Episode 87
Edinburgh’s Surgical Revolution
Goat Glands, Chloroform, and the City That Saved Surgery
(How Edinburgh dragged American medicine out of the Wild West)
When we think about modern surgery, it’s easy to imagine it has always been clean, safe, and scientific. However, that could not be further from the truth. Surgery was more like a horror show just over 150 years ago. Patients faced unbearable pain, filthy instruments, and shocking guesswork.
Today, we’ll explore how the Scottish city of Edinburgh transformed surgery — and how America, for far too long, ignored the science in favor of quick fixes and fast profits. Along the way, we’ll meet heroes like James Young Simpson and Joseph Lister, as well as villains like John R. Brinkley and Willard Bliss. We’ll also see why modern “wellness influencers” aren’t so different from the quacks of the past.
Edinburgh: The Peak of Medical Science
In the 18th and 19th centuries, Edinburgh was the world’s medical capital. Students from across Europe and the American colonies traveled there to study anatomy, surgery, and the latest medical theories.
Because of this, early American physicians like Benjamin Rush and John Morgan brought Edinburgh’s teachings home, helping to found the first U.S. medical school at the University of Pennsylvania. Harvard soon followed with a similar model.
However, while a few elite schools adopted Scottish standards, most of America remained a medical free-for-all. Outside major cities, anyone could call themselves a doctor, and “miracle cures” were everywhere. This was the true “Wild West” of medicine — long before the cowboy era we usually imagine.
James Young Simpson: Ending Pain in Surgery
Next, let’s fast-forward to the mid-1800s. At this time, one of the greatest problems in surgery was pain. Without anesthesia, operations had to be done quickly, often in less than a minute, and the suffering was unbearable.
That changed in 1846, when ether anesthesia was first used in Boston. News of ether’s success quickly crossed the Atlantic. By the time the next ship arrived in Edinburgh, surgeons were already experimenting with it — and looking for something even better.
Enter James Young Simpson, an obstetrician and, yes, one of my relatives. In 1847, Simpson discovered that chloroform worked better than ether and was easier to use. His famous breakthrough happened during a dinner party experiment, where he and his friends inhaled chloroform, passed out, and woke up amazed. Surgery would never be the same again.
Joseph Lister: Stopping Deadly Infections
Solving pain was one thing, but there was another huge problem: infection. After surgery, most patients didn’t die from the knife — they died from the germs they couldn’t see.
This is where Joseph Lister changed history. Influenced by Louis Pasteur’s germ theory, Lister realized that microorganisms caused infection. He began using carbolic acid to clean wounds and sterilize instruments. While some of his colleagues mocked him, the results spoke for themselves: surgical death rates plummeted.
Lister’s work eventually led to asepsis, the sterile environments we now take for granted in operating rooms.
America Ignored the Science — and a President Died
Unfortunately, the United States was slow to adopt these life-saving ideas. A tragic example is the death of President James Garfield in 1881. After being shot, Garfield’s wound was not fatal. He should have survived.
However, his doctor, Willard Bliss, refused to believe in germ theory or antiseptic techniques. Bliss and several others repeatedly probed Garfield’s wound with unwashed hands and unsterilized instruments. For seventy-nine days, the president suffered — not from the bullet, but from a massive infection. Bliss then billed the government $25,000 for his “services,” which would be roughly $750,000 today.
The Wild West of Quackery: From Goat Glands to Instagram
Even after American medicine improved — especially after the 1910 Flexner Report, which shut down low-quality medical schools — quackery never fully disappeared. It simply evolved.
In the 1920s and ’30s, John R. Brinkley became famous for implanting goat testicles into men as a cure for impotence. He used radio to market his “miracle” to millions, proving that loud marketing could still beat good science.
Sound familiar? Today’s hucksters may not use goat glands, but they use similar tactics. Some sell expensive stool tests and invent conditions like “leaky gut” to push costly supplements. Others, like the carnivore diet influencers, ignore decades of data on the Mediterranean diet and claim you should eat nothing but steak. They dismiss the science on cholesterol, flaunt their abs, offer life coaching, and sell overpriced “special salt” — even though salt is salt, and plain Pedialyte has been used safely in millions of rehydrations.
Why Hucksters Don’t Advance Science
People sometimes wonder: If these charismatic figures turned their energy toward research, could they make real progress? The answer is no.
First, most lack the deep scientific training needed to do real work. Second, those who do have training have deliberately left the hard road of science — the years of study, failed experiments, and peer review — for the fast money of “miracle cures.” Their goal isn’t discovery; it’s sales.
The Lesson from Edinburgh
Walking through Edinburgh’s Surgeons’ Hall Museum, you see both sides of medical history: the breakthroughs and the blunders, the heroes and the hucksters. It reminds us that progress is fragile and must be defended against those who prefer profit over evidence.
Edinburgh gave the world anesthesia and antisepsis. It gave us the model of evidence-based medicine. And while America eventually followed, the fight against quackery continues — from goat glands to $70 detox supplements.
Transcript
>> Dr. Terry Simpson: Mhm.
Speaker:Today on 4Q, why medicine isn't
Speaker:and never has been a quick fix. Why
Speaker:hucksters never seem to go away. And how
Speaker:a city famous for kilts, castles and very
Speaker:questionable dinner parties, Edinburgh
Speaker:dragged American surgery out of the Wild west
Speaker:and into the modern age. We'll talk goat
Speaker:testicles, carbolic acid, chloroform,
Speaker:experiments in living rooms. And why the President of the
Speaker:United States once died not from a bullet,
Speaker:but from doctors who couldn't be bothered to
Speaker:wash their hands.
Speaker:I am your Chief Medical Explanationist, Dr. Terri Simpson,
Speaker:and this is Fork U Fork
Speaker:University, where we bust myths, make sense of the
Speaker:badness, and teach you a little bit about medicine.
Speaker:In the 18th and 19th centuries, Edinburgh was the
Speaker:world's medical capital. Its anatomical
Speaker:training, surgical rigor and clinical
Speaker:innovations drew students from everywhere,
Speaker:including the American colonies. Physicians
Speaker:like Benjamin Rush, who also signed the Declaration of
Speaker:Independence. John Morgan, William Shippen
Speaker:Jr. Studied here in Edinburgh and then went
Speaker:home to found America's first medical school
Speaker:at the University of Pennsylvania and ultimately
Speaker:shape Harvard's medical program. But here's
Speaker:the thing. While these elite schools
Speaker:planted the seeds of evidence based medicine in
Speaker:America, most of America
Speaker:remained medical chaos.
Speaker:Patentonics, unlicensed
Speaker:practitioners and magnetic healers peddling
Speaker:miracles. It was the Wild west, and
Speaker:louder claims, not better science, won the
Speaker:crowd. But Edinburgh didn't just
Speaker:export talent, it created
Speaker:breakthroughs. Enter James Young Simpson.
Speaker:Yes, a relative of mine, the man who
Speaker:gave the world chloroform anesthesia.
Speaker:When ether was first used In Boston in
Speaker:1846, the idea sailed across the
Speaker:Atlantic. By the time the next ship docked in
Speaker:Edinburgh, Scottish surgeons were already refining ether
Speaker:masks. And within weeks, Simpson and his
Speaker:colleagues had moved chloroform, a more potent and
Speaker:practical anesthetic. The famous story,
Speaker:a dinner party. Simpson and his friends inhale
Speaker:chloroform, collapse on the parlor floor, wake up
Speaker:amazed, and realize they ended surgical
Speaker:agony. Yes, when you go to a dinner party
Speaker:in Edinburgh, you never know what's going to happen. And it's not just
Speaker:the beer or the Scotch. Quick
Speaker:breakthrough, sure, but only because of years of study
Speaker:and preparation made him ready for that moment.
Speaker:If Simpson solved pain, Lister
Speaker:solved infection. Lister
Speaker:spent years at the microscope, studying
Speaker:inflammation, devouring Pasteur's germ
Speaker:theory and connecting the dots no one else saw.
Speaker:His weapon was carbolic acid. He sprayed it
Speaker:on wounds, tools, bandages, even
Speaker:the air. Colleagues scoffed. Invisible
Speaker:germs offended Victorian pride.
Speaker:But death rates plummeted.
Speaker:Dogma was outdone
Speaker:by data, and antisepsis evolved into
Speaker:asepsis, sterilizing everything from instruments to
Speaker:gowns to hands. Modern surgery was
Speaker:born. Well, it Edinburgh, at
Speaker:least. America, of course, was busy ignoring
Speaker:this progress. In 1881, President
Speaker:James Garfield was shot. The bullet
Speaker:wasn't fatal. He should have lived. But his
Speaker:physician, Willard Bliss, dismissed
Speaker:Lister's ideas, probing Garfield's
Speaker:wounds again and again and again
Speaker:with unsterilized instruments and unwashed
Speaker:hands, and invited a parade of other doctors to
Speaker:do the same. 79 days later,
Speaker:100 pounds lighter, Garfield died at his
Speaker:summer home in Long Beach, New Jersey. Not from
Speaker:a bullet, but from the infection Bliss
Speaker:introduced. And Bliss? He billed the
Speaker:government $25,000 for his trouble.
Speaker:About three quarters of a million today. Thankfully, Congress
Speaker:only paid $6,500. What a bargain.
Speaker:Proof that sometimes the worst thing that can happen to
Speaker:you isn't being shot. It's being treated
Speaker:by a doctor who puts money and grift
Speaker:over reading. By 1910, the
Speaker:Flexner Report finally dragged American medicine
Speaker:towards science. Diploma mills closed.
Speaker:Laboratory training became mandatory. Schools
Speaker:like University of Pennsylvania and Johns Hopkins,
Speaker:modeled on Edinburgh, set the new
Speaker:standard. But if you think this killed quackery, think again.
Speaker:While Edinburgh gave us modern medical science,
Speaker:America gave Edinburgh. Chiropractors.
Speaker:Sorry, friends, Meet John
Speaker:R. Brinkley, the goat gland doctor.
Speaker:He didn't have a formal medical education.
Speaker:He got his degree from a diploma mill. And in the
Speaker:1920s and the 1930s, he made millions
Speaker:of dollars implanting goat testicles
Speaker:into men to restore virility. Let
Speaker:me put this to you another way. You take a goat, you
Speaker:whack off a testicle, you implant it in the scrotum, and. And
Speaker:you say, look, you're restoring virility. Did it
Speaker:work? No. But people
Speaker:thought it did. Testimonials poured
Speaker:in, but data was nowhere to be found.
Speaker:Brinkley pioneered medical marketing, using radio,
Speaker:the social media of the day, to broadcast
Speaker:his miracle in quotes to millions. He ran
Speaker:for governor twice. He built an empire on
Speaker:goat glands. And only when the AMA's Morris
Speaker:Fishbein hounded him in did it finally
Speaker:collapse. America shut down his
Speaker:radio station. But lessons were
Speaker:learned. Hucksters have evolved.
Speaker:They never go extinct.
Speaker:Let's fast forward to now. Goat testicles are gone, but the
Speaker:grift. The grift is thriving
Speaker:today. Snake oil wears lab coats and call
Speaker:itself functional medicine or root cause Wellness.
Speaker:They pedal expensive stool tests. It's invent
Speaker:conditions like leaky gut and sell you supplements that
Speaker:allegedly fix what only they can diagnose.
Speaker:They use enough medical jargon to make it sound
Speaker:Real. And then there's the carnivore crowd,
Speaker:the influencers telling you to eat nothing but steaks. Ignore 70
Speaker:years of data on the Mediterranean diet, dismiss the science
Speaker:of cholesterol and instead admire their abs.
Speaker:Sign up for their life coaching, buy their overpriced special
Speaker:salt for rehydration. News flash. Salt to
Speaker:salt and Pedialyte, used in 92
Speaker:million rehydrations around the world, doesn't need
Speaker:their branding. Sometimes people ask me, if these
Speaker:hucksters turned their genius for making money toward
Speaker:actual science, could they help medicine? The answer
Speaker:is no. First,
Speaker:most don't have the scientific foundation to begin
Speaker:with. And those who do, self select out of the
Speaker:grind, out of the painful erudition that real
Speaker:medicine requires. They leap straight to the
Speaker:shortcut. The miracle, the grift.
Speaker:Second, even those with training have chosen the
Speaker:con. Their drive isn't discovery, it's
Speaker:dollars. Progress is slow,
Speaker:ungrammarous work. Selling dehydrated
Speaker:beef liver is easier.
Speaker:Which is why we're standing here at the Surgeon's
Speaker:Hall Museum. Why this place
Speaker:matters. This isn't just scalpels
Speaker:and skeletons.
Speaker:It's a cautionary tale. Breakthroughs in
Speaker:butchery, science and snake oil side by
Speaker:side. Progress is fragile.
Speaker:And the line between huckster and healer
Speaker:isn't thin. It is a line of thick
Speaker:evidence. But it appears thin to the general
Speaker:public. Because while they don't have that
Speaker:long foundational ability to understand the
Speaker:difference between quackery and. And real science,
Speaker:we have to keep bringing it up.
Speaker:Edinburgh, uh, gave the world more than anesthesia and
Speaker:antisepsis. It gave us a model.
Speaker:Evidence over ego, humility
Speaker:over hype. America eventually followed,
Speaker:but the hucksters never disappeared. They just
Speaker:rebranded. Goat Gland Radio became the
Speaker:wellness Podcast. Patent tonics became the
Speaker:$70 detox supplements. The promises
Speaker:are the same, only the fonts and ring
Speaker:lights are fancier. The cure for
Speaker:quackery isn't charisma. It's science.
Speaker:And that's the real lesson behind these glass
Speaker:cases. If you're ever in
Speaker:Edinburgh, while you might go and buy yourself
Speaker:a kilt and some great scotch, please see this
Speaker:museum. It is truly a testament
Speaker:to the modern wonders of how we got here today.
Speaker:And finally, I want to give a huge thanks to the following
Speaker:people. Kushina, Thomas, Jordana,
Speaker:Shanti, and Kat, everyone at the
Speaker:Edinburgh Museum who welcomed us so warmly
Speaker:and shared their work. And a special thanks to
Speaker:producer girl who made these
Speaker:episodes possible. And, ah, future episodes.
Speaker:This has been Fork University with me, Dr. Terri Simpson, your
Speaker:chief medical explanationist. And, and here's the thing.
Speaker:While I am a doctor, I am not
Speaker:your doctor. And if you're seeking or hear about some
Speaker:miracle cure, please see a board certified
Speaker:physician. Not a chiropractor, not an
Speaker:eastern trained shaman, but a real doctor
Speaker:who can sit down and explain to you why uh, that miracle
Speaker:detox won't help you. Why that worm
Speaker:dewormer that they're trying to sell you for some
Speaker:parasite cleanse will not help you.
Speaker:But instead we have some real medicine that
Speaker:is often cheaper than the fake one that
Speaker:won't even cure you. Thanks to our distributing
Speaker:partners, Simpler Media Productions and the pod
Speaker:God himself, Mr. Evo Terra. Have
Speaker:a good week everybody.
Speaker:Hey Evo. You know the
Speaker:scotch here was pretty good. I'm pretty sure
Speaker:this might be a cure for something. I just don't know
Speaker:what.
Speaker:Yes, sorry, I'm still thinking about
Speaker:testicle testimonials. Yeah,
Speaker:I went there.
