Sir Benjamin Collins Brodie (1783

Abstract

This article examines the life and work of the eminent surgeon Benjamin Collins Brodie. It details the progress of his career as surgeon including his training, contributions to surgery and final years, and examines in passing his contributions to the development of physiology and pathology.

Benjamin Collins Brodie (Figure 1) was the leading London surgeon of the early Victorian period.¹ He became a Member of the Royal College of Surgeons in 1805, was elected a Fellow of the Royal Society in 1810, received the Society's Copley Medal in 1811 and gave the Croonian Lecture in 1813. He was appointed Professor of Comparative Anatomy and Physiology at the Royal College of Surgeons in 1819 and lectured there until 1823. He became a member of the Council of the College in 1829 and continued to serve until his death in 1862. Gazetted personal surgeon to King George IV in 1828, he was appointed Sergeant-Surgeon to King William IV in 1832 and created a Baronet in 1834. He became an Examiner at the Royal College of Surgeons in 1832 and gave the Hunterian Oration in 1837. He was President of the Medico-Chirurgical Society in 1839–40. As Vice-President of the Royal College of Surgeons in 1842–43, Brodie took a leading role in the successful campaign to obtain the new Charter which instituted the Fellowship examination. He became one of the original 300 Fellows of the College in 1843 and President in 1844. He was the inaugural President of the General Medical Council from 1858 until 1860 and President of the Royal Society from 1858 to 1861, the first surgeon to receive this honour.²

Figure 1

Sir Benjamin Collins Brodie after an oil painting by George Frederic Watts RA (1817–1904) © The Royal Society

Early life and training

Brodie was born in 1783 at Winterslow in Wiltshire where his father, Peter Bellinger Brodie (1742–1804), was the Rector.³ He never attended school but, together with his three brothers and two sisters, was educated at home by his father. Surprisingly perhaps, given his subsequent success, Brodie displayed no early interest in the medical profession. Instead it was family connection that decided his father that medicine should be his son's chosen career; the young Brodie was apparently content to comply.⁴ He began his medical studies in 1801, moving to London and attending the popular anatomy lectures of John Abernethy at St Bartholomew's Hospital.⁵ Lacking a university degree, Brodie could not aspire to become a physician and embarked instead on the training to become a surgeon. In the era before the establishment of medical schools and the development of the medical curriculum, there were two linked routes to gaining a surgical education. First, the student required a detailed knowledge of anatomy and, second, direct experience gained from apprenticeship to a master. During 1802, therefore, Brodie continued his training in anatomy by enrolling at the Hunterian School in Great Windmill Street and carrying out dissections there under the direction of James Wilson (1756–1822). He also mastered the rudiments of pharmacy by working in an apothecary's shop in Little Newport Street near Leicester Square.⁶ In 1803 he became a surgical pupil of Everard Home (1756–1832)⁷ at St George's Hospital, Hyde Park Corner, then on the fringes of the metropolis.⁸

Brodie became associated with Home when the latter was at the height of his considerable powers, ‘a great surgeon … deeply versed in anatomy, full of enthusiasm, tempered by sound judgement, and distinguished by an indomitable perseverance of practice’.⁹ From the moment Brodie began to ‘walk the wards’ the indifference he had felt initially about his chosen career evaporated and he became utterly engaged with his subject. As he put it:

To those who really desire to learn, the wards of a hospital are soon found to be replete with interest. At first all is confusion. The nice distinction of symptoms on which the diagnosis of disease depends, why the pulse in one case indicates immediate danger, and in another none at all, why one patient recovers and another dies, why some kind of treatment is successful in one instance and fails in another, these and a multitude of other matters, are quite inexplicable to the young student. Everything is seen in a mist. After no long time, however, the mist begins to clear away, and whoever has advanced thus far finds no difficulty afterwards. Every case is an interesting subject of enquiry. A great game is being played, in which the stake is often nothing more nor less than the life or death of a fellow creature.¹⁰

Brodie had found his vocation and he set about mastering it with what Power described as ‘the rage for hard work’ that consumed him throughout his life.¹¹

The young Brodie made rapid progress in his studies and was appointed house surgeon at St George's in 1805. He held the post for only three months before resigning to undertake a dual role as co-joint lecturer in anatomy with Wilson at the Hunterian School and assistant to Home in his private practice and his researches into comparative anatomy.¹² Brodie continued with these activities for the next two and a half years, a period during which he made valuable contacts with leading scientists including Sir Joseph Banks (1744–1820) and Humphry Davy (1778–1829). It was also during this period that he conducted his original enquiries into physiology, including the experiments on the influence of poisons, which earned him Fellowship of the Royal Society and the award of the Copley Medal.¹³ Brodie's experimental activity in the sphere of physiology was relatively short-lived as, prompted by his surgical observations, his interest increasingly shifted to pathology. However, he did succeed in making a modest contribution to the evolution of the subject. Thomas argues that Brodie demonstrated ‘that the brain is not necessary to the action of the heart, and that the circulation may be maintained by the heart for a long period of time, provided that respiration is continued artificially… It may well be claimed that artificial respiration for these purposes was Brodie's chief contribution to physiological science’.¹⁴

Brodie as surgeon

Brodie was elected assistant surgeon to St George's Hospital in 1808 and commenced private practice in 1809, taking a house at 22 Sackville Street off of Piccadilly, adjacent to Home's residence and mid-way between the hospital and Great Windmill Street. He augmented his modest income by lecturing in surgery (as well as anatomy) at the Hunterian School and accepting three private pupils on a residential basis. He remained assistant surgeon to St George's for fourteen years, finally being elected surgeon in 1822. He resigned from his post in 1840 at the age of 57 to concentrate on private practice and fulfil his many public duties. Throughout his career Brodie accorded great significance to the taking and maintaining of detailed case notes, using them as an aid to diagnosis and as the basis of his surgical lectures. He believed case notes augmented mere observation with the opportunity for wider reflection and also provided important material for future reference. As he put it in a lecture to his medical students at St George's:

You should investigate cases for yourselves … you should take written notes of them in the morning, which you should transcribe in the evening; and in doing so you should make what are regarded as the more trifling cases the subject of reflection … You will be at once sensible of the great advantage arising from your written notes of cases. But that advantage is not limited to the period of your education. Hereafter, when these faithful records of your experience have accumulated, you will find them to be an important help in your practice.¹⁵

It was through the process of preparing scrupulous case notes that Brodie embarked in 1812 on amassing the material that eventually resulted in his major publication Pathological and Surgical Observations of Diseases of the Joints which was first published in 1818 and went through five editions between then and the final edition of 1850.¹⁶

In 1820 Brodie was one of what Power described as the ‘formidable array of medical men’ who assisted Astley Cooper in the removal of a sebaceous cyst from the scalp of George IV.¹⁷ At the time of the King's operation, Astley Cooper was the leading London surgeon with a huge and lucrative private practice. However, the 36-year-old Brodie, who had married in 1816 and was in need of increased income, was ambitious to take Cooper's place.¹⁸ He was, on his own admission, what we might today term ‘a young man in a hurry’. As he put it in his memoirs, ‘Sir Astley Cooper … too confident of his position, had already begun to lose some of the vast reputation which he had previously enjoyed. Some one else was wanted and I was ready to fill the vacant place’.¹⁹ Brodie undoubtedly possessed a degree of finesse that the older man, notwithstanding his many achievements, patently lacked. As Holmes observed:

[Brodie] had not only the activity and industry, the extensive pathological knowledge, and the keen insight of Cooper, but he also had the scholarly mind and the wide acquaintance with the world of science in which that great surgeon was deficient, and was well qualified to hold his own with the leading spirits of the age, the savants of the Royal Society, and the literary celebrities of Holland House, as with the magnates of the College of Surgeons … As Sir Astley Cooper's practice declined, Brodie more and more took his place as the leading London surgeon.²⁰

The bulk of Brodie's career as a surgeon took place in the period immediately before the widespread introduction of general anaesthesia in the 1850s and he died before the Listerian revolution of the 1870s. His surgical interventions were of necessity limited and his general approach to surgery ‘conservative’ rather than ‘heroic’. For Brodie, all surgery, however minor carried with it the risk of death. As he put it, again in a lecture to his students at St George's:

… an operation, while it may do good, may also be productive of evil. A man has a stone in the bladder: he is suffering torture: he has nothing but a frightful death to which he can look forward. As the least of two evils, he is content to submit to the operation of lithotomy: and it may be, that in the brief space of three minutes he is placed in a situation of perfect comfort, and that in forty-eight hours you are able to declare with confidence that his life is perfectly safe … But then, on the other hand, there are other cases, in which the patient after lithotomy, may die within forty-eight hours, although he might have lived – in misery it is true – had he been let alone, for a year longer … I have known a patient die from erysipelas that followed the simple operation of cupping; and there have been not a few instances of fatal venous inflammation supervening after a common bleeding of the arm. A lady had a small encysted tumour on her head not larger than a pea. A surgeon … removed it but did it imperfectly. The disease returned, and another surgeon … removed it more effectually. The patient died of erysipelas of the scalp. So others have died from the removal of piles, and other apparently trifling operations.²¹

As a general surgeon, it fell to Brodie to undertake various operations including lithotomy (the removal of bladder stone). Richardson has traced the nineteenth century development of the operation as follows:

The operation performed throughout history involved cutting into the bladder below, through the perineum (the area in front of the anus and behind the external genitalia) – perineal lithotomy … The coming of anaesthesia and antisepsis ousted lateral lithotomy from favour and the suprapubic approach (a technique whereby the bladder was approached through the lower part of the abdomen) became the route of choice when surgeons cut for stone.²²

Brodie's second major literary work after his book on diseases of the joints was his Diseases of the Urinary Organs that appeared first in 1832 and he was a highly competent, if somewhat reluctant, lithotomist. Mindful, however, of the many risks that attended the use of perineal lithotomy, he was prompted to adopt lithotrity whereby an instrument is inserted through the urethra so the stone might be crushed and the fragments removed or passed in the urine. Brodie did not invent lithotrity, which was first performed by Jean Civiale (1792–1867) in 1823, but played a significant role in improving instrumentation for the operation and also in elaborating the details of the process involved. It is interesting to note that when Brodie provided an account of his experience of lithotrity he observed that he preferred his patient to be awake rather than anaesthetized. As he put it, ‘the surgeon must use his own discretion, being guided chiefly by the amount of inconvenience which the patient suffers [which] leads me on the whole, to prefer not putting the patient under the influence of chloroform, as it prevents the patient from describing those sensations which may help to guide the surgeon in his practice’.²³

Brodie's most notable, or at least best documented, operation was carried out in 1843 when he operated to facilitate the removal of a half sovereign from the right bronchus of the engineer Isambard Kingdom Brunel.²⁴ Brunel had swallowed the coin while performing a conjuring trick for some children. The immediate effect was an attack of violent coughing and nausea. Over the next few days he began to expectorate mucus tinged with blood and to experience a sharp pain in the right side of his chest. He discovered that if he placed himself in the prone position, with his breastbone resting on a chair and his head and neck inclined downwards, he could feel a loose object slipping forward along his trachea. When this procedure precipitated a fit of convulsive coughing, forcing him to resume an upright position, he could feel the object move in the opposite direction – from his trachea towards his chest. Brunel continued to suffer discomfort for several weeks before approaching Brodie who, after an initial consultation, placed him in the prone position on a platform that was moveable on a hinge in the centre, a kind of seesaw. With his shoulders and body secured by means of straps, Brunel's head, supported at the forehead, was lowered until the platform came to an angle of approximately 80 degrees. Brodie then struck Brunel firmly on the back in the hope of dislodging the coin. This procedure was repeated several times without success and only caused ever more violent fits of coughing until Brodie, fearing for his patient's life, terminated the experiment.

Brodie was fully convinced that if the coin were not removed then Brunel would certainly die. He decided to carry out a tracheotomy. In making this decision Brodie had a two-fold purpose. On the one hand it might be possible to extract the coin with forceps and, on the other, the artificial opening would serve as a safety, valve, enabling the experiment with the moving platform to be repeated without risk of suffocation. On 27 April 1843 Brodie assisted by the outstanding Guy's surgeon Charles Aston Key FRS (1793–1849)²⁵ and his young protege Charles Hawkins (1812–92),²⁶ operated on the fully conscious Brunel. He was placed on a table with a pillow under his shoulders and his head thrown back and steadied by Hawkins. Brodie had carried out tracheotomy on various animals during his experiments in physiology and, in preparation for the operation on Brunel, had rehearsed the operation on cadavers, experiencing no difficulty in extracting a half-sovereign from the bronchus. However, although Brodie performed the tracheotomy successfully, his attempts to insert forceps sent Brunel into involuntary convulsive spasms and paroxysms of coughing. After several attempts by Brodie and Aston Key to reach the coin, Brunel became exhausted and the operation was temporarily abandoned for fear of causing the patient accidental but fatal damage. A further attempt was made on 2 May with identical results and so further attempts to remove the coin were not made. Instead it was decided to enable Brunel to recuperate until he was physically strong enough to be placed on the platform again. Meanwhile, the wound resulting from the tracheotomy was kept open by regularly introducing a probe. By 13 May Brunel was sufficiently recovered to undergo a further session on the platform and on this occasion the procedure was successful. The half-sovereign quit the bronchus without distress and was driven against Brunel's upper teeth. Brunel made a full and rapid recovery, suffering no lasting harm.²⁷

Final years and concluding remarks

Brodie's final years were characterized by failing health as the burden of relentless work began to take its toll. In particular, he experienced progressive loss of vision. In July 1860 he ‘submitted to iridectomy on both eyes, afterwards to extraction of a cataract, and finally to an operation for artificial pupil’.²⁸ In spite of the best efforts of the eminent ophthalmologist Sir William Bowman (1816–92)²⁹ the operation was not a success and Brodie was left practically blind. Under the weight of his affliction he resigned as President of the General Medical Council in 1860 and as President of the Royal Society in 1861. His wife died in July 1861 and he withdrew from London to his country house, Broome Park, Betchworth in Surrey where he spent his last months arranging his papers for publication. Brodie died on 21 October 1862, the immediate cause being a malignant tumour in the neighbourhood of his right shoulder, apparently situated at the site of an old riding injury. Although Brodie's written works contain passages of philosophical speculation, his approach was above all practical, one might almost say utilitarian. Above all perhaps, while recognizing the undoubted value of medicine, he nevertheless saw its necessary limitations. As he told his students at St George's, ‘keep it in your recollection that there are bounds to human powers; and that, in the exercise of our art we cannot do all that is required of us; for if we could, pain and misery would be banished from the world, man would be immortal, and the order of the universe would be disturbed’.³⁰

Footnotes

Acknowledgements

I would like to thank the Royal Society of London; King's College London; and the Royal College of Surgeons of England for their kind assistance in the preparation of this article. I would also like to thank Dr Tina Matthews, Consultant Cytohistopathologist at Kingston Hospital for her advice on the clinical aspects of the piece. Finally, I am grateful to the anonymous referees and editor of the journal for constructive criticism and useful suggestions.

References

D'arcy Power observes that Brodie ‘rose to be the first surgeon in England, holding a position similar to Sir Astley Cooper’, while Le Fanu refers to him as ‘the leading surgical consultant’ and Lambert depicts him as ‘the doyen of the surgical profession’. See Power D. Plarr's Lives of the Fellows of the Royal College of Surgeons. London: Royal College of Surgeons, 1930:145; Le Fanu W. Sir Benjamin Collins Brodie, FRS. Notes and Records of the Royal Society of London. 1964; 19: 46 and Lambert

. Sir John Simon and English Social Administration. London: Macgibbon & Kee, 1963: 104.

The original choice for President was Michael Faraday (1791-1867) but he refused to serve and Brodie was elected instead. See Hall

. All Scientists Now: the Royal Society in the Nineteenth Century. Cambridge: Cambridge University Press, 1984: 100.

Brodie's father was educated at Charterhouse and Worcester College, Oxford. As a young man he was for a time a close companion of the Holland family, including the leading Whig politician Charles James Fox (1749-1806). It was through the patronage of the Holland family that he became Rector of Winterslow. Unfortunately, his prospects of further preferment were blighted by the Whigs’ fall from power and he was constrained thereafter to live the somewhat modest life of a rural clergyman, albeit becoming a magistrate and Deputy Lieutenant of the county. The association with the Holland family proved useful to Benjamin Collins Brodie who, as a young man in London, was welcomed to Holland House, thereby gaining an entrée to the glittering and influential social circle around the society hostess Lady Elizabeth Holland (1770-1845). See Brodie

. Memoir of the Late Sir Benjamin Collins Brodie, Bart. 2nd edn. London: Longmans, Green & Co., 1865: 3–6.

Brodie's paternal aunt was married to the eminent obstetrician, Thomas Denman (1733-1815). Their daughter, Brodie's cousin, was married to Dr Matthew Baillie, FRS (1761-1823) who inherited the Great Windmill Street School of anatomy from his uncle, the famous obstetrician William Hunter FRS (1718-83). Baillie, author of the influential The Morbid Anatomy of Some of the Most Important Parts of the Human Body, was a physician at St George's Hospital where Everard Home FRS was surgeon - see note 7 below. Home was the brother-in-law and successor of Baillie's other uncle, the younger brother of William Hunter, the ‘father of modern surgery’, John Hunter, FRS (1728-83). It was through Baillie that Brodie was introduced to Home, thereby gaining entry to the medical elite of the metropolis.

John Abernethy was born in 1764 in Wolverhampton where he received his brief formal education. At the age of 15 he went to London and was apprenticed to Sir Charles Blicke (1745-1815) at St Bartholomew's Hospital. He attended the anatomy lectures of Sir William Blizzard (1743-1835) at the London Hospital and also those of Sir John Percival Pott (1714-88) and John Hunter. In 1787 he became assistant surgeon at St Bartholomew's, a post he held for 28 years! In 1813 he was appointed surgeon to Christ's Hospital; Professor of Surgery at the Royal College of Surgeons in 1814 and, finally, surgeon to St Bartholomew's in 1815. Abernethy retired from his surgical posts at Bart's and Christ's Hospital in 1827 and 1828, and from his Professorship at the Royal College of Surgeons in 1829. He died at his house in Enfield, Middlesex in 1831.

Brodie (op. cit. Ref. 3): p. 37.

Everard Home was born in Hull in 1756, the youngest son of an army surgeon, and a descendant of the Barons of Polworth, ancestors of the Earls of Marchmont in Scotland. Educated at Westminster School, he gained a place at Trinity College, Cambridge but never went there, opting instead for a medical career under the supervision of his brother-in-law, John Hunter. Home was assistant surgeon to St George's Hospital 1787-1793; surgeon 1793-1827 and surgeon to the Royal Hospital, Chelsea 1821-1832. He was elected a Fellow of the Royal Society in 1785 and was appointed Sergeant-Surgeon to King George III in 1808. In the latter year he received the Copley Medal of the Royal Society in recognition of his various papers on anatomy and physiology published in the Society's Philosophical Transactions. He was created a baronet in 1812, the first surgeon in active practice to receive the honour. Home was Master of the College of Surgeons in 1813 and 1821 and President (the title having been changed) in 1822. He died in his residence at Chelsea Hospital in 1832. See Obituary notices of Fellows deceased. Proceedings of the Royal Society of London 1830-1837;3:145-6.

St George's Hospital was founded in 1733 in Lanesborough House at Hyde Park Corner, which had been built in 1719. The original building was gradually extended until, by 1744, the hospital possessed fifteen wards and in excess of two hundred and fifty beds. It was to this establishment that Brodie became attached. Lanesborough House was demolished when the new St George's (with its familiar façade of Doric columns) was completed in 1844. Now the old hospital building forms the Lanesborough Hotel. See Gould

, Uttley

. A Short History of St. George's Hospital and the Origin of Its Ward Names. London: The Athlone Press, 1997: 3.

The Lancet 1850; i:541. An insight into Home's approach to the mastery of surgery, together with evidence of his admiration for John Hunter, can be found in his Lectures in Practical Surgery given in 1794-95 where he states that the successful surgeon requires ‘judgement matured by extensive experience and much study … the rules followed by Mr J Hunter who had that sagacity of mind, boldness of thought, nicety of hand and everything requisite to form a great surgeon’. See King's College London College Archives reference GB 0100 G/PP2/20. Unfortunately, towards the end of his career Home's abilities sadly declined as the result of what today might be described as ‘a drink problem’. Rightly, he has been criticized for his decision in 1823 to destroy some of Hunter's manuscripts which had been entrusted to him as keeper and afterwards as joint trustee with Matthew Baillie, of the Hunterian Collection. For a discussion, see Moore W. The Knife Man: the Extraordinary Life and Times of John Hunter, Father of Modern Surgery. London: Bantam Press, 2005.

10.

Brodie (op. cit. Ref. 3): p. 45. Brodie makes no mention of the stench and general squalor of the dissecting rooms and operating theatres he encountered or of the necessary dealings with ‘resurrection men’. A near contemporary account of these matters can be found in the memoirs of John Flint South (1797-1882) who became an apprentice surgeon at St Thomas's Hospital in 1814. See Memorials of John Flint South. London: Centaur Press, 1970.

11.

Power (op. cit. Ref. 1): p. 145.

12.

Holmes

. Benjamin Collins Brodie. New York: Longmans, Green & Co., 1898: 38, 43.

13.

The Copley Medal is the Royal Society's oldest award, having been established in 1731. It is awarded annually for outstanding achievements in any branch of science.

14.

Thomas

. Benjamin Brodie: Physiologist. Medical History 1964; 8: 286–91. Brodie's work on poisons, including the action of the so-called ‘arrow poison’ curare were published in the Philosophical Transactions of the Royal Society in 1811 and 1812.

15.

Hawkins

, ed. The Works of Sir Benjamin Collins Brodie with an Autobiography. London: Longmans, Green & Co., 1865; 1: 47.

16.

For a critical clinical discussion of this work see Buchanan

. Sir Benjamin Collins Brodie (1783-1862). Rheumatology 2003:42:689–91. For an evaluation of Brodie's contribution to the development of pathology see Matthews T, Sheldrake J. Benjamin Collins Brodie: surgeon and pathologist. Bulletin of the Royal College of Pathologists 2006; 135: 54-6.

17.

The operation was a success and the grateful king created Cooper a Baronet. Cooper was born in 1768 in Norfolk and trained under Henry Cline (1750-1827) at St Thomas's Hospital, London and became Demonstrator in Anatomy there in 1789. He lectured in anatomy at the College of Surgeons from 1793 to 1796 and was elected a Fellow of the Royal Society in 1802. He was a surgeon at Guy's from 1800 to 1825 and was a founder of the Medico-Chirurgical Society and its President in 1819. He was President of the Royal College of Surgeons in 1827 and 1836, and Vice-President of the Royal Society in 1836. He was appointed Sergeant-Surgeon to George IV in 1828 and continued in the position under his successor William IV. Cooper died in London in 1841. For a recent account of Cooper's career see Burch

. Digging Up the Dead: Uncovering the Life of Astley Cooper, An Extraordinary Surgeon. London: Chatto and Windus, 2007.

18.

In 1819 Brodie and his wife settled in a house at 14 Savile Row that previously had been the home of the playwright and Whig politician Richard Brinsley Sheridan (1751-1816). The house, dating from 1734, is currently the headquarters of the Hardy Amies (1909-2003) company.

19.

Brodie (op. cit. Ref. 3): pp. 127–8.

20.

Holmes (op. cit. Ref. 12): pp. 85, 100.

21.

Brodie

. Clinical Lectures on Surgery Delivered at St. George's Hospital. Philadelphia: Lea & Blanchard, 1846: 32–3.

22.

Richardson

. The Story of Surgery: An Historical Commentary. Shrewsbury: Quiller Press, 2004: 48.

23.

Hawkins (op. cit. Ref. 15): Vol. 2, p. 663.

24.

Isambard Kingdom Brunel FRS (1806-59) was the son of Marc Kingdom Brunel FRS (1768-1849) with whom he worked on the planning and execution of the Thames Tunnel from Rotherhithe to Wapping, used now by the London Underground. His major work was undertaken in his role as the Chief Engineer for the Great Western Railway from London to Bristol. In addition to the London and Bristol termini, he also designed and built the bridges, viaducts and tunnels associated with the railway, Box Tunnel being the most impressive.

25.

Charles Aston Key FRS was a pupil of Sir Astley Cooper's at Guy's Hospital, becoming a surgeon there in 1824 and senior surgeon in 1833. He became a member of the Royal College of Surgeons in 1821, a member of the Council of the College in 1845 and surgeon to Prince Albert in 1847. Key was one of the first surgeons to use ether as an anaesthetic. He died after a day's illness in the cholera epidemic of 1849.

26.

Charles Hawkins became a student at St George's Hospital in 1831 and a member of the Royal College of Surgeons and assistant to Benjamin Brodie in 1836. Following Brodie's death, Hawkins edited his collected works.

27.

For a full account of the case see Brodie

. An Account of a Case in Which a Foreign Body Was Lodged in the Right Bronchus. London: Richard Kinder, 1843. Regarding the impact of the operation on Brunel, Hawkins noted that ‘Brunel died in 1859 and I saw him at the time of his death, and had the opportunity of examining his body afterwards. The cause of death was quite unconnected with the accident. The wound in the trachea was perfectly united, and there was no disease in the lungs’. (Hawkins op. cit. Ref. 15): p. 132.

28.

Holmes (op. cit. Ref. 12): p. 197.

29.

Sir William Bowman trained at King's College Hospital and became Joint Professor of Physiology and Anatomy there in 1856. He was joint editor of the Cyclopedia of Anatomy (Four Vols. 1836-59) and was co-author of Physiological Anatomy and Physiology of Man (1843) that became a standard text. He was elected a Fellow of the Royal Society in 1841. Among his many activities, Bowman undertook substantial research on the structure of the eye and helped to found the Ophthalmological Society of the United Kingdom (later the Royal College of Ophthalmologists), becoming its first President in 1880.

30.

Brodie (op. cit. Ref. 21): p. 24.

Sir Benjamin Collins Brodie (1783–1862)