Sir William Macewen was one of the greatest surgeons of his age, and he helped make Glasgow a birthplace of modern surgery. A pupil of Joseph Lister, he took his master’s antiseptic method and carried it further still, into the strict asepsis of the modern operating theatre. He was among the very first surgeons in the world to open the living skull and operate upon the brain — a founder of neurosurgery — and he transformed the surgery of bone besides. In his last years, working on the banks of the Clyde, he rebuilt the shattered bodies of the men who had lost limbs in the Great War.
This page follows his story: his island boyhood, his training under Lister, his pioneering brain and bone surgery, his work on the airway, his years as professor, and the hospital he built for the limbless at Erskine.
A son of Bute
William Macewen was born on 22 June 1848 at Rothesay, on the Isle of Bute in the Firth of Clyde, the youngest child of a seafaring family. Educated in Glasgow, he entered the University of Glasgow to study medicine, graduating in 1869. He was not a brilliant student in the conventional sense, but he had an insatiable curiosity and a determination to see everything for himself — hours spent among the anatomical specimens of the Hunterian Museum taught him more than any lecture. It was a habit of independent, hands-on investigation that would carry him, in time, into surgery no one had attempted before.
The pupil of Lister
Macewen came of age at exactly the right moment and place. As a student at the Glasgow Royal Infirmary he fell under the influence of Joseph Lister, whose antiseptic method — killing germs with carbolic acid — was even then transforming surgery from a butchery of infection into a science. Macewen embraced Listerism utterly, but did not stop there. Where Lister fought germs during an operation, Macewen sought to exclude them altogether: sterilising instruments, gowns and dressings in advance, and scrubbing everything clean. This shift from antisepsis to strict asepsis, worked out at Glasgow, is the foundation of the modern operating theatre.
Opening the skull
Clean surgery made possible what had been unthinkable: surgery inside the head. Armed with the new science of cerebral localisation — which linked particular functions to particular parts of the brain — Macewen learned to read a patient’s symptoms, deduce where a lesion must lie, and cut straight to it. In 1879 he removed a tumour from a patient’s brain, one of the first such operations ever performed, and went on to treat brain abscesses and haemorrhages that had always been fatal. His book on the infective diseases of the brain and his atlas of head sections made him a founder of the whole discipline of neurosurgery.
The surgery of bone
Macewen’s other great field was bone. He understood, before most, that bone is living tissue — able to grow, heal and be transplanted — and he pioneered bone grafting, taking living bone from one place to repair another. He devised operations to straighten the bent limbs of children crippled by rickets, and a celebrated radical cure for hernia; his name still attaches to surgical landmarks and to the osteotome, the chisel he designed for cutting bone cleanly. Around 1880, working with the matron Rebecca Strong, he also helped create a rigorous training scheme for nurses, doing much to make nursing the skilled profession it became.
Breath & the airway
Even the humble matter of how a patient breathes on the operating table bears Macewen’s mark. In 1878 he performed one of the first recorded cases of oral endotracheal intubation — passing a tube down through the mouth into the windpipe to keep the airway open and deliver anaesthetic — in place of the cruder and more dangerous methods then in use. It was decades ahead of its time, and the technique he pioneered is now used in operating theatres and intensive-care units the world over. Few surgeons have left their fingerprints on so many corners of medicine.
Professor & knight
In 1892 Macewen was appointed Regius Professor of Surgery at the University of Glasgow — the very chair Lister had held when Macewen was his student — and moved his work to the Western Infirmary. Honours flowed: Fellow of the Royal Society, Surgeon to the Queen in Scotland, a knighthood in 1902, and the presidency of the British Medical Association. Yet he remained, to the end, a Glasgow and a Clyde man, loyal to the city and the university that had made him and turning down the pull of London. His restless originality never left him, and his greatest act of service still lay ahead.
Erskine
When the First World War flooded the hospitals with maimed and limbless young men, Macewen — by now in his late sixties — threw himself into their care. In 1916 he helped found the Princess Louise Scottish Hospital for Limbless Sailors and Soldiers at Erskine, on the north bank of the River Clyde, and became its first chief surgeon. Characteristically, he turned to the shipyards for help: with Clyde engineers he designed a cheap, strong, workable artificial limb — the Erskine limb — and trained pattern-makers to produce it in numbers. He worked on almost to the end, dying in 1924, his life’s work written into the practice of surgery everywhere.
At a glance
| Feature | Detail |
|---|---|
| Born | 22 June 1848, Rothesay, Bute |
| Died | 22 March 1924 |
| Teacher | Joseph Lister, at Glasgow |
| Fields | Brain & bone surgery; asepsis |
| Chair | Regius Professor of Surgery, 1892 |
| Wartime work | Erskine Hospital for the limbless |
| Legacy | A founder of neurosurgery |
Frequently asked questions
Who was Sir William Macewen?
Sir William Macewen (1848–1924) was a Scottish surgeon, based in Glasgow, regarded as one of the founders of modern brain surgery. A pupil of Joseph Lister, he pioneered techniques in neurosurgery, bone surgery, asepsis and anaesthesia that shaped surgery worldwide.
Why is Macewen important?
He was among the first surgeons ever to operate successfully inside the living brain, a founder of neurosurgery. He also pioneered bone grafting, the surgery of deformity and hernia, early endotracheal intubation, and the strict aseptic technique on which modern surgery depends.
What was Macewen’s connection to Joseph Lister?
Macewen trained under Lister as a student at Glasgow Royal Infirmary and adopted his antiseptic method. He then developed it further into strict asepsis, and in 1892 succeeded to the very chair — Regius Professor of Surgery at Glasgow — that Lister had once held.
What did Macewen pioneer in brain surgery?
Using the new science of cerebral localisation, he learned to locate brain lesions from a patient’s symptoms and operate on them. In 1879 he removed a brain tumour in one of the earliest such operations, and he pioneered the surgical treatment of brain abscesses and haemorrhages.
What did Macewen do for bone surgery?
He recognised bone as living tissue and pioneered bone grafting, transplanting living bone to repair damage. He devised operations to correct deformed limbs and to cure hernia, and designed the osteotome, a chisel for cutting bone, which still bears the mark of his work.
What was Macewen’s role at Erskine?
During the First World War he helped found the Princess Louise Scottish Hospital for Limbless Sailors and Soldiers at Erskine, on the Clyde, and was its first chief surgeon. With Clyde shipyard engineers he designed the Erskine artificial limb and organised its manufacture for wounded servicemen.
How is Macewen remembered?
As one of the great surgeons in history and a founder of neurosurgery. Knighted in 1902 and President of the British Medical Association, he remained loyal to Glasgow throughout his career, and his pioneering techniques are still reflected in surgery around the world.