The Butchering Art by Lindsey Fitzharris
This is the second of my reviews of books shortlisted for the 2018 Wellcome Book Prize, read as part of the shadow panel.
Lindsey Fitzharris is an American with a doctorate from Oxford in the History of Science, Medicine and Technology, and a post-doc Fellowship from the Wellcome Trust itself. She certainly has a taste for the macabre – if you visit her website, it’s all black and dripping with red, her grisly blog is titled The Chirurgeon’s Apprentice, and she has a Youtube channel called Under the Knife in which it is clear that she is no shrinking violet and has a flair for performance. It’s all very entertaining and informative, so I really hoped that this would transfer to the page of her book, The Butchering Art, subtitled Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine. It certainly does!
If you had to go to hospital in Victorian times, you were very likely to end up dead. Surgery, without anaesthetic until the advent of ether and chloroform, was the absolute last resort and more often than not involved amputations, which the few superstar surgeons of the time did at superfast speeds, like Robert Liston…
“Now, gentlemen, time me!” he yelled. A ripple of clicks rang out as pocket watches were pulled from waistcoats and flipped open.
It took just 28 seconds for Liston to remove a man’s leg. Surviving the surgery was one thing. Then the poor patients had to avoid dying of sepsis and gangrene. No antiseptics, disinfectants, or sterilization existed: tools were unwashed, surgeon’s aprons were covered with the blood and pus from previous patients. Doctors believed that it was poisonous air around wounds that infected them, never realising that they may have introduced the fatal bacteria themselves. Epidemics were rife in the filthy hospital wards.
It’s into this germ-ridden world that a shy Quaker called Joseph Lister embarked on his medical career at UCL in London. Lister was an unusual student, for starters he possessed a superb microscope and had long looked at slides of anything and everything under it. He was quiet, efficient and observant, and saw early on in his career that clean, debrided ulcers tended to heal better. Examining microscopic slides of pus, he later recorded:
“… I made a sketch of some bodies of pretty uniform size which I imagined might be the materies morbi … the idea that it was probably of parasitic nature was at that early period already present in my mind.”
We follow Lister’s career from it’s infancy through a variety of positions, as surgeon and professor in institutions in London, Edinburgh and Glasgow. Such was his later eminence, that he was called upon to operate on Queen Victoria at Balmoral when she got an abscess in her armpit in 1871. By this stage, he’d introduced his antiseptic treatment for wounds, based on phenol, and a carbolic spray device to (unnecessarily, but he didn’t know that yet) clean the air around operations.
To be absolutely honest, I found the first half of the book far more exciting than the second. Reading about Lister as a student, dissecting limbs and corpses obtained by bodysnatchers, and the threat to his own health too – no surgical gloves – beware the student who nicked his own skin while deep in a pustulating corpse, the death rate amongst students was significant too. Once Lister started to develop his antiseptic techniques and face the hard task of persuading the medical world that everything they knew about germs was wrong, alongside all the internal politics of surgeons jockeying for position in the main institutions, the entertainment value of the book decreases alongside the death rate!
That’s not to say that this isn’t an extremely readable account of a ground-breaking career which led to real advances in hospital medicine. I enjoyed the whole, but particularly the grisly bits! (8.5/10)
Source: Own copy
Lindsey Fitzharris, The Butchering Art (Allen Lane, 2017), hardback, 304 pages incl notes/index.
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