Lawson Tait, born Robert Lawson Tait (1 May 1845 – 13 June 1899) was a pioneer in pelvic and abdominal
surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
and developed new techniques and procedures. He emphasized
asepsis
Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deriv ...
and introduced and advocated for surgical techniques that significantly reduced
mortality
Mortality is the state of being mortal, or susceptible to death; the opposite of immortality.
Mortality may also refer to:
* Fish mortality, a parameter used in fisheries population dynamics to account for the loss of fish in a fish stock throug ...
. He is well known for introducing
salpingectomy
Salpingectomy refers to the surgical removal of a Fallopian tube. This may be done to treat an ectopic pregnancy or cancer, to prevent cancer, or as a form of contraception.
This procedure is now sometimes preferred over its ovarian tube-sparin ...
in 1883 as the treatment for
ectopic pregnancy
Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. ...
, a procedure that has saved countless lives since then. Tait and
J. Marion Sims
James Marion Sims (January 25, 1813November 13, 1883) was an American physician in the field of surgery. His most famous work was the development of a surgical technique for the repair of vesicovaginal fistula, a severe complication of obstruc ...
are considered the fathers of
gynecology
Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined are ...
.
Early life and education
Tait was born in
Edinburgh
Edinburgh ( ; gd, Dùn Èideann ) is the capital city of Scotland and one of its 32 Council areas of Scotland, council areas. Historically part of the county of Midlothian (interchangeably Edinburghshire before 1921), it is located in Lothian ...
, the son of Isabella Stewart Lawson, of
Leven Leven may refer to:
People
* Leven (name), list of people with the name
Nobility
* Earl of Leven a title in the Peerage of Scotland
Placenames
* Leven, Fife, a town in Scotland
* Leven, East Riding of Yorkshire, a village in England
* Leven sta ...
, Fife and Archibald Campbell Tait, a
lawyer
A lawyer is a person who practices law. The role of a lawyer varies greatly across different legal jurisdictions. A lawyer can be classified as an advocate, attorney, barrister, canon lawyer, civil law notary, counsel, counselor, solic ...
, (not to be confused with his
cousin of the same name who was Archbishop of Canterbury). He attended primary school at an independent school called
Heriot's Hospital
George Heriot's School is a Scottish independent primary and secondary day school on Lauriston Place in the Old Town of Edinburgh, Scotland. In the early 21st century, it has more than 1600 pupils, 155 teaching staff, and 80 non-teaching staff. ...
, where he showed exceptional promise. In 1860, the 15-year-old Tait won a scholarship and attended the
University of Edinburgh
The University of Edinburgh ( sco, University o Edinburgh, gd, Oilthigh Dhùn Èideann; abbreviated as ''Edin.'' in post-nominals) is a public research university based in Edinburgh, Scotland. Granted a royal charter by King James VI in 15 ...
as a student of Arts. He subsequently changed course to study medicine. Among his greatest influences was
James Syme
James Syme (7 November 1799 – 26 June 1870) was a pioneering Scottish surgeon.
Early life
James Syme was born on 7 November 1799 at 56 Princes Street in Edinburgh. His father was John Syme WS of Cartmore and Lochore, estates in Fife ...
, the University's Chair of Clinical Surgery. Tait considered Syme to be a remarkable surgeon who emphasized care and cleanliness, and he particularly admired Syme's taste for controversy.
One of Syme's closest students was
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 ...
, with whom Tait would later have significant disputes over the rival practices of
Antisepsis
An antiseptic (from Greek ἀντί ''anti'', "against" and σηπτικός ''sēptikos'', "putrefactive") is an antimicrobial substance or compound that is applied to living tissue/skin to reduce the possibility of infection, sepsis, or putre ...
and
Asepsis
Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deriv ...
. Another influence from student days was Professor (later sir)
James Young Simpson
Sir James Young Simpson, 1st Baronet, (7 June 1811 – 6 May 1870) was a Scottish obstetrician and a significant figure in the history of medicine. He was the first physician to demonstrate the anaesthetic properties of chloroform on humans ...
who became a powerful supporter throughout Tait's life and Tait supported many of Simpson's causes throughout his lifetime. In 1862 Tait transferred to the
Extramural School of Medicine and qualified in 1866 with the joint diploma of
LRCPE,
LRCSEd . licentiates granted by the two Edinburgh medical colleges.
Like many students of his generation he did not sit for a
Bachelor of Medicine
Bachelor of Medicine, Bachelor of Surgery ( la, Medicinae Baccalaureus, Baccalaureus Chirurgiae; abbreviated most commonly MBBS), is the primary medical degree awarded by medical schools in countries that follow the tradition of the United King ...
degree.
Career and work
Early work
Tait worked as a resident surgeon at the Clayton Hospital in
Wakefield
Wakefield is a cathedral city in West Yorkshire, England located on the River Calder. The city had a population of 99,251 in the 2011 census.https://www.nomisweb.co.uk/census/2011/ks101ew Census 2011 table KS101EW Usual resident population, ...
as a resident surgeon from 1866 until 1870, when he took over a private practice in
Birmingham
Birmingham ( ) is a city and metropolitan borough in the metropolitan county of West Midlands in England. It is the second-largest city in the United Kingdom with a population of 1.145 million in the city proper, 2.92 million in the West ...
. He became an active member of the
British Medical Association
The British Medical Association (BMA) is a registered trade union for doctors in the United Kingdom. The association does not regulate or certify doctors, a responsibility which lies with the General Medical Council. The association's headquar ...
, and in this position became known as an "offensive and invidious" medical doctor.
Members of the group saw him as antagonistic and overstepping his place. Despite this opposition, Tait desired acceptance in
London
London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
. As such, he attended meetings in London societies and pursued a fellowship at the
Obstetrical Society of London
The Obstetrical Society of London existed from 1858 to 1907.
History
The Society was set up in 1858, the successor to an Obstetric Society dating from 1825, and in the aftermath of the Medical Act 1858. The founding group included James Hobson Ave ...
.
From around this time until 1879 he also took a job at the
Birmingham and Midland Institute
, mottoeng = Endless Learning
, established = 1854 by Act of Parliament
, city = Birmingham
, province = West Midlands
, country = United Kingdom
, president = Sir David Cannadine
, vice_president = Dr Serena Trowbridge, Sami ...
as a physiology and biology lecturer. In addition, Tait devoted significant efforts towards supporting Arthur Chamberlain, who was working on developing a hospital exclusively for women. Chamberlain and Tait were successful, and Tait worked as a member of this hospital's staff until 1893, when he resigned.
Vivisection
Tait was a strong and outspoken opponent of
vivisection
Vivisection () is surgery conducted for experimental purposes on a living organism, typically animals with a central nervous system, to view living internal structure. The word is, more broadly, used as a pejorative catch-all term for experiment ...
, the practice of surgery on animals for the sake of instruction and practice. He argued that there were four strong arguments against this practice:
* Abstract morality: Tait argued that vivisection was a selfish act in which humans forced living animals to suffer in order for their own benefit.
* Political avenue: Tait argued that the only people outside of medical fields who supported vivisection were the rich. These proponents acted as "amateur poultry butchers" and took to maiming pheasants for fun. As such, the less wealthy saw supporting vivisection as enabling the frivolous and wasteful lifestyles of the wealthy.
* Religion: Tait considered
evolution
Evolution is change in the heritable characteristics of biological populations over successive generations. These characteristics are the expressions of genes, which are passed on from parent to offspring during reproduction. Variation ...
as an aspect of his religious beliefs. He claimed that, as humans share a history with lesser animals, they deserve equal rights. As such, despite their inability to speak for themselves, they should be treated with care and respect as one would treat a human being.
* Scientific inquiry: Tait argued that it remained uncertain as to whether vivisection has, on the whole, led to a decrease in suffering through the expansion of human knowledge. To Tait, any argument for vivisection should be absolutely decisive with no ambiguity, and he did not believe this was even possible.
In a letter addressed to the ''
Medical Press and Circular
''Medical Press and Circular'' was a medical publication from Dublin, Ireland. It was established in 1866 with the merger of the ''Dublin Medical Press'' and the ''Medical Circular''. Its masthead featured a Latin language version of the Cicero mo ...
'' he wrote:
[Quoted in '']The Zoologist
''The Zoologist'' was a monthly natural history magazine established in 1843 by Edward Newman and published in London. Newman acted as editor-in-chief until his death in 1876, when he was succeeded, first by James Edmund Harting (1876–1896) ...
'', 4th series, vol. 3 (1899), issue 697 (July, 1899), p. 336.
Asepsis
Tait was suspicious of the prevailing practice of
antisepsis
An antiseptic (from Greek ἀντί ''anti'', "against" and σηπτικός ''sēptikos'', "putrefactive") is an antimicrobial substance or compound that is applied to living tissue/skin to reduce the possibility of infection, sepsis, or putre ...
, advocated for by
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 ...
. The two doctors agreed that it was necessary for surgeons to ensure that their hands and instruments were clean in order to reduce the risk of infection. Lister argued that surgical cleanliness could only be achieved through
sterilization, which required the use of compounds like
carbolic acid
Phenol (also called carbolic acid) is an aromatic organic compound with the molecular formula . It is a white crystalline solid that is volatile. The molecule consists of a phenyl group () bonded to a hydroxy group (). Mildly acidic, it requir ...
. Unlike Lister, Tait used nothing more than boiling water for cleaning his instruments and yet had similar results. Tait was able to achieve exceptional results in his surgery using his techniques, as they were simple, low-cost, effective, and not limited by the presence of chemicals.
Reducing surgical mortality
Tait's first success came with his demonstration that ovariotomy could be done safely. While
Ephraim McDowell
Ephraim McDowell (November 11, 1771 – June 25, 1830) was an American physician and pioneer surgeon. The first person to successfully remove an ovarian tumor, he has been called "the father of ovariotomy" as well as founding father of abdomina ...
had successfully performed the first
ovariotomy
Oophorectomy (; from Greek , , 'egg-bearing' and , , 'a cutting out of'), historically also called ''ovariotomy'' is the surgical removal of an ovary or ovaries. The surgery is also called ovariectomy, but this term is mostly used in reference t ...
in
Kentucky
Kentucky ( , ), officially the Commonwealth of Kentucky, is a state in the Southeastern region of the United States and one of the states of the Upper South. It borders Illinois, Indiana, and Ohio to the north; West Virginia and Virginia to ...
in 1809, mortality for this operation was over 90%. In his first paper in 1872, Tait reported only 1 death out of nine cases, a major breakthrough. His techniques of use of intra-abdominal ligatures for the ovarian pedicle in favor of an extraperitoneal clamp, abdominal closure, and meticulous surgical cleanliness were novel and important for abdominal surgery. With further recognition, he was instrumental in the opening of the
Birmingham
Birmingham ( ) is a city and metropolitan borough in the metropolitan county of West Midlands in England. It is the second-largest city in the United Kingdom with a population of 1.145 million in the city proper, 2.92 million in the West ...
Hospital for Women where he worked for 20 years.
Surgical milestones
![Robert Lawson Tait](https://upload.wikimedia.org/wikipedia/commons/2/20/Robert_Lawson_Tait.jpg)
During this time, his work included:
# First removal of an organ (
ovary
The ovary is an organ in the female reproductive system that produces an ovum. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. There is an ovary () found on each side of the body. ...
) (
oophorectomy
Oophorectomy (; from Greek , , 'egg-bearing' and , , 'a cutting out of'), historically also called ''ovariotomy'' is the surgical removal of an ovary or ovaries. The surgery is also called ovariectomy, but this term is mostly used in reference to ...
) for pain.
# Observation of association of cystic ovaries and excessive menstrual bleeding.
# Surgical induction of
menopause
Menopause, also known as the climacteric, is the time in women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause usually occurs between the age of 47 and 54. Medical professionals often d ...
by removal of ovaries.
# Removal of infected tubes.
# Drainage of
pelvic abscesses.
# First
appendectomy
An appendectomy, also termed appendicectomy, is a Surgery, surgical operation in which the vermiform appendix (a portion of the intestine) is removed. Appendectomy is normally performed as an urgent or emergency procedure to treat complicated acu ...
1880. It was later learned that he was anticipated by French-born English surgeon
Claudius Amyand in 1735.
# First
cholecystotomy
Cholecystectomy is the surgical removal of the gallbladder. Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. In 2011, cholecystectomy was the eighth most common operating room procedure performed i ...
(
gallbladder
In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although ...
surgery).
#
Asepsis
Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deriv ...
in lieu of Lister's
antisepsis
An antiseptic (from Greek ἀντί ''anti'', "against" and σηπτικός ''sēptikos'', "putrefactive") is an antimicrobial substance or compound that is applied to living tissue/skin to reduce the possibility of infection, sepsis, or putre ...
; he avoided the use of
carbolic acid
Phenol (also called carbolic acid) is an aromatic organic compound with the molecular formula . It is a white crystalline solid that is volatile. The molecule consists of a phenyl group () bonded to a hydroxy group (). Mildly acidic, it requir ...
.
# Flushing of peritoneal cavity at end of operation.
Ectopic pregnancy
In 1881, it was suggested to him to remove the ruptured tube in case of an ectopic pregnancy. "... the suggestion staggered me, and I am ashamed to say that I did not receive it favourably." The postmortem examination convinced him that it could be done. So, 2 years later, Tait ligated the
broad ligament
The broad ligament of the uterus is the wide fold of peritoneum that connects the sides of the uterus to the walls and floor of the pelvis.
Structure
Subdivisions
Contents
The contents of the broad ligament include the following:
* Reproduc ...
and tube in another patient, and this patient survived. In 1888, Tait reported only 2 deaths out of 42 operated cases, a marked improvement for a condition that had been almost always fatal.
Later life
Tait's career began to decline in 1892. Due to his lifelong history of advocating for new techniques and against common practices (e.g. vivisection and antisepsis), there were many who saw him as an enemy and a nuisance. Tait's productivity slowed to a halt due to his declining health, along with two legal situations. The first of these was a lawsuit from Andrew Denholm, and the second was a threat to bring action against Tait for supposedly seducing a nurse.
In his retirement, Tait continued to stay active within medicine. Many younger doctors respected and admired him, and he regularly contributed to meetings at several Medical Institutions. He died in 1899, at the age of 54, of chronic
nephritis
Nephritis is inflammation of the kidneys and may involve the glomeruli, tubules, or interstitial tissue surrounding the glomeruli and tubules. It is one of several different types of nephropathy.
Types
* Glomerulonephritis is inflammation of th ...
and
uremia
Uremia is the term for high levels of urea in the blood. Urea is one of the primary components of urine. It can be defined as an excess of amino acid and protein metabolism end products, such as urea and creatinine, in the blood that would be nor ...
, after a week and a half of severe illness. He remained lucid in his final days, and left instructions that his body be buried in a cave near his home.
At the time of his death, several of his contemporaries published writings in praise of his medical advances, character, and work at hospitals for poor women.
Legacy
The Lawson Tait Society, an undergraduate history of medicine society at the
University of Birmingham Medical School
The University of Birmingham Medical School is one of Britain's largest and oldest medical schools with over 400 medical, 70 pharmacy, 140 biomedical science and 130 nursing students graduating each year. It is based at the University of Birmi ...
, is named in honour of Tait. They have embarked upon a project of digitising Tait's work and resources related to Tait.
Selected publications
''The Uselessness of Vivisection Upon Animals as a Method of Scientific Research''(1882)
''The Pathology and Treatment of Diseases of the Ovaries''(1883)
''Diseases of Women''(1886)
''Last Speech on Vivisection''(1889)
References
*Risdon W
Robert Lawson Tait London: National Anti-Vivisection Society; 1967. Digitised by th
Lawson Tait Society*
*
*
*
External links
{{DEFAULTSORT:Tait, Lawson
1845 births
1899 deaths
19th-century Scottish medical doctors
Anti-vivisectionists
Medical doctors from Edinburgh
Deaths from kidney failure
Scottish gynaecologists
Scottish surgeons
People from Birmingham, West Midlands