Sir William Arbuthnot Lane, 1st Baronet, CB, FRCS (4 July 1856 – 16 January 1943) was a British surgeon and physician. He mastered orthopaedic, abdominal, and ear, nose and throat surgery, while designing new surgical instruments toward maximal asepsis. He thus introduced the "no-touch technique", and some of his designed instruments remain in use.
Lane pioneered internal fixation of displaced fractures, procedures on cleft palate, and colon resection and colectomy to treat "Lane's disease"—now otherwise termed colonic inertia, which he identified in 1908—which surgeries were controversial but advanced abdominal surgery. During World War I, as an officer with the Royal Army Medical Corps, he organised and opened Queen Mary's Hospital in Sidcup, which pioneered reconstructive surgery. The late-Victorian and Edwardian periods' preeminent surgeon, Lane operated on socialites, politicians, and royalty. Lane thus attained baronetcy in 1913.
In the early 1920s, as an early advocate of dietary prevention of cancer, Lane met medical opposition, resigned from British Medical Association, and founded the New Health Society, the first organisation practising social medicine. Through newspapers and lectures, sometimes drawing large crowds, Lane promoted whole foods, fruits and vegetables, sunshine and exercise: his plan to foster health and longevity via three bowel movements daily. Tracing diverse diseases to modern civilization, he urged the people to return to farmland.
For his New Health, Lane eventually became viewed as a crank. Lane's explanation of the association between constipation and illness as due to autointoxication is generally regarded by gastroenterologists as wholly fictitious, and Lane's earlier surgeries for chronic constipation have been depicted as baseless. Yet constipation remains a major health problem associating with diverse signs and symptoms, including psychological—sometimes still explained as Lane's disease—and total colectomy has been revived since the 1980s as a mainstream treatment, although dietary intervention is now the first line of action.
Life and career
Childhood
William Arbuthnot Lane was born in 1856 in Fort George near Inverness, Scotland, as the eldest of the eight children of Benjamin Lane,"Sir William Arbuthnot Lane (1856–1943)", Historic Hospital Admission Records Project (HHARP), Website access: 1 October 2003. a military surgeon enlisted to the British Empire. William attended schools in eight countries on four continents—Ireland, India, Corfu, Malta, Canada, South Africa, and others—while his family followed the army regiment. Amid his mother's bearing seven children in rapid succession after him, William was often left in the care of military personnel.González-Crussi, Carrying the Heart (Kaplan, 2009), p 73. At age 12, he was sent to boarding school at Stanley House School, Bridge of Allan in Scotland.
Education
In 1872, his father arranged for him, age 16, to study medicine at Guy's Hospital. Apparently shy and appearing young even for his age, William initially had some troubles with fellow students, but they rapidly recognized his exceptional abilities.Mostofi, Who's Who in Orthopedics (Springer, 2005). Soon, he was persuaded to switch to surgery, however, a surer career than medicine. Later, he received the degrees bachelor of medicine and master of surgery from the University of London.
Career
In 1877, at age 21, he qualified as a member of the Royal College of Surgeons, and began to practise in Chelsea, London, at the Victoria Hospital for Children."Victoria Hospital for Children in the 1960s—20th Century", Virtual Museum, Royal Borough of Kensington and Chelsea, Website access: 1 October 2013: "Victoria Hospital for Sick Children was opened in 1866. A group of local residents raised funds to convert Gough House into a hospital for 'poor afflicted children'. The first medical officer was Sir William Jenner, physician to Queen Victoria. It was enlarged in 1875. By 1890 the outpatients' department was treating 1,500 children a week. New buildings were added in 1905 providing 100 beds. It became part of the St George's Hospital group and moved to the main hospital in Tooting in 1964. This photograph shows the hospital shortly before its demolition in 1966". In 1883, Lane became a Fellow of Royal College of Surgeons and joined Great Ormond Street Hospital, where he was consultant until 1916. In 1888,HHARP states 1882, yet R Brand states 1888, a conflict the present author judges, by synthesizing both recounts of events, to favor 1888. at age 32, Lane returned to Guy's Hospital as anatomy demonstrator and assistant surgeon, and remained with Guy's for most of his career.
Lane became especially known for internal fixation of displaced fractures, neonatal repair of cleft palate, and developing colectomy, which, although highly controversial and opposed by most surgical peers, notably advanced abdominal surgery. Lane collaborated with Down Brothers to design a number of surgical instruments, including screw driver, periosteal elevator, tissue forceps, intestinal anastomosis clamp, bone-holding forceps, and osteotome. For his surgery on British royalty, he was awarded baronetcy in 1913.
Lane became an officer in Royal Army Medical Corps, head of army surgery,Nicolson, Great Silence (Grove/Atlantic, 2009). during World War I (1914–18). For this work as consulting surgeon in Aldershot at the Cambridge Military Hospital and for opening Queen Mary's Hospital in Sidcup—where, overcoming government resistance to fund it, he gave Harold Gillies a ward where Gillies pioneered reconstructive surgery—Lane was appointed Companion of The Most Honourable Order of the Bath. In 1920, rather soon after returning from wartime service, Lane retired from Guy's Hospital, yet continued private practice out his home office.
Writing
He first published in 1883, seven years after starting his surgery career. He published about 189 articles, including 72 on fractures, 16 on harelip and cleft palate, many others on other subjects, and, after year 1903, 89 articles directly on chronic intestinal stasis—which, like many Victorians, Lane experienced. He wrote several books, including one on cleft palate, one on surgery for chronic intestinal stasis, and one on New Health. Not for print, his autobiography—manuscript dated March 1936, soon before his 80th birthday—was written for family at the urging of his children.Dally, Fantasy Surgery (Rodopi, 1996), p 85.
Family
William's first wife, Charlotte Jane Briscoe—daughter of John Briscoe, himself son of Major Briscoe—bore Irene Briscoe in 1890 and Eileen Caroline in 1893, both in St Olave parish.FreeBMD. At age 78, Charlotte Jane died in 1935. Sir Lane's daughter Eileen was married to Nathan Mutch, whose sister was Jane Mutch. In 1935, Sir Lane married Jane Mutch (who died in 1966 at age 82).
Image
Lane was tall, rather thin, seemingly aged slowly, his reactions were often difficult to discern, and yet he often exhibited strong opinions. It was often said that Lane was George Bernard Shaw's model for the scurrilous surgeon, Cutler Walpole—obsessed with excising the "nuciform sac", said to be nickname for the colon—in Shaw's play The Doctor's Dilemma.Dally, Fantasy Surgery (Rodopi, 1996), pp 152–53, quotes Shaw's letter dated 13 March 1948: "I never met AL. Cutler Walpole was in print years before I ever heard of Lane. You have been misled by the fact that Lane became known for inventing and practising the operation of shortcircuiting the bowels by cutting out yards of colon: a surgical monstrosity which obsessed him as the nuciform sac obsesses Walpole". Yet the play was nearly surely about Sir Almroth Wright, whom Lane knew well. After Lane's death, Shaw stated that the play was published long before he had ever heard of Lane, but still regarded Lane's bowel surgeries as "monstrous". And the play well suggests the view of Lane as held by many of Lane's contemporaries.
After 1924, abandoning his private medical practice as well as surgery, Lane's public devotion was social medicine and public education on dietary and lifestyle subversion of constipation and promotion of general wellbeing, his New Health. Of diverse interests, Lane traveled frequently, often visiting America, while gaining friends and colleagues internationally. Among his associates and acquaintances were Alexis Carrel, John Benjamin Murphy, Elie Metchnikoff, Sir James Mackenzie, William Worrall Mayo and sons William James Mayo and Charles Horace Mayo of Mayo Clinic fame.
Quotes of Lane by his Guy's Hospital house surgeon and biographer, William E Tanner:Ole D Enersen, "Sir William Arbuthnot Lane", Whonamedit? (A dictionary of medical eponyms), Website access: 2 October 2013.
The man whose first question, after what he considers to be a right course of action has presented itself, is What will people say? is not the man to do anything at all. If you get a rude letter, always send a polite one back. It's much better. If everyone believes a thing, it is probably untrue!
Death
He died at his home, 46 Westbourne Terrace, Paddington, London, W2.
Medical spotlight
Surgery master
By 1886, Lane authored a surgery textbook.W Arbuthnot Lane, Manual of Operative Surgery (London: G Bell and Sons, 1886). In 1889 in America at Johns Hopkins University's medical school, William Halsted, a pioneer of abdominal surgery, introduced surgical gloves, and then contracted Goodyear Rubber Company to manufacture thin ones to preserve hands' tactile sensitivity. In the 1890s, glove use still uncommon, Lane introduced long surgical instruments to keep even gloves off of tissues. In his open reductions and plating of fractured bones, Lane introduced the "no-touch technique". Thus pioneering aseptic surgery, an advance beyond antiseptic surgery, Lane enabled new surgeries previously too dangerous.Martin Pugh, We Danced All Night (Bodley Head, 2008), p 48.
Widely renowned, Lane's surgical skill exhibited imperturbable calm at difficulties encountered during the operations. A contemporary noted "the originality of his procedures and the smoothness, ease, and perfection of technic that proclaimed a real master, a master who dared where others quailed and who succeeded where others would have failed without his skill, his precision, and the confidence with which he planned and executed his operations". Although most of Lane's surgical career was attended by controversy, it could not be denied that—with but the possible exception of Sir Frederick Treves—Lane was London's best surgeon as to technique.
Internal fixation
Only anecdotal reports of using internal fixation to set displaced fractures predate Joseph Lister's 1865 introduction of antiseptic surgery, whereupon Lister reported silver wire on a displaced petellar fracture. Yet even before radiography, Lane had found that conventional setting by manipulation and splints yielded poor outcomes—bone disunion and joint changes or wear in individuals under much physical activity—and Lane started using wires and screws in 1892. Amid the conservative medical community's vehement opposition, Lane's approach was so revolutionary that organizations certifying surgeons sometimes automatically dismissed students able to elaborate on such procedures, as nearly 50% of patients whose closed fractures were opened died by ensuing infections. Yet with not antiseptic, but aseptic, surgical techniques, previously unheard of, Lane forged ahead.