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Sir Morell Mackenzie

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Sir Morell Mackenzie

Birth
Leytonstone, London Borough of Waltham Forest, Greater London, England
Death 3 Feb 1892 (aged 54)
London, City of London, Greater London, England
Burial Wargrave, Wokingham Borough, Berkshire, England
Plot Near the lychgate
Memorial ID 120014245 View Source
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Physician
The eldest son of a general practitioner Morell Mackenzie studied medicine at London Hospital College and received the Doctor of Medicine degree in 1862. As a student he had been introduced to the recently invented laryngoscope and he began a practice dedicated to the treatment of maladies of the throat. His practice was successful and his reputation grew quickly. His three volume essay entitled "On the Pathology and Treatment of Diseases of the Larynx: The Diagnostic Indications to include the Appearance as Seen in the Living Person" won the Jacksonian Prize of the Royal College of Surgeons and the same year he coined the terms "abductors" and "adductors" to describe the muscles which open and close the opening between the vocal cords. He was also instrumental in the founding of the Hospital for Diseases of the Throat in 1865 which was the first hospital of its kind in the world. He was additionally a founding member of the British Rhino-Laryngological Association and he established several new specialty journals.

His textbooks were widely read and consulted. They included:
"The Use of the Laryngoscope in Diseases of the Throat," 1865.
"Growths in the Larynx," 1871.
"Diseases of the Nose and Throat, volumes 1 and 2," in 1880 and 1884
So influential was the last of these works that it was still known for many years after Mackenzie's death as the "laryngologist's Bible."

Mackenzie was at the peak of his career in 1887 when he received the consultation that was to plunge him into controversy for the rest of his life. The German Crown Prince Frederick had been suffering from chronic hoarseness for many months and attempts by German physicians to treat what appeared to be a benign polyp on the vocal cord had been unsuccessful. They were beginning to suspect laryngeal cancer and wanted to incise the larynx through the thyroid gland (a so-called thyrotomy) to try to remove the lesion more completely but this could have cost the Crown Prince his voice and the Kaiser (or the Crown Prince's wife) - (no one is really sure) - called for a throat specialist. The Crown Princess was English...so the English physician with the best reputation in the field of laryngeal diseases, Morell Mackenzie, was summoned. Mackenzie performed several biopsies which were all read by the world's leading pathologist - Rudolf Virchow - as being benign. Treated with watchful waiting the lesion never improved and a new growth soon appeared. Now convinced it was cancer Mackenzie told the news to Frederick who declined the only potentially curative surgery - a laryngectomy. He was next in line to become Kaiser and who ever heard of a Kaiser with no voice?

Frederick's condition was leaked to the press and soon Mackenzie was blamed by the media for failing to diagnose the condition sooner. Frederick's father died in March and Frederick was crowned Kaiser. He was ill for his entire reign and Mackenzie remained at his bedside until his death in June 1888. Prior to his death Frederick awarded Mackenzie the Cross and Star of the Hohenzollern Order leading to his being knighted by Queen Victoria. After Frederick's death the German press attacked Mackenzie with a a vengeance. Even Frederick's wife, the Empress Victoria was criticized for having brought the foreign doctor to Berlin when there were plenty of German experts who likely could have saved the Kaiser's life. Physicians around the world began to question Mackenzie's handling of the case.

"Lady Duff Gordon recalled that "it was impossible to imagine the furor created by the case of the German Crown Prince; nothing else was talked of for months, and Mackenzie's name was on everybody's lips every hour of the day". She had even "known people to stand on chairs in a hotel restaurant to watch Mackenzie at dinner."" [1]. Mackenzie retaliated with the publication of a book entitled The Fatal Illness of Frederick the Noble - a work which was roundly criticized by the British and German medical establishments for violating patient confidentiality and engaging in rancorous and unprofessional public debate with colleagues. Four years after he Kaiser's death, Mackenzie who never fully recovered his reputation, died from post-viral pneumonia.

Among the great "what-if's" of history has been the "what if" Frederick III had not died so soon after ascending to the throne and his son Wilhelm II had not been able to become Kaiser as such a young man? Perhaps the First World War could have been averted. But it is unlikely that any treatment in that day could have saved Frederick's life - even early laryngectomy.

The question has remained as to why Virchow failed to make the diagnosis despite receiving at least four different biopsy specimens and recent research has suggested that Frederick may have had a rare variant of laryngeal cancer called verrucous carcinoma [2]. Such a diagnosis would be consistent with the gross description described by Mackenzie and the histological description described by Virchow.

In any event Morell Mackenzie owes his fame not only to his major contributions to the science of laryngology but also for the part he played in the great drama surrounding the final illness of a European monarch.

Bibliography
1. "Morell Mackenzie," American Academy of Otolaryngology-Head and Neck Surgery, http://www.entnet.org/museum/famous-figures/morell-mackenzie.cfm
2. Cardesa, et. al., "The Kaiser's Cancer Revisited: was Virchow totally wrong?," Virchows Arch (2011), 458: 649-667.


Inscription

Sir Morell MacKenzie MD CCH/ Born July 7th. 1837/
Died Feb 3rd. 1892/
Lives of great men all remind us/ We can make our lives sublime/ And departing leave behind us/ Footprints on the sands of time/
I will love you best/
Margaret/ his wife/ Died April 10th. 1899/
(the next line giving age is illegible)
The peace of God which passeth all understanding

Gravesite Details

Inscription and gravestone photos courtesy of Iain MacFarlaine - 26 Aug 2010


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