William Cheselden Biography (1688-1752)


William Cheselden, a quick and precise surgeon who could remove bladder stones in less than one minute, was instrumental in raising surgery to a profession. Cheselden also was a significant educator on the early teachings of anatomy, and served as court physician to Queen Caroline.

Born in 1688 in Somerby, Leicestershire, England, Cheselden's premedical education consisted of classical Greek and Latin literature. At age 15 he was apprenticed to a Leicester surgeon. Moving to London, he studied under the anatomist William Cowper and James Ferne, a surgeon at St. Thomas's Hospital.

After Cheselden was admitted to the Company of Barber-Surgeons, he began lecturing on anatomy at St. Thomas's at age 22. Three years after that, hepublished Anatomy of the Human Body, which was written in English instead of the Latin, which was commonly used for such books. Cheselden's Anatomy remained in print for almost a century. Venturing beyond mere structural anatomy, it described the role of saliva in digestion. At the time, digestion was generally believed to result from the mechanical actions of the abdominal muscles and diaphragm on the stomach, but Cheselden argued that otherparts of the abdomen especially the fetus in a pregnant woman received more muscular force than the stomach, yet were never digested.

His Anatomy was not only appreciated for its scientific merit, but forits artistic quality as well. This was also true of a book later written byCheselden, Osteographia, or the Anatomy of the Bones, also published in numerous editions. The initial pages of Osteographia contained muchadmired illustrations of the skeletons of the crocodile, bear, ostrich, and other animals in action, produced with the help of a camera obscura, a predecessor of the photographic camera.

Led by Cheselden, London surgeons left the Company of Barber-Surgeons in 1745to form their own Company of Surgeons, which would later evolve into the Royal College of Surgeons of England. The uneasy relationship with barbers had existed since 1540, but by the 1700s surgeons were becoming better educated than their hair-clipping colleagues and Cheselden and others pushed for professional recognition.

In 1727, Cheselden introduced to England the lateral lithotomy procedure forswift removal of bladder stones. Prior to that, stones were removed using instruments inserted through the urethra, which was enlarged by surgical incision. Cheselden's quick method, adopted from the French surgeon Jacques de Beaulieu, involved cutting through the perineum (the area between the anus and theurethral opening). Since surgical anesthesia was not developed until the nineteenth century, Cheselden's patients, with little more than rum to ease their pain, appreciated the speed of his procedures. His average time for performing a lateral lithotomy is estimated between 30 and 90 seconds.Cheselden's innovation remained in use for more than 200 years until it was replaced by a procedure that mechanically crushes the stones.

Another major accomplishment was his restoration of sight to a young man whohad been blind since birth. Cheselden performed an iridotomy, using a cataract-extraction knife to create an artificial pupil.

Despite his skill, Cheselden, however, experienced considerable anxiety before his operations. He wrote: "If I have any reputation in this way I have earned it dearly, for no one ever endured more anxiety and sickness before an operation, yet from the time I began to operate all uneasiness ceased and if I have had better success than some others I do not impute it to more knowledgebut to the happiness of mind that was never ruffled or disconcerted and a hand that never trembled during any operation."

Cheselden was appointed physician to the Court of Queen Caroline in 1727, butappears to have somehow fallen from royal favor during the following decadewhen the Queen died in 1737 of a strangulated umbilical hernia and was not consulted.

Just before his death in 1752, Cheselden provided surgical training to John Hunter, now considered a founder of pathological anatomy.

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