Blood and Guts: A History of Surgery

FURTHER READING

I was surprised when I started writing Blood and Guts how few books are available on the history of surgery. There are some excellent books on medicine, particular surgeons or episodes, but few broader histories. If you want to find out more about a particular era, surgeon or practice (such as lobotomy), I have listed some suggestions below. A few of the books are out of print, but, thanks to the wonders of the Web, are usually obtainable. Rather than give a long list of my sources and references for this book, which would run to a separate, sprawling and dull chapter, I thought it might be helpful to point to some general sources of surgical history, facts and inspiration.

I cannot recommend highly enough a visit to the Old Operating Theatre Museum and Herb Garret near London Bridge (www.thegarret.org.uk). Here, up a narrow winding staircase at the top of a church, is the original operating theatre from St Thomas' Hospital, complete with operating table and surgical instruments from the early nineteenth century. The museum also has displays on early medicines, bleeding and the development of anaesthetics and antiseptics. One of my favourite exhibits is a walking stick that a surgeon had his patients bite on during operations, to help them cope with the pain. You can still make out the tooth impressions.

Another fascinating museum is the Hunterian at the Royal College of Surgeons near Lincolns Inn (www.rcseng.ac.uk/museums). I have not written much about John Hunter (see Chapter 3), but in the museum you will find an incredible collection of the weird and wonderful. You will also see how much he achieved in advancing our understanding of human biology.

If there is one single institution that made this book possible, it is the Wellcome Library (on Euston Road in London). I have spent many happy hours there, leafing through old books, papers and journals. The library contains Robert Liston's books on Victorian surgery and the case notes for the first anaesthetic. It holds translations from Vesalius and Semmelweis, papers on the first heart surgery, and even descriptions of groundhogs (see Chapter 2). The biggest problem with the Wellcome Library is that it is very easy to get diverted. I spent an afternoon reading graphic case notes on early eye operations, only to realize that there was no space for them in the book. The library is free to join and much of it (particularly the images) is accessible online (http://library.wellcome.ac.uk).

The library is housed alongside the Wellcome Collection, where you will find beautifully displayed surgical knives, cupping bowls and an exhibition on the latest developments in biotechnology.

The book that I think gives the most complete account of surgical history is A History of Surgery by Harold Ellis (Greenwich Medical Media, 2000). Ellis is a world expert on surgical history, and although the book was probably aimed at a medical and surgical readership, it is clearly written and well illustrated. Unfortunately, the book is out of print, but I understand a new edition is in the pipeline. For a glimpse into the mind of a surgeon I recommend Atul Gawande's thrilling and entertaining Complications: A Surgeon's Notes on an Imperfect Science (Profile, 2002). In a similar vein David Wootton's Bad Medicine: Doctors Doing Harm since Hippocrates (Oxford University Press, 2006) suggests that, until relatively recently, doctors were often doing more harm than good.

I also relied on several human physiology and anatomy textbooks. I hope that, with their help, I have not made any glaring errors in my anatomical explanations. The other book that proved invaluable was my mum's nursing textbook from the 1940s, A Complete System of Nursing (Temple Press, 1947) which gave useful information on the treatment of patients and an alarming insight into just how basic medical practice was even then (penicillin is mentioned only briefly as it was not yet widely available, and anaesthetics were still administered from a 'drop bottle' on to a mask).

Below are a few further reading suggestions:

The Greatest Benefit to Mankind, Roy Porter (HarperCollins, 1997) This substantial book covers the whole history of medicine, but is readable throughout. Porter has written many books on medical history, all of which are equally impressive.

Moments of Truth: Four Creators of Modern Medicine, Thomas Dormandy (John Wiley, 2003)

Stories about four of the people who helped shape modern medicine, including an excellent section on Ignaz Semmelweis.

Seven Wonders of the Industrial World, Deborah Cadbury (Fourth Estate, 2003)

Based on the BBC series of the same title, it includes a section on John Snow, and in the chapter on the transcontinental railroad gives an excellent account of the environment that Phineas Gage (see Chapter 5) would have worked in.

King of Hearts, G. Wayne Miller (Crown, 2000)

Although the writing style is sometimes a bit sentimental, this is nonetheless a gripping biography of Walter Lillehei.

The Knife Man, Wendy Moore (Bantam Press, 2005)

An extremely entertaining and evocative biography of John Hunter.

Transplant: From Myth to Reality, Nicholas L. Tilney (Yale University Press, 2003)

This is a rather skewed account of transplant surgery from a US perspective, but it does give an insider's overview of the discipline's development. Far better, I think, is Joseph E. Murray's Story of the First Human Kidney Transplant(Mitchell Lane, 2002).

There are three superb books relevant to the chapter on plastic surgery: Gillies: Surgeon Extraordinary, Reginald Pound (Michael Joseph, 1964); Gladys, Duchess of Marlborough, Hugo Vickers (Weidenfeld & Nicolson, 1979) – a fascinating account of an extraordinary life; The Reconstruction of Warriors, E.R. Mayhew (Greenhill Books, 2004). I also recommend taking a look at Jacqueline Saburido's website (www.helpjacqui.com).

An Odd Kind of Fame: Stories of Phineas Gage, Malcolm Macmillan (MIT Press, 2000)

This is a forensic account of Gage and the myths surrounding him. The book is meticulously researched, but does come from an academic perspective, so it can be a bit dry at times. However, Macmillan's research in uncovering the story of Gage is truly impressive.

Harvey Cushing: A Life in Surgery, Michael Bliss (OUP, 2005)

There is so much more to say about Cushing than I have been able to, and it can be found in this well-written and accessible account of his brilliant and complex life.

The Lobotomist, Jack El-Hai (John Wiley, 2005)

If you read only one other book (apart from mine) on the history of surgery, make it this one. It is superbly researched and entertainingly written. If you want more, get a copy of My Lobotomy by Howard Dully (Vermilion, 2008). It includes some of Freeman's original notes and Dully's personal journey to try to understand why he was lobotomized.

The Terminal Man, Michael Crichton (Arrow Books, 1972)

Although this is a work of fiction, in the light of some of the experiments being conducted at the time, it turns out to be terrifyingly close to reality.

Finally, if you want an insight into the, shall we say, hinterland of medical research, I suggest taking a look at Alexis Carrel's Man the Unknown (Harper & Bros, 1935) and The Culture of Organs (P.B. Hoeber, 1938). Likewise, José Delgado's Physical Control of the Mind (Harper & Row, 1969) is worth flicking through, if only for the pictures.



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