Eye Surgery in the Georgian Age

Ayesha Hussain and Anna Maerker, Department of History, King’s College London

Fig 1: Portraits of King George III in blindness. Samuel William Reynolds (1820), National Portrait Gallery, NPG D8002.

Fig 2: Portraits of King George III in blindness: Charles Turner (1820), National Portrait Gallery NPG D16056

In his old age, King George III suffered from blindness due to cataracts in both eyes.The affliction was movingly documented in portraits from 1820 by artists Charles Turner and Samuel William Reynolds (Figs.1-2). The King’s doctors considered the possibility of an operation to remove the cataracts, but ultimately decided against it, as they feared a failed attempt to cure his blindness might further damage the aged King’s disturbed mental state. In general, however, in this period surgeons and eye specialists called oculists had already developed effective operations to remove cataracts. Two of the most important innovators in the treatment of cataracts and other eye complains were the royal oculists Baron de Wenzel and John Taylor.

Fig 3: Baron de Wenzel: portrait by John Conde, 1789 (British Museum, no. 1862, 1213.22)

Baron Michael de Wenzel (or Wenzell, 1724-1790), oculist-in-ordinary to King George III from 1772 until his death in 1790, was an inspiration to many British and European eye surgeons (Fig.3). His work on the treatment of cataracts, in particular, was very influential. Surgeons in the eighteenth century had no access to modern-day anaesthetic, and so eye surgeons had to develop methods which would cause the least suffering. Wenzel was known for the fast pace and accuracy of his operations. It has been recorded that his method of cataract removal lasted less than thirty seconds, using what became to be known as the ‘Wenzel knife’ to form a crescent-like incision in the eye. The Wenzel knife was custom-made by Paul Savigny, the first cutler in England to become a specialist in making surgical instruments (Fig.4). Smaller than the usual opthalmic knives, the Wenzel knife was designed to lessen the escape of the ‘aqueous humour’ in the eye. The virtuosity of Wenzel’s surgical performances meant that sometimes members of high society would watch them for entertainment, as David Chodowiecki’s etching suggests (Fig.5).

Fig 4: Trade card of Paul Savigny: British Museum (museum number: Heal,52.91)

Fig 5: Wenzel operating: Etching by Daniel Chodowiecki, Wellcome Images V0015913. Courtesy of the Wellcome Library, London

Wenzel competed for royal appointments with a dynasty of eminent oculists, the Taylors. John Taylor (1703-1772), who had studied at St Thomas’s Hospital specialising in diseases of the eye, was appointed to George II as his personal oculist in 1736, after travelling for almost a decade as an itinerant eye-doctor (Fig.6).  With degrees from the universities of Basel, Liege and Cologne, and as a fellow of the College of Physicians, Taylor was a well-known oculist He self-advertised constantly, referring to himself as the ‘Chevalier.’ In his autobiography, he stated that he was ‘the most public man under the sun, being personally known not only in every town in Europe, but in every part of the globe.’ Ironically, it is said that John Taylor became blind himself, just before his death in 1772.

Fig 6: John Taylor: The National Library of Medicine, Digital Collections. Image ID: B024718

Both John Taylor’s son and grandson also became eye-doctors, John Taylor (1724-1787), on the death of Baron de Wenzel, was made oculist to George III. John Taylor (1757-1832) was oculist to both George III and George IV. Perhaps the most famous episode in the second John Taylor’s career was his cure of the ‘The Blind Boy of Ightham.’ The eight-year-old William Taylor had been born blind, with cataracts in both eyes. John Taylor operated on him, in front of sixteen spectators, and as soon as the first cataract was removed, the boy reported his “Wonder, at the strange Shapes, Forms, and Colours of many Things, so incomprehensible about him, that He beheld the Room full of Lights, and Moons”.

Restoring vision was important not just for the King himself, but also for his subjects. Loss of vision meant loss of livelihood for many: “The importance of this organ [the eye] and its utility to every individual need not be urged, but to the poor it is their all. Deprived of their sight, their endeavours either for their own support or that of their offspring are cut off and they are on their parishes and a misery to themselves.” A particular threat to the eyes was the condition of ophthalmy, described in 1800 by Edward Moore Noble as ‘a certain redness or inflammation of the eye, with pain.’ Sometimes, when the Ophthalmy was very severe, it would cause the anterior chamber of the eye to fill with pus and eventually caused a paralysis of the retina. As royal physicians Wathen Waller observed, “The soldiers and sailors from their being more confined together have been the greatest sufferers.” In 1802, for instance, the Egyptian Ophthalmia ravaged the Second Regiment of Argyllshire Fencibles. In response, specialist institutions were founded across Britain, especially in the South. Eye hospitals opening in Bristol were especially important as they were partly used to treat naval officers and soldiers.

Sources

Royal Archives, Windsor: Letter from Wathen-Waller to the Duke of Cumberland. Ref: 4720-1, Main Series.

William Oldys, Observations on the cure of William Taylor, the blind boy of Ightham, in Kent; who being born with cataracts in both eyes, was at eight years of age, brought to sight, on the 8th of October, 1751, by Mr. John Taylor, jun. oculist, … Also some address to the publick, for a contribution towards the foundation of an Hospital for the blind, already begun by some noble personages. [London]: Printed by E. Owen, in Hand-Court, Holborn, 1753.

James Ware, Observations on the cataract, and gutta serena: including a translation of Wenzel’s treatise on the cataract: a new chapter on the operation of largely puncturing the capsule of the crystalline humour: and many additional remarks on the gutta serena. Third edition London: Mawman, Cox; Edinburgh: Black, 1812.

Images

Portraits of King George III in blindness: Charles Turner (1820), National Portrait Gallery NPG D16056. Samuel William Reynolds (1820), National Portrait Gallery, NPG D8002.

Ophthalmia, Wellcome Images L0033534 “Diagrams of ophthalmia, inflammation of the eye” From: John Vetch, An account of the ophthalmia which has appeared in England since the return of the British Army from Egypt. London: Longman, Hurst, Rees, and Orme, 1807.

Baron de Wenzel: portrait by John Conde, 1789 (British Museum, no. 1862, 1213.22)

Wenzel operating: Etching by Daniel Chodowiecki, Wellcome Images V0015913.

Trade card of Paul Savigny: British Museum (museum number: Heal,52.91)

Wenzel knife: in Ware 1812. [Foyle Special Collections]

Operation for removing cataracts: in Ware 1812. [Foyle Special Collections]

John Taylor: The National Library of Medicine, Digital Collections. Image ID: B024718