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William Lawrence and the English Ophthalmology Textbooks of the 1830S and 1840S SPECIAL ARTICLE William Lawrence and the English Ophthalmology Textbooks of the 1830s and 1840s H. Stanley Thompson, MD; Patricia G. Duffel, RPh, MLIS illiam Lawrence was a leading English ophthalmic surgeon in the middle of the 19th century. This article briefly discusses his life, career, and well-known text- book (Treatise on Diseases of the Eye). His book and 3 others were the best- known English texts on diseases of the eye of the 1830s and 1840s. The 3 others Wwere William Mackenzie’s Practical Treatise on Diseases of the Eye, Richard Middlemore’s Treatise on the Diseases of the Eye and Its Appendages, and Thomas Wharton Jones’ Manual of the Principles and Practice of Ophthalmic Medicine and Surgery. Arch Ophthalmol. 2012;130(5):639-644 William Lawrence (1783-1867) anatomy by Johann Friedrich Blumen- (Figure 1) was a general surgeon who bach,1 a famous professor of physiology took a special interest in diseases of the eye and physical anthropology from Go¨ttin- and became famous in London, England, gen, Germany. Also, during these years, as an ophthalmic surgeon in the middle Lawrence wrote a much admired book on of the 19th century. His father, a success- the treatment of hernias that was re- ful surgeon in Cirencester, England, sent printed 5 times.2 The fourth edition of A him, at 9 years of age, to Elmore Court, a Treatise on Ruptures (1838) was a substan- grammar school near Gloucester, En- tial work of 636 pages. gland, for a solid classical primary educa- By the time he was 30 years old (1813), tion. In 1799, at the age of 16, he began Lawrence had been elected an adjunct sur- his medical career as an apprentice to John geon at Barts and became a fellow of the Abernethy (1764-1831) (Figure 2), who Royal Society (Figure 3), and at 42 years was a well-known surgeon and a founder of age, after 26 years at Barts, he was named of the medical school at London’s very old a surgeon. This promotion was considered St Bartholomew’s Hospital (Barts). to be a speedy climb up the rungs of aca- Lawrence lived for 3 years in Aber- demic surgery at the time. When his for- nethy’s establishment with several other mer mentor Abernethy eventually re- apprentices. Then, Abernethy found him signed his leadership position in 1827, a paying job as a lecturer in anatomy at Lawrence applied for and gained Aber- Barts so that, at 19 years old (1802), he nethy’s administrative job as the principal could support himself while finishing his surgeon of Barts. The students’ nickname medical training. He apparently became a for this position was dictator of Barts3 be- good teacher and demonstrator of cause no one on the premises outranked the anatomy, even though he was, at first, principal surgeon. Lawrence held this po- younger than some of his students. sition until well after the usual retirement In 1805, at 22 years of age, he took his age and continued to teach and treat pa- medical examinations and became a mem- tients. It is notable that, when he was 75 ber of the Royal College of Surgeons (RCS) years old, the official mandatory retire- and then an assistant surgeon. At the age ment age at Barts was, rather pointedly, set of 24 years (1807), he translated, from Ger- at 65 years, and Lawrence voted for this rule. man into English, a book on comparative When asked why, in that case, he had not yet retired, he said, with a smile, that he had Author Affiliations: Department of Ophthalmology and Visual Sciences, University decided that the rule did not apply to him of Iowa, Iowa City. but only to future principal surgeons.3 ARCH OPHTHALMOL / VOL 130 (NO. 5), MAY 2012 WWW.ARCHOPHTHALMOL.COM 639 ©2012 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/26/2021 1817), which were quickly pub- lished. His lectures were influ- enced by his reading of the histol- ogy of Xavier Bichat and the comparative anatomy of Georges Cuvier and J. F. Blumenbach. When these 2 lectures at the RCS ap- peared in print, they caused quite a fuss. Abernethy, whose conserva- tive position went down well with most of the English medical com- munity and with the Church of En- gland, was outraged at Lawrence’s scandalous ideas and arranged to publish his own RCS lectures.4 Unlike Abernethy, Lawrence found that he rather favored the Figure 3. William Lawrence, fellow of the Royal French idea that physics and chem- Society. istry should be applied to understand- ing the human body and its func- Figure 1. William Lawrence at 37 years of age. he thought of anyone with an op- tions. He pointed out that if the brain posing opinion, but his published itself were malformed or injured, it opinions tended to be smooth, po- usually did not work very well, and lite, and reasonable. His mentor the patient might have little or no Abernethy was the opposite; he was mental activity; thus, the mind (call inclined to give anyone with an op- it the soul if you must) is a product posing view a vigorous, condemna- of the brain, and it must therefore be tory tongue-lashing. part of the body. The British, having In 1814, at the age of 50, Aber- been recently at war with France nethy accepted an added position as (1793-1814), considered these ideas professor of anatomy and surgery at altogether too French and objected to the RCS. It was customary for a new them because they seemed to leave no RCS professor to give 1 or 2 intro- place for the immortal soul, so cries ductory lectures to the college. The of “materialist!” and “atheist!” were publication of these lectures was heard. However, the objections of- considered optional. Abernethy gave fered by Abernethy and many others 2 such lectures in 1814 and 1815.4 on this subject just stimulated the They were in praise of the concepts strong-willed Lawrence to wade fur- of “vitalism” that he had been taught ther into the argument. He set about by John Hunter. Vitalism had been summarizing and defending his po- popular in England in the late 18th sition and came out with a book called century, but Lawrence considered it Lectures on Physiology, Zoology, and to be hopelessly old-fashioned. It was the Natural History of Man, and, of Figure 2. John Abernethy. a worldview in which life, body, and course, he did it in his usual forth- mind (read soul) were 3 entirely right way, letting the chips fall where An elderly and then famous Law- separate God-given entities; to Ab- they may.6,7 rence attended to Queen Victoria’s ernethy, the immortal soul was not Eighteenth-century scientists eye problems, and the queen made something that grew in the body, it knew there were animal bones in him one of her serjeant surgeons. was a divine gift, added to the body.5 some geologic strata that suggested Then, just before his death in 1867 The Oxford English Dictionary of- there had been animals on the earth at the age of 84, she gave him a bar- fers the following clarifying state- much longer ago than anyone had onetcy—a title that he could pass on ment: “The mind was thought of as imagined. Lawrence blithely stated in to his oldest son, Trevor. When Sir the system of cognitive and emo- his new book that the biblical story William died, he had a right hemi- tional phenomena and powers that of creation found in Genesis seemed paresis from a recent stroke but was constituted the subjective being in simply to be derived from ancient He- still clinging to his position as boss a person. This was the spiritual part brew traditions, and therefore the of Barts. of a person, and thus the ‘soul’ as dis- whole matter of the origins of man- During much of his life, Wil- tinguished from the body.” kind was clearly open for discus- liam Lawrence seemed to have cul- In 1815, Lawrence, at the age of sion. Naturally, there were many who tivated a sharp, sarcastic wit. He was 32, was also offered an RCS profes- disagreed. quick to express his opinion and was sorship, and he too gave some in- Bringing religious belief into this quite ready to say (very clearly) what troductory lectures (in 1816 and discussion was perhaps a tactical er- ARCH OPHTHALMOL / VOL 130 (NO. 5), MAY 2012 WWW.ARCHOPHTHALMOL.COM 640 ©2012 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/26/2021 ror. The matter was soon brought be- fore the old-fashioned Chancery Court (Figure 4). Apparently, many in the court suggested that Law- rence, by saying that the Genesis story was wrong, was “contradicting the word of God.” Therefore, he was surely guilty of blasphemy and, given the close connection between the Crown and the Church of England, perhaps also of sedition. The lord chancellor, using his court in its most ancient role as a court of con- science, agreed. It soon became obvious to Law- rence that this rumpus was going to affect his career as a surgeon. After all, who would want an established blas- phemer to remove his cataract—a procedure that, in those days, re- quired 4 assistants to hold the pa- tient down and keep the head immo- bile? Would God still guide and Figure 4. The Court of Chancery (in approximately 1810). steady the hand of such a sinful surgeon? to his audience.
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