Sir Peter Freyer (2 July 1851 – 9 September 1921) was an Irish surgeon with an expertise in genitourinary surgery, best known at first as an Indian Medical Service (IMS) officer, for making popular the procedure for crushing bladder stones to allow them to be evacuated through the natural passages, a procedure known as a litholapaxy. Following retirement from the IMS after 20 years of service in India, he returned to England and popularized a procedure for benign large prostates. This was known as the suprapubic prostatectomy, a transvesical prostatectomy or the Freyer operation, where the prostate is removed through an abdominal incision above the pubic bone but below the umbilicus and through the bladder, and it included using suprapubic drainage post-operatively.
He entered the Bengal Medical Service as a surgeon in 1875 and served almost exclusively in civil employment in the North-Western Provinces and Oudh in the United Provinces of India. While based at Moradabad in 1888, he successfully operated on Muhammad Mushtaq Ali Khan, the Nawab of Rampur, crushing his bladder stone with a lithotrite. Freyer defended the remuneration he received from the Nawab, which had caused a controversy with the British establishment in India at the time. This and an eye injury caused while serving the civil surgeoncy of Benares contributed to Freyer taking early retirement and returning to England in 1896.
In England he set up a private practice in Harley Street and was appointed a consulting surgeon in the surgery of the urinary organs at St Peter's Hospital for stone, London. He first performed the procedure of suprapubic prostatectomy in 1900, on a man who then survived 12 years. Although Freyer was not the first to introduce this operation, despite his claim otherwise causing the second significant controversy in his career, he is credited with popularising it. In 1920, he was elected the first president of the section of urology of the Royal Society of Medicine and in his presidential address, claimed to have performed 1,674 of these operations with a low mortality.
The Department of Surgery, NUI Galway, hosts the annual Sir Peter Freyer Memorial Lecture and Surgical Symposium in his honour, and the James Hardiman Library at the NUI hold around 660 items of his memorabilia.
Early life and education
Peter Johnson Freyer, named after his paternal grandfather who was a chief officer in the Irish Coast Guard, was born in County Galway on 2 July 1851, the eldest child of landholder Samuel Freyer and his wife Celia Burke, who was a Roman Catholic. Freyer and his siblings however, were brought up as Protestant, a likely effect of the influence of the Irish Church Missionss (ICM) on the people in the area at that time. On 26 July of that year, he was baptised in Ballinakill's parish church. In 1855, his father, who was a tenant of the ICM supporter Sir Christopher Lighton, had in possession 17 acres of land at Moorneen and property and land in Knockbrack, both of which are located in Clifden. Twenty one years later, in 1876, when a list of those owning more than one acre was compiled, he was recorded as owning 210 acres.
Freyer was educated at Erasmus Smith's College, Galway, and won a scholarship to attend Queen's College (now NUI Galway). He graduated in 1872 with a gold medal and a first class honors degree in arts. Two years later, in 1874, he earned his MD and M.Ch. having won another gold medal. While a medical student he also spent some time as a resident pupil at Dr Steevens' Hospital in Dublin. Following a short time working in Paris, he returned to sit the competitive examination of the Indian Medical Service.
Indian Medical Service
Admission to the Bengal Medical Service
Freyer came first in the competitive examination for a commission as a medical officer in the Bengal Medical Service, which later became part of the IMS. Entering the service as a surgeon on 30 September 1875, he became a civil surgeon in Azamgarh in April 1877. He started publishing his medical articles in The Indian Medical Gazette in 1878. Subsequently, he became a surgeon-major and surgeon lieutenant-colonel after 12 and 20 years' service respectively and retired from service on 3 May 1896. He served almost exclusively in civil employment in the North-Western Provinces and Oudh in the United Provinces of India, where he then held the civil surgeoncies successively of Moradabad, Bareilly, Allahabad, Mussoorie and Benares, and was also for a short time surgeon on the staff of the Lieutenant-Governor.