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Liverpool Homœopathy—a surgeon's eye-view
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Brieger, J. (1960) Calcarea carbonica or Ostrea edulis? The British Homceopathic Journal, 49, 41. Burnett, J. C. (1879) Gold as aRemedy in Disease, p. 138. London. Quoted by Gutman, q.v. Foubister, D. (1950) gomceopathie prescribing in childhood. The British Homceopathiv Journal, 40, 302. Foubister, D. (1952) Discussion on Miasms and Arehotypes. The British Homceopathic Journal, 42, 137. Foubister, D. (1954) Komoeopathy and p~ediatries. The British Hom:eop~thic Journal, 4~, 175. Foubister, D. (1957) Clinical impressions of Homceopathy in paediatrie surgery. Th~ British Homceopathic Journal, 46, 12. Foubister, D. (1959) Tarentula Hispanica. The British Hom~eopathicJournal, 48, 27. Foubister, D. (196l) Homoeopathie paediatric case-taking. The British Homveopathic Journal, 50, 246. Gutman, W. (1961) Aurum metallicum. Journal of the American Institute of Homceopathy with the Homeeopathic Recorder, 55, 39. Hubbard, E. W. (1960) Mental portraits of remedies familiar and unfamiliar. The British Homeopathic Journal, 49, 105. Manasse, O. E. (1959) Tarentula Hispanica. The British Homeeopathic Journal, 48, 28. Moncrieff, A. (1937) Constitutional types in children. The British Homveopathic Journal, 9,7, 248. Moncrieff, A. (1943) Tubereulinum bovinum. The British Homceopathic Journal, 33, 12. Paterson, J. (1934) The mentally aI/d physically deficient child. The British Homveopathic Journal, 24, 343. Tyler, M. (1925) Treatment of mental deficiency in children. The British Homo~opathic Journal, 15, 267. Woods, F. (1937) Discussion on Constitutional types in children. The British Homeeopathic ,lour~al~ 27, 255.
Liverpool Homoeopathy a surgeon's eye-view After-dinner speech to the British Homceopathic Congress 1973, at Chester A. CLIFFORD
BREWER,
F.R.G.S.
Senior Surgeon, Liverpool R o y a l I n f i r m a r y , a n d C o n s u l t a n t Surgeon, H a h n e m a n n Hospital, Liverpool
Dr. Martin, Mr. President Sir, Dr. Boyd, Ladies a n d G e n t l e m e n . W h e n I learned from the Secretary of this Congress t h a t it was to be m y pleasure a n d d u t y to reply on behalf of the g u e s t s - - a n d I t h a n k y o u for i t - - I i m m e d i a t e l y t h o u g h t what a t h a n k f u l , h a p p y a n d easy t a s k it would be. To reply, Sir, on behalf of y o u r guests to y o u r t o a s t is indeed very easy because one is helped b y at least half the diners in one's effort. I myself have been a " g u e s t " of t h e Homceopathic F a c u l t y in Liverpool for some 27 years, i n m y h u m b l e f u n c t i o n as the "guest at the Homceopathic H o s p i t a l on the Top F l o o r " . I m u s t say I was i m m e n s e l y impressed, on listening to his speech, b y Dr. B o y d ' s versatility. I t r e m i n d e d me
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immediately of the versatility of a Liverpool character whom I will mention to you again at a later date, Dr. Stuart MeAusland. I t is said that Dr. McAusland, who appeared very frequently in Court, in the morning session appeared as an expert witness in a general surgical case and My Lord took the evidence from him with great interest. At the end of the morning he appeared again as an expert witness, on this occasion it was a gynaecological case, and My Lord again took the evidence without batting so much as an eyelid. But My Lord was a little disturbed, after the recession, when the first case in the afternoon was a venereal case, and along came Dr. McAusland again as the consultant expert. My Lord turned to Dr. McAusland and said, "Dr. McAusland, could you tell me exactly in what you are a specialist." Dr. McAusland, quick as light, "Sir, I am a specialist in Rodney Street." This is typical of the versatility of Dr. McAusland and typical of his ready wit. One cannot meet with members of the Homceopathic Faculty without immediately becoming infected with the spirit of friendship and comradeship which your Faculty radiates. You have always, I think Sir, produced this indefinable quality of friendship and it is this particular quality which pervades so markedly the Liverpool Hahnemann Hospital. I see that it pervades not only our own hospital here but obviously metastasises, as it were, through London, Glasgow and Bristol. Now I myself do in fact occupy an unusual position as your guest here tonight, and I say this very sotto voce, so that the administrators should never know. My introduction to the Liverpool Hahnemann Hospital was somewhat unorthodox. At that time the Surgeon to the Liverpool Homceopathic Hospital was Mr. Hugh Reid and he took me along to one of the Medical Boards and said to me, "Would you like to work here with me ?" Now I didn't at the time know exactly what all this implied. I was later to find out that it consisted, more or less, of doing all the work at the Homceopathic Hospital. But I, in m y innocence at the time, was only too pleased and flattered. I have never been "appointed" as Surgeon to the Liverpool Homceopathic Hospital. There are no minutes that ever record m y appointment and in actual fact I have never, I think, had any paid sessions on the hospital during the 27 years that I have worked there. So I am more or less one of those strange remaining creatures, a truly honorary "Consultant Surgeon". Now my first actual acquaintance with the Hahnemann Hospital came on walking into a Medical Board. I was immediately impressed because the Medical Board room at the Hahnemann Hospital is dominated, and when I say dominated I mean dominated, by a large head of Hahnemann. You will I am sure be aware that many hospitals have smaller heads of Hahnemann but this is rather like the biggest aspidistra in the world, truly perhaps the largest head of Hahnemann. It is some 4-5 ft. in height and, as I have said, it dominates the Medical Board. When I saw this somewhat cadaverous gentleman, as it were, bearing down on the Medical Board, I realized to myself that "these fellows certainly have something". On looking round the table I was also immediately impressed because here was a gathering of some of the most extraordinary characters that Liverpool has ever produced. This was borne to my notice because one of them took from under the table a large black box some 3 ft. by 2 ft. and placed it on the middle of the table. I thought that this might be some form of recording machinery. I thought its purpose must be to take down the important remarks that were about to be made. No, no, not at all. On opening the side of this box the physician took from it a large pair of headphones and set them on his head. This was, in fact, Mr. Saxon Bartons hearing aid. Whereas most of us
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would have the smallest possible, he had what must be the largest. Of course he could not only hear what people were saying but actually what they were thinking, which was a very great advantage. Mr. Hugh Reid pointed out to me that m y duties at the "Hahnemann" would really be minimal. He pointed out to me, and I think some of you may have heard me say it before, that he could easily prove mathematically that we did in fact do absolutely no work at the Hahnemann. He did this by saying, " Y o u see what we do, the most you'll ever be asked to do, is an 8-hour day. This is one third of the days in the year, there are 365 days in the year, so for one third or 122 days you might be called upon to do something. There are, of course, 52 Sundays and there are two half days, that is another 52, 104 altogether, which only leaves 28 days. You have, of course, 3 weeks holiday, 21 days, leaving some 6 or 7 days. There are, of course, four Bank Holidays in the year." And so he had proved to me mathematically that really the duties were very light, and that I would not really be expected to go there very frequently and as I have said before, I have been wandering along there every day ever since. Our dear President has asked me to say a little about the earlier history of the Hahnemann Hospital. When I first went there it was a hospital provided with ahnost all the specialities. I t had an Ear, Nose and ThrOat Department, an Eye Department, a Gynaecological Department, Dental Department, Anaesthetic Department, Medical Department, Physiotherapy, Radiological, the service was complete, all being under one roof. I t was indeed an extremely busy and very active hospital. It had at that time a resident staff, a point which has always been a bone of great contention and is so at the moment. We are now told that we should not operate if we do not have resident staff. There is, of course, now no resident staff. It is to me a peculiar thing that we are unable to operate because the people who have brought forward this necessity for resident staff are surgeons who are quite happy to operate in the numerous nursing homes throughout the country without any resident staff. They apparently are willing to subject their private patients to conditions to which they would not subject their hospital patients. In our hospital we always have the help of Clinical Medical Officers, one of whom is here tonight, Dr. Majka. Our other Clinical Assistant, Dr. Rodgcrs, is not with us, but they have always proved to be of the greatest help and they have always been readily and immediately available. However, by virtue of the fact of not having resident staff, we have had to greatly curtail what surgery we are able to do. Saxon Barton, whom I mentioned to you and who had the very large hearing aid, had not only a large hearing aid, but everything to do with Saxon Barton was enormous. He was about 6 ft. 8 in. in height, he weighed some 22 stone. When he operated he was a gynaecologist--he used to sit down in the operating chair and you never saw the patient. The patient was completely eclipsed by Saxon Barton. He was finally very unfortunate--he always ran one of the largest Rolls-Royce motor-cars, he had a Phantom 3, nothing less--but unfortunately on one occasion he borrowed his wife's small Morris car and while passing through the town of Hollywell he unfortunately bent down to pick up his gloves which had fallen from the glove tray. Pulling his steering column to the right he went head on into a vehicle coming towards him and received fatal injuries from which he died. He was an extremely attractive and fascinating gentleman. He had a great knowledge of archaeology and was a particular friend of the archaeologist Dr. Nelson. The Nelson collection of archaeological objects is now in the British Museum. Dr. Nelson used to have on his finger the ring worn by
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Warwick the Kingmaker at the Battle of Barnet. I remember how Saxon Barton was always so fascinated by the history of this ring because it was hacked from the finger of Warwick when he was killed at the Battle of Barnet and they knew the stages in the history of that ring, from the moment it was pul]ed from the finger of the Kingmaker to the time when they wore it on their own hands. Barton had wide interests, he was a numismatist with a very extensive collection of coins. He also had an extensive collection of antique furniture and pictures. He had a collection of antique books and both he and his friend Dr. Nelson were experts on mediaeval stained glass. He had usually sitting with him at the Medical Board, one Dr. Bickerton, who was also a somewhat unusual character. Bickerton, who was himself an ophthalmologist, was the son of Dr. Bickerton, an ophthalmologist. The father had made a great fortune on the tobacco market. Being, as it were, uot short of this world's goods, it was possible for Dr. Biekerton, when the State Medical Service started, not to enter into this Service. He was also very much against the State Medical Service in general and he made a point of raising arguments against the State Medical Service on every possible opportunity. He was on the Central Committee in regard to Ophthalmological Services and it was said that he made his point here by going to a meeting, chaired by Duke Elder, at which the advantages of State Medical Service spectacles were discussed. They were so much better, said Duke Elder, than anything else one could get elsewhere. Without making any further remarks, Bickerton managed to get the janitor to go quietly round the room and pick up the various spectacles belonging to members of that august body, and he brought these to Bickerton. Bickerton got hold of them, dropped them on the floor and promptly jumped on the lot. Imagine the consternation, people in the middle of London with no spectacles. " D o n ' t worry, I will provide you all with State Service spectacles, the best spectacles that can possibly be obtained. These expensive bits of tortoise-shell you've got are not the things for you gentlemen." Bickerton had made his point in his own unusual w a y . - - F r o m having a great interest in alcohol he became a teetotaller. He had a very fine and very extensive cellar. He unfortunately, along with his father, hired one of the Liverpool Ferry Boats, he also hired the Band of the Salvation Army and the Salvation Army played their hymns as they sailed out of the Mersey. At the Bar of the Mersey he dropped the whole of the Bickerton cellar into the water. I believe people have been fishing for it ever since. Bickerton was also very keen on gardening. He had one unfortunate disadvantage in that he was not a particularly good driver. He had bought for himself a very large and very powerful lawn mower because, of course, he had a very big lawn. I t was by no means uncommon, on calling to see him, to hear that Bickerton was once again "somewhere in the garden". You would invariab]y find him about three or four feet deep in a rhododendron bush into which he had unfortunately become embedded by his powerful mower, which he was unfortunately unable to control. He did, nevertheless, give many gifts to our hospital. I always think of him when he was sitting in our dining-room because someone remarked that the fireplace was a little t a t t y and, of course, Bickerton was just the sort of person who would immediately rush off down town and buy a new fireplace. Anything you wanted he would rush off and buy for you. His generosity knew no bounds. I t was fortunate that being ophthalmologically concerned it was very easy for him, previous to the percentage method of finance, to add up his money. What he did was he cleared from his cabinet, those useless glasses which are used to put in front of your eyes when they are testing whether you
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can see or not, a n d he p u t in t h e i r place sixpences, shillings a n d half-crowns. T h e y were all in t h e i r n e a t rolls so if ever he h a d to p a y a bill he w o u l d pull out his o p h t h a l m o l o g i c a l cabinet a n d t h e n one, two, three, four, five, a n e a s y w a y to a d d up, a n d so m u c h b e t t e r t h a n h a v i n g those r a t h e r useless glasses which t h e y w o u l d p u t in front of y o u r eyes. H e himself was v e r y s h o r t s i g h t e d a n d it is said t h a t w h e n e v e r he t o o k off his own glasses in order to e x a m i n e a p a t i e n t ' s eyes w i t h an o p h t h a l m o s c o p e , he h a d to feel where t h e p a t i e n t s h e a d h a d gone. H o w e v e r , he was a v e r y successful m e m b e r of t h e c o m m u n i t y a n d it was u n f o r t u n a t e for us t h a t he failed, or d i d not wish, t o p r a c t i c e with us after t h e onset of t h e S t a t e Medical Service. The F a c u l t y of H o m c e o p a t h y in L i v e r p o o l at this t i m e was d o m i n a t e d b y Dr. J u l i a n . Dr. J u l i a n was an aesthetic a n d a t r u e disciple of H a h n e m a n n . H e was e x t r e m e l y keen, he was e x t r e m e l y intelligent, a n d he was a v e r y strong and f o r t h r i g h t character. H e was t h e l e a d e r of homceopathie t h o u g h t in Liverpool for a v e r y considerable period of time. H e was g r e a t l y concerned, I always r e m e m b e r , w i t h t h e altering p a t t e r n of disease. H e was f a s c i n a t e d b y t h e w a y t u b e r c u l o s i s - - w h i c h as a y o u n g m a n h a d been so g r e a t a p r o b l e m for h i m practising in L i v e r p o o l was in fact fast disappearing. I n t h e same w a y t h e r e was no d i p h t h e r i a which a g a i n h a d been to h i m so g r e a t a p r o b l e m in looking after his many paediatric patients as a young man. And there was the fact that cancer of the lung which was so rare a disease when he was a young man, had become so prevalent a disease. It is interesting also to note that Mr. Hugh Reid, whom I mentioned to you before, once wrote one of the earliest papers on cancer of the lung in Liverpool. He described therein three cases of cancer of the lung occurring in 1922. It is interesting to observe how different the pattern of disease rapidly becomes. Dr. J u l i a n was also v e r y i n t e r e s t e d in literature. H e was p a r t i c u l a r l y i n t e r e s t e d in p o e t r y . H e was a keen p o e t himself, a n d he p u b l i s h e d a b o o k of his own poems. H e h a d a friend who w o r k e d w i t h h i m a t t h e L i v e r p o o l H a h n e m a n n H o s p i t a l at this time, a l a d y friend, who was o b v i o u s l y v e r y a t t a c h e d to Dr. J u l i a n a n d v e r y keen on H o m c e o p a t h y . She was, I t h i n k , a v e r y fine poet, in fact so good as to be a l m o s t u n b e l i e v a b l y good a n d she left, when she died, a collection of her poems in t h e H a h n e m a n n H o s p i t a l . She o b v i o u s l y h a d wished to h a v e a child, b u t she h a d h a d no child. I f I j u s t r e a d to y o u quickly one of t h e poems she left b e h i n d in t h e H a h n e m a n n , w h e n she died, I t h i n k y o u w o u l d see t h e q u a l i t y of t h e p o e t r y which people like J u l i a n a n d his friend were p r o d u c i n g when t h e y were a t our hospital. Dr. J u l i a n ' s friend was s u b m i t t i n g a n i n v o c a t i o n to t h e Goddess K w a n Yin, t h e Chinese goddess of f e c u n d i t y a n d if I m a y s a y so, t h e Goddess who in m a n y w a y s epitomizes H o m c e o p a t h y , t h e Goddess of Mercy, t h e Goddess of Tenderness, t h e Goddess to w h o m m a n y of t h e Chinese t u r n when t h e y look for God. I t is interesting to observe t h a t t h e E g y p t i a n s t u r n e d to a male God of Medicine, t h e y t u r n e d to I m H o t e p , a scribe, a b M d - h e a d e d a n d r a t h e r u n a t t r a c tive-looking i n d i v i d u a l . The Greeks t u r n e d to Asklepios. The Chinese t u r n e d to a female figure, t h e y t u r n e d to K w a n Yin, a Goddess of Mercy, a Goddess of Softness, n o t t h e Goddess K a l i of I n d i a , a Goddess of Revenge, a terrible Goddess of Medicine. No, t h e Chinese t u r n e d to simplicity. J u l i a n ' s friend w r i t i n g t o K w a n Y i n writes as follows: A t e a r d r o p lies, like petMled dew, a g a i n s t her pallid cheek H e r prayers, her sighs, on incense-laden air rise up to seek Compassion from t h e skies.
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Kwan Yin, Kwan Yin, Mother of Mercy, hear; Lady of consolation, Bend low in pity, hear me I pray, Barren am I. At t h y creative word The fish, the flower, the bird Enjoy their yearly birth incarnate on the earth, The sleeping garden wakens, the almond will blossom, Buds will burden the cherry, the fruits will come. But bare, oh bare is m y bosom, Mother of solace and mercy, pity my desolate womb. Visit me with touch that quickens, Goddess most mild; Lady of consolation, earth is with child, Fill me with glad gestation, leave me not alone. Yearning I make petition, grant me Thy highest boon. Grant me to bear My Son. I do not think that many of the products of the Julian "era", from the literary point of view, were extremely high and to a large extent they are more or less unrecognized and unpublished. At the same time when we could boast Dr. Julian we could also boast of Dr. Stuart McAusland. They were two somewhat different characters, but they were both keen disciples of the same discipline. McAusland remained the perpetual student. He was terribly keen on the student body. He was Treasurer of the Students Union Guild throughout his life. He was extremely clever with money, to say the least of it, a great advantage and rare in a medical man. He had been trained as an accountant and he used to create chaos by telling all of us that he never really paid any Income Tax. When he was ill, in his final illness, he informed us in the Hahnemann Hospital that he possessed no less than one hundred and sixty thousand shares in Smith & Nephew. We all immediately felt that he had probably bought one share every time he put on an Elastoplast bandage. He always wished to establish a Memorial Dinner. Indeed his object had been apparently to establish a number of memorial dinners and shortly before he died he was most anxious to do this. What a pity it is that he never accomplished his wish. He wished to have one memorial dinner for the students, he wanted to have one for the Clubs to which he belonged and no doubt he would perhaps have liked to have had one for his Homceopathic Faculty. He was a very attractive and very gracious man and he left behind him a great reputation. Many others we tend to forget, like Mr. Horace Mather--Horace was one of those extraordinary surgeons who was able to do more or less everything. He did both E.N.T.s and Eyes, but he was quite capable of doing all the general surgical procedures perhaps better than I was myself and he was also very versatile in many other ways. He always remarked how strange it was in Liverpool that if you drove through the City you found medicine divided into little boxes. As you went along the street you would see the Eye Hospital, the Ear Hospital, the Nose Hospital, the Foot Hospital and so on. In Liverpool if you went along Myrtle Street all these hospitals had their names on the outside and he used to say how curious it was, since anybody who was any good could do all these things without any trouble at all. Liverpool, however, wanted to chop them off into little boxes.
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We also must not forget that we had a most active Dental Department, run recently by Mr. Smith. Smith, again, was one of those dentists who was capable of doing anything. He used to describe at great length how he took out a large infected molar tooth from our large and imposing gynaecologist, Mr. Saxon Barton. Barton arrived and told Smith he had a "pretty terrible molar". Said Smith, "Yes, it looks pretty terrible to me. Perhaps it would be better if you had it out". "Right", said Saxon Barton, "Take it out". Smith, of course, got out his syringe and his local anaesthetic and was about to plunge the local into Barton's jaw when Barton said: "Oh, none of that high-falutin messing about for me, just take it out". Well, of course, Smith had a long argument with Saxon Barton as to how impossible it would be without anaesthetic and he describes how he grabbed this tooth and hung onto it while his 6 ft. 8 in. patient rolled all over the surgery. Finally Barton was parted from his tooth. The homoeopaths of Liverpool are indeed made of "stern stuff". Hugh Reid, whom I mentioned to you originally, m y mentor, was always a perfect gentleman. It gives me indeed great pleasure to see at this particular meeting a lady who was his House Surgeon. I won't say how long ago Dr. Burger was his House Surgeon. Of Hugh, the perfect gentleman, it is said that one day a tough Liverpool patient who had had a partial gastrectomy performed by him in the hospital--Hugh walked past the patient, having said that he might go out. As he walked past, the patient said "Hey, hey". Hugh stopped and regarded the patient. "~Vhat can I eat", said the patient. Hugh, " I beg your pardon, m y man", fixing his monocle. Again, " W h a t can I eat?" Hugh looked at him and said, "Well, you know, more or less anything, perhaps a little game in season". Then there was the House Surgeon who borrowed a book from Hugh and said: " I must return that book to you as soon as I can". "Oh, no, no, don't bother", says Hugh, "Send it round with your man". Hugh always lived in a little world all of his own. I must tell you that our large friend Dr. Saxon Barton had to help him no less a person than Dr. Cecily Burroughs. Whereas Barton was large and portly, Burroughs was thin and tall. She was a lady of many parts. She had one somewhat unhappy habit which made it difficult for me as a general surgeon working in the same theatre. Like most surgeons she took off her clothing to operate, but she used to leave on a somewhat unusual and highly colourcd pair of bloomers. She naturally wore her gown over these and being short sighted she used to work very close and lean over her patient. Her gown was usually split open down the back and she and her patient presented a somewhat extraordinary sight. One obviously had to show interest in the medical problem involved, but it was difficult at the same time not to observe this somewhat unusual sight. All this time we were fortunate to be backed up by Dr. Ruth Dovey as our anaesthetist. I almost said "Dear old Ruth". No, no, this is the the last thing that I should say, for although she has been an anaesthetist for us for a very long time, she is indeed dear to our hearts. She is "the old faithful" of the surgical floor and is still giving her excellent anaesthetics. Now, however, she is doing a locum for herself and she acts as a locum to the locum anmsthetist. I am sorry in some ways that we meet here in Chester, in that you have been unable to visit and see the attractive features of the Liverpool Homceopathic Hospital. I do feel that it is a great pity that you missed seeing our theatre, because should the hospital close down, some of you may never see it. It is an attractive and unsual theatre. Situated on the top floor, when you enter through the door you are immediately in the theatre itself, there being no anaesthetic
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room. Our a n t i s t a t i c floor covering w o u l d i m m e d i a t e l y c o m m a n d y o u r a t t e n t i o n . W e used to h a v e a floor in beautiful I t a l i a n terrazzo. This was a v e r y fine floor indeed, a b e a u t i f u l thing. I t h a d to go, as it was said n o t to be a n t i s t a t i c a n d i t was r e p l a c e d b y t h e s o m e w h a t hideous coloured squares of r u b b e r which y o u see t o d a y . I well r e m e m b e r when t h e y were completing this a n t i s t a t i c r u b b e r floor, I could n o t for t h e life of me see how it was m o r e a n t i s t a t i c t h a n t h e terrazzo. " W e l l y o u see, Mr. Brewer, it is due to t h e fact t h a t we h a v e copper strips u n d e r n e a t h t h e r u b b e r which help to m a k e it a n t i s t a t i c . " Yes, y o u are quite correct, t h e y h a d p u t d o w n t h e r u b b e r floor w i t h o u t t h e copper strips, so t h e y h a d t o t a k e it all up again. One o t h e r small point. I h a v e a p e c u l a r i t y of colour vision of t h e usual grey, green, r e d t y p e . I believe it is c o m m o n in t h e male a n d as m a n y as I 1 per cent. o f m e n h a v e this defect. This m a k e s it possible to see s o m e w h a t b e t t e r in a d i m light t h a n with t h e o r d i n a r y eye. I f o u n d this v e r y a d v a n t a g e o u s in t h e H a h n e m a n n H o s p i t a l because we h a v e h a d an o p e r a t i n g l a m p , given I t h i n k b y T a t e himself, in t h e y e a r 1893. A l t h o u g h of g r e a t historical i n t e r e s t I a m sure t h a t if I h a d n o t h a d m y m i n o r colour blindness I m i g h t h a v e f o u n d it difficult in m y first t w e n t y y e a r s to see w h a t I was doing. N o w we are u n d e r t h e U n i t e d Liverpool H o s p i t a l s a n d t h e r e are new l a m p s a n d new spotlights all over t h e t h e a t r e . I t is now a l m o s t impossible to see w h a t y o u are doing for t h e glare. The view from t h e w i n d o w of t h e o p e r a t i n g t h e a t r e was second only to t h a t seen from t h e o p e r a t i n g t h e a t r e s of t h e Radcliffe I n f i r m a r y , Oxh)rd. The old Radcliffe t h e a t r e s look out on t h e O b s e r v a t o r y , built in b e a u t i f u l Cotswold stone which, seen in t h e colour of t h e setting sun, is a most b e a u t i f u l thing. The view from t h e H a h n e m a n n H o s p i t a l showed t h e magnificent spire of H o p e S t r e e t Church i m m e d i a t e l y opposite. This was a b e a u t i f u l church b u i l t in the same t y p e of mellow stone as was t h e O b s e r v a t o r y a t Oxford. R o u n d t h e tower of t h e church were four magnificent statues of Saints: Matthew, Mark, L u k e a n d J o h n . I t was clear t h a t L u k e r e g a r d e d t h e h o s p i t a l with special interest. The spire a n d t h e s t a t u e s are no more, as t h e y , like so m u c h else in Liverpool, h a v e been d a s h e d to t h e ground. Dr. Higginson of syringe f a m e was a s i d e s m a n at this church. I t is i n d e e d a g r e a t p i t y t h a t so beautiful a n o b j e c t has been r e m o v e d so t h a t we can now sit a n d see it no more. W h e n I s a y sit, I m e a n sit, because we h a v e a retiring r o o m used b y t h e Surgeons, A n a e s t h e t i s t s a n d Staff. I t is an a t t r a c t i v e room. U n f o r t u n a t e l y it is o n l y some 4 b y 10 ft. a n d t h e p r o b l e m is t h a t if a n y more t h a n t h r e e wish to sit down a t a n y one t i m e t h e n one would h a v e to be more c o n v e n i e n t l y sitting on t h e l a v a t o r y . This is a small p o i n t of little consequence, as ours is i n d e e d a m o s t friendly hospital. The difficulties of changing in this r o o m in m i x e d c o m p a n y can also be considerable a n d of course if a n y of us is on h o l i d a y t h e locum m u s t h a v e all these small m a t t e r s carefully explained. I n spite of m y l i g h t - h e a r t e d a p p r o a c h to t h e a t t r a c t i o n s of t h e L i v e r p o o l H a h n e m a n n H o s p i t a l I a m n a t u r a l l y worried concerning its future. W i t h so m a n y faithful servants over so long a p e r i o d of t i m e it seems indeed a p i t y t h a t it should d i s a p p e a r in t h e m a e l s t r o m of r e o r g a n i z a t i o n which we a p p e a r to be a p p r o a c h i n g . M a n y of t h e s e faithful s e r v a n t s h a v e been its nursing officers. Miss T r a c y who was M a t r o n for m a n y y e a r s a n d our last M a t r o n , Miss H e n d y , who showed such wonderful d e t e r m i n a t i o n a n d character. Miss H e n d y h a d a c a r c i n o m a of t h e k i d n e y r e m o v e d b u t c o n t i n u e d to w o r k for some five years. She d e v e l o p e d a s e c o n d a r y in her lung a n d h a d a p n e u m o n e c t o m y a n d she c o n t i n u e d for a f u r t h e r t h r e e y e a r s as our Matron. Only when she d e v e l o p e d m u l t i p l e m e t a s t a s e s was she u n a b l e to continue. W e h a v e w i t h us t o n i g h t our A c t i n g
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Matron and many other members of the nursing profession, all of whom have shown the greatest interest and devotion to our hospital. We have a multiplicity of nurses, sisters, radiographers, secretaries and many others, who have given long and faithful service to the hospital. I t is, of course, these who have allowed the hospital to continue. One great cause for anxiety is the growth of "administration from a distance". The administrators often have little knowledge of and scant sympathy with the clinical problems of service. One extraordinary thing is that the administrators today seem to think that by the creation of new buildings they can dramatically improve the medical services. Many of us, however, realize, that medical practice consists of the summation of personalities and that if we are to produce the right personalities, in a reasonable environment, our medical services will indeed prosper. This may be difficult in the enormous and complicated buildings which seem so popular in the hospitals of the future. I t is very probable that our hospital here will disappear in the near future with the reorganization of the medical services. When you get to my stage of life you may well feel that you are not too depressed in that you may not have too long to work in the reorganized service. One may, however, worry that we have lost one of the basic facts on which we all agreed to enter a State Medical Service. This is the idea that the patient must have freedom of choice as to by whom he is to be treated and where he is to be treated. The new organization does not directly deny the patient this freedom. The patient, however, is to be "regionalized". Where we now go will largely depend on where we live. The patient is to be sent down a tunnel to the hospital serving the area from which he emanates. We are also told that the all-embracing State Medical Service will not tolerate other than one standard of service. Now we know that standards depend on personalities and their devotion to duty, two qualities commonly found in our hospitals. Indeed many of the smaller hospitals are able to provide services which although less scientific are often more applicable to the patient's problem. I t is a great pity that these smaller hospitals should be closed to make way for the all-embracing, massive, scientific institution. I f the Liverpool Hahnemann Hospital should be one of the first to disappear then it should serve as a warning to you who run your hospitals in other towns. The same may well happen in Bristol, Glasgow and London. You must beware that you are not destroyed by a policy of "omission". Our Liverpool Hospital has long been attacked by this policy of omission. When our gynaecologists retired there was no discussion, they were simply not replaced. The same happened regarding our Eye Department and our E.N.T. Department. When an anaesthetist retires they do not appoint a replacement, they merely appoint a locum. B y this subtle method of omission it is possible to hinder and slowly destroy without the necessity of public argument and discussion. May I, Sir, compliment you and your Faculty on being able to continue in the face of difficulty created by the administrative machine. I would also compliment you on the fact that you have been able to preserve your Faculty in spite of many difficulties. I can only hope, as your guest tonight, that you may long be able so to continue as a Faculty, that you may be able to practice your gentle art and that you may be able to do so with freedom and to the advantage of your fellow man. May I repeat as your guest tonight that I think we might call to m e m o r y - the words of the late Lord Moynihan in his Romanis Lecture of 1935. I think he said "We who, like the happy Warrior, are doomed to go in company with fear and bloodshed, are not as ordinary men. It is for us so to labour that we may prove not unworthy".
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Brieger, J. (1960) Calcarea carbonica or Ostrea edulis? The British Homceopathic Journal, 49, 41. Burnett, J. C. (1879) Gold as aRemedy in Disease, p. 138. London. Quoted by Gutman, q.v. Foubister, D. (1950) gomceopathie prescribing in childhood. The British Homceopathiv Journal, 40, 302. Foubister, D. (1952) Discussion on Miasms and Arehotypes. The British Homceopathic Journal, 42, 137. Foubister, D. (1954) Komoeopathy and p~ediatries. The British Hom:eop~thic Journal, 4~, 175. Foubister, D. (1957) Clinical impressions of Homceopathy in paediatrie surgery. Th~ British Homceopathic Journal, 46, 12. Foubister, D. (1959) Tarentula Hispanica. The British Hom~eopathicJournal, 48, 27. Foubister, D. (196l) Homoeopathie paediatric case-taking. The British Homveopathic Journal, 50, 246. Gutman, W. (1961) Aurum metallicum. Journal of the American Institute of Homceopathy with the Homeeopathic Recorder, 55, 39. Hubbard, E. W. (1960) Mental portraits of remedies familiar and unfamiliar. The British Homeopathic Journal, 49, 105. Manasse, O. E. (1959) Tarentula Hispanica. The British Homeeopathic Journal, 48, 28. Moncrieff, A. (1937) Constitutional types in children. The British Homveopathic Journal, 9,7, 248. Moncrieff, A. (1943) Tubereulinum bovinum. The British Homceopathic Journal, 33, 12. Paterson, J. (1934) The mentally aI/d physically deficient child. The British Homveopathic Journal, 24, 343. Tyler, M. (1925) Treatment of mental deficiency in children. The British Homo~opathic Journal, 15, 267. Woods, F. (1937) Discussion on Constitutional types in children. The British Homeeopathic ,lour~al~ 27, 255.
Liverpool Homoeopathy a surgeon's eye-view After-dinner speech to the British Homceopathic Congress 1973, at Chester A. CLIFFORD
BREWER,
F.R.G.S.
Senior Surgeon, Liverpool R o y a l I n f i r m a r y , a n d C o n s u l t a n t Surgeon, H a h n e m a n n Hospital, Liverpool
Dr. Martin, Mr. President Sir, Dr. Boyd, Ladies a n d G e n t l e m e n . W h e n I learned from the Secretary of this Congress t h a t it was to be m y pleasure a n d d u t y to reply on behalf of the g u e s t s - - a n d I t h a n k y o u for i t - - I i m m e d i a t e l y t h o u g h t what a t h a n k f u l , h a p p y a n d easy t a s k it would be. To reply, Sir, on behalf of y o u r guests to y o u r t o a s t is indeed very easy because one is helped b y at least half the diners in one's effort. I myself have been a " g u e s t " of t h e Homceopathic F a c u l t y in Liverpool for some 27 years, i n m y h u m b l e f u n c t i o n as the "guest at the Homceopathic H o s p i t a l on the Top F l o o r " . I m u s t say I was i m m e n s e l y impressed, on listening to his speech, b y Dr. B o y d ' s versatility. I t r e m i n d e d me
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immediately of the versatility of a Liverpool character whom I will mention to you again at a later date, Dr. Stuart MeAusland. I t is said that Dr. McAusland, who appeared very frequently in Court, in the morning session appeared as an expert witness in a general surgical case and My Lord took the evidence from him with great interest. At the end of the morning he appeared again as an expert witness, on this occasion it was a gynaecological case, and My Lord again took the evidence without batting so much as an eyelid. But My Lord was a little disturbed, after the recession, when the first case in the afternoon was a venereal case, and along came Dr. McAusland again as the consultant expert. My Lord turned to Dr. McAusland and said, "Dr. McAusland, could you tell me exactly in what you are a specialist." Dr. McAusland, quick as light, "Sir, I am a specialist in Rodney Street." This is typical of the versatility of Dr. McAusland and typical of his ready wit. One cannot meet with members of the Homceopathic Faculty without immediately becoming infected with the spirit of friendship and comradeship which your Faculty radiates. You have always, I think Sir, produced this indefinable quality of friendship and it is this particular quality which pervades so markedly the Liverpool Hahnemann Hospital. I see that it pervades not only our own hospital here but obviously metastasises, as it were, through London, Glasgow and Bristol. Now I myself do in fact occupy an unusual position as your guest here tonight, and I say this very sotto voce, so that the administrators should never know. My introduction to the Liverpool Hahnemann Hospital was somewhat unorthodox. At that time the Surgeon to the Liverpool Homceopathic Hospital was Mr. Hugh Reid and he took me along to one of the Medical Boards and said to me, "Would you like to work here with me ?" Now I didn't at the time know exactly what all this implied. I was later to find out that it consisted, more or less, of doing all the work at the Homceopathic Hospital. But I, in m y innocence at the time, was only too pleased and flattered. I have never been "appointed" as Surgeon to the Liverpool Homceopathic Hospital. There are no minutes that ever record m y appointment and in actual fact I have never, I think, had any paid sessions on the hospital during the 27 years that I have worked there. So I am more or less one of those strange remaining creatures, a truly honorary "Consultant Surgeon". Now my first actual acquaintance with the Hahnemann Hospital came on walking into a Medical Board. I was immediately impressed because the Medical Board room at the Hahnemann Hospital is dominated, and when I say dominated I mean dominated, by a large head of Hahnemann. You will I am sure be aware that many hospitals have smaller heads of Hahnemann but this is rather like the biggest aspidistra in the world, truly perhaps the largest head of Hahnemann. It is some 4-5 ft. in height and, as I have said, it dominates the Medical Board. When I saw this somewhat cadaverous gentleman, as it were, bearing down on the Medical Board, I realized to myself that "these fellows certainly have something". On looking round the table I was also immediately impressed because here was a gathering of some of the most extraordinary characters that Liverpool has ever produced. This was borne to my notice because one of them took from under the table a large black box some 3 ft. by 2 ft. and placed it on the middle of the table. I thought that this might be some form of recording machinery. I thought its purpose must be to take down the important remarks that were about to be made. No, no, not at all. On opening the side of this box the physician took from it a large pair of headphones and set them on his head. This was, in fact, Mr. Saxon Bartons hearing aid. Whereas most of us
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would have the smallest possible, he had what must be the largest. Of course he could not only hear what people were saying but actually what they were thinking, which was a very great advantage. Mr. Hugh Reid pointed out to me that m y duties at the "Hahnemann" would really be minimal. He pointed out to me, and I think some of you may have heard me say it before, that he could easily prove mathematically that we did in fact do absolutely no work at the Hahnemann. He did this by saying, " Y o u see what we do, the most you'll ever be asked to do, is an 8-hour day. This is one third of the days in the year, there are 365 days in the year, so for one third or 122 days you might be called upon to do something. There are, of course, 52 Sundays and there are two half days, that is another 52, 104 altogether, which only leaves 28 days. You have, of course, 3 weeks holiday, 21 days, leaving some 6 or 7 days. There are, of course, four Bank Holidays in the year." And so he had proved to me mathematically that really the duties were very light, and that I would not really be expected to go there very frequently and as I have said before, I have been wandering along there every day ever since. Our dear President has asked me to say a little about the earlier history of the Hahnemann Hospital. When I first went there it was a hospital provided with ahnost all the specialities. I t had an Ear, Nose and ThrOat Department, an Eye Department, a Gynaecological Department, Dental Department, Anaesthetic Department, Medical Department, Physiotherapy, Radiological, the service was complete, all being under one roof. I t was indeed an extremely busy and very active hospital. It had at that time a resident staff, a point which has always been a bone of great contention and is so at the moment. We are now told that we should not operate if we do not have resident staff. There is, of course, now no resident staff. It is to me a peculiar thing that we are unable to operate because the people who have brought forward this necessity for resident staff are surgeons who are quite happy to operate in the numerous nursing homes throughout the country without any resident staff. They apparently are willing to subject their private patients to conditions to which they would not subject their hospital patients. In our hospital we always have the help of Clinical Medical Officers, one of whom is here tonight, Dr. Majka. Our other Clinical Assistant, Dr. Rodgcrs, is not with us, but they have always proved to be of the greatest help and they have always been readily and immediately available. However, by virtue of the fact of not having resident staff, we have had to greatly curtail what surgery we are able to do. Saxon Barton, whom I mentioned to you and who had the very large hearing aid, had not only a large hearing aid, but everything to do with Saxon Barton was enormous. He was about 6 ft. 8 in. in height, he weighed some 22 stone. When he operated he was a gynaecologist--he used to sit down in the operating chair and you never saw the patient. The patient was completely eclipsed by Saxon Barton. He was finally very unfortunate--he always ran one of the largest Rolls-Royce motor-cars, he had a Phantom 3, nothing less--but unfortunately on one occasion he borrowed his wife's small Morris car and while passing through the town of Hollywell he unfortunately bent down to pick up his gloves which had fallen from the glove tray. Pulling his steering column to the right he went head on into a vehicle coming towards him and received fatal injuries from which he died. He was an extremely attractive and fascinating gentleman. He had a great knowledge of archaeology and was a particular friend of the archaeologist Dr. Nelson. The Nelson collection of archaeological objects is now in the British Museum. Dr. Nelson used to have on his finger the ring worn by
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Warwick the Kingmaker at the Battle of Barnet. I remember how Saxon Barton was always so fascinated by the history of this ring because it was hacked from the finger of Warwick when he was killed at the Battle of Barnet and they knew the stages in the history of that ring, from the moment it was pul]ed from the finger of the Kingmaker to the time when they wore it on their own hands. Barton had wide interests, he was a numismatist with a very extensive collection of coins. He also had an extensive collection of antique furniture and pictures. He had a collection of antique books and both he and his friend Dr. Nelson were experts on mediaeval stained glass. He had usually sitting with him at the Medical Board, one Dr. Bickerton, who was also a somewhat unusual character. Bickerton, who was himself an ophthalmologist, was the son of Dr. Bickerton, an ophthalmologist. The father had made a great fortune on the tobacco market. Being, as it were, uot short of this world's goods, it was possible for Dr. Biekerton, when the State Medical Service started, not to enter into this Service. He was also very much against the State Medical Service in general and he made a point of raising arguments against the State Medical Service on every possible opportunity. He was on the Central Committee in regard to Ophthalmological Services and it was said that he made his point here by going to a meeting, chaired by Duke Elder, at which the advantages of State Medical Service spectacles were discussed. They were so much better, said Duke Elder, than anything else one could get elsewhere. Without making any further remarks, Bickerton managed to get the janitor to go quietly round the room and pick up the various spectacles belonging to members of that august body, and he brought these to Bickerton. Bickerton got hold of them, dropped them on the floor and promptly jumped on the lot. Imagine the consternation, people in the middle of London with no spectacles. " D o n ' t worry, I will provide you all with State Service spectacles, the best spectacles that can possibly be obtained. These expensive bits of tortoise-shell you've got are not the things for you gentlemen." Bickerton had made his point in his own unusual w a y . - - F r o m having a great interest in alcohol he became a teetotaller. He had a very fine and very extensive cellar. He unfortunately, along with his father, hired one of the Liverpool Ferry Boats, he also hired the Band of the Salvation Army and the Salvation Army played their hymns as they sailed out of the Mersey. At the Bar of the Mersey he dropped the whole of the Bickerton cellar into the water. I believe people have been fishing for it ever since. Bickerton was also very keen on gardening. He had one unfortunate disadvantage in that he was not a particularly good driver. He had bought for himself a very large and very powerful lawn mower because, of course, he had a very big lawn. I t was by no means uncommon, on calling to see him, to hear that Bickerton was once again "somewhere in the garden". You would invariab]y find him about three or four feet deep in a rhododendron bush into which he had unfortunately become embedded by his powerful mower, which he was unfortunately unable to control. He did, nevertheless, give many gifts to our hospital. I always think of him when he was sitting in our dining-room because someone remarked that the fireplace was a little t a t t y and, of course, Bickerton was just the sort of person who would immediately rush off down town and buy a new fireplace. Anything you wanted he would rush off and buy for you. His generosity knew no bounds. I t was fortunate that being ophthalmologically concerned it was very easy for him, previous to the percentage method of finance, to add up his money. What he did was he cleared from his cabinet, those useless glasses which are used to put in front of your eyes when they are testing whether you
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can see or not, a n d he p u t in t h e i r place sixpences, shillings a n d half-crowns. T h e y were all in t h e i r n e a t rolls so if ever he h a d to p a y a bill he w o u l d pull out his o p h t h a l m o l o g i c a l cabinet a n d t h e n one, two, three, four, five, a n e a s y w a y to a d d up, a n d so m u c h b e t t e r t h a n h a v i n g those r a t h e r useless glasses which t h e y w o u l d p u t in front of y o u r eyes. H e himself was v e r y s h o r t s i g h t e d a n d it is said t h a t w h e n e v e r he t o o k off his own glasses in order to e x a m i n e a p a t i e n t ' s eyes w i t h an o p h t h a l m o s c o p e , he h a d to feel where t h e p a t i e n t s h e a d h a d gone. H o w e v e r , he was a v e r y successful m e m b e r of t h e c o m m u n i t y a n d it was u n f o r t u n a t e for us t h a t he failed, or d i d not wish, t o p r a c t i c e with us after t h e onset of t h e S t a t e Medical Service. The F a c u l t y of H o m c e o p a t h y in L i v e r p o o l at this t i m e was d o m i n a t e d b y Dr. J u l i a n . Dr. J u l i a n was an aesthetic a n d a t r u e disciple of H a h n e m a n n . H e was e x t r e m e l y keen, he was e x t r e m e l y intelligent, a n d he was a v e r y strong and f o r t h r i g h t character. H e was t h e l e a d e r of homceopathie t h o u g h t in Liverpool for a v e r y considerable period of time. H e was g r e a t l y concerned, I always r e m e m b e r , w i t h t h e altering p a t t e r n of disease. H e was f a s c i n a t e d b y t h e w a y t u b e r c u l o s i s - - w h i c h as a y o u n g m a n h a d been so g r e a t a p r o b l e m for h i m practising in L i v e r p o o l was in fact fast disappearing. I n t h e same w a y t h e r e was no d i p h t h e r i a which a g a i n h a d been to h i m so g r e a t a p r o b l e m in looking after his many paediatric patients as a young man. And there was the fact that cancer of the lung which was so rare a disease when he was a young man, had become so prevalent a disease. It is interesting also to note that Mr. Hugh Reid, whom I mentioned to you before, once wrote one of the earliest papers on cancer of the lung in Liverpool. He described therein three cases of cancer of the lung occurring in 1922. It is interesting to observe how different the pattern of disease rapidly becomes. Dr. J u l i a n was also v e r y i n t e r e s t e d in literature. H e was p a r t i c u l a r l y i n t e r e s t e d in p o e t r y . H e was a keen p o e t himself, a n d he p u b l i s h e d a b o o k of his own poems. H e h a d a friend who w o r k e d w i t h h i m a t t h e L i v e r p o o l H a h n e m a n n H o s p i t a l at this time, a l a d y friend, who was o b v i o u s l y v e r y a t t a c h e d to Dr. J u l i a n a n d v e r y keen on H o m c e o p a t h y . She was, I t h i n k , a v e r y fine poet, in fact so good as to be a l m o s t u n b e l i e v a b l y good a n d she left, when she died, a collection of her poems in t h e H a h n e m a n n H o s p i t a l . She o b v i o u s l y h a d wished to h a v e a child, b u t she h a d h a d no child. I f I j u s t r e a d to y o u quickly one of t h e poems she left b e h i n d in t h e H a h n e m a n n , w h e n she died, I t h i n k y o u w o u l d see t h e q u a l i t y of t h e p o e t r y which people like J u l i a n a n d his friend were p r o d u c i n g when t h e y were a t our hospital. Dr. J u l i a n ' s friend was s u b m i t t i n g a n i n v o c a t i o n to t h e Goddess K w a n Yin, t h e Chinese goddess of f e c u n d i t y a n d if I m a y s a y so, t h e Goddess who in m a n y w a y s epitomizes H o m c e o p a t h y , t h e Goddess of Mercy, t h e Goddess of Tenderness, t h e Goddess to w h o m m a n y of t h e Chinese t u r n when t h e y look for God. I t is interesting to observe t h a t t h e E g y p t i a n s t u r n e d to a male God of Medicine, t h e y t u r n e d to I m H o t e p , a scribe, a b M d - h e a d e d a n d r a t h e r u n a t t r a c tive-looking i n d i v i d u a l . The Greeks t u r n e d to Asklepios. The Chinese t u r n e d to a female figure, t h e y t u r n e d to K w a n Yin, a Goddess of Mercy, a Goddess of Softness, n o t t h e Goddess K a l i of I n d i a , a Goddess of Revenge, a terrible Goddess of Medicine. No, t h e Chinese t u r n e d to simplicity. J u l i a n ' s friend w r i t i n g t o K w a n Y i n writes as follows: A t e a r d r o p lies, like petMled dew, a g a i n s t her pallid cheek H e r prayers, her sighs, on incense-laden air rise up to seek Compassion from t h e skies.
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Kwan Yin, Kwan Yin, Mother of Mercy, hear; Lady of consolation, Bend low in pity, hear me I pray, Barren am I. At t h y creative word The fish, the flower, the bird Enjoy their yearly birth incarnate on the earth, The sleeping garden wakens, the almond will blossom, Buds will burden the cherry, the fruits will come. But bare, oh bare is m y bosom, Mother of solace and mercy, pity my desolate womb. Visit me with touch that quickens, Goddess most mild; Lady of consolation, earth is with child, Fill me with glad gestation, leave me not alone. Yearning I make petition, grant me Thy highest boon. Grant me to bear My Son. I do not think that many of the products of the Julian "era", from the literary point of view, were extremely high and to a large extent they are more or less unrecognized and unpublished. At the same time when we could boast Dr. Julian we could also boast of Dr. Stuart McAusland. They were two somewhat different characters, but they were both keen disciples of the same discipline. McAusland remained the perpetual student. He was terribly keen on the student body. He was Treasurer of the Students Union Guild throughout his life. He was extremely clever with money, to say the least of it, a great advantage and rare in a medical man. He had been trained as an accountant and he used to create chaos by telling all of us that he never really paid any Income Tax. When he was ill, in his final illness, he informed us in the Hahnemann Hospital that he possessed no less than one hundred and sixty thousand shares in Smith & Nephew. We all immediately felt that he had probably bought one share every time he put on an Elastoplast bandage. He always wished to establish a Memorial Dinner. Indeed his object had been apparently to establish a number of memorial dinners and shortly before he died he was most anxious to do this. What a pity it is that he never accomplished his wish. He wished to have one memorial dinner for the students, he wanted to have one for the Clubs to which he belonged and no doubt he would perhaps have liked to have had one for his Homceopathic Faculty. He was a very attractive and very gracious man and he left behind him a great reputation. Many others we tend to forget, like Mr. Horace Mather--Horace was one of those extraordinary surgeons who was able to do more or less everything. He did both E.N.T.s and Eyes, but he was quite capable of doing all the general surgical procedures perhaps better than I was myself and he was also very versatile in many other ways. He always remarked how strange it was in Liverpool that if you drove through the City you found medicine divided into little boxes. As you went along the street you would see the Eye Hospital, the Ear Hospital, the Nose Hospital, the Foot Hospital and so on. In Liverpool if you went along Myrtle Street all these hospitals had their names on the outside and he used to say how curious it was, since anybody who was any good could do all these things without any trouble at all. Liverpool, however, wanted to chop them off into little boxes.
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We also must not forget that we had a most active Dental Department, run recently by Mr. Smith. Smith, again, was one of those dentists who was capable of doing anything. He used to describe at great length how he took out a large infected molar tooth from our large and imposing gynaecologist, Mr. Saxon Barton. Barton arrived and told Smith he had a "pretty terrible molar". Said Smith, "Yes, it looks pretty terrible to me. Perhaps it would be better if you had it out". "Right", said Saxon Barton, "Take it out". Smith, of course, got out his syringe and his local anaesthetic and was about to plunge the local into Barton's jaw when Barton said: "Oh, none of that high-falutin messing about for me, just take it out". Well, of course, Smith had a long argument with Saxon Barton as to how impossible it would be without anaesthetic and he describes how he grabbed this tooth and hung onto it while his 6 ft. 8 in. patient rolled all over the surgery. Finally Barton was parted from his tooth. The homoeopaths of Liverpool are indeed made of "stern stuff". Hugh Reid, whom I mentioned to you originally, m y mentor, was always a perfect gentleman. It gives me indeed great pleasure to see at this particular meeting a lady who was his House Surgeon. I won't say how long ago Dr. Burger was his House Surgeon. Of Hugh, the perfect gentleman, it is said that one day a tough Liverpool patient who had had a partial gastrectomy performed by him in the hospital--Hugh walked past the patient, having said that he might go out. As he walked past, the patient said "Hey, hey". Hugh stopped and regarded the patient. "~Vhat can I eat", said the patient. Hugh, " I beg your pardon, m y man", fixing his monocle. Again, " W h a t can I eat?" Hugh looked at him and said, "Well, you know, more or less anything, perhaps a little game in season". Then there was the House Surgeon who borrowed a book from Hugh and said: " I must return that book to you as soon as I can". "Oh, no, no, don't bother", says Hugh, "Send it round with your man". Hugh always lived in a little world all of his own. I must tell you that our large friend Dr. Saxon Barton had to help him no less a person than Dr. Cecily Burroughs. Whereas Barton was large and portly, Burroughs was thin and tall. She was a lady of many parts. She had one somewhat unhappy habit which made it difficult for me as a general surgeon working in the same theatre. Like most surgeons she took off her clothing to operate, but she used to leave on a somewhat unusual and highly colourcd pair of bloomers. She naturally wore her gown over these and being short sighted she used to work very close and lean over her patient. Her gown was usually split open down the back and she and her patient presented a somewhat extraordinary sight. One obviously had to show interest in the medical problem involved, but it was difficult at the same time not to observe this somewhat unusual sight. All this time we were fortunate to be backed up by Dr. Ruth Dovey as our anaesthetist. I almost said "Dear old Ruth". No, no, this is the the last thing that I should say, for although she has been an anaesthetist for us for a very long time, she is indeed dear to our hearts. She is "the old faithful" of the surgical floor and is still giving her excellent anaesthetics. Now, however, she is doing a locum for herself and she acts as a locum to the locum anmsthetist. I am sorry in some ways that we meet here in Chester, in that you have been unable to visit and see the attractive features of the Liverpool Homceopathic Hospital. I do feel that it is a great pity that you missed seeing our theatre, because should the hospital close down, some of you may never see it. It is an attractive and unsual theatre. Situated on the top floor, when you enter through the door you are immediately in the theatre itself, there being no anaesthetic
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room. Our a n t i s t a t i c floor covering w o u l d i m m e d i a t e l y c o m m a n d y o u r a t t e n t i o n . W e used to h a v e a floor in beautiful I t a l i a n terrazzo. This was a v e r y fine floor indeed, a b e a u t i f u l thing. I t h a d to go, as it was said n o t to be a n t i s t a t i c a n d i t was r e p l a c e d b y t h e s o m e w h a t hideous coloured squares of r u b b e r which y o u see t o d a y . I well r e m e m b e r when t h e y were completing this a n t i s t a t i c r u b b e r floor, I could n o t for t h e life of me see how it was m o r e a n t i s t a t i c t h a n t h e terrazzo. " W e l l y o u see, Mr. Brewer, it is due to t h e fact t h a t we h a v e copper strips u n d e r n e a t h t h e r u b b e r which help to m a k e it a n t i s t a t i c . " Yes, y o u are quite correct, t h e y h a d p u t d o w n t h e r u b b e r floor w i t h o u t t h e copper strips, so t h e y h a d t o t a k e it all up again. One o t h e r small point. I h a v e a p e c u l a r i t y of colour vision of t h e usual grey, green, r e d t y p e . I believe it is c o m m o n in t h e male a n d as m a n y as I 1 per cent. o f m e n h a v e this defect. This m a k e s it possible to see s o m e w h a t b e t t e r in a d i m light t h a n with t h e o r d i n a r y eye. I f o u n d this v e r y a d v a n t a g e o u s in t h e H a h n e m a n n H o s p i t a l because we h a v e h a d an o p e r a t i n g l a m p , given I t h i n k b y T a t e himself, in t h e y e a r 1893. A l t h o u g h of g r e a t historical i n t e r e s t I a m sure t h a t if I h a d n o t h a d m y m i n o r colour blindness I m i g h t h a v e f o u n d it difficult in m y first t w e n t y y e a r s to see w h a t I was doing. N o w we are u n d e r t h e U n i t e d Liverpool H o s p i t a l s a n d t h e r e are new l a m p s a n d new spotlights all over t h e t h e a t r e . I t is now a l m o s t impossible to see w h a t y o u are doing for t h e glare. The view from t h e w i n d o w of t h e o p e r a t i n g t h e a t r e was second only to t h a t seen from t h e o p e r a t i n g t h e a t r e s of t h e Radcliffe I n f i r m a r y , Oxh)rd. The old Radcliffe t h e a t r e s look out on t h e O b s e r v a t o r y , built in b e a u t i f u l Cotswold stone which, seen in t h e colour of t h e setting sun, is a most b e a u t i f u l thing. The view from t h e H a h n e m a n n H o s p i t a l showed t h e magnificent spire of H o p e S t r e e t Church i m m e d i a t e l y opposite. This was a b e a u t i f u l church b u i l t in the same t y p e of mellow stone as was t h e O b s e r v a t o r y a t Oxford. R o u n d t h e tower of t h e church were four magnificent statues of Saints: Matthew, Mark, L u k e a n d J o h n . I t was clear t h a t L u k e r e g a r d e d t h e h o s p i t a l with special interest. The spire a n d t h e s t a t u e s are no more, as t h e y , like so m u c h else in Liverpool, h a v e been d a s h e d to t h e ground. Dr. Higginson of syringe f a m e was a s i d e s m a n at this church. I t is i n d e e d a g r e a t p i t y t h a t so beautiful a n o b j e c t has been r e m o v e d so t h a t we can now sit a n d see it no more. W h e n I s a y sit, I m e a n sit, because we h a v e a retiring r o o m used b y t h e Surgeons, A n a e s t h e t i s t s a n d Staff. I t is an a t t r a c t i v e room. U n f o r t u n a t e l y it is o n l y some 4 b y 10 ft. a n d t h e p r o b l e m is t h a t if a n y more t h a n t h r e e wish to sit down a t a n y one t i m e t h e n one would h a v e to be more c o n v e n i e n t l y sitting on t h e l a v a t o r y . This is a small p o i n t of little consequence, as ours is i n d e e d a m o s t friendly hospital. The difficulties of changing in this r o o m in m i x e d c o m p a n y can also be considerable a n d of course if a n y of us is on h o l i d a y t h e locum m u s t h a v e all these small m a t t e r s carefully explained. I n spite of m y l i g h t - h e a r t e d a p p r o a c h to t h e a t t r a c t i o n s of t h e L i v e r p o o l H a h n e m a n n H o s p i t a l I a m n a t u r a l l y worried concerning its future. W i t h so m a n y faithful servants over so long a p e r i o d of t i m e it seems indeed a p i t y t h a t it should d i s a p p e a r in t h e m a e l s t r o m of r e o r g a n i z a t i o n which we a p p e a r to be a p p r o a c h i n g . M a n y of t h e s e faithful s e r v a n t s h a v e been its nursing officers. Miss T r a c y who was M a t r o n for m a n y y e a r s a n d our last M a t r o n , Miss H e n d y , who showed such wonderful d e t e r m i n a t i o n a n d character. Miss H e n d y h a d a c a r c i n o m a of t h e k i d n e y r e m o v e d b u t c o n t i n u e d to w o r k for some five years. She d e v e l o p e d a s e c o n d a r y in her lung a n d h a d a p n e u m o n e c t o m y a n d she c o n t i n u e d for a f u r t h e r t h r e e y e a r s as our Matron. Only when she d e v e l o p e d m u l t i p l e m e t a s t a s e s was she u n a b l e to continue. W e h a v e w i t h us t o n i g h t our A c t i n g
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Matron and many other members of the nursing profession, all of whom have shown the greatest interest and devotion to our hospital. We have a multiplicity of nurses, sisters, radiographers, secretaries and many others, who have given long and faithful service to the hospital. I t is, of course, these who have allowed the hospital to continue. One great cause for anxiety is the growth of "administration from a distance". The administrators often have little knowledge of and scant sympathy with the clinical problems of service. One extraordinary thing is that the administrators today seem to think that by the creation of new buildings they can dramatically improve the medical services. Many of us, however, realize, that medical practice consists of the summation of personalities and that if we are to produce the right personalities, in a reasonable environment, our medical services will indeed prosper. This may be difficult in the enormous and complicated buildings which seem so popular in the hospitals of the future. I t is very probable that our hospital here will disappear in the near future with the reorganization of the medical services. When you get to my stage of life you may well feel that you are not too depressed in that you may not have too long to work in the reorganized service. One may, however, worry that we have lost one of the basic facts on which we all agreed to enter a State Medical Service. This is the idea that the patient must have freedom of choice as to by whom he is to be treated and where he is to be treated. The new organization does not directly deny the patient this freedom. The patient, however, is to be "regionalized". Where we now go will largely depend on where we live. The patient is to be sent down a tunnel to the hospital serving the area from which he emanates. We are also told that the all-embracing State Medical Service will not tolerate other than one standard of service. Now we know that standards depend on personalities and their devotion to duty, two qualities commonly found in our hospitals. Indeed many of the smaller hospitals are able to provide services which although less scientific are often more applicable to the patient's problem. I t is a great pity that these smaller hospitals should be closed to make way for the all-embracing, massive, scientific institution. I f the Liverpool Hahnemann Hospital should be one of the first to disappear then it should serve as a warning to you who run your hospitals in other towns. The same may well happen in Bristol, Glasgow and London. You must beware that you are not destroyed by a policy of "omission". Our Liverpool Hospital has long been attacked by this policy of omission. When our gynaecologists retired there was no discussion, they were simply not replaced. The same happened regarding our Eye Department and our E.N.T. Department. When an anaesthetist retires they do not appoint a replacement, they merely appoint a locum. B y this subtle method of omission it is possible to hinder and slowly destroy without the necessity of public argument and discussion. May I, Sir, compliment you and your Faculty on being able to continue in the face of difficulty created by the administrative machine. I would also compliment you on the fact that you have been able to preserve your Faculty in spite of many difficulties. I can only hope, as your guest tonight, that you may long be able so to continue as a Faculty, that you may be able to practice your gentle art and that you may be able to do so with freedom and to the advantage of your fellow man. May I repeat as your guest tonight that I think we might call to m e m o r y - the words of the late Lord Moynihan in his Romanis Lecture of 1935. I think he said "We who, like the happy Warrior, are doomed to go in company with fear and bloodshed, are not as ordinary men. It is for us so to labour that we may prove not unworthy".