Abraham Groves
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Abraham Groves (September 8, 1847 – May 12, 1935) was a Canadian physician and surgeon in
Fergus, Ontario Fergus is the largest community in Centre Wellington, a township within Wellington County, Ontario, Wellington County in Ontario, Canada. It lies on the Grand River (Ontario), Grand River about 18 km NNW of Guelph. The population of this com ...
, who is credited with performing the first
appendectomy An appendectomy (American English) or appendicectomy (British English) is a Surgery, surgical operation in which the vermiform appendix (a portion of the intestine) is removed. Appendectomy is normally performed as an urgent or emergency procedur ...
in North America, in 1883. He is also recognized for performing Canada's first suprapubic
lithotomy Lithotomy from Greek for "lithos" (stone) and "tomos" ( cut), is a surgical method for removal of calculi, stones formed inside certain organs, such as the urinary tract (kidney stones), bladder (bladder stones), and gallbladder (gallstones), t ...
and for his early use of
aseptic technique Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deri ...
in surgery, possibly being the first person to use
surgical gloves Medical gloves are disposable gloves used during medical examinations and procedures to help prevent cross-contamination between caregivers and patients. Medical gloves are made of different polymers including latex, nitrile rubber, polyvinyl ch ...
for infection control. Groves practiced in Fergus for sixty years, and the hospital he founded, formerly the Royal Alexandra, is now named the Groves Memorial Community Hospital in recognition of his work.


Early life and education

Groves was born in
Peterborough Peterborough ( ) is a City status in the United Kingdom, cathedral city in the City of Peterborough district in the Ceremonial counties of England, ceremonial county of Cambridgeshire, England. The city is north of London, on the River Nene. A ...
,
Canada West The Province of Canada (or the United Province of Canada or the United Canadas) was a British colony in British North America from 1841 to 1867. Its formation reflected recommendations made by John Lambton, 1st Earl of Durham, in the Report ...
, on September 8, 1847, the fifth child of Irish immigrants Abraham and Margaret Groves. In 1856, the family moved to a farm outside the town of Fergus. Groves completed his early schooling in Fergus and in 1867 moved to
Toronto Toronto ( , locally pronounced or ) is the List of the largest municipalities in Canada by population, most populous city in Canada. It is the capital city of the Provinces and territories of Canada, Canadian province of Ontario. With a p ...
to study at the Toronto School of Medicine, where he was a classmate of
William Osler Sir William Osler, 1st Baronet, (; July 12, 1849 – December 29, 1919) was a Canadian physician and one of the "Big Four" founding professors of Johns Hopkins Hospital. Osler created the first Residency (medicine), residency program for speci ...
. While Groves received a thorough education in anatomy at the Toronto school, the quality of clinical training was poor due to the temporary closure of the
Toronto General Hospital The Toronto General Hospital (TGH) is a major teaching hospital in Toronto, Ontario, Canada and the flagship campus of University Health Network (UHN). It is located in the Discovery District of Downtown Toronto along University Avenue (Toronto), ...
and a shortage of instructors. Groves graduated in 1871, and after six months of training under a Toronto doctor, he returned to Fergus where he set up a medical practice. Unaffiliated with local hospitals, Groves travelled to patients' homes and lodging places to carry out surgeries.


Career

Groves was an early practitioner of
aseptic technique Asepsis is the state of being free from disease-causing micro-organisms (such as pathogenic bacteria, viruses, pathogenic fungi, and parasites). There are two categories of asepsis: medical and surgical. The modern day notion of asepsis is deri ...
in surgery. During his first
laparotomy A laparotomy is a surgical procedure involving a surgical incision through the abdominal wall to gain access into the abdominal cavity. It is also known as a celiotomy. Origins and history The first successful laparotomy was performed without ...
in 1874, Groves boiled his instruments and sponges before use and cleaned his hands and his patient's skin with boiled water. This would become his routine practice: the
Dittrick Museum of Medical History The Dittrick Museum of Medical History is part of the Dittrick Medical History Center of the College of Arts and Sciences of Case Western Reserve University, Cleveland, Ohio. The Dittrick Medical History Center is dedicated to the study of t ...
holds one of Groves's surgical knives, manufactured in 1870, which shows wear from frequent boiling. Regarding boiling instruments, Groves stated to the museum curator in 1932 that "previous to that date I never heard it was done". In 1885, Groves had just operated on a pus-filled abdomen when he encountered another patient who needed urgent surgery. Recognizing that it would be dangerous to operate with his bare hands, Groves boiled his rubber riding gloves and wore them during the surgery. If this date, given in Groves's 1934 memoir, is accurate, this would be the first documented use of
surgical gloves Medical gloves are disposable gloves used during medical examinations and procedures to help prevent cross-contamination between caregivers and patients. Medical gloves are made of different polymers including latex, nitrile rubber, polyvinyl ch ...
to prevent infection. In 1878, Groves performed Canada's first
suprapubic lithotomy The hypogastrium (also called the hypogastric region or suprapubic region) is a region of the abdomen located below the umbilical region. Etymology The roots of the word ''hypogastrium'' mean "below the stomach"; the roots of ''suprapubic'' mea ...
, in a tavern in
Guelph, Ontario Guelph ( ; 2021 Canadian Census population 143,740) is a city in Southwestern Ontario, Canada. Known as The Royal City, it is roughly east of Kitchener, Ontario, Kitchener and west of Downtown Toronto, at the intersection of Ontario Highway 6, ...
. At the time,
bladder stone A bladder stone is a stone found in the urinary bladder. Signs and symptoms Bladder stones are small mineral deposits that can form in the bladder. In most cases bladder stones develop when the urine becomes very concentrated or when one is ...
s were extracted through the
perineum The perineum (: perineums or perinea) in placentalia, placental mammals is the space between the anus and the genitals. The human perineum is between the anus and scrotum in the male or between the anus and vulva in the female. The perineum is ...
, but this route was not suitable for this patient as he weighed over . Groves made an abdominal incision to access the patient's bladder and extracted six stones. The patient recovered quickly. Groves was an early practitioner of many urologic surgeries, including
prostatectomy Prostatectomy (from the Ancient Greek language, Greek , "prostate" and , "excision") is the surgical removal of all or part of the prostate gland. This operation is done for benignity, benign conditions that cause urinary retention, as well as ...
, removal of the
renal capsule The renal capsule is a tough fibrous layer surrounding the kidney and covered in a layer of perirenal fat known as the adipose capsule of kidney. The adipose capsule is sometimes included in the structure of the renal capsule. It provides some ...
, and surgical repair of the
bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the bladder is a distens ...
and
urethra The urethra (: urethras or urethrae) is the tube that connects the urinary bladder to the urinary meatus, through which Placentalia, placental mammals Urination, urinate and Ejaculation, ejaculate. The external urethral sphincter is a striated ...
. Groves is credited with performing the first
appendectomy An appendectomy (American English) or appendicectomy (British English) is a Surgery, surgical operation in which the vermiform appendix (a portion of the intestine) is removed. Appendectomy is normally performed as an urgent or emergency procedur ...
in North America. Abdominal surgery was rare at the time: Groves stated that "during my undergraduate course there was not, so far as I know, one abdomen opened in the Toronto General Hospital". The operation took place on May 10, 1883. Groves removed the appendix of a twelve-year-old boy, using a flame-heated probe to sterilize the site where it was severed. The boy recovered, but his father was unhappy with Groves, believing the doctor's actions to be reckless. When Groves shared the news of his operation with other doctors, they were similarly displeased. A colleague recounted that the Toronto Medical Association condemned his actions, calling him a "backwoods doctor". Nevertheless, Groves went on to perform many appendectomies. Groves kept the appendix from his first surgery preserved in a glass bottle, which his widow donated to the Toronto Academy of Medicine in 1961. However, the specimen was lost following the 2002 closure of the
University of Toronto The University of Toronto (UToronto or U of T) is a public university, public research university whose main campus is located on the grounds that surround Queen's Park (Toronto), Queen's Park in Toronto, Ontario, Canada. It was founded by ...
's History of Medicine Collection. Some uncertainty exists regarding the date of Groves's appendectomy, as Groves did not publish his findings at the time. The 1883 appendectomy was first described in a review of appendicitis published by Groves in 1903. Groves gave a contradictory account of his appendectomy in a 1928 interview, claiming to have based his technique on papers by British surgeon
Lawson Tait Lawson Tait, born Robert Lawson Tait (1 May 1845 – 13 June 1899) was a Scottish pioneer in pelvic and abdominal surgery who developed new techniques and procedures. He emphasized asepsis and introduced and advocated for surgical techniques tha ...
which were first published in 1890. A student of Groves, John Wishart, claimed to have performed North America's first appendectomy in 1885. In 1902, Groves opened the Royal Alexandra Hospital in Fergus and established a nursing school. In 1932, Groves closed the nursing school in response to regulatory pressure and donated the hospital to the community. After Groves's death, the hospital was renamed to Groves Memorial in his honour. As of 2019, the Groves Memorial Community Hospital continues to serve the town of Fergus and surrounding areas. Groves practiced in the town of Fergus for a total of sixty years. During his career, he served as physician and surgeon for the
Grand Trunk Railway The Grand Trunk Railway (; ) was a Rail transport, railway system that operated in the Provinces and territories of Canada, Canadian provinces of Quebec and Ontario and in the List of states and territories of the United States, American sta ...
and the
Wellington County House of Industry and Refuge The Wellington County House of Industry and Refuge, located in Fergus, Ontario, is the oldest surviving state-supported poorhouse in Canada. Constructed in 1877, the site operated as a poorhouse and farm until 1947, and as an old age home unti ...
. He also established an electric lighting plant in Fergus. In 1934, Groves published an autobiography titled ''All in The Day's Work'', which reflected on his medical career. The book received positive reviews in ''
The Lancet ''The Lancet'' is a weekly peer-reviewed general medical journal, founded in England in 1823. It is one of the world's highest-impact academic journals and also one of the oldest medical journals still in publication. The journal publishes ...
'' and the ''
British Medical Journal ''The BMJ'' is a fortnightly peer-reviewed medical journal, published by BMJ Publishing Group Ltd, which in turn is wholly-owned by the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world ...
''. Groves died of pneumonia in Fergus on May 12, 1935, at the age of 87.


Personal life

In his personal life, Groves was a devout
Anglican Anglicanism, also known as Episcopalianism in some countries, is a Western Christianity, Western Christian tradition which developed from the practices, liturgy, and identity of the Church of England following the English Reformation, in the ...
, publishing several poems on religious subjects. He was a member of the
Masonic Order Freemasonry (sometimes spelled Free-Masonry) consists of fraternal groups that trace their origins to the medieval guilds of stonemasons. Freemasonry is the oldest secular fraternity in the world and among the oldest still-existing organizati ...
, and served on the Fergus school board and village council; he was elected reeve in 1885, but could not take the position due to his post at the Wellington County House of Industry. Groves married Jennie Gibbon of
Elora, Ontario The Historic Village of Elora is a community in the township (Canada), township of Centre Wellington Wellington County, Ontario, (Wellington County) in the Ontario, Province of Ontario, Canada. It is well known for its 19th-century limestone arc ...
, in 1874 and had two children with her. After Gibbon's death, Groves married Ethel Burke, a graduate nurse in Fergus. Groves owned a pet alligator and a parrot named Polly. The parrot was
taxidermied Taxidermy is the art of preserving an animal's body by mounting (over an armature) or stuffing, for the purpose of display or study. Animals are often, but not always, portrayed in a lifelike state. The word ''taxidermy'' describes the process ...
and donated to the Wellington County Museum and Archives in the late 1970s.


Further reading

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References

{{DEFAULTSORT:Groves, Abraham Canadian surgeons 1847 births 1935 deaths People from Wellington County, Ontario