West, a Londoner by birth, trained at St Thomas' Hospital. He settled in Birmingham in 1854 at a time when surgery was being transformed. Anaesthesia, after its inception in the mid-1840s, enabled surgeons to operate without subjecting patients to the agonising ordeals of the past and was adopted with enthusiasm by West and his colleagues. Lister's antiseptic methods, on the other hand, were greeted with hostility by many when they were first communicated to professional colleagues in 1867. Those, like West, who did embrace Listerism, had to convince their more sceptical counterparts of its efficacy while they, in turn, sought to prove rigorous attention to hygiene was equally effective.James West kept a journal. The last and only surviving example has been included in the biography. The diary contains a wealth of information about his family, friends, colleagues and patients, as well as providing an insight into West's character. West was also an inveterate traveller visiting - on occasions with his wife, a native of Great Houghton, near Barnsley in Yorkshire - British and continental hospitals, medical schools and health resorts. West's career was not trouble free. In 1857/8, he fought a long and bitter election dispute for the post of Honorary Surgeon to Queen's Hospital, Birmingham, but by the time he died at the age of fortynine, West was a well-respected, successful and wealthy man.