Sir William MacEwen

Neurosurgeon, born in Glasgow, W Scotland, UK. His interest in surgery was stimulated by Joseph Lister, then professor of surgery at Glasgow University. He adopted and extended Lister's antiseptic surgical techniques and pioneered operations on the brain for tumours, abscesses, and trauma. In addition, he operated on bones, introducing methods of implanting small grafts to replace missing portions of bones in the limbs. In 1892 he was appointed to the chair which Lister had held when MacEwen was a student.

Sir William MacEwen (June 22, 1848-March 22, 1924) was a Scottish surgeon who was a pioneer in modern brain surgery.

Macewen was born in Rothesay (Isle of Bute, Scotland) in 1848, and got his medical degree in 1872 at the University of Glasgow. By following Lister and adopting systematically the use of scrubbing (deep cleansing and desinfection of hands and arms), sterilization of surgical tools, use of surgical gowns, and anesthesia (which was also recently discovered)), 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.

One of his earliest contributions while at the Royal Infirmary, in 1877, was in orthopedics, by means of the development of the first bone grafts, but also in knee surgery using a special instrument (Macewen's osteotome) both techniques becoming key treatments for the highly prevalent disease of rickets (caused by a lack of Vitamin D). He developed surgical treatments for mastoid disease and pyogenic cists 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.

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.

He performed the first successful intracranial surgery where the site of the lesion (a left frontal meningioma) was localized solely by the preoperative focal epileptic signs (twitching of the face and arms in the opposite site of the lesion).

According to one of his biographers, "his thorough knowledge of the natural history of pyogenic diseases of the temporal bone and nasal sinuses, 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. Macewen's diagnosis was based on clinical findings superbly illustrated by his three clinical stages of brain abscess development" (Canale, 1996).

Another important contribution by Macewen to modern surgery was the technique of 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.

In 1892 Macewen became Regius Professor of Surgery at the University of Glasgow (the post which Lister had held when McEwen was a student) where he remained until his death, in Garrochty, Isle of Bute, in 1924. Macewen became a Fellow of the Royal College of Physicians and Surgeons of Glasgow in 1874, a Fellow of the Royal Society in 1895, a Honorary Fellow of the Royal College of Surgeons of England in 1900, and the president of the British Medical Association in 1922.