Sue Young Histories

Robert Lawson Tait 1845 - 1899

June 21, 2010

** **{::}**Robert Lawson Tait** 1845 - 1899, was a British orthodox surgeon, who introduced the salpingectomy in 1883, he is known as one of the fathers of gynaecology, and he worked at the Birmingham Hospital for Women for 20 years,

Lawson Tait declared that ‘… If humanity demanded, he would consult with any man who was a regular graduate of their own school, regular or irregular, if that man was a gentleman, for no one school knows it all…’ (Anon, Texas State Journal of Medicine, Volume 5, Issue 4, (Texas Medical Association, 1909). Page 173), and ‘… In 1874, as a struggling young specialist, I made up my mind that a qualified young practitioner was a person to whom I was bound to give my services in consultation, regardless of his views **.**.. and I declared my intention of meeting homeopathic practitioners just as I would others…’_]( (Anon, [_Medical Brief: A Monthly Journal of Scientific Medicine and Surgery, Volume 21, Issue 1, (1893). Page 504).

Lawson Tait was happy to allow homeopathic practitioners into his Lecture Theatre, including Martha Dunn Corey 1852 - ?, who was studying at the Homeopathic College of New York, and his text books were widely used in homeopathic colleges.

Lawson Tait was censored by _The Lancet_ for accepting a donation from a homeopath towards the building fund for a new library (William John Stewart McKay, Lawson Tait, his life and work: a contribution to the history of abdominal surgery and gynaecology, (Wood, 1922). Page 74).

Lawson Tait came out to defend John Maberly, physician at the hydrotherapy establishment at the Leamington Spa Arboretum,

Lawson Tait was an antivivisectionist, writing _On the Uselessness of Vivisection on Animals as a Method of Scientific Research (Robert Lawson Tait, On the Uselessness of Vivisection on Animals as a Method of Scientific Research, (reprinted by BiblioBazaar, 2011)). Swedenborg Archive K125 _contains letters from James John Garth Wilkinson to Dr. and Mrs. Tafel (Rudolph Leonhard Tafel (1831-1893)) and includes a letter to Dr. Tafel dated 8th July 1882 with an enclosure, a pamphlet on vivisection by Robert Lawson Tait, which James John Garth Wilkinson was very much in support of.

Lawson Tait was also interested in plant physiology, and in 1876, he persuaded Charles Darwin to forward his paper on pitcher plants to the Royal Society, a paper which was ultimately rejected.

See and Robert Lawson Tait was born in Edinburgh, Scotland on the 1st May 1845. He was educated at Heriot’s Hospital and, at age 15 studied Arts at the University of Edinburgh on a scholarship.

He subsequently changed to Medicine and qualified with LRCS and LRCP age 21. In 1867, he was appointed as a House Surgeon in Yorkshire and performed his first ovariotomy.

During this time he married Miss Sybil Stewart.

In 1870 aged 25, he moved to Birmingham and, in the following year, was appointed as one of the three chief surgeons in the newly founded Hospital for the Diseases of Women.

As well as performing many operations over the next few years, he performed and described several ‘first’ operations. These included oophorectomy for sepsis, bilateral oophorectomy for menstrual problems along with the first successful appendicectomy and cholecystectomy.

In 1873, he performed a laparotomy for excision of a term, extra-uterine fetus and developed the technique of leaving the placenta in situ to reduce the risk of haemorrhage.

In 1874, he performed an abdominal subtotal hysterectomy for fibromyoma and in 1880 he performed the first successful hepatotomy for hydatid cyst of the liver.

He described ‘Tait’s operation’ as the excision of the fallopian tubes and ovaries for inflammatory disease and wrote about the involvement of the tubes and ovaries in pelvic inflammatory disease.

Following this he described a second ‘Tait’s operation’ - the repair of the perineum by bringing together the levator muscles after reflection of the posterior vaginal wall. Repair of the rectum and anal sphincter were also explained. One of his greatest achievements was the development of laparotomy and salpingectomy for ectopic pregnancy.

His surgical successes were due in part to his ‘aseptic’ techniques. He did not agree with Joseph Lister’s use of carbolic acid for antisepsis and instead used soap and water to wash his hands thoroughly. His instruments were boiled and his linen laundered.

He tended to use a small incision and post operatively he removed excess blood from the abdomen and used a peritoneal ‘wash-out’ of boiled water. The operations were performed quickly to reduce the risk of infection.

Most of his operations were performed in the Crescent, the small hospital for women in Birmingham, or at the patients own home.

Over the years he published extensively. In 1885, he founded and became president of the Medical Defence Union (MDU). However, his strong and outspoken views against vivisection brought such criticism that he was forced to resign as president of the MDU.

A short stout portly, he was well known for his enjoyment for food, alcohol and cigars. After 1891, there were no more ‘discoveries’ and he presented few papers. His reputation and practice declined further after two significant events - he was sued for libel and was accused by one of his nurses of being the father of her child. Financial loss meant that he had to sell many of his possessions.

Tait died on June 13, 1899 at the early age of 54 from ‘nephritis’. Just before his death, he smoked one of his favourite cigars, realising that this would be his last.

Lawson Tait became a pioneer in pelvic and abdominal surgery and developed new techniques and procedures. He emphasized asepsis and reduced surgical mortality significantly.

He is well known for introducing salpingectomy in 1883 as the treatment for ectopic pregnancy, a procedure that has saved countless lives since then.

Tait and James Marion Sims are considered the fathers of gynecology.

Tait’s first success came with his demonstration that ovariotomy could be done safely. While Ephraim McDowell had successfully performed the first ovariotomy in Kentucky in 1809, mortality for this operation was over 90%.

In his first paper in 1872, Tait reported only 1 death out of nine cases, a major breakthrough. His techniques of use of intraabdominal ligatures for the ovarian pedicle in favor of an extraperitoneal clamp, abdominal closure, and meticulous surgical cleanliness were novel and important for abdominal surgery.

With further recognition, he was instrumental in the opening of the Birmingham Hospital for Women where he worked for 20 years…

Tait was well recognized during his time, a founder and member of professional societies, and published extensively. He died of kidney failure.

The Lawson Tait Society, an undergraduate history of medicine society at the University of Birmingham Medical School, is named in honour of Tait. They have embarked upon a project of digitising Tait’s work and resources related to Tait.