ISS: Information Services and Systems

Case 1: Philanthropy and Medicine at Guy's, 1725-1770

Exhibition curator: Brandon High

Title page and frontispiece of: James Howell. Epistolae Ho-Elianae. Familiar letters, domestic and forren. London: printed for Thomas Guy, 1678.

James Howell. Epistolae Ho-Elianae. Familiar letters, domestic and forren. London: printed for Thomas Guy, 1678

Guy's Hospital Historical Collection

James Howell (1594?-1666) was a friend of Ben Jonson and Sir Kenelm Digby, and has been described in the Dictionary of National Biography as, "one of the earliest Englishmen who made a livelihood out of literature". He is also notable for his advocacy of spelling reform, including eliminating the e in "done". The book ran to eight editions before 1754, and is an interesting pot-pourri of speculations on religion, astronomy, wine and tobacco. It is intended to appeal to a wide readership, and its narrow margins and small print indicate that it was not meant to be an expensive production. The edition published by Thomas Guy (1645?-1724) in 1674 is one of the first books which we are certain was published by him.

Thomas Guy's career as an extremely successful bookseller and publisher was marked by an awareness of popular demand for cheap reading material, especially Bibles, which he imported from Holland at first. Through this, and by his arrangement with Oxford University to provide the capital to print Bibles at affordable prices, he accumulated the fortune which he used to found Guy's Hospital.

A copy of the last will and testament of Thomas Guy. London: printed for John Osborn, 1725.

A copy of the last will and testament of Thomas Guy. London: printed for John Osborn, 1725. London: printed in the year 1732.

Guy's Hospital Historical Collection

Thomas Guy's rise from an artisanal background to wealth was aided by a shrewd eye for gaps in the bookselling trade; by investment in government securities; by a frugal lifestyle; and by exceptional luck with his investments in the South Sea Bubble. He became a governor of St. Thomas's Hospital in 1704, and he had endowed its expansion plans. However, demographic pressures threatened to overwhelm existing hospital provision in London. This caused an extension of existing hospitals and the creation of new ones, through the efforts of wealthy philanthropists such as Thomas Guy.

Using the proceeds from his speculation, he founded in 1721 a hospital for four hundred people who were defined as "incurables" (many of whom could survive, but needed longer treatment) and "lunatics", for whom there was no space at St. Thomas's. He left over £200,000 in his will towards the hospital that was to bear his name. Guy's itself was overwhelmed by the end of the eighteenth century, and had to be expanded.

On the front pastedown of the 1725 edition there is a handwritten list which details some of the beneficiaries of Guy's will, including Dr. Richard Mead (1673-1754) and other governors of St. Thomas's. Mead, a noted bibliophile, was physician to the poet Alexander Pope (1688-1744).

William Cheselden. A treatise on the high operation for the stone. London: printed for John Osborn, 1733

William Cheselden. A treatise on the high operation for the stone. London: printed for John Osborn, 1733. [King's College School of Medicine and Dentistry RD581 CHE]

King's College School of Medicine and Dentistry RD581 CHE

Cheselden achieved eminence in his field through the advances which he achieved in lithotomy and ophthalmology. He was renowned for his skill in removing cataracts and for his invention of an artificial pupil.

Although surgery in the eighteenth century usually involved no more than external, relatively minor operations (amputations were rare until Astley Cooper's era in the early nineteenth century) there were some notable advances, one of which was Cheselden's operation to remove bladder stones. He took up the method which had been pioneered by Jacques de Beaulieu (1651-1719), which involved cutting into the perineum and opening up the bladder and bladder neck. The method prescribed by Celsus in the first century AD had led to significant mortality through haemorrhage and incontinence. Cheselden could remove a stone in less than a minute, and more than halved the mortality rate from lithotomy, thus setting a standard for speed and virtuosity in surgery in the pre-anaesthetic era which others felt bound to emulate.

The case history shown here not only illustrates the lack of anonymity which patients had to endure, but also the advances which external surgery was making into more complex operations.

Samuel Sharp. A treatise on the operations of surgery, with a description and representation of the instruments used in performing them ... London: printed by J. Watts: and sold by J. Roberts and J. Brotherton, 1739 . [Guy's Hospital Historical Collection]

Samuel Sharp. A treatise on the operations of surgery, with a description and representation of the instruments used in performing them ... London: printed by J. Watts: and sold by J. Roberts and J. Brotherton, 1739

Guy's Hospital Historical Collection

Samuel Sharp (1700?-1778) was an apprentice pupil of Cheselden. During his apprenticeship he visited France, made the acquaintance of Voltaire, and acquired a knowledge of French surgery which seems to have been necessary for every forward-looking surgeon from Cheselden to Thomas Hodgkin. He was a surgeon at Guy's from 1733 to 1757. Until his resignation in 1746, he gave lectures to naval surgeons which combined instruction on anatomy with the principles of surgery. This was the foundation of William Hunter's Great Windmill Street school of medicine, where lectures on anatomy were attended not only by aspiring surgeons but also by interested men of letters such as the historian Edward Gibbon (1737-1794) and Samuel Johnson.

This page shows some of the instruments used in Cheselden's celebrated operation to remove bladder stones.