Learning from mistakes: early twentieth-century surgical practice

Archibald Watson was an Australian anatomist and surgeon who kept operating theater diaries. He made detailed notes on the work of surgeons that he observed in Britain and North America, as well as in Australia. Watson's diaries provide significant evidence that early twentieth-century surgeons did not just apply scientific knowledge produced somewhere else. They generated new surgical knowledge themselves and worked within a culture that valued innovation. Some of the surgeons observed by Watson practiced in academic centers and regularly engaged in laboratory research, but most did not. Nevertheless, it is clear that whether in Australia, Britain, or North America, the active search for improved techniques was a routine feature of the practice of full-time surgeons. In the process, they often made mistakes--or rather, they often did things with which at least some of their colleagues did not agree. Much of surgical practice was contestable. Doing things the "right" way and finding better ways to do things were overlapping categories; but it is often difficult or impossible to draw any distinction at all between doing things the "wrong" way and failed attempts at finding a better way to perform an operation. This article examines some aspects of the relationship between scientific ideas, clinical experience, contestable errors, and the generation of new knowledge through surgical practice.     

中亚的"未知地区"

在公元第三个千年到来之际,世界地图上似乎已没有"空白",在我们生活的地球上,似乎再没有人类没有到过的地方.然而隐蔽在亚洲的几个山脉和沙漠中的偏远地区仍在等待着人类去探险、发现和研究.蒙古的阿尔泰地区就是这样一个地方(图一).到目前为止,这个地区的考古学研究仍是空白.     

The Liverpool cholera epidemic of 1832 and anatomical dissection--medical mistrust and civil unrest

Asiatic cholera reached Britain for the first time in late 1831, with the main epidemic occurring during 1832. The disease caused profuse diarrhea, severe dehydration, collapse, and often death. There was widespread public fear, and the political and medical response to this new disease was variable and inadequate. In the summer of 1832, a series of "cholera riots" occurred in various towns and cities throughout Britain, frequently directed against the authorities, doctors, or both. The city of Liverpool, in the northwest of England, experienced more riots than elsewhere. Between 29 May and 10 June 1832, eight major street riots occurred, with several other minor disturbances. The object of the crowd's anger was the local medical fraternity. The public perception was that cholera victims were being removed to the hospital to be killed by doctors in order to use them for anatomical dissection. "Bring out the Burkers" was one cry of the Liverpool mobs, referring to the Burke and Hare scandal four years earlier, when two men had murdered people in Edinburgh in order to sell their bodies for dissection to the local anatomy school. This issue was of special concern to the Liverpool citizenry because in 1826, thirty-three bodies had been discovered on the Liverpool docks, about to be shipped to Scotland for dissection. Two years later a local surgeon, William Gill, was tried and found guilty of running an extensive local grave-robbing system to supply corpses for his dissection rooms. The widespread cholera rioting in Liverpool was thus as much related to local anatomical issues as it was to the national epidemic. The riots ended relatively abruptly, largely in response to an appeal by the Roman Catholic clergy read from church pulpits, and also published in the local press. In addition, a respected local doctor, James Collins, published a passionate appeal for calm. The Liverpool Cholera Riots of 1832 demonstrate the complex social responses to epidemic disease, as well as the fragile interface between the public and the medical profession.     

'A field for private members': The Wolfenden committee and Scottish homosexual law reform, 1950-67

The proceedings and report of the Wolfenden Committee on Prostitution and Homosexual Offences (1954-7) figure prominently in the historiography of homosexuality in later twentieth-century Britain. However, in the main, research has centred on the social politics of the Committee and its implications for sexual law reform in England, and there is a notable lack of regional studies. Using a range of government archives, this article focuses on the written and oral evidence of Scottish witnesses to the Committee. It documents the pre-existing legal and medical provisions for the treatment of 'homosexual offences' in Scotland, and surveys the Scottish evidence for and against the decriminalization of homosexual practices. Thereafter, it examines the views of the Scottish members of the Committee in the context of the Wolfenden Report. The article then surveys the wide-ranging opposition to homosexual law reform within Scotland in the period 1957-67, culminating in its exclusion from the 1967 Sexual Offences Act. Finally, it evaluates the implications of the Scottish experience and concludes that, in some important respects, it does not conform to the innovative and transitional picture advanced in many previous interpretations of the Wolfenden Committee and its aftermath.     

Microscopy in Camillo Golgi's times

The research by Camillo Golgi in histology and pathology dates from 1865, the year in which he obtained his MD degree, to 1923, when his last scientific article was published. Beginning in the mid 1855s, microscope manufacturers in Europe started producing objectives based on the principle of immersion introduced in 1847 by Giovan Battista Amici. The immersion objectives greatly improved the resolution of microscopic observations at high magnifications. From 1860 to 1872, technological improvements in microscope optics and the practicality of their use provided a larger community of investigators effective tools needed to study the structure of the nervous system. This progress in microscopy was associated with the application of new histological techniques, mastered by the chromoargentic reaction introduced by Golgi in 1873. In 1872, further progress in microscopy stemmed from the application of notions of applied physics to the production of microscope optics. These developments in microscopy will be briefly reviewed here.