The reputation of the Edinburgh Medical School in the early 19th Century owed much to the talents of a series of surgeon-anatomists. John Lizars, who lived and worked in Edinburgh throughout his life, established himself as a popular teacher in the Extra Mural School . With his brother W.H. Lizars, the most gifted engraver in Edinburgh, he published a “System of Anatomical Plates”, still ranked amongst the greatest ever produced in that era. His subsequent success as a surgeon was based on that anatomical foundation and enabled him to sustain a serious but friendly rivalry with his contemporary, Robert Liston.
An innovative surgeon, he was to perform the first ovariectomy in Britain, the first to perform a resection of the maxilla for sarcoma, and the first to perform ligation of the innominate artery for aneurysm.
John Lizars, born in Edinburgh and educated at the High School, began his medical career as an apprentice to John Bell(qv) (1763 –1820), an Edinburgh surgeon who was the elder brother of Sir Charles Bell (q.v.). Having obtained his Diploma he went on to graduate MD from Edinburgh University and joined the Royal Navy as a surgeon. He served in naval vessels on the Spanish and Portuguese coasts during the peninsular war.
Returning to Edinburgh in 1815 he became a Fellow of the College and almost immediately was invited to join the partnership of his former masters John Bell and Robert Allan. John Bell had been snubbed by the Scottish Surgical Establishment and established an anatomical school in 1790, close to Surgeons’ Hall, in what was later called Surgeons’ Square. His younger brother, Charles, had attended his anatomy classes and, having similarly been snubbed by the Establishment, moved to London where he became one of the greatest teachers of anatomy and surgery of his day, teaching at the Great Windmill Street School of Anatomy which had been founded by William Hunter.
As a teacher of anatomy, Lizars probably surpassed even his master, John Bell. His classes grew and soon were attracting around 150 students, the success of his teaching in marked contrast to that of his contemporary in the University, Alexander Munro Tertius, whose students deserted his lectures and of whom Charles Darwin, a long suffering pupil, once said “he made his lectures on human anatomy as dull as he was himself”.
Yet in the Extra Mural School, Lizars had to contend with some of the greatest anatomists of the age. It was during this time that he produced his “System of Anatomical Plates” a superbly illustrated book of anatomical illustrations based on his own dissections. His brother William Home Lizars had established himself as Edinburgh’s leading engraver, and was from 1826 to engrave the first 10 subjects of Audubon’s “Birds of America”. The anatomical plates which they produced were to become classics of their day.
Whilst this approach was immensely popular with students (who also appreciated Lizars’ mnemonics to aid anatomical learning), this was an approach which did not find favour with the anatomy teaching establishment of the day. In that as in many other respects, Lizars was decades ahead of his time. Throughout the days of anatomy teaching he had continued in active surgical practice.
The Edinburgh College of Surgeons, in an attempt to make surgical teaching more specialised, decided that each teacher should only teach one subject. Lizar chose to lecture in surgery, giving over his anatomy teaching practice to his brother Alexander who went on to become Professor of Anatomy in Aberdeen.
In 1831 when the Chair of Surgery to the Royal College of Surgeons of Edinburgh became vacant, Lizars contested the vacancy with Syme. As a result of support from Robert Liston and Sir William Fergusson, Lizars was elected. Syme took the defeat badly and the animosity between them was life long. Lizars was openly critical of Syme and on one occasion had to pay costs and damages for a slander about the quality of Syme’s practice.
Yet five years after Lizars’ death, Syme put the quarrels behind him and publicly acknowledged several of Lizars’ surgical innovations.
Lizars was a truly innovative surgeon. He was the first in Britain to perform the operation of ovariectomy on a regular basis. The first successful oviarectomy was performed by McDowell in Kentucky. Like Lizars he had been a pupil of John Bell and there is a suggestion that Bell may have suggested the possibility of the procedure to his pupils. McDowell did not publish this historic case for some 7 years but rather sent an account to Bell, his former teacher. The report passed to Lizars who went on to perform oviarectomy successfully in surgical practice, making the procedure acceptable and paving the way for abdominal surgery.
His surgical boldness is further attested to by the operation of ligation of the innominate artery for aneurysm, which he again was the first in this country to perform.
In the pre-antiseptic, pre-anaesthetic era of surgery he successfully resected the maxilla for sarcoma.
Lizars’ surgical vision is exemplified by his suggestion that enlargement of the prostate might be treated by cutting out the entire gland. For many years he operated alongside Robert Liston, often in the same theatre and before the same students. Liston’s skill, speed and dexterity were such that to be compared so directly with him was the severest test to which any surgical reputation could be exposed. Unlike many others, the rivalry between Liston and Lizars was a friendly one based on mutual respect.
In 1859, the year before his death, he published “ Practical observations on the uses and abuses of tobacco” in which he linked tobacco smoking to cancer of the mouth and tongue. With prophetic vision he anticipated that tobacco induced “ injury to the constitution of the young may not appear immediately, but cannot fail ultimately to become a great national calamity”.
He retired from the Chair of Surgery at the Royal College of Surgeons in Edinburgh in 1839 and the College abolished the chair. Lizars continued with his surgical practice until his death in 1860.
