Born on 6 October 1881 the eleventh child of the Rev Alfred James, Rector of Burwarton, Salop, and his wife Lucy Woodward and grandson of William James who was MP for Carlisle for nearly thirty years and served as High Sheriff for Cumberland, James was educated at Winchester College and St George's Hospital. He took the Conjoint qualification in February 1906 and the FRCS in May, but had to wait for his twenty-fifth birthday in October to be admitted a Fellow. He held resident posts at St George's and at Moorfields, where he became chief clinical assistant to William Lang, and at the Royal Westminster Ophthalmic Hospital; he was deeply influenced by Sir John Parsons. He became ophthalmic registrar at St George's in 1909 and assistant ophthalmic surgeon after a few months, a post he held for seventeen years, becoming ophthalmic surgeon only in 1926 and retiring in 1931. He was ophthalmic surgeon to the West Ham, now Queen Mary's, Hospital 1911-18. At St George's Hospital Medical School he was Dean 1918-22 and Treasurer 1925-27. He retired from private practice in 1935 and settled at Woodbridge, Suffolk in 1939, having previously lived at Ealing with consulting rooms first in Lower Berkeley Street and later at 46 Wimpole Street. Rutson James was secretary of the Ophthalmological Society of the United Kingdom 1918-21, later served on its Council, and received the uncommon distinction of honorary membership in 1936; he edited the Society's *Transactions* 1939-45; he was sub-editor of the *British Journal of Ophthalmology* 1924-29 and then editor for twenty years. James was by temperament a scholar and antiquary. He transcribed and annotated the registers of admissions to St George's Hospital Medical School 1759-1918 and the registers of the Barber-Surgeons Company 1540-1745. These and other scholarly transcripts he deposited in the College Library with a gift of £1000, and presented his outstanding collection of book-plates of medical men. He made many contributions to his own and other journals, on clinical and historical subjects, and published three historical books: *The School of Anatomy adjoining St George's Hospital 1830-1863* (1928), *Studies in the History of Ophthalmology in England prior to 1800* (1933), and *Medical Practitioners in the Diocese of London 1529-1735* (1935). James married in 1910 Margaret Julia Newson, who died on 4 March 1959; he died at Woodbridge on 28 September 1959 a week before his 78th birthday, and was survived by his only daughter. James was extremely modest and reserved, but did much good work and many kindly acts almost in secret; he was beloved by his friends.