Sir William Macewen | |
|---|---|
 | |
| Born | (1848-06-22)22 June 1848 Port Bannatyne,Isle of Bute, Scotland |
| Died | 22 March 1924(1924-03-22) (aged 75) Glasgow, Scotland |
| Education | University of Glasgow |
| Known for | Pioneering work in brain surgery, hernia surgery and bone grafts endotracheal anaesthesia pneumonectomy |
| Medical career | |
| Profession | Surgeon |
| Institutions | Glasgow Royal Infirmary Western Infirmary Royal Hospital for Sick Children |
| Sub-specialties | Neurosurgery,Orthopedic surgery |
| Awards | Knighthood Cameron Prize for Therapeutics of the University of Edinburgh(1896) |
Sir William Macewen (/məˈkjuːən/mə-KEW-ən; 22 June 1848 – 22 March 1924) was aScottishsurgeon. He was a pioneer in modernbrain surgery, considered thefather of neurosurgery and contributed to the development of bonegraft surgery, the surgical treatment ofhernia and ofpneumonectomy (removal of thelungs).
Macewen was born nearPort Bannatyne, nearRothesay on theIsle of Bute, in western Scotland in 1848.[1]
He studied Medicine at theUniversity of Glasgow, receiving a medical degree in 1872. He was greatly influenced by Joseph, LordLister (1827–1912), who revolutionised surgery by developingantisepsis, by the use ofphenol, thus decreasing drastically the enormous mortality of surgical patients due to infections. By following Lister and adopting systematically the use of scrubbing (deep cleansing anddisinfection of hands and arms),sterilisation of surgical tools, use of surgical gowns, and (recently discovered)anaesthesia, Macewen became one of the most innovative surgeons of his time and was able to greatly advance modern surgical technique and improve the recovery of patients.
In 1875, he became an assistant surgeon at theGlasgow Royal Infirmary, being promoted to full surgeon in 1877. Around 1880 he began a training programme for nurses (focussing on sterilisation) at the infirmary under the charge of the Matron, MrsRebecca Strong (1843-1944).[2] In 1881 he was appointed lecturer on Systematic Surgery at the Royal Infirmary School of Medicine.[3] In 1883 he was appointed as Surgeon to theRoyal Hospital for Sick Children in Glasgow. In 1892 Macewen becameRegius Professor of Surgery at the University of Glasgow (the post which Lister had held when Macewen was a student) and transferred his surgical activities to theWestern Infirmary.[3] In 1896, Macewan was awarded theCameron Prize for Therapeutics of the University of Edinburgh.
He wasknighted in the1902 Coronation Honours for services to medicine,[4] receiving the accolade from KingEdward VII atBuckingham Palace on 24 October that year.[5]
In 1916 Macewen helped to found thePrincess Louise Scottish Hospital for Limbless Sailors and Soldiers inErskine (now the Erskine Hospital), near Glasgow, which was urgently needed to treat the thousands of military who had lost their limbs in theFirst World War. Macewen was its first chief surgeon and with the help of engineers and workers at the nearbyYarrow Shipbuilders he designed the Erskineartificial limb. He trained a team of pattern-makers to manufacture them for the hospital. Macewen recruited the first matron for Erskine, Agnes Carnochan Douglas, who he had worked with in the Western Infirmary in Glasgow.[6]
Macewen died inGlasgow on 22 March 1924.[3] He lived at Garrochty on the Isle of Bute until his death and was buried nearby in the churchyard of St Blane's Church atKingarth.
Following the work ofJohn Hughlings Jackson (1835–1911) andDavid Ferrier (1843–1924) on neurological mapping of functions in the brain, Macewen demonstrated in 1876 that it was possible to use a precise clinical examination to determine the possible site of atumour or lesion in the brain, by observing its effects on the side and extension of alterations in motor and sensory functions. Thus, in 1876 he diagnosed an abscess in the frontal lobe of a boy, but the family refused permission to operate. When the patient died his diagnosis and localisation were found to be correct.
In 1879 he performed the first successful intracranial surgery where the site of the lesion (a left frontalmeningioma) was localized solely by the preoperative focalepileptic signs (twitching of the face and arms in the opposite side of the lesion). On the basis of these signs Macewen thought that there was good evidence of an "irritation to the lower and middle portions of the ascending convolutions…in the left frontal lobe". A trephined hole in the skull near the purported site of the lesion showed a big subdural tumour. The patient, a teenage girl, lived for eight more years, and a subsequentautopsy showed no trace of the tumour. He later used this many times to successfully operate on brainabscesses (in 1876) andhematomas and on thespine. This was a great triumph of medicine.
According to one of his biographers, "his thorough knowledge of the natural history of pyogenic diseases of thetemporal bone andnasal sinuses, in addition to his clear description ofcranial anatomy, as illustrated in hisAtlas of Head Sections, were especially important in developing his successful treatment of brain abscess. TheX-ray had not yet been discovered; Macewen's diagnosis was based on clinical findings superbly illustrated by his three clinical stages of brain abscess development." (Canale, 1996).
One of his earliest contributions while at the Royal Infirmary, in 1877, was inorthopaedics, by means of the development of the first bone grafts, but also in knee surgery using a special instrument (Macewen'sosteotome) both techniques becoming key treatments for the highly prevalent disease ofrickets (caused by a lack ofVitamin D). Macewen was interested in the biology ofbone and carried out a classical series of experiments on animals in order to determine how bones grow and may be repaired. He developed surgical treatments formastoid disease andpyogenic cysts of thetemporal bone and has identified an anatomical structure in this bone, thefoveola suprameatica, which was namedMacEwen's triangle in his honour.
His method of surgical removal of lungs became a major medical weapon in the treatment oftuberculosis and lung cancer, thus saving many patients. His name was also immortalised in Medicine in two other instances: theMacewen's operation foringuinal hernia and theMacewen's sign forhydrocephalus and brainabscess.
Another important contribution by Macewen to modern surgery was the technique ofendotracheal anaesthesia with the help of orotrachealintubation, which he described in 1880, and still in use today.
Macewen was noted for his early and creative use of photographs for documenting patients' cases and for teaching surgery and medicine. He pioneered the use of photos of body parts and pathological specimens, as well as photos taken before, after and during treatment/surgery.
After his death, a memorial fund was set up in his name.[7] As part of the late 1970s redevelopment of Glasgow Royal Infirmary, where Macewen spent most of his career, a new laboratory block was named in his honour. It opened in 1981.
The archives of Sir William Macewen are maintained by theArchives of the University of Glasgow[8] and theRoyal College of Physicians and Surgeons of Glasgow.[9]
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