A place for healing and wisdom

Jul 14 2007 by David Charters, Liverpool Daily Post

For 170 years, from the days of incurable diseases, through all the advances in surgery and pharmacy, a Liverpool building has been home to great healers. David Charters reports

FROM windows, set deep in the stone walls of the Institution, whose veneration elicits hushed voices, cushioned steps and the gentle chink of teacups on china saucers, you could see gaggles of students in mortarboards and gowns, posing for graduation day photographs with their parents, purring in front of the Catholic Cathedral.

Here, in this Liverpool of high culture, we have a monument to faith and another to science, divided by a few paving stones.

Those who nurse the soul and those who tend the body have much to celebrate together in this life.

Yet, behind its Ionic pillars, the Liverpool Medical Institution (LMI) remains a mysterious edifice to passing eyes more familiar with the purpose of its neighbours – both cathedrals (the Anglican one being at the top of Hope Street), Liverpool University, the Philharmonic Hall and, of course, the Philharmonic pub renowned for the brass and porcelain of its lavatories.

In this classical setting, a dreamer walks by, a bottle of red biddy peeping from his coat pocket and a thicket of whiskers on his chin. Maybe, somewhere in the blur of time and places, his body and his soul have needed a little patching, here and there.

“You know I could have been one of them,” he says, taking a gulp from his bottle, as he stares at the graduates in front of the cathedral.

Couldn’t we all, old bean. It’s all in the twists of fate.

In the chilled air of the Institution’s basement, Mair Pierce Moulton, the librarian, is admiring ancient volumes on the shelves. Here, we have the thoughts of the great philosophers rubbing covers with books dedicated to the homely manners of the kind, auld country doctors – those figures in Donegal tweeds with leather bags and stethoscopes around their necks, checking the pulses of old ladies or pale children.

Here is much of the wisdom, which enabled man to heal. But we still don’t know the secrets of eternal life, as can be seen in the numerous portraits in the rooms and halls, each giving its subject’s date of birth and date of death.

The LMI, a friend to the city, opened in this building 170 years ago, though its origins are much earlier than that.

In its roots, medicine brought rationality to what for long had been the mystical workings of the human body, a subject for divine intervention rather than healing hands. Hippocrates (460-377BC) is regarded as the father of medicine on the basis of 72 treatises written by him or his followers. He had identified the four “humours” of the body – blood, phlegm, yellow bile and black bile, which he thought were the seats of disease.

In all societies, herbal remedies were tested. Some worked and were gradually absorbed into the canon of medical knowledge.

Meanwhile, surgery was for the most part a sideshow of war, in which damaged limbs were amputated by chaps on your own side.

Without adequate anaesthesia, the speedy cutter obviously rose in esteem among the ranks. If you were to live, the operation had to be done as quickly as possible and the blood-flow staunched.

Medical methods advanced with experience and this seaport provided that in abundance.

In the 1560s, the council had fined people for washing sheepskins and wool in the water supply, showing an early appreciation of how contaminated water could spread disease.

But, in 1577, nothing could stop the black death sweeping through the hovels, claiming the lives of about one third of Liverpool’s 700 inhabitants. Prayers were offered, knees were bruised. Potions were brewed and the leeches sucked blood from the dying. But still the grim reaper grinned, as the priests spread holy oil on the eyelids, ears, mouths and heads of the dying.

Pioneers of medicine in Liverpool included Sylvester Richmond (1616-1692), described as “a professor of physick and surgery”. His skill won him a high social position and he was mayor in 1672.

In those times, there were barber-surgeons, who could trim your hair, scalp your warts and carry out other simple surgical procedures; apothecaries, who could dispense drugs; and physicians, who often carried a doctorate in medicine from Oxford, Cambridge or some exalted European university.

A rapid rise in Liverpool’s population from 5,000 in 1700 to 34,000 in 1773 added to the wretched conditions endured by many people in the stinking, narrow streets.

Of the deaths recorded the previous year, 358 were attributed to consumption, 219 to smallpox and only 28 to “the decay of age”. Life expectancy was 24.

By 1776 Liverpool had six physicians, 14 surgeons, three surgeon-apothecaries and an unknown number of chemists.

The first infirmary, the Royal, had opened on Shaw’s Brow in 1749 on a site now occupied by St George’s Hall. Others followed. So people were being treated. But there was a desperate need for more to be learned of human anatomy.

To this end, the surgeons John Lyon, Henry Park and Edward Alanson started a reading club in 1770, depositing their books in a room at the Royal Infirmary. Alanson was particularly concerned about the result of amputations.

Of 46 patients, subjected to surgery, 10 died from haemorrhage, tetanus or a lethal infection. Complete healing of the stump was rarely achieved.

Ways of improving surgical techniques were described in his monograph, Practical Observations on Amputation and After Treatment.

Soon, the library contained such locally-produced volumes, as well as standard texts. In 1779, physicians, surgeons and general practitioners met at the Union Coffee House in Mount Pleasant, to formally inaugurate the Liverpool Medical Library. It moved between the Royal Infirmary and the Dispensary on Church Street and other locations, including Lime Street. Its embrace widened as lectures and discussion were held, leading to an off-shoot Medical Society.

After seemingly interminable negotiations and rows, it was finally decided to build a new centre “for every purpose for which it could be required by the profession”.

John Rutter, born in Liverpool in 1762 to the chandler and painter Thomas Rutter, was the physician involved in both the library and the society responsible for steering through the measures, which led to the formation of the Liverpool Medical Institution.

The building, designed by Clark Rampling, was built for £4,000. It opened in 1837. The following year Rutter died, exhausted by his efforts.

Dr Roy Farquharson, the gynaecologist now stirring his tea with appropriate precision, is this year’s president of the LMI. On the table near him are the instruments used in the surgical procedures of an earlier age. The inexpert eye might note how similar they look to the tools carried by carpenters and plumbers.