556368
research-article2014
SRIXXX10.1177/1553350614556368Surgical InnovationTsoucalas et al
Letter to the Editor
Sir Gordon Gordon-Taylor (1878-1960), Anatomist and Surgeon: Surgical Innovations in the “Laboratory of War,” His 1948 Lecture in Athens
Surgical Innovation 2015, Vol. 22(4) 441–442 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1553350614556368 sri.sagepub.com
Gregory Tsoucalas, MD, PhD1, Konstantinos Laios, MD, PhD2, Styliani Giatsiou, MD, MSc3, and Markos Sgantzos, MD, Prof1 Sir Gordon Gordon-Taylor, the humanitarian, mentor, teacher, anatomist, and surgeon, was born in London in 1878. Following the loss of his father he was taken to Aberdeen by his mother. In Aberdeen, he was schooled at Robert Gordon’s school, graduated in 1898, and almost at once the family moved to London, where he entered the Middlesex Hospital Medical School in October 1898. Gordon-Taylor firstly loved anatomy and wrote 6 papers, which covered human anatomy, comparative anatomy, embryology, cytology, histology, and a general essay on anatomy, to gain his master’s. He had then moved to London where he entered Middlesex Hospital as a student and was recognized early on as having considerable potential merit, gaining his qualification in 1903. At age 29 he was appointed to the staff of the Middlesex Hospital in the face of powerful competition and sometime later he was also appointed to the Great Northern Hospital. During World War I, he was stationed in France to specialize in abdominal wounds, stating, “the bad surgical risk of a decade or two ago is now a normal or good risk, so will the despairs of today be the certainties of the tomorrow” and boldly started to operate deep abdominal traumas that were considered certainly fatal for the inflicted soldiers during that era. He then returned to Middlesex Hospital of London to become a surgeon-consultant. When World War II broke out, he was promoted to the rank of Surgeon Rear-Admiral, consultant of the Royal Navy.1-3 To judge from the illustrations in his published work, the dissections must have been of great excellence, his skill unmatchable, he must have been the greatest war-surgeon of the era.3 On March 10, 1948, on the occasion of his honorary doctorate in the University of Athens, he had summarized all surgical innovations of the 2 World Wars, to present them to his Athenian colleagues. He started his memorable speech with the assumption that innovations, advances, perfection, and speed in surgery “form the antiquity until today, are being acquired in the laboratory of war.” Thus, his first reference was about blood transfusion. War surgeons during 1914-1917, made up an equation of the severity of the bleeding to understand the level
of hypovolemic shock.4 While blood transfusion was introduced during the World War I, it was during World War II that it had a huge impact in surgery on the battlefield, and raised the survival percentage from 27% to 44.5% up to the remarkable 66.6% to 70%.4,5 GordonTaylor used about 1 L of blood in his every surgical procedure, estimating the total amount of blood and dried blood derivates that had been used during the war at about 478 million liters. During World War I, he promoted early operation for abdominal gunshot wounds.4,6 The next innovation that he referred to was the extensive use of haemostatic glues, such as fibrinogen and thrombin. In difficult cases of brain, nerve, and liver surgery, in transplants and skin flaps during plastic surgery, GordonTaylor used specialized fibrin foam. He had also understood the significance of the role of total proteins of the human organism for the overall survival of the soldiers operated upon. A ligation of a traumatic main artery should be combined with the ligation of the adjacent vein, while sympathectomy was proposed in the case of an artery aneurysm. Intracardiac catheters were used for the first time to estimate the volume of blood per heartbeat, so that the severity of the vascular lesion could be documented. According to Gordon-Taylor, this was the key factor for a difficult operation of a multiwounded soldier to proceed. He finished listing the surgical hallmarks of the wars, by naming a plethora of new syndromes such as “immersion blast” (underwater), “crush syndrome,” “fat embolism,” which had been introduced then,4 and then ended by recognizing that the drastic improvement in the outcomes and management of spinal cord injuries were mainly observed in World War II, while neurosurgery 1
University of Thessaly, Larissa, Greece University of Athens, Greece 3 General Hospital of Larissa, Larissa, Greece 2
Corresponding Author: Gregory Tsoucalas, History of Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece. Email: [email protected]
Downloaded from sri.sagepub.com at Stockholm University Library on November 12, 2015
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Surgical Innovation 22(4)
advanced with the use of vitallium,4,7 and by rewarding the extended use of penicillin that had marvellous treatment effects.4 Gordon-Taylor, in a short period of time, successfully gave a vigorous description on surgical innovations of the 2 World Wars, to a scientific audience that suffered the most the past decades.4 His war experience transformed him into a great humanist who operated upon his patients for free, teaching and supporting surgeons from all over the world and promoting his noble beliefs.3,6 References 1. Windeyer B. Sir Gordon Gordon-Taylor: First GordonTaylor Memorial Lecture delivered at the Royal College of
Surgeons of England on 11th June 1964. Ann R Coll Surg Engl. 1965;36:98-115. 2. Sellors TH. Gordon-Taylor: his contributions to surgery. Ann R Coll Surg Engl. 1968;43:297-312. 3. Wall EW. Sir Gordon Gordon-Taylor, surgeon-anatomist and humanist. Ann R Coll Surg Engl. 1977;59:4-10. 4. Gordon-Taylor G. Impressions of a surgeon from the two wars. Hosp Chronicles Euaggelismos. 1948;5:305-312. 5. Till AS. Gordon-Taylor, war surgeon and historian. Ann R Coll Surg Engl. 1974;54:33-47. 6. Mellick S. Gordon-Taylor 1878-1960: master of language and surgery. ANZ J Surg. 2004;74:694-699. 7. Dowdy J, Pait JD. The influence of war on the development of neurosurgery. J Neurosurg. 2014;120:237-243.
Downloaded from sri.sagepub.com at Stockholm University Library on November 12, 2015
research-article2014
SRIXXX10.1177/1553350614556368Surgical InnovationTsoucalas et al
Letter to the Editor
Sir Gordon Gordon-Taylor (1878-1960), Anatomist and Surgeon: Surgical Innovations in the “Laboratory of War,” His 1948 Lecture in Athens
Surgical Innovation 2015, Vol. 22(4) 441–442 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1553350614556368 sri.sagepub.com
Gregory Tsoucalas, MD, PhD1, Konstantinos Laios, MD, PhD2, Styliani Giatsiou, MD, MSc3, and Markos Sgantzos, MD, Prof1 Sir Gordon Gordon-Taylor, the humanitarian, mentor, teacher, anatomist, and surgeon, was born in London in 1878. Following the loss of his father he was taken to Aberdeen by his mother. In Aberdeen, he was schooled at Robert Gordon’s school, graduated in 1898, and almost at once the family moved to London, where he entered the Middlesex Hospital Medical School in October 1898. Gordon-Taylor firstly loved anatomy and wrote 6 papers, which covered human anatomy, comparative anatomy, embryology, cytology, histology, and a general essay on anatomy, to gain his master’s. He had then moved to London where he entered Middlesex Hospital as a student and was recognized early on as having considerable potential merit, gaining his qualification in 1903. At age 29 he was appointed to the staff of the Middlesex Hospital in the face of powerful competition and sometime later he was also appointed to the Great Northern Hospital. During World War I, he was stationed in France to specialize in abdominal wounds, stating, “the bad surgical risk of a decade or two ago is now a normal or good risk, so will the despairs of today be the certainties of the tomorrow” and boldly started to operate deep abdominal traumas that were considered certainly fatal for the inflicted soldiers during that era. He then returned to Middlesex Hospital of London to become a surgeon-consultant. When World War II broke out, he was promoted to the rank of Surgeon Rear-Admiral, consultant of the Royal Navy.1-3 To judge from the illustrations in his published work, the dissections must have been of great excellence, his skill unmatchable, he must have been the greatest war-surgeon of the era.3 On March 10, 1948, on the occasion of his honorary doctorate in the University of Athens, he had summarized all surgical innovations of the 2 World Wars, to present them to his Athenian colleagues. He started his memorable speech with the assumption that innovations, advances, perfection, and speed in surgery “form the antiquity until today, are being acquired in the laboratory of war.” Thus, his first reference was about blood transfusion. War surgeons during 1914-1917, made up an equation of the severity of the bleeding to understand the level
of hypovolemic shock.4 While blood transfusion was introduced during the World War I, it was during World War II that it had a huge impact in surgery on the battlefield, and raised the survival percentage from 27% to 44.5% up to the remarkable 66.6% to 70%.4,5 GordonTaylor used about 1 L of blood in his every surgical procedure, estimating the total amount of blood and dried blood derivates that had been used during the war at about 478 million liters. During World War I, he promoted early operation for abdominal gunshot wounds.4,6 The next innovation that he referred to was the extensive use of haemostatic glues, such as fibrinogen and thrombin. In difficult cases of brain, nerve, and liver surgery, in transplants and skin flaps during plastic surgery, GordonTaylor used specialized fibrin foam. He had also understood the significance of the role of total proteins of the human organism for the overall survival of the soldiers operated upon. A ligation of a traumatic main artery should be combined with the ligation of the adjacent vein, while sympathectomy was proposed in the case of an artery aneurysm. Intracardiac catheters were used for the first time to estimate the volume of blood per heartbeat, so that the severity of the vascular lesion could be documented. According to Gordon-Taylor, this was the key factor for a difficult operation of a multiwounded soldier to proceed. He finished listing the surgical hallmarks of the wars, by naming a plethora of new syndromes such as “immersion blast” (underwater), “crush syndrome,” “fat embolism,” which had been introduced then,4 and then ended by recognizing that the drastic improvement in the outcomes and management of spinal cord injuries were mainly observed in World War II, while neurosurgery 1
University of Thessaly, Larissa, Greece University of Athens, Greece 3 General Hospital of Larissa, Larissa, Greece 2
Corresponding Author: Gregory Tsoucalas, History of Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece. Email: [email protected]
Downloaded from sri.sagepub.com at Stockholm University Library on November 12, 2015
442
Surgical Innovation 22(4)
advanced with the use of vitallium,4,7 and by rewarding the extended use of penicillin that had marvellous treatment effects.4 Gordon-Taylor, in a short period of time, successfully gave a vigorous description on surgical innovations of the 2 World Wars, to a scientific audience that suffered the most the past decades.4 His war experience transformed him into a great humanist who operated upon his patients for free, teaching and supporting surgeons from all over the world and promoting his noble beliefs.3,6 References 1. Windeyer B. Sir Gordon Gordon-Taylor: First GordonTaylor Memorial Lecture delivered at the Royal College of
Surgeons of England on 11th June 1964. Ann R Coll Surg Engl. 1965;36:98-115. 2. Sellors TH. Gordon-Taylor: his contributions to surgery. Ann R Coll Surg Engl. 1968;43:297-312. 3. Wall EW. Sir Gordon Gordon-Taylor, surgeon-anatomist and humanist. Ann R Coll Surg Engl. 1977;59:4-10. 4. Gordon-Taylor G. Impressions of a surgeon from the two wars. Hosp Chronicles Euaggelismos. 1948;5:305-312. 5. Till AS. Gordon-Taylor, war surgeon and historian. Ann R Coll Surg Engl. 1974;54:33-47. 6. Mellick S. Gordon-Taylor 1878-1960: master of language and surgery. ANZ J Surg. 2004;74:694-699. 7. Dowdy J, Pait JD. The influence of war on the development of neurosurgery. J Neurosurg. 2014;120:237-243.
Downloaded from sri.sagepub.com at Stockholm University Library on November 12, 2015
