It is difficult for most surgeons to achieve eminence by their early thirties. Richard James Mackenzie was an exception to that. A brilliant and innovative young Edinburgh Surgeon, he was assistant to James Syme and seemed destined for an illustrious career in surgery. He studied in major continental centres including Paris, Vienna and Berlin where his observations allowed him to publish important works on the differences between Continental and British surgery. A popular and eloquent teacher, arguably his greatest achievement was the publication of a series of papers on a variety of innovative surgical procedures. During active service as a surgeon in the Crimean War, he died of cholera at the early age of 33. His death was seen as a loss of a potential future leader of British Surgery and it was Joseph Lister who succeeded to his lectureship in Edinburgh.
Richard James Mackenzie was born in Edinburgh, the fourth son of the Deputy Keeper of Her Majesty's Signet. His school years, at the New Academy marked him out as a distinguished scholar. At the age of 17 he became apprentice to Dr Adam Hunter, Fellow of the Royal College of Surgeons of Edinburgh. In 1840 he became resident clerk to Professor Sime in the Royal Infirmary of Edinburgh, graduated medicine in 1842 and was elected a Fellow of the College 2 years later. His surgical education was rounded by a series of visits to the major continental schools of the day. Studying in Paris under Malgaigne and Roux he moved to Hamburg, Vienna and Berlin. On returning to Scotland in 1844 he gave a major paper on the differences between the Continental and British Surgical Practice. He became a Medical Officer at the New Town Dispensary where he established a reputation as a humanitarian. A contemporary was to write, "The Medical Officer’s duty often consists as much in deeds and words of kindness and benevolence as in the prescription of medicines." In this position, Dr Mackenzie was regarded as friend of the poor as well as physician to the sick.
He soon distinguished himself as a lecturer. In 1849 he succeeded Dr Argyll Robertson as lecturer in the Extra-Academical school where his eloquence marked him out as a highly successful and popular lecturer, the size of his classes increasing year on year. From the time of his appointment as Surgeon to the Royal Infirmary, he wrote a remarkable series of innovative paper s on surgical techniques across the whole spectrum of his surgery of the day. He described successful ligation of the subclavian artery. A modification of Syme's amputation of the ankle joint, is still referred to as Mackenzie's operation. Urethral stricture was largely treated by bouginage, but he described several cases of external excision. Re-constructive surgery of the upper lip, the cheek and the eye lid were also described using multiple flaps.In addition to the more customary procedures of the day he was clearly a skilful operator and an innovative surgeon.
Contemporaries regarded his surgical experience as unique for one of his age, and in his early 30's he was already regarded as a potential world leader of the profession. In 1854 he volunteered for active service as a surgeon in the Crimean War travelling to join the Highland Brigade as Surgeon in Scutari. After acting as Field Surgeon for 4 months he died of cholera.
His premature death was regarded as a particular loss to the Edinburgh School of Surgery for which he was ear marked as a potential future leader. He was succeeded in his lectureship by Joseph Lister.
Edinburgh Medical Journal; 1855; v82; p281
Comrie JD; History of Scottish Medicine; v2; p590-591