William MacEwen
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{{Infobox Medical Person
|name =Sir William MacEwen
|image =
|image_width =
|caption =
|birth_date ={{birth date|1848|6|22}}
|birth_place =[[Rothesay, Argyll and Bute|Rothesay]], [[Isle of Bute]], [[Scotland]]
|death_date ={{death date and age|1924|3|22|1848|6|22}}
|death_place =
|profession =[[Surgeon]]
|specialism =[[Neurosurgery]], [[Orthopedic surgery]]
|research_field =
|known_for =Pioneering work in brain surgery, hernia surgery and bone grafts<br>[[endotracheal tube|endotracheal anaesthesia]]<br>[[pneumonectomy]]
|years_active =
|education =[[University of Glasgow]]
|work_institutions =[[Glasgow Royal Infirmary]]<br>[[Western Infirmary]]<br>[[Royal Hospital for Sick Children]]
|prizes = [[Knighthood]]
|relations =
}}
'''Sir William MacEwen''' [[Fellow of the Royal Society|FRS]] ([[June 22]], [[1848]]-[[March 22]], [[1924]]) was a [[Scotland|Scottish]] [[surgery|surgeon]]. He was a pioneer in modern [[neurosurgery|brain surgery]] and contributed to the development of bone [[medical grafting|graft]] surgery, the surgical treatment of [[hernia]] and of [[pneumonectomy]] (removal of the [[lung]]s).
==Career==
Macewen was born in [[Rothesay, Argyll and Bute|Rothesay]], [[Isle of Bute]], [[Scotland]] in 1848 and studied at the [[University of Glasgow]], receiving a medical degree in 1872. He was greatly influenced by Lord [[Joseph Lister, 1st Baron Lister|Joseph Lister]] (1827-1912), who revolutionized surgery by developing [[antisepsis]], by the use of [[phenol]], thus decreasing drastically the enormous mortality of surgical patients due to infections. By following Lister and adopting systematically the use of [[scrubbing]] (deep cleansing and [[disinfection]] of hands and arms), [[sterilization (microbiology)|sterilization]] of surgical tools, use of surgical gowns, and (recently discovered)) [[anaesthesia]], Macewen became one of the most innovative surgeons of his time and was able to greatly advance modern surgical technique and improve the recovery of patients.
In 1875 he became an assistant surgeon at the [[Glasgow Royal Infirmary]], being promoted to full surgeon in 1877. From 1881 to 1889 he was a lecturer at the Royal Infirmary School of Medicine. On appointment as a Professor of Clinical Surgery he transferred his surgical activities to the [[Western Infirmary]]. In 1883 he was appointed as Surgeon to the [[Royal Hospital for Sick Children]] in Glasgow. In 1892 Macewen became [[Regius Professor]] of Surgery at the University of Glasgow (the post which Lister had held when Macewen was a student).
In 1916 MacEwen helped to found the [[Princess Louise Scottish Hospital for Limbless Sailors and Soldiers]] in [[Erskine]] (now the [http://www.erskine.org.uk/ Erskine Hospital]), near Glasgow, which was urgently needed to treat the thousands of military that lost their limbs in the [[First World War]]. Macewen was its first chief surgeon and with the help of engineers and workers of the nearby [[Clydeside]] [[shipyard]]s, he designed the Erskine [[artificial limb]]. He trained a team of pattern-makers to manufacture them for the hospital.
==Neurosurgery==
Following the work of [[John Hughlings Jackson]] (1835–1911) and [[David Ferrier]] (1843-1924) on neurological mapping of functions in the brain, Macewen demonstrated in 1876 that it was possible to use a precise clinical examination to determine the possible site of a [[tumor]] or lesion in the [[brain]], by observing its effects on the side and extension of alterations in motor and sensory functions. Thus, in 1876 he diagnosed an abscess in the frontal lobe of a boy, but the family refused permission to operate. When the patient died his diagnosis and localization were found to be correct.
He performed the first successful intracranial surgery where the site of the lesion (a left frontal [[meningioma]]) was localized solely by the preoperative focal [[epilepsy|epileptic]] signs (twitching of the face and arms in the opposite site of the lesion). On the basis of these signs Macewen thought that there was good evidence of an “irritation to the lower and middle portions of the ascending convolutions…in the left frontal lobe”. A trephined hole in the skull near the purported site of the lesion showed a big subdural tumor. The patient, a teenage girl, lived for eight more years, and a subsequent [[autopsy]] showed no trace of the tumor. He later used this many times to successfully operate on brain [[abscess]]es (in 1876) and [[hematoma]]s and on the [[vertebral column|spine]]. This was a great triumph of medicine.
According to one of his biographers, "his thorough knowledge of the natural history of pyogenic diseases of the [[temporal bone]] and [[nasal sinus]]es, in addition to his clear description of [[cranial]] anatomy, as illustrated in his ''Atlas of Head Sections'', were especially important in developing his successful treatment of brain abscess. The [[X-ray]] had not yet been discovered; Macewen's diagnosis was based on clinical findings superbly illustrated by his three clinical stages of brain abscess development" (Canale, 1996).
==Contributions to surgery==
One of his earliest contributions while at the Royal Infirmary, in 1877, was in [[Orthopedic surgery|orthopedics]], by means of the development of the first bone grafts, but also in [[knee]] surgery using a special instrument (Macewen's [[osteotomy|osteotome]]) both techniques becoming key treatments for the highly prevalent disease of [[rickets]] (caused by a lack of [[Vitamin D]]). Macewen was interested in the biology of [[bone]] and carried out a classical series of experiments on animals in order to determine how bones grow and may be repaired. He developed surgical treatments for [[mastoid disease]] and [[pyogenic cyst]]s of the [[temporal bone]] and has identified an anatomical structure in this bone, the [[foveola suprameatica]], which was named [[Macewen's triangle]] in his honor.
His method of surgical removal of lungs became a major medical weapon in the treatment of [[tuberculosis]] and [[lung cancer]], thus saving many patients. His name was also immortalized in Medicine in two other instances: the [[Macewen's operation]] for [[inguinal hernia]] and the [[Macewen's sign]] for [[hydrocephalus]] and brain [[abscess]].
Another important contribution by Macewen to modern surgery was the technique of [[endotracheal tube|endotracheal anaesthesia]] with the help of orotracheal [[intubation]], which he described in 1880, and still in use today.
Macewen was noted for his early and creative use of photographs for documenting patients cases and for teaching surgery and medicine. He pioneered the use of photos of body parts and pathological specimens, as well as photos taken before, after and during treatment/surgery.
==Honours==
* Fellow of the [[Royal College of Physicians and Surgeons of Glasgow]] in 1874;
* Fellow of the [[Royal Society]] in 1895;
* Honorary Fellow of the [[Royal College of Surgeons of England]] in 1900;
* President of the [[British Medical Association]] in 1922;
* Knighted in 1902.
Macewen lived at Garrochty on the Isle of Bute until his death in 1924. He was buried nearby in the churchyard of St Blane's Chapel.
==Archives==
The archives of Sir William MacEwen are maintained by the [[Archives of the University of Glasgow| Archives of the University of Glasgow (GUAS)]].
==External links==
<!-- * [http://195.195.163.80/onearchive.asp?refcode=10 MacEwen, Sir William (1848-1924), Surgeon] -->
* {{cite web| url=http://www.archives.gla.ac.uk/gghb/collects/macewen.html| title=Sir William MacEwen (1848-1924)| author=University of Glasgow Archive| accessdate=2007-04-07}}
* {{cite journal| url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8613822&dopt=Abstract| author=Canale, DJ| title=William MacEwen and the treatment of brain abscesses: revisited after one hundred years| journal=J Neurosurg| year=1996| volume=84| issue=1| pages=133–42}}
* {{cite journal| author=Summerly, P| url=http://www.archives.gla.ac.uk/about/dunaskin/mar2003/macewen.html| title=Sir William MacEwen (1848-1924) and the Glasgow Royal Infirmary Collection Of Clinical Photographs| journal=Newsletter of Glasgow University Archive Services (Dunaskin News)| issue=9 - March| year=2003| format={{Dead link|date=May 2008}}}}
* {{cite book| author=[[A. J. Cronin]]| title=[[Adventures in Two Worlds]] (autobiography)| pages=9-12| publisher=McGraw-Hill Books| year=1952}} description of a brain surgery carried out by Macewen around 1918
* {{cite web| url=http://www.theglasgowstory.com/image.php?inum=TGSJ00046| title=Photograph of Sir William Macewen operating| author=The Glasgow Story| accessdate=2007-04-07}}
*{{cite web| url=http://www.archives.gla.ac.uk/about/dunaskin/mar2003/sarcoma2.html| title=A clinical photograph| author=William Macewen's Glasgow Collection| accessdate=2007-04-07}}
{{DEFAULTSORT:Macewen, William}}
[[Category:1848 births]]
[[Category:1924 deaths]]
[[Category:People from Argyll and Bute]]
[[Category:Scottish surgeons]]
[[Category:Scottish neuroscientists]]
[[Category:People from Rothesay]]
[[Category:Fellows of the Royal Society]]
[[fr:William MacEwen]]