John Alexander Sinton, MD FRS VC (1884-1956)

Brigadier John Sinton is the only individual in history to have been both awarded the Victoria Cross and also elected to the Royal Society. He qualified at Belfast and afterwards joined the Indian Medical Service (IMS). Serving before and during the Great War (1914-18), he was first posted to the North-West Frontier province, and afterwards as a captain in the Indian Expeditionary force in Mesopotamia (now Iraq). It was there in 1916 that, shot in both arms during an engagement and under heavy gunfire, he remained steadfastly at his post; for this bravery he received the Victoria Cross. Following the war he carried out major researches into malaria in India, and became Director of the Malaria Survey of India Both there and shortly afterwards, Sinton published about 200 papers on various aspects of malaria and leishmaniasis. In England, he later worked at the London School of Hygiene and Tropical Medicine and the Ministry of Health's laboratory at Horton, Epsom. In 1946, he was elected to the Royal Society for his researches into malaria and kala-azar, and following retirement he underwent another distinguished career in Northern Ireland.

The Hospital for Tropical Diseases at Endsleigh Gardens, Euston--1920-1939

From 1920 until 1939, London's Hospital for Tropical Diseases sponsored by the Seamen's Hospital Society was located at Endsleigh Gardens, Euston. Unfortunately, written records of that era were destroyed in air raids on Greenwich in 1940 and 1941. Oral reminiscences documented in this paper help remedy this loss.

Neil Hamilton Fairley KBE FRCP FRS (1891-1966): an outstanding tropical physician in the twentieth century

In the late nineteenth and early twentieth centuries, British physicians led the way in tropical medicine research. Several years later scientific advances had slowed, and Fairley's numerous contributions were thus most welcome. Neil Hamilton Fairley was born of Scottish parents at Victoria, Australia. After qualification at Melbourne, he joined the Australian Army Medical Service (AAMS) and after several minor research projects, made valuable contributions to the understanding of tropical sprue at Bombay (now Mumbai), India. However, Fairley's major researches were carried out during World War II (1939-45). Together with J S K Boyd he demonstrated the great value of sulphaguanidine in bacillary dysentery. Working in northern Australia and the south-Pacific region, he both contributed to elucidation of the Plasmodium vivax life-cycle, and more importantly demonstrated the value of alternative anti-malarial compounds to quinine (which was not readily available). Back in London after the war, Fairley briefly occupied the Wellcome Chair of Tropical Medicine, strongly supported London's clinical tropical medicine, and was subsequently knighted in 1950.

Thomas Spencer Wells, Bt FRCS (1818-97) and his contributions to naval medicine

Sir Thomas Spencer Wells (1818-97) is best remembered both as a gynaecological surgeon, who introduced ovariectomy, and as the one who introduced the surgical forceps named after him. Far less is known of his career in the Royal Navy (RN) as an assistant surgeon and then a surgeon, and his contributions to naval medicine. Wells enlisted for the RN at the age of 23 years and for most of his naval career (1841-56) he served at the Naval Hospital, Malta (1841-48). However, from 1851 to 1853 he was surgeon and sanitary officer on the sloop, HMS Modeste. Most of Wells' contributions to the health of sailors were of a preventive nature, especially involving ventilation, in RN ships. He was also an enthusiast for quarantine and vaccination.

Committee for the Relief of Distressed Seamen: correspondence from the Admiralty in 1818-19

The Seamen's Hospital Society, which was to become a great Victorian charity, with the object of caring for both the physical and spiritual health of seafarers (most merchant seamen) in the Port of London, was founded at a meeting on 8 March 1821. However, it is not widely known that it had a temporary predecessor--The Committee for the Relief of Distressed (Destitute) Seamen. Ready cooperation was received from the Admiralty in most of its affairs, but "disposal" of many of these "redundant" mariners proved to be a somewhat difficult matter.

History of Tropical Medicine William Ernest Cooke, FRCSI (1879-1967) and his Asian tour of 1929-1930

Dr. W.E. Cooke was not one of the most distinguished of tropical physicians, but the specialty was heavily dependent on his likes. After several junior appointments, he was Superintendent of the Hospital for Tropical Diseases in London. He carried out an extensive tour of Asia in 1929-1930 and kept careful daily notes throughout this period, giving a valuable insight into the challenges faced by the pioneering tropical physicians and surgeons from European countries.

Leonard Rogers KCSI FRCP FRS (1868-1962) and the founding of the Calcutta School of Tropical Medicine

Sir Leonard Rogers made enormous research contributions to 'medicine in the tropics', especially in Bengal where the spectrum of disease was already well delineated. He also did much to enhance the formal discipline of tropical medicine. But perhaps his most lasting memorial lies in the Calcutta School of Tropical Medicine--that occupied a decade of politicking and stress--which survives to this day and is a timely reminder of a past era in India. It is not widely appreciated, however, that the original impetus for this institution came not from Rogers but from a young medical practitioner, Alfred McCabe-Dallas, attached to an Assam tea plantation.

The practice of euthanasia at the highest level of society: the Lords Dawson (1864-1945) and Horder (1871-1955)

The intimate involvement of Lord Dawson of Penn in the terminal illness of King George V in 1936 was highlighted 50 years later when his personal papers were released for perusal in the public arena. A popular jingle of the time relating to Dawson was recalled in a leading article in The Times newspaper in 1986. Knowing that a similar rhyme was in circulation involving Lord Horder of Ashford, I wrote to his son in order to verify exactly what this was; his reply is reproduced in this article.

Richard Dobson Kt MRCS FRS (1773-1847) and the inferior status of naval medicine in the early nineteenth century: end of the fleet physicians

In the eighteenth and early nineteenth century assistant-surgeons in the Navy possessed an inferior status compared with their equivalents in the Army, despite protestations from the Physician of the Navy, Sir William Burnett FRS; lack of promotion was a major complaint. By abolishing the title physician in the Navy, Sir Richard Dobson, FRS, surgeon to Greenwich Hospital, did much to rectify this injustice. Instead of only two promotions in 26 years, 26 medical officers were, as a result of his exertions, advanced to the rank above that of Surgeon in two years.

Transfer of hospitals and "additional premises" to the state: questionable morality in the implementation of the National Health Service Act (1946)

The National Health Service Act of 1946, pioneered by Aneurin Bevan, came into being on the "appointed day", 5 July 1948. Hospitals with their "additional premises" throughout Britain were "seized" by the state and incorporated into this vast socialist enterprise. While the majority of the population welcomed this new initiative in the creation of a welfare state, associated with medical care from cradle to grave, not all (especially members of various Hospital Boards of Management) were so enthusiastic. The hospitals for "incurables" (long stay patients) were unhappy and lost a vast proportion of their income owing to a great deal of procrastination; but most of them ultimately managed to escape nationalisation after a prolonged period of negotiation, by a claim that they were "homes" rather than "hospitals". The confiscation of property which had been built as a result of voluntary subscription was another huge and highly contentious matter, which has been highlighted in recent years. The future of the Seamen's Hospital Society's properties represents a good example of this.

Scurvy in the British Mercantile Marine in the 19th century, and the contribution of the Seamen's Hospital Society

When long voyages in sailing vessels were commonplace, scurvy was a major health hazard in mariners of all nations. The observations of James Lind (1716-94) and others indicated that citrus fruits had both a preventive and curative role in this disease. In the light of this work, by 1800 the disease had been virtually eliminated from Britain's Royal Navy. However, it continued in the merchant navies of all nations until the latter half of the 19th century. In 1867, the Merchant Shipping Amendment Act was passed by the British Parliament largely as a result of a concerted effort by the Seamen's Hospital Society (SHS), one of whose physicians, Harry Leach (1836-79) was the major proselytiser for improved conditions in the merchant service. Examination of the SHS records before and after this event demonstrate a marked reduction in the prevalence of scurvy in the Port of London. Although other factors-such as the introduction of steam ships, which resulted in faster voyages-were clearly important, the compulsory administration of genuine lime juice under supervision in the merchant service seems to have exerted a significant effect.

Andrew Halliday, Kt FRCPE (1781-1839): service in the Napoleonic Wars and West Indies, and first physician to the Seamen's Hospital Society

Sir Andrew Halliday (1781-1839) was domestic physician to HRH the Duke of Clarence (1765-1837) (who was later to become King William IV). He also served in the Napoleonic Wars-in Portugal, Spain and Waterloo-as well as in the West Indies, and became the first physician to the Seamen's Hospital Society. Unlike many of his contemporaries, Halliday was also a prolific author, many of his publications being on lunatic asylums in Great Britain and Ireland.

Caring for "incurables": the 150th anniversary of the Royal Hospital for Neuro-Disability, Putney

The Royal Hospital for Incurables (RHI), now known as the Royal Hospital for Neuro-Disability and situated on West Hill, Putney, was founded by Andrew Reed DD exactly 150 years ago. The RHI was thus the pioneer in modern times of long stay institutions for the sick and dying. It became one of the great Victorian charities, and remained independent of the National Health Service, which was introduced in 1948. Originally the long stay patients suffered from a multiplicity of diseases; in recent years chronic neurological disease has dominated the scenario. This institution has also become a major centre for genetic and trauma-associated neurological damage, and rehabilitation.

Dr D G James FRCP and the Fellowship of Postgraduate Medicine

Dr D G James recently retired as Vice President of the Fellowship of Postgraduate Medicine. The following article is based on a speech given at a dinner at the Athenaeum Club on 10 October 2002 to thank Dr James for his contributions to the Fellowship of Postgraduate Medicine over 50 years.

The medical career of Robert Seymour Bridges, FRCP (1844-1930): physician and Poet Laureate

Robert Bridges OM is the only medical graduate (he was elected to the Fellowship of the Royal College of Physicians of London in 1900) to have held the office of Poet Laureate. Educated at Corpus Christi College, Oxford and St Bartholomew's Hospital he practised as a casualty physician at his teaching hospital (where he made a series of highly critical remarks of the Victorian medical establishment) and subsequently as a full physician to the Great (later Royal) Northern Hospital. He was also a physician to the Hospital for Sick Children. It had for long been his intention to retire from the medical profession at the early age of 40! In 1913, Bridges was appointed Poet Laureate by King George V, and following a disappointingly sparse output of "official" work, published his greatest literary contribution-The Testament of Beauty-on his 85th birthday.

Henry Currey FRIBA (1820-1900): leading Victorian hospital architect, and early exponent of the "pavilion principle"

The "pavilion plan" for hospital design originated in France in the 18th century and was popularised in England by John Roberton and George Godwin in the mid-19th century; the underlying rationale was that with improved ventilation the mortality rate (at that time exceedingly high) was significantly reduced. Among the enthusiasts for this new style was Florence Nightingale (herself a miasmatist)--who had experienced astronomically high death rates in the hospital at Scutari during the Crimean War (1854-6). One of the leading exponents of this style of hospital architecture was Henry Currey (1820-1900) whose greatest achievement was undoubtedly the design for the new St Thomas's Hospital on the Lambeth Palace Road.

Charles Wilberforce Daniels, FRCP (1862-1927): underrated pioneer of tropical medicine

Charles Wilberforce Daniels was a major pioneer in the early days of the newly-formed medical specialism--tropical medicine. At the London School of Tropical Medicine (LSTM) of which he was a leading stalwart, he took an active part in research, teaching and administration. But like others in the new discipline he spent a great deal of time at various tropical locations: Fiji, British Guiana--where he made important observations on various forms of filariasis-- east Africa, and Malaya. However, his most important research contribution was arguably confirmation of Ronald Ross' 1898 discovery of the complete life-cycle of avian malaria, in Calcutta.

Reactions from the medical and nursing professions to Nightingale's "reform(s)" of nurse training in the late 19th century

In 1860, the Nightingale School of Nursing opened at St Thomas's Hospital, London. Florence Nightingale's overriding raison d'etre in the setting up of this foundation was a replacement of the old fashioned nurse (caricatured by Mrs Gamp-an "ignorant and immoral drunkard") by the highly trained, and eminently respectable "lady-nurse". While this change met with a great deal of approval from the lay public and the majority of the nursing profession, a minority of the latter together with the bulk of medical practitioners (including several leading physicians and surgeons of the day) wholeheartedly opposed this revolutionary move. It was felt, by them, that the medical profession was in danger of losing control over nursing with the resultant sacrifice of satisfactory patient care. Today, both medical student and nurse training is moving noticeably away from the bedside, an orientation which has added such an important dimension to British medical/nurse training over so many generations. Is this 19th century experience yet another example of history repeating itself in the medical sphere?

History of 'tropical nursing' in East London: the Dreadnought experience

In the latter years of the nineteenth century, the 'Dreadnought' Seamen's Hospital (previously the Infirmary of the Greenwich Hospital) became London's centre of excellence for the healthcare of 'seamen of all nations' (many had 'tropical' and/or sexually-transmitted diseases); this followed a 50-year period (1821-1870) during which three successive hospital ships (anchored on Greenwich Reach) had been used for this purpose' (1). Numerous mariners 'afloat and ashore' therefore owed their lives (and good health) to the skill of the physicians and surgeons based there, but equally (and perhaps more) important was the care and devotion of the nursing staff (2).

A difficult metamorphosis: the incorporation of the Ross Institute & Hospital for Tropical Diseases into the London School of Hygiene and Tropical Medicine

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The Albert Dock Hospital, London: the original site (in 1899) of Tropical Medicine as a new discipline

The London School of Tropical Medicine, and indeed the 'new' discipline of tropical medicine, originated in 1899 at the Albert Dock Hospital - situated in London's east-end. The founder of the discipline was Patrick Manson - with a great deal of political assistance from the British Secretary of State for the Colonies (Joseph Chamberlain). The hospital (originally opened in 1890) was rebuilt in 1937-1938 and ultimately demolished in 1993.

The College of Physicians in the nineteenth century

For much of the nineteenth century (during which there were 16 Presidents) events within the College were dominated by widespread demands for medical reform, culminating in the great Medical Reform Act of 1858. This led to major changes within the College, including an overhaul of the system(s) of elections; the old licentiates disappeared (to be replaced by the new licentiates), whilst introduction of the membership (by examination) was instituted. The style of Presidential elections was also changed. Internal College activities centred on the Library and on the London Pharmacopoeia. Early in the century, the College once again moved geographically, this time from the City to the West End of London. Regarding contemporary issues, including medical advances (notably introduction of the 'germ-theory' of disease causation) and important social changes (dominated by Poor Law reform), the College's input proved minimal.

The Seamen's Hospital Society: a progenitor of the tropical institutions

1999 marks the centenary of the two major British Schools of Tropical Medicine, founded in London and Liverpool, respectively. The origin(s) of the former clearly lies in the Seamen's Hospital Society, which dates from 1821. It seems likely that the foundation of this school (with Government support) also acted as a catalyst for the school at Liverpool, which in fact opened its doors a few months before that in London.