Book Review

Surgical Case-Histories from the Past

N Engl J Med 1995; 332:405February 9, 1995

Article

Surgical Case-Histories from the Past
By Harold Ellis. 235 pp., illustrated. London, Royal Society of Medicine Press, 1994. £20. ISBN: 1-85315-222-6

Surgical Case-Histories from the Past, a compilation of historical case notes and narratives from a variety of sources with introductions by Harold Ellis, contains four parts, entitled “Major Advances,” “The Surgeon at War,” “Surgical Emergencies and Disasters,” and “The Surgeon at Work.” Some of the material has been published previously in the periodical literature.

The first part of the book — “Major Advances” — contains Ephraim McDowell's description of the first successful ovariotomy in 1809, John Collins Warren's report on operations using ether anesthesia in 1846, Joseph Lister's case reports of the first antiseptic operations (1867), Jules Péan on the first successful elective splenectomy in 1867, John Stough Bobbs on the first cholecystotomy for gallstones in 1868, Jonathan Hutchinson on the first successful operation for intussusception in an infant in 1874, Sir William Macewen on the first successful excision of an intracranial tumor in 1879, Theodor Billroth on the first successful gastrectomy in 1881, Carl Langenbuch on the first cholecystectomy in 1882, Sir William Arbuthnot Lane on transabdominal cardiac massage in 1902, Sir Henry Sessions Souttar on the first mitral transauricular valvotomy in 1925, and Charles Dubost on resection of an aortic aneurysm in 1951.

Surgeons and others especially interested in the history of medicine may be familiar with the broad outlines of some of the information presented in this section, but Ellis has included fresh items of interest that embellish the discourse. For example, Ellis reports that Sir William Macewen of Glasgow, characterized by Harvey Cushing as “the chief pioneer in craniocerebral surgery,” was offered the chair of surgery at the newly established Johns Hopkins Medical School. Dr. Macewen declined because he could not be assured that he would be responsible for the supervision and training of the nurses.

As regards Billroth's “first successful gastrectomy,” he himself wrote in an open letter to Dr. L. Wittelshöfer (Wiener Medizinische Wochenschrift 1881;31:162): “Seventy years have passed since a young physician, Karl Theodor Merrem, published a dissertation in which he demonstrated, by means of experiments on dogs, that the pylorus could be successfully excised and the stomach joined to the duodenum.” Merrem had also suggested that this operation would be useful as a treatment for pyloric cancer.

“The Surgeon at War” features a description by Ambroise Paré of his treatment of gunshot wounds in Turin in 1537. Paré abolished not only the treatment of wounds with boiling oil but also the cauterization of bleeding blood vessels after amputation, substituting ligatures. Always humble, he declared, “I dressed the wound and God healed him.” Other descriptions of the treatment of war injuries are Richard Wiseman's reports concerning wounds of the brain (1686), Thomas Eshelby on the amputation of Admiral Nelson's arm (1797), Dominique Jean Larrey, Napoleon's surgeon, on gunshot wounds of the bladder (1814), George Grey Turner on “a bullet in the heart” (1917), Harvey Cushing on gunshot wounds of the head (1917), and Gordon Gordon-Taylor on gunshot wounds of the abdomen (1918). A description of civilian injuries caused by the bombing in England during 1941 and 1942 is also included.

“Surgical Emergencies and Disasters” contains descriptions of a variety of urgent situations, including traumatic avulsion of the forequarter (1737), rupture of a strangulated umbilical hernia (1778), ligation of the abdominal aorta (1817), fatal hemorrhage after hemorrhoidectomy (1825), hemorrhage from a cut throat (observations by Sir Charles Bell, 1828), ruptured aortic aneurysm (1840), ligation of the common carotid artery (1849), successful repair of a gunshot wound to the femoral artery (a report by J.B. Murphy, 1897), and early operative treatment of acute appendicitis (by Charles McBurney, 1889).

The fourth section of the book, “The Surgeon at Work,” is a potpourri of operations, conditions, and events that are of interest but that do not have the historical importance of those presented earlier in the book. The subjects of these case reports include amputation of a cancerous breast (1720), John Hunter's description of the excision of a massive parotid tumor (1785) and a bony tumor of the thigh with metastases to the lung (1786), replacement of the nose (1816), Baron Guillaume Dupuytren's lecture on his contracture, and some early contributions by William Stewart Halsted. Concluding this section is a group of anonymous cases entitled “Instructive Mistakes (1912),” previously published in the British Journal of Surgery.

Surgical Case-Histories from the Past is an attractive, interesting, and readable book. The literary style is felicitous. Dr. Ellis, a well-known surgical historian, writes with the easy and engaging facility with which he speaks. The illustrations are extensive, the references are sparse but adequate, and the production values of this handsome book are quite good. There is no index, but perhaps none is called for in this book of modest length, which contains a fully detailed table of contents. This informative book is a pleasure to read and will be a valuable addition to the physician's library.

James D. Hardy, M.D.
University of Mississippi Medical Center, Jackson, MS 39216