Vignette - Sir Herbert Seddon

THERE are few surgeons of Sir Herbert Seddon’s generation who have made such an important contribution to their specialty.

The gifted and dedicated professional was a pioneer in two fields of surgery – first making groundbreaking advances in the understanding and treatment of tuberculosis and poliomyelitis, where many of his patients were children. He then went on to make great advances in the repair of peripheral nerve injuries that improved the lives of thousands of wounded soldiers.

His extensive clinical research in the 1930s also produced valuable contributions on the nature of spinal tuberculosis that inspired a new surgical approach and dramatically improved the prognosis.

During the war years Sir Herbert advised the British Government on polio epidemics and also helped many developing countries deal with their orthopaedic problems. During his appointment as Nuffield professor of orthopaedic surgery to the University of Oxford from 1939, he set up the most important peripheral nerve injury unit in Britain where his experiences in treating the wounded from World War 2 helped him become a master at repairing peripheral nerve injuries.

His scientific approach, meticulous recording, precision, objectivity and honesty uncovered vast knowledge in the field of peripheral nerve injury and he went on to write the seminal Surgical Disorders of the Peripheral Nerves which became the standard textbook on the subject for many years. His many remarkable achievements have been detailed in a book by Julia Merrick, Sir Herbert Seddon and the book he nearly didn’t write, whose title references his Surgical Disorders book which was 30 years in the making.

In her biography, Merrick describes how Sir Herbert made the Royal National Orthopaedic Hospital internationally renowned, adding: “He worked hard, influenced a generation of young surgeons, travelled widely” and exported “highly qualified orthopaedic surgeons.”

Sir Herbert – known to friends as Jim – was born in July 1903 in Derby and spent his childhood in Manchester before studying at the medical college at St Bartholomew’s Hospital, graduating MB, BS London University in 1928 and in the same year gaining the FRCS. In 1930 he took up the post of instructor in surgery at the University of Michigan where he met his future wife Mary Lytle. The couple went on to have two children, Sally and James.

He returned home in 1931 when he was appointed resident surgeon to the Royal National Orthopaedic Hospital in Stanmore, Middlesex.

The increasing problem of polio reached epidemic proportions in 1938 and it was in researching this disease that Sir Herbert would do some of his most important work. His knowledge and practical experience in treating the disease was in demand even beyond the UK and in the early 1940s he travelled to Malta and Mauritius to lend his expertise.

During this period he also made important discoveries surrounding spinal tuberculosis, defining two types of paraplegia – acute due to pressure on the cord from an anterior abscess and late onset due to gliosis. These concepts led to the development of the anterolateral approach – an operation in which Sir Herbert became very skilled – which dramatically improved patient outcomes. Another of Sir Herbert’s great contributions to medicine was the work he engaged in to convince the next generation of medics the value of basic research.

Sir Herbert’s career achievements were many. He became the first professor of orthopaedics at the University of London in 1948, he was president of the British Orthopaedic Association from 1960-1961, he was knighted in 1964 and made an honorary fellow of Worcester College in 1966. His work took him around the world, including on extensive tours of Africa as a member of the Advisory Medical Council of the Colonial Office.

And while he spent long hours working in his specialist field, Sir Herbert also found time to indulge his other interests. He was a keen climber, gardener, photographer and painter who became accomplished in these pursuits by employing the same determined approach he used in his work. Even in retirement his contribution to medicine continued with the longawaited publication of his book Surgical Disorders. He spent a lot of time planning and implementing the Medical Research Council’s investigation into the treatment of tuberculosis of the vertebral column, with centres set up across the globe in Korea, Hong Kong, Bulawayo and South Africa. The end result was one of the most valuable pieces of clinical research ever completed for the council.

In a tribute to Sir Herbert in the BMJ following his death, one colleague wrote: “Jim was not always deep in thought: he could be the centre of wit and humour of any dinner party. A pause for a moment for reflection may enable us to catch a fleeting glimpse of the breadth and depth of this personality, which sought increasingly to unravel the secrets of medical science by exposure of factual truth and simultaneously to preach the Gospel from a fountain of undoubted faith.”

Sir Herbert Seddon and the book he nearly didn’t write (2010) by Julia Merrick is available at Blackwell’s Bookshop, South Bridge, Edinburgh and also on Amazon.co.uk