Dictionary of National Biography, 1927 supplement/Horsley, Victor Alexander Haden
HORSLEY, Sir VICTOR ALEXANDER HADEN (1857–1916), physiologist and surgeon, was born in Kensington 14 April 1857. His father was John Callcott Horsley, R.A. [q.v.]; his mother was a sister of Sir Francis Seymour Haden [q.v.]. He was the second son in a family of seven children. His childhood was spent in his father's country house at Cranbrook, Kent, and he became a day-boy at Cranbrook grammar school. In 1874 he matriculated at the university of London; and in his student years at University College Hospital he was already beginning studies of his own in physiology and bacteriology. In November 1880 he qualified for practice. He was house-surgeon to John Marshall [q.v.], and surgical-registrar at University College Hospital. It was at this time that he made a long series of observations on the action of anaesthetics on his own brain. From 1884 to 1890 he was professor-superintendent to the Brown Institution (University of London), in those days a place of great importance, not only as a veterinary hospital, but as the chief centre in London of advanced research in pathology and physiology. It was crippled by lack of funds, but it did admirable work. At the Brown Institution Horsley followed three main lines of study: (1) the action of the thyroid gland, (2) the protective treatment against rabies, (3) the localization of function in the brain.
(1) In 1873 Sir William Withey Gull [q.v.] had published the first description of myxoedema, and thereafter, William Miller Ord [q.v.] and others studied the disease. By 1883 myxoedema and cretinism were coming to be regarded as a result of the absence or inefficiency of thyroid tissue. In 1883 the Clinical Society appointed a committee to investigate the whole subject. Horsley was a member, and to him was entrusted the experimental work. It is important to note that his first experiments (removal of the thyroid) were made on monkeys. He proved beyond all dispute the action of the thyroid, and made certain what had only been guessed. The committee's report, published in 1898, gives a very good summary of myxoedema, but there is not a word of hope about curing the disease. Finally, in 1890, Horsley advised treatment by transplantation of a sheep's thyroid under the patient's skin, as Schiff had suggested. Later, came the work of George Murray and others on the administration of thyroid extract. Horsley's work does not stand absolutely alone; but it was he who founded in this country the modern study of the thyroid gland, and gave us the rational treatment of myxoedema and sporadic cretinism.
(2) The date of Pasteur's first use of the preventive treatment against rabies is July 1885. In 1886 the Local Government Board appointed a commission to study and report on the treatment. Horsley was secretary of this commission. He and (Sir) John Burdon Sanderson [q.v.], (Sir) Thomas Lauder Brunton [q.v.], and Sir Henry Enfield Roscoe [q.v.] went to Paris, where Horsley learned the whole method and collected many notes. It is literally true that Horsley, at the Brown Institution, was the only thorough student of rabies, and the only representative and interpreter of Pasteur's method in this country. He studied the outbreak of rabies among the deer in Richmond Park in 1886–1887, when no less than 264 deer died. In 1888 he examined and exposed the claims of a quack cure for rabies, the ‘Bouisson bath treatment’. He was chairman of the society for the prevention of hydrophobia, and together with other members of the commission rendered great services to the government over the enforcement of the order for the muzzling of dogs (1897).
(3) In 1884 Horsley began his chief work in physiology, his investigations of the localization of function in the brain and spinal cord. He was associated in this work with (Sir) E. A. Sharpey Schafer, Charles Edward Beevor [q.v.], (Sir) Felix Semon [q.v.], and his brother in law, Francis Gotch. He came to the work at the time of the high tide of interest in the physiology and pathology of the brain; and his contributions to the literature of the subject are numerous and very important.
In 1885 Horsley became assistant surgeon at University College Hospital. In 1886, at the very height of his experimental studies, he was elected a fellow of the Royal Society and professor of pathology at University College. That year, also, he was appointed surgeon to the National Hospital for the Paralysed and Epileptic, Queen Square, a post which brought him the leadership in a great field of surgery. Fifty years ago the rules for surgical interference with the brain were those which Ambroise Paré had followed in the sixteenth century. Trephining is not cerebral surgery: it is skull surgery. The recorded cases of real modern cerebral surgery, on the principles of localization of function, were not more than a dozen or so, when Horsley was appointed to the Queen Square hospital. He was only twenty-nine years old: but he was exceptionally well qualified for the work. His experimental work on monkeys, with nothing to guide him except the localization of function, had familiarized him with cerebral surgery. Before the end of 1886 he had done ten operations at Queen Square, nine of them successful. On 9 June 1887 he removed a tumour from the spinal cord: it was the first operation of its kind, and an event which takes a great place in the history of surgery. He had become familiar with the method and principles of the operation, by his experimental work on the cord. It may truly be said that the work of these two years set Horsley in the very front of his profession, and his reputation extended over the civilized world. During 1893 he made a long series of experiments on the effect of bullet wounds in the brain, which provided the evidence that the immediate cause of death in such cases is failure, not of the heart, but of the respiration. In 1906, when the British Medical Association met in Toronto, Horsley gave the address in surgery. He reviewed in it the whole field of cerebral surgery; and this address is one of the most significant among his writings.
The list of Horsley's published writings is of amazing length; so also is the list of his honours in this and other countries. He was knighted in 1902. The wonder is that he produced so much original work and writing, even in the years when he was at the zenith of his practice and was in demand everywhere. Moreover, he made time, even early in his career, to give himself zealously to the politics of his profession. He was president of the Medical Defence Union, served on the General Medical Council, and was one of the leaders of the British Medical Association. In these affairs of administration he was always on the side of reform inside the profession; and was incessantly befriending his less fortunate brethren.
The general election of 1910 brought Horsley into the rush of party politics, though he never entered parliament. He had no liking for compromises, and offended people by his vehemence and by his ardent and persistent support of the claims of women to citizenship. But there is every probability that if he had lived longer, he would have done excellent work in parliament for the national welfare. He took a leading part in the agitation against alcohol in this country, and, with Dr. Mary Sturge, published in 1907 a well-known book, Alcohol and the Human Body.
In the European War Horsley at first was surgeon to the British hospital at Wimereux, but in May 1915 he was sent to Egypt, and in July was appointed consultant to the Mediterranean expeditionary force. In March 1916 he went to India and Mesopotamia. Both in Egypt and in Mesopotamia he had grave reason to find fault with some of the arrangements for the wounded, and he fought hard to improve them. On 16 July 1916 at Amarah, hard at work up to the last moment, he died of heat-stroke.
No man in the profession has ever achieved a record equal to Horsley's twofold work in physiology and surgery. Envy had a good deal to do with the current criticisms of him; and there was much resentment against his occasional moods of intolerance. But his life was full of devotion to science and duty. He was generous to his patients and true to his friends; and he passionately desired to be of service to the nation, especially to its women and children.
Horsley married in 1887 Eldred, third daughter of Sir Frederick Joseph Bramwell [q.v.]. They had two sons and one daughter. Before 1892 he lived at 80 Park Street, Grosvenor Square, thereafter at 25 Cavendish Square.
[Horsley's published writings; Stephen Paget, Sir Victor Horsley, A Study of his Life and Work, 1919 (portraits); personal knowledge.]