The first page of 'The Bone' MS 42/2/4/4, University of Stirling Archives
Among the Drummond Family Papers, housed in the University of Stirling Archives, lies a long-form diary entry ominously titled in pencil 'The Bone'.
The Drummonds were a wealthy local family. William Drummond (1760-1824) established a business in the late 18th Century as a nurseryman and seedsman in the Bannockburn area. In 1831 William Drummond held his first exhibition of agricultural produce in Stirling which attracted thousands of visitors. In response to the success of this event, Drummond’s Agricultural Museum was established in 1833 and members of the family continued this business.
Sitting between notes of business, Henry Drummond (1809-1888) provides a detailed account of an unfortunate incident involving his son James. On 8th March 1853, James Drummond (then 3 years old) was eating a barley soup made with a large beef bone when, 'all at once our dear boy called out ‘O a bone, a bone’, which was followed by violent coughing and painful choking.'
Henry states the family first tried all the rural home remedies before taking their son to a local Dr Johnston, who examined him and, finding nothing, presumed the bone had already been expelled and the coughing was simply irritation that would subside in a few days. However, unfortunately for James, Dr Johnston was wrong and the next eight pages describe poor Jamie's prolonged struggle with the bone.
A Notable Surgeon
A few weeks passed with no improvement so it was resolved to take James to Edinburgh to visit a Professor Syme.
James Syme (1799-1870) was Chair of Clinical Surgery at the University of Edinburgh. Not only was he a well-respected teacher from 1833 - 1869, but he was also one of the leading surgeons of his day. In 1823 at the age of 24, he performed the first amputation at the hip joint to have been done in Scotland. He was known for his pioneering surgery involving amputations and the speed at which he carried out his operations, something which was especially important in the time before anaesthetic. His opinion was therefore well respected and founded on a great deal of experience.
Portrait of James Syme (1799-1870) FRSCEd (1823), PRCSEd (1849-1851) by George Reid (1841-1913) in the Royal College of Surgeons of Edinburgh Collection ED.CS.2010.212, c.1860
Professor Syme believed that taking into account the otherwise good health of the boy it was best to let the 'thing' work its way out on its own. The Drummonds made up their minds to “wait hopefully and patiently and with a full dependence on the over-ruling province of the almighty”. After 8 weeks and a good deal of cod liver oil and sleeping upright, James was in better general health however the bone still stayed and Jame’s voice was weak and he was prone to violent coughing at night. James’ parents brought him to Professor Syme once more, who was pleased with the improvement and congratulated himself that he had not attempted an operation, still believing the bone would remove itself.
Operating at Home
James continued to struggle with breathing, although his general health remained until 22nd June when his breathing worsened alarmingly and became agony for poor James. The family arranged to see Dr Syme once more. Henry describes how after half a minutes examination Dr Syme said, ‘(with a sad countenance for a man of his stamp), “that there [was] no chance now but an operation, but as it is one that has hitherto found so many unsuccessful I’ll take no responsibility upon me.”’
They had the opinion confirmed by Dr Johnstone on their return to Stirling and the only thing left was to decide whether to travel through to Edinburgh for the operation or have it performed at the Drummond’s home in Park Place. On Dr Johnstone's advice, the Drummonds decided to have the operation done at home and he wrote to Dr Syme asking him to come through to Stirling the following day.
New Anesthetics
On the 28th of June 1853, three and a half months after the bone had first become stuck and following the worst night of breathing for poor James, Dr Syme operated to remove the bone. The expert surgeon made an incision while James was under the influence of Chloroform.
The anaesthetic properties of Chloroform had been demonstrated by Scottish obstetrician James Young Simpson in 1847 and by the 1850s it was being produced on a commercial basis. In April of that year, Dr John Snow had administered chloroform to Queen Victorian for the birth of Prince Leopold, an event credited as improving public confidence in the substance. However, there were many, including those in the medical profession who still saw it as dangerous - The Lancet had recently described chloroform as ‘an agent which has unquestionably caused instantaneous death in a considerable number of cases… the deplorable catastrophes were clearly and indisputably referable to the poisonous action of chloroform, and to that cause alone.”[1]
Two anaesthetic inhalers, designed and made by P. Stenvenson of Edinburgh in the mid-19th century found in the National Museums Scotland T.1861.698.1 and T.1861.698.2. James Drummond would likely have inhaled the chloroform through something similar to these.
However, it was clear in the diary that for little Jamie there was no other option. The family describes the arrival of both doctors that morning as like the arrival of a hearse. After making a small incision, Dr Syme placed his finger in the boy's throat and felt a sharp resistance. The bone had become firmly fixed in the windpipe by two sharp corners and could only be extracted with a heavy pull.
Marble sculpture of James Syme’s hand, found in the Royal College of Surgeons Edinburgh Collection HC.AS.1.11
Dr Syme said he never had performed one he felt more proud of, he had so very little hopes of success indeed he expected to hear of poor Jame's death on his arrival at the station. The events had caused a ‘great sensation in Stirling’ with everyone in the town and neighbourhood feeling deeply interested in his recovery.
Thankfully James recovered fully, this account not only describes the turmoil for his family but also links to advances in the history of medicine, like the use of chloroform, the practices of Doctors at the time and patient outcomes. By looking at non-medical collections referencing medical events we can understand more the decisions and impact on patients and their families.
[1] Editorial. The Lancet 453, May 14, 1853.