History of the South West Laryngological Association

The SWLA was founded by Bristol ENT surgeon Mr Patrick Watson Williams. Patrick Watson Williams was born in 1861, the son of a Clifton General Practitioner, Dr Eubulus Williams. His mother was a sister of the late Sir Patrick Watson, a well known Scottish surgeon who was one of the first to perform a laryngectomy. Patrick was educated at Clifton College and Bristol University graduating as MRCS in 1884. In 1885 he obtained the MB(Hons) at London University and in 1932, in recognition of his outstanding services to Medicine was awarded an Honarary MD from the University of Bristol.

He embarked on a long and distinguished career at the Bristol Royal Infirmary. He held the offices of House Physician in 1887 and Assistant Physician in 1888. Whilst an Assistant Physician he attended Golden Square in London as a Clinic Assistant. He was appointed Physician in charge of Nose and Throat in 1906 and this is when the Ear, Nose and Throat Department was officially formed in Bristol. In 1910, he was appointed Physician in Charge of Ear, Nose and Throat, ear surgery having previously been the province of the General Surgeons.

Watson Williams nearly did not become an ENT Surgeon. He was an eligible candidate for the post of Honarary Obstetric Physician. In those days, appointments to the medical staff depended on the votes of the Trustees. There is no doubt he would have been chosen but for the dubious and often questionable methods by some, not favouring his candidature. He chose to withdraw his application. This was a blow at the beginning of his professional work but it proved a blessing in disguise because he was appointed Assistant Physician in 1888.

He formed a long friendship with Sir Felix Semon and with other colleagues formed the Laryngological Society of London, later becoming the Laryngological Section of the RSM. He was President of the Section of Laryngology in 1911, and during his year of office he represented the RSM at the Berlin International Laryngological conference, and was President of Honour at the First International Congress for TB in Paris. Also during his year of office the Semon Lecture was established, largely due to the efforts of Patrick Watson Williams. In recognition of his work he was Semon Lecturer in 1925, the title being The Toll of Chronic Focal Sepsis on the Mind and Body.

His life's work can be summed up in three phases:

Phase 1. Physician with an interest in Laryngology, helping it to evolve into a specialist branch of surgery. During this period he published widely and wrote with Felix Semon, the chapters on Disease of the Throat in the standard text book of the time; Allbutt's System of Medicine.

Phase 2. Recognising the wide possibilities open to the Laryngologist by the evolution of modern surgery, he threw himself, with great enthusiasm, ingenuity and intelligence into the surgical treatment of sinus infections and became a world authority. He did not advocate indiscriminate operations. His diagnostic method was rigid endoscopy of the nose, looking for signs of pus or inflammation around the natural ostia. This was followed by his own technique of suction exploration with careful bacterial analysis of the specimens.There are certain similarities between FESS introduced by Stamberger and Kennedy and Watson Williams' exploration for focal sepsis 60 years earlier. Both introduced a rational form of treatment based on logical deduction from pathophysiological concepts. Both have offered the prospect of relieving relatively major disease by eliminating a relativley minor focal cause and by simple methods. Both have used the latest technology and have relied on endoscopes for diagnostic precision.

Phase 3. The third phase combined the general outlook of a physician and the operating surgeon. He set out to emphasise the neglegted close association between infection, particularly of the nose and throat and general constitutional disease. He published his major work: Chronic Nasal Sinusitis and its relation to General Medicine in 1931, the 2nd edition in 1933.

He married Margaret Long Fox in 1889. She was daughter of Dr Edward Long Fox, a distinguished Bristol Physician. They had three daughters and two sons: Marjorie, Ruth, Mary, Eric and Guthrie.

Patrick Watson Williams was a man of very generous disposition, kindly, welcoming, with a genial smile and old world curtesy. He died on November 14th 1938 at his home in Clifton. His funeral service at Bristol Cathedral was attended by many representatives of the medical and academic world. A.J. Wright, his colleague at The Bristol General Hospital wrote 'With his death in 1938, we have lost a most valuable and enterprising member of that small band of pioneers, who in this country changed Otorhinolaryngology from a casual occupation to a highly developed speciality'. He can certainly be regarded as one of the fathers of British Otorhinolaryngology.

Eric Watson Williams, elder son of Patrick, was born in 1890, educated at Clifton College, Bristol and Cambridge and his medical studies at Kings College Hospital, London.He served in the First World War and was awarded the Military Cross. He became ENT Surgeon to the Bristol Royal Infirmary in 1926, played a major part in local Bristol medical life and was President and Editor of the Bristol Medico Surgical Society and edited the Bristol Med. Chi Journal. With colleagues from the South West and Wales, he founded the SWLA in 1947 and was the first Chairman and Secretary for three years.

Eric Watson Williams (Watty) was a widely educated man, keenly interested in the classics, in modern literature and anthropology. He made many contributions to medical literature and was a man with a deep sense of personal responsibility to his patients. He demanded implicit obedience from his Junior Staff to whom he often found it difficult to delegate work. He retired in 1954 and moved to Cambridge where he was happily engaged in literary work. He had four children, the eldest son, John became a Haematologist in Canada.

Eric Watson Williams died in Addenbrooke's Hospital on 26^thJanuary 1964. The Centenary of the Society will be celebrated in 2048 and the names Watson Williams and Angell James continue to be remembered with pride and gratitude.

From a presentation by Mr P.G. Bicknell, Reflection on the Life and Work of Watson Williams, SWLA Meeting 31^st January 1998