Surgical Networks in Nineteenth Century Britain
This week, PhD student Agnes Arnold-Forster (King’s College London) demonstrates that medical investigation frequently operated as a network of communication across the four nations.
At the turn of the nineteenth century London was the centre of elite surgery. The anatomist and surgeon John Hunter, during life and after death, led an intellectual network of elite surgeons and physicians who represented the medical orthodoxy of the time. Histories of medicine in this period have largely supported this narrative, collapsing studies of Britain down into studies of the metropolis. However, networks of communication and collaboration spread across all four nations, and investigation of these networks can reveal the ways in which ideas circulated and the contributions made by surgeons outside London.
My PhD is on the history of cancer in the nineteenth century, and here I will use one example from that history to show the benefits of taking a four nations approach to medicine in that period. Founded in 1802 ‘The Society and Institution for Investigating the Nature and Cure of Cancer’ was both a network of medical practitioners and an institution central to cancer theory and practice at the turn of the century. It was ‘for the express purpose of investigating the nature of cancer, and of making experiments, for the discovery of a method of curing that disease.’ [i]
The committee comprised of prominent figures in the metropolitan medical community. These men represented the theoretical and practical orthodoxy of the time. Several were associated with Hunter – central figures such as John Abernethy, Everard Home, John Pearson, Matthew Baillie and Thomas Denman had all at one time or another studied under him in London.
You can learn much about cancer theory at the beginning of the nineteenth century from reading the tracts and treatises these five men published on cancer in response to ‘The Society.’ However, a study that focuses on London-based activities and publications misses contributions made by surgeons from Scotland, Ireland, Wales, and the rest of England. In 1802 ‘The Society’ issued a set of thirteen queries, designed to extend the network of doctors and researches beyond the confines of the metropolis. They were a set of basic questions to be circulated to all members of the medical community.
The thirteen queries inspired multiple responses – by the end of the first year ‘The Society’ had over fifty corresponding members. Richard Carmichael, a Surgeon from Dublin, wrote An Essay on the Effects of Carbonate, and Other Preparations of Iron, Upon Cancer in 1809 and called it, ‘An attempt to answer the queries of the Medical Society, established in London, for investigating the nature and cure of cancer.’ John Rodman, a physician from Paisley, wrote in the introduction to his Practical Explanation of Cancer in the Female Breast (London, 1818), ‘This Treatise is…in obedience to the London Society, which was instituted for investigating the nature and cure of Cancer.’
Contained within these two books are multiple new approaches and perspectives on the disease. They are evidence that ideas did not move linearly from ‘centre’ to ‘periphery’, but were rather appropriated and reconfigured according to different contexts and motivations. However, the tracts are not just revealing to an intellectual history of cancer, but also shed light on the social dynamics of surgery at the turn of the nineteenth century across the British Isles.
Surgeons were keen to emphasise the collaborative nature of their approach to cancer. The thirteen queries were an explicitly collective exercise: ‘The Medical Committee very early drew out and distributed the following queries, for the consideration not only of the corresponding members, but of all medical men, to whom opportunities of answering them might, by study or by accident, occur.’[ii]
The committee desired the medical population of the British Isles to work together to further understand the nature and cure of cancer: ‘It may be necessary to observe that the promoters of this institution have never entertained the idea of creating the jealousy, or of interfering with the interests, of those who are engaged in institutions of a similar kind; their intention being solely that of co-operating in the laudable endeavour to lessen the mass of human misery.’[iii]
This suggests that there was considerable intangible capital to be derived from presenting surgery in this period as a collective comprised of multiple individuals on equal footing working together for a common humanitarian goal.
In other words, medical investigation in this period frequently operated as a network of communication across England, Ireland, Scotland and Wales. Moreover, cancer discourse at the end of the eighteenth and beginning of the nineteenth centuries demonstrates that the relationship between surgeons in London and the rest of the British Isles was reciprocal. Even more interestingly, that was the way the men involved wanted it to be – they wanted a four nations approach to surgical problems and made explicit this desire in their rhetoric and discourse.
[i] Thomas Denman, Observations on the Cure of Cancer, (London, 1810), 87
[ii] Thomas Bernard, ‘Institute for Investigating the Nature and Cure of Cancer’, Edinburgh Medical Surgical Journal, 2 (1802), 382
Agnes Arnold-Forster is a PhD student at King’s College London. She is researching the history of cancer in nineteenth-century Britain and the United States. She tweets from @agnesjuliet.