Transcriber’s notes
As the title indicates, this book recounts the history of Moorfields
Eye Hospital over the first one hundred years following its founding
in 1805, the significance of which is that it was the world’s first
hospital created to service a single specialty, viz. ophthalmology. In
recent times, two more volumes have been published to bring the history
up to date but copyright constraints prevent them being available in
digitised format.
The text of this e-transcription has been preserved as in the original,
including inconsistent spelling (storey/story) and hyphenation
(inpatient/in-patient, and ‘retching’ being misspelt as ’reaching’
on p.165. Italic text is denoted by _underscores_ and bold text by
*asterisks*
THE HISTORY AND TRADITIONS OF THE
MOORFIELDS EYE HOSPITAL
PLATE I.
[Illustration: JOHN CUNNINGHAM SAUNDERS.
From an engraving by Anthony Cardon, after a picture by A. W. Devis.]
THE HISTORY & TRADITIONS
OF THE
MOORFIELDS EYE HOSPITAL
ONE HUNDRED YEARS OF
OPHTHALMIC DISCOVERY & DEVELOPMENT
BY
E. TREACHER COLLINS
CONSULTING SURGEON; MEMBER OF THE COMMITTEE OF MANAGEMENT;
FORMERLY, CLINICAL ASSISTANT; JUNIOR AND SENIOR HOUSE
SURGEON; CURATOR OF THE MUSEUM AND LIBRARIAN;
ASSISTANT SURGEON AND SURGEON
WITH TWENTY-SEVEN PLATES
[Illustration: Publisher's logo]
LONDON
H. K. LEWIS CO. LTD.
1929
DEDICATED TO THE MEMORY
OF THE
MEMBERS OF THE SURGICAL STAFF
OF THE
MOORFIELDS EYE HOSPITAL
IN THE YEARS 1883 TO 1887
TO WHOSE INFLUENCE AND INSTRUCTION
THE AUTHOR IS SO DEEPLY INDEBTED
PREFACE
Great traditions are the most valuable assets which a hospital or a
teaching establishment can possess. They give it a personality which
makes it beloved and respected. Traditions are made up of the energies
and enterprise of those who have gone before, and will live on from
generation to generation long after the bones of those who have created
them have crumbled into dust. The primary aim of this book is to put on
record the traditions of the Moorfields Eye Hospital for the benefit of
past, present, and future workers within its walls.
So intimately associated has this Hospital been with all the
discoveries and developments which have taken place in connection with
ophthalmology during the nineteenth century, that it was not possible
to write a history of the first hundred years of its existence without
giving an account of them also. By having done this, it is hoped that
the book may find a wider circle of readers than those for whom it was
in the first instance intended.
An endeavour has been made to give an account of events as they have
happened in chronological order, and by so doing to produce the effect
of a cinematograph film, rather than that of an album of photographs.
For the facts recorded, numerous different sources have been tapped.
Much information as to the commencement of the Institution has been
derived from Barnsby Cooper’s biography of his uncle, Sir Astley
Cooper. Great use has been made of the minute books of the Committee of
Management of the Hospital, and of its annual reports.
For biographical details, the _Dictionary of National Biography_ has
been consulted, and also the articles on the “British Masters of
Ophthalmology” which have been published in the _British Journal of
Ophthalmology_.
It has been said that “when a medical man begins to write on the
history of his subject it is a sure sign of senility.” The writer of
these traditions does not claim that his case is any exception to this
rule. In early life a man has to learn history. In middle life he is
engaged in making history; and it is in his later years that he becomes
best qualified to write history. It is then that, on looking back, he
obtains the most comprehensive view, and is able to regard objects in
their truest perspective.
In conclusion I have to thank the Committee of Management of the
Hospital for its permission to reproduce the portraits of several
former members of the surgical staff, which hang in its Board Room;
also the _British Journal of Ophthalmology_ for permission to use the
blocks of some of the illustrations which have been published in its
pages; and lastly my friend Mr. Frank Juler for kindly reading through
and correcting the proof-sheets.
CONTENTS
CHAPTER PAGE
I. THE FOUNDERS AND FOUNDATION 1
II. THE WORK OF JOHN CUNNINGHAM SAUNDERS 17
III. BENJAMIN TRAVERS AND SIR WILLIAM LAWRENCE 33
IV. REMOVAL TO MOORFIELDS 48
V. THE ROYAL LONDON OPHTHALMIC HOSPITAL 67
VI. THE INTRODUCTION OF INHALATION ANÆSTHESIA
AND OPHTHALMIC SURGERY 82
VII. THE DISCOVERY OF THE OPHTHALMOSCOPE 99
VIII. THE COMMENCEMENT OF “THE OPHTHALMIC
HOSPITAL REPORTS” 119
IX. GROWTH AND EXTENSION 132
X. ANTISEPTICS, BACTERIOLOGY, AND LOCAL ANÆSTHESIA 152
XI. THE SELECTION OF A NEW SITE, AND THE ERECTION
OF THE NEW HOSPITAL 168
XII. THE HOSPITAL IN THE CITY ROAD 190
LIST OF PLATES
PLATE FACING PAGE
I. JOHN CUNNINGHAM SAUNDERS _Frontispiece_
II. SHOWING THE SOUTH SIDE OF CHARTERHOUSE
SQUARE AND NO. 40 WHERE THE LONDON DISPENSARY
FOR CURING DISEASES OF THE EYE AND EAR
WAS FIRST OPENED IN 1805 14
III. SIR ASTLEY PASTON COOPER, BART., F.R.S. 34
IV. BENJAMIN TRAVERS, F.R.S. 38
V. SIR WILLIAM LAWRENCE, BART., F.R.S. 44
VI. THE LONDON OPHTHALMIC INFIRMARY AS FIRST
ERECTED AT MOORFIELDS IN 1822 52
VII. FREDERICK TYRRELL 62
VIII. JOHN SCOTT 65
IX. DR. JOHN RICHARD FARRE 73
X. JOHN DALRYMPLE, F.R.S. 78
XI. GEORGE CRITCHETT 86
XII. SIR WILLIAM BOWMAN, BART., F.R.S. 94
XIII. WILLIAM CUMMING 102
XIV. JAMES DIXON 105
JOHN CAWOOD WORDSWORTH 105
XV. JOHN WHITAKER HULKE 111
GEORGE LAWSON 111
XVI. SIR JONATHAN HUTCHINSON, F.R.S. 123
XVII. EDWARD NETTLESHIP, F.R.S. 140
XVIII. THE HOSPITAL AT MOORFIELDS AFTER THE ADDITION
OF A NEW WING IN 1868, AND A NEW STOREY
IN 1875 143
XIX. WAREN TAY 151
XX. JOHN COUPER 157
XXI. R. MARCUS GUNN 160
XXII. JAMES E. ADAMS 163
XXIII. A. QUARRY SILCOCK 167
XXIV. THE PLEASURE BATH, PEERLESS POOL, CITY ROAD 175
XXV. THE ROYAL LONDON OPHTHALMIC HOSPITAL IN
THE CITY ROAD, OPENED IN 1899 190
XXVI. SIR JOHN TWEEDY, LL.D. 202
XXVII. WILLIAM LANG 204
THE HISTORY AND TRADITIONS OF THE MOORFIELDS EYE HOSPITAL
CHAPTER I
THE FOUNDERS AND FOUNDATION
In the board room of the Royal London Ophthalmic Hospital hangs a
framed document in which the names of Saunders, Farre, and Battley are
associated as being the first promoters of the institution.
Who were these three men? What brought them together? And how came they
to establish an institution unlike any which had previously existed?
John Cunningham Saunders was born and bred in Devonshire; he first saw
the light of day at Levistone on October 10th, 1773. He went to school
at Tavistock and South Molton, and at the age of seventeen commenced a
five years’ apprenticeship to Mr. John Hill, surgeon, of Barnstaple.
It was during his apprenticeship that he had his first introduction to
ophthalmic surgery, for Mr. Hill, though only a country practitioner,
was bold enough in those pre-anæsthetic days to operate for cataract.
It was from him also that Saunders first learnt the value of the use of
belladonna for dilatation of the pupil. William Adams, who also became
an ophthalmic surgeon, was likewise a pupil of Mr. John Hill, but of
him more anon.
Saunders, at the expiration of his apprenticeship, came to London to
complete his medical education at the then combined borough schools
of St. Thomas’s and Guy’s Hospitals. The skill and diligence which
he displayed in the dissecting room, together with his deftness as a
draftsman, soon attracted the attention of Astley Cooper, who was then
rapidly rising into fame. On Cooper’s election to the chair of anatomy
in 1797, he offered to take Saunders into his house and make him a
demonstrator of anatomy on the terms shown in the following letter:
“Dear Sir,
“I ought long since to have informed you of my plan for the winter,
so far as it concerns you, and as I have been able to decide.
“It is my wish that you should lodge and board in my house. I have
informed you that I live in a plain and economical style, and that
you are only to expect a joint of meat and a pudding; if this will
satisfy you, a bed will be ready whenever you return to London.
“I can say nothing about the salary you are to receive, for I have
not been able to form any idea of what will be proper, or how much
you may expect; all I can say is that the sum shall be annually
increased, which at the same time as it may act as a stimulus to
you, and make it an object to proceed in your career, will be more
convenient to myself, because, if no stroke of adverse fortune
prevents it, my income must be yearly improving.
“It is my wish that you should dissect for lecture-work in
Comparative Anatomy, and assist in my preparations. With respect to
the first of these, the labour is certain, and all other occupations
and objects must yield to it; with regard to the latter, the quantum
of employment shall be guided by your feelings. It is a duty I have
performed, without injury to my health, with much amusement, and
great advantage.
“I am in hopes that you will have no objection to giving me three
months’ information if any other pursuit should lead you to quit the
situation, as otherwise, I may be unable to procure a substitute, and
suffer great inconvenience from the want of one.”
Saunders accepted the offer, and was shortly afterwards appointed the
demonstrator of anatomy at St. Thomas’s Hospital. His association with
Astley Cooper proved an exceedingly happy one, he on several occasions
being entrusted with the charge of Cooper’s patients during his absence
in the country. Saunders was evidently a good teacher, and possessed
of a most attractive personality, so that he became exceedingly popular
with the students, who on several occasions presented him with pieces
of plate as a token of their regard.
John Richard Farre was two years younger than Saunders, being born in
Barbados in 1775, where he was educated, and commenced the study of
medicine under his father. He came to England in 1792 to complete his
studies at St. Thomas’s and Guy’s Hospitals. The commencement of his
acquaintance with Saunders and Battley may best be given in his own
words:
“In 1792 I entered as a dresser at Guy’s Hospital. At that time Sir
Astley Cooper had, by his open manner, become well known among the
pupils, but I was not intimate with him, until after my return, in
1794, from the expedition in which I served under Lord Moria. I then
became more particularly acquainted with him in the following manner.
“About the year 1798, Sir Astley excited great zeal in the
prosecution of minute anatomy, and the order of the day became the
injection of the absorbents, and the dissection of parts concerned in
operations, especially those of hernia. It was at this time that my
acquaintance commenced with Mr. Saunders and Mr. Battley, who were
both engaged in the dissecting room. So earnest were we all in the
pursuit of the subjects above described, that Mr. Saunders and myself
became jaundiced, in consequence of the continually constrained
position to which we were subjected, while leaning over bodies under
dissection.
“Mr. Saunders also suffered from a punctured wound of the finger
received while dissecting, which was followed by extensive
inflammation of the arm; nor did this subside until nearly two
hundred leeches had been applied.”
Richard Battley was older than his two friends, having been born at
Wakefield in 1770; he was educated at the Grammar School there, and
subsequently became the pupil of a physician in that town. For a while
he studied at the Infirmary in Newcastle-on-Tyne, and came to London in
1795. Entering as a pupil at St. Thomas’s Hospital at the same time as
Saunders, a close and lasting intimacy sprang up between the two men.
Having thus brought these three men together from Devonshire, Bermuda,
and Wakefield to the dissecting room at St. Thomas’s Hospital, it next
becomes necessary to trace the circumstances which led them to start
the “London Dispensary for Curing Diseases of the Eye and Ear,” the
name by which the present “Royal London Ophthalmic Hospital” was first
known.
In 1800, when twenty-seven years of age, Saunders became anxious
about his future prospects. His ambition prompted him with the desire
to practise as a surgeon in London; probably also about this time
influences began to work which made him desire to settle down with an
assured income, so that he might enter into the state of matrimony.
There was little prospect of his obtaining any higher appointment
than that of demonstrator of anatomy in the hospital at which he was
working, the custom in the old-established hospitals at that time being
to select for the staff appointments a pupil of one of their surgeons,
and one who had been articled at the Royal College of Surgeons for
at least six years. Saunders had not been so articled, having served
his apprenticeship in the country. He was not, therefore, eligible to
compete against those who had proceeded in the recognised manner, no
matter how great his merits. This was pointed out to him by Astley
Cooper, who advised him in his own interests to seek some other means
of support. Saunders then resigned his post as demonstrator of anatomy
and took over the practice of a surgeon in Gravesend.
Astley Cooper, however, soon began to miss his able assistant, and
found that the other arrangements he had made, which had to some extent
caused Saunders to take offence, did not work smoothly. He therefore
wrote him the following letter, and induced Saunders’ friend Battley to
go to Gravesend to use his influence in persuading him to resume his
old post:
“LONDON,
“_July_ 28_th_, 1801.
“Dear Sir,
“I have so often explained my reasons for the change which I made
last winter at the Hospital, that I consider it as almost unnecessary
to say anything further upon the subject. The trial has been made;
Mr. D——has been weighed against you in the balance, and been found
wanting.
“His excessive vanity has disgusted, his want of perseverance has
disappointed me, and I feel most thoroughly convinced that his
abilities are inadequate to the task which has been assigned to him.
“I felt it my duty to act as I have done, and my conduct, I fear, has
been the cause of uneasiness to you; but as our separation was not
the effect of misconduct upon your part, or of any disapprobation
on mine, I hope we shall be again united in the pursuit of medical
science, and that we shall entertain for each other that respect and
esteem which I must ever feel for you.
“As I told you in our last conversation, I have ever felt a degree
of veneration for your acquirements and abilities, which has made me
diffident in expressing my wishes. But as you have now courted it, I
will say, that I have wished to see you join in the debates of Guy’s
Medical Society. The capability of expressing our ideas in public is
a source of more power than anything with which I am acquainted. It
is the road to bring a public teacher to character and to fortune.
“_Secondly_, I should much wish for your assistance in making
experiments upon animals. I am certain that everything valuable
in physiology is only to be so obtained. What is every day under
observation of the senses is well known, but few men have sufficient
knowledge of anatomy to be capable of making the interior parts of
the body the subject of inquiry.
“_Thirdly_, you will do me a favour by making my collection in
comparative anatomy more complete. This, I am aware, is the greatest
favour I can ask, as you are neither captivated by its splendour nor
convinced of its utility; but as I have embarked on it, you will
confer an obligation upon me by assisting me in making it complete.
“I shall endeavour to make your situation comfortable in a pecuniary
point of view, but I had rather make that the subject of conversation
when I see you.
“I am, dear Sir,
“Yours, with the utmost esteem,
“A. C. ”
Battley had a high appreciation of his friend’s talents, and felt
strongly that they would not have sufficient scope in such a confined
sphere as Gravesend. The combined effect of his persuasive influence,
and of Cooper’s letter, ultimately induced Saunders to resume the
duties of demonstrator of anatomy at St. Thomas’s.
Shortly afterwards he took a house in Ely Place, with the intention
of practising as a surgeon, and on April 7th, 1803, married Miss Jane
Louisa Colkett.
During the last years of the eighteenth and the first years of the
nineteenth centuries England was at war with France. Farre, in 1793,
went with Lord Moira’s expedition to France, returning, however, to
London on its failure. Battley for a time served in the Navy as an
assistant surgeon, and was present at several engagements under Sir
Sidney Smith.
In 1799 Napoleon invaded Egypt, and after the destruction of his fleet
by Nelson at the Battle of the Nile, English troops under Sir Ralph
Abercrombie were landed at Aboukir, in 1800. Almost all were attacked
by what was called “Egyptian ophthalmia,” but which we now know must
have been a mixed infection of purulent ophthalmia and trachoma.
After the evacuation of Egypt by the English in 1803, the troops were
disbanded, and spread this very infectious form of eye disease in all
the stations at which they stopped and throughout Great Britain.
Mr. Patrick Macgregor, surgeon to the Royal Military Asylum, writes of
the effects of the disease in the Army as follows:
“The progress of the ophthalmia since its first introduction into
this country in the year 1800 has, in the Army, been very rapid and
extensive, and has at different periods materially interfered with
its discipline and efficiency. It has crippled many of our best
regular regiments to such a degree as for a time to render them unfit
for service; and though the regiments which were in Egypt have,
in general, suffered most from the disease, yet it has prevailed
extensively in others which have never served in that country.”
The terribly destructive character of the disease may be shown by its
effects on the second battalion of the 52nd Light Infantry, which are
recorded by Dr. Vetch: out of 636 cases 50 were dismissed with the loss
of both eyes, and 40 with that of one.
The spread of the disease was not confined to the Army, but extended
widely throughout the country in the towns and villages, when the
disbanded troops returned to their homes carrying infection with them.
That the medical men and the hospitals in this country were badly
prepared to deal with such an immense increase in eye diseases may be
shown by quoting a description of the condition of things which then
existed, written by Sir William Lawrence some thirty years later:
“The diseases of the eye, in general hospitals, are inadequate, from
the smallness of their number, to the purposes of practical study,
particularly that of exemplifying the various operations. Thus these
institutions have been inefficient in reference to this important
department. As the general body of surgeons did not understand
diseases of the eye, the public naturally resorted to ‘oculists’” [in
speaking of “oculists” he refers to those that have bestowed that
title on themselves without having had any regular medical training]
“who, seeing such cases in greater numbers, became better acquainted
with the symptoms, diagnosis, and treatment; and especially
more skilful in the operative department. At the same time, the
subject, being imperfectly understood, was neglected in the general
surgical courses, in which many important affections were entirely
unnoticed, and the whole very inadequately explained. Thus students,
who resorted to London for the completion of their professional
studies, had no means of learning this important department of
the profession, which was tacitly abandoned, even by the hospital
surgeons, and turned over to the ‘oculists.’ The latter, not being
conversant with the principles derived from anatomy, physiology, and
general pathology, attended merely to the organ, and relied almost
exclusively on what is comparatively of little importance, local
treatment. Hence ophthalmic surgery, being in a manner dismembered
from the general science, was reduced to a very low ebb. Until within
a few years, it was, in this country at least, in a state of almost
total darkness.”
It will thus be seen that at the time Saunders established himself as
a surgeon in London there was an immense increase in the amount of
eye disease, but that very few medical men were in any way trained or
competent to deal with it, and scanty, if any, provision was made for
its treatment in the hospitals.
Saunders’ attention had early in his career been attracted to diseases
of the eye during his apprenticeship under Mr. John Hill, and his
studies in the dissecting room had afforded him a sound basis for their
treatment, in an intimate knowledge of the anatomy of the organ and its
surrounding structures. His association with Astley Cooper had also
led him to devote special attention to the anatomy of the ear and to
disorders of hearing. Astley Cooper in 1800 made a communication to the
Royal Society, on the effects of destruction of the tympanic membrane
of the ear. He had found that considerable openings might be made in it
without impairment of the hearing power, and was thereby led to perform
the operation of puncturing the membrane in cases of deafness resulting
from obstruction in the Eustachian tube, with a remarkably good result
in the restoration of hearing, in the first cases in which he employed
it. Subsequent experience, however, showed it not to be so generally
useful as he had originally anticipated. He made a second communication
on the same subject in the following year, and in 1802 was elected a
Fellow of the Royal Society, and awarded the Copley Medal.
Whilst these papers were being written the subject of them must have
been much discussed by Cooper and his assistant Saunders, the latter’s
interest in ear disease being thereby awakened.
On starting in practice at Ely Place, Saunders decided to devote
himself to the treatment of diseases of the eye and ear, a decision
which must have required considerable courage at that time by one who
wished to remain of good repute with other members of his profession.
Up to that time the treatment of eye diseases had been mainly in the
hands of itinerant quacks, who dubbed themselves oculists.
George Coats, who has written an account of the lives and practices
of many of these worthies, has well described the condition of things
which then existed. He says:
“In the eighteenth century ophthalmology had not yet vindicated,
in England, its position as a separate branch of practice. It was
the province of a set of ambulant practitioners who toured the
country accompanied by all the apparatus of shameless advertisement
(including ‘monkies,’ we are told), couching cataracts, and selling
infallible salves and eyewashes. This taint of quackery appears
to have deterred respectable surgeons from meddling much with the
subject; their operative experience was probably small, and the
procedure of couching, attended frequently with brilliant immediate,
but disastrous after, results, was likely to be performed with fewer
scruples by itinerant oculists, here to-day and gone to-morrow, than
by settled practitioners who had to abide the consequences of their
handiwork.”
Such men were naturally looked upon as charlatans by the medical
profession, but that did not prevent them becoming the recipients of
royal favours.
One William Read, who commenced life as a tailor, and became a
mountebank and itinerant quack oculist, settled in London in 1694,
advertising in the _Tatler_ “that he had been thirty-five years in the
practice of couching cataracts, taking off all sorts of wens, curing
wry necks and hair-lips [_sic_] without blemish.” In 1705 he was
knighted, “as a mark of royal favour for his great services, done in
curing great numbers of seamen and soldiers of blindness gratis”; and
about the same time was appointed oculist-in-ordinary to Queen Anne. It
is stated that the wealth he acquired enabled him to mix with the best
literary society of the day. Swift, in writing to Stella, commented on
the quality of his punch which he served in golden vessels. One sample
of his methods of treatment need only be quoted—“the putting of a louse
into the eye when it is dull and obscure, and wanteth humours and
spirits. This,” he says, “tickleth and pricketh, so that it maketh the
eye moist and rheumatick and quickeneth the spirits.”
On Sir William Read’s death in 1715, his rival, Roger Grant, succeeded
to the post of oculist to Queen Anne, and afterwards to George I.
Grant, originally a cobbler and later a Baptist minister, lost one eye
as a soldier in the service of the German Emperor, and then set up as
an oculist in Mouse Alley, Wapping. He advertised profusely in the
journals of the day, giving accounts of his cures, with certificates
attached from the patients themselves and others.
George II. appointed as his oculist-in-ordinary John Taylor, better
known as “Chevalier Taylor,” of whom Coats says:
“Amongst travelling quacks the name of the ‘Chevalier’ Taylor stands
pre-eminent for unblushing effrontery, blatant self-laudation, and
all the methods of the charlatan, but also for mental endowments far
above the average of his tribe, and for real acquaintance with the
contemporary state of ophthalmic knowledge. His fame extended to
every country in Europe; his boast of having conversed with kings
and princes is no idle one; he had an acquaintance, not always
felicitous, with some of the best known men, medical and lay, of
his time; counting translations and minor works he was the author
of nearly fifty books; and in later life he wrote an autobiography,
which, if it gives few and unreliable particulars as to his actions,
does much to reveal the character of the man.”
The Chevalier’s talents seem to have been hereditary, for his son and
two grandsons followed the same line of practice, and were each in turn
the recipients of royal favours.
It was with such prating mountebanks that Saunders ran the risk
of being confused in devoting himself specially to the treatment
of eye diseases. He was not, however, the first reputable medical
practitioner in London to specialise in this line of work, having
been preceded by both Wathen and James Ware. Dr. Wathen published, in
1785, _A Dissertation on the Theory and Cure of Cataract_, and held
the appointment of oculist to George III. He took Ware when a young
man into partnership with him, a partnership which lasted for fourteen
years, during which time Ware acquired such a liking for eye work that
he decided to devote himself exclusively to it.
Ware, like Saunders, had studied at St. Thomas’s Hospital, and held
there the post of demonstrator of anatomy, so it would seem highly
probable that his example may have had some influence in determining
Saunders to take up surgery of the eye as a special branch of practice.
In 1801 Ware contributed to the Royal Society a paper dealing with
the case of a boy of seven years of age upon whom he had operated for
cataract, and as the result of this communication he was elected a
Fellow of the Royal Society. It was one of Saunders’ most noteworthy
achievements, as we shall see later, to introduce an operation for
cataract in infants who are born blind.
The suggestion that Saunders should start a special institution for the
treatment of diseases of the eye and ear is stated by Battley to have
originated with Astley Cooper, whose own experience, in the treatment
of diseases of the ear, had shown him what insufficient accommodation
the General Hospitals offered for the treatment of diseases of the
special organs. As his letters show, he held a very high opinion of
Saunders’ professional abilities, and he saw only too clearly that the
nature of Saunders’ apprenticeship would prevent him being promoted
to any surgical post at either of the Borough Hospitals. Consequently
the idea suggested itself to him that a special hospital might be
established for diseases of the eye and ear, at which Saunders might
find a suitable field for the exercise of his skill and ingenuity.
Before taking any action in the matter, Saunders first sought the
advice of the physicians and surgeons of St. Thomas’s and Guy’s
Hospitals, and having obtained from them a testimonial of their
approbation, on October 1st, 1804, he published the following proposal
for instituting “A Dispensary for the Poor afflicted with Diseases of
the Eye and Ear,” with their testimonial attached:
“Among the many charitable institutions which mark the wisdom and
benevolence of the inhabitants of this Metropolis there is none
particularly appropriated to the relief of the poor afflicted with
diseases of the Eye and Ear. No diseases which do not affect the
life of the patient are more distressing than such as are incident
to these organs or demand greater dexterity and skill in their
treatment. The structure of the Eye and Ear is so delicate and
complex and their irritability under injury so extreme, that they
cannot easily be treated but by those who make them the objects of
peculiar study and attention. The acknowledged difficulty in the
treatment of the diseases to which they are liable has induced a few
to separate themselves from the general practice of professional
duties and to devote themselves to the exercise of this branch alone,
a fact which sufficiently establishes the necessity of making them
the objects of a specific institution. Every surgeon must allow
that most unremitting care and attention is necessary after some
of the capital operations on the eye, and that through the want of
it some of the most dexterous operations are frequently defeated.
In large hospitals and dispensaries which embrace a variety of
objects, where the medical attendants are deeply interested in the
most formidable and excruciating diseases, it can rarely happen that
sufficient leisure is afforded for the exercise of that strict care
and attention which operations on the eye demand, much less will
it happen, when patients are the subjects of fortuitous operations
and retire afterwards to their own homes where they experience a
miserable want of every comfort and convenience, that such operation
can be successful. Impressed with these considerations the author of
this address, who devotes himself to the treatments of diseases of
the Eye and the Ear, solicits the public to patronise an institution
which will enable him to extend relief to the poor afflicted with
these diseases. An institution of this kind will be the means of
restoring to society the exertions of many industrious individuals
and will be established and carried on at a very moderate expense.
The author of this address offers his services to the Charity without
any emolument to himself and he pledges himself to the promoters
of the institution, that the public shall reap the fruits of their
beneficence.
“J. C. SAUNDERS,
“_Surgeon and Demonstrator of Practical Anatomy at St. Thomas’s
Hospital_.
“24, Ely Place, Holborn,
“_October_ 1_st_, 1804.”
“We are of the opinion that the establishment of the dispensary will
prove beneficial, and is therefore worthy of public support, and that
the author of the proposal is qualified to procure the accomplishment
of its object.
Signed:
_Physicians of St. Thomas’s_. _Physicians of Guy’s_.
Wm. Lister, M.D. Wm. Babington, M.D.
W. C. Wills, M.D. James Curry, M.D.
Thos. Turner, M.D. M. Alexander, M.D.
G. Gilbert Currey, M.D.
_Surgeons of St. Thomas’s._ _Surgeons of Guy’s_.
G. Chander. T. Foster.
I. Birch. Wm. Lucas.
H. Cline. Astley Cooper.”
As the outcome of the issue of this circular a committee was formed
which held its first meeting at the City Coffee House on January 4th,
1805, Mr. Benjamin Travers, a wealthy City merchant and the father of
the surgeon of the same name, being in the chair.
This Mr. Benjamin Travers, Sen., in the keen pursuit of knowledge,
had attended Astley Cooper’s lectures on anatomy, and had become so
interested in them and the lecturer, that he apprenticed his son to him
as a pupil, and later extended his patronage to the project of founding
an eye dispensary put forward by Cooper’s demonstrator and protégé.
At the meeting the following resolutions were moved and unanimously
agreed to:
“That a dispensary be instituted under the name of the London
Dispensary for the Relief of the Poor afflicted with Diseases of the
Eye and the Ear, where they may apply and obtain advice and medicines
gratis.
“That the dispensary be situated in a central part of this city and
contain beds for the reception of patients who undergo the operation
for the cataract or any other operation of the eye requiring minute
care.
“That the Charity consist of a Treasurer, Governors, Secretary, and
Medical Officers.
“That Henry Kensington, Esq., be appointed Treasurer.
“That a person contributing an annual subscription of one guinea
be a governor and have the right of recommending and keeping under
the care of the charity one out-patient, and if two guineas, two
out-patients, and so in proportion to his subscription.
“That patients admitted into the house be admitted according to
priority of recommendation, except in cases of emergency, when the
medical officers must determine.
“That Mr. J. C. Saunders be appointed Surgeon of the Dispensary, and
that Dr. Farre be appointed Consulting Physician in cases requiring
medical aid.”
Richard Battley, who was then practising as an apothecary in St. Paul’s
Churchyard, undertook the duties of Secretary, which he continued to
discharge in an honorary capacity, with the utmost assiduity, for
fourteen years.
Many City merchants, with whom Saunders had no previous acquaintance,
became subscribers, and sufficient funds were soon forthcoming to
provide for the purchase of the lease of No. 40, Charterhouse Square,
for eighteen years, for the sum of £300 and an annual rental of £65.
PLATE II.
[Illustration: SHOWING THE SOUTH SIDE OF CHARTERHOUSE SQUARE AND NO. 40
Where the London Dispensary for Curing Diseases of the Eye and Ear was
first opened in 1805.]
On March 25th, 1805, _The London Dispensary for Curing Diseases of the
Eye and Ear_ was opened for the reception of patients.
Sir Charles Price, Bart., a former Lord Mayor, and Member of
Parliament for the City of London, accepted the post of President of
the Institution, and several of the Aldermen of the City became its
Vice-Presidents.
One Sarah Clark was appointed nurse and housekeeper, she being required
to act under the control of the Surgeon, who had power to dismiss her
for misconduct. She was allowed coals and candles and a gratuity at the
end of the year “such as the Committee may deem proportionate to her
services.” Her husband was subsequently engaged to dispense drugs, and
the two of them received £50 a year for their services, together with
the aforesaid coals and candles.
In 1804, after Saunders had brought forward his proposal for the
establishment of an Eye Dispensary, Mr. Wathen (afterwards Sir Wathen
Waller), an oculist of eminence, described to King George III. the sad
state of the soldiers and sailors who had returned from the campaign
in Egypt suffering from ophthalmia, and suggested the desirability
of establishing an Infirmary exclusively for eye diseases: “Their
Majesties and the Royal Family graciously and humanely approved of the
plan, and honoured it with their patronage and benefactions.” Such was
the origin of the Royal Infirmary for Diseases of the Eye, in Cork
Street, which commenced under Mr. Wathen, and was subsequently carried
on as a comparatively private institution, under the charge of Mr.
Charles Alexander, up to the time of his death in 1872.
This institution must not be confused with that started in the Western
district of London, by the Army surgeon Guthrie, in 1816, which exists
to-day as the Royal Westminster Ophthalmic Hospital.
That Wathen’s Infirmary was opened for the reception of patients three
months before the London Dispensary, though the proposal for its
establishment was not made until after the publication of Saunders’
circular, evidently caused the latter considerable annoyance, for in a
letter addressed to the Committee of the Dispensary in 1808 Saunders
writes:
“Subsequently to the date of my Proposal, a similar Institution,
honoured with the Royal Patronage, was formed and established in
Westminster. Although the Prospectus of the Royal Infirmary was not
heard of until many months after the Publication of my Proposal,
yet it must be admitted that that Institution first appeared before
the Public in a regular and organised form, and this, which is the
original, is consequently considered by all who are unacquainted with
the facts as the copy. Apprehensive of this impression, I immediately
claimed by public advertisements, which were never answered, the
priority of my Proposal.
“I should be excused for thus obtruding on your notice if I sought
merely the indulgence of honest pride, by maintaining this just
claim to respect, but I shall yet more readily be excused, when
you reflect, that if I had abandoned this claim, the Public would
continue to regard me as an humble copyist.”
This Royal Infirmary, whose rivalry at its commencement caused Saunders
so much annoyance, continued in existence until Alexander’s death in
1872. It was then resolved at a meeting of its Life Governors and
Subscribers to close the Institution and to hand over the balance of
its funds, after the settlement of all its liabilities, to the Royal
London Ophthalmic Hospital. Two hundred pounds was ultimately received
by the Hospital, and three of the Committee of the old Infirmary were
elected as Life Governors, one of them being a relative of the late Mr.
Alexander.