The influence of the Enlightenment was felt throughout Scottish medicine throughout the 18th century and well into the 19th. Amongst doctors there was increasing knowledge of and interest in philosophy and the arts, and the Edinburgh Medical School in particular became attractive to students from around the world. Much of the reputation of the Medical School had been built on the teaching of anatomy. John Bell and his younger brother, Charles (q.v.) were articulate surgeons and inspiring teachers, whose artistic gifts allowed them to produce anatomical etchings of a very high quality. John Bell founded the Extramural School of Anatomy in what was later called Surgeons’ Square. Widely regarded as the founder of applied surgical anatomy, his career as a teacher was curtailed as he fell foul of the University establishment, principally James Gregory the Professor of Medicine. Bell was to become the most successful surgeon in Scotland for the first two decades of the 19th century.
John Bell was born in Edinburgh, the son of an Episcopalian clergyman. His younger brother went on to fame and distinction as surgeon, anatomist and physiologist, Sir Charles Bell (q.v.). John Bell, like his brother, was a son of the Enlightenment. From an early age he amassed a large and varied library and was well read. His interest in literature made him a fluent writer and he was also an eloquent orator. The interest in art which he shared with this brother, Charles, resulted in superb illustrations in his textbook “Anatomy of the Human Body” published in 1793.
Bell’s surgical training began as apprentice to Mr Alexander Wood (“Lang Sandy”) (q.v.). The two seemed to have had, on the face of it, little in common. Wood, eccentric, bohemian and convivial and Bell, bookish, disciplined and artistic. Yet Bell’s respect for his master is demonstrated by his dedicating the first volume of his anatomy textbook to his former master. After visiting centres in Europe and Russia, he became a Fellow of the Royal College of Surgeons of Edinburgh, which allowed him to act, in rotation, as Surgeon to the Royal Infirmary. He made his mark as a dextrous and successful surgeon. At the same time, he came to appreciate the deficiencies of anatomy teaching in the University under the Munros. Munro Primus and Secundus, both acknowledged as brilliant teachers, were not practising surgeons. Furthermore the shortage of bodies for dissection meant that as few as three dissections could take place per year. These bodies, after preservation in spirit, lost much of their value for the teaching of anatomy and the demonstrations took place some distance from the students. Bell began to teach applied anatomy, surgical anatomy relevant to the surgical procedures of the day and produced for his students his book “Engravings of the Bones, Muscles and Joints”, published in 1794. For the ten years from 1786 he was so successful a teacher that he built an Extramural School of Anatomy in what was later to become Surgeons’ Square. Here his fame as a teacher spread.
His success provoked professional jealousies. Dr James Gregory, Professor of Medicine in the University, persuaded the authorities that only six members of the College of Surgeons should act as Surgeons to the Royal Infirmary, each for a period of two years. This effectively banished John Bell from surgical practice in the hospital and he stopped lecturing in the Extramural School.
This resulted in a vituperative, bitter war of words between the two, conducted by an exchange of letters and pamphlets, some of which were posted in public around Edinburgh.
Bell continued in private surgical practice and, over the next 20 years, was the most successful surgeon of his day in Scotland.
Amongst the contributions which he made to operative surgery was the technique of successfully suturing arterial lacerations. In his surgical textbook “Principles of Surgery” he describes, in detail, the suture technique for an arterial laceration which resulted in restoration of the distal arterial pulse.
His was a holistic approach to surgery, which emphasised the importance of surgeons as physicians rather than mere operators. In an effort “to moderate the rage for operations” he suggested that “operations have come at last to represent the whole science, and the surgeon, far from being valued according to his sensibilities in general knowledge, is esteemed excellent only in proportion as he operates with skill in this, as in many other areas”.
His reputation resulted in invitations to many centres in Europe and whilst visiting Rome in 1820 he took ill and died. He was buried next to John Keats in a grave marked by a Celtic cross, erected by the Royal College of Surgeons of Edinburgh in 1891.
