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The Sharpe Knife
  1. Richard Keeler,
  2. Arun D Singh,
  3. Harminder S Dua
  1. Correspondence to Mr Richard Keeler, 1 Brookfield Park, London NW5 1ES, UK, rkeeler{at}blueyonder.co.uk

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The history of cataract surgery is punctuated by many great names and many landmark events. In the western world, Jacques Daviel is considered as the early pioneer who performed his first cataract operation in 1747 using a set of instruments. He announced his successful method a few years later at the Royal Academy of Surgery in Paris. A year later, on the 7th of April 1753 Samuel Sharpe (figure 1) described his method of opening the cornea with a knife, the only instrument he used, in cataract surgery. That year he read a short paper to The Royal Society on “A Description of a new Method of opening the Cornea, in order to extract the crystalline Humour” which was published in the Philosophical Transactions (figure 2). Whilst giving full credit to Jacques Daviel for his invention of the extraction of the cataract he put forward his method of extraction using only a knife. This was faster thereby decreasing pain to the patient as well as preventing the collapse of the eyeball through the special shape of his knife, which he described as ‘Straight on its flat, somewhat convex on its back, slightly concave on its edge, a little less than an inch long and at its heel about one eighth to one inch wide tapering gradually to a point.’ Later the same year he read another paper before The Royal Society “A second account of the new method of opening the cornea for taking away the cataract”. In this he reported on a number of successful cases using his new knife.

Figure 1

Portrait of Samuel Sharpe (c1700–1778) a Legitimate Surgeon and Anatomist. Wellcome Library, London.

Figure 2

Sharp's cataract knife. Phil. Tr., Lond., 1753 with enlargement superimposed on right.

Samuel Sharpe was born in Jamaica, his precise birth date is unknown but was around 1700. Details of his early years, like his birth date are unknown but he appears to have been well educated, being familiar with both the French and Italian languages. In March 1724 he was apprenticed to the greatest surgeon of the time, Willam Cheselden (1688–1752) of St Thomas’ Hospital, to whom his father was obliged to pay £300. With his indentures he was bound to the surgeon for 7–9 years giving his solemn oath of loyalty and obedience and in return he was provided lodging, meat, drink and apparels. The most important benefit of all was to be his introduction to the mysteries and knowledge of the craft of surgery. Sharpe attended Cheselden's famous anatomical lectures and soon became his highly thought-of assistant.

Cheselden introduced Sharpe to Sauveur-Francois Morand of Paris, one of France's outstanding surgeons. Sharpe went to Paris to study under Morand and later became a member of the Royal Academy of Surgeons of Paris. Although he first met Voltaire (whose real name was Francois Marie Arouet) in London in 1726–1729 he became his frequent guest in Paris.

In 1731 Sharpe was admitted as a ‘freeman’ of the Barber-Surgeon Company. He successfully demonstrated his high proficiency and was granted a ‘grand diploma’ the following year. This meant that he could be called Master in Surgery and Anatomy and could practice anywhere.

Sharpe helped in the preparation of the plates for Cheselden's famous Osteographia published in 1733. In 1749 Sharpe became a Fellow of the select body of savants called the Royal Society. Influenced by Cheselden, Sharpe became a surgeon at Guy's Hospital London, close to St Thomas’ where he stayed until 1757.

Sharpe's major publications included the “A Treatise on the Operations of Surgery…(1739)” of which further nine editions were published in English with one in French (1741) and another in Spanish (1773). In this book there were three short chapters on ophthalmic operations including one on couching the cataract although by the sixth edition he also referred to extraction of the lens by Jacques Daviel and his own method for this cataract operation. In this book there is a chapter “Of cutting the Iris” and one on his operation “Of the Fistula Lachrymalis. The illustration of the instruments he used in this operation is shown on the cover of this edition of the BJO. In this image (A) depicts the eye with the two black spots indicating the orifices of the lachrymal channels; (B) the exact dimension of the lachrymal channels and lachrymal bag; (C) a small incision knife, more handy than a larger one for opening the lachrymal bag; (D) the perforator to destroy the Os Unguis if necessary and (E) a pliable plate attached to the forehead and containing a covered button at the end of a screw to be placed on the Saccus Lachrymalis to provide pressure on the lachrymal bag. In 1750 he published “A Critical Enquiry into the present state of Surgery.” Four editions in English and several in foreign languages including French, Spanish, German and Italian followed. He also constituted a course of anatomical lectures to which were added surgical operations. In 1746 due to pressure on his time he resigned his lectures to William Hunter who was then a surgeon. In due course these lectures became the nucleus of the celebrated school of medicine called the ‘Great Windmill Street School’, which was the foundation of modern medical teaching.

Sharpe was greatly in demand and his practice immediately had grown into a large and lucrative one. As a result of the pressure from his large practice and poor health related to asthma, he resigned from Guy's in 1757 but continued to practice until 1765. He died in 1778 having lived to an advanced age of nearly eighty. Sharpe was highly regarded as a surgeon and perhaps was one of England's greatest.

Footnotes

  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.