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Astley Paston Cooper, the son of Dr. Samuel Cooper, a clergyman, was born in Brooke, Norfolk on 23rd August, 1768. At the age of sixteen he became a medical student at St. Thomas' Hospital in London. He studied under Henry Cline and John Hunter.
Henry Cline had radical views on politics. According to Druin Burgh, the author of Digging up the Dead (2007): "Henry Cline... believed that parliamentary representation should not be the property of rich landlords, and that the payment of taxes brought with it the right to have a say in how they were spent, a right to a voice in the running of the country."
Henry Cline introduced Cooper to friends such as John Thelwall and John Horne Tooke, who were active in the campaign for parliamentary reform. Both men were eventually imprisoned for their beliefs.
Cline also supported the French Revolution claiming that the "French revolution was a glorious cause for a man to shed his blood in." Cooper visited Paris during the revolution and observed what became known as the September Massacres when almost 1,500 people were killed. Cooper managed to escape back to London. He later wrote: "A revolution may sometimes be a good thing for posterity, but never for the existing generation for the change is always too sudden and violent."
In 1789 Cooper was appointed demonstrator of anatomy at the hospital. Two years later he became joint lecturer with Henry Cline in anatomy and surgery. In 1800 he was appointed surgeon to Guy's Hospital.
In 1804 Cooper published the first volume of Anatomy and Surgical Treatment of Hernia. The second volume appeared three years later. As a result of this important work he was elected as Fellow of the Royal Society. He was appointed professor of comparative anatomy to the Royal College of Surgeons.
In 1817 he performed his famous operation of tying the abdominal aorta for aneurism. Astley Cooper was now one of the most well-known doctors in England and it is reported that he had an annual income of £21,000. In 1820 he removed an infected sebaceous cyst from the head of George IV. The following year he received a baronetcy.
Cooper was subsequently appointed sergeant surgeon to George IV, William IV and Queen Victoria. Other publications by Cooper include Dislocations and Fractures (1822), Lectures on Surgery (1827), Illustrations of Diseases of the Breast (1829), Anatomy of the Thymus Gland (1832) and Anatomy of the Breast (1840).
Astley Cooper died in London on 12th February 1841.
Astley Cooper: Surgeon to rich and famous
Sir Astley Paston Cooper was the most distinguished British surgeon of his day. In 1793, the then Professor Cooper was appointed Lecturer in Anatomy at the Royal College of Surgeons for three years. This involved the duty of public dissection of criminals executed at the Old Bailey. He was also in contact with the Resurrectionists, (body snatchers), who supplied corpses for his experiments.
Professor Cooper’s private practice became the largest that any Surgeon had ever held, and amongst his many rich and famous patients were George IV, the Duke of Wellington and Sir Robert Peel. In 1820, he was called upon to perform an operation on George IV, for which he was later awarded a baronetcy. Apart from a house in London, Sir Astley spent a great deal of time at his Gadebridge Estate.
Hemel Hempstead Local History and Museum Society cared for by the Dacorum Heritage Trust
It was transferred in 1831 to the West Herts Infirmary, endowed and built by another local landowner, Sir John Saunders Sebright. Since he was childless, Sir Astley was succeeded at his death on 12 February 1841, by his nephew, Astley Paston Cooper. It was his eldest son who succeeded as the third baronet on 6 January 1866.
Until the end of the nineteenth century, the local landowners, as Justices of the Peace, were all powerful. Thus Sir Astley, the first Baronet, was a magistrate for Hertfordshire and his great-nephew, the third Baronet, was a magistrate for both Hertfordshire and Suffolk and also became High Sheriff for Hertfordshire in 1885. Although the Bailiwick was controlled by the Whigs, the Cooper family maintained a strong Tory-Anglican influence for most of the nineteenth century. They were all elected to the Bailiwick Jury and the first Baronet was elected Bailiff in 1825.
The third Baronet held office in 1873 and his youngest brother, Clement Astley Paston Cooper, also became Bailiff in 1885. Although the second Baronet did not hold office, he interfered in the Bailiwick’s affairs, whether it was the construction of the Gas Works or the building of the new Town Hall. Instead of the Bailiff , it was he presided over all the Bailiwick functions, including the prestigious Wool Fair Dinner.
Sir Astley Paston Cooper’s “Manual of Surgery”.
The Dacorum Heritage Trust
*To find out more about this family and to discover what life was like in Hemel Hempstead’s High Street, see ‘Times Highway’, by Elizabeth Buteux, published by The Dacorum Heritage Trust or call 01442 879525
The Beauty of Bodysnatching
Wax model in the natural history museum La Specola in Florence, Italy, is one in a collection designed to teach anatomy. From the late eighteenth century to the middle of the nineteenth, various artists sculpted clay models based on dissections from the Hospital of Santa Maria Nuova. Plaster molds were made of the models, then casts were made using a mixture of waxes, resins, and coloring agents, after which the models were assembled and given finishing touches.
Born body and soul into the Romantic era, Hector Berlioz found beauty in the wonder of music. As the son of a physician, however, he was encouraged by his parents to enter a career in medicine. When he began anatomical studies, he found the dissecting room was not wholly his idea of a pleasant place:
At the sight of that horrible human charnel-house, its fragments of limbs, its grimacing faces and cloven heads, the bloody cesspool in which we walked around, the revolting odor it exhaled, the swarms of sparrows fighting over scraps of lungs, and the rats in the corners gnawing bleeding vertebrae, such a feeling of horror possessed me that I leapt out of the window, and ran panting home as though Death and all his hideous crew were at my heels. I spent twenty-four hours stunned by this first impression, wanting to hear no more talk of anatomy, or dissection, or medicine, and meditating on a thousand mad schemes to extricate myself from the future that menaced me.
In spite of that initial shock, Berlioz managed to stick with his studies, at least for a time.
I consented to return to the hospital and face the funereal scene once more. How strange! Seeing again the objects that had inspired in me such profound horror, I remained perfectly calm, I felt absolutely nothing but a cold disgust I had become as familiarized with the spectacle as a veteran soldier. It was all over. I even found some pleasure in rummaging in the gaping breast of a poor corpse for a bit of lung to feed the winged inhabitants of that charming place.
“Well done!” cried [my fellow student] Robert, laughing, “You are becoming quite human! Feeding the little birds!”
“And my bounty extends to all nature nature,” I answered, throwing a shoulder-blade to a great rat that was staring at me with famished eyes.
As a young medical student, I did not expect experiences with corpses to be easy (one might be worried if they were). What I was unprepared for was the physical impact of the hospital. The wards seemed full of the elderly, the decaying, and the demented. The smell of incontinence and diarrhea seeped into the air, clinging to me when I walked home. The institutional food merged its sickly perfume with that of the patients. They sat vacantly propped in their beds or slumped in chairs, a few clutching tattered magazines or newspapers (I came to realize that these barely altered—the same paper would do as well one day as the next). Books were scarcely to be seen, conversations hardly heard. How grateful I used to be to escape, and when it was into a sunny evening and a warm breeze, it felt like leaping into cleanness. Keats, who qualified as a family doctor and a surgeon, recalled the horrors of his own hospital wards in one stanza of his Ode to a Nightingale, wishing to
Fade far away, dissolve,
and quite forget
What thou among the leaves
hast never known,
The weariness, the fever, and the fret
Here, where men sit and hear each other groan
Where palsy shakes a few, sad,
last gray hairs,
Where youth grows pale,
and spectre-thin, and dies
Where but to think
is to be full of sorrow
And leaden-eye despairs,
Where Beauty cannot keep
her lustrous eyes,
Or new Love pine at them
In the Romantic era in particular, where you saw beauty—or horror—was a matter of acute and widespread concern. There was more wisdom in birdsong than in study, wrote Wordsworth. Yet while he was writing about the spiritual benefits of the countryside’s natural beauty, and Keats was worn into retreat by his experiences of suffering and death, another man was heading wholeheartedly in the opposite direction. He lived from 1768 to 1841, and his international reputation—among the populace as much as the cognoscenti—was remarkable. “We think it is indisputable that no surgeon in this, or any other country,” said one obituary, “ever realized such a fortune, or acquired such wide spread fame.” The Times of London said his career had made him the richest professional man, of any profession, ever to have lived.
Sitting around their fireside while snowstorms came down on the Yorkshire moors, the Brontë family—not medical in the least—included this surgeon in their imaginary games, placing him alongside the Duke of Wellington, conqueror of Napoleon, in their personal pantheons. He was intimately involved in the French Revolution and came close to being executed for treason for supporting revolutionary democracy in Britain. Unless you happen to be a surgeon or a medical historian, however, you are unlikely to have heard of him. His name was Astley Paston Cooper.
What had Cooper done to achieve such success, such fame? His anatomical and surgical advances are traditionally given as reasons, but for all the orthodoxy of answering the question in that manner, it’s a mistake. His discoveries about blood vessels, joints, limbs, ears, breasts, hernias were real and they mattered. Underlying those triumphs, though, was something else. Cooper showed an ability to pursue scientific thoughts in ways that others could not, and it came not from any cold intellectual superiority but from a warm aesthetic one. What drove Cooper and made him special was his peculiar ability to fall all-consumingly in love with parts of natural history that were ostensibly revolting.
Attracted partly by the conjunction of his once-sweeping fame and his present obscurity, partly by his wild and colorful life, I spent some time writing a biography of Cooper. More than anything, though, what fascinated me about him was his influence on Keats, who was his student and who, I should admit immediately, has always seemed to me one of the finest men to have ever lived. Keats, as tough as they came, was the opposite of an effete and dreamily disconnected Romantic. A small man who handled himself well in a fight, he would enter into one on principle when he saw bullying or cruelty. While still a student he was awarded a prestigious assistantship in one of the world’s leading hospitals, and his daily work there was grim, bloody, and brutal. Keats wrote poetry as a way of grappling with the reality of the world, its ugliness as well as its beauty, and of doing some great and lasting good. He was a surgeon for the same reasons. Why did he admire Cooper? In his surviving letters Keats never says, but it was for something more than the older man’s financial success and operative skill.
A charismatic but shiftless adolescent, Cooper seemed set on fraud and criminality. What pushed him onto a more adult path was anatomy. A mentor, despairing of Cooper’s failure to attend to his studies, decided to no longer tolerate the young man’s lack of attendance in the dissecting room. In the blunt manner of the time, he brought a human arm home and slammed it down on a table, demanding Cooper immediately set to work dissecting it. Cooper did so. Something about the arm gripped him, and it never let go. As an old man, Cooper remarked that he felt the day wasted if he laid his head on his pillow without having dissected something. His days were rarely, in that sense, ever wasted.
The literal truth of the anecdote has to be dubious, at best. Romantic biographies had a tradition, even in their own day, of describing childhoods of ruinous wildness that were transformed by moments of epiphany into greatness. While the incident almost certainly happened, I am not at all sure that Cooper’s transformation was quite as sudden as it is portrayed. But in later life, that’s what he believed had happened: he believed that the beauty revealed by human dissection had blasted his youth into a love affair with the hard study of reality, and away from the slick easiness of delinquency.
The laws he continued to break were those on the desecration of graves, since in those days to study anatomy required stealing corpses. Cooper went from digging them up himself in the dead of night to running an international network of men who did it for him. As king of the body snatchers he acquired human dead in every state of liquefaction and decay. He risked himself daily in order to examine bodies—the slightest slip and the smallest wound, and infections commonly turned anatomists into cadavers.
“Become a doctor!” exclaimed Berlioz.
Study anatomy! dissect! witness horrible operations! instead of delivering myself heart and soul to music, that sublime art of which I had already glimpsed the grandeur! Forsake the empyrean for the saddest place on Earth! The immortal angels of poetry and love and their inspired songs for filthy hospitals, dreadful medical students, hideous cadavers, the shrieks of patients, the groans and death-rattles of the dying. Oh! no, it seemed to me the utter reversal of the natural conditions of my life—monstrous and impossible.
If I had come across Berlioz’s writings in the years I first walked the wards of hospitals, I’d have agreed wholeheartedly. Even today I think he has a point.
Literature professors—who preach about the importance of reading, but often have a disdainful and shaky grasp of the literature of science—give us Keats on how the delight of the rainbow is destroyed by unweaving it, Wordsworth announcing that “we murder to dissect.” What gets more often overlooked is Keats as a bloody and successful surgeon, Coleridge as a devotee of science (“I shall attack [study] Chemistry, like a Shark”), and Wordsworth as someone capable of recognizing not merely the utility of science but also its natural beauty. “Wherever we sympathize with pain,” Wordsworth wrote, “it will be found that the sympathy is produced and carried on by subtle combinations with pleasure.”
The Man of Science, the Chemist and the Mathematician, whatever difficulties and disgusts they may have had to struggle with, know and feel this. However painful may be the objects with which the Anatomist’s knowledge is connected, he feels that his knowledge is pleasure and where he has no pleasure he has no knowledge.
Wordsworth may have been the leading poet of his day, but the leading critic was William Hazlitt. He reached similar conclusions:
The anatomist is delighted with a coloured plate, conveying the exact appearance of the progress of certain diseases, or of the internal parts and dissections of the human body. We have known a Jennerian Professor as much enraptured with a delineation of the different stages of vaccination, as a f lorist with a bed of tulips. . . . Not only the imitation pleases,—the objects imitation pleases,—the objects themselves give as much pleasure to the professional inquirer, as they would pain to the uninitiated. The learned amateur is struck with the beauty of the coats of the stomach laid bare, or contemplates with eager curiosity the transverse section of the brain. . . .It is here, then, the number of the parts, their distinctions, connections, structure, uses in short, an entire new set of ideas, which occupies the mind of the student, and overcomes the sense of pain and repugnance, which is the only feeling that the sight of a dead and mangled body presents to ordinary men.
A contemporary used the same analogy for Cooper, describing him on a ward round as like a florist tending his flowerbeds. Cooper sought out the diseased, the traumatized, and the mutilated. He vivisected animals unstintingly, buying them or stealing his neighbors’ pets and subjecting all to every imaginable atrocity. He operated on his fellow human beings without anesthetic or painkillers, without even the morphine and alcohol that were freely available but which he believed (with good reason) reduced their chances of survival. He operated on people without warning and without their consent—sometimes, indeed, when they were actively against it.
“Sir,” protested one of his patients afterwards, “you had no right to do that without consulting me God bless my soul! Sir, the pain is intolerable—if you had asked me, I don’t think I should have submitted.”
“The very reason,” retorted the surgeon, “that I considered it right to think for you.”
To perform an operation only when necessary was a commonly held professional ideal. Cooper pursued the notion that when an operation was necessary, it ought to be done. No matter if the patient was too frightened to agree, no matter if the chances of success were tiny. Given the appalling pain and complication rates of operations, surgeons were often terrified of performing them. Cooper watched his surgeon uncle sigh with relief when a patient with a tumor on his leg fled, after limping into the operating theater and seeing the bone saws at the ready. It was a failure of manliness, Cooper believed. It was understandable that the patient should quail, inexcusable for the surgeon to have done so.
When a young Chinese man traveled all the way to London to have a vast growth removed from one testicle, a group of surgeons gathered for the operation. Cooper was not due to take part, but his opinion was sought, and he advised his colleagues that he thought their plans mistaken. Their aim was to try to delicately dissect the tumor away and preserve, at his urgent request, the young man’s genitals. Cooper accused them of cowardice—of cowardice masquerading as compassion. Only a swift and brutal operation had a chance of success. The patient might be too frightened to make the right decision his surgeons needed the moral courage to do better. The slower operation went ahead as planned and, over its drawn-out course, the patient bled agonizingly to death.
A colleague once confided to Cooper that he felt surgery a worthy but also an awful and a chilling profession. But in the anatomical structure of the world Cooper found beauty, in the animal experiments on which he built his skill and knowledge he found pleasure, and in the useful practice of surgery he took joy.
Did Cooper behave the way he did because he had a suspiciously high tolerance for other people’s pain? It doesn’t seem so. A bit of sadism crept in, but for the most part he was free of it—remarkably free, given how he spent his life.
Astley Cooper’s postmortem of King George IV (1762–1830)
The other object that moved me unexpectedly was odd from the beginning. In a box of anatomical illustrations was a scene of a forest. It was unmistakably painted with Romantic sensibility. Against a pitch-dark background a mysterious tangle of trunks and leaves were silver under an unseen moon. What was it? No forest, it turned out, but an illustration made for Cooper’s final book, which was about the human breast. The trunks were not of trees but were the ducts along which flowed a mother’s milk the leaves were the glands producing it.
Cooper’s work on the breast depended on obtaining specimens. He jotted down a request to the body snatchers to provide “breasts of any age (old women or young).” The specimens they supplied were diseased, rotten, hacked apart. Is there anything more calculated to destroy one’s sense that the human form is beautiful than to steal from the grave the breasts of dead women, and then to dissect them?
“This sketch was made in great haste, and by candle-light,” records one Cooper illustration.
There was very little difference in colour between the areola and the surrounding integuments. There were no hairs. Four or five prominences were apparent beyond the areola and superiorly. Two rows of tubercles were slightly visible. . . . The parts, generally, much resembled those of the Venus de Medici according to my recollection of that Statue.
The book saved lives, massively improving diagnostic skills—breasts were often removed because surgeons mistook abscesses for cancers—and establishing an understanding of anatomy, and in particular the lymphatic drainage of the breast, so advanced it gets cited as a relevant authority in modern research papers.
Cooper’s stubborn hold on the idea of human beauty was based on two things. The first was the conviction that to see the world truthfully, to observe natural history with all the power and clarity one could bring to bear, was fundamentally honorable.
The breasts are slung upon the chest, supported by the fibrous tissue, and they are projected at the nipple forwards and outwards. I have, in my work on the Testis, pointed out the errors of those who paint or chisel from imagination, and not from observation of nature, in placing those bodies of equal height, although the left is usually much lower than the other and the same remark may apply to the breasts, modellers, sculptors, and painters sometimes represent the nipples as being pointed forwards, and place them as their imagination leads them to conceive them to be, and not as they really are.
By forcing himself and his colleagues to attend more closely to things as they really were, Cooper made his breakthroughs. He recognized anatomy in new ways, saw the strengths and weaknesses of approaches to it, explored experimentally whether his ideas had clinical power. Close attention to natural history fortified his obstinate sense of its beauty, for his other great conviction was that deepening one’s understanding of the natural world deepened one’s appreciation of it. The beauty of the breast was not in its anatomy alone, but in the way its anatomy reflected its role in human life:
Cooper’s illustration of a dissection of the breast demonstrates the milk glands and ducts.
This natural obliquity of the mamilla, or nipple, forwards and outwards, with a slight turn of the nipple upwards, is one of the most beautiful provisions of nature, both for the mother and the child. To the mother, because the child rests upon her arm and lap in the most convenient position for sucking.. . . But it is wisely provided by nature, that when the child reposes upon its mother’s arm, it has its mouth directly applied to the nipple, which is turned outwards to receive it whilst the lower part of the breast forms a cushion upon which the cheek of the infant tranquilly reposes. Thus it is we have always to admire the beauty, and the utility, of those deviations of form in the construction of the body which the imagination of man would lead him, à priori, to believe most symmetrical, natural, and convenient.
Astley Cooper’s discoveries in anatomy and surgery won him worldwide renown, but it was aesthetic achievement that made him. When Mary Shelley wrote of Victor Frankenstein, she told a story of a man whose inability to perceive beauty was fatal. “The dissecting-room and the slaughter-house furnished many of my materials and often did my human nature turn with loathing from my occupation.” Not only did Frankenstein regard his creature as physically repulsive, he also assumed that physical unattractiveness was a marker of spiritual repulsiveness. In making that assumption he doomed his hopeful monster and himself. Cooper’s life showed what could be achieved by seeking beauty where others saw only horror, and by apprehending beauty through being sensitive to its meaning.
Study the patterns and connections in natural history, Cooper found, and even the most off-putting parts of it yield up wonder. For medical students getting used to the smell of hospital wards and the decay that age and illness bring, for scientists seeking to understand the human body in richer detail, for statisticians daunted by the apparent coldness of numbers, for poets sitting in their gardens and listening to songbirds—for all of them, Cooper’s success makes for a fine lesson. To see heaven in the pursuit of science is necessary for enjoying it, and just as vital in order to do it well.
Druin Burch has written a biography of Astley Cooper, Digging Up the Dead: Uncovering the Life and Times of an Extraordinary Surgeon (Random House UK, 2007)
ROGERS, Anthony Astley Cooper
ROGERS, Anthony Astley Cooper, A Representative from Arkansas born in Clarksville, Sumner County, Tenn., February 14, 1821 received a limited schooling engaged in mercantile pursuits moved to Arkansas in 1854 candidate of the Union supporters for delegate to the State convention in 1861 opposed secession arrested for his loyalty, was imprisoned, and forced to give bond to answer the charge of "treason against the Confederate Government" elected to the Thirty-eighth Congress but was not allowed to take his seat, his State not having been readmitted moved to Chicago, Ill., in 1864 and engaged in the real estate business returned to Arkansas in 1868 elected as a Democrat to the Forty-first Congress (March 4, 1869-March 3, 1871) unsuccessful candidate for reelection in 1870 to the Forty-second Congress postmaster at Pine Bluff, Ark., from January 7, 1881, to July 24, 1885 again engaged in mercantile pursuits moved to Los Angeles, Calif., in 1888 and died there July 27, 1899 interment in Rosedale Cemetery.
Astley Paston Cooper Ashhurst Papers
This is a finding aid. It is a description of archival material held at the Historical Medical Library of The College of Physicians of Philadelphia. Unless otherwise noted, the materials described below are physically available in our reading room, and not digitally available through the web.
Ashhurst, Astley Paston Cooper, Dr., 1876-1932
Title: Astley Paston Cooper Ashhurst Papers Date: 1895, 1904-1933, 1963, undated Call Number: MSS 2/0349 Extent: 1.26 Linear feet Language: English Abstract: The Astley Paston Cooper Ashhurst Papers document the military and professional accomplishments of this noted physician. Ashhurst (1876-1932) established himself as a prominent surgeon and teacher in Philadelphia, and also served as in various medical capacities during World War I. The collection encompasses two series: “Military Service,” and “Subject Files,” and dates from 1895, 1904-1933, 1963, and undated. Researchers interested in the career of Astley Paston Cooper Ashhurst, or in the medical history of World War I will find material of interest in this collection.
Astley Paston Cooper Ashhurst was born on August 21, 1876 in Philadelphia, PA to John Ashhurst Jr. and Sarah Stokes Wayne. He completed his Bachelor’s degree in 1896, and his medical degree 1900, both from the University of Pennsylvania.
During his career, Ashhurst held numerous hospital positions, including Surgeon to the Episcopal Hospital in Philadelphia from 1904 to 1930, Surgeon at the Philadelphia Orthopedic Hospital and Infirmary for Nervous Diseases from 1904 to 1930, Surgeon to the Dispensary at the Children’s Hospital from 1906 to 1911, and Chief of Gynecological Dispensary at Pennsylvania Hospital from 1906 to 1911. Ashhurst also held several teaching positions at the University of Pennsylvania, including Prosecutor to the Associate Professor of Applied Anatomy from 1904 to 1911, Instructor in Surgery from 1911 to 1920, and Professor in Clinical Surgery in the Graduate School of Medicine from 1923 to 1930.
Ashhurst served the United States military with distinction. In 1916 he attended the Medical Officers Training Camp, and in December 1917 was sent to France with Base Camp Unit No. 34 to aid in the World War I effort. From January to March of 1918, Ashhurst served as Director of Base Hospital No. 34 with the American Expeditionary Forces in Nantes, France. From April to July 1918, Ashhurst was sent to the Beauvais and Oise areas of France to serve in a medical capacity with the French army and from July to November 1918, served as Chief of Operating Team at Nieully-sur-Seine, Chierry, and Souilly sous Verdun. Toward the end of the war, Ashhurst served as Consultant in Surgery from November to December 1918 in Savenay, Nantes, St. Nazaire and the Camp Hospitals at Coetquiden and Neucon. Ashhurst then returned home, and from January to April 1919 served on duty as Chief of the Surgical Service at Walter Reed General Hospital for returning veterans. For his service, Ashhurst received a citation from General Pershing for “Exceptionally Meritorious and Conspicuous Service with Base Hospital 34.”
Ashhurst’s other accomplishments include publishing several monographs on surgical subjects, his Textbook on Surgery, co-written with John B. Deaver, being his best known work. Ashhurst also belonged to several medical societies, and was particularly active with the American Surgical Association, which he joined in 1913. He became a Fellow at the College of Physicians of Philadelphia in 1906.
In May 1930, Ashhurst suffered a cerebral hemorrhage stemming from a car accident, and was forced to retire from the medical profession. Later that year, he wed Anna P. Cambell. In August and September 1932, Ashhurst suffered two more cerebral hemorrhages and passed on September 19th.
Mutscheler, Louis H. “Memoir of Astley Paston Cooper Ashhurst,” in Transactions of the College of Physicians of Philadelphia, Fourth Series, vols. 1 & 2, pp. xliv-xlvii, 1934.
Scope and Contents
The Astley Paston Cooper Ashhurst Papers collection contains correspondence and writings from Ashhurst’s military service and medical career. The collection encompasses two series: “Military Service,” and “Subject Files,” and dates from 1895, 1904-1933, 1963, and undated. Researchers interested in the career of Astley Paston Cooper Ashhurst, or in the medical history of World War I will find material of interest in this collection.
The “Military Service” series documents Ashhurst’s military service from World War I to his post-war involvement with the Reserve Officers Corps. The series contains two subseries: “During World War I,” and “After World War I,” arranged chronologically. The series dates from 1916-1929, and undated.
The “During World War I” subseries contains correspondence, notes, and regulation orders from Ashhurst’s service during the war. The correspondence is grouped together, and includes letters exchanged with the American Red Cross and War Department, among others. Other items in the subseries include financial notes, a history of Base Hospital 34, and medical notes on patients. The folders are arranged alphabetically and date from 1916 to 1920, and undated.
The “After World War I” subseries contains correspondence, publications, and regulations from Ashhurst’s involvement in the Officers Reserve Corps. The correspondence is grouped together, and includes letters from the Association of Military Surgeons as well as with the War Department. Several additional letters concern regulations for participation in the Officer Reserve Corps. Other significant items in the subseries include biographical notes for Ashhurst's World War I service, copies of the “Bulletin” publication, and other special orders for officers. The folders are arranged alphabetically and date from 1919 to 1929. The “Subject Files” series contains material from Ashhurst’s medical career and personal life. The series contains six subseries: “Correspondence,” “Writings,” “Trips,” “Exhibits at College of Physicians of Philadelphia,” “Laboratory work,” and “Miscellaneous,” arranged by bulk of material. The series dates from 1895, 1904 to 1933, 1963, and undated.
The “Correspondence” subseries contains letters between Ashhurst and others, largely of a professional nature. Correspondents include the American Surgical Society, L. E. Snodgrass, College of Physicians, and S. Weir Mitchell among others. While the bulk of letters span from 1900 to 1932, one letter from 1963 relates to the transfer of Ashhurst’s letters after his passing. The folders are arranged alphabetically and date from 1895, 1900, 1904 to 1933, 1963, and undated.
The “Writings” subseries contains writings largely by Ashhurst, as well as one article from a colleague. The writings by Ashhurst include biographies of his father John Ashhurst Jr., as well as writings on medical topics such as surgery and fractures. The subseries also includes reviews sent to Ashhurst on his work, including “The Patience of Surgery.” The folders are arranged alphabetically and date from 1905, 1907, 1910 to 1931, and undated.
The “Trips” subseries contains written accounts by Ashhurst on his trips to Europe, Michigan, and Minnesota. Also included are postcards from Ashhurst’s trip to Ann Arbor, Michigan. The folders are arranged alphabetically and date from 1904, 1907, and 1914.
The “Exhibits at College of Physicians of Philadelphia” subseries contains lists of material for the display of an exhibit on the centenary of Lord Lister, and on bone fractures. The folders are arranged alphabetically and date from 1927, and undated.
The “Laboratory Work” subseries contains an undated list of supplies for Ashhurst’s laboratory.
The “Miscellaneous” subseries contains a folder of unidentified, undated notes from the collection.
The History of Myringotomy and Grommets
The first recorded myringotomy was in 1649. Astley Cooper presented 2 papers to the Royal Society in 1801, based on his observations that myringotomy could improve hearing. Widespread inappropriate use of the procedure followed, with no benefit to patients this led to it falling from favor for many decades. Hermann Schwartze reintroduced myringotomy later in the 19th century. It had been realized earlier that the tympanic membrane heals spontaneously, and much experimentation took place in attempting to keep the perforation open. The first described grommet was made of gold foil. Other materials were tried, including Politzer's attempts with rubber. Armstrong's vinyl tube effectively reintroduced grommets into current practice last century. There have been many eponymous variants, but the underlying principle of creating a perforation and maintaining it with a ventilation tube has remained unchanged. Recent studies have cast doubt over the long-term benefits of grommet insertion is this the end of the third era?
Keywords: Eustachian tube history myringotomy otitis media ventilation tube.
Astley Paston Cooper
Cooper was devoted to the study and teaching of anatomy, and is said to have dissected daily throughout his career. President of the Royal College of Surgeons on two occasions (1827 and 1836).
Performed various operations at a time before antiseptic procedures. The first to tie the abdominal aorta in treating an aneurysm (1817) and in 1820 he excised and infected sebaceous cyst from the scalp of King George IV.
Sir Astley Cooper is credited with the first or very early reports of sternoclavicular dislocation Galleazi fracture Tillaux Fracture and the Monteggia fracture
If you are too fond of new remedies, first you will not cure your patients secondly, you will have no patients to cure
Key Medical Contributions
Galleazi fracture (1822)
First described the Galleazi fracture pattern in 1822 and published in his treatise on dislocations, and on fractures of the joints in 1824 some 110 years prior to Galeazzi’s publication. [1824: 473–476 and plate XXVIII Fig 1,2]
Tillaux Fracture (1822)
One of the first to describe: Tillaux Fracture in his chapter in 1824 on dislocation of the ancle joints
Monteggia fracture (1824)
Cooper described anterior, posterior, and lateral dislocations of the radial head with and without fracture of the ulna in his treatise on dislocations, and on fractures of the joints.
LATERAL DISLOCATION OF THE RADIUS. Mr. Freeman, Surgeon, of Spring-gardens, brought to my house a gentleman of the name of Whaley, aged twenty-live years, whose poney having run away with him, when he was twelve years of age, he had struck his elbow against a tree whilst his arm was bent and advanced before his head. The olecranon was broken, and the radius dislocated upwards and outwards, above the external condyle and when the arm is bent, the head of the radius passes the os humeri. He has an useful motion of the arm, but neither the flexion nor the extension is complete.
Cooper 1824: 444
War of words with Henry Earle (1789 – 1838) when he proposed that neck of femur fractures could unite with conservative management only… Upon reading this work, Sir Astley Cooper was heard to exclaim ‘Good God! Is this written by an English surgeon ‘ and charged Earle with misleading the rising generation of surgeons. Acrimonious discourse at a meeting of the London Medical Society was recorded in the Lancet 1823.
I have been baffled at every attempt to cure, and have not yet witnessed one single example of union in this fracture….no argument can ever settle the question of the possibility of union, which can only be decided by observation.Cooper 1823
…the question never can be decided in the affirmative by following the doctrines which he [Cooper] has inculcated, as the practice Sir Astley recommends and follows renders union by bone a moral impossibility…there is no actual law in the animal economy prohibiting such union. By reasoning, I have endeavored to explain the causes which have hitherto contributed to interrupt bony union, and by reasoning, I hope to induce my professional brethren not to abandon these cases as hopeless.Earle 1824
The endocrine regulation of bone metabolism and bone mass
In 1983, Riggs and Melton proposed that the osteoporosis diagnosis should be subdivided based on the proposed pathogenesis:
- Type 1 osteoporosis: due to decreased oestradiol levels and loss of trabecular bone (the major component of the vertebrae) following the first 3–5 years after the menopause, leading to increased risk of vertebral fractures and
- Type 2 osteoporosis: a form of senile osteoporosis primarily due to advanced age with impaired calcium handling, resulting in reduced levels of circulating 1,25-OH-vitamin D, lower calcium absorption, and secondary hyperparathyroidism, coinciding with an increased risk of hip fracture 17 .
Although this proposition was reasonable, based on the evidence present at that time, the results from later epidemiological and experimental studies did not support this division of the diagnosis for several reasons. First, the risk of vertebral fracture in women is not greatest in the first years following the menopause, but instead rises gradually with increasing age and is highest after the age of 75 years 18 . Secondly, low circulating levels of oestradiol were later shown to similarly predict both spine and hip fractures, whilst the levels of 25-OH-vitamin D and parathyroid hormone (PTH) were not associated with hip or spine fractures 19 . Finally, evidence has emerged from clinical studies in which bone characteristics have been measured using computed tomography (CT) to suggest that most accelerated trabecular bone loss begins in young adult life, when oestradiol levels are preserved, and that cortical bone loss accelerates following the menopause, indicating that oestradiol levels are primarily important for cortical and not trabecular bone loss 20 .
Dictionary of National Biography, 1885-1900/Cooper, Astley Paston
COOPER, Sir ASTLEY PASTON (1768–1841), surgeon, was fourth son of the Rev. Samuel Cooper , D.D., curate of Great Yarmouth, and rector of Morley and Yelverton, Norfolk (B.A. of Magdalene College, Cambridge, 1760, M.A. 1763, D.D. 1777), author of a poem called ‘The Task,’ published soon after Cowper's famous ‘Task,’ upon which Dr. Parr made the epigram:
To Cowper's Task see Cooper's Task succeed
That was a Task to write, but this to read.
Samuel Cooper published a large number of sermons, wrote comments on Priestley's letters to Burke on civil and ecclesiastical government (1791), and died at Great Yarmouth on 7 Jan. 1800, aged 61 (Gent. Mag. 1800, i. 89, 177).
Mrs. Cooper, a Miss Bransby, wrote story-books for children and novels of the epistolary kind. Their eldest son, Bransby, was M.P. for Gloucester for twelve years, from 1818 to 1830.
Cooper was born on 23 Aug. 1768, at Brooke Hall, about seven miles from Norwich. He was a lively scapegrace youth, and learnt little, being educated at home. His grandfather, Samuel Cooper, was a surgeon of good repute at Norwich, and his uncle, William Cooper, surgeon to Guy's Hospital. He was apprenticed in 1784 to his uncle, but soon transferred to Henry Cline [q. v.], surgeon to St. Thomas's, who exercised very great influence over him. He spent one winter (1787–8) at the Edinburgh Medical School, under Gregory, Cullen, Black, and Fyfe. Both before and after his return to London he attended John Hunter's lectures. He was appointed demonstrator of anatomy at St. Thomas's in 1789, being only twenty-one years old. Two years later Cline made him joint lecturer with himself in anatomy and surgery. In December 1791 he married Miss Anne Cock, who brought him a considerable fortune. The summer of 1792 was spent in Paris, security being obtained through friends of Cline, whose democratic principles Cooper warmly espoused.
On his return from Paris, Cooper devoted himself largely to study and teaching, and succeeded in developing the subject of surgery into a separate course of lectures from anatomy. At first too theoretical to please, he soon found that his strength lay in discussing his own cases, with all the illustration that he could supply from memory of other cases. He thus became a most interesting practical lecturer, and meddled little with theory. In 1793 he was selected to lecture on anatomy at the College of Surgeons, which office he held till 1796 with great success. In 1797 he removed from Jeffreys Square to 12 St. Mary Axe, formerly Mr. Cline's house.
In 1800 Cooper was appointed surgeon to Guy's on the resignation of his uncle, but not before he had abjured his democratic principles. From this time forward, while he gave much of his time to the hospital and medical school, his private practice rapidly increased until it became perhaps the largest any surgeon has ever had. In 1802 he was elected a fellow of the Royal Society, being awarded the Copleian medal for his papers on the ‘Membrana Tympani of the Ear.’ He continued an indefatigable dissector, rising very early. All kinds of specimens of morbid anatomy which could illustrate surgery were brought to him, and he was also resolute in making post-mortem examinations wherever possible. He was often in contact with the resurrectionists of the period, and many interesting anecdotes of this part of his career are given in his ‘Life.’ He himself stated before a committee of the House of Commons: ‘There is no person, let his situation in life be what it may, whom, if I were disposed to dissect, I could not obtain. The law only enhances the price, and does not prevent the exhumation.’
In 1805 Cooper took an important part in founding the Medico-Chirurgical Society, being its first treasurer. Its early volumes of ‘Transactions’ contain several papers by him. He now published his important work on ‘Hernia,’ part 1 in 1804, part 2 in 1807, the illustrations to which were so expensive that Cooper was a loser of a thousand pounds when every copy had been sold. In 1806 he left St. Mary Axe for New Broad Street, spending here the nine most remunerative years of his life. In one year his income was 21,000l. His largest fee, a thousand guineas, was tossed to him by Hyatt, a rich West Indian planter, in his nightcap, after a successful operation for stone.
In 1813 Cooper was appointed professor of comparative anatomy by the Royal College of Surgeons, and lectured during 1814 and 1815. In the latter year he moved to New Street, Spring Gardens, and in the following May performed his celebrated operation of tying the aorta for aneurysm. In 1820, having for some years attended Lord Liverpool, he was called in to George IV, and afterwards
- performed a small operation upon him. This was followed by the bestowal of a baronetcy.
It was not till 1822 that Cooper became an examiner at the College of Surgeons, publishing in the same year his valuable work on ‘Dislocations and Fractures of the Joints.’ In January 1825 he resigned his lectureship at St. Thomas's but finding that he was to be succeeded by Mr. South as anatomical lecturer, contrary to his understanding that his nephew, Bransby Cooper, was to be appointed, he induced Mr. Harrison, the treasurer of Guy's, to found a separate medical school at Guy's, with Aston Key and Bransby Cooper as lecturers on surgery and anatomy respectively. St. Thomas's claimed the valuable specimens Cooper had deposited there to illustrate his lectures, and the latter vigorously set about making a new collection. His energy and name, although he now became consulting surgeon to Guy's, and seldom lectured, started the new school successfully.
In 1827 Cooper was president of the College of Surgeons. In 1828 he was appointed surgeon to the king. He had for some years spent much time at his estate at Gadesbridge, near Hemel Hempstead. From 1825 he took his home farm into his own hands, and one of his experiments was buying lame or ill-fed horses in Smithfield cheaply and feeding and doctoring them himself, often turning them into much better animals. Lady Cooper's death in 1827 was a heavy blow to him, and he resolved to retire altogether from practice. By the end of the year, however, he returned to his profession, and in July 1828 married Miss C. Jones. The publication of further important works occupied him, and in 1836 he was a second time president of the College of Surgeons. He died on 12 Feb. 1841, in his seventy-third year, in Conduit Street, where he had practised latterly, and was buried, by his express desire, beneath the chapel of Guy's Hospital. He left no family, his only daughter having died in infancy. The baronetcy fell to his nephew, Astley, by special remainder.
A statue of Cooper, by Baily, was erected, chiefly by members of the medical profession, in St. Paul's Cathedral, near the southern entrance. An admirable portrait of him by Sir Thomas Lawrence exists. His name is commemorated by the triennial prize of three hundred pounds, which he established for the best original essay on a professional subject, to be adjudged by the physicians and surgeons of Guy's, who may not themselves compete.
No surgeon before or since has filled so large a space in the public eye as Cooper. He appears to have had a singularly shrewd knowledge of himself, as evidenced by the following quotations from an estimate he left, written in the third person (Life, ii. 474–6). ‘Sir Astley Cooper was a good anatomist, but never was a good operator where delicacy was required.’ Here, no doubt, Cooper does himself injustice. ‘Quickness of perception was his forte, for he saw the nature of disease in an instant, and often gave offence by pouncing at once upon his opinion … He had an excellent and useful memory. In judgment he was very inferior to Mr. Cline in all the affairs of life … His principle in practice was never to suffer any who consulted him to quit him without giving them satisfaction on the nature and proper treatment of their case.’ His success was due to markedly pleasing manners, a good memory, innumerable dissections and post-mortem examinations, and a remarkable power of inspiring confidence in patients and students. His connection with the resurrectionists and the marvellous operations attributed to him combined to fascinate the public mind to an extraordinary degree. A great portion of his practice was really medical, and in this department his treatment was very simple. ‘Give me,’ he would say, ‘opium, tartarised antimony, sulphate of magnesia, calomel, and bark, and I would ask for little else.’ He had a genuine, even an overweening, love for his profession. ‘When a man is too old to study, he is too old to be an examiner,’ was one of his expressions ‘and if I laid my head upon my pillow at night without having dissected something in the day, I should think I had lost that day.’ He cannot be classed among men of genius or even of truly scientific attainments his works are not classics, but they are more than respectable. They are defective especially from their almost entire omission to refer to the works of others. The ‘Quarterly Review’ (lxxi. 560) terms him ‘a shrewd, intelligent man, of robust vigorous faculties, sharp set on the world and its interests.’
Mr. Travers, who became Cooper's articled pupil in 1800, says at that time he had the handsomest, most intelligent and finely formed countenance he ever saw. He wore his hair powdered, with a queue his hair was dark, and he always had a glow of colour in his cheeks. He was remarkably upright, and moved with grace, vigour, and elasticity. His voice was clear and silvery, his manner cheerily conversational, without attempt at oratory. He spoke with a rather broad Norfolk twang, often enlivened with a short ‘Ha! ha!’ and, when he said anything which he thought droll, would give a very peculiar short snort and rub his nose with the back of his hand ( South , Memorials, p. 33). He suffered from hernia early in life, but was able to keep himself perfectly free from derangement by his own method of treatment.
His life by his nephew is a most tedious performance, but includes much interesting matter, including anecdotes of Lord Liverpool and George IV.
The following is a list of Cooper's most important writings: 1. ‘Observations on the effects that take place from the Destruction of the Membrana Tympani of the Ear,’ two papers, ‘Phil. Trans.’ 1800, 1801. 2. ‘Anatomy and Surgical Treatment of Hernia,’ two parts, folio, 1804, 1807 2nd ed. 1827. 3. ‘Surgical Essays, by A. Cooper and B. Travers,’ two parts (all published), 8vo, 1818, 1819. 4. ‘On Dislocations and Fractures of the Joints,’ 4to, 1822. 5. ‘Lectures on the Principles and Practice of Surgery, with additions by F. Tyrrell,’ 8vo, 3 vols. 1824–7 8th ed. 12mo, 1835. 6. ‘Illustrations of Diseases of the Breast,’ part i. 4to, 1829 (no more published). 7. ‘Structure and Diseases of the Testis,’ 8vo, 1830. 8. ‘The Anatomy of the Thymus Gland,’ 4to, 1832. 9. ‘The Anatomy of the Breast,’ 4to, 1840 besides numerous articles in the ‘Medico-Chirurgical Transactions’ and medical journals, and surgical lectures published by the ‘Lancet’ in 1824–6 (see the full bibliography in Dechambre's Dict. Encyc. des Sciences Médicales, vol. xx. Paris, 1877).
Watch the video: Astley cooper year eights, 2009 x (July 2022).