Charles White (physician): Difference between revisions

'''Charles White''' [[Fellow of the Royal Society|FRS]] (4 October 1728 – 20 February 1813) was an English physician and a co-founder of the [[Manchester Royal Infirmary]] along with local industrialist Joseph Bancroft as well as the St Mary's Hospital for Lying in Women in 1790. White was an able and innovative surgeon who made significant contributions in the field of orthopaedics, surgery and [[obstetrics]]. He was a founderfounding andmember thenof forthe 23[[The yearsPortico aLibrary|Portico Library]] Vice Presidentand of the Manchester Literary and Philosophical Society, thewhere secondhe oldestwas suchalso institutionVice inPresident thefor country.23 He is with the Halls the founder of Medicine in Manchesteryears.

White was born in [[Manchester]], England, on 4 October 1728, the only son of Thomas White, a surgeon and man-midwife, and his wife Rosamond Bower. After being educated by the Reverend Radcliffe Russell, White joined his father's practice as an apprentice, in about 1742. He was able to assist in surgery and deliveries from the tenderyoung age of 14. He subsequently studied medicine in London under the anatomist and [[obstetrician]] [[William Hunter (anatomist)|William Hunter]] in 1748, being one of a small select group of students that included in his year John Hunter. The two young men became life longlifelong friends. After finishing his training with Dr Hunter he went to Edinburgh to further his studies before returning to Manchester in 1751 to Manchester. He joined his father, in practice, at their home in King's street. After his father's death he continued his practice there until he retired to his father's country house at Sale Priory.

* From the 1750s onwardsonward, White became increasingly recognised as an able and innovative surgeon. He presented a paper to the [[Royal Society]] in 1760 describing his successful treatment of a fractured arm by reuniting the ends of the broken bone. In 1762, the year he became a fellow of the society, he presented another paper, on the use of sponges to stop bleeding. Most people were using a ligature which was extremely painful. the sponge was less painful and more effective than a ligature in lacerated areas and when there was much contusion. In his report to the Royal Society he recorded 13 cases which were entirely successful where all others methods had failed. he also noted that the wounds were cleaner and so later this persuaded him to use dry sponges to foul abscesses and ulcers with success. He became a member of the [[Royal College of Surgeons of England|Company of Surgeons]] same year.{{r|ODNB}}<ref>{{Cite book|last=Burgess|first=A.H.|title=The Hunterian Oration 1941 p11}}</ref>

* He devised a method for reduction reducing dislocations of the shoulder . He reported that in twenty years he had yet to fail to reduce the joint. It was even successful in a number of chronic dislocations. The method entailed the use of an iron ring in the ceiling and a pulley fixed into it, the other end fastened by bandages the forearm above the wrist. By drawing up the patient. supported by staff, he could then relocate the humerus.

* In 1768 a boy of 14 who presented with an infected osteomyelitis of the humeral head. The abscess was drained. The treatment would have routinely been an amputation of the arm. White exposed the humeral head and excised it sawing off 2 inches of bone. the patient recovered and had full use of his arm and movement at the shoulder. Although he was not as has been claimed the first to excise the humeral head for disease, none the less was the pioneer in the operation of partial diaphysectomy for acute osteomyelitis.

* Anatomy Lecturer. He and his son Thomas delivered possibly the first ever series of Lectures in the provinces at the Manchester Literary and Philosophical Society in 1783. They also started instructional Anatomy lectures from his house in King Street from 1787.

White will be forever remembered in Manchester as the founder of the hospital and a formidable surgeon and often acclaimed as the "father of conservative surgery"<ref>{{Cite book|last=Burgess|first=A.H.|title=The Hungarian Oration 1941 p13}}</ref> None the less it is as a man midwife that he like [[William Hunter (anatomist)|Dr William Hunter]] in London really made his mark. In this field however White was unique. During much of this time he was in charge of Midwifery for the Poor of Manchester and surrounding districts. His major work a '''''Treatise on the Management of Pregnant and Lying-in Women''''', was published in 1773 and went through some five editions. It was published not only in the United Kingdom but also in the USA and then translated and printed in Germany and France. In it he suggested significant changes in the care of women in pregnancy, during childbirth and in the [[puerperium]]. Medical students today will learn of the apparently seminal work of Ignazz [[Ignaz Semmelweis|Semmelweis]] in changing the course of maternity care from 1845-1860. However almost all of the suggestions that [[Ignaz Semmelweis|Semmelweis]] was to make had been encouraged and practiced by Charles White of Manchester starting a century before and detailed in this remarkable book. In it he describes the prevailing practice. The room for a woman to deliver in was often crowded. A fire was lit, the windows were all shut, the curtains stitched. theThe woman was encouraged to lie flat and be completely covered by blankets. After delivery she was confined in a horizontal position for days so that the lochia tended to remain in the vagina stagnating and festering. He made a point of having the room cooled, the windows to be opened to encourage a flow of fresh air. He insisted on hygienic conditions, regular hand washing, changes of bed linen, towels and sponges and instruments. Although unaware specifically of bacteria he urged not only scruplulous scrupulous cleaning but also separate bed chambers for women in labour. Where this was not possible then if any woman developed fever she should be isolated for a week or ten days to prevent spread of the fever. In such a case, after the woman had left the hospital, the room should be scrubbed including the woodwork, the curtains and floor. He even advocated where possible stoving with brimstone.

He also encouraged rapid mobilisation of women after delivery in the first or second days. The normal was for them to be bed bound for days. This again was far sitedfarsighted and although we would agree today even a hundred years later his advocates could not quite believe this.<ref>{{Cite journal|last=Cullingworth|first=charles|date=17 August 1889|title=Address to the Section of Obstetrics|journal=British Medical Journal}}</ref>

Puerpural Fever was a common cause of illness and mortality in women. White's practices practically eliminated this terror. He was sure that free flow of noxious fluids by gravitational drainigedrainage. forFor this he designed a chair to encourage such flow. Such an innovation is also often called a Fowler Chair after the American Surgeon who designed something similar a hundred years later for treatment of [[Peritonitis]]. Again White is credited in being the originator by Curtis.<ref>{{Cite book|last=Curtis|first=A.H.|title=Obstetrics and Gynaecology|year=1933}}</ref> White was so successful in this that he practically eliminated Puerpural Fever from his wards. In 1789 in Vienna they appointed Professor Boer who had studied White's methods at the Lying in Hospital there. He had learned White's methods whilst in England and used them in Vienna. During his time there 65,000 women passed through the Vienna Lying In Hospital with a death rate of 1.3%. He was deposed by Professor Klein who discarded White's methods and also at the same time he brought in the practice of teaching on the Cadavercadaver to his juniors. His mortality rate increased to 7.8% in the first year and as high as 29% one year. It was into this situation that Semmelweis came and slowly brought forward his insights into the causes and prevention of Puerpural fever. He stopped the students attending [[cadaver]]s in 1846 but it took him until 1861 to emphasise the importance of foul bed clothes, general cleanliness and the washing of hands of midwives etc. In almost all areas White's writings advise the same precautions as Semmelweis 75 years later. theThe only omission was in avoiding cadavers which was not a factor in Manchester. White was first to pronounce on good care to avoid infection. His work saved thousands of lives.

When he returned to Manchester in 1751, he agitated so actively for the establishment of an infirmary that the prominent local merchant Joseph Bancroft was persuaded to defray all expenses, provided Dr White would give the institution his medical services. In 1752 a house was taken at No 10 Garden Street providing a hospital with 12 beds. Three years later, on 9 April 1755, the Manchester Public Infirmary was opened at new premises. He was to remain as Surgeon to the hospital for 38 years.

In 1757 White married Ann Bradshaw, whose father had been a high sheriff for the county of Lancaster. They had eight children, four sons and four daughters. Two of his sons had become doctors but they and his two other sons predeceaseddied before him. In 1803, White suffered an attack of [[ophthalmia]], which initially only affected his left eye and with difficulty he continued to work. However inIn 1811 it affected the right eye and he soon became blind.. He died at his home in [[Sale, Greater Manchester|Sale]], on 20 February 1813.{{r|ODNB}} He was survived by his daughters, one of whom, Anne White, married Sir Richard Clayton, to whom hisWhite's thesis on Regular Gradation of man was dedicated.

The incident made John's sister, [[Manchester Mummy|Hannah Beswick]], fearful that she might accidentally be buried alive. Hannah requested in her will that White keep her above Ground for 100 years after her death.<ref>{{cite book|last=Cullingworth|first=Charles|title=Charles White FRS A Great Provincial Surgeon and Obstetrician p19-20}}</ref> Following Hannah's death in 1758 White had her embalmed, White kept Hannah's mummified body in his museum where he had 300 other pathological specimines in this museum.<ref>{{cite book|last1=Leach|first1=Penny|title=St Mary's Hospital Manchester 1790-1990|date=1990|location=Manchester}}</ref> When the museum was made over to the St Mary's hospital the mummy was moved to the attic at Sale Priory. Following his death in 1813 he gave the mummy to Dr Ollier, his personal physician ,who donated it on his death to the [[Manchester Museum|Museum of the Manchester Natural History Society]],{{sfnp|Portland|2002|p=85|ps=none}} There she became known as the [[Manchester Mummy]], or the Mummy of Birchin Bower.{{sfnp|Cooper|2007|p=87|ps=none}} Her body was put on display in the museum's entrance hall,{{sfnp|Bondeson|1997|p=102|ps=none}} described by one visitor in 1844 as "one of the most remarkable objects in the museum".{{sfnp|Kohl|1844|p=130|ps=none}}

Although this sounds odd to modern ears, Dr White was following practices that were not uncommon at the time. Others physicians doing likewise included Dr John Hunter, Dr William Hunter, Dr Cruickshank and DrSheldon.<ref>{{Cite journal|last=DOBSON|first=JESSIE|date=1953|title=Some Eighteenth Century Experiments in Embalming|url=http://dx.doi.org/10.1093/jhmas/viii.october.431|journal=Journal of the History of Medicine and Allied Sciences|volume=VIII|issue=October|pages=431–441|doi=10.1093/jhmas/viii.october.431|issn=0022-5045}}</ref>

White spent much of the littlehis spare time he had studying [[Anthropometry|Anthropemetry]]. He examined many people andincluding sailors of mixeda racesvariety toof seeethnicities ifto there werestudy anatomical differences between them. He was much influenced by work done by John Hunter which he had seen in London. HeLike likewiseHunter, foundhe differencedescribed indifferences thein skull and facial shapes and also the length of forearm toand humerus and came to the incorrect conclusion that there was a Gradation between different 'races and that they' were of separate origins.