Golding Bird

Golding Bird (9 December 1814 – 27 October 1854) was a British medical doctor and Fellow of the Royal College of Physicians of London. Bird became a great authority on kidney diseases and published a comprehensive paper on urinary deposits. He was also notable for his work in the collateral sciences, especially the use of electricity in medicine and electrochemistry. He lectured at Guy's Hospital, London, a well-known teaching hospital usually referred to simply as Guy's and he published a popular textbook on science for medical students.

Bird developed an interest in chemistry while still a child, largely through self-study, and was advanced enough to deliver lectures to his fellow pupils at school. He later applied this knowledge to medicine and did much research on the chemistry of urine and of kidney stones. He was the first to describe oxaluria, a condition which leads to a particular kind of stone being formed.

Bird was innovative in the field of the medical use of electricity, designing much of his own equipment. In his time, electrical treatment had acquired a bad name in the medical profession through its widespread use by quack practitioners. Bird made efforts to oppose this quackery and was instrumental in bringing medical electrotherapy into the mainstream. Bird was quick to adopt new instruments of all kinds; he invented the single-cell Daniell cell and made important discoveries in electrometallurgy with it. He was not only innovative in the electrical field: he also designed a flexible stethoscope and was the first to publish a description of such an instrument.

Bird held strong Christian convictions. In his view, Christian study and prayer were just as important to medical students as their academic studies. He endeavoured to promote Christianity amongst medical students and encouraged other professionals to do likewise. To this end, Bird was responsible for the founding of the Christian Medical Association but it did not become active until after his death.

Life and career

Bird was born in Downham, Norfolk, England on 9 December 1814 to a father (also named Golding Bird), who had been an officer in the Inland Revenue in Ireland, and an Irish mother, Marrianne. In character the son was precocious and ambitious but childhood rheumatic fever and endocarditis left him with poor posture and lifelong frail health. He received a classical education when he was sent with his brother, Frederic, to stay with a clergyman in Wallingford where he developed a lifelong habit of self-study. From the age of twelve he was educated at a private school in London, which was not very interested in science and gave only a classical education. Bird, who seems to have been far ahead of his teachers in science, gave lectures in chemistry and botany to his fellow pupils. He had four younger siblings, of whom his brother Frederic also became a physician and published on botany.

Golding Bird served his apprenticeship with the apothecary William Pretty in Burton Crescent, London 1829–1833 and was licensed to practise by Apothecaries' Hall (the Worshipful Society of Apothecaries) in 1836. He received this licence without examination due to the reputation he had gained as a student at Guy's. He became a medical student at Guy's in 1832 (while still also working at his apprenticeship) where he was influenced by Thomas Addison, who recognised his talents early on. Bird was an ambitious and very capable student. He became a Fellow of the Senior Physical Society early on (for which a thesis was required); he received prizes for medicine, obstetrics, and ophthalmic surgery at Guy's and the silver medal for botany at Apothecaries' Hall. Around 1839 to 1840 he worked on breast disease at Guy's as an assistant to Sir Astley Cooper.

Bird graduated from the University of St Andrews with an MD in 1838, and an MA in 1840. As St Andrews required no residence or examination for the MD, Bird obtained his degree by submitting testimonials from qualified colleagues, which was common practice at the time. Once qualified in 1838, at the age of 23, he entered general practice with a surgery at 44 Seymour Street, Euston Square, London, but was not at first successful because of his youth. However, that same year he became physician to the Finsbury Dispensary and held that post for five years. By 1842 he had an income from his private practice of one thousand pounds per year. Adjusted for inflation this amounts to a spending power of about £119,000 now. He became a Licentiate of the Royal College of Physicians in 1840, and a Fellow in 1845.

The Golding Bird Gold Medal for sanitary science

Bird lectured on natural philosophy, medical botany and urinary pathology from 1836 to 1853 at Guy's. He lectured on materia medica at Guy's from 1843 to 1853 and at the Royal College of Physicians from 1847 to 1849. He also lectured at the Aldersgate School of Medicine. Throughout his career Bird published extensively, not only on medical matters, but also on electrical science and chemistry.

Bird was the first head of the electricity and galvanism department at Guy's in 1836 under the supervision of Addison, since Bird did not graduate until 1838. In 1843 he was appointed assistant physician at Guy's, a position he had lobbied hard for, and in October that year he was put in charge of children's outpatients. The children, like his electrical room patients, were largely poor relief cases who could not afford to pay for medical treatment and were much used for training of medical students. It was generally accepted at this time that poor relief cases could be used for experimental treatment and their permission was not required. Bird published a series of reports in the hospital journal on diseases of children based on case studies from this work.

Bird married Mary Ann Brett in 1842 and moved from his family home at Wilmington Square, Clerkenwell to 19 Myddleton Square. The couple produced two daughters and three sons. Bird's second son, Cuthbert Hilton Golding-Bird (1848–1939), became a notable surgeon.

Bird was a member of the Linnaean and Geological Societies, and a Fellow of the Royal Society of London. He was also a member of the London Electrical Society founded by William Sturgeon and others. This body was very unlike the elite scholarly institutions, it was more along the lines of a craft guild with a penchant for spectacular demonstrations. Nevertheless, it had some notable members and new machines and apparatus were regularly discussed and demonstrated. Bird was also a Freemason from 1841 and was the Worshipful Master of the St Paul's lodge in 1850. He left the Freemasons in 1853.

Bird was vain in character with a tendency to self-promotion and his driving ambition occasionally led him into conflict with others. There were a number of very public disputes in the pages of the medical journals of the time, including the dispute with the Pulvermacher Company and a dispute over the development of the stethoscope. However, when dealing with his patients he was said to show them his undivided attention and a complete commitment to their welfare.

He was diagnosed with heart disease by his brother in 1848 or 1849 and was forced to stop work. By 1850, however, he was again working as hard as ever and had extended his practice so much that he needed to move to a larger house in Russell Square. But in 1851 acute rheumatism caused Bird to take an extended holiday with his wife Mary in Tenby where he pursued the investigation in the field of botany, marine fauna, and cave life as pastimes. These long summer breaks were repeated in 1852 and 1853 at Torquay and Tenby. Even on holiday his fame caused him to be pestered with many requests for consultations. In 1853 he purchased an estate, St Cuthbert, for his retirement in Tunbridge Wells but it first needed some work and he was not able to leave London until June 1854. In the meantime he continued to see patients, but only in his house, despite seriously deteriorating health. He died 27 October 1854 at St Cuthbert from a urinary tract infection and, ironically for one who had studied them so much, suffering from kidney stones. The young age of 39 was perhaps ultimately due to a combination of lifelong frail health and overwork, certainly Bird himself believed that this was so. He is buried in Woodbury Park Cemetery, Tunbridge Wells. After his death Mary instituted the Golding Bird Gold Medal and Scholarship for sanitary science, later named the Golding Bird gold medal and scholarship for bacteriology, which is awarded at Guy's teaching hospital.

Collateral sciences

The collateral sciences are those sciences which have an important role in medicine, but which do not form part of medicine themselves. The sciences most often falling into this category are physics, chemistry, and botany (because botany is a rich source of drugs and poisons). Until the end of the first half of the 19th century, it was rare for chemical analysis to be used in medical diagnosis, even hostility to the idea existed in some quarters. Most of the work in this area at this time was carried out by researchers associated with Guy's.

By the time Golding Bird was a medical student at Guy's, the hospital already had a tradition for studying physics and chemistry as they related to medicine. Bird followed this tradition and was particularly influenced by the work of William Prout an expert in chemical physiology. Bird became well known for his knowledge of chemistry. An early indication was his comments on a paper on arsenic poisoning (being delivered by his future brother-in-law R. H. Brett) to the Pupils' Physical Society. Bird criticised the copper sulphate test for arsenic poisoning. This test has a positive result when a green precipitate is formed. Bird claimed the test was not conclusive because precipitates other than copper arsenite can produce the same green colour.

Bird did not limit himself to challenging his brother-in-law. In 1834 Bird and Brett published a paper on the analysis of blood serum and urine in which they argued against some work by Prout. Prout had said (in 1819) that the pink sediment in urine was due to the presence of ammonium purpurate but Bird's tests failed to verify this. Even though Bird was still only a student and Prout held great authority, Prout felt it necessary to reply to the challenge. Bird later (1843) tried, but failed, to identify the pink compound, but convinced that it was a new chemical, gave it the name purpurine. This name did not stick, however, and the compound became known as uroerythrin from the work of Franz Simon. The structure of this compound was not finally identified until 1975.

Astley Cooper, recognising Bird's abilities in the field of chemistry, asked Bird around 1839 to make a contribution to his book on breast disease. Bird wrote a piece on the chemistry of milk and the book was published in 1840. Although the book is primarily about human anatomy, it includes a chapter on comparative anatomy covering several species. For this Bird carried out an analysis of the milk of the porpoise and a dog bitch. Also in 1839, Bird published his own book (Elements of Natural Philosophy), a textbook on physics aimed at medical students. Bird felt that existing texts were too mathematical for medical students and largely omitted this kind of material altogether in favour of clear explanations. The book proved popular and remained in print for thirty years, although some of the mathematical shortcomings were made good in the fourth edition by Charles Brooke.

Electricity

In 1836 Bird was put in charge of the newly formed department of electricity and galvanism under the supervision of Addison. While this was not the first hospital to employ electrotherapy, it was still considered very much experimental. Previous hospital uses had either been short-lived or based around the whim of a single surgeon such as John Birch at St Thomas' Hospital. At Guy's, the treatment was part of the hospital system and became notable amongst the public; so much so that Guy's was parodied for its use of electricity in the New Frankenstein satirical magazine.

Electrical equipment

Friction electrostatic generators: cylinder (left) and disc (right) designs. According to Bird, the disc design has a greater power output, while the simpler construction of the cylinder makes it easier to operate.

It was already clear from the work of Michael Faraday that electricity and galvanism were the same thing in all essentials. Bird realised this, but continued to divide his apparatus into electrical machines, which (according to him) delivered a high voltage at low current, and galvanic apparatus, which delivered a high current at low voltage. The galvanic equipment available to Bird included electrochemical cells such as the voltaic pile and the Daniell cell, a variant of which Bird devised himself. Also part of the standard equipment were induction coils which, together with an interrupter circuit, were used with one of the electrochemical cells to deliver an electric shock. The electrical machines (as opposed to galvanic apparatus) available at this time were friction operated electrostatic generators consisting of either a rotating glass disc or cylinder on which silk flaps were allowed to drag as the glass rotated. These machines had to be hand turned during treatment, but it was possible to store small amounts of static electricity in Leyden jars for later use. By 1849 generators based on Faraday's law of induction had become advanced enough to replace both types of machine and Bird was recommending them in his lectures. Galvanic cells suffered from the inconvenience of having to deal with the electrolyte acids in the surgery and the possibility of spillages; electrostatic generators required a great deal of skill and attention to keep them working successfully. Electro-magnetic machines, on the other hand, have neither of these drawbacks; the only criticism levelled by Bird was that the cheaper machines could only deliver an alternating current. For medical use, particularly when treating a problem with nerves, a uni-directional current of a particular polarity was often required. This required the machine to have split-rings or similar mechanisms although alternating current machines were, according to Bird, suitable for cases of amenorrhœa.

This issue of the direction of the current required from the machines was connected with the direction electric current was though to flow in nerves in the human or animal body. For motor functions for instance, the flow was taken as being from the centre towards the muscles at the extremeties, and consequently artificial stimulation by the use of electricity needed to be in the same direction. For sensory nerves the opposite applied; flow was from the extremity to the centre, and the positive electrode would be applied to the extremity. This principle was demonstrated by Bird in an experiment with a living frog. A supply of frogs was usually to hand through their use in the frog galvanoscope. The electromagnetic galvanometer was available at this time but frog's legs were still used by Bird because of their much greater sensitivity to small currents. In the experiment, the frog's leg was completely severed from its body except for the sciatic nerve and electric current then applied from the body to the leg. The result was convulsions of the leg as the muscle was stimulated. Reversing the current, however, produced no movement of the muscle, merely croaks of pain from the frog. Bird, in his lectures, also describes many experiments with a similar aim on human sensory organs. In one experiment by Grapengiesser for instance, electric current is passed through the subject's head from ear to ear causing a sound to be hallucinated. The ear connected to the positive terminal hears a louder sound than that connected to the negative.

Bird designed his own interrupter circuit for delivering shocks to patients from a voltaic cell through an induction coil. Previously, the interrupter had been a mechanical device requiring the physician to manually turn a cog wheel, or else employ an assistant to do this. Bird wished to free his hands to better apply the electricity to the required part of the patient. His interrupter worked automatically by magnetic induction at a reasonably fast rate. The faster the interrupter switches, the more frequently an electric shock is delivered to the patient and the aim is to make this as high as possible.

Bird's interrupter had the medically disadvantageous feature that current was supplied in opposite directions during the make and break operations. Treatment often required that current was supplied in one specified direction only. Bird produced a uni-directional interrupter using a mechanism we would now call split-rings. This design suffered from the disadvantage that automatic operation was lost and the interrupter had to once again be hand-cranked. Nevertheless, this arrangement remained a cheaper option than electromagnetic generators for some time.

Treatments

Electrotherapeutic treatment to stimulate facial muscles, 1862

There were three classes of electrical treatment in use. One form of electrotherapy was the electric bath. This consisted of sitting the patient on an insulated stool with glass legs and connecting the patient to one electrode, usually the positive one, of an electrostatic machine. The patient's skin became charged as if he or she were in a "bath of electricity". A second class of treatment could be performed while the patient was in the electric bath. This consisted of bringing a negative electrode close to the patient, usually around the spine, causing sparks to be produced between the electrode and the patient. Electrodes of various shapes were available for different medical purposes and place of application on the body. Treatment was applied in several sessions of around five minutes, often causing skin eruptions. The third class of treatment was electric shock therapy in which an electric shock was delivered from a galvanic battery (later electromagnetic generators) via an induction coil to greatly increase the voltage. It was also possible to deliver electric shocks from the stored charge in a Leyden jar but this was a much feebler shock.

Electric stimulation treatment was used to treat nervous disorders where the nervous system was unable to stimulate a required glandular secretion or muscle activity. It had previously been successfully used to treat some forms of asthma. Bird used his apparatus to treat Sydenham's chorea (St Vitus's Dance) and other forms of spasm, some forms of paralysis (although the treatment was of no use where nerves had been physically damaged), opiate overdose (since it kept the patient awake), bringing on menstruation where this had failed, and hysteria, a supposed disease of women. Paralysed bladder function in young girls was attributed to the now archaic condition of hysteria. This was treated with an application of a strong electric current between the sacrum and the pubis. Although the treatment worked, in that it caused the bladder to empty, Bird suspected that in many cases it did so more through fear and pain than any therapeutic property of electricity.

Electric shock treatment had become fashionable amongst the public but often was not favoured by physicians except as a last resort. This led to many inappropriate treatments and fraudulent practitioners were widespread. Quack practitioners claimed the treatment as a cure for almost anything, regardless of its effectiveness, but could nevertheless make large sums of money from the practice. Bird, however, continued to stand by the treatment when properly administered. He convinced an initially sceptical Addison of its merits, and the first publication (in 1837) describing the work of the electrifying unit was authored by Addison, not Bird, although Bird is clearly, and rightly, credited by Addison. Having the paper authored by Addison did a great deal to gain acceptability of a still suspicous medical fraternity. Addison held great authority, whereas Bird at this stage was an unknown. Bird's 1841 paper in Guy's Hospital Reports contained an impressively long list of successful case studies. In 1847 he brought the subject fully into the realm of materia medica when he delivered the annual lecture to the Royal College of Physicians on this subject. Bird tirelessly spoke out against the numerous quack practitioners, in one case he exposed railway telegraph operators who were claiming to be medical electricians, but had no medical training at all. In this way Bird was largely responsible for the rehabilitation of electrical treatment amongst medical practitioners. His work, with Addison's support, together with the increasing ease of using the machines as the technology progressed, brought the treatment into wider use in the medical profession.

The electric moxa

Bird is the inventor of the electric moxa, which he created in 1843. The name moxa is a reference to the acupuncture technique of moxibustion but the electric moxa is not intended for acupuncture use. Bird was probably influenced in his choice of name by the introduction of electroacupuncture, in which the acupuncture needles are augmented with an electric current, just a couple of decades earlier in France. The electric moxa was used to produce a suppurating sore on the skin of the patient to treat some inflammatory and congested conditions by the technique of counter-irritation. Prior to the electric moxa, the sore was created by much more painful instruments such as the cautery or even burning charcoal. Bird's design was based on a modification of an existing instrument used to apply local electrical treatment for hemiplegia. The electric moxa consisted of a silver and a zinc electrode connected together by copper wire. Two small blisters were produced on the skin to which the two electrodes were then connected and held in place for a few days. Electricity is generated by electrolytic action with body fluids. The blister under the silver electrode heals up, but the one under the zinc electrode produces the required suppurating sore.

The healing of the blister under the silver electrode was of no importance for a counter-irritation procedure, however, it suggested to Bird that the electric moxa might be used for treating obstinate leg ulcers. This was a common complaint in Bird's time amongst the working classes, and hospitals were unable to admit for treatment the majority of cases that presented. The moxa was thus an advantage in that sufferers could be treated as outpatients. The silver electrode of the moxa was applied to the ulcer to be healed, while the zinc electrode was applied a few inches away to a patch of surface where the upper layer of skin had been cut away. The whole apparatus was then bandaged in place as before. The technique was successfully applied by others on Birds recommendation. It was later discovered by Thomas Wells that damaging the skin under the zinc plate was unnecessary. Wells merely moistened the skin with vinegar before application of the zinc electrode.

Controversy

Pulvermacher's chain

There was some controversy over Bird's endorsement of a machine invented by one I. L. Pulvermacher that became known as Pulvermacher's chain. Pulvermacher's main market for these devices was the very quack practitioners that Bird so detested, but it did actually work as a generator. Bird was given a sample of this machine in 1851 and was impressed enough with it that he gave Pulvermacher a testimonial stating that the machine was a useful source of electricity. Bird thought that it could be used by physicians as a portable device. Electrically, the machine worked like a voltaic pile, but was constructed differently. It consisted of a number of wooden dowels each with a bifilar winding of copper and zinc coils. Each winding was connected to the next dowel by means of metal hooks and eyes which also provided the electrical connection. The electrolyte was provided by soaking the dowels in vinegar. Naively, Bird appears to have expected Pulvermacher not to use this testimonial in his advertising. When Pulvermacher's company did exactly that Bird came in for some criticism for unprofessional behaviour, although there was never any suggestion that Bird benefited financially in any way and Bird stated in his defence that the testimonial was only ever intended as a letter of introduction to physicians in Edinburgh. Bird was particularly upset that Pulvermacher's company had used quotes from Bird's publications about the benefits of electrical treatment, and misrepresented them as if Bird had said they were the benefits of Pulvermacher's product. Bird also criticised the Pulvermacher claim that the chain could be wrapped around an affected limb for medical treatment. Although the flexible nature of its design lent itself to wrapping, Bird said that it would be next to useless in this configuration for medical application of electricity. The patient's body would provide a conductive path across each cell thus, according to Bird, preventing the device from building up a medically useful voltage at its terminals.

Electrochemistry

Bird used his position as head of the department of electricity and galvanism to further his research efforts and to aid teaching his students. Bird was interested in electrolysis and repeated the experiments of Antoine César Becquerel, Edmund Davy and others to extract metals in this way. He was particularly interested in the possibility of detecting low levels of heavy metal poisons with this technique, pioneered by Davy. Bird also studied the properties of albumen under electrolysis, finding that the albumen coagulated at the anode due to the production of hydrochloric acid there. He was able to correct an earlier erroneous conclusion by W. T. Brande that high electric current caused coagulation at the cathode also. Bird showed that this was entirely due to fluid flows caused by the strong electric field.

The formation of copper plates on the cathode were noticed in the Daniell cell shortly after its invention in 1836. Bird began a thorough investigation of this phenomenon the following year in 1837. Using solutions of sodium chloride, potassium chloride and ammonium chloride, He succeeded in coating a mercury cathode with sodium, potassium and ammonium respectively, producing amalgams of each of these. Not only chlorides were used; beryllium, aluminium and silicon were obtained from the salts and oxides of these elements.

As mentioned earlier, Bird, in 1837, constructed his own version of the Daniell cell. Originally, the Daniell cell held the two solutions (copper sulphate and zinc sulphate) in two separate, but linked, containers, an arrangement described as two half-cells. The novel feature of Bird's cell was that the two solutions were in the same vessel, but kept separate by a barrier of plaster of Paris, a common material found in hospitals for setting bone fractures. Plaster of paris being porous allows ions to cross the barrier while preventing the solutions from mixing. This arrangement is an example of a single-cell Daniell cell and Bird's invention was the first of this kind. Bird's cell was the basis for the later development of the porous pot cell, invented in 1839 by John Dancer.

Bird's experiments with this cell were of some importance to the new discipline of electrometallurgy. A surprising result was the deposition of copper on and within the plaster without any contact with the metal electrodes. On breaking apart the plaster it was found that veins of copper were formed running right through it. So surprising was this result of Bird's, that it was at first disbelieved by electrochemical researchers, including Michael Faraday. Deposition of copper, and other metals, had been previously noted, but always previously it had been metal on metal electrode. Bird's experiments sometimes get him credit for being the founder of the important industrial field of electrometallurgy. However, Bird himself never made practical use of this discovery, nor did he carry out any work in the field of metallurgy as such. Some of Bird's contemporaries with interests in electrometallurgy wished to bestow the credit on Bird in order to discredit the commercial claims of their rivals.

Bird thought that there was a connection between the functioning of the nervous system and the processes seen in electrolysis at very low steady currents. He was aware that the currents in both were of the same order. To Bird, if such a connection existed it made electrochemistry an important subject to study for purely biological reasons.

Chemistry

Arsenic poisoning

In 1837 Bird took part in an investigation of the dangers posed by the arsenic content of cheap candles. These were stearin candles with white arsenic added which made them burn brighter than ordinary candles. The combination of cheapness and brightness made them popular with the public. The investigation was conducted by the Westminster Medical Society, a student society of Westminster Hospital, and was led by John Snow, later to become famous for his public health investigations. Snow had previously investigated arsenic poisoning when himself and several fellow students were taken badly ill after a new process for preserving cadavers was introduced by Snow. The new process involved injecting arsenic into the blood vessels of the corpse. Snow found that the arsenic became airborne due to chemical reactions with the decomposing corpse and it was in this way that it was ingested. Bird's part in the candle investigation was to analyse the arsenic content of the candles, which he found to have been greatly increased of late by the manufacturers. Bird also confirmed by experiment that the arsenic became airborne when the candles were burnt. The investigators exposed various species of animal and bird to the candles in controlled conditions. The animals all survived but the birds died. Bird investigated the bird deaths and analysed the bodies, finding small amounts of arsenic. No arsenic was found on the feathers, however, indicating that poisoning was not by way of breathing airborne arsenic since arsenic in the air would be expected to adhere to the feathers. However, Bird found that large amounts of arsenic were in the bird's drinking water indicating that this was the route of poisoning.

Carbon monoxide

The danger of carbon monoxide poisoning from stoves burning carbonaceous fuels was not, at first, recognised. A coroner's inquest into the death of a nightwatchman, James Trickey, in 1838 who had spent all night by a new type of charcoal burning stove in St Michael, Cornhill concluded that the poison involved was carbonic acid (that is, carbon dioxide) rather than carbon monoxide. Both Golding Bird and John Snow gave evidence to the inquest supporting poisoning by carbonic acid. Bird himself started to suffer ill effects while he was collecting air samples from the floor near the stove. However, the makers of the stove, Harper and Joyce, produced a string of their own expert witnesses at the inquest who convinced the jury to decide that death was caused by apoplexy with "impure air" being only a contributing factor. Amongst the unscientific claims made at the inquest by Harper and Joyce were that carbonic gas would rise to the ceiling (it is actually heavier than air and would lie in a layer close to the floor just where Trickey's sleeping head would rest according to Bird) and that "deleterious vapour" from the coffins in the vaults had risen into the church. After the inquest Joyce threatened to sue a journal which continued to criticise the stove for its lack of ventilation. In a subsequent clarification, Bird made it clear that any stove burning carbonaceous fuel was dangerous if it did not have a chimney or other means of ventilation. Ironically, Trickey had only been placed in the church in the first place at Harper's suggestion. Harper was looking for favourable reports of the new stoves performance which Trickey, had he lived, was expected to give.

Bird read a paper to the Senior Physical Society in 1839 in which he tests the effects of poisoning by carbonaceous fumes on sparrows. This paper was of some importance and resulted in Bird giving his views to the British Association (where he acted as one of the secretaries to the chemical section in Birmingham) that same year. Bird also presented the paper at the Westminster Medical School where Snow took a special interest in it. Snow, up to then, had believed, along with many others, that carbonic acid acted merely by excluding oxygen. The experiments of Bird and others convinced him that it was deleterious in its own right but he still did not ascribe to the view held by Bird that it was an active poison. Also in 1839, Bird published a comprehensive paper in Guy's Hospital Reports, complete with many case histories, in which he documents the state of knowledge. He realised that at least some cases of poisoning from stoves were not due to carbonic acid, some other agent was involved, but he had still not identified the unknown substance as carbon monoxide.

Urology

Uric acid crystals drawn by Golding Bird. On the left are crystals formed in normal urine and on the right are crystals from a patient suffering from stones.

Bird did a great deal of research in the field of urology, including the chemistry of both urine and kidney stones and soon became a recognised expert. A large proportion of his effort was taken up with this work and his writings on urinary sediments and kidney stones was the most advanced in the field at the time. His work followed on from, and was much influenced by, that of Alexander Marcet and William Prout. Marcet was also a physician at Guy's; Prout held no position at Guy's, but was connected and well known there. For instance, when Marcet discovered a new constituent of kidney stones, xanthic oxide, he sent the substance to Prout for analysis. Prout was himself the discoverer of a new substance in 1822; a constituent of urine which he named melanic acid due to it turning black on contact with the air.

Bird studied and categorised the collection of stones at Guy's particularly concentrating on the nuclei crystal structures since stone formation followed once there was a nucleus to form on. He considered study of the chemistry of the nuclei to be the most important aspect of stone formation. Bird identified many species of stone, classed by the chemistry of the nucleus, but determined that they all fell within two overall groups; organic stones caused by a misfunctioning bodily process, and excessive inorganic salts causing sediment on which the stone could nucleate. Bird was the first to describe, in 1842, the condition oxaluria, sometimes called Bird's disease, caused by an excess of oxalate of lime in the urine. This is the second most common cause of stones, the first being uric acid and its ammonium salt. There are several others such as ammonium oxalate. In his great work Urinary Deposits Bird devotes much space to the identification of chemicals in urine by microscopic examination of the appearance of crystals in the urine. Bird shows how the appearance of crystals of the same chemical can vary greatly under differing conditions and especially how the appearance changes with disease. Urinary Deposits became a standard text on the subject; there were five editions of the book between 1844 and 1857. Bird added in the fourth edition a recommendation to wash out the bladder in cases of alkaline urine. This was in consequence of an experiment by Snow which showed that fresh urine slowly dripped into stale urine caused it to become alkaline. Alkaline urine was known to Bird to encourage phosphate precipitation and the consequent encrustation and stone formation. The last edition was updated after Bird's death by Edmund Lloyd Birkett.

Bird was the first to recognise that urinary casts are a diagnostic indication of Bright's disease. Casts were first discovered by Henry Bence Jones. They are microscopic cylinders of Tamm-Horsfall protein which have been precipitated out in the kidneys and then released into the urine.

Vitalism

A prevalent idea in the 18th and early-19th centuries was that illness was a result of the condition of the whole body. The environment and the activity of the patient thus played a large part in any treatment. The epitomy of this kind of thinking was the concept of the vital force which was supposed to govern the chemical processes within the body. For this reason it was held that formation of organic compounds could only take place within living organisms where the vital force could come into play. This belief was known to be false ever since Friedrich Wöhler succeeded in synthesising urea from inorganic precursors in 1828. Despite this counter-example, the vital force continued to be invoked to explain organic chemistry in Bird's time. Sometime in the middle of the 19th century a new way of thinking started to take shape especially amongst younger physicians fueled by rapid advances in the understanding of chemistry. For the first time, it became possible to identify specific chemical reactions with specific organs of the body and trace the effects through the various functional relations of the organs and the exchanges between them.

Counted amongst these younger radicals were Golding Bird and John Snow. Counted amongst the old school was William Addison (a different person from Bird's superior at Guy's). Addison disliked the modern reliance on laboratory and theoretical results favoured by the new generation and challenged Richard Bright (of Bright's disease) when he suggested that the source of the problem in edema was the kidneys. Addison preferred to believe that the condition was caused by intemperance or some other external cause and that since the whole body had been disrupted it could not be localised to a specific organ. Addison further challenged Bright's student, Snow, when in 1839 he suggested from case studies and laboratory analysis that edema was associated with an increase in albumin in the blood. Addison dismissed this as a mere epiphenomenon. Bird disagreed with Snow over Snow's proposed treatment, but his arguments against Snow clearly show him to be on the radical side of the fence and were completely devoid of any whole-body arguments. Snow had found that the proportion of urea in the urine of his patients was low and concluded from this that urea was accumulating in the blood. Snow thus proposed bloodletting as a treatment to counter this. Bird disputed that increasing urea in the blood was the cause of kidney disease and the effectiveness of this treatment citing the results of François Magendie who had injected urea into the blood, apparently with no ill effects. It is not clear whether or not Bird accepted Snow's reasoning that urea must be accumulating, or was merely accepting it arguendo; he had disputed this very point while a student in 1833 with another of Bright's students, George Rees.

Justus von Liebig is another figure of some importance for the new thinking, although his position in some respects is ambiguous. He explained chemical processes in the body with addition and subtraction of simple molecules from a larger organic molecule. Bird followed Liebig's scheme in his own work but even the materialistic Liebig continued to invoke the vital force for processes inside living animal bodies. This seems to have been based on a belief that the entire living animal is required for these chemical processes to take place. Bird is responsible, at least in part, for moving this kind of thinking on by showing that specific chemistry is related to specific organs in the body rather than the whole animal. Bird challenged some of Liebig's conclusions concerning animal chemistry; for instance, Bird showed that Liebig's prediction that the ratio of uric acid to urea depended on the level of activity of a species (or individual) was false. Bird also felt that it was not enough to simply count atoms as Liebig did, but an explanation of why the atoms recombined in that particular way rather than any other was also required. Bird made some attempts to provide this explanation by invoking the electric force, rather than the vital force, based on his own experiments in electrolysis.

Flexible stethoscope

Bird's flexible stethoscope

Bird designed and used a flexible tube stethoscope and was the first to publish, in 1840, a description of such an instrument. Bird mentions in his paper an instrument already in use by other physicians (Drs. Clendinning and Stroud) which he describes as the snake ear trumpet but thought that this device was of little utility. The form of Bird's invention is similar to the now ubiquitous modern stethoscope excepting that it has only one earpiece. An ill-tempered exchange of letters occurred in the London Medical Gazette between another physician, John Burne, and Bird. Burne claimed that he also used the same instrument as Clendinning and Stroud and was offended that Bird had not mentioned him (Burne) in his paper. Burne, who worked at the Westminster Hospital, pointed with suspicion to the fact that Bird's brother, Frederic, also worked at the same establishment. A somewhat bemused Bird pointed out that in his original paper he had already made clear he claimed no credit for this earlier instrument. It has been suggested that part of Bird's motivation for inventing his flexible stethoscope was that his severe rheumatism caused him difficulty in leaning over patients when using a rigid stethoscope and the flexible stethoscope greatly eased this problem.

Elements of Natural Philosophy

When Bird took up lecturing science at Guy's, he could not find a textbook suitable for his medical students. He needed a book that went into some detail of physics and chemistry but which medical students would not find overwhelmingly mathematical. Bird, with reluctance, undertook to write such a book himself, based on his 1837–1838 lectures, and the result was Elements of Natural Philosophy, first published in 1839. It proved to be spectacularly popular, even beyond its intended audience of medical students, and went through six editions. Reprints were still being produced more than 30 years later in 1868. The fourth edition was edited by Charles Brooke, a friend of Bird's, after the latter's death. Brooke made good many of the mathematical omissions of Bird. Brooke continued editing editions of the book and in the sixth edition of 1867 he thoroughly updated it. The book was well received and was praised by reviewers for its clarity.

The Literary Gazette, for instance, thought that the book "...teaches us the elements of the entire circle of natural philosophy in the clearest and most perspicuous manner..." The reviewer recommended that the book was suitable not just for students and not just the young; the volume, it said, "...ought to be in the hands of every individual who desires to taste the pleasures of divine philosophy, and obtain a competent knowledge of that creation in which they live..."

Medical journals, on the other hand, were not quite so unrestrained in their praise. The Provincial Medical and Surgical, for instance, in its review of the second edition, thought that it was "a good and concise elementary treatise...presenting in a readable and intelligble form, a great mass of information not to be found in any other single treatise..." However the Provincial had a few technical nitpicks. Amongst these was the complaint that there was no description of the construction of the stethoscope. The Provincial reviewer thought that the book was particularly suitable for students who had no previous instruction in physics. The sections on magnetism, electricity and light were particularly recommended.

Popular Science Review noted that the author was now named as Brooke in their review of the sixth edition and observe that Brooke had now made it his own. The reviewers looked back with nostalgia to the book they knew as "the Golding Bird" when they were students. They note with approval the many newly included descriptions of the latest technology such as the dynamos of Henry Wilde and Werner von Siemens, and the spectroscope of Browning.

The scope of the book was wide-ranging, covering much of the physics then known. The 1839 first edition included statics, dynamics, gravitation, mechanics, hydrostatics, pneumatics, hydrodynamics, acoustics, magnetism, electricity, atmospheric electricity, electrodynamics, thermoelectricity, bioelectricity, light, optics, and polarized light. In the 1843 second edition Bird expanded the material on electrolysis into its own chapter, reworked the polarized light material, added two chapters on thermotics (thermodynamics – a major omission from the first edition), and a chapter on the new technology of photography. Later editions also included a chapter on electric telegraphy. Brooke was still expanding the book for the sixth and final edition. New material included the magnetic properties of iron in ships and spectrum analysis.

Christian works

Bird was a committed Christian throughout his life. Despite his extremely busy professional life, he meticulously observed the Sabbath and saw to the Christian education of his children. Bird showed generosity to the poor, offering treatment to them at his house every morning before going about his professional schedule. After it became clear that the remainder of his life was going to be very limited, he devoted all his time to his religion. It was a great ambition of Bird's to promote Christian teachings and Bible reading amongst medical students. From 1853 Bird organised a series of religious meetings amongst medical professionals in London. The aim was to encourage physicians and surgeons to exert a religious influence over their students.

For several years prior to 1853 student prayer meetings had been held in some of the London hospitals, particularly St Thomas'. Bird aimed to mould this movement into a formal association, an ambition which was to crystallise as the Christian Medical Association. In this Bird was heavily influenced by the Medical Missionary Society of John Hutton Balfour at Edinburgh University. Bird aimed to form a national body with a chapter in each teaching hospital; a prototype student group was already in existence at Guy's. Bird was strongly opposed by some sections of the medical profession who felt that students should concentrate on their studies. Amongst the more inventive insults hurled at Bird were "saponaceous piety" and being a Mawworm. This opposition continued after the formation of the Association. The constitution for the new Christian Medical Association was agreed at Bird's home on 17 December 1853 in a meeting of medical and surgical teachers and others. This constitution was based on a draft prepared by the Guy's student group. Bird died before the inaugural public meeting of the Association in November 1854 at Exeter Hall.

Bird was quick to defend the virtuousness of students. In November 1853, in a reply to a letter from a student in the Provincial Medical and Surgical Journal complaining of lack of moral care from his superiors, Bird attacked the prevalent public view that students were "guilty of every kind of open vice and moral depravity". Bird laid much of the blame for this public opinion on the caricatures of students in the writings of Charles Dickens. Bird goes on to say that the behaviour and character of students had greatly improved over the preceding ten years (implying, of course, that in earlier times their behaviour had not been quite so exemplary). Bird attributes this improvement in part to the greatly increased study requirements of students, but also in part to Christian influences acting on the students. He goes on to say that pious students were once ridiculed but are now respected.

Works

• Elements of Natural Philosophy; being an experimental introduction to the study of the physical sciences (John Churchill, London, 1839)
• Lectures on Electricity and Galvanism, in their physiological and therapeutical relations, delivered at the Royal College of Physicians, in March 1847 (Wilson & Ogilvy, London, 1847)
• Lectures on the Influence of Researches in Organic Chemistry on Therapeutics, especially in relation to the depuration of the blood, delivered at the Royal College of Physicians (Wilson & Ogilvy, London, 1848)
• Urinary Deposits, their diagnosis, pathology and therapeutical indications (John Churchill, London, 1844)

Journal articles

• Bird's first publication of his modification of the Daniell cell, Report of the Seventh Meeting of the British Society for the Advancement of Science, vol.6 (1837), p. 45, London: J. Murray, 1838.
• "Observations on induced electric currents, with a description of a magnetic contact-breaker", Philosophical Magazine, pp. 18–22, no.71, vol.12, January 1838.
• "Observations on the existence of saline combinations in an organized state, in vegetable matter", The Magazine of Natural History, pp. 74–78, vol.2, February 1838.
• "Observations on indirect chemical analysis", Philosophical Magazine, pp. 229–232, no.74, vol.12, March 1838.
• "Experimental researches on the nature and properties of albumen", Philosophical Magazine, pp. 15–22, no.79, vol.12, July 1838.
• "Observations on some peculiar properties acquired by plates of platina, which have been used as electrodes of a voltaic battery", Philosophical Magazine, pp. 379–386, no.83, vol.12, November 1838.
• "Mucous and purulent secretions", Guy's Hospital Reports, pp. 35–59, vol.3, 1838.
• "Notice respecting the artificial formation of a basic chloride of copper by voltaic influence", Report of the Eighth Meeting of the British Society for the Advancement of Science, vol.7 (1838), pp. 56–57, London: J. Murray, 1839.
• "Notice respecting the deposition of metallic copper from is solutions by slow voltaic action at a point equidistant from the metallic surfaces", Report of the Eighth Meeting of the British Society for the Advancement of Science, vol.7 (1838), pp. 57–59, London: J. Murray, 1839.
• "Observations on some of the products of nitric acid on alcohol", Philosophical Magazine, 1838.
• "Observation on poisoning by the vapours of burning charcoal and coals", Guy's Hospital Reports, vol.4, pp. 75–105, 1839.
• "Advantages presented by the employment of a stethoscope with a flexible tube", London Medical Gazette, vol.1, pp. 440–412, 11 December 1840.
• "Report on the value of electricity, as a remedial agent in the treatment of diseases", Guy's Hospital Reports, vol.6, pp. 84–120, 1841.
• "Fatty urine", The Medical Times, p. 175, no.223, vol.9, 30 December 1843.
• "Treatment of uric acid gravel by phosphate of soda", Medical Gazette, p. 689, 23 August 1844.
• "Infantile syphylis", Guy's Hospital Reports, p. 130, April 1845.
• "Treatment of disease by moist air", Medical Gazette, p. 999, 3 October 1845.
• "The nature of the green alvine evacuations of children", The Medical Times, pp. 74–75, no.317, vol.13, 18 October 1845.
• "Treatment of disease by moist air", The Medical Times, p. 228, no.325, vol.13, 13 December 1845.
• "Diseases of children", Guy's Hospital Reports, pp. 108–141, series 2, vol.3, 1845.
• "Acetate of lead in diarrhoea", The Medical Times, p. 465, no.337, vol.13, 14 March 1846.
• "Case of excessive secretion of the ammonio-magnesium phosphate by the kidneys, with long continued vomiting", The Medical Times, pp. 522–523, no.340, vol.13, 4 April 1846.
• "Case of internal strangulation of intestine relieved by operation", from Transactions of the Royal Medico-Chirurgical Society, with John Hilton, London:Richard Kinder, 1847.

Bird also frequently appeared in the transactions of the Medical Society of London. Some examples;

• "Transactions of the Medical Society of London, Oct 16", The Medical Times, pp. 39–40, no.213, vol.9, 21 October 1843. Report on the poisoning of a watch enameller by arsenic vapour.
• "Transactions of the Medical Society of London, Jan 15 1844", The Medical Times, pp. 271–274, no.227, vol.9, 27 January 1844. Report on a case of a child with inflammatory croup.

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