St Thomas' Hospital: a brief history to1900
The Library at St Thomas'
Journals in the St Thomas' Historical Collection
Some notable provenances
Resources for the history of St Thomas' Hospital and its library
The Historical Collections of the library of St Thomas' Hospital Medical School, which along with those of Guy's and King's College Hospital, is now held at the Foyle Special Collections Library, King's College London, numbers 3,966 monographs and 1,990 journals. It collection includes only pre-1901 material and its particular strengths lie in comparative anatomy and in surgery, with a number of related sciences, such as zoology and chemistry, well represented. The following is an attempt to outline the history of the library against the background of the development of the Hospital and the Medical School.
St. Thomas's Hospital: a brief history to 1900
Although it is possible to regard 1551 as the founding date of the modern St Thomas' Hospital, its origins lie much further back in a small infirmary attached to the Augustinian Priory of St Mary the Virgin (St Mary Overie). During the twelfth century, this stood at the foot of London Bridge in the vicinity of the present Southwark Cathedral.
In 1173, the infirmary (but not the priory itself) assumed the name of St Thomas the Martyr, soon after Thomas à Becket's canonisation. In 1215, owing to a fire which had destroyed the priory three years earlier, the infirmary moved to a site further east from the Old Priory on the north side of St. Thomas's Street, off Borough High Street, which it occupied until it was removed in 1862 by the construction of a railway from London Bridge to Charing Cross.
The Hospital moved to its present site in 1871, having made do for the previous nine years with buildings in Surrey Gardens, Newington, which were formerly used as a music hall and zoo! From 1215 until its dissolution as a religious foundation in 1540 as part of the Henrician Reformation, it was an institution separate from the priory with its own staffing, part ecclesiastical and part lay.
It is not at all clear whether the hospital had its own library or if anything which could be described as a medical book was available to the staff. It is possible that the apothecary possessed some medical treatises, but that is speculation. It has to be remembered that, as was the case with other religious institutions, the infirmary cared for the old, beggars and travellers in general, particularly those embarking on a pilgrimage to Canterbury. Long after hospitals had started to specialise in the care of the sick they were still primarily places for the poor and not the affluent. In this, they retained a vestige of their ecclesiastical inheritance. In 1540 the infirmary had approximately 40 patients but it is not known how many of them could be designated as such in the term's modern usage.
Throughout this period St Thomas' depended on almsgiving by ecclesiastical and lay benefactors, including such wealthy City merchants and aldermen as Richard Whittington (fl. ca. 1350-1423), who established a refuge for unmarried mothers there. In this period lie the origins of the close association of St. Thomas's with the City of London, which was to be crucial during times of crisis and rebuilding. The prominent Whig politician and City financier Sir Robert Clayton (1629-1707) played a major part in rebuilding the Hospital at the end of the seventeenth century, partly through supplying his own funds, as did Thomas Guy and Sir Christopher Wren. Through successive re-buildings and refurbishments, the Hospital used the restricted space available to it to the best advantage, accommodating improving standards of cleanliness, demographic pressures and the demands of increasingly professional teaching and the widening scope of medical research.
In 1551, eleven years after the religious foundation was closed and the staff dismissed, the Mayor of London and the Bishop of London (Nicholas Ridley) petitioned Edward VI to re-found St Thomas'. There was a pressing need for such an institution, not only to fulfil its former role but also to cope with new demands, such as the care of soldiers wounded in the Irish wars. In this capacity, the hospital would also be much needed in the English Civil War. From 1551, it was known as the "Hospital of St Thomas the Apostle", to reflect the new Protestant dispensation.
From the middle of the sixteenth century the governors managed the properties (including the estates of Savoy Hospital, which now formed part of St. Thomas's endowment) which provided the Hospital with much of its income and paid some of the medical staff's salaries; the remainder was derived from the fees paid by the apprentices, dressers and pupils of the surgeons, and, from 1715, the pupils of the Hospital Apothecary. A dresser lived with the surgeon, whom he assisted, and would have had access to his medical books. Pupils were not attached to a particular surgeon and, in the absence of a library, had difficulty in obtaining access to books.
From the middle of the sixteenth century, the Hospital began to acquire both the recognisable generic features of a modern hospital and the particular characteristics of innovations in both surgical practice and medical care which have become the hallmarks of St Thomas'. At the beginning of the seventeenth century it ceased providing for night-lodgers and pensioners, in order to concentrate on its role in caring for the sick. New rules, stringently applied, controlled the movements and behaviour of patients. It became the first hospital to provide separate male and female wards for patients suffering from venereal disease.
During the sixteenth century and for much of the seventeenth St Thomas' had only three surgeons instead of six, as originally planned. This perhaps reflected the sharp diminution in the number of patients for whom the hospital catered from the original number of 300. Despite this, it acquired, from the early seventeenth century, a distinctive profile as a hospital which specialised in lithotomy, as practised by Thomas Hollier (fl ca 1609-1690) and by three generations of the Molins family. This tradition was carried on by William Cheselden (1688-1752) in the following century. Through their efforts and through the work of Sir Astley Cooper (1768-1841) on cancers of the testis and of the breast, St. Thomas's made a significant contribution toward the enhanced esteem which surgery began to enjoy from the eighteenth century onwards.
As the surgeons, and not the physician, had apprentices and pupils (a fact which was officially recognised in 1702) they were able to exert much influence in the medical world. Parallel with this was the association of St. Thomas's with anatomical investigation. Cheselden had his own anatomy school; Henry Cline (1750-1827), who taught Sir Astley Cooper, had himself been taught by John Hunter, arguably the most distinguished British anatomist of the eighteenth century. The anatomists Joshua Brookes (1761-1833) and Richard Grainger (1801-1865) had connections to St Thomas': Grainger took up an appointment there in 1842 and both bequeathed their libraries to St.Thomas'. Henry Cline was a proponent of Jenner's method of vaccinating against smallpox, although another surgeon at St Thomas', John Birch (1745-1815) opposed Jenner. Birch was also a proponent of the use of electricity in healing, sometimes preferring it to surgery.
Those who occupied the post of Physician at St Thomas' were often no less distinguished, even though some, such as the bibliophile and art connoisseur Richard Mead (1673-1754) and the poet Mark Akenside (1721-1770) were somewhat more renowned for their cultural interests than for their medical work. Thomas Wharton (1614-1673) wrote the first major work on endocrinology ; Sir Gilbert Blane (1749-1834) made pioneering discoveries on the causation of scurvy by diet; and John Elliotson (1791-1868), though diverted by mesmerism and spiritualism, introduced the stethoscope to England, and was the first to link atmospheric conditions with hay fever. Until the late eighteenth century, physicians were expected to acquire cultural accomplishments and social polish as well as medical knowledge, and, unlike surgeons, were not deemed lowly enough to get their hands dirty. Blane, however, had been a naval surgeon before being appointed Physician at St. Thomas's, so this perhaps points to the rigid distinction between the two starting to break down.
During the nineteenth century, St Thomas' continued to be a trailblazer in adopting medical improvements, such as anaesthetics and asepsis. The establishment of a nursing school at St. Thomas's (despite the objections of some of the medical staff) by Florence Nightingale (1820-1910), which aimed at the creation of a unified nursing profession with common training and standards of care, contributed to this reputation. Sir John Simon (1816-1904) was for many years a lecturer in pathology and full surgeon at St Thomas', but was more celebrated for his work in public health and disease prevention. Nightingale and Simon were rivals in the field of public health, and both entered into controversy about the location of St Thomas'. Nightingale favoured a more rural location and Simon a more central one.
The Library at St Thomas'
Unlike the library of the Guy's Hospital Physical Society, which was acquired over time through a deliberate intention to purchase those texts which were needed by medical students, the library at St. Thomas's was before 1900 largely built up through donations and bequests. The provenance of many of the books is thus intimately connected with the history of the hospital and its medical school. It tends to reflect the medical specialisms of St Thomas' until the 1830s (when it was forced to develop additional areas of expertise), such as anatomy and surgery, even though there was apparently no deliberate policy to develop collections systematically in these areas.
Although no date can be ascertained for the establishment of the library, one seems to have been in place by the 1740s. From its earliest days, Richard Mead donated books from his important collection; this example was followed by John Flint South and Joseph Henry Green. The death of Joshua Brookes, the closure of Richard Grainger's anatomy school in 1842 and the generous donations of Sir Arthur Howard, a Treasurer of St Thomas' during the mid-twentieth century, have resulted in significant holdings of human and comparative anatomical works, including early editions of Vesalius, Helkiah Crooke, Albinus and Gautier d'Agoty. Many of them still retain their original bookplates. In those cases where the bookplates have been removed, the provenances are recorded in the St. Thomas's card catalogue, available in the Foyle Special Collections Library. Later in the nineteenth century, the donation of many of Sir John Simon's books (primarily in the field of public health) and the acquisition of the private library of the Hospital Apothecary, Richard Gullet Whitfield, broadened the collection. Some items which were presented by Florence Nightingale to medical staff at St Thomas' mark significant milestones in the Hospital's history.
From the early 1840s, the library at St Thomas' began to acquire the characteristics of a professionally managed organisation. It is not coincidental that this occurred at approximately the same time as the Hospital took the medical school under its wing and initiated several reforms, including the establishment of a Medical School Fund and a Medical School Committee and the opening of dresserships to competition. These changes had taken place because the acrimonious conclusion in 1825 of a previously symbiotic relationship between the medical schools of Guy's and St Thomas' had left the medical school at St. Thomas's financially and professionally exposed. The cost of maintaining new facilities and the departure of several lecturers only served to underline the crisis. The problems were aggravated by competition from the new university medical schools in London.
An inquiry into the library service in 1836 (the same year in which a student fracas over the presumed right of dressers at Guy's to attend surgical demonstrations at St. Thomas's had led to the end of co-operation between the Guy's and St. Thomas's medical schools) concluded that the library service had to be established on a more professional basis. However, as the library was funded throughout the nineteenth century by subscription (a guinea per member), and not by direct subvention from either the Medical School or the Hospital, it had to continue to rely on bequests and donations.
Accordingly, in 1842, the first Librarian, a Mr. Burrows, was appointed at a salary of £100. Although he was at first expected to make anatomical drawings, it was recognised after a few years that the work required the Librarian's constant attention. A catalogue and an acquisitions policy were put in place. In 1860 a fines system was introduced, with a charge of a shilling per volume. The Librarian kept a list of missing volumes and checked the book stock twice a year. In addition to books and journals, the library housed a collection of bones and, from 1857, a microscope. Meetings of the students' Physical Society were held in the library. With the acquisition, over a period of thirty years, of the collections of Brookes, Grainger and Whitfield, the Medical School acquired both a working library and historical medical collections dating back to the late fifteenth century.
Journals in the St Thomas' Historical Collection
As most of the St. Thomas's Historical Journals Collection was acquired after the medical schools of Guy's and St Thomas' separated, it attempted to provide a self-sufficient, core collection of journals, reflecting the enhanced importance of the periodical as a publication genre from the late eighteenth century onwards. From this period, pamphlets began to be subsumed in journals as the volume of research intensified and the demand for it from a growing number of medical students increased. The establishment of university medical schools from the 1820s ensured that there would be libraries which could hold long runs of journals.
However, as might be expected, there is an emphasis on surgery. There are some comparatively rare serials, including the Sussex County Asylum Reports, the Annals of Medicine and Surgery and the Centralblatt für offentliche Gesundheitspflege, and some which date from the seventeenth century, such as the Journal des scavans (1664-1690).
Some notable provenances
Albert James Bernays (1823-1892) Bernays' inscription is in volume 1 of the Jahresbericht uber die Fortschritte der Chemie und der Mineralogie. Bernays was the son of Dr. Adolphus Bernays, Professor of Modern Languages at King's College London. He was educated at King's College School. He studied chemistry under Justus Liebig at Giessen. In the 1840s and 1850s, he established his reputation as a popular lecturer and writer on science, giving more than a thousand free public lectures. He also developed an interest in food and hygiene, and in 1851 served as a juror for those classes at the Great Exhibition. From 1860 until his death he was lecturer in chemistry at St Thomas'. He made inventions in water filtration and investigated the atmosphere in Cornish mines. Several of his works are included in the St Thomas' Historical Collection, such as Household chemistry and Manuals of health.
Joshua Brookes (1761-1833) Brookes, whose bookplate is attached to volume 1 of the Essays and observations, physical and literary, was a noted anatomy lecturer and demonstrator of the late eighteenth and early nineteenth centuries. Brookes, like other anatomy teachers, used his home to store his collection of anatomical specimens and to teach medical students (with whom he was very popular, as he used specimens rather than pictures in his lectures, and his fees were only half those of the College Council of the Royal College of Surgeons). His collection of more than 6,000 preparations, models and casts was considered second only to that of John Hunter, probably the most renowned British anatomist of the eighteenth century. He was elected a Fellow of the Royal College of Surgeons in 1819 for his discovery that injecting his specimens with nitre could improve their preservation in hot weather. Brookes' career ended when the Royal College of Surgeons decreed that only certificates issued from the universities and from London hospitals, or countersigned by London surgeons, were valid. It can be speculated that professional jealousy played a part in his downfall.As the historian Susan Lawrence records , for many years attendance at Brookes' demonstrations was highly recommended for London medical students.
Henry Cline (1750-1827) Cline, whose signature can be found in two volumes of the Medico-Chirurgical Transactions, was a pupil of John Hunter, and surgeon at St Thomas'. He taught Astley Cooper, and was a friend of John Thelwall and Horne Tooke, both of them radicals. He used his influence to ensure Cooper's safety while he was studying in France.
Sir Robert Jones (1857-1933) The bookplate of the orthopaedic surgeon Sir Robert Jones is on the front pastedown of the Guy's Hospital Reports for 1882. He established in 1906 one of the first orthopaedic outpatient clinics, the only one at the time to cater for both injured workers and for disabled children. He was also innovative in the way he used physiotherapists, social workers and limb setters in the healing process. He was very successful in applying these methods to injured soldiers of the Great War, and assisted in restoring them to full operational condition. He did much to establish orthopaedics as a medical discipline in its own right. He established the orthopaedic department at St Thomas' in 1919.
Charles Murchison (1830-1879) The inscription of Charles Murchison can be found on some volumes of The Annual Register of Births, Marriages and Deaths, The British and Foreign Medico-Chirurgical Review and Reports of the London Fever Hospital. Murchison was assistant physician at King's College Hospital from 1856 to 1860, and became physician and lecturer in medicine at St Thomas' in 1871. He was best known for his work on the means of communication of typhus and of typhoid fever. He also wrote widely on liver diseases, although his work ignored the contribution of biochemistry in this area.
Sir John Simon (1816-1904) Sir John Simon, whose elegant bookplate can be found in several journals in the St Thomas' Collection, including the Centralblatt fur offentliche Gesundheitspflege, a leading German public health journal, worked at both King's College Hospital and at St Thomas'. He was demonstrator in anatomy at King's College London from 1830 to 1847 and assistant physician at King's College Hospital from 1840 until 1853. He was appointed lecturer in anatomical pathology at St. Thomas's in 1847, and was full surgeon at St. Thomas's from 1863 to 1876. Simon's fame lies in the area of public health, in which he held several appointments, and enjoyed an importance equal to that of Sir Edwin Chadwick, with whom he did not always see eye to eye. Several monographs in the collection by English and German authorities in the area of public health are inscribed to him. The collection also includes first editions of works by Sir John Simon which cover problems such as poor sanitation and adulteration of food, such as Reports relating to the sanitary condition of the city of London (1854).
Carl Sternberg (1872-1935) Sternberg's bookplate and bookstamp are in three volumes of the Wiener klinische Wochenschrift. He specialised in tuberculosis and bowel diseases, and also extended Thomas Hodgkin's researches in the field of leukaemia. He was a military doctor during the Great War and was renowned for his concern for the welfare of soldiers. These volumes were donated to St Thomas' Hospital after his death.
Joseph Griffiths Swayne (1819-1903) Swayne, whose bookplate can be found in some copies of the Bristol Medico-Chirurgical Journal, studied at Guy's Hospital after attending Bristol Medical School and the Bristol Royal Infirmary. In common with the general concerns of nineteenth century medical science, he advocated hygienic improvements in surgical practice, including asepsis in the operating environment, and short hair and beards for those practising surgery or midwifery, it had been common practice for surgeons during the eighteenth century to retain their wigs while operating ! His career testifies to the existence of a medical tradition outside London. In Bristol the most outstanding representative of this tradition was Thomas Beddoes.
John Louis William Thudichum (1829-1901) Thudichum's inscription can be found in one of the issues of Annals of chemical medicine, which he edited, and which also records his giving it to Sir John Simon. He had to flee German-speaking countries after the 1848 revolutions. He was no longer welcome during the period of reaction after 1848, because he had supported the republicans. From 1864 to 1883 he was chemist to the Local Government Board under Sir John Simon, with whom he shared literary and artistic interests. In 1866 he won a silver medal of the Royal Society of Arts for a paper on "Diseases of meat as affecting the health of the people." He also conducted important research on the chemistry of the brain and the use of electricity in treating disease. From 1865 until 1871 he was first lecturer and then director of a new laboratory of chemistry and pathology at St. Thomas's. He served as a volunteer surgeon during the Franco-Prussian War, as did another member of staff at St. Thomas's, the surgeon and lecturer Sir William MacCormac (1836-1901).
Resources for the history of St Thomas's Hospital and its library
Lists of the catalogued books and journals held in the St Thomas' Hospital Historical Medical Collection can be obtained from the Library catalogue. The Archives of King's College London hold a significant amount of material relating to the history of St Thomas' Hospital and its medical school as does the London Metropolitan Archives.
David T. Bird. Catalogue of the printed books and manuscripts (1491-1900) in the library of St Thomas' Hospital Medical School. London: St. Thomas's Hospital Medical School, 1984. [Special Collections Reference Z921. S7 B5 ]
C. L. Feltoe (ed.) Memorials of John Flint South. London: John Murray, 1884. [St. Thomas's Historical Collection 28.e.7]
E. M. McInnes. St. Thomas' Hospital London. London: St. Thomas's Hospital, 1990. [Special Collections Reference RA988.L8 S53 MCI]
Susan C. Lawrence. Charitable knowledge: hospital pupils and practitioners in eighteenth century. London: Cambridge: Cambridge University Press, 1996. [New Hunt's House/ St. Thomas's WZ56 LAW]
F. G. Parsons. The history of St Thomas' Hospital. London: Methuen & Co., 1932-1936. [Special Collections Reference RA988. L8 S53 PAR.]