Our History

George Ernest Gask (1875-1951) 

During the First World War, Gask played a distinguished part in the RAMC, securing the most up-to-date treatment for wounds of the chest and lungs, at that time a new specialty. He was particularly concerned with improving the education of younger surgeons and after the war, introduced a full-time professorial unit at Bart’s Hospital. His brilliant team of Sir Thomas Dunhill, Geoffrey Keynes and Ronald Ogier Ward established the success of this innovation. He was active with the British Journal of Surgery and succeeded Moynihan as Chairman of the Editorial Committee. He retired from all surgical activity in 1935, but with the outbreak of hostilities in 1939 joined the Radcliffe Infirmary, became involved in the work of the Oxford medical school and became adviser in surgery for the region

George Gask had shown in the First World War that for unilateral injuries the chest could be safely opened and closed. After the war Arthur Tudor Edwards applied this expertise in civilian practice, first for tuberculosis, and later in tumours, bronchiectasis and diseases of the oesophagus. His work was made possible by the skill of his anaesthetist Sir Ivan McGill who had done so much for plastic surgery. Pioneering work went on in the old sanatoria where collapse therapy by phrenic nerve crash, artificial pneumothorax, thoracoplasty and plombage were developed to ‘rest’ the lung.

Arthur Tudor Edwards (1890-1946) 

At the Brompton Hospital, Edwards was a pioneer in applying his wartime experience of thoracic surgery to civilian illnesses, including pulmonary tuberculosis, bronchiectasis, tumours of the mediastinum and tumours of the lung. In this work he was supported by his colleagues RA Young - a physician, and Ivan Magill – an anaesthetist. His work established thoracic surgery as a specialty and himself as it’s recognised leader. During the Second World War he organised the reception centres for thoracic casualties under the Emergency Medical Service and provided intensive courses of instruction for service thoracic units. He was President of the Society of Thoracic Surgeons and President of the Association for the Study of Diseases of the Chest. He served on Council from 1943 until his early death in 1946. 

Sir Thomas Holmes Sellors (1902-1987) 

Following resident medical and surgical appointments at the Middlesex and Brompton Hospitals, Sellors was surgical registrar at the Middlesex. In an era in which tuberculosis was a major bane to society, Sellors' decision to specialise in chest surgery kept him busy. He secured appointments at several London county council hospitals and sanatoria and started chest units at infirmaries around the country. From the outbreak of the Second World War until his retirement, Sellors worked as an adviser in thoracic surgery at Middlesex, serving also as consultant surgeon to the National Heart Hospital and setting up three new open heart surgery units. Known to a generation of his devoted pupils as 'Uncle Tom', Sellars had a strong dedication to public service, serving on numerous committees and holding many offices, including President of the College from 1969 to 1972.

Others to develop the new speciality between the wars were Sir Thomas Holmes Sellors and Lord Brock. Brock had been responsible for fundamental work on the segmental anatomy of the lung to locate long abscesses. This lead to lung resection for segmental disease. As the threat of tuberculosis receded, thoracic surgeons turned their attention to the heart and the aorta and mitral valvotomy, which Sir Henry Souttar had shown to be feasible as early as 1925, was revived. Holmes Sellors was one of those in the vanguard, confronting the large number of congenital cardiovascular anomalies. Success with patent ductus arteriosus and coarctation of the aorta opened up the field of open-heart surgery with whole-body cooling and circulatory arrest and pump oxygenators in the late 1950s. Bypass of occluded coronary arteries, introduced in 1968, transformed cardiac surgical practice.

Sir Henry Sessions Souttar (1875 - 1964)

Souttar enjoyed a great reputation as a teacher , clinician, writer, examiner and as a wise medical politician. He performed an historic operation in 1925 by opening the heart of a 15 year-old girl suffering from mitral stenosis in order to dilate the mitral valve, without using any antibiotic cover or modern means of anaesthesia. It was 22 years before such an operation was repeated. Drawing on his mathematical knowledge and engineering skills, Souttar devised many surgical instruments, such as an atraumatic intestinal needle, an oesophageal tube, steam cautery and a craniotome. He served on Council from 1933 - 1949 and was vice president in 1943 - 1944. Souttar suggested that the college form faculties in anaesthesia and dental surgery, and received honorary fellowships from both faculties when found in 1947 and 1948, respectively.

The first meeting of the Society of Thoracic Surgeons of Great Britain and Ireland took place at the Brompton Hospital in November 1933, under the Presidency of H Moriston Davies and attended by 23 members. The Thoracic Society developed as an offshoot, holding its first scientific meeting at the London School of Hygiene and Tropical Medicine in July 1945 and developing its own journal – ‘Thorax’. The two societies merged again as the Society of Cardiothoracic Surgeons of Great Britain and Ireland in 1984 .

Sir Terence English (born 1932 - ) 

Born in South Africa English came to the UK in 1955 to study medicine at Guy’s Hospital. He trained under Lord Brock and Donald Ross and then at the Brompton and National Heart hospitals. Appointed a Consultant at Papworth and Addenbrooke's hospitals, he established the UK cardiac surgical register in 1977 and performed Britain's first successful heart transplant in 1979. He was president of the International Society of Heart Transplantation from 1985 to 1986 , president of the Royal College of Surgeons of England 1989 to 1992 and president of the British Medical Association (BMA) 1995 to 1996. He was also master of Saint Catherine's College Cambridge  

The UK cardiac surgical register, the concept of Sir Terence English was established in 1977. It correlated post-operative deaths from all UK National Health Service cardiac units, and was the first attempt to collect national activity and outcome data. Cardiac surgery has remained in the spotlight, since failure to achieve the expected outcome can be lethal. A more comprehensive data collection system was introduced in 1994 covering demographic, procedural and outcome information on all patients undergoing cardiac and thoracic surgery.

The Cardiothoracic Society has retained its position as a leading speciality in the collection of data and exploring methods of external validation.

At the beginning of the 20th Century surgeons began to specialise in a particular form of surgery. This development of specialisation was accelerated by the First World War [Riberio]. In 1918 the British Orthopaedic Association was formed and in 1926 the Society of British Neurosurgeons was founded by two surgeons who practised exclusively as neurosurgeons. Despite its rather limited scope at this time developments in thoracic surgery were rapid and it increasingly became an area of specialisation [Abbey Smith].

In this era of development, on 19th September 1931, Bryce[1] wrote to Morriston Davies[2] ‘Since the day when I enjoyed your hospitality at Ruthin I have thought more and more of the idea of forming some sort of little surgical club or society for people interested in Thoracic Surgery.’ Later he writes ‘Do you think the London men would be interested in such a project?’

Presumably the response from Morriston Davies was positive because on 2/11/31 Bryce wrote to Roberts[3] at 26 Harley Street, London, raising the idea of a thoracic surgery club.

In May 1932 the Association of Surgeons annual meeting was held in London. Evidently Bryce and Roberts met there and talked further because on 19th April 1933 Bryce writes again to Roberts asking if he is coming to the Association of Surgeons meeting in Manchester in 1933 where he has arranged a dinner to ‘renew the discussion about the formation of a society of thoracic surgeons.’

The dinner took place on Friday 5th May 1933 at the Midland Hotel in Manchester. Present were Bryce, Morriston Davies, Tudor Edwards[4], Price Thomas[5] and Moir[6].

We have no record of this meeting beyond the menu however subsequent correspondence indicates that the formation of ‘The Thoracic Surgeon’s Club’ was agreed. In deference to seniority, Morriston 

Davies was to be President, Roberts and Tudor Edwards Vice-Presidents and Bryce Secretary. The intention was to limit membership to 20 to 25 and to hold an annual meeting in October or November alternating between a venue at home and one abroad.

In June 1933 Bryce writes a series of letters to those surgeons known to have an interest in thoracic surgery seeking their support for the club. All replies are very supportive including the ‘London men’ who all write from a Harley Street address. Nelson[1], in his reply of 9th June 1933, from 26 Harley Street, suggests that an Association would be more appropriate than a club. At some point before the first Annual Meeting the name became The Society of Thoracic Surgeons of Great Britain and Ireland.

Fig. 1 The signing in book for SCTS’ first Annual MeetingThe first annual Meeting was held on Saturday 11th November 1933 at The Royal Brompton Hospital figure 1. A business meeting was held in the morning, Morriston Davies was confirmed as President, Roberts and Tudor Edwards as Vice-Presidents and Bryce as Secretary. The members of the committee were Anderson, Hunter, Moir, Morison and Romanis. The constitution and an annual subscription of half a guinea[2] were agreed. In the afternoon operations were performed by Roberts and Tudor Edwards. Dinner was held at the Langham Hotel.

The second committee meeting was held on the London to Folkstone train on Sunday 11th November 1934. The committee were travelling to the second Annual Meeting in Davos-Platz, Switzerland.

Notes

[1] Alexander Graham Bryce 1890-1968. Thoracic surgeon at Manchester Royal Infirmary became interested in thoracic surgery in 1929 and was the driving force behind the foundation of SCTS. He was Secretary 1933 to 1946, Vice-President 1947 to 1949 and President 1950 to 1951.

[2] Hugh Morriston Davies 1879-1965. Specialised in thoracic surgery from 1908 whilst working in London, he pioneered many important developments and was developed an international reputation.  In 1916 he cut his right hand whilst operating on an empyema. The subsequent infection in his hand and forearm left his hand effectively useless. Considering his surgical career to be over he purchased a sanatorium in North Wales, however recognising that many of his patients required surgery he taught himself to operate left handed and resumed surgery in 1921.

[3] James Ernest Helme Roberts 1881-1948. Thoracic surgeon in London who helped develop thoracic surgery after the First World War.

[4] Arthur Tudor Edwards 1890–1946. Thoracic surgeon in London, who like Morriston Davies and Roberts was a pioneer of the specialty in the twenties.

[5] Sir Clement Price Thomas 1893-1973. Thoracic surgeon in London trained by Tudor Edwards. On Sunday 23rd September 1951 he performed a left pneumonectomy on King George VI at Buckingham Palace. It may be apocryphal but it is said that after removing the lung, Price Thomas left his assistants to close and went to speak to the waiting Royal Family. Princess Elizabeth, now her Majesty Queen Elizabeth, asked if she could see her father to which Price Thomas replied that they were just finishing the operation. Princess Elizabeth replied asking why Price Thomas was not in the operating theatre then. Price Thomas replied ‘Ma’am, I haven’t  closed a chest in 25 years and I am not going to start again with the King of England.’ 

[6] Percival John Moir 1893-1980. Professor of Surgery at Leeds. Is best known as a general surgeon but must have has a thoracic surgical interest at this stage of his career.

[7] Henry Philbrick Nelson 1902-1936. Born in New Zealand he was educated in England and trained in London. He died from streptococcal septicaemia contracted after he cut himself whilst operating.

[8] Half a guinea, ten shillings and six pence equivalent to about twenty five ponds today.

References

Ribeiro B, Chaplin S, Peel A, Treasure T, Leopard P, Jackson B. Surgery in the United Kingdom, Arch Surg 2001;136:1076 – 1081.

Abbey Smith R. The development of lung surgery in the United Kingdom. Thorax 1982;37:161 – 168.

Acknowledgements

Article written by Mr Graham Cooper (SCTS President 2016-2018)

I am grateful to Isabelle Ferner for access to the SCTS archive and The Royal College of Surgeons of England, Library for access to their archive.

On Friday 14th July 1950, an emergency meeting of the Executive Committee of the Society of Thoracic Surgeons of Great Britain and Ireland was held in the Guild Hall, Bath. The meeting had been called by president Alexander Graham Bryce after receiving a letter from Dr Brian Blades, secretary of the American Association for Thoracic surgery (AATS). This letter announced the formation of a travelling fellowship for the study of thoracic surgery in the United States or Canada with a value of $10,003. The Society of Thoracic Surgeons of Great Britain and Ireland had been invited to nominate the first recipient of the fellowship. 

Present at the meeting were:

1. The president, G. Bryce, 
2. Secretary O.S. Tubbs
3. Committee members P.R. Allison, V.C. Thompson, A. Logan and L.L. Whytehead.

They decided that the privilege of selecting the candidate should rest with the Executive Committee. The fellowship was advertised to all members and associate members of the Society and also announced in the British Medical Journal on 12th August 1950 (figure 1 below). 

Fig 1: The notice in the British Medical Journal announcing the first AATS fellowship in 1950.

One year later, on 18th July 1951, the Executive considered the four candidates who had applied and ‘after long and careful consideration it was unanimously agreed to recommend LL Whytehead.’4 In 1952 and 1953 the Executive Committee selected the second and third recipients of the fellowship. However, at its meeting on 11th November 1954, in light of comments from Sir Russell Brock that ‘a number of approaches had been made to him with regard to elements of dissatisfaction that had been felt in America concerning Fellows’ , the Executive decided to begin interviewing candidates for the Fellowship. 

The following year the Society heard from the AATS that these rumours had no substance. From the minutes, one can almost hear the sigh of relief when the rumour was dismissed.  From that point onward, the selection of the travelling fellow was the first standing item of business at most Executive Committee meetings.  It was not surprising that there was a good relationship between the two professional societies, as many of the senior members of the specialty in Great Britain had undertaken at least some of their training in America5.  

In November 1955, the Executive Committee formed a sub-committee to discuss how the British Society could show its gratitude for the generosity of the AATS.  Their report from 23rd February 1956 described three options: 

·       A similar reciprocal scholarship 
·       A shorter reciprocal scholarship 
·       A simple gift of a chain of office for the President of the AATS  

The final option was selected, probably because of financial considerations. 
 

The Presidential Badge and Chain of Office for the AATS 

The twentieth Annual Meeting of the Society of Thoracic Surgeons of Great Britain and Ireland was held at the Institute of Engineers in Cardiff on the 2nd and 3rd November 1956. At the business meeting, there was the usual approval of the previous minutes, confirmation of officers, and presentation of accounts. The first item of new business was the proposed design of the Presidential Badge and Chain of Office to be given to the AATS; the design was shown and accepted. The cost was to be met by a one-time assessment of £2 for full members and £1 for associate members. 

The commission for the design and making of the Badge and Chain (figure 2) was given to Stanley G. Morris. We have no records about the commission or how Stanley G. Morris was selected.  However, at the time he was one of the country’s leading designers and craftsmen and one of the few who had the skill to design as well as fabricate. Stanley G. Morris lived from 1919 to 2010 and was a fourth generation silversmith from Birmingham. He trained at the Birmingham School of Jewellery and Silversmithing and School of Art. During his training, he was supported by prestigious Junior and Senior scholarships from the Worshipful Company of Goldsmiths. In 1947 he set up his own workshop in Birmingham. Much of his work was ecclesiastical; examples can be found in many churches across the country.  Morris achieved national recognition when his ‘Olympic Symbolic Torch’, designed and made with Bernard Cuzner, another renowned Birmingham silversmith, won Bronze Medal in the 23rd Olympiad Arts Competition in 1948.  His work was also showcased at The Festival of Britain in 1951.  He created pieces for many prestigious people including a cup presented by Queen Elizabeth, the Queen’s mother, to the flower growers of London and a bowl presented to Princess Margaret. His last major commission, in 1992, was to build the Westland Aviation Trophy, presented to the best all round student on the Rotary Wing Course at the Empire Test Pilots’ School. 

Fig. 2 The Presidential Badge and Chain of Office of the American Association for Thoracic Surgery, front and back

Fig 3: The presentation of the Presidential Badge and Chain of Office to the American Association for Thoracic Surgery, 1957.

Left to right (we think!) J.L. Collis, Secretary SCTS, G.A. Mason, Vice-President SCTS, C. Haight, President AATS. 

The Presidential Badge and Chain of Office was presented to Dr Cameron Haight, AATS President, by J.L. Collis, Secretary and GA Mason, Vice-President of SCTS at the Annual Meeting in Chicago Illinois between 4th and 7th May 19579 (figure 3). The Chain of Office contained 17 links; after each annual AATS meeting, a link on the chain was engraved with the president’s name and year of term. In 1973 Morris made a second Chain of Office, as the links on the first were full (figure 4). 

Fig 4: Stanley Morris with the American Association Presidential Badge and the second Chain of Office, the first Chain is in the foreground. January 1973. Reproduced courtesy of Mirropix. 

The Presidential Medal of the Society for Cardiothoracic Surgery 

In planning the Presidential Medal to be given to SCTS, the AATS wished to recognise William Harvey.  On
1st August 1600, Harvey was elected as the British representative to the world’s leading medical school at the University of Padua. Each representative or ‘consiliarius’ had a coat of arms, symbol or Stemma engraved on a tablet in the Great Hall of the University.  Harvey chose as his Stemma an arm and hand holding the torch of truth; this forms the centrepiece of the design of the Presidential Medal.  Two serpents, associated with Aesculapius, the Greek God of medicine, entwine the torch (figure 5).  

The task of making the medal, in 14 carat yellow gold, was given to Allan Adler, who like Stanley G Morris, was the leading silversmith in America at the time. Allan Adler lived from 1916 to 2002, and initially worked as a building contractor.  In 1938 he married Rebecca Blanchard, the daughter of Porter Blanchard one of America’s foremost silversmiths. He served a two-year apprenticeship with Porter and set up his own business in Los Angeles in 1940.  His shop Sunset Boulevard attracted many stars, including Katherine Hepburn, Errol Flynn and Michael Jackson.  Adler became known as Silversmith to the Stars.  He made a coffee urn for John F. Kennedy and a silver hairbrush for Winston Churchill.  Adler’s biggest thrill, which he likened to Paul Revere’s midnight ride, was to design and make lapel pins for the crew of Mercury 7, the first Americans in space. Like Stanley Morris, Allan Adler was a talented designer as well as a craftsman. After the war, despite increasing automation, Adler continued to work by hand.   This tradition is continued today by his grandson Danny Parsell. 

The medal was presented at the SCTS Annual Meeting in 1978 at Leeds. The delegation from the AATS consisted of
J. Gordon Scannell, Myron W. Wheat and Lyman A. Brewer. They were met at the airport by Sir Donald Ross and Marian Ionescu. Given the value of the Presidential Medal, Brewer and Ionescu hurried into London to deposit it with Barclays Bank for later safe transport to Leeds. The presentation was made to the President of SCTS H.R.S Harley at the meeting on Friday 29th September 1978.  

The Badge and Medal in 2018 

Both the Presidential Badge and Chain of Office and Presidential Medal remain in use today. The AATS Badge is worn by the President during official duties at the Annual Meeting and of course during the Presidential Address. The design of the badge is the official letterhead of the Association and will of course be familiar to readers of the Journal of Thoracic and Cardiovascular Surgery.  

The SCTS medal is worn by the president at the Societies’ annual business meeting and during the biannual presidential address. The medal is currently valued at £13,550 (US $17600).  The medal contains a hallmark dated 1988 by a company called Argenta Design who have now ceased trading but were based in London. The hallmark identifies that the gold is 9 carat. We have had the medal independently weighed and the medal is indeed 9 carat. There are two possible explanations for this. First, the original medal may have been lost and the current medal is a replacement made in 1988 by Argenta Design.  However, there is no mention of loss of the medal or obtaining a replica in the SCTS Executive minutes of this period. We believe that it is unlikely that such an occurrence would not have been recorded in the minutes. The second and more likely explanation is that the hallmark was added in 1988 after the company Argenta Design valued the medal and that the documentation describing it as made of 14K yellow gold is wrong. A hallmark is not required to be stamped on all gold goods in the United States of America. 

Conclusion 

The notes prepared by the AATS to in the presentation of the Presidential Medal refer to the ‘deep bond of friendship between the two societies, their early histories and the profound impact that they have had on the development of thoracic surgery’.  The British sentiment was similar, and the Executive Committee clearly held their colleagues in the American Association in high regard.   

In 2019, a Presidential Badge and Chain of Office and Presidential Medal may seem anachronistic but both the AATS and SCTS have taken great pride in the history and display of these symbols of our mutual admiration and respect.  It seems fitting to retell the story of their history, if only to celebrate the deep ties between our two professional organisations.

Acknowledgements

Article written by Mr Graham Cooper (SCTS President 2016-2018)

The following have all provided valuable help in researching this article: 

• Eleni Bide and Sophia Tobin at The Goldsmiths’ Company 
• The Royal College of Surgeons of England Archive 
• Stephanie Higgs, niece of Stanley G Morris 
• Dauvit Alexander, School of Jewellery, Birmingham City University 
• Isabelle Ferner, SCTS 
• Bill Maloney, AATS 

• 1934 Mr H Morrison Davies
• 1936 Mr J R H Roberts
• 1938 Mr A Tudor Edwards
• 1945 Mr J B Hunter
• 1947 Mr W M Anderson
• 1948 Mr R B Purse
• 1950 Mr A Graham Bryce
• 1952 Sir C Price Thomas
• 1954 Mr H Reid
• 1956 Mr B Dick
• 1958 Sir R Brock
• 1959 Mr G A Mason
• 1961 Sir T Holmes Sellors
• 1963 Mr R F J Henry
• 1964 Mr N R Barrett
• 1966 Mr V C Thompson
• 1968 Mr P R Allison
• 1969 Mr A L d’Abreu
• 1970 Mr A Logan
• 1971 Mr O S Tubbs
• 1972 Mr F R Edwards
• 1973 Mr J L Collis
• 1974 Mr R H R Belsey
• 1975 Mr R S Barclay
• 1976 Mr W P Cleland
• 1977 Mr H R S Harley
• 1978 Mr R Abbey Smith
• 1979 Mr R P Moore
• 1980 Mr J R Belcher
• 1981 Mr M Bates
• 1982 Mr J M Hill
• 1983 Mr J F Dark
• 1984 Mr D N Ross
• 1985 Mr M Paneth
• 1986 Mr M V Baimbridge
• 1987 Sir K Ross
• 1988 Professor W H Bain
• 1989 Mr W G Williams
• 1991 Professor D I Hamilton
• 1992 Professor G H Smith
• 1994 Mr B Ross
• 1995 Mr J Bailey
• 1996 Professor H Matthews
• 1997 Professor D Wheatley
• 1998 Mr J Dussek
• 2000 Mr J Monro
• 2002 Mr C Hilton
• 2004 Mr P Magee
• 2006 Professor Sir B Keogh
• 2008 Mr L Hamilton
• 2010 Professor D Taggart
• 2012 Mr J Roxburgh
• 2014 Tim Graham
• 2016 Graham Cooper
• 2018 Richard Page
• 2020 Simon Kendall
• 2022 Narain Moorjani