'We remember him as a College man. He was a traditionalist, conformist, modest, reticent and a man of unbounded generosity and activity. He was very human. His handwriting, in the best medical tradition, was appalling.' Those words, which partly summarise Sir Francis Avery Jones’s character were, in fact, written by him about William Harvey in 1980 when he delivered the Harveian oration to the College. Avery, with his impish, gentle humour, must have realised how well he emulated those excellent characteristics of Harvey, but his modesty and reserve would never have allowed him to acknowledge it.
He fully recognised the high honour which attends the invitation to give the Harveian oration, and treasured it in his last months of life when he asked his wife to read him several of the other orations. Sir Francis, at different times, fulfilled many other positions of importance in the College, having been Goulstonian lecturer in 1947, Lumleian lecturer in 1956, and Croonian lecturer in 1969. In 1971 he received the Ambuj Nath Bose prize for research, and the Moxon medal in 1978. He was second vice-president in 1972, and chaired the College’s working party on dietary fibre which reported in 1980. Possibly his most important contribution was to persuade Robert Platt [Munk’s Roll, Vol.VII, p.470] (then President) to establish a committee on smoking and health (which Avery joined), the report of which in 1962 was a major contribution to the public health.
He was born in Briton Ferry, south Wales, where his father, Francis Samuel Jones, was a general practitioner. His mother was Marion Rosa née Chaston, the daughter of a farmer. Avery was brought up in Beccles, Suffolk. He attended the Falconberg School there, and then the Sir John Leman School (where Dorothy Hodgkin [Munk’s Roll, Vol.X, p.217] was a classmate), before beginning his medical studies at St Bartholomew’s Hospital, London (having arrived on an arts scholarship, acquiring a science scholarship later). He qualified in 1934, passed the MRCP two years later, and in 1935 married Dorothea Pfirter; they had one son, John (who became a distinguished tax lawyer, eventually a Commissioner of Taxes). He was house physician successively to Sir Francis Fraser [Munk’s Roll, Vol.V, p.141], Leslie Witts [Munk’s Roll, Vol.VII, p.618], and Ronald Christie [Munk’s Roll, Vol.VIII, p.86], all distinguished physicians. He was awarded the Baly research scholarship and became chief assistant on the Bart’s medical unit under Witts and this was the start of his lifetime in gastro-enterology. He became interested in peptic ulcers and the then revolutionary concept of feeding patients with ulcer bleeding and went on to show how mortality could be reduced by blood transfusion.
In 1937 he was taken as a guest to the foundation meeting of a gastro-enterological club organised by Sir Arthur Hurst [Munk’s Roll, Vol.IV, p.509]. This club soon became the British Society of Gastroenterology, to which Avery was devoted all his life. He was president in 1966, and for many years its archivist, but surprisingly was never asked to give its Arthur Hurst lecture. The Society’s chief award for research was given his name and, until the year before his death, he was always there to present the medal to its winner. One of his greatest contributions to the Society was to persuade the British Medical Association not only to share in the foundation of a British journal of gastro-enterology, but also to call it by the simple and memorable title Gut. He was consecutively the journal’s editorial secretary, then editor in succession to Harold Edwards. He gave great encouragement to Nelson Coghill [Munk’s Roll, Vol.XI, p.115] in establishing the British Digestive Foundation (later Digestive Disorders Foundation, later Core) to raise money and award it for research in gastro-enterology.
At the outbreak of war in 1939 Avery Jones held the post of casualty physician and was sent with a contingent of Bart’s staff to Friern Hospital, Colney Hatch (a sector hospital of the Emergency Medical Service), where he had his own beds. He hoped for an appointment to the staff of Bart’s, but this did not come about. Horace Joules [Munk’s Roll, Vol.VII, p.307] promptly offered him wards at the Central Middlesex Hospital to establish a gastro-intestinal unit, and the Middlesex County Council appointed him consultant physician there in 1940, at the age of 30. His skills of quiet but effective collaboration, matched by the enthusiasm of Horace Joules and Richard Asher [Munk’s Roll, Vol.VI, p.16], came to make this county ‘district’ hospital as sought after a place for aspiring physicians as the more famous teaching hospitals. They taught a generation of students from the Middlesex Hospital Medical School. At ‘the Central’ (as it was always known) he was in charge of the diabetic service, and encouraged improved neonatal care, but particularly pioneered many advances in what, for many years, was the only gastro-enterology department in Britain. He was one of the first to use the semi-flexible Wolf-Schindler and then the Hermon Taylor gastroscopes, using them to assess ulcer healing in therapeutic trials in collaboration with Richard Doll [Munk’s Roll, Vol.XII, web], who had joined him in 1946 after Avery obtained a grant from the Medical Research Council. He designed his own oesophagoscope (with its flexible introducing sheath and rigid telescope), and inspired Basil Hirschowitz to seize the opportunity of Hopkins’s invention of fibre-optics to produce the first fully flexible endoscope, the fore-runner of the instruments ubiquitous today.
In 1949 Clifford Naunton Morgan invited him to join the staff of the then entirely surgical St Mark’s Hospital (for colo-rectal disorders). Avery Jones introduced physicians to the sigmoidoscope, often producing it from the ‘poacher’s pocket’, which he always had made inside his suit jacket. The important medical-surgical collaboration here was an extension of what he had already created at Central Middlesex, where he encouraged surgeons (especially Peter Gummer, with whom he worked closely) to return patients to his ward after their operations. He was later given the rare honour (for a physician) of a fellowship of the Royal College of Surgeons.
Throughout his career he catalysed research by others, such as J J Misiewicz at the Central, and John Lennard-Jones at St Mark’s. He persuaded the Medical Research Council to establish a research unit alongside his wards at the Central Middlesex, headed by E N (Tom) Rowlands, and through this growing enterprise came a procession of the best young people from Britain and abroad, many of whom became leaders in their own departments. Most people had a desk there, but he never did. He was never pompous and always accessible.
He was associated with the King’s Fund for almost 50 years, beginning with his nutritional enthusiasms, which had led to his involvement with Invalid Kitchens of London, fore-runner of ‘Meals-on-Wheels’. He spent 25 years on the King’s Fund catering committee, upgrading the kitchens of London hospitals. He was active in many other areas: consultant to the Royal Navy; on the British Council for several years and also its medical adviser; and on the council of Surrey University, which later gave him an honorary degree.
He was a prodigiously hard worker, often doing a 16-hour day, seeing patients at ‘unsocial’ hours but never seeming hurried. He believed that the secret of his success was ‘persistence’, but he was also patient and tolerant. His success on committees stemmed partly from his assiduousness in attending them. He was a campaigner, and kept writing to The Times about the many causes he supported. Although he loved learning and the pursuit of truth, he never held an academic position or title, which made his membership of the University Grants Committee from 1969 to 1974 all the more valuable.
Although a strong supporter of the NHS, he developed a huge private practice, having been encouraged to do so, curiously, by Horace Joules, who was an avowed communist. He saw many patients from abroad. After an unexpected absence from London, he explained that he had been in a Gulf state “helping Mr Norman Tanner deal with the King’s haemorrhoids”. “What on earth were you doing?” asked the colleague. With his shy smile Avery said “I was holding the legs”.
He was honest, loyal and utterly selfless, not only in public affairs but in personal matters too. He was good at helping young colleagues realise that apparent defeat was but a temporary set-back. Alexander Pope said “Do good by stealth and blush to find it fame”. Francis Avery Jones spent his life doing good by stealth, but he did not blush about his fame and accepted it with grace and modesty. He was appointed CBE in 1966 and knighted in 1970.
In later life, as his professional obligations lessened, he developed a passion for gardening, creating a fine garden with his second wife, Joan Edmunds, at Nutbourne, and creating a medicinal garden at the Barber-Surgeons’ Hall, of which he was proud to be a member and master, a position his son later held. He also loved art and was president of the Medical Artists’ Association.
J R Bennett
[The Independent 13 May 1998; The Times 13 May 1998; The Daily Telegraph 16 May 1998; The Guardian 18 May 1998; Brit.med.J.,316, 1998, 1678]