‘The soundest of understandings and the kindest of hearts’ – Brian Maye on pioneering surgeon Abraham Colles

Ireland has produced many pioneers in medicine, one of the earliest and greatest of whom was Abraham Colles, who was born 250 years ago on July 23rd. He ranks as one of Ireland’s great 19th-century surgeons, was instrumental in making surgery respectable here and developed an outstanding international reputation.

He grew up in Millmount, Co Kilkenny, the second of four children of William Colles, owner of Kilkenny marble quarries, and Mary Anne Bates. It’s said that while he was attending Kilkenny College, a local physician’s house was flooded, that Colles found an anatomy book belonging to the doctor in a field and returned it to him and that the doctor, sensing Colles’ interest in medicine, let him keep the book.

On entering Trinity College in 1790, he was apprenticed to Philip Woodroffe at Dr Steevens’ Hospital for five years, received the Licentiate Diploma of the Royal College of Surgeons in Ireland (RCSI) and graduated BA from Trinity in 1795, and graduated MD from Edinburgh Medical School two years later. For a short period afterwards, he worked for the famous London surgeon Astley Cooper before returning to Dublin.

There he taught anatomy and surgery privately and worked at the Dispensary for the Sick Poor, Meath Street, and the Sick and Indigent Roomkeepers’ Society before being appointed successively as resident surgeon (1799-1813), assistant surgeon (1813-41) and governor (1819-41) at Dr Steevens’ Hospital. On failing to be chosen for its chair of anatomy and surgery, he took Trinity College to court in 1803, on the grounds that the person appointed had only an honorary medical degree and was therefore not qualified to give clinical instruction, but was unsuccessful.

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However, elected member, assistant, censor and president of RCSI in succeeding years from 1799 to 1802, he was co-professor of anatomy and physiology (1804-27) and professor of surgery (1804-36) there, where he proved to be an excellent teacher, innovator and reformer. He attracted large numbers of students to the college, so successful was he in making surgery a respectable profession in Ireland. “He was skilful in drawing graphic pictures of disease and, as a clinical teacher, readily admitted his own shortcomings in order to instruct his students,” according to Helen Andrews, who wrote the entry on him in the Dictionary of Irish Biography.

She considered that his knowledge of surgical anatomy was one of his great virtues as a surgeon and teacher. His Treatise on Surgical Anatomy (1811) was the first such work based closely on the surface and design of the body’s organs, and several of the anatomical discoveries it contained were to be called after him, such as “Colles’ fascia” and “Colles’ ligament”. His famous 1814 paper, “On the Fracture of the Carpal Extremity of the Radius” led to the eponym “Colles’ fracture”; this paper was far ahead of its time as it was published long before the use of X-rays.

He became an authority on venereal disease with his publication in 1837 of “Practical Observations on Venereal Disease and on the Use of Mercury” (he recommend that small rather than the usual large doses of mercury should be given) and his discovery that a baby with the disease will infect a wet nurse but not a mother who breastfeeds it led to the formulation of “Colles’ law” (that this was because the mother had the disease in latent form was only later understood).

He developed an outstanding international reputation and was visited by doctors from all over the world although Helen Andrews maintained that “his anatomical and clinical discoveries are considered important rather than revolutionary”.

Colles co-founded, co-edited and contributed to the Dublin Hospital Reports (1815-39), founded the Dublin Pathological Society (1838) and was consultant to the Rotunda and Victoria Lying-in Hospitals and Baggot Street Hospital. Becoming very wealthy from his practice, he acquired the large estate of Bonnettstown Hall in Co Kilkenny. He turned down a baronetcy in 1839 as it had no interest for him. A contemporary described him as having “perfect probity, the soundest of understandings and the kindest of hearts”, according to Helen Andrews.

He married Sophia Cope in 1807 and they had six sons and five daughters. Gout, bronchitis and emphysema led to his retiring from his various appointments. He died at 21 St Stephen’s Green on December 1st, 1843, having lived there for many years, and was buried in Mount Jerome Cemetery following a public funeral.

There is a bust and portrait of him in RCSI, a suite of rooms is named after him there, the college began the annual Abraham Colles Postgraduate Lectures in 1956, and St James’s Hospital in Dublin has a ward named after him.