R233.Sor''°'^'*a'-— RECAP SOTJCHON OR ICr INAL GOMTR I3UT TONS OF LOUISIANA TO IKDICAL SOIJiJNCE. ^^L^ ^o£l Columbia e,^,nititrsftp intlirOpofilfttignrk College of ^tP^icianS anU burgeons Hibvavv Digitized by tine Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/originalcontribu1916souc Original Contributions of Louisiana to Medical Sciences JiOX ^ Bibliographic Study c/i mmmmmmmmmm EDMOND SOUCHON. M. D. Professor Emeritus of Anatomy, Tulane School of Medicine NEW ORLEANS Ratm'res- Jones Printing Company, Baton Rouge, La. Original Contributions of Louisiana to Medical Science A Bibliographic Study EDMOND SOUCHON, M. D. Professor Emeritus of Anatomy, Tulane School of Medicine NEW ORLEANS ORIGINAL CONTRIBUTIONS OF LOUISIANA TO MEDICAL SCIENCES. By Edmond Souchon, M. D. Professor Emeritus of Anatomy, Tulane School of Medicine H. F. A. C. S. New Orleans, Louisiana. A BIBLIOGRAPHIC STUDY. Upon reflecting on the awakening of the scientific spirit in America within the last thirty years, it occurred to me that it would be very interesting to study the achievements made especially in the form of original contributions by America to Medical Sciences. In this study, I confined myself to the United States of America. America is barely more than a century old but in that century it has contributed more than any other single century of the Old World, barring the century of Pasteur and his followers; and yet, with transmissibility of puerperal fever, with anesthetics, general and local, gynecology, abdominal surgery, dentistry, eradication of yel- low fever and malarial fever, it follows closely in the trail of the Pasteur century. By original contribution is meant something new, that has not been done before by somebody else. In some instances it is difficult, from the description, to decide if the contribution has been made in America for the first time, or for the first time in the world. Doubtless a great number were made in America without any knowledge that they had been done before by somebody else, and that is quite creditable in itself. To obtain information, I have sent out over six hundred circu- lar letters to as many men occupying prominent positions and who ought to know what has been done in the profession in this country. Through the courtesy of the Editor, the circular letter was published in the Journal of the American Medical Association. It required eight months to gather the data and write the paper. It was truly a labor of love to bring together the workers of our country. The contributions of Louisiana are here described as a biblio- 4 Edmond Souchon, M. D. graphic Study. In a previous paper read December 15, 1915, before the Louisiana Historical Society the subject was considered bio- graphically, i. e. gave specially an account of the lives of the contri- butors, whereas in this bibliographic study it is specially their writ- ings and achievements that are described. All the contributors from Louisiana are from the City of New Orleans, except Dr. Prevost. DR. FRANCOIS PREVOST practiced in Donaldsonville. In 1830 (?) he performed the first Cesarian Section in America. He operated four times successfully losing but one mother and operating twice on the same woman. His claim is well established in a paper published by Dr. Robert P. Harris of Philadelphia, published in the New Orleans Medical and Surgical Journal, June, 1879, page 933. DR. DUBOURG, (New Orleans) was the first to perform vaginal hysterectomy in America, if not in the world. (Statement of Professor E. S. Lewis of Tulane.) DR. CHARLES ALOYSIUS LUZENBERG, 1805-1848, (New Orleans) first removed gangrenous bowel in hernia, and sutured the ends successfully. DR. JOHN LEONARD RIDDELL, 1807-1865, (New Orleans) invented the binocular microscope. DR. WARREN STONE, 1808-1892, (New Orleans) was the first to resect a portion of rib to secure permanent drainage in cases of empyemia. He was the first to apply a wire ligature to a human artery for aneurism. He applied it to the common iliac for an aneur- ism of the external iliac. He first cured a traumatic aneurism of the second portion of the subclavian artery by digital compression. Priority is also claimed by Dr. Jonathan Knight of New Haven, Conn. Digital compression is undoubtedly an American procedure. DR. CHARLES JEAN PAGET, Sr., 1818-1884, (New Orleans) discovered the lack of correlation between the pulse and the tempera- ture in yellow fever. While the temperature goes up the pulse goes down or remains stationary. It is pathognomonic of yellow fever. DR. TOBIAS GIBSON RICHARDSON, 1827-1892, (New Or- leans) was the first to amputate both legs at the hip joint at one time in the same subject, the patient recovering. He was the first to write an Anatomy in which English names were substituted for the Latin names. He was the first to use strong injections of nitrate of silver for cytitis. His wife's devotion to his memory caused her to contribute magnificent buildings on Tulane Campus devoted to medical edu- cation. Original Contributions of Louisiana to Medical Sciences 5 DR. H..D. SCHMIDT, 1823-1888, (New Orleans), demonstrated the origin of the bile ducts in the intercellular spaces. DR. COMPTON, (New Orleans), in 1853, was the first to excise both the radius and ulna. DR. ANDREW WOOD SMYTH, (New Orleans) was the first to cure a subclavian aneurism of the third portion. He first ligated simultaneously the innominate and the common carotid and later the vertebral artery. His ligation of the innominate artery is the first successful one in the world. His patient survived, whereas Dr. Mott's did . not. It is by ligating the vertebral artery on the ap- pearance of secondary haemorrhage in his case that he cured the case. DR. ALBERT BALDWIN MILES, 1852-1894, (New Orleans) was the first to use a loop ligature on the first portion of the sub- clavian artery while operating on an aneurism of the third portion. DR. JOSEPH JONES, 1833-1896, (New Orleans) discovered the plasmodiimi of malarial fever before Laveran. (Statement of Professor Duval of Tulane.) DR. EDMOND SOUCHON, (New Orleans) devised a New Method to design colored charts for class demonstrations. The sketch is copied from a book with a pantograph and the shading is done by willow charcoal and black crayons. The coloring is done with pastels. The drawing is made on book paper, the back of which is painted with thin Damar varnish and turpentine which fixes the pastel and prevents its rubbing off. The paper is then pasted on large Bristol boards (30x40) and its surface is sized with thin gelatine and then varnished with thin damar. Preservation of Anatomic Dissections with permanent color of Muscles and Organs by two methods. The curing Method using arsenic, calcium chloride and formol. The Physical or Paint Method by which colorless muscles in a dissection are given permanent color by painting them with artist's paint or house paints. Founded Preservative Anatomy after the method described above. Founded Methodic Anatomy as evidenced in a plea for a Metho- dical Textbook on Anatomy. A single and uniform guide is strictly followed in describing each and every organ, from the largest to the smallest. Founded Philosophic Anatomy as exemplified in the publica- tion of Philosophic Anatomy of the tongue, liver, lungs, kidneys. The peculiarities only of the organs are considered and it is endeavored to explain the reasons of things, the why and wherefore. Founded Esthetic Anatomy by using systematically in teaching 6 Edmond Souchon, M. D. four hundred large pastel colored charts and projecting on the screen a complete series of three hundred colored lantern slides, the re- production of the atlases of Bonamy, and Beau and of Hirsfeldt and Leveille. Founded the Souchon Museum of Anatomy at Tulane Universi- ty. It was so named by resolution of the Board of Administrators. It contains 350 dissections, large and small. They are all natural preparations. There are no dried, wax, or papier mache specimens. All the muscles and organs present permanent color. No other Museum an^-where presents this feature. They are prepared after the Souchon Method of Preserving Anatomic Dissections. Surgical Collateral Branches of the Main Arteries. Each and every main artery presents a collateral branch which takes the place of the main artery when that artery has been ligated. Embalming of Bodies for Teaching Purposes. The chemicals used are arsenic, formol, alchohol, ghxerine, carbolic acid, and creo- sote. The originality lies in the combinations selected, in the pro- portions of each and the result obtained in the color of the muscles. First Complete History of Aneurisms of the Arch of the Aorta. First Complete History of the Operative Treatment of Aneur- isms of the Third Portion of the Subclavian Artery. First and Only Dissection of a Subclavian Aneurism of the Third Portion of the Subclavian Artery, demonstrating the collateral cir- culation, after ligature of the main arteries. It took place through the amastomoses of the Aortic perforating interostals with the branch- es of the subscapular, in the substance of the great serrate muscle. The specimen is now in the Army Medical Museum in Washington. First to advocate Simultaneous Ligation of the first portion of the subclavian and the vertebral artery without rupturing the coats for the cure of subclavian aneurism of the third portion. First to advocate the ligation of the axillary artery above the origin of the subscapular for the cure of recurrent aneurisms of the third portion of the subclavian. First Complete History of Double Aneurism of the same artery. First Complete History of the Operative Treatment of Irre- ducile Dislocations of the Shoulder Joint. Resection of the head is better and easier than reduction. Complete History of Drilling holes through the skull to explore with syringe and needle. First Complete History of Wounds of the Large Surgical Veins. When a large vein has been injured and ligated, if the collateral venous circulation is inadequate and gangrene is threatened, the main artery of the region must be ligated, but below the largest collateral Original Contributions of Louisiana to Medical Sciences 7 which will carry enough blood to nourish the parts beyond, while the ligation of the main trunk will diminish the quantity of blood and equalize the arterial and the collateral venous circulation. First Complete History of the Treatment of Abcesses of the Liver by Aspiration. Small abcesses of not over one quart are often cured by a single aspiration. First to write a Complete History of the Surgical Diseases and Injuries of the Neck. Each region of the neck is considered separ- ately. The peculiarities only of diseases are considered. No generali- ties are mentioned. First to write a Methodic Description of a Surgical Disease. A single uniform plan or guide is adopted and is strictly followed in describing each and every surgical disease. Devised Souchon's Anesthetizer, an apparatus to inject anesthe- tic vapors in the lower pharynx b^^ a rubber tube introduced through the nose or the mouth. The apparatus is worked by one hand which presses a bulb and forces the vapor through the tube. Its originality lies in its small size and simplicity. Other apparatuses used for this purpose are large, clumsy and worked with the foot and bellows. Devised Speculum Holder for Sims duck bill speculum. An up- right with a line of nails is screwed to the side of the operating table. The outside end of the speculum is held by a loop of rubber with a string to it. The string is wound around a nail on the upright, It is quite a help and relief to the assistant who has only to guide the inside speculum in the proper position. First Formal Plea for a Reform in Medical Education. First Formal Plea for a Reform in University Education. Wrote the first Formal Sanitary Code in America for the Louis- iana State Board of Health. Reminiscences of Dr. J. Marion Sims in Paris. Designed the Floor Plans of the Josephine Hutchinson Memorial School of Medicine of Tulane University. It is the largest and most elaborate under one roof medical college in America. First to write a formal History of the Original Contributions of America to Medical Sciences. DR. RUDOLPH MATAS, (New Orleans), "Drum snares," solid rings for end-to-end and lateral intestinal anastomosis. Method of securing circular constriction with fixation pins of the Auricle, to obtain hemostasis in operations for cavernous and other angiomas of the Auricle. Pins are inserted around the auricle and an elastic thread is wound around the pins. Easy method of securing hemostasis in bleeding injuries of the upper lip in hemophilic subjects. Arrest of hemorrahage by direct 8 Edmond Souchon, M. D. elastic compression. An ordinary wide elastic band (stationers) is adjusted over the lip and fixed by threads to prevent slipping up or down. New Method of reducing and securing fixation of displaced fragment in zygomatic fractures. A long semilunar Hagedorn needle threaded with silk is entered one inch above the middle of the displaced fragment, is passed well into the temporal fossa, and made to emerge one-half inch below the arch. The silk is used to pull the bone into position. A firm pad is applied externally and the wire is twisted over the pad. On the 9th or 10th day the wire, pad, etc. are removed permanently. Adaptation and modification of the Kraske method for cases of congenital inperforation of the anus. Modification of the Fell-0'Dw^^er apparatus for direct intra- laryngeal insufflation (first effort to apply positive pressure in the surgery of the thorax in the United States) for anesthesia in over- coming surgical pneumothorax. A new graduated air pump for positive pressure in its applica- tion to medical and surgical practice. The Matas-Smyth pump. Ap. adjustable metallic interdental splint for the treatment of fracture of the lower jaw. An apparatus for massive infiltration anesthesia with weak analgesic solutions. Original methods of Blocking the Nerves in Regional Anesthesia: (1) Original method of anesthesia of the forearm and hand by intra- neural and paraneural infiltration with cocain, novocain, and other succedanea, into the trunks of the musculo-spiral, median and ulnar. This procedure secures complete analgesia of the forearm and hand, permitting amputations, resections, or any other operation. First case operated by this method, January, 1898. (2) Regional anesthesia of the territory supplied by second division of the trigeminus by blocking the nerve at its exit rotundum, by two routes: (a) By in- troducing the needle through the spheno-maxillary fissure into the spheno-palatine fossa and reaching the nerve and even the Gasserian ganglion through the foramen rutundom. This route to the superior maxillary division of the Trigeminus was first applied by Dr. Matas in removing both upper maxillae for carcinoma, April 29, 1899. This route is now known as the "Payr route" in Germany, though its ap- plication has only recently obtained in Germany, (b) The inframa- lar route to the second and third division appeared also at the same time (1899) to block the second and third division of the Trigeminus for operations on the jaw, thus antedating Schlosser and now recog- nized as the "Matas Route" (see Braun, Lokal Anesthesia, ed. 2, Original Contributions of Louisiana to Medical Sciences 9 1913; also Haertel, loc. cit, 1913). Original account of these and other procedures described by Dr. Matas. See Phi. Med. Jo., Nov. 3, 1900. Was also the first to apply spinal subarachnoid anesthesia for surgical purposes in the United States (Nov. 10, 1899) though Leonard Corning of New York had applied it for medical purposes in 1886, and had laid the foundation for the surgical procedure. A Bier, then of Kiel, Germany, first introduced and resorted to it for surgical piirposes in April, 1899 (see Phil. Med. Jo., Nov. 3, 1900). An operation for the radical cure of aneurism by endo-aneuris- morrhaphy with intrasaccular suture ("The Matas Operation"), first applied in March, 1888. In this, three different methods are described for the first time: (1) Obliterative; (2) Restorative; (3) Reconstructive Endo-aneurismorrhaphy. 225 operations by these methods were reported in August, 1913, to the 17th International Congress of Medicine, London. The flexible, flat, removable aluminum band for the occlusion of large surgical arteries (with Dr. Carroll W. Allen). "Matas-Allen Band." For testing the efficiency of the collateral circulation in the circle of Willis and other parts (a modification of the Halsted band). A method of testing the efficiency of the collateral circulation as a preliminary to the occlusion of the great surgical arteries. Hy- peremia reaction or living color test, (used on the extremities): Complete ischaemia of the limb is obtained by elevation and appli- cation of an elastic bandage to the level of the lesion. Then a Matas compressor is applied to the proximal side and as near the aneurism as possible, until the aneurism is absolutely stilled, and is allowed to remain from six to ten minutes. Immediately on removal of the elastic bandage, the compressor being still in place, a hyperemic flush descends the limb rapidly. The digits retain a cadaveric, waxy lifeless palor for several seconds, which may be prolonged to ten to forty minutes or even longer, according to the development of the collaterals. If there is no collateral circulation, the limb will remain ischaemic. The second test is based on the premliinary occlusion of the main artery with the pliable and removable aluminum band, which can be removed in 56 hours without injury to the vessel in the event of manifestations of ischaemic phenomena; for example, hemiplegia, stupor, and coma after the obliteration of the common carotid artery. A method for reducing the calibre of the thoracic aorta by pli- cation or unfolding of its walls by means of lateral parietal suture 10 Edmond Souchon, M. D. applied in one or more stages. (An experimental investigation with Dr. Carroll W. Allen.) Direct duodenal catheterization through the gall bladder and common duct for nutrient and medicinal purposes (an extension of Mc Arthur's gall bladder drip). A simple expedient in treating complicated fractures of the lower jaw in conditions forbidding the use of splints or intrabuccal pros- thesis (with Dr. L. Landry). Four or five turns of a thin Esmarch bandage are taken around the face and jaw from the bregma to the chin and under jaw; this is fixed by a bandage passed around the fore- head to prevent slipping. Immobilizes the fragments after reduction; assists materially in getting rid of swelling and edema. The prophylaxis of post-operative tetanus based upon proper dietetic measures, and upon contamination of the alimentary canal with Tetanus bacillus introduced in uncooked vegetable foods. Dr. Matas has devised a special Rachitome which he uses with advantage in performing laminectomy for extensive spinal lesions. This is a simple but very strong chisel with a short powerful cutting, tooth prolonged into a long curved metallic handle. The chisel has enormous strength and leverage and can cut a continuous linear section through the laminae in a very short time without injury to the dura. Dr. Matas has also devised and uses with advantage a special long suture carrier which greatly facilitates the tacking of the omen- tum or mesentery in making colonic or other visceral suspensions for prolapsed stomach, colon, etc. It permits of an extensive suturing of distanced displaced organs through a comparatively small median incision. In this way a colonic suspension may be made in the course of a pelvic operation through a short and low laparotomy incision with little additional trauma or intraperitoneal manipulation. In an exhaustive monograph on the surgical treatment of ano- rectal imperjoration (congenital) Dr. Matas laid special stress upon the advantages of the perineo-cocygeal route and described a pro- cedure which he first applied with decided success in a case of im- perforated anus with a high placed enteron. In this case the distended gut was brought down from a high position in the pelvis by a partial Kjraske, which allowed it to be pulled down to the proctodeum or infundibulum, to which it was sutured by a lateral anastomosis. In this way the sphincter fibres of the anal region are preserved and a better chance of rectal control is obtained. Dr. Matas says that his effort to simplify the cure of aneurism by the principles involved in the modern treatment of aneurisms, and his insistance upon the security of studying the conditions of the Original Contributions of Louisiana to Medical Science 11 collateral and peripheral circulations before attempting the per- manent occlusion of the great surgical arteries; and by which the efficiency or inefficiency of the collateral circulation can be deter- mined, — are the contributions which he would prefer to have recog- nized. DR. ARTHUR WASHINGTON DE ROALDES was the first to establish a Nose, Eye, Ear and Throat Hospital in the South, from the Atlantic to the Pacific and from St. Louis to the Gulf. DRS. F. W. PARHAM and E. D. MARTIN devised a new treatment for fractures. It consists in a band that fits snugly around any unevenness of the bones. Especially useful in the treatment of oblique fractures. DR. CHARLES WARREN DUVAL, (New Orleans), claims to be the first to obtain the bacillus of Leprosy in pure culture. Sub- cutaneous leprous nodules are removed under sterile conditions, cut into small bits and planted aerobically on a medium of split protein products. After removal it is autolized by adding some proteoly- tic bacteriimi or allowing the tissue to slowly disintegrate under sterile conditions at 37 C. for several weeks, then extracting the juice by Berkfeld filtration. Dr. Duval has discovered the causal agent of Infantile diarrhea or Summer Complaint and proved that it is a bacillus belonging to the dysentery group. DR. WILLIAM HERBERT HARRIS, (New Orleans): Pro- duction of Pellagra in the Monkey by a Berkefeld filtrate derived from human lesions. The filtrate was injected hypodermically. DR. MAURICE COURET, (New Orleans), demonstarted that the fish is the host of the bacillus of leprosy. The fish were inocu- lated simultaneously with a bacterial emulsion of bacillus leprae. Fish were fed on himian leprosy nodules and the flesh of infected fish. All the bacilli multiplied in the fish and were harbored by them without apparent discomfort or outward evidence of the disease. DRS. CHARLES CASSEDY BASS and FOSTER MATTHEW JOHNS, (New Orleans), were the first to cultivate the Plasmosium of Malarial Fever. They showed that when blood with Plasmodium was heated to a certain temperature the Plasmodium continued to live for a certain time but would eventually die. By adding some dextrose the Plasmodium continued to live and multiplied. They have studied specially the influence of emetine and ipecac as a specific remedy against the protozoon of pyorrhea alveolaris, specially proper dose, best method of administration, duration of treatment and prevention of lapse or reinfection. DR. MARION SIMS SOUCHON, (New Orleans), was the first 12 Edmond Souchon, M. D. to remove a urinan^ calculus from the vesical portion of the ureter through the perineal route. He was guided by the touch through the rectum and through the wound. DR. ROBERT CLYDE LYNCH, (New Orleans), claims to be the first to remove a tumor whole from the larynx. Also to be the first to have sutured a surgical wound in the interior of the larynx. MR. LLOYD ARNOLD, (New Orleans), is the first to demon- strate the occurrence in the human ovary of several ova in the same follicle. The work was done under the direction of Professor Irving Hardesty in the Laboratory of Anatomy at Tulane University. DR. CARROLL WOOLSEY ALLEN, (New Orleans,) is the first to publish the only thorough book on Local Anesthesia in the English language. DR. ANSEL MARION CAINE, (New Orleans), devised a warm ether apparatus, without using a flame. The apparatus con- sists of a bellows worked by foot pressure which vaporizes the ether. The vapor is driven through a coil of pipe enclosed in a metal recep- tacle containing acetate of soda. This receptacle is immersed in boiling water for fifteen minutes before using and the soda will retain the heat for several hours. The vapor driven through the heated coil is delivered warm to the patient. DR. HENRY DICKSON BRUNS, (New Orleans), was the first to devise a tucking operation for shortening any one of the straight muscles of the eye. DR. OSCAR DOWLING was the first in the Southwest to equip a Health Car for the Louisiana State Board of Health and with it to travel over the country to perform the true functions of a State Beard of Health, i. e. to teach the people how to preserve and improve their health. DR. STANFORD CHAILLE JAMISON was the first to dis- cover that when the large splenic vessels were ligated, the spleen would not slough if it were covered by omentum. THE STATE OF LOUISIANA is the first and only State to establish and maintain a Leprosarium (Leper's Home). Tulane University, St. Charles Avenue, New Orleans. Date Due <^