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Biographical entry Holt, Barnard Wight (1816 - 1894)

MRCS May 3rd 1839; FRCS Aug 12th 1847.

Born
1816
London
Died
27 February 1894
Occupation
General surgeon

Details

Born in Westminster, where his father, grandfather, and great-grandfather had been medical practitioners. In 1835 he became a pupil of Anthony White (qv), President of the College of Surgeons in 1842, and after qualifying was elected by competition House Surgeon. Such was then the vogue of Westminster Hospital, where, besides Anthony White, Guthrie and Carlisle were Surgeons, that the surgeons could get a fee of £100 for a house surgeoncy; indeed, in Holt's case it was paid early in his time as a student in order to secure the post.

After starting in practice he was appointed Surgeon to the South London Dispensary, and in 1846 Assistant Surgeon to Westminster Hospital on the retirement of Anthony White, to whom Benjamin Phillips had succeeded. He acted as Demonstrator of Anatomy with Erichsen, afterwards Sir John Erichsen (qv), and later with John Wilson Croker Pennell as Lecturer. On the resignation of F Hale Thomson in 1850, Holt was promoted Surgeon and filled the office until 1873, being Lecturer on Surgery, and finally Consulting Surgeon. He was also Surgeon to the Royal Society of Musicians, Medical Officer of Health for Westminster, and Surgical Adviser to the Railway Passengers Assurance Company, in connection with which he often gave evidence in Law Courts. From 1872-1878 he was a Member of Council of the Royal College of Surgeons.

Some two years before his death he was attacked by influenza, which permanently impaired his health. He suffered much from calculus in the ureter, but continued to practise at 14 Savile Row until a fortnight before his death on Feb 27th, 1894; he was buried at Kensal Green. Sir Benjamin Brodie had lived and practised in the same house; it was taken by Barnard Holt after his death. He was married in 1844, and was survived by two sons and a daughter.

Barnard Holt's name is connected with a phase in the treatment of urethral stricture which brought him forward prominently. During his tenure of office as Surgeon the neighbourhood of Westminster was inhabited by neglected soldiery. The barrack accommodation was inadequate, and soldiers were still billeted in inns and public houses, with little provision for their wives and families when the men were on foreign service. Venereal disease was rampant, and neglected treatment of gonorrhoea led to a very large number of patients with stricture coming to the hospital as out-patients. Holt used a method of rapidly dilating the stricture by mechanical means. He modified an instrument invented by Perreves consisting of two fine blades joined at the end and tapering to a point. This was passed along the urethra with more or less force and served as a guide. A blunt rod was then introduced between the blades and the stricture might either be torn through or a false passage made, often leading to extravasation of urine and the necessity for an external urethrotomy. At the best, and in skilful hands, the stricture might be dilated, but the benefit was only temporary. The method was rough and unscientific ; fortunately it was not practised extensively by other surgeons, and it soon fell into complete disuse.

Holt was an excellent judge of a horse and was a regular rider to hounds. His carriage and pair was one of the best-turned-out equipages in London, and it was said that he either owned or had a large interest in some fashionable livery stables in Regent Street.

Publications:
"A Case of Popliteal Aneurysm which had been Cured by Digital Compression of the Femoral Artery." - Lancet, 1870, i, 481. The young man was kept more or less under chloroform for twenty hours without which the compression could not be borne. (See HOLDEN, LUTHER.)
On the Immediate Treatment of Stricture of the Urethra by the Employment of the Stricture Dilator, 1861; 2nd ed, 1863.
Opinions and Statistics on the Immediate Treatment of Stricture of the Urethra by the Employment of the Stricture Dilator, 1865.
"Errors in Diagnosis and Treatment of Retention of Urine not connected with Stricture." - Lancet, 1863, i, 202; 1865, i, 320; 1866, ii, 631.
"Observations (and Case) on a New Winged Catheter." - Ibid, 1870, i, 261.

[There is a detailed description of Holt's operation and instrument in the Lancet, 1852, i, 146. The instruments themselves are preserved in the College Museum. An earlier instrument known as 'Wakley's railroad catheter' is described in the Lancet, 1851, i, 274; 1852, i, 144, 481]

The Royal College of Surgeons of England