SURGERY. 



627 



literature, the politics, the philanthropy of the day. j 

 His influence was so wide-spread, his practice so ex- 

 tensive, and his skill in all departments of medical 

 science so great, that his name naturally begins the 

 list of great American practitioners ; but his contem- 

 porary, Dr. John Jones, also a Philadelphia^ was 

 perhaps at the same period the best known surgeon 

 of the country. He was a pupil and friend of Mr. 

 Pott, a physician to the Pennsylvania Hospital, and 

 vice-president of the College of Physicians. He 

 wrote one of the first American treatises on surgery, 

 which was published about 1777. He was an expert 

 operator, particularly in cases of stone, which he ex- 

 tracted with great rapidity, a more important matter 

 in those days than in these of anaesthetics. He is 

 said to have performed the first operation of this 

 kind in America in 1790. He attended Dr. Franklin, 

 who suffered with stone in the bladder, and was the 

 family physician of Washington. 



Philip Syng Physick, the pupil of John Hunter 

 and a professor of surgery in the University of 

 Pennsylvania at the beginning of this century, earned 

 the title of "The Father of American Surgery" by 

 his admirable teachings and his skilful work as an 

 operator. One of his most noted operations was that 

 upon Chief Justice Marshall, from whom, when he 

 was at an advanced age, he removed upward of ono 

 thousand vesical calculi. Dr. Physick originated a 

 process of employing animal ligatures, selecting for 

 the purpose dog-skin cut into suitable strips and 

 then rolled on a marble slab to impart to them the 

 requisite degree of hardness, roundness, and smooth- 

 ness. Dr. John SyngDorsey, after numerous experi- 

 ments performed at the instance of Physick, was led 

 to employ for this purpose French gut, using it in 

 various amputations and in a number of capital op- 

 erations, cutting the ends off close to the knot and 

 treating the wound as if no ligature had been used. 

 He was professor of anatomy in the University of 

 Pennsylvania, and was the first surgeon in tho 

 United States who ligated the external iliac artery. 

 Dr. William Gibson, who held the chair of surgery in 

 the same institution, was the first surgeon who ever j 

 tied the common iliac artery. At about the samo 

 time lived Dr. John C. Warren, a son of Dr. John 

 Warren, who was the surgeon-general during tho 

 Revolutionary war and professor of anatomy and 

 surgery in Harvard College. He performed the 

 first successful operation for the relief of dropsy of 

 the pericardium, drawing off the accumulation of 

 fluid with a trocar and caunula. The younger Dr. 

 Warren succeeded his father in the joint professor- 

 ship at Harvard, and was the first surgeon who ever 

 pave ether as an aniesthetic during a surgical opera- 

 tion. 



Dr. John Rhea Barton invented the well-known 

 operation for the treatment of anchylosis, having per- 

 formed excision of the hip on a sailor in 1826, de- 

 scribed a fracture of the lower end of the radius 

 still known by his name, introduced the bran dress- 

 ing in the treatment of fractures and dislocations 

 of the leg, and devised the bandage known by his 

 name and employed in fractures of the lower jaw. 



Dr. Valentine Mott, of New York, was the first 

 surgeon who ever tied the innominate artery, but his 

 reputation rests upon a long series of brilliant and 

 successful operations. Dr. Gross says of him : " No 

 surgeon, living or dead, ever tied so many vessels, or 

 so successfully for the cure of aneurism, for the re- 

 lief of injury, or the arrest of morbid growths." The 

 catalogue, inclusive of the celebrated case of the in- 

 nominate artery, comprises 8 examples of the sub- 

 clavian artery, 51 of the primitive carotid, 2 external 

 carotid, 1 common iliac, 6 external iliac, 2 internal 

 iliac, 57 femoral, and 10 popliteal in all, 138. 



Dr. Ephraim McDowell, of Kentucky, was the first 

 ovariotomiat of the world, and shared with all other 



great discoverers the universal opprobrium and bit- 

 ter criticism of his fellows. He was also one of the 

 most successful Hthotomists of the early part of this 

 century, attaining very enviable success in the lateral 

 operation for stone. 



The first ligation of the primitive carotid artery was 

 performed in this country by Dr. Amos Twitchell, 

 in 1807, some time before the famous case of Sir 

 Astley Cooper, which was supposed to be the first of 

 its kind on record. 



In the treatment of ununited fracture, various im- 

 provements were made by American surgeons, nota- 

 bly the introduction of the seton by Dr. Physick, the 

 union of the ends of the fragments by a metallic pin 

 or screw as practised by Dr. Joseph Pancoast, and 

 the freshening and wiring of the extremities as done 

 by Dr. Rodgers, of New York. Dr. Reid, of Roches- 

 ter, demonstrated by a series of dissections and ex- 

 periments the possibility of reduction of dislocations 

 by manipulation and by dispensing with the cum- 

 brous and sometimes dangerous appliances which 

 had been used for that purpose. His paper on this 

 subject was followed by others by Prof. Gunn, of 

 Chicago, and Moore, of Rochester ; and, still later, 

 by a comprehensive monograph by Prof. Bigelow, of 

 Harvard. 



The first operations for the relief of anchylosis of 

 the inferior maxillary were performed by Dr. Car- 

 nochan, of New York, and by Dr. S. D. Gross, of 

 Philadelphia. 



Among the brilliant surgery of the century, we 

 can only briefly record the operations of Dr. J. 

 Kearney Rodgers, for ligatiou of the left subclaviau 

 between the scalene muscles ; of Hunter McGuiro 

 for ligation of the abdominal aorta ; of Onderdonk 

 for ligation of the femoral in arthritis of the knee ; 

 for extirpation of the clavicle by Mott. The inven- 

 tions or modifications of splints by Physick, Hodg- 

 den, N. R. Smith, and-others were of the highest prac- 

 tical importance, while Fox's apparatus for fracture 

 of the clavicle is yet in common and effective use. 

 Dugas, of Georgia, pointed out one of the most valu- 

 able diagnostic signs of scapulo-humeral luxations, 

 and Bigelow, in the paper above mentioned, revolu- 

 tionized tho theory of the mechanism of dislocation 

 of the hip. Dr. Joseph K. Swift, of Easton, Pa., was 

 tho first surgeon to employ adhesive plaster as a 

 means of extension in fractures of the lower extrem- 

 ities, an enormous step in advance, both as to com- 

 fort of patients and practical results obtained. 



The employment of rest in general affections, 

 which has recently been insisted on with great vigor 

 by numerous European writers, was taught and prac- 

 tised in this country one hundred years ago by Dr. 

 Physick. Trephining for bone abscess, usually 

 credited to Sir Benjamin Brodie, was first per- 

 formed by Nathan Smith, of New Haven, in the lat- 

 ter part of the 18th century. The first excision of 

 the upper jaw ever performed was done by Dr. 

 Jamison, of Baltimore, and the first resection of 

 both bones by Dr. Rodgers, of New York. Dr. J. 

 Mason Warren, of Boston, was the first to suggest 

 the importance of dividing the muscles in the arches 

 of the palate as a means of facilitating the union of 

 the edges of the fissure after operations for cleft 

 palate. Dr. Milton Antony in 1823 published, in the 

 Philadelphia Journal of the Medical and Physical 

 Sciences, a case in which he removed, along with a 

 diseased rib, a large portion of lung-tissue which 

 was involved. The drainage of the bladder through 

 the perineum in case of chronic cystitis suggested by 

 Mr. Guthrie, of London, was first put into practice 

 by Prof. Willard, of New York. 



The most important advance in the surgery of the 

 urinary organs made within the century was intro- 

 duced to the profession by Dr. Henry J. Bigelow of 

 Boston, in January, 1878. Until that time it had been 



