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D'Arcy Little MD CCFP FCFP FRCPC,

D’Arcy Little, MD, CCFP, FCFP, FRCPC, Medical Director, Journal of Current Clinical Care and www.healthplexus.net Radiologist, Orillia Soldiers’ Memorial Hospital, Adjunct Assistant Professor, Department of Medical Imaging cross-appointed to Department of Family and Community Medicine, University of Toronto, University of Toronto, Toronto, ON.

CLINICAL TOOLS

Abstract:
This article explores Edinburgh’s pivotal role in the evolution of medicine through the perspective of a radiologist attending a medical conference. Walking from the Real Mary King’s Close to Surgeons’ Hall and the old Royal Infirmary, the author reflects on the transition from humoral theory to antiseptic surgery, highlighting Joseph Bell, Joseph Lister, and a remarkable Brodie’s abscess specimen. The journey underscores the enduring importance of observation, evidence, and compassionate patient care.

Key Words: medical history, Edinburgh, antisepsis, radiology.
Medical history is local and walkable in Edinburgh. The Real Mary King’s Close, the Surgeons’ Hall Museums (Royal College of Surgeons of Edinburgh), and the old Royal Infirmary buildings near Infirmary Street sit within a short walk of one another and trace medicine from the humoral era to antisepsis.
Joseph Bell’s clinical observation, taught at the Edinburgh medical school, inspired Conan Doyle’s Sherlock Holmes—and remains a useful emblem of diagnostic reasoning, including the inference-from-evidence at the heart of radiology.
Joseph Lister’s antisepsis is commemorated on Infirmary Street by a plaque installed in 1957 by physicians from Toronto.
William Ernest Henley wrote “Invictus” (1875) while under Lister’s care, fighting to save his remaining foot from tuberculosis of the bone; he later inspired Stevenson’s Long John Silver.
Brodie’s abscess is a subacute/chronic osteomyelitis presenting as a walled-off intraosseous abscess, classically in the metaphysis of a long bone (often the tibia), typically due to Staphylococcus aureus. It is characteristically indolent and can mimic a bone tumour. On radiographs it appears as a lucent lesion with a sclerotic reactive rim; on MRI the “penumbra sign”—a rim of granulation tissue around the cavity—is a helpful discriminator. The museum’s specimen, in which the patient fashioned a wooden plug to drain the cavity intermittently, is a striking pre-antibiotic illustration of the same lesion clinicians still encounter today.
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Related Terms: Radiology, medical history, Edinburgh, antisepsis, radiology
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