SIR ASTLEY COOPER, BART.
AN ESTIMATE OF HIS CHARACTER AND CAREER
AN ESSAY
Read before the Historical Club of Johns Hopkins Hospital
May 9, 1898
BY
JAMES G. MUMFORD, M.D.
BOSTON
SURGEON TO OUT-PATIENTS, MASSACHUSETTS GENERAL HOSPITAL; VISITING
SURGEON, CARNEY HOSPITAL
Reprinted from the Boston Medical and Surgical Journal of
August 11 and 18, 1898
BOSTON
DAMRELL & UPHAM, PUBLISHERS
283 WASHINGTON STREET
1898
DER
Taubaan / Rare
BOOK Room
487
cole
1898
S. J. PARKHILL & co., BOSTON, U.S.A.
PRINTERS
SIR ASTLEY COOPER, BART.1
AN ESTIMATE OF HIS CHARACTER AND CAREER.
One of the most interesting and picturesque figures
in all surgical history is that of Astley Paston Cooper.
Well born and bred; highly gifted both mentally and
physically; of enormous industry and ambition ; living
at a time of revolutionary changes in the world's his-
tory - changes social, political and intellectual — he
was a fit contemporary of such men as Fox and Can-
ning and Mirabeau and Hamilton - less mercurial
than the first and only less brilliant than the last.
Somewhat younger than those distinguished men,
he was brought under the same great influences; and
though he died near the middle of the present century,
he had known Dr. Johnson, had heard Hunter, had
seen Robespierre and George III, had experienced
Waterloo, and had lived to be honored by the Citizen
King. Whatever there was in life for the finding, that
Cooper found, and amid all the changes and chances
of an extraordinary era he is seen always steadily ad-
vancing.
Astley Cooper was born on the 23d of August, 1768,
one year before the great Napoleon. In France old
Louis XV was living ; in Germany Frederick was
resting on his laurels ; in America Washington was
an obscure country gentleman, and in England George
III was still a young king. There was peace at home
and abroad, though the great undercurrent was already
at work, destined to overturn the geography and
dynasties of the world. Of all the peoples about to
become embroiled in this turmoil, the English and
Americans alone were to emerge with added strength;
and parallel with the fluctuating but always advancing
fortunes of his people, Cooper's life developed in
vigor, resourcefulness and success.
A great deal has been written and said about this
man, but I do not find that his true significance has
been appreciated. He was not a hero; perhaps not
one of the world's great men ; but like a few others
of that day, he early felt the import of wbat was be-
ing done by the wide forces behind men, and in his
own sphere of life he grew to typify the revolution in
which he lived.
Great changes in politics, philosophy, literature
and science do not come suddenly, full grown, as we
know. It is evolution that leads to what men call
revolution. Rousseau preceded Jefferson ; Descartes
preceded Darwin, and John Hunter preceded Astley
Cooper.
The traditions which lay behind and surrounded the
young Cooper were certainly not of a kind to develop
his natural genius. His ancestors belonged to the
country gentry class; his father was an excellent
clergyman of independent fortune, his mother a fond,
sweet woman who wrote moral poems and tales for
the young and found a publisher. He was born a
younger son to this couple at Brooke, in Norfolk.
There, and later in Yarmouth, he grew up a wild,
generous, mischievous, brilliant boy, the plague and
astonishment of his parents.
I find no tales of him that presage his later fame.
His dull and pompous nephew, Bransby Cooper, has
written a life of him, and tells of how he applied a
tourniquet to the thigh of his young foster brother,
who had been injured and was bleeding from the fe-
moral artery. A chapter is devoted to this scene and
there is much feeble wagging of heads; but I doubt
not that boys other than embryo great surgeons have
done the same before and since.
This young Astley was forever in scrapes and would
have none of books. The practical jokes of the day
were brutal enough, and of them he had his sbare.
Such tales are but dull to bear.
So he grew up, wild, upgoverned and unread, but
kind and gentle toward all women and young children.
In the course of time his brothers, steady persons, well
instructed by the good scholar their father, went their
ways to the university. For him there was nothing
in life of that sort, and it was not until his uncle, Wil-
liam Cooper, from London, a surgeon of repute, came
down to visit at the parsonage, that a clear path be-
came open to him.
The anxious father was only too glad to find some
congenial employment for the exuberant son, and so
with many anxious prayers and solemn blessings from
his elders the lad was sent to London to make his
way.
Astley Cooper was sixteen years old when he began
the study of medicine. His preparation was slight.
enough; a little Latin and mathematics, a smattering
of French and a good constitution were his stock. He
had read little and never became a reading man. Like
Hunter, Hume, Brodie and many others, he would
learn all things for himself, and cared little for the
written thoughts of others ancients or moderns. It
was a sign of the times; men were finding out the
facts of life for themselves and cared little for knowl-
edge at second-hand.
Here is a description of his outer man, in the stately
words of his biographer : “ His manners and appear-
ance at this time were winning and agreeable. Though
only sixteen, he was tall and finely proportioned,
healthy and manly, with a countenance handsome and
expressive. His talk was brisk and animated, his
voice and manner pleasing and well-bred. He was
graceful and agreeable, popular in society, and always
greatly influenced by women.” This is a pleasant
picture, and one sees him the young Apollo indeed.
Cooper had the rare good fortune to be placed as
articled pupil with one of the greatest surgeons of his
time — Henry Cline. The uncle who had brought him
to London seems to have been a jealous and uncom-
fortable person, and readily parted with his tempestu-
ous kinsmap.
Cline was an interesting man. At this time, 1784,
the American war had been concluded, and those dem-
ocratic principles, which had gained such headway in
France, were professed in a milder degree by great
numbers of liberal Englishmen. Cline was always an
advocate of such views, and at this time was intimate
with the celebrated Horne-Tooke and with Thelwall.
To such a band was joined young Cooper, who eagerly
adopted their views, and so pained beyond expression
his anxious friends at home.
It is evident to one following his course that his
whole trend of thought and endeavor were strongly
influenced by such pursuits, and though, like most
Englisbmen, he fell back in later life with the strong
conservative tide setting against all things French,
still the broad manner of thinking which be early
learned colored always bis subsequent career.
Cline cared much for all these things, but that did
not prevent him from being a sound surgeon and an
accomplished teacher. He was eighteen years Cooper's
senior. In later years, Sir Astley wrote many comments
on men he had known, and this is what he says of Cline
in one place : “In surgery he was cool, safe, judicious
and cautious; in anatomy, sufficientiy well informed
for teaching and practice, but he lacked industry and
professional zeal. He was gentle, firm, mild, unruf-
fled.” This is pleasant, but not high praise. Cooper
had high ideals, and after middle life, when phenome-
nal success had established his own confidence and
self-esteem, he was never lavish of praise for others.
But Cline's political friends were not his only asso-
ciates. He knew well and appreciated John Hunter.
To that remarkable man his young apprentice was
soon introduced, and the teachings of the great scien-
tist at once captivated and engrossed the youthful
scholar.
Of the method of Hunter I need say but a word.
It was a method as old as that Babylonian Zadig, of
of whom Huxley tells the story. It was what we call
the inductive method. But what Hunter did was to
apply it faithfully, unselfishly, unfalteringly to biologi-
cal science and the study of medicine; until, in spite
of opposition, hatred, contempt and ridicule, he placed
these studies, and the men who profess them, in that
dignified and endobled position before the eyes of the
world which a bundred years have only increased and
strengthened.
Cline appreciated him, and this is what he says of
him: “Having heard Mr. Hunter's lectures on the
subject of · Disease,' I found them so far superior to
everything I had conceived or heard before that there
seemed no comparison between the great mind of the
man who delivered them and all the individuals,
whether ancient or modern, who had gone before him.”
Cooper himself later said of Hunter: “ Mr. Hunter
was, as Lavater said, a man who thought for himself,
but he was more ; he was the most industrious man
that ever lived." Here is an anecdote which Cooper
tells of Hunter, who was often slipshod and indiffer-
ent in practice, in spite of bis enormous knowledge:
“Mr. Howden had a patient with an obstinate run-
ning sore whom he brought to Mr. Hunter for con-
sultation. They went into Mr. Hunter's room and
the case was explained. Mr. Hunter folded his aris
and said: "And so, sir, you have ap obstinate running
sore?! Yes, sir.' • Why then, sir,' said Mr. Hunter,
• if I had your running sore I should say, Mr. Sore,
run and be damned.'”
Cooper early perceived (and it was a knowledge he
received from Hunter, not from Cline) that a thor-
ough knowledge of anatomy was at the bottom of all
successful surgery. Before his day there was no
anatomical study and instruction as we know it.
There were some anatomists, but they were not to be
found among the ordinary students and practitioners
of surgery.
Mr. Cline was surgeon to St. Thomas's Hospital,
and it was in the schools of the United Borough Hos-
pitals, St. Thomas's and Guy's, that Cooper received
his education. The amount of time that he put into
anatomical studies would be impossible to students of
our day, with their elaborate curriculum and care-
fully regulated hours. In those days there were no
graded courses. Certain lectures on anatomy, sur-
gery and medicine were held, and bedside teaching was
given ; but until the time came for going into prac-
tice the young men were allowed to dispose of their
hours as they pleased, so far as the school was con-
cerned. It was over the articled pupils oply that
any real control was exercised, and these were always
the men who rose to position and influence in after
life.
To Astley Cooper the study of anatomy meant not
only the normal dissections, but pathological dissec-
tions and comparative anatomy. From the second
term of his medical studies until the day of his death,
his industry in all these lines was enormous.
To rise at four, to dissect for two hours before
breakfast, to demonstrate for his fellow-students all
the morning, to hear lectures and assist at autopsies
until dinner and to dissect again until near midnight
- these were for many years his regular occupations.
The various and fascinating lines of research which
engross students to-day were mostly unknown a hun-
dred years ago. Microscopy was in its infancy,
chemistry was crude, bacteriology and all its attend-
ant interests were of course undreamed of, so that the
patient and thorough student confined himself mostly
to gross inspections in the case of human pathology,
and to the investigation of phenomena in animals
living and dead.
It is marvellous to what a degree of accuracy those
men trained their unaided senses. Without the micro-
scope, the culture tube, the stethoscope or tbe thermom-
eter, those differentiations known to us were impos-
sible. But students made the most of their few talents
and the great collections of Hunter, Cooper and others
bear witness to the enthusiasm and wide range of
their inquiries. It was in their observations on the
structure of the lower animals that both of these men
excelled and outstripped their contemporaries. Hunter
did not stop at the dissection of a whale, and Cooper
had a dead elephant brought to his own house and
worked upon it in his court-yard. Both secured the
reversion of animals that died in the collection at the
Tower, and found in this a perfect mine of material
for their work.
As Cooper grew into practice he never allowed
anything to interfere with such daily avocations.
When patients thronged to him in the morning he put
them off until his consulting hour of eight o'clock, so
that the time between five and seven might be devoted
uninterruptedly to anatomy and pathology. He made
one great collection which he gave to St. Thomas's,
and later, when the schools were separated, he plunged
with renewed ardor into the formation of a museum
for Guy's; and before his death this too bad grown
to great size. In these pursuits there was no rest for
his assistants. He knew good men and how to make
use of them, and was able to inspire them with his
own enthusiasm. If an autopsy was desirable it must
be obtained ; if a strange animal was heard of it must
be brought to him for dissection ; if a lecture was to
be given it must be illustrated by specimens from his
own museum, and if his collection was at fault the
lack must be made good. Wherever he went he
studied and investigated; when at home with his
parents he haunted the shop of the local chemist;
when travelling abroad for pleasure he spent his time
in museums, hospitals and dissecting-rooms; when at
his place in the country he tried vivisection experi.
ments on his own pointers, and stopped to dissect the
very birds that he shot.
In 1834, when he was sixty-six years old, he made
an extended tour on the Continent, and from notes in
his diary we find the sort of busy man he was :
“Paris, Oct. 7th. At half-past ten I called upon M.
Dupuytren. He was ill. I found him with loaded
lungs and a quick pulse, 140, short breathing and with
a sunken countenance. ...
"Dupuytren has provided me with all I wish for as
to the cadavers.
. “Oct. 8th. Rose at six and went with Dr. Marx to
see the provision Dupuytren had made for my dissect.
ing. We went to the Hôtel Dieu, and I found a room
devoted entirely to myself. A cadaver there. I dis-
sected for nearly two hours before breakfast, and after-
wards for four hours, between ten and two o'clock.
os Oct. 9th. Dissected from ten until one. ...
“Oct. 11th. Went to the dissecting-room but found
they had removed my subject.”
He never rested, and I doubt if he could have been
a very comfortable person with whom to live ; but his
friends loved him and from the very first he secured
the enthusiastic admiration of his contemporaries in
the profession.
Poverty never came to burden or to stimulate
Astley Cooper. In his student days he was comfort-
ably supported by his father, and in the beginning of
his practice he married a wife with a fortune. The
unceasing anxiety and effort to make a fair living
which submerges and drives to the wall so many
brilliant young professional men did not come to him.
He never knew the maddening anxiety of waiting for
a practice, and even in the height of his career he
subordinated his patients to his teaching.
To learn for bimself and to tell others wbat he
knew were the first and ever present objects of Astley
Cooper. He was the first English surgeon to break
away utterly from empiricism and quackery, and to
lay down the sound ethical principles which we know.
John Hunter had shown the way, but in his practice
had fallen far short of the high standard which Cooper
always maintained.
Cooper was but eighteen years old when he began
to teach anatomy. He was a young student; clever,
assiduous, enthusiastic, and his fellows sought his ad-
vice in their dissections. His popularity constantly
increased and before long he had unwittingly drawn
most of the students from the teaching of the regular
demonstrator. Dislike and jealousy naturally followed,
and continued for some years. At length, fortunately,
10
the regular demonstrator retired; he was a man very
much Cooper's senior, and at the age of twenty-one
the young surgeon was appointed demonstrator at St.
Thomas's Hospital. His first act was revolutionary.
The sciences of anatomy and surgery bad always gone
hand in hand up to this time, but Cooper had the
wisdom to see that a broad and sound knowledge of
the former must precede the study of the latter. In
spite of great opposition he carried out bis plan of
separating the two courses. He had now been five
years a student, and the next three years, preparatory
to his starting in practice, he devoted to teaching.
Long afterwards he wrote of himself:
“My industry, at this time, may be gathered from
the following circumstances :
“I went to the hospital before breakfast to dissect
for lecture. I demonstrated to the students before
lecture. I injected their subjects. I lectured from
two o'clock until half-past three. In the evening,
three times per week, I lectured on surgery. I at-
tended to the interesting cases in the hospital, making
notes of them, and in this latter practice I always per-
severed.”
Cooper's method of teaching showed from the out-
set his facility and adaptability; his readiness to con-
tipue what was approved by experience or to depart
radically from old and dull routine. On assuming his
lectureship his instant resolve was to inculcate the doc-
trines of Hunter - by which he meant the study of
normal function and pathological change before going
on to speak of diagnosis and treatment. At the outset
he found himself in deep waters. The students of the
day were not ready for that style of thing. The attend-
ance, which was voluntary, immediately fell off; and
he felt that his new plan was in some way at fault.
At once he changed his method but not his purpose,
and organized that form of combined didactic and clini-
cal lecture which is still most popular in our schools.
He has left us copious reports of his teaching, and to
read these is still a novelty and a delight. His wide
experience, his teeming note-books, his varied collec-
tions and his phenomenal memory combined to furnish
a fascinating discourse; and his lectures, carefully
planned and accurately carried out, supplied at once
variety, anecdote, instruction and conviction. His
statements are short, sound and lucid, his cases graphic
and to the point.
As the years went by his material multiplied; at
the age of thirty-two he was appointed surgeon to
Guy's Hospital, and with added experienee and power
he came to be known far and wide as the greatest sur-
gical teacher in Europe. His students came from
England, Germany, Italy, Switzerland, France, Den-
mark, Sweden, Scotland, Ireland, America, until in
his later life, when he went travelling about the
world, he found an old friend in every village and
counted his pupils by thousands. This was a great
power, and needs no comment. Best known among
those who came under his influence were Aston Key,
Bransby Cooper, Benjamin Travers, John Morgan,
John Collins Warren, John Hilton, Edward Cock,
Alfred Poland and Frederick LeGros Clark.
The fine portrait, by Sir Thomas Lawrence, shows
us Sir Astley Cooper in the prime of life; as such a
man he is best known to us, and as such he was in the
very height of his life-work. His practice at that
. time was enormous, and he saw more patients than
would be possible for any one man in our elaborate
days. After his morning dissections and breakfast he
saw his gratuitous patients first, and then from nine
o'clock until one came the stream of regular patients
to his consulting-room. Here he did every variety of
practice — from advising boarding-school girls about
their diet to operations of considerable magnitude.
Quick and sudden cutting was common with him.
He would open a felon, excise a lipoma or amputate
a finger with hardly so much as a by your leave.
Promptly at one o'clock, regardless of the fact that
his house was still crowded with patients, he would
jump into his carriage and drive rapidly to the hospi-
tal. There he always made the ward visit at once,
accompanied by a throng of students. His manner
towards hospital patients was always most kindly and
considerate, and he used to say that he owed half his
success in practice to his invariable rule of impartial
courtesy towards rich and poor. At two o'clock
promptly he began his daily clinical lecture, which,
combined with operating, lasted from one to two hours.
He then left the hospital to make his round of private
calls, and arrived at home for dinner about seven
o'clock. After dinner came a half-hour's nap, then
the evening calls and home to bed between twelve and
two.
He insisted strongly upon the value of a certain
amount of general medical practice, as he felt that no
surgeon who narrowed his attention to the immediate
and obvious lesion under inspection could consider
properly the broad bearings of surgical disease upon
the individual. He always stated in his lectures that
the mere operation was a small detail in surgical thera-
peutics ; that general conditions of health required the
most careful investigation -- for which only a man in
large general practice was competent, and that the
care of the sick after operation demanded the widest
experience.
Astley Cooper did not jump at once into practice.
His beginnings were small enough and he met with
the rebuffs and insolence with which all young profes-
13
sional men are familiar. Here is a schedule of his
third year 641.; fourth year, 961. ; fifth year 1001. ;
sixth year, 2001. ; seventh year, 4001. ; eighth year,
to Guy's Hospital) 1,1001. This was the year 1800
and he was thirty-two years old.
In those days, as is well known, surgeons did not
make stated charges, but received the fees proffered
them. In 1813 Cooper received the fee of £1,000
from a patient for the operation of lithotomy. This
was the largest fee he ever received. The year 1815,
when he was forty-seven years old, saw him at his
busiest. After that year he moved to another quarter
of London and used to take longer and more fre-
quent holidays at Gadesbridge, his country place.
In 1815 his bank book shows his professional income
to have been twenty-one thousand pounds or more
than one hundred thousand dollars — a far larger sum
at the beginning of the century than it is now. Be it
remembered, too, that this income represented the ac-
cumulation of a vast number of small fees, and that it
was not derived from a limited number of high-priced
operations, such as to-day constitute the practice of
surgeons with large incomes.
Having reached the height of his professional
career, appointments and honors were showered upon
him from many quarters. He was made sergeant-
surgeon to two kings, George IV and William IV;
he was decorated by foreign monarchs, he was made
honorary member of many famous scientific bodies and
given the highest rewards of the profession at home
by his contemporaries.
George IV made him a baronet, not, as Billings
states, because he removed a wen from the royal head
- a perversion of fact. He was made surgeon to the
.
10
king and performed the trivial operation because he
was the first surgeon in Europe; and because of his
high professional standing he received the rank.
It is refreshing to read Cooper's estimate of him-
self and his career. He was a great journal writer.
Here are the ingenuous remarks which he once made
in his old age; they were written in Paris : “I then
went to the Soirée de l'Institut, and this I feel to be
one of the proudest days of my life; being in a
foreign country, among strangers and received with
so much honor. When I look back upon myself, as
the son of a country clergyman, then made a lecturer
on Anatomy and Surgery, F.R.S., Surgeon to Guy's
Hospital, Surgeon to the King, Sergeant-Surgeon to
the King, Fellow of most of the societies of Europe,
Trustee of the College and an Examiner, a member
of the Legion of Honor, etc., I have indeed reason
to be thankful for the blessings I have enjoyed; and
when I add to these my title and fortune I feel how
much my success has exceeded my deserts.”
“Young medical men,” said Sir Astley Cooper, “find
it so much easier a task to speculate than to observe;
they are apt to be pleased with some sweeping theory,
which saves them the trouble of observing the processes
of nature.” And so, as I have said, he was wont to in-
vestigate all things for himself. This habit produced
in him one unfortunate effect. He seldom read. He
acquired a vast amount of contemporary information
from discussions with his colleagues, but he was not a
reader. He wrote. He was continually talking,
lecturing, writing: surgical essays, collected lectures,
monographs, monumental works. From the time be
joined the Physical Society as a young student, until bis
death, he was constantly writing and talking and
rubbing against able men. When he did a new or
clever operation he talked about it, and when he had
15
concluded a series of investigations he wrote about
them. He is famous for his work on aneurisms. In
1809 he tied successfully the carotid for aneurism,
after having first assured himself of the safety of the
operation by vivisection experiments on dogs. The
case was reported in the Transactions of the Medical
and Chirurgical Society. Seven years later in 1816 he
performed the operation for wbich he is most cele-
brated - ligature of the aorta for aneurism. This,
too, was preceded by experiments on dogs, which
proved its feasibility. The patient was a middle-
aged laboring man in the Guy's Hospital wards. The
aneurism was of enormous size, occupying the left
common iliac and some portion of the abdominal aorta.
The man was extremely feeble and exsanguipated
from repeated sligbt hemorrhages. The operation
was done at night, of course without anesthetics,
intra-peritoneally. The man survived for forty hours.
I find eight recordel cases of this operation all
fatal – but all before the days of clean surgery. Sir
Astley's original case shows the patient surviving longer
than did those of any of his successors. In 1804 he
published bis well-known “ Treatise on Hernia”; in
1837 the " Treatise on Dislocations and on Fractures of
the Joints"; and in 1840 that “On the Anatomy of the
Breast." These three great works were for a long time
classics, and represented a vast amount of dissection and
investigation. They were published in handsome form,
but were sold cheaply so as to be within easy reach of
the professional public; and to their author the
pecuniary return was less than nothing. During the
thirty-six years between the first and last of these
works he published many monographs and volumes of
collected lectures - of great value and interest to-day.
Here is what the Medico-Chirurgical Review says
of the second work, that on "Fractures." ...
“Such a mass of important practical material was
never, we believe, before laid open to the public; and
Sir Astley Cooper's work, when the author has
moulded in the dust, will continue to exercise that
influence on the surgical profession at large which he
has so long exercised within the sphere of his personal
acquaintance and practice.”
He says of himself: “My objects in life have
been three-fold : First, to learn; secondly, to prac-
tice; thirdly, to publish to the world.” ...
Like most greatly successful men, Astley Cooper
grew somewhat self-assertive and arrogant as he ad-
vanced in life.
In 1825 he resigned his lectureship at St. Thomas's
on account of some impairment of health. Before
this resignation he supposed he understood that his
associate, Mr. Key, was to succeed him. The com-
mittee saw fit, however, after accepting the resignation,
to appoint a Mr. South. Sir Astley, who had a very
hot temper, after attempting to withdraw his resigna-
tion, and not being permitted to do so, decided
to establish an opposition school of medicine at
Guy's Hospital, this largely through the good offices
of a friendly treasurer, Mr. Harrison. The plan
succeeded beyond all anticipation; new buildings
were erected and appointments made according to his
desire.
Out of this affair grew a quarrel which stopped
short of a duel only. Dr. Cholmeley, a jealous per-
son, and a physician to Guy's, made offensive re-
marks about Sir Astley, charging him with self-inter-
ested motives, and this in a public lecture-room. Sir
Astley heard of it, and sent à demand for an apology
or a hostile meeting. Eventually Dr. Cholmeley apolo-
gized, and a public retraction was made.
The School of Guy's Hospital, thus established by

17
Cooper, continued to flourish as we know it to-day.
It was ever a favorite interest of his, and on his death
he left it a legacy of £4,000; the interest of which
was to be paid out annually as a prize for an essay on
some medical or surgical subject. This prize was
open to all competitors, and the members of the
hospital staff were appointed judges.
The ingenuous and childlike self-approval of many a
genius is refreshing. Sir Astley Cooper was one of
these pleasant persons. There is nothing offensive in
his egotism. He was appointed lecturer on anatomy
to Surgeons' Hall when twenty-five years old, and
this is what he wrote of the transaction in his
memoirs.
“I was appointed Professor of Anatomy to the
Company of Surgeons, and gave lectures on executed
persons, which were received with great éclat, and I
became very popular as a lecturer. The theatre was
constantly crowded and the applause excessive. My
uncle was quite delighted and Mr. Cline complimen-
tary, which he seldom was.”
In another place, when writing of his lectures at
Guy's Hospital, he says:
“My lectures were highly esteemed, but my opera-
tions were less thought of, ..still I rose; for --
and- , of Guy's, were indifferent surgeons,
and- , surgeons of St. Thomas's were still inferior;
although excellent, Mr. Cline was very cautious never
to attempt but those things which he was sure to
accomplish. He was slow, cautious and successful.
I was sometimes great, sometimes in difficulties from
venturing too much.”
Then he goes on frankly to criticise his colleagues :
“ Abernethy was a man of talent, with what the king
would call . a potato in his head.
was vain, ignorart and puzzle-
“ Sir –
18
headed, excessively envious of others, but he was so
great a fool that he was not dangerous."
* Mr. Norris . . . was very ignorant of anatomy.”
“ Sir - had genius but no judgment."
6. Mr. — was a tolerable anatomist but quite de-
void of scientific views.”
And of himself, he says: "Sir Astley Cooper was
a good apatomist, but never was a good operator where
delicacy was required.
“Quickness was his forte . . . his proguosis good.
In judgment he was far inferior to Mr. Cline in
all the affairs of life. His imagination was vivid and
always ready to run away with him if he did not con-
trol it.
“ His principle in practice was never to suffer any
one who consulted him to quit him without giving him
satisfaction on the nature and proper treatment of his
case."
Quacks and impostors flourished in those days even
as in ours. Human nature will always demand the
marvellous, and a hundred years of effort have not
succeeded in instructing the community, though laws
have been passed and pseudo-science is widespread.
One of the most exasperating tricks of the charla-
tans is their frequent habit of trading on great names
and truths. In our time Koch and Charcot and
Lister have been so afflicted. Cooper, too, was a
victim. Among other impositions was what was known
as "the Ashley Cooper set.” The substitution of
the name Ashley from Astley saved them from the
law. They advertised far and wide under the sem-
blance of tbe great surgeon's name and are said to have
dove an extensive practice.
For a!l these things Cooper had a contemptuous
tolerance, feeling that such evils would be righted by
time.
19
Before his great work on hernia instructed the pro-
fession, the treatment of this condition was much
neglected in England, and consequently fell into the
hands of the “rupture doctors," — dangerous and
uuscrupulous fellows, engaged in a trade analogous to
that of the so-called “bone-setters” of to day. Cooper
did more than any other one man to break up the
practice of these persons.
In the profession at large Sir Astley was univer-
sally popular. His great reputation, his charming
presence, his cordial manner and his unfailing courtesy
won hosts of friends, especially among the general
practitioners. There is a story of his happening to
he present at the Norwich Hospital in 1809, when a
local surgeon was operating for the cure of popliteal
aneurism. In the presence of the distinguished visitor
the operator became coufused, and though he had
made his cut over Hunter's canal, he failed to find
the artery. While he was fumbling about in hopeless
indecision, Cooper, looking over his shoulder, said,
5. You have it there”; and passing his finger into the
lower part of the wound disclosed the vessel. The
whole thing was done so tactfully that the incompe-
tence of the surgeon was not made to appear, though
the kindly act won the respect and admiration of all
present.
It was not in his professional relations alone that
he was esteemed. He was held in the highest regard
by all who came within the circle of his influence,
and from the king down he was almost universally
popular. This, too, in spite of a fierce and hasty
temper which seemed only to endear him the more
to its victims. He had little time for social amuse-
ments - but when he would take his ease, the club
known as the Athletæ, composed mostly of profes-
sional men, was his favorite resource.
20
He was ever active. He hated delays. When
travelling he always posted, and feed the post-boys
beyond all precedent for fast time.
One of his peculiarities was a terror of the sea.
Though a bold and venturesome person in all the
other affairs of life, a sea voyage was always a source
of horror to him. He became excessively seasick,
and this only added to his fears ; on one occasion
when making a voyage of rather unusual length for
him, the combined effects of mental and physical
distress threw him into a pitiable agony of delirium,
amazing to those who knew his usual fortitude.
He was a very emotional man. In 1827 his wife
died, and the event prostrated him with grief. He
felt that all the interests of life were over for him.
He fell into au acute physical decline, sold his town
house, threw up his practice and other professional
employments, and retired to his country place to pass
his last days. Within a year of the sad event he had
returned to town, taken another house, resumed prac-
tice with increased vigor, and married again. He was
then sixty years old. He lived on until 1841 and
died in his seventy-fourth year.
As with many other great but self-centred men,
Sir Astley Cooper's estimate of others not in his
own path of life was apt to be curiously erroneous.
Successful men are wont to regard others only as
they affect themselves; and to prefer unobtrusive
or flattering mediocrity to abusive and pugnacious
genius.
George IV was an agreeable and kindly patron to
his sergeant-surgeon, so this is Sir Astley's estimate of
the king -- an extraordinary estimate to us, after the
lapse of seventy years.
“ The abilities of George the Fourth were of the
first order. He would have made the first physician
21
speaker in the House of Commons or Lords, though
perhaps not the best divine. As a king he was
prosperous, for he had the good sense to be led by good
ministers. ...
66 The king was indolent, and therefore disposed to
yield to avoid trouble; pervous, and therefore anxious
to throw every onus from his own shoulders. He was
the most perfect gentleman in his manners and address
- possessing the finest person, with the most dignified
and gracious condecension, yet excessively proud. ...
“George the Fourth had an extraordinary memory
- he recollected all that he had read or seen -- and
had the faculty of quickly comprehending everything.
works in English literature. He was an excellent
classic. He was a good historian. He spoke German
and French as well as his own language. He spoke
remarkably well. ... His judgment was good. . . .
He was in danger in coming back to England after his
visit to Ireland, and behaved with the greatest coolness.
- The king was sometimes coarse in his conversa-
tion and anecdotes, but nobody could be more refined
when he chose. He was witty. He woke early and
read from six until ten. He did not in general drink
much. ..."
Listen to Thackeray's words about the same man,
written thirty years after the king's death.
“To make a portrait of him at first seemed a matter
of small difficulty. There is his coat, his star, his wig,
his countenance simpering under it ... and yet after
reading of him in scores of volumes, hunting him
through old magazines and newspapers, having him
here at a ball and there at a dinner, you find you have
nothing - nothing but a great simulacrum.”
So William Thackeray; and so Sir Astley Cooper.
We admit that at such work the pen is mightier than
the scalpel.
But in spite of all this we must not think of Sir
Astley Cooper as being a courtier. In his age he
grew to have a great respect for the constituted au-
thorities. To him a king was a king; and a lord was
a lord indeed. England was the most beautiful and
pleasant country under the beavens; and there were to
be found the bravest and wisest men, the most lovely
and virtuous women. He says 80 a dozen times, and
we think none the less of him. The democracy of his
ardent youth fell from him, as it has done from so
many others; but his great work in life went on.
Always the houor and prosperity of his profession
were most dear to him. Whenever he heard of a fine
professional action he gloried in it, and he labored
through life to elevate his calling in the eyes of men.
His fellows recognized this in him, and this was the
great reason for his constantly increasing popularity.
To conquer shams, to foster science, to expose cant, to
teach the truth, to seize the happy moment, to know
real worth, to labor always for progress, these were
the great things in life to him.
And when at last, in old age, he died in harness, his
ambition unquenched, and his courage firm and un-
faltering to the last, the profession and the world felt
that a monument in St. Paul's was but a humble tribute
to the greatest surgeon of his time.
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