Rutherford Morison

Biography

• Born 10 October 1853 in Hutton-Henry, County Durham. Son of surgeon John Morison
• 1874 – LRCP
• 1875 – MB, Edinburgh
• 1876 – General practice in Hartlepool
• 1888 – Assistant surgeon at the Royal Victoria Hospital, Newcastle under the influence of Sir David Drummond (1852 – 1932)
• 1890 – MRCS, FRCS
• 1897 – Editor of the Journal of the Northumberland and Durham Medical Society
• 1916 – Whilst serving in the Northumberland War Hospital, he introduced BIPP to operations
• 1919 – Hon LLD; MA; and DCL Durham. Elected fellow of the American College of Surgeons
• Died 9 January 1939 Newcastle-upon-Tyne

Medical Eponyms

Pouch of Rutherford Morison* (1894)

[* aka Morison’s pouch; pouch of Morison; hepatorenal recess; subhepatic recess]

In 1894, Morison published his anatomic description of the hepatorenal space; its role in the surgical treatment of gallbladder disease; and proposed the value of postoperative drainage of that space.

Morison indicated that with the liver retracted upward and the transverse colon downward, one would expose a potential space. The proposed space has an anterior wall bounded right to left by the peritoneal surface of the diaphragm and the undersurface of the right lobe of the liver and gallbladder, extending to the gastrohepatic ligament. The posterior wall formed by the ascending mesocolon over the right kidney and by the duodenum.

…underneath the right lobe of the liver there exists a pouch hitherto undescribed, shut off by natural barriers from the general peritoneal cavity….By the relation of nine cases in which the operation for gall-stone was performed in accordance with the principles I was advocating, I endeavored to show that the secret of success in gall-stone operations was efficient drainage of the pouch demonstrated.

Rutherford Morison 1895

Morison proposed that the drain tract for this space would most advantageously exit in the area of the lower pole of the right kidney. Morison viewed provision for adequate postcholecystectomy drainage of this dependent space as a paramount feature of a successful operation.

BIPP: Bismuth, iodoform and paraffin paste

Morison introduced “BIPP” for the prophylaxis of sepsis in traumatic war wounds sutured primarily.

WOUND infection has been the great surgical curse of this war. Until recently all the means I had seen tried at our War Hospital had failed to satisfy the most moderate surgical ambitions. Since I have now developed a simple method, necessitating but few dressings, by which many wounds can be sterilised at once, while in the remainder, so far as my present experience goes, the spread of infection can be checked and limited, I consider it a duty to submit results without further delay.

The paste : Bismuth subnitrate, 1 oz.; iodoform 2 oz.; paraffin liq. q.s. to make a thick paste. I suggest for this the name “Bipp.” A convenient means of applying it was suggested to me by Sister Middleton, of Ward 20. She gave me two bone eggspoon , one to lift the paste and the second to plaster it in and on with.

Rutherford Morison: Lancet, 1916

In the Lancet 1916, I published a method of treating infected, suppurating war wounds, and claimed for it that in some cases sterilisation of the wound could be accomplished at once, and that in the remainder the spread of infection could be checked and limited…

Rutherford Morison: BJS, 1916

Key Medical Attributions

• Along with David Drummond, Morison introduced omentopexy as a cure for ascites

Controversies

Major Publications

• Morison JR The anatomy of right hypochondrium relating especially to operations for gall stones. Br Med J 1894; 2: 968-971 [Morison Pouch]
• Morison R. On Gall-stones. Ann Surg. 1895; 22(2): 181–204. [Morison Pouch]
• Morison R. A Case of ascites due to liver cirrhosis treated by operation. Ann Surg. 1903; 38(3): 361-6
• Morison R. XI. A Clamp for the Fixation of Ununited Fractures. Ann Surg. 1909; 50(6): 1114–1117.
• Rutherford Morison J. An introduction to surgery. 1910
• Rutherford Morison, Richardson WG. Abdominal injuries. 1915
• Rutherford Morison J. The treatment of infected suppurating war wounds. The Lancet, 1916; 188(4850): 268-272. [BIPP]
• Rutherford Morison J. The treatment of infected suppurating war wounds. British Journal of Surgery 1916; 4(16): 659-678 [BIPP]
• Rutherford Morison. Surgical contributions from 1881-1916 – General Surgery. 1916
• Rutherford Morison. Surgical contributions from 1881-1916 – Abdominal Surgery. 1916
• Rutherford Morison J. BIPP treatment of war wounds. 1918

References

• Bibliography. James Rutherford Morison. World Cat Identities
• Biography: James Rutherford Morison. Plarr’s Lives of the Fellows Online. Royal College of Surgeons of England.
• Biography: Presentation to Rutherford Morison. Br Med J 1915; 2: 455
• Obituary: James Rutherford Morison. Br Med J 1939;1:139; 1939;1:194
• Obituary: James Rutherford Morison. Lancet; 233(6021): 178
• Gilliam JW Jr, Schein CJ. The Morison Pouch. Arch Surg. 1976; 111(3): 227-228
• Hajdu N, de Lacey G. The Rutherford Morison pouch; a characteristic appearance on abdominal radiographs. Br J Radiol. 1970; 43(514): 706-9