Charles Ballance

Sir Charles Alfred Ballance (1856-1936) was an English surgeon.

Proposed a method for diagnosing splenic rupture; pioneer in neurotologic and skull base surgery; and first surgeon in history to perform a facial nerve crossover anastomosis in 1895

Ballance along with Sir William Macewen (1848-1924) led the way in establishing improved surgical treatment of suppurative disease in the middlc ear and of its complications


  • Born 30 August 1856 in Clapton, England
  • 1881 – MBBS St. Thomas Medical School (gold medal in surgery)
  • 1885 – FRCS Fellow of the Royal College of Surgeons
  • 1915 – Consultant surgeon to the British Army, stationed at Malta
  • Aural Surgeon to St. Thomas’ Hospital
  • 1912 – 1926 Chief Surgeon to the metropolitan police
  • 1906 – President of the Medical Society of London
  • Vice-President of the Royal College of Surgeons
  • 1918 – KCMG; Knight Commander of the Order of St Michael and St George
  • 1926 – First president of the Society of British Neurological Surgeons
  • 1933 – Lister medal
  • Died 8 February 1936

Medical Eponyms

Ballance’s (triad) sign (1898)

Ballance proposed a method for diagnosing splenic rupture in blunt abdominal trauma in particular fixed dullness to percussion in the left flank and shifting dullness to percussion in the right flank seen with splenic rupture/haematoma

…diagnosis of ruptured spleen is arrived at from: (1) The locality of the injury. (2) The evidence of internal haemorrhage; and (3) The large fixed dulness in the left flank. The fixed dulness in the left loin and splenic region is not present in intra-abdominal haemorrhage from other organs, and is caused by this region being occupied by large quantities of clot. The dulness, therefore, cannot change with position, and is pathognomonic of this injury. The unusually large proportion of white corpuscles in splenic venous blood offers an explanation of the local coagulation of the effused blood in splenic rupture. Further, the exceptional coagulability of the splenic blood offers an explanation of the fact that these patients do not rapidly bleed to death

Ballance CA, 1898: 357

Major Publications


BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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