water at George’s Quay on 15 August, he was rescued and taken to the property of a nearby grocer, who kept a box of humane society apparatus on his premises. The victim’s successful recovery was attributed to the correct use of the humane society’s apparatus (p. 15).26 When a 12-year-old boy was taken from the water 4 days later, he ‘was not treated with any Violence, by rolling, or hanging his Head downwards, but kept in a natural Position, and by Friction, and inflating his Lungs, was in less than Half an Hour restored to Life’ (p. 15).26 Humane societies were, thus, seen as exercises in reason and good medical practice, as well as sensibility and civil duty.

Crucial to the work of the RHS was the public recognition of instances of life saving and bravery, and the rewarding of such courageous acts with medals and monetary sums. In his analysis of the social creation of heroes and the rewarding of courage in the nineteenth century Craig Peter Barclay persuasively argues that the RHS ‘used its medals … as a means of recognising the achievements of those who had furthered the aims of the awarding body’; prizes not only rewarded bravery but served to inspire others into similar acts of valour.27,49 The RHS’s prizes oftentimes crossed the Irish Sea, as the London parent body encouraged life-saving feats throughout the UK. For instance, in 1831 the RHS transmitted £10 and a gold medal to the crew of a Claddagh fishing boat, who rescued the crew of a merchant vessel stranded off the Galway coast in a strong gale;50 later in the same decade coastguard Owen Jones of Five Mile Point, County Wicklow, was awarded an honorary silver medal ‘for yr [sic] courage and Humanity in saving the crew of the “Noveau Destin” on the coast of Wicklow during a heavy gale’;51 in January 1840 a Mr Smyth was also awarded the society’s honorary silver medal ‘for yr [sic] noble courage and Humanity in plunging into the river Shannon and saving the life of S. Bindon Scott Esq on the night of the 11th of Augt last’.52 As well as highlighting and rewarding instances of courage in life-saving endeavours, the humane society movement also promoted new research into life-saving techniques and in 1822 the RHS advertised a prize gold medal, patronised by King George IV, ‘for the best essay of discovery … On the prevention of shipwreck, and the preservation of shipwrecked mariners’.53 The prize was funded through the bequest of Dr Anthony Fothergill, whose 1794 RHS research prize was awarded for his pioneering work on resuscitation techniques in cases of drowning.33 Although advertised in 1822, the medal was not struck or awarded until 1847.54

Conclusion

The emergence of humane societies in the late eighteenth and early nineteenth centuries can be located within a wider European and transatlantic context of the expanding realms of corporate philanthropy and associational culture, as well as the increased medical exploration of resuscitation techniques, especially in relation to victims of apparent drowning. Throughout Europe and the Atlantic world humane societies corresponded with their counterparts, sharing ideas and advice on organisational structure, appropriate medical interventions in cases of drowning and other accidents, and technological innovations in life-saving equipment, as well as developing a system of rewarding acts of bravery. The founders of the RHS in London were inspired by precedents set by earlier life-saving organisations in Europe and the promotion of the RHS’s resuscitation techniques drove the spread of this transnational humane society movement, fostered by an exchange of intellectual ideas and items of material culture.

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46 Hibernian Journal, 8 September 1780.

47 Saunder’s Newsletter, 1 April 1785.

48 Saunder’s Newsletter, 29 August 1793.

49 Barclay CP. “Our heroes of to-day”: the Royal Humane Society and the creation of heroes in Victorian Britain. In: Wendt S, editor. Extraordinary Ordinariness: Everyday Heroism in the United States, Germany, and Britain, 1800-2015. Frankfurt and New York: Campus Verlag; 2016. pp. 25–51.

50 Freeman’s Journal, 11 January 1831.

51 Berkeley Westropp to Owen Jones, 13 July 1839, p. 197 (London Metropolitan Archives, Royal Humane Society (RHS) Letter Book, LMA/4517/A/03/002).

52 Berkeley Westropp to R.C. Smyth, 17 Jan. 1840, p. 308 (London Metropolitan Archives, Royal Humane Society Letter Book, LMA/4517/A/03/002).

53 Dublin Evening Post, 19 November 1822.

54 Jones M. ‘The Fothergillian Medal of the Royal Humane Society’. Br Numismatic J 1984; 54: 248–62.