James Wardrop

Educated at Edinburgh, London, Paris, Berlin and Vienna, James Wardrop took an early interest in applying the emerging principles of pathology to enhance the understanding of eye disease in the early years of the nineteenth century. He described keratic precipitates and coined the term “keratitis” as well as classifying retinoblastoma as a malignant tumour. His management of sympathetic ophthalmitis and attribution of corneal oedema to raised intraocular pressure have further added to his reputation as the father of ophthalmic pathology.

Studying first at Edinburgh under John Barclay and Alexander Monro Secundus, he was apprenticed to Benjamin Bell, James Russell and his own uncle Andrew Wardrop. He further studied moral philosophy under Dugald Stewart and as a member of the students’ Academic Society befriended David Brewster who later became Principal of St Andrews and Edinburgh Universities. He then sailed to London where Astley Cooper and John Abernethy taught him at Guy’s and St Thomas’s Hospitals. Making his way to Paris during the respite in hostilities afforded by the Peace of Amiens, soon after his arrival he was interned by Napoleon’s troops, but made his escape bearing a false passport in the name of an American merchant. He travelled to Germany and Austro-Hungary learning the new surgical techniques in Vienna and Berlin before returning to Edinburgh. During his time in Europe he also added to his collection of minerals.

He became a Member of the Royal College of Surgeons and was appointed to a post in the Pathological Museum where his entries in the first catalogue can be found. He was in practice with his uncle and also at the Royal Public Dispensary, and published “Essays on the morbid anatomy of the human eye”, and his work on retinoblastoma entitled “Observations on the fungus haematodes”, but finding his opportunities for developing his own clinical practice were limited he moved to London in 1809.

In London he established himself in practice in St James’ and continued to publish case reports and a second volume of “Essays on the morbid anatomy of the human eye”. He did not hold an appointment at the major teaching hospitals, and founded the West London Surgical Hospital off Edgware Road, a voluntary hospital giving free treatment to the poor. In his private practice he attracted members of the staff of the Prince Regent at nearby Carlton House, and through this and knowledge of horses dating from his childhood he came to the attention of the Court officials. He was appointed an Extraordinary Surgeon to the Prince Regent just before the death of George III, and continued in this office with the newly crowned George IV. He travelled with the King on his visit to Edinburgh in 1822, when they became more closely acquainted.

He taught at the Aldersgate School of Medicine and later lectured in anatomy and surgery at the Windmill School and published work on the treatment of aneurysm by distal ligation, but an outspoken and critical man, he antagonised senior members of the London medical establishment, who were also influential members of the King’s circle. He played an active part in successfully opposing restrictive practices in medical education on the part of the Royal College of Surgeons of England. George IV’s lifestyle was anything but healthy and his illnesses became more protracted until in 1830 he died. His close medical advisers, particularly Sir William Knighton, excluded Wardrop from attending him in his last illness and he became more embittered. After the King’s death he published anonymous “Intercepted Letters” in The Lancet which purported to be written by the late King’s doctors, containing scurrilous comments on one another. Wardrop was identified as the true author and he became further alienated. His continuing support of blood letting as a mode of treatment when it had already been discredited was detrimental to him, but he published a book on diseases of the heart nevertheless. His compatriot from West Lothian, Robert Liston, on moving from Edinburgh to London complained that Wardrop blocked him out of practice with the Scottish nobility, but his practice declined and he became more embittered.

He had studied drawing in Edinburgh and knew David Wilkie and Andrew Geddes from schooldays. At one time his collection contained works by Corregio, Rubens, Cuyp, Tiepolo, Gainsborough, Turner and Wilkie and on the formation of the National Gallery of Scotland in 1850 he donated two paintings which remain in the collection.

He became reclusive for several years but would entertain his old friends who visited him and after he died at his London home was buried in Bathgate near his mother’s ancestral burial place in accordance with his wishes.

His contribution to the understanding of ophthalmic pathology helped to reclassify inflammation of the eye, hitherto referred to as ophthalmia whatever the cause, and his recognition that early excision would improve the prognosis in retinoblastoma, the malignant tumour of the retina occurring in childhood, has since been implemented. His observations on the management of perforating injuries of the globe in horses led to treatment by early evisceration or enucleation in humans and provided the only treatment to avoid blindness for the succeeding hundred years. Considering the primitive instruments and illumination available to him, his contributions to the advance of clinical practice were remarkable.