Blood and Guts (36 page)

I was surprised when I started writing
Blood and Guts
how few books
are available on the history of surgery. There are some excellent
books on medicine, particular surgeons or episodes, but few
broader histories. If you want to find out more about a particular
era, surgeon or practice (such as lobotomy), I have listed some
suggestions below. A few of the books are out of print, but, thanks
to the wonders of the Web, are usually obtainable. Rather than give
a long list of my sources and references for this book, which would
run to a separate, sprawling and dull chapter, I thought it might be
helpful to point to some general sources of surgical history, facts
and inspiration.

I cannot recommend highly enough a visit to the Old
Operating Theatre Museum and Herb Garret near London Bridge
(
www.thegarret.org.uk
). Here, up a narrow winding staircase at
the top of a church, is the original operating theatre from St
Thomas' Hospital, complete with operating table and surgical
instruments from the early nineteenth century. The museum also
has displays on early medicines, bleeding and the development of
anaesthetics and antiseptics. One of my favourite exhibits is a walking
stick that a surgeon had his patients bite on during operations,
to help them cope with the pain. You can still make out the tooth
impressions.

Another fascinating museum is the Hunterian at the Royal
College of Surgeons near Lincolns Inn (
www.rcseng.ac.uk/museums
).
I have not written much about John Hunter (see Chapter 3),
but in the museum you will find an incredible collection of the
weird and wonderful. You will also see how much he achieved in
advancing our understanding of human biology.

If there is one single institution that made this book possible,
it is the Wellcome Library (on Euston Road in London). I have
spent many happy hours there, leafing through old books, papers
and journals. The library contains Robert Liston's books on
Victorian surgery and the case notes for the first anaesthetic. It
holds translations from Vesalius and Semmelweis, papers on the
first heart surgery, and even descriptions of groundhogs (see
Chapter 2). The biggest problem with the Wellcome Library is that
it is very easy to get diverted. I spent an afternoon reading graphic
case notes on early eye operations, only to realize that there was no
space for them in the book. The library is free to join and much
of it (particularly the images) is accessible online (
http://library.wellcome.ac.uk
).

The library is housed alongside the Wellcome Collection, where
you will find beautifully displayed surgical knives, cupping bowls and
an exhibition on the latest developments in biotechnology.

The book that I think gives the most complete account of
surgical history is
A History of Surgery
by Harold Ellis (Greenwich
Medical Media, 2000). Ellis is a world expert on surgical history, and
although the book was probably aimed at a medical and surgical
readership, it is clearly written and well illustrated. Unfortunately,
the book is out of print, but I understand a new edition is in the
pipeline. For a glimpse into the mind of a surgeon I recommend
Atul Gawande's thrilling and entertaining
Complications: A Surgeon's
Notes on an Imperfect Science
(Profile, 2002). In a similar vein David
Wootton's
Bad Medicine: Doctors Doing Harm since Hippocrates
(Oxford
University Press, 2006) suggests that, until relatively recently, doctors
were often doing more harm than good.

I also relied on several human physiology and anatomy textbooks.
I hope that, with their help, I have not made any glaring
errors in my anatomical explanations. The other book that proved
invaluable was my mum's nursing textbook from the 1940s,
A
Complete System of Nursing
(Temple Press, 1947) which gave useful
information on the treatment of patients and an alarming insight
into just how basic medical practice was even then (penicillin is
mentioned only briefly as it was not yet widely available, and anaesthetics
were still administered from a 'drop bottle' on to a mask).

Below are a few further reading suggestions:

The Greatest Benefit to Mankind
, Roy Porter (HarperCollins, 1997)
This substantial book covers the whole history of medicine, but is
readable throughout. Porter has written many books on medical
history, all of which are equally impressive.

Moments of Truth: Four Creators of Modern Medicine
, Thomas
Dormandy (John Wiley, 2003)

Stories about four of the people who helped shape modern medicine,
including an excellent section on Ignaz Semmelweis.

Seven Wonders of the Industrial World
, Deborah Cadbury (Fourth
Estate, 2003)

Based on the BBC series of the same title, it includes a section on
John Snow, and in the chapter on the transcontinental railroad
gives an excellent account of the environment that Phineas Gage
(see Chapter 5) would have worked in.

King of Hearts
, G. Wayne Miller (Crown, 2000)

Although the writing style is sometimes a bit sentimental, this is
nonetheless a gripping biography of Walter Lillehei.

The Knife Man
, Wendy Moore (Bantam Press, 2005)

An extremely entertaining and evocative biography of John Hunter.

Transplant: From Myth to Reality
, Nicholas L. Tilney (Yale University
Press, 2003)

This is a rather skewed account of transplant surgery from a US
perspective, but it does give an insider's overview of the discipline's
development. Far better, I think, is Joseph E. Murray's
Story of the
First Human Kidney Transplant
(Mitchell Lane, 2002).

There are three superb books relevant to the chapter on plastic
surgery:
Gillies: Surgeon Extraordinary
, Reginald Pound (Michael
Joseph, 1964);
Gladys, Duchess of Marlborough,
Hugo Vickers
(Weidenfeld & Nicolson, 1979) – a fascinating account of an
extraordinary life;
The Reconstruction of Warriors
, E.R. Mayhew
(Greenhill Books, 2004). I also recommend taking a look at
Jacqueline Saburido's website (
www.helpjacqui.com
).

An Odd Kind of Fame: Stories of Phineas Gage
, Malcolm Macmillan
(MIT Press, 2000)

This is a forensic account of Gage and the myths surrounding him. The
book is meticulously researched, but does come from an academic
perspective, so it can be a bit dry at times. However, Macmillan's
research in uncovering the story of Gage is truly impressive.

Harvey Cushing: A Life in Surgery
, Michael Bliss (OUP, 2005)

There is so much more to say about Cushing than I have been able
to, and it can be found in this well-written and accessible account of
his brilliant and complex life.

The Lobotomist
, Jack El-Hai (John Wiley, 2005)

If you read only one other book (apart from mine) on the history of
surgery, make it this one. It is superbly researched and entertainingly
written. If you want more, get a copy of
My Lobotomy
by Howard Dully
(Vermilion, 2008). It includes some of Freeman's original notes and
Dully's personal journey to try to understand why he was lobotomized.

The Terminal Man
, Michael Crichton (Arrow Books, 1972)

Although this is a work of fiction, in the light of some of the experiments
being conducted at the time, it turns out to be terrifyingly
close to reality.

Finally, if you want an insight into the, shall we say, hinterland of
medical research, I suggest taking a look at Alexis Carrel's
Man the
Unknown
(Harper & Bros, 1935) and
The Culture of Organs
(P.B. Hoeber,
1938). Likewise, José Delgado's
Physical Control of the Mind
(Harper &
Row, 1969) is worth flicking through, if only for the pictures.

Accident and Emergency (A&E)

acromegaly

Adams, Joseph

aggressive behaviour, controlling

alcohol

and hypothermia induction

as pain-reliever

Allies

American Academy of Arts and Sciences

amputation

accidental

arm

finger

hand

leg

in the Roman era

tying off of blood vessels

anaesthetic

chloroform

endotracheal intubation

ether

and plastic surgery

and wound exposure times

anatomy

16th-century ideas of

Galen's study of

ancient Greeks

Anderson, Thomas

aneurysm, aortic

animal studies

blood vessel closure

heart surgery

neurosurgery

transplant surgery

anti-coagulants

antibiotics

antibodies

antiseptic operating techniques

carbolic acid

in neurosurgery

salt solution

antisocial behaviour, controlling

aorta

aortic aneurysm

apothecaries

appointment of surgeons

Aristotle

arm

amputation

compound fractures

arrogance

arrow wounds

arteries

16th-century anatomy of

aorta

carotid

femoral

Galen on

iliac

and kidney dialysis

repairing

stemming the blood flow of

artists, Renaissance

Aryan race

Asclepius

assassinations

atomic weapons

atria

atrial septal defects

autopsies

see also
post-mortems

B cells

barbers

Barnard, Christiaan

Barnum's American Museum

basal ganglia

battlefields

see also
field hospitals; war wounds

Bavolek, Cecelia

BBC
see
British Broadcasting Corporation

BBC4

Beatrice, Princess

beauty, classical

bedlinen

Bellevue Hospital, New York

Bennett, A. Hughes

Bigelow, Henry

Bigelow, Henry Jacob

Bigelow, Wilfred Bill

Billroth, Theodor

black bile

Black Gang

bleeding to death

blood

circulation

clots

draining

Galen on

and heart-lung machines

William Harvey on

blood flow control

in heart surgery

in neurosurgery

without blood vessel damage

blood groups, AB negative

blood poisoning

blood pressure, high

blood transfusions

blood vessels

re-attachment

repairing

tying off

see also
arteries; veins

bloodletting

'cupping' technique

with leeches

scarifiers

bodysnatching

Bologna, Italy

bone nippers

bones
see
skeletons

Borel, Jean

Boschetti, Count Paolo Emilio

Boston Medical and Surgical Journal

'botched' operations

brain

activity

basal ganglia

dissection

donation to science

dura

electronic implants

frontal lobes

functional map of the

Galen's study of the

meninges

motor cortex

oxygen demands

'switching off'

see also
neurosurgery

brain damage

and personality change

brain tumours

brainwashing

breast cancer

breasts, male

Breindenbach, Warren

Britain, battle of

British Broadcasting Corporation (BBC)

see also
BBC4

British Medical Journal

bull-fighting

bullets

burns

Butler, Peter

Calne, Roy

Campbell, Gilbert

Canadian prairie, nr Toronto

cancer

breast

carbolic acid

cardiac surgery
see
heart surgery

Carlisle

Carnot, Sadi

carotid artery

Carrel, Alexis

Carstairs, Jane

Carter, Stuart

catgut sutures

cats

cauterizing

see also
electrocautery devices

cauterizing irons

cemeteries, bodysnatching from

Central Intelligence Agency (CIA)

Charles V, Holy Roman Emperor

Chicago

childbed (puerperal) fever

childbirth

children

lobotomised

chin operations

Chinese surgeons

chloride of lime

chloroform

dosage

fatalities

cholera

Church

Churchill, Frederick

Churchill, Winston

circulation

Clark, Sophie

cochlea implants

Columbus, Christopher

Conolly, Martin

convulsions

see also
fits; seizures

cooling bodies

Córdoba, Spain

Crichton, Michael

Crimean War

criminals

dissection

harvesting the organs of

skeletons

cross-circulation operations

'crow's beak' device

crush injuries

'cupping' technique

Cushing, Harvey

Cushing Tumour Registry

cyclosporine A

D-Day

Darwin, Charles

Deacon, Gladys, Duchess of Marlborough

death sentence

Delgado, José

Demikhov, V.P.

dentistry

Department of Health

dermatomes

Detroit riots

Devlin, Joe

DeWall, Dick

diabetes

digestive system

Dillon, Laura Maude (later Michael)

Dillon, Sir Robert

Dinoire, Isabelle

disease

see also
infection

dissection, human

brain

public

see also
autopsies; post-mortems

dog attacks

dog studies

'dressers' (assistant surgeons)

dressings

antiseptic

drink-driving

drugs

psychotropic

see also
immunosuppressive drugs

Dubost, Charles

Dully, Howard

Dully, Lou

dura (brain membrane)

duration of surgery

ears

Edinburgh

Edinburgh University

Edouard Herriot Hospital, Lyon

electric scalpels

electrocardiograph (ECG)

electrocautery devices

electroconvulsive shock therapy (ECT)

electroencephalograph (EEG)

electromagnets

electronic implants, brain

Elizabeth, Queen Mother

emotions

induction through brain implants

neurological basis

endotracheal intubation

enemas

England

English Channel

epilepsy

Ervin, Frank

ether

flammability

eugenics

euthanasia

Evans, Martin A.

explosives

face transplants

false teeth

fear

femoral artery

fever

field hospitals

see also
battlefields; war wounds

Fifteenth Thoracic Centre

First World War

fits

see also
convulsions; seizures

Flanagan and Allen

Flavell, J.M.

fluoroscopy

forceps

Ford, Henry

four humours

Foxley, Bill

fractures, compound

arm

infection

leg

France

François I

Freeman, Walter

French Resistance

French surgeons

frock coats

frontal lobes

frostbite

Gage, Phineas

Galen

Galenic medicine

gangrene

Gardener, Bill

gas attacks

George Washington University Hospital, Washington DC

Gibbon, John H. Jr

Gillies, Sir Harold

gladiators

Glasgow

Glastonbury, Somerset

Godlee, Rickman

gonorrhoea

Great Northern Railway

great saphenous vein

Greco, Vic

Greener, Hannah

Greenlees, James

Grenfell, Joyce

Grey Turner, George

Groote Schuur Hospital, Cape Town

groundhogs

growths

guillotine

Guinea Pig Club

gunpowder

Guthrie, Charles

Guy's Hospital, London

Hadlow, Janice

haemoglobin

haemorrhage

see also
bleeding to death; blood flow control

Hakim, Nadey

Hall, John

Hallam, Clint

Halsted, William

Hammatt, Alice

Hammersmith Hospital, London

hands

burns

transplants

hanged men

Hardy, James

Hariz, Marwan

Harken, Major Dwight

Harlow, John

Harrison, J. Hartwell

Harvard Medical School

Harvey, William

head injury

headaches

heart

16th-century anatomy of

atria

hole in the

normal

pericardium

ventricles

heart attack

sudden

heart surgery

animal-lung methods

closed-heart

cooling bodies for

cross-circulation operations

heart transplants

and heart-lung machines

open-heart

and stopping the heart

timing issues

heart valves

artificial

defects

heart-blocks

heart-lung machines

Lillehei-DeWall bubble oxygenator

Heath, Robert

Hebra, Professor

Henderson

heparin

Herrick, Richard

Herrick, Ronald

Herskowitz, Ida

hibernation

Hibernin

high blood pressure

Hill, Dr (brother of Luther)

Hill, Luther Leonidas

Hindu tradition

Hippocrates

Hitler, Adolf

Holtz, Howard

homosexuality

Hospital for Epilepsy and Paralysis, London

Hospital for Sick Children, Toronto

hospitalism

humours

Hunter, John

Hurricanes

Hutchinson, Ian

Hyde, Jonathan

hygiene

see also
antiseptic operating techniques

hypnotism

hypospadias

hypothermia

icepick lobotomies

immortality

immune system

radioactive suppression

tissue typing

and transplant surgery

immunosuppressive drugs

cyclosporine A

in transplant surgery

India

Indian medical practice

infection, hospital

inferior vena cava

Inquisition

Institut de Beauté, Paris

insulin

intensive care units

International Business Machine Corporation (IBM)

intestines

Ionesco, Ellen

Japan

Jewish Hospital, Louisville

John Radcliffe Hospital

Johnson, Jacqueline

Journal of the American Medical Association

Kantrowitz, Adrian

Keats, John

Kennedy, Joe

Kennedy, John F.

Kennedy, Rosemary

Kent, Duchess of

kidney dialysis

kidney (renal) failure

kidney transplants

kidneys

Kirklin, John W.

knee pain

knives, surgical

Kolff, Willem

Kolle, Frederick

Kolletschka, Jakob

Kostakis, Alkis

Lancaster bombers

Lancet
(journal)

Las Vegas

Laughlin, Henry

leeches

leg

amputation

compound fractures

Leonardo da Vinci

Leopold, Prince

Leroudier, Madame

leucotome

leucotomy

Lewis, F. John

ligatures

Lillehei, Walter

Lillehei-DeWall bubble oxygenator

Lindbergh, Charles A.

Lindbergh pump

Lister, Joseph

Listeria

Listerine mouthwash

Listerism

Liston, Robert

liver transplants

lobotomy

conscious

transorbital

Loman, Gladys

London

Longmore, Donald

Los Altos, California

Louisville, Kentucky

Louvain, Flanders

Lower-Austrian Mental Home

Lucas, William

Lumley, Second Lieutenant Henry

lung

transplants

lymphatic system

lymphocytes

B cells

T cells

Lyon

Macfee, Mr

Magill, Ivan

Marcus Aurelius

Mark, Vernon

Marlborough, 9th Duke of

Marlborough, Gladys, Duchess of

Marston, Robert

Massachusetts General Hospital, Boston

mastectomy

Mayo Clinic, Rochester

McBirnie, John

McCreadie, Rory

McIndoe, Archibald

Medical Mavericks
(TV series)

medicine

Meggison, Thomas

melancholy

Melrose, Denis

meninges

meningitis

mental health problems

mesmerism

metabolism, slowing of

Metrazol

miasma

micro-organisms

microsurgery

midwives

Miller, Bernard

Miller, Glenn

Minneapolis

mitral stenosis

mitral valve

Moniz, Egas

monkey studies

Montgomery, Alabama

mortality rates

200 per cent

300 per cent

from bloodletting

from childbed fever

from chloroform use

from heart surgery