Sectional Vol. 52 page 7 Proceedings of the Royal Society of Medicine 231 Section of the History of Medicine President-Sir WELDON DALRYMPLE-CHAMPNEYS, Bt., C.B., M.A., D.M., F.R.C.P. Meeting December 3, 1958 John Sheldon, F.R.S., and the Exeter Medical School By NORMAN CAPENER, F.R.C.S. Exeter EXETER is an ancient City and was a provincial with requisition and billeting. The archives of metropolis. It is, therefore, natural that we Exeter provide an interesting illustration of this. should find mirrored there many of the features In 1688 William of Orange landed at Torbay of medical evolution which are familiar in the and with thirteen thousand men marched on great national metropolis itself. It is my purpose Exeter which he entered "amidst the shouts of to give an account of a place rather than of a its citizens". There exist lists of some of the man although the particular man, John Sheldon, casualties and the cost of treatment by the F.R.S. (1752-1808), is one of the more surgeons, apothecaries and by Widow Westcott picturesque features in this interesting back- (evidently the nurse in charge) at the Blue ground. It is exactly one hundred and fifty Maidens Hospital. Then there is an appeal in years since he died. 1706 to Queen Anne requesting payment of the From medieval times until the eighteenth account which William evidently had forgotten. century hospitals differed greatly in their "Whereas your Majesty's Predecessor, King functions. Some were little more than orphan- William of ever blessed memory (when Prince of ages, or were hostels for the aged poor and in Orange) did a little after his landing at Torbay the course of time became schools and alms- desire the Chamber of Exeter to take care of houses. Some were used for the isolation of part of his Army (Which there lay sick and destitute individuals suffering from such diseases disabled in and near this City) and to furnish as leprosy which made them a danger to the them with necessaries. At the same time community. When Exeter's Norman Cathedral proniising to reimburse the Chamber with such was completed in the twelfth century each of sums as (by them) should be, on this Account, these types of hospital was already established expended." The expenditure is stated to be there and has continued in some form or another £354 4s. 2jd. The Blue Maidens Hospital which until the present time. Notable amongst these had been converted into a Military Hospital was was the Hospital of St. Mary Magdalene, which one of the mediaeval schools and is now the is recognizable as a leper hospital in a Charter Maynard School, an excellent grammar school of Bishop Bartholomew in A.D. 1163, confirmed for girls. later by a Papal Bull of Celestine III in 1192. In medieval times there existed an Exeter This hospital was established just outside the Guild of Surgeons which is noted in the records city wall on a road, still called Magdalen Street, of the Guildhall but no records of the Guild which was a medieval by-pass for traffic to the itself remain. frontiers of civilization which were but a few Although it is usual to look for the origins of miles farther on. There is thus a resemblance our modern hospitals in the eighteenth century in time and possibly in early function to St. we note that the public conscience was being Bartholomew's and St. Thomas's-both outside aroused in the century before. At an early date the city walls and on the main line of com- the City fathers were making efforts to do munications: but there the resemblance ceases something, and in 1656 there was a bequest by for the Hospital of St. Mary Magdalene in due the Mayor, Thomas Ford, which was "towards course became a refuge for the aged sick and erecting a hospital for poor, sick and wounded itself fell into decay; the foundation, however, persons according to the order of St. Thomas's in the nineteenth ceiztury was moved to a new Hospital in Southwark". The first Exeter site and is now represented by some old Hospital so called was built by the commonalty almshouses which retain their ancient name. in 1665 and a new hospital was planned through Hospitals were also needed during and after an Act of Parliament passed in 1694. This wars. Such is the origin of Chelsea Hospital. second Exeter Hospital, completed in 1718, They were often arranged by improvisation; remained until 1942 when the old buildings were APRIL 232 Proceedings of the Royal Society of Medicine 8 destroyed by enemy action. Later nineteenth and the conscience of the Church was aroused. century and more modern buildings now form During this social awakening other Hospitals the nucleus of a good modem general hospital. were founded. In London Bart's, Thomas's, This old Exeter City Hospital within a few Bethlem and Chelsea already existed, but in years came into conflict with a new and more succession Westminster-1719, Guy's-1725, St. broadly based institution established by charitable George's-1733 and the London Hospital-1740, enterprise. Perhaps we see in this the roots of were established. At Edinburgh, Bristol and the deep prejudice of Englishmen against Winchester, hospitals were founded in 1736 and submitting their bodies to the care of municipal- at Bath the Mineral Water Hospital in 1740. ities, but perhaps even more against being The Devon and Exeter came in 1741. All these compelled by taxation to do something more hospitals existed long before those at Liverpool, rightly to be regarded as a matter for conscience Manchester or Newcastle and before Adden- and as an object for the display of pity and brooke's, the Radcliffe, Middlesex or St. Mary's. benevolence. The first physicians of the Devon and Exeter Hospital were men of great learning enriched by study abroad and especially with the great Dutch teacher Boerhaave. They included Michael Lee Dicker, a Quaker with well-marked administrative ability, and Thomas Glass, a greatly loved and respected physician who collected a great library of the medical classics which he left to the Cathedral Library. Around him there appears to have been established a Medical Society but apart from the fact that there was such a society no record of its activities remains. He was succeeded in 1783 by another physician of great literary ability, Dr. Bartholo- mew Parr, F.R.S. (1750-1810) the author of a great "London Medical Dictionary". The earlier surgeons appear to have been worthy men but we know little about their work. John Patch, senior, had been on the staff of the Old Pretender in Paris and was a considerable anatomist; he was the head of a medical dynasty in Exeter and London. His son John was appointed to the Hospital at the same time as his father: as a surgeon he made a great name for himself; his John one FIG. 1.-John Patch,. Jr. (1723-1787). Engraving portrait by Opie makes after portrait by John Opie, R.A. understand that "he had a prodigious memory, great penetration and sound judgement and his [Figs. 1, 2 and 3 are reproduced by permission of the Governors of the Royal Devon and Exeter conversation charmed by its warmth and Hospital.] benevolence". Through their portraits now in the Hospital The Devon and Exeter Hospital was founded board room we are brought into touch with in 1741 by Dean Alured Clarke who, in 1736 interesting figures in the world of art and letters. while at Winchester, had founded one of the first Michael Lee Dicker and John Tuckfield, an early County Hospitals. It was a time of great social benefactor, were painted by Thomas Hudson degradation, which was well portrayed by Gay who was the master of Joshua Reynolds, the in his "Beggars' Opera". The Gentleman's Plympton boy who became the first President Magazine contains many interesting details; for of the Royal Academy. example in 1736 it recorded an incident but a Thomas Glass and John Patch, junior, were short distance from this Society's House in a painted by John Opie, the poor Cornish prodigy list of births: "A woman in Vere Street-of her who had been befriended by John Wolcot (the 35th child by one husband." And in almost satirist "Peter Pindar"). Brian Hill (1954) gave every month of that year we see that the burials an entertaining account of these two men. were at least double the christenings, and Wolcot who came from South Devon was half the burials were of infants under 5 years. alternately a parson and a doctor but later There was great anxiety about the iniquitous gin devoted himself to teaching, and then managing, trade. The Wesleys had started their crusade the youthful artist. Having exhausted the 9 Section of the History of Medicine 233 portraiture of the county families of Cornwall, his appointment as "surgeon to the General Wolcot brought Opie to Exeter for two years Medical Asylum, St. Marylebone". In it he also before going on to' London and introducing him announced special financial assistance to former to Sir Joshua. Here Opie needed no further help pupils of Magnus Falconer, another Hunterian after Sir Joshua's introduction to the Court. disciple who, after establishing his own school It is sad to find that after a journey to Paris for of anatomy, had, like Hewson, died prematurely. study his later portraits were lacking the In 1779 Sheldon founded a medical society of distinction of his earlier work which Reynolds which he was the first president: there were described as "like Caravaggio only finer". about 150 members in London and the provinces We should note that when the Devon and and it carried on for several years. More Exeter Hospital was founded in 1741 William important than that there were four presidents Hunter was 23 years old and his brother John 13. who were governed by the rule that each must Four years later the Surgeons' Company in "wear his hat while in the chair", is the fact of London separated from its unhappy association there being such a society within five years of the with the barbers. Cheselden soon followed founding of the Medical Society of London. Ranby as Master and a few years later William When 31 he succeeded William Hunter as Hunter and Percivall Pott became associated as Professor of Anatomy to the Royal Academy Masters of Anatomy. In 1746 William Hunter and was the next year elected a Fellow of* the had brought back to London from France the Royal Society and married the daughter of a Paris method of teaching anatomy by individual Devonshire parson. student dissections. In 1748 at the Windmill Sheldon was not a prolific writer. In 1781 he Street School of Anatomy he was joined by his edited a catalogue of Camper's works, and in brother John, who went to Portugal in 1760 and the following year an edition of four dissertations after three years returned to London to establish by Lieberkuhn. At this time he was preparing himself independently. his work on the lymphatic system. Sheldon's A link with William and John Hunter and with work was evidently very well thought of by the Exeter is now to be found in John Sheldon, an Italian anatomist Antonio Scarpa, for the latter erratic genius whose work and influence deserve made for the work a drawing of one of Sheldon's to be remembered more than the doubtful injected specimens. It is said that Sheldon was episode with which his name is unjustly more the first to shape the cannula as seen in a modern commonly linked. hypodermic needle. The resemblance is certainly very striking. In Sheldon's description of his JOHN SHELDON bevelled injecting pipes he said "I would John Sheldon was born in 1752, the son of an recommend" that they should be "formed in a apothecary-surgeon in Tottenham Court Road, particular manner, which I contrived many and at an early age was apprenticed to Henry years ago, for passing into small vessels, Watson the anatomist who enthused him with especially veins. This improvement consists in his methods of injecting bodies and started him shaping the ends of these pipes like the mouth upon experiments in embalming. For clinical of a pen, taking care to make the edges and training he was a pupil at the Westminster and point blunt to avoid cutting the vessel when we Lock Hospitals. In 1774 he succeeded Hewson, introduce them". He stressed that these pipes after his premature death, as resident pupil to as he called them must be made out of solid John Hunter and attended William Hunter's well-tempered wire which was drilled out-he school. In 1775 he gained the diploma of the had no use for tubes made from flat metal folded Surgeons' Company and was appointed to the over and soldered. He fully explained his own staff of the Lock Hospital. He had as one of his methods, and for this reason the book was patients a young woman of 24 suffering from praised by Jesse Foot in words that were taken phthisis to whom he became very attached and from Sheldon's own introduction and of which before she died she asked him to preserve her the following is an extract: body. This he did and removed the embalmed body to his house. In 1776 he was appointed "Prefixed to this my first essay on the absorbent lecturer in William Hunter's school and was so system, there is also a chapter on the method of these successful that the next year he opened his own discovering, injecting and preparing vessels, school in Great Queen Street, Lincoln's Inn with a plate of the lymphatic injecting tube, which will prove useful to all who wish to prosecute these Fields. Although he was only 25 years old he inquiries. This unreserved discovery, I flatter was one of the leaders of his profession and the myself, will induce other anatomists to publish with outstanding teacher of his generation. At his their works, whatever they know respecting anatomical school he gave lectures in anatomy, physiology pursuits, or investigations; for the progress of the and surgery and the published prospectus notes science has undoubtedly been much impeded by 234 Proceedings of the Royal Society of Medicine 10 the mystery observed among anatomists respecting earth and Blanchard is reported to have the composition of their injections, and their method exclaimed "If you are my friend you will alight. of dissecting, injecting and preparing the different My fame, my all, depends on my success". parts: a mystery which deserves the severest censure, Sheldon, however, was determined to continue and is unworthy of the character of a philosopher or a man." the journey, whereupon Blanchard "in a violent passion, swore that he would starve him and He also wrote of the pleasures of discovery as threw out all the provisions". It was commented found in the writings of Asellius who first at the time that this was a good French notion discovered the lacteals: "The natural and simple to get rid of an Englishman. Sheldon, however, manner in which Asellius expresses himself, still insisted on continuing the journey and the faithfully represents . . . his astonishment, and balloon, lightened by the loss of the food, rose gives an idea of the sensation which all anatomists again and passed over Hammersmith, Chiswick experience at the instant of making any interesting and Twickenham and gradually descended near discovery." Again: "I have now finished the Sunbury. Here Sheldon did alight and Blanchard whole of the anatomical encheiresis and dis- went on to Romsey 73 miles from London to covered, without reserve, every circumstance which Sheldon followed on horseback and they which may prove useful to those, who wish to returned to London together the following day. trace and prepare the absorbent system. The In 1784 when he was elected a Fellow of the height of my ambition will be to increase the Royal Society he was visited by Monsieur number of practical anatomists, and to raise a Saint-Fond, Professor of Geology in Paris who spirit of emulation among them, which may later reported his visit to Sheldon's Museum, in tend to the further progress of the science, which the most interesting exhibit was the particularly in this important and hitherto almost mummy already mentioned. "It occupied a unexplored, track of anatomical knowledge." distinguished place in the chamber where the Sheldon never completed the second volume anatomist usually slept." It lay in a mahogany for his attention was distracted elsewhere, which table with a glass top and Sheldon demonstrated was a great pity, for as Miss Dobson (1954) to him the perfect preservation and flexibility of says, it was a most learned treatise that corrected the parts of the body. Even the skin partly many previous errors. Had he completed it he retained its colour, though exposed to the air. would have been remembered rather than Sheldon explained how he had carried out the Cruickshank as the earliest English authority on embalming ten years previously and he stated lymphatics. Cruickshank who had worked with that "the remains were those of a mistress whom Sheldon published his work two years afterwards he tenderly loved". and strangely made no mention of Sheldon's After his death his widow offered the mummy pioneer work which was remarkable when to the Royal College of Surgeons where it compared with Sheldon's own generous acknow- remained until destroyed by enemy action in ledgments of other workers. For example, he 1941. Many apocryphal stories have been told mentions "the illustrious Haller . .. immortal about the identity of the lady in the case. Sir Hewson .. . the late most accurate Mr. William D'Arcy Power stated that he often used to visit Hewson . . . my indefatigable predecessor the late her in the College basement but the body could

Dr. Hunter. . . the ingenious Mr. Cruickshank. . . not then have been very beautiful, for it was ingenious Mr. Falconer ... immortal Harvey ... "shrunken and hard as a board, the skin of the that lynx-eyed anatomist Lieberkiihn". Surely arms, neck and chest quite white; the face, where this was a great and generous man. apparently the colour injected had remained, a Sheldon was carried away by other enthu- dull red all the more ghastly for its colour and siasms. The first was ballooning. In 1782-3 the long brown hair beautiful no more". the brothers Montgolfier and other Frenchmen The episode of Sheldon and the mummy of his had carried out their pioneer flights. Sheldon supposed mistress has, I maintain, been magnified himself made an unsuccessful experiment. In into a piece of scandal on the evidence of only 1784 Blanchard, who first had used a condemned one perhaps rather imaginative witness. Rather criminal as an experimental animal for his than this being a labour of love I regard the ballooning trials, carried out several ascents actions of Sheldon's wife and his own character, himself and then came to England and in as seen in his writings, as proofs that what he partnership with Sheldon made an ascent. achieved was a work of art and science in a field Blanchard was greatly piqued because he wanted which at that time dominated the whole of to make the ascent himself and appropriate all medical and surgical progress-the convenient the glory. After rising a short distance, with study of anatomy. various instruments which Sheldon took for In 1786 Sheldon was appointed surgeon to the scientific investigation, the balloon came to Westminster Hospital and was a leader in his 11 Section of the History of Medicine 235 profession, with his own teaching school and %ate practice and in 1796 he contributed an his own museum, a recognized authority on cle to a volume of "Essays by a Society of lymphatics; and it is incomprehensible why he tlemen at Exeter". One of the leading should have abandoned all this a year or two its in this was Downman the poet and a later. One story has it that his museum was sician at the Devon and Exeter Hospital. attacked and demolished by a mob before the Idon's essay was on the structure of the iris troops arrived. With John Hunter, Sheldon was i a theory of muscular motion, in which he irterested in the anatomy of whales and devised aght that the fluid content of muscle fibres a poisoned harpoon for capturing them. In merely a continuation of blood vessels which the spring of 1788 he set off for Greenland and -ted to the stimulus of light and in different on the journey contracted what was called brain es of engorgement contracted or relaxed. fever. His illness was long and he retired to lough we may now recognize the fallacy, the Devon to recuperate with one of his sisters. On was not far removed from Sharpey-Schafer's hearing this Cruickshank attempted to secure )ry of variations in fluid content of muscles, the Professorship at the Royal Academy but ch was the current explanation of muscular Sheldon's brother Thomas and his sister on until the beginning of the present century. petitioned the Queen and Sheldon continued to n April 1797 Sheldon was the centre of give the annual course of lectures until he died flict occasioned by his application for the in 1808. In 1789 he published an interesting ?ncy of surgeon to the Devon and Exeter paper on fractures of the patella which he ;pital upon the resignation of Bartholomew recognized as being due most commonly to r, senior. The voting upon Sheldon, favour- muscular violence. In treatment he stressed that by one committee, was reversed by a Court it was necessary to flex the hip in order to relax Governors: and so it went backwards and forwards four times before Sheldon was finally accepted. His work and character were greatly esteemed by the mem- bers of the staff and by the patients. He died aged 56 in October 1808 and is buried in Coombe Raleigh Church, Honiton. In 1809 Jesse Foot wrote: "He was humane, active in every intercourse of friendship, though of so animated a character, mild, forbearing and affable. His conversation was lively as well as erudite and he had a strong sense of humour and great ingenuity in displaying it. There was nothing like envy in his composition; on the contrary, if useful knowledge was discovered by anybody, * he was zealous to diffuse it, and to procure due honour for L his forebears." iI_ With John Sheldon another interesting character was ap- pointed to the staff in Dr. John Blackall, a physician of FIG. 2.-John Sheldon (1752-1808) in later life. enquiring mind, a former student of Bart's and D.M. the rectus femoris muscle. Some of the figures Oxfcord who anticipated Bright in relating dropsy for this work were drawn for Sheldon by to al[buminuria and renal disease. Professor Camper and two of the specimens were TI he study of medicine and surgery at this time from William Hunter's collection. was largely by means of apprenticeship, in which In Exeter Sheldon established himself in surg,eons had their pupils and physicians their 236 Proceedings of the Royal Society of Medicine 12 clerks. Amongst the pupils of Sheldon at Exeter improving the educational facilities for medical were Samuel Barnes and John Haddy James. students at the Devon and Exeter Hospital and Both men came to London and studied at Bart's in bringing a corporate spirit into this training and both, at different times, were house pupils so as to raise a rather restricted system of of John Abernethy. apprenticeship into that of a medical school. On January 7, 1819, they petitioned the Devon and SAMUEL BARNES Exeter Hospital that it being their intention "to Samuel Barnes was a brilliant student and give an annual course of Anatomical Demon- later was an outstanding surgeon. He is said to strations to the medical pupils of the place on have been the first provincial oculist. He was subjects procured from London for this purpose, not a creative scientist but he made an extensive they request, in concurrence with the other collection of osteology which later formed part medical officers of the House, permission to of the Medical School Museum that he and Haddy James estab- lished. He was a classical scholar with great literary interests which, it appears, were more important to him than his surgery. These led him to become for forty-five years the Secretary of a literary society- the Devon and Exeter Institution- which still exists. He is also to be noted as one of the ancestors of the actress sisters Irene and Violet Vanbrugh. JOHN HADDY JAMES John Haddy James was a colour- ful personality an account of whose life and work has been well written by Rocyn-Jones (1953). After being a student under Sheldon, James was one of Abernethy's favourite pupils and there still exists a very interesting corres- pondence between the two. He was a house surgeon at Bart's and then became an assistant surgeon in the Life Guards and served at Waterloo of which he gave a most graphic description. "He left the Army in 1816 on his appointment as surgeon to the Devon and Exeter Hospital . . . and was most assiduous in his hospital duties making careful and copious notes of his cases. He displayed great ingenuity FIG. 3.-John Haddy James (1788-1869). in devising mechanical contrivances to aid in the treatment of injuries by way of special employ the laboratory of the Hospital for this splints, syphons to aspirate exudate from wounds purpose". Permission was readily given. A and abscesses, and a device to provide a constant pathological museum was formed of which water drip for inflamed surfaces. In 1818 he won the Jacksonian Prize of the Royal College of Surgeons James became curator and wrote the catalogue. for his essay on 'Inflammation' which he afterwards For many years he and Barnes gave an annual expanded into a larger work entitled 'On the General course of lectures on anatomy. James attracted Principles and Treatment of Inflammation' which many pupils, of whom some were resident in was published in 1821 and followed by a second his house and all were dressers at the hospital. edition in 1832." "By Here arranging hospital teaching for the apprentices I would particularly note the close the Exeter surgeons tended to unite them into a association of James and Barnes as leaders in body, thus rendering them only partly subservient 13 Section of the Hit,story qf Medicine 237 to their individual masters." Based upon the surgery but he who had the heart and mind to requirements of the Society of Apothecaries in introduce it deserves to be remembered." 1815 "it was an early attempt to provide in part a He died on March 17, 1869. provincial as opposed to an exclusively metropolitan medical education. The same idea of improving THE MEDICAL SCHOOL the tone of provincial medicine and supplying a The Minute books of the Governors of the medium for discussion and diffusion of medical knowledge induced James and several others to meet Royal Devon and Exeter Hospital extend back Charles Hastings at the Worcester Infirmary in 1832 to its foundation in 1741 and are a mine of in order to found the Provincial Medical and Surgical information upon provincial hospital conditions Association. At the inaugural meeting James was in the eighteenth and nineteenth centuries. elected member of the Council and a paper by him There are frequent references to the house on the diagnosis of strangulated hernia, with some pupils of the apothecary and of the surgeons. practical remarks on the operation, appeared in the The intention to provide some better educational first volume of the Association's Transactions. At facilities is first seen in 1813 when the committee the annual meeting held in Liverpool in 1839 he received a request to form a library and museum: delivered the Retrospective Address in Surgery: in 1842 he was the president of the two-day meeting a library trust was established the same year. at the Athenmum in Exeter. James delivered a In 1819 a start was made with the courses upon presidential address and gave clinical demonstrations anatomy already mentioned and these attracted in his wards at the Devon and Exeter Hospital. It a large number of pupils from Devon and is interesting to note that at the Association Dinner Cornwall, each coming for four or five years. held in the New London Inn on August 4 one of the This time was followed by a year in one of the guests who replied eloquently to a toast was great teaching centres of London, Edinburgh or Archdeacon J. H. Pott-son of Percivall Pott." Dublin. In 1823 courses in chemistry were also In 1843 when the Royal College of Surgeons started. was reconstituted James was elected one of the An interesting incident of the state of affairs original Fellows and took a leading part in their previous to the Anatomy Act should be men- affairs. tioned. There was keen demand for bodies by "James was a good anatomist and pathologist; a the new provincial schools as well as from careful though not a dexterous operator and on London. There were organized gangs of body occasion bold. He had a gift for invention, his snatchers and it seems that when things were wards had many original devices designed to promote too hot for them in one area the gang moved healing or restoration of function in his patients, elsewhere, e.g. from Liverpool to Exeter on one about whose welfare he was very solicitous. He occasion. One wonders whether that had made many contributions to surgical literature: anything to do with the case reported in the besides those already mentioned two others should Lancet in 1824 when Mr. Cooke, an Exeter be noted; one entitled 'Some Contributions to the was before the assizes and fined £100 Pathology of Fibrous Tumours', in two articles in surgeon, the Lancet (1868), the other 'On Ligature of the for having received the body of a young woman External Iliac Artery in a Case of Double Aneurism' from resurrectionists who had removed it from (1884). the graveyard of St. David's. Wakely, the "Early in life he infected himself at an autopsy Lancet editor, made an impassioned appeal for and became dangerously ill on his way to London; help and raised £200 to defray the fine and he was treated by Abernethy in his own house. costs. Afterwards James enjoyed robust health until his In 1827 the Dissecting Room was active in a last five years when he developed glaucoma and peculiar way for it was resolved "that the optic neuritis which ended in blindness. . He admission of strangers to view the body of a modelled himself on Abernethy of whom he was both pupil and friend. He took a prominent part condemned malefactor brought to the Hospital in raising the standard of extra-metropolitan surgery for dissection be allowed on the day of execution and was a powerful supporter of the movement to only". In 1832 the Hospital applied for a bring all members of the profession together into licence under the new Anatomy Act. In 1833 an association for mutual instruction and protection. the Government's Inspector of Anatomy recorded ... He had an inventive mind. . . . One of his the number of bodies used in provincial schools. resourceful inventions was directed towards providing Manchester had the most with 24. The others continuous yet tolerable traction in the treatment of were Birmingham (20), Sheffield (19), Liverpool skeletal injuries. This he achieved by weight and Leeds Bristol Exeter Bath pulley. The apparatus he described was so simple (16), (9), (7), (5), (3), in design that it was capable of use in any country Cambridge (1), Hull (0) and Nottingham (0). cottage. The need for continuous traction had long Oxford is not mentioned. been felt but James's contribution towards its In 1834 the Devon and Exeter Hospital was provision was scarcely appreciated. Weight and one of the provincial centres selected for enquiry pulley traction is now a commonplace procedure in by the Parliamentary committee upon Medical 16 238 Proceedings of the Royal Society of Medicine 14 Education. The pages of the Lancet in that year this library and published a catalogue. Its pages gave an abstract of some of the evidence give some idea of the scope of the collections embellished by Wakely's satire. Abernethy which amount to several thousand volumes. (described by Wakely as "that most subtle From a fourteenth century manuscript of John knave in medical politics") had said that "many of Gaddesden, a Celsus of 1497, and a Galen of of the provincial hospitals (not recognized by the sixteenth century, there are works by John the Council of the Royal College of Surgeons) of Vigo, Roger Bacon, Manardus, Eustachius and present a larger field for the acquirement of Vesalius, Harvey, Spigelius, Willis, Glisson, practical knowledge, than is to be met with in Havers, Musgrave, Burton, Cowper, Bartholin, some of the metropolitan hospitals which were Pare, Fabricius, Scultetus, Wiseman, Sydenham, recognized as schools of surgery". Guthrie had Heister, Boerhaave, Haller, Morgagni, Cheselden, also mentioned that the Westminster was not Pott, Monro, William and John Hunter, Hewson, the equal of Manchester-the former recognized Jenner, Abernethy, Astley Cooper, Charles Bell: and the latter not. Later that year the Lancet these are a few of the important names. published a protest from 27 pupils of the Devon I believe this sketch of hospital evolution in and Exeter Hospital supported by 38 medical Exeter is of more than parochial importance. practitioners of Exeter against new regulations Hospitals in Exeter were in the forefront of of the Company of Apothecaries extending advance; and developments were guided by men the length of time required in London Hospitals. of vision who were determined to do something In 1851 the surgeons appear still to have been better for medical education than already existed, taking the major part in the training of students and furthermore to advance the welfare and and they pressed for better accommodation for maintain the professional competence of prac- lectures and the museum. They could get no titioners. The long tradition of medical teaching help from the Governors. The staff then set at Exeter is very much alive to-day. My belief about collecting funds and raised £650 privately is that we owe the stimulus for this in no small (a large sum in those days). It was enough to degree to the influence of John Sheldon, F.R.S., build what was needed and provide a small who died exactly one hundred and fifty years ago endowment. With the passing of the Medical in October 1808. Act of 1858 the School came to an end but the buildings were still in existence when I went to It is a pleasure to acknowledge my great debt to Exeter in 1931. The Library and Museum, now Mr. W. R. LeFanu and Miss Jessie Dobson of the rehoused, provide the home of the Devon and Royal College of Surgeons and to the Librarians of the Royal Society of Medicine and the Royal Exeter Medico-Chirurgical Society which was Aeronautical Society; to Mr. N. S. E. Pugsley, the formed in 1870 as the successor of previous librarian and keeper of the City Archives, Exeter; Medical Societies, the first of which is noted in Mr. John Lloyd, the librarian of the Exeter Cathedral 1783, the Exeter Medical Library Society in Library and Miss M. Crichton, its former librarian, 1813, the Exeter Pathological Society in 1832, the Mr. Arthur Rocyn-Jones, Miss B. Farrington, Miss Exeter Dispensary Society in 1848, &c. Blanche Patch, Mr. J. Sullivan, the Secretary of the Royal Devon and Exeter Hospital, and Mr. T. EXETER MEDICAL LIBRARY Crook, the Secretary of the Exeter and Mid-Devon The Exeter Medical Library is a remarkable Hospitals Management Committee; and to the Editor and is in of the Journal of Bone and Joint Surgery for per- collection two parts, the more important mission to quote from Mr. Rocyn-Jones' article on sections of which were housed together at the John Haddy James. Devon and Exeter Hospital from 1815 until 1948. The older section goes back to the Middle Ages and is now again part of the Exeter BIBLIOGRAPHY Cathedral Library to which most of it was CAPENER, N. (1955) Medical Art and History in bequeathed by Dr. Thomas Glass in 1786. The Exeter. Catalogue of an exhibition held in the rest of the library which is still at the Hospital Royal Albert Memorial Museum, Exeter, April 1955. has been added to throughout the years from DOBSON, J. (1954) Practitioner, 173, 77. 1815. In 1824 it received the Parr collection, HARRIS, J. D. (1922) History of the Royal Devon and and in 1841 notable additions bought from the Exeter Hospital. Exeter. residue of a Cholera Fund raised in 1832 to HILL, B. (1954) Practitioner, 172, 81. relieve the sufferers from the calamity of that ROCYN-JONES, A. (1953) J. Bone Jt. Surg., 35B, 661. year and which was recorded in a notable SHAPTER, T. (1849) The History of the Cholera in epidemiological report by Dr. Thomas Shapter Exeter in 1832. London. (1849). SHELDON, J. (1784) The History of the Absorbent In 1955 I prepared an exhibition of works in System. London.