This Doctor Was Known For His Speed in Amputating Limbs… Which Wasn’t Always a Good Thing

This Doctor Was Known For His Speed in Amputating Limbs… Which Wasn’t Always a Good Thing

Trista - November 25, 2018

Few people get excited about surgery. The thought of having your body cut open so that somebody can stick his or her hands inside will make even the most hardened person shudder. Today, many surgeries can be carried out with minimal invasion and laser targeting. Recovery times are quicker than what they were decades ago, and side effects are drastically lessened nowadays, too. Still, people tend to worry about going under the knife, and historically speaking, they have good reason to be.

Historically, surgery has long been a nasty business. One of the oldest recorded operations was trepanation, a form of lobotomy. During the procedure, a hole would be drilled in the back of the skull to release pressure on the brain and supposedly treat different illnesses. Trepanation was apparently a rather standard procedure. At a gravesite in France dating to 6500 BCE, out of 120 skulls that were uncovered, one-third of them had evidence of undergoing trepanation. Considering that this procedure would have taken place without any anesthesia, except maybe a conk on the head to knock the person out, modern brain surgery seems like a walk in the park.

This Doctor Was Known For His Speed in Amputating Limbs… Which Wasn’t Always a Good Thing
Skull that underwent an ancient lobotomy. historycollection.

Alternatively, consider the archaic practice of blood-letting. Ancient Greek doctors, such as Erasistratus, believed that illness was primarily due to an overabundance of different elements in the blood. The solution was to reduce the volume of those elements by causing the person to bleed obsessively. Sometimes, the patient’s skin was cut to induce bleeding. Other times, leeches were applied to the surface. The patient was always at a very high risk of infection, which could be life-threatening. Blood-letting continued to be used throughout the Middle Ages and even in the colonial period of American history.

This Doctor Was Known For His Speed in Amputating Limbs… Which Wasn’t Always a Good Thing
Leeches were often used for blood-letting activities. Wikipedia.

In the ancient Near East, particularly in Sumer, the common belief was that illness was caused by demonic activity. To qualify as a physician, one had to be able to identify the 6,000 different demons that could be responsible for diseases, with the implicit understanding being that the ability to perform exorcisms was a necessary prerequisite to medical care. For cases when exorcisms failed, the Code of Hammurabi details some surgical procedures that were carried out. Ten shekels were the reward for a surgeon who would successfully remove a tumor over the eye; should he fail to do so and the person died on the table, the surgeon’s hands would be cut off.

This Doctor Was Known For His Speed in Amputating Limbs… Which Wasn’t Always a Good Thing
Pictures of surgery tools at Kom Ombo, Egypt.

Not all pre-modern surgical procedures were quite as macabre. One of the most successful was the setting of bones that had been broken. The ancient Aztecs developed a method for setting bones that is very similar to modern techniques. Moreover, Julius Caesar, the great Roman emperor, was born via cesarean section – the reason why the common obstetric surgery takes his name – when his mother died during labor. Though his mother was already dead, he survived the surgery and ended up in history books.

This Doctor Was Known For His Speed in Amputating Limbs… Which Wasn’t Always a Good Thing
Portrait of Robert Liston painted in 1847 by Samuel John Stump. BBC Your Paintings (now available by Art UK)/The Royal College of Surgeons of Edinburgh; Supplied by The Public Catalogue Foundation/Wikimedia.

Dr. Robert Liston

As medicine began to advance into the modern era, people began to rely less on ideas of demonic possession and exorcism and more on scientific analysis. At the same time, given the public’s fascination with science and public displays of scientific experiments, surgery was becoming a bit of a theatrical affair. People could actually watch operations, often for their own entertainment. Today, typically only medical students view surgeries, and this practice is strictly regulated under privacy laws. However, in a day before privacy laws, and before anesthesia, watching medical procedures be performed was a bit of a past time for people (perhaps that’s why we refer to the “operating theatre”).

Imagine that you severely burned your arm in a cooking accident. The wound was carefully attended to, but it became infected before finally developing gangrene and becoming necrotic. The physician recommends that the arm should be amputated as soon as possible (read: immediately), to keep the infection and necrosis from spreading. You are brought to the operating room of Dr. Robert Liston after waiting in line behind dozens of other patients who are in need of amputation. You cradle your arm, knowing that you will have to undergo this life-altering surgery that could save your life but may also end it. Worse yet, you will have to endure it without any anesthesia.

This Doctor Was Known For His Speed in Amputating Limbs… Which Wasn’t Always a Good Thing
Robert Liston, photograph circa 1845 by Hill & Adamson.
George Eastman Museum/Wikimedia.

Your turn arrives for the operating theater. “Time me!” the doctor flamboyantly tells his assistant. He takes out his surgical instruments and ties a tourniquet near your elbow to reduce the blood flow to the spot where he will amputate. He then begins sawing at your arm, with both speed and bravado, to the applause of onlookers. To save time, when he switches surgical instruments, he holds the knife in his mouth, then begins suturing your arm. Within two and a half minutes, the entire procedure is complete. Your severed arm is thrown into a wastebasket, and you, delirious with pain, can begin your recovery.

In the nineteenth century, Dr. Robert Liston was a Scottish surgeon who was revered as one of the best in all of Britain. Seeing as his career was during a period before antibiotics or anesthesia, speed was entirely of the essence in both reducing the patient’s agonizing pain and the threat of infection. He practiced in Edinburgh and was known to have the fastest knife in the entire West End. His record for limb amputation was all of 28 seconds. He was known to be able to amputate a person’s leg and suture the wound in under three minutes.

Other surgeons of the time did not regard Liston too highly. He had a reputation for being abrupt, abrasive, and argumentative. At the same time, he extended charity to the poor by performing surgeries for those who were unable to afford the procedure. People would line up at his office in order to have him perform their amputations, knowing that under him, they had the best chance for survival. He would see to all of them. Despite his charity, he made a fortune in his medical practice.

This Doctor Was Known For His Speed in Amputating Limbs… Which Wasn’t Always a Good Thing
Knives that Liston used for operations.

Dr. Robert Liston’s Legacy

Despite all of his achievements, Dr. Robert Liston has a legacy that is not entirely favorable. In addition to being perceived as argumentative and abrasive, he also had a reputation for reveling in the limelight of the operational theatre. In fact, he was so showy with his surgical techniques that one time, he cut off a patient’s testicles while performing an amputation. In another surgery, a young boy presented with a pulsating abscess in his neck. Liston insisted that it was a tumor and brandished his knife on the boy, who quickly died of blood loss.

In another case, he performed surgery on a man who had a 45-pound tumor in his scrotum. The poor man had to carry it around in a wheelbarrow to get around. The procedure took only four minutes. In what is possibly his most famous case, he amputated a leg in two and a half minutes, but in his bravado, also severed the fingers off of his assistant, who died as a result of gangrene in the lacerated area. A spectator to the surgery thought that he had been stabbed with the surgeon’s knife and died of fright. The patient survived the surgery but died of gangrene. This was perhaps the only operation in history that had a 300% mortality rate.

This Doctor Was Known For His Speed in Amputating Limbs… Which Wasn’t Always a Good Thing
A picture displaying a patient being held down for surgery. tinypic.

Still, Liston had one of the best mortality rates in surgery. Only one in ten of his patients died, compared to an average of one out of three. One might say that he set a standard for surgical mortality in which such a high mortality rate – over 30% of patients – could no longer be considered acceptable. He went on to perform the first procedure in Europe that used general anesthesia, something that drastically changed the face of surgery and increased the person’s likelihood of surviving. No longer did an assistant have to hold someone down while the doctor hacked off an infected limb.

Additionally, Liston published several books and pioneered medical innovations. His 1837 book Practical Surgeries spoke of the need to perform surgeries quickly and efficiently to decrease the pain of the patient and increase the chance of survival. In 1835, he became a professor of clinical surgery at London’s University College Hospital, where he passed on his techniques to many aspiring surgeons. He invented a type of leg splint that is still used today to help stabilize dislocations of the femur, as well as Bulldogs forceps and isinglass sticking plaster.


Where did we get this stuff? Here are our sources:

“History of surgery.” Wikipedia.

“Robert Liston.” Wikipedia.