William Arbuthnot Lane
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Sir William Arbuthnot Lane, 1st Baronet, CB, FRCS (4 July 1856 – 16 January 1943) was a British surgeon and physician. He mastered orthopaedic,
abdominal The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. ...
, and ear, nose and throat surgery, while designing new surgical instruments toward maximal asepsis. He thus introduced the "no-touch technique", and some of his designed instruments remain in use. Lane pioneered
internal fixation Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the m ...
of displaced fractures, procedures on cleft palate, and colon resection and colectomy to treat "Lane's disease"—now otherwise termed ''
colonic inertia Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
'', which he identified in 1908—which surgeries were controversial but advanced abdominal surgery. During
World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...
, as an officer with the
Royal Army Medical Corps The Royal Army Medical Corps (RAMC) is a specialist corps in the British Army which provides medical services to all Army personnel and their families, in war and in peace. The RAMC, the Royal Army Veterinary Corps, the Royal Army Dental Corps a ...
, he organised and opened Queen Mary's Hospital in
Sidcup Sidcup is an area of south-east London, England, primarily in the London Borough of Bexley. It is south-east of Charing Cross, bordering the London Boroughs of London Borough of Bromley, Bromley and Royal Borough of Greenwich, Greenwich. Before ...
, which pioneered reconstructive surgery. The late-
Victorian Victorian or Victorians may refer to: 19th century * Victorian era, British history during Queen Victoria's 19th-century reign ** Victorian architecture ** Victorian house ** Victorian decorative arts ** Victorian fashion ** Victorian literature ...
and Edwardian periods' preeminent surgeon, Lane operated on
socialite A socialite is a person from a wealthy and (possibly) aristocratic background, who is prominent in high society. A socialite generally spends a significant amount of time attending various fashionable social gatherings, instead of having traditio ...
s, politicians, and royalty. Lane thus attained
baronet A baronet ( or ; abbreviated Bart or Bt) or the female equivalent, a baronetess (, , or ; abbreviation Btss), is the holder of a baronetcy, a hereditary title awarded by the British Crown. The title of baronet is mentioned as early as the 14th ...
cy in 1913. In the early 1920s, as an early advocate of dietary prevention of cancer, Lane met medical opposition, resigned from
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 founded the New Health Society, the first organisation practising social medicine. Through newspapers and lectures, sometimes drawing large crowds, Lane promoted whole foods, fruits and vegetables, sunshine and exercise: his plan to foster health and longevity via three bowel movements daily. Tracing diverse diseases to modern civilization, he urged the people to return to farmland. For his New Health, Lane eventually became viewed as a crank. Lane's explanation of the association between constipation and illness as due to autointoxication is generally regarded by gastroenterologists as wholly fictitious. And Lane's earlier surgeries for chronic constipation have been depicted as baseless. Yet
constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
remains a major health problem associating with diverse signs and symptoms, including psychological—sometimes still explained as Lane's disease—and total colectomy has been revived since the 1980s as a mainstream treatment, although dietary intervention is now the first line of action.


Life and career


Childhood

William Arbuthnot Lane was born in 1856 in Fort George near
Inverness, Scotland Inverness (; from the gd, Inbhir Nis , meaning "Mouth of the River Ness"; sco, Innerness) is a city in the Scottish Highlands. It is the administrative centre for The Highland Council and is regarded as the capital of the Highlands. Historic ...
, as the eldest of the eight children of Benjamin Lane,"Sir William Arbuthnot Lane (1856–1943)"
Historic Hospital Admission Records Project (HHARP), Website access: 1 October 2003.
a military surgeon enlisted to the
British Empire The British Empire was composed of the dominions, colonies, protectorates, mandates, and other territories ruled or administered by the United Kingdom and its predecessor states. It began with the overseas possessions and trading posts esta ...
. William attended schools in eight countries on four continents—
Ireland Ireland ( ; ga, Éire ; Ulster Scots dialect, Ulster-Scots: ) is an island in the Atlantic Ocean, North Atlantic Ocean, in Northwestern Europe, north-western Europe. It is separated from Great Britain to its east by the North Channel (Grea ...
,
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
,
Corfu Corfu (, ) or Kerkyra ( el, Κέρκυρα, Kérkyra, , ; ; la, Corcyra.) is a Greek island in the Ionian Sea, of the Ionian Islands, and, including its small satellite islands, forms the margin of the northwestern frontier of Greece. The isl ...
,
Malta Malta ( , , ), officially the Republic of Malta ( mt, Repubblika ta' Malta ), is an island country in the Mediterranean Sea. It consists of an archipelago, between Italy and Libya, and is often considered a part of Southern Europe. It lies ...
,
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...
,
South Africa South Africa, officially the Republic of South Africa (RSA), is the southernmost country in Africa. It is bounded to the south by of coastline that stretch along the South Atlantic and Indian Oceans; to the north by the neighbouring countri ...
, and others—while his family followed the army regiment. Amid his mother's bearing seven children in rapid succession after him, William was often left in the care of military personnel.González-Crussi, ''Carrying the Heart'' (Kaplan, 2009)
p 73
At age 12, he was sent to boarding school at Stanley House School, Bridge of Allan in Scotland.


Education

In 1872, his father arranged for him, age 16, to study medicine at
Guy's Hospital Guy's Hospital is an NHS hospital in the borough of Southwark in central London. It is part of Guy's and St Thomas' NHS Foundation Trust and one of the institutions that comprise the King's Health Partners, an academic health science centre. ...
. Apparently shy and appearing young even for his age, William initially had some troubles with fellow students, but they rapidly recognized his exceptional abilities.Mostofi, ''Who's Who in Orthopedics'' (Springer, 2005). Soon, he was persuaded to switch to surgery, however, a surer career than medicine. Later, he received the degrees bachelor of medicine and master of surgery from the
University of London The University of London (UoL; abbreviated as Lond or more rarely Londin in post-nominals) is a federal public research university located in London, England, United Kingdom. The university was established by royal charter in 1836 as a degree ...
.


Career

In 1877, at age 21, he qualified as a member of the
Royal College of Surgeons The Royal College of Surgeons is an ancient college (a form of corporation) established in England to regulate the activity of surgeons. Derivative organisations survive in many present and former members of the Commonwealth. These organisations a ...
, and began to practise in
Chelsea, London Chelsea is an affluent area in west London, England, due south-west of Charing Cross by approximately 2.5 miles. It lies on the north bank of the River Thames and for postal purposes is part of the south-western postal area. Chelsea histori ...
, at the Victoria Hospital for Children. In 1883, Lane became a Fellow of
Royal College of Surgeons The Royal College of Surgeons is an ancient college (a form of corporation) established in England to regulate the activity of surgeons. Derivative organisations survive in many present and former members of the Commonwealth. These organisations a ...
and joined
Great Ormond Street Hospital Great Ormond Street Hospital (informally GOSH or Great Ormond Street, formerly the Hospital for Sick Children) is a children's hospital located in the Bloomsbury area of the London Borough of Camden, and a part of Great Ormond Street Hospital ...
, where he was consultant until 1916. In 1888, at age 32, Lane returned to Guy's Hospital as
anatomy Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having its ...
demonstrator and assistant surgeon, and remained with Guy's for most of his career. Lane became especially known for
internal fixation Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the m ...
of displaced fractures,
neonatal An infant or baby is the very young offspring of human beings. ''Infant'' (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is a formal or specialised synonym for the common term ''baby''. The terms may also be used to ...
repair of cleft palate, and developing colectomy, which, although highly controversial and opposed by most surgical peers, notably advanced
abdominal surgery The term abdominal surgery broadly covers Surgery, surgical procedures that involve opening the abdomen (laparotomy). Surgery of each abdominal organ is dealt with separately in connection with the description of that organ (see stomach, kidney, l ...
. Lane collaborated with Down Brothers to design a number of surgical instruments, including screw driver, periosteal elevator, tissue forceps, intestinal
anastomosis An anastomosis (, plural anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf#Veins, leaf veins, or streams. Such a connection m ...
clamp, bone-holding forceps, and osteotome. For his surgery on British royalty, he was awarded
baronet A baronet ( or ; abbreviated Bart or Bt) or the female equivalent, a baronetess (, , or ; abbreviation Btss), is the holder of a baronetcy, a hereditary title awarded by the British Crown. The title of baronet is mentioned as early as the 14th ...
cy in 1913. Lane became an officer in
Royal Army Medical Corps The Royal Army Medical Corps (RAMC) is a specialist corps in the British Army which provides medical services to all Army personnel and their families, in war and in peace. The RAMC, the Royal Army Veterinary Corps, the Royal Army Dental Corps a ...
, head of army surgery,Nicolson
''Great Silence''
(Grove/Atlantic, 2009).
during
World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...
(1914–18). For this work as consulting surgeon in
Aldershot Aldershot () is a town in Hampshire, England. It lies on heathland in the extreme northeast corner of the county, southwest of London. The area is administered by Rushmoor Borough Council. The town has a population of 37,131, while the Alders ...
at the
Cambridge Military Hospital Cambridge Military Hospital was a hospital completed in 1879 in Aldershot Garrison, Hampshire, England which served the various British Army camps there. During World War I World War I (28 July 1914 11 November 1918), often abbreviate ...
and for opening Queen Mary's Hospital in
Sidcup Sidcup is an area of south-east London, England, primarily in the London Borough of Bexley. It is south-east of Charing Cross, bordering the London Boroughs of London Borough of Bromley, Bromley and Royal Borough of Greenwich, Greenwich. Before ...
—where, overcoming government resistance to fund it, he gave Harold Gillies a ward where Gillies pioneered reconstructive surgery—Lane was appointed Companion of The Most Honourable Order of the Bath. In 1920, rather soon after returning from wartime service, Lane retired from Guy's Hospital, yet continued private practice out his home office.


Writing

He first published in 1883, seven years after starting his surgery career. He published about 189 articles, including 72 on fractures, 16 on harelip and cleft palate, many others on other subjects, and, after year 1903, 89 articles directly on chronic intestinal stasis—which, like many
Victorians In the history of the United Kingdom and the British Empire, the Victorian era was the period of Queen Victoria's reign, from 20 June 1837 until her death on 22 January 1901. The era followed the Georgian period and preceded the Edwardian ...
, Lane experienced. He wrote several books, including one on cleft palate, one on surgery for chronic intestinal stasis, and one on ''New Health''. Not for print, his autobiography—manuscript dated March 1936, soon before his 80th birthday—was written for family at the urging of his children.Dally, ''Fantasy Surgery'' (Rodopi, 1996)
p 85


Family

William's first wife, Charlotte Jane Briscoe—daughter of John Briscoe, himself son of Major Briscoe—bore Irene Briscoe in 1890 and Eileen Caroline in 1893, both in St Olave parish. At age 78, Charlotte Jane died in 1935. Sir Lane's daughter Eileen was married to Nathan Mutch, whose sister was Jane Mutch. In 1935, Sir Lane married Jane Mutch (who died in 1966 at age 82).


Image

Lane was tall, rather thin, seemingly aged slowly, his reactions were often difficult to discern, and yet he often exhibited strong opinions. It was often said that Lane was
George Bernard Shaw George Bernard Shaw (26 July 1856 – 2 November 1950), known at his insistence simply as Bernard Shaw, was an Irish playwright, critic, polemicist and political activist. His influence on Western theatre, culture and politics extended from ...
's model for the scurrilous surgeon, Cutler Walpole—obsessed with excising the "nuciform sac", said to be nickname for the colon—in Shaw's play '' The Doctor's Dilemma''.Dally, ''Fantasy Surgery'' (Rodopi, 1996)
pp 152–53
quotes
Shaw Shaw may refer to: Places Australia *Shaw, Queensland Canada *Shaw Street, a street in Toronto England *Shaw, Berkshire, a village *Shaw, Greater Manchester, a location in the parish of Shaw and Crompton *Shaw, Swindon, a List of United Kingdom ...
's letter dated 13 March 1948: "I never met AL. Cutler Walpole was in print years before I ever heard of Lane. You have been misled by the fact that Lane became known for inventing and practising the operation of shortcircuiting the bowels by cutting out yards of colon: a surgical monstrosity which obsessed him as the nuciform sac obsesses Walpole".
Yet the play was nearly surely about Sir Almroth Wright, whom Lane knew well. After Lane's death, Shaw stated that the play was published long before he had ever heard of Lane, but still regarded Lane's bowel surgeries as "monstrous". And the play well suggests the view of Lane as held by many of Lane's contemporaries. After 1924, abandoning his private medical practice as well as surgery, Lane's public devotion was social medicine and public education on dietary and lifestyle subversion of constipation and promotion of general wellbeing, his ''New Health''. Of diverse interests, Lane traveled frequently, often visiting America, while gaining friends and colleagues internationally. Among his associates and acquaintances were Alexis Carrel, John Benjamin Murphy,
Elie Metchnikoff Elie and Earlsferry is a coastal town and former royal burgh in Fife, and parish, Scotland, situated within the East Neuk beside Chapel Ness on the north coast of the Firth of Forth, eight miles east of Leven. The burgh comprised the linked vi ...
,
Sir James Mackenzie Sir James Mackenzie (12 April 1853 – 26 January 1925) was a Scottish cardiologist who was a pioneer in the study of cardiac arrhythmias. Due to his work in the cardiac field he is known as a research giant in primary care, and was knighted by ...
, William Worrall Mayo and sons
William James Mayo William James Mayo (June 29, 1861 – July 28, 1939) was a physician and surgeon in the United States and one of the seven founders of the Mayo Clinic. He and his brother, Charles Horace Mayo, both joined their father's private medical practice ...
and Charles Horace Mayo of
Mayo Clinic The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research. It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staff, ...
fame. Quotes of Lane by his Guy's Hospital house surgeon and biographer, William E Tanner: *''The man whose first question, after what he considers to be a right course of action has presented itself, is ''What will people say?'' is not the man to do anything at all.'' *''If you get a rude letter, always send a polite one back. It's much better.'' *''If everyone believes a thing, it is probably untrue!''


Death

He died at his home, 46 Westbourne Terrace, Paddington, London, W2.


Medical spotlight


Surgery master

By 1886, Lane authored a surgery textbook. In 1889 in America at Johns Hopkins University's medical school, William Halsted, a pioneer of abdominal surgery, introduced
surgical gloves Medical gloves are disposable gloves used during medical examinations and procedures to help prevent cross-contamination between caregivers and patients. Medical gloves are made of different polymers including latex, nitrile rubber, polyvinyl c ...
, and then contracted
Goodyear Rubber Company The Goodyear Tire & Rubber Company is an American multinational tire manufacturing company founded in 1898 by Frank Seiberling and based in Akron, Ohio. Goodyear manufactures tires for automobiles, commercial trucks, light trucks, motorcycles, S ...
to manufacture thin ones to preserve hands'
tactile Tactile may refer to: * Tactile, related to the sense of touch * Haptics (disambiguation) * Tactile (device), a text-to-braille translation device See also * Tangibility, in law * Somatosensory system, where sensations are processed * CD96 CD9 ...
sensitivity. In the 1890s, glove use still uncommon, Lane introduced long surgical instruments to keep even gloves off of tissues. In his open reductions and plating of fractured bones, Lane introduced the "no-touch technique". Thus pioneering ''a''septic surgery, an advance beyond ''anti''septic surgery, Lane enabled new surgeries previously too dangerous.Martin Pugh, ''We Danced All Night'' (Bodley Head, 2008)
p 48
Widely renowned, Lane's surgical skill exhibited imperturbable calm at difficulties encountered during the operations. A contemporary noted "the originality of his procedures and the smoothness, ease, and perfection of technic that proclaimed a real master, a master who dared where others quailed and who succeeded where others would have failed without his skill, his precision, and the confidence with which he planned and executed his operations". Although most of Lane's surgical career was attended by controversy, it could not be denied that—with but the possible exception of Sir Frederick Treves—Lane was
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 ...
's best surgeon as to technique.


Internal fixation

Only
anecdotal Anecdotal evidence is evidence based only on personal observation, collected in a casual or non-systematic manner. The term is sometimes used in a legal context to describe certain kinds of testimony which are uncorroborated by objective, independ ...
reports of using
internal fixation Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the m ...
to set displaced fractures predate
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 ...
's 1865 introduction of ''anti''septic surgery, whereupon Lister reported
silver Silver is a chemical element with the Symbol (chemistry), symbol Ag (from the Latin ', derived from the Proto-Indo-European wikt:Reconstruction:Proto-Indo-European/h₂erǵ-, ''h₂erǵ'': "shiny" or "white") and atomic number 47. A soft, whi ...
wire on a displaced petellar fracture. Yet even before
radiography Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography ("diagnostic" and "therapeut ...
, Lane had found that conventional setting by manipulation and splints yielded poor outcomes—bone disunion and joint changes or wear in individuals under much physical activity—and Lane started using wires and screws in 1892. Amid the conservative medical community's vehement opposition, Lane's approach was so revolutionary that organizations certifying surgeons sometimes automatically dismissed students able to elaborate on such procedures, as nearly 50% of patients whose closed fractures were opened died by ensuing infections. Yet with not antiseptic, but
aseptic 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 ...
, surgical techniques, previously unheard of, Lane forged ahead. In the meantime, other surgeons' poor results, such as
sepsis Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...
causing failed union, were sometimes erroneously associated with Lane. 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 ...
appointed a committee to investigate Lane's practise—and ruled in Lane's favour.González-Crussi, ''Carrying the Heart'' (Kaplan, 2009)
p 74–75
Whereas other surgeons would attempt asepsis but lapse, perhaps touching an unsterilized surface, Lane's utterly fastidious protocol was unrelenting. His 1905 book ''The Operative Treatment of Fractures'' reported good results. And in 1907, Lane introduced plates, made of
steel Steel is an alloy made up of iron with added carbon to improve its strength and fracture resistance compared to other forms of iron. Many other elements may be present or added. Stainless steels that are corrosion- and oxidation-resistant ty ...
. (
Stainless steel Stainless steel is an alloy of iron that is resistant to rusting and corrosion. It contains at least 11% chromium and may contain elements such as carbon, other nonmetals and metals to obtain other desired properties. Stainless steel's corros ...
, discovered the next decade, was not widely used in medicine or surgery until much later.) And later, Lane's assertion of frequent disunion via nonsurgical intervention was vindicated by radiography. Altogether, Lane's influence introducing internal fixation rivals and may exceed that of other, early pioneers like Albin Lambotte and later William O'Neill Sherman.


''Intestinal stasis''


Backdrop

At 1886, Russian emigrant
Elie Metchnikoff Elie and Earlsferry is a coastal town and former royal burgh in Fife, and parish, Scotland, situated within the East Neuk beside Chapel Ness on the north coast of the Firth of Forth, eight miles east of Leven. The burgh comprised the linked vi ...
—discoverer of phagocytes mediating innate immunity—was welcomed to Paris by
Louis Pasteur Louis Pasteur (, ; 27 December 1822 – 28 September 1895) was a French chemist and microbiologist renowned for his discoveries of the principles of vaccination, microbial fermentation and pasteurization, the latter of which was named afte ...
with an entire floor at the
Pasteur Institute The Pasteur Institute (french: Institut Pasteur) is a French non-profit private foundation dedicated to the study of biology, micro-organisms, diseases, and vaccines. It is named after Louis Pasteur, who invented pasteurization and vaccines f ...
.Tauber & Chernyak, ''Metchnikoff and the Origins of Immunology'' (Oxford, 1991), p
viii11
As did Paul Ehrlich—theorist on
antibody An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and viruses. The antibody recognizes a unique molecule of the ...
mediating
acquired immunity The adaptive immune system, also known as the acquired immune system, is a subsystem of the immune system that is composed of specialized, systemic cells and processes that eliminate pathogens or prevent their growth. The acquired immune system ...
—and as did Pasteur, Metchnikoff believed nutrition to influence immunity. Sharing Pasteur's vision of science as a
means Means may refer to: * Means LLC, an anti-capitalist media worker cooperative * Means (band), a Christian hardcore band from Regina, Saskatchewan * Means, Kentucky, a town in the US * Means (surname) * Means Johnston Jr. (1916–1989), US Navy adm ...
to combat humankind's woes, Metchnikoff brought France its first yogurt cultures, aiming its
probiotic Probiotics are live microorganisms promoted with claims that they provide health benefits when consumed, generally by improving or restoring the gut microbiota. Probiotics are considered generally safe to consume, but may cause bacteria-host i ...
microorganisms to suppress the colon's putrefactive microorganisms allegedly causing toxic seepage, '' autointoxication''. Later the Pasteur Institute's director and a 1908
Nobelist The Nobel Prizes ( sv, Nobelpriset, no, Nobelprisen) are awarded annually by the Royal Swedish Academy of Sciences, the Swedish Academy, the Karolinska Institutet, and the Norwegian Nobel Committee to individuals and organizations who make out ...
, Metchnikoff viewed the colon as a primitive organ that had stored our wild ancestors' waste for long periods, a survival advantage amid abundant predators, but a liability since civilization had freed humans to excrete without peril. Metchnikoff predicted the colon's evolutionary shrinkage until, allegedly alike the
appendix Appendix, or its plural form appendices, may refer to: __NOTOC__ In documents * Addendum, an addition made to a document by its author after its initial printing or publication * Bibliography, a systematic list of books and other works * Index (pub ...
, it became
vestigial Vestigiality is the retention, during the process of evolution, of genetically determined structures or attributes that have lost some or all of the ancestral function in a given species. Assessment of the vestigiality must generally rely on co ...
.González-Crussi, ''Carrying the Heart'' (Kaplan, 2009)
pp 76–78
Metchnikoff's book ''La Vie Humaine'' foresaw a courageous surgeon removing the colon. Lane and Metchnikoff met in Lane's home. The pioneer British psychiatrist Henry Maudsley asserted much "evidence that organic morbid poisons bred in the organism or in the blood itself may act in the most baneful manner upon the supreme nervous centers. The earliest and mildest mental effect by which a perverted state of blood declares itself is not in the production of positive delusion or incoherence of thought, but in a modification of mental tone", then perhaps "a chronic delusion of some kind", though "its more acute action is to produce more or less active delirium and general incoherence of thought". Famed British surgeon William Hunter incriminated ''oral sepsis'' in 1900, and lectured to a Canadian medical faculty in Montreal in 1910. Two years later, Chicago physician Frank Billings termed it ''focal infection''. Within the
English-speaking world Speakers of English are also known as Anglophones, and the countries where English is natively spoken by the majority of the population are termed the '' Anglosphere''. Over two billion people speak English , making English the largest languag ...
, the lectures of Hunter and of Billings "ignited the fires of focal infection",Ingle, ''PDQ Endodontics'', 2nd edn (People's Medical, 2009)
p xiv
whose
theory A theory is a rational type of abstract thinking about a phenomenon, or the results of such thinking. The process of contemplative and rational thinking is often associated with such processes as observational study or research. Theories may be s ...
converged with the autointoxication principle.Noll, ''American Madness'' (Harvard U P, 2011)
pp 117–21
Since 1875, American medical doctor John Harvey Kellogg in
Battle Creek, Michigan Battle Creek is a city in the U.S. state of Michigan, in northwest Calhoun County, Michigan, Calhoun County, at the confluence of the Kalamazoo River, Kalamazoo and Battle Creek River, Battle Creek rivers. It is the principal city of the Battle C ...
, at his huge sanitarium—advertised as "University of Health", staffing some 800 to 1 000, and yearly receiving several thousand patients, including US Presidents and celebrities—had battled degeneration and disease by fending off ''bowel sepsis''.Scull, ''Madhouse'' (Yale U P, 2005)
pp 34–36
John H Kellogg, ''Autointoxication Or Intestinal Toxemia'', 2nd edn (Battle Creek MI: Modern Medicine Publishing, 1919)
"Preface"
pp 3–11.
In the early 20th century, rebuking alleged "health faddists" like Kellogg and
Sylvester Graham Sylvester Graham (July 5, 1794 – September 11, 1851) was an American Presbyterian minister and dietary reformer known for his emphasis on vegetarianism, the temperance movement, and eating whole-grain bread. His preaching inspired the graha ...
, American physicians who embraced focal infection theory cast themselves in the German tradition of "scientific medicine".Scull, ''Madhouse'' (Yale U P, 2005)
p 33
Kellogg argued that German researchers ostensibly repudiated the autointoxication principle, but, by using different terminology, supported it circuitously. Since French pathologist Charles Jacques Bouchard, in his 1887 book, coined the term ''autointoxication'', French researchers had investigated and openly advocated the principle, already presaged by multiple researchers in Europe and America. Meanwhile, British surgeons still knife-happy, Hunter warned of "intestinal stasis" impairing mental stability, and called for "surgical bacteriology".Scull, ''Madhouse'' (Yale U P, 2005)
p 37


Lane

In 1908, Lane reported a syndrome of severe chronic constipation, often with dysfunction of
pelvic muscles The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the leva ...
and obstructed defecation—invariably with psychological dysfunction, impairing quality of life, but affecting mostly women—a syndrome soon termed ''Lane disease'', yet now otherwise termed ''slow transit constipation''as well as ''colonic inertia''.WR Schouten & AF Engel, ch 19 "Motility disorders of the distal gastrointestinal tract", subch "Surgical aspects", § "Slow transit constipation without megacolon", in JJB van Lanschot, DJ Gouma, GNJ Tytgat ''et al'', eds, ''Integrated Medical And Surgical Gastroenterology'' (New York: Thieme, 2004)
p 365
"This condition, also described as
colonic inertia Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
, occurs almost entirely in women. Patients with this syndrome have infrequent defecation, two or less bowel actions per week, due to a marked prolongation of colonic transit time. Most patients develop the first symptoms around the time of their first menstruation. Sometimes, colonic inertia develops shortly after childbirth or
hysterectomy Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries (oophorectomy), Fallopian tubes (salpingectomy), and other surrounding structures. Usually performed by a gynecologist, a hysterectomy may b ...
. All patients with this syndrome have a colon of normal size. Routine
histopathologic Histopathology (compound of three Greek words: ''histos'' "tissue", πάθος ''pathos'' "suffering", and -λογία ''-logia'' "study of") refers to the microscopic examination of tissue in order to study the manifestations of disease. Spec ...
examination of the large bowel does not reveal any abnormality. Most patients with colonic inertia present with associated symptoms, such as general
malaise As a medical term, malaise is a feeling of general discomfort, uneasiness or lack of wellbeing and often the first sign of an infection or other disease. The word has existed in French since at least the 12th century. The term is often used ...
, bloating, abdominal pain, nausea and vomiting, which interfere with the ability to work and enjoy social activities. Many patients also have
gynecologic 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 ...
and/or
urologic Urology (from Ancient Greek, Greek wikt:οὖρον, οὖρον ''ouron'' "urine" and ''wiktionary:-logia, -logia'' "study of"), also known as genitourinary surgery, is the branch of medicine that focuses on surgical and medical diseases of t ...
problems. A delay in gastric emptying and a prolonged
small bowel The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the pa ...
transit have also been found, suggesting that inertia of the
large bowel The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system in tetrapods. Water is absorbed here and the remaining waste material is stored in the rectum as feces before being ...
might be the colonic manifestation of a gastrointestinal motility disorder. Medical treatment with laxatives, enemas and prokinetic agents, such as cisapride, does not relieve the burdensome symptoms. Retrograde colonic irrigation has limited value".
That same year, Lane treated it by surgery. The following year, Lane's book ''The Operative Treatment of Chronic Constipation'' was published in London. Lane began with colon bypass, and then, at insufficient improvements, performed total colectomy. Famed for an
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 ...
saving England's monarch, Lane warned of "chronic intestinal stasis"—its "flooding of the circulation with filthy material", thus autointoxication—warnings taken seriously by the public. Such views on the colon, constipation, and autointoxication were standard in the medical profession, yet disagreement raged over the proper explanation and the proper intervention, and so controversy trailed Lane's surgeries.Dally, ''Fantasy Surgery'' (Rodopi, 1996)
p 154
Apparently, Lane had had trouble publishing in the ''
British Medical Journal ''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Origi ...
'' and in ''
The Lancet ''The Lancet'' is a weekly peer-reviewed general medical journal and one of the oldest of its kind. It is also the world's highest-impact academic journal. It was founded in England in 1823. The journal publishes original research articles, ...
'' his first articles on chronic intestinal stasis. Some who endorsed the autointoxication principle interpreted constipation to have a role in it, but a role "obscure", as some thought the drying of fecal matter to diminish putrefaction, but the stasis of the small bowel, rather, to be the especial source of autointoxication.Adolphe Combe & Albert Fournier, ''Intestinal Auto-Intoxication'', English trans by William G States (London: Rebman, 1908), p
72107–08110415
In any case, most surgeons opposed Lane's operating on constipation. The
Royal Society of Medicine The Royal Society of Medicine (RSM) is a medical society in the United Kingdom, headquartered in London. History The Society was established in 1805 as Medical and Chirurgical Society of London, meeting in two rooms in barristers’ chambers ...
called a 1913 meeting, but, despite some 60 synonyms circulating for ''autointoxication'' from varying perspectives, suggested neutrality by choosing none and introducing a new term, ''alimentary toxæmia''. Several authors, including Lane, presented papers, whereupon some two dozen responded from April to May. There, "chronic intestinal stasis received its deathblow", when a Fellow's severely antagonistic speech, apparently influencing the course of Lane's career, preempted Lane's opening a surgery school.
World War I World War I (28 July 1914 11 November 1918), often abbreviated as WWI, was one of the deadliest global conflicts in history. Belligerents included much of Europe, the Russian Empire, the United States, and the Ottoman Empire, with fightin ...
broke out in 1914, diverting the attention of Lane, newly head of army surgery. Returning from war service, Lane retired from
Guy's Hospital Guy's Hospital is an NHS hospital in the borough of Southwark in central London. It is part of Guy's and St Thomas' NHS Foundation Trust and one of the institutions that comprise the King's Health Partners, an academic health science centre. ...
in 1920, and continued in private practice. From then onward, Lane wrote almost only on chronic intestinal stasis. Meanwhile,
focal infection theory Focal infection theory is the historical concept that many chronic diseases, including systemic disease, systemic and common ones, are caused by focal infections. In present medical consensus, a focal infection is a localized infection, often asy ...
—a primary means of interpreting the autointoxication principle—was "coming of age". In 1916, Henry Cotton in America had embraced focal infection theory with unmatched zeal, became the first to apply it to
psychiatry Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial psych ...
, and rapidly rose to international fame for prescribing removal of
dentition Dentition pertains to the development of teeth and their arrangement in the mouth. In particular, it is the characteristic arrangement, kind, and number of teeth in a given species at a given age. That is, the number, type, and morpho-physiolo ...
, sex glands, and internal organs—most controversially the colon—to treat
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
and manic depression, while claiming up to some 80% cure rate, seemingly worth the 30% death rate. (Soon, independent investigators ventured to Cotton's facility and performed, it seems, psychiatry's first two
controlled clinical trial Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, dieta ...
s, finding Cotton's claims false.) In 1923, on his European lecture tour, Cotton arrived in Britain, where he learned from Lane an improved surgical technique—as well as a new, far less radical surgical procedure. In autumn 1923, Lane had performed the first 19 "pericolic membranotomies", putatively releasing intestinal adhesions. Wherever apparently possible, Lane replaced colon bypass and colectomy with pericolic membranotomy.Scull, ''Madhouse'' (Yale U P, 2005), p
126

259


New Health

In the early 1920s, Lane began advocating cancer prevention through diet, but, thereby drawing conflict with 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 ...
, resigned from the association in 1924, renouncing his lucrative private medical and surgical practice, some 10 000 pounds a year. In 1925, Lane founded the New Health Society, the first organised body for social medicine, which German pathologist and statesman Rudolf Virchow had pioneered in late 19th century to undo disease's
sociopolitical Political sociology is an Interdisciplinarity, interdisciplinary field of study concerned with exploring how governance and society interact and influence one another at the micro to macro Level of analysis, levels of analysis. Interested in the ...
causes. The term ''New Health'' largely referred to nonsurgical healthcare against constipation.Dally, ''Fantasy Surgery'' (Rodopi, 1996)
p 86
With advertising by physicians being forbidden, Lane averted disciplining by the
General Medical Council The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by c ...
by having his name deleted from the Medical Register. Lane then promoted his views on healthful lifestyle and nutrition, including return to farmland, ample sunlight exposure, ample exercise, greater intake of whole foods, particularly grains, vegetables, and fruits, and nutritional yeast for B vitamins—Lane's plan to foster defecation thrice daily, cancer prevention, general health, and longevity. Meanwhile, colectomy for constipation was abandoned amid low success rates but high complication rates. New Health Society sought to transform the "rapidly degenerating community" into a "nation composed of healthy, vigorous members". Blending a
utopian A utopia ( ) typically describes an imaginary community or society that possesses highly desirable or nearly perfect qualities for its members. It was coined by Sir Thomas More for his 1516 book ''Utopia'', describing a fictional island society ...
vision,
progressive Progressive may refer to: Politics * Progressivism, a political philosophy in support of social reform ** Progressivism in the United States, the political philosophy in the American context * Progressive realism, an American foreign policy par ...
gender ideology,
social darwinist Social Darwinism refers to various theories and societal practices that purport to apply biological concepts of natural selection and survival of the fittest to sociology, economics and politics, and which were largely defined by scholars in W ...
rhetoric, and eugenic rationales—which, altogether, reflected the period's prevailing framework—New Health Society's view, not hereditarian, however, depicted humankind's regeneration as pivoting on health education. Sidestepping issues of poverty and inequality, it took health as a personal responsibility and duty of citizenship, whereby health and happiness were attainable by all who consumed a high-fibre diet, exercised, and got ample sunshine, while using
birth control Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unwanted pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth contr ...
and reforming men's dress. Although embracing modern science, technology, and
mass media Mass media refers to a diverse array of media technologies that reach a large audience via mass communication. The technologies through which this communication takes place include a variety of outlets. Broadcast media transmit information ...
, New Health Society suggested valorisation of "native" culture, and found the bowels central to health, while constipation anchored many of civilisation's ills. Lane said that his lecture in Oldham, Lancashire, was "packed by three thousand or more people", and "that many people had to be carried out fainting, while outside mounted policemen were kept busy holding back and controlling the crowd who wished to force their way into the hall".Scull, ''Madhouse'' (Yale U P, 2005)
p 34


Legacy

Seven years before his 1943 death, Lane's autobiography explained himself as a man "acting upon the repeated request of his children that I should write for them a rough sketch of my life", although "it can be of no interest to others".Louis K T Fu
Review: "The memoirs of Sir William Arbuthnot Lane"
''Bone & Joint'', British Editorial Society of Bone & Joint Surgery, Website access: 2 October 2013.
Rather, two of his former house surgeons at
Guy's Hospital Guy's Hospital is an NHS hospital in the borough of Southwark in central London. It is part of Guy's and St Thomas' NHS Foundation Trust and one of the institutions that comprise the King's Health Partners, an academic health science centre. ...
—first W. E. Tanner and later T. B. Layton—would borrow from it to author biographies on Lane. By then, however, consensus had formed that Lane's surgeries to treat constipation had been misguided, and perhaps even Lane himself had concluded so.Bashford, ''
Spectator ''Spectator'' or ''The Spectator'' may refer to: *Spectator sport, a sport that is characterized by the presence of spectators, or watchers, at its matches *Audience Publications Canada * ''The Hamilton Spectator'', a Hamilton, Ontario, Canada, ...
''
1946
(Website access: 2 October 2013).
By 1982, colectomy for constipation was declared "clinically futile". And yet, in Lane's lifetime, it was instead his New Health, including his claims that modern society was ruining health, whereby Lane became, at last, viewed as a crank.


Autointoxication

The autointoxication principle became an alleged myth scientifically discredited, while interventions to subvert it were deemed
quackery Quackery, often synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, ...
.Stephen Barrett
"Gastrointestinal quackery: Colonics, laxatives, and more"
'' Quackwatch'', 4 August 2010 (last revised), Website access: 2 October 2013.
Lane's rationale and his era's very notion of autointoxication have been depicted as wholly unfounded and irrational or "illogical," due to a pervasive psychological effect of toilet training or a figment of the
Victorian era In the history of the United Kingdom and the British Empire, the Victorian era was the period of Queen Victoria's reign, from 20 June 1837 until her death on 22 January 1901. The era followed the Georgian period and preceded the Edwardia ...
's culture.González-Crussi, ''Carrying the Heart'' (Kaplan, 2009)
p 77–82
Yet by the late 1990s, the autointoxication concept and thereby
colon cleansing Colon cleansing, also known as colon therapy, or colon hydrotherapy, or a colonic, or colonic irrigation encompasses a number of alternative medical therapies claimed to remove unspecified toxins from the colon and intestinal tract by remov ...
was being renewed in alternative healthcare, allegedly upon a fictitious basis. Combating alleged myths, some gastroenterologists asserted that "no evidence" supports the autointoxication concept that toxins are absorbed from waste in the large intestine. In basic research, if freed from its simplistic reduction to constipation, the autointoxication principle has now been substantially supported as an independent mechanism whereby gastrointestinal microorganisms contain or
produce Produce is a generalized term for many farm-produced crops, including fruits and vegetables (grains, oats, etc. are also sometimes considered ''produce''). More specifically, the term ''produce'' often implies that the products are fresh and g ...
toxins exhibiting systemic effects—as by transmigration into circulation and driving systemic inflammation—effects that include the psychological. Apparent instances of autointoxication associate not merely with constipation, however, but principally with alternating constipation and diarrhea, as Lane had noted in his 1908 paper that described constipation as but the earlier, underlying etiological factor whereby autointoxication may incite diarrhea, too.


Constipation

There is much disagreement over the meaning of ''
constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
'', far overreported by the general public versus conventional medical criteria—under two defecations per week. Despite the general public's remaining prevalence of belief that maintaining good health requires defecation at least daily, many constipated individuals apparently are quite healthy—some even defecating under once a week—whereas others who defecate daily are unhealthy.Whorton, ''Inner Hygiene'' (Oxford U P, 2000)
pp 7–8
Still, constipation remains a "major health problem". Gastroenterologists attribute chronic constipation's associated signs and symptoms to slow colon transit, to irritable bowel syndrome, to pelvic floor dysfunction—apparently a cause of
refractory In materials science, a refractory material or refractory is a material that is resistant to decomposition by heat, pressure, or chemical attack, and retains strength and form at high temperatures. Refractories are polycrystalline, polyphase, ...
constipation in adolescents, too—or to obstructed defecation, which along with slow colon transit have remained incompletely understood. Individuals have varied complaints and try many remedies for signs and symptoms. Treating constipation, gastroenterologists' first line of intervention is now dietary— whole foods, principally vegetables, fruits, and grains—or
fiber supplement Fibre supplements (also spelled fiber supplements) are considered to be a form of a subgroup of functional dietary fibre, and in the United States are defined by the Institute of Medicine (IOM). According to the IOM, functional fibre "consists o ...
s. Meanwhile, roles for lifestyle—exercise, mindset,
socioeconomic Socioeconomics (also known as social economics) is the social science that studies how economic activity affects and is shaped by social processes. In general it analyzes how modern societies progress, stagnate, or regress because of their local ...
status—have been recognized,Whorton, ''Inner Hygiene'' (Oxford U P, 2000)
p 6
although some gastroenterologists as recently as 2012 have claimed that there is "no evidence" supporting a role for exercise. Some 15% to 30% of constipation patients exhibit slow colon transit, which laxatives and medical drugs do not amend. Thus,
refractory In materials science, a refractory material or refractory is a material that is resistant to decomposition by heat, pressure, or chemical attack, and retains strength and form at high temperatures. Refractories are polycrystalline, polyphase, ...
constipation is sometimes treated surgically reportedly successfully, but sometimes successfully, or even worsening abdominal pain.


Lane disease

The syndrome that Lane reported in 1908, "Lane disease" or "Arbuthnot Lane disease", is now usually termed by gastroenterologists either ''slow transit constipation'' or ''slow colon transit'' or ''colonic inertia'',Jorge, "Constipation" in ''Diseases of the Colon'' (Informa, 2007)
pp 118–19
exhibited by some 15% to 30% of constipation patients. By 1985, Lane's early article on surgical treatment of chronic constipation had become a classic, while physiologic testing and more accurate patient selection renewed interest in total colectomy with ileorectal anastomosis—that is, removing the entire large intestine and joining the
small intestine The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the p ...
's outlet to the
rectum The rectum is the final straight portion of the large intestine in humans and some other mammals, and the Gastrointestinal tract, gut in others. The adult human rectum is about long, and begins at the rectosigmoid junction (the end of the s ...
—to treat colonic inertia, Lane disease. By now, gastroenterology's accepted view is that, although few patients meet the selection criteria, surgery ought to be offered as a treatment option for severe chronic constipation.Jorge, "Constipation" in ''Diseases of the Colon'' (Informa, 2007)
p 117–18
Selection criteria ought to be extremely stringent, including multiple confirmation of slow colon transit by physiologic testing, and further medical, psychological, and psychosocial evaluations, with patients understanding that colectomy might not improve the condition and might even worsen abdominal pain.


Relevance

Willie Lane was among the last surgeons of an era where one could master three specialties— orthopaedic,
abdominal The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. ...
, and ear nose and throat—and some of his designed surgical instruments are still used today. Lane's introduction of the "no-touch technique", which permitted
aseptic 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 ...
surgery, is perhaps his greatest contribution to surgery. Even in the 21st century, particular descriptions by Lane "should be required reading by orthopaedic surgeons". Lane's life ought to interest historians of medicine as well as believers in
holistic medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and alte ...
. In his time, some thought Lane a genius, while others disagreed, including
Sir Arthur Keith Sir Arthur Keith FRS FRAI (5 February 1866 – 7 January 1955) was a British anatomist and anthropologist, and a proponent of scientific racism. He was a fellow and later the Hunterian Professor and conservator of the Hunterian Museum of the ...
who claimed him not clever but carried by faith. In any event, Lane can be characterised as "a crusader, a perfectionist, and an extraordinarily talented surgeon".Dally, ''Fantasy Surgery'' (Rodopi, 1996)
p 88


Footnotes


References

* Bashford, H H
"Books of the day: Arbuthnot Lane"
''
Spectator ''Spectator'' or ''The Spectator'' may refer to: *Spectator sport, a sport that is characterized by the presence of spectators, or watchers, at its matches *Audience Publications Canada * ''The Hamilton Spectator'', a Hamilton, Ontario, Canada, ...
'', 25 Apr 1946, pp 16–17. * * Dally, Ann, ''Fantasy Surgery 1880–1930'' (Amsterdam & Atlanta GA: Rodopi B V, 1996). * González-Crussi, F, ''Carrying the Heart: Exploring the Worlds Within Us'' (New York:
Kaplan Publishing Kaplan, Inc. is an American for-profit corporation that provides educational and training services to colleges, universities, businesses and individuals around the world. Founded in 1938 by Stanley Kaplan, the company offers a variety of test prep ...
, 2009). * Ingle, John I, ''PDQ Endodontics'', 2nd edn (Shelton CT: People's Medical Publishing House, 2009). * Mostofi, Seyed B, ed, ''Who's Who in Orthopedics'' (London:
Springer-Verlag Springer Science+Business Media, commonly known as Springer, is a German multinational publishing company of books, e-books and peer-reviewed journals in science, humanities, technical and medical (STM) publishing. Originally founded in 1842 in ...
, 2005)
"Sir William Arbuthnot Lane"
pp 183–86. * Nicolson, Juliet
''The Great Silence: Britain from the Shadow of the First World War to the Dawn of the Jazz Age''
(New York: Grove/Atlantic, 2009). * Noll, Richard, ''American Madness: The Rise and Fall of Dementia Praecox'' (Cambridge MA:
Harvard University Press Harvard University Press (HUP) is a publishing house established on January 13, 1913, as a division of Harvard University, and focused on academic publishing. It is a member of the Association of American University Presses. After the retirem ...
, 2011). * Pugh, Martin
''We Danced All Night: A Social History of Britain Between the Wars''
(London: Bodley Head, 2008). * * Scull, Andrew, ''Madhouse: A Tragic Tale of Megalomania and Modern Medicine'' (New Haven:
Yale University Press Yale University Press is the university press of Yale University. It was founded in 1908 by George Parmly Day, and became an official department of Yale University in 1961, but it remains financially and operationally autonomous. , Yale Universi ...
, 2005). * Tauber, Alfred I & Leon Chernyak, ''Metchnikoff and the Origins of Immunology: From Metaphor to Theory'' (New York:
Oxford University Press Oxford University Press (OUP) is the university press of the University of Oxford. It is the largest university press in the world, and its printing history dates back to the 1480s. Having been officially granted the legal right to print books ...
, 1991). * Whorton, James C, ''Inner Hygiene: Constipation and the Pursuit of Health in Modern Society'' (New York:
Oxford University Press Oxford University Press (OUP) is the university press of the University of Oxford. It is the largest university press in the world, and its printing history dates back to the 1480s. Having been officially granted the legal right to print books ...
, 2000). * * Jorge, J Marcio N, ch 5 "Constipation—including sigmoidocele and rectocele", in ''Diseases of the Colon'' (New York:
Informa Healthcare Informa plc is a British publishing, business intelligence, and Trade fair, exhibitions group based in London, England. It is listed on the London Stock Exchange and is a constituent of the FTSE 100 Index. It has offices in 43 countries and ar ...
, 2007), D Wexner Steven & Neil Stollman, eds. * Wong, Shing W & David Z Lubowski, ch 15 "Surgical treatment of colonic inertia", in ''Constipation: Etiology, Evaluation and Management'', 2nd edn (London: Springer-Verlag, 2006), Steven D Wexner & Graeme S Duthie, eds.


External links

* * * {{DEFAULTSORT:Arbuthnot-Lane, William, Sir, 1st Bt 1856 births 1943 deaths Alternative detoxification promoters Alumni of the University of London Baronets in the Baronetage of the United Kingdom Companions of the Order of the Bath Diet food advocates Fellows of the Royal College of Surgeons Scottish surgeons