Home > William Macewen

Macewen was born in Rothesay (Isle of Bute, Scotland) in 1848, and got his medical degree in 1872 at the University of Glasgow. He was greatly influenced by his former teacher of surgery, the great Lord Joseph Lister (1827-1912), who revolutionized surgery by developing antisepsis, by the use of phenolPhenol or carbolic acid is a white crystalline solid, with a chemical formula of , a melting point of 43°C, and a boiling point of 182°C at the pressure of 1 atmosphere (or 101080 Pa). It is not a real alcohol, because the hydroxyl group is fixed on a uns, thus decreasing drastically the enormous mortality of surgical patients due to infections. By following Lister and adopting systematically the use of scrubbing (deep cleansing and desinfection of hands and arms), sterilizationFor the process of removing or killing all microorganisms from an object, see Sterilisation (microbiology). Sterilization is a surgical technique leaving a male or female unable to procreate. It is a method of birth control. A vasectomy in males. The vasa of surgical tools, use of surgical gowns, and anesthesiaAnesthesia ( AE), also anaesthesia ( BE), is the process of blocking the perception of pain and other sensations. This allows patients to undergo surgery and other procedures without the distress and pain they would otherwise experience. There are several (which was also recently discovered)), Macewen became one of the most innovative surgeons of his time and was able to greatly advance modern surgical technique and improve the recovery of patients.

In 1875 he became an assistant surgeon at the Glasgow Royal Infirmary , being promoted to full surgeon in 1877. From 1881 to 1889 he was a lecturer at the Royal Infirmary School of Medicine, and later on a Professor of Clinical Surgery. On this appointment he had to transfer his surgical activities from the Royal to the Glasgow Western Infirmary . In 1883 he was appointed as Surgeon to the Royal Hospital for Sick Children in Glasgow. He also helped to found in 1916 the Princess Louise Scottish Hospital for Limbless Sailors and Soldiers in ErskineErskine is a small commuter town in Renfrewshire, Scotland, located on the southern bank of the River Clyde. The name Erskine comes from 'Eriskyne', a contraction of the Gaelic 'air an sgian', meaning 'upon the knife'. This was said to have been uttered b (now the Erskine Hospital), near Glasgow, which was urgently needed to treat the thousands of military that lost their limbs in the First World War. Macewen was its first chief surgeon and he designed the Erskine artificial limbFoosball with two prosthetic limbs Artificial limbs are a type of prosthesis and are classified by the type of amputation they would replace, for example Transtibial: Below the knee Transfemoral: Above the knee Transradial: The upper arm For congenital (f with the help of engineers and workers of the nearby StrathclydeStrathclyde was one of the regional council areas of Scotland from 1974 to 1996. It was named after the Kingdom of Strathclyde, which covered broadly the same area. Its largest city was Glasgow, and it was the largest region in the country, with a populat shipyards, and trained a team of pattern-makers to manufacture them for the hospital.

One of his earliest contributions while at the Royal Infirmary, in 1877, was in orthopedics, by means of the development of the first bone grafts, but also in knee surgery using a special instrument (Macewen's osteotome) both techniques becoming key treatments for the highly prevalent disease of rickets (caused by a lack of Vitamin D). Macewen was interested in the biology of bone and carried out a a classical series of experiments on animals in order to determine how bones grow and may be repaired. He developd surgical treatments for mastoid disease and pyogenic cists of the temporal bone and has identified an anatomical structure in this bone, the foveola suprameatica, which was named Macewen's triangle in his honor.

His method of surgical removal of lungs became a major medical weapon in the treatment of tuberculosis and lung cancer, thus saving many patients. His name was also immortalized in Medicine in two other instances: the Macewen's operation for inguinal hernia and the Macewen's sign for hydrocephalus and brain abscess.

Following the work of John Hughlings Jackson (1835–1911) and David Ferrier (1843-1924) on neurological mapping of functions in the brain, Macewen demonstrated in 1876 that it was possible to use a precise clinical examination to determine the possible site of a tumor or lesion in the brain, by observing its effects on the side and extension of alterations in motor and sensory functions. Thus, in 1876 he diagnosed an abscess in the frontal lobe of a boy, but the family refused permission to operate. When the patient died his diagnosis and localization were found to be correct.

He performed the first successful intracranial surgery where the site of the lesion (a left frontal meningioma) was localized solely by the preoperative focal epileptic signs (twitching of the face and arms in the opposite site of the lesion). On the basis of these signs Macewen thought that there was good evidence of an “irritation to the lower and middle portions of the ascending convolutions…in the left frontal lobe”. A trephined hole in the skull near the purported site of the lesion showed a big subdural tumor. The patient, a teenage girl, lived for eight more years, and a subsequent autopsy showed no trace of the tumor. He later used this many times to succesfully operate on brain abscesses (in 1876) and hematomas and on the spine. This was a great triumph of medicine.

According to one of his biographers, "his thorough knowledge of the natural history of pyogenic diseases of the temporal bone and nasal sinus es, in addition to his clear description of cranial anatomy, as illustrated in his Atlas of Head Sections, were especially important in developing his successful treatment of brain abscess. The x-ray had not yet been discovered; Macewen's diagnosis was based on clinical findings superbly illustrated by his three clinical stages of brain abscess development" (Canale, 1996).

Another important contribution by Macewen to modern surgery was the technique of endotracheal anaesthesia with the help of orotracheal intubation, which he described in 1880, and still in use today.

Macewen was noted for his early and creative use of photographs for documenting patients cases and for teaching surgery and medicine. He pioneered the use of photos of body parts and pathological specimens, as well as photos taken before, after and during treatment/surgery.

In 1892 Macewen became Regius Professor of Surgery at the University of Glasgow (the post which Lister had held when McEwen was a student) where he remained until his death, in Garrochty , Isle of Bute, in 1924. Macewen became a Fellow of the Royal College of Physicians and Surgeons of Glasgow in 1874, a Fellow of the Royal Society in 1895, a Honorary Fellow of the Royal College of Surgeons of England in 1900, and the president of the British Medical Association in 1922. He was knighted in 1902.