GORDON LOWE Talk

A SHORT HISTORY OF SCOTTISH MEDICINE
Gordon Lowe was Professor of Vascular Medicine from 1993; and Chair of the Scottish Clinical Guidelines Network (SIGN), 2002-2007. His talk comprised an introduction to Scottish Medical History, tracing its evolution during the Pre-historic, Roman and Monastic eras up to the present day. Gordon emphasised how Scotland has punched well above its weight in terms of its contribution to the development of modern medicine. The story began in prehistoric times from 3000 BC with grains of Spirea, from which Aspirin could be derived, being found in Scara Brae in Orkney, and signs of skull trepanning found in a skeleton dating from the Bronze Age in Bute. In the Roman era from 84-211 AD there was sanitation, hospitals, surgical instruments and also the earliest prescriptions for herbal medicines.
The tale continued with the herbal medicines and healing pools of the early Christian Era and the roles of monasteries, with, for example, the opening of saints’ tombs to pilgrims seeking cures. In Glasgow, Provands Lordship next to Glasgow Cathedral, was one of the earliest hospitals, founded in 1471. From the 16th Century with the renaissance came also a medical renaissance, in which Scotland played a pivotal role, with medical students travelling to study in European centres, and the development of the Royal Colleges.
The 18th century saw the establishment of the Scottish University Medical Schools and the Royal Infirmaries. And from the mid-18th Century the Scottish Enlightenment also brought with it further developments in science and medicine with a rapid acceleration in understanding of diseases and their causes culminating in the development of scientific medicine. Milestones included: the provision of free smallpox vaccination in Glasgow; the first controlled trial of treatment for scurvy with the role of citrus fruits being identified; the use of Chloroform for general anaesthesia; the development of antiseptic and then aseptic surgery; and, in the late 19th Century, the first clinical X-ray department.
From the 19th Century up to the present with numerous developments included: the first TB hospital in Edinburgh in 1887 with the regime developed there leading to a halving of the death rate from TB; immunisation for deadly diseases such as diphtheria also greatly reducing deaths from infections; and the discovery of insulin and the successful treatment of diabetes with John McLeod in Aberdeen sharing the Nobel Prize for this discovery.
Scots who have continued to play major roles in the development of modern medicine and health services up to the present day include: Alexander Fleming who discovered penicillin; John Crofton in Edinburgh who was involved in trials of triple therapy for TB; and Kenneth Murray in Edinburgh who developed a vaccine for hepatitis B. The tale continues with developments too numerous to itemise in the fields of cardiovascular disease. Neurosurgery, Pharmacology and Psychiatry. Archie Cochrane and Ian Chalmers were also particularly involved in the development of evidence-based medicine.
Gordon noted that, despite its distinguished history in relation to the development of medicine, Scotland was also notable for the poor health of many in its population, spurring developments in Public Health and moves to overcome marked health inequalities.