This institution, the first general infirmary in Upper Canada, began operation in 1829. It was periodically hampered by administrative and financial difficulties but through the initiative of the influential businessman, Sir Joseph Flavelle, Chairman of its Board of Trustees (1904-21), services were reorganized and steps taken for the construction here of a new hospital. Designed by the firm of Darling & Pearson, it was begun in 1911 and officially opened two years later. Toronto General Hospital quickly moved to the forefront of Canadian medicine as an outstanding teaching and research centre. In association with the University of Toronto, Connaught Laboratories and other institutions, it achieved international recognition in the fields of radiology, heart surgery, and the treatment of diabetes, arthritis, and kidney and vascular disease.