Lionel's Legacy

The Iodine Legacy

Every individual is a creature of his or her time and of their environment and this is as true of Lionel Stretton as anyone. If being born into a supportive, medical family was just chance, in other respects, the times and events could not have been more fortuitous. The late Victorian medical period was a time of great advances in public health, in surgery and in patient care. The proper application of science to medicine for the first time saw mortality rates decline steeply during the Victorian period and into the 20th century. (Estimates are that the death rate declined from about 21.8 per thousand per year in 1868 to 11.7 in 1926 - source Death in the Victorian Family, Pat Jalland). For the first time it could really be said that doctors and nurses were making a difference in the health of the adult and infant population at large.

There were other ways that Lionel shared in the general advances of the Victorian and Edwardian period that were going on all around him. This was one of the great periods of innovation in many fields, not just in medicine. Communication, education, leisure, travel and the appearance of the first consumer items were changing the world. The air was filled with the expectation of improvement. In parallel scientific fields, inventors, businessmen and scientists were inventing, improving and fine tuning products in a way that had never been experienced previously. Competition to be first, to be better and to discover were the motifs of the age.

This technological and social change is something we instantly recognise today, but, as Lionel Stretton's life demonstrates, the technological changes also coincided with a great period of public service. Education reform, civic improvement schemes were combined in with the idea of service linked to the British Empire. There was less expectation of financial reward for this contribution to the public good than there is today. This may in part be one of the reasons Lionel Stretton is less well known today than he should be.

Why is 'tincture of iodine' so important?

Writing in December, 1910, Charles L Gibson, the surgeon of St Luke's Hospital in New York described tincture of iodine's benefits:

  1. Its greater efficiency in emergency cases
  2. Its absolute simplicity, saving time, labor, and expense for ante-operation dressings
  3. The avoidance of discomfort and psychical disturbance
  4. the patient in abolishing the trying and oftentimes terrifying " preparation."
  5. The suppression of the painful and dangerous dermatitis frequently provoked by soap poultices and antiseptic solutions

Ground Breaking Science

If Lister was the pioneer of antiseptic surgery, Lionel Stretton was one of the second wave of pioneers intent on improving and enhancing Lister's work. His association with identifying and refining the use of "tincture of iodine" was ground breaking in a number of ways. Two articles in the British Medical Journal provided the hard science to back up his adoption and adaptation of the techniques of the early users of iodine. His research was an outstanding piece of scientific work demonstrating the direct benefits of using tincture of iodine at specific, lower concentrations which reduced the irritation associated with earlier treatments.

More rapid, highly effective sterilisation was now available at a low cost. Preparation time and effort by the surgeon and staff was radically reduced. Local sterilisation of a small wound became a possibility, which was even more important in the context of the dirty conditions that many people worked in. The armoury of techniques the professional surgeon had at his or her fingertips to ensure patient survival expanded.

If proof of the efficacy of "tincture of iodine" was needed, Lionel himself was to report of its widespread use in battlefield situations by 1915. Until superceded by flavine and the use of preprepared dressings, ampoules would be carried in First Aid kits by soldiers and sailors as a sure way of preventing local infection. It was still carried in the M2 first aid kit by US Marines in the Second World War.

The Other Inventions and Improvements

If Lionel had done nothing but the 40,000 operations he made in his lifetime, that would have been enough for most people, but he was responsible for developing several of his own inventions for improving surgical practice, including operating tables, cabinets for operating equipment, commodes to help patients after surgery and many other medical improvements.

In his biography, we also see Lionel involved in local politics where he took an active role in trying to improving the living conditions of the local lodging houses. He was a prolific contributor to the British Medical Journal

Nursing, Medical and Administrative Contribution

Lionel took a real interest in the improvements in nursing. Part of this was through his involvement with various management committees and the local board of health, but, like his father before him, he worked tirelessly with the local matrons to support nursing training with lectures and nurses working conditions with campaigns for improved working and living conditions.

His legacy would also include his work to provide proper ambulance services and training for ambulance workers and the introduction of X-rays into the Kidderminster Hospitals. We know this thanks not only to his own memoirs but to the part the family played in local politics and to the evidence of various money raising drives which were what was needed to raise the funds for each of the improvements:

  • Nurses training scheme - 1890s
  • X-ray facility - 1910
  • New nurses home - 1913
  • Kidderminster and District General Hospital extension - 1926

 On top of this, there was almost no medical or charitable organization that Lionel was not associated with. When you realise that he was for many years the President of the Group which administered the hospital and raised most of its funds, and that he was the major figure in the local BMA and medical groups, you begin to wonder how he found the time to commit so much of himself to his work. He provided his own answer:

"Some men - and I am happy to be one of them - are so infatuated... with their occupation that they never want to leave it and they do not get stale at it... My own work provides me with constant changes. No two cases are alike and the study of their infinte variety is so fascinating to me that I have been unable to tear myself away for the past thirty years. I cannot help feeling that my own experience negatives the present-day fetish that an annual holiday is necessary for everyone."