British Orthopaedic Association: first Founders' lecture.

I am deeply conscious of the honour you have done me in inviting me to give this, the first Founders’ Lecture. I have no doubt that your choice was influenced by the fact that of the three surviving Founding Fathers-Sir Thomas Fairbank, Mr Arthur Rocyn Jones and myself-it fell to my lot to be the first Honorary Secretary of the young Association launched forty years ago. The story of the growth of the Association from small beginnings in 1918 is a chapter in the history of the evolution of orthopaedic surgery in Great Britain during the first half of the twentieth century. Some of this story has been admirably told by Mr Rocyn Jones in his Presidential Address to the Orthopaedic Section of the Royal Society of Medicine in 1937. and more recently by Mr H. Osmond-Clarke in the special commemorative number of our official Journal in 1950. But, unlike the elephant, “ young men forget “; and some of the events of those early years will, I hope, bear repetition-and perhaps embellishmentwhen related by one who was an eye witness of the scene. At the turn of the century orthopaedics in Great Britain occupied an unimportant position as a differentiated speciality within the realm of surgery, and by common consent its field was limited to the correction of established deformity. The great mass of deforming diseases and injuries was at that time treated by general surgeons in general and children’s hospitals. Amongst the forty original members of the short-lived British Orthopaedic Society founded in 1894. there had been a mere handful of surgeons who practised orthopaedics exclusively. But in the decade before the outbreak of the first world war the scene had begun to change, and the stage was being prepared for the launching of a new specialist association. In London the three independent and rival charities, the Royal, National, and City orthopaedic hospitalsall institutions of small size-had merged in the new Royal National Orthopaedic Hospital, opened in Great Portland Street in 1909. Of the five surgeons brought together on the staff of the combined hospitals, two only were orthopaedic surgeons and nothing else-Mr E. Muirhead Little and Mr Evan Laming Evans. A. H. Tubby, well known for his writings, T. H. Openshaw. and J. Jackson Clarke, were also general surgeons at the Westminster, the London. and the Hampstead General respectively. It was true that at St Bartholomew’s an orthopaedic department, so-called, had existed since 1864; but until 1912, when Mr R. C. Elmslie was appointed to take charge, the department had been simply a special out-patient clinic conducted by one of the assistant surgeons of the hospital. Of these, one who made notable contributions to the literature of orthopaedics was Howard Marsh. In 1906 the Charing Cross Hospital had unwittingly made history by creating a department with a few beds under H. A. T. Fairbank, who had already begun to achieve distinction in children’s orthopaedics at Great Ormond Street. At Guy’s also orthopaedics was emerging from its subordinate status under the control of the general surgeons, and, after a period of travel which included Liverpool and Scandinavia, W. H. Trethowan was elected as the first specialist orthopaedic surgeon in 1913. Blundell Bankart, also a Guy’s man, had previously thrown in his lot with the Royal National Orthopaedic Hospital, where after serving as registrar he had been appointed Assistant Surgeon with the duty of acting as substitute in the absence of any one of the five senior surgeons.