Mackenzie’s great reputation earned him the title of Father of British Laryngology. In 1863 he founded the Golden Square Throat Hospital, London, the first hospital in the world devoted solely to diseases of the throat; he was also the founder of the Journal of Laryngology. He was called to attend Crown Prince Frederick, afterwards Emperor Ferderick III of Germany, who suffered from, and succumbed to, a cancer of the larynx. Mackenzie was much maligned by a section of the German medical profession for refusing to agree to operation until biopsy had been performed. Three specimens proved negative and operation was delayed until too late. Mackenzie’s health was affected by his arduous duties on behalf of the Emperor and he died in 1892. The Manual was the standard work on the subject and had an important influence on the development of laryngology.