The Chloroformist

By Christine Ball

Operating with bare hands, dressed in his street clothes, he had taken those first steps that every training surgeon must take-gripping the handle of a scalpel and making the first, irrevocable cut into live human flesh. For the surgeon training in the early 1840s, these first surgical milestones were performed on a person who would recoil in terror and horror, flinch, pull away, shake-and scream and scream and scream.

Until 1846, surgery was performed without anaesthesia: extraordinary operations, carried out on conscious, terrified patients. Surgeons of that era were bold and courageous and saved many lives, but anaesthesia changed everything. With an unconscious patient, the surgeon could take his time. Surgery became slower, more careful and more delicate. And as anaesthesia removed the pain of surgery, the medical world gave more attention to surgical infection, heralding in the use of antiseptics and eventually aseptic surgery. By 1881, the operating theatre was unrecognisable.

Much has been written about surgery in the nineteenth century, but little has been said about the development of the relationship between surgeon and anaesthetist. For anaesthesia to mature and allow further advances in surgery, a professional relationship had to develop between surgeons and anaesthetists. Joseph Clover arguably did more than any other anaesthetist to develop that relationship.

In The Chloroformist, Christine Ball tells the captivating story of an innovative, hard-working and deeply humane pioneer of modern patient care.

• Language: English
• Publisher: Melbourne University Publishing Ltd
• Release date: Aug 3, 2021
• ISBN: 9780522877755

Christine Ball

Christine Ball is of Romany Gypsy background and recently lost her Husband. She also lost her Son Naylor 13 years ago in a car accident. After years of suffering from depression it has inspired her to write this book to help others. She is a mother of three children, a grandmother of twelve and a great-grandmother of three. She currently works in a small family run deli.

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Christine Ball is an anaesthetist at the Alfred Hospital in Melbourne, co-manages a Master of Medicine (Perioperative) at Monash University, and is the 2020–2024 Wood Library-Museum Laureate of the History of Anesthesiology. She has been an honorary curator at the Geoffrey Kaye Museum of Anaesthetic History for thirty years and is the author of many works in this field.

MELBOURNE UNIVERSITY PRESS

An imprint of Melbourne University Publishing Limited

Level 1, 715 Swanston Street, Carlton, Victoria 3053, Australia

[e-mail]

www.mup.com.au

First published 2021

Text © Christine Ball, 2021

Images © various contributors, various dates

Design and typography © Melbourne University Publishing Limited, 2021

This book is copyright. Apart from any use permitted under the Copyright Act 1968 and subsequent amendments, no part may be reproduced, stored in a retrieval system or transmitted by any means or process whatsoever without the prior written permission of the publishers.

Every attempt has been made to locate the copyright holders for material quoted in this book. Any person or organisation that may have been overlooked or misattributed may contact the publisher.

Text design and typesetting by Cannon Typesetting

Cover design by Pfisterer + Freeman

Cover image by John Templeton Lucas, 1862

Printed in Australia by McPherson’s Printing Group

9780522877748 (paperback)

9780522877755 (ebook)

Contents

Introduction

1 An Apprentice in Norwich

2 The Draper’s Shop in Market Place

3 A Medical Student in London

4 Sweet Oil of Vitriol

5 Qualifications and Mortality

6 A Scotsman in London

7 The Apothecary

8 Expanding Horizons

9 Chloroform

10 And Now for the Cobra …

11 44 Mortimer Street

12 The Consequences of War

13 Debt, Difficulties and Opportunities

14 The Basement in Cavendish Place

15 Measurement and Exhibition

16 The Chloroform Committee

17 The New Zealand Banker

18 Ovariotomy

19 Lithotrity

20 The Complexities of Anaesthesia

21 Laughing Gas

22 Dentists Unite

23 The First Nitrous Oxide Committee

24 The Case of Mr Statham

25 A Girl Who Painted

26 Births, Deaths and Publicity

27 Equipment Concerns

28 Change

29 Ether and Nitrous Oxide

30 Be Prepared

31 The Seventh International Medical Congress

32 Perfect Peace

33 The Tour

Acknowledgements

Sources

Notes

Index

Introduction

IT STARTED WITH a book—an old casebook, written in beautiful cursive script—pressed into a picture frame and then forgotten. When it resurfaced, it was a mystery, the first clue on the front cover. It had been a gift from a British anaesthetist to Geoffrey Kaye, a colleague in Melbourne. Inscribed in 1935, almost a hundred years after it was written, it was intended as a contribution to the anaesthetic museum Kaye was establishing.

The Geoffrey Kaye Museum resides in the Australian and New Zealand College of Anaesthetists. It has had many homes—attics, basements, cupboards and corridors—and at times has been neglected, and at other times much loved. Today it is carefully tended, professionally managed and beautifully displayed. The long-lost casebook has been lovingly restored, and during that restoration, the book revealed some of its secrets.

The casebook belonged to Joseph Thomas Clover, who worked as a surgeon in London in the middle of the nineteenth century. It was written when he was still a medical student, before he trained as a surgeon, and around the time that anaesthesia was discovered. Eventually Clover abandoned surgery and became the most important authority on anaesthesia in Britain. He is featured on the crest of the Royal College of Anaesthetists, alongside John Snow, who is probably the best-known figure in the history of anaesthesia. There is a green plaque in London at the site of Clover’s former home and another in Aylsham, where he was born. Yet little has been written about Clover and few outside the world of anaesthesia have heard his name. Some biographical articles have been prepared over the years, and several articles about the equipment he designed, but the man himself remains elusive—what he thought, what he believed, whom he loved.

Clover left many papers but, like the casebook, they were dispersed—scattered all over the world, sold or given to others, hidden in private libraries or obscure public collections. The growth of technology and the opportunities afforded by the internet have now allowed most of his papers to be rediscovered and digitally reunited. There are diaries in Vancouver and Chicago, letters in America and England, case notes in the Wellcome Library in London, family documents in Norwich, photographs in the Netherlands—and, of course, a casebook in Australia. Periodically, other items appear at auctions. Some manage to find their way into anaesthetic history collections but others disappear back into private hands.

Over the years, as I have reassembled this collection, I have discovered a person I understand, someone who embodies the speciality of anaesthesia as it exists today. At the same time, a story has evolved— the story of how anaesthesia and surgery developed together, as interrelated disciplines.

Patients who have operations generally remember their surgeon, bearing the scars for the rest of their lives. But few remember their anaesthetist. Anaesthesia is a poorly understood specialty—even within the medical profession, few know exactly what anaesthetists do. Yet they are essential to the patient’s surgical journey. Before an operation can take place, the anaesthetist must ensure the patient is fit enough for the surgery. During the operation, the anaesthetist keeps a close watch over the patient, continuously monitoring their vital signs. If there is blood loss, shock, heart failure, an allergic reaction, any emergency at all, the anaesthetist deals with it. They keep the patient unconscious, unaware and alive while the surgery is conducted. Once the procedure is complete, the anaesthetist remains until the patient is safe and conscious, their pain under control and their resuscitation complete. During this whole process, there is constant communication between the surgeon and the anaesthetist, each dependent on the other to know what should happen next, each alert to anything unusual or unexpected. Together, the surgeon and the anaesthetist steer the patient through the operation, working closely as a team, relying on each other’s skill, experience and expertise.

It was not always that way. Until 1846, surgery was performed without anaesthesia—extraordinary surgery, performed on conscious, terrified patients. Surgeons of that era were bold and courageous and saved many lives. But anaesthesia changed everything. With an unconscious patient, the surgeon could take their time. Surgery became slower, more careful, more delicate. And as anaesthesia removed the pain of surgery, the medical world gave more attention to surgical infection, heralding the use of antiseptics and eventually aseptic surgery. By 1881, the operating theatre was unrecognisable—in just thirty-five years, everything had changed.

Joseph Clover began his career as an apprentice in 1841, learning the art of surgery in the pre-anaesthetic era. He was present when the first major surgical operation was performed under ether anaesthesia in London, in December 1846. He must have realised this was a groundbreaking moment, but he could not have anticipated the impact it would have on his career, or the huge role he was to have in the future.

Clover continued his surgical training and worked for a while as a specialist surgeon. But he gained great expertise in anaesthesia and a number of significant life events led him to eventually largely abandon operating to concentrate on administering anaesthesia for his surgical colleagues. While this was often done by untrained personnel in the nineteenth century, Clover became an expert, and his status as a surgeon gave him greater credibility with his colleagues. He was their peer, their equal, and they trusted him. He was the person they turned to when they had difficult cases or important patients in positions of power and authority. He helped them in every way: giving anaesthetics, designing surgical equipment, attending their meetings, even lending them money.

He was also a gentle, caring doctor. He put great thought into his anaesthetics, designing equipment for the delivery of anaesthesia, but always considering the comfort and safety of the patient. He sat on many influential committees investigating anaesthetic agents, and conducted experiments in hospital laboratories and his own home. His careful scientific work was often presented in the medical literature or at medical meetings, and he conducted audits of his own practice and the practices of others using his equipment.

Joseph Clover existed in the shadows. The anaesthetist, always present but seldom remembered—watching, listening, recording, allowing others to do their job, providing support inside and outside the operating theatre. Clover’s papers reveal many stories. They tell much of the man himself, but even more about the world he lived in, a world transformed by anaesthesia and aseptic surgery. Much has been written about surgery in the nineteenth century, but little has been said about the development of the vital relationship between surgeon and anaesthetist, a relationship that developed slowly. Surgeons were used to taking sole responsibility for their patients and it was difficult for them to accept another professional into their domain. But for anaesthesia to mature and allow further advances in surgery, a professional relationship had to develop between surgeons and anaesthetists. Joseph Clover arguably did more than any other early anaesthetist to encourage this effective teamwork, setting the stage for good patient care, for safe surgery and for optimal surgical outcomes.

CHAPTER 1

An Apprentice in Norwich

FOR MOST OF July 1841, it rained in Norwich. ¹ But on Monday the 26th, sufficient sunlight broke through the clouds for Dr Edward Lubbock to commit to performing the operation. ² With his doctor’s bag in hand, he knocked on the door of the young girl’s home. Standing beside him was sixteen-year-old Joseph Thomas Clover, ³ a young student contemplating a career in medicine. At that exact moment, though, he was contemplating nothing but the door in front of him, fighting rising anticipation, excitement and fear. Surgery in the early 1840s was not for the faint-hearted. Fortunately, the ordeal, for both him and the patient, was short-lived. The little girl was wrapped tightly in a sheet and held in the light beneath a window. Before she was really aware of what was happening, a gag was inserted between her teeth and cranked open. Dr Lubbock then quickly reached to the back of her throat with his scalpel and severed a large piece from her swollen tonsils. As the girl registered the sharp pain and warm rush of blood into her mouth, the doctor removed the gag, and the arms holding her softened, allowing her to cough and clear her throat. Leaving her to be carried back to bed, the doctor gathered up his instruments, left instructions and shepherded his young charge back out into the street. When that day ended, the young student returned to his lodgings and started a brand new notebook. He wrote nothing of his feelings about his interesting first day; he merely documented that this operation had taken place. ⁴

Joseph Clover had just finished school and was considering an apprenticeship in medicine. Apprenticeships were still a common way to acquire a medical qualification in the 1840s.⁵ Although universities, like Oxford and Cambridge, provided medical degrees in the form of an MD, many still chose the more practical route of an apprenticeship. Typically, they were five years, but usually the last two years were spent in more formal study, attending lectures and sitting examinations. There were benefits for both parties. For the doctor, apprentices were an important source of income. They also functioned as assistants, able to perform more menial tasks and to help with complex procedures. In return, apprentices were provided with board and lodging, along with invaluable practical experience and knowledge. If things worked well, they would also have a lifelong mentor who could advise them throughout their career. Eventually, once the candidate had completed their apprenticeship, attended the approved lectures and passed a series of examinations, they could apply for qualifications. In the 1840s, most applied for the Licentiate of the Society of Apothecaries (LSA) and the Membership of the Royal College of Surgeons (MRCS). With these two qualifications, they could prescribe medications and perform operations, essential requirements for general practice.

Five years was a big commitment, and an expensive one. Clover’s great-grandfather had been a veterinary surgeon with considerable standing in the area,⁶ but there were no doctors in the immediate family. We do not know why Clover was attracted to medicine, but since there was no-one close who could advise him, he was fortunate to be able to spend a few weeks investigating the profession before deciding whether to commit to an apprenticeship.

For the rest of the summer, young Joseph Clover followed Dr Lubbock around Norfolk. Together, they excised skin tumours, opened abscesses, divided contracted tendons, tapped hydrocoeles,⁷ amputated toes and removed a cataract. All these procedures were performed on conscious, terrified patients who were held tightly by friends or relatives, and who struggled to control their desire to flee from the surgeon’s knife and the agonising pain. Clover, Lubbock and the unfortunate patients had no way of knowing that the discovery of anaesthesia was just a few years away; at the time it was not even a consideration. So the patients bore their painful ordeal as best they could and Clover’s records remain silent on their suffering.

That summer convinced Clover he could cope with the demands of medical practice, and on 18 September 1841 he was formally apprenticed to 33-year-old Charles Mends Gibson, Dr Lubbock’s younger partner.⁸ Joseph and his father, John Wright Clover,⁹ signed a standard five-year contract,¹⁰ agreeing to pay a total of £240—£80 a year in three instalments.¹¹ Gibson and Lubbock’s extensive practice provided a full range of medical and surgical services, including dispensing medications and delivering babies. Gibson committed to deliver tuition and experience in all these areas to his apprentice, along with board, food and medical care as required for the first three years. Lubbock is not mentioned in the contract but he was to play a big role in Clover’s training.

Dr Lubbock was a controversial figure in Norwich and it was a bold decision by the Clover family to apprentice their son to this practice. Lubbock had an honorary appointment as a physician to the main regional hospital, the Norfolk and Norwich Hospital. Honorary appointments were highly sought after; although they were unpaid, they enhanced a doctor’s reputation and experience, bringing paying patients to their private rooms. But in his private practice, Lubbock chose to work not as a physician but as a surgeon.¹² Theoretically, there was nothing to stop him from doing this, as he had a great deal of experience in both areas. But usually, once a doctor had declared himself a specialist in either medicine or surgery, it was expected he would confine his practice to that specialty. The honorary surgeons at the Norfolk and Norwich Hospital took issue with assigning the medical care of their public hospital patients to someone who was effectively syphoning off their private surgical practice.¹³

Unfortunately, Lubbock’s controversial standing in the Norwich medical community created problems for his business partner as well. Charles Gibson was a well-qualified and experienced surgeon but, despite repeated attempts, he was never able to obtain a surgical appointment at the Norfolk and Norwich Hospital. His association with Lubbock was almost certainly a factor, but it is likely that his nonconformist religious beliefs also put him at odds with the hospital’s governors, most of whom belonged to the Church of England.¹⁴

The Clover family must have been fully aware of these circumstances when they entrusted their son to the care of Gibson and Lubbock. Although a deeply religious family, they would have had no issue with Gibson’s nonconformism. Joseph Clover’s father and his Uncle Joseph were members of the New Jerusalem congregation, followers of the eighteenth-century Swedish scientist and writer Emanuel Swedenborg. This small sectarian group drew supporters and clergy from many denominations, and the Clovers probably had sympathy with Gibson’s religious beliefs. We do not know why they chose Gibson as a mentor rather than one of the high-profile surgeons at the Norfolk and Norwich Hospital, but it was soon apparent that Gibson and Lubbock offered far greater surgical experience than any other practice in Norfolk at that time.

After signing the contract, Clover purchased his first anatomy book and moved into the Gibson family house in Pottergate Street with Gibson, his wife Susanna and his twelve-year-old stepdaughter Mary.¹⁵ The only records from Clover’s apprenticeship are surgical. He recorded nothing of his apothecarial or other duties—either those records are lost or his passion from the outset was surgery. Alongside the casebooks, Clover made elaborate tables, with detailed information about the surgical patients: some made at the time in his immature teenage writing, some produced later in the careful copperplate that graces most of his preserved documentation. They provide an extraordinary record of the surgery being performed in the early 1840s, in the years immediately before the advent of anaesthesia.

From July 1841 until September 1844, Clover documented 150 operations by Lubbock and only nine by Gibson. Of course, we have no way of knowing whether these records are complete, but they are at least indicative of what he experienced. At first glance, the tables tell a terrible story of pain and suffering, one which is incomprehensible in the modern world, with its anaesthesia, antiseptics and antibiotics. But beyond the obvious first impression is also a clear record of the disruption Dr Lubbock was causing—it appears the surgeons of Norwich had good reason to be upset with him.

In the early 1840s, many operations were conducted in private homes or in the doctor’s surgery, with nursing care provided by the family or domestic staff. Public hospitals, like the Norfolk and Norwich, were reserved for the poor, and even then patients were only admitted if they could gain access to the beds via the complicated subscription system. The truly destitute were not admitted to the hospital as they were felt to have appropriate access to medical care through the workhouses.¹⁶

The Norfolk and Norwich Hospital had a particular reputation for the successful treatment of bladder stones, a problem endemic to the area.¹⁷ The local water, diet and genetics were all variously blamed for this problem, with diet being the most likely culprit. Bladder stones were more common in men than in women, since women were more likely to pass them before the stones reached any significant size. Untreated, they led to immense suffering, growing bigger and bigger, and creating pain, obstruction and infection. Longstanding sufferers were unable to walk, sit or sleep. The only solution then was to surrender to the surgeon’s knife, a risky and excruciating ordeal with no guarantee of success.

‘Cutting for stone’ was the common term for what surgeons referred to as a lithotomy. The surgical approach involved securing the terrified patient on their back with their knees pressed up against their chest—held or strapped firmly—while the surgeon cut through the perineum into the bladder,¹⁸ attempting to locate and extract the stone. There were many complications in those who survived this operation; fistulas, infection and incontinence, along with injuries to the urethra, bladder and rectum, were all common sequelae. Surgeons with success in this operation were highly sought after, and those who practised at the Norfolk and Norwich expected to become proficient in the difficult cases presenting to the hospital, in order to grow their reputation and private practice. Rich private patients usually sought help early, when the treatment was relatively straightforward. The poor struggled on until the situation was desperate—by the time they presented to the hospital, they had large stones that obstructed the flow of urine, leading to infection, extreme pain and often kidney damage.¹⁹ These were the cases that could be written up in journals and discussed at meetings; these were the cases that built a reputation, producing the most interesting stones for collection and display.

And display them they did. Every lithotomist kept the stones they extracted. In September 1845, a museum was opened at the Norfolk and Norwich Hospital containing 757 stones, each catalogued with the name of the operator, the patient, the patient’s age, the date and the ultimate outcome.²⁰ By 1851, the museum had purchased special tables for displaying these calculi where, ‘for the first time, the real value and beauty of this unmatched collection may be appreciated’.²¹ Even Lubbock and Gibson ultimately donated their 143 specimens to the collection.

Dr Lubbock completely disrupted the operating patterns at the Norfolk and Norwich Hospital. At the height of his career, only one or two patients with bladder stones were being admitted to the hospital each year. The bulk of the patients who would normally have attended the hospital were being treated by Lubbock in his own private facilities, many of them free of charge.²² Whether he was motivated to do this by charity, ego or simply a desire to operate is not known, but by the time Joseph Clover came to study with him, Lubbock was maintaining three establishments for the surgical treatment of patients, all in or around Crooks Place, just behind the Norfolk and Norwich Hospital.²³

Lubbock employed three nurses to run these establishments: Mrs Mayes, Mrs Cowles and Mrs Susan Cooper. Little is known about these women or what experience they had, but Clover’s casebooks and tables do allow us a glimpse of the care the patients received. Some were admitted for weeks, or even months. Many underwent horrendous operations, including amputations of limbs and fingers, division of tendons for contracted limbs, and mastectomies for breast tumours. Penile amputations were performed for cancer, hydroceles drained and testes removed. The fact that many of these patients survived is a testament to both the operator and the nursing care they received. There was less chance of cross-infection in these small private establishments, something the patients probably appreciated. Hospitals at the time were known to be risky places, with death from infection being a very real possibility. The germ theory was still a few decades away and no-one knew the cause of these infections—but it was clear to all that they thrived in hospitals. This is one of the many reasons the wealthy avoided admission to hospital. Lubbock’s small institutions gave the poor a better option as well, one they clearly used to advantage.

Over the three years he worked with Lubbock, Clover documented thirty-one lithotomies. Twenty-seven of these were recorded in his tables, with three deaths reported; a further four lithotomies are noted in his casebooks and these patients appear to have survived, although it is not possible to be certain.²⁴ Either way, these are good results. In 1845, the average death rate for lithotomies was one in 7.75, very close to the one in 7.6 reported at the Norfolk and Norwich Hospital.²⁵ Robert Liston, the professor of clinical surgery at University College Hospital, had excellent results with a death rate of one in eleven. Clearly Lubbock was a skilled surgeon with good outcomes. The nursing care he had established seems to have been adequate and the only criticism that can really be levelled at him is that he was depriving the public hospital of teaching cases. For Joseph Clover, though, this was a golden opportunity—for a young apprentice to have exclusive access to such a large volume of surgery was exceptional.

Clover quickly learnt the skills necessary to be a useful apprentice. Once he had adequate experience, he began to assist at operations, laying out instruments, helping with the surgery and cleaning up afterwards. He became responsible for the dressings, helping with the postoperative care of the patients. As the months went by, he purchased his own instruments: scalpels, dissecting scissors, stethoscopes, a cataract knife, a full set of dressing instruments, even a stomach pump.²⁶ His book collection grew as tomes on materia medica and botany were purchased, along with texts on physiology, obstetrics and surgery. A botanical magnifying glass joined the collection, along with several sets of test tubes.

Clover also began attending lectures at the Norfolk and Norwich Hospital. Despite the animosity shown to his mentors, Clover was able to access the hospital on an informal basis from early in his apprenticeship, recording occasional attendance at operations in 1842. In October that year, he obtained an additional position as a dresser to Mr Johnson, a surgeon at the hospital, and over the next two years he combined this position with his duties for Gibson and Lubbock. Attending the hospital allowed him to interact with other medical students, giving him friends to study with and access to bodies for dissection. In October of one year, he recorded spending 5 shillings to meet ‘My share of expenses in burying &c the dissected body of the man who hung himself in jail’.²⁷

Attending the Norfolk and Norwich Hospital also broadened Clover’s surgical experience, exposing him to more traumatic emergency surgery. In his first few months at the hospital, he encountered some horrific accidents and a great many fatalities. In April 1843, a Mr Clark was admitted with a nasty open fracture of his lower leg, having been run over by a loaded wagon. Despite his bones being driven through his leg muscles and considerable blood loss, it was decided not to amputate. The poor man waited in vain for healing to commence until a decision was made to amputate after three weeks, when ‘²⁄³ of the soft parts came away’.²⁸ The amputation was only partially completed due to haemorrhage, a concept almost impossible to imagine. Further bone was removed a week later. Two days later, the man’s suffering finally ended when the stump fell apart and profuse haemorrhage ensued, stemmed briefly by a tourniquet.

On the day of Mr Clark’s death, a loaded wagon ran over the head and hand of another man. He survived, despite injuries to his eye and jaw, and the surgical removal of his fingers. Even more remarkable was the survival of a thirty-year-old man, also run over by a wagon wheel, who presented with an arm so infected that he could not be moved without profuse discharge of pus from his armpit. Survival seemed so unlikely that the amputation was conducted in his bed in the ward to lessen the stress.

Cases such as these are described in detail in Clover’s notebooks— indicative of the impact they had on the young man, and also his growing level of knowledge. What is striking about these reports is the time taken to perform many of the operations. Conventional wisdom has it that pre-anaesthetic surgery was fast, but the detail recorded by Clover suggests that care and time were taken with these surgeries. A cyst removed from a woman’s face, and found to be connected to the parotid gland, required careful dissection over half an hour to ensure no lasting fistula remained. Even more remarkably, ‘Mr J removed by piecemeal a fibrous tumour from the uterus/weighing 32 ounces. The operation lasted two hours and a half’.²⁹ This extraordinarily stoic woman recovered, albeit after six weeks in hospital.

Although all that survives of Joseph Clover’s apprenticeship are his case notes and account books, it is clear that, from the outset, surgery was what interested him. He was not to know he was embarking on a career which was about to undergo a major upheaval, that over the next forty years everything about this specialty would change. Both anaesthesia and antisepsis were just around the corner, and he and his colleagues were to play a major part in these changes. But meanwhile, in the pre-dawn of this new era, the young apprentice was slowly learning the art of surgery as it still was. Operating with bare hands, dressed in his street clothes, he had taken those first steps which every training surgeon must take—gripping the handle of a scalpel and making the first, irrevocable cut into live human flesh. For the surgeon training in the early 1840s, these first surgical milestones were performed on a person who would recoil in terror and horror, flinch, pull away, shake—and scream and scream and scream. No amount of anatomy training, no study of the physiology books, could prepare a doctor for this. Only an apprenticeship where they experienced this every day would tell a young budding surgeon if they had the temperament for this gruelling work.

CHAPTER 2

The Draper’s Shop in Market Place

ONCE, WHEN THE weather was fine, Clover borrowed Charles Gibson’s pony and rode the 13 miles of winding country roads to his family’s home just out of Aylsham, a picturesque market town on the River Bure. ¹ But usually he caught the coach, alighting in the Market Place outside Black Boys Inn, the historic pub that is still there to this day. Before walking up the road to the house, he may have stopped in at the general store, remembering the years he lived on the other side of the counter.

The Clovers’ shop was on the corner of Market Place, diagonally opposite Black Boys Inn.² Today, a pharmacy sits on the site, marked by a commemorative plaque. Above the pharmacy, where the family’s private rooms would have been, is a modern housing commission com- plex known as Joseph Clover Court. All that remains of the original shop is an old stone with the Clover name on it, built into a wall at the back of a new supermarket. Market Place retains its original configuration, although today it is mostly filled with parked cars. Henry VIII granted the town a Saturday market in 1519 and markets are still held twice a week, along with a farmers’ market twice a month. Some of the original buildings remain, the oldest being the inn. Built in the fifteenth century and converted to an inn in the 1650s, Black Boys Inn has seen centuries of visitors pass through its doors—and one publican who refused to leave. The original owner was killed by one of Oliver Cromwell’s men, and reportedly his ghost still haunts the striking building—many years after Lord Horatio Nelson attended a dance in the Assembly Rooms there on 15 December 1792.

Clover’s great-grandfather was also Joseph Clover. A Norwich veterinary surgeon and farrier, he purchased the shop in 1774, allowing the family to establish a drapery business. Aylsham was an ancient weaving town with a thriving linen industry in the fifteenth century. Gradually, linen was replaced with wool, and as the weaving industry declined, the shop evolved into more of a general store, providing a wide range of goods. Joseph’s son Thomas and his wife, Ann Barnard, took over the business in 1780, a year before Joseph retired from veterinary practice.³ Ann gave birth to many children over those years, in the large cottage at the rear of the shop, but they were not happy times.⁴ A large gravestone in the local cemetery silently records years of sorrow: six of the Clovers’ twelve children died in the early years of their marriage—some in infancy, others as teenagers. Thomas himself followed in 1803, leaving his 23-year-old son, John Wright Clover,⁵ to take over the shop and care for his mother and younger siblings. Another child died a few months later, and then, in 1808, Ann also succumbed, worn out by grief and childbirth. Two more children followed her within months, leaving just three surviving sons: John Wright, who ran the shop; Thomas,⁶ a farmer in nearby Colby; and Joseph,⁷ destined to become a significant portrait painter.

John Wright was Joseph Thomas Clover’s father. His first marriage was not terribly successful. In 1810, he caused a scandal by abandoning the shop and running away to Gretna Green in Scotland with his pregnant girlfriend, the nineteen-year-old ward Elizabeth Taylor. Like so many runaways of this period, they had married there before eventually making peace with Elizabeth’s guardians. The couple then returned to Aylsham, where on 14 June 1810 the marriage was blessed in St Michael’s, just up the road from the shop, with two of the girl’s guardians as witnesses. A child, Ann, was born four months later. But sadly, within a few years Elizabeth had passed away, aged only twenty-seven, adding to the sorrowful history of the little shop. She joined all the previous family members in the family grave in St Michael’s Churchyard. It is not clear who raised Ann from 1818; all that is known is that she stayed in the area, eventually married a local farmer named George Gower, and had four boys before dying at the age of twenty-eight. John Wright continued to run the shop, remaining single for several years before finally marrying again in November 1821. His second wife was a local girl, Elizabeth Mary Ann Peterson, the niece of a wealthy landowner, John Bayfield Peterson.

Once again the shop rang with the sounds of children, but these were happier times—all of these children survived into adulthood. Five were born in quick succession: Emma, John, Joseph, Frances (Fanny) and Elizabeth (Bess).⁸ Young Joseph Clover grew up gazing from the upstairs windows into the busy market square below, watching the horse-drawn coaches come and go to Norwich and Cromer from the stop outside Black Boys Inn. The inn was also the site of many local meetings