John Lionel Stretton

The 'Iodine' Surgeon

John Lionel Stretton (1860 - 1943) was a medical pioneer who introduced tincture of iodine for skin sterilisation, for which he should be recognised alongside Joseph Lister, the father of 'antiseptic surgery'. He was also responsible for various items of 'aseptic furniture' which would be familiar even to today's surgeons. Following his training at Bart's hospital in London, he worked in Kidderminster for 56 years, undertaking over 40,000 operations and promoting healthcare for working people.

He might have remained buried in history, but for the discovery of the only surviving copy of the manuscript of his autobiography, which was published in 2012 and which opened up the door again into the life of this remarkable surgeon, about whom it can be said, that were it not for his innovation, many of us might never have been born.

Childhood and Adolescence

John Lionel Stretton was born into a medical family, both his grandfather and father being surgeons who trained at Bart’s hospital. His father, Samuel, was Assistant Surgeon at Renkioi Hospital in the Crimea, during the Crimean War, from 1855–1856, before returning to buy a private practice in Kidderminster.

Samuel was a model of Victorian family values, producing fifteen children, three of whom did not survive and five of whom he sent off with £100 each to make their life in New Zealand.

Lionel stayed at home and recalls a very relaxed early education. At the local grammar school when he was 10, he recalls that he had ‘a distaste for lessons and always evaded them by every means I could think of ’. Instead he was more interested in practical things and learning from his father, performing his first ‘operation’ at the age of eleven when he extracted a tooth for a neighbour. It will be no surprise that he was not top of the class. He did, however, excel at games, being captain of the football and cricket teams, but left school in 1876 without having obtained any qualifying examinations. He was then sent every day by train to a tutor in Birmingham, passing his preliminary examination for the Royal College of Surgeons in 1877.

He was now on course for his medical career and was apprenticed to his father the same year where he gained much practical experience from the extensive general practice.

Bart's Hospital

In October 1878 Lionel was taken by his father to start his training at Bart’s hospital where he was smart enough to choose the ‘right sort’ of friends', noting that ‘There were so many temptations in London and so many tragedies among the students of the hospital. I can quite conceive that I might have gone altogether wrong if I had been introduced into a fast set.'

He was immediately attracted to the sporting scene, as he had been at school, but then realised that he had a mountain to climb if he was to realise his professional ambitions, so he sent all his sporting kit back home. This only compounded his early feelings of inadequacy against seemingly better educated students, but he soon found that his apprenticeship had given him an enormous advantage when it came to the practical elements of his training. In 1880 Lionel sat the RCS examination and failed. Despite being at the top of his group, he’d misread a question and given a good answer, but not the one that was required.

Another attempt would follow but not before, in 1881, Lionel collapsed into five days of delirium, having contracted diphtheria and scarlet fever. Samuel travelled to London to help his son and wrote to the BMJ following his awful experience in trying to locate an ambulance to take Lionel to hospital. This letter records: ‘On its arrival, I was in dismay I can only describe it as a cross between a hearse and a dirty linen cart, painted black and with funereal side glass; a black horse, with dismal harness, and a driver of the most woeful aspect, also in deep black. It was surely enough to put the finish to any sensitive patient, dangerously ill as my son then was.

Thankfully Lionel survived the journey to hospital but lost four months in convalescence before passing his exams and gaining his MRCS qualification in October 1881.

Return to Kidderminster

Over the next nine months Lionel held various positions at Bart’s before receiving a telegram to say that his father was seriously ill. Resigning his position at the hospital he returned to assist with his father’s practice, helping Samuel to live for another 40 years and nearly dying again himself, when he contracted anthrax and was unconscious for 5 days in 1904. Working together, Samuel and Lionel were instrumental in improving healthcare for the local population. As a surgeon in Kidderminster for 56 years, Lionel carried out over 40,000 operations and was constantly fundraising and driving improvements to the hospital facilities. Financing hospital extensions and keeping the facilities working brought a constant tension with the local industrialists, who often sought to blacken Lionel’s name.

In developing the hospital facilities both Samuel and Lionel were hugely keen to recognise and promote the status and role of their nurses. As early as 1889 Lionel published a booklet entitled 'A Course of Ambulance Lectures Delivered in Kidderminster', and the hospital was providing high-quality training for nurses at that time, being formally recognised as a first-class training school for nurses in 1922. He notes, with less enthusiasm, some problems with house surgeons: ‘Another excellent house surgeon was found by the old Matron one night in a very compromising situation with one of the nurses. Of course both he and the nurse were immediately discharged.’

Pioneering Innovation

A highlight of Lionel’s career was his innovative work with iodine for the sterilisation of skin prior to surgery. Others had tried using iodine but Lionel’s innovation was to develop and introduce tincture of iodine. Following a series of definitive, scientific trials, he published his findings in a paper, entitled The Sterilization of the Skin of Operation Areas, in the BMJ in August 1909. Use of tincture of iodine was a major surgical advancement and was adopted worldwide. In an appreciation of Lionel, printed in a national newspaper a week after he died, the author noted that, for his achievements, Lionel should be as well recognised as Joseph Lister.

Lionel’s inventiveness didn’t end there; he was also responsible for various items of surgical equipment, including the design of aseptic hospital furniture, with which today’s surgeons will be familiar.

Read more about Lionel's Legacy...

Lionel's Later Life

Lionel was a man who dedicated his life to work and to public service. He was a major local figure, not just medically as the head of the regional BMA, but as President of the local Hospital Board. Although a local political clash and the death of his father in 1920 briefly reduced his local role, the major part of his life was spent as President of the Hospital Board, as either Senior Surgeon or Senior Consulting Surgeon at the hospital, in running his surgery at Church Street and in acting on behalf of local charities.