Benjamin Bell

Until the latter half of the 18th century, the influence of Edinburgh surgeons was largely confined to Scotland. Some members of the Incorporation like Archibald Pitcairn and Alexander Munro primus had established European reputations, the former in the field of medicine and the latter in anatomy. It was Benjamin Bell, regarded by many as the “father of the Edinburgh Surgical School", who was the first to establish an international reputation for Edinburgh Surgery.

Working in Edinburgh in the age of the Scottish Enlightenment, Benjamin Bell was truly a son of that Enlightenment. A polymath, original thinker, and innovator, he was the first to publish a comprehensive surgical text book in the English language.

Like two other sons of the Enlightenment, Allan Ramsay and Thomas Carlisle, Bell was born in Dumfriesshire. After local schooling he was apprenticed to Mr James Hill, surgeon in Dumfries, and in 1766 entered the Edinburgh Medical School. His teachers at the time included many inspiring figures. Joseph Black was Professor of Chemistry and John Hope taught Botany; Munro Secundus taught Anatomy, while his father Munro Primus was still lecturing in Surgery. The Chairs of Medicine were held by William Cullen and John Gregory. He was admitted to Fellowship of the Royal College of Surgeons of Edinburgh in 1771. Perhaps inspired by the Monros, he decided to further his studies in Paris and London. "Medicine is taught in Edinburgh in greater perfection than in any other part of Europe" he wrote to his father, "but there are some particular branches which are to be had in Paris and nowhere else, particularly with regard to surgery". He spent two years in London and Paris learning surgery. In London he studied with John Hunter, whom he described as "the most agreeable and at the same time the most useful acquaintance I ever met with". His brother William Hunter taught him anatomy.

This wealth of experience led to a highly successful practice when he returned to Edinburgh and at the young age 24 was appointed Surgeon to the Royal Infirmary. His career progression was temporarily interrupted by a fall from his horse, which forced him to take some two years off form his practice to convalesce at Liberton Farm (which still, incidentally functions as a farm to this day only three miles from the College). During this time he undoubtedly developed his thinking not only on surgery but on agriculture and political economy; all topics on which he was to make significant literary contributions in later life. His surgical practice and reputation continued to grow and he became the most sought after surgeon in Scotland causing one contemporary to write that, "at one time nobody could die contented without having consulted Benjamin Bell". His success as a doctor and as teacher was enhanced by his personality. His contemporary, James Ward, spoke of his, "kindly disposition" and his opinions expressed in "very plain and accurate language". He possessed that all-important quality in a physician, that of "giving great assurance and confidence to the sick".

Besides being one of the foremost practical surgeons of his day, he was an original thinker and a surgical innovator. In many ways he was ahead of his time in being one of the first to emphasise the importance of reducing post-operative pain. He was an innovator too in surgical procedures. He recognised that poor wound healing in amputation often resulted from insufficient skin and muscle flaps and his technique became known as "the triple incision of Bell". His aphorism "saved skin" was responsible for improved wound healing in this common operation.

The use of a seton had been advocated by James Ray (qv). Bell, however, was the first to rationalise its use and to define the indications. These, and other innovations, were included in his magnum opus entitled System of Surgery which was and published in six volumes between 1783 and 1788 was the first comprehensive textbook of surgery in the English language. It was truly a giant work of surgical literature which described not only his practice of surgery but aimed "to exhibit a view of the art of surgery as it is at present practised by the most expert surgeons in Europe". It went through seven editions and was translated into French and German.

Another important original contribution was a paper, based on an extensive clinical experience, which showed that the causes, natural history and clinical features of gonorrhoea and syphilis were different and suggesting that they were different diseases.

Besides success in surgery, Bell enjoyed success in property speculation and, by the time of his death, owned most of the suburb of Newington in Edinburgh. It was in Newington House that he died in 1806.

His descendants were also to achieve distinction in surgery. His elder son George Bell (1777 - 1832) and his son Benjamin Bell were both Fellows of the College and surgeons in Edinburgh. His younger son Joseph was also a Fellow of the College and his son Benjamin Bell was President of the College form 1863 - 1865. His son, Joseph Bell, great-grandson of that first Benjamin Bell, also became President of the College and famously the model for the character of Sherlock Holmes.