Joseph Sampson Gamgee (known as Sampson) was born in 1828 at Leghorn in northern Italy, the eldest son of Joseph Gamgee, a British veterinary surgeon^2,3,4,5,6. The family moved to Florence, where Sampson was educated⁷. He first visited England at the age of fifteen, when he rode across Europe on horseback; at eighteen he left Italy permanently to come to London^3,4,5,8. With his cosmopolitan upbringing he was fluent in French, German, Italian and Spanish as well as English.

Intending to become a veterinary surgeon like his father, he entered the Royal Veterinary College in London in 1847 and by the age of twenty-one was a member of the Royal College of Veterinary Surgeons^3,4,5. Gamgee always maintained his veterinary interests, being for a time vice president of the College². While a veterinary student he was invited to attend lectures at University College Hospital^4,6,7 and his work was so good that he was persuaded to become a student there⁷. Joseph Lister was a classmate with whom he shared lodgings⁶. Though they later disagreed professionally, they remained friends. During the summer of 1849 he travelled through France, Germany and Italy, making contacts in various clinics and hospitals^3,6. In Paris, he was befriended by Louis Pasteur, who gave him an excellent testimonial⁸. Before obtaining Membership of the Royal College of Surgeons in 1854, he had won five gold medals including the Liston Gold Medal for surgery, becoming a Fellow of the Royal Society of Edinburgh a little later^2,7. His first post was as house surgeon to Sir John Erichsen at University College Hospital, and he then moved on to become surgeon to the British-Italian Legion, first-class staff surgeon to the Royal Navy, and superintendent of the Military Hospital in Malta during the Crimean War^3,4,8. After a short spell as assistant surgeon to the Royal Free Hospital he gained the post of surgeon to the Queen's Hospital, Birmingham in 1857. It is said that he moved there because of its large Italian community⁶. His reason for resigning from the Royal Free was that ‘The management of that hospital was not in accordance with the only principles consistent with due regard for the interests of mankind and of science⁹.’ Details of this dispute have yet to emerge.

Gamgee's election to the surgical staff of the Queen's Hospital was fraught with controversy. Appointments were made by the Governing Council of the Hospital and Medical School, composed of laymen, professors at the Medical School and members of the hospital staff. The professors would submit to the Council the names of two applicants, with a special recommendation for one of them^3,5. Their chosen candidate was usually elected: this time he was turned down. The professors had declared Gamgee's superiority over the other five applicants¹⁰ for the following reasons¹¹: he had distinguished himself at University College London and University College Hospital; he had received strong testimonials while studying in Europe; the Secretary of State for War, the Director-General of the Army Medical Department and others had expressed a high opinion of his services during the Crimean War; some of the most distinguished medical men in the country had submitted testimonials in his favour; and his literary work was well known. The lay members, led by the Rev Dr Miller, Rector of St Martin's in the Bull Ring, elected by one vote J F West, house surgeon at Queen's Hospital (the only position he had held)⁴. Even West admitted his opponent's superiority¹². The election was disputed: views were expressed in the press, the BMJ ran a commentary on the events, and Dr Miller even preached a sermon on the subject^3,4. The professors distributed a statement opposing the appointment, firstly because canvassing (which was forbidden) had occurred on West's behalf and, secondly, because the post should have gone to the candidate whom the professors regarded as ‘best fitted’, which West was not. Four days later, West's appointment was declared void and Gamgee was elected¹⁴. West's friends were angry, claiming that the substitute appointment should not have happened without a separate meeting¹⁵. Eventually a compromise was reached and both Gamgee and West were elected¹⁶. But this was not the end: who would be the senior, Gamgee or West?¹⁷. It was decided that they would be on equal terms, with seniority to be determined later. Surprisingly, four years later West was appointed as Gamgee's senior². The following testimonials¹⁴ show that Gamgee had already made a name for himself.

Gamgee, however, was ahead of his time. In 1865 he asked ‘What should a surgeon be?’, and his answer was ‘A physician and a good deal more’¹⁹. In a lecture entitled The Surgical Epoch he stressed that without true scientific knowledge surgery would be reduced to a mere handicraft²⁰.

From Gamgee's writings it can be seen that he taught ten principles for surgical practice²¹.

• Study each case as fully as possible
• Win the confidence of the patient
• Be prepared for every emergency
• Have all your appliances on the spot and ready for use
• Make up your mind what to do, and do it without hesitation
• Use firm delicacy or gentle force as required
• Swiftness is good, but safety is better; the best evidence of skill is not in the rapidity of movements or sleight of hand, but in the recovery of the patient
• Be collected and self-reliant
• Treat every case as if your reputation depends upon it
• After operation, work is only changed, not ended; postoperative watchfulness is indispensable.

During the nineteenth century, medical services for the poor shifted from philanthropy towards self-help⁴², and in Birmingham, Sampson Gamgee was instrumental in bringing about this shift. Hospital Sunday had been introduced in 1859, providing for collections by church congregations. Hospital Saturday was to cause a more rapid move towards self-help. Gamgee opposed the system of indiscriminate hospital relief, with huge numbers of people visiting the outpatient departments of charitable institutions though not in need of charity⁴³. He prophesied that, as standards of living and education rose, working people would not want charity, preferring to support hospitals for treatment as a right for which they had paid⁵. The public would no longer expect the medical profession to provide unpaid service, and reform of the system would allow doctors to conduct their original research without having to earn a living in private practice³.

Sampson Gamgee had married Marion Parker, the daughter of an Edgbaston veterinary surgeon, in 1860⁶, and they had two daughters and two sons, who both qualified in medicine^3,5. His younger son Leonard had a notable career as a surgeon, retiring as professor of surgery in 1931³.