Sir Victor Horsley (1857-1916) was the first neurosurgeon appointed to the National Hospital Queen Square, and was known worldwide as the ‘Father of Neurosurgery’.
Neurology and neurosurgery
After studying medicine at University College Hospital, Horsley took up surgical roles from 1880. He was the first to be appointed to a hospital position at the National Hospital for the Paralysed and Epileptic in Bloomsbury (1886), when he undertook his first brain operation. The National Hospital didn’t have an operating theatre so he modified a day room.
Among the operating ‘firsts’ following Horsley’s appointment, were the first removal of a tumour from the spinal cord (1887) and the first carotid ligation (binding of the artery) for a cerebral aneurysm, while his experimental work on the thyroid gland paved the way for many modern treatments in pituitary disease.
Horsley was arguably without peer in successful intracranial operations before 1890. One modern worldwide historical survey of brain surgery states that he ‘may legitimately be called the first neurosurgeon’.
During his career at the National Hospital he successfully transformed patients’ lives by pioneering resective neurosurgery for epilepsy, tumours, abscess, head injury, spinal and pituitary disease, and trigeminal neuralgia, in an era where there were no x-rays or antibiotics.
He also co-developed the Horsley-Clarke stereotaxic apparatus which enabled the accurate pinpointing of a particular area of the brain for treatment. In terms of scientific landmarks, its invention has been compared to that of the telescope and microscope. Another of Horsley’s innovations was an antiseptic compound of beeswax and almond oil – known as ‘Horsley’s Wax’ – which is still used to stem bleeding from the cranial vault.
Between 1883 and 1891 he was Professor-Superintendent of the Brown Institution in Wandsworth Road, established to carry out research ‘useful to man’ and where he specialised in studying the functions in the brain and spinal cord.
He was a brilliant experimentalist, elected as FRS at the age of 29 years for his work on cerebral localization and comparative anatomy. He also worked also on rabies, vaccine, antisepsis, anaesthesia and military medicine.
In addition to his pioneering neurosurgical work, Sir Victor Horsley was a powerful debater and orator, reforming a number of medical organisations including the GMC and BMA, for whom he served as president
He was an iconoclast and social reformer, active in the Temperance Movement, a supporter of female suffrage, health care of the working class, vivisection and medical reform. Twice he stood unsuccessfully for parliament, as a Liberal, and he actively supported Lloyd George’s health insurance reforms, a stance that put him at odds with many in the medical profession.
Although he was fifty-seven at the outbreak of the First World War, Horsley volunteered for active service. He was sent first to the Dardenelles, after which he volunteered to go to Mesopotamia. Characteristically, Horsley fought hard to improve conditions for the care of wounded and diseased troops, but died of heatstroke on 16 July 1916 at a military hospital at Amara, near Baghdad; he was also buried there.
Honours and awards
He won the Gold Medal of the Royal Society, and was knighted in 1902.
The National Hospital has a ward and department after him in honour of his contribution to neurosurgery.
Queen Square: A History of the National Hospital and its Institute of Neurology, https://www.nationalbrainappeal.org/product/queen-square-history-book/