James Wardrop
James Wardrop or Wardrope was a Scottish surgeon and ophthalmologist. Surgeon to King George IV and responsible for being the first to describe a retinoblastoma and uveal melanoma. And coining the term 'keratitis'.
Early life
Wardrop was born on 14 August 1782, the youngest son of James Wardrop and his wife, Christian Marjoribanks, at Torbane Hill, in Bathgate, West Lothian, a family estate where the Wardrops had lived for several generations. But at four years of age moved with the family to live in Edinburgh where he attended the High School, and then St Andrews University.Wardrop’s father had initially pursued legal studies, but abandoned them at the age of 20 following the death of his own father. Wardrop's mother, Christian, died in childbirth a year after his birth. She was the sister of Alexander Marjoribanks, owner of Balbardie House, an Adam-style mansion in Bathgate.
In 1786, when James was four years old, the Torbane hill estate was put up for sale. The family then relocated to a residence in south Edinburgh overlooking The Meadows.
Wardrop began his education at the High School in Edinburgh before the age of seven. At the time, the school had an enrollment of around 570 pupils, making it the largest in the United Kingdom. Under the rectorship of Dr. Alexander Adam, the curriculum focused heavily on Greek and Latin.
Among Wardrop’s contemporaries at the High School were several notable figures, including Adam Black, James Abercromby, and the brothers Leonard and Francis Horner. Another classmate, Andrew Geddes, went on to become a portrait painter and later painted portraits of both James Wardrop and his father.
Medical Training and Education
Although initially intended for a naval career, Wardrop developed a strong interest in natural history, which ultimately led him to pursue medicine. In 1800, at the age of 18, on the same day as James Keith he was apprenticed to a leading firm of surgeon apothecaries in Edinburgh, which included Benjamin Bell, James Russell and his great uncle Andrew Wardrop, former president of the Royal College of Surgeons of Edinburgh, and in 1801 was appointed House Surgeon at Edinburgh Royal Infirmary. Three months earlier, the surgeon apothecaries accepted John Henry Wishart of Foxhall, to whom Wardrop would later dedicate one of his books.Wardrop studied anatomy under Alexander Monro secundus and John Barclay at an extra-mural school in Edinburgh. He was appointed house surgeon at the Royal Infirmary of Edinburgh, then located in the William Adam-designed building on Infirmary Street. During his tenure there, he famously performed a thigh amputation on a young patient to assess whether he had the temperament necessary for surgical practice.
In 1801, Wardrop travelled to London to continue his medical education under John Abernethy and Astley Cooper at St Thomas’s, Guy’s, and St George’s Hospitals. Cooper, who had previously studied in Edinburgh in 1787, was a leading surgeon of the time and reportedly once charged a wealthy West Indian planter 1,000 guineas for a bladder stone removal.
In 1803, Wardrop moved to Paris to further his medical education. There he encountered the work of notable physicians such as Guillaume Dupuytren and Marie François Xavier Bichat. However, shortly after his arrival, war was declared between France and Britain as part of the Napoleonic Wars. British nationals in France were subject to arrest, and Wardrop initially avoided capture by hiding in a secluded room at the École de Médecine.
Eventually, he was detained and interned at Fontainebleau along with other British nationals. Despite the circumstances, the detainees engaged in recreational activities, including picnics and swimming in the canals. Wardrop even practiced swimming with the idea that he might need to cross the Rhine to escape. During his internment, he secretly returned to Paris on several occasions to continue his studies and made sketches at the Louvre.
Wardrop eventually obtained a false passport identifying him as an American merchant and fled to Antwerp, hoping to sail to the United States. Finding no available sailings, he continued overland to Germany, successfully crossing the Rhine at Koblenz, and eventually reaching freedom. From there, he travelled to Vienna, where his friend John Wishart was studying ophthalmology under Georg Joseph Beer, one of the most prominent ophthalmic surgeons in Europe at the time.
He was admitted a Fellow of the Royal College of Surgeons of Edinburgh in 1804 and worked at the Public Dispensary and set up in surgical practice specialising as an ophthalmic surgeon. In 1807 he became assistant curator of Surgeons' Hall Museum under Professor John Thomson and was elected a Fellow of the Royal Society of Edinburgh in 1808, upon the proposal of Andrew Wardrop, Alexander Keith of Dunnottar and James Russell. In 1805 he was elected a member of the Aesculapian Club. In 1808 he was sharing a large Georgian house in Edinburgh's First New Town at 4 South Hanover Street alongside his uncle and former mentor, Andrew Wardrop. During this time, he began to take a particular interest in diseases of the eye, which would shape much of his later work.
Career
In 1807, Wardrop was appointed assistant to Professor John Thomson, then Professor of Surgery and the first Regius Professor of Military Surgery at the University of Edinburgh. In this capacity, he also served as curator of the museum of the Royal College of Surgeons of Edinburgh. The first volume of the College’s General Catalogue includes entries in Wardrop’s own handwriting, documenting specimens—some of which he had donated himself.He became an active participant in several medical societies, including the Royal Medical Society and the Medico-Chirurgical Society. His first scientific publication appeared in the Edinburgh Medical and Surgical Journal in 1806, describing a case of crural hernia he had observed in Paris, illustrated with a drawing of his own.
In 1807, Wardrop published additional case reports and a significant paper titled Observations on the Effects of Evacuating the Aqueous Humour in Inflammation of the Eyes, and on the Changes Produced in the Transparency of the Cornea from the Increase or Diminution of the Contents of the Eyeball. This work built upon earlier research by John Barclay, who had demonstrated corneal opacification in a bullock’s eye following injection of the ophthalmic veins with mercury. Wardrop’s publication detailed five clinical cases of patients aged between 13 and 45, likely suffering from uveitis and secondary glaucoma, although not primary angle-closure glaucoma.
In 1808, he followed this with Practical Observations on the Mode of Making the Incision of the Cornea for the Extraction of the Cataract. In this work, he advocated using Beer’s knife, lubricated with oil and applied perpendicular to the corneal surface to prevent premature escape of aqueous humour—a method that remains relevant in modern cataract surgery. The precise technique of corneal incision continues to be a subject of discussion among ophthalmologists nearly two centuries later.
Also in 1808, Wardrop published the first volume of his textbook, Essays on the Morbid Anatomy of the Human Eye. He dedicated the work to his uncle Andrew Wardrop, writing:
“This essay is inscribed as a testimony of the author’s gratitude, for the professional advantages derived, and the benefits experienced, from the kindness of an affectionate relative, and sincere friend.”This volume focused on corneal disease and introduced the term "keratitis" into medical literature. Unlike previous authors who used the broader term "ophthalmia", Wardrop described ocular conditions with reference to the specific anatomical structures affected. He gave accurate descriptions of keratitic precipitates, though he incorrectly attributed them to inflammation of Descemet’s membrane. In the Preliminary Observations, he emphasized the advantages of the eye as a subject for pathological study, noting:
“For this beautiful organ is not only composed of a great variety of textures, but the transparency and ready examination of many of its parts in the living body admit of a great minuteness and accuracy of observation, and the various morbid changes can be seen going on much more distinctly than in any other part of the body.”In 1809, Wardrop published another notable work, Observations on the Fungus Hæmatodes, which presented 17 cases of a malignant ocular tumour initially named in 1805 by William Hey of Leeds. This condition would later be reclassified as retinoblastoma. Drawing on both previous literature and his own clinical and pathological observations, Wardrop correctly identified the tumour’s origin in the retina, its potential to invade the optic nerve, and the need for early enucleation—though this approach was impractical in children before the development of effective general anaesthesia.
Around this time, Wardrop was also commissioned to write the article on Surgery for the Encyclopædia Britannica.
In 1808, seeking to establish an independent practice and facing limited immediate opportunities in surgery in Scotland, Wardrop moved to London, where he worked as an ophthalmic surgeon from 1809 to 1869. He was awarded his doctorate by his alma mater, St Andrews University, in 1834. He taught surgery from 1826 at the Aldersgate Street medical academy with Sir William Lawrence and Frederick Tyrrell, and published surgical treatises. Wardrop was early appointed Surgeon-in-Ordinary to the Prince Regent. This annoyed his rivals in London, and he found the doors of the large hospitals closed to him. In retaliation he founded the West London Hospital for Surgery near the Edgware Road, and invited general practitioners to watch him operate. Further royal honours came, but he declined a baronetcy and moved out of royal circles. His social gifts, a knowledge of horses and marriage to a wife with aristocratic connections, brought him popularity.
He initially lived in rented accommodation on York Street, later settling at 2 Charles Street, St James’s Square, where he remained for the rest of his life. From this residence, he ran his medical practice, attracting a number of Scottish expatriates as patients and likely teaching at private medical schools.
Wardrop also came into contact with Carlton House, the residence of the Prince Regent, where he treated members of the royal household. His work brought him to the attention of Sir Benjamin Bloomfield, the Prince's secretary, and Lord Lowther, a close associate of the Regent. In recognition of his service, Wardrop was appointed Surgeon Extraordinary to the Royal Household. During this period, he also became acquainted with Matthew Baillie, a prominent physician whose private museum Wardrop was permitted to access.
Though he did not hold a teaching hospital appointment—possibly limiting his academic output—Wardrop continued to publish selectively. In 1818, he released the second volume of his major work, Essays on the Morbid Anatomy of the Human Eye, aiming both to advance his professional reputation and supplement his income. The volume, dedicated to his friend John Wishart, comprised 55 short chapters covering a wide range of ophthalmological subjects including the aqueous humour, iris, choroid, lens, vitreous body, sympathetic ophthalmia, amaurosis, night-blindness, colour vision, strabismus, and nystagmus, then referred to as "involuntary motion of the eyeball."
In this volume, Wardrop provided one of the earliest descriptions of iridodonesis—the tremulous motion of the iris—writing:
“In some cases where the operation for cataract has been performed, and where the iris remains apparently uninjured and the pupil of its natural form, the iris has been observed to have a very singular undulatory motion, being agitated to and fro like a piece of cloth exposed to a fluctuating wind.”The book also includes the first published reference to sympathetic ophthalmia, a serious inflammatory condition of the eye, and remained an influential text well into the late 19th century, predating William Mackenzie’s Treatise on the Diseases of the Eye by 12 years.
In the same year, Wardrop published a separate treatise titled On the Effects of Evacuating the Aqueous Humour on the Different Species of the Inflammation of the Eyes and in Some Diseases of the Cornea. This 57-page report presented 17 clinical cases, two of which are particularly notable. In the first, a 50-year-old man with a two-week history of visual disturbance experienced immediate improvement following paracentesis using Cheselden’s needle. Wardrop recorded that the patient was immediately able to "perceive a finger with a ring" and that the cornea quickly regained its natural transparency. In the second case, a middle-aged woman with a four-day history of intense frontal pain and ciliary injection saw an immediate resolution of symptoms following the procedure.
Wardrop compared the sudden reduction of intraocular pressure to the relief obtained from the evacuation of an abscess. Although he did not recognize it at the time, he was effectively treating acute angle-closure glaucoma, a condition not clearly defined until much later.