Milestone moments in medical advances
NEWS of a worldfirst keyhole operation at Hull Royal Infirmary is another milestone in medical history which has featured in the hospital’s story.
The latest development on a man in his 80s suffering a second aneurysm, this one being just below his right kidney, meant conventional surgery was not an option.
Consultant Dr Raghu Lakshminarayan worked with Lombard Medical in Oxfordshire to create a special fenestrated (window) Altura graft, the first of its kind in the world, to save the man.
The story was the latest in the hospital’s successes in medical developments going back over more than 200 years.
An early medical pioneer was Dr John Alderson whose work involved treating, among others, 24-year-old ship’s carpenter George Ford, a man “of strong athletic make” for whom things looked grim when he was admitted to the hospital in November 1793.
He was unable to use his right side and suffered memory loss, both of which baffled doctors treating him.
But thanks to an experimental treatment using a new “wonder drug” he survived and went on to live a normal life.
The drug came from “the strong, moist loam” of a Cottingham nursery in which grew Poison Oak, which as its name suggested, was widely regarded as dangerous. But Dr Alderson turned it into a medicine.
He wrote that the plant, if touched accidentally, would lead to “a swelling and troublesome itching. Some men at the nursery had suffered so much as to lose such parts of the skin which juice from the plant had touched.
When George Ford was admitted to the infirmary on November 13, he had developed symptoms which were so severe he could not even tell doctors about his complaint. He had been “blooded” by an old woman and on entering the
infirmary “a vomit was given” followed by “warm purgative volatile and stimulant medicines through the week.”
They didn’t work.
In stepped Dr Alderson who ordered use of the pills he developed known as Toxicodendron, which were made from the leaf of poison oak.
The pills were given three times a day. On the second day the patient was feeling “sudden, convulsive twitching” but in three weeks, recorded Dr Alderson, “every injured muscle had felt the influence of this powerful drug and he regained the free and perfect motion of his leg and arm and recovered his mental facilities.”
Another patient lost the total use of all his limbs and even
his mental faculties. He underwent a similar paralysis. “He was reduced to a state nearly as helpless as that of a child only six months.”
The pills were given and, said Dr Alderson, “he rests without opium, though for a long time in the constant habit of taking it; his animal spirits are wonderfully invigorated; and although he has not yet acquired the perfect use of his limbs, they seem to be recovering their tone, and I have every reason to hope, that he will, in time, be restored to the full enjoyment of life.”
Alderson may have been the first infirmary doctor in Hull to try out a new treatment, but others would follow.
A major step forward was achieved by Hull surgeon Mr David Lowson in 1893, who became the first man to successfully remove a lung, or part of it.
To be able to use his technique on a living patient he wrote that he subjected himself “to the direst legal penalties” – a couple of vivisection experiments. “These, together with numerous other experiments on the dead body, at last gave me sufficient knowledge and sufficient courage to operate on the human lung when a suitable case presented itself.”
He first tried vivisection on a rabbit and then collected lungs from different species of animals obtained from a butcher’s shop.
The first patient was a 34-year-old woman and within a short time he said she had “improved rapidly in both appetite and in flesh.”
Dr Lowson gained other acclaim when he was honoured for the “highly dangerous” practice of removing from a child’s throat the false membrane characteristic of diphtheria. As a result he, too, caught the disease and became seriously ill.
Another Hull Royal Infirmary doctor who made a place in medical history was Frank Eve, who worked at the hospital from 1906 to 1952 and came up with his own method of artificial respiration which was to be used in first aid work across the world.
Early in the Second World War, Dr Eve revealed his system which would become acknowledged by lifesavers across the world as a highly successful technique to help victims to keep breathing indefinitely, without exhausting those administering the treatment.
Dr Eve came up with the idea of simply tilting a person up and down on a see-saw allowing the diaphragm to move up and down, encouraging air to move in and out of the lungs.
The method is effective and simple and requires almost no equipment, even a pile of stones on which a plank can be laid for the victim to lie on can be used in an emergency situation.
A more sophisticated way of doing this, and one which is widely available now, is to use a specially designed machine to carry out the task.