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Remembering Past Greats: Robert Lawson Tait

Author Information

Prasad M*, Venkatesh S**.
(* Assistant Professor, ** Professor and Head of Department, Department of Obstetrics and Gynecology, Vydehi Institute of Medical Sciences and Research Centre,  Bengaluru, India.)

Robert Lawson Tait (1845-1899) was a pioneering gynecologist. Though he is considered by most as more of a generalist surgeon, rather than a gynecologist in strict terms, his contributions to the subject are commendable.[1] He was born in Edinburgh and lived most of his life in Birmingham. While he received the Licensiate of Royal college of physicians, he never received a bachelor’s degree (which was considered more superior). He was an active member of the British medical association and the Obstetric Society of London.[2]  He was contemporary of some other medical greats including Spencer Wells, Billroth and Joseph Lister. He was greatly influenced by James Young Simpson and James Syme.[3] Tait and Billroth were considered as pioneers in the field of abdominal surgery, with Tait publishing work including the first cholecystotomy in 1879. His publication titled “General summary of conclusions from one thousand cases of abdominal section” way back in 1884 was reproduced by the American Journal of Obstetrics and Gynecology as a “classic” publication in the field.[4]  Tait’s professional relationships were stormy and controversial, with one book using the term “real character” to describe him. With Spencer Wells, he shared an unparalleled professional rivalry that they were not in talking terms.  He openly ridiculed Joseph Lister and his concepts. This nature of Tait is well illustrated by an article in 1982 titled “L Tait: The rebellious surgeon”.[5] The specific works for which he became illustrious are mentioned below.[6]
Salpingectomy for ruptured ectopic pregnancy: Upon analyzing the postmortem findings of shattered fallopian tubes in women who died following acute abdomen, he decided to introduce salpingectomy for tubal ectopic pregnancy and is credited with the first ever such procedure (1883). This was met with tremendous reduction in mortality rates (only 2 out of 42 cases, as reported in 1888). 
Ovariotomy for menstrual disorders: Though not scientifically appropriate in the modern context, he had popularized the performance of ovariotomy for various gynecological disorders. Though it induces an artificial menopause, symptomatic relief was achieved and was considered pioneering in those days.
Appendicectomy: In the 1880s, Tait is credited to have performed one of the first few appendicectomies for appendicitis. The Lancet carried an article in 1956 titled “Lawson Tait and Acute Appendicitis” in honor of his initial contribution to this condition.[7]
Opposition to animal experimentation: Giving a variety of justifications, Tait strongly opposed the practice of gaining surgical expertise by operating on animals (also known as vivisection). His writing of articles in public fora about this topic led to him being considered as a dissenting member of the medical community.
Antisepsis: The main opposition between him and Lister was this matter. While Lister advocated the use of a variety of chemicals (including Carbolic acid) to achieve antisepsis, Tait strongly opposed this. He considered that the mere act of boiling instruments in water was sufficient. This vigorous antisepsis was the reason for much of his success rates in operative procedures. While Lister’s principles were proved correct later, Tait’s principles still hold good in low-resource settings.
To summarize, Lawson Tait was a remarkable gynecologist who introduced procedures that remain gold standard even today. His life, ideas and works shall continue to inspire many future generations of surgeons and gynecologists.  

References
  1. Biographies. In O’Dowd MJ, Philipp EE, editors. The History of Obstetrics and Gynecology. 1st ed. Lancs: Parthenon Publishing Group 2000; pp. 644
  2. Golditch IM. Lawson Tait: the forgotten gynecologist. Obstet Gynecol. 2002 Jan;99(1):152-6.
  3. Lawson Tait. Available from : https://en.wikipedia.org/wiki/Lawson_Tait 
  4. Tait RL. General summary of conclusions from one thousand cases of abdominal section-Classics.  Am J Obs Gyn. 1974: 118 (5):717.
  5. Lawrence C. Lawson Tait: the rebellious surgeon (1845–1899). Med Hist. 1982 Jan; 26(1): 109–110.
  6. Lawson Tait: His Life and Work. A Contribution to the History of Abdominal Surgery and Gynæcology. JAMA. 1923;80(7):501-2.
  7. Shepherd JA. Lawson Tait and Acute Appendicitis. The Lancet. 268(6956): 1301-2.
Citation

Prasad M, Venkatesh S. Remembering Past Greats: Robert Lawson Tait.  JPGO 2019. Volume 6 No.3. Available from: https://www.jpgo.org/2019/03/remembering-past-greats-robert-lawson.html