The Eye Doctor

Johann Sebastian Bach was one of the greatest musical geniuses of all time.    Though better recognized during his lifetime as an organist than as a composer, his musical skills kept him in demand well into old age.   Unfortunately, while he was extremely healthy for most of his life, the great composer's health declined rapidly in 1749.  Years of writing musical manuscripts with insufficient light had damaged his eyes to the point that he became almost blind.    He may also have developed problems with cataracts and possibly diabetes mellitus as well.   

Bach's fame, and the financial support he received from his patrons, were enough for him to receive the finest help available at the time.   Unfortunately, that help took the form of a consultaion with English oculist, John Taylor, self-styled "Opthalmaiter" to the Pope and "every crowned head in Europe."   Taylor had become famous for practicing a radical eye operation for removing cataracts.   This operation, called "couching" actually has  a venerable history and may have been practiced as early as 2000 BCE.    Since cataracts are due to a clouding of the lens in the eye, the couching operation involved dislodging the clouded lens and breaking John_Taylor_oculist[1]it up into pieces.    Considering John Taylor used unsterilized instruments, the immediate results were usually good but his patients were at grave risk of developing infection afterward.    Many went blind completely or died of infections.   In Bach's case, the surgery was an immediate success but later complications set in leaving him completely blind.     And he was hardly the only case of blindness linked to the Opthalmaiter.

 Born in Norwich in 1703, John Taylor was the son of a prominent surgeon (also named John Taylor).   After studying at St. Thomas' Hospital in London under the prominent eye surgeon, William Cheselden, Taylor decided to become an eye specialist in his own right.   Following a brief stint in a Norwich hospital, he established a traveling practice which took him across the United Kingdom and, eventually, across much of Europe.   An accomplished showman, Taylor traveled in style in an ornate coach which was painted all over with eyes.    Along with managing to become appointed official oculist to King George II, Taylor tended to many of Europe's royal families as well as some of the most prominent members of the arts, including composer Georg Handel and writer Edward Gibbon.   

It was quite a life for John Taylor,  who along with being "the greatest of travelers" as he described in his autobiography, was also an ardent womanizer who boasted of his conquests.   In promoting his traveling practice, the routine was always the same.  After arriving in a new town, he always gave a public lecture on eye disease and then offered his services to anyone with vision problems.   Like many oculists of the time, Taylor needed to keep moving since the improvements produced by his couching operation were usually only temporary.   While he prescribed eyedrops for his patients after the operation, that was virtually all the postoperative care they received.  By leaving town before the inevitable medical complications arose, Taylor was able to avoid the nasty  backlash that would follow.   In an era before social media, word of his failures were often slow to spread and Taylor never found himself short of patients.  

Along with carefully controlling the news of his arrival in various towns (through planted news stories and flyers), Taylor often arranged for untreated patients to arrive in town ahead of him to spread the word of his services.    Even when surgeons' guilds tried to act against him, they were usually overrulled by town council members who felt that Taylor's royal patronage made him untouchable.    Taylor also flaunted his various medical degrees though he faced a running battle with medical organizations across Europe over whether he was actually qualified to perform operations in their countries.    It was a battle which Taylor usually won since he was rarely in any city long enough for serious opposition to develop.

But Taylor didn't just do cataract operations.   He had treatments for virtually any eye problem posed to him, from squinting to glaucoma though many of his remedies seemed like quack remedies.   The greatest demand was for couching however and Taylor continued to use the same standard operation for all his cataract patients.   While he had to be aware of the complications that often set in, John Taylor showed no interest in changing his preferred way of treating patients.   Though a better surgical procedure was already becoming available which involved complete extraction of the lens,  Taylor seemed unwilling to try it with his own patients.  

And he certainly had his critics.  Samuel Johnson dubbed him as " the most ignorant man I ever knew", while more prominent physicians and professors of anatomy at various European universities denounced his methods and his "successes."    When Taylor operated on Bach in Leipzig on April 1, 1749, he was in the middle of yet another triumphant European tour with various news stories (planted by Taylor) touting the benefits of his eye operations.    After Bach's first operation,  news stories (planted by Taylor)  reported that the composer had "recovered the full sharpness of his sight."    A second operation on Bach was done a short time later and Taylor then left Leipzig on April 8 to travel to Berlin.   Even then however, news of what was happening with his patients was already beginning to spread.   Taylor left Berlin not long afterward when the Prussian king personally ordered him to leave Prussia.

As for Johann Sebastian Bach, he began experiencing medical complications shortly after Taylor left Leipzig which left him completely blind.   While Bach was still able to dictate his last few compositions to his son-in-law,  his career as an organist was over.   Though Bach claimed to recover his sight in July in 1750, there is no evidence that this was anything more than a hallucination.  Within hours, he had a seizure and slipped into a week-long coma.   Bach died on July 28, 1750 without ever regaining consciousness.  Afterward, at least one newspaper suggested that his death was due to "the unhappy consequences of the very unsuccessful eye operation."   Though modern medical historians believe that Bach died as a result of a stroke linked to pneumonia, the medical problems linked to his eye operation are believed to have played a significant role in his death.

While Georg Handel went blind himself not long after Bach's death, there is less evidence linking his blindness to Taylor's treatment (though he had operated on both composers).    For whatever reason, Taylor's career as an oculist went downhill sharply by the time he published his autobiography in 1761.    The title of this epic tome likely says it all about the good Chevalier:

History of the Travels and Adventures of the Chevalier John Taylor, Ophthalmiater; Pontifical-Imperial and Royal--The Kings of Poland, Denmark, Sweden, The Electors of the Holy Empire-- The Princes of Saxegotha, Mecklenberg, Anspach, Brunswick, Parme, Modena, Zerbst, Loraine, Saxony, Hesse Cassel, Holstein, Salsborg, Baviere, Liege, Bareith, Georgia, &c. Pr. in Opt. C. of Rom. M.D.-C.D.--Author of 45 Works in different languages: the produce of upwards of thirty Years, of the greatest Practice in the Cure of distempered Eyes, of any in the Age we live--Who has been in every Court, Kingdom, Province, State, City, and Town of the least Consideration in all Europe, without exception. Written by Himself. Introduced by an humble Appeal, of the Author to the Sovereigns of Europe. Addressed to his only Son.

But time and the increasingly successful attacks of medical associations eventually put an end to Taylor's mobile practice.  Doctors became better able to warn other towns about him and Taylor found himself being forbidden to see any patients by town burgomeisters (who no longer had any fear of his "royal patrons").    He was eventually chased out of the Netherlands after being fined for practicing medicine without a license and the Amsterdam surgeon's guild denounced him as "an adventurer who earned his living by wandering about through the country to make money."    Eventually, the doors closed on him in most other countries as well.

Ironically enough, Taylor would spend the last few years of his life completely blind though this hardly prevented him from living well.   Beyond the role he played in blinding hundreds of eye patients during his amazingly long career, including Bach {and possibly Georg Handel as well),  John Taylor's notorious reputation also ensured his literary immortality as well.   Along with Samuel Johnson, other prominent satirists heaped abuse on him in their writing.    The epitaph which likely described him best was one by satirist Charles Churchill who referred to Taylor as "As well prepared, beyond all doubt, To put eyes in, as put them out."

So how was John Taylor able to continue performing his dangerous eye operations for so long?   Though Taylor was often denounced as a quack, he was no swindler.   He certainly didn't try selling the various patent medicines that many of the medical confidence artists of his time often did.   Sadly enough, his couching operation was considered the standard remedy of the time and his failure to clean his instruments before surgery was also typical of most 18th century surgeons.   If anything, the public lectures he always gave on arriving in a new town helped cement his reputation as a legitimate medical expert.   While other doctors objected to how he treated patients, it was the protection Taylor obtained from many grateful patients, including King George II, that kept him in business.   That, and his canny ability to leave town before patients began complaining about complications.  

Much of Taylor's success as an eye surgeon seems to have depended on the same kinds of publicity tricks practiced by medical hucksters before and after him.  Though he may not have been consciously  trying to deceive his patients,  his wandering eye practice was obviously intended to avoid the problems he would have had by staying in one place.   That his more pedestrian colleagues often faced enormous barriers in preventing him from doing any more operations certainly resonates today with medical doctors trying to put modern hucksters out of business (and often failing).   While a John Taylor might have trouble operating today, his spirtual descendants are still with us.










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