In 1894 Lambotte performed, successfully, his first gastrectomy. In 1900 he succeeded Dr. Léon Desguin as chief surgeon of the Stuyvenberg Hospital and performed his first laminectomies and craniotomies. He advocated, almost 100 years ago, in carefully selected cases of cerebral hemorrhage, prompt trephining and removal of the blood clot. Eighty years ago he insisted that the only justifiable method of treating osteoartic- ular tuberculosis was immediate and complete cleaning out of the focus of infection, even though it involved extensive bone resection. This was before the days of antibiotics. His colleagues shrugged their shoulders.
Although his reputation as a general surgeon had already spread beyond the borders of Belgium, it was in a professional atmosphere of indifference and even hostility that, in 1902, he began his work on osteosynthesis of the femur.
He faced at once the absence of tools for his new trade. In the following years, his time was divided between operating room and his workshop, where he designed, forged, hammered and, on his lathe, turned his devices for fixation and the instruments for manipulating them. As he made them, he tried them. If they performed acceptably, he made a model and sent it to Paris, to Collin, who had an unbounded admiration for his work. Lambotte believed that tool making was excellent training for the techniques of orthopedic surgery. He impressed the value of this form of manual train- ing on all his students. They learned to drill with precision, to saw a straight line, to tape a thread smoothly. His relationship to them was alternately that of professor to students and that of master workman to apprentices. His book, never trans- lated, Chirugie Operatoire des Fractures, was published in Paris in 1913.
The many testimonials that have appeared since his death are all eloquent of Albin Lambotte’s influence on his students and their affection for him. His interests covered many fields in addition to surgery and all were included in his teaching.
He loved music, loved to make music. He was quite happy as one of a chamber music quartette.
He became a violin maker, designed a new bridge, made violas, violins, and violin cellos. The Queen of Belgium, and the conservatories of Paris, Brus- sels and Antwerp are proud possessors of his hand- iwork. He read widely and catholically, from Plutarch to Perrault to Simenon. His interest in art made him first a frequenter of museums and then, typically, a sketcher of no mean talent and an accomplished wood carver.
In the interests of surgery, he traveled widely.
On a long voyage to Buenos Aires, he became interested in astronomy, and, once back in his workshop, made a telescope. An ardent fly fish- erman, he designed and made his own feather- weight reel and his own split bamboo rod. All of these interests he offered to the men who studied under him.
He roused, the day before his death, to say to his wife: “the greatest crime a man commits against himself and humanity is to be inactive.”
182 Who’s Who in Orthopedics
Constantine LAMBRINUDI
1890–1943
Constantine Lambrinudi enjoyed a unique posi- tion in British surgery because he, more than any of his contemporaries, advanced the mechanistic concept of orthopedic surgery. He was a man of striking personality and great charm, and his character was made all the more impressive by the absence of what many consider essential qual- ities in an orthopedic surgeon of the first rank.
Lambrinudi cared little for administration, and those who worked with him did so because they enjoyed it rather than as members of a depart- mental machine. It may have been that his physi- cal disability compelled him to devote all his attention to what he loved most, leaving the rest to take care of itself. In late years of life, his health and even his life were endangered by heart
disease; and when, to his own delight and that of his friends, he was allowed back to work, his activities were severely restricted for a long time, and all heavy physical effort had to be avoided.
He knew that he would not live for many years, but in spite of this, perhaps because of it, he returned to his work with an infectious gaiety and unquenchable enthusiasm.
It may be that Lambrinudi’s name is not widely known outside Britain. Here there was no ant-like industry to leave a dusty monument of publica- tions; his life was too short and too chequered by reverses. In any case humdrum work was dis- tasteful to him; he had hardly any use for col- lected data, for statistics, or for the well-worn methods of pathological investigation. Once when he was asked to look at a section he said,
“It’s no use expecting me to see anything there, I’m color blind.” Perhaps he was, yet the truth was that he cared little about the material struc- ture of the body, but everything about its mecha- nism, about form in relation to function.
Lambrinudi spent endless time studying the workings of the foot. Out of this labor came his conception of a stabilizing operation for drop- foot, and the first rational procedure for the cor- rection of clawing of the toes in pes cavus—so well thought out that he predicted and proved that in the milder cases correction of the action of the toes would reduce the deformity of the arch itself—and his description of the condition, which he called metatarsus elevatus. It was the same in his work on adolescent kyphosis and congenital dislocation of the hip. His recent advocacy of the teaching of orthopedic surgery in the first clinical years sprang from a conviction that no knowledge of the body, in health or disease, could be com- plete without some understanding of the machin- ery of the limbs, the spine, and the body as a whole; and he undoubtedly put his finger on a weak point in medical teaching.
In the last year of his life, Lambrinudi made plans to write a book on orthopedic surgery. It is lamentable that now it can never be written, for it might well have brought out his emphasis upon function and vital mechanics from beneath the shapeless mass of pathological data, carpenters’
tricks, and shaky generalizations that we find in most textbooks on orthopedic surgery and that obscure the fact that whatever else it may be, the greater part of the body is, in a literal sense, a machine.
There is, however, no need to fear that Lambrinudi will be forgotten. His many friends
will always remember the refreshing vigor of his conversation, his boyish delight in discovery—
whether the work was his own or another’s—and his outspoken but good-humored contempt for humbug and hypocrisy. Very occasionally the chain of his physical weakness produced signs of chafing; but there was no bitterness in him only regret, that he could not do all that his eager spirit desired. While yet a medical student he had served the country of his birth in the Balkan wars.
Just before the Second World War he played with the idea of going there again, to set up a national orthopedic scheme. As he said, “I’d have a shot at being the Robert Jones of Greece.” Lam- brinudi succeeded Trethowan as orthopedic surgeon at Guy’s; he was president of the Ortho- pedic Section of the Royal Society of Medicine;
and he served two terms as a member of the Executive Committee of the British Orthopaedic Association. He held other offices, too. Yet these are only the professional trappings, and it is the man and his character that stand out in the remembrance of his colleagues who mourn his early death.
183
Who’s Who in Orthopedics
Sir William Arbuthnot LANE
1856–1943
Sir William Arbuthnot Lane was a surgeon of sur- passing operative dexterity and by his pioneer work has exerted great influence on bone surgery.
