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Biographical entry Wade, Robert (1798 - 1872)

MRCS Dec 3rd 1819; FRCS Dec 11th 1843 one of the original 300 Fellows; LSA 1820.

Born
23 November 1798
Suffolk
Died
16 January 1872
London
Occupation
Apothecary, General surgeon and Urological surgeon

Details

Born on Nov 23rd, 1798, near Woodbridge in Suffolk, in which town his father carried on business as a brewer. He received his early education at a neighbouring school, and having been duly apprenticed came to London when 20 years of age. He had expected at once to attend lectures and hospital practice, but his father having become involved in difficulties, young Wade was thrown upon his own resources. Of a robust frame, strong will, and a hopeful disposition, he looked to the future with confidence. He became assistant to one of the 'top apothecaries' in the West End, and for some years was a veritable drudge. He made up all the medicines, attended most of the night cases and all the lower class of midwifery. He entered St George's Hospital about the year 1817, passed the College of Surgeons in 1819, and the Apothecaries' Society in 1820. The office of Apothecary to the Westminster General Dispensary falling vacant, Wade became a candidate for it and was elected by a small majority. He fulfilled the duties of his appointment with great credit to himself and benefit to the institution for some years. About 1828 he commenced practice on his own account, at 68 Dean Street. For some time he eked out a somewhat scanty income by taking pupils, who always spoke of him afterwards with affectionate respect.

Wade, on his retirement from the office of Apothecary to the Dispensary, was unanimously elected Surgeon to the institution, and this office he held to the day of his death, performing the duties with such fidelity and punctuality that he was presented by the Governors with a handsome piece of plate in recognition of his services.

The name 'specialist', when he took the office of Surgeon to the Dispensary, was all but unknown, but circumstances drove him, as it were, to choose a particular line of practice. Amongst the crowd of patients which attended on his 'days', numbers were affected with stricture of the urethra in all its forms. He soon found that some of them could not be successfully treated by simple dilatation, and he directed his mind to discover some means by which they could be treated with safety. Shortly before, the system of treatment carried out most extensively by Sir Everard Home had fallen into discredit, in consequence of the disastrous results ensuing from it. Home had recourse to the nitrate of silver, and no doubt was very successful in many cases, but he carried his practice to a degree of heroism which ended in its downfall.

Thomas Whateley, after the failure of the lunar caustic, practised and advocated the use of the potassa fusa in the more intractable kinds of stricture. He had but a limited success, and at his death no one seemed desirous to become his successor. Then a new system of treatment was practised by some surgeons of more or less eminence, G J Guthrie (qv) and R A Stafford (qv) being foremost amongst them. This consisted in what was termed internal incision: a bougie armed with a knife was inserted into the urethra, and when the seat of the obstruction was fairly reached, the knife, being worked by a spring at the handle of the instrument, was protruded and the stricture freely divided. For a time all went well, but cases of severe haemorrhage were common, and fatal results occasional, so this variety of internal urethrotomy lost ground and died with Stafford, who, notwithstanding all its dangers and drawbacks, contended to the last that it was, on the whole, the most efficient and the safest that could be employed.

Wade had opportunities of trying these plans of treatment, and after a long and anxious trial came to the conclusion that Whateley's was the best remedy; but he was soon convinced that the caustic potash had been used too freely by Whateley, just as the lunar caustic had been too freely employed by Home. He accordingly commenced his application of caustic potash in very minute quantities, and gradually increased them. He soon found that all the benefits of this agent could be obtained without resorting to the more powerful, and sometimes dangerous, amount employed by Whateley. Always cautious and painstaking, he hesitated long before he gave his views to the profession.

At length, fortified by an experience of several hundred cases in public and private practice, he ventured to stand forth as the advocate of the use of that remedy in cases of irritable and intractable stricture. He denounced at first in unmeasured terms the 'perineal section' of Syme; but he was not a bigoted antagonist, and when he found he was wrong he acknowledged his error. One instance will suffice. Thomas Henry Wakley (qv) proposed and practised a most ingenious plan of treating stricture by gradual dilatation. In one edition of his work Wade strenuously opposed this plan, believing that it would cause laceration and danger; but he felt bound to satisfy himself on that point, and after some trial of the plan was convinced that in certain cases it might be employed with safety and advantage. In the very next edition of his work on stricture, he not only acknowledged his error, but actually gave a lithographic illustration of Wakley's instruments, and spoke of them with approbation. This is to his honour; for the Lancet, which represented the interests of Wakley, had attacked him with a rancour which was neither just nor justifiable.

In 1834 he delivered a course of lectures on pathology at the Little Windmill Street School. He took few holidays - 'work to him was leisure'; but he annually rented a house at Hampstead for a 'little change', where he walked and talked with his family and friends amid the quiet lanes, the fertile fields, and the wooded heights of that suburban 'paradise'.

A great appreciator of everything beautiful in nature, and a lover of the arts, he was anxious to obtain some works of William Henry Hunt (1790-1864). It was not, however, till 1851 that his means allowed him to indulge in what he then regarded as an expensive outlay. This was done with much caution and misgiving. The drawings by this distinguished artist at this period were but one-tenth of the value which they afterwards realized at public auctions. In an interview with William Vokins, who at this time had the majority of Hunt's works from the easel, and while contemplating a drawing of a 'Bird's Nest', the price of which was but twenty-two guineas, Wade expressed his great desire to purchase, but added: "I am but a poor surgeon, and though I should like it much, I hardly feel justified in doing so; but tell me honestly, should it so occur that I am unable to retain it, is it likely I may get my money again?" Being perfectly assured on this point, Wade bought the picture, and it was the nucleus of a collection of drawings of fruit, flowers, etc, entirely by this master - not large, but admitted to be unique in quality by everyone acquainted with the matter who had seen them, either on his walls or at the loan exhibitions, to which he was at all times a willing contributor. The possession of these drawings led to his acquaintance with the artist, and he became his medical adviser, attending him in his last illness. The collection - a remarkably fine one - was subsequently sold by Christie & Manson, and fetched enormous prices. Wade died at his house in Dean Street, Soho, two hours after a cerebral haemorrhage, on Jan 16th, 1872.

Publications:-
Observations on Fever, 8vo, London, 1824.
Practical Observations on the Pathology and Treatment of Stricture of the Urethra, 8vo, London, 1841; 2nd ed, greatly enlarged, 1849; 4th ed, 1860. Conservative Surgery of the Urethra...Treatment by Potassa Fusa, 12mo, London; 2nd ed, 1868.

Sources used to compile this entry: [Autobiographical Recollections of the Medical Profession, by J F Clarke, 8vo, London, 1874, 449].

The Royal College of Surgeons of England