St. Mark's Hospital

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St. Mark's Hospital (informally St. Mark's) is a hospital in the Harrow and Wembley border as well as the London Borough of Harrow and London Borough of Brent border in northwest London. It is the only hospital in the world to specialise entirely in intestinal and colorectal medicine and is a national and international referral centre for intestinal and colorectal disorders.<ref>St. Mark's Hospital ? Welcome to St Mark's Hospital</ref> It is the only hospital in the UK, and one of only 14 worldwide, to be recognised as a centre of excellence by the World Organisation of Digestive Endoscopy.

St. Mark's is closely associated with Imperial College London and is a major centre for teaching and research.



The beginnings of St Mark's Hospital were in a small room at No 11 Aldersgate Street where, in 1835, Frederick Salmon opened 'The Infirmary for the Relief of the Poor afflicted with Fistula and other Diseases of the Rectum'. There were just seven beds and in the first year 131 patients were admitted. Frederick Salmon was born in Bath in 1796 and served his apprenticeship in medicine there. He qualified at St Bartholomew's Hospital in 1817 and subsequently became a house-surgeon. In 1827, he was elected to a Surgeon's post at the Aldersgate Street Dispensary. However, Salmon resigned five years later, along with the rest of the medical staff, because of a dispute with the Management Committee about the method of choosing new staff. Tired of the restrictions of working within the establishment, Salmon decided to found his own institution to provide treatment for those conditions which were regarded as 'the most distressing that can afflict our common nature'. So the 'Fistula Infirmary', as it came to be known, was started. Much of the financial support came from the City of London. The Lord Mayor, William Taylor Copeland, was a grateful patient of Salmon's and became the first President. Another benefactor was Charles Dickens, who blamed his need for Salmon's surgical attentions on 'too much sitting at my desk'! There was an overwhelming need for such an institution giving specialist treatment free of charge to London's poor. Therefore, in 1838, when the number of patients had trebled, Salmon moved to larger premises at 38 Charterhouse Square, where there were fourteen beds and more space for treating out-patients. Thirteen years later, a site in City Road was purchased from the Dyers' Company and the almshouses that occupied it were converted to a 25-bed hospital. This was opened on St Mark's Day, 25 April 1854, and took the name of St Mark's Hospital for Fistula and other Diseases of the Rectum. The staff consisted of a surgeon, a Matron, a dispenser, nurses and servants. St Mark's was unique in not employing a physician until 1948. (That all changed in 1950, with the arrival of Francis Avery-Jones, “the father of British gastroenterology”, pioneer of medical treatment of peptic ulcer ) In 1859, Frederick Salmon resigned from his post as Surgeon. He is said to have performed 3,500 operations without a single fatality, a remarkable feat in an age when anaesthetics were only just beginning to be used and antiseptics were unknown. The Governors commissioned a portrait of him which is now displayed outside of the ward that bares his name. <ref name=autogenerated1></ref> <ref name=autogenerated2>AIM25: St Bartholomew's Hospital: St Mark's Hospital</ref><ref>Sir Francis Avery Jones • Arthur Milton Bowler • Arthur Moreland Brown • Richard Morris Butler • Alistair Hugh Cameron • Peter Bruno D'Souza • James William Fawcett • Lionel Travers ("Leo") Martin • Elspeth Marguerita Whittaker Stokes • Verna Wright • Philip Metcalfe Yeoman - Baron et al. 316 (7145): 1678 - BMJ</ref>

New St Mark’s

By the 1870s, ever-increasing demands on the Hospital caused rebuilding to be considered. The adjacent site, occupied by rice mills, was acquired but could not be developed for some years due to lack of funds. Eventually, building began and in January 1896 the 'New St Mark's' was opened. There was considerable difficulty in meeting the costs of maintaining the new building and it was the entertainment industry that finally came to the rescue. Lillie Langtry organised a Charity Matinee at her theatre in Drury Lane and the Hospital was saved. In 1909, the name of the Hospital was changed for a second time to St Mark's Hospital for Cancer, Fistula etc., reflecting the work and interests of Lockhart-Mummery, who was a pioneer in cancer surgery. The First World War seems to have made little direct impact, although ten beds were given over to servicemen. Despite the stringency of the times, the Governors purchased more land on the east side of the Hospital which gave room for expansion after hostilities had ceased. An Appeal Fund launched in 1920 which was very successful. In 1926 work began on a large extension which gave the Hospital a new appearance and provided two new wards, as well as new Out-Patient, X-ray, Pathology and Research Departments. A nurses' home was also provided for the first time. This was replaced by a self-contained home in 1936, when the former accommodation became a private wing named after Lockhart-Mummery, who had retired the previous year. A Samaritan Fund was established to assist patients, and meetings ceased in May 1949 when administration of the Fund officially passed to the Ladies Association. The Ladies Association became the Friends of St Mark's in June 1971. <ref name=autogenerated1 /> <ref name=autogenerated2 />

1948 to present

St Mark's was taken over by the new National Health Service in 1948. It was administered jointly with Hammersmith Hospital until the NHS reforms of 1972, when it became attached to St Bartholomew's Hospital. After 1974, St Mark's was part of the newly established City and Hackney Health District, which also included Hackney General, the Mothers', the German, the Eastern and St Leonard's Hospitals. During the 1980s, many of the hospitals in the City and Hackney District were closed and their services transferred to the new Homerton Hospital. The government introduced self-governing NHS Trusts and in 1992, Sir Bernard Tomlinson's Report of the Inquiry into the London Health Service proposed radical changes to the hospital groupings then in place. St Mark's remained part of the Barts NHS Shadow Trust (later Barts NHS Group) until April 1994, when the changes envisaged by the Tomlinson Report came into force. At this point, Bart's joined with the Royal London and the London Chest Hospitals to form the Royal Hospitals NHS Trust (later Barts and The London NHS Trust). St Mark's became part of the North West London NHS trust and moved to the same site as Northwick Park Hospital. The hospital maintains strong teaching ties with Imperial College School of Medicine. <ref name=autogenerated1 /> <ref name=autogenerated2 />

Centre of excellence

Following are highlights of the achievements made at the hospital over the years:

  • The Lockhart-Mummery technique was developed at St Mark’s in the early 1900s by the pioneering cancer surgeon whose name it bears.
  • The ‘Dukes’ staging system, still in use, was developed at St Mark’s by Cuthbert Dukes who worked there from around 1920 till 1950.
  • David Henry Goodsall 1843–1906 who described Goodsall's rule of anal fistula
  • The Ileo-anal pouch, a replacement rectum, was developed at St Mark’s in the 1970s by Alan Parks
  • St. Mark's polyposis registry, established in 1924, is the oldest in the world and scientists funded by the Imperial Cancer Research Fund, based at St Mark's, played an important role in identifying the APC gene responsible for causing Familial adenomatous polyposis.
  • Recent Academic Publications]<ref name=autogenerated1 />



External links

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