SIR VICTOR HORSLEY* by J. B. LYONS MANY years ago G. K. Chesterton called the English 'the eccentrics of the earth' because of their unawareness of the 'very existence of some of their most extra- ordinary claims to glory and distinction'. He referred to a neglect of Chaucer the Father of English Poetry but today, with science in the ascendant, his stricture may be applied to the medical profession for allowing obscurity to threaten the memory of the Father of Neurosurgery whose boon to mankind is more universally applicable than any gift of letters, but whose splendid achievements, and no less splendid aspira- tions for the betterment of his countrymen, appear to have shrunken in the general mind to a single eponym, 'Horsley's wax'. How fitting, therefore, that the Osler Club of London, a bastion against neglect, should have held this commemorative meeting! Fifty years have elapsed since Sir Victor Horsley's death on active service in Mesopotamia. A reappraisal of his career is overdue. The venue-the National Hospital which he graced with such distinction- could not have been more appropriate. Victor Horsley was born at 2 Tor Villas, Campden Hill, Kensington on Tuesday 14 April 1857. He was the son ofJohn Calcott Horsley, an artist, but his earliest known ancestor was a medical practitioner. This man who practised successfully in Carlisle early in the eighteenth century deserted his family at the height of his career. His wife with her two sons followed him to London but he was not seen again. One of the boys became a cabinet maker. His son, William, Victor Horsley's grandfather, was born in Swallow Street, Golden Square, in 1774. In boyhood William Horsley assisted his father in the manufacture of pianoforte keys and in this unorthodox way embarked on a musical career. He succeeded John Wall Calcott as Organist to the Asylum for Female Orphans in Westminster Bridge Road. Later he married Calcott's eldest daughter. By 1823 when they moved to 1 High Row, Kensington Gravel Pits, they had five children, Mary who married Isambard Kingdom Brunel, John an art student at Sass's Academy, Fanny, Sophy, and Charles Edward who followed his father's bent and was at one period Mendel- ssohn's pupil. Fanny and Sophy Horsley were amusing, talented girls. A collection of their letters', entitled Mendelssohn and his Friends in Kensington has been published and gives a vivid picture of their home. It was a household where, after God, music held a supreme place, and after music, books, languages, and ideas. To an aunt Sophy wrote: Miss Skerret and I had a most delightful conversation about books, languages, German, Gotz von Berlicken etc. which I enjoyed very much. Today ... I have been reading Robertson's History of America, practising, writing harmony, playing Fidelio, reading German and Italian, and have had a very nice German lesson and later a still nicer supper off peas and bacon ... * Guest-speaker's paper at a Horsley Commemorative Meeting held by the Osler Club of London at the National Hospital, Queen Square, on 10 November 1966. 361 Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.234, on 28 Sep 2021 at 11:08:40, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0025727300012503 J. B. Lyons In 1854 John Calcott Horsley married Rosamund, daughter of Dr. Charles Haden author of Practical Observations on the Management and Diseases of Children. When their third child was born, on the same day as Princess Beatrice, their friend Miss Skerret, who had an important position at Court, mentioned the coincidence to Queen Victoria. Her Majesty graciously requested that the boy be given her own names. Following a family custom the maternal surname was added-the infant was christened Victor Alexander Haden Horsley. Though by birth a Londoner, Victor Horsley was by upbringing a Man of Kent. His early years were spent at Cranbrook where his father had purchased Willesley, a charming house which today is a country-club. On the plaster ceiling of the dining- room the embossed initials of the former master and mistress of Willesley may still be seen. And on a rear gable one can still read Victor's parents' inscription: 'Except the Lord build the house their labour is but lost who build it'. His life was almost cut short by the action of a vindictive nurse who threw him on to a heap of stones. Fortunately he survived this malevolent act without apparent ill-effect but a depressed area remained on his skull and during a later phase when he indulged in self-experiment he discovered that the bone was thinned and that he could make it spring in and out. He observed that firm pressure on the centre of the area caused a neuralgic pain in his teeth which ceased immediately the pressure was removed. It has been said that 'everybody's youth is a dream, a form of chemical madness'; the dancing molecules in Victor's bloodstream drove him in those early days notoriously to mischief. He was for ever in a scrape. One morning his father ad- monished him at the breakfast-table for his latest prank. He listened for a while and then said, 'All right, I'll try to remember, but I must be off to school now'. As he jumped up he caught his foot in the table-cloth and dragged the breakfast things to the floor. He was a good-looking boy, bright, alert, unassertive and very happy. Long- limbed and prodigiously active he stood very straight and walked very fast. He had blue eyes with a slight outward cast and talked with a hint of a lisp. Left-handed, he was trained early to be ambidexterous. After attending Cranbrook Grammar School where his reports were never better than 'very good' he matriculated at London University in 1874. He wished to become a cavalry officer but accepted instead his father's suggestion that he should study medicine. One of his first mentors in the natural sciences was a local general practi- tioner, Dr. Thomas Joyce of Shepherd's House, Cranbrook. The Horsleys returned to London in 1875 and lived at 1 High Row, Kensington Gravel Pits (now 128, Church Street, Kensington). Walter, the eldest boy, was an art-student despite colour-blindness, a defect from which Victor and Gerald, the youngest son, also suffered. Victor took the preliminary science examination in the summer of 1875 and in October he entered the medical school at University College. The pre-clinical teachers who exerted a formative influence on him were John Burdon Sanderson and Edward Schafer. Burdon Sanderson who had recently succeeded William Sharpey in the chair of physiology made the work as experimental as possible and Schafer said later,2 362 Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.234, on 28 Sep 2021 at 11:08:40, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0025727300012503 Sir Victor Horsley 'There can be no possible doubt it was this training in experimental physiology which determined Horsley's future career, both as a physiologist and as a scientific surgeon'. His teachers at University College Hospital included F. J. Roberts, Sydney Ringer, Christopher Heath, John Marshall, Henry Charlton Bastian, William Gowers, and Marcus Beck. Roberts had brought his technique of bedside examination to such a degree of perfection that he could detect fluid in a chest by simply running his fingers down the chest wall and sensing changes in the resistance beneath his finger-tips- he rather despised technical advances speaking disdainfully of 'microscopes and spectroscopes and all the other scopes people use nowadays'. Ringer had a courtly eighteenth-century air and preferred the old wooden stethoscope to the binaural type. A large experience had made him cautious and he would say, 'You young men like to be right; we old men don't like to be wrong'. Heath, a courageous operator, attributed a high death-rate to London fogs. He regarded Lister's ideas as new- fangled, whereas Beck was their apostle. Horsley was surgical dresser to John Marshall and clinical clerk to Bastian who may have been the first to interest him in the nervous system, and in collaboration with whom he wrote, while still a student, his first scientific publication. Gowers, too, must have been a vital influence and Horsley carried out anatomical studies which the former used in his Diagnosis of Diseases of the Spinal Cord. Victor Horsley took the M.R.C.S. in November 1880; in the following year at the university 'finals' he was awarded the gold medal in surgery. Meanwhile he had spent a six month period as house-surgeon at University College Hospital devoting much of his spare time to research acting as his own guinea-pig. In August 1881 an International Medical Congress was held in London and I digress to mention briefly some of the problems of the day. Klebs discussed the relationship of minute organisms to certain specific diseases, for bacteriology still rested on the shifting-sands ofmedical opinion; Goltz and Ferrier vigorously disputed the function of the cerebral cortex; Michael Foster, supporting Virchow's denuncia- tion of the anti-vivisectionists, declared, 'We sigh in our bondage, like the Israelites of old; we are asked to make bricks when they have taken away our straw'. Sir John Erichsen, Consulting Surgeon to University College Hospital, delivered the Address in Surgery and with what he imagined to be sagacity remarked, 'There must, indeed, be a limit to the progress of operative surgery ..