The Portable Ophthalmometer

Within our museum collection there are a variety of medical instruments, from the simple to the complex to the mysterious. One such mysterious item is the Thomas Reid Portable Ophthalmometer:

2003.77.30_thomas reid portable ophthalmometer

On first glance, this small instrument appears to be some type of pocket telescope! However, this device was designed for ophthalmic purposes rather than astronomical. An ophthalmometer is used to measure the curvature of the cornea, the transparent layer of the front of the eye, which would have aided with the diagnosis of astigmatism.

eye anatomy 900

Astigmatism is a very common condition of the eye where the shape of the cornea or lens is not circular, but more oval. This results in a distortion of vision. In fact, your favourite Digital Heritage Officer at the College has astigmatism in her right eye!
So, who was Thomas Reid? Dr. Thomas Reid graduated from the University of Glasgow in 1857, and became a fellow of the Faculty of Physicians and Surgeons of Glasgow in 1867. He began to work in general practice before working at the Glasgow Eye Infirmary as a house surgeon in 1868 [1]. It was here that he worked alongside the great Scottish ophthalmologist, William Mackenzie. His post involved putting together medicines, administrative work, bloodletting patients, and helping with surgeries when needed. He even followed in the footsteps of Mackenzie when he became the Waltonian Lecturer in Ophthalmology at the University of Glasgow, a post previously occupied by Mackenzie [2].
He was an incredibly well-read man and had a keen interest in mathematics, especially with regards to optics. This can be seen in the designs of the instruments he invented. His pocket ophthalmometer was demonstrated to the Ophthalmological Society of the United Kingdom, now the Royal College of Ophthalmologists, in 1886 and his paper on the instrument was read at the Royal Society of London by the then president, Lord Kelvin, in 1893 [3].
For such a small instrument, it is incredibly complex. An aspherical lens is situated in front of two rectangular prisms, through which the image of the cornea passes to the telescope at the opposite end of the device. Light shines through a disc at the side of the instrument, and the level of exposure can be altered at will. The curvature of the cornea is then measured manually by the ophthalmologist, who determines whether the patient has astigmatism or not.
Being a man who didn’t want a lot of public attention, it is understandable that Dr Thomas Reid is less well-known than his colleague, William Mackenzie. However, it is clear to see that Reid continued the excellency in ophthalmic practice and teaching that Mackenzie had established in Glasgow all those years ago.

 

References
1. Wright Thomson, A.M., 1963. The history of The Glasgow Eye Infirmary, 1824-1962. Glasgow: John Smith.
2. Buchanan, L., 1919. Thomas Reid, M.D. (1830-1911). The British Journal of Ophthalmology. Available at: <http://bjo.bmj.com/content/bjophthalmol/3/7/nil2.full.pdf&gt;.
3. Reid, T., 1893. On a Portable Ophthalmometer. Proceedings of the Royal Society of London, 53, 1-5. Available at: <http://rspl.royalsocietypublishing.org/content/53/321-325/1.full.pdf+html&gt;.

Artist in Residence: Month Two with Joseph Lister

Our Artist in Residence, Marianne MacRae, tells us more about her work at the College and how she is getting on with Joseph Lister. 

My second month here at the College has gone a little quicker than I might have liked which is why this blog is a touch later than I’d intended! According to my notes I’m on “Lister, Day 26” as I write this, which makes it sound as though Lister has become my metaphorical Everest. Gargantuan as his achievement was, I don’t think I need to don my snow shoes just yet. In fact, Joe and I are (tentatively) getting along quite well. I’ve slowly but surely been reading through his Collected Papers, which show a lovely turn of phrase about his writing – I’ve managed to work some of his words into a poem about urine, which I’m quite pleased with. I’ve also been battling through some handwritten lecture notes by his students, but must admit this has been very stop-start on account of the fact that some of the handwriting is atrocious! Imagine a continuous line that occasionally peaks and troughs. Reading it is not unlike watching a heart monitor actually, so maybe these guys were just really in tune with their own rhythms? Either way, I was able, after much squinting, to decipher an interesting entry about his technique for removal of the tongue (we all have a preferred method, right??) and the ways in which the antiseptic technique had to be adapted to deal with wounds in the mouth.

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Pic. 1: Terrible Victorian student handwriting hurts my modern eyes.

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Pic. 2:Comparatively great presentation skills from this student.

I’ve also been reading a biography of Lister written by Hector Charles Cameron, son of Hector Clare Cameron, a student and advocate of Lister during his time at Glasgow. It’s been great to read more about him from the perspective of someone who actually met him. Some of my favourite discoveries so far have been the brief glimmers of Lister’s character. For example, he survived a bout of smallpox, he had vertigo and he was a terrible timekeeper. These small, human details are really helpful in making a connection to a historical figure, allowing me to form a well-rounded impression of his personality, which I hope translates well into the creative work I’m producing. It also turns out Lister’s ancestors were from Bingley, West Yorkshire, about 15 miles from where I grew up. To be fair, this is of little relevance since my own ancestors are conversely all from Glasgow so there could be absolutely no crossover, but it was nice to read a familiar place name all the same!
Speaking of which, I’ve spent some time this month wandering around the city, trying to get a feel for the history of the place from its atmosphere. We came here a lot to visit family when I was growing up, but this is the first time as an adult that I’ve had the chance to really experience the city. And (don’t tell Edinburgh) I’ve already written more “place” poems than I ever have about anywhere else! When it’s not threatening rain, lunchtime down at the Clyde is just the right mix of bustling and serene. I really want to make sure Glasgow itself, now and in Lister’s time, becomes a central feature of the project.

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Pic. 3: Sunny Lunch at the Clyde.

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Pic. 4:  Sun disappears, I get soaked.

Outside of the writing itself, plans are currently being laid to put together a wee video that will draw together the different aspects of the residency; namely Lister, the heritage collection here at the College, the city and my own poetic output. It should be a very accessible overview of the project as a whole and I’m quite excited to get started with it! Similarly we’ve been discussing some workshops that I’ll be facilitating with a group of local school children, with the aim of encouraging a creative response to Lister’s work from them. However I shall save the details of that until we meet with the school and get their input on the project.
To end, I thought I’d share this quote I found in the Lister biography last week. Supposedly Lister said this when he was teaching students on his wards – a kind of self-fulfilling prophecy, perhaps? Either that or Cameron exercised huge poetic license and just pretended this was verbatim…I’ll let you decide!
“Trouble of the gravest kind is always apt to follow…when a wound of the skin is present. How is this? The man who is able to explain this problem will gain undying fame.”

Introducing our Artist in Residence

In June 2017 we were tremendously excited to welcome the College’s first Artist in Residence. Poet and performer Marianne MacRae will work creatively with our Joseph Lister collections and heritage, particularly exploring the influence of Glasgow on the famous surgeon’s achievements and legacy. Marianne is in the final stages of her PhD at the University of Edinburgh. The residency is a partnership between the College, the University, and the Scottish Graduate School of Arts and Humanities (SGSAH). It is a timely appointment as 2017 marks the 150th anniversary of Lister’s public announcement of his antiseptic method in the Lancet, an innovation he developed and put into practice in Glasgow.

Marianne LP 21-04-17

Marianne MacRae

 

So what will an Artist in Residence do at the College?

The residency will tackle three main questions –

  • How were Joseph Lister’s achievements in antiseptic surgery shaped by his Glasgow experience in the 1860s?
  • How can we better engage the local community with this history that revolutionised health care across the world?
  • How can we ensure Lister’s spirit lives on in the College buildings?

Marianne will be based within the College 2 or 3 days per week between June and December 2017, researching our collections and soaking up the rich history of our building. She will organise workshops and events in which members of the public can learn about Lister through creative activities. We are already planning these and will announce dates very soon. We’ll be tweeting about the residency, and Marianne will blog about her progress, linking this to items she is discovering in our collections.

lister table

Detail from table from Lister’s ward at Glasgow Royal Infirmary, 1860s

 

A creative residency is always about finding new stories to tell, and new ways of telling them. The ultimate aim is to create new work, in this case poetry. We hope to use Marianne’s work in ways that help bring Lister, his work and achievements to life in the College. This will link closely to one of our key Heritage themes – Innovation in Surgery. This theme will inform our new display spaces and will be central to how we tell the stories of the College’s past, present and future.

So what does poetry have to do with surgery?

Poetry has always been used as a way of memorialising or celebrating significant people and achievements, including in the discipline of surgery. College founder and surgeon Peter Lowe’s book The Whole Course of Chirurgerie (1597) has four poems in the preliminary pages, all dedicated to his skill and character. Lister himself was the subject of a number of poems by writer William Ernest Henley, when he was being treated by the surgeon in Edinburgh in the 1870s. Henley’s collection of poems In Hospital (1875) features the poem ‘The Chief’, painting a complimentary portrait of Lister (who had saved his leg from amputation) –

“His faultless patience, his unyielding will,

Beautiful gentleness and splendid skill…”

Marianne’s work is unlikely to memorialise Lister in this way, but will instead create a lasting, contemporary piece of work that will help illuminate the story of the surgeon, the city of Glasgow, and the impact of his innovations. Telling this story is more important than ever as we look towards April 2018, when we celebrate 150 years since Lister’s first public lecture on his antiseptic method, held here in our St Vincent Street building.

SGSAH2

Uncovering our medical instruments – British Science Week 2017

In June 2016 we started an exciting project to digitise items from our museum collection. The project, which has been kindly funded by Museums Galleries Scotland, is sadly nearly at an end, so to celebrate all the amazing work that has been done we’re hosting a special drop-in session as part of British Science Week.

The drop-in session will give visitors the opportunity to view some items from our collection, learn about how they were used, take a look at the processes involved in their digitisation, and maybe take a few photos too!

The drop-in session takes place on Wednesday, 15th March 2017 from 1pm – 3pm. No need to book – just pop in to the College!

Horsley's Skull Trephine

Horsley’s Skull Trephine

So far, our digitisation intern has photograph over 300 items including our collection of 18th/19th century stethoscopes, apothecary cabinets, the surgical instruments of William Beatty (surgeon on board HMS Victory at the battle of Trafalgar), early 19th century x-ray tubes, Victorian quackery gadgets, and many other fascinating surgical instruments.

Surgical Instruments of William Beatty

Surgical Instruments of William Beatty

The collection dates back to the mid 1700s – the earliest item we have is a trephine set – and covers all areas of medicine, surgery and dentistry. You can read a little bit more about some of the items we’ve digitised and get updates on the project on our blog.

For more information on British Science Week 2017 please visit: https://www.britishscienceweek.org/

Flyer for our British Science Week event

Flyer for our British Science Week event

Amputation

In this post by our Digitisation Project Intern, we look at our amputation instruments, while referring to the work of Maister Peter Lowe, College founder and 16th century surgeon.

The surgical procedure of an amputation involves the removal of a section of a limb of the body. The volume of tissue removed from the body depends on a variety of factors, including the severity of the patient’s condition.

instruments-and-cauters-actuals-for-extirpation-copy

Woodcut illustration, 2nd ed. of Lowe’s Chirurgerie (1612)

 

It is uncertain as to how long amputations have been a regular form of surgical treatment, however the term can be traced back to the 16th century. For example, Peter Lowe uses the term “amputation” when describing how to treat a gangrenous limb in his 1597 work The Whole Course of Chirurgerie [1].  Here he explains how the operation should be carried out, referencing the works of previous scholars:

The judgements are, that it is for the most part incurable, and the patient will die in a cold sweat. The cure, in so much as may be, consists only in amputation of the member, which shall be done in this manner, for the patient must first be told of the danger, because often death ensues, as you have heard, either from apprehension, weakness, or loss of blood.”

It has only been within the last 170 years that amputations, and surgical procedures in general, have been performed in a safe manner, e.g. with the patient under anaesthesia. Prior to this, the limb was removed as quickly as possible. A successful and speedy amputation required precision, strength, skill, and a steady hand, as well as a set of sharp amputation instruments!

amputation-set

Mid 19th century amputation set

 

Within the museum collection are examples of amputation sets from the 1800-1900s.

Several components make up a set, from trephine heads to amputation saws to tourniquets. Each instrument would be used at a different stage of the surgical procedure. Let’s take a look at how a lower limb amputation would be performed.

First of all, the patient would be prepped for the surgery. In the days before pain relief, alcohol was the method used to calm the nerves. The patient would be given some rum or whisky, and then wheeled into the surgical theatre. Most likely the theatre would be structured with the operating table in the centre of the room surrounded by rows and rows of stands for spectators. Spectators would include the students of the chief surgeon involved in the procedure- not only was this a surgical operation, it was also a lesson. Once the patient was placed on the operating table, the chief surgeon would enter the theatre and the operation would commence.

One of the major dangers of amputating a limb is blood loss. Several blood vessels must be carefully salvaged during the procedure in order to limit haemorrhaging [1]. To enable the surgeon to operate on a bloodless area of the body, a Tourniquet was applied proximal to the site of amputation (a couple of inches above the site of incision).

“The use of the ribband is diverse. First it holds the member hard, that the instrument may curve more surely. Secondly, that the feeling of the whole part is stupefied and rendered insensible. Thirdly, the flow of blood is stopped by it. Fourthly, it holds up the skin and muscles, which cover the bone after it is loosed, and so makes it easier to heal.”[1]

tourniquet

Example of a tourniquet from an amputation set

 

The tourniquet would have been tightened in order to restrict blood flow and reduce haemorrhaging. It would also have reduced sensation to the limb, providing slight pain relief. However, this would also mean that oxygen was restricted. Hence another reason as to why amputations were performed as quickly as possible.

tourniquet-illustration

The initial incision would have been made with a sharp amputation knife. Amputation knives evolved in shape over the years, from a curved blade to a straight blade. Peter Lowe comments on the use of a curved blade for the procedure:

“…we cut the flesh with a razor or knife, that is somewhat crooked like a hook…”[1]

The blade was curved in order to easily cut in a circular manner around the bone (see image from Lowe’s book above) [2]. Amputation blades became straighter as the incision technique evolved. An example of a straight amputation knife is that of the Liston Knife. With a straight and sharp blade, this knife was named after the Scottish surgeon Robert Liston. Liston is best known for being the first surgeon in Europe to perform an amputation procedure with the patient under anaesthesia [3].

liston-knife

Liston knife, mid 19th century

 

The straight blades enabled the surgeon to dissect more precisely in order to form the flap of skin and muscle that would become the new limb stump.

As one can imagine, bone tissue would not be easily removed by an amputation knife. Instead, an amputation saw was required to separate bone. Amputation saws were similar to those found in carpentry, with sharp teeth to dig into and tear bone tissue for a quick procedure.

amputation-saw

Amputation saw, mid 19th century

 

Aside from the major dissecting tools, there are more specialised instruments within an amputation set that we must consider. One of the main risks of an amputation operation was death by haemorrhaging. For years, the letting of blood was used to treat certain ailments according to the ancient teaching of the “Four Humors”. However, in a surgical procedure the major loss of blood was something to be avoided. In order to prevent the haemorrhaging of dissected vessels, the surgeon would have used a Ligature to tie off the vessel and disrupt blood flow. This technique was pioneered by French surgeon Ambroise Paré during the 1500s [4].

Found within our amputation sets are trephine heads with accompanying handles. Rather than being used during an amputation procedure, trephine heads were used to drill into the skull to treat conditions by relieving intracranial pressure. Nowadays, access to the brain via the skull is achieved with the use of electric drills.

trephine1

Trephine, mid 19th century

 

Amputation procedures have changed dramatically since the days before anaesthesia and antiseptics, but the risks have remained. Blood loss, sepsis, and infection are factors that can still occur today. Thankfully, their likelihood is much lower than they were 170 years ago.

References

  1. Lowe, P., 1597. The Whole Course of Chirurgerie.
  2. Science Museum, 2016. Amputation Knife, Germany, 1701-1800. Brought to Life: Exploring the History of Medicine. [online] Available at: http://www.sciencemuseum.org.uk/broughttolife/objects/display?id=5510
  3. Liston, R., 1847. To the Editor. The Lancet, 1, p. 8.
  4. Hernigou, P., 2013. Ambroise Paré II: Paré’s contribution to amputation and ligature. International Orthopaedics, 37(4), pp. 769-772.

Art, Culture and Patronage in Renaissance Scotland

Last year we were very fortunate to host placements for four undergraduate history students from the University of Glasgow. The placements were undertaken as part of their class ‘Art, Culture and Patronage in Renaissance Scotland, 1406-1625’ and involved working with primary source materials from the collections of either the University’s Archives and Special Collections, the Hunterian Museum, or the Royal College of Physicians and Surgeons. Each student spent time studying a single item from one of these repositories, thinking about how to interpret the source, assessing its significance, and imagining the curatorial possibilities it offers.

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A manuscript rental on a blank page in ‘The workes of the most High and Mightie Prince, James’ (1616)

The students’ work is now available to read on the class blog:

You can read more about the students’ work in other repositories on the class blog: https://glasgowuniscotrenaissance.wordpress.com/.

Events: January – June 2017

Our programme of events for the first half of 2017 is now available. We have some really exciting events coming up this year including our annual Goodall Symposium which will celebrate a very special medical milestone – the 150th annivesary of the publication of Joseph Lister’s ground-breaking article on antiseptic surgery. There’ll also be the chance to learn more about our digitisation project “Uncovering our Medical Instruments”, and our beautiful College Hall will house a unique pop-up art installation as part of Festival of Museums. Download our programme (7MB) to find out more.

Events programme January - June 2017

Events programme January – June 2017.

The image of catgut ligature used on the front of our events programme is a nod to our Goodall Lecture, Safer Surgery – the Lasting Legacy of Joseph Lister in June 2017. In addition to samples of catgut ligatures in our museum collection, our archives contain correspondence between Joseph Lister and William Macewen, on the preparation and use of catgut. Both had articles in the British Medical Journal of 1881 (i, 150, 185) detailing the development of this material as a key component of antiseptic surgery.