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Biographical entry Syme, James (1799 - 1870)

MRCS April 6th 1821; FRCS Dec 11th 1843 one of the original 300 Fellows; FRCS Edin 1823; Hon. FRCSI 1867; Hon MD Dublin 1867; Hon MD Bonn, 1868; Hon DCL Oxon 1868; FRS Edin 1830.

Born
7 November 1799
Edinburgh
Died
20 June 1870
Edinburgh
Occupation
General surgeon

Details

The second son of John Syme, of Cartmore and Lochore in the Kingdom of Fife, was born at 56 Princes Street, Edinburgh, on Nov 7th, 1799, his father being a Writer to the Signet. He received most of his early education at the Edinburgh High School and spent much of his spare time working with Robert Christison at chemistry in Dr. Hope's laboratory. As the outcome of this work Syme at the age of 18 discovered a solvent for india-rubber and a method of waterproofing fabrics. He published an account of his discovery, but pursued it no further. The process was afterwards patented in 1823 by Charles Macintosh, a manufacturing chemist, who made a fortune.

Syme spent two years at the arts classes of the University, and in 1817 joined the anatomy class of John Barclay (1758-1826), where Robert Liston (qv) was the principal demonstrator. When Liston began to lecture on his own account he appointed Syme first as Demonstrator in 1818, afterwards as his assistant, and when Liston devoted himself entirely to surgery Syme took over the class in 1823.

He was appointed Superintendent of the Edinburgh Fever Hospital in 1820, and in 1821 read a paper on "Caries of the Bones" at the Royal Medical Society, which showed that he was already becoming interested in what was to be a part of his life's work. He visited Paris in 1822 with his friend William Sharpey, attended the clinic of Dupuytren, and took a course of operative surgery under Lisfranc. On his return to Edinburgh he gave a regular course of anatomical lectures, to which in 1825 he added surgery. He abandoned the teaching of surgery in 1826 and quarrelled with Liston. The quarrel lasted for many years, and rose to so great a height that when Syme applied to be appointed Surgeon at the Royal Infirmary in 1829 the Managers refused to appoint him lest there should be an open rupture within the walls of the institution. Syme thereupon opened Minto House as a private surgical home, admitted patients deemed inoperable, treated them successfully, and inaugurated a system of clinical teaching. Amongst his earliest pupils was John Brown (1810-1882), author of Rab and his Friends, with whose apprenticeship fee Syme used to say he bought his first carriage - a gig.

In 1831 Syme was defeated in a contest for the post of Professor of Surgery at the Royal College of Surgeons, John Lizars (1787?-1860) being appointed, Liston helping him, by a majority of one vote, in succession to John Turner. The quarrel culminated in 1883, when Syme was elected to the Chair of Clinical Surgery in the University, Liston being also a candidate. The Managers of the Royal Infirmary were then obliged to afford him accommodation for lecturing. Liston settled in London in 1884 and Syme was left without a surgical rival in Scotland. In 1888 he was appointed Surgeon in Ordinary in Scotland to Queen Victoria, and he continued to enjoy a very large practice.

Liston died in 1847, and Syme accepted an invitation to succeed him as Surgeon to University College Hospital. He moved to London in February, 1848, found the conditions and surroundings uncongenial, resigned in May, and in July was reappointed to the Chair which he had held in Edinburgh. He was also elected President of the Medico-Chirurgical Society of Edinburgh.

Between 1850 and 1855 Syme interested himself in medical reform, and represented the Universities of Edinburgh and Aberdeen at the General Medical Council from 1858-1869. In 1861 he was elected Chairman of the Jury on surgical instruments at the International Exhibition. In 1868 Thomas Carlyle underwent an operation at his house, and in 1869 he was busy fighting the battle of 'the two sites' upon which the Royal Infirmary was to be rebuilt. He had a hemiplegic attack on April 6th, 1869, which caused him to resign his various appointments though he still continued to see patients, and he died after a second stroke at Milbank - his country house - near Edinburgh, on June 20th, 1870. He was buried at St John's Episcopal Church, of which he had long been a member.

He married: (1) the daughter of Robert Willis, a Leith merchant; she died in 1840; and (2) in 1841 Jemima Burn, by whom he was survived with a son. Of the two daughters by his first wife, Agnes, the elder, married Joseph Lord Lister (qv) and was childless.

Syme was the boldest and most original surgeon of the era which immediately preceded the introduction of anesthesia. As early as 1823, when he was only 24 years of age, he performed the first amputation at the hip-joint which had been done in Scotland - Liston helping him. In 1827 he removed the lower jaw successfully, and in 1829 he excised the upper jaw for the first time in Great Britain. He divided the sternomastoid muscle for the relief of wry-neck in 1832, and claimed that this subcutaneous tenotomy was the first recorded in British surgery.

The amputation at the ankle-joint which now bears his name was first performed in 1842, and a few years later he was occupied with the treatment of aneurysm, a subject which fascinated him because it developed and displayed his unrivalled qualities as a surgeon - foresight, dexterity, and unfailing resource. Pressure forceps were unknown, and it was his custom to lay open the sac, insert his hand, stop the bleeding from within, and ligature the artery above and below. His treatment of urethral stricture by external urethrotomy after passing a staff through the constricted passage was published in 1849, though he had performed the operation as early as 1840. It was a great advance upon the older methods, and held its ground until it was replaced by C G Wheelhouse's operation.

Syme was a great clinical teacher of surgery in relation to superficial lesions. He described his method in the following words in the Lancet (1864, ii, 390):

"The plan which I introduced into the Edinburgh School thirty-five years ago is to bring the cases one by one into a room where the students are comfortably seated, and if the patients have not been seen previously by the Surgeon so much the better: then ascertain the seat and nature of their complaints and point out the distinctive characters. Having done this so that everyone present knows distinctly the case under consideration, the teacher, either in the presence or absence of the patient according to circumstances, proceeds to explain the principles of treatment with his reasons for choosing the method preferred, and lastly does what is requisite in the presence of his pupils. The great advantage of this system is that it makes an impression at the same time on the eye and ear which is known from experience to be more indelible than any other, and thus conveys instruction of the most lasting character."

He was not only a great teacher and a very fine operator, but the paper "On the Power of the Periosteum to form New Bone" (Trans Roy Soc Edin, 1840, xiv, 158) shows him as a scientific surgeon. He was, too, fully alive to the advantages of the antiseptic system introduced by Joseph Lister, his son-in-law, and successor as Professor of Clinical Surgery in the University of Edinburgh.

Syme in his younger days fought through a period when medical quarrels were constant and bitter, both in Edinburgh and London. He entered into them con amore, but always behaved as a gentleman. In old age he had a pleasing and restful time, beloved by his family, with hosts of friends, and with gardening as his hobby. 'The Syme Surgical Fellowship' was established during his lifetime by his former pupils. There are two engravings in the College Collection, and a life-like portrait as he appeared in old age in the British Journal of Surgery.

Publications:-

On the Excision of Diseased Joints, 8vo, Edinburgh, 1831.
The Principles of Surgery, 8vo, Edinburgh, 1882; 5th ed, 1863.
Contributions to the Pathology and Practice of Surgery, 8vo, Edinburgh, 1848.
On Diseases of the Rectum, 8vo, Edinburgh, 1838; with Supplement, 1851.
On Stricture of the Urethra and Fistula in Perineo, 8vo, Edinburgh, 1849.

Sources used to compile this entry: [Memorials of James Syme, by R Paterson, MD, 8vo, Edinburgh, 1874, with two por┬Čtraits and a bibliography. Dict Nat Biog, sub nomine et auct ibi cit. Brit Jour Surg, 1914, ii, 189, with portrait. Cowrie's History of Scottish Medicine, 8vo, London, 1927, 264].

The Royal College of Surgeons of England