An Historical Vignette

 

Keith D. Roberts (M 1945)

I collect old medical instruments and amongst a job lot obtained at auction I found a photographic glass plate by H.J. Whitlock of 11 New Street, Birmingham. I had this printed and it revealed a portrait of a distinguished looking Victorian gentleman named T.H. Bartleet. Investigation found that there was such an individual who was Professor of Physiology at Queen’s College and also a surgeon at the General Hospital. This brought to mind the origin of surgeons in the 1800s. Before that date men like Astley Cooper in London and Edward Townsend Cox in Birmingham were, after apprenticeship, simply members of the Surgeons Company and wrote no letters after their names.

 

William Sands Cox was born in 1801 and, following the custom of apprenticeship, was articled to his father, Edward. William’s initial training was at the General Hospital followed by Guy’s and St. Thomas’s in London, where he developed a friendship with Astley Cooper. In 1800 the Surgeons Company became the Royal College of Surgeons which awarded the diploma of Membership of the College (MRCS) after examination. In 1815 the Apothecaries Act prescribed five years apprenticeship as a condition for the diploma of Licentiate of the Society of Apothecaries (LSA). During the decade of 1815-1825 the average number of students obtaining the diploma of LSA was 240, and of the MRCS, 110. In 1929 the number of qualified practitioners in Birmingham was 120.

 

In 1823 William obtained the LSA at the age of twenty two and in 1824 qualified as MRCS, twenty two being the lowest age for admission. Following qualification, Sands Cox visited Paris where he attended the practices of Dupuytren, Laennec, and of Baron Larrey at the Military Hospital. On returning to Birmingham he was appointed to a vacant post of surgeon at the General Dispensary and became a partner with his father at 24 Temple Row, under the style of ‘E.T. Cox and Son, Surgeons’.

 

In 1825 William Sands Cox commenced a course of anatomical lectures, with physiological and surgical observations, at the house in Temple Row. In 1826 the Court of Examiners of the Society of Apothecaries resolved that ‘Mr Cox’s certificate of a teacher of anatomy be accepted’. In 1827 William was authorised, jointly with his father, to undertake the unpaid duties of surgeon to the Town Infirmary. In 1828 it was decided to form a School of Medicine and Surgery in Birmingham and lecturers were appointed from the staffs of the General Hospital and Birmingham to Dispensary.

 

Despite the occasional use of the Birmingham Institute of Fine Arts the cramped space at Temple Row led Sands Cox to acquire a site in Snow Hill. A building was erected and remained the headquarters of the School until 1834 when it moved to larger premises in Paradise Street opposite the Town Hall, then under construction. In 1836 Sands Cox was elected a Fellow of the Royal Society. In the same year King William IV agreed to become patron of the School which would then be styled the Royal School of Medicine and Surgery of Birmingham. A major influence on the history of the Royal School, and later also of the Queen’s Hospital, was the Rev. Samuel Wilson Warneford who was ready to give liberally to educational institutions connected with the Church. His name was given to the Warneford Hospital at Royal Leamington Spa and also to the Warneford Hospital in Oxford.

It became apparent that the Royal School needed a hospital to be established for the instruction of medical students. Building commenced in 1840; it was the first provincial hospital built specifically as a teaching hospital. Queen Victoria agreed to be patron, jointly with the Queen  Dowager, and as a signal honour named it the Queen’s Hospital. In 1841 Prince Albert became its first President and in 1901 Queen Alexandra renewed the mark of royal favour by continuing the title. In 1859 the Hospital Saturday Fund was founded at the suggestion of the Rev. Canon Miller,Rector of St. Martin’s and in 1860 the collections went to the Queen’s Hospital. The building needed to be enlarged and an extension took place in 1871. This was largely at the instigation of Joseph Samson Gamgee, who had been appointed surgeon to the Hospital in 1857.

Funds were provided by the Hospital Saturday Fund with numerous other donations including 100 guineas from Queen Victoria. The additional accommodation included an outpatient hall with consulting rooms, a new dispensary and residents’ rooms.

The building was extended further in 1908; it continued as a teaching hospital until The Queen Elizabeth Hospital and the new Medical School was opened in 1938. The old Queen’s Hospital became the Birmingham Accident Hospital in 1941 and the only part of the Queen’s remaining was the obstetric clinic and district in the charge of that formidable senior midwife, Hetty King. I spent one month there as resident obstetric student. Domiciliary midwifery in the bug and flea infested slum houses around Five Ways was not a pleasant experience! Those wishing for a graphic description of domiciliary midwifery as a student in that era can do no better than read “The Young Physician” by Francis Brett Young, who graduated from Birmingham in 1906 (see Aesculapius page 11, 2001).

 

The first year in which the diploma of Fellow of the Royal College of Surgeons (FRCS) was awarded was 1843 and Sands Cox was one of the first group of 300 members to be elected to the Fellowship. In the same year The Royal School became a College by Royal Charter and a new building was erected as Queen’s College. In 1846 a Royal Warrant granted the College the right to issue certificates whereby students could become candidates for the University of London degrees of MB and MD. In addition to the Medical School, Queen’s College also had departments of theology and mechanical engineering.

 

The Church of England character of the College was all-pervasive, due to the influence of the Rev. Warneford. In 1851 a rival Medical School – Sydenham College – was formed by the General Hospital staff. The students there were free from the religious and other constraints imposed by Queen’s College and the new college was therefore more attractive to many students. The disadvantage of two competitive medical schools was apparent and in 1867 the Queen’s College Acts permitted the amalgamation of the two colleges into one medical school. The only part of the old Queen’s College remaining was the department of theology, which now persists as the Queen’s Foundation Birmingham (Theological Education) in Somerset Road, Edgbaston.

 

In 1880 Mason’s Science College was built by the generosity of Josiah Mason who made his fortune from the production of steel pen nibs. It became obvious that there would be advantages if the preclinical course of Queen’s College were to be taken at Mason College. This was the forerunner of the University of Birmingham, established by Royal Charter in 1900, largely at the instigation of Joseph Chamberlain.

 

When I was a medical student in 1940-45 the imposing Mason’s College building was still in use by the Arts faculty and its refectory was used by those attending the General Hospital for non-ration book lunches, baked beans on toast, stewed prunes and Davenport’s beer! To return to T.H. Bartleet! Thomas Hiron Bartleet was born

in 1837, the son of Edwin Bartleet who was a surgeon at the Eye Infirmary in Birmingham. Thomas attended King Edward’s School and then entered Queen’s College and the General Hospital as a medical student. He later went to Kings College, London, and qualified MRCS, LSA and MB London, with a gold medal in surgery, in 1860. After a course in midwifery at the Rotunda Hospital, Dublin, and operative surgery in Paris, he returned to Birmingham. In 1862 he was appointed acting surgeon to the Children’s Hospital but relinquished this post in 1867 when he was elected a surgeon to the General Hospital after a contest which cost him £800! He became an FRCS in 1871. For some years he taught physiology at Queen’s College but took part in the amalgamation of the two colleges and in the foundation of Mason’s Science College. He then gave up the teaching of physiology and devoted himself to the practice and teaching of surgery. He practised at 27 Newhall Street and resided at 26 Hagley Road, Edgbaston.

 

In 1867 Thomas married the only child of Samuel Berry FRCS, and the marriage produced two sons and three daughters. He was an active member of the Birmingham Branch of the British Medical Association, being for some years the Secretary of the Branch and later, its President. At the meeting of the Association in Birmingham in 1890 he was President of the Surgical Section. He made a number of communications on surgery to the Birmingham medical periodicals. He followed his father-in-law, Samuel Berry, and his senior partner Dr M. Hazlewood Clayton in actively promoting the Birmingham Medical Benevolent Society. He was a devoted member of St. George’s Church, Edgbaston, acting as churchwarden under the Rev. C.M. Owen.

Thomas died in 1891 having worked until a few days before his death being survived by his wife and children. He was buried with his father and mother at Chipping Camden.

 

Interestingly, the Annual Report of the General Hospital for that year records the decision to commission a stained glass window in his memory, to be erected in the new General Hospital, when it was built. In due course the window was placed in the hospital chapel. Both are still in existence following the conversion of the General Hospital to the new Children’s Hospital and it is perhaps appropriate that he should be remembered by both hospitals.

 

In 1912 one of Bartleet’s daughters was one of the first two women to be elected to the Board of Management of the General Hospital, having been responsible for setting up the‘after care committee of the hospital’ the previous year.