A Medico-Technical Appendix to Postblogging Technology, July 1953: Heart-Lung Machines and Autopilots

 

I guess it won't surprise anyone that Port Alice didn't have a movie theatre, so I saw most of the movies that shaped us Gen Xers (more-or-less; technically I belong to the last gasp of the Baby Boom) on TV at a later date. Star Wars IV and 1982's Young Doctors in Love are exceptions, and, of  the two, A New Hope was the better movie. Does Young Doctors in Love even have a life support/heart-lung machine scene? I guess it also won't surprise anyone that I am not going to rewatch it to find out! It's probably not nearly as hilarious as I remember, from the look of the Youtube extracts I watched looking for a heart-and-lunch machine scene. This one's got the surgical theatre-blinking-lights machines, so it will do, and I will preserve my nostalgia for a time just slightly past. 

Because times change! Way back on 24 September we covered the President's actual heart attack of 1954 in the context of a presumptively rumoured one of 1953 (that is, rumours of a previous heart attack came up during the post-hospitalisation press conference. I am assuming without proof that this is people taking a conspiratorial view of the President's  1953 flu hospitalisation, which seems to have dropped down the memory hole as far as the Internet is concerned, but, Goddamn it, it happened!  

Magamp module, collection of the
Avionics Museum, Rochester

Anyway, the point is that I wanted then to learn more about the President's guest-bedroom-ECG diagnosis, which seemed cool, and the home truth that there was nothing medicine could do about a heart attack in 1953 was brought home. This, you appreciate, is coming to me after a hard-driving departmental manager of my acquaintance had the inevitable-and-anticipated-for-many-years emergency admission quadruple bypass surgery, and the conversation within the company is how many months he would be off work. I advance this not-quite anecdote to illustrate how blase we've become about cardiac health, as even in 2023, considering the amount of work that T. use to do, the answer is "Forever months" although no doubt he'll be back in some capacity eventually. 

"Brukhonenko's Autojektor"

In contrast, in 1953, we have Eisenhower's heart attack and stroke on the horizon, Churchill's stroke, and Stalin's death to deal with, all in the summer of 1953. And we have the University of London's heart-and-lung machine, envisioned currently for use providing massive blood transfusions, and at some point in the future for "new surgical techniques, especially in heart and lung operations." The Wikipedia article on "Cardiopulmonary bypass machines" traces the history of the technology to the usual mad science origins, in this case the "Austrian-German physiologist Maximilian von Frey," who sounds straight out of central casting even before you realise that he was working in advance of the discovery of surgical blood thinners like heparin. Continuing down the B-movie path, "Soviet scientist Sergei Brukhonenko" built his own for "canine experiments," and Clarence Dennis of the University of Minnesota conducted the first surgery on a human patient involving "open cardiotomy with temporary mechanical takeover of both heart and lung functions." The patient did not survive, and we skip right on to the first successful surgery on record, carried out at the Thomas Jefferson Memorial in Philadelphia on 6 May 1953. The device used in this surgery went on to be further developed by Dr. John Kirklin, then of the Mayo Clinic. I've not reproduced most of the Wikipedia links in this even briefer summary of a brief history, but I've made an exception for Dr. Kirklin, who is made to sound in his biography like the practical inventor of the cardiopulmonary bypass machine, which had only been used once successfully prior to Dr. Kirklin's eight experimental surgeries of 1955 with 50% survival rate, a sentence which actually asserts that Gibbon's machine had only been used once successfully prior to Kirklin's work. As we've seen, the whole point of this post is that a magnetic amplifier-using heart-lunch machine was exhibited in Manchester in the summer of 1953. The Wikipedia history mentions that "a team of scientists at the University of Birmingham (including Eric Charles, a chemical engineer) were among the pioneers of this technology," but cites an article by Clarence Dennis with only a cursory literature review. 

Fortunately, the machine was later developed into a production series at Francis Kellerman's (he can't be obscure; there's a walk named after him in Colchester!) New Electronic Products, Ltd, and an example built in 1958 was donated to London's proprietary museum. An actual physical specimen is hard to memory hole, and the Science Museum online exhibit has some scanty details. Specifically, it was designed by D. G. (Dennis) Melrose, better known for discovering the role of potassium citrate in stopping the heart. This leads me to the full biography at the Royal College of Surgeons site, with an entry that must of been written by that one son who lives in his Dad's shadow forever, because the entry says, unabashedly, that "Dennis Melrose played a crucial role in designing and developing the first heart-lung machine." It also gives me Francis Kellermans' name and Hungarian emigre origins, although not much else about that worthy.   

The Engineer article describes the control apparatus of the heart-lung machine, which ideally would be automatic, but probably is nowhere near close to that in 1953, in some detail. The basic point being that we need the machine to back off what it is doing if the patient gets too hot, blood pressure rises too high, and so on. The mag-amp is favoured for giving speed control of the pump, and controlling the valve on a reservoir of blood in case pressure begins to fall. That makes it effectively the master unit  for the pump. I'm not clear on whether the heater is similarly controlled, but you would think so. 

The "English Electric Magamp" that, we've seen, is also going into the latest version of the Smith's Electric Pilot, is currently favoured because of its very high reliability compared with vacuum tubes. Transistors are as yet hardly in sight for such uses. A full explication of magnetic amplifier technology is found at Wikipedia at the previous link, which both mentions its use in "early Autoland applications," the very successful Elliot 803, which was an attempt to implement the potential of "magnetic logic," a hybrid of magnetic cores and semiconductors that produced one of the industry's early attempts to add a bit of secret sauce to the basics of digital logic. As you can see from the embedded photo, the one American attempt along this line, the Alwac III, was so early in computing history that the publicity photo shows a woman operating it like it was some kind of grotesquely complicated Burroughs accounting machine. (Which are for girls because it is for payroll and not aerodynamics.)

Anyway, it looks like the first successful cardiac operation in Britain was with the Melrose/Kellerman/NEP machine and not the prototype pictured in The Engineer, and it was in 1957, so several years after Kirklin's surgeries in the United States, so the inference is that the British team spent a few more years getting things right with their "heart and lung" machine before daring open-heart surgery with it. Hugh Henry Bentall,along with Bill Cleland, is credited with the first (unsuccessful) open heart surgery in the UK "in 1953"  and later joined the Melrose/Kellerman team, and an obituary based, it seems on a colleagues Arthur Hollman's recollections, notes that Melrose's machine "was not, of course, the first such piece of equipment." Ironically, the Melrose team's climactic moment was an open heart operation in Moscow for an almost unheard-of audience of Soviet surgeons who "[S]aw Melrose's machine at a trade fair somewhere" and invited him to Moscow to demonstrate it, the team flying home in a Tu-104, "the Russians' copy of the UK's Comet." Maybe the Russians were catching up on old numbers of The Engineer? 

By Lars Söderström - http://www.airliners.net/
photo/Aeroflot/Tupolev-TU-104B/0168123/L/, CC BY-SA 3.0,
https://commons.wikimedia.org/w/index.php?curid=4460512

So there you go. Someone had a University of London heart and lung machine in the summer of 1953. It was probably designed by Dennis Melrose and Francis Kellerman, but was not  used (at least successfully) for heart surgeries until 1957, at which point it became a minor export success out in soft-money country, being beat out for precedence by an American machine first used in a reliably successful way in 1955. 

As for the English Electric Magamp connection, a search brings me to this potted history of the company's Kidsgrove works, into which it moved in 1952 with various projects ongoing transferred in, including the "Luton Analogue Computing Engine," which  sounds like someone was laying the foundations for a third Austen Powers movie; but the Magamp work there started with control units salvaged from V-2s. English Electric also borrowed its first transistor designs from RCA, so there is plenty here to give aid and comfort to the Audit of War crowd, just not the story of this forgotten bid for cardiopulmonary bypass primacy. It is, however likely that equivalent technologies to the Magamp existed in Britain already and the issue is more one of recognising that all these things are the same thing. Arthur Cable's online memoirs explore his work with "the Illgner System" at the Steel Company of Wales works starting in 1950, a technology which was not then seen as using a "Magamp" because the word did not exist for what was, after all, a "controller" and not an "amplifier." (The difference being a matter of the arrangement of the logic gates.) 
 
 

Not this guy. Another guy. 

That being said, I've no reason to doubt that the Melrose/Kellerman design used English Electric Magamps explicitly modelled on the ones recovered from V-2s. So that's what I've got. No neat conclusion all wrapped up in bows, just a series of historical anecdotes framed around this episode in history of technology; another forgotten chapter, and, perhaps, grist for some kind of argument that British embarrassment and reticence about the jingoistic excesses of the "New Elizabethan Age" might be flipped on its head and turned into evidence that the "New Elizabethan Age" was an abortion, and not a stillbirth.