Astley Cooper reached his zenith in Broad Street. In one year his income reached £21,000; for many years it was £15,000. One merchant prince paid him £600 a year; the story of another, who tossed him a cheque for a thousand guineas in his night-cap, after a successful operation for stone, is well known. Many of his patients wrote a cheque for their fee when they consulted him, and never made it less than five guineas. It is amusing to contrast with his reputation as a surgeon and operator, the extremely limited pharmacopœia to which he trusted. “Give me,” he would say, “opium, tartarized antimony, sulphate of magnesia, calomel and bark, and I would ask for little else:” and from five or six formulæ he gave his poorer patients a constant stock of medicine.
Mr. Cooper was appointed Professor of Comparative Anatomy at the Royal College of Surgeons in 1813, being the first appointment after Sir Everard Home retired. He lectured during only two seasons, in 1814 and 1815. Not being deeply read in his subject, he resolved to see what industry could do, and restricted himself to three or four hours’ sleep, that he might gain additional time for the dissection of animals. He also employed several assistants to dissect for him, and the result was that his specimens came by coach-loads to each lecture. Mr. Clift remarks of one lecture, “This was an overpowering discourse, and highly perfumed, the preparations being chiefly recent and half-dried and varnished.” His lectures were very successful, though he would have preferred lecturing on surgery, which was allotted to Abernethy. In the year last mentioned he resigned the professorship and also moved to New Street, W., hoping thereby to diminish the fatigue occasioned by the numerous visits which he had to pay westward. In the following May he signalised his skill by his celebrated operation of tying the aorta or principal artery of the body, for aneurism, in a case in which life was in the extremest peril. The ease with which he prepared for the operation and the masterly skill and success with which he completed it—without the aid of chloroform, be it remembered—excited admiration throughout the profession, who could best judge of the difficulties which had to be overcome. The patient died of incurable disease, but the success of the operation was undoubted.
After having for some years attended Lord Liverpool, Mr. Cooper was in 1820 called in to George IV., who afterwards insisted on his performing a small operation upon him, although he then held no court appointment. He was very reluctant, fearing erysipelas, and only at length yielded to command. His success in this was followed by the conferment of a baronetcy, which was hailed with acclamation by all his friends both professional and public.
In 1822 Sir Astley first became an Examiner at the College of Surgeons. In this capacity he was very conscientious and considerate, never asking catch-questions, or making abstract inquiries, but invariably dwelling upon practical matters, and putting his questions in simple and straightforward language. In the same year appeared perhaps his most important work, that on Dislocations and Fractures of the Joints, and as was his fixed principle, he published it at a price just sufficient to cover the cost of the letterpress and engravings.
In January 1825 Sir Astley resigned his lectureship at St. Thomas’s, owing to the impairment of his health. Mr. Key had previously been delivering part of his surgical course, and his nephew Bransby Cooper had undertaken the anatomical lectures; and Sir Astley was determined to secure their succession to his appointments. He had only resigned in the firm conviction that this was generally agreed upon. His astonishment may be imagined when he learnt that Mr. South had been appointed anatomical lecturer. Sir Astley, desiring to withdraw his resignation, was informed that it was too late. Mr. Harrison, however, the then spirited treasurer of Guy’s, came to the rescue, and offered to establish a school of medicine at Guy’s, totally independent of St. Thomas’s, and to appoint Mr. Key and Mr. Bransby Cooper to the chairs of surgery and anatomy. This was at once agreed to, and a lecture theatre and other premises hastily built during the summer, so that the new school of Guy’s was opened in the succeeding October. A large proportion of the old pupils of the united schools of St. Thomas’s and Guy’s entered at Guy’s, and a considerable number of new pupils coming up, the now famous school was prosperously floated. Sir Astley did not lecture much for the new school, though he gave a few occasional lectures on anatomy and surgery, which of course were crowded to excess. He now became consulting surgeon to Guy’s, and evidenced his zeal by commencing the formation of a museum like that which he had already deposited at St. Thomas’s, and which he would have removed thence had it been in his power. In 1827 he was elected President of the College of Surgeons.
By this time Sir Astley had adopted the habit of spending as much of his time as possible on his estate at Gadesbridge, near Hemel Hempstead. Here he became a rural character, shooting and “making shoot” with eagerness and joviality. Lady Cooper, having lost her adopted daughter, Mrs. Parmenter, and having had no second child, could not endure living in London. In 1825, Sir Astley took his home-farm upon his hands, and kept it in consummate order, at considerable expense, it must be owned. He was always either experimenting or trying to carry out some new plan he had heard of or observed. He again and again became violently angry, as he grew older, when he found that his ideal farm only produced substantial loss: and used repeatedly to vow he would never allow such passion to overcome him again. One of his experiments in farming was the purchase of lame or ill-fed horses at Smithfield at from five to seven pounds apiece, feeding and doctoring them himself at Gadesbridge, and turning them into much better animals. He sometimes made a good profit in this way, and for years drove in his own carriage horses that had only cost him twelve pounds ten. If they were past cure, he would experiment upon them according to what investigation he might have in progress at the time.
Lady Cooper’s death in June 1827 was a heavy blow to Sir Astley, and he was so much affected by it that he resolved to retire altogether from practice. Before the end of the year, however, he found the ennui of retirement insupportable, and returned to town and full practice again. He was married a second time to Miss C. Jones in July 1828. The same year he was appointed Sergeant-Surgeon to the King, an appointment in which he was continued at William IV.’s accession. Having no lectures, he still dissected, and occupied himself largely with completing his various works for the press. His “Illustrations of Diseases of the Breast” appeared in 1829, and was followed by “Diseases of the Testis,” 1830, “The Anatomy of the Thymus Gland,” 1832. He was for a second time President of the Royal College of Surgeons in 1836.
In his old age, even when travelling about, Sir Astley never lost his passion for dissecting, and always visited every hospital and surgeon of note on his travels. He never liked staying more than a few days in one place; he soon began to pine after his accustomed pursuits. On several occasions, when detained longer than he liked in one place, he would get up early and leave by coach for London, without giving any warning of his intention.
On a visit which he made to Edinburgh in 1837, the freedom of the city was conferred upon him and the honorary LL.D. He had previously been made D.C.L. of Oxford. He continued his anatomical and surgical investigations to the last, publishing a splendid work on the Anatomy of the Breast in 1840, preliminary to a complete account of the diseases to which it is liable, which was never completed. He died on the 12th of October 1841, in the seventy-third year of his age, at Conduit Street, where he had practised latterly. He was buried, by his own particular request, beneath the chapel of Guy’s Hospital. A statue of him, by Baily, was erected, chiefly by the members of the medical profession, in St. Paul’s Cathedral, near the southern entrance. An admirable portrait of him by Sir Thomas Lawrence exists. Sir Astley’s name is commemorated by the triennial prize essay of three hundred pounds for the best original prize essay on a professional subject, to be adjudicated by the physicians and surgeons of Guy’s, who may not themselves compete.
A criticism on Sir Astley during his life accorded to him a great share in establishing pure induction as the only sure means of just diagnosis, and in introducing a simplicity of treatment in accordance with the processes of nature. Before his time, operations were too often frightful alternatives or hazardous compromises; he always made them follow, as it were, in the natural course of treatment; and he succeeded in a great degree in divesting them of their terrors by performing them unostentatiously, confidently, and cheerfully. He stated an opinion and fact to the Committee on Medical Education, which might well have been borne in mind by some examiners since his day: “Whenever a man is too old to study, he is too old to be an examiner; and if I laid my head upon my pillow at night, without having dissected something in the day, I should think I had lost that day.” Sir Astley left among his private papers an estimate of himself, written in the third person, which is worth quoting. “Sir Astley Cooper was a good anatomist, but never was a good operator where delicacy was required. He felt too much before he began ever to make a perfect operator.... Quickness of perception was his forte, for he saw the nature of disease in an instant, and often gave offence by pouncing at once upon his opinion. The same faculty made his prognosis good. He was a good anatomist of morbid, as well as of natural structure. He had an excellent and useful memory. In judgment he was very inferior to Mr. Cline in all the affairs of life.... His imagination was vivid, and always ready to run away with him if he did not control it.”