Three matrons at the Hospital resigned from ill-health in the course

of a few years, and, in 1895, Miss Ada Robertson, a former sister at

the London Hospital, was appointed to the post. She not only carried

through the difficult task of transferring the work of the Hospital

from the old to the new building, but also, with skill and tact, raised

the nursing to a higher standard of efficiency than it had reached

before.

In 1897 Mr. Charles Gordon, who had acted as Chairman of the Committee

of Management for eighteen years, and who had taken an active part in

all the negotiations for the removal of the Hospital to a new site, on

the eve of the laying of the foundation stone, found it incumbent upon

him to resign owing to his advanced years; he died two years later.

Thus, like Moses, having led his colleagues to within sight of the

promised land, he left it for them to enter into its occupation.

Mr. H. P. Sturgis, a director of the London and Westminster Bank, was

elected Chairman in his place.

About the same time, Mr. Robert J. Newstead, after twenty-five years’

service as secretary, had to resign from ill-health, and died at the

end of the year. Mr. Robert J. Bland was appointed as his successor.

On the 28th of May, 1897, the work of clearing and preparing the

foundations being sufficiently advanced His Royal Highness the Prince

of Wales (afterwards King Edward VII.), on behalf of Her Majesty

Queen Victoria, laid the foundation stone of the new Hospital. His

Royal Highness was accompanied by their Royal Highnesses the Princess

of Wales (afterwards Queen Alexandra) and Princess Victoria, the

former graciously consenting to receive purses containing donations

in aid of the Hospital. The silver trowel used on the occasion, which

was provided by Mr. E. Hogg, one of the members of the Committee of

Management, was presented to His Royal Highness, who stated “it is Her

Majesty’s great and earnest wish that this Hospital may be prosperous

and successful in every way.” Her Majesty further manifested her

continual interest in the Charity by giving a donation of £100 to

the Budding Fund. The Prince of Wales on his departure signified his

intention to become a Patron of the Hospital.

In the removal of the Hospital from a prominent situation which had

developed into a great business centre to a less known district easily

accessible to those to whose needs it ministered the Committee of

Management hoped to defray the cost of the building by the proceeds of

the sale of the old site, and in doing so it was not far out in its

reckoning. The old Hospital was sold for £78,500, and the new Hospital

cost about £80,000. To provide the funds for the new building, whilst

the work was being carried on in the old one, large loans had to be

negotiated on the security of its freehold and leasehold property.

In addition to the cost of the building the Committee had to provide

funds for furnishing the new building, and equipping it with appliances

and apparatus in keeping with its position as the leading ophthalmic

institution in the British Empire. For this purpose it made a special

appeal which was liberally responded to by the Corporation of the City

of London and the following City Companies: The Worshipful Company of

Carpenters, of Clothworkers, of Drapers, of Dyers, of Fishmongers, of

Goldsmiths, of Grocers, of Leather Sellers, of Mercers, of Merchant

Taylors, of Sadlers, of Salters, and of Skinners.

The fund was further augmented by a festival dinner held at the Grand

Hotel, Charing Cross, on the 6th of May, 1898, over which His Royal

Highness the Duke of Cambridge graciously presided, he himself making

a liberal contribution to the cause for which he pleaded. In the

following year a large and influential number of ladies promoted a ball

in the Empress Rooms at the Royal Palace Hotel, Kensington, on the

Hospital’s behalf, and Sir Squire Bancroft generously gave to it the

proceeds of one of his inimitable readings.

When the clearance of the site for the new Hospital in the City Road

was commenced, a Building Committee was appointed, consisting of

certain members of the Committee of Management, with Mr. H. Davidson

as chairman, and three representatives of the Medical Council, Tweedy,

Gunn, and its honorary secretary, at first Morton, and later Treacher

Collins.

One of the first questions this Committee had to consider was the dual

one of the ventilation and warming of the new building. Was the system

of ventilation to be “natural” or “artificial”? If artificial, was it

to take the form of propulsion or extraction, or a combination of

both? It has been well said “that theories in ventilation and warming

are as numerous as trees in a forest,” and so the Building Committee

discovered when they commenced to consider the problem. Several

hospitals in which artificial ventilation was in use were inspected;

ultimately it was decided that artificial ventilation on the planum

system should be adopted for the out-patient department, and that

natural ventilation should be relied upon for the wards.

The air forced into the out-patient department is first filtered, and

then warmed or cooled as required. A shaft is provided which allows the

foul air to escape. The force employed is a large rotating fan-wheel

which propels the air along underground passages, and through gratings

which open into the various compartments. It is filtered by passing

through a coke-screen, which is cleaned with a stream of water flowing

over it automatically at periodic intervals. It is warmed by passing

over hot-water radiators situated close to the gratings opening into

the compartments. It can be cooled by substituting blocks of ice placed

on the radiators for the hot water contained in them.

In the wards the position of the windows is arranged to allow of cross

ventilation, and the main sources of heat are open fires. Additional

sources for warmth and ventilation are provided by hot water radiators,

past which fresh air is allowed to enter through gratings near the

floor. A separate sanitary block running through the centre of the

building is cut off from it by cross-ventilation lobbies.

Only those who worked in the old Hospital in Blomfield Street can fully

appreciate the amenities afforded by the new one in the City Road.

Daily at noon the whole in-patient department in the old building

became permeated with the odour of cooked meat. In the new Hospital all

such disagreeable smells have been avoided by having the kitchen placed

on the top floor. Most of the cooking is carried on by steam, supplied

from boilers in the basement. A special service lift conveys goods to

the kitchen, and also permits of the distribution of food and fuel to

various parts of the building. Both this lift and the passenger lift

are worked by hydraulic power; the latter allows of the conveyance of

a patient on a wheeled trolley, in the recumbent position, to his bed

from the operating table.

The lighting arrangements in the out-patient department, for the

examination of the patients and the testing of their eyesight, and

in the operating theatre to meet its varied requirements, engaged

the architect’s and the Committee’s prolonged consideration. For the

examination of patients in the first instance, and for many operations,

uninterrupted direct skylight from a northern aspect was regarded as

essential, and the new building was so planned as to allow of this in

the large consulting room and in the operating theatre. As the work

of the Hospital has to be carried out on dark days as well as bright

ones, adequate means for the examination of patients by artificial

light, in the absence of daylight, had to be provided. In the old

Hospital, where gas was the main source of artificial illumination,

there were various contrivances rendering it more or less efficient

by the use of reflectors. In the operating theatre, a device used

by the Nottingham lace workers had been employed. It consisted of a

large hollow glass globe filled with water and suspended from the

ceiling, which concentrated light from a lamp placed behind it on to

the face of a patient lying on the operating table. The introduction

of electricity for illuminating purposes throughout the new building

simplified matters considerably. In the consulting room, movable

flexes and adjustments permit light being easily brought into the most

suitable position in which to conduct an examination. The employment

of electric light globes for ophthalmoscopic examinations in the dark

room, in place of argand gas burners, renders the atmosphere in it far

more healthy and pleasant to work in, but it is doubtful if any form of

electric bulb supplies quite such a uniform and satisfactory area of

illumination for these examinations as the old argand gas burner.

The electric current supplied to the Hospital for lighting purposes is

an alternating one; fortunately a constant current was also available

in the district, being used in neighbouring factories. One of the chief

purposes for which it is required is for working electro-magnets for

the extraction of chips of iron or steel implanted in the interior of

the eyeball.

It has been already mentioned how in 1858 Dixon tried unsuccessfully

to remove a chip off the edge of a chisel, seen floating in the

vitreous chamber, by a permanent magnet. In a similar case, McKeown of

Belfast, in 1874, succeeded in the removal of the foreign body by the

introduction of the tip of a permanent magnet into the interior of the

eye.

In 1878 Malcolm McHardy, who was later ophthalmic surgeon to King’s

College Hospital, employed for the first time an electro-magnet, and

with it successfully removed a chip of steel which had become embedded

in the crystalline lens. A few years later, Snell of Sheffield,

Hirschberg of Berlin, and Bradford of Boston, U.S.A., had constructed

electro-magnets which could be held in the hand, and have suitable

terminals attached to them for introduction into the interior of the

eye. Considerable success attended the use of such instruments when

fragments of iron were situated in the front parts of the eye, but only

on rare occasions when they had become deeply placed in the vitreous

humour. In these latter cases, the foreign body was often hid from

view, due to opacity of the lens caused by the injury, so that its

exact position was unknown, and there was some doubt as to whether it

had lodged in the eyeball or not. It was only when the nozzle of the

hand magnet came close to the foreign body that it possessed sufficient

traction power to draw it out, and in searching for it much damage was

liable to be inflicted on the structures in the interior of the eyeball.

On the discovery of the X-rays by Professor Röntgen in 1895 it occurred

to many ophthalmic surgeons that they might be utilised for the

detection of foreign bodies in the eye. Two practical difficulties at

first presented themselves, both of which were ultimately overcome.

One was the density of the bony structures around the eyeball, and the

other that of locating accurately the position of a foreign body when

detected. It was found that excellent skiagrams, showing exceedingly

minute pieces of metallic substances in the orbit, could be obtained

if the sensitive plate was placed against the temple on the side of

the injured eye, and the Crookes tube 10 to 15 mm. distant from the

opposite temple. The most accurate localisation of foreign bodies

implanted in the body was effected by an ingenious device of Mackenzie

Davidson’s in which, after superimposing two skiagrams taken at

slightly different positions, he followed the tract taken by the rays

from the Crookes tube to the foreign body by means of threads, noting

where they crossed in relation to the position of other known points.

Mackenzie Davidson (afterwards Sir James Mackenzie Davidson) worked

at Moorfields as clinical assistant, and subsequently practised as an

ophthalmic surgeon in Aberdeen. Soon after the discovery of X-rays, he

removed to London and devoted himself specially to their application

to surgery and medicine. His combined interest in ophthalmology and

X-rays made him desirous of testing his method of localising foreign

bodies in connection with eye injuries. Several members of the staff

at Moorfields sent cases to him to report on, and such accurate and

helpful information did he supply, not only as to the presence or

absence of a foreign body in the eye, but also as to the exact position

in which, when present, it could be found, that a desire arose to

establish a special X-ray department and to secure his services in

connection therewith. On the recommendation of the Medical Council,

this was agreed to by the Committee of Management in November, 1898,

£80 being voted for the cost of apparatus and an annual expenditure

of £20 for the working expenses of the department. Mackenzie Davidson

consented to accept the appointment of honorary medical officer in

charge of the X-ray department, and a special room was fitted up in the

new Hospital with the necessary conveniences for carrying on the work.

The introduction of the constant electric current into the operating

theatre allowed of the employment of far more powerful magnets for the

extraction of fragments of iron from the eyeball than had previously

been used in this country. These powerful magnets have appropriately

been described as “giant magnets”: they were originally introduced into

ophthalmic practice by Professor Haab of Zurich. Their traction force

is so great that a chip of iron hidden in the back part of the eyeball

can be drawn forward into view in the front part.

In the _Hospital Reports_, H. V. McKenzie, the house surgeon in 1895,

collected notes of all the cases in which a foreign body had been

removed from the eye by the small hand magnet—_i.e_., prior to the

introduction of X-ray localisation, and found that in 26 per cent, of

those in which it was lodged in the vitreous the eye was saved. In 1902

the house surgeon, A. F. MacCallan, tabulated the results obtained

by the use of Haab’s Giant Magnet, and found that in a similar class

of cases by its use 58 per cent. of the eyes were saved, and that in

half of these good vision was obtained. If accurate localisation of

the foreign body by X-rays was carried out previous to the use of the

magnet, a still larger percentage of success resulted.

The operating theatre in the new Hospital has been designed to make

possible the practice of aseptic surgery. Antiseptic surgery, as first

introduced, relied on the destruction of micro-organisms by chemical

agents, and it was thought essential, whilst an operation was in

progress, to have a spray of carbolic acid playing to prevent aerial

infection of the wound. Later, as the result of experience gained in

bacteriological laboratories, it became realised that such a precaution

was unnecessary; micro-organisms being like dust particles subject

to the law of gravitation, all that was required was to prevent any

accumulation of dust and to avoid currents of air.

To avoid any accumulation of dust in the new operating theatre, its

walls, ceilings, and floor are so constructed that at any time they

can be washed over with a hose. The wall and ceiling are lined with

glass tiles, technically known as “opalite,” the floor is paved with

terazzo, and all the corners are rounded. All the pipes are of copper,

and the radiators of the same metal. The latter are constructed so that

they can be swung out on a pivot, and no dirt be allowed to accumulate

behind them; they are in three divisions, which allow of variations in

the amount of warmth given out as may be required.

To permit as many onlookers as possible being able to watch the

operator’s procedures, without inconveniencing him or his assistants,

fixed stands are erected on each side of the operating table, each

stand being composed of three tiers, and each tier accommodating four

persons.

The colour of the tiles on the walls and ceiling is a creamy-white with

a dado of pale green. As some operations have to be conducted in a

darkened room by artificial light concentrated on the eye, a dark blind

is provided which can be drawn up from below, being enclosed when not

in use in a brass box.

The case in which the instruments are stored is constructed entirely of

brass and glass, and apparatus is provided to allow of the instruments

being sterilised by boiling them before use. A special steriliser for

dressings is also provided, with an outer jacket for steam, which

permits of them being delivered dry when required for use.

In the wards, passages, and other parts of the building, all possible

precautions are taken to avoid any lodgments for the accumulation of

dust, the floors of all the wards being constructed of polished teak,

and wherever possible the corners are rounded. All cupboards have

sloping tops, and are fixed to the walls at such a height that the

highest part of them is easily within reach. Arrangements are made for

the storage of the patients’ clothes, when in bed, in special cupboards

outside the wards, and the small marble-topped lockers placed beside

their beds were specially designed just to contain a few of their

possessions.

A special eye hospital differs from a general hospital in the large

proportion of its patients who are able to be up out of bed during the

daytime. It is, therefore, desirable to have special day rooms in which

they can congregate away from the wards, and have their meals. In the

new Hospital, on each floor, such day room accommodation is provided.

Notwithstanding the enormous amount of work involved in the removal to

the new building, it was effected with scarcely any interruption in

the routine work of the Institution. The new building was opened for

the reception of patients on September 4th, 1899, the work in the old

Hospital being carried on for in-patients up to August 19th, and for

out-patients up to August 26th.

CHAPTER XII

THE HOSPITAL IN THE CITY ROAD

On June 28th, 1899, the now dreary neighbourhood of the former

“Peerless Pool” once again awoke to life and notoriety with a visit

from their present Majesties King George V. and Queen Mary, then the

Duke and Duchess of York, to open the new “Peerless” Eye Hospital.

A lengthy description of the ceremony appeared in The Times on the

following day.

The Duke and Duchess of York, attended by Sir Charles Cust and Lady

Katherine Coke, arrived at the Hospital shortly after half-past 3

o’clock, and were received by Sir John Lubbock, the President, Mr.

H. P. Sturgis, Chairman of the Committee of Management, and the

architects, Messrs. Keith Young and H. Hall. The Duke, who received a

gold key from the architects, unlocked the door of the main entrance

hall, where the surgeons of the Hospital, the matron, Miss Robinson,

and the secretary, Mr. R. J. Bland, were presented to their Royal

Highnesses. The Royal party were then conducted over the building, and

after completing their inspection they entered the out-patients’ hall,

which had been prettily decorated for the opening ceremony, and where a

large company had assembled. Among the visitors, in addition to those

already named, were the Lord Mayor and Lady Mayoress, Mr. Alderman

and Sheriff Alliston, Lieutenant-Colonel and Sheriff Probyn and Mrs.

Probyn, the Bishop of Islington and Mrs. Turner, the Rev. Prebendary

Whittington (chaplain), Sir J. Whittaker Ellis and Lady Ellis, Lady

Faudel-Phillips, Sir Squire and Lady Bancroft, Mr. J. Lea Smith

(trustee), Mrs. Sturgis, Sir T. Lipton, and the Rev. Dr. Hermann Adler

and Mrs. Adler, Mr. H. Davison (chairman of the Building Committee)

and Mrs. Davison, Mr. A. G. Pollock (chairman of the Special Appeal

Committee) and Mrs. Pollock. The little daughter of Mr. John Tweedy,

the senior surgeon, presented a handsome bouquet of pink roses to the

Duchess, who was dressed in pale green eau de Nil silk with a toque of

pink roses. Prayers having been said by the Bishop of Islington, Sir

John Lubbock called upon Mr. Sturgis to make a statement.

PLATE XXV.

[Illustration: THE ROYAL LONDON OPHTHALMIC HOSPITAL IN THE CITY ROAD,

OPENED IN 1899.]

Mr. Sturgis said that they valued extremely the presence of the Duke

and Duchess of York, inasmuch as their Royal Highnesses represented

the fourth generation of the Royal Family who had shown interest in

the Hospital. He related the circumstances which had necessitated its

removal from its old site at Moorfields and the erection of the present

building, which the Committee had endeavoured to make as perfect as

possible, and which they would come into free from debt. This, however,

he went on to say, was only the beginning of their task. They had to

consider the maintenance of the establishment. The cost of maintenance

at the old building was about £8,000 a year, and their regular income,

including grants from the Hospital funds, did not reach the sum of

£3,000 a year, so that they had to make up the difference in other

ways. But the cost of maintenance in the new building would be as

much as £11,000 a year. He hoped their income would increase to a

corresponding extent. What they wanted more than anything else was an

increase in annual subscriptions, and they wished to raise a fund of

£50,000 which would be a guarantee for the large ground rent which they

now had to pay.

Sir John Lubbock, after expressing indebtedness to all those concerned

in the work of the Institution, asked the Duke of York to declare the

building open.

The Duke of York said:

“Sir John Lubbock, Mr. Sturgis, Ladies and Gentlemen, I am grateful

to Sir John Lubbock for the kind words he has used with regard to

our coming here to-day, and I have been very much interested in all

I have heard from Mr. Sturgis, the Chairman of the Committee. I

thank you all in the Duchess’ name as well as my own for the very

kind reception you have given us. It is an especial pleasure to

the Duchess and myself to come here to-day, as my father laid the

foundation stone of the new building in 1897, and therefore we are

completing the work, so to speak, which he inaugurated.” (Cheers.)

“As Mr. Sturgis told us just now, of late years the number of

patients increased so enormously that the old buildings were found

quite inadequate to their wants, and the Committee were compelled to

seek a larger site for this new building. And, if I may be allowed to

do so, I wish to congratulate the architects on the excellent result

of their labours, and I also wish to congratulate the Committee and

the medical staff on occupying a new Hospital designed and equipped

according to the most modern requirements. The cost of maintenance of

these new buildings, which cover three-quarters of an acre, will be,

I fear, as Mr. Sturgis has just told us, very heavy, but I am sure

the Committee deserve the generous support of the charitable public

to enable them to continue the useful work that has been so ably

carried out by this Hospital for nearly a century, and I can only say

that I trust that the public will come forward and help this Hospital

and prevent it from getting into debt by their annual subscriptions.

I have now much pleasure in declaring this new building open, and the

Duchess joins with me in wishing the Royal London Ophthalmic Hospital

continued prosperity in this new building, and a long career in its

great and important work.” (Cheers.)

Their Royal Highnesses then left the building, and were heartily

cheered by a large crowd in the street as they drove away.

As a lasting memorial of the visit of their Royal Highnesses the

Children’s Ward was named the “Princess May” Ward. After their visit,

they consented to become Patrons, and presented copies of their

portraits to the Hospital, with their autographs attached.

The hopes expressed by Mr. Sturgis, the Chairman of the Committee,

at this opening ceremony, that increased financial support would be

forthcoming to meet the additional annual expenditure, were completely

shattered for a time by the outbreak of the South African War. As at

the time of the Crimean War, the sympathies and contributions of the

public became diverted to funds for soldiers and sailors, and the

donations and new subscriptions to the Hospital almost ceased to come

in, the result being that the Hospital, in September, 1900, found

itself £5,000 in debt.

One of the largest and most unforeseen items in increased expenditure,

resulting from the removal of the Hospital, was the enormous addition

to the amount in rates which it was called upon to pay. The Hospital at

Moorfields was assessed by the City of London Union at a nominal amount

the rates for the year 1897 being only £88. The Holborn Union, in whose

area the new building was situated, adopted a different course, and

the rates for 1900 amounted to £870 nearly an eleventh part of the

Hospital’s annual total expenditure. In 1901 they increased to £948,

and in 1902 to £972. No other hospital in London was assessed so highly

in proportion to its income and size, St. Thomas’s and Guy’s being the

only London hospitals paying heavier rates.

In answer to an appeal against such excessive rating the authorities

replied that, as the Hospital relieves patients from every part of

London, as well as many parts of the country, they could not treat it

on the footing of a local charity.

In 1900 the Hospital, owing to its embarrassed financial condition,

was in arrears with the payment of two instalments of rates, amounting

to £324, and a summons was served on it. The Justice of the Peace who

had to deal with the matter stated “that he had no other course but

to order payment within fourteen days.” This summons became widely

reported and commented on in the public press; considerable sympathy

with the Hospital was thereby evoked, and in the course of three days

donations and subscriptions came in, amounting to £300, which enabled

it temporarily to meet its difficulties. Ever since, however, the

annual amount which it has had to pay in rates has fluctuated between

£800 and £1,000. Thus this Institution, which every year rescues

numbers of people from loss of sight and from becoming rate-supported,

has to raise this large sum in voluntary contributions from the

benevolent public to pay out in rates.

Until the year 1875 hospitals were not regarded as ratable, as there

was no obvious person connected with them to be assessed. In that year,

however, the House of Lords ruled that voluntary hospitals had no right

to such exemption and must pay rates as other premises, though no one’s

sense of justice had appeared to be offended. If, as they so frequently

profess, public bodies wish to aid and support the work of voluntary

hospitals, no more efficient method could be found than to exempt

them again from this inconsistent and burdensome form of taxation. In

connection with the Rating and Valuation Bill, which was before the

House of Commons in July, 1928, a discussion on the rating of hospitals

took place, being raised in connection with an amendment proposed by

Mr. Harris, Member for South-West Bethnal Green, and seconded by Mr.

Briant, Member for North Lambeth. The Minister of Health, Mr. Neville

Chamberlain, whilst expressing his sympathy with the matter, did not

consider the Bill to be one in which relief of that kind to hospitals

could be given effect, it being for the stimulation of industries,

and he refused to consider that the maintenance of the health of the

community was likely to give such stimulation.

What at first seemed likely to be a most severe blow to the Hospital’s

means of maintenance ultimately resulted in its salvation. This was

the establishment of the Prince of Wales’ Hospital Fund (afterwards

King Edward’s Hospital Fund), and the diversion to it of annual

subscriptions previously paid to the Hospital—_e.g_., the Drapers’

Company, which had for several years given a subscription of ten

guineas, notified in 1900 that it would in future be discontinued as

the Company was subscribing annually to the Prince of Wales’ Fund. The

receipt of the following letter was, therefore, a source of immense

relief and satisfaction to all connected with the Hospital:

“THE PRINCE OF WALES’ HOSPITAL FUND FOR LONDON.

“THE BANK OF ENGLAND,

“27_th December_, 1901.

“THE TREASURER,

“ROYAL LONDON OPHTHALMIC HOSPITAL

“City Road, E.C.

“Sir,

“By the desire of His Royal Highness, the President, I have the

honour to enclose a cheque for £2,850.

“Of this sum, £900 is an annual grant to open eighteen closed beds,

on the condition that by the opening of these beds eighteen more are

made available for the sick poor in your Hospital; and the balance of

£1,250 is a special donation for this year.

“I am also directed to inform you that your building is reported on

as a very fine new building. The Visitors state that all the Wards,

Operating Rooms, etc., are thoroughly practical and up-to-date, and

that your very complete Hospital requires considerable additional

funds to carry on its useful work.

“Kindly acknowledge the receipt of the above.

“Yours faithfully,

“(Signed) S. CROSSLEY,

“_Honorary Secretary_.”

In June, 1902, His Majesty the King himself became an annual subscriber

of ten guineas to the Hospital.

In December, 1902, a still more liberal grant was made by the King

Edward’s Hospital Fund for London, as shown by the following letter:

“Sir,

“I am directed by His Royal Highness the President to enclose a

cheque for £4,500.

“Of this sum, £900 is an annual grant to support 18 beds opened by

the aid of this Fund. The balance, which consists of £1,100 as an

annual grant and £2,500 as a special donation for this year, is given

on the condition that 30 more beds are opened in your Hospital so

that by opening those beds 30 more are made available for the sick

poor in your Institution.

“Kindly acknowledge the receipt of the above.

“Yours faithfully,

“(Signed) SAVILE CROSSLEY,

“_Honorary Secretary_.”

The wards in the new Hospital were constructed to hold 138 beds, but at

first, owing to its serious financial deficiency, only 70 could be made

available for use. By the help of the King’s Hospital Fund in 1901, 18

more were opened up, and, in the following year, by the help of the

same fund, an additional 30, leaving only 20 vacant. The opening of the

wards containing the additional 30 beds in 1902 was made a ceremonial

occasion by the visit to the Hospital in state of the Lord Mayor and

some of the Sheriffs of the City of London.

In order to pay off its liabilities, the Committee of Management,

during 1902, had to obtain a loan of £5,000 on the security of the

Harry Sedgwick Trust Fund, £7,000 of which was retained by the Charity

Commissioners until such time as the compound interest on it had

sufficiently accumulated to repay the loan. The annual income of the

Hospital was thereby temporarily reduced by the interest on these

two amounts. In 1909, by the realisation of certain legacies, the

Hospital was enabled to repay this loan, the dividends on the fund then

reverting to it.

To find some fresh source of income it was agreed, at a joint meeting

of the Committee of Management and the Medical Council, to try

experimentally what could be obtained by asking each out-patient on

admission to make a voluntary contribution, no compulsion to do so

on any account being used. At the end of three months it was found

that an annual amount of £1,150 could be obtained in this way, without

giving any offence to those solicited for help.

The way in which the new building was constructed necessitated some

changes in the customs of the staff. The out-patient department was

entirely separated from the in-patients, and it was thought desirable

that the two classes of patients should be kept completely apart. This

necessitated a second operating room specially for out-patients, for

which provision had been made, and over which a special sister was

appointed to preside. In the immaculate in-patient operating theatre it

became the established custom for the surgeons working there to wear

sterilised white cotton coats, instead of their ordinary ones, as they

had done previously.

It may also be noted how customs have changed with regard to the

hirsute appendages of the face in the members of the medical staff at

different epochs. In the first half of the nineteenth century, all the

members of the staff wore side whiskers. During the Crimean War our

soldiers grew beards, and on their return beards became the fashion of

the time. The surgeons at Moorfields, from the middle of the century up

to the commencement of what may be described as the aseptic era, all

wore beards. No surgeon on the staff now wears a beard; they are all

either clean-shaven, or at most wear a closely-cut moustache.

The costume of the in-patients when taken into the operating theatre

also needed consideration, and in the provision for them of special

overalls the idea of a ladies’ working guild first originated. The

following description of its commencement and early progress was given

in its Fifth Annual Report, dated December 31st, 1904:

“In the winter of the year 1900, Mrs. Quarry Silcock, Mrs. Treacher

Collins, and the matron, Miss Richards, with a few other ladies who

had special opportunities of knowing the difficulties with which the

Hospital had to contend for lack of funds and public interest, banded

themselves together and determined to help the Institution. They

formed themselves into a Committee under the Presidency of Lady John

Tweedy, and were fortunate in inducing many of their friends to join

them. They determined to take upon themselves the essentially womanly

task of supplying all the clothing, house and bed linen required in

the Hospital for the use of the patients, and so successful were

they that, not only were they able to do this, but by the end of

the second year they were in a position to hand the sum of £50 to

the general funds. The movement has since so far grown that many

more necessaries have been added. The beds in the new wards, opened

in 1903, were supplied with blankets, coverlets, and sheets from

the fund, and the Guild has for the past two years maintained a

Cot and a Woman’s bed in the wards. It also extends its operations

in other directions that can be of help to the Hospital. Through

the consideration of several members, the Nurses’ library has been

replenished with interesting and useful books. Other members have

rendered personal service by visiting at the Hospital, and have thus

relieved the monotony of the hours spent by the suffering patients by

reading pleasant books, entering into kindly conversation with them,

and amusing them with singing and music. The cheering effect of such

visits and the assistance they are in the work of recovery cannot be

overestimated.”

Extensive as were the improvements in the new Hospital over the old,

in course of time fresh requirements cropped up, and it was discovered

that some of the arrangements might have been better still. Any

imperfections cannot, however, be attributed to oversight on the part

of the architect, but rather to want of foresight and imagination on

the part of those from whom he received instructions as to what to

provide for. When first the rebuilding of the Hospital was decided on,

the question was discussed as to whether the out-patient consulting

room should be constructed to allow for accommodation of an increase

in the number of the surgical staff, and the decision was deliberately

arrived at that no such increase was desirable or likely to be required.

By the appointment of Soelberg Wells as an additional assistant-surgeon

in 1867, the number of the surgical staff became increased to nine.

Three surgeons attended each day and each came twice a week. Such an

evenly balanced arrangement worked satisfactorily for a number of

years. In 1867 the number of new out-patients was 17,211; in 1900

the number had increased to 36,932—_i.e_., more than double. The

work entailed in dealing with this large increase of patients was,

however, far more than double in amount to what it was in 1867, because

sight-testing and the correction of errors of refraction had increased

both in extent and accuracy. It is not surprising, therefore, that

those surgeons who had but few clinical assistants found themselves

unable to cope with all the demands made on them. In 1890 the post of

paid refraction assistant had been created to aid the staff in that

class of work. T. Phillips held this post for a number of years: he

attended daily and became exceedingly expert in dealing with a large

number of cases in a very short time. When, however, he was absent

on a holiday or from illness, those who relied upon his assistance

experienced great difficulties in getting through their work, patients

even sometimes having to be sent away unseen.

In 1900 the Committee of Management determined that some fresh

arrangement was essential, and advocated the appointment of additional

assistant-surgeons: after considerable discussion this was agreed to,

and the surgical staff was increased to twelve. The three new members

to be appointed were to rank as assistant-surgeons, and their work

was to be confined to the out-patients, except in the absence of the

surgeon of the day. This was a reversion to a former plan, which after

a short trial broke down, each member of the staff again attending to

both out- and in-patients. Fortunately at that time there were a large

number of able clinical assistants, who became candidates for the new

posts, from amongst whom Percy Flemming, assistant ophthalmic surgeon

at University College Hospital, J. Herbert Fisher, assistant ophthalmic

surgeon at St. Thomas’s Hospital, and Arnold Lawson (afterwards Sir

Arnold, and ophthalmic surgeon at the Middlesex Hospital) were elected.

The result of this increase of the staff was that the out-patient

consulting room, originally designed to accommodate three surgeons and

their clinical assistants, had to accommodate four.

When the number of beds in use became increased to 118, the services

of a third house surgeon were found requisite, those of the two senior

being required for the in-patients, and those of the junior being

confined to the out-patients. No accommodation had been made in the new

building for an increase in the resident staff, and some reconstruction

of rooms became necessary.

The accommodation required for the nursing staff had been sadly

underestimated, and a part of the building which had been designed as

an isolation quarters for sick nurses had to be taken into general use.

At the present time, even with these additional rooms, it would be

impossible to make use of all the beds for in-patients with which the

Hospital is provided without first securing increased accommodation for

nurses.

A nurse may have completed three years’ training at a general hospital

and have acquired sufficient theoretical knowledge to pass the

examination which is considered essential before she is granted a

certificate, and yet be incompetent to nurse a case of eye disease.

Moorfields Hospital has become, not only a special training school for

ophthalmic surgeons, but also for ophthalmic nurses. Many who have

been trained there have subsequently been appointed to take charge of

ophthalmic institutions or departments in various parts of the United

Kingdom, in the Colonies, and in America.

In 1896 courses of lectures given by members of the surgical staff

were instituted for nurses, in addition to the instruction which they

received from the matron: such courses have been regularly carried on

ever since. In 1907 arrangements were made with the authorities of the

Queen Victoria’s Jubilee Institute for Nurses to allow of the district

nurses employed by them to attend at the Hospital and receive practical

instruction in ophthalmic nursing free of charge. Fifty-three such

nurses attended at the Hospital in 1907, and fresh ones have continued

to attend ever since.

A large room was set apart in the new Hospital as a lecture theatre,

and, as the teaching became more systematised and the number of

students steadily increased, it became desirable to have a Dean

appointed to advise the students as to their studies, and to

superintend the classes: to this post W. T. Holmes Spicer was elected

in 1899. The teaching at Moorfields up to 1920, when the Royal Colleges

of Physicians and Surgeons established a Diploma of Ophthalmology, had

been post-graduate and almost entirely clinical and pathological, the

laboratory and museum affording excellent facilities for the latter.

In order to obtain the Diploma of Ophthalmology it became necessary

for students to pass a first examination in optics, and in the anatomy

and physiology of the parts concerned in ophthalmic surgery. To meet

the requirements of candidates for this examination, Moorfields then

instituted special courses of instruction in these scientific subjects,

upon which the practice of ophthalmology must always be based. In so

doing it has become a complete school of ophthalmology.

Graefe, in his work on the ocular muscles, described what are termed

latent squints—_i.e_., squints which only become manifest when the

desire to see singly with the two eyes is removed. Increased attention

to them was awakened in 1886 when Stevens of New York suggested

a convenient form of nomenclature to describe their different

varieties, and in 1890 when Maddox of Bournemouth introduced a simple

and expeditious method for their detection and measurement. Some

enthusiasts at first tended to exaggerate the importance of these

defects in the balance of the ocular muscles, attributing to them

numerous ills to which the flesh is heir, and practising operative

procedures for their correction. On the other hand, some were slow

in devoting sufficient attention to them. Had more importance been

attached to them at Moorfields, at the time the new building was under

construction, better provision might have been made in it for their

investigation.

In the closing years of the nineteenth century the science of

bacteriology increased both in its importance and in its technique

by leaps and bounds. In 1901 the medical staff, finding that more

bacteriological investigations were required than the pathologist

had time to devote to them in association with his other duties,

recommended the establishment of a special bacteriological department

and the appointment of a special bacteriologist. This entailed the

provision of additional laboratory accommodation, and it was not until

six years later that the Committee could see their way to the erection

of a new laboratory above that part of the pathological department

occupied by the Museum and curator’s room, part of a legacy left to the

Hospital by the late Mr. Samuel Lewis being used to defray the cost.

PLATE XXVI.

[Illustration: SIR JOHN TWEEDY, LL.D.]

John Tweedy, who had been elected on the staff at the comparatively

early age of twenty-nine, resigned in 1900 at the age of fifty-one, and

was appointed consulting surgeon, the Committee of Management putting

on record at the time its appreciation of the “numerous occasions he

had pleaded the cause of the Hospital in powerful and most interesting

public addresses, endorsing his advocacy with liberal donations to

its funds.” Tweedy was a fluent and learned writer; he served for a

long time on the editorial staff of the _Lancet_, so that most of

his contributions appeared anonymously. He did not contribute much

to the literature of ophthalmology, though he had had a very large

experience and was frequently called into consultation by his

colleagues in difficult cases. An American student once asked him

which he considered the best textbook on ophthalmology. Tweedy took a

deep breath, with which, on account of some chest affection, he always

preceded any oratorical remark, and, with a dramatic wave of the arm

towards a crowd of patients that were waiting to see him, said: “There,

that is the best textbook.”

Three years after his retirement from the staff of the Hospital, he

became President of the Royal College of Surgeons; he held that post

for three years, and was knighted in 1906. He possessed remarkable

administrative capacity, and was skilful in putting through the

business of a meeting with efficiency and dispatch. He also presided

over the Ophthalmological and Medico-Legal Societies, the Medical

Defence Union, and the Royal Medical Benevolent Fund. He died in 1924

at the age of seventy-five.

With the discovery of the ophthalmoscope the interests of

ophthalmologists became largely medical as well as surgical; though

they still style themselves ophthalmic surgeons, some might more aptly

be termed ophthalmic physicians; Marcus Gunn was one of these. The

distinguished neurologist, Sir William Gowers, in 1879, wrote a book

on _Medical Ophthalmoscopy_, which was the leading manual of its kind

for many years; its third edition, which appeared in 1890, was edited

by Marcus Gunn. He was a most careful ophthalmoscopic observer, and for

several years devoted his attention to certain changes in the retinal

bloodvessels. Writing on the outcome of these observations in 1898, he

said:

“The chief importance of this retinal arterial change lies in its

association with a more general arterial disease of a similar nature,

particularly in the kidneys and brain, and in its prognostic value in

regard to the results which may follow in cerebral vessels. It has

been well said that ‘a man is as old as his arteries.’ I would urge

that ophthalmoscopic observation is one of the most ready clinical

means for the early detection of important arterial changes.”

Rheumatism is a term which is applied to a multiple of ills, and

during the nineteenth century a number of cases of inflammation of

the iris were so classified. The most typical and well-defined form

of rheumatism is rheumatic fever or acute articular rheumatism, and

investigations of a number of such cases at general hospitals, and of

cases of iritis at Moorfields, showed that the two affections were but

rarely associated. Iritis not uncommonly occurs in connection with

inflammation of the joints due to gonorrhœa, which is sometimes termed

“gonorrhœal rheumatism,” but a very large number of cases of iritis

are met with unassociated with any joint affection or any venereal

disease. Of recent years, largely as the outcome of the observations

and teaching of William Lang, it has become recognised that such cases

are secondary to some focus of inflammation elsewhere in the body, very

often a septic condition in connection with the teeth. Seeing how many

people suffer from septic teeth who never develop iritis, considerable

scepticism at first prevailed as to its being the cause of the disease.

The satisfactory way in which iritis subsides and ceases to recur after

the septic focus in the mouth has been removed seems, however, to

have definitely established the relation of the one to the other, and

provided a means of eradicating a very potent cause of suffering and

destruction of sight.

The reawakening of the importance of the medical side of ophthalmology

made the surgical staff desirous in 1899 of securing for their patients

at the Hospital the aid and assistance of a physician who had had a

special training as a neurologist. For this purpose, it was decided

to appoint a second physician who should be required to attend the

Hospital once a week to examine and report on such cases as were

selected for him by the surgical staff. Dr. James Taylor, who had

studied under Dr. Hughlings Jackson, and who may be regarded as one of

his most ardent disciples, was elected to this post.

PLATE XXVII.

[Illustration: WILLIAM LANG]

The systematic and orderly keeping at Moorfields of the clinical

records of in-patients, and of the pathological examination of the

eyes removed, over a number of years by successive house surgeons

and curators of the Museum, has provided a large amount of valuable

material for the investigation of the natural history of certain

diseases from which useful inferences as to their incidence and

prognosis can be drawn. Such method of investigation has been applied

by a succession of workers, over a period of fifty-seven years, to the

different forms of malignant growths originating in the eyeball, and

has added considerably to our knowledge concerning them, the results

being published in the _Hospital Reports_.

A distinguished ophthalmic surgeon from New York who visited Moorfields

went away much impressed by Nettleship, because he showed and discussed

with him nothing but his failures. Most operating surgeons like to

exhibit their successes and keep their disasters in the background,

but by the study of our failures lies the road to future success.

The curator of the Museum at Moorfields, or pathologist as he is now

called, has the opportunity of examining critically all the eyes

removed after the failure of operative procedures by the various

members of the staff. From such examinations much valuable information

has been collected and published, both in connection with operations

for the removal of cataract and for the relief of glaucoma. To have had

the advantage of carrying out these examinations must necessarily be an

excellent training for one who is to become an operator himself. It is

not, therefore, surprising that all those who have in recent years held

the post of pathologist have subsequently been promoted to the surgical

staff.

C. Devereux Marshall, who held the post of curator of the Museum

from 1894 to 1899, was elected assistant- surgeon on the retirement

of Tweedy from the staff. William T. Lister (now Sir William Lister,

K.C.M.G.) was the curator from 1899 to 1901, and was elected

assistant-surgeon on the retirement of Waren Tay in 1904. John Herbert

Parsons (now Sir John Parsons, C.B., F.R.S.) was curator from 1901 to

1905, and was elected assistant-surgeon to fill the vacancy caused by

the death of A. Quarry Silcock in 1904.

When, in 1891, elementary education was made universal and compulsory,

those responsible for the measure little realised all that it would

involve. They little thought that in 1927 it would lead to the

provision of 16,000,000 meals for school-children, and the medical

examination of 2,000,000, involving the employment of about 2,000

doctors, 600 dentists, and 5,000 nurses, or that it would develop

into what Sir George Newman, the chief medical officer of the Board

of Education, describes as “the grand inquest of the nation directed

towards laying the foundation of the nation’s health.”

It soon became evident that it was futile to compel children to study

if their physical condition was such that they would not profit

thereby, or if it was likely to lead to their physical deterioration.

The question of their eyesight and its possible impairment from study

early attracted attention. At first the teachers of the London School

Board were given instructions to test the children’s eyesight, and to

give the parents of those in whom they found it defective a printed

paper, stating that their child was suffering from a defect of vision,

and, in the child’s interests, they were strongly advised to consult an

oculist without delay. To this notice was attached a list of hospitals

with eye clinics and the times at which they were open for patients.

The periodic rush of school-children with their parents to these

clinics created chaos in their ordinary working routine.

In 1908 the Board of Education issued a circular stating that

suitable provision can be made by a local education authority for the

prescription and purchase of spectacles; and that, in this connection,

the Board will be prepared to entertain proposals for contributions

to the funds of hospitals on terms of adequate advantage, and the

contributions are specially desirable in the case of eye hospitals.

Also that “it is permissible to include among the conditions of

contribution a provision allocating a reasonable remuneration to the

medical men working for such institutions.”

In the following year, in response to the invitation of the London

County Council Education Committee, the Committee of the Hospital

agreed to co-operate with it for the treatment of children whose eyes

required attention, on the basis that not less than 3,000 nor more than

6,000 children be sent during the year, and that the Council would pay

for the extra assistants which the Committee would have to appoint to

carry out the work.

When the new Hospital was built, a portion of it on the ground floor

had been left uncompleted, it being thought that it might ultimately

be used as a chapel. The chaplain found it most convenient to conduct

his services in the day wards. So, in 1909, through the generous

help of some friends of the Hospital, donations were collected for

the special purposes of carrying out certain alterations to this

unoccupied part of the building to provide and equip a refraction

department for school-children, separate from the other out-patients.

This school-children’s department was completed and became ready for

use in 1910. While the majority of the children which attend require

spectacles for the correction of errors of refraction, some are found

to be suffering from some other affections of the eye, and these are

referred for treatment to the ordinary out-patient department.

On the death of Queen Victoria, who had been a Patron throughout the

whole of her long reign, in 1901, King Edward VII, and Queen Alexandra

consented to continue the patronage of the Institution which they had

extended to it as Prince and Princess of Wales. In the same way, the

Prince and Princess of Wales agreed to continue the patronage which

they had bestowed on it when Duke and Duchess of York.

On the removal to the new Hospital, it had been foreseen that special

steps would have to be taken to provide for the payment of the ground

rent of £1,210 a year, and in 1899 John Tweedy started the “Rent Fund”

with a generous donation of £150, to which he later added a further

donation of £50. Owing, however, to the South African War and the

pressing need to defray current expenses, but very slow progress was

made in the collection of donations to this fund. In 1904, to celebrate

the centenary of the foundation of the Hospital, the Committee decided

to change the name of the fund to that of the “Centenary Fund,” and

to make a special appeal for contributions to it, all donations to be

invested and the interest on it devoted to the payment of the rent.

A Centenary Festival Dinner was held at the Hotel Cecil on May 10th,

over which Sir Charles Wyndham presided, delivering a most eloquent

appeal on behalf of the Charity. The following ladies kindly acted as

hostesses on the occasion: Princess Alexis Dolgorouki, the Hon. Helen

Henniker, Lady Critchett, Lady Burnand, Lady Wyndham, Lady Walker, Mrs.

Marcus Gunn, Mrs. Widenham Fosbery, Mrs. Edward Nettleship, Mrs. F. C.

Scotter, Mrs. Beerbohm Tree, Mrs. Brooman-White of Arddaroch, Mrs. J.

S. Wood. Three hundred guests were present, and the proceeds of the

dinner, amounting to £2,270, were added to the Centenary Fund.

In former times it was the custom to end a story by drawing a moral;

all such moral conclusions are nowadays regarded as out of fashion,

and even a plot is no longer considered as essential in a story. All

that is required is just to describe a slice out of life, beginning

anywhere and ending when the requisite number of pages have been

filled. This story of the Moorfields Eye Hospital describes a slice out

of the life of an institution, commencing with its foundation in 1804,

and ending, whilst it is still full of progressive vigour, with the

celebration of its centenary.

Most people will agree that the chief object of raking over the ashes

of the past should be to acquire inspirations for the future; and so,

though it may be hopelessly out of fashion, this story will conclude

with some maxims which may be deduced from all that has gone before.

The general principle on which the Hospital was established was that

the treatment of diseases of the eye and visual disorders should be

recognised as a branch of medicine and surgery, and not left in the

hands of unqualified and imperfectly trained practitioners. With

this end in view, it has always been insisted on that the members of

its medical staff should hold the highest possible qualifications

as physicians and surgeons, and that every encouragement should be

given to qualified medical men to come to it to study the treatment

of eye diseases as a branch of medicine and surgery. The necessity

for the recognition of this general principle, now in 1929, is just

as necessary as in 1804, there being, as then, no short road to the

efficient treatment of visual defects apart from a complete training as

a medical practitioner.

The question is sometimes asked: Do special hospitals justify their

existence? The perusal of this book, it is hoped, will at any rate show

that the Moorfields Eye Hospital has justified its existence.

One of the incomparable advantages afforded by a special hospital is

the field which it offers for mass observation, both clinical and

pathological. It was by taking advantage of the extensive opportunities

for clinical research which Moorfields Hospital affords that Sir

William Lawrence, Sir Jonathan Hutchinson, Dr. Hughlings Jackson,

Edward Nettleship, and others have been able to make their most

valuable contributions to our knowledge of the natural history of eye

diseases.

Pathological research in connection with eye disease depends almost

entirely on the investigation of eyes which have had to be removed

during life, and at Moorfields the custom of placing the mass of such

material at the disposal of one man, the curator of the Museum, whilst

he holds office, has proved to be of inestimable advantage in the

promotion of that line of research.

To arrive at an accurate estimate of the benefits to be derived from

any special line of treatment or from some operative procedure, it is

necessary that it should be tried in the various varieties and phases

of a disease; inferences drawn from isolated cases must always prove

fallible. The mass of cases provided by a special hospital allows of

reliable estimates being arrived at.

The facilities for mass observation which a special hospital affords

are of as great advantage to the student as to the investigator. It

enables him, not only to get a comprehensive picture of a disease in

all its manifestations firmly impressed on his mind, but also to see

in a comparatively short time several examples of what, in a more

restricted sphere, would be regarded as rare affections. It has been

the recognition of such advantages that has induced medical men from

all parts of the world, for over a hundred years, to congregate at

Moorfields to gain instruction and experience.

It has not, however, been only the size of the clinic which has

attracted students of ophthalmology to Moorfields, but also to a large

extent the personnel of its medical staff. To listen to discussions on

debatable matters by able exponents, holding forth day after day from

the same pulpits, and to watch varying forms of procedure on similar

conditions carried out in the same theatre by different operators,

stimulates students to observe and to think for themselves —a form

of training which is far preferable to the absorption of dogmatic

aphorisms from a single teacher, or the attendance at courses of

didactic oratory.

Medicine and surgery are not exact sciences, and probably never will

be; any increase in exactitude in connection with them may, however,

be regarded as synonymous with progress. The immense increase in

exactitude in connection with ophthalmology which has taken place

since the discovery of the ophthalmoscope can be realised, if we

consider the number of well understood conditions which are now

differentiated, and which were formerly grouped under the vague heading

of “Amaurosis.” Ophthalmology is closely associated with such exact

sciences as mathematics, chemistry, and physics. It was, indeed, from

the association of the latter with ophthalmology that the discovery

of the ophthalmoscope resulted; for, as Helmholtz himself said, “When

a well-trained physicist came and grasped the importance of such an

instrument, nothing more was wanted, since all the knowledge had been

developed which was required for its construction.”

William Cumming had grasped the possibilities of such a discovery,

but, lacking himself the necessary training in physics and failing to

consult anyone who had, missed the way to the end for which he was

striving.

It was the fortunate circumstance of Sir James Mackenzie Davidson being

interested in both physics and ophthalmology, at the time of Professor

Röntgen’s discovery of the X-rays in 1895, that led to their early

employment at Moorfields in connection with foreign bodies implanted

in the eyeball, and the introduction of an accurate method for their

localisation.

Of the intimate association of mathematics with ophthalmology we

have evidence in Helmholtz’s great work on physiological dioptrics.

Donders, in the preface to his book _On the Anomalies of Accommodation

and Refraction of the Eye, with a Preliminary Essay on Physiological

Dioptrics_, published by the New Sydenham Society in 1844, writes as

follows:

“In the doctrine of the anomalies of refraction and accommodation,

the connection between science and practice is more closely drawn

together than in any part of medicine.

“Science here celebrates her triumph, for it is at her hand that

this branch has acquired the exact character which makes it also

worthy of the attention of natural philosophers and physiologists.

It is, indeed, satisfactory to see, how in the accurate distinction

between anomalies of refraction and accommodation with exclusion of

every condition foreign to those anomalies, the system assumed, as if

spontaneously, an elegant simplicity; and how the cause and mode of

origin of many an obscure type of disease emerged into the clearest

light.

“Practice, in connection with science, here enjoys the rare but

splendid satisfaction of not only being able to give infallible

precepts based upon fixed rules, but also of being guided by a clear

insight into the principles of her actions— advantages the more

highly to be estimated as the anomalies in question are of more

frequent occurrence, and as they more deeply affect the use and

functions of the eyes.

“Is it, then, strange that the study and treatment of my subject

have been to me a labour of love? the more so, as I felt proud in

having been called upon to elaborate it for a country in which Young,

Wells, Ware, Brewster, and Airy have pointed out to us the track

which we had only to follow, and happy in being able to offer my work

in this form to my highly esteemed friends and colleagues, whose

proofs of kindness and affection have left with me the most agreeable

recollections of my visits to England.”

In its indebtedness to chemistry, ophthalmology shares with all

other branches of medicine and surgery. It was to the chemist Louis

Pasteur that we owe the upgrowth of the new science of bacteriology.

It is to Madame Curie’s chemical researches that we are indebted for

radium, which promises to be the most effectual means for dealing with

malignant neoplasms apart from operations.

It is to Wassermann that we owe the possibility of a chemical means of

diagnosing syphilis, and to Ehrlich a chemical compound which will kill

the invading organism without damaging the tissue of the infected host.

From what has gone before it would seem that measures, which tend

to bring about a close association between the clinical work in the

Hospital and the laboratory work of the trained observers in these

exact sciences, are those most likely to prove fruitful in the

promotion of the progress of ophthalmology in the future.

Hospitals in the first part of the nineteenth century were institutions

founded and supported by the rich for the relief of suffering in the

indigent poor, the inmates admitted to which were given everything for

nothing.

Under altered conditions, they are now rapidly becoming institutions

for the relief of suffering in the community at large, supported in

part by donations from munificent persons, and in part by contributions

from those who receive benefits in them.

In former times the word “hospital” raised in the mind a picture of a

barrack-like building, associated with pain and suffering, with poverty

and death.

John Couper, when senior surgeon at the London Hospital, was journeying

to it down the Mile End Road in one of the old horse-drawn omnibuses,

and asked the conductor to put him down at the London Hospital; the

conductor shouted out to the driver, “Stop at the slaughter-house Bill.”

Since the introduction of anæsthetics and antiseptics hospitals are

no longer regarded as slaughter-houses by the general public, but as

places where pain and suffering are relieved, and health and vigour

are restored. No longer are they forbidding barrack-like structures,

but temples of hygienic cleanliness. No longer is it a luxury to be

ill, or to have an operation performed in one’s own home, where all the

necessary appliances have to be imported or improvised. Far preferable

has it become to go to an institution specially constructed for such

purposes, furnished with the most up-to-date contrivances, and with a

staff efficiently trained to meet all emergencies.

In a Report of a Special Committee of the King Edward’s Hospital Fund

for London on “Pay Beds,” dated July, 1928, the present relation of

various sections of the general public to hospitals is set out as

follows:

“During recent years there has been a considerable extension,

both of the classes included amongst Voluntary Hospital patients

and of the payments made by ordinary patients. There was a time

when the Hospitals were only called upon to provide comparatively

simple treatments for the necessitous poor, which meant those who

were unable to pay for medical attendance. With the development of

expensive methods of treatment and diagnoses, large numbers of the

middle and professional classes are now unable to pay the full cost

of these services, some of which, according to our evidence, are

often difficult to obtain outside the Hospital.

“At the same time, experience has shown that large numbers of the

ordinary Hospital patients are both able and willing to contribute

towards their cost. At present, therefore, there is a demand for

Hospital treatment from several different classes which may be

grouped into three: First, those who cannot afford to pay anything,

and who receive, when in the ordinary wards, free maintenance and

treatment; second, those who can and do contribute according to their

means towards their cost of maintenance in the ordinary wards, though

still receiving free medical attendance from the visiting staff of

physicians and surgeons; third, those whose standard of living causes

them to desire better accommodation, or at all events more privacy,

than is provided in the ordinary wards, and who are prepared to

pay for it according to their means, and also to pay something for

medical attendance. Beyond these, there is a fourth class, those who

can afford to obtain their treatment in private nursing homes and to

pay full medical fees.”

Institutions, like individuals, if they wish to survive in the struggle

for existence, have to obey the universal law of adaptation to

environment. Moorfields Hospital, during the first hundred years of

its existence, has undergone reconstruction, had additions made to it,

and has twice been removed to a new site, in response to the demands

made upon it by the increasing number of patients attending for relief,

and to the developments and discoveries in the methods of applying

relief.

To be capable of such frequent fresh adaptations, an institution

must be prepared to obey another biological law—that of retaining a

high degree of plasticity, which, in the case of an institution, is

equivalent to maintaining a big margin for expansion.

As has been shown, Moorfields is largely indebted to the foresight

of its architects for having retained such a margin for expansion

to meet new requirements. When first a new Hospital was erected

on the Moorfields site, Sir Robert Smirke, the architect, advised

the Committee to secure the freehold of a piece of vacant ground

immediately behind the Hospital, upon which, after the discovery of the

ophthalmoscope, a new out-patient department with a large dark-room

was built. It was also, probably by his advice, that Dr. Farre secured

the lease of the piece of ground on its south side, part of which he

for a time let off for a stables and in part used for the Saunderian

Institute, but upon which a new wing of the Hospital was subsequently

built, when the demand for more in-patient accommodation became urgent,

after the introduction of anæsthetics and the great increase in the

number of operative procedures. When the removal to a new site again

became necessary, it was the proceeds derived from the greatly enhanced

value of these sites, which had been so fortunately obtained, that

supplied the funds for the erection of the new building.

It was due to the advice of the architects, Keith Young and Bedell,

that the large site in the City Road was chosen for the present

Hospital, instead of the cramped one in Eldon Street adjoining the

former building, to which at the time sentiment made a strong appeal.

In the twenty-five years which have elapsed since the celebration

of the Hospital’s centenary, fresh discoveries and altered economic

conditions have produced further changes in environment, calling

for more expansion in one direction and another. Fortunately, the

plasticity of the present large site is by no means exhausted, and with

suitable adaptation it is capable of providing all the demands likely

to be made upon it for several years to come.

The last maxim, however, to be drawn from the past history of the

Hospital is the necessity of keeping ever alert for adaptations to meet

fresh changes in its environment as they arise.

APPENDIX

PRESIDENTS

_Date of_ _Date of_

_Appointment_. _Resignation_.

Sir Charles Price, Bart. 1804 1818

Mr. William Mellish 1818 1838

Rt. Hon. Earl Fitzwilliam 1838 1856

Mr. William Cotton, D.C.L., F.R.S. 1857 1867

Sir John Lubbock, F.R.S., M.P.

(afterwards Lord Avebury) 1867 1913

His Royal Highness Prince Arthur

of Connaught, K.G. 1914

CHAIRMEN OF THE COMMITTEE OF MANAGEMENT

Mr. Harry Sedgwick 1804 1818

Mr. Ralph Price 1818 1830

Mr. Stuart Donaldson 1831 1837

Rev. J. Russell, D.D. 1837 1857

Mr. Richard Heathfield 1857 1859

Mr. F. G. Sambrooke 1860 1871

Mr. Philip Cazenove 1871 1879

Mr. Charles Gordon 1879 1897

Mr. H. P. Sturgis 1897 1921

Mr. Theodore W. Luling 1921

HONORARY MEDICAL AND SURGICAL OFFICERS

_Physicians_

John Richard Farre, M.D. 1805 1857

Frederick J. Farre, M.D. 1843 1880

Robert Martin, M.D. 1856 1884

Sir Stephen Mackenzie, M.D. 1884 1905

James Taylor, C.B.E., M.D. 1899 1919

Gordon M. Holmes, C.M.G., C.B.E., M.D. 1914 1927

William J. Adie, M.D. 1927

_Surgeons_

J. Cunningham Saunders

(Founder) 1804 Died 1810

Benjamin Travers, F.R.S. 1810 1817

Sir William Lawrence, Bart., F.R.S. 1814 1826

Frederick Tyrrell 1817 Died 1843

John Scott 1826 1846

Gilbert Mackmurdo, F.R.S. 1830 1856

John Dalrymple, F.R.S. 1832 1849

James Dixon 1843 1868

George Critchett 1843 1877

Sir William Bowman, Bart., F.R.S. 1846 1876

Alfred Poland 1848 1861

H. H. Mackmurdo 1851 1852

John C. Wordsworth 1852 1883

J. F. Streatfield 1856 Died 1886

J. W. Hulke, F.R.S. 1858 1890

George Lawson 1862 1891

Sir Jonathan Hutchinson, F.R.S. 1862 1878

John Couper 1866 1895

J. Soelberg Wells 1867 Died 1880

Waren Tay 1877 1904

James E. Adams 1877 1884

Sir John Tweedy, LL.D. 1878 1900

Robert Lyall 1880 Died 1882

Edward Nettleship, F.R.S. 1882 1898

R. Marcus Gunn 1883 1909

W. Lang 1884 1912

A. Quarry Silcock 1886 Died 1904

J. B. Lawford, LL.D. 1890 1918

A. Stanford Morton 1891 1909

E. Treacher Collins 1895 1922

W. T. Holmes Spicer 1898 1920

Percy Fleming 1900 1919

J. Herbert Fisher 1900 1927

Sir Arnold Lawson, K.B.E. 1900 1914

C. Devereux Marshall 1900 Died on active

service, 1918

Sir William T. Lister, K.C.M.G. 1904 1905

1919

Sir John Herbert Parsons, C.B.E., F.R.S. 1905

Claud Worth 1905 1921

W. Ilbert Hancock 1909 Died 1910

George Coats 1909 Died 1915

Malcolm L. Hepburn 1910 1926

A. Cyril Hudson 1913 1928

R. Foster Moore, O.B.E. 1914

R. Affleck Greeves 1915

F. A. Juler 1918

Charles Goulden, O.B.E. 1919

B. T. Lang 1920 Died 1928

M. H. Whiting, O.B.E 1921

P. G. Doyne 1922

Humphrey Neame 1926

Miss Ida C. Mann 1927

W. Stewart Duke-Elder 1928

Rupert S. Scott 1928

_Ear, Nose, and Throat Surgeon_

G. Seccombe Hett 1923 1929

_Medical Officer to the X-Ray Department_

Sir James Mackenzie Davidson 1899 1910

Albert Bowie 1910

_Dental Surgeons_

Arthur E. Relph 1913 1915

R. M. Fickling 1915 1928

Stanley A. Riddett 1928

_Medical Officer to the Ultra-Violet Ray Department_

W. Stewart Duke-Elder 1927

Mr. Richard Battley 1804 1818

Mr. Matthew Heathfield 1818 1834

Mr. William Bircham 1835 1844

Mr. Robert Francis Dalrymple 1844 1846

Mr. F. A. Curling 1846 1856

Mr. Charles Gordelier 1856 1860

Mr. J. Mogford 1860 1872

Mr. Robert J. Newstead 1872 1897

Mr. Robert J. Bland 1897 1923

Mr. Arthur J. M.  Tarrant

INDEX

Abercrombie, Sir Ralph, 6

Adams, James, 146

his loss of sight, 163

Adams, Sir William, 1, 22, 28

at Exeter, 29

monetary grant to, and change of name, 30

Airy, the Astronomer Royal, 115, 212

Alexander, Charles, 15, 16

Amasis, King of Egypt, 43

Anæsthesia, general, 82

local, 165

Anatomy of the human eye, 94

Anderson, Mrs. Garrett, 179

Anderson, Dr. James, 167

Ansley, Alderman, 39

Antiseptics in ophthalmology, 154

Arlt, of Vienna, 96, 114

Artificial eyes, 86

Artificial pupil, operations for, 89–91

Aseptic surgery, 187

Asthenopia, 114

Astigmatism, 114

Avebury, Lord, 135, 217

Avicenna, 89

Babbage, Charles, his ophthalmoscope, 102, 127

Bacteriology, 202

Bader, Charles, 95

appointed curator, 110, 122, 138

Bancroft, Sir Squire, 182

Barth, Joseph, of Vienna, 44

Battley, Richard, early life, 3, 6, 11

appointed secretary, 14, 30, 46

and materia medica, 55–57, 59, 71

death of, 79, 220

Bedell, hospitals surveyor, 172, 215

Beer, Professor, of Vienna, 44

Belladonna, 1, 19, 23

Bennett, Dr. Hughes, 164

Bethlehem, Royal Hospital, 52

its burial ground, 132

Bircham, Francis William, 66, 78, 220

Bircham and Co., solicitors to the Hospital, 66

Blomberg, Rev. Dr., 67, 68

Blood, withdrawal of, 40–41

Boerhaave, of Leyden, 44

Bonnet, of France, 86

Bovell, J. Roach, 72

Bowman, Sir William, candidature, 75

employment of chloroform, 83

operation on lacrymal passages, 88, 120

operation for artificial pupil, 89–91

meeting with Graefe and Donders, 93–95

iridectomy for glaucoma, 96–97, 112

retirement from Hospital, 143–144

later life, 145–146

and antiseptics, 155, 159, 161

Boycott, Miss, 143

Bradford, of Boston, U.S.A., 185

Brailey, W. A. , curator, 141, 142

Brass, Robert, architect, 134

Bruecke, 95, 112

Buller, Frank, 142

Calabar bean, 131

Cambridge, H.R.H. Duke of, 108, 182

Cataract, congenital, 11, 19–24, 27, 60, 62, 88

after-treatment, 153, 156

Cazenove, Philip, 137, 149

Charnley, W., 159

Charter, granting of, 171

Charterhouse Square, 14, 48

Chloroform, 84–85

Churchill, John, 77, 79

City Companies, donations, from, 182

City Road site, 172

Clark, Sarah, 15

Clinical assistants, institution of, 109

Coats, George, 9, 10, 219

Cocaine, 164

Colkett, Miss Jane Louisa, 6

Collins, E. Treacher, 179, 182, 218

Conjunctiva, inflammation of,

in infants, 22

Conradi, 20, 27

Consulting surgeons, duties of, 144–145

Cooper, Sir Astley, connection with Saunders, 2–8

suggestion for a special institution, 11, 13

description of, by Travers, 33, 38

his pupils and relatives, 59, 75

Cooper, Samuel, 45

Cooper, White, 84, 127

Cork Street, Infirmary in, 15

Cotton, William, 108, 135, 217

Couper, John, 109

appointed assistant-surgeon, 134, 136

word picture of, 157–158

his ophthalmoscope, 158–159, 179, 213, 218

Cramer, 112

Crimean War, 104, 125, 197

Critchett, Sir Anderson, 97, 146

Critchett, George, 75, 85

and excision of the eyeball, 86

and operation for squint, 87

and operation for artificial pupil, 89–91

for glaucoma, 96–97, 108, 134

and duties of consulting surgeons, 143–145

on Poor Law schools, 140–141, 146, 218

Cuignet, 159

Cumming, William, 100, 101, 102

Curie, Madame, 212

Curling, F. A. , 78, 220

Cyrus, King of Persia, 43

Dalrymple, John, secretary to academy, 58

assistant surgeon, 64, 73, 74

early training 75–76

atlas of pathology of the eye, 77–78, 81, 118, 218

Dalrymple, Robert Francis, 78, 220

Dalrymple, William, 75–76

Davidson, H., 182, 191

Davidson, Sir James Mackenzie, 186, 187, 211, 219

Daviel, 19

Dean, appointment of, 201

Delafield, Dr. Edward, 35, 38

Desmarres, of Paris, 96

Devis, portrait of Saunders by, 32

Diet, 41

Diploma of Ophthalmology, 201

Dispensary for diseases of the eye and ear proposed, 12

Dodson, Mrs., 80

Donders, Franz Cornelius, first meeting with Graefe and Bowman,

92–94, 95, 96, 99

on Helmholtz, 103

and anomalies of refraction and accommodation, 112–114, 145, 147,

211

Doublet, Thomas, 116

Ear, anatomy of, 17

Earle, Henry, 45

East India Company, 34, 36

Egerton, C. J. , 37

Egyptian ophthalmia, 6, 29

Ehrlich, 213

Eldon Street, negotiations regarding site in, 169–171

Electro-magnets, 185

Ether, 82

Excision of the eyeball, 85–86

Exeter Eye Infirmary, 29

Farre, Dr. Arthur, 106

Farre, Dr. Frederick J., 60, 70, 72, 73, 75, 106, 215

Farre, Dr. John Richard, early life, 3

consulting physician, 14, 24

edits Saunders’ writings, 26–28, 38, 45, 53

courses of instruction, 54–56

and Saunderian Institution, 56–57

attacks on, in Lancet, 59–61

his journal, 71

his portrait, 72–73 74, 75, 81, 106, 215, 217

Finsbury, neighbourhood of, 161

Fisher, J. Herbert, 200, 218

Fitzwilliam, Earl, 69, 108, 215

Fixation forceps, 126

Flemming, Percy, 199, 218

Forbes, Litton, 159

Forster, 129

France, Mr., 126

Fraser, Dr. Thomas R., 131

Gamgee, J. S. , 106

General hospitals, ophthalmic departments in, 126, 135

Gibson, Benjamin, 28, 60, 88

Gill, Rev. T. , 51, 55, 56

Glaucoma, operations for and treatment of, 91–93, 126, 141–142

Gordon, Charles, 149, 180, 215

Governors, privileges of, 107

Graefe, A. von, operation for glaucoma, 91

meeting with Bowman and Donders, 93–94, 103, 127

and perimetry, 129

death of, 141

and latent squints, 201

Grant, Roger, 10

Greek writers, 43

Green, 27, 59

Gunn, Marcus, 160, 203, 218

Guthrie, 15

Haab, of Zurich, 187

Harkness, 109

Harnet, Miss, 143, 165

Hawes, Alfred, 116

Hawes, William, 116

Helmholtz, Professor von, 99, 103, 211

Herbert, Sydney, 105

Herodotus, 43

Hey, 23

Hill, John, 1, 8, 29

Hirschberg, of Berlin, 185

Hogg, E., 181

Horner, Professor, of Zurich, 155

Hulke, John Whitaker, 82, 85, 106, 109

microscopical and scientific work, 111, 112

career, 124–125

and the perimeter, 129, 135, 147, 177, 218

Hutchinson, Sir Jonathan, 109, 112

work on inherited syphilis, 122–123, 130

on tobacco amaurosis, 148–149 151, 159, 218

Hypermetropia, 113

Inquiry officer, 179

Iriddesis, 90–91

Iris, essay on inflammation of, 19

Jackson, Dr. Hughlings, 109, 130, 205

Jacksonian Prize Essay, for 1859, 111

for 1878, 142

Jaeger, Edward von, 117, 160

Janin, 44

Jeafferson, 37

Jones, Wharton, 102, 115, 127

_Journal of Morbid Anatomy, etc_., 71

Jussieu, Joseph de, 164

Kemp, William, 174

Kensington, Henry, 14

Kent, the Duchess of, 67, 68

Kepler, 114

King Edward VII., 208

King Edward’s Hospital Fund, 195, 214

King George I., oculist to, 10

King George II., oculist to, 10

King George III., oculist to, 11, 15

King William IV., oculist to, 31

Koller, Karl, 164

Ladies’ Working Guild, 197–198

Lancet, 46, 56, 58, 59, 202

Lander, the hospitals surveyor, 170, 172

Lang, William, 164, 204, 218

Laquer, 131

Lawford, J. B. , 162, 177, 218

Lawrence, Sir William, treatment of eye diseases at general

hospitals, 7, 33, 37

the withdrawal of blood, 40–41

history of ophthalmology, 43–44

estimates of, 44

and venereal diseases of the eye, 45–46, 54, 55

and _Lancet_, 58–59, 61

influence of one eye on the other, 86

obstruction of tear duct, 88, 114, 123, 151, 209, 218

Lawson, Sir Arnold, 200, 219

Lawson, George, 109

his career, 124, 125, 157

treatment of out-patients, 177, 218

Leber, Professor, 139

Leeches, 41

Lenses, system of numbering, 116

Library, 72

Lighting of new Hospital, 184

Lister, Joseph, 152

Lister, Sir William T., 206, 219

Liston, Robert, 82

Little Portland Street, Infirmary in, 31

Livingstone, 98

Lubbock, Sir John, 145, 170, 191, 217

Lyell, Robert, 150, 218

MacCallan, A. F. , 187

Macgregor, Patrick, 6

McHardy, Malcolm, 185

McKenzie, H. V. , 187

Mackenzie, of Glasgow, 82, 126

Mackenzie, Sir Stephen, 160, 215

McKeown, of Belfast, 185

Mackmurdo, Gilbert, 64, 73, 74, 79, 106, 218

Mackmurdo, H. H. , 81, 218

Maddox, of Bournemouth, 201

Madras Eye Infirmary, 37

Magnet operations, 125, 187

Maitre-Jan, 44

Mansion House, sale at, 64

Marshall, C. D. , 156, 205, 219

Martin, Dr. Robert, 106, 129, 160, 215

Massachusetts Charitable Eye and Ear Infirmary, 36

Medical Council, formation of, 108–109

Medical-legal observations, 120

Mellish, William, 47, 49, 64, 68, 69, 215

Milles, W. Jennings, 142

Missionaries, admitted to study at Hospital, 98

Mogford, J., 138, 220

Moorfields, 48–53

“Moorfields Club,” 161

Morax-Axenfeld bacillus, 163

Morton, A. Stanford, after-treatment of cataract operations, 153,

156, 177

his ophthalmoscopic drawings, 178, 218

Muscles of eye, paralytic affections of, 127

Myopia, 114

Nagel, 116

Nettleship, Edward, 139

appointed curator, 140, 148, 150, 151

his scientific work, 180, 205, 210, 218

Newman, Sir George, 206

Newstead, Robert J., 138, 181, 220

New York Eye and Ear Infirmary, 35

Nightingale, Miss Florence, 105, 134–153

Nunn, T. N. , 81

Nurses, Queen Victoria’s Jubilee Institute of, 201

Nursing, changes in, 165, 166

Nursing, School of, 200

O’Ferrall, of Dublin, 86

Ophthalmological Society, 145, 149, 161

Ophthalmoscope, discovery of, 99

Osler, Sir William, 142

Paget, Sir James, 44

Palmerston, Lord, 30

Parsons, Sir John, 206, 219

Pasteur, 161, 212

Pay beds, report on, 214

Pearson, Karl, 180

Peel, Mrs., 165

Peerless Pool, 174–175

Peerless Street, 173

Peninsular War, 39

Perimetry, 129

Periscope, 128, 148, 149

Pharmacopœia, 72

Phillips, T., 199

Phillips, Thomas, R.A., 72, 73

Price, Sir Charles, 15, 21, 39, 47, 215

Price, Ralph, 61, 215

Prichard, of Bristol, 87

Prince and Princess of Wales, 181, 208

Prince of Wales’ Hospital fund, 195

Poor Law children and ophthalmia, 140, 141

Queen Alexandra, 208

Queen Anne, oculist to, 10

Queen Victoria, 39, 46, 69, 177, 207

Railway termini, 132, 133

Rating and Valuation Bill, 194

Rating of new Hospital, 193, 194

Rawson, Sir William, 30

Read, Sir William, 9, 10

Reports, Ophthalmic Hospital, 119

colour of paper in, 127

Retinal arteries, changes in, 203

Retinoscopy, 159

Reynolds, Dr. Edward, 35

Rheumatic affections of the eyes, 204

Richardson, R., 37

Robertson, Miss Ada, 180

Robertson, Dr. Argyll, 131

Rodgers, Dr. J. Kearney, 35

Roman Emperors, 43

Röntgen, Professor, 186

Royal Westminster Ophthalmic Hospital, 15

St. Ives, 44

Sambrooke, F. G. , 117, 137, 138, 217

Saunders, John Cunningham, early life, 1

association with Astley Cooper, 2–6, 11

proposal to start dispensary, 11–14, 16

and diseases of the ear, 17–19

operation for congenital cataract, 19–24

death of, 25, 26, 28, 29, 32, 49, 57, 60, 81, 118, 218

Saunderian Institution, 56, 57, 70

Saunders, Mrs., 26

Savory, Sir William, 44

Scarpa, 23, 28

Schmidt, 44

School-children, sight-testing of, 206, 207

School of Ophthalmology, opening of, 34

Schweizer, 110

Scott, John, 61; monograph on cataract, 62, 64

obituary notice, 65; 74, 75, 77, 81, 218

Sedgwick, Harry, 47

trust fund, 117, 118, 196, 215

Shepherdess Walk, 175, 176

Silcock, A. Quarry, 167, 206, 218

Simpson, Sir Janies, 82

Smee, Alfred, 116, 133

Smirke, Sir Robert, 49, 51, 53, 215

Smith, Priestley, 139, 142

Snell, of Sheffield, 185

Snellen, of Utrecht, 117

Soemerring, 44

South African War, 193, 208

Spicer, W. T. Holmes, 180, 201, 218

Squint, operation for, 87

Squints, latent, 201

Stanley, Edward, 45

Stephenson, Sydney, 141

Stevens, of New York, 201

Stevenson, John, 22, 28, 30, 31, 33

Streatfield, J. F. , 106; his career, 107–108

editor of the Reports, 119, 125, 127, 135, 136

gigantic model of eye, 166, 218

Tarsus, excision of, 22, 29

Tay, Waren, 146, 148, 151, 162, 206, 218

Taylor, “Chevalier,” 10

Taylor, Dr. James, 205, 218

Teale, Pridgin, jun., 88

Tear duct, operations on, 88

affections of, 152

Tobacco, amaurosis due to, 148

Travers, Benjamin, 33

early career of, 34

and East India Company, 36–37

his treatise on eye diseases, 38, 42, 59, 64, 70, 218

Travers, Benjamin, sen., 13

Tubercle of the eye, 140, 162

Tweedy, Sir John, 149, 157

career of, 202–203, 206

starts rent fund, 208, 218

Tyrrell, Frederick, 45, 48, 54

and Wakley, 58–59

description of, 62–63, 64, 65, 74, 76, 104, 114, 218

Tyrrell, John, 48, 50

Tyrrell, Timothy, 48, 50

Tyrrell, Walter, 106, 109

Usher, C. H. , 180

Venereal diseases of the eye, 45

Ventilation of new Hospital, 182–183

Vernon, Bowater, 139

Vetch, Dr., 7

Victoria, H.R.H. the Princess, 67–68

Wakley, Thomas, 58, 59, 60

Walton, Haynes, 82

Ware, James, 11, 20, 28, 113, 212

Wassermann, 212

Wathen, Dr., 11, 15, 31

Weber, Adolph, 131

Weekes, Henry, bust of Saunders by, 32, 118

Wells, J. Soelberg, 109

and sight-testing, 115

description of, 127–128 136, 147

his treatise on diseases of the eye, 149–150, 152, 199, 212, 218

Women become eligible as pupils and clinical assistants, 179

Wyndham, Sir Charles, 208

X-rays, 186

York, H.R.H. the Duke of, 30, 49, 67

York Hospital, Chelsea, 29

Young, Keith, 172, 190, 215

Young, Thomas, 114

Zinn, Professor, 44

H. K. Lewis and Co., Ltd., 28, Gower Place, London, W.C.1.