Our Artist in Residence “meets” Joseph Lister

Our Artist-in-Residence, Marianne MacRae writes about her introduction to Joseph Lister and her role at the College.

I took up my position as Artist-in-Residence at the Royal College of Physicians and Surgeons of Glasgow in June and have spent the last month getting a little better acquainted with Joseph Lister. Having come here with only a relatively vague idea of what Lister did to earn him his position as “the father of modern surgery”, I’ve been really keen to read and absorb as many details of his work as possible before I get down to the real “artistry” of the residency.

Joseph Lister

Joseph Lister: the man, the legend

In brief, and for anyone who isn’t aware, Joseph Lister pioneered antiseptic surgery back in the mid-1860s, aka when surgery was the next best thing to a death sentence. Following Louis Pasteur’s pasteurisation experiments, Lister made the connection between germ theory and infection rates in compound fractures (i.e. broken bones that pierce the skin, thus creating an entry point for bacteria). More than half of patients with compound fractures at the time died due to infection. He began testing carbolic acid as a potential solution to the problem, recognising its antiseptic properties after reading that it was used to treat sewage. His experiments were successful and he published his findings in 1867 in The Lancet, which I’ve read and I can tell you there is a lot of detailed pus in those articles, but all necessary in the name of ground-breaking medicine (wouldn’t advise eating, say, a custard tart right after reading though).

Lister promoted the use of antiseptic dressings, sterile surgical instruments and handwashing. His work revolutionised surgical practice and facilitated the aseptic method universally employed by surgeons nowadays. Listerine is also named after him. Overall, a top lad, I’m sure you’ll agree.

My role here
I’m currently doing a PhD in Creative Writing at the University of Edinburgh (don’t hold it against me, Glasgow, I love you both equally), researching animal otherness in the work of Marianne Moore, D.H. Lawrence and Elizabeth Bishop, while also writing my own collection of poetry. So really nothing to do with revolutionary Victorian surgical practices…BUT it does involve a lot of close observation, analytical thinking and, to some degree, experimentation (with words etc.), which is…kinda the same? Hmm, maybe not. Well anyway, I’ll be writing poetry in response to my engagement with the heritage collection here at the college and running some workshops later in the year – more details of those in due course. All this will be specifically in relation to Lister’s time here in Glasgow, which plays an important role in his pioneering work, not least because it was at Glasgow Royal Infirmary that his initial tests on patients took place, while he was Professor of Surgery at Glasgow University.

Photo of notebooks

A poet’s accoutrements

What have I done so far?
It turns out tuning your mind in to a completely new field of study doesn’t happen quite as quickly as you might think. But here on day 10, I’ve got a few first draft poems that should be ready for human consumption soon, as well as a deeper knowledge of surgery…I mean, don’t hold me to it, but I’m pretty sure at this point, based on my reading of surgical techniques back in the day, I could perform a quick procedure to a Victorian standard. I would even wash my hands before and after, which is more than you could expect from many of Lister’s naysayers. (Please note: I will not be performing any surgical procedures as part of this residency.)

Logo of the College featured on the Lock Room carpet

Lock Room carpet pals

The Heritage team have kindly said I’m free to roam the rooms of the college and spend time getting to know the place a little better. So far my favourite is the Lock Room, which is a v. cosy wee library that has a bunch of Lister-related texts available for perusal. It also has, to my mind, the funkiest carpet (see above) though the tartan of the Alexandra Room is also quite impressive.

Lock Room

Lock Room

I’ve spent some time familiarising myself with some of the socio-historical factors that were pertinent at the time. I’ve been particularly taken with Thomas Annan’s photographs from the period, which document the horrendously impoverished conditions that the working class people of Glasgow were living in at around the same time Lister was making his discoveries. I’m currently working my way through a book called Midnight Scenes and Social Photographs: Being Sketches of Life in the Streets, Wynds, and Dens of the City of Glasgow (bit of a mouthful), which offers an account of life in the tenements. The writer, known only as “Shadow” (v. mysterious), is certainly not the most sensitive of documentarians and the people he describes are often dehumanised to a disgraceful degree. At the same time though, it offers an interesting insight into the lives of the poor, which are too often written out of history altogether. I’d really like bring these people back to life somehow, and will be working on a way to incorporate this in to the scope of the project.

Finally…
I’m really excited to be here! It’s amazing to be given the chance to write about such an interesting period of change in Scotland that had a worldwide resonance and recapitulated the way we approach not only medicine, but personal hygiene and sanitation. That we can divide the history of medical discoveries into “before Lister” and “after Lister” is a testament in itself, so I’ll be working really hard over the coming months to do his story artistic justice.

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

Joseph Lister, Glasgow and the Birth of Antiseptic Surgery

2017 marks 150 years since Joseph Lister published his ground-breaking article “Antiseptic Principle of the Practice of Surgery” in the medical journal, The Lancet. To mark this occasion our annual Goodall Symposium will be celebrating Joseph Lister and his outstanding contribution to antiseptic surgery.

There is, arguably, no more appropriate place to celebrate the beginnings of antiseptic surgery than in Glasgow as it was in Glasgow Royal Infirmary that Lister first started using carbolic as an antiseptic, heralding the beginnings of a surgical revolution.

Lister ward at Glasgow Royal Infirmary c.1900

Lister ward at Glasgow Royal Infirmary c.1900

Based on Louis Pasteur’s research into fermentation, Lister began covering wounds in dressings containing carbolic acid which was known to prevent putrefaction in substances of animal origin. His first attempt was a failure but with his second patient, an eleven year old boy, Lister succeeded. As part of the patients treatment, pure carbolic acid on calico was applied to all areas of the wound – the wound healed; there was no infection, no gangrene and so amputation was avoided.

Lister continued to expand his use of carbolic acid using a steam spray (pictured below) to spray the air in his operating theatre. He was particularly driven by his intense revulsion towards the conditions of the surgical rooms and wards at Glasgow Royal Infirmary and devoted his full attention to reducing cross infection. Poor sanitation in 19th century hospitals meant patients were at serious risk of contracting diseases such as pyaemia, gangrene and tetanus. Lister was constantly battling with the managers of the Glasgow Royal Infirmary over the poor conditions of the wards and in 1870 wrote a letter to the Lancet entitled On the effects of the antiseptic treatment upon the salubrity of a surgical hospital, where he described the wards at the Royal as “some of the most unhealthy in the Kingdom”. The wards had been built over cholera burial pits and were close to the pauper burial pits at Glasgow cathedral. Lister also stated that the wards had not been properly cleaned for three years and were dreadfully overcrowded.

A Lister carbolic spray c.1870

A Lister carbolic spray c.1870

Lister’s success with antiseptic procedures revolutionised the treatment of disease and injuries.

Join us to celebrate 150 years of safer surgery!

Lister continues to be an inspiration to many of today’s doctors and surgeons and we are delighted to welcome Mr Pankaj Chandak, Specialist Registrar in Transplant Surgery at Guy’s, St Thomas’ and Great Ormond Street Hospitals and Research Fellow at Kings College London, to deliver the Goodall Lecture. Mr Chandak is passionate about Lister’s achievements and his legacy in surgical safety, linking the innovations of the 1860s with today’s developments in 3-D printing, robotics and perfusion machines. You can see more of Mr Chandak here – https://www.youtube.com/watch?v=JKUIvt9DI_Q

Setting the context of Lister’s 1867 article is Mr David Hamilton, transplant surgeon, medical historian, and author of the classic text The Healers: a History of Medicine in Scotland.

Our Goodall Symposium takes place on the 15th June 2017.
Time: 7pm (refreshments from 6:30pm)
Price: Free
To book contact library@rcpsg.ac.uk or call 0141 221 6072.

Our Goodall Symposium is part of the Glasgow Science Festival 2017.

Flyer advertising the Goodal Symposium

Glasgow Surgical Instrument Makers

One of the themes for this year’s Doors Open Day Festival in Glasgow is industrial heritage.  The College museum collection contains many items relating to surgical instrument makers during the 19th century and several of these items are on display in the College’s Crush Hall until the end of September.

Designated surgical instrument makers appear in Glasgow from around the beginning of the 19th century. W.A. Norie, for example is known to have been established at Hutcheson Street, Glasgow, by 1801. The rise in instrument makers coincides with the growth of Glasgow as a large industrial city and the establishment of hospitals, clinics and surgeries to care for the growing population. Glasgow Royal Infirmary opened its doors to patients in 1794 and remained the main city hospital until the second half of the 19th century; the Western Infirmary opening in 1874 and the Southern General in 1890. The variety of instruments manufactured by the Glasgow makers demonstrate the great advance in surgical techniques that occurred from the second half of the 19th century onwards, often developed in conjunction with local surgeons.

Scalpel by Norie, Glasgow, early 19th century. Liston amputation knife and dental forceps by James Dick, Glasgow 19th century.

Scalpel by Norie, Glasgow, early 19th century. Liston amputation knife and dental forceps by James Dick, Glasgow 19th century.

W.B. Hilliard and Sons were the largest surgical instrument maker in Glasgow during the 19th century. The firm was known for its fine workmanship and was awarded several medals and prizes in exhibitions in both Glasgow and London. Originally established in Buchanan Street in 1834, the firm subsequently moved to Renfield Street. The firm worked closely with local surgeons to perfect and introduce new instruments and also imported items from specialist manufacturers in Europe. By 1888 Hilliard and Sons was said to supply ‘with but few exceptions, all the principal infirmaries, asylums and institutions in Scotland with surgical instruments and fine steel goods’. In addition to surgical instruments the firm also patented and sold two different types of ice skate.

Haemorrhoid forceps manufactured by W.B. Hilliard, 19th century

Haemorrhoid forceps manufactured by W.B. Hilliard, 19th century

W.B. Hilliard took a keen interest in the development of surgical instruments and was keen to perfect the items he manufactured. He published a paper in the Glasgow Medical Journal in 1859 “On lithotomy instruments”.   The rectangular lithotomy staff had been developed for Dr Andrew Buchanan in 1846 (President of the Faculty of Physicians and Surgeons of Glasgow 1877-80). Hilliard considered the rectangular staff to be ‘the greatest improvement which has been made in lithotomy instruments since the use of a staff in the operation was first discovered’. In comparison to the previous curved version: ‘It affords the shortest route to the bladder; it gives ready and certain access to the knife; and offers no obstruction to the passage of the knife’.

Part of lithotomy set by W.B. Hilliard and Sons

Part of a lithotomy set including rectangular staff by W.B. Hilliard and Sons

Hilliard also manufactured a form of lithotrite for crushing bladder stones in situ.  The lithotrite had been devised by French surgeon Jean Civiale (1792–1867) who, in 1832 performed transurethral lithotripsy, the first known minimally invasive surgery, to crush stones inside the bladder without having to open the abdomen (lithotomy). This particular lithotrite is an example of one developed by Scottish surgeon Sir William Fergusson (1808-77), Professor of Surgery at King’s College, London. The key is inserted into the main screw shaft to lock it. The set belonged to Sir George H.B. McLeod (1828-1892), Regius Professor of Surgery at the University of Glasgow, 1869-1892 who entered the Faculty of Physicians and Surgeons of Glasgow in 1858.

Lithotrite and key manufactured by W.B. Hilliard, c. 1860.

Lithotrite and key manufactured by W.B. Hilliard, c. 1860.

Tinsmith Andrew Brown based in George Street, Glasgow was a familiar figure at the Glasgow Royal Infirmary during the last half of the 19th century/early years of the 20th century.  As a boy he had worked for Joseph Lister when Lister was at the Glasgow Royal Infirmary. Brown’s sterilizers were used in the Glasgow Royal Infirmary and many nursing homes. The College has an example of a foot warmer made by Brown in the early years of the 20th century.

Foot warmer made by tinsmith Andrew Brown.

Foot warmer made by Andrew Brown, early 20th century.

Optometrists Black and Lizars are celebrating their 185th anniversary this year.  John Lizars (1810-1879) set up shop as an optician in Glassford Street in 1830. By 1859 he was selling spectacles, eyeglasses, telescopes, microscopes, barometers, thermometers and a ‘great assortment’ of other items.

Sight testing set by Lizars. On loan from Black & Lizars optometrists.

Sight testing set by J. Lizars. On loan from Black & Lizars optometrists.

The firm was subsequently directed and expanded by Lizars’ son-in-law, Matthew Ballantine and his successors. In 1999 Lizars merged with C. Jeffrey Black to form Black & Lizars with a combined total of more than twenty branches mainly in the West of Scotland. Black & Lizars have kindly loaned glass eyes and sight testing equipment especially for our display.

Glass eyes manufactured by Lizars, Glasgow. On loan from Black & Lizars optometrists.

Glass eyes manufactured by Lizars, Glasgow. On loan from Black & Lizars optometrists.

John Trotter set up business in Gordon Street, Glasgow in the 1880s with a branch opening in Edinburgh in the 1920s. Trotter was a pioneer in many branches of optical science and he also advised hospitals on the instillation of X-ray apparatus.

Newman’s cytoscope for examination of the bladder by John Trotter Ltd.

Newman’s cystoscope for examination of the bladder by John Trotter Ltd.

Ophthalmic surgeon Hugh Wright Thomson worked with Trotter to develop the skiascope which he used initially for eye examinations in school children although he subsequently also found it helpful for adults in hospital refraction work. A long stem was attached to its centre and the circular frame was fitted with twenty of the lenses most commonly used in retinoscopy (technique to objectively determine the refractive error of the eye – farsighted, nearsighted, astigmatism – and the need for glasses).

Skiascope developed by Hugh Wright Thompson in conjunction with John Trotter

Skiascope developed by Hugh Wright Thompson in conjunction with John Trotter, 1905

Trotter died in 1940, the firm continuing in operation until it was acquired by Black & Lizars in 2014.

For further information about any of the items described in this blog please email library@rcpsg.ac.uk

 

 

Glasgow’s contribution to radiology

The college’s triennial conference, Advancing Excellence in Healthcare, takes place at the SECC in Glasgow on the 19th and 20th June 2014. To celebrate, we’ve been running a series of blogs relating to the History of Medicine symposium which is focusing on Glasgow’s contribution to medicine. This week we turn our attention to Professor Ian Bone’s talk on “Macintyre and the world’s first radiology department”.

John Macintyre was born in High Street, Glasgow in 1857. He initially trained as an electrician under the tutelage of Lord Kelvin before going on to complete his degree in medicine at the University of Glasgow in 1882. It was this interesting combination of expertise that placed Macintyre at the forefront of the development of radiology.

Sketch of Dr John Macintyre

Sketch of Dr John Macintyre

Professor Wilhelm Roentgen, a German physicist, first discovered x-rays in the November of 1895 whilst studying electrical effects on vacuum tubes. Roentgen sent details of his discovery to Lord Kelvin who passed the information on to Macintyre. At this time, Macintyre was employed by Glasgow Royal infirmary as their Medical Electrician and he very quickly grasped the significance of the discovery – In March 1896, only a few months after the discovery of x-rays, Macintyre obtained permission from the hospital managers to establish an x-ray laboratory, creating the first x-ray unit in the world to provide a service to patients.

electrical department at Glasgow Royal Infirmary c.1914

Electrical department at Glasgow Royal Infirmary c.1914

Macintyre was a pioneer of x-rays and is credited with taking the first x-ray of a kidney stone in-situ, a foreign body (halfpenny stuck in the gullet of a child), and the first cineradiogram showing the movement of a frog’s legs.

We hold many items relating to Dr John Macintyre and his work in our collections but perhaps the most interesting (and fragile!) is a set of high voltage vacuum discharge tubes used by Macintyre at the Glasgow Royal infirmary to create x-rays.

high voltage vacuum discharge tubes used by Macintyre

3 high voltage vacuum discharge tubes used by Macintyre

In recognition of his achievements he was made President of the Roentgen Society, Doctor of Laws of Glasgow University, President of the British Laryngological and Rhinological Society (Macintyre also specialised in otolaryngology and opened a very lucrative private practice at 179 Bath Street, Glasgow), and a Fellow of the French and American Associations. He became a Fellow of our College (then Faculty) in 1918.

Dr John Macintyre’s signature in our Register of Fellows

Dr John Macintyre’s signature in our Register of Fellows

To find out more about the History of Medicine Symposium, or for more information and booking details for the triennial conference, please visit the Advancing Excellence in Healthcare website: http://aeh2014.rcp.sg.

Rebecca Strong – remarkable nursing pioneer

Rebecca Thorogood was born on the 23 August 1843 in London.  She married and had a daughter before the age of 20.  Very little is known about her husband apart from his surname, Strong, and the fact that he died within a couple of years of marriage and was buried in Liverpool.

Widowed at a very young age, Rebecca Strong decided to go into nursing and was accepted as a probationer at the Nightingale Training School which had started in 1860 at St Thomas’ Hospital in London.  In 1868, following her training, she gained nursing experience at Winchester and at the British Army hospital at Netley, being appointed matron of the Dundee Royal Infirmary, in 1874.  At Dundee, Rebecca Strong was able to introduce new nursing practices (see the Dundee Women’s trail for further information about her time in Dundee).

In 1879 Mrs Strong was appointed matron at Glasgow Royal Infirmary, the largest voluntary hospital in Scotland.  Attracted by the challenge, when she arrived in Glasgow she was shocked to find how backward the Infirmary appeared in relation to its nurses.  She devoted her energies to improving nurse education and training and working conditions.

An example of the letters from Mrs Strong to Sir William Macewen in the College archive (RCPSG 10/1A/128/49)

An example of the letters from Mrs Strong to Sir William Macewen in the College archive (RCPSG 10/1A/128/49)

Letters from Rebecca Strong can be found in the papers of Sir William Macewen in the College archives.  The relationship between the two could at times be stormy but they greatly respected one another.

In January 1891, Macewen gave an address at Glasgow Royal Infirmary on the subject of “Nurses and Nursing”.  A copy of the address is in the College archive (RCPSG 10/1A/129/11).  In the lecture he said “Cannot nursing be raised to a distinct profession, with its entrance examination, its minimum requirements, theoretical and practical, its teachers, its examiners and its diploma?”  He also felt that  nursing was specially suited for women: “Nursing is, beyond all cavil, a sphere for women’s work; indeed man can scarcely enter there . . . one can scarcely expect a man to be a nurse, as his instincts and training do not suit him for it . . .  A woman possesses such a magnificent compass of susceptibilities, is so full of human sympathies and soft compassions, if her life is not to be a barren wilderness she requires opportunities to enable these to expand”.

With the support of Macewen, Rebecca Strong initiated the ‘block apprenticeship’ training programme, later adopted world-wide.  Short periods of instruction in the hospital school was followed by periods of practice on the wards.  This was a great improvement on previous nurse instruction whereby nurses were expected to attend lectures and study while still working long hours on the wards.  The pioneer Preliminary Training School was opened in January 1893 under an arrangement between Glasgow Royal Infirmary and St Mungo’s Medical College.

Mrs Strong Medal in Medical Nursing

Mrs Strong Medal in Medical Nursing

In 1942 the Macewen medal in surgical nursing and the Mrs Strong medal in medical nursing were established at Glasgow Royal Infirmary to commemorate the pioneer work of Macewen and Strong in elevating nursing to the status of a profession.

Rebecca Strong was a strong supporter of State Registration for nurses which eventually happened in 1919.  She also worked for the improvement of the social life of nurses and was the moving spirit, along with Sir William Macewen, in the opening of a club for them in Glasgow in 1918.  In 1939, at the age of 95, she was awarded the O.B.E.  and celebrated her 100th Birthday on 23 August 1943.  She died almost exactly a year later, on 24 April 1944.

Further biographical details about Rebecca Strong can be found on the Royal College of Nursing website

For those wishing to find out more about the early years of nursing, digitised copies of the The Nursing Record/British Journal of Nursing can also be found on the Royal College of Nursing website.

The College Library holds books on the history of Glasgow Royal Infirmary and also has some archive material relating to the hospital.  The administrative records of Glasgow Royal Infirmary (including registers of nurses) are in the NHS Greater Glasgow and Clyde Archives.