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Robert Liston

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This article is about the surgeon. For the British diplomat, seeRobert Liston (diplomat).For the clergyman, seeRobert Liston (minister).

Robert Liston
FRCSEFRCSFRS
Portrait of Robert Liston painted in 1847 by Samuel John Stump
Liston, 1847 portrait bySamuel John Stump
Born(1794-10-28)28 October 1794
Ecclesmachan,West Lothian, Scotland
Died7 December 1847(1847-12-07)(aged 53)
London, England
Alma materUniversity of Edinburgh Medical School
Scientific career
FieldsSurgery

Robert ListonFRCSEFRCSFRS(28 October 1794 – 7 December 1847)[1]was a Britishsurgeon.Liston was noted for his speed and skill in an era prior toanaesthetics,when speed made a difference in terms of pain and survival.[2][3]He was the first Professor of Clinical Surgery atUniversity College Hospitalin London and performed the first public operation utilizing modernanaesthesiain Europe.

Early life[edit]

He was born in the manse ofEcclesmachan,the son of Margaret Ireland fromCulrossand her husband RevHenry Listona clergyman and an inventor, fromEcclesmachaninWest Lothianwest ofEdinburgh.His grandfather – alsoRobert Liston– was theModerator of the General Assembly of the Church of Scotland.[2][3][a]

Career[edit]

After a local education both from his father and inAbercornvillage school, Liston studied atEdinburgh Medical Schoolfrom 1808, and in 1810 became assistant to his tutorDr John Barclay.In 1816, he went to London for a year to train underWilliam Blizard.He returned to Edinburgh to teach anatomy alongsideJames Syme.He was then living at 95Princes Street– a fine house facingEdinburgh Castle.[4]In 1820, he married the daughter of Adam Crawford, aLeithwine merchant.[5]In 1818, he had become house surgeon inThe Royal Infirmary of EdinburghunderDr George Bell.[2][3]However, he was dismissed in 1822 due to disagreements with Bell and not reinstated until 1827. In 1828, he was promoted to operating surgeon.[6]

He became first 'The Northern Anatomist' ofBlackwood’s Magazine.[3]In 1832/1833, he is listed as living at 99 George Street in the centre ofEdinburgh's New Town.[7]In 1833, he applied forEdinburgh's Professorship of Anatomy but was beaten byJames Syme(5 years his junior) who had a much better aptitude for teaching. Liston then left Edinburgh and relocated to London.[6]

For the last seven years of his life[8]he lived at 5 Clifford Street, offBond StreetinMayfair,in a building and area now of historical significance,[9]hence Richard Gordon's specific mention of this address in his section on Robert Liston.[10]

He was elected aFellow of the Royal Societyin 1841.[6]

The coffin of Robert Liston FRS in the Terrace Catacombs,Highgate Cemetery

Death[edit]

He died of a rupturedaorticaneurysm[11]on 7 December 1847 at his Mayfair home, and his funeral took place at St Michael's Church,Highgate,six days later. The funeral procession from his home consisted of five mourning coaches and fifteen private carriages. In the former were relatives and his fellow medical professors of University College, and in the latter were friends of eminence in the higher ranks of society. Near the cemetery, the cortege was met by four hundred of his former pupils, and by about two hundred medical practitioners and others. He was buried on the western side ofHighgate Cemeteryin the Terrace Catacombs.[12][5]

Legacy[edit]

Liston's legacy comprises both that which has made its way into the popular culture, and that found primarily within the medical fraternity and related disciplines.

In 1837, he publishedPractical Surgery,arguing the importance of quick surgeries; "these operations must be set about with determination and completed rapidly."[13]

Liston's image has been preserved in both bust and portrait form.[14]Following Liston's death, a meeting was held of his friends and admirers, who "unanimously resolved to establish some public and lasting Testimonial to the memory of this distinguished surgeon". A committee of some 78 people was formed, which resolved that the testimonial should consist of a marble statue to be placed in some designated public spot, and the inauguration of a gold medal, to be called the "Liston Medal", "and awarded annually, as the Council of University College, may decide".[15]

Reputation[edit]

Robert Liston, photograph circa 1845 byHill & Adamson

Richard Gordondescribes Liston as "the fastest knife in the West End. He could amputate a leg in 21⁄2minutes. "[10]He is reputed to have been able to complete operations in a matter of seconds, at a time when speed was essential to reduce pain and improve the odds of survival of a patient.[2]

InFlorence Nightingale'sNotes on Nursing,she states "there are many physical operations whereceteris paribus(all else being equal) the danger is in a direct ratio to the time the operation lasts; andceteris paribusthe operator's success will be in direct ratio to his quickness. "[16][17][b]

Gordon described the scene thus:

He was six foot two, and operated in a bottle-green coat with wellington boots. He sprung across the blood-stained boards upon his swooning, sweating, strapped-down patient like a duelist, calling, 'Time me gentlemen, time me!' to students craning with pocket watches from the iron-railinged galleries. Everyone swore that the first flash of his knife was followed so swiftly by the rasp of saw on bone that sight and sound seemed simultaneous. To free both hands, he would clasp the bloody knife between his teeth.[10]

Gordon's prose is more than just caricature. He describes how the link between surgical hygiene and iatrogenic infection was poorly understood at that time. At an address byDr Oliver Wendell Holmesto theBoston Society for Medical Improvementon 13 February 1843, his suggestions for hygiene improvement to reduce obstetric infections and mortality frompuerperal fever"outraged obstetricians, particularly in Philadelphia".[18][a][19]In those days, "surgeons operated in blood-stiffened frock coats – the stiffer the coat, the prouder the busy surgeon", "pus was as inseparable from surgery as blood", and "Cleanliness was next to prudishness". He quotesSir Frederick Treveson that era: "There was no object in being clean...Indeed, cleanliness was out of place. It was considered to be finicking and affected. An executioner might as well manicure his nails before chopping off a head."[20]The connection between surgical hygiene, infection, and maternal mortality rates atVienna General Hospitalwas only made in 1847 by Vienna physicianDr Ignaz Philipp Semmelweisfrom Hungary, after a close colleague of his died. He instituted the hygiene practices exhorted by Holmes, and the mortality rate fell.[21]

Such was the era in which Liston lived. Gordon states that Liston was "an abrupt, abrasive, argumentative man, unfailingly charitable to the poor and tender to the sick (who) was vilely unpopular to his fellow surgeons at the Edinburgh Royal Infirmary. He relished operating successfully in the reeking tenements of theGrassmarketandLawnmarketon patients they had discharged as hopelessly incurable. They conspired to bar him from the wards, banished him south, where he became professor of surgery at University College Hospital and made a fortune ".[22]

In writings on Liston, he is portrayed as a man of strong character and ethics, which was the source of some of his confrontational style. In one case, he confronted a medical colleague (Dr Robert Knox) over the treatment of a young woman (Mary Paterson) who it later transpired was murdered (seeBurke and Hare murders), with Knox thought complicit in the murder. She was in Knox's dissecting rooms within four hours of her death, and kept in whisky for three months before dissection, during which time she was essentially on voyeuristic display.[23]Liston's response is documented in a letter from him:

According to Liston, he saw Mary Paterson's body in Knox's rooms and immediately suspected foul play. He knocked Knox down after an altercation in front of his students – Liston assumed some students had slept with her when she was alive, and that they should dissect her body offended his sense of decency. He removed her body for burial.[24]

Liston's firsts[edit]

While Liston's pioneering contributions are paid tribute within popular culture such as Richard Gordon, they are best known within the medical fraternity and related disciplines.

Liston's most famous case[edit]

Although Richard Gordon's 1983 book pays tribute to other aspects of Liston's character and legacy as noted elsewhere in this article, it is his description of some of Liston's most famous cases which has primarily made its way into what is known of Liston in popular culture. Gordon describes what he calls Liston's most famous case in his book, as quoted verbatim below.

Amputated the leg in under 21⁄2minutes (the patient died afterwards in the ward fromhospital gangrene;they usually did in thosepre-Listeriandays). He amputated in addition the fingers of his young assistant (who died afterwards in the ward from hospital gangrene). He also slashed through the coat tails of a distinguished surgical spectator, who was so terrified that the knife had pierced his vitals he fainted from fright (and was later discovered to have died from shock).[29]

— Richard Gordon[30]

This episode has since been dubbed as the only known surgery in history with a 300 percent mortality rate. The situation that Gordon labels "Liston's most famous case" has been described asapocryphal.[31][32]No primary sources confirm that this surgery ever took place.[33]

Publications by Liston[edit]

  • "Cases of Aneurism; Fracture of the Femur; Case of Aneurism",The Edinburgh Medical and Surgical Journal,vol. 16, pp. 66–74, 212–215, 348–352, 1820,retrieved16 July2010
  • "Spontaneous Mortification – Case occurring in the upper extremity",The Lancet,Lectures Delivered at the North London Hospital, by Robert Liston, Esq., Lecture IX, vol. 1, no. 602, pp. 846–851, 14 March 1835,doi:10.1016/s0140-6736(02)96871-6,S2CID51697598,retrieved18 July2010
  • Liston, R. (1837), "Observations on Some Tumours of The Mouth and Jaws",Medico-Chirurgical Transactions,20:165–199,doi:10.1177/095952873702000112,PMC2116728,PMID20895635Also via Google books(Note: The volume listing for Google is incorrect, as evidenced by the first page which clearly states "volume the twentieth" ).
  • Practical Surgery, with One Hundred and Twenty Engravings on Wood.London: John Churchill & Henry Renshaw. 1837.Retrieved24 October2009.Full text at Internet Archive (archive.org)
  • American edition (1838).Practical Surgery, with Notes and Additional Illustrations by George W. Norris, one of the surgeons to the Pennsylvania Hospital.Philadelphia: James Crissey.Retrieved24 October2009.Full text at Internet Archive (archive.org)
  • Elements of Surgery(2 ed.). London: Longman, Orme, Brown, Green & Longmans. 1840.Retrieved24 October2009.Full text at Internet Archive (archive.org)
  • American edition (1842) from the 2nd London edition.Elements of Surgery.Philadelphia: Ed. Barrington & Geo D. Hasswell. Simultaneously published in: New York, by J. & H.G. Langley; Charlestone, S.C., by WM. H. Berrett; Richmond, V.A., by Smith, Drinker & Morris; Louisville, KY, by James Maxwell, Jr.Retrieved24 October2009.{{cite book}}:CS1 maint: numeric names: authors list (link)Full text at Internet Archive (archive.org)
  • "A Course of Lectures on the Operations of Surgery, and of Diseases and Accidents Requiring Operations: Lecture IX",The Lancet,vol. 2, no. 1102, pp. 65–68, 12 October 1844,doi:10.1016/s0140-6736(02)64540-4,retrieved18 July2010
  • "On Fracture of the Neck of the Femur",Dissertations by Eminent Members of the Royal Medical Society,Paper read on 1820, Edinburgh: David Douglas, 1892,retrieved16 July2010See also BiblioLife reproduction via Google

See also[edit]

Notes[edit]

  1. ^abThe difference in pagination between the 1983 and 2001 editions is attributable to the fact that for the 1983 edition, the frontispiece is counted as page 1, with printed page numbering commencing at page 13, which is the first chapter, on Robert Liston. Conversely, the online edition commences numbered paginationatchapter one. A comparison of the 1983 edition and the viewable online text shows no discernible deletions of text. Certainly chapter one appears word-for-word, as does chapter 11 (Disastrous Motherhood). In the latter case, the 1983 pagination encompasses four pages, whereas the online book encompasses three. However, the text is the same. The 1983 edition has each sequential chapter commencing on the same page as the preceding chapter ends, which causes a greater page range for some chapters. The online edition has each chapter commencing on its own page. Text is compressed so that there are more words per line, but of the text is verbatim for that able to be compared.
  2. ^There are several publications ofNotes on Nursing,including online versions. The exact pagination will depend on such things as prefaces and introductory chapters on Nightingale. There may be additional variations in online sources. Some online versions may even not contain some footnotes or margin notes from Nightingale's book. However, the online source cited at the same time as this footnote, does have Nightingale's footnote on page 30.

References[edit]

  1. ^University College London Hospitals."Timeline 1800–1899".Retrieved16 October2019.
  2. ^abcdefg"Robert Liston".Retrieved25 March2017.
  3. ^abcdGordon, Richard(2001)."Triple Knock-Out: Disastrous surgical enthusiasm".Great Medical Disasters.London: House of Stratus. pp. 1–3.ISBN978-1-84232-519-3.Retrieved16 July2010.1983 publication by Hutchinson & Co., London. pp. 13–15.ISBN0-09-152230-7.
  4. ^Edinburgh Post Office Directory 1819
  5. ^abCansick, Frederick Teague (1872)."The Monumental inscriptions of Middlesex".www.archive.org.Retrieved2 April2021.
  6. ^abc"Liston, Robert (1794–1847)".livesonline.rcseng.ac.uk.Retrieved24 October2021.
  7. ^"Edinburgh Post Office annual directory, 1832–1833".National Library of Scotland.p. 110.Retrieved25 February2018.
  8. ^"Death of Robert Liston, Esq., F.R.S",The Lancet,2(1267): 633–634, 11 December 1847,doi:10.1016/s0140-6736(02)73183-8,retrieved16 July2010
  9. ^Sheppard, F.H.W. (General Editor) (1963)."British History Online".Survey of London – Cork Street and Savile Row Area: Table of notable inhabitants on the Burlington Estate Vols 31 & 32(Pt2).pp. 566–572.Retrieved17 October2009.{{cite book}}:|last=has generic name (help)
  10. ^abcdGordon, Richard (2001), p.1
  11. ^Jones, Andrew J."Time me, gentlemen! The bravado and bravery of Robert Liston"(PDF).facs.org.
  12. ^London Cemeteries: An illustrated Gide and Gazetteer H Meeler 7 B Parsons
  13. ^Liston, Robert (1837).Practical Surgery.John Churchill. p. 323.
  14. ^Stanley, Peter (2003),"For Fear of Pain: British Surgery, 1790–1850",Clio Medica (Amsterdam, Netherlands),The Wellcome Series in the History of Medicine, Clio Medica 70, Amsterdam & New York: Rodopi: 15,ISBN978-90-420-1024-6,ISSN0045-7183,PMID12737690,retrieved18 July2010
  15. ^"Liston Testimonial Fund",The Lancet,vol. 1, no. 20, p. 514, 13 May 1848,retrieved18 July2010
  16. ^Nightingale, Florence(1974).Notes on Nursing: What it is and what it is not.Glasgow & London: Blackie & Son Ltd. p. 22 (footnote).ISBN978-0-216-89974-2.
  17. ^Nightingale, Florence (1860).Notes on Nursing: What it is and what it is not.Boston: William Carter. p.30in online text.Retrieved24 October2009.Full text at Internet Archive (archive.org)
  18. ^Gordon, Richard (2001). "Disastrous Motherhood: Tales from the Vienna Wards".Great Medical Disasters.London: House of Stratus. pp. 34–36.(p. 43 of pp. 43–46 in 1983 edition)
  19. ^Holmes, O.W. (1842–1843). "On the contagiousness of puerperal fever".New England Quarterly Journal of Medicine.i:503–30.in Gordon, R. (1983), p.147.
  20. ^Gordon, Richard (2001) p.35; (1983) p.44
  21. ^Gordon, Richard (2001) pp.34–36; (1983) pp.43–45
  22. ^abGordon, Richard (2001), p.2
  23. ^Richardson, Ruth (1987),"Trading Assassins",Death, Dissection and the Destitute,London: Routledge & Kegan Paul, pp. 131–158,ISBN978-0-7102-0919-1,retrieved16 July2010
  24. ^Richardson (1987), p.327 inReferencessection.
  25. ^Flemming, P. (1926). "Robert Liston, the first professor of clinical surgery at UCH".University College Hospital Magazine.1:176–85.in Gordon, R. (1983), p.146.
  26. ^Centenary of the first public operation under an anæsthetic in Europe carried out at University College Hospital by Robert Liston on 21st December 1846.U.C.H Medical School. 21 December 1946.Retrieved22 February2021.
  27. ^Cock, W.F. (1911). "The first operation under ether in Europe".University College Hospital Magazine.1:127–44.in Gordon, R. (1983), p.146.
  28. ^abThomas, Bill (1 February 2012)."Saints and sinner: Robert Liston".The Bulletin of the Royal College of Surgeons of England.94(2): 64–65.doi:10.1308/147363512X13189526439197.ISSN1473-6357.
  29. ^"How Surgeon Robert Liston Killed His Patient — Plus Two Bystanders".allthatsinteresting.com.5 October 2017.
  30. ^Gordon, Richard (2001), p.3;(1983), p.15
  31. ^Soniak, Matt (24 October 2012)."'Time Me, Gentlemen': The Fastest Surgeon of the 19th Century ".Mental Floss.The Atlantic.Retrieved30 April2019.
  32. ^Tansey, Tilli(2017)."Health: The war on germs".Nature.550(7674): 36–37.doi:10.1038/550036a.ISSN1476-4687.
  33. ^"31. The Myth of Robert Liston by Historical Hysteria".Anchor.Retrieved13 March2022.

22. "Great Medical Disasters", Gordon, Richard. 2001. Print. Page 15.

Further reading[edit]

External links[edit]

Wikisourcehas the text of the1911Encyclopædia Britannicaarticle "Liston, Robert".
Retrieved from "https://en.wikipedia.org/w/index.php?title=Robert_Liston&oldid=1228261594"