有一个名字所有的医学生和医生都认识，他就是发现和命名急性阑尾炎的压痛点，即麦氏点，定义了阑尾切除术基本手术技术原则，手术切口也以他的名字命名，即麦氏切口，这位医生被称为阑尾切除术的先驱，他就是：Charles McBurney。
关于他的生平介绍不多，可能的原因是他的时代是医学逐渐走向成熟的阶段，因此没有比他早一个世纪的那些先哲们那么耀眼。
昨晚看到一篇关于Charles McBurney的生平介绍不多，与大家分享。
The name of Charles McBurney is linked now and forever with appendicitis, for which he described a diagnostic sign (1889) and a surgical incision (1894), both of which bear his name .
Yet McBurney's interests and achievements ranged beyond the vermiform appendix. He was also a pioneer in operations on the common bile duct, although his contributions in this area failed to gain him an eponymic reward.
In 1891 he operated on a 43-year-old jaundiced woman
who came to him with a diagnosis of "cancer" but whose
history suggested "gallstone was the cause of the trouble."
At operation, he found a "very dense mass" behind the
duodenum but failed to find the gallbladder. "By careful
manipulation and by exploring.., with a round needle," he
demonstrated the mass to be a gallstone "in the cystic duct"
[sic]. He decided to approach the stone through an incision
in the duodenum, which showed the stone to be "raising the
mucosa" of the ampulla near its orifice, into the intestine.
He then "cut through the mucosa" into the duct, and "slit
it upward," and thus was able to extricate the stone through
the incised ampulla. The intestine was "sewed up in the
usual manner" and the patient made an "unbroken recovery." The original textual reference to the "cystic duct" undoubtedly referred to the intraduodenal portion of the
common bile duct. In his later publications he corrected the
terminology "cystic duct" to read "common duct."
Encouraged by this experience, he performed a similar operation on "six different occasions" which he reported in 1898 . With a probe in the ampullary orifice he incised the mucosa over the ampulla, dilated the ampulla with forceps, and then manipulated the stone into the duodenum for retrieval. He stated that "my experience would lead me to prefer this plan for the removal of a calculus situated at any point from the termination of the cystic duct to the point of entrance of the common duct into the duodenum," He felt that the orifice of the duct "may be freely incised for at least half an inch in perfect safety."
It was this approach to the common duct via the duodenum, with ampullary dilatation and sphincterotomy, that McBurney advocated as a simpler, safer approach to common duct stones than anterior choledochotomy. Subsequent history did not support this view and this recommendation was not accorded the reception that McBurney thought it deserved. Nevertheless, this novel approach anticipated by at least half a century the operation of sphincterotomy for common duct stones, now a mainstay of endoscopic prac- tice.
Charles McBurney received his M.D. from the College of Physicians and Surgeons in New York in 1870 and interned at Bellevue Hospital in 1871. After a short postgraduate sojourn in Vienna, Paris, and London, he entered the practice of medicine in New York City in 1872. Although he served on the staff of a number of New York Hospitals, his major allegiance was to Roosevelt Hospital, where he was the sole visiting surgeon. It was at Roosevelt Hospital that a philanthropic bequest enabled Dr. McBurney to plan and direct the building of a model private surgical pavilion, "The Syms Operating Pavilion." This surgical facility, opened in 1892, achieved national and worldwide prominence for its surgical teaching and research. It was here that he introduced the practice of having the entire surgical team wear rubber gloves, shortly after Halsted had recommended this practice at Johns Hopkins.
Although the Syms amphitheater and operating rooms no longer function as such at the present St. Lukes Roosevelt Hospital in New York, a small segment of the original building is still designated as a New York City landmark.
McBurney's principal academic affiliation was to the College of Physicians and Surgeons (Columbia University), where he was professor of surgery from 1889 to 1894 and clinical professor until his retirement in 1907.
McBurney's incision for his biliary tract surgery was a 4-inch incision "under the tenth rib alongside the rectus muscle." What finally evolved as the "McBurney" incision for appendicitis was not evident in his 1889 publication, Therein he advised, "The incision should be a liberal one.., and a five inch cut in the adult is not too much. It should follow as nearly as possible the right edge of the rectus muscle." The gridiron incision which he described in 1894 had actually been described before by Louis L. McArthur, who had used it prior to McBurney in 60 cases. McBurney gracefully acknowledged this primacy, but history has not done as well. It is, has been, and shall always be the "McBurney" incision for many generations of surgeons, all striving for the most inconspicuous evidence of their handiwork. Laparoscopic appendectomy carries this cosmetic goal to near-perfection.
Charles McBurney died in Brookline, Massachusetts, in 1913. His legacy to surgery of the biliary tract was not awarded the recognition that his contributions in appendi citis received. But his early advocacy of sphincterotomy for common duct stone is worthy of remembrance.
