was a pioneering Scottish
Scotland is a country that is part of the United Kingdom. Occupying the northern third of the island of Great Britain, it shares a border with England to the south and is bounded by the North Sea to the east, the Atlantic Ocean to the north and west, and the North Channel and Irish Sea to the...
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
, and the son of the Scottish minister and inventor Henry Liston
Henry Liston was a Scottish minister and inventor. Born on 30 June 1771 he was the oldest son of Robert Liston, minister of Aberdour, Fifeshire. He studied for the ministry and in 1793 became minister to the parish of Ecclesmachan, Linlithgowshire, and was clerk of its presbetery and in 1820 he...
, whose father was also a Robert Liston
Robert Liston was a Scottish Minister, Moderator of the General Assembly of the Church of Scotland.-Life:...
, Moderator of the General Assembly of the Church of Scotland
The Moderator of the General Assembly of Church of Scotland is a Minister, Elder or Deacon of the Church of Scotland chosen to "moderate" the annual General Assembly of the Church of Scotland, which is held for a week in Edinburgh every May....
Liston was noted for his skill and speed in an era prior to anaesthetics, when speed made a difference in terms of pain and survival. In Florence Nightingale
Florence Nightingale OM, RRC was a celebrated English nurse, writer and statistician. She came to prominence for her pioneering work in nursing during the Crimean War, where she tended to wounded soldiers. She was dubbed "The Lady with the Lamp" after her habit of making rounds at night...
's Notes on Nursing
Notes on Nursing: What it is and What it is Not is a book first published by Florence Nightingale in 1859. A 136-page volume, it was intended to give hints on nursing to those entrusted with the health of others...
, she states "there are many physical operations where ceteris paribus
or is a Latin phrase, literally translated as "with other things the same," or "all other things being equal or held constant." It is an example of an ablative absolute and is commonly rendered in English as "all other things being equal." A prediction, or a statement about causal or logical...
the danger is in a direct ratio to the time the operation lasts; and ceteris paribus
the operator's success will be in direct ratio to his quickness".
Richard Gordon describes Liston as "the fastest knife in the West End. He could amputate a leg in 2 minutes". Indeed, 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; he is said to have been able to perform the removal of a limb in an amputation in 28 seconds.
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.
Gordon's talent for 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 by Dr Oliver Wendell Holmes
Oliver Wendell Holmes, Sr. was an American physician, professor, lecturer, and author. Regarded by his peers as one of the best writers of the 19th century, he is considered a member of the Fireside Poets. His most famous prose works are the "Breakfast-Table" series, which began with The Autocrat...
to the Boston Society for Medical Improvement on 13 February 1843, his suggestions for hygiene improvement to reduce obstetric infections and mortality from puerperal fever "outraged obstetricians, particularly in Philadelphia". 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 quotes Sir Frederick Treves
Sir Frederick Treves, 1st Baronet, GCVO, CH, CB was a prominent British surgeon of the Victorian and Edwardian eras, now most famous for his friendship with Joseph Merrick, "the Elephant Man".-Eminent surgeon:...
on 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". Indeed, the connection between surgical hygiene, infection, and maternal mortality rates at Vienna General Hospital
The Vienna General Hospital is the University medical center of the city of Vienna, Austria. The AKH is the largest hospital of Austria and Europe, the second largest hospital in the world, and at 85-m high is one of the tallest hospital buildings in the world...
was only made in 1847 by Vienna physician Dr Ignaz Philipp Semmelweis
Ignaz Philipp Semmelweis was a Hungarian physician now known as an early pioneer of antiseptic procedures. Described as the "savior of mothers", Semmelweis discovered that the incidence of puerperal fever could be drastically cut by the use of hand disinfection in obstetrical clinics...
after a close colleague of his died. He instituted the very hygiene practices exhorted by Holmes, and the mortality rate fell.
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 the Grassmarket
The Grassmarket is an historic market square in the Old Town of Edinburgh, Scotland.In relation to the rest of the city the area is a hollow, well below surrounding ground levels.-Location:...
and Lawnmarket on 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".
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
Robert Knox was a Scottish surgeon, anatomist and zoologist. He was the most popular lecturer in anatomy in Edinburgh before his involvement in the Burke and Hare body-snatching case. This ruined his career, and a later move to London did not improve matters...
) over the treatment of an attractive young woman (Mary Paterson) who it later transpired was murdered (Burke 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 whiskey for three months before dissection, during which time she was essentially on voyeuristic display. 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 her sense of decency. He removed her body for burial.
Liston received his education at the University of Edinburgh
The University of Edinburgh, founded in 1583, is a public research university located in Edinburgh, the capital of Scotland, and a UNESCO World Heritage Site. The university is deeply embedded in the fabric of the city, with many of the buildings in the historic Old Town belonging to the university...
, became first 'The Great Northern Anatomist' of Blackwell's Magazine
, and in 1818 became a surgeon in The Royal Infirmary of Edinburgh. He lived from 1840 to 1847 (the year of his death) at No. 5 Clifford Street, off Bond Street in Mayfair, in a building and indeed area now of some historical significance, hence Richard Gordon's specific mention of this address in his section on Robert Liston.
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.
Liston's image has been preserved in both bust and portrait form. 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".
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 became the first Professor of Clinical Surgery at University College Hospital
University College Hospital is a teaching hospital located in London, United Kingdom. It is part of the University College London Hospitals NHS Foundation Trust and is closely associated with University College London ....
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
- He also performed the first operation in Europe under modern anaesthesia, utilising ether, then a new substance from America, on 21 December 1846 at the University College Hospital. His comment at the time: "This Yankee dodge beats mesmerism hollow".
- He invented see-through isinglass sticking plaster, the 'bulldog' locking artery forceps, and a leg splint used to stabilise dislocations and fractures of the femur
The femur , or thigh bone, is the most proximal bone of the leg in tetrapod vertebrates capable of walking or jumping, such as most land mammals, birds, many reptiles such as lizards, and amphibians such as frogs. In vertebrates with four legs such as dogs and horses, the femur is found only in...
, and still used today.
Liston's most famous cases
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 Liston's four most famous cases in his book, as quoted verbatim below.
Fourth most famous case:
Third most famous case:
Second most famous case:
Liston's most famous case:
Publications by Liston Also via Google books
(Note: The volume listing for Google is incorrect, as evidenced by the first page which clearly states "volume the twentieth"). Full text at Internet Archive (archive.org) Full text at Internet Archive (archive.org) Full text at Internet Archive (archive.org) Full text at Internet Archive (archive.org) See also BiblioLife reproduction via Google
Further reading Book description
- Robert Liston at the Gazetteer for Scotland
The Gazetteer for Scotland is a gazetteer covering the geography, history and people of Scotland. It was conceived in 1995 by Bruce Gittings of the University of Edinburgh and David Munro of the Royal Scottish Geographical Society, and contains 15,500 entries as of January 2008, making it one of...
- Robert Liston at general-anaesthesia.com on BTLC Research website.