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Sir Charles Alfred Ballance was born in Clapton, Middlesex, in 1856. He was educated at Taunton College under the Rev William Tuckwell, and afterwards in Germany. He entered St Thomas's Hospital where he served as house-surgeon and was for a time demonstrator of anatomy. At the University of London he gained one of the gold medals at the examination for the BS in 1881. He was appointed aural surgeon to St Thomas's Hospital in 1888. He quickly developed the department, practically and scientifically. He was among the first to perform the radical mastoid operation with ligation of the jugular vein and drainage of the lateral sinus. He further improved the operation by lining the cavity in the mastoid with an epithelial graft. He was made assistant surgeon in 1891, and surgeon in 1900. He held office until 1919 when he resigned and was appointed consulting surgeon. He was also elected surgeon to the National Hospital for the Paralysed and Epileptic in Queen Square, Bloomsbury, 1891-1908. He was chief surgeon to the Metropolitan Police, 1912-1926. Having already accepted a commission as captain a la suite, to which he was gazetted in 1908, in the newly formed RAMC branch of the territorial force, Ballance was called up on the outbreak of World War One, and attached to the second London (City) general hospital. He was promoted temporary colonel AMS in 1915 and was ordered to proceed to the Near East. Here he was posted as consulting surgeon at Malta with Sir Charters Symonds, FRCS as his colleague. The two surgeons organised, supervised, and inspired with enthusiasm the large number of emergency hospitals required during the Gallipoli campaign. For his services he was given an honorary MD by the University of Malta, became a Knight of Grace of the Order of St John of Jerusalem, was decorated CB (military) in 1916, and was made a KCMG in 1918. At the Royal College of Surgeons, Ballance was an examiner in anatomy, 1887-1891; a member of the Court of Examiners from 1900-1919; served on the Council, 1910-1926; and was a vice president in 1920. He was Erasmus Wilson lecturer, 1888-1889; Bradshaw lecturer, 1919; Vicary lecturer, 1921; Lister memorial lecturer, 1933, and received the Lister memorial medal for his distinguished contributions to surgical science. Finally he gave the Macewen memorial lecture at Glasgow. He served as President of the Medical Society of London in 1906 and was the first President of the newly founded Society of British Neurological Surgeons in 1927. He only held office for a year, but on resigning he was elected honorary president. He died in 1936.