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Sir Victor Ewings Negus, MS, FRCS (6 February 1887 – 15 July 1974) was a British surgeon who specialised in laryngology and also made fundamental contributions to comparative anatomy with his work on the structure and evolution of the larynx. He was educated in London, studying at King's College School, then King's College, London, followed by King's College Hospital. The final years of his medical training were interrupted by the First World War, during which he served with the Royal Army Medical Corps. After the war, he qualified as a surgeon and worked and taught at King's College Hospital where he became a senior surgeon in 1940 and a consulting surgeon in 1946. He was elected a Fellow of King's College, London, in 1945.

His major publications included The Mechanism of the Larynx (1929) and his work on the clinical text Diseases of the Nose and Throat, starting with the fourth edition of 1937. He also published many medical papers and several other works on comparative anatomy and laryngology. Negus was one of the founders of the British Association of Otorhinolaryngologists, and was a member of numerous international and national otolaryngology organisations.

Negus, who married in 1929 and had two sons, retired from hospital work in 1952, though he continued to work and publish on comparative anatomy and the history of medicine. His honours before and after retirement included an honorary degree, the Lister Medal (1954), a knighthood (1956), honorary fellowships of the Royal College of Surgeons of both Edinburgh and Ireland, and the Honorary Gold Medal of the Royal College of Surgeons of England (1969). He died aged 87 in 1974.

Early life and education

The chapel of King's College, where Negus studied at university

Victor Ewings Negus was born on 6 February 1887 in Tooting, London, the youngest of three sons born to William and Emily (née Ewings). His father, William Negus, was a solicitor, Justice of the Peace, and Lieutenant for the County of Surrey. Victor's pre-university education took place at King's College School. In 1906, he was awarded a Sambrooke scholarship to King's College, London, on the Strand, where his studies for the next three years included premedical and preclinical subjects.

After passing the required examinations, he proceeded in 1909 to the next stage of his basic medical education at the nearby King's College Hospital, also on the Strand. Three more years of study led to the attainment in 1912 of the MRCS and LRCP degrees (the 'conjoint diploma'), marking his formal qualification to practice medicine. In the final year of these studies, Negus was an usher at the funeral service for Lord Lister at Westminster Abbey. Another connection with Lister's generation came when Negus worked under William Watson Cheyne. The postgraduate stages of Negus's training involved specialisation in diseases of the ear, nose and throat, a direction influenced and guided by the otorhinolaryngologist St Clair Thomson (1857–1943). In the years following his qualification in 1912, Negus worked at King's College Hospital, and had started further clinical training at the Hospital for Diseases of the Throat in Golden Square, Soho, but this was interrupted by the outbreak of the First World War.

Negus served in the Royal Army Medical Corps with the British Expeditionary Force for the first 18 months of the war. He initially deployed with the 1st General Hospital, then saw action in the trenches on the front line with a machine-gun battalion at the First Battle of Ypres. The effects of explosives during this period left him with tinnitus. This was followed by a period serving on hospital barges. In 1916, Negus, still with the RAMC, was posted to the 3rd (Lahore) Division (part of the British Indian Army) and took part in the Mesopotamia Campaign. As one of those who had deployed to the Western Front in the opening months of the war, he was later awarded the Mons Star. He was also mentioned in dispatches. His service in the RAMC ended in 1919.

Surgical career and family

The structure of the larynx, in which Negus specialised

Following his discharge from the army, Negus, again with the advice and guidance of St Clair Thomson, resumed his studies and preparations for a career in throat surgery. By 1921 he had graduated MB BS (London) and by 1922 he had taken the surgical exams for the FRCS (Fellow of the Royal College of Surgeons) qualification. To gain further experience, he spent periods of time abroad studying with renowned laryngologists: firstly with Emil-Jean Gabriel Moure and Georges Portmann in Bordeaux, France; and secondly with Chevalier Jackson in Philadelphia, USA. On his return to London, he became clinical assistant to St Clair Thomson at King's College Hospital.

At this point, still early in his surgical career, Negus took a different approach to that which was common at the time. Rather than be apprenticed to a leading surgeon in his ENT speciality, he undertook basic research on the structure of the larynx that would lead to a higher degree in 1924 and the publication of books and papers on the topic in later years. While engaged in this research, Negus continued his work at King's College Hospital, being appointed junior surgeon in 1924. It was during this period, following his return from the USA, that Negus both promoted the methods and tools he had seen used in Philadelphia by Jackson, and worked to improve the designs of the endoscopes and other equipment used in ENT surgery. These instruments, developed in collaboration with the Genito-Urinary Company of London, included laryngoscopes, bronchoscopes (such as the Negus bronchoscope) and oesophagoscopes. Other surgical innovations developed by Negus included an operating table (known as the King's College table), and a speaking valve for use in tracheotomy tubes. He also helped develop strategies for treatments of throat cancer to aid the choice between surgery and radiotherapy.

In 1929, Negus married Winifred Adelaide Gladys Rennie (1901–1979, known as Eve) with whom he would have two sons. His surgical and medical teaching career continued to progress, and he was appointed surgeon in 1931. It was in 1937 that his major work in clinical medicine, the fourth edition of Diseases of the Nose and Throat, was published. This work, "still used for reference", was described as "for many years the standard textbook in English on this subject", and as Negus's "major literary contribution to clinical medicine". The 1937 edition continued work on earlier editions by St Clair Thomson, who worked jointly with Negus on the new edition. A fifth edition worked on by both men was published in 1948 following Thomson's death, and the sixth edition by Negus alone appeared in 1955.

In 1939, the Negus family moved to Haslemere, Surrey. During the Second World War, Negus again served in a medical capacity, this time with the Emergency Medical Service (EMS) at Horton Hospital, Epsom, from 1939 to 1946. In 1940 he had been appointed senior surgeon at King's College Hospital, and in 1946 he reached the peak of his profession as a consulting surgeon.. Negus retired from clinical and teaching work six years later in 1952 at the age of 65.

Comparative anatomy

Examples of animal larynges, like those dissected by Negus. At left is the larynx of a horse. At right is the larynx of a pig.

In parallel with his career as a throat surgeon at a teaching hospital, Negus become a leading expert on the comparative anatomy of first the larynx and then the nose and the paranasal sinuses. This strand of his professional life started with the research he carried out in his thirties in the 1920s that eventually led to his degree of Master of Surgery (MS), awarded by the University of London. This work started as early as 1921 in the laboratories of the Royal College of Surgeons of England, whose museum housed the collections of animal specimens gathered by the anatomist John Hunter. Working on these specimens, and adding to them with others supplied by the Zoological Society of London, Negus carried out meticulous dissections that enabled him to trace the stages of evolution and development of the larynx across a wide variety of animals. Part of this research was submitted as his thesis, and the excellence of the work was recognised by the award of a Gold Medal with his MS degree in 1924. In addition to this, Negus gave the Arris and Gale Lecture on 28 April 1924 at the Royal College of Surgeons, with his talk titled 'On the Mechanism of the Larynx'.

Further recognition of his work came when Negus was made Hunterian Professor at the Royal College of Surgeons in 1925, followed three years later in 1928 by the awarding of the triennial John Hunter Medal (1925–7) from the Royal College of Surgeons, which came with a prize of £50. The following year Negus published his observations and conclusions in The Mechanism of the Larynx (1929), a "classic piece of research" still referred to forty-five years later in 1974 as "the standard reference book" on this topic. Negus's work had shown that the main function of the larynx is as a valve that only allows air into the lower respiratory tract. In humans, the voice is only a byproduct of this more vital function. Another lecture resulting from this work was given under the auspices of the University of London's Semon Lectureship, named after the German-born British laryngologist Felix Semon (1849–1921). This talk was delivered on 6 November 1930 at the Royal Society of Medicine under the title 'Observations on Semon's Law'.

These earlier works were followed after the Second World War by the publication of Comparative Anatomy and Physiology of the Larynx (1949). It was in the post-war period that Negus would increasingly study the function of the nose, both as the organ for the sense of smell (olfaction) and the role of the nose in respiration. This was prompted by wartime damage in 1941 to the Royal College of Surgeon's Hunterian Museum, which included the loss of parts of the Onodi Collection. This collection had contained specimens of the accessory sinuses (paranasal sinuses) prepared by the Hungarian laryngologist Adolf Onodi (1857–1919) and demonstrated by him in 1900. Negus undertook to replace the destroyed and damaged specimens and to extend the collection with animal specimens. This work was covered in Negus's Hunterian Lecture, delivered on 20 May 1954 at the Royal College of Surgeons under the title 'Introduction to the Comparative Anatomy of the Nose and Paranasal Sinuses'. This was followed four years later by the publication of Comparative Anatomy and Physiology of the Nose and Paranasal Sinuses (1958). Much of this later work was carried out after retirement in 1952, both at the laboratories of the Royal College of Surgeons and at the Ferens Institute of Otolaryngology at the Middlesex Hospital. Negus's research over many years on these topics and their relation to nose and throat surgery led to the awarding of the 1954 Lister Medal. This was presented the following year when Negus delivered the Lister Oration on 5 April 1955 at the Royal College of Surgeons. The oration was titled 'The Comparative Anatomy and Physiology of the Respiratory Tract in Relation to Clinical Problems'. Ten years later, towards the end of his life, Negus published The Biology of Respiration (1965).

Negus's legacy in this field was assessed in 1986 by the British surgeon and comparative anatomist Sir Donald Frederick Norris Harrison, himself an expert on the mammalian larynx. Writing further on the subject in 1995, Harrison states that Negus's "pioneer research into the mechanism of the animal larynx established him as a unique comparative anatomist." Harrison quotes from the Scottish anatomist Sir Arthur Keith's preface to The Mechanism of the Larynx. In this preface, Negus's 1929 work is described as showing "the same patient power of assembling observation after observation as Darwin had and some of the hot pursuit of function as urged by Hunter".

Societies and administration

The Royal College of Surgeons of England, at Lincoln's Inn Fields, London

As one of the leading practitioners in his speciality, Negus served in many roles in its organisation and administration at both a national and international level. In particular, he worked closely with the Royal College of Surgeons of England, the body responsible for the accreditation and representation of surgeons practising in England and Wales, and also the organisation that supported him in his researches in comparative anatomy. The Royal College of Surgeons is located in London, and from 1939 to 1941 he was President of its Listerian Society.

In 1942, Negus was President of the Section of Laryngology at the Royal Society of Medicine. When Negus had been training as a surgeon, laryngology, rhinology and otology had been separate specialities, but this was changing with the advent of ENT (ear, nose and throat medicine) as a combined discipline. Following the war, Negus was co-opted to the Council of the Royal College of Surgeons in 1947 to represent otolaryngology, the first to represent that speciality at Council level. He was also a member of the college's court of examiners, and worked to set up the first examination in otorhinolaryngology that could be taken for the FRCS diploma. This reorganisation was taking place against a background of immense change in how medicine was practised in the UK, due to the advent of the National Health Service (NHS). Negus's colleague, Geoffrey Bateman, writing in 1974, credits him with having the foresight to represent the interests of otolaryngology and see it established as a major speciality in its own right within the NHS. It was Negus and colleagues who, failing to set up the necessary structure within the Royal Society of Medicine, founded the British Association of Otorhinolaryngologists which would be able to represent ENT surgeons through the Royal College of Surgeons.

Negus became President of the British Association of Otorhinolaryngologists in 1951, and this was one of a number of presidencies he held, including that of the Thoracic Society (1949–50) and the Fourth International Congress of Otolaryngology. The latter was a large event that took place in London over a week in July 1949. It was held in the Great Hall of King's College, London, and was attended by over 700 otolaryngology specialists from thirty-nine countries. The patron was King George VI and the congress was opened by the Duchess of Kent. Negus also presided over the annual meeting of the Collegium Oto-rhino-laryngologicum Amicitiae Sacrum, held in London in 1954; he was also that organisation's honorary treasurer for the twenty years up to 1956. Negus was also associated with, and gave talks to, numerous medical societies in the UK and abroad, with his connections ranging from honorary fellowships to corresponding and honorary memberships. These foreign societies included the American Broncho-Esophagological Association, and the countries included Sweden, Denmark, Canada, the USA, Austria, France, Italy, Hungary, and Turkey. Bateman opined in his obituary of Negus that it seemed unlikely that any other British ENT surgeon "has been honoured by so many societies".

Following his retirement, Negus continued his involvement with the Royal College of Surgeons, becoming a trustee (and later chairman of the trustees) of the Hunterian Collection, the same collection that included the specimens that had underpinned his research some thirty years earlier. He also published books on the history of the college and its collections: The History of the Trustees of the Hunterian Collection (1965); and The Artistic Possessions at the Royal College of Surgeons of England (1968).

Honours and awards

In his later years, Negus received many awards and honours. In 1945, he was made a Fellow of King's College, London. On 25 July 1949, he received the honorary fellowship of the Royal College of Surgeons of Edinburgh. Further tributes followed as an honorary Doctor of Science (D.Sc.) was conferred on him on 17 May 1950 by the University of Manchester. Back in London, the Royal Society of Medicine made him an honorary fellow in 1954. Two years later, Negus was made a knight bachelor with the investiture taking place at Buckingham Palace on 7 February 1956. In 1958, it was the turn of the Royal College of Surgeons of Ireland to bestow their honorary fellowship on him. In addition to these awards, Negus continued to give lectures, including an Erasmus Wilson demonstration awarded by the Royal College of Surgeons of England in 1953, and the John Hopkins Lecture on 30 April 1957. Negus also wrote part of the article on 'Voice' for the 1952 edition of the Encyclopedia Britannica, and received the 1963 Gould Award from the William and Harriet Gould Foundation of Chicago, USA, "for his monumental contributions to the science of laryngology".

On 13 February 1969, Negus and two others (Sir Geoffrey Keynes and Sir Stanford Cade) were presented with the Honorary Gold Medal of the Royal College of Surgeons of England. This award, which had only been made thirty times since 1802 prior to the 1969 ceremony, is presented for "liberal acts or distinguished labours, researches and discoveries, eminently conducive to the improvement of natural knowledge and of the healing art." The medal was presented by Sir Hedley Atkins, the President of the Royal College of Surgeons, who paid tribute to Negus: "Sir Victor Negus is perhaps the most distinguished of all those who have served the Council as a co-opted member. He has always been known to us as a great research worker and scientist, whose labours earned him the Lister Medal, a man of exceptional integrity and industry and a persistent advocate of the value of tradition in its best sense." Atkins also paid tribute to Negus's wife, Lady Negus, who had crafted and presented to the college a tapestry of its coat-of-arms. Responding, Negus thanked the members of the Council for the award and for the privilege of having used college facilities since 1921, concluding: "I take this honour as a mark of approval for any work I have done, and I feel I can now sit back and leave it to others to carry on. I would also like to thank you for inviting my wife to be here to-day; she has taken a great part in all I have done."

Negus died in Hindhead, Surrey, on 15 July 1974, at the age of 87, survived by his wife and children.

Notes

  1. King's College School had originally been located in the premises of King's College, London on the Strand in Central London, but moved to Wimbledon in the suburbs of South-West London in 1897. As of 2011, entry to the school is from the age of seven.
  2. This funeral service on 16 February 1912 was a grand affair, attended by representatives from all over Europe. A contemporary description is given in Funeral Of Lord Lister, The British Medical Journal, Vol. 1, No. 2669 (Feb. 24, 1912), pp. 440-446
  3. Negus's memoirs from this period were deposited in archives at the Royal College of Surgeons of England, see Negus, Sir Victor (1887-1974) Knight Surgeon (The National Archives).
  4. For details of Negus's work on comparative anatomy, see the section: #Comparative anatomy.
  5. This marriage, which was announced in The Times, took place around four years after the death of Negus's father, who had died in the period 1924/5. Negus's mother died in 1939. Negus's wife was the daughter of an engineer, Robert Rennie.
  6. The quote from Sir Arthur Keith refers to Charles Darwin and John Hunter.
  7. The entry for Negus in Who Was Who includes a listing of these societies.
  8. Both the Oxford Dictionary of National Biography entry for Negus, by consultant ENT surgeon Neil Weir, and Bateman's obituary in the Annals of the Royal College of Surgeons of England, give details of the role played by Negus's wife Eve, describing her as "an artist of considerable merit" who illustrated several of his books.
  9. Negus's status in the history of laryngology in the UK was remarked on in his obituary in The Times, which stated that he "made a worthy fourth to Morell MacKenzie, Felix Semon, and St Clair Thomson".

References

  1. ^ Negus, Sir Victor Ewings (1887–1974), Neil Weir, Oxford Dictionary of National Biography, Oxford University Press, 2004, accessed 26 December 2011
  2. ^ Negus, Sir Victor, Who Was Who, A & C Black, 1920–2008; online edn, Oxford University Press, Dec 2007, accessed 26 December 2011
  3. ^ Sir Victor Negus, Br Med J. 1974 Jul 27; 3(5925): 263.
  4. ^ 'Obituary: Sir Victor Negus - Distinguished laryngologist', The Times, Wednesday, Jul 17, 1974; pg. 18; Issue 59141; col F
  5. ^ In memoriam. Sir Victor Ewings Negus., Geoffrey Hirst Bateman, Ann R Coll Surg Engl. 1974 October; 55(4): 201–202.
  6. ^ Sir Victor Negus, page 16 of The Anatomy and Physiology of the Mammalian Larynx (Cambridge University Press, 1995) by Sir Donald Frederick Norris Harrison
  7. The award of this Gold Medal (still awarded by the University of London in 2011) is covered in Back matter, The Journal of Laryngology & Otology (1924), 39: pp b1-b5
  8. On the Mechanism of the Larynx, The Lancet, Volume 203, Issue 5255, 17 May 1924, Pages 987-993
  9. Scientific Notes and News, Science, 18 May 1928: 505-508. "The John Hunter Medal in bronze, with the triennial prize of £50, has been awarded by the Royal College of Surgeons of England to Victor Ewings Negus, for his investigations into the comparative anatomy and physiology of the larynx and the bronchi in their relation to surgery."
  10. Observations on Semon's Law, The Journal of Laryngology & Otology (1931), 46: pp 1-30
  11. To Acknowledge a Generous and Welcome Gift from Sir Victor Negus, Ann R Coll Surg Engl. 1962 October; 31(4): 267–268
  12. Introduction to the Comparative Anatomy of the Nose and Paranasal Sinuses, Ann R Coll Surg Engl. 1954 September; 15(3): 141–173
  13. Lister Medal, Ann R Coll Surg Engl. 1954 September; 15(3): 173. "...in recognition of Mr. Negus's services to the advancement of knowledge in the surgery of the nose and throat by means of his researches into the comparative anatomy and physiology of the larynx and paranasal sinuses."
  14. The Comparative Anatomy and Physiology of the Respiratory Tract in Relation to Clinical Problems, Ann R Coll Surg Engl. 1955 May; 16(5): 281–304
  15. Victor Negus: 57 years later, D. F. Harrison, Ann Otol Rhinol Laryngol. 1986 Nov-Dec; 95(6 Pt 1): 561-6.
  16. 'Ear, Nose, And Throat Research Opening Of Congress', The Times, Tuesday, Jul 19, 1949; pg. 3; Issue 51437; col G
  17. Royal College of Surgeons of Edinburgh, Br Med J. 1949 August 6; 2(4622): 341 "At a reception held on July 25 the Honorary Fellowship of the College was conferred on Mr. Victor Ewings Negus. M.S., F.R.C.S., President of the Fourth International Congress of Otolaryngology held in London last month..."
  18. University of Manchester, Br Med J. 1950 April 1; 1(4656): 795–794. "On Founder's Day, May 17, the honorary degree of D.Sc. will be conferred on Victor Ewings Negus, M.S., F.R.C.S., Surgeon to the Ear, Nose, and Throat Department, King's College Hospital, for his contributions to medical research, particularly in laryngology..."
  19. 'Royal Society of Medicine', The Times, Wednesday, Jul 21, 1954; pg. 8; Issue 52989; col B
  20. Victor Ewings Negus, The London Gazette, 10 February 1956, Issue 40706, page 5 of 64
  21. Sir Victor Negus, The Journal of Laryngology & Otology (1967), 81 : pp 259-262
  22. 'Royal College of Surgeons', The Times, Friday, Jan 09, 1953; pg. 8; Issue 52515; col E
  23. The Etiology of Pharyngeal Diverticula, Bull Johns Hopkins Hosp. 1957 Oct; 101(4):209-23
  24. The Laryngoscope Volume 74, Issue 5
  25. ^ Award of the Honorary Medal of the College, Ann R Coll Surg Engl. 1969 March; 44(3): 169–171

External links and further reading

Obituaries and biographical articles
Portraits
Publications
Lectures
Other
  • Collections, The Royal College of Surgeons of England (includes over 200 sagittal sections of animals prepared by Sir Victor Negus)
  • The Collections, Grant Museum of Zoology (includes collection of bisected animal heads prepared by Sir Victor Negus)
  • Victor Negus: 57 years later, D. F. Harrison, Ann Otol Rhinol Laryngol. 1986 Nov-Dec; 95(6 Pt 1): 561-6. (Twelfth Daniel C. Baker Jr memorial lecture)
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