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Langdon Down’s health broke down before he could savour the opportunities of his post. The description of his symptoms suggests that he developed tuberculosis. Over the next three years he made a slow recovery. When he had recovered he worked again in the family business. As an employee he was paid £50 a year (approximately £3,000 today). When his father died in 1853 he decided he would have no more of it. He had saved enough to pay his medical school fees and he resisted family pressures to stay in Torpoint. The family had even gone so far as to make him joint owner of a cottage. The death of his father relieved him of the filial duty of support. Working in a business in which he was highly qualified but playing second fiddle to his brother, who had no formal qualification, was clearly a recipe for disaster. If he could not do medicine he would become an analytical chemist.

His sister Sarah had, by good fortune, met and married Philip Crellin, in 1849. Sarah had probably been back to London where her grandfather had retired to live in a large property in Hackney. The bond between the couple was their Non-Conformist church work and activity. Philip and Sarah gave Langdon Down the help he needed. They brought him to stay with them and gave him board and lodging through his years as a medical student. This made it possible for him to enter the London Hospital, one of the hospitals with higher student fees.

In his final year in Torpoint Langdon Down was the winner of an essay competition on the subject “Nature’s Balance; on the wisdom and beneficence of the Creator as displayed in the compensation between the animal and vegetable kingdoms”. The idea of a prize essay on this subject derived from a legacy of £8,000 left by the Earl of Bridgewater to the Royal Society to fund tracts which would counter the new element of dissent from traditional concepts of creation. Langdon Down presented a copy of his essay to Philip Crellin’s sister Mary. She studied it closely underlining the text as she went along. Their introduction in the Crellin household laid the foundation of a life long relationship.