West Sussex History of Medicine Society 13th October 2018
Consultant Urologist, Dominic Hodgson MBChB DHMSA MA MSc FRCS(Urol) — who may well be the new ‘face of WSHOMS’ — introduced the speakers, (one of whom was himself!). The topics today were somewhat related in that they covered three historical figures who introduced new techniques to medicine, each in their own unique way.
Lecture 1: Sake Dean Mahomet, Shampooing Surgeon to George IV
By David Beevers MA FSA the Keeper of the Royal Pavilion Brighton
This was the romping tale of the first Indian gentleman to publish a book in English. Not only that, but he started a kind of massage parlour in London, and later Brighton, in which he offered his ’shampooing’ treatments, which are actually more like massage and saunas, and very fashionable.
His name was well known in his time, and even long after his death, though I had not heard of him before. Sake Dean Mahomet (1759 – 1851), was a confident chap, who served in the army of the British East India Company and travelled to Britain with his mentor Captain Baker in 1782. Emigrating to Ireland a couple of years later he ditched his muslim religious origins when he fell in love, and eloped with, an Irish lass, called Jane Daly, with whom he had seven children after becoming an Anglican Christian. He was an enterprising fellow, but a bit of a chancer by the sound of things, writing his book on his travels (The Travels of Dean Mahomet), starting the first Indian restaurant in England too, called The Hindoostane Coffee House in London and promoting his therapeutic ’shampooing’ venture to the well shod and susceptible set.
Lecture 2: Fredrick Henry Horatio Akhbar Mohomed of Guy’s Hospital, the first to describe essential hypertension
By Professor Gareth Beevers MD FRCP FBHS
Taking over from his nephew, the second part of this lecture was given by Professor Gareth Beevers, and continued the story of Sake’s descendants.
Sake’s son, Fredrick, continued the ‘medicated vapour and sea water baths’ in Brighton, whilst his son (Sake’s grandson) Frederick Akbar Mahomed (1849 – 1884), became something of a celebrated nephrologist, and one of a handful of inventive and perceptive doctors involved in identifying and measuring blood pressure for the first time.
The early sphygmomanometer, or sphygmograph, an invention he worked on and improved, has been with us ever since. Fortunately it now functions in a manner that patient and physician alike can use with ease, unlike the original cumbersome tracing device of those early days.
Lecture 3: Chichester’s John Wickham (1927 – 2017) – The Godfather of Robotic Surgery
Having moved to the Chichester area not too long ago, Dr Hodgson wanted to sing the praises of this very local, influential and well loved man.
Though born to a humble family in Littlehampton, and a semi-orphan from the age of five, John Wickham attended Chichester Boys School, where he showed great gifts of intellect and creativity. Pursuing a career in medicine, he gained a place at St Bartholomew’s Hospital Medical School, starting out with an interest in neurology and neurosurgery, but later specialising in urology and, more particularly, renal surgery.
Removal of kidney stones has been a subject great concern for centuries, and they are mentioned in all sorts of literature, so it was well known that this was a tricky and challenging area of surgery. John Wickham rose to the challenge, and, with a degree of chutzpah, convinced medical authorities to permit him to do things which had hitherto not been attempted before.
He used a laser via the ureter to remove the kidney stones, and it worked! He was quoted as saying “I don’t know how we got away with it – Don’t quote me on that!” and later, on his death bed in 2017 he is also quoted as saying “I hope our efforts over these years may have had some small impact on reducing unnecessary surgical injury to our ever trusting patients”.
I include this quote (which I got from Wikipedia) because it seems that, over many centuries, patients have indeed let doctors and surgeons experiment on them — sometimes wildly — yet with a peculiar kind of trust, born in parts perhaps out of desperation, but also, I am sure, from the selfless desire to be part of an advance in medical science. When this trust is rewarded by real success — as with Wickham’s major advancements in surgery (which I will mention below) — all is well, but we need to be mindful that all too often ‘doctors bury their mistakes’.
John Wickham was a man of great skill and inventiveness, introducing extracorporeal shock wave lithotripsy (which vibrates and breaks kidney stones, rendering them more passable), and also laparoscopic nephrectomy, coining the term ‘minimally invasive surgery’.
Though common place now, key-hole surgery was slow to be adopted by surgeons who were familiar with the ‘open’ method of cutting and viewing their patients’ interiors through a wide open incision, with all the obvious potential for tissue disruption inherent in such a procedure.
As the pioneer of robotic surgical instruments, in 1988 Wickham developed a new technique – the automatous robotic TURP machine (trans-urethral resection of the prostate) which was further developed in the USA and called the Da Vinci, and is now used in thousands of surgeries across the world.
After retiring in 1992 Wickham invented a pen-like surgical instrument, the Syclix, used to grab tissue, and was awarded with more than one prize for this:
You can read more about John Wickham under his Old Boy entry at The Chichester High School for Boys.