He died of carcinoma of the mandible.

career flourished and included later appointment to the chairs of surgery at the universities of Bonn and Leipzig. He was an important leader in German surgery during the last half of the nine- teenth century. He was the founder of the German Society of Surgeons and became its president.

Trendelenburg was a practical surgeon of wide experience. He popularized what has become known as the Trendelenburg position as an aid to performing pelvic and lower abdominal pro- cedures. He raised the possibility of surgically removing pulmonary emboli of large blood clots, although he never performed the operation itself.

He died of carcinoma of the mandible.

make full notes and to write long explanatory letters to doctors. Fortunately, a selection of these letters expressing Trethowan’s views on topical orthopedic conditions (foot anomalies, abnormal- ities of the back, disorders of the knee and bone grafting) has been published in book form by his associates, Lambrinudi and Stamen. Reading these is almost to hear the fervent advocacy or condemnation all over again. It is to be hoped that this remarkably fine little book, containing the views of one of the greatest, if not always the soundest, of teachers will be reproduced.

One recalls his outpatient sessions: there was never a dull moment. His imitations of gaits in various orthopedic conditions can never be for- gotten by any who had the good fortune to be present. He maintained that the object of ortho- pedic surgery could be written on a thumbnail—

function. As an operator he has never been equalled. Indeed, a house surgeon of his once said: “I would insist on Treth (as he was known to all) doing in my operation if Elmslie decided that an operation was necessary.” A disciple of Arbuthnot Lane, he quickly mastered the no- touch technique and applied it to every operation, great and small. His incisions were long, to enable him to see before he cut and to make it unneces- sary to use the sense of touch. He never ligated vessels, maintaining that if a surgeon exposed bone at its most superficial point and stayed close to bone, he was unlikely to cut any vessels of importance.

Bone-grafting was perhaps his special forte. He favored long intramedullary insertion of the graft at one end and a mortise fit to the circumference of the bone at the other. In the writer’s judgment he was a greater technician in this field than Albee, who was not embarrassed by adherence to a no-touch technique!

At conferences he often favored the dramatic touch. Few will ever forget seeing him, during a discussion, probably on foot deformities, spring to his feet brandishing a Thomas’ wrench and exclaiming, “This is a barbarous weapon!” as he threw it to the floor. His good friend Robert Jones was not perturbed and let the remark pass with a kindly smile. Trethowan was a generous friend and a remarkable host. No one enjoyed a party more and he was always the last to leave. Many will recall parties at his Hampstead home where in the billiard room he had installed an enormous organ. An able performer, he would begin to play perhaps at midnight and continue fortissimo well into the early hours of the morning. He was a

Who’s Who in Orthopedics

W.H. TRETHOWAN

1882–1934

W.H. Trethowan was a student of Guy’s Hospital and was appointed its first orthopedic surgeon in 1912. He was one of Robert Jones’ team at Shepherd’s Bush in World War I. After the war, he joined the staffs of the Royal National Orthopedic Hospital and Queen Mary’s Hospital for Children, Carshalton, and quickly established one of the largest private practices in London.

He was a genius; but unfortunately he seldom

committed his ideas to print. Indeed, his only

writings were “The Treatment of Simple Frac-

tures” in Robert Jones’ Textbook of Military

Orthopedic Surgery (1920) and an article of

singular clarity and brevity on orthopedics in

Choyce’s System of Surgery. It was his custom to

Joseph TRUETA

1897–1977

Joseph Trueta was professor emeritus of orthope- dic surgery in the University of Oxford. He qualified in Barcelona and became chief surgeon to the Caja de Provision y Socorro in 1929. As professor of surgery in Barcelona in 1935, he was faced, almost at once, with the problem of treating the casualties of the Spanish Civil War, which led him to develop the closed plaster tech- nique. Early in 1939, his liberal convictions drove him to move himself and his family to London, where his first-hand experience of air-raid surgery resulted in a great demand for his services as a lecturer and an invitation to Oxford as an adviser to the Ministry of Health. In 1949, he was elected to the Nuffield Chair of Orthopedic Surgery in Oxford and held this post until 1966. He was thus able to reorganize the Wingfield Morris Hospital as the Nuffield Orthopedic Centre and produce a steady stream of publications on almost every aspect of orthopedic surgery. His international reputation was recognized by an honorary DSc from the University of Oxford, and an honorary fellowship of the Royal Colleges of Surgeons of England and of Canada, and of the American College of Surgeons. He was an Officier de la Légion d’Honneur and honorary fellow of many other orthopedic associations round the world.

great figure, a most simulating chief, and a good friend.

The British Orthopedic Association presented him with the scroll of honorary fellowship during the sixth combined meeting in September 1976.

Joseph Trueta retired to his Catalonian mother- land in 1966 but continued his surgical and sci- entific work. He died on January 19, 1977, in his 80th year. His wife died in 1975, but he was sur- vived by his three daughters.

Many are so familiar with Trueta’s work on war (and other) wounds that there is no need to reca- pitulate his perfection of the method that Winnett Orr had previously and somewhat hesitantly devised. That Trueta arrived in this country in 1939 was a godsend; after a short-lived display of characteristic British scepticism, we were con- verted to the “closed-plaster” regimen. I had the immense privilege of seeing those wounds before and after he had dealt with them: but it fell to my lot to take a later look inside far more often than even J.T. himself. Because the Wingfield was an official nerve injuries center, hundreds of men with complex injuries came to us. Trueta—and Jim Scott—dealt with their soft-tissue and skele- tal injuries—apart from the damaged nerves, which we tackled as soon as they said it was safe to do so. Scores of photographs attest how benign was the scarring we encountered.

J.T.’s energy and scholarship were immense.

He made time for some refined experiments on the renal circulation, prompted by the anuria that is sometimes seen after a severe crushing injury of a leg. He and John Barnes found that the appli- cation of a tourniquet to a rabbit’s hind leg pro- duced arterial spasm extending up to the renal vessels. An imposing team headed by J.T. and Barclay produced an account of a comprehensive study in 1947. It was not accepted by the nephrol- ogists. Now I have it from one of the best of them that Trueta and his colleagues were very nearly right, but they overstressed the shutting down of the cortical, as opposed to the medullary, circula- tion. I quote: “the standing of Trueta, Barclay et al. is therefore very high still.”

But perhaps one remembers this great man best as the embodiment of the Spirit of Catalonia (the title of a work of filial piety that he published in 1946). It was always a pleasure to see his fine figure and handsome, vivacious face, and to listen to him, even though he never quite understood that going at top speed in a foreign tongue was not exactly the same as fluency. But there were

Who’s Who in Orthopedics