BOOKS OF THE DAY
A Medical Cause Célèbre
More11 Mackenzie. By R. Scott Stevenson. (Heinemann. 15s.)
MORELL MACKENZIE, who was born in the year that Queen Victoria came to the throne, can justly be described as the founder in this country of laryngology as a special branch of medicine and surgery. It was he who, as a private venture, founded the first hospital in London especially devoted to the treatment of diseases of the throat. He introduced into England the laryngoscope, the principle of which had been discovered by Manuel Garcia, a Spanish tea:her of sing- ing, in 1854 and later developed by Tiirck in Vienna and Czennak in Budapest ; and his volume on Diseases of the Throat and Nose published in 1880, with a second volume published in 1884, was a pioneer classic on the subject, recognised as such throughout the world. He had distinguished forbears. His grandmother was. an aunt of Rowland Hill, the founder of penny postage, and a great aunt of John Addington Symonds. His uncle, who acted as Henry Compton, was the father of Miss Compton, who married the play- wright R. C. Carton, and of the actor Edward Compton, whose children were to include Fay Compton and Compton Mackenzie. But Mackenzie himself had to struggle against early adversity. His father, a doctor at Leytonstone, died when Mackenzie was only four- teen and the eldest of eight children. Though he had always dreamed of being a doctor he had to obtain work in a city office, reading science before breakfast and attending classes in the evening ; and ultimately it was a benevolent aunt who made it possible for him to enter the London Hospital as a whole-time medical student and later to spend a year at Paris and a further year in Vienna, where he first became interested in laryngology, learned the use of the laryngoscope, and began to see the path of his future success.
• He did not have long to wait for this. At the age of twenty- nine he was appointed assistant physician to the London Hospital, having previously married the daughter of a prosperous Cheapside merchant ; at thirty-three he moved into a house in Harley Street, where he was soon entertaining on a large scale, his guests including Henry Irving, Ellen Terry, Pinero George Grossmith, Whistler and Patti ; and by the time he was ihirty-six his practice had become so large that he resigned his appointment on the staff of the London Hospital. In many ways he was ahead of his times. He believed in medicine as a career for women. He foresaw the inevitability—bitterly- opposed by many of his colleagues—of the increase of specialities such as his o' • and his personal dexterity was admitted by all. But not even M. Scott Stevenson: who has reviewed with immense diligence and care all the circumstances of the cause Mare that was to make Morel Mackenzie, for a time, a world figure, can show him to us either as a lovable or a noble person. He may have been—and indeed probably was—unjustly maligned by thousands, especially in Germany, but after making all possible allowance, it A hard to believe, in the modern phrase, that he did not ask for it.
It was in May, 1887, that he received a summons to go to Berlin to see the Crown Prince Frederick, later for ninety-nine days to be Frederick III, and the father of Kaiser Wilhelm II. Whether his summons originated with the Crown Prince's English wife, the daughter of Queen Victoria, or from the German doctors in attendance on the prince, was later to be hotly debated. But it was Mackenzie himself, Mr. Stevenson tells us, who caused the summons to be printed in The Times as from "our own corres- pondent." The royal patient was suffering from a growth of one of his vocal cords, believed by the majority of the German doctors to be cancer. An operation, which might have involved the removal of his larynx, had been advised—a radical measure which, supposing the diagnosis to be correct, might at that stage have eliminated the disease, but which might also, at that time, itself very probably—on the available statistics—have killed the patient. Mackenzie, before committing himself to a diagnosis, advised the removal of a small portion of the growth for microscopical examina- tion by Virchow, the world's leading pathologist. Two portions were removed by Mackenzie. Virchow's report on each was negative, but not very confidently so. It seems probable that in neither case did he receive a sufficiently large portion of the growth upon which to form a positive opinion. One of the German surgeons alleged that, while removing one of these portions, Mackenzie damaged a vocal cord, which Mackenzie himself indignantly denied. In any case, no operation was performed, the German doctors making it publicly clear that the responsibility was henceforward Mackenzie's, and there then followed a long series of fluctuating reports both in the news- papers and from Mackenzie himself. The Crown Prince was able to attend Queen Victoria's Jubilee and ultimately to succeed—albeit by then an obviously dying man—to the throne.
Owing to the distinction of the patient and the widely advertised personal and racial antagonisms involved, the whole affair became a feast for enterprising journalists of every nation. • Mackenzie seems to have done nothing to discourage this. People crowded to see him wherever he went, and, when his royal patient died from what had almost certainly been cancer from the beginning, he had to face the full blast of inevitable and hostile criticism. That he did not, as was freely alleged, sacrifice his medical integrity far political reasons, Mr. Scott Stevenson would seem to have established. That his treatment rendered more comfortable and perhaps even prolonged his patient's last days is at least arguable, and Frederick himself and his wife believed so. But unfortunately, in reply to the attacks made upon him, he published an acrimonious defence of himself, in popular form, under the title of The Fatal Illness of Frederick the Noble. This very understandably brought down upon him the severe censure of the bulk of his colleagues for unprofessional conduct, and, althouga he won a libel action against The Times, his own last years—he died at the age of fifty-four—remained to some extent clouded. He had been the principal figure—however much or little to be blamed—in an episode that remains one of the least pleasant in the history both
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