THE FAMOUS MEDICAL CONGRESS
OF 1881
Leaders in the medical world of the nineteenth century convened international medical conferences every few years, partly to exchange and discuss new developments in medicine and partly, so it seems, to showcase the country hosting the congress. Born out of the French Medical Congresses, the first International Congress convened in Paris in 1867 during the Paris Exposition. The largest of the medical extravaganzas was the Seventh International Medical Congress, held in London in 1881. Over 3,000 names from numerous countries filled the registration book. The names included luminaries such as James Paget (president of the Congress), William Jenner (currently president of the Royal Society of Medicine), Joseph Lister, Thomas Huxley, Rudolf Virchow, Louis Pasteur,
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| James Paget in 1881 (Wikipedia) |
Robert Koch, Jean Marie Charcot, Bernard von Langenbeck and, from America, John Shaw Billings, Samuel Gross, Austin Flint, and William Osler.
Queen Victoria served as patron of the Congress and the Prince of Wales opened the proceedings on August 2 with his cousin the crown prince of Prussia at his side. The principal organizer was Sir William MacCormac, a prominent surgeon who had, with the American surgeon, J. Marion Sims, led the Anglo-American Ambulance Service during the Franco-Prussian War, caring for the wounded from both sides. Sadly, female physicians were absent from the Congress in spite of an appeal from 43 women licensed to practice medicine in their respective countries and the presence in London of the Medical School for Women.
The germ theory of disease, despite doubters, was reasonably established and many papers dealt with the role of bacteria in disease. Robert Koch startled the participants with his demonstration of the use of solid culture media to isolate individual bacteria, prompting Pasteur to famously remark, “C’est un grand progress, Monsieur.” Pasteur himself gave papers on vaccines against chicken cholera and anthrax, major milestones in disease prevention. In the surgical section, Lister’s antiseptic techniques were discussed in depth. By this time many surgeons, especially in Germany, had adopted the carbolic acid solutions and sprays, acknowledging the importance of bacteria in wound infections. Primary closure of wounds without drainage, especially in abdominal surgery, was controversial, with some surgeons reporting infections and even carbolic acid poisoning after surgery. Lister held to his principles but commented that perhaps the spray could be dispensed with, an unexpected statement.
Sir Henry Thompson, England’s first urologist (see essay of January 2023), and Henry Bigelow from Boston discussed lithotrity, the non-invasive technique for dealing with bladder stones, disagreeing mainly over the size of the instruments used. On public health, known then as “state medicine,” John Shaw Billings spoke about yellow fever, claiming that it could be transmitted from person to person and through contaminated clothing and similar articles. Then a doctor working in West Africa opined that the disease arose from local causes and was not directly transmissible. The debate was not resolved until the Walter Reed project in 1900. Austin Flint spoke on the need to standardize the terminology used for physical diagnosis. Thomas Huxley spoke eloquently on the need for medical students to learn the workings of the human body through the study of basic sciences such as physiology and chemistry in order to understand treatment of diseases. John Shaw Billings (founder of what became the National Library of Medicine) held the podium again with a talk on the development of medical literature. William Osler presented cases of “exudative endocarditis” in which he noted the constant presence of bacteria but was doubtful of their significance.
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| John Shaw Billings, portrait in the National Library of Medicine (Wikipedia) |
A major problem discussed at the Congress was vivisection. England had recently passed the Cruelty to Animals Act (1876), a rather comprehensive law restricting vivisection. The medical profession viewed this as an impediment to progress and the Congress passed a resolution favoring vivisection, stating that experiments on animals have been of great service to medicine and “are indispensable for its further progress.” Cautioning on the need to avoid inflicting unnecessary pain, the resolution continued, “it is not desirable to restrict competent persons in the performance of such experiments.”
Several museums allowed physicians to examine preserved specimens, illustrations, and even a few patients. Illustrations by Sir Charles Bell of wounds encountered during the battle of Waterloo were a main attraction.
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| Charles Bell's drawing of war wound (Wellcome Library) |
The only sour note at the Congress was news of President Garfield who had been shot on July 2, one month before the opening. The London medical press carried weekly bulletins on his depressing medical status.
Entertainment was not neglected at the Congress. The Lord Mayor of London gave a banquet for 300 guests one evening and a later one for 3500 guests in the Guildhall, the latter lit by electric lights – a novelty at the time. Numerous dignitaries organized their own parties, one in Kew Gardens. The Royal College of Surgeons threw a large reception in their spacious museum, again illuminated with electric lights, that “had a somewhat ghastly effect” (Lancet report). One reception resulted in a notable artwork: that of the Baroness Burdette-Coutts, a wealthy heiress. She invited 100 selected guests and memorialized the occasion in a painting (below) that now hangs in the Wellcome Library.
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| Garden Party (Wellcome Library) |
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| Key to many of the figures in the painting |
On the final evening the guests dined at the opulent Crystal Palace, after which a magnificent display of fireworks that included fiery portraits of Paget, Charcot, and von Langenbeck, lit up the sky.
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| Crystal Palace in 1851, a huge structure (Wikipedia) |
It was a memorable Congress (described as a “week’s carnival of medical science” in The Lancet), attended by a Who’s Who of the medical world, enriched by the latest in bacteriology and surgery, and, not least, by extravagant entertainment.
SOURCES:
Sakula, A, “Baroness Burdette-Coutts’ Garden Party: The International Medical Congress, London, 1881,” Medical History 1982; 26: 183-190.
The Lancet, August 13-27, 1881.
Hunt, E M, “The Sanitary Significance of the International Medical Congress of 1881.” Public Health Papers and Reports 1881; 7: 353-67.
