Morell Mackenzie

Biographical Timeline

• 1837 – Born July 7 in Leytonstone, Essex, eldest son of Dr. Stephen Mackenzie (1803–1879), general practitioner, and Margaret Harvey. His younger brother Stephen Mackenzie (1844–1927) later became a prominent physician at the London Hospital.
• 1858 – Qualified M.R.C.S and Licentiateship of the Society of Apothecaries (LSA) after training at the London Hospital.
• 1859–1861 – Studied medicine in Paris (Trousseau, Nélaton, Ricord), Vienna (Oppolzer, Skoda, Rokitansky, Hebra), and Budapest, where Johann Czermak introduced him to the laryngoscope of Manuel Garcia.
• 1861 – Graduated M.B. from the University of London.
• 1862 – Awarded M.D. (London). Established himself in private practice as a throat specialist.
• 1863 – Won the Jacksonian Prize of the Royal College of Surgeons for his essay On the Pathology and Treatment of Diseases of the Larynx. In his BMA presentation that year, he introduced the terms “abductors” and “adductors” for laryngeal muscles.
• 1863 – Founded the Metropolitan Free Dispensary for Diseases of the Throat and Loss of Voice, London.
• 1865 – Published The Use of the Laryngoscope in Diseases of the Throat; translated into multiple languages, it secured his reputation as a pioneer. In the same year he opened the Hospital for Diseases of the Throat, Golden Square — the first specialist laryngological hospital in the world.
• 1887 – one of the founders of the Journal of Laryngology and Rhinology and of the British Rhino-Laryngological Association
• 1871 – Published Growths in the Larynx, reporting 100 surgically treated cases using the laryngoscope.
• 1873 – Appointed Physician to the London Hospital, but soon resigned to devote himself fully to laryngology and the expanding Golden Square hospital.
• 1880 – Published Diseases of the Throat and Nose, Vol. I (larynx and pharynx), a landmark textbook.
• 1884 – Published Diseases of the Throat and Nose, Vol. II (nose and naso-pharynx). The two volumes were hailed as the standard authority in laryngology, later described as the “laryngologist’s Bible”.
• 1887 – Co-founded the Journal of Laryngology and Rhinology (later Journal of Laryngology & Otology). In the same year, he was knighted for his services to medicine.
• 1887–1888 – Attended Crown Prince Frederick of Prussia (later Emperor Frederick III). Mackenzie’s refusal to sanction immediate radical laryngeal surgery became one of the most famous medical controversies of the century. He later defended his management in The Fatal Illness of Frederick the Noble (1888).
• 1888 – Received the Grand Cross and Star of the Royal Order of Hohenzollern from Emperor Frederick III.
• 1888–1891 – Continued active private and hospital practice in London. Faced professional censure from the Royal Colleges for his controversial book on Frederick.
• 1892 – Died February 3 in London, aged 54, after a long history of asthma. Buried in Wargrave, Berkshire.

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Key Medical Contributions

Barrett’s oesophagus (1884)

1884 – Sir Morell Mackenzie (1837–1892) provided an early clinical delineation of oesophagitis and its complications. Quoted by Norman Rupert Barrett (1903-1979) in 1950 for his original work and definition of acute oesophagitis:

Acute idiopathic inflammation of the mucous membrane of the oesophagus giving rise to extreme odyn[o]phagia, and often to aphagia. The disease is attended with some danger, but generally ends in resolution, and only in extremely ran cases terminates in ulcer, abscess, or gangreneMackenzie 1884

Acute oesophagitis: Acute idiopathic inflammation of the mucous membrane of the oesophagus giving rise to extreme odynphagia, and often to aphagia. The disease is attended with some danger, but generally ends in resolution, and only in extremely ran cases terminates in ulcer, abscess, or gangrene

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The Hospital and the Laryngoscope

Mackenzie was one of the first physicians to grasp the full diagnostic and therapeutic potential of the laryngoscope, introduced by Manuel Garcia and popularised on the continent by Czermak. He published The Use of the Laryngoscope in Diseases of the Throat (1865), the first English textbook on the subject, translated into several languages and running through multiple editions.

In 1863 he founded the the first dedicated laryngological hospital in the world, the Metropolitan Free Dispensary for Diseases of the Throat and Loss of Voice, which grew into the Hospital for Diseases of the Throat, Golden Square (1865). Here Mackenzie treated an ever-increasing number of patients and trained a generation of British laryngologists.

His mechanical ingenuity extended to surgical instruments; he refined forceps, mirrors, and operating chairs for throat work, ensuring laryngology was not a theoretical innovation but a practical clinical discipline.

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Controversies

Frederick the Noble and the Controversy

Mackenzie’s fame and notoriety came with his role as personal physician to Crown Prince Frederick of Prussia (1831–1888), later Emperor Frederick III. In 1887, German physicians advocated immediate radical surgery for a suspected laryngeal cancer. Mackenzie, citing negative pathology and his own clinical judgment, advised delay.

When Frederick briefly acceded to the throne but died 99 days later, the case became a matter of international scandal. Mackenzie published The fatal illness of Frederick the Noble (1888) to defend his decisions, a book as polemical as it was clinical. German colleagues accused him of mismanagement; the Royal Colleges in London censured him for publishing confidential details; his reputation never recovered.

Yet viewed in historical context, his decisions reflected the limits of late 19th-century diagnosis and the risks of then-available surgery. Even his critics acknowledged his technical skill: Sir St Clair Thomson (1859-1943) later remarked that “whenever a new book on laryngology was published, I read Mackenzie’s old one, and there found many of the so-called new ideas.”

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Major Publications

• Mackenzie M. The Use of the laryngoscope in diseases of the throat. 1865 [Jacksonian Prize Essay for 1863]
• Mackenzie M. Essays on throat diseases II: Growths in the larynx. 1871
• Mackenzie M. Diphtheria: its nature and treatment, varieties and local expressions. 1879
• Mackenzie M. Diseases of the Pharynx, Larynx, and Trachea. 1880 (2e 1884)
• Mackenzie M. A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, oesophagus, nose and naso-pharynx. 1880
• Mackenzie M. The Hygiene of the vocal organs: A Practical Handbook for Singers and Speakers. (2e 1886, 6e 1888)
• Mackenzie M. The fatal illness of Frederick the Noble. 1888
• Mackenzie M. Hay Fever and Paroxysmal Sneezing: Their Etiology and Treatment : with an appendix on Rose Cold 5e 1889

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References

Biography

• Haweis HR. Sir Morell Mackenzie; physician and operator; a memoir compiled and ed. from private papers and personal reminiscences. 1893
• Sir Morell Mackenzie (1837–1892). Nature 1937; 140: 16
• Stevenson RS. Morell Mackenzie. 1946
• Stevenson RS, Guthrie D. A History Of Oto-Laryngology. 1949
• Chalat NI. Sir Morell Mackenzie revisited. Laryngoscope. 1984 Oct;94(10):1307-10.
• Weir N. Otolaryngology: An Illustrated History. 1990
• Weir N. Mackenzie, Sir Morell. Oxford Dictionary of National Biography

Frederick III, Crown Prince of Germany

• Schweig H. Case of Emperor Frederick III. 1888
• An interview with John O. Roe MD regarding “Sir Morell Mackenzie’s book on ‘[The fatal illness of Frederick the Noble’ 1888