James Hogarth Pringle (born 26 January 1863 in
Parramatta
Parramatta () is a suburb and major Central business district, commercial centre in Greater Western Sydney, located in the state of New South Wales, Australia. It is located approximately west of the Sydney central business district on the ban ...
, Australia – died 24 April 1941 in
Killearn
Killearn (Scottish Gaelic: ''Cill Fhearann'', from orig. ''Ceann Fhearann'', "Head/End of (the) Land/Territory" – until the 15th century when ''Ceann'' was replaced by ''Cill''; denoting the presence of a house of worship) – is a smal ...
, Scotland) was an
Australia
Australia, officially the Commonwealth of Australia, is a Sovereign state, sovereign country comprising the mainland of the Australia (continent), Australian continent, the island of Tasmania, and numerous List of islands of Australia, sma ...
n-born British surgeon in
Glasgow
Glasgow ( ; sco, Glesca or ; gd, Glaschu ) is the most populous city in Scotland and the fourth-most populous city in the United Kingdom, as well as being the 27th largest city by population in Europe. In 2020, it had an estimated popul ...
, who made a number of important contributions to surgical practice. He is most famous for the development of the
Pringle manoeuvre
The Pringle manoeuvre is a surgical technique used in some abdominal operations and in liver trauma. The hepatoduodenal ligament is clamped either with a surgical tool called a haemostat, an umbilical tape or by hand. This limits blood inflow thr ...
, a technique still used in surgery today.
Early life
He was the only son of
George Hogarth Pringle (1830–1871) a well known surgeon in Parramatta, New South Wales, Australia. Before emigrating to Australia George Hogarth Pringle had worked in Edinburgh with Joseph Lister and had been responsible for the introduction of antiseptic surgical practice into Australia. After his father died in 1872, James returned to Britain to school at
Sedbergh
Sedbergh ( or ) is a town and civil parish in Cumbria, England. The 2001 census gave the parish a population of 2,705, increasing at the 2011 census to 2,765. Historically in the West Riding of Yorkshire, it lies about east of Kendal, no ...
in Cumberland and from there entered the
University of Edinburgh Medical School
The University of Edinburgh Medical School (also known as Edinburgh Medical School) is the medical school of the University of Edinburgh in Scotland and the United Kingdom and part of the College of Medicine and Veterinary Medicine. It was esta ...
to study medicine, graduating in 1885.
After graduation he was able travel to Europe to study surgical practice at Hamburg, Berlin and Vienna. This visit to European centres was to prove important because he maintained links particularly with German, Austrian and Swiss surgeons, keeping up to date with their literature. He had training in ophthalmology at
Moorfields Eye Hospital
Moorfields Eye Hospital is a specialist NHS eye hospital in Finsbury in the London Borough of Islington in London, England run by Moorfields Eye Hospital NHS Foundation Trust. Together with the UCL Institute of Ophthalmology, which is adjacent ...
in London before becoming house surgeon under Professor
Thomas Annandale
Thomas Annandale, FRCS FRSE (1838–1907) was a Scottish surgeon who conducted the first repair of the meniscus and the first successful removal of an acoustic neuroma, and introduced the pre-peritoneal approach to inguinal hernia repair. H ...
(1838–1907) in
Edinburgh Royal Infirmary
The Royal Infirmary of Edinburgh, or RIE, often (but incorrectly) known as the Edinburgh Royal Infirmary, or ERI, was established in 1729 and is the oldest voluntary hospital in Scotland. The new buildings of 1879 were claimed to be the largest v ...
, and then house surgeon under
Sir William Macewen
Sir William Macewen, (; 22 June 1848 – 22 March 1924) was a Scottish surgeon. He was a pioneer in modern brain surgery, considered the ''father of neurosurgery'' and contributed to the development of bone graft surgery, the surgical trea ...
(1848–1924) in
Glasgow Royal Infirmary
The Glasgow Royal Infirmary (GRI) is a large teaching hospital. With a capacity of around 1,000 beds, the hospital campus covers an area of around , and straddles the Townhead and Dennistoun districts on the north-eastern fringe of the city cen ...
. In 1892, he became a fellow of the
Royal College of Surgeons of England
The Royal College of Surgeons of England (RCS England) is an independent professional body and registered charity that promotes and advances standards of surgical care for patients, and regulates surgery and dentistry in England and Wales. The ...
(FRCSEng) and was appointed Surgeon to Glasgow Royal Infirmary in 1896. He became a Fellow of the
Faculty of Physicians and Surgeons of Glasgow
The Royal College of Physicians and Surgeons of Glasgow, is an institute of physicians and surgeons in Glasgow, Scotland.
Founded by Peter Lowe after receiving a royal charter by James VI in 1599, as the Glasgow Faculty, it originally exist ...
in 1899.
Supporter of women in medicine
Pringle and Sir William Macewen were among the few senior figures in medicine at that time who were sympathetic to women in medicine, readily accepting women students into their clinics. Some of these were to become well known figures in later life including
Louise McIlroy
Dame Anne Louise McIlroy (11 November 1874 – 8 February 1968), known as Louise McIlroy, was a distinguished and honoured Irish-born British physician, specialising in obstetrics and gynaecology. She was both the first woman to be awarded a ...
(1874–1968),
Elsie Inglis
Eliza Maud "Elsie" Inglis (16 August 1864 – 26 November 1917) was a Scottish doctor, surgeon, teacher, Women's suffrage, suffragist, and founder of the Scottish Women's Hospitals for Foreign Service, Scottish Women's Hospitals. She was the ...
(1864–1917), and Helen Wingate (1895–1985). In 1899, Pringle was appointed Lecturer in Surgery and Demonstrator in Anatomy to
Queen Margaret College which had been established for women students and opened in 1868 and began to teach women medical students in 1890–91.
Fracture treatment
Pringle made a particular study of the treatment of fractures, where he was at an advantage because X-rays had been introduced very early into clinical practice in Glasgow Royal Infirmary, an innovation that allowed Pringle to gain wide personal experience of fractures and their management. His colleague
John Macintyre
John Macintyre or Mcintyre FRSE (2 October 1857 – 29 October 1928) was a Scottish doctor who set up the world's first radiology department at the Glasgow Royal Infirmary, in Glasgow.[Joseph Lister
Joseph Lister, 1st Baron Lister, (5 April 182710 February 1912) was a British surgeon, medical scientist, experimental pathologist and a pioneer of antiseptic surgery and preventative medicine. Joseph Lister revolutionised the craft of s ...]
had first introduced antisepsis and would surely have been aware of his own father's work on antisepsis in introducing Listerian antisepsis into Australia. He was, like Sir William Macewen, an early exponent of aseptic technique in surgery. Both of these factors undoubtedly contributed to his expertise and success with fracture management.
He was a pioneer of treating fractures by fixation and had impressive results with an amputation rate for sepsis of only 2.6%, a dramatic reduction on the norm for the time.
“There are few cases," he wrote, " which afford a better test of aseptic methods." But it was his policy of fixation of long fractures in an age when treatment by traction was the norm that marked him out as a pioneer. "... In every case," he wrote, "I have employed some form of 'fixation' of the bone fragments; the 'fixation' being effected in some instances by wiring the main fragments, in others by the use of 'plates' and in others generally in the case of a small fragment (e.g. a portion of an articular surface) which has been fractured off and the use of a screw to fix the small to the large segment of the bone."
In 1910, he published ''Fractures and their Treatment'', a textbook which became a standard and authoritative work on fracture treatment for more than a generation.
Hindquarter amputation
He was also a pioneer of
hindquarter amputation, a radical operation involving division of the pubic symphysis and the sacroiliac joint, performing the first successful such amputation in Britain in 1900 for tuberculosis of the hip which had spread to the pelvis. He was the first in the world to perform the one stage procedure for sarcoma of the thigh. The size and relative success of Pringle's series may be judged by comparison with the subsequent experience of
Sir Gordon Gordon-Taylor, widely regarded as a pioneer of the technique, who was generous in his praise of Pringle's technique and results.
Head injury
Pringle developed expertise in head injury, working as assistant to Macewen, a pioneer of neurosurgery. Pringle's casebooks demonstrate the standard skull charts he devised for the recording of head injuries and the precise site and extent of skull fractures. In these casebooks he recorded the levels of consciousness, meticulous neurological examinations and fundoscopy which he had performed in such cases. These casebooks, neatly written and with meticulous coloured illustrations, offer an insight into the mind of a surgeon who was both painstaking and methodical.
Malignant melanoma
In 1908, Pringle published the first description of en-bloc excision for malignant melanoma, reporting the procedure in two patients. Some thirty years later he was able to publish a follow-up reporting two of these cases alive and well, 30 and 38 years on. His description of en-block excision is much as is practised today and appears to be the first description of what was to become an accepted surgical treatment.
Reconstructive arterial surgery
Pringle was the first surgeon in Britain to carry out a
free vein graft. He did this using a saphenous vein graft to restore continuity after excision of a syphilitic aneurysm of the popliteal artery and characteristically in this paper he duly acknowledged the "splendid work of Carrel".
Alexis Carrel
Alexis Carrel (; 28 June 1873 – 5 November 1944) was a French surgeon and biologist who was awarded the Nobel Prize in Physiology or Medicine in 1912 for pioneering vascular suturing techniques. He invented the first perfusion pump with Charle ...
had been the first surgeon to make an arterial anastomosis, work which led to his being awarded the Nobel Prize in Physiology or Medicine in 1912. The technical quality of Pringle's operative technique is demonstrated by the fact that in this pioneering operation "not one drop of blood escaped at either of the lines of suture and distal pulses were instantly restored".
The Pringle manoeuvre
It is for the
Pringle manoeuvre
The Pringle manoeuvre is a surgical technique used in some abdominal operations and in liver trauma. The hepatoduodenal ligament is clamped either with a surgical tool called a haemostat, an umbilical tape or by hand. This limits blood inflow thr ...
that his name remains known throughout the surgical world. The technique of occluding the portal triad to control haemorrhage in liver trauma which he described in the ''Annals of Surgery'' in 1908
is still widely used in modern hepatic surgery to minimise blood loss. Pringle's paper attests to the originality and logic of his thinking, often flying in the face of mainstream opinion. In describing his experience in dealing with liver injury he observed that portal triad occlusion controlled the bleeding from the liver sufficient to allow suturing or packing. "An assistant," he wrote, "held the portal vein and the hepatic artery between a finger and thumb and completely arrested all bleeding.”
Later life
Pringle served in the First World War as a major in the RAMC at number 4 General Hospital at
Stobhill
Stobhill is a district in the Scottish city of Glasgow. It is situated north of the River Clyde.
Part of Springburn, it gives its name
A name is a term used for identification by an external observer. They can identify a class or catego ...
, Glasgow. He retired from surgical practice in 1923 at the age of 60 and was elected Visitor (Vice-President) of the
Faculty of Physicians and Surgeons of Glasgow
The Royal College of Physicians and Surgeons of Glasgow, is an institute of physicians and surgeons in Glasgow, Scotland.
Founded by Peter Lowe after receiving a royal charter by James VI in 1599, as the Glasgow Faculty, it originally exist ...
in that year. He was a founder member of the
Association of Surgeons of Great Britain and Ireland The Association of Surgeons of Great Britain and Ireland is a British medical association founded in 1920 with the twin aims of the ''advancement of the science and art of surgery and the promotion of friendship amongst surgeons''. Association of Su ...
and of th
Moynihan Chirurgical Club He died at his home in
Killearn
Killearn (Scottish Gaelic: ''Cill Fhearann'', from orig. ''Ceann Fhearann'', "Head/End of (the) Land/Territory" – until the 15th century when ''Ceann'' was replaced by ''Cill''; denoting the presence of a house of worship) – is a smal ...
, Scotland, on 24 April 1941 at the age of 78
[Registrar General for Scotland. Statutory records of births, marriages and deaths. Death certificate: James Hogarth Pringle 1941 ref 482/000026]
References
Further reading
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{{DEFAULTSORT:Pringle, James Hogarth
1863 births
1941 deaths
Fellows of the Royal College of Surgeons
Scottish surgeons
Alumni of the University of Edinburgh
19th-century Scottish medical doctors
20th-century Scottish medical doctors
Fellows of the Royal College of Physicians and Surgeons of Glasgow
University of Edinburgh Medical School alumni
20th-century surgeons