Joseph Lister’s Impact on America

Sir Joseph Lister’s impact on the field of surgery was monumentous, applying the germ theory to humans and solving the mystery of why wounds so often got infected. By dabbing wounds with carbolic acid, as well as dressing the wounds in acid-dipped lint, Lister was able to stop the putrification of wounds and sepsis altogether. Today, it is easy to see how revolutionary his work was. However, Lister’s findings were not as well received at the time as one might think.

As soon as he published his initial papers on antisepsis in The Lancet in 1867, Lister received vast amounts of criticism from distinguished surgeons around the world. Despite having support from his colleagues and students, the number of people opposed outweighed them all. With all this opposition, it seemed almost impossible that Listerism would catch on [1]. But catch on it did, and this was in part due to the few individuals bold enough to stand up for Lister and employ his practices in antisepsis. One such man was that of William Halsted, one of the greatest American surgeons of all time.

William Halsted was born in New York City in 1852, and graduated from the College of Physicians and Surgeons in New York City in 1877. Before graduating from medical school, he obtained an internship at the Bellevue Hospital, an internship that was usually only offered to medical graduates. However, Halsted showed such potential that the hospital offered him the internship before he even graduated!

After graduating, Halsted became the house physician at the New York City Hospital, where after a year he travelled to Europe to study the practises of European surgery. Upon returning from his European travels, Halsted began to implement the practice of safe surgery in New York City. His regime was built upon the three pillars of surgery; anaesthesia to relieve pain, the prevention of haemorrhaging, and antisepsis to prevent wound infections. The latter, as we know, was introduced and pioneered by Sir Joseph Lister as a surgeon at the Glasgow Royal Infirmary.

Halsted copied Lister’s use of carbolic acid as a disinfectant not only to sterilise wounds, but also his surgical instruments. The downfall of using carbolic acid in antisepsis was its hazardous chemical properties. Although it was an effective antiseptic, carbolic acid was also corrosive and toxic. This meant that severe damage could be done to an individual from over-exposure. One example was that of Mr. Halsted’s wife, Caroline, who happened to be his chief nurse in the operating room [2]. In 1889, Caroline contracted severe contact dermatitis from using carbolic acid in the operating theatre. This condition is characterised by the formation of a rash alongside blisters. To overcome this issue, Halsted suggested that his wife wear rubber gloves in theatre to avoid skin contact with the carbolic acid. Not only did this move prevent Caroline’s dermatitis from worsening, but it also improved Lister’s antiseptic technique. This is the first known documented use of rubber gloves in surgery.

Why all this talk about William Halsted? Not only was he an advocate of antisepsis, but he was also a keen scientist, and introduced several new operations into the field. With these new operations were introduced adaptations of popular medical instruments, such as the artery forceps (haemostats). Artery forceps are essentially clips that are used to temporarily clamp blood vessels and arrest the flow of blood. Halsted designed his own form of artery forceps, known as the “Halsted Mosquito Forceps”, an example of which is held within the College’s museum collection:

 

2003.2.13_halstead artery forceps

 

This haemotstat is ratchetted and would have been used to block small blood vessels during an operation. The teeth of the handle allow the haemostat to be locked in place, meaning that the haemostat can clamp the vessel and stand alone, instead of having to be held for the entire operation. Halsted mentions in one of his publications that his instruments were immersed in carbolic acid to keep them sterile, and that the operator handling the instruments would have worn gloves to prevent the spread of infection [3]. Throughout his published works he reiterates the importance of Lister’s antiseptic technique and the part it plays in the practice of safe surgery.

It may have taken some convincing, but Lister’s findings on antisepsis proved to be true and not only impacted America, but the world.

 

References

  1. Rutkow, I., 2013. Joseph Lister and His 1876 Tour of America. Annals of Surgery, 257(6), pp. 1181-1187.
  2. Cameron, J.L., 1996. William Stewart Halsted: Our Surgical Heritage. Annals of Surgery, 225(5), pp. 445-458.
  3. Halsted, W.S., 1913. Ligature and Suture Material: The employment of fine silk in preference to catgut and the advantages of transfixion of tissues and vessels in control of haemorrhage, also an account of the introduction of gloves, gutta-percha tissue and silver foil. The Journal of the American Medical Association, 60(15), pp. 1119-1126.

Uncovering our Medical Instruments- Lucy Baldwin and Maternity Health

Childbirth has always been considered a miraculous event. Bringing a new life safely into this world is always a momentous occasion and victory. The health of both mother and child is of utmost importance to those involved in maternity health, and the practice as we know it today is the safest it has ever been in history.

However, there was a time when childbirth was considered a death sentence for the expectant mother [1], and maternity healthcare was based on class, on where the mother ranked in the public hierarchy. Not only was the likelihood of the mother dying during childbirth much higher than it is today, the life expectancy of the child was much shorter, although this varied depending on where the child was brought up. Yes, the process of childbirth has changed tremendously in the past 200 years and this change has been brought about by those fighting for better maternity healthcare.

One man that vastly improved the survival rate of mothers was Ignaz Semmelweis, an unsung hero of antisepsis. Working as an obstetrician at the Vienna General Hospital in 1846, Semmelweis noticed a difference in mortality rates between the two maternity clinics there. Where the clinic run by midwives had a mortality rate of around 4%, 10% of mothers died after giving birth in the clinic run by teaching staff of the University of Vienna [2]. These mothers were dying of a condition known as “childbed fever”.

Semmelweis took it upon himself to solve this mystery. The difference between clinics, he discovered, was in hygiene- the medical students would attend their patients straight after performing autopsies and would not have washed their hands or clothes efficiently in between sessions. This meant that the wounds and reproductive tracts of the recovering mothers were being contaminated, resulting in childbed fever and ultimately death.  The concept of contamination was not yet understood at this time in history, thus explaining Semmelweis’ difficulty in identifying the root of the problem.

When Semmelweis discovered this, he put in place the practice of handwashing with chlorinated lime in both clinics in 1847. Obstetricians were to wash their hands before and after examining patients in the first clinic, as well as the midwives in the second clinic. With this change in hygiene, the mortality rate of the first clinic dropped to around 1% within two months. However, Semmelweis was not recognised for his astounding work due to his unpopularity in the research field. The lack of belief from his contemporaries drove him insane, which resulted in his admittance to a mental institution in 1867. Semmelweis sadly died of blood poisoning, from the contamination of a wound caused by the institution staff [3]. It has only been after his death that his work has been recognised and praised.  His work paved the way for Lister’s contribution to antiseptic practices in medicine.

Another name often associated with maternity healthcare is Lucy Baldwin. Lucy Baldwin, Countess Baldwin of Bewdley, was the wife of Stanley Baldwin, the prime minister of the United Kingdom from 1923-1924, 1924-1929, and 1935-1937. Although some may remember Countess Baldwin as a Prime Minister’s wife, Baldwin was an active writer and campaigner for equal maternity health care for all women. Having six children of her own, Baldwin was all too aware of the importance of maternal care during and after childbirth.

In the early 1900s, the rate of maternal deaths was incredibly high and little was being done to reverse the statistics [4]. Baldwin supported the work of the National Birthday Trust Fund to improve the care of pregnant women, and had an important role in obtaining equal access to anaesthesia for all mothers regardless of their financial income. Her great efforts lead to the introduction of self-administered anaesthetic machines into many hospitals across the country [5]. She had close ties with maternity health in Glasgow, having opened a New Infant Health Visitors Association centre in Bridgeton, and paved the way for the employment of the first anaesthetists at the Glasgow Royal Maternity Hospital in 1930 [6]. Named after her in her honour, a Lucy Baldwin Gas-Oxygen Analgesia Apparatus can be found with the College’s museum collection, [Fig 1].

2003.74_Lucy Baldwin apparatus 4

The apparatus would include a face mask, which was connected to the machine through a tube. The midwife could then manipulate the dial to alter the percentage of oxygen within the gaseous mixture. The machine would be mounted onto 4 wheels for easy movement between patient beds.

Although Baldwin was not medically trained herself, she used her position and the resources available to her to fight for equal rights in healthcare.

For more information on the Lucy Baldwin Gas-Oxygen Analgesia Apparatus, feel free to contact us at: library@rcpsg.ac.uk

 

References

  1. Cellania, M., 2013. The Historical Horror of Childbirth. Mental Floss. [online] Available at: http://mentalfloss.com/article/50513/historical-horror-childbirth
  2. Semmelweis, I., 1861. Etiology, Concept, and Prophylaxis of Childbed Fever.
  3. Carter, K.C., 1994. Childbed Fever: A Scientific Biography Of Ignaz Semmelweis. Transaction Publishers: New Jersey.
  4. Schafer, E., 1998. Schafer on Williams, ‘Women and Childbirth in the Twentieth Century: A History of the National Birthday Trust Fund 1928-93’. Humanities and Social Sciences Online. [online] Available at: < https://networks.h-net.org/node/24029/reviews/29853/schafer-williams-women-and-childbirth-twentieth-century-history>
  5. Blakeway, D., 2011. The Last Dance : 1936 The Year Our Lives Changed. Hodder Paperbacks: London.
  6. Dow, D.A., 1984. The Rottenrow: The History of the Glasgow Royal Maternity Hospital 1834-1984. The Parthenon Press: Lancashire.

Shine a Light on Those Backstage: Recognising the Engineers Behind Medical Technology

Our digitisation intern discusses some of the remarkable people behind medical technology.

When looking back at significant moments in medical history, it is easy to see the progression of medical technology along with the practice. From the replacement of dental keys with dental forceps, to the development of the heart-lung machine, medical technology has greatly advanced.

The manufacturing of this technology was often performed by instrument makers, specialised engineers in the fields of medicine and surgery. It was up to these men to deliver products that matched every detail of the original design to perfection. Anything less and the apparatus may not work at all. These were the men that were producing new technology. Their names are unforgettable.

Or are they? Having such important roles to play in the advancement of clinical practice, surely these men are remembered by all? Unfortunately, this is not the case. Aside from some brief mentions in published articles, it is rare to find much detail about the lives of instrument makers. All credit was given to the professional pioneering the technology, not the engineer.

As the research continues in the “Uncovering our Medical Instruments” project, the lack of information on instrument makers from history becomes more and more evident. This begs us to ask a question: Did they ever get the recognition they deserved?

The topic of instrument makers was brought up after digitising an artefact from our anaesthesia collection- the Portable Anaesthesia Apparatus:

Portable anaesthesia apparatus

This apparatus is a nitrous oxide/oxygen machine dating from 1955-1960. There is no hidden meaning in the name; this tool was an anaesthesia apparatus that could easily be transported from location to location. This particular machine was manufactured by the British Oxygen Company (BOC). With regards to manufacturers, most people would be satisfied knowing that the BOC made this product. However on closer inspection of this particular instrument, other names are mentioned:

Portable anaesthesia apparatus

BOC trademark (top left) with the names of Coxeter and King displayed around the edge.

Around the BOC trademark are the names “King” and “Coxeter”. After some digging into the archives, it was discovered that these names referred to two instrument makers; A. Charles King and James Coxeter.

Arthur Charles King was an engineer from London, active during the early 1900s. After the First World War, he set up his own company in London, manufacturing simple medical instruments to local physicians. As anaesthetic technology was advancing abroad, King was one of the first engineers to sell the machines in the UK. Thus, he made a name for himself in the anaesthesia world, [1]. Unfortunately, King’s business plummeted and was ultimately taken over by the British Oxygen Company in 1939.

James Coxeter was an active instrument maker during the 1800s, establishing his own business in 1836, [2]. Based in London, Coxeter was a supplier to many, including the University College Hospital, of which he was the chief instrument maker, [3]. Coxeters also specialised in anaesthetic equipment, including producing Boyle’s Anaesthetic Machine, designed by British anaesthetist Henry Boyle,[1]. The company grew over the years, but was also taken over by BOC. This will be why the names “King” and “Coxeter” are on the trademark.

For all the hard work behind the scenes, was a reference in a publication the best they could get? Thankfully, no. James Coxeter was such a respected instrument maker that he was able to publish articles in the Lancet, giving detailed descriptions of new instrument designs he had created. And it wasn’t just one publication. In fact, Coxeter was published in the Lancet several times, [4,5,6]. A side note to one article describes Coxeter’s contribution to medicine and surgery:

“We have examined the instruments described by Mr Coxeter, and think them ingenius modifications of those in use, and worthy the attention of the profession.” [4]

Although he was very much a member of the backstage crew, Coxeter, and many like himself, were able to get the proper recognition and thanks that they deserved. It is hoped that this article will be added to that list of thanks.

The Portable anaesthesia apparatus

The Portable anaesthesia apparatus

References
1. Wilkinson, D.J., 1987. A. Charles King: a unique contribution to anaesthesia. Journal of the Royal Society of Medicine, 80(8), p. 510-514. Available at: < http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1290960/>
2. Science Museum Group, Collectors Online- people. Coxeter. Available at: < http://collectionsonline.nmsi.ac.uk/detail.php?type=related&kv=46728&t=people>
3. Braithewaite, W., and Braithewaite, J., 1845. The Retrospect of Practical Medicine and Surgery: Being a Half-yearly Journal Containing a Retrospective View of Every Discovery and Practical Improvement in the Medical Sciences …, Volumes 10-12. W.A.Townsend Publishing Company.
4. Coxeter, J., 1845. New Surgical Instruments. The Lancet, Volume 2.
5. Coxeter, J., 1874. Aspirators. The Lancet, 103(2635), p. 319.
6. Coxeter, J., 1849. The Sonometer and instruments used in the application of glycerine in deafness. The Lancet, 54(1352), p. 109-110.

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.

Glasses through the Ages: What’s Your Style?

Our digitisation intern, Kirsty Earley, takes a look at some of the fascinating items in our spectacles collection.

Eric Morecambe, John Lennon, Harry Potter – all figures who made glasses iconic. There are scores of celebrities (and fictional characters!) who have had an impact on the popularity of certain styles of glasses, which was certainly unique to the 20th century. From monocles to aviators, the styles of glasses and frames available today are as varied as ever. What were once used as modes of magnifying written text can now simply be worn as a fashion accessory. And with any item of fashion, there were clear trends in eyewear throughout history.

Folding pince-nez style spectacles

Folding pince-nez style spectacles

It is uncertain as to who invented glasses for eyewear, but it is known that they originated in Italy between the 13th and 14th centuries.1 Originally, glasses did not have sides2 that hooked over either ear, but instead were held on the bridge of the nose. This style was known as the Rivet Spectacle (Figure 1). Due to the lack of support, it wasn’t uncommon for the wearer to have to adjust to a position where the glasses wouldn’t fall off!3

illustration of Rivet Spectacles

Figure 1: Illustration of Rivet Spectacles

From the rivet emerged the Scissor Spectacles, which were originally manufactured during the 1700s.4 Named after their similarity to the scissor shape, these glasses were linked to a handle for easier use. Understandably, these glasses were not for constant wear, but rather occasional viewing. Their design led the way for a style of spectacle popular amongst opera fans – the Lorgnette.

The lorgnette was invented in 1770 by George Adams.3 Although inspired by the design of scissor spectacles, the lorgnette differs in that one lens is directly attached to the handle rather than both (Figure 2).

Lorgnettes

Figure 2: Lorgnettes

The example of a lorgnette in the College museum collection contains a spring mechanism, making it easier to carry (Figure 3).

Lorgnettes

Figure 3: The lorgnettes had a spring mechanism which enabled the wearer to fold them away when not needed.

Another style of spectacle held within the museum collection is the Pince-Nez (Figure 4). Literally translated to “to pinch the nose”, pince-nez glasses were popularly worn by President Theodore Roosevelt. Although lacking sides, the pince-nez remained stationary due to the pinch of the bridge of the spectacle on the nose, and could avoid damage by securing an ear chain to one side.

pince-nez

Figure 4: Pince-nez

The production of the pince-nez remained active well into the 20th century, and is still worn by some people today.

Frames with sides passing over either ear had been around since around the early 18th century, but this style became more and more popular during the 20th century. By this point in time, plastic frames, as well as metal frames, also became available for purchase. These frames tended to be much more durable and comfortable.

Wire framed spectacles

Wire framed spectacles

After the founding of the National Health Service in 1948, members of the public could receive free eye tests and also claim a free pair of glasses through the NHS.3 Although not the most aesthetically pleasing glasses, the number of people requiring spectacles was high. This ultimately led to glasses being seen as a fashion accessory rather than a sign of poor eyesight. Indeed today, the style and colour of glasses worn by an individual can reflect part of their personality, their identity.

Although the primary function of glasses in aiding eyesight has not changed over the years, the styles and designs have. There is now greater choice than ever, with even more emphasis on how the glasses look rather than what they do.

References

  1. Stein, H.A., Stein, R.M., and Freeman, M.I., 2012. The Ophthalmic Assistant: A Text for Allied and Associated Ophthalmic Personnel. Elsevier Health Sciences: China.
  2. The College of Optometrists, 2016. A bit on the side – The development of spectacle sides. [online] Available at: http://www.college-optometrists.org/en/college/museyeum/online_exhibitions/spectacles/side.cfm.
  3. The College of Optometrists, 2016. Rivet Spectacles. [online] Available at: http://www.college-optometrists.org/en/college/museyeum/online_exhibitions/spectacles/rivet.cfm.
  4. American Academy of Ophthalmology, 2016. Museum of Vision: Spectacles 1700s. [online] Available at: http://www.museumofvision.org/collection/sets/?key=26.

Update (22nd December 2016): Many thanks to Neil Handley (@neilhandleyuk), curator of the British Optical Association Museum at the College of Optometrists, for lending his expertise to correct some inaccuracies in an earlier version of this post.

Helping others

Latest blog post from our digitisation intern, Kirsty Early.

A recent focus of research for the digitisation project has been a medical bag dating from the 1930s. More specifically, the focus has been on the doctor who owned the medical bag, Dr. Maud Perry Menzies.

Medical bag of Dr Maud Perry Menzies

Medical bag of Dr Maud Perry Menzies

Dr. Menzies earned her medical degree at the University of Glasgow, graduating in 1934. Not only was she one of the minority of females graduating from medicine at that time, but she was the top ranking student in Surgery, receiving the Sir William Macewen Medal for her efforts.

Menzies had a passion for helping and healing members of the public, which was evident in her work as a general practitioner and a medical officer [1]. The outbreak of war lead to the spreading of many infectious diseases across Europe, including Diphtheria. This is an airborne condition caused by the bacterium Corynebacterium Diphtheriae. An indicator of infection is the appearance of a grey membrane at the back of the throat, which can lead to breathing and eating problems.

Due to its mode of transmission, diphtheria was particularly prevalent in major cities such as Glasgow. The child death rate in Glasgow was the highest in Europe at the time, primarily due to the crowded and unsanitary conditions of the slums [2]. Thankfully, the vaccine for diphtheria had been in practice since the 1920s, so action could be taken to prevent the spread of the disease. The vaccination would have been administered by an intramuscular injection using a syringe and hypodermic needle, such as the one pictured below (Fig 1).

Hypodermic needle

Fig 1: Hypodermic needle

Other infectious diseases would have required multi-puncture vaccinations, with several needles puncturing the skin simultaneously. This method was accomplished using vaccinators (Fig 2.). The needles were dipped in the vaccine, which would then be injected into the patient during the puncture.

Vaccinator

Fig 2: Vaccinator

As an assistant medical officer of health, Dr. Menzies launch an immunisation campaign for diphtheria in Rutherglen. She also went on to work for the RAMC during the European Campaign of the Second World War, returning to Glasgow to become the principal medical officer for the school health service [1]. Such was her drive for helping others.

References
1. Dunn, M., and Wilson, T.S. 1997. Obituaries: Maud Perry Menzies. The British Medical Journal, 2, 433.
2. Reid, E., 2014. The lesson my father taught me. Herald Scotland [online]. Available at: http://www.heraldscotland.com/opinion/13168642.The_lessons_my_father_taught_me/