Pierre Dionis and the Franco-British dialogue in surgery

Pierre Dionis (1643??1718), though not himself a very innovative surgeon, has been acclaimed as the author of a surgical textbook that opened a new era in which French surgical teaching dominated Europe. This dominance is reflected in the Gordon Craig Library, which contains four copies of the book by Dionis in English translation, as well as a number of other books by influential French 18th century surgical writers, notably Henri François Le Dran and François Quesnay. It is significant that many of these writers benefited from government patronage in various forms. Dionis himself began his career as demonstrator in anatomy and surgery at the Jardin du Roi, in his time the premier teaching institution in those sciences. He later became a court surgeon. During the course of the 18th century, French surgery gained ascendancy over French academic medicine and also on the inter­national stage. English surgery, likewise, made great progress. There was a very productive dialogue between medical scientists and teachers in both countries, assisted by textbooks in translation. The French Revolution demolished the medical and surgical institutions established under the old regime, but French surgery emerged from the rubble to play a great part in the birth of modern clinical medicine     

Dr Nicolaes Tulp of Amsterdam, 1593-1674: anatomist and doctor of medicine

The renowned Dr Nicolaes Tulp of seventeenth century was a practising surgeon and physician, a civic leader and an anatomist who was appointed Praelector in Anatomy to regularize public dissections, and he was also charged by the Surgeons' Guild to apprentice surgeons. Rembrandt's famous painting 'The Anatomy of Dr Tulp' brought growing recognition not only to the painter for his artistry, but also to the surgeon for it introduced a new dimension into anatomical paintings by displaying both anatomical detail and muscle function. Tulp's interests included botany, drug therapy and the production of the official Dutch Pharmacopoea. In civic affairs too, he played an important role, becoming the Mayor of Amsterdam as well as a judge - he was indeed a most noteworthy citizen of his time.     

The monarch and the master: Peter the Great and Frederik Ruysch

The extraordinary European journey of Tsar Peter the Great and his passage to Amsterdam, The Netherlands, allowed him to meet a great figure of medical history who offered insight into the mysteries surrounding the structure of the human body. The famous Dutch anatomist Frederik Ruysch, preeminent in dissection and anatomical preservation, impressed the emperor and inspired his love for anatomy and surgery. Peter the Great was fascinated by the study of the structure of the human body and spent many hours in the anatomical cabinet of Ruysch. This impressive collection of cadavers and anatomical specimens, described as "a perfect necropolis," was both a laboratory for teaching anatomy and a bizarre and unique form of art. The profound and enduring impression that the West made on the emperor also led him to modernize the medical services in his homeland, Russia.     

Herbert Moran Memorial Lecture. Exploring the legacy of history

Herbert Michael Moran was born on 29 April 1885 in Sydney and died on 20 November 1945. I never had the good fortune to meet him but in 1946, when I was a fourth year medical student in Brisbane, I purchased a small brown-coloured book called Beyond the Hill lies China. To this day I cannot recall what led me to that purchase but I have looked at it from time to time over the past years and found it increasingly evocative of my own student and early hospital days. I have drawn deeply from the previous Moran lectures, particularly Sir John Loewenthal's lecture in 1974, which revealed for me the greatest detail about the man himself. I am indebted to Colin Smith, the College Archivist, for information held in his files; and Michael Moran who is here today for a number of personal reminiscences as well as family memorabilia. Moran was intensely interested in history. He was the founder of the first society dedicated to the study of the history of medicine in Australia, and through this activity he met the physician Leslie Cowlishaw whom he introduced to the College with the aim of securing Cowlishaw's 'vast knowledge of medical history and (his) wonderful library'. By a nice coincidence the third Cowlishaw Symposium was held at the College just 3 days ago, and Moran's College legacy is thereby increasingly recognized.     

Medicine, Gabriel García Márquez, and 'Love in the time of cholera'

The Nobel award-winning author Gabriel García Márquez (born 1927) originally released his book Love in the Time of Cholera in Colombia in 1985. For us physicians and surgeons this book contains lessons about medical humanities and the opportunity to apply them to our profession. Dr. Juvenal Urbino, one of the book's central figures, is a distinguished physician with impeccable training in Paris in the late 1870s to early 1880s. He returned to his native Colombian Caribbean coast to practice medicine and surgery. There his practice set an example for contemporary and future generations of physicians. Urbino was knowledgeable, dedicated, committed, studious, and well-intentioned. He mastered the humanities to the benefit of patients and society alike. He was an outstanding professor at the medical school and a favorite teacher to his attentive students. For all his good virtues, however, he did not serve the poor as much as he should have, possibly as a consequence of his opulent origin in the District of the Viceroys of his natal city. In short, Dr. Urbino brought to the medical profession a bright example of responsibility, professionalism, and integrity. Thus, he should be remembered as a physician and professor worthy of imitating in today's practice of medicine.     

English roots of medical education in Australasia: Kenneth F. Russell memorial lecture

Some individuals have a heightened perception of history. K. F. Russell was one of these gifted people, and he wrote many books and papers on historical subjects. Two are classics: his history of the Melbourne medical school and his catalogue of the historical books in the library of the Royal Australasian College of Surgeons. Among the books catalogued by Russell is a small work by James Paget entitled Records of Harvey: In Extracts from the Journals of the Royal Hospital of St Bartholomew. This book recalls Paget's career as a teacher and reformer in medical education during the second half of the 19th century, and also his role in drafting a model curriculum for Australia's first university medical school, in Melbourne. Medical education in Melbourne and Adelaide was largely moulded by Paget and other leading London teachers. Cambridge was also influential in Adelaide. Scottish influences were stronger in Dunedin and Sydney. In the two decades before World War I, many graduates from these new medical schools went to Britain for postgraduate experience. They were assisted by British educational institutions inspired by the contemporary ideology of imperialism.     

Medicine,Gabriel García Márquez,and Love in the Time of Cholera

The Nobel award-winning author Gabriel García Márquez (born 1927) originally released his book Love in the Time of Cholera in Colombia in 1985. For us physicians and surgeons this book contains lessons about medical humanities and the opportunity to apply them to our profession. Dr. Juvenal Urbino, one of the book's central figures, is a distinguished physician with impeccable training in Paris in the late 1870s to early 1880s. He returned to his native Colombian Caribbean coast to practice medicine and surgery. There his practice set an example for contemporary and future generations of physicians. Urbino was knowledgeable, dedicated, committed, studious, and well-intentioned. He mastered the humanities to the benefit of patients and society alike. He was an outstanding professor at the medical school and a favorite teacher to his attentive students. For all his good virtues, however, he did not serve the poor as much as he should have, possibly as a consequence of his opulent origin in the District of the Viceroys of his natal city. In short, Dr. Urbino brought to the medical profession a bright example of responsibility, professionalism, and integrity. Thus, he should be remembered as a physician and professor worthy of imitating in today's practice of medicine.     

Illustrations of neurosurgical techniques in early period of Ottoman Empire by Şerefeddin Sabuncuoğlu

Summary   Background. Şerefeddin Sabuncuoğlu (A.D. 1385–1468) was the author of the first illustrated surgery atlas Cerrahiyyetü’l Haniyye (Imperial Surgery), which was written in Turkish in 1465. The purpose of this report is to present his unique contribution to modern neurological surgery. Methods. Cerrahiyyetü’l Haniyye consists of 412 pages in three chapters, in which there are a total of 191 sections dealing with a variety of surgical specialties, including neurosurgery. In each section of the book, a sentence written in rhyme and meter gives the diagnosis, classification and surgical technique in detail. Şerefeddin Sabuncuoğlu describes medical and surgical management of neurological diseases such as spinal trauma, epilepsy, migraine, facial palsy, hemiplegia, low back pain, cranial fracture, hydrocephalus and abscesses of the head in his textbook. Conclusions. Şerefeddin Sabuncuoğlu was a great surgeon in Turkish medical history and the sections on neurological diseases in Cerrahiyyetü’l Haniyye are of great importance in neurosurgery. Today, he is justified as a pioneer of surgery, an investigator and a medical illustrator in the early period of Ottoman Empire. His atlas is a modification of original contributions from earlier treatises.     

The "schola medica salernitana": the forerunner of the modern university medical schools

The schola medica salernitana is considered the oldest medical school of modern civilization. Salerno's long medical tradition began during the Greco-Roman period in a Greek colony named Elea, where Parmenides decided to found a medical school. The fame of the school became more and more important during the 10th century, and it was best known in the 11th century. In the middle of 12th century, the school was at its apogee, and Salerno provided a notable contribution to the formulation of a medical curriculum for medieval universities. The most famous work of the Salernitan School was the Regimen Sanitatis Saleritanum, a Latin poem of rational, dietetic, and hygienic precepts, many of them still valid today. The school also produced a physician's reference book, with advice on how to treat a patient, a sort of code of conduct to help the physician to respect the patient and his or her relatives. The first science-based surgery appeared on the scene of the discredited medieval practice in Salerno, thanks to Roger of Salerno and his fellows. He wrote a book on surgery, called Rogerina or Post Mundi Fabricam, in which surgery from head to toe is described, with surprising originality. The important contribution to the School of Salerno made by women as female practitioners is outlined, and among them, Trotula de Ruggiero was the most renowned. The period when the School of Salerno, universally recognized as the forerunner of the modern universities, became a government academy was when Frederick II reigned over the Kingdom of the Two Sicilies, as Emperor of the Holy Roman Empire.     

Artificial impaction in hip fracture. By F. J. Cotton, 1911

Frederic Jay Cotton (Fig. 1) was born in Prescott, Wisconsin, and educated at Harvard. After postgraduate study in New York and in Europe, he returned to Boston where he had an association with most of the important hospitals. In addition to great surgical talent, he also was an able administrator and medical politician. He is remembered primarily for his work on fractures, which is summarized in his book, Dislocations and Joint Fractures. The two editions of this book were illustrated by many of the author's own drawings. Cotton was a founder of the American College of Surgeons and served as Regent of the College as well as on the Committee on Fractures. He served in both the Spanish American War and World War I. In the summer of 1918, he was the Chief of Surgery at Walter Reed Army Hospital in Washington, D.C. This article on "Artificial Impaction in Hip Fracture" is an example of the application of a clinical observation to the development of an improvement in the care of patients. It had been known for a long time that impacted fractures of the neck of the femur healed, while displaced fractures did not. Cotton was the first to suggest that impaction, after reduction of the fracture, would be of value. Cotton published three additional papers on the use of impaction in the treatment of hip fractures, the last in 1938, the year of his death. Impaction of fractures of the neck of the femur after reduction of the displacement was rapidly incorporated into all of the procedures for internal fixation of such injuries.     

SIR DOUGLAS SHIELDS (1876–1952) A FORGOTTEN AUSTRALIAN SURGEON*

The remarkable and colourful career of sir douglas shields of melbourne is unparalleled among australian surgeons of his generation: murray morton describes it as a romance. He graduated in 1897 and was, in turn, a country general practitioner, the principal medical officer of an overcrowded plague-ship bringing home soldiers from the boer war, senior surgeon of st vincent's hospital. Melbourne then, in london, surgeon-in-chief of his own hospital converted to the ‘hospital for wounded officers’ with promotion to the ranks of brigadier-general and rear-admiral, then knighted and, finally, a consultant surgeon with private hospitals in park lane and in cannes, and with patients largely drawn from the aristocracy, the rich and the famous. His name is now virtually forgotten in australia but, for many years after he left melbourne in 1912, stories used to be told about his career and experiences, many of which had little basis in fact, and even the two brief biographical accounts of his career by murray morton and ormond smith contradict each other. This paper will, i hope, help to preserve the memory of sir douglas shields whom ormond smith considered ‘one of the brightest ornaments of the medical school of the melbourne university’.     

Anatomy Lessons by the Amsterdam Guild of Surgeons. Medical Education and Art

The Amsterdam Guild of Surgeons organized lessons in anatomy as part of the education of surgical trainees and surgeons. Appreciating that the acquisition of correct anatomical knowledge by regular perceptive education during dissection of the human body was essential for surgeons, in 1555 Philip II, King of Spain and Holland, gave his permission to the Amsterdam Guild of Surgeons to perform anatomical dissections on bodies of deceased humans. The anatomy instructors, called “praelectores anatomiae”, who were always academically educated medical doctors, were appointed by the guild for the teaching of anatomy. They commissioned painters to produce group portraits, with the “praelector anatomiae” delivering an anatomy lesson as the central figure. Probably the best-known of such paintings is the masterpiece of Rembrandt van Rijn (1632) "The anatomy lesson of Dr. Nicolaes Tulp". Although these paintings are historical portraits rather than authentic pictures of an anatomical dissection, today this series of paintings of the Amsterdam Guild of Surgeons still reminds us of this essential part of the surgical training programme. While anatomy lessons on bodies of deceased humans was already an obligatory and crucial part of the medical (i.e., surgical) education in the 16^th century, nowadays many medical schools unfortunately do not provide such practical anatomy lessons for their students, for whom usually only theoretical lessons and textbooks constitute the educational tools for learning human anatomy.     

First colored illustration and detailed description of hermaphroditism by a Turkish surgeon, Serefeddin Sabuncuoğlu, in the 15th century

Cerrahiyyetü'l-Haniyye (Imperial Surgery), written by the surgeon Serefeddin Sabuncuo?lu in the 15 century, is the first illustrated surgical book in Turkish-Islamic literature containing human figures. Sabuncuo?lu had begun a new era by demonstrating for the first time the application of many surgical methods on human beings, with illustrations in the style of miniatures in his handwritten work. This was a first in medical history, and, owing to this property, Sabuncuo?lu's book was one of the most important original works of that period. In this study in which we aim to examine Sabuncuo?lu's surgical book, in particular with regard to the disease of hermaphroditism, we first demonstrated the historical development of the subject through general sources. From sources concerning Sabuncuo?lu, we gathered information on his life and works. Then, examining the information on hermaphroditism in Sabuncuo?lu's work, we discussed this information in light of our current knowledge.     

The papal anatomist: Eustachius in renaissance Rome

Bartholomeo Eustachi, usually latinized as Eustachius, was an important anatomist in the 16th century, arguably second only to his contemporary and rival Andreas Vesalius. He was the first to identify several important anatomical structures, including the suprarenal glands, though he was probably not the first to describe the Eustachian tube. However, it has been hard to evaluate his achievements, because during his lifetime he published only some short monographs, and his career as a teacher in Rome is not well documented. He and his assistant P.M. Pini were the first to use copper plate engravings to illustrate human and animal anatomy, but most of their engravings were not published in their time, and the original plates were lost for some 140 years after the death of Eustachius. Early in the 18th century, these plates were rediscovered by the anatomist and papal physician G.M. Lancisi; he published the engravings in a book which aroused much interest and many reprintings. In 1744, Bernhard Siegfried Albinus of Leiden University published a version of these engravings, with commentaries by himself. The engraved illustrations prepared by Eustachius and Pini are clear and largely accurate. They idealize the findings of actual dissections, and have a diagrammatic quality that facilitates understanding and memory. They are the ancestors of later anatomical atlases, which have helped generations of surgeons in teaching and in planning operations.     

The History of Surgery According to Owen Wangensteen

Owen Wangensteen (1898–1981), the great Minnesota surgical master, made a firm and intense dedication to the history of surgery from the early stages of his exemplary surgical career. While in Germany and Switzerland, he learned from distinguished European professors and clearly realized the importance of history on the understanding and appreciation of important surgical problems. In 1928, on returning to Minneapolis, he began his quest to introduce history into many of his clinical and research laboratory works. In 1930, he attained the surgery chairmanship at the University of Minnesota, and there he excelled until his retirement from surgical practice in 1967. Throughout his career and until he died in 1981, the history of surgery was his continuous and persistent companion. In fact, this discipline, the history of surgery, was indeed part of the family, since his wife Sally Davidson Wangensteen was a dedicated contributor to their common papers and the scholarly jewel of their work, the monumental treatise, The Rise of Surgery: From Empiric Craft to Scientific Discipline.     

"Most brilliant in judgment": Alexander the Great and Aristotle

From historical sources, it is evident that Alexander the Great was indebted to one of his teachers, Aristotle of Stagira. It was the teaching of Aristotle that evoked all the nascent talents of young Alexander and turned him into a great man. Alexander was extremely interested in the secrets of medicine and considered it an art. The medical knowledge he acquired from Aristotle may have saved his life and the lives of his troops on many occasions. If Alexander did not possess medical knowledge and if his everyday life had not been so greatly influenced by medicine, he might never have been able to create his empire.     

Four moral questions for human embryonic stem cell research

Human embryonic stem cell research offers great promise for the treatment of many serious disease conditions in a variety of medical areas, including wound healing. Before this promise can be realized, society and individual researchers, clinicians, and patients will have to answer four ethical questions: 1) Can we ever intentionally destroy a human embryo? 2) Can we benefit from others' destruction of embryos? 3) Can we create an embryo to destroy it? 4) Can we clone human embryos? After outlining the issues raised by each question, the author concludes by indicating his own affirmative answer to each of these questions.     

George Guthrie (1785-1856): surgeon to the Duke of Wellington, and a pioneer thoracic surgeon

George Guthrie had a distinguished career as a soldier, surgeon and medical reformer. He revolutionized military surgery following his active service during the Peninsular War in Spain and Portugal. His book Commentaries on the Surgery of War was based on this experience and was updated continuously; it remained the standard military text for half a century. During this campaign, he also struggled to improve the poor administration of the Army Medical Service. He had little respect for established dogma and was a man of great humanity and integrity who based his opinion on personal statistical observation together with his own anatomical and postmortem studies. His influence on surgical thinking was enormous and he was three times the President of the Royal College of Surgeons of England.     

Dr George Home: Royal Australasian College of Surgeons Fellow 169

George Home was Fellow number 169 of the Royal Australasian College of Surgeons. He was born in San Francisco in 1870, coming to New Zealand as an infant. He overcame the early death of his father to excel at school and graduate top of his class at the University of Edinburgh in 1892. During his time in Edinburgh, he was taught by Lord Lister and developed a lifelong interest in surgical asepsis and antisepsis. After working in Liverpool for five years, he returned to New Zealand and commenced practice as a surgeon in New Plymouth in 1899. He remained in New Plymouth for the remainder of his life, although served with distinction in World War I and was the longest serving New Zealand medical officer in the Gallipoli Campaign. Upon his return to New Zealand after World War I, he founded and developed many community institutions and was a noted amateur alpinist, photographer and botanist. He died in 1956 after a lifetime dominated, not by one single achievement, but by much service to his community.     

Claude Bernard's philosophy of medical science

The great French physiologist Claude Bernard (1813-1878) spent most of his life in Paris, where he held academic appointments and was active in a variety of research fields. In addition to his many contributions to medical science his views on experimental procedure and on philosophy have had an important influence on the development of medical science.