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Interventional Cardiology and
Cardiac Catheterisation
Interventional Cardiology and
Cardiac Catheterisation
The Essential Guide
Second Edition

Edited by
John Edward Boland BSc Hons, MSc (Pathology)
Department of Cardiology, St Vincent’s Hospital
School of Medical and Applied Science, Central Queensland University
Sydney, Australia
David W. M. Muller, MBBS, MD, FRACP, FACC
Cardiac Catheterisation Laboratories, St Vincent’s Hospital
Sydney, Australia
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742

© 2019 by Taylor & Francis Group, LLC

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Library of Congress Cataloging‑in‑Publication Data

Names: Boland, John, MSc., editor. | Muller, David W. M., editor.

Title: Interventional cardiology and cardiac catheterisation : the essential guide / [edited by] John
Boland, David W.M. Muller.
Other titles: Cardiology and cardiac catheterisation.
Description: Second edition. | Boca Raton, FL : CRC Press, Taylor & Francis Group, [2019] |
Preceded by Cardiology and cardiac catheterisation : the essential guide / edited by John Boland and
David W.M. Muller. 2001. | Includes bibliographical references and index.
Identifiers: LCCN 2018050505| ISBN 9781138481510 (hardback : alk. paper) | ISBN
9781351060356 (ebook)
Subjects: | MESH: Cardiac Catheterization | Cardiac Surgical Procedures
Classification: LCC RC683.5.C25 | NLM WG 141.5.C2 | DDC 616.1/20754--dc23
LC record available at https://lccn.loc.gov/2018050505

Visit the Taylor & Francis Web site at

http://www.taylorandfrancis.com

and the CRC Press Web site at

http://www.crcpress.com
To all scholars, teachers and researchers everywhere.
Contents

Foreword xi
Preface xiii
Editors xv
Foreword to the first edition xvii
Preface to the first edition xix
Contributors xxi

Part 1 INSTRUMENTATION AND TECHNOLOGY 1

1 The cardiac imaging and monitoring systems 3

Steven Kelly and Jeffrey Lui
2 Non-invasive physiological monitoring 11
Mark Butlin, Isabella Tan, Edward Barin and Alberto P. Avolio
3 Determination of oxygen status in human blood 21
Marcus Juul
4 Coagulation and the coagulation cascade 33
John Edward Boland and David E. Connor
5 Thrombosis, heparin and laboratory monitoring of heparin therapy 45
Steven Faddy
6 Laboratory coagulation assays 55
Bruce Toben and David E. Connor

Part 2 PATIENT CARE AND LABORATORY SAFETY 67

7 Radiation safety in the cardiac catheterisation laboratory 69

Cameron Jeffries
8 Infection control procedures 81
David Andresen and Giulietta Pontevivo
9 Nursing care of the cardiac catheterisation patient 89
Julie Parkinson, Jo-Anne M. Vidal and Eva Kline-Rogers
10 Vascular access site management and arterial closure 123
Peter Hadjipetrou

vii
viii Contents

11 Medical management of the cardiac patient undergoing coronary angiography 131

Sara Hungerford, Peter Ruchin and Gerard Carroll
12 Patient risk assessment: Use of risk calculators 143
Edwina Wing-Lun and David Smythe
13 An evidence-based guide to cardiac catheterisation 157
Steven Faddy and Gary J. Gazibarich

Part 3 PHYSIOLOGY AND PHARMACOLOGY 167

14 Pressure waveforms in the cardiac cycle 169

John Edward Boland and David W. Baron
15 Physiological interpretation of pressure waveforms 189
Geoffrey S. Oldfield
16 Measurement of cardiac output and shunts 209
Michael P. Feneley
17 Analysis and interpretation of Fick and thermodilution cardiac output determinations 221
Gary J. Gazibarich, John Edward Boland and Louis W. Wang
18 Pressure-volume loops: Background theory with practical examples 233
Pankaj Jain and Christopher S. Hayward
19 The electrocardiogram in ischaemic heart disease 249
Geoffrey S. Oldfield and Dennis L. Kuchar
20 Recognition of common arrhythmias 263
Nicholas P. Kerr and Rajesh N. Subbiah
21 Formation and progression of atherosclerosis 283
Siddharth J. Trivedi and Brian J. Nankivell
22 Basic pharmacology of cardiac drugs 293
Terence J. Campbell
23 Drug therapy in the cardiac catheterisation laboratory: A guide to commonly used drugs 313
John Edward Boland, Fuyue Jiang and Andrew Fenning
24 Antiplatelet therapy in interventional cardiology 333
Christopher Yu and Harry C. Lowe

Part 4 DIAGNOSTIC PROCEDURES 351

25 Coronary angiography: Techniques and tools of the trade 353

Roberto Spina and Tom Gavaghan
26 Physiological assessment of coronary lesion severity 371
Usaid Allahwala and Ravinay Bhindi
27 Non-invasive assessment of ischaemic heart disease 381
James Otton, Patrick Pender and Neville Sammel
28 Right heart catheterisation and evaluation of the pulmonary hypertension patient 391
Eugene Kotlyar and Anne Keogh
29 Haemodynamic evaluation of the heart transplant patient 417
Kavitha Muthiah, Christopher S. Hayward, Andrew Jabbour and Peter Macdonald
30 Trans-septal cardiac catheterisation 427
David W. M. Muller
 Contents ix

Part 5 PERCUTANEOUS CAROTID INTERVENTIONS 433

31 Advances in stent technology 435

Smriti Saraf and Paul Bhamra-Ariza
32 Facilitated coronary interventions: Adjuncts to balloon dilatation 455
David W. M. Muller
33 Catheter-based reperfusion in acute myocardial infarction 467
Ming-Yu (Anthony) Chuang, Richard Brogan and Derek P. Chew
34 Percutaneous carotid interventions 489
Taraneh Amir-Nezami and Anthony Grabs
35 The intra-aortic balloon pump: Principles and use 499
Anthony Nicholson

Part 6 INTERVENTIONS FOR STRUCTURAL HEART DISEASE 515

36 Interventional transoesophageal echocardiography 517

Mayooran Namasivayam and Martin Shaw
37 Interventions for congenital heart disease 525
David W. M. Muller
38 Mitral valvuloplasty: The Inoue balloon dilatation technique 533
Paul Roy
39 Transcatheter aortic valve implantation 539
David A. Roy
40 Transcatheter interventions for mitral and tricuspid regurgitation 563
David W. M. Muller
41 Transcatheter left atrial appendage occlusion 579
Roberto Spina, David W. M. Muller and Brendan Gunalingam
42 Cardiac surgery and percutaneous cardiac interventions 591
Arjun Iyer and Paul Jansz

Part 7 INTERVENTIONS FOR ARRHYTHMIAS 605

43 The electrophysiology laboratory 607

Dennis L. Kuchar
44 Catheter ablation therapy 613
William Lee and Bruce Walker

Index 623
Foreword
The collective knowledge and expertise con-
tained within a major clinical, teaching and
research institute such as St Vincent’s Hospital,
Sydney, is truly impressive and would fill several
books of encyclopaedic proportions. This text-
book is an attempt to tap into a small part of that
immense knowledge by documenting informa-
tion from one specific area of medicine: the car-
diac catheterisation laboratory. To this end, much
of the information provided in this textbook
forms part of the coursework for the Bachelor of
Echocardiography (Cardiac Physiology), Graduate
Diploma of Echocardiography provided by
Central Queensland University, Australia, and we
proudly acknowledge this collaboration between
St Vincent’s Hospital and CQ University.
A publication of this type would not be possi-
ble without collaboration from many individuals
and organisations. We are deeply grateful to our
publisher, Taylor & Francis Group for accepting
what was initially a tenuous project depending on
the dedication and goodwill of so many people,
and to all our contributors for their willingness
to participate in this production. We believe the
final product justifies their commitment and
reflects the highest standards of academia.
We are also indebted to all our reviewers and
assistant editors, all of whom devoted countless
hours of work in editing, proofing and re-proof-
ing all material. In particular, we wish to thank
Pow-Li Chia, Dennis Kuchar, David W. Baron,
Lawrence Schneider, Krishna Kathir, Christopher
Anthony, Gary Gazibarich, Matthew Cameron,
Julie Parkinson, Steven Faddy and Roslyn Prichard
for editorial assistance, and Medici Graphics and
Imagination Graphics for their graphics artwork, as
well as Quok Ngo and Julie Williams, our librarians
at St Vincent’s Hospital, for invaluable assistance
with documenting references.
Our gratitude extends to Medtronic and
Edwards Lifesciences for initial seed funding and
material for a draft copy, and to Boston Scientific,
Abbott, Terumo, Edwards Lifesciences and other
corporations for providing educational material
reproduced herein.
Finally, to our families and colleagues who sup-
ported us in so many undefinable ways during a
difficult period, we thank you all for your patience
and understanding.
John Edward Boland
David W. M. Muller
xi
Preface
The new entrant into the world of the cardiac cath-
eterisation laboratory faces a highly complex envi-
ronment with many layers of practice, including an
arcane language of pressure measurement, haemo-
dynamic assessment, imaging and radiation use
and safety, plus a myriad of unique diagnostic and
therapeutic procedures. For many beginners, it is
a completely overwhelming and often bewildering
experience.
To make catheterisation comprehensible, it is
natural to turn to a comprehensive text for infor-
mation. The last decade has seen a cascade of books
on advanced techniques, specialised technologies,
and the many sub-specialties that have developed
within the international community. There are also
now a growing number of case-based compendi-
ums on advanced interventional procedures and
the newest devices. These texts, however, add to the
subspecialist’s need to know more and more about
less and less, leaving a void for the professional
seeking something more general or basic.
What is needed is a complete source that
addresses the basics and makes the funda-
mentals of cardiac catheterisation more acces-
sible. Interventional Cardiology and Cardiac
Catheterisation: The Essential Guide fills this void,
presenting the basics in a current, up-to-date
manner. As an example, this spirit is captured in
the introduction in Chapter 9, which notes that
the chapter ‘highlights recent changes in nursing
practice’. The same spirit is evident in chapters on
more advanced subjects, such as Chapter 40 where
discussion of background information makes
the details of the newest therapies eminently
understandable.
The first chapters detail the fundamentals of
imaging, monitoring systems, and basic cardiac
physiology from the laboratory perspective,
followed by the fundamentals of thrombosis,
anticoagulation, vascular access and haemo-
stasis. Basic clinical and interventional phar-
macology are addressed by experts in the field.
The basics of the broad topics of patient man-
agement, nursing perspective, coronary and
peripheral vascular intervention, intervention
for myocardial infarction, pulmonary hyperten-
sion, transplantation, and therapies for struc-
tural and congenital disease are all covered
by experienced authors with many decades of
cumulative experience.
The breadth of material covered helps this
text exceed the expectations defined by the title
‘­essential guide’, and is well targeted to the health
care professional who is new to the catheterisa-
tion laboratory. It also true that even the most
experienced providers sometimes need to revise
the basics, and this book addresses that need as
well. The uneasy feeling that most people have on
first exposure to a cardiac catheterisation labora-
tory, ‘How can I ever learn all of this?!’ is best
treated with knowledge and experience. This
textbook provides the essential knowledge that
is the first part of the knowledge and experience
equation.
Ted Feldman
Cardiac Catheterization Laboratory
Interventional Cardiology
NorthShore University Health System
Evanston Hospital
Clinical Medicine
University of Chicago Pritzker School of Medicine
xiii
Editors
John Edward Boland is a Science graduate with
a background in research and education and has
participated as convenor, presenter or invited
speaker at numerous local and international sci-
entific and educational meetings. With a particu-
lar interest in instrumentation and technology,
he has worked as Physiologist/Senior Hospital
Scientist for over 30 years as part of the clinical
team in the cardiac catheterisation laboratories
at St Vincent’s Hospital, Sydney, and has a con-
joint appointment as Senior Lecturer with Central
Queensland University. He is an associate mem-
ber of the Cardiac Society of Australia and New
Zealand and the New South Wales Diagnostic and
Interventional Cardiology Nurses Group.
David W. M. Muller is director, Cardiac
Catheterisation Laboratories at St Vincent’s
Hospital, Sydney, and St Vincent’s Private Hospital,
and is associate professor of medicine at the
University of New South Wales. His major inter-
ests include optimising the outcomes of complex
coronary and peripheral vascular interventions,
and the percutaneous management of structural
heart disease. He is Principal Investigator for
numerous international clinical trials including
several first-in-man trials of new devices. He has
authored or co-authored multiple peer-reviewed
papers, book chapters and abstracts, and has
served as an editorial consultant to all the major
cardiology journals.
xv
Foreword to the first edition
Cardiac catheterisation began in 1929, when
Werner Forsmann exposed a vein in his left
arm, introduced a ureteric catheter under local
anaesthetic, walked to the X-ray department and
advanced it under fluoroscopic guidance into the
right atrium. This was lost in the world litera-
ture until a Frenchman, A. F. Cournard, and an
American, D. W. Richards, in 1914 used the tech-
nique to measure cardiac output and pulmonary
artery pressures. In 1947 Lewis Dexter and his col-
leagues used cardiac catheterisation to study and
diagnose congenital heart disease.
In Australia, catheterisation of the right heart
began at Royal Prince Alfred Hospital in 1947 and
at St Vincent’s Hospital, both in Sydney, in 1954.
At St Vincent’s Hospital, the studies were carried
out in a small room in the X-ray department under
fluoroscopic control. There was no image intensifi-
cation and no check or control of radiation safety.
Pressures were recorded using cumbersome equip-
ment that often took an hour or more to calibrate,
and pressure waveforms were recorded using
either direct writing pens or photographic equip-
ment. There were no display screens or computers.
Catheters were re-used and were sterilised by boil-
ing in water. It was not unusual for the patient to
experience rigors after the procedure as a result of
pyrogens within the catheter. There were 104 cases
performed in the first year.
The senior doctors had learned the techniques
in Great Britain and America but were largely self-
taught. They instructed the assisting nurses and
later the medical registrars, science graduates and
technicians. Collective knowledge and expertise
were passed down by word and example. There was
no course and no textbook to introduce the new-
comer to the mysteries of cardiac output, the Fick
principle, or the changes in waveform in the differ-
ent cardiac chambers.
In 1957, catheterisation of the left heart began, and
Dr George Benness performed the first coronary
arteriogram in Australia at St Vincent’s Hospital
in 1962.
Since then, image intensification, display
screens, computers, sophisticated catheters and
percutaneous techniques have revolutionised the
cardiac catheterisation laboratory. The laboratory
has become a relatively insulated section of the
hospital where several disciplines interact in a very
sophisticated environment to provide high-class
patient care. Despite these advances there has until
now been no textbook to which the newcomer
could turn to for appropriate information.
John E. Boland and David W. M. Muller have
now filled this void by editing a valuable contri-
bution covering all aspects of the techniques and
problems encountered in both the cardiac diag-
nostic and research laboratories. Their co-authors
are experienced cardiologists and scientists from
Australia and overseas.
I hope that this excellent monograph will be
widely read and prove of great help to the many
medical, nursing and health professional support
staff without whom modern procedural cardiology
would not be possible.
John B. Hickie
Emeritus Professor
xvii
Preface to the first edition
The field of cardiovascular medicine has catapulted
forward in the past few years, owing to significant
changes in our approach to patients with acute
ischemic heart disease, valvular abnormalities,
and prevention of serious arrhythmias. Back in the
1980s, cardiology was revolutionised by an aggres-
sive approach to restoring coronary blood flow in
acute myocardial infarction. This took several years
to become standard practice, but the spirit of more
aggressive management has been transmitted to
virtually all diagnoses and treatments in cardiol-
ogy and cardiac surgery. Of note, these changes
have only come about as an outgrowth of intensive
clinical investigation, with rigorous, large-scale
randomised trials and insightful mechanistic stud-
ies. The buzz word of ‘evidence-based medicine’ has
been a cornerstone for accepting many of the newer
and more active strategies.
It is hard to find a reference source that captures
the latest developments in a comprehensive way.
But this book, carefully edited by John E. Boland
and David W. M. Muller, is a superb contribution
to our field. This monograph covers core clinical
areas such as the electrocardiogram, pressure wave
forms, and physiological monitoring. Building on
this theme, there is heavy emphasis on the physi-
ologic approach to the patient, with chapters on
cardiac output and shunts, determination of oxy-
gen status, use of pressure-volume loops for assess-
ing left ventricular function, and two chapters
dedicated to interpreting pressure waveforms. With
fundamental reviews of atherosclerosis, coagula-
tion, and cardiovascular pharmacology, all of the
latest therapies are reviewed including anticoagu-
lants, new anti-platelet agents, and reperfusion
therapy. Not just the pharmacology is reviewed,
but also device therapies including stenting, vascu-
lar closure devices, catheter-based reperfusion of
acute myocardial infarction, endovascular therapy
of the carotid and peripheral vasculature, approach
to valvular diseases, and the potential for angio-
genesis and gene therapy. Some particularly useful
and hard to find chapters are included on radiation
safety, nursing considerations, infection control,
haemodynamic monitoring in transplant patients,
and evidence-based cardiac catheterisation.
In aggregate, this book is a unique monograph
which covers many vital aspects of cardiovascular
medicine and surgery in a thorough, refreshing,
and highly pragmatic fashion. It will undoubt-
edly be well received by the cardiology physician,
trainee, and nurse community. John E. Boland and
David W. M. Muller, together with their superb
expert contributors, deserve kudos for their fine
work.
Eric J. Topol
Department of Cardiology
Cleveland Clinic Foundation
Cleveland, Ohio
xix
Contributors

Usaid Allahwala Paul Bhamra-Ariza

Department of Cardiology Frimley Health NHS Trust
Royal North Shore Hospital London, United Kingdom
and
University of Sydney Ravinay Bhindi
Sydney, Australia Department of Cardiology
Royal North Shore Hospital
Taraneh Amir-Nezami and
Department of Vascular Surgery University of Sydney
St Vincent’s Hospital Sydney, Australia
Sydney, Australia
John Edward Boland
David Andresen School of Medical and Applied Sciences
Infectious Diseases Central Queensland University
St Vincent’s Hospital and
Sydney, Australia Cardiac Catheterisation Laboratories
St Vincent’s Hospital
Alberto P. Avolio Sydney, Australia
Department of Biomedical Sciences
Faculty of Medicine and Health Sciences Richard Brogan
Macquarie University School of Medicine
Sydney, Australia Flinders University of South Australia
Adelaide, Australia
Edward Barin
MQ Health: Cardiology, Macquarie University Mark Butlin
Health Sciences Centre Department of Biomedical Sciences
and Faculty of Medicine and Health Sciences
Department of Clinical Science Macquarie University
Faculty of Medicine and Health Sciences Sydney, Australia
Macquarie University
Sydney, Australia Terence J. Campbell
Professorial Unit
David W. Baron St Vincent’s Hospital
Cardiac Catheterisation Laboratories Sydney, Australia
St Vincent’s Hospital
Sydney, Australia

xxi
xxii Contributors

Gerard Carroll Andrew Fenning

University of New South Wales Medical and Applied Physiology
and Metabolic & Physiological Health
The Mater Hospital Medical Sciences & Pharmacology
Sydney, Australia School of Medical and Applied Sciences
CQ University
and
North Rockhampton, Australia
Riverina Cardiology
and Tom Gavaghan
Wagga Wagga Rural Referral Hospital Sydney Adventist Hospital
Wagga Wagga, Australia Wahroonga, Australia

Derek P. Chew Gary J. Gazibarich

School of Medicine Department of Thoracic Medicine
Flinders University St Vincent’s Hospital
and Sydney, Australia
Department of Cardiovascular Medicine
Southern Adelaide Local Health Anthony Grabs
Network Department of Vascular Surgery
Adelaide, Australia St Vincent’s Hospital
Sydney, Australia
Ming-Yu (Anthony) Chuang
Flinders Medical Centre Brendan Gunalingam
Flinders University School of Medicine Cardiac Catheterisation Laboratories
and St Vincent’s Hospital
Department of Cardiovascular Medicine Sydney, Australia
Southern Adelaide Local Health
and
Network
Adelaide, Australia Gosford Public and Private Hospitals
Gosford, Australia
David E. Connor
School of Medical and Applied Science Peter Hadjipetrou
and Interventional Cardiologist
St Vincent’s Centre for Applied Medical St Andrews Hospital Heart Institute
Research Brisbane, Australia
St Vincent’s Hospital
and Christopher S. Hayward
University of New South Wales Department of Cardiology
Sydney, Australia St Vincent’s Hospital
and
Steven Faddy University of New South Wales
Clinical Services and
NSW Ambulance Service Victor Chang Cardiac Research Institute
Rozelle, Australia Sydney, Australia

Michael P. Feneley
Department of Cardiology
St Vincent’s Hospital
Sydney, Australia
 Contributors xxiii

Sara Hungerford Steven Kelly

St Vincent’s Hospital Sydney Cardiac Catheterisation Laboratories
and St Vincent’s Hospital
University of New South Wales Sydney, Australia
and
The Mater Hospital Anne Keogh
Sydney, Australia Pulmonary Hypertension Unit
St Vincent’s Hospital
Arjun Iyer and
Cardiothoracic Surgery and Transplantation University of New South Wales
St Vincent’s Hospital Sydney, Australia
Sydney, Australia
Nicholas P. Kerr
Andrew Jabbour Cardiac Electrophysiology and Pacing
University of New South Wales St Vincent’s Hospital
and Sydney, Australia
Cardiovascular Imaging
St Vincent’s Hospital Eva Kline-Rogers
and Cardiovascular Nurse Practitioner
Victor Chang Cardiac Research Institute University of Michigan Medical Center
Sydney, Australia Ann Arbor, Michigan

Pankaj Jain Eugene Kotlyar

Department of Cardiology Department of Cardiology
St Vincent’s Hospital St Vincent’s Hospital
and and
University of New South Wales University of New South Wales
Sydney, Australia and
University of Notre Dame
Paul Jansz Sydney, Australia
Cardiothoracic Surgery and Transplantation
St Vincent’s Hospital Dennis L. Kuchar
Sydney, Australia Cardiac Electrophysiology and Pacing
St Vincent’s Hospital
Cameron Jeffries and
South Australian Medical Imaging Faculty of Medicine
Flinders Medical Centre University of New South Wales
Adelaide, Australia and
Victor Chang Cardiac Research Institute
Fuyue Jiang Sydney, Australia
Cardiac Catheterisation Laboratories
St Vincent’s Hospital William Lee
Sydney, Australia Cardiac Electrophysiology and Pacing
St Vincent’s Hospital
Marcus Juul and
Department of Thoracic Medicine Victor Chang Cardiac Research Institute
St Vincent’s Hospital and
Sydney, Australia University of New South Wales
Sydney, Australia
xxiv Contributors

Harry C. Lowe Anthony Nicholson

Cardiac Catheterisation Laboratories School of Animal and Veterinary Sciences
Concord Repatriation General Hospital University of Adelaide
and Roseworthy, Australia
Centre for Thrombosis and Vascular Research
Faculty of Medicine Geoffrey S. Oldfield
University of New South Wales John Hunter Hospital
Sydney, Australia and
CCU, Catheterisation & Angioplasty
Jeffrey Lui Laboratory
Philips Healthcare Australia and New Zealand Lake Macquarie and Lingard Private
Sydney, Australia Hospitals
Newcastle, Australia
Peter Macdonald
Cardiac Transplant Unit James Otton
St Vincent’s Hospital Department of Cardiology
Sydney, Australia Liverpool Hospital
and
David W. M. Muller Victor Chang Cardiac Research Institute
Cardiac Catheterisation Laboratories Sydney, Australia
St Vincent’s Hospital
University of New South Wales Julie Parkinson
Victor Chang Cardiac Research Institute Cardiac Angiography Unit
Sydney, Australia Gosford Hospital
Gosford, Australia
Kavitha Muthiah
Department of Cardiology Patrick Pender
St Vincent’s Hospital Department of Cardiology
Sydney, Australia Liverpool Hospital
Sydney, Australia
Mayooran Namasivayam
Department of Cardiology Giulietta Pontevivo
St Vincent’s Hospital Infection Prevention Management and
and Staff Health Services
Faculty of Medicine St Vincent’s Hospital
University of New South Wales Sydney, Australia
and
Victor Chang Cardiac Research Institute David A. Roy
Sydney, Australia Cardiac Catheterisation Laboratories
St Vincent’s Hospital
Brian J. Nankivell Sydney, Australia
Department of Medicine
University of Sydney Paul Roy
Westmead Hospital Cardiac Catheterisation Laboratories
Westmead, Australia St Vincent’s Hospital
Sydney, Australia
 Contributors xxv

Peter Ruchin Isabella Tan

University of New South Wales Department of Biomedical Sciences
and Faculty of Medicine and Health Sciences
The Mater Hospital Macquarie University
Sydney, Australia Sydney, Australia

and
Bruce Toben
Riverina Cardiology Senior Director of Scientific Affairs
and Instrumentation Laboratory
Wagga Wagga Rural Referral Hospital San Diego, California
Wagga Wagga, Australia
Siddharth J. Trivedi
Neville Sammel Department of Cardiology
Department of Cardiology Westmead Hospital
St Vincent’s Hospital Sydney, Australia
Sydney, Australia
Jo-Anne M. Vidal
Smriti Saraf Cardiac Catheterisation Laboratories
The Manchester Foundation Trust St Vincent’s Hospital
Manchester, United Kingdom Sydney, Australia

Martin Shaw Bruce Walker

Department of Anesthetics Cardiac Electrophysiology and Pacing
St Vincent’s Hospital St Vincent’s Hospital
Sydney, Australia and
Victor Chang Cardiac Research Institute
David Smythe and
Cardiology Department University of New South Wales
Christchurch Hospital Sydney, Australia
Christchurch, New Zealand
Louis W. Wang
Roberto Spina St Vincent’s Clinical School
New York Presbyterian Hospital University of New South Wales
Columbia University Medical Center Sydney, Australia
New York, New York
Edwina Wing-Lun
and
University of Notre Dame
Cardiac Catheterisation Laboratories and
St Vincent’s Hospital University of New South Wales
Sydney, Australia and
Cardiac Catheterisation Laboratories
Rajesh N. Subbiah St Vincent’s Hospital
Cardiac Electrophysiology and Pacing Sydney, Australia
St Vincent’s Hospital
and Christopher Yu
Victor Chang Cardiac Research Institute Concord Repatriation General Hospital
and Sydney, Australia
University of New South Wales
Sydney, Australia
 1
Part    

Instrumentation and technology

1 The cardiac imaging and monitoring systems 3

Steven Kelly and Jeffrey Lui
2 Non-invasive physiological monitoring 11
Mark Butlin, Isabella Tan, Edward Barin and Alberto P. Avolio
3 Determination of oxygen status in human blood 21
Marcus Juul
4 Coagulation and the coagulation cascade 33
John Edward Boland and David E. Connor
5 Thrombosis, heparin and laboratory monitoring of heparin therapy 45
Steven Faddy
6 Laboratory coagulation assays 55
Bruce Toben and David E. Connor
Another random document with
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The Project Gutenberg eBook of Edinburgh
sketches & memories
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Title: Edinburgh sketches & memories

Author: David Masson

Release date: October 30, 2023 [eBook #71958]

Language: English

Original publication: London: Adam and Charles Black, 1892

Credits: Richard Tonsing, Susan Skinner, and the Online

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*** START OF THE PROJECT GUTENBERG EBOOK EDINBURGH

SKETCHES & MEMORIES ***
Transcriber’s Note:
New original cover art included with this eBook is
granted to the public domain.
 EDINBURGH
SKETCHES & MEMORIES
BY

DAVID MASSON
PROFESSOR OF ENGLISH LITERATURE IN THE UNIVERSITY OF
EDINBURGH

LONDON AND EDINBURGH

ADAM AND CHARLES BLACK
1892
 PREFATORY NOTE

The following Papers, though in their collected state they have a

certain continuity of general subject, were written at different times
and for different purposes. One is a modified reprint of an article
which appeared in the Westminster Review as long ago as 1856.
Seven of the others were contributed, at intervals within the last
twelve years, to Macmillan’s Magazine, The Scotsman, or The Scots
Observer, and are reprinted now with courteous permission. The
remaining five are from manuscript of various dates since 1867, and
are now published for the first time. An occasional small recurrence
of fact or of phrase in the series may be excused in consideration that
the Papers, thus written separately, may still be read separately.
Edinburgh: March 1892.
 CONTENTS

PAGE
I. Queen Mary’s Edinburgh:—
1. Queen Mary’s Return to Scotland, August 1561 1
2. Plan and Fabric of Edinburgh in 1561 9
3. The Edinburgh Population in 1561 20
II. Robert Rollock and the Beginnings of Edinburgh
University 35
III. King James’s Farewell to Holyrood 61
IV. Proposed Memorial to Drummond of Hawthornden 76
V. Allan Ramsay 88
VI. Lady Wardlaw and the Baroness Nairne 110
VII. Edinburgh through the Dundas Despotism 141
VIII. The Last Years of Sir Walter Scott 204
IX. Carlyle’s Edinburgh Life:—
Part I.—1809–1818 226
Part II.—1818–1822 262
Part III.—1822–1828 302
X. Charles Kirkpatrick Sharpe 359
XI. John Hill Burton 372
XII. Dr. John Brown of Edinburgh 384
XIII. Literary History of Edinburgh: a General Review 417
 QUEEN MARY’S EDINBURGH[1]

I.—QUEEN MARY’S RETURN TO SCOTLAND,

AUGUST 1561
On a clear day the inhabitants of Edinburgh, by merely
ascending the Calton Hill or any other of the familiar heights in or
around their city, can have a view of nearly the whole length of their
noble estuary, the Firth of Forth. To the right or east, its entrance
from the open sea, between the two shires of Fife and Haddington, is
marked most conspicuously on the Haddingtonshire side by a distant
conical mound, called Berwick Law, rising with peculiar distinctness
from the northward curve of land which there bounds the horizon. It
is thither that the eye is directed if it would watch the first
appearance of steamers and ships from any part of the world that
may be bound up the Firth for Edinburgh by its port of Leith. Moving
thence westward, the eye can command easily the twenty miles more
of the Firth which these ships and steamers have to traverse. The
outlines of both shores, though the breadth between them averages
twelve miles, may be traced with wonderful sharpness, pleasingly
defined as they are by their little bays and promontories, and by the
succession of towns and fishing villages with which they are studded.
Of these, Musselburgh on the near side marks the transition from the
shire of Haddington to that of Edinburgh; after which point the Firth
begins to narrow. Just below Edinburgh itself, where its port of Leith
confronts the Fifeshire towns of Kinghorn and Burntisland, with the
island of Inchkeith a little to the right between, the breadth is about
six miles. There the main maritime interest of the Firth ceases, few
ships going farther up; but, for any eye that can appreciate scenic
beauty, there remains the delight of observing the continued course
of the Firth westward to Queensferry and beyond, a riband of
flashing water between the two coasts which are known prosaically
as those of Linlithgowshire and West Fifeshire, but which, in their
quiet and mystic remoteness, look like a tract of some Arthurian
dreamland.
While something of all this is to be seen on almost any day from
any of the eminences in or near Edinburgh, it is only on rare
occasions that it can be all seen to perfection. Frequently, even in
sunny weather, when the sky is blue above, a haze overspreads the
Firth, concealing the Fifeshire shore, or blurring it into a vague
cloud-like bank. Sometimes, on the other hand, when there is little
sunshine, and the day seems rather sombre in the Edinburgh streets,
the view of the Firth and of the other surroundings of the city from
any of the higher spots is amazingly distinct to the utmost possible
distance, though with the distinctness of a drawing in pen and ink.
Worst of all the atmospheric conditions for a survey of the Firth, or
of the scenery generally, from Edinburgh, is that of the thick, dull,
drizzling, chilling, and piercing fog or mist, called locally a haar,
which the easterly wind brings up at certain seasons from the sea. Up
the Firth this haar will creep or roll, converting the whole aerial gap
between the opposed shores into a mere continuous trough of
seething and impenetrable mist, or of rain and mist commingled,
drenching the Fifeshire hills on the one side, enveloping all
Edinburgh on the other, and pushing itself still westward and inland
over the higher and narrower reaches of the estuary, till the aforesaid
tract of gleaming Arthurian scenery is absorbed into the long foggy
gloom, and even Alloa and Stirling feel the discomfort. No chance
then, from any height near Edinburgh, of seeing the ships and
steamers in any part of their course from the mouth of the Firth to
the port of Leith. If any there be, they are down in the vast abysm of
mist, at anchor for safety, or piloting their Leithward course slowly
and cautiously through the opaque element, with bells ringing, horns
blowing, and now and then a boom from the cannon on the deck to
warn off other vessels or ascertain their own whereabouts. So even
during the day; but, when the haar lasts through the night, and the
opaque gray of the air is deepened into an equally opaque black or
umber, the confusion is still greater. The sounds of fog-signals from
the bewildered vessels are incessant; the shore-lights from the piers
and landing-places can throw their yellow glare but a little way into
the turbid consistency; and, if any adventurous vessel does manage
to warp herself into port in such circumstances, it is with excited
vociferation and stamping among those on board, and no less hurry-
skurry among the men ashore who assist in the feat. Happily, an
Edinburgh haar at once of such dense quality and of long duration is
a rare occurrence. April and May are the likeliest months for the
phenomenon, and it passes usually within twenty-four hours. It may
come later in the year, however, and may last longer.
Just after the middle of August 1561, as we learn from
contemporary records, there was a haar of unusual intensity and
continuance over Edinburgh and all the vicinity. It began on Sunday
the 17th, and it lasted, with slight intermissions, till Thursday the
21st. “Besides the surfett weat and corruptioun of the air,” writes
Knox, then living in Edinburgh, “the myst was so thick and dark that
skairse mycht any man espy ane other the lenth of two pair of butts.”
It was the more unfortunate because it was precisely in those days of
miserable fog and drizzle that Mary, Queen of Scots, on her return to
Scotland after her thirteen years of residence and education in
France, had to form her first real acquaintance with her native shores
and the capital of her realm.
She had left Calais for the homeward voyage on Thursday the
14th August, with a retinue of about 120 persons, French and
Scottish, embarked in two French state galleys, attended by several
transports. They were a goodly company, with rich and splendid
baggage. The Queen’s two most important uncles, indeed,—the great
Francis de Lorraine, Duke of Guise, and his brother, Charles de
Lorraine, the Cardinal,—were not on board. They, with the Duchess
of Guise and other senior lords and ladies of the French Court, had
bidden Mary farewell at Calais, after having accompanied her thither
from Paris, and after the Cardinal had in vain tried to persuade her
not to take her costly collection of pearls and other jewels with her,
but to leave them in his keeping till it should be seen how she might
fare among her Scottish subjects. But on board the Queen’s own
galley were three others of her Guise or Lorraine uncles,—the Duke
d’Aumale, the Grand Prior, and the Marquis d’Elbeuf,—with M.
Damville, son of the Constable of France, and a number of French
gentlemen of lower rank, among whom one notes especially young
Pierre de Bourdeilles, better known afterwards in literary history as
Sieur de Brantôme, and a sprightly and poetic youth from Dauphiné,
named Chastelard, one of the attendants of M. Damville. With these
were mixed the Scottish contingent of the Queen’s train, her four
famous “Marys” included,—Mary Fleming, Mary Livingstone, Mary
Seton, and Mary Beaton. They had been her playfellows and little
maids of honour long ago in her Scottish childhood; they had
accompanied her when she went abroad, and had lived with her ever
since in France; and they were now returning with her, Scoto-
Frenchwomen like herself, and all of about her own age, to share her
new fortunes.
It is to Brantôme that we owe what account we have of the
voyage from Calais. He tells us how the Queen could hardly tear
herself away from her beloved France, but kept gazing at the French
coast hour after hour so long as it was in sight, shedding tears with
every look, and exclaiming again and again, “Adieu, ma chère
France! je ne vous verray jamais plus!” He tells us how, when at
length they did lose sight of France, and were on the open sea
northward with a fair wind, there was some anxiety lest they should
be intercepted, and the Queen taken prisoner by an English fleet. In
the peculiar state of the relations between England and Scotland at
the time, this was not an impossibility, and would hardly have been
against the law of nations. There had been some angry
correspondence between Elizabeth and Mary respecting the non-
ratification by Mary of a certain “Treaty of Edinburgh” of the
previous year, stipulating that she would desist from her claim to
Elizabeth’s throne of England. Elizabeth had consequently refused
Mary’s application for a safeguard for her homeward journey; and
there was actually an English squadron in the North Sea available for
the capture of Mary if Elizabeth had chosen to give the word. But,
though the English squadron does seem to have waylaid the French
galleys, and one of the transports following the galleys was taken and
detained for some reason or other, the galleys themselves, by rapid
sailing or by English sufferance, threw that danger behind, and
approached the Scottish coast in perfect safety. What then
astonished Brantôme, and what he seems to have remembered all his
life with a kind of horror in association with his first introduction to
Queen Mary’s native climate and kingdom, was the extraordinary
fog, the si grand brouillard, in which they suddenly found
themselves. “On a Sunday morning, the day before we came to
Scotland,” he says, “there rose so great a fog that we could not see
from the stern to the prow, much to the discomfiture of the pilots
and crews, so that we were obliged to let go the anchor in the open
sea, and take soundings to know where we were.” Brantôme’s
measure of time becomes a little incoherent at this point; and we
hardly know from his language whether it was outside the Firth of
Forth altogether, or inside of the Firth about Berwick Law, that the
fog caught them, if indeed he remembered that there was such a
thing as an estuary at all between the open sea and Leith. He
distinctly says, however, that they were a whole day and night in the
fog, and that he and the other Frenchmen were blaspheming
Scotland a good deal on account of it before they did reach Leith.
That, as other authorities inform us, was about ten o’clock in the
morning of Tuesday the 19th.
The Leith people and the Edinburgh people were quite
unprepared, the last intimation from France having pointed to the
end of the month as the probable time of the Queen’s arrival, if she
were to be expected at all. But the cannon-shots from the galleys, as
they contrived to near Leith harbour, were, doubtless, a sufficient
advertisement. Soon, so far as the fog would permit, all Leith was in
proper bustle, and all the political and civic dignitaries that chanced
to be in Edinburgh were streaming to Leith. Not till the evening,
according to one account, not till next morning, according to
another, did the Queen leave her galley and set foot on shore. Then,
to allow a few hours more for getting her Palace of Holyrood, and her
escort thither, into tolerable readiness, she took some rest in the
house in Leith deemed most suitable for her reception, the owner
being Andrew Lamb, a wealthy Leith merchant. It was in the
afternoon of Wednesday, the 20th of August, that there was the
procession on horseback of the Queen, her French retinue, and the
gathered Scottish lords and councillors, through the two miles of
road which led from Leith to Holyrood. On the way the Queen was
met by a deputation of the Edinburgh craftsmen and their
apprentices, craving her royal pardon for the ringleaders in a recent
riot, in which the Tolbooth had been broken open and the
Magistrates insulted and defied. This act of grace accorded as a
matter of course, the Queen was that evening in her hall of Holyrood,
the most popular of sovereigns for the moment, her uncles and other
chiefs of her escort with her, and the rest dispersed throughout the
apartments, while outside, in spite of the fog, there were bonfires of
joy in the streets and up the slopes of Arthur Seat, and a crowd of
cheering loiterers moved about in the space between the palace-gate
and the foot of the Canongate. Imparting some regulation to the
proceedings of this crowd, for a while at least, was a special company
of the most “honest” of the townsmen, “with instruments of musick
and with musicians,” admitted within the gate, and tendering the
Queen their salutations, instrumental and vocal, under her chamber-
window. “The melody, as she alledged, lyked her weill, and she willed
the same to be continewed some nightis after.” This is Knox’s
account; but Brantôme tells a different story. After noting the
wretchedness of the hackneys provided for the procession from Leith
to Holyrood, and the poorness of their harnessings and trappings,
the sight of which, he says, made the Queen weep, he goes on to
mention the evening serenade under the windows of Holyrood as the
very completion of the day’s disagreeables. The Abbey itself, he
admits, was a fine enough building; but, just as the Queen had
supped and wanted to go to sleep, “there came under her window
five or six hundred rascals of the town to serenade her with vile
fiddles and rebecks, such as they do not lack in that country, setting
themselves to sing psalms, and singing so ill and in such bad accord
that there could be nothing worse. Ah! what music, and what a
lullaby for the night!” Whether Knox’s account of the Queen’s
impressions of the serenade or Brantôme’s is to be accepted, there
can be no doubt that the matter and intention of the performance
were religious. Our authentic picture, therefore, of Queen Mary’s
first night in Holyrood after her return from France is that of the
Palace lit up within, the dreary fog still persistent outside, the
bonfires on Arthur Seat and other vantage-grounds flickering
through the fog, and the portion of the wet crowd nearest the Palace
singing Protestant psalms for the Queen’s delectation to an
accompaniment of violins.
Next day, Thursday the 21st, this memorable Edinburgh haar of
August 1561 came to an end. Arthur Seat and the other heights and
ranges of the park round Holyrood wore, we may suppose, their
freshest verdure; and Edinburgh, dripping no longer, shone forth, we
may hope, in her sunniest beauty. The Queen could then become
more particularly acquainted with the Palace in which she had come
to reside, and with the nearer aspects of the town to which the Palace
was attached, and into which she had yet to make her formal entry.
 II.—PLAN AND FABRIC OF THE TOWN IN 1561
Then, as now, the buildings that went by the general name of
Holyrood were distinguishable into two portions. There was the
Abbey, now represented only by one beautiful and spacious fragment
of ruin, called the Royal Chapel, but then, despite the spoliations to
which it had been subjected by recent English invasions, still
tolerably preserved in its integrity as the famous edifice, in Early
Norman style, which had been founded in the twelfth century by
David I., and had been enlarged in the fifteenth by additions in the
later and more florid Gothic. Close by this was Holyrood House, or
the Palace proper, built in the earlier part of the sixteenth century,
and chiefly by James IV., to form a distinct royal dwelling, and so
supersede that occasional accommodation in the Abbey itself which
had sufficed for Scottish sovereigns before Edinburgh was their
habitual or capital residence. One block of this original Holyrood
House still remains in the two-turreted projection of the present
Holyrood which adjoins the ruined relic of the Abbey, and which
contains the rooms now specially shown as “Queen Mary’s
Apartments.” But the present Holyrood, as a whole, is a construction
of the reign of Charles II., and gives little idea of the Palace in which
Mary took up her abode in 1561. The two-turreted projection on the
left was not balanced then, as now, by a similar two-turreted
projection on the right, with a façade of less height between, but was
flanked on the right by a continued chateau-like frontage, of about
the same height as the turreted projection, and at a uniform depth of
recess from it, but independently garnished with towers and
pinnacles. The main entrance into the Palace from the great outer
courtyard was through this chateau-like flank, just about the spot
where there is the entrance through the present middle façade; and
this entrance led, like the present, into an inner court or quadrangle,
built round on all the four sides. That quadrangle of chateau,
touching the Abbey to the back from its north-eastern corner, and
with the two-turreted projection to its front from its north-western
corner, constituted, indeed, the main bulk of the Palace. There were,
however, extensive appurtenances of other buildings at the back or at
the side farthest from the Abbey, forming minor inner courts, while
part of that side of the great outer courtyard which faced the
entrance was occupied by offices belonging to the Palace, and
separating the courtyard from the adjacent purlieus of the town. For
the grounds of both Palace and Abbey were encompassed by a wall,
having gates at various points of its circuit, the principal and most
strongly guarded of which was the Gothic porch admitting from the
foot of the Canongate into the front courtyard. The grounds so
enclosed were ample enough to contain gardens and spaces of
plantation, besides the buildings and their courts. Altogether, what
with the buildings themselves, what with the courts and gardens, and
what with the natural grandeur of the site,—a level of deep and
wooded park, between the Calton heights and crags on the one hand
and the towering shoulders of Arthur Seat and precipitous
escarpment of Salisbury Crags on the other,—Holyrood in 1561 must
have seemed, even to an eye the most satiated with palatial
splendours abroad, a sufficiently impressive dwelling-place to be the
metropolitan home of Scottish royalty.
The town itself, of which Holyrood was but the eastward
terminus, corresponded singularly well. Edinburgh even now is,
more than almost any other city in Europe, a city of heights and
hollows, and owes its characteristic and indestructible beauty to that
fact. But the peculiarity of Old Edinburgh was that it consisted
mainly of that one continuous ridge of street which rises, by gradual
ascent for a whole mile, from the deeply-ensconced Holyrood at one
end to the high Castle Rock at the other, sending off on both sides a
multiplicity of narrow foot-passages, called closes, with a few wider
and more street-like cuttings, called wynds, all of which slope
downward from the main ridge in some degree, while many descend
from it with the steepness of mountain gullies into the parallel
ravines. Whoever walks now from Holyrood to the Castle, up the
Canongate, the High Street, and the Lawnmarket, walks through that
portion of the present “Old Town” which figures to us the main
Edinburgh of Queen Mary’s time, and is in fact its residue. But
imagination and some study of old maps and records are necessary
to divest this residue of its acquired irrelevancies, and so to reconvert
it into the actual Edinburgh of three hundred years ago. The
divisions of the great ridge of street from Holyrood to the Castle were
the same as now, with the same names; but objects once conspicuous
in each have disappeared, and the features of each have been
otherwise altered.
The first part of the long ascent from Holyrood was the
Canongate. Though occupying nearly half of the whole, and in
complete junction with the Edinburgh proper up to which it led, it
was a separate “burgh of regality,” which had formed itself, as its
name implies, under the protection of the abbots and canons of
Holyrood. By virtue of that original, it was not yet included in the
municipal jurisdiction of the Edinburgh Magistrates and Town
Council, but held out under a magistracy of its own. Hence some
characteristics distinguishing this lower part of the ascent from the
rest. The old Canongate was by no means the dense exhibition of
dingy picturesqueness now known as the Canongate of Edinburgh,
with repulsive entries and closes on both sides, leading to cages of
crammed humanity of the poorer sort, or to inner recesses of bone-
yards, pipe-clay yards, and the like. It had the sparseness and
airiness of a suburb of the Court. The houses, whether of stone or
partly of wood, were pretty thickly put together, indeed, along the
immediate street-margins, with the inevitable access to many of
them by entries and closes, but did not go so deeply back on either
side as not to leave room for pleasant gardens and tracts of vacant
ground behind. A paved and causewayed street, ascending
continuously between two rows of houses, of irregular forms and
varying heights, but few of them of more than three storeys; other
houses at the backs of these to some little depth all the way, reached
by closes from the street, and generally set gablewise to those in
front; and, behind these again, garden grounds and grassy slopes and
hollows: such was the ancient Canongate. In token of its claims to be
a separate burgh, it had its own market cross, and, near this, its own
Tolbooth or prison and council-house. The present Canongate
Tolbooth, though an antique object, is only the successor of the older
Canongate Tolbooth of Queen Mary’s time.
The ending of the Canongate and beginning of the High Street of
Edinburgh proper was at a cross street, the left arm of which,
descending from the ridge into the ravine on that side, was called St.
Mary’s Wynd, while the arm to the right was called Leith Wynd.
Here, to mark more emphatically the transition from the smaller
burgh into the greater, one encountered the separating barrier of the
Nether Bow Port. It has left no trace of itself now, but was a
battlemented stone structure, spanning the entire breadth of the
thoroughfare, with an arched gateway in the middle and gates for
admission or exclusion. That passed, one was in the lower portion of
the High Street, called specifically the Nether Bow. Here, it was not
merely the increasing breadth of the thoroughfare and the increasing
height of the houses that showed one had come within the
boundaries of the real civic and commercial Edinburgh. No such
sparseness of building now as in the Canongate; no mere double
fringe of houses to a short depth, with entries and closes ending in
gardens and vacant ground; but a sense of being between two masses
of densely-peopled habitations, clothing the declivities from the
ridge to their lowest depths on both sides, and penetrable only by
those courts and wynds of which one saw the mouths, but the
labyrinthine intricacy of which in the course of their descent baffled
conception.
The same sensation accompanied one on advancing still
upwards into the middle and broadest part of the High Street. Here
the street had much the same striking appearance as now. One saw a
spacious incline of oblong piazza, rather than a street, lined by
buildings, some of solid stone throughout and very tall, others lower
and timber-fronted, all of quaint architecture from their basements
to their peaked roofs and chimneys, and not a few with “fore-stairs,”
or projecting flights of steps from doors on the first floor down to the
causeway. It was here, too, that the lateral fringes of habitation down
the steep alleys were of greatest width. That on the right was stopped
only at the bottom of the ravine on that side by a lake called the
North Loch, while that on the left, after reaching the bottom of the
other ravine, mingled itself there with an independent and very
aristocratic suburb that had grown up in the ravine itself, under the
name of the Cowgate, as a southern parallel of relief to the main
Edinburgh of the ridge above. This low-lying, aristocratic suburb,
though accessible from the piazza of the High Street by the wynds
and closes on the southern side, did not come easily into the
cognisance of a stranger that might be exploring the piazza itself. He
had enough to arrest his attention where he was. One difference
between the old High Street and the present, despite their general
resemblance, consisted in a huge obstruction, now removed, which
interrupted the old High Street at its very midmost point,
immediately above the Town Cross. Just above the spot now marked
in the causeway as the site of this Town Cross, and beginning exactly
where the great church of St. Giles protrudes its complex pile on the
left and raises into the sky its remarkable tower and open octagonal
crown of stonework, there stood in the old High Street a stack of lofty
masonry, stretching up the centre of the street for a considerable
way, and leaving only a gloomy and tortuous lane for pedestrians
along the buttresses of the church on one side, and a somewhat wider
channel,—called the Luckenbooths,—for shops and traffic, on the
other. The lower portion of this obstructive stack of masonry
belonged to the Luckenbooths, and was included in the name, the
basement being let out in shops or stalls for goods, while the upper
floors were parcelled out as dwellings. The higher and larger portion,
separated from the lower by a narrow suture called “The Kirk Stile,”
was nothing less than the famous Heart of Midlothian itself, or Old
Tolbooth, which had served hitherto as the prætorium burgi, at once
the jail of Edinburgh, its Town Council House, the seat of the
Supreme Courts of Justice for Scotland, and the occasional meeting-
place of a Scottish Parliament. Little wonder if one lingered round
this core of the High Street and of the whole town. The channel of the
Luckenbooths on one side of the street, the lane between the
Tolbooth and St. Giles’s on the other, and the cross passage or Kirk
Stile, were worth more than one perambulation, if only on account of
their amusing interconnection; at the back of St. Giles’s Church,
overhanging the Cowgate, was St. Giles’s Churchyard, the chief
cemetery of the town; and the Tolbooth alone might well detain one
by its look and the interest of its associations. In 1561 they were
voting it to be too old and decayed, if not too unsightly, for the
various and important purposes which it had hitherto served; and
within a few months from our present date there was to be an order
for its demolition, and for the erection of another building more
suitable for those purposes, and especially for the accommodation of
the Lords of Council and Session. But, though they did then begin to
take it down, and though a “New Tolbooth” or “Council House” was
built near it in the same part of the High Street, the old or original
Tolbooth escaped its doom, and was left standing after all. A little re-
edified, it was to survive its more modern substitute, and to be
known till 1817 as at least the Jail of Edinburgh and real old Heart of
Midlothian. Some persons still alive can remember it.