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Sleisenger and Fordtran’s
Gastrointestinal
and Liver Disease
REVIEW AND ASSESSMENT
This page intentionally left blank

11 th
EDITION
Sleisenger and Fordtran’s
Gastrointestinal
and Liver Disease
REVIEW AND ASSESSMENT
Emad Qayed MD, MPH
Associate Professor of Medicine
Department of Medicine
Division of Digestive Diseases
Emory University School of
Medicine
Chief of Gastroenterology
Grady Memorial Hospital
Atlanta, Georgia
Nikrad Shahnavaz MD
Assistant Professor of Medicine
Emory University School of Medicine
Atlanta, Georgia
Elsevier
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
SLEISENGER AND FORDTRAN’S GASTROINTESTINAL AND LIVER DISEASE:

REVIEW AND ASSESSMENT, ELEVENTH EDITION ISBN: 978-0-323-63659-9
Copyright © 2021 by Elsevier, Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
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This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).
Notice
Practitioners and researchers must always rely on their own experience and knowledge in evaluating
and using any information, methods, compounds or experiments described herein. Because of rapid
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Library of Congress Control Number: 2020945517
Senior Content Strategist: Nancy Anastasi Duffy

Content Development Specialist: Kevin Travers
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Last digit is the print number: 9 8 7 6 5 4 3 2 1

DEDICATION
To my dear wife, Yara; and my children, Bassem, Zaina, and Mazen.
Emad Qayed
To my parents; my dear wife, Suzanne; and our beautiful children Andrew and Eliza.
Nikrad Shahnavaz
And to all of our colleagues, contributors, and trainees.
ACKNOWLEDGMENTS
The authors would like to thank Nancy Anastasi Duffy and Kevin Travers
for their valuable contributions in publishing this book.

CONTRIBUTORS
Shahzad Ahmed, MD Raj Dalsania, MD
Gastroenterology and Hepatology Fellow Gastroenterology and Hepatology Fellow
Department of Medicine Department of Medicine
Division of Digestive Diseases Division of Digestive Diseases
Emory University School of Medicine Emory University School of Medicine
Atlanta, Georgia Atlanta, Georgia
Chaitanya Allamneni, BA, MD Tanvi Dhere, MD

Gastroenterology and Hepatology Fellow Director of Inflammatory Bowel Diseases
Department of Medicine Associate Professor of Medicine
Division of Digestive Diseases Department of Medicine
Emory University School of Medicine Division of Digestive Diseases
Atlanta, Georgia Emory University School of Medicine
Atlanta, Georgia
Cameron Body, MD
Gastroenterology and Hepatology Fellow Mary Flynn, MD
Department of Medicine Assistant Professor of Medicine
Atlanta, Georgia
Jason M. Brown, MD
Assistant Professor Anthony Gamboa, MD
Department of Medicine Assistant Professor
Division of Digestive Diseases Digestive Diseases
Emory University School of Medicine Vanderbilt University Medical Center
Atlanta, Georgia Nashville, Tennessee
Lisa Cassani, MD Stephan Goebel, MD

Assistant Professor Associate Professor of Medicine
Department of Medicine Division of Digestive Diseases
Division of Digestive Diseases Emory University School of Medicine
Emory University School of Medicine Atlanta, Georgia
Atlanta, Georgia
Hazem Hammad, MD
Saurabh Chawla, MD Assistant Professor of Medicine
Associate Professor Division of Gastroenterology
Department of Medicine University of Colorado
Division of Digestive Diseases Aurora, Colorado
Director of Endoscopy Thuy-Van P. Hang, MD
Gastroenterology
Emory St. Joseph’s Hospital Gastroenterology and Hepatology Fellow
Atlanta, Georgia Department of Medicine
Jennifer Christie, MD Atlanta, Georgia
Professor of Medicine
Department of Medicine Amneet K. Hans, MD
Emory University School of Medicine Gastroenterology and Hepatology Fellow
Atlanta, Georgia
vii
viii Contributors
Heba Iskandar, MD, MSCI Angel B. Morales-Santiago, MD

Associate Professor of Medicine Transplant Hepatology
Anand Jain, MD Sobia Mujtaba, MD, MPH

Assistant Professor Gastroenterology and Hepatology Fellow
Steven Keilin, MD Ramzi Mulki, MD

Associate Professor of Medicine Gastroenterology and Hepatology Fellow
Director of Pancreaticobiliary Service Department of Medicine
Associate Director of the Advanced Endoscopy Fellowship Division of Digestive Diseases
Division of Gastroenterology Emory University School of Medicine
Atlanta, Georgia
Harini S. Naidu, MD
Jan-Michael A. Klapproth, MD Assistant Professor of Medicine
Associate Professor of Medicine Digestive Diseases
Division of Gastroenterology Emory University Hospital
University of Pennsylvania Atlanta, Georgia
Philadelphia, Pennsylvania
Mohammed Naseemuddin, BS, MD
Jennifer Kolb, MD Gastroenterology and Hepatology Fellow
Fellow Department of Medicine
Departments of Gastroenterology and Hepatology Division of Digestive Diseases
University of Colorado Anschutz Medical Campus Emory University School of Medicine
University of Colorado-Denver Atlanta, Georgia
Denver, Colorado
Rosemary Nustas, MD
Edward LeVert, MD Gastroenterology and Hepatology Fellow
Assistant Professor Department of Medicine
Atlanta, Georgia
Pramod Pantangi, MBBS
Julia Massaad, MD Assistant Professor of Medicine
Associate Professor of Medicine Internal Medicine–Gastroenterology
Department of Medicine Morehouse School of Medicine
Division of Digestive Diseases Atlanta, Georgia
Atlanta, Georgia Samir Parekh, MD
Ambreen Merchant, MBBS Department of Medicine
Research Scholar Division of Digestive Diseases
Department of Medicine Emory University School of Medicine
Atlanta, Georgia Mehul Parikh, MD
Ahmed Messallam, MD Department of Medicine
Gastroenterology and Hepatology Fellow Division of Digestive Diseases
Atlanta, Georgia
Contributors ix
Anand Patel, MD Gordon T. Robbins, BS, MD

Assistant Professor Gastroenterology and Hepatology Fellow
Division of Digestive Diseases University of Maryland Medical Center
Department of Medicine Baltimore, Maryland
Atlanta, Georgia Giorgio Roccaro, MD, MSCE
Assistant Professor
Vaishali Patel, MD, MHS Department of Medicine
Assistant Professor Division of Digestive Diseases
Atlanta, Georgia Sonali Sakaria, MD
Assistant Professor
Srikrishna Patnana, MD, MPH Department of Medicine
Assistant Professor Division of Digestive Diseases
Atlanta, Georgia Salih Samo, MD, MSCI
Gastroenterology and Hepatology Fellow
Meena Prasad, MD Department of Medicine
Director of IBD and Assistant Chief of Gastroenterology Division of Digestive Diseases
Gastroenterology Emory University School of Medicine
Atlanta VA Medical Center Atlanta, Georgia
Department of Medicine Kavya Sebastian, MD
Emory University School of Medicine Assistant Professor
Decatur, Georgia Department of Medicine
Emad Qayed, MD, MPH Atlanta, Georgia
Department of Medicine Anand S. Shah, MD
Emory University School of Medicine Assistant Professor of Medicine
Chief of Gastroenterology Department of Medicine
Grady Memorial Hospital Division of Digestive Diseases
Atlanta, Georgia
Shreya Raja, MD
Rushikesh Shah, MD
Department of Medicine Clinical Associate
Atlanta, Georgia
Mohammed A. Razvi, MD
Nikrad Shahnavaz, MD
Assistant Professor
Department of Medicine Assistant Professor of Medicine
Atlanta, Georgia
Preeti Reshamwala, MD
Melvin Simien, MD
Department of Medicine Gastroenterology and Hepatology
Division of Digestive Diseases Interventional Endoscopy
Emory University School of Medicine Director of Interventional Endoscopy
Atlanta, Georgia Gastroenterology and Hepatology
Morehouse School of Medicine
Atlanta, Georgia
x Contributors
Dharma Sunjaya, MD Joel P. Wedd, MD, MPH

Gastroenterology and Hepatology Fellow Assistant Professor
Cesar Taborda, MD, MSC Field Willingham, MD, MPH

Gastroenterology and Hepatology Fellow Director of Endoscopy
Emory University School of Medicine Professor of Medicine
Ravi S. Vora, MD Atlanta, Georgia
Atlanta, Georgia
PREFACE
In writing this 11th edition of Sleisenger and Fordtran’s Gas- book a standalone review tool. For those using this book as a
trointestinal and Liver Disease Review and Assessment, we have supplement to the main textbook, each answer has been ref-
been fortunate to work with an extremely talented group of erenced to its corresponding chapter to encourage readers to
faculty and fellows from our own division of digestive dis- review the subject comprehensively and sharpen their clinical
eases at Emory University, and also from prominent institu- knowledge.
tions nationwide. Similar to the previous edition, there is an online test com-
In this edition, we included revised and new questions that ponent that can be taken in an untimed study mode or in a
are board-style, case-based patient vignettes, with a strong timed assessment mode. We compiled two exams (200 ques-
focus on clinically relevant information. These questions test tions each, with four sections of 50 questions) that can be
medical knowledge, clinical reasoning and interpretation, and accessed in a timed mode to simulate the exam settings. If
problem-solving skills. The new edition mimics the format you are thinking of completing these exams, we recommend
of the gastroenterology board examinations in content, style, that you do this first, as they contain questions taken from
and number of questions for each section, and each question throughout this book.
has a single best answer. As with the previous edition, we We hope you enjoy testing and refining your gastroenterol-
avoided questions that have more than one correct answer ogy knowledge using this book as much as we enjoyed writ-
choice, as well as “all of the above,” “none of the above,” ing and editing these questions.
and “all except” types of questions. In writing and editing
the answers, we made sure every answer clearly explained Emad Qayed
the correct and incorrect answer choices, thereby making this Nikrad Shahnavaz
xi

LAB STUDIES REFERENCE
RANGES
American Board of Internal Medicine Laboratory Reference Ranges, January 2020
Laboratory Test Reference Range
Albumin, serum 3.5–5.5 g/dL
Alkaline phosphatase, serum 30–120 U/L
Alkaline phosphatase, bone specific 5.6–18.0 μg/L for premenopausal women
Alpha1-antitrypsin (AAT), serum 150–350 mg/dL
Alpha-fetoprotein serum Less than 10 ng/mL
Aminotransferase, serum alanine (ALT, SGPT) 10–40 U/L
Aminotransferase, serum aspartate (AST, SGOT) 10–40 U/L
Ammonia, blood 40–70 μg/dL
Amylase, serum 25–125 U/L (80–180 [Somogyi] units/dL)
Amylase, urine 1–17 U/hr
Antibodies to double-stranded DNA 0–7 IU/mL
Anti-F-actin antibodies, serum 1:80 or less
Antihistone antibodies Less than 1:16
Anti-LKM Less than 1:20
Antimitochondrial antibodies 1:5 or less
Antinuclear antibodies 1:40 or less
Anti–smooth muscle antibodies 1:80 or less
Bicarbonate, serum 23–28 mEq/L
Bilirubin, serum
Total 0.3–1.0 mg/dL
Direct 0.1–0.3 mg/dL
Indirect 0.2–0.7 mg/dL
Calcium, serum 8.6–10.2 mg/dL
CD4 (T4) lymphocyte count 530–1570/μL
Chloride, serum 98–106 mEq/L
Cholesterol, serum
Total
Desirable Less than 200 mg/dL
Borderline high 200–239 mg/dL
High Greater than 239 mg/dL
Copper, serum 100–200 μg/dL
Copper, urine 0–100 μg/24 hr
C-reactive protein 0.8 mg/dL or less
C-reactive protein (high sensitivity), serum Low risk = less than 1.0 mg/L; Average risk = 1.0–3.0 mg/L; High
risk = more than 3.0 mg/L
Creatine kinase, serum
Total Female: 30–135 U/L; male: 55–170 U/L
MB isoenzymes Less than 5% of total
Continued
xiii
xiv Lab Studies Reference Ranges
American Board of Internal Medicine Laboratory Reference Ranges, January 2020—cont’d

Creatinine clearance, urine 90–140 mL/min/1.73 m2
Creatinine, serum Female: 0.50–1.10 mg/dL; male: 0.70–1.30 mg/dL
D-dimer, plasma Less than 0.5 μg/mL
Electrolytes, serum
Sodium 136–145 mEq/L
Potassium 3.5–5.0 mEq/L
Chloride 98–106 mEq/L
Bicarbonate 23–28 mEq/L
Erythrocyte sedimentation rate (Westergren) Female: 0–20 mm/hr; male: 0–15 mm/hr
Fecal fat Less than 7 g/24 hr
Fecal pH 7.0–7.5
Fecal potassium Less than 10 mEq/L
Fecal sodium Less than 10 mEq/L
Ferritin, serum Female: 11–307 ng/mL; male: 24–336 ng/mL
Folate, red cell 150–450 ng/mL of packed cells
Folate, serum 1.8–9.0 ng/mL
Gamma-glutamyl transpeptidase, serum Female: 8–40 U/L; male: 9–50 U/L
Gastric secretion
Basal acid analysis 10–30 units of free acid
Basal acid output Female: 2.0 ± 1.8 mEq of HCl/hr; male: 3.0 ± 2.0 mEq of HCl/hr
Maximal output after pentagastrin stimulation 23 ± 5 mEq of HCl/hr
Gastrin, serum Less than 100 pg/mL
Haptoglobin, serum 83–267 mg/dL
Hematocrit, blood Female: 37%–47%; male: 42%–50%
Hemoglobin, A1c 4.0%–5.6%
Hemoglobin, blood Female: 12–16 g/dL; male: 14–18 g/dL
Immunoglobulins, serum
IgA 90–325 mg/dL
IgE Less than 380 IU/mL
IgG 800–1500 mg/dL
IgM 45–150 mg/dL
Insulin, serum (fasting) Less than 20 μU/mL
Iron, serum 50–150 μg/dL
Iron-binding capacity, serum (total) 250–310 μg/dL
Lactate dehydrogenase, serum 80–225 U/L
Lactate, arterial blood Less than 1.3 mmol/L (less than 1.3 mEq/L)
Lactate, serum or plasma 0.7–2.1 mmol/L
Lactate, venous blood 0.7–1.8 mEq/L; 6–16 mg/dL
Lactic acid, serum 6–19 mg/dL (0.7–2.1 mmol/L)
Leukocyte count 4000–11,000/μL
Segmented neutrophils 50%–70%
Band forms 0–5%
Lymphocytes 30%–45%
Monocytes 0–6%
Basophils 0–1%
Eosinophils 0–3%
Lipase, serum 10–140 U/L
Magnesium, serum 1.6–2.6 mEq/L
Magnesium, urine 14–290 mg/24 hr
Mean corpuscular hemoglobin 28–32 pg
Mean corpuscular hemoglobin concentration 33–36 g/dL
Lab Studies Reference Ranges xv
American Board of Internal Medicine Laboratory Reference Ranges, January 2020—cont’d

Mean corpuscular volume 80–98 fL
Mean platelet volume 7–9 fL
Osmolality, serum 275–295 mOsm/kg H2O
Osmolality, urine 38–1400 mOsm/kg H2O
Oxygen saturation, arterial blood 95% or greater
Phosphatase (alkaline), serum 30–120 U/L
Platelet count 150,000–300,000/μL
Potassium, serum 3.5–5.0 mEq/L
Prealbumin, serum 16–30 mg/dL
Total 5.5–9.0 g/dL
Albumin 3.5–5.5 g/dL
Globulin 2.0–3.5 g/dL
Alpha1 0.2–0.4 g/dL
Alpha2 0.5–0.9 g/dL
Beta 0.6–1.1 g/dL
Gamma 0.7–1.7 g/dL
Prothrombin time, plasma 11–13 seconds
Red cell distribution width (RDW) 9.0–14.5
Reticulocyte count 0.5%–1.5% of red cells
Reticulocyte count, absolute 25,000–100,000/μL
Sodium, serum 136–145 mEq/L
Specific gravity, urine 1.002–1.030
Transferrin saturation 20%–50%
Transferrin, serum 200–400 mg/dL
Triglycerides, serum (fasting)
Optimal Less than 100 mg/dL
Normal Less than 150 mg/dL
Borderline high 150–199 mg/dL
High 200–499 mg/dL
Very high Greater than 499 mg/dL
Urea nitrogen, blood 8–20 mg/dL
Urea nitrogen, urine 12–20 g/24 hr
Uric acid, serum 3.0–7.0 mg/dL
Uric acid, urine 250–750 mg/24 hr
Vitamin B12, serum 200–800 pg/mL
Zinc, serum 75–140 μg/dL
Modified from American Board of Internal Medicine, Philadelphia, Pennsylvania

CONTENTS
CHAPTER 1
Biology of the Gastrointestinal Tract�� 1
Emad Qayed and Mehul Parikh
QUESTIONS��1
ANSWERS��4
CHAPTER 2
Nutrition in Gastroenterology�� 8
Jason M. Brown, Nikrad Shahnavaz, and Vaishali Patel
QUESTIONS��8
ANSWERS��13
CHAPTER 3
Symptoms, Signs, and Biopsychosocial Issues�� 20
Heba Iskandar, Amneet K. Hans, Emad Qayed, and Ramzi Mulki
QUESTIONS��20
ANSWERS��32
CHAPTER 4
Topics Involving Multiple Organs�� 44
Jan-Michael A. Klapproth, Pramod Pantangi, Stephan Goebel, Shreya Raja,
Dharma Sunjaya, Lisa Cassani, and Emad Qayed
QUESTIONS��44
ANSWERS��66
CHAPTER 5
Esophagus�� 81
Rushikesh Shah, Field Willingham, Anand Jain, Salih Samo, and Ambreen Merchant
QUESTIONS��81
ANSWERS��89
CHAPTER 6
Stomach and Duodenum�� 98
Mohammed A. Razvi, Raj Dalsania, Anand S. Shah, and Mohammed Naseemuddin
QUESTIONS��98
ANSWERS��107
CHAPTER 7
Pancreas�� 117
Jennifer Kolb, Hazem Hammad, Saurabh Chawla, Ahmed Messallam, and Emad Qayed
QUESTIONS��117
ANSWERS��132
xvii
xviii Contents
CHAPTER 8
Biliary Tract�� 144
Emad Qayed, Anand Patel, Steven Keilin, Melvin Simien, and Anthony Gamboa
QUESTIONS��144
ANSWERS��160
CHAPTER 9
Liver�� 172
Edward LeVert, Angel B. Morales-Santiago, Mary Flynn, Giorgio Roccaro,
Nikrad Shahnavaz, Samir Parekh, Thuy-Van P. Hang, Ravi S. Vora, Mohammed Naseemuddin,
Preeti Reshamwala, Joel P. Wedd, and Cesar Taborda
QUESTIONS��172
ANSWERS��218
CHAPTER 10
Small and Large Intestine�� 249
Julia Massaad, Cameron Body, Kavya Sebastian, Gordon T. Robbins, Nikrad Shahnavaz,
Meena Prasad, Chaitanya Allamneni, Tanvi Dhere, Harini S. Naidu, Sonali Sakaria,
Jennifer Christie, Shahzad Ahmed, Srikrishna Patnana, Sobia Mujtaba, and Emad Qayed
QUESTIONS��249
ANSWERS��292
CHAPTER 11
Additional Treatments for Patients With Gastrointestinal and Liver Disease�� 329
Emad Qayed and Rosemary Nustas
QUESTIONS��329
ANSWERS��331
ILLUSTRATION CREDITS�� 334

Another random document with
no related content on Scribd:
The earliest reference to Parker Street (formerly Parker’s
Lane) so far discovered, belongs to February,[143] 1620, when mention
was made of “a way or passage of twenty feet broad, lately marked
out by the said Walter Burton, leading from Drury Lane to and
through the ground of the said Sir Charles Cornwallis, knight,
towards Holborn.”[144] The “marking out” of Parker Street took place
therefore between July, 1615, and February, 1620. There seems great
probability that the street owed its name, as suggested by Parton,[145]
to Philip Parker, who certainly had a share in building the houses
there.[146] That he actually held ground in the neighbourhood of
Parker Street is evident from the terms of Burton’s lease to Edlyn of
1620, when, in granting his own interest in the land on the south side
of Parker Street for a space of 520 feet westwards from the Rose
Field boundary, he adds: “and the said Thomas Burton grants to
Edmund Edlyn all the interest, right, claim or demand which he hath
or ought to have in and to that piece of ground holden by Philip
Parker.” In the Subsidy Rolls for 1620–21 and 1618–9, Philip Parker
is shown as residing in Drury Lane, perhaps the house (the third on
the east side, north of Parker Street) where William Parker was living
in 1646.[147]
The Council’s collection contains:—
[148] No. 166, Drury Lane. Stone tablet (drawing).
XXXI.—No. 18, PARKER STREET.
Ground Landlord.
Name unobtained.
General description and date of
structure.
No. 18, Parker Street seems to have been rebuilt in 1774.[149]
Plate 11 shows a typical ground floor front of an 18th-century
tenement in this parish. The window was probably provided with
stout shuttering for protection.
Condition of repair.
The house is in fair repair.
The Council’s collection contains:—
[150]No. 18, Parker Street. Exterior of ground floor (photograph).
No. 46, Parker Street. Exterior view, brick and weather boarded
structure (photograph).
No. 58, Parker Street. Exterior showing timber bay window
(photograph).
XXXII.—GREAT QUEEN STREET (General.)
The eastern part of Great Queen Street was formed upon

Purse Field, but the western and larger portion, together with Wild
Street and Kemble Street, occupies the site of the field known in
Elizabethan times as Aldwych Close. The boundaries of this close,
which had a reputed area of eight acres, were in the year 1567
described[151] as “the close nowe the quenes majesties called Dalcona
Close[152] on the easte parte, ... the lane leading frome the Strond
towardes the towne of Saynt Gyles aforesaid of the west parte, ... the
close of Sir Willm. Hollys and the gardyn belonginge to Drurye
House of the southe parte, and the close nowe the Quenes Majesties
called the Rosefelde on the north parte.” Of these boundaries the
northern is represented by the line dividing the houses on the south
side of Parker Street from those on the north side of Great Queen
Street,[153] and the eastern by the line of the court between Nos. 6 and
7, Great Queen Street, continued to meet Sardinia Place,[154] while the
southern corresponds with the old parish boundary.
Aldwych Close was included in that part of the property of the
Hospital of St. Giles which eventually came into the hands of Lord
Mountjoy, through his wife, Katherine, daughter of Sir Thomas Legh.
[155]
On 20th January, 1566–7, it was purchased of the Mountjoys by
Richard Holford, who was at the time actually in occupation of the
field.[151] Holford died on 12th January, 1569–70, leaving the
property to his son Henry, then aged 20,[156] during whose ownership
the field began to be cut up for building. In 1600 only two houses
were in existence on the close.[157] At about this time Holford began
to mark out the close and let portions on lease for building. There is
no complete record of these leases, but the largest transaction of the
kind was effected on 28th April, 1607, when Holford granted to
Walter Burton, who has already been mentioned in connection with
the development of Rose Field, a lease, for 51 years from the previous
Christmas, of “that peece or parcell of grounde latlie taken out of the
north side of the close of the said Henry Holford called Oldwych
Close ... as the same ys severed and divided ffrom the residue of the
same close with a pale latelie erected, and all that mesuage or
tenemente latelie erected uppon a parte of the said peece or parcell
off ground by one Henry Seagood, and nowe in the occupacion of the
said Henry Seagood, and alsoe twoe other mesuages or teñts with the
gardens, backsides, and garden plottes to the same adioyninge or
belongeinge in the tenure or occupacion of Humfrey Grey or his
assignees scituate on the west parte of Oldwych Close aforesaid, and
lately alsoe enclosed out of the said close.... And alsoe all that other
peece or parcell of ground which was then agreed and staked out to
be enclosed of and from the west side of the said close ... next
adioyninge unto Drewrie Lane.... By the name of three mesuages and
three acres of pasture with the appurtenances.”[158]
The three messuages in question can easily be identified.
Henry Seagood’s house occupied the site of Nos. 36–37, Great Queen
Street,[159] and the houses of Humphrey Grey (which no doubt were
the two houses in existence in 1600) are identified later[160] as The
White Horse, in Drury Lane, opposite Long Acre, and another house
(divided between 1635 and 1658 into two houses) adjoining it on the
north. The “three acres of pasture” was the remaining portion of the
triangular piece of ground now bounded by Drury Lane, Wild Street
and Kemble Street.[161]
From the foregoing it will be evident that by the year 1607
there were the merest beginnings of building on the Drury Lane
frontage of the close. The first two streets to be formed were those
now known as Kemble Street and Great Queen Street, the former
being probably an old public way leading across Aldwych Close and
Purse Field to Holborn, the route of which was afterwards marked by
the archway on the west side of Lincoln’s Inn Fields, and the latter
being in its origin a royal private way through the fields,[162] used as
the route to Theobalds, in Hertfordshire, James I.’s favourite
residence. Kingsgate Street (formerly existing nearly opposite the
northern termination of Kingsway), where there were two gates[163]
into the fields on either side of Holborn (see Plate 2), and Theobald’s
Road mark the continuation of the royal way. There was also at first
probably a gate[164] at the street’s western entrance,[165] which was
very narrow, and the first mention we have of the street seems to
refer to this. In a petition to the Earl of Salisbury, undated, but
evidently belonging to the period 1605–1612,[166] the “inhabitantes of
the dwellinges at the newe gate neere Drewry Lane” state that they
have petitioned the Queen (obviously Anne of Denmark, the consort
of James I.) “to gyve a name unto that place,” and have been referred
to him; they therefore request him to give it a name on her behalf.
It seems reasonable to conclude that it was as the result of this
application that the name “Queen Street” (or “Queen’s Street”)[167]
was given to the thoroughfare. Blott, indeed, states this as a fact, but
no entry in confirmation has been found in the Domestic State
Papers. Assuming, therefore, that the petition above mentioned had
reference to this street, and having regard to the probability,
amounting to practical certainty, that the plan of Purse Field
reproduced in Plate 2 dates from 1609,[168] it follows that the title
“Queen Street” must have been given during the period 1605–1609.
The name “Great Queen Street” used to distinguish it from “Little
Queen Street” does not seem to have been in common use until about
1670.[169]
The earliest buildings erected in Great Queen Street were,
contrary to the usual statements made in the matter,[170] on the north
side of the street. The dates at which this took place cannot,
unfortunately, be determined with certainty. Clanricarde House was
in existence in 1604.[171] Henry Seagood’s house (occupying the site of
Nos. 36–37) was built before April, 1607.[172] The site of Nos. 38–45,
which in 1597 contained only a forge, was built on by May, 1612.[173]
The site of Nos. 7–13 was leased for building purposes to Thomas
Burton on 7th May, 1611. These facts, fragmentary though they are,
seem to point to the north side of the street, so far as it was situated
in Aldwych Close, being built during the period 1603–1612.[174] In
this connection it is interesting to note the statement made, on
unknown authority, by Dobie,[175] that the house on the south side of
the street in which Lord Herbert of Cherbury died[176] was “one of the
fifteen built in the third year of James I. (1603).” The third year of
James I. was actually 1605–6, but it is quite certain that no houses
were built on the south side of Great Queen Street for over thirty
years afterwards. The date seems, however, to fit in well with the
facts concerning the north side of the street.
XXXIII.—No. 2, GREAT QUEEN STREET
(Demolished).
structure.
The eastern portion of Great Queen Street, comprising the
sites of Nos. 1 to 6 on the north side, and of all the houses above No.
69 on the south side, was formed on Purse Field.
On 30th July, 1638, Newton leased to William Sandfield a
portion of the ground, on which at some time subsequently, but
before January, 1640, a house was built. On 29th March, 1642, the
property is described[177] as a plot of ground having a breadth of 26
feet at the north end, and 25 feet at the south, and a length of 76 feet
on the east side, and 81 feet on the west; “scituate at the east end of
Queene Street, on the north side of it, between the highway there
leading to the Kinges Gate on the east, a certen lane called Parker’s
Lane on the north, and the King’s highway leading into Queene
Street on the south.” This is easily identifiable with the site of No. 1,
Great Queen Street, and other property in the rear.
On 14th January, 1639–40, Newton sold to Francis
Thriscrosse[178] a plot of ground having a breadth of 23 feet 4 inches
at the north end, and 22½ feet at the south, and a length of 81 feet
on the east side and 86 feet on the west, “and abutteth east upon a
peece of ground and the house thereon built let to William
Sandfeild,” Parker’s Lane on the north, and the King’s highway on
the south. On this plot a house had been erected, representing No. 2,
Great Queen Street. Similarly it may be proved that the site of No. 3
had been built on by Richard Webb by August, 1639.[179] As regards
Nos. 4 to 6, no sufficiently early deeds have come to light to enable
the date of building to be ascertained, but it is probable that all were
built about the same time.
It would seem that these six houses were superior to most of
the others erected on the north side of the street. Such is certainly
the impression derived from Hollar’s Plan of 1658 (Plate 3).
Moreover, Bagford, after alluding to the stateliness and magnificence
of the houses on the south side, goes on to say: “At ye other side of ye
way, near Little Queen Street, they began after ye same manner with
flower de lices on ye wall, but went no further.”[180]
The original buildings on the site of Nos. 1 and 2 were pulled
down about 1735, for a deed dated 7th February in that year,
referring to the site, describes it as “all that toft, peice or parcell of
ground, scituate in Great Queen Street on the north side of the same
street, and extending itself from Queen Street to Parker’s Lane,
together with the old ruinous messuage or tenement and the coach
house, stable, and other erections and buildings thereupon
standing.”[181] Moreover in the sewer ratebook for 1734, there is a
note against the house: “Pulled down and rebuilt.”
The second building on the site of No. 2 was demolished in
connection with the formation of Kingsway. The front had little
architectural merit, judging from a water colour drawing by T. H.
Shepherd, dated 1851, now in the Crace Collection.[182]
The interior had a notable mahogany staircase (Plates 12 and
13) of six flights, the four lower ones having carved brackets, while
the upper part had straight strings more simply treated.
The beautiful balustrade and decorative details were
preserved by the London County Council when the house was pulled
down, and have been lent to and exhibited at the London Museum.
Biographical notes.
The indications as to who exactly were the occupants of particular
houses on the north side of Great Queen Street during the 17th century are
not always very clear, and the following list of persons occupying No. 2 is
perhaps occasionally during the period named open to suspicion:—
1646. Sir M. Lumley[183] (?)

Before 1664 to after 1675. Matthew Hewitt.
Before 1683 to 1700. Henry Moreland.
1700 to after 1720. Samuel Knapton.
1727. Susan Knapton.
1734–75. John Crofts.
1784– Poyser Roper.
Sir Martin Lumley, of Bardfield Magna, Essex, son of Sir Martin

Lumley or Lomley, Lord Mayor of London (1623–4), was born about 1596.
He was sheriff of Essex, 1639–40; and was M.P. for that county in the Long
Parliament, from February 1641, until secluded in December, 1648. He was
created a Baronet on 8th January, 1641, being knighted at Whitehall on the
day following. He died about 1651.[184]
In the Council’s collection are:—
[185]Mahogany staircase, ground to second floor, and second to third
floor (measured drawing).
[185]Mahogany staircase, do., do., details (measured drawing).
XXXIV.–XXXVI.—Nos. 26 to 28, GREAT
QUEEN STREET.
Ground landlord.
The names of the ground landlords of Nos. 27 and 28 have not
been obtained.
structure.
The date of erection of the original houses on the sites of Nos.
26 to 35 is uncertain. The Subsidy Roll for 1628–9, however, among
its few (12) entries relating to Queen Street, contains the names of
three persons[186] who are known to have lived in this row, and that
for 1620–21 contains one;[187] it is therefore fairly certain that the
houses on the site of Nos. 26 to 35 were already in existence by the
latter date.
The ground on which they stood had, it is known, been let on
building lease for a term expiring at Christmas, 1657, and it seems
more than likely that the lease in question was that granted to Walter
Burton on 28th April, 1607. It will be noticed[188] that a part of that
grant comprised a piece of ground taken out of the north side of the
close, and Henry Seagood’s messuage erected on a part of that piece.
Now Seagood’s house occupied the site of Nos. 36–37[189], and the
piece of ground alluded to above certainly did not extend to the west
of Seagood’s house, as that property (the site of Nos. 38 to 45) had
already been disposed of by Holford. It seems, therefore, probable
that it included the ground to the east of the house, thus taking in the
site of Nos. 26 to 35.
The earliest description of the property which has been found
is dated 30th May 1661,[190] where, evidently repeating the account
given in the lease of 1636 (when it was let for 51 years as from 27th
December, 1657) it is referred to as “all those severall messuages or
tenements ... with their appurtenances, scituate, lying and being on
the north side of ... Queene Street ... now or late in the several
tenures of [here 13 names are given]; abutting upon a messuage or
tenement now or late in the tenure ... of John Sparkes, his assigne or
assignes, on the east, and on a messuage or tenement, now or late in
the tenure of one Henry Seagood, his assigne or assignes, on the west
part, and the said Queene Street on the south ...; all which said
messuages ... conteyne in length from east to west 180 feet ... and in
breadth from north to south 60 feet.” It is clear from the entries in
the ratebooks that the original houses on the sites of Nos. 27 and 28
were pulled down between 1723 and 1734, a period which agrees
perfectly with the evidence of the dates on the cisterns mentioned
below.
The present houses have three floors in addition to a
basement and an attic storey. The fronts are treated in brickwork.
No. 27 contains an ornamental cast lead cistern (Plate 15) dated
1733, and in No. 26 is a cistern of somewhat similar design, bearing
the initials B.B. and the date 1725. On the latter house is a cast lead
rain-water head illustrated on Plate 15.
The only external features of interest are the two doorcases,
side by side, which are of deal with Roman Doric pilasters, block
entablatures and pediments. The doorways are recessed, and have
elliptical arches, enclosing fanlights, as shown by the measured
drawing (Plate 14).
The staircase of No. 27 has the original carved brackets. That
of No. 28 is modern.
DEAL STAIR BRACKET TO OUTER STRING TO No. 27 GT.

QUEEN ST.

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The eastern part of Great Queen Street was formed upon

1646. Sir M. Lumley[183] (?)

Sir Martin Lumley, of Bardfield Magna, Essex, son of Sir Martin

DEAL STAIR BRACKET TO OUTER STRING TO No. 27 GT.

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Full download Sleisenger and Fordtran's Gastrointestinal and Liver Disease Review and Assessment 11th Edition Emad Qayed file pdf all chapter on 2024

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