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Biographical entry Macewen, Sir William (1848 - 1924)

Knight Bachelor 1902; CB 1920; Hon FRCS July 25th 1900; FFP and S Glasgow (honoris causa) 1874; MB CM Glasgow 1869; FRS 1895.

Born
22 June 1848
Isle of Bute
Died
22 March 1924
Occupation
General surgeon

Details

Born in the Isle of Bute on June 22nd, 1848, the younger son of John Macewen, who had been in business in Rothesay and was afterwards master of the Breadalbane, a yacht employed during the summer months to carry Free Church Ministers to and from the islands on the West Coast of Scotland. He was educated in Rothesay and at the Collegiate School in Glasgow, and is described at 15 as a big, ingenuous Rothesay boy, full of animal spirits, bright and intelligent but indifferent to book learning, more at home in the gymnasium than in the classroom, and a master of single-stick. His boyish carelessness vanished when he entered the University of Glasgow in 1865 in company with his literary friend, J W Allan, afterwards Superintendent of the Belvedere Fever Hospital, whose sister he married. Glasgow University was remarkable at the time for its distinguished medical teachers - Allen Thomson, William Tennant Gairdner, Andrew Buchanan, Joseph Lister; but none of them seems to have exerted much influence over Macewen, who spent much of his time alone in the Hunterian Museum.

He graduated MB CM in 1869 after serving as dresser to Lister, and was House Surgeon at the Old Royal Infirmary under Sir George Macleod. In this post he showed his inventive ability by employing a method of keeping the lips of a flap together after amputation without the use of sutures. He also served a term of office as House Physician, and in 1870 became Superintendent of the Belvedere Fever Hospital, which had been opened in 1865 as the Municipal Fever Hospital. Macewen took advantage of the many opportunities it offered for surgical practice, but, being poor and having to gain a livelihood, he entered upon general practice, became parochial medical officer, and was Casualty Surgeon to the Central Police Station. His able conduct in these positions and in various junior offices at the Royal Infirmary led to his election as Visiting Surgeon in 1877 at the early age of 29. He held the post until 1892, when he was appointed Regius Professor of Surgery in the University of Glasgow and Surgeon to the Western Infirmary. As Visiting Surgeon to the Royal Infirmary and as Surgeon to the Hospital for Sick Children, Macewen had but few students to teach and no systematic lectures to deliver. His time was mostly his own from 1877-1892, and he made good use of it in the advancement of surgery.

He was interested in the treatment of wounds as early as 1874, and by that time had fully accepted the Listerian principles, although he soon developed these along lines of his own which led him to asepsis rather than antisepsis. In 1874 he published in the Glasgow Medical Journal (vi, 87) his article on "Ovariotomy: Removal of Both Ovaries Performed and Treated Antiseptically", and in the following year in the same journal (1875, vii, 1), "Penetrating Wounds of the Thorax and Abdomen Treated Antiseptically". In 1879 he published in the British Medical Journal (1879, i, 656) a clinical lecture proving that he had invented and perfected the operation of linear osteotomy. He then showed that he had grasped the first principles of aseptic surgery, for he caused his newly invented osteotome to be forged in a single piece and highly polished that it might be boiled, when other surgeons were using bone-handled scalpels and wooden-handled chisels. In 1880 he published his book on Osteotomy which soon became a classic. Bone and its mode of growth always interested him, and as early as 1881 he wrote "Observations concerning Transplantation of Bone", which were continued intermittently till 1912, and were considered of such originality and importance as to lead to his being elected FRS on June 20th, 1895. They culminated in his paper on "The Growth and Shedding of the Antlers of the Deer" which appeared in 1921.

In 1879 he anticipated O'Dwyer's tubes in his "Clinical Observations on the Introduction of Tubes into the Trachea through the Mouth instead of performing Tracheotomy or Laryngotomy", which appeared in the Glasgow Medical Journal (1879, xii, 218) and the British Medical Journal (1881, ii, 523). In 1886 he busied himself with the radical cure of hernia, the detachment and inversion of the sac being the essential feature of his first successful operation. The surgery of the lung next occupied his attention, and from 1895 he proved himself a pioneer. His results, though valuable, were improved upon and the methods simplified as a result of experience gained in the European War of 1914-1918.

Macewen achieved his greatest triumphs in the surgery of the brain, and his fine address at the Glasgow Meeting of the British Medical Association in 1888, published in the British Medical Journal (1888, ii, 302), showed him to be one of the pioneers in the subject. In 1876 he had localized a traumatic abscess in the left frontal lobe from the clinical symptoms on the basis of the recently acquired knowledge of localization in relation to aphasia. This differed from the position of the cicatrix which had followed the injury. The site indicated lay between the speech centre and the internal capsule. He trephined, and the knife entered the abscess half an inch under the surface, unfortunately only after the death of the patient. The case is reported in the British Medical Journal (1888, ii, 303). In 1883 he removed a gumma from the paracentral lobule. It had set up brachiocrural monoplegia. Marked improvement followed, but some hemiplegic gait and contracture persisted (see Glasgow Med Jour, 1884, xxi, 142). In 1893 he published his interesting and valuable Pyogenic Infective Diseases of the Brain and Spinal Cord, which embodied the work of ten years' practical experience. His last contribution to the surgery of the brain was the Presidential Address at the Glasgow Meeting of the British Medical Association in 1922; this appeared in the British Medical Journal (1922, ii, 155).

During the European War Macewen acted as Consulting Surgeon to the Navy. He operated at the Hospital at Mount Stuart, and took a great part in establishing and carrying on the Princess Louise Scottish Hospital for Limbless Sailors and Soldiers. He was decorated CB for these services in 1920, having already received the honour of knighthood in 1902. In 1922 he was President of the Société Internationale de Chirurgie in succession to Dr W W Keen of Philadelphia, when the meeting took place in London. Later in the year he was President of the British Medical Association at Glasgow. He then visited Australia, New Zealand, and the United States, being enthusiastically welcomed by old pupils and by the surgeons in every town.

Many honours fell to the lot of Sir William Macewen in addition to those already mentioned. He was one of the Surgeons to the King in Scotland. The University of Glasgow conferred upon him the honorary degree of LLD in 1890, and the University of Durham the DCL. The Universities of Oxford and Dublin each gave him the DSc. He was a Fellow of the Royal College of Surgeons in England and in Ireland, and was an honorary member of the Imperial Academy of Military Medicine at St Petersburg, the German Surgical Society, the Hungarian Medical Society, the Royal Medical Academy of Rome, and the American Medical Society. He was also a corresponding member of the Surgical Society of Paris and one of the joint-editors of the Annals of Surgery.

He died of pneumonia with unimpaired faculties on Saturday, March 22nd, 1924. He married Mary Watson, daughter of Hugh Allan, of Crosshill, Glasgow, and a sister of his early friend and fellow-student, Dr J W Allan. She made him a perfect wife and bore him three sons and three daughters. Hugh Allan Macewen, OBE, became Senior Medical Officer at the Ministry of Health; John Allan Craigie Macewen was Surgeon to the Glasgow Infirmary; and William Macewen, OBE, was Assistant School Medical Officer to the London County Council.

Macewen was a very great surgeon, comparable on the scientific side with John Hunter, but without the wide outlook and the insatiable curiosity of the great master. Throughout his life he worked alone, for it was not in his nature to share his ideas or his results with his colleagues or his subordinates. As an operator he was slow and unhurried, aiming at thoroughness rather than speed and dexterity. As a teacher he swept aside tradition and made his students study the patient alone and build up their knowledge of surgery on the basis of pathology. He was tall and lithe, with features so clear-cut as to appear as if they had been chiselled; his eyes were deep-set, grey, and piercing; his voice soft and, even in lecturing, hardly raised. He was stubborn, even to rudeness, in the maintenance of a principle which he thought right, for he was no respecter of persons and was frank of speech. He loved travelling and was as much at home on the Continent of Europe as in English-speaking countries. He had a sense of humour, and told with relish the story of the American chauffeur who asked in all seriousness, "Say, sir, are you fleeing from justice?" when he was told to drive faster to escape the attention of some of his well-wishers when he was in the United States.

There are busts or other memorials of Macewen at Glasgow University, at the Royal Infirmary, Glasgow, and at the Princess Louise Hospital for Limbless Sailors and Soldiers, Erskine, near Glasgow.

Sources used to compile this entry: [Glasgow Med Jour, 1924, ci, 217, with a portrait and a bibliography. Brit Jour Surg, 1925, 413, with a portrait. Personal knowledge. Information kindly given by Dr H A Macewen].

The Royal College of Surgeons of England