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 SIR VICTOR HORSLEY
 
 SIR VICTOR HORSLEY 
 
 A STUDY OF HIS LIFE AND WORK 
 
 BY 
 
 STEPHEN PAGET 
 
 Misit de summo, et accepit me : 
 et assumpsit me de multis aquis. 
 
 My sword I give to him that shall succeed me in my pilgrimage, 
 and my courage and skill to him that can get it. 
 
 ILLUSTRATED 
 
 NEW YORK 
 
 HARCOURT, BRACE AND HOWE 
 
 I 920
 
 Printed in Great Britain
 
 TO LADY HORSLEY
 
 PREFATORY NOTE 
 
 By Lady Horsley 
 
 When at the age of fifty-nine Victor Horsley died, struck 
 down by the furnace heat, the mental misery, and the over- 
 work of Mesopotamia, he was still in the fulness of his 
 powers. These he had planned to use, on his return home, 
 for the promotion of the social reforms in wliich he was 
 most keenly interested, the health, housing, and land of 
 the people. He intended again to offer himself for Parlia- 
 mentary election and, as the letter from Huddersfield quoted 
 in the Memoir shows, he would probably have been returned 
 to Parliament by a constituency choosing him as their 
 representative for his personal qualities and his high 
 ideals. 
 
 He belonged to a long-lived family. He was himself strong 
 and vigorous. He would under normal circumstances 
 probabl}' have lived to old age, and so long as strength of 
 mind and body remained to him it would have been used 
 in attempting to further the interests of the people. And 
 he would have furthered them. He possessed in a high 
 degree the power of influencing other men, and not only 
 those of his own age but also the young, a much rarer gift. 
 Th«n' felt that he was not of the past or even of the present 
 but of the future, and that his leading was always onwards 
 and upwards. When he joined a cause, his name at once 
 added strength to it. It could not be merely sentimental, 
 or wanting in justification, if it had attracted to it so manly 
 a man and so keen an intellect. Thus he would have been 
 a teaching and inspiring force in the coimtry, and he has 
 left a void which so far no one has come forward to fill. 
 
 It seemed wrong, when all this vitality and power was 
 so suddenly arrested, that no effort should be made to 
 
 vii
 
 viii SIR VICTOR HORSLEY 
 
 set forth his Ufe and labours as an incentive to others to 
 take up the work he had too early laid down. 
 
 The task however of preparing such a record was a very 
 arduous one, for probably few men who have done so much 
 have written so Uttle, and it needed all Mr. Paget's literary 
 powers and enthusiasm for his theme to overcome the 
 difficulties which confronted him. 
 
 The sincerity of that enthusiasm no one can doubt who 
 read his words when the news came from Amarah in 1916. 
 Yet it would be hard to find two men of goodwill more 
 widely separated in their mental attitude than the author 
 of the Memoir and the subject of it. They differed in 
 religious convictions, in politics, in social ideas, in their 
 ways of approaching men and matters, and these differ- 
 ences constantly make themselves apparent in the book 
 and in the critical attitude of the author. 
 
 Nevertheless no attempt has been made to suppress or 
 soften this. Those who regard Victor Horsley's memory 
 with most reverence and most affection are well content to 
 let his life speak for him and to let those who read it judge 
 for themselves. The object of the book will have been 
 sufhciently attained if it serves to preserve an influence 
 that was never more needed than it is now at this most 
 critical hour. 
 
 June, 1919.
 
 ERRATA 
 
 P. 119, line 3. False quotation. 
 
 P. 126, line 13. For 'Army' r^t?^ ' Navy.'
 
 CONTENTS 
 
 PART I 
 
 SCIENCE AND PRACTICE 
 
 CHAP. PAGE 
 
 I. From 1S57 to 1873 .... 3 
 
 II. Fro.m January 1874 to September 1878 . . 15 
 
 III. From October 1878 to May 1881 . .27 
 
 IV. From 1881 to 1884 ..... 39 
 V. The Cure of Myxcedema . . . .54 
 
 VI. The Prevention of Rabies . . .68 
 
 VII. The Localisation of Function in the Brain 90 
 
 VIII. From 1885 to 1887 . . . . .114 
 
 PART II 
 
 SCIENCE AND PRACTICE. PROFESSIONAL POLITICS. 
 PUBLIC LIFE 
 
 I. From 1888 to 1892 . 
 
 II. From 1893 "^o ^^98 . 
 
 III. From 1899 to 1906 . 
 
 IV. From 1907 to August 19 14 
 V. Professional Politics 
 
 VI. The Fight .\gainst Alcohol 
 
 VII. Brotherhood Addresses 
 
 VIII. Private Practice. Homk Lifi- 
 
 b 
 
 133 
 
 149 
 167 
 r86 
 2 1 2 
 230 
 
 255 
 263
 
 SIR VICTOR HORSLEY 
 
 PART I I I 
 DURING THE WAR 
 
 CHAP. PAGE 
 
 I. London. Wimereux ..... 285 
 
 ir. Egypt ....... 295 
 
 III. India. Mesopotamia ..... 313 
 
 Published Writings . . .341 
 
 Index . . 35 i
 
 LIST OF FULL-PAGE PLATES 
 
 Sir Victor Horsley 
 
 Mr. and Mrs. J. C. Horslf.y in the Din'ng 
 
 ROOM AT WiLLKSLEY ... 
 
 Victor Horsley at the age of Elf yen . 
 Myxcedema before Thyroid Treatment . 
 Same Patient, after Treatment . 
 Pointed (Service) Bullet, "22 calipre. Cast o 
 
 Effect in Clay .... 
 •310 Soft Lead Bullet. Cast of Effect 
 The Operating Theatre, Queen Square, 1906 
 Horsley's Room, University College 
 Drink Shops, Southwark, 19 14. Tapard Street 
 
 District ..... 
 Sir Victor Horsley 
 Sir Victor Horsley's Grave at Amarah. 
 
 Frontispiece 
 
 facing page 6 
 
 54 
 54 
 
 155 
 155 
 184 
 
 ,, 200 
 
 230 
 „ 285 
 
 LIST OF ILLUSTRATIONS IN THE TEXT 
 
 Diagram showing the Influence of Muzzling over 
 
 Rabies . . . . . . 87 
 
 Diagram of the Dog's Brain, showing the five 'Motor 
 
 Centres' localised by Fritsch and Hitzic, 1S70 93 
 Motor Region of Cerebral Cortex (external suriace) 98 
 Motor Region of Cerebral Cortkx (mesial suhack) 99 
 Drawing made during Experiment on the Motor 
 Region ok the Cerebral Cortex ok an Orang- 
 outang ....... 108 
 
 Facsimile of Horsley's Rebus . .129 
 
 Sketches in Letters from France and Mesopotamia, 
 
 292, 320, ■?2i, 324, 725. 327, 330, 332, 33 ^ \\.\, 335
 
 TO 
 
 WILLIAM W. KEEN. M.D., LL.D., 
 
 EMERITUS PROFESSOR OF SURGERY, JEFFERSON 
 
 MEDICAL COLLEGE ; LATE PRESIDENT, AMERICAN 
 
 PHILOSOPHICAL SOCIETY. 
 
 Dear Dr. Keen, — When this book was published in 
 England, Lady Horsley let me dedicate it to her. 
 In America, it dedicates itself to you, of its own 
 accord, without asking my leave. Your name and 
 your work are familiar to us over here ; you knew 
 Victor Horsley well : you and he stood side by side 
 for the advancement of surgery : and you are a true 
 lover of England. No wonder that the book takes 
 this opportunity of dedicating itself to you : and I 
 admire tlic wisdom of its choice. — Yours very truly, 
 
 Stephen Paget. 
 
 LiMPEFiELD, Surrey, 
 December 1919.
 
 PART I 
 
 SCIENCE AND PRACTICE
 
 From 1857 to 1873 
 
 It was part of the happiness of Victor Horsley's hfe that he 
 was of good birth and had a family record to be proud of. 
 He was a son of John Callcott Horsley, the artist, and 
 a grandson of William Horsley, the musician. WiUiam 
 Horsley married a daughter of John Wall Callcott, the 
 musician, brother of Sir Augustus Callcott, the artist. One 
 of William Horsley's daughters married Isambard Brunei, 
 the engineer : another married Dr. Seth Thompson : another, 
 Miss Sophy Horsley, a woman of keen intellect, and a notable 
 pianist, was a great friend of Mendelssohn ; he dedicated 
 some of his works to her. 
 
 Victor Horeley's mother was a sister of Sir Francis 
 Seymour Haden, the surgeon and artist who was founder 
 and first President of the Royal Society of Painter-Etchers. 
 She was a daughter of Charles Haden, a surgeon in good 
 practice in Sloane Street : he was a great friend of Miss 
 Austen. He died young, but not before he had made a 
 name in his profession. He was a son of Thomas Haden of 
 Derby, one of the foremost surgeons in the provinces. 
 There is a well-known etching of Thomas Haden, by his 
 grandson Seymour Haden, after a portrait by Wright of 
 Derby. 
 
 John Callcott Horsley was born in 1817, in Brompton. 
 Six years later, the family moved from Brompton to the 
 house which now is 128 Church Street, Kensington, but 
 then was i High Row, Kensington Gravel Pits. This was 
 Mr. Horsley's home in London for eighty years, from 1823 to 
 his death in 1903. Near the end of his long life he wrote his 
 Recollections of a Royal Academician. The surroundings 
 of the house have changed for the worse, but it still has an
 
 4 SIR VICTOR HORSLEY 
 
 air of quiet dignity, and there is a garden behind it, and 
 Kensington Gardens and Kensington Palace are not far off. 
 He could remember the Princess Victoria riding daily past 
 the house : 
 
 It was a charming sight to see them scampering up Church 
 Lane at a hand-gallop, passing the woodland Campden Grove, 
 past old Campden House and its entrance-gates — and the 
 Princess, who, of course, led the cavalcade, with a cool and 
 experienced equerry at her bridle-hand, pulling up at the 
 turnpike gate, which barred the road, just opposite the 
 stable gate of No. i High Row. 
 
 He was a student at Sass's Academy when he was only 
 thirteen years old. In 1831, he became a Royal Academy 
 student. In 1845, he was chosen to paint two of the wall 
 pictures in the new Houses of Parhament. He was elected 
 A.R.A, in 1855, and R.A. in 1864, and was Treasurer of the 
 Royal Academy from 1882 to 1897. His early picture, 
 ' Rent Day at Haddon Hall,' brought him praise and success : 
 he loved to study Haddon Hall, and it influenced much of 
 his work. One of his pictures was placed in his hfetime — 
 a very exceptional honour — in the National Gallery. And 
 he did a memorable service to art in England, for it was he, 
 more than anybody, who organised the Winter Exhibitions 
 ot Old Masters at Burlington House, He was a member of 
 the Exhibitions Committee for twenty-seven years ; and he 
 delighted in the duties \vhich it put on him. He had to 
 visit private collections, persuading the owners of master- 
 pieces to lend them, and refusing all that was not worth 
 showing ; and he made the Winter Exhibition the chief 
 event of the London year for lovers of good pictures. 
 
 He was twice married : his first wife was Miss Elvira 
 Walter ; three children were bom to them. She died of 
 consumption ; and her children did not long outhve her : 
 all three of them died of scarlet fever. In 1854, he married 
 Miss Rosamund Hadcn. Seven children were bom to them : 
 Walter, Hugh, Victor, Emma, Fanny, Gerald, and Rosamund. 
 Two of them, Hugh and Emma, died in childhood of scarlet 
 fever. Geiald, the architect, died in July 1917. The 
 members of the family now are Colonel Walter Horsley, the
 
 FROM 1857 TO 1873 5 
 
 artist, Lady WTiitelegge (Fanny), and Mrs. Francis Gotch 
 (Rosamund). 
 
 Victor was bom on April 14, 1857. It was the day on 
 which the Princess Beatrice was bom ; and the Queen, who 
 had kindly regard for the family, noted the coincidence, and 
 sent word that she wished him to be named after herself. 
 He was presented to her, at a very early age. Victor 
 Alexander Haden Horsley — but there never was a man who 
 made less use of a superfluity of Christian names. From 
 six to eighteen, he gradually reduced them : Victor A. 
 Haden, Victor A. H., V. A. H. By the time when he was 
 twenty-one, the A and the H were gone. 
 
 In 1858, Mr. Horsley bought a country-house, Willesley, 
 near Cranbrook, in Kent. He writes, in his Recollections, of 
 the beauty of the place : 
 
 WTiere 's Cranbrook ? I remember saying to old Tom 
 Webster one day, when he told me he was going down into 
 Kent to see the young artist, F. D. Hardy, who was painting 
 the cottage interiors in the neighbourhood. . . . One of the 
 most picturesque old houses in the High Street became 
 Webster's studio, when, at a later date, he lived no longer in 
 the farmhouse, but in a square and substantial red-brick 
 house in the town. Tempted by Webster's account of Cran- 
 brook, we went there, and often occupied lodgings, till the 
 chance came of buying an old house standing about half a 
 mile out of the towTi on a hill. 
 
 The house was enlarged and decorated by young Mr. 
 Norman Shaw. Oak panelling, sixteenth-century stamped 
 leather from a French chateau, curtains from a palace in 
 Venice, were bought or given for its adomment : 
 
 It was Norman Shaw himself who first drew bold designs 
 on the soft, new plaster of the ceiling, and who was delighted 
 to find his ideas ably and conscientiously carried out by the 
 rustic ' Men of Kent,' the Cranbrook workmen, with a skill 
 and verve that could never have been found in Londonci^i of 
 the same calling. He made the delightful design on the 
 gable of tlic j)c;icock, and the familiar words, ' K.xccjjt the 
 Lord build the house, their labour is but lost who build it.' 
 
 This pleasant country house is still in the family : Colonel 
 Walter Horsley lives there. It gave the children all that
 
 6 SIR VICTOR HORSLEY 
 
 they could desire. They had also, on this or that occasion, 
 a holiday at the seaside ; and their mother once took them 
 to Boulogne, but the lodging-house was so dirty that she 
 whirled them back to England. They did not lose any- 
 thing : no sensible child, having Willesley to play with, 
 would care to play with Boulogne. After 1873, the house 
 in Kensington became home to them, and Willesley was 
 kept for hohdays ; but up to 1873, they were always in the 
 country. 
 
 The Recollections of a Royal Academician are good read- 
 ing ; but it is an old man's book : it does not say much about 
 the home hfe at Willesley in the earlier years. Mr. Horsley 
 was a man of restless energy, impulsive, hot-tempered, but 
 generous and quick to make amends. He worked hard, 
 and was intolerant of any break in his work. He loved 
 company, and was bored by solitude. His letters to his 
 wife are full of weathercock changes of thought, sharp httle 
 criticisms, and spurts of slang and chaff : he tells her all 
 about home and the children, what they are all doing, how 
 he is getting on with his work : for instance, what a friend 
 has paid, at a sale, for one of his pictures — ' An old stoopid : 
 I 'd have painted him a much better picture same size for 
 the money.' Over small grievances and small domestic 
 perplexities, he was fidgety : he liked to arrange and plan 
 everything, and to have it just so. Over greater troubles, 
 he was more patient. In rehgion and in poUtics, he stood 
 on the old ways of unquestioning faith and of loyalty to the 
 Sovereign. His friendships were in art and music, not in 
 politics, nor in science : he was averse from the revolutionary 
 spirit which was refashioning the world all round him : 
 neither Huxley nor the Pre-Raphaelites found their way to 
 him. But that which told against his authority among 
 artists was not his dislike of Pre-Raphaelitism, but his dread 
 of the influences of the French Salon, and his opposition to 
 the study of the naked model. He said what he thought of 
 it all, in 1885, in the Times ; and there was a good deal of 
 rather angry laughter over that controversy. 
 
 It would be waste of time to try to decide what in Victor 
 was Horsley and what was Haden. He got his good looks
 
 FROM 1857 TO 1873 7 
 
 from his father. If we may go by the evidence of hands, 
 both famihes were represented in him. The Horsleys were 
 proud of their hands, the long slender fingers and well- 
 shaped nails : the Hadens had square hands, with square 
 nails : as Se^Tnour Haden said of an old portrait, ' That 's 
 the woman who brought the damned ugly hand into the 
 family.' Victor's hand was a blend of the two : it was 
 rather square, but with well-shaped fingers and nails. His 
 mother had a thoroughly Haden hand. She was very 
 skilful and very practical with her hands : for forty years, 
 she made the costumes for Mr. Horsley's models, and she 
 could deal as cleverly with carpenter's tools about the house 
 as \\ith needle and scissors. She was small of stature ; 
 busy, strong-willed, capable : as Victor, in the later years, 
 said of her, ' She used to make things go.' She could be 
 rather terrible toward an offending servant or tradesman : 
 nor did the children find it easy, as they grew up, to adapt 
 themselves to her frequent censure. She bore pain and 
 faced operations with extraordinary courage, but was not 
 free from that sort of timidity which then was more common 
 among women than it is now — the fear of dark nights, 
 horses and cows, hansom cabs, and so forth. She had been 
 brought up in France, and mostly had hved in France to the 
 time of her marriage : she knew French history as it were 
 by heart, and all the intricacies of the French dynasties. 
 She was on the alert, even when she was more than eighty 
 years old, over points of history ; and her talk with its 
 wealth of memories was of great interest. In society, she 
 liked to keep herself to herself, and did not go out of her way 
 to make new friends : the circle of art and music round her 
 in London was wide enough without that. In all affairs 
 of manner and of conduct, she maintained the high standard 
 of the Victorian Age, and the rigid observance of proprieties ; 
 but was none the less independent, and proud of her inde- 
 pendence, hating to feel herself beholden to anybody. 
 Toward her husband, she was of one mind with him over the 
 great things, but was more apt than he to leave the lesser 
 things to shape themselves ; and he sometimes was vexed 
 that she was so philosophical.
 
 8 SIR VICTOR HORSLEY 
 
 It was inevitable, from the tragedy of his first marriage, 
 that they should be incessantly anxious over their children's 
 health. ' I am sorry for being so fussy,' he writes to her, 
 ' but if I hear of anything being the matter with the children, 
 it is as if a knife were driven into me.' Except for this 
 persistent watchfulness, the children had nothing or next to 
 nothing to complain of. Obedience was expected of them, 
 and they were taught to be content with simple food, and 
 to respect the difference between their parents and them- 
 selves ; there was not the present equality or pretence of 
 equahty ; they did not offhand invite their parents to play 
 games and share secrets with them ; but they had all the 
 freedom that was usually given to the children of that 
 generation, and more than some children would have dared 
 to ask for. On Sunday — that everlasting test of home life — 
 they had to go to church once, but not more than once ; 
 and, by a strange turn of casuistry, were allowed to amuse 
 themselves with drawing but not with painting, because 
 painting was their father's work, and they must not work on 
 Sunday. 
 
 Victor's earliest letters, from 1863 to 1868 — from his sixth 
 year to his eleventh — are short, objective, and abounding in 
 happiness. They show a quick sense of the beauty of the 
 world, but are neither sentimental nor imaginative. The 
 spelling is remarkably correct : it may have been controlled 
 from above. One or two of the letters are in French ; and 
 that so bad that it may have been intentional ; but opinions 
 arc divided on this point. It is recorded of him, at the age of 
 six, that he asked his governess whether a chair in French 
 were still feminine if a man sat on it. 
 
 1863. To his mother. April 13. I hope you will come on 
 my birthday and bring me some presents from London. On 
 Sunday we went for a walk, and when we came back we made 
 an r)ld man of sand. Grass is iiis hair, two lapides for his 
 eyes, a curled piece of stick for his nose, and a straight piece 
 of stick for his mouth. I am going to draw hunting a tiger. 
 April 16. I think you will be glad to hear that my cold is 
 better. I had some sugar and a baked apple last night. I 
 have two mountain ashes, some beans and peas in my garden. 
 April 28. It is very stormy to-day, and I think there will be
 
 FROM 1857 TO 1873 9 
 
 lightning. This morning I gathered a very large violet. We 
 have a great many beans which Jenner gave us. I want to 
 put affectionate now. 1866. To his mother. May i. I hope 
 that you have arrived in London safely with no accident at 
 all. I have done all that I have to do this evening, and, 
 having some spare time, I tliought I would write to you. 
 You know the side which I had my swell face, well, on the 
 opposite side I have a gumboil. 
 
 1867. To his father. April j. How are you ? Have you 
 been to the Academy ? Did you get my letter yesterday ? 
 Do you know it is only four days to the holidays ? We went 
 to Admiral Houston's yesterday. Near their garden (at least 
 it is joined to it) is a little wood full of Httle paths. The 
 ground there is carpeted with primroses, anemones, blue, 
 white, and purple periwinkles, besides some red primroses. I 
 think it must have been a garden once, but now it is all 
 shrubs, moss, young and old trees. At the bottom of this 
 little road there is a stream. Will you ask Grandmamma for 
 some seeds ? May 21. How are you ? Is the Exhibition a 
 nice one, and are there many pictures ? It has been very 
 rainy to-day except this evening. There is a beautiful sun- 
 set, it seems quite to gild the dining-room. Oct. 30. Have 
 you arrived at London safely ? How many students had you 
 to teach to-night ? Did you have more than 30 or 40 ? 
 How old are some of them ? Are there any about 20 there ? 
 because I want to know. Nov. 7. On Monday night w^e 
 had a dozen squibs, 12 blue hghts, 12 crackers, 3 Roman 
 candles, and 18 Catherine wheels. We invited Mr. Garden, 
 the two girls, and Freddy. I bought a dormouse to-day 
 for a shilling, witli a cage too, from a schoolboy, he is called 
 Louis Broome. It was not his, it was the eldest Yates, but 
 he owed Broome a little more than a shilling, so I was to 
 give it to Broome. Walter is making a bowsprit and mast to 
 the boat Mr. Paine made for us. He made the body for us, 
 not what Walter is making this evening. Have you gone to 
 the students this week ? What sort of model was it ? Was 
 it the same one that was there last week ? How are you ? 
 Will you ask Aunt Sophy if she has any stamps for us. An 
 answer is requested. Dec. 15. I have fmislicd tlio drawing 
 for Mama on Christmas. We have been examined in Enghsh 
 and Roman History, in Geography, and Greek. We are going 
 to begin Bible Examination to-morrow. We begin our holi- 
 days on Thursday. . . . Did you hear the Fenian explosion ? 
 I will draw you a picture. 
 
 1868. To his father. Front Broadstairs. Mon cher Papa 
 Joliannes. We have bathed twice and are learning to swim. 
 The man is a jolly old fellow, there is a nice hfcboat and jetty, 
 and there is a beautiful little boat. Sept. 4. From Ramsi^ate. 
 We went to Pcgwell to-day and they were firing off the
 
 lo SIR VICTOR HORSLEY 
 
 cannons at a target, I liked it very much. You could hear 
 the ball as it went along. They made some ver>' good hits, 
 one went clean through the canvas twice while we were 
 there, and knocked away the right pole. This is where they 
 fired from : the Range was a thousand yards. We stood at A. 
 
 The children had good friends of their own age, in or near 
 Cranbrook : the sons of F. D. Hardy, the artist ; and the 
 O'Neills, cousins and near neighbours ; and the Vizards 
 at Sissinghurst, a large family, the girls all set on earning 
 their own living ; one of them, in 1873, was governess at 
 Willesley, The liberties of Sissinghurst were an escape from 
 the restraints of W'illesley, and the Horsley boys used to 
 go there on Saturday half-holidays. Mrs. Carter (Miss 
 Jessie Vizard) remembers them well. It seems that Walter 
 was her favourite : Gerald used to offer his heart and hand 
 in fantastical style to each of the young ladies in turn : 
 Victor was full of fun, laughing and skylarking, with little 
 fugitive moods of quietness. A letter from him to her, when 
 he was thirteen, and she was teaching some children in 
 London, contains a very good sketch of her and them 
 groping their way through a London fog. Her sister, Mrs. 
 Hubbard, writes : 
 
 I knew Victor, first of all, when I was seven and he was 
 nine years old : we were tremendous friends in those days. 
 He and I used to go about together, getting rabbits' food, 
 hiding together in our many games of hide-and-seek, and 
 generally contriving to do things together. Later, we used 
 only to meet in the summer hohdays, and then I connect 
 him with teaching us tennis, but chiefly with a game which 
 we invented, all of us, called ' ghosts ' : a most blood- 
 curdling form of hide-and-seek, to be played in the evening, 
 preferably by moonlight. 
 
 But Victor's chief delight at Willesley was in the skittle- 
 alley which Mr. Horsley had added to the house. The boys 
 played the nobler form of the game, throwing the discus, 
 the big wooden ' cheese.' Victor's highest score may still 
 be seen on the wall, and the black cat which he painted as a 
 target for pistol-practice. He would swing from a horizontal 
 bar by one hand, and fire with the other ; not without some 
 danger to his httle sister, Rosamund. She writes of him :
 
 VICTOR HORSLEY. 
 At the Age of Eleven.
 
 FROM 1857 TO 1873 Ti 
 
 I wonder how old he was when this, which I have heard 
 my father relate, happened. They were riding together, he 
 on a small pony by the side of my father's big mare ; and 
 my father asked him what he would like to be when he grew 
 up. ' A cavalry ofificer,' he said. ' No, my boy, I couldn't 
 afford that : how would you like to be a doctor ? ' ' Oh, all 
 right : plenty of riding and driving and cutting about.' I 
 think that this was very indicative of his then state of mind, 
 for he was a t}'pical country boy : not particularly brilliant 
 at school, keen on birds'-nesting and bathing and adventures 
 in woods and fields, always in scrapes at home and abroad, 
 trespassing after birds' eggs and fleeing from gamekeepers : 
 wrapped up in his silkworms and dormice, and in the little 
 mechanical devices connected with them. 
 
 Later, the subject was naturally resumed. On this occa- 
 sion he said that he would be an artillery officer, and was 
 again told that it could not be afforded. He then said that 
 he would be a doctor, on this condition, that he should be a 
 surgeon, not a physician. My father accepted this de- 
 cision, and promised him a set of scalpels for a birthday 
 present. 
 
 We Uved only half a mile from Cranbrook, with its EUza- 
 bethan grammar-school, where the boys went, and my 
 impression is that Victor was in almost perennial hot water. 
 Once, at the midday meal, my father had been reading him 
 a long and serious lecture on the enormity of his conduct in 
 general, with special reference to his destructive proclivities, 
 to which he listened respectfully — probably at the same time 
 bending back, under the tablecloth, the prongs of a fork, to 
 see how far they would go without snapping. Then suddenly 
 he said clieerfuUy, ' All right, I '11 try to remember, but I 
 must be off to scliool now ' — jumped up, caught his foot in 
 the tablecloth, and dragged half the glass and china to the 
 floor. My fatlicr sank back in his chair, arms thrown 
 aloft in half-humorous anger. It was a good iUustration of 
 what he was often saying, ' The essence of mischief is bottled 
 in a boy.' 
 
 Victor was always daring, rather reckless, and full of 
 courage. I remember sitting with my mother one after- 
 noon, and he came into the room, from playing hockey, with 
 his face covered with blood and one eye apparently destroyed. 
 ' Can you see anything in my eye ? ' was his characterislic 
 question. 
 
 I think that, so soon as he made uj) his mind, in consequence 
 of my father's suggestion, to be a medical man, he started 
 investigating tiie interiors of birds and animals, for I was 
 very early fascinated by watching the dissection of a 
 starling on the table in tlic summer-house, and later of 
 a mole.
 
 12 SIR VICTOR HORSLEY 
 
 After all, there is nothing unusual in a boy making up his 
 mind to be a doctor. Besides, the family was closely 
 associated with the profession. Haden of Derby, Charles 
 Hadcn, Seymour Haden, and Scth Thompson, all belonged 
 to it; and the adventures of another member of the family, 
 Isambard Brunei — not as a surgeon, but as a surgical 
 patient — had been talked of far and wide. He had been 
 conjuring with a half-sovereign, pretending to swallow it, 
 and it had shpped into his air passages : he had undergone 
 tracheotomy, had devised a revolving table on which he 
 could be suddenly turned head downward, and after many 
 days had coughed up the coin. With these associations, it 
 was natural that Mr. Horsley should think of having a son 
 in the medical profession. It was no less natural that 
 Victor's first thoughts should be of the Army. Walter and 
 he were always drawing pictures of soldiers in action. The 
 children were allowed any amount of pencils and paper ; 
 and Walter's early battle pieces are admirable. Later, they 
 joined the Volunteers, and worked hard in that nationa 
 service. Failing the Army, Victor was willing to be a 
 surgeon. At the most, he was not more than fifteen when 
 he made his choice : for his father writes, in September 
 1872, ' Vic has to attend a class from two to three, arranged 
 on half-holidays especially for those with Victor's future 
 views.' He found, among his father's books at Willesley, 
 Albinus's Anatomy; and the plates were of great interest 
 to him. 
 
 By June 1873, he started to work with the microscope. 
 There is a letter to his mother, June 22, 1873, in French, 
 more or less wilfully bad : no boy of sixteen could write 
 such French with perfect seriousness. The letter recalls 
 exactly the beginning of microscope work in those days : 
 
 J'espere que vous etes tres bien (ou avez belle sant^). 
 Vous savez que les livres do Mr. Macaulay etaient 10 francs, 
 et que j'eu dans la Bourse vingt ct cinq francs. Je va a 
 Mr. Clarke's Samcdi le 21""' et il me donne du thi et me 
 pret^ un livre de la preparation des objets pour le microscope. 
 Mr. Clarke dit qu'il suit necessaire que je I'achete. Je veux 
 que Gualtier aille k Mr. Raker No. 244 High Holbom quand 
 il lui plait et achctd ces articles suivantes.
 
 FROM 1857 TO 1873 13 
 
 I oz. de ' mixed ' circular thin covering glasses. 
 12 slides, rough edges. 
 
 Une petite bouteille du ' Canada balsam.' 
 
 Une ditto de gold size. 
 
 Une ditto d'Asphalte. 
 
 Trois tubes de verre. 
 
 Une petite syringe. 
 
 24 ivory rings (comme on dit) des ' mixed ' sizes. 
 
 II ne sera plus que dix francs s'il est tantot, avec le prix de 
 livre qui est 2s. 6d. (On Preparing and Mounting Micro- 
 scopic Objects, bv T. Davies. Published by R. Hardwicke, 
 192 Piccadilly.) Mr. Baker est le plus ' cheap ' et le meilleur, 
 comme Mr. Clarke dit. 
 
 La coste des livres de Macaulay subtracte de la monnaie 
 dans la Bourse will leave 15 francs. Si la coste des articles 
 nomm^s n'est pas egal a ce prix (15 francs) je veux que le 
 remainder be sent, car il faut que j'ai fit une table de verre 
 (turn-table) que Mr. Clarke dit etre indespensable. Avec 
 mes plus meilleurs regards a tons, Je ramener votre plus 
 affectionate fils Victor A. H. Horsley. J'ecri cette lettre 
 avec le main courant. 
 
 In December 1873, he left Cranbrook School : he had been 
 there since 1866. In Victor's time, it had passed through a 
 period of depression, and was going up rapidly in numbers, 
 under its new head master, Dr. Crowden : who remembers 
 Victor, in 1866, as a ' small chubby-faced boy, who on wet 
 days came to school with his brother Walter in a covered 
 donkey-cart. He was not greatly distinguished in his 
 school work, but he obtained his moves from form to form 
 with creditable regularity.' The new school buildings are 
 later than Victor's time : the present ' Big School ' was 
 built in 1884-85 : the old ' Big School ' is now the School 
 Chapel : it used to be curtained off into classrooms, and Dr. 
 Crowden used to take the sixth form, at the upper end of the 
 room. A narrow wooden staircase leads up to it from the 
 old playground, and on this staircase Victor had a fight with 
 one of the older boys, who was bullying a new boy. In 
 1866, there were only forty boys. He of course was a day 
 boy, and went home for the midday meal. He had not the 
 present advantages of Cranbrook — the new buildings, the 
 armoury for the cadet corps, the laboratories and lecture 
 room for chemistry and physics. But he had the coiuitry-
 
 14 SIR VICTOR HORSLEY 
 
 side for a playground, and the skittle-alley for a gymnasium, 
 and the rifle butts for an armoury ; and he could afford to 
 wait for a laboratory. 
 
 He was in the sixth form on the classical side when he left 
 the school. He had gained some prizes, in classics, in draw- 
 ing, even in French : these last might well have been be- 
 stowed elsewhere. He was fond enough of the school games, 
 but was not very skilful at them : he greatly enio\'ed fooiball 
 and hockey, but cared little for cricket. Greek and Latin, 
 as languages, never got much of a hold on him : but his 
 reading of the classics helped him toward that love of 
 archaeology which was so strong in him all his life. But 
 Cranbrook made no deep impression on him, nor he on 
 Cranbrook. He ought to have gone to some great public 
 school far from home. The day boy's life, the monotony 
 of the half-mile four times in every twelve hours, the same 
 setting of his work and play, year in year out — these were 
 not good enough for him : he needed to be sent right away, 
 into wider experiences and statelier traditions, under such 
 discipUne as neither Cranbrook nor Willesley could give him. 
 He came near to having this advantage, but never had it. 
 There is a letter from his father to his mother, August 25, 
 1872, saying that ' the fever,' i.e. scarlet fever, had broken 
 out again in the little towTi : 
 
 This brings me to another important consideration that has 
 been simmering in my mind, for some days, about Victor. I 
 don't at all like the idea of his living anywhere in our filthy 
 town. I think the school has done very well up to the 
 present time, but I think we might do better for Vic. for the 
 next year and a half, by sending him as boarder (which he 
 must be wherever he goes when we are away) to such a school 
 as Charter House. We know that it is now in a splendidly 
 healthy position, newly built with every modern appliance. 
 I know liaig Brown, the Head Master, and Vic would have 
 his friend Daldy to introduce him. Moreover a year or two 
 at such a good public school might be of much service to 
 him. . . . Think of this. I would write and find all particu- 
 lars as to cost, etc. As long as that town of Cranbrook 
 remains as it is, undrained and with such a bad water supply 
 or supply of bad water, I should never be easy to have any 
 one I cared for in it. Daldy, having done so well and being 
 so good a mathematician, might be a great help to Vic.
 
 II 
 
 From January 1874 to September 1878 
 
 In January 1874 he matriculated at the University of 
 London : he was prepared for examination by Mr. (Sir 
 Philip) Magnus. After it, he set to work for his prehminary 
 scientific examination, attending lectures at University 
 College, and reading at home, and \\'ith Mr. Magnus : two 
 other students, William Pasteur, now Senior Physician to 
 the Middlesex Hospital, and Alfred Lendon of Adelaide, 
 were his fellow pupils. Dr. Lendon remembers him well at 
 this time, a tall, manly youth, with a very delightful smile : 
 
 He had a strong sense of humour, which was very congenial, 
 for we were both staunch admirers of Dickens : he was over- 
 flowing with the joie de vivre : he had been brought up to 
 enjoy country' life. In conversation, he was inclined to be 
 assertive and disputatious : ' Oh rot ! ' was a very favourite 
 expression : he was always distinctly dogmatic in his views : 
 if sarcastic at times, there was no venom introduced ^vith the 
 sarcasm. His way home from Mr. Magnus's house passed my 
 way : he walked with a long stride, and it was rather an 
 effort for me to keep up with him. 
 
 Sir Oliver Lodge, who in 1874 was an assistant teacher at 
 University College, writes of him : 
 
 It is very surprising that I remember him so well as a 
 student, but I do. although he was only studying Physics for 
 one year in the usual fasliion prescribed for a Medical Uni- 
 versity Course. But he made an impression on me from the 
 first. I remember even wlicrc he used to sit, in tlic front 
 row on the left-hand side of the lecture table in tlie old 
 Physics Theatre above the Botanical Tlicatre at University 
 College. He and another man, whose name I do not re- 
 member, used to sit togetlier, and were easily first in marked 
 ability. For though the Course was only the Junior Physics 
 appropriate to the Prel. Sci. M.B., yet I perceived that he 
 
 16
 
 16 SIR VICTOR HORSLEY 
 
 wa3 one of those men who would do, in a first-class manner, 
 whatever they undertook. 
 
 The Course was not mine, it was given by Carey Foster ; 
 1 was only a senior student employed by him to correct the 
 exercises and to go about among the students helping them 
 to do their problems or criticising the way in which they were 
 done. Consequently I saw more of the individual men than 
 if I had been the Lecturer. 
 
 I was the Lecturer in later years, but not in 1873-75, and 
 it was in one of the quite early 3'ears (probably in 1874) that 
 I first remember Horsley. I cannot tell you anything in 
 detail about him, but the fact remains that no student at that 
 period made so distinct an impression on me, and when he 
 came out as a brilliant surgeon later on, it was with pleasure 
 that I remembered my first acquaintance with him. 
 
 In holiday time at Willesley, in and after 1874, he worked 
 with Dr. Joyce of Cranbrook ; it was pleasant, informal, 
 discursive work, and it gave him his first insight into 
 general practice. Dr. Joyce writes : 
 
 He worked with me for a few months after leaving Cran- 
 brook School : we chiefly did microscopic and biological work. 
 I still have some slides which he put up : one is a section of 
 the parietal bone of a stag, another is a section of fossil wood 
 from Kentish ragstone, which he ground downi. . . . When 
 we had nothing better to do, we used to amuse ourselves by 
 overhauling the dumps of Kentish ragstone at the roadside, 
 in search of fossils, and one day, to his great delight, we came 
 across a nest of oyster-spat : the tiny oysters were about 
 one-eighth inch across : he carted them off for the museum 
 which he was then beginning to form. The last work I recol- 
 lect his doing with me before he began practice in London, 
 was on a poisoning case : a woman had given her husband 
 and her child something that she thought was yellow sulphur : 
 both died, and I had cliarge of the case. He rigged up a 
 Marsh's apparatus, and got a deposit of metallic arsenic from 
 the contents of the man's stomach. We found out after- 
 wards that he had been given a dose of Cooper's sheep-dip. 
 
 In July 1875, he passed his preliminary scientific ex- 
 amination, and got a College gold medal for anatomy. 
 His father's letters to his mother recall the worship of 
 examinations at that time : 
 
 /«/v 22. I am very sorrv I forgot to leave a message for 
 Victor to tell him to write to me, as last night, about his day's
 
 JAN. 1874— SEPT. 1878 17 
 
 work. Tell him how much I think of him and how very 
 frequently I have prayed to God that his industry of the 
 past year may be rewarded with success. At the same time 
 I am quite prepared to know that he has not succeeded, and 
 that the work has been too much for the time in which he 
 has had to do it. I trust he has remembered to pray for 
 strength in this and in all his work. July 23. I was much 
 disappointed that you did not mention how Victor had got 
 on on Wednesday. Tell me all about his work, and what 
 his impression is as to the result. July 25. I dreamt last 
 night that I went to inquire, and saw a hst in which V.'s 
 name was not : however, a porter came forward and said 
 that was not the hst in which he would appear, and that it 
 would not be out for a week ! July 31. You '11 have got 
 Vic's telegram, I trust, and will, I am sure, be as thankful as 
 I am at his success. To have passed his PreUminary Sci. 
 1st division and got the medal too is a great achievement. . . . 
 I gave V. a sovereign for the medal, and now I 've given 
 him another. I thought at one time of a ' fiver,' but perhaps 
 I have done enough. Aug. i. Victor got his medal to-day, 
 a very pretty one, \vith his name engraved, and a good- 
 looking testimonial to his diligence and industry, etc., signed 
 by Lords Belper and Kimberley and Professor Allchin. I 
 have put it in the iron safe, and the medal shall go 
 there aJso. 
 
 The ne.xt three years, from October 1875 to July 1878, 
 were given to anatomy and physiology. He took his time 
 over them : he had Ellis and Thane, Burdon Sanderson 
 and Schafer, for his teachers : he could not wish for any- 
 thing better. His father writes, November 17, 1875 : 
 
 Vic and I were at breakfast before 8, and he was off 
 before 8.15. He is deeply interested in his ' part ' [entre 
 nous a bit of an old 'ooman), and from what I sec and hear, 
 nothing could be more satisfactory than liis proceedings. I 
 find from Morton that he dines when he comes home about 
 2.30, and then goes and dines again most days with tlie 
 William Callcotts, at 7, which, as Morton says, docs for 
 tea and supper ! ! He won't starve I She says he is always 
 home by 8.30. He feels now that any one with him would 
 be in his way, as he works every evening. 
 
 And Victor, in a letter of the same month, says, ' It is 
 quite necessary that I should work till it p ^t. now, especially 
 as eight hours' sleep is oceans.' 
 
 B
 
 18 SIR VICTOR HORSLEY 
 
 Dr. Lendon, who was just senior to him at University 
 College, writes : 
 
 I remember, about the time when he first made his ap- 
 pearance in the dissecting-room, demonstrating to him with 
 chalk, and with the seat of a wooden stool for a blackboard, 
 the intricacies of the brachial plexus, and I can even recall 
 the pleased look he gave me. 
 
 For three sessions, from 1875 to 1878, he attended the 
 lectures in anatomy and in physiology : his notes of 
 Burdon Sanderson's lectures are a model of careful note 
 taking. In the Students' Medical Society, he read a paper, 
 in the winter session of 1875-76, ' On the ending of the 
 tendons in the rat's tail,' and a paper, in the winter 
 session of 1876-77, ' On the terminations of muscular fibres ; 
 and a note on the structure of intervertebral discs.' The 
 first paper is lost ; the second paper is a long and carefully 
 written record of good original microscope work, such as 
 few students were doing at that time ; and in 1877, the 
 Students' Society gave him a prize of £5 for it, and put him 
 at the head of the list of students elected to be its officers. 
 At the end of the summer session, 1877, in the College 
 examination in physiology, Bilton Pollard got the gold 
 medal, and Francis Gotch and Horsley and Rushton Parker 
 were tied for the silver medal : in the examination in 
 practical physiology — section cutting, chemical testing, 
 etc. — W. H. Neale got the gold medal, and Horsley the 
 silver medal. Then came the great event of 1877, a month's 
 holiday, with J. F. \V. Silk, in Germany. His diary of this 
 tour, a hundred and twenty closely written pages, has come 
 to hand : doubtless it was required of him by his father : 
 its tone is none the less, or all the more, independent. The 
 young men went by Queenboro' and Flushing, up the Rhine, 
 and from one German town to another, now by rail, now 
 sending their bags ahead and walking with knapsacks. They 
 saw what they could of universities and museums and 
 laboratories, with the help of a card of introduction from 
 Burdon Sanderson ; it is stuck in the cover of the diary as 
 ' our passport.' They made the most of their time, rising 
 at 6.30, river bathing, sight seeing, tramping. The diary
 
 JAN. 1874— SEPT. 1878 19 
 
 is the very image of him. The fastidiousness, the extra- 
 vagantly worded condemnation of all offending persons, 
 institutions, or works of art, the perfect self-sufficiency — 
 in the good Greek sense of the word — these all playing on 
 the surface of his life. He had to be saving of money : 
 his expenses, all the way to Wiirzburg and back — from 
 August 4 to September 2 — were j^i8. los. 8d. 
 
 Flushing — the Dutch Army: 'The soldiers were most 
 absurd and apparently were innocent of any discipline what- 
 ever. They were )'oung, and as stupid-looking as possible. 
 We saw a company being marched to breakfast. The officers 
 were pretty smart, but the men like convicts : they are 
 armed with the Chasscpot and ordinary bayonet. ... At 
 Bergen-op-Zoom some of the troops were encamped in bell 
 tents. At Rosendaal were several Hussars, who were decent, 
 and that is all. Besides, they must have ridden about 
 14 or 15 stone.' Cologne: ' The table d'h6te at the Victoria 
 was characterised by dead silence, and the awful and fatal 
 haste with which the people eat — the most awful and stupid 
 lot I ever saw. . . . The soldiers, of course, are very numer- 
 ous. As a rule they are short and very young, mere boys 
 most of them, but well made.' In the museum : ' The pic- 
 tures were, as a rule, hideous Catholic things, and the Roman 
 antiquities, considering the importance of the place, were but 
 commonplace things.' A Schiitzenfest at Deutz : ' The 
 greatest jest and farce of the wliole was the prime object, the 
 shooting. The men had blunderbuss carbines, rested ! ! ! 
 them in a wooden cupboard affair, and fired at round discs 
 a foot broad about 30 yards from this cupboard affair.' 
 Table d'hdte again : ' There was a swell who talked sense, 
 and a snob who talked nonsense ; the latter, by the way, ex- 
 pressed himself strongly anti-German, so, looking at his brain, 
 we came to the conclusion that argument was of no avail. 
 He became excited under the Nicdersteincr, and finally spilt 
 some in pouring it out, saying, " I like this wine." I could 
 not help chuckling, and he was immediately silent and con- 
 tinued so throughout.' Bonn — the University : ' A long, 
 straggling line of buildings : it is awfully ugly, and has a 
 gingerbread-looking statue in front.' The Coblcntzer Thor : 
 ' Over which was another gilt affair of St. George assiduously 
 tickling a bright yellow dragon, who had evidently given up 
 long ago, and was merely expostulating.' The anatomical 
 institute and museum : ' The comparative anatomy skeletons 
 were good and orderly in arrangement : the human anatomy 
 was most disorderly, and utterly useless for any systematic 
 reading or even demonstration.' KcnigswitUtr : ' The room
 
 20 SIR VICTOR HORSLEY 
 
 we were in was nice and airy, but had recently been varnished, 
 so that if we remained some time in any place it was difficult 
 to " tear ourselves away." ' 
 
 Coblentz — the fortifications of Ehrenbrcitstein and the 
 Karthause : ' The Schutzplatz was very absurd : they fired 
 in long ditches with the target at the end. In this way tliey 
 avoided all difficulties of sun, wind, etc., but lost view of the 
 fact that these are unavoidable.' St. Goar — the Rlieinfels : 
 ' The custodian was a great joke : he talked very clearly, so 
 it was easy for us to understand him : our xdews on the 
 Eastern Question coincided, and he declaimed, with great 
 vigour that both the Russians and Turks were pigs.' Mainz — 
 the soldiery : ' Very small and grubby-looking : the Hussars 
 are the best, and they seem to ride far too heavily.' The 
 museum : ' The best things were Romano-Frankish graves, 
 one complete, being well worth the visit. The collection of 
 implements, too, is very fine, and more especially the Roman 
 sandals : it appears that they came on a find of them in the 
 Emmenstrasse : they certainly are very perfect. The gold 
 torques, too, were very magnificent. But one would see 
 Greek, Roman, Frank, and mediaeval helmets on the same 
 shelf.' Frankfort — the Romer : ' The beggars who painted 
 the Kaisersaal were sweeps, for they have left out the Earl 
 of Cornwall, who was Emperor for twenty-two years.' 
 Heidelberg — the hotel : ' where we were gorgeously received 
 by half a dozen waiters and the landlord into the bargain, 
 who was such a nob that I instinctively took off my hat, 
 but soon put it on again.' The physiological laboratory, with 
 Ewald ; ' He kindly showed us the vision purple : one sees 
 a beautiful picture of the retinal elements from behind.' 
 The anatomical museum : some rare specimens ; but ' the 
 museum was perhaps in the most disgraceful and unkempt 
 condition that it was possible to be in, and beyond serving 
 as a storehouse for a demonstration, it was of no use what- 
 ever. For this fraud we had to pay half a mark each : this 
 is the case with all these museums, and it certainly reflects 
 no credit on the scientific guardians : it seems more odd from 
 being so totally unknown in England and so utterly unex- 
 pected in Germany.' The collection of duelling-swords : 
 ' Really one would think the men would have a httle more 
 common -sense than to fool about in this extraordinary' way, 
 for it is very rarely an affair of honour, and as the students 
 are (so far as we have seen) quite the reverse of beautiful, 
 they cannot spare any good looks to be disfigured.' Stras- 
 bourg — the physiological institute : ' We saw Professors 
 Goltz's and Hoppe-Seyler's laboratories. That of the latter, 
 except his private room, was in a most filthy condition, and 
 how they could get trustworthy results is a mystery. We 
 saw several of Goltz's dogs, which were very interesting.'
 
 JAN. 1874— SEPT. 1878 21 
 
 From Appenweier. a thirty-four miles walk to Fremdenstadt : 
 ' The odours of all kinds that came through the house were 
 positively starthng. First the stables, then a drain, then 
 coffee, backed up by the cowshed.' To Stuttgart : sixty-miles 
 walk in two days : ' A good museum : a bad service at the 
 Enghsh church.' Ulm: Augsburg: a day at Lech/eld, for 
 a sight of the Army autumn manceuvres. 
 
 Munich — bags not arrived : ' Every official here is a little 
 king, and accustomed to lord it. Even a telegraph fellow 
 was a bumptious httle chap, and I only wished I knew 
 enough German to sarcasticise him. . . . The German papers 
 are really very odd. They have small telegrams containing 
 hardly any news, with a useless article on the war. The 
 remainder of the paper is filled with advertisements and bosh, 
 backed up by a novel : the latter is the backbone indeed of 
 the paper. The gist of the whole matter is, of course, that 
 they are so fettered by the Press Laws. Surely this over- 
 government cannot last long. It shows itself in the most 
 extraordinary ways. . . . The interiors of the pubhc build- 
 ings are grand and fine, but the exteriors are inexpressibly 
 hideous, prison-hke, and, moreover, covered with the extra- 
 ordinary bilious yellow-green with which every government 
 building is painted. How an artistic city could perpetrate 
 it is very wonderful.' The museum of fossils : ' it almost 
 rivals that department of the British Museum in complete- 
 ness and beauty. The Solenhofen quarries, of course, have 
 furnished beautiful invertebrates especially. This museum 
 should be studied with Owen. Both works are well worthy 
 of each other.' 
 
 Finally, Niiremberg, where he was properly delighted with 
 the treasures of art in the churches ; and was plagued with 
 toothache — ' however, managed to read not a little KoUiker, 
 which staved it off somewhat ' — and Wiirzburg, where he 
 came in for a festival in honour of the Crown Prince, who 
 made a speech to the people, ' in which he promised to tell 
 the Emperor what a good town Wiirzburg was.' And from 
 Wiirzburg home, full tilt : this masterful young man of 
 twenty, who knew his own mind, and could exorcise the 
 toothache by reading Kolliker's Entwickclungsgeschichtc 
 There is no room here for his praises of the beauty of the 
 country', his delight in the open-air life. 
 
 He was at home through all the seven years of his time as 
 a student : from January 1874, when he was sixteen, and 
 began reading for his preliminary scientific exaiuinaticm, to
 
 33 SIR VICTOR HORSLEY 
 
 November 1880, when he was twenty-three, and passed his 
 qualifying examination at the Royal College of Surgeons. 
 These all-important years refuse to be cut into periods. 
 The events of them are plain enough : but there is more than 
 that in them. He was kept at home too long ; he ought to 
 have had his freedom before 1880, before the influences of 
 home and the influences of the Hospital were in final conflict 
 over him. 
 
 Mrs. Gotch has written of these years at home : 
 
 No sooner did he really take up the study of medicine 
 than everything gave place to it. He was a bom enthusiast. 
 He gave up everj-thing which would interfere with his work, 
 though to the last his boyish love of fun and games and the 
 country was as keen as when he was fourteen. But these 
 things were only recreations : work came first. For instance, 
 he was fond, as a boy, of dancing, and I have a vision of him 
 waltzing at a party in our big dining-room at VVillesley, 
 almost lost in the folds of the dress of the very large and 
 stout wife of the country solicitor ; but I don't think he ever 
 went to a dance after he came to London, though his more 
 frivolous brothers and sisters earned for themselves the title 
 of the Dancing Dervishes. All theatres were given up for 
 some years, at the same time. Partly, he felt that theatre- 
 going was against his duty to his work ; partly, there was a 
 touch of the puritan spirit — he did not hold with the theatrical 
 world, he thought it somehow wrong. 
 
 He was always kind to me, his much younger sister, and 
 delighted to teach me odds and ends of zoology and anatomy, 
 for I had been interested in these subjects from the time of 
 the early dissections at Willesley. With his early days at 
 University College, when he was working for the preliminary 
 scientific, began a system of Sunday afternoon walks in 
 Kensington Gardens, where we would sit on a bench and he 
 would illustrate his descriptions of amoebae and ciUated 
 organisms with elaborate drawings on the sandy gravel. As 
 he got on to anatomy proper, he would sometimes bring 
 home small ' parts,' of the dissection of which I was always 
 the privileged spectator, and he would teach and explain, 
 with that patience and enthusiasm which characterised him 
 all his life. 
 
 Another thing which he liked to teach me, and which I 
 loved to learn, was physical exercises. For many years he 
 was a devoted member of the Artists' Corps, which he only 
 gave up because of its interference with his professional 
 work, and for hours we used to go through the bayonet 
 exercise, or singlestick movements, he with a huge old
 
 JAN. 1874— SEPT. 1878 23 
 
 Snider, I with some counterfeit weapon of a lighter nature : 
 or we would stand solemnly opposite each other bending first 
 one knee and then the other, to strengthen the muscles of the 
 thighs, and see how long we could keep it up. 
 
 He dehghted in long walks. It is on record that when he 
 was not more than fourteen, he and his friend Lewis Hardy 
 walked from Willesley to Pevensey, thence by train to 
 Hastings, and so to Etchingham, and walked home from 
 Etchingham, 9 miles, in the dark. Altogether, a 40-miles' 
 walk. Lunch was eaten under a hedge before they reached 
 Pevensey. On another occasion, in the earlier years in 
 London, the brothers walked to Windsor, 22 miles, in snow 
 and sUppery frozen slush, and that same year, on Good 
 Friday, they walked to St. Albans and back, and saw the 
 Cathedral as well, 45 miles. He was not a good rider : he 
 was clumsy at some things : impetuosity was his chief 
 characteristic. 
 
 It was after we came to live in London that he learned to 
 love the river, for in Kent there was no water worth speaking- 
 of uithin our reach. Almost the first time that I remember 
 going on the river was at Weybridge, where we were staying 
 about 1877. He hired a boat to take my sister and me out, 
 and we were very much appalled when my mother, who had 
 a horror of the water, insisted on coming too, so as to look 
 after us. But her nerves got the better of her maternal 
 feelings, and she was put ashore, happily before the following 
 incident occurred, and I need hardly say that she never heard 
 of it. As it was hard work pulling against the stream, he 
 and I got out to tow, leaving my sister to sit in the boat and 
 steer ; but the tow-Une was too rotten to stand his energetic 
 pulling, and broke : my sister was left helpless with one 
 scull, quite ignorant how to use it (we had fastened the other 
 to the tow-line), and was being rapidly carried down stream 
 toward a weir, when Victor, with lightning speed, made up 
 his mind, tore along the bank, flinging off his garments as he 
 went (which I, flying after him, assiduously picked up), dived 
 in ahead of the boat, swam to it, climbed in, and managed 
 to bring it ashore. 
 
 It was very early in his student days that he took up the 
 temperance and anti-tobacco causes, and the most heated 
 arguments used to take place, particularly at Sunday suppers, 
 to which he very often invited one or two of liis University 
 College friends. My father, as a non-smoker, cordially 
 agreed with him as to the evils of tobacco, but was inclined 
 at first to resent his abuse of ' God's good gift ' of wine (an 
 expression which particularly roused Victor's ire), though 
 he practically became a teetotaller, soon after that time, for 
 the rest of his life. We had a clever, reallv brilliant, German 
 lady living with us as governess, and after my parents had
 
 24 SIR VICTOR HORSLEY 
 
 gone up to the drawing-room, tremendous battles would take 
 place between her and Victor and his friends, on meta- 
 physical and religious subjects, to which I would Hsten from 
 a (lark comer, hoping that I should not be noticed and sent 
 to bed. W^en Victor was a small boy, I think he was 
 singularly easygoing and good-tempered, showing none of 
 the pugnacity, and impatience of other people's opinions, 
 which marked his later life : but with the dawn of his intel- 
 lectual development these characteristics certainly began to 
 show themselves, and I remember a desperate row with the 
 governess, in which the slamming and locking of the dining- 
 room door played a part, though I have forgotten the cause of 
 the scene. And, a little later, I remember his withering scorn of 
 our poor old family doctor's methods when I was being treated 
 for bronchitis ; and my mother's horror at his blasphemy. 
 
 There existed, in University College, a mixed club — ' The 
 Club,' it was called quite simply — for the discussion of various 
 subjects, and for the social intercourse of the men and women 
 students, and at one of the meetings he read a paper on 
 Reformed Dress for Women. This he showed me, and though 
 my blood froze at the appalling spectacle of the creature he 
 had drauTi in illustration of the scheme — a female in trousers 
 to the ankle and a sort of very full frock-coat buttoned up 
 to the throat — I don't remember making any spoken pro- 
 test : anything he thought or advocated was far too sacred 
 to be objected to openly. 
 
 Of the books which they read together, Mrs. Gotch re- 
 members Clough's poems, and Bo3'd Dawkins's Early Man in 
 Britain ; and, above all, Kingsley's Yeast, Two Years Ago, 
 and Health and Education. They put themselves heart and 
 soul under Kingsley's authority ; he gave her Kingsley's 
 Life, and marked passages in it for her, and she writes to him, 
 in 1879, ' I am still busy on Health and Education, but I don't 
 know when I shall finish it, for it contains such mines of 
 thought that I find mj'self dreaming over one paragraph till 
 my time is up.' 
 
 On April 5, 1878, he passed the first examination for the 
 membership of the Royal College of Surgeons, and on May 
 29 the first examination for the fellowship. Between these 
 two examinations, he and his brother Walter were at the 
 Easter manoeuvres : 
 
 To his father. April 20. Sutton: Carpenter's shop. You 
 see I am up next the roof. The other men are in a bam. 
 By the way, I reported of it, the bam, that the ventilation
 
 JAN. 1874— SEPT. 1878 25 
 
 was not sufficient, so boards were stove out. We are on 
 straw, comfortable, of course. We marched in, having 
 drilled three times on the way, which set the men up. Have 
 beef here. We went for a walk round town after adjutant's 
 parade. I saw tea chalked up : we had it in the kitchen 
 with the people, which was very jolly. From Mr. Horsley 
 to Mrs. Horsley, April 24. The boys turned up about four 
 o'clock, looking the picture of health and strength. They 
 were of the baggage-guard coming up, and slept at Mitcham 
 last night, having enjoyed themselves utterly, Victor, as 
 usual, the most loud in his entoosymoosy. 
 
 At the end of the summer se.ssion, 1878, he got the Filliter 
 Exhibition in Pathological Anatomy. In August, he passed 
 the first examination for the degree of Bachelor of Medicine 
 of the University of London : he was in the first class in both 
 subjects, anatomy and physiology ; and he got the gold 
 medal for anatomy. This success was gained under diffi- 
 culties, for he was crippled with a sore foot. The family- 
 hohday this summer was at Fontainebleau ; he joined them 
 after a sea-trip to Falmouth. He writes from London to his 
 sister Rosamund in Paris : 
 
 Aug. I. Fortunately the papers have been easy as yet 
 at the M.B., so my leg has not had much effect. I suppose 
 I must come to Fontainebleau and vegetate. It is, of 
 course, a great nuisance, as I just wanted to get into decent 
 training after the last nine months. Have you seen the 
 scientific side of the Exhibition yet ? Try and find out the 
 movements of the troops, i.e. what time you see them going 
 to or coming back from drill. Aug. 4. As to tiie scientific 
 part of the Exhibition, we must have a day or two there 
 together, as it is evidently full of interest and objects that 
 you will understand ^ aite well if they are only pointed out. 
 Of course all my plans are upset. The last idea is that I 
 should ' voyage ' to Falmouth and back in one of the Irish 
 steamers, in order to get gaseous food in, and perhaps let 
 solid food out. The air would be worth anytliing. ... I 
 have ridden into town every day in a hansom, which is first- 
 rate. The horses seem to know that whenever a gap occurs 
 in the crowd, they are to run for it : consequently need 
 
 httle stimulation. Mr. came yesterday to see Walter's 
 
 picture, and said it only wanted a little more ' 'eat and 
 'azincss ' in it. 
 
 To his father, Aug. 11, ss. ' Lady Eglinton.' Off the Needles. 
 Coming into Portsmouth, the wind dropped a ]ittl<\ and 
 enabled us to see the Fleet at anchor splendidly. The Queen
 
 26 SIR VICTOR HORSLEY 
 
 reviews them to-morrow. The first line, thirteen ironclads, 
 broadside vessels. The second hne consisted of the Turret 
 Ships, which are like haystacks with most of the sides cut 
 away, since they are all painted a hideous yellow-ochre 
 colour. Went ashore at Southampton into the public park, 
 which was yet young : they have there gymnastic bars, poles, 
 ladders, for all the little blackguards to fool about on. A 
 very good idea. Southampton is a straggling place of no 
 particular architecture. Aug. 15, Hodge's Temperance Hotel, 
 Falmouth. In the evening I went to see the parade of the 
 Falmouth rifle company, over 120 strong. With more look- 
 ing after by the N.C.O.s they would be very good, but there 
 was too much talking, and the rapidity with which they 
 stood easy at the word Stand at ease was amazing. They 
 were almost all fine men, the average height being quite 
 5 feet 10 inches. To-day I was going to Truro, but coming 
 out I met a man who is in the ' Artists ' : he offered me to 
 fish, so we went out at nine and got back at five. In running 
 back home we saw a shag : one of the men had a gun aboard, 
 so we tacked all over the place, pursuing the beggar. It 
 was a glorious joke. Of course it escaped, after two pots 
 at it. In the evening I went to the Polytechnic to try to 
 get a book out. The great foods here are pasties. Fortu- 
 nately this hotel is invaded (it is also a kind of eating-house) 
 by hosts of Cornish tourists from Truro and the inland, who 
 are well worth watching. Aug. 17. Went to Truro and 
 back yesterday, up the river Fal 12 miles. Very fortunate 
 in getting into museum and library. I called on a Dr. Jago, 
 F.R.S., on the strength of my calling, as I found he was a 
 man having authority in the place. . . . Cornwall is a mass 
 of antiquities and scientific objects of enormous value, so it 
 is rather hard to leave. Obviously a walking tour is the 
 only way to do it. 
 
 At Fontainebleau, he and Walter studied the practice of 
 the Artillery School. ' Our two volunteers,' his father 
 writes, ' are of course much interested, and most critical, in 
 the military work. They had a narrow escape the other day, 
 for a shell burst in the muzzle of a large howitzer and blew 
 off half the gun, and the pieces of it and the shell were droj> 
 ping all round them.' From Paris, on his way back from 
 Fontainebleau, Victor writes, ' The Exhibition is disappoint- 
 ing in the medical line. I have finished the pictures, which 
 took me a day and a half. I have found a temperance coffee- 
 bar, where I get what dinner I want.'
 
 Ill 
 
 From October 1878 to May 1881 
 
 Before October 1878, he had seen something of the practice 
 of the Hospital, but as it were on sufferance. Now, he 
 clerked and dressed in the wards and out-patient depart- 
 ments, and attended lectures, post-mortem examinations, 
 operations, and so forth. Like many students, he was at 
 first unable to look-on at operations without faintness ; he 
 would get a friend to support him, or would leave the theatre 
 for a few minutes and come back to it. He also held, at one 
 time or another, junior demonstratorships in anatomy, 
 physiology, and pathology. Dr. Marten of Adelaide re- 
 members first seeing him, as a junior demonstrator of 
 anatomy, in 1878 : 
 
 We first -year's men had to assemble for a ' bone class ' at 
 the far end of the old dissecting-room, and punctually as 
 the clock struck noon, in walked the Demonstrator, with a 
 lot of vertebrae and chalks. He had a quiet, unassuming 
 personality, and at once gained our attention, for he ex- 
 plained all the intricacies of the bones in a wonderful way : 
 moreover, he had the happy knack of so imparting knowledge 
 that it seemed to remain with you always. 
 
 There is a reference, in Gowers's Diagnosis of Diseases of 
 the Spinal Cord — an address given in October 1879, pub- 
 lished in 1880 — to some anatomical studies, which Horsley 
 made for him, on the relations between the spinal column 
 and the origins of the spinal nerves. 
 
 In the wards, he clerked for Dr. Bastian, and dressed 
 for Mr. John Marshall. It is well known of Bastian that 
 he was the last of the opponents of Pasteur and Tyndall in 
 the controversy over ' spontaneous generation ' ; but he was 
 also one of the founders of our present knowledge of the 
 diseases of the nervous system. He is in the company of 
 
 17
 
 28 SIR VICTOR HORSLEY 
 
 Hughlings Jackson, Charcot, Cowers, Ferrier. In 1879, 
 Horsley made two of the drawings for Bastian's book, pub- 
 lished in 1880, The Brain as an Organ of the Mind, and in 
 1880, in the April number of Brain, Bastian and he published 
 a paper, 'Arrest of development in the left upper limb, in 
 association with an extremely small right ascending parietal 
 convolution.' The notes and drawings of this case had been 
 made by Horsley in 1879. To the same year, belong some 
 admirable notes and microscope-drawings of two cases of 
 tubercular retinitis ; but these were not published. The 
 paper in Brain is his first contribution to medical literature. 
 In it, Bastian and he refer to a similar case, which Cowers 
 had published in 1878 : then they say : 
 
 It would seem that we have here another instance tending 
 to corroborate the view that there is a correlation of some 
 kind between the functional activities of these regions of the 
 ascending parietal convolutions and the movements of the 
 opposite hand and fingers, as indicated by the experimental 
 observations of Dr. Ferrier. It seems something more than 
 can be accounted for by mere coincidence when precisely the 
 regions of the cortex indicated by him are found to be 
 defective in bulk in two consecutive cases of absence or 
 arrest of development of the hand. 
 
 In 1880, Horsley and F. W. Mott were occupied for seven 
 months, off and on, with a subject of bacteriology. They 
 published their results in the Journal of Ph\'siology, 1882, in 
 a paper ' On the existence of bacteria, or their antecedents, 
 in healthy tissues.' This question, whether bacteria, ' or 
 their antecedents,' could or could not be discovered in the 
 healthy tissues of newly killed animals, was regarded, in 
 1880, as a great stumbling block in the way of ' Listerism.' 
 These two students, who afterwards gained such high 
 distinction, were already, in 1880, doing bacteriological 
 work far in advance of their contemporaries : they planned 
 it and completed it with amazing thoroughness. 
 
 Thus, when he was not yet qualified to practise, he was 
 teaching, experimenting, and publishing observations in 
 physiology and bacteriology. But his leadership of his 
 fellow-students, his irresistible hold over them, were given to 
 him not by these advantages, but more by what he was in
 
 OCT. 1878— MAY 1881 29 
 
 himself. One of his contemporaries, J. E. Hine, afterwards 
 Bishop of Northern Rhodesia, writes : 
 
 He and 1 entered the Medical School on the same day in 
 October 1S75. That year's entry was a good one, and pro- 
 duced some men who have become well known : Francis 
 Gotch, late Professor of Physiology at Oxford, F. W. Mott, 
 Angel Money, Dawson Williams, Sidney Martin, C. E. Beevor, 
 Bilton Pollard, Bond of Leicester, were all contemporaries. 
 Several of these have obtained the F.R.S. 
 
 Our teachers at University College Hospital in those days 
 were Viner EUis, Burdon Sanderson (who very soon, I think, 
 recognised Horsley's merits and powers), Ringer, Bastian, 
 Russell RevTiolds, Wilson Fox. Among the younger members 
 of the Staff, with whom Horsley would have more particu- 
 larly to do, were Marcus Beck, R. J. Godlee, A. E. Barker, 
 and Cowers. The great L. S. Jameson (Sir Starr) was 
 demonstrator of anatomy, and subsequently resident medical 
 officer. 
 
 I remember Horsley in those days as a keen, energetic 
 person, with a ' dolichocephalic '-shaped head, always with 
 an alert look and with an inquiring and sceptical mind. I 
 think we all felt that he had a future before him, and was a 
 greater man than others of his year. Personally he was 
 always charming, perfectly ' straight,' self-dependent. He 
 always had a contempt for examinations as any real test of 
 knowledge or capacity. He had a strong hatred of humbug 
 of all kinds : he protested against words and phrases hke 
 ' special idiosyncrasy,' which he called a mere cloak for 
 ignorance. He also held strong views on subjects like food, 
 alcohol, etc. Mustard and suchlike condiments he denounced 
 with vigour. I remember once in a debate the mustard 
 question came up, and Dudley Buxton quoted against him 
 Katharine's saying, in The Taming of tlie Shrew, about a 
 piece of beef and mustard — ' A dish that I do love to feed 
 upon ' — but this carried no conviction to Horsley's mind. 
 
 I have no letters of Horsley's. I only corresponded with 
 him once, about a question which came up at tlie Lambeth 
 Conference — danger of infection by use of the chalice in the 
 Communion. Horsley asked me to go and see him and talk 
 it over, but for some reason, the interview fell tlirough. Our 
 lines had drifted too far apart : he, the great surgeon in 
 London, and I a missionary in Central Africa for twenty-five 
 years. 
 
 I think lie enjoyed ' having his knife ' into anybody — not 
 surgicaUy speaking, but metaj)horically : anything that 
 seemed to him an abuse, real or imaginary, he loved to attack. 
 But though he must (?) have had controversies witii many 
 persons in different connections, I think every one must have
 
 :^o SIR VICTOR HORSLEY 
 
 admired him, so thoroughly sincere, genuine, as he was, 
 brilliant in intellect and blameless in life. 
 
 Mr. C. J. Bond of Leicester, one of Horsley's life-long and 
 closest friends, writes : 
 
 It would be some time during the summer session of 1877 
 that he first invited me to his home at High Row, Kensington, 
 and I remember weU the amused expression with wliich he 
 recounted to me a family escapade which had ended in injury 
 to one of his father's paintings. This occurred from an over- 
 zealous practice with firearms in the garden behind the studio. 
 
 About this time, a few of us students at University College 
 became interested, as young men with inquiring minds are 
 apt to be, in intellectual problems of a fundamental kind, 
 and during 1878 Dudley Buxton, H. D. Waugh, Harrington 
 Sainsbury, P. Shearman, Hubert Murray, Horsley, myself, 
 and one or two others started a small circle called the Uni- 
 versity College Philomathic Society. One of the earliest 
 discussions was introduced by a paper by Dudley Buxton, 
 ' Can there be an absolute right and wrong, independently of 
 a Theistic existence ? ' This was followed by papers, in the 
 nature of rephes, from each of us : and Horsley, in his 
 contribution to the discussion, tried to show that the follow- 
 ing conclusions were justified : (i) The question of the exist- 
 ence of an abstraction, without an exact knowledge of it, is 
 incapable of solution. (2) We can conceive of absolute 
 right by the use of our experience, employed in its positive 
 and negative aspects. 
 
 It must have been in connection with one of these discus- 
 sions that Horsley wrote to me, just before the summer 
 vacation of 1878, ' You are sure to have some leisure during 
 the next two months, and I want you to write down your 
 own idea as to what you mean by " the soul." Mind, not 
 any one else's opinion, but your own.' I still have this letter 
 and my own in reply, and though youthful enthusiasm and 
 inexperience may have detracted from the value of our con- 
 clusions, I cannot help thinking that we were engaged in a 
 not wholly useless exercise. 
 
 He was immensely popular with fellow-students and 
 fellow-residents, all of whom he was ever ready to help, and 
 I remember Marcus Beck, then Assistant-Surgeon to the 
 Hospital, a great friend of the students, expressing his own 
 finn conviction that Horsley was a genius and would have a 
 brilliant future.* 
 
 * To be praised by Marcus Beck was one of the finest things that could 
 happen to students of the Hospital. He understood them perfectly : 
 they coveted his good opinion, and not they alone : his memory is had in 
 reverence by everybody who knew him. There was no man at the Hospital
 
 OCT. 1878— MAY 1881 31 
 
 I left the Hospital in 1879 ^^ t'^^^ ^P ^ house-surgeoncy at 
 the Bedford General Infirmary, Horsley came down to 
 spend some days with me in the old building, now puUed 
 down to make room for the modern Hospital. We spent 
 our spare time boating on the river Ouse, and working out 
 some details in the microscopic structure of the salivary glands 
 of the green woodpecker. I still possess some sUdes labelled 
 in Horsley 's handwriting, with pencil-sketches of sections of 
 this compound gland. 
 
 He took his dominant place in ' the best set ' — the strong- 
 \\'illed, hard-thinking young men who are the making of 
 a great Medical School, wherever they are. To him, now 
 and always, everything was a matter of principle, and he 
 defended his opinions so earnestly, and so good-naturedly, 
 that where lesser men would have lost influence, he gained it. 
 He did not stop at renouncing theatres and wine and tobacco. 
 He hated loose talk, and would not let it pass ; and he 
 obeyed, all his life, the rule of absolute chastity. He 
 delighted to help men over their work. And in everything 
 he had a way with him, a magic of his own. For his de- 
 votion to bacteriology — which then was a new science, full 
 of large and amazing surprises — they called him the Germ : 
 other names, less often used, were the Professor, which 
 explains itself, and the Vulture, for his insistence on the 
 value of post-mortem studies : and a later name was Archibald 
 Allright, for his invincible optimism. 
 
 At Christmas-time, 1878, he got a couple of days of hard 
 walking in Kent : ' We lunched at Brasted for the magnificent 
 sum of 3d. The village is shopless and consists of four or 
 five houses, but was called by one of the aborigines a "town." 
 . . . There was a very nice little Inn at Hever, but the vicar 
 had filled it with wedding guests, and so we had to come on 
 here (Edcnbridge). . . . Bridge rocks are very magnificent, 
 
 whom Horsley more admired. As he said, many years later, in his address 
 to the Sheffield Medical Scliool, 1 895, ' If you ask nie for a Ruitle or example, 
 I can at once — thouj^h not a believer in hcro-worsliip — point to one who 
 was a striking example of the powerful inllucnce for good tliat some men 
 evidently exert.' lie went on to sjwak of (Juy dc Chauliac's ideal surgeon : 
 ' bold when sure, cautious in danger, kind to the sick, friendly with fellow- 
 workers, constant in duty, not greedy of gain.' 'These words are now 
 placed on the memorial to Mr. Beck in University College Hospital, and 
 just as he showed us in his life how true they arc, so let us also keep them 
 before us to remind us what should bo the ciiaractcr of our life's work.'
 
 32 SIR VICTOR HORSLEY 
 
 like Fontainebleaii only very much more so. . . . The view 
 into the misty Weald under the sunset was scrumptious.' 
 In August 1879, he and Dudley Buxton and Walter Pearce 
 had a walking tour in Cornwall and Devon. The letters of 
 this holiday are illustrated with rough sketches, and they 
 are of prodigious length : ' Strange to say, I have developed 
 a feeling at any rate (not to say more) for letter writing.' 
 
 Aug. 21, St. Just. At Padstow a ferryman swindled us 
 with great success, so Pearce was instructed to put a spoke 
 in his wheel if possible with the authorities. In this, how- 
 ever, our charitable intentions were frustrated, as the beggar 
 had a private contract, and had, it appeared, done the Town 
 Constable under similar circumstances. The Padstow people 
 are quite satisfied to drink solutions of their decomposing 
 ancestry, I suppose in order that family characteristics may 
 be perpetuated. ... As we came over the cliffs into New 
 Quay, we passed two tumuli, one of which had been opened 
 and stiU showed the stone ' chest ' grave very beautifully. 
 I have made a sketch of it. Later I found in New Quay the 
 farmer on whose land they were opened by Mr. Borlase, and 
 from him found that the only implement discoverable was 
 of stone. . . . All the further country to Perran Porth lay 
 across genuine sand-dunes, the likes of which I don't much 
 mind if I don't go over again. . . . There was extensive 
 lead-mining on the dunes, but all are now abandoned, the 
 same general misery being found all over the country. Here 
 at St. Just there are only three working out of seventeen. 
 At St. Ives we found a man of U.C.H. lately set up, and 
 with him went to Hayle regatta : the day would have 
 been very slow had not we luckily got into a fishing lugger 
 and pulled the sweeps round home. St. Ives is a marvellous 
 place as being the resort of humdrum lives and bad smells. 
 The upper ten play Pope Joan for five hours at a stretch, 
 finished with a heavy supper and instant departure. To-day 
 we walked past Gurnard's Head and over regular moor 
 country. St. Just is a town much too large for itself. We 
 had a jolly climb round tlic cliffs : the spray was magnificent, 
 just like big guns. I wish Rosamund were here. 
 
 Aug. 23. Penzance: Matthew's Temperance Hotel. . . . 
 The poor inland of Cornwall, an unfertile moorland covered 
 with heather save where cultivated — grey granite blocks, 
 looking as if they had seen any number of cycles, standing 
 boldly through the peat, not afraid of any knockdown blows 
 the weather may offer them. Of course, taken thus alone, 
 such scenery is very grand, and, however wretched to some 
 people, there is nothing more jolly to me than to see the
 
 OCT. 1878— MAY 1S81 33 
 
 grey mist waving about such hills, and the lonelier the bttter. 
 But there is one feature in tlie landscape which introduces 
 misery into the view, accordingly deducting from our pleasure, 
 and that feature is the constant occurrence of a disused 
 mine. ... At St. Just, I and Buxton slept in a fairly narrow 
 bed with not many clothes, and yet I kicked not, neither did 
 I struggle, finally waking in the position in which I fell 
 asleep. . . . From Land's End to Logan Rock we thought 
 ourselves clever by taking off our boots, etc. and wading 
 through the surf. The end of it was we had to swarm up 
 the granite cUff, and so got to the Logan, which was a fraud 
 inasmuch as it would not ' log.' However, that was a small 
 matter, as we had a jolly good climb to get at it. As we 
 came away, we saw a tripper and a guide ! Such is the folly 
 of mankind ; moreover, as we were having lemonade and 
 milk at Porthguarra, a cub-party hove in sight, consisting 
 of the tutor, a pale-faced man with a green silk umbrella, 
 and the following, which was made up of youths and boys 
 of various ages. The Logan Rock is obviously a perfectly 
 natural production, and old Borlase and traditions may 
 hypothesize any number of Druids, but on poor basis. . . . 
 Of course, one learns all through every tour how to do the 
 thing better, and this much is ' klar,' that Cornwall can only 
 be properly done by staying at places and then scrambHng 
 about eveiywhere all day long. Every rock comer is well 
 worth climbing round. 
 
 Penzance is a very clean town, and like many Cornish 
 towns, several of the gutters have hillside Icats running in 
 them. The aborigines are a go-ahead people, and have had 
 a fine Geological Institute since 1833. Their minerals are 
 very fine. The fossils, of course, I have seen before, but 
 found more I had not noticed before. Unfortunately their 
 Biological Museum and Archajological ditto are in a very 
 poor state, and I suppose as tin is down so everything goes : 
 the biological interest has flagged terribly. However, it 
 may yet move. . . . We first went to the Museum and then 
 over the rocks to the Mount. The granite rock driven up 
 through the slate makes a splendid eyrie, and I only wish 
 it were mine to live in. I should fortify it to the teeth and 
 have a splendid laboratory fitted vsith every imaginable 
 instrument and reagent. At Mousehole we hired a man, who 
 was much amused and puzzled when Pearcc and myself 
 discussed his fare in Gcnnan. He was a very fine fellow, 
 and told us no end of a lot. He is in the Naval Reserve, 
 and looked for\vard to using the Henry Martini. I wish you 
 were here as I could show you no end. 
 
 Aug. 24. Plymuuth: Wolfrey's Temperance Hotel. We 
 strolled round to the Barbican and soon got into a boat. 
 Buxton and I pulled up to Oreston, while Pearce extracted 
 
 c
 
 34 SIR VICTOR HORSLEY 
 
 from the boatman the old story how drink had entirely 
 broken up liis family and left him with no resources what- 
 ever : he was half screwed, and when we landed at Oreston, 
 wanted half a pint, but we shoved him off into deep water 
 again, so he went back. , . . The nautical folk here are 
 very jolly, and I only wish we were staying a month to enjoy 
 the place thoroughly — enjoy it, not as the Plymouthians 
 seem to do, viz. after the manner of Vanity Fair, but one 
 could spend more than months in rowing round all the inlets. 
 Next day we went straight down to the Barbican again and 
 got hold of our yesterday's man, old Cowell, who was sober, 
 and pulled away across the Catwater under the lee of Baggy 
 Point, and dived off the boat into the deep green sea. We 
 tossed and, as I won, rowed back again. Then we went for 
 Stonehouse, walked round the Devil's Point into the Victual- 
 ling Yard. The biscuit is very jolly eating, and I wouldn't 
 mind a turn with our bread. . . . From the Victualling Yard 
 we went up to a fort, sat on a wall and ate our sandwiches, 
 then dropped down on Devonport Dockyard. Of course 
 we were shown round by a policeman, but Buxton was done 
 up and Pearce does not care much for military equipage, so 
 we were hurried. Must go through it another day by oneself 
 with a pass. Then we went up to Stoke Park to enjoy the 
 perspective. As we came down the hill to go into Plymouth, 
 we passed the Military Hospital, but as it was, unfortunately, 
 eighty years old, we did not learn much from the N.C. who 
 showed us over. 
 
 Aug. 29. Lee, near Ilfracombe. . . . Newton Abbot must 
 be a deadly alive place, for the poor visitors were reduced to 
 archery. After condoling with the Newtonians and regret- 
 ting that we could not attend the Wesleyan Conference, we 
 were wedged into a carriage with bulky females who, for 
 the most part, luckily got out at the next station. After 
 longsuffering we got out ourselves at Torquay, and repaired 
 along the searoad on the general skoot to a Temperance 
 House. There are, it seems, three British Workman Houses 
 erected by a kind of coffee subscription. . . . The ' garrison ' 
 consisted of two men, whom we designated mutes, as they 
 never spoke even to each other, a middle-aged female who 
 might have been a lady's-maid, and two other males who 
 produced literature and slept heavily over their intellectual 
 fare. We cleaned up, went to a barber's, were scraped, 
 and then found out Tuke's abode by my geograpliical nose. 
 His mother and sister are, of course, very nice people and 
 
 very sociable. Staying with them is a Miss , also a 
 
 Quakeress : she is very interesting indeed, has read a great 
 deal, and can talk and reason very well and correctly. . . . 
 The two girls came out in waterproofs and sensible boots. 
 Their boots were not thick enough in the sole, but the heels
 
 OCT. 1878— MAY 1881 35 
 
 were first-rate, and as they don't wear stays and dress very 
 quietly, you can understand that they are very rational. 
 
 Miss wants to be a medical student, so I told her 
 
 what to do. I hope she will take up science at any rate, as 
 there are evidently plenty of brains behind a red collection 
 of hair to work whatever she turned to. Well, we took them 
 round Kent's Cavern, and gave lectures at various points : 
 Pearce worried the old man who, fortunately, only became 
 extremely communicative, just as a bit of lard gets more oily 
 if you finger it. Of course the best point is the enormous 
 age of the bears' remains. ... I think the Museum is 
 capital, and only wants extending in other directions to be 
 of the greatest possible value. We came here by train after 
 spending a dehghtful hour, which I wish had been many 
 others, in the Museum at Exeter. 
 
 In contrast with the fault of hardness in these letters 
 there is a letter to his sister Rosamund, April 1880 ; a week- 
 end with the Pearces at Maidenhead. He tells her every- 
 thing : the look of the orchards, ' every branch seemed to be 
 loaded with flowers, and the air was scented as we rode past ' ; 
 the look of the woods and the riverside, and Marsh Lock — 
 ' you may judge how well the water looked, as perfectly 
 green and white it rushed over the different weirs and through 
 the penstocks : at one place in particular one could look up 
 through the water to the sky, and it was just the appearance 
 of a transparent mass of spar ' — and the final flower gather- 
 ing — ' in a small shaw out in a field, where bluebells and 
 primroses and anemones grew rampant. Besides, in our 
 absence, Mrs. Pearce had collected a quantity of garden 
 flowers, so that each of us was armed with fine bouquets for 
 the Hospital.^ . . . There is an old navvy in the Hospital, 
 who is a native of Lincolnshire, though naturally he has 
 travelled about a great deal in following work. He told me 
 an immense amount of interesting facts about the frns : 
 how that in sinking wells they came generally on llint- 
 bearing chalk ; that the peat subsoil was often 16 feet thick 
 
 • He writes to .Mrs. Sthiifer, June 2O, 1882, ' Wards i and 2 desire to 
 assure Mrs. Scliiifcr tl-.at tlic Depth of (iratitudc fell by tlieni on receiving 
 the quite too lovely Water-Ldies canNOT be expressed by the 70,000 
 resourccsof the British lanf^uage.' in December 1882, when he was warded 
 in Hospital, she sent him some flowers. He wrote back, * To say that I 
 make a worship of llowers would be as much an exagRcration as to say that 
 any one thing is my solitary object of devoUon, but that I am exce!>^ivcly 
 fond of them 13 as equally true.'
 
 36 SIR VICTOR HORSLEY 
 
 and then came clay. He said, too, that the trunks of trees, 
 which of course are commonly found in peat, frequently lay 
 in one direction for some distance. The wood is usually 
 carbonised, Uke the Irish bog-oak.' 
 
 In November 1880, he passed the final examination for 
 the membership of the Royal College of Surgeons. He 
 writes to his father, November 18, ' I have managed the 
 M.R.C.S. all right, although they adopted a bullying tone 
 which shifts my centre of equihbrium ; so that I am now 
 qualified to practise.' Then, a short holiday, by sea from 
 Liverjwol to Gibraltar : some water-colour sketches are left 
 from it, but no letters. In December, he went into residence 
 at the Hospital, for six months, as House-surgeon to Mr. 
 John Marshall. Thus, the end of his home life came of 
 necessity, with the change of his work ; and it was oppor- 
 tune : for he had outgrown the constraints of home, and 
 had departed from its religious observances. The Sunday 
 mornings were given to microscope-work, at a table in 
 Walter Horsley's studio ; Victor and a friend worked 
 together over the fascinating but secular pursuit of the 
 embryology of the mouse. The Sunday evenings drifted 
 into controversy. The younger children used to dread 
 sitting as models to their father ; for he could not keep 
 himself from questioning them. ' Where does the boy get 
 these monstrous opinions from ? ' he would say to them. 
 It was who should have him, the Hospital or home : and 
 the Hospital won, hands down. In the later years — it was 
 not all his fault — he gradually let his old home stand too 
 far in the background of his crowded life. 
 
 The term of residence in Hospital, as a House-physician 
 or House-surgeon, is likely to be one of the happiest times of 
 a doctor's existence. It gives him that quiet sense of be- 
 longing to the place, that enjoyment of privilege and of near 
 friendship, which make Cambridge and Oxford so delightful ; 
 and it gives him responsibility and experience, more than he 
 would get in the time from either University. In this 
 charmed circle, Horsloy was Mr. John Marshall's House- 
 surgeon from December 1880 to the end of May 1881. Mr. 
 Marshall was one of his father's friends and colleagues.
 
 OCT. 1878— MAY 1881 37 
 
 for he was Professor of Anatomy at the Royal Academy. 
 He was a Fellow of the Royal Society, Professor of Surgery 
 at University College, and senior surgeon to the Hospital, 
 and in 1883 President of the Royal College of Surgeons : 
 a courteous gentleman and a good scholar. His daughter 
 writes that Horsley ' was his favourite student. I know that 
 he thought very highly of him, and took him to assist at 
 private operations, and on one occasion left him to take 
 charge of the patient, the first night after a very severe 
 operation.' 
 
 There are two letters of this time, from Horsley to his 
 sister Rosamund : 
 
 U.C.H., March 3, 1881. . . . Don't forget, if possible, to 
 bring up some flowers for this benighted spot in Creation. 
 My last set of dressers ornamented the women's ward with 
 pots of flowers, as a passing souvenir. It was a very good 
 idea of theirs, and, of course, was considerably appreciated. 
 There is so much to do now that we have no time for general 
 amusements, hence absence of news. ... I have got a new 
 set of dressers who are a very superior lot to the other set 
 of rascals, who I could barely trust out of my sight, and who 
 played the fool most unaccountably under any circumstances. 
 
 March 12. ... As my week began on Wednesday, this is 
 the first moment's peace I have had, and even now I ought 
 not to be writing, but, as it will save a post, an effort is 
 desirable. Multitudinous thanks for the primroses, which 
 are the cynosure of many neighbouring eyes and have made 
 glad the hearts of men and women. I have put into the 
 box some dissecting instruments, in case they may be of use 
 to you. ... I have had a frightful week of it. Cases keep- 
 ing me up till four o'clock in tiie morning. On Saturday at 
 midnight we had an amputation at the shoulder joint, and 
 on Monday evening, as we had arrived at the cheese, or, as 
 we call it, the soap stage of dinner, a child was brought 
 choking to the door and apparently expired there and then. 
 However, I cut into the trachea, and Maudslcy and I sucked 
 the blood and mucus out of the said pipe, whrroupon after 
 doin;:^ artificial rc'Si)ir;ition for a (juarttT of an hour, it came 
 to life again. It was generously presented by its fellows 
 with a piece of raw Spanish chestnut, which it promptly 
 inhaled : of course aspliyxia was the result. Well, it coughed 
 the bit of nut through the silver tube put into the trachea, 
 so that now its chance of life is very good indeed : conse- 
 quently Maudslcy and I are very cockalioop about it, as the 
 other fellows gave it up, ui fact, two went away and said
 
 38 SIR VICTOR HORSLEY 
 
 wc were wasting uui luiie. As we did not know whether it 
 had diphtlieiia or not, we washed our mouths out with 
 quinine, wliereupon the unfortunate Maudsley reproduced 
 his dinner, and was promptly offered another by the Resident 
 Med. Offr., who is the dinner president, but this last offer 
 he did not accept. 
 
 He lillcd ills days with work : his room at the Hospital 
 bore witness — the table covered with books and papers, the 
 arm-chair made impossible l^y microscope-shdes laid out on 
 it to dry : he, in the middle of it all, would gravely practise 
 his rifle-drill.
 
 IV 
 
 From i88i to 1884 
 
 The term of residence in Hospital seems to have told on 
 his health, for Mr. C. J. Bond writes : 
 
 It was during his House-surgeoncy, 1880-81, that Horsley 
 suffered, for some time, from a troublesome cough, and was 
 told by one of the physicians to the Hospital that he had 
 phthisis. This led to his writing me a characteristic letter, 
 in which he referred to the disease, and to one of its un- 
 favourable signs. With this letter came a beautifully made 
 little trephine, 4 mm. in diameter, suitable for operation 
 on the frog's skull. We had been discussing, on several 
 occasions, the great field that was waiting for exploration 
 in the physiology and surgery of the central nervous system. 
 We had been bemoaning the small results that had attended, 
 up to that time, the treatment of cerebral and cerebellar 
 abscess. Mace wen's epoch-making work had not then been 
 published, and Horsley felt keenly tliat tlic time had come 
 for more active surgical intervention in these and other head 
 cases. And the point of his giving me the little trephine 
 was, that Willie Tuke, a brilliant fellow-student and a great 
 friend of Horsley 's, had just been struck down by phthisis, 
 from which he died : Horsley, in view of his own persistent 
 cougii, feared that he might share this fate, and he was deeply 
 anxious that these new problems in cerebral and spinal 
 surgery should be grappled with in the near future, even 
 though he might be prevented by illness from taking an 
 active part in the campaign. 
 
 The little trephine was used during the following vacation 
 at my home in Leicestershire, and I well remember the interest 
 with which he listened to my description of the effect of 
 removing the greater portion of the cerebral hemispheres in 
 the toad : the arrest of the toad's instinctive habit of digging 
 itself into loose ground, at the approach of winter, by an 
 outward shovelling movement of the Hexed hind limbs. 
 
 It may be that Horsley was ni immediate danger of 
 phthisis ; but he had no trouble of that sort in the later years. 
 
 19
 
 40 SIR VICTOR HORSLEY 
 
 The diagnosis of phthisis could not, in 1881, be decided by 
 the finding of tubercle-bacilli in the sputa ; for Koch's dis- 
 covery of the bacillus was not made known till 1882. It 
 appears that he said nothing to his people of what had been 
 told him. Doubtless he was resolved that they should not 
 send him out of London. 
 
 During his House-surgeoncy, or just after it, he began a 
 long series of experiments on his own brain. Many of us, 
 going under an anesthetic, have watched with interest, and 
 with anxiety, the gradual blotting-out of our faculties ; but 
 not man}' of us would care to do what Horsley did. He an- 
 aesthetised himself, or got a friend to ancesthetise him, it is said 
 about fifty times in adl : it might be partially, or it might be 
 completely ; and he devised ways of recording and signaUing 
 his experiences. 1 Dr. Marten of Adelaide writes : ' He used 
 to come into our sitting-rooms, where having set us down 
 at a table with pen and paper, he proceeded, whilst lying 
 back in an armchair, to administer chloroform to himself. 
 At his dictation we had to write down in what order his cere- 
 bral centres became inactive. It was found that the loss of 
 brain function always took place in the same order, and that 
 after he was able only to mumble a few words he could still 
 move his arms. When quite imconscious, we had to remove 
 the mask and allow him to sleep off the effects of the drug.' 
 Dr. G. E. Tw3'nam remembers giving him gas three times at 
 one sitting. Mr. Salter Chappell remembers an occasion 
 when Horsley was no sooner out of the ancesthetic than he 
 demanded to be put under it again ; but the anaesthetist 
 objected — If anything went wrong, what should he do if 
 ever he met Horsley's father ? ' Well,' said Horsley, ' you 
 would raise your hat like a gentleman, of course.' For some 
 experiments, he took not gas but ether. It is said that the 
 Hospital authorities called the attention of the Staff to the 
 strange increase of consumption of the gas. From studying 
 
 * There is a reference to these rather hazardous performances in his 
 Lees and Raper Memorial Lecture, 1900. His notes and signalling codes 
 were the beginning of a collection which he made of examples of oddities 
 and vagaries of the brain's action in fatigue or disease; the trailing-off of 
 a man's writing if he falls asleep over it, the meaningless repetitioo of 
 phrases in a letter, and so forth.
 
 FROM 1881 TO 1884 41 
 
 his highest cerebral centres, he went on to study his reflexes. 
 As he sa^-s in his ' Note on the patellar knee-jerk/ published 
 in Brain, October 1883 : 
 
 ... I venture to record a few observations on the con- 
 dition of this phenomenon when the subject of experiment 
 is under the influence of nitrous oxide gas. In 1S81, while 
 experimenting (on myself) with this gas for a different pur- 
 pose, it occurred to me to contrast the condition of the 
 superficial and deep ' reflexes.' ... To avoid the possibility 
 of error in stating the depth of narcosis, only the result of 
 experiments (fifteen in number) made on myself is here 
 stated, but the facts were verified by observations made on 
 other subjects. 
 
 In all cases the anaesthesia was complete. . . . The anaes- 
 thesia was pushed until rigidity and sometimes cyanosis 
 resulted. The recovery of consciousness was very frequently 
 attended with considerable muscular spasm and semi-co- 
 ordinated convulsive struggles and excitement. The ' re- 
 flexes ' were examined at regular intervals of five seconds, 
 from the commencement of the experiment to the return of 
 consciousness. 
 
 In the summer of 1881, he took the degrees of Bachelor of 
 Medicine and Bachelor of Surgery of the University of 
 London. The gold medal in surgery was awarded to him, 
 with an University Scholarship. He did not proceed to the 
 degree of Master of Surgery. 
 
 At the end of 1881, he went to Berlin and Leipzig. He 
 lived in Berlin with the Oppenheims, friends of his people, 
 and relations of Mendelssohn, and he had letters of intro- 
 duction to other friends in Berlin from his aunt. Miss Sophy 
 Horsley. He writes to her, from Leipzig : 
 
 Stadt Rom Hotel, Dec. 18, 1881. Of course I was very 
 sorry to leave Berlin, but Leipzig is, on the whole, more 
 interesting in a general way. Of course one's acquaintance 
 with Londtm aiul Paris docs not allow of one's finding nuich 
 novelty in P.orlin, except in the ' manners and customs of 
 the aborigines.' ... In HerUn I believe I saw all that was 
 possible in the time, and at any rate all that was immediately 
 necessary for me to see. The life at the Oppenheims was 
 just like being at home, and all their friends did not srem 
 strangers at all, so that it is (juite iinj)ossiblc that any visit 
 could have been much more agreeable. Leij)zig is beautiful, 
 although Mis. Wach has just left nie, saying that she thought
 
 42 SIR VICTOR HORSLEY 
 
 it ' hasslich.' The odours are very powerful indeed for winter 
 tinie, but all the back alleys, the market, etc., are splendid 
 and ' quite too ' mediaeval. The people, too, are different 
 from the Berliners, and it is always very amusing to wacch 
 foreigners, especially when they are in their native wiids. 
 {N.B. — My letters are always egotistical, so the occurrence 
 of ' I ' in the following must not be a surprise.) The train 
 from Berlin was supposed to be a Schnellzug direct to Munich, 
 but all the trains here run as if time was no object to any- 
 body. It arrived at Leipzig about twelve midday, I was 
 conducted to a droschky, the horse of which had a method 
 of progression quite peculiar to himself, viz. a succession of 
 small hops in which the whole body of the animal moved as 
 one piece. It was physically interesting, but not conducive 
 to rapid progression. . . . Berlin and Leipzig are upside down 
 with preparations for Christmas, and the Augustus Platz 
 here is full of Christmas trees, which are the tops of fir-trees 
 stuck into square bits of wood as stands. There is no snow 
 or ice, which is a mystery to the populace and a grief to the 
 shopkeepers, w-ho say here that the people don't buy so much 
 because it is not a genuine Weihnachtszcit. Yesterday I 
 paid a visit to Prof. Cohnheim, who was very kind, in 
 fact he had previously been primed up by Mrs. Wach. Un- 
 fortunately he does not know any English, but I take headers 
 into German sentences, and if survival occurs the people 
 generally understand. It is evident that this is the best 
 Medical School, and it would be very jolly to stop some 
 time. The surrounding country, however, is hideous.* 
 
 1882 [est. 25) 
 
 8|[Hc' and C. J. Bond, this year, were sharing a bedroom and 
 a sitting-room at loi Charlotte Street, Fitzroy Square ; a 
 little shabby-genteel street, not far from the Hospital : 
 more shabby now than genteel, but it has this distinction, 
 that the Rossetti family lived in it. Bond was working for 
 
 ' There is a letter from Mr. Oppenheim to Mr. Horsley, dated December 
 20, Unter den Linden, 8 ; 'I must tell you and Mrs. H. how very much 
 we enjoyed Victor's visit, and congratulate you to such a son. Of course 
 I knew very little of him until now, but I grew very fond of him and so 
 does my wliolc family. My wife told me so often and the two girls ex- 
 press repeatedly their dissatisfaction, that " der englische Herr Horsley ' 
 has left us already. It is a pity indeed that his visit was so short. His 
 fresh, modest, natural way took all our hearts, and besides he has the 
 exquisite recommendation to be so much like his father. When he 
 laughed, or explained a thing, or told a story, we thought him exactly like 
 the " old one." (I beg your pardon, only in comparison of course.) Of 
 course this is his less imiwrtant side, but he is certainly on the way to 
 become a man above the average. VVe all griisiien Victor intensely.'
 
 FROM 1881 TO 1884 43 
 
 the Fellowship of the Royal College of Surgeons. He writes 
 that Horsley ' never seemed to get tired in those days. On 
 one occasion, after working in the wards all day, we passed 
 the night in the post-mortem house, carrying out operations 
 on the dead body, and resumed our Hospital duties as usual 
 next day.' And he remembers that Horsley, in 1882, had 
 not the democratic mind of the later years : ' his outlook at 
 this time on many sides of life, and on many sociological 
 problems, was distinctly conservative.' 
 
 During 1882-84, Hoi-sley was Surgical Registrar to the 
 Hospital. It was his business to see that the students took 
 proper notes of all surgical cases allotted to them, to 
 arrange and have charge of these notes, and to draw up 
 annual reports. The Surgical Registrar is always in and 
 out of the wards ; he gives informal teaching to the House- 
 s' irgeons, students, and nurses; he is in close touch with 
 the Staff, and is marked for promotion among them ; and, 
 best of all, he has endless opportunities for learning, because 
 every surgical case in the Hospital comes under his observa- 
 tion. The appointment is non-resident : he is free to start 
 in private practice, and to pursue lines of w^ork of his own, 
 so far as he has time. 
 
 In 1882 also, Horsley was appointed Assistant-Professor 
 of Pathology. These two appointments kept him close to 
 the Hospital. Dr. Marten remembers of him as Surgical 
 Registrar, that ' he weis most indefatigable in his work, and 
 a most pleasant man to have any dealings with. He in- 
 variably came to the Hospital between nine and ten o'clock 
 at night, and dear old Lizzie Church, the head nurse of the 
 ward, always made him a large basin of bread and milk 
 before he left for home.' In his work for the Department of 
 Pathology, he was no less keen : ho would take any amount 
 of trouble to obtain specimens, and to get leave for post- 
 mortem examinations. 
 
 In March 1882, he made two cxpcrinKnts on the injection 
 or transplantation of particles of tumours ; one from man 
 to a cat, the other from a rat to a rabbit. One of them gave 
 a positive result : the specimen wiu^ placed in University 
 College Museum. There is a note by him, dated January
 
 44 SIR VICTOR HORSLEY 
 
 1882, ' Causes of failure in transplantation of tumours. Con- 
 sidering the results obtained in transfusion of blood (Schafer, 
 Landois, Blundeli, etc.), failure probably due to the fact of 
 one tumour substance not being transplanted into animal 
 of same or very closely allied genus. Transplantation from 
 man should be made into monkeys or domesticated cami- 
 vora. Transplantation from rats into rats and rabbits, 
 guinea pigs, etc' 
 
 During the spring of 1882, he was writing a Report for the 
 Local Government Board, ' On " septic bacteria," and their 
 physiological relations.' He had been instructed to report 
 especially on the chemical action of bacteria, and their pro- 
 duction of ' sepsin.' It was a long piece of work, fifty pages, 
 with a list of two hundred and ninety references. On 
 May 23, at a meeting of the Royal Medical and Chirurgical 
 Society, he showed some of these bacteria — wound-infection, 
 pyaemia, anthrax. Watson Cheyne, at the same meeting, 
 showed the bacilli of tubercle. 
 
 In July, he was making some drawings for the ninth 
 edition of Quain's Anatomy. He writes from the Hospital, 
 on July 25, to Mrs. Schafer, apologising for delay ; no ice 
 for the microtome, therefore no drawings for the Professor, 
 who was one of the editors : 
 
 It is to be hoped that the recording angel wept sufficiently 
 to blot out the Professor's language on not finding the 
 drawing among his letters. Fact is, this noble and charitable 
 institution was reduced yesterday afternoon to enough ice 
 for one small but severe emergency, and though the district 
 was scoured as far as Holborn, no ice could be obtained for 
 money or really love, since a Hospital porter could scarcely 
 be expected to develop a sudden affection for an ancient 
 ice-mercliant, even to aid in the noble work of illustrating the 
 new ' Quain.' 
 
 He contributed two articles this year, ' Zyme ' and 
 ' Bacilli,' to Quain's Dictionary of Medicine. But there is 
 more interest in Mr. Bond's account of an observation which, 
 in 1882, was a discovery indeed : 
 
 One hot Sunday in the summer of 1S82 I spent at Wimble- 
 don with Frank Penrose. In the course of an afternoon 
 ramble, Penrose and I noticed a mouse sitting, in a partly
 
 FROM t88i to 1884 45 
 
 conscious condition, with a roughened coat, on the side of 
 the railway bank near Penrose's iiouse. The mouse was so 
 ill that it allowed me to pick it uj), and we examined a drop 
 of its blood under the microscope on reaching the house. We 
 found the blood crowded with actively moving trypanosomes 
 (probably Lewisii), and I took several films back with me to 
 London. Penrose showed a slide next day to Ray Lankester, 
 who was at that time Prof, of Zoology in the College. 
 Horsley took a great interest in the investigation : he stained 
 a number of films to show the parasite, and in his cheery way 
 wrote a large label on one slide, To C. J. Bond, from his 
 devoted admirers. 
 
 In October, he and Bond got the delight of a holiday in 
 Italy. They had planned for Egypt, hoping to see some- 
 thing of the military surgery of the Egyptian campaign ; but 
 this plan failed, so they went by sea to Genoa ; then Pisa, 
 Naples, and Paistum, then Rome, and back through Florence, 
 Venice, and Milan. Horsley had armed himself with a 
 revolver against possible — in 1882 not impossible — brigands, 
 and on board ship the two young men were allowed to prac- 
 tise with it. Town or country, they made good use of their 
 time : but the holiday was too much of a rush. Mr. Bond 
 remembers a visit to the Dohm marine biological station at 
 Naples ; a walk by moonlight through Pompeii, and a wordy 
 conflict with a sentry ; the malarial look of many of the 
 country children ; Horsley 's keen imaginative enjoyment 
 of Rome ; a visit to the laboratory of Marchiafava, who was 
 working at malaria ; and the horrid sight, in a Rome hospital, 
 of maggots, dropped from wounds, on the floor of the ward. 
 In Florence, in the Pitti Palace, they met Lord Leighton, 
 who gave them a discourse on the pictures. Between 
 Florence and Venice, the Po was in flood, and they were 
 rowed over submerged tobacco-fields from one point of the 
 line to another. There arc postcards from Horsley to his 
 people : and a long letter to his sister Rosamund, from Rome, 
 telling her everything. It is Imperial Rome that he most 
 cares for ; next in honour comes the SLstine Chapel. He 
 says nothing of Italian art before the time of Michael Angelo ; 
 he has that contempt for Bernini which is natural to youth ; 
 and he is made angry by the dirtiness and the neglect of 
 Rome as it then was :
 
 46 SIR X'irTOR HORSLEY 
 
 The whole town reeks with work by Bernini and his 
 school. . . . Bernini is responsible for ' decorating ' the 
 Bridge of St. Angelo with ridiculous figures of angels. Ridi- 
 culous because their legs are all in the same position, and 
 their fingers and arms extended like marionettes — ' You 
 hold yourself like this,' etc. etc. . . . The remains of the 
 Imperial buildings are, of course, indescribable, the only 
 drawback being the awful state of smash and indefiniteness 
 in which they are at the present time. Fortunately, by 
 means of thorough excavation and by the happy existence 
 of plans, medals, etc., a fairly accurate restoration is pos- 
 sible, but the feeling of every one with any archaeological 
 ideas must be unpleasant if not disappointing. Of course 
 one is, to a certain extent, prepared by engravings, pictures, 
 etc., but none of these convey a tenth either of instruction 
 or pity that the actual ruins do. . . . Everywhere in Rome 
 the same thing is to be seen, namely, black ruins crowded 
 round by houses, usually dirty and repulsive in appearance. 
 It is from not appreciating these facts, although one has so 
 often seen them drawn in etchings, Piranesi, etc., that dis- 
 appointment and regrets come over you. So you had better 
 take this warning. 
 
 In November 1882, he moved from Charlotte Street to 
 129 Gower Street, where he was only a few yards from the 
 Hospital and the College. Here he lived with his friend 
 (Sir) Arthur Whitelegge : a few years later, they were not 
 only friends, but brothers-in-law. Gower Street, in a quiet 
 way, has been helpful to many young physicians and 
 surgeons of the Hospital, making them comfortable till they 
 could make themselves eminent. The house has a pleasant 
 look ; and here Horsley put up his name, and stayed till 
 1885. There was some delay over the brass plate : ' the 
 lazy man who makes them never managed to be at home 
 when I called ' : but by February 1883 it was on the door. 
 
 During his time in Gower Street, he wrote a slasliing paper 
 for the Students' Medical Society, ' On the evil effects of 
 Tobacco.' It is unanswerable : his list of the many poisons 
 in the plant, his facts and evidences, his instances from 
 Bertillon, make a heavy indictment. But he is even more 
 concerned with the ethical objections. There is a passage 
 which recalls what was so characteristic of him, his clean 
 fastidiousness — as he said long ago to a friend who was 
 smoking, ' Why spoil the beautiful things on God's earth by
 
 FROM 1881 TO 1884 47 
 
 creating such a horrible smell ? ' — and his aristocratic 
 dislike of all violence done to the natural goodness of things : 
 
 Nothing is more depressing, in the enjoyment of a glori- 
 ously fine day and keen, bracing, cool air, than suddenly a 
 cloud of tobacco smoke trailing in front of one's face. To 
 my mind, it is just as objectionable, from an abstract point 
 of view, as the snobbishness of writing one's name on old 
 ruins, and as wantonly mischievous as the wholesale murder 
 of seagulls by so-called sportsmen on our coasts. For it is 
 the destruction of a beautiful thing. With what ulterior 
 object ? Why, simply the injurious narcotisation of only 
 one individual of the community. 
 
 1883 {ist. 26) 
 
 With the move to Gower Street, he became more attentive 
 to social life : his letters in 1883 touch the year's interests 
 in art, the Rossetti Exhibition at Burlington House, the 
 performance of Lohengrin at Covent Garden, and of Caste 
 at the old Prince of W^ales's Theatre. He writes to Mrs. 
 Schafer of a plan for a theatre party : 
 
 A ' tea in the North is understood to mean the ' high ' 
 tea of the South, viz. one in which the demoralising action 
 of theine is to a certain extent counteracted by larger than 
 usual doses of food, which it is hojicd will have the power of 
 supporting the system during the tiirilling scenes of Caste. 
 Of course, I mean the whole party of dissipators to meet 
 here. My landlady, though accustomed to great eccen- 
 tricities in the way of suddenly providing, likes to know 
 beforehand. 
 
 Other letters to her are to say that he cannot come to a 
 party, or to a temperance meeting : 
 
 Jtily 18. I found so much to do with the M.R.C.S. 
 youths that I filt obliged to offer them another demonstra- 
 tion, which met with a reception that I must attcnij)! to 
 justify. As they arc in great triijiilation, I shall not csrapc 
 before five. July 28. I 'm awfully sorry to say that I 'vc 
 a tea-fight on Monday, in this way — I have instituted this 
 sort of thing, viz. a tea meeting, in order to collect the new 
 clerks in an unofficial way, so that they should fraternise 
 and I should instil into them my notions of surf;ical note- 
 taking. I am vrry sorry, .'is on»' does not do anylhinf; in 
 the way of preaching the Temperance Gospel outside this
 
 48 SIR VICTOR HORSLEY 
 
 place, and the susceptible British public is ready to listen to 
 either Medicine or the Church on this subject. 
 
 And there are three letters which are delightful because 
 we have the key to them. The Schafers had persuaded him 
 to read A Chance Acquaintance, by W. D. Howells: a httle 
 work of art so dehcate that the young people of the present 
 generation would find it too mild for them. He takes with 
 bewildering solemnity this featherweight story of a broken 
 engagement, and says what he thinks of it : 
 
 To Professor Schafer. Nov. 3. I have read the Chance 
 Acquaintance, and must say I don't like it. The heroine is 
 a vulgar little wretch ultimately guilty of utter meanness. 
 However, am much obhged to you for it, as it extends one's 
 reading. I return it herewith. To Mrs. Schafer. Nov. 5. 
 I think Kitty was vulgar (i) Because she fell in with her 
 odious cousin's plan and actually put on her cousin's 
 CLOTHES !!!!!! to appear better in Mr. A.'s eyes. (2) Be- 
 cause she advanced towards him and encouraged him when 
 really she hadn't made up her mind in the least as to what 
 she really felt towards him, and when she actually had no 
 real sympathy with him or his ideas. . . . Fancy rushing into 
 public curiosity the moment it was settled. ... I think the 
 American notion of people meeting in that sort of way and, 
 without anything like a complete knowledge of each other's 
 ideas and ways of thinking, settling down for hfe together, is 
 too ridiculous, and, of course, ends notoriously in early and 
 frequent separations. ... I have for some years past 
 watched this side of life on the European and American 
 systems, and am strongly in favour of ' long service.' To 
 Mrs. Schafer. Nov. 8. ... It certainly never entered my 
 head that Mr. A. was ashamed of Kitty when the Bostonians 
 appeared, for it appears to me absolutely impossible that a 
 man could be ashamed of the girl he really loved. The 
 thing is so absurd that it did not even occur to me. 
 
 We require some explanation of this tirade ; and we find 
 it in the light of the fact that he was just engaged to be 
 married. He and Miss Eldn^d Bramwell, a daughter of Sir 
 Frederick Bramwell, became engaged in October 1883. 
 There had long been friendship : the daughters of the two 
 famiUes had met at Lord Armstrong's country house, and 
 in London houses ; and the Bramwells one summer had 
 taken Willesley. Earlier, the young ladies had gone together 
 to VV^illesley for a few days' holiday, in which they were to
 
 FROM 1881 TO 1884 49 
 
 ' do ever^'thing for themselves ' ; and he had suddenly joined 
 them ; come, he said, to black the boots and carry the coals 
 and be generally useful. He writes to his sister Rosamund, 
 ' Things always come all right in the end. One can only be 
 aware that the ship is only launched and that hfe really 
 begins now.' And to Mrs. Schafer, ' Yes, I was "sick" of, 
 or rather at, your note ; but it was because there was not 
 enough of it. My appetite for communications is insatiable. 
 As I habitually feel about 90 per cent, more than I express 
 in words, you will understand me in my most gratefully 
 appreciating the kindness of your postscript. Like all my 
 friends you are too kind, if it were possible. Of course We 
 are burdened with theories of existence, and it will be 
 amusing to see what our line will be like compared to the 
 theoretical one.' 
 
 Lesser events of 1883 were as follows, (i) On May 26, 
 he became a Fellow of the Royal College of Surgeons. (2) 
 On December 6, Mr. John Marshall gave the Bradshaw 
 Lecture ' On the operation of nerve stretching for the relief 
 or cure of pain.' Horsley made diagrams and microscope- 
 specimens, and some experiments on the dead body, for this 
 lecture ; and drawings for it when it was pubhshed. (3) On 
 December 13, at a meeting of the Physiological Society, he 
 read notes ' On four cases of injury of the brain, illustrating 
 the position of the motor centres.' ^ 
 
 1884 {cBt. 27) 
 
 In this memorable year came the beginning of his work 
 with Professor Schafer, the beginning of his work with Dr. 
 C. E. Beevor, and his appointment to the Brown Institution. 
 
 He published three papers this year, (i) ' On a case of 
 occipital encephalocele, in which a correct diagnosis was 
 obtained by means of the induced current.' — Brain, July 
 1884. (2) ' On substitution as a means of restoring nerve 
 
 ' See Journal of Physiology, vol. iv. supplement, p. 5. In one of thase 
 cases, he had taken a muscle-tracing. ' This showed minimal and maxi- 
 mal contractions of the muscle, most of which appeared to be single waves 
 although the longest (at the end) were of no less than ^\ sec. duration. 
 Query. Direct discharge from the cortex of the cerebrum through the 
 cells of the anterior cornua of the spinal cord (acting as conductors) to tho 
 muscles ? ' 
 
 D
 
 50 SIR VICTOR IIORSLEY 
 
 function, considered with reference to cerebral localisation.' 
 — Lancet, July 5, 1884. (3) ' Consensual movements as 
 aids in diagnosis of disease of the cortex cerebri.' — Med. 
 Times, August 16, 1884. But more effect was produced by 
 his paper at a meeting of the Royal Medical and Chirurgical 
 Society, January 22, ' On the existence of sensory nerves and 
 nerve endings in nerve trunks, true " nervi nervorum." ' 
 This paper was much talked of : for it gave a precise answer 
 to a precise question which Marshall had just been asking 
 in his Bradshaw Lecture : ' Have the nerves got nerves of 
 their own ? Is the sheath of a nerve sensitive ? ' There was 
 some evidence, but no proof, of the existence of these nerves 
 of nerves. Horsley, by a then new method of section- 
 staining, demonstrated them in a human nerve. Up to the 
 time of the reading of his paper, he had not found them in 
 sections of animal nerves ; and it does not appear that he 
 pursued the enquiry further : there was no reason why he 
 should. 
 
 Toward the end of the year, he writes to Mrs. Schafer : 
 
 As regards my ' future existence,' I found that pure 
 Science meant either waiting an interminable time before 
 ' settling ' was possible, or it meant more or less exile, and an 
 early marriage. Personally I would rather strike the happy 
 mean, and therefore am busy taking a house in Grosvenor 
 St., the lower regions of which I shall occupy mj'sclf, and let 
 the rest until the said settling becomes practicable. There 
 was a determining element also in the fact that Eldred wanted 
 me to go in for Surgery and not pure Pathology. In any 
 case (as you know), I believe that the most solid work in 
 Pathology has been done by men in practice, and at least 
 one wiU have an idea as to what is more likely to be practically 
 useful in the way of Research. 
 
 He was Professor-Superintendent of the Brown Institution 
 for six years, from 1884 to 1890. Things have so changed, 
 that even the name of the Institution is hardly kno\vn to 
 the younger members of his profession, and they have no 
 idea of its importance thirty years ago. It was founded by 
 Mr. Thomas Brown of Dublin. He died in 1852 : he left a 
 sum of money to the University of London, ' for the found- 
 ing, establishing, and upholding an Institution for investigat- 
 ing, studying, and, without charge beyond immediate
 
 FROM 1881 TO 1884 51 
 
 expenses, endeavouring to cure maladies, distemf)ers, and 
 injuries, any quadrupeds or birds useful to man may be 
 found subject to.' The Institution was to be within a mile 
 of either Westminster, Southwark, or Dublin : and the 
 University of London was empowered to appoint a Com- 
 mittee ' to control the number and cases of diseased or in- 
 jured animals to be taken charge of, and to decide about the 
 purchase of diseased or injured animals or their carcases for 
 the promotion of science, as well as for to determine about 
 any contingency not hereinbefore provided for relative to 
 the said Animal Sanatory Institution.' The site for the 
 Institution, 149 Wandsworth Road, S.W., was purchased 
 by means of gifts of £2000 from Mr. John Cunhffe and £700 
 from Professor Burdon Sanderson. The Institution was 
 not estabUshed till 1871. The value of the legacy was by 
 that time about £33,000. 
 
 By 1871, the study of pathology was very different from 
 what it had been in 1852. The University therefore 
 established the Institution not only as a veterinary hospital 
 for the study and treatment of the diseases and injuries of 
 animals, but also as a centre for advanced physiological and 
 pathological research. They appointed Burdon Sanderson 
 to be its first Professor-Superintendent. After him came 
 Greenfield, Roy, Horsley, Sherrington, Rose Bradford, and 
 Brodic. The present Superintendent is Mr. Twort ; whose 
 work on Johne's disease of cattle is well known to all patho- 
 logists. These, all of them, arc the names of men of science, 
 who would regard human pathology and animal pathology 
 as one and indivisible, and would make use of the experi- 
 mental method. The hospital department of the Institution 
 was not in any way interfered with or neglected : it was 
 thoroughly elficient, and more than 200,000 animals have by 
 this time been treated as ' in-patients ' or as ' out-patients ' ; 
 but the research department was far beyond the range of 
 veterinary practice, and wiis concerned with the most 
 advanced study of problems of general physiology and 
 pathology. To be working at the Brown Institution was 
 of itself a notable privilege. There was no Lister Institute : 
 and the science departments of the Medical Schools were
 
 52 SIR VICTOR MORSLEY 
 
 planned not for research but for elementary teaching. The 
 Brown Institution, small and out of the way though it was, 
 had great influence and authority. Special investigations 
 were made there (or the Local Government Board, the 
 London County Council, the Army Veterinary Department, 
 the Royal Agricultural Society, the Grocers' Company, and 
 the Royal Society. 
 
 Thus it gave Horsley just what he wanted ; not only a 
 lal)oratory of his own, but a little Academy of his own. It 
 put him at the head of a group of diligent young men, each 
 working independently, but all willing to take a suggestion 
 from him. Besides, it made him thoroughly famihar with 
 the diseases of animals. And it brought him into touch, 
 here and there, wuth public affairs. 
 
 But the Institution in later years lost ground, and now 
 is almost forgotten. It never was large enough, nor central 
 enough, to capture the attention of London ; the forces of 
 anti-vivisection were brought against it ; and it was never 
 free from poverty. Again and again, in his annual reports, 
 Horsley complains of the want of money for its proper 
 maintenance : in the 1887 report, for example, he writes 
 as follows of the want of proper arrangements for the 
 hospital department : 
 
 It will be seen that the gravest operations are attended 
 with a most regrettably high mortality. I have elsewhere 
 dwelt strongly upon tlie popular delusion that the wounds 
 and surgical treatment generally of the lower animals require 
 less care and attention than those of man. In fact, to ensure 
 the healing of wounds without suppuration and inflamma- 
 tion it is necessary to adopt, as far as possible, the most 
 rigid antiseptic precautions. I have been always very anxious 
 that this fact should find practical expression in the work 
 of our Institution. It has been perfectly possible to carry 
 this out in the laboratory work, the value of which, in many 
 cases, is entirely dependent upon its achievement ; but I 
 regret to say that it is impossible in the present state of the 
 Hospital to attempt it in the hope of success. For we have 
 no room or ward which we can set apart for operations, we 
 have no operating tables, we have none save impromptu 
 means for deaUng with post-operation surgical emergencies. 
 All these, the essentials of success in modern surgery, would 
 of course be at our disposal, if the pubUc gave to us those
 
 FROM t88t to 1884 53 
 
 funds which are collected by so-called ' Anti-vivisectionists,' 
 and spent in wanton and mendacious abuse of the Institu- 
 tion and its work. 
 
 Later, came the beginning of things as they are now : more 
 advantages for research at the Universities and Medical 
 Schools ; the establishment of the laboratories of the Royal 
 Colleges of Physicians and of Surgeons ; and the founding 
 of the Lister Institute. It was impossible for the httle house 
 and sheds in the Wandsworth Road to hold out against these 
 odds. Last of all came the War. To see the Brown Insti- 
 tution now, is to wish that the University of London would 
 either make an end of it altogether, or keep it, after the War, 
 as nothing more than a veterinary hospital. The pursuit 
 of physiology and pathology has been attracted away from 
 it, and will never come back. In Horsley's time there was 
 a company of men working there: now, the Superintendent 
 is aU alone : even the hospital department is at vanishing 
 point. After all, there is nothing to be mourning over. The 
 Institution did good service for many years ; it set the 
 standard of research work, and it has only given place to 
 larger and wealthier institutions. 
 
 For his own share of the work, Horsley followed three 
 main hnes of research. He studied (i) The localisation of 
 function in the brain, and the pathology of epilepsy and of 
 canine chorea. (2) The thyroid gland ; with special refer- 
 ence to myxoedema and cretinism. (3) The protective 
 treatment against rabies (hydrophobia). His work on the 
 thyroid gland, and on rabies, was all, or nearly all of it, at 
 the Institution ; and was done as it were single-handed. 
 His work on the localisation of function in the brain was in 
 part at the Institution, in part elsewhere ; and was done in 
 co-operation with other men. 
 
 What he did for the cure of myxoedema, and what he did 
 for the stamping-out of rabies, come first to be described ; 
 for they can be isolated from the record of his work for 
 surgery. What he did for the localisation of function in 
 the brain cannot be thus isolated ; it is therefore put last, 
 so that the record of his work for surgery may be taken up 
 immediately after it.
 
 V 
 
 The Cure of Myxcedema 
 
 I 
 
 On October 24, 1873, at a meeting of the Clinical Society 
 of London, Sir William Gull read a paper ' On a cretinoid 
 state supervening in adult life in women.' This famous little 
 paper, the first description of myxcedema, is only five pages 
 long, and is concerned with five cases, which he had observed 
 in his private practice. Two of them he described minutely : 
 the other three he had seen, but had not closely studied. 
 All these five patients were women. He was careful not to 
 assert that the condition was peculiar to women : but the title 
 of his paper gave a bias in that direction. In his description 
 of the likeness of these cases — when the condition is far 
 advanced — to cases of cretinism, he referred to the papers by 
 Curling and by Hilton Fagge on sporadic cretinism, i.e. 
 cretinism as it occurs in this country, a case here and a case 
 there. Curling and Fagge had noted that in cases of sporadic 
 cretinism which they had studied the thyroid gland was 
 ' atrophied,' or was even ' absent.' In Gull's ceises, it was 
 certainly not enlarged ; but he could not be sure of more 
 than that. He described his cases admirably: but the con- 
 dition was new to him, and he did not attempt to explain it : 
 
 It will be noticed that I have designated this state cretinoid. 
 My remarks arc rather tentative than dogmatical, my hope 
 being that once the attention of the profession is called to 
 these cases, our clinical knowledge of tliem will in proportion 
 improve. That tlie state is a substantive and definite one, 
 no one will doubt wiio has had fair opportunity of obser/ing 
 it. And that it is allied to the cretin state would appear 
 from the form of the features, the changes in the lips and 
 tongue, the character of the hands, the alteration in the
 
 9 H 
 
 o = 
 
 X t 
 2^
 
 THE CURE OF MYXCEDEMA 55 
 
 conditions of locomotion, and the peculiarities, though slight, 
 of the mental state ; for, although the mind may be clear 
 and the intellect unimpaired, the temper is changed. 
 
 Four years later, on October 23, 1877, at a meeting of the 
 Royal Medical and Chirurgical Society, Dr. Ord's paper was 
 read, ' On Myxcedema : a term proposed to be applied to an 
 essential condition in the " cretinoid " affection occasionally 
 observed in middle-aged women.' Like Gull, he had seen five 
 cases : all of them women : it is possible that one or even two 
 of them were the same that Gull had seen. Two of them had 
 been under Ord's observation up to the time of death ; and, 
 in one of these, leave had been granted for a post-fnortem 
 examination. He thus proved that the thickening of the 
 subcutaneous tissue, and of other connective tissues, was 
 due not to any sort of ' dropsy,' but to the excessive forma- 
 tion of a gelatinous or mucinoid substance. He therefore 
 gave to the disease its name, myxcedema, i.e. swelling due 
 to mucin. He noted that the thyroid gland was markedly 
 diminished in all his cases ; indeed, in the case examined 
 post mortem, it was * practically annihilated ' : but he took 
 this to be merely the result of shrinkage, due to compression 
 of the gland by excess of mucinoid substance in the inter- 
 stices of its connective tissue. He referred, of course, to 
 Curling, Fagge, and Gull ; but the real value of his paper 
 was not in its theorising, but in its exact evidence as to the 
 microscopical and chemical changes in the connective 
 tissues. 
 
 During the next few years, cases of myxcedema were 
 observed and published, by Charcot and others : and its 
 occurrence in men came to be recognised. 
 
 Up to 1882, all that was known about the thyroid gland 
 more hindered than helped the study of the disease. Cre- 
 tinism was associated, in some cases, with diminution of the 
 thyroid gland : in others, with that huge enlargement of the 
 thyroid gland which is called goitre : in others, the gland was 
 neither notably diminished nor notably enlarged. Endemic 
 cretinism, i.e. cretinism permanently settled among a people 
 — as in some parts of SwitzerL-md — certainly had some 
 association with goitre ; not all Swiss cretins were goitrous.
 
 56 SIR VICTOR HORSLEY 
 
 but many were : some more, some less. On the other hand, 
 sporadic cretinism did not seem to be in any way associated 
 with goitre : indeed, Curhng long ago had emphasised the 
 fact that in his cases of sporadic cretinism the thyroid 
 gland was atrophied, if not ' absent ' : and Fagge had even 
 gone so far as to suggest that the atrophy of the gland might 
 be the cause, or one cause, of sporadic cretinism, and that 
 goitre might be, on the whole, more antagonistic than favour- 
 able to endemic cretinism. In myxoedema the gland was 
 ' diminished ' ; but that might be a result of the disease. 
 Besides, the gland can only just be felt in the neck. Let the 
 reader try to feel his or her own : it cannot be accurately 
 measured : it can only just be felt. 
 
 The problem was insoluble, for this reason, that nobody 
 knew what the thyroid gland was for. Men hesitated even 
 to call it a gland : they called it the thyroid body. It had 
 no duct : it made no visible contribution to the maintenance 
 of the general health. Its anatomical relations, blood supply, 
 and microscopic structure, had been studied to a finish. 
 Every medical student knew that its acini, its ultimate sub- 
 divisions, were lined with glandular epithelium, and con- 
 tained a colloid or mucinoid substance : its lymphatic spaces 
 also contained this substance. There were networks of 
 capillary blood-vessels round the acini ; and the look of a 
 microscope-section of the gland suggested that the contents 
 of the acini were obtained from the blood by the epithehum 
 lining the acini, and were re-absorbed into the blood through 
 the lymphatic spaces. But the actual work and office of the 
 gland, its administrative purpose in the economy of the body, 
 were unknown, even to that great master of physiology, 
 Claude Bernard : who writes in his Physiologic Op^ratoire 
 — the 1879 edition, pubhshed in the year after his death : 
 
 The descriptive anatomy, and the microscopical character 
 of the thyroid gland, the facts about its bloodvessels and its 
 lymphatics — are not these as well known in the thyroid gland 
 as in other organs ? Is not this true also of the thymus 
 gland, and the suprarenal capsules ? Yet we know absolutely 
 nothing about the functions of these organs : we have not 
 so much as an idea of what use and importance they may 
 possess: because experiments have told us nothing about
 
 THE CURE OF MYXCEDEMA 57 
 
 them : and anatomy, left to itself, is absolutely silent on the 
 subject. 
 
 In 1882-83, the problem was brought nearer to solution by 
 a set of facts as unexpected as they were unwelcome. It 
 was found that many experiments had indeed been recently 
 made on the thyroid gland ; but they had been made not on 
 animals but on man. The antiseptic method had so advanced 
 surgery that some of the Swiss surgeons had been dealing 
 with goitre by the removal of it en masse. Some of these 
 patients, at various intervals after the operation, had shown 
 signs resembling those which had been observed, in England, 
 in cases of myxoedema 
 
 The earliest description of these Swiss cases was given by 
 Professor Reverdin, of Geneva, on September 13, 1882, at 
 a meeting of the Geneva Medical Society. He and Professor 
 Kocher, of Berne, a few days before, had been talking over 
 these ' accidents g^n^raux tardifs,' as Reverdin called them ; 
 but had come to no conclusion about them : indeed Reverdin, 
 at this time, had only had one case under his own observa- 
 tion. He was of opinion, in September 1882, that the 
 condition might be due either to the loss of some ' blood- 
 making function ' of the gland, or to some injury done by 
 the operation to the nerves in the neighbourhood of the 
 gland. A short note on this meeting of the Geneva Medical 
 Society was published in the Revue de la Suisse Romande. 
 
 On April 4, 1883, at the Twelfth Congress of the German 
 Surgical Association, Kocher gave an address ' On the 
 extirpation of goitre, and its consequences.' It was pub- 
 lished in Langenbeck's Archiv. He suggested, for these 
 cases, the name ' cachexia strumipriva,' i.e. ill-health from 
 loss of the thyroid gland. Like Reverdin, he did not see 
 their full significance : he was inclined, on the whole, to 
 think that the operation had somehow affected the trachea, 
 and thus had interfered with the free exchange of the air 
 in the lungs and impaired the nutrition of the tissues. 
 
 During April- June 1883, Professor Reverdin and Auguste 
 Reverdin published in the Rovue de la Suisse Romande their 
 ' Note sur vingt-deux opcTations de goitre." They had by 
 this time learned of the English cases of myxoedema, from
 
 58 SIR VICTOR HORSLEY 
 
 one of Dr. W. B. Hadden's writings. They now recognised 
 the more than likeness, the ' rapprochement complet,' 
 between the EngUsh cases of myxoedema and their own cases 
 of ' myxced^me operatoire ' ; and they were convinced that 
 the sohition of the problem Wcis to be found in the thyroid 
 gland, and nowhere else. But they were inclined to think 
 that ' myxoed^me operatoire ' was due rather to the loss of 
 the gland's nerve-influences than to the loss of its chemical 
 influences : 
 
 Si nous tenons compte de ces fails, de I'existence ^vidente 
 de troubles vaso-moteurs dans nos cas, comme dans ceux 
 dc myxoedeme, nous sommes amends k faire jouer un r61e 
 preponderant aux alterations nerveuses dans la pathogenie 
 de ces accidents, et k en placer le point de depart dans les 
 parties nerveuses de la thyroide. 
 
 On November 23, 1883, at a meeting of the Clinical Society 
 of London, there was a discussion over a case of myxoedema 
 shown by Dr. Drewitt ; and Sir Felix Semon called attention 
 to Kocher's observations, and said positively that cretinism, 
 myxoedema, and cachexia strumipriva, were closely aUied 
 conditions, having in common either absence or probably 
 complete degeneration of the thyroid gland ; and that they 
 could hardly be attributed to any other cause. On December 
 14, the Clinical Society appointed a Committee to mvesti- 
 gate the whole subject. Ord was Chairman, Hadden was 
 Hon. Secretary, and Horsley was a member of the Committee. 
 
 It was of necessity, that the investigation should include 
 the experimental study of the healthy gland in healthy 
 animals. Nothing more was to be gained by theorising over 
 cases. The Committee had the evidence of cachexia 
 strumipriva to guide them ; but they could not found any 
 exact knowledge of the healthy gland on this half-knowledge 
 of the grossly diseased gland. Some cretins were goitrous : 
 some were not. Some operations for the removal of goitre 
 had been followed by cachexia strumipriva : some had not. 
 Goitre was a great mass of ill-formed connective tissue, 
 with remnants of thyroid gland surviving here and there in 
 it : the working power of the gland was more or less de- 
 stroyed : but nobody knew what that working power was.
 
 THE CURE OF MYXOEDEMA 59 
 
 Till they knew what the healthy gland was actually doing, 
 what it really was for, the Committee might investigate any 
 number of cases without being much the wiser. Anatomy, 
 and the microscope, had told them nothing, or next to 
 nothing. Clinical observation, and post-ttioriem observation, 
 and the facts of cachexia strumipriva, had given them, after 
 ten years, a good working theory. In the light of that 
 theory, slowly attained at the expense of mankind, they 
 must begin at the beginning, with the healthy gland ; and 
 the pity is, that they did not begin sooner. Now, in 1883-84, 
 at last, recognising ' the hitherto undreamt-of importance of 
 the thyroid gland,' they asked Horsley to study it by the 
 experimental method. They needed a physiologist, and a 
 surgeon : and they had them in him. 
 
 II 
 
 He began this work in the autumn of 1884, in Professor 
 Schafer's laboratory : and he continued it at the Brown 
 Institution. He writes to Professor Schafer of his first 
 experiments : in these, he had the help of another member 
 of the Committee, Mr. (Sir Rickman) Godlee. The letter is 
 undated : a very rare omission with him : it must have 
 been written about October 1884 : 
 
 I have started some experiments with Godlee on the 
 thyroid body. Schiff published some papers lately on the 
 removal of the said organ in dogs and rodents, etc., finding 
 that the animals all died and usually with nerve symptoms 
 such as tremors, etc. Well, we did four monkeys last week, 
 and one of them has the said tremors very badly. I have 
 taken a tracing, it looks just like ankle-clonus. . . . 
 
 In December, at the University of London, he gave two 
 lectures, ' The Thyroid Gland : its relation to the pathology 
 of myxoedema and cretinism, to the question of the surgical 
 treatment of goitre, and to the general nutrition of the 
 body.' There is something characteristic of him in this 
 comprehensive title. Up to 1884, there had not been, in 
 any country, much study of the thyroid gland by the ex- 
 perimental method ; and, in our coimtry, there had been 
 next to none. The few experiments which had been made
 
 6o SIR VICTOR HORSLEY 
 
 over here had been valueless ; partly for want of the anti- 
 septic method, partly because the men who made them 
 had not known what to look for : they had not solved 
 any problem, because no problem had been set to them. 
 Myxoedema set the problem : later, cachexia strumipriva 
 set it in more definite terms. And Horsley, so far as this 
 country is concerned, did more than any man to solve it. 
 
 His decision, at the very beginning of his work, to make 
 use of monkeys, is a good example of the value of the 
 imagination in science. Not that his experiments on dogs 
 and cats were in any way contradictory to his experiments 
 on monkeys. He got positive and final evidence, alike in 
 camivora and in monkeys, that cachexia strumipriva was 
 due neither to an}^ sort of interference with the aeration of 
 the blood, nor to any sort of injury to the adjacent nerves, 
 but to loss of the thyroid gland, and to that alone. But 
 there were well-marked differences, in the incidence and 
 intensity of the results of complete removal of the gland, 
 between the animals less like man and the animals most 
 like man. In the dog, the results came rapidly, and were 
 soon fatal : in the monkey, they showed themselves more 
 gradually, and made a more complete picture. If the 
 phrase may be pardoned, he produced in dogs a condition 
 which men of science could accept as evidence : but he 
 produced in monkeys a condition which the man in the 
 street could accept as evidence. 
 
 And though he was unwilling, at this stage of his work, to 
 deny point-blank the possibihty that the results of the re- 
 moval of the gland might come, not directly from the loss of 
 its chemical influences, but indirectly from the loss of its 
 influences over the vaso-motor and trophic nerves, yet he 
 was already beginning to see the whole thing as a chemical 
 process. ' The question arises,' he says, ' whether we have 
 not to do with the simple case of total removal of an excretory 
 organ, with the usual result of death.' 
 
 His description of the monkeys must be given in his own 
 words : 
 
 The phenomena which follow thyroidectomy in monkeys 
 ^re very striking, and may be sunimarised as follows. At
 
 THE CURE OF MYXCEDEMA 6i 
 
 a variable period after the operation, but averaging about 
 five days, tlie animal is found to have lost its appetite for 
 a day or two, and, on closer examination, to exhibit slight 
 constant fibrillar tremor in the muscles, of the face and hands 
 and feet more especially. These tremors disappear at once 
 on voluntary effort. At the same time, the animal is noticed 
 to be growing pale and thin, in spite of the appetite returning 
 quickly with great increase ; rapidly the tremors increase, 
 affect all the muscles of the body without exception ; the 
 animal becomes languid, paretic in its movements, and 
 imbecile. Then puffiness of the eyelids and swelling of the 
 abdomen follow, with increasing hebetude. During these 
 last stages, the temperature, gradually falling, becomes 
 subnormal ; and then tiie tremors gradually disappear as 
 they came. Meanwhile, the pallor of the skin often becomes 
 intense ; and, leucocytosis having been well marked, ohgaemia 
 follows, and the animal dies perfectly comatose in a variable 
 period, but usually about five or seven weeks after the 
 operation. 
 
 In these lectures — which he illustrated with photographs, 
 pulse - tracings, etc. — he compared, point by point, the 
 symptoms produced in animals with the symptoms of cretin- 
 ism, myxcedema, and cachexia strumipriva in man. He 
 emphasised the importance of the chemical analyses made 
 by Professor HaUiburton. The monkeys showed not only 
 a great increase of mucin in the connective tissues, and a 
 trace of mucin in the blood, but a very great increase of 
 mucin in the saliva. There was also marked enlargement 
 of the parotid salivary glands. 
 
 He referred, in these lectures, to the work that was being 
 done in Switzerland, Austria, and Italy ; especially to Schiff 's 
 papers, published in the Revue de la Suisse Romande, Feb- 
 ruary and August 1884. But he did not refer to the one 
 set of Schiff 's experiments which was far and away the most 
 important of all. He had not verified them for himself ; 
 he could hardly take it for granted that they were authori- 
 tative ; and he w^as working on his own lines. Schiff had 
 found that an animal could be safeguarded against some ol 
 the consequences of thyroidectomy, by transplantation of a 
 thyroid gland from another animal of the same species. The 
 engrafted gland compensated the animal, more or less, for 
 the loss of its own gland :
 
 62 SIR VICTOR HORSLEY 
 
 La thyroidectomie perd ses dangers et une partie essentielle 
 de ses eifets si Ton a introduit et &xe d'abord dans la cavite 
 abdominale d'autres corps thyroldes de la merae espece 
 animale. 
 
 Then comes a sentence which is even more remarkable : 
 ' It would be interesting to know whether an emulsion of 
 thyroid gland would not have an analogous effect ' : 
 
 II serait int^ressant de savoir si des glandes thyroides 
 broy^es ou ecrasees, introduites dans une cavite du corps ou 
 sous forme de clystere par Ic rectum, n'auraient pas un effet 
 analogue. Les conditions de notre laboratoire ne nous ont 
 pas pcrmis de faire ccs experiences, qui pourraient offrir un 
 interet pratique. On devrait d'abord examiner si les thyroides 
 de nos ruminants ont sur le chien le meme effet que les 
 thyroides canines. 
 
 Here, in print, in 1884, was a clear indication of the way to 
 cure myxoedema : and it is hard to miderstand why Horsley 
 did not immediately follow it up for all it was worth. 
 
 In 1885, he extended and confirmed his work of the pre- 
 vious year : he made two experiments on sheep, and one on 
 a donkey : but especially, this year, he studied the effects of 
 removal of the gland, in relation (i) to the age of the animal, 
 (2) to the temperature in which the animal was kept after 
 the operation. On these two very important subjects he 
 writes as follows, in his Report for 1885 to the Committee 
 of the Brown Institution : 
 
 (i) The effect of removing the gland in the young animal 
 is the rapid appearance of violent nerve symptoms, and death 
 in a few days ; in a rather older animal, i.e. a one-year-old 
 dog, the symptoms are less violent, later in their appearance, 
 and the animal survives perhaps for a fortnight or three 
 weeks ; in a very old animal the removal of the gland simply 
 hastens the torpor of old age ; these observations refer to 
 dogs and cats. In the higher animals, monkeys, the opera- 
 tion on a young individual produces the same result as in a 
 young dog ; but, as I showed last year, an older animal, if 
 kept under ordinary circumstances, will survive for six or 
 seven weeks, dying at the end of that time of myxoedema. 
 ... I desire here to draw special attention to the fact that 
 the symptoms of old age, namely, wasting of the actively 
 functional parenchymatous tissues, atropliy, and falling out 
 of the hair, decay of the teeth, dryness and harshness of the 
 skin, tremors, etc., are exactly the most prominent features
 
 THE CURE OF MYXCEDEMA 63 
 
 of the myxoederaatous state, whether it occurs naturally in 
 the human being, prematurely as in cretinism, or artificially 
 as in my experiments on monkeys. 
 
 (2) I have kept another series of animals, on whom I have 
 performed thyroidectomy, at a constant temperature of 
 90° F., and when they exhibited any nerve-symptoms, 
 i.e. tremors, etc., placed them in a hot-air bath at a tempera- 
 ture of 105° F. The effect of this has been to lengthen the 
 duration of life (in all but very young animals) to four or 
 five times the extent of that observed in the first series. 
 Instead of living four to seven weeks they now live as many 
 months. These observations refer solely to monkeys. The 
 animals pass through three stages : (i) neurotic, (2) mucinoid. 
 (3) atrophic. The neurotic stage may be scarcely marked : 
 or, if the nerve-symptoms occur, and the animal be put in 
 the hot-air bath, they soon disappear. Next, the animal 
 lives through the mucinoid stage, i.e. myxcedematous con- 
 dition ; and arrives in the third stage, the atrophic. The 
 symptoms of the second stage are just as much subdued as 
 those of the first : there is no excessive secretion of mucus, 
 the parotid glands do not swell, and the post-mortem examina- 
 tion does not reveal the extensive mucinoid degeneration 
 observed in the first series. Finally, the third, atrophic, 
 stage into which the animal passes is evidenced by great 
 emaciation, functional paresis and paralysis, imbecihty, 
 falling blood-pressure and temperature, with death by coma. 
 
 I am disposed to regard this fact of the animals passing 
 these neurotic, mucinoid stages, and dying at the end of the 
 atrophic, as the key to the observation that cretins in whom 
 the thyroid gland is very slowly destroyed, and very chronic 
 cases of myxoedema, do not exhibit much mucinoid 
 degeneration. 
 
 In 1886, he examined, and disproved, two theories — one 
 old, one new — of the thyroid gland : (i) That its right and left 
 lobes were somehow related to the circulation through the 
 right and left hemispheres of the brain. (2) That its activity 
 was regulated by the recurrent laryngeal nerve. After 1886, 
 he began to be more occupied with otiier studies, and less 
 with the experimental study of the thyroid gland. 
 
 In 1888, the Investigation Committee of th(> Clinical 
 Society publislK.'d their long-exix^cted Re|>ort on Myxoedema. 
 It is 215 pages long : it includes reports from Halliburton. 
 Horsley, Semon, and Ord ; and it gives tables of 109 ca.ses. 
 each case divided under no less than eighty-eight headings. 
 There could hardly be a better example of thoroughness ; and
 
 64 SIR VICTOR HORSLEY 
 
 it was everywhere accepted as of authority. Its conclusions 
 were — That the one condition common to all cases of myxoe- 
 dema was destructive change of the thyroid gland. That 
 the apparent immunity of some patients from cachexia 
 strumipriva, after removal of goitre, might be explained 
 either by the presence of accessory thyroid-tissue, or by 
 accidentally incomplete removal, or by insufficiently long 
 observation of this or that case. That myxoedema was 
 ' practically the same disease ' as sporadic cretinism, was 
 ' probably identical with ' cachexia strumipriva, and was in 
 ' very close affinity ' with endemic cretinism. 
 
 But the Report contained not a word of hope of any cure 
 of the disease. It gave to treatment, out of 215 pages, 
 one. A warm room, a warm climate, tonics, drugs to make 
 the skin act, and nitro-glycerin to make everything else act 
 — and there the hst ends, and might as well not have begun. 
 It recalls Dr. Scarbrugh's phrase for the eleven physicians 
 round the deathbed of King Charles the Second — toins medi- 
 corum chorus ab otnni spe dcstihUus. 
 
 Ill 
 
 Finally, on February 8, 1890, Horsley published in the 
 British Medical Journal his ' Note on a possible means of 
 arresting the progress of myxoedema, cachexia strumipriva, 
 and alHed diseases.' He harks back to Schiff's transplanta- 
 tion experiments, and to similar experiments by von 
 Eisselsberg : 
 
 It seems to me that these observations, of Professor Schiff 
 and of Dr. von Eisselsberg, are of especial value, as they 
 suggest to my mind that possibly myxoedema, etc., may be 
 treated with success by transplanting thyroid tissue into the 
 patient. ... I would propose, therefore, when opportunity 
 offers, to try transplanting a portion of the thyroid gland 
 from a sheep. 
 
 He learned afterwards that Dr. Bircher of Aarau, on 
 January 16, 1889, had practised this method in one case, 
 and that Kocher also had practised it, in one case, in 1883, 
 without success, and in a few cases, in 1889, with one success. 
 
 Here at last was the specific treatment of myxoedema.
 
 THE CURE OF MYXCEDEMA 65 
 
 Not that the transplantation treatment was perfect : for in 
 some cases the transplanted tissue gradually became ab- 
 sorbed, and thus ceased to be efficient. But here was the 
 first rational way of dealing with the disease : and, for certain 
 cases, Horsley was still in favour of it, so late as iqi2. 
 
 Last of all, in July 1891, at the Bournemouth meeting of 
 the British Medical Association, Dr. George ^lurray of New- 
 castle, now Professor of Medicine in the University of Man- 
 chester, read his paper, ' On the treatment of myxoedema by 
 hypodermic injection of an extract of the thyroid gland of a 
 sheep.' He refers to a very successful case of transplanta- 
 tion, published by Bettencourt and Serrano, of Lisbon : 
 then he says : 
 
 It seems reasonable to suppose that the same amount of 
 improvement might be obtained by simply injecting the 
 juice or an extract of the thyroid gland of a sheep beneath 
 the skin of the patient. 
 
 If we consider that myxoedema and cachexia strumipriva 
 are due to the absence from the body of some substance 
 which is present in the normal thyroid gland, and which is 
 necessary to maintain the body in health, it is at least rational 
 treatment to supply that deficiency as far as possible by 
 injecting the extract of a healthy gland. G. Vessale has 
 made intravenous injections of an extract of the thyroid 
 gland in dogs after thyroidectomy with beneficial results. 
 As far as I am aware, this means of treatment has not before 
 been tried in the human subject. Since suggesting this 
 treatment at the February meeting of the Northumberland 
 and Durham Medical Society, I have been able to carry it 
 out in a well-marked case of myxoedema. Such decided 
 improvement has resulted that the details of the method of 
 treatment employed and the results obtained are worth 
 recording. 
 
 He and Horsley had of course been in correspondence 
 over this plan of treatment : there are two letters from 
 Horsley to him : ^ 
 
 Dec. 3, 1890. The only experiments I know of on injec- 
 tions of the gland have only j)roduccd slight results, similar 
 
 * Professor Murray has written : ' I first met Horsley when I was a 
 student and house physician at University College Hospital, from 1886 
 to 1889. I attended his course of practical pathology, and his outpatient 
 practice. He gave me some very Jiscful introductions when I went to 
 BerUn in 1889. Our friendship really began after I had settled in New- 
 castle in 1890. Ever since then, our friendship has continued, and bo 
 
 E
 
 66 SIR VICTOR IIORSLEY 
 
 90 far as I could see to what might have been caused by 
 injections from any other tissue. However, it cannot do any 
 harm, and I think it would be worth trying, as it is possible 
 from Schiff's results of imperfect transplantation that an 
 emulsion of the gland might possess some of its active 
 properties. 
 
 June 22, 1891. I am ashamed to have kept you so long, 
 but I wanted to re-verify one reference, and I have been 
 absolutely unable, principally in consequence of inauguration 
 of a family, to visit the Hbrary before to-day. I am very 
 glad to say that the reference only contains a suggestion, not 
 the actual practice. In that, you have only been forestalled 
 experimentally. Thus, Vessale (Centralblatt fiir Medicinische 
 Wissenschaften, 1891, p. 14) injected the expressed juice of 
 the thyroid into dogs in which thyroidectomy had previously 
 been performed, and he found that the cachectic symptoms 
 did not occur or, if they did, were considerably modified. 
 The clinical reference is as follows — Bettencourt and Serrano 
 (Progres Medical, 1890, vol. xii. p. 170). These authors, 
 who had adopted the suggestion of grafting the thyroid, 
 suggest that the benefits obtained therefrom are due to 
 absorption of material from the gland, and the same idea 
 had occurred to Schiff and others. Hoping this is not too 
 late for your wants, and that you will publish at once, — I 
 am yours very sincerely. 
 
 Murray's paper was published in the British Medical 
 Journal, October 10, 1891 ; with a note by Mr. E. H. 
 Fenwick on a similar case. 
 
 Early in 1892, Horsley published his ' Remarks on the 
 Function of the Thyroid Gland : a critical and historical 
 review.' (Brit. Med. Journ., January 30 and February 6, 
 1892.) He had already published this review, in German, 
 in Virchow's Festschrift, 1891. 
 
 There was still one great improvement to be made in the 
 treatment of the disease : it came in October 1892, when 
 Dr. Hector Mackenzie published his paper, ' A case of 
 myxoedema treated with great benefit by feeding with fresh 
 thyroid glands,' and Dr. E. L. Fox of Plymouth published 
 his paper, ' A case of myxoedema treated by taking extract 
 
 always gave me the greatest help and encouragement. I spent many 
 happy holidays with liim, as we both were very fond of shooting. He 
 was a most chaiminp host, and the life and soul of the party. He was one 
 of the most unselfisli men I ever met, in both scientific and social questions : 
 and was certainly the greatest member of our profession in liis generation. 
 By his death I have lost one of my kindest and best friends.*
 
 THE CURE OF MYXCEDEMA 67 
 
 of thyroid by the mouth.' This method had also been used 
 by Dr. Howitz of Copenhagen : but Hector Mackenzie and 
 Fox discovered it independently of him. Their papers were 
 published in the British Medical Journal, October 29, 1892. 
 During the next few months, little culinary devices were 
 invented to make the dose palatable, till the manufacturing 
 chemists were able to supply the preparations of thyroid 
 gland which are now in use. With these, men and women 
 whose thyroids fail them can take care of themselves : they 
 can treat themselves when they feel the need of it ; they 
 can free themselves from myxoedema to the end of their 
 lives. 
 
 During 1893, many cases were put on record ; many 
 patients were shown at medical meetings ; the efficacy of 
 the new drug was proved over and over again. One of the 
 more notable cases, in 1893, was a case of sporadic cretinism, 
 treated by transplantation, by Dr. Lockhart Gibson of 
 Brisbane. 
 
 It is twenty years from 1873 to 1893 : from Gull's observa- 
 tion of ' a cretinoid state supervening in adult hfe in women,' 
 to the general recognition of the cure of myxoedema. The 
 discovery came not from one line of study but from many. 
 Horsley does not stand alone. But it was he who founded 
 in this country the modem study of the thyroid gland : and 
 it was he who first, in this country, suggested the rational 
 method of treatment. Those of his profession who re- 
 member the years of ignorance, and the wonder and the 
 delight of the new learning, are not likely to forget what he 
 did in 1884-86 for science, and in 1890 for practice.
 
 VI 
 
 The Prevention of Rabies 
 
 His work for the prevention of rabies (hydrophobia) was 
 ended and put away when the disease, by the enforcement 
 of muzzling and by quarantine of dogs, was stamped out 
 from this country. Up to that time, he was Pasteur's 
 chief representative and interpreter over here. He, more 
 than anybody, explained Pasteur's method to the British 
 public. It was a position of remarkable authority for him, 
 and him so young, to be the one man in the kingdom able 
 to say, by the employment of Pasteur's test, whether a dog. 
 killed on suspicion of rabies, had or had not been suffering 
 from the disease. Nor did his work stop there : for he also 
 saw many cases of the disease in man and animals, studied 
 its incidence, examined and exposed a much-advertised 
 ' cure,' and fought, in the press and on the platform, and by 
 all ways of influence open to him, till there was nothing left 
 to fight for. 
 
 The story of Pasteur's discovery of the anti-rabic treat- 
 ment has been told many times, and I need not tell it here. 
 I remember him dining with my father, Sir James Paget, on 
 April 21, 1884 : Professor Tyndall, Lord Reay, Lord 
 Avebury, and Sir Andrew Clark were of the party, and over 
 the dessert Pasteur described the results which he had 
 already obtained from the experimental study of the 
 disease ; speaking very slowly and very gravely, that no 
 point should be missed. Horsley was not there, more 's the 
 pity : of all the younger men, he was the one whose work 
 my father most admired, saying of some of it that it marked 
 an epoch in the history of medicine : but I remember him 
 dining at my father's house in 1887 : of course, he took 
 neither wine, nor a cigarette after dinner, and my father 
 looked across the table at him, with affection just touched 
 
 68
 
 THE PREVENTION OF RABIES 69 
 
 with resentment of the unusual, and said, ' Haven't you 
 one vice ? ' Horsley laughed and blushed, and said, ' I 'm 
 afraid I 've got a great many. Sir James.' 
 
 THE COMMISSION OF ENQUIRY INTO PASTEUR S METHOD 
 
 It was on July 6, 1885, that Pasteur, having proved, by 
 a very long series of experiments and control-experiments, 
 that he could immunise dogs against rabies, not only before 
 infection, but during the latent period after infection, 
 ventured to treat his first patient. In April 1886, a Com- 
 mission was appointed over here, by the Local Government 
 Board, to enquire into Pasteur's method. The members 
 of this Commission were Sir James Paget, Chairman of 
 Committee, Sir Lauder Brunton, Dr. George Fleming, Lord 
 Lister, Sir Richard Quain, Sir Henry Roscoe, and Sir John 
 Burdon Sanderson, with Horsley as Secretary. There is a 
 letter from Sir Henry Roscoe to Sir James Paget, April 12, 
 1886: 
 
 You will see from the enclosed letters that the Committee 
 can appoint a Secretary with a remuneration of £50, and 
 also that we are to divide our enquiry into two parts : (i) As 
 to the evidence obtainable in Paris relative to Pasteur's 
 discovery ; (2) As to further investigations which we may 
 consider it necessary, in consequence of evidence obtained 
 in Paris, to make in this country. Also that we are to report 
 to the Local Government Board the results of our first 
 enquiry before entering on our second. I also enclose letter 
 from Mr. Chamberlain, in reply to a letter from me enclosing 
 your letter. From this you will perceive that aU idea of 
 appointing a person in favour with the antivivisectionists 
 has very properly been abandoned. 
 
 At the first meeting of the Committee, on April 15, it was 
 agreed ' that a letter should be written to M. Pasteur, in- 
 forming him of the appointment and purpose of the Com- 
 mission, and asking him to name a day in the next week on 
 which he could receive some of the members.' The letter 
 was written by Sir James Paget, and was taken to Paris by 
 Burdon Sanderson on April 16. Brunton, Roscoe, and 
 Horsley went to Paris a few days later. The £50 did not.
 
 70 SIR VICTOR HORSLEY 
 
 by a long wav, cover Horsley's expenses : but Sir Henry 
 Roscoe's generosity did. 
 
 Pasteur, this April, had been suffering miserable anxiety 
 over the Russian cases of wolf-bite.^ He was heavily over- 
 worked, and was beset by a host of critics, many of them 
 downright fools. All this, coming to a quick-tempered 
 man, already burdened with ill-health and with griefs of 
 his own, made him what Horsley lightly calls ' irritable ' : 
 and the visit of the Committee was not well-timed. 
 
 It is certain that they went with no sort or kind of ready- 
 made belief in the method. ' I went over,' said Brunton, 
 many years later, ' perfectly convinced that Pasteur was 
 wrong : but I came away perfectly convinced that Pasteur 
 was right.' Horsley likewise went over in doubt. No micro- 
 organism of rabies had been discovered : the method was 
 in accord with the principles of bacteriology, but did not 
 follow the usual procedure of bacteriology : but he came 
 back with perfect confidence in it. That Burdon Sanderson 
 went over in doubt, is plain from his letter, a day or two 
 after he reached Paris, to Sir James Paget : 
 
 I was present during M. Pasteur's inoculations of about 
 one hundred persons, all supposed to have been bitten by 
 rabid dogs — one by a wolf. Each of these persons received 
 half the contents of a subcutaneous syringe of sterilised 
 bouillon, in which the spinal cord of a rabbit which had died 
 of ' rabies ' was suspended. Of the thousands of persons 
 
 * ' During the early part of March, Pasteur received nineteen Russians, 
 coming from the province of Smolensk. . . . Five of these unhappy 
 wretches were in such a condition, that they had to be carried to the 
 H6tel Dieu. . . . Because of the gravity of the wounds, and to make up 
 for the time lost by the Russians before they started, Pasteur decided on 
 making two inoculations every day, one in the morning and one in the 
 evening. . . . Their condition was the more alarming, that a whole fort- 
 night had elapsed between their being bitten and the date of the first 
 inoculations. Statistics were terrifying as to the results of wolf-bites, the 
 average proportion of deaths being 82 per 100. General anxiety and 
 excitement prevailed concerning the hapless Russians, and the news of 
 the dealii uf three of them produced an intense emotion. Pasteur had 
 unceasingly continued his visits to the H6tel Dieu. He was overwhelmed 
 with grief. ... As he passed through the wards, each patient in his bed 
 inspired him with deep compassion. And that is why so many who only 
 saw him pass, heard his voice, met his pitiful eyes resting on them, have 
 preserved of him a memory such as the poor had of St. Vincent de Paul.' 
 (Vallery-Radot, Vie de Pasteur.) It is to be noted that the three who died 
 had received only the ' ordinary treatment ' : the sixteen who recovered 
 had received the ' intensive treatment.'
 
 THE PREVENTION OF RABIES 71 
 
 who have been so injected, none have experienced either local 
 or constitutional effects of any kind. I asked Pasteur after- 
 wards whether he could give us a few cases and groups of 
 cases to investigate as regards their antecedents. He agreed, 
 and has given me the addresses and photographs of eleven 
 persons in the neigiibourhood of Paris. . . . 
 
 In the afternoon I witnessed the inoculation of rabbits, 
 which is done very skilfully by M. Pasteur's laboratory 
 servant. It never happens that the rabbits get meningitis. 
 They have no symptoms whatever until the sixth day or 
 later, after which what P. calls paralysis comes on and 
 the animal dies a few days later. Such a rabbit affords a 
 material which, on the one hand, can be injected into a 
 human being, if ' prepared,' with impunity, and on the other 
 produces a specific and infallibly fatal disease in the rabbit, 
 which proves itself to be rabies by producing rabies in the dog. 
 
 This fact (if a fact) appears to me to be the nucleus which 
 includes everything. If it is true, there can be no reason 
 for doubting the evidence supphed by cases. But in case 
 it should be found not to be true, case evidence would go 
 for nothing. 
 
 On April 24, Horsley writes to Sir James Paget from the 
 Hotel Louvois : ^ 
 
 As Dr. Sanderson left for Blois on Friday night, it is just 
 possible he has not written to you as he thought of doing ; 
 I will venture, therefore, to express what he talked of saying 
 to you. 
 
 M. Pasteur expressed some chagrin that neither yourself 
 nor Sir Joseph Lister had come to see him and his work in 
 connection with the investigations of the Commission. This 
 fact would not have so much importance, were it not that 
 M. Pasteur is in a very irritable state, and we are much afraid 
 that the request which we intend to make before we leave 
 {viz. to be given a rabid spinal cord, and an inoculated rabbit) 
 
 * Mr. J. A. Fuller-Mai tland writes : ' I only met him once, but it was 
 in rather favourable circumstances, at a small bourgeois hotel in Paris, 
 the ' Lxjuvois,' which has now blossomed out into a jiretentious and rather 
 tiresome place ; where were also the Bunion Sandersons, who being con- 
 nections of mine, introduced me to Horsley. He was fearfully excited 
 about a discovery of a whole slice or section of a Roman amphitheatre in 
 the middle of a triangular block of houses out of tiie Rue Monge. Th« 
 inhabitants had comj)lacentIy looked out of their back windows uixjn 
 this archaeological treasure, and said " nothing to nobody " for years. 
 Then came a tramway company, and wanted to use the space inside tho 
 triangle for their cars, when, lo, they found this slice, all complete, from 
 the numbered scats at the top, to the wolves, " Christian," ami other Iwxcs 
 at the bottom I At least that is my impression, but I don't thiuk I ever 
 got (or ijcrhaps couldn't get) permission to see it myself.'
 
 72 SIR VICTOR HORSLEY 
 
 will be refused unless he cools down a little. He was very 
 kind on Friday — sat for i^ hours giving me cases to look 
 up, on which work I am now engaged, and, so far, have 
 had fair success. Yesterday, for instance, I investigated 
 the effects of nine different dogs. I may, perhaps, now say 
 that Sir Henry Koscoe was of the opinion that if you could 
 run over (if only for a day) it would be of the utmost service : 
 and this was the point of Dr. Sanderson's letter which he 
 proposed to write to you. Pasteur does practically nothing 
 on Sundays. 
 
 AU this week I shall be engaged in hunting up cases in the 
 immediate neighbourhood of Paris, and then on Saturday I 
 shall go to Lyons and St. Etienne, which are very striking 
 foci of the disease, and where, fortunately, I have consider- 
 able official interest which will greatly expedite my re- 
 searches. I have altogether about lOO cases to look up. 
 M. Pasteur has inoculated about 850 individuals representing, 
 I suppose, about 250 dogs, wolves, and a few cats. The 
 wolf cases, of course, are out of the question, being in Russia. 
 Unfortunately, too, the next largest focus in France is the 
 Basses Pyrenees, which is at an inconvenient distance. I 
 have hired a hght vehicle and a good horse for the day, 
 i.e. 8.30-6.30, and, so far, have found that very httle time is 
 lost. 
 
 Will you kindly tell Miss Paget that I presented her 
 affectionate compUments to Pasteur, but as one of his 
 Russian patients (bitten by a dog) was dying then, he was 
 rather irritable, and (as possibly my accents, intended to be 
 especially pohte, were, equally certainly, especially British) 
 he smiled but httle. 
 
 On April 29, he writes to Mrs. ^chafer, thanking her for 
 her congratulations on his nomination for the Royal Society ; 
 
 As it was quite understood I thought — from what my 
 counsellors told me — that I had no chance this time, it came 
 as a tremendous blessing. My one idea now is to hope that 
 the Society will duly elect me on June 4th — a dreadfully 
 long time for them to change their minds in, if so inchned. 
 Let 's hope they won't. I trust it wUl hasten matters in the 
 hymeneal direction, a road which is not very clearly marked 
 in my mental map of future events. Will you toll your 
 professorial lord that 1 shall be ready to do any number of 
 experiments on Saturday moniing, i.e. the 8th, and possibly 
 on Friday, but of that I will advise him by telegram. Fact 
 is, I run about from 5 a.m. to 6 p.m., and then all the evening 
 write reports of the notes I have made in the day. I think 
 I have never seen so much physical and moral degradation 
 in my Ufe as in the last ten days. This place Paris, which I
 
 THE PREVENTION OF RABIES 73 
 
 thought I knew pretty well, is a perfect sink hterally and 
 metaphorically.^ Please excuse my dilating further, as I 
 might, on what I have seen which is pleasing. I am very 
 sorry to ask it, but I have so much to write I am afraid of 
 going to sleep. 
 
 On May 4, he writes agam to Sir James Paget : good 
 news, this time : 
 
 You will be glad to hear that Pasteur (who, two days ago, 
 refused Dr. Sanderson what we asked for, viz. a rabbit's 
 spinal cord) offered me anything to-day. He told me (I 
 returned from Lyons this morning early, Dr. Sanderson left 
 yesterday) that he had not understood what Dr. Sanderson 
 wanted. It has occurred to me that your letter to him may 
 have arrived to-day, and that that was the cause of the 
 fortunate change. However, he certainly did not under- 
 stand what would be the feeling of criticism in England if 
 we had simply brought back two dogs inoculated with what, 
 of course, purported to be the medulla of a rabid rabbit, which 
 was what was finally decided upon (as, of course, much 
 better than nothing) by Dr. Sanderson. However, he will 
 now give two rabbits, so that I can start the experiments 
 from the Rabbit, and that will be everything. 
 
 He came back to London a day or two later, and started 
 his experiments at once. Among his papers are twenty- 
 six letters from Pasteur, between May 1886 and July 1887 : 
 and a letter from Sir James Paget, September 12, 1886, 
 from St. Sauveur, Pyrenees : 
 
 I never felt less hke the Chairman of a Committee than I 
 do now, writing in this lovely scenery, with open window 
 and doors, in a really dehcious cool air ; but I had better 
 pretend to be in my place and say that I think you have 
 done quite right with the bitten man. I only wish tliat you 
 could yourself have treated him, for one case inoculated by 
 yourself in England would liave had great persuasive power 
 with some Enghsh people. 
 
 And there arc three letters from Pasteur to Sir James 
 Paget, between May and August 1886. The first of them 
 is to decline an invitation to England : the other two arc 
 to explain his impatient desire that the Committee should 
 bring out their Report with all possible speed : 
 
 ' He was made sick and furious by a man who offere<l to show him 
 ' the night-side of Pans ' : and at a theatre — some friends havinj; taken him 
 to a play which offended him— ho walked out in the middle of it.
 
 74 SIR VICTOR HORSLEY 
 
 Paris, le 8 mai, 1886. Cher et \€n€x6 maitre, je re9ois 
 votre aimable lettrc ou vous avez I'obligeance d'accumuler 
 seductions sur seductions. Certainement j'ai bien besoin de 
 repos et j'aurais un grand plaisir a allcr pour quelques jours 
 en Angleterre. Mais pour le moment c'est impossible. Je 
 suis pris dans un engrenage dont je ne puis sortir. Je songe 
 cependant sdrieusement k remettre en d'autres mains 
 I'application de la mdthode de prophylaxie. Mais que de 
 peine j'aurai a m'cn d^sinteresser ? Kecevez, je vous prie, 
 I'exprcssion de ma reconnaissance et celle de Mme. Pasteur, 
 et de mon af lection. 
 
 J'attcndrai avec une certainc impatience I'effet que pro- 
 duira sur le public anglais le rapport de la Commission dont 
 vous faites partie. Voyez, par I'article, ci-joint, extrait du 
 journal fran^ais, Le Temps, tout ce qui se passe chez vous 
 et chez nous. On imagine difficilement I'hostilit^ sourde ou 
 publique h. laquelle je suis voue par cette decouverte de la 
 prophylaxie de la rage aprcs morsure. Un journal beige, 
 rempli de mensonges et de calomnies odieuses, a ^t^ jusqu'a 
 insurer dans ses colonnes une provocation a I'assassinat sur 
 ma personne. 
 
 Heureusement, j'ai de quoi m'en consoler de ces turpitudes 
 en pensant que je touche au nombre de mille personnes d^jk 
 trait^es, et que je n'ai pas eu a d^plorer un seul accident du 
 au traitement ; que sur la jeune Pelletier seule, trait^e 
 37 jours apres une ^norme blessure k la tete et k I'aisselle 
 droite, le traitement a ^t^ inefficace ; ainsi que sur quelques 
 russes mordus par des loups enrages a la tete et au visage. 
 
 Prdsentez, je vous prie, mes tres respectueux hommages a 
 Mme. et h. Mile. Paget, et recevez, vous-meme, I'expression 
 de tout mon respect. — L. Pasteur. 
 
 Paris, le 12 aout, 1886. Cher et illustre maitre, j'ai ddja 
 manifesto au Profr. Horsley, non sans quelque impatience, 
 le desir de voir paraitre le rapport de la Comm"" anglaise. 
 Comme il me remet de mois en mois, je prends la Ubertd de 
 venir vous dire le motif de ma hate de connaitre le rapport. 
 
 Je I'attends impatiemment parce que, dans la conviction 
 qu'il sera favorable de tout point a ma methode de prophy- 
 laxie, je veux m'aider de ses termcs et de ses conclusions 
 pour faire au gouvemement anglais une proposition bardie. 
 
 Je lui dcmanderai I'autorisation de vacciner tous les chiens 
 lie rile Maurice, \)\i\s de prendre dcs mesures de surveillance 
 a r(5gard des chiens qui seraient ult^rieurement ramen^s 
 dans I'ile. 
 
 Je sais que, sur les chiens, comme sur les honunes, la rage 
 est fr^quente dans cette ile. Ce serait Ik une grandiose 
 experience qui serait un acheminement h la vaccination de 
 tous les chiens et k Textinction de la rage, qui n'est jamais 
 spontanee.
 
 THE PREVENTION OF RABIES 75 
 
 Recevez, cher et tr^s dminent maitre, I'assurance de ma 
 haute consideration et veuille presenter h. Mme. et a Mile. 
 Paget rhommage de tout mon respect. — L. Pasteur, 45 rue 
 d'Ulm, Paris. 
 
 Arbois (Jura) 20 aouf, 1886. Cher et tres Eminent maitre, 
 je m'empresse de vous remercier des excellentes et tres 
 utiles indications que vous voulcz bien me dormer au sujet 
 de mon projet de vaccination des chiens dans une ile ou la 
 rage est frequente, I'ile Maurice, de preference. J'attcndrai 
 patiemment le rapport de la Commission, et je vais me mettre 
 en mesure, comme j'en informe M. V. Horsley, de lui envoyer, 
 pour la Commission, la hste de toutes les morsures (celles des 
 loups comprises) qui ont eu une issue fatale, malgre le 
 traitement. Je ne prendrai que tres peu de jours pour ce 
 travail. Votre tres devoue confrere, L. Pasteur. 
 
 The island which finally served to demonstrate the stamp- 
 ing-out of rabies was not Mauritius, but Great Britain. That 
 was the central fact of Pasteur's teaching, for us who live 
 on an island : La rage n'est jamais spontanSe ; rabies cannot 
 come of itself ; we over here, by muzzling, and by quaran- 
 tine of imported dogs, could both kill off rabies and keep it 
 from coming to life again. There was no hope of muzzling 
 wolves in Russia, or pariah-dogs in India, and there was no 
 hope of preventing rabies from getting across the frontier 
 between one Continental nation and another. But we, 
 with the sea for our frontier, could and did stamp out rabies 
 by Government orders enforced by the pohce. As Horsley 
 said, many years later, in his evidence before the second 
 Royal Commission on experiments on animals : 
 
 The freedom of England from rabies I take to be one of 
 the great achievements of modem science, and we owe it 
 entirely to M. Pa.steur. . . . Wlicn the Committee was in 
 Paris, M. Pasteur said to us, ' Why do you come here to 
 study my method ? . . . You do not require it in England 
 at all. I have proved that this is an infectious disease : all 
 you have to do is to establish a briof quarantine covering the 
 incubation period, muzzle all your dogs at the present 
 moment, and in a few years you will be free.' When the 
 Committee returned and reported to the Houses of Parlia- 
 ment, this point, of course, was always before us. 
 
 The Report of the Commission of Enquiry was published 
 in June 1887, and was presented by Pasteur on July 4 
 to a meeting of the Academic des Sciences. A few weekb
 
 76 SIR VICTOR HORSLEY 
 
 before the Report was published, he had written again to Sir 
 James Paget : 
 
 . . . Je n'ai pas besoin de vous repetcr ce que j'ai dit au 
 Professeur Horsley, que le rapport de la Commission anglaise 
 aura una importance tres grande, une importance particuliere, 
 sur I'opinion pubhque. Depuis mes etudes d'autrefois sur 
 la question des generations, dites spontanees, depuis que les 
 ' intransigeants ' n'osent plus s'elever de la matiere mindrale 
 a la ceUule vivante et de proche en proche au singe et a 
 I'homme, au nom de la science, je suis leur bite noire. Tout 
 le parti politique est irrite contre moi. Joignez-y les anti- 
 vaccinateurs, les anti-vivisectionnistes, les medecins envieux 
 et ignorants, et vous aurez une idee affaiblie des calomnies 
 qui me poursuivent et des mensonges que Ton accumule 
 contre la m^thode de prophylaxie de la rage. 
 
 The Report of the Commission says that Horsley's experi- 
 ments, begun in May 1886, ' entirely confirm M. Pasteur's 
 discovery of a method by which animals may be protected 
 from the infection of rabies. ... It would be difficult to 
 overestimate the importance of the discovery, whether for 
 its practical utility or for its appUcation in general path- 
 ology.' Of the protective treatment of persons bitten, 
 the Report says : 
 
 Between the end of last December and the end of March, 
 M. Pasteur inoculated 509 persons bitten by animals proved 
 to have been rabid either by inoculation with their spinal 
 cords, or by the deaths of some of those bitten by them, or 
 as certified by veterinary surgeons. Only two have died, 
 and one of these was bitten by a wolf a month before inocula- 
 tion, and died after only three days' treatment. If we omit 
 half the cases as being too recent, the other 250 have had a 
 mortality of less than i per cent., instead of 20 or 30 per 
 cent. . . . From the evidence of all these facts, we think 
 it certain that the inoculations practised by M. Pasteur on 
 persons bitten by rabid animals have prevented the occur- 
 rence of hydrophobia in a large proportion of those who, if 
 they had not been so inoculated, would have died of that 
 disease. And we believe that the value of his discovery will 
 be found much greater than can be estimated by its present 
 utility ; for it shows that it may become possible to avert 
 by inoculation, even after infection, other diseases besides 
 hydrophobia. 
 
 The Report of the Committee of the House of Lords, which 
 was concerned only with administrative measures, was pub-
 
 THE PREVENTION OF RABIES 77 
 
 lished a few weeks later, in August. This Committee held 
 nine sittings, and examined twenty-eight witnesses. The 
 evidence of Brunton, Fleming, Horsley, and Whitelegge, is 
 good reading now, across the thirty years since 1887. 
 
 In February 1889, at a meeting of the Epidemiological 
 Society, Horsley read a paper on rabies, and on Pasteur's 
 method. He spoke of the occurrence of paralytic rabies in 
 man : and of the intensive treatment. ' It is evident that 
 the intensive treatment is very successful in coping with the 
 worst cases ; and that instead of being itself a cause of death, 
 as asserted by those who gain notoriety and subsistence by 
 vihfying and misrepresenting scientific progress, it is a power- 
 ful agent in saving life.' He went into two cases, sent from 
 our country to Paris, in which the treatment had failed. 
 These two cases had been much talked of, and much that was 
 false had been said about them.^ A full account of Pasteur's 
 work was also given by (Sir) Armand Ruffer at the annual 
 meeting of the British Medical Association in Leeds. 
 
 On July 1, 1889, a meeting was held at the Mansion House, 
 the Lord Mayor, Sir James Whitehead, presiding. Horsley 
 moved one of the resolutions — that the Government should 
 be invited to introduce a Bill for the simultaneous muzzling 
 of all dogs throughout the British Islands, and for the estab- 
 lishment of quarantine, for a reasonable period, of all dogs 
 imported. At this meeting a fund was started for a donation 
 to the Pasteur Institute, which had just been inaugurated, 
 and for the help of necessitous patients who could not other- 
 wise afford to stay in Paris for the treatment. In November 
 1889, the sum of 40,000 francs was sent to the Institute. 
 
 Our country had not a ' service de la rage,' a centre of 
 its own for the protective treatment against rabies. Our 
 cases went to Paris. For the employment of Pasteur's test, 
 we had Horsley. There was Pasteur in the rue d'Ulm, and 
 later in the rue Dutot ; and there was Horsley in the Wands- 
 worth Road : and that, for the practical purposes of any- 
 body in this country who had been bitten by a dog either 
 
 * See also the paper by Horsley and Bristowc, read at a meeting of the 
 Clinical Society, November 9, 1888, ' A case of paralytic rabies in man ' 
 (Clin. Soc. Trans., xxii. 38).
 
 78 SIR VICTOR HORSLEY 
 
 mad or supposed to be mad, was all that there was. Horsley 
 had the two rabbits from the rue d'Ulm. By transmission 
 of rabies from them, he was able to demonstrate and uphold 
 Pasteur's method over here, and to employ Pasteur's test : 
 and at every step of his work he could say of his dogs and 
 rabbits what Villemin, in 1865, said of the rabbits on which 
 he demonstrated the infectivity of tubercle, ' En voici les 
 preuves.' 
 
 horsley's wokk on rabies at the brown 
 institution 
 
 It was in May 1886, that he began the experimental study 
 of the disease : but his practical acquaintance with it began 
 with his appointment to the Institution, and his reports of 
 the work of the Institution, from 1884 to 1890, all of them 
 call attention to it. The writing of these reports seems to 
 have troubled him : ' The Moloch of the Annual Report,' he 
 calls it, ' which rests on my shoulders hke the Old Man of 
 the Sea ' — a fine confusion of images. The statistics of the 
 hospital department were provided for him by Mr. Ernest 
 Batt, the veterinary surgeon to the Institution. The reports 
 are concerned, of course, with the whole output of each year's 
 work, both in science and in veterinary practice : rabies only 
 comes in as one of many subjects. 
 
 In 1884, near the end of the year, there was a slight out- 
 break of rabies in London. Of nineteen rabid animals 
 brought to the Institution during the year, nearly all came 
 during the few weeks of the outbreak, and many other 
 animals in the neighbourhood were known to have been 
 bitten. 
 
 In 1885, the number of rabid animals was seventeen : 
 
 Although rabies has not been quite so prevalent in this 
 district, it has raged in other parts of London, particularly 
 in the N.W. ; and it is a matter for congratulation that the 
 attention which was first drawn by the Brown Institution 
 to the disease has had the effect of causing the authorities 
 to attempt to stamp out the disease. Since the enforced 
 seclusion of dogs, there has been but one case at the Brown 
 Institution, and from other districts a sensible diminution 
 is reported.
 
 THE PREVENTION OF RABIES 79 
 
 In 1886, there was a notable decrease of rabies and there- 
 fore of hydrophobia. Only five rabid animals were brought 
 to the Institution, and there were only nine deaths from 
 hydrophobia in London, against twenty-six in 1885. More- 
 over, the muzzling order of November 1885 had reduced 
 not only rabies but also distemper : 
 
 The statistics of the Institution show an unforeseen proof 
 of the value of the police regulations, especially with regard 
 to the immediate destruction of o\vnerless dogs. Distemper, 
 the most contagious disease among the camivora, and not 
 only very frequently a fatal malady, but also one which pro- 
 duces the most lamentable sequelae, e.g. blindness, chorea, 
 etc., has diminished by more than one-third of what it was 
 in 1885. 
 
 During 1886-87, at the Institution, Mr. G. F. Doweswell 
 tested the action of many drugs on rabies : he found that it 
 was neither prevented, nor influenced — unless it were for 
 the worse — by any of them. In 1886, he beheved that he 
 had discovered the germs of the disease : and Horsley for 
 a time was inclined to share this behcf . 
 
 In 1887, there was only one case of rabies. But the 
 disease was beginning to work its way from Surrey into 
 South London : and, while rabies was slowly reasserting 
 itself, distemper, having only a short period of incubation, 
 was rapidly reasserting itself. This year, Horsley established 
 the use of Pasteur's test — the subdural inoculation of a 
 rabbit with spinal-cord tissue from a case of rabies. Before 
 1887, it could always be said, ' Are you sure that the animal 
 was really rabid ? Are you sure that the man really died 
 of hydrophobia ? ' To these questions, Horsley, and he 
 alone in our country, gave the fmal answer. If a minute 
 portion of spinal cord, taken from the dog's body, or from 
 the body of the man, were put under the dura mater covering 
 the brain of a rabbit ; and if the rabbit, after the predicted 
 number of days, developed the predicted form of the disease 
 — this evidence was all that was needed. In 1887, he 
 applied this test to 23 specimens, sent to the Institution 
 from all parts of the country (.| human, 2 cows, i horse, 
 16 dogs). In 5 of the dog cases, the result was negative ; 
 in the other 18 cases, it was positive.
 
 8o SIR VICTOR HORSLEY 
 
 In 1888, there were 4 cases of rabies brought to the 
 Institution, and 13 specimens were tested (2 human, i deer, 
 
 1 heifer, 9 dogs). In the heifer case, and in 5 of the dog 
 cases, the result was negative ; in the other 7 cases, it was 
 positive. Horsley's report for 1888 was not in print till 
 May 1889 : by which time, rabies and distemper were both 
 of them on the increase : 
 
 Already the deaths among human beings are rising in 
 London, three having occurred during December 1888- 
 February 1889. Urgent representations should be made to 
 the Privy Council to ensure adoption of universal restrictive 
 measures, which, as has been proved ad nauseam, are per- 
 fectly adequate to stamp out the disease. 
 
 In 1889, cases of rabies 4 : specimens tested 20 (i human, 
 
 2 deer, 17 dogs). In 8 of the dog cases, the result was 
 negative ; in the other 12 cases, positive. The general 
 outlook was brighter. Horsley's report for 1889, printed 
 in July 1890, says : 
 
 The Board of Agriculture, which replaced the Veterinary 
 Committee of the Privy Council at the beginning of 1888, 
 applied in July (1889) the muzzling regulations to all centres 
 of the disease, and to the surrounding districts. The result 
 has been most favourable, not a single death among human 
 beings having been recorded in London since January i of 
 the present year (1890). 
 
 The muzzling regulations had also brought do\\Ti dis- 
 temper : 
 
 The mode of infection in distemper is by contact, the nasal 
 discharge containing the virus. The muzzling regulations 
 of 1889 have already effected a most marked diminution in 
 the number of dogs and cats admitted suffering from this 
 disastrous disease. It is to be hoped that the beneficent 
 action of the muzzle will be allowed to continue, and that 
 the absurd and cruel fallacy that a dog must have the dis- 
 temper will die out with the disease. 
 
 In 1890, no case of rabies was brought to the Institution : 
 14 specimens were tested (2 human, i sheep, 11 dogs). In 
 the sheep case, and in 4 of the dog cases, the result was 
 negative ; in the other 9 cases, it was positive. 
 
 As regards rabies, our returns show that not a single case 
 of that disease was admitted during 1890, while distemper
 
 THE PREVENTION OF RABIES 8l 
 
 has very greatly fallen, and indeed the present moderate 
 amount of disease is maintained by its being prevalent among 
 cats, the amount of cases among dogs being very notably 
 diminished. 
 
 Fortunately the pubHc has learnt so much from its experi- 
 ence of the beneficent action of the regulations since 1885, 
 that the discreditable anti-vivisectionist agitation against 
 the muzzle will not mislead in future those who are ignorant 
 of the manner in which these specific diseases are communi- 
 cated from animal to animaJ. 
 
 THE OUTBREAK OF RABIES AMONG THE DEER IN 
 RICHMOND PARK, 1886-87 
 
 Up to the time of this amazing outbreak, rabies had never 
 been identified among deer, either in this country or in 
 France or in Germany : but there had been outbreaks 
 among deer, in this country, of a disease which, after 1886-87, 
 was judged to have been rabies. 
 
 The Richmond Park disaster occurred toward the close 
 of a serious outbreak of rabies among dogs in London and 
 the suburbs. An admirable account of it is given by Mr. 
 Cope.^ The number of deer in the Park was about 1200, 
 in herds of from 100 to 200 : the herds mostly kept away 
 from each other : they rarely intermixed. The Park is 
 open all day : it would be easy for a dog to get in and bite 
 one or more deer and get out again. The outbreak began 
 in September 1886 : the keepers found a doe, which was 
 suckling a fawn, ' staggering about in the herd pasturing 
 near the entrance gate at East Sheen.' Mr. Cope's report 
 goes on to say : 
 
 Some days after the death of this doe, the keepers noticed 
 otiiers of the deer in the same herd beiiaving in a very erratic 
 manner. At first tliey were constantly rubbmg their heads 
 against the stems of trees or on posts, and with such force 
 that their hair was in some cases entirely removed. They 
 were frequently seen to be biting the skin about tlieir shoulders 
 and bellies until they were perfectly raw, tearing out their 
 hair, and at times they charged at the other deer. . . . The 
 
 • Reports on the Outbreak of Rabies among Deer in Rjchmoml Vask 
 during the years 1880-7. ^Y ^^^- A. C. Cope, Chief Inspector, Agricultural 
 Department, Privy Council Ollice, ami I'rofcssor Victor llorslcy, F.K.S., 
 Professor Superintendent of the 13rown Institution. London, Eyre and 
 Spottiswoode, 1888. Pp. 16. 
 
 F
 
 82 SIR VICTOR HORSLEV 
 
 disease spread slowly through the herd, the animals dying at 
 the rate of four a week ; and by April 1887, 160 had died. 
 
 It was not till April 1887 that Mr. Cope was asked to 
 investigate the disease : 
 
 It being impossible to devote sufficient time in the Park 
 to study the symptoms and nature of the disease, a buck and 
 a fawn were forwarded to the Royal Veterinary College ; the 
 fawn, however, died four hours after admission. . . . The 
 medulla of this animal was taken to the Brown Institution, 
 where under the direction of Professor Horsley rabbits were 
 inoculated, which died of rabies. The buck became so wild 
 and violent that the persons in charge were unable to enter 
 the loose box in which it was placed. This animal died two 
 days after its arrival, and other rabbits were inoculated with 
 portions of its spinal cord, with the same results as in the 
 former case. 
 
 At Mr. Cope's request, a dog was inoculated. The rabbits 
 had died of paralytic rabies, the usual fonn of the disease 
 in rabbits. The dog died of violent rabies, the usual form 
 of the disease in dogs. 
 
 In June 1887, the disease appeared in another herd, which 
 had been grazing in the Park next to the herd first infected. 
 Altogether, no less than 264 deer died of rabies. Horsley 
 had three under observation at the Brown Institution : one 
 of them, before admission, had been seen to bite another of 
 them about the neck and ears. 
 
 These 264 cases of rabies in deer, and Horsley's authori- 
 tative work during the outbreak, have long been forgotten : 
 indeed, the whole picture of rabies in herds of deer close to 
 London must look strange to modem Londoners. 
 
 THE ' BOUISSON BATH TREATMENT ' 
 
 In 1888, he examined and exposed the ' Bouisson Bath 
 Treatment for the Prevention and Cure of Hydrophobia.' 
 It was the invention of a French doctor who had persuaded 
 himself that he was suffering from hydrophobia — there are 
 many such cases on record — and had sought to kill himself in 
 a vapour-bath, and had found that he was ' cured.' Horsley 
 published his results in the British Medical Journal, June
 
 THE PREVENTION OF RABIES 83 
 
 9, 1888. He was bound to take the matter seriously : for 
 the Bouisson Bath was advertised far and wide ^ : 
 
 As might be supposed, its adoption is principally urged by 
 those who are, for obvious reasons, opposed to the advance- 
 ment of science, the paid antivivisectionist agitators. These 
 persons spread broadcast glowing misrepresentations of the 
 system, and raise, as I have myself seen, many false hopes, 
 and so cause much pain in the minds of the patient and his 
 friends. . . . What the ' antivivisectionists ' clearly desire 
 is that the profession at large should make a series of experi- 
 ments on man to see whether tliis Bouisson treatment is 
 worth going on with or not. 
 
 He therefore studied the influence of vapour-baths on 
 animals inoculated with rabies : in some of them the 
 disease was still latent, in others it had already declared 
 itself : he could thus judge whether the treatment had any 
 effect either to prevent or to cure the disease : 
 
 I was careful to carry out this treatment, not only thera- 
 peuticaUy, but also prophylactically, but I regret to say that 
 it favoured rather than hindered the course of the disease, 
 death being invariably the result in each case. 
 
 The experimental method adopted was as follows. I 
 inoculated by the usual subdural method eleven animals 
 with what M. Pasteur calls the virus fixe — that is to say, 
 the pure virus of the disease, which, in the series that I 
 possessed, produced its first symptoms almost invariably 
 upon the eighth day after inoculation ; sometimes, but more 
 rarely, on the ninth day. I also inoculated three rabbits 
 with virus taken from the medulla of rabid dogs of the street, 
 such virus usually producing, as is well known, its first 
 symptom about the sixteenth day, but in certain rarer in- 
 stances, in the manner of the virus fixe, from about the 
 seventh to the nintii day. These fourteen animals I placed 
 in a hot-air bath, according to Dr. iiouisson's suggestion, 
 directly they sliowcd the hrst distinct symptoms of the 
 disease. 
 
 Finally, I inoculated two other animals with the virus fixe, 
 
 * A Bouisson batli was installed at tho ' Anti-vivisccUou ll(jspital.' 
 The editor of one of tho anti-vivisecUon journals published a statement, 
 ' Tho treatment is simplicity itself : it is merely tho use of tho vajwiir- 
 bath, which causes a free action of the skin to bo set up ; this draws tho 
 blood to the surface of the Ixjdy, and so rehcvcs tlio congestion of tho 
 internal organs.' And the chairman of one of the anti-vivisecUon soaetios 
 published a statement that tho treatment was ' founded on the common- 
 sense principle that if poison is injcctcrl into a porson'a veins the best 
 thing 13 to got It out as quickly as possible'
 
 84 SIR VICTOR HORSLEY 
 
 and on the third day after inoculation commenced prophy- 
 lactic treatment with the hot-air bath. This treatment 
 antedated by two days the onset of the symptoms, and so 
 expedited the fatal results. 
 
 Except that the treatment slightly raised the temperature 
 and quickened the respiration, its only effect was to exhaust 
 the nerve-centres. It thus had a slight sedative influence : 
 but it tended to hasten death. He found records of two 
 cases in which it had been tried on man : in one, the patient 
 was quieted for an hour or so : in the other, the patient 
 complained of the heat of the bath, and would not let it be 
 repeated : both patients died. 
 
 THE SOCIETY FOR THE PREVENTION OF HYDROPHOBIA 
 
 The anti-vivisectionists also upheld the false belief that 
 rabies could ' come of itself.' For instance, one of the anti- 
 vivisection witnesses before the Committee of the House of 
 Lords said that hydrophobia was ' a condition arising in the 
 course of various diseases ' ; and that if he broke his leg, 
 he might get hydrophobia from that injury. This belief 
 commended itself to the opponents of the muzzling of dogs : 
 and they and the anti-vivisectionists were represented by 
 the Dog Owners' Protection Association. Against this 
 Association, in the autumn of 1886, the Society for the 
 Prevention of Hydrophobia and Reform of the Dog Laws 
 was formed : and Horsley became Chairman of its Com- 
 mittee in January 1887. On the Committee were Fleming, 
 Everett Millais, Penberthy, Briton Riviere, Romaines, and 
 Tyndall. The Hon. Secretary was Mr. Karslake : Horsley 's 
 many letters to him, from 1886 to 1891, are full of angry 
 contempt for his adversaries — as he profanely says of the 
 
 death of one of them, ' What a divine blessing that has 
 
 been taken away.' Horsley had seen more cases of rabies 
 and hydrophobia than all the members of the Dog Owners' 
 Protection Association together had seen. 
 
 1886. Dec. 22. I could not go to the meeting of our 
 opponents to-night, but it will be a loss if we cannot get an 
 amendment moved to whatever absurd resolution they pass. 
 This rcsciiidin^i of the Muzzling Order is most unfortunate
 
 THE PREVENTION OF RABIES 85 
 
 and ill-advised. Dec. 27. Thanks very much for the Press 
 notices and report of the Enemy's Council. It struck me 
 as being very feeble from the reports even. If I have long 
 enough notice to prevent other engagements I shall be very 
 happy to go with you another time to have a shy at them. . . . 
 By the way, I lecture on Jan. 31 at Kensn. Town Hall on 
 Hydrophobia, on behalf of the Church of England Waifs 
 and Strays Society. You had better let me have a few 
 prospectuses to distribute on the chairs galore. The Dog 
 Owners' Protection Association will hear a few plain truths 
 if they come, and I hope they will. 
 
 1887. Dec. 13. The Dog Owners' report is lovely to read. 
 
 I suppose that Uttle idiot found himself getting into 
 
 queerer water than even he liked. That awful lie about 
 Nottingham could best be met by sending to all their sub- 
 scribers, say 270 in number, my brother-in-law's report about 
 
 Nottingham. Aug. 29. Let the Echo go to well, where 
 
 it ought to go : papers of that sort make no final impression. 
 I have been thinking over matters relating to our progress, 
 and I think that we have advanced most materially. The 
 enemy blaspheme and will, in spite of everything, but we are 
 really advancing. 
 
 1888. May 8. Since I wrote to you, I was asked by the 
 Govt, to sit on a Comm. of Inquiry into Pleuropneumonia, and 
 not being able to refuse find my time completely swamped 
 and I may say without a halfpenny of return, for the posi- 
 tion is purely honorary. Under these circumstances I am 
 really doing enough for an ungrateful country, or to put it 
 in other words I must limit my other opportunities to raking- 
 up bread and butter somehow, so I cannot do the article. 
 
 Lord is a \&vy feeble reed indeed, and was so hipped 
 
 over the character of the antiviviscctionist agitation against 
 our views (he was an antiviviscctionist some years ago) that 
 I fancy he does not want to identify himself with any agita- 
 tion. June 6. You know I consider that is both inane 
 
 and unreliable, therefore I personally do not wish to have 
 anything to do with him. However, don't misunderstand 
 me. I shall not in any way object to his being interviewed 
 for the purposes of conversion : I only mean that I cannot 
 be the missionary. Dec. 6. Urgent. Can you let me know 
 by return the name and town of the Lancashire lady who 
 last year was so courageous in defending children from a 
 rabid retriever and who got severely bitten herself. I am 
 informed that she alone went to Pasteur, and is still alive, 
 whereas the children bitten died. I want to find whether 
 this is true or not, and in a hurry. 
 
 i88g. June. Answer the idiot as follows. The increase 
 of rabies is demonstrated by the police returns of rabid dogs 
 killed. It was shown by these that it was excessive in 1885.
 
 86 SIR VICTOR HORSLEY 
 
 The muzzle was then applied, with extra care in the destruc- 
 tion of stray dogs. seems to want to make out that 
 
 this was done for the first time, whereas it is always going 
 on. The answer to his absurd statement re muzzling is that 
 it has been shown both here and abroad that the slaughter 
 of strays alone is not enough and the muzzle is also necessary. 
 The reason is obvious. The stray dogs are not the only ones 
 infected. Those cared for by private owners are also diseased, 
 as emphasised strongly by the fact that of recent cases of 
 extensive biting of human beings by rabid dogs, the large 
 majority were by dogs of private owTiers : some, very 
 well-to-do people. ... As to this last para., the evidence 
 is that of the police reports. 2h years ago the disease 
 was temporarily extinguished in London, no case being re- 
 ported by the police. Since that time the disease, as shown 
 by the same returns, steadily increased until the present 
 spring, when it suddenly increased. Rabies presents two 
 periods of increase : in the spring and autumn. We have 
 just passed the spring epidemic increase, and from our 
 previous experience we must expect another, and a larger 
 
 one, in November. ... No panic is sought, and has 
 
 no right to make such a suggestion. It is with the object 
 of preventing a panic, and what is more important, prevent- 
 ing an outbreak of rabies, that we wish the muzzle on now. 
 That will do. He is hardly worth answering. November. I 
 hope Millais and yourself will stop to dinner, and we can 
 go down to this absurd meeting afterwards. I will move an 
 amendment with pleasure. . . . Did you ever keep those 
 rascally broadsheets they used to issue denying the existence 
 of rabies ? If so, can you let me have one ? Dec. 29. But 
 just returned from Yorkshire, (i) Don't think appesJ is 
 required now. The Government are evidently now on their 
 feet : vide total want of opposition. Magistrates I see are 
 now fining 20/- etc. (2) St. James's Gazette better left alone. 
 
 Article is clearly by , and he anonymously or onymously 
 
 is not worth powder and shot. I am not lazy, but I believe 
 a little contempt now, i.e. for a month, is good medicine. If 
 they follow up, why, we will have a good smash at them. 
 
 1891. February. Owing to an accident to Ajoion, I have 
 to give a Friday Evening lecture at the Royal Institution. I 
 intend to give Hydrophobia and to show up Miss Cobbe and 
 her lying crew, and publish the lecture in the XIX Century 
 if Knowles will have it. In any case the statistics for it 
 will come in most handy for our paper in August at the 
 Hygienic Congress. Can you help me in this very sudden 
 emergency to collect the figures ? I can collect Pasteur's, 
 but I must have London cases of rabies in dogs and hydro- 
 phobia in man — and England — at once, so as to construct a 
 fine red diagram for the lantern, to show how muzzhng
 
 THE PREVENTION OF RABIES 
 
 87 
 
 knocked the wind out of rabies and its apostle Miss Cobbe — 
 Science versus Ignorance. Dec. 2. Nothing is simpler than 
 
 the demolition of that blackguard . In the first place, 
 
 are his quotations true ? If they are, come here at 5 o'clock, 
 and we will concoct the answer. 
 
 The defeat of the meeting of the Dog Owners' Protection 
 Association, November 25, 1889, was arranged and led by 
 Horsley. He issued a notice, four days before, asking 
 medical men and students to come and support a wrecking 
 amendment ; it was moved by him, seconded by Mr. Sidney 
 Turner, and carried by ' an overwhelming majority ' ; and 
 the meeting came to an end. After this defeat, the anti- 
 muzzling movement gradually died out. Unhappily, in 
 1892, the Muzzling Order was relaxed. 
 
 DIAGRAM SHOWING THf-: INFLUENCE OF MUZZLING 
 OVER RAUI1-:S. 
 
 From Roicn.-iu. Published by permission of Messrs. Appleton. 
 
 The enforcement of the Muzzling Order, and of quarantine 
 of imported dogs, not as a half-hearted precaution in this 
 or that district, but as a national mctliod of stamping out 
 rabies everywhere, was an uphill business : but Mr. Walter 
 Long held on with it, till we were free, at last, from the
 
 88 SIR VICTOR HORSLEY 
 
 disease, and from the fear of the disease.* Many years 
 later, Mr. Long said of his work : 
 
 When we embarked upon that enterprise, I venture to 
 say that we should never have dared to do it — and I may say, 
 further, that our attempt would not have been justified — 
 had it not been for the knowledge that those experts who 
 advised us, and upon whom we depended, possessed know- 
 ledge which not only proved itself to be incontrovertible, 
 but which surmounted every difficulty that was offered to 
 us during those five anxious years. 
 
 That is to say, it was Pasteur, and men over here able to 
 judge of his work, who strengthened the hands of our 
 Government to make an end of rabies and hydrophobia. In 
 1918, after our country had been for many years absolutely 
 free from the disease, there was an outbreak of rabies in 
 Plymouth and Devonport : the disease, somehow, had been 
 imported. Strict precautions were taken : persons bitten 
 received the protective treatment, and no case of hydro- 
 phobia has been reported. It is to be noted that the number 
 of patients treated at the Pasteur Institute in Paris greatly 
 increased during the War. The utmost vigilance will be 
 needed to prevent the importation of infected dogs into our 
 country. 
 
 Lady Horsley writes : 
 
 The Dog Owners' Meeting was reall}' a very amusing one — 
 the crowded hall, the rapidity with which the attacking force 
 were turned into a disconcerted rabble by the weight of the 
 knowledge opposed to them, the extreme discomfiture of 
 the Chairman, the hilarity of the medical students, and the 
 cheerful persistence with which they heckled one of the 
 speakers with ' How about that broken leg ? ' — and Victor's 
 face flashing with the joy of killing a he — all make up a 
 picture that I shall never forget. The real reason, of course, 
 why Victor was so exceedingly keen about this question was 
 because, having seen cases of hydrophobia in private practice, 
 the sufferings of the patients filled him with the most intense 
 
 * See the Report of the Departmental Committee appointed by the 
 Board of Agriculture to inquire into and report upon the working of the 
 laws relating to dogs. Appointed April 1896 : Chairman, Mr. Charles 
 A. Whitmore, M.P. Horsley gave evidence on July 17. The Report 
 was published 1897.
 
 THE PREVENTION OF RABIES 89 
 
 pity. I think I am right in saying that of all diseases he 
 thought hydrophobia the most awful. He was caUed down 
 from London to see a case where a man, rich and with a 
 well-fed and well-kept dog, had been bitten by it and had 
 not gone to Pasteur, and by the time Victor arrived was in 
 the final stage of the disease : and he was absolutely horrified 
 with his sufferings. 
 
 NOTE 
 
 It is to be remembered against the anti-vivisectionists, 
 that they not only reviled the work of the Pasteur Insti- 
 tute in Paris, but also, about 1894, tried to prevent the 
 founding of the Kasauli Institute, the first Pasteur Insti- 
 tute for India. See Sir Leonard Rogers's evidence before 
 the Royal Commission, May 15, 1907. 
 
 The spread of rabies, which began in 1918, has carried 
 the disease into many parts of England. At the present 
 time (April 30, 1919), the number of cases confirmed by 
 the Board of Agriculture is 162. Proper ' services de la 
 rage ' have been established in London and in Plymouth. 
 Happily, no case of hydrophobia has been reported. 
 
 There is an admirable account of the relations between 
 the Pasteur Institute and our country, and of the enforce- 
 ment of the Muzzling Order, in Sir Rickman Godlee's Life 
 of Lord Lister, ch. xxix., 'The Lister Institute.' 
 
 The Society for the Prevention of Hydrophobia has 
 lately been re-constituted, with Mr. Sidney Turner as 
 Chairman of Committee.
 
 VII 
 
 The Localisation of Function in the Brain 
 
 It was natural that Horsley should take the brain as his 
 chief subject of study. The choice was decided for him ; 
 it was more compulsion than choice ; it was thrust on him 
 at lectures and in talk and in reading, and by every ' head- 
 case ' in the Hospital. All that was intellectual in him 
 urged him to care more for the seat of the intellect than 
 for any other organ in the body : it offered him problems 
 and opportunities and rewards that nothing else could offer : 
 it was the kingdom intended for him, and he for it. Not 
 that he started to find his kingdom with any philosophical 
 or psychological theories to impede him on the journey. 
 He took the only right road and kept it, the way of cHnical 
 observation, pathology, and experimental physiology ; and 
 was in very good company. 
 
 In Richet's great Dictionary of Physiology, there is a long 
 review, by Soury, of theories of the brain : beginning with 
 Alcmseon of Crotona, who hved, as John Hunter says of 
 Sonnertus, ' the Lord knows how long ago.' Horsley would 
 not be troubling himself over the theory of Descartes, 
 that the pineal body is ' the seat of the soul,' nor over 
 Kant's philosophical answer to Descartes, that the ego is 
 not in space, and therefore is not to be localised anywhere : 
 but he was fond of quoting from Soury the case of Pausanias 
 the sophist, one of Galen's patients.^ But what concerns us 
 here is Soury 's reminder, that the philosophers, physi- 
 
 * ' I am fon<i of referring to Galen,' he says in an address in 1904, ' because 
 it is perfectly astonishing what an amount of accurate neurological know- 
 ledge Galen acquired by his experiments on the lower animals and demon- 
 strated to his pupils in Rome.' Again, at the Festival Dinner of the Queen 
 Square Hospital in 1907, he spoke of Galen ; and drew from Mr. Danvers 
 Power this charming compliment — ' If Galen was physician to thegladiators 
 in his day, we may say of Sir Victor Horsley in our day that he is gladiator 
 to the physicians.' 
 »0
 
 LOCALISATION OF FUNCTION IN BRAIN 91 
 
 ologists, psychologists, and even the phrenologists, all were 
 up against problems of localisation : they were all attempt- 
 ing to define the site of consciousness : 
 
 The scientific theory of cerebral localisation came into the 
 world late enough : but the principle of the locaUsation of 
 functions, psychical, intellectual, and moral, is almost as old 
 as human thought. 
 
 By the time of Galen, 131-200 a.d., it was agreed that 
 neither the heart, nor any other region of the body except 
 the brain alone, was the seat of sensation, voluntary move- 
 ment, and inteUigence. * Where the origin of the nerves 
 is,' said Galen, ' there is the command of the soul.' 
 
 Then came ages of thought, but not of experiment, nor 
 of unfettered thought. The world had to wait to the nine- 
 teenth century for the discovery of cerebral localisation : 
 and neither philosophy nor psychology had anything to do 
 with it. They who make discoveries in the kingdom of the 
 natural sciences enter it, as General Allenby entered Jeru- 
 salem, on foot. The date of the first precise and followed- 
 up proof of cerebral locahsation is 1861. It was on April 
 14, 1861, that Broca, at a meeting of the Anthropological 
 Society of Paris, showed the brain of a man who for twenty- 
 one years had suffered loss of the faculty of speaking. He 
 could hear, read, understand, and make himself understood 
 by gestures ; his tongue and his larynx were not at fault ; 
 but the most that he could utter was a meaningless sound 
 of one syllable, tan, Ian : and once, in a moment of anger, 
 he swore. Year after year, this one disability, the loss of 
 sp)eaking, was all that was the matter with him. Later, 
 there came signs of progressive failure of the brain. The 
 post-mortem examination showed softening of the left 
 frontal lobe : and this softening had begun in the third 
 left frontal convolution, and had extended, very slowly, 
 into the adjoining convolutions. Soury puts it thus : 
 
 Broca saw clearly what Bouillaud and Aubertin had fore- 
 seen, that the demonstrated reality of this first localisation 
 upheld the grncral principle of the localisation (jf the func- 
 tions of the brain : that is, of the brain considered hence- 
 forth not as one organ with one function all of one sort,
 
 92 SIR VICTOR HORSLEY 
 
 but as a group or groups of organs, diverse in nature and 
 distinct in position, and thus answering to the diversity and 
 the independence of the psychical functions. 
 
 This case, and others which Broca collected and put on 
 record, mark the beginning of the new learning : but he 
 must not be exalted too high above the men of his time, 
 as if he alone had thought of the departmental working 
 of the brain. 
 
 From 1861 to 1870, the new learning was advanced by 
 clinical and pathological study, not by experimental physi- 
 ology. Then, in 1870, came the work of Fritsch and Hitzig : 
 it had not a wide range : it was soon surpassed by Ferrier's 
 work : but it was of the utmost importance. Men had 
 known, for ages, that the surface of the brain is insensitive : 
 that it does not ' feel pain ' as the surface of the body ' feels 
 pain ' : this fact was as old as Aristotle. Age after age, 
 the insensitiveness of the surface of the brain had prevented 
 men from understanding the character of the surface of the 
 brain. Even when they had thorough knowledge of its 
 microscopic structure, and of all that had been made out 
 by science and practice, they were still kept back by the 
 apparent impossibility of putting a direct question to it. 
 and getting a direct answer from it. That is to say, they 
 were waiting for the discovery that the surface of the brain 
 answers to the electric current. Broca's case had been a 
 demonstration, given by Nature, of the character of one 
 small area : Nature had asked the third frontal convolu- 
 tion, ' What are you for ? ' — and it had answered that it 
 was for the faculty of speaking. Fritsch and Hitzig put 
 the question, by means of the electric current, to other 
 areas : and, from some of them, they obtained an answer. 
 It took the form of movement of this or that definite group 
 of muscles on the opposite side of the body. (Opposite, 
 because of the crossing over of nerve-fibres at the base of 
 the brain : whereby the left cerebral hemisphere is related 
 to the right side of the body, and the right cerebral hemi- 
 sphere to the left side of the body.) They used the galvanic 
 current, of a minimal strength, just enough to cause a move- 
 ment : and they were able to map out, as it were on a chart,
 
 LOCALISATION OF FUNCTION IN BRAIN 93 
 
 certain ' centres ' for movements of the neck, the hmbs, 
 and the face. 
 
 They pubHshed this discovery in April 1870. (Ueber 
 die elektrische Erregbarkeit des Grosshims. In Reichert's 
 and Du Bois Reymond's Archiv, 1870, p. 300.) They mark, 
 on their diagram, five centres, and no more. By 1875, their 
 
 DIAGRAM OF THE DOG'S BRAIN, SHOWING THK FIVK MOTOR 
 CENTRES' LOCALISED BY FRITSCH AND HlTZKi, 1870. 
 
 From their paper in Reichert's Archiv. 
 
 chart was already out of date : still, there it is, the first of 
 its kind that ever was put in the hands of men. 
 
 Ferrier, in 1873-75, using not the galvanic but the faradic 
 current at minimal strength, localised many more centres, 
 and so precisely charted them that Fritsch and Hitzig were 
 left far behind. He also localised some centres not of move- 
 ments, but of certain acts of perception. Thus our country, 
 in this field of exp)erimcntal physiology, was soon ahead of 
 Germany : as it was shown at the time of the International
 
 94 SIR VICTOR HORSLEY 
 
 Medical Congress in London, in 1881, when Ferrier and Yeo, 
 at a crowded meeting of physiologists, confuted Goltz. 
 And in clinical and pathological knowledge, which ulti- 
 mately are as inseparable from experimental physiology 
 as the convexity from the concavity of a curve, no country 
 was ahead of ours, no, nor equal to ours. As Horsley, 
 long afterwards, said of Hughlings Jackson ; that he 
 was ' the father of neurology, in this country, and every- 
 where else.' 
 
 This account of the arrival of the new learning may be 
 useful to non-medical readers ; for whom alone it is intended. 
 After 1875, the output of work, in this and other countries, 
 became so great that no man can describe it. The main 
 lines of it are clear enough. One was the apphcation of 
 the facts of cerebral locahsation to the study of injuries and 
 diseases of the brain ; with special reference to cases of 
 ' Jacksonian epilepsy.' Another was the advancement of 
 the surgery of the brain. Another was the incessant 
 criticising and interpreting and adjusting of all new facts 
 and theories as they came to hand. Another was the 
 modem study of the deeper parts of the brain, and of the 
 spinal cord. Along these and other lines, all of them cross- 
 ing and recrossing, legions of men were at work. Thus, 
 Horsley and his contemporaries came into the very thick 
 of it. 
 
 In January, 1884, he began work with Professor Schafer, 
 who in 1883 had been appointed Professor of Physiology at 
 University College ; who writes : 
 
 I had planned, amongst other work, tlie carrying out of 
 a series of researches upon the brain of the monkey, with the 
 view of testing and, if possible, extending the work of Ferrier 
 and Yeo. I invited Vicior Horsley, who had just com- 
 pleted his surgical training, to co-operate with me : rightly 
 considering tliat his skill and experience in the methods 
 of antiseptic surgery, in which I had not myself been trained, 
 would be of great value in the investigation. We began our 
 joint work in January 1884, and it was continued until 
 July 1886, a period of two and a half years. For a con- 
 siderable portion of the time, Horsley was carrying on 
 similar work at the Brown Institution, in conjunction with 
 Dr. Beevor. Their observations, although in some measure
 
 LOCALISATION OF FUNCTION IN BRAIN 95 
 
 coinciding with ours, were published quite independently, 
 and indeed happened to appear first : the publication of 
 our results was delayed by the re-drawing of elaborate illus- 
 trations. Our complete results were pubHshed in the Phil. 
 Trans, for 1887 : but this paper had been preceded by one 
 or two preliminary communications elsewhere. 
 
 In the Library of the Royal Society of Medicine, there 
 are two volumes, presented by Horsley, of collected papers 
 from the Transactions of the Royal Society. These give 
 us the work which he did, between 1884 and 1891, with 
 Schafer, Beevor, Semon, Spencer, and Gotch : eight papers, 
 525 pages in all, with thirty-three pages of plates. The 
 literary style of the papers is not above criticism ; they 
 were written in collaboration, but it is probable that Horsley 
 did most of the writing ; and he had not the knack of 
 putting abstruse arguments in easy sentences. He could 
 write with admirable clearness on ' practical ' subjects : 
 but when he is thinking his way through a labyrinth of 
 physiological evidences, his style suffers. 
 
 The eight papers are as follows : 
 
 1. A Record of Experiments upon the Functions of the 
 Cerebral Cortex. By Victor Horsley and E. A. Schafer. 
 Read February 17, 1887. 
 
 2. A Minute Analysis (Experimental) of the Various Move- 
 ments produced by stimulating in the Monkey different 
 Regions of the Cortical Centre for the Upper Limb, as defined 
 by Professor Ferrier. By Charles E. Beevor and Victor 
 Horsley. Read June 10, 1886. 
 
 3. A further Minute Analysis by Electric Stimulation of 
 the so-called Motor Region of the Cortex Cerebri in the 
 Monkey {Macacus sinicus). By Charles E. Beevor and 
 Victor Horsley. Abstract read, June ib, 1887. 
 
 4. An Experimental Investigation into the Arrangement 
 of the Excitable Fibres of the Internal Capsule of the Bonnet 
 Monkey {Macacus sinicus). By Charles E. Beevor and 
 Victor Horsley. Read December 12, 1889. 
 
 5. A Record of the Results obtained by Electrical Excita- 
 tion of the so-called Motor Cortex and Internal Capsule 
 in an Orang-Outang {Simia satyr us). By Charles E. Beevor 
 and Victor Horsley. Read June 12, 1890, 
 
 6. An Experimental Investigation of the Central Motor 
 Innervation of the Larynx. By Felix Semon and Victor 
 Horsley. Read June 19, 1890. 
 
 7. On the Changes produced in the Circulation and Respira-
 
 96 SIR VICTOR HORSLEY 
 
 tion by Increase of the Intra-cranial Pressure or Tension, 
 By Walter Spencer and Victor Horsley. Read June 19, 
 1890. 
 
 8. The Croonian Lecture. On the Mammalian Nervous 
 System, its Functions, and their Locahsation determined 
 by an Electrical Method. By Francis Gotch and Victor 
 Horsley. Read February 26, 1891. 
 
 That is the order of his experimental study of cerebral 
 localisation, from 1884 to 1891. First, the more general 
 work with Schafer. Then, the more special work with 
 Beevor : the study of localisation in one species of monkey ; 
 the study of localisation not only at the level of the surface 
 of the brain, but at the level of the nerve-fibres passing 
 from the surface of the brain toward the spinal cord ; and 
 the single study of the brain of one anthropoid ape. Then, 
 the special work with Semon : the study of the localisation 
 of centres for the movements of the larynx. 
 
 The work with Spencer, and the work for the Croonian 
 Lecture with Gotch, were not directly concerned with the 
 study of cerebral localisation : they are noted in later 
 chapters. 
 
 THE FUNCTIONS OF THE CEREBRAL CORTEX. (wiTH SCHAFER) 
 
 The method in these experiments was either stimulation 
 with the faradic current at minimal strength, or ablation, 
 i.e. removal of the little area of ' grey matter ' controlling 
 this or that group of muscles : 
 
 All these experiments have been performed with the 
 strictest antiseptic precautions and under carbolic spray, 
 and the wound, after being closely stitched, has been dressed 
 with antiseptic gauze, and this again overlaid and rendered 
 firmly adlierent to the scalp by a layer of thick collodion. . . . 
 All the operations have been performed under anaesthetics, 
 either chloroform or ether being used, almost always sup- 
 plemented by the hypodermic injection of morphia (as much 
 as from one half to one grain of the acetate having usually 
 been given). This has the great advantage of causing the 
 animal to remain perfectly quiet for several hours after the 
 operation, and of permitting it, during the slow process of 
 recovery from the effects of the morphia, to become accus-
 
 LOCALISATION OF FUNCTION IN BRAIN 97 
 
 tomcd to the collodion dressing, which would otherwise be 
 irksome, and this would load to attempts at removal. The 
 morphia has also appeared to us to diminish the haemorrhage 
 from the cut cerebral surface. This is in any case easily 
 stayed by the application of gentle pressure. 
 
 This description of the method of operating may stand 
 for all Horsley's experiments on the nervous system : except 
 that he gave up the use of the spray. 
 
 The main results of these researches with Schafer may 
 be stated, in outline, as follows : 
 
 1. The Prefrontal Region. — ' The results of our experi- 
 ments upon the anterior part of the frontal lobes have been 
 completely negative so far as electrical stimulation or the 
 permanent result of ablation are concerned. In this we are 
 in agreement with Ferrier and Yeo, but in contradiction of 
 the results obtained by H. Munk.' They altogether reject 
 Munk's statement that the prefrontal convolutions contain 
 any ' motor centres ' : they are of opinion that he used a 
 current of such strength that it was diffused beyond the 
 points at which it was applied, and that he was not suffi- 
 ciently careful over the enforcement of the antiseptic method. 
 This clearing of the ground was a great service to physiology. 
 
 2. The Motor Region of the Cortex. — Many physiologists 
 since 1870 had been studying the ' external ' convolutions, 
 i.e. those on the convexity of the brain, on the surface imme- 
 diately under the skuU. None had studied with equal 
 attention the ' mesial ' convolutions, i.e. those which form 
 the walls of the deep narrow cleft between the two hemi- 
 spheres of the brain. This cleft, the longitudinal fissure, 
 runs the length of the brain, in the middle hne of the head : 
 and the mesial surfaces of the two hemispheres face each 
 other like very high houses on either side of a very narrow 
 street. Thus, the mesial surface of either hemisphere is 
 less easy of accass than the external surface, and was still 
 waiting to be studied by the experimental method. 
 
 By their experiments on the external surface, Schafer 
 and Horslev not only confirmed Ferrier's results, but added 
 to them, filling in the picture, here and there, with a finer 
 analysis of this or that group of movements : 
 
 Our experiments show that tiio motor portion of the 
 cerebral cortex may be mapped out into a certain number 
 of main areas, each of wiiich is chiefly concerned witli the 
 
 G
 
 98 SIR VICTOR HORSLEY 
 
 movements of a particular part or limb, and in some of which 
 certain centres concerned with more specialised move- 
 ments may be worked out. 
 
 They describe the ' overlapping ' of adjacent tracts — how 
 every centre and area overlaps to a greater or less extent 
 the surrounding areas. That is to say, there is a ' primary 
 movement,' of this or that muscle or group of muscles on 
 the opposite side of the body, which is represented, above 
 all other movements, at one particular point of the cortex : 
 
 MOTOR REGION OF CEREBRAL CORTEX (EXTERNAL SURFACE). 
 
 From the paper by Horslcy and Scliiifer in the Philosophical Transactions 
 of the Royal Society. (Paper read February 17, 1887.) 
 
 and there are * secondary movements,' which likewise are 
 evoked by stimulation at this particular point, but are 
 more strongly represented at some adjacent point. Thus, 
 the same movement has its ' primary representation ' at 
 that point where it is most strongly represented, and its 
 'secondary representation ' at one or more adjacent points. 
 By their experiments on the mesial surface, they proved 
 that the motor region extends dowTi over the greater part 
 of the mesial surface : the wliole of the marginal convolu- 
 tion (gyrus marginalis) is motor. By these experiments,
 
 LOCALISATION OF FUNCTION IN BRAIN 99 
 
 they added, to our map of the external motor region, a map 
 of the mesial motor" region. 
 
 a. MOTOR REGION OF CEREBRAL CORTEX (MESIAL SURFACE). 
 F"roin the same paper. 
 
 3. The Occipital Lobes. — ' Our experiments upo.i the occi- 
 pital region, though few in number, seem to Hnk together 
 the conclusions arrived at by Munk, and by Ferrier and Yeo, 
 as the result of their experiments. They indicate that the 
 occipital lobes and angular gyri are concerned with visual 
 perceptions, in such a manner that each occipital region is 
 connected with the corresponding lateral half of each retina, 
 and that a part only of the cortex of the region in question is 
 able to take on in great measure — how completely, cannot 
 be determined in animals — the functions of the whole. 
 This is in conformity also with the results obtained by 
 Luciani.' 
 
 4. The Tcmfwro-Sphcnoidal Lobe and the Limbic Lobe. — 
 Their experiments on the tcmporo-sphcnoidal lobe gave no 
 positive results : no distinct evidence was obtained either 
 for or against Ferrier's conclusion that the superior temporo- 
 sphenoidal gyrus is associated with auditory consciousness. 
 (The ' limbic lobe ' is Broca's name for the gyrus fornicatus 
 and the gyrus hippocampi, which form one continuous 
 structure : the gyrus fornicatus, shown in diagram 2, is the 
 convolution below the gyrus marginalis, separated from it 
 by the calloso-marginal fissure.) 'I*heir experiments on the
 
 loo SIR VICTOR IIORSLEY 
 
 limbic lobe led them to conclude that this portion of the 
 cortex is largely, if not exclusively, concerned with the 
 appreciation of sensations of pain and of touch. 
 
 In later years, Horsley doubted the validity of these 
 experiments on th(^ limbic lobe. 
 
 II 
 
 THE CORTICAL CENTRE, IN THE MONKEY, FOR THE UPPER 
 LIMB. (with BEEVOR) 
 
 Beevor and Horsley begin this paper with a study of the 
 comparative anatomy of the upper-limb area, in the monkey 
 and in man. They identify a small fissure in the monkey's 
 brain, which Schafer had provisionally called sulcus x, 
 with the superior frontal sulcus in the human brain. 
 
 They planned out the area into subdivisions of about 
 4 mm. square, and used electrodes 2 mm. apart. The 
 current was of minimal strength, just enough to give a 
 prickhng sensation on the tongue : 
 
 This very weak secondary current was always employed, 
 so as to obviate the fallacy of diffusion. That this object 
 was attained was obvious, for, if a certain movement was 
 always obtained at one place, shifting the position of the 
 electrodes for even one millimetre was sufficient to produce 
 a totally different result. 
 
 Working thus in millimetres, they found ' that the 
 ascending parietal convolution has less claim than the 
 ascending frontal to be considered as an area of extensive 
 representation of movement.' 
 
 They formulate two axioms, based on these experiments : 
 
 1. Viewing as a whole the ' motor area ' of the cerebral 
 cortex for the upper limb, as defined by Professor Ferrier, 
 we find that the regions for the action of the larger joints 
 are situated at the upper part of that area, close to the 
 middle line, while those for the smaller and more differen- 
 tiated movements lie peripherally at the lower part of the 
 area. 
 
 2. As a general rule, extension of all the joints, particu- 
 larly of the wrist and elbow, is the most characteristic move- 
 ment of the upper part of Ferrier 's arm centre ; \\\\\\q. flexion 
 is equally characteristic of the movements obtained by
 
 LOCALISATION OF FUNCTION IN BRAIN loi 
 
 stimulating the lower part. Finally, between these two 
 regions there is a small portion where alternate flexion and 
 extension predominate, a condition to which we have given 
 the name of confusion. 
 
 This confusion-theory failed to gain acceptance among 
 physiologists. Doubtless, the condition which suggested it 
 to Beevor and Horsley was brought about by some sHght 
 diffusion of the current : they did not completely ' obviate 
 the fallacy of diffusion.' 
 
 After a very minute analysis of these movements, they 
 take up their first axiom, in its relation to Hughlings Jack- 
 son's W'ork ; especially, his work on those cases of epilepsy 
 in which the convulsive movements begin always in one 
 and the same group of muscles, and spread by a definite 
 and orderly ' march ' or progress to other groups. Against 
 his will, the name of ' Jacksonian epilepsy ' had been given 
 to these cases. He resented this phrase : it asserted more 
 than it could prove : he preferred the phrase, ' the Jack- 
 sonian attack.' 
 
 It seemed to us highly important to note the order of 
 movement of the different segments of the limb — in fact, 
 the ' march,' as it lias been tenmd by Dr. Huglilings Jack- 
 son, of the nerve discharge — since we consider that a com- 
 plete series of observations of this kind would enable us to 
 construct a definite scheme which would show at a glance 
 where certain primary movements are really centralised. 
 By this we mean that we applied the electrodes to the 
 cortex just long enough to evoke movement in one joint 
 only, and then noted which moved first, and in what direc- 
 tion. This first movement we considered to be the primary 
 or fundamental movement in the given portion of cortex 
 stimulated. 
 
 They were able, by separate study of each square on their 
 plan, to ascertain which of the joints had ' priority of move- 
 ment ' in each cerebral centre or group of r('ntrt\s. They 
 give a table of their results, and comment (<n it : 
 
 As is shown in this tabic, the sequence in the movement 
 of the parts is fundamentally similar to that which had been 
 arrived at from clinical observation by Dr. Hughlings Jack- 
 son in cases of epilepsy. . . . The first and most fundamental 
 fact concerning the successive invasion of the various joints
 
 I02 SIR VICTOR HORSLEY 
 
 has already been determined by Dr. Hughlings Jackson, 
 viz. that when a movement emanating from tlie cortex, e.g. 
 of the upper hmb, begins in the shoulder, it proceeds down- 
 ward involving successively the elbow, wrist, and fingers ; 
 and inversely, when it begins in the thumb and fingers, the 
 ' march ' proceeds up the limb, . . . The observation of 
 these movements as produced in our experiments has enabled 
 us to form certain definite generalisations concerning the 
 order of their march. 
 
 Ill 
 
 further minute analysis of the motor region, 
 (with beevor) 
 
 In this paper they link up the facts of experimental 
 physiology closer to the facts of daily experience : they write 
 with more assurance of the identity of these experimental 
 movements with the complex purposeful movements of 
 ordinary life. 
 
 For perfect accuracy of localisation, this series of experi- 
 ments, twenty-three in all, was made on one species of 
 monkeys. In each case, the animal was killed before 
 recovering from the anaesthetic. The usual method was 
 followed : but they now studied results not only at the centre 
 of each square on the plan, but also at midway points. The 
 total amount of observations was very large. For example, 
 they distinguish ten forms of movement of the head and 
 eyes, and define the number and the position of the centres 
 of primary and secondary representation of each of them. 
 They even speak of tertiary and quaternary representation. 
 
 I. Movements of the Head and Eyes. — They call attention 
 to the great extent of the area over which the movement of 
 turning tlic licad and eyes sideways is represented. ' As a 
 primary movement, its importance entitles it to first con- 
 sideration. Of the 104 occasions on which this movement 
 was observed to occur, in 100 instances it was primary. 
 This is, no doubt, a demonstration of the necessity that 
 this primitive movement should precede all others.' That 
 is to say, the turning sideways of the head and eyes, being 
 essential to the perception of food, the avoidance of danger, 
 and so forth, is ensured by a very wide representation. 
 Beevor and Horslcy also determined, more or less exactly, 
 the ' march ' of the movements of the head and eyes ; and
 
 LOCALISATION OF FUNXTION IN BRAIN 103 
 
 found that the movements of the head and the movements 
 of the eyes are not invariably svnchronous. 
 
 2. Movements of the Lower Limb. — The movements of the 
 extreme joints, the foot and the hip, have a more important 
 primary representation than the movements of the inter- 
 mediate joints, the knee and the ankle. 
 
 The representation of the lower-limb movements is much 
 less higlily differentiated than the representation of the 
 upper-limi) movements. That is to say, the ordinary experi- 
 ence of daily life — that whereas the upper limb performs 
 movements of great complexity and spcciaUty of purpose, 
 the lower limb is engaged in actions which are far less 
 specialised — is re-stated on the surface of our brains. 
 
 The movements of the hallux (great toe) are very widely 
 represented over almost the whole of the lower-limb area : 
 they also have a very wide primary representation. The 
 maximum representation, i.e. the chief region of primary 
 representation, is round the upper end of the fissure of 
 Rolando. 
 
 The movements of all toes have their primary representa- 
 tion at the two extremities of the lower-limb area. From these 
 two points, their representation gradually diminishes in 
 intensity toward the focus of representation for the hallux. 
 The movements of the small toes apart from the hallux are 
 poorly represented. ' It is evident, from the general rarity 
 of primary movement of the small toes, that it is of very 
 inferior importance among the movements of the lower 
 limb.' 
 
 The representation of the movements of the ankle is what 
 might be expected from the relation of the ankle to the 
 rest of the limb : it takes part in almost all the movements 
 of the limb, but it takes a subordinate part. In such move- 
 ments, for example, as walking, or turning round, or with- 
 drawing the foot, it helps, but does not start, the action. 
 Its representation is in accord with its importance. It has 
 a very wide representation, but mostly secondary. 
 
 The movements of the knee, likewise, have that representa- 
 tion which might be expected from what we know of our 
 own actions. We all are aware that the movements of the 
 knee are mostly subordinate to the movements of the hip 
 and the foot : for example, we flex the knee to reheve the 
 strain of flexion of the hip. Accordingly, the primary repre- 
 sentation of the movements of the knee is ' most insigni- 
 ficant.' 
 
 The movements of the hip have a far stronger representa- 
 tion. The focus of representation is in the lower anterior 
 portion of the lower-limb area. 
 
 3. Movements of the Upper Limb. — As in the lower limb, 
 so in the upper limb the movements of each segment have
 
 £04 SIR VICTOR HORSLEY 
 
 that quantity and quality of representation to which the 
 segment is entitled by its contribution to the ordinary pur- 
 poses of daily life. Even the superiority of the upper limb, 
 as an implement, over the lower limb, is written on the 
 surface of the brain : the movements of the index-fmger, 
 and of the wrist, are more elaborately represented than the 
 movements of the second toe, and of the ankle : and the 
 representation of pronation of the hand — the turning of 
 the palm downward— is especially strong, this movement 
 being absolutely essential to the fine and accurate use of 
 the thumb and index-finger. In the ' march ' of the move- 
 ments of the upper limb, also, the exceptional value of the 
 index-finger shows itself. 
 
 4. Miscellaneous Facts. — Among the notes under this 
 heading, one is of special interest. Beevor and Horsley offer, 
 with some hesitation, a theory of the movements involved 
 in the taking of food. The area for the turning sideways 
 of the head and eyes is situated between ' the presumably 
 higher psychical centres of the prefrontal region ' and the 
 upper-Umb area. In the upper-limb area, the centres for 
 advancing and extending the hand lie in front of the centres 
 for withdrawing the hand and bringing the arm toward the 
 trunk. This anatomical arrangement of the brain's surface 
 would come into use over the act of taking food : the impulse 
 would travel direct. First, the psychic sense of some edible 
 object ; then the directing of the gaze to it ; then the reach- 
 ing forward of the hand to it ; lastly, the carrying of the 
 hand to the mouth. They admit that these are ' neces- 
 sarily speculative deductions ' : still, it is a sound theory : 
 but it had to be modified : indeed, it was modified by the 
 observations which they record in their next paper. 
 
 IV 
 
 the arrangement of the internal capsule. (with 
 
 beevor) 
 
 This work seems to have been even more elaborate than 
 the work already done. They had studied the surface of 
 the brain : now, they studied its deeper structures. They 
 set themselves to investigate the anatomical aiTangcment 
 and physiological action of the nerve-fibres passing down 
 from the surface of the brain toward the cord. They studied 
 these fibres along that stretch of their course which is called 
 the ' internal capsule.' This name is meaningless nowadays, 
 when we only think of a capsule as a sort of envelope : but
 
 LOCALISATION OF FUNCTION IN BRAIN 105 
 
 it had a meaning in the days when anatomists talked Latin, 
 Capsa is a paper-basket, such as the Romans used for hold- 
 ing a dozen or so of tail rolls of manuscript. Capsula is a 
 little paper-basket. The sheaves of millions of fibres were 
 likened to close-packed rolls of parchments standing side 
 by side. They are often likened to the sticks of a fan : 
 but we have to think not of one but of thousands of 
 fans. 
 
 On these fibres, Bcevor and Horsley made forty-five 
 experiments. In each case, the animal was kiUed before 
 recovering from the ana^thetic. They begin their paper 
 with a review of the work done by others, and with a very 
 minute description, thirteen pages long, of the anatom}' of 
 this part of the brain. Then they describe their method. 
 They worked on a plan of sub-divisions of only i mm. square ; 
 and they studied the fibres not only at one level of their 
 course, but at eight levels. That is to say, they studied 
 not one, but eight, ' groups ' of fibres. Each group, of 
 course, has its own outline on transverse section, and its 
 own position in relation to the gangha at the base of the 
 brain, just as each cross-section of the wood of a tree has 
 its own veining. But the outline of the internal capsule, 
 as a whole, is a narrow tract of white matter, bounded by 
 the basal gangha, and having two ' limbs,' anterior and 
 posterior, at an obtuse angle to each other. 
 
 Their use of engine-ruled paper is to be noted : and their 
 method of standardising the eight ' groups ' of the fibres : 
 
 Upon paper, on which fine lines were engraved by an 
 eiif^iiic with mathematical accuracy so as to cover the surface 
 with squares (jf i mm. side, wc drew by means of compasses 
 the exact outline of the basal ganglia as exposed by the section. 
 In this way wc obtained at once the cut surface of the in- 
 ternal capsule correctly projected on paper divided into 
 squares of i nun. ; these s(|uaros wo then nuni])cred from 
 tlu' front of the anterior limb of tlu; capsule to the jxjstnior 
 end of the lenticular nucleus. iMually we stinuilated each 
 of these bundles of fibres thus obtained of i square mm. 
 area, and recorded the effect produced. The electrodes 
 used were two fine |)latinum jioints, i mm. apart, so that 
 the excitation should be exactly limited to each square 
 excited. . . . After the experiment was comi^letcd, the
 
 i()6 SIR VICTOR HORSLEY 
 
 animal was killed by excess of chloroform, the hemisphere 
 removed, washed in salt solution, and the surface photo- 
 graphed. Upon the photograph thus obtained, the numbers 
 representing the different bundles of fibres (i mm. square) 
 were transferred by compasses from the plan originally 
 drawn on tlic ruled paper. . . . 
 
 In plotting out the plan of tlic capsule during an experi- 
 ment, we arranged it so that the more important posterios 
 limb should be drawn parallel to one direction of the rowr 
 of squares on the ruled paper ; consequently, as the anterior 
 hmb forms an obtuse angle with the posterior limb, the 
 squares dividing it were necessarily dchelonned. We there- 
 fore expressed eacli square, or bundle of fibres, by a fraction, 
 the numerator of which denoted the distance that it was 
 situated from the anterior end of the capsule, while the 
 denominator gave the total length of the capsule in that 
 particular section. In this wise, one fraction, or in other 
 words the position of one bundle of fibres in one section, 
 is strictly comparable with that in another section. 
 
 In order to bring aU the fractions, thus obtained, together, 
 and to find the average position of the representation of 
 any given movement in each group, we converted all the 
 fractions into decimals to two places. We took two places 
 as adequately accurate, since any error beyond would only 
 amount to , ^^ ^^ th of the length of the capsule : and as this 
 actually amounts, on the average, to not more than 02 mm., 
 it is a length far too small to be considered among the errors 
 of the experimental method. 
 
 Working thus in fractions of millimetres, and studying 
 the internal capsule at no less than eight levels, Beevor and 
 Horsley were able to construct a very perfect scheme of it. 
 Their paper is illustrated with many photographs and many 
 tables of figures, and with 152 diagrams. The general 
 results which they obtained — it is absurd, to give a ' sum- 
 mary ' of work so minute — were as follows : 
 
 1. There is no evidence that any fibres descending from the 
 cortex pass into the basal ganglia. 
 
 2. The anterior limb of the internal capsule is almost all of 
 it composed of fibres coming from the prefrontal region. 
 That part of tiie brain is not immediately concerned with 
 motor impulses, and the fibres coming from it have no 
 efferent motor function, and give no response to electrical 
 stimulation. 
 
 3. That portion of the internal capsule which does respond 
 to stimulation is composed of fibres coming from the fronto- 
 parietal region.
 
 LOCALISATION OF FUNCTION IN BRAIN 107 
 
 4. The extremity of the posterior hmb is composed of 
 fibres coming from the temporal and occipital regions : 
 these regions are not immediately concerned with motor 
 impulses, and this portion of tlie capsule gives no response 
 to stimulation. 
 
 5. The excitable fibres are arranged, antcro-posteriorly, 
 in the same order as the foci of representation in the excitable 
 portion of the cortex. 
 
 6. Likewise, the arrangement, in the internal capsule, of 
 the representation of the movements of each segment of a 
 limb corresponds to the arrangement in the cortex. 
 
 7. Likewise, the character of each movement is represented 
 in the internal capsule, as in the cortex. 
 
 This last conclusion modified the importance of the cortex 
 as a factor of purposive movements, and emphasised Hugh- 
 lings Jackson's teaching, that all representation is re-repre- 
 sentation ; that our purposive movements are represented 
 at many lower levels of our central nervous system, and 
 that the cortex is nothing more than the highest level. As 
 he said, ' I believe that the cerebrum represents all parts 
 of the body ; and that the cerebellum also represents all 
 parts of the body.' And again, ' Of what substance can 
 the organ of mind be composed, unless of processes repre- 
 senting movements and impressions ? And how can the 
 convolutions differ from the inferior centres, except as 
 parts representing more intricate co-ordinations of impres- 
 sions and movements in time and space than they do ? ' 
 
 THE BRAIN OF AN ORANG-OUTANG. (WITH BEEVOR) 
 
 In this one experiment on the cortex and the internal 
 capsule of the brain of a young orang-outang, they found 
 that the orang required more of the anaesthetic, both ab- 
 solutely and relatively, thim the bonnet monkeys : and 
 that a rather stronger current was needed to evoke any 
 movement. The drawing here produced was made by 
 Horsley at the time of the experiment ; it shows the 
 numbering of the 2 mm. squares over the motor area. The 
 paper is illustrated with thirty i>hotographs of the orang's
 
 io8 
 
 SIR VICTOR HORSLEY 
 
 brain : and begins with a review of the comparative anatomy 
 of the cortex in the bonnet monkey, the orang, and man. 
 
 
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 DRAWING MADE DURING KXPERIMENT ON THE MOTOR REGION 
 OF THE CEREBRAL CORTEX OF AN ORANG-OUTANG. 
 
 From the paper by Beevor and Horilcy in the Philosopliic.il Transactions of 
 the Royal Society. (Paper read June 12, 1890.) 
 
 1 . Movements of the Lower Pari of the Face. — Beevor and 
 Ilorsley note the great mobility of the Ups ; they describe 
 seven distinct movements of the mouth and hps, and give 
 the representation of each movement. In their preceding 
 paper, they had discussed bilateral movements, i.e. those 
 movements which are brought about, simultaneously and 
 symmetrically, on both sides of the body, by the action of 
 one side of tlic brain. They now divide the movements 
 of the mouth and lips into those which are bilateral and 
 those which are unilateral. 
 
 2. Movements of the Tongue. — They describe five distinct 
 movements, ranging from complete protrusion to complete 
 retraction. The representations of these movements were 
 arranged on the cortex hi a line from above downward.
 
 LOCALISATION OF FUNCTION IN BRAIN 109 
 
 3. Movements of the Upper Limb. — They call attention to 
 the remarkable individual clearness, the high ' integration,' 
 of the representation of each movement. In the brain of 
 the bonnet monkey, they had very rarely obtained isolated 
 primary movements : even a momentary application of 
 the electrodes was apt to evoke secondary movements over 
 and above the primary movement. In the brain of the 
 orang, each centre was more able to keep itself to itself : 
 they could easily obtain isolated primary movements. 
 
 4. Movements of the Lower Limbs. — ' Probably in all the 
 higher animals the representation of the lower limb is less 
 integrated than that of the upper limb : but it was especially 
 necessary to see what was the condition in an anthropoid like 
 the orang, whose customary vertical posture places it in 
 an intermediate position between the macaques and man.' 
 In accord with this fact, they found, in the orang's brain, a 
 very wide and highly differentiated representation of the 
 movements of the hip. And they especially note that in 
 the orang, extension of the hip and knee was produced much 
 more often than flexion : whereas, in the macaque, flexion 
 was produced much more often than extension. 
 
 The representations of the movements of the lower hmb — 
 liip, knee, ankle, hallux, and small toes — were arranged, on the 
 cortex of the orang, in a hne from below upward : but on 
 the cortex of the macaque, in a line from before backward. 
 
 From these facts, Beevor and Horsley deduce a very in- 
 genious theory, which they ' venture to suggest is not merely 
 fanciful.' The habits of the two animals, they say, seem to 
 agree with the arrangement of their lower-limb centres. 
 The macaque saves itself in flight by climbing, for which 
 purpose the first movement is, of necessity, flexion of the 
 hip : and, in the macaque, the representation of this move- 
 ment is situated at the most anterior point of the lower- 
 limb area, just where it ought to be for the psychical order 
 of events, i.e. first the directing of the gaze, then the initial 
 movement of flight. Tiie orang, for the initial movement 
 of flight, rises on its lower limbs, extending the hip and 
 knee : and, in the orang, extension of these joints is more 
 strongly represented than flexion. 
 
 Finally, Beevor and Ilorsky come back to the extra- 
 ordinarily high differentiation of the orang's brain. In llic 
 macaque, they say, the excitable area of the cortex is con- 
 tinuous : ill the orang, it is traversed by intervening zones 
 which are not excitable : 
 
 It is well known that in the lower orders of animals the 
 integration of representation becomes less perfect as wc
 
 no SIR VICTOR HORSLEY 
 
 descend in the scale — that, in fact, it is increasingly difficult 
 U) diffcivntiate the areas for the limbs ; while, on the con- 
 trary, in ascending the scale, we have shown in our previous 
 communications that it is easy to differentiate between the 
 areas of representation of even the segments of the limbs : 
 and finally, when we now arrive at the orang, the segments 
 are not only differentiated in representation, but the nature 
 of that representation is that of single movements. 
 
 The existence of non-excitable lines or ' zones ' is not now 
 admitted by physiologists : the theory of the excitability 
 of the post-central convolution, also, was to some extent 
 corrected by the later work of Sherrington and others.* 
 None the less, this study of the orang's brain — the first 
 anthropoid brain thus studied either in this country or 
 any other — was of great value. 
 
 VI 
 
 the central motor innervation of the larynx, 
 (with semon) 
 
 There are two sets of small muscles for the movements of 
 the vocal cords : those which bring the cords together, 
 and those which draw the cords apart. These two sets of 
 muscles are called the intrinsic muscles of the larynx, 
 because they are part of its structure : they lie just under 
 the mucous membrane. The large outside muscles, the 
 extrinsic muscles, which draw the larynx up and down en 
 masse, have nothing to do with the movements of the vocal 
 cords. 
 
 The bringing together of the cords is called adduction : 
 the drawing apart of the cords is called abduction. To 
 speak, we use our adductor muscles ; to take a deep breath, 
 
 • In 1909, in his Linacro Lecture, Ilorslcy spoko as follows of this 
 question of the excitabihty of the post-central convolution: 'The first 
 experiment in an anthropoid wa,s a sohtary observation by Dr. Beevor 
 and myself. We only obtained evidence of excitability of the post- 
 central gyrus at two points. This single experiment, confirmed in all 
 other essential particulars, has been superseded by the extensive researches 
 of Sherrington and Griinbaum, wlio were enabled to make a great many 
 experiments on the orang, cliiinpanzcc, and even the gorilla. They found 
 that the gyrus post-centralis in the anthropoid was inexcitable to a stimulus 
 which evoked a response from tlic gyrus prc-ccntralis ; but " faciUtated " 
 elicitatioD of movemeat from the gyrus pre-ccntradis.'
 
 LOCALISATION OF FUNCTION IN BRAIN iii 
 
 we use oiir abductor muscles. In quiet breathing, the 
 cords are held about halfway between adduction and full 
 abduction. 
 
 Semon, in 1881, in the Archives of Laryngology, laid down 
 a rule so importimt that we may call it Semon's law. In 
 cases of organic disease involving the motor nerves of the 
 larynx, the abductor muscles fail before the adductors : 
 in cases of functional disease, the adductors fail before the 
 abductors. A patient with organic disease involving these 
 nerves has difficulty in drawing the cords far apart, while 
 he is still able to bring them together : a patient with 
 ' hysterical aphonia ' has difficulty in bringing them together, 
 but none in drawing them apart. On this fact, Semon and 
 Horsley founded their study of the cerebral centres for the 
 control of respiration and phonation. Three initial diffi- 
 culties had to be reckoned with : 
 
 1. They found differences, in the localisation of the laryngeal 
 centres, between different species of animals. 
 
 2. They found differences between animals of the same 
 species but of different ages. 
 
 3. Most unexpected of all, they found that the anaesthetic, 
 ether, in very large doses, had a direct local influence of its 
 own on the larjmgeal muscles.^ 
 
 They begin their paper with a review of the work done 
 by others, especially by Ferrier, who comes first of all : 
 it was he who discovered the cortical centre for adduction. 
 The results obtained by Semon and Horsley must be divided 
 according to the level at which they were observed, and 
 the species of the animal. 
 
 I. The cortex. — In the monkey, they exactly defined the 
 centre for adduction, at tiie lower end of the ascending 
 frontal convolution. Outside this focus, there was an area 
 
 * An American laryngologist, Dr. Hooper, had called attention to this 
 purely local action of cther-vuixjur. Semon and Horsley studied it 
 thoroughly, and read a \m\\>cx on it at the Annual MceliuK in iS8o of the 
 British Medical Association. Tiicy argued, from this sclecUve action 
 of etlicr, that there must be a pliysical dilferencc between the two groups 
 of muscles : and tht-y confirmed tins argument by a vi-ry simpli- txperi- 
 ment. They removed the larynx from an animal imnudiattly after 
 death, and exjxjscd the muscles by rapid dissection, and found tliat the 
 abductors ceased to respond to the faradic current stK)ner tiian the 
 adductors : that is to say, the abductors died before the adductors.
 
 112 SIR VICTOR HORSLEY 
 
 where adduction was less strongly represented and was 
 associated with movements of the ph:irynx. The adduc- 
 tion was always bilateral. They found no cortical centre 
 for abduction. In the dog (adult) they obtained bilateral 
 adduction, usually associated with movements of the pharynx. 
 They found no centre for abtluction. By stimulation of 
 points adjacent to the centre for adduction, they were able 
 to quicken the rate and increase the range of the ordinary 
 laryngeal movements of respiration. In the cat, they found 
 a remarkable difference from the dog. Abduction was 
 well represented. In the rabbit, they found no focal area 
 either for adduction or for abduction. Such movements 
 as did occur were usually adduction, and were always 
 associated with movements of the pharynx. 
 
 2. The Internal Capsule. — The arrangement of the excitable 
 fibres of the internal capsule, from before backward, was 
 as follows : Acceleration of the respiratory movements : 
 abduction : increased range of the respiratory movements : 
 adduction. The relative position of these four groups of 
 fibres was ' constant and strictly homologous in the different 
 species of animals.' 
 
 3. The Medulla. — These experiments were on the dog 
 or the cat, not on the monkey. They proved the existence 
 of small but well-defined areas, on the floor of the fourth 
 ventricle, for adduction (unilateral or bilateral) and for 
 abduction (bilateral). 
 
 In early animal life, efficiency of respiration is more 
 important than efficiency of phonation : that is to say, 
 abduction is more important than adduction. In accord 
 with this fact, Semon and Horsley fomid that abduction, 
 in all young animals, had a much stronger cortical repre- 
 sentation than adduction. Thus, the central motor inner- 
 vation of the larynx — as Semon had suggested at the 
 International Medical Congress in Copenhagen in 1884 — 
 is adjusted not only for phonation but also for respiration ; 
 and adapts itself, in each species of animal, to the change 
 from early life to adult life. 
 
 It is more than a quarter of a century, since the last of 
 these six papers was published. They were pioneer work ; 
 they have been modified or corrected at this or that point, 
 since 1800 : none the less, they are a very memorable 
 achievement in research, a series of studies such as few 
 men could have planned and put through. And the wonder
 
 LOCALISATION OF FUNCTION IN BRAIN 113 
 
 is, that Horsley yet made time for so much else — for all 
 his work on myxoedema, and on rabies, and in Hospital : 
 and already, in 1886, at Queen Square, was beginning to use 
 in surgery the facts and the methods which he had acquired 
 from experimental physiology, and to advance the surgical 
 treatment of the brain and the spinal cord. 
 
 NOTE 
 
 Dr. A. Salusbuiy MacNalty, who can speak with authority of 
 this aspect of Horsley 's work, has kindly revised and corrected 
 this chapter.
 
 VIII 
 
 From 1885 to 1887 
 
 In 1884, the Brown Institution had given him what he most 
 needed for the pursuit of experimental physiology and 
 pathology : he was not made for solitary work, nor for the 
 teaching of elementary facts to a class of students : he was 
 at his best when he was working with men of his own age 
 and standing in science. In 1885, he became an Assistant- 
 Surgeon to University College Hospital. In 1886, he 
 became Surgeon to the National Hospital for the Paradysed 
 and Epileptic, Queen Square ; and Professor of Pathology 
 at University College. The advantages of these appoint- 
 ments must be reckoned not by addition but by multipUca- 
 tion : each of them heightened the value of the others. 
 
 He was an Assistant-Surgeon to University College 
 Hospital from 1885 to 1893 : a ' Full Surgeon ' from 1893 
 to 1900 : and a ' Surgeon in charge of Hospital Beds ' from 
 1900 to 1906 : he then retired, and was made a Consulting 
 Surgeon. Thus, he was on the visiting staff for twenty-one 
 years : but it was only for the last six years that he had 
 wards of his own. He began work in the old building : it 
 stood where now is the grand new building, the gift of Sir 
 Blundell Maple. Horsley was on a staff which was rightly 
 called * brilliant ' : one thought of University College 
 Hospital as one thought of Balliol among the Oxford 
 Colleges. But there are no great events in this part of his 
 life's work : it might almost be regarded as uneventful : he 
 was doing what other men were doing. Only, it helped to 
 make him what he was : as he said once, half-jest, half- 
 earnest, to a friend who apologised for consulting him over a 
 trivial accident, ' I take all human infuTnity for m}' province.' 
 He never lost hold, in special surgery, of general surgery. 
 
 114
 
 FROM 1885 TO 1887 115 
 
 With his appointment to University College Hospital, and 
 with the name that he was winning for himself, it was time 
 that he should be in the consultants' quarter of London. 
 The plan for a house in Grosvenor Street fell through : and 
 in 1885 he moved from Gower Street to 80 Park Street, 
 Grosvenor Square. 
 
 On May 12, 1885, at a meeting of the Royal Medical and 
 Chirurgical Society, he took part in the discussion of a paper, 
 by Hughes Bermett and Godlee, on a case of removal of a 
 tumour from the brain. The date of this operation, the 
 first of its kind either in this country or, so far as we know, 
 in any other, is November 25, 1884. Horsley spoke of what 
 he and Schafer had learned from their experiments on 
 monkeys : especially, of the use of morphia plus the anais- 
 thetic, the use of a dry permanent dressing, and the disuse 
 of the galvano-cautery. 
 
 There is a reference to these experiments, in a letter to 
 Schafer, June 10 : 
 
 Can we get the stimulation experiments supplemented and 
 published as soon as possiljle ? I shall be quite ready to do 
 as much as you Hke after this week. What are your arrange- 
 ments as to holidays, etc. ? Fact is, I have been working 
 at the same tiling in choreic dogs, and I don't find mucli 
 difference so far. Then also our localisation of motor centres 
 is supported by clinical evidence much more strongly than 
 Ferrier's, and I think we ought to publish it, altliougli 1 
 am extremely sorry the two plans do not coincide exactly. 
 
 In September, he published notes of a case in University 
 College Hospital, of septic peritonitis, with recovery after 
 operation : this was his first contribution to the hterature 
 of general surgery. 
 
 i886 {crt. 29) 
 
 On January 14, the Neurological Society of London was 
 founded, at a meeting at Dr. de Watteville's house. 
 Hughlings Jackson was its first President : Hoi-sley was one 
 of the original members. At a meeting of the Society on 
 May 26, in the physiological laboratory of University 
 College, Schafer and Hoi-sley opened a discussion, ' On the
 
 Ii6 SIR VICTOR HORSLEY 
 
 sensory and niotui lucalisalionb.' At a meeting on December 
 i6, Bastian read a paper, ' On the muscular sense, its 
 nature, and cortical localisation.' Horsley was one of the 
 many speakers in the discussion. The paper and discussion, 
 which occupy, in published form, no less than 137 pages 
 of Brain, April 1887, were concerned with the question. 
 What is the true nature of the cortical motor centres ? ^ 
 Bastian gave them the ill-sounding name of kinaesthetic, i.e. 
 motor-sensory. Horsley did not admire this word : he 
 rightly preferred his own phrase, ' the so-called motor 
 centres.' He argued from the microscopic structure of the 
 cortex ; it was a line of argument which in 1886 had hardly 
 been attempted : he advanced a theory, that the larger 
 nerve-cells, the ' fourth layer ' of the cortex, probably were 
 motor ; and the smaller nerve-cells, the more superficial 
 layers, probably were sensory. 
 
 The paper and discussion wasted some of their force in 
 talk about consciousness. Horsley was on his guard against 
 all such talk. ' It is not for me,' he said, ' to enter to-night 
 into questions of much deeper import, questions of philo- 
 sophic thought.' Bastian had said that consciousness is 
 ' of the nature of an epiphenomenon.' Horsley would not 
 care for that sort of saying : it never was of any use to offer 
 him a stone for bread. 
 
 On February 9, 1886, he was appointed Surgeon to the 
 National Hospital for the Paralysed and Epileptic, Queen 
 Square. It is not the only Hospital of its kind in London : 
 but it was ' the oldest, the largest, the richest, and the best ' : 
 it was known far and wide for its work and its teaching. But 
 they who now are students, or are just starting in practice, 
 can hardly realise all that it stood for, in the years when the 
 
 » There was general agreement, that they are not only a departure- 
 
 {)latfonn for impulses going to the muscles, but also an arrival-platform 
 or impressions coming from the muscles and from the surface of the 
 body. The movements of walking, for example, are the ultimate result 
 of certain experiences of touch and position and weight and equilibrium : 
 they are decided by tho ' feel ' of our muscles and our joints ; by the ' con- 
 sciousness ' that we have our feet on the ground ; and by previous experi- 
 ences of these impressions, stored up in us ever since we began to walk. 
 The arrival-platform for all these factors of walking must be continuous 
 with the departure-platform for the act of wsilking : there must bo one 
 tarauaus, under one roof.
 
 FROM 1885 TO 1887 117 
 
 new learning was new. We who were students about 1880 
 regarded it with downright reverence, as a place where men 
 thorough!}' understood the nervous system. All other 
 systems, and their diseases, we thought that we ourselves 
 imderstood : if not we, the ph3'sicians of our several Hospitals 
 understood them : but with the nervous system it was other- 
 wise. The diseases of that system were not calculable and 
 exphcable, like fevers, and diseases of children : nor were 
 they a fair subject for an examination paper : the place for 
 them was Queen Square. 
 
 His operating-theatre was simple enough : it was a room 
 which was intended for, and is now, the day-room of Margaret 
 Gibbins ward. The Hospital's first operating-theatre, which 
 now is the lecture-theatre, was opened in 1891. The 
 present operating-theatre was opened in 1904. 
 
 Before Horsley, the appointment had been held by 
 Mr. William Adams, a kindly, skilful, rather old-fashioned 
 surgeon, one of the foremost representatives of orthopaedic 
 surger}'. He did all that could be done, by the straightening 
 of bones, the division of tendons, the adjustment of supports, 
 and so forth, to improve the usefulness of deformed, con- 
 tracted, or paralysed limbs. Surgery, up to 1886, had been 
 employed at the Hospital as a rather mechanical art. Indeed, 
 a famous London surgeon, who had thought of applying for 
 the appointment, had been dissuaded, for this reason, that 
 it was below his dignity. But there was a far stronger 
 reason. The Staff intended to have Horsley, and nobody 
 else : it might even be said that they created the appoint- 
 ment for him : Mr. Adams did not retire till 1890. In 1891, 
 Mr. (Sir Charles) Ballance was appointed : he and Horsley 
 were Surgeons together : and in 1906, Mr. Donald Armour 
 and Mr. Percy Sargent were appointed Assistant-Surgeons. 
 
 Fifty years ago, and less than fifty years, the rules for 
 operating on the head were those which Ambroise Par6 had 
 taught and followed in the sixteenth century. The con- 
 ditions requiring operation, and the precautions to be 
 observed, were well known. The operation of trej)hining 
 the skull could not improve itself : it could only wait for 
 some outside discovery to improve it. Par(5 gives thirty
 
 Ii8 SIR VICTOR HORSLEY 
 
 folio pages to the treatment of wounds of the head : and 
 he writes of them with admirable judgment. Here, for 
 example, from Johnson's translation, is one of his many 
 cases : 
 
 Monsieur do la Bretcsche, in the triumphant entrance of 
 King Henry the second into Paris, was so hurt with a stone, 
 that the Os Petrosum, or scaly bone, was broken with the 
 violence of the blow, and the temporal muscle was vehemently 
 contused, yet without any wound. I being called the next 
 day (viewing the manner of the hurt, and the condition of 
 the wounded part) thought good to bring some Physicians 
 and Chirurgcons with me to consult hereof. . . . When all 
 of them at the last had inchned to my opinion, I presently 
 divided the musculous skin which was over the upper part 
 of the fracture, with a three-cornered section : the day 
 following, which was the third of his disease, I trepanned 
 him ; and after I had done, some few days later, I took out 
 some four splinters of the broken bone ; and I put in a plain 
 leaden pipe, by which (I wishing the Patient ever when I 
 drest him to hold dowTi his head, to stop his mouth and his 
 nose, and then strive as much as in him lay to put forth his 
 breath) much sanious matter came forth, which was gathered 
 between the skull and Crassa Meninx. Other filth which 
 stuck more fast, I washed out with a detergent decoction, 
 injected with such a Syringe as is here exprest ; and I did 
 so much, God blessing my endeavours, that at length he 
 recovered. 
 
 The method of operating by stages in such cases was given 
 up : but that is not the point here. The point is that a 
 surgeon, half a century ago, could not do more than Pax6 
 had done. He must have something to guide him, some- 
 thing to go by : wound or scar or depressed fracture. 
 Trephining, of itself, was not brain-surgery, but skull- 
 surgery ; it was the repairing of the roof of the house of life. 
 The skull must be dealt with, for the sake of the brain : but 
 the less that the surgeon saw of the brain, the better he was 
 pleased. 
 
 The date of the earliest recorded case, in this country, of 
 real brain-surgery, is 1876. A boy of eleven, a patient of 
 Macewen of Glasgow, showed signs of acute brain-disease 
 which, from the evidences of cerebral localisation, ' were 
 judged to indicate cerebral abscess situated in the left 
 frontal lobe, in the immediate vicinity of the base of the
 
 FROM 1885 TO 1887 119 
 
 third frontal convolution, between the speech-centre and 
 the internal capsule.' There speaks the new learning, with 
 authority : Nova rerum nascitur ordo. Macewen desired 
 to operate without delay, but the operation was put off by 
 the boy's friends ; he died thirty hours after the consulta- 
 tion ; Macewen was allowed to perform the operation post 
 mortem, and found the abscess where he had locahsed it. 
 His next case, an abscess in the left temporo-sphenoidal 
 lobe, was in 1881 : he operated, and found the abscess : but 
 it had already infected the lateral ventricle, making the case 
 hopeless. The first successful operation in this country 
 for temporo-sphenoidal abscess was by Arthur Barker, in 
 1886. We can count on our fingers the cases of modem 
 brain-surgery recorded in our surgical literature, up to the 
 time of Horsley's appointment to Queen Square. 
 
 He was more than qualified for it ; he was the one man 
 for it. He had been engaged for two years, in his work with 
 Schafer and with Beevor, over brain-surgery on monkeys ; 
 he had done more than a hundred of these operations on 
 animals ; he brought to Queen Square a precise and habitucd 
 method ; he had worked it out on monkeys, he did not 
 have to work it out on man. Especially, he had acquired 
 familiarity with brain-surgery under the very conditions 
 which he would find at Queen Square ; the conditions of 
 operating with neither wound nor scar nor depressed 
 fracture to guide him, nor anything else except the facts of 
 cerebral localisation. Six points in his method are to be 
 noted : but, of course, as time went on, he modified it here 
 and there : 
 
 1. He was absolutely determined to prevent wound- 
 infection. 
 
 2. He was thoroughly familiar with the action of anaes- 
 thetics on the brain. 
 
 3. Instead of the old cruciform incision, he made a long 
 curved incision and turned down a flap of skin and muscle, 
 so as to expose the skull very freely. There was another 
 advantage ; the flap, when it was brought back into posi- 
 tion and secured with sutures, kept up steady pressure over 
 the brain. 
 
 4. He knew exactly how to expose the brain by a rapid 
 and well-planned removal of bone. So early as 1887, he
 
 120 SIR VICTOR HORSLEY 
 
 added, to the use of the trephine and the bone-cutting 
 forceps, the use of a miniature circular saw driven by a 
 Bonwill's surgical engine. 
 
 5. He never used the galvano-cautery. 
 
 6. To stop bleeding from the cut edge of the bone, he 
 devised the use of antiseptic wax.^ 
 
 The date of his first operation at Queen Square is May 
 25, 1886. The patient, a young Scotsman aged twenty-two, 
 had been run over when he was seven, and had been in 
 the Edinburgh Royal Infirmary under Annandale, with a 
 compound fracture of the left side of the skull and escape of 
 brain-substance. At the age of fifteen, he began to have 
 fits : he was in Queen Square in 1885, and was readmitted 
 in 1886. The mind was dull, there was partial paralysis of 
 the right arm and leg, and the fits were of extraordinary 
 frequency : he had 2870 fits during his first thirteen days in 
 Hospital. The ' march ' of the fits was well defined. The 
 gap in the skull from the original injury lay over the upper 
 third of the left ascending frontal convolution. The 
 diagnosis was ' scar involving the hinder end of the superior 
 frontal sulcus,' Horsley removed the scar in the brain, and 
 the surrounding brain-substance, to a depth of two centi- 
 metres. The wound healed well : the mental condition 
 was improved : and the fits ceased. 
 
 The physicians watched the operation with keen interest : 
 and when it was over, Hughlings Jackson let himself enjoy 
 the relaxation of the strained mind. He beckoned to 
 Ferrier : ' Awful, perfectly awful,' he said. Ferrier was 
 shocked : the operation had seemed to him faultless. Again 
 Hughlings Jackson murmured that an awful mistake had 
 been made. ' Here 's the first operation of this kind that 
 we have ever had at the Hospital : the patient is a Scots- 
 man. We had the chance of getting a joke into his head, 
 and we failed to take advantage of it.' 
 
 On May 28, at a meeting of the Clinical Society, Horsley 
 read a paper ' On a case of suppuration of the mastoid cells : 
 with remarks on the prevention of septic embolism in such 
 
 * In his experiments in 1885, he had made use of ordinary modelling 
 wax, worked soft in the fingers. See bis letter, Brit. Med. Journ., 1892, 
 i. 1165.
 
 FROM 1885 TO 1887 T2I 
 
 cases.' This paper contains the first suggestion ever made 
 in this country, or, so far as we know, in any other, for the 
 ligature of the jugular vein in cases where suppuration, 
 spreading from the ear to the mastoid bone, has caused the 
 formation of a clot of blood (thrombosis) in the lateral sinus 
 of the brain ; particles of the clot may be carried by the 
 circulation into the heart and lungs (embolism) : the 
 ligature of the jugular vein would prevent this : 
 
 There remains the question how to prevent embolism of 
 the thoracic viscera, supposing thrombosis to be well declared. 
 The solution of this problem is a simple matter enough, 
 looking at it from the merely mechanical point of view ; 
 resolving itself of course into the not very serious operation 
 of ligature of the jugular vein in the middle of the neck.^ 
 
 In August, at the Annual Meeting of the British Medical 
 Association in Brighton, Horsley read a short paper ' On 
 Brain-Surgery.' He had done three operations at Queen 
 Square : he described them, and showed the patients — May 
 25, excision of scar ; June 22, removal of tubercular tumour 
 and of the thumb-area ; July 13, removal of splinter of bone 
 and surrounding cyst. This paper was the great event of the 
 Brighton meeting. In the discussion of it, Charcot, Hugh- 
 lings Jackson, and Erichsen were among those w^ho con- 
 gratulated him. 2 Erichsen said : 
 
 The old lines of ordinary cUnical observation and dead- 
 house pathology have long since been followed to their final 
 termination : we can but multiply the facts already so 
 carefully observed and so admirably recorded by countless 
 observers in every civihsed country. It is not to following 
 these old Unes that modem surgery will owe its advance ; 
 but it is in the application to it of those means of experi- 
 
 * In 1888, Sir Arbuthnot Lane proved the value of this mctliod (Clin. 
 See. Trans., xxii. 255) ; and in 1890 Sir Charles Ballance fornuilatcd 
 exact rules for it, and brought it into general recognition : see his classical 
 paper, in the Proceedings of the Medical Society of London, March 21, 1890. 
 
 * He stayed at Lancing, witli Mr. Frank Cutlack ; who writes, ' I can 
 recall his preparations the day before the lecture, when he had his diagrams 
 and an array of instruments all spread out in my conservatory. On Iho 
 afternoon of the lecture, I ran into tlie Itrigliton I'avilion to pick him up : 
 in time to sec his patient walking up an<l ilown the platform, and to hear 
 deligiitful old Cliarcot in his courteous way thank H(jrs!cy for his lecture, 
 and for his wonderful services to suffering mankind. It was indeed a 
 glorious triumpli, as even a layman such as I could perceive, for so young 
 a professional man.'
 
 122 SIR VICTOR HORSLEY 
 
 mental research which are now being worked out in the 
 biological and pathological laboratory, that we may hope 
 to find the solution of many of those problems that have 
 hitherto baffled the surgeon. 
 
 Horsley's fourth operation at Queen Square, September 
 23, was wonderful indeed. The patient was completely 
 paralysed on the left side, was suffering from fits, and had 
 been semi-comatose for ten days before the operation. The 
 diagnosis was ' tumour of the cortex involving the upper 
 part of the arm-centre in the right hemisphere.' Horsley 
 removed a mass of glioma of 4^ oz. weight. The patient 
 regained consciousness ; the fits ceased ; the mental state 
 remained perfect for three months ; and the paralysis became 
 less marked, till he could walk with a little help. He died 
 of recurrence of the disease, six months after the operation. 
 
 By the end of 1886, Horsley had done ten operations at 
 Queen Square. Nine had been successful — ranging from 
 improvement to complete recovery. One had been followed 
 by death : the patient was a boy with cerebellar tumour : 
 he was worn out with pain, vomiting, and fits ; was paral3'sed, 
 more or less, in all four limbs ; and had been bed-ridden for 
 a year before the operation. 
 
 At the Brown Institution this year — beside all his other 
 work there — he made many experiments on epilepsy : his 
 Brown Lectures, at the end of the year, were two of them 
 on the thyroid gland, and three on epilepsy (Lancet, 1886, 
 ii. 1 163, 121 1). He spoke of the confusion of theories of 
 epilepsy, and of the vague phrases in which the disease was 
 described. He would have nothing to do with Nothnagel's 
 theory of the existence of ' special convulsive centres.' He 
 discussed the value of the theory that each hemisphere 
 ' represented both sides of the brain ' : and said that it could 
 not be proved either from chnical evidence or from experi- 
 mental evidence. He emphasised the evidences of the in- 
 dependent action of each hemisphere apart from the other ; 
 he was of opinion that ' convulsions due to cortical discharge 
 are evoked in various groups of muscles by nerve energy 
 proceeding from that centre in each hemisphere which is 
 in relation to each group of muscles, and that in general-
 
 FROM 1S85 TO 1887 123 
 
 ised epileptic convulsions both cerebral hemispheres are 
 involved.' 
 
 He made a special series of experiments on the disease, 
 during March- July, planned on the Unes of Brown-Sequard's 
 work : with direct reference to a very strange case of 
 epilepsy which was under the care of Hughlings Jackson. 
 This case was described by Hughlings Jackson at a meeting 
 of the Medical Society, on November 15 ; and Horsley 
 showed at this meeting some instantaneous photographs of 
 epileptic guinea-pigs. 
 
 About this time, also, he made two experiments on the 
 results of removal of the pituitary body : partly, because of 
 the association of epileptiform movements with disease of 
 the pituitary body ; partly, because of the analogy between 
 the pituitary body and the thyroid gland.* 
 
 Other events of this memorable year were as follows : 
 (i) He was elected a Fellow of the Royal Society. (2) He 
 published a translation of Koch's monograph ' On the 
 Investigation of Pathogenic Micro-organisms.' ^ (3) He dis- 
 puted with Schiff (Brain, April and October 1886) over the 
 course of certain tracts of the spinal cord, and their con- 
 nection with the motor area of the cortex : he had the last 
 word in this elaborate controversy ; and he fought, it seems, 
 with ease, and even with enjoyment. 
 
 1887 {cBt. 30) 
 
 On March 4, at the Royal Institution, and later at the 
 Harveian Society and the Anthropological Institute, he 
 lectured on ' Brain-Surgery in the Stone Age.' He had 
 studied in Paris the prehistoric skulls, with marks of trephin- 
 
 » These seem to have been the first experiments ever made on the 
 pituitary Ixnly. The connection between enlargement of the pituitary 
 body and the disease called ' acromegaly ' bad not then been tlrtamcd of. 
 It is true that Pierre Marie's note, ' Sur deux c;is d'acromd'galie,' was pub- 
 hshed in Apnl ib86: but he made out nothing at that time as to the 
 cause of the disease (Revue de M^decinc, Aprd 1886). It was not tdl 1891 
 that he and Georges Mannesco pubhshcd ' Sur L'Anatomie Pathologiquo 
 d'Acrom6galie ' (Archives dc M6dccme, 1891, i. 3, 539. See also New 
 Sydenham Society, 1891). 
 
 » This translation, seventy -eight pages long, is in ' Recent Essays by 
 various authors on nartcria in relation to Disease': e<lited by Watson 
 Cheyne, pubhshcd by the New Sydcnliam Society, London, ibhO.
 
 124 SIR VICTOR IIORSLEY 
 
 ing on them, in the Broca Museum of Anthropology, and 
 had taken many photographs of them. Never were lecturer 
 and subject more happily suited to each other. All his life, 
 he delighted in the study of ancient monuments— British 
 barrows, Roman camps, Norman churches, all the banked-up 
 and built-up history of the countryside ; archaeology not in 
 glass-cases but under the open air : he had that sense of the 
 past of the earth which is in Mr. Kipling's Puck of Pook's 
 Hill : he loved to explore and to excavate : and the notes 
 and maps and photographs of his findings at Lympne in 1893, 
 and at Eynhallow Monastery in 191 1 — many days of hard 
 open-air work at Lympne, starting at 6.30 a.m., with men 
 under him — bear witness to his diligence. Thus, the fact 
 that trephining was practised far and wide in the Stone 
 Age found its proper exponent in him, who was both surgeon 
 and antiquarian. The skulls in Paris had been waiting for 
 him ever since they were trephined : and he set everybody 
 talking about them. 
 
 It does not appear that he published this lecture ; but it 
 was reported far and wide : and there is a good abstract of 
 it, and of a discussion after it, in the Journal of the Anthro- 
 pological Institute, xvi. 100. From the marks on the skulls, 
 Horsley judged that the trephining had been done, in most 
 cases, by sawing : which in some cases might have been 
 supplemented by scraping. In almost all cases, it had been 
 done over the motor region of the brain : and he ventured on 
 a very ingenious theory : 
 
 This region of the brain is the seat of origin of that special 
 form of convulsions which is known as Jacksonian epilepsy, 
 and which so frequently follows injuries to the skull and 
 brain. . . . This special form of epilepsy most usually com- 
 mences with a peculiar sensation in one delinite part of 
 the body, whence it travels up the limb towards the head — 
 this usually constituting the aura or warning of the onset 
 of tlic fit. This factor is of special importance, since it 
 commonly happens that at the moment when the sensation 
 appears to reach the head, consciousness is lost. If, more- 
 over, the mischief is occasioned by a depressed fracture, 
 there will be considerable tenderness at the injured place ; 
 and this becomes exaggerated at the period of convulsions. 
 Putting these facts together, with minor details of such
 
 FROM 1885 TO 1887 125 
 
 cases, too numerous to be mentioned here, the following 
 mode in which tlie practice may have originated among so 
 savage a people seems to be possible. 
 
 The tender cicatrix may first have been excised as the 
 source of pain. This probably would have produced a 
 temporary benefit, sufficient to encourage the patient to 
 undergo, in cases of relapse, a further operation for the re- 
 moval of bone. This would in most cases be followed by 
 rehef, not only of the pain, but of the fits also. Conse- 
 quently the operation would gain a certain reputation for 
 the cure of convulsions generally, and as such might have 
 been frequently practised. 
 
 In the discussion at the Anthropological Institute, Francis 
 Galton said that this theory implied more intelligence than 
 savages usually showed. ' In their surgery and medicine 
 they were apt to proceed in a very offhand, ruthless, and 
 unintelligent manner, following their fancies and super- 
 stitions rather than experience.' Miss Buckland and 
 Professor Leith said that the trephining had been done to let 
 out the evil spirit, and that convulsions would have been 
 regarded as possession : but they did not accept the argu- 
 ment from the position of the trephine-openings. 
 
 In April, he published in the International Jourucd oi 
 Medical Sciences his first contribution to American literature : 
 an essay on the accurate use of such lines and angles of 
 measurement as give the relations between the surface of 
 the skull and the surface of the brain, and enable the surgeon 
 to visualise the motor area of the brain in its exact position 
 under the skull. The necessity for this surveying of the 
 skull had become urgent ; much had been done toward it, 
 but not enough : 
 
 The necessity has arisen so rapidly within the last few 
 years as to force each practical surgeon to work out the 
 required facts for himself with tlie aid of the few papers 
 that have appeared on the subject. In the absence of any 
 such desired comprchcnsivo monograph giving a complete 
 directory, as it were, of those parts of the brain whose func- 
 tion is so far understood as to permit of the locaHsation 
 of lesions within their boundaries, a pcrs(jnal experience, 
 which has so far fortunately l)een equal to tlie exigencies 
 of ten cases sul>m ittod to operation, may be of use to those 
 who are similarly called upon to explore the cranial cavity.
 
 126 SIR VICTOR HORSLEY 
 
 On June 6, at a meeting of the Odontological Society, he 
 read a paper ' On avulsion of the fifth nerve in trigeminal 
 neuralgia.' This was the beginning of his work and of his 
 teaching for the operative treatment of the disease. From 
 this beginning he went on to the operation for removal of 
 the Gasserian ganghon. No surgeon will ever surpass him 
 in skill and in judgment over this very difficult operation : 
 and, in the carhcr years, none was equal to liim. 
 
 Three days later, came an event which takes a great plac^ 
 in the history of surgery. It was on June 9, 1887, that he 
 removed a tumour from the spinal cord : the first operation 
 of its kind that ever was done. The patient was an officer 
 in the Army : he had suffered for three years, and had been 
 subjected to all sorts of worse than useless treatment. The 
 pain had been so intense that the question had been raised 
 whether he were quite sane. Early in 1887, he began to 
 lose power over his legs. By June 1887, he was suffering 
 not only horrible pain, ' increased to evident agony on any 
 movement,' but partial paralysis of the bladder and com- 
 plete paralysis of the legs. He was seen in consultation by 
 Sir William Gowers, Sir William Jenner, and Dr. Percy 
 Kidd : and Horsley was asked to operate. The case is 
 recorded by Gowers and Horsley (Trans. Roy. Med. Chir. 
 Soc, liii. 'ijy). After a description of the operation, Horsley 
 considers, one by one, the objections which were in force 
 against operating on cases of fracture of the spine with 
 injury to the spinal cord. These were the only cases in 
 which any operation had been done. There were three 
 objections : (i) the gravity of the operation, (2) the danger 
 of wound-infection, (3) the probability that the cord was 
 irremediably injured, and that no surgical interference would 
 make any difference to it. These objections were so strong 
 that the operation of laminectomy — removal of the vertebral 
 arches, at the seat of fracture, so as to take off pressure from 
 the cord — had seldom been done, though it had been known 
 for more than a century. So late as 1881, Page of Newcastle 
 had said, ' It has made no progress in surgery, nor is it 
 likely to do so : it is an operation not within the range of 
 practical surgery.' No surgeon could think hghtly of its
 
 FROM 1885 TO 1887 127 
 
 difficulties and risks : and the best of surgeons might well 
 dread the responsibility of doing it for the lii-st time. It was 
 essentially an operation which needed to be studied on 
 animals : but the Act of 1876 had made it a criminal offence 
 for anybody to experiment on a vertebrate animal for the 
 purpose of attaining manual skill. No precise rules had been 
 formulated for dealing with the special difficulties of the 
 operation. 
 
 But Horsley, by 1887, had already done the operation, in 
 the course of his work with Beevor, on animals. And he 
 had done it under the conditions which were present in this 
 patient's case ; the conditions of operating, through un- 
 injured muscles and bone, on the cord. He had got his 
 method ready-made, he had worked it all out, every step and 
 stage of it. Even with these safeguards, the operation was 
 of the utmost anxiety ; the tumour was very small, and lay 
 higher in the spinal canal than had been expected ; and 
 Horsley hesitated to extend the wound further. Sir Charles 
 Ballance, who was assisting him, urged him to extend it : 
 and the tumour thus was exposed and removed. The 
 wound healed well. The patient, a year later, repf)rt('d that 
 he was in excellent health, and had done a sixteen-hours day's 
 work, with much standing and walking. The tumour was of a 
 kind which does not recur : he remained well up to the time 
 of his death from another cause, some twenty yeai^s later. 
 
 At the end of his account of the case, Horsley gives a list, 
 from British and foreign text-books and journals, of fifty- 
 eight recorded cases of tumour of the cord. With charac- 
 teristic thoroughness, he tabulates each case under no less 
 than twenty-seven headings. In twenty cases, the tumour 
 wiLS extra-dural, i.e. outside the sheath of the cord : in 
 thirty-eight cases, it was intra-dural. The list is full of 
 hopeless misery. ' For all the horrible sufferings of the 
 fifty-eight cases, in only two was any treatment of avail.' 
 One was his patient (intra-dural) : in the other case, some 
 relief was given, for a short time, by the removal of part 
 of a large extra-dural tumour. But of fifty-eight |)atients, 
 fifty-six died without any help from surgery, after pro- 
 tracted and severe suffering.
 
 128 SIR VICTOR HORSLEY 
 
 In these years of his hfe, he took no long hohdays : but 
 Mrs. Gotch remembers a Uttle holiday of this year, 1887, a 
 boating expedition down the Avon, from Stratford to 
 Gloucester : 
 
 He was always in his element on these expeditions, full of 
 energy and resource, of delight in the country and the open- 
 air life ; of interest in the little old inns wliere we put up 
 for the night ; and untiringly exploring the churches and 
 villages which we passed. 
 
 Of such holidays as these, Sir Edward Schafer writes : 
 
 I have been looking through old diaries of the eighties, 
 in which mention is made of many expeditions — on the river 
 and elsewhere — in which Victor Horsley, and later Eldred 
 Bramwell, were constant ingredients : and I may add 
 Frank Gotch and Rosamund Horsley — indeed the two 
 engagements crystalhzed out under these watery condi- 
 tions. Many incidents are recalled by the short entries 
 giving dates and places and personnel. On one occasion, 
 when we were passing along a canal with enormous locks 
 and no lock-keepers, we were nonplussed by having no lock- 
 key. Victor insisted on trying to manufacture one with 
 a pocket-knife out of a fence-post : and was quite annoyed 
 with Frank Gotch and myself — the other members of the 
 partj^ — because we insisted on buying a key from a passing 
 barge, instead of waiting for him to finish the manufacture : 
 although I think, if we had waited for a key made in his 
 way, we should still be there ! On another occasion, when 
 I was taking a walk with Victor in the Lake District — 
 and a very strenuous one it was — he spent the whole time 
 we were resting (!) on the summit of Scafell Pike, in endeav- 
 ouring to bury under cainis the evidences, in the shape of 
 paper, left by previous travellers who had picnicked there : 
 but the task proved too Herculean even for him. The 
 amount of superfluous energy he possessed would have been 
 sufficient to endow six ordinary people : and what is extra- 
 ordinary, the expenditure of it, instead of wearing him down 
 to a premature senihty, kept him in a perpetual state of 
 juvenility : I, at any rate, never knew any man who re- 
 mained so long young or showed evidences of age so httle. 
 
 On Sc^ptembcr 26, 1887, Horsley writes from the Brown 
 Institution to Semon, about their work together : and at 
 the end of the letter he says, ' I do so look forward to our 
 resuming work in the winter, when life will be a paradise, 
 not the hell it has been.' He and Miss Bramwell had been
 
 FROM 1885 TO 1887 129 
 
 engaged for four years : he was sick of waiting. He used to 
 say, in later life, that the four years had been a waste of 
 time, not real hfe : that they had done nothing for him : 
 that he had only been marking time. 
 
 On October 4, they were married, at St. Margaret's, 
 Westminster. It was a quiet wedding, with very few 
 people there : and the hone^^moon was delayed, because a 
 Hospital patient was bringing an action against an omnibus 
 company, and he might be called to give evidence. Happily, 
 the action broke down : and they went to Italy. He was 
 overworked and overtired when they started : he ought to 
 have planned a holiday nearer home : and in Bologna he 
 was laid up with a bad attack of appendicitis. But marriages 
 are above romance ; which is made on earth, but marriages 
 are made in Heaven ; and they are made there, because 
 they must be made where the hearts and the intellects for 
 them are made. Heaven was so pleased with this marriage, 
 that it made another, to go with it : Frank Gotch and 
 Rosamund Horsley were married on December 15, 1887. 
 
 It was at some time after 1887 that Horsley devised, for 
 signature of his more intimate letters, his rebus of the 
 
 galloping horse, with its V-shaped saddle. The little horse 
 never stood still : it seldom trotted or cantered : it preferred 
 to gallop. Now and again, in his letters to his wife, it 
 pranced, or threw up its heels : but these antics were not 
 for the world to see. With his largest handwriting, it would 
 grow to near three inches long : but it was mostly a small 
 animal, but full of energy : only, it had an archaistic air, 
 as if it were trying to look Uke the White Horse on the 
 Berkshire Downs.
 
 PART II 
 
 SCIENCE AND PRACTICE. PROFESSIONAL 
 POLITICS. PUBLIC LIFE
 
 I 
 
 From 1888 to 1892 
 
 It was easy to divide into chapters the record of the years 
 from 1857 to 1887 : but the years from 1888 to 1914 are not 
 so easily divided. In these later years, without ceasing to 
 work for the advancement of science and practice, he made 
 time to give himself to professional politics, to plans for 
 the improvement of the national health and efficiency, and 
 to Parliamentary politics. These years, the summer and 
 autumn of a life which had no winter, cannot be kept in 
 strict order of time : there are interests m them which 
 require separate chapters. But this and the next three 
 chapters are concerned chiefly with his work for science and 
 practice. 
 
 1888 {crt. 31) 
 
 On March 5, 1888, at a meeting of the Medical Society of 
 London, Fcrrier and Horsley reported a case of cerebral 
 abscess ' treated by operation, with uninterrupted and 
 complete recovery' (Proc. Med. Soc, xli. 233). The day 
 of the operation was December 10, 1887. At this meeting, 
 Horsley spoke of the treatment of septic thrombosis of the 
 lateral sinus, and said that he had already, in one case, 
 ligatured the sinus and removed the septic clot from it. 
 This is the first, or one of the first, references in the hterature 
 of surgery to any operation on the lateral sinus. 
 
 In April, he was appointed on a Parliamentary Committee 
 ' to inquire into and rcjiort upon the nature and extent of 
 pleuro-pncumonia in the United Kingdom, and the effects 
 of inoculation and other preventive measures on that 
 disease : also, to inquire into the nature and extent of 
 tuberculosis in the United Kingdom, and the means to be 
 adopted to arrest its progress.' Thirty years ngo, the
 
 134 ^IR VICTOR HORSLEY 
 
 protective inoculation of cattle against pleuro-pneumonia 
 was a rough-and-ready method in Australia, New Zealand, 
 and South Africa, which was not well thought of in this 
 country. The whole study of the diseases of cattle was very 
 different from what it is now. The detection of tuberculosis 
 in cattle by the tuberculin test was unknown : tuberculin 
 had not yet been discovered. The Committee felt them- 
 selves able to deal with these two colossal questions in less 
 than three months : their report is dated July lo. There is 
 a supplementary report by Horsley, recommending ' that 
 both the forbiddal of breeding from diseased animals, and 
 the notilication of the disease (in cattle), should be included 
 in any legislation for tuberculosis.' 
 
 On June 7, at a meeting of the Royal Society, Beevor's 
 and Horsley 's paper was read, ' Note on some of the motor 
 functions of certain cranial nerves, and of the first three 
 cervical nerves, in the monkey [Macacus sinicus).' See 
 Proc. Roy. Soc, xliv. 
 
 In the summer of 1888, Gotch and Horsley were working 
 together in Oxford, for their Croonian Lecture : and in August 
 they submitted to the Royal Society their preliminary 
 paper, ' Observations upon the electromotive changes in the 
 mammalian spinal cord following electrical stimulation of 
 the cortex cerebri ' (Proc. Roy. Soc, xlv. 18). Before 1888, 
 the influence of the brain over the movements of the Umbs 
 had been studied at the beginning of its course, in the cortex, 
 and at the end of its course, in the muscles : but there had 
 been no study of it, or next to none, midway in its course, in 
 the spinal cord. Thus, there was no saving what changes 
 might be imposed on it by the cord. In a case of epilepsy, 
 for example, the convulsive movements might be decided 
 not only by the brain but also by the cord : they might even 
 be more of ' spinal origin ' than of ' cortical origin ' : there 
 are cortical centres, and there are spinal centres : and no 
 observation of the movements of the muscles could dis- 
 tinguish what might be cortical from what might be spinal. 
 Gotch and Horsley set themselves to this problem. 
 
 In order to ascertain what share respectively the centres 
 in the cortex, and those in the spinal cord, have in the pro-
 
 FROM 1888 TO 1892 135 
 
 duction of the characteristic epileptic sequence, the action 
 of the latter must be eliminated. . . . For this purpose, 
 we determined to obtain, if possible, evidence as to the 
 excitatory processes of the epileptic convulsion in the spinal 
 cord, by ' tapping ' the cord and noting the electromotive 
 changes which, as is well known, accompany functional 
 activity in nerves. 
 
 They used a capillary electrometer : and they studied the 
 cord at the level of the lower dorsal region. That form of 
 muscular movement which is called ' epileptic ' has a well- 
 marked character, whether it occurs naturally in a case of 
 epilepsy or is produced experimentally by stimulation of a 
 cortical centre. There is, first, a short stage of uninterrupted 
 contraction, which is called ' tonic ' : then, a stage of in- 
 terrupted contraction, with jerking of the muscles, which is 
 called ' clonic' If the character of the electromotive 
 changes in the cord were found to be in keeping with this 
 twofold character of the epileptic movement, it would be 
 evidence that the movement was almost entirely of cortical 
 origin. That is to say, it would be evidence that the move- 
 ment of the lower limb, induced by stimulation of the 
 surface of the brain, was hardly modified by the spinal 
 centres for the lower limb : for these centres are in the 
 lumbar region of the cord, below the level at which the cord 
 was being tested. 
 
 Gotch and Horsley made out two facts of great importance : 
 
 1. In the lower dorsal region of the cord, i.e. below the 
 spinal centres for the upper limb, but above the spinal 
 centres for the lower limb, stimulation of the surface of 
 the brain was followed by electromotive changes in the 
 cord if the cortical centres for the lower limb were stimulated, 
 but not otherwise. This rule was invariable : it is a good 
 instance of the strictness of the locahsation of function in 
 the cord. 
 
 2. The electromotive changes in the lower dorsal region 
 of the cord, which attended nervo-impulscs passing from 
 the surface of the l^rain to tlic hnver limb, were in kccjiing 
 with the twofold character of the movement of tliat limb : 
 that is to say, they gave evidence of their cortical origin ; 
 and the capillary electrometer registered this evidence. 
 ' The electromotive change was, first, a persistent stage, 
 next, a rhythmical stage : answering to the tonic and clonic 
 stages of the convulsion. . . . \Vc have repeated this obsor-
 
 T36 SIR VICTOR HORSLEY 
 
 vation thirty or forty times, and feel ourselves justified in 
 concluding that we have obtained evidence that during a 
 cortical epileptiform discharge the electromotive changes 
 in the cord are exactly parallel, as regards the character 
 of their sequence, to the convulsions of the muscles as re- 
 corded by the graphic method.' 
 
 In the autumn of 1888, the first Triennial Congress of 
 American Physicians and Surgeons was held, in Washington. 
 Horsley was one of those who attended it by special in- 
 vitation, and a very hearty welcome was given to him. 
 He took part in a discussion ' On cerebral localisation in its 
 practical relations.' He spoke of his work in experimental 
 physiology — ' These experiments have been performed by 
 myself in conjunction with other observers, and therefore 
 when I refer to them inadvertently as my own work, I beg 
 you to imderstand that I am simply the spokesman of my 
 colleagues, Drs. Schafer, Beevor, Gotch, and Felix Semon.' 
 He reaffirmed his theory of the motor centres, which he had 
 submitted to the Neurological Society in December 1886 : 
 
 I beUeve that in this so-called motor region we have three 
 functions clearly represented : (i) Shght representation of 
 the tactile sensation. (2) Representation of the so-called 
 ' muscular sense.' (3) Great representation of movement. 
 The evidence in favour of this belief is both morphological 
 and physiological. We must beUeve that these three func- 
 tions are wrapped up closely together, and that in every 
 given particle of grey surface there is represented this triune 
 function for a single segment of the body. Morphologically, 
 we find that the large cells in the fourth layer are the seat of 
 the representation of movement. I therefore cannot under- 
 stand why we should not give, to the small cells of the upper 
 layer, the representation of sensation. The physiological 
 evidence on which this belief is founded is both experi- 
 mental and clinical. 
 
 And he went on to speak of the rules to be observed in the 
 operative surgery' of the brain. 
 
 By 1888, also, he was able to define the operative treat- 
 ment of those cases of tumour of the brain in which it is not 
 possible to remove the tumour. He had proved that great 
 relief was given by a very free trephining. It lowered the 
 intracranial pressure, and thus arrested, or delayed, the 
 pain, vomiting, and optic neuritis, which are common in
 
 FROM 1888 TO 1892 137 
 
 these cases. The date of the first of his op)erations of this 
 kind is January 1887. This palliative treatment — its name, 
 ' decompression ' was given to it, later, by Professor Harvey 
 Gushing — is all that can be done, in very many cases : and 
 the histor}^ of brain-surgery is in great part concerned with 
 the decision of the question — so far as it can ever be decided — 
 In what cases ought the surgeon to set himself to remove the 
 disease, and in what cases ought he to refrain from attempt- 
 ing more than the reUef of the intracranial pressure ? 
 
 1889-1890 
 
 In March, 1889, Walter Spencer and Horsley pubhshed in 
 the British Medical Journal their ' Report on the control 
 of haemorrhage from the middle cerebral artery and its 
 branches by compression of the common carotid.' The 
 middle cerebral artery, or one of its branches, is the usual 
 starting-point of a cerebral haemorrhage in apoplexy. 
 Spencer and Horsley exposed the artery, in the brain of the 
 monkey ; and found that its blood-supply was easily con- 
 trolled by digital pressure on the carotid artery in the neck. 
 ' The vessels were not entirely emptied : some blood still 
 remained in them, but no pulsation could be seen even in the 
 largest of them. The cortex which the vessel supplied 
 became pale. On releasing the carotid, pulsation immedi- 
 ately returned, and the colour of the cortex came back.' 
 If the branches were divided, digital pressure on the carotid 
 stopped the bleeding from them in a few seconds. Doubt- 
 less, this method of first-aid treatment might be of great 
 usefulness, if it could be given to the patient at the very 
 onset of the haemorrhage : but, in practice, this opportunity 
 would hardly ever occur. None the less, the suggestion was 
 founded on observed facts ; and is the only suggestion for 
 any really direct treatment of these cases. 
 
 In May, at a meeting of the Neurological Society, there 
 was a discussion as to the causes of the difference of tem- 
 perature, in some cases of injury to the brain, between the 
 two sides of the body, Horsley spoke of eighteen instances 
 of this difference of temperature, which he had observed in
 
 138 SIR VICTOR HORSLEY 
 
 a period of seven years. The problem, he said, could only 
 be solved by experimental physiology : meanwhile, he was 
 averse from all theorising about ' heat-centres.' 
 
 On November 7, he gave an address to the Medical Society 
 of Owens College, Manchester, ' On the diagnosis of brain- 
 disease.' 
 
 In June, 1890, at a meeting of the Royal Society, Spencer's 
 and Horsley's paper was read, ' On the changes produced in 
 the circulation and respiration by increase of the intra- 
 cranial pressure or tension.' 
 
 In August, 1890, he demonstrated and described, at the 
 International Medical Congress in Berlin, the chief results 
 of his work in physiology with Schafer, Beevor, and Semon.* 
 It is certain that he, though he was only thirty-three years 
 old, was one of the most notable figures at the Congress : as 
 it was said of him, that week, ' Dem gehort die Zukunft ' : 
 to him belongs the future. He gave these demonstrations 
 before large audiences of physiologists and surgeons, many 
 of them averse from admitting all that he had come to show 
 to them : just as in 1889, in Bale, when he produced by 
 stimulation one very delicate and closely deiincd move- 
 ment, and heard over his shoulder a murmur from Goltz, 
 ' Es ist ganz wahr ' : it is perfectly true. At Professor 
 Waldeyer's house, he arranged an exhibition of photographic 
 studies of brains — such photographs as had never been seen 
 in Berlin. At a great meeting of the Sections of Surgery and 
 of Neurology, he gave an address ' On the surgery of the 
 central nervous system.' He had operated on the brain in 
 44 cases. Among these 44 cases, there had been 10 deaths. 
 These deaths had been mostly in cases of brain tumour of a 
 malignant nature (glioma, glio-sarcoma). He had done 5 
 operations for cerebral cyst, and 6 operations of decom- 
 pression, without a death. He had operated on the spinal 
 cord in 19 cases : in 6 of these, he had opened the sheath of 
 the cord : among these 19 cases, there had been i death. 
 
 ' Sir Feli.x Semon writes : ' Nobody seemed to have expected a demon- 
 stration of that convincing character. . . . Everybody was struck by 
 his extreme modesty. To all the corapUments justly pjiid to him, he only 
 responded by an amiable smile, or by disclaiming any extraordinary 
 merit.'
 
 FROM t888 TO 1892 139 
 
 He was elected, this year, an Honorary Fellow of the 
 American Surgical Association. This year, also, he resigned 
 his appointment to the Brown Institution : and was ap- 
 pointed FuUerian Professor at the Royal Institution. He 
 writes, in April, to a friend : 
 
 The time has come when I must give up the Brown. I 
 can no longer go such a distance, and moreover I want to 
 devote myself to working up my new Laboratory at Uni- 
 versity College. The loss of the income, however, is a very 
 serious point to me, it being nearly ;^300. The [Royal In- 
 stitution] Professorship supplies a third of this blank, and 
 when I heard that Romanes would not apply for re-election, 
 I resolved to go in for it. A hundred a year cannot be 
 disregarded under any circumstances : but for me it becomes 
 a necessity to obtain if possible another chance of fixed 
 income, since as a matter of fact I spend at University 
 College the whole of the fees I receive for my classes. 
 
 Strange, that he should have to be thinking of £100 a 
 year, when his work was teUing on science and practice in 
 half a dozen countries. 
 
 1891 [cet. 34) 
 
 This year, the house in Park Street was wanted back by 
 its owner : and the Horsleys moved to 33 Seymour Street for 
 a few months — here their first child, Siward, was bom — and 
 thence to 25 Cavendish Square. Other events of 1891 were 
 the Croonian Lecture ; Horsley's Fullerian Lectures ; the 
 founding of the Journal of Pathology, with Sims Woodhead 
 as editor ; and Horsley's appointment to be Vice-Dean of 
 the Medical Faculty of University College. He writes to 
 Schafer, on May 11, ' I will endeavour to discover what are 
 the fimctions of a Vice-Dean besides being vicious. No 
 introductory for me, I think. Let us have a tea-party and 
 side-shows instead.' It was a year, also, of much writing of 
 papers for societies and journals. 
 
 The Croonian Lecture was given, in abstract, at a meeting 
 of the Royal Society, on February 26, 1891. The full text 
 of it, magnum opus indeed, occupies 250 pages of the Trans- 
 actions. Gotch and Ilorslcy had studied the passage of 
 nerve impulses not only between the cortex and the cord.
 
 140 SIR VICTOR HORSLEY 
 
 but between many other levels of the nervous system : they 
 give a list, as follows : 
 
 Part exposed for Excitation. Part exposed for Observation. 
 
 Brain (cortex and fibres) . Spinal cord. 
 
 Mixed nerve. 
 . Spinal cord at another level. 
 Mixed nerve. 
 Spinal cord. 
 
 Spinal cord 
 
 Mixed nerve 
 Spinal roots 
 Posterior roots 
 
 Mixed nerve. 
 
 The principal subjects which they investigated were : 
 
 1. The resting electrical difference between the cut surface 
 and the uninjured longitudinal surface of nerve-fibres. 
 
 2. The evidence of the locaHsation of function in the cortex 
 which is afforded by electromotive clianges in the cord. 
 
 3. The electromotive changes, in cord and nerve, which 
 follow excitation not of the cortex but of the nerve-fibres 
 of the brain. 
 
 4. The various conditions under which the electromotive 
 changes, in cord and nerve, afford evidence of unilateral or 
 bilateral representation of function in the cortex. 
 
 5. The degree of unilatcrality of representation in the 
 cord : and the conditions which favour the spread of im- 
 pulses from one column of the cord to another. 
 
 6. The paths in tlie cord along which different impulses 
 travel upward on their way to the brain. ' By far the 
 majority of afferent impulses ascend the cord on the same 
 side as the entering root, both by direct and indirect paths ; 
 a small minority ascend by the posterior column of the 
 opposite side ; and a mere fraction by the lateral column 
 of the opposite side.' That is to say, the frequency with 
 which each of these paths was taken by impulses entering 
 the cord by a posterior (sensory) nerve-root, and ascending 
 the cord toward the brain, was as follows, expressed in per- 
 centages : posterior column of same side, together with lateral 
 column of same side, 80 per cent. ; posterior column of oppo- 
 site side, 15 per cent.; lateral column of opposite side, 5 per 
 cent. 
 
 7. The complete obstruction to all centripetal impulses 
 which may reach the cord by the central end of the anterior 
 (motor) root. 
 
 8. The marked quantitative diminution, and delay, of 
 impulses lca\ang the cord by the anterior roots. 
 
 9. The comparative effects, in a mixed nerve, of reflex 
 excitation and direct excitation.
 
 FROM 1888 TO 1892 141 
 
 At the Annual Meeting of the British Medical Association, 
 in Bournemouth, he read a paper ' On craniectomy in 
 microcephaly.' Lannclongue of Paris had recently devised 
 this operation ; the free removal of one or more areas of the 
 skull, in cases of microcephalic idiocy, to lessen the pressure 
 on the brain, and thus to give it some chance of develop- 
 ment. Lannelongue had done this operation in two cases, 
 Keen of Philadelphia in three, Horsley in two : one of his 
 patients had been improved, the other had died after the 
 operation, with rapid hyperpyrexia — that rise of the tem- 
 perature to 107° or 108° which occurs in some cases of injury 
 or disease of the brain. In his paper, he called attention to 
 this danger of the operation — that the brain, with its im- 
 perfect development, might fail to adapt itself to the sudden 
 change, and might react in some abnormal way, leading to 
 death. Still, he was inclined to be in favour of the operation 
 because of ' the utterly hopeless future that awaits these 
 cases,' and because the one and only possibility of saving 
 them from it was by operation. ^ 
 
 At the opening of the winter session at University College, 
 he gave the introductory address, on ' The Student and the 
 Practitioner ' : it is admirable, full of good advice and good 
 feehng. 
 
 On November 12, at a meeting of the Ophthalmological 
 Society, he and Beevor reported a case of cerebral abscess 
 in the left angular convolution, with right hemianopsia 
 and ' word-blindness.' 
 
 In November, also, he published, with Dr. James Taylor 
 
 1 A letter has come (May, 191 7) from the father of a child on whom 
 Horsley did this operation. With the letter, were two photographs, one 
 of a microcephalic idiot baby, the other of a good-looking young officer. 
 ' In the autumn of the year 1897, I took my child, then about nine months 
 old, to seek the doctor's advice, the baby's forehead being contracted, 
 there being no fontancUe. Sir Victor strongly advised an operation : and 
 as I was not well off it was a great relief to me that he never charged me 
 a penny cither for the two consultations or for the two operations (my 
 wife's brother and my own brother being doctors), besides which he 
 gratified my wife's longing to be with her child — her first — by procuring 
 a private ward for her at University Hospital. Two pieces of bone were 
 removed at an interval of a fortnight. The child rapidly recovered. . . . 
 He has been a comfort to us all our life. . . . He has been a year in charge 
 of a trench mortar battery, and has been especially cnmmende<l for 
 repelling a raid in the trenches. So that I have much to be thankful 
 for, that under God I met with Sir Victor.'
 
 142 SIR \'ICTOR HORSLEY 
 
 and Dr. Walter S. Colman, a long paper, ' Remarks on the 
 various surgical procedures de\ased for the relief or cure 
 of trigeminal neuralgia' (Brit. Med. Joum., November 28, 
 December 5, December 12, 1891). It is a full historical 
 review of the rise and advance of the operative treatment 
 of the disease. It was published just before he had finally 
 mastered the operation for the complete removal of the 
 Gasserian ganglion. He had made dissections for the study 
 of this operation, some years before : but he was still held 
 back by one difficulty : ' for this reason, I believe that the 
 complete removal of the Gasserian ganghon is not possible.' 
 Beside these addresses and papers, he published : 
 
 1. On the Analysis of Voluntary Movement. XIX Century, 
 June 1891. 
 
 2. Die Function der Schilddriise : eine historisch-kritische 
 Studie. In Virchow's Festschrift, 1891. 
 
 3. Ueber den Gebrauch der Elektricitat fiir die Localisi- 
 rung der Erregungserscheinungen im Centralnervensystem. 
 With Professor Gotch. Centralbl. f. Phys, January 31, 1891. 
 
 1892 {cBt. 35) 
 
 The house in Cavendish Square, which was the Horsleys' 
 home from 1892 onward, had been occupied by Dr. Radchffe, 
 a scholarly old physician ; and, before him, by Dr. Brown- 
 S^quard. It is a fine house, well suited alike for entertain- 
 ing and for a great rush of home affairs : but in the annals 
 of consulting practice it is only the ground floor that comes 
 to be described. His consulting-room was the front room 
 on the ground floor ; it looked on the Square, which is 
 pleasant enough to look at, when the leaves are on the trees ; 
 it was comfortable, cheerful, white-walled, and neither too 
 large nor too small. Among his belongings in it were models 
 in yellow marble of temple-columns in the Roman Forum, 
 and a very beautiful drawing of San Miniato in Florence, by 
 Gerald Horsley ; and, on the mantelpiece, bronzes from 
 Rome, and some treasured little casts of a monkey's brain. 
 Opening into the consulting-room, there was a well-fitted 
 dark-room, for the examination of the eye, ear, and throat ; 
 it is probable that no other surgeon in London had such a 
 good dark-room. And it is certain that he was the first of the
 
 FROM 1888 TO 1892 143 
 
 Staff of University College Hospital to have a telephone in 
 his house. In the dining-room, which was used as the 
 waiting-room, the chief picture was a great photograph of 
 the Tiber with St. Peter's and the Castle of San Angelo : 
 this he had brought from Rome in 1882. But the pride of 
 the ground floor was neither of these rooms, but the great 
 sky-hghted room at the back, which was his workshop. 
 Probably it had begim life as a billiard-room. He made it 
 live up to every inch of its space and every ray of its light. 
 Here in spare hours and half-hours he worked with his hands, 
 dissecting, section-cutting, photographing and developing, 
 drawing and diagram-making, and so forth. One side of the 
 room was taken up with apparatus for photography and 
 micro-photography : ^ on the opposite side was a lathe : 
 there was a big stack of cartoons for lectures, and accumu- 
 lated photographs and negatives, and lantern shdes, and his 
 coUection of thousands of microscope shdes, and on the 
 shelves a heavy load of notes and papers which he did not 
 hve to put in order. Always, he loved to use his hands ; 
 he did everything for himself. It was not a private museum 
 that he was making, it was a records office : he had no love 
 of collecting for the sake of collecting : he kept evidences of 
 cases, just as he kept notes of cases. 
 
 At the annual meeting of the British Medical Association 
 in Nottingham, he was President of the Section of Pathology ; 
 and spoke his mind against that sort of pathology wliich 
 hardly gets beyond the microscoping and exliibiting of 
 diseased organs : 
 
 However absurd the statement may appear to some, I 
 venture to assert that pathology, as such, is almost unknown 
 among us. The fact is, that what is commonly spoken of 
 as ' pathology,' taught as ' pathology ' and made the subject 
 of examinations in ' pathology,' is nothing of the sort — it is 
 not pathology, it is morbid anatomy. 
 
 * Dr. MacNalty writes, ' I went with him to purchase an excellent and 
 costly apparatus for micro-pholORraphy (Zeiss) ; and we spent many 
 Sunday afternoons and evenings toRetlier, takins; photographs, developing 
 them, and trying the effect of different coloured solutions to act ivs filters 
 for the electric arc light. His hands wore sometimes stained with chemical 
 reagents: and a lady patient is rej>orted to have said, " 1 hko Sir Victor 
 Horsley very much ; but I do wish ho would wash his hands before he 
 comes to sec me." '
 
 144 SIR VICTOR HORSLEY 
 
 Suppose a student had paid to be instructed in physiology, 
 and suppose all that his teacher did was, first, to describe 
 the coarse or naked-eye structure of the healthy body, next 
 its minute or microscopical structure, and, finally, to make 
 some crude guesses as to how the various organs worked, 
 should we not say that that student had been defrauded ? 
 Yet is not this picture a fair representation of what is usually 
 done with pathology in this country ? We have in London 
 a society whose function, as defined in its title, is to promote 
 the study of pathology : but unfortunately it has hitherto 
 been only an emporium of morbid anatomy. ... I regret 
 that in the representative work of the Pathological Society 
 this study should be allowed to usurp the place of pathology. 
 The pathologist should be the student of disordered function, 
 as well as of disarranged structure. . . . 
 
 What a mass of facts has been accumulated in elucidation 
 of the various changes in the structure of the lungs produced 
 by pneumonia, phthisis, etc. But how many workers have 
 been found to investigate the degree and effect of the loss 
 of the respiratory function, of the disorder of the normal 
 oxygen and carbonic acid ratios ? Yet this is what kills, 
 this is the whole work of the disease : and this is what must 
 be solved before the treatment of such diseases can be worthy 
 of mention other than as empirical palliation. . . , 
 
 To what are we to ascribe this surprising indifference to 
 pathology ? I have not the sHghtest hesitation in saying 
 that it is due to want of familiarity with modem progress 
 in physiological and chemical research. Fortunately, labora- 
 tories are springing up now on all sides, original investiga- 
 tions are being pushed forward, light and knowledge widely 
 diffused. The reproach that we have been dead-house 
 students rather than true pathologists will therefore soon 
 be wiped away. 
 
 This high-handed criticism of the Pathological Society 
 was answered by Hadden : but the fact remains, that the 
 Society did lend itself too easily to the mere exhibiting of 
 specimens and ' card-specimens ' ; and some of us, it may 
 be, were tempted to call attention to our specimens for the 
 purpose of calling attention to ourselves. Horsley had no 
 patience with that. To him, pathology must be advanced 
 and guided, like physiology, by the experimental method. 
 He rather avoided than sought the older Medical Societies : 
 he preferred the new, exclusive, less formal societies — the 
 Physiological, the Neurological, and the little Medical 
 Research Club — which cared only for work of originality.
 
 FROM 1888 TO 1892 145 
 
 and were utterly opposed to anything commonplace and 
 third-rate.^ 
 
 Early in 1892, he moved up a place on the staff of Univer- 
 sity College Hospital; and thus became assistant-surgeon to 
 Mr. Christopher Heath, and had charge of the wards when 
 Mr. Heath was away. He also had the night work : for 
 Mr. Heath did not care for it. The two men were not well 
 suited to each other ; they were apart in age, and in out- 
 look ; strong-willed, both of them ; and Mr. Heath was apt 
 to be in the imperative mood. There are letters of 1894. 
 which recall a frequent difficulty of Hospital practice. Mr. 
 Heath writes : 
 
 I must again ask you to exercise a little more care in send- 
 ing patients into my wards. Last Monday I saw a woman 
 to whom you had just given an order for immediate admis- 
 sion. ... As it was clearly a case not admitting of operation, 
 I sent her to the parish infirmary. 
 
 To-day I find a case of hernia admitted by your order 
 for radical cure, the man being forty-eight years of age, 
 and no proper care having been given to fit a proper truss. 
 I have ordered a truss and shall then send him out. Cases 
 of this kind should, I think, be treated by the out-patient 
 surgeon. 
 
 I shall be glad to give notice at the next meeting of the 
 Medical Committee of the following — Mr. Heath to move 
 That all cases of Empyema, and Intestinal Obstruction, be 
 admitted to the medical wards in the first instance. 
 
 Horsley answers at once : 
 
 . . . Personally I do not think it is proper treatment to 
 merely apply a truss in a man aged forty-eight, who being 
 
 ' There is a letter to him, January 1892, from E. H. HaDkio, who then 
 was in Agra, organising the work of chemistry and bacteriology in tlic 
 North-West Provinces : ' 1 am sending you a reprint of a paper of mine 
 on alexins. In it you will see that I have returned to the (juestion of the 
 relation of my work to Wooldridge's, and have made an attempt to justify 
 the view that I have taken of it. . . . Perhaps you will remember an 
 occasion at tiic Medical Research Club, when everybody was gaily jump- 
 ing on me, more intent on proving their points than on sparing my feelings : 
 and I much hope that the exponmcnt.s I have now pubhshed will enable 
 us to bury the hatchet. At present 1 am more keen on jKJisons than on 
 bacteriology. I have nothing to do but medico-lcg:il work, and I feol 
 pretty sure that many of the native poisons are completely unknown to 
 science. I have a large collection of them already, and the only diUiculty 
 is to know which to investigate first.' 
 
 K
 
 146 SIR VICTOR HORSLEY 
 
 healthy has presumably several decades of life before him, 
 during which he is constantly exposed to the risk of strangu- 
 lation. ... I will arrange that your motion shall be put on 
 the Agenda paper for the next meeting. Personally I am 
 not sure that it is advisable to raise the point for discus- 
 sion in the way indicated, since every one is agreed that 
 more cases die from operation being undertaken too late 
 than from any other cause. 
 
 In March, 1892, he gave an address to the Cardiff Medical 
 Society, ' On the origin and seat of epileptic disturbance ' 
 (Brit. Med. Joum., 1892, i. 693). He spoke of the experi- 
 mental study of the disease, and the work of the Croonian 
 Lecture : he demolished the old theory that an epileptic 
 fit is accompanied by ' anaemia of the brain ' : and he was 
 unwilling to believe in epilepsy of ' spinal origin.' 
 
 Much of his time, in 1892 and 1893, was spent over the 
 preparing and giving of the Fullerian Lectures at the Royal 
 Institution : he gave twelve lectures in 1892, and ten in 
 1893 ; all of them on subjects related to the nervous system. 
 It was no easy duty, with his many other engagements, to 
 get through these long courses of lectures ; he had to range 
 far and wide for subjects ; thus, one of the 1893 lectures was 
 on hypnotism. Some of the earlier lectures were published, 
 in 1892, in book form : they are good, but they suggest 
 Pegasus in harness : they do not show the strength of his 
 work. 
 
 A more notable piece of writing, this year, was his long 
 paper, ' Topographical relations of the cranium and surface 
 of the cerebrum,' published in vol. vii. of the Cunningham 
 Memoirs, Royal Irish Academy, Dublin, 1892. It is, of 
 course, on the lines of his 1887 paper in the International 
 Journal of Medical Sciences : but he adds new details, and 
 references to the regional anatomy of the brain at different 
 periods of life. 
 
 In October, 1892, at the Church Congress in Folkestone, 
 he spoke in a discussion of the question, ' Do the interests 
 of mankind require experiments on hving animals, and, if 
 so, up to what point are they justifiable ? ' He swayed the 
 meeting to such excitement as nobody had expected of it.
 
 FROM 1888 TO 1892 147 
 
 Miss Cobbe had just published her book, The Nine Circles: 
 he spoke of it as foUows : 
 
 I have taken the trouble to collect all the experiments in 
 which cutting operations are described as having been per- 
 formed by Enghsh scientists, and in which I knew anaes- 
 thetics to have been employed. These experiments are 
 26 in number. In all of them chloroform, ether, or other 
 anaesthetic agent was employed. But of these 26 cases, 
 Miss Cobbe does not mention this fact at all in 20, and only 
 states it without quahfication in two out of the remaining 
 six. When we inquire into these 20 omissions in the 26 
 cases, we find in the original that again and again Miss 
 Cobbe has, in making her extracts, had directly under her 
 eyes the words ' chloroform,' ' ether,' ' etherised,' ' chloro- 
 formed,' ' anaesthetised,' ' during every experiment the animal 
 has been deeply under the influence of an anaesthetic,' and 
 so forth. ^ 
 
 He went on to tell of a certain Duke, whose brother, at a 
 time when rabies was about, was bitten by a dog : how the 
 Duke, though he was a Vice-President of an anti-vivisection 
 society, had asked for the use of Pasteur's test on a rabbit. ^ 
 PubUc opinion, in the course of the quarter of a century since 
 1892, has come to see the value and the necessity of experi- 
 ments on animals, and this episode of the Folkestone Church 
 Congress is of no present interest : but Horsley's speech 
 at the time had great influence, and was reported every- 
 where. He pursued Miss Cobbe and others into the Times, 
 and went so far as to call her a bar ; Tyndall, among those 
 who wrote to him, praised him for ' calling a spade a spade ' ; 
 and there was a little picture by George du Maurier, in 
 Punch, of ' Miss Fanny ' and ' Master Victor ' : the original 
 drawing was bought and given to Horsley by some of his 
 friends. He writes to Schiifer, on October 28, of the closure 
 
 * Miss Cobbe had said in her preface, ' So far as it h.-is been possible, the 
 use or absence of anaesthetics has been noticed in regard to ah the experi- 
 ments cited in this book.' It was urj^cd in her excuse, after tlie exposure 
 of the book, that it had been ' compiled ' not by her, but for her. 
 
 * In January, 1891, Horsley had written a very pohtc lellir to the Duke, 
 suggesting that, as he had consented to experiments on animals, he ought 
 to withdraw his name from the anti-viviscction society — ' On the occasion 
 
 of the attack upon I-ord by a presumably rabid <log, you consulted mo 
 
 as to the advisability of his lordship being treated by M. Pasteur's mctho<l, 
 and requested that inoculation exiwriments from the body of the animal 
 should Ix; carried out for you {to determine the question of its rabidity), 
 wluch was accordingly done.'
 
 148 SIR VICTOR HORSLEY 
 
 of the correspondence in the Times, and of a proposal for a 
 book about experiments on animals : 
 
 Oct. 28. I personally do not think it would be well to 
 write to-day, or possibly under a week. Tlie reasons are 
 first, that I went last niglit to the Times office to meet 
 Buckle, the Editor, whom I know well. Buckle told me that 
 he is most an.xious to close the discussion altogether, and I 
 quite understood from him that he would not put in any 
 more letters after mine of to-day. The next point is that 
 the Association [for the Advancement of Medicine by Re- 
 search] will bring the facts out as soon as possible. They 
 are considering now the offer received from Griffiths and 
 Farran to publish the work free of cost. Your summarised 
 statements would form admirably the basis of the book. 
 Nov. 19. Frank Gotch and I propose to walk in the Lakes. 
 Of 4 Xmas walks not one has been unsuccessful, and if we 
 have snow the scenery is very fine. What do 30U say ? 
 I trust Yes.
 
 II 
 
 From 1893 to 1898 
 
 1893 {cet. 36) 
 
 In January, Horsley and Rubert Boyce published in the 
 British Medical Journal their ' Preliminary report on oedema.' 
 The old easy-going notion of oedema as nothing more than 
 a physical process, a mere oozing of blood-serum into the 
 tissues under mechanical conditions of pressure, had been 
 disproved by Ranvier, Heidenhain, and Wooldridge. 
 (Edema was the result of the actions and interactions of 
 living tissues ; all physical explanations were useless : 
 the facts of oedema were as complex as life could make them ; 
 and Horsley and Boyce were able to give a formidable list 
 of no less than nineteen ' divisions of the subject, on which 
 more information must be obtained.' 
 
 In March, he gave a chnical lecture at Queen Square, ' On 
 paraplegia as a result of spinal caries (compression-myelitis) 
 and its treatment' (CHn. Journ., March 15, 1893). It is 
 a reminder, to all students of his life, that his work for the 
 surgery of the spinal cord is every bit as great as his work 
 for the surgery of the brain. In this lecture, he speaks of 
 those cases of spinal caries in which the cord is compressed 
 (with paralysis below the site of compression) not by de- 
 formity of the vertebrae, nor by abscess, but by inflammatory 
 thickening of the sheath of the cord. He showed five cases : 
 two of inflammatory thickening, three of abscess : all of 
 them had improved since operation, and would improve 
 further with more time. ' I would press the advisability 
 of early resort to operation. I have seen the most painful 
 deaths occur in these cases unrelieved, when a timely opera- 
 tion would have saved their lives.' 
 
 On May 18, at a meeting of the Royal Society, Beevor's 
 
 Hi
 
 150 SIR VICTOR HORSLEY 
 
 and Horsley's paper was read, ' A further minute analj'sis, 
 by electrical stimulation, of the so-called motor region 
 (facial area) of the cortex cerebri in the monkey {Macacus 
 sinicus).' They define the centres for the movements of 
 the face, the tongue, the soft palate, and the pharynx ; 
 especially, they differentiate the centres for the movements 
 of the lips, and of the comers of the mouth : they also 
 clear up a confusion in the use of the term ' bilateral move- 
 ment.' 
 
 At the Newcastle-on-Tyne meeting of the British Medical 
 Association, he spoke in discussions on the treatment of 
 mastoid disease, and on the pathology of the thyroid gland ; 
 and opened a discussion on the treatment of cerebral tumour. 
 During the seven years since his first operation, he had 
 modified his method : he had changed the pattern of an 
 instrument ; he had adopted Bramann's method of applying 
 the antiseptic gauze ; he had given up, or was about to give 
 up, the combination of morphia with a volatile anaesthetic ; 
 and he was performing the operation in two stages, first the 
 removal of the bone, later the removal of the tumour. He 
 had not modified his principles ; he had only strengthened 
 them by wider acquaintance with cases kept for years under 
 useless medical treatment ; and he said again, as he had 
 said in Berlin in 1890, that the medical treatment and 
 watching of ' suspicious ' cases ought to be hmited to six 
 weeks, unless some notable improvement took place in that 
 time : but he would allow a longer time for the medical 
 treatment of a tuberculous growth in the brain. The case 
 must be judged ' suspicious ' from the progressive character 
 of the symptoms. ' In the first case of cerebral tumour 
 upon which I operated, there was no optic neuritis, no vomit- 
 ing, and only some headache. The frequency of this ex- 
 emption is known to all neurologists. To wait, therefore, 
 as is frequently done, for the onset of optic neuritis, vomiting, 
 or headache is not justifiable.' Finally, he spoke (i) of the 
 bad outlook in all cases of glioma or glio-sarcoma, (2) of 
 the great reUef given by decompression, (3) of the bare 
 chance that decompression, in this or that case, may bring 
 about not only relief of the symptoms, but actual retro-
 
 FROM 1893 TO 1898 151 
 
 cession of the growth. On the first of these points, he 
 said : 
 
 I do not know what may be the experience of other surgeons, 
 but personally I have never been asked to operate in any 
 case of gUoma in which the symptoms had not become so 
 marked as to make it evident, or at least suggestive, that 
 very considerable infection had already occurred ; and in 
 every case of glioma or glio-sarcoma that I have removed, 
 the tumour has been of such a size as to render it uncertain 
 at the time of the operation whether or no the complete 
 removal had been effected ; and in all such cases recurrence 
 has ultimately taken place. I have, therefore, in cases of 
 gUoma considered the question of operation more from the 
 point of palhation than cure. But that is only because, 
 under the present regime, these cases come far too late to 
 the surgeon ; and until we have a case of gUoma or sarcoma 
 operated upon under the same circumstances as it would 
 be were the tumour situated in the Hmbs and not in the 
 brain, it is ob\aously quite illogical to draw conclusions as 
 to the curabiHty of glioma from statistics drawn from the 
 cases at present offered to the surgeon. 
 
 This year, he received from the Faculty of Medicine of 
 the University of Edinburgh the Cameron Prize, awarded 
 annually ' to the practitioner or member of the medical 
 profession who has done most in the past year for practical 
 therapeutics ' : and in December he lectured in Edinburgh, 
 at the Oddfellows' Hall, on some points in the physiology of 
 the brain and of the thyroid gland. 
 
 Other writings, in 1893, were as follows : 
 
 1. An Introduction to ' The Chemistry of the Blood, and 
 other Scientific Papers, by the late L. C. Wooldridge.' ' 
 This volume was edited by Horsley and Starling. 
 
 2. The FuUerian Lectures for 1893. 
 
 3. The Evening Lecture at the annual meeting, in Notting- 
 ham, of the British Association : on ' The discovery of the 
 physiology of the nervous system.' 
 
 4. A post-graduate lecture on ' The surgical treatment of 
 nervous diseases.' 
 
 ' Wooldridge died young ; he would have become one of the greatest 
 of our physiologists. His death was a grievous loss to Horsley. They 
 had stood against each other for the appointment to the Brown Institu- 
 tion : they had worked together there in close fncndship. Horsley 
 learned much from Wooldridge, and had the utmost regard for his work ; 
 and to be learning from men always made Horsley desire to be in frieod- 
 ship with tliem.
 
 152 SIR VICTOR HORSLEY 
 
 On February 14, 1893, the Horsleys' second son was 
 bom.^ There is a letter from a grateful patient in Odessa, 
 on whom Horsley had operated for trigeminal neuralgia : 
 
 The operation, which you have so skilfully and artistically 
 performed, is in a very splendid state. I feel myself very 
 well, no idea of neuralgic pains, no dizziness, neither deaf- 
 ness nor disease. The medical men of Odessa are really 
 astonished by my present state of health, and they admire 
 ' la finesse ' of your operation. Receiving the ' Graphic,' 
 as a voice of my friendly England, I was happy to read a 
 short notice about your lecture concerning hypnotism. 
 Another new incident occasioned to my whole family a 
 shouting sensation and cheers — Imagine yourself, dear 
 Professor, what a noise could be made if there took part a 
 chorus of my seven children and five others with papas and 
 mammas. I proposed a cheer for Mr. and Mrs. Horsley, 
 their first and second son 1 God grant you and your lady 
 and children a happy and a long life ; you are and you will 
 be our dearest friend, and we shall never forget your kindness. 
 
 1894 {cBt. 37) 
 
 Two signal honours came to him this year : (i) The 
 Royal Society awarded to him one of its gold medals, ' for 
 his investigations relating to the physiology of the nervous 
 system, and of the thyroid gland, and to their applications to 
 the treatment of disease.' (2) The University of Halle, at 
 its bicentenary festival, gave him the honorary degree of a 
 Doctor of Medicine. 
 
 He began, this year, a long series of experiments, with 
 Dr. Butler Harris, on a wholly new subject in physiology : 
 the estimation of the oxidising power of the several tissues 
 of the body. 
 
 In brain-surgery, he published (i) his lecture at the 
 Royal Institution, April 6, ' On the destructive effects of 
 projectiles ' ; (2) his paper in the Quarterly Medical Journal, 
 
 » Captain Oswald Horsley, M.C. (and bar), Gordon Highlanders. Edu- 
 cated at Bcdale's School, and at Christ Church : received liis Commission, 
 November 1914 : thrice wounded : joined Royal Flying Corps in August 
 191 7 : promoted flight-commander, March 1918 : killed, while flying, by 
 a failure of his machine, August 19, 1918. He, like his father, had a 
 wonderful power of drawing men to liimself : wherever he was, at school, 
 at Oxford, in training at Aberdeen, or on active service in France, men 
 remember the charm of his presence and of his influence.
 
 FROM 1893 TO 1898 153 
 
 July, ' On the mode of death in cerebral compression, and 
 its prevention.' 
 
 These two writings, and the paper by him and Spencer, in 
 1890, on intra-cranial pressure, ought to be taken together : 
 they are concerned, all three of them, with the evidences 
 that in death either from disease or from injury of the brain, 
 the failure of respiration precedes, not follows, the failure of 
 the heart. 
 
 The paper in the Quarterly Medical Journal begins with 
 an account of the experimental studies of this subject by 
 Leyden, Leonard Hill, and others : then it comes to the 
 question. What is to be done ? Sudden death is frequent, 
 among cases of cerebral timiour, haemorrhage, or inflamma- 
 tion : there is increased intra-cranial pressure in all of them : 
 and it arrests the breathing before it arrests the heart. 
 Horsley writes of four cases of cerebral tumour. In one, 
 the patient had died suddenly in bed, a few hours before 
 the time fixed for operation. In the other three cases, the 
 operation had just been begun : 
 
 Since the clinical picture of this alarming accident was 
 precisely the same in each case, one description will serve 
 for the three instances. 
 
 The patient had been successfully anaesthetised, placed 
 on the operation table, the head suitably arranged, and the 
 skin-flap and superficial tissues removed from the bone. 
 In one the trephine had already been applied for a few 
 seconds, in the others not, when the patient suddenly turned 
 very white, the respiration became extremely shallow for 
 a few breaths, and then stopped altogether. In each case 
 artificial respiration was immediately commenced, and 
 while it was going on the skull was opened very freely in 
 a few minutes, as quickly as possible, with the trephine and 
 bone forceps, and in each case over the presumed situation 
 of the tumour. ... In every instance, directly the skull 
 was adequately opened, and the pressure relieved, normal 
 respiration returned, the movements being naturally a little 
 shallow at first, but soon assuming their customary pro- 
 portions. 
 
 In these cases the arrest of respiration would have been 
 inevitably fatal, as has been the result in other cases of which 
 I have been infonncd, where the patient either died on the 
 tabic, or as soon as artificial respiration was stoi)peii. A 
 very striking instance of prccibcly the same event, and of
 
 154 SIR VICTOR HORSLEY 
 
 the recognition of the true state of things by the operating 
 surgeon, is a case of cerebral abscess, pubUshed by Mr. 
 Jalland in the Lancet, where during exposure of the abscess, 
 the patient having stopped breathing, he punctured the 
 brain, and witnessed the gratifying return of respiration in 
 proportion as the pus flowed out. 
 
 He goes on to speak of certain cases not of disease but of 
 sudden injury to the brain : 
 
 The class in question is that in which a patient receives 
 a violent blow, frequently in the occipito-temporal region, 
 e.g. from a fist or cricket-ball, or from an explosion, and 
 in which the person struck falls, as is stated, dead. In 
 these instances we do not observe that any attempt is made 
 to do artificial respiration, although this is just a measure 
 which is universally taught in ambulance classes, and can 
 be practised properly by any intelligent layman. In all 
 probabiUty these have always been considered to be deaths 
 by heart failure, but they are as certainly deaths from respira- 
 tory arrest, a fact which can be proved experimentally on 
 the lower animals, with unfaiUng accuracy. 
 
 Dr. Kramer and myself have recently shown precisely the 
 same to be the pathological explanation of sudden death 
 from bullet-wounds of the cerebral hemispheres. 
 
 This long series of experiments, with Dr. S. P. Kramer 
 of Cincinnati, was made during 1893 : toward the end of 
 that year, Horsley read a paper, at a meeting of the Liver- 
 pool Medical Institution, ' On the cause of death from bullet- 
 wounds of the cerebral hemispheres ' : on March 15, 1894, 
 at a meeting of the Royal Society, a paper by Kramer and 
 Horsley was read : and on April 6, Horsley gave his lecture 
 at the Royal Institution. 
 
 It is characteristic of him, that he was quick to find the 
 meaning in surgery of facts which had been put on record 
 without reference to surgery : he went over great stretches 
 of published science as a man goes over the ground with a 
 divining-rod. Experiments had been made and published, 
 before 1893, on the effects produced on non-hving structures 
 by the firing of bullets into them : none had been made on 
 the physical effects of a bullet-wound of the brain during life. 
 He therefore not only repeated these earher experiments, but 
 added to them a series of experiments of an altogether new
 
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 FROM 1893 TO 1898 155 
 
 kind : and his lecture at the Royal Institution gives an 
 account of the whole output of his work on this subject. 
 
 He begins by clearing away the old idea that the ' wind of 
 the shot ' — the air compressed in front of the projectile, 
 which Boys had made visible in a photograph of a flying 
 bullet — has any destructive effect. In the first place, it 
 exerts very feeble pressure, as tested by a dehcate vane ; 
 and in the second place it is certainly easily reflected from 
 surfaces of but moderate density. Nor does the rotation of 
 the bullet, nor the heat of it, have any destructive effect. 
 What does destroy the tissues is the sudden rise of fluid 
 pressure in them. Huguier had recognised this fact, after 
 the fighting in Paris in 1848 : ' it will be remembered that 
 in that struggle, as in others, the appearance of bursting 
 within the tissues was very noteworthy, and gave rise to 
 the notion of explosive bullets having been employed by the 
 combatants.' Huguier had fired into dead organs — lung, 
 hver, etc., which have much fluid in them — and had con- 
 vinced himself that ' the energy of the moving projectile 
 being imparted to the particles of water caused the dis- 
 persion of these in a hydrodynamic fashion.' Kocher, in 
 1874-76, by many experiments, had proved the truth of this 
 theory of hydrod3mamic action : that not the bullet but 
 the tissues are explosive. 
 
 Kocher's experiments had been made with the Vetterli 
 rifle : Horsley's were made with the '303 rifle, which had 
 lately been introduced into the services : and Sir Andrew 
 Noble had, at his request, provided him with a 22-calibre 
 rifle modified to fire a 40-grain bullet at any set velocity from 
 a few hundred to 3500 feet per second. He experimented 
 with clay, with doughs containing known proportions of 
 water, with canisters filled with dry or wet hnt ; with skulls, 
 and with bullets fired through water. To get permanent 
 records of the effect of firing bullets into masses of clay, he 
 took plaster casts of the explosion cavities : these famous 
 casts are now (July 1918) in the War Museum of the Royal 
 College of Surgeons. This long scries of experiments on 
 non-living structures made it plain that Huguier, and 
 Kocher after him, were right : that the effects of a pcnetrat-
 
 156 SIR VICTOR HORSLEY 
 
 ing bullet-wound of the head must of necessity be (i) a 
 slight increase of intra-cranial pressure, by depression of the 
 fracture of the skull : followed immediately by (2) a very 
 great increase of intra-cranial pressure, a hydrodynamic ex- 
 plosion, most marked on the side of entry, and so powerful 
 that it might even disrupt the skull. 
 
 To these experiments in physics, he added a long series of 
 experiments on animals under anaesthesia. He proved that 
 the infliction of a bullet-wound of the brain was followed, 
 first, by complete arrest of respiration, and slight fall of the 
 central blood-pressure, with consequent slight fall of the 
 peripheral blood-pressure. From five to ten seconds later, 
 there came a remarkable rise of the blood-pressure, till it 
 was even above the normal : 
 
 These observations prove beyond doubt that the first 
 cause of death is not what it is usually supposed to be, and 
 as taught in the text-books, namely, arrest of the heart, 
 and syncope : since, as you see, the heart goes on beating 
 although the respiration has completely stopped. Further- 
 more, if we quickly perform artificial respiration, we obtain 
 recovery from the otherwise fatal arrest. This suggests very 
 strongly that the police and persons who are trained in 
 giving first aid to the wounded should be taught that, with 
 a gunshot wound of the cerebral hemispheres, the proper 
 thing to do is to employ artificial respiration rather than 
 the giving of stimulants, etc. But, as you may well expect, 
 the matter does not end here, nor is it so very simple. 
 
 Anaemia of the brain, or pressure from haemorrhage into 
 the brain, would tend to make artificial respiration useless. 
 Still, the fact holds good, which Horsley first worked out, 
 that the respiration fails before the circulation. Some years 
 ago, a man called on Dr. Shuter of Chiswick, complaining of 
 sleeplessness and nervousness. He had been drinking, and 
 was strange in his behaviour : and by and by he pulled out 
 a revolver. Put thai down, said Dr. Shuter : the man fired 
 at him, then turned the revolver to his own head, and shot 
 himself, and feU. Dr. Shuter at once did artificial respira- 
 tion ; but, as Horsley says, ' the matter is not so very 
 simple ' ; and the man did not come back to life. But there 
 is a well-known case — not of injury but of disease affecting
 
 FROiM 1893 TO 1898 157 
 
 the brain — in which the patient's life was saved by this 
 method : and a very vahiable hfe it is. 
 
 1895 {at. 38) 
 
 Three honours, this year : (i) He was made a Correspond- 
 ing Member of the Societe de Chirurgie de Paris. (2) The 
 membership of the Athenaeum was given to him, without 
 ballot. (3) At the end of the year, the Fothergillian Prize 
 was awarded to him by the Medical Society of London. 
 
 In Februar}', at a meeting of the Newcastle-on-Tyne 
 Clinical Society, he read a paper ' On oxidation in the 
 tissues ' : an accoimt of the experiments which he and 
 Dr. Butler Harris had made, by Ehrlich's method, on the 
 oxidising or reducing powers of various tissues of the body, 
 as shown by their influence on methylene-blue injected into 
 a vein. 
 
 In March, he gave evidence in a legal action over Harness's 
 ' electric belts ' ; and lectured, at the Royal Institution, on 
 electrical currents in the living body. He said that, though 
 the construction of a scientific basis for medical electricity 
 was not yet very far advanced, it was none the less in 
 progress : ' the chief need was for more investigators, and 
 for more general sympathy with a branch of medical treat- 
 ment which had hitherto been somewhat unfortunate, 
 owing to the manner in which it had been exploited by 
 ignorant pretenders.' 
 
 In July, he published a paper, in the Practitioner, on ' Five 
 cases of leontiasis ossium, in three of which the disease was 
 removed by operation.' 
 
 But his chief contribution to surgery, this year, was at 
 tlie annual meeting, in London, of the British Medical 
 Association : ' On seven cases of injury or disease of the 
 cervical vertcbrtX- treated by laminectomy.' This address 
 was of the more importance, because interference with the 
 cervical part of the spine had rightly been judged more 
 hazardous than interference with the dorsal or the lumbar 
 part. Of these seven patients, one had died, not from the 
 operation, but four months after it, and a month after
 
 158 SIR VICTOR HORSLEY 
 
 leaving the Hospital. At the meeting of the British Medical 
 Association the year before, in Bristol, Mr. Alfred Parkin had 
 spoken very hopefully of the operation, and had reported 
 six cases : but in only two of them had the operation been 
 on the cervical part of the spine : and the general opinion of 
 the meeting had not been hopeful of much gain from inter- 
 ference in that region. Three of Horsley's patients attended 
 the London meeting, and displayed their powers : ' it was 
 hard to believe,' says a medical journal, ' that when they 
 came under Mr. Horsley's care they were paralysed in all 
 four limbs.' 
 
 In October, he gave the introductory address at the open- 
 ing of the winter session of the Sheffield Medical School. 
 He told the students that their calling was ' at once the 
 most difficult and the most straightforward ; the most re- 
 sponsible and the most interesting ; the most discussed and 
 the least understood of all professions.' He told them that, 
 so soon as they had passed their final examination, they 
 ought either to assist a good general practitioner for six 
 months, or hold a Hospital appointment, or travel. Then 
 he spoke of drawbacks in practice ; of unfair competition, 
 of touting and bullying ' Medical Aid Associations,' and of 
 quacks — ' the wretches who rob the ignorant not only of 
 their wealth but of what is beyond price, their health.' 
 Finally, he spoke of the British Medical Association, the 
 Medical Defence Union, and the General Medical Council — 
 what had been done to help and protect the profession, and 
 what had been left undone. 
 
 1896 {at. 39) 
 
 His published writings, this year, were : (i) The Fother- 
 gilhan Lecture, on the thyroid gland, with special reference 
 to ' Graves's disease.' (2) A lecture at University College 
 Hospital, on traumatic neurasthenia. (3) A paper in the 
 Medical Magazine, on the duties and functions of the General 
 Medical Council. 
 
 At the Carlisle annual meeting of the British Medical 
 Association, there was much hostile criticism of the General 
 Medical Council, by him and others.
 
 FROM 1893 TO 1898 159 
 
 At the opening of the winter session, he gave the intro- 
 ductory address at Yorkshire College, Leeds : it is in part 
 concerned with the praises of chemistry as a foundation of 
 all medical teaching. 
 
 Another event of 1896 was his resignation, in February, 
 of the Professorship of Pathology at University College ; 
 he no longer had time for the systematic lecturing. Before 
 him, Bastian had been Professor, and had given the lectures ; 
 Horsley had been Assistant-Professor, and had taught the 
 practical class. When he succeeded to Bastian, he had 
 rearranged the department, making it more convenient for 
 research work in pathology and bacteriology ; he had 
 published its Reports, in fine style ; and he had instituted 
 a sub-department of pathological chemistry, under Dr. 
 Vaughan Harley. The Professorship had cost him more 
 than it had paid him. He writes to a colleague, February 5 : 
 
 The fact that I have run the Department at a loss, and 
 that it cannot at present be managed other%\ase, is of course 
 no credit to the College, but I think it is unavoidable for at 
 least some years to come : and that is my reason for saying 
 that I think it must form one of the possible conditions 
 which my successor would have to contemplate meeting. 
 In thus recognising the inevitable, I do not put the point 
 forward as constituting a qualification for the post, only an 
 eventuality in which the future professor will be involved, 
 and therefore one which must be laid before the candidates. 
 
 It goes without saying, that he had set himself, year in 
 year out, to advanced teaching. He and Rubert Boyce, 
 the Assistant-Professor, had resolutely maintained the work 
 of the department at a very high level : too high for any 
 student who cared only to satisfy the examiners. Dr. 
 Charles Bolton has written : 
 
 When he was appointed to the chair of pathology at 
 University College, experimental pathology was practically 
 non-existent in Great Britain. Under Horsley's directions, 
 the pathological department at University College became 
 a di-finitc and well-known centre for research in experi- 
 mental pathology. He did not teacii from the examina- 
 tion point of view in the veiy least ; but his aim Wiis to give 
 an account of the processes of disease as ascertained by
 
 i6o SIR VICTOR HORSLEV 
 
 experimental inquiry : and he illustrated all his statements 
 of fact by experiments on every possible occasion.^ 
 
 On his resignation of the Professorship, his students pre- 
 sented to him a gift of silver, and an album. Dr. Sidney 
 Martin was appointed Professor. Horsley had supported 
 another candidate, who, to his thinking, had not been fairly 
 treated : and over this more or less imaginary grievance he 
 went so far as to wreck one of the best of all his friendships. 
 
 l&xcept that he was no longer called Professor, and was 
 freed from the systematic lecturing, his position at University 
 College remained what he had made it : he still had his own 
 room, in which he worked, and to which he attracted men to 
 work under him. Later, when the Medical School was 
 separated from the College, a special ' Department of Ex- 
 perimental Neurology ' was instituted for him ; but this was 
 hardly more than a convention, to keep him in touch with 
 the School, and in possession of his old room behind the 
 anatomy theatre. One of his colleagues has written of these 
 later years : 
 
 There he was always to be found, on certain afternoons 
 in the week, tackling fresh problems with undiminished 
 ardour, as the pages of Brain testify. None who have ever 
 worked there under his aegis are likely to forget his infectious 
 keenness and his unequalled generosity. All that he asked 
 for was that men who came there should be workers : and 
 they did come, from home, from the colonies, from America, 
 Germany, Poland, France, and clsewiiere. It was a matter 
 of indifference to him whether their researches were pub- 
 lished with or without his expressed collaboration ; aU 
 
 ' He spoke of the value of this method of teaching, in his evidence 
 before the second Royal Commission on experiments on animals. He 
 chose, for a good example to give to the Commission, the demonstration 
 on the anaesthetised animal, of an epileptic fit. ' I wish to point out that 
 having lectured on pathology, and havmg illustrated my lectures by 
 experiments on animals, the necessity of this method has been borne in 
 upon me very closely. As an example I have chosen epilepsy, with con- 
 vulsions of all kinds, as being a very common form of disease, and yet one 
 which the student has no means of analysing in ordinary hospital work, 
 and very often hardly sees a patient in a lit at all. And yet epilepsy, for 
 instance, can be reproduced experimentally with absolute fidelity by the 
 simple injection into the veins of a drop of essence of absinthe. In twenty- 
 five seconds you have a typical epileptic fit produced, and a student who 
 has once seen it, and watched it develop through the body of the animal, 
 never could forget, and never has forgotten it.*
 
 FROM 1893 TO 1898 161 
 
 recognised that he was the leading spirit in the international 
 coterie that laboured in that odd-shaped and out-of-the- 
 way room, which to many of the younger generation of 
 neurologists at home and abroad was a veritable Mecca. ^ 
 
 Among the innumerable letters which he kept, there is 
 one, of this year, from Hughlings Jackson, about a case at 
 Queen Square. It brings us back to practice : 
 
 I am not clear as to the deafness in the case. Consider- 
 ing the great symmetry' of the paralysis, I fear the cord itself 
 is involved. The paralysis is of parts supplied by the 4th 
 lumbar and lower roots. (I got Beevor to see the patient with 
 me, as Beevor is more famihar uith the nerve-roots than 
 I am.) The man has great pain, and the operation may 
 relieve this. If you think there is comparatively little risk, 
 I shall be glad if you will explore as you suggest, if the patient 
 consents. The patient has yet to be spoken to. 
 
 This letter does not stand alone : there are many other 
 letters, from Hughlings Jackson and from Gowers, about 
 cases at Queen Square ; and something comes to be said of 
 them here. They give the lie direct to the gossip which was 
 talked against Horsley — that he was in a hurry to operate, 
 that he would even operate for the sake of operating, and so 
 forth. This brutal nonsense had not a word of truth in it. 
 Indeed, the only time when Gowers and he had a quarrel, 
 was when Gowers wanted an operation to be done, and 
 Horsley insisted on a longer period of medical treatment. 
 The letters show the careful thought and watching given to 
 the patients. The difficulties of exact diagnosis, and the 
 difficulties of deciding for operation or against it, were even 
 greater than those which arise in general surgery : and the 
 
 * Mr. Wilfrwl Trotter writes, in the British Journal of Surgery, October 
 1916 : ' Year after year, certain hours of the week were regularly set aside 
 for the laboratory, and all who were associated with him soon learned 
 that these hours were to be regarded as the most serious of his engage- 
 ments and the least liable to be set aside by other calls. When the 
 immense range of other matters in which he was deeply interested is con- 
 sidered, it is possililc to get .some idea of tlie strcngtli in him of this master 
 passion lor science, and tlic fortitude of the will wliicli could maintain it 
 against encroachment tlirough more than thirty muUilu<linously crowded 
 years. Of all that was accomj)lislicd in that time no complete record is 
 now, or perhaps ever will be, recoverable. Horsley was always infinitely 
 more interested in the carrying out of his researches than in tbo record 
 and publicatioD of them.' 
 
 L
 
 i62 SIR VICTOR HORSLEY 
 
 proportion of very grave cases was higher than it is in 
 a general hospital. Of course, it takes a doctor to read 
 between the lines of these letters : the references to optic 
 neuritis, and to the look of the optic discs and papillae, will 
 not mean much to non-medical readers. 
 
 The letters from Gowers — only a few are given here — are 
 undated. It is not unhkely that the letters marked 3 and 
 4 refer to one and the same case. 
 
 1. I have a man named Christian in the Hospital, whom 
 I admitted after seeing him for possible operation to-morrow. 
 But further scrutiny shows it cannot be yet. I should like 
 you to see him. Don't let the House-physician say what 
 I think, but form your own opinion. I know you are as 
 ready to change your opinion, if mine comes with more 
 light, as you are to take mine. Remember of this man 
 Christian, Everley Taylor of Scarboro' would come up 
 travelling through the night to see it. 
 
 2. There is a man from Prague, whom I almost think you 
 introduced to me, and another from Cleveland, Ohio, who 
 are anxious to see the operation, and that on the syringo- 
 myelia case. Is a notice of an operation put up in the 
 hall of the Hospital ? Do you object to many spectators 
 on the benches ? 
 
 3. On the one hand, I don't think the swelling of the 
 discs is greater. I think the neuritis is subsiding. If you 
 put much weight on this, you miglit get Gunn to examine 
 them again. His second more careful estimate quite con- 
 firmed my opinion that the left was the worse. On the 
 other hand, Purves Stewart's case shakes rather my idea 
 of an infiltrating glioma of the pons, and makes me inclined 
 to think that the probabilities are equal between that and 
 a tumour of the right cerebellar hemisphere near the pons 
 — perhaps not far from the seat in Stewart's case. Have 
 you got the reprint I asked him to send you ? Later. That 
 cerebral tumour case is strange. Never have I seen such 
 rapid subsidence of neuritis. Of course there has been 
 oedema as an clement, but I think leucocytes — such as we 
 find in such immense quantities in the swollen papillae — 
 must have passed away by the lymphatics or vessels. The 
 headache seems getting less, though only slowly. Still, I 
 cannot help thinking improvement in the growth may be 
 occurring. I have seen her brother, and they are willing 
 and indeed grateful to keep her in. I shall be glad to learn 
 your opinion. When you saw the eyes, the condition was 
 very different from that which existed when she came in. 
 But it is an ocular condition that may invalidate conclu-
 
 FROM 1893 TO 1898 163 
 
 sions for ordinary cases. But see here ; if you had trephined 
 a few days after admission, must I not have felt absolutely 
 certain that a subsidence, more rapid than I had ever seen 
 before, was due to the operation ? It is a curious illustra- 
 tion of danger, 
 
 4. I may not delay you longer from doing what you think 
 wise about that girl. The pain is too severe : subsidence is 
 not maintained. It is, as to the optic neuritis. Dismiss 
 the eyes entirely from your mind in considering the 
 question. That is all I can say. I am quite perplexed as 
 to the rest, and dare not attempt to advise you. You will 
 understand that I have waited to the last, before saying 
 this. Later. I wish I had sooner withdrawn my hindrance. 
 That girl is suffering most agonising pain, and has to be 
 kept under morphia, or she would I think die of pain. The 
 retraction of the head is great when the pain is on, and surely 
 this must show subtentorial disease. Even the nurses are 
 longing for Monday morning. Later. I do not remember 
 a case that has grieved me so much. I blame myself for 
 having hindered you, and then for having biased you in 
 favour of subtentorial disease. I should think that if ever 
 a Hfe could have been saved by surgery with the utmost 
 facility, it is this. I wonder if you were influenced by what 
 I said. I suppose you have received my notes. I am re- 
 vising report of my lecture on the case for the Clinical 
 Journal. It is one in which there is a moral compulsion 
 to be frank, as you will feel. 
 
 5. Probably tubercular. But no good can be done to 
 sight. Neuritis is now in stage of subsidence : but an 
 amount of damage such as I have never seen. Every nerve- 
 fibre is destroyed, and the huge quantity of inflammatory 
 tissue will maintain the absolute destruction, or rather, 
 would cause it if it were partial in degree. No inlluence 
 on the condition can possibly lead to any improvement in 
 siglit. The operation must be for the pain alone. I was 
 going to lecture on the case on Wednesday, but if you think 
 well to operate to-morrow, I will take another subject. 
 Lot it be as you think well. You may like to wait a few days. 
 
 1897 {(St. 40) 
 
 In April, he was invited to give the Cartwright Lectures 
 in New York ; but could not accept the invitation. In the 
 summer, he worked in Hamburg for two or three weeks, 
 on the oxidising power of the tissues. In October, he was 
 elected to the General Medical Council. In November, he 
 was appointed on the Senate of the University of London.
 
 t64 sir victor HORSLEY 
 
 He published, this year, (i) Short notes, in Brain, on the 
 presence of true Pacinian bodies in muscles, and on the 
 survival of muscle-spindles even in extreme atrophy of a 
 muscle after section of its motor nerve. (2) A paper at the 
 Medical Society, on traumatic neurasthenia. (3) A clinical 
 lecture at Queen Square, on the diseases of the spinal cord 
 requiring surgical treatment. (4) An address to the South- 
 West London Medical Society, on ' The Medical Acts, as they 
 are and as they ought to be.' (5) Das Sauerstoffbediirfniss 
 des Organismus, Miinch. Med. Wochenschrift, No. 19, 1897. 
 (6) Blutbefinde bei der intravitalen Methylenblaumethode, 
 ibid., No. 23, 1897. These last two were in connection with 
 his work in Hamburg, 
 
 He also pubUshed three papers, one in physiology and two 
 in surgery : 
 
 1. ' On the relations between the cerebellar and other 
 centres (namely, cerebral and spinal) witli especial refer- 
 ence to the action of antagonistic muscles.' A paper by 
 Dr. Max Loewenthal and Horsley, read at a meeting of the 
 Royal Society, February 25, 1897. 
 
 2. ' On torticollis.' The Annual Lecture for 1897 to the 
 Hunterian Society. 
 
 3. ' On the treatment of trigeminal neuralgia. Two 
 clinical lectures at Queen Square. 
 
 The operative treatment of torticollis (spasmodic wry- 
 neck) will always be associated with his name. He was one 
 of the hrst surgeons who maintained that all such cases must 
 be treated in strict accordance with the exact distribution 
 of the nerves to all the involved muscles ; and that the 
 division of the nerves, in severe cases, must be done very 
 thoroughly, by an extensive operation, if the patient is to 
 be completely cured. He was not the first of all to work out 
 these facts. Risien Russell had determined them in neuro- 
 logy by the experimental method ; and Gardner of Melbourne 
 and Keen of rhiladelphia had devised and performed the 
 new operation. Horsley is careful to reckon himself as 
 their follower. He had in 1897 performed this ' tedious but 
 very satisfactory ' operation in five cases ; ' and certainly 
 with very gratifying results : in only one did I consider that
 
 FROM 1893 TO 1R98 165 
 
 the result was not good.' Always, he regarded it as one of 
 the most difficult of all operations. 
 
 The lectures on trigeminal neuralgia review the whole 
 subject of this disease and its surgical treatment. In 1891, 
 he had in one case divided the trigeminal nerve close to the 
 brain, between the base of the brain and the Gasserian 
 ganglion ; but had not seen his way to the complete removal 
 of the ganglion. In 1892, William Rose, by Horsley's help, 
 had devised one method of gaining access to it ; and Krause 
 of Altona had devised another, which Horsley greatly pre- 
 ferred to Rose's method. In America, Hartley devised a 
 method very similar to Krause's. Horsley added certain 
 improvements : his operation may therefore be called a 
 ' modified Krausc-Hartley operation.' In 1897, he was 
 able to say, ' I have been personally informed by Professor 
 Krause that he has done the operation in thirty cases with 
 but one death. I have myself done it in eight cases, all of 
 which have been healed without an accident. In neither 
 his cases nor in mine has there been any return of pain so 
 far.' 
 
 1898 [cat. 41) 
 
 To this year belong (i) A paper on ' The true interpreta- 
 tion to be placed on the Medical Acts ' ; published as a 
 supplement to the Clinical Journal, February 9, 1898. (2) A 
 paper in the Medical Magazine, on ' The duties and functions 
 of the General Medical Council.' (3) A lecture on ' Pene- 
 trating wounds of the central nervous system ' ; published 
 in the Clinical Journal. (4) A paper at the Edinburgh 
 meeting of the British Medical Association, on ' The treat- 
 ment of spinal caries.' 
 
 In August, at the meeting in Cambridge of the Inter- 
 national Physiological Congress, Beevor and he read a paper, 
 ' On the excitabk: fibres of the crus cerebri.' 
 
 He succeeded Sir George Savage, this year, as President 
 of the Neurological Society ; and gave a presidential 
 address, ' A contribution towards the determination of the 
 energy developed by a nerve-centre.' He had advanced 
 the work of the Croonian Lecture a step further. Gotch
 
 i66 SIR VICTOR HORSLEY 
 
 and he, in 1888, had studied and measured the electro- 
 motive changes which attend a discharge of nerve-energy : 
 but they had not studied or measured nerve-energy itself : 
 
 When we speak of the discharge of nerve-energy from a 
 nerve-centre, it is a little disturbing to find that we know 
 nothing about nerve-energy, except the rate of its trans- 
 mission along the nerve-fibres, and the circumstances under 
 which it is evolved. It has of course been compared to 
 all forms of physical energy, and Newton himself speaks of 
 a nerve impulse as amounting to a vibratory disturbance 
 of the particles of the nervous system. 
 
 To measure nerve-energy, Horsley measured the ' lift ' of 
 a contracting muscle. In this research, he had the assistance 
 of Dr. Veraguth and Dr. Christiansen. He states his results 
 as follows : 
 
 No nerve-centre, by any means that I have employed and 
 described, is capable of evoking as much work from the 
 muscle as excitation of the motor nerve to the muscle pro- 
 duces. The nerve-centres do not cause a complete explo- 
 sion of the potential contractility of the muscle. Further, 
 the average ' lift ' obtained from the cortex is about three- 
 fifths of that obtained from excitation of the motor nerve.
 
 Ill 
 
 From 1899 to 1906 
 
 During the next few years, it was impossible even for him 
 to give much time to the writing of scientific papers. He 
 was hard at work in professional politics ; and he was at 
 the zenith of his practice. The lists, in his engagement- 
 books, of consultations in London, and of country journeys, 
 are so long that one can hardly see how he had time at 
 all for science. By 1904, professional politics were less 
 urgent ; and the output of his writing came back to full 
 strength. 
 
 There is a good instance, in 1899, of the range of his 
 interests ; a lecture at the Royal Institution, February 3, 
 on the Roman Defences of South-East Britciin. It shows 
 him just as keen for antiquities as for physiology and 
 surgery and politics : with knowledge gained not only from 
 books, but more by observation and by the use of his 
 hands. Lympne, Pevensey, Reculver, Richborough — Partus 
 Lenianus, Anderida, Regulbium, Rutapis — their Latin names 
 are almost as familiar to him as their English : he had 
 learned all about the Roman naval squadrons, their ofhcers, 
 and their stations : the one or two coins, and the stamped 
 tiles, and the cobblestone paving which he found at Lympne, 
 all help him to see the place as it was. At the end of the 
 lecture, he describes the ruins of a Roman villa, excavated by 
 Mr. Storry, the curator of the Cardiff Museum : 
 
 On foliowinf; up the passage, which was the first part of 
 the villa opened into, Mr. Storry found it led into a large 
 room with a good pavement, the tesserae of wiiich were 
 broken and the surface indented with horses' hoofs. The 
 floor was covered by numerous human skeletons, and those 
 of horses, while in the comer of the room were the skeletons 
 of two children, and across, in front of them, that of a woman. 
 
 167
 
 i68 SIR VICTOR HORSLEY 
 
 Further, in three graves dug in tlie floor, were found the 
 skeletons of men of a larger and more powerful build than 
 those whose remains were left unburied where they fell. 
 The evidence is circumstantial but complete. The whole 
 story is told. The unfortified dwtlling-house, the attack 
 by the stronger invaders, the retreat of the household along 
 the passage to its inmost room, the last stand of the little 
 garrison, the slaughter of the men, the murder of the woman, 
 and last of all the massacre of the children, in front of whom 
 she had thrown herself in a final desperate effort to save 
 them from the inevitable destruction. There are those who 
 find the study of old walls dull, and wonder that some can 
 pore for hours over a jaw from a cave, a flint from a field, 
 or a bit of Roman mortar, but these things arc the key 
 to the unwritten history of man, and when we find how 
 vivid a page of history can be restored to us from the floor 
 of a single house, one's wonder should rather be that so 
 much still remains uncarcd for and unread. 
 
 In surgery, this year, he published two papers : (i) On 
 injuries to peripheral nerves. (2) On the rational treat- 
 ment of goitre. In professional politics, his chief engage- 
 ments were on June 15, when he spoke at a meeting of 
 medical men in Stratford, and defended Mr. Balfour's Bill 
 for the Registration of Midwives ; and on November 22, 
 when he spoke at a meeting of 160 medical men in Newcastle, 
 called to hear him and the other two direct representatives 
 on the General Medical Council. 
 
 1900-1901 
 
 In 1900, at last, he had wards of his own in University 
 College Hospital. One of his old House-surgeons, Dr. 
 Wirgmans, writes : 
 
 My first intimate association with him was in 1900, when 
 my fatlicr broke his thigh, and I asked Horsley to see the 
 case in consultation. Although there was no reason at all 
 why a fee should not have been accepted, it was refused, 
 I will not say with scorn, but as quite an unheard-of idea ! 
 I was fortunate enough to be his House-surgeon for six 
 months in 1901-02. I well remember my first day with him 
 in the theatre. He was a firm believer in the constant irri- 
 gation of the operation area with hot perchloride solution ; 
 and hot the solution had to be. It never quite boiled, but 
 to the H.S. who had to keep it dripping, the difference
 
 FROM 1899 TO 1906 169 
 
 was inappreciable ! At the end of the day I was more 
 or less soaked. I crept home with an umbrella pressed 
 to my legs, trying to conceal as much bloodstain as pos- 
 sible. Another noticeable thing in his work was the vast 
 quantity of gauze used in the dressing of head-cases, I 
 should not describe him as a great teacher or lecturer, but 
 his example was worth much, particularly to those who were 
 lucky enough to be brought into close contact with him. 
 He had a pecuhar gift of inspiring one witii confidence in 
 oneself, and trusted his House-surgeon very greatly, which 
 naturally calls out the best service from a man. There was 
 nothing more irritating, or amusing — I hardly know which 
 word to use — than the way in which his anti-vivisectionist 
 opponents described him as a cruel man. I never knew one 
 who was more careful to lessen suffering, and to avoid causing 
 pain. His dressers were soon taught that the dressings had 
 to be soaked till they came away of themselves ; or they 
 got a sharp telling-off. To his patients he was kindness 
 itself ; and for those who went to him for advice there was 
 always full and careful help in every way possible. 
 
 One of his colleagues remembers of him that he was fond 
 of giving to his ward-teaching the appearance of a consulta- 
 tion, in which this or that student would be expected to 
 reason out the points of a case with him. Another writes 
 of the devotion which he gained from his House-surgeons 
 and his students by ' his easy simplicity, his charming sense 
 of fun, his assumption of complete equality.' He had 
 neither time nor inclination for teaching the commonplaces 
 of general surgery ; and he usually transferred to his assistant- 
 surgeon cases which offered to himself no opportunity of 
 teaching or of learning. But, ' little as he did of formal 
 teaching, his influence upon the whole surgical tone of his 
 school was profound.' 
 
 At Queen Square, in 1900, faults of administration, which 
 had been going on for many years, reached their height. 
 The Hospital Sunday Fund withheld a grant to the Hospital, 
 till things should be better managed : a Committee of 
 Enquiry was appointed, under Sir Edward Fry, and the 
 unhappy dispute was j)roclaimed far and wide in the news- 
 ])apers. The Staff were not to blame for these troubles : 
 there never was a Staff more loyal in the service of their 
 Hospital. They had two very serious grievances : they
 
 170 SIR VICTOR HORSLEY 
 
 were not properly represented on the Board of Management, 
 and they were subjected to a sort of nagging espionage ; as 
 if they were the servants not of the Hospital, but of the 
 Board of Management.^ WTien one thinks who they were, 
 the notion of any body of non-medical men behaving un- 
 generously toward them is comical : but the harm done to 
 the Hospital was beginning to be tragical. In these years 
 of conflict, Horsley did his share of the fighting, but not more 
 than his share. The final manifesto of the Staff against the 
 Board of Management is dated August 4, 1900. With the 
 appointment of Mr. Dan vers Power as Chairman, every- 
 thing was gradually changed : he was the saving of the 
 Hospital. 
 
 In 1900, Horsley published a clinical lecture on compres- 
 sion-paraplegia : an address at a conference, in Manchester, on 
 ' Medical Organisation ' : and his Lees and Raper Memorial 
 Lecture on the effect of alcohol on the human brain. In 
 1901, he published, with Dr. Thiele, ' A study of the degenera- 
 tions observed in the central nervous system in a case of 
 fracture-dislocation of the spine.' 
 
 1902-1903 
 
 In 1902, he received the honour of knighthood ; to his 
 great astonishment : for the letter offering it was the first 
 intimation of any kind which he had of it, nor did he even 
 know who had recommended him. He and Beevor, this 
 
 ' There was another condition of Horsley's work, which vexed him 
 again and again. He never had beds of his own : all cases must be admitted 
 under the physicians : he could not take charge of any patient except at 
 the request of one of the physicians. Even those patients who were 
 sent to the Hospital for the express purpose of being under his care must 
 be admitted as ' medical cases.' He never got away from this rule. The 
 physicians mostly did their best to make it easy for him. Sir VVilUam 
 Gowers, for example, writes to him about a patient, in July, 1896: ' A 
 case I admit for you I regard as being only nominally under my care, and 
 I have been waiting for an expression of your desire that I should look 
 into this case. . . . You know I entertain the strongest opinion on the 
 injustice of the arrangement by which you have no beds of your own.' 
 The rule ought to have been modified or revoked. It was absurd, that a 
 patient should travel a hundred miles or more to be under Horsley, and 
 then should be under somebody else. Besides, mistakes or misunder- 
 standings were apt to happen, and to be sharply resented not only by 
 him but by the patient's friends, or by the medical man who had sent 
 the patient to the Hospital.
 
 FROM 1899 TO 1906 171 
 
 year, published in Brain a minute account of the nerve-fibres 
 passing from the cerebral cortex to the corpora quadrigemina 
 and the optic thalami. In their earher work, not having 
 the use of Marchi's method, they had failed to trace these 
 fibres.^ In October, he gave the introductory address of the 
 winter session at University College, Bristol. He also read 
 a paper, at the Bolingbroke Hospital, on the radical cure of 
 hernia : and Risien Russell and he opened a discussion, at 
 the Medical Society of London, on the medical and surgical 
 treatment of epilepsy. 
 
 In February, 1903, at a meeting of the Leicester Medical 
 Society, he spoke ' On the consolidation of the public and 
 professional interests of medical men.' He referred to the 
 great increase in the number of medico-ethical societies, and 
 to the reconstruction of the British Medical Association on 
 stronger and wider lines : ^ and he attacked the Council of 
 the College of Surgeons for not doing more for the profession : 
 
 Though in the Middle Ages the Corporate Guilds may have 
 exercised considerable influence, the College of Surgeons only 
 increased its membership with the development of the pro- 
 
 * An admirable account of Marchi's method was given to the second 
 RoyaJ Commission on experiments on animals, November 27, 1907, by 
 Dr. Head. ' The beginning of our present knowledge came with Waller's 
 discovery that a nerve degenerated when separated from its nutritive 
 centre. This law was the direct outcome of experiments on animals, 
 and its application to the brain and spinal cord has been responsible for 
 the greater part of that knowledge we now possess of the structure of the 
 nervous system. When a nerve is separated from its nutritive centre, 
 it becomes gradually funclionless ; but also it becomes gradually destroyed 
 entirely, so that no nervous matter is left behind. . . . Imagine a wall 
 covered with creepers arising from several stems. If we wished to know 
 from which of these any one branch takes its origin, wc could cut one stem, 
 and every branch arising from it would die, marking out among the healthy 
 foliage the offshoots of the divided stem. This is the principle that has 
 been used in tracing the paths in the nervous system. . . . By experiments 
 on animals, a tract or .set of tracts can bo divided precisely ; tlic animal 
 is kept alive until degeneration has taken place, and is then killed. By 
 suitable means the deatl parts can bo coloure<l .so as to stanil out clearly 
 in the microscopical picture. The method by which these dead structures 
 are made to show up clearly against the liealtliy parts was discovered by 
 Marchi from experiments on animals. Waller's law and Marchi's method, 
 applied to material obtained from experiments on animals and from disease 
 or injury in man, are responsible for almost all our knowledge of the 
 anatomical paths in the nervous system.' 
 
 • The medico-ethical societies worked apart, each in its own ilistrict. 
 There was talk of making a federation of them : but this plan was set 
 aside by the reconstruction of the British Medical Association,
 
 T72 SIR VICTOR HORSLEY 
 
 fession, and, like all other medical corporate bodies, it has 
 become more interested in preserving its existence than justi- 
 fying it. The members of its Council, who, though but 
 twenty-four in number, have arrogated to themselves the 
 rights and privileges of their 20,000 colleagues who com- 
 pose the College, do httle more than carry on the adminis- 
 tration of the conjoint examinations, and maintain the 
 buildings and museum of the College. They have never 
 publicly moved in support of the interests of the profession 
 as a whole. Neither will they move. In fact it is prac- 
 tically certain that the attitude of the Council of the College 
 of Surgeons will be to oppose the Medical Acts Amendment 
 Bill which we require, because they believe that a real refonn 
 will threaten their income. 
 
 Surely he overstates his case here ; and again, in the 
 address which he gave in October, at the opening of the 
 Birmingham winter session, on ' The purposes and main- 
 tenance of our Universities,' when he spoke of ' the sterile 
 training in dead languages and somewhat moribund systems 
 of philosophy unfortunately characteristic of an old Uni- 
 versity like Oxford,' and dismissed Sir William Anson's views 
 on education as if they were hardly worth considering. But 
 he spoke with good judgment of the maintenance of our 
 Universities ; and made a line appeal for State aid for 
 them. 
 
 At the meeting in Swansea of the British Medical Associa- 
 tion, he was Chairman of the Meeting of Representatives. 
 
 1904 {£bL 47) 
 
 At Queen Square, in 1904, the Nervous Diseases Research 
 Fund was instituted, for the microscopical, chemical, and 
 bacteriological study of these diseases. Some months later, 
 he received a gift of /^looo for any charitable purpose ; and 
 had the pleasure of using it for this Fund. Mr. Danvers 
 Power writes : 
 
 I saw a good deal of him, when I was Chairman of the 
 Hospital under its new constitution, after the dispute between 
 the Staff and the Board, in which he was really the leading 
 spirit. From first to last I found him the exact opposite 
 of what I had expected from liis controversial writings.
 
 FROM 1899 TO 1906 173 
 
 Having had the good fortune to be the humble instrument 
 of providing him with a proper operating-theatre at the 
 Hospital, and also of setting on foot a little research fund, 
 I can truly say that — whatever it may have been to opponents 
 — his ordinary manner to those who showed any kind of prac- 
 tical sympathy with liis work was, as far as my experience 
 went, very gentle and most attractive. He never forgot 
 to back support from laymen by his own exertions, and 
 always showed warm gratitude for it. I never knew him 
 make an unreasonable request. 
 
 As you know, he had extreme views on some subjects, 
 and they occasionally brought him public rebuffs. I re- 
 member his once saying to me, when he was suffering from 
 one of these, ' What they don't see is that my object is the 
 health of the country.' I wish every one could say as much. 
 
 In ]\Iarch, he gave evidence before the Committee on 
 Physical Deterioration. He so feared and hated this 
 national evil, that he must have longed to speak of every 
 aspect of it ; but he was limited to one subject, the venereal 
 diseases, their effect on the national health, and the measures 
 to be taken against them. The first thing to be done, he 
 said, was to appoint a Commission to enquire into their 
 prevalence. Statistics founded on Hospital practice were 
 useless. So were statistics founded on death-certificates : 
 
 At the present moment, when a medical man gives a 
 certificate of the cause of death, he is writing a document 
 which is for the information of the family, but it is a docu- 
 ment which is indirectly to be the scientific basis of statistics 
 for the nation. These two things are really quite apart : 
 you cannot combine them. Therefore it comes to this, tiiat 
 any document certifying the cause of death ought to be a 
 scientific document, a (iovemmcnt document, wliat we may 
 call a State j)apLr and a piivilcgt^d i)aper, to be given to the 
 Government ofhcial, the Registrar-General : and the con- 
 tents of that document should only be communicated to 
 the friends or relatives of the patient at the Registrar-General's 
 discretion. 
 
 He was in fuvi'ur ol compulsory notification : but li<- saw 
 the dilhcultics in the way of it. He was asked whether lie 
 thought that any serious penalty ougiit to be imposed on a 
 man who knowingly caused infection ; and he answered : 
 
 I think that, as the ordinary outcome of a Notification 
 Act, it w(;uld be possible to have a statutory penalty on
 
 174 SIR VICTOR HORSLEY 
 
 persons of both sexes. I do not think it ought to be Umited 
 only to the male sex, but I think certainly there ought to 
 be a penalty, so soon as the thing is put upon the ordinary 
 basis of an infectious disease. 
 
 The Committee, in their Report, July 1904, recommended 
 that a death-certificate ' should be regarded as confidential, 
 and its contents should never be divulged by the Registrar, 
 as is permissible at present, to the friends of the deceased. 
 It should be sent by the local Registrar direct to the Regis- 
 trar General.' They also recommended the appointment of 
 a Commission of Enquiry into the prevalence and effects of 
 syphilis, having special regard to the question of the possi- 
 bility of making the disease notifiable, and to the adequacy 
 of Hospital accommodation for its treatment. 
 
 At the Oxford meeting of the British Medical Association, 
 he opened a discussion on chloroform-anaesthesia. This 
 discussion was the chief event of the meeting. It was three 
 years since the Association, by Dr. Waller's advice, had 
 appointed a Committee to study chloroform through and 
 through. Waller, Sherrington, Vernon Harcourt, Dudley 
 Buxton, Horsley, and others had been working at it from 
 all points of view ; in physics and chemistry and pathology 
 and physiology and practice. They had just issued their 
 third report ; they had corrected or re-stated the results 
 obtained by the Hyderabad Commission. Chloroform is 
 one of those drugs which will never let the last word be said 
 about them. 
 
 They had proved that rather less than two per cent, of 
 chloroform-vapour in air is sufficient to induce anaesthesia, 
 and that much less than two per cent, is sufficient to maintain 
 it during an operation. The question was, Ought the 
 anaesthetist to use a special apparatus exactly registering the 
 percentage of vapour, and enabhng him exactly to control 
 and adjust it during the operation ? Or ought he to use 
 the simplest of all methods, sprinkling the drug on a fold of 
 lint, relying on his own experience and watchfulness, without 
 having to attend to any sort of apparatus ? The debate at 
 Oxford was followed by debates at the Society of Anaesthet- 
 ists and at the Royal Medical and Chirurgical Society. Mr.
 
 FROM 1899 TO 1906 175 
 
 Vernon Harcourt, and Dr. Alfred Levy, had invented two 
 forms of apparatus ; with either of them the anaesthetist 
 could exactly tell what dose he was giving at any moment : 
 but the art of giving anaesthetics is so ' personal,' so closely 
 dependent on the individuality of the anaesthetist, that 
 opinions were divided, w'hether science could rightly dictate 
 to practice. Horsley was quite sure that the percentage 
 ought to be exactly controlled. He always liked to have 
 the Vemon-Harcourt inhaler used for his operations. He 
 especially valued it in cases of brain-surgery with increase of 
 intra-cranial pressure : this pressure might of itself cause 
 sudden death, or might make fatal a percentage which 
 otherwise would be absolutely safe. But he also used the 
 inhaler in operations of general surgery. 
 
 He gave an address, this year, to the Wimbledon Medical 
 Society, ' On tactile sensation.' It is concerned with the 
 question. How is the study of tactile sensation useful as a 
 guide for the localising of a disease or injury of the brain ? 
 He begins with an account of the work done on this subject 
 by Head and Mott ; he agrees with them, that the sensory 
 channels terminate in the centres of the optic thalamus, and 
 that new channels start from the optic thalamus to the 
 cortex : 
 
 Under these circumstances, we naturally expect that the 
 representation of sensation in the cortex must be something 
 very special ; and I venture to submit to you that it is, 
 and that by a determination of this character we can form 
 an exact diagnosis of the lesion, as to whether it is in the 
 cortex cerebri or in the region below the optic thalamus. 
 
 He points out that the motor area of the cortex does 
 receive sensory hbres ; and so he comes to the question, 
 What special sort of insensitiveness is evidence of injury or 
 disease involving the cortex ? And he answers, that the 
 cortex enables us not only to be conscious of a touch, but to 
 identify the point touched : 
 
 I have urged again and again, and perhaps it may be 
 known to some — but I would like to repeat it — that m our 
 clinical investigation of cases of anaesthesia it is not suffi- 
 cient for us simply to touch a patient and say ' Do you feel
 
 176 SIR VICTOR HORSLEY 
 
 that ? ' and so on, because if he has any tactile sensation 
 at all he will say ' Yes ' quite correctly ; but the part to 
 be tested should be screened from the patient (it is much 
 better than blindfolding him) and the part should be touched 
 very lightly, and he should then be compelled to mark with 
 his own index-finger the part which you have touched. 
 If you do that, you may discover, often to your surprise, 
 that he has entirely lost his knowledge of the exact spot 
 which was irritated. Under these circumstances you are 
 at once furnished with a differential diagnosis : you know 
 perfectly well that the lesion cannot be anywhere below the 
 optic thalamus, and you know it must be somewhere in the 
 region of the cortex. 
 
 At the Oxford meeting, he had invited Dr. MacNalty, who 
 
 was working with Dr. Gustav Mann on the structure of the 
 
 optic thalamus, to come and work in London. From 1904 
 
 to 1909, Dr. MacNalty assisted him in his researches at 
 
 University College and at home ; and writes of these years : 
 
 He began his day at 7 a.m., breakfasted at 7.30, often 
 earher, and was usually operating soon after 8. From then, 
 work went on almost uninterruptedly until 11 p.m. When I 
 first knew him (1904) he was surgeon both to University 
 College Hospital and to Queen Square ; he had a large 
 private practice ; he was on the General Medical Council, and 
 busy with affairs of the British Medical Association ; and he 
 was daily engaged in cerebral research, either in his private 
 laboratory behind the anatomical theatre of University 
 College, or at his own house. ^ He was constantly in demand, 
 
 ' Of course, he was forbidden, by the Act, to make experiments on 
 animals at his own house : they must be made only in places registered 
 under the Act. Once, in 1893, he had leave to make two inoculation- 
 experiments at a private house ; but he did not, after all, make them. 
 See his evidence before the second Royal Commission : ' These experiments 
 were the inoculation of blood from a patient suffering from filaria sanguinis 
 hommis. This is a peculiar worm which discharges its embryos into the 
 blood of a patient at night-time. The embryos do not come into the blood 
 till about ten o'clock at night, and they flourish in the blood when the 
 patient is lying half unconscious or unconscious in sleep ; and when he 
 wakes in the morning, anrl begins to move about, these embryos disappear 
 again : hence, the only time you can get the living embryos is in the 
 night, so that it is necessary to ilo this inoculation in the niglit-timc. All 
 the laboratories are closed at night ; and Sir Patrick Manson, for whom I 
 was going to do the inoculation, brought the patient to a private house for 
 me to do it. As a matter of fact, wc examined the patient's lilood, and 
 we found that he had no embryos in his blood, or hardly any ; the reason 
 bemg, tliat lie had injured the lymph-glands in which the parent worm 
 was living : which had caused inflammation and ha<l caused the death of 
 the parent worm. And there was an end of the experiment : and there 
 was an end of the whole matter, because I have never done any experi- 
 ment in any unregistered place at any time in my life before or since.* 
 (Minutes of Evidence, vol. iv. p. 128, November 13, 1907.)
 
 FROM 1899 TO 1906 177 
 
 also, for political addresses, lectures at medical societies, 
 etc. He never neglected any detail of his work. I have 
 often been working with him in the evening, when he has 
 looked at his watch, pushed a tray of sections over to me, 
 and announced that he had some cases to dress. I think he 
 often strained his amazing powers to the utmost. Some- 
 times, after a long day, a very weary look would come over 
 his face, and he would say that he must sleep for a little 
 while ; and he would fall asleep for five or ten minutes and 
 then wake up refreshed and ready to continue work. 
 
 Neurologists from all over the world would attend to 
 watch him at his experimental work, and any keen resident 
 at U.C.H. or Queen Square was certain of an invita- 
 tion to the laboratory. As far as possible, he set aside 
 Thursday afternoons and Saturday mornings for experi- 
 mental work. The same scrupulous precautions were 
 observed in experiments as in a surgical operation. He 
 always dressed and bandaged the wounds himself, and 
 looked very carefully after the well-being of the animals. 
 He was very fond of animals, and would caress and play with 
 the monkeys and feed them with bananas. Apart from 
 his stated hours, he would appear in the laboratory at odd 
 moments, often in the early morning, and cut sections for 
 about half an hour. I think the mere mechanical work of 
 using the microtome rested him. At such times he would 
 talk to one on all sorts of subjects and at intervals would 
 whistle tunes out of the Gilbert and SulHvan operas. 
 
 He only gave up his private laboratory within a year or 
 two of the outbreak of the War. His amount of scientific 
 output in those precious hours snatched from other work 
 would have amply sufficed for the whole time of many a 
 professor of physiology. He had the gift of mental concen- 
 tration in no small degree. Like Arnold of Rugby, he could 
 work with liis family round him. 
 
 1905 
 
 This year, R. H. Clarke and Horsley published their paper 
 ' On the intrinsic fibres of the cerebellum, its nuclei, and its 
 efferent tracts.' They had set themselves to answer the 
 questions, How is the cortex of the cerebellum linked up 
 from point to point of its surface ? How is it linked up to 
 the underlying cerebellar nuclei ? Is there a direct efferent 
 tract from the cerebellum to the spinal cord ? (That is 
 to say, Do the peduncles, the great bundles of nerve- 
 
 M
 
 178 SIR VICTOR HORSLEY 
 
 fibres between the brain and the cord, contain any fibres 
 coming direct from the cerebellum ?) If such a tract does 
 exist, is it derived from the cerebellar cortex ? Or is it 
 derived from the cerebellar nuclei ? And, if so, from which 
 nuclei ? 
 
 They made altogether twenty-three experiments, using 
 Marchi's method. In their paper, they review the work of 
 other writers on the subject, from 1891 to 1905 ; and are in 
 agreement with Ferrier, Aldren Turner, and Risien Russell. 
 They give an elaborate description of the naked-eye anatomy 
 of the cerebellum, its divisions and subdivisions : here they 
 mostly adopt the nomenclature devised by Elliot Smith. 
 Finally, they point out that the temporal region of the 
 cortex cerebri is closely associated with the cerebellum ; it 
 is concerned with the sense of hearing ; it may therefore be 
 concerned with that sense of equilibrium which is controlled 
 by a portion of the auditory nerve ; and here may be a clue 
 to the disturbances of equiUbrium which attend injury or 
 disease of the cerebellum. 
 
 They sum up the microscopic structure of the cerebellum 
 as follows : 
 
 All the specimens show abundant arcuate fibres con- 
 necting various parts of the cortex, and other fibres passing 
 to the nearest cerebellar nuclei ; but none going directly 
 from the cortex cerebelli to any of the peduncles. Our 
 series of sections also show that all efferent cerebellar cortical 
 fibres, in the first instance, pass to one or other of the central 
 nuclei, and principally to the one which is nearest to their 
 origin. 
 
 Another paper in Brain this year, by Horsley, is of a very 
 different kind, on a chance observation made in the course 
 of his work : he had found a ' trigeminal-aural reflex in the 
 rabbit,' i.e. a reflex movement of the rabbit's ear, following 
 stimulation of the trigeminal nerve. The setting up of the 
 ears, as he says, ' has always been regarded as voluntary — a 
 high purposive act on the part of the animal to detect a 
 source of danger.' But he found that if he gently touched 
 the skin or the long hairs, in the infra-orbital region, which 
 is supplied by the trigeminal nerve, the ear on that side
 
 FROM 1899 TO 1906 179 
 
 was raised and carried forward : it remained thus for some 
 seconds, and then slowly dropped : 
 
 Pricking of the ears being undoubtedly associated with 
 an appreciation of danger, it is reasonable that it should 
 occur when the infra-orbital region, and especially the 
 vibrissae, are touched ; since a rabbit in escaping from 
 danger encounters numerous obstacles as it runs in the 
 depths of the burrow, or through bushes and grass in the 
 dark, and therefore must largely rely on contact-impressions 
 from its face. 
 
 From this chance observation in natural history, which 
 would have delighted Mr. Darwin, he goes on to speak of his 
 experiments — especially those which he had made in 1904 
 with Magnus of Christiania — on the representation, in the 
 corpora quadrigemina, of this listening-movement of the 
 ears ; a movement altogether different from the setting 
 back of the ears, for protection in fighting, which ' can be 
 obtained from a wide area of the cortex cerebri in all 
 animals, notably the ungulata.' The representation, in 
 the corpora quadrigemina, of the listening-movement, was 
 first observed by Ferrier, long before 1904 : Horsley now 
 couples it with the fact that the sense of hearing, hkewise, is 
 represented there. 
 
 In 1905, also, he gave the Boyle Lecture, in Oxford, to the 
 Junior Scientific Society of the University : ' The Cerebellum, 
 its relation to spatial orientation and to locomotion.' 
 
 1906 
 
 This year seems to mark the end of a period ; not only by 
 the work which he did, but by the work which he resigned. 
 It was the fiftieth year of his Hfe. He gave up his appoint- 
 ment at University College Hospital, and his Profcssoi-ship 
 of Surgery at University College. His second term of oflice 
 on the General Medical Council came to an end ; and he 
 did not seek re-election. He completed twenty years at 
 Queen Square ; and, in his Toronto address on brain- 
 surgery, he summed up what h<' had learned in all tiiat 
 time.
 
 i8o SIR VICTOR HORSLEY 
 
 It has been said of him, that he would have done far more 
 for science, if only he had kept clear of politics. There is 
 very httle truth in that saying. His chief discoveries in 
 physiology and in surgery were made early, in the wonderful 
 years between 1884 and 1900, when politics had not much 
 hold on him. Besides, the output of his work for science, 
 now more now less, never stopped : it went on right up to 
 the time of the War. 
 
 He certainly did enough, in 1906, both for science and for 
 practice, to satisfy the greediest of his critics. 
 
 In February, in Sheffield, he gave an address, ' On the 
 diagnosis and surgical treatment of diseases of the pituitary 
 gland.' It wiis thirty years since he had made, at the Brown 
 Institution, the first experiments ever made on the removal 
 of the gland. By 1906, he had operated on nine patients, of 
 whom two had died : but in neither case was the opera- 
 tion the only cause of death. The whole subject is too 
 new, and too abstruse, to be considered here : it is 
 very fully considered in Harvey Cushing's classical book. 
 The Pituitary Body and its Disorders (Lippincott, Philadel- 
 phia, 1912). 
 
 He gave the Hughlings Jackson Lecture, this year, to the 
 Neurological Society, ' On the physiological relations between 
 the cerebrum, the cerebellum, and the spinal cord.* It was 
 the fiftieth year of Hughlings Jackson's practice : a good 
 occasion to thank and praise him : 
 
 His teaching of first principles will always be gratefully 
 remembered by the ever-increasing army of neurologists ; 
 but this is the opportunity for those of us who have enjoyed 
 the inestimable privilege of being immediately his pupils, 
 specifically to recall the profound deptli of our indebted- 
 ness to him. . . . 
 
 The greatest principle, whicli underlies all he has written, 
 is the true nature of localisation of function in the central 
 nervous system : namely, that it is relative and not abso- 
 lute ; that conceivably every part of the body is repre- 
 sented in every nerve-centre, just as it of necessity is in the 
 single primordial ovum : and that when the nervous system, 
 considered functionally, is regarded, in the view of Flourens, 
 as working as a whole, the determination of action by any 
 given part is never more than relative. . . . When we are
 
 FROM 1899 TO 1906 181 
 
 labouring with the difficulties of endeavouring to establish 
 a differential diagnosis, we are Ukely to forget that the whole 
 machine is in active operation while our attention may be 
 drawn to one point only. 
 
 He published three papers, this year, in Brain : (i) On 
 the taenia pontis. (2) On the orientation of points in space. 
 (3) On apparent re-representation, in the cerebral cortex, 
 of the type of sensory representation as it exists in the spinal 
 cord. 
 
 1. The taenia pontis is a small tract of nerve-fibres along 
 the anterior border of the pons Varolii. It is seldom sym- 
 metrical : and it may be either superficial, or embedded in 
 the pons. The lower the type of brain, the more probability 
 that the taenia will be superficial. He studied it in three 
 types of brain — the hippopotamus, the camel, and man. 
 Up to 1906, it had been regarded as a tract of efferent fibres, 
 passing from the cerebellum to the pons. By a single ex- 
 periment (Marchi's method) he proved that the fibres are 
 afferent ; that they pass from nuclei in the pons to nuclei in 
 the cerebellum. 
 
 2. The orientation of points in space was worked out with 
 the help of Dr. Townley Shngcr. The observations were 
 made some in London, some in Cambridge with the help of 
 Dr. Rivers, and some at the South Norwood College for the 
 Blind. Horsley had devised a glass plate ruled in squares 
 of half a centimetre ; it could be set at any plane, and 
 screened from sight. The person tested had to keep a 
 fmger of one hand on the under surface of the plate, and to 
 try to touch with a finger of the other hand the correspond- 
 ing point on the upper surface of the plate. This and 
 similar tests were especially useful for the study of disease 
 of the cerebellum. They gave the exact measure of those 
 faculties which we exercise in the game of pinning, blindfold, 
 a paper tail to a pajx^r donkey : we are guided, in that 
 orientation, by the ' feel ' of our joints and muscles. The 
 results of this very long series of observations were as 
 follows: 
 
 I. The faculty of orientation in space, as determined by 
 the muscular and arthrodial sense, progressively diminishes
 
 i82 SIR VICTOR HORSLEY 
 
 from the surface of the body outwards to the Umits of the 
 arm extended in any direction. 
 
 2. Orientation-knowledge increases in passing from point 
 to point in the space around the body, beginning above the 
 head, coming down to the front of the body, and gradually 
 approaching the centre of gravity of the whole body. 
 
 3. Orientation-knowledge also increases in passing from 
 point to point in the space around the body, beginning 
 laterally, e.g. in the plane of the shoulder, and approaching 
 the mesial sagittal plane of the body. 
 
 3. The third paper was written with Dr. Colin K. Russel ; 
 and was issued from the Neurological Department of Queen 
 Square. Like Horsle3''s paper in 1904 on tactile sensation, 
 it is concerned with our ability to identify the exact position 
 of a touch on the skin. The ill-sounding name of topognosis, 
 i.e. knowledge of position, had been given to this abiUty. It 
 had long been of interest to physiologists : Horsley, so far 
 back as 1885-86, had observed that it may be impaired by 
 injury or disease of the cortex. But there are two ways of 
 estimating topognosis : and Horsley and Colin Russel now 
 called attention to that way which up to 1906 had been 
 overlooked. Take, for example, the upper limb. We may 
 regard it as made up of segmental groups of muscles, from 
 end to end of its length : or we may regard it, by analogy 
 with the fore-limb of a quadruped animal, as made up of 
 pre-axial and post-axial groups of muscles, from front 
 to back. 
 
 In the spinal cord, the representation of the sense of touch 
 in the upper limb is arranged according to the axis of the 
 limb, not according to its segments. That is to say, the 
 distinction between the pre-axial and the post-axial groups 
 of muscles is maintained in the arrangement of the nerve- 
 fibres of the cervical portion of the cord. This fact had 
 been known for some years : but nothing was known 
 about the re-representation of this distinction at any higher 
 level. 
 
 In 1894, in a patient with disease of the brain, affecting the 
 area of the middle cerebral artery, Horsley found ' marked 
 dissociation between the pre-axial and post-axial reaction 
 to light touches. The patient, who was a higlily-trained
 
 FROM 1899 'fC) 1906 183 
 
 scientific observer, had himself previously recognised a 
 certain sense of loss of relative knowledge of the sides of the 
 fore-limb.' That is to say, there was impairment not only 
 of his ability to judge at what point of the length of the limb 
 he was touched, but also of his ability to judge whether he 
 was touched on the pre-axial or on the post-axial aspect of 
 the limb. 
 
 With this case to guide them, Horsley and Colin Russel 
 examined a series of cases of disease of the brain, at Queen 
 Square and in private practice. In all of them, there was 
 ' a topognostic error of response to light touches : in two 
 directions at right angles to each other.' There was not only 
 a ' segmental error,' there was also a ' post-axial or pre- 
 axial error.' So the conclusion is reached, that what ' may 
 properly be termed the mid-axial line and region of the hand 
 and fore-arm ' are represented in the cord, and re-represented 
 in the brain. 
 
 In July, the Horsleys, with their children, went to Toronto 
 for the meeting of the British Medical Association. The 
 University conferred on him the degree of a Doctor of Law. 
 On August 22, he gave the Address in Surgery. At a meet- 
 ing of the Section of Physiology, he gave an account of his 
 most recent work with R. H. Clarke. At a luncheon of the 
 Ontario Branch of the Dominion Temperance Alliance, he 
 and Sims Woodhead spoke to an audience of 500. At 
 the festival dinner of the Association, a speech was loudly 
 demanded from him ; and he spoke, on the impulse of ' what 
 was uppermost in his mind at the moment,' of the need, in 
 the old country, to raise the wage-earning capacity of his 
 profession. ' It was a question of improving the conditions 
 of each one. Not only that : it meant that the occurrence 
 of misfortune to the members of the great army of medical 
 men might be prevented.' 
 
 The Address in Surgery is one of his most important 
 writings. It was just twenty years since he had shown, at 
 the Brighton meeting, his first three patients. He now 
 reviewed the whole field of brain-surgery ; with special 
 reference to his own cases of cerebral tumour at Queen 
 Square. He spoke of the want of definite agreement over
 
 i84 SIR VICTOR HORSLEY 
 
 the question, How long ought such cases to be under medical 
 treatment, before consulting a surgeon ? At Queen Square, 
 the period tended to be about three months. ' This view of 
 the situation, unfortunately, has not yet been discussed in 
 the profession. Even in the present year, I have been 
 asked to operate on a patient with a lateral tumour of the 
 cerebellum who had been known to have optic neuritis for 
 nine years, and last year I did operate on such a patient who 
 had been known to have optic neuritis for thirteen years.' 
 Next, he spoke of the very great value of decompression for 
 the arrest or improvement of optic neuritis : that was the 
 fact on which he was always insisting, that the intra-cranial 
 pressure can be relieved, in cases where nothing more can 
 be done : and at this meeting he showed such lantern- 
 photographs of optic neuritis as might well be called sensa- 
 tional. Next, the general principles of brain-surgery, and 
 the details of operating — ' Virtually, it will be found that the 
 fundamental purpose of every detail is the prevention of 
 shock and the maintenance of the physiological integrity of 
 the nervous system.' For the prevention of shock, it was 
 necessary that the anaesthetic should be rightly given. His 
 experiments in 1883-85 had taught him the disadvantages 
 of ether-anaesthesia. For his earlier operations, he had com- 
 bined morphia with chloroform : later, he had used chloro- 
 form only. The percentage of the vapour ought to be 
 exactly controlled : between 2'0 and 0*5 per cent., according 
 to the sensitiveness of the parts. For the treatment of the 
 brain itself, less than 0-5 sufficed : the anaesthetic might even 
 be shut off altogether for some minutes. A cylinder of 
 oxygen was adjusted to the inhaler, that venous congestion 
 and capillary bleeding might be checked, at any moment of 
 the operation, by giving oxygen instead of chloroform. 
 
 Finally — after speaking of each step in operating, and of 
 the variable risk of shock, and of the low resistance of 
 the central nervous system against wound-infection — he 
 came to cases of cerebral tumour of a malignant nature 
 (glioma, gho-sarcoma). He analysed fifty-five cases, of 
 which he had the complete history up to 1906, and said 
 that the outlook, in all such cases, was bad. He hoped that
 
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 FROM 1899 TO 1906 185 
 
 better surgical results would be attained with earlier diag- 
 nosis. He found some slight hope, also, in the bare possi- 
 bility of retrogressive change in the growth, in this or that 
 case. 
 
 In December of this eventful year, he gave an address, in 
 Sheffield, ' On the necessity of union in the medical 
 profession.'
 
 IV 
 From 1907 to August 1914 
 
 1907-1908 
 
 At the festival dinner in aid of Queen Square, March 11, 
 1907, he proposed ' Success to the Nervous Diseases Research 
 Fund,' and described the work that was being done by Dr. 
 Farquhar Buzzard on the bacteriology of diseases of the 
 nervous system, and by Dr. Gordon Holmes on their micro- 
 scopic pathology. He spoke hghtly and happily : he made 
 better after-dinner speeches on water than most of us make 
 on wine. 
 
 In November 1907, he gave evidence, over two days, 
 before the second Royal Commission on experiments on 
 animals. He was closely examined as to a series of experi- 
 ments on surgical shock, which had been made, with his 
 help, by Dr. Crile, Professor of Surgery in Cleveland Uni- 
 versity, lately on active service with the American Army. 
 The experiments had been severe : they were made, of 
 course, on animals under an aniesthetic and killed before 
 recovering from the anaesthetic : and the question had been 
 raised, whether any of the animals had been capable of 
 feeling pain.^ But the whole of Horsley's evidence, all thirty- 
 one pages, is well worth reading. One part of it is of especial 
 interest ; he argued against that clause of the Act which says 
 ' The experiment shall not be performed for the purpose of 
 attaining manual skill' (Act 39 & 40 Vic, c. ^^j, ss. 3, 6). 
 
 ' Final assurance on this point was given in the House of Commons, 
 at the time of pubhcation of the Report of the Commission, by Lord 
 Lamboume, one of the Commissioners. He had no bias in favour of experi- 
 ments on animals : indeed, at the time when the Commission was appointed, 
 he belonged to one of the anti-vivisection societies. He stated that the 
 Commissioners, after carefully searching through the whole question, 
 beheved that the animals used in these experiments were absolutely sense- 
 less and without pain (I'arliamentary Debates, xxxv. 20, p. 1045). 
 186
 
 FROM 1907 TO AUGUST 1914 187 
 
 He described the use made of this method at the Johns 
 Hopkins Hospital : and he divided his argument under 
 three heads : 
 
 1. The need of teaching students Jww to operate. — ' The 
 Commission are well aware that at the present moment 
 the only practical teaching in surgery that a student re- 
 ceives, except by what amounts to his experiments on 
 human beings, is from operations on a dead body. . . . The 
 texture, and the method of dealing with the Uve tissue, 
 is quite different from that in deahng with the dead tissue ; 
 and from the ethical point of view it seems to me that it 
 is not moral for students to gain their knowledge on man 
 when they can perfectly well gain it on an anaesthetised 
 lower animal. In that sense, I would bring the use of animals 
 for education in surgery on to exactly the same level as 
 the use of animals for food. What is justifiable for the 
 one is justifiable for the other. 
 
 2. The need of teaching students how to give anasthetics. — 
 ' I wish to draw the attention of the Commissioners to the 
 fact that the risk of death from anaesthesia has always 
 been justly looked upon as a great reproach ; and I wish 
 to express my personal opinion that it is purely a matter 
 of knowledge of the dose required, and that, as regards the 
 education of students in anaesthetising patients, no one 
 ought to be allowed to render a human being unconscious 
 before he has had practice on animals.' 
 
 3. The working out of new methods in surgery. — ' I shall 
 show directly that many of the operations which are per- 
 formed now arc based entirely on experiments on animals : 
 but I would hke to point out that from the ethical and 
 moral point of view, it seems to me that this is an abso- 
 lutely essential procedure, which ought to be adopted before 
 any new operation is carried out ; for the reason, that if 
 a new operation upon an organ or tissue of the body is per- 
 formed, no one can foretell what will be the immediate con- 
 sequences to the animal as a whole. . . . The thing is either 
 nKjral or immoral ; and I venture to suggest that any new 
 operation, any new operative method or procedure, ougiit 
 to be tried on an animal before it is tried on man.' 
 
 The Act is more than forty years old : it was drafted when 
 things were very different from what they are now : and the 
 Commissioners ought to have recommended some modifica- 
 tion of this clause. 
 
 Other events of Ujo'^ were hib election to the Russian
 
 1 88 SIR VICTOR HORSLEY 
 
 Surgical Society ; and the publication of the book by 
 him and Dr. Mary Sturge, Alcohol and the Human 
 Body. 
 
 In February, 1908, he writes to Sir Edward Schafer about 
 the founding of the Research Defence Society : 
 
 I quite agree with you about the Research Defence Society. 
 It must have local branches, and these must consist of 
 as many non-medical and non-scientific people as possible. 
 I will not have anything to do witli it if it is going to be 
 another case of taxing the profession for maintaining a 
 thing the social benefit and profit of which accrues to the 
 public and not to the profession. 
 
 On March 12, 1908, at a meeting ol the Royal Society, his 
 paper was read, ' Description of the Brain of Mr. Charles 
 Babbage, F.R.S.' This relic of the great mathematician, 
 the inventor of the calculating engine, had been for thirty- 
 six years in the Museum of the Royal College of Surgeons : 
 and the Council of the College, in 1906, had asked Horsley 
 to report on it. This long and elaborate report was one of the 
 very first contributions toward the foundation of a true 
 ' phrenology ' — a good Greek word which has been so de- 
 based that men of science dare not use it, though it is just 
 what they want. But there was nothing very remarkable 
 in this particular brain : except that it bore witness ' as to 
 the neurological value of symmetry as a feature of cerebral 
 growth in an individual of high intellectual abiUty ; and as 
 to the relative development of the areas of representation of 
 locutory and graphic functions in contrast to sensorial 
 representation.' This does not take us far : none the less, 
 this, and this alone, is true phrenology.* 
 
 At the Oxford Ophthalmological Congress, in July, he 
 spoke on optic neuritis : and again, at a meeting of the 
 Ophthalmological Society in London. He had a strong con- 
 viction that in cases of cerebral tumour the optic neuritis 
 
 ' Spitzka, about the same time, published his ' Study of the brains of 
 six eminent scientists and scliolars ' (Trans. Amer. Phiiosoph. Soc, 
 Philadelphia, 1907, p. 175). It is to be noted that Horsley, in his will, left 
 his skull and his brain to the Neurological Society. The rest of his body 
 he left for the preparation of anatomical specimens for the museum of 
 Uoiver^uty CoUoge.
 
 FROM 1907 TO AUGUST 1914 189 
 
 is usually more marked in the eye which is on the same side 
 as the disease, and that it usually shows itself first in a 
 special part of the retina. He published two papers, this 
 year, in Brain : one, a ' Note on the existence of Reissner's 
 fibre in higher vertebrates ' : the other, with R. H. Clarke, 
 * The structure and functions of the cerebellum examined 
 by a new method.' 
 
 1. Reissner's fibre had been described, by Sargent of 
 Harvard and others, in the central nervous system of those 
 lower vertebrates in which it is most developed, especially 
 in the frog and the fish : but it had not been observed in any 
 creature so high as the monkey. Horsley therefore went 
 through his great collection of microscope-sections of the 
 brains of monkeys, and found three slides which showed it. 
 From the physical peculiarities of this curious solitary 
 microscopic fibre, and especially from its resistance to the 
 ordinary conditions of degeneration of nerve-fibres, he was 
 disposed to regard it not as an integral part of the nervous 
 system, but as a vestige of a skeletal structure. 
 
 2. The paper with R. H. Clarke, eighty pages long, is a 
 description of method only, not of results. In 1905, they 
 had not needed to differentiate lesions of the cerebellar 
 nuclei from lesions of the cerebellar cortex : and the problem 
 was still before them, to produce a lesion exactly limited to 
 this or that nucleus, without doing violence to the overlying 
 cortex. They required, to begin with, a complete series of 
 sections of cerebella, 2 mm. thick, cut in three planes, 
 sagittal, frontal, and horizontal : these were to serve as 
 charts or indicators. The special microtome for this 
 purpose was devised by R. H. Clarke : who also devised a 
 stereotaxic apparatus, probably the most complex of all the 
 mathematical instruments of physiology, for the exact 
 directing of an insulated electrolytic needle by graduated 
 movements in three planes. Thus moving by hairsbreadtlLs, 
 and on planes exactly determhicd, they were able to produce 
 a minimal electrolytic lesion of a cerebellar nucleus, without 
 involving the cerebellar cortex. This was the first use of 
 electrolysis in experimental physiology. 
 
 Among the workers in llursley's laboratory during 1907-08 
 
 k
 
 I90 STR VICTOR HORSLEY 
 
 was Dr. Ernest Sachs, of the University of St. Louis : 
 who writes : 
 
 I had the rare privilege of working with him from September 
 1907 to December 1908. Though I was a total stranger to 
 him, he took me into his laboratory, and had me, at times 
 almost daily, in his home in Cavendish Square. 
 
 I recall incidents which have always seemed to me typical 
 of his character. On a certain Sunday — we always made 
 rounds in the National Hospital on Sunday morning, and 
 he would pick me up in his machine on his way to the Hospital 
 — as I entered the car he said, ' You have heard the news ? 
 The walrus died.' I had not heard it, and wondered 
 why he was so enthusiastic over it, but his next sentence 
 explained it. It was the first walrus that had been autopsied 
 in London for many }Tars. He was to do a Gasserian gang- 
 lion the following morning, and the autopsy of the walrus 
 had been set for 9 o'clock at the Zoological Gardens. He 
 asked me to breakfast with him at about 6, and then went 
 to the nursing home and did the ganglion in his masterly 
 way, dressed rapidly, and dashed downstairs to get to the 
 Zoological Gardens in time. As we entered the machine, 
 I asked whether the autopsy would not interfere seriously 
 with his consultations for the morning : and he said, ' If 
 people want me to continue to improve myself, they must 
 wait.' As soon as we reached the Gardens, he dashed 
 over to the appointed place and — though there was snow 
 on the ground — in his shirt-sleeves took out the brain of 
 the walrus, and returned to attend to his daily routine. 
 
 Another incident, that I always felt was typical of his 
 industry, was at Christmas 1907. A number of us were 
 spending the Christmas week with him, and were busy every 
 day with shooting, walking, or golf, in all of which under- 
 takings he was the leader : and then when the rest of us 
 sat round at tea in the afternoon, he would be examining 
 microscopic sections, and joining in the conversation that 
 was going on. 
 
 One incident more seems to be characteristic. When I 
 presented to him a manuscript of a piece of work that I 
 had been doing in his laboratory, I naturally had put his 
 name as well as mine at the top of the article. He quietly 
 crossed his name out, saying, ' You have done most of this 
 work ; and as long as people have the habit of giving credit 
 for a piece of work to the one whose name is better known, 
 I won't let my name appear.' 
 
 Of the many privileges that I have had in my hfe, work- 
 ing with various big men, that year and a quarter I spent 
 with him I prize as the most valuable and delightful I ever
 
 FROM 1907 TO AUGUST 1914 191 
 
 had. I went to him in order to take up neurological surgery, 
 and ever since my return to this country I have devoted 
 myself to that work. 
 
 1909 {cBt. 52) 
 
 Lesser events of the year : (i) On February 16, at a 
 meeting of the Medico-Legal Society, Mr. Bernard Shaw 
 gave an address on ' The Socialist criticism of the medical 
 profession ' : and Sir T. Clifford Allbutt and Horsley spoke 
 in the discussion. (2) On March 6, at the Royal Society 
 of Medicine, Horsley took part in a discussion on vertigo. 
 (3) On October 20, he distributed the prizes at the London 
 School of Dental Surgery. The Government Committee 
 on Anaesthesia had lately been appointed, and the Anaes- 
 thetics Bill was under consideration : and he spoke of the 
 improved teaching of anaesthetics to dental students. (4) On 
 November 13, at University College, Cardiff, he gave an 
 address on ' Housing and Alcoholism.' 
 
 In Brain, this year, he and Dr. MacNalty published their 
 paper on the cerebellum. They had thoroughly studied, by 
 the experimental method, [a) the tracts of nerve-fibres 
 passing from the cervical spinal cord to the cerebellum, 
 (b) the relation of the cerebellum to the nerves of the fore- 
 limb, (c) the co-ordinating action of the cerebellar cortex. 
 They state their conclusions as follows : 
 
 Each part of the spinal cord must, practically speaking, be 
 represented in every unit of the cortex to which the fibres 
 run. From the point of view of afferent function, there 
 cannot be said to exist any evidence of differentiation of 
 the cerebellar cortex into localised receiving stations for the 
 impressions which ascend from the ann, trunk, or leg muscles, 
 joints, etc., respectively. It would appear, therefore, that 
 the cerebellar cortex is a structure in whicii tliese muscular- 
 sense impressions are associated together, or — to use a 
 more frequently employed expression — co-ordinated. 
 
 On February 27, at Queen Square, Horsley gave the most 
 notable of all his clinical lectures : ' On chronic spinal 
 meningitis.' He had operated — it is a remarkable instance 
 of the amount of his practice in the surgery of the nervoas 
 system — on no less than twenty-one cases of tliis rare
 
 192 SIR VICTOR HORSLEY 
 
 disease, opening the sheath of the cord, and irrigating it 
 with a mercurial lotion ; and this without a death. One 
 patient had died of heart disease, six weeks after the healing 
 of the operation-wound. 
 
 On June 25, at a meeting of the West London Medico- 
 Chirurgical Society, he gave the Cavendish Lecture. He 
 spoke of the relation of the cerebellum to such movements as 
 walking and balancing ; of the influence of the reflex system 
 over all such movements, and of Sherrington's invaluable 
 work on this subject; and of the cross-movements of the 
 arms and the legs in walking — ' we are not single animals : 
 we are really two individuals joined together in the middle 
 line.' Then, speaking of the association between the cere- 
 bellum and the vestibular part of the internal ear, he de- 
 scribed two cases of birds, a hen and a homing pigeon, which 
 had suffered from unilateral disease of the internal ear. In 
 each case, the bird displayed the so-called cerebellar attitude 
 of the head — ' it should be spoken of as the vestibular 
 attitude.' The keen interest which he took in these birds 
 is shown by the many notes and photographs which he made 
 of them.^ 
 
 In July, at the Belfast meeting of the British Medical 
 Association, he gave an address on optic neuritis. He 
 resolutely defended the position which he had taken, the 
 year before, in Oxford and London : and he backed his 
 clinical evidences with a great series of photographs. 
 
 On November 22, at a meeting of the Medical Society of 
 London, he spoke of the operative treatment of trigeminal 
 neuralgia. He had at tliis time done 149 operations for 
 the removal of the Gasserian ganglion. The mortahty had 
 been seven per cent. But this applies only to patients over 
 fifty years of age : he had not lost any patient under fifty. 
 The chief risk of the operation was from arterio-sclerosis, 
 which is common among those who suffer from trigeminal 
 neuralgia. 
 
 But the best of his many lectures and addresses of this 
 
 * Notes and a sketch have come to hand of a similar case, a cock, which 
 he saw and studied, in 1885, at the Brown Institution : doubtless the first 
 observations ever made on this condition in poultry.
 
 FROM 1907 TO AUGUST 1914 193 
 
 year was the Linacre Lecture, which he gave before the 
 Master and Fellows of St. John's College, Cambridge. It is 
 perhaps the most ' philosophical ' of all his writings : and, 
 from the fine style in which he had it pubhshed, he seems to 
 have been justly proud of it. He took once more, for his 
 subject, ' The fimction of the so-called motor area of the 
 brain ' ; and spoke as it were the epilogue to his work in 
 this field of physiology : spoke it with authority, and with 
 faultless dignity. It was twenty-three years since he had 
 submitted to the Neurological Society, in December 1886, 
 his theory that the more superficial cells of the motor area 
 were ' probably sensory,' and the deeper cells were ' probably 
 motor.' He had made this suggestion, as he now says, ' on 
 somewhat slender grounds ' : but the work of Mott, Ramon 
 y Cajal, and others, had shown the truth of it. But so 
 many thousands of observations had been accumulated, 
 since 1886, by workers in science and practice in all civilised 
 countries, that he felt the need of getting back to first 
 principles. Besides, he was addressing an audience of 
 learned men, but not of physiologists. So he starts from the 
 primary fact that ' there is no such thing as a purely motor 
 centre in the cortex cerebri ' : 
 
 The true method of regarding the anatomical construc- 
 tion of the cortex cerebri should begin by accepting the 
 principle first enunciated, by HughHngs Jackson, from 
 the consideration of the nervous system from the evolu- 
 tionary standpoint— namely, that every centre in the nervous 
 system must be scnsori-motor. Such a thing as a pure 
 motor centre could not exist ; since it would be unfur- 
 nished with the causative sensory mechanism essential 
 to the occurrence and production of the motor or efferent 
 imj)ulsc ; and, in fact, a muscular action would be an effect 
 without a cause — an absurdity which indeed the old idea 
 of psychic spontaneity of action involved. 
 
 That is to say, at every level of the central nervous system, 
 incoming impulses are stored and ' memorised ' and made 
 antecedent to outgoing impulses. He takes only one level, 
 the highest, and one area at that level : he takes the cortical 
 representation of the movements of the upper limb — ' which 
 part of the body, including as it does some of the most 
 liighly trained combinations of sensation, is specially 
 
 N
 
 T04 SIR VICTOR IIORSLEY 
 
 .worthy of study.' He descril)es the work recently done on 
 this area : he acknowledges that one of the conclusions from 
 his work with Beevor has been corrected by Sherrington and 
 Griinbaum : but this problem of physiology — as to the 
 excitability or non-excitability of the post-central gyrus — 
 does not annul the fact that the whole arm area, from the 
 point of view of surgery, is Umited to the pre-central gyrus. 
 So he comes to the final question, What are the powers em- 
 bodied in the pre-central gyrus ? What sensory impulses 
 are accumulated in it, rendering it serviceable to the move- 
 ments of the upper limb ? He answers this question with 
 a case at Queen Square. The patient was a boy of fourteen, 
 afflicted with violent convulsive movements of the left 
 upper limb : they had begun when he was seven : 
 
 He was in a very distressing condition, and was referred 
 to me by Dr. Risien Russell, with the view of arresting 
 the spasms by an operation. Having stopped athetoid 
 and clonic movements in two previous cases by excision 
 of the so-called ' motor ' area, I advised that the arm-area 
 in this case should be delimited by excitation and then 
 removed. 
 
 On March 20, 1908, Horsley exposed the right pre-central 
 and post-central gyri ; mapped out exactly, by electrical 
 stimulation, the whole arm-area (pre-central gyrus) ; and 
 removed it. The convulsive movements immediately 
 stopped ; and more than a year later — at the time of the 
 Linacre Lecture — there was no sign of any return of them. 
 Purposive movements began to return a month after the 
 operation, and gradually became more efficient : he attri- 
 butes this return of purposive movements chiefly to com- 
 pensatory action of the post-central gyrus. Tactile sensation, 
 the ' feel ' of the muscles and joints (muscular sense, arthric 
 sense), the appreciation of temperature, the appreciation of 
 pain, and the ability to identify a point touched (topognosis) , 
 were impaired ; and there was profound impairment of the 
 ability to recognise, by contact, the shape of solid objects 
 (stereognosis) : 
 
 He could recognise nothing (nail-brush, prayer-book, 
 bottles, coins, knives, pipe, match-box) when the objects
 
 FROM jqny TO AUGUST 1014 105 
 
 were placed in his hand, and even when the fingers were 
 pressed over them ; though he once guessed a tumbler 
 to be a bottle, because it was cold. When I was thus test- 
 ing him for stereognosis three weeks after the operation, 
 he made the striking remark, ' If I could only move my 
 hand about, I should know what the things were ' : thus 
 showing under the stress of effort what the real basis of 
 the stercognostic sense is — namely, merely a complex of 
 tactile, muscular, and arthric memories of movements, 
 which are, in fact, the compound experiences of grasping 
 and feeling objects. 
 
 Thus, from this one case, Horsley was able to say that 
 ' the gyrus pre-centralis is in man the seat of representation 
 of (i) slight tactility, (2) topognosis, (3) muscular sense, 
 (4) arthric sense, (5) stereognosis, (6) pain, {7) movement.' 
 
 1910 {^t. 53) 
 
 The General Elections in January and December of this 
 year brought him with a rush into public life. In the 
 January Election, he placarded his house with cartoons — 
 the big loaf and the little loaf, and the peer and the working 
 man — and rented a hoarding where the old Vera Street 
 Post Office was in course of demolition. In the December 
 Election, he stood for the University of London. He had 
 made up his mind, long before 1910, that when he was sLxty 
 he would retire from practice and enter Parliament. He 
 failed to get into Parliament : and he did not live to win 
 success out of failure. He wrote and said things which he 
 might well have left unwritten and unsaid ; he fought so 
 angrily for female suffrage that he may have done it more 
 harm than good ; he made sacrifice of himself, losing time 
 and money and health and peace of mind — all this when he 
 was ov(;rworkcd and overstrained and burdened with 
 anxiety over the lu'alth of one who was very dear to him — 
 and he was defeated in one constituency and thrown over by 
 anf)ther. 
 
 But it is to be remembered, first, that he never for one 
 moment regarded politics as less important than science 
 and practice, never doubted of the necessity and the right- 
 eousness of a great political upheaval ; fought for that, not
 
 196 SIR VICTOR IIORSLEY 
 
 for his own ends. Next, that it was, after all, only a few 
 years that were thus embittered, just the four or five years 
 before the War : politics, in those evil years, had venom hid 
 in them : and he, unlike St. Paul, when there came a viper 
 out of tlie heat, and fastened on his hand, was not able to 
 shake off the beast into the fire and feel no harm. Last, it 
 is to be remembered that the course of events has already 
 brought unexpected fulfilment of purposes for which he 
 fought. 
 
 Three honours came to him in iqio. In March, he was 
 elected a foreign associate of the French Academy of Medicine. 
 In July, he was elected a corresponding member of the Royal 
 Prussian Academy of Sciences. At the meeting in London 
 of the British Medical Association, he was President of the 
 Section of Surgery. 
 
 In Brain, this year, he and Dr. Otto May published a 
 paper on the mesencephalic root of the trigeminal nerve, 
 giving the results of a long series of researches into its centres 
 of origin. 
 
 On October 6, in Berlin, at the annual meeting of the 
 German Society of Neurologists, he gave an address, ' On 
 the surgical treatment of intra-cranial tumour, in contrast 
 with the expectant medical treatment.' He says that wait- 
 ing, in these cases, is like the waiting which used to be the 
 rule in cases of appendicitis. Seeing that the only result 
 to be ' expected,' in a case of cerebral tumour, is the death of 
 the patient, he finds the stamp of inhumanity on the phrase 
 ' the expectant treatment.' He reviews the early symptoms 
 of the disoiLSc ; and he suggests certain rules of practice : 
 
 1. Every case of focalised epilepsy ^ not definitely proved 
 to bo idiopatliic in origin must be treated by exploratory 
 operation. 
 
 2. Every case of progressive motor or sensory paralysis of 
 intra-cranial origin must be treated by exploratory operation. 
 
 3. Every case of intra-cranial tumour definitely diagnosed 
 must be treated according to its situation, cither by removal 
 or by decompression. 
 
 * ' By focalise<l epilepsy I mean all varieties of epilepsy in which the 
 focus or starUng-point of the seizure can be localised to one lobe of the 
 cerebrum.'
 
 FROM 1907 TO AUGUST 1914 197 
 
 He speaks of the difficulties involved in deciding between 
 these two procedures ; and refers to a case in which the 
 decision was made not by him but by the patient. He is 
 inclined to beheve that, ' except in the case where the field 
 of removal involves direct destruction of the representation 
 of such a single faculty as speech,' removal slxjuld be the 
 rule, and decompression the exception. Decompression, 
 he says, should be kept for those cases in which the tumour 
 is known to be in a position from which it caimot be safely 
 dislodged, and those cases in which it cannot be localised. 
 He adds, that in one or two cases of a certain kind, he has 
 obtained a good result from the intra-cranial use of a 
 mercuric lotion. 
 
 In November, the Liberal Association of the University 
 of London invited him to stand for the University, against 
 Sir Phihp Magnus, at the coming Parliamentary election. 
 They had invited him on a former occasion, and he had 
 declined ; now, he accepted. He writes, on November 23, 
 to Sir Felix Semon : 
 
 I am not the ungrateful brute I appear to be by not writing 
 before to thank Lady Semon and yourself for (as usual) 
 much kindness. In addition to my other work I am con- 
 testing the University of London scat, and unless you think 
 Magnus a heaven-sent statesman, I hope you wiU recom- 
 mend me to every graduate of the University and beg him 
 to vote for me. Yes, I was greatly pleased with the Berlin 
 friends. It is the greatest scicntilic lionour 1 have received 
 and I value it accordingly. When in Berlin a month ago, I 
 called on VValdcycr, who was very agreeable, and on Munk, 
 but unfortunately the latter most chirpy ancient was away. 
 We shall most assuredly run down and see you in your rural 
 palace. With best love from us both to you both — Yours 
 as ever. 
 
 He was adopted on November 28, nominated (m December 
 3 : only a few days before the election. The forces of anti- 
 vivisection were of course employed against him. Also, a 
 circular was sent out saying that hf, in i()02, ' was one of the 
 signatories to a letter inviting Sir Philip Magnus to contest 
 the seat in the Unionist interests and seeking from him 
 assurances i;f his " political adherence to the general 
 principles of the Unionist Party." ' To this rather >.habby
 
 198 SIR VICTOR HORSLEY 
 
 score, Horsley answered that his action on that occasion 
 ' was, hke that of other graduates, wholly non-political, and 
 was due to the fact that the sitting member had not acted 
 constitutionally towards the electors.' It is possible that 
 he regarded his candidature as more or less of an experiment. 
 He and a University constituency, nine yeai"s ago, were 
 hardly intended for each other : and on December lo, Sir 
 Philip Magnus was declared to be elected by a large majority. 
 Mr. Francis Hyndman, Hon. Secretary of the Liberal 
 Association of London University, writes of Horsley's 
 candidature : 
 
 He asked mc to be his agent ; so that I came into close 
 touch with him and with his home for some time. I think 
 perhaps the most marked character I noticed was his hatred 
 of compromise, even that smoothing of a statement or 
 an attitude wliich is almost essential in consolidating the 
 diverse elements in a constituency. This is perhaps more 
 important in a University than anywhere, as all the appeal 
 has to be documentary, and there can be no attempt at 
 anything but a plain statement of position. He was of 
 course an abstainer of the most uncompromising kind, and 
 supported his views with a wealth of scientific argument 
 and data. I well remember his relating an incident which 
 struck me at the time. A foreign admirer, Italian I think, 
 had sent him a present, which liad to be taken out of bond 
 and cost some two or three pounds. On opening, it was 
 found to be a number of bottles of fine liqueurs. Wliat did 
 he do, present them to a hospital, or sell them and give 
 the money ? No, they were handed to the children to 
 bum : and they said they burnt very well ! 
 
 Another incident also struck me. The addressing and 
 distributing agents had made some stupid mistake about 
 a number of important papers : which not only entailed 
 considerable extra expense, but ran the chance of losing 
 a number of votes, because essential papers did not arrive 
 until the last moment. He took a most easy-going view, 
 and reproved me in a friendly way for having written a 
 strongly condemnatory letter : and after all it mattered 
 to him and not to mc in the end. What interested mc 
 was the general kindliness of his point of view. 
 
 London University gave liim no chance ; as the majority 
 of his own profession, which is the largest and the most 
 uncertain in its votes, were certainly against him, not from 
 any defined reason, but because his very individuahty and 
 power of action made them nervous of some possible attack
 
 FROM 1907 TO AUGUST 1914 199 
 
 on their rights or privileges. The scientific people were 
 largely for him, about fifty per cent., I think. The law, 
 rather strongly against him, for the same reason as the 
 medicos. 
 
 1911 
 
 On January 19, 1911, the Lannelongue Prize was awarded 
 to him.^ It had just been instituted, by Professor 
 Lannelongue of Paris ; a gold medal and 5000 francs, for 
 the surgeon who in the previous ten years shall have done 
 most for the advancement of surgery ; to be awarded, once 
 in five years, by a committee of surgeons, representatives of 
 many nations — Great Britain and Ireland ; the United 
 States and Canada ; South America ; Japan and China ; 
 Italy ; Spain, Portugal, and Mexico ; Scandinavia and 
 Holland ; Belgium ; Germany ; Austria and the Balkan 
 States — one representative of each of these nations or groups 
 of nations. Horsley received this unexampled honour, the 
 first Lannelongue Prize, from the hands of the President of 
 the Soci^te de Chirurgie. He spoke a few words of thanks, 
 and of compliment to Professor Lannelongue ; and said that 
 his own country, which had long been under the influence of 
 John Hunter's teaching, had later come under the influence 
 of Claude Bernard, who had joined together physiology and 
 surgery. ' That is what I have striven to realise. Un- 
 fortunately, if surgical science advances with fair rapidity, 
 its practice progresses more slowly. That is because we are 
 held in bondage by traditions from which we have difficulty 
 in freeing ourselves.' 
 
 At the Birmingham meeting of the British Medical 
 Association, he and Dr. Finzi read a paper, ' On the action of 
 filtered radium rays when applied directly to the brain.' 
 In these experiments, they had filtered off the less pene- 
 trating /:?-rays ; and luid used the radium as it would be 
 used in surgical practice. They came to the conclusion tluit 
 
 ' Lady Horsley writes to a friend, ' Victor has been awardetl the Lanne- 
 longue prize, for the greatest advance in surgery in the last ten years ; 
 and goes to Tans to receive a gold medal an<l a douceur of ^^200. And a 
 grateful patient in Australia luis sent us a white kangaroo ! I Kings at 
 the bell tlicrcforc make us extremely nervous, and at tho first approach 
 of a railway cart 1 prcparu inybcli fur luslaut flijiht.'
 
 200 SIR VICTOR HORSLEY 
 
 radium rays ' exert no iiillueiice, discoverable by present 
 methods, on the nerve tissues, but do cause notable changes 
 in the blood-vessels.' 
 
 In November, he and Dr. Handelsmann published their 
 ' Preliminary note on experimental investigations on the 
 pituitary body.' They had made a very long series of ex- 
 periments ; Dr. Handelsmann had planned a full report ; 
 but in the lirst winter of the War, serving as a surgeon with 
 the Russian army, he was taken prisoner by the Austrians. 
 
 Horsley had not to wait long for a second chance of enter- 
 ing Padiament : he was invited, in June 1911, to address the 
 North Islington Liberal and Radical Association, with a 
 view to being their candidate at the next election : he was 
 adopted, and during igii-1912 did a great deal of work for 
 the constituency. 
 
 1912-1913 
 
 Two more honours, in 1912 ; from Sweden, and from 
 Italy. In May, he was elected a member of the Royal 
 Society of Science of Upsala, in succession to Lord Lister. 
 In December, he was elected an honorary fellow of the 
 Itahan Society of Neurology. 
 
 On January 19, 1912, at the Royal Society of Medicine, he 
 and C. E. West opened a discussion on the factors which 
 help toward success in the treatment of brain-abscess follow- 
 ing a discharge from the car. On February 13, at the Royal 
 Society of Medicine, a paper by Dunhill of Melbourne was 
 read, ' On partial thyroidectomy under local anaesthesia, 
 with special reference to exophthalmic goitre.' James 
 Berry, Horsley, and many others took part in this discussion ; 
 which was twice adjourned, because of the number of 
 speakers. On March 27, at the Hunterian Society, Horsley 
 opened a discussion on the therapeutic value of alcohol ; 
 but failed to win sujiport for his opinions. At the Liver- 
 pool meeting of the British Medical Association, he read a 
 paper, ' On the diagnosis and treatment of compression- 
 paraplegia.' Thes(; all are epilogues to his surgical teaching. 
 
 On August 24, he and Dr. Agnes Savill and Mr. Mansell
 
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 FROM 1907 TO AUGUST 1914 201 
 
 MouUin published in the Lancet their ' Prehminary Report on 
 the Forcible Feeding of Suffrage Prisoners.' 
 
 Toward the end of 191 2, he was invited to stand, at the 
 next election, for the Harborough Division of Leicestershire ; 
 and resigned his candidature for North Islington. On 
 January 11, 1913, he was adopted by the Council of the 
 Harborough Liberal Association. 
 
 On April 24, 1913, he spoke at a meeting of the National 
 Conference against the Opium Traffic. On June 9, he 
 spoke at a conference in Paris against the State-regulation 
 of vice. He described what was being done in England 
 against it ; and he denounced and showed up the notion that 
 sexual intercourse is necessary to a mans health. Then, 
 dropping English and speaking in French, he suddenly 
 proposed a resolution in favour of female suffrage. ' We are 
 always talking,' he said, ' of the rights of man : we ought 
 therefore to talk also of the rights of woman. In England, 
 we hope, at a time not too far off, to have female suffrage 
 — perhaps restricted — still, female suffrage. All these 
 questions of State-regulation, all these social questions, 
 ought to be decided not by a part of the community, but by 
 the whole community together.' 
 
 In August, the great International Medical Congress was 
 held in London, under the Presidency of Sir Thomas Barlow, 
 with Sir Wilmot Hcrringham as General Secretary : and on 
 August II, at a meeting ni the Section of Neuropathology, 
 there was a discussion on the treatment of cases of cerebral 
 tumour. The year before the Congress, Dr. Howard Tooth, 
 C.M.G., had pultlished a minute analysis, from the point oi 
 view of pathology, of 500 casts of cerebral tumour, at Queen 
 Square, during 1902-1911. He had studied, with the very 
 utmost care, what may be called the natural history of the 
 tumours of a malignant nature, the gliomata — their methods 
 of growth, their character, their vitality — and, from that 
 point of view, had come to believe stiongly that in all cases 
 of glioma the operation for decompression was preferable to 
 the operation for removal : 
 
 If these appearances arc to be accepted— and I offer them 
 witii the greatest possible diflidence — one is forced to infer,
 
 202 SIR VICTOR UORSLEY 
 
 on pathological grounds ulone, that surgical interference, 
 exploration, or manipulation, with few notable exceptions, 
 is liable to awake into greater activity an exuberance which 
 perhaps may be almost latent at the time. . . . There may 
 be some hope of treatment in the future by some applica- 
 tion of ultra rays after removal of the bone, such as has 
 given results in some otiier vascular growths. ... It 
 seems that in the present state of our knowledge we must 
 be content witii relieving pressure by decompression in all 
 gliomata, lest worse befall. 
 
 At the meeting on August ii, 1913, he read a further paper, 
 ' On the treatment of tumours of the brain, and the indica- 
 tions for operation.' He now had analysed 265 operations, 
 at Queen Square, on cases of cerebral tumour, of all kinds, 
 malignant or non-malignant. He stated his conclusions as 
 follows : 
 
 There must always be a high mortality, with or without 
 operation ; but every surgeon must agree, and perhaps still 
 more after study of the preceding pages, that the mortality 
 is probably capable of reduction, not by shrinking from 
 operation, but by judicious choice of the fonn of operation, 
 and modification of procedure. I go so far as to say that 
 the period of surgical activity, of which this report has 
 been the survey, has been a necessary stage in the develop- 
 ment of cerebral surgery, as it has been in abdominal, rectal, 
 and other branches. On the other hand, the survivals 
 also present many briUiant results, lives not only saved but 
 rendered useful and indefinitely prolonged. But close 
 consideration of the state of the patient in the less fortu- 
 nate survivals may well raise the question as to whether, 
 by less energetic and extensive surgical treatment, as good 
 or even better results could not have been obtained. . . . 
 The fact is tliat most cases of declared intra-cranial tumour 
 need operation, perhaps sooner than later, and the risk 
 has to be taken. The question is rather what class of opera- 
 tion shall be selected. 
 
 Horsley, at this meeting, spoke of the hope, which never 
 failed him, that earlier diagnosis and earlier treatment 
 would improve the results of the operation for removal of a 
 tumour of the brain. Here is not the place to say more of 
 these difhculties, in surgery and in ethics. The reader must 
 ask himself or herself, What should I wish to be done, if I
 
 FROM 1907 TO AUGUST 1914 203 
 
 were suffering from the disease, or if one of my family were 
 suffering from it ? 
 
 In November, came the end of Horsley's candidature for 
 the Harborough Division. The Executive Committee were 
 of opinion that he ' had rendered his candidature futile ' ; 
 and they gave him his dismissal. There is something in this 
 Market Harborough episode which recalls Dogberry's charge 
 to the watch : 
 
 You shall comprehend all vagrom men ; you are to bid 
 any man stand, in the prince's name. 
 
 How if a ivill not stand ? 
 
 Why then, take no note of him, hut let him go ; and 
 presently call the rest of the watch together, and thank 
 God you arc rid of a knave. 
 
 But they had no doubt that he was ' endangering the seat ' ; 
 and their business was to keep it safe. They had been glad 
 enough, in January, to get him : and he had put his views 
 clearly before them. They had let him know that the con- 
 stituency was not in favour of female suffrage : his agent 
 wrote to him, January 6, before the first of his many 
 addresses to audiences in or near Leicester : 
 
 Many of those present will be superior agricultural labourers 
 who are not quick at grasping points, but if slow in thought 
 always f,'ft there — so that it will be desirable to use the 
 simplest language and emphasise the points. They have 
 no more enthusiasm for ' Votes for Women ' than the Execu- 
 tive has — we have suffered much from women voters — so 
 you will not be surprised if that part of the programme is 
 
 received in silence. They have tolerated it from Mr. 
 
 in consideration of his other articles of faith. 
 
 So far as he could, Horsley took this advice. He did not 
 make female suffrage the chief subject of his addresses ; he 
 never made it the only subject of an address : he expounded 
 the whole programme, just as he had said that he would : 
 he covered a very wide range, and the heckling made it 
 even wider. At fust, everything went smoothly : he writes 
 to a friend, January 13, ' 1 have just started in at Market 
 Harboro', or rather the Harboro' Division (South half) of 
 Leicestershire, quite easily. The people are very kind, as 
 also they have been in North Islington.' On June 25, he
 
 204 SIR VICTOR IIORSLRY 
 
 writes, * 1 can see tliat llie Leicester people are l)eginning to 
 realise there is more in female suffrage than they thought. 
 It is curious to see how backward they really are on the 
 point.' But the fate of his candidature was in the hands 
 of the Council of the Liberal Association : and in July he 
 received a more or less formal intimation that he was in 
 risk of being thrown over. 
 
 Probably, the harm wius dune not by what he said in the 
 constituency, but by what he was saying in London and 
 writing in the London papers. Some of these papers found 
 that his unrestrained sayings were ' good copy ' : for example, 
 his speech at a Queen's Hall meeting, July 8, 1913, on the 
 Temporary Discharge of Prisoners Act, the ' Cat and Mouse 
 Act.' He so hated the thought of women being forcibly 
 fed that he did not care what gibes and platform epithets 
 he flung at the Home Secretary and others : he just let 
 himself go. He had published certain statements about 
 forcible feeding, which the Home Secretary had referred to 
 the President and Council of the Royal College of Surgeons ; 
 they had declined to interfere. Here, said Horsley to the 
 meeting, was Mr. McKenna — whom he nicknamed Viscount 
 Holloway — seeking his revenge by secret intrigue. ' Fancy 
 a Home Secretary thus secretly intriguing against private 
 citizens. . . . What an end to a backbiting intrigue by a 
 Minister of the Crown. Such always will be the result of 
 changing Government by Law for Government by a bureau- 
 crat and secret pohce.' It is no wonder that the Harborough 
 Association was frightened. His reverence for women, his 
 behef in their intellectual power,* his longing for their rights 
 and their welfare, made him blind to the impasse in which 
 the Government was held. He raged against things as they 
 were, but could not suggest any escape from them save 
 
 • Among the many Idlers from his patients, one has come from a la<ly 
 on wiiom he ojxjratcd, in 1902, for di.sea.sc of the spinal cord : ' I do not 
 think a nobler hfe has been lost iluring this terrible war. . . . Sir Victor 
 was most modest, he held that boys inherited their brains from their 
 mother, and frequently put in his letters to me that whatever brains his 
 sons possassed they inherited from their mother.' Among the profes- 
 sional arlvantages which lie hcl]>cd women to obtain, were the member- 
 ship of the Physiological Society, and admissloD to the practice of Queen 
 Square.
 
 FROM 1907 TO AUGUST 1914 205 
 
 by unconditional surrender ; and this when the mihtant 
 suffragettes were still at their criminal offences, and the 
 surrender of the Government to them against the will 
 of the people would have been utterly disastrous and 
 shameful. He could not or would not see that ' govern- 
 ment by law ' is inseparable from government by legal 
 punishment. 
 
 Year in year out, he and Lady Horsley worked together in 
 the cause of female suffrage : there is not room even for a 
 bare list of his addresses : only one or two points may be 
 taken from his rough notes. He believed that the ' establish- 
 ment of democratic rule by the poHtical enfranchisement 
 of all men and women ' would tend to prevent war. He 
 believed that female suffrage would be powerful against the 
 dishonour of women — ' Contempt for women is the founda- 
 tion of sex-immorality. Hence the anti-suffrage movement 
 is the cult which leads to woman's degradation, and from it 
 to prostitution.' He resented the indifference of so many 
 women toward the cause : he said that they were deliberiitely 
 unpatriotic, content to lead a selfish life, not caring either to 
 help other women or to be of service to their country. He 
 did not see why the cause should be set aside for the War : 
 he said that war-time * is the very moment when the need 
 of a great sense of civic brotherhood and of social schemes 
 for helping one another compels people to study the principles 
 of human politics.' He never doubted that women would 
 vote for the men who would work hardest to help women and 
 children. 
 
 The notes for his addresses contain also many quotations, 
 to be used some with approval and others with derision. 
 Among the litter, are a saying of Alcuin to Charlemagne, 
 ' We should not listen to those who are wont to say Vox 
 populi vox Dei : for the noise of the mob is very near to 
 madness ' ; and a saying of Rousseau, ' Being incapable of 
 judging for themselves, womtm ought to accept the decision 
 of their fathers and their husbands, like those of the Church.' 
 Among the former, are Penn's ' Liberty without obedience is 
 confusion, and obedience without liberty is slavery'; and 
 two of John Bright's sayings, ' 1 have nut the smallest
 
 2o6 SIR VICTOR HORSLEY 
 
 objection to the widest possible suffrage that the ingenuity 
 of man can devise ' ; and again, ' The people who talk about 
 danger from an extension of the franchise are hke children 
 who are afraid to go to l)ed in the dark.' Above all, he 
 enjoyed to quote Mr. Asquith's phrase, ' The free-will 
 offering of a free people.' 
 
 But he had said and written much that could not be 
 washed in Lethe and forgotten by the Harborough Ex- 
 ecutive : and they asked him to confer with them on his 
 predicament. He writes to a friend, September lo : 
 
 It was a great thought of yours to send me Trevelyan's 
 Bright, and I have just finished it with much gratitude to 
 you. As regards the lessons, I fear that my cerebral apparatus 
 must be less appreciative, for I cannot draw from the book 
 the moral that compromise is in principle good. I rather 
 learnt the opposite from my precious knowledge of J. B.'s 
 career. ... I quite of course intend on November 4th, 
 which I think is my date for meeting my executive, to be 
 very friendly and ' compromiseable.' All I ask is for plain 
 speaking, of which there is not enough in the poUtical world. 
 I quite recognise method is requisite, but I do not believe 
 ever that method should conflict with principle even tem- 
 porarily. 
 
 He attended a meeting on November i : there was 
 another meeting, without him, on November 8. The 
 Executive Committee passed a resolution as follows : 
 
 That as Sir Victor Horsley, by the course he has taken in 
 reference to Women's Suffrage, has created the impression 
 among the electors of the Harborough Division (a) Tiiat he 
 regards that as the most important question before the 
 country, (6) That he docs not disapprove of the lawless 
 methods of the miHtants, (c) That he would not hesitate 
 about sacrificing a Government engaged in promoting the 
 most momentous reforms, if ministers refused to run counter 
 to tiic wishes of the great majority of the people on the 
 Suffrage question — and as he has thereby rendered his 
 candidature futile, this Committee requests the officers 
 to seek another candidate. 
 
 Horsley's answer, printed, is dated November 17. On 
 point (a), he answers that he had held twenty -six meetings :
 
 FROM 1907 TO AUGUST 1914 207 
 
 ho had not made female suffrage his chief subject. He gives 
 a Hst of his subjects : 
 
 The Liberal Programme and Government's record : 15 
 meetings. 
 
 Tariff Reform : 12 meetings. 
 
 Land Question, Rating Reform, etc. : 11 meetings.* 
 
 Labour and Social Questions : 9 meetings. 
 
 Finance : 7 meetings. 
 
 Franchise Bill, Adult Suffrage, and Plural Voting : 7 
 meetings. 
 
 Insurance Act : 5 meetings. 
 
 Temperance Legislation : 2 meetings. 
 
 On point {b), he answers that he had said plain!}' and often 
 that he was not in favour of mihtancy. On point (c), he 
 answers that the statement is baseless, and that no oppor- 
 tunity of repudiating it has been given to him. Finall3^ he 
 says : 
 
 I would emphasise the fact that the present issue is not 
 one of my personality, or of my predilections for a con- 
 stituency in which I have found so many friends, but whether 
 a Liberal candidature is to be determined on an open ques- 
 tion or upon the whole series of social refonns wliicli 
 constitute the legislative programme of the Liberal party. 
 This latter was your view when you adopted me as the pro- 
 spective candidate for the Harborough Division, it was also 
 my view, and I have not departed from it. 
 
 On November 19, one of the chief men of Leicester writes 
 to him : 
 
 I could not be faithful to you if I did not frankly express 
 to you what my experience has iDcen. I fmd the consensus 
 of opinion is that }'our chances of success are gone, as there 
 is a very strong fcchng against tlie sympathy you have 
 shown to the militant side (jf tiie suffragette movement. , . . 
 
 told me strongly that, from his own knowledge, 
 
 from every part of the division, he had strong testimony 
 from the workers, that it would be useless for your cancH- 
 daturc to continue with any certainty of success. ... I 
 may say it is very painful to me to make this communi- 
 cation t(i you. and I wish I had not to writ(\ l)ut I cannot 
 be faithful to you if I withhold from you what I have heard. 
 
 » He was a Vicc-Prcsitlcnt of the Associalion for llic Taxation of Land 
 Values : he resented, lie.irt and soul, tlic jiossession of huge estates in 
 London by a few landowners of prodigious wealtli.
 
 208 SIR X'lCTOR HORSLEY 
 
 A few days later, the Council of the Association held a 
 final meeting, at which Horsley took leave of them with all 
 dignity, and they of him with such dignity as they could 
 command. He generously remained a good friend to 
 Leicester, interesting himself in plans for its welfare. He 
 was ' approached,' between January 1914 and May 1915, 
 on behalf of four constituencies. The last of these four offers 
 came to him just as he was leavmg for Egypt. He writes 
 back, on May 17, 1915 : 
 
 I am certainly anxious to get into Parliament, and par- 
 ticularly to represent a Northumberland or Durham con- 
 stituency. I would gladly have come to Gateshead to talk 
 it over with you, but am just, in half an hour, embarking 
 with a division of the Dardanelles Force as Surgcon-in-chief 
 of a Hospital, Surgical Division. I therefore may not be 
 at liberty for many months. This may render me, in the 
 eyes of the Liberal Association, as unknown to them, an 
 impossible candidate. But I hope not. Further I am sure 
 that the Labour party would, under present circumstances 
 particularly, so far approve my candidature as a Liberal 
 that they would not oppose me. At least I have every 
 reason to think so. I am extremely well known to the 
 Labour leaders. 
 
 Last of all, an offer from Huddersfield. H he had lived to 
 come back from Mesopotamia, there was that constituency 
 wanting him. For on March 23, 1915, he had given an 
 address in Huddersfield, which had won him much goodwill : 
 he went to France on March 28 : but the Huddersfield 
 Liberals made up their minds to wait for him. There is a 
 letter, written six days after his death, to his elder son, 
 Captain Siward Horsley, Gordon Highlanders, from the 
 President of the Huddersfield Liberal Association : 
 
 We held a meeting this afternoon, to bring forward your 
 father's name as a likely candidate for our town's representa- 
 tion in Parliament. His was tlie only name to be con- 
 sidered, and I have no doubt tliat it would have been gladly 
 and unanimously welcomed. All that we could do was 
 to bow to a Higher call, and lament our loss. I was unani- 
 mously asked to convey to you and your family our deepest 
 sympathy ; and to say that we share your loss and sorrow 
 with you. I find tiiat Sir Victor was well known in this 
 district, and higlily honoured : and we all feel that it is a
 
 FROM 1907 TO AUGUST 1914 209 
 
 national bereavement : but the memory of his noble hfe 
 and great sacrifice will be fragrant for many years to 
 come, 
 
 1914. January to August 
 
 In April, he gave evidence before the Royal Conimission 
 on Venereal Diseases. He laid stress on live points : 
 (i) That death-certificates ought to be privileged statements, 
 not shown to the family, but sent direct to the Registrar. 
 (2) That there ought to be more education of children in 
 the facts of sex. (3) That there cjght to be more education 
 of adults in the facts of venereal disease ; this education 
 to be given mostly by non-medical teachers. (4) That the 
 venereal diseases ought to be made notifiable : the notifica- 
 tion would be regarded as confidential. (5) That there 
 ought to be protection for any doctor who should warn 
 persons against the danger of infection from this or that one 
 of his patients. But Horsley's evidence is only a small part 
 of the service which he rendered, in this matter, to the public. 
 He and others had been quietly working for many years 
 to get the Commission appointed : and the letter in the 
 Morning Post, which led up to the appointment, was partly 
 his.i 
 
 On May 28, he writes to a friend : 
 
 People who a year ago thought I was cracked are coming 
 to see that they too must accept women's enfranchisement as 
 a measure of vital and urgent importance, and that militancy 
 is a symptom of the disease-condition set up by McKcnna's 
 stujjidity in being antisuffragist. ... I am quite sure that 
 I did the right thing with tlie Harboro' constituency. No, 
 it is the temperance factor which is as much or more 
 against me. 
 
 In June, in Birmingham, at the annual conference of the 
 
 ' As Mr. E. B. Turner saiil, at a meeting held a few days after the news 
 of Horsley's death — ■' Twenty years ago, the light to get the Kuyal Com- 
 mission on Venereal Diseases Ixjgan ; and it wius seen that a man was 
 required of forceful nature, who would give time, trouble, and energy ; 
 who wouhl collect, collate, and bring forward the ma.ss of medical informa- 
 tion that was needed to convince the public. Sir Victor threw himself 
 into the campaign, spoke at meetings, and helped to wear down the opjKJSi- 
 tion. Whatever good came from the Commissioners' work, the whole 
 nation would owe to Sir Victor Horsley an enormous debt of gratitude for 
 what ho did.' 
 
 O
 
 210 SIR VICTOR ilORSLEY 
 
 National Council oi Trained Nurses, he gave an address on 
 ' Nursing under the Insurance Act ' : 
 
 People say ' There are not enough properly trained nurses 
 in the country.' I know there are not. Now is the oppor- 
 tunity for the nursing profession to tell the public why 
 there are not enough trained nurses. I do hope the public 
 will read their papers, and consider the points and condi- 
 tions of nursing w'ork. I am convinced that the shortage 
 of fully-trained nurses is due to the fact that fewer persons 
 are entering the profession, and that the chief reason for 
 this is that the remuneration of nursing, as a skiUed and 
 learned work, is insutlicient. Secondly, the hours of nursing 
 are long. Two months ago we had an interesting paper 
 suggesting an eight-hour shift, and showing that it could 
 be successfully carried out. It is certain that the hours 
 of working arc too long, and the work is often monotonous. 
 Lastly, we have to recognise the competition of other channels 
 of work, equaUy or better paid, and giving greater hberty. 
 
 In Jime, also, in Southsea, he spoke at the annual con- 
 ference of the International Abohtionist Federation. His 
 speech is reported as follows : 
 
 He said that prostitution was to a large extent due to 
 drink ; not necessarily drinking to excess. His personal 
 experience was supported by statistics from Sweden, The 
 wage question he also regarded as a fundamental one, and 
 at the bottom of the problem. It had been proved that 
 with low wages the rate of prostitution became high. The 
 improved morality of the Army began in 1904, when increased 
 pay was given to the soldier. He regarded the land question 
 as a contributory factor to prostitution, because the present 
 land system had its results in bad housing, overcrowding 
 conditions, slums, etc. ' The discomforts of home drive a 
 girl on to the streets for amusement, and sometimes for prosti- 
 tution.' They had 5,000,000 people living in slums, and 
 until they adopted a rational system of land values they 
 would never solve the housing question. Another cause 
 of prostitution was the social position of women, and the 
 theory of a dual morality — one for women, another for 
 men. He held that anti-suffrage views were responsible in 
 a great measure for the continuance of that idea of degrada- 
 tion. He urged that what was wanted for dcahng with 
 this and other problems was the national co-operation of 
 men and women. 
 
 In July, he published a short note on a point of general 
 surgery, ' Ha;mostasis by application of living tissue.' The
 
 FROM 1907 TO AUGUST 1914 211 
 
 annual meeting of the British Medical Association, this year, 
 was in Aberdeen : and the University of Aberdeen took 
 occasion to confer on him the degree of a Doctor of Law. 
 He read a paper on ' The reform of the vital statistics of the 
 nation ' — his old theme, the misuse of death-certificates — 
 with a prophecy of the Ministry of Health : * The office of 
 the Registrar-General ought to be completely reconstituted 
 as a sub-office of a Ministry of Public Health, which will 
 unite the three existing and incoordinate branches of pubhc 
 health work, namely the Local Government Board, the 
 Board of Education, and the Home Office.' He also gave an 
 address, at a men's Sunday meeting, on ' Alcohol as a racial 
 poison ' : and, at a great open-air meeting in Castlegate, 
 spoke on female suffrage. From Aberdeen, he and Lady 
 Horsley went to Orkney, where he spoke in Kirkwall on 
 female suffrage. They got back to London in the first week 
 of the War.
 
 Professional Politics 
 
 The administrative affairs of his profession, its place in the 
 social system, its influences on the mind of the community, 
 were of unfailing interest to him : they exercised his desire 
 to improve the conditions and the rewards of general prac- 
 tice, and to uphold the rights of his less fortunate brethren 
 against the insolence of office. The education and examina- 
 tion of students, the penalties for wrongdoing, the protection 
 of honourable men from slander or blackmail, the protec- 
 tion of the public from quackery, the teaching of hygiene 
 and temperance, the adjustment of the balance between 
 State-service and private practice, the registration of nurses, 
 the registration of midwives — these all appealed to him. 
 He had well-dehned rules of action : he knew what he 
 wanted, and he was ingenious to plan assaults and to carry 
 them through. One of his friends has said that it vexed 
 hnn, to l)e told that he enjoyed fighting : and of course it 
 vexed him to feel that a man could think of him as merely 
 quarrelsome, flying at harmless passers-by just for the fun 
 of it : but he was the Achilles of his profession — ' Impiger, 
 iracundus, inexorabilis, acer ' — and its politics were never 
 dull to him. Only, his habit of taking for weapons any 
 handy phrases, not carefully weighing their offensiveness or 
 reckoning their effects, and the rather dictatorial air which 
 was natural to him, delayed the success of his plans : he 
 was too ready to use insolence of rebuke against insolence 
 of office. 
 
 This readiness to find fault with people in high places 
 was reconciled in him — he was lull of vivid contrasts — with 
 unceasing thoughtfuhiess for those who neither were nor
 
 PROFESSIONAL POLITICS 213 
 
 ever would be anywhere near the high places. * And, of 
 course, it is not only in professional politics that one observes 
 this contrast in him. Always, he lived up to the difficult 
 saying, ' All men are equal in the sight of God.' For 
 example, he rebuked the Archbishop of York, for saying 
 something charitable, early in the first year of the War, of 
 the Kaiser. He rebuked Lord Morley, for half a dozen 
 words in his Rousseau : any physiologist might resent them, 
 without calUng Lord Morley to account for them. As for 
 lesser persons in high places, he took them to task when 
 they needed it. Happily, he adopted into his life not the 
 fust half only, but the whole of the text, ' Deposuit potentes 
 de sede : et exaltavit humiles.' 
 
 His love of his profession was not sentimental : it was 
 clear-sighted, masterful, and creative. As he came to be 
 on the side of democracy, so he came to regard his profes- 
 sion as a trade-union : it was of a kind apart, for its members 
 did a vast amount of work for nothing, nor could they strike. 
 None the less, it was a secular body of men of busmess, 
 whose object was to earn a liveUhood : and many of them 
 could not earn so much as they deserved, but were over- 
 worked, underpaid, put-upon, ill-organised, and ill-repre- 
 sented. He longed for every one of them to have a good 
 time. That is the abiding spirit of all his action in profes- 
 sional politics. The set scenes for it were (i) the Medical 
 Defence Union, (2) the General Medical Council, (3) the Royal 
 College of Surgeons, (4) the British Medical Association. 
 
 I. THE MEDICAL DEFENCE UNION 
 
 The episode of the Folkestone Church Congress in i8f)2 
 was the beginning of his representative work for his pro- 
 fissioii. 'i'lie Medical Defence Union was founded, in i8cS5, 
 
 ' Dr Alfred Cox, Medical Secretary of the British Medical Association, 
 who was for many years in close work with Horsley over the Association's 
 affairs, writes : ' Tlic man who could \)C overl)carinK «^"'l even insolent to 
 his equals and " superiors " was always most considerate to smaller men. 
 Nothing in his character was more reniaikalile to me than the deferential 
 way in which ho would listen to the humhlc workers in the causes in which 
 he was interested, and the way in which ho would willinRly Rivo way on 
 many occasions to ]>ersonal cxj>orienco in matters which he could only 
 deal with theoretically.'
 
 214 ^IR VICTOR MORSLEY 
 
 in London. It was not founded on the right lines ; and at 
 tirst it failed. In 1888, it was reconstructed, in Birmingham, 
 with Mr. Lawson Tait as President, and was made successful. 
 Hut Mr. Tait's methods were not approved by everybody : 
 and at tlie time of the Church Congress he spoke, at a meet- 
 ing of anti-vivisectionists, in a t(me which his profession 
 deeply resented.^ He resigned his Presidency ; and the 
 Medical Defence Union came back to London, with Horsley 
 as President. There is a letter to Horsley, written a few 
 days after the Folkestone Church Congress, from one of the 
 officials of the Medical Defence Union : 
 
 Your courage and able defence only show us that the 
 best interests of the profession lie in your hands, and we owe 
 you grateful thanks for your disinterested conduct. If 
 you were elected President of the Union, would you under- 
 take the duties ? I am writing unofficially of course at 
 present — at the request of well-known men in London. 
 Your action has won the respect and gratitude of every 
 man I have come across, and I can only say we honour you 
 for it. 
 
 Dr. A. G. Bateman, its Hon. Secretary for more than a 
 quarter of a century, writes : 
 
 He threw himself heart and soul into the work of Medical 
 Defence, sparing neither himself nor the Executive in the 
 fulfilment of his duties. He not only attended every Council 
 and Executive Meeting, but gave many other hours of his 
 valuable time to the Union. 
 
 He held tliat the work of Medical Defence is threefold, 
 concerning a medical man in relation to his patients, to his 
 colleagues, and to tlie general public ; and that it is both 
 direct and indirect. Direct defence, by an impersonal and 
 ])owerful association, was needed, because a medical man is 
 peculiarly exposed to blackmail and other methods of attack 
 from unscrupulous people. It was of the utmost importance 
 that his defence siiould be conducted by an impersonal body 
 like the Union : it proved to the public, the Court, and the 
 parties concerned, that the assailed practitioner did not 
 
 * His position with regard to experiments on animals was equivocal : 
 for in 1893, at an important meetinR of his profession in Birmingham to 
 promote the founding of the British Institute of Preventive Medicine (the 
 Lister Institute), he said that he fully assented to the resolution, feeling 
 that, while he objected to a certain class of surgical investigations, bacterio- 
 logical experimeoLs 00 aiumaJs had proved of great value.
 
 PROFESSIONAL POLITICS 215 
 
 stand alone but had the support of his fellows. Horsley 
 urged this point very strongly ; and his persistent advocacy 
 of its importance brought a large increase of members. In 
 many instances, the mere fact that the Union, with Horsley 
 at the head of it, was prepared to support and defend a 
 practitioner against litigation, made his assailants recon- 
 sider their position and withdraw their attack ; but it 
 must be clearly understood that the Council had a legal 
 right to refuse any man whose conduct had been, in their 
 opinion, unprofessional or improper. Blackmailing prac- 
 tically ceased when the Union was proved to be ready for 
 action. 
 
 Indirect defence refers, inler alia, to conditions under 
 which a man is injured not only by disputes with other 
 practitioners but by competition of an improper and un- 
 lawful character. Injurious competition may come either 
 from his qualified colleagues or from unqualified practi- 
 tioners and quacks. 
 
 While Horsley was President, a case arose in which two 
 members of the Union were concerned. It involved serious 
 issues : for by an error of the Executive, the case of one 
 member was refused, and the case of the other was accepted. 
 The refused member took legal proceedings against the 
 President. It became necessary to prevent the mischief 
 from spreading, to the detriment, if not disruption, of the 
 Society. Horsley 's management of this grave trouble 
 showed his masterly skill in tactics : the legal proceed- 
 ings were kept within reasonable limits and brought to a 
 satisfactory end ; he visited, with two of the Society's 
 officers, the chief centres in the provinces, and held meet- 
 ings at which the cause of the trouble was fully and clearly 
 explained : and thus prevented the threatening disruption. 
 His charm and his diplomacy at the meetings worked 
 wonders : and the Society, instead of losing strength, gained 
 it, and witii it gained increase of the general confidence in 
 its Executive. 
 
 Horsley always felt that the defence of the profession 
 against unqualified practice was seriously handicapped by 
 the wording of the penal sections of the Medical Act, 1858, 
 It was held that, by these sections, medical practice was 
 not the monopoly of registered practitioners : that only 
 the scheduled medical titles were conserved. In other 
 words, any unqualified person could practise medicine with 
 impunity, provided that he did not call himself by anv of 
 the nunu-rous titles apjienfled to the Medical .Act. Horsley 
 strove in every possible way to obtain amendment of the 
 Act : but though he drafted or helped to draft many Bills, 
 no progress was made in the face of the extraordinary love 
 of quackery which is to be found among MembeiT; of I'arlia-
 
 2l6 SIR MCTOR IIORSLEY 
 
 mcnt in both Houses. He urged in season and out of season 
 that, for the protection of tlie pubhc, medical attendance 
 on the sick ought to be restricted to quahfied practitioners ; 
 and that there was urgent need of legislation, not to create 
 a monopoly, but to protect the public. But the opposi- 
 tion was too strong : and during his Presidency, and since 
 then, it has only been possible to prosecute unqualified 
 persons under section 40 of the Act, which is hopelessly 
 inadequate. 
 
 In October 1897 he had to resign the Presidency, on his 
 election to the General Medical Council : but he never lost 
 touch with the Union. Its work was congenial to him : 
 and he was ever ready to admit that he had learned a great 
 deal from the many thousands of medico-legal cases which 
 were dealt with during his term of office. The experi- 
 ence was of value to him on the General Medical Council, 
 in the iniquities of medical aid associations, the covering 
 of unqualified assistants, and unqualified practice. 
 
 His services as an expert witness, on behalf of members 
 unjustly attacked, were often asked for and never refused ; 
 and he would at any time confer with those who were con- 
 ducting the defence. A keen fighter, he was equally happy 
 either defending or attacking. ' Compromise ' was a word 
 not to be found in his dictionary : and ' tactics ' suited him 
 better than ' tact.' They who worked with him soon realised 
 that time was made for man, and that ' office hours ' had 
 no strict limit : certain work had to be done and finished 
 straight on end, according to him. 
 
 2. THE GENERAL MEDICAL COUNCIL 
 
 In 1896, at the Carlisle meeting of the British Medical 
 Association, Horslcy and others had urged the reforni of 
 the General Medical Council : and on October 13, 1897, he 
 was elected to it as one of the three direct representatives 
 chosen by the whole profession. He had said very plainly, 
 in his electoral address, that the Council was remote from 
 present needs, and of little use to men in practice. It had 
 shown itself indifferent to cases sent up to it from the 
 Medical Defence Union : but that was a small matter. The 
 serious grievance was in the slowness of its ways, and the 
 difficulty of access to its doings. He went to it, as he let it 
 know, to stir it up : it was not minded to be reformed at 
 short notice : and he did not at first gain its approval. The
 
 PROFESSIONAL POLITICS 217 
 
 wo:k of the Medical Defence Union, at closer range and 
 with quicker results, had exactly suited him, for he was 
 always intended by nature to be in final authority — an 
 admirable President, an admirable Chairman — but he did 
 not fare so well in the givo-and-tnke of Committee-meetings. 
 It was a great change for him, from the rapid decisions of 
 the Medical Defence Union, the hand-to-hand encounters 
 with litigants, the adventures in the Law Courts, to the 
 intricate and argumentative affairs of the General Medical 
 Council, its formalities, deliberations, and wearisome corre- 
 spondence with universities and colleges over examinations 
 and degrees. He offended by his vehemence ; and, it may 
 be, by his annual ' addresses to his constituency,' in which 
 he explained to the profession at large what the Council was 
 doing or was leaving undone. But, in the long run, he put 
 through, or helped to put through, many of his plans. 
 
 One of his colleagues on the Council, Sir Charles S. Tomes, 
 writes of him : 
 
 His first public action on the Council was to raise the 
 question of infringement of its members' rights to inspect 
 documents preserved in the Council's archives : he had 
 been denied access, by the President, to documents bear- 
 ing upon recent decisions. Thus, his first action brought 
 liim into direct confiict with the President : and his motion 
 was defeated. But in the next session, other direct repre- 
 sentatives moved that members wanting to inspect docu- 
 ments should obtain leave from the Council or from its 
 Executive Committee or, if neither were in session, from 
 the President : but only the Council should give leave 
 for inspection of documents relating to penal cases, these 
 hoAup, confidential. This compromise was agreed to, and 
 Ilorsley at once obtained leave to inspect the documents 
 relating to some recent penal cases. 
 
 About the same time, he raised a question as to the con- 
 duct and expenses of the legal business of the Council : he 
 failed to carry his motion : later, he returned to the charge, 
 and called attention to the fact that neither the solicitor 
 nor the standing rounsel (legal assessor) had ever received 
 any formal appointment. 
 
 As one reads the Minutes of the Counril, dnring ITorsley's 
 early days of membership, one cannot fail to see tliat his 
 proposals were very often flefcatcd, and later, and perhaps 
 in fliffcrent terms, were effective. The explanation is not 
 far to seek. Feeling strongly on them, and often having
 
 2i8 SIR VICTOR IIORSLEY 
 
 a very strong case, he was not careful to present it in a 
 non-personal form : on the contrary, he sought to fasten 
 blame on individuals, and thus provoked antagocism. 
 This was a defect of his qualities. Directness, earnest- 
 ness of purpose, dislike of compromise, and some inability 
 to recognise that when he was convinced of being in the 
 right, others migiit differ from him without being actuated 
 by wrong motives, combined to give a cast to his methods. 
 He had some consciousness of this habit of mind, and did 
 not in the least object to being chaffed with such enquiries 
 as ' Who is your latest scoundrel ? ' 
 
 The Use of Titles. — A case wliich greatly interested him. 
 and had much to do with his attitude toward the Council, 
 was that of Mr. , a licentiate of the Society of Apothe- 
 caries and an M.D. of Philadelphia. He held no British 
 quahfication except the L.S.A. He styled himself both 
 M.D. and ' Physician and Surgeon ' : but later he seems 
 to have abandoned the use of the M.D. The Penal Cases 
 Committee recommended that proceedings be taken against 
 him : and he was convicted before a bench of magistrates 
 on the wrongful use of the title of ' physician.' The charge 
 of wrongful use of the title of ' surgeon ' was not pressed 
 after the one conviction. An appeal was lodged : he died 
 before it was heard : finally, the conviction was quashed : 
 the Court held that though he had no right to the title of 
 ' physician,' or ' pliysician and surgeon,' he had not used these 
 titles ' wilfully and falsely.' The Council were behind this 
 action : but the nominal complainant was a solicitor's 
 clerk. Horsley thought that the prosecution was alto- 
 gether improper and should never have been undertaken : 
 though it had been intended, more or less, to be merely 
 a ' test-case.' His interference was between the convic- 
 tion and the hearing of the appeal. It led to some very 
 hot discussions : one member of the Council went so far 
 as to call him a Yahoo : his motion against the Penal Cases 
 Committee was defeated : but the attention called to the 
 whole affair was not without effect. 
 
 The Midtc'ives Bill. — About this time, he was appointed 
 a member of the Conference on the proposed Midwives Bill, 
 which became law in 1902 : he took great interest in this 
 work, and in the relations finally established between the 
 Central Midwives Board and the Council. 
 
 Personal ion. — Several instances of the personation, by 
 unqualified men. of deceased or far-away practitioners, 
 came to the knowledge of the Council. The law on this 
 matter was peculiar. Personation was not, of itself, a legal 
 offence, though it might easily induce the pretender to commit 
 some offence. The Council therefore desired to make per- 
 sonation as difficult as possible, and a Committee was
 
 PROFESSIONAL POLITICS 219 
 
 appointed, witli Horsley as Chairman, in 1899. Questions 
 of law had to be decided : it was not till 1902 that the Com- 
 mittee made its recommendations. These mostly were 
 adopted, and have been found very useful. 
 
 Licensing bodies and their examinations. — It appeared to 
 the Council that there was no agreement among the various 
 licensing bodies as to the exemption from portions of their 
 examinations to be granted to students who had passed 
 in these subjects elsewhere. Horsley moved that tlie Council 
 should be furnished with lists of these exemptions : and this 
 is still done annually. It was found that some bodies gave 
 no exemption, and others gave a good deal, but not in their 
 final examinations. He raised a furtlier question as to 
 the examinations of the Conjoint Board (England) in the 
 preliminary scientific subjects, and their recognition of 
 teaching institutions not yet recognised by the Council. 
 He was of opinion that the requirements in chemistry were 
 insuflicient — he included those of the Conjoint Board of 
 Scotland — and that the matter ought to be reported to the 
 Privy CouncU. 
 
 Aynendment of Companies Acts. — About this time, a 
 Companies Acts Amendment Bill was before Parhament : 
 and a small Committee (the President, Horsley, and myself) 
 were empowered to ask the Government to insert a clause 
 preventing the registration of Companies to carry on medical, 
 surgical, and dental work. One way of evading the pro- 
 visions of the Acts was by incorporation into a Limited 
 Company, generally of the one-man type, with the required 
 number of signatories made up of men of straw. The Com- 
 mittee, having waited without success upon the President 
 of the Board of Trade, drafted a memorial to the Lord 
 Chancellor, which was favourably received. Amendments 
 were introduced, in the House of Lords, and were thrown 
 out in the Commons. This question of evasion by incor- 
 poration came up again and again, and Horsley always 
 took an active part. But little has been done, save that 
 the registrars of Joint Stock Companies now refuse to register 
 titles which too clearly arc against the spirit, if not against 
 the letter, of the law. 
 
 Finance of the Council. — The Act constituting the Council 
 (1858) laid down a very definite j)lan for the aclniinistration 
 of the finances of the Council, and of its Bran( h Councils : 
 hut this plan involved a sort of battlcdore-and-shuttlecock 
 transference of monii'S from one account to the others and 
 back again, which was hard to follow. Horsley moved 
 for a Committee to simplify these matters, and was appointed 
 a member of it. The expenditure of the Council and its 
 Branches largely exceeded the joint income ; and the Com- 
 mittee had to consider possible economies, as well as simpli-
 
 220 SIR VICTOR IIORSLEY 
 
 fication of accounts. It was not thought desirable to try 
 for an Amending Bill in Parliament : but expert advice 
 was taken, and some improvements were made in the pre- 
 sentation of accounts. 
 
 Tluis, it will be seen that Horsley, as might have been 
 expected, took a very active and useful part in the work 
 of the Council, and after his initial stormy period was largely 
 concerned with less controversial subjects, and was more 
 uniformly successful in carrying liis points. 
 
 At the end of his first term of office of five years, he was 
 re-elected, by a large majority. Just before the end of 
 his second term, he resigned, that he might save the Council 
 from the expense and trouble of a separate single election. 
 His reason for not desiring a third term of office was. that 
 he considered that for the most part the things which he 
 desired to do on the Council had been accomplished, and 
 that ho now could be more useful elsewhere. 
 
 3. THE ROYAL COLLEGE OF SURGEONS 
 
 The Royal College of Surgeons of London was founded on 
 what was left, in the eighteenth century, of the old Guilds. 
 In 1743, the union of the Barbers' Company and the Surgeons' 
 Company was dissolved, and the Corporation of Surgeons 
 of London was instituted. Near the end of the eighteenth 
 century, the Corporation of Surgeons was dissolved, or was 
 alleged to have been dissolved : and in 1800 it was rein- 
 stated or reconstituted by a Charter, under the title of the 
 Royal College of Surgeons in London. The Fellowship of 
 the College was not instituted till 1843. By the Charter of 
 1843, the right of serving on the Council of the College was 
 given to F(^ll()ws only. Members have no place on the 
 Council, and no voice in the election of the Council. In 1884, 
 the reception of the Erasmus Wilson bequest made it neces- 
 sary to apply for a new Charter, as the College wjls not 
 allowed to hold property of a yearly value above ;f20oo. 
 At this time, two associations were formed, one of Fellows, 
 the other of Members : both of them were in favour of 
 making the management of the College more widely repre- 
 sentative : but the new Charter, granted in 1888, left things 
 as they were. In i88q, the Association of Members un- 
 wisely attempted to hold a meeting of their own at the
 
 PROFESSIONAL POLITICS 221 
 
 College, against the will of the Council ; and found them- 
 selves locked out. Over this defeat, they went to law with 
 a ' test-case,' Steele v. Savory ; it was decided against them 
 in 1892 : the failure and the heavy cost of this lawsuit 
 killed the Association : but in 1894 it was formed again, 
 as the Society of Members. Thus there are two bodies 
 outside the Council as its critics — the Association of Fellows, 
 and the Society of Members. Horsley belonged to both of 
 them. In 1896, the Committee of the Association of Fellows 
 asked him to stand for the Council, and promised to support 
 him : but he did not accept this invitation. 
 
 For thirty years, 1884-1914, at every annual meeting of 
 the College, certain Members have protested against the 
 exclusion of Members from a place on the Council and a 
 vote for the Council, and have asked for direct representa- 
 tion. ' Resolutions to this effect,' says one of them, * have 
 been carried by large majorities, and often without a single 
 vote recorded in opposition.' Nothing comes of these 
 resolutions : the Council receives them with impassive 
 dignity : hke the Senate, who remained silent on their chairs 
 of oflice when the Gauls broke into the Senate-house. For 
 one who has never taken part in these affairs, it is hard to 
 see why the Members should not have what some of them 
 so greatly desire. The Council, about 1904, decided ' That 
 as the Members of this Council represent the body-cor- 
 porate of the Royal College, and consequently its Members 
 as well as its Fellows, it is the opinion of this Council that 
 no further representation is desirable.' Doubtless the 
 Council was afraid of entanglement in controvei-sies which 
 would hinder and impair its regular work. 
 
 In 1912, and again in 1914, Horsley moved the invariable 
 old resolution — word for word the same, each time — on 
 behalf of the Society of Members, at the Annual Meeting 
 of the Collfge. In 191 2, one of the Council answtMcd him, 
 denying that the Council ' considered the Mcmbci-s unlit 
 to sit with them,' and saying that 
 
 The reason why they did not agree to admit Members 
 into the Council was because the Council of the ("olU^go was 
 not a legislative body. The mutters with which it had
 
 222 SIR VICTOR HORSLEY 
 
 more especially to concern itself were the care of the most 
 valuable museum of its kind in the world, the care of a 
 library which deserved the high reputation it held, and the 
 inspection and conduct of what he maintained were the 
 most important and the finest examinations in surgery. 
 He did not think that the Council would be better qualified 
 to deal with these matters if Members were elected on it. 
 The next reason was that an election in which all the Members 
 of the College, who were scattered all over the world, took 
 part, would be very costly, difficult, and he thought im- 
 practicable. In matters affecting the profession, the 
 Members had the British Medical Association, which had 
 proved itself to be admirably fitted to safeguard the inte- 
 rests of members of the profession. 
 
 4. THE BRITISH MEDICAL ASSOCIATION 
 
 The affairs of the Medical Defence Union, the General 
 Medical Comicil, and the Royal College of Surgeons, were 
 not permanent in Horsley's life ; he came to them, followed 
 them, and went on from them : but the affairs of the 
 British Medical Association are continuous with him, and 
 he is never away from them. He set himself to help to 
 make it what it is now, the Doctors' Union, powerful and 
 effective and well-organised on modem lines. He wrote in 
 its Journal, took a chief part in its Annual Meetings, was 
 one of the founders of its new Constitution, served on its 
 Council and Committees, was Chairman of its Meetings of 
 Representatives, and Chairman of the Marylebonc Division 
 of its Metropolitan Counties Branch. He worked, for it and 
 through it, along every possible way of politics. To him, 
 it stood for the resistance of his profession against auto- 
 cracy and bureaucracy ; he looked for its strength to tell 
 on the nation, the Government, Parliamentary Committees, 
 Fri«;ndly Societies, and pubhc institutions of education and 
 of health ; it was ' democratic,' in touch with the present, 
 not bound by traditions ; it could do what the Royal 
 Colleges and the General Medical Council were not doing ; 
 it could make people hear what it said to them. As he 
 wrote in 1901, ' It is in my opinion ridiculous, trying to 
 concihate the old men at the head of the G.M.C. They 
 must be crushed or driven to do the right thing, and if we
 
 PROFESSIONAL POLl 1 ICS 223 
 
 can only organise the B.M.A. successfully, we shall do the 
 rest easily.' He had constantly in liis mind the power 
 which the Association might attain on these lines, as the 
 one great intermediary between the State and his profes- 
 sion, the one system m which the doctors would be united 
 to defend themselves from injustice, to provide a better 
 service for the nation, and to enforce proper rates of pay- 
 ment of their work. 
 
 Dr. Alfred Cox, Medical Secretary, has written of this 
 factor of Horsley's hfe : 
 
 More than any other man he made the demand for the 
 reconstitution ot tlie Association on democratic lines ; lor 
 he was the chief inspiration as well as the leader of those 
 who called together the Manchester Conference in 1900, 
 and afterwards approached the Council of the Association, 
 at Ipswich, witli tiie proposals which led it to set up the 
 Constitution Committee. 
 
 ... It was natural that Horsley should become the 
 first Chairman of Representative Meetings. He held ofiice 
 from 1903 to 1906 ; and I beheve he was as proud of that 
 ofhce, and all tliat it meant in providing opportunities for 
 moulding the organisation of the profession, as of any lionour 
 that was ever conferred on him : for he had a great idea 
 of the dignity and importance of the Association, and of 
 the great responsibility of its ciiief executive officers. He 
 contmued to be a member of the Representative Meeting 
 until 1912, and was as able and helpful as a member as 
 he had been as Chairman. 
 
 He filled nearly every post in the Association except tliat 
 of President and Chairman of Council. He was a niLinbcr 
 of Council from 1900 to 1912, and was chairman of many 
 committees. His chief Association work was done in con- 
 nection witli tlie Organisation Committee, where he took a 
 very active and prominent part in drafting tlie Articles 
 and By-laws, and in the ap])lication for a Royid Charter : 
 and on the Medico-l'olitical Committee. On the latter, he 
 took the leading part in forming the policy of the Associa- 
 tion in regard to reform of Coroners' Law and Death Regis- 
 tration, Medical Inspection and Treatment of School Cliildren, 
 Amendment (A Medical Acts, the constitution of a Mini.sliy 
 of Public Health, State Registration of Nurses, and suppres- 
 sion of unqualified practice and quack advertisements.* 
 
 * How hard he worked, is bhown by the mass ot his corrcsiKjinlencc, 
 notes for addresses, minutes of mocUngs, rcixjrls, iiud press-cut Ungu. 
 Tho work (or the reform ol Loroours' Law, which began with tlie atlroata
 
 224 ^IR VICTOR UORSLEY 
 
 ... It will help some readers to realise the kind of man 
 he was, to recall his action in regard to a presentation the 
 Representatives proposed to make to him when he left 
 the Chair. A considerable sum of money was collected by 
 Dr. W. Douglas, and a handsome piece of plate bought, 
 before Horsley heard of it. He at once informed Dr. Douglas 
 that he would rather the presentation were not made, much as 
 he valued the feeling that inspired it. His reasons were 
 very characteristic. First, he said, he had already been 
 thanked very generously for his work in the Chair, and 
 secondly, he had ail his life held the view that personal pre- 
 sentations should not be made for pubhc service, except 
 by the State — ' Work, whether pohtical or scientific, if 
 done in the interests of the profession, brings with it not 
 only the ample satisfaction of having contributed to social 
 progress, but also earns constantly recurring grateful acknow- 
 ledgment from those who happen to more directly benefit 
 by what has been attained.' 
 
 . . . He, a consultant of the consultants, was able to under- 
 stand and sympathise with the difficulties of the general 
 practitioner in a way that was all the more effective because 
 taken from a detached point of view : and his labours on 
 the Contract Practice Sub-committee left him with a deep 
 conviction of the need to improve the economic position 
 of the general practitioner, particularly in the poorer districts. 
 
 That is the meaning of his fight for the Insurance Act. 
 All his work, year in year out, had made it clear to him 
 that the Act, though it must have its faults, would provide 
 
 put on the doctors by the Coroner for South-West London, took three 
 years, 1903-1906, and came to nothing, or next to nothing : the work for 
 the medical care of school children, the estabhshment of school dental 
 chnics, and the teacliing of hygiene and temperance in schools, took tnany 
 more than three years : the registration of nurses in England occupied 
 him even in Mesopotamia ; he writes to Dr. Alfred Cox on May 15, 191O ; 
 he is angry over the new College of Nursing, and says unkind things of 
 its supporters : ' I have just received the report of the Conference between 
 
 and the Kegistrationisls. It is very dillicult out here some three 
 
 hundred miles up the Tigris on a burning mud Hat in the middle of cholera, 
 dysentery, diarrhoea, etc. etc. etc., to judge exacUy what is being done 
 at home, but it is quite clear that all the old enemies of the B.M.A. are 
 
 behind , and pushing his nasty College for all they are worth. It seems 
 
 to me that it being only a manccuvre to push off Registration, the B.M.A. 
 ought to support Chappie and his Bill more actively. Also that our 
 present representatives on the Central Committee to run the Bill must 
 do much more to fight tliis vile private hole-in-the-corner arrangement. 
 Considering that we have been working for twenty-live years, it is a little 
 too much to see the whole thing jockeyed. . . . The idea of starting a 
 College, not a truly e<lucaUonal body, but the sham archaic examinational 
 institute for private registration that we have suffered from so bitterly 
 all these years, is so like the enemies of liberty. ... It is very annoying 
 bctug in all this chaos of folly and not able to help at home'
 
 PROFESSIONAL POLITICS 225 
 
 not only better service for the insured, but more favourable 
 conditions for men overworked and imderpaid in general 
 practice. Having this invincible faith, he stood up against 
 a great outpouring of ill-will and abuse from many of those 
 whom he was working for. 
 
 It was in June, 1911, that the British Medical Association, 
 on behalf of the profession, finally stated the ' six cardinal 
 points ' which it was determined to obtain : 
 
 1. An income limit of £2 a week for those entitled to 
 medical benefit. 
 
 2. Free choice of doctor by patient, subject to consent of 
 doctor to act. 
 
 3. Medical and maternity benefits to be administered by 
 local Health Committees, and not by friendly societies. 
 
 4. The method of remuneration of medical practitioners 
 adopted by each local Health Committee to be according to 
 the preference of the majority of the Medical Profession of 
 the district of that Committee. 
 
 5. Medical remuneration to be what the Profession con- 
 siders adequate, having due regard to the duties to be per- 
 formed and other conditions of service. 
 
 6. Adequate medical representation among the Insurance 
 Commissioners in the Central Advisory Committee and in 
 the local Health Committees, and statutory recognition of 
 a local Medical Committee representative of the profes- 
 sion in the district of each Health Committee. 
 
 A few days later, the British Medical Association sent 
 out the ' pledge ' which was signed by the very great majority 
 of the profession : 
 
 I, the undersigned, hereby undertake that in the event 
 of the National Insurance Bill becoming law, I will not 
 enter into any agreement for giving medical attendance 
 and treatment to persons insured under the Bill, except- 
 ing such as shall be satisfactory to the medical profession 
 and in accordance with the declared policy of the British 
 Medical Association ; and that I will enter into such agree- 
 ment only through a local Medical Committee, representa- 
 tive of the medical profession in tlie district in whirh I 
 practise, and will not entrr into any individual or separate 
 agreement with any approved Society or other body for 
 the treatment of such persons. 
 
 On November 23, at a Special Meeting of Reprosmtatives, 
 it was decided that the Association should hold to tfie six 
 cardinal points. 
 
 P
 
 226 SIR VICTOR HORSLEY 
 
 On November 30, the Prime Minister's private secretary 
 wrote to Mr. Smith Whitaker, the Medical Secretary of the 
 Association, offering him the position of Deputy-Chairman 
 of the Commission under the Act. On December 2, the 
 Council of the Association discussed this offer. Horsley 
 said that ' the real question before them was, Would they 
 be acting in the best interests of the profession, if they gave 
 permission to Mr. Smith Whitaker to accept it ? He 
 beheved that they would, and that their action could be 
 justified completely, at any meeting of the profession, by 
 the simple statement that the Bill would be passed in spite 
 of the profession.' It was decided, by 38 votes to 3, that 
 Mr. Smith Whitaker was free to accept the offer. At 
 the same time, a memorandum, signed by the Chairman 
 of the Representative Meetings and the Chairman of the 
 Council, was sent to the Members of the Association. It 
 went over the six cardinal points, and the pledge ; and it 
 advised the profession to be content with what it had 
 gained : 
 
 The Insurance Bill will probably become law within the 
 next fortnight, and the Association and the profession 
 have to consider their future action towards it. 
 
 The poUcy of the Association as expressed in the above 
 stated six cardinal principles is absolutely unchanged. 
 
 The Bill by the efforts of the Association has now been 
 so amended that there is no legal barrier against the profes- 
 sion securing the fulfihnent of its entire policy. 
 
 The following principles of the Association have been 
 incorporated in the Bill as it has now left the House of 
 Commons — namely, the free choice of doctor ; the adminis- 
 tration of medical and sanatorium benefits by the local 
 Health Committee ; the representation of the profession 
 on all the administrative bodies established under the Act ; 
 the statutory nxognition of a committee of the medical 
 profession in each district. 
 
 In addition, the essential principle of a wage limit is 
 recognised by Clause 15 (3) in the Bill, the precise amount 
 being fixed by the profession in each district in negotiation 
 with the local Health Committee. 
 
 The remaining principles of the pohcy of the Associa- 
 tion not dealt with under the Bill are the rate and method 
 of remuneration, and the amount of the wage Umit. The 
 first of these — the most essential of the principles of the
 
 PROFESSIONAL POLITICS 227 
 
 Association — the Representative Rod}' decided should be 
 settled by agreement between the members of the profes- 
 sion in each district and the local Health Committee. As 
 regards the second, it decided that this also, if not embodied 
 in the Bill, should be fixed by local negotiation. 
 
 On December 12, Horsley spoke at a Branch Meeting of 
 the Association ; he defended the appointment of Mr. Smith 
 Whitaker : ' After all, the Insurance Bill was going through 
 over the heads of the profession. When they came to the 
 real fight in the Divisions of the Association, they would 
 have a good friend on the Central Body. The Council had 
 had to make the best of a bad situation.' On December 16, 
 the Act received the Royal Assent. On December 19, came 
 the disastrous ' mass meeting ' at Queen's Hall ; it did no 
 good, and it degraded the profession in the eyes of the 
 pubhc. Horsley was not on the platform, but in the body 
 of the hall. A resolution was moved and seconded, ' That 
 this mass meeting of the medical profession is of opinion 
 that the six cardinal points originally formulated by the 
 British Medical Association are not guaranteed by the pro- 
 visions of the Insurance Act in a manner which satisfies the 
 profession.' He rose to speak, and was hissed and shouted 
 at : he was invited on the platform, and stood there, and 
 was howled down. He bore it well : he was writing his 
 letters at home, half an hour later, as if nothing had happened. 
 Finally, came the threat that if the doctors would not work 
 the Act, men would be found, somehow, to take their place : 
 and the miserable day when the newspapers got out their 
 sensational posters. The Doctors Brought to Heel, Stampede 
 of the Doctors — that sort of thing. 
 
 It is to be noted, that he was not a member of the State 
 Sickness Insurance Committee, which had formulated the 
 Association's policy : and that he had only thrown in his 
 lot w ith his colleagues on the Council, and with the Divisional 
 Representatives. But men who think them.selves betrayed 
 must find somebody to call a traitor ; and he, with his 
 imperious self-assertion, his flashes of insolence, his loader- 
 ship in practice, his name in public life, was just wliat thoy 
 wanted. Long after the passing of the Act, their ill-wiU
 
 228 SIR VICTOR HORSLEY 
 
 pursued him, and a lot of nonsense was put about — he was 
 playing to the gallery, he was hoping for a peerage, he was 
 in secret understanding with the Chancellor of the Exchequer 
 — to whom he never had spoken a word, except that he was 
 introduced to him on a platform somewhere. But the irony 
 of it : that he should be denounced by the men whom he 
 was helping, and that he who was averse from all compro- 
 mise should be the victim of compromise. But his profes- 
 sion was not enough of a trade-union to fight and beat the 
 Government over a question of remuneration, nor ever will 
 be, nor ever was intended to be, for it cannot strike : it will 
 always, at the last, subordinate its pohtics to its ideals. 
 
 He writes from Orkney, January 6, 1912, to Dr. Otto 
 May, one of the many who were furious over the disgrace 
 of the mass meeting : 
 
 The United Household is very much pleased with your 
 epistle and its frank criticisms of our vocabularial Conserva- 
 tive friends. It is a great pity that I am stiU a member of 
 the Council and cannot write to the Times to show up these 
 silly idiots, who I see are now starting a third — or is it fourth ? 
 — association. It really has a comic side, although to see 
 our trade-union in the hands of such riotous folk is enough 
 to make the gods weep. I do not yet see the limits of their 
 ' influence,' and cannot yet gauge the loss of prestige which 
 we shall suffer as a profession ' operating ' human affairs. 
 
 At the end of 1912, he writes to a grateful patient, thank- 
 ing her for a Christmas gift, a silk necktie : 
 
 Not having ready at hand an adequate stock of adjec- 
 tives to describe correctly the exquisite new line in ties you 
 sent me, I paused for breath. My efforts at recovery were 
 interrupted by the now unfortunately successful attempts 
 of our Tory friends who run the B.M.A. to commit suicide. 
 As they are all Tariff Rcfomicrs, poor things, they naturally 
 cannot see far in front of their noses, and consequently 
 they resolved on Monday {a) to violate our six Cardinal 
 Points and pledge, (6) negotiate with the insured persons, 
 ignoring the Government. 
 
 Clearly they lived in a lotus atmosphere, the world forget- 
 ting, for as a matter of fact the insured persons have no 
 spare cash, and the Government was to provide the funds ! 
 Can you imagine 182 Bonar Laws in one room talking such
 
 PROFESSIONAL POLITICS 229 
 
 drivel ! However, there we are. My only joy is to gaze 
 upon your present with admiration.* 
 
 He remained on the Association's Sub-committee for 
 the Medical Inspection of School Children ; and gave help 
 over this or that point of affairs, when he was asked. But 
 his faith in its Council had been injured past repair. Indeed, 
 if it comes to talking of ' the Great Betrayal,' as it was called 
 in December 1911, we might say that he had been not the 
 traitor but the betrayed. 
 
 In 1913, he was still at work over the tangle of difficulties 
 involved in the Act. He writes to Dr. Mary Sturge of 
 Birmingham, February 10, 1913 : 
 
 I don't believe myself there are any substantial grievances. 
 There are some friction-points, of course, like in all new 
 boots. For the record system, the card-index is I under- 
 stand to be substituted. I do not quote the East End 
 doctor, but what is a more trying case, namely the country 
 doctor. What the deficit is, if any, we shall find out in the 
 working of the Act ; and by the working of the Act alone 
 can we find out. Why imagine results ? Let us work and 
 find out the proper figure. The Government cannot refuse 
 it. I shall be delighted to speak ; but at present it looks 
 as if the nursery motto of ' Speak when you are spoken to ' 
 is best. 
 
 * At Christmas time, 1913, he writes thanking her for another tie : 
 ' Hardy annuals are most agreeable, and to present needs most opportune 
 and likely to be tested, since I am just off to Norway with my family 
 to a snow hotel 4000 feet up, and where we are told the snow is now six 
 feet deep. I shall without doubt be identified when found by the briUi- 
 ancy of my tie. So you will have done more than one noble act by your 
 labours and sacrifice. Why you go about, and yet no nimbus discernible, 
 baffles me : but of course we have not employed Mr. Stead's photographer. 
 Probably a well-ordered plate would show the nimbus, especially one 
 of such spiritual character, most distinctly ; and no mere ring, but a good 
 4th century 6-in. broad one.'
 
 VI 
 
 The Fight against Alcohol 
 
 It is a common belief that physicians and surgeons who are 
 opposed to the use of alcohol have slowly made up their 
 minds, by observation of many patients and feeling of 
 many pulses. Horsley made up his mind, in boyhood, by 
 observation of himself ; which may be the best way of all. 
 He was reading for one of his examinations, and found that 
 he could read better of an evening if he took neither beer 
 nor wine at dinner. At University College, he and his friend 
 Walter Pearce upheld the cause of total abstinence, in 
 debates and in talk. Doubtless his influence would have 
 been greater, if he had not also been opposed to smoking, 
 and to the use of ' condiments ' : but any fellow-students 
 who put his abstinence from alcohol on a level with these 
 other abstinences did not properly know what they were 
 looking at. 
 
 On October 4, 1882, he gave a lecture to the St. John 
 Baptist Total Abstinence Society, entitled ' Is Alcohol a 
 Food ? ' This is the earliest record of his lecturing which 
 has come to hand. In 1886, at a meeting of medical students, 
 arranged by the British Medical Temperance Association, 
 he spoke of ' the immense public influence which medical 
 men could wield, both politically and socially, in promoting 
 sobriety.' In January 1887, at a meeting of the National 
 Temperance League, he spoke of experiences of Hospital 
 hfe : he said that in London 90 per cent, of the injuries 
 admitted on Saturday nights to Hospitals might be attri- 
 buted to drink : that in two Hospitals known to him every 
 admission, on Boxing Day, 1886, had been due to drink : 
 that as small-pox and rabies were kept down by law, so 
 ought law to restrict the drink-trade. 
 
 280
 
 LC.C. Slums l^-'cui Drink Trade . 
 Drink S hops . South wark .w;. Tabard S- Dis : rict. 
 
 ^^^ 
 
 ^"SES.^.p^^,L.o=OlHCR"ON".B.O|-r. 
 
 
 Map of Southwark Area. From Horsleys Presideiuial Addrcoo 
 to the National Temperance Federation, 1914.
 
 THE FIGHT AGAINST ALCOHOL 231 
 
 In 1888, a man working with him put this question to 
 him — I have tried to give up both alcohol and tobacco : 
 I find that I cannot give up both : which ought I to allow 
 myself ? Horsley wrote back : 
 
 August 23. Smoking, of course. But I dare say you 
 don't really care to go back to it : the stale odour is too 
 dreadful. Re your consumption of alcohol. You must 
 not misunderstand me. It may be, for aught I know of 
 your internal mechanism, that alcohol may be necessary 
 to you as a drug. If, as it seems, you take it rather as a 
 hypnotic, I would very strongly recommend you to try 
 food instead : and if you can take it I think that there is 
 nothing in the world so good as hot milk and biscuits, about 
 half an hour before bedtime. If this is unpalatable to you, 
 take what you Uke : but it must be digestible within a short 
 time. Write again when you have made the experiment : 
 but I must not give you much advice in absence of knowing 
 what your constitution is. October 22. I am so glad you 
 are better, and so soon. The disappearance of alcohol and 
 tobacco is apt to make their absence painful for months 
 rather than weeks. 
 
 In 1892, he became a Vice-President of the National 
 Temperance League ; and gave an address, at its annual 
 meeting, on alcoholic paralysis, and on the reduction of the 
 use of alcohol in Hospital practice. He always had a 
 special hking for his chart of the alcohol coming down, 
 and the milk going up, through fifty years, in seven great 
 Hospitals in London : their total annual expenditure fall- 
 ing, in alcohol, from £8000 to £1200, and rising, in milk, 
 from £3000 to £12,000. 
 
 In 1896, he was asked to be President of the British 
 Medical Temperance Association. 
 
 About 1898, he accepted without reserve the evidences 
 of science that even very small quantities of alcohol hamper 
 the machinery of the brain. Innumerable experiments, by 
 Kraepehn and Aschaffenburg and others, carefully planned 
 and controlled, and extended over a period of ten years, 
 had proved that a dose of alcohol speeds up, for a few 
 minutes, the simpler acts of consciousness, and then retards 
 them for some hours : but it retards the more complex acts 
 right away, without any prehminary speeding up. For
 
 232 SIR VICTOR HORSLEY 
 
 example, it enables a man, for a few minutes, to be quicker 
 at answering a word or a signal suddenly given to him ; and 
 then, for some hours, it makes him slower at answering : 
 but it retards, right away, his power of doing sums in his 
 head, memorising sentences, and associating ideas one with 
 another. 
 
 On these and the hke observations, and on other evidences 
 and arguments, Horsley founded his behef that even those 
 non-abstainers who are strictly temperate are doing hann 
 to themselves : and in 1900, when he gave the Lees and 
 Raper Memorial Lecture, he put the whole case for science 
 against the non-abstainers. The lecture is published in 
 pamphlet form, under the title ' The Effect of Alcohol on 
 the Human Brain.' He began with a statement of his 
 theme : 
 
 I propose to summarise the work that has been done 
 most recently on the effect of taking into the body, not 
 of large doses of alcohol (for we all recognise that as in- 
 jurious) but of those small quantities which are ordinarily 
 used at meal-times and are spoken of as dietetic. 
 
 He described the anatomy of the brain, and the structure 
 and arrangement of its cells and fibres, and showed lantern 
 photographs of them. Then he came to the work of Krae- 
 pelin and Aschaffenburg ; his own experiments with anaes- 
 thetics, long ago, on himself ; the use of Kraepelin's tests, 
 which he demonstrated to the audience ; the special action 
 of alcohol on the cerebellum ; and the degenerative changes 
 in the brains of drunkards. He was careful to say that 
 these gross and ruinous changes occur only in extreme 
 alcohohsm ; he appealed not to the evidences of the post- 
 mortem room, but to the dehcate measurements of a man's 
 quickness of response and strength of grip ; and to the 
 rather vague deductions which are drawn from the action 
 of alcohol on lower forms of life : 
 
 The practical argument for total abstinence is based on 
 the irrefutable proofs derived from physiological investi- 
 gation. . . . From a scientific standpoint, the contention 
 which we have so often had put before us by our friends, 
 that small doses of alcohol, such as people take at meals. 
 Lave practically no deleterious effect, cannot be main-
 
 THE FIGHT AGAINST ALCOHOL 233 
 
 tained. . . . We can only come to one conclusion, that 
 from a scientific standpoint total abstinence must be our 
 course if we are to foUow the plain teaching of truth and 
 commonsense. 
 
 It may be wrong to divide into periods the record of his 
 fight against alcohol : but this lecture seems to mark the 
 end of what may be called his early period. He now had 
 evidences against temperance — we must not play fast and 
 loose with words : total abstinence may or may not be a 
 better thing than temperance, but it is not the same thing 
 as temperance — evidences which to him were ' irrefutable 
 proofs.' They are of no light weight : but he is begging 
 the question, when he calls them physiological. They 
 are physiology vitiated by experimental psychology. His 
 appeal to science is up against the temperate man's appeal 
 to individual experience, to the only hfe, his own, of w'hich 
 he has first-hand knowledge. By innumerable experi- 
 ments in psychology, it has been proved, that the equivalent 
 of the temperate man's wine or beer at dinner or supper 
 slows ' ideation ' ; the adding up of figures, the memorising 
 of sentences, and so forth. The temperate man can still 
 answer, ' But I am fairly sure that it does not slow, but 
 quickens, my evening's enjoyment of music, reading, home- 
 hfe. I add up and memorise, all day long, in the City : 
 if that be what you call ideation, I say that I mean 
 something different, of an evening, from that.' On this 
 borderland between collective experiments and individual 
 experience, neither the total abstainer nor the temperate man 
 is moving among physiological facts : they are both of them 
 arguing from psychology, the one from observations made 
 on great numbers of men, the other from observations made 
 on himself. 
 
 II 
 
 After 1900, Horslcy led the fight against alcohol in this 
 coimtry. It had many leaders, but none quite equal to 
 him, with his authority in science and practice, his mastery 
 of the art of lecturing, his constant use of a wealth of dia- 
 grams and kintcrn-shdcs, his courtesy toward his audiences ;
 
 234 SIR VICTOR MORSLEY 
 
 he knew exactly how to keep the happy mean between tall 
 talk and condescending talk, and how to answer questions. 
 It is possible that he did not make enough of the fact that 
 our bad habits mostly contain something which must be 
 called our own fault. It is possible, also, that his lectures 
 would have been the better for more lightness : there is a 
 pleasant touch of relief in one of them, where he describes 
 our three most British institutions, John Bull, Father 
 Christmas, and Henry viii, as examples of fatty degenera- 
 tion due to chronic alcoholism : but these touches are rare. 
 He was, of course, in great demand ; and it is only a few 
 of many occasions which can be noted here. 
 
 In 1902, at the ' temperance breakfast ' of the British 
 Medical Association,^ he spoke on the Peel Report. Here, 
 of all questions, he said, was a medical question : yet the 
 Report, from cover to cover, dealt with drink as a purely 
 social question. It was the duty of the medical profession 
 to make everybody see that drink was essentially a question 
 for science to decide. And, as a matter of science, the 
 profession ought to be more strict over the wording of death- 
 certificates : they ought to name chronic alcoholism, in 
 every case where it had been a cause of death : no exact 
 figures of the mortality from drink had been given to the 
 Commissioners. 
 
 In 1903, at a Sunday meeting in St. James's Hall, he 
 spoke of the new temperance movement in France ; and 
 opposed the pohcy of compensation in our country : ' Why 
 should we compensate people for doing us harm ? ' Be- 
 sides, grocers' licences had been thrust on the community : 
 ' What are we going to do with them ? Are we going to 
 compensate the grocers too ? ' In 1903 also, at the Medical 
 Institute of Binningham, he gave an address on Alcohol 
 and the Medical Profession. They knew, he said, better 
 than any class of men, the evils of alcoholism ; they saw 
 
 • Long before 1902, this breakfast had become an event of each annual 
 meeting of the Association. He was always keen for its success, and 
 enjoyed speaking at it : for example, in 1892, ho denounced the adver- 
 tisements of secret remedies against alcoholism. It was not an official 
 event, and it needed men like him to run it in the earlier years : he writes 
 so late as 191 1, ' I have always till the last two years had to watch its 
 welfare.'
 
 THE FIGHT AGAINST ALCOHOL 235 
 
 what went on behind the scenes of the social hfe of the 
 nation ; they knew not only that the number of deaths 
 from chronic alcohohsm was far greater than the number 
 pubhshed, but that moral deterioration from drink came 
 long before the bodily signs of drink : and he thought that 
 medical men ought to take up a much stronger position — 
 that they ought to say, when patients asked whether it 
 would not be wise to take a little alcohol, ' No, it is not 
 wise.' 
 
 In Birmingham, Dr. Mary Sturge asked him to meet Miss 
 Lowenstein, who wanted his help to get the teaching of 
 hygiene and temperance introduced into schools, by means 
 of a petition from the medical profession to the Board of 
 Education. He set to work at once ; a strong Committee 
 was formed in London, with Sir William Broadbent as Chair- 
 man ; a petition was sent for signature to every practitioner 
 in the United Kingdom ; and Miss Lowenstein came to 
 London, ' to fetch and carry.' She remembers him at 
 Cavendish Square, one evening, coming in just at dinner- 
 time, and asking her to get out some papers. ' The gong 
 \nll sound in a minute,' she said. ' And why should we 
 waste a minute ? ' he said ; and took the papers to the 
 dining-room, corrected a proof with his left hand, fed him- 
 self with his right, and joined in the talk — ' it was always 
 easy to him to do two or three things at the same time ' — 
 or, as Charles Beevor said, ' Horsley has three brains.' The 
 number of answers from practitioners was 14,118. Then 
 came the long business of a detailed scheme for the teach- 
 ing of children of various ages ; the preparation of a coun- 
 terblast to Sir Michael Foster's syllabus ; and the siege of 
 the Board of Education. ' It took three separate deputa- 
 tions, at long intervals,' says Dr. Mar}' Sturge, ' before the 
 door opened even a crack. Finally, on the third occasion, 
 after a serious and rather indignant speech from Sir Thomas 
 Barlow, the Minister of Education remarked that he could 
 not understand why anything so obvious had not iK'cn done 
 before. Victor Horsley spoke at all the deputations : and, 
 at the last, he gravely urged the Board of Education to 
 appoint a Medical Olficer, and described how long the
 
 236 SIR VICTOR HORSLEY 
 
 British Medical Association had desired this improvement. 
 Soon afterwards, Dr. George Newman was appointed.' 
 
 In 1906, in Toronto, at the great temperance meeting 
 held during the Association-week, Horsley spoke of the 
 reduction of alcohol in Hospital surgical practice as one of 
 the results of Lister's work : 
 
 I would remind you that the introduction of antiseptic 
 surgery, or rather, its more general use, occurred about 1882. 
 In fact, I am an example of traditional architecture myself, 
 because I was brought up in a septic atmosphere, which 
 gradually developed into an antiseptic atmosphere, and 
 therefore I have seen this change [the reduction of alcohol] 
 in the treatment. ... I believe that the movement really 
 began with the surgeons. ... It is one of the innumerable 
 benefits which have resulted from the discovery of a great 
 principle by a great discoverer. Antiseptic surgery ren- 
 dered unnecessary the treatment of cases as before with 
 alcohol. 
 
 It went further than that in my own Hospital. At Uni- 
 versity College, when I was a student, it was still the custom 
 to give every patient who was going into the theatre three 
 or four ounces of brandy. That was the custom ; it was in 
 apostolic succession from the time when anaesthetics were 
 not known. . . . 
 
 Then of course as regards post -operative conditions again, 
 during the last twenty years we have had a whole armamen- 
 tarium of drugs which serve our purpose far better, in getting 
 rid of shock, than anything like alcohol, which has a long- 
 continued and too depressing effect. 
 
 In 1907, he and Dr. Mary Sturge published their book, 
 ' Alcohol and the Human Body.' It is a great store, close 
 packed and well arranged, of references and evidences from 
 chemistry, physiology, pathology, psychology, and economics 
 — from the Navy and the Army, industrial life, hospitals, 
 insurance companies, and reports by medical officers of 
 health and public registrars — the whole argument enforced 
 with sayings of men whose names are familiar as household 
 words. Here, at last, was the long-needed supply of muni- 
 tions for the fight against alcohol. The plans for the teach- 
 ing of hygiene and temperance to children, over which 
 Horsley worked for years and years, had brought the need 
 of a manual for the teachers : and Dr. Sturge had suggested 
 to Horsley the writing of the book. She says of it :
 
 THE FIGHT AGAINST ALCOHOL 237 
 
 Forthwith, hohday time though it was, he began to decide 
 the chapters, and settle the scheme of the volume, insisting 
 on putting the nervous system first in the book. 
 
 This combined work went on for three years, chiefly on 
 Sundays, when, after a surgical morning at Queen Square 
 and elsewhere, and a dash in the car with his children to 
 look at the outside of the Tower of London, or possibly 
 a walk with them in the Zoological Gardens, he would try 
 to settle down for an hour or so to the book. Mostly, it 
 was written in the drawing-room, while family music went 
 on as an enjoyable undercurrent — interrupted of course 
 by the telephone, and by enquiries from Lady Horsley as 
 to the answers required to manifold urgent letters. Callers 
 were rare in that busy house, although foreigners dropped 
 in, and young medical men, or often Americans who were 
 at the time working in his laboratory : these all received a 
 cordial welcome and were at once included in the family 
 group. On such occasions the junior partner in the book 
 was apt to vanish in despair, to such time as Sir Victor 
 came to look for her and to report either the coast clear or 
 himself willing to work in a quieter room. 
 
 We had about equal shares in the work for the first edition : 
 but it was Sir Victor who provided the added matter of all 
 the later editions : he always carried about on holidays — 
 and out to Egypt — a copy of the book, into which he pinned 
 everything that he might wish to add. Requests from 
 India led us to add a chapter on Alcohol and Tropical Con- 
 ditions, which he wrote, and submitted to Sir Leonard 
 Rogers.* For the edition of 1915, he wrote, with much 
 else, the chapter on Alcohol and the Services. Thus, the 
 greater part of the book is of his making. It was a con- 
 stant matter of satisfaction to him that the Drink Trade, 
 as he always called it, had never been able to refute one 
 line of the book. 
 
 Among his papers, are more than a hundred answers to a 
 circular which he sent, in March, 1907, to the Head Masters 
 of our chief schools, asking them (i) Is it the general custom 
 for the boys in your school to drink alcohol {i.e. beer, wine, 
 
 » Sir Leonard Rogers writes to him, from the Medical College, Calcutta, 
 November 29, 191 4 : ' You may be interested to hear my personal experi- 
 ence. I came out to India just twenty-one years ago ; and soon after, 
 when dining with eighteen K.A.M.C.oHiccrs, I wa.siuske<l what I wouhl drink; 
 and when 1 replied that I did not care for any alcohol, althougli I liavc 
 never been a signed teetotaler, I was told I sliould be dead in a year if 
 I did not take any. I replied that I would sec if that was the case or 
 not : and I have never taken any alcoholic drink since. ... I have 
 rarely worked less than ten hours a day. Of course I have a good con- 
 stitution : but I am certainly not the worse for having taken no alcohol, 
 and am probably much better without it.'
 
 238 SIR VICTOR HORSLEY 
 
 etc.) or water, at their principal meal ? (2) If the use of 
 alcohol is exceptional, what percentage of the boys take it ? 
 By 1915, the year of the fifth edition, 20,000 copies of 
 the book had been issued. It has had influence far and 
 wide. A separate edition was issued for Sir William 
 Hartley to give away broadcast. The Tasmanian Temper- 
 ance Alliance ordered 400 copies, and gave them to the 
 libraries of all the pubUc schools in Tasmania. A school- 
 master in Oomaru, New Zealand, ordered 20 copies for 
 his senior science form, and wrote to Horsley : 
 
 It is my earnest endeavour to win all the boys (230) of 
 this school, year by year, to total abstinence, and to fortify 
 them with sound scientific arguments. One half the 
 school have already signed the pledge of total abstinence, 
 and the rest will fall into line as our scientific teaching 
 convinces them. 
 
 Indeed, the book so attacks and pursues the non-abstainer 
 that it seems to leave him no hole or comer to creep into. 
 There is no refuge for him in the fact that alcohol may be 
 regarded, after all, as partaking, in some remote way, of 
 the nature of a ' food ' ; the claims of alcohol, qud alcohol, 
 to be called a food rest on the deep scientific meanings of 
 that word, which are known to the physiologists only ; 
 he is well aware that he does not take wine or beer as food, 
 and that they do not nourish him as bread and milk and 
 bacon nourish him. Perhaps his best chance is to hide 
 himself in that individuahsm which science is apt to over- 
 look. He can say that the results of a glass of wine on him 
 are altogether out of the reach of science ; he might even 
 say to science, ' Who would have thought, sixty years ago, 
 that the husks of rice — not the grain, but the husks — contain 
 a ferment which is essential to health ? Who would have 
 thought that beri-bcri, which has killed nobody knows how 
 many thousands of human beings, comes of a diet of rice 
 deprived of its husks by milling ? The results of wine on 
 me are just as subtle as the results of rice-husks on a native 
 of the Malay States.' He might thus far dare science to 
 contradict him : but he had better not venture on gener- 
 alities against this classic of the hterature of total abstinence.
 
 THE FIGHT AGAINST ALCOHOL 239 
 
 In January 1908, Horsley spoke in Belfast at the Jubilee 
 meeting of the Irish Temperance League. 
 
 In 1909, the International Congress on Alcoholism was 
 held in London : and he was asked to be President of the 
 International Association of Abstaining Physicians. In 
 January of this year, he gave an address, at Wliitefields 
 Tabernacle, on Alcohol and the National Life. It contains 
 his douTiright statement, ' I mean, by temperance, total 
 abstinence ' ; and his estimate of a man's right to please 
 himself : 
 
 Our friends take alcohol in small quantities, because it 
 gives them pleasure, because they like it. I want to suggest 
 that such men should reform their ideas of their pleasures, 
 because, when you come to consider the universal good- 
 ness of human nature — I am not a believer in the badness 
 of human nature — when you come to consider that every- 
 body has in them a majority of good as compared with evil, 
 it is impossible that such friends can have examined into 
 the question of what really constitutes pleasure, if they 
 go on saying that they take alcohol because they like it 
 as a pleasure-giving substance. There is no real thing in 
 hfe which may be called a pleasure unless it conduces to 
 the physical or moral benefit of the individuals of our race, 
 and this cannot be said of alcohol. 
 
 In the spring of 1910, Miss Elderton and Professor Karl 
 Pearson published, from the Galton Laboratory for National 
 Eugenics, their ' First Study of the Influence of Parental 
 Alcoholism on the Physique and Ability of the Offspring.' 
 They had obtained unexpected results, which confused the 
 issues of the fight against alcohol and bewildered the public 
 mind. An account of their method must therefore bo put 
 here. 
 
 They describe the difficulties of the investigation ; and 
 the ways in which parental alcoholism may affect the 
 offspring, (i) By direct heredity : ' The child is defective, 
 not because the parent is alcohcjlic, but because it is the 
 product — like the parent — of a defective germ-plasm. Tlie 
 child may be physically and mentally fit, and yet, when 
 adult, may exhibit alcoholic tendencies.' (2) By cro.ss 
 heredity : ' If alcohoUsm is a mark of a defective germ- 
 plasm, that defect may take one form in one individual of
 
 240 SIR VICTOR HORSLEY 
 
 the stock, and another form in a second. Such associated 
 lieredities are well known to the student of insanity and of 
 human deformities.' (3) By enfeeblement of the physique, 
 or possibly of the germ-plasm, of the parents, with alcohol. 
 (4) By poverty, neglect, and unwholesome surroundings at 
 home. 
 
 They are not concerned with direct heredity, for they 
 are dealing only with children, not yet of an age to exhibit 
 alcoholic tendencies. Prohibition of the sale of alcohol 
 would not remedy the influence of cross heredity : ' it 
 could only be met by the prohibition of parentage for 
 members of affected stocks.' The evils of sdcohohc en- 
 feeblement would be stopped at once by complete prohibi- 
 tion of alcohol. The evils of environment would be met 
 either by complete prohibition of alcohol or by removal of 
 the children from home. ' Surely it is worth while to get 
 some hght on these points, before we tackle this great 
 problem of alcoholism.' 
 
 Next, they define their use of certain words : 
 
 By the term ' alcoholism,' in this paper, is not neces- 
 sarily meant the ' chronic alcoholism ' of medical htera- 
 ture. We believe that many, possibly the majority, of our 
 drinking class would be found to suffer more or less from 
 chronic alcoholism ; they at any rate in the opinion of 
 trained social workers — assisted by the judgment of police 
 and employers — are drinking more than is good for them 
 or their homes. On the other hand, by ' sober ' is not 
 meant total abstinence, but cases in which the use of alcohol 
 is so moderate, if it exists, that it does not appear to inter- 
 fere with the health of the individual or the welfare of the 
 home. Such then is the distinction between ' parent drinks ' 
 and ' parent is sober ' of the following investigation. ' Parent 
 has drinking bouts ' denotes a third well-marked class from 
 the standpoint of the social observer ; namely, periodic 
 outbursts of alcohohsm, usually marked, when they occur, 
 by more obvious immediate detriment to health, and more 
 intense dcstniction of home welfare, e.g. discharge from 
 emplo}Tncnt, or visits to the police court. 
 
 They take two sets of statistics : (i) the Report of the 
 Edinburgh Charity Organisation Society, (2) an account 
 of the children in the special schools of Manchester, by Miss 
 Mary Dendy. They examine these evidences, point by
 
 THE FIGHT AGAINST ALCOHOL 241 
 
 point ; and they come to conclusions, some of which neither 
 they, nor anybody else, had expected : 
 
 1. There is a higher death rate among the offspring of 
 alcoholic than among the offspring of sober parents. This 
 appears to be more marked in the case of the mother than 
 in the case of the father : and since it is sensibly higher in 
 the case of the mother who has drinking bouts than of the 
 mother who habitually drinks, it would appear to be due 
 very considerably to accidents and gross carelessness, and 
 possibly in a minor degree to a toxic effect on the offspring. 
 
 0\ving to the greater fertility of alcoholic parents, the 
 nett family of the sober is hardly larger than the nett family 
 of the alcoholic. 
 
 2. The mean height and weight of the children of alcoholic 
 parents are shghtly greater than those of sober parents : 
 but, as the age of the former children is shghtly greater, 
 the correlations when corrected for age are shghtly posi- 
 tive, i.e. there is shghtly greater height and weight in the 
 children of the sober. 
 
 3. The wages of the alcohohc as contrasted with those 
 of the sober parent show a shght difference, compatible with 
 the employers' dishke for an alcohohc employee, but wholly 
 inconsistent with a marked mental or physical inferiority 
 in the alcoholic parent. 
 
 4. The general health of the children of alcohohc parents 
 appears, on the whole, shghtly better than that of sober 
 parents. There are fewer delicate children, and in a most 
 marked way tuberculosis and epilepsy are less frequent than 
 cimong the children of sober parents. The source of this 
 relation may be sought in two directions ; the physically 
 strongest in the community have probably the greatest 
 capacity and taste for alcohol. Further, the higher death 
 rate of the children of alcohohc parents probably leaves the 
 fitter to survive. Epilepsy and tuberculosis both depend- 
 ing upon inherited constitutional conditions, they will be 
 more common in the parents of affected offspring, and, prob- 
 ably if combined with alcohol, are incompatible with any 
 length of life or much size of family. If these views be correct, 
 we can only say that parental alcoholism has no marked 
 effect on filial health. 
 
 5. Parental alcoholism is not the source of mental defect 
 in offspring. 
 
 6. The relationship, if any, between parental alcoholism 
 and filial intelligence is so sliglit, that even its sign cannot 
 be determined from the present material. 
 
 Finally, they sum up. The danger of alcoholic parentage 
 lies chicliy in the direct and cross hereditary factors of 
 
 Q
 
 242 SIR VICTOR HORSLEY 
 
 which it is the outward mark : not in the enfeebUng influ- 
 ence of alcohol on the parents, nor in the bad surroundings 
 of home. And they end on a jarring note : 
 
 We fear it will be long before the temperance reformer 
 takes this to heart. He is fighting a great and in many 
 respects a good fight ; and in war aU is held fair, even to 
 a show of unjustifiable statistics. Yet the time is approach- 
 ing when real knowledge must take the place of energetic 
 but untrained philanthropy in dictating the lines of feasible 
 social reform. 
 
 This imhappy flourish of last words not only angered the 
 temperance reformers but provokes the average man. What 
 lines of feasible social reform are dictated by the theory 
 of the continuity of the germ-plasm ? The prohibition of 
 parentage for members of affected stocks is not feasible : nor 
 would it be social reform, even if it were feasible. 
 
 Among the opponents of the memoir were Professor Alfred 
 Marshall and Mr. J. M. Keynes, Dr. Kyle, and Dr. Maurice 
 Craig. For some months, Horsley kept out of the contro- 
 versy. But in 1907, a httle handful of medical men had 
 spoken up, in one of the medical journals, for alcohol : this 
 casual statement of their opinions had been used to bait 
 pubhc-houses : and Horsley may have feared that the 
 memoir also was being used for this vile purpose. When 
 he did enter into the controversy, he and others carefully 
 ransacked the Edinburgh C.O.S. Report, to get the exact 
 family-history of the 1400 school children included in it. 
 Dr. Sturge writes that ' they had imagined that at least 
 a sprinkling of real teetotalers would be found — parents 
 who had abstained from alcohol for some years before the 
 birth of their children. But it was discovered that the 
 real teetotal family, where both parents were abstainers 
 in this sense, was practically absent from the Report.' That 
 was Horsley 's strong point against the memoir : as he says, 
 in the National Temperance Quarterly, September 1910 : 
 
 The enquiry purports to differentiate between alcoholic 
 and non-alcohohc parentage ; yet there is no indication as 
 to whether the alcoholism had set in before the offspring 
 were bom I When children aged fourteen are being investi- 
 gated, we require to know the habits of the parents fifteen
 
 THE FIGHT AGAINST ALCOHOL 243 
 
 or more years previously I Yet ttiis simple precaution has 
 been entirely overlooked. 
 
 Toward the end of 1910, the authors of the memoir pub- 
 lished their defence, their ' Second Study.' They say that 
 the question, as to the habits of the parents before the 
 children were bom, is left unanswered by several writers on 
 parental alcoholism, whose opinions none the less are 
 quoted by Horsley as of the utmost authority. They say 
 also that the solution of the difficulty raised by him and 
 others 
 
 could have been found by them at once, had they studied 
 the data in our memoir. Of the alcoholic parents, a slightly 
 larger percentage of the offspring falls below five and seven 
 years of age than in the case of the sober parents, 30 per cent, 
 as against 27 per cent., and the ratio of the number of 
 children between five and seven to those between twelve and 
 fourteen is for both drinking and sober parents i-6. But if 
 the parents only became alcohohc to any sensible extent 
 after the birth of their children, it will be clear that the 
 ratio of young to old children in the case of the alcohohc 
 must be very different from what it is. 
 
 In January 1911, Horsley and Dr. Sturge published their 
 answer, ' On some of the biological and statistical errors 
 in the work on Parental Alcoholism by Miss Elderton and 
 Professor Karl Pearson.' This answer produced a ' final 
 answer.' The position of the opponents, at the end of the 
 controversy, is for experts to judge. There was not only 
 the deadlock between the passionless mind of eugenics and 
 the passionate mind of the light against the drink-trade : 
 there was also the want of agreement over the meanings of 
 words. To the authors of the memoir, the temperate non- 
 abstainer was ' sober ' : Horsley was inchned to call him 
 ' alcoholic' As Dr. MacNalty has written : 
 
 He hated compromise ; and the via media in life, wliicii 
 so many men prefer to traverse, was an abomination to liim. 
 I was working one evening at tlie microscope in Cavendisii 
 Square, and Sir Victor was discussing with Lady Horsley 
 the question of obteiining some signatures to a memorial 
 on Temperance Reform. The name of a distinguished 
 surgeon was suggested — a most temperate person, tliough 
 not a total abstainer — but Sir Victor shook his head, with 
 the comment, ' He is an alcoholic' I could not refrain
 
 244 SIR VICTOR HORSLEY 
 
 from smiling : he observed me, and his eyes twinkled with 
 fun. ' I cannot help appreciating Mac's keen sense of 
 humour,' he said. 
 
 In July 191 1, at the Birmingham meeting of the British 
 Medical Association, came a great event of the fight against 
 alcohol, the fifty temperance addresses from members of 
 the medical profession, forty-four men and six women : 
 they were given on a Sunday, and were attended by 15,000 
 persons. The arrangements in Birmingham were made by 
 the Brotherhood and federated societies, on a plan worked 
 out in London by the Horsleys and Dr. Sturge. Horsley 
 spoke, in the afternoon, on Citizenship and Temperance 
 from a medical point of view ; and in the evening, on 
 Unselfishness. He and Lady Horsley had invited all the 
 speakers to tea : he stayed to photograph his great after- 
 noon audience, came in for tea late but very happy, and 
 motored off to his evening audience. The achievement of 
 these fifty addresses in one city on one day was reported 
 everywhere. The doctors, at their great annual meeting, 
 had shown themselves willing to be public teachers. The 
 example set by Birmingham in 191 1 was followed by 
 Brighton in 1913, and by Aberdeen in 1914. 
 
 Ill 
 
 In the later years, he was not always careful to be civil to 
 this or that man who differed from him. And, as demo- 
 cracy got more hold on him, he began to make more use of 
 this argument against drink, that it was a wrong done to 
 the people by the enemies of the people ; a steady poison 
 thrust on the poor by wealthy brewers and distillei-s, and 
 sold everywhere under the protection of the Government. 
 In the earlier years, he had mostly been concerned with the 
 evidences of science, and with the witness of his profession. 
 In the later years, he was more concerned with the ethics 
 of the whole business ; his hatred of drink began to be 
 touched with denunciation of those who made drink, sold 
 it, or profited by it : and he was often speaking to audiences 
 that preferred pohtics to science.
 
 THE FIGHT AGAINST ALCOHOL 
 
 245 
 
 The number of his pohtical and temperance addresses in 
 the later years, and the range of them, are amazing. Here 
 are two months, from his engagement-books ; one before 
 the War, the other during the War : 
 
 January g. 
 .. 13- 
 
 16. 
 ., 17- 
 ,. 19- 
 
 20. 
 21. 
 22. 
 25- 
 
 26. 
 
 27. 
 29. 
 
 1913 
 
 Temperance Lecture : Belle Isle. 
 
 Finance : or how money has to be got for 
 nation's needs. 
 
 Temperance Lecture at Deal. 
 
 Market Harboro' meeting. 
 
 (Sunday.) Lecture to South-West Ham I.L.P. 
 Subject, The Feeding of School Children : 
 and Clinics. 
 
 Islington Health League. 
 
 West Leicester and Harborough. 
 
 Quarterly meeting Land Values. 
 
 Islington Health League. Lecture on Tuber- 
 culosis. 
 
 (Sunday.) Plaistow. Lecture on Feeding 
 School Children. 
 
 Edmonton Central Hall. Temperance Cam- 
 paign. 
 
 Oxford. Temperance Lecture to Under- 
 graduates. 
 
 1915 
 
 January 3. (Sunday.) P.S.A., St. George's Presbyteri.m 
 Church, Southend-on-Sea. 
 ,, 8. Temperance League, Paternoster Row. 
 
 9. National Commercial Temperance League, Ilford. 
 ' Total Abstinence the only true Patriotism.' 
 II. Address to soldiers and friends, Dc Walden 
 Ch. Institute, Regent's Park. 
 ,, 13. Temperance Conference, Caxton Ilall. 
 
 24. (Sunday.) P.S.A., Kingsway Ilall. ' I low to 
 prevent another War.' 
 ,, 26. Church Lecture Hall. 
 
 28. Aldershot, A.S.C. Theatre. 
 „ 31. (Sunday.) P.S.A., Woolwich. 
 
 There must be many ' ofticial lecturers ' well paid for 
 doing less, though they be doing nothing else. 
 
 In 1913, by the unanimous vote of the Executive Com- 
 mittee, he was elected President of the Nation^U Temperance
 
 246 SIR VICTOR HORSLEY 
 
 Federation. This great Federation, founded in 1884 by 
 the union of thirty associations for temperance or for total 
 abstinence, has a membership of two and a half millions. At 
 the Annual Meeting in February, 1914, he gave his Presiden- 
 tial Address. He spoke (i) of the danger of ' disinterested 
 management,' with special reference to the superiority of 
 Norway in temperance legislation, (2) of that old grievance, 
 the trade in medicated wines, (3) of the action of the Insur- 
 ance Commissioners toward the meeting of approved 
 societies on licensed premises. Of the trade in medicated 
 wines, he said that 
 
 The point of view of the medical profession was, that 
 alcohol was being discreditably thrust ufx)n the people vid 
 the medical and nursing profession. . . . The medical pro- 
 fession, so far as it had gone, had cleared itself of complicity 
 in this dreadful business. The British Medical Journal had 
 refused to insert advertisements of these wines : but it had 
 done more, it had published analyses of them, and had 
 invited the general press to insert its advertisements of 
 exposure ; but many leading papers had refused. There 
 was really no protection for the public, except by the action 
 of the medical profession. 
 
 He soon had further ground for complaint : for in June, 
 1914, the proprietors of a medicated wine brought an action 
 against some medical men who had pubhshed a pamphlet 
 saying what they thought of it, and got ;f25o damages : 
 they had claimed £5000. 
 
 With the War, came the fight against the rum ration. 
 He was in the wrong here : he spoke and wrote in a style 
 unworthy of him : besides, the attempt of the Temperance 
 Societies to stop all issue of rum to our men at the front 
 ought never to have been made. He was quick to admire 
 everything else that was being done for the welfare of the 
 Army. ' The present campaign,' he wrote early in 1915, 
 ' with the single exception of the rum ration, has been 
 fought on physiological and, one might almost say, on ultra- 
 scientific lines. Everything that human science can suggest 
 has been brought into play by the nation.' But he was 
 horrified by the evil, in the winter of 1914-15, of the heavy 
 drinking everywhere, the increase of drunkenness among
 
 THE FIGHT AGAINST ALCOHOL 247 
 
 women, the crazy treating, all the steps of that dance on 
 the edge of a precipice — to him it was heartbreaking : no 
 wonder, that he fought furiously. On October 13, he said 
 at a meeting in Manchester : 
 
 I ask you to get the Government to help the Army, and 
 not to hinder it. We are allowing another army to hang 
 on our flank, to rob us of our reserves — the army of brewers 
 and distillers. In peace time they kill 60,000 every year. 
 The enemy put horses into the wells to poison the water 
 for our soldiers, but one of our Government departments 
 sends out poison to put into the bodies of our men. I have 
 been told on unimpeachable authority that contracts are 
 now entered into for 500,000 gallons of rum, and yet every 
 one knows that that stuff spells defeat for the British Army. 
 It saps the energy of the soldier, confuses his senses, spoils 
 his shooting, but, above all, destroys his morals and his 
 discipline. 
 
 In October, also, the National Temperance Federation 
 sent out a memorial, signed by Horsley as President and 
 Mr. Guy Hayler as Hon. Secretary. It set forth ' the con- 
 tention of the Federation, that the rum ration should be 
 immediately abandoned, and a ration of hot refreshing and 
 sustaining food suppUed in its stead.' It backed this facile 
 advice, as follows : 
 
 It is certain from the experience of previous campaigns, 
 as well as from the teaching of all scientific facts, that the 
 wonderful withdrawal of the Expeditionary Force from 
 Belgium to the Mamc would have been gravely endangered 
 if rum rations had then been issued to the troops. 
 
 A well - known Member of ParHament, to whom the 
 memorial had been sent, wrote to correct this statement : 
 he quoted a letter from a friend in the Irish Guards, wounded 
 about the fifth day of the Retreat to the Marne ; who had 
 said that but for the rum ration at night he did not think 
 the retreat could have been accomplished : 
 
 The first time that rum was issued to us was after the 
 retreat from Landrccics. We had a very long march on 
 the top of stiff fi/^'hting, and were very done. Wc had 
 also lost our kits and had to sleep on the bare ground, which 
 was wet. The tot of mm which was served to us, 75 per 
 cent, diluted with water, made us feel warm and sleepy. 
 When I was with the troops it was not served regularly every
 
 248 SIR VICTOR HORSLEY 
 
 night, only when one had had a very bad doing and needed 
 it, and it was always diluted by the Quartermaster. I 
 cannot tell you the immense difference it made to one's 
 comfort. 
 
 On this correspondence, Horsley commented : 
 
 On looking at our Memorial again, I see that we did not 
 say anything definite, but that the Retreat ' would have been 
 gravely endangered if Rum Rations had been issued to the 
 troops.' Our infomiation was to the effect that none was 
 given. He now says Some was. Our comment will be. 
 Was it ? Then we are sorry to hear it, for it grossly 
 endangered the Retreat, and now we understand why 
 there were 8000 missing ! So we have him both ways. I 
 am very glad now, as I do not trust him. . . . 
 
 On November 6, he wrote in the Manchester Guardian : 
 
 Rum rations are being issued not only to the troops in 
 France but to the recruits in England. The Army contracts 
 last month, as I showed in the Free Trade Hall on October 
 13, amounted to 500,000 gallons. The mm is not issued as 
 a drug at all, and no ' doctor's prescription ' is ever written 
 for it. It is issued by the quartermaster's department 
 as an intoxicant, and even only one-half of the amount 
 given to each soldier causes a falling off of from 30 to 50 
 per cent, in the accuracy of his shooting, besides other depre- 
 ciation of his efficiency. 
 
 On December 3, he wrote to Admiral Sir George King- 
 Hall, on the rum ration, and on the popular fallacy that 
 drinking water, with spirit added to it, cannot convey 
 infection : 
 
 Many thanks for your valuable letter, which came as a 
 refreshing counter to another I had from a hard-worked 
 clergyman, who had been told by an officer that the men 
 in the trenches ' must take their rum to continue alive during 
 exposure in the trenches ' ! 
 
 This really ridiculous as well as false statement is entirely 
 due to the most recent Army Regulations — see 8/Allow- 
 ances/89, 1914, p. 16, Reg. 34 — which says the rum ration 
 ' may be issued under the authority of the G.O.C. when 
 certified (!) by the senior medical officer to be absolutely 
 necessary for safeguarding the health of the troops ' I I 
 
 When such outrageously false statements are made in the 
 King's Regns., a poor clergyman may well believe all the 
 yams he hears from the front.
 
 THE FIGHT AGAINST ALCOHOL 249 
 
 The point you raise is another well-worn mis-statement. 
 The fact is, that water containing infective microbes cannot 
 be sterilised by adding the rum to it. The best case I know 
 of was during the Caterham epidemic, 1879. A groom 
 rode into Caterham from a place 10-12 miles off, and drank 
 a glass of whisky and water. He returned forthwith to 
 his master's house, and punctually on the tenth or eleventh 
 day developed his typhoid, to the extreme astonishment of 
 every one, especicdly his doctor, who worked out the cause. 
 I hope you will denounce this cruel and dangerous fiction. 
 
 On January 9, 1915, at a temperance meeting at Ilford, he 
 spoke of the great decrease, of late years, in the amount of 
 mm issued to the Navy : the rule had come into force that 
 every sailor desiring the mm ration must apply for it, and 
 that those not applying should receive ^V of a- penny a day 
 instead of it : 
 
 Rum drinking in the Navy was dying out ; and this was 
 shown by the fact that the log in days gone by was marked 
 T against the extraordinary person who was a teetotaler, 
 but to-day the letter marked in the book was G showing 
 those who required grog. 
 
 This month w^as a heavy uphill time : as it is noted in his 
 letters to Mr. Hayler : 
 
 January 12. I received a telegram last night from Boulogne 
 that my second son was there wounded, and I must see him 
 to satisfy myself. My intention is if possible to return 
 by the afternoon boat. January 19. This wretched Influ- 
 enza has washed out of my memory many things, including 
 the enclosed draft. February 2. Unfortunately, having to 
 give addresses and lectures when not quite recovered from 
 an influenza attack, I am now hors de combat with acute 
 pharyngitis. 
 
 On January 30, he published in the British Mtdical Journal 
 his article, ' The Rum Ration : the alleged responsibility 
 of the medical profession for its reintroduction.' It was 
 reprinted, and quoted everywhere : letters thanking him 
 for it came even from the United States, India, and China. 
 It begins with an account of the introduction of rum into 
 the Army : 
 
 The spirit-drinking habit was first contracted by tlie 
 British Army in Flanders during Marlborough's campaign 
 at the beginning of thr eighteenth cmtury. ... It was
 
 250 SIR VICTOR HORSLEY 
 
 during the eighteenth century that the spirit ration became 
 part and parcel of the soldier's diet, and hideous punish- 
 ments — that is, floggings and other tortures — were inflicted 
 in order that discipline (so-called) should be preserved 
 among the unfortunate men whose morale was ruined by 
 the rum given to them by their superiors. 
 
 Then, the evidence, early in the nineteenth century, of Sir 
 James McGrigor, Inspector-General Fergusson, and many 
 others, proving grave harm done to the health of troops by 
 the issue of spirits. Then, the Crimean War : 
 
 The disasters of the Crimea campaign, in which rum was 
 regularly issued, and the effect of many years of condemna- 
 tion and protests by mihtary hygienists and authorities, 
 caused a cessation of the rum evil until about thirty years 
 ago, when the rum ration was specifically declared by the 
 Regulations to be reserved for the exceptional occasions of 
 flying columns. Even in 1897, the issue of rum was made 
 under the Army Regulations, and each ration was obhged to 
 be paid for — namely, id. by the man receiving it . . . The 
 pernicious rum ration is now completely restored to the 
 Regulations and dietary of the soldier, to his injury and 
 ruin. 
 
 He criticises and condemns the rule as it stood in 191 5. 
 ' The rum ration in France,' he says, ' is not issued on " very 
 exceptional occasions," but every day ; and in one case 
 which has come to hght it was issued twice a day. The 
 practice differs according to the views of the officer com- 
 manding a unit ; but from being sporadic, as ordered in 
 the Regulations, it has now become epidemic and constant 
 up to the present date.' Finally, he gives a list of its ill- 
 effects : 
 
 The following physiological effects have been observed 
 by mihtary and naval officers to follow from the issue of 
 the mm ration : 
 
 1. Decadence of morale. Causation of grousing, friction, 
 
 and disorder. 
 
 2. Drunkenness. Punishments. Degradations in rank. 
 
 3. Decadence of observation and judgment. Causation of 
 
 errors and accidents. 
 
 4. Loss of endurance and diminution of physical vigour. 
 
 Causation of fatigue, falhng out and slackness. 
 
 5. Loss of resistance to cold. Causation of chilliness, 
 
 misery and frost-bite.
 
 THE FIGHT AGAINST ALCOHOL 251 
 
 6. Loss of resistance to disease (particularly those occur- 
 
 ring under conditions of wet and cold), namely, 
 pneumonia, dysentery, typhoid fever. 
 
 7. Loss of efficiency in shooting. (Half the rum ration 
 
 causes a loss of 40 to 50 per cent, in rifle shooting. 
 
 The Navy rum ration causes a loss of 30 per cent. 
 
 in gunnery shooting.) 
 That all these evils, and increase of the difficulties our 
 men have already to contend against on active service, 
 are the direct and invariable result of issuing the rum ration 
 is, of course, well known. ^ 
 
 But who are the military and naval officers ? Are they 
 of to-day ? How many of our officers, in 1915 — let alone 
 1918 — would say that grousing, friction, disorder, drunken- 
 ness, punishments, degradations in rank, decadence of 
 observation and judgment, fatigue, falling out, and slack- 
 ness, are well known to be the direct and inevitable result 
 of issuing the rum ration ? 
 
 About this time, he spoke at Eastbourne, Cambridge, 
 Fleet, Ipswich, Leeds, and Huddersfield. He was angered, 
 with some reason, by the official statements in the House 
 of Commons, March 1915, as to the difficulty or impossi- 
 bility of providing any alternative for rum to our men in 
 the trenches. 
 
 On the eve of going to France, he writes to Dr. Saleeby, 
 March 27, 1915 : 
 
 I cannot, alas, help you. I quite agree, and see that 
 vodka's character is going to be put on a level with other 
 
 ' When he says that the rum ration causes grousing, he means of course 
 that men grumbled if they did not get it : for he writes to a friend, December 
 14, 1914, ' 1 wish the W.U. people were at the bottom of the sea, for 
 I hear the men grouse most abonunably on the days wlien no rum is 
 issued.' For loss of eiliciency in shooting, he had as evidence (i) the 
 ' grog-curvo ' worked out by Captain Ogilvy, K.N., Gunnery Instructor 
 to the Navy, (2) tlio experiments made in the Swedish Army, by Stall- 
 Surgeon Mernetsch, on a large number of non-commissioned officers and 
 men, under varying conditions, and over long periods of time. Some sort 
 of answer to these evidences w;us attempted by a little society callcil the 
 ' True 'rem{)crance Association,' which made a few rather worthless 
 counter-experiments. But the i.ssue of the rum ration was not intended 
 to meet the need of accurate marksmanship. I had the honour of knowing 
 a man who for nearly three years served as a stretcher-bearer on the 
 Western Front : he was killed in iiourlon Wood ; I know that he bcheved 
 that the rum ration was not altogether useless: and I put this young Sir 
 Galahad's experience above a thousand experiments not made under the 
 conditions of actual fighUng.
 
 252 SIR VICTOR HORSLEY 
 
 spirits which are accused of poisoning people not because 
 they contain alcohol, but something extra, namely x an 
 unknown quantity. One of the worst offenders in this 
 particular was a medical officer on the West Coast, in the 
 Report to the Colonial Office. Unfortunately I am going 
 to-morrow to France to take up duty there, and so am quite 
 off the chance of finding out about vodka, but I will about 
 absinthe. Re Alcohol and the Human Body, we have just 
 completed (practically rewriting) a fresh edition. The 
 racial part always was obsolete and just patched. I am 
 just considering one rewritten chapter and shall be glad 
 of your suggestions. We are in some complex conditions 
 with the pubUshers re all these changes, but hope to struggle 
 out. Thanks for your enquiries. Our boy is here. I 
 have picked out the pieces of shrapnel from his head, and 
 it is doing well. The other boy has healed and gone back. 
 Curses on the Kaiser. 
 
 And there are two letters, one from Alexandria, the other 
 from Mesopotamia. They were written, one a few months, 
 the other a few weeks before his death. They are put here 
 in full : the first of them has already been published with a 
 dozen alterations calmly made in it ; and it is better to 
 put them in full than to hint at them ' by pronouncing of 
 some doubtful phrase.' 
 
 I. To Mr. Guy Hayler. From Alexandria, Jan. 17, 1916 
 
 I do not know what Resolutions your agenda paper may 
 contain, but I hope one will be passed asking the Constituent 
 Associations to put renewed pressure on the Government 
 and Lord Kitchener and the Army Council to withdraw the 
 rum ration, and to amend the Regulations.^ As regards 
 this second point, I believe that a Petition to the King will 
 also be necessary. 
 
 My point is that the rum ration is not only a gross injury 
 to the rank and file, but it constitutes an officially sanctioned 
 excuse for the officers' disloyalty in refusing to follow the 
 King's example. 
 
 The position in point of fact is worse than disloyalty, and 
 really amounts to insult to His Majesty as titular head of 
 the Army, for whisky and liqueurs are the rule in all messes 
 
 * Before 1916 was out, the rule came into force, ' Rum is only issued 
 to the troops at the discretion of the General Officer Commanding on the 
 recommendation of the Medical Officer. When an issue of mm is ordered 
 for troops serving with the Expeditionary Forces in the Field, individual 
 soldiers who have an objection to the spirit may be supphed with cocoa 
 or chocolate instead.'
 
 THE FIGHT AGAINST ALCOHOL 253 
 
 at all hours. Morning visitors, even on duty, are offered 
 a whisky and soda as a matter of course. As a typical 
 instance of demoralisation due to the officers drinking, 
 the following is sufficient. The Hd. Qrs. Staff closed the 
 bars in Cairo to the rank and file at 5 p.m. during the Christmas 
 days. This nearly caused a mutiny, not because the men 
 wanted more drink for themselves, but because, as they 
 said, they could not stand the sight of the officers drinking 
 heavily in the hotels after the appointed closing time. 
 The men set fire to a Staff motor car outside the chief hotel. 
 Of course this is the country of cheap alcohol, and Cairo 
 and Alexandria reek with whisky and every fonn of vice. 
 
 The British Medical Journal last summer entered a protest 
 against the scandalous whisky drinking among the ofiicers 
 of Kitchener's Army training at home. These men we are 
 now getting out here. 
 
 The lack of moral courage always has been the bane of 
 every army, and the result of it is shown in the neglect of 
 the men's comfort and health. The further result, of course, 
 in a pestilential place hke this, is a heavy sickness rate and 
 a steady loss of fighting efficiency. 
 
 Our enormous loss (about 5500 men crippled and dead) 
 from frost-bite and cold alone was due to several factors 
 in wliich alcohol not only played a prime part directly, but, 
 in my opinion, the neglect of the personal care and treat- 
 ment of the men (which also was a large factor) was due to 
 the idle satisfaction which whisky drinking produces and 
 leads a man to let things drift a bit. 
 
 The medical considerations in army affairs are so entirely 
 regulated by the combatant staff that if these officers are 
 rendered somewhat lazy by whisky, then, seeing tliey are 
 absolutely ignorant of healthy principles also, the inevitable 
 consequence is the ruin and destruction of the private soldier, 
 about whose fate many of them are absolutely callous and 
 indifferent. 
 
 2. To Mr. M. Fraser, Bon Accord, Winnipeg. From 
 Mesopotamia, May 15, 1916 
 
 I am extremely ol)liged to you for your Militai-y Poster. 
 It ought to be in tlie office of every Minister and official 
 responsible for carrying on this war. That is to my mind 
 the most distressing part of these campaigns. The directors 
 of mihtary operations are practically all wliisky drinkers, 
 and tlicrefore wish the soldier to drink too. Out here in this 
 torrid chmate they actually still issue rum instead of food 
 and sterile water, and as a result we now have cholera, 
 dysentery, and diarrhoea to contend witli. Any one would
 
 254 SIR VICTOR HORSLEY 
 
 suppose that no military surgical history had ever been 
 written or published. 
 
 Our gross failure and stupidity are in my opinion due to 
 the whisky affecting the intellectual organs and clearness 
 of our leaders. Of course they do not reahse that alcohol 
 in small doses acts as a brake on their brains. If they did, 
 they would have sufficient loyalty to follow their King's 
 example. 
 
 Fancy to yourself the position. The King is the head of 
 the Army. As he went teetotal for National safety, every 
 military mess ought to have followed him. Not one did ! 
 It is a repulsive exhibition of selfishness and luxurious 
 treachery to our Country.
 
 VII 
 
 Brotherhood Addresses 
 
 He had desired to be in Parliament, that he might be able 
 to do more for democracy, and for his profession : he would 
 have worked hard on Committees : and he would have 
 taken his place, outside the House of Commons, as a man 
 elected to speak with authority to decisive audiences. If 
 he had been returned in 1910 for the University of London ; 
 if he had steadily submitted himself to the limitations and 
 the discipUne of the House ; if he had hved to now — there 
 is no saying how high he might have risen in the world of 
 pohtics : he might well have been put at the head of the 
 new Ministry of Health, and would have done enduring 
 work for it. 
 
 Market Harborough had spoiled everything. It had 
 thrown him over : and this reverse had come when he was 
 at the worst of his unpopularity and was giving offence right 
 and left. He was kept out of one thing after another. 
 Quiet Utile committees, with nobody on them whose record 
 in science and practice could hold a candle to his, were of 
 opinion that they would ' get on better without him.' 
 Neither his own profession, nor the professional politicians, 
 dared to play him for all he was worth. Opportunities were 
 entrusted to lesser but safer men : and he was left, in the 
 world of pohtics, to find his audiences for liimself. 
 
 It is waste of time now to be wishing that he had not been 
 so lavish of his presence. He was aristocrat turned democrat : 
 he had the convert's zeal : he was content, or more than 
 content, even with audiences which were not half good 
 enough for liim. Of coui^sc, he never got to Ix; altogether 
 one with his hearers, nor to be wholly unconscious that he 
 was in rather strange company : he went to them as their
 
 256 SIR VICTOR HORSLEY 
 
 leader, not as their ' comrade ' : and they, happily, were 
 loyal to him, and proud of his leadersliip. 
 
 Some of us, disliking his pohtics, hardly troubled to study 
 his principles. We are able now to dig down closer to the 
 foundations of his political faith : we have the rough notes 
 for his Sunday afternoon addresses at Brotherhood meet- 
 ings, 1912-15, and other similar meetings. They are incom- 
 plete, written in haste, words doing duty for sentences, his 
 pen rushing across half a dozen sheets of folio paper in the 
 loose far-flung hand which was ' Horsley all over ' : but 
 on this or that occasion they were written with more care, 
 not on paper but on small cards. 
 
 The Brotherhood Movement arose in the Free Churches, 
 some thirty years ago, out of their P.S.A. (pleasant Sunday 
 afternoon) meetings. The Brotherhood now has a member- 
 ship of half a milhon. Its motto is, ' One is your Master, 
 even Christ, and all ye are brethren.' Its intention, ' To 
 be non-sectarian, and to know no party pohtics.' Its ideal, 
 ' To win the people for Jesus Christ. To lead men and 
 women into the Kingdom of God. To unite them in Brother- 
 hoods of Mutual Help. To encourage the study of social 
 science. To enforce the obligations of Christian citizen- 
 ship. To promote the unity of social service. To promote 
 international brotherhood.' The Report for 1916 says of 
 Horsley that he had been ' among the greatest of Brother- 
 hood men — apostle of the war against disease and alcohol 
 on our platforms, member of the London Speakers' League, 
 a man to whom some of our leadei-s were looking as a 
 potential National President.' 
 
 Sometimes, for an address, he would take a special 
 subject : for instance, the Guilds of the Middle Ages ; or 
 would speak on behalf of some special fund or institution. 
 More often, he took a very wide range : for instance : 
 
 Sympathy in Public Affairs. 
 The Responsibility of Manhood. 
 National Progress and Unselfishness. 
 Christian Basis of Human Action. 
 Self-Sacrifice. 
 Brotherhood and Socialism.
 
 BROTHERHOOD ADDRESSES 257 
 
 His rough notes for these addresses must look amiss 
 in print : but they so clearly show his mind that they 
 may be useful here. 
 
 Sympathy in Public Affairs. (Leicester, 191 3) 
 
 Am I my brother's keeper ? Yes. Sympathy through 
 all. Christian ideal. . . . People say, ' That 's not my 
 business,' and ' WTiat is everybody's business is nobody's 
 business.' We have to negative this. What is every- 
 body's business must be attended to by everybody. For 
 that, every one must be a citizen. Public affairs can only 
 be well carried on by the citizens, actuated by s^Tnpathy. 
 Men and Women enfranchised. Franchise a Public Affair. 
 Sad want of sympathy on the Franchise. Propertied men 
 sajang to the poor man and lodger, ' You are not fit to have 
 a vote.' Some men say to the women of the State just the 
 same. Not a httle Hypocrisy re Violence : people, true 
 patriots, lose control when the authorities are purbhnd to 
 National Progress. . . . Vista of National Progress : men 
 and women in sympathy voting for and carrying progressive 
 legislation. Want of sympathy due to Individualism. We 
 must constantly remind ourselves we are our brother's 
 keeper : every time we see a slum, register vow to help legis- 
 lation. ' We live in an Empire where the sun never sets, 
 and in slums where the sun never rises.' Every time we 
 pass one of those vortices of illness, misery, and death, the 
 doors of a drink shop, resolve that day to help the starv- 
 ing and suffering children of our city. . . . Business of the 
 World : relation between Nations. Detestable attitude of 
 our Jingoes : equally detestable attitude of the Junkers 
 in Germany. . . . Montaigne's position ' The honourable 
 Vocation is to work lor the commonwealth and the profit 
 of the many.' 
 
 The Responsibility 0/ Manhood. (Ferme Park, 191 3) 
 
 Responsibility of Each. Xtian Sociological Scheme. 
 Description of World, St. Luke vi. 21-38 incl. The world 
 full of offences ' for it must needs be that offences come, 
 but woe to that man by whom offence cometh.' Xtian 
 view. Instances of rcaUsation of manhood responsibility, 
 (i) In 1643, Cromwell wrote, acknowledging men, arms, 
 and subscriptions, ' Sir, I understand by these GentKmen 
 the good affections of your Young Men and Maids, for which 
 God is to be praised.' (2) In 1682, Cromwell was dead. 
 Degraded Stuart dynasty restored. Clear to all tiiat not 
 
 R
 
 258 SIR VICTOR HORSLEY 
 
 only was Charles the Second's Court Inferno of Corrup- 
 tion, but King's successor would establish Inquisition and 
 attack Protestantism, strength of Nation. Taunton (siege, 
 war) supported principles of Liberty of Subject and, above 
 all. Liberty of Conscience. An Humble Address of the Young 
 Men of Taunton to Edmd. Prideaux and J. Trenchard — 
 members of ParUament who had made a good fight against 
 the attacks of the Court Party on Liberty and Protestantism : 
 ' Sir, Though we are not immediately concerned in the 
 electing Members to serve in Parhament, yet we are deeply 
 sensible that we shall bear an equal share with others in 
 the same common danger and universal slavery which Hell 
 and Rome have been and still are attempting to involve 
 our Protestant nation in.' 
 
 Read George Fox's Journal — a record of incredible hard- 
 ships and suffering : a man repeatedly in prison and, like 
 many reformers, ' bound over to good behaviour,' when 
 explaining and advocating Xtian Principles. Fox's 
 record even exceeded by the prison treatment of Pamell. 
 Treatment of Wesley. 
 
 The Christiaji view of Citizenship knows no class, nor 
 distinction of sex, nor differences of rich and poor. In the 
 Christian scheme of life, all are equal. Surely, greatest 
 stabihty secured when the Nation links to itself all its Citizens, 
 men and women, with threads of equal tension. And while 
 all are morally speaking equal, the responsibilities of all are 
 equal. This is the true Pohty of Citizenship. 
 
 Christian code requires equaUty and justice between the 
 sexes : between everybody. Our law gives neither equality 
 nor justice. The gross inequality has caused Divorce Com- 
 mission to report for its removal. Yet actually Lord 
 
 dared to claim a dual code : one grade of morahty for women, 
 and a lower grade for men. Fortunately the Commission 
 treated him with contempt. Surely an acknowledgment of 
 the Responsibihties of Manhood will stimulate us to strive 
 for this Higher Equahty of Citizenship. . . . We are pro- 
 gressing towards the Light. I confess I have little patience 
 with those who talk of Decadence. I see no sign, but, on 
 contrary, recognition of Responsibility. Times' leader, 
 October 3, 1913, on Woman's Part in Life. ' When women 
 maintain the standard of sexual morality for men is lower 
 than their own and needs raising, it is impossible to deny 
 the charge. . . . This is not a question of puritanical inter- 
 ference or bigotry : it is a question of Ufe. Vice is hostile 
 to life : it is death. . , . Life is the ultimate reaiity that 
 we know, and the one test of what is good and desirable is 
 whether it serves life or not.' No paper would have pub- 
 lished a passage like that, five years ago.
 
 BROTHERHOOD ADDRESSES 259 
 
 Christian Basis of Human Action. (Upper Holloway, 1912) 
 
 Faith, Hope, Charity — greatest of these is Charity. Faith 
 in Principle. ReUgious opinions differ, but P.S.A. move- 
 ment stands for Faith in Principles, as against Expediency. 
 Hope : striking feature of true rchgious feeUng : firm hope 
 in upward Progress. Cannot understand people without 
 hope. Teaching of Science — incessant progress and develop- 
 ment — breeds hope, creates hope : hope that is justified. 
 Charity, what it is, what it is Not — attempt to undo Evils 
 that ought never to have been created. True Charity. 
 Principle of the P.S.A. movement — For God and Humanity 
 — i.e. Personal service in Social Work, helping others. 
 Pessimism : low views of Human Nature. Parkes : Law : 
 Lord Salvesen : Article ix., ' Man is of his own nature in- 
 clined to evil ' : Lord : and : example of a large 
 
 number of people who have lost Spirit of Charity, says we 
 are living at the end of a Great Period. People more humane, 
 kinder, much keener realisation of Duty towards our Neigh- 
 bour : sympathy with Progress and Principle — evidence of 
 Coal Strike. Splendid example to us of man just dead, 
 Lister. Consider his position — a Quaker — home surround- 
 ings — plunged into atmosphere of dirt and suffering — state 
 of hospitals ' sickening and heart-rending ' — did not become 
 a Pessimist : an Idealist in Charity, Simplicity, and Sincerity, 
 strong in faith of Progress ' for God and Humanity,' knowing 
 that the one requisite is Principle ... no pessimist, but 
 an optimist, and above all a worker : never lost faith in 
 Mankind, nor in our physical and moral progress : thus, 
 firm believer in, and practitioner of. Charity in its highest 
 development. We must see to it that Statesmen are not 
 led aside by party feeling but shape legislation on the lines 
 of true Charity, namely Social Betterment. This is the work 
 and Influence of the Brotherhood Movement. Personally 
 I consider this is the real trend of most modem Politics, 
 and that we are indeed on the Upward Path. . . . 
 
 To this transcript of some of his notes, may be added 
 some of the passages of prose or verse which he used to 
 quote in his addresses. He took th(Mn from many sources : 
 and they are put here without attempt at arrangement : 
 
 Fate holds her best gifts till we show 
 We 've strength enough to make her let them go. 
 
 God make the Nations see 
 That men should brothers be, 
 And form one Family 
 The wide world o'er.
 
 26o SIR VICTOR HORSLEY 
 
 The years are slow, the Vision tarrieth long, 
 
 And far the end may be : 
 But one by one the fiends of ancient wrong 
 
 Go out and leave us free. 
 
 Too long the gulf betwixt 
 This man and that man fixt 
 
 Yawns yet unspanned ; 
 Too long that some may rest 
 Tired millions toil unblest : 
 
 God save our lowliest, God save our land. 
 
 Look not mournfully into the past ; it comes not again. 
 Wisely improve the present ; it is thine. Go forth to meet 
 the shadowy future without fear and with a manly heart. 
 
 Dusummat. Du good service if you can. Butdusummat. 
 
 All men are by nature equall made all by one worckman 
 of lyke myre, and howsoever we deceave ourselves as dere 
 unto God is the poorest begger as the most pompous prince 
 living in the Worlde. 
 
 {Book of Ordinances, Bricklayers' Guild, 1400.) 
 
 They helped every one his neighbour, and every one said 
 to his brother, Be of good cheer. 
 
 {Motto of London Trades Newspaper, 1825.) 
 
 In a Country like this, where the public business of the 
 State is the private duty of every citizen, those who dechne 
 to use their pohtical power are guilty of treachery both to 
 God and man. {Dr. Dale.) 
 
 It is plain that these Brotherhood addresses were very 
 grave discourses. There is something of the spirit of 
 Kingsley in them, and of Ruskin : whom he calls ' the great 
 master of sociology.' He is hopeful ; he praises ' optimism,' 
 and rails at ' pessimism ' : but he does not push his hopes 
 in advance of his facts. Admiration of the heroes of Pro- 
 testantism ; familiar use of the Bible prophets, the Psalms, 
 and the sayings of our Lord ; contempt for the old-fashioned 
 talk about Christian resignation ; rage at the ill-treatment 
 of children — ' killed, violated, starved, tortured ' — and at 
 fornication — ' Dead Sea fruit, full of bitterness and cor- 
 ruption ; we men escape condemnation, whereas woman 
 realises truth, wages of sin is death ' — all these are in him ; 
 and he gives them a Christian setting ; and they would have
 
 BROTHERHOOD ADDRESSES 261 
 
 it of their own accord, if he did not give it to them. For 
 him, Christianity was Christian ethics and social service : 
 these he took and worked into the fabric of his life : what 
 he did not feel to want, he did not care to take, nor to pro- 
 vide for his children. His ignorance of questions of doctrine 
 shows itself in a letter, so late as 1916, where he refers to 
 a well-known man ' who did not believe in the Immaculate 
 Conception, or some theological central point, but never- 
 theless was, and maybe still is, a Canon of the English 
 Church.' He did not understand ' abstract thought.' Such 
 little time as he allowed himself, of an evening, for any 
 reading outside science and practice, he loved to give to 
 archaeology and old maps, to anything and everything about 
 Ancient Rome, to history, biography, books of miUtary 
 campaigns, (He hardly ever read a novel : there are not 
 half a dozen references to fiction in the whole of his corre- 
 spondence : but one of them is notable : he writes to a 
 
 man in 1889, ' For heaven's sake drop Mr. comme une 
 
 pomme de terre chaude. His novel is simple filth, and of 
 a puerile kind.') 
 
 If he had cared to be labelled, he would have written the 
 label himself, Agnostic, in his big masterful hand. One 
 of his nurses tells an amusing story of a lady who went to 
 him, ' because he is the special surgeon for my case : but 
 of course, if it hadn't been for that, I would never have 
 gone to a man who is so very agnostic' It was no part of 
 his plan of his hfe, that he should be in quest of ' the reason 
 o' the cause an' the wherefore o' the why.' It was not in 
 his temperament : it was not m his education. He had 
 not been through that mill of reading when he was young. 
 It had pleased him well enough, in his University College 
 days, to try to think of the Absolute : but that pleasure 
 does not last long ; and he did not find his way, in the later 
 years, to any books which compelled him to listen to them. 
 Popular theology, and sham metaphysics, were utterly 
 distasteful to him ; and all the fashionable jargon which 
 pretends to-be systematic thought. 
 
 It is not likely that he would have determined himself 
 — if he had hved to old age — to cultivate ' the will to believe,'
 
 262 SIR VICTOR HORSLEY 
 
 or to follow up the evidences in poetry and philosophy to 
 the Christian faith. It is possible that he would have 
 thought it merely a sign of the failing brain, to be thus 
 restless for assurance. It may be that his growing sense 
 of the world's iniquities would have driven him to a venture 
 of belief. There was a phrase of his, ' the powers of evil,' 
 which he used very gravely, in the years just before the 
 War : it might have taken him far : but the powers of 
 evil were still on their thrones, the last that he saw of 
 them.
 
 VIII 
 
 Private Practice. Home Life 
 
 To look at, he was a man created for friendship and for 
 happiness. It was a pleasure to watch his face, handsome 
 and sensitive, with his feelings displayed in it without con- 
 cealment. He had the grand air ; the look of distinction, 
 pride, youth, enjoyment of hfe : the average man looked 
 sadly commonplace by the side of him. ' I was lucky 
 enough,' says a well-kno\\Ti surgeon, who was his assistant 
 in private practice, ' to be associated with him for many 
 years ; and my admiration for him steadily grew throughout 
 the time, and under conditions in which bogus " greatness " 
 could not fail to betray itself. There was in him a hint 
 of the archangel that I never discovered in any other man, 
 and that made one feel that he could never be anything but 
 young and strong.' It is the exact phrase, ' a hint of the 
 archangel in him ' : or the look of a head of Apollo on a 
 Greek coin : but the upper part of his face was stronger 
 than the lower part. His eyes were dark blue-grey, deep-set, 
 and keen ; he had perfect vision, but a touch of colour- 
 blindness : and he and his brother Gerald had a httle 
 ' flare ' of white hair above the forehead. The tone of his 
 voice and laughter was very musical : and he and Gerald 
 had a way of pronouncing th as v. In the use of his hands, 
 he was absolutely ambidextrous : he had been left-handed 
 to begin with. He could even draw on wood equally well 
 with either hand. His movements were quick and purpose- 
 ful. Al^says, he held his head up and his shoulders back : 
 no tricks, no pose : he was just himself, wherever he was. 
 He neit."ier showed off his gifts, nor could he hide them ; 
 and whtn he came into a dull roomful of guests, there was 
 
 an odd effect as if the lamps went up of their own accord. 
 
 let
 
 264 ^IR VICTOR HORSLEY 
 
 There are lives, and his was one of them, at which we are 
 able to warm our hands : the pity is, that so many people 
 — it was more his fault than theirs — did not warm their 
 hands but burned their fingers at his life. 
 
 In the lesser matter of clothes, he was well dressed, but 
 not under the rule of the tall hat and the frock-coat : and 
 his example helped his profession to get rid of that badge 
 of all their tribe. There was something in the look of his 
 clothes which bespoke his everlasting love of the country : 
 besides, he was the first consulting surgeon in London to 
 use a bicycle to visit his patients, and he could not cycle in 
 a frock-coat and a tall hat. (It is said that Mr. Christopher 
 Heath found him on a Sunday morning cycling in the garden 
 of Cavendish Square, and there and then rebuked him 
 through the railings.) So soon as he had a car, he taught 
 himself to drive and repair it. Dr. Neale remembers an 
 expedition with him, in the early days of his motoring : 
 
 I had a patient in Bournemouth ; and Horsley and Risien 
 Russell were to see the case in consultation with me. Horsley 
 could only go on Sunday : so we agreed to Sunday : but 
 he had a new motor, and would not hear of going by train. 
 So, to make sure of getting him, we submitted : and at 
 6 A.M. started — we three, an American sui^eon who was 
 staying with Horsley, and the chauffeur — aL' five : Horsley 
 drove. At Winchester, something went wrong with the 
 petrol tank. ' You fellows go and have breakfast,' he said, 
 ' and see the Cathedral : I '11 put the motor all right.' So 
 he got under it, and did put it right. We got to Bourne- 
 mouth, saw the patient, and had lunch. Risien Russell 
 wanted to get on to a consultation at Bath. ' All right : 
 we '11 drop you at Salisbury.' We got to Salisbury just in 
 time to see the train leaving the platform. ' All right : we '11 
 drop you at Reading.' But on the road from Sahsbury to 
 Reading a tyre burst : we had to stop and buy a new one : 
 happily, we had the money between us. We got to Reading 
 about midnight : the last train to Bath had gone : we got 
 to Piccadilly Circus about 1.30 a.m. 
 
 Dr. MacNalty writes of later expeditions : 
 
 He always drove himself, and said that he could not bear 
 to sit stiU and be driven by another. He would start early 
 in the morning, motor sixty or eighty miles, driving himself 
 all the way, and tlicn perform a cerebral operation with 
 unfaltering hand and nerve. He said it blew the cobwebs
 
 PRIVATE PRACTICE. HOME LIFE 265 
 
 of London av/ay, to get out into the countr}'. Meetings 
 at Oxford or Cambridge of the Physiological Society always 
 served as objects for these expeditions : Lady Horsley, 
 and a scientific friend, such as Dr. Janet Lane-Claypon, 
 usually were with us. On my first visit to Cambridge, he 
 insisted on taking me a lightning tour of the Colleges, in 
 the half-hour before tiie Society met : we did it somewhat 
 in American fashion. Sir Victor striding on ahead pointing 
 out the beauties of Cambridge, with Dr. Batten and myself 
 at his side, while Dr. Charles Beevor followed at some dis- 
 tance behind, remarking plaintively, ' I wish Horsley would 
 not walk so fast.' 
 
 One glorious expedition in 1908 I remember especially. 
 It was the end of January, and I breakfasted with him at 
 6.30 : we started off soon after 7 in the big Daimler, and 
 motored to Warminster, where he had a consultation : on 
 the way, we halted to look at Stonehenge : after Warminster 
 and lunch, he showed me the old Sa.xon church of Bradford- 
 on-Avon : then we visited Bath : and returned, ^vith tea at 
 Marlborough on the way, and reached Cavendish Square 
 at 9.30, having done over two hundred miles. 
 
 On a holiday, his love of the country and of open-air life 
 inspired him to get and to give happiness all round. If 
 there be a genius of holidays, it was in him. In the earlier 
 years, there was neither time nor money for more than a 
 few days of tramping or of boating : but he dehghted in 
 every mile of them. In the later years, he used to take a 
 big country-house, with land to shoot over ; and he and 
 Lady Horsley were incessantly hospitable. There is a 
 pleasant story of one guest saying to another, ' Why, the 
 man 's absolutely selfless.' And he was selfless not only 
 in hospitality but in his will to give up everything at a 
 moment's notice, and travel three hundred miles to London, 
 for nothing, to see a surgeon, a stranger to him, who needed 
 his help. 
 
 So many of his friends have written of holidays witli him, 
 that two of thorn must speak here for all of them. 
 
 From Dr. Huxley 
 
 About ten years ago he and Lady Horsley insisted on the 
 whole family spending Christmas in Norfolk at a shooting- 
 place he had taken : a serious matter, a family of four children 
 besides ourselves. The children were thoroughly spoilt and
 
 266 SIR VICTOR HORSLEY 
 
 the small boys came out shooting : I see Victor now, having 
 appropriated Kit, aged six, with directions to hand his 
 cartridges : the pheasants came streaming over, and up 
 went his gun, with no results except a roar of laughter as 
 he realised that in the excitement of the moment he had been 
 given the empty cartridges. Michael, my next eldest boy, 
 and he carried on a varied correspondence. Victor collected 
 postage-stamps for him, and used to send them in a vast 
 envelope, addressed, on one occasion, to Michael Huxley, Esq., 
 The Comer, The Nursery. Michael addressed his letter to 
 Sir V. Horsley, The Arm-chair, The Consulting-Room. 
 
 I met him constantly in work, and learned more from his 
 metiiods than from any one I have ever known. The kindest 
 of men — he was ever ready to operate on or see the needy 
 folks, with or without a nominal fee ; and in all these years 
 I never found his considered judgment of a case at fault. 
 I have seen most of the great surgeons of our time operate, 
 but none surpassed him in dexterity and in care of every 
 detail of treatment. . . . 
 
 I think that no one except my father ever cared less for 
 pubUc opinion, as long as he thought a thing was right to 
 do or say. 
 
 From Mr. C. J. Bond 
 
 For many years I and my family had the happiness of 
 spending an autumn hoHday with Victor Horsley and his 
 family. These began with a visit of a few days to Hinwick 
 near WeUingborough, where Horsley rented a partridge- 
 shoot in 1897. After Hinwick, came a shooting at Ashford 
 in Kent : wliQe staying there I persuaded Horsley to take 
 up photography ; and I remember the interest which Sir 
 Frederick Bramwell, his father-in-law, took in working out, 
 from the elongated picture of the moon, the relative move- 
 ments of the earth and moon, from a rather successful 
 photograph. Ashford was followed by shootings at Angmer- 
 ing in Sussex, Pitcaple in Scotland, and various country- 
 houses in Norfolk. It was while sta\ang at Worthing that 
 Horsley persuaded a butcher to allow him to kill several 
 bullocks by shooting them with the Lee-Metford service rifle : 
 he was at that time interested in investigating the explosive 
 effects of bullets. 
 
 One delightful fortnight spent by us with the Horsleys in 
 the island of Rousay in the Orkneys, August 1911, ever 
 comes back to my memory. Mornings spent on the moor, 
 or in fishing : afternoon explorations of cairns and old 
 Pictish burial mounds : excursions to neighbouring islands — 
 E>Tihallow \nth its monaster^', Egilshay with its ruined 
 Saxon church dedicated to St. Magnus, Veira with its seals,
 
 PRIVATE PIL^CTICE. HOME LIFE 267 
 
 all were visited and photographed on many occasions. The 
 uninhabited little Holm of Scothess gave us an opportunity 
 of investigating a problem of odd eye-colour in a hybrid 
 race of rabbits which flourished on the island. . . . 
 
 These holidays on Rousay, between 1909 and 1914, were 
 full of happiness. He set himself to be useful ; he studied, 
 with Professor Meldola's help, the chances of reviving the 
 kelp-industry ; the plans for a better medical service in 
 the Orkneys, and the management of small holdings ; he 
 was President of the Orkney Agricultural Society, and a 
 Life-member of the Orkney and Shetland Association ; and 
 he and Lady Horsley, with Mr. John Logie, were the founders 
 of a Co-operative Society. He writes to Dr. Mary Sturge : 
 
 Trumland, Rousay, September 10, 1910. We have had 
 an extraordinarily fine time here. Next year you really must 
 come and see how delightful it all is, and how absolutely 
 free. I am writing this in quite burning sun, in the garden 
 alcove, with honeysuckle, bees, etc. — writing on my knee, 
 which, however pleasantly idle, is not conducive, as you 
 see, to copper-plate style. The boys are in great feather, 
 as the bag of seals, grouse, plover, etc. has been very good, 
 and as they, including a school friend, and I made a raid 
 on the North Isles as far as Papa (early Xtian missionary 
 =papa) Westray, the last but one north. There and at 
 Westray we put up in farms under conditions rather too 
 primitive for some, but which were certainly novel and 
 interesting. We walked all over the islands, found some 
 birds and a great deal of interest : altogether a very profit- 
 able raid, which took about six days. We are holding a 
 tea on Tuesday, endeavouring to start a Farmers' Co-opera- 
 tive Society, at a school four miles from here which is the 
 only building on this island capable of holding about 120 
 people. Orkney is a great place for co-operation, but 
 may be made more so. Altogether socially it is very interest- 
 ing. The captain of the North Isles little coasting steamer 
 is a leading temperance advocate, Craigie by name. We 
 must send him a copy of the new Edition, or more Crom- 
 wellio the New Model. 
 
 Next to these holiday letters, come letters from patients : 
 they show not only gratitude, but downright reverence, as 
 if the writers could not find words good enough for him : 
 some of them treasure his photograph, or a few lines of 
 his handwriting : they praise his gentleness, sympathy,
 
 268 SIR VICTOR HORSLEY 
 
 generosity, his ' Heraclean cheerfulness and courage.' One 
 could paint a portrait of him, from these letters, as the 
 beloved surgeon ; and it would be a true likeness. But of 
 course the letters fall short of the thing itself. As a letter 
 says, ' One had to sec that toss of the head, and a sort of 
 flash of interest, sympathy, annoyance, or humour — elusive 
 and indescribable.' 
 
 There never was a man who made less of the distinction 
 between Hospital practice and private practice. What he 
 was to his Hospital patients may be judged from three 
 sayings which by chance have been remembered. ' The 
 patients he and watch for his coming,' said one of the Staff 
 of University College Hospital. ' I think it was through Sir 
 Victor,' said a medical man, whose life Horsley had saved, 
 ' that I tried to be kind to poor people.' And a patient in 
 Queen Square said, ' I do believe, if one of us were to die, 
 and Sir Victor got him within half an hour, he could bring 
 him to hfe again.' 
 
 Foolish or envious people said that he ' advertised,' that 
 he sought popularity, and so forth. None of them is worth 
 answering. It would be nearer the mark to say that he 
 sought unpopularity ; that he was attracted by causes 
 which were in disgrace. As for advertising, he was one of 
 the very few men who never felt the need of it. His record 
 in science and practice dtivertised him. Even before he 
 was thirty, his profession was talking of him as the coming 
 man. By the time he was thirty, everybody was beginning 
 to talk of him. This is not to say that he was not proud 
 of his work for physiology and surgery ; he was openly 
 proud of it. Nor did he take much trouble to hide his mind, 
 when patients came to him from men who had not done 
 the very best thing for them. But that is not what his 
 profession means by ' advertising.' He was in public life : 
 and the newspapers made it their business to tell us every- 
 thing about him. They told us, in 1897, that he was going 
 to Russia to attend the Tsar ; not a word of truth in it ; 
 he could hardly write and proclaim that he was not going ; 
 it would only complicate matters : then comes a black- 
 guardly anonymous postcard all the way from Dublin — he
 
 PRIVATE PRACTICE. HOME LIFE 269 
 
 kept even^thing — ' Any other advertising quack couldn't 
 have done better. Bravo Horsley ! Advertise away, damn 
 the expense.' 
 
 Over his fees, he was very generous. He would not take 
 a fee from a veterinary surgeon : and during the War he 
 would not take a fee from any wounded officer : ' I 'm not 
 going to take money from a man who was wounded defend- 
 ing me.' His rule that no medical man should pay a fee 
 to him was absolute. One writes : 
 
 I do hope you will not omit to note specially the immense 
 amount of work he did for his medical friends without any 
 money reward. During a long illness, dating back to 1901, 
 he was always ready and willing to help me when necessary. 
 Once he came down to Ventnor to see me, once he came 
 here ; and he operated on me at least thrice. On no occasion 
 would he take any payment : ' Dog does not eat dog,' he 
 said. On one occasion I tried to send him a cheque as a 
 Christmas gift. It came back to me with a note sa\ing 
 that if I wished to continue his friend I must not do it again. 
 
 Another doctor, whose daughter Horsley had seen — a 
 hopeless case — away from her home, tried to convey a fee 
 to him through the ladies with whom she had been staying. 
 Horsley found this out, and wrote : 
 
 I gather that you have been awaiting a letter from me 
 in regard to the extremely sad case of your daughter whom 
 I saw last week at Hove. I regret now therefore that I 
 did not write to you, but having in view the fact that I 
 regarded the case as one for which unfortunately nothing 
 could be done, and that I expressed this view quite dis- 
 tinctly to those who were with the patient, I own I rather 
 shrank from communicating to you personally an opinion 
 which I knew could only cause you so much pain. There 
 is just one point further to mention. You must allow me 
 to return you the enclosed cheque. I could not possibly 
 accept it from one of our Profession, and as it is not my 
 privilege to be able to help you otherwise in the case, you 
 must at least allow me this means of showing my desire 
 to be of service had it been possible. 
 
 Another doctor tells of a case, near Birmingham, of a boy 
 suffering from basal meningitis : the case was hopeless : 
 there had already been a consultation, and the doctor had 
 wisely persuaded the boy's father not to incur the further
 
 270 SIR VICTOR HORSLEY 
 
 expense of sending for Horsley : but one of the family 
 telegraphed for him. He came at once, took the position 
 of things with infinite kindness and courtesy to everybody, 
 refused to be paid, and went back by a night train : ' one 
 of the greatest men I have known,' writes the doctor, 
 ' whose heart I believe was the greatest part of his greatness.' 
 
 A lady, on whom he had operated without payment, went 
 to see him afterwards, and offered him the usual fee for 
 consultation. ' I don't suppose you have been left a 
 fortune,' he said : ' when you have, we can see about fees.' 
 A working-man brought his daughter to him, all the way 
 from Wigan. ' Several friends informed me that he would 
 not spend more than two minutes with me, and that I 
 should not get clear for less than a fifty pounds fee.' Horsley 
 said that no operation was needed, that the girl would soon 
 be all right : then started a talk on things in general. ' When 
 I told him I was a life-abstainer and secretary of a Rechabite 
 Tent, he was dehghted, and talked on for over half an hour.' 
 He would not take a fee : he said that he didn't often get 
 the opportunity of having a chat with a working-man. 
 
 Another working-man, on whom he operated at Queen 
 Square for cerebral abscess, writes, ' I cannot express in 
 words how kind and generous he was to me and also my 
 friends, and with a patience untiring : I am sure nothing I 
 can say or do can half express my feeling of how grateful 
 I am. Our doctor has sent me a photo of Sir Victor which 
 I shall prize as long as I live.' 
 
 Another letter describes his kindness to a small child, on 
 whose head he did two operations : 
 
 Children understood and trusted him at once : he never 
 chaffed or ' talked down ' to them, and though very gentle 
 and pitiful, he was always bracing and straightforward ^^^th 
 a young patient, and he seemed able to really see from the 
 child's point of view. . . . When a further operation had 
 to be faced, he questioned the parents, * What does the boy 
 remember about the last time, and what will he dread most ? 
 He 's a plucky little chap, and I 'm not going to have him 
 frightened.' When he heard it was the preliminary pre- 
 parations, and the anaesthetic, the child would dread, he 
 reduced the former to what could be done by the mother 
 almost unaided ; and arranged that the child should be
 
 PRIVATE PR.\CTICE. HOME LIFE 271 
 
 put to bed at the usual hour, vAth a dose of trional. Then, 
 an hour or two later, he was chloroformed in his sleep, and 
 the operation took place during the night, to the great 
 inconvenience of the long-suftering staff of the Nursing 
 Home ; but the child's peace of mind was secured. . . . 
 When Sir Victor had time, and sometimes when he had 
 not, he would sit down and talk Uncle Remus or Jungle 
 Book, with the keenness of ten years old and the apprecia- 
 tion of a man of letters. And who but he knew the psycho- 
 logical moment when a visit to the Zoo was what a weary 
 little boy needed to make life worth living, and exactly 
 where to go when you got there to find the most attractive 
 beasts, and what to give them to eat ? 
 
 Other letters describe what may be called his Jungle Book 
 talks with grown-ups. ' Apart from his sympathy and 
 kindness,' writes one patient, ' his intense interest in every- 
 thing, from trivial schoolgirl incidents to suffrage and 
 political questions, was never-ending and amazing.' Another 
 writes, ' Sometimes he would come into my room in the 
 evening, and talk until he was called away, about temper- 
 ance, women's suffrage, and above all — Home Rule ! He 
 was an ardent Home Ruler, and I had been brought up a 
 Unionist, so the argument was always hot. I kept a photo 
 of Sir Edward Carson in my room : and he would tell me 
 to take it down, as I " never would get better with him look- 
 ing at me." He was especially kind to me, I think, because 
 I was very young and very Irish ! He would listen for ages 
 to stories of the peasants and country people.' 
 
 If a patient did not really need him, and was in good 
 hands, and was doing well, he would take his leave so soon 
 as he could : and he sometimes gave offence in this way. 
 It looked like indifference or neglect : it was neither : it 
 was the natural result of his confidence in his assistant, or 
 in the practitioner, or in the nurse, to whom he entrusted 
 the case : he knew that they would let him know at once, 
 if he were really needed : and he made it his business not 
 to interfere with them, but to keep in touch with them. It 
 was not in him, to be thoughtless of cases. To somebody 
 who was praising the scenic effects of London, he answered 
 that he never noticed them ; that he was thinking of his 
 patients.
 
 272 SIR VICTOR HORSLEY 
 
 It was said of him that he was hard and inconsiderate 
 toward nurses. One of his patients writes, ' I had never 
 seen him, and thought he would be very fierce and alarming. 
 I must say the way he spoke to the nurses confirmed me 
 in this idea.' But a nurse who worked for him for fourteen 
 years in a Nursing Home is able to speak with authority on 
 this point. She says that he may have been hard on nurses 
 who perhaps only saw him once or twice, and did not under- 
 stand his ways ; that of course he had ways of his own at 
 an operation ; he insisted that all who were taking part in 
 it should work well together : but he was not hard on any 
 nurse who understood his ways ; and, so soon as the strain 
 of the operation was over, he would be courtesy itself. The 
 same is said by a surgeon who knew him intimately : that 
 he would get an idea that a nurse had made a mistake, and 
 from that time he would not have a good word for her ; she 
 would be ' not a good nurse ' ; and if he were in a mood of 
 irritation, he might speak roughly to her : but when he 
 knew and trusted a nurse, he would be charming to her. 
 
 In his practice, he was quick to accept any suggestion, 
 if it were carefully put to him ; but he had to be ' approached 
 the right way.' If that were done, ' it was so easy to get 
 him to see your point of view, that he would even carry it 
 further ; and what you had meant as a suggestion was 
 taken, at last, as a sort of order.' 
 
 He never boasted of his power of diagnosis and his 
 dexterity in operating : indeed, he rather made light of 
 them : he said that ' anybody could acquire manual dex- 
 terity ' : and he sought to encourage other men by attribut- 
 ing his success to the fact that he hved in Cavendish Square. 
 To a surgeon starting in consulting practice, he said, ' Now, 
 my dear boy, I '11 give you a bit of advice. Mind you start 
 in the right place : I started in Gower Street : that was a 
 great mistake. Since I moved to Cavendish Square, I 've 
 had nothing to complain of.' He would have achieved 
 success, even if he had put up his name at the base of the 
 Monument and lived in the cage on the top. 
 
 But his practice fell off miserably, during the four or five 
 years before the War. Partly, the medical men who thought
 
 PRIVATE PRACTICE. HOME LIFE 273 
 
 that he had ' betrayed ' them over the Insurance Act were 
 unwiUing to send patients to him. Partly, it was said that 
 he was giving up practice. Partly, there were invalids 
 who so disliked his politics that they preferred another 
 surgeon : indeed, one medical man, who had been in the 
 habit of asking for consultations with him, said now ' that 
 his patients objected.' It was natural enough, after 1910, 
 that strangers to him, who were fearing the possibihty of 
 an operation, should hesitate, thinking him ' immei-sed in 
 pohtics.' He writes to a friend, Jan. 1913 : 
 
 I only saw your kind letter about the boycott yesterday. 
 As regards the general thing itself you are probably correct. 
 What of course is more militant against my doing more 
 practice is the report being industriously circulated — and 
 reached me to-day — that I am retiring from practice. This 
 of course I have known a long time would be done, as 
 indeed it was when I resigned Univ. Coll. Hosp. six years 
 ago. As regards the second point, namely that my surgery 
 is mediaeval, that of course is possible, and to avert the 
 true part of that I shall not operate after sixty. This I 
 decided long ago. Doubtless, also, it will choke off work. 
 We must just see. 
 
 Under the unhappiness, illness, and overstrain of these 
 years, he would have broken down, if it had not been for 
 his home-life. All of us saw the side of him that he faced 
 the world with : but those of us who did not see the other 
 side of him, the home-life, did not know him. Indeed, it 
 was perfect : it was the making of him and the saving of 
 him. Not that it was leisurely : it was incessantly strenu- 
 ous : it drove ahead, every day and all day long, toward the 
 attainment of a hundred purposes. He and his wife were 
 of one mind in contempt for whatever things are second-rate, 
 sham, selfish, or wasteful of time or thought : they planned 
 their life, and they lived it, above all idolatry. For many 
 years they refu.scd invitations to dinners and evening parties 
 — which then were frequent and ostentatious in London, 
 and not least in the neighbourhood of Cavendish Square ; 
 they did not go to a theatre more than once or twice a year : 
 and when the fashion for week-ends was invented, they did 
 not follow it. The evenings were for work. He read hard ; 
 
 s
 
 274 SIR VICTOR HORSLEY 
 
 no man in his profession was better acquainted with the 
 science and practice of his own and other countries. As he 
 used to say, ' I hate having to say " I don't know." ' He 
 had the rare gift of enjoying to work with his family round 
 him : one of his friends writes of ' his power of being able 
 to " concentrate " on many things simultaneously : prac- 
 tically all his writing was done in his drawing-room, with 
 all sorts of distractions ; yet he could write a paper, dictate 
 letters, discuss sociology and politics, and play with his 
 little fox-terrier, almost in the same moment.' On Sundays, 
 if his work and his popular lecturing would let him, his 
 favourite place was the Zoological Gardens. He was not only 
 a naturalist, he was a bom lover of animals : the instinctive 
 understanding between him and them was perfect. There 
 was an amusing example of it, during the trial of the ' brown 
 dog' case, November 1903: a cat found its way into the 
 Court, disregarded the supporters of anti-vivisection, went 
 to Horsley, and sat on his knee with evident pleasure. 
 
 What is far more, he was a devout lover of children, and 
 had wonderful influence over them. A young nephew of 
 his, on naval medical service during the War, wrote home, 
 on the news of his death : 
 
 All yesterday I went about in a sort of dream : I really 
 don't know what happened at all. It seemed impossible : 
 and yet, you know, I felt that he wouldn't come back again 
 — from the first — I don't know why — but I somehow 
 imagined that for the first time in his life he had under- 
 taken something beyond his strength, and that he would 
 not be able to see it through, even he. As a small boy I 
 used to idoHse him in my own mind as almost a god. His 
 figure and agility and youth and health, on the physical 
 side ; and his amazing, consummate genius ; and his effort- 
 less — or wliat seemed effortless — way of tackling things 
 with almost complete success in the medical or scientific 
 world ; and then his astounding sense of duty in every- 
 thing he did ; and his radiant kindness. I really don't 
 know anybody who excited — or rather intoxicated — me 
 from my earliest boyhood, like he did. I remember, every 
 time he used to pay a flying visit to the Lawn in the old 
 days, how I used to count the minutes I spent in his pres- 
 ence, and how I used to treasure every word he said : I 
 repeated his name over and over again, then, which thrilled
 
 PRIVATE PRACTICE. HOME LIFE 275 
 
 me. He seemed to me immortal in a sort of way. Nothing 
 was apparently beyond his reach. I couldn't have borne 
 it, seeing him getting old. 
 
 That is what he was to the generation which comes after 
 him. A letter from Dr. Flemming, of Bradford-on-Avon, 
 tells what he was to a friend of his own age : 
 
 I found him one day, not long before the War, in his 
 drawing-room ; several dozen lantern-slides spread on a 
 table ; he was arranging them for a lecture on the Great 
 Roman Wall across England, that he was to give at some 
 society next evening : he had taken the photographs him- 
 self, and years before had taken part in excavating some 
 of the Wall. Wliile we talked, he ate his simple meal of 
 eggs and bread and butter and tea, excusing himself as he 
 had to go soon to speak at a meeting of some society that 
 dealt %\ith the abuses of ground landlords. It came out 
 that the night before he had been in Oxford lecturing on 
 early brain-surgery ; and had taken the opportunity while 
 there to address undergraduates on temperance. We talked 
 of the coming Aberdeen meeting of the B.M.A., and of 
 matters of medico-political interest to be discussed there ; 
 and he told me that when he returned from his hoUday 
 he was going by invitation to Vienna, to open a discussion. 
 He also asked me if I could find out about a xiv. century 
 castle near Frome, Somerset — if they were going to raise 
 money to keep it in repair, as he would like to help. 
 
 What always struck me so much, apart from his personal 
 charm and fascination and his genius for friendship, was 
 his extraordinary capacity for finding time and thought 
 for every friend. I was only one of hundreds, quite as it 
 were a casual friend, but he would find time for long con- 
 versations, to drive me to the station, to spend a whole 
 Sunday afternoon at the Zoo — can one imagine a more 
 delightful visit there than with Horslcy, his knowledge of 
 comparative anatomy and of the habits and characteristics 
 of animals, his evident love for everything living ? 
 
 What wonder that he inllucnccd the lives and thoughts 
 of men, and their outlook on life. I doubt whether yet the 
 profession, especially general practitioners, realise how hard 
 he fought for them, how much he did for them. At a time 
 when men were growing dissatisfied with the B.M.A., and 
 complaining tliat it was too much managed by consultants, 
 here was a consultant par excellence figliting for the control 
 of the Association by the general practitioner, fighting then 
 as he after\vards did nbout the Insurance Act, absolutely 
 regardless of iiis own uitcrcbts.
 
 276 SIR VICTOR HORSLEY 
 
 How did he ever manage to be disliked, he who was 
 made to be admired ? Envy had not much to do with it : 
 envy and admiration can well keep house together. No- 
 body could help env}dng him. How was it that anybody 
 could help liking him ? 
 
 Some of us, members of his profession, were more solemn 
 than we needed to be in our dislike of his vehemence, his 
 displayed contempt for the other man's point of view. This 
 of all faults has least chance of hiding itself : and in him 
 we ought not to have taken it so tragically. We wanted 
 him to be like the rest of us, and that is just what he was 
 not. We could be content with compromises and measures 
 of expediency : he could not : his motto should have been 
 Brand's intolerable text. All or nothing. He despised 
 expediency, he believed in principles. He did not hold 
 with letting things slide, nor with dismissing them un- 
 examined. If a phrase in a letter vexed him, he would be 
 inclined to ' have it out ' with the writer, and would even 
 lecture him in a correspondence of steadily growing ex- 
 asperation on both sides. Some whom he offended were 
 his seniors, men of high standing : he would speak out his 
 mind as it were ex cathedra, he would even give the cut 
 direct : it was inevitable, that they should resent his 
 behaviour to them : they had reason enough for saying 
 that he was ' dillicult to work with.' 
 
 But the young men who worked with him in Hospital 
 wards and physiological laboratories did not find him 
 difficult to work with : they found him keen to help them, 
 lavish of his gifts, enjoying to advise and guide them in 
 their work so that it should tell to the best advantage not 
 for him but for them. And they are but a few of the many 
 of us whom he greatly helped. Let alone all the consult- 
 ing and operating that he did for love not for money, he 
 was always generous if a gift of money were needed and 
 deserved. And there are men whom he stood by and 
 befriended, year in year out, with steady personal kind- 
 ness, seeing them through one perplexity after another. 
 
 Besides, though he was quick to take and to give offence, 
 he did not set himself to enlist on his side, either in pro-
 
 PRIVATE PRACTICE. HOME LIFE 277 
 
 fessional or in general politics, those of us who were non- 
 combatants : there are many who can look back over 
 thirty years of constant friendship with him, though he 
 and they were never agreed in poUtics, nor ever desired to 
 be agreed. 
 
 Besides, some of us found offence where none was intended ; 
 we took seriously his hght use of flamboyant words, which 
 were nothing more than the slang of his early years ; mock- 
 heroic epithets, to be let off hke fireworks. He would call 
 So-and-so a ruffian or an arch-liar or a scoundrel ; saying it 
 with a smile and a good-natured shrug of the shoulders, 
 or digging his hands into his pockets and throwing back 
 his head and laughing at the bare image of the man. It was 
 habit : there are scoundrels in a letter of 1881, and ruffians 
 on a postcard of 1882. The trouble was, that So-and-so 
 would not be aware of that : he would only hear that 
 Horsley had caUed him a scoundrel. 
 
 The fact remains, that he alienated men whom he could 
 just as easily have bound to himself in friendship. He was 
 not — in the deepest sense of the phrase — a good judge of 
 men. A physician or a surgeon, by the exercise of his 
 calling, becomes a good judge of those men and women 
 whom he attends ; he sees them under conditions of sin- 
 cerity and of confidence, and sometimes of pitiful disclosure ; 
 he is perpetually learning from them : but he may fail 
 to be a good judge of people who have nothing the matter 
 with them. Horsley understood his patients, with insight, 
 sympathy, and gentleness : but he did not so well under- 
 stand his opponents. We are told that we must observe 
 the distinction between the sin and the sinner : it is not 
 so easy as it sounds : and he did not care to trouble himself 
 over it. If he disUkcd a hne of action, he tended to dislike 
 the man who was taking it ; and sometimes would try to 
 defeat him with heavy sarcasm. The action was the man. 
 The action being ' criminal ' or ' immoral,' there must be 
 something wrong with the man. 
 
 This inability to ' honour all men ' was nothing to us, so 
 long as it remained inside the sphere of professional affairs, 
 in comparison with his achievements. None of us could
 
 878 SIR VICTOR HORSLEY 
 
 do his work or take his place. But in the later years, when 
 he carried his vehemence into pubhc hfe, we had some 
 excuse for looking solemn. Our admiration of him was 
 baulked by what he was saying in the press and on the 
 platform : we took it amiss — ' we that had loved him so, 
 followed him, honoured him ' — that he was at the mercy 
 of the newspapers. 
 
 He might well have borne himself more quietly. For 
 what he was doing was something new, which the rest of 
 his profession was not doing. He was ' creating a pre- 
 cedent ' : and as he created it in his own image, it was ' a 
 dangerous precedent.' He was abandoning the stately old 
 idea, that a medical man should avoid pubhcity and be 
 content with practice. Against this old idea, he set his 
 new idea, that a medical man is just as free as any other 
 man to fling himself into open poUtical warfare, and to 
 fight for any cause which appeals to him. The great 
 physicians and surgeons of the generation before him upheld 
 the old idea. They kept themselves to themselves. They 
 were afraid of seeming to advertise, and they were afraid 
 of lowering the tone of the profession. They did not care 
 to go outside the happiness that they found, and the good 
 that they did, in science and practice. 
 
 Now and again, they were afraid where no fear was : they 
 would have been more useful to the community, on this or 
 that occasion, if they had spoken out what was in their 
 minds, and had published it far and wide. But they were 
 held back, not only by dislike of pubhcity, but by the sense 
 that the pubhc did not understand either their science or 
 their practice. Why should they talk to it about things 
 which it could not imderstand ? When they did handle 
 politics — what one of the greatest of them called ' these 
 beastly poUtics * — they preferred the indirect method : they 
 approached the Government by a circuitous path, as if 
 they were stalking it. They obtained some good results : 
 but it WcLS a slow business. Their interests were repre- 
 sented, more or less, in Parliament ; but it cannot be said 
 that their representatives were dominant figures. 
 
 Times are changed : and the medical profession is learn-
 
 PRIVATE PRACTICE. HOME LIFE 279 
 
 ing, rather painfully, to adapt itself to the change. We are 
 more willing now to educate our masters, and to throw in 
 our lot with them. Even before the War, some of us were 
 at work on the new lines : but Horsley was ahead of us : 
 he had ' gone in for pohtics,' he was scattering the past 
 about, hke the New Age in Matthew Arnold's poem. Through 
 the difficult years which are coming, whatever public duties 
 may be required of our profession, it was Horsley who gave 
 us a lead in the years before the War. 
 
 One more criticism remains to be considered, not of his 
 work in pohtics, but of his work in physiology ; that he 
 was impatient for results ; that he ought to have made 
 fewer experiments, and to have observed them more labori- 
 ously ; that he did not attain Pasteur's ideal of a man of 
 science, who ' must compel himself to fight against himself, 
 for days, weeks, perhaps years ; to try to defeat his own 
 experiments ; and not to proclaim his discovery till he has 
 exhausted all other possible theories.' But he followed, 
 early in life, three great and well-marked Hues of scientific 
 research : on the locahsation of function in the brain and 
 cord, on myxoedema, and on rabies. This threefold work, 
 1884-1893, was all of it early work : the latest of it is a 
 quarter of a century old. Like all research in the natural 
 sciences, it had to be corrected here and there. He took up 
 each subject at the decisive moment ; in the nick of time. 
 Everywhere men were talking of cerebral locahsation, the 
 thyroid gland, and the protective treatment against rabies. 
 He comes in at the topmost height of our expectations. 
 The adjustment of surgery to the physiology of the brain 
 and cord, the discovery of the action of the thyroid gland, 
 the stamping out of rabies and hydrophobia — all these we 
 were hoping for, and were looking to him to help us toward 
 them. Nobody can say that he failed us. Nobody denies 
 the authority and the staying power of his work for science 
 and practice. He is with Ambroise Par6, Lister, and 
 Hunter : with them, not below them. Par^, in practice, 
 was one of the greatest of all surgeons ; but he had only 
 such science as the age could give him. Lister is greatest 
 of all the ' saints laiques ' in the doctor's calendar ; but
 
 280 SIR VICTOR HORSLEY 
 
 he docs not equal Horsley in range and imaginative insight. 
 Hunter was magnificent : but he did not trouble himself 
 over the welfare of the community : he was content with 
 a rather selfish hfe. 
 
 That, after all, is the distinctive note of Horsley's hfe and 
 work ; that he could not rest in all science and practice, 
 but must also be in pohtics. We have lost a man who was 
 always willing to set aside his own interests for the whole- 
 hearted, full-blooded pursuit of an unpopular cause. We 
 had been with him, followed him, or come into coUision 
 with him in the streets of hfe, always conscious of him, 
 always saying that there was nobody hke him : and then 
 of a sudden he was gone, and we were left standing on the 
 old ways of individualism, honourable but unad venturous. 
 
 If it were possible to put him in a sentence, he had the 
 supreme gift of dehght in the use of all his gifts. He seemed 
 never to be idle, never slack or vague or at a loss for some- 
 thing to work at or admire or fight for. It is the secret of 
 our envy of him, that he was heart and soul in love with 
 life. That is why his death so took the colour out of things. 
 
 Like Ajax raging to himself in his tent, and mistaking a 
 flock of sheep for his enemies, he was unwise in his wrath, 
 and would attack harmless people with strange misunder- 
 standing of them. He bewildered and exasperated us : he 
 shook us up : he shone us down. It all comes back to the 
 phrase that there was nobody hke him : as it was said of 
 him, at some German festival dinner, ' Und da steht Horsley 
 wie ein Gott.' One can hardly imagine him in old age, slow 
 and infirm and past work : he did not have to face it. 
 
 When he died, he was nearing the end of his inventive 
 and imaginative power in physiology and in surgery. He 
 said, not long before the War, to one who complained that 
 he was giving up science for politics, ' It 's all very well ; 
 but my brain 's not boiling with ideas as it was when I was 
 thirty.' Some time after 1914, he said to his daughter that 
 he was losing his keenness for research ; that it did not stir 
 him, when younger men talked to him of what they were 
 doing. His hfe was beginning to tell on him. Always, he 
 had taken the responsibihty of advising and treating those
 
 PRIVATE PRACTICE. HOME LIFE 281 
 
 who were nearest and dearest to him, even operating on 
 them : it will never be known, save to one or two, what a 
 strain some of these cases put on him. If he had come back 
 from Mesopotamia, he would have devoted himself to the 
 pohtical advancement of national happiness and health 
 and efficiency, and would have done more than any man in 
 his profession was doing. 
 
 He, and he alone, had the planning of his hfe : we had 
 designs of our own for him : but he alone decided how to 
 use up all that was in him. Always, he had spent himself 
 with superb extravagance : he was still at work, the day 
 before he died. It is not in the range of men's intellects, 
 to understand, through and through, a man's hfe. The 
 real values of it are hid from them, and are not clear even 
 to him. This man, at any rate, played his hfe for all it 
 was worth : there is nothing that he kept back from us, 
 there is nothing that he feared.
 
 PART III 
 DURING THE WAR 
 
 I. LONDON. WIMEREUX 
 II. EGYPT 
 III. INDIA. MESOPOTAMIA
 
 e
 
 I'liiito S/<ciiii!lil. I.ditilon 
 
 SIR VICTOR HORSLEY.
 
 London. Wimereux 
 
 On the Monday, August 3, 1914, he had occasion to write to 
 friends in Berlin, who were looking after one of his patients ; 
 the letters came back ' Undehverable,' and were put away ; 
 they are concerned with the treatment of the case, but he 
 states in them his first thoughts of the War : 
 
 (i) Of course I think it is wholly unjustifiable, though I 
 appreciate that Austria's difficulty in keeping order in the 
 Balkan States must be very great. Still I do not think 
 that she should have begun war, for it was obvious the 
 whole of Central Europe would start in. As to Russia, no 
 one detests Russia and all her ways more than I do, and 
 it is most disturbing to feel that in any way directly or 
 indirectly one is helping Slav barbarism. My only hope 
 now is that the people of each nation will rise and stop the 
 whole gang of Chancellors and Emperors by wiping them 
 off the scene. But I fear the millennium is too far off as yet. 
 
 (2) Until the officials are under the power of the whole 
 people, men and women, this stupid, insane folly of war 
 must go on. I can only hope that as after 1870, Socialism 
 will get more strength and put an end to the arbitrary 
 miseries, injuries and losses heaped on millions of people 
 by their rulers. I remember well in Berlin in 1890 Virchow 
 made a speech at a small dinner I was at, when he spoke of 
 the Russian danger to Germany, and how it could only be 
 opposed really by the German people receiving pohtical 
 liberty. Of course so far he was right, and I trust that this 
 will be the result of the war. 
 
 He was too ready with his judgment. It is true that he 
 saw, and said in public, that a state of war brings out fine 
 qualities in men ; he loved to praise the mind of Abraham 
 Lincoln ; and much that he foretold has already come true. 
 But, if we are to go by his letters, he wrote of the War, and 
 of all war, as stupid murderous folly, a sort of criminal 
 insanity brought upon a nation, somehow, by tyrants and
 
 286 SIR VICTOR HORSLEY 
 
 diplomatists, a madness to be cured by democracy and 
 universal suffrage. He is so confident of his ability to judge 
 the War, that he does not realise how the War is judging 
 him. There is next to nothing, in his letters, about the 
 War and the nations, that rises above contempt and invec- 
 tive phrases : one longs for something else — the Greeks had 
 a word for our proper attitude in the presence of the Gods — 
 some confession of faith, humility, ignorance : something 
 to redress the balance. 
 
 There is a letter of a very different sort, a curiosity of the 
 War ; it came to him from Germany, a few weeks later ; 
 a good typewritten example of stock letter-writing ; doubt- 
 less from an old patient, for it is signed Yours very grate- 
 fuUy: 
 
 Although by this unnatural war all confidence has been 
 destroyed between our two nations I feel that even now an 
 English gentleman will believe the word of a German gentle- 
 man. I uill put some facts before you and on my word of 
 honour declare them to be true. Our German soldiers have 
 not shot a single Belgian civilian nor burnt a single Belgian 
 house unless by order of their superiors to punish outrages 
 unheard of in the history of modem European warfare 
 although not unknown in the Belgian Kongo. 
 
 Belgian men, women and children have murdered German 
 soldiers peacefully sleeping in their houses and coaxed into 
 security the evening before. They have cut out the eyes 
 of the wounded, mutilated them, shot nurses and doctors. 
 
 The town and population of Loewen [Louvain] was not 
 touched until the Gennan garrison was fired on by the 
 whole civilian population. Then there was a fight and after 
 the fight the whole population was ordered out of the town 
 and fire put to many houses. Nevertheless when by order 
 of their superiors our soldiers were busy extinguishing the 
 fire to protect the town hall they were again fired on. 
 
 Many thousands Dum Dum bullets have been found in 
 the pockets of many French soldiers, they were of French 
 make and obviously manufactured. 
 
 It is not true that the Russians are progressing in Germany, 
 we have beaten them in a decisive battle on the 29th of 
 August, and made 90,000 prisoners ; in the last three days 
 we have won another great victory and now there are prac- 
 tically no more Russians on this side of the frontier. 
 
 He had been a Captain in the Territorial Force since 
 1910, and was on the Staff of the 3rd London Hospital ;
 
 LONDON. WIMEREUX 287 
 
 he worked hard for its organisation and equipment, so soon 
 as war was declared ; but of course he was longing for 
 more active work : he was, as he afterwards said, ' eating 
 his heart out at home in enforced idleness ' : and he tried all 
 possible means to put his services at the disposal of the sick 
 and wounded. On August 12, he writes to Sir Arthur 
 Sloggett : 
 
 As I am extremely anxious to serve in the present War, is 
 it not possible for me to be transferred to the Active Ser\ace 
 List, and given an appointment as Surgeon to a Base Hospital 
 either in England or on the Continent ? I will wait on you 
 to-morrow at the War Office on the chance of your being 
 able to see me. I may say I have my kit, and could leave 
 at once. 
 
 He was advised not to ask for immediate transference. 
 
 A few days later, he writes again : 
 
 I venture to hope that you may think it weD to form a 
 group of supernumerary officers, attached to the Expedi- 
 tionary Force, and at the disposition of the Principal Medical 
 Officer of that Force, in order that he might supplement the 
 estabHshment of any base hospital upon which special 
 pressure of work happened to fall. This would not in any 
 way mean the appointment of a special group of ' consultants,' 
 a course which has always seemed to be contrary to Service 
 organisation and discipline. On the other hand, the appoint- 
 ment of supplementary officers would not only augment 
 the general surgical staff when required, but also, if desired, 
 add to the consultant strength.^ 
 
 On August 25, he writes to Dr. Lendon of Adelaide : 
 
 The situation is exactly what you would expect from the 
 aristocrats who rule Europe. Austria tr^-ing to smash 
 Servia : Germany coolly smashing Belgium. Burglary 
 and murder arranged in the name of God by rulers and 
 nobles. And all the while the people who are starved, 
 tortured, and killed have not liad a single voice in the matter I 
 
 ' To Dr. Mary Slurge, Aug. 17. — ' Clearly we can push forward now [with 
 the fifth edition of Alcohol and the Human Body], though it is really 
 very difficult to work with any ko or purjKjse when one is quite certain 
 that one could really be of much more service elsewhere, vis. in the 
 Belgian base hospitals. However, I am not going out in any of these 
 fashionable and disreputable sideshows, I am glad to say. Moreover, as 
 a T.F. otTicer, the War OfTire have the determination of my movements, 
 n they agree to my application to be transferred from the T.F. to the 
 active service list, I would probably be off somewhere aUiuf Sept. i, 
 I suppose, but I am doubtful how far my innumerable haters will succeed 
 in dishing my application altogether.'
 
 288 SIR VICTOR HORSLEY 
 
 The worst is that the people generally, and especially the 
 Germans, are not civihsed, and are so uneducated pohtically 
 that they are like sheep, and I doubt really whether, when 
 all this mad folly is over, they will claim democratic and 
 parliamentary Government. If they do not, then all the 
 same rotten expenditure on armaments and fleets and ' glory ' 
 will go on just as before, and in another fifty years there 
 will be another turn-up of the same kind. Of course we 
 must simply now keep the pot boiling until the Germans 
 have evaporated to dryness, or life will not be worth having 
 for anybody anywhere. Siward and Oswald being in the 
 Teiritorials and I in the Territorial Medical Service, we 
 chucked our hohday on mobiUsation, and came back here 
 to remain. My base hospital having a staff twice too large, 
 and my seniors having started first with the posts, I have 
 volunteered for the Expeditionary Force in France, but 
 doubt whether they will appoint any Supernumerary Officers 
 yet. However, my name is down first to be employed from 
 the Territorial Force, so if I am not appointed it will be the 
 usual official opposition to hberty and anything short of 
 senile humbug. In the Boer War no one of any independ- 
 ence of thought was selected. 
 
 In September, to refute the German assertion that our 
 soldiers had been supplied with ' dum-dum bullets,' he was 
 asked by the War Office to report on the rifle and revolver 
 ammunition issued to the forces ; and made some experi- 
 ments, on the lines of his previous work with Dr. Kramer. 
 His two reports bear date September 13 and 15, I9I4.'^ There 
 is a letter to him from the War Office, September 15 : 
 
 Lord Kitchener has asked me to thank you very much 
 indeed for your memorandum on the service rifle bullet 
 in reference to its effects, and he hopes to make great use of 
 it. He immediately asked me about the revolver bullet, 
 and I told him that you had very kindly arranged to send 
 another memorandum on that. 
 
 In October, he accepted an invitation to join the Union 
 of Democratic Control ; and at once tried to persuade 
 
 ^ For the German assertion, see the Times, September 10. The report 
 of the War Office (Times, November lo) proves that the ammunition 
 issued to our forces was in absolute accord with the requirements of the 
 Hague Convention. It says also that German troops, ' both in Togoland 
 and in France, have been proved to have used bullets with a soft core 
 and hard, thin envelope not entirely covering the core, which type of 
 bullet is expanding, and therefore expressly forbidden by the Hague 
 Convention.' Such bullets, of no less than three types, were found on 
 German soldiers, both in Togoland and in France.
 
 LONDON. WIMEREUX 289 
 
 them to include female suffrage in their programme. On 
 October 9, in Liverpool, he gave the Mitchell Banks Memorial 
 Lecture. He spoke of Mitchell Banks's influence on the 
 operative treatment of cancer, and on the radical cure of 
 hernia : and he described his own method for the radical 
 cure, which he had used since 1890. Finally, he spoke of 
 the good social and civic work which Mitchell Banks had 
 done for Liverpool ; and quoted one of his sayings : 
 
 We must be something more than mere prescribers of 
 physic and healers of wounds. In my youth I had it strongly 
 recommended to me to stick to my profession and leave 
 everything else severely alone. The life of a doctor was to 
 see patients, do operations, order drugs, and collect fees. 
 I thank God that I entirely repudiated this idea of my 
 profession. 
 
 In November, he took part in a controversy over the best 
 method for the immediate treatment of heavily infected 
 gimshot-wounds. 
 
 By December, he still had not the work to which his 
 record in science and practice entitled him. To be one of a 
 dozen men on the staff of a Hospital in London was not 
 good enough for him. It is worth guessing, what Germany 
 would have done with him, if it had possessed him, and had 
 not imprisoned him for his politics. Perhaps it would have 
 given him a Hospital of a thousand beds — some K.K. 
 Anstalt for Wounds of the Nervous System — with a 
 host of doctors and nurses working under him. Mr. Bond 
 writes : 
 
 I was in Australia when the War broke out ; and saw 
 Horsley soon after my return in October 1914. His two 
 sons had already joined the combatant ranks of the New 
 Army : and when I returned from my first visit to France, 
 in December, Horsley expressed to me in forcible and moving 
 language his own great desire to be of some personal use 
 in the national cause. 
 
 Early in 1915, he was appointed in charge of the Surgical 
 Division of the 21st General Hospital, for service in France. 
 Meanwhile, he had promised to be Surgeon to the British 
 Hospital established at Wimereux by Sir Henry and Lady 
 Norman. The 21st General Hospital was not yet organised : 
 
 T
 
 290 SIR VICTOR IIORSLEY 
 
 he was therefore allowed to keep to his arrangements for 
 Wimereux. 
 
 On February 8, he opened a discussion, at the Medical 
 Society of London, on Gunshot Wounds of the Head. He 
 went over the experiments made by him and Dr. Kramer : 
 and he took point by point the signs and conditions to be 
 observed in these cases. He spoke against what he called 
 the wicked tradition, the fatal and detestable practice, of 
 ' leaving head cases alone ' ; and upheld the example of a 
 case in which Major Sherran had saved a man's life by 
 trephining within a very few minutes after the infliction 
 of the wound. There is one touch of bitterness ; and no 
 wonder : ' I have not been permitted to see any cases in 
 the present War, except a few exceptional cases which 
 happened to be referred to me unofficially.' 
 
 On March 8, in Leeds, and on March 15, in Huddersfield, 
 he spoke on the need of more control over the drink-trade. 
 He went to Wimereux on March 28. 
 
 The British Hospital was in the Hotel Bcllevue ; the two 
 first floors as wards, and the top floor for the Staff ; their 
 meals at a near little restaurant ; ' everything quite good 
 and simple and rough.' His letters to Lady Horsley begin 
 with his hrst impressions of Wimereux : 
 
 March 29. This place would reduce you to tears on 
 coming into it, and twenty-four hours would place you in 
 Bedlam. It consists of half-built French houses and a few 
 hotels planted in a hollow with a little river, muddy because 
 tidal, about 15 yards wide, running dowTi the middle. The 
 country immediately round it is a desert. The river runs 
 in front of my bedroom, and the ducks on it demand their 
 breakfast punctuaUy at 6 a.m. with no uncertain voice. 
 
 The ' family party ' was a happy family : ' The life is of 
 course interesting and very pleasant in its funny way. The 
 Matron and sisters are all excellent and know their work 
 well.' The wards, at first, were half empty : ' The morning's 
 work has taken about i^ hours, but the experts have called 
 on me, mirahilc dictn, and so that takes up the morning as 
 well.' There was time for some sight-seeing: he writes 
 of the churches at Audinghen and Marquise, the ' wonder- 
 ful stateliness in a small church — all Early Enghsh I
 
 LONDON. WIMEREUX 291 
 
 think of course can be stately ' — and of white violets 
 by the roadside, and of the Convalescent Camp : ' From 
 having been a mud misery of wet tents it is now a hutted 
 estabhshment very thoroughly installed and admirably 
 administered, thoroughly and economically : the paths all 
 stone causeways, and, between the huts, flower-beds, with 
 national symbols.' On Saturday, dinner with the mess 
 of the 14th General Hospital, ' of which we are really an 
 annexe ' ; on Sunday — 
 
 Sunday was rather amusing. Lady Norman had insisted 
 on our having a P.S.A. as soon as she found that I knew all 
 about it : and we found at the Convalescent Camp a capital 
 young Canadian lieut. who was a host in himself and 
 brought down a congregation for us, who possessed six 
 experts in mouth-organs and a piper of the 2nd Gordons, 
 Tennent by name, who was in Oswald's company. We 
 began the show with the Cock of the North on the pipes, 
 and then Tipperary by the mouth-organ band. Then a 
 hjnnn, then Norman, who I insisted on being in the Chair, 
 read at my request the 55 Ps., which he did with 
 splendid verve. It seems he is a great reader. Then I 
 gave my usual war address, which was much appreciated : 
 then another hymn : then Won't you give me your answer, 
 Maggie Mackenzie ? on the mouth-organs : and another 
 obligato. Really excellently done and enormously appre- 
 ciated. Closed of course with God Save the King. Alto- 
 gether a vast success. The Good Templars in the Army 
 here want me to hold forth. I will write to Miss Coomber 
 and get her, as you will be away, to send me out my slides. 
 It seems they have a lodge here, and one at Boulogne. (By 
 the way, I think almost all the mess drank wine in spite 
 of tlie King. I quite agree as to the Temperance party 
 keeping low awhile. The King's example is I can sec crush- 
 ing, but taking time to work.) In the evening I went over 
 to the Australian Hospital, where they have every three 
 weeks a most interesting gathering of all the surgeons, or 
 two from each hospital. They all have to select representa- 
 tives, and consequently all tlic experience is well collected. 
 Then a beautiful walk home over the ch0, as it was a clear 
 cold evening. 
 
 Monday. Robinson and I liavc had a fine time in pelting 
 rain. We went in the tram to Boulogne : settled about a 
 poor chap I have, and want to get to England : liopeless 
 spinal-cord paralysis : a fine young fellow but doomed : 
 and I am anxious to get him home to see his people before 
 it is too late. The haibour is a mass of orderlies, mud,
 
 292 
 
 SIR VICTOR HORSLEY 
 
 and good-natured hard-worked officials. Then a grand 
 tour to the old tovvTi, where I am thankful to say I found 
 Henry viii's cannon-ball stuck in the wall. These beggars 
 here would not beheve in its existence. The children of 
 
 course were running about in their capes in all sizes and 
 proportions. In consequence of the said rain, I found two 
 harrowing sights at front doors. The agony of the fingers 
 trying to reach the bell-push was only equalled by the con- 
 vulsions of the legs. Tragedy No. 2 I put an end to by 
 ringing the bell and walking away. Long before we got 
 
 out of sight we saw the door opened, and of course the 
 unfortunate one went in hke a streak. 
 
 Through the first half of April, the work was slack : ' it 
 is the unsatisfactory business of amateurism. These private 
 hospitals are not wanted, though the beds are ' : and his 
 letters to his wife are concerned both with his work and 
 with hers — with the affairs of the British Women's Temper- 
 ance Association and the Women's Liberal Association. 
 And one letter is to say that he wants twenty cakes of 
 verbena soap from Atkinson's in Bond Street : ' I mislaid
 
 LONDON. WIMEREUX 293 
 
 mine here while going round, and two sisters thought they 
 were being distributed, so naturally impounded them 1 
 Now I must furnish all the rest ! and have one for myself ! ' 
 The Hospital, hke private hospitals elsewhere, had to ask 
 for patients : then came a rush of work : 
 
 April 17. Wc have had such a day and night business of 
 it that I have not had time to write. Also, there was a 
 block on the line, and consequently the septic cases arrived 
 in bad state, and that means many more dressings per day. 
 Now we have got things straight, and I am thankful to say 
 an amputation at the shoulder I had to do for spreading 
 gangrene is going to recover. He is such a splendid chap : 
 a Manchester cotton-weaver. . . . Now as regards your 
 
 biz. Of course is an arrant old incapable humbug. She 
 
 always has been a pro-alcoholist : and of course got into 
 very serious relations with the American quack pra3dng 
 woman who called herself a doctor. I would quietly go 
 for her at the meeting bald-headed. . . . The steady deter- 
 mination in the newspapers of the alcoholists to disregard 
 the King and Lord Kitchener is very striking. What have 
 
 and , etc. etc., done? It would be worth while 
 
 making a census of one's friends. Here the Normans are 
 the only ones who have dehberately followed the King. 
 
 did for a few days, and then relapsed : he is 
 
 extraordinary in liis reactionary ideas : but 90 per cent, 
 good - hearted. Of course he is a rabid anti- suffragist. 
 Fortunately I find all the sisters here are first-rate people 
 and all progressive : so when we are thoroughly sick of his 
 and 's ' arguments,' we can concoct plans for the future. 
 
 April 21. >X'e have had a doing of it, chiefly owing to 
 the number of cases not of wounds but all sorts of ailments, 
 trivial and othcrv\'ise, arriving at all hours of day and night, 
 especially midnight. That part is very badly arranged, as 
 the train leaves the railhead at 8 or 9, and takes twelve 
 hours to go about fifty miles. Every case has to be looked 
 at, and always some to l)e attended to at once. On the whole 
 the wounds come down well dressed and comfortable. . . . 
 
 made me very angry yesterday by coolly saving that 
 
 we (the English) were on the whole carrying on tiiis war 
 very clicaply ! He meant in the loss of hfe I I told liim 
 that if he were in the firing hnc he migiit have some justifi- 
 cation for saying such a thing. April 25, 6 A.M. y\s I 
 had to dress a case at 4. and a frcsli convoy of wounded 
 arrived at same time, I am up and writing while the unfor- 
 tunate victims of men's government arc being washed 
 and got to bed. May 8. We are having a steady stream of 
 bad cases admitted now at all hours, and I hoar that this
 
 294 SIR VICTOR HORSLEY 
 
 is likely to be the case now. As a matter of fact all this 
 country should be organised as Base-hospitals, it seems to 
 me, at least as far as Calais. Etaples in my opinion is 
 unnecessarily far off. Unfortunately we are beginning to 
 get rather more sepsis with the warmer weather ; and the 
 men's chances vary directly, as I maintained last August, 
 with the promptitude they are treated with after the moment 
 of wounding. We have some gassed people, but on the 
 whole not bad ones. Four head cases severe all doing 
 well. One is a regular Northumbrian from Alnwick, who 
 works in the Park, and was frightfully bucked because the 
 Duke had heard he was gravely wounded and wired to 
 know how he was getting on. He was shot through one 
 frontal lobe and partly the other, so he is a ' good case.' 
 
 There was a plan for his wife and his daughter to come 
 over. Le Touquet would not please them — ' a \'ile hole as 
 you may suppose of the worst artificial French seaside 
 place. The pine - trees which are all about 20 ft. high 
 are interspersed with rustic seats ; and the plage a hideous 
 collection of houses.' But Etaples promised well : 
 
 I believe it would be quite a good move for you and P. 
 to take up quarters in a nice old house there, or board with 
 some decent people. I saw some quite good houses, one 
 witli a beautiful garden, cherry-trees full blossom, etc. etc., 
 and Henri iv waDs. 
 
 But these plans came to nothing : for in May the 21st 
 General Hospital was ordered to Egypt. He had a few 
 days in London, to get his tropical outfit : he was gazetted 
 Major, R.A.M.C.(T.) : and on May 20, 1915, he left England. 
 The six weeks at Wimereux had been a pleasant time : but 
 the work was not enough for him. The private hospitals, 
 even the best of them, were imperfect instruments : he 
 envied the discipline of the Austrahan Hospital : ' They are 
 very good up there, and have got their place on strict 
 military footing.' But his Wimereux letters are delightful : 
 for they recall his gaiety, his kindness, and his enjoyment 
 of the world's kindness — its fine architecture, and its white 
 violets, and those twenty cakes of verbena soap from Bond 
 Street — and his last sight of a country as beautiful, and 
 almost as dear to us now, as our own.
 
 II 
 
 Egypt 
 
 The Staff and Nursing Staff of the 21st General Hospital 
 left Southampton, on H.M.S. Delta, on May 20, and reached 
 Alexandria on May 29. He began well, with ' a powerful 
 Atlantic swell which cut off half the population of our 
 tables and established for me a great reputation, because I 
 went round and dosed the sufferers with anti-nausique and 
 effected great and marvellous cures. ... I am glad to 
 say the 21st Hospital is shaping very well. The O.C, Col. 
 Robinson, knows his job and does it. The second in com- 
 mand. Major McDowall, is I should fancy a very good officer, 
 and one who not only knows his business but can see that 
 we do ours : so that is a good start. I come next, and 
 therefore all the bullying must start from my level. Our 
 quarters are very comfortable : a few have cabins to our- 
 selves, but the majority are in ward cots. Unfortunately, 
 as the ship has been gutted to make the Hospital, we have 
 to feed in two lots, which is not nice for those who must 
 dine at 6. The Captain is a very nice little chap, Le Mare 
 by name, and most successful. Altogether it is a very 
 " happy " ship.' 
 
 May 22. At night the afterglow was magnificent. Of 
 course you won't believe I saw them, but the colours were 
 Sky, deep blue, green, pale yellow, deep red ; Sea, dark 
 indigo : shading into each other ' as per diagram.' At 5 
 I woke and looked out just in time to sec a very fine pre- 
 dawn effect behind a really large hill cape with a dark wreath 
 of cloud round it, and the suspicion of dawn as a hght back- 
 ground. 
 
 May 24. Wc passed Gibraltar like many ships do ' in 
 the night,' and arc now going diagonally through the Strait 
 some 120 m. E. of Gib. The Spanish coast is most 
 effective in a limited way. The tops of the mountains
 
 296 SIR VICTOR HORSLEY 
 
 were quite ' floating,' as people say, on the mists. The sea 
 is calm and as tedious as usual with nothing to be seen. 
 
 May 26. The Northern shore of Algeria developed as a 
 wonderfully forbidding wall rather like the Lynton coast in 
 general design, but in detail simply atrocious. Blue sand- 
 stone and limestone cliffs with dry watercourses grooving 
 them and curious scrubby woods spread over the ridge. 
 Later, the coast settled down into the conventional sandy 
 wastes which we suppose to be the regular thing for N. 
 Africa. We have now turned the Tunis comer and are 
 running past a volcanic island called Pantellaria covered with 
 the usual scrub on the top, and most of the rest of the surface 
 cultivated in little fields, and each small holding has a little 
 house. I suppose that as it is an Italian convict station, it 
 is a kind of Botany Bay. 
 
 May 27, We are grinding away through a pure ultra- 
 marine sea almost calm, and nothing to see or do. Satan 
 therefore suggested to the Colonel that he and the two 
 Majors had better be inoculated against typhoid ; so we 
 were duly done and my arm is proportionately disagreeable. 
 However, it appears that the regulations say, no alcohol of 
 any kind is to be taken during the inoculation period. On 
 enquiry I find that the War Office worthies learnt by experi- 
 ence that when the injection-area began to hurt owing to 
 the local congestion, a small quantity of alcohol (one go 
 of whisky for example) caused not only much more pain 
 and throbbing from vascular dilatation but also produced 
 more headache and general disturbance, owing to the fact 
 that sundry toxins being also present in the blood, the 
 alcohol increased the constitutional discomfort they caused. 
 It is really a lovely demonstration that small doses of alcohol 
 produce very definite ill-effects on the body. I pointed 
 this out to the drinkers at our table who had not considered 
 the point. 
 
 May 28. Still oozing through the liquid ultramarine : 
 and nothing else. The cats here on board are amusing and 
 numerous. The progenitor of the race used to be a great 
 ratter, and was an animal of great discrimination, because 
 whenever she caught a rat she brought it to the Captain's 
 cabin to present it to him : and if he was not in, she took 
 it to the 1st ofBcer, who of course was pretty sure to be 
 in his bunk if the Captain was out and about. Nobody else 
 was ever noticed. There are two terra-cottas, one black 
 (a half-bred Siamese), one iron-grey, and an inexhaustible 
 kitten who spends most of his time on his hind legs and makes 
 us all the 200 rank and file play with him. . . . The climate 
 is just beginning to stoke up and feel rather like New York 
 did. I can't think of any more, you will be glad to hear. 
 Farewell. Talking at Beaulieu of water-wagtails, I find
 
 EGYPT 297 
 
 that the Arabic for him is Abu faraikh, which means ' Father 
 of Promenaders.' Quite agreeable, is it not ? 
 
 He was in Egypt from June 1915 to March 1916. In 
 August, Lady Horsley joined him. In October, he visited 
 Mudros and GalhpoU. In October, also, their daughter 
 joined them. In November, she had very severe dysentery, 
 and nearly died of it. At the end of the year, he visited 
 Mersa Matruh. In February 1916, he got a few days with 
 his wife and his daughter at Helwan and Luxor. In 
 February, also, he received the honour of the Order of the 
 Bath.i In March, he went to India, and from India to 
 Mesopotamia. 
 
 Ahke in Egypt and in Mesopotamia, he had grave reason 
 to find fault with the administration of the medical services. 
 Nobody doubts that they were ill-prepared for the War : 
 nobody doubts that he had much to do with their im- 
 provement. But his hatred of alcohol tends to make him 
 embitter the case : he writes now and again as if he were 
 fighting for dear fives against men so dulled by whisky that 
 they hardly cared to do the right thing. 
 
 The building assigned to the 21st General Hospital was 
 the Outer Barracks, close to the Khedival Palace, Ras-el-Tin, 
 Alexandria. 
 
 His letters to his wife, at first, are in great part concerned 
 with advice to her not to come out till the hot season is over : 
 
 May 30. . . . No real preparations made for us at all, 
 so we shall be frantically busy licking into shape the rotten 
 old barracks which have been handed over to us to convert 
 into a hospital. The Israelites in Egypt were not in it 
 re making tjricks. We arc temporarily billeted in a frowsy 
 Greek hotel until we have made comi)arativcly clean the 
 floors and walls (^f our new (piarters. Of course the colours, 
 sunset, etc. etc., are lovely, but the smells and flies are some- 
 what turgid. June i. ... So much for climate. Now 
 
 * This was the last of his many honours : but it is worth noting that 
 Professor Pctren, of Stockholm, had more tlian once proposed him for 
 one of the Nobel Prizes : and that he had accepted an invitation from 
 Vienna, a few months lK'f(ire the War, to ^'ive the Nothnajjol Lecture. 
 No man in his profession had more (nciids and admirers, up to the time 
 of the War, in Germany and Austria. He was the man to watch oi>crating, 
 to be proud of knowing, to ask after — ' You are an English doctor ; do 
 you know Sir Victor Horsley ? '
 
 298 SIR VICTOR HORSLEY 
 
 for Alexandria. Really not worth visiting artistically. As 
 an introduction to the East, and a halfway house, it will 
 pass : but I foresee many days in which more work will be 
 a relief. For you and P., life would be very slow and not 
 pleasant, unless the weather was tolerable, which of course 
 at present frankly it is not. Mind you, I like the heat and 
 feel extremely well with it, but I think without occupation 
 it would be unspeakable. We have cockroaches here as 
 big as mice : one has just descended my chest of drawers. 
 I fear this little invasion would not please you. Mosquitoes 
 are just getting to work. {Xote. — The said cockroach has 
 just gone to ground, having perceived me uneasily from an 
 eyrie on one of the brass handles, which I suppose he absurdly 
 thought suited his complexion mimetically.) So much for 
 insects. Now for history'. I cannot now explain fully the 
 position of the wounded British Soldier out here. Thank 
 goodness the boys are in France. . . . You cannot in adminis- 
 tration get people of one age. Naturally, the man at the 
 top is a good deal older, and ' What was good enough when 
 he was a young man,' etc. etc. That is the only way I 
 can account for this never-ending repetition of conditions 
 which have been pilloried from the time of Florence Night- 
 ingale onwards. June 2. I went this morning to the Indian 
 Hospital (San Stefano) and found them in great feather, 
 as they had taken my advice and operated on a head case 
 and got out the bone and pus I suggested was in his head. 
 I operated for them on a like case, and then hurried back 
 to our shop where we spent a busy morning setting up the 
 theatre and A;-ray departments. . , . The poor old Delta 
 is still in harbour taking off wounded in an outrageously 
 slow and heartbreaking way. Among them to-day was 
 a small bugler about 14 wounded in the arm, with 
 apparently a tumour on his shoulder. This on examination 
 proved to be a pet monkey concealed under his coat over 
 his dressings ! I am glad to say the Maj. R.A.M.C. in charge 
 allowed him to keep his monkey on the ship ; so they will 
 have a time of it, I expect, going home. 
 
 June 7. We have had a strenuous three days bug destroy- 
 ing, masonry ditto, firing with paraffin blowers and finally 
 spraying with formalin and washing with crcsol these large 
 barrack rooms. The bug section I led with three most 
 excellent subs, and so I photographed them which pleased 
 them. Then we had to clean tlie windows and doors, so 
 now we really are aseptic at the present moment.* I am 
 
 * Pte. J. K. Matthews writes, May, 1917 : ' I was in Mesopotamia, 
 and just at the time he arrived there, the fellows who were in Hospital, at 
 any rate the particular one in which I was, were very miich bucked up, 
 and talk generally was, llungs will be much better after liorslcy has paid
 
 EGYPT 299 
 
 sitting in the verandah, which is a dusty but cool brick 
 loggia. This is what is in front. The broken line is a reef 
 of rocks with surf, and a boat is making for a gap. The 
 object on the right horizon is a fort we busted in 1882 : 
 and the objects on the sea-wall are two normal Egyptians 
 in their niteys conversing affably. The surf bar with the 
 flat shallow bay is of all imaginable colours from ultra- 
 marine in the far distance to light transparent green in the 
 foreground. . , . The native children play here at football 
 in the broiling sun : also knucklebones hke the Pompeians : 
 also the game of horses, as played with the shirt (only) 
 as reins. Now to w^ork again. June 12. I had my second 
 inoculation on Sunday. Owing to there being no pre- 
 parations whatever for our coming, and the needs for the 
 wounded being something not yet to be described and 
 therefore requiring every one to buck up, we had a hot 
 time, and on Wednesday I wrenched my bad arm, so it 
 paid me out with a feverish attack from which I am already 
 recovered. It was nothing in my opinion but a dose of 
 toxins, and sure enough has disappeared. . . . Small jokes 
 have enhvened our work. We were hunting for operating 
 overalls and aprons : and while I was laid up, one of my 
 subs, a very good man, said he had found them and was 
 steriHsing the lot. In the evening, came a note from the 
 Quarter Master's Office, ' Would he very kindly return the 
 Cook's aprons, which they heard were being sterilised ' ! 
 
 Jttne 14. The work grows exceedingly, and unfortu- 
 nately the difficulty of enthusing our own people to do the 
 best for the wounded and not put them off with a make- 
 shift is terrible. Any one would suppose they thought it 
 the wounded 's own fault they got injured and must put 
 up with a few wholly avoidable inconveniences, many of 
 which can cause death itself. I really could not have 
 imagined such wooden cerebration. The equipment of 
 this hospital, supposed to be most modem, falls short of 
 absolutely essential things in some cases, and I am trying 
 to get them locally, but it requires incessant appHcation 
 to the powers, who not being conversant with modem surgery 
 cannot of course recognise the terribly urgent need of various 
 essentials. The usual formula is, Can't you ask Sister to 
 do it ? Sister being already done to death. Meantime 
 
 us a visit : and such a bright picture was painted that, when his death 
 was announced — well, to say the Ica-st, it was a terrible shock. Kvcn- 
 tually, 1 arrived at a flospital in Alexandria : and it happened to Iw ono 
 which, when it was taken over, needed a lot of cleaning out : and I met 
 there <i man who told rae Sir Victor w;is with their detachment when they 
 took over this place, and spoke in glowing terms of him taking his sharo 
 with the iTifn in all kinds of dirty work which was needed to make things 
 suitable fur Hospital work.'
 
 300 SIR VICTOR HORSLEY 
 
 liberal expenditure on the drink trade, and the Sister's salary 
 cut down. 
 
 June 17. The chaos here continues in full swing, out of 
 which we are slowly evolving a hospital. We are told we 
 are to receive 400 sick and wounded to-day. We have 
 nurses for 150 ! To supplement, I understand other places 
 which arc understaffed and overworked are to be still 
 further denuded to supply our wants. ... I see they have 
 actually run a Derby in England. Certainly the hold drink 
 and gambling has on our people to the exclusion of every- 
 thing else is inconceivable except to those who have 
 reahsed it before. The mess still goes on in its stupid and 
 disloyal alcoholic way. 
 
 Jtme 20. I had to come into Alexandria to hunt up some 
 x-ray help, since the creators of chaos have poured 160 
 wounded upon us while we are getting in, and while our 
 .r-ray apparatus cannot be fixed up, as they know, till 
 Thursday. This is the history of all the hospitals here : and 
 some have none at all. The public-house loafer at home 
 is far better treated by the nation medically than the soldier 
 who is sacrificing his life. Of course the usual lie will be 
 uttered, ' Oh, but this is War.' The net result is that the 
 shirker and drinker benefit enormously and the unfortunate 
 wounded are practically told to shut up. The work as you 
 can understand is depressing beyond words, and the more 
 so as every effort to get better drugs and conditions is 
 criticised and thwarted as if something unreasonable was 
 being asked, instead of the bare essentials of medical treat- 
 ment. Egypt produces nothing but raw cotton and food. 
 Consequently when the home authorities refuse to send out 
 x-vdcy plates ordered as long ago as last April, it is obvious 
 that the drink trade has got well hold of our nation, for 
 they know that we cannot by any manner of means get hold 
 of these prime necessities of mihtary surgery. One authority 
 I heard of dared to say of A;-rays that they were ' so mis- 
 leading.' Of course such an infemahty he would not venture 
 to say in a meeting at home. I am not, therefore, in any 
 condition to write you amusing or interesting letters : all 
 my energies are devoted to trying to get for our unfortunate 
 men the merest elements of mediccd care. 
 
 On June 24, he writes to a friend in England, ' In a few 
 days I shall be appointed Consultant (I am practically 
 acting as such now) to the hospitals : so my sphere of work 
 will be altered, and I shall be rushing about all over Alex- 
 andria and its suburbs instead of superintending the one 
 department in this hospital.' On July 14, he was appointed
 
 EGYPT 301 
 
 Consultant to the Mediterranean Expeditionary Force, with 
 the rank of full Colonel, A.M.S., with the duty of visit- 
 ing hospitals, hospital ships, and officers, in the interests of 
 the sick and wounded. He is outspoken : he writes, for 
 example, in one of his reports, ' I have just been on board 
 
 the , a so-called hospital ship (though her latrines are 
 
 defective, her operating theatre wretched, and she has no 
 x-ray apparatus at all) because a case of gunshot wound of 
 the brain was admitted from her in a hopeless state into 
 the 2ist General Hospital.' 
 
 He and Lady Horsley and their daughter had rooms in 
 Mme. Caillard's house, Villa Yasmin, Glymenopoulo, near 
 Ramleh. Colonel Tubby, Consultant M.E.F., who also was 
 at Villa Yasmin, remembers that Horsley, even in the heat 
 of the summer and autumn, used to work through the hot 
 evenings, writing letters and notes of his cases. A car, 
 after some delay, was allotted to him : it was a 4-cylindered 
 Bayard, eleven years old and worn, but it behaved far 
 beyond expectations : it was named The Emden. Mr. 
 Edward May, his chauffeur during the last two months in 
 Egypt, remembers of him that ' When driving along at any 
 time of the day, should a nurse, soldier, or one of my own 
 friends be going our way, he would always stop the car 
 and give them a lift. At times he would go out to Aboukir 
 in the desert, by some old ruins — fossil-hunting as I used 
 to term it.^ There were always three or four friends with 
 him on these trips, so we used to have tea in the desert before 
 we returned home : my duty was to get the billy boiling 
 whilst he prepared the tea : on no ;iccount would he let 
 me sit away from the party : and on one or two occasions 
 we had our photos taken . . . Upon returning from the 
 hospitals one day, he presented me with a book of which 
 he was part author, " Alcohol and the Human Body." He 
 put inside' , To Edward May, with one of the authors' best 
 wishes for a speedy return to civilisation and common- 
 sense.' 
 
 * Horsley never look out the car except when >t had to go on Hospital 
 work ; he was very careful to keep to tins rule. The halt at Aboukir 
 woald be od tho way to or from a Hospital.
 
 302 SIR VICTOR HORSLEY 
 
 Of Horsley at Gallipoli, Major Aspinall, ist Field Ambu- 
 lance, ist Division Australian Army, writes : 
 
 I met Sir Victor Horsley at Anzac on 14th October 1915. 
 He had been visiting the medical units at Suvla Bay, and 
 came across to Anzac. Colonel (now Sir NeviUe) Howse, V.C., 
 deputed me to take Jiim round to see the conditions under 
 which Field Ambulances were working in ' dug-outs.' On 
 walking round I was much struck by the ease with which 
 he walked up steep paths without showing the least sign of 
 exhaustion : he told me that he was in very good condition. 
 At that time, in response to our appeal for more medical 
 men from the base, some fairly old men had volunteered 
 and been sent up. Speaking to Sir Victor about the deple- 
 tion of our medical officers from sickness and wounds, I 
 made the remark that in my opinion it was wrong for men 
 of some fifty years or thereabouts to be exposed to the 
 danger and discomfort of work at the front under the trying 
 conditions we were experiencing at Gallipoli just then, and 
 said that it was a young man's job. To my surprise he 
 said, ' I do not agree with you : the loss of a young life is 
 of much more consequence. For example, what does it 
 matter if I am killed ? I have had my day.' 
 
 Talking to him as we were walking along, I was much 
 impressed with his courtesy, and the kind way in which he 
 listened to my account of head-wounds I had seen, and 
 the trouble he took to answer my questions. One of our 
 officers. Major Dunlop, a young man like myself, had been 
 seen by him : almost every one who met him at Anzac 
 asked him if he had seen Dunlop, and to each he repHed so 
 kindly and thoroughly. On October 15 he addressed a 
 gathering of all the medical men who could be present, at 
 the Stationary Hospital recently erected in tents near the 
 beach, and gave a most interesting address on the best 
 methods of deahng with wounds under the unusual condi- 
 tions met with at Anzac, where there was no place free 
 from the risk of sheU fire. This gathering really suggested 
 the formation of the Anzac Medical Society. 
 
 He was away on this visit from October i to October 23. 
 He reports of it : 
 
 I walked over the ground at Suvla Bay, Anzac, and Cape 
 Helles, and visited almost all the Field Ambulances and 
 Casualty Clearing Stations, as well as many of the regi- 
 mental dressing stations and advanced dressing stations in the 
 supi orting trenches and in the firing Une. At each of the 
 clearing stations and aml:)ulances, the officers commanding 
 kindly collected their officers as far as possible, when I
 
 EGYPT 303 
 
 had the opportunity of addressing them and consulting 
 with them on their experiences and difficulties. In this 
 way much time was economised, e.g. at Anzac some sixty 
 officers attended. 
 
 He recommends that a short pamphlet should be printed 
 and circulated, with notes on the use of the Hey Groves 
 splint, and on other details of treatment. And he calls 
 attention to (i) the absence of roofing materials for the 
 dug-outs, (2) the shortage of warm clothing and covering, 
 (3) the absence of digestible fatty food. ' On all these 
 points, special action should be taken at once, not only on 
 behalf of the troops on the Peninsula, but also those who 
 are under canvas at Mudros.' 
 
 On November 30, he writes to Dr. Mary Sturge : 
 
 A hurried Hne to say that we are passing through a terrible 
 time here, as Pamela has a very severe attack of dysentery. 
 . . . To-day she is much better thank goodness and I am 
 assured tliat she has good prospects. Fortunately we got 
 her into the 5th Indian Hospital here, where McCarrison has 
 simply devotedly waited on her actually hourly. Every one 
 is very kind, and the Matron of 17th Gen. Hospital has 
 sent me splendid sisters to nurse her. Eldred has stood 
 the strain splendidly : but really what she has had to go 
 through, the last 18 months, is intolerable to think of. 
 Looking back over these 8 days, one can see that Pamela 
 has made a fine fight of it, and as symptoms are bettering 
 and not worsening I suppose we are entitled to optimism. 
 I am sorry to give you such a sketchy account. I know 
 you must want to ask a hundred questions, but it cannot 
 be. I must write when the anxiety is less heavily on me 
 than it is now : and I have an article for Pitman's on Parent- 
 hood and Alcohol I must turn to. By the way, I was 
 scandalised, on opening our book, to find a vulgar design 
 by Walter Crane of a young man and woman drinking wine 
 and Cupid underneath. This on a bookmarker by the 
 Scottish Widows Co. I wrote to tiiem and to Macmillan. 
 The former iiave answered as enclosed. Of course to Mac- 
 millans I protested against such a thing being stuck in our 
 book, and to both I protested against its issue just now when 
 the country was staggering with drink when it ought to be 
 marching against the enemy. 
 
 In Dect-mbcr, he went to Mei-sa Matruh, to inspect and 
 help to organise the medical arrangements on the Western
 
 304 SIR VICTOR IIORSLEY 
 
 front of our forces in Egypt. He writes in igi6, from 
 Alexandria, to Miss Alys Clarke, one of his patients in 
 England ; a long illustrated letter, to amuse a young Irish 
 girl: 
 
 I was ordered here from France last May, and may get 
 pushed on somewhere else. In September, I went up to the 
 Front on the Gallipoli peninsula and to Lemnos, i.e. Mudros. 
 When I got back from there, they sent me just after Xmas to 
 the western front, about 170 miles from here, where we are 
 fighting the Turks and Arabs who have been paid by the 
 Germans to make a dust in Egypt on the side opposite to 
 the Canal. But they are wondrously stupid, because their 
 notion of attacking is so spasmodic, it is quite obviously 
 nothing but a draw-off. The place I went to, I dare say, 
 you won't find in a map, but it must have been ' some place,' 
 as the Americans say, in the time of the Romans. It is 
 called Mersa Matruh : Mersa is Arab for harbour. The 
 harbour is a landlocked bay of deep blue water and exquisite 
 white sand on a rocky base, so that steamers can lie up 
 against the sand as it were. There are three such lagoons ; 
 one is now cut off completely, and called the Salt Lake. 
 The third on the W. side was the chief Roman harbour, 
 and still has Roman quays, etc., which of course Antony 
 and Cleopatra are said to have used when he had to make 
 tracks after the battle of Actium. By the way, Cleopatra's 
 portraits on her coins here make her as you might imagine 
 a very unpleasant party. Of course as a matter of fact 
 all the Egyptian queens of that period were not the sort 
 of people you would have called on or asked in to tea. Just 
 below the hills on which our pickets were set there were 
 very interesting remains : one, a Roman villa, with a great 
 deal standing. ... I am so glad you are well, and the scar 
 improving. When the war is over we must meet again. 
 I hope they give you plenty to eat and plenty of time to 
 play at the College ! When we meet again I am sure you 
 will agree that Carson is no good ! 
 
 Another letter, February 2, 1916, is to an English friend 
 in America. It was written in one of his moods of extra- 
 vagant thought : 
 
 ... If the Enghsh people choose to go on without universal 
 suffrage for men and women, then, as Lecky points out, they 
 will have to have wars, and as they get killed and the kings 
 and emperors don't, it does seem rather stupid of them. 
 
 My eldest son Siward, who was wounded at Neuve Chapelle, 
 has been invalided and is at present testing steels in Arm-
 
 EGYPT 305 
 
 strong's gun works. The second, Oswald, who was shot in 
 the left shoulder in 1914, was hit in the right shoulder last 
 August, but luckily without involving the joint. He was in 
 charge of the bombers, and rather distinguished himself, so has 
 been mentioned in despatches ; and is now back at Aberdeen 
 getting a new draft to go out again. My wife joined me out 
 here in August : and Pamela in October while I was up 
 at the front in GallipoH. They worked in the stores of a 
 neighbouring hospital : and Pamela was struck down with 
 malignant dysentery. Fortunately she had the devoted 
 care of an I. M.S. colleague of mine. Major McCarrison, who 
 pulled her through splendidly : and after six weeks I got 
 her and her mother off to Helwan near Cairo where they 
 are rusticating and recuperating on the desert edge. Now 
 you know all about us. 
 
 As to what we are doing, I can only say that my whole 
 Hfe is spent trying to get order out of chaos, trying to make 
 the aged and incompetent realise that the British Soldier is 
 a human being. ... It is very difficult to explain the sense 
 of weariness produced by the dull apathetic indifference of 
 the person above you in command. And what is also fatigu- 
 ing is the realisation that owing to the censorship and oli- 
 garchical government the people at home are kept in a 
 fool's paradise. I daresay it 's not a fool's paradise, but 
 they have no real conception of what is going on. What 
 too is irritating is that, as of course we shall win ultimately, 
 it is certain that the lives sacrificed will be wholly forgotten 
 in a year or two, except by the poor relatives of those thou- 
 sands who have died for absolutely nothing, and the hundred 
 and fifty thousand who have been crippled. 
 
 He writes on another subject to a friend in England, 
 January 14, 1916 : 
 
 I quite agree with you as to our future bearing towards 
 our German friends. It is impossible for our or the next 
 generation to trust them again ; but I do not see that any 
 action could be taken on such distrust, aj)art from non- 
 employment and non-assistance on any but humanitarian 
 problems. These they are not likely to trouble us with : 
 but to take a case in point, any medical question we ought 
 to help them to solve just as our own people. Personally I 
 shall never invite any of my former German friends to my 
 house, etc. It is not a question of thereby depressing the 
 activities of the decent peo{)le. Tliat would have some force 
 with me as an argument, if it were shown that the decent 
 minority are not completely Ilohenzollerned. As a matter 
 of fact it is clear that they arc. . . . The naturally servile 
 brain of the German is completely cowed. Unfortunately 
 
 U
 
 3o6 SIR VICTOR HORSLEY 
 
 our stupidity and drunken misdirection of our militaxit efforts 
 simply encourages the German slave in his belief that his 
 slavery is something miles better than our freedom. 
 
 During January-March, 1916, Lady Horsley and Miss 
 Horsley were first at Hehvan, then at Luxor. His letters 
 give them not only health-advice, but the news of each 
 day's doings, his movements, the comedy and gossip of 
 Alexandria, and what he thinks of So-and-so, and httle 
 fugitive jests and scores ; anything to hghten the depres- 
 sion of convalescence in exile. He has £140 left of a gift 
 from Mr. Cadbury to buy comforts for soldiers ; and he 
 makes a fine list of quantities and prices of them. He 
 writes also of pohtics in England ; of the evasiveness of a 
 well-known member of the Union of Democratic Control ; 
 of a visit with Signor Breccia to some excavations at 
 Aboukir ; of a surgical discussion (March 2, 1916), at the 
 17th Hospital, on head-injuries : ^ and of some of his patients 
 — they ranged from a Pasha's daughter at Cairo to Mme. 
 Caillard's Persian cat. His longing for the happiness of 
 his wife and daughter is incessant : ' I try to stir up every 
 nice person, e.g. Col. Grey, to go to Luxor if possible at 
 once. They ought some of them to roll up and make 
 things pleasant for you both.' For himself, the trouble is 
 that his work is falling off : 
 
 February 1, 1916. I hope the Museum business is proving 
 as pleasant as your letter sounded ; also that stray guests 
 and friends continue to crop up and amuse P. Here things 
 are in a very funny state. No one seems to have anything 
 to do, and yet they drift along contentedly just like May- 
 flies on a stream. February 5. It is a godsend, these people 
 turning up to keep the ball rolling : long may they flourish. 
 I am struggling hard to clear off the things to be written, 
 but somehow carmot get anything done, though the work 
 in the hospitals has sunk to absolute zero. AU sorts of 
 
 » ' We had a very successful meeting yesterday at No. 17 on the Head- 
 injuries. Quite 130 turned up. I introduced the subject, and Boyd and 
 Whitaker read excellent papers. Net result of discussion, warm approval 
 of my method. But, such is life, I went to 19 this evenmg and found 
 a really serious case whose external wounds had scabbed, with no dress- 
 ings on his head ! It really is enough to make one physically cry. I 
 don't know what can be done to alarm our people. They seem to have 
 no fear of microbes.'
 
 EGYPT 307 
 
 changes are developing rapidly. February 6. Obviously in 
 another fortnight, unless the Mersa Matruli people buck 
 up, there will be nothing doing at all. Fortunately Sandwith 
 is here, and responsible for all the medical work. No fight- 
 ing, no surgical work : so there you are. 
 
 The week or ten days of holiday with his wife and his 
 daughter, at Luxor, were a golden time, every hour of them. 
 He had borne the fearful strain of his daughter's illness : 
 he had done enduring work in Egypt : he was beginning 
 to feel, with all sorts of changes developing rapidly, that 
 even greater work was coming to him. He had got away, 
 at last, from all that he disliked in Alexandria ; he gave 
 himself joyfully to sight-seeing, admiring, photographing — 
 one or more photographs were obtained by swarming up 
 a telegraph-pole — never w^as he happier than in these few 
 days. 
 
 Back in Alexandria, he writes to Lady Horsley at 
 Luxor : 
 
 February 28. I hope you people are using your mosquito- 
 net curtains. I find the sand-fly occurs at Luxor, as well as 
 mosquitoes : and its fever, which is, I take it, the same 
 thing as dengue, is very annoying though not dangerous. 
 Also I hope Walshe is really better. Tell him that the spine 
 man at 17th Gen. Hosp. does not require operation : he is 
 enormously better. Whitaker is going home. It is said 
 that nothing is in the air here or likely to be : but of course 
 every one is as ignorant as his neighbour. 
 
 On March 5, he writes of a picnic at Aboukir — ' The 
 desert flowers are wonderful : sheets of blue, etc., all small 
 but extraordinarily spread ' — and of his work : ' To-day 
 I have had to operate at the Indian, and Ras el Tin ; and 
 got through the mail : but get a moment to write up what 
 we have done, I cannot.' Then he says, ' Finding there was 
 much work at Bombay, I raised the point of my going there 
 to Babtic. He wrote saying it was not his area (really 
 Indian Govt.) and wanted to know whether I wished to 
 go home. It is a rotten position, asking people what they 
 want when you don't tell them a word as to what is likely 
 to happen. I am answering liini tli.it I am in their hands, 
 all I want is work. ... I know all the ropes here : it
 
 308 SIR VICTOR HORSLEY 
 
 would be stupid of them to throw that away. However, 
 we shall see.' 
 
 On March 9, he writes to one of his patients in England : 
 
 Poisonous though this country is in microbic maladies and 
 all the vices that man is possibly capable of, it possesses a 
 charming climate, and the antiquities are worth all they 
 say about them. Moreover tlie Gippy himself has his points, 
 and considering the outrageously parasitic manner in which 
 all the High Contracting Xtian Powers sit and feed on 
 him and profit by his extraordinary industry (when super- 
 vised !) he is to be respected as well as pitied. Not having 
 much of a kick in him, he naturally lies down and leaves all 
 the fighting to his Bedawi friends who rattle about the desert 
 on the fringe of the cultivated areas. ... I don't know what 
 is going to be done with us, of course. This force is being 
 scattered, I expect to France in the main, but I may be 
 sent to Bombay or possibly Basrah. The only wounded 
 practically are in that area now. 
 
 He writes, the same day, to a friend in England : 
 
 In this unfortunate country, since all business is in the 
 hands of parasitic foreigners, no one cares about social 
 questions really ; and though the editor of the chief news- 
 paper here is very bright, he cannot create an atmosphere 
 which does not exist. It is very serious, because it blocks 
 sanitary progress as well as other branches of intellectual 
 work. . . . Eldred and Pamela come back to-night, and 
 will return to England in April. I have to wait for orders 
 from the W.O. before moving, as they may want one for the 
 Mesopotamia wounded. If not, one would hope for the 
 clearing up in France to be the last stage, and get over there 
 from here. 
 
 On March 15, he left Port Said for India. He writes, on 
 his way out, to one of his sons : 
 
 I heard there were some considerable difBculties in the 
 Persian Campaign, so volunteered : and after a few days' 
 work in Bombay expect to sail for the Tigris, so as to get as 
 near as I can to the front. There is no doubt that one can 
 be of most use the nearer to the firing hue, as the worst cases 
 are the most difficult. Of course tlie poor old Turks may 
 shake off the German yoke, but I doubt it. 
 
 On the whole, he had enjoyed his time in Egypt : he had
 
 EGYPT 309 
 
 seen something of its wonders and its antiquities, ^ had 
 gained many friends, had made his work tell : and he now 
 was looking forward to the ' one fight more, the best 
 and the last.' Sir Henry Maudsley, Professor of Medicine 
 in the University of Melbourne, and on active medical 
 service in the Australian Army — he and Horsley had been 
 together at University College Hospital in 1881 — remembers 
 Horsley's delight, the evening before he left Alexandria, 
 at the thought of going where he would ' have a free hand.' 
 Four letters, from other men who knew him, must have 
 a place here. 
 
 From Capt. Arderne-Wilson 
 
 I often had the pleasure of meeting him at tlie Bombay 
 Presidency General Hospital, San Stefano, where he frequently 
 came as consulting surgeon in the cases of injuries involving 
 the nerv'ous system. One morning he was to remove a 
 bullet from the neural canal in the lower dorsal region. He 
 directed that the operation would be performed at 9 a.m. 
 He arrived at 8.55, prepared himself in the ante-room, and 
 walked into the operating - room ; the patient was only 
 just then being brought in ; he expressed surprise at this. 
 He was told that the patient was brought up immediately 
 he arrived. With a smile he kindly and gently but firmly 
 said, ' Please understand for the future that when I say 
 the operation is to be at 9 a.m.. I make my incision at that 
 time.' 
 
 From Lt.-Col. Luxford, C.M.G., chaplain N.Z.E.F. 
 
 Perhaps I am the only New Zcalander who was privileged 
 to receive his services. I had been brought to No. 17 General 
 Hospital, Alexandria, from Gallipoli, with a bad wound in 
 the right leg. Before amputation was decided on, the N.Z. 
 
 * On June 2, 1915, four days after getting to Alexandria, he writes of 
 the Graeco-Roman museum, that it has enabled liim to convert two of 
 his colleagues from inditlercnce to keenness over archaeology: 'There is 
 really not so much of first-class stuff as a lot of interesting things, and 
 some wonderful Greek sculptures small scale, and larf^e Tanagras.' On 
 June 30 : ' Alexandria is of course extremely interesting as the place 
 where the Ptolemies and the Homans kept ti»c old Kgyptian cult going 
 without really understanding it, and there arc tombs and catacombs here 
 in which one has the most wonderful transitional work. Then on the top 
 of that we have the early Xtians, wiiosc development is certainly more 
 interesting. The trouble is that there have been .so many wars, out- 
 breaks, etc., that practically all Alexandria dates from about 1750. All ^v 
 the work is underground.' ^ (. 
 
 ^1
 
 310 SIR VICTOR HORSLEY 
 
 authorities asked for a consultation with Sir Victor Horsley. 
 It was in August 1915. I shcill never forget how cheerfully 
 and s>Tnpathetically he spoke to me. His presence was hke 
 the sunlight. After he had examined the wound, he smiled 
 and said, ' Now for the consultation, and I promise you one 
 thing — we won't take away your character.' I knew what 
 he meant, and think it was a channing way of convejdng 
 bad news. His presence and words, in a trying and anxious 
 time to me, are a happy memory. 
 
 From Col. Manifold, I. M.S. 
 
 Headquarters, I.A.N. Z. A. C. May 27, 1917. . . . Sir Victor 
 was one to whom the Indian Medical Service must always 
 remain grateful. He was by no means carried away by the 
 wave of somewhat indiscriminate enthusiasm which in 
 the early days of the war was exhibited over the work of the 
 R.A.M.C., and which by somewhat ungenerous and small- 
 minded natures had been exploited to the detriment of the 
 I. M.S. when the two services, both in Eg^'pt and on the 
 Continent, came together. The same I heard in Mesopotamia, 
 where the I. M.S. found him their best friend. In Egypt, 
 he had made enemies by expressing, with all that contempt 
 for anything that was not thorough, his views of much 
 that was faulty in the arrangements for the first rush of 
 wounded from Gallipoli, and tlie administration in Cairo. 
 A somewhat amusing experience occurred when he was there 
 in his rank of Major, before being appointed Consulting 
 Surgeon with the rank of full Colonel. In one of the Egyptian 
 Hospitals to which wounded in the early rush from Gallipoli 
 were sent, and which hospitals were entirely under the 
 charge of surgeons of Egj-ptian nationality, one of these 
 latter had several cases of severe head-injuries under his 
 care ; and he telegraphed that a speciaUst on brain-surgery 
 might be sent from Alexandria. Sir Victor at once started 
 off, saw the cases, and gave his advice as to what was to 
 be done in each case. The Egyptian surgeon did not know 
 the name and fame of his visitor, but was not at all satisfied 
 that the best had been done for his patients when he saw 
 only a Major in the R.A.M.C. had come, and one who from his 
 age, he felt, could not be a distinguished member of the 
 service, or he would certainly have attained a higher rank 
 by that age : he accordingly wrote in to the authorities of 
 his own service, stating that whilst he was doing his best 
 according to his liglits, he felt tliat the military authorities 
 were not giving him proper help and support, as when he 
 had telegraphed for a brain-specialist they had only sent 
 him an old K.A.M.C. Major ! 
 
 Sir Victor's work in Egypt was splendid : and, as I say.
 
 EGYPT 311 
 
 he would have no good word ior shams. He went out to 
 Mesopotamia against the wishes anU advice of men of tropical 
 experience who recognised that he was not at his age fitted 
 for the arduous work in such a climate. He however refused 
 to be deterred, as he said he felt he could do good, and recog- 
 nised there was much which needed sweeping reform : a 
 truthful criticism. The I. M.S. \vill always mourn his loss. 
 This is written hurriedly in the lull of fighting : but I felt 
 such an admiration for the sterling soul in the man that I 
 felt bound to write. 
 
 From Capt. Allen, R.A.M.C., O.C. Military Hospital for 
 Officers, Alexandria 
 
 July 9, 1917. Sir Victor came out in June 1915, but as 
 there was such a demand made by surgeons here for him 
 to see their head-cases from GaUipoli, he was quickly made 
 a consulting surgeon. Previous to his coming out here, I 
 only knew him on paper, and had the idea that he was selfish 
 and difficult to work with. I very speedily altered my 
 opinion. All the hospitals were full of very serious cases 
 from the first landing at GaUipoli, and many head-cases 
 were among them. Sir Victor was everywhere. One was 
 particularly struck by the wonderful accuracy of his prog- 
 nosis, and the very definite good results from his line of 
 treatment. He was a particularly kind and dehghtful man 
 to work with, always helpful and interesting and most 
 generous. If he had any spare time, he was never idle : 
 directly he arrived, he began to study the Egyptian 
 language, and could soon make himself understood : he 
 possessed a wide knowledge about things Egyptian, and 
 investigated everything. 
 
 Of course his personal bravery was so well shown by his 
 going to Mesopotamia : but a httle incident which I saw 
 in 1915 is worth giving. When the Arabs (Senussi cam- 
 paign) were fighting at Matruh and Sollam, an officer in 
 the Bucks Hussars was shot through the abdomen by a 
 large Turkish bullet. . . . They wired to Alexandria for a 
 consultant : Sir Victor was asked at 12 noon if he would 
 go ; the only way to go was 16 hours' journey by sea 
 by a trawler ; at that time a liigh sea was raging, and it 
 looked to mc as if he would not be able to go : but he rushed 
 home, got his haversack and cemicra, dashed into the town 
 to buy some films, and at 2 P.M. had kft Alexandria. I 
 heard aftervsards that it was a particularly bad voyage ; 
 but he slept like a top : next day arrived at Matruh, saw 
 the patient — who eventually came down to the Hospital 
 and recovered — visited the various Field Ambulances, in-
 
 312 SIR VICTOR HORSLEY 
 
 vestigated some Roman remains of buildings, and returned 
 in a trawler. 
 
 As you know, he made a kind of walking-tour round 
 Gallipoli : landed somewhere near Suvla, visited nearly 
 every Hospital and Field Ambulance, talked and lectured 
 to the M.O.s right up to the trenches, and was passed on 
 to tlie next unit. Everywhere he was hailed with dehght, 
 and I have frequently met men who saw him there and 
 testify to his bravery and deep interest in the work. I 
 cannot say more than how greatly his loss was felt by the 
 Territorial and New Army doctors : all felt that he had our 
 interest at heart : he recognised the very great difference 
 experienced by men, who were accustomed to be regarded as 
 somebody in their own small way, suddenly finding themselves 
 atoms of one big machine : he did everything he could to 
 encourage them and keep them interested in their work 
 for their own and the work's sake.
 
 Ill 
 
 India. Mesopotamia 
 
 He reached Bombay on March 25, 1916 : visited Delhi 
 and Simla : left Bombay on April 9, and reached Basrah on 
 April 16. He died at Amarah, on July 16, in his sixtieth 
 year. 
 
 I 
 
 From Port Said to Bombay. P. & 0. s.s. Arabia 
 
 To Lady Horsley 
 
 March 16. The Canal is picturesque in its own desert way. 
 Ismailya is a one-horse place, though the sweet-water canal 
 enables the trees to make a fair show. The Austrahan 
 pickets along the Canal were very pleased to see us : asked 
 ' Where we were going to ? ' also ' Is there a War on ? ' also 
 appealed for ' bakscheesh cigarettes ' — dreadfully mono- 
 tonous life. These Bitter Lakes are pretty : queer sort of 
 trees and shrubs on the shore : the black sandy mountains 
 in the background form the desert tableland south of the 
 road from Cairo to Suez. The colouring of the sand here is 
 very good, rich golden red, whereas that on the tops of the 
 hills is pale Naples yellow : water bright blue of course. I 
 am desolated that you are not here for the rest fulness of 
 this sort of glorified penny steamer trip : as this scenery 
 is so different to the Delta. Very few birds unfortunately. 
 . . . March ly. There are of course very few passcnjarcs : 
 a Madras Judge Oldficld, and his wife who is a great pianist, 
 and I am going down at n to hear her play Schumann : 
 then there arc one or two colonels and oflicers who are all 
 revelling in mufti, in accordance with the inscrutable aiTny 
 habit of cutting their profession at the first opportunity, 
 a habit which is partly accountable for the prolongation of 
 the war. I got a good story for a suffrage meeting out of 
 Mrs. Oldficld. The native servant likes brains ; one was 
 ordered to cook a sheep's head ; when it turned up at dinner, 
 the brain was absent : when remonstrated with, he said, 
 ' Dis one female sheep, have no brains.' I am afraid his 
 
 313
 
 314 SIR VICTOR HORSLEY 
 
 unnatural history did not save him : but it will be a good 
 text. . . . Practically what I want to be informed about 
 are (i) General Politics, (2) Temperance, (3) Suffrage. For 
 (i), the Manchester Guardian and Pioneer are enough. . . . 
 
 I have written to , answering his pohtical letter and asking 
 
 him to call when opportunity offers on the Mayor at Gates- 
 head to find out whether there is anything in that move 
 
 now. Also I am writing to , asking him to let me know 
 
 if he hears of anything in the constituency line. I thought 
 
 of writing to , but really I am not at all sure that he 
 
 would help, and it is possible that he would divert the official 
 animus from himself to me as a temperance worker. Of 
 course too his employer's venom would be poured on my 
 head : so I shall leave him alone. March 23. Aden was 
 very picturesque, quite the mediaeval mountain, the rock 
 a fine volcanic business with all sorts of fantastic shapes and 
 surfaces. Of course we had the usual rot of not being allowed 
 to land, though we were there for six hours ; very irritating, 
 as they have some cisterns which I particularly wanted to 
 see. . . . This boat is distinctly comfortable, and the captain 
 a very decent old bird. I am wiring you to say that it is 
 going to take Lord Hardinge home. Now I think that is 
 good enough for you to secure berths on it, since we may be 
 pretty sure that they will escort him at any rate. She is 
 going to be scraped too at Bombay and therefore will be 
 able to do her 17 knots. These ships are so put out of form 
 that although you may find a good one in the list it does 
 not follow she is clean and able to steam her pace as per repu- 
 tation. . . . Do not forget to wire me on the day you leave, 
 and your arrival at Marseilles and Dover respectively. 
 
 II 
 
 India. March 25 — April 9 
 
 In Bombay, he was the guest of Lord Willingdon at 
 Government House : 
 
 March 25. This house and surroundings would suit you 
 to a T : and it 's miserable work, your not being here. I 
 am writing in a beautiful verandah outside my suite of 
 rooms : the verandah looks out over the bay to Bombay, 
 which now 8 p.m. is a long row of glittering lights. . . . All 
 the people very picturesque and bright, mucli more intel- 
 lectual looking than the Arabs : the whole mise-en-scene 
 much brighter and prettier than Egypt. ... Of course 
 unfortunately the servants cannot leave one alone, and want 
 to dress you, etc., which is singularly distressing. In fact 
 the whole idea here in India and feeling is that of being
 
 INDIA 315 
 
 run. It is interesting to appreciate the sensation of an 
 autocratism and how completely and without any fuss the 
 idea of independence and liberty is quietly destroyed. Egypt 
 is nothing to it. March 28. A hurried note is all I can do. 
 The work here is really gigantic, and I shall have an oppor- 
 tunity in the train on Thursday, when I must go to Delhi 
 or Simla to see the topknots who require much help to 
 wisdom. Froom very kindly has reserved you a 3-berth 
 cabin on the port side, which is the side I came out on. 
 The Arabia is very comfortable and an extraordinarily 
 steady boat in a choppy sea. The only thing that worries 
 me is w'hether you will have got my wires. . . . 
 
 Delhi, March 31. Here we are in the Commander-in- 
 Chief's house — Sir Beauchamp Duff. He was very friendly : 
 but as unfortunately the Viceroy is leaving, and he is moving 
 his office to Simla for the hot weather, he says we must 
 travel up there to-night with him to get sufficient time to 
 talk things over with the D.M.S. I am afraid it is partly the 
 Indian leisurely way of doing things. ... I hope to see the 
 hospital here this morning, if there is one for the war, and 
 in any case the Station hospital, then run round the Fort 
 and the chief Mosques. They lose a lot of time here, and 
 the distances are of course considerable. The journey was 
 very interesting, because when we woke up at 7 we were 
 already in the plains running through a bare sandy country 
 covered with a feeble forest ; trees every 20 yards, half- 
 dead, and no leaves anywhere : the leaves, having the 
 decency to remember it is really winter, have dropped off, 
 and are only now beginning to sprout again. The natives 
 were cheerfully encouraging their herds to graze on what 
 appeared to be nothing at all : and it was only now and 
 then that the traces of cereal culture explained why they 
 were in any condition at all except bones. Some 700 
 mUes from Bombay, the old hill forts of the Mahrattas came 
 in sight : the plain they looked over is anything from 30 
 to loo miles before you come to another little range. 
 . . . The costumes are good : the young ladies until they 
 come out are fully attired in blue bead-nccklaccs, gold nose- 
 ring, and a pair of bags literally : but they do not, of course, 
 look in the least like savages, as my scrawl suggests, because 
 tlu'V have so much refinement of carriage. . . . Lord 
 Willingdon was most interesting about India, and is obviously 
 doing first-rate work on the progressive line ; more so than 
 
 , who is doing the usual thing of saying we must go slowly. 
 
 Considering the utter conservatism of India, naturally this 
 is absurd beyond measure. Naturally he is hampered by 
 money considerations. It seems to me that the rwiancial 
 people here are thoroughly asleep and not rising to the fact 
 of War at all.
 
 3i6 SIR VICTOR HORSLEY 
 
 Bombay, April 4. We arrived just now from Simla : 2200 
 miles in 5 J da^^ : not bad going. Am very fit in spite 
 of considerable heat and unspeakable dust. 
 
 Ill 
 
 Front Bombay to Basrah. Hospital skip Sicilia 
 
 April 9. I was horrified to find in your letter you pro- 
 posed going 2nd class. It is quite impossible. I got the 
 berths for you on the best side of the ship and close to the 
 boats. Under no circumstances could you go second. I 
 found on the Arabia that she was immediately dry-docking 
 to scrape and buck her up, so that you could not be in a 
 better ship as far as that goes. Then also she is extraordin- 
 arily steady. As regards , it would be nothing to us 
 
 to pay the difference in her case, so as to keep the party 
 together. ... On board we have Col. Blenkinsop in 
 charge, and five medical officers and four sisters, also Mr. 
 Ridsdale : he is a greyish artistic-looking man who is out 
 here to organise the Red Cross business properly, and has 
 brought out 800 cases of stores from somewhere. He is 
 a very decent chap and I hope to foregather with him 
 to-morrow. At present things are looking up, accord- 
 ing to the telegrams : but what our muddled plans really 
 will be goodness knows, though I imagine that we must 
 go to Bagdad to adequately settle the occupation of the 
 country. If so, then there will be considerable need for him 
 and his stores, because the Indian Government officials are 
 playing the extraordinary game of pretending that India is 
 not at war. Result, chaos of course : but what is worse is 
 that organisation preparations which should be on a war scale 
 are made on a peace one. Hence overwork, discontent, and 
 non-fulfilment of duties, etc. Lord and Lady Willingdon were 
 certainly exceptional people. He of course was Liberal 
 member for Hastings. If it had not been for the Willing- 
 dons, who organised a kind of Red Cross which they called 
 the Women of India's Branch, and furnished the troops 
 with absolute necessaries, e.g. shirts, socks, etc., the Govern- 
 ment's course would have left them to welter in the extreme 
 hardships of this campaign. As it is, of course, very little has 
 been done in reahty for the men. Whisky every^vhere. . . . 
 We returned from Simla the day on which Chelmsford 
 arrived and Hardinge left. Therefore nothing much could 
 be done in Bombay, because although the natives take very 
 little interest in the doings of the Viceroy, etc., the streets 
 are lined with police, etc., as if large cheering crowds were 
 expected. Of course the Parsees turn out more or less, 
 because they are the most cosmopoUtan of this congeries of
 
 INDIA 317 
 
 races ; and the wealthy Hindoos, of whom there are a fair 
 number. Motor-cars everywhere. The next day I harangued 
 the medical students, men and women together, at the Grant 
 Medical CoUege, and got in the usual points. I think it 
 was interesting to them, and beheve it has stirred up all 
 sorts of people in authority to think about things and 
 especially the alcohol question a little more. I have found 
 a fearful condition of slackness, bad equipment everywhere. 
 Due to the utter fear of the finance people and infamous system 
 
 worshipped by . The Indian Government appointed 
 
 a Commission to enquire into Mesopotamia : wiiat they 
 want is an enquiry into the whole of their medical business. 
 Of course our people (the medical profession) are to blame 
 also. They have deliberately gone on with shockingly in- 
 ferior means, actually saying that they did ' pretty well.' . . . 
 At any rate, the ridiculous Commission now enquiring, which 
 consists of a Major-General Bingley and a Mr. Vincent, a 
 Civil Service man having no medical knowledge whatever, 
 have no means of getting at the truth. 
 
 April 15. Rolling off the bar. We could have got a pilot 
 from the lightship : but no : lay to until the Syria, the 
 corresponding ship, came down : and took her pilot back. 
 By that time of course it was too late : not enough water : 
 so we stuck, and only with great difficulty got back into 
 deep water, where we are now lying and shall remain till 
 to-morrow morning. Thus a whole day has been lost by 
 ultra folly. Nobody seems to care. All this apathy is 
 simply chronic stupidity of whisky drinkers. . . . 
 
 When 1 return to India I shall go all through it [the adminis- 
 tration of the Indian Medical Service] to see the whole 
 working and scheme, to see if possible how it can be righted. 
 Above all to find out where the financial difhculty really 
 lies. Of course it is fundamentally clear that the whole 
 service is starved, and that the medical officers have been 
 terrorised into incapable indifference. They think in terms 
 of cost, and not of scientilic care of their patients' interests. 
 The extreme difficulty is to find out where the obstruction 
 lies, whether inside the I. M.S., i.e. in their accountants' 
 department, or at the Viceroy's Council, i.e. in the Finance 
 Department. ... To make matters worse, the Commission 
 which enquired into the Civil Service, etc., has not reported 
 and will not till well after the War. I cannot find from any 
 of the men here what evidence they put up : so that avenue 
 of information seems small enough. Perliaps I can put it 
 riglit in Mesopotamia : there must be stacks of I. M.S. men 
 there. It really is a very interesting constitutional question, 
 this financial control, quite a chapter in itself because so 
 fundamental. Matters of principle are always worth 
 hundreds of detail.
 
 3l8 SIR VICTOR HORSLEY 
 
 To Col. McCarrison, I. M.S., Alexandria 
 
 April 12. I found at Bombay that the A.D.M.S. 
 was an old friend : Col. VVanliill, who was at Univ. 
 Coll. Hosp. He of course was very helpful: but above 
 all General Knight, who commands the I3ombay Brigade, 
 and who poor man was being obliged to run the one port, 
 through which the whole war is being conducted, on a peace 
 footing. I never heard of such fatal views as to how to 
 run a war. I arrived 25.3.16. After seeing the hospitals 
 and base stores I was so appalled I talked to Knight : and 
 having settled I must see the D.M.S. to regularise my posi- 
 tion out here, I suggested I could hang on to the visit all 
 my ideas on these points and urge immediate reforms. 
 Knight, who was as keen as mustard, went one better, and 
 insisted on my going to Delhi and seeing the Cder. in Chief 
 as well. Arrived Delhi : C. in C. said, ' I am going to Simla : 
 run round Delhi in motor ' : which I did and saw everything, 
 though hurriedly : went in evening with C. in C. to Simla : 
 at Kalka, got into his car and motored up the 58 
 miles. Wonderful ride : most people made seasick by the 
 comers. . . . He was extremely kind to me and talked all 
 these points for 36 hours. I think I helped him ' some,' 
 at any rate he said I did, and wants me to cable ideas 
 direct to him. ... Of course the fatal error has been here 
 as in Egypt : the Govt, has not recognised that these coun- 
 tries are non-productive. Why, I find they cannot even 
 repair or sharpen surgical instruments, and as to ordinary 
 equipment it simply is not in the country at all. I have 
 suggested what could be made by energetic shoving, but a 
 corps of hustlers is badly wanted. I left Simla in a motor 
 car on railway wheels : bowled down the line delightfully. 
 Continued at Bombay the struggle, with more result : and 
 fm.'dly left on 9.4.16 Sunday midday. Things are shaping 
 but there will have to be a complete reform and a powerful 
 enquiry at the end of the War. In the meantime I urged 
 on the C. in C. to draw materiel and personnel from Egypt 
 where it was doing nothing. I beheve he is following this 
 advice. 
 
 IV 
 
 Mesopotamia. April 16- July 16 
 
 To Lady Horslcy 
 
 Ashar, April 19. Goodness knows when you will get this, 
 as I am just told letters posted to-night go by next week's 
 mail ! That is a loss of a week to start with. Then to 
 Bombay six days, then Lome three weeks : probably five
 
 MESOPOTAMIA 319 
 
 altogether. Certainly the Indian organisation all round is 
 astounding. After aU the ideas we had about the constant 
 efficiency of the Indian military system. Another delusion 
 gone. Now is the momeni: (one hour only) to give you some 
 idea of this place. The Tigris as we ascended it for about 
 60 miles is a broad yellow river with very picturesque 
 creeks and date-groves innumerable. The cultivated strip, 
 like Eg>'pt (Upper), is very narrow owing to centuries of 
 militarism and destructive invasions. The whole country 
 requires reorganisation, and then the wretched inhabitants 
 will have some chance of raising themselves out of savagery. 
 Basrah itself I have not yet seen, as the inspection work is 
 very heavy, and still more the writing notes and copies of 
 the documents which show the actual work of the place 
 medically for the last year : the town we are Uving in is 
 really called Ashar, It is just hke the squalid Arab to\sTi 
 anywhere : mostly built of yellow flat Roman bricks, and 
 mud-huts galore. Our people have policed and cleaned it 
 into more or less respectabilit}' : but of course it is smells 
 and dust and dirty people all through. . . . The house was 
 built b}' a pious Islamite as a rest-house for pilgrims (there 
 are a vast number of holy places up the Euphrates, and a 
 tremendous business done in pilgrims). He is buried in 
 the floor of the room marked x : I have indicated his grave 
 also. Fortunately this was two years ago or more, so there 
 is no odour of sanctity about him like Appleby church. 
 The whole real traffic of the place is done not by roads and 
 paths so much as by ' bellums ' : these are exactly like dug- 
 outs, narrow and tituppy gondolas, with two Arabs in full 
 costume poling and cursing every one they meet. In the 
 main stream and up the creeks are wonderful ' mahclalis ' ; 
 these are large trader boats ; a solitary Arab squats on the 
 tiller, perched up hke a mediaeval ship. Then in the fair- 
 way are anchored all the ocean-going steamers which draw 
 not more than 18 feet and can get over the bar. All this is 
 very picturesque : inlinitely more so than Eg\'pt. Of course 
 the discomforts are enormous, chiefly and wlioUy owing to 
 our own unspeakable folly, stupidity, and criminality. Au 
 enormous amount has to be done, and now is being done, 
 I hope. I have discussed everything here too, and I think 
 with the same success as in India. One most importimt 
 change I urged at Simla has been already made : so I am 
 hoping for more. 
 
 I must take this round the swamps to the P.O. The frogs 
 here chirp like the thousands of sparrows roosting in the 
 Mahomet Ali Square : and I am glad to sec in the swamps 
 fish which eat the mosquito larva*, but of course only 
 ' some.' The blue jay, a lovely bird, is common ; also a 
 bird that sings like a tiirush ; so there 's plenty to sec.
 
 320 
 
 SIR VICTOR HORSLEY 
 
 To his Daughter 
 
 Basrah, April 23. . . . It was a great contrast to come 
 from all the large scale work [Bombay and Delhi] to this 
 curiously savage hole. The people here are mostly Arabs 
 of the conventional type, but very wild and savage-looking 
 for the most part, as if they had combined a hard struggle 
 for existence with chronic piracy and a dash of murder in 
 it now and again. One of the engineer subs here was sent 
 up the river some 70 or 80 miles in a large launch to 
 assist a grounded barge. When he got there and tied up, 
 he heard a ' loud noise.' and discovered that the rival Arab 
 tribes of the district were having their annual battle. So 
 many volleys poured over his head that he moved down until 
 the battle was over. Next day they were all at work again. 
 
 This is ' unrest,' a disease 
 which is practically physio- 
 logical not pathological to 
 these people. Of course they 
 are gloriously lazy. Owing to 
 the high rudder and tiller, one 
 gentleman I saw this morning 
 steering with his head, so he 
 could sit still and enjoy life. 
 There are some industrious 
 people here who on the con- 
 trary seem always at work : I 
 don't know what they are, but possibly Persians. The small 
 mosque here . . . the interior was very impressive, because 
 it had pointed arches and four enomious pillars about 10 
 feet in diameter, while by the side of the Kibla was the 
 pulpit, like that of a refectory, in the wall, and with a Httle 
 Early English arch over it. The old caretaker Muezzin 
 person was greatly pleased with my appreciation of it, and 
 so also the 20 idle cutthroats, who were most respectful 
 when I took my boots and gaiters off, and accompanied me 
 round to see all fair. 
 
 To Lady Horslcy 
 
 Basrah, April 25. ... I have imearthed a terrible number 
 of things ; have cabled twice to Simla and once to Keogh 
 already. The Commission here enquiring into the medical 
 arrangements, and with no medical man on it, is going along 
 in its futile way. In consequence of what I saw in India, I 
 ultimately cabled to know if the field dressings were sterilised, 
 and received the staggering reply No. Of course I cabled 
 immediately that it should be done, smd have written as
 
 MESOPOTAMIA 321 
 
 well. It never entered into my head for a moment but that 
 they were. . . . 
 
 About 40 miles below Aviarah, April 27. We sailed in 
 due course yesterday morning on the little hospital boat, 
 and slept in one of the cots under the awning. After Quma, 
 we entered the great marshes which extend for about 50 
 miles on each side of the river. Quma is the place where 
 the tree of knowledge grew (at the apex of the Garden of 
 Eden) : unfortunately the top was blown off the other day, 
 and it now is hke this, standing on the quay with a mud- 
 wall behind it and the rough encampment of the stores of a 
 miUtar}- post of Sikhs. The inhabitants and cattle are in 
 and out of the water all day, consequently the men towing 
 the big trade-boats imitate Adam faithfully. The small boys 
 who are innumerable and who hurry to the bank expecting 
 donations of biscuits and scraps from the Tommies arc given 
 the head-dress and a few feet of stuff for a galabca : the 
 results are too comic : every stage in the evolution of a 
 complete costume. . . . 
 
 The bird Hfe is very pleasant. Large numbers of herons 
 of all sizes, black and white large crows, and innumerable 
 kingfishers : great colonies of the common (in the East) 
 black and white kingfisher, greyer than the Egyptian one 
 and very cheerful : chirps about all over the place : and 
 this morning very early they were sitting on every bush and 
 
 lump at the water's edge, waiting for their breakfast to come 
 along : they were in pairs, like Darby and Joan, one looking 
 up stream the other down, so as to miss nothing. Every 
 available bank was full of their nesting holes. They have 
 no fear of the boat. Other occupants of the banks are turtles, 
 who cock their heads up like bitterns, and as you see them 
 at the Zoo. They had for the most part no intentions of 
 going into the soup-tureen, and so gently slid off into the 
 water when we really got within hail. . . , Yesterday I saw 
 at least a dozen greater bitterns, like the one we saw at St. 
 John's lake, but larger. It was a great pleasure to see it, 
 as it is nearly extinct in Lincolnshire. 
 
 We tied up for^ the night about 3 miles below Ezra's 
 
 X
 
 322 SIR VICTOR HORSLEY 
 
 tomb. This is a most charming tomb, nominally of Ezra, 
 who said he was to be buried near the sea, so they worked 
 down the river till they came to where a tide was just 
 perceptible, so they decided it must be the sea, and popped 
 him underground. Jolly glad, I expect, not to go another 
 step with the old gentleman. The dome was a beautiful 
 blue enamel, with a little crown of simple diaper, and the 
 neck of yellow bricks with more diaper, and the whole 
 thing surrounded by a delicately arcaded wall and palm-trees. 
 
 At the Front, April 30. The question now is what is going 
 to be done. At present we are close (2 miles) to the tiring 
 hne, and it remains to be seen whether the Turks will come 
 on or not. After we left Amarah, we had a disagreeable 
 incident : a man, a stoker, either fell or jumped overboard : 
 and though he tried to swim to the bank, he was carried 
 away in the swirling current and drowned. This river is 
 a boiling stream of pea-soup, and though a fine waterway 
 needs a lot of attention. We met corpses of men and horses 
 floating down our druiking water : and on the nmd banks 
 was a huge tarpon, quite 7 feet long, and some shark-like 
 fish higher up, killed I suppose by a shell exploding in the 
 water. This country of course is most forbidding. Nothing 
 but flat ground covered with rough grass and camelthom. 
 I am writing this outside the mess-tent of the 24th Indian 
 Field Ambulance, where we have fortunately got in. I 
 drew tents at Bombay luckily : and when we arrived here 
 we had to camp on the river bank, ht a fire, and dined sump- 
 tuously off tea, biscuit, and horribly salt bully beef. The 
 insect Ufe here would drive you screaming mad. On the 
 hospital ship, the last two nights, directly the lights were 
 turned up, we were invaded by millions of flying beetles. 
 The table, food, heads, faces and hands covered with a thick 
 swarm, including enormous black beetles. The only thing 
 to do was to cat like mad and turn out the lights. They got 
 into the beds and felt like old cnnnbs and grit. Fortunately 
 they none of them really bit. They only got annoyed when 
 entangled in your hair, when they sometimes in sheer worry 
 I suppose held on with nippers. My mosquito curtain so 
 far has done wonders, and I was only bitten once at Basrah, 
 by sitting writing at dusk. Most people have suffered from 
 sand-fly : so far I am all right too, so the net must be a 
 good one. The flics of course are very bad. This camping 
 ground has had many horses over it : and last night the Anny 
 Corps sanitary staff with which we camped actuaUy moved 
 on to old cavalry ground. I never saw such stupidity. Fortu- 
 nately now we have got into an ambulance camp which is on 
 good dry clean ground, and shall stop as long :is 1 remain here. 
 
 I have inspected four ambulances so far already, and hope 
 to do the front line and the others during the next four days, 
 but it is slow work owing to the lack of transports and extra-
 
 MESOPOTAMIA 323 
 
 ordinarily nasty climate. Everybody is very kind : but the 
 starvation policy and methods of the Indian Govt, are terrible 
 and only exceeded by the hes in the House of Commons. 
 
 Shaik Saad, May 5. I came down here because nothing 
 was doing at the front, and tliis place is designed to develop 
 medically hke Amarah. It is wlicre one of the very worst 
 fights took place, and disgraceful conditions to which the sick 
 and wounded were subjected, with torrential rains on the 
 top of it all. It consists of Arab mud-houses, in one of which 
 I have a room : which has been remudded and petroleumed, 
 so it is very comfortable. We have an amusing puppy, 
 cocks and hens, swaUows, and sparrows and cats in the little 
 farmyard, and in my room when they are so disposed, so 
 there 's no lack of company. I am staying in a very nice 
 mess, that of the 6ist Indian Stationary Hospital, commanded 
 by Major Goodbody, I. M.S., very successful and popular, 
 running the show with great acumen and aplomb. His staff. 
 Indian and British, are also very efficient and pleasant, so 
 we are on our feet as usual. ... I had to walk in the morning 
 about ten miles out and back to visit some cavalry and other 
 field ambulances : but so far, though the heat is curiously 
 burning, it is not so exhausting as might be thought, if you 
 drink a fair amount of (boiled) water. One of the horrible 
 laches of this business is that the lighting men are not 
 even yet adequately suppUed with water. I see Austen 
 Chamberlain said in the House that probably an enquiry 
 will be held. If so, I hope and pray that I shall be allowed 
 to give evidence. The bogus Commission out here now may 
 possibly furnish a confidential report, as they were appointed 
 departmentally, but I gather Chamberlain meant a large 
 affair when we all come home again. 
 
 Of course the inevitable alcohol is always cropping up. 
 This force drinks far less than the Egyptian one. Tlie large 
 majority of this mess are regular teetotallers, and at lunch 
 to-day five out of nine present were non-smokers. ... A 
 
 typical case is that of the here. Some six weeks ago, 
 
 when the men were really half-starved and getting the old- 
 fashioned rations with the result that scurvy, diarrlirca, 
 and beri-beri are relatively common events, the extremely 
 precious steamer-room was takt^n up by enormous and 
 numerous cases of champagne, port, whisky, etc., for the 
 officers' mess. This morning I f(jund that in that one 
 regiment alone 46 men reported sick, and the rest an- 
 languid, tired. Of course because of the wicked neglect of 
 the water we have sporadic cases of cholera in every camj) 
 practically, though if the water is boiled there is no danger. 
 Of course the habitual whisky-drinker thinks it sterilises 
 the water and he doesn't care anyvvay but clianccs it. . . . 
 
 I am hard at work here tr\'iiig to get the surgical conditions 
 improved ; it is haid, seeing that every clcmcutaxy rule of
 
 324 SIR VICTOR HORSLEY 
 
 sanitation is avoided (not necessarily evaded) and there is 
 no medical ofticer except Goodbody who dares take a strong 
 line to protect his patients : and as for the administrative 
 officers, it seems as if their one idea is how to get the poor 
 fellows away rather than how to protect them from the 
 commonest evils. Of course they themselves arc paralysed 
 because the chief command has never provided transport of 
 ordinary materials, let alone engineering materials for water 
 supply, etc. But here the catalogue is endless. Suffice it 
 to say that everything wants looking into. If it had not 
 been for the War Oflicc letter of June 1915, I could hardly 
 have done a stroke of work except by sheer bluff. I had 
 better shut up, as I am drafting memos, and they take such 
 a time. PS. — An O.C. of an infantry regt. has just sent in to 
 see me about conditions I This is instructive ! 
 
 Shai/i Saad, May 15. . . . Real swelter, last two days : 
 108-110 in shade : with exquisite moonlight nights. Packing 
 
 a small bag makes you stream. 
 The grasshoppers are enormous 
 here, like locusts but less stomach, 
 like Huxley's real lover the male 
 Rotifer. They stroke their noses 
 like cats. This is his actual 
 size, but they are not like 
 locusts, though the largest have 
 wings. They are very friendl}', 
 quite unUke the flies, which 
 adopt every known means of 
 biting you. Yesterday a very handsome person in the shape 
 of a tarantula sort of spider, with wonderful shirt and waist- 
 coat of white and light chocolate stripes, arrived. We en- 
 couraged him in the hope he would dine off the various other 
 visitors. He was evidently well anned, as he displayed no 
 emotion at our presence. There is no doubt the Army and 
 Navy mosquito-net is very good : I have watched from the 
 inside lots of sand-flies using dreadful language on the out- 
 side because they couldn't get in : and my numerous bites 
 are all acquired in the evening before I can make tracks for 
 my little bed. The quinine every day prevents any of the 
 biters' attentions in the way of fever. ... I see that in the 
 House of Commons the people are being fooled to the top 
 of their bent. There is no medical transport of the sick 
 and wounded, except one small steamer. They are still 
 brought down in stinking filtliy store-barges, very often with 
 no water-tank, and never more than one foul latrine. It 
 
 really is incredible until you have seen it. That liar 
 
 said there was ice and fans in the hospitals.^ I believe there 
 
 * A statement to this effect had been made in the House of Commons
 
 MESOPOTAMIA 
 
 325 
 
 is ice at Basrah, but we are over 300 miles, and the 
 hundreds of patients here and everywhere above Amarah 
 have no beds even. Cholera patients lie on ground or on 
 stretchers. How these scandalous falsehoods are concocted 
 I cannot imagine. The enquiry will have to find that out. 
 I do hope the fall of Kut has been taken up by the public : 
 but I suppose it is limited to ' our sympathy goes out to 
 the gallant men,' etc. etc. May 16. I had hoped to get 
 down to Amarah to-day, but no boat has yet arrived. The 
 new D.M.S., Treheme, is coming up to Amarah to discuss 
 with me the transit of ' surgical cases.' Willcox has also 
 arrived, and is coming up with him. As I see no increase 
 of transport during this month, there is no chance of a proper 
 medical service. What lines the discussion therefore will take 
 heaven knows. Even here at Shaik Saad, where a great 
 medical station is designed, we cannot settle anything because 
 the corps Staff will not issue any precise orders on the move- 
 ment and constitution of the units. I have drawn out fully 
 what the units will require in the way of equipment, and 
 left it with the active O.C.'s here while I go to Amarah : 
 but suspect I shall be back again in two or three weeks, 
 unless the Turks cut us all off and take us to Constantinople 
 like brother Townshend. 
 
 Just been on the roof like Sister Anne to see if any boat is 
 in sight. ' Answer in the negative.' Was greeted on arrival 
 
 by a cow on the roof of the next house : and she proceeded 
 to walk up the ' street ' irom roof to roof. . . . They have 
 large coracles here, which carry up to ten tons. Thurston 
 
 siiw one towed by a mare swinuuing wiiile the foal w;ls on 
 board, thus, and the Arab^ jjaddlcd to steer. Had to break
 
 326 SIR VICTOR HORSLEY 
 
 off, as Col. Acland Troyte, commanding the Devons here, 
 came to settle tilings, having written the enclosed amiable 
 letter. Must shut up and wash for dinner. 
 
 Amur ah. May 21. As there is a layer of fluid all over 
 one's body all day and night, it is difficult to write except 
 on a folded handkcrciiief as a guard. I shall stop here until 
 something definite occurs at the front. . . . What to do 
 God knows, as everything is wrong here, and nothing but 
 astounding work in India and at home can possibly put 
 things right. I tnist my telegrams to the Commander-in- 
 Chief and the D.M.S. have started the ball rolling, because 
 they have wired to say that more M.O.'s, etc., are coming 
 from Egypt as I suggested. Also material. 
 
 Amarah is quite a picturesque comer of the river. The 
 river is quite 250 yards broad, and a powerful current at 
 the comer, where the stream divides. The date-groves on 
 the other side of the river are very pretty, with undergrowth 
 and large flowers growing 6 feet high. We used to have 
 them at WiUesley. At a distance, they might be taken for 
 true hollyhocks, but they are nothing like them really, and 
 at home they only grew about 2 feet high. The flower is 
 like a Xmas daisy. The nightingale was singing, not so well 
 as at home and much less continuous. These coppices are 
 being made into convalescent places for officers, and on the 
 outskirts only, I fear, for tlie men. We went across in the 
 usual gondola, which is rougher here, and held by enormous 
 nails like a Turkish door. That reminds me — the tympana 
 of the doors here are full of diaper work which is exactly 
 Norman, i.e. ours : I suppose post-crusadal. . . . Treheme 
 seems to be aware of the follies and crimes, and simply is 
 here to try and smooth things out. Lord knows where you 
 are, I have not had any letter of yours since March 23, I 
 think. 
 
 To Col. McCarrison, in Alexandria 
 
 Amarah, May 25. I have had a very interesting time in 
 acquiring new experiences, e.g. the smell of cholera, etc. etc., 
 but of course terribly depressing ones. I am pleased with 
 our new D.M.S., Treheme, he is certainly a movie. Of course 
 the evils arc so incredible that it takes a man some time 
 actually' to realise what is going on : and until you have 
 realised it to the full you cannot suggest remedies. This 
 campaign will like the rest of the War gradually pull out as 
 we require : but I see no chance of getting to India for my 
 round, before going home, under less than a year. ... I can 
 quite sec that the I. M.S. as a service is temporarily played 
 out. I say temporarily, because if it were completely re- 
 organised it could be made a fine thing, but you would be
 
 MESOPOTAMIA 327 
 
 grey before that occurred, not to say a white-haired cherub, 
 if such things can be. I left Shaik Saad with great regret, 
 as Sweet and all the other people were so very pleasant, and 
 moreover there was a chance of getting constructive reforms 
 carried out. ... Of course it is intensely hot here : prickly 
 heat, etc., all the go. Food here at Amarali, ' fair to middling ' : 
 was very short. Quarters now comfortable in a house. 
 
 To Lady Horsley 
 
 Amarah, May 26. We have had a grand reUef here — 
 the blowing of the North wind. It has made lovely cool- 
 nesses at times, and one is dried so quickly that the dis- 
 comfort of the liquid layer is gone. So also have most of 
 the insect world. This afternoon I had to go to the cholera 
 camp here, and afterwards walked along a ^villow-bordered 
 branch of the Tigris by which fig-trees and a few vines are 
 cultivated more or less, chiefly less. It was a lovely evening, 
 and the black and white kingfishers were having a great time 
 
 on a shoal. ... I have just heard to-day that had 
 
 actually had the hardihood to refuse the Y.M.C.A. offer 
 of canteens on the ground (among others) that they would 
 
 not sell whisky to the officers. . . . visited recently a 
 
 Brigade which has been reduced to a shadow, in which he 
 thanked them for their fighting and hardships, and said he 
 was doing his best to reward them by getting up beer I 
 The men are furious at this insult, and say they came to 
 fight for the Empire and not for half a pint of beer. I suppose 
 he is just one of the alcoholics with which our Staff is planted 
 thickly, and poor wretched man tliought he was giving 
 pleasure by his wretched jape. Considering the intense 
 sufferings of these men it was 
 beyond endurance to be promised 
 a glass of beer. . . . 
 
 Amarah, May 30. . . . I am 
 perfectly fit. Of course it 's no 
 end hot, but that doesn't worry 
 me like the work, which is endless 
 and excessively difficult. As regards 
 the heat, the sparrows sit like 
 this, and the fowls not only do the 
 same but stand in a draught 
 (when that can be found) holding 
 their wings out so as not to warm their bodice. Fortu- 
 nately, wljcn it lias mounted up day after day and you think 
 it 's going to bust the tluTuiomctcT, the N. wind blows up, 
 as to-day for instance, and then although it 's a hot blast 
 it acts like the fans which the liars in tlu' House of Commons 
 said the poor chaps in the hospitals had got, and at any rate
 
 p8 SIR VICTOR HORSLEY 
 
 you are dry, which for work and especially writing is a great 
 comfort. 
 
 I enclose 's kind notliingnesses in answer to my request 
 
 that if he heard of anything, would he communicate to you. 
 If you get the opportunity, it would be just as well to ask 
 him to find out if the Liberal party intend to oppose me as 
 they are doing all the time, as then my course would at least 
 be clear. I note liis statement with satisfaction, that no 
 constituencies are being nursed, because that at any rate 
 would mean a much fairer show when the General Election 
 does come. It would be a better run for it at any rate. 
 
 Now about the U.D.C. Of course I quite agree, and as 
 regards Ponsonby's attack on Morgan I have written a 
 quiet protest pointing out that all Morgan has done is to 
 publish evidence of the results to be obtained from mili- 
 tarism and conscription : that the German atrocities he 
 never claimed to be not due to militarism : and that since 
 the Kriegsbuch was publislied in a time of peace without the 
 slightest objection from the German people, it was obvious 
 that they were suffering from a certain degree of moral 
 decadence : and that Germany was the only nation which 
 had pubUshed such instructions to its officers. As to Morel, 
 of course it is unpardonable : and Dr. Sj-nge's letter (which 
 had already appeared in War and Peace, and I think the 
 Common Cause as well) is quite knocked out by the Witten- 
 berg report. Wittenberg was one of the camps she visited 
 after it had been cleaned up : and she does not, I think, 
 allude to the horrors at all. 
 
 A Sikh has just brougiit in your most welcome wire to 
 say you have got home all right. That is very great : and 
 I suppose the floodgates of speech are now open wide. It 
 must feel very pleasant to be home again, and I am now 
 perfectly thankful, especially as the two boys will both be 
 there to meet you. I can quite imagine it, and it is a delight- 
 ful dream. My love and respects to them all. ... I think 
 I will turn in now, the hurricane lamp is an abominably 
 bad light and collects all the beetles round for miles. If 
 you don't look out they get into bed with you and mak« it 
 gritty. Love to all the party. How glad they must be to 
 see you. 
 
 Amarah, June 5. I have had a splendid mail this week, 
 quite a shower of letters, so am naturally very bucked, 
 because I now know wliat is going on with each and all. I 
 find that is the real trouble of being away. . . . Now for 
 details, 'orribil dcctoils. This upside-down sort of place is 
 going it strong in the way of a hot boisterous wind and 
 burning sun. If you get well in the wind's eye, you are 
 pleasantly cooled, because it dries you up far quicker than
 
 MESOPOTAMIA 329 
 
 the sun can make you perspire, so you keep moving .*. cool- 
 ing .•. smiling. As to ' our ' health, we are quite well and 
 robust. As to ' our ' servant, he is the very idlest scoundrel 
 
 1 have met, who having evidently served some globe- 
 trotters reedises he cannot do me. He serves some pur- 
 poses, develops extraordinary maladies, which is common 
 among these followers here, because they live like pigs, 
 batlie in the muddy water and drink it at the same time, 
 and you can't stop them because they having no educa- 
 tion whatever are per conseq. pigheaded. Now the other 
 servant we got, and who died of the cholera in our camp at 
 24 F.A. the Front, was a substantial sort of person ; and 
 we are left with this Uttle villain. A few days ago he swelled 
 all over, much to ' our ' annoyance : it all went down with 
 iron and arsenic, and he probably is an opium-eater. Fortu- 
 nately I see to evcrj'thing myself : and so he has his uses, 
 base though they are. As to ' our ' food, it may be ' whole- 
 some, but it (certamly) is not good.' The ration bread is 
 excellent : we have now got plenty of jam : the flies won't 
 go near the butter, which is eatable — very odd they don't 
 like it, but they won't look at it — which is very fortunate : 
 good eggs : quaker oats (you would laugh to see me eating 
 porridge per force, though I am gradually getting to partly 
 like it) : once in a blue moon cornflour and tinned plums. 
 . . . The mess here are very agreeal)lc fellows, mostly Irish 
 and quite amusing : we occasionally go out in a bcUum to 
 go do\vn and walk into the mudflats and see the crops ! 
 Yesterday went for a walk up the river bank among the palm- 
 trees, etc., and came to a shrine-mosque which the Hindoo 
 sepoys had defiled. It was I suppose out of revenge for 
 the sniping and robbery which still goes on because, chiefly, 
 our people are distinctly slack in arranging the camp defences. 
 Night before last I was dining with the mess of the 12th 
 Indian Hospital : their mess is a mosquito-net room on the 
 river bank under the palm-trees, and very pleasant indeed : 
 with the coffee arrived a shot, and then on each bank the 
 sentries began potting steatlily. It's all right as long as 
 they fire outwards, but they don't always. Tlicrc had been 
 
 2 Arabs tried the day before, and will be hung to-day : 
 so I daresay they were trying to get some of their own back. 
 Then the jackals started their Promenade Concert : but they 
 never keep it up for more than ten minutes, so it 's small 
 and early with them. By the aforesaid shrine, I heard a 
 black partridge (really a francolin) so tracked him and tiicn 
 put him up : it Wiis very fine, as he got up with the hen, 
 only a few yards away. ... I am sending you 19 i)rints, 
 to show you the country, the water-supply, and conveyance 
 of the sick and wounded.
 
 330 
 
 SIR VICTOR HORSLEY 
 
 To his Daughter 
 
 The forward rako of the boats' masts is tiot bad drawing : it is their 
 picturesque rule. Also colour in your mind's eye the cap of the minaret with 
 beautiful l)lup enamel, and here and there yellow. The insects, thouRh the 
 largest of their kind, I have been obliged to omit as out of proportion to 
 the boats. 
 
 Amarah, June 8, . . . This here tovNTi of Amarah seen 
 from the bridge of boats (Turkish) makes quite good attempts 
 to be picturesque : the ladies in the foreground are paddling 
 a farm-boat, which brings up vegetables and fuel, brush- 
 wood and dried cowdung. There are mud fortified farm- 
 steads all along the banks. Not a few have palm-groves 
 J mile long, with figs, limes, etc., under, so that they really 
 form very pleasant but exceedingly rough walks, for the 
 original deep-ploughed furrows are left and covered with 
 grass and weeds a foot or two high. Of course they make 
 wonderful jackal covers, and the demoniacal row those 
 ladies and gentlemen made last night was worthy of a gramo- 
 phone close where you didn't want it. Inside the walls, 
 which are only about 2 feet thick but wondrously hard, 
 they have malting huts, ovens, cooking places, and a sakkya 
 of modem construction, made in England as a rule, for 
 distributing water to the faiTnstead and farm generally. 
 
 The children are most amusing here, always fooling. The 
 adults here, though frequently getting wet of course, always 
 try to tuck their skirts up, and squat to wash their hands. 
 I saw a person aged four imitating her betters, when a com- 
 panion pulled the back of her tucked-up nitey, with fatal 
 results. They both roared with laughter, and rolled about 
 in the muddy water like pra\\Tis. Boys will be boys, and 
 those of Aniarali act up to this great principle most com- 
 pletely. 
 
 The Bazaar here is quite good, because it is a dark lofty 
 tunnel of Arab houses. At the entrance is an interesting 
 caf^, quite a Teniers interior : I may get a photo of it, but 
 have no films to spare till I get some from Bombay : the 
 fircj)lace for boiling the coffee has a wonderful fluted hood 
 over the charcoal, some H feet high. All the coffee-pots here
 
 MESOPOTAMIA :^3i 
 
 are Persian, with enormous spouts like a toucan's beak : 
 and they also sell Rose's lime-juice with sugar and water. 
 This is a popular drink. Considering the Army demand 
 too, Mr. Rose must ' be doing well as any lunatic can tell.' 
 Our company here has been increased by a lady of very 
 mature age named Dugga. She has taken a fancy to sleep 
 under my table, and is always ready for ftwre water. She 
 is a fairly well-bred Persian greyhound, quite an acquisition, 
 black. . . . Well, I must adopt the gentle shout of the 
 undergrads at the Cambridge Suffrage meeting, ' plea- 
 SESHUTUP.' Farewell. 
 
 To Lady Horsley 
 
 Amarah, June 12. ... I find I am being of considerable 
 use. I get letters and visits (numerous) from people I never 
 heard of, recounting changes on the lines I laid down as 
 principles in Simla. I really do not think that it ever 
 occurred to the Ind. Govt, to deal with the Army and Medical 
 Services on principles at all. Only expediency. It is very 
 curious, and a wonderful study of constitutional govern- 
 ment. I am extremely anxious this vile rot should cease, 
 so that I may get to India to see more on the spot. This 
 peripheral business, however, is of course the finest test, 
 because it shows how absolutely helpless the expedientist 
 is when he has to direct things which are out of his immediate 
 (short) sight. We had yesterday arrive just on a flying visit 
 
 the officer sent out from England to replace at Simla. 
 
 He lunched here on his way through. Two or three colonels 
 were here too, and he rather put me in a ' difhculty ' with 
 the rest by insisting on speaking privately to me for 20 
 minutes in my room. He really wanted to know what I 
 tiiought of the whole condition of things medically, and 
 what wanted doing. He had got hold entirely of the right 
 end, namely, the outrageous state or rather absence of 
 necessary transport, and in fact seemed to me a ' very intel- 
 ligent fellow Bob.' . . . 
 
 We are all very fit here, those who are teetotallers. The 
 weather, as the General says in Our Boys, ' It is hot ' : and 
 the funny thing is that everything feels hotter than you 
 expect, because of course it is about 110°. For instance if 
 I want to look inside a book and open it, the inside pages 
 feel hot and make you nearly jump. Of course in the sun 
 it is 150° and over : and if you inadvertently touch iron 
 you do jump, and probably two or three times, ' not once 
 and again, but again and again and again.' Of course the 
 evenings are charming, though now wann : tiie nuK)nlight 
 on the river and the sunset lights over the palm-groves 
 when wc sit down to dinner on the mud roof aie very charm-
 
 332 SIR VICTOR HORSLEY 
 
 ing. When the insects (which vary) are in full blast, and 
 we are bombarded by locusts and beetles, there comes over 
 our heads a good-sized night-jar, like an express train, who 
 dines above us if not exactly with us. 
 
 Amarah, June 19. I am going up to the front again 
 to-morrow to complete the surgical equipment. The incredible 
 slowness with which things move here is very difficult to 
 put into words. The convoy of the sick and wounded is 
 siill, as I wired to Simla, ' grossly insanitary and inhuman.' 
 (Cock sparrow hard at work tearing up 
 my matting in this room to get lining 
 for his nest.) What is so infernal is that 
 this is an Indian Govt. show. Now in 
 India soda-water is every one's per- 
 quisite, as it were. It is as common cis 
 ordinary water. Out here the convoys 
 of sick, with a temperature of I20°-I37° under the awnings, 
 have 3 or 4 doz. sodas for 315 sick and convalescents. 
 The answer is, ' Oh, there are no more bottles ' : these 
 scoundrels in India never taking the sHghtest trouble during 
 these 20 months to provide bottles and machines. But 
 there you are : this (in the face too of provision of 
 whiskies and sodas for the staff) is but one of the looi 
 scandals of this campaign. My business now is of course 
 to see that the surgical ship is in full swing, and to 
 arrange for two sisters to come up. . . . 
 
 One of the Augean Stables that I found in full swing and 
 General Treheme was scandalised with, and supplied the 
 administrative power I do not possess, was the so-called 
 Convalescent Depot. Photo i is this filthy hole into which 
 no less than 1424 men were put convalescent. It was really 
 an old granary used as a stable by a mountain battery. They 
 cleared out the battery, scraped the ground a little, and the 
 same afternoon put in convalescents, etc. It was exactly 
 like the drawings we had of 1S15 of Napoleon visiting the 
 Hospital at Jaffa. The men were actually of course living 
 on this horrible mud floor, and had their food-tins on it, 
 etc. Next to it, though separated by a narrow roadway, 
 was a huge compound (photos 2 and 3) full of sick iiorses 
 and remounts. When I was there the mud and filtii was 
 partly drying up : see a mass in the foreground of 3, in 
 front of the Arab sayces. The smell was obvious : but I 
 was told by the M.O. in charge that for 2 months it had 
 been awful, and no remonstrances could get rid of the horses, 
 though the convalescents were made sick by it. 
 
 . . . Give my best respects all round. Send me out 
 20 Alcohol and Human i3odj' : I can easily get rid of 
 them. They have frankly told me here that the different 
 messes were panic-stricken by my advent : thought I should
 
 MESOPOTAMIA 
 
 333 
 
 get up and physically and morally denounce them, and as 
 they knew they had no excuse for their whisky drinking 
 they were proportionately uncomfortable. Now they all 
 want me to stop, although I have denounced them over and 
 over again. PS. — Moreover they are drinking less. 
 
 On board T2, going to Front, June 22. T2 is a large sort 
 of passenger tug ; and lashed alongside are two mahelas 
 and their Arab and Sidi boys (descendants of slaves, Africans 
 of course) crews. The prow of the port one is quite pleasant, 
 as well as the furnishings of the forecastle. The prow is 
 quite a work. It is carved ad lib. with geometrical designs : 
 
 
 on the top is a bronze corroded Turkish crescent and star : 
 nailed to the middle of the star by a big bolt is an absurd 
 bird, sort of Caran d'Ache, really to serve as a belaying-pin, 
 which the head and tail admirably fulhl. The yard like all 
 Arab yards, a wonderful compound of odds and ends. The 
 coiled hawser behind the prow, completed by a blanket, 
 makes a hut under which two hens pass a happy day, especially 
 after they have been lowered into the river to cool. Hy the 
 side is a calabash tobacco-pipe, sort of ' ship's tocjthbrush ' ; 
 any one who has tobacco to put in the funni'l end is entitled 
 to suck at the other. The mud oven is about 3 feet high 
 and a foot wide at the top. In the evening it is very pretty, 
 as they heat it by wood and the llames come gaily out at 
 the top, to the imminent destruction of the whole fleet : 
 but barring Kamcses in. I haven't secnjja ship on fire, though
 
 334 
 
 SIR VICTOR HORSLEY 
 
 they are laden with compressed chaff, matting, etc. etc., 
 and of course no one lias any lire appliances. The crew all 
 have coffee in the afternoon, or tea. The tea-things and 
 little coffee cups and spoons are all solemnly packed away 
 again in a little square box with compartments and orna- 
 mented with strips of perforated and bordered steel. They 
 eat their chupatties baked in the oven dipped in the tea, 
 and spread wonderful carpets and thick padded rezais, sort 
 of mattress quilt, to sleep on. The poor old mahelas leak 
 somewhat, and day and night at intervals have to be bailed 
 out in pailfuls, as of course they won't run to a pump ; 
 although such is the cost of wood, the expense of building 
 a mahela is about £800. 
 
 To his Daughter 
 
 112th Indian Field Ambulance, Filayich, July i. . . . We 
 have got Mr. Nebuchadnezzar's furnace heated ' seven times 
 hotter than before.' The N. wind really is bucking up, 
 but as it blows over several hundred miles of mud flat, 
 etc., it is no longer a mountain breeze from glaciers, but 
 something quite the reverse. However, it moves the air, 
 and that is distinctly worth having, even though of course 
 there is dust everywhere. We sleep usually for half an 
 hour before lunch and an hour after, so ' contemplation ' is 
 easy as an excuse. All the insects go to sleep too at the 
 same time : except the house-flies, of whom a hardy half- 
 
 dozen survive chiefly to annoy us if sleeping. However, 
 thank goodness, we keep one or two tarantula spiders, like 
 this person, who live up at the top of the tent-poles and dash
 
 MESOPOTAMIA 
 
 335 
 
 round like Bedouins and mop up the flies which always 
 towards evening tend to roost on the roof-canvas. Talking 
 of insects, I was writing a Report outside the tent last night, 
 when a passing acquaintance hurried by, chinchilla-grey 
 bonnet and terracotta and black shawl. He or she explored 
 
 various plants, and then selected a bare stalk, not really 
 up to weight, but that did not stop him climbing nimbly 
 to the top and beginning to eat the said stalk from the 
 top downward. He ate the whole tiling, descending all 
 the time, and even finished the stump in the ground. 
 He reminded me of the drunken rioter in Hogarth's picture 
 sawing off the signboard. . . . We also have a very 
 tame sort of wagtail, grey body and 
 wings and dark red tail, which drinks 
 at our coolers — Persian water pots, 
 porous, which leak slowly into 
 saucers. The only other birds are 
 the sand-grouse and bee-eater. It 
 is rather a land of surprises. The 
 ground is covered with a melancholy- 
 looking grey scrub, bushes about a 
 
 foot high, and here and there some rather larger ones. These 
 yestcrclav morning were covered witli flowers exactly like 
 Christmas roses : quite pretty, and much appreciated because 
 unexpected. 
 
 All the grey scrub makes it very difficult to spot things at 
 a distance, and the mirage renders it absohitely impossible 
 about 3 miles off. Consequently our guns are rather 
 outed, and carry on a kind of morning and evening hate. 
 The shell-bursts in this funny soil give all sorts of shaj^cs : 
 I wanted to photo them tlirougli a loophole ; but tiio Turks 
 arc very handy with their machine-guns on our loopholes : 
 and no one is allowed to open them up, except when there 
 is a strafing going on. . . . The Turkish aeroplanes being 
 twice as fast as ours do what they like ; and droj^j^cd a note 
 expressing the hope tliat if (as hajipened on this side) they 
 had to evacuate llicir trenclics, they hoped we would not 
 claim we had ' carried them.' A nasty bit of sarcasm richly
 
 336 SIR VICTOR HORSLEY 
 
 deserved by us. ... I hope all our young friends are doing 
 well, especially my two sons I Farewell. 
 
 To Lady Horsley 
 
 112th Indian Field Ambulance, Front, July 5. It is now 
 quite obvious that nothing can or will be done here till 
 October. I am therefore arranging to go back to India 
 and do some of the inspecting work I have got to do at the 
 end of this business, and return here in say September (end). 
 My plan is to go from here down to Shaik Saad, stop there 
 a couple of days ; go on to Amarah, stop there two days 
 and pick up my rest of Idt. At Basrah I shall probably 
 be kept a week for a boat, and in any case shall have to 
 hold no end of pow-wows with people who do not neces- 
 sarily understand, even when you have got them face to 
 face. Treheme's plans here are really destroyed, the only 
 thing that is surviving and clearly must survive is my surgical 
 hospital ship, P8. They are fixing it to the left bank, which 
 I asked for as the non-dusty one, but which I was assured 
 was impossible. It is really almost absurd for any unit 
 to make any arrangement : it is certain to be upset : and 
 probably, once in a new place, will i)e sent back to its old 
 one ; which has just happened to the only clearing station 
 we had here, tliough Treheme's plan involved four such 
 stations being planted here. Of course this sort of thing 
 is inevitable in a hand-to-mouth arrangement bom of non- 
 preparation. I only hope that the Mesopotamian Enquiry, 
 when it comes off, will have sufficient sense to understand 
 all these causes of failure. As regards my programme. It 
 is quite plain that I have to make a localised tour from 
 Bombay to inspect stations — Poona, Nagpur. Now I think 
 I can get all that done during August and September : so as 
 to enable me to make a straight run round — Karachi, Lahore, 
 Lucknow, Calcutta, Hyderabad, Madras, Ontacamund, 
 Ceylon — when all this infernal stupidity is over. 
 
 I must be off now to see the D.D.M.S., to try and find out 
 whether I can get down to-morrow night to Shaik Saad. 
 There is nothing going on, except the evening aeroplane 
 comes over and bombs us as he likes, because we have nothing 
 to do him with. ' This is War.' Blooming health, in spite 
 of continuous 1 10-120 in shade. 
 
 On July 14, Colonel Fell visited him in Amarah, and had 
 tea with him. On that day, he said that he was not feeling 
 very well : but he was still at work. ' I was talking to him,' 
 one of his friends writes, ' two days before he died. He was
 
 MESOPOTAMIA 337 
 
 full of the bad conditions everywhere, and of the improve- 
 ments that should be made. He then told us that any 
 influence he might possess would be used to the utmost to 
 get all medical arrangements put on a better footing. He 
 was very thorough in everything he did, not sparing himself 
 in the shghtest, and often working throughout the hottest 
 part of the day, when most men (much younger men too) 
 were resting. When he went down from the front, he took 
 with him all the evidence he could collect — such as specimens 
 of Ume-juice issued to the troops, etc. — all carefully labelled, 
 dated, and tabulated, ready for when he drew up his report.' 
 His notes on these matters have not reached his home. 
 
 On the 15th, his temperature w^as 103° ; and so soon as 
 the hottest time of the day was over, he was moved into 
 No. 2 British Gk^neral Hospital. Captain T. M. Body, 
 R.A.M.C, who had been admitted to it two days before, 
 writes : 
 
 There is no one for whom I ever had a greater respect. 
 He came to Mesopotamia as a Consulting Surgeon, but at 
 a time when there was practically no surgery ; so he in con- 
 sequence had to take rather a wide view of his work ; and 
 I think decidedly that there was no one who could have 
 done that work with more enthusiasm — and what is more 
 important, such good results. His enthusiasms were bound- 
 less ; and in a country which is not noted for energy, this 
 characteristic was invaluable, as not even the most slothful 
 of us could sit down and see a man nearly 60 years of age 
 doing more than us, some twenty or more years younger. 
 Like all good sociahsts, he was an absolute autocrat, conse- 
 quently he got things done, often much to the disgust of 
 the regular officials at the irregularity of the method. He 
 argued that if things were necessary for the health of the 
 men, and these things could not be got through the ordinary 
 channels, then we must find other means. But when I 
 proceeded to tell him of the few things I had stolen for my 
 operating-theatre, he thought that I should iiave had re- 
 course to otiier means. Wc lost a man, fearless and honest, 
 who was doing something, and would have done more. As a 
 member of the medical profession I feel this more, as he was 
 one of the very few medical men who had the car of the 
 public — (you who hve in London must shed your provin- 
 cialism before you can appreciate this) — and would have used 
 his voice to improve and help our profession, and help it 
 at a time when wc want so much help. . . . 
 
 Y
 
 338 SIR VICTOR HORSLEY 
 
 On Saturday, July 15, about 5 p.m., I saw Victor Horsley 
 carried into the Hospital in a carr^-ing-chair, sitting up, look- 
 ing fairly vveU. The impression left on my mind was that he 
 considered that he was being made rather an unnecessary fuss 
 of. His temperature on admission was about 103°, and rose 
 the same evening to 105° or higher. His medical officer was 
 Barwell, a University College man, who was on the junior 
 staff in Victor Horsley 's time ; a thoroughly good physician ; 
 and everything was done that human skill and ingenuity, 
 and the means at disposal, allowed : all the available ice, 
 which I am afraid was not much, was used : but in spite 
 of it all, the temperature remained high. 
 
 The Hospital was on the left bank of the river : a good 
 stone building, originally a Sheikh's palace. In 1915, it 
 was captured and held very gallantly by the Norfolks : a 
 mere handful of men held it for several days, before rein- 
 forcements could arrive up the river : from this exploit, it 
 had got the name of Norfolk House. Major Mackworth, 
 I.M.S., who hkewise was a patient in the Hospital, writes : 
 
 The first time we met was when he visited our Indian 
 General Hospital. Lt.-Col. Anderson, the O.C. of the 
 Hospital, introduced him. I failed to catch the name of 
 the colonel wearing red tabs ; and took him to be some 
 inspecting combatant officer. Just then the O.C, being 
 called away, asked me to do the honours and show the officer 
 round. We entered the operating-theatre. I showed him 
 the wonders therein : an artery forceps — ' an instrument 
 for pinching blood-vessels when they arc cut ' — along with 
 some other instruments in daily use. I still remember that 
 amused smile, and his remarks — ' How marvellous ' — ' How 
 very interesting.' We proceeded to the wards. I shudder 
 to think of the offhand way I demonstrated 15 trephine- 
 cases under my charge. It was not till afterwards one 
 reahsed his identity, and what an enormous faux pas had 
 been perpetrated. He visited our hospital on the next day, 
 whereupon I apologised for not having recognised who he 
 was. ' That 's all right,' says he : ' you must excuse me 
 my little joke.' After that wc became very friendly ; he 
 was a frequent visitor, and one benefited much from his 
 useful advice. 
 
 On my remonstrating with him for going out in the heat 
 of the day on one occasion (3 p.m. June, Mesopotamia is 
 decidedly warm) with only a puggri, cloth coat on, and no 
 spinal pad, his rejoinder was, ' Are you a teetotaller ? ' 
 Sad to say, shortly after this we were patients together in
 
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 3 i
 
 MESOPOTAMIA 339 
 
 the Hospital where he died. I will ever remember him as 
 one of the most kindly and courteous gentlemen I have ever 
 met. One never felt the slightest restraint in discussing 
 with him even subjects which were his speciahty. 
 
 Even on the Saturday, he was still at work. There is a 
 letter in the British Medical Joumal, September 2, 1916, 
 from Amarah : 
 
 I have just been to the Hospital where Sir Victor Horsley 
 was lying ill ; to find that he passed away a few minutes ago. 
 He had only j days ago returned to Amarah from the front, 
 and seemed to be in his usual health and spirits. Only 
 yesterday, Saturday morning, I had some conversation with 
 him on a subject which was interesting him, the provision 
 of hospitals with laboratories : and he then set out to walk 
 back to his camp, which was about a mile and a half away 
 across the Tigris bridge and over the open plain. The 
 shade temperature was over 110°, and the atmosphere humid. 
 When he got to his tent, he heard there was a sick officer 
 he knew, about half a mile further on ; he went on to see 
 him, and examined him carefully. He complained of head- 
 ache later in the day, and was admitted to the Hospital on 
 Saturday evening. ... I can speak of his untiring energy 
 and the loyal devotion and singleness of purpose shown in 
 his every action up to but a few hours ago. Those who have 
 met him recently are aware that he had framed a very severe 
 indictment against those he beheved were responsible for 
 the mismanagement which he thought characterised some 
 aspects of the campaign. It is only three days since he 
 returned from the front, and he was about to return to India 
 for a spell to prepare liis report. 
 
 Major Grey Turner writes : 
 
 I happened to come across him just as he was about to 
 be admitted to Hospital. Though he was looking ill, he 
 was as cheerful as ever, and at once began to talk about some 
 arrangements of mutual interest. He told me that up to 
 that Saturday he had been absolutely well, and that he had 
 not felt the heat too trying. I am told that it was a very 
 usual thing to see him in Amarah during the heat of the day, 
 and there are many who thought that he exposed Iiimsclf 
 too much. 
 
 On Sunday, July 16, his temperature rose to 107°: he 
 became unconscious, and died that evening. It is certain 
 that he died of heat-stroke ; there was a rumour that he also
 
 340 SIR VICTOR HORSLEY 
 
 had paratyphoid fever : but the blood-tests gave no support 
 to this belief. 
 
 Mr. Martin Swa3nie, in his book ' Mesopotamia,' describes 
 the funeral : 
 
 Shortly after we left Amarah, the news came that Sir Victor 
 Horsley had died. It was in a season of extreme heat, when 
 death comes suddenly in many forms. Eighty officers attended 
 his f unercd. He had a coffin. Wood was precious in Amarah. 
 There were some other bodies sewn up in blankets. A long, 
 dusty march of a mile to tlie cemetery, a shallow earth grave, 
 a brief ceremony, the same for all, and a weary tramp home 
 in the sun — that was the final picture. There is one more 
 detail to add, and that is the lovely playing of the ' Last 
 Post ' over the graves. 
 
 Palms were laid on his grave. Later, a cross of white 
 marble was placed over it. He had gone to Mesopotamia 
 knowing that he might die there. He said to Lady Horsley, 
 just before he left Egypt, ' Don't worry about me : I 
 don't matter : I can't live for ever : it 's the young that 
 matter.'
 
 PUBLISHED WRITINGS 
 
 i88o. Arrest of development in the left upper limb, in association 
 with an extremely small right ascending parietal con- 
 volution. By H. Charlton I3astian and Victor Horsley. 
 Brain, April 1880. 
 
 1882. On ' Septic Bacteria ' and their Physiological Relations. 
 Appendix to nth Annual Report of Local Government 
 Board. 
 
 1882. On the existence of Bacteria, or their Antecedents, in 
 Healthy Tissues. With Dr. F. W. Mott. Joum. 
 Phys., iii. 188. 
 
 1882. Articles ' Bacilli ' and ' Zjmfie ' in Quain's Dictionary of 
 
 Medicine. 
 
 1883. Note on the Patellar Knee-jerk. Brain, Oct. 1883. 
 
 1883. Four cases of injury to the brain in man, illustrating very 
 
 exactly the position of the cortical motor centres. 
 Joum. Phys., iv., supplement, p. 5 ; Proc. Phys. Soc, 
 Dec. 13, 1883. 
 
 1884. Case of Occipital Encephalocele in which a correct diagnosis 
 
 was obtained by means of the induced current. Brain, 
 Pt. xxvi., 1884. 
 
 1884. On the existence of sensory nerves and nerve-endings in 
 nerve-trunks, true ' nervi nervorum.' Proc. Roy. Med. 
 Chir, Soc, n.s., i. 196. See also Proc. Physiol. Soc, 
 June 7, 1884. 
 
 1884. On Substitution as a means of restoring Nerve Function, 
 considered with reference to Cerebral Localisation. 
 Lancet, July 5, 1884. 
 
 1884, Consensual movements as aids in diagnosis of disease of 
 
 the Cortex Cerebri. Medical Times and Gaz., Aug. 
 16, 1884. 
 
 1884-1890. Annual Roports to the Committee of the Brown 
 Institution. 
 
 1885. The Thyroid Gland : its relation to the pathology of 
 
 Myxccdcnia and Cretinism, to the question of the 
 surgirnl trrntmont of Goitro, and to ihr General Nutri- 
 tion of the P>ody. Brit. Med. Juurn., Jan. 17. 1885. 
 
 Ml
 
 342 SIR VICTOR HORSLEY 
 
 1885. The Motor Centres of the Brain, and the Mechanism of the 
 Will. RoyiU Institution Lecture, March 27, 1885. 
 
 1885. Acute Septic Peritonitis : operation : recovery. Med. Times 
 
 and Gaz., Sept. 26, 1885. 
 
 1886. Abstracts of Brown Lectures : two on the thyroid glaud, 
 
 three on epilepsy. Lancet, 1886, ii. 1163, 1211. 
 
 1886. Brain Surgery. Address at Brighton. Brit. Med. Joum., 
 Oct. 9. 1886. 
 
 1886. Epilepsy produced in guinea-pigs. Proc. Med. Soc. Lond., 
 1886, X. 86. 
 
 1886. (t) On the Relation between the Posterior Columns of the 
 Spinal Cord and the Excito-Motor Area of the Cortex, 
 with especial reference to Prof. Schiff's views on the 
 subject. (2) A further and final criticism of Prof. 
 Schiff's experimental demonstration of the relation 
 which he believes to exist between the Posterior 
 Columns of the Spinal Cord and the Excitable Area of 
 the Cortex. Brain, April and October, 1886. 
 
 1886. Translation of Koch's monograph, ' On the Investigation of 
 Pathogenic Organisms ' : published in ' Recent Essays 
 by various authors on Bacteria in relation to disease.' 
 Edited by W. Watson Cheyne. London, New Syden- 
 ham Society, 1886. 
 
 1886. On an apparently peripheral and differential action of 
 Ether upon the Laryngeal Muscles. With Felix Semon. 
 Brit. Med. Joum., Aug. 28 and Sept. 4, 1886. 
 
 1886. A case of Suppuration of the Mastoid Cells. With 
 
 remarks on the prevention of septic embolism in such 
 cases. Clin. Soc. Trans., xix. 
 
 1887. Notes on the pathology of inveterate Neuralgia of the 
 
 Fifth Nerve : illustrated by cases treated successfully 
 by avulsion of the nerve close to the skull. Trana. 
 Odontol. Soc, June 1887. 
 
 1887. Remarks on Ten Consecutive Cases of operations upon the 
 brain and cranial cavity, to illustrate the details and 
 safety of the method employed. Brit. Med. Joum., 
 April 23, 1887. 
 
 1887. Trephining in the Neohthic Period. Joum. Anthropol. 
 Inst., xvii. 100. 
 
 ?i887. Recherches Exp^rimentales sur I'ficorce C^r^brale des 
 Singes, d^montr^es par une experience actuelle devant 
 la Socidte de Biologic de Paris. Par MM. Charles E. 
 i^eevor et Prof. Victor Horsley. London, H. K. Lewis 
 (undated).
 
 PUBLISHED WRITINGS 343 
 
 1887. A Note on the means of Topographical Diagnosis of Focal 
 Disease affecting the so-called Motor Area of the Cerebral 
 Cortex, Amer. Jouni. Med. Sc, April 1887, pp. 342-69. 
 
 1887. A Minute Analysis (Experimental) of the various move- 
 
 ments produced by stimulating in the Monkey different 
 regions of the Cortical Centre for the Upper Limb, as 
 defined by Prof. Ferrier. With C. E. Beevor. Phil. 
 Trans. Roy. Soc, vol. 178, B, 1887. 
 
 1888. Evidence before Parliamentary Committee on Pleuro- 
 
 pneumonia and Tuberculosis in Cattle. 
 
 1888. Note on some of the Motor Functions of certain Cranial 
 Nerves, and of the three first Cervical Nerves, in the 
 Monkey {Macactis sinicus). With C. E. Beevor. Proc. 
 Roy. Soc, xliv. 269. 
 
 1888. A Record of Experiments upon the Functions of the 
 Cerebral Cortex. With E. A. Schafer. Phil. Trans. 
 Roy. Soc, vol. 179, B, 1888. 
 
 1888. A further Minute Analysis by Electrical Stimulation of the 
 so-called Motor Region of the Cortex Cerebri in the 
 Monkey {Macacus sinicus). With C. E. Beevor. Phil. 
 Trans. Roy. Soc, vol. 179, B, 1888. 
 
 1888. A case of Cerebral Abscess successfully treated by opera- 
 tion. With Dr. Ferrier. Proc Med. Soc. Lond., xi. 232. 
 
 1888. A Case of Tumour of the Spinal Cord : removal : recovery. 
 With Dr. Cowers. Trans. Roy. Med. Chir. Soc, Ixxi. 
 
 1888. Reports on the outbreak of Rabies among Deer in Rich- 
 mond Park during the years 1886-7. With Mr. A. C. 
 Cope. Eyre and Spottiswoode, 1888. 
 
 1888. On Hydrophobia and its ' Treatment,' especially by the 
 Hot-air Bath, commonly termed the Bouisson Remedy. 
 Brit. Med. Joum., June 9, 1888. 
 
 1888. A Case of Paralytic Rabies in Man ; with remarks. With 
 Dr. J. S. Bristowe. Clin. Soc. Trans., xxii. 
 
 1888. A Case of Thrombosis of the Longitudinal Sinus, together 
 
 with the Anterior Frontal Vein, causing localised foci 
 of Haemorrhage which produced remarkably localised 
 Cortical Epilepsy. Brain, April 1888. 
 
 1889. Die Functionen dcr Motorischen Region dcr Hindrindc. 
 
 Deutsche Med. Wochenschrift, No. 38, 1889. 
 
 1889. On Rabies ; its treatment by M. Pasteur, and the means 
 of detecting it in suspected cases. Address to the 
 Epidemiological Society. Brit. Med. Jouni., Feb. 16, 
 1889.
 
 344 SIR VICTOR IIORSLEV 
 
 1889. Report on the control of hasmorrhage from the Middle 
 Cerebral Artery and its branches by compression of 
 the Common Carotid. With Walter G. Spencer. Brit. 
 Med. Joum., March 2, 1889. 
 
 1889. On the value of Differences observed in the Temperature 
 of the two sides of the body, as symptomatic of cerebral 
 lesions. Brit. Med. Joum., June 22, 1889. 
 
 1889. Ein Fall von RiickenmarksgeschwTjlst mit Heilung durch 
 Exstirpation. Von Dr. W. R. Gowers und Victor 
 Horsley. Uebersetzt und den Mitgliedem der Deutschen 
 Gesellschaft fiir Chirurgie bei dem 18. Congress gewidmet 
 bei Dr. Bemhard Brandis. Berlin, Hirschwald, 1889. 
 
 1889. On the Central Motor Innervation of the Larynx. With 
 
 FeUx Semon. Brit. Med. Joum., Dec. 21, 1889. 
 
 1890. On the relations of the Larynx to the Motor Nervous 
 
 System. With Felix Semon. Deutsch. Med. Wchnschr., 
 1890, No. 31. 
 
 1890. Du Centre Cortical Moteur Laryng^ et du Trajet Intra- 
 cerebral des Fibres qui en emanent. With Felix Semon. 
 Ann. des Mai. de I'Oreille et du Larynx, x\i. 
 
 1890. An Experimental Investigation of the Central Motor 
 Innervation of the Larynx. With Felix Semon. Phil. 
 Trans. Roy. Soc, vol. 181, B 57, 1890. 
 
 1890. An Experimental Investigation into the Arrangement of 
 the Excitable Fibres of the Internal Capsule of the 
 Bonnet Monkey {Macacus sinicus). With C. E. Beevor, 
 Phil Trans. Roy. Soc, vol. 181, B 52, 1S90. 
 
 1890. A Record of the Results obtained by Electrical Excitation 
 of the so-called Motor Cortex and Internal Capsule in 
 an Orang-outang {Simia satyrus). With C. E. Beevor. 
 Phil. Trans. Roy. Soc, vol. 181, B, 1890. 
 
 1890. Sur la chirurgie du systcmc nerveux central. Translation 
 of Horsley 's address at Int. Med. Congress in Berlin. 
 Mercredi Mddical, Aug. 27, 1890. 
 
 1890. Note on a possible means of arresting the progress of 
 
 Myxoedema, Caclicxia strumipriva, and aUicd diseases. 
 Brit. Med. Joum., Feb. 8, 1890. 
 
 1891. On the Analysis of Voluntary Movement. Nineteenth 
 
 Century, June, 1891. 
 
 1 891. Ueber den Gebrauch der Elektricitat fiir die Localisirung 
 der Erregungserscheinungen im Centralnervensystem. 
 With Francis Gotch. Ccntralbl. f. Phys., Jan. 31, 1891.
 
 PUBLISHED WRITINGS 345 
 
 1891. On the Mammalian Nervous System, its Functions, and 
 their Localisation determined by an Electrical Method. 
 The Croonian Lecture for 1891. With Francis Gotch. 
 Phil. Trans. Roy. Soc, 1891. 
 
 1891. Die Function der Schilddriise : eine historisch-kritische 
 Studie, Contributed to the Virchow Festschrift, Bd. i. 
 
 1891. Remarks on the various surgical procedures devised for the 
 relief or cure of Trigeminal Neuralgia (Tic-douloureux). 
 With James Taylor and Walter S. Colman. Brit. Med. 
 Joum., Nov. 28, Dec. 5, Dec. 12, i8gi. 
 
 1891. On a Case of Traumatic Abscess in the neighbourhood of 
 the left angular gyrus, with right hemianopsia and word- 
 bUndness, treated by operation. With C. E. Beevor. 
 Trans. Ophthalmol. Soc, xii. 
 
 1891. On the Changes produced in the Circulation and Respiration 
 by increase of the Intra-cranial Pressure or Tension. 
 With Walter Spencer. Phil. Trans. Roy. Soc, vol. 182, 
 B, 1891. 
 
 1891. The Structure and Functions of the Brain and Spinal Cord. 
 
 Fullerian Lectures for 1891, London, Griffin and Co., 
 1892. 
 
 1892. Topographical Relations of the Cranium and Surface of 
 
 the Cerebrum. Royal Irish Academy: Cunningham 
 Memoirs, Dublin, 1892, vol. vii. pp. 306-55. 
 
 1893. Introduction to ' The Chemistry of the Blood ; and other 
 
 Scientific Papers by the late L. C. Wooldridge. Arranged 
 by Victor Horsley and Ernest StarUng.' London, 
 Kegan Paul, 1893. 
 
 1893, A Clinical Lecture on Paraplegia as a result of Spinal Caries 
 (Compression-Myehtis) and its Treatment. Clin. Joum., 
 March 15, 1893. 
 
 1893. The Surgical Treatment of Nervous Diseases. A Post- 
 Graduate Lecture. Med. Press and Circular, April 5, 
 1893. 
 
 1893. The Discovery of the Physiology of the Nervous System. 
 Address at meeting in Nottingham of the British 
 Association. Med. Press and Circular, Sept. 27, 1893. 
 
 1893. Discussion on the Treatment of Cerebral Tumours. 
 
 Address at Newcastle. Brit. Med. Joum., Dec 23, 
 1893. 
 
 1894. A further Minute Analysis by Electrical Stimulation of the 
 
 so-called Motor Region (I'^acial Area) of the Cortex 
 Cerebri in the Monkey {Macacus sinicus). With C. E. 
 Beevor. Phil. Trans, Roy. Soc, vol. 185. B, TM. i., 
 1894.
 
 346 SIR VICTOR HORSLEY 
 
 1894. On the Mode of Death in Cerebral Compression, and its 
 Prevention. Quarterly Medical Journal, July 1894. 
 
 1894. The Destructive Effects of Projectiles. Royal Institution 
 
 Lecture, April 6, 1894. 
 
 1895. The Differential Diagnosis of Cerebral Tumours : with 
 
 some remarks on treatment. Clin. Joum., Feb. 13, 1895. 
 
 1895. Five cases of Leontiasis Ossium, in three of whicli the 
 disease was removed by operation. Practitioner, 
 July 1895. 
 
 1895. The Results of Operative Treatment of Injury or Disease 
 of the Cervical Vertebrae. Lancet, Aug. 17, 1895. 
 
 1895. Introductory Address deUvered at the openuig of the winter 
 
 session of the Sheffield School of Medicine. Quarterly 
 Med. Joum., Oct. 1895. 
 
 1896. Traumatic Neurasthenia. A lecture at Univ. Coll. Hosp. 
 
 Clin. J(jum., March 4, 1896. See also Proc. Med. Soc. 
 Lond., XX. 216. 
 
 1896. The duties and functions of the General Council of Medical 
 
 Education and Registration. Med. Magazine, v. 109. 
 
 1897. On the Diseases of the Spinal Cord requiring Surgical 
 
 Treatment. Clin. Joum., Jan. 13, 1897. 
 
 1897. On the relations between the Cerebellar and other Centres 
 (namely, Cerebral and Spinal) with especial reference 
 to the action of antagonistic muscles. With Dr. Max 
 Lowenthal. Proc. Roy. Soc, vol. Ixi., 1897. 
 
 1897. Torticollis. Clin. Joum., June 30, 1897. 
 
 1897. On the effects produced on the circulation and respiration 
 by Gunshot Injuries of the cerebral hemispheres. With 
 Dr. S. P. Kramer. Phil. Trans. Roy. Soc, series B, 
 vol. 188, 1897. 
 
 1897. Short note on Sense-organs in Muscle ; and on the pre- 
 servation of Muscle-spindles in conditions of extreme 
 muscular atrophy, following section of the motor nerve. 
 Brain, Pt. Ixxix., 1897. 
 
 1897. Das Sauerstofibediirfniss des Organismus. Miinch. Med. 
 Wochenschrift, No. 19, 1897. 
 
 1897. Methylenblaufiirbung der Blutkorperchen. Miinch. Med. 
 
 Wochenschrift, No. 23, 1897. 
 
 1898. A Contribution towards the Determination of the Energy 
 
 developed in a Nerve Centre. Presidential Address 
 to the Neurological Society. Brain, Pt. Ixxxiv., 1898. 
 
 1898. On the Excitable Fibres of the Cms Cerebri. With Dr. 
 C. E. Beevor, Fourth International Physiological 
 Congress, Cambridge. Joum. Phys., xxiii.
 
 PUBLISHED WRITINGS 347 
 
 1898. On Penetrating Wounds of the Central Nerv^ous System. 
 Clin. Joum., xii. 261. 
 
 1898. The true interpretation to be placed on the Medical Acts. 
 Suppl. to Clin. Joum., Feb. 9, 1898. 
 
 1898. On the work of the General Medical Council. Abstract of 
 
 Address to the Manchester Medico-Ethical Association. 
 Lancet, Dec. 24, 1898. 
 
 1899. Roman Defences of South-East Britain. Royal Institu- 
 
 tion Lecture, Feb. 3, 1899. 
 
 1899. On Injuries to Peripheral Nerves. Practitioner, Aug. 1899. 
 
 1899. On the rational treatment of Goitre. Address to the North- 
 
 West London CUnical Society, Oct. 27, 1898. Clin. 
 Joum., March 8, 1899. 
 
 1900. The Effect of Alcohol on the Human Brain. Lees and 
 
 Raper Memorial Lecture. See Brit. Joum. Inebriety, 
 iii. 69. 
 
 1901. A Study of the Degenerations observed in the Central 
 
 Nervous System in a case of Fracture Dislocation of 
 the Spine. With Dr. F. H. Thiele. Brain, Pt. xcvi., 
 1901. 
 
 1902. On the Pallio-tectal or Cortico-mesencephalic System of 
 
 Fibres. With Dr. C. E. Beevor. Brain, Pt. c, 1902. 
 
 1903. The Purposes and Maintenance of our Universities. 
 
 Address at Birmingham. Birmingham Medical Re- 
 view, October 1903. 
 
 1904. On Tactile Sensation. Practitioner, Ixxiii. 581. 
 
 1904. Evidence before Parliamentary Committee on Physical 
 
 Deterioration. 
 
 1905, On the Intrinsic Fibres of the Cerebellum, its Nuclei, and 
 
 its Efferent Tracts. With R. H. Clarke. Brain. Pt. 
 cix., 1905. 
 
 1905. On a Trigeminal- Aural Reflex in tlie Rabbit. Brain, 
 Pt. cix., 1905. 
 
 1905. An Address on Ha^morrlioids. CHn. Journ., Feb. 15, 1905. 
 
 1905. The Cerebellum : its relation to Spatial Orientation and to 
 
 Locomcjtion. The Boyle Lecture for 1905. Bale, Sons, 
 and Danielsson, London, 1906. 
 
 1906. Note on the Taenia Pontis. Brain, 1906. 
 
 1906. Upon the Orientation of Points in Space by the muscular, 
 artlirodial, and tactile senses of the upper limbs, in 
 normal individuals and in blind jxTsons. With Dr. R. 
 Townlcy Slingcr. Brain, Pt. cxiii., 1906.
 
 348 SIR VICTOR HORSLEY 
 
 1906. Note on apparent Re-representation, in the Cerebral Cortex, 
 of the type of Sensory Representation as it exists in 
 the Spinal Cord. With Dr. Colin K, Russel. Brain, 
 Pt. c.xiii., 1906. 
 
 1906. On Dr. HughUngs Jackson's Views of the Functions of 
 the Cerebellum, as illustrated by Recent Research. The 
 Hughlings Jackson Lecture for 1906. Brain, Pt. cxvi,, 
 1906 ; Brit. Med. Joum., 1907, i. 803. 
 
 1906. On the Technique of Operations on the Central Nervous 
 System. Address in Surgery, Toronto, Brit. Med. 
 Joum., Aug. 25, 1906 ; Lancet, 1906, ii. 484. 
 
 1906. Address on Temperance : given in Toronto. Medical 
 
 Temperance Review, October, 1906. 
 
 1907. Alcohol and the Human Body. With Dr. Mary Sturge. 
 
 Macmillan, London, 1907. Fifth edition, 1915. 
 
 1907. Evidence before the Royal Commission on Experiments 
 
 on Animals. 
 
 1908. Note on the existence of Reissner's Fibre in Higher Verte- 
 
 brates. Brain, Pt. cxxi., 1908. 
 
 1908. The Structure and Functions of the Cerebellum examined 
 by a New Method. With R. H. Clarke. Brain, Pt. cxxi., 
 1908. 
 
 1908. The Operative Treatment of Optic Neuritis. Address at 
 
 Oxford. Ophthalmoscope, Sept. 1908. 
 
 1909. On the Cervical Spino-bulbar and Spino-cerebellar Tracts, 
 
 and on the question of Topograpliical Representation in 
 the Cerebellum. With A. Salusbury MacNalty. Brain, 
 Pt. cxxvii., 1909. 
 
 1909. Description of the Brain of Mr. Charles Babbage, F.R.S. 
 Phil. Trans. Roy. Soc, Series B, vol. 200, pp. 117-31, 
 1909. 
 
 1909. A CUnical Lecture on Chronic Spinal Meningitis : its 
 Differential Diagnosis and Surgical Treatment. Brit. 
 Med. Joum., 1909, i. 513. Translated in Joum. de 
 M6d. et de Chir. Prat., June 10, 1909. 
 
 1909. Alcohol and the National Life. An address at Whitefield's 
 Tabernacle, Jan. 1909. 
 
 1909. The Cerebellum. The Cavendish Lecture. West London 
 Medical Journal, 1909. 
 
 1909. The Function of the so-called Motor Area of the Brain, 
 The Linacre Lecture. Brit. Med. Joum., July 17, 1909. 
 Reprinted : British Medical Association, London, 
 1909.
 
 PUBLISHED WRITINGS 349 
 
 1910. The Mesencephalic Root of the Fifth Nerve. VVitli Dr. 
 Otto May. Brain, October, 1910. 
 
 1910. Die chirurgische Behandlung der intrakraniellen Ge- 
 schwiilste, im Gegensatz zu der abwartcnden Therapie 
 bctrachtet. Vortrag, gehalten auf der 4. Vcrsammlung 
 der Gesellschaft Deutscher Ncrvenarzte am 6 Oktober, 
 1910. Deutsche Ztschr. f. Ncrvenh., 1911, xh. 91. 
 Also published in Enghsh. 
 
 1910. The Topographical Diagnosis of Tumours of the Cerebral 
 Hemisphere. University College Hospital Magazine, 
 i. I, June 1910. 
 
 1910. A Paper on Optic Neuritis, ' Choked Disc,' or ' Papill- 
 
 cedema.' Address at Belfast. Brit. Med. Joum., March 
 5, 1910. Reprinted : British Medical Association, 
 London, 1910. 
 
 191 1. Preliminary Note on experimental investigations on the 
 
 Pituitary Body, With Dr. Handelsmann. Brit. Med. 
 Joum., Nov. 4, 1911. 
 
 191 1. On some of the biological and statistical errors in the work 
 on Parental Alcoholism by Miss Elderton and Professor 
 Karl Pearson, F.R.S. With Dr. Mary Sturge. Brit. 
 Med. Joum., Jan. 14, 1911. 
 
 1911. Factors which conduce to success in the treatment of 
 
 otogenic Brain-abscess. Proc. Roy. Soc. Med., 1911-12, 
 v., Otol. sect., pp. 45-72. 
 
 1912. Preliminary Report on the Forcible Feeding of Suffrage 
 
 Prisoners. With Agnes F. Saviil, M.D., and C. W. 
 Mansell MouUin, F.R.C.S. Lancet, Aug. 24, 1912. 
 
 1914. Evidence before the Royal Commission on Venereal Dis- 
 eases. 
 
 1914. Present-day lessons from the life-work of Mitchell Banks. 
 The Sir WiUiam Mitchell Banks Memorial Lecture. 
 Medical Press, Oct. 14, 1914. 
 
 1914. On the Reform of the Vital Statistics of the Nation. 
 
 Brit. Med. Journ., Nov. 7, 1914. 
 
 1915. The Brotherhood Movement and the War. Brotherhood 
 
 Journal. April 1915. 
 
 1915. On the Alleged Responsibihty of the Medical Profession 
 for the rcintroduction of the Rum Ration into tlic 
 British Army. Brit. Med. Journ., Jan. 30, 1915. 
 
 1915. Remarks on Gunshot Wounds of the Head. Brit. Med. 
 Joum., Feb. 20, 1915 ; and Proc. Med. Soc. Lend., 
 1915-
 
 INDEX 
 
 Aberdeen : Hon. Degree given to 
 Horsley by the University, 211. 
 
 Acad6mie de Medecine de France, 196. 
 
 Acland Troyte, Colonel, 326. 
 
 Acromegaly, Pierre Marie's study of, 
 123. 
 
 Adams, Mr. William, 117. 
 
 Advancement of Medicine by Research, 
 Association for, 148. 
 
 Alcohol, 200, 211, 230-254: results of 
 small quantities, 231-233 : reduction 
 of alcohol in hospitcds, 231, 236 : 
 alcohol and the national life, 230 : 
 effects of parental alcoholism on 
 children, 239-243. 
 
 ' Alcohol and the Human Body,' by 
 Horsley and Dr. Mary Sturge, 236- 
 238, 252, 303, 332. 
 
 Alcoholic paralysis, 231. 
 
 Alexandria, 297-312. 
 
 Allbutt, Sir T. Cliflord, 191. 
 
 Allen, Capt., 311. 
 
 Amarah, 326-333, 336-340. 
 
 Ambidexterity, Horsley's, 263. 
 
 American Physicians and Surgeons, 
 Congress of (1888), 136. 
 
 Surgical Association, 139. 
 
 Ammunition (1914) : experimental 
 study of, 288. 
 
 Anaesthetics: Horsley's experiments on 
 himself, 40, 232 : on animals, 96, 147 : 
 methods of administering chloroform, 
 174, 184 : teaching to students, 187, 
 191 : Government Committee, 191 : 
 Hyderabad Commission, 174. 
 
 Anaesthetists, Society of, 174. 
 
 Annandale, Prof., 120. 
 
 Antagonistic muscles, experimental 
 study of, 164. 
 
 Anthropological Institute, 124. 
 
 Antiseptic surgery a cause of the reduc- 
 tion of alcohol, 236. 
 
 wax, Horsley's use of, lao. 
 
 ' Anti-vivisection,' 52, 81, 83, 89, 147. 
 
 Anzac Medical Society, 302. 
 
 Arderne- Wilson, Capt., 309. 
 
 Arm-area : removal of, 194. 
 
 Armour, Mr. Donald, 117. 
 
 Armstrong, Lord, 48. 
 
 Arrest of correlated development of 
 brain ami hand, 28. 
 
 Artists' Corps, the, 22, 24. 
 
 Aschaflcnburg's experiments with al- 
 cohol, 231. 
 
 Asbar, 319. 
 
 Aspinall, Major, 303. 
 
 I Assistant-Professorship of Pathology, 
 Univ. Coll. (1882), 43. 
 
 Association of Fellows of Royal College 
 of Surgeons, 220. 
 
 of Members of Royal College of 
 
 Surgeons, 221. 
 
 Athenaeum, membership without bal- 
 lot, 157. 
 
 Australian Hospital, Wimereux, 294. 
 
 Avebury, Lord, 68. 
 
 B 
 
 Babbage, Mr. Charles, F.R.S. : Hors- 
 ley's study of his brain, 188. 
 
 Babtie, Sir William, 307. 
 
 Bacteria, ' or their antecedents,' In 
 healthy tissues, 28. 
 
 Ballance, Sir Charles, 117, 121, 127. 
 
 Barker, Mr. Arthur, 119. 
 
 Barlow, Sir Thomas, 201, 235. 
 
 Basrah, 320. 
 
 Bastian, Dr. Charlton, 27, 116, 159. 
 
 Bateman, Dr. A. G., 214. 
 
 Batt, Mr. Ernest, 78. 
 
 Beck, Mr. Marcus, 30. 
 
 Beevor, Dr. C. E., 29, 95, loo-iio, 141, 
 150, 165, 170. 
 
 Berlin, visit to (1881), 41 : International 
 Medical Congress (1890), 138. 
 
 Bernard, Claude, on the ductless glands, 
 56. 
 
 Berry, Mr. James, 200. 
 
 Birchcr, Dr., 64. 
 
 Birmingham, temperance addresses in, 
 244. 
 
 Blenkinsop, Colonel, 316. 
 
 Board of Agriculture, 80, 88. 
 
 Body, Captain T. M., 337. 
 
 Bombay, 314. 
 
 to Basrah, 316-318. 
 
 Bond, Mr. C. J., 29, 30, 39, 45, 266, 289. 
 
 ' Bouissoii Batli,' the, 82. 
 
 Boyce, Prof. Rubcrt, 149, 159. 
 
 Boyle Lecture at Oxford, 179. 
 
 Boys, Prof, Vernon, 155. 
 
 ' Boys hihcrit their brains from their 
 niothiTS,' 204. 
 
 Bradford, Sir J. Rose, 51. 
 
 Brain, early papers on disease or Injury 
 of, 28, 49 : experiment il study of 
 localisation of function (1884-1890), 
 90-113 : first papers on brain-surgery, 
 121, 122, 136. Other addresses on 
 brain-surgery : Berlin, i^8 ; New- 
 castle, 150 ; Toronto, 183 ; Cam- 
 bridge, 193 ; Berlin, 196 ; London, 
 390 ; Alexandria, 306. 
 
 S6l
 
 352 
 
 SIR VICTOR HORSLEY 
 
 Bramwcll, Sir Frederick, 48, 266. 
 
 Breccia, Sijcnor, 306. 
 
 Bristowc, Dr., 77. 
 
 British Association, Nottingham meet- 
 ing (1893), 151. 
 
 General Hospital, Amarah, 338. 
 
 Hospital, Wimereux, 289-294. 
 
 Medical Association, 222-229, 275. 
 
 Briton Rivi6rc, Mr., 84. 
 
 Broadbent, Sir William, 235. 
 
 Broca Museum of Anthropology, 124. 
 
 ' Broca's convolution,' 91. 
 
 Bro.lic, Prof. T. G., 51. 
 
 Brotherhood Movement, the, 256. 
 
 Brown Institution, 50-53, 78-82. 
 
 Brown-Soquard, Dr., 123, 142. 
 
 Brunei, Isambard, 3, 12. 
 
 Brunton, Sir T. Lauder, on rabies, 69, 
 70. 
 
 Buckland, Miss, 125. 
 
 Bullet-wounds of brain, experimental 
 study of, 154-157, 288. 
 
 Burdon Sanderson, Sir John, 17, 51, 
 
 69-73- 
 Buxton, Dr. Dudley, 29, 30, 32. 
 Buzzard, Dr. Farquhar, 186. 
 
 ' Cachexia strumipriva,' 57-67. 
 
 Cadbury, Mr., 306. 
 
 Caillard, Mme., 301. 
 
 Callcott, Sir Augustus, 3. 
 
 John Wall, 3- 
 
 Cameron Prize, Univ. Edin., 151. 
 
 Cardiff Medical Society, 146. 
 
 ' Cardinal points ' of the National 
 Insurance Act, 225. 
 
 Cartwright Lectures, 163. 
 
 Cavendish Lecture, the, 192. 
 
 Cavenflish Square, the Horsleys' house 
 in, 142. 
 
 Cerebellum, clinical and experimental 
 study of the, 177-178, 179, 189, 191, 
 192. 
 
 Cerebral abscess, operation for, 118, 
 133. 137, 154, 200. 
 
 aimpression, clinical and experi- 
 mental study of, 137. 
 
 ha}morrhage, experimental study 
 
 of, 137. 
 
 tumour : results of treatment, 
 
 with and without operation, 196, 
 201 : choice of operation, ibid. 
 
 Cervical spinal disease, operative treat- 
 ment of, 157. 
 
 Chalice, the : question of risk of in- 
 fection, 29. 
 
 Chappell, Mr. Salter, 40. 
 
 Charcot, Prof., 55, 121. 
 
 Charlotte Street, Fitzroy Square (1882), 
 42. 
 
 Charterhouse, 14. 
 
 Chemistry, the foundation of medical 
 education, 159. 
 
 Cheyne, Sir W. Watson, 44, 123. 
 
 Children, Horsley's love toward, 270, 
 274. 
 
 Christian Basis of Human Action : a 
 Brotherhood address, 259. 
 
 Christiansen, Dr., 166. 
 
 Church Congress, Folkestone (1892), 
 
 146, 213. 
 Clark, Sir Andrew, 68. 
 Clarke, Miss Alys, 304. 
 
 Mr. R. H., 178, 184, 189. 
 
 Clinical Society's Report on Myxoedema, 
 
 63. 
 Cobbe, Miss Frances Power, 147. 
 Cohnhoim, Prof., 42. 
 College of Surgeons, 36, 49 : War 
 
 Museum, 155 : Council, 171 : F'el- 
 
 lows and Members, 220. 
 Colman, Dr. Walter S., 142. 
 Compression of the brain, clinical and 
 
 experimental study of, 153-157. 
 Compression-myelitis, operative treat- 
 ment of, 149, 200. 
 ' Condiments,' arguments against, 29. 
 ' Confusion-theory,' Beevor s and Hors- 
 ley's, lOI. 
 Consultant, M.E.F., Horsley appointed, 
 
 301. 
 Convulsive centres, Nothnagel's theory 
 
 of, 122. 
 Coomber, Miss Helen, 291. 
 Cope, Mr. A. C. : report on rabies among 
 
 deer, 81. 
 Cornwall, holidays in, a6, 32. 
 Coroners' law, 223. 
 Cox, Dr. Alfred, 213, 223. 
 Craig, Dr. Maurice, 242. 
 Cranbrook, 5, 14. 
 Cranbrook School, 13. 
 Cranial measurements in relation to 
 
 brain-surgery, 125, 146. 
 Cretinism, sporadic and endemic, 54-67. 
 CrUe, Prof., 186. 
 Croonian Lecture, 139. 
 Cruelty to Animals Act (1876), 127, 
 
 187. 
 Cunliffe, Mr. John, 51. 
 Cunningham Memoirs, Royal Irish 
 
 Academy, 146. 
 Curling, Mr., 54. 
 
 Gushing, Prof. Harvey, 137, 180. 
 Cutlack, Mr. Frank, 121. 
 
 D 
 
 Death-certificates : need of strict 
 veracity, and of privilege, 174, 209, 
 211, 234. 
 
 Decompression, operation for, 137, 
 184, 197. 
 
 Deer in Richmond Park : 264 deaths 
 from rabies (1886-87), 81. 
 
 Delhi, 315, 318. 
 
 Demr)cratic Control, Union of, 288, 
 306, 328. 
 
 Demonstration of experiments on ani- 
 mals, 160. 
 
 Dendy, Miss Mary, 240. 
 
 Dental Surgery, London School of, 191. 
 
 Derby, the (1915), 300. 
 
 ' Disinterested Management ' of public- 
 houses, 246. 
 
 Distemper : reduced by enforcement 
 of muzzling, 79, 80.
 
 INDEX 
 
 353 
 
 Dog Owners' Protection Association, 
 
 84-87. 
 Dominion Temperance Alliance, 184. 
 Douglas, Dr. W., 224. 
 Doweswell, Mr. G. F., 79. 
 Drewitt, Dr. Dawtrey, 58. 
 Drinking-water not steniisecl by alcohol 
 
 put in it, 249, 323. 
 Du Maurier, George, 147. 
 ' Dura-dum ' bullets, 288. 
 Dunhill, Dr. James, 200. 
 Dunlop, Major, 302. 
 
 Edinburgh, Horsley's lecture in, 151. 
 
 Eisselsberg, Dr. von, 64. 
 
 Elderton, Miss, 239-243. 
 
 Electrical currents in the body, 157. 
 
 Electrolysis in experimental sHidy of 
 cerebellar nuclei, i8g. 
 
 Electro-motive changes in spinal cord, 
 experimental study of, 134, 140. 
 
 Elliot Smith, Prof., 178. 
 
 Embolism : ligature of internal jugular 
 vein, 121. 
 
 Encepbalocele, notes on a case of, 49. 
 
 Engine-ruled paper, Horsley's use of, 
 105. 
 
 Epidemiological Society, the, 77. 
 
 Epilepsy, experimental study of, 122, 
 123, 146, 160. 
 
 Erichsen, Sir John, 121. 
 
 Ether-vapour : local action on laryn- 
 geal muscles, iii. 
 
 Ewald, Prof., 20. 
 
 Exophthalmic goitre, 158, 200. 
 
 Experiments on animals, demonstra- 
 tion of, 138, 160 : Horsley's evidence 
 before Royal Commission, 186. 
 
 Ezra's tomb (Mesopotamia), 322. 
 
 Fagge, Mr. Hilton, 54. 
 Falmouth, sea-trip to, 25. 
 Feeding-movements, a theory rii, 104. 
 Fell, Colonel, 336. 
 Female Suflrage, 195, 201, 203-211. 
 Fenwick, Mr. E. Hurry, 66. 
 Fergusson, Inspector-General, 250. 
 Fcrrier, Sir David, 03, iii, 137,178,179. 
 Filayieh (.Mesopotamia), 334. 
 Filliter Exhibition, the, 25. 
 Finzi, Dr. Neville S., 199. 
 Fleminp, Dr. George, 69, 84. 
 Flemmiiig, Dr. Charles, 275 
 Flight-niovements, a theory of, 109. 
 Flowers for the Hospital, 35, 37. 
 Fontamcbleau, holiday at, 25. 
 Forcible feeding of Suffrage prisoners, 
 
 200, 204. 
 Poster, Prof. Carey, 16. 
 Fothcrgillian Prize and Lecture, 157, 
 
 158 
 Fox, Dr. E. L., 66. 
 France, the Temperance movement in, 
 
 234. 
 Fritsch and Hitzig, 92. 
 Fry, Sir Edward, i(>g. 
 
 Fuller-Maitland, Mr. J. A., 71. 
 Fullerian Professorship and Lectures, 
 Royal Institution, 139, 146. 
 
 Galen, and the experimental method, 90. 
 Gallipoli, Horsley at, 302, 304, 312. 
 Gallon Laboratory for National 
 
 Eugenics, 239. 
 
 Sir Francis, 125. 
 
 Galvano-cautery, Horsley's disuse of, 
 
 115- 
 Gardner, Dr., of Melbourne, 164. 
 Gasserian ganglion, removal of the, 
 
 142, 165, 190, 192. 
 General Elections of 1910, 195. 
 
 Medical Council, 158, 165, 216-220. 
 
 Germany : walking tour (1877), 18 : 
 
 Leipzig, 41 : Berlin, 41, 138, 196, 
 
 197 : German statements about the 
 
 War, 286, 288. 
 Gibson, Dr. Lockhart, 67. 
 Glioma and glio-sarcoma of the brain, 
 
 138, 150, 184, 201. 
 Godlee, Sir Rickinan J., 59, 89. 
 Goodbody, Major, I. M.S., 323. 
 Goitre, 54-67. 
 Goltz, Prof., 20, 94, 138. 
 Gotch, Prof., 18, 95, 128, 139. 
 
 Mrs., 5, 22, 129. 
 
 Gower Street : early years in practice, 
 
 46. 
 Gowers, Sir William, 27, 126 : letters 
 
 from, 162, 170. 
 Grant Medical College, Bombay, 317. 
 Greenfield, Prof., 51. 
 Griinbaum, Prof., no, 142, 194. 
 Gull, Sir \Villiam, 54. 
 Gunshot wounds, heavily infected, 
 
 treatment of, 289 : gunshot wounds 
 
 of head, 290. 
 GuydeChauliac,on the perfect surgeoo, 
 
 31- 
 
 H 
 
 Hadden, Dr. W. B., 58. 
 
 Haden, Charles, 3. 
 
 Sir Francis, 3, 7. 
 
 Thomas, 3. 
 
 HiPmostasis by application of living 
 tissue, 210. 
 
 Halle, University of, 152. 
 
 Halliburton, Prof., 61. 
 
 Hankin, Dr. E. H., 145. 
 
 Harborouglj Division : Horsley's can- 
 didature, 200, 203-208, 255. 
 
 H.ncourt, Mr. A. G. Vernon, 174. 
 
 Hardy, F. D., 5, 10. 
 
 Harley, Prof. Vaughan, 139. 
 
 ' Harness's electric belts ' : legal action, 
 157. 
 
 Harris, Dr. Butler, 152, 157. 
 
 Hartley, Sir William, 23S. 
 
 Hayler, Mr. Guy, 247, 241), 25a. 
 
 Held, Dr. Henry, 171, 175. 
 
 He.iith, Ministry of, 21 1, 255. 
 
 Hralli, Mr. Christopher, 145, 264. 
 
 Heidrnh.iiii, Prof , 149.
 
 354 
 
 SIR VICTOR HORSLEY 
 
 HerriBgham, Sir Wilmot, 201. 
 
 Hey Groves splint, the, 303. 
 
 High Row, Kensington, 4. 
 
 Hill, Dr. Leonard, 153. 
 
 Hine, Bishop, 20 
 
 Holidays, 125, 265, 307. 
 
 Holmes, Dr. Gordon, i86. 
 
 Home-life, 273. 
 
 Hooper, Dr., iii. 
 
 Hoppe-Seyler, Prof., 20. 
 
 Horsley, Gerald, 4, 10, 142, 262. 
 
 John Callcott, 3-8, 11, 26. 
 
 Mrs. J. C, 7- 
 
 Lady, 48, 50, 88, 128, 204, 265. 
 
 Capt. Oswald, 152, 305. 
 
 Miss Pamela (Mrs. Stanley Robin- 
 son), 297, 303, 3<j6, 3-0. 330, 334- 
 
 Capt. Siward, 139, 208, 304. 
 
 Miss Sophy, 3, 41. 
 
 Sir Victor. Childhood and early 
 
 years, 3-10: Cranbrook School, 11-14: 
 medical student, 15-36 : house- 
 surgeon, 36-40 : surgical registrar, 
 43 : engagement, 48 : work at 
 Brown Institution, study of thyroid 
 gland, and of rabies, 50-89 : study of 
 localisation of function in brain, 90- 
 113 : Hospital appointments, 116 : 
 first operation at Queen Square, 120 : 
 first removal of tumour of spinal cord, 
 125 : marriage, 129 : at Berlin 
 (1890), 138 : Royal Society medallist, 
 152: at Toronto {1906), 183: at 
 Berlin (1910), 196: Lannelongue 
 Prize, 199. Work of professional 
 politics : the Medical Defence Union, 
 the General Medical Council, the 
 British Medical Association, the 
 National Insurance Act, etc., 212-229. 
 Work of national politics : female 
 suffrage, and other measures of re- 
 form, 195-229. The fight against 
 alcohol, 230-254 : ethical teaching, 
 and Brotherhood addresses, 255-262. 
 Hospital practice and private prac- 
 tice ; holidays ; and the home life 
 at 25 Cavendish Square, 263-281. 
 The War : Horsley in London, and 
 at the British Hospital, Wimereux, 
 285-294 : Egypt, Gallipoli, Mersa 
 Matruh, 294-312 : India, 313-316 : 
 Mesopotamia, 318-340. 
 
 Col. Walter, 4, 24. 
 
 William, 3. 
 
 Hospitals : less alcohol given, and 
 
 more milk, 231. 
 House-surgeoncy, 36-40. 
 Housing and alcoholism, 191. 
 Howells' ' A Chance Arquaintance,' 48. 
 Howitz, Dr., 67. 
 Howse, Sir Neville, 302. 
 Huddersfield : Horsley chosen as 
 
 Liberal candidate, 208. 
 Hughes Bennett, Dr., 115. 
 Hughlings Jackson, Dr., 94, loi, 107, 
 
 120, 161, 180, 193. 
 Huguier's experiments on effects of 
 
 projectiles, 155. 
 Hunter, John, 280. 
 
 Huxley, Dr. H.. 265. 
 
 Hygiene and temperance to b« taught 
 
 in schools, 224, 235. 
 Hyndman, Mr. I-rancis, 198. 
 Hyperpyrexia in cerebral cases, 141. 
 
 I 
 India, 314-318. 
 Indian Field Ambulances, 322, 336. 
 
 Medical Service and Government 
 
 of India, 310, 317, 331. 
 
 Stationary Hospital, 6ist, 323 : 
 
 12th, 329. 
 
 Intensive treatment against rabies, 
 
 70, 77- 
 ' Internal capsule,' the, 104. 
 International Medical Congress, Berlin 
 
 (1890), 138 : London (1913), 201. 
 International Physiological Congress, 
 
 Cambridge (189K), 165. 
 Introductory addresses, 141, 158, 159, 
 
 171. 
 Italian Society of Neurology, 200, 
 Italy, a holiday in (1882), 45. 
 
 ' Jacksonian epilepsy,' 94, loi, 124. 
 Jameson, Sir Starr, 29. 
 Jenner, Sir William, 126. 
 Johne's disease of rattle, 51. 
 Johns Hopkins Hospital, 187. 
 Joyce, Dr. Thomas, 16. 
 Jugular vein : ligature, to prevent 
 embolism, 121. 
 
 K 
 
 Karslake, Mr. Frank, 84. 
 
 Keen of Philadelphia, Dr., 141, 164. 
 
 Keynes, Mr. J. M., 242. 
 
 Kidd, Dr. Percy, 126. 
 
 King-Hall, Admiral Sir George, 248. 
 
 Kingsley, Charles, 24. 
 
 Kitchener, Lord, 288. 
 
 Knight, General, 318. 
 
 Knighthood, honour of (1Q02), 170. 
 
 Kocher, Prof., 57, 64, i55- 
 
 Kraepelin's experiments with alcohol, 
 
 231. 
 Kramer, Dr. S. F., 154, 288. 
 Krause, Prof., 165. 
 
 Lambourne, Lord, 186. 
 Lane, Sir Arbuthnot, 121. 
 Lane-Claypon, Dr. Janet, 265. 
 Lankester, Sir E. Ray, 45. 
 Lannelongtie, Dr., 141, 199. 
 
 Prize, 199. 
 
 Larynx, central motor innervation of, 
 
 110-112. 
 Lateral sinus, septic thrombosis of, 121. 
 Lees and Raper Lecture, 170, 232. 
 Leifihton, Lord, 45. 
 Leipzig, visit to (1881), 41. 
 Leith, Prof., 125. 
 
 Le Mare, Capt., H.M.S. Delta, 295. 
 Lendon, Dr. Alfred, 15, 18, 287.
 
 INDEX 
 
 355 
 
 Leontiasis ossium, 157. 
 Levy, Dr. Alfred, 175. 
 Leyden, Prof., 153. 
 Linacrc Lecture, no, 193. 
 Lister Institute, 53. 
 
 Lord, 6(), 236, 259, 279. 
 
 Lodge, Sir Oliver, 15. 
 
 Loeweathal, Dr. Max, 164. 
 
 Logie, Mr. Jobn, 267. 
 
 London, rabies and hydrophobia in, 
 
 (1884-1890), 78-81. 
 Long, Mr. Walter, 87. 
 Lowenstein, Miss, 235. 
 Luzford, Lt.-Col., 309. 
 Luxor, 307. 
 
 M 
 
 McCarrison, Colonel, LM.S., 303, 505, 
 
 318, 326. 
 McDowall, Major, 295. 
 Macewen, Sir William, 118. 
 McGrigor, Sir James, 250. 
 McKenna, Mr., 204. 
 Mackenzie, Dr. Hector, 66. 
 Mackworth, Major, LM.S., 338. 
 MacNalty, Dr. A Salusbury, 113, 143, 
 
 176, 191, 243. 
 Magnus of Cbristiania, 179. 
 
 Sir Philip, 15, 197. 
 
 Manifold, Colonel, LM.S., 310. 
 Mann, Dr. Gustav, 176. 
 Marchi's method, 171. 
 Marcbiafava, Prof., 45. 
 Marinesco, Dr. Georges, 123. 
 Marshall, Prof. Alfred, 242. 
 
 - Mr. John, 36, 49. 
 Marten, Dr. R. H., 27, 40, 43. 
 Martin, Prof. Sidney, 29, 160. 
 
 ' Mass meeting ' at Queen's Hall (Na- 
 tional Insurance Act), 227. 
 Matthews, Pte. J. R., 298. 
 Maudsloy, Sir Henry, 37, 309. 
 .Mauritius, rabies in, 74. 
 May, Mr. Edward, 301. 
 
 Dr. Otto, 196, 228. 
 
 Medical Acts, the, 164, 165, 215. 
 Companies, registration of, 219. 
 
 Defence Union, 213-216. 
 
 Licensing Bodies, 219. 
 
 Research Club, 144, 145. 
 
 Medicated wines, the trade in, 246. 
 
 Medico-ethical Societies, 171. 
 
 Medico-legal Society, the, 191. 
 
 Meningitis, chronic spinal, 191. 
 
 .Mi-riietsch, Staff-Surgeon, 251. 
 
 Mersa .Matruh, Horsley at, ^04, 311. 
 
 Mesopotamia, 318-340 : Indian Govern- 
 ment Commission, 317, 320, 323 : 
 British Goverun^ nt Commission, 
 323, 336 : at the Iront, 322, 336. 
 
 Microcephalic idiocy, operative treat- 
 ment of, 141. 
 
 Midwives, registration of, 168, 212, 3ift. 
 
 Millais. Sir Everett, 84. 
 
 Mitchell Banks Memorial Lecture, 289. 
 
 Money, Dr. Angel, 29. 
 
 ' Morbid Anatomy ' I'rrsws Experimental 
 Pathology, 144. 
 
 Motor centres, tiic nature of, 116, 193. 
 Motoring expeditions, 264. 
 Mott, Sir F. W., 28, 29, 175, 193. 
 Moullin, Mr. Mansell, 21. 
 Mudros, Horsley at, 303. 
 Munk, Prof., 97, 197. 
 Murray, Prof. George, 65. 
 Muzzling Order, the, 87. 
 Myxcedema, 54-67. 
 
 N 
 
 National Insurance .Act, 224-229. 
 Navv, reduced use of rum in the, 249. 
 Neale, Dr. W. H., i«, 264. ^ 
 Nerve-energy, Horsley's measurement 
 
 of, 166. 
 Nerve-stretching : Mr. Marshall's Brad- 
 
 shaw Lecture, 49. 
 ' Nervi nervorum,' Horsley's paper on 
 
 (1884), 30. 
 Nervous Diseases Research Fund, 172. 
 Neuralgia, trigeminal, operative treat- 
 ment of, 142, 165, 192. 
 Neurological Society, 115, I37i I44f 
 
 160, 282, 288. 
 Neurology, Experimental, 160. 
 Newman, Sir George, 236. 
 Nobel Prizes : Horsley proposed for 
 
 one, 297. 
 Noble, Sir Andrew, 155. 
 Non-excitable zones of cortex cerebri, 
 
 Horsley's theory of, no. 
 Norman, Sir Henry and Lady, 289, 291. 
 North Islington : Horsley adopted »s 
 
 Liberal candidate, 200. 
 Nothnagel Lecture, 275, 297. 
 Nurses, registration of, 224. 
 Nursing Homes, 272. 
 
 the College of, 224. 
 
 under the Insurance Act, 210. 
 
 O 
 
 Oidenia, experimental study of, 149. 
 
 Ogilvie, Capt., 251. 
 
 Oldfield, Mrs., 313. 
 
 O'Neills, the, 10. 
 
 Ophthalmological Congress, Oxford 
 
 (1908), 188. 
 
 Society, 141, 188. 
 
 Opium trafl&c. National Conferente 
 
 against, 201. 
 Oppenheini, Mr., 42. 
 Optic neuritis in cases of tumour of the 
 
 brain, 162, 184, 188, 192. 
 Orang-outang : experimental study of 
 
 brain, 107. 
 Ord, Dr. William, 55. 
 Ortlcr..f the Bath, honour of (191 6), 397. 
 Orientatiitn of points iu space, clinical 
 
 study of, i8i. 
 Owens College, Manchester, 138. 
 Oxidation in living tissues, experi- 
 mental stuily of, 152. 157. '63. 
 Oxygen, adjustment of cylinder to the 
 
 Vernon Harcourt inhaler, 184.
 
 OD' 
 
 S6 
 
 SIR VICTOR HORSLEY 
 
 * Pacinian bodies' in muscles, 164. 
 Page, Mr. Frederick, 126. 
 Paget, Miss, 72. 
 
 Sir James, 68-76. 
 
 Paralytic rabies in man, 77 : in rabbits, 
 
 82. 
 Par6, Ambroise, 117, 279. 
 Park Street, Grosvenor Square, the 
 
 Horsleys' house in, 115. 
 Parker, Mr. Kushton, 18. 
 Parkin, Mr. Alfred, 158. 
 Pasteur, 27, 68-89. 
 
 Dr. William, 15. 
 
 Patellar knee-jerk, Horsley's paper on, 
 
 41- 
 Pathological Society, 144. 
 Patients, in Hospital and private 
 
 practice, 267-271. 
 Pearce, Mr. Walter, 32, 35, 230. 
 Pearson, Prof. Karl, 239-243. 
 Peel Report, the, 234. 
 Penberthy, Prof., 84. 
 Penrose, Dr. Frank, 45. 
 Personation, not of itself a legal ofience, 
 
 218. 
 Petren, Prof., of Stockholm, 297. 
 Philomathic Society, the, 30. 
 Phrenology, true and false, 188. 
 Phthisis, Horsley threatened with it 
 
 (i88i), 39. 
 Physical Deterioration, Commission on, 
 
 173- 
 Physiological Society, 144, 265. 
 Pierre Marie, on acromegaly, 123. 
 Pituitary body : experimental study, 
 
 123 : operation, 160. 
 ' Pledge ' of conditions of service under 
 
 the National Insurance Act, 225. 
 Pleuro-pneumonia of cattle. Com- 
 mission on, 85, 133. 
 Pollard, Mr. Bilton, 18. 
 Port Said to Bombay, 313. 
 Power, Mr. J. Dan vers, 90, 170, 172. 
 Practice, addresses on, 141, 158. 
 
 falling off before the War, 272. 
 
 Prevention of Hydrophobia, Society 
 
 for, 84-89. 
 Projectiles : experimental study of 
 
 destructive effects, 152-157, 266. 
 ' Pure Science ' and Practice, 50. 
 
 Quain's Anatomy, 44. 
 
 Quain, Sir Richard, 69. 
 
 tjueen Square Hospital, 116, 120, 122 : 
 cases at, 162 : difficulties of manage- 
 ment, 169 : research fund, 172 : 
 festival dinner, 186 : analysis of 
 cases at, 201 : women admitted to 
 its practice, 204. 
 
 Queen's Hall : siififraRc meeting, 204 : 
 ' mass meeting ' at doctors, 227. 
 
 Quma (Mesopotamia), 321. 
 
 R 
 
 Rabbit's ear : reflex movement of, 178. 
 Rabies (hydrophobia), 68-89. 
 
 Radclilte, Dr., 142. 
 
 Radium, experimental studf ot, 199. 
 
 Ramon y Cajal, Dr., 193. 
 
 Ranvier, Dr., 149. 
 
 Rcay, Lord, 68. 
 
 Rebus of the little horse, 129. 
 
 Reissner's fibre in the brain of the 
 monkey, 189. 
 
 Representation and re-representation, 
 179, 181. 
 
 Research Defence Society, 188. 
 
 Respiratory failure preceding heart 
 failure in cerebral cases, 153-157. 
 
 Responsibility of Manhood : a Brother- 
 hood address, 257. 
 
 Reverdin, Prof., 57. 
 
 Richet, Prof., 90. 
 
 Richmond Park : 264 deer with rabies 
 (1886-87), 81. 
 
 Ridsdale, Mr., 316. 
 
 Robinson, Captain, 291. 
 
 Colonel, 295. 
 
 Rogers, Sir Leonard, 237. 
 
 Roman Defences of South-East Britain, 
 lecture on, 167 : the Great Roman 
 Wall, 275- 
 
 Romanes, Prof., 84, 139. 
 
 Rome in 1882, Horsley's account of, 46. 
 
 Roscoe, Sir Henry, 69, 70. 
 
 Rose, Mr. William, 165. 
 
 Rousay, holidays at, 266, 267. 
 
 Roy, Prof., 51. 
 
 Royal Prussian Academy of Sciences, 
 196. 
 
 Society : nomination, 72 : elec- 
 tion, 123 : gold medal, 152. 
 
 of Science of Upsala, 200. 
 
 Rum ration, the, 246-251. 
 
 Russel, Dr. Colin, 183. 
 
 Russell, Dr. J. Risien, 164, 178,194,264. 
 
 Russian Surgical Society, 187. 
 
 Ryle, Dr. R. J., 242. 
 
 Sachs, Prof. Ernest, 190. 
 
 Sainsbury, Dr. Harrington, 30. 
 
 Salecby, Dr., 251. 
 
 Sandwith, Colonel, 307. 
 
 Sargent, Mr. Percy, 117. 
 
 Savage, Sir George, 165. 
 
 Savill, Dr. Agnes, 200. 
 
 Schafer, Mrs., 33, 44, 47-50, 72. 
 
 Sir E. Sharpey, 17, 59, 94, 96, 
 
 115, 128, 188. 
 
 Schiff, Prof., 59, 61, 64, 123. 
 
 School children, medical care of, 223, 
 229 : teaching of hygiene and tem- 
 perance, 224, 236-238 : dental clinics, 
 234. 
 
 ' Seat of the soul,' the, 90. 
 
 Semon, Sir Felix, 58, 95, no, 128, 
 138, 197. 
 
 ' Septic bacteria,' Horsley's report to 
 Local Government Board, 44. 
 
 Seventeenth General Flospital, 30J, 
 306, 307, 309. 
 
 Shaik Saad (Mesopotamia), 323. 
 
 Shaw, Mr. Bernard, 191. 
 
 Sheffield Medical School, 158.
 
 INDEX 
 
 357 
 
 Sherran, Major, 290. 
 
 SherringtoD, Prof., 51, no, 192, 1)4. 
 
 Sbuter, Dr. G. P., 156. 
 
 Silk, Dr. J. F. W., i8. 
 
 Simla, 316, 318. 
 
 Sloggett, Sir Arthur, 289. 
 
 Smoking, arguments against, 23, 46. 
 
 Soci6t6 de Chirurgie de Paris, 157, 199. 
 
 Soury, Prof., 90. 
 
 Southampton to Alexandria, 295, 296. 
 
 Spencer, Mr. Walter G., 95, 137, 138. 
 
 Spinal cord : experimental study of, 
 134-136, 139 : removal of tumour 
 from, 126 : compression-myelitis, 
 149 : chronic spinal meningitis, 191. 
 
 Spitzka, Dr., 188. 
 
 Starling, Prof., 151. 
 
 State-regulation of vice, 201, 210. 
 
 Stereognosis, clinical study of, 194. 
 
 Stereotaxic apparatus, R. H. Clarke's, 
 189. 
 
 Stone Age, trephining in the, 123. 
 
 Storry, Mr., 167. 
 
 Students' Societies, Univ. Coll., ifl, 24. 
 
 Sturge, Dr. Mary, 229, 235-237, 243, 
 287, 303. 
 
 ' Surgical cases ' and ' medical cases,' 
 145, 170. 
 
 Surgical Registrarship, 43, 47. 
 
 Surrey, rabies in, 79. 
 
 Swayne, Mr. Martin, 340. 
 
 Sympathy in Public Affairs : a Brother- 
 hood address, 257. 
 
 Tactile sensation, clinical study of, 175. 
 
 Taenia pontis, experimental study of 
 the, 181. 
 
 Tait, Mr. Lawson, 214. 
 
 Taxation of Land Values, Association 
 for, 207, 2 75- 
 
 Taylor, Mr. Everley, 162. 
 
 Dr. James, 141. 
 
 Temperance : early lectures on, 250 : 
 National Temperance League, 231 : 
 British Medical Temperance Assoc., 
 231 : Internl. Assoc, of Abstaining 
 Physicians, 239 : National Temper- 
 ance l-ederation, 246 : Irish Temper- 
 ance League, 239 : True Temper- 
 ance Ass^jc., 251 : British Women's 
 Temperance Ass<jc., 192: 'Temper- 
 ance breakfasts,' the, 234. 
 
 Temperature : difference between two 
 sides of the body, in cases of injury 
 to the brain, 137. 
 
 Thane, Sir George, 17. 
 
 Thiele, Dr., 170. 
 
 Third London Hospital, 286. 
 
 Thompson, Dr. Sclh, 3. 
 
 Tiivroid Klan'l, the, 54-67. 
 
 Titles, the use of medical, 2i8. 
 
 Tomes, Sir Cliarlcs S., 217. 
 
 Tooth, Dr. Howard, 201. 
 
 Topognosis, clinical study of, 175, 181. 
 
 Toronto Meeting;, Brit. M-d. Assoc. 
 (1906), I. S3, 
 
 Torticollis, operative treatm<-iit of, 164. 
 
 Tracheotomy, a case of, 37. 
 
 Trade-unions and Professions, 213 
 223, 228. 
 
 Trained Nurses, National Council of, 
 209. 
 
 Transplantation of thyroid tissue, 61, 
 64. 
 
 Tree of Knowledge (Mesopotamia), 321. 
 
 Treherne, General, 325, 326, 332, 336. 
 
 Trephining, prehistoric, 123. 
 
 Trigeminal nerve, mesencephalic root 
 of, 196. 
 
 neuralgia, operative treatment of, 
 
 142, 165, 192. 
 
 Trotter, Mr. Wilfred, 161. 
 
 Trypanosoraes, early study of, 45. 
 
 Tubby, Colonel, 301. 
 
 Tubercle and tuberculin, 40, 44 : tuber- 
 culosis in cattle, 134. 
 
 Tubercular retinitis, early study of, 28. 
 
 Tumours, early experimental study of, 
 
 43- 
 Turuer, Dr. Aldren, 178. 
 
 Mr. Edward B., 209. 
 
 Major Grey, 339. 
 
 Mr. J. Sidney, 87, 89. 
 
 Tuke, Mr. William, 32, 39. 
 Twenty-first General Hospital, 289, 
 
 294-300. 
 Twort, Mr. F. W., 51. 
 Twynam, Dr. G. E., 40. 
 Tyndall, Prof., 27, 68, 84, 127. 
 Typhoid, protective treatment against, 
 
 296, 299. 
 
 U 
 
 Universities, purposes and maintenance 
 of, 172. 
 
 University College, debating societies, 
 i8, 24, 30, 46 : Department of Path- 
 ology, 43, 116, 159 : Department of 
 Experimental Neurology, 160. 
 
 College Hospital, 27, 36, 43, 114, 
 
 145, 168, 179. 
 
 of London: examinations, 41: 
 
 Senate, 163 : Parliamentary repre- 
 sentation, 197. 
 
 Unrcjjistered places (Cruelty to Animals 
 Act), 176. 
 
 Venereal diseases, 173, 209 
 
 Vcssale, Dr. G, 65, 66. 
 
 Vcra>;uth, Dr., 166. 
 
 Veterinary surgery, 51, 269. 
 
 Villa \'asiiiiii, 301. 
 
 Villeuiiii's study of tuberculosis, 78. 
 
 Virchow, Prof , 285. 
 
 Virchow's leslschrilt, 143. 
 
 ' Virus (ixe ' of rabies, 83. 
 
 Vizards, the, lo. 
 
 W 
 
 Waldeycr, Prof., 138, 197. 
 WallT s Law, 171. 
 Walrus, brain of, 190. 
 Waller, Mlss Elvira, 4.
 
 358 
 
 SIR VICTOR HORSLEY 
 
 Wanhill, Major, 318. 
 
 War Ofifice : Horsley's memoranda 
 
 (1914), 288. 
 de Watteville, Dr., 115. 
 Waugh, Dr H. D., 30. 
 West, Mr. C. E., 200. 
 West London Med. Chir. Society, 192. 
 Whitaker, Mr. Smith, 226. 
 Whitehead, Sir James, 77. 
 Whitelegge, Sir Arthur, 46, 77. 
 
 Lady, 5. 
 
 Whitmore, Mr. Charles A., 88. 
 WiJlcox, Colonel, 325. 
 Willeslcy, 5-14, 22, 48, 326. 
 Williams, Dr. Dawson, 29. 
 Willingdon, Lord and Lady, 314, 316. 
 Wimbledon Medical Society, 175. 
 
 Wimerevix, 290-294. 
 
 Wirgmans, Dr., 168. 
 
 Woodhead, Sir George Sims, 139, 183. 
 
 Wooldridge, Prof., 144, 149, i5i- 
 
 Women's Liberal Association, 292. 
 
 x-ray apparatus, deficient in Egypt 
 (1915), 30O1 301- 
 
 Yeo, Dr. Gerald, 94. 
 
 Zoological Gardens, 190, 237,274, 175- 
 
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