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Who were they?
Current Orthopaedics (2002) 16, 240 ^242 doi:10.1006/cuor.2002.0274, available online at http://www.idealibrary.com on
Who were they? Question 1 He was born in Belfast in 1888 and after graduation at Queen’s University he worked as House Surgeon for Sir Robert Jones in Liverpool. He was recalled from the Great War to Alder Hey Military Orthopaedic Hospital in Liverpool. He became Liverpool’s ¢rst Professor of Orthopaedics in 1938. He wrote about oblique displacement osteotomy of the hip for arthritis and a sign for posterior horn meniscal tears. His dexterity as an operator was legendary and he could remove the whole of the meniscus including the posterior horn in less than 5 min. He was encouragingly forceful and would say ‘Feel it laddie’ or ‘Get on with it laddie’. It is said that when doing nothing he did it thoroughly and to see him gazing from his cottage over the Denbyshire hills was an education in relaxation. He had a tall, handsome presence and a perpetual appearance of youth. He died in1949 on his way to visit his orthopaedic son in South Africa.
Question 2 He was a GP in Oswestry, close to the Orthopaedic Hospital. When Robert Jones visited his hospital he quickly came under his spell and became an Orthopaedic Surgeon. He was sent to Oxford in the Great War where the general hospital became one for the orthopaedic wounded. He and Robert Jones proposed a national scheme for the care of crippled children.Outside Oxford a man called William Morris ran a large automobile factory and Morris, along with this man’s anaesthetist, began to play golf together. He won one particular game and Morris asked,‘What are we playing for?’ He named an amount that would pay for his new hospital and William Morris (then Lord Nu⁄eld) wrote out the cheque. He put into operation a plan for the comprehensive care of the crippled child including peripheral clinics in surrounding towns and villages. His operation of resection of the femoral head and the lip of the acetabulum as the end of the line for hip patients bears his name. He died in 1950 and Sir Herbert Seddon took over his job.
articular end of one of the long bones entering the joint a¡ected’. He stated ‘It seems that in many cases, the formation of a sub-articular abscess in the bone must have been the ¢rst step in joint a¡ection since, while the articular end of the bone was extensively excavated, the aperture through which the abscess had burst into the joint was a mere pin-hole and, though the joint contained pus, the articular cartilage was apparently healthy’. This description was written whilst he was an outpatient assistant at Barts. He also described xanthomatosis of bone in 1865, long before Hand, Schuller and Christian. He died in 1909.
Question 4 He was born in 1827, the son of a wealthy Quaker wine merchant who invented an achromatic lens which probably in£uenced his interest in microscopy. He studied medicine at University College, London which was then known as the Godless University because both Oxford and Cambridge required students to take an oath and subscribe to the 39 articles of the Church of England. He then became Syme’s Lecturer in Surgery in Edinburgh and married Syme’s eldest daughter. In 1860, he became Regius Professor of Surgery in Glasgow and was elected a Fellow of the Royal Society. Here he noted the high surgical mortality related to sepsis and that simple fractures healed rapidly, whereas compound fractures were often infected and resulted in gangrene and death. In 1867, he reported in the Lancet ‘on a new method of treating compound fractures’ which involved spraying with a liquid. Many surgeons angrily opposed his ideas but he was supported in Europe by Volkmann and Billroth. He then became Professor of Surgery in Edinburgh in 1867 and went back to London to King’s College Hospital in 1877. His classes, however, became less and less populous and those who attended who put forward his views failed their exams. He was made a Baronet in 1883 and President of the Royal Society in 1897. He died in 1912 and his funeral was in Westminster Abbey where only two other medical men have had their graves FThomas Willis and John Hunter.
Question 3 He was born in Kent in1833 and trained at Barts. He was then a surgeon there and at Great Ormond Street. He was a good and kindly man who did not write books F he said ‘It is the men who don’t get the cases that write books about them’. He did, however, keep details of most of his cases and in 1874 reported upon 21 fatal cases which on post-mortem examination he found ‘in all instances a considerable and rapid loss of substance in the
Question 5 He was born in 1858 and was a neurologist and psychiatrist who worked at the Salpetrie're in Paris. In 1912, he wrote up a case with his Resident of a man of 46 who was admitted with pleurisy, pulmonary congestions and nephritis and ‘on ¢rst physical examination his
WHO WERE THEY?
appearance was striking. He appeared to have no neck. His head rested on his trunk which astonished us. There was a marked deviation of his head to the left so that his ear touched the shoulder. His hairline went far down reaching the third dorsal spinous process’. He died of nephritis and the autopsy description stated ‘There was a total absence of cervical vertebrae . . . .This explains the limitation of movement of the head forward and backward’. His spine was X-rayed which revealed a thoracic cage reaching to the base of the skull. He also described a cutaneous haemangioma of a limb which may extend to the trunk as well as a neurological sign when passive extension of a £exion contracture of the ¢ngers results in involuntary £exion of the ¢ngers and abduction of the thumb in pyramidal tract disease. He died in 1942.
Question 6 He was born in 1872 and became the 30th President of the United States of America. He was a Republican and succeeded to the Presidency in 1923 following Warren Harding. He was a Conservative who favoured a policy of non-interference. Frankness and sincerity greatly appealed to the people. He made the famous statement ‘The business of America is business’. His son died in 1924 from blood poisoning caused by a blister on his toe which developed by playing tennis with sneakers but without socks.The blister became infected and within a few days he died at the Walter Reed Hospital in Washington. He was never the same again and became to be regarded as one of the least successful Presidents. He wrote of his son ‘When he went, the power and glory of the Presidency went with him’. He died in 1933.
241
terior part of it will occasion a diminution of the size of the spinal canal, but the removal of any portion of the vertebra which is accessible to an operation will be of little avail as the irregularity of the anterior part of the canal made by the displacement of the body must be the same after as it was before the operation’. He was President of the Royal Colleges of Surgeons of England and in 1843 introduced the Fellowship examination. In 1858 he was President of the Royal Society as well as the ¢rst President of the General Medical Council. He died in 1862.
Question 8 He was born in Kent in 1860 and was Lister’s house surgeon. He took antiseptic surgery with him when he emigrated to Melbourne in 1890. He stated that with a mid-shaft femoral fracture ‘the shortening is caused by the tonic contraction of certain long muscles that are attached above to the pelvic bone and traverse the entire length of the thigh to be inserted into the tibia and ¢bula . . . the numerous muscles that are attached to the femur itself play little if any part in the production of shortening’. He stated that his apparatus was ‘far from being foolproof and cannot and will not look after itself. . .the house surgeon’s duty will be to inspect and adjust the pillows beneath the thigh and the leg so that there may be no backward sagging at the site of the fracture and the heel shall not be in contact with the bed’. He founded the College of Surgeons of Australasia and was its ¢rst Director-General. In the outback, he sustained a Colles fracture and as there was no medical help nearby he promptly reduced it himself and continued to treat it. He was killed in 1933 in a road tra⁄c accident.
Question 7
Answer 1
He was born in Wiltshire in 1783, the son of a clergyman and studied at the Great Windmill School of Anatomy under Sir Everard Home. Having quali¢ed in 1805 he became assistant surgeon at St George’s Hospital at the age of 24 and subsequently became a surgeon. He did a huge amount of clinical work, one reason being that his chief’s appearances were infrequent! He avoided operations if possible and it was said ‘His vocation was more to heal limbs than to remove them’. He became one of the best known surgeons of his day and treated King George IV. His book On the Pathology and Surgery of Diseases of the Joints was a classic of its day. He also pioneered the surgery of varicose veins for which there is a test that bears his name. He was the ¢rst to understand the importance of anterior spinal cord decompression in trauma and stated ‘If the whole or nearly the whole of the vertebra be driven forwards, the depression of the pos-
Thomas Porter McMurray
Answer 2 Gathorne Robert Girdlestone (1881^1950), the ¢rst Nu⁄eld Professor of orthopaedic surgery in Oxford.
Answer 3 SirThomas Smith
Answer 4 Joseph Lister
242
CURRENT ORTHOPAEDICS
Answer 5
Answer 7
Maurice Klippel (Klippel ^Feil syndrome; Klippel ^ Trenaunay^Weber syndrome; Klippel ^Weil sign).
Sir Benjamin Brodie (the Brodie ^Trendelenburg test).
Answer 6
Answer 8
John Calvin Coolidge
Robert Hamilton Russell
Who were they? Question 1 He was born in Belfast in 1888 and after graduation at Queen’s University he worked as House Surgeon for Sir Robert Jones in Liverpool. He was recalled from the Great War to Alder Hey Military Orthopaedic Hospital in Liverpool. He became Liverpool’s ¢rst Professor of Orthopaedics in 1938. He wrote about oblique displacement osteotomy of the hip for arthritis and a sign for posterior horn meniscal tears. His dexterity as an operator was legendary and he could remove the whole of the meniscus including the posterior horn in less than 5 min. He was encouragingly forceful and would say ‘Feel it laddie’ or ‘Get on with it laddie’. It is said that when doing nothing he did it thoroughly and to see him gazing from his cottage over the Denbyshire hills was an education in relaxation. He had a tall, handsome presence and a perpetual appearance of youth. He died in1949 on his way to visit his orthopaedic son in South Africa.
Question 2 He was a GP in Oswestry, close to the Orthopaedic Hospital. When Robert Jones visited his hospital he quickly came under his spell and became an Orthopaedic Surgeon. He was sent to Oxford in the Great War where the general hospital became one for the orthopaedic wounded. He and Robert Jones proposed a national scheme for the care of crippled children.Outside Oxford a man called William Morris ran a large automobile factory and Morris, along with this man’s anaesthetist, began to play golf together. He won one particular game and Morris asked,‘What are we playing for?’ He named an amount that would pay for his new hospital and William Morris (then Lord Nu⁄eld) wrote out the cheque. He put into operation a plan for the comprehensive care of the crippled child including peripheral clinics in surrounding towns and villages. His operation of resection of the femoral head and the lip of the acetabulum as the end of the line for hip patients bears his name. He died in 1950 and Sir Herbert Seddon took over his job.
articular end of one of the long bones entering the joint a¡ected’. He stated ‘It seems that in many cases, the formation of a sub-articular abscess in the bone must have been the ¢rst step in joint a¡ection since, while the articular end of the bone was extensively excavated, the aperture through which the abscess had burst into the joint was a mere pin-hole and, though the joint contained pus, the articular cartilage was apparently healthy’. This description was written whilst he was an outpatient assistant at Barts. He also described xanthomatosis of bone in 1865, long before Hand, Schuller and Christian. He died in 1909.
Question 4 He was born in 1827, the son of a wealthy Quaker wine merchant who invented an achromatic lens which probably in£uenced his interest in microscopy. He studied medicine at University College, London which was then known as the Godless University because both Oxford and Cambridge required students to take an oath and subscribe to the 39 articles of the Church of England. He then became Syme’s Lecturer in Surgery in Edinburgh and married Syme’s eldest daughter. In 1860, he became Regius Professor of Surgery in Glasgow and was elected a Fellow of the Royal Society. Here he noted the high surgical mortality related to sepsis and that simple fractures healed rapidly, whereas compound fractures were often infected and resulted in gangrene and death. In 1867, he reported in the Lancet ‘on a new method of treating compound fractures’ which involved spraying with a liquid. Many surgeons angrily opposed his ideas but he was supported in Europe by Volkmann and Billroth. He then became Professor of Surgery in Edinburgh in 1867 and went back to London to King’s College Hospital in 1877. His classes, however, became less and less populous and those who attended who put forward his views failed their exams. He was made a Baronet in 1883 and President of the Royal Society in 1897. He died in 1912 and his funeral was in Westminster Abbey where only two other medical men have had their graves FThomas Willis and John Hunter.
Question 3 He was born in Kent in1833 and trained at Barts. He was then a surgeon there and at Great Ormond Street. He was a good and kindly man who did not write books F he said ‘It is the men who don’t get the cases that write books about them’. He did, however, keep details of most of his cases and in 1874 reported upon 21 fatal cases which on post-mortem examination he found ‘in all instances a considerable and rapid loss of substance in the
Question 5 He was born in 1858 and was a neurologist and psychiatrist who worked at the Salpetrie're in Paris. In 1912, he wrote up a case with his Resident of a man of 46 who was admitted with pleurisy, pulmonary congestions and nephritis and ‘on ¢rst physical examination his
WHO WERE THEY?
appearance was striking. He appeared to have no neck. His head rested on his trunk which astonished us. There was a marked deviation of his head to the left so that his ear touched the shoulder. His hairline went far down reaching the third dorsal spinous process’. He died of nephritis and the autopsy description stated ‘There was a total absence of cervical vertebrae . . . .This explains the limitation of movement of the head forward and backward’. His spine was X-rayed which revealed a thoracic cage reaching to the base of the skull. He also described a cutaneous haemangioma of a limb which may extend to the trunk as well as a neurological sign when passive extension of a £exion contracture of the ¢ngers results in involuntary £exion of the ¢ngers and abduction of the thumb in pyramidal tract disease. He died in 1942.
Question 6 He was born in 1872 and became the 30th President of the United States of America. He was a Republican and succeeded to the Presidency in 1923 following Warren Harding. He was a Conservative who favoured a policy of non-interference. Frankness and sincerity greatly appealed to the people. He made the famous statement ‘The business of America is business’. His son died in 1924 from blood poisoning caused by a blister on his toe which developed by playing tennis with sneakers but without socks.The blister became infected and within a few days he died at the Walter Reed Hospital in Washington. He was never the same again and became to be regarded as one of the least successful Presidents. He wrote of his son ‘When he went, the power and glory of the Presidency went with him’. He died in 1933.
241
terior part of it will occasion a diminution of the size of the spinal canal, but the removal of any portion of the vertebra which is accessible to an operation will be of little avail as the irregularity of the anterior part of the canal made by the displacement of the body must be the same after as it was before the operation’. He was President of the Royal Colleges of Surgeons of England and in 1843 introduced the Fellowship examination. In 1858 he was President of the Royal Society as well as the ¢rst President of the General Medical Council. He died in 1862.
Question 8 He was born in Kent in 1860 and was Lister’s house surgeon. He took antiseptic surgery with him when he emigrated to Melbourne in 1890. He stated that with a mid-shaft femoral fracture ‘the shortening is caused by the tonic contraction of certain long muscles that are attached above to the pelvic bone and traverse the entire length of the thigh to be inserted into the tibia and ¢bula . . . the numerous muscles that are attached to the femur itself play little if any part in the production of shortening’. He stated that his apparatus was ‘far from being foolproof and cannot and will not look after itself. . .the house surgeon’s duty will be to inspect and adjust the pillows beneath the thigh and the leg so that there may be no backward sagging at the site of the fracture and the heel shall not be in contact with the bed’. He founded the College of Surgeons of Australasia and was its ¢rst Director-General. In the outback, he sustained a Colles fracture and as there was no medical help nearby he promptly reduced it himself and continued to treat it. He was killed in 1933 in a road tra⁄c accident.
Question 7
Answer 1
He was born in Wiltshire in 1783, the son of a clergyman and studied at the Great Windmill School of Anatomy under Sir Everard Home. Having quali¢ed in 1805 he became assistant surgeon at St George’s Hospital at the age of 24 and subsequently became a surgeon. He did a huge amount of clinical work, one reason being that his chief’s appearances were infrequent! He avoided operations if possible and it was said ‘His vocation was more to heal limbs than to remove them’. He became one of the best known surgeons of his day and treated King George IV. His book On the Pathology and Surgery of Diseases of the Joints was a classic of its day. He also pioneered the surgery of varicose veins for which there is a test that bears his name. He was the ¢rst to understand the importance of anterior spinal cord decompression in trauma and stated ‘If the whole or nearly the whole of the vertebra be driven forwards, the depression of the pos-
Thomas Porter McMurray
Answer 2 Gathorne Robert Girdlestone (1881^1950), the ¢rst Nu⁄eld Professor of orthopaedic surgery in Oxford.
Answer 3 SirThomas Smith
Answer 4 Joseph Lister
242
CURRENT ORTHOPAEDICS
Answer 5
Answer 7
Maurice Klippel (Klippel ^Feil syndrome; Klippel ^ Trenaunay^Weber syndrome; Klippel ^Weil sign).
Sir Benjamin Brodie (the Brodie ^Trendelenburg test).
Answer 6
Answer 8
John Calvin Coolidge
Robert Hamilton Russell