Hogarth paintings are undergoing restoration in London, but what do they have to do with a surgeon from North Dorset? Rachael Rowe reports

St Bartholomew’s, the oldest hospital in England, is celebrating its 900th anniversary this year. It was founded in London by King Henry I’s courtier Rahere in 1123. The hospital is famous for many innovative medical developments, including the discovery of blood circulation in 1628 by William Harvey – today it is one of the largest cardiovascular centres in Europe. As part of the Barts 900 celebrations, a major restoration programme is under way, funded by a £5m award from the National Lottery Heritage Fund and focused on the Georgian North Wing. The building is famous for its paintings by William Hogarth, but what is their connection with North Dorset?

A local lad
John Freke (1688-1756) was born in Okeford Fitzpaine, the son of the village rector. He grew up in the North Dorset countryside and was educated locally. At 17 he was apprenticed to Richard Blundell, a prominent London barber-surgeon. In the days before medical schools became widely established, apprenticeships were often the only route into the profession. Blundell had a prolific practice and also attended the Court of Queen Anne.
Freke went on to marry Richard Blundell’s daughter Elizabeth in 1713, and having served a long apprenticeship he qualified as a barber-surgeon in 1720.
Four years later, at the age of 36, he was appointed as assistant surgeon at St Bartholomew’s Hospital.
In the 18th century, physicians were considered the experts in medicine. Barber-surgeons were seen to perform the ‘dirtier’ side of medical treatments; lancing boils, applying leeches and performing amputations. Anaesthetics had not yet been invented,, so the job was harrowing (as were the treatments). They also cut hair, including monks’ tonsures, and were known for styling beards. Today, traditional barber shops have red and white poles signifying the blood and bandages – the legacy of the days of the barber-surgeon.

A surgical pioneer
During the early part of the 18th century, the surgical profession we know today began to specialise and develop formal standards in training. Freke was asked by the governors at Barts to pioneer eye surgery. Through the development of a technique called couching for cataracts, John Freke became the first ophthalmic surgeon in 1727. He was also responsible for a number of other discoveries; he modernised obstetric forceps, making them safer, and he was the first to recognise the importance of removing lymphatic tissue in breast cancer. Freke also wrote about electricity, rickets, and recognised the importance of studying the body. He became the first curator of the pathology museum at Barts, which acted as a study resource for the hospital’s medical students.
With fellow surgeon Percivall Pott, Freke was instrumental in establishing the College of Surgeons (later the Royal College of Surgeons). This move distinguished the surgical profession and its modern, stringent standards from the old barber-surgeons – who returned to cutting hair. It was a pioneering move, and his legacy has saved thousands of lives through safer training standards.

Art and Science
John Freke became a governor of St Bartholomew’s Hospital at a time when it was being redesigned by James Gibbs. Part of the 18th century restoration of the already 500-year-old hospital was to the North Wing, and Italian artist Jacopo Amigoni was about to be commissioned to complete the decoration of the stairs.
However, William Hogarth, a local artist and friend of John Freke, stepped in, incensed that an Italian had (almost) got the job. Hogarth offered his services without charge.
He lived on nearby Bartholomew Close and had married a Dorset girl – Jane Thornhill, the daughter of Sir James Thornhill of Stalbridge, himself a distinguished artist. Barts Heritage chief executive Will Palin says: ‘We know from the archives that Freke was an advisor to the workings of the hospital building and we can be certain he knew Hogarth.’

Sickness in the paintings
Hogarth created two large paintings which still adorn the stairway – now known as the Hogarth stair – which leads to the Great Hall. The Pool of Bethesda and The Good Samaritan were completed in 1736 and 1737 respectively and both depict healing scenes from the Bible at huge scale, featuring figures around seven feet high.
But there is more to the artwork than meets the eye. Within the paintings are people with medical conditions, thought to have been modelled by patients from the hospital. It is thought that Freke advised Hogarth on the accuracy of the appearance of some of these diseases. Unusually for an artist known for caricatures, none of the illnesses are exaggerated, and they reflect what would have been seen regularly at the hospital at the time. Within the art are signs of gout, jaundice, rickets, breast cancer (possibly another connection to Freke’s work), and the body language of fear and anxiety. There is also a blind man in the foreground of the Pool of Bethesda, possibly alluding to John Freke’s role as first ophthalmic surgeon.
The paintings have served as a unique teaching aid for medical students and nurses for 300 years. They are still used today.

The legacy continues
Hanging above the paintings on the Hogarth Stair is an elaborately carved gilded chandelier which was commissioned by John Freke and given to the hospital. It is inscribed with ‘ John Freke, surgeon of this hospital’ in Latin around the centre.
Hogarth had specifically requested that the completed canvases never be varnished, but when they were cleaned in the 1930s, seven coats of varnish were removed. As an indication of how much dirt the paintings accumulate, when they were again cleaned in the 1960s it was only then that an inscription in the foundation stone in the second tableau was discovered. Will Palin says: ‘The Hogarth Stair is one part of a much bigger project. The £5m grant will restore the entire North Wing, including the Great Hall. Freke’s chandelier will also be getting a careful clean as part of the project and it will look splendid.’
Today, as the hospital celebrates the past and looks forward to the future, the legacy of John Freke lives on in safer surgical professional standards that have saved thousands of lives.

St Barts has a small museum open to the public, and there are also guided tours of the historic hospital including the Hogarth Stair. More information about the paintings is on the
Barts Heritage site.