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The subject of this book, James Hill (1703-1776), was born into a Scotland which had been riven for half a century with political and economic conflicts, which had direct effects on his own family. King Charles II was restored to the UK throne in 1660 and a period of expansion of the arts science and trade followed in England. In Scotland, the period was quite different. Charles was the head of an Episcopalian church and was determined that Presbyterian Scotland should return to this form of worship. There followed years of persecution and mutual intolerance. James received his medical education as an apprentice to an Edinburgh surgeon, George Young who was closely involved in the Scottish Enlightenment. His apprenticeship was followed by two years at sea. He then returned to his home region of Dumfries and started to practice surgery in 1732, continuing there until 1776. As this book shows, he achieved a grand reputation as a surgeon, and was respected not only locally, but also in neighbouring counties and the capital. His greatest contribution was in the treatment of head injuries, treating 18 cases, of which only three died. Two of these had untreatable injuries and the third refused surgery. The book notes that, despite James Hill’s close relationship to the harshness of religious conflicts, this does not seem to have been a major influence on him. On the other hand, the Enlightenment was clearly important given his attitude to prefer his own observations to the teachings of past authorities. His reputation persisted for a century after his death, but has since gradually faded, and, as such, this book documents the contribution of a most important surgeon in the management of cranial trauma.
It has become increasingly clear that it is easy to misunderstand how surgery functioned in the past. It is all too easy to regard our ancestors as less privileged than ourselves, whereas they were probably every bit as intelligent, but with a different set of priorities. This book traces the development of the profession of surgery and the preoccupations and concerns of its practitioners, from Hippocrates to the early nineteenth century. Topics discussed here include the personal characteristics of surgeons and the regulation of the practice of surgery. The study of anatomy and its limitation by political and philosophical taboos is also considered, while common procedures without merit such as bloodletting or trepanning are analysed. The illogical myth of laudable pus is examined in some detail, as are the modern conceptions of surgical infection in times past. The book’s main concern is to demonstrate the profession’s resistance to new ideas, preferring the comfort of accepted notions even if the evidence confounds them.
This book attempts to combine many different threads into a comprehensible whole. Since the subject is the Gamma Knife and the author is a neurosurgeon, the field of clinical interest is restricted to intracranial pathology. The discipline of radiosurgery now applies to patients who may reasonably be referred by internists, neurologists, otolaryngologists, endocrinologists and several others. Some of the topics, touched upon, such as stereotaxy and the construction of a radio surgical instrument are unfamiliar to the majority of medical men. Other topics, such as those pertaining to the reactions between radiation and living tissue, are not exactly unfamiliar and yet, for most of us, they are not comfortable areas of expertise: in that we have some basic knowledge but not enough to draw conclusions and interpret. In particular, it is not easy to answer the very sensible questions that patients ask, when being considered for this particular form of treatment. The author has attempted to describe the basic relevant phenomenology in terms that should be readily understandable to a non-specialist physician. To do this, he has been heavily dependent on the expertise of a number of mathematically sophisticated collaborators, who have checked his manuscript. They are named in the acknowledgments section. The relevance of the different sections of this book will naturally be assessed differently, according to the experience and interest of the reader. To simplifY access to the information that is required, the book is divided into three main sections.
This book takes readers on a journey around the world and through time, accompanied by a modern neurosurgeon who reviews historical techniques and instruments used for cranial opening. The author draws on original medical and surgical books to provide a comprehensive history of these techniques and tools. To complement the general overview and offer readers a more ‘hands-on’ sense of context and atmosphere, extensive historical references, stories, media news and illustrative cases have been included for each historical and geographical scenario. In addition, original illustrations and plates of these archaic instruments and techniques are supplied. Neurosurgical surgeons, nurses, technicians, medical historiographers, paleo-pathologists and researchers interested in surgical techniques for cranial opening will find the volume a valuable guide, intended to increase the historical and cultural awareness of this core topic in neurological surgery.
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