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Obituary.SIR THOMAS SPENCER WELLS, BART., F.R.C.S., &c.,PAST PRESIDENT OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND ; ;

SURGEON TO HER MAJESTY’S HOUSEHOLD ; AND CONSULTINGSURGEOX TO THE SAMARITAN FREE HOSPITAL

FOR WOMEN.

WE deeply regret to have to announce the somewhatsudden, but not altogether unexpected, death of Sir SpencerWells, which occurred on Sunday last at Cap d’Antibes.

Sir Spencer Wells was born at St. Albans, Hertfordshire,on Feb. 3rd, 1818, being the eldest son of Mr. WilliamWells, who, as well as his father before him, had residedin that city. At an early age he turned his attention tothe study of natural science, taking the greatest possibleinterest in the habits of all manner of living creatures, andwhen but a boy heexpressed his deter-mination of followingthe medical profes-sion. In this choicehe was confirmed byhis parents, who sawclearly that not onlydid his tastes lie inthat direction, butthat he possessed thevery characteristicswhich were calcu-lated to lead him tosuccess in the pro-fession. He was s

quite a lad when hebecame a pupil ofMr. Michael Sadler,a general practitionerat Barnsley, in York-shire, then by no

means the populoustown into which ithas developed, buteven at that time an

important centre ofthe textile and linen

industry. The weav-

ing machinery was inthose days imperfect,and accidents of a

more or less severe

character were of afrequency which gavemany opportunitiesfor the observationof injuries which didnot as a rule comeunder the notice ofthe young pupil of ageneral practitioner.After this initiationThomas SpencerWells, then a youthof seventeen, becamea pupil of, and un-qualified assistant to,

SIR THOMAS SPENCER WELLS, BART., F.R.C.S.,PAST PRESIDENT OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND.

a parish surgeon at Leeds. While residing under thisgentleman’s roof he had the opportunity of attendingthe lectures of William Hey, "the second," who did somuch to promote the interests of medical education in thenorthern counties and who took so prominent a part in theestablishment of the Leeds School of Medicine. He likewiseattended the classes of the elder Teale, an equally eminentsurgeon in Leeds. Besides the teachings of these two men,to whose influence he always referred with the warmestfeelings of gratitude, he had the privilege of attending thesurgical practice of the Leeds Infirmary, an institution atthat time among the foremost centres of operative surgery inthe provinces.He stopped little more than a year in Leeds and then pro-

ceeded to Trinity College, Dublin, and during his residencethere made the best use of his time, attending the lectures ofSir Philip Crampton in Surgery and those of Arthur Jacob,the anatomist and ophthalmic surgeon. He left Dublin

in 1839 and proceeded to St. Thomas’s Hospital, London,where Joseph Henry Green, Benjamin Travers, and FrederickTyrrell were the surgeons and Dr. Williams, Dr. Roots, andDr. Burton the physicians. At the end of his first session atSt. Thomas’s Hospital Spencer Wells won the prize offeredfor the most complete and detailed reports of the post-mortem examinations made of the patients dying in thewards of the hospital during the session. After another

year’s attendance on the practice of St. Thomas’s Hospitalhe obtained, in 1841, the Membership of the RoyalCollege of Surgeons of England, and joined the navy as asurgeon. There was no war being carried on at the time,so that he had no prospect of immediate adventure or evenof great activity. He was ordered to Malta, where heserved in the Naval Hospital for six years, during whichtime he was permitted, besides his official or service daties,to frequently meet in consultation and to assist many ofthe resident medical men, both English and Maltese.Although he saw much practice and did much good work

at Malta ne atter-

wards stated that hesaw only one case

there which raisedeven a suspicion inhis mind of theexistence of ovariandisease. -

Having served sixyears at Malta, heleft the navy and in1848 proceeded toParis with the viewof perfecting hisstudies in pathology.Magendie was thenat the height of hisfame and ClaudeBernard had for someyears been advancingtowards the positionto which he after.wards attained as

a teacher. ManyEnglish practitionersand students were inParis at this time,having been attractedthither by the fameof the great array ofprominent thinkersand experimentalists,who, in their turn,attracted by thefacilities and en-

couragements offeredfor the experimentaldiscovery of the truenature of disease,had settled there.Among SpencerWells’s s acquaint-ance in Paris was

the late Dr. Waters,afterwards s ofChester, who firtdirected his attentionto the operation of

ovariotomy. The two had many discussions on the sub-ject, and ultimately concluded, aq had previously beenalmost universally acknowledged in England, that it was anunjustifiable operation. It was not until ten years later thatWells returned to the subject in earnest; and up to the timeof his residence in Paris (1850), as he afterwards stated, hehad never, so far as he could lemember. encountered a singlecase which he could safely assert to be ovarian diseaseeither during his student days in Barnsley, Leeds, Dublin,or London, or during his stay in Malta and Paris.On his return to London in 1853, Spencer Wells settled

down in practice, and in a short time attained considerablesuccess, turning his attention more especially to obstetricwork, although he showed a remarkable aptitude for, andachieved some good work in, ophthalmic surgery, for whichbranch of his art his mechanical ingenuity and manipulativedexterity rendered him particularly suited. In 1854 hebecame connected with the Samaritan _Free Hospital for

399Women and Children in the Marylebone-road, which hadbeen established but seven years, and was little more thana dispensary for the diseases of women, not being providedwith in-patient accommodation. With this institution heremained connected throughout his life. It was duringthis period of his career that, for a time, he edited theMedical Times and 6azette, and it was in his editorial

capacity that he came into contact with many prominentmembers of the profession who were afterwards closelyassociated with his work. The man who probably exertedthe greatest influence over his future was Mr. BakerBrown, the gynxcologist, who was at this time essaying therevival of the generally condemned operation of ovariotomyAlthough John and William Hunter had discussed theadvantages and disadvantages of the operation and themethods of performing it, they had never put their theoriesinto practice. Aston Key and Bransby Cooper had performedit a few times at Guy’s Hospital, but their results had beenby no means such as to encourage the advocates of theoperation. It was not, however, until Charles Clay appearedas an advocate of the operation that it became in anyway recognised as coming within the realm of practicaland useful surgery, and even then the untoward results of aterribly large percentage of cases caused it to be looked uponwith suspicion if not with absolute disapproval by the bulkof British practitioners.In April, 1854, Spencer Wells, in company with his friend,

Mr. T. W. Nunn of the Middlesex Hospital, assisted Mr.Baker Brown in his eighth case of ovariotomy. This wasthe first time that Spencer Wells had seen the operation per-formed, and its result, like that of six others of BakerBrown’s first nine cases, was not encouraging. In discussingthe operatien afterwards Mr. Baker Brown remarked, "It’sthe peritonitis that beats us," for it was chiefly in the matterof after-treatment that the results of the operation iormedsuch a discouraging picture. Temporarily disheartened byhis ill-success in seven out of nine cases, Mr. Baker Brownfor a time abandoned all hope of introducing the opera-tion, although he was in his own mind convinced of itsreasonableness and ultimate utility. It was not until 1857,however, that Spencer Wells himself attempted the opera-tion, and this he did contrary to the express advice of hisfriend, Mr. Baker Brown, who nevertheless assisted him.The result of this his first venture was not encouraging, forhe lost his case. He was not discouraged by this untowardbeginning, but persevered, and in the following year hishopes were realised by the entire success of his secondcase. From that time forward the results obtained by himare a portion of the surgical history, not only of the century,but of all time.

It is not only on account of his mechanical dexterity in aparticular operation that Sir Spencer Wells deserves to havehis name kept in honoured remembrance. At the time whenhe turned his attention to ovariotomy the operation was sofatal as to be generally regarded as unjustifiable ; and n()common force of character was required to persevere withthe operation. Feeling assured with the instinct of genius ofthe possibility of its ultimate success he says himself, 11 owntaking up this subject as a matter of study and trial, justat the crisis when obloquy was the thickest and opposi-tion the strongest, I felt that nothing but the most

open frankness would carry conviction of success, or incase of failure justify the operation....... I there-fore pledged myself to make known through the pressall that I did and all that befell me " Sir Spencer Wellsdeserves the greatest credit both for having at that time thecourage to make public his failures as well as his successesand also for recognising that only in such a way could it behoped to establish ovariotomy as a justifiable operation.There can be no doubt that the large number of abdominaloperations performed at the present day owe their inceptionto ovariotomy, and to Sir Spencer Wells belongs the credit,not of inventing ovariotomy, but of taking the principalshare of the work involved in establishing that operation on arecognised basis.

In 1857 he became Lecturer on Surgery at the Grosvenor-place Medical School, which eight years afterwards becamemerged in the school of St. George’s Hospital. Betweenthe time when Spencer Wells first turned his attention toovariotomy and the first occasion when he practically essayedit his energies were directed for the space of a year or more6a a very different kind of work. Shortly after the war brokeoat in the Crimea he temporarily abandoned his work at theSamaritan Hospital and his private practice and proceededto Smyrna, where he became surgeon to the British Civil

Hospital there as well as at Renkioi, whither he afterwardsproceeded. He saw a great class of injuries which werealmost entirely new to him, and in the course of hiswork had the opportunity of attending to many abdominalwounds, experience which afterwards proved most useful inhis surgical work. He frequently stated in after years thatit was during the war that he realised that the peritoneumwould stand much rougher handling than he had previouslyimagined, and it was this knowledge in great measure thatreassured him in the operation and gave him the boldnesswhich characterised his later work and which results amplyjustified. At Renkioi he was closely associated with Dr.Parkes, who was one of his oldest professional friends.

Sir Spencer Wells’s literary works comprise a number oftreatises and contributions which have been of great practicalutility to the medical profession both in England and abroad.In 1851, after his term of service had expired for a yearor two, he published a useful " Scale of Medicines for usein the Merchant Marine," and while in London previously tothe outbreak of the Crimean War he contributed a valuabledissertation on "Gout and its Complications" (1854). Itwas while he was occupying the chair of Surgery at the

Grosvenor-place School that he delivered his lecture on"Cancer and Cancer-curers," which was printed in theJledical Times and Gazette and afterwards published in

pamphlet form in 1860. Among the archives of ovariotomySir Spencer Wells’s works rank among the most valuablecontributions; based as they were upon his personal expe-riences and being accounts in tabular form of the work ofthe foremost ovariotomist of the time, they form in realitylittle less than the history of the revival of this opera-tion in England. In 1865 he published his first workon this subject under the title of "Diseases of theOvaries," and in it he not only provided valuablestatistics supplied by his earlier years as a successfulovariotomist, but conveyed many inestimable hintstowards the diagnosis of ovarian tumours. Simultaneouslywith this work he published "A Note-book for Cases ofOvarian and other Abdominal Tumours," which was intendedto assist practitioners in classifying their cases of thesedisorders and thus increasing the sum of statistical know-ledge on this subject. This note-book has been throughseven editions- a fact which testifies to its practical valueand general utility. In 1882 an enlarged work founded onthe two foregoing publications appeared, and was chieflyinteresting in that it contained, in both a descriptive andtabular form, an accurate and detailed account of the personalwork of the great ovariotomist. Its scope was to all intentsand purposes limited to what its author had himself seenand done. A short history of the revival of ovariotomywas printed in 1884 and a second edition was called for inthe following year. A considerable portion of his works onthe subject of the operation with which his name is so

intimately associated has been translated into the Germanlanguage by Dr. R. von Volkmann and enjoys a wide popularityon the Continent. He was the author of a very large numberof interesting and valuable communications to the Obstetricaland other societies as well as of numerous contributions tothe medical press.His opinions on the question of cremation were very

decided, and in 1885, when the controversy begun by SirHenry Thompson and others was at its height, he wrote aneloquent and outspoken letter to the Times advocating crema-tion, not only from a sanitary point of view, but pointing outwhat an impetus its adoption would give to the arts.Cinerary urns have in all countries where the practice iscarried out been amongst the most beautiful features of thetemples and other resting places of the departed. He like-wise lectured at the Parkes Museum of Hygiene on the

subject and brought similar arguments to bear.It was during his residence in Malta-namely, in 1844-

that the Royal College of Surgeons of England conferred onhim the honorary degree of Fellow, the order of Fellowshaving been created by the new Charter. With the Collegeof Surgeons his connexion was thenceforth of a most intimatecharacter. In 1871 he was elected a member of the Council,in 1877 Hunterian Professor of Surgery and Pathology, andin 1879 a Vice-President. On the retirement of Sir ErasmusWilson from the Presidency in 1883 Spencer Wells waselected to the chair, which he filled for a year. In 1883 hedelivered the Hunterian Oration, and five years later heldthe post of Morton Lecturer on Cancer and CancerousDiseases. In 1890 he was Bradshaw Lecturer.

Sir Spencer Well; was made an honorary Fellowof the King’s and Queen’a College of Physicians of

400

Ireland, and when the Universities of Leyden and Bolognarespectively celebrated the third and eighth centenaries oftheir existence, both of these bodies conferred on him thehonorary degree of M.D. He was likewise honoured by theDoctorate of the University of Charkof and was a KnightCommander of the Norwegian Order of St. Olaf. He was aFellow of the Royal Medical and Chirurgical Society, of thePathological Society, of the Medical Societies of Paris,Moscow, and Stockholm, and a Member of the ObstetricalSocieties of London, Berlin, and Leipzig. On May llth,1883, Her Majesty conferred on him the honour of a

baronetcy of the United Kingdom in recognition of hisservices to medical science and to humanity. Sir SpencerWells was a deputy-lieutenant for the county of London.He married in 1853 Miss Elizabeth Wright, daughter ofMr. James Wright, solicitor, of New Inn, by whom heleaves five daughters and one son, Arthur Spencer Wells,who succeeds to the title.

___

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DEATHS OF EMINENT FOREIGN MEDICAL MEN.-Thedeaths of the following eminent medical men are

announced :-Dr. L. Calori, Professor of Anatomy in the

University of Bologna.-Dr. Pantaleo, Emeritus Professor ofMidwifery in Palermo.-Dr. Jose Maria Vilches, Professorof Clinical Medicine in the Cadiz Medical School.-Dr.W. H. Pancoast, Professor of Anatomy and Clinical Surgeryin the Philadelphia Medico-Chirurgical College.-Dr.Theodore Wormley, Professor of Chemistry and Toxicologyin the University of Pennsylvania.-Dr. Karl HerrimannSatherberg of Stockholm, well known not only for his workson orthopaedics but as a poet.

’

STATISTICAL REPORT OF THE HEALTHOF THE NAVY FOR THE YEAR 1895.

OuR Royal Navy has of late years undergone, and is still

undergoing, a considerable increase to its strength in theway of ships, and it is a matter of some consideration at thepresent time where we are to get the men to man them-forwe need scarcely add that the seamen of our fleet have to bea strong, healthy, highly-trained body of men such as cannotbe picked up promiscuously or every day.The head of the Medical Service of the Navy tells us in

the report under notice that the returns for the total forcefor 1895 may be regarded as satisfactory on the whole.There has been an increase in the number of cases of diseasecompared with the previous year, but this is attributed

principally to the increased prevalence of influenza in theHome, China and Cape of Good Hope, and West Coast ofAfrica stations.The total force in the Service afloat in 1895 was 67,960

officers and men, of whom 59’9 9 per cent. were between theages of fifteen and twenty-five, 29 C4 per cent. betweentwenty-five and thirty-five, 9 47 per cent. between thirty-fiveand forty-five, and only 1-57 per cent. were above forty-fiveyears of age, so that our Navy is, as it should be, mainly ayoung one.The ratio of invaliding in 1895 was 25’26 per 1000, which

is lower, with the exception of 1889, than that recorded forany year since 1856, when, we are told, the present systemof statistical reports was started. The ratio of deaths in1895 (6-6 per 1000) was a slight increase on that of 1894, butsomewhat less than the average of the last eight years. Thisincrease is explained by being cbiefly attributable to thefoundering of the pinnace of the Edgar at Chemulpo, withthe loss of forty-eight officers and men. The total numberof cases of disease and injury entered on the sick-list givesa ratio of 959’32 per 1000, being an increase of 40 12 on thatof 1894, but a decrease of 14’54 per 1000 as compared withthe average ratio of the last eight years. The averagenumber of daily sick in 1895 was 2789 32, which is in theratio of 41’04 per 1000 ; and it is calculated that the averageloss of service from disease and injury amounted to 14’ 98for each person.Taking the distribution of sickness throughout the different

stations it is stated that the lowest sick-rate was on theSouth-East Coast of America station and the highest on theEa,st Indies station. The ratio per 1000 of men sick daily onthe Home station was 40-43; Mediterranean, 37’19; NorthAmerican and West Indian, 36’52; South-East coast of

America, 33’38 ; Pacific, 41’12 ; Cape of Good Hope andWest Coast of Africa, 48’85 ; East Indies, 49’9; China, 45’12;Australian, 44-87 ; and in the irregular force, 43-06.The naval operations connected with expeditions on the

East and West Coasts of Africa gave rise to a great increaseof sickness from malarial fevers, more especially those con-ducted up the Brass River.Turning to some of the special kinds of disease and ineffi.

ciency, we find there were 10,292 cases of venereal diseasereturned during the year under report. Of these, 3296 wereof primary and 1651 of secondary syphilis. The numberinvalided for these diseases was 173 and there were 5 deaths.Upwards of 5000 cases are recorded at the home stations.The number of cases comprised under the heading of

diseases of the respiratory system in the total force is 8109,the invalidings number 223, and the deaths 81.

There was a severe outbreak of measles on board theBritannia in 1895, fifty-two cases having occurred, three ofwhich ended fatally.

Sixty-five cases of enteric fever occurred, distributedthroughout twenty-four ships at the home station, fifteen ofwhich died.

In the Mediterranean Squadron, composed of thirty-threevessels in all, with a mean force of 10,270, the admissionsfor disease and injury during the year were 9990. Amongthe fevers there were 505 cases of simple continued fever and82 of enteric fever, 557 of influenza, 9 of dysentery, and 11of mumps. Sixteen cases of enteric fever ended fatally and17 were invalided.The health of the squadron on the East Indies station in

1895, judging from the invaliding rate (42-47 per 1000), thedeath-rate (1021), which was 3-26 higher than 1894, and thedaily average number of men ineffective, was not so favour-able as in the preceding year.

Scattered here and there through these reports are

some interesting medical notes and cases which give occasionfor regret that they are not more frequently encountered.Surgeon F. H. A. Clayton, M.B., of the Thrush, has someexcellent remarks on West African fevers in connexionwith the organism discovered by Laveran and studied sosuccessfully by Golgi, and of the value of that discovery insettling the diagnosis of certain obscure cases of malarialdisease. Surgeon John Lowney, of the Redpole, on theChina station, describes a case in which a hydatid cyst wasexpelled from the stomach-rarely the seat of that parasite.Surgeon V. G. Thorpe, of the Penqitin, and Surgeon James M.France, of the Ringdove, have also some good observationson malarial fevers, and Surgeon E. A. Penfold, M,B. Edin.,alludes to a curious case of poisoning from the consumptionof a fish caught off Malo Island, New Hebrides.The information in these naval medical reports is mainly

statistical, and that which is added of an explanatorycharacter, or as illustrative of the type and nature of thediseases at the different stations, is generally of the mostcondensed kind. The interest of these reports would, in ouropinion, be very much increased by more extended extractsfrom reports made by medical officers whose observations,’derived from so many different climates and parts of theworld, must often be of value.

ROYAL COLLEGE OF PHYSICIANS OFLONDON.

THE ordinary quarterly Comitia of the Fellows of the RoyalCollege of Physicians was held on the 2g!ihult., the President,Dr. S. WILKS, F.R.S.. occupying the chair.The PRESIDENT stated that since the last meeting he had

taken part in the award of the Gilbert Blane medal, whichhad been bestowed on Surgeon E. G. Thorne. He hadnominated Dr. Markham Skerritt as the Bradshaw Lecturerfor 1897 and Dr. S. M. Copeman as Milroy Lecturer for 1898.The President also drew attention to the dies of the Weber-Parkes medal, prepared by Mr. Boucher from designs byDr. H. Weber. Replicas of the medal were on the table andwere much admired by the Fellows.The following gentlemen were admitted to the Membership

of the College :-Jas. Barr, M.D. Glasg., A. P. Beddard,M.R.C.S., L.R.C.P. Lond., G. H. A. C. Berkeley, B.A.,M.B. Camb., C. R. Box, M.D. Lond., R. J. McL.Buchanan, M.D. Viet., M. Craig, M.A., M.B. Camb., J. J:Perkins, M A., M.B. Camb., and R. A. Young, M.D. Lond.