The end of an era

But as staff and patients prepare to make the journey to Headington, where they will become part of an expanded John Radcliffe, it will not only be the people of Oxfordshire who will have cause to look back on the RI with gratitude.

For the old hospital at the bottom of Woodstock Road has a long and proud record of pioneering medical advances, that have marked its name indelibly on the medical map of the world.

The building itself is, of course, part of the fabric of the city, with its original structures as beautiful and historic as any of the nearby Oxford colleges.

Thankfully, when Oxford University takes possession of the 10.5-acre site next year - with the hospital eventually to be become the university's new £240m city centre campus - much of the original architecture will be retained.

A university spokesman, who set out plans for academic buildings, teaching and research facilities along with a £40m Institute of Mathematics, promised: "The university has a long tradition as a custodian of historic buildings within the city and will look at using those at the RI in ways that are sympathetic to their history."

But from its origins in 1770 the RI has always been more about people than buildings, particularly the medical staff who have treated patients, developed specialisms and established Oxford as a centre of medical excellence.

Many of the most brilliant medical clinicians associated with Oxford - such as Sir Henry Acland, the great pioneer in the use of diagnostic instruments like the stethoscope, the hugely influential physicians Sir William Osler and the brain surgeon Hugh Cairns - are associated with the hospital.

So are Oxford's two great benefactors Lord Nuffield and, of course, John Radcliffe.

The RI story is all the more remarkable, when it is recalled that the hospital was paid for with money left over from a bequest to build Oxford's famous Radcliffe Camera.

Radcliffe, the immensely successful doctor who was physician to Mary II, William III and Queen Anne, is a name no one living in Oxford can escape for long. He came to University College, Oxford, from Wakefield in 1665 at the age of 13, and practised medicine in the city before making his fortune in London. Radcliffe never doubted the university's part in his success and when he died in 1724, leaving £140,000, Oxford was handsomely repaid.

He left money to Univ to enlarge the college and build a Master's Lodging. The second part of his bequests was for the building of a great library between St Mary's Church and the Bodleian Library. Although a hospital had no part in the doctor's beneficent designs, the trustees allocated the residue of the estate to building an observatory (which now stands in Green College), with £4,000 also released to build a hospital in the open fields of St Giles, given by Thomas Rowney, the MP for Oxford.

The building was designed by the wonderfully named Stiff Leadbetter, surveyor to St Paul's Cathedral, who died four years before the hospital opened in 1770, when seven patients were admitted to the two original wards, Marlborough and Lichfield. The women's ward was named in honour of the third Earl of Lichfield, MP for Oxford County and a chancellor of Oxford University, regarded by many as the real driving force behind the new hospital.

By the time it was completed in 1775, there were 94 beds on seven wards. Mattresses were then stuffed with straw. By 1875 the hospital could boast of 166 beds on 17 wards, with 1,300 in patients, 3,400 outpatients and 1,800 casualties receiving treatment that year.

Oxford had seen other hospitals. For example, the Hospital of St John the Baptist was built by an Oxfordshire knight, where Magdalen College now stands, in 1180 for "poor scholars and other miserable persons".

Six hundred years later the Radcliffe Infirmary began life to also concentrate on treating the poor, while depending on voluntary contributions. Subscribing £3 a year apparently entitled the city's wealthier citizens to recommend deserving patients to the new infirmary. The first physicians and surgeons gave their services free, maintaining themselves by private practice.

Andrew Moss, whose book about the Radcliffe Infirmary is being published in January, said: "This hospital was founded as a charity by those who could afford to pay for a doctor themselves, for the benefit of those who could not. It has, in fact, depended on benefactors, legacies and fundraising for most of its life."

An early set of rules established the criteria for admission, with no pregnant women or children under seven admitted except for major surgery or emergencies. (The first children's ward was not opened until 1867, with a children's block opened a few years later by Queen Victoria's youngest son, Prince Leopold.) The RI's progressive approach to treatment was shown when the first operation under ether anaesthesia was carried out there by Charles Parker in 1847, little more than two months after the first operative use of ether in London.

The late 19th century saw extensive building, with the Oxford Eye Hospital moving to the infirmary and an outpatient department added in 1863.

In 1907, Dr R H Sankey began an X-ray department in a hut. Other advances followed with pioneering work in the fields of plastic surgery, heart medicine and with the development of an obstetric 'flying squad', prompted by the number of mothers who were rushed into hospital on the point of death.

In 1941, the first accident service in Britain opened at the RI, initially in a single room in casualty with a small outpatient theatre, 60 surgical beds and a tiny office. That year also saw perhaps the Radcliffe Infirmary's greatest claim to international fame, when in the dark years of the Second World War the first dose of penicillin was injected into a patient.

After Alexander Fleming had abandoned his work on penicillin in 1935, supposing it would be useless to the human body, it was left to three Oxford scientists, led by Prof Howard Florey, to turn the chance discovery into a life-saving drug.

Penicillin had been given to mice with remarkable results. But in February 1941 the decision was made to give it to a seriously ill patient at the RI to test whether it would give the body the power to fight back against infection.

The patient was Albert Alexander, a 43-year-old Oxford police constable, who had suffered a scratch on his face while working in his rose garden. The cut became infected and spread to his eyes and scalp.

After just eight penicillin injections, his scalp ceased discharging pus, his temperature fell and his appetite returned.

Sadly, the stabilising of his condition coincided with the exhaustion of penicillin supplies and the Oxford team had to watch helplessly as the flood of septicaemia swept through him.

But the power of 'the miracle drug' had been established and so was the fact it could be given to a human over five days without toxic effect.

Mr Moss, who worked in the NHS for 25 years and is a former head of public relations for the health service in the Oxfordshire region, will launch his book at a reunion of RI staff on January 27.

Much of it concentrates on the fascinating figures associated with the hospital, such as John Grosvenor, one of the four surgeons appointed, who was one of the first people in England to see the benefits of massage to improve the mobility of joints. It includes accounts and illustrations too of dramatic events such as the Shipton-on-Cherwell train crash on Christmas Eve in 1874, when a train plunged down an embankment at Hampton Gay. Thirty people died making it the worst rail disaster in history at the time. A special train was sent to bring the injured to Oxford, with scores of the injured taken through the streets on stretchers to the RI.

But those who gathered at the RI's St Luke's Chapel (built in the 1860s as a gift from Thomas Combe, the superintendent of the Clarendon Press) for a farewell carol service on Tuesday will doubtless dwell on more recent personal memories.

Few people who have lived in Oxford for any length of time, do not have some indelible memory or link with the RI.

For me there are memories of visiting a friend, still only in her twenties, just a few days before her death from a tumour. Then there was my wife's week-long stay while pregnant with our daughter, when she inexplicably suffered loss of hearing. Since then there have been anxious visits to the eye hospital following accidents, the worst I recall involving a boomerang.

For Patricia Vickers, a staff nurse at the RI from 1966 to 1972, there are warm memories of countless friends and colleagues. "It was an amazing place to work, said Mrs Vickers, who lives in Steeple Aston. "Everything was done properly and everyone respected everyone else. It was one the the great teaching hospitals in the world. And yes we were proud.

"When we had a reunion of the nurses who worked at the RI 40 years ago, 32 people turned up. They came from New Zealand, Belgium and America because it meant the hospital meant that much to them."