REMOVAL TO MOORFIELDS
The lease of the house in Charterhouse Square was purchased for a
period of eighteen years; at the end of nine years it became obvious
that, to cope with the continuously increasing work of the Charity, it
would be necessary when the lease expired to provide larger and more
commodious premises. It was, therefore, decided in 1813 to open a fund
for the provision of a suitable freehold and building. To this fund the
Lord Mayor, Aldermen, and Common Council of the City of London, as a
mark of their approval, contributed £100.
In March, 1819, a Building Committee was appointed to find a suitable
site and to draw up plans. The possibility of acquiring from the City a
piece of ground in Moorfields soon came under consideration. Frederick
Tyrrell was the son of Timothy Tyrrell, who was the City Remembrancer
and resided at the Guildhall, and it was with his aid that negotiations
for this site were entered into. Timothy Tyrrell became a member of the
General Committee of the Infirmary, and his eldest son, John Tyrrell, a
barrister, became an active member of the Building Committee.
Though the option for refusal of a plot of land to the north of the
Roman Catholic Chapel in Moorfields was then obtained from the City,
it was not until more than a year later that an agreement to acquire
the freehold was decided upon. In the meantime, several other possible
sites had been inspected and rejected.
It was in October, 1820, that, at a meeting at the Guildhall with the
Committee of the City Lands, the following terms were finally entered
into:
“That the Infirmary should acquire the freehold of a plot of land
on the North-East side of Moorfields, to the extent of 88 ft. in
width and 85 ft. in depth, for the sum of £800, to be paid at the
time of the roof of the intended building being complete, and that
a pepper-corn rent only be paid from Christmas next until Lady Day
1822. The Institution to be at the expense of preparing the Title.”
Robert Smirke, F.R.S., F.A.S., R.A. (afterwards Sir Robert), was
commissioned to prepare plans for the building, the expenses of which
were to be limited to £5,000. Subsequently Smirke found that, in
consequence of the unexpected loose nature of the land of the site
chosen, extra expense would be incurred in forming the foundations of
the proposed building, and the limit of the amount was increased to
£5,500.
On May 2nd, 1821, the General Committee of the Infirmary, after
having assembled at the City of London Tavern, proceeded with the
President to the ground in Moorfields to lay the foundation stone of
the new building, in which stone was deposited the following coins: 1
sovereign, 1 half-sovereign, 1 crown, 1 half-crown, of the reign of
George IV.; 1 shilling, 1 sixpence, and in silver, one piece value each
4d., 3d., 2d., 1d., of the reign of George III.; upon these was placed
a brass plate having the following inscription engraved thereon:
“London Infirmary for Curing Diseases of the Eye, founded by the late
John Cunningham Saunders Esq., A.D. MDCCCIV. The foundation-stone of
the new building for the same Institution, henceforth to be entitled
The London Ophthalmic Infirmary, was laid in Moorfields, on the
second day of May, 1821, by the President.
_Patron_: Field-Marshal His Royal Highness
the Duke of York, K.G., etc.
_President_: William Mellish, Esq.
_Vice-Presidents_:
St. Asaph, The Right Rev. Sir Charles Flower, Bart., Ald.
Lord Bishop of. Thos. F. Foster, Esq.
John Ansley, Esq., Ald. Sir William Leighton, Ald.
John Julius Angerstein, Esq. Sir Charles Price, Bart.
William Babington, M.D., F.R.S. Jeremiah Olive, Esq.
George Bainbridge, Esq. Thomas Rowcroft, Esq.
Thomas Boddington, Esq. Sir James Shaw, Bart., Ald.
George Byng, Esq., M.P. John Thompson, Esq.
Henry Cline, Esq, F.R.S. Benjamin Travers, Esq., F.R.S.
Astley Cooper, Esq., F.R.S. Sir Robert Wingram, Bart.
_Treasurer_: Michael Bland, Esq., F.R.S.
_Medical Directors_.
_Physician_: John Richard Farre, M.D.
_Surgeons_: William Lawrence, Esq., F.R.S.
Frederick Tyrrell, Esq.
_Committee_:
Aaron, Lewis, Esq. Kerr, Niven, Esq.
Bainbridge, John, Esq. Mackie, John, Esq.
Bonsor, Joseph, Esq. Mellish, Thos., Esq.
Blades, John, Esq. Ommanney, Sir F. M., M.P.
Brandain, Samuel, Esq. Pearce, J. M. , Esq.
Brown, Thomas, Esq. Price, Ralph, Esq.
Browning, William, Esq. Price, Richard, Esq.
Brydon, William, Esq. Price, Charles, Esq.
Battley, Richard, Esq. Russell, Rev. John, D.D.
Cazenove, John, Esq. Read, Samuel, Esq.
Clarke, John, Esq. Row, William, Esq.
Cohen, Joseph, Esq. Rudge, Rev. Jas., D.D., F.R.S.
Crawley, William, Esq. Smirke, Robert, Esq.
Croskey, J. D., Esq. Solly, Thomas, Esq.
Curtis, Timothy, Esq. Sparks, R. W. , Esq.
Dean, John, Esq. Towle, Thomas, Esq.
Elgie, William, Esq. Thomas, John, Esq.
Gamble, Robert, Esq. Tyrrell, John, Esq.
Hartshorne, John, Esq. Tyrrell, Timothy, Esq.
Heathfield, Richard, Esq. Warburton, Thos., Esq.
Hodgkinson, John, Esq. Ward, Samuel, Esq.
Horner, John, Esq. Yates, William, Jun., Esq.
_Hon. Chaplain_: The Rev. Thos. Gill, M.A.
_Solicitor_: Robert Pitches, Esq.
_Secretary_: Matthew Heathfield, Esq.
_Apothecary_: Mr. Charles Craddock.
_Architect_: Robert Smirke, Esq., F.R.S., F.A.S., R.A.”
A prayer suitable to the occasion was offered up to Almighty God by the
Chaplain.
At six o’clock the Governors and friends of the Charity dined at the
City of London Tavern, when contributions since January 1st of that
year were announced to the amount of about £1,200 for the building fund.
Moorfields was originally a piece of moorland lying to the north of
the old City wall, access to which was obtained through the Moorgate.
Early in the seventeenth century it was drained, laid out in walks, and
planted with trees. For a long time it remained a place of recreation
and jollification for the City folk—a place of swings and roundabouts,
as is described in the following verses in the vade mecum for malt
worms:
“In Moor’s most pleasant Field, where Northern Lads
With Western Youths contend for broken Heads,
And where our Weal thy Citizens repair
To lengthen out their Lives with wholesome Air;
Jointing to Trotter’s famous Castle, stands
A noted Mansion built by artful Hands;
Where Young and Old, at small Expense can find
Delightful Pastimes to refresh the Mind.
Hither the sprightly Genius has recourse
To practise Riding on the Flying-Horse;
Where danger-free, he through the Air may scow’r,
And, void the Wings, fly fifty miles an Hour;
Nor that has this Courser, tho’ he runs so fast,
One living Leg to expediate him hast,
Yet carries double, treble, if requir’d,
But never stumbles or is ever tir’d.
As for the pregnant Wife, or tim’rous Maid,
Here’s a true South-Sea Coach, that sporting flies
Between the humble Earth and lofty skyes,
Manag’d to rise and fall with little Pains,
Like the uncertain Stock that turns our Brains.
Liquors, the best, are also vended here,
From Heav’nly Punch to Halsey’s Noble Beer,
By gen’rous Whitehead, who deserves the Bays
From all the Sons of Malt that Merit praise;
Therefore, if any will prove the Poet just,
Thither repair and you will surely find
Your entertainment good and Landlord kind.”
In a map of London of the middle of the eighteenth century Moorfields
is shown divided up into three sectors, Upper, Middle, and Lower. The
site of the Upper Moorfields is now marked by Finsbury Square, and that
of Lower Moorfields by Finsbury Circus; Middle Moorfields lay between
the two.
It was at the north-east corner of Lower Moorfields that the Infirmary
was erected. No paved roads led up to it, only tracks: one of these to
the north, then called Broker Row, became Eldon Street, another leading
out of London Wall to Broker Row became Blomfield Street. It was in
the angle between these two streets that the Infirmary was situated.
The site now occupied by Broad Street Station, directly opposite the
Infirmary, was then an open space.
On the laying of the foundation-stone of the new building its name
was changed, for the third time, to that of “The London Ophthalmic
Infirmary and this was yet again altered in 1837, under circumstances
that will be mentioned later, to that which it now bears, “The Royal
London Ophthalmic Hospital.” The name, however, by which it is most
generally known is “The Moorfields Eye Hospital,” though it has never
been officially so designated.
PLATE VI.
[Illustration: THE LONDON OPHTHALMIC INFIRMARY AS FIRST ERECTED AT
MOORFIELDS IN 1822.
From an engraving by R. Acon, after a drawing by Tho. H. Shepherd.]
It was not the first “Moorfields Hospital”; if a patient had said that
he had been an inmate of “The Moorfields Hospital” in the eighteenth
century he would have been regarded as an escaped lunatic. “The
Bethlehem Royal Hospital” for lunatics was built on the south side of
Lower Moorfields in 1675; it was a substantial building accommodating
150 patients, and remained in existence until 1815, when it was
removed to Lambeth. To go and see the lunatics at Moorfields was for
over 200 years one of the sights of London, the public being admitted
to view the poor wretches on the payment of a small charge. It is
stated that as much as £400 a year was received towards the upkeep of
the Institution in this way; the chains with which the patients were
secured and the other sufferings to which they were subjected is,
however, not part of this history.
The architect of the Ophthalmic Infirmary, Robert Smirke, R.A., who
was knighted in 1832, has left his mark deeply impressed on London;
to him we owe, amongst other important London buildings, the British
Museum, Covent Garden Theatre, the East Wing of Somerset House, the
College of Physicians, and the Carlton and other Clubs. The Infirmary
in its original state was a plain, unpretentious, but not unpleasing
structure; in later years, whatever merits its external appearances
originally possessed were destroyed by the addition of a new wing
on one side and an upper storey. It originally consisted of three
floors, a flight of stone steps leading up to the entrance hall in
the centre of the ground floor. The out-patient consulting room was
on the right of the entrance hall, and a room was specially set apart
for Dr. Farre’s use on the left. In the basement, besides the kitchen,
etc., there were the porters’and maids’ rooms, and the one bathroom
and wash-house. On the first floor, in the centre, was the operating
theatre, on the right a committee room, and on the left a room
designated as the library, but not used as such for some years. The
apothecary and the nurse-housekeeper also had their apartments on this
floor, the second floor being devoted to wards for the patients.
The in-patients in the house in Charterhouse Square were restricted
to operation cases, and cases of purulent ophthalmia; with increased
accommodation in the new building no such restrictions were made, and
a nurse was engaged to assist the nurse-housekeeper. To relieve the
apothecary of some of his duties, a professional cupper was appointed
to attend three days a week, and a room was set apart for him in the
basement in which to carry on his sanguinary proceedings.
Smirke, the architect, advised the Committee of the Infirmary, and
as afterwards turned out most wisely, to secure the vacant land in
its immediate vicinity with a view to possible future extensions. The
ground immediately behind the Infirmary, having a frontage of 36 feet
to the north and a depth of 69 feet, had already been disposed of by
the City to a Mr. Turner, who consented to part with his purchase for
£15 per annum, or at twenty years’ purchase, £300, for which latter it
was ultimately secured.
When the building of the new Infirmary was completed, work commenced
there without any ceremonial opening procedure. The first committee
meeting held in it was on October 2nd, 1822, and it must have been
opened for the reception of patients the same month.
On November 12th, 1822, Dr. Farre delivered to the pupils an
introductory lecture in which he announced the arrangement of the
following courses of instruction:
Lectures on Morbid Anatomy illustrative of the Practice of Physic in
general, as well as Ophthalmic Medicine in particular. To be given
occasionally and separately announced.
By Dr. J. R. Farre, Physician to the Infirmary.
Lectures of the Anatomy, Physiology, and Diseases of the Eye. First
Course on Tuesdays, Thursdays, and Saturdays at half-past 5 o’clock.
Second and subsequent courses on Tuesdays and Saturdays at the same
hour.
By Mr. William Lawrence, F.R.S., Senior Surgeon to the Infirmary.
Clinical Lectures, on select cases of Ophthalmic Diseases occurring
in the In- or Out-Patients of the Infirmary. To be given on days and
at hours adapted to the convenience of the pupils.
By Mr. F. Tyrrell, Junior Surgeon of the Infirmary.
Lectures in Optics. To be given on Thursdays at 7 o’clock in the
evening.
By the Rev. T. Gill, M.A., Hon. Chaplain to the Infirmary.
Dr. Farre concluded his announcement of these lectures with the
following remarks:
“There remains one subject of great interest—The Chemistry of
Light—to which I have invited the attention of Mr. Battley, not
because he was the oldest and most faithful friend of Mr. Saunders,
but because he has actually worked for a long time at that part of
the subject which respects the vegetable kingdom, and his labour has
deservedly attracted the attention of the College of Physicians. I
think that the profession is much obliged to him, and I shall do
everything in my power to promote his very interesting enquiries
respecting the composition and decomposition of those more important
vegetable substances which form a part of the Materia Medica. His
success in the decomposition of opium, and in the discovering the
_Liquor Opii Sedativus_, one of the most valuable preparations of
opium, whether externally applied for the mitigation of extreme
suffering, as in the cancerous fungi of the eye and other parts
of the body, or internally administered for the cure of various
irritative diseases, and his beautiful preservation of the natural
green pigment and medical virtues of other preparations of the
narcotic tribe, as _Digitalis Conium_, and the like, induced me,
in July last, to invite him to communicate his thoughts on those
subjects to the class of the Infirmary, and, in a letter received
only this day, he has led me to hope that he will indulge my wishes
in the spring of the ensuing year.”
To what extent this ambitious programme of instructions was carried
out is uncertain. Of Dr. Farre’s teaching but few records remain; with
regard to it, Lawrence said in the introductory chapter of his treatise:
“Dr. Farre set the example at the Infirmary, of applying the general
principles of pathology and therapeutics to the elucidation and
treatment of ophthalmic diseases. In the clinical illustration of
cases, the exposition of curative indications and simplicity of
treatment, he could not be surpassed. All who have had the advantage
of his instructions will remember them with gratitude and respect,
and will regret that he has not communicated to the public, through
the Press, the interesting results of his long practice, his close
observation and mature reflection.”
The report of one of his lectures at the Infirmary in the _Lancet_
gives anything but a good impression of him as a teacher; it is a long
rambling discourse, professedly on the cardiac system, with but scant
reference to eye disease, and set out with scriptural quotations and
protests against materialism. We learn, however, from it that he had
previously delivered a course of lectures on the gastric system as
applicable to ophthalmic medicine.
Lawrence’s lectures were reported as they were delivered in the
_Lancet_ in 1825–26, and subsequently formed the basis of his treatise.
The Rev. T. Gill resigned his appointment as Chaplain to the Infirmary
in February, 1823, owing to some disrespectful behaviour to him on the
part of the housekeeper, for which she was duly reprimanded. So he
could only have given one course of instruction on optics; there is no
record of any of his successors taking on a similar duty.
A room in the basement, which it had been suggested to Battley might be
used by him as a laboratory and museum, was not found suitable for that
purpose, and the courses of instruction which it was suggested that he
might give in Materia Medica seem to have been left in abeyance until
the establishment of what was termed “The Saunderian Institution.”
Besides the unoccupied land behind the Infirmary, already referred
to, there was another piece to the south of it, lying between it and
the Roman Catholic Chapel. The leasehold of this was offered to,
and secured by, Dr. Farre, who subsequently transferred it to the
Infirmary. Part of the agreement permitted the previous owner of the
lease to erect a stable for his own use on about two-thirds of the
site, for which he was to pay only a peppercorn rent. On the remaining
one-third, Dr. Farre obtained permission to erect, at the expense of
the Saunderian Fund, which had been established by him, a building to
be called “The Saunderian Institution.” The purpose of this Institution
was the cultivation of minute anatomy, especially of the eye, and a
general analysis of the Materia Medica to increase the remedial agents
of the Hospital, as well as benefit the profession. The management of
the Institution was to remain entirely in the hands of Dr. Farre during
his life.
“The Saunderian Fund” was one specially established for the erection
of a monument to John Cunningham Saunders; to it Dr. Farre himself
contributed £120, and to it also were added the proceeds of the sale
of the second edition of Saunders’ book edited by Dr. Farre. Out of
the fund a bust of the late J. C. Saunders was constructed, which now
stands in the entrance hall of the present Hospital; the remainder of
it seems to have been devoted to this Institution.
In the year 1827, the Laboratory of the Institution was opened by Mr.
Battley for the analysis of the vegetable substances of the Materia
Medica, with a view to the improvement of Pharmacy, by showing wherein
the efficient powers of these substances reside and by what means the
most useful preparations of them may be obtained. It appears that he
held large classes of students there, more than 2,000 from various
Medical Schools, British and foreign, having attended for instruction.
Dr. Farre, in an Introductory Lecture entitled “Apology for British
Anatomy,” at the opening of the pathological department of the
Institute, or Academy, as he sometimes described it, pointed out that
the objects which it had in view were: the study of the anatomy of
structure; the performance of post-mortem examinations; the study of
minute morbid anatomy; the publication of a journal; the publication
of separate essays; the cultivation of the Fine Arts of drawing and
modelling as connected with minute practical and morbid anatomy.
John Dalrymple, who afterwards became a surgeon to the Ophthalmic
Infirmary, was appointed demonstrator and secretary to the Academy.
In connection with the announcement of Lawrence’s resignation of his
post of surgeon to the Ophthalmic Infirmary in 1826, there commenced
a series of editorial articles in the _Lancet_, attacking members of
the Committee of Management and imputing to them the most base and
degrading motives.
The _Lancet_ had been founded in 1823 by Thomas Wakley, and at first,
as his biographer says, “Some men read it, some men laughed at it, and
some men wondered at it, but nobody much marked it, for its views were
not sufficiently condensed and its objects not definitely defined.”
In 1825 Tyrrell summoned Wakley for libel, claiming £2,000 damages, in
that the _Lancet_ had accused Tyrrell of plagiarism in connection with
his publication of Astley Cooper’s Surgical Lectures. Though the jury
gave their verdict in Tyrrell’s favour, they only assessed his damages
at £50.
Gradually after this trial the policy of the _Lancet_ became directed
to three main objects:
(1) The maintenance of a right to publish, for the benefit of the
profession at large, the sayings and doings of members of the
Hospital Staff’s, with or without their permission.
(2) A fight against nepotism in the matter of staff appointments at
the Hospitals.
(3) An exposure of, what Wakley delighted in calling, a “Hole in the
Corner Policy” by members of Hospital Staffs—_i.e_., the employment
of secretive methods in their practice.
In the affairs of the Ophthalmic Infirmary Wakley found a suitable
field for attack in these three directions, and, though his objects
may have been excellent, his mode of conducting his campaign was
inconsiderately bitter and personal.
For the unauthorised publication in his Journal of the notes of
cases at St. Thomas’s Hospital, Wakley had been expelled from that
Institution, where he had studied as a student, the letter of expulsion
being signed by the three surgeons, Travers, Tyrrell, and Green.
Lawrence, who was at that time a prominent medical reformer, and for
whom Wakley evidently had a great admiration, welcomed the publication
of his lectures, delivered at the Ophthalmic Infirmary, in the _Lancet_.
Tyrrell, who had been prominent in the fight against Wakley at St.
Thomas’s and who had also taken legal proceedings against him, resented
having his demonstrations at the Ophthalmic Infirmary reported in
the Journal. On this matter there may very likely have been some
disagreement between the two surgeons of the Infirmary. There is no
note in the minute book of the Committee of any discussion on the
matter having taken place, or of any bye-law being passed to the
effect that “no pupil should be allowed in future to take notes of
cases.” Wakley, therefore, seems to have been wrong in attributing
Lawrence’s resignation of his post on the staff of the Infirmary to
his disgust with the Committee for having passed such a bye-law. When
the _Lancet_’s first attacks on Dr. Farre and Mr. Battley were brought
to the notice of the Committee, Lawrence protested emphatically that
neither directly nor indirectly had he been in any way concerned in
them. The real reason of his resignation probably was that he had
become connected with the newly constituted Aldersgate Street School of
Medicine, where he delivered a course of lectures on Surgery.
As has been mentioned, the idea of establishing a special institution
for treating diseases of the eye was originally suggested to Saunders
by Sir Astley Cooper, who always took a fatherly interest in it.
It was, therefore, inevitable that, to commence with, it should be
mainly staffed by his disciples and followers. Saunders had been
his house pupil and demonstrator; Travers and Tyrrell were both his
articled pupils, the latter having also married his niece. Farre and
Battley had both studied under him. In making his charge of nepotism,
Wakley complained chiefly of the rule which made it obligatory that a
candidate for the post of surgeon should have served an apprenticeship
at one of the Hospitals of the Metropolis. He pointed out that for
these apprenticeships to the London Hospital surgeons a premium of as
much as £1,000 was sometimes demanded and received, and that those for
whom these large sums were paid thereby obtained an unfair advantage
when competing for staff appointments likely to lead to renown and
emoluments.
He also commented on a rumour that a post of assistant-physician to
the Infirmary was about to be created, to which Dr. Frederick Farre,
Dr. J. R. Farre’s son, was to be appointed. This, as we shall see, did
ultimately take place, but not until ten years later and after the post
had been duly advertised, Dr. Frederick Farre being the only applicant.
The Infirmary’s announcement of Saunders’ operation for cataract in
infancy, before he had made known to the profession his method of
procedure, afforded Wakley an excellent illustration of secret surgery,
or “Hole in the Corner methods” as he termed them. He eagerly made the
most of it, raking up what he considered the misdeeds of Saunders, who
had been dead seventeen years, and whom he had never known personally.
He reprinted much of Gibson’s article on operations for congenital
cataract from the _Edinburgh Medical and Surgical Journal_, to show
that the publication of his procedure actually preceded Farre’s
publication of Saunders’ posthumous work by two months. He even accused
Dr. Farre of wilful delay in the matter, a delay which was entirely due
to the difficulties which arose in connection with the copyright.
The Committee of the Infirmary took legal advice in connection with
these defamatory articles, but contented itself with the insertion of
the following letter in The Times and other leading papers:
“LONDON OPHTHALMIC INFIRMARY, MOORFIELDS.
“At a meeting of the Committee, 6th November, 1826, Ralph Price,
Esq., in the Chair, five numbers of a weekly publication, called
the _Lancet_, dated the 7th, 14th, 21st and 28th October last, and
4th instant, and _The Times_ newspaper of the 28th October, were
laid before the Meeting; the former containing false statements and
offensive reflections upon the Members of this Committee in their
official capacities, but in a particular manner calculated to insult
the memory of the late Mr. Saunders, and wound the feelings of Dr.
Farre and Mr. Battley; and the latter echoing similar calumnies in
the form of a letter, directed ‘to the Editor of _The Times_’ and
signed ‘A Governor’; when it was resolved: That the freedom of the
Press has been violated, by becoming, in the instances referred
to, an instrument of gross malignity and abuse, and of the foulest
injustice towards two of the earliest and most tried supporters of
the Charity; that this Meeting experiences the greatest satisfaction
in again bearing testimony to the high value of Dr. Farre’s and Mr.
Battley’s undeviating and disinterested exertions during a period of
twenty-two years, which, in conjunction with their liberal pecuniary
subscriptions, have largely contributed to the rise and establishment
of this Institution.
That, this Resolution, signed by the Chairman, be inserted in four of
the Morning and two of the Evening Papers.
“RALPH PRICE, _Chairman_.”
On the retirement of Lawrence from the post of surgeon to the
Infirmary, John Scott, who had served his apprenticeship at the London
Hospital with Sir William Blizard, was appointed as Tyrrell’s colleague.
Lawrence, as has been shown in the previous chapter, was what may
be described as “a whole hogger,” so far as withdrawal of blood was
concerned for the relief of inflammation in the eye. Tyrrell, though
he employed it in many cases, was evidently doubtful as to its general
utility; thus he writes in his textbook:
“It is a great mistake to suppose that it is necessary to take away
large quantities of blood; or to bleed to such an extent as to
occasion faintness, in order to check severe local disease: I am
confident that more harm than good results from such practice.”
He advocated the importance of promoting and maintaining power in
the circulation, the principal means on which he relied being “diet,
stimuli, and tonics, which are materially aided by quietude, proper
clothing, and pure air.”
In the preparation for extraction of cataract, to prevent subsequent
inflammation, especially in the robust and plethoric, Lawrence
practised depletion, taking blood freely and repeatedly by venesection
before operation. Gradually this preliminary measure seems to have been
less and less resorted to, and, in a small monograph on _Cataract and
its Treatment_, published by Scott in 1843, he writes:
“Of the last fifty cases of extraction, taken in succession, which I
have performed at the Ophthalmic Hospital, where an accurate record
of the treatment is kept, I have not had occasion to draw blood from
the arm in a single instance, either before or after the operation.”
An anonymous writer has recorded his personal recollections of Tyrrell
thus:
“His appearance was prepossessing, his manner to his patients kind
and reassuring, and his calmness was conspicuous in circumstances
of difficulty. It is a singular fact that, when first attached to
Moorfields, his ill success as an operator was so great that he was
suspended from performing the major operations for a year; yet by
steady perseverance he acquired a dexterity with either hand that
could not be surpassed. In extraction of cataract his neatness was
remarkable, and we well remember an instance of his coolness. The
point of the section knife broke off, and dropped into the anterior
chamber. Mr. Tyrrell withdrew the knife, and without the least
expression of impatience, asked for the blunt-pointed knife, with
which he enlarged the section. He then removed the bit of steel and
proceeded to extract the lens with such perfect _sang froid_ that no
one who had not seen the breaking of the knife would have known
that anything untoward had occurred.
“Mr. Tyrrell’s great success depended fully as much on his judicious
after-treatment as on his manual dexterity; and his secret lay in not
exhausting the systems of his patients unnecessarily, but keeping the
balance of power precisely at healing point.
“On a hot day in May, 1843, whilst an active competition for a
house was going on at the Auction Mart, an alarm was raised that a
gentleman had fainted. He was carried out. Alas! it was Frederick
Tyrrell, who had attended the sale for the purpose of purchasing the
very lot then under competition, which, indeed, was the house he
occupied. His heart was diseased and thus he died!”
PLATE VII.
[Illustration: FREDERICK TYRRELL.]
In 1840 he published a book in two volumes entitled _A Practical Work
on the Diseases of the Eye and their Treatment, Medically, Topically,
and by Operation_. It was dedicated to his ophthalmic pupils, and
contained the outcome of the extensive experience which he had gained
at the Infirmary. His memory has, however, become enshrined in the
annals of ophthalmology, not so much by his writings, as by a blunt
hook which he introduced for the operation of making an artificial
pupil, which is still known as “Tyrrell’s hook,” and without which no
ophthalmic armamentarium is complete.
It is interesting here to note how far more frequent operations to
produce an artificial pupil were one hundred years ago than they
are now. In all the early treatises on eye disease much space was
devoted to the discussion of the various methods of producing such
artificial openings for the restoration of sight. The only inference
is that occlusion of the natural pupil by inflammatory membranes was
then of more frequent occurrence, and that the improved methods of
treating inflammatory eye affections, and the more successful operative
procedures for cataract, have reduced the number of such occlusions.
In 1828 a body of ladies interested in the Charity carried out a
most successful sale of useful and ornamental work on its behalf. The
President of the Infirmary, Mr. William Mellish, obtained for the sale
the patronage of the Lord and Lady Mayoress, and permission to hold it
in the Egyptian Hall at the Mansion House. The sale commenced on April
30th, and lasted three days; stalls were presided over by thirteen
ladies, and the sum of £2,309 9s. 6d. was realised.
On the announcement of this result at a General Meeting of Governors a
long and flowery resolution of thanks was passed to all concerned, of
which the opening sentence will suffice as an example of the rest:
“That this unprecedented success of the plan conceived with so much
benevolence and executed with so much zeal and ability by the ladies
who have honoured the Institution with their patronage on this
occasion, whilst it reflects the highest honour on the ingenuity,
industry and charity, which combined to produce so beneficial a
result, is eminently conducive to the best interests of the Infirmary
and highly gratifying to its Governors and friends.”
In 1830 Tyrrell, who had been carrying on the duties of surgeon
to the Institution for twelve years, became desirous of receiving
some aid, and applied to the Committee for the appointment of an
assistant-surgeon; this was agreed to, and after the post had been
advertised two applicants came forward, Gilbert Mackmurdo and John
Dalrymple. In the ballot which ensued 591 Governors voted, Mackmurdo,
who had served his apprenticeship under Travers at St. Thomas’s
Hospital, obtaining a majority of 143.
Two years later it was found desirable to open the Infirmary for
out-patients on four days a week instead of three, as had up to
then been the custom, and also to make the hours of attendance from
8 a.m. until 10 a.m. instead of from 12 noon to 2 p.m. A second
assistant-surgeon was then appointed to act with John Scott, and John
Dalrymple, who was the only applicant, was elected.
PLATE VIII.
[Illustration: JOHN SCOTT.
From an engraving, after a picture by H. Howard, R.A.]
John Scott, shortly after his appointment as surgeon to the
Infirmary, was appointed assistant-surgeon to the London Hospital,
becoming full surgeon there in 1831. He continued his work at the
Ophthalmic Infirmary until shortly before his death, which occurred
after a prolonged illness in 1846.
His name is best remembered in General Surgery in connection with his
treatment of joints and chronic ulcers of the leg. “Scott’s dressing”
and “Scott’s ointment” are still well known, the latter being a
camphorated mercurial ointment. He was the first surgeon in England to
remove the upper jaw, and was renowned for his skill in bandaging. His
only published contribution to ophthalmology was a small monograph on
_Cataract and its Treatment_, in which he described a new method of
making the section of the cornea in the operation of extraction. It
had previously been the custom to use a wedge-shaped knife for this
purpose, which was made to cut by thrusting it through the anterior
chamber of the eye; the force necessary to do so tended to rotate the
eyeball in an objectionable manner. Scott devised a knife, shaped like
a sickle, with which he was able to transfix the cornea and then cut
upwards. Though his knife has fallen completely out of use, the general
principle of first transfixing and then cutting out is now almost
universally employed. The writer of his obituary notice, his junior
colleague at the London Hospital, Walter Rivington, describes him as
“an honest but very irritable man,” and one who had no sympathy with
humanity.
Another writer who knew him says:
“A colleague of Frederick Tyrrell’s at Moorfields was John Scott,
who presented as great a contrast to the former as could well be
imagined. Impatient and irritable in manner, he could not bear
anything to go wrong; no man lost vitreous humour more frequently
during extraction, at which he was invariably annoyed, ascribing it,
however, to fluidity of that body.”
A great loss to the Infirmary in 1835 was occasioned by the death of
its secretary, Matthew Heathfield, who had served it in that capacity
with marked assiduity and enthusiasm for fifteen years. His successor
only held the office for a few months before he was obliged to give
it up on account of ill-health. In April, 1835, Francis William
Bircham was appointed secretary at a salary of £52 10s. annually.
It is noteworthy that the firm of solicitors to which he belonged,
Messrs. Bircham, Dalrymple and Drake, now Messrs. Bircham and Co., of
46, Parliament Street, S.W.1, still act as honorary solicitors to the
Hospital.