COLUMBIA LIBRABIES OFFSITE HEALTH SCIENCES STANDARD HX64105105 R229 .Ml 3 1 91 7 Some ot the medical RECAP iiSllilli,,,,, iiiiiiiiiltr ... Columbia Wlnibetsitp in ttft Citp ot^\a ^orfe Colkge of ^fjpsttiansf anb ^uvseoM ^tttvmtt 2.itirarj> Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/someofmedicalpioOOmcco KENTUCKY MEDICAL JOURNAL. Chloretone A broadly serviceable hypnotic and sedative Chloretone induces natural sleep. It acts as a sedative to the cerebral, gastric and vomiting centers. It does not depress the heart. It does not disturb the digestive functions. It produces no objectionable after-effects. It does not cause habit-formation. INDICATIONS. Insomnia of pain. Insomnia of mental strain or worry. Insomnia of nervous diseases. Insomnia of old age. Insomnia of tuberculosis. Alcoholism, delerium tremens, etc. Acute mania. Puerperal mania. Periodic mania. Senile dementia. Agitated melancholia. Motor excitement of general paresis. Spasmodic affections, as asthma, epi- lepsy, chorea, pertussis, tetanus, etc. Nausea and vomiting of anesthesia. Seasickness. The pains of pregnancy. Vomiting of pregnancy. Chloretone has been pronounced the most satisfactory hypnotic and sedative available to the medical profession. CHLORETONE: Ounce vials. CHLORETONE CAPSULES : 3.grain. bottles of 100 and 500. CHLORETONE CAPSULES: 5-grain, bottles of 100 and 500. Dose, 3 to 15 grains. Home Offices and Laboratories, Detroit, Michigan. Parke, Davis & Co. 50 Years of Pharmaceutical Progress -J KEXTUCKY MEDICAL JOUEXAL. I I ^Ki if ESTABLISHED 1901 8 jj ATO ADVERTISEMENT can do •| "'■^ justice to the work of this |{ II Hospital. Much has been said about it by medical au- || II tliorities and its plau of treatment for habits and addictions has || M been incorporated in standard medical texts. Much also bearing II f ! on every phase of alcoholism and drug addiction has been issued f z II by the Hospital itself. It II The findings of leading medical men who know the Hospitafs || II work and the results of its sixteen years' experience are available 11 9 i II The Following Publications II II II il Reprint from the Journal of the American If I Medical Association, setting forth Every I Detail of the Treatment carried out here. II The Alcoholic Problem in its Institutional, ^^ II Medical and Sciological Aspects. If II Help for the Hard Drinker. || II Perils of the Drug Habit. ii II The Injury of Tobacco. 11 II The Drug Taker and the Physician. II If How to Eliminate the Alcoholic as an Insane Problem zz Il Federal Responsibility in the Solution of the || II Habit-Forming Drug Problem. || II The Personal Problem confronting the Phy- f f II sician in the Treatment of Drug and Al- f 1 jJ coholic Addiction. If II Anv or all of tliese will be sent vou if interested. || II If II CHARLES B. TOWNS HOSPITAL, NEW YORK II «... g KENTUCKY MEDICAL JOURNAL. HIGHLAND SANITARIUM NASHVILLE TENNESSEE . # ^,, 1 ^'^4 ■■ -_^ ^^^^Sk^ . -- FOR THE TREATMENT OF Nervous and Mild Mental Disorders, General Invalidism and the Addictions Under tlip Supervision of Dr. A. E. DOUGLAS, former Superin- tendent of the Central Tennessee State Hospital, assisted b}- a Staff of Fifteen of Nashville's Most Eminent Physicians. Situated in the suburbs of Nashville, three miles from heart of city on Murfreesboro Pite in midst of 10 acres of beautiful blue grass woodland and ornamental shrubbery. A quiet, homelike, strictly ethical, splendidly equipped hospital for patients of this character, operating" under state license and in charge of a successful and widely known physician who has given his entire professional life to the study of ways and means of relieving and cur- ing these unfortunates. Number of patients limited, assuring jjcrsonal attention of Su- perintendent. Special facilities installed at an enormous cost for giv- ing hydrotherapy, electrotherapj', massage, baths and rest treatment. Address : HIGHLAND SANIXARIUIVI Telephone Main 1826 {. F. D. 7, Nashville, Tenn. PETTEY & WALLACE SANITARIUM f 958 S. Fifth Strec-8 MEMPHIS TENN v: FOR THE TREATMENT OF Drug Addictions, Alcoholism, Mental and Nervous Diseases A quiet, home-like, private, high-class institution. Licensed. Strictly ethiceJ. Complete equipment. Best Accommodations. Resident physicians and trained nurses. Drug patients treated by Dr. Pettey's original method. Detached building for mental patients. KENILWORTH SANITARIUM KENII-.WORXH, ILL,. ESTABLISHED 190S RESIDENT MEDICAL STAFF : (C. & N. W. R'y. Six Miles North of Chicago.) Built and equipped for the treatment of nervous and mental diseases. Approved diagnostic and therapeutic methods. An adequate night nursing- service maintained. Sound proof rooms with forced ventilation. Elegant appointments. Bath rooms en suite, steam heating, electric lighting, electric elevator. All correspondence should be addressed to KENILWORTH SANITARIUM, Kenilworth, Illinois Ella Blackburn, M.D., Assistant Physician ; Sherman Brown. M.D.. Medical Sup . ; Sanger Brown, M.D., Chief of Staff. 59 E. Madison Street, CHICAGO, ILLINOIS Telephone: Randolph 5794 — Consultation by appointment only ed to question reliability of our advertii Whc this JOUK^s'AL. KENTUCKY MEDICAL JOURNAL. UNIVERSITY OF LOUISVILLE MEDICAL DEPARTMENT Eightieth Annual Session Begins September 25, 1917 ENTRANCE REQUIREMENTS Applicants for admission to the ]\redical School of this University must have completed a four years' course in an accredited High School, and In addition one year of collegi- ate work, which must include courses in Chemistry, Physics, Biology and a Modern Language (French or German). Beginning with September 1918 (Session of 1918-1919) applicants for admission will be required to have had two years of college work in addition to the iour years' Higii School course. F»RE-iyiEDICAI_ COURSE A pre-raedical course is given in the College of Arts and Sciences of the University for students who are deficient in college work. COIMBINED B. S., IVI.D. DEGREES The College of Arts and Sciences and the Medical Department of the University offer the combined degTee of B. S., M. D. to students after two years of study in the College of Arts and Sciences, or, to those who enter the Arts and Science Department, having made ten units in the prescribed subjects leading *"o the baccalaureate degTee in a rec- ognized College of Arts and Sciences, spending the second year in study in the Uni- versity of Louisville, followed by four years in the Medical School. The prescribed studies in the combined Academic and Medical degree courses are as follows: Math- ematics, I and II; English, I and II; Chemistry, I; Biology, II; German, I or French, I; Physics, I; History, II and Philosophy, V. CLINICAL, F'ACIL.ITIES The clinical work of the Junior and Senior years is done in the new million-dollar City Hospital, of 500 beds, and in the out-patient department of the Hospital, with a walk- ing clinic of 250 patients a day. Individual instruction is given advanced students at the bed-side. Ward classes in all practical departments. Each senior student attends obstetrical cases under the direction of competent instructors. The hospital was con- structed as a teaching hospital, and is especially equipped and adapted for this purpose. LABORATORIES The handsome modern college building at the corner of First and Chestnut streets is admirably constructed and arranged for laboratories. The laboratories and small lec- ture rooms attached are equipped with every facility for laboratory instruction. Lab- oratories for advanced instruction, and for post-mcrtem examinations are provided in the City Hospital. CREDENTIALS It is important that prospective students for either pre-medical or medical courses be- gin correspondence as early as possible with the Dean of the Medical School, in order that a full record of literaiy credits may be on file before date of matriculation. This School is rated in Class "A" by the Council of Medical Education of the A. M. A., and is a member of the Association of American Medical Colleges. INF^ORIMATION For full information and bulletin of the University, address — HENRY ENOS TULEY, M. D.. Dean 101 ^Ve8t Chestnut Street Louisville, Ky. KENTUCKY MEDICAL JOURNAL. INFANT FEEDING In extreme emaciation, which is a characteristic symptom of conditions commonly known as Malnutrition-Marasmus -Atrophy it is difficult to give fat in sufficient amounts to satisfy the nutritive needs; therefore, it is necessary to meet this emergency by substitut- ing some other energy-giving food element. Carbohydrates in the form of maltose and dextrins in the proportion that is found in MELLWS FOOD are especially adapted to the requirements, lor such carbohydrates are readily assimilated and at once furnish heat and energy so greatly needed by these poorly nourished infants. The method of preparing the diet and suggestions for meet- ing individual conditions sent to physicians upon request. MELLIN'S FOOD COMPANY, BOSTON, MASS. Electric Centrifuge HlB An unusually low price for a practical electric centrifuge. Never befoie sold for less than $25.00, and we are able to make the price only by producing large quantities in the most efficient manner. Why use the o 1 d style hand centrifuge when for a little more yon can secure this up-to-date and effi- cient electric ceutii' fuge which will great- ly simplify your work? The new electric centrifuge is equipped with a Universal motor (for either di- rect o r alternatiu; current), mounted o: heavy cast base which can be fastened tc shelf or table. It is equipped with rheo SI at in base to control speed and comes com- plete with 2 aluminum tube holders, plaii and graduated glasi tubes, cord and sock- et In actual i \Mth tubes filled speed of 1,800 R.P.M. IS secured on direct current, on alternat- ing current 2,400 R.P.M. 9W42I5 — Electri Centrifuge with Universal Motor $12.50 Haematokrit. Complete with Tube $4.50 Extra Electric Heating Pad, only H-^ Materials have advanced tre- mendously but we have been able to produce this high class pad in one size only, 8 X 12 inches, in enormous quanti- ties so as to give onrcutsomers this special offer for a limited time. The pad is a standard type, llexible, covered with eiderdown and coming com- plete with silk cord and socket. This is a two heal pad, offering a range in tempera- ture that will meet any condition. It is provided witli two safety fuses which positively prevent overheat- ing. It is only by manufaturing a single size pad in large quantities that we have been able to make this special price. 9W4670-8xl2 inch Electric Heal- ing Pad. Special Price $4.50 FRANK S. BETZ COMPANY, Hammond, Ind. 30 East Randolph Street ii KENTUCKY MEDICAL JOURNAL. CALENDAR OF COUNTY SOCIETY IVIEETINGS UODNTy SKCHtTAUy RESIDENCE DATE Adair R. T. Hindman Columbia Xovcmlier 7 Allen II. M. Meredith Scottsville November 24 Anderson .T. W. Gilbert Lawrenceburg November 3 Ballard Hob C. Overby La Center December 11 Barren J. M. Taylor Glasgow November 21 Bath H. J. Daily OwingsviUe November 12 Bell O. P. Nuckols Pineville November 9 Boone S B. Nunnelly Bullittsville November 2 J. Bourbon Jas. A. Orr Pans November 15 Boyd J. M. Pichard Ashland November 5, 20 Boyle F. H. Montgomery Danville November 13 Breathitt O. H. Swango Jackson November 1 Breckinridge J. E. Kincheloe Hardinsburg December 13 Bullitt R. L. Hackworth Brooks November 12 Butler J. H. Austin Morgantown November 7 Caldwell W. Ij. Cash Princeton November l.T Calloway W. G. Graves Murray November 14 Campbell Kenton P. A. Stine Newport November 15 Carlisle W. Z. Jackson Arlington Noi'ember 6 Carroll F.M.Gaines CarroUton November 13 Carter G. B. O'Roark Grayson November 13 Casey Wm. J. Sweeney Liberty November 22 Christian J. W. Harned Hopkinsville November 20 Clark W. Carl Grant' Winchester November 16 Clay November 2 1 Clinton S. P. Stephenson Albany. . . ; November 1*7 Crittenden C. G. Moreland Marion November 12 Cumberland W. F. Owsley Burkesville November 7 Daviess J. J. Rodman Owensboro December IS Estill G. A. Embry Irvine November 14 Fayette L. C. Redmon Lexington November 13 Fleming .T. B. O'Bannon Plemingsburg R. F. D. No. 4. November 21 Floyd M V. Wicker .. Garrett November 9 Franklin U. V. Williams Frankfort November 6 Pulton Seldon Cohn Fulton November 1-J Gallatin J. M. Stallard Sparta November 15 Garrard J. B. Kinnaird Lancaster . . Novemljer 15 Grant J. G. Renaker Dry Ridge '. .November 2] Graves H. H. Hunt Mayfield November 7 Grayson C. L. Sherman Millwood November 29 Gri'di 0. IT. Shively Greenburg November 1 Greenup C. E. Vidt.. Russell Novembf r 1 Hardin W. F. Alvey Elizabethtown November 8 Harlan Chas. V. Stark . . . .Evarts November 24 Harrison W. B. Moore Oynthiana. . . November 5 Hart C. H. Moore Oanmer November 6 Henderson Wm. B. Negley Henderson November 12, 2'; Henry W. B. Oldham Newcastle November 26 Hickman Charles Hunt Clinton November 1 Hopkins A. O. Sisk Earlington November 1 Jackson G. C. Goodman Welchbur^ November 7 JeiTerson E. Owsley Grant Louisville, . Every Monday Evening Jessamine J. A. VanArsdall NicholasvilTe November 22 Johnson J.P.Wells Paintsville November 24 Knott November 24 Knox C. L. Heath Lindsay November 20 Larue W.E.Rodman HodgenviHe -. December 20 Laurel Oscar D. Brock London November 2 I Lawrence L.S.Hayes Charley November 19 Lee A. B. Hoskins Beattyville November 10 Leslie November 28 Letcher Bert C. Bach Whitesburg November 23 Lewis II. M. Bertram Vanceburg November 19 Lincoln D. B. Southard Stanford November 16 Livingston Tidward Davenaort Hampton. November 21 Logan Walter Byrne, -fr Russellville November 5 Lyon L. P. MoUoy Kuttawa November 20 McCracVen W. H. Parsons Paducah November 14, 28 McCreary Robert Sievers Pine Knot November 13 McLean W. W. Spicer Calhoun November 8 Madison Murison Dunn ■ Richmond November 8 Magoffin M. M. Price Salyersville Novembers Marion C B. Kobert Lebanon December IS Marshall L. L. Washburn Benton November 21 Mason G. L. Howard Maysville Every Wednesday Evening Meade 1-J. C. Harlman Brandenburg, , , ", November 22 Menifee J M. Kosh Frenchburg Mercer C. B. VanArsdall Harrodsburg November 13 Metcalfe H. R. VanZant Edmonton December 1 KENTUCKY MEDICAL JOURNAL. CODNTT SKCRETARV BE8IDBN0E DATB Monroe R. F. Duncan Tompkinsvillp .November 15 Montgomery J. P. Jones Mount Sterling November 13 Morgan W, H. Wheeler West Liberty November 12 Muhlenberg Clarerce Woodburn Central City November 2S Nelson .Hugh D. Rodman Bardstown December 19 Nicholas B.F.Reynolds Carlisle November If) Ohio Oscar Allen Cromwell November 7 Oldham It. B. Cassady La Grange December 6 Owen J, H. Chrisman Owenton .November 1 Owsley C. M. Anderson Booneviile November 7 Pendleton L. T. Eckler Falmouth,. November Id Perry M. E. Combs Hazara November 12 Pike . . . . W. J. Walters Pikevilln November 1 Powell 1 W.Johnson Stanton November 5 Pulaski Carl Norfleet Somerset November S Robertson Alton U. Wells Mount Olivet .November 19 Rockcastle Lee Chestnut Mount Vernon December 13 Rowan G. C. Nickell Morehead November 27 Russell J. B. Scholl Jabez November 12 Scott 11. V. Johnson Georgetown November 1 Shelby W.E.Allen Shelbyville November Ij Simpson N.C.Witt Franklin Novembers Spencer E C. Wood Wakefiela . . November 19 Taylor J. L. .Atkinson Campbellsville November 8 Todd L. P. Trabue Elkton November 7 Trimlilo F.W.Hancock Bedford November "i Trigg J. L. Hopson Cadiz November 28 Union S. L. Henry Morganfield November 7 Warren W.P.Drake Bowling Green November 14 Washington J. H. Hopper Springfield. R. P. D. No. 3 November 21 Wavne J. 1. :^-nng. Monticello November Webster RoyOrsDurn "' ^^ -i.— = Whitley A. A. Richardson .Wm. T. CoMptte . Sebree November 30 . Williamsburg November 1 November 5 . . . Versailles November 1 CURRAN POPE A. THRUSTON POPE AMOniiRN up-to-date private infirmary equipped with steam heat, electric light, electric fans, modern plumbing and new furnishings. Solicits all chronic cases, functional and organic nervous diseases, diseases of the stomach and intestines, rheumatism, gout and uric acid troubles, drug habits and non-surgical diseases of men and women. No insanity or infectious cases treated. Bed-ridden cases not received without previous arrangement. Hydrolheratiy. Mechanical Massage, Static, Galvanic, Faradic, High Frequency, Arc LItht and X-Ray Treatments given by comfietenl Physicians and Nurses under the immediate supervision of the Medical Superintendent. Special laboratory facilities for diagnosis by urine, blood, sputum, gastric juice and X-Ray. Recreation hall with pool and billiards for free use of patients. Rates $i8 per week,' including treatment, board, medical attention and general nursing. Send for | large illustrated catalog. The Sanatorium is supplied daily , from the Pope Farm, with vegetables, poultry and eggs; also milk, cream, butter and buttermilk from its herd of registered Jerseys. THE POPE SANATORIUM 115 West Chestnut Street LOUISVILLE, KENTUCK' KfjyrUCKY MEDICAL JOVRXAL. WHY YOU SHOULD USE CHLORAZENE The United States Naval Medical Bulletin of July, 1917, states that after a significant series A^ater, ^lillc and F'ood .A.nalyses. CORRESPONDENCE INVITED TELL YOUR PATIENTS TO DRINK PHILLIPS' DIGESTIBLE COCOA COMPOUND Consisting of Cocoa, Sugar and Phosphates, with Vanilla Flavoring Delicious and Highly Nutritious--Easily Digested PREPARED BY THE CHAS. H. PHILLIPS CHEMICAL CO. NEW YORK LONDON No need to question reliability '»' '^ur advertlBers — all are guaranteed. When answering ads mention this JoDBNAL. KENTUCKY MEDICAL JOURNAL. This page is donated by the Kentucky State Medical Association to as- sist in the campaign against Tuberculosis. NOW OF»EN Under new management, with Resident Physician and Medical Advisory Board of twenty well known physicians from the State at large and from Louisville. Infirmary and four cottages for pulmonary tuberculosis patients in all stages. DR. 0. 0. MILLER, Physician in Charge DR. CUTHBERT THOMPSON, Chairman, Medical Advisory Board DR. BEN CARLOS FRAZIER, Vice Chairman, Medical Advisory Board HAZELWOOD SANATORIUM R WjI^ ^^^^^ t^SsssS Administration Building and Infirmary. Operated without any profit by the Louisville Anti Tuberculosis Association for the benefit of patients from any part of Kentucky. PULMONARY CASES RECEIVED IN ALL STAGES Patients should not be sent for treatment without preliminary arrangements for admission. Reservations should be made as early as possible. Capacity is limited to 60 patients. For booklet, terms and reservation of bed or room, address, HAZELWOOD SANAXORIUIM DR. 0. 0. MILLER LongDistanceConnection With All Telephones in the State Station E., Louisville, Kentucky No need to question reliability of advertisers — all are guaranteed. When answering mention this JouRXAL. KENTUCKY MEDICAL JOURNAL. Garrel-Dakin Apparatus Complete as Illustrated $5.00 The Improved Madaco Physician Scales $10.50 THEO. TAFEL 319 Third Street Louisville, - - Kentucky Bran Is Made Delightful Hidden in Wheat Flakes We hide flake bran in rolled wheat flakes, so that users hardly suspect it. The result is a flavory dainty, welcome every morning. Not so efficient as clear bran, perhaps, if people will eat clear bran. But they quit it, as you know. Pettijohn's is something they don't quit. With Pettijohn's Flour it supplies a bran food for every meal, if wanted. We made Pettijohn's to please our doctor friends. And thousands of other doctors have come to rec- ommend it. h is certainly the most popular bran food made. Rolled Wheat with Bran Flakes Soft, flavory wheat rolled into luscious flakes, hiding 25 per cent of unground bran. A famous breakfast dainty. Pettijohn's Flour is 75 per cent fine patent flour mixed with 25 per cent tender bran flakes. To be used hke Graham flour in any recipe; but better, because the bran is unground. The Quaker Q^ts Company Chicago KEXTUCKY MEDICAL JOUEXAL. THE WALKER HOSPITAL EVANSVILLE. IND. A New Nurses' Home is being- erected, having- a capacity of fift-^ beds. Will be finished about October first. DR. EDWIN WALKER DR. JAMES Y. WELBORN ^^^^ Waukesha Springs Sanitarium FOR^THE^CARE^AND TREATMENT OF NERVOUS DISEIi^SEIS Building Absolutely BYRON M.CAPLES..M.D.. Supt. Fireproof AVaukesha, Wis. CATGUT |^f.HTIJ:ll»] A Physiologically Correct Germicidal future T JJ.-WTS & CtF:CIs.. I>r> 21T-2SI DuftieJcl Street ^ Brooklyn, y:.\:, t:.S..A I Louisville Research Laboratory | OF BACTERIOLOGY, PATHOLOGY AND SEROLOGY (Incorporatei) Rooms 700-1-3 Atherton OuUding, T .01 TLgyrT I .T .f: , ky. WASSERMAN REACTION SIO.OO COMPLEMENT FIXATION TEST for GONORRHOEA. 10.00 E.XAMINATION OF TISSUE 5.00 AUTOGENOUS VACCINES 5.00 URINALYSIS BACTERIOLOGICAL EXAMINATIONS BLOOD ANALYSIS .... SPUTUM AN.ALYSIS . . . . S2.50 S2 TO S5.00 $2 TO S5.00 S3.00 ( Entire professional services devoted lo laboratory work. Containers and further information mailed on reauest J. D. AT J .F:N, A-B., IV1.D., Oix' in the Univesity of Louisville, going later to Philadelphia where he completed his long and brilliant career as Professor of Surgery in Jefferson ^Medical College. While residing in Louisville Professor Gross met many of the contemporaries of Dr. McDowell, and thereby learned much of the personality and professional work of that pioneer of American siu'g- ei'.y. Professor Gross resurrected Dr. ^FcDoweH's report of his cases of ovari- otomy from the files of "The Eclectic Repertory and Analytical Review" pub- lished in Pliiladelphia, and in his Report on Kentucky Surgerj^ to the Kentucky State iledical Society in 1852 set forth in a thorough and masterful paper Mc- Dowell's priority as the first surgeon in the world to successfully invade the I'eritoneum and remove an ovarian tumor. This paper was subsecpiently incor- porated in Professor Gross' American Medical Biography, published by Lindsay and Blakiston of Philadelphia in 1861. In 1873 the late Dr. John D. Jackson, of Danville, Ky., wrote and published a "Biographical Sketch of Ephraim ^McDowell," which added materially to ex- isting knowledge of ilcDowell's character and surgical achievements. -In this admirable sketch Dr. Jackson portrayed the claims of jMcDowell to the gratitude of the 'Women of the world and also the honor due to his memoiy from the medical profession. Dr. Jackson urged that Dr. IMcDowell's remains should be removed L'rom the neglected family burying-ground at "Traveler's Rest," the former country home of GoA^ernor Shelby, and suggested that the women of the world who have been rescued from lingering death by the operation he devised should erect a monument over his grave. Dr. Jackson was so deeply imbued with this idea that his enthusiastic appeal in the press, in the medical societies and m pri- v^ate correspondence won the approving interest of Professor Gross, Dr. J. JIarion Sims and other prominent American surgeons. In 1875 Dr. Jackson presented his appeal to honor McDowell's memory to the American Medical Association, and a Committee, of which Dr. J. ilariou Sims was Chairman, reported a recommendation that a fund to be known as the ^lo- Dowell Memorial Prize Essay Fund be established to perpetuate McDowell's memory, and that "tO' the profession of the State of Kentucky be left the privi- lege of suitably marking his resting place.'" Under the conditions of the or- ganization of the American Medical Association at that time such disposition of the subject was equivalent to its burial, although Dr. Sims did not so intend. At that time all executive business was transacted in the general session, and the 'personnel of the convention changed from year to year with the place of meeting. Tn December of 1875 Dr. Jackson died, and his pupil and devoted friend, Dr. Lewis S. I\IcMurtry, then of Danville, now of Louisville, a recent graduate in medicine, assumed the continuance of Dr. Jackson's cherished plan to place a suitable local memorial to McDowell. Dr. Mcilui-ti-y brought the subject before tlie Kentucky State IMedical Society, at Hopkinsville, in the following year, and a Committee, with Dr. McMurtry as Chairman, Avas appointed to erect a monument to Dr. McDowell in Danville. Dr. MeJ\Iurtry undertook this difficult task with a very limited acquaintance with the medical profession of the State, and carried it to a successful conclusion despite many obstacles and much discouragement. He raised the money from subscriptions of members of the profession to provide the granite shaft which now marks McDowell's grave in McDowell Square in Danville. In addition he secured for this purpose the beautiful square near the center of Danville, and removed thereto the remains of Dr. McDowell and his wife. In response to his appeal the citizens of Danville contributed a fund to grade, enclose and beautify the square. Professor Gross, Dr. E. R. Peaslee, and other distinguished American surgeons encouraged Dr. McMurtry 's efforts by sending contributions to the McDowell Memorial Fund. This was Dr. McMurtry 's first important public service rendered in liehalf of llie medical profession of his native State, and won for him the gratitude and esteem with which the profession has since honored him. In 1879 the Kentuck;\^ State Medical Society convened in Danville, and this was. the most brilliant occasion in its history. Professor Gross came to personally dedicate the McDowell monument, and in the presence of a large concourse of Kentucky physiciajis, with many distinguished surgeons from other states, among them Dr. Lewis A. Sayre, President of the American Medical Association, and Dr. Gilman Kimball, of IjowcII, ]\Iass.. a famous ovariotomist of that day, many prominent laymen, including the Governor of the Commonwealth, delivered the eloquent address which will be found with the other proceedings of that occasion in this mimber of the Journal. Thus was fixed in history for all time the fame of Kentucky's greatest pioneer surgeon. J. N. McCormack. Ephraim ]\IcDowell. ,3y permission of the American Gynecological Society.) 1771-1830 From a painting, supposed to have been made about time his first ovariotomy was performed. I. THE McDowell group BIOGRAPHICAL SKETCH OF DR. EPIi- RAiM McDowell.* By John D. Jackson, iM. D., Danville. Dr. Ephraini ilcDowell 'was born in Ropi^- bridge county, Va., on the llth day of Mo- vemlier, 1771. His ancestors belonged to the clan of the Duke of Argyle, in Scotland, but, iiaving embraced the covenant, were so perst cutecl during the reign of Charles L, that they TOOK reruge in the counties of Antrim ana liOndondery, in the north of Ireland. In 1737 they removed to the Valley of Virginia, and settled upon an immense tract of land in Rockbridge county, granted by James II. to Benjamin Borden, who. in partnership with the McDowells, furnished the emigrants re .'quired to make the grant effective. His father, Samuel McDowell, (his mother's maiden name was Sarah MeClung,) was for many years engaged in political life as a mem- ber of the Legislature of Virginia, but in 1782 he was appointed by the Virginia Assembly a Ijand Commissioner for Kentucky, then a coun- ty or appanage of Virginia, and in the follow- ing year removed with his family to Danville, Ky., where he received the appointment of Judge of the District Court of Kentucky, which held its first sitting, and all those of its early years, in the town of Danville. ^''oung Ephraim JMcDowell received his early education at the classical seminary of Messrs. Worley and James, :who taught at (xeorgetown, and afterwards at Bardstown. He then went to Virginia, and entered the of- fice of Dr. Humphi'eys, of Staunton, as a medical student, where he remained for tiwo or three years. Of Dr. Humphreys we know but little, save the fact that he was a gradu- ate of the University of Edinl;)urgh, and that in his day he enjoyed a considerable local reputation, and an extensive ijraetice in Staunton and its vicinity. That he was a good instructor, also, is highly probable; at least we know the fact that another of his pu- pils, Dr. Samuel Brown, one of the founders, and one of the first corps of lecturers of the Medical Department of Transylvania Uni- *Eeprintea from the Kichmond and Louisville Medical Journal, 1873. \ersity at Lexington, arose to high distinc- tioji. In 1793-4 McDowell attended lectures at the University of Edinburgh contemporaneous- ly with his -countrymen. Dr. Samuel Brown, above alludedi. to, and Drs. Hosack and Da- •iiclge, of New York, and Brockenborough, of Virginia, all of whom subsequently gained eminence in the profession. AVhile in attend- ance on the course at the University he also took a private course under John Bell, who at that time did not belong to the Faculty, ajid it seems that the brilliant predilections 01 this most able and eloquent of the Scotch surgeons of his day impressed him very pro- foundly. That portion of his course in which he lectured upon the diseases of the ovaries, dwelling upon the hopeless death to which their victims were inevitably fated, and mere- ly suggesting the possibility of success follow- ing so shockingly severe an operation as any attempt at their extraction would prove, was never forgotten hy his auditor, for undoubted- ly it 'WHS the principles and suggestions at this time enunciated by the master which, six- teen years after, determined the pupil to at- tempt his first ovariotomy. He did not re- main long in Edinburgh after finishing his <,'0urse, but i-eturned to Danville at the ex- piration of two years, preceding his return liome by au extended tour afoot through Scot- land, in company with two of his American compatriots, Drs. Brown and Speed. As far as we know, the degree of JM. D. was not actually conferred upon him until 1823, when, entirely unsolicited on his part, the Univers- ity of Jlarylancl honored itself by conferring upon him the honorary degree of M. D. The I\ledical Society of Philadelphia, at the time the oldest and most distinguished of the kind in this country, had sent him its diploma in 1807. Upon his returii to Danville in 1795, Dr. JlcDowell at once entered upon the practice of his profession and, commencing as he did, with the eclat of an attendance upon the then mo.st famous medical school of the world — for i^Jdinburgh at that time held the position since occupied by Paris, and now held by A'ienna, as the centre of medical science — he soon assumed the first professional position ]2 KEXTVCKY MEDICAL JOURXAL. in his looalily, and speeilily advauciug the L-xteut of his reputation within a very few \ears, l)ecaiiie known throughout all the Western and Southern States as the first surgeon west of Philadelphia. For a quarter of a century indeed, or irntil Dr. Benjamin W. Dudley of Lexington, came upon the field, and as a lecturer upon surgery yearly came liflore large classes of young men assembled at the JMedical DeiDartment of Transylvania L'niver.sity from all portions of the Ohio and jlississippi Valleys, had an opportunity for extending a reputation such as no man in the West ever had before him. we may .say that Dr. ^IcDowell stood ^\-ithout one to dis- pute his position as facile princcps in surgery west of the Alleghanies. During this time his practice extended in every direction, persons coming to him for treatment from aU the neighboring states, and he frequently taking horseback jotirneys for hundreds of miles, generally the only mode of travel for long distances at that day, when neither turnpikes nor railways existed, to o]j(?rate npon persons whose difficulties were of stteh a nattire as to j^revent their visiting him at Danville. As far as is known, he was in tlie habit of performing e^•ery surgical op- eration then taught in the science. In lith- otomy he was extremely successful; up to 1S2S he was known to have operated twenty- two times without a single death. For stran- gulated hernia he also operated in a large number of cases, and we have good rea.sons for believing that he successfully extirpated the parotid gland long before MeClellan or any other American surgeon had attempted it. Indeed, there was scarcely anj'thing from a simple amputation to tracheotomy which was to be done btit that, if Dr. I\IcDowell was accessible, he was sent for to perform it. It was in the winter of 1809, when he had l)een practicing his profession for fourteen years, that he wa.s sent for to see Mrs. Craw- ford, residing in Green county, Kentucky, some sixty miles from Dau\ille, who was thought by her dcc-toi-s to have gone long be- yond her time in pregnancy, or to be the stib- .iect of extra-uterine foetation. ilcDowell found her trouble really to be an ovarian tu- mor, rapidly hastening to a fatal termination. Tu quote the graphic description of Dr. Gross : ""After a most thorough and critical exarnin- alion. Dr. ^FcDowel! informed his patient, a woman of unusual courage and strength of n.ind, that the only chance for relief was the excision of the diseased mass. He explained to her, with great clearness and fidelity, the nature and hazard of the operation: he told her that he had never performed it, bvit that he was ready, if she were x^illing, to under- take it. and ri.sk his reputation upon the isstie, adding that it was an experiment, but an ex- periment well Avorthy of trial. 'Mrs. Craw ford listened to the surgeon witli great pa- tience and coolness, and; at the close of the interview, promptly assured him tJiat she was not only willing, but ready to submit to his decision; asserting that any luode of death, suicide excepted, was prefer- aljle to the ceaseless agony which she was en- du)-ing. and that she would hazard an\-thing that held out even the most remote prospect of relief. The result has been long before the profession. ]Mrs. Crawford submitted to the operation, and thus became the first sub- ject of ovariotomy of whom we have any knowledge." 3Irs. Crawford was fortj'-seven at the tame of the opei'ation, and died on the 30th of -March, in 1841, aged seventy-eight. Althotigh the success in Mrs. Crawford's case had been everything which cottld be de- sii'cd, it was not until seven years afterward, and when he had twice repeated the opera- tion, that he published any account of it. In J 81 6 he prepared a brief account of his lii"St three cases, a copy of wliich he forwarded to his old preceptor, John Bell, who was then ti-aveling on the Continent for his health, and had left his patients and professional corre- spondence in the charge of Mr. John Lizars. Though 3Ir. Bell lived until 1820, he never leturned to Edinbttrgh. and for some reason the commttnicatiou of his old pupil failed to reach him. Another copy of the report, how- ever, was sent to Philadelphia for iJubliea- fion, and appeared in the Eclectic Repertory a lid Annlijtical Be view, for October, 1816. and will follow this paper. The brevity and the rather loose manner in which his first ca.ses were recorded, exposed Dr. ^IcDowell to criticism, and Dr. Hender- son and Dr. ^lichener, of Philadelphia, each, in articles in the Repertory, i-eviewed him rather sarcastically and doubtingly, while Dr. James Johnson, the catistie editor of the Lon- doii Meclico-Chinireiical Review, did not hesi- tate to take advantage of the opportunity, and declared outright his total disbelief of Dr. ^fcDowell's statements. A few years there- after, when the accuracy of the report had been fully confirmed, he. however, frankly ac- knowledged his pre^^ous error, sa^•ing: "A back settleui'^nt of .\merica, Kentttcky. has beaten the mother eottntry, nay Europe it- self with all the boasted stirgeons thereof, in tlie fearful and formidable operation of gas- trotoray with extraction of diseased ovaries. * * * There were circumstances in the nar- i-ativc of the first tltree cases that raised mis- givings in our minds, for which tmeharitable- Jiesp we a.sk pardon of God and of Dr. !Mc- Do>vell, of Danville." In the Heperlory for October. 1819, he re- ]iorted two more eases, and, in connection with t]i-?m. incidentally alltided to his critics and Iheii- criticisms to this effect: MEDICAL PIONEEh'S OF KENTVCKY. 13 ■'I thought my statement sufficiently ex- plicit to warrant any surgeon performing the operation, when necessary, without haz- arding the odium of making an experiment, and I think my description of the mode of op eration, and of the anatomy of the parts con- cerned, clear enough to enable any good anat- omist possessing the judgment requisite for a surgeon, to operate with safety. I hope no ojierator of any other description may ever attempt it. It is my most ardent wish that this operation maj^ remain to the mechanical surgeon ever incomprehensible. Such have been the bane of the science, intruding them- selves into the ranks of the proifession, with destructive to their patients, and disgracefiil to the science. It is by such the noble science has been degraded, in the minds of many, to the rank of an art." In the summer of 1822 he made a long horseback jonrney of some hundreds of miles into iliddle Tennessee and back, and perform- ed ovariotomy with a successful result upon ^Irs. Overton, who resided near the Hermi- tage, the residence of the late President Jack- son. Mrs. Overton was enormously obese, and ho- had to cut through four inches of fat ujion the abdomen. The only assistants he had in the operation, as we have been inform- ed, were General Jackson and a ilrs. Priest- TRAVELERS' REST Near Danville, the home of Isaac Shelby, first and sixth Governor of Kentucky. Here Dr. McDowell was mar - rled to Sarah Shelby, daughter of the Governor, in 1S02. and here they both lay buried until their bodies were removed to Monumsnt Square, Danville, in 1879. no other qualification, but in boldness in un- dertaking, ignorance of theiT responsibility and indiifereuce to the lives of their patients -, jiroceeding according to the special dictate of some author as mechanical as themselves, they cut and tear "with fearless indifference, in- capable of exercising any judgment of their own in cases of emergency ; and sometimes without possessing the slightest knowledge of the auatomjr of the parts concerned. "The preposterous and impious attempts of such pretenders can seldom fail to prove le,y. General Jackson seems to have been greatly pleased with the Doctor and had him to go to his house and remove a large tumor growing from the neck and shoulder of one of ills negro men. Dr. I^IcDowell's charge for his operation upon Mrs. Overton was five hundred dollars, but the husband, with n commendable generosity, gave a check upon one of the Nashville banks for fifteen hun- dred dollars, which upon the Doctor's pre- senting for payment, and discovering the pre- suined error for the first time, sent a messen- 14 KENTUCKY MEDICAL JOUL'XAL. gur back to ^Ir. Overtou to have it corrected, iiut that g-entleiuau replied that, far from be- ing a niistaJve, he felt that he had not even tlieu made a fiUl cooipeusatiou for the great service which Dr. .McDowell had rendered. How many times during his career he had occasion to perl'orin ovariotomy is not now certainly known. He seems to have been fonder of the scalpel than the pen; indeed, to have been of that cla.ss of mankind, of which we liave all seen si:)ecimens, even among the ablest ami most cultivated, who have a nat- ural antipathy to writing. He is said to have kept no notes of his cases, and with the ex ception of the two communications above quoted, and in 1826, when many tried to wrest liis honors from him, a card to the pro- tcssion, and addressed especially to the ■"-Medical Faculty and Class at Lexington," which he was induced to publish, defending his veracity and claims to having been the hrst to perform and estahlish the feasibility of the :-einoval of diseased ovaries, is about all he wrote for publication regarding his o])eratious. However, his nephew, Dr. Wm. -\. McDowell, who was for five 3'ears his pu- pil, and two yeai-s Ms partner, tells us that up to J 820 his uncle had done seven cases, six of which he witnessed, and that six of the seven were successful. After the removal of this nepiiew from Kentucky tO' Fineastle, Vir- ginia, Dr. Albaii G. Smith succeeded to his position as partner to Dr. Eplii'aim McDow- ell, and while with him Dr. Smith himself twice performed ovariotomy. The younger .McDowell stated that he had reliable testi- mony of his uncle having during his life op- erated at least thirteen times, exclusive of the two eases Dr. Smith operated upon, when they were in partnership, and that of the cases operated upon by his uncle subsequent to )iis retiring from partnership, he had per- sonal knowledge of the recovery of two. This Mould make a total of thirteen cases, with eiglit recoveries. Or. ^IcDowell seems to have been very cai-eless of either his present or posthumous fame, and to have originally drawn up the report of his cases at the repeated solicitation oi' liis nepliCAV, Dr. James McDowell, who, up to the time of ills premature di,'ath, had been tile partner of his uncle, as his cousin Will- iam, to whom we have alluded, afterwards was. The idea that his success would be pleas iiig to his former preceptor, John Bell, to wlicm he felt he owed his determination to perform the operation, according to his nephew, seemed more than all el.se to have in- duced him to put his cases befoi-e the profes- sional world. Long after all dispute of the authenticity of Dr. ^IcDowell 's cases had ceased, the med- ical literature of the past was ransacked to find some one who had preceded him in the ojieration. Indeed, until the critical investiga- tions of Dr. Gross, it was generally believed that L'Aumonier, Dzondi, and Galenzowski had all preceded hun, by having each done at least a single ovariotomy. Going to the orig- inal records of these gentlemen, however, it was found that the first had only punctured an abscess of the ovai-y. that Dzondi 's was sim- ply a case of gastrolomy upon a boy for a pelvic tumor, and Galenzowski 's case while really an imperfect ovariotomy, was not done initil 1827, eighteen years after the first ease of ?iIeDowell. When Dr. Ephraim McDowell performed his fii'st operation, as he said in the publication of it, he had never "heard of an attempt or success attending any opera- lion such as this required." At present we are not aware tliat even the most persevering antiquarian research has been able to find an undoubted ovariotomy before the time of Mc- Dowell; for although we observe that Mr. Sjiencer Wells, in his recently published his- tory of the oi'igin and progress of ovariotomy, sa.vs, on the authority of Dr. Washing-ton L. Alice, that Dr. Robert Houston operated near Glasgow in 1701, and that "from this case it will appear that ovariotomy originated with Uritish surgeiy, on British ground," yet a reference to the original record shows very jiiainly that Dr. Houston was never really an ovariotomist, in the sense of his having re- moved an ovarj^, his operation, like L'Aumon- ier's, consisting of laying open the diseased ovary and evacuating a large quantity of gel- atinous fluid, when, as he saj's, "I. squeezed out all I could and stitched up the wound in three places almost equidistant." We ob- serve that Dr. Allee, in his volume on "Ovar- ian Tuuiors, " dedicates the book to his brother, Dr. John L. Atlee, and to the mem- ory of "Dr. Eplu-aim McDowell, the Father of Ovariotomy." Even had the operation been done many times before, forgotten or un- noticed, as the case lay among the dead rec- ords of the past, it should not and would not derogate at all from the glory of Dr. Mc- Dowell, who had never heard even of any at- tempt to perform it, and who, after liis per- formance of it, first succeeded in ef^tabldsli- ing it as a legitimate operation in the medical world. When we think of one living on the border of Western civilization, in a little town of between four and five hundred inhabitants, far removed from the opportunity of consulta- tion with any one whose opinion might be of any value to him in such a case, and near a thousand miles away from the nearest hos- pital or college dissecting-room at which he might have had opportunity of studying and ])racticing upon some body who had perished of the disease before performing a new tm- tried operation of such fearful magnitude up- on the living, and learn of his liaAnng ponder- ed and contemplated all the difficulties, and MEDICAL PIONEERS OF KENTUCKY. 15 with a full sense of the dangers liable to envi- ron him in the attempt, and then, without ether or chloroform, and by the aid of prob- ably only one fully skilled assistant and two or three medical students, see him attempt and successfully perform tlie first ovariotomy, our admiration for Dr. Ephraim McDowell's courage and skill rises to its full height, and we feel that he is justly entitled to have ap- ].)]ied to him Horace's words, describing the stoutness of heart of the first mariners who had the boldness to go down into the sea in ships : Illi robur ct ase triplex, Circa pectus erat, qui fragilem truci Ccimmisit vclago ralem Primus. Dr. McDowell, in person, was nearly six- feet in height, of commanding carriage, of a rafher florid complexion, with black eyes and dark hair, and deemed in youth a quite hand- some man. He was always remarkable for liis strength and agility, and while at Edin- Irargh was pronoiinced the swiftest foot-racer of the whole University, He was one of the kindest-hearted and most amiable men, over- ilowing with cheerfulness and good humor, and readily approachable by the world. He seemed to be totally devoid of all reserve and austerity, a tinge of which is generally char- acteristic of the scholar and professional man, and never appeared to assume that thei-e was any difference between the plane of his voca- tion and that of the humblest imlettered artisan. This seemed instinctively to strike all who came in contact with him, and an easiness amounting almost to familiarity ex- isted b(4ween him and his fellow-citizens. So true was this, that with the masses, prob- ably because of this very fact, he was not gen- erally appreciated for his true worth. A man in manner arrogating to himself nothing above the populace, as may readilv be believ- ed, would not, save by those gifted with some- thing above common penetration be acknowl- edged to be superior to their sphere. Never, however, was any of this air of familiarity in the slightest degree tinctured with profes- sional demagoguery. His bitterest enemies did not once accuse him of this. Bv a gentle man of keen perception, yet living, whose father's family physician Jie was, I am told that never was there a man- whose life was freer from the acts of the charlatan, or more entirelv devoid of all the petty "tricks of trade," which too frequently disgrace the medical profession. Wliile in- the sick rooin, though he was fond of gossiping about loea'' matters and the events of the dav, he habitu- ally refrained from discussing things medical, or any of the affairs of his rivals, with some of whom he was publicly kncnvn to be on ajiything but good terms. While in daily competition with certain members of the pro- fession, whose chief strength /was in the ap- ])lication of such arts, they and their artifices were held in supreme contempt by him. From what we can learn, one of the constant en- deavors of these gentlemen, who knew that they never could approach McDowell by fair competition, was to try to train the com- munity to believe that there was a sort of essential incompatibility between surgery and medicine; and that because he was infinitely their superior in surgical knowledge and manual dexterity, ,iust by so much was he their inferior in all the intricacies of the prac- tice of medicine, whose arcana were not so appreciably evident to the public as the more demonstrable worlc of the surgeon. Or, as thej'' were in the habit of putting it, that while he was a bold surgeon, he was but a poor "fever doctor." So far from this being the case, however, he kept himself fully abreast with the progress of medicine by reading all that was new on the subject, and was prob- alily really as far in advance of his coimpetit- oi's in physic as in surgery. Certainly we now know that in the treatment of fever, he was in some respects ahead of his time, though at variance with the generall}^ accepted doc- trines of his day and the prevailing custom of the physicians of his section. At that period it was customary to give more or less mercurj- in the progress of every fever and, a.fter a dose of calomel or blue-mass, to allow the pa- tient cold water was thouaht to be recklessly dan serous. The standard ti-eatment of the country was, to let the patient have no drink l)ut what was warmed, and this usually con sisted of water in which a piece of burnt bread-crust or wann toast had been .soaked. On the contrary. Dr. McDowell used to tell his patients that there was no danger in cold water while the skin was hot and, while such was the case, he allowed them to u.se it ad lih- ilHW.. 1 have heard an old gentleman, who lived in an adjoining countv tell how. when he was a. boy, and one of his brothers lay verv ill of a fever. Dr. McDowell was sent for, and of the anxious fears of the family, while obeying" the directions of the Doctor, who had the patient laid naked upon the floor, and bueketful after bucketful of cold water nour- ed over him, to his great relief and ultimate recoverv. In medicine he looked upon Syden- baiu and Cullen as the master minds and set their works above all others on practice. To the svstem of over-drupitring. then so common, he was an enemy, belie^dnsf that as then given bv the mass of the profession, without discrimination, drues were produc- ins'. in the asiarregate. more harm than g-ood, Tlionaii practicing medicine with more than ordinarv abilitv. vet his inclinations were alwavs especiflllv toward sura-erv, and it was his custom, when practicable, to throw as far 16 KEXTUCKY MEDICAL JOVnXAL. as possible the iiiedieal practice into tlie hands oh" liis partner. lie was a most aceomfplished anatomist, !i)i(i nsod every winter, in conjunction with liis office students, of whom he generally had at least two or Ihree, to dissect in the upper story of an old abandoned building -which lind formerly been the county jail; and his office, in the course of time, had quite a uuui her of anatomical preparations, the work of liis own hand. "When having determined upon tlie performance of any capital operation, his custom was to di'ill beforehand his students who were to assist him thoroughly, until each, was perfect in the part he was to perform : not only this, but he compelled each to give a succinct history of the nature of the difficulty i-equiriu-g the operation, the anatomy of the jiarts involved, the tissues to be divided, and then to rehearse the different steps of the op- eration itself. As an operator, it was the in- variable opinion of all competent judges that, for coolness and dexterity, they had never seen his equal. From the moment he took the knife in his hand, preparatoiy to operating, he -.eemed to become enthused, and to the by- standers looked like quite a different man. He po.ssessed an excellent medical library for his day and locality, and was in the habit of purchasing most of the principal new works on their issue. While having a fair knowledge of the classics, yet most of his pro- fessional leisure he gave to history and belle- lettres. Burns was an especial favorite with him. and fro'u his familiai-ity with the Scot- tish dialect, acquired while in Edinburgh, his readings and quotations were given with the idiom as perfect as if he had been a native of '"Auld Keekie." As a citizen, he was charitable and public spirited, favoring and contributing, by his means, to mo.st of the enterprises which prom- ised wood to the conuuuuitv in which he resid- ed. He was an especial friend to r'entre Col- h'ge, cooperating larselv by his influence and money toward its foinidation, and was indeed one of its original corporators and curators. This. too. although its government was the Presbvterian Church, while he himself was. in ]-eligion. an Episcopalian. The site of the present Episcopal edifice. TrinitA- Chui-ch, was a contribution from Dr. IMcDowell. In ISO? he marT'jed Sarah, a daughter of Governor Isaac Shelby, -with whom he lived happilv, and raised a family of two sons and four daughters, onlv three of whom suiwived hitn. ^Irs. ^rcT^owell was his survivor by ten years. While in the full vigor of life, and in the iiiidst of his professional work, he contracted an "inf.amniatorv fever " and, after an ill- ness of a fortnight, died in DauAnlle on the 2fith dav of -June. 1S30. and was buried at Ti'avelers' Rest, one of the estates of the Shel- by family, some six miles south of the town. When we consider the results to mankind of the labors of Dr. ^McDowell, we do not hesi- tate to rank him with the great benefactors of the race. Before the 19th century, of the thousands of women afflicted with ovarian ili'opsy, to net one could the most astute or boldest of the healing profession pi-omise a ay thing hopeful. Tlie promise of the doctor, wh'm called to such a case, was that of the pi'iest, and not much more; for he could only say: "two years of life, filled -with gradually increasing nr'sery. is the full. compass of the days allotted to a woman who may find that she has an ovarian tumor, and unless God \\orks a n\iracle in your case, such is your in- evitable fate." But now, since the establish- ment of ovariotomy by ^McDowell, the matter stands quite differently, for the physician of our era to-day, can say; "it is trae that with- out an riperation you are ine\itably doomed to death after some two j-ears of miserable suf- fering; but by ovariotomy you have seventy chances or more out of a hundred, much bet- ter than one undergoing an amputation of the thigh, not only of recovery, but a full restor- ation to health." Dr. Peaslee has made a calculation, based on this kno'wn law of the length of life of i woman who had an ovarian tumor uninter- fered with, and the average age of all the recorded cases of ovariotomy up to 1S70. and the probabilities of longevity of healthy wo- men of that age, according to the most ap- proved tables of life insurance, and has sho'svn that, "in the United States and Clreat Brit- ain alone, ovariotomy has, within the last thirty years, directly contributed more than thirty thousand years of active life to woman : all of which would have been lost had ovari- otomy never been performed"; to say nothing of saving her more than a thousand years of TUitold suffering. With these facts before them, most devoutly indeed should all wo- mankind bless the name of I\rcDowell. To one living in Athens in the days of the glory of ancient Greece,, and conferring siach a boon on the hitman race as OA'ariotomy. rank among the demigods with a temple and an altar, wotdd have beeii accorded him by accla- mation of the people. Had he lived in the palmv davs of the "Roman Republic, the high- est civic honors, a medal and a statue, if not a shrine in the teiuple. would have been his bv a decree of the Senate: and had Ephraim ^IcDowell been born and flourished in any one of the principalities of Europe, instead of the I"^nited States, long since would the Government, proud of siich a son, have con- ferred titles of distinction upon him and his children while living, and erected a fittinor monument to his memory when dead. But it seems that to us of the boa.sted Great Repub- MEDICAL PIONEEh'S OF KENTUCKY. 17 lie of the Western World, the proverbial charge regarding the ingratitude of Republies is literally applicable in the case of the sub- ject of our sketch. Sueh were the thoughts wliieh crowded upon us recently, when we made a pilgrimage to the burial-ground of the Shelby family at Travelers' Rest, and af- ter climbing the stone-wall enclosure, finally succeeded in struggling our way through the brambles, briars, tall weeds, and rank grass, to the neglected, lichen-covered sandstone slab, with simply the name of Ephriam Mc- Dowell upon it, which lies superimposed above erect the tallest shaft in all the land to mark his resting-place, she would but justly confer the worthiest of honor on one of her children ; yet does his fame not rest with us alone, nor is the benefieience of ovariotomy confined alone to our part of the globe. Ijike Jenner, McDowell has been a bene- factor for the generations of all times, and all countries, and as a few years ago the world at large contributed to the statue of Jenner, now erected in Hyde Park, London, so do v/e think it most fitting that all nations be al- lowed to contribute to a suitable statue to Mc- THE GRAVES OF DR. AND MRS. McDOWELL AT TRAVELERS' REST the remains of one to whom the whole world should feel deeply grateful, and of whom Kentucky and the American Republic may always be justly proud. While Kentucky, and nearly every state of the Republic, have at different times voted monuments, statues or paintings, to one and another political favorite or military idol of the day, the worthiness of the commemoration of none of whom is to be compared to that of McDowell, and while if our State should Dowell, to be erected in Danville, the scene of the first ovariotomy. But since Dr. McDowell has been woman's special benefactor, we think it would be especially appropriate that the gratitude of the women of all nations should be allowed to display itself in the erection of a fitting memorial to their friend. Indeed, that a bronze statue of life size should be erected solely from the voluntary contribu- tions throughout the world of those who may owe their lives to the operation of ovariotomy. ]8 KENTUCKY MEDICAL JOURNAL. TTIUEE OASES OJ^^ EXTIRPATION OF DISEASED OVARIES.* I5y EpiTRAiM McDowell, M. D. '•Ciiso I. Ill Deeeinlier, 1809, I was called to see a Mrs. Crawford, who had for several iiionths thought herself pregnant. She was aPfeeted with pain .similar to labor pains, for was to one side, admitting of an easy remov- al to the other. Upon examination, per \aginaui, I found nothing in the nterns, which induced the conclusion that it must be an en- larged ovarium. Having never seen so large ;i substance extracted, nor heard of an at- tempt or success attending any operation such as this required, I gave to the unhappy wo- man information of her dangerous siutation. THE FIRST OVARIOTOMY Copy of an idealized picture, said to have been painted from a sketch and description by Dr. Albin Goldsmith, a partner of Dr. McDowell, and an assistant at this and other of his operations. By the courtssy of Dr. Fayette Dunlap. DanvHle which she could find no relief. So strong was the presumption of her being in the la'st stage of pregnancy, that two physicians who were consulted in her case requested my aid in de- livering her. The abdomen was considerably t'ularged. and had the appearance of preg- nancy, Ihough the inclination of the tumor *.V reprint from the Electric Kepertoiw anfl Analytical Review, of Philadeluhia. October. ISlii.then the only medical journal published in this country. She appeared willing to undergo an experi- ment, which I promised to perform, if she would some to Danville, the town where I live, a distance of sixt,y miles from her place of residence. This api:)eared almost imprac- ticable b.y any though the most favorable con- veyance, though she performed the journey in a few days on horseback. "With the assist- iuice of my nephew and colleague, James ^Ic- Dowell, M. D.. I commenced the operation, MEDICAL PIONEERS OF KENTUCKY, 19 which was concluded as follows: Having j)laced her on a table of the ordinary height, on her back, and removed all her dressing 'which might in any way impede the opera- tion, I made an incision about three inches long, from the musculus rectus abdominis, on the left side, continuing the same nine inches in length, parallel with the fibres of the above- named muscle, extending into the cavity of the abdomen, the parietes of which were a good deal contused, which we ascribed to the resting of the tumor on the horn of the saddle during tlie journey. The tumor then appear- ed full in view, but was so large that we could not take it away entire. We put a strong liga- ture around the Fallopian tube near to the utei'us ; we then cut open the tumor, which was tlie ovarium, and the fimbriated part of the Fallopian tube very much enlarged. We took out fifteen pounds of a dirty, gelatinous- looking substance ; after which we cut through tlie Fallopian and extracted the sac, which ^^•eighed seven pounds and a half. As soon as the external opening was made, the intestines i-ushed out upon the table, and so completely was the abdomen filled by tumor, that they could not be replaced during the operation, which was terminated in about twenty-five minutes. We then turned her upon her left side, so as to permit the blood to escape, af- ter Avhich we closed the external opening with tlie interrupted suture, leaving out at the lower end of the incision the ligature which surrounded the Fallopian tube. Between every two stitches we put a strip of adhesive plaster, which, by keeping the parts in con- taet. hastened the healing of the incision. We then applied the usual dressing, put her to bed, and prescribed a strict observance of the antiphlogTstic regimen. In five days, I visited her, and much to my astonishment found her engaged in making up her bed. ] gave her particular caution for the future and in twenty-five days she returned home, as she came, in good health, which she continued to enjoy." "Case II. Since the above case, I was call- ed to a negi'o woman who had a hard and very painful tumor in the abdomen. I gave her mercury for three or four months, with some abatement of pain, but she was .still un- able to perform her usual duties. As the tumor was fixed and immovable, I did not advise an operation, though, from the earnest solicitation of her master and her own dis- tressful condition, T agreed to the experiment. 1 had her placed upon a table, laid her side open, as in the above case, put my hand in, found the ovarium very much enlarged, pain- ful to 1he touch, and firmly adhering to the vesica-urinaria and fundus uteri. To iex- trai.'t, I thought would be instantly fatal ; but l)y way of experiment, I plunged the scalpel into the diseased part. Much gelatinous sub- stance, as in the above case, with a profus- ion of blood, rushed to the external openiug, and I co]iveyed it off by placing my hand un- der the tumor and suffering the discharge to take place over it. Notwithstanding my great cai.-e, a quart or moi'e of blood escaped into the abdomen. After the hemorrhage had ceased, I took out as cleanly ns possible the blood, in ^vhich the bowels were completely enveloped. Though I considered the case as nearly hope less, T advised the same dressings and the sa.ae regimen as in the above case. She has entirely recovered from all pain, and pursues her ordiiiary occupation.'' "Case II. In May, 181,6, a negro woman was brought to me from a distance. I found the ovariiun much enlarged, and as it could be easily moved from side to side, I advised the extraction of it. As it adhered to the left side, I changed my plan of opening to the linea alba. I began the incision, in company with my partner and colleague. Dr. Wm. Coffer, an inch below the umbilicus, and ex- tended it to within an inch of the os pubis. I then put a ligature around the Fallopian tube, and endeavored to turn, out the tumor, but could not. I then cut to the right of the umbilicus and above it two inches, turned out a scirrhous ovarium, weighing ,six pounds, and cut it off close to the ligature put arOund the Fallopian tube. I then closed the external opening as in former cases, and she complain- ing of cold and chilliness, I put her to bed prior to dressing her ; then gatve her a wine- glassful of cherry-bounce and thirty drops of laudanum, which soon restoring her warmth, when she 'was dressed as usual. She was well iji two weeks, at the end of which time the cord was taken away, and she now, withoiit complaint, officiates in the laborious occupa- tion of cook to a large family. ' ' Danville, Kentucky. 20 KEXTI'CKY MEDICAL JOUFXAL. FACSIMILE OF A LETTER FROM DR. McDOWELL.* WRITTEX THE YKAR BEFORE HIS DEATH. ^./-^^.^ ^^^^..^^^ ^>^.J^J_^C^^. ^ ^-»-k c •This letler. cletailinsr the circumstances leading up to and attending the first ovariotomy, was written to Dr. Robert J. Thompson, then a medical student in Philadelphia, but always a citizen, and until his death in 1SS7, a highly respected phy- sician, of Woodford county. Kentucky, where three of his children, including Dr. E. J. Thompson, junior, still reside. It is expected that the original letter, handsomely framed, will be given an honored place on the walls of the State Historical Society, in the Capital Building at Frankfort. As will be seen, this letter was written before the days of stamps and en- velopes. MEDICAL PIONEEIW OF KENTUCKY. 21 ^ ^l^C-^'^y J-^' •^ < r\,t-*,--r-%. ,#**-/ KENTUCKY 3IED/(!AL JOURNAL. 'Tw' Cf, Z/^**-/ ./I «-' »-v-#'r*» ^/.^ fT\^*-r^ ■. ^^ .1^ ^ / ■j^;6*. 1. 1 -7a KESrrcKY MEDKAL JOfRXAL. .Toiix DAViRs JACKSOX. :\r. D. Hy Lewis S. .Mc:^IrKTnv, .M. I).. L.L. D. ■Tolin Davios Jaeksoii was born in Danville on Dec-ciuber 12, 1834 and died in that place on December S, 187o. not completing the forty-first year of his life. He was the eldest child of John and Margaret JaeksoU; both natives of Kentucky. He reeived his educa- tion at Centre College in Danville, from which institution he received the degree of A. B.. in l.So-i. He was an excellent student, and early gave e\'idence of the power of close appliea- ing disposition, jiublic recognition of his abil- ity and qualifications came very slowh' ; but ho was never idle. He gave himself with en- thusiasm and close application to the stud}- of medical literature. He also began the study of the French language, in which he became quite profiiient and thei-eby familiarized him- self with the best medical literature of Eu- rope. The unremitting labor of these early ^eai-s of practice laid the foundation of broad scientific culture which distinguished his later career. Dr. Jackson had become fairlv establi.shed DOCTOR JOHN D. JACKSON 1S34--187S lion. Immediately after his graduation he entered upon the study of medicine, and iu Ihe autumn of 1S54 matriculated in th^' ]Med- ical Department of the University 'of Louis- ville. After one course in the University, he went to Philadelphia and entered the iledical Department of the University of Pennsyl- vania, from which he graduated with the de- gree of .^L D., 1857. He returned immediately to his native town of Danville and entered the practice of med- icine. He never ceased to be a student. Be- ing naturally of modest demeanor and r?tir- in practice when the war between the states broke upon the country. He entered the Con- federate Army with the rank of Surgeon, and was engaged in active service iu the field throughout the great conflict. He received his pai'ole at Appomattox, and returned to his home at Danville immediately. At this time he found himself without means, but with abundant courage and faith in the future he opened his office and resumed his professional labors. He seemed to bring to his work re- newed energy and determination, and soon his time was fully occupied with private prae- MEDICAL PIONEEUS OF KENTUCKY. 25 lice. He gave himself wholly to his profes- sional work. He resumed the study of the l'']"euch language and began to collect a li- brary which in time became one of the finest private medical libraries to be found in this country. His collection was very rich in old copies of the medical classics, and his tahle was alwaj^s filled with the very best current literature of the day. Dr. Jackson at this time realized the great importance of advanced clinical study and, in order that he might repair the deficiencies of lijs earlj' training, he iwent to New York and devoted himself to private courses upon special branches in medicijie. He was especi- ally interested in surgery-, and applied him- self with enthusiasm to the most recent ad- vances in surgical pathology and practice. Almost every year from 1869 until his death he spent some months in New York in this way. In 1869 he contributed an article to the American Journal of Medical Sciences upon " Trichiniasis " which is one of his most valuable publications. This essay shows thor- ough familiarity with the literature upon this subject in all laugxiages. Very soon after his return from the army he established a private dissecting-room and began to take pupils for instruction in the elementary branches of medicine. He gave thorough courses in prac- tical anatomy and in surgical operations upon the cadaver. He made numerous contribu- tions to the medical literature, all of which were of practical character, and based upon thorough knowledge of the subject. He at- tended the annual meetings of the American Medical Association and at the time of his death was the first vice-president of that body. lie founded the Boyle County Medical So- ciety, which became one of the most efficient organizations in the State, and was a regu- lar attendant and contribiitor to the annual meetings of the Kentucky State Medical So- ciety. In order to perfect his professional knowl- edge. Dr. Jackson went to Europe in 1 872. He attended the meeting of the British Medical Association as a delegate from the American Medical Association, and spent much time in London, Edinburgh, Paris, and other Euro- jjean centers. In Paris he spent several months in pursuit of special studies. He made numerous acquaintances among prom- inent teachers of Euroi^e, and by correspond- ence kept in touch with members of the pro- fession there during the remainder of his life. Upon his return home after his visit to Eu- rope, his labors became more extensive. His practice extended throughout central Ken- tnekry, and his services were commanded as a consultant verj^ extensively. His growing practice, however, did not prevent his de- votion to the study of medical science, which he cultivated with the utmost devotion throughout his career. In 1873 he translated Farabeuf's "Manual on the Ligation of Ar- teries," which was published by J. P. Lip- pincott & Co., of Philadelphia. About the same time he wrote a biographical sketch of Dr. Ephraim McDowell (see page 11) which attracted renewed attention to the achieve- ments of this great pioneer surgeon. The idea of erecting a monument to the memory of McDowell originated -with Dr. Jackson, and he pressed the subject upon the attention of the profession until it received consideration by the Kentucky State iMedical Society and the American Medical Association. In the spring of 1873, while engaged in an autopsy Dr. Jackson infected one of his fingers, and suffered mth a severe systemic infection. His illness taxed severely his strength, and he never fully recovered. During his convales- ence he developed pulmonary tuberculosis, and after a long illness succumbed to this dis- ease. As previously stated his death occurred in December, 1875, before the completion of his forty-first year. Dr. Jackson possessed superior talents, high S(;liolarship, untiring industry, and a mind of singular alertness and vigor. He loved science for its owtq sake, and looked upon his profession as a great privilege of service and dutJ^ His ideals were high, and he lived up to them with incorruptible honor and integ- rity of character. He performed many of the most important operations in surgery, and his contributions to surgical literature show a profound knowledge of the subjects treated therein. As a writer he was clear and con- cise, and his language gave evidence of schol- arly attainments. During the last year of his activities, he was intensely interested in the researches of Lister, which were attracting great attention at that time, and had he lived he would have been one of the first to gTasp and apply in surgical practice the great prin- ciples of the antiseptic system. He was a model preceptor, and inspired his pupils with ambition and a thorough appreciation of the high aims and purposes of the profession . He v/as a delightful companion, and was devoted- ly loved by his personal friends and those to whom he administered as a physician and sur- geon. He was one of the most sincere and steadfast friends. In personal appearance he was above the medium height, very erect and rather slen- der. He had fbie bluish-gray eyes, a firm ex- pression about the mouth and a forehead indi- cative of intellect. In his habits he was sys- tematic, and in all his engagements he was promptness itself. Dr. Jackson was unmarried, his social visits were few, and his entire life was devoted to his profession. 2G KhJXTCCKY MFDICAL JOn.'XAL. DKDK'ATUliY ADDKKSS. 1'kok. S\M\ F.I, D. (truss. .M D. C. L. Oxon. I).. L.L. 1) Gentlemen of the Kentucky State Medical So- ciety, Ladies and Gentlemen: Nearly fifty years ago the citizens of Dan- ville, then a small, obscure village, carried to its last resting place all that was mortal of the man whose monument will henceforth mark an era in the histoiy of the medical pro- fession, and of the people of Kentucky. The announcement of his death, after a In-ief ill- ness, in the fifty-ninth year of his age, on the Of those who were present on that melan- choly occasion, one after another has disap- peared. New generations have sprung up, and a scene that wi-apped a whole community i!i sorrow and caused general regret in the American medical profession is. with the most 01 the people of this section of Kentucky, a mere tradition. The marble slab erected by tlie hand of affection over the mortal remains bears the simple but significant insr:ription, FiFHRAiii .^McDowell. \Vho was this man, this Ephraim McDowell, in honor of whose memory we have assembled here this evening ? Was he a hero whose bodv THE MONUMENT 20th of Jiine, 1830, caused deep and wide- spread grief in the community in which he had so long lived, and of which he had been so conspicuous, honored, and beloved a mem- ber. By none was his loss more profoundly deplored than by the poor of Danville and its neighborhood, who had been so frequently benefited by his skill and so frequently the recipient of his bounty, ilany a tear was shed as the body was tenderly laid in the earth, and many a sigh was heaved as the re- flection came that the mantle of such a man would be long in finding worthy shoulders. was scarred as he was leading his armies in the defense of his country? Was he a gi-eat magistrate, meeting out justice to his fellow citizens, protecting their rights, and wisely interpreting their laws ? Was he a legislatoi-, devising means for the development of the re- sources of his state, and the promotion of the happiness of society ? Was he a great senator, like Clay or Crittenden or Webster, expound- ing the constitution and convulsing the Amei'ican people by the power and ma.jesty of his eloquence? Ephraim McDowell was not anv of these, and vet he was none the less a MEDICAL riONEEHS OF KENTUCKY, good and a wise man, nor is lie any the less entitled to the world's gratitude. Following the noble vocation of a practitioner of the healing art, liberally dispensing alike to poor and rich the blessings of his knowledge and of his skill, he silently pursued the eveii tenor of his way,, a faithful servant of his profession, with no ambition for meretricious distinction. It was here, on this very spot, that he achieved that renown which so justly entitles him to be ranked among the benefactors of his race. It was here, while engaged in the daily routine Ephraim McDowell will be regarded in all time to come as the "Father of Ovariotomy," and as one of the master spirits of his profes- sion. We are here this c^vening to place upon his tomb a wreath of immortelles, expressive of our admiration and respect, and of the gratitude of more than two thousand women rescued from an untimely grave by his opera- tion. That his claims to this distinction are well founded the history of this operation a])undantly attests. For a long time it was thought that other surgeons had anticipated DOCTOR SAMUEL D. GROSS 180S--1884 of his calling, that he performed an exploit which no one had ever achieved before, and wliich, although for a long time denounced and condemned by many otheiiwise enlighten- ed surgeons and practitioners as an outrage- ous, if not murderous innovation, is now uni- versally admitted as one of the established procedures in surgery ; an operation which, in its aggregate results in the hands of different surgeons, has already added upwards of for- ty thousand years to woman's life, and which is destined as time rolls on, to rescue thou- sands upon thousands of human Ijeings from premature destruction. him in this undertaking, but all the doubt that had hung over the subject was at length completely dispelled in 1852 in an address which I had the honor to read before the Ken- tucky State Medical Society at its annual meeting at Louisville, entitled ''A Report on Kentucky Surgery." In the prosecution of ray inquiries I became deeply interested in the subject of ovariotomy, and especially in the claims of McDowell as its originator. With this end in view I engaged in a long and laborious correspondence, in which I was kindlv assisted by Professor Daniel Drake, Dr. William Gait, and Dr. William A. Mc- KENTUCKY MEDICAL JOTJENAL. Dowel, a nephew and at one time a partner of tile great surgeon. Letters were addressed to pliysioiaJis in different parts of the State, and also to the surviving jnembers of Dr. McDow- elTs family, asking for infoimation respect- ing the nuiii'ber and results of his eases, as well as the names and residences of his pa lients, and any other intelligence calculated to throw liglit upon his life and character; matters concerning which, tip to that period, hardly anything definite was known. These documents are still in my possession, and will probably at no distant day be given to the public. When this investigation -was begun tbe origin of this operation was generally ascrib- etl to a French surgeon, L'Aumonier, of Rou- en, who, it was contended, had performed it in 1776, when McDowell was hardly five years old. Move recently the honor has been claim- ed by our British brethren for Dr. Robt. Hous- ton, of Glasgow, whose name appears in con- nection with an operation upon the ovary as eai'lj' as 1771. The oj)eratiou, however, has been fonnd upon a careful examination of the history of the case to be entirely different from that of the Kentucky surgeon. The case was simply one of ovarian tumor, the eon- tents of which were partially evacuated by an incision made through the abdomen, the cyst itself being left behind. These and other pretensions that have been set up by different nationalities are wholly unsupported by facts; for a careful study of the cases which have been reported by their respective operators will serve to convince any unprejudiced mind that, so far from be- ing examples of ovariotomy, they were sim- ply instances of cystic tumors, similar to those ali'eady mentioned in connection with the names of L'Aumonier and Houston. In- deed a considerable number of such opera- tions were performed during the last century, chiefly by French, German and English sur- geons, or, as they would now call themselves, if living, gynecologists. The first actual case of ovariotomy of which there is any authentic account oeeur- I'ed in this town in December, 1809, in the hands of Ephraim i[eDowell, and to him and til him alone is due the credit of having de- vised and first successfully executed the opera- tio]i. All honor, then, we say, to the man Avho thus ]iaved the way to a new path of human- ity, snu;e so nobly trodden by his siiecessors ' All honor to the man who had the corn-age and skill to do that which no man had ever dared to do befori' ! All honor, too, to the heroic wo- man who, with death literally staring her in the face, was the first to submit calmly and resignedly to what certainly was at the time a surgical experiment. To her, too. let a jiionumeut be erected, not by the Kentucky State ^Medical Society or by the citizens of Kentucky, but hy suffering women who, with her example before them, have been tlie re- cipients of the inestimable boon of ovariotomy, with a new lease of their lives and with im- munity from subsequent discomfort and dis- tress. J know of no greater example in all history of heroism than that displayed by this noble woman in submitting to an untried operation. McDowell himself must have been siartled, if not al)solutely abashed, when he found how willing she was, after he had de- picted to her, in the most glowing colors and in the strongest and plainest language, the risks of the operation. When a surgeon, how- ever experienced or skillful, meets with, a des- perate case, and finds that, after having in- li.u-med his patient that if an operation be jterform.^d it wi!l be likely to destroy him, he is willing and ready to incur the risk, his lieart often fails hhu and he deeply regrets that the poor suft'erer ever fell into his hands. So no doubt McDowell felt upon this occasion. "Having never," he said, "seen so large a substance extracted nor heard of an attempt or success attending any operation such as this required, I gave the unhappy woman in- formation of her dangerous situation. She seemed mlling to undergo an experiment, which I promised to perform if she would come to Danville, the to^vn where I live, a dis- tance of sixty- miles." She did come, and the experiment, as jMcDowell very properly calls it, was, as already stated, performed. A rapid recovery ensued, and the patient, Mrs. (_'rawford, a Kentucky lady, survived the op- eration thirty-two 3'ears, enjoying for the most part excellent health, and dying at length in the seveny-ninth year of her age. Thus, it will be seen, this heroic and courageous wo- mail owed nearly two-fifths of her life to the skill and care of her surgeon. Our admira- tion of this noble woman is greatly enhanced when we reflect that the operation was per- formed without the aid of anesthetics, wliich were not introduced into practice until a third of a century afterward, as is our admiration of the surgeon when we recall the fact that he had no trained assistants to aid him in his work, executed despite the most strenuous and persistent efforts to persuade him from under- taking it. J. : i.! It is not a little remarkable that no ac- count of this operation was published until eight years after it was performed. Whether this was due to inherent modest^^ on the part of ]\IcDowell, to indifference to fame, to sheer apathy, to an aversion to -svi-iting, or to fear of "ritieism, 1o which such an undertaking, witlioitt a precedent in the annals of surgery, would necessarily expose him, it would be idle to conjecture. It is sufficient for my pur- l>ose to know that the first notice of it appear- ed in 1817. in the F'hiladelphia Eclectic Ee- pcrtori) and Analytical Review. The com- MEDICAL PIONEERS OF KENTUCKY. 29 nmiiicatioi]. which covered not quite three oc ti:ivo pages of printed matter, was entitled "Three Cases of Extirpation of Diseased Ovaria," and was drawn up so loosely and carelessly as to be well calculated to elicit ad- verse criticism, as indeed it speedily did both at liome and abroad in a way not at all calcu- lated to reflect credit upon the author as a lit- erary and scientific man. The details of the cases were singularly meagre ; there was noth- ing said respecting their origin, progress, or diagnosis, and even the operations themselves were very imperfectly described. If such operations had been performed in our day the most minute circumstances would have speed- ily found their way into print. The fact is McDowell possessed no facility as a writer, and he lacked that grace of diction and power of expression so well adapted to impart inter- est even to the driest details, and which can be acqiiired only by long practee. In a word, he was a stranger to the pen and had no fancy ;.'o!- :ts use. Writing was a great bore to him. a compulsory necessity. The report of his cases soon after its publication was severely criticised, and an attempt was made to thro^v discredit upon his statements, or, in other terms, to impugn his veracity. Had McDow- ell lived in our da.y, when intelligence flashes with lightning speed, not only from one sec- tion of the country to another but from con- tinent to continent, such an occurrence would not have been possible. Dr. James Johnson, the very able and learn- ed editor of the London Medico-Chirurgical Beview, a journal widely circulated both in Great Britain and in the United States, was especially savage and satirical. He could not imagine it to be possible that an American surgeon, living in a small, obscm-e village in the wilds of Kentucky^ or in the backwoods of America, as he expressed it, could perform such an operation, or become a pioneer in a new branch of surgery. In commenting up- on McDowell's first ease, especially upon the wonderfully rapid recovery of the patient, he exclaims, apparently in holy horror and with uplifted hands, "C red at Judoeus, non ego." In a subsecinent article, published in 1827, Johnson again calls attention to McDowell's cases, adding that of five cases reported four had recovered and only one had died. "There were circumstances," remarks this Cerberus, "in the narratives of some of the first cases that raised misgivings in our minds, for which ^mcharitableness we ask pardon of God, and of Dr. Ephraim McDowel], of Dan- ville." It is presumable that this fr.ank and manly recantation on the part of a man who occupied so elevated and influential a posi- tion as the editorship of the most widely read medical .journal in the world had some effect in controlling professional sentiment and in- spiring confidence in the declarations of a surgeon whom he had only a few years before denounced as a backwoods operator unworthy of credence. Nevertheless Dr. McDowell had for a long time no imitators. Among those who, on this side of the Atlantic, had the cour- age to follow in his footsteps, were Nathan Smith, of New Haven, in 1821, Alban G. Smith, a partner of McDowell, in 1823, and Dr. David L. Rogers, of New York, in 1829. All of the cases terminated favoraibly. Mc- Dowell himself, as clearly as I could determ- ine in preparing my report on Kentucky Surgery, operated altogether thirteen times, with the result of eight cures, four deaths, and one failure, due to an inability to complete the operation on account of extensive adhesions of the tumor ; a degree of success which, consid- ering the fact that he had no precepts exicept his own experience to gniide him, was emin- ently creditable to his judgment, care, and skill, and which, although exceeded in recent times, was for a third of a century pretty much the average in the hands of his follow- ers, both in America and in Europe. If we go to the other side of the Atlantic we shall find that the first attempt at ovariotomy in Great Britain occurred in the practice of Mr. John Lizars, of Edinburgh. This gentleman in 1825 published a beautiful monograph upon the subject, in wliich he gave a detailed account of four cases, Avith two recoveries, one death, and one an utter and disgraceful failure, due lo an erroneous diagnosis, both OA'aries being perfectly sound. Mr. Lizars, who was a surgeon of considerable note in his ■day, was led to turn his attention to this sub- jtict from having read an account of McDow- ell's operations, which had accidentally fallen into his hands during the absence of Mr. John Bell, McDowell 's old preceptor, upon the continent, from which he never returned. The brochure here referred to was, there is reason to believe, of great service in calling to the subject the attention of European surgeons generally, the more especially as it embraced a full report of the Kentucky cases, which, np to that period, had lain, as it were, in a slate of dormancy. Nothing, however, of' any moment was done anj'-vvhere, either at home or abroad, until 1842, when ovariotomy received a new impulse at the hands of Dr. Charles Clay, of Manchester, England, followed short- ly after by Dr. Frederick Bird, of London, and the two brothers Altee, John and Wash- ington, of Pennsylvania, the first case of the former having occurred in IS43 and that of the latter in 1844. To these gentlemen is un- questionably due the great merit of reviving the operation and of placing it upon a firm, and immutable basis as one of the established procedures in surgery. Their attempts to gen- eralize the operation met every where with great opposition and even obloquy. Dr. Clay, who introduced it into England, in referring ?.o KENTUCKY MEDICAL JOURNAL. to the subject states that he had to wade tlirough much vexatious opposition, great mis- appreheusioiis, and gross misunderstandings; and the experience of Dr. Washington L. At- iee was still more trying and annoying. In an address which he delivered in 1S72 before the I'hihulelphia County iledical Society, enti- tled "A Retrospect of the Struggles and Tri- umphs of Ovariotomy in Philadelphia," he depicts in glowing language the obstacles which this operation had to encounter in this country and in his own city. "Ovariotomy." he exclaims, "was every where derided. It was denounced by the general profession, in the medical societies, in all the medical col- leges, and even by the majority of my own col- leag"ues. I was misrepresented before the medical public, and was pointed at as a dan gerous man, and even as a murderer. The op- position went so far that a celebrated pro- fessor, a popular teacher and captivating writer, in his public lectures, invoked the law to arrest me in the performance of this opera- tion. " This rancorous opposition, however, founded as it was upon ignorance and preju- dice, gradually wore away, and the men who ^^•ere most clamorous in keeping it up either disappeared fi-om the active scenes of life, or yielded gi-acefuUy to the light of reason and experience. Dr. Clay, writing in 1874, states that he had operated upon two hundred and seventy-six cases, while those of Dr. Atlee, at the time of his death, less than a year ago, a.niounted to three hundred and eighty-seven. Mr. T. Spencer Wells, of London, whose bril- liant career as a ovariotomist began in 185S, wrote to me on the 29th of April, 1879, that he had just had his nine hundred and thirty- eighth case. JMr. Thomas Keith, of Edin- burgh, whose career in this field of surgery is also wonderfully brilliant, informs me, in a letter written a short time previously to that 01 his English confrere, that he had operated, up to that date, two hundred and eight j'-f our times. Dr. John L. Atlee has operated fifty- seven times; Dr. Alexander Dunlap, of Ohio, one hundred and forty-three times; Edmund K. Peaslee, seventy-seven times; Professor T. Caillard Thomas, one hundi-ed and twenty- six times, and Dr. Oilman Kimball, the oldest and most renowned American ovariotomist since the death of Dr. Wasliingtou L. ATlee, two hundred and forty times. Professor iJriggs, of Nashville, who has operated up- ward of fifty times, recently bad three eases of ovariotomy on the same day. the patients living within a short distance of each other. It is an interesting fact with regard to the history of ovariotomy in this country that Dr. John L. Atlee 's first operation, performed in 1S43, was also the first operation in which both ovaries were removed. In the report of this remarkable case, an unusually elaborate one, in the Amei-ican Journal of the Medical Science, for January, 1844, after instituting a comparison between this and other capital operations. Dr. Atlee makes a strong appeal in favor of ovariotomy. "Let this opera- tion," he says, "but be placed upon its legiti- mate basis, and let it receive that attention from the profession Avhich has been devoted to other departments of surgery, and we shall soon arrive at such a knowledge of the proper time and manner of operating, and before those complications exist which render it im- practicable, as \\'ill be the means of saving many unfortunate and hopeless victims." When this operation was performed Dr. Atlee \\-as not aware of the cases that had occxirred in England in the practice of Dr. Clay and llr. Walne, and he informs me that he would never have performed it if he had not studied with great care the report of McDowell's Ci:ses. The success of his operation, one of the most brilliant on record, induced him and his brother to repeat it on the first favorable op- X>ortunity, despite the opposition and clamor of their professional brethren. Up to 1850 onl.v eighteen American surgeons, including the originator, had perfonued this opera- tion. In 1 855 it received a new impulse from the publication of Dr. Washing-ton L. Atlee 's first thirty-five eases, and in the following year appeared the admirable prize essay of Dr. George H. Lyman, of Boston, entitled "The History and Statistics of Ovariotomy;" embracing a summary of three hundred cases, being all that there were then known as hav- ing occurred in diiferent parts of the world. On the continent of Europe ovariotomy made, until recently, very slow progress, although f'hrysmar, of Germany, had performed it three times before the close of 1820, and con- sequently several years before it was attempt- ed by Lizars. of Edinburgh. In France it was performed for the first time in 1847. In these countries, as in the United States and Great JViitain, it was long denounced as an unsafe and improper operation, and that this should have been the case is not surprising when we consider the enormous mortality which at- tended it, even in the- hands of many of the most accomplished siu'geons. The resiilts of late years, however, have been more encoin-ag- ing, and have been particularly flattering in tJie hands of Koeberle. of Strasbourg. Shroe- der. of Berlm, and Skoeldberg, of Sweden, not to mention others. Ovariotomy is no lon- ger on trial ; it has successfully passed that ordeal, and is now performed in every coiin- try of the earth where civilization has carried the blessings of scientific medicine. The frequency of ovarian diseases is appall- ing: far greater, indeed than it is generally supposed to be. One surgeon alone, Dr. Clay, of England, declares that he had exam- ined within a single decade eight hundred and fifty cases ! Who, in view of these occur- MEDICAL PIONEERS OF KENTUCKT. 31 reiices, will deny the blessings of ovariotomy, especially when we take into consideration the fact that few women lahoring under analadies ot this kind live longer than about four years, unless relieved by surgical interference? The mortality of this operation is worthy of brief notice in connection with Dr. Mc- Dowell's name and fame. His owu cases — thirteen in number, with eight cures, forir deaths, and one failure to complete the opera- tion on account of extensive adhesions, sho'w an astonishing degree of success when we rec- ollect all the circumstances attending them, especially the operator's own inexperience, and the absence of any rules to giiide him in his undertakings. For a number of years af- ter I\fcDoweirs death the mortality in the hands of diiferent surgeons exhibited but lit- tle improvement Tipon that in his own prac- tice. Thus, of one thousand four hundred and eight cases collected by me in 1871. from various sources, native and foreign, four hun- dred and fifteen died, affording a mortality of t^venty-iour per cent., or one death in every three and two fifth cases. That the results of the operation are materially influenced by the manner in which it is performed, and by the previous and subsequent treatment, is a fact long since fully established. Thus, if we take the statistics of one hundred cases in the hands of so many different surgeons, men who have no experience in such cases and who follow the ordinary method of operating, the mortal- ity will be found to be enormous, just as it would be likely to be under similar circum- stances in any other grave operation, as litho- tomy, the larger amputations, trephining of the skull, and the liaration of the larger ar- teries. No one will deny that experience is a ■most important factor in saving or destroy- ing life in all the more serious, severe, or cap- ital operations. The results of ovariotomy in the hands of professed or skilled ovari- otomists. men who make a specialty of abdom- inal surgery, are among the greatest triumnbs of our art, entitling them to be ranked among the noblest benefactors of the present day, or indeed of anv dav. The cases of "Washinston I, Atlee, Charles Clay, t. Spencer Wells, Thomas Keith. Gilman Kimball. Alexander Dunlap. T. Gaillard Thomas, and others, are counted, not bv tens or twenties or thirties, but bv hundreds. It is this enormous multi- plication of cases that makes th^se men such experts and that gives them such superiority over those whose practice is comparatively limited. One of the most .ofratifying circum- stances connected with this operation is the gradually decreasing mortality, even in the hands of the most successful surgeons. This is strikinglv shown, to eo no farther, by the statistics of Dr. Clay, of Manchester, who, as previously stated, introduced ovariotomy in England, On the first twenty cases the death- rate was one in two and one half: of the sec- ond twenty, one in three and one-third ; and of the last thirty-one, one in four. In Mr. Wells's cases the same gratifying results are apparent, and so also is those of Mr. Keith, of I'ldinbiirgh. Who will dare to assert that tliese triumphs are not due to superior skill in operating, and to increased care and experi- ence, and not to the selection of the cases, al- though this will doubtless, now that the diag- nosis between innocent and benign ovarian diseases is so well established, have its in- fluence 1 The attention bestowed upon the after- treatment must necessarily exert a powerful influence upon the patient's fate. All the pro- fessed ovai'iotomists employ trained and ex- perienced nurses and personally superintend their cases from first to last. Mr. Keith, in referring to this subject, says. "No one knows the anxiety that ovariotomy has given me, nor the time and thought and care I have be- stowed on the patients." There can be no doubt that the chances of recovery after the oiieration are greater when the patient is treated in a private hospital, situated upon airy ground, and provided with all the means and appliances which such an institution ought to possess. This fact has been striking- ly exemplified in the practice of Mr. Keith and also in that of Mr. Wells while he was in charge of the Samaritan Hospital. London. Leaving out of the question the results of less experienced ovariotomists, iwhat can be more wonderful than the results of Mr. Keith's eases, two hundred and eighty-four, with a mortality of only thii'ty-five, or one death in about eight operations. Of the last 158 cases only twelve succumbed, of the last seventy- seven- only thii'teen, and of the last forty-nine not one, thus verifying his assertion that ■'this long-despised operation is now the saf- est of all the great surgical operations, at least judging from these re.sults. " The .statistics of the operations of Mr. Wells are equally astonishing. Both these surgeons are now making constant use of antiseptics, notwith- standing thev obtained most brilliant results from the ordinary treatment, conducted with that care which their increasing experience had taught them to employ. Mr. Keith does not hesitate to ascribe much of his wonderful snccess in his late cases to the efficacy of anti- septics. IMr. Wells, in the letter previously I'cf erred to. says -. "1 began the year 1 878 with the eisfht hundred and eisrhtv-eishth case, bv adopting the antiseptic system of Lister, and have kept it up ever since, the result of forty- five cases being forty recoveries and five deaths. The recoveries have taken place, as a j'lde, without fever." "I believe," he adds, "that the antiseptic system will certainly re- duce mortality and expedite convalescence." Of the thirty-eight cases of the ninth hundred, 32 KEXTVCKY MEDJCAL JOrRXAL. the number operated upon by Mr. Wells up to April 29. five, he informs me. have died, and thirty-three are well or convalescing. Of Mr. Clay's two hundred and seventy-six eases two hundred recovered and seventy-six died. Koeberle, during the last four years, operated one Inmdred times with eleven deaths. The mortality in Dr. AYashington L. Atlee's three hundi'ed and eighty-seven cases was, as I am informed l)y his son-in-law. Dr. Thomas "M. Drysdale, about thirty per cent., which, considering that he did not select his cases, and frefjuently had no opportunity of super- intending the after-treatment, always a mat- ter of great moment in every severe operation. may be regarded as a fair average. Dr. Johu L. Atlee's fifty-seven cases show forty recov- eries and twelve deaths, witli five failures to complete the operation on account of extens- ive adhesions. Of Dr. Duulap's one hun- dred and forty-three patients one hundred and twelve recovered and thirty-one died. Of Dr. Peaslee's seventy -seven operations the re- sidls of twenty-eight only are positively known, and of these nineteen recovered and ]iine perished. -T. Taylor Bradford had thirty cases with three deaths. Professor T. Gail- lard Thomas's one hundred and twenty-nine show ninety-six recoveries and thirty-three deaths. The mortalitv of Dr. Kimball's cases is in tlie ratio of one to four : of his last twenty-four cases twenty-one have recovered and three have died. It would be foreign to my purpose, in an address like this, and especially before such an audience, to speak of the causes which mainly influence the results of this operation: but there is one circumstance to which I can not forbear alluding. T refer to the import- ance of establishing in every ease, before an operation is attempted, a correct diagnosis. Fortunately this can now be done, with proper care, almost in every instance, and with the aid of the microscope. Dr. Thomas ^M. Drys- dale, availing himself of the great opportun ities afforded by ^Ir. Atlee's operations, has. after numerous examinations, satisfied him self of the existence, in all innocent forms of ovarian cysts, of what he calls the "" ovarian gi'annle cells." These cells, which are very small and of a roiinded or oval shape, are largely supplied with nuclei and nucleoli, and. as they are not present in any other af- fections or in di-opsical fluids, they may be regarded as characteristic. More recently Dr. Toulis. of Edinburgh, and Dr. iCnowsley Thornton, of London, have ascertained that malignant ovarian tumors can be distinguish- ed from benign ovarian growths by the pres- ence of groups of large, pear-shaped, i-onnd. or oval cells, occupied by granular material with nuclei, nucleoli, vacuoles, or transparent globules. The value of these researches, in which Dr. Drysdale has taken the lead, can not, in a diagnostic point of view, be over- estimated, for they clearly indicate the neces- sity, in eveiy case of doubt, of making a thor- ough examination of the contents of these classes of tumors before finally deciding up- on the propriety of using the knife. The brilliant success which h-as attended ovariotomy both in America and in Europe has led to an extension of the whole domain of rbdominal surgery, and has emboldened op- erator to invade other regions of the body lua- til recently regarded as too sacred to be med- dled with. Indeed, there would seem to be hardly any longer any forbidden territoiy! The uterus, the spleen, and the kidneys have of late years been the coveted objects of the surgeon's cupidity. Very lately the gall- lihidder has not only been aspirated for the piirpose of relieving it of distending fluids, liut actually, in several instances, extirpated. IMany years ago, dui-ing ray residence in Ken- tucky-, I received a telegram from a distin- guished surgeon of Columbu-S, Ohio, sajnng he liad just excised the liver, and that as his patient was progressing favorably he indrdg- ed great hope of her recovery. The woman, however, died the next morning, when it was di.seovered that, instead of the liver, only an ovary had been removed, thus depi'iving my friend of the glory of being a pioneer in hepatic surgery I Within the last ten years a number of cases of excision of the larjTix have been reported, including, in some in- stances, portions of the tongue and of the esophagus, and yet despite the mutilation some of the siu'vivors, with the aid of an artificial substitute, articulate nearly as well, it would seem, as before the operation. The entire tongue, too, has on a number of oc- casions, perhaps in not less than forty oi- fifty eases, been extirpated with, as is alleged, very little impairment of the patient's voice or power of speech. With such inroads, such innovations, on the part of siu-geiy, we need not be surprised if, on waking some morning, we should find tjie papers filled with accounts of the snccessful amputation of the head with- out anv serious detriment to the patient's me]ital faculties, despite the assertion of ^bms. Blandin, a French surgeon, that this j'ortion of the body, wliieh he iiivariably designates as the encephalic extremity, "can not be removed during life without stopping respiration and causing other inconveniences which, unhappily, render the operation inad missiblel" This language, however, it must not be forgotten, was uttered fiftv years ago, when surgery was in a comparatively crude <>ondition, and is therefore hardly applicable at the present day. But pleasantry aside, as p.<»rhaps iinbecoming the occasion, while I have always been a friend to progress it is evident that there must be limits to the use of the knife. What the fate of some of these MEDICAL PIONEEKS OF KENTUCKY. 33 operations may be. whether any or all of them will be ultimately admitted into the domain of legitimate surgery, must for the present re- main an open question. We are no more jus- tified now in condemning what may seem to us to be an improper operation than physicians were in the days of McDowell in condemning ovariotomy. Expei'ienee alone can determine how far the knife shall go or shall not go. What has been called, perhaps oddly enough, normal ovariotomy, an operation first performed by Dr. Robert Battey, of Georgia, may be regarded as a natural out- growth of McDowell's operation, or ordinary ovariotomy, rendered necessary, as is alleged, on account of organic or fiuactional disorder of the ovaries, incurable by ordinary treat- men. The results obtained thus far are not very satisfactory, and it is evident that further light is required before we can determine its real merits. Different methods of reaching the faulty structures have been suggested, but there is not one that is wholly free from dan- ger, while that originally practiced by the courageous and ingenious inventor does not always afford sufficient space for the purpose. The statistics of this oi^eration published in 1878 by Dr. George J. Engiemann, of St. Louis, embracing forty-three cases, show that the risk is very considerably greater than in ordinary ovariotomy, fourteen of the eases terminating fatally, while of the twenty-nine surviving patients nine only, or thirty-one per cent, were cured, and eleven were more or less improved. Many of the operations were not completed on account of the impossibility of extracting the entire ovary. Dr. Battey, as he informed me only a few days ago. has performed this operation fifteen times with two deaths and thirteen recoveries. Of these thirteen cases foiir were promptly and entirely cured, nine were benefitted, and of those not completely relieved every one had made notable progress during the last twelve months. In delineating the character of McDowell the question naturally arises, how was he led to perform, for the first time in the history of surgery, so dangerous an operation? Was it his superior knowledge of abdominal and pelvic diseases, or had he made a special study of them, and thus qualified himself above all other men to become a pioneer in a branch of surgery whose territory had never before been invaded by the knife? Or was it his superior sagacity or his more profound penetration which led him to iindertake it? finally, had the lessons which as a student he imbibed in the lecture-room during his so- journ at Edinburgh any agency in the matter ? It must not be forgotten, in discussing this subject, that long before McDowell launched into this then unexplored field of surgery a niunber of distinguished physicians, in view of the hopeless character of ovarian diseases, suggested their removal through an opening in the wall of the abdomen. Among others •who seriously thought of the matter may be mentio]ied more especially the names of .Schlenker, Willius, Preger, Chambon, and the celebrated William Hunter, the foremost ob- stetrician of his day in Great Britain. None of these men, however, had the courage to un- dertake such an operation. Prior to Mc- Dowell no surgeon had been so bold as to do more than to open occasionally an ovarian cyst and to let out its contents. No one dared to I'emove an ovarian tu.mor of any kind bodily. In reflecting ripon this subject I have always thought that the in.struction which IFcDowell had received while attending the lectures of the celebrated Mr. John Bell, of Edinburgh, had mainly paved the way to this undertak- ing. It is a well-known fact that the young Kentuckian was greatly impressed by the lec- tures of this great surgeon, who was a man of .splendid genius, of high intellectual en- dowments, an eloquent teacher, and a bold, dashing operator, then in the zenith of his re- nown. We may well imagine with what pathos such a man, a man of the most ardent temperament and a most accomplished scholar, ^vould describe abdominal surgery, and with wiiat force and emphasis he would dwell upon the hopeless character of ovarian tumors. No 7nan perhaps ever taught surgery to more ad- miring piipijs, or jnore completely fascinated tliem by the power of his eloquence. There was, moreover,from all accounts a wonderful magnetism about John Bell, which drew to him, as with an irresistible charm, every one who came Avithin his presence. Listening to the lectures of such an enthusiast, a kind of Tom Marshal] in his way, it is not probable tliat the young American sat listlessly with closed eyes and ears upon the hard bench of the amphitheater. On the contrary his atten- tion was all agog. We can see him even now, as it were, -with open mouth and protruding head, with his chin resting upon his hands, eagerly drinking in eveiw word .is it fell from the lips of this divine son of Aesculapius. 'I'he snarks of genius which such a teacher emits kindle a fiarae in the minds of his pu- pils which the waters of all the rivers and seas of the earth cannot extinguish. That the pre- dilections of this wonderful man exerted a powerful influence in moulding the character of McDowell and in inspiring him with bold- ness and confidence as an operator is unques- tionable. How far they affected his career as an ovariotomist is of course a mere matter of eonjedure. The knowledge which he brought home with him, and his warm sympathy for suiTering woman, no doubt exercised a power- ful effect upon his future life. Besides, he WRS not unaware of the fact that success had often attended the Cesarean section, and that ?A KEXTUCKY MEDICAL JOURXAL. persons not unfrequeutly recovered after se- vere wounds and other injuries of the abdomi- nal and pelvic viscera, iloreover, it is no! improbable that, in reflecting upon the sub- ject, lie came to the conclusion, long since uni- versally recognized, that the peritoneum, when chronically diseased, is generally compara- tively tolerant of the rudest manipulation, \v):frcas the slightest exposure of. or interfer- ence with, the healthy membrane is sure to lie })romptly resented, almost invariably, indeed, at the expense of the patient's life. Finally, it must not be forgotten that ^IcDowell was a bold surgeon, and a man of a broad, elevat- ed mind, capable of taking a comprehensive view of anji:hing that was presented to him. With a heart as tender and gentle as that of a woman, he was not afraid of the sight of blood. For many years he had had the field of snrgerj^ in Kentuets- almost wholly in his owji hands. He had not been home long from liis foreign residence before patients began to flock to him from all parts of tlie Southwest. and he found himself immersed in a large surgical practice demanding the performance not only of the more common but also of manv of the more difficult and severe operations. His first case of ovariotomy occurred when he had hardly been twelve years engaged in the pi'actice of l;is profession. He was about the same age as Valentine ^lott when he pei-form- ed his great feat of tying for the first time the innominate ai'tery ; an operation which in com- jiarison with that of ^IcDowell is of utter in- significance, for of the nineteen or twenty cases in which it lias been done only one life has been saved, whereas the other has already re- stored to health and comfort iij^wards of two thousand women. The career of ^IcDowell is so intimately bound up in the great operation already so frequently mentioned that one jnight suppose nothing of interest remained to be considered. This, however, is far from being the case. In many respects, indeed, it is replete ^vith inci- dents. Born in Tvockbridge Counts-, Virginia, in 1771, he was brought, when hardly two A-ears old, by his parents to Danville, at a time wlien Kentucky was literally a -wilderness, re- sounding with the howl of the panther and of the savage, and reekiuar with blood of its early settlers. The terrible battle foiight near "Blue Lick Springs, in which Daniel Boone played so conspicuous a part and lost a son. and which proved to be so disastroiis to his follow, ers and companions in arms, took place only a short time after this advent, and filled the country with pain and sorrow. The frequent wai"s of which it was the theater gave it a pe culiar claim to the title of the "Dark and Bloody GrouTid," from which it derived it? name. At the period in question Kentucky was still a territoTy. and it was not until afte'- repeated conventions, the last of which was liekl in this city, that it was fijially. in June, 1792, admitted as a state into the Union. ^IcDowell was of Seotch-Ii*ish parentage, and the ninth of twelve children. His great- grandfather, after whom he was named, was P^pliraim ^IcDowell, a brave and courageous man, who, after having done some fighting in the civil wai'S of Ireland, in the cause of the Covenanters, emigrated, after he was past middle life, to Pennsylvania, which he left in 1737 for Augusta Countn-, Virginia, where he died at a very advanced age shortly before the revolutionary war. From an elaborate genea- ological article in the Cincinnati Commei'cial, January 1-i. 1879, under the 710m -de plume- of Keith, it appears that the descendants of the Scotch-Irish emigrant have become almost as numerous as the sands of the sea-shore, and tliat they represent by their intermarriages many of the most respectable and influential families in ]\Iaryland, Virginia. Kentucky. Ohio, Illinois. Indiana. I\Iissouri. and indeed almost in the entire Southwest. If called to- gether they would form, at least numerically, a powerful elan. Besides the gi'eat surgeon, who has immortalized the family, many of these people have held important positions, as governors of difi'erent states, congi'essDien, laAvyers, judges, di-^anes, physicians, politici- ans, and ai'my officers. Joseph Xash ^McDow- ell. who died only a few years ago. was a ne])liew of Ephraim. a great teacher of anato- my and surgery, and the founder of a medical school at St. Louis. Another nephew, the late Dr. "William A. McDowell, of Louisville, occu- pied a high position as a sagacious and suc- cessful physician. The name of Gen. Irvine McDowell, Ignited States Army, is familiar to every American citizen. The father of Eph- raim was Samuel ^leDowell, an accomplished gentleman, a member of the Legislature of Virginia, and. after his removal to Danville, a judge of the district court, a position which he hi>ld until within a short time of his death. On the mother's side he was descended from the ^leClungs. a distinguished family of Vir- .dnia. The son's early education was obtained at a classical seminaiy at Georgetown, in his adopted state, under ' the supeiwision of Messrs. Worley and James, two accomplished teachers. How long he remained hei-e. or A'.hat progress he made in his studies. I am unable to say. but it is safe to affirm that, al- though he was fond in after life of literary reading, his primary education was sadly nes- lected. and that he never surmounted his early deficiencies. He wrote, as has alreadv been stared, with jjreat difficiilty,* and his only lit- erary contributions are two short articles con- tained in the Philndelphw Jfcdicol Repertory •The lacsimUe letter of McDowell published herewith larsrel.v for this purpose, and the histor.r of his education, his life and what he accomplished, all show that his lacli of literarj" attainments have been greatly exaggerated.' MEDICAL PIONEEUS OF KENTUCKY, 35 and Analytical Review for 1817 and 1819. His medical ediication was commenced in the office of an eminent physician, Dr. Humph- reys, of Staunton, Virginia, a graduate of the Ijiiiversity of Edinburgh. It was doubtless tlirough the infJueJice of his preceptor that the youth determined to go at once to the foun- tain-head of medical education and learning, as the Scotch metropolis was then very justly regarded. At all events there is no proof to sho'W that he ever attended any lectures in Philadelphia, at that time the only place of resort for the medical student in this countiy. The T^niversity of Edinburgh, of which he was a member in 1793-4, enjoyed a world-wid" reputation at this period on account of the learning and ability of its professors, among whom may be mentioned as especially worthy of notice the uam.es of Cullen and Black, two great luminaries, whose fame added liister to the school and attracted pupils from all parts of the civilized world. Not waiting to take a degree, he immediately, upon his return to America, settled at Danville, where, having brought ^^^th him the prestige of foreign study, he soon acquired the confidence of tlie public and rapidly rose to distinction as a surgeon and as an expert operator, a jiosition of which he retained undisputed possession Tinlil the organization, in 1819, of the medical scliool at Lexington, when he was gradually ecli]"'sed by his young rival. Dr. Benjamin Winslow Dudley, a gentleman of highly fas- cinating manners, a popular teacher, and, as all the world knows, a great surgeon. It is not the design of this address to entei into minute details respecting Dr. ilcDowell's more ordinary surgical achievements. It will subseiwe my purpose to state that he was an excellent lithotomist, and that he repeatedly performed many of the great operations of surgery. The subject of one of these opera, tions was -Tames K. Polk, afterward President of the United States, at the time a thin, emaci- ated stripling, fourteen years of age. worn out by disease, uneducated, and without appai'ent pi'omise of future usefulness or distinction. ' ' As an operator. ' ' as Dr. Alban G. Smith, who late in life changed his name to Dr. Gold- smith, and who knew him well, having at one time been his partner, told me, "as an opera- tor he was the best I ever saw in all cases in which he had a rule to guide him;" no slight ]iraise from a man who was himsel-f an expert operator; and yet Dr. Goldsmith seemed to forget that this man did certainly once operate in a ease in which he had no rule to guide him, a case which was destined to confer immortal- ity upon his name. i\Tr:Dowe!l was not onlv a good ODerator, but he possessed all the higher attributes which make up the character of a great surgeon, in tense consciousness and a scrupulous regard for the welfare of his patients. He never op- erated merely for the sake of operating. He had always an eye to consequences. For the mere mechanical surgeon he had an unmiti- gated contempt. In speaking of ovariotomy, in answer to some strictures pronounced upon his first three eases, he expressed the hope that no su(!h surgeon will ever attempt it. "It is,", he adds, "my most ardent wish that this operation may remain to the mechanical surgeon for ever incomprehensible." He con- sidered the i^rofession of medicine as a high and holy office, and physicians as ministering angels, whose duty it is to relieve human .suf- fering and to glorify God. He had a warm and loving heart, -in full sympathy with the M'Oiid around him. To the poor sick he was particularly Icind. He was a loyal and devot- ed husb.and. a tender and loving father, an honest, high-toned citizen. In all the relations of life he was a model. Naturally of a lively, social disposition, he enjoyed a good joke or a spicy anecdote, and was the delight of every social entertainment which he honored vnt\\ his presence. Late in life he devoted much of his leisure to reading and meditation. His fa- vorite medical authors were Sj^ndenham and Cullen; his favorite literary authors. Burns and Scott. During his sojourn in Scotland he passed several months of his vacation in ramb- ling over the country trying to make himself familiar with the nature and habits of tht peasa,ntr^^ In these perambulations he had the society of two of his Kentuckj^ friends, Drs. Brown and Speed, the former of whom became afterward Professor of iledicine in Transylvania I.Tniversity. "When the trio reached home someone asked Brown, "What do you think of ilcDowell ? " " Tliink of him ' Why he went abroad as a gosling and has come back a goose." It would be well if our country had more of such birds! He had lit- tle confidence in the efficacy of medicine, and constantly cautioned his .stiidents against the too free use of drags, saying that they were more of a curse than a blessing. He consider- ed surgery as the most certain branch of heal- ing art, and spai-ed no means to extend his knowledge of it. He was an excellent anatom ist. and it is said that he never performed anv serious operations without previouslv recall- ins to his mind the stmictures involved in it. 1)^1807 the Medical Society of Philadelphia sent him its diploma of membership, and in 1823 the Universitv of JIarvland conferred on him the degree of Doctor of Medicine. At the ase of thirt^^-one he married Sallie, daughter of Governor Isaac Shelby, of Kentuckv^ by ^vhom he had six children, two sons and four daughters, two of the latter of whom, Mrs. Deadrick. of Tennessee, and Mrs. Anderson, of Paris, Missouri, are still living at an ad- vanced as'e, the parents of large and highly i-espectable families. He was nearly six feex in height, with a florid complexion, black eyes. 36 KENTUCKY MEDICAL JOURNAL. a commanding pTesenee and remarkalile mus- cular po Wei's. As an illustration of bis great pliysical strength, he used to tell with peculiar glee an anecdote of a circumstance which oc- curred while he attended medical lectures at l''dinburgh. One day, as the story goes, a celebrated Irish footracer, a kind of Mike Fink, arrived, boasting that he could outrun, outhop, and outjump any man in the city, and bantered the whole medical class. McDowell was selected as their champion, the distance being si.xty feet, the stake ten guineas. The backwoodsman purposely allowed himself to be beaten. A second race for one hundred guineas, at an increased distance, came off soon afterward, and this time the Irishman, after much bullying, was badly worsted, much to bis own chagrin and the delight of the stu- tlents. Although l\IcDoweirs means were not large he was liberal in the bestowal of his charities, and generous to a fault in his dealings with his patients. In 1828. only two years before his death, he united himself ^^ith the Episco- pal Church, of which he remained a zealous and consistent member, A vein of piety ran through his whole life. As a proof of this fact it juay be staled that he always preferred to perform any great operation that he might have on hand on the Sabbath, knowing, as be affirmed, that he would then have the prayers of the Church with him. Trinity Church of Danville was the special object of his care; and as an evidence of the interest he felt in it I may mention, what does not seem to be gen- erally known even among your own citizens. that he gave it the lot upon which the present building is situated. Indeed McDowell, to use the language of one of your most noble and accomplished women, was the head and front of its van-guard, which embraced many dis tinguished names in the past historv of this portion of KentuekA'. Of Center College he was one of the founders and original trustees. Such, fellow-citizens of Kentucky, was the character of Ephraim IMcDowell ; kind-heart- ed, benevolent, and jnst in all his dealings, an excellent citizen, an original thinker, a bold, fearless, but most .judicious siirgeon, and above all. a Christian gentleman. Such, citi- zens of Danville, was your former townsman, whose career has shed so much li^ster upon his age and country, and who, if he could be in our midst this day. might justly echo the words of the T?07nan poet, "Exegi monumenf- iim acre nereirnms." The latter years of this good man's life were clouded by an attempt made, strange as it may appear, by one of his ovm nephews and private pupils, to deprive him of bis claims as the oriffinatnr of the operation so frequently montioned. This circumstance induced him, in 1826. only a few years before bis death, to address a printed circular to the physicians and surgeons of the West in vindication of his rights. Without entering into any pai*ticu- lars respecting this matter, I am satisfied, from a careful examination of all the facts connected with it, that the pretensions set up by this gentleman, were, like the "baseless fabric of a vision, ' ' without the slightest foun- dation in truth. It was not given to McDowell to see the fruit of his labors beyond the limits of his own countrj'; the seed which he sowed fell upon meagre soil, and was slow in germinating. Now and then, it is time, a blossom shot forth and shed its fragrance upon the air, but fully a quarter of a century elapsed before it ripen- ed into vigorous fruit. No single age has ever- witnessed the birth and the maturity of any branch of human knowledge. JIcDowell lived in advance of his time and of his profession; his boldness, as his contemporaries were in- clined to view bis conduct, took them, by sur- I'.rise, and shocked their sensibilities; hence, instead of investigating the inerits of his op- ei'ation, as reasonable men should and would liave done, they rejected it as the device of a crack-brained man, who deserved to be prose- cuted for violation of the sixth commandment. It Avas unfortunate for McDowell that he lived at a time when there were no societies for the diflPusion of knowledge, and when the means of communicating intelligence were so scanty as they were in the earlj' part of the present century. News at that period of our history, locked up as it always was in the mailbags of the cumbersome four-wheeled stage-coach, was often stale before it reached its destination. In those days, as well as for a long time afterward, there were no rail- roads, no steamships, no telegraphs. The world moved at a snail-like pace, or, as it were upon the back of a tortoise, at the I'ate of six or eight miles an hour. To publish re- ports of medical cases or of surgical operations was then, as it is now, unprofessional. Be- sides, even if such a course had been permis- sible they would have found their way very tardily to the public. Journalism was at a low ebb ; there were comparatively few news- papers, and newspaper I'eporters had no ex- istence. Medical news traveled still more slowly than miscellaneous. In 1817, when McDowell's first three cases Avere reported in the Philadelphia Medical Fcpcrtorif and Avali/ficaJ Be vie v. there was, if I mistake not. only one other medical periodical in the United States. Had ^IcDowell's operation been performed in our day the news would have spread far and Avide AAdthin the firet twenty-four hours, and in an almost incredi- bly short time Avould have been carried to the utmost limits of civilization. As it was. it was locked up first for eight years in the brain of its originator, and then in an obscure med- ical journal, and Avhen at length it reached the MEDICAL PIONEERS OF KENTUCKY, 37 other side of the Atlantic it met only with ridicule and incredulity. An account of McDowell's first three cases was, it seems, sent to Dr. Physick, of Phila- delphia, but from some cause or other it fail- ed to interest him or to attract his attention. He probably knew little or nothing of the hack^voods surgeon, and therefore, it may be, looked upon him as an adventurer unworthy of notice. However this may be, it fared much better in the hands of Dr. James, the amiable Professor of Midwifery in the Uni- versity of Pennsylvania. This gentleman, deeply impressed with the novelty and im- portance of the subject, and thoroughly ac- quainted with the hopeless character of the ordinary treatment of ovarian diseases, read an account of the cases before his class, and caused it shortly after to be published in the journal, already several times referred to, and of which, in fact, he was one of the editors. He, hoiwever, failed to make any editorial com ments upon the subject, or to defend the op- ei'ation when assailed by ignorant critics. Me Dowell also sent an abstract of his cases to his old master, STr. John Bell, but as this gentle- man had been for some time absent on the Continent, and not long aftei'ward died at Rome, it never reached him. The paper, how- ever, fell into the hands of one of his pupils, Mr. John Lizars, of Edinburgh, by whom it was published in the Edinburgh Bledical and Surgical Janrnal for 1824. Mr. Lizars, as be- fore stated, was the first to perform McDow- ell's operation in Great Britain. In no purauit of life does history repeat it- self more frequently than in affairs relating to huma]i progress, innovation, and discovery. From this occurrence pur profession is not exempt. The history of the discovery of the circulation of the blood, one of the most bril- liant achievements of the hviman intellect in the seventeenth century, is a striking instance in point. Of Harvey's contemporaries not one, it is said, over forty years of age accept- ed his teachings. Many years elapsed before the value of vaccination w^as fullv recognized, and even now an operation which has saved millions of lives has its opponents not alone amonsr the vulgar, but among otherwise high- ly enlightened people. The use of the stetho- scope as a means of diagnosis was long reject- ed by medical men, and the speculum, an in- strument as old as Herculaneum, reintroduc- ed to the notice of the profession less than fift\ years aeo by Pecamier, of Paris, met with no better fate. Ever\d3ody knows with what suspicion many physicians regarded the em- ployment of anesthetics, and it is fair to say that much "Drejudiee in resrard to the use of this class of remedies still lingers in the pub- lic mind. Ignorance, superstition, and preju- dice have ever been giants in the path of pro- gress. The idea of erecting a monument to the memory of Dr. McDowell originated with one of the citizens of Danville, the late lamented I.)r. John D. Jackson, a gentleman whose death, a few years ago, in the prime of life, threw a whole community into mourning, and ivhose memorj' will long be cherished on ac- count of his varied accomplishments as a phy- sician, his lovable character as a man, and the many amiable impulses of his great heart. This idea was in due time communicated to the Kentucky State Medical Society^ of which Dr. Jackson was a prominent member, and acted upon through a committee whose duty it became to collect the necessary funds for carrying out the noble design. This commit- tee made known its wishes not only to the pro- fession of this country, but to our brethren in Europe, and also, if I mistake not, to the women who had been the fortu)iate recipients of the fruits of Dr. McDowell 's operation. Finally in 1875, a stirring appeal was made to the American Medical Association at its annual meeting at Louisville in May of that year. Prom no one of these sources, however, was any substantial aid derived, and it de- volved at last upon the society in which the de- sign originated to furnish nearly the entire sum necessary to carry it into execution.* 'While, therefore, the granite shaft which graces yonder eemetei-y is a just tribute to the memory of a great and good man, whose title to immortality is well founded, let us not forget the part borne in its erection by the Kentucky Medical iSociety, which had the sagacity to perceive, and the liberality to exe- cute, a design which reflects so much credit uDon the medical profession and the State of Kentucky. I feel a just pride when I recall the fact that I was one of the founders of a Society which now includes among its mem- bers nearly all the medical talent, cidture, and refinement of the State, and which has established a reputation for ability, learning, and enterprise not ex'ceeded bv any similar association in the United States. Dr. Mc- Dowell is not the only physician of whom Kentucky has reason to be nroud. She furn- islied the first case of hip-joint amnutation on this continent in the hands of Dr. "Walter Bj-ashear, of Bardstown. of lithotritv in the practice of Dr. Alban G-. Smith, of Danville, and the most flattering results in ovariotomy *An. in fact, that the Ampriean Mpflical Association rlid was to pass an emptv rosointion. leavinsr. as the ilinstT'ious chairman. Dr. .T. Marion Sims. p,\-nresspcl it. "to Kentucky tlie grratefnl privilege of providing a local monnment to the memory of Pr. McOowell." and reanestiner Ihe Association to contribute thrnuerh its individual memhei-s the sum of ten thousand dollars as a fund, to he called the "McPowell Memorial Fund." to he devoted to the payment of prizes for the best essays reiatinar to the diseases and surg-ery of the ovaries. This fund is still unborn, and it is not probable that it will receive aoy further attention from the Assccia- tion. 08 KENTUCKY MEDICAL JOURXAL. iu the hands of Dr. J. Taylor Bradford, of Augusta. The triniuphs of Dr. Benjamin W. Dudlej- in lithotomy established for him an unrivaled reputation in his day as a gi'eat op- erator in calculus affections. Her medical teachers were foi' a long time, as they still are, anions the foremost in the laud, and it is but just to say that her practitioners have no where any superiors. Kenti^ckj^ was the first Slate west of the Allegrhany ilountains to establish a medical school and to send forth its first medical graduate iu the West. If in statesmanship she may boast of a Clay and of a ''silver-tongued" Crittenden, whose elo- quence enchanted admiring audiences, and elicited the applause of the senate chamber; if her bar was long kno\vn as one of the most elegant, austere, and learned in the land: if her pulpit was dignified by the piety, erudi tioii. and oratory of her Campbells and her I^reckinridges. and is still adorned by het Humphreys, her Robinsons, and other great divines, she has their counterparts in het Caldwell, her Drake, hpr Dudl-^y. her 'Miller, her "Rogers, ber Yandell. her Bush, and othei great phvsicians whose names stand high up- 071 the roll of fame, and who, if thev had di- rf'Cted their attention to other pursuits, would have been equally distinguished. These men need no monuments to peipetuate their vir- tues or their services; their names live in the esteem and affc'-tion of their fellow-citizens, eusrraved iu o-ood acts, desisned to relieve hu- man suffering, and to exalt the dignity- of human nature. I stop here for a moment to ask. what is the object of a monument? Ts it to glorify the dead or to eneourasre the living? The boy, as he passes along Charles Street. Baltimore, under the shadow of the Washington ]\Ionu- iiient. pauses to read the inscription upon its eutablatm-e : "Erected by the State of Mary- land in grateful recognition of the virtues and services of the 'Father of bis Coiuitry'." He gazes at the august figure at the top, and dis- cerns in it all the attributes of a great man ; he goes home and curiosity impels him to iu- (|uire into hi.-: character; perhaps he consults his childish history, and there finds that Washington, the grandest subject of all his- toiw. was the saviour of his country: like him- self, at one time, an obscure youth, but now, long after his death, the idol of the American p ople. He has learned an important lesson ; his ambition is roused ; his energies have re- ceived a new impulse : in a word, new life has been infused into l;is soul, and that boy is al- ready the coming man. The granite shaft which we have this day dedicated to the mem- ory of 'McDowell is a li-\ang biography, design- ed not merely to commemorate the vii-tues and seiwices of a great and good man. biit to ex- cite the emulation of Kentucky's youths, and to urse them on to deeds of valor and of hu- manitj-. A eoimtry without monuments is a country without civilization. 1 can not forbear introducing here the ap- propriate and beautiful remarks of an old and distinguished pupil, Dr. David W. Tan- dell, made upon a recent festive occasion, when contrasting the fame of the statesman, the orators, and the military men of Ken- tueks' with that of jMcDowell. "Chief among all of these," says my eloquent friend, "is he who bears the mark of our guild, Ephraim ^McDowell ; for the labors of the statesman will give way to the pitiless logic of events, the voice of the orator grow fainter in the com- ing ages, and the deeds of the soldier eventu- ally find place only in the librar)' of the stu- dent of military campaigns, while the achieve- ments of the village surgeon, like the widen- ing waves of the inviolate sea, shall reach the uttermost shores of time, hailed by all ci'vili- zalion as having lessened the suffering and lengthened the span of human life." In selecting Danville for the site of the "^rcDowell 'Monument." the Kentiieky State Medical Society made a happy choice, for it was here that the Father of Ovariotomy en- conn+ered and vanquished his earlv profes sional struggles; here that he perfonued his great achievements; here that at the close of a well-spent life he was laid quietly in the grave. Wlien ^IcDowell, after his return from Europe, began tlie practice of medicine here, Danville contained a mere handful of inhabitants: but he soon identified himself with its prosperity, watehins: its progi'ess with a jealoiis eye, and contributing largely by his means and his s'ood sense to make it what it now emphatically is, the Athens of the West, a distinction at one time so justly con- ceded to her neighbor, Lexington. Its insti- tutions of learning have become the foremost in the State. Center College has educated many of Kentuekv-'s greatest citizens. Its theological school has widely disseminated the lessons of Christianity". Its female seminaries have planted the seeds of ^drtue. piety, and learning in the hearts and minds of her young women. The institution for the education of deaf-mute« was the first of the kind establish- ed in the West. Founded in 182.3. shortlv af- ter those of Hartford. Philadelphia, and Xew York, it gradually, despite great obstacles, at- tained under the wise management and fos- tering care of the late ]Mr. John A. Jacobs, extendiuir over a period of forty-four years, a degree of reputation not less creditable to the country at larse than to his adopted State. His death in 1869 was a public loss, widely deplored. Nearly forty years have elapsed since I was called to the chair of surgery in the Univers- ity of Louisville, and responded, along with Professor Drake, at the request of my col- leagues, to an invitation issued bv the late Dr. MEDICAL PIONEEIifi OF KENTUCKY, 3S William L. Sutton, of Georgetown, to assist in I'orjiiing a State medical society. The first attempt proved abortive, but another, made uJider more favorable auspices several years later, was successful, and the society soon as- sumed important proportions. Of the origin- al members, of whom Dr. Sutton was one of the most zealous and influential, few survive: i)ut it is gratifying to know that the work which they inaugurated has been so nobly inished forward by their successors, not a few of whom have achieved a Avide and endearing reputation as medical pliilosophers, clear thinkers, accurate observers, and accomplish- ed and sagacious practitioners. If any evi- dence were needed of their zeal to advance the interests of medical science and of suffer- ing humanity, it would be found, not in idle talk or vapid boasting, but in hard work and steady and persistent effort, as shown in the transactions of their society and in our peri- odical literature. Progress of the most laud- able character is everywhere visible in its ranks. Since the period adverted to, most of lay earlier Kentucky friends in and out of the profession have passed away, while of my eai'lier colleagues in the University of Louis- ville not one remains. Drake and Caldwell and Sliort and Cobb and Miller and the Elder Yandell have gone to their last home, to that sleep which knows no waking. Palmer and Pogers, who entered the school at a later day, have also been gathered to their fathers; the one a brilliant anatomical teacher and a genial and intelligent companion; the other for up- ■ward of a third of a century Louisville's hon- ored, beloved, and favorite physician, with a heart gentle as a woman's and a countenance benignant as an angel's. Kentucky has a long list of deceased physicians, who have left behind them a rich legacy and an exam- ple worthy of the emulation of their success- ors, whose duty it should be to cherish their memories and to transmit to their descendants the history of their lives. It would be unjust alike to the occasion as it would be to my own feelings if I failed to connect with each other and with the great ovariotomist. as with an adamantine chain, the )iaines of those of our surgeons, already several times mentioned, who have been in- strumental in reviving this operation in this countrj^ and thus giving it a ne}v impulse. The names which stand most conspicuously u]-)on this honored list are those of the two brothers Atlep, John and Washington, J. Tay- lor Bradford, Edmund Randoli^h Peaslee, Gil- man Kimball, and Alexander Dunlap. Of these six pioneers in this field of surgery, three have passed away, while the other three, John L. Atlee, Gilman Kimball and Alexan- der Dunlap, are still spared to us, in a ripe but vigorous old age, to battle with disease and death and to earn additional laurels for themselves and their country. Of the early life of Dr. J. Taylor Bradford, ^.yha died a number of years ago in the prime and vigor of life, I know nothing, although our acquaintance extended over a period of twenty years. He received his medical degree h-ora the ITniversity of Louisville during the early part of my connection with that insti- tution, and, settling at Augusta inunediately afterward, soon acquired a large and com manding practice, performing m.any import- ant surgical operations, and earning an envi- able reputation as a most successful ovarioto- mist. Had he reached the age usually allotted to man his cases would probably have been counted by the hundred. Dr. Washington L. Atlee, who died at his home in Philadelphia in September, 1878, was, as is his brother John, a native of Lan- caster, Pennsylvania, where he was born in February, 1808. After having received ari academic education he graduated at the Jef- ferson Medical College in 1829. Having been fellow-students in the office of Professor George MeClellan, the eminent surgeon, and having met with him very frequently after my removal to Philadelphia in 1856, I had excellent opportunities of forming a correct es- timate of his character, wdiich no one perhaps appreciates more fully than myself. If his character was not perfect in the true sense of that term it was a model worthy of universal imitation. He had many striking traits of character, with a strong, vigorous mind in- eased in a strong body, and accomplished a vast deal of work. He performed a much greater number of professional journeys than ever fell to tlie lot of any American physician. His visits extended into almost every State of tlie Union ancJ even into a number of our Ter- ritories. His power of endurance was gi- gantic. He often traveled thousands of miles without taking any rest except such as he found upon the swiftly flying railway train. Not unfrequently he performed two ovariot- omy operations on the same day. Such labor could not fail to make serions inroads upon the stoutest frame, and, although the day of I'eckoning was long put off, it was sure to come at leTigth. The early professional life of Atlee was spent in earnest practice, enlivened by the study of botany and other branches of nat- ural science, for which he had a great fond- ness. Much of his leisure during the first few y(>ars was spent among the flowers and grasses of his native county. After his removal, in 18-4-1. to Philadelphia he occupied for eight A'cars the chair of chemistry in wdaat was then known as the Pennsylvania Medical College. His career as an ovariotomist began, as al- ready stated, in 1844 and terminated only with his life. His first ease proved fatal. As 40 KENTUCKY MEDICAL JOURNAL. an operator in his specialty he had no su- perior on this continent, if indeed anywhere. Despising display, always so well calculated to entrap the viiJgar, he eiuploj'ed the fewest possible instruments and went about his work cahuly and deliljerately, with the greatest care for the welfare of his patient, which, it is safe to say. no man bad ever more at heart. There was no hurry, no parade, no ostenta- tion. 1 witnessed a number of his operations and was strongh' impressed by the simplicity of his movements and the coolness of his man- ner. Such, iji a few words was his character as an operator. But it must not be inferred that Dr. Atlee was a mere specialist. For many years he enjoyed a large and lucrative general practice, although during the last quarter of a century of his life his business ^ras maijily in the direction of abdominal surgery, in which he achieved an enduriug reputation. He wrote largely for the medical press, and late in life published an able and elaborate treatise on the "Diagnosis of Ovar- ian Tumors," a subject which he invested with new light. His operation for the remov- al of the fi!)roid growths of the utems consti- tutes a new era in snrgerj-, precious alike to science and to humanity. Like McDowell's operation, Atlee's was received with distrust, and remained unappreciated for upward of a quarter of a century. Time, however, which geuerall}^ measures things according to their real value, has made a strong verdict in its favor, and it is therefore not sui*prising that the gynecologists of America and Europe should unite in proclaiming it as one of the g;reatest achievements of modern surgery. Atlee's own successes should have 'been quite sufficient to convince any unprejudiced mind of its great value. Atlee had a strong but tender, sympathiz- iug heart, a well-regulated temper, a high sense of honor, and a clear and well-cultivat- ed mind. Tall and erect in person, he had a eonunanding presence, blended with the air and graces of. the well-bred gentleman. In the sick-room he was cheerful and winning in his manners, with a heart full of kindly feel- ing for the sufferer. He was the idol of his family, a warm friend, a loyal citizen, a con- sistent Chi-istiau. His last ilkiess. extending over a period of three months, was ci'uelly se- vere, but he bore his suffering, which was daily making sad inroads upon his previous- ly robust frame, without a miirmuj' of com- plaint or impatience. The gradual decay of his body did not impair his intellectual pow- ers, and his mind remained clear to the last. No man, perhaps, ever set his house more per- fectly in order than he did ; not even the most minute details were overlooked. Impartial his- tory will assign to Washington L. Atlee a high rank in the temple of fame as an original thinker, an accomplished surgeon and phy- sician, and a benefactor of his race. Dr. Edmund Kandolj)!! Peaslee, whose name, as has been stated, is, like that of Atlee, so honorably associated with the progress ot ovariotomy in this country, died m January, i.878, only about eight months before his dis- tinguished Philadelphia confrere. Born in New Hampshire in 1^14, he was emphatically a many-sided man, of high culture, great re- finement, vast industry, and extraordinary l^rofessional resources in cases of emergency. With the exception of Nathan Smith, of New Haven, a contemporary of McDowell, I have no recollection of any man who in recent times lectui'ed on so many branches of med- ical science or filled chairs in so many medical schools. Anatomy and physiology, general pathology, surgery, obstetrics, and gjoiecol- ogy were the diversified themes which from tijne to time enga^ged his facile brain as a pub- lic teacher. He was also an expert and cau- tious operator and a most accomplished phy- sician, especially distinguished for his skill as a diagnostician. Besides numerous papers contributed to the periodical press, he Avas the author of several books ; among others an ex- haustive treatise on "Ovarian Tumors," pub- lished in 1872, a production which, while it greatly enhanced his reputation at home, made his name widely known abroad. Of his operations I have already spoken. The pri- vate character of Dr. Peaslee may be best summed up in the beautiful words of his bi- ographer, the Rev. Dr. Bartlett, President of Dartmouth College, who, having known him long and well, thus speaks of him: "His day," says this accomplished scholar, "is done ; his sun is set. But from the scene of its setting there streams up a trailing brightness, as of some perpetual zodiacal light — the sliin- ing example of one who, while profound in science, wise in counsel, and excellent in skill, ■sras also sincere in piety, blameless in man- hood, true in friendship, genial in inter- course, and whose presence enters the siek- chamber like a sunbeam from heaven stream- ing into a darkened room. Its mild radiance lingers in hundreds of homes and thousands of hearts. It is a life profitable for yoiuig men to contemplate." Young men of the Kentucky State Medical Society, listen to the voice of one who has grown old in his profession, and who will probably never address you again, as he ut- ters a parting word of adAnce. The great question of the day is. not this operation or tljat, not ovariotomy or lithotomy, or a hip- joint amputation, which have reflected so much glory on Kentucky medicine, but is preventive medicine, the liA^giene of our per- sons, our dwellings, our streets: in a word, our surroundings, whatever and wherever they may be, whether in city, town, hamlet. MEDICAL PIONEEh'S OF KENTUCKY, 41 or country, and the establishment of efficient town and state boards of ' health, through wiiose agency we shall be tlie better able to prevejit tlie origin and fatal effects of what are known as the zymotic diseases, which carry so inuch woe and sorrow into our families and which often sweep, like a hurricane, over the earth, destroying millions of iiuman lives in an incredibly short time. The day has arrived when the people must be roused to a deeper and more earnest sense of the people's weltare, and when suitable measures must be adopted for their protection as well as for the better development of their physical, moral, and intellectual powers. This is the great problem of the day, the question which you, as representatives of the rising generation of physicians, should urge, in season and out of season, on the attention of your fellow^-citi- i-eiis; the question which, above all and beyond all otliers, should engage your most serious thoughts and elicit your most earnest cooperation. When this great, this mighty ob- ject shall be attained ; when man shall be able to prevent disease and to reach with little or no suffering his three-score years and ten, so graphically described by the Psalmist, then, but not till then, will the world be a paradise, with God, Almighty, AlL-wise, and All-merei- ful, in its midst, reflecting the glory of His majesty and power, and holding sweet con- verse in a thousand tongues with the human family. PRESENTATION ADDRESS. REMARKS MADE BY PROPESSOK BICHABD 0. COW- LING, M. D., OP liOUISVn^LE, IN PRESENT- ING THE DOOR-KNOCKER OP DR. MC- DOWELL TO DR. GROSS. Dr. Gross, the Kentucky State Medical So- cietj' thanks you for the beautiful oration yon have just delivered on Ephraim McDowell. Surely hereafter, when history shall recall his deeds and dwell upon his memory, it will re- late how*, when he was fifty years at rest, the greatest of living surgeons in America came upon a pilgrimage of a thousand miles to pro- nounce at his shrine the noble words you have spoken. The Society does not wdsh that you should return to your home without some memento of the occasion wdiich brought you here, and which shall tell you also of the admiration, the respect, and the affection it ever bears for you. I have been appointed to deliver to you this simple gift, with the trust and the belief that it will always pleasantly i-ecall this time, and be a token of our feelings toward you. We wished to give you something directly connected with McDowell and it occurred to us that this memento of the dead surgeon would be most appropriate. It is only the knocker which hung upon his door, but it car- ries much meaning wicn it. itie sweetest memories of our lives are Avoven aoout our uomestic emuiema. Xne heartnsione around wnicn we na,ve gatnereu, ttie uuair in wnicn our iovea ones nave sat, tue cup tiieir iips nave Kissea, tne iute tneir nanus have swepL — ivvnat jeweis can repicice tneir value? uo you remember tne encnantment liiat Douglas derroia wove about a nat-peg? liow at tne cnristening ot a cuiiu tney gave it great guts oi aiamouus ana pearis anu laces ; iuid WiiKU tne lairy goumoiner came, anu tney expected tnat sue would eciipse tnem aii witn liie magnincence ot Uer dowry, now sue gave It siiupiy a nat-peg? Tney wouaered wnai good couid come oi that, llie boy grew to be a man. In wiiu pursuiis his ricnes were wast- ed, and at last ne came nome and nttud It's liat upon that peg. And wnne tne goouman's liat was hangiug there peace and plenty and oi'der and arteciion sprang up m ms nome, and the hat-peg was indeed the talisman of hisi life. ] would that the magician's wand were granted me a while to weave a titting iegeuei around this door-knocker, wiuch comes irom McDowell to you, Dr. Gross. Ihere is mucli in the emblem. No one knows better than you how good and how great was the man of whom it speaks, it wiii teil ol many sum- mons upon mercy's mission which did not sound in vain. Ofttimes has it roused to action one whose deeds have tilled the world with fame. A sentinel, it stood at the doorway of a happy and an honorable home, whose master, as he had bravely answered its signals to duty here below, so when the greater summons came, as trustfully answei-ed that, and laid ,down a stainless life. It belongs bj^ right to you, Dr. Gross. This household genius passes most fittingly from the dearest of Kentucky's dead surgeons to the most beloved of her living sons in medic- ine. She will ever claim you as her son, and will look with jealous eye upon those who would wean you from her dear affection. And as this emblem which now is given to you hangs no longer in a Kentucky doorway, by this token you shall know that all Ken tucky doorways are open at your approach. By the relief your skill has wrought; by the griefs your great heart has healed ; by the sunshine you have thrown across her thresholds; hy the honor your fame has brought her ; bj' the fountains of your wisdom at which your loving children within her bor- ders have drunk, the people of Kentucky shall ever open to your their hearts and homes, DR gross's reply. I am much overcome, gentlemen of the Kentucky State Medical Society, by this mark 4i: KENTUCKY MEDICAL JOUKNAL. of your approbation. I am not the great man yonv speaker has declared me to be, but J gi'atet'ully appreciate tlie feelings that have l^rompted his words. I claim to be but an eai-nest follower of surgery, who during a period which has now extended bejond a half a century, has striven to the best of his abilitj' to grasp its truths and to extend the beneficence of its offices, I am not to be and much of the fruition of its hopes. To the warm hearts of the many friends it M'as my good fortune to secure within these borders do I owe it that those struggles were cheered and regards beyond my deserts were secured. I take this emblem now oiJered me as the most vah^ed gift of my life. It shall be re- ceived into my hoaue as a household god, en- vironed by all the memories of goodness and DOCTOR RICHARD O. COWLING 1839—1881 placed by the side of ilcDowell, for what 1 may have done in our art : but if this reward be a measure of the appreciation I hold of the good-will of the people in this Commonwealth, I may claim it for that. The years of my life which I passed in Ken- tucky represent the most important era in my career. Thev witnessed manv of its struggles greatness to which your speaker has referred, and above all recalling this scene. Dying I shall beqiieath it, among my most important ])ossessions, to the family that I may leave, or in failure of that, to be presented to the arch- ives of some society. I thank j^ou again, gentlemen, and I wish I were able to tell you better how much I thank vou. MEDICAL PIONEEL'S OF KENTUCKY. 43 ADDRESS OP PROFESSOR LEWIS A. SAYRE, M. D. PRESIDENT OP THE AMERICAN MEDICAL ASSOCIA- TION WHEN THE MONUJIENT WAS DEDICATED. No word from me can add a single laurel to the crown of the immortal McDowell, whose history and services to mankind have been so beautifully and truthfully portrayed by the distinguished orator of the evening, the Nestor of American surgery. Prof. Gross. In fact, any remarks from me in my individual ca- tion to the memory of Ephraim McDowell, who has contributed more to the alleviation of human suffering and the prolongation of hu man life than any other member of the med- ical profession in the nineteenth century. We can scarceh' comprehend the greatness of this man's mind, and the truly wonderful genius of McDowell, until we stop to consider who he was, what he did, and when and where he did it. A village doctor in the backwoods frontier, surrounded by Indians and the buffalo, al- most beyond the bounds of civilization, with no books to refer to, with no precedent to guide, with no one to consult but his own uu- DOCTOR LEWIS A: SAYRE 1820-1900 pacity would seem almost inappropriate, but in my official capacity as President of the American Medical Association it is my duty as well as my pleasure to bring to the monu- mental shrine the ovations of the entire med- ical profession of these United States. And, Sir, I venture here the prediction that in all times to come the intelligent surgeons, either in person or in thought, from every part of the civilized globe, will wander here to Dan- ville to pay their respects and sense of obliga aided judgment, with no one to share the re. sponsibilit.y if unsuccessful unaided and alone assumes the responsibility of removing a disease which up to that time had been con- sidered absolutely incurable. Think for a mo- inent what would have been the result of fail- ui-e — a coroner's jury, and a verdict of will- ful murder, which at that time would have been pronounced correct hy the entire medical profession throughout the civilized globe. All this he dared and did assume, because his 44 KENTUCKY MEDICAL JOURNAL. clear iiiteilect had reasoued out his plau ot pioceuure, and. Jiis careiul uisseeiioiis liau j^iomieu uut 10 liim llie jjatu to victory. Auu Jiow every imeiiigeiit surgeon :n tue woriu is Xierloriniijg tlie operaiion as occasion requires, uiicii ai lue present time, as i-'r. inoiiicis Uas siaiea, lony tnousana years have aireauy been auuea to tue sum total ot human lile Ijy tJus one uiscovery oi i^jpnraim JicUowell. Anoi]ier lact scriKes ine very toreibly, ^Ir. Presiaeut, and tuat is tue heroic ciiaracter ot the woiuau wUo permitted tuis experimental oijei-atiou to be periormea upon her. Tiie \vo- luen ot KentueJiy in that period oi: her early lustory were heroic ana courageous, ace us- tomeU to brave the dangers of tne tomahawk ana scalpmg-Jmite, ana had more seii-reli- auee ana true heroism than is generally touna iu the more retiuea society oi city lue ; ana hence the courage of ^Mrs. Crawford, who, con- scious tuat deatn was mevitaule from tue ais- ease ■with which she suifered, so soon as tliis village aoctor explainea to her his plan ol ahoraiug her relief, ana couvmcea her juag- meut that it was feasible, immediately repliea, ■■Doctor. I am read}- for the operation; please proceea at once ana perform it. ' ' All honor to -Mrs. Crawford ! Let her name and that of Ephraim JMcDowell pass down in history together as the founders of ovariot- omy. Kentucky has many things to boast of in climate, soil, and magnificent forests of oak carpeted with her native hluegrass, far sur- passing in beauty and grandeur the most ele- gauth' cultivated parks of England. She is famed for her beautiful and accomplished wo- men: she is renowned for her statesmen,, her ci'ators, and her jurists: her Clays, her John- sons, her ^Yickliffes, her Crittendens, her jNLarshalls, her Shelbys, her Prestons, her Breckiuridges, and a host of others; but no name will add more to the luster of Iter fame than the one whose name we this day com- memorate by erecting this monument to Eph- raim McDowell, the ovarictomist. CORRESPONDENCE. LETTERS OF REGRET FROM DISTINGUISHED MEM- BERS OF THE PROFESSION WHO COULD NOT ATTEND THE DEDIC.A.TION. L. S. McMurtrij. M. D., Chainnayi McDowell Moiiiiiiwnt Committee : Dear Sir : — I thank you very much for j'our iiivitation to attend the meeting coiuiected with the .McDowell monument, aud I deeply regret that I am unable to leave London at jiresent. It would give me extreme pleasure to be present at so interesting a ceremony, to make the acquaintance of so many of my American professional brethren, and to show my respect to the memory of ■'the Father of Ovariot- omy. " ' 1 shall hope iu some future year to visit your great couutiy again, and to see the mon- ument you have raisea over the grave of Jic- Dowell. Very sincerely, T. Spencer Wells. o Upper Grosvenor Sti'eet, Lonaou \V., April 2i, 1879. L. S. McMurtrij, (jimu man McDowell Monu- ment Committee : Dear fciir: — 1 regret that it is not in my porter to renew tne pleasure of a foriuer visit to ixentucJi}' ana taKe part m tUe exercises at tbe aeaicaiion oi tne JicUoweli monument, ai least so lar as. to be a sympatuetic listener to all tne eloquence wnicn tue occasion will call forth. i feel a personal interest in the surgical conquest wUicU is to be commemoratea m aa- aiiion to that wnicli ail tne woria recognizes. Among the birtns of the century tuis is a twin u'lth myself. Dr. xUcDoweu s hrst opera- tion aates from the same year as tUat m \vmch i ILrst mhalea the slow poison tnat en- velops our planet, tne effects ox wmcU i nave so long survivea. i thanji Cioa that itie otuer twin will long outlive me ana m.v memory; carrying the ugiit of lite into the suaaows of impenuing aoom, tUe message oi hope into tue dariv realm of aespair ; opening tne prison to them that are bouua anu giving tueiU oeauty for ashes, tne beauty of a nert'-uorn existence eveu, It may be, as i have out recently seen it, of youthttU ana hapjjy maternity in piace oi the ashes for whieu tne inevitable urn seemed already waiting. I am glad that this great achievement is to be thus publicly claimed for American sur- gery. Our trans-Atlantic counsms have a microphone u-hicli enables tliem to hear the lightest footsteps of their owu diseoverei-s and inventors, but they need a teiepucne "irith an eart-trumpet at their end of it to make them hear auvlhing of that sort from our side of the water. There is another kind of trumpet they do not always find themselves uuprond- ed with, as those wlio remember Sir James Simpson's astonishing article, ■'Chloroform," in the eighth edition of the Eucyclopedia Britannica, decently omitted and ignored in the ninth edition of the same work, do not need to be reminded. If there was one who could dispute Dr. Mc- Dowell's claim to be called "the Father of Ovariotomy" it would have been our own Dr. Nathan Smith, our own and your own too, for he also was born and lived and died on the sunset side of the Atlantic, and within the starry circle which holds us all. Dr. Smith performed the operation of ovariotomy with success early in the century, but unfortunate- MEDICAL PIONEEI.'S OF KENTUCKY, 45 ly there is no record, so far as I know, of the exact date. I allude to this fact not to invali- date Dr. jMcDowell's claim, for an undated case can not do it, but to couple with his name as at least next in priority that of another native American practitioner worthy of com- panionship with the greatest and best. A single thought occurs to me which may help to give this occasion something more than professional significance. Although our po- litical independence of the mother country has been long achieved, our scientific and literary independence has been of much slower growth. And as we read the inscription on this monument, let us gratefully reimember that every bold, forward stride like this grand triumph of American science, skill, and moral courage, tends to bring us out of the present period of tutelage and imitation into that brotherhood and self-reliance which should belong to a people no longer a colony or a province, but a mighty nation. I am, dear sir. Yours very tnily, Oliver Wendell Holmes. Boston, May 9, 1879. L. S. McMurtry. Chairman McDoivell Monu- ment Go'mmittee: My Dear Sir: — It is with extreme regret that I find myself prevented from accepting your kind invitation to take part in the dedi- cation of the monument to the "Father of Ovariotomy." Although absent in body let me assure j'ou that I shall be present in spirit. Kentucky cherishes the memory of many noble sons, but nowhere in her annals can she point to a name more deserving of her pride than that which adorns the monument erect- ed to commemorate McDowell's glory. Others have given her the proud records of the w^arrior, the statesman, the philosopher, and the philanthropist. McDowell, favored by God above other men, has already bestow- ed upon humanity more than forty thousand years of active life, and insured for the future results which will surely dwarf those of the past. The noble tribute which you erect in his honor will last long, but it will crumble into dust and be scattered abroad by the winds, while his memory will continue -to live green and vigorous in the hearts of a grateful pos- terity. With sentiments of sincere regard, I am dear sir. Yours very truly, T. Gaillard Thomas. 294 Fifth Ave., New York, May 1, 1879. L. 8. McMurtry, Chairman McDoivell Monu- ment Committee: Dear Doctor : — 1 have much pleasure in ac- knowledging receipt of the invitation to at- tend the memorial occasion in honor of "the Father of Ovariotomy." Unfortunately for me some professional duties here, wnicu can not in any way be postponed, will compel my return liome trom Atlanta imimediately after the adjournment of the American iieciical As- sociation. It is well in the name of American surgery, and in the name of a common philantnropy, that this honor, though tai'dy, should be paid to the memory and fame of hiphraim Mc- Dowell. I cannot but think of the fact that the erection of the monument is largely due to the original suggestion and active etforts of one who recently passed away from earth before he had reached the noon of his power and reputation, one who was esteemed and admir- ed by every physician North, South, East and West. The monument will tell not only of ' ' the Father of Ovariotomy, ' ' but also of John D. Jackson. I am, dear sir, yours very truly ,Y Theophilus PakviN; Indianapolis, Ind., May 1, 1879. L. S. McMurtry M. D., and Others of the Mc- Dowell Monument Committee: Gentlemen: — Your kind invitation to at- tend the dedication of the McDowell monu- ment is just received, for which I beg leave to return my thanks, and the assurance of my sincere regret that I shall be prevented from taking part in the interesting ceremonies. The occasion is one of extraordinary im- port, in that it is the first and only instance in the history of the United States that such honors have been paid- to the memory of a physician; and secondly, that the virtues \vhieh it is proposed to perpetuate in the monument were consecrated to the saving of human life and the mitigation of human suffer- ing. Of the man Ephraim McDowell -we know comparatively little, but of the great orig- iual ovariotomist no one at all concerned in tlie progress of surgery can be ignorant. As a Kentuekian no less than as a surgeon 1 have always felt the deepest interest in his history, and have sought in his life and surroundings to penetrate to the origin of the great thought, and still greater courage, that gave expression to the thought which, without the sanction of precedent, and unaided by the advice or sym- pathy of others, culminated in the institution of an operation by 'which thousands of women heretofore doomed to early death now live to bless his name. But who can discover and open the secret door which hides from profane view the sacred laboratory of genius? Or who can trace the footsteps of the inspired discovei'er as he works his narrow way out to the con- 46 KENTUCKY MEDICAL JOURNjLL. lines of liuiuan exjjerience. and with purged eye looks into the mysteries which lie beyond '.' All that we can do is to cheer on with our ■words of encouragement, and, when the work is done, with willing hands distribute its bene- fits to those who are in need, never forgetting to pronounce a blessing upon the author. In this spirit of humble reverence I bow my bared head Itefore him whom you this day ex- alt in the sight of the whole world as one of its gi'eatest benefactors, and proclaim by your act that the highest and noblest ambition of the physician should be the saving oi' human life. Who is there since the days of Jenner, who can in this respect compare with the "back- woods surgeon of Kentuckj-?" I would not derogate in the slightest degree fi-om the de- served honor which belongs to many who have followed their profession with equal zeal and EPHKAI.M :\rcDOAVELL.* By I.EWis S. .AIc-MuRTRY, :\I. D., L.L. D.. Louisville. It is most oppropriate that in this one hun- dreth year since ilcDoweU's epoch-makin? work this society, foiinded by his followers in America, should celebrate his achievement and thereby keep afresh in the professional mind the source and origin of a great depart- ment of surgery. No conception of Ephraim- McDowell's character and personality could be more re- mote from the truth than that lie was a rude, liut courageous, backwoodsman, who by acci- dent or mishap undertook an unti-ied feat in surgery and succeeded in spite of a disregard of all surgical rules and establislied principles. CAMBUS KENNETH THE HOME OF DR. McDOWELL, NEAR DANVILLE earnestness, and who have added largely to the resources of the healing art. but in the in- scrutable wisdom of the Creator of all things it has not been given to any other single la- borer in the field of medicine and surgerj' up- on this western hemisphere to confer so great a blessing upon the human race. All honor to the memory of Ephriam ]Mc^ Dowell, the man of genius, the wise and heroic surgeon, the benefactor of his kind." "When the granite shaft which you have erected to signalize what he ^^as, and what he did shall have fallen into decay, his name will still be perpetuated by the many lives saved through his instrumentality. I am. gentlemen, with great esteem, your obedient servant, T. G. TiicnvRDSON. New Orleans. :Mav 9. 1879. Let us for a moment consider his origin and preparation. He was born in Rockbridge county, Virginia, on - the eleventh day of 3Iarch, 1771, when the American colonies were i]i the agitation preceding the revolution. His fathei-, Samuel ilcDowell, was a prominent man in Virginia and a member of the Assem- bly of that State. In 17S2, he was sent by the Legislature a^ a land commissioner to Ken. tuclrv, which was then a county or appanage of Virginia. A year later he was appointed judge of the District Court of Kentucky aurl removed his family to the town of Dan^-ille where the sittings of the court were held and where lie resided permanently thereafter. *An .iddress delivered before the .\.merican Gynecological Societ.v at the Centennial Celebration of McDowell's flrst Ovariotamj". MEDICAL PIONEERS OF KENTUCKY, 47 Ephraim McDowell's mother was Sarah Mc- C!lu):g, a member of a distinguished Virginia family. McDowell was a product of that civilization which was planted on the Virginia coast, and from which came Washington, Jef- ferson, Richard Henry Lee, Patrick Henry, }>enjamin Harrison, Edmund Pendleton, George Mason and other soldiers, statesm.en, and patriots who founded this great republic. His eai'ly education was attained at the class- ical seminary at Georgetown, Kentucky, the best school accessible at that time. After com- pleting his studies at the seminary, he went to Staunton, Virginia^ and following the cus- tom of that period entered upon the study of medicine in the office of Dr. Humphreys, a graduate of the University of Edinburgh and a practitioner of high reputation. In 1793-94 he attended the University of Edinburgh, then universally regarded the most famous centre of medical education in the world. As fellow students. IfcDowell was associated there with Dr. Samuel Brown, afterward one of the founders and teachers of Transj-lvania ITniversity at Lexington, Kentucky, aiid Dr. Hosack and Dr. Davidge, of New York, all of whom subsequently attained eminence iii the profession. As far as we know, the de- gree of M. D. was not conferred upon him un- til 1823, when, entirely im solicited on his part, the University of Maryland conferred upon him the honorary degree of M. D. The Med- ical Society of Philadelphia, at the time the most distinguished of its kind in this country, sent him its diploma in 1 807, two years before he performed his first ovariotomy. Thus it will be seen that McDowell had attained na tional distinction as a surgeon before he un- dertook the work which has made him famous. VZhile at the University of Edinurgli, Mc' Dowell attended the private instructions of John Bell, the most able and eloquent of the Scottish surgeons of his day. That portion of his lectures describing tumors of the ovaries and the power and eloquence with which he depicted the hopeless fate to which their vic- tims were condemned, made a powerful im- pression upon his auditor. Indeed, McDowell afterwards stated that the principles and sug- gestions at this time enunciated by his master impelled him sixteen years afterward to at- tempt what was considered an impossibility. In 1795 McDowell returned to his home at Danville and entered upon the p'ractiee of his profession. Being a man of classical educa- tion, coming from the most famous medical school of the world, he soon easily assivmed the first professional position in his loealitv, and within a few years was known throiisrh- out the Western and Southern States as the first surgeon of his entire section of country. Indeed, until Dr. Benjamin W. Dudlev. of Lex^ ington, Kentucky, came into the field Dr. Mc Dowell was undisputedly the most eminent surgeon west of the Alleghanies. During this time his practice extended in every direction, persons coming to him from all the neighbor- ing States, and he frequently making long journeys on horseback to operate upon per- son? whose condition would not permit them to visit at his home. As far as is known, he was in the habit of performing every surgical operation then practiced. In lithotomy hs was especially successful, and was known to have operated, up- to 3828, twenty-two times witiiout a death. • He operated many times for strangulated hernia, and did successfully various amputations and other operations, in- cluding tracheotomy. We must remembei^ that anesthesia was unknown in his day. In 1809, fourteen years after he began the THE FAMILY CREST practice of his profession, McDowell's oppor^ tunity was presented. He was called to see a Mrs. Crawford, living sixty miles distant from Danville, who was supposed by herself and her physicians to be pregnant and be- yond her term, with most seriou.s complica- tions. After careful examination he pro- nounced the case to be one of ovarian tumor; explained the hopeless character of the dis- ease ; expressed his conviction that it was feas- ible to undertake its removal; frankly an- nounced that it would be in the nature of an experiment, but an experiment that was prom- ising. In a word, he had faith in himself and his resources, which inspired confidence and hope in the patient. Mrs. Crawford accepted the profl'ered aid at once, and in a few days went to Danville, sixty miles distant, on horse- back, where the operation was successfully 48 KENTUCKY MEDICAL JOVRNAL. performed and follo^\•ed by prompt and per- fect recovery. It is known that ]\IcDo\vell had an excellent medical library for that time, and that he de- voted much of his leisure time to his books, but he possessed an avei'sion to writing. Like many able men in our profession of the pres- ent day. he was absoi'bed in practice, and lit- erar.v ^^•ork of every kind was burdensome to him. ^loreover, we must remember that he did not have the stimulus of the daily mail and numerous medical journals; also that no medical society was in existence in his section of the coTintry. Seven years elapsed after the operation before he made a report for piiblication, during which time he had operat- ed in two additional cases, both followed by recoveiy. The title of his paper is "Three Cases of Extirpation of Diseased Ovaries," and his description of the symptoms and op- eration is concise and clear, describing most essential points, but without any minute ac- count of the pathology- and daily progress af- ter operation. That he was inspired by the teachings of I^Ir. John Bell, of Edinburgh, to undertake the operation is apparent from the fact that his report of his cases was forward- ed to his revered master. The report failed 1o reach ^Fr. Bell, who was absent on account of ill health, and ^McDowell prepared another copy and forwarded it to the Echefic Bever- t'lni anrj Avnhiiical Review, published in Philadelphia, where it appeared in the issue of October. 1S16. The brevity and disregard of many essential details which characterized the report, exposed McDowell to criticism., and articles sarcastic and incredulous appear- ed in the Bepprfoni, while Dr. .Tames John- son, the learned editor of the London MrrJiro- Chhnirnirnl Rrrinr. expressed outright his disbelief of 'McDowell's' statements. A few years aftei-ward when the accuracy of the re- ports had been verified and confinned by the report of additional cases. Dr. Johnson edi- torially acknowledged his error, saying. "There were circumstances in the narrative of the first three cases that raised misgi^nngs in my mind, for which uneharitableness we ask pardon of f^od and Dr. ^IcDowell, of Dan- ville." In October. 1819, three years subsequent to his first publication, hf published in the same .iournal two additional cases. In this report, he alludes to thp several criticisms which had appeared resrarding his first paper in these words- "T thought my statement sufficiently explicit to warrant any siirgeon's performincr the operation when neeessaiy without hazard- ing the odium of making an experiment, and I think my description of the mode of oper- ating, and of the anatomy of the parts con- cerned, clear enough to enable any good anat- omist, possessing ihe judgment requisite for a surgeon, to operate with safety. I hope no operator of am^ other description may ever attempt it. It is my most ardent wish that this operation may remain to the mechanical surgeon forever incomprehensible." If we had no other knowledge of ^IcDowell's mental cast and surgical ideals, these words would stamp him as a surgeon of broad and elevated view, with lofty conception of the science and art of surgery, and keen appreciation of the advanced ground on which he trod. The total number of ovariotomies he performed is not certainly known. Dr. "William A. Mc- Dowell, his nephew and piipil, afterwards his partner, stated that the total number of ovariotomies done by Ephraim McDowell was thirteen, with eight recoveries and five deaths. Tlie essential points of ^McDowell's opera- tive technique are: (1) The parietal incision was made external to the border of the rectus muscle; (2) the pedicle was Ugated before opening and evacviating the cyst; (3) care was observed to cleanse the peritoneum ot fluids; (4) drainage was provided by bring- ing the ligature out through the lower angle of tlie incision and the ligature eliminated in that way- (5") the operation occupied only twenty-five minutes, expedition resulting more from the absence of an anesthetic, doubtless, than otherwise. In the report of the second caS'='. he says, "I laid her side open." In the third case, he adopted the median incision, which he indicates thus: "I changed my place of opening to the linea alba." In all his cases he ligatured the pedicle befoi-e separating ad- hesions or tapping the tumor. In the third case he mentions that the ligatures were not released for five weeks, at the end of which time the cord was taken away. In the brief report of his first ease. Dr. 'Mc- Dowell failed to record such details of env- ironment, preparation, and after treatment as so important an operation should have receiv- ed. He even failed to record the room or house in which the operation was performed. Either tradition or imagination has depicted the operator fearlessly doins- his work while a mob gathered about his house threateninc; his life on account of the fancied reckless hazard of life in attempting an untried ex- periment. Having been born and reared near Danville, and educated there, and ha-^-in? known some of TJcDowell's contemporaries. T am «i;re this stoiy is pure fiction, without anv semblance of facts for its basis. IMcDowell was pei-haps the most prominent and popular citizen of the community', commanding the respect and confidence of all classes, and known far and near as a great surgeon. The house in which ^Irs. Crawford underwent op- eration and remained while under treatment is not known. It is not probable that such an operation was done In the doctor's office: but MEDICAL PIONEEBS OF KENTUCKY, 49 more probably m some bedroom prepared for her care and niTrsing after operation. ]n a most accurate and painstaking sketch of McDowell by the late Dr. John D. Jackson, of Danville, he states that in 1822 McDowell made a journey of several hundred miles on horseback to the Hermitage, the residence of P]"esident Andrew Jackson, near Nashville, I'ennessee, to do an ovariotomy in the case of a J'Irs. Overton. He was assisted in the oper- ation by General Jackson and a Mrs. Priest- ly. Mrs. Overton recovered. McDowell was the guest of General Jackson during his stay in the neighborhood. Another one of his jja- tients in Tennessee was James K. Polk, after- ward President of the United States, upon whom, he did lithotomy when the patient was fourteen vears of age. la 1802, Dr. McDowell married Sarah, a daughter of Isaac Shelby, Kentucky's first and greatest governor, a soldier and states- man, with whom he lived imost happily and raised a family of two sons and four daugh ters, only three of whom survived him. Mrs. McDowell survived her husband by ten years. Dr. McDowell was nearly six feet in heigth, with dark hair and eyes, and possessed of ex- ceptional strength and endurance. He was dignified in bearing and possessed a command- ing presence, but quite free from austerity. He is described as an amiable and approach- able man, with abundant cheerfulness and good humor. As a citizen he took an active part in all movements for the welfare of the community. He was especially interested in education, and contributed liberally of his time and means to provide educational facil- ities so much needed at that time. He was a members of the first P>oard of Trustees of Cen. tre College of Kentuelcy, no'w Central Uni- versity of Kentucky. He contributed person- ally the lot upon which Trinity Episcopal Church in Danville now stands. In his fifty- ninth year while in the full vigor of life, h.-^ was seized with an acute fever and died on the twentieth day of June, 1830, after a brief illness. In 1852, twenty-two years after the death of Ephraim McDowell, Professor Samuel D. Gross, then a resident of Louisville, presented to the Kentucky State Medical Society a sketch of the life and original surgical work of the first ovariotoraist. Professor Gross brought to his task his characteristic accuracy and thoroughness of investigation. He engag- ed in a laborioiTS correspond euee with the fam- ily, relatives and contemporaries of McDow- ell, and collected all available knowledge bear- ing upon his life and character. This sketch was subsequently incorporated in Gross' American Medical Biography, published by landsay & Blakiston, of Philadelphia, in 1861. The critical investigations by Professor Gross of the original reports of various operators, together with the incontrovertible testimony presented as to McDowell's priority, placed McDowell's claims beyond all dispute and es- tablished firmly his position as the originator, by successful accomplishment, of the radical cure of ovarian tumors by abdominal section. In 1879, the Kentucky State Medical So- ciety erected over the grave of McDowell, at Danville, a monument to perpetuate his name and fame. The dedication of this monument, on the fourteenth day of May, 1879, was the most imposing event in the annals of the med- ical profession of Kentucky. The address of the occasion was delivered by Professor Gross before a large audience composed of members of the State Medical Society, officials of the State, and a large concourse of prominent citizens. Upon the speaker's stand were seat4 ed the Governor of the Comanonwealth, the Secretary of State, and other officials; the president of the American Medical Associa- tion, Dr. Lewis A. Sayre ; the venerable Dr. Oilman Kimball, of Lowell, Mass., who had ]>erfoi"med ovariotomy nearly three hundred times ; and numerous other eminent American surgeons. Among the tributes to McDowell presented on this occasion were letters from Sir Spencer "Wells, Oliver "Wendell Holmes, T. Gaillard Thomas, Edmund Randolph Peaslee, Theophilus Parvin, and others. The oration of Professor Gross is a master-piece of bio graphical literature, quite worthy of the oc casion and its distinguished author. The oc- casion is memorable for the achievement it celebrated, and memorable for the poet who put it in verse. Achilles can never be forgot- ten because Homer fixed his fame. Other and more eloquent speakers will tell you of the struggles of McDowell's followers in America, in Great Britain, in France, and in Germany. The work was in the hands of a few courageous spirits, who fought on in the face of opposition and even persecution un- til the dawn of the Listerian era lighted the way to the present proud position of abdomi- nal surgery. Pelvic and abdominal surgery began with ovariotomy; ovariotomy began with McDowell. 11. THE TRANSYLVANIA UNIVERSITY GROUP FOREWARD THE MEDICAL DEPARTMENT OP TRANSYLVANIA UNIVEESITY* liy RoBEKT Peter, A. M., M. D., Lexington. The history of medicine and of the earliest nacdical men in Kentucky clustex's around the name of Transylvania University. The State of Virginia, in 1780 — ^when ''Kan-tnek-ee" or "Ken-tuckee." as this ary of learning.'' that "might at a fn- tni'e day be a valuable fund for the mai}ite- nance and education of youth ; it being the interest of this Commonwealth always to pro mote and encourage every design 'which might tend to the improvement of the mind and the diffusion of knowledge, even amongst the most remote citizens, whose situation a barbarous neighborhood and a savage iatercourso might otherwise render unfriendly to sci- ence." Three years thereafter, 1783, when Ken- TRANSYLVANIA UNIVERSITY MEDICAL HALL Erected in 1839. Burned in 1863. Provision seems to have been made for the medical classes in the first University building, but from the time this was destroyed in 1829 until the construction of Medical Hall, above shown, in 1839, these classes appear to have been more or less migratory bodies, lectures and demonstrations being given in the offices of individual professors, or in a room provided by them independently, as is shown in the context and in the picture of Fairlawn. country was then called, was only a little-ex- plored portion of that State — placed eight thousand acres of escheated lands witliin that county into the hands of thirteen trustees "for the purposes of a public school or semin- *The medical profession of Kentuclc.v is indebted to the Filson Club for the use of many of the sketches and pictures in this group. tueky had become a district of Virginia, the General Assembl.v, by a new amendatory Act, re-endowed this "public school" with twelve thousand acres more of escheated lands and gave it all tlie privileges, powers, and immun- ities of "any college or university in the State," under the name of "Transylvania Seminary." MEDICAL PIONEERS OF KENTUCKY, 51 In the wild and sparsely settled country this seminary began a feeble existence under the special fostering care and patronage of the Presbyterians, who were tlien a leading religious body, aided by individual subscrip- tions and by additional State endowments. The Reverend James Mitchell, a Presby. terian minister, was its first "Grammar Mas- ter," in 1785. In 1789 it was placed under the charge of Mr. Isaac Wilson and located in Lexington, with no more than thirteen pupils all told. The Reverend James Moore, educat- ed for the Presbyterian ministry but subse- quently an Episcopalian, and first Rector of Christ Church, Lexington, was appointed "Director," or the first acting President of the Transylvania Seminary, in 1791. He taught in his own house for want of a proper seminary building, with the aid of a small li- biary and collection of philosophical appar- atus,. This library and apparatus had been donated by the Reverend John Todd, of Vir- ginia, who, with other influential Presbyteri- ans, had been maiiily instrumental in procur- ing the charters and endowments from the Crenneral Assembly of Virginia. The offer of a lot of STOund in the town of Lexington to the trustees of Transylvania Seminary, bj'' a company of gentlemen calling tliemselves the "Transylvania Land Com- pany," indxiced the trustees to permanently locate the s&m.inary in that place in 1793. On that lot, the first school and college building were placed, and on it was afterward erected the more commodius LTniversity edifice in which taught the learned and celebrated President, Doctor Horace Holley. This first University building was destroyed by fire ?Jay 9. 1829. In later years, 1879, this old "College lot" was beautified and improved by tree-planting and otherwise by liberal citizens of Lexington, moved by the efforts of Mr. H. H. Gratz. and designated first "Centennial Park," and afterward "Gratz Park," in honor of Benjamin Gratz, being not now util- ised for special educational purposes. With limited success the first "Director of Transylvania Seminary" taught in Lexing- iion until 1794, when he was superseded by the election by the Board of Trustees of Mr. Hany Toulmin as first President of the Semi- nary. This gentleman, a learned Unitarian min- ister of the school of Doctor Priestley, and a native of England, resigned the Presidency in 1796, and was Secretary of State of Kentucky under Governor Garrard. Intense feeling at the election of Mr. Toul- min on the part of the leading Presbyterians, ^\'ho claimed the Seminary as their own pe- culiar institution, caused them to obtain in 1796 a charter from the Legislature of Ken- tucky, now a State, for a new institution of learning which they could more exclusively control. This was the ' ' Kentucky Academy, ' ' of wliich the Reverend James Blythe, of their communion, was made President. On the establishment of the Kentucky Academy by the dissatisfied Presbyterians in 1796, an active rivalry between that school and Transylvania Seminary operated to the injury of both institutions as well as to the cause of education in general. Therefore, af- ter two years of separate existence these two institutions, with the consent of the trustees of both, were united in 1798 by an Act of the General Assembly of Kentucky into one, "for the promotion of public good and learning," under the title of Transylvania Universiiy. The consolidation was made under the orig- inal laws which governed the Transylvania Seminary, as enacted by the General Assem- bly of Virginia. Under the act of consolidation of December 22, 1798, this University was organized by the appointment of Reverend James Moore, of the Episcopal Church, as first acting Presi- dent, with a corps of professors. And now, for the first time in the Mississipi Valley, was the effort made to establish a medical college. Early in 1799. at the first meeting of the trustees of the new Transylvania University, they instituted "The Medical Department" or College of Transylvania, which subsequent- ly became so prosperous and^o celebrated, by the appointment of Doctor Samuel Brown as Professor of Chemistry. Anatomy, and Sur- gery, and Doctor Frederick Ridgely as Pro- fessor of TMateria Medica,, Midwifery, and Practice of Physic, Dr. Brown qualified as Professor October 26, 1799, and Doctor Ridge- ly the following November, Dr. Brown was authorized by the Board to import books and other means of instruction for the use of the medical professors to the amount of five hundred dollars, a considerable sum in those days, and he and his colleagues were made salaried officers of the University. A Law College was also organized at this time in the University by the appointment of Colonel George Nicholas, a soldier of the Revolution and member of the Virginia Con- vention, as Professor of Law and Politics. The annals of the earlier efforts to estab- lish medical education and a medical college in connection with Transylvania University, the first in the whole West and the second in the United States, are meager and unsatis- factory. As already stated, the first Medical Pro- f(^ssors in this University, Doctors Samuel Brown and Frederick Ridgely, 1799, no doubt taught and lectured occasionally to such stu- r.2 KENTUCKY MEDICAL JOURNAL. clouts as were present. The files of the old Keniuchy Gazette show that Doctor James Fishbaek. who was uiiauimously appointed to the Chair of Theory and Practice of Medicine in Trauf^ylvania in 1805. advertised to lecture, and did probably lecture on these subjects. But he resigned in 1806. Doctor James Over- ton, who had been appointed to the chair of ]\rateria iledica and Botany in 1809, said in his letter of acceptance, on the occasion of his reappointment in the reorganization of the Jfedical Faculty in 1817, that he "had en- gagcd for some time in giving lectures on Theory and Practice in this town," etc. .\eeording to the best recollection of the late Doctor Coleman Kogers, for a long time before his death a resident of Louisville, the Medical College of Transylvania University was reor- ganized in 1815 by the appointment of the following Faculty: Doctor Benjamin W. Dudley, Professor of Anatomy and Surgery. Doctor Coleman Rogers, adjunct to this chair. Dr. William H. Richardson, Obstetrics, etc. Doctor Thomas Cooper, Judge Cooper, of Pennsylvania to the chair of Chemistry, Min- eralogy, etc. Doctor James Blythe, then acting Presi- dent of the University, was to give chemical instj'uction. Doctors Cooper and Rogers did not accept this appointment. According to Doctor Rogers' recollection a resailar course of lectures was not delivered by this Faculty, although Doctors Dudley and Overton prob- ablv bo^h lectured or taught "as they previ- ously had done." Dr. C. C. Graham says: "What few private students there were in Lexington went ft'om shop to shop, at that day doctors' officers were so called, anrl got three onlv, Dudley, Rich- ardson, and the eccentric Overton, to give us a talk." Dr. Dudley's own recollection, as detailed to the present writer, was also that he and Doctor Overton, as well as Doctor Blythe, lec- tured in 1815-lfi to about twenty students, of whom the late Doctor Ayres and the yet si;r- viving Nestor of Transylvania graduates, Doctor Christopher C. Graham, of Louisville, now almost a centenarian, were in attendance as pupils. "Very little can now be ascertain- ed, from existing records, of the character of Professor James Overton, Doetar Christo- pher C. Graham, in a recent letter to the writer, gives some reminiscences of him in the followins: language: 'Doctor Overton was a small, black-pved man, very hypochondriacal and sarcastic, notoriously so. and ^-et quite chatty, humorous, and agreeable: telling his class manv funny thinsrs. He was well edu- cated for his dav and plumed himself especi allv on his Greek." Doctor Overton removed from Lexington to Nashville, Tennesspe, in 1818. The late Doctor Ayres, of Danville, and lat- tcT'ly of Lexington, informed the writer that, in 1815, Doctor Dudley, having recently re- turned from Europe, was invited by himself and other medical students to demonstrate to tbein in anatomj' and surgery. Learning that he would lecture to them if a class were form- ed, they made up one of from twenty to twen- t\'-five, and Doctor Dudlej' lectured to them ou anatomy and surgery in "Trotter's Ware- house," a house situated on the southeast cor- ner of Main and Mill streets. opposite the site of the old original Lexington block-house. In the next winter, he recounts, he lectured to about fifty or sixty students, some of Avhora w'U'e from Ohio. Doctors Overton and Bly- the, one or both, also lectured in both winters. This may be said to be the real beginning of the successful career of the Sledical Depart- ment of Transylvania L^niversity, and of that of Doctor Dudlev as a medical professor. The Kenfucl-fi Gazette of ilarch 10, 1817, contains a card published by a committee of the medical students of Transjdvauia, signed David J. Ayres. Thomas J. Garden, and Charles TT. Warfield, committee of the medical cla>5s. headed a "Tribute of Gratitude," in ■\vh.ich they retu.rn grateful thanks to their professors, Doctore B. W. Dudley, James Overton, and the Reverend Doctor Blythe, for the ability, fidelity, and perseverence with which they had taught them, a further proof that a medical session was held in the Transvl- vania School in 1816-17, ^Fanj'' circumstances in these early times fa- vored the establishment of a medical college in Lexington. Not only had that city beet! rccr.onized for many years as a great center of public education for the whole State, made so by the location in it of the State's Univers- ity, "Transylvania," but it was also at that time the great metropolis of the West. The country around it, though fast becoming set- tled and improved by enterprising pioneers, had not as yet been provided with roads or good means of communication with older set- tlements. To ascend the Ohio River and cross the Alleghany Moimtaius to Philadelphia, where the only other medical school in this coimtry then existed, was a tedious and la- borious undertaking, and not devoid of dan- ger. On ]\rarch 2, 1816, one thousand dollars were appropriated by the Trustees of Tran- sylvania and placed in the hands of Doctor Blythe and John D Clitiford for the immedi- ate pui'chase of chemical apparatus. Doctor Blythe, who had been actiug President of th'^ I'uiversity up to this time, resigned and ac- cepted the position of Professor of Chemistry in, the IMedical Department. In 1817, the iledical Faculty was further MEDICAL PIONEERS OF KENTUCKY, 53 reorganized by the appoiutmePit of tlie cele- bi'ated, talented Doctor Daniel Drake to the chair of Materia Mediea and Medical. Botany. Hie organization was then as follows : Doctor Benjamin W. Dudley, Professor of Anatomy and Snrgery. Doctor James Overton, Professor of Theory and Practice. Doctor Daniel Drake, Professor of Materia Mediea and Medical Botany. Doctor William H. Eichardson, Professor of Obstetrics, etc. Doctor James Blvthe. Professor of Chemis try, etc. Doctor Drake has stated that twenty pupils attended this course of lectures, and the de- and returned to Cincinnati at the end of this session, returning subsequently in 1823 to oc- cupy the same chair, to resign it again in 1827. Professor Eichardson did not lecture this session. He, not having yet received the degree of M'. D., was allowed to be absent. DOCTOE SAMUEL BEOWN. By EoBEET Petek. a. M., M. D., Ijexington. Tlie first Itfedieal Professor of Transylvania l''n:Iversity and of the great Western country, was born in Augusta, Eockbridge County, Virginia, January 30, 1769, and died near ITuntsville, Alabama, January 12, 1830. He was the son of the Eeverend John Brown, a DOCTOR SAMUEL BROWN 1769--1830 gree of M. D., was, for the first time in Lexing- ton, conferred on John Lawson McCullough, of that city. Each professor lectured three times a- week, and his ticket was fifteen dollars. During this session ill feelings arose between Doctors Dudley and Drake, leading to the duel be- t ween Doctors Dudley and Eichardson al- ready described. Doctor Drake resigned his professorship Presbyterian ininister of great learning and piety, and Margaret Preston, a woman of re- markable energy of character and vigor of iiiind, second daughter of John Preston and Elizabeth Patton. He was the third of four distinguished brothers. Honorable John Bi-own, Honorable James Brown, Doctor Sam- uel Brown, and Doctor Preston Brown. After graduating at Carlisle College, Penn- sylvania, where he had been sent by Ms elder KENTVCKY MEDICAL JOUEXAL. brother, he studied medicine for two j'ears in Edinburgh, Scotland. Doctor Hosaok, of New York, and Doctor Ephraim ^IcDowell, of Danville, Kentucky, were of the same class. Jvcturning to the United States, he commenc- ed practice in Bladensburg, but soon removed to Lexington, Kentucky, where he was made Professor of Chemistry. Anatomy, and Sur- gery in Transylvania University in 1799, as above stated. In 1806, he removed to Fort Adams, ^lissi.ssippi, where he married Misa Percy, of Alabama. Afterwards, returning to Lexington, he was re-appointed in 1819 to a chair in the Medical Department of Transyl- vania, that of Theory and Practice. Here he was a distinguished coUeaame of Professors E. W. Dudley. Charles Caldwell, Daniel Drake. William Richardson, and James Bh^he until 1825, when he finally left Ken- tucky. Dr. P>rown was a man of fine personal ap- pearance and mannei"s: an accomplished scholar, gifted with a natural eloquence and humor that made him one of the most fascin- ating lecturers of his day. Learned in many branches, he was an enthusiast in his own pro- fession, scrupulous in regard to etiquette, and exceedingly benevolent and liberal of his time and services to the poor. Although active in scientific pursuits he , left no extensive work, and but a few detach- ed writings, to perpetuate his fame. His name appears among those of the contributors to the .American Philosophical Transactions, and to the medical and seientifie periodicals of the day. both in this country and in Europe. In those Transactions and in Bruce 's Jour- nal of ^lineralog^-, he described a remarkably larse nitre cavern on Crooked Ci'eek. in I\Iadi- son Couuty. now Rockcastle Courity. Keii- tucky-. In this and in a subsequent com.muni- eation in Volume 1 of Siniman's Journal he described the process of nitre manufacture in eaves, and gave the best theoin- of its forma- tion, according to the science of the day. In various other journals he described several iiiterestiug cases which occurred in his own practice, and in the renowned Medical Logic, by the distinguished Gilbert Blane. of Lon- don, Doctor Samuel Brown, of Lexington, is quoted as authority for a certain scientific fact. "To him we are indebted for the first inlroduetion in the '^'est of the Prophylactic use of the cow-pox. As early as 1802 he had vaccinated upwards of five hundred persons, when in New Yo)-k and Philadelphia physici- ans were onl\- just making their first expen- iiiental attempts. The virus he used was taken from its original source the teats of the cov.-, and used in Lexinsrton even before Jen- ner coidd gain the confidence of the people of his own country." A curious anecdote, illustrating progi-ess, was told of Doctor Samuel Brown by his nephew, the late Orlando BrowTi, Esquire, of Frankfort, in a letter to the present M'riter: ''I remember once when talking of calomel, lie said he never would forget the first dose of it he gave a patient. It was looked upon as 'the Hercules,' and he used it accordingly. The case was desperate and he resolved to venture upon calomel and give a strong dose. He accordingly weighed out with scrupulous- accuracy four gi-ains, gave it to his patient, and sat up all night to watch its effects. The man got well and the Doctor afterwards used calomel more freely." "What -^vould he have thought of the heap- ing tablespoouful doses, quickly repeated pro re nata, or the poitud of calomel taken in a day, and survived, which characterized the cholera treatment of one of the later Pro- fessors of the Transylvania School ? DR, FREDERICK RIDGELY.* 17.56—1824. By Robert Petek, A. il., 31. D., LexingtoTi. Of a weUknown family in ^laryland, and one of the most celebrated of the early phy- sicians of the "West, studied medicine in Dela- ware, and attended medical lectitres in Phila- delphia. He was appointed Surgeon to a rifle corps in Virginia when only nineteen years of age, served in different positions as Surgeon-Gen- eral in General Wayne's army in 1794. and after that decisive campaiam was ended re- turned to Kentucky^ in 1799, and was made Professor of ^fateria Mediea, ^lidwifery, and the Practice of Physic in the same year in the ^fedical Department of Transylvania Uni- versity, at th.e first organization of this de- partment. V\^idely known as a successful practitioner and a gentleman of great benevolence, disin- terestedness, and affabilitv-, he was also one of the medical preceptors of Kentuctv's dis- tinornished surgeon, Benjamin W Dudley, aiid for many years gave active support to Transvlvauia I'niversity as a member of the Board of Trustees. In'l 799-1800, he deliver- ed to tlie small class of medical students then ir. attendance a course of ptiblie instruction which did him much credit, a fact of peculiar interest, "as it proves him to have been," with his able colleague. Doctor Samuel Brown, "the first who taught medicine by lec- ture in Western America." He died at the aire of sixtv-eiarht at Davton. Ohio. December 21.1824. These first laedieal professors in Transyl- vania Universit:.' were no doubt the first in *After thp most patient inouir.v no portrait of this able man. or additional facts in regard to his life and work, could be obtained. MEDICAL PIONEERS OF KENTVGKY, 55 tJie proDiotion of medical education in the West. Medical and Laiw societies were soon establislied and were in active operation, as we learn from the columns of the Kentucky Gazette, published at the time. How many pupils thev' attracted and taught we can not now definitely ascertain. in 1801, the meager existing records of the Univei'sity show a reorganization, in which the Reverend James Moore, who had been re- placed in 1799 by a Presbyterian clergy^man, the Reverend James Welsh, was restored to the Presidency. "Doctor Frederick Ridgely was made Professor of Medicine, and Doctor Walter Warfield was made Professor of Mid- wifery, in addition to Doctor Samuel Brown." Doctor Warfield, a physician of Lexington, did not long occupy this chair, and appears not to have lectured in it. In 1804, the Reverend James Blythe, D. D., of tlie Presbyterian church, who had been President of Kentucky Academy, was made actiug President of Transylvania University, which position he held until 1816. He was subsequently, in 1817, under Doctor HoUey's administration, appointed Professor of Chem- istry, etc., in the Medical Department. This position he retained until, in 1831, he accept- ed the Presidency of Hanover College, In- diana. Doctor Blythe died in 1842, aged seventy- seen, having devoted his life mainly to relig- ion : having been one of the pioneers of the Preshyterian church, in Kentucky. He made no distinguished reputation as a chemical pro- fessor in the Medical School, for chemistry in those days had few advocates, but he did good service in the University as a teacher of what was called "Natural Philosophy" in early times. The ^Medical College of Transylvania Uni- versity seems not to have attracted many stu- dents in tiiis early period of its history, nor were its means of instruction or its organiza- tion complete. In 1805. Doctor Jaimes Fishback, D. D., was made President of the Theory and Practice of Physic in this department. He was charac- terized as an eloquent, learned, though erratic divine ; an able writer ; a physician in good ]>ractice: an influential lawyer, and an up- right man. He was the son of Jacob Fish- back, who came to Kentuckv from Yirginia in 17S3. He resigned this chair in 1806, having given lectures to such small medical classes as wei'C present. In 1808, he was elected Repre- sentative to the General Assembly of Kentucky. In 181.3, he published "The Philosophy of the Mind in Respect to Religion," and, in 1834, "Essays and Dialogues on the Powers and Susceptibilities of the Human Mind to Re- ligion." He was also preceptor in medicine, and for a time partner in the practice, of the celebrated surgeon, Benjamin "W. Dudley. He died at an advanced age in 1854. An effort was again made to organize a full Faculty and establish a medical school in T]-ansylvania University in the year 1809, \\dien Doctor Benjamin W. Dudley was ap- pointed to the chair of Anatomy and Physi- ology, Doctor Elisha Warfield to Surgerj^ and Obstetrics, Joseph Buchanan, A. M., to the Institutes of Medicine, and Doctor James Overton to Materia Medica and Botany. But Doctor Warfield. resigned in the same year, and Doctor Buchanan in 1810. The late Lewis Rogers, M. D., of Louisvile, thus men- tioned Doctor Buchanan in his inaugural ad- di'css as President of the Kentucky State Medical Society in 1873 : "He died in Louis- ville in 1829 : and I call up from the memories of my boyhood with great distinctness his slender form, massive head, and thoughtful, intelligent face. He was a man of great and varied powers of mind. He was a mechanical, medical, and political philosopher. His "spiral" steam boiler, the pi'ototype of the ex- ploding and exploded tubular boiler, and his steam land-carriage were among the wonders of the day. As a physician his papers attract- ed distinguished notice from the medical savants of Philadelphia, then a center of med- ical science." As a polilical writer he ably discussed the most weighty problems of the times, he being editor of the Louisville Focus. Want of con- centration of his wonderful mind prevented I'lim from becoming eminent in medicine as in other pursuits which divided his mental pow- ers. No systematic medical instruction seems to have resulted from this imperfect organiza- tion of the Medical School in 1809, although occasional lectures may have been delivered and private instruction given. Doctor Dudley, after having graduated in medicine in the University of Pennsylvania, visited Europe in 1810, spending four years in Paris and London in the arduous pursuit of medical and surgical infonnation and ex- perience under the celebrated teachers of that day. Returning then to Lexington he began a career as a practical surgeon and teacher, in which his name became distinguished through- out the civilized world. 56 KENTUCKY MEDICAL JOURNAL. A ]\rE:\[OIR OF THE LIFE AND WRIT- INGS OF DR. bexja:min W. DUDLEY.* By L. P. Yandei T,, :\[. D.. Louisville. The announcement of the death of Dr. B. W. Diidley. though from his great age and in- creasing infirmities an event not unexpected, Avili he read with feelings of sadness bv evei'y ^Vnieriean physician: and educated surgeons in eveiy country will feel, when tliey read it, that a great light of the profession has gone Gi^it. The oldest by many years of all the em- inent medical men of the West and South, for our surgeons has occupied a larger space in the public e.ye. He achieved indeed a great reputation. He was equally distinguished as a surgeon and as a teacher of surgery. His life and character were in man.v respects re- markable, and furnish materials for a memoir of extraordinary interest. It woiild be a pleasure to write a histoiy of his professional career ; and one, no doubt, will be written in due time worthy of his fame and services. In the limited space that can be afforded by a journal like this, nothing more can be at- terapted than a brief notice of the more prom- inent events and labors of his life. DOCTOR BENJAMIN W. DUDLEY 178S--1870 a long time the unrivaled surgeon of the ^lis- sissippi Valley, one of the found.ers of the earliest of all our western schools of medicine, he was the last remaining Unk between the present generation of physicians and that which has passed away with him. If he leaves behind him. any superior in the profession of oiir country, it is certain that no one of all •Read at a meetinsrof the State Medical Soci«t.v at Bowling Green, April. 1870. Dr. Benjamin Winslow Dudley was born of respectable and pious parents in Spottsyl- vauia county, Virginia, on the 12tli of April, 1785. His father, the Rev. Ambrose Dudley, long known as a leading Baptist minister in Kentucky, and whose memory is still affect- ionately cherished in the churches where he labored, removed from Virginia to the neigh- borhood of Lexington, into what was then called the county of Kentucky, when tliis gifted son was a year old. In that neighbor- MEDICAL PIONEERS OF KENTUCKY, 57 hood his long life was passed. He grew up with the beautiful city which was his pride, and of which he was always a favorite son, TJie opportunities for acquiring an education in Kentucky when, he was growing up were limited, and it is not known that he enjoyed any which his own immediate neighiborhooct could not furnish. If he studied any language hut his own at school, it must have been su- ]iei-ncially, for he made no pretensions to any knowledge of either Greek, or Latin; and the ]jerfeet eomniand of the French which he is known to have possessed he acquired later in life, and pi-incipallj' when he was abroad. He was prohalily not a student, and it may be that his turn of mind was not literary in early life. But certainly his education was not neglected, and the training which he received was in studies which fitted him well for a life of action. No doubt in subsequent life he of- ten felt painfully the want of those classical attainments which in the public mind are al- ways associated with a x'i'ofPSisional ediica- tion. But if he missed the grace of a thor- ough education, he was saved from the temp- tation to which scholars are exposed, of wast- ing upon vain studies those powers to which he devoted with so much success to matters of practice. He had not to reg'ret at the end of his life, with the learned Grotius, that he had consumed it in levities and strenuous inan- ilies. iledicine being the profession to which his taste inclined him, he was placed by hifs father, when very young, under the tuition of Dr. Frederick Ridgely, an eminent phy- sician at that time and for manj' years after in a large practice in Lexington. In the of- liee of this excellent instructor he was not only taught the elements of medicine, but had constant opportunities of becoming acquainted with disease at the bedside. Dr. Dudley al- waj^s spoke with warmth and esteem of his scholarly and urbane preceptor, as a physici- an whose high culture of mind and elevated moral tone reflected dignity upon his pro- fession. In the fall of 1804 he went to Philadelphia to attend medical lectures. He met in the Uni- versity of Pennsylvania, among the students of that winter, John Eston Cooke, Daniel Drake and William H, Richardson, names des- tined afterward to be associated so often and so closely with his own. The coin-cidence is interesting. Two of these students, like him- self, were from the backwoods, and felt as he did the disadvantages of a deficient education. Richardson had been reared in his own im- mediate neighborhood, and had not made himself even an English scholar, Drake by great assiduity had already supplied many of the deficiencies of his early tuition, but knew no language except his own mother-tongue. All became distinguished, and two of the three who were with him in that class rose to an eminence liardly exceeded by his own. At different times all subsequently were associ- ated with him as colleagues, and two sustained to him, at a later period, the relation of stren- uous competitors in rival medical schools. But whether working harmoniously together in the same institution, or striving to build up rival schools, all were engaged in shaping the profession of medicine in the frontier states, and will always hold a place among the mosi useful and honored of its pioneers. In the interval between the lectures, from Api'il to October, Dr. Dudley engaged in practice with Dr. Fishbaek, a distmguishec! physician of Lexington. At the close of his second course in the University of Pennsyl- vania he took the degree of M. D., near the end of March, 1S06, just two weeks before he was twenty-one years old. Then returning to Lexington, which had now become a town or note, and was indeed the literary and com. Hiereial emporium of the West, he became again a candidate for practice. But he seems not to have entered heartily into the business. He was not satisfied with his professional at- tainments. His ambition was fired by his as- sociations in Philadelphia. He was resolved to qualify himself for the highest position in his profession. And this, ho thought, could only be done by studying in the hospitals and under the great teachers of Europe. His en- ergies were all directed to the accomplishment of this end, and with the view of acquiring the requisite means he added some commercial business to the practice of physic. On some adventure connected with trade he went to New Orleans in a tiatboat about the year 1810. Tliere he bought a cargo of flour with which some time in that year he sailed to Gibraltar. Disposing of his cargo advantageously at that j)oint and at Lisbon, he made his way through Spain to Paris. He remained nearly four years in Europe, and the larger portion of that time was spent in the French capital. Its vast hospitals and dissecting-rooms afforded the facilities he was iu quest of. His mind craved a knowledge of facts ; and though the fame of the great sur- geons of London and Paris had inflamed his ambition, it was things he had gone abroad to see and learn. Diseases in their varied phe- nomena and aspects, operations on the living subject, the minute structure of the human, body, these were the objects of his study. Paris furnished them in amplest measure, and on the most liberal terms; and it was in Paris undoubtedly that he gained that perfect knowledge of anatomy and that familiarity with sm'gical operations which laid the foun- dation of his siaccess as a surgeon. But though acquiring most of the knowledge which availed him in future years through the in- stitutions of Paris, it was for the surgeons of KENTUCKY MEDICAL JOURNAL. London that lie habitually expressed the high- est adniiratioji, Baron Larrey perhaps except- ed. They certainly of all his teachers had the largest share in shaping his opinions and molding his professional character. In man- ners he came home a Frenchman, but in med- ical doctrine and practice he was thoroughly Ejiglish. It ^vas impossible that he should not adjnire the great military surgeon of France, and be captivated by the recital of his won- derful experience. The memoirs of this ex- traordinary man fui-nished him indeed with numberless incidents which he afterward add- ed to the dramatic interest of his own surgical lectures. But it ^\•as Abernathy -nho impress ed him as the leading surgeon of Europe. Sir Astley Cooper was his beau ideal of an opera- tor, but Abernathy he always quoted as the highest authority on all points relating to surgery, as at ouee the observant student of nature, the profound thinker, and the sound medical philosopher. The j'ears embraced in Dr. Dudley's stay in Europe belong to one of the most eventfid periods in the histoiy of France, a period as favorable as could be for the study of that branch of his profession to which he was speci- ally de^'oting himself. How wisely he improv- ed those fine oportunities is best attested by the perfect masterj' of his profession which he aftei'ward exhibited in all the emergencies of practice. j_ , j§|^ It was while pursuing his studies in Paris that Napoleon set on foot his gigantic Russian campaign. Having made the acquaintance of Caulaincourt, the Emperor's trusted minister, he was admitted to the chamber of deputies on the occasion of Napoleon's appearing be- fore that body at the close of his disastrous ex- pedition. The writer has often heard him de- scribe the scene as the most impressive that he had ever v.'itnessed. The Emperor's address was brief — "The Grand Ai-my of the Empire is Annihilated." These were the terrible Mords with which he commenced it. In the summer of 1814 he returned to his old home at Lexington. He returned with high aspirations, and with a consciousness of superiority given by his advantages. There was now no longer any hesitation in his move- ments or diversion of his mind from medicine l.y foreign pursuits. His profession had be- cctne tlie engrossing object of his thoughts, and from that time on iintil age made it neces- sary for him to relax his labors, "he applied himself to it with undeviating fidelity. I am sure I have never known a physician who made himself more a slave to his profession. He had no holidays. He sought no recrea- tion: no sports interested him. If his friends prevailed on him to quit the citj- on a trip of pleasure, he returned to his business rather wearied than refreshed by the excursion. His thoughts, he has been heard to say, were al- ways on the cases he had left behind, and not on the objects or the amusements around him. Such devotion had not long to wait for its reward. But, apart from this faithful appli- cation to Ijusiness, there were other circum- stances which rendered the time of his return peculiarly auspicious to his success. Great as were the western states at that day, and grow- ing, as they were, dailj- greater, they were still ^^^thout a surgeon of note, and without a medical school. Students of medicine had then to cross the mountains, or practice with out a diploma on the knowledge derived from attendance on lectures. Dr. Dudley soon gave assurance of his aliility to meet both of these public wants. With his consummate knowl- edge of anatomy, and the skill he had attain- ed in the use of the knife, he was not long in acquiring national reputation as a surgeon; and when, a short time after his return, the project of reviving a school of medicine began to be agitated, public opinion pointed at once to him as its head. Added to these influences, which gave him early distinction, another eir- cu'jistance favored liis immediate introduc- tion into practice. He found a disease pre- senting some strange featui-es prevailing in the countrj^ when he reached home. Traces of the typhoid pneumonia which had just swept across the continent were to be seen e^-erywhere in Kentuclsy'. The fatal epidemic had given place to a bilious fever, character- ized, like the plague, by a tendency to local affections. Abscess formed among the mu.s- cles of the body, legs, and arms, and were so intractable that limbs were sometimes ampu- tat^'d to get rid of the evil. Arri^-ing in the midst of so alarming an epidemic. Dr. Dudley was not long without calls. His attention while abroad had been specially directed to the bandage as an agent, among other things, for controlling ulcers of the extremities. It at once occurred to him that this appliance was adapted to the treatment of the burrow- ing abscesses with which he was contini;ally meeting. The efficiency of the bandage, no^' recognized by every surgeon, was at that time not fully understood. Dr. Dudley's success with it in these cases was striking, and from its novelty, as well as its efficacy, his practice drew upon him general attention. In 1817, three yeai-s after his return to Lex- ingion. the Board of Trustees of Transylvania I^niversity determined to re-organize the med- ical department of that in,stitution, then the leading college in the West. Dr. Dudley was made professor of anatomy and surgery, and two of his fellow students of 1805 were asso- ciated with him. Dr. Drake in the chair of ma- teria medica, and Dr. Richardson in that of obstetrics. Dr. James Overton was elected professor of theory and practice of medicine, MEDICAL PIONEER^; OF KENTUCKY, 59 and to the Rev. James Blythe, D. D., was as- sigiaed the chair of chemistrj-. A small class of medical students encouraged the enter- prise, and at the close of the session one of the number, W. L. Sutton, of Georgetown, af- terward a distinguished physician of Ken- tucky, was admitted to the doctorate. The be- ginning was regarded as favoraible, but before the winter was over misunderstandings oc- curred among the members of the faculty, and the feuds resulted in its disruption. Drake went bacli to Cincinnati to inaugurate measures for establishing a medical school in that rising city, and Overton, disgiisted with medical politics, removed to Nashville. Bit- ter aniiTJOsities, some sharp pamphleteering, and a duel between Dr. Dudley and Dr. Rich- ardson ensued, in which the latter received a pistol shot in the thigh. No attempt was made that year to carry on the department, but the year following a new faculty was or- ganized, with Dr. Dudley in his former chair, and Dr. Richardson and Dr. Blythe again as two of his colleag-ues. To these were added Dr. Charles Caldwell and Dr. Samuel Bro^^Ti, the former in the institutes of medicine, the latter in theory and practice, and both wide- ly known to the profession. It should be remarked, as a fact credita)ble to Dr. Dudley^ that in the reconstruction of the faculty he made no objections to serving with a gentleman v/itli whom a little while be- fore- he had had a hostile meeting ; and that a few years later he united with his colleagues in an invitation to Dr. Drake to return to the scliool, though that gentleman in a public controversy with him had written much that it was not easy to forgive. The fact shows that he was both magnanimous and wise. He was able to rise superior to the prejudices which personal bickerings engender, and gave his voice for the men who had the greatest fitness for the places, regardless of their social relations to him. Dr. Dudley had in the faculty as now con- stituted some colleagues who were worthy of him. Caldwell and Brown, gifted and learn- ed, ripe in their powers, both of the anost im- posing presence and already known to fame, were just the men to cooperate with him in his enterprise. Caldwell especially had the qual- ities of mind and temper to render the infant school the. most important services. To his varied learning and imcommou eloquence lie added boldness and energy, and a devotion which never waned or wavered. All his time, all his gifts as a writer and a speaker, were fully and enthusiastically devoted to the in- stitution. The Transylvania Medical School under this organization grew apace. In the numiber of its pupils, it began in a few years to vie with the older schools on our Atlantic border. The ability of its faculty could not be ques- tioned. Its alumni showed themselves to be equal in attainments and professional skill to +he graduate;; of the oldest instituxious. It took rank in a little while with the schools of Baltimore, New York and Philadelphia; and the reputation o-f Dr. Dudley rose with it. His admiring pupils bore to every part of the country reports of his surgical skill and of his powers as a teacher. Unquestionably from tlie beginning he was in their estimation the foremost man in the faculty. Drake entered it in the fifth year of the scliool, when its suc- cess had become assured, and he brought to it a brilliant reputation. But Dudley's preem- inence continued undisturbed. Students doubtless there were not a few who would have declared for other professors, who took more interest in other lectures than his, but the great body of the class he had always with him. To him they always hurried, however listlessly they may have repaired to other teachers ; and whatever other rooms were de- serted his am.phitheater was always full. Why, it is natural to ask, was this ascend- ency? What was the source of that superior influence which he so long exerted? It will not be claimed, I tliink, by his most ardent admirers that he was intellectually sitperior to all his colleagues. Nay, he was the readi. est himself to admit, as I myself know, that in point of mental endowments several of his as- sociates had the advantage of him. There were with him in the facitlty at all times men who surpassed him in all the qualities that go to form the popular lecturer. Caldwell was far jnore brilliant and eloquent, besides being a profound scholar. Brown was superior to him in voice and person, in versatility of mind, and in depth and variety of learning. Drake exceeded him in elocution, in earnest- ness, in the extent of his attainments, and in grasp of mind. He laid no claims indeed to oratorical powers or to professional erudition. He was not a logician, he was not brilliant, and he had neither humor nor wit. And yet ill ability to enchain the attention of students, to i mpress them with the value of his instruct- ion and his greatness as a teacher, he bore off the palm from all the gifted men who at va- rious periods taught by his side. By common consent he stood as an instructor among the foremost of them, facile princeps. This was partly due undoubtedly to the de- partment of medicine taught by him. There is, as all medical teachers well know, an in- herent charm about surgery for medical stu- dents, a dramatic interest in the cases of the surgeon, an eclat about his operations which is found in no other branch of art. Some- thing is also to be set down to his holding two j)rofessorships. This had its effect upon the imagination of students. But all this is far from accounting for the superiority which he maintained so long in the midst of such com- 60 KENTUCKY MEDICAL JOURNAL. petition. The true explanation of the fact is to be found, I think, in the perfect devotion of his life to one pursuit. Choosing this wise ly with reference both to his own ai^titudes and its dignity, he concentrated upon it al! tlie jjowers of his mind and made himself a master in it. All other studies he neglected. I'o all jileasure that would draw him away from it he turned a deaf ear. Cool, quick, calm, decisive, with a sound judgment and a steady hand, he had all the attributes of a great surgeon, and he improved them by se- vere application. In point of skill he rose to an eminence which no one around him ap- proached. Patients came to him from afar oracular, conveying the idfea always that the mind of the speaker was troubled with no doubts. His deportment before his classes was such as further to enhance his standing. He was always in the presence of his students not the model teacher onlj^, but the dignified urbane gentleman ; conciliating regard by his gentleness, but repelling any approach to fa- miliarity ; and never, for the sake of raising a laugh, or eliciting a little momentary ap- plause, descending to coarseness in expression or thought. That is, to his pujiils he was al- M'ays and everywhere great. The medical school at Lexington, owing to the influence of his great name more than to "FAIRLAWN", THE HOME OF DR. DUDLEY, NEAR LEXINGTON. The outbuilding marked witli a cross is the one in wliieli he taught, gave demonstrations and made dissec- tions, when the University Buildings were not available. In renovating this building recently Dr. Barkley in- forms me that four skeletons, evidently left over from cadavers, were found in a basement, probably unused since Dudley gave up teaching more than half a century ago. because it was believed that he did what others could do better than any one else, and that he did much no one else in reach could do. Students looked up to him as an opera- tor who had distanced competition, and a teacher who gave them not what was in the books, but much that the writers of books had never understood. Like John Hunter, he ratlier prided himsdf on his independence of authorities, and tliis increased the admiration of his pupils. They listened to his words as those of a master who drew continually upon the stores of his own ample experience, and not upon the teachings of others. They were liersuadc'd th:it there was much they must learn from his lips or learn not at all. His manner as a lectiirer was singularly imposing and impi'essive. It was magisterial. any other cause, flourished for more than twenty years. But he was painfull.y aware that it was beset by difficulties which must ultimately cause its decline. He often allud- ed mournfully to these circumstances in con- versation with his colleagues; and when the efl'ort was made, in 1837, to transfer the school to Louisville, it Avas expected that lie would favor the measure. But he decided otherwise. His attachment to Lexington, where he had been brought up and was surrounded by such troops of friends, overbore all considerations of policy, and he remained with the school, on the spot Avhere they had risen together. His last coni-se of lectures was delivered in 1849. In some respects Dr. Dudley, as a practi- tioner, was in advance of his age. He con- MEDICAL PI0NEEE8 OF KENTUCKY, 61 demned blood-letting, and used to say that a man's life was shortened a year for every bleeding. On this point he was up with thtfse of our day who are the most ultra. His use of the trepine in epilepsy and his treatment of fungus cerebri were original. The band- age in his hands assumed an importance not dreamed of in our country before his time. His views on many surgical subjects were pe- culiar, and. he adopted novel methods in the cure of other affections which have since been sanctioned by general experience. But at his practice in another and a large class of af- fections the physician of modern times stands* aghast. To "puke and purge, pvirge and puke," as he advised, day after day, for weeks and months together, in tubercular dis- eases, affections of the hip-.joint, spine, etc., all the while restricting patients to a diet of skimmed milk and stale bread, or a few half pints of Avater gruel, would be, as we regard it, to conspire with the disease against the life of the patient. And yet if Dr. Dudley was not a successful practitioner he was greatlj' deceived, and the public was sadly deceived with him. ITuquestionably he had the reputa- tion of success, and he was himself fully per- suaded that he was making cures all his life, by his energetic practice, of diseases which are esteemed the most unmanageable. Dr. Dudley's reputation as a surgeon rests chiefly upon his operations for stone in the bladder, in which he succeeded better than all other surgeons of the world, either of our own or of former times. He performed lith- otomy in the course of his life two hundred and twenty -five times, and it was not until af- ter about his hundredth case that he lost his first patient as a result of the operation. This success, it is believed, is unparalleled. He never adopted lithotritj^, but performed the lateral operation, and to the last adhered to the gorget for making the incision into the bladder, and preferred an instrument rather under than over size, regarding the danger from contusion of the parts in extracting a large calculus as less than that of hemorrhage fro'm a free incision. He v.^as an expert opera- tor but rather cautious than bold, and con- servative rather than adventurous ; not inclin- ing at all to operate in doubtful cases. His confidence was great in the constitutional treatment of patients about to toe submitted to the knife, and his rpm-arkaWe success he al- ways attributed more to the care Avith which he prepared his subjects for operations than to his superior skill in operating. It was not until Dr. Dudley had been many years a leading teacher that he became known as a writer. It is doubtful in fact whether he would ever have written at all but for the ap- pearance of a journal of medicine under the auspices of Transylvania University. He had no taste for writing, and but little leisure for it. Tiie Transylvania Journal of Medicine was issued on the 1st of February, 1828, edited by Professors Cooke and Short, and through, their influence Dr. Dudley was induced to prepare a paper on injuries of the head. This remarkable paper forms the first article in the first number of that journal. Seldom has an article appeared in modern times setting forth more original views. By a number of cases he showed that epilepsy is frequently caused by pressure on the brain, resulting from frac- tures of the cranium, and is curable by tre- phining. Five epileptics were operated upon, and three out of the five were relieved, and the other two were much benefited by the opera- tion. Spicula of bone in some instances were found growing from the seat of the fracture and penetrating far into the brain. The sense of relief experienced by some of the patients was immediate and in some of them there wa.s no recurrence of the convulsions after the bone was removed. .Dr. Dudley always and justly referred to his operation of trephining for epilepsy as constituting a new era in surgery. But another lesson of the greatest value was communicated in this paper, in illustration of which other striking cases are reported. They relate to the treatment of fungus cerehri. In one of his cases a brick-mason had his head extensively fractured by a piece of falling timber. The depression 'was so great that the surgeon thought he might have buried his forearm in the cranium. At the conclusion of the third week a fungus of frightful magnitude was detected growing up from the brain. For this formidable growth Dr. Dudley adopted graduated pi-essure. Dry sponge Avas placed on the fungus, and bound as close as the feelings of the patient would permit. By imbibing moisture the sponge exerted a gradually increased press- ure. On removing the dressings he had satis- factory eA'ideuce of the efficacy of the remedy, but it Avas discovered that the fungus had shot branches into the sponge. To prevent this subsequently a piece of thin muslin Avas inter- posed, and the patient recovered fully. And, Avhat Avas remarlrable, he shoAved on recoveiy a decided increase of intellect, Avhieli continu- ed, however, for only a few years. In the end he became epileptic, and thirteen years after receiving the injury was nearly fatuous. Dr. Dudley, in connection Avith this case, remarks that he had cured fungus cerebri by the use of drj^ sponge in five days. His second paper appeared in the following number of the same journal. The subject is hydrocele, in which he proposed a new opera- tion: a free incision into the tunica vaginalis, the introduction of a tent, and excision of the preternatural sac, if one is found to exist. In the fourth number he commenced an elab- orate article on the bandage, which is continu- 62 KENTUCKY MEDICAL JOVUXAL. ed through three successive numbei-s. lu the fifth volume he reports another case of epi- lepsy successfully treated by the trephine. His next paper appeared in the ninth volume, and treats of fractures, in the management of which he shows tlie great utility of the baud- age. His last paper was on the nature and treatment of calculous diseases, and was pub-' lished in the same volume of that journal. It is rich in details most interesting to the sur- geon. In his first case he found it necessary to apply a ligature to the transvei-se perineal was executed before anyone else present had remarked the difficult3\ This is the sum of Dr. Dudley' 's conti-ibu- tions to medical literature. He meditated other papers, but never found time to prepare tliem. It was once said of liim by a colleague, who greatly admired him both as a surgeon and as a teacher, that "his Hippoerene soon ran dry. ' ' From the turn of his mind aud the nature of his studies this was necessarily so. ll'e wrote only on subjects purely practical; aud where his experience ceased, there he stop- THE DUDLEY GRAVES. artery, on account of its unusual size.. Of oue hundred aud fort>--five patients who. up to the time at which he wrote, had applied to him. he operated upon all Imt ten. In one case, when his patient was on the tflble before his class and some of his eolleagiies, he discovered that his accustomed operation was impracticable froin deformity of the pelvis, aud wlule his as- sistrnts were taking their positions resolved to make the external incision transverse, which ped. But if the stream which flowed from his pen was not an abounding river, it was a Yau- clusa fountain which has arrested the attention of surgeons everjTvhere, and by the banks of ^\•luch students of surgery still love to linger. Dr. Dudley was married on the 9th of June, lSi!l. to I\riss Anna ^Marie Short, daughter of IMajor Pe^"ton Short, and sister of the late Prof. Charles W. Short. This estimable lady died A'oung, leaving him two sons and a MEDICAL PIONEEBS OF KENTUCKY, 63 daughter: the present Dr. Wilkins Dudley, W. A. Dudley, Esq., and Mrs. Anna Tilford. He never married a second time. In the sum- mer of 18-48 he removed to Fairlawn, his beautiful country residence near Lexington, and gradually ■\vithdrew from the practice of his profession. He delivered his last lecture in Februai'y, 1850, and the last entry on his booirs bears date April 28, 1853. He was con- sulted often after^vard by his professional brethren, but from that time forward he never treated any patient of his own. His death took place on Thursday, the 20th day of Janu- ary, 1870, in tlie eighty-fifth year of his ag'e. The life of this distinguished and useful man was extended far beyond the term allot- ted to those who commenced life with him and were his closest friends. Of the surgeons who competed with him in early manhood, and of all those who were associated with him as teachers in the earlier organizations to which he belonged, not one now remains. He was permitted to linger on amid the scenes which had witnessed his triumphs for eighteen year.s after the last one of those who had officiated with him in the first medical faculty of which he was a member had passed away, and for a quarter of a century after most of his old as- sociates were gone. His benefieient life had s^irrounded him by hosts of friends. In his prime he had wisely provided for an old age of infirmity, and his declining years were solaced by all the comforts that wealth and af fection can supply. DR. DANIEL DRAKE. J?.y Henry A. Cottetx, A.M.,M.D , Louisville One of the foremost among the worthies sketched in these biographies is Dr. Daniel Drake, scholar, orator, writer, politician, and promoter ; a genius in the initiative, a master in the executive, and "a problem in physical and mental dynamics." Dr. Samuel D. Gross who knew him well as friend and colleague thus pictures him: "No one could approach him or be in his presence vdthout feeling that he was in contact with a man of superior in- tellect and acquirments. His features, re- markably regiilar, were indicative of manly beauty, and were lighted up by blue eyes of vonderful power and penetration. His fore- head was high, well fashioned, ^nd strongly denotive of intellect. The nose was promin- ent,, but not too larsre. His voice was remark- ably clear and distinct. "The life of Dr. Drake was eminently eventful. No man that our profession has yet produced has led so diversified a career. He was, probably, connected with more medical schools than anv individual that ever lived. It is rare that physicians interest themselves in so many public and professional enter- prises as he did. His mind was of unlimited application. His own profession, -which he served so well and so faithfully, was incap- ah]p of i'estraini]:g it ; eveiy now and then it overlapped these boundaries, and wandered off into other spheres. His career, in this re- spect, affords a remarkable contrast mth that of jnedical men generally, whose pursuits furnish few incidents of public interest or im. j'ortance. His mission to his profession and to his age was a bright and happy one. No Ainericau physician has performed his part bett'^r, or left a richer savor along his life- track. "But his life was not only eventful; it was also eminently laborious. No medical man ever worked harder, or more diligently and faith- fully : his industry was untiring, his persever- ance unceasing. It was to this element of his character, blended with the intensity we have described, that he was indebted for the success ■^vliich so pre-eminently distinguished hiTri from his professional contemporaries. He had genius, it is true, and genius of a, high order, but without industry and perseverence it would have availed him little in the accotnp- lisnment of the great aims and objects of his life. He seemed to be early impressed with the truth of the remark of Seneca: 'Non est ad astra mollis a terris via.' He felt that he did not belong to that fortunate class of be- ings whose peculiar privilege it is to perform great enterprises without labor, and to achieve great ends without means. His haib- its of industry, formed in early boyhood, be- fore, perhaps, he ever dreamed of the destiny that was awaiting him, forsook him only with, his existence. The great defect in his eharac- ler was restlessness, growing apparently, out of his ardent .".nd impulsive temperatment, which never permitted him to pursue any sub- ject very long without becoming tired of it. or panting for chauffe. His mind required di- versity of food. Hence, while engaged in the composition of his great work, he coidd not resist the frequent temptations that presented themselves to divert him from his labors. His delight was to appear before the public, to de- liver a tempprance address, to preside at a pnlilic meeting, or to make a speech on the snbieet of internal improvement, or the Bible or missionary cause. For a similiar reason he st.e]>ped out of his way to write his letters on slavery, and his discourses before the Cincin- nati Medical Library Association. No man in our land could have done these things better, few, indeed, so well ; but, useful as they are, it is to be regretted that he undertook them, because they occupied much of his time that might, and, in the opinion of his friends, ousrht to have been devoted to the composi- tio'i and completion of his ffreat woi'k, the ul- timate aim and object of his aimibition. Like Adam Clarke, he seemed to think that a man KENTUCKY MEDICAL JOURNAL. could not have too many irons in the fire, and eonseqnenee was that he generally had the tongs, shovel, and poker all in at the same time. ''It was the same restless feeling that caus- ed his frequent resignations from medical in- stitutions. Had his disposition been more calm and patient, he would have been satis- fied to identify himself with one medical school, and to labor zealously for its perman- ency and renown. In moving about so fre- quently, he induced people to believe that he was a r[uarrelsome man, who could not agree with his colleagues, and whose ruling passion was to be a kind of autocrat in every medical Principal Diseases of the Interior Valley of North America." a Avork which, comprehens- ive in scope, philosophic in spirit, and abound- ing in graphic pictures of disease, will remain a storehouse of knowledge and a monument to the niginality of its gifted and versatile author. He said to the speaker when he was about to enter on the practice of his profes- sion : 'I have never seen a great and perman- ent practice the fomidations of which were not laid in the hearts of the poor. Therefore, cultivate the poor. If you need another though a sordid reason, the poor of to-day are the rich of to-morrow in this country. The DOCTOR DANIEL DRAKE 17SS--18S2 faculty \\\\\\ which he was connected. But, while his own conduct gave color to siich an idea, nothing could have been more untrue." Dr. D. TV. Yandell, who sat at his feet in student days, speaks of him thus: '"As a lec- turer Dr. Drake had few equals. He was never dull. His was an alert and masculine mind. His words were fiiU of vitality. His manner was earnest and impressive. His elo- quence was fervid. While connected with the ITniversity he composed his work upon "'The poor will be the most gi-ateful of all your pa- tients. Lend an ear to all their calls'." Dr. Drake was the son of Isaac Drake and Eli7abeth Shotwell, and was born in Essex Counts-, Xew Jersey, October 30th, 1785. "When Daniel was two and one-half yeai"s old his father moved his family to IMayslick, ila- son County, Kentucky-, Here a log cabin was Imilt after the manner of pioneers. In this rude hut and another of similar architecture on the Lexington road, the boy lived until he MEDICAL PIONEERS OF KENTUCKY, 65 was 15 years of age, when he went to Cincin* iiati, then holding only a thousand souls, and began the study of medicine under Dr. Will- iain Go forth. Here he read Quincy's Dispen satory, and ground quick-silver for mercurial ointment. Years afterward he facetiously said that "the latter was much the easier task of the two." After studying and working for a term of five years, he was given an autograph diploma by his preceptor. As there was in that day no medical school West of the AUe- ghanies, and as Ohio was not then a state, this act was doubtless legal and authoritative. On this diploma he practiced for eleven years when, at a Commencement held for the pur- pose, by the University of Pennsylvania, Drake was honored by having the Doctorate degree of that school conferred upon him. Of this action, Dr. Joseph Kanshoff says, "It was a function thereunto without precedent, and to my Imowledge never repeated, but the ex.- cellence of his thesis, together with the con- tributions he had already made to science, justified the faculty in this signal distinc- tion." What a compliment to a young back- woodsman of 31 years. His firfst \'isit to Philadelphia was in 180.5. He spent the year 1806 in Kentucky. In 1807, at the age of twenty-two, he married Harriet Sisson, age twenty years, of New Haven, Con- necticut, with whom he lived happily till her death a quarter of a centuiy later. Of this, years after, he wrote: "We began the world in love, and hope and poverty." His children immbered five, and his domestic life, save in the death of two infants, was unclouded. From the biosyranhical sketch puhlished by his son. Chas. D. Drake, in 1860, we quote the following beautiful tribute to his wife. It is not onlv a testimonial to his domestic felicity ; but will ffive the reader a fine example of Drake's literary force and style. "We lived together, not merely at home, and in the houses and societv of our friends, but frequently, as far aS" possible, in conjunc- tion, all places of rational curiosity, of im- provement, and of innocent and attractive amusement. On such occasions, her observa- tions were always just, instructive, and piq- uant. I relied upon her taste and judgment; I adopted her approval : I submitted mv own impressions to her decision ; I was gratified in jiropoi'tion as she approved and enjoyed. A more devoted mother never lived. The love of her offspring was at once a passion and a prin- ciple. After her husband, all her solicitude, her ambition, and her vanity were for her children. She loved them tenderly, she loved them practically, but she loved them without discretion, and was jealous of whatever could impair their qualities, manners, or physical constitution. Her tenderness was without follv, her care without sickliness. Her af- fection begat vigilance, and modified the in- dulgence which maternal love too often sane- tious, to the ruin of its object. She loved her children, but she also respected virtue, intel- ligence, modesty, industry, accomplishments and honest distinction. She loved them as candidates for excellence. Hence her affect- ions were chastened with severity, and the greater her attachment the more intense her desire to reserve the subject of it from folh^, vulgarity, and vice. Her care rose with her love, and her corrections multiplied "v^dth her admiration." In 1817 he was called to the chair of Materia i\Iedica in Transylvania University, Lexing- ton, Kentucky. He tau.ght for one session only here ; then went to Cincinnati where he made plans for a literaiy and scientific college, a medical school and a hospital, and obtained from the Legislature, a charter for each of these institutions. Thus was established be- side the first named, the Medical College of Ohio, and the Commercial Hospital, in which Drake took the initiative. The College has been for more than 90 vears one of the great medical schools of the West, while the hospital was destined to become one of the first marine hospitals of the United States. In 1823 he returned to Transylvania and resumed bis work as professor of Materia Medica, being later transferred to the chair of practice, which he held till 1827, Jefferson Medical College Philadelnhia, called him to the chair of Practice in 1830. Spending one vear only in Philadelphia, he returned to Cincinnati and founded a Medical Department to Miami T^niversity, which, before the opening of the first session, united with the Medical College of Ohio. Being dissatisfied with the subor- dinate position there elven him, he retired to private life. His restless ambition could not long brook the obseuritv of retirem.ent, and v,'e find him in 183.5 establishing the Medical Department of the Cincinnati College. As- sumins;- the dean.ship he called to his aid an able facultv. of which the a-reat Samuel D. Cross, destined to become his life Ions; friend, became a member. This school was short lived, and Drake, takina' Gross with him went to Louisville, the former beins; assia:ned to the chair of Clinical TMedicine and Pathological Anatomy, and the latter to the chair of Sur- g'(>ry, in the T"^niversity of Louisville. In 1844, he was transferred to the chair of Practice of Medicine which he held till 1849, when he re- signed and returned to Cincinnati; havin,» been reappointed to the chair of Practice in the Medical College of Ohio. In 1850, in con- sequence of a college broil, he resigned his pro- fessorship. He was recalled to Louisville, and resumed the chair of Practice in the Univers- itv. in the year 1851-52, The iledical College of Ohio being reorganized, Drake went back 66 KENTUCKY MEDICAL JOURNAL. to Cinciunati to occupy the chair lie had va- catfid two years befoi-e. But the hand of death was upon him, and after seeing the oi)euing of the se.ssion he paid the mortal dehf on Novemfber 5th. 1852. He was literally worn out by prodigioiis labor ; saj^s Prof. Rau- sohofif : ''It would be beyond reason on an ac- casion like this to touch upon every activity of so versatile a man as Drake, and oue can only touch upon the chief of the many radiating ways travelled by the influence of this master mind. And of them, next to that of his writ- ten woi'k, was that of the lecture room. Drake loved to teach, and because he loved it, did it well. During thirty-five years, he held nine professorsliips, in five different .schools. A I'estlessness innate in his make-up and an ha- bitual discontent with his professional env- ii'onmeut made him an itinerant in medicine. The longest continuous professorship, ten years, he held at Louis^alle. " Besides this he was constantly pi'omoting secular and civil schemes, establishing non- medical institutions for the iipbuilding of his chosen city, Cincinnati owing more to him tlian to any dozen others of her pioneers, pro- jecting schemes foi' a great railroad, the Cin- cinnati Southern, promoting and establishing philanthropie and religious institutions, edit- ing journals, scientific and medical, and writ- ing a library of books dealing with every phase of thought and enterprise, besides lec- tures, pamphlets, maps and brochures. His one great work, the huge volume on "The Principal Diseases of the Interior Valley of Noi'th America," rivals Gibbon's Decline and Fall of the Roman Empire, in the schol- arship, study, and research demanded of its author, 1o say nothing of the mechanical la- bor of writing it down. Such a record spells genius, and enough of his work lives after him to secure immortality to his name. He had his faults, doubtless, but he iwas without a vice, chaste, A'irtuous and clean in body, soul and mind. A character so noble outshines the luster of his genius and will stand forever the highest testimonial to culture, and to the clor^v of medicine. JOHN ESTIN COOKE. By Henry A. Cottell, M. D., Ijonis\'ille. "The beloved physician." was the decora- tion worn by St. Luke in the Apostolic Col- lege, and countless thousands of doctors since his day have won the title through devotion to the well being of their fellows, in the tender ministrations of their calling, and worn it cracefully. and modestly. But among the em- inent teachers of Tran.sylvania and the Fni- vei'sity of Louisville there was none to whom the decoration could be more appropriately applied than -John Estin Cooke. Of him Dr. Luusford P. Yandell, Sr., wrote, "Dr. Cooke was one of the few men who might have been safely trusted to write his autobiography. He would have reviewed his carer with a truth- fulness, a modesty, a candor that would have exalted his character in the eyes of men. His Avorks will be read by the curious for a long time to come, and \yi\] always be read 'with advantage by the earnest student." John Estin Cooke, son of Stephen Cooke, a ^^irginia physician who had served as surgeon in the war of the Revolution, was born in Boston, ]\rass., Slarch 2, ]78.3. His parents were on a visit to that town at that time. He studied medicine with his father, and acquir- ed the doctoT'ate at the Universitj^ of Pennsyl- vania in 1805. He began practice in Warren- ton, Faucpiier County, Virginia, and after a sojourn in that place of about six years moved to Winchester. Wliile in this place, his ambi- tion showed itself in an effort, with a Dr. l\Ic- Guire, to orgajiize a medical school. In 1827 he was called to the chair of theory and prac- tice of medicine in Transvlvania University, succeeding Dr. Daniel Drake, who strongly opposed his doctrines. He wrote an article on Autumnal Fever, publi.shed in the Medical Bc'jord in 1824. This attracted public atten- tion, and led to his call to Transylvania. A "Treatise of Pathology and Therapeutics," published in two octavo A'olumes of 540 pages eacii. was the first systematic work issued by a profe.ssor of Transylvania A third volume was promised. It never appeared ; but essays subsequently published amounted practically to another volume. In the fii-st year of his professorship he was made co-editor, with Chas. Wilkins Short, of the Tran.si/lvnnia Joiir- nal of ^frdicinr and the Allied Scioicef;. a journal issued by ■^he medical faculty of Transylvania University. Through this medium, Cooke and Charles Caldwell were the advocates and defendei-s of the false doctrines and theories theji in vogue, and inventing net a few others, which powerfully influenced medical thought not only throughout the Southwest, but almost the civilized world OA'er. In 1837 Cooke was called to LouisA-ille and was ffiven the chair of Theorv and Practice of ^ledicine in the ^Tedical Institiite there out of which came the TJniversity of Louisville. Cooke was by this act one of the foiuiders of that great school. The theory which made him famous was elaborated duringr his long rides as a country doctor in Virginia. It is thus succinctly stated by his colleaeu^s of old Transylvania. Dr. Robert P'^ter. "His fame was mainly built on his celebrated theory of the universal origin of disease, which was, that disease was caused bv cold or malaria. That especiallv it commenced in weakened action of the heart, resultins' in eou!?estion of the vena cava, its branches and capillai'y dis- MEDICAL PIONEEJ.'S OF KENTUCKY, 67 trilnitioji, and that fever was but the reaction of the vital force to overcome this condition, which nni-elieved would result in death. Ac- cording' to him, all autumnal and malarial fe- vers were but variations of one diseased condi- tion ; and even those fearful scourges the plague, cholera, yellow fever, dysentery, etc., were simply varied forms and conditions of congestion of the vena cava." To destroy this many-headed hydra, while he would use cold water to reduce too great febrile excitement and even sometimes give repeated pro re nata; actually giving one pound in one day to a young patient, without fatal resiilt. " iempora! mores! Two survivals of Cooke's theory and prac- tice are in the mind of the writer; when he was a student in the Universitv of Louisville Dr. Lunsford P. Yandell, Ji'.'; (1870-71-72) then professor of Slateria Medica, Therapeut- ics, and Dermatology, evolved a theory of the malarial origin of all diseases except syphilis and tuberculosis. He excused the vena cava and brought into play more correctly and sci- DOCTOR JOHN ESTEN COOKE I783--1853 antimonial wine, his main reliance was on blood-letting and cholagogue purgatives; as he believed it was by increasing the secretion of the liver and causing it to pour out con- stant "black bile" that the venous congestion was to be relieved and the jDatient cured. Among all these remedies calomel was his chief reliance, and was given by him in doses not measured by the balance but by the effect they produced ; so that in the latter days of his practice, notably during the epidemic of cholera in Lexington in 1833, he absolutely re- sorted to tablespoonful doses of this mercurial, entifieally the portal cirtulation, and, work- ing out the pathological features of the theory to his O'wn satisfaction, prescribed quinine for every disease, except tuberculosis and syphi- lis, that he was called upon to treat. The writer recalls a case of acute diffused acne, involving almost the entire cutaneous surface of the patient's body. Yandell looked the pa- tient over carefully and said: ''this looks like syphilitic acne, but T believe it is malarial, give her quinine in ten grain doses three times a day." I complied, and had the pleasure d* 6S KENTUCKY MEDICAL JOURXAL. seeing the patient cured in less tlian two weeks' time. The instance of the survival of Cooke's practice, was exhibited bj' a j^oung doctor who some fifteen years ago, came to Louis\ilk- froui the heart of the" Blue Grass, and was tlie coisen'atcr of Transylvania tradition so far that he horrified his medical friends and fel- lows of our local medical societies by advo- cating teaspoonful doses of calomel in the treatment of bilious and other fevers. But the glory and fame of Cooke is a strangely negative one. Of this Dr. David W. Yandell in his Seini-Centennial Doctorate ad- dress at the University of Louisville, tells the story. "Dr. Cooke, reading from his desk in Louisville, saw in bile, yellow bile, and black bile, the hands on the dial-plate of disease which pointed unerringly to the one and only treatment. The three biles constituted his medical trinliy, and appealing to this he com- pressed his means of cure into one drug, and that drug was calomel. This he gave in huge doses, by day and by night, in season and out of reason, first, last, and all the time." But a pathologA' so narrow could not long sumive, and a practice which trusted the aw- ful issues of life and death to a single agent failed to satisfy the growing intelligence of the people. Physicians at large assailed the patliology. The public rejected the practice. ^\nd, as extremes do so often meet, there grew up with this such strong opposition, that, out of it came a sect which condemned as poisons all medicines derived from the mineral world, and found in the vegetable kingdom alone their remedial agents. This sect called itself Eclectic. Tt was founded by Samuel Thomp- son, a man of much mother-wit, great shrewd- ness, and but little knowledge, and for a time it held large sway throughout the country. The sovereign metal of Dr. Cooke was driven from the field by steam, lobelia and number six. But if it were permitted this ingeuous, original man, to look down upon the practice of to-day, he would have the satisfaetion of seeing the remedy on which he rested all his hopes come out bravely from the eclipse which ij-mporarily obscured it. His pathology, es- sentially bad. naturally perished. The rem- edy he advocated, essentiallv good, as natur- ally survived and, under wiser restrictions, .t ir.oro eon'eel pathology, and enlightened interpretation of its action, is at present in more general use than at any prev.QUs time in the history of the world. Eclecticism, too, has peri.shed ; another proof that "what is xiseful will last, what is useless will sink," In testimony of the above who has not heard and is not to-day hearing people talk of Cooke's pills- The formula of that famous creation is for each pill, calomel gr. 1-2, aloes and rhubarb aa gr. j. soap gr, 1-2, Wliat a letting do\ra from the dosage prescribed by the master in his prime. To reach ami:hing like Cooke's original dosage of calomel, through these pills, the patient would be com- l)elled to take not less than a peck of them. The winning features of Cooke's character were, earnestness, sincerity, devotion, love, charity, and piety. Collins, the historian, tells this story illus- trating the depth of his convictions, "One Sunday morning, waiting on some of his fam- ily to get ready for church, the Methodist church, of which he and they were members, he picked up a discourse by the Reverend Doc- tor Chapman, then an Episcopal clergjmian of Lexington. The argument for the Old Church of England attracted his attention. He perused and studied it fully, sent for all the available authorities on the subject ; stud- ied them with such efiEect that at once he changed his communion to the Episcopal Church and was ever after a rigid and zealous jiillar to that church, and an industrious stu- dent of the writings of the theological fathers." The dogma that drove him into this church was the apostolic succession. Cooke was not a pleasing speaker. Accord- ing to the elder Yandell, he lacked dramatic talent and thought ; always eai-nest, and en- thusiastic at times, he had no turn for wit or ridicule. He was near-sighted, wore glasses, and delivered his lectures with a feeble voice, labored articulation, and awkward gestures. His doctrine though erroneous was easy to un- derstand, sparing the student time, and the trouble of studying the many pathological and therapeutic features not involved in it. Moreover, it was promulgated with such logic, earnestness and sincerity that it was readily accepted, believed, and practiced by the ma- jority of them. As a statement of his doe- trine, ajid a sample of his diction, style, and logic I quote the following from his Essay No, 1 on Autumnal Epidemics. "We have abund- ant reason to believe that these wasting pesti- lences are the effects of a dense gas, the pro- duct of the decomposition of vegetable matter. The agent in q\;estion, commonly distinguish- ed by the name of mjasmat=dical education. This want of special training and experi- ence in this branch of science on his part nat- urally caused opposition to his appointment to this chair, which was. allayed by making the late Hez4dah Hulbert Eaton. A. IsL. an ad- .iuuct to the Chemical chair, and giving him one-third of the tuition fees. Professor Eaton was a young man of fine attainments and thorough practical training in chemistiy and natural science generally : a gradnate of Rensselaer Tirstitute of Troy. New York, under the administration of his father, the cderated Amos Eaton. Professor Eaton died of consumption at thp age of twent7.--thi'ee, before the end of the first year ; but durin? the- short term of his service he had, by his industrv and practical knowl- edge, greatly improved the means of instruct- ion in the Chemical Department by a complet-^ reorganizalioii of the laboratory and the pro- curement of !nuch new apparatus. After the death of Profes.sor Eaton, .\ugust 16. 1832. the present writer, then residing in Pittsburs:. Peunsylvania. who had also been a student in the Rensselaer Institute and conse- quently Icuown to Professor Eaton, was per- suaded by the late Reverend Benjamin On Peers to visit Lexington, Kentucln'. to deliver a course of Hiemical lectures in the Eclectic Tn.stitute. of which ^Ir. Peers was principal, and of which younar Professor Eaton had been a professor. During this eoiirse. in 1832, the MEDICAL PIONEEhiS OF KENTUCKY, 75 writer was indiioed by Professor Yandell, by private arrangement, to assist him in lais next eoui'se of lectures to the regular students of Ti'ansjdvania aiid to co-'nanence the regular study of medicine with a view to graduation. Under this arrangement, which continued until the disruption of the Medical Faculty in 1837, Doctor Yandell. in his usual able and la-illiant manner, delivered the chemical lec- tures to the students, while to the writer was committed the preparation and performance of the demonstrative experimental parts. On the removal to Louisville in 1837, to join in the establishment of the rival school, the Louisville Medical In^iitute, Doctor Yandell Trustees of the school, having come to the con- elusion that Professor Caldwell had beeomt? superannuated, placed Doctor Yandell in the chair of Physiology, for which subject he had a decided taste. This change procured him the animosity of his whilom friend. Doctor Caldwell, who, in his rather unfortunate Autobiography, written in his last declining years, indulged in' much bitter denunciation of his late colleague. It is much to the credit of Doctor Yandell that, although when this angry publication was fresh from the press he retaliated bj^ showing in ample quotations fro'n the autobiography some of the weak points in Doctor Caldwell's character, he was DOCTOR LUNSFORD P. YANDELL, Sr. :805--I878 taught in the combined chairs of Chemistry and Materia Medica, never failing ably and impi'essively to perform his arduous duties. Not having any particular taste for so severe a study as practical chemistry, although no one was more impressed with the philosopliic- al beauty and wide practical value of the sci- ence, he naturally sought a transfer to a chair more congenial w^ith his tastes and the charac- ter of his mind than that of chemistry. This, circumstances prevented until, in 1849, the years, as the writer these weaknesses the disj^osed in following knows, to extend over mantle of kindness. Doctor Yandell occupied this chair of Physiology with great credit until he resign- ed, in 1859, to accept a chair in the Medical School of Memphis, Tennessee. During the Civil AYar he devoted himself to hospital ser- vice. In 1862, he was licensed to preach by the Presbytery of l\Iemphis, and in 1864 was ordained pastor of the Dancyville Pres:byteri- KENTVCKY MEDICAL JOURXAl,. an church. He resigned his pastorate in 1867, and returned to Louisville to resume the prac- tice of medicine, wliich he had never entirely al)andonod during the whole of his life. Wliile I'esident in Lexington he was foi some years sole editor of the Transylvanifi Jouninl of Medicine, to which he contributed sevral able papers. In Loiusville he was ed- itor for some time of the Western Journal of McJicii'c and Surgery, in both eases filliiig tlie editorial chair with characteristic activ- ity and ability. He was always a contributor Louisville, and at the time of his death he was President of the State ^ledicai Society of Ken- tuckj'. His decease occurred February 4 187S, in the seventy-third year of his age. DOCTOR JAMES MILLS BUSH. By Robert Peter, A. M., M. D., Lexington. .\ native of Kentuckj', bom in Frankfort, May, 3808. graduated .as A. B. in Centre Col- lege, Danville, Kentuek\', and began the study of medicine and surgery in the ofiSce of the DOCTOR JAMES M. BUSH 1808^-1375 to the medical literature of his day in numer- ous papei-s, especially in biographical sketches and obituaiy memoirs of medical men of Ken- tucky and Tennessee, a more complete collect- ion of which he was said to be pj-eparing at the time of his last illness. He held a facile peri; fe^v writers of our times have produced more classical and gi-aceful essays. As a public .speaker and lecturer he was ever ini- pi-essive. graeefid, and chaste. His social qualities made him always welcome and prom- inent in all public assemblies of his medical brethren. In 1872, he was elected President of the College of Physeiaus and Sm-geons of celebrated Alban Goldsmith, Louisville. Ken- tucky. He removed to Lexington in 1830, to attend medical lectures in Transylvania Uni- versity, and to become a private pupil of its reno'rtTied surgeon, Professor Benjamin "W. Dudley. To Doctor Dudley he became per- sonally attached by sentiments of affection and esteem, which were warmly returned by his eminent preceptor; so that, when young Bush received the honor of the degree of Doc- tor of iledicine in 1833, Doctor Dudley im- mediately appointed him his demonstrator and prosector in anatomy and surgery, to MEDICAL PIONEER."^ OF KENTUCKY, which branches of medical science and art Doctor Bush was ardently devoted. T'lis responsible office he filled with emin- ent ability and success until 1837, when he was offieiaUy made Adjunct Professor of Anatomy and Surgery to his distinguished colieag'ue and friend, Doctor Dudley. He oc- cupied this honorable position to the great satisfaction of all concerned until the year LSll, when he became the Professor of Anat- omy, Doctor Dudley retaining the chair of Surgery. In the chair of Anatomy he con- tinued until the dissolution of the Transyl- vania Medical School in 1857. In the meanwhile this school, in 1850, had been changed from a winter to a summer school: Doctor Bush, with some of his col- Lewis Rogers, in 1873: "When Doctor Dud- ley retired from teaching. Doctor Bush was appointed to the vacant chair. When Doctor Dudley retired from the field of his brilliant achievements as a surgeon Doctor Bush had the rare coui-age to take possession of ii. No higher tribute can be paid to him than to say that he has since held possession without a saecessful rival." i'\Iost abh^ and successfully did he thus maintain himself as one fit to follow in the footsteps of our great surgeon. His sterlin:^ qualities as a man, his most kind and endear- ing manners as a physician, his great skill and experience in anatomy and surgery, which had been as well the pleasure as the devoted labor of his life; his remarkable accuracy of THE HOME OF DOCTOR BUSH, IN LEXINGTON. Built on the site of the Transylvania University Medical Hall. leagues and some physicians of Louisville, having thought proper to establish the Ken- tucky School of Medicine in Louisville as a winter school. In this latter college Doctor Bush remained for three sessions, giving thus two full courses of lectures per annum, when he and his Lexington colleagues, resigning from the Louisville school, returned to that of I^exington, re-establishing a winter session. Doctor Bush was ever a most conscientious and ardent laborer in his profession, and, during the lifetime of his preceptor, Doctor Dudley, vpas his constant associate and assist- ant as well in the medical school as in his medical and surgical practice. On the retire- ment of that distinguished surgeon and pro- fessor, his mantle fell upon Doctor Bush. In the language of his friend, the late Doctor eye, the more acute because of congenital my- opia, his delicacy of hand and unswerving nerve in the use of instruments in the most difficult operations, endeared him to his pa- tients and won the respect and admiration of his medical brethren. Doctor Bush was a lucid and impressive teacher of his peculiar branch of medieal irt and science, and always attached his pu[)ilrj strongly to him as an honored preceptor and friend. During his active lifetime, spent chiefly in acquiring and putting in practice the rare pi'ofessional skill which distinguished him, he gave but little time to the use of his ])en. Hence he left no large book as the record of his experience. His principal writings were p\iblished, in 1837, in the tenth volume of the 7S KENTUCKY MEDICAL JdCRNAL. Transylvania Journal of Medicine, and these were written for that joui-uai on the solicita- tion of tlie present writer, who edited that volume. They consist of : 1. A short report of a case of epilepsy, prodiieed in a negro girl by blows of the wind- lass of a well on the parietal bone, wliich was euiii'eh" and speedily cured, after the isreliui- inary treatment of mercurial purgatives and low diet, by the use of the trepiue, which, as is Avell known, had been used with great suc- cess by Doctor Dudley in such cases. 2. Report of a case of insidious inflamma- tion of the pia mater, complicated with pleur- itis, witli the autopsy. o. A more estejided paper, entitled "Re- marks on Mechanical Pressure Applied by Me.ms of the Bandage; Illustrated by a Va- net}^ of Cases.' In which the mode of ap- plication and modus operandi are most clear- ly given, and iUnstrated by many interesting eases, mostly from tlie surgical practice of Doctor Dudley. 4. "Dissection of an Idiot's Brain." The subject, a female twenty-five years of a^ge, had been born idiotic, deaf, and dumb; the head was very small, and the hrain on dissection wfis found to weigh only twenty ounces, an*;! to have large serous cavities in the corneal portions of the cerebral hemispheres. The anatomy of the eyes was perfect, but there was no nervous connection between the optic nerve and the thalmi nervorum optieomm. o. A short iiotice of three operations of lituotomy. performed on May 31, 1837, by Doctor Dudley, with his assistance. 6. "Interesting Autopsy." On the body of a negro man wbo had been the subject of sudden falling fits, and was under treatment for diseases of the chest. The autopsy dis- closed hypertrophy of the I'lglit side of the heart, and a most remarkable lengthening of the colon. 7. "Observations on the Operation of Lithotomy, Illustrated by Cases from the Practice of Professor B. W. Dudlej'. " An extensive and lucid description of the method of operation and the remarkably successful e.\perience of Doctor Dudley in this part of liis practice, giving report of one hundred and fifty-two successful eases np to that time. In addition, the Doctor contrilrated an oc- casional bibliographical review or notice. And these seem to be the whole -of his pub- lisli-d pj'ofessional writings. Dr. Bush was married, in 1835, to IMiss t'liarlotte -Tames, of Chillicothe, Ohio. Of then- three children the eldest, Benjamin Dudley, was a young man of remarkable promise as a surgeon and physician when he was cut off by death, an event which east a gloom over tb.e remaining days of the life of ids father. Few young men of his age had ever attained such proficiency or developed such sterling qualities. The death of Doctor Bush, which took place on Februaiy 14, 1875, was followed by gener- al and unusual ma;iifestations of respect and I'egret not only on the part of the members of tlie pi'ofession. but by the people of the city at large. Few citizens were more extensively known, loved, and honored in life, or follow- ed to the grave by a greater concourse of mourning friends. DOCTOR ROBERT PETER. By Rei'ben T. Durrett^ Esquiee Louisville. CLate President of the Pilson Club.) The late Doctor Robert Peter, one of the most distinguished analytical chemists of his time, was a member of the IMedical Faculty of Transylvania University from 1833 to the time of the dissolution of that institution, and aftei'ward occupied chairs in the different col- leges with which Transylvania was merged, lie was one of the most active of the pro- f' ssors and did as much as any one else to j'aise the University to the lofty heights it at- tained as a school of literature, law, and med- icine. It occurred to him after the merger of the Transylvania into the Kentuctv tlnivers- ity that an institution which had led the way and done so much for literature, law, and medicine should not be permitted to vanish and leave nothing but a name and memory be- hind. He, therefore, went to work, after the weight of years was gathering fast upon him, to write the history of Transylvania Univers- ity, and had his work almost finished in 1894, when death, which alone could have arrested Idm in his undertaking, relieved him of the task at the age of eighty-nine. His daughter, ^liss Johanna Peter, with filial affection wor- thy of so excellent a father, and public spirit equal to the occasion, rightly estimated the value of such a work, if it should be published and put into the hands of the public, under- took to prepare his manuscripts for publica- tion. One of these, manuscripts prepared by her embraced the Literary Department of Transylvania, and was published by The Fil- sou Club in 1896, as its eleventh volume. AVlien this publication was made, it was iu- limated, if not promised, that it would be fol- lowed in tlie near future by one of the medic- al department. jMiss Peter, therefore, pre- pared tliis second manuscript of her father Icr publication, and The Filson Club now pre- sents it in the pages which follows, as the twentieth number of its regular annual series. The J\Iedical Department of the Tr-^insylvan- ia University no longer exists. Indeed, noth- ing of the Transylvania University exists ex- cept its name. Its learned professors have gone the way of all flesh. The last one of MEDICAL PIONEEL'S OF KENTUCKY, 79 them recently went down to his grave. Its Iraildings have recently been swept away by fire, or have passed to other institutions with its library and apparatus. Yet all of this re- nowned University has not passed away. Its fame yet lives,, and will not perish wliile the memory of the living holds sacred the good deeds of predecessors. Its distinguished pro- fessors made Transylvania University fam- twentieth publication of The Filson Club, the manuscript will make its way to many and pi-esent them with pen and portrait likenesses of those who devoted their lives to instructing the young of our land in the art of adminis- tering to the sick and afflicted. The author knew all of his contemporary professors, and the likeness which he has given of some of the'n wiU be the ones by which they will be DOCTOR ROBERT PETERS 180S-1894 ous, and made history at the same' time, and they theinselves are now entitled to a place in history. It is the purpose of The Filson Club, b}^ this publication, to assist in securing for them the place they deserve in the memory of mankind. Doctor Peter, the author was the fittest of men to sketch these professors and to present life pictures of them. His work, however, if it had remained in manuscript, as he left it, would have been seen but by few, and could have done but little good. In this known in after years. Pen pictures are some- times as efficient as likenesses in oil, and the cliaracteristic of Doctor Peter's pictures is fi- delity so executed that they seem to be the or- iginals standing in life before us. In a work like this the essence of its history is biographic and Doctor Peter has made his work to con- sist chiefly of biographical sketches of those who made Transylvania University what it was. He gives the leading facts in tlie life of each of the professors he skei:ohes, and enum- so KENTUCKY MEDICAL JOURXAL. crates tlip oilier colleges in which they occu- pied chairs. Mild srives the titles of the works they puiilishod cither in hook form or maga- zine articles. He omits nothing in the sketch tliat is necessary in forming a just idea of the character portrayed. In the long career of Transj'lvania Univers- itj'' she did not fail to make enemies, but she made more friends than enemies to remember her. A few of the living students and the many descendants of the deceased professors and graduates now scattered broadcast over the land will be glad to read what is here said of old Transylvania, and the woi-k will thus be widely known and read. All who see it will be thankful to Doctor Peter for prepar- ing it for the press, and to The Filson Club for publishing it. There is in our nature something like the love of the relic which makes tis revere the memory of Transylvania University. Early in the year 1799 a medical department was at- tached to this University, which was the first medical college in the great ^Mississippi Val- ley and the second in the whole United States. The medical department of the University of Pennsylvania antedated it, as it antedated all others afterward established in any part of our vast domain. We can not, like our Eng- lish coiisins. go back along the pathway of centuries to the colleges of Oxford and Cam- bridge and revere them for their age ; we have nothing in our new country that partakes of such age. We are a young people in a young country, and our Traaisylvania ^ledical Col- lege was old enough from our standpoint to be crowned with hoary years. "We revere it as the first medical college on this side of the Alleghanies. "We revere it for the efforts it made to prepare our young physicians to cope with the diseases that afflicted our people. "We revere it for the fame it acquired and for the good name it gave our State. "We revere it for the success of Professor Brown in in- troducing vaccination in advance of its dis- coverer, for the brilliant and numerous opera- tions in lithotomy by Professor Dudley, and for the noble efforts of others of its professors in prolonging human life and mitigating its pains. "What it did in the day of its glory is set forth in the pages which follow, and he who reads thciii will hardly doubt that the medical department of Transylvania Univers- itv is worthv of the record here made for it. DOCTOR HENRY :\rARTYX SKILOIAX. By John "W. Scott, M. D., Lexington. Doctor Skillman was the youngest child of Thomas T. and Elizal.'eth Farra Skillman: he was born September 4, 1824 at Lexington, Kentucln-. His father came to Lexington from New -Jersey in 1809 and founded the largest publishing house in the ^Mississippi Valley: publishing in 1823 an edition of sev- eral thousand copies of the entire bible. He received his academic education at Transylvania University and after two or- three years in tlie drug business re-entered Transylvania as a student of Medicine and re- ceived from it the degre of Doctor of ^Medicine in 1 S47. The following year he was made Deiijonstrator of AnatomA- in the Colleee and. in 1851 was appointed Professor of CTcneral ajid Pathological Anatomy and Physiology-. Such a chair in a modern school would re- C(uire the aeti-^dties of some half dozen full pi-ofessorships. to say nothing of scores of as- sistants and laboratory workers. Yet the sub- ject of this sketch is said to have "occupied this position with .skill and success until the close of the IMedical College in 1857." This is an illuminating commentary upon the pro- gress of ^Medicine in the last half century. In 1851 he married Margaret Scott the daughter of IMatthew T. Scott. President of the Northern Bank of Kentuclrs"; one child, Henry M. Skillman. sui'vives him. For the succeeding twenty-five yeare he devoted him- self to the practice of both medicine and surgery: in 1877 his nephew. Doctor IMatthew T. Scott, entered into practice with him and all of Doctor Skillman 's surgical work wag transferred to him : from that time until his death on "March 21, 1902 he continiied the active practice of his pi-ofession, having done a day's work on the day upon whicli he died. Tn addition to his large practice he found time for out.?ide affairs : he was an active member of the Second Presbyterian Church, a director of the Security Trust Company and occupied other similar positions. Thre was a benediction about Ms face, a power of peace and love in his smile, a charm in liis entire pei'sonality which defies descrip- tion: Avith a great sympathetic heart he com- bined the most knightly courtesy : this gave him a bearing at the bedside which none who witnessed it can ever forget? there was so- licitude withoitt anxiety, cheer without gay- ety, dignity- witho\it coldness and. withal, a poise which inspired confidence in not only the will but the ability to help. The same character was shown in his relation to other members of the pi-ofession. Tn addition to the most scrupulous observance of its ethics, there was an imfailing kindness and gener- ositv which was shown toward the humblest MEDICAL PIONEERS OF KENTUCKY, 81 of his colleagues in the same measure as to the most distinguished. To the profession his career was particular- ly notable in three particulars : first, in that it was given to him, as it has been to few men, to occupy a position of eminence in the practice thousai:J! to a city of more than thirty thou- sand ; he was the relentless enemy of discord iiud evil speaking among doctors, and an irre- sistible peace maker in the profession for over half a century. To those who revere the memory of the old DOCTOR HENRY M. SKILLMAN 1824--1902 of medicine for more than half a century, having been made a member of the fa.culty of the Medical Department of Transylvania in 18.51; and at the time of his death, fifty-one years later, still probably the most sought for consultant in Lexington, which during that time he had seen grow from a town of eight Transjdvania and its Sledieal Department, Doctor Skillman was notable as the last sur- vivor of its medical faculty and, with Doctor John W. Wliitney, his intimate friend, the connecting link for many of us to that heroia age, that Twilight of the Gods, the Transyl- vania Medical Faculty. OLD MEDICAL DEPARTMENT OF THE UNIVERSITY OF LOUISVILLE Erected In 1838 w occupied by the City Public School Department, the Medical School beine conducted in the commodious new building at Chestnut and First Streets. III. LOUISVILLE MEDICAL SCHOOLS' GROUP FOREWORD I. THE MEDICAL DEPARTl'IENT OF THE UNIVERSITY OF LOUISVILLE. The reader will find a concise account of the movement which transferred the famous medical school of Transylvania University from Lexingrton to Louisville in Professor I/, ed actively in the changing events of that period. The professors who resigned from Transylvania and accepted chairs in the Lou- isville IMedical Institute soon found them- selves surroiuided with large classes of young men from all sections of the great and grow- ing south-west. After a few years (1845) the Medical Institute was constituted the JMedical Department of the newly chartered Univers- ity of Louisville. With the prestige of the DOCTOR JAMES M. BODINE 1831--191S For more than forty years Dean of the Medical Department of the University of Louisville, and a great teacher of anatomy. P. Tandell's address which is in gTeat part reproduced herewith. This address, intro- ductory to the course of instruction of 1852- 1853, was delivered at a time when all the facts were known and by one "who participat- great men composing the faculty, the school continued upon a career of great prosperity and usefulness. Large classes filled its lec- ture-rooms, the professoi's wrote some of the most authoritative and erudite text-booh", cf 84 KENTUCKY MEDICAL JOVEXAL. that day, and by both the spoken and writ- ten word moulded medical tliought and prae tiee throughout a great and prosperous sec- tion of the country. Tn 1849 the Faculty was constituted as follows: Samuel D. Gross, Professor of Surgery; Eogers, Professor of ilateria ilediea; Daniel Drake, Professor of Theory and Practice of iledicine; Tobias G. Richardson, Demonstra- tor of Anatomy. Professor Cobb was Dean of the Faculty. In lSo2 Dr. Daniel Drake and Dr. Jebe- DOCTOR WILLIAM BAILEY, A. M. 1833-1911 A teacher in the Medical Schools of Louisville from the days of the Civil War until his death; a medical veteran of the war: a member of the State Board of Health for a quarter of a century, and President at the time of his death; President of the State Society and of the American Public Health Association, and one of the most beloved physicans and consultants Louisville ever had. Henry Miller, Professor of Obstetrics; Jebe- diah Cobb, Professor of Anatomy; Lunsford P. Yandell, Professor of Physiologj-; Benja- min Silliman, Professor of Chemistry; Lewis diah Cobb resigned their chairs and were suc- ceeded by Dr. Austin Flint and Dr. Benjamin R. Palmer. Dr. Austin Flint, a native of r>Iassachusetts. had taught in Buffalo. New MEDICAL PIONEERS OF KENTUCKY, 85 York, and in New Orleans, before coming- to Louisville. Later he aided in founding the Hellevue Hospital Medical College, in New York, where for many years he taught and practiced with eminent renown, Dr. Benja- min R. Palmer was a native of Vermont, and won distinction as a teacher of Anatomy. Great names are these. They were borne by men of profound thought, intense energy and impressive personality. They moulded med- ical science as taught in America, and educat- ed a generation of practitioners of medicine. While in Lotiisville Professor Gross wrote his famous treatise on Pathological Anatomy, and the first edition of his monumental work entitled a System of Snrgery. While teach- ing in the University of Ijouisville, Professor Hint laid the foundation for his great text- book on the Science and Practice of Medicine. Professor Miller wrote his well-known treatise on Obstetrics published in 1849, which became a standard text-book. No two books in the his- tory of American medicine have been so mni- versally accepted by the pi'ofession as authori- tative as were the iworks of Gross and Flint. Bomid in strong sheep-skin they were to be found in the office of every American phy- sician, in the city, hamlet and country, and were for many years the trusted guides in diagnosis, pathologj^ and treatment. As time advanced, with increasing popula- tion and improved facilities of travel, many changes have taken place, but throughout and until the present day, the Univereity and its many graduates in all parts of the country have maintained its traditions. The history of this school is one of the most brilliant chap- ters in the medical annals of Kentuckj'-. After more than a half century of prosperous achievement, the University was selected by unanimous vote as the parent school in merg- ing the medical schools of Louisville. In 1907 the 3Iedical Department of Kentucky Uni- versity, Louisville's youngest medical school, was merged with the University of Ijouisville. The following year .the Kentuckj' School of Medicine, the Louisville Medical Coljege and the Hospital College of Medicine joined in the merger, and thereby united into one school under the title and charter of the Medical Department of the University of Louisville. It is gratifying to record that in this present time this famous old school, the only medical school in the Com^monwealth, 'maintains a worthy position in the highest grade of Ameri- can medical colleges. IT. THE KENTUCKY SCHOOL OF MEDICINE. From time immemorial medical schools have been centres of professional jealousy, intrigue and antagonism. That this should be seems somewhat illogical when we realize that the faculties of tlie colleges were composed of men selected by reason of their ability, learning and distinguished position. Nevertheless, the lust of power and preeminence, the jealousies born of rivalrj^ at close range, produce their logical results here as elsewhere in the field of human endeavor. At the period of which we write, the med- ical schools offered the only direct avenue to prominence and leadership in the profession. Hospitals were few and primitive, medical lit- erature was scant, and medical societies did not offer the opportunities of the present time. The professors in the medical colleges were accepted leaders and authorities of the time, and the colleges offered a sure road to distinction. Hence there were many aspir- ants for places in thg faculties of the schools. Young men of high purpose and lofty ambi- tion sought the subordinate positions in the colleges as a proper-, and legitimate method of improving their knowledge and advancing to prominence. In this way very naturally there soon became numerous applicants for each probable vacancy, and the most reason- able outlet for the congestion was the estab- lishment of a new medical school. The origin of siich schools will almost in- variablj- be foimd in factional strife within the faculties of established schools, facilitated by the numerous aspirants for professional positions outside the schools. In tlie early days such increase in the number of colleges was not without good results both for the col- leges themselves and for the advancement of the profession. The competition which neces- sarily obtained, stimulated the teachers to better work and fostered a spirit of rivalry which was helpful to both teacher and pupil. It was only in later times, when schools were established for which there 'was really no good i-<'ason for their existence, that the multiplica- tion of medical schools became destructive in- stead of nonftiructive agencies of professional progress. These observations are suggested by the faci that in 1850, when the Medical Department of the University of Louisville was firmly estab- lished in professional favor, occupying a new and eopunodious building, with lai'ge classes an,1 a renowned faculty, application was made to the Legislature of Kentucky for char- ter of a new medical college to be known as the Kentucky School of Medicine, and to be located in the city of Louisville. The charter was granted, and at the head of its first fac- ulty appears the name of Benjamin W. Dud- «»; KENTUCKY MEDICAL JOURNAL. ley, one of the most brilliant teachers in Tran- sylvania University at Lexington, who had strenuously opposed his colleagues in the re- moval of that school to Louisville. Indeed Dudley had reorganized the faculty after most of Ijis colleagues had removed to Louis- ville, and made a futile effort to maintain the old school at Lexingtou. The establishment of a rival school in Louisville was a continua- tion doubtless of Dudley's antagonism, aided by the natural desire of his associates in the new school for professional distinction. will be found many names familiar in Ken- tucky medicine: B. W. Dudley, Emeritus Professor of Anat- omy and Surgery ; John Hardin, Professor of Obstetrics and Diseases of Women and Chil- dren ; Chaj'les W. Wright, Professor of- Chem- isti-y and Toxicology ; Heniy W. Bullitt. Pro fessor of Physiology and Pathology' ; Theo dore S. Bell, Professor of Theoiw and Prae tice of ^ledicine ; T. 6. Richardson, Professor of Principles and Practice of Surgerj-; N. B. ^Maj'shall. Professor of ^ifateria Sledica and DOCTOR WILLIAM H. WATHEN 1S46--1913 Dean of the Kentucky School of Medicine for thirty years, a leading surgeon and erynecoloffist, president and active worker in the State Medical Society, and. as Medical Referee in Louisville, an im- portant factor in the suppression of quackery in Kentucky. Wliile Dudley did not remove his residence to Louisville, he headed the faculty for several years as Emeritus Professor of Surgery, and gave to the neiw school the valuable aid of his great reputation and influence. The new school brought together an able faculty- of young and enthusiastic men. auu atti'aeted excellent classes. The following lisi of the faculty is copied from the annual an nouncement of the session of 1856, in which Therapeutics: John S. Seaton, Professor of Anatomy; James ~Sl. Bodine, Demonstrator of Anatomy. Among others will be observed Theodore S. Bell, afterward a learned Professor in the L'niversity; and Dr. James M. Bodine. for fort.v years the popular Dean and Pi-ofessor of Anatomy in the L'niversit.v. Dr. T. G. Richardson, the Professor of Sm'gery, was a pupil of Pi-ofessor Gross, of the University MEDICAL PIONEEllS OF KENTUCKY, 87 faculty, and for several years a teacher of Anatomy at the University. He was the au- thor of a text-book of Anatomy, and later a disting-uished teacher of Surgery in New Or- leans. He won a national reputation and was elected President of the American Medical As- sociation. During the great civil war this school was closed, but after the restoration of peace it reopened with a new and reorganized faculty. A few years later the faculty and trustees changed the timo of holding the annual ses- sions from the fall and winter months to the spring and summer months, a change which subserved the convenience cyf many students of medicine. The school maintained its success and with an aWe faculty and large classes continued until merged with the other schools in the University of Louisville. At the time of the merger the school occupied a commodi- ous college building of its own, and adjacent thereto a modern well-equipped hospital, also the property of the school. III. THE LOUISA^HjLB MEDICAL COLLEGE. On July 25, 3868 the surviving trustees of the Clay School of Medicine* met at the office of Dr. David Cummings in Louisville. The Board of Trustees was completed by the elec- tion of seven new trustees, and Hon. Littleton Cooke was elected President and Dr. B. M. Wible. Secretary. Ai the session of the Leg- islature of Kentucky in the winter of 1868-69 the eliaj'ter was amended so as to change the name of the school to "The Louisville Medical College. ' ' On January 29, 1869 the Board of Trastees elected the following professors : J. D. Burch and R. F. Logan. Anatomy; John Goodman, Obstetrics ; Donald Maclean, Surgery ; S. P. Breekenridge, Material Medica ; H. M. BuUiti, Physiology and Pathology; J. A. Ouchter- lony. Theory and Practice of Medicine. The first session of the College was held in ] 869-70. During the following year, several import- ant changes were made in the faculty, Drs. Burch, Logan, Maclean and Breekenridge re- tired, and Drs. E. S. Gaillard, J. A. Ireland, J. M. Keller, C. W. Kelley and J. W. Max- well were elected professors. Later Dr. J. M. ITollowaj^ was received into the facult.y. The college at once met with favorable rec- ognition from the profession, and the classes increased in number' until the attendance quite equaled that of the University. It will *ThewritPr has not been able tofind any record of the Clay School of Medicine beyond the mere mention contained in the minutes of the Board of Trustees of the Louisviile Medi- cal College. It is probable that a charter was obtained for such an Institution, but no organization was perfected previous to this date. be observed that this college was founded soon after the close of the great Civil War, during that period of rehabilitation in the southern states known as reconstruction. Many young men who had been in the army sought profes- sional careers. The professors in the Louis- ville Medical College, with few exceptions, had served in the Medical Corps of the Armies, and their names were familiar to southern soldiers. The Dean, Dr. E. S. Gail- lard, a native of South Carolina, owned and edited the Richmond and Louisville Medical Journal, a monthly medical magazine with wide circulation throughout the 8onth. He was a cultured physician, an impressive teacher, and wieldecl a facile and trenchant pen. Professor Henry Millei*, long a prominent member of the Faculty' of the University, ac- cepted a professorship in the Louisville iledical Colleg'e and was actively identified with the new school for a number of years. This College maintained its prosperity with an able faculty and large classes until merged with the other schools into the University. The magnificent granite building now occu- pied by the Medical Department of the Uni- versity was built by the Faculty of the Louis- ville Medical College. IV. THE HOSPITAL COLLEGE OF MEDICINE. In 1878, an additioiial Medical School was founded in Louisville, under the charter, and by authoritj' of the Board of Curators of the Central University of Kentucky. This Uni- versity was located at Richmond, and was or- ganized by the Presbyterian Church in Ken tucky. The Medical School was established in a building immediately opposite the City Hospital on Chestnut Street, and in its first announcement gave prominence to clinical teaching as its most distinctive feature. Thb Faculty was organized as follows: Dr. E. D. Force, Emeritus Professor of, and Lecturer on Diseases of Women ; Dr. John J. Speed, Professor of the Institute of Medicine and Public Hygiene ; Dr. James M. HoUoway, Professor of General and Clinical Surgery ; Dr. William Bailey, M. A., Pro- fessor of the Principles and Practice of Medicine and Clinical Medicine; Dr. John T. Williams, Professor of Descriptive and Sur- gical Anatomy: Dr. Wm. H. Boiling, Pro- fessor of Obstetrics and Diseases of Women, and Dean of the Faculty ; Dr. John A. Larra bee, Professor of Materia Medica and Thera- peutics and Clinical Lecturer on Diseases of Children; Dr. Frank C. Wilson, Professor of Physiologj' and Clinical Medicine ; Dr. Dud- ley S. Reynolds. Professor of Ophthalmology and Otology: Dr. J. B. Marvin, B. S., Pro- fessor of Medical Chemistry and Toxicology-; 8« KENTUCKY MEDICAL JOURNAL. Dr. Martin P. Coomes, Demonstrator of Anatomy and Lecturer ou Diseases of th(« Ear. Throat and Nose. The first session was opened with a small class, but within a few years the Faculty was rewarded bj' increased patronage and favor- able recognition. After a few years the school became well established, and graduated many physicians who attained distinguished posi- tions in the profession. Later the time of holding the annual sessions was changed to the spring and summer months, and this gi'eatly increased the attendance. The school was the first of the Louisville schools to adopt tlie three years graded course, and by doing so won the commendation of the profession. In later years important additions were made to the Faculty, a new college building was erected and also a commodious modern lios- l^ital T\-as built adjacent to the college, thereby providing excellent clinical facilities. At the time of the merger (1908), the college had large classes and a strong faculty. V. MEDICAL DEPARTMENT OF KEN- TUCKY UNIVERSITY. In 1898 differences arose in the Kentucky School of iledicine which proved irreconcilable and terminated in complete disruption of the faculty of that institution. As a result a new .school was established, all the pi-ofessors, with one or two excpptions, having been teachers in the Kentucky School of Medicine. The new school received the approval of the Trus- tees of the Kentuek\' L'niversitj' located at Lexington, and the Facult.y was empowered to use the title of that LTniversity. The Fac- ulty was announced as follows: Dr. Joseph B. jMarvin, President ; Dr. Thomas C. Evans, Dean : Dr. James J\I. HoUo- way: Dr. C. W. Kelley: Dr. Sam E. Woody: Dr. J. Garland Sherrill; Dr. Louis Frank: Dr. Leon L. Solomon ; Dr. Henry Euos Tulev ; Dr. Carl Weidner; Dr. W. Ed. Grant. The first session was held in 1899, begin- ning in January and terminating in June. Tile members of this Faculty were experienc- ed and successful teachers, widely known to the profession, and attracted from the begin- ning excellent classes. They devoted them- selves to the work with great enthusiasm, and inspired their students with keen interest in the school. At the opening of the second ses- sion a building which had ' been pur- chased by the Facility and remodeled to suit the requirements of medical teaching, was oc- cupied and added materially to the facilities of the institution. The school maintained a successful career, with growing classes, until 1907. when it was merged into the iledical Department of the University of Louisville. VI. sum:\iary. When in 1908 the medical schools were merged \- 'o ofr, transferring their pi'oper- ties and prestige, and joining their alumni in- to one body, under the title of the Medical De- l^artment of the University of Louisville, a new era was born in the history of medical education in Kentucky. The transition from the old order to the new regime was the re- sult of the irresistible foi-ces of eyolution> wherebj' medicine became intimateh' connect- ed with biological and other allied sciences. ^Medicine became a science and ceased to be empirical, and medical education, conformed to the inevitable change. The old system was the outgrowth of the ap- prenticeship which in early days was the es- tablished form of medical pupilage. A pros pective physician or surgeon became the ap- prentice of an esta-blished physician, usually one connected with an hospital, and often liv- ed in the master's home. He paid a certain sum for board and tuition. Later this rela- tion was known as preceptor and ofSce pupiL which continued until very recent times. Then several physicians and surgeons, iisually connected with the same hospital, handed themselves together, teaching different branches, and took pupils in common, the student paying each teacher by taking his ticket for admission to his lectures. Thus was established the so-called proprietary medical schools, which were enlarged from time to time to meet the advancing requirements of the medical curriculum. iluch adverse criticism has been visited up- on the medical schools which were the out- growth of this s^^stem of teaching. While ]nany evils undcubtedh' existed, and the com- mercial spirit became dominent in some places, to the shame of the profession, these were more the exception than the rule. Strict- ly speaking, all the medical schools in America would have to come under the head of proprietary schools in the times of which we are writing. "Wliile in many instances the college property was owmed by a ITiiiversity or Board of Trustees, the Faculty conducted the business of the college, paid the expenses and divided the students' fees among the pro- fessors. This was true of the famous schools in Philadelphia, New York and Boston as well as in other parts of the country. This system of education was the outgrowth of conditions then existing in the TTnited States. The pop- idation was scattered over a wide territory, and more doctors were required to serve the people than would ohtain in a smaller area with dense population. In the greater part of the coimti-y educational facilities were in- adequate to justifj' a high preliminary re quirement of the medical student. MEDICAL PlONESnS OF KENTUCKY, la Louisville, while the University of Lou- isville owned the building, and Central Uni- versity of Kentucky owned the building of the Hospital College of Medicine, the connect- ion between these ITuiversities and the medical schools was inerely nominal and the schools were conducted entirely independent of the university authorities. In the independent medical colleges, the Boards of Trustees exerted practically no control over the standards and managemeni of the colleges, the faculties being in unre- stricted authority. Indeed, as a rule, the liiembers of the Board of Trustees took only a nominal interest in the colleges. Under thia system with all its abuse of privilege, hun- dreds of competent and skilled physicians were educated and the esprit de corps of the profession was maintained throughout. The leading medical schools voluntarily, and often at personal pecuniary sacrifice, made extens- ive and costly improvements in their facil- ities for teaching. Under the new regime the laboratory' and the hospital ward have re- placed the amphitheatre and crowded lecture room. Demonstrative teaching and clinical training by nrofessional teachers have taken the place of the teachers who were both teach- ers and practitioners. The prolonged course of pupilage and the preliminary education necessary for scientific study are making a new generation of doctors, wherein scholar- shij) and scientific attainments are the rule instead of the exception. The medical schools are now integral jjarts of universities, and conform to the university system of teaching. Laboratories and hos- pitals afford the student unlimited facilities for study and training. A college education with special instruction in biology, chemistry and the Latin language are requisite condi- , tions for admission to the study of medicine, and the college diploma is no longer a license for practice. The old system had its day, and the man who instructed with lecture and quiz prepar- ed the way for the greater achievements of the present age. The science of medicine ha.s made wonderful strides in these latter years, but there were great men and master minds in the olden time. Ijewis S. McMurtry now LOUISVILLE SUCCEEDED LEX- INGTON AS A CENTER OF MED- ICAL EDUCATION.* ByLuNSFORD p. Yandell, Sr., M.D. Our country was slow to embark in the medical instruction of her own sons. A cen> tury and a half after the colonies were set- ll(?.d the medical students of America were still obliged to repair to the colleges of Eu- rope for the completion of their studies. It was not until the University of Edinburgh had been attracting scores of young American physicians across the sea for forty years, that any serious effort was made to establish a med- ical school on our continent. This honor be- longs to Dr. John Morgan, who, by an address remarkable for its earnest and sound argu- ment, prevailed upon the trustees of the col- lege of Philadelphia to fovuid the institution now represented by the Medical Department of the University of Penjisylvania. This first American school of medicine was organized in 1765, while Dr. Franklin presided over the C'Ollege. Three years afterwards a similar institution was founded in New York, but fail- ed to command the success which has attend- ed the Philadelphia school. A medical facul- ty was appointed in 1782 to give lectures on the different branches of medicine in Har- vard University; and in 1804 Dr. John B. Davidge laid the foundation of the medical school at Baltimore. He had returned a few years previously from the University of Edin- burgh, where he formed the resolution, in common with his fellow-students. Dr. Hosack, and Dr. Samuel Brown, of establishing a med- ical school in his native country. I have heard him relate, that the project appeared to the student of the old country extremely ab- surd, and they made great sport of the embiyo professors of America. The opening of his enterprise was anything but auspicious; his first class niimbered only six, and his second had but one addition to it. The rise of the other early American schools, though not quite so gradual as that of my old preceptor and friend, was by no means rapid when com- pared with those of our day. It remained for the West fully to develop the activity of such institutions. The tide of immigTation had been pouring into the Valley of the Misissippi for more than thirty years, and the then Western states were still without a medical school. Such students as could afford the necessary means resorted to the Atlantic colleges; those who were unable to incur the expense entered *Kxtracts from the Introductory Lecture of. Dr. Yandell, Delivered November 1, 1852. 00 KENTUCKY MEDICAL JOURNAL. upon the practice of their profession without the advantage of piiblic instruction. Ken- tuclfj', the pioneer of the new states, took the leaci in medical education. With whom the thought of founding a medical college in Lex- ington first originated,* it is perhajjs impos- sible now to ascertain, but as early as 1S16 some steps had been taken in that direction. in the Faculty of the Medical Department of Transylvania ITniversity. These gentlemen d(!livei-ed a course of lectures to a class of twenty students, of whom Dr. W. L. Sutton, the First President of the Kentucky Jledical Soeiet^^ is one of the surviving members. The result of this enterprise does not appear to have been satisfactory; troubles originated in DOCTOR LUNSFORD P. YANDELL, Sr. 1805--1878 A teacher and writer of great industry and ability, and President of the State Medical Society at the time of his death. In that year lectures were delivered by Dr. Wm. H. Richardson while yet an under-grad- uate in medicine. In 1S17 he was associated with Dr. Benjamin W. Dudley, Dr. Daniel I)rake, Dr. James Blythe, and James Overton, *It would appear tliat Dr. Yandell was not advised of tlie fact that "Early in 1809 at the first meeting: of the Trustees of the new Transylvania University, they instituted 'The Medical Department' of Collesre of Transylvania, which subse. At the end of this session Dr. Joshua 15. Flint retired from the school, and was succeeded in the chair of Surgery bv its pres- ent incumbent. Dr. Samuel D. Gross, The class had now grown to be so large that the usual mode of giving clinical instruction, the students following the professors through the wards of the hospital, and catching, as tliey could, the remarks made at the bedsides of the patients, was found to be ineffectual ; and in order that this most important branch of medical teaching might be rendered effici- ent and useful, the Faculty determined, with the consent of the City Council, to ered a clin- ical theatre adjoining the Marine Hospital. The follonving course of lectures was delivered to 209 students, and no portion of it was more satisfactory than that which was given in the clinical amphitheatre. The effect of the im- in-ovement was felt to be most salutary. The succeeding class numbered 268. In eonseauence of the embarrassed state of the coimtry, the number of students declined the ensuing session, and was only 190 ; but the institution soon recovered from the temporary depression and the following years exhibited a rapid increase. Its sixth class reached 246; its seventh 290 ; and its eighth, 347. Tt was now confessedly ahead of all the neighboring schools, and probably behind none in the coun- try except the two principal schools of Phila- delphia. During the winter of 1843-44, Dr. Cooke, 9G KENTUCKT MEDICAL JOVUNAL. wlio had retired to a fMrm in lhe neighborhood of Louisville, gave notice to the Board of Man- agers that he would vacate his chair in the spring, a step which his declining liealtli shortly afterwards would have rendered nec- essary. Pie was the first of those who had taken part in the organization of the school to I'esign his seat in it. The peculiar medical theories and practice of this original man have been extensively commented upon, and are known to every one who has read much of American medicine. "Whatever may be the judgment of medical men concerning these, sion, the Legislature of Kentucky granted a cliarter for the Univei'sity of Louisville, of wliicb the Medical Institute was constituted the Medical Department. By the provisions of the charter, the Board of Trustees were to be elected by the City Council, and to hold office for a limited period, instead of filling their own vacancies, and continuing in office for life, as under the original charter. The first class that assembled in the Medical Depart- ment of the Universit}' of Louisville number- ed 353 students, and the second rose to 406. This was in 184.7, ten years from the com- DOCTOR AUSTIN FLINT, Sr. 1812-1886 there can be among those who have known him intimately but one opinion as to the pur- ity and excellence of his character. However mistaken he may have been in any of his views, no one ever doubted his sincerit.y. No one ever associated long with him without the conviction that he was a just, upright, and tlioroughly honest man. The feeble state of his health has compelled him entirely to aban. don his profession, and for several years past he has lived on liis farm, in Trimble county, on the banks of the Ohio. In February, 1845, during its eighth ses- mencement of the enterprise, and I suppose I am safe in saying, that no medical school ever attracted so many students in so short a time. The number, the ensuing session, was 3;i3. Extensive changes in the Faculty took I)]ace after the close of this session. In Feb- ruary, 1S49, Dr. Drake signified to the Board of Trustees that he would resign his profes- sorship at the end of the term. Later in the season the chair held by Dr. Caldwell was va- cated; and in June, Dr. Shoi't carried into effect a wish which he had long indulged, of MEDICAL PWNEELS OF KENTUCKY, 97 retiring from the turmoil which seems to bfe inseparable from medical schools. These pro- fessors were all meji experienced, learned, and widely known. Dr. Caldwell was for many years one of the chief ornaments of Transyl- vfinia University, and by his energy and in- dustry, his great learning, and his eloquence, had contributed a full share to its rapid rise and wide x^opularity. lie was far more active- ly concerned than any of his colleagues in pro- curing from the city of Louisville the noble would have taken a high rank in any medical school. Dr. Short ditfered in the character of his mind frojn both of his distinguished col- leagues, but possessed qualities which render- ed him a most valuable officer. His high sci- entific attainments, the soundness of his judg- ment, his dignity and urbanity of manners, his amiable temper, and blameless life, added character and weight to the institution. These eminent teachers were succeeded by Dr. Blisha Bartlett, Dr. Lewis Rogers, and Dr. DOCTOR SAMUEL M. BEMISS. 1821-1884 A teacher in the University of Louisville in early life, and second State Registrar of Vital Statistics in Kentucky. Was a leader in the profession of New Orleans, both as a teacher and practitioner, and a member of the National Board of Health after leaving Louisville. endowment of the Medical Institute, aucl his reputation for learning and originality had been of the greatest sei-vice to the institution in its earlier years. Dr. Drake was at the height of his popularity, and in the full ma- ,turity of his intellect. As a lecturer or writer, he had made himself known to every educated American physician. With an unfailing zeal in his profession, untiring industry, a mind singularly active, vigorous, and comprehens- ive, and an elegance which never failed to ex- cite and gratify the interest of his pupils, he Benjamin Silliman, Jr., the latter in the chair of Chemistry, the Board of Trustees having done me the honor to assign to me the department of Physiology and Pathological x\natomy. The influence of so extensive a revolution was feared by some, but the sequel proved that the institution had become suf- ficiently established in the confidence of the public to bear the change without loss. The number of the succeeding class was 376, a gain of more than forty upon the one of the KENTUCKY MEDICAL JOURNAL. previous year, and the largest tout one ever attracted to the University. The prospects of the school were never brighter than tliey appeared to be at the close of that session. There was not a speck to be (li'scried npon its horizon in any direction. Its ]'"aculty was united and harmonious; its pu- pils had retired to their homes in the most fa- vorable temper ; it had been now for several versity of NeM' York. Dr. Drake was recalled by the Board to the professorship which he had formerly held, and Dr. Gross was succeed- ed by Dr. Paul F. Eve, of the Georgia Medical College, at A ugusta. The number of students the session ensuing was 2S2. At the close of his first eouree of lectures in New York, Dr. Gross returned to Louisville, and Dr. Eve resigned the chair of Surgery K .>" ' ' / ■ ^- ^ t -< ,,. .^^m-^ ^^m^A mmm^ ^^^B^^^^f^ HBHB ^>a^- 'i^^l ^Hf^,. .!^^l ■!^' I^H ■ - -fi^fl^^H ^^^fj -^^^^^^^^^^ ^^^^^^^^^v DOCTOR TOBIAS GIBSON RICHARDSON. 1827-1892 Teacher, Author, Surg-eon. One of the Founders of the Ken- tucky State Medical Society. O Medical Association. The late Orleans. e time President of the American years of his life spent in New \-ears far in advance of all the western schools; all the omens were auspicious. But b.''fore the opening of another collegiate year, ihc Trustees were called upon to till two va- cancies in the faculty. Dr. Bartlctt and Dr. Gross, late in the summer of 1850, resigned their places, and accepted chairs in the Uni- in his favor. Dr. Gross was re-elected in 1S51, and Dr. Eve, who had generously re- linquished a place to which he felt that his friend had stronger claims, was inv-ited to a chair in the medical school about to be organ- ized at Nashville. The number of the class, as you are aware, was 262. MEDICAL PIONEERS OF KENTUCKY, HENRY MILLER, M. D. By H. M. GrOODM-AN, M. D., Louisville. Henry Miller was born in Glasgow, Ken- tuckj', November 1, 1800. His father, who was one of the first three settlers of Glasgow, was a native of Maryland. After having re- reived a good common school education, at the age of seventeeii; he entered upon the studv of medicine, in the office of Drs. Bainbridge and. Gist, in his native town, where he remain- ed two years. He then entered the Medical School of Transvlvania Universitv, in Lex tule, the first school of ^Medicine founded in that city. The faculty with which the institu- tion started was one of distinction, comprising Drs, Charles Caldwell. John Esten Cooke, Lunsford P. Yandell, M'ho had been memihers of the Transylvania Medical School, and Drs. Cobb and Flint. Tiie list -v^-as completed b> the appointment of Dr. Henry Miller to the chair of Obstetrics. The school was, in 1846, merged into the L^niversity of Louisville, Dr, i'iller retaining his professorship until 1858. Having served continuously for twenty-three years and feeling the need of a change, he, DOCTOR HENRY MILLER 1800--1874 ington, where he graduated in 1821. Such was his proficiency that he was at^ once ap- pointed demonstrator of anatomy, in which position he laid the foundation of the high reputation he achieved later. Subsequently, he attended a course of lectures in Phila- delphia and, upon his return to Kentucky, be- gan the practice of medicine in Glasgow. In 1.S27. he moved to Harrodsburg, Kentucky, and practiced his profession with success un- til 1835, when he was called to Louisville to aid in the organization of the Medical Insti- in that year, resigned his chair and devoted himself to his private practice. In this, his great skill and thorough knoM'ledge of his pro- fession gave him a large patronage and he soon became a favorite family physician. In 1367, he was recalled to the institution, and was for two years, professor of medical and surgical diseases of women, when he again re- signed. Subsequently, he accepted a similar chair in the Louisville Medical College, hold- ing it at the time of his death, which occurred Februarv 18, 1874. 100 KENTVCKY MEDICAL JOURNAL. Dr. ^filler was an extensivo writer upon medical topics and, in addition to many mono- graphs on various subjects, was the author of two standard medical works. The first, en- titled, "Theoretical and Practical Treatise on Human Parturition." was published in IS-lf). and the second. "Principles and Practice of Obstetrics," several years later. The latter liecame the to.xt book in most of the schools of 1he day, and still ranks among the very firet in this day medical literature, as a standard authority, especially the chapters relating to the ^Meclianism of Labor, which have been Init slightly changed since he first published hi:? views. He enjoyed to an luiusual degree the satisfaction of being recognized and appreci- ated in his lifetime, instead of looking for- ward to posthumous fame. P>y both the medi- cal fraternity and the lait\'. he was esteemed, honored and beloved. In addition to his mem- bership in many local and state societies, ht was a member of the American ^ledical Asso- ciation, and its president in 1859. In religious association, he was a Presbyterian. His style was particularly terse and lucid, his judff iiieiit admirable, his success eminent. It is not too much to sa^- that there is not a li^^ng I'Lipil, of the thousands who listened to his lec- tures on uterine hemorrhage, who cau not vividly recall the picture, when he said with characteristic earnestness, "the Hand, — the IlaJid, — Gentlemen." His wife, to whom he was married June 24, 1S24. was Miss Clarrissa TJobinson, daughter of "William and Clarrissa Robinson of an old Virginia family. Of the children born to them six attained mati^rity. Dr. "Wm. E. ^filler. George ^liller. Dr. Edward Miller, ]\Iar\ I\Iiller, Henrietta Miller, and Caroline D. Sniler. wife of Dr. John Goodman of Louis- ville. DR. THEODORE S. BELL. By Hexrv a. Cottell. A.^L, M.D. Louisville. Theodore Stout Bell, philanthropist, phy- sician, teacher, writer and philosopher was born in Lexington, Kentucky, in 1807. He was of humble parentage and, losing his father in childhood, was put to work for the support of his widowed mother. He began life as a newsboy and later learned the tailor- ing trade. His love of learning soon asserted itself, and in spite of unfavorable surround- ings he made r ■al advancement in the aecpii- sition of knowledge. The words of Edward Holmes, spoken of a famous okl-world musical genius, appropi'iately apply to Bell: "Such a career is hardly to be conceived unsupported by the consciousness of a great destiny, and its secret sustainings from within." Indeed, the only evidence of vanity be ever displayed was in the exhibition of the needle with which he supported himself and mother while he wa.s acij airing the rudiments of his education. He was ably assisted in his studies by Mr. James Logue, a learned teacher of Lexington, who ^nthout pay devoted his after school hours to teaching this boy, whose talents gave promise of a brilliant future. Later Bell studied with the gi'cat surgeon. Dudley, who found ^or him a way to enter the Transyl- \ Muia Scliool of ^ledicine. from which he grad- uated in the year 1832. and soon thereafter came to Louisville, where for .52 years he lived and labored for the fame of medicine and the glory of liumanit\'. Though no politician there was no public measure for good that did not enlist his sympath^^ and support. Notably in this line was his effort to bring the Transyl- vania L'niversity to Louisville. This failijig, he was largely instrumental in the creation of the Louisville IMedica] Institute, which called Caldwell, Yand*^!! and Cooke to Louisville, and out of which grew the University of Louisville. He Avrote volumijiously in be- half of the development of his City, and in favor of public improvements. He was editorially connected with the Lou- isvile Joiirnnl and was the family physician of its great editor. Georffe D. Prentice. In 1838. with Dr. L. P. Tandell. Sr., he founded the Ltiidsinile Ifrdiml Jouriwl and later, in 18-10- 41. with Yandell and Dr. Henry IMiller, estab- lished the 'Wrtiifirn Journal of Mrdicine and Siirgery. In 1857 he was made professor of the Sci- ence and Art of ^ledieine and Public Hygiene in the Fnivei'sity of Louisville, a position which he held until his death. In 1833 he married Susanne Hewitt, a sister of one of Louisville's most famous physicians Dr. R. C. Hewitt. To this union was born one child, a son, Carson Hewitt Bell. In 1861 he was made president of the Kentucln- branch of the United States Sanitary Commission. The Kentucky Institute for the Blind, for whose promotion he labored A\'ith fond solicitude, under his influence and wise counsel as ju-esident of its board of visitors, became one of the foremost institutions of its kind in America. Dr. Bell was a man of vast and varied learning, and a writer of peculiar grace and force. His medical writings embrace a wide range of topics but his favorite themes were hygiene and the epidemic diseases. His ca- reer antedated the bacteriological era. It is true that the Bacillus .\utbraeis had been seen in the blood of infected animals by Pollender in 1849 and by Davaine in 1850. who. in 1S63, demonstrated its causal relation to Charbon. and that Pasteur in 1879 established its ideu- lity by pui-e culture, and that Koch had dis- covered the bacillus luberculosis in 1882, but Bell did not live to see the era of bacterio- logical medicine, nor did he ever come to a MEDICAL PIONEEJ^S OF KENTUCKY, 101 clear understanding of the causal relation of microbes to anthrax and tuberculosis ; while he scorned the doctrine that epidemic diseases like cholera, yellow fever, the bubonic plague, and malaria, could be caused by anything but his three etiological factors, heat, moisture, and vegetable decomposition, and the state- ment that malaria is caused by a Plasmodium carried by the mosr(uito, would have shocked his nerves beyond recovery. So powerfully, and so plausibl}^ did Dr. Bell urge and seem- ingly demonstrate his eri'oneous theories that liouisville. His memorable "isothermic line" so far as it defined the limits of the great epi- (lejnies, like Mason and Dixon's Line and its supposed limitation of the area of slavery, went into the limbo of the unproved and im- practicable. Dr. Bell was a savage contro- versialist and in his many word battles gener- siWy downed his opponent 'with the scorn of i.Tveelive sarcasm, yet he was gentle and af- fectionate in disposition, loving his friends and not hating his enemies. He was an almost incessant reader, having DOCTOR THEODORE S. BELL 1807--1884 they attracted the attention of medical mag- nates abroad and caused some of his students to go to their death in certain yellow fever, and cholera, epidemics of the South, vainly trusting in his sovereign prophylactics, to- vdt : high sleeping apartments, and quinine ; while many of our citizens lost their lives in tl'.e epidemic of 1878, because of his unequivo- cal contention that yellow fever could not de- velop a single indigenous case, in a place of the latitude, and daily mean temperature, of his tables and even his bed piled M'ith books ^-.'hich he read and studied far into the night, allowing himself only four hours of the twen- ty-four for sleep. Dr. Bell was, in the true sense of the word, a Christian man. No life more fully than his illustrated the teachings of Jesus Christ. He sold all that he had and gave to the poor, and literally took no thought for the morrow, knowing that He who marks the fall of the sparrow and heeds the young raven's cry for J 02 KEMrCKY MKOICAL JOVRXAL. food, would keep his i/ovenant witli liis aged, faithful servant. He died alone and unattended, but this was as he wished to die. At least it was his oft ex- pressed desire that he might fall with the har- ness on. On the day before his death he was. though in vej-y feeble health, attending to his practice, and on the morning when his dea^^ body was found, it was evident from the con diticn of the room that he had passed mue^i of the night at his desk with his books, as was his wont. This seeming austerity of manner argues none in heart. No man had more friends than Dr. Bell; no man loved his friends better than he. or was better loved in return by his friends. His death, although his span of life had measured almost the fuH limit of the Psalmist, carried sorrow to vsry many hearts, and seem to awaken in the whole community the sense of an irreparable loss. Th.ousands thronged to ^dew his body as it lay in state, and his obsequies were those of a patriarch. It is fitting that we close with the eloquent tribute wi-itten by Dr. E. S. Gaillard. who, during his sojourn in Louisville, was editor of the Eichmonrl and Louisville Medical Journal. and a professor in a rival school. He had mort than one tilt with Bell, who had scorned him most unmercifully. Dr. Gaillard 's feet were on the brink of the dark river when he wrote this noble, just and forgiving tribute: De mortnis nil 7iisi bonum: "He deserved well of his generation, and whatever may be the encomiums it sha^l I'en- der, the just will say that he was worthy of (hem all. Even those who were not permitted tf. be the intimates of Dr. Bell must feel sad over the end of such a life; over the lonelv termination of a life so strong, so useful, so worthy, so admirable; this sad, almost mys- terious passing away of a rugged, lonely., strong and genuine man. How like his last days to those of Thomas Carlyle: secluded, sad, yet laborious, independent, \iseful. The last day, the last hours, spent in work: and when the golden bowl was broken- it was, as evei", beside the fountain where it had so often been fillod to ovei-flowiny. Where else should the inental laborer wish to die. if not aniii': the silent companions of his life-work? A lonely, solitary death : Init an eloquent one, for it declares the choice and the character of .'' well-spent life!" D.WH) W. YAXDELL. .AI. I).. L.L. D. A Loving Tribute by His Daughter, IMrs. .\1.\ri.v Y.\ndell Roberts. David Wondel Yandell wa.s born on the 4th day of September, 1826, at Craggy Bluff, his father's country home, si.x miles from ^Nlur- fi'eesboro, Tennessee, a spot whereon was fought one of the bloodiest battles of the Civil ^\^!r. The aucesto]'s of the Yandell 's came froni Eiigland and .settled in South Carolina Whether they were of Captain Christopher Newport's importation or not. we do not know ; but that they were chivalry of the chiv- ;: Irons is weH attested In- the fine intellect, iiiauly beauty, personal courage, and geutle- niuiily bearing of alJ who have held tliis hon- o)-ed name. For two generations, in this country, his family had been distinguished in medicine. His grandfather. Dr. AVilson Y^an- dell. was one of the most noted physicians of liis locality. His father was the eminent Dr. LuTisford Pitts Yandell. of blessed memory, a pioneer of medical education in the West, a professor in Old Transylvania and one of the founders of the ^fedical Department of Vhe T'niTcrsity of Louisville. His mother ^■'a.'-' Susan Jiiliet Wendel. whose father David Wendel. was a substantial ^ler- chant of Murfrecsboro, a man of high stand- i))g and probity. In her were combined all nature's choicest gifts. With uncommon heauts' of form and features were united rart intellectual endowments. To David descended the ancestral gif+s in measure full and over- flowing. In him was the culmination of the genius of the Yandell family. AYheu five yeai'S of age. his family moved to the heart of the bluegrass region. ''Classi;- Lexington." Doubtless it was here that Yan- dell laid the foundation for that fondness for horses, dogs, the hunt and the chase which, were to be the chief sources of his recreation during his long and laborioiis professional career. At the age of eleven, the family mov ed to Tjouisville. where David was placed un- dei' the care of the famous educator. Noble Butler. Later he attended several sessions at Centre College. Danville, where he seems noi to Iiave been a methodical students, for he left the school without a diploma and entered up- on the study of medicine, luider his father's dii-ection. in the Fniversity of Louisville. Ht gi-aduated from this school in 1846. Like Goldsmith, Beethoven, Scott and other great men. he is said not to have beeu a brilliant student. It was even hinted, by enemies, of course, that he sraduated in medicine onh- by "tlie grace of God and the good will of the facr.lty." and iipon the further condition tliai he should go at once to Europe and make up for lost time. Be this as it may. the voung MEDICAL PIONEEBS OF KENTUCKY, 103 fli.dgling in medicine loved science and thirst- ed for kno'.vledg'e ; and these qualities, rein- forced by keen powers of observation, a mar- velonsly retentive memory, a philosophic fac- vlty for digesting and assimilating what he saw, heard and read, enabled him to acquire a finished culture and an erudition in things medical and non-medical of imposing breadth and depth. His sojourn in Europe lasted aljout two yeai's. During this time, which was spent chiefly in London, Dublin and Palis, he studied medicine, learned the this series, Dr. Yandell showed that a saying he was wont to quote in after years was not the maxim of a flippant tongue, but a real working formula, "1 am a man, and think nothing foreign to me which pertains to hu- uuiJiity. ' ' The letters show not only a knowledge of men, their arts and institutions, remarkable ill a young man of twenty, hut a com.mand of language and a finished style seldom seen in one so young. The letters pertaining to his profession were written in !1847, during the DOCTOR DAVID W. YANDELL surgeon of Louisville. President of the A Efreat teacher, editor and orator. Medical Association. Pi'ench language, and acquired much of that knowledge of men, manners and custonifci which made him the wonder of all who knew him in subsequent years. This period is marked by two series of letters. One was on the people and their institutions. It was con- tributed to the Louisville Journal, which was ■edited by George D. Prentice. The other was on Medicine, and was published in the West- ern .Medical Journal, edited by Drs. Drake, L. P. Yande]] and Colescott. In the first of second year of his pilgrimage. They are in the style of a master, full of facts, common sense and philosophic comment. They are classics in medical literature. But the power and perspicacity of his style "grew with his growtli and strengthened 'with his strength," until in later life his forceful diction and power of condensation, clearness and bril- liancy rivaled the classic periods of Sir Thomas Watson, or the glowing sentences of Macauley. 104 KENTUCKY MEDICAL JOURNAL. His Europeau sojourn ended, Yaudell re- turned to Louisville and began in earnest the practice of his profession. Young, brilliant, incisive, with a charming- presence and ad- dress and tine professional equipment, he was soon well upon the way to success. He was appointed demonstrator of anatomy in his Alma Mater, and in this office acquired that intimate knowledge of the human bodj' and that deftness of haiid which in time made him faalc prinrcps in sni'gery. In 1S51, his health gave way and coiupelled him to relinquish, for a time, professional work. Buying a farm near Nashville. Tennessee, he devoted two years to the pursuit of agricultui-e. .Retrieving health in his country retreat, Yandell came back to Louisville and entered upon his professional work with renewed vigor and a most phenomenal success. It was Kt this time that he established "The Stokes Dispensary," and thus became the founder ot a clinical teaching in the West. His practice grew to imposing proportions and he soon made for himself a great name as a teacher of nu-'dicine. He was soon made professor of Clinical Medicine in the University. His work here was destined to be brief. The Civil War was upon the countiy, and the j^oung doctor became a soldier-, casting his lot with the Southern cause. He enlisted at Bowling Green under General Bucknerj but was soon transferred to General Hardee's command, from which he was taken by General Alberi ►Sidney Johnston, who made him medical di- r(3ctor of the department of the West. Dr. "i'andell continued to lill the high office of medical director till the close of tlie war, sei-A'- ing successiveh' on the staffs of Generals Beauregard, Hardee, Joseph E. Jolmstou and Kirby Smith. He was in the battles of Shi- loll, ^lurfreesboro and Chickamauga. He was always a soldier of soldiers, calm and brave in the face of danger, and unflinching to duty. His department was admitted to be one of the best ordered in the service. At the close of the war. Dr. Yandell return- ed to Ijouisville, where he was welcomed alike by Unionists and Confederates. A meeting of Ibe American ^ledical Association was ap- ])ointed to take place in Cincinnati in 1S65. Berweeu the victorious Unionists and the con- quered Confederates, the feeling was intense and bitter, and the gap in friendship, alreadv wide, was widening. Dr. Yandell took the in- itiative in "shaking hands over 'the bloody chasTii," with his nortliern brethren. In ^ noble, peace-making speech, wherein he nomi- nated his great master. Dr. Gross, for the ])residency, he carried the day for harmony, hatred was deposed, and brotherly love en- throned. Thus the medical profession was the first to substitute the white banner of peace for the blood-stained ensign of war. At iliis meeting, Di'. Yandell was elected one of 'he four vice-presidents of the Association. In 1867, Dr. Yandell was elected to the chair of the Science and Practice of ^ledicine in ihe Uiiiversity. In 1869, he was made pro- fessor of Clinical Surgery, a chair which he held till the close of his earthly career. As a teacher of clinical surgery, he probably had no superior in Ihe woi'ld. Tall, Apollo-like in foi'm, graceful, handsome, not selfconsci- ous, Avith flowing chestnut locks, deep brown, pi^jjetrating eyes, a face lined by thought, aiid so muscled as to express every gamut of emotion from smiles and tears to tempest- uous passion, with a rich, sonorous, baritone voice modulated to ^very mood, and with ges- ture, pose and action sjiited to the word, he was an or.-itor of overwhelming power. As a .surgeon. Dr. Yandell was pre-eminent. Ill operating, he cut to the line and to the re- quired depth Avitli geometrical precisjon. His dressings were beautiful, while his treatment of wounds, surgical and accidental, was char- acterized by a scrupulous cleanliness which setraed nothing less than a prophecj^ of the since splendid triumphs of aseptic surgery. His gentleness, tenderness and sympathy in dealing with the sick were proverliial all over tlie wide field of his gi'eat practice. He was a wit and had he been so minded might have entered this field of literature in successfu? rivalry with Douglas Jerrold. Artemus Ward, Josh Billings, 3Iark Twain and their like. He was a royal host. Wlienever a dignitary was to lie entertained !)y the City, Yandell always headed the committee of entertainment. His fame as a conversationalist was co-extensive with the English-speaking profession. In 1870, Dr. Yandell, in conjunctio]i with Dr. Theopilus Parvin, established the .-l»(er- icav. Practitirour, which at once took a com- manding position in medical literature and continued to influence medical opinion for sixteen years, when it was combined with the Medical News. As an editor he was consci- entious and painstaking. H^ was a pungent and witty paragraphist. One of his own sci- entific papers, published in the second volume of the Practitioner, has become classic in med- ical litoT-ature. It is an analysis of 415 cases of tetanus. The work was done with the as- sistance of the late Dr. R. 0. Cowling. The conclusions to which this analysis led have lieen quoted in nearly every gi'eat work in general surgery that has appeared since 1S70. In 1871, Dr. Yandell was elected president of the American ]\IedicaI Association, the high- est honor that can be conferi-ed upon a phy- sician. He presided at the subsequent meet- ing with so much grace, dignity and abilitv that the celebrated Dr. Bowditch. of Boston, j>ublicly expressed the wish that he might be made president of the Association for life. In 1870, Dr. Yandell again visited Europe, MEDICAL PIONEERS OF KENTUCKY. 105 where he wrote another series of sprightly and instructive letters, which were publish- ed in his own journal of that year. His last visit to Europe_ was in 1880. In 1886, he was ]iiade Surgeon-Ueneral of the State Guard. In 1889, he was elected President of the American Snrgieal Association. His address as retiring- president of that body, at its meet- ing in Washington, in ]890, was on Pioneer Surgery in Kentucky. It is exquisitely writ- ten, and recites the great deeds of Brashear, JMcDowell and Dudley. Just about this time he was made a representative of the American Medical Association to the medical societies o!; Europe. He was also a fellow of the Medical Society of London, a member of the Medico- (ihirurgical Society, showing how the Euro- pean profession recognized his position in the medical world. Hunting was his favorite pastime. He had hunted from ]\Iaine to Georgia, from the Yel- lowstone to the Rio Grande, from the Bear- grass to the Sacramento. Among the fellows of his field sports were found celebrities, home and foreign, of every calling and rank, from common life to royalty. Dr. Yandell was a good fighter and a fair hater. He could give and take hard blows, but he loved with a great heart and with a con- stancy that knc'W" no change. His reverent re- gard for his great master, Dr. Gross, attests this truth. This love began when Gross was a Professor in the University, young, inex- perienced, unknown to fame, and when Yan- dell was his student and assistant. The love was returned by the master in good measure, and when the master died. Dr. Yandell crys tfdiized his m'^mory in an epitaph, engraved on the tomb of Dr. Gross, which will live among epitaphs so long as our language shall last. Dr. Gross and Dr. Yandell. master and pu- pil, "were lovely and pleasant in their lives," and let us hope that in death they are not dv vided; for of them it may be said with equal truth as of Saul and Jonathan, "they were swifter 1 han eagles ; they were stronger than lions." It was now the beginning of the last decade of the centurj', and Dr. Yandell was an old raan. Though erect in body and sage and elo- cpient in conversation, he felt, and those who loved him could see, that the fiery splendor of his wonderful soul must ere long "fall into abatement and low price." He seldom went out after night, was less attentive to practice, had less confidence in operating and wrote but little. He continued, however, to find solace in his books, boiwer, or fireside, and leaned more upon the bosom of his trusted household, where loving hearts and willing hands were ever ready to antici- ]3ate his every behest, to lighten the burden of accumulating years, and make smooth and beautiful the sunset of his devoted life. He died on the second of May, 1898, at his home, which had been his own and his father's, since 1848. EARLY HISTORY OF OVARIOTOMY IN LOUISVILLE.* By Davjd W. Yandell, M. D. It may be remembered by some members now present that in a, paper entitled an "Ab stract of Six Cases of Ovariotomy," which I had the honor of reading at the last annual meeting of the Society, I included a case where the operation was incomplete, by rea- son of the adhesio2is making it impossible to remove the cyst. I will not repeat here what i said then, but will take up the ease where I left it at that time. The tiunor continued to refill, and discharg- ed great quantities of purulent fiuid. Almost every known antiseptic and astringent inject- ion was employed, but without avail. A large (h'ainage-tnbe constantly worn became indis- pensable; frequent cleansing of the cyst was equally so. The patient, however, regained her health, and went to her home, in Illinois, iu the summer. She has continued in good gejieral health since, though unable to give up the drainage-tube until a few months ago, Vvhen it came out; and being unable to re-in- troduce it, she has since gone without it, while the cyst had not appreciably refilled. I hardly dare hope, however, that the cure will be permanent. I have performed ovariotomy but three times since I had the honor to be appointed a special committee on that subject. One of these, performed on a lady aged sixty from Ijexington, Ky, and kindly sent to me by the late lamented Prof. Bush and Dr. Skillman, was successful, the patient returning home in six weeks after having a tumor removed which with its contents weighed one hundred and fourteen pounds. The second and third cases terminated very differently. The second case was placed in my care by Dr. Durrett, a medical friend liv- ing near Louisville. The patient was an un- married lady, aged nineteen, of excellent con- stitution and health, from Anderson County, Kentucky. The tumor had been first noticed about two years before, had grown very slow- ly until a few months prior to its removal, and had been unattended by any severe at- tacks of abdominal pain, or until recently by appreciable constitutional disturbance. The abdomen was opened by the long incision ; the contents of the tumor, which consisted of a straw-colored albuminous fluid, were drawn otT, and the cysts removed with greater ease *Read before the State Medical Society at Henderson in 1875. •('6 KEXTUCKY MEDICAL JOll.'XAL. iIkiu 1 hail I'ver met with in auy f)revious operation. Tliere wi^re no adhesions. It was not necessary to carry even a finger into the t.ixloniinal cavity. The tujnor was composed ot" one large and several smaller cysts, and weighed along with its contents about twenty pounds. On the second day after the opera- lion peritonitis set in, and in two more days proved fatal. The Third ease was sent to me from ilissis- sippi, and was in the person of a married wo- man, aged fifty, a mother, who had noticed aji abdominal growth for some years before applying to me. It had been tapped many times, and large quantities of fluid had been lemoved. For many montlis before I saw her the tappings were required to be made in the epigastric region : for if made below that lo- cality, the amount of fiuid which flowed away was loo small to give any relief to the abdom- iiial tension and dys^onoea, both of which at •iines were extreme. The lady was full of cour- age and of hope, with tirst-rate appetite and very fair general health. An incision through the abdominal walls revealed a multiloeular tumor, which was so generally and firmly ad- herent that no amount of such skill as I pos- sessed enabled me to detach it sufficiently to allow of the introduction of even the half of ray hand. The tumor Avas tapped, but only a small amount of .ielly-like fluid escaped, the gentlemen present all concurring that the op- eration could not be completed, the wound was cai-efully closed in the usual way. The patient experienced but little shock : but when riade aware of the failure to remove the tu- mor she expressed extreme disappointment, soon became greatly depressed, and abandon- ed all hope, if not also all desire, of recovery. She died of peritonitis on the fourth day. j'rof. Cowling, Dr. T\oberts and myself were occupied for more than an hour after hev death in removing the tumor, which, originat- ing in the left ovary, was attached literally to everything in the abdominal cavity except the stomach. On examination it proved to be a mixed tumor — partly colloid, partly almost solid. These three cases, with the six previously reported, give me a total of nine eases, with five recoveries. In order to add to the interest of a repoi-f which, if it embraced an account only of my own work in this field within a twelvemonth, would be but a poor i-eturu for -the honor done me by the sooiet.v, I have endeavored to gather a brief history of the operation of ovariotomy as it has been done in the city of Louis^'ille and the county of Jefferson. If 1 accomplish no other resiilt by this undertak- ing. 1 shall at least lighten the laboi's of my successors in this field, by furnishing them in an accessible form with the statistics of tie operation in this locality up to this date. The first ovariotomy performed in the c" of Louisville was in 1848, and was done by the late Prof. Henry Jliller: the second was in ISIO, by Prof. Gross; the third was in the Sfuue year, by Prof. Bayless. Dr. ililler die! his second operation in 1859, his third in 1S60, and all these were successful. Between the latter period and 1868, he operated on thre-^ orher cases, all of which terminated fatally. Prof. ]\liddletou C4oldsmith did ovai-iotomy once in this city while residing here, but in what year I have been unable to ascertain. The result I leai-n. however, was unfortunate. The late Prof. Bayless operated five times in ibis city with a fatal result in every case. Dr. ^IcLean, then professor of surgery in the Kentucky School of Medicine, and an opera- toi' of undoubted skill, operated in 1869. The patient, who was a young unmarried woman, resided in Louisville. Prof. ileLean made ilv sho2-t incision, and removed a unilocular tumor, which was without adhesions. Death occurred in a few hours from shock. Dr. Garvin has given me the following ac- count of his first and only case. Patient un- married, aged thirty years, healthy; tumor first observed two years before operation, which was done in 1869 : long incision ; ex- tensive adhesions; tumor multilocular ; pedicle long, secured by ligature. Death in nine hours from shock. Througli the kindness of Dr. Thos. J. Grif- fiths I have the following bi"ief outlines of a case occurring in his practice and operated ou in 1S72 by Dr. W. H. Newman, formerly of this eit.v. Patient aged forty-four years, nuirried ; observed tumor four years before : had been tapped three times: long incision: no adhesions: tumor imilocidar: pedicle secured by ligature; extra-peritoneal. Dr. X., being of the opinion that the fatality which had at- tended ovariotomy in Louisville might per- haps be dne in some degree to the nausea ^\■hiel^ so often follows chloroform narcosis, operated without an anesthetic. His patient died two days after of exhaustion. 3Iy friend Dr. E. 0. Bro\\-n has had one case of ovariotomy in his practice, the opera- lion, at his request, ha'vang been performed by Professor J. M, Keller in November, 1873. The patient was married and aged thirty-five years. The tumor was multilocular; long in- cision; ligature: extra-peritoneal. The pa- tient died in about thirty hours. Prof. Cowling has operated twice, both cases proving fatal. Prof. Ireland has oper- ated once. The subject was forty-three years old, married; had noticed the tumor for sev- eral years. On one occasion, one or more of the cysts had burst, the fluid escaping into the peritoneal ca\-ity with evident diiiiinu lion in the size of the tumor. She had at tliis time rigors, sinking, extreme abdominal pain, and other symptoms of peritonitis. Some MEDICAL PIONEEL'S OF KENTUCKY, 107 months after tlus she was tapped and the fluid in the peritoneum withdrawn. Ninety days subsequent to the tapping the tumor was removed through the ■ long incision and the pedicle tied externally. There were extensive adhesions. The patient recovered well from the chloroform, and for four hours was com- fortable. She then vomited and experienced a gush of fluid from the wound. This she mistook for blood, and was seized with the ap- prehension of sadden dissolution. Although assured that no hemorrhage had taken place, she grew cold, the pulse sank, and in spite of well-directed treatment she expired within twenty hours. The cyst contained a bunch of hair as large as the fist, and several well- formed teeth, the roots of which were imbed- ded in the cyst walls. Prof. A. B. Cook operated on the following case in 1871 : Mrs. — , age thirty years, the mother of three children, the youngest eight- teen months old, had observed an abdominal tumor six months before. One of the cysts was emptied by the aspirator of six qi^arts of pur- ulent fluid. A month later a multilocular tumor was removed by the long incision. There were very firm adhesions, embracing a large portion of the parietal peritoneum, the ascending and descending colon, and portions of the small intestines. The jjedicle was short, ^\-as secured by ligature and dropped back in- to the abdomen, the ends of the ligature being brought out at lower angle of wound. Death ensued in seventy-two hours from shock, rhe autops}^ revealed that the abdominal wound had united h.y first intention. Those IJortions of the peritoneum and intestines which had been adlierent to the tumor were glued together by plastic fibrin ; the pedicle was well glazed. There were no evidences anywhere of undue inflammatory action, and but a few spoonfuls of s'erum in tlie pelvic cavity. Dr. W. L. Atlee operated in 1872 in this city on a middle-aged, unmarried lady, remov- ing a unilocular unadherent tumor by the small incision. The patient died in about seven- ty hours from exhaustion. Dr. Dunlap, of Ohio, removed some time during the war an ovarian tumor in this city with a successful result. It will thus ))e seen that ovariotomy has bcer.v done in Louisville and -Jefferson County tliirty-six times, resulting m nine recoveries and twenty-seven deaths. IV. THE GENERAL KENTUCKY GROUP FOREWORD The arrangenieiit adopted for this group, as is true to an extent of all of the others, in- volves an unavoidable anachronism. In fact, iiut for the convenience of the reader, and a natural tendency of writers and speakers to comijlieate the simplest subjects by attempts at division and classification, all of the biog- raphies and papers contained in this volume might "well have been placed in this one gen- I'l'al group. Besides, broadly considered, there was much in common in both the origin and accomplish- riiejits of these remarkable men. Nearly all of tliera sprang from what is distinctly known in this part of the Union as the cavalier class. 'L'he office of the preceptor, rather than the medical school, as it is to-day, was then the portal to the profession, and onlj' those were adiuitted to the study of medicine M'ho either came of good families and had ability, or who themselves had exceptional ability and char- acter : which always presuj^posed a far higher education than was required for entrance to the medical schools during and for a long period after the civil war. Admitted to the study of medicine after such tests, the train- ing was far more thorough and practical than that of the comjnercial medical schools of thL' after the war regime. Such a student hand- led, compounded, often gathered, the drugs, and, incidentally, was something of a botanist and nature student, and he Avas mercilessly drilled in anatomy, physiology and the other fiuidamenlal branches, and difficult obstetrical operations and other practice, and scarcely less important, was a constant observer, often look a modes^^ part in the simple and natural, but highly aft'able, social methods which ob- tained in the conduct of practice in that day. bolh in Ihe office of {he physician and in fhe liomes of his patrons. After an extended ap- prenticeship of this practical kind, all who could do so attended one or more sessions at one of the two or three Jiigh grade medical schools of this country, while a fortunate few,- like Brashear, McDowell. Dudley and Brown availed themselves of the best foreign schools and travel before considering their education complete. With such an origin, advantages and at- tainments, the i^hysician then was a self-re- specting and higlily respected man, somewhat opinionated and dogmatic it may be, Init, none the less on that account, recognized as one of the leaders of thought and of public affairs in his community. In the days of slavery in Ken- tucky there was little or no charity practicf' for him to do. except for a few worthy widows aiid clergymen, upon whom he considered it a jn'ivilege to attend. In striking contrast with the present day experience with the colored race, it was a common saying then "that a ne- gro riding up to a doctor's office on a mule to call him to visit a patient, white or black, on any plantation, was the equivalent to him of two guarantees, the darky and his mount, that he would be paid for his .services;" and, all tilings considered, he was paid far better fees than his successor of this da.'S'. As a result of these conditions a few years of practice usu- ally .suffi.ced to make him financiallj^ independ- ent : he rode the finest and best caparisoned liorses, had the choicest man-serAant to care for his clothes and person, and his home, one of the best of the comnuiuity, was usually a centre of culture and refinement. And this fhiancial independence, as it is to-day, was as important to the community as to himself, be- cause it made it possible for him to have the kind of library and instrumental equipment which fitted him to meet any emergency with '.vhich he was confronted in his life-saving A\'ork, as these biographies show that he did with great intelligence and courage. And, using this much abused term in its broadest and best sense, these were highly educated men. Herbert Spencer argiies with indisputable power and logic that, "To pre ])are us for complete living — how to use all our faculties to the greatest advantage of our- selves and others — is the function which edu- cation has to discharge ; and the only ration- al mode of judging of any educational course is, to jitdge in what degi-ee it discharges such function." That is, to use the words of the blaster, the last and best of all authorities, "By their fruits shall ye know them." ^Measured by these standards, fixed by the highest authorities on education and its uses, or by any other, as relates to our profession, wliich has regard for utility and humanity how do these Kentucky pioneers compare with the erudite medical savants of all the ages which pi'eeeded them. "Look on this pic- ture and then on that." From the founding of the first Eui'opean medical school at the MEDICAL PIONEERS OF KENTUCKY, 109 University of Salerno in the twelfth century, not only to the day McDowell saw Mrs. Craw- ford in what fl'as then the wilds of Green County, in 1790, but until almost a generation afterwards when scholarly incredulity as to the work of this master mind in this western wilderness was overcome, countless thousands of women A^-ith ovai'ian tumors must have come under the observation of the university- bred scholars of Rome, Vienna, Paris, Lon- don, Edinburgh, and the other great medical centres, and gone on to their miserable deaths without so much as an effective suggestion, even for the mitigation of these conditions, and, mth a proper modification of expression, the same may be said in a degree of the work of Dudley. Brashear. Bradford and others. How did these forbears of ours, these pio- neers, succeed where through cou]itless ages, all others had failed? Why did they, Hke (.'olumbus, embark o'er a trackless ocean to discover new worlds in medicine and surgery, and why, like him, did they scorn derision and incredulity until they had not only discovered these worlds, but had established the verity and value of their discoveries? What was the real basis of their courag'e and success? In a word, what was there in them not found in other members of our profession of all the ages who had preceded them? Was there some- thing superior in the fiber of their more re- mote ancestors, mothers as well as fathers. who courageously emigrated to this new world ; or still more, was such fiber or ciual- ities developed and intensified in their par- ents who faced the denizens of the untrodden forests, savage and beast, on their way to, and about their settlements in Kentucky, or by their birth and growth amidst such surround- ings and dangers? Did they gain such mental momentum and grasp in overcoming difficult- ies encountered in laborious self -education that it carried them over or through the ob- stacles which stood in the way of their discov- eries? Or was there something in the Siluri- an or Devonian rocks and measures they trod, or in the water or food impregnated by them, which built upon the ancestry referred to and developed a still higher Iraman product, as seems to be shown in the lives of Clay, Critten- den, Breckinridge and other of our great leaders in public affairs, and in horses and otlier high bred animals in Kentucky. Or, as seems more probable, was it a fortunate com- bination of all these ancestries, surroundings and influences, which lu'ought such boons to suffering humanity, and such an inheritance to us ? Humanity is receiving its full measure of the benefits, and it behooves us to so order our lives, and professional accomplishments that we shall prove worthy to build and im- prove upon this inheritance. J, N. JMcCoRirACK ^!^ no KENTUCKY MEDICAL -Jor'h'NAL. THE BIRTH OF THE KENTUCKY STATE ilEDiCAT SOCIETY.* IVnNrTTES OF ORGANIZATION CONVENTION PRE- CEDING FIRST ANNUAL MEETING. At a eonveution of the Physicians of Ken- tucky, held in the Senate Chamber at I'rank- lortron the 1st day of October, 1851, 10 o'- clock A. M., Dr. W. Ij. Sutton, of Georgetown, was called to the chair, and Drs. E. H. Wat- son and J. ^r. ilills, of Frankfort, appointed Secretaries. On motion, a committee, consisting of Drs. D. Thompson, R. -J. Breckinridge, Jr., N. B. Anderson and J. B. Flint, of Louisville: E. D. Force, -Jefferson County; J. Dudley and J. P. Letcher, Nicholasville ; W. L. Sutton, ]]enry Craig, and John D. Winston, George- town; C. H. Spillman, Harrodsburg; W. R. Evans, jMercer County; A. Evans, Covington; W. R. Chew. Midway; George B. Harrison, Fayette County; W." S. Chipley and D. J. Avers, Lexington; W. C. Sneed, H. Rodman, C." C. Phythian, E. H. Watson, Ben [Monroe, Jr., J. i\L IVIills, Joseph G. Roberts .and Ben ^ensleJ^ Frankfort ; L. Y. Hodges, Franklin County; E. H. Black and James R. Adams, DOCTOR WILLIAM L. SUTTON 1797- -1861 One of the leading spirits in oreranizing: the State Medical Society, and its first President. It was due to his influence mainly that the first lavv was passed requiring the registration of births and deaths, and he was the first State Regis- trar of vital Statistics and published valuable reports for a number of years. Chipley, Evans, and Breckinridge, was ap- jjointed to ascertain the names and localities of the physicians present, who reported the t'ollon-iiig: Drs. S. D. Gross. Henrv [Miller, W. H. .Mil- ler. David W. Yandell. T. G. Richardson, D. Reprint fron 1853. the Medical News and Lihrat-y, .Tanuary Scott Countv: Joshua Gore, Nelson Countv; D. L. Slaughter and R. W. Glass, Shelb\-A'ille ; L. G. Ray and Edward Ingles. Paris, and E. C. Drane, Henry County. Dr. Flint offered the following resolution: Resolved, That be a committee 1 f, report to this Convention a suitable adcLress to the profession of tlie State, calling upon MEDICAL PIONEEJiS OF KENTUCKY, 111 them to assemble at such time and place as this meeting may advise, for the purpose of organizing" :\ permanent State Medical So- ciety; and that, in the meantime, we take steps at once to connect tlie profession of our State with the national organization, by ap- j-.ointing delegates to attend the next annual meeting of the American Medical Association. Dr. Breckinridge offered the following as a substitute for the resolution of Dr. Flint. Strike out all after the word resolved, and insert the follo\^^ng: That a committee be appointed to report the order of business for the convention now assembled. The original resolution and substitute were |ioth laid on the table, and a committee con- sisting of Drs. Chipley, Spillman and A. Ev- il ds, Dudley a]id Sneed, was appointed to draft a constitution for the formation of a State Medical Society. The Convention ad- .journed until half past 2 o'clock. Half Past 2 'Clock P. M. The Convention was called to order by the I'resident. Dr. Chipley, from the committee appointed to draft a constitution, presented the following report, which, on motion of Dr. Gfoss, was received.* 1'he reported constitution was taken up, etich article separately considered, and, after slight amendments, was adopted as a whole. On motion of Dr. Gross, a committee, con- sisting of one from each city and county now represented, and entitled to a representative in the State Legislature, was appointed to jiominate officers of the Society for the pres- (•nt year. The following gentlemen were appointed : Dr. Breckinridge, of Louisville : Dr. Foree, of Jefferson; Dr. Letcher, of Jessamine: Dr. Spillman, of Mercer; Dr. Harrison, of Fay- ette; Dr. Roberts of Franklin; Dr. Gore of Nelson; Dr. Slaughter, of Shelby; Dr. Evans, of Kenton ; Dr. Chew, of "Woodford, and Dr. Black, of Scott; who after a short interval, I'oported the names of the following persons as suitable to fill the various offices: For President— Dr. "W. L. Sutton, of Georgetown. For Senior Vice-President — Dr. W. S. Chipley, of Tjexington. For Junior Vice President — Dr. J. Dudley, of Nicholasville. For Beeording Secretary — Dr. W. C. Sneed, Frankfort. For Corresponding Secretary — Dr. R. J. ]'>reekinridge, Jr., of Louisville. For Librarian — Dr. Ben Moore, of Frank- fm-t. The report was received, and the ballot bo- . ing taken on each officer separately, the nomi- *See Coristitution, Page 112. nees of the committee were declared duly elected. Drs. J. M. Mills, E. H. Watson, and W. C. Sneed, of Frankfort, were elected a committee of pn'blication. T'ho Convention then adjourned sine die. and the first annual meeting of the State Medical Society of Kentucky was held, and proceeded to business. W. L, Sutton, President. E. H. Watson. J. M. Mills, Secretaries. PROCEEDINGS OF THE FIRST AN- NUAL MEETING OF THE STATE MEDICAL SOCIETY OF KEN- TUCKY. At the first annual meeting of the State JMed- ica Society of Kentucky, held in the Senate Chamber at Frankfort, on the 1st day of Oc- tober, 1S51, at 5 o'clock, P. M., the President. Dr. W. L. Sutton, took the chair, and called the Society to order. On motion of D^. Ayres, a committee, con- sisting of Drs. Dudley. Yandell. Garrison, Roberts, and Wilson, was appointed to apply to the next m.eeting of the Legislature for a charter for the Society. On motion of Dr. Chipley, the next annual laeeting of the Society as ordered to be held in the city of Louisville, on the tliird Wednes- day in October, 1852. On motion of Dr. Richardson, it was Resolved, That the Code of Medical Ethic? of the .'Vmerican Medical Association be adopted as the Code of this Society. Dr. Chipley presented a form of charter for the Society, which, after some discussion, was v\dth drawn. On motioii of Dr. Breckinridge, a commit- tee, consisting of Drs. Rodman, Anderson, 'J'homson. Ayres, and Spillman, was appoint- erl to draft a set of by-laws. The application of Dr. J. C. Darby, of Lex- ington, was received for membership, and then the Society adjourned until half past 7 'clock. Half Past 7 'Clock. The Society was called to order hy the Presi dent. The application of Dr. Darby was taken up, and he was duly elected a member of the So- ciety. The president announced the appointment of the following gentlemen as Chairmen of the various standing committees, each Chair- ),iian ha.ving the liberty to select two others as associates:! "Up to tho time of the proceedings going to press, the Chairmen of several of the committees had not handed in the names of their associates. J]-. KEXTUCKY JIEDKAL JOVRXAL. Chairman of Committee of Arrangements— Di- Anderso!!: Drs. Breckinridge and W. H. -Miller, Associates. (""hairman of Committee on Improvements ill Practical iledieine — Dr. Force; Drs. Koil- ]iian and Ricliardson, Associates. ( 'hairman of Comjnittee on Improvements in T'harmacy— Dr. ilills; Drs. Crore and Ray> -Vssociai es. C!hairma7i of Committee on Vital Statistics — Dr. Cliipley: Drs. Yandell and Dudley, As- sociates. Cliairman of Committee on Obstetrics — Dr. 11. driller: Drs. Sneed and Letcher, Associ- ates. Chairman of Committee on ^ledical Eth'cs —Dr. A. Evans. Chairman of Committee on Public Hvgiene —Dr. E. C. Drane. Chairman of Committee on Epidemics— Dr. Darby. Chairman of Committee on Improvement in Surgery — Dr. Gross. Chairman of Committee on Indigenous Botany — Di-. Spillman. Chairman of Committee on Finances — Dr. Tliompson. On motion of Dr. Bi-eckinridge, the Presi- dent was appointed Chairman of a committer to memorialize the Legislature upon the sub- .iect of registration of marriages, births, and deaths. The Comn-'ittee on By-Laws was granted until UHXt regular meeting of the Society to report. On motion of Dr. Breckinridge, the Society determined to go into the election of honorary inembers. The vote was reconsidered, and the snb.iect for the present postponed. The Society elected +he following pei*sons as delegates to the ne.xt animal meeting of the American ^ledical Association, viz: Drs. E. 0. Rav, E. D. Force. T. G. Richardson. D. J. Ayei-s, D. S. Slaughter. E. C. Drane, W. H. ."^tiller. IV. R. Evans and Joshua Gore. A series of resolutions were offered by the Pi-esident, Dr. Sutton, which were laid over until the next regular meeting. The Secretary and Treasure)- were requir- ed to give bonds in the sum of two hundred iiollars each, for tlic faithful performance of their respective duties. On motion of Dr. Gross, the Pi-esident was requested to deliver an opening address at the next annual meeting of the Society.' The Society recommended the formation oi County ^ledical Societies. The record of proceedings was read, am) alter sliglit ainenii'd dn what they can to have it compla'd v- ith throiighout the State. On motion of Dr, Bell, an invitation was extended to Dr, Charles Caldwell, to visit the Society during its sittings, and participate in its deliberatiojis. The President. Dr, Sutton, read his annual address, which was received and referretl to the Committee on Pidilication, The Society then adjourned mitil 10 o'clock to-morroiw. SECnXD day's proceedings. The Society met and was called to order by the President, the minutes of yesterday were read and adopted. Dr. Gross moved the appointment of the following committeis, to report at the next annual meeting of the Society, or as soon thereafter as practicable : (1) On 'Medical Biography, or the lives of meritoi'ioiis or distinguished Ph.ysicians and Surgeons of Kentucky. (2^ On ]\Iedical Literature, or the History of the ^lediea] Authorship of Kentucky. (S"! On the Relations between Diseases and peculiar Geological Formations. (4) On the Statistics of Hernia. (5) On the Statistics of Lithotomy and Calculous Diseases. (6^ On the History and -Mode of Manage- ment of Hospitals, Asyhnns, Infirmaries, Pen- itentiaries and Prisons. ^7) On .Suits for ^Malpractice. ('•S) On the Results of Surgical Operations in ^lalignaut Diseases. (!)) On Epiilemie Erysipelas. I'lO) On Epidemic Dj'sentery. (IT) On Typhoid Fever. ('[2) On Placenta Previa. (13) On the Statistics of Remedies in Dis- eases. On motion of Dr. (xross, Dr. Drake, of Cin- cinnati, was invited to take part in the de- lilierations of the Societ}^ Dr. Tliompson. on behalf of the Physicians of Tiouisville, invited the Society to partake of a festal supper at the Louisville Hotel, on to- morrow night. The Society, on motion, proceeded to ballot for officers A number of gentlemen were put in nomination, and after several ballottings, Dr. Chipley. of Lexington, was elected Presi- dent. Dv. Peter moved that a Committee consist- ing of one member from each county repre- sented, and one from the City of Louisville, be appointed to nominate the candidates to fill (he )-emaining offices, which was adopted. Dr. Gross moved that the reports of Stand- ing Committees he m.ade in the order in which they are reported in the proceedings of the first annual meeting. The following committees failed to make tlieir annual i-eports, viz : The Committee on Arrangements, the Com- mittee on Practical IMedicine, the Committee on Improvements in Pharmacy, and the Coni- mittee on Public Hygiene. Dr. Evans, Chairman of the Comvaittee on J-Ithics, read his report, which was received and referred to the Committee on Piiblication. The Soeietv then adjourned to 3 o'clock P. M. evi5n:ng session. The Society met according to adjournment and was called to order by the President. The Nominating Committee made the fol- lowing report: They nominate the following gentlemen to fill the offices attached to their names. For Senior Vice-President, Dr. E. C. Drane, of New Castle ; for Junior- Vice-President, Dr. atJ KEXTUCKT MEDICAL JOJ'RSAL. A. Evans, of Covington ; for Recording Seere- Uwy, Dr. Sncecl, of Frankfort: for Corre- sponding Secretary, Dr. Breckinridge, of Ijouisville: for Librarian, Dr. B. Monroe, of i-'i'ankfort : on Publications, Drs. Bell, Ron- ald and Foree of Louisville: the report was received and Committee discharged. The Society then proceeded to ballot for Senioi'-Vice-President. Dr. Drane having re- ceived a majority of all the votes east, was de- clared duly elected; Dr. Knight, was elected Junior- Yice-President : Dr. Sneed, Recording Secretary: Dr. Breckinridge, Corresponding Secretary ; B. ]\rouroe. Librarian : and Drs. Bell. Foree and Ronald, the Publication Com- mittee. Dr. ^liller, the Chairman of the Committee (in Obstetrics, then read his annual report, Mhicli was received and referred to the Com- mittee on Publication. J)r. Sutton, Chairman of the Committee on Registration, read his annual report, which was received and referred to the Committee on Publication. The Society then adjourned to half-past seven, P. M. 73 ^ o'clock P. M. The Society met according to adjournment, after being called to order by the President, proceeded to the election of members. Dr. Wible offered the following preamble and resolution which was adopted: Whereas. Physicians are frequently called on to give evidence in Courts of justice, to make post-mortem examinations, and institute investigations in cases of poisoning, sei-\T.ces of a strictly professional character, requiring expense, time and labour on the part of the pViysieian ; and. whereas, these services are of- ten of great iranortanee to the welfare of so- ciety, and as physicians ought not to be ex peeted to perform these A^ithout remunera- tioJi. it is ■lhe opinion of the Kentuckv State ^Fedieal Society, that the interests of human ity demand that laws be enacted which will properly secure these services when recjuir- ed by coroners, and other officei-s of the law. Therefore, it is resolved that a committee of three be appointed to prepare a report to be read at the next annual meeting of this So- city, on the subject presented in the forego- ing preamble. Dr. Darby. Chairman of the Committee on Epidemics, read the annual report, which was received and properly referred. This Society, by a vote, decided upon Lex- ington as the place for holding the next an- nual meeting. The Society then adjourned til to morrow morning at 10 o'clock. THIRD day's PROCEEDIXGS. The Society met at 10 o'clock A. 'SI., and AVPs called to order bv the President, Dr. Gross's resolutions, offered yesterday, were brought up and adopted. A set of by-laws was adopted. Dr. Gross, Chairman on Improvements in Surgery, made his annual report, which was ri'oeived and referred to the Committee on Publication. Dr. Spillman, Chairman of the Committee on Improvements in Pharmacy, also reported which report was referred to the same Coni- inittee. Dr. Spillman, in connection with the above r<'i"jort, offered the following resolutions, Avhich Were adopted : Resolved. That this Society regard the cul- tivation of our own botany as essential to a full development of onr professional resources, and to a more successful practice of our art. Resolved, That the profession throughout lhe State, and the members of this Soe!et\' particularly, he requested to give special at- tention to this .subject, and, by cultivating the field of observation and research, in con- nection with the unexplored regions of vege- table nature within our own limits, ascertain to what extent the demand of the healing art can be supplied at home. Resolved, That any physician discovering a new remedy, or a new property in one already known, or any information touching the med ical botany of our State, that can be render- ed practically available, be requested to com- municate such information to the Chairman of the Committee on Indigenous Botany. Resolved, That the Committee on Publica- tion, at as early a date as practicable, by a brief circular or otherwise, communicate the objects embraced in these resolutions to the in-ofession tlu-oughout the State, giving the nni.oe and location of the Chairman of the Committee on Indigenous Botany, and earn- estly requesting contributions. The Pj-esident announced the followiusr Standing Committees: Committee on Arrangements, Dr. Darby, cf Lexington. Committee on Practical ^ledicine. Dr. Foi'ce, of Louisville. Committee on Pharmacy. Dr. Silliman. of LouisAulle. Committee on Vital Statistics. Dr. Sutton, of '.leorgetown. Coiujnittee on Obstetrics, Dr. Powell, of Louisville. I'ommittee on "Medical Ethics. Dr. Hewett, of Louisville. Committee on Public Hygiene. Dr. Bell, of Lo.iisville. Committee on Epidemics. Dr. Bullitt, of Louisville. (Committee on Surgerv, Dr. Flint, of Louis- ville. MEDICAL PIONEEL'S OF KENTUCKY, 117 Coramittee on Indigenous Botany, Dr. Em- uu'tt, of Piko County. Commitlee on Finance, Dr. Letcher, of Jes- samine county, and also the following special coi.imittees: 1. On Medical Biography, or the lives of meritorious or distinguished physicians and surgeons of Kentucky, Dr. Breckinridge, of Louisville. 2. On Medical Literature, or the History, of the Medical J^uthorship of Kentucky, Prof. L. P. Yandell, of Louisville. 3. On the relation between diseases and I>artieular Geological Formations, Dr. Peter, of Lexington. 4. On the Statistics of Hernia, Dr. S. B. Richardson, of Louisville. 5. On the Statistics of Lithotomy and Cal- culous Diseases, Dr. Gross, of Louisville. 5. On the History and Mode of Manage- ment of Hospitals, Dr. Raphael, of Louisville ; of Penitentiaries and Prisons, Dr. W. C. .Sneed. of Frankfort. 7. On Suits for :\ral-Practice, Dr. Spill- man, of Harrodsburg. ■S. On the Results of Surgical Operations in Malignant Diseases, Dr. Colescott, of Lou- isville. 9. On Epidemic Erysipelas, Dr. Owens, of Henry Coiiuty. 10. On Epidemic Dysentery, Dr. Pry, of Louisville. 12. On Placenta Previa, Dr. ]\Tiller, of Louisville. 13. On the Statistics of Remedies in Dis ease. Dr. Lewis Rogers, of Louisville. Dr. Sutton offered the following resolution, which was adopted, and the same, with Dr. Wibel's resolution of .yesterday, were referred to a special committee. Dr. ^yibel, Chairman, with the privilege of adding such other mem- bers as he may wish : Resolved, That a committee be appointed to consider whether any, and if any, what lueasures can be brought into requisition to lesson the heavy burden of pauper practice, and report at the next annual meeting of this Society. Dr. Thompson, Chairman of Committee on Finance, presented a report. l")r. Bell. Chairman of Committee on Case Book, made a report, which was received and referred to the Committee on Publication. The Society elected the following gentlemen as delegates to the National Medical Society. Dr. "W. S. Chipley, of Lexington ; Dr. Free- man, of Oldham County; Dr. W. C. Sneed, ol Frankfort : Dr. B. J. Raphael, of Louisville ; i:»r. T. J. Moore, of Harrodsburg ; Dr. Wibel, of Ijouisville : Dr. John Hardin, of Louisville, and Dr. Hewett, of Louisville. The Society then went into the election of Honorary iMembers, when the following gen- tlemen were unanimously elected: Dr. D. Drake, of Cincinnati ; Dr. Deadrick, of Ten- nessee, and Dr. Elisha Bartlett, of New York. On motion of Dr. Jacobs, the follo'wing reso- lution was unanimously adopted: Resolved. That the thanks of this Society be tendered the officers for the faithful, aible and impartial manner in which the.y have dis- charged their respective duties. And then the Society adjourned. W. S. Chipley, President. "W. G. Sneed. Rec. Secretary. The above is a true copy of an article pub- lished in the number of "The Medical News and Library," January, 1853. S. G. Fulton. ROSTER OF THE MEMBERS OF THE KENTUCKY STATE MEDICAL SOCIETY IN 1856.* Anderson, N. B. Louisville. Abell, S. R., Hardinsburg. Allen, A. S., Winchester. Ayres. D. J., Lexingrton, Allen, John R., Lexington. Annan, S., Lexington. Black, E. H.. Scott County. Breckinridge, R. J., Louisville. Bruce. C. D., Lexington. Bell, T. S., Louisville. Bullitt, H. M.. Louisville. Bartlett, John, Louisville. Brown, E. 0., Brandenburg. Bright, J. W., Louisville. Broadwell, S. E., C.ynthiana. Bradford. J. T., Augusta. Bush, J. il.. Lexington. Beraiss, Samuel M., Louisville. Bryson, CD., Kenton County. Blackburn, C. J., Covington. Barbour. J. H.. Pendleton County. Craig, Henry. Georgetown. Chipley, W. S., Lexington. Chambers, W. M., Covingt.on. Caldwell, "W. B., Louisville. Chenoworth. H., Louisville. Cromwell, W. B., Lexington. Conway, G. W., Yelvington. Cummins, David, Louisville. Colescott. W. H., Louisville. Cochran, P. H., Louisville. Chinn, J. G., Lexington. Craig, J., Stanford. Curran, , Kenton Count3^ Dudley, J., Nicholasville. Darby. John C, Lexington. Durritt, R., Louisville. Drane. J. S., New Castle. Dunhoff, John. Louisville. Dudley, E. L., Lexington. Darnaby, B. M., Fayette County. Duke, J.M., Maysville. Drake, B. P., Lexington. ^?so one of these men liviii.?. n.8 KENTUCKY MEDiCAL JOl'RXAL. Diil.nicy. J. J., Covington. Downard, L., Kenton Connty. ]']vans, Asbury, Covington. Evans, W. R., -Nfercer County. Ewing. T^. E., Louisville. Emmert. J. W., Pikeville. Flint, Joshua T5., Louisville. Foree, E. D., Jefferson County. Freeman, U. L., Ballardsville. j'>y, (/. H., United States Army. Forsj'th, H., Louisville. Foster. J. 0. A., Newport. Poss, S. A..' Jefferson County. Gross, Samuel D., Louis\'ille. Core, Joslma, Bullitt County. Gtrant, E. L.. Pendleton County. Gazley, L. E., Henry County. GiveiLS, H. L., Oldham County. Harrison, (xeorgo B., Fayette County. Hodges. Tj. Y., Franklin Countv. Hew'itt. P. C. Louisville. Hopson, H., Jefferson Connty. Hunter, S. V.. Hawesville. Hundley W. A., Louisville. Hardin. John, Louisville. Plall, S. N., Louisville. Hynes, B., Bardstown. Hawkins, J. H., Harrison County. Hunt, R. H.. Covington. Holt, W. D., Covington. Hughes, J. N., Louisville. Ingles, Edward, Paris. Jaeohs, W. Tt.. Louisville. Jones. R. ^L, Lexington. Johns. A. H.. Kenton. Jenkins, H. D.. Lexington. Knapp, Jas.. Tjouisville Knight, J. W.. T.ouisville. Kirkpatrick. John, C.vnthiana. Keller, David, Jeffer.son County. Letcher, J. P., Nicholasville, Lyle, C. L., Louisville. Lewis, ., Jefferson Connty. Lee, E. Y., CoAnngton. Long, E. T., Henrv County. Letcher. Samuel, Tjexington. Miller, Henry. Louisville. ]\riller, W. H.. Louisville, Amis, J. Ar„ Frankfort. ^lonroe, Ben,, Frankfort, ^loore. T, J.. Hari-odslnirg. Aletealfe, J. C. Louisville. Aleriwether. H. C, Louisville. Aliller, John T. .Morris, "W.P., Daviess County. Mattingly. C. P.. Bardstown! Afartin. JT. D., Paris. Ala.ior, Fr,. Covington. AleCrearv, J. C„ Simpson County. Montgomery, .W. C'., Lincoln Comity. ArcCauley, W. D., Louisville. Owen, W. T., Louisville. \o on" of the=c Owen, L. F., New Ca.stle. Owen, S. R., Somerset. O'Rilev. Dennis. Louisville. Phythian, C. G., Frankfort. Powell. L., Louisville. P.vles, N. Louisxille. Pirtle, C, Louisville. Peter, Robert, Lexington. Price, J. G., Franklin County. Patterson, A. A., Fayette County. Pilkinton. S. C, Lexington. Pi'itlow, R., Covington, J'ei'riue. H.. Lexiuglon. Poliii, Francis E., Springfield, Powell. W. J., fiercer County. Richardson. T. G., Louisville. Rogers, Lewis, Louisville. Ronnald. G. W., Louisville. I'oss, John 0.. Louisville. Rudd, R. H.. Louisville. Richardson. S. B , Louisville. Rodman. H„ Frankfort. Roberts, J, G., Frankfort, Ray, L. G.. Paris. Raphiel, B. J., Louisville, Riffe, J. M. Winchester. Rankin, Paul, Georgetown. Ray, J. D., Paris. Richardson. Edw'd.. Kenton County. Reddiek, P. L., Newport. Ridley, J, 0„ Louisville. Sntton. W. L.. Georsetowu. Snecd, W. C, Frankfort. Swain, John, Ballardsville. Spillmau, C. H., Harrodsbure. Slauu-hter, D. L., Shelbyville, Sale, T. J,. Louisville, Sliced, John J., Louisrille, Silliman, B., Jr.. Louisville. Smith, Joseph, Danville. Smith, C, Richmond, Smith. W. 0., Colemansville, Saunders, Th., Shelbyville. Singleton, .. Jessamine County. Sloan, W. J,. Newport, Singleton. J. W., Paducah. Shaler. N. B., Newport. Sentenay, W. W., ,Tefferson County. Southg.ate, B. W.," Kenton County! Smith, "W", C„ Harrison County, Sehue, A.. Shelb>Tille, Smith, J. L,, Louisville, Smith, J, F„ Covington, Scott, S, S , Kenton County. Tyler, G. B., Owensboro. Thornbury. P.. Louisville. 'rimm, AFaTideville. Thu.'u, G. W., Louisville. Tinsley, J. J., Louisville. Thom.son, D, D,, Louisville, Trabue, B. F., Glasgow, Tingle, J. Thornton, G. "W.. Newport. Tibbelts, "\Y., Covington. MEDICAL PIONEERS OP KENTUCKY. 119 VVinston, J. D., Georgetown. Watson, E, H., Frankfort. VVhitlev. -J. J., Lexin^'ton. White, 'E. p., JVIoimt Sterling. Wible, B. M., Louisville. Wethorford, E. D,. Louisville. Waj', J. C, Louisville. V¥ise, T. J., Covington. Wise, T. N., Covington. Walton. C. J., Hart County. Vandell, L. P. Sr.. Louisville. Yandell. D. W., Louisville. No oue of these men living. A SELP-EXPLAN.4T0RY COMMUNICA- TION FROM THE PRESIDENT OF THE STATE SOCIETY*. Frantfoi't, Ky., December, 1856. To ike Mcnihera o^ the Kentiickij State Med- ical Society : While acting in the capacity of Secretary for three years, and since my promotion to the office of President of your society, I have re- ceived numerous communications from mem- bers and from phy.sieians not members, who feel some interest in the permanent success of the enterprise, making inquiries as to when the transactions of the several meetings, not published, would be given to the public. To all these inquiries. I have been compelled to give an indefinite and unsatisfactory answer. It is well kno'wn to most of you, that valuable and interesting reports were made at the an- imal sessions held in 1853-54, which have not been published for want of funds to pay the expense of printing them. This has resulted riiainly from a want of promptness on the part of the members in sending up their an- nual assessments, which, had they been for- ■^varded, 'wonld have been amply sufficient to enable the committee on publications, to have had the transactions promptly printed and distributed. The last annual meeting was held during the inclement weather of Febru- ary, and the number present, though respect- able, was not as large as at the fo]-m.er meet- ings. No definite arrangements were made for publishing the transactions of that meet- ing, and the reports were left in my hands to be disiposed of in such way as might seem best. I have, with the advice of some of the mem- (■ers, ventured to have the transactions of thai meeting published, mainly upon my OAvn re- sponsibility. There being a balance in the Treasury belonging to the Society, I have ap- propriated it in part payment, for printing these transactions. The transactions herein published, are cred- itable to the Society, and too valuable to be lost. Those of former meetings to the promo- tion of so laudable a cause. By reference to the list of members appended, it will be seen tliat an annual contribution of $3 each, would be amply sufficient to publish the transactions of each annual meeting, and would furnish each member with a volume, worth more than his assessment. The transactions not publish- ed are, For the Session of 1853 : Annual address by the President, Dr. Chipley. Report on Surgei-y — Prof J. B. Flint, iledieal Biographj' — Dr. L. P. Yandell. Statistic^ of Hernia— Dr. S. B. Richard- son. Epidemic Erysipelas — Dr. L. F. Owens. (^n the relation between Diseases and Par- ticular Ceologica! Formations — Dr. Peter. Vital Statistics— Dr. W. L. Sutton. History of Prisons and Penitentiaries— Dr. W. C. Sneed. On Public Hygiene— Dr. T. S. Bell, aiedical Ethics— Dr. W. S. Cliipley. On Medical Grievances in Courts of Jus- tice— Dr. B. M. Wible. ' TJiose of the Session of 1854, are: The Address of the President — Dr. Gross. On Suits for Malpractice — Dr. C. H. Spillman. On the Use of Tlold Water as a Thera- peutic Agent — Dr. J. C. Darb.y. On the Treatment of Typhoid Fever — Dr. Joseph Smith. These reports would make a large and valu- able volume, tilled with matter not to be had in any other waj'. To publish them, will re- Cfuire onl}' a small sum froni each memher of the Society, and if each one will respond promptly, these valuable reports may be in tlieir hands long before the next annual meet- ing. Hoping that what I have done will meet with your cordial approbation, and that you will respond promptly to my suggestions, and aid me to have all the transactions of the So- ciety published at an early day. I remain yoiirs, &c., W. C. Sneed, President Kentucky State Medical Society. J 20 KEXTUCKT MEDICAL JOVRKAL. XA:\rES AND RESIDENCES OF THE PRESIDENTS AND SECRETARIES, WITH THE PLACES AND DATES OF :\rEETJNGS OF THE STATE MEDICAL SOCIETY OF KENTUCKY, FRO.M 1851 TO 1917\ YEAR NAME ADDRESS PLACE OF MEETING 1S51 President- Seoretary- -William L. Sutron* -AV. C. Sneed,* Georgetown Frankfort Fi-aukfort 1852 Pi-esident- Seeretery- -William L. Sutton.* -W. 0. Sneed,^ l:ieorgeto\vn T'rankfort Louisville 185;} Prpsident- Secrctary- -William S. Chiplev,* -W. G. Sneed,* Lexington Frankfort Lexington lcS54 President^ Secretary- -Samuel D. Gross,* -W. C. Sneed.* liOuis^ille Frankfort Co^-ington 1856 Presidont- Seerelary- -C. H. Spillmau^,* -W. C. Sneed.* Harrodsburg Frankfort Frankfort jS57 President- Soeretarj- -W. C. Sneed.* -Tobias G. Richardson,* Frankfort Louisville LouLS^-ille jcS58 President- Socretaj-y- -W.T. Owen,* -Tobias G. Richardson,* Ivouisville Louisville. Louisville 1850 President- Seerelary- -Joshua B. FUnt,* -Samuel 11. Beniiss.* Louisville 1/ouisviile. Lebanon 1S68 President- Secretary- -D. N. Porter,* -Preston B. Scott,* Eminence LouisA-ille. Danville 1SG9 I'resident- Secretary- -William Pawling.* -Stanhope P. Breckinridsre. Danville, *DauvilIe liexington ISTO President- Seeretary- -Henrv :\I. Skilbnan%* -M. E. Poynter,* Lexington .Midway Bowling Green 1S71 President- Seeretary- -William A. Atchison.* -John D. Jackson.* Bowling Green Danville Co\nngton 1872 Pressident- Seeretai-y- -T. N. Wise.* -William B. Rodman.* C. F. n^ieh^* Covington Frankfort Louisville Louisville 1S73 President- Seeretian- -Lewis Rogei-s,* — ] A. Larribee,* Louisville liouisville Paducah 1874 Presideut- Sccretar>'- -J. AY. Thompson,* -J. A. Larribee,* Paducah Louisville Shelbj^^ille 1S75 President — Jerman Baker,* Secietai-y — -T. A. I.arribee,* Shelbjn-ille Louisville Henderson 1876 President- Ser-rfttarv- -J. A. Hodge,* . -J. W. Singleton,* Henderson Paducah Hopkinsville 1877 Pi'csideijt- Seeretary- -R. W. Gaines,* —James H. Letcher, Hopkinsville Henderson Louisville •Dead. 1. This title was changed to "The Kentucky State Medical Association" in 1903. 2. The mintites of the meeting in 1835 were not published or preserved, and, while the tradition is that regular meet- ings were held from 1859 to 1867, except for two or three years during the Civil War. a diligent search of over a year has failed to find a face of the minutes or about the officers or places and dates of meeting. 3. On account of serious illness. Dr. Skillman could not attend the meeting and the Senior Vice-President, Dr. .\tchi- son, presided and was elected President for the succeeding term. 4. Dr. Rodman did not attend the meeting and Dr. TJirich was elected Secretary pro tempore and served for the entire meeting. MEDICAL PIONEERS OF KENTUCKY, 121 YEAR NAME ADDRESS PLACE OF MEETING 1S78 Presidrnl- Seeretary- -Lunsford P. Yandell, Sv., •John L. Dismnkes^* —James H. Letcher, ,'■'' Louisville Mayfield Henderson Frankfort ISvO President- Secretary- -Charles H. Todd,* —James H. Letcher, Owenshoro Henderson Danville 1.^80 Prcsident- Seeretary- -R. W. Bunlap,* -Arch Dixon, Danville Henderson Lexington ]S31 Pr.-sident- Secretary- -Lyman Heecher Todd,* —Lewis S. McMurtry, Lexington Danville Covington 1S82 President- Secretary- -James W. Holland, -Lewis S. MeMurtry, Louisville Danville Louisville ;:S83 President- Seeretary- - \iicil D Price,* -Lewis S. JMcMurtry, Harrodsburg Danville Louisville 1884 President- Secretary- -J. N. McCormack; -Samuel M. Letcher.* Bowling Green Kichmond Bowling Green 1,884 President- Seoretary- -Pinckney Thompson,* -Samnel M. Letcher,* Henderson Ivichmond Crab Orchard 1886 President- Secretary- -Joseph P, Thomas,* -Steele Bailey, Pemliroke Slanford Winchester 1887 T'resident- Secretary- -William IL Wathen,* -Steele Bailey, Louisville Stanford Paducah 1888 Prosident- Seeretary- -John G. Brooks,* -Steele Bailey, Paducah Stanford Crab Orchard 1889 President- Secretary- -Lewis S. McMurtry, -Steele Bailey, Louisville Stanford Richmond 1890 President- Seeretarj'- -Jolm A. Ouchterlony,* -Steele Bailey, Louisville Stanford Henderson 1891 President- Secretary- -George B-eeler,* -Steele Bailey, Clinton Stanford Lexington 1892 President- Seeretary- -Hawkins Brown.* -Steele Bailej^, Houstonville Stanford Louisville 1893 President- Secretary- -Arch Dixon, -Steele Bailey, Henderson Stanford Frankfort 1894: President- Seeretary- -J. Q. A. Stewart,* -Steele Bailey, P'rankfort Stanford Shelbyville 1895 President- Secretary- -Joseph B. Marvin,* -Steele Bailey, Louisville Slanford Harrodsburg 1896 President- Secretary- -John A. Lewis, -Steele Bailey, Georgetown Stanford Lebanon 1897 President- Secretary- -Kobert C. MeChord, -Steele Bailey, . Ijebanon Stanford Owensboro 1898 President— Secretary- -Joseph M. Mathews, -Steele Bailey, Louisville Stanford JIaysville 1899 President- Secretary- -David Barroiw, -Steele Bailey, Lexington Stanford Louisville 1900 President- Secretary- -William Bailey,* -Steele Bailey, Louisville Stanford Georgetown On account of the death of Dr. Yaudell, the Senior Yicfe-President, In-. DismuVes, succeeded to the Presidenc V22 KKSTUCKY MKDK'AL jOl'l.'XAL. YEAR NAME ADDRESS PLACE OF MEETING 1!H)1 President- Secretary - -Jaraes H. Letcher. -Steele Bailey, Henderson St anf ord Louisville 1W2 President- Seeretary- -T. B. Greenley,* -Steele Bailey, Meadow Lawn S1 an ford Paducah v.nr.i President- Seeretarj''- -William W. Richmond, -Steele Bailey, Clinton Stanford Louisville 1904 President- Secretary- -Steele Bailey. -James B. Bullitt. Stanford liouisville Lexington VM)5 "President^ Secretary- -Frank H. Clarke, -James B. Bullitt, Licxiiigton Louisville Loui-sville 11)06 President- Secretary- -Charles Z. Aud, -James B. Bullitt, (.'eeilian Loui.sville Oweusboro ifioy President- Secretary- -Daniel M. Griffith, -Arthur T. IMeCormaek, ' Oweusboro J^owling Green Louisville :I908 PT-i'sident- Seeretary- -Jo)m C. Cecil,* -Arthur T. MeCormack, Louisville P.owling Creen Winchester 39U9 President- Seeretary- -Isaac A. Shii'ley, -Arthur T. MeCormack, Wiii Chester Bowling Green Louisville 1910 President- Seeretary- -Joseph E. Wells, —Arthur T. MeCormack, (.'ynthiana Bowling Green Lexington 1911 Presideiit- Seeretar}'-- -James CI. Carpenter, —Arthur T. ileCormack, Stanford Bowling Green Paducah 1912 Presideiit- Secretary- -David 0. Hancock,* -Arthur T. MeCormack, Henderson Bowling Green Louisville 1913 President- Secretary- -William 0. Roberts, -Arthur T. MeCormack, Louisville liowling Green Bowling Green l:-)]4 Prcsidont- Secretary- -Ja<.nes W. Ellis,^ John J. iloren, -Arthur T. MeCormack, ilasouville Louisville Bowling Green Newport 1915- Presidcnt- Secretary- -James W. Kincaid, —Arthur T. MeCormack, Catlettsburg Bowling Green Loui.sville 1916 President- Secreta)-y- -Ap. Morgan Vance,-* Milton Board, -Arthur T. MeCormack. Louisville Louisville Bowling Green Hopkinsville 1917 President- Secretary-- -Phillip H. Stewart, -Arthur T. ]\IcCormack, Paducah I'iowling Green Louisville commendation of the Council, Dr. Moren >D(!ad. 1. Dr. Ellis was nnalile to attend tlie meeting, and, upon l.v elected President. ii. Dr. Vance died December 9, 1915, and upon recommendation of the Council Dr. Board was unanimously elected President. MEDICAL PIONEEh'S OF KENTUCKY. 123 FACTS AND REMTNISCBNCBS OF THE ilEDTCAL HISTORY OF KEN- TUCKY.* By Lewis Rogers, M. D., Louisville. Oentlemen of the Society : 1 esteem it a very great honor to be the pre- siding officer of the Kentucky State Medical Society, an association composed of members, past and present, many of whose names arc among the most distinguished of this country. 1 deem myself specially fortunate in being varied observations and study to the common stock. I am sure that I shall not be mistaken ill the expectation that this meeting in Pa- diieah will add greatly to the future useful- ness of the Society by enlisting new and zeal- ous workers who have not heretofore been as- sociated with us. As the time for our annual reunion ap- proached, my mind became someiwhat solicit- ious as to the sub.jeet of this address. What sliall I or what can I write about that had not been presented to ,you in a more attractive form than I felt that it was possible for me For many years ( DOCTOR LEWIS ROGERS 18I2--1875 le of the leading: teachers and practitione and President of the State Society. permitted to enjoy this honor in4he prosper- ons and hospitable metropolis of Western Kentucky. I am pleased with the centrifugal movement which this meeting inaugurates. ITeretofore we have met in the more central parts of the state: hereafter we may indulge the hope that the members from the remote parts will more fully participate in our pro- ceedings, and contribute the result of their state Medical Sn- to present it was naturally a question of much anxiety to me. The subject of medical ■education was "a thrice-told tale." In all of its many important phases as connected with medical .schools and office instruction, h had been discussed over and over again much more ably than I could discuss it. This would not do. And so in regard to the amount and the kind of education which should be requir- ed as preliminary to the study of medicine. This had formed the vexed topic of many an .12^ KEXIUCKY MEDICAL JOl'FiXAL. iuierestijig debate before this body and else- \".Jiere. yauitary science, in all of its wide range, had often been pressed upon your at- Iciition and disposed of as it should be. 1 could add nothing to it. ,\nd so again witli the AnatO)riy Bill, with the law for tne goveru- ineut of apothecaries, and many other mat- ters of equal and even greater monieut. They all have reference to the present or future iuterests of the public and tlae profession, and 1 have felt so sure that they would continue lo eommand the public and professional mind until their beuebcent purposes were aceoinp- lished that 1 could but deem it uuprotitabla to raise my voice in their behalf. The history of medicine in Kentucky, the remarkable record which the profession has made since the very infancy of the state, are topics whic'h may be recalled with just pride and very great plea.sure. I propose to speak of some of these by-gone things as " " Facts and Ixcminiscences of the iledical History of Ken- tuck}^" ^\Iany of the facts are ali-eady fa- railiar to you iu a fragmentary form; it may not be unprofitable or unintei'esting to view them in a group. I\Ij- own reminiseuces maj" be received for what they are worth. \\Tiatever may be the present status of Kentuckj- medicine, and I hold that it is high, the past at least is secure. When Kentucky was to a large extent a wilderness, and not /et wholly free from hostile incursions of tu^ Indians, when the population was so sparse as scarcely to give encouragement to any edu- cational entei"prises except such as were uecc. sary for the simplest branches of learning, the mterests of medicine were not only not neg- lected but received conspicuous regard. Ju 1798 "Transylvania University" ana the '"Kentuck}- Academy" were united under one board of trustees, with the name of "Transylvania University," and in 1799 law and medical departments were added to the academical. Br. Sami;el Brown was appoint- ed the first professor of medicine iu Transyl- vania, and the first in the West. Dr. Francis Kidgeley was appointed a professor in the Inivei-sity shortly after Dr. Brown, and was .iie fii"St to deliver a eoiu-se of medical K tiires in the West. From 1799 to 1817 various a])pointnients wei-e made in the medical de- l)artment. and partial courses of lectures were delivered. During this interval, among tlie locally-distinguished men who were appointed (() professorships, none were more ri^markalile 1ha)i Dr. Joseph Buchanan. He died in Lou- isville in 1S29 : and I call up from the memor- ies of my boyhood, with great distinctness, his slender, flexible form, massive head, and thougthful. intellectual face. He was a man of gi-eat and varied powers of mind. He was a mechanical, medical, and political philoso- plier. His "spiral" steam boiler, the proto- type of the exploding and exploded tubular boiler, and his steam land-carriage, were among tlie wonders of the day. As a piiysici- au, his papers attracted distinguished notice from the medical savants of Uhiladelphia, dieu the great center of medical science, -a-^. a poLiticai writer, he was deemed worthy to discuss, and did discuss with power and effect, the momentous problems of special and gen- eral political economy agitating the country at the stirruig period when Ciay, Webster, Jolm Qiiiney Adams. John C. Calhoun, and Andrew Jackson were the ruling spirits. Dr. jJuchanan was the editor of the Louisvuic Focus, a post for which he was selected by the discerning mind of William W. Worsley, the founder of the Louisvillo Focus and of the great pubUsbing house of Johu P. Morton & Co. If Dr. Buchanan had concentrated his Avouderful mind upon some one of the great branches of medicine, he woidd have added much to the luster of Kentucky medicine. ■ ■ His fidl nature, like that river of which Alexander broke the strength, spent itself in channels which had no great name on the earth." In 1817 a full course was given in Tran- sylvania to a class of twenty- pupils, and in the spring of 1818 the degree of M. D., was conferred for first time in the West. John Lawson i[cC"ullough, of Lexington, was the first graduate in medicine iu the valley of the Mississippi. History thus assigns to Ken- tuekv the honor of iuauguT-ating the teaching of scientific medicine in the West. The first to begin, she has occupied the most prominent position in this field of education to the pres- ent time. Her schools have been the most popular, her classes the largest, her profes- soi*s tlie most learned, her graduates the lead- ing praetitionei-s of the South and West, aud her influence upon practical medicine and surgery greater thau that of all other schools. Eauck's Histoi'v of Lexington states "tua; vaccination had been introduced for several years in Lexington by Dr. Samuel Brown, of Transylvania, when the first attempts at it were being made in New York and Phila- delphia. Up to 1802 he had vaccinated up- ward of five hundred persons iu Kentucky.' This invaluable discoveiy was announced by -leuuer in 1798, and we find it successfully introduced into the backwoods of the West, liy Kentueks- enterprise, before 1802. The Kiue-poek Institution of New York was es- tablished in 1802. The Eastern Lunatic Asylum has long en- joyed a distinguished place among institu- tions of the kind in this coimtry. Dr. W. S Chipley, for so many yeai-s the eminent su- periulendent of this asylum, has made it known at home and abroad by his valuable re- ports and oth.er papers upon mental aliens tioii. This asylum was founded in 1816. im- der the name of the "Fayette Asylum." It MEDICAL PIONEERS OF KENTUCKY, 125 was the first, ever established in the western I'ltiy be talnilated, so as to be seen more clear- countrv, and the second state asylum opened ly: in the United States. Spencer Wells 73.25% in connection with the history of mediciuc Clay 72.807o pertaining to Lexington, Dr. B. W. Dudley W. L. Atlee 71.00% must ever occupy a conspicuous place. Dis Bradford 90.00% tinguished in every branch of sui'gery, he was Kimball 66.11% particularly eminent, as we all know, as a Dunlap 80.00% lithotomist'. If not the tirst surgeon to per- Peaslee 67.:85% form this operation in KentucJiy and the Thomas, 66.66% West, he was the first lithotoniist in the num.- ^^-^^ j^^^ attained the highest success yet Ijerand successful results of his eases of the ^^..^e^g^ ^^ Europe, having saved 81 of his period m which he lived. His fame was Co- ^.^.^^ ^qq ,^^^ 30 ^^ j^-^ ^^^^ gg ^^^^^ ^^ existent ^vith surgical literature. ^j^^ ^t^.^^^^ g^^^^^ ^^^ .^^ ^^ -^ g.. K Kentucky had couf erred no other bene- ^^^^ _ -^ (.^^^^ g^i^^^^ g^ -^ ^^^^^^ 50 taction upon mankind the operation oi -^ Oermanv 41.66. Spencer Wells thinks the ovariotomy performed tor the first time by ^ ^^^ ^^^ ^^ ^^ ^^^^^_ ^^ ^^^^^ .^^ Dr. Ephraim McDowell, of Danville, in 1809, .-^^^-^ practice, mthout excluding those ex- would entitle her to immortal honor^ I belie .. ,^.^^^g ^^^^^ -^ ^^,j^i^j^ ^1^^ operation is perform- that_ no one no.w denies to Dr. McDowell the ^^ ,^^ ^ j^^^.^^^.^ j originality of this lieroic surgical achievement. ^^^^ ^,n-pose in presenting these details is to Kvery surgeon in this conntry concedes it. ^^^^ attention to the fact that Dr. Taylor In a conversation which I had, m 1865, .^oth a j.,,^,ifo,.^ ^f Augusta, Kentucky, has already number of eminent surgeons of Great Brit- .,^ Gained the 90 per cent, success which Wells am, among- whom may be mentioned air. jj^-^j^^ ^^ ultimately attained. In Ken- Spencer Wells, Mr. Baker Brown, and Sir ^^^.j. ^^^j^^^.^ ^j^^ operation was first nerform- James Syme, no one had any reserve on the ^j^^ j^- j^,^^^ ^^^^^^^^ j^^^ ^^^^ reached. ^ subject except Mr. Syme. While he did not p^^^^^^ presents the great benefits confer- deny the claim of Dr. McDowell, he did not ^^,^^ , ovai'iotomv in the following words : " It admit It. It IS not a little amusing sometimes ^^ ^^^^^^^^ ^j;^^^ -^^ ^1^^ United States and to note with what reluctance European ^^reat Britain alone ovariotomy has within the writers recognize thegreat -works of American ^^^^^ ^j^-^,^^^ ^^^^^^ directly contributed more surgeons and physicians. In a recent article ^,^g^ ^^-^^^ thousand years of active life to in the Echnhurgh Review upon the progress ^^^^ ^^ ^^ ,^^,j^.^j^ ^^^^^1^-^ j^.^^^ ^^^^^ ^^^^ j^,,-, of medicme and surgery, the operation of ^,^-.,i.ioto^,. ^g.^er been performed." ovariotoinv is tullv discussed without the „, ^ \.^ ^ n t^ j. ^ ■ T-^ -n mention of Dr. McDowell. Mr. Spencer Wells ,. "^^ Institute for Deaf-mutes .n Danvil e. is made the hero of the operation ! -Kentucky was founded m 1823 It was he The value of this operation can be better ;^Is\"i«™T ^^*^^'"^f established m the estimated bv the statistics of eminent special- J'^s t It followed closelv upon those ot ists. It is to be viewed as a remedy for a dis- Hartford, New 1 ork, and Philadelphia Prom ease of utter hopelessness, if permitted to pur- ^^ «"f ^ be|ii™ing it has become a noble and sn.e an undisturbed career. Medicines haA^e !^^ost beneficient sehool. Mr. Jacobs, so long 1.0 influence over it. Though a few may live jtf ^^P^'-^flf '^^^ .,.^^^ "" n%l . ^.X many drearv years, the average duration of throughout the civilized, world. The results " -^ • . ' 1 attained m the education ot deat-mutes are ovarian tumors is from tw^o to three years, astonishing. They no longer .speak by a Dr. McDowell operated thirteen times, as far uianual alphabet or manual signs only, but as can be ascertained. He preserved the lives are trained to utter their thoughts in artieu- of six out of seven of his first patients. How late sounds wonderfully perfect, raanv of the other cases were successful is not Dr. McDowell and Mr. Jacobs have given known, thoush it is certain that several were the "Hme of Danville an illustrious perpetuity ■'^ - -, n . T,r TiiT n > • + and bequeathed to their successors m that saved. Fp to June last Mr. Wells s ovariot- i^^g^^^iful town a reputation which their pride omies numhered 500, with 128 deaths. From should be emulous to sustain. It is not an un- March, 1870, to .-Vpril, 1871, he had a success- deserved eulogium to say that Dr. John D. ion of 32 cases in private practice without one Jackson and his associates of the Boyle Couu- death. Dr. Keith, of Edinburgh, up to July ty Medical Society uphold very ably the -,,,„,. -,, 1 oc prestige alreadv acquired, ast had operated 146 times with only 26 >■ ^ n t^ -..^ .,■.+.-,,.+ +- ^^ .^ ^ . ^-, £ -ni -1 1 1 I ■ 1, Dr. Alban Goldsmith was an assistant t(j deaths. Dr. W. L. Atlee. of Phdadelphia, has -,^^, jf^j^^^.p^ ^.^ ,^^,,,,^1 of his ovariotomies, operated about 300 times. Mr. Clay, of Man- .-|,^^ operated himself one or more times. He Chester, up to December, 1871, had operated visited Europe at the time that Civiale was 250 times, with 182 successes. The results attracting great attention to his original op- 3L>6 h'EXrrCKY MEDICAL Jori^XAL ei-atiou of lithotripsy. Dr. Goldsmith, vuider the teachings of this master, perfected him- self in this specialty'; and returning to his home in Kentucky operated on a gentleman in Lincoln County in 1829. the first operation of lithotripsy ever peifornied in Kentucky or in tlie United States. Dr. Goldsmith, desiring a wider field for his labors, removed to Louis- ville in a short while. In that city I had the 1 Measure of seeing him operate in this special way and in other branches of surgery. While )-esiding in Louisville he conceived the project of another medical school, recognizing the im- portance of a large hospital and its clinical facilities in the teacliing of medicine and surg- ery. To eaiTv out tliis admirable design he procured from, the legislature, in 1833, the charter of the "^ledical Institute" of Louis- ^•ille. A faculty was organized, but did not lecture. "When a jriortion of the faculty of the ^fedical Department of Transylvania Univers- ity seceded from that school, in 1837, tliej^ or- ganized under the charter of the Institute, and continued to act under it until the Uni- versity of Louisville was chartered, in 1815. Dr. Goldsmith may thus be eonsidei-ed the le- gal founder of a school so long sheltered by iiis charter. From Louisville Dr. Goldsmith removed to Cincinnati, and for a time was profes-sor of surgei'y in one of the schools of that city ; but finally settled permanently in the city of New York, pursuing to the close of his life the special branch of surgery in which he was sn skilled. His son Professor Middleton Gold- smith, is well known to the profession of this state as an able teacher and practitioner oi surgery. Dr. Gi'oss, in his report on Kentucky Sur- gery, made to this Society in 1852. remarks: "In the treatment of hernia Kentucky may jxistly claim the credit of having effected one laost valuable improvement. The truss in- vented li.v ^[r. Stagner, and afterward.^ modi- lied by Dr. Hood, has acquired a world-'nide celebrity. The value of the invention of Stag- ner and Hood can be fully appreciated by those only who are familiar with the nature and treatment of hernia, and with the state of our knowledge thereof prior to their time." In the same report Dr. Gross records "tha' some years ago Dr. Bowman of Han-odslnirg, showed me an instrument for injecting the parts immediately around the abdominal canal and apertures with a weak solution of iodine avid other articles. It was constructed upon the principles of an ordinary s.vringe. with an extrem':'lv deliriate nozzle, intended to bt introduced throush a small opening in the skin. TVe h^re find the hvpodermic s.vringe foreshadowed, if not actually invented. When Wood published his first papers on the sub- ject of hypodei-mic medication. I carried out Ihe practice, with the syi'inge having a deli- cately-curved nozzle used by dentists, in the treatment of an obstinate case of lumbago. Dr. S. Brandies, of Louisville, imported the fir.st hypodennic syringe ever used in Kentuckj', as he also did, through me, in 1862, the first laryngoscope. The Loiiisville Marine Hospital was found- ed in 1817, and was among the first of the great public charities in the valley for sick and disabled marines. It was sustained partly in- taxes upon sales at auction, and partly by a fund created, under the law of the United States, from weekly or monthly sums paid by all sailors na^■igatin^ the Ohio and other western rivers. This in.stitution was admir- ably managed. Its trastees were selected from the best citizens of Louisville, and its physiciajis and surgeons were the elite of the profession, mature men engaged in a large and busy private practice. Among them I re- call the names of Drs. Richard Ferguson, George W. Smith, Coleman Rogers, Sr., Jo- seph iliddleton, John P. Harrison, R. P. Gist, and Llewelynu Powell. Conspicuous in this medical staff, for personal virtues, for the qualities of the Chritsian gentleman and for all of the attributes of the accomplished phy- sician, it gives me pleasure to single out for special notice Dr. Harrison, ^ly earliest recollections of medicine are asso- ciated with this remarkable man. I knew him ^vell. and his history has always been a favor- ite theme with me. In this hospital he labored very faithfully, and laid the foundation of a medical career of great usefulness and dis- tinction. Kent!iclr\' never produced a more \\orthy son. He was an assidious worker at the bedside and in the dissecting room. He speJit many of the long winter nights in the study of all forms of anatomy by minute and careful dissection. Not content with the r:!odicum of anatomical knowledge acquired while at1 ending his several courses of lectures, it was his custom to revise this important lii'anch of study every winter. As a boy, T was oftmi his companion in the fourth stoxy of the hospital. Dr. Harrison was a general as well as a medical scholar. He delighted in all kinds of polite literature. He was pecul- iar in his habits of reading. The lighter ivorks of general literature occupied his leis- ure hours in the warm summer months, while tht long winter evenings were devoted to the severer studies of the sciences. He was never idle. Of an ardent and active temperament, he could not be idle. He was a man of the purest pei"sonal and professional honor. To- ward his professional brethren he bore him- self with fastidioiis care. In naedical ethics he was a martinet. There were subordinate qualities aboiit Dr. Harrison which should and can pertain to every phyisican. Every one can not be tall and graceful in form as Dr. Harrison was, with dark hair and com- MEDICAL PIONEERS OF KENTUCKY. 127 plc'xion and keen gray eyes; but every one can have agreeable manTiers, a dignified, beai'- ing and be neat in dress and person. Dr. Har- rison was always so. He dressed simply but elegantly, and everj'thing about him looked the refined gentleman. His office was attract- ive, the furniture good and in order, the books in his large library systematically arranged. When his patients called upon hini they were impressed by these things. His horse was al- ^vays well groomed, his harness Ijright, and his gig perfectly clean. In all regards lie sus- tained the respectability of his calling. These personal details may seem unworthy of notice in an address like this, but they have an im- portant moral. I am sure that the influence and usefulness of medical men in cities, vil- lages, and country places, are materially less- ened by inattention to such matters as were striking qualities of Dr. Hari'ison. Person- al qualities are often tokens of professional character. Slovenly dress, unkempt hair, a dirty office, with a. few broken chairs, and a rickety table with a dusty slate on it, are not likely to inspire the sick with pleasant ideas of their medical adviser. Such conditions spring from and react upon the character of the physician. Dr. Harrison kept himself fully up with the advances of medicine. The first stetho- scope I ever saw, and the first one brought to Kentuckj^ was imported by him. It was of the pattern originally devised and made by Laennec himself, and was in my possession for many years. Dr. Harrison talked of going to Plurope to study this new physical diagnosis of diseases of ihe chest, but was for a time skeptical as to Ihe reality of Laennec 's great revelations. In this connection my memory calls up the interesting fact that Prof. Henry M. Bullitt, of the Louisville Medical College, was the first physician in Kentucky, as far as I am in- formed, to carry the stethoscope into the daily study of his cases. He returned from Phila- delphia in 1838. having become an expert in this method of diagnosis, under the teachings of Gerhard and Pennock. I was then pur- suing the same study in the wards of the Marine Hospital, and owe my first advances to rhe instruction of Dr. Bullitt. Dr. Bullitt brought wiih him, besides this practical knowledige, a mind thoi'oughly and ardently imbued with Louis's inductive^ method o': studying diseases. This method, substituting carefiilly-ascertained acts and the results in- ductively evolved from them for mere closet theories, was then bringing about a thorouah revolution in the science of medicine. In this Dr. Bullitt played an efficient part by his pen and his teaching. Dr. Harrison, appreciated at an earh^ day the importance of clinical medicine, and was among the first in the "West to give clinical h-ctiires, in the wai-ds of the Marine Hospital, to a class of students. The clinical advantages of Louisville caused him to look to that city as the future seat of a great medical school. In 1834 Dr. Harrison removed to Phila- delphia to find a more suitable theatre for the ]'ealization of his ambitious purposes. He was called very soon, however, to fill an important chair in one of the schools of Cincinnati. While teachinig here, and for many years be- fore, his pen was prolific in the production of valuable papers on, various medical subjects. As 11 teacher of materia medica he was dis- tinguished for his sound and practical thera- jieutics. He was an able practitioner, and bi-ought before his class the ripe fruits of an extensive experience. He published a "Treat- ise on Materia Medica and Therapeutics," tlie first and only systematic work on this sub- ject by a western j)hysician. The practical po.itions of this work are excellent, and worthy of all respect even at the present day. The book is remarkable as being probably the last ever published in this country in which the doctrines of pure solidism are asserted and those of humoralism opposed. The idea of the absorption of medicines by the blood-ves- sels is vehementlv rebuked. In 1838 Dr. Charles Caldwell delivered the first clinical lectures of the University of Lou- isville in the wards of the Marine Hospital. I was his clinical assistant. In 1839 the first clinical amphitheater ever founded in the West 'was attached to this Hospital. From that room, for more than thirty years, the practical lessons of Drake, Gross, Eve, J. B. Flint, Bartlett. Ethelbert Dudley, Annan, Austin Flint, Palmer, Hardin, Middleton Goldsmith, D. W. Yandell, and their asso- ciates and successors, have been diffused throughout the length and breadth of this country. Dr. Samuel L. Metcalfe, who died in Phila- delphia in 1856, had a scientific character of which Kentucky may well be proud. Though known to many of the older physicians, he is possibly unknown to some of the junior mem- bers of the profession. In 1833 Dr. Metcalfe jjublished at New York, a. treatise, entitled '"A New Theory of Terrestrial Magnetism," containing speculations of a remarkable char- acter, and contending for the idenity, in cer- tain relations, of heat, electricity, and mag- netism. In it were the germs of the great Ijhilosophical theory called "the correlation of forces," now accepted by the scientific world. This book was reviewed by Dr. T. S. Bell, in the Louisville Journal, shortly after it was published, and pronounced the first work of its kind on the subject. In 1838 this work was expanded into a noble treatise, entitled "Caloric; its Mechan- ical, Chemical, and Vital Agencies in the Phenomena of Nature." Dr. Metcalfe took .T2S KENTUCKY MEDICAL JCFKNAL. the maniisc-ript to London and endeavored to liiid a puMislier. One was at last found, who a.ureed to publish it provided the author would permit hiiu to submit the manuscript to the inspection and approval of: a scientific reader employed for such purposes. The iv.anuscript was kept for some weeks, and af ■ te]' junny calls Dr. iretealfe succeeded in re- covering it, with the information that the judgmeut of the reader was unfavorable. Prof. J. B. Flint was in London at the time, purchasing the library for the IMedical De- partment of the TTniversity of Louisville, and lo liim Dr. JMetcalfe communicated these facts with the additional statemfnt that he had ascertained, beyond a doubt, that Michael Faj'aday was the reader to whom his manu- .script had been submitted. The doctrine of "The Correlation of Forces" which forms a conspicuous element of the fame of Faraday, was cleai-ly and pop;ently ^aug'ht in this new work of the Kentucky philosopher: and prior to the time that Dr. IMetcalfe's manuscript was perused by Faradav he had never taught aov thing- of the kind. ' In 1843 Dr. Metcalfe published his treatise in two large volumes. It was received in Europe with an unusual amount of favor. In 1833 a second edition Avas published, a copy of whidi is owned by my distinguished friend, Dr. T. S. Bell. Dr. Metcalfe resided near Simpsouville, Shelby County, while in KentucW. The state, and especially the medical men, have abundant reason to cherish his well-earned fame. His reputation was so firmly establish- ed in Europe that he was importuned to be- come a candidate for the Gregorian Chair in the TTniversity of Edinburgh, which he de- clined. In January, 1843. Dr. Wm. A. McDowell, a cousin of the great ovariotoraist. and one of his aids in the performance of his operations, ]ml)li.shed an octavo volume, of two hundred and sixty-nine pages, entitled "A Demonstra- tion of the Curability of Pulraonarv Con- sumption in all of its Stages." Dr. ^IcDowell removed to Louisville some j'ears anterior to th.is date, with a name and prestige which soon won for him an exeellent practice in all of the branches of medicine. Pulmonary consumption was one of his favorite subjects, and he soon put forth the claim of unusual success in the treatment of this disease. Such unusual results were announced as to excite in the minds of his professional friends an un- just suspicion of ehai-lantry. "When his book appeared it was received not only with in- credulity but with severe and sneering criti- cisms. Time, however, has done justice to Dr. McDowell's character and claims. The Avork, tiiough defective in literary merit, crude in many of its ideas, and asserting powers for many medicines which they do not possess, contained not onlv the germ but the substance fully developed of the therapeutics of con- sumption now considered orthodox. He states that he fii-st derived the views which he inculcates, modified by what he denomi- nates the antipodal plan, from Dr. Joseph i'arrish, of Philadelphia. To quote the lan- guage of his pi-efaee: "We concluded upon com (Dining his theory with an antipodal plan \ 'hich we ourselves had determined to adopt, consisting of a course of dietetics and regi- men calculated to produee acquired gout; for we regarded gout as tlie extreme athletic or tonic morbid conditio!], consumption as the extreme atonic." Though this mode of pre- senting the subject be crude and coarse when compared with our more retined and seeming- ly more recondite rationale of treatment, the s.iUiie gre.at analeptic truth underlies both. T have no doubt that Dr. ilcDowell cured many cases of genuine phthisis pulmonaris. and pro- longed the lives of many more, as the tonic and restorative plan, now universally adopt- ed, is well known to do. His book was in ad- vance of the times in this country certainly, a)\d T do not know that a formal presentation of the subject had been made in Europe. Dr. J. Hughes Bennett, of Edinburgh, and other distinguished co-workers, were beginning to inculcate very strongly the .same method of treatment, but had not given a published form to their views. This book of Dr. IMcDow- elTs has not secured the place in the litera- ture of pulmonary consumption to which its intrinsic merit entitles it. The Kentucky Institute for the Blind was incorpoi'ated in 1842. The movement for such a school in our state was inaugurated by Dr. S. (t. Howe, of JIassachusetts, who had so successfully begun the beneficient work in the latter state. Kentiicky was among the first to follow the example of the "Old Bay State." ]"rom its foundation to the present time, this institution has been an object of just pride. l\l uch of its progressive success has been due to an eminent member of our profession. "To inaugurate a great charity is a noble work; but to watch over it, to foster it, to stand by it h'om the beginning, to be its firm friend through every disaster and its coun- selor in every emergency; to give it un- wearied attention for over thirty years, and sacrifice to its good an incalculable amount of aiixious thou.ght and valuable time, is surely equally noble. Such services the state of Kentucky has received fi'om Dr. Theodore S. Bell." This is the testimony of one who is familiar with the devotion of this remarkable man to this iustituti'^n. I can add my own testimony to the same effect. In my many professional drives in the direction of the Blind Asylum I rarely fail to meet Dr. Bell making his dailv visit to his pet institution. By his effort? the Bible was stereotyped, and a copy giveu to every wortb>- pupil of th-^ MEDICAL PIONEEI,;s OF KENTUCKY, 129 school. Kenlacky enjoys the honor of being the first state in the world to make a provis- ion by law of this kind. The history of the Blind Asylum has a bright page for this constant friend. The history of Kentucky medicine for the last fo]*ty years will also devote to him a large and varied space. Ever busy, working more hours every day and sleeping fewer than any one I ever knew, there is scarcely a depart- ment of medicine upon which he has not left his impress. As a public hj^gienist, as a med- ical philosopher and journalist, as a contro- versial Avriter, as a practitioner and teacher, he has long occupied and now occupies a con- spicuous position. Seem.ingly untouched by time, he is to day as fresh and strong in phys- ical and mental power as he ever was. Kentucky was one of the first states of the West, probably the very first, to comprehend the incalculable vahie of a careful registration of the marriages, births, and deaths of her citizens. The importance of such registration, fully appreciated by many of the states of Europe and hy a few of this country, was ably set forth in Kentucky, and impressed ■upon the public and legislative attention, with great force and effect by the first regular president of this Society, Dr. W. L. Sutton, of Georgetowai. In effecting the passage of a very perfect law. by the legislature of 1851-2, he was ably re-enforced by Dr. W. S. Chip- ley of Lexington, and Dr. T. S. Bell, of Louis- ville. It will not be deemed immodest in me to say that a ' ' Lecture on Sanitary Reform, ' ' delivered by me to the medical class of the TMver.sity of Louisville at the opening ses- sion of 1S51-2. and published by the class, had some influence, by the logic of its statistics, in determining the passage of the act. Dr. Sut- ton was the first registrar, and most success- fully carried the law into execution. Before, however, even a partial realization of the great results anticipated by him. Dr. Sutton Avas removed by death from this sphere of I)ub]io usefulness, and was succeeded by Dr. S. M. Bemisfs, now of New Orleans. Dr. Beraiss proved to be a worthy follower of Dr. Sutton, He carried the work forward mtli zeal and ability, and his reports attracted nnich attention both at home and in foreign countries. The war of 1861 put an end to this as to all other civil pursuits, and since its close the law has not been I'cvived. It is a reproach to the intelligence of the state, and most deeply damaging to her interests, that it has not been restored. Dr. Sutton was one of the ablest men of the ])rofession in Kentucky. Plain, modest, prac- tical, an excellent observer, a good writer and a sound practitioner, the state has produced few superior to him. In sanitary science he was the foremost man among us. His broch- ure on Typhoid Fever, and a few other pa- pers on medical subjects, gave him high rank in medicine proper.. In October, 1846. ether as first used by in- halation as an anesthetic. In the winter or spring of 1847 Dr. Joshua B. Flint adminis- tered it for the first time in Kentucky, and jioissibly in t)ie west, in an amputation of a lower limb performed by him in the presence of a number of professional friends. I was present. The ether as then called "letheon," and administered by the aid of a complicated inhaler. Chloroform as first brought forward by Sir James Y. Simpson, as a substitute foj ether, in November, 1847. It was used for the first time in midwifery in the city of Loii- isville, and as far as is 'known in the state of Keiituckv, bv Prof. Henn^ Miller, on the 20th of February, 1848. I'rof. S. D. Gross, was the first surgeon in Louisville to use chloroform as an anesthetic in surgery. lie operated upon a servant un- der its influence in the family of Thos. F. Smith, ri.mioving a large tumor. Professor Miller was a pioneer in several other important branches of his specialty. In an able and very candid paper denominated '•Retrospect of TTterine Pathology and Thera- peutics in the United tSates, especially in re- gard to intrauterine medication in chronic in- to-nal metritis," published by Dr. Miller, in 1871, it is certainly established that he was • the first in the West to use the speculum uteri .systematically in the treatment of dis- eases of the OS aiid cervix uteri. This was m early as 183-5, a period when the speculum was almost unknown practically to the pro- fession in f[ny part of the United States. The first speculum was brought to Louisville by Dr. Allan P. Elston, a distinguished young physician, who after a residence in Europe for several years returned to Louisville and re- sumed his professional labors. Failing health compelled him to retire after a short but hon orable career. Dr. Miller was present when Dr. Elston examined one of his patients in the Workhouse Hospital, and becoming enam- ored of the speculum forthwith devoted him self to this interesting branch of siirgery. It is needless for me to tell this audience' -with wYvat distinguished results. For a time the treatment by the aid of the speculum was lim- ited to the OS and cervix utei-i. In 1843 Dr. Miller extended +his local treatment still deeper, and made applications to the cavity of tlie organ. In the paper above mentioned he proves conclusively that he 'was in advance o P cverj^ one else in the United States in intra- uterine medication. Kentucky justly claims })riority in both forms of uterine therapeuTics. Dr. Miller is the author of the first system- atic work upon midwifery ever published in th.e West, a work which ranks in original i:iO KEXTVCKY MEhKW] .JOUKXAL. thought and practical value among the best ever published. Kentucky has been ever prompt to obey the rrquii-eraents of philanthropy. Under the wise counsels and benevolent influences of Robert W. Scott, the legislature, in 1S60, founded the Kentucky Institution for tlie l-klucation of Feeble-Minded ('liildren and Idiots. This is tlie only institution of the kind south of the Ohio River. There are sev- ei-al in the North, which have undoubtedly ac-hieved surprising results in elevating the mental status of these unfortunate beings, 'i'licy who have not observed the amount of mental improvement which may be effected by systematic training, in sidi.jects who seem to be hopelessly feeble, would scarcely credit the real results. Our owji institution prom- ises to be a benefaction worthy of generous encor.ragement. The Louis^'ille Colleee of Pharmacy was es tablished in August. 1870. It has organized a school of pharmacy, with efficient professors, to teach the theory and practice of pharmacy, materia medica, chemistry, and the collateral sciences. Such an institution has long been needed in KentuckA-. and there now exists no reason why every apothecary should not be a graduate of this or some other equally worthy college, and his qualifications fully ascertain- ed, before he is permitted to dispense medic- ine. The interests of the piddic, no less than of the professio]! demand the enactment of such a law. On the 2Stli of IMarch, 1872, the legislature of Kentucky passed an act incorporating the ' ' Centi-al Kentufln' Inebriate Asylum. ' ' This asylum is intended for the medical treatment, control, and restoration of the inebriate. It is invested ivitb. tlie power to receive and retain all iviebriates who enter it. either voluntarily or liy the order of the committee of any habitual tirunkard. The committee of the person may keep him in the asylum at disci*etion. This act does not indicate by what power tliis com- ■.nirtee is created. Some pi'evious law mu.st exist and I presume that an act, approved ilarcli 18, 1872. to pi'ovide for the presei'^.'atiou of the eslates and security of pei"sons of unsound mind, who by habitual or excessive use of poi- sonous drugs have become incompetent to m.aiiase tliemselves or estates with prudence and discretion, supplies the defect or provides for it. This act empowers the circuit or ehan- cex-y court of the county to appoint a com- mittee of one or more pei-sons to take charge oi any person who ''y the habitual or excessive use of opium or liashcesh, or any other dnig, lias become incompetent to manage himself or estate. The fact of such incompetency must be brought before the eoiirt by affidavit of two or more respectable persons?, and an incpi^st must be held by jury in open court to inquire into the fact. The committee of eustodv and control is invested with the power to confine such person in any pinvate asylum or in one of tlie lunatic a.sylums of this commonwealth. It will 1)0 observed that tliis act specifies (ijiium, hasheesh, or any poisonous drug, but does not mention by name alcohol and its preparations. A fair and scientific construct- ion would include these: yet a doubt is left, and diffucuty might spring up if any ono chose to contest tlie point and insist upon a literal interpretation of the law. Habitual and inveterate drunkenness is certainly one of the forms of insanity. It is a condition in which the will is under the master^' of the pas- sion. It is recognized by the best authorities as insanit}-, and has received the names of dipsomania and inomania. The interests o** the individual and of the entire communit" would be advantageously consulted if this \"iew of drunkenness were carried into prac- tical effect, and the drimkard made amenable to the law which is applied to the ordinary lunatic. Wliether the asylum just incorpor- ated be one merely for voluntary confinement or one to which a jui'v may send any proper subject, Kentuck>- has led the advance, as far as 1 am informed, in this direction, in the val- ley of the ^lississippi. It is a creditable fact, reflecting the esti- i.'i; te in which Kentucky- medicine is held by thf^ profession of the United States, that our strte has directly furnished two pi-esidents oi' the American ^Medical Association, in the I'evson of Drs. Rpury ^filler aud David "W. Yandell. and indirectly a third in the person of .Or. S. T). Gross,, all members of this Society. Xo member of the profession in this eoimtry has received more honors at home and more foreign decoi-ations than Dr. J. Lawrence Smith, another uiem.l'er of this Society. The establishment of a new school in 1837, aud of several others at later dates, led to im- portant results in the histoiy of Kentucky medicine. These schools have been the means of developing and bringing into more con- sincuous position many of our own most gift- ed pliysician. and have invited from other places some of the :uost eminent pliysicians of the T'nited States. Amon? the former may be mentioned Bush. Peter, Ethelbert Dudley, :\Iiller. Powell. Hardin. Richardson, Bullitt, the Yandells Force. Breckinridge. Cummins, Bell. Bemiss. Bayless aud Bodine. Among the latter. Bart left. Silliman, J. B. Flint, Drake, Cobb. Colescott. Austin . Flint, Sr., F,ve, Gross. Palmer, J. La'WTenee Smith and ^liddleton Goldsmith. Some of the best con- triluitors to .\merican medicine and surgery were made by several of these genfleinen while liiev we'-e connected with the schools of Ken- tucky", and these may be fairly considered as belonging to the medical literature of our slate. If all of the works were not written here, much of the matter which gives them in- MEDICAL PIONEELS OF KENTUCKY 131 terest was obtained while then- authors were connected with the schools and hospitals of Louisville. This is particularly true of the works of Gross, Drake and Austin Flint. Connected with the schools of medicine- which have existed in Kentucky many remin- iscences of men and things arise in my mind. Among the most pleasant of these is my recol- l>"Clion of Dr. Wm H. Richardson, so long the professor of obstetrics in Transylvania: ]''ew men ever had nobler traits of character. He 'was w-arm-heartod, brave, and, a sincere friend. I knew him from my earliest boy- hood, and have passed many happy and in- structive hours at his magnnfieent home in J''ayette county. His hospitality was profuse and elegant. I listened to his public teach- ings as a professor with interest and care, be- cause I knew that he taught the truth as far as lie possessed it. He was not scholarlj^ nor graceful aiid flu.ent as a lecturer ; but lie was ardent and impressive, sufSciently learned in his special branch, and had at his i-eady com- inand a large stock of ripe personal experi- ence. I honor his memory beyond that of most men whom I have known. ] have often recalled with wonder the su- preme satisfaction with which I looked upon the whole science and art of medicine, after listening to one course of lectures by Dr. John }]steu Cooke, for so many years the venerable incumbent of the Chair of Practice in Tran- sylvania, and iu the University of Louisville. Few teachers ever held such sway over the minds of intelligent professional men as Dr. Cooke, over the entire medical mind of the val- ley of the Mississippi. Every one entei'tained X^rofound respect for his great intellect and general learning, and for his purity of char- acter and honesty of pui^DOse. His theory of medicine was peculiar to himself, and elabor- ated with great care. It seemed to be built ii])CTi an impregnable logic. It was dogmatical- ly taught, and carried captive the minds of the hundreds of young men who listened to his positive enunciations. There were no graces of oratory about him, yet he had a subtle way of infusing the poison of his false doctrines which were of singular simplicity and universal adaptedness. The practice grow- ing out of them, so long dominant in the South and West, w^as equally simple and adaptable. Three familiar medicines consti- tuted the trinity of his practical creed. Quinine and opium were not Imown in his ma- teria medica. With the retirement of Dr. Cooke, in 1 844, a new medical era commenced in .the wide region over which his teachings so lono- prevailed ; and now not a vestige of either his theory' or practice remains except in the pages of his book and in the minds of a few of the ancient members of the profes- sion. Who that ever saw Dr. Charles Caldwell can fail to have a living remembrance of him? Who that ever listened to Inm as a teacher can Jail to recall with admiration the great intel- lect, the varied scholarship, the beauty and l>ower of pen and the polished eloquence of the grand old man ? He impressed every one by the stateliness of his personal appearance. He looked a very monarch, as, with scepter waving in his hand, he moved majestically along. Dr. Caldwell was largely instrumental in carrying the JMedical Department of Ti-ansyl- vania to its high point of prosperity. He was one of the great levers by which the School of Louisville was elevated to a still loftier posi- tion. By reason of certain attractive quali- ties, and peculiar powers foreign to pure med- ical teaching, he was eminently successful as an architect of medical schools. Despite these facts, the truth of history compels the averment that he was never a teacher of true practical medicine, nor of that kind of medic- al philosophy Avhieh Forms the useful medical un'nd. Tn these res'ards he has not left »n enduring record in the annals of Kentucky iijedieino. Wliile Dr. Caldwell was yet holding a con- spicuous place as a medical leacher a revolu- tion was going on in the whole science of medicine. Old medicine was exniring and new medicine t.ikinsr its plnce. Before the pressure of professional oninion created bv this revolution. Dr. Caldwell, like his old col- leas'ue. Dr. Cooke, retired, from professional life in 1849. Wlien the trustees of the Louisville Medical Institute ^vere orp'anizing the first faculty, in 1S37. Dr. Caldwell, the chief artitieer of the enterprise, was furnished with carte hlanrhe. Kud sent on a mission to find a professor of surgery. A careful search eventuated iu the selection of Dr. Joshua B. Flint, of Boston, Ma.ss. Dr. Flint was a a-raduate of the Academic and Medical Department of Har- vRTd. He was indorsed to Dr. Caldwell, bv the best men of Boston, as a mature and tliorough senera! find mecf'sal scholar, as a conservative, skillful surgeon, and as an ac- ceptable teacher. He was tendered the chair of suracry in the institute, accepted it. and sun- dering bis many ties iu Boston i^ame to Louis villf> and united his fortunes with our school and our people. The impression wdiich h-^ made upon the profe.ssion in Louisville was favorable in the highest degree. He disclos- ed qualities which at once commanded con- fidence and re.spect. He was ouiet and mod- est, avoidine- rather than courtino- conspicu- ous 7iotice. His fine scholarship, literarv and professional, made itself evident to all ap-. ]")reciative observers. He was not ostentatious in this regard. His sound judgment as a practitioner of -surgery, and his rare de~- 182 KEXTUCKY MEDICAL JOURNAL. terity and coolness as an operator, were read- ily ]-eeognized. In the field of operative sur- geiy he was distinguished, beyond all other men of his time, for his conservatism. ^Many litiilis and parts were saved by him which would have been lost hy less considerate sur- cons. Tie did not desire the eclat which great si;rgical feats elicit. As a teafher, Dr. Flint came forward at a time when medicine and medical teaching were in a transition stage ; when mere theories were giving place to facts, and things ■wei'e tanght and not mere speculations. His style was quiet, eminently and purely didac- tic. He was not a declaimer, had no ad cap- idiuhim arts, said nothing for effect merely or to elicit applause. His lectures derived their ornament from correct rhetoric and classical illu-strations. Tliey were never soiled by coarse anecdote or indelicate allusions. He was a dignified teacher of the facts and truths of a serious science. He did not seek popular- ity with his classes. He hoped to win their confidence and approval by giving them sound instruction. Possibly he made the distance too sreat between the master and the pupil. This had \wi been the usage in this wild west- ern country. Tt was so in the place of his tdncation. and in the foreign schools. He was kno\^ni to favor the use of the professorial cap and gown. As a candidate for biisiness before the piib- lic. he stood, coldly, upon his demeanor as a gentleman and his real merits as a prac- titioner. He had no arts about him to win popularity. He rather repelled than attract- ed people. He was punctiliously careful in his intercourse \\\\\\ the patients of other phy- sicians. Tn this relation he was, as Charles Ij(imb said of his Father, "a man of losing lionestv. " Socially no man was more charm- ing. Though dry and not much of a talker generally, on festive occasions his conversa- tion was brilliant and his wit sparkling. At a dinner or "venine: party, among cultivated ])eoplp, he was delightful. J must mention one other quality in Dr. Flint. To his sick brethren he was constant in his attentions, aiding them by his wise couiisel and cheering them by his hopeful words. Dr. Flint retired from the institute at the close of his third course of lectures, but was reinstated in his same chair after the lapse of a few years. Dr. Daniel Drake, thouerh claiming Cincin- Jiati as his home was really a Kentucln' phy- sician, having passed the most active yeare of his life in our state, and achieved his great fame as a teacher and writer while connected with our schools. It is unnecessary to detail his brilliant medical historv. It is known to everv one. T wish to mention the single hon- orable fact that he was the first physician of the "West ever called to fill an important chair in an eastern medical school. In 1830 he was appointed professor of theory and practice of medicine in the Jefferson ^ledical College of Philadelphia. Dr. ,S. D. Gross was appointed to the chair of surgezy in the same .school at a later day and, as far as I now rememl)er, was the second western man thus distinguished. As the intimate personal friend and fellow student of Dr. Jas. ~Si. Bush, 1 had the oppor- tunity to learu, at an early da.y; the genius as an artist, the quick perceptive faculties and the logical qualities of mind which form the basis of his high professional reputation. He was a student first in the office of Dr. Alban Coldsmith. and then in that of Dr. B. W. Dudley. He won the high regard of both of these eminent men. As soon as he graduated in medicine he became prosector for Dr. Dud- ley, and then hi« associate in the practice of surgery. When Dr. Dudley retired from teach- ing. Dr. Bush was appointed to the vacant chair, and discharged its. duties with eminent ability. When Dr. Dudley retired from the field of his brilliant achievements as a sur- geon, Dr. Bush liad the rare courage to take possession of it. Xo higher tribute can be paid to him than to say that he has since liPld possession without a successful rival. In the sciences collateral to medicine Ken- tucky has played a distinguished part. In tlie interesting departments of botany, geol- ogy, and chemisti-y. Dr. Charles Wilkins Short and Dr. Kobert Peter are known throughout the scientific world. As teachers and modest, almost shrinking manner, the seemingly superb dignity, and the Addisonion style of the one, and the hicid expositions and brilliant illustrations of the other, must be r'-raembered by all who ever listened to them. I can not close these hasty and imperfect j'eminiscences, so unworthy of their sub.iects ■i\'ithout the mention of one with whom I had the honor to be upon terms of personal and professional intimacy for more than thirty :\ears. I refer to Dr. Llewellyn Powell. Dr. Powell held the chair of obstetrics, fii-st in the Kentuek>- School of ^ledieine. for some years, and afterward in the. University of Louisville. In both he was recognized as an able, eloquent aiid instructive teacher. He gave unqualified satisfaction to colleagues and pupils. There are two classes of niedierd teachei-s: tlie one professional, trained in the arts of elocution and happy illusti-ation. studiously skilled in the many ways of putting things: not subordinating matter to manner wholly, but relying largely upon felicitous modes of presenting their siibjeets. The other class in- chules phvsicians of mature study and obsei'- vation, who have accumulated a large stock of practical knowledge from which to draw the m.atter of their teaching. Out of the fidl- ness of their knowledge the.v are teachers. The graces of rlietorie and the tricks of elo- MEDICAL PIONEEL'S OF KENTUCKY. 133 culion are not conspicuous elements of their style. Dr. Powell happily blended the best qualities of both of these classes. By nature he was wonderfidly endowed with the gift of language. Words the most appropriate were uttered promptly and gracefully at the bid- di]jg of every thought. Though he was not trained to the special work of teaching, he seemed to possess the happy facility of the professional teaeher. With such a manner he was prepared to impress upon his pupils with singular effect the practical knowledge deriv- ed from many years of clinical obsers'-ation. Dr. Robert J. Breckinridge was reared and educated in Louisville. Of a distinguished family and singularly pleasing address, grace- ful and easy as a speaker, as a writer forcible, pointed, and scholarly, he would but for his isnlimely death have plucked the highest hon- oi's in the profession. Dr. Carey H. Fry. an original member of this Society, died, on the 5th of ilarch, in the city of San Francisco. He was present and took an active part in our memorial meeting of 1852. He was with us, in Louisville, in 1872, with undiminished interest in our pro- ceedings. Truth warrants and personal af- fection impels me to say that he was the peer of the highest in all noble qualities of charac- ter. He was a refined gentleman, an accomp- lished physician, and a gallant soldier. WhatcA^er of renown the University of Lou- isville may have acquired, a portion of it is due to two distinguished members of another Ijrofession, Hon. John Rowan and Hon. James Guthrie. Judge Rowan was the first president of the board of trustees, and gave the influence of his national name to the foiin. dation and early fortunes of the school. Mr. Guthrie became the president upon the death of Judge Rowan, and continued so until the close of his long and useful life. No institu- tion ever had a more devoted friend. His fealty to it never faltered. Amid the cares of .state and a large professional business, he always found time to work for the interests oi' the University. Whatever seemed likely to promote these interests met wth his warm approval : whatever opposed them was sure to meet his stern and inflexible hostility. His name is indissolubly linked with an interest- ing part of the histoiy of Kentucky medicine. The medical journalism of Kentucky has alwaj^s been of a high order. Though com- menced at a later date than thai of her sister state of Ohio, Kentucky was in advance of all other states of the valley. The Transylvania Journal of Medicine and the Associate Sciences as the first .journal published in Kentucky. It dates from 1828. and continued to be the leading journal until its close, in 1838. Its successive editors were Professors John Esten Cooke, Charles Wilkins Short, Luusford P. Yaudell, and Robert Peter. The next was the Louisville Journal of Medicine, in 1853, edit- ed by Professor Henry Miller. L. P. Yandell, and Dr. T. S. Bell. This had a brief existence. Then came the Western Journal of Medicine, and Surgery, edited at first by Profs. Drake and Yandell, and then bv Professors Yandell and T. S. Bell. It lived from 1840 to 1855. The Western and Southern Medical Recorder was published by Dr. James Con(iuest Cross, in Lexington, in 1841-2. The Kentucky Medical Becorder, a continuation of the Tran- sylvania Journal, was editer by Profs. Henry iVl. Bullitt and Robert J. Breckinridge, in ] 851-2, in Tiouisville. Dr. L. J. Frazee edited a semi-monthly journal called the Louisville Medical Gazette, in 1859. Drs. Bemiss and Benson published the Louisville Medical Neirs, in 1859-60. The Louisville Revieiv, ed- ited by Gross and Richardson, in 1856, and the Tjouisville Mcdiccd Journal, by Dr. Cole- scott, in 1860, wore short-lived. The Sanitary Reporter was published, semi-monthly, by the United States Sanitarv Commission, in Louis- ville, in 1863-4. A distinguished editor of the first journaJ of Kentucky still survives, in the full vigor of his intellectual powers, and is yet a large contributor of his mature learning and experi- ence to the journalistic literature of the State. A brilliant and instructive teacher, first in Ti'ansjdvauia and then in the University of Louisville, no member of the profession in the West has written more gracefully and power- fully than Dr. Lunsford P. Yandell. No Ken- tucky author has written more or unon a greater variety of important topics. His sci- entific reviews, elaborate monographs upon various subjects of medicine, papers upon geology and other branches of natural histor.y. his introductorj'^ and valedictory addresses, aud contributions to general and popular lit- erature exceed one hundred in number. Be- sides these, I can not omit to mention a most valuable unpublished report made to this So- ciety, in 1853, upon the IMedical liiterature of Kentuek3^ It is a work of exhaustive re- search, and an accurate index to the papers of all the writers of Kentucky. It should be con- tinued to the present time, and published by tliis Society. The two journals which now represent this branch of medicine. in Kentucky, iliQAmerican Practitioner and the Ei^hmond and Lovisvlll'^ Medical Journal, rank among the ablest of this counti^^. In a community which has founded and fos- tered so many gi'eat medical institutions, true science would necpssarilv always command respect and confidence. In no part of this eountiT have the many forms of qiiackery inet with so little encouragement. Every- 'Wbere, of course, will be found ianorauce, cred- ulity, and th« other w^eak elements upon which medical fungi grow; but Kentucky lU KENTUCKY MEDICAL JOURNAL Jciay be justly proud of her remarkable ex euiption from them. Time aucl .your exhausted patience admon- ish me that I must bi-iua: this liistoi'ical olla poflrkla to a close. I trust that what T have said may sei've to add sometliing to the good ]iauie of our beloved .state, and stimulate us to contribute yet more to the renown which our illustrious fathers have achieved for it. I wish to say a few words as to the work of our present meeting. "We have come, many of lis. a long distance to do this work. Ijet us do it thoroughly and well. Let our sessions be devoted to scientific business, undisturbed, as far as possible, by matters which can not advance the interests of our beneficient call- ing, and may mar the usefulness and happi- ness of our annual reunion. I have a hope that this meeting may he signalized by the dis- )iity of its conduct and the number and value of its contributions to medical science. THE :MF,DTCAI, LITT^'RATURE op KEN- TUCKY.* By LuNSFORD p. Yandell, Sr.. M. D., Louisville. I have undertaken, in compliance with the wishes of the I\Iedieal Society of Kentucky, to \s'rite a history of the ^.ledical Literature of the State, and have the honor to submit the fol- lowing report as the result of my labors. The I'tport emliraces a period of seventy-five years, and refers to the productions of more than two hundred Kentucln' physicians who have written on medicine. It is conseciuently long, and. if deemed by the society worthy of pub- lication, must exteud through at least two vol- umes of its Transactions. lu preparing it two plans occurred to my mind : one to pre- sent a continuous history of the various pub- lications as they appeared; the other to take up the several authors in the order of their api^earauee. and then, having introduced them, to follow each down to the present time or 1o the close of his career. The latter has been adojited as having upon the whole most advantages, and this notably among others, that with every author named in the report will be seen at a single view a list of all his w;'itings. The report, besides notices of the medical literature of Kentuck^^ embraces some ac- count of the origin of her medical schools, with liiographical sketches of a number of her uiore distinguished medical men. In collect- ing the materials for it my chief reliance has been upon the medical journals of our conn ti-y, and all thesi> have been examined iu which it was thought anything was likely to be foimd from the pens of Kentucky physicians. *Koatl iit n mppting of the State Medical Society at Hen- derson .\pril, 187.T. 'I'he transactions of our .society from the be- ginning and those of the American Medical Association have also been consulted. I have sought in addition to gather up all the intro ductory lectures delivei-ed in our niedical schools, and all the more ephemeral publica- tions not contained in the joui-nals of medii;- ijie. The reports of our hospitals, lunatic asylums, institutions for the blind and for deaf-mutes have also been referred to. The larger and more elaborate works on medicine have received due attention, and in addition to all I have had recour.se to other than med- ic tl books for some facts that bear upon th- history of Kentuclcy medicine. But with all my efforts to make the report complete I can hardly hope that many omissions M^ill not be found in it which more time and greater care might have prevented ; and still le.ss reason have I to expect that my readers, however, courteous, will concur in all the judgments expressed copcerning nur medical writers and their Avorks. On the latter point I claim only to have formed these judgments candidly, and without any feeling of which I am conscious thi:t would tempt me to do injustice to any one. Almost nil that relates to the medical schools of Kentucky I have written from my own recollection, and venture to hope that im account of them will be found free from prejudice. Whatevei' were the controversies ■ in A\'hicn 1 bore a part while connected wath those institutions, the time since has been suf- ficient to allay all the animosities they en- kindled. On an impartial review of the labors of Ken- tuckv physicians and surseous. and a candid comparison of her medical literature with that of her sister states, I believe it will be ad- mitted that a work lias been performed b^^ her medical profession of which she may well feel proud. Hei' gi-p,nt physicians and surg- eons lose nothing by comparison with the statesmen, orators and soldiers who have con- ferred luster upon her name. A near neigh- bor to the Sage of Ashland, his medical coun- selor and intimate frieid. lived the most suc- cessful litholomist of his times. With the hero of Buena Vista grew up to manhood iu 1h(> backwoods of Kentuclrs- another surgeon, to whose boldness and skill the woidd is in- debted for ovaT'iotoray, an operation which has already added years to the avei-age dura- lion of life in women. The most original and elaborate treat i^p on medicine by an American physician is from the pen of a writer who was reared in Kentucky, and while engaged in its preparation was a teacher in one of her med- ical schools. One of the most comprehensive systems of surgery in our language was writ- ten by a former teacher in the same school; and the work on practice which stands at the head of American medical books is made up MEDICAL PIONEERS OF KENTUCKY. 1,35 in part of materials collected by the autlioi- ■wiiile a teacher of medicine in Kentucky. Among those who were first attracted by evu'iosity or by a spirit of adventure to the wilds of Kentucky were two physicians whose names have come down to us. Dr. Walker visited the ■ eastern borders of the state as early as 1747, a good many years in advance of Daniel Boone, and Dr. Connolly came out in 1770, only a year after the great pioneer. (,'oiinolly was one of the company which laid out the plan of the city of Louisville in 1773, a year before the first log cabin was reared by a white man in the state. These hardy ad- venturers came and saw the glories of our primeval forests and our fertile lands, but left l)e!iind them no history of their observations or adventures ; and but little further is known of thorn tlian that Connolly became a tory on the breaking out of the Revolutionary War- after having shared in the confidence of Wash- ington was captured with dispatches on his persoii hostile to the colonies, and cpnfined many years in prison. The medical literature of Kentucky dates back a few months beyond the beginning of iJie jjresent century. It is an interesting fact that the idea of originating a medical school in Kentucky is as old as her literature, As eiirly as 1799 the Medical Dejiartment of Transylvania University was partially organ- i.^ed, and Dr. Samuel Brown was elected to the chair of Theory and Practice of Medicine and Chemistrj'. About the same time Dr. Frederick Ridgely, who had distinguished Iiiinself as a surgeon in the Revolutionary army, delivered a course of lectures in the University to a small class of medical stu- dents. To this dignified and worthy pioneer of the profession therefore belongs the honor of having inaugurated the public teaching of medicine in Kentucky. Dr. Ridgely was a pu- pil and afterward a correspondent of Dr. Rush, and in all the moral elements that go to form a good physician, as well as in general scholar- ship and medical learning, he was a worthy jtnpil of his illustrious teacher. No one who only for a moment turns his mind to the medical literature of Kentucky can fail to remark how great an influence has been exerted over it from the beginning by her medical schools. It originated with Dr. Samuel Bro^vn, who was also first to receive an appointment in the earliest organized school. The medical .iournals, which have done so much to stimulate professional writ- ing, have been chiefly sustained by our schools of medicine. About the time that Dr. Brown was made a professor in Transylvania University he be- came a writer for the medical press. The first medical paper from the pen of a Kentucky pliysician that I have been able to trace is one written bv him for the American Medical Be- pository, at that time, I believe, the only journal of medicine published in the United States. It bears date of June, 1799, and is contained in the fourth volume of that jour- nal. In the same volume is the report of a case by Dr. Brown, dated November, 1800, to- gether with a second one of a later date; and these are followed, in svibsequent numbers, by other medical histories, which, as possessing an inherent interest, as 'well as being matters of curiosity at this day, I shall, notice in de- tail. Dr. Brown, the father of our medical liter- ature, was in every respect a remarkable man. In person he was much above the ordinary size of men, as well as pleasing and commancl ing. He was of a noble aspect, and his man- ners were in keeping with his presence. High- ly gifted by nature, his, fine parts were set off by all the advantages of education. A scholar, with a quick, observant mind, enlai-g- ed and polished by intercourse with the world; witty, fluent in speech, fvill of gener- al knowledge and anecdote gathered from ex- tensive travel, he was fitted to shine as a lec- turer; and if necessity or taste had turned his attention seriously to the practice of medicine, as a physician he might have attained to the highest rank. But with all his powers and varied accoraplishments he was not a success- ful teacher, nor for many years did he take any serious part in the practice of medicine. His mind was a discursive one, and he could not brook the drudgery of his profession. He was a desultory rather than a severe student, and was always captivated by novelty, at the same time his strong common-sense saved him from the wild philosoijhy which pervaded some of the schools of medicine in his day. Dr. Brown was a native of Virginia, and on his mother's side was descended from John Preston, of the Blue Ridge, to whom so many gifted men of the South trace their lineage. He was sent to Edinburgh to complete his medical education, and heard the lectures of Monroe, Bell and Black, where sat beside him fellow-students from America ; Hosack of New York, Davidge of Baltimore, and Mc- Dovvell of Kentucky. He was wont to relate to his classes in Lexington that three of the young Americans resolved among themselves to become teachers of medicine on their re- turn home. The idea, he told us, seemed pre posterons to the students of the old coiintry, find the Americans were not a little ridiculed for their lofty designs. "But," he continued, "we were not to be laughed out of our pro- jects, and in a little while after his return Hosack was announced a professor in his na- tive city, and Davidge was at work laying the foundation of the University of Maryland. I was appointed a professor in this young Uni- versity, but the chair proved to be- a barren scepter in my hand. After many years a new 136 KENTUCKY MEDlt'AT. JOVKXAL. organization was effected, in which my name (lid not appear. But the enterprise failed; The professors disagreed, got into contro- versies, aspersed one another in acrimonious pamphlets, and the faculty was broken up. A iv^'W attempt was made, and my long-cherish- ed vision was at last j-ealize^. I found myself, after so long a time, in a flourishing mediea) school. ' ' ]5ut as he adhered long to no system of medicinC; so he soon grew tired of the business of teaching, and in five years relinquished the place in the school for which he had waited so long. Dr. Caldwell, the most scholarly of his colleagues, on account of this readiness to embrace new theories and sj'stems, pursue them eagerly for a little while and then aban- don them for something newer, was in the habit of compai'ing him to a 'cur-dog hunting rabiiits. ' He certainly was wedded to no doc- trine in medicine. Of none could be ever have said, with the gi'eat Hunter, that "he would never give them up till he gave up the ghost." His anecdotes, -which he told in the happiest manner, formed the most attractive featu7-e of his lectures, or at least the parts which T find clinging most tenaciously to my memory. One in particular I remember re- laied in his valedictory address to his class in. 1824. "I knew a professor in Edinburgh," he said, "who from repeated dislocations of his lower jaw was liable to that accident every time he yawned. On account of liis infirmity it beeam.e necessary to take with him constant- ly' a servant who had learned the art of re- ducing the dislocation. His students soon came to undertsand the case, and when at any ijiue the professor grew tedious, thej' had only 1o set up a general yawning to e.xcite the same i>iovement in him, whereupon, before he thought of it, his jaw would iiy out of place, and while his servant was at woi'k setting it they would hurry out of his room, pretending to think file lecture was over. No doubt, aen- tlemen, he continued, with a pathos that af- fected the most thoughtless of his pupils, you would have been glad many a time this winter if you could have exerted the same con- trol over m,y jaw." Like nearly all great men, Dr. Brown was natural in manner and simple in his tastes, as far as possible removed from that pedanti-j- aiul pomposity that all at one time seemed characteristic of medical men. The follow- ing incident is illustrative of this pleasing trait in )iis character. He had been "called to see a sick cliild in consultation with a leading practitioner of Lexington, and among the nveasures agreed upon was a warm foot-bath. i-e;urning to the chamlier of the little patient the physician in attendance proceeded to give directions to the moth(>r in terms somewhat like these: "You will immerse the lower ex- tremities of your infaiit in tepid water. iuadam, and subsequently use friction freely v.ith a napkin." The mother was lost in the succession of long words and i-aised her eyes in bewilderment. Dr. Brown saw her em- barrassment. and hastened to relieve her by saying, "Bathe your child's feet and legs in warm water, mj' good ■woman, and wipe them dry with a towel." The crowning labor of Dr. Brown's life, from which he expected the happiest results, was the formation of a society designed to pro- mote harmony among the memljers of the pro- fession. He styles it the Kappa Lambda As- sociation, ft jiicluded among its members many of the most eminent physicians in our country. Dr. Brown was its president, and it was his purpose to devote the evening of his days to visiting the branch societies in the towns and cities of the Union, thus cultivating the social relations of physicians. He resign- ed his chair in 1825, and died near Hunts- ville, Alabama, on the 12th of Januaiy 1830. Dr. Daniel Drake succeeded to the chair of Theory and Practice in the Fniversitv. He had been connected with the efforts, in 1817, to form a medical school iy Lexington. His associates T\ere Drs. Dudley, Richardson, Over- toji, and Blythe. The enterprise failed, and the faculty was disorganized at the close of the first session ; Overton returning to Nash- ville a good deal disgusted with medical schools, and Drake returning to Cincinnati to establish one in that city. The feuds th;it led to the disruption resulted in a bitter per- sonal controversy which was carried on for a time in pamphlets, and ended in a duel be- tween Dudley and Richartlson. Dj'ake was al- ready an author before his first connection Avith the FniversitA', and as such was known beyond the boiinds of his own countiy. His "I'icture of Cincinnati" had given him a repu- tation among scientific men in Euroi^e. With the circular letter announcing the reorganiza- tion of the Lexington school came from him to us in Tennessee a prospectus of the Ohio Medical College, setting forth its claim to public patronage. With his indomitable will and perseverence he had procured a charter for a school of medicine in Cincinnati. The gifted anatomist, Godman, was associated with him: but he was doomed to a second dis- appointment, for Godman. after a year or two, became discouraged and resigned his profes- sorship. Two other colleagues became i-efrac- tory and conspired against him. In his char- ter he had unwisely placed the governing po-wer of the college in the hands of the pro- fessors, and when dissensions arose in the faculty there was no umpire to settle them. Having the appointing power, they claimed also the right to expel an obnoxious member. Dr. Drake was president of the factulty, and would at anv time after the first vear or two MEDICAL PIONEEm OF KENTUCKY. 137 have cheerfully accepted the resignation ol; his colleagues,, but being in the minority he could not force them to resign. After God- luan gave up his place but thx'ee professors remained; Jesse Smith, Elijah iSlack and Dj-ake. Things went on from bad to worse, ujitil the majority made up their minds to get rid of the difficulties by expelling the presi- dent. A meeting of the faculty was accord- ingly called. The president had no right to decline taking part in it, and at the appointed liour appeared in his seat. A motion was made by Prof. Smith that Prof. Drake be ex- pelled form his chair in the Ohio Medical Col- lege. It was duly seconded by Prof. Slack, and the president put it to vote. There were two votes in the affirmative, and the chair having no right to vote except in case of a tie, the president gravely announced that "Pro- f(?ssor Drake was unanimously expelled from. t)ie Ohio Medical College;" and Dr. Slack taking up the only candle in the room where tliis scene was being enacted conducted the extruded professor down stairs. in October, the same year, I met Dr. Drake in Lexington, whither I. had repaired to at- tend my first course of lectures. He had re- turned to Transylvania again, chastened by defeat and with powers enlarged by experi- ence. I saw him take the oath of office admin- istered to the professors in the University, and heard his Latin oration when inducted into office. For colleagues he had Caldwell. Brown, Dudley. Richardson and Blythe. I know that large deductions must be made for first impressions on an ardent youthful mind. Much of the enthusiasm excited by new men and strange scenes, I am aware, is to be set down to the charm of novelty ; but my con- viction is still strong, after the lapse of these fifty years, that I have never seen in any medical school a more splendid combination of talent than adorned Transylvania Uni- versity at that day. Caldwell, in all the per- sonal and intellectual qualities that strike the eye and the ear in a lecturer, has rarely been ecjualed by a teacher of medicine. Though al- ready advanced in years, he retained all the fire and vigor of early manhood. His spirits were buoyant and his temper sanguine, and whether on the rostrum or in his study, his air was that of a man who was doing his best. During the mnter Drake engaged him in a debate on the question of spontaneous genera- tion. He affirmed the truth of the doctrine, and adduced many facts to prove that acorns ] night be developed in the earth and fish in miiiponds. Drake overwhelmed him by au- thorities to the contrary, and out of a class nTimhering two hundred canned nearly every student with him. Dr. Drake was in the habit of saying that "he" had resigned more professorships and been oftener expelled than any medical teacher in the United States." His appoint- ments amounted to not less than ten, and he was connected with five scJiools, two of which were his own projecting. It is significant that from his first effort in Lexington down to his last winter iji the University of Louisville, as often as he came to Kentucky he found relief from pecuniary pressure, and with this also comparative peace and tranquility of mind; and that as often as he returned to his loved Cincinnati it was only to encounter jealousy and failure. DOCTOR WALTEU, BRASHBAR.* P>y M. F. CooMES, A. M., M. D., Louisville. ' ' So fleet the works of men back to their earth again, That ancient and holy things fade like a dream. ' ' In telling this story of Dr. Brashear's great work, and being able by accident to pro- duce a likeness of him with it, forcibly recall- ed to my mind the fact so beautifully express- ed in the lines at the head of this page. It is trae that the works of men live long after their mortal bodies have "given up the ghost," but in these modern times it is a pleasure to resurrect from the ruins of the past, as it were, the likeness of some great man that had been lost to the world, and re- store him to the place where he properly be- longs. I always had a great desire to see the face of Dr. Brashear, and never let an oppor- tunity pass if I thought there was a chance to find a picture of him. Persistence in this in- stance proved valuable. Mrs. Guthrie, a niece of D]'. Brashear's called on me for advice con- cerning her eyes, and while discussing the operation that was to be done, not knowing Avhile we were talking that she was Dr. Brash- ear's niece, she remarked that her uncle was a. great surgeon. I at once wanted to know who tlie uncle was, aud of course was delight- ed to have the niece of so distinguished a man for my client. I expressed regret that some likeness of Dr. Brashear had not been left, as I had always wanted to see what kind of a looking man he was; and was sure that a large proportion 'if the medical profession shared this desire with me. "When Mrs. Guthrie told me she had a likeness of her uncle, m.y cup was full to overflowing, and I did not rest until I had it in my possession, and in truth, in the hands of the photog- rapher, and finally in the hands of the finish- ing artist ; and now that I have succeeded in reclaiming the image of this illustrious m.an, and in giving the profession some additional facts about him that have heretofore been unknown to the priblic, I feel that I have been ♦Reprint from the Louisville Medical Monthly, March, 1894. IMS KENTTJCKY MEDK AL JOrUNAL. full>- i-p])aid for my long aud diligent search, Itucause I know that the profession all over tlie world will rejoice at having an opportun- ity to critically view the face of this distin- guished surgeon, and read in its outlines the truth of what has been said of him. Dr. Walter Brashear. the sub,ieet of this siceteh, was horn in iMaryland in 1776. and hi.s father moved to Kentucky in 1784 and en- gaged in farming in Bullitt County, near Shepherdsville. Walter was the seventh son, and according to tradition, was intended for a doctor. His father seems to have been mind- ful of this fact, and sent him to Transjdvania delphia and attended upon a cour.se of lee- tiu'cs at the T^'niversity of Peiuisylvania. " At that time, Barton, Physiek and Rush illumin- ated the medical horizon of the East and were connected with the University of Pennsyl- vania, and no doubt but .young Brashear was deepl.v impressed with the greatness of thi.s trio of medical savants, for in these three was fonnrl all that go to make up a great surgeon and doctor; and Brashear was cei'tainly the personifieation of phy.siician and surgeon, as his modest but remarkable career will s'.iow. Dr. Brashear was of a restless disposition, and after a year spent in Philadelphia, he DOCTOR WALTER BRASHEAR 1776-1860 United States Senator from Louisiana. University at Lexington, then the gi,'eat liter- ai-y institution of the Southwest Young Walter was eager for knowledge, and. we ai'e told, held a high rank as a Latin scholar. .After finishing his literary education. \\-hich was at the age of twenty-, he began to read medicine under the tiitelage of Dr. Fred- crick TJidsely. of Lexington, and remained under his care for two .% ears, and at the end of that time, "he rode on horseback to Phila- shipped to China as surgeon of a vessel. While there he was consulted by one of the dignitaries of the Floweiw Kingdom, concern- ing his wife who had a cancerous brea.st. He assui'ed his celestial friend that he could re- move the breast and that it would result in giving the woman relief. The opei-ation having been finished, Dr. Brashear started to leave the iialact>. but was halted at tho door and told that he could not leave for three MEDICAL PIONEEL'S OF KENTUCKY. 139 days. The American did not comprehend This, but was given to understand that if the woman died inside of three days, that he would be beheaded. This was evidently a part of the programme that had been kept back, but as there was no other alternative, he re- iiuiined the three days, and at the end of that time his patient was doing well and he was permitted to go. Probably no man living was better prepar- ed to hear this ultimatum than Dr. Brashear, I'or the man who had the courage to undertake the amputation at the hip-joint in the month of August, in Kentucky, without any prece- dent to guide him. no anesthetic and with un- trained assistants, certainly had coiirage to to do auj'thing. In the first part of this paper, I have quoted liberally from an address de- livered by Prof. David W. Yandell in 1890, before the American Medical Association, aiu] I can not do better than to use his language in reporting the work of Dr. Brashear. He says : "In 1806, the earliest original and successful surgical work of any magnitude done in Ken- tucky, by one of her own sons, was an ampu- tation at the hip-joint. It proved to be the first of the kind not only in the United Stat(!s l)nt in. the world. The undertaking was made necessary because of extensive fracture of the thigh with great laceration of the soft parts. The subject was a mulatto boy, seventeen years of age. a slave at St. Joseph's College. The time was August, 1806; the place Bards- town; the surgeon, Dr. Walter Brashear; the assistants. Dr. Burr Harrison and Dr. John Goodtell ; the result, a complete success. The operator divided his work into stages. The ^Irst consisted in amputating the thigh through its m.iddlethird in the usual way, and in tying all bleeding vessels. The second con- sisted of a long incision of the outside of the limb, exposing the remainder of the bone, which being freed from its muscular attach- ments, was then disarticulated at its socket." Thus briefly detailed, is an account of one of the gTeatest surgical operations performed in tlie civilized world, and Dr. Yandell, in his report, says: "But whether or not Brashear had ever heard or read a description of what had been accomplished in this direction by surgeons elsewhere, the .young Kentuckian was the first to amputate at the hip joint in America, and tlie first to do the real thing suc- cessfully in the world. Dr. Brashear seems to liave set no high estimate of his achievement, and never published an account of the case." Ex-Governor Robert Wickliffe, of Louisi- ana, who is a near relative of Dr. Brashear 's, is my authority for the facts concerning his imprisonment in China at the time that the am])utation '^f the breast was performed and. (Governor Wickliffe also told me that Dr. Brashear was offered the "Chair of Surgery" in the Academv of Science at Paris, France. His wife, who was exceedingly anxious to Jiave him accept the position, was much sur- in-ised to hear him say that he would not think of accepting it, as it was bad enough to live in Paris under any circumstances, much less to occupy the position of a poor doctor. Dr. Brashear was not without political as- pirations, and it would appear that he was iiLuch above the average politician, as he suc- ceeded in being elected to the United States Senate from Louisiana. Dr. Brashear 's boyhood was probably not without some very exciting experience, for at that time this country was full of Indians, and his father was a noted Indian fighter. Dr. T. B. Greenly, of West Point, Ky., told me a few days since that he attended Dr. Brashear 's brother, Robert, in his last illness, some years since, and, while speaking of the matter, recalled an incident that happened at the Salt Works, which were owned and oper- ated by Dr. Brashear 's father, Ignacius Brashear. The Doctor and his brother were boys that were not to be run over by every fellow that clianced to pass, and. in fact, were no led as fighters. In those good old times, the weapons that God gave men were about all that were used to. settle personal difficulties, and it seems that Walter and Robert Brashear knew how to use them. On a certain occasion a "bully" happened to he in the Brashear neighborhood, and concluded he would go up and w^hip the two Brashear boys, and when he arrived he found Walter at the Salt Works by I'.iiiiself, and it did not take long for him to pick a quarrel wdth young Brashear. Brash- ear, however, felt tliat the stranger had the best of him in size, and probably in the "fistic-art" he would have little chance, but lie determined to get the best of his antagon- ist and get the first lick, and other advantages also if they were to be had. There was a jtond near by, and at a favorable moment when the stranger stepped near the pond, Robert sent out a right-hander and lancled it under his ear, which sent him sprawling into the pond, and quicker than thought Brashear was on top of liira, and in a, short time the fel- low was crying for mercy. Dr. Brashear was married at Lexington, in 1802, to Miss Margaret Barr, by whom he had seven children : three sons, RolDcrt, Walter and Darwin, and four daughters. Mary, Re- becca, Caroline and Frances. I have no his- lory of any of his daughters, save one, who is living in New Jersey. None of his sons ever became doctors. Darwin died young, and Robert was a successful sugar planter in Louisiana, and died during the late war. His son, Walter, a grandson of the doctor, is now iu Louisiana. The Brashear home in which he was reared is still standing in Bullitt County, in a fair 40 KEXTUCKY METHi'M. .JOURXAL. state of preservation. Dr. Walter Brashear (lied October the 23rd. 1S60. aged eighty-four years, and is resting- iu the soil of his adopted State, Louisiana. DOCTOR JOSHTLl TAYLOR BRADFORD. By W. W. AxDERSOx, M D., Newport. In writing the biography of a modest man many years after his death one is beset "irith serions difficulty because of the scarcity of data. The modest man however great his worth and however important his work, does not thrnst himself into the limelight of pub- ihat its meager offering maj' call forth from the memory of those still living a richer and more intimate history of this remarkable man. ^rcDowell's great woi'k had not succeeded iii establishing ovariotomy as a proper sur- gical procedure. It had barely blazed the way and few had dared to walk therein and mcst of these few had trodden upon disaster. The groat schools of T^ondon. Edinburgh and J'aris to which the American profession look- ed for inspiration and authority condemned the operation. Sui'geons turned deaf ears to the distressed cry of the unhapp.y sufferers with ovarian tumor and disease and abandon- DOCTOR JOSHUA TAYLOR BRADFORD Who revived ovariotomy after it had fallen into disuse in the middle of the last century, and was a distinguished medical officer in the Civil War. licity. ^Inch of what he was and what he did are likely to be lost in the lapse of the years. "Were the character and labors of the late Dr. Joshua Taylor Bradford of Augusta, so to fade into oblivion an irreparable loss will have been sustained. That the honor of Ken- tucky iriedicine and the glory of its great achievements be not dimmed by forgetfiiluess this biographical sketch is indited iu the hope ed them to their fate. It required a man of L'Oth sjnnpathetie and courageous heart to un- dertake their relief, and a man of rare learn- ing and consummate skill to succeed in the undertaking. Such a man was Joshua Ta.^lor Bradford. He was born in Bracken County, Kentucky, ill 1817, the sou of a minister, a descendant of William Bradford of the ]\Iawflower Pilgrims, MEDICAL PIONEEhs OF KENTUCKY. 141 second governor of Plymouth Colony, and also of William S. Bradford, second U. S. Aitornej^ General under Wasliington. He was educated at Augiista College, Transylvania University and the Jefferson Medical College, Philadelphia. He was an ardent admirer of Ephraim Mc- Dowell both as a great surgeon and as a (christian gentleman. That he was an earnest (.'hristian himself is attested by the fact that his medical -writings abound in apt quotations oF scripture, and that his life even more than liis language porti-ayed a generous good will toward his critics and an imselfish service to all, which are the best possible evidences of disoipleship to the Great Physician who went about doing good. Lizars of Edinburgh had attempted to fol- low McDowell 's lead but losing 75 per cent of his cases gave it up. No serious attempt to revive the operation anywhere in the world appears to have followed for a score of years. Then it was taken up by Clay of Manchester. England, with a mortality gradually dimin- ishing between the years 1842 and 1856 from 40 per cent to 25 per cent. By this time Dr. Bradfoj'd had revived the operation on its native soil of Kentucky in a series of seven consecutive cases without a death. On hear ing of this Mr. Clay wrote him, "I am delight- ed to hear of your great success, far exceed- ing my own." Dr. Samuel A. Cartwright of New Orleans, himself a noted siirgeon, wrote in 1857, "The writers and teachers of London and Paris will find difficulty in believ- ing that a physician in the little toiwn of A\i- gusta, in far distant Kentucky, has been en- gaged in seven successive operations for ovar- ian dropsy, all proving successful, when their most successf'.il surgeons have failed in five out of seven," Dr. Bradford's complete series of ovariot- omies numbered thirty, with a mortality of only ten per cent. When it is remembered that he died in 1871 at the age of 54. that all his w(.rk was done before the use of antiseptics, and some of it before anesthesia, it stands as a wonderful i-ecord of achievement, iinequall- ed in all the world befoi'e the days of modern surgery. And yet there was no magic or flight of genius about it. Like intelligence and training, equal courage and care, the same thoughtful devotion and painstaking diligence, have always brought forth extra- ordinary results and will still do so. Dr. Bradford's life and work well illustrate the thought that the man who undertakes re- sponsibility for the life of his fellows should be truly religious, not in the dogmatic or doe- t)'inaire sense but in the practical outworking of his everyday existence. A lover of his kind he could not rest easy in the presence of suffering unrelieved. It was not sufficient for him that the surgery of his day offered no re- lief. He must seek a better surgery. Deeply conscious of the sacrediiess of numau life he could not operate recklessly, or repeat the mortality ot Lizai's and others. He must find a safer way. Keenly seiisitive to criticism and sternly faithful to diny he could consent neither to deserve the one nor to desert the other. In tlie midst of an operation at Paris, Kentucky, the patient collapsed. His assist- ants, appalled by the serious siituation and the i'ear of criticism deseited liim, refusing to have anything more to do with the case. Ap- plying restoratives, he answered tlieir implied condemnation by saying, "Gentlemen, this operation has been conducted according to the best surgical knowledge of the day," complet- ed the work unaided and saved the patient. He studied his cases with uncommon care, taking a very complete history, eliciting all signs and symptoms with practical skill, and coordinating the whole with fine diagnostic I'easoning. He attributed Ms success to a careful selection of cases. This better select- ion was due in turn to more efficient diagnosis. He never mistook a solid tumor for a cyst, or one widely adherent for one comparatively free, and thus avoided the dangers of what in liis day would liave been reckless surgery. In spite of his brilliant results, so far aliead of his time, he was not satisfied. His faithful report of his unsuccessful cases portrays a keen sense of failure in such instances. He read everything available in his line and cor- j-esponded with the leading surgeons at home and abroad, eagerly seeking betterment of his work. His very full report on ovariotomy to the Kentucky State Medical Association in 1857 represented two years of arduous labor in collecting and tabulating cases and work- ing out the conclusions to be drawn from tliem. He seems to have been the first to solve the problem and demonstrate secondary hem- orrliage was due to retraction of the stump. He insisted on the most careful preparatory and after treatment, and followed up his cases to restored health or to the post mortem table '.vjien fatal. To him each patient was a real ])ersona]ity to bo seiwed, not merely a speci- men of scientific interest. This holding himself sternly to the doing of his best, this "New England conscience" of the man, was the outgrowth of a sincere ( 'hristianity and a deep devotion to his pro- fession, expressing itself not in creeds but in deeds. His was the heritage of a goodly race ajid his a worthy progeny. A son and daugh- ter, the offspi'ing of his marriage with Sarah Armstrong, still survive; Rev. W. G. Brad- ford of Augusta and Mrs. H. D. Yoder of To- peka. Kansas, both persons of note in the clerical and literary world. Dr. Bradford's achievement in other lines of medicine and surgery were only second to tbose in ovariotomy and would, of themselves, 142 KEXTFCKY MED/CM. .KHUSAL. have given him liigh rank iu the profession. He served iu the J^'ederal army iu the Civil War as surgeon of Nelsou 's brigade. At Pitts- lan-g Landing he led back to tlie tiring line a body of troops that !iad lost its officers ana was retreating in disorder, and was then found treating a wounded and captive Con- federate. Wliile home ou sick leave he com- manded the Home Guards iu the defense of Augusta against the supei-ior force of Geu. .fohu H. ."Morgan and alter the surrender he was eialn-aeed by Gen. ^Morgan who exclaimed, "1 love a brave 'iian wherever I lind him." A man of ];is worth could not escape fame. Gross's surgery, shortly before his death, ac- corded him the lowest mortality iu ovari- otomy on either side of the Atlantic. He was oii'ered the chair of surgery in the iledical College of Ohio as successor to liis friend, the famous Dr. Geo. C. Blackmau, and was often ui-ged to seek larger fields for his talents but alwaj-s declined, ha^-ing no ambition that cen- tered in himself. It seems part of the irouy of fate that his man who did so much for the advancement of abdominal sui-gery should have lost his o\\n life by an abdominal tumor in 1871 at the early age of fifty-four. But even in this he proved the courage of his convictions by suh- luittijig hiiiiself to an operation which, how- ever, proved unavailing. Perhaps it may in some measure be said of ever^' savior of men. ""He saved others. Himself he can uot save.' SELECTION KitO.M A liEPOI^T ON oyarioto:my.* By JosHu.i Taylor Bradford, M.D., Augusta. "Go to the Parthenon and find out, not what bungler.s, but what great men have left undone." — Sculptor to his Pupil. .\ Word of Explanation. — To you, mem- ) : Second cases, 1 death in SV^ ; Last cases, 1 death in 4. ' ' "This," says ^[r. Clay, is '"I believe, the le- gitimate mode of viewing the question pro- MEDICAL PIONEELS OF KENTTJCKY. 145 gressivelj^, by wliicli the mortality is shown to 'be gradually lessened by practical experi- ence. ' ' Charles Clay was the first English surgeon to perform the oT)eratiou of ovariotomy by the loug incision, and it is said by Dr. Blum- dell, that "perhaps no operator in any branch of surgery ever had such a weight of profes- sional odds against him. as had Mr. Clay in the operation of ovariotomy." He had ti-iumphed., however; and his record is before you, over his o',vn signature. I\Ir. Clay is now fifty-six years old. He is reputed to be a "bold, prudent, graceful, and elegant operator in any department of sur- gery." At the time of his fifty-fifth opera- tion, not less than "eleven hundred pounds of diseased structure has been removed from the human body in this special operation alone.'' It would now, perhaps, make an average of twenty-five pounds to the patient, amounting to near two thousand pounds. I^fr. Clav is now in possession of the largest obstetric librarv in the world, being able to quote from 2,500 authors on that subject alone; and whilst yet a student, he is said to have taken notes from 500 volumes. In the Lnndnn Medical Circular and Gen- eral Advertiser, to which T am indebted for much of the information relative to IMr. Clay, I find letters from James Blundell, congratu- lating Mr. Clay upon his success. I will q^^ote briefly a part of each. Dear Sir: My cordial congratulations on your success ; not the hap of lucky incident, but the well-earned result of a just mixture of enterprise, science, and exact care. A few years and T trust it will appear, abdominal surgery is at present only in its infancy; but then, what an infancy ! how full of bloom and promise! Jas. Bwjndeli., M. D. A orain, in another letter dated October. 1845: "Foi-be's rcAaew I have just i^ead. It ought not to disturb you for a moment. These vden are butting their heads against a stoiie wall ; and the grimaces they make on feeling the sol- idity of the materials, are as amusing as they are pitiable. Applauded by all who have hon esty and intelligence enough to appreciate your efforts, you may well persevere, for to use tlie reviewer's own citation, it is indeed a 'high and holy undertaking.' Yours, etc., -Jas. Br.rNDEKL, M. D. Professor Simpson, of Edinburgh, among many others, encouraged Mr. Clay, sent him patients for his opinion, and was the first 1o suggest the +orm ovariotomy, which Mr. C1a,y at once adopted. DOCTOR wrASHINCTON ATLEE. Next in the ai'ena of operators, in 1814, our own countryman. Dr. AVashington Atlee, of Philadelphia, comnusnced his seri'"-s of opera- tions. He informs me by letter, which is made a part of this report, that his operations now, March, 1854, amount to twenty-three eases. Of first 10,6 died, 4 recovered ; Of second. 13, 4 died, 9 recovered. The profession, in this county, owe Dr. At- lee a lasting debt of gratitude for his vigorous and energetic exertions in behalf of the opera- tion of ovariotomy. His table of cases bearing date as far back as 1701, and coming up to 1851, comprising 222 operations, then the most numei'ons collected in the world, must have cost him an incredible amount of labor. And this arduous task has been no less signal, than the brilliancy and success of his opera- tions. Dr. Atlee 's "Prize Essay on the surgical treatment of certain fibrous tumors of the uterus," tosrether with his numerous contri- butions to the American Journal of MedieaJ Science, on ovurian disease, is full of interest and instruction; and to these articles, to- gether with the publication of his own opera- tions in ovariotomy, we may attribute, in a great desjree. the spread of the operation throughout this country. It would be both difficult and tedious fur ther to particularize operations in this coun- try, however earnestly I may be induced to do so. L may say, however, and I trust with as uuich truth as pride, that, in the West, the op- eration of ovai'iotomy has attained as great, if not a greater degree of success, than in any p.;rt of the United States • and in Kentuekv, as renowned for her sursrery as for hej' chival ry, we have gone as far "as he who goes ffirthest." Tliose of you ^vho have read the report of Professor Gross on "Kentucky Surgery," must feel proud of the surgery of your State. It has kept pace with the intelliffence, the agriculture, and the chivalry of her sous. And wliilst the repiitation of the intellect and patriotism of her statesmen is world-wide: whilst even along the classic shores of Greece, "They minale witli their g-rateful lav, Bozzaris with the name of Clay," yon have prodnced the first and greatest ovariotomist. Dr. Ephraim McDowell; and you have produced the most renowned lith- otomist known in anv clime, Dr. Benjamin W. Dudley. Diagnosis. " Ah ! there 's the rub. ' ' And when I approach the examination of a case in wliicli a proper diagnosis is sought. T am frequently remind^^d of that remarkfdile pas- sage in the Book of Books. "He that thinketb he standeth. take heed lest he fall." It is said by the historian, ilaeauley. that a "history of the eriors and follies of a nation is- essential to the generation which follows." So it is with ovariotomy. Its past history pre- 146 KENTUCKY .MEDICAL JOVHNAJ.. soiits an array of errors and grave deceptions v."l>ir'h is, perhaps, \\-itliout a parallel, in mind or inemorv. It is said liy ;\rr. Phillips, that the most learned men of Edinburgh examined a case ^rith l\Ir. Ijizars, and after agreeing that it Avas ovarian tnmor, Lizars proceeded to operate, whereupon obesity and flatulence j'evcaled themselves, instead of ovarian tumor. In a second case of Jlr. Lizars, the memor- able ease of IMagdalene Biiss.v, a case often appealed to by opposers of ovariotomy, to show how long ovarian disease may j-emain liarmless, Mr. Lizars attempted the opera- tion for ovarian tumor, but failed; the wound ■ivas closed up and the patient recovered. Twenty-five years after, this patient died of ai)oplexA\ Dr. Simpson was present at the ])ost mortem examination, and in a note to Dr. Tilt, says: "The tumor was pediculated, but fibrinous and uteri7ie, not ovarian." In a let- ter to Dr. Robert Lee. after the nost mortem examination. ^Iv. Lizars says: "Then, allud- ing to the time of the oneration. every one who examined her. considered +he tumor oA'arian and free from adhesions."* In the case of Smi+h and ^McDowell, where the patient had tapped herself ninety times lioth eonsidei'ed the diagnosis as certain, but on oneninc the abdomen, no ovarian tumor was found, but a mass of intestines matter to gether by adhesions. f Dr. Ijyman relates the case of Boinet, where the best surs'eong were unable to decide upon a tnmor. A consultation was held; among those present were. Roux. Blandiu, Roberl PJontaine, of Lvons, Recamier, Joxbert. INfar- tiu, Lolin and others. Opinions were divided between pregnancy., extra uterine pregnancy, foecal aecumiilations, encysted ovary, collect- ion nf blood in the uterus, etc. She was under observation many months, the tumor eventu- allv disappearing after an attack of diarrhoea. TTenrv Smith relates a case where an incis- ion eight inches in length was made for the removal of ovarian tnmor. Both ovaries were found to be .somid and indurated omentum found to be the cause. t Prince relates a case which was pronounced to be ovarian tumor. He operated; tapped the patient: Imt a few drops of blood escaped; he eut and tore ^he part with the finger ; tent in Iroduced. Tu a few days the patient died. A post mortem examination was held, whereup- on a large pedunculated tumor of the spleen was found, looselv adherent to peritoneum. tt Dr. Philip Bnckner. foi-merly of Kentuckv, tc whom T am indebted for much of my early infoi'ination with reference to the operation of ovariotomy, diagnosed a case as ovarian tu- mor- "opei-ated by an incision of nine inches; *Lni,ilnn l.nncti. vol. 1, 1841. tAppendix to Cooper's Surgical l^ictionary. tPhUnddphin Medicnl Examiner, January, 18-55. ttimerfcan Journul of Medical Science, 1852. no ovarian tnmor found : but a tumor situated in the mesentery, between the lamina of the jieritoneum. and surrounded by small intes- tines. The opera+ion was proceeded with, the. tumors dis'jected out. and the superior mesen- teric artery and other small arteries tied. The pa+ient recovered, and in spite of the great separation of the mesentery from the intestines, no apparent bad consequences of any kind ensued." "This," says ilr. Brown, of Edinburgh, "is the most hazardous feat of oi)erative proceeding I am accjuaiuted with, in which our transatlantic brother has gone ahead." 'SIv. Harvey presented a ease of much inter- est to the London Medical Society of sup- posed ovarian dropsy. Ovariotomy was de- termined upon, but not performed ; and when, the pati'^nt died, the disease was found to be an hydated cyst, connected with the liver, no ovarian disea.se whatever existing.ti T have collected msnv other cases of equal interest bearing unon this point, but those al- readv nuoted are "proof strono' »s holv writ." tlia*" the diagnosis in ovarian disease It^s been, and still is, most wofullv defective. But while 1 freely a^knowledsre the enormity of these errors. I am fully convinced that the diae- nosis is yet in its infanev. and that m-^nv of these errors have and will vield to the increas ing enercry whi<^h is being brought to bear by many of the first men of the profession on tills subieet.** It is not alone in ovarian disease that verv grave and flaoT-^nt errors have been commit- ted bv distininiished sm-p-eons It is said that Sir Astley Cooner and Dr. Hip-liton. of Lon- don, in a case of nresnancy. where the quan- tity of linuor anrnii was so enormous as to ren- der fluctuation distinct appointed a dav foi- the opera+ion of paracentesis. In the mean time, the ladv was taken in labor and deliver- ed of a chiM.f * Mr. S. ininl nf :M^dicaJ .Science. October. 1852. '*nro\vii. p. 9fi. ■ +*Brown on Surgery, Diseases of Women, p. 190, MEDICAL PIONEEL;> OF KENTUCKY. 147 who decided that no organic disease existed, ajid that the difficulty was nervous irritabil- ity, and required hina "to feed well on good roast beef," and "to take two generous glasses of wine" with his dinner. Mr. Abercrombie, of Edinburgh, afterwards confirmed the opinion of Sir Benjamin Brodie. It is now twenty-five years since this con- sultation occurred and Mr. Goodrich is still living, having already sold his own writings seven million copies. t* "How often," says Dr. Buchanan, "has (lie operation of lithotomy been performed without finding a stone in the bladder, or, if found, tlie stone being enc jested and not re- moved, and the operation remaining incom- plete." Yet in surgery this is legitimate. In all departments of surgery, as well as of ordi- nary practice, and in diseases, too, about v^hich the profession have been writing and investigating for hundreds of years, grav^ and serious errors liave been committed. "Why not in a disease that is as yet in its in- fancy as to science? I might cite ,vou to numerous instances in pregnancy, from the medical jui-isprudence of the country, and from obstetricians, where serious and acknowledged errors have been committed. Indeed, I know, in my own his- tory, of a case where two respectable practi- tioners deiibei'ately examined a lady suppos- ed to be presrnant, and who was then in the sixth month, but who declared that she was not pregnant, and that it was a foul slander upon her character. However, "murder wil) out." and in the course of time, a son was the result of their grave diagnosis. This same pa- tient was under the treatment of a practi- tioner for several months, but, with all the jjouitices and hot fomentations his genius an.l skill eoidd bring to bear upon the swelling, i1 would not go down until nine calendar months had duly elapsed. I might enumerate many instances in the common practice of our profession, where errors in "high places" are daily committed. I will mention one from the memorabilia of m_y own case book. Not long since. I was called to see Judge ]\Iori'is, of Chicago, who was at that time in Kentucky. I found him .jaundiced and much emaciated. He had been unwell for manv months, had been treated, he said, by the fac- ult.v of Chicago, by some for a neuralgic af- fection of the stomach and liver, and hy others for a spasmodic action of the "duct leading from the liver." He was finally ad- vised to travel, but before reaching Cincin- nati, on his way to Kentucky, was attacked in the cars. At Cincinnati he was treated bv Dr. Taliaferro, who advised him to go to the J^Goodrieh's Recollecti( Lifetime, p. 282 Blue Lick Springs. He went there with the liope of clearing up his skin, and was there at- tacked again. From thence he went to Brook- ville, at which place I saw him, in consulta- tion /with Dr. Corlis. He was then suffering "with a severe paroxysm of pain, commencing in the right hypocondriac region, branching ojf to the shoiilder. The pain was increased by motion, and often after a meal, pulse near- ly regiilar : and when these irregiilar attacks of i)ain would cease, it was all of a sudden. It goes off like no other pain, with or without inflammation. After I had finished the exam- ination and had a conference with Dr. Corlis, he requested me to give an opinion. I told him he was suffering- from gall stones, passing from the liver. "What." said the patient, "a quarry in the liver?" He reminded me that each medical man whom he had consulted had a different opinion, and that he did not know whom or what to believe. I directed the nurse, when the bowels were acted upon again, to thin their contents by pouring on water, and then to pour out the contents of the vessel on a white cloth. On the next morning the nurse handed to the patient two small pebbles or gall stones, one as large as a pea, and the olher the size of a grain of wheat. On my next visit I found him cheerful and "ready to render unto Ca?sar the things M'hich are C'tPsar's." In a few weeks he went home. Soon- after he was eonfi.ned to the bench for three or four weeks, trying the well known case of Green for the murder of his wife, and was again attacked. I was telea-raphed to .go and see him, and in connection with his attend- ing physician, advised him to leave the bench. He did so, and since then married near Lex- ington, Ky., and is, I learn in good health. A correct diagnosis is the keystone of sue- cpss in ovariotomy, and the care with which we trace its parts should be the landmarks — tlie corner trees by which ^ye take distance and move with our compass. IMuch of the illiberal opprobrium heaped upon the operation, and on operators in gen eral, has been the result of "itehino' palms" for professional renown, of umnatured and hasty diagnosis, and of the difficulty inexperi- enced operatoi's have had to get what infor- mation is legitimately in the hands of experi- ejiced operators. There is perhaps no disease incident to human fle.sh which recpiires so de- liberate, close, and patient investigation, as 1hat which relates to ovarian disease. A drop of water falling into a bucket is small in itself, and scarce worthy of note, but in this way the bucket may become full. So it is in the diagnosis of ovarian disease, each svmptom, however minute and seemingly of little conse- ((uonce in itself, if carefully noted and prop- erly weighed as a whole, will generally en- able us to arrive at proper conclusions. A";l US KESTVCKY MEDICAL .JOl'RXAL. in 1his rule of action lies one of the secrets of success in ovariotomy. Show me a surgeon who in other operations may have his share of Miceess. InU ivho has a snmmaiy way of ex- amining his patients, and of dispatching his (iperations, and I will show you one who is unsuccessful in ovariotomy. I am fully sensible of the importance, and 1 ill' difficulties we encounter in obtaining sucJi information ns will guide us in the examina- tion of ovarian diseases. Less has been ■writ- ten about it. in proportion to its importance, than any class of diseases known to the "'heal- ing art." I shall tlierefore attempt, from my own humble experience, and that of others, so to r-hissify the symptoms and means of exam- ination, that ""he who runs may read."' I may sa\', however, that yon may meet ^vith eases which for the time being may baffle youi- strongest apprehensions and your most scruti- lii.^ing examination. T believe with Dr. Arm- strong, '"that when we find oui-selves in the dark, it is be+ter to stand still until the light returns," than to run the risk of going over a ])reeipice. In other words, it is better pru- dently to wait for further difficulties by dar- ing to oppose them." and in this age of won- ders there is scarcely am-thing insuperable. 1 remember to have read of. or seen at some time, a picture representing a party of men, tlieir hats and coats lying by their side, and, with pick-ax in hand, attacking the base of a mountain, whose summit towers far above tlieir heads. T^e look again, and the steam- liO)-se, as though "the speed of thought were in liis limbs." follows their footsteps through tlie bowels of the earth. Before commencing the examination of a pal^ient supposed to have ovarian tumor, or dropsy of the ovaries, it is important to have the bowels and bladder emptied. If there is much tendei-ness or soreness in handling the iumor, it is better to give the patient chloro- form, as it will enable you, without pain on lier part, to conduct a more complete examin- alion. Prior to this, liowever. sit f|uietly down, as if the day was devoted to tliis par- ticular purpose, and obtain from the patient a complete history of the case. How and when the disease connuenced, of how long duration, whether painful or not. in what state the gen- eral health, ^\]lether the menstrual discharge is I'egular. does the tumor move from one side to ihe other in turning, is it, as far as you have observed, movable at all has it by any course of treatment diminished in size, ha,s. it any time been accompanied with swelling of one or liotli of the lower extremities, etc., etc. The patient should be placed upon the back, with the extremities flexed, so as 1o relax the abdominal muscles. Our aim must be, in the examination, to ascertain whether the tumor is ovarian or not. and then its pathological charactei*. Tu two-thirds of the eases which I have examined, I have found the tumor to commence in the right or left iliac fossa : and the patient to describe it, wiien first noticed, to have lieen as big as a hen's or goose egg. In other instances, it attains to considerable size before it is noticed. I operated on a case last summer, where the tumor attained the Weight of twenty-four pounds in thirteen months. The patient did not know upon which side the tumor commenced, and was lui- der the impression that she was merely be- coming fleshy, so little was she complaining. In ovarian tumor there is generally but littl« disturbance of the general health. The stom- ach, liver, and kidneys generally maintain their usual action. So even with the menstru- al discharge except where both ovaries are diseased. Dr. Frederick Bird has published a case, where the disease was of sixteen years' standing, and during seven years of that time the menses disappeared, operation, patient re- covered. If fibrous or scirrhus tumors of the ovaria, the menses are oftener irregular than in en- cysted tumors. Occasionally you \vill meet with a case, where, in +he early part of the disease, the patient suifers with what she sup- poses to be colic, .\t such time, if the tmnor. or bowels, is firmly pressed upon, the pain )aay b.e traced deep clown in the right or left iliac fossa. At other times, from active exer- cise, or exposure to a sudden change of aii- while exercising, a diffused soreness will be felt over the bowels. A lady, ^Irs. Burns, from near ^larietta, Ohio, came to Augusta to con- sult me for the treatr^ent of "dropsy of the bowels," Soon after her arrival, she was at- tacked with ^'iolent pain and great tenderness of the abdomen, so much so, that no pressure could be borne upon the bowels. She was con- fined to her bed for ten days. I learned from her that such attacks were frequent, and she attributed the present one to the travel in the cars, or from the walk from t\\e boat to the hotel, "^^len the pain and soi-eness of the bowels had subsided, T made a careful examin- ation of tile case, which convinced me that it was ovarian tumor. "With the exception of these occasional attacks, her general heo.ltli is good, and in consequence of this fact, I have not yet operated upon her. May these attacks not originate from the friction of the tumor against the peritoneum, causing some degi-ee of inflammation to set in ■? I merely mention this case, and may, by the way mention othere, where it ^^ill illus- trate a fact or corroborate a principle. As the tumor increases in size, it maintains a rounded outline, and is uniformly dull over the region by percussion, in whatever posi- tion the patient may be placed. As it ascends from the pe]%-ic eavitj^ to the abdominal, it MEDICAL PIONEEu.S OF KENTUCKY 149 rises in front of the bowels, and in proportion as it extends to the opposite side from which it made it-"! appearance, and spreads out over the bowels, will the dullness be obsei-ved by percussion in the same ratio. The intestines lie under or behind the tumor, whilst in ascites thej- float on top of the liquid, contain- ing, as they always do, more or less gas. In the former we have the dull sound peculiar to ovai-ian tumor, while in the latter the sound on percussion will be resonant. The more advanced the disease, and the larger the accumulation of liquid, the thinner and tighter are the walls within which it is confined, and the more distinct the fliictua- tions. "Even when the quantity is small," says Dr, Watson, "not exceeding a few onnces, a little practice and management will enable you to detect it. Percuss with one linger the most dependent part of the cav- ity, and apply at the sam.e time a finger of the other hand very near the part struck ; and if liquid be there, yon will perceive a limited, yet a distinct, fluctuation. Tn the same way, tlie presence of liquid in a small cyst may sometimes be ascertained."' The veins of the abdomen are increased in size and number; this, however, is not so marked until the tumor has attained consid- erable size. The uni-locular cysts present a uniform sur- face, whilst the multi-locular have an uneven and irre.u'nlar surface. In the uni-locular cyst fluctuation is distinct from one side of the ab- domen to the other, and generally per vagin- am also ; whilst in the multi-locular it is dis- tinct only over a particular part of the abdo- liien, in the immediate part of that particular cyst. I remember to have examined a ease where fluctuation could not be felt from one side of the abdomen to the other, but was dis- tinct in a certain space on both sides. It was not perceptible per vaginam, from the fact, as it proved afterwards, that the tumor consisted of three cysts, one occup}dng the pelvis, and one on either side of the abdomen. In this case, the womb was thrown back upon the rec- tum, as it often is, and the uterine sound could not be easily introduced until an assist- ant, standing by the side of the patient, plac- ed his hand in front of the tumor and lifted it up with considerable force. By this maneuver of an assistant if we re- tain our finger in the vagina, and there ar^ any considerable adhesions to the womb, or the tumor is a part of the womb itself, the womb will sometimes be lifted nearly or quite out of rea.'h of the finger. When the vagina is elongated and drawn up under the arch of the pelvis, or the uterus thrown back on the rectum, with an assistant stationed as above, we will be better enabled to use the uterine sound, and push the womb from side to side, if there he no adhesions. Wlien it is remembered, that the most fatal adhesions are generally found at the base of the tumors, wc can not exercise too much cau- tion in +his part of our examination. In the diagnosis of uterine, and non-uterine tumors, I have found the uterine sound, at times, in- dispensable. And here allow me to describe its use in its inventor. Prof. Simpson's, own language. "It may be used in one of three ways : ■'1st. The uterus may be retained in its situation, with the bougie, and then, by the as- sistance 0^ the hand above the pubis, or by some fingers in the vagina, the tumor, if unat- tached to the uterine tissue, may be moved away from the fixed uterus. "2nd. The tumor being left in its situa- tion, it may be possible to move away the uter- us from it to such a degree as to show them to be unconnected. "Or, 3rd. Instead of keeping the uterus, ^>olh may be moved simultaneously; the uterus by the sound, and the tumor by the hand or fingers, to opposite sides of the pelvis, to such an extent as to give still more conclus- ive evidence of the same fact." Wlien the tumor is small, by introducing tile middle finger into the vaigina and the thumb into the rectum, we will lie enabled to fee] an elastic, egg-like tumor between the rec- tum and vagina. It is sometimes slightly painful and tender, but again there is no un- easiness manifested to the touch. Dr. Churchill, in his Diseases of Women, says: "If the finger be introduced into the rectum past the tumor, we will find the fun- dus uteri, and be able to distinguish it from the enlarged ovary. This is very necessary, or we might conclude the case to be retroversion of the womb. In addition, it may perhaps en- able us to decide whether one or both ovaries are diseased." "It .should be remembered," says Dr. Brown, "that hernia may descend between the vagina and rectum, and feel like a tumor in that region : but in the absence of s3anptoms of strangulation, we must distinguish it from ovarian cyst hy the effort of coughing and change of posture, and by beih'g una^ble to pass the finger bej'ond the tumor." The pressure of the tumor in the pelvic eav ity soraetimei? gives rise to difllculty in void- ing urine, torpidness of the bowels, etc. There are sometimes occasional symptoms of preg- n.ini',y, morning sickness, enlargement of the breasts, and sometimes violent pains set in, re- sembling labor pains. Here the stethoscope is our guide, together with the time which has elapsed since the commencement of the dis- ease. A young lady, upon whom Dr. Dunlap and myself operated, presented some of the above symptoms, and it produced no little commotion in the community among whom fiho lived. 150 KENTUCKY MEDICAL JOVRXAI . There is anothei- means of diagnosis and ex- airiination to whieb in invite your careful at- tention and cultivation. It is the sense of touch, or pressure upon the abdomen, with the the ends of the fingers. If we percuss or press firmly, and in quick succession, with the ends of the fingers over an ovarian cyst, there is, at the cessation of pei-cussion. or pressure, an elastic sensation — a rebound to the senti- ent extremities of the fingers — a resisting or reSeeting back of the fingers, in the distended cyst; whilst in ascites there is not the same elastic response to the finger. In fibrous tu- Tiuirs and enlargement of the spleen, there is a doughy, fleshy sensation to the fingers, which is niore easilv felt by the pi-acticed finger than described. This means of diagnosis requires practice of the fingers, as it does to distin- guish the different shades of the pulse. Of this diagnostic sisn. Dr. "Watson says: ' ' If you prpss suddenly with the tips of the fingers in a direction perpendicular to the sur- face, a sensation which it is difficult to de- scribe in words, yet which is quite decisive, and not to be mistaken, a sensation of the dis- placement of liquid and of the impinging of your fingers upon some solid substance be- low." The same writer fi;rther states, in reference to Ihe senses: "You will find what previous to positive trial you might not suspect, that the senses, the eye, the ear, the toiich. however sharp or delicate they may naturally be. reciuire a special course of training and education, be- fore their evidence can Ije trusted in the in- vestigation of disease." Dr. Latham says. (I quote fi-om Bennett. "i with equal truth, that the "knowledge of the senses is the best kuo^yledge, but the delusions of the senses are the worst delusions." Swelling of the lower extremities we some- times meet with, both in early and later stages of the disease. This originates from the pres- sin-f of the tumor upon the vessels which re- turn the blood to the heart. See case of ^frs. V.Uliams, of Indiana, and ^Irs. Martin, of Maysville. Ky. In the latter case, ascites, swilling of the limbs, and ovarian tumor co- exist. AAlien we have diagnosed the disease as ovarian tumor, next in importance is the ex- tent of adhesions and the prospect of its re- moval. Perhaps the .<^uide of no author is bet- tor, or the experience of any individiwl more to be relied upon, than that of Air. Brown, of Edinburgh, in his tests for adhesions. Af- ter placing the patient on the back, with the (■\i remit ies flexed, .so as to relax the ahdominal jiarietes, he directs the cyst to l)e moved from si^le to side. If this were readily done, he knew tluit there were no adhesions. He then jn-essod firmly over the relaxed parietes, and moved them ovpr the cyst : if they were read- ily moved, he knew there were no adhesions on the upper and lateral surfaces of the cyst. He then g'-asps and puckers up tlie parietes, and moves them over the cyst, and .saw if they v.-ere gathered up readily, without raising the cyst itself. He then requires the patient to take a full inspiration, and if there be no ad- hesions to th'^ extent of an inch, the place ])reviously or-eupied by the tumor being taken up by the intestines, a dull sound over that region is elicited by percussion during ordi- nary respiration ; but when the patient takes a deep in.spiratiou, an intestinal resonance is There perceptible. "Freedom of motion in the tumor," says Dr. L^nnau "though not altogether decisivp, is indicative of *\\e absence of adhesions." It is now one of the fixed facts, that the most dan- gerous and insupei'able adhesions are general- ly found at the base of the tumor, and found, too. when the tumor is easily moved from side to side. The ease of Dieft'enbach. Beidiu.. is in p.oint. Here +he tumor wa,s movable in eveiw direction, and partly on its own axis even: tho operation was commeneed. but abandoned, on account of the difficult adhesions to the ver- tebral column. The patient, after much dif- ficulty recovered "We might, also, refer to the case of Page, \vhere the tumor was movable, operation com- menced, cyst evacuated and drawn partly out. when it was found adherent to the "surround- ing parts about the pedicle, and to several inches of intestines " The operation was aban- doned, and the patient died. If I can satisfy myself, and I generally can by the uterine sound and bv other means, that the adhesions at the base of the tumor are not insuperable, the immovability of the upper portion would not alwavs deter me from op- erating. See the case of Dr, Dunlap and my- self. Airs, Lastley. Portsmouth. Ohio. Twelve months before Dr. Dunlap and I performed the operation. Dr. Kinibro. of Lowell. Alassa- chusetts. attempted the operation and opened tlie abdomen : Init finding, as he did, a mass of adhesions at the superior part of the tumor, abandoned the operation and closed up the wound. In this case, the upper part of i\\<^ ttnnor was immovable, but, after a careful and diligent examination by both of \is, we de- cided that the adhesions at the base of the tu- .•aor. if any at all, were very slight. The case was successful, but required the application of twelve ligatures to the superior adhesions, M-hieh were principally peritoneal. It gives me mu.eh pleasure to state that this accom- plished iaily is now, nearly a year after the operation, in good health. In another case of Dr. Dunlap 's and mine. Afrs. Kamsey, of AA'inehester Ohio, operation performed November 15, 1855, a large multi- locular tumor, weighing sixtv pounds after its MEDICAL PIONEERS OF KENTUCKY. 151 removal, so completely filled up tke abdomen and packed itseff .into the pelvis, that it was imp(;ssible to ascertain the extent of the ad- hesions. Fluctuation, however, was distinct in each cyst, and after discharging their eon- ieuts, we came upon one of several adhesions near the pedicle, which was attached to the peritoneum with a tapering- neck, as it near- ed the tumor, so much so, that a shoulder, oi button-like piece, was dissected out of the tu- mor to prevent the ligature from slipping off. The case did well, and the patient is now ir. good health. A further test of Dr. Frederic Bird for su- perior adhesions, I have found to be a valu- able one, namely, by putting the abdominal muscles in action, and noticing whether they ri?e much from the surface of the tumor. Thus if the patient, while lying on her back, be told to raise herself up in bed without Tising her arms, tlie recti-muscles will start up into a prominent band, if their sheath is not tied down by adhesions ou its peritoneal surface, but not if it is tied clown. JDr. Washington Atlee, in an article publish- ed in the American Medical Journal, places consideralile reliance on the pulsation of the tumor itself, or the "aortic impulse as being moi-e manifest in solid or encysted growths than in cases of ascites. Before 1 leave this part of our diagnosis, T wish to say an additional word in reference to percussion. Among those who are expert in their perception of ovarian tumors, and they are few and far between, perhaps as much, if not more importance is attached to the use ot percussion than to any other symptom or set of symptoms. We have, over the umbilical region, in ovarian tumor, in whatsoever posi- tion yon place the patient, a dull sound on percussion ; whilst in one or both of the flanks we have the resonance peculiar to the intes- tines. This diagnostic evidence is, perhaps, junety-nine times in a hundred, correct in reference to tumors. Dr. Watson, however, gives us an anomalous case, which is a rare illustration as an exception. "The history of the case was the histoiy of ovarian tumor;" yet, continues he, "the umbilical region, when percussed, always rendered a hoUow sound." L''pon the death of the patient the mystery was solved : air hissed forth from the opening made by the scalpel through the abdominal parietes, and an ovarian cyst of considerable magnitude was found adhering to the peri- tojieum in front of the belly, and containing no liquid, but some yellowish shreds only. This ovarian bag had been filled with air, which had given rise to the equivocal soutfcLs. Th;> air, it is supposed by the author, wms formed from the decomposition of a degener- at,e cyst wnthin. T have alluded to the examination per vaginam ei ner rectum, but perhaps not so specifically as its merits demands. You will often be enabled by the finger to detect fluctu- ation in a cyst, and as frequently to detect a filjrous tumor of the ovaria from a uterine one. .\llow me to cite a case : Miss Strader, formerly of JMaseon, Ohio, but then of Cin- cinnati, came to A.ugusta to consult me about the proprietj' of an operation for what her pliysicians pronounced ovarian tumor. On examination T found the tumor occupying the central and right side of the abdomen. It was easily moved in any direction without any apparent pain. There was no fluctuation, aJidthe ease mi\\\ which the tumor could be lifted out and turned from side to side, made, for the moment, an impression on my mind that although perhaps fibrous, with a narrow pedicle, it would justify an operation. But remembering my motto, which heads this ar- ticle on diagnosis, "He that thinketh he statideth, take heed lest he fall," I proceeded to other tests. On introducing the finger into the vagina, T found it completely tilled up with an obtuse lobe of the tumor, dipping deep down into the pelvis. At first I thought it might be retroversion of the womb, but by a rectal examination, I found a smaller lobe I)ressing upon tlie rectum, which seemed to sprout off from the lobe in the vagina in a pei'pendicidar direction. I came to the con- clusion that it was an intra-murul tumor of the uterus, forming in the walls, and extend- ing both upward and inward. The patient re- turned home, but came back a second time, in- sisting still upon an operation. I wrote a note to Dr Dunlap, who came and examined the case with me. He formed a similar eon- elusion to the one I have just expressed. Miss Strader was subsequently examined by Profs. jMarshall and Bayless, of Cincinnati, and since then by Dr. Washington Atlee, of Phila- delphia, as "will be seen from the following note : Philadelphia, Nov. 9, 1854. "Dear Sir: Your patient, Miss Strader, presented her- self to me to-day. and, upon examination, 1 have arrived at the same conclusion you did — that is, a fibrous tumor of the uterus. The uterus, however, can not be clearly diagnosed, and consequently as the relation of the tumor with it can not be defined, no operation ought t'i be recommended. Yours, truly, Washington Atlee, 418 Arch Street. J. Tavlor Bradford. M. D. ASCITES AND OVARIAN TUMOR. The distinguishing characteristics of ascites as compared with ovarian tumor are import- ant. It is not always an easy matter to distiu- KENTUCKY MEDICAL .JOURNAL. ^uisli Ix'twpi'ii the I wo. and it has once occur- r.'i! to mc to c'licountcr moi'c difficulty in de- ciding between ascites and ovarian tumor, than it was to establish a correct diagnosis l>etwcen uterine and ovari;m disease. lii the maturity of both diseases, when the a'idonien is distended to its utmost, many of tilt symptoms which assist and guide us in the early stages, are lost. The ovarian cyst llie;i loses its circumscribed and lateral pre l)onderanee, and a^'commodates its groavth to ilie inequalities and recesses of the abdominal cavity. In the earlier stages of ascites, we generally i\\\ '. an equable enlargement of the abdomen on both sides, M'hilst in ovarian tumor the swelling is circiunseribed, and confined iiiostty to one or the other side. In ascites there is more constant and imin- terrupted tenderness of the peritoneum, '•y pressing firmly and quickly with the ends of the fingers, whilst in ovarian tumor it is only occasionally Ihe ease. In ascites the gen- er:il liealth is sooner and more seriously dis- turbed, whereas in ovarian tumor it often re- mains good for months, or even years. In ascites the secretion fi'om the kidneys is usu- ally scant and defective, whereas in ovarian tumor, except in the rapidly enlarging cases, there is but little change. In ascites we find till' patient oftener with a dry skin, thirst, and a ]nore fi'equent and irregular pulse, whereas ir, ovarian tumor They are only oeeasionally if at all, present. In ascites we can generally trace the cause of the disten.sion to some car diac, renal, hepatic, or other organic af- fection, whereas in ovarian tumor, if of long duration, the mystery is how the patient car- ries twenty, thirty, forty, or even sixty pounds, without constant complaining. In ascites the bowels, always containing more or less gas, float to the surface of the fluid, whilst in ovarian tumor they lie behind or undei'- neath the tumor. "\Ye have, then, on percus- sion, in ascites, whatever position the patient assumes, the resonant or hollow sound pecul- iar to the intestines, which remain uppermost, with corresponding dullness below. In ovarian tiunoi- we have the dull sound over the region of the umbilical or latero-umbilieal and latero-pubic, in whatever position the pa- tient may take: or, as ^Ir. Brown more strik- ingly describes it, "want of resonance in the lowest part, in all positions, with tympanitic sound in the highest, in all positions, .indi- cates a.scites." To these characteristics, usually considered so important. Dr. Watson has given us some anomalous and interesting exceptions. In one rase the distension in ascites was so great that Ihe mesentery was not broad enough to allow the buoyant intestines to reach the surface, when the patient was supine. In this ease, then, instead of the resonance peculiar to the intestines, it gave a muffled or dull sound. The second case was found, upon post mor- tem examination, to be ascites, where the "omentum had formed into a thick cake," and was "strapped tightly over the subjacent intestines." Here, of course, we would have a dull sound, although ascites existed. He alludes to another possible contingency, in wdiich the sounds by percussion would be equall}' deceptive. This may occur in conse- quence of the "adhesion of the various coils of intestine to each other, and the parts be- hind them." Such cases, however, fortunate- ly for the diagnosis of ascites, are very rare, and I do not know a single author, save that rare teacher and profound thinker. Dr. Wat- son, ^^'ho has met with them. I have now a patient, I\Irs. Kenyon, oppo- site Vaneeburg, Kentucky, whose abdomen is very much distended, and the history of whose disease is purely ovarian. It has been of nearly three years' standing. The general habit it but very little distiirbed, and the sound elicited by percussion over the entire abdomen is resonant, except oecasionalh', when, just below the umbilicus, a thickening of the parietes, or what feels more like the "omentum cake," takes place, over which a dull sound ^^nll be elicited imtil it subsides, which it generally does in two or three weeks. The usual and general approved remedies for ascites have not decreased the size of the ab- domen. It is clearly, in my mind, not ovarian, but ascites; but to what may it be attributed?* When, in either ascites or ovarian tumor, the quantity of liquid is small, fluctuation by the usual mode is not always distinct. In such cases, we will find the mode of IMr. Tarral. as detailed by Professor Wood, worthy of use. It consists in appl.ving the thumb and middle finger of the same hand, upon the surface, and percussing with the index finger between them. The test, already alluded to. of Dr. Bird, of London, with reference to adhesions in ovarian tumor, I have found to be one among the most convincing tests in ascites : and I do not now recollect any writer who has alluded to it as one of the tests in that disease. That is, if the patient, whilst lying upon her bed, be directed to raise herself up in lied without using her arms, the fluid vdW bulge up prom- inently between, and laterally to, the recti muscles, whilst in ovarian tumor, on account of the circum_scribed sac, it ^\"ill not admit of such a degree of prominence. The parietes of the abdomen will admit of considerable ex- tension, whereas the sac and the recti muscles *I have tapped this Indy twice, a-nd with the application of a lisht bandage after the second tapping, she has entirely recovered. MEDICAL PIONEEKS OF KEXTUCKY. 153 will not admit of the same marked protuber- iuiee and inequality. It sometimes happens that ovarian tumor and ascites exist together. I have met with one remarkable case of this kind, Mrs. Martin, of ilaysville, Kentucky. By pressing firmly with the ends of the fingers, the ascitic fluid was readily displaced, and a tumor of the left ovary found floating in the surrounding ii(]Lnd. The patient was sixty years old, and the disease had progressed so far, and the gen- eral health so much declined, that I did not advise or solicit an operation. She lived but a few weeks aifter I saw her, and no post mor- tem examination was obtained. In response 1(1 a circular addressed to the physicians of Kentucky by myself, I received from Dr. Dimmit, of Lewisburg, an intelligent and promising physician of that place, and whose piitient she had been up to the time of her re- iT'Oval to Maysville, the following history of the case : "T saw her for the first time three years ago. at which time the tumor, occupying the left side, was firm, movable, and dropsical. The disease appeared subsequent to the ces- sation of the eatamenia. Her general health at that time was moderately good. She suf- fei'ed at times extreme pain in the region of the tumor, ai, which time a nervous train of symptoms, resembling hysteria, set in." I saw l\Irs. Martin in one of the nervous at- tacks alluded to by Dr. Dimmit. She would lie for a time motiomless and apparently life- less, but would retain her consciousness throughout the paroxysm. The attacks were superinduced by pain, fright, or excitement of any kind. I merely quote this case to illus- trate how nnlike different persons may be af- fected by the same disease, and that ovarian tumor is not without its collaterals and con- comitants in the nervous system. It may appear to you that I have dwelt un- reasonably long upon the diagnosis of this ' 'hydra of calamities," and the cases cited by way of illustration may, for the time being, appear irrelevant, but these cases and these symptoms and tests, may one day meet you at the bedside. DISEASES LIABLE TO BE MISTAKEN von OVARIAN DROPSY. Dr. Brown, in his excellent work on ''Surgical Diseases of Women," classes these diseases as follows: 1. Retroversion and retroflection of the uterus ; 2. Tumors of the uterus — a. solid, h. fibro- cystic ; .'I. Ascites ; 4. Pregnancy ; 5. Pregnancy, complicated with ovariav; dropsy; 6. Cystic tumors of the abdomen ; 7. Distended bladder; 8. Accumulation of gas in the intestines ; 9. Accumulation of feces in the intestines : jO. Enlargement of the liver, spleen, or kidneys, or tumor connected with these viscera ; 11. Recto -vaginal hernia, and displace- ment of the ovary; 12. Pelvic abscess; 13. Retention of the menstrual fluid from imperforate hymen: 11. Ilydrometra. A description of these different diseases, under their particular class in the different medical works, will generally enable you, if not possessed of the "tumor mania," to dis- tinguish them from ovarian dropsy. I shall only allude to a few of them in which I may have had some personal experience. 1^'rom what I have read and observed, I am inclined to the belief that malignant disease of the ovary is very rare. I have met with but one ease. This was a patient of Dr. Duke's, of Maysville, the wife of the Rev. M.. Upon examination I found a large, uneven, but solid tumor, occupying the left side, and extending up to the umbilicus. It was par- ticularly firm, with numerous obtuse lobes jirojeeting upward; rather tender to the touch, and so completely adhei*ent to the surrounding parts, particularly to the womb, that l>ut little if any movement could be ef- fected. An examination per vaginam reveal- ed the same hardened and uneven surface. The pain and suffering were vei*y great, gen- eral health bad, and that peculiar cast of countenance which indicates a system worn down by malignant disease. Soon after I saw hei', I learned from Dr. Duke that the tumor had grown so rapidly, and infringed so seri- ously upon the bladder, that it was almost im- possible to pass the catheter, which for some time, had been the only means of passing urine. No post mortem examination was ob- tained. WTien we add to the albove symptoms that in cancerous growths, the tumor is uneven in its gi-owth, the pain and soreness much greater than in other forms of disease, the general cachectic, and sallow complexion, the peculiar hardness and rapidity of its growth, the general health and strength soon wasted, wt will have but little difficulty in determin- ing its nature. I have already directed your attention to the case of Prince, where a patient was oper- ated on for ovarian dropsy, which proved, upon post mortem examination, to be a tu- mor of the spleen. I was once consulted in a case, ]\Irs. , of Boone County, Kentucky, which a numbei- of physicians had pronoiineed ovarian. She 151 KE XTFCKY ME Die A L JO URXAL. came to Augusta. I fciiud. upon examiua- tion, the abdoiiKni enormoiisly distended, the tiDuoi- rearliinir from the pubis to the ensi- forin eartilagre. and ocevipying almost the en- tire side. Upon pressure, a hard or dough)' feel was imparted to the tinger. There wa.i no iluetiiation manifest, and a dull sound was elicited upon jiereussion throughout the ab- domen, except the right h^-pogastric region. The tumor was movable, and upon dipping the finger deep down between the pubis and the tumor, a "eaetus-like"' lobe of the tumor was felt, which could be slightly raised with- out an apparent pain. The symptoms gener- ally were obscure. She complained but little except from the weight, which could not be less than twenty pounds. Examination per vaginam revealed no sign of a tumor in the pelvic cavity. But little was known about the history of the case with the exception of patient's avowal that it commenced on the '"left side. imm.ediately mider the ribs," and was of two vears' standing. The "cactus" or notched-like feel of the tumor, together with the condition of the pelvic organs, and the history of the e.ise, led me to the conclus- ion that it was not ovarian disease, but en- largement of the spleen, h^•pertrophy. I have since understood that the family have moved "We.st, and have lost the history of the case. I saw another well-:narked case of diseased spleen in the daiigliter of ^Ir. . of Nicho- las County, which had been diagnosed as ovarian tumor. OVARIAN TUMOR— PREG.nANCY CO- EXISTING. In the Transactions of the American [Medic- al Association, 1851, Atlee's tables, is a case of Dr. Atlee's, where the patient was two inoiiths pregnant at the time of operation. No miscarriage. Tumor weighed eiglity-one j)Ounds. Died of starvation. In the ^fcdico-Chirurgical Transactions, vol. 30. is a case of Dr. Bird, where there was no sign of pregnancy : operation performed ; weight of tumor fifty pounds; abortion sec- ond day ; recovered, and had a child subse- (|uently. -\CCT'lin..\TIOX OF FECES IN THE BO^^'ELS. In Prof. Cfross' Pathological Anatomy, a remarkable case is related, as oceurriug in the 7)ractice of Dr. Lean, of Columbia, South T'arolina. It occurred in a young lady aged twenty-five yeai-s. No ahnne evacuation had been had for nine weeks. Upon a post mor- tem examination the intestines were found enormonsly distended : colon, duodenum and ileum measuring thirteen and one-half inches iii circviinference the quantity of fecal matter amounted to nearly seven gallons. ^Ir. Brandle relates a case where the fecal accnmulation irapaoted in the colon amount- ed to thirty-three pounds. Mr. Brown says: "I once saw a case of sim- ple encysted ovarian dropsy, which, in its earliest stage, was considered by a veiy dis- tinguished surgeon, in London, to be accumu- lation of feces." I mention these eases that you may be on your guard end not mistake, as some prom- ine]it English surgeons have done, fecal ac- cniuulation for ovarian tumor. In 1S54, wliiLst attending the State :\Iedica] Society in Covington, Ky., I visited, with Di'. Chambers, a patient of his lalioring under dis- ease of the omentum. The abdomen was con siderably enlarged, with some degree of ascites, but by displacing the liquid by per- cussing firmly with the ends of his finger,-, that peculiar knotted or rigid feel which characterizes enlargement of the omentum was manifest. The history of the case, the jioint at which it first made its appearance, to- gether with that ridged or serrated feel of transverse lines. M-ith more pain and tender- ness than is usually the ease with ovarian tu- laor, enabled me to decide in my oaxti mind that the disease was omental and malignant. I have .seen one ease of this since, a patient of Dr. Adamson. of ^laysville, Kentuela-. The disease in this case presented the above char- acteristics, except that it was more uneven in surface, lumpy and knotty, with all the lead- irig indications of true malignancy. No post mortem examination was obtained. LETTEPvS FROil SUPGEOXS ANT) OP- ERATOES. Th.e following letters, which I trust will ]5rove of much interest on this subject, have fallen into miy hands in answer to inquiries ill search of stati.sties on ovariotomy. Philadelphia. Jan. 24, 1854. "\Iy Dear Sir : Your interesting letter came to hand last month, hut has not been replied to. in conse- quence of my numerous and various engage- ments, and depression of spirits from domes- tie affliction. T regret that I shall not be able to render vou much assistance in the investiga- tion you are engaged in. Some years ago I took a lively interest in the subject, from having carefully examined Dr. Bird 's preparations in London, and from having read Play's and other's works sent me by their authors. Being, however, rather out of the line of my studies and practice, I have not recently turned my attention to the sub- ject — not enoijgh, certainly, to justify my of- fering any decid<^d sentiments in relation to it. especially as I have never performed or ■witnessed the operation. The books, more- MEDICAL PIONEEF 01 KENTUCKY 155 over, referred tc, T forwarded some years since to Dr. John L. Atlee, of Lancaster. In conversing a few days since with that distinguished gentleman, I took the liberty to show him your letter and to ask him for sta- tistics. He referred me at once to his brother's. Dr. Washington Atlee, writings, which embodied everA^hing known, he re- mai-ked, iipon the subject, including Dr. Lee'.s statistics. These I will get and send you mth out delay. I will only add that I have no prejudice to (;outend with in the matter. My feelings, ] confess, are in favor of the operation in proper oases; and I would not hesitate to per- form it if called upon, after due study and preparation, for I have a strong conviction, derived from my two successful cases of Cie- sarean section, saving both mother and child, that little danger is to be apprehended from oi)ening the abdomen, provided the peri- toneum be carefully handled, and ordinary skill and prudence be exercised in the opera- tion. The views thus given I do not consider worth making known. I have no objection, nevertheless, if you think luy authority in col- lateral matters of any weight, that my name be used in accordance with the remarks above stated. The case you are about to publish is cer- tainly a verj' interesting one, and I shall take great pleasure in reading it. "With great respect, I am yours. W. Gibson. Philadelphia, ilarch 27. 1859. J\lY Deae Sik : Your letter was received last mojith. and would have had an earlier repty, but it came to hand in the midst of building and moving. My paper.s even yet have not been arranged so as to enable me to give you a satisfactory answer, although T have a large mass of ma- terials, ■ which would go a great way toward estabH.shing gastrotomy in the minds of the profession ; T mean those members of the pro- fession who are influenced more by facts and truths in sui'.gery than by opinions and preju- dices. My professional engagements are so press- ing at present that I can not pretend to ana- lyse the matter in my possession for your use, T 'will, however, send you several pamphlets, among thera my table of cases which will give .you all the facts on record iip to date of pub- lication. I may say, in reference to the opera- tions occurring since the publication of my table, that the success of the operation is cer- tainly not less than there represented. -This ought to make it as justifiable and legitimate as any other capital operation in the cata- logue of surgery. Indeed, I consider tht arguments employed against it by the oppos- ers of gastrotomy equally as applicable to raany other operations long since established. l\Iy owii cases now amount to tweuty-three. These may be divided into two classes : First. Those where death was impending, and daily looked for; and. Second. Those in a more favorable condi- In the first class were ten cases, and four lives were saved by'tlie operation. The death of Lhe other six was supposed not to have heen hastened by it. while the comfort of all the pa- tients was improved, and in some of the cases life was thought to have been prolonged. In none of these could death be attributed so much to the operation as to the disease. Among the recoveries, one patient was sixty ujne years old, tumor twenty-eight poimds; another was fifty-six years of age, tumor fifty pounds ; another was pregnant and the tumor WAS heavier than the patient; while the fourth was bloodless from flooding after mis- carriage, witii a small, thread-like pulse, 1.30 per 7jiinute. These cases, I believe, were snatched from the grave by the operations. in the second class are thirteen cases, nine recoveries, four deaths, very nearly the same proportion as in Clay's operations. 1 congratulate you and Dr. Dunlap on the snccess of your operations, and would be pleased to have a report of each ease, as well as all other information which yon can furn- ish me on this and similar subjects. Please accept a copy of my prize essay, v.iiich I also forward to your address. I have operated on six cases since its publication. Very respectfully yours, Washington Atlee. Manchester, England, Dec. 15, 1856. My Dear Sie: , J ', I have just received your kind note, dated November 2.3, 1856, and have to thank you for the many kindnesses therein expressed. When I wrote last to you I was busy prepar- ing a small volume entitled "Hand-Book of C.>bstetrie Operative Surgery" for the press, intending to follow it up by a larger work on ovariotomy, stating my experience in full. With great difficulty 1 found time to complete my Hand-Book, which 1 hope by this time you have seen, in which you will 'find a long chapter devoted to ovariotomy. But 1 need scarcely tell you, my increasing professional engagements interfere so seriously with my time, that I can scarcely attend to any thing that T am not really compelled to; otherwise, 1 have abundant material to communicate to the world, which I imagine would be desir- able. I am delighted to hear of your great sue- 156 KEXTCf'KY MEDICAL .JOVRXAL. ci'ss, far exeeediiiii: even my own: indeed, T al- most envy yon and Di'. Dnnlap, and earnestly hope for its continnanee. ] have not yet given 111* my intention of publishing my ovarian work. It is only waiting time, not inclination, to complete. In the meantime, I can only add a lew particnlars to my last statement of cases, whicii now amount to seventy-six, and may be read thus: Of first 20. 8 died— 13 recovered; Of second 20, 6 died — 14 recovered; Of the last .36. H died — 27 recovered. ] believe this is the legitimate mode of view- ing the qnestion, progressively, by which the mortality is shown to be gradually lessened by pi-aotical experience, thus: First cases, 1 death in 21/2 ; Second cases, 1 death in S^^ ; Last cases, 1 death in 4. I should like row to refer to my new Haud- T)Ook for such practical hints as I have, from time to time, elicited by practice, and I will w rite to my publisher to forward you a copy. 1 am entirely of your opinion, that the cas'^s require great care in .selecting, and should not be operated upon mereh' because Ihey are ovarian. 1 have little to say as to the want of credence in those who take ground against the opera- lion. I can, however, with pride and pleasure r.^fer them to many men of the highest stand- ing in my own country, amongst them Prof. Simpson, Dr. Bennett of Edinburgh, Dr. R. Ijcf. Sail'ord Lee. and a list of hundreds >vho have communicated with me on the snb.iect, as to my veracity, not forgetting Professors Lee. Z. Channine-, with Dr. Atlee, in your own hind. Tlie opposition in England to the operation is i'ast giving way, and I trust it may be said, lliat in legitimate cases there are few surgeons here who oppose it. I can not at present do moi'e than give you this short resume. I have some few cases i;nder my care on which I expect very shortly to operate, and T trust I shall be as successful as I have been, if not more so. With kind regards and best wishes for ycr.ir (oiitiTni'Hl success, I am. my dear sir. Yours, most sincerely, Charles Clay. ^I. D. Dr. J. Tavlor Bradford, Surgeon, Augusta, Ky.. IT. S. I regret to say that 1 have not received the "TIand-Book" alluded to in the above letter of Mr. Clay. Dk'r Sir: In reply to your letter of the 24th ult.. I have to say that I regard ovariotomy as fairly within the precincts of regular sui-gery. Ohio, it should seem, holds a prominent rank ill Ihe operation. Very respectfully, R. D. MussEY. Cincinnati, Jan. 1, 3 857. Extract from a letter to me by Dr. Black- man, Cincinnati. Jan. 2, 1857: "If you see the Western Lancet, you are ]iroliably already aware that I regard ovari- otomy as a justifiable operation in suitable cases. I would not operate in a case of en- cephaloid disease of the ovary; and I would not persevere in an oi^eration already com- menced, .should I find very extensive adhes- ions, for I have seen a patient from the break- ing up or rather dividing with the knife such cidhesions, die on the talJe. I saw such a case occur to Dr. . I was one of his assist- ants." Truly yours, George C. Blackman. De. Bradford: 1 have received yours asking for the results of my observation upon the operation for ovarian tumors. Upon this subject it is not in mj' power to say anything from my own experience in favor of the operation. .Many eases in the early stages of enlarge- ment have been under my care ^^-ithin medical treatment removed the enlargement, and restored the health of the patients, while others of protracted existence, of malignant growth, or of complex organization, attended by great enlargement, have offered me no evi- dence in favor of an operation. It is proper, however, to observe that in reference to these, Uiy observations have been limited, as you will infer on being advised, that in a practice of five and forty vears, embodying every variety of surgical practice. I have operated uj^on one case only. The tumor appeared to occupy the entire abdominal cavity, and was organi.'^ed throughout. The patient died on the fourth or fifth day after the operation, and possibly might have recovered under the advantages of good nursing, directed by professional skill, neither of which were at command. With great regard, very truly yoiu' friend, Ben-jamin W. Dudley. Dr. J. T. Bradford, Augusta, ICy. Lexington, Jan. 4, 1857. Louisville. January 17, 1857. ] feel that I owe you an apology for so long delaying to answer your letter of the 24th of December last. The fact is, that T have been I'eluctant to write on the subject to which your letter relates, because I have scarcely loi-med any very decided opinion on many points connected with it. Of the propriety and necessity of ovariot- MEDICAL PIONEERH OF KENTJJCKY. 157 omy in certain eases, I liave no doubt; but to confine the eases witli pi-ecisiou, for tlie guid- ance of those wlio may be debating tlie matter in tlieir minds, and need to be helped to a jiroper decision, is, I apprehend, a difficult task. It is, I think, perfectly clear that no pa- tient with a diseased ovary, who does not suf- fer much inconvenience from her malady, and is yet capable of enjoying life and contrib- uting to the happiness of others, ought to be advised to tJie risk of so dangerous an opera- tion. ]3ut, on the other hand, if the operation be deferred until life itself is a burden, the chances of its successful performance are greatly diminished, and to decide exactly how heavily this burden must press before we shall be justified in resorting to the knife, is a verj'' nice point, and one the decision of which involves, of course, much responsibility-. Probably future and more extended experi- ence may clear up the obscurity tliat now per- I^lexes this view, and dissipate or at least di- miiiish other difficulties that embarrass the wliole subject. A\ present, while I entertain the opinion that under certain circumstances the extirpation of diseased ovaria is a justi- fiable operation, I should feel at some loss were I called upon to decide the conditions, though I might be able to apprehend them in practice. i\Iy own personal experience in ovariotomj^ is very limited, being confined to three cases. In one of these, operated upon by Dr. Dudley, many years ago, the patient survived the re- jnoval of'the tumor only a few days. The sec- ond occurred in the practice of Dr. Gross, and was likewise followed by fatal termination. The third was my own case, which had a more fortiniate result, the patient entirely recover- ing. I say fortunate, for I do not ascribe the issue to my superior skill, but purely to luck. I might have performed the operation sev- eral times since, but I confess I have not any decided wish to repeat it. but have rather been disposed to evade it. or, as we sometimes say, dodge it. Do not, I pray j^ou, think me a surgical pol- troon on account of this confession, but at- tribute my hesitation rather to the want of clear and satisfactory perception of the line of surgical duty. Hoping that your report ma)' enlighten me, and be alike creditable to vourself and the so- cieiy. I remain, my dear sir, your friend, Henry ]\Iillek New Orleans, March 30, 1857. My Dear Sik : Excuse me for not replying to yours of the 7th of P^ebruarj' sooner, asking my views on the propriety of ovariotomy. Pressing busi- ness at the time it was received compelled me to lay it by, and the subject passed from my mind until now. You are perhaps aware that 1 am the advocate of a new method of curing ovarian drops3% which obviates the pain ana dinger of ovariotomy fully as much as Civi- ale's method of removing stone from the bladder obviates the pain and danger of lith- otomy. But as Civiale's invention is not applicable to all cases, neither is my method, practiced with success in one case, of treating ovarian encysted tumors, by reaching them through the Fallopian tubes, practical in all cases. Perhaps it is applicable in only a very few. \'ou might naturally expect me to be among those who are disposed to magnify the dan- gers attending excision, to attract the greater jdtention to the discovery of a method of cure void of either pain or danger. But I am not among them. I am in favor of the McDowell operation when it offers the only chance of saving the life of the patient. I call it the McDowell operation, bcause he was the first surgeon to perform it with success for encyst- etl abdominal tumors, requiring for their ex- lirpatioii the whole abdominal parietes to be laid open from the sternum to the pubis. The tumor removed by Dr. McDowell, of Danville, 'K.y., from Mrs. Crawford, weighed fifteen pounds, and the cure was complete in about ii month. The operation was performed in the year ISOO, yet in 1826, the fact that such an operation had been performed with suc- cess by a physician in an obscure village in Kentucky, was not fully believed either in ?\ew York or London, although JMcDowell, as also the two Smiths, Nathan and Alban, had, in the meantime, performed a number of op- erations of tlie kind with success. The Lon- don medical journals sneeringly noticed Mc- Dowell's cases, which Mv. Lizars had append- ed to his work on ovarian disease, published in 1825. .\ New York physician in a mono- graph on the same subject, published in the Medical Recorder of Philadelphia, vol. x, p. 262-269, 1 826, noticed these sneers of the Lon- don editors, and expressed a "hope," italiciz- ing the word, "to see Dr. McDowell come out well in the affair, and make good his claims." — .267. The editor of the Medical Recorder, Dr. Calhoun, at the conclusion of the article, as.sured his readers that there was no doubt in regard to the cases reported by McDowell, as lie had been assui-ed of their truth b,y com- munications of the most respectable character from Kentucky. But because some cockney editors of London chose to sneer at IMcDow- ell's cases of svtccessfnl ovariotomy fifteen or sixteen years after they had been reported and duly authenticated, tlie New York phy- sician seemed to think it was incumlbent on McDowell to make good his claims, which he had already made good so far back- as ]809, when he cured Mrs. Crawford, by an operation i-equiring an incision from stern- 15S KEXTrrKY MEDICAL JOVBXAL. urn to pubis througli the walls of the ab- domen. So loug did it take truth to travel from Kentucky to New York, and so strong were London sneers against it when it got there, tliat ^Irs. Hunt, a patient of three New York Ijhysieiaiis, was permitted to die a miserable death without getting the benetit of thai ti'uth, her physicians looking on and gi\'ing their assent for her to suffer and die without s.irgieal aid, with a disease wluch ^IcDowel! had proved to be a remediable ailment by his success with Mrs. Crawford and others. The London editor's sneers were too strong for the Kentucky editor's facts with the New "iork physicians, and they let her die without attemptuig ovariotomy to save her. On exam- ination after death, they found no adhesions of any consequence, and "" posteriorly, " to use their own words, '"the attachments easUy Nielded to tlie fingers, and we rolled out a huge mass almost without the aid of the knife." "Its attachment to the body was by two pedicles, not larger than a finger, on the original sight of the ovar-ium." See Medical Recorder, vol. x, p. 265. At a later period in the year 1828, Dr. I'oreman, of New Jersey, reported a case, in the Mf.dicnl Receirder, voL xiv. pp ,"^66 and o77, of ovarian dropsy, which he tapped a niunber of times, diawing ofi', at different tijiies, upwards of twenty gallons of dark col- ored, viscid humor, and which, after five months suffering, terminated fatally. On ex- a.minatiou after death, '"the position of the tumor in the abdomen was foimd to be an- t.'rior to all the viscera, and its adhesions to them was so slight as to require the scissors in one place only to free it, when it rolled out a huge fluctuating mass upon the table." p. in reporting the case. Dr. Foreman, seeing how slight tile adhesions were, very correctly concludes, ''that in encysted dropsies, unless the containing sack can be entirely removed from the body, or destroyed by suppuration, there is very little ground to hope that the\ ever can be cured by art. Therefore, when the ovarium is the seat of the disease, we are war- ranted by the successful results of the few operations of tlie kind that have been per- formed, in laying open the cavity of the ab- domen and removing the diseased organ from it at once. If this coui-se had been pursued toward my patient she might at this time have been living. These organs have been remov- ed sufficiently often, without dangerous symp- toms intervening, to fully justify the opera- tion in al) cases where the general health of the patient is good, and the diagnosis clear. The appallins exposure of the viscera in this operation, should. T admit, deter from its per- formance, wfre death not inevitably ninety- nine times in a hundred without it." "Un- fortunately the dread of attempting to do good for fear that evil may grow out of it, paralyzes the hands of surgeons, and satisfies them to sanction inevitable death rather than incur the possible dangers of a timely opera- lion. The time, however, has come when these desradiug apprehensions are giving wav. " etc., p. 36i. I could not express my views on this inter- esting subject moi-e clearly than Dr. Fore- man has expi-essed them for me in the above quotation, an.l T beg you to receive the same as my answer to the important question, in r'.'gard to the propriety of the operation of ovariotomy, that you propounded to me. Those who are disposed to blame the New ^'oj-k physicians for letting the sneers of Lon- don editors paralyze their hands, so far as to sanction the ine\-itable death of Mrs, Hunt, rather than give her a chance for her life by resorting to ovariotomy in her case, should not hold the physicians of the present day lilameless. who condemn the operation mider all circumstances, for no better reason tliau that some flippant Earopean writers and lee turers have condeumed it without making themselves acquainted with the facts contrib- uted by American surgeons. Fifteen or twenty years after ovariotomy had been successfully performed in a number of cases in Kentucky and other parts of the I'nited States, doubt and suspicion were east upon them by European ^^Titers, and now, af- ter the facts called in question have been proved beyond ca-sil or dispute, they are very much inclined to ignore them entirely, and to treat the subject as if no such opera- tion h.ad ever been successfully performed in America, Thus Watson, in his fourth lecture, speaking of ovariotomy, says : ' ' The results of experience have been so discouraging, as well nigli, in most minds, to prohibit such attempts in future." Watson had evidently not infoniied himself in regard to the facts, or designedly ignored Dr. McDowell's and other American surgeons successfid opera- tions. It does not follow that because the op- eration lias been unsuccessful among the pau- per and laz.-'aroni classes in the European hospitals, that well fed Americans, surroiuid- ed with all the comforts of life and who stand o})erations much better than European hos- pital patients, should be deprived of the chance it gives them for their lives. Both in surgery and in th? practice of medicine, it is high time for America to set up for herself, and to be governed by her own experience and observation, and not by the experience and observation of Europe, drawn mostly from hospital practice. It is true that the op- er.alion of ovariotomy would be apt to kill a half starved pauper in a crowded European hospital, and so would a hasty plate of soup, MEDICAL PIONEERS OF KENTUCKY. 159 a full meal; a dose of calomel and jalap; or a free blood-letting. In the Boston Medical Journal, vol. v, p. o7S, 380, Dr. Thos. Fereday, of Dudley, re- ])orted a ease of ovarian tumor, spontaneous- ly subsiding by a discharge of fluid from the vagina, estimated at from two to three gal- lons, in one night. In this instance the water no doubt made its way through the Fallopian tube into the uterus, and passed out of that organ through the vagina. A similar ease is reported in the Traiisi/l- viuvia Jnwniul of 1829, vol. ii, p. 97, 98. The patient had taken a dose of senna, and report- ed 1o the attending physician that it had not oul}^ operated on the bowels, but that she "had urinated, during the night to an amount lliat not only astonished but alarmed her." The next moi-ning the ovarian tumor, a very large one, had entirely disappeared. It had evidently broken into the uterus, through the P'allopian tube, and passing out, per vias nat- vrales, was mistaken for urine. The Fallo- pian, canal, when enlarged by hydroma or oiher causes, affords an open way to the cav- ities of the serous membranes, through which fluids, extravasated in the abdomen, may find their way out. It would also give a ready outlet to the water contained in ovarian cysts. Cysts are lined with a distinct secreting mem- brane, sometimes single, but generally com- Ijosed of smaller cysts oontained \dtliin a par- ent, attached by narrow pedicles, and com- municating between themselves. AVlien e.ysts are opened from without, no matter how .small they may be. a dangerous inflammation is sure to follow, which nothing can cure but an entire destruction of the secreting surface by suppuration or by total excision. Tlenee no eases of ovarian dropsy, which Jiave been treated liy puncture from without, Jiave recovered, so far as my observation ex- tends. T have seen the operation tried under the most favorable circumstances, and always \vithout success. Mo inflammation followed in the case- in \\hich I drew off a large quantity of gelatin- ous fluid by probing the Fallopian tube. The ^voman entirely recovered, and has since had a number of children. The other two cases above mentioned, where the ovarian tumor spontaneously dis- appeared in one night under the excessive dis- charge of water from the natural passages, also entirely recovered. This new operation of reaching the cyst through the Fallopian duets, is decidedly preferable to any other in eases which will admit of the fluid being reached in that manner. The operation is nei- ther difficult nor painful, when the tube is sufficiently open to admit a small sized probe. In a lady who was subject to a profuse dis- charge occasionally from the vagina, suppos- ed to be leuccrrhea, T have several times pass- ed a smaU sized catheter into the Fallopian tube. After gaining the cavity of the uterus, the catheter was passed very readily and without pain to so great a distance as to de- monstrate, beyond a doubt, that it was far up in the P"'allopian tube. It was only during the period of those aqueous discharges that I succeeded in passing it with faeility to a dis- tance that proved it to have passed beyond the cavity of the uterus. I am aware that ovarian tumors, besides the aqueous, semi- gelatinous, melicerous, and atheromatous matter, contain, in many instances, hair, teeth, fleshy substances and bones. Evacu- ating the liquid contents through the Fallo- pian tubes, it is very probable would cause the more solid, scirrhous, or sarcomatous materi- al?, to liquify, and to escape in the same waj'. In the case that I reported, a mass of hard matter, as large as the fist could be felt in the ovarian region, which continued for a year or more before it finally disappeared. "When I first operated she was fully as large us a pregnant woman at her full time. Ovarian pathology mocks at all the learn- ing of the schools. Who can account for a rlcns sapicntia in the ovarium? Yet Dr. Archer, of Maryland, found a tooth of that character in the ovarium of a patient of his. See Medical Repository, vol. xii. p. 365. New \'ork. 1859. A great many other cases are recorded in v;irious works on good authority, not only of hair, bones, and teeth being found in the ovaria, but, in some instances, of teeth set in an alveolar process, and in one case of bones in the ovarium of a child ten years old. Too little attention is paid to the facts de- rived from American fields of experience, and too much importance is attached to the dogmas and opinions of book-makers and teachers in the large cities of Europe. They are mostly opposed to ovariotomy, because of the ill success which has attended it in Eu- rope, and are slow to believe that inexperi- enced counti'y physicians, in the backwoods of America, have been more successful than their m.ost experienced and dexterous sur- geo}is of their large hospitals. The error lies in their not taking into consideration the vast difference between the unfortunate people of Europe, living in an abnormal condition, scarcely one in a thousand occupying the po- sition in society that nature intended him or her to fill — the sickly, infirm, and half-fam- ished masses being compelled to overtask themselves to pamper to the luxuries of a few, whom luxury is enervating; and the more fortunate American people, living in a normal condition, all classes of society, men, women, and children, and negroes, occupying tb.e position that nature intended for them, each having as nuich liberty as comports with the happiness, morality, prosperity, and com- 3 60 KEXTrCKV MEDICAL JOIRXAL. fort of tlie whole. Until clue allowance is ii'ade foi- tlie difference of circumstances be- Ivreen tlie people of despotic Europe and tliose of rlie model Kepuhlie of the New "World, the writers and teachers iu London and Paris will find difficulty in believing; that a physici- an in the little town of Augusta, in far distant Kentuckv, Dr. Bradford, liad been engaged in seven suocessive operations for ovarian drop- sy, all proving siiccessful, when their most sueeesful surgeons have failed in five cases out of seveJi. I\rany good meaning men, who have tried to probe the Fallopian tubes, both in the dead sui).ject and the living, without success, would sooner believe that I had made a mistake and got no farther than tlie cavity of the uterus, than concede that a surgical operation had been perfoi-med. which Prof. Jackson and otliers of less note have regarded as imprac- ticable, forgetting that the practicabilitv or impracticability of the operation depends up- on the circumstances of the case and not upon any remarkable skill of the operator — forget- ting, also, that disease can work such changes iu the Fallopian tubes as to give sufficient ca- pacity to admit the hand, much less a probe. ^Vlien the medical men of Europe take a les- son in politics and learn the impoi'tant truth, A^hat a normal government, bv diffusing the blessings and comforts of life among all classes of society, can do in enabling the citi- zens thereof to bear surg-ical operations, that nine out of ten of the half-stai'^'ed. over-vrork- ed subjects of abnormal governments would die under, they will be prepared to give due weight to the facts that American operators have contrilmted to surgery, and not before. Respectfully, your obedient .servant, Saii'l a. C.AJ^TWRIGHT, 31. D. Dr. J. Tavlor Bradford. Augusta, Kv. I have other letters of much interest in fa- A'or of the operation, the authors of which are unwilling that they should go to the society in their present shape. Tliey are mostly, how- ever, confirmatory of the propriety of the op- eration, not statistical. It is a singular fact, tliat iu this country the operation of ovariotomv belonsrs almost exebisively to "Young America." So. too, in Eiigland an.d France, few of the older sur- greons are found operating, but rather seem to have reversed that luctrv ma.\im which Dean Swift practiced and taught. "That because he had spent a part of his life in leaving un- done the things which he might have done, he would not throw away the remainder in de- spair." No one thing, perhaps, has done more to j)re.iudice the older surseous aeaiust the od- eration than tlie blunders aiid errors of 'Sir. Lizars. And where errors aud injudicious operations are committed by great men. v^e are too apt to regard the thing, as in itself, hopeless under tlie same or similar circum- stances. Is it not a fact, then, with the dimin- ishing fatality of the operation, that many, very many, of the elder surgeou-s, without due investigation and reflection that the ovary is n^^ither essential to the life or the health of the patient, declined to operate or counte- luuiee the legitimacy of the operation, because men ecpially or more renowned than they had failed, not. perhaps, from the manner in which the operation was performed, but selection of cases, from the undeveloped means of a pi'oper diagnosis. No one skilled in the selection of cases would have taken more than one out of the four eases operated on by ^Iv. Lizars: and their failure, because of his high position, for a time, rendered the operation palsied in all Europe. You will observe iu the letter of our dis- tinguished countr;\unan. Prof. ^lott. of New York, addressed to me in 1854, and I hope it will not be considered uneourteous in alluding to it by way of ilhistration. that his prejudice to the operation is the result of tlip loss of two cases of his own. aud of four which came under his obser\'atiou. "In no one of these cftses. " says he. "was the tumor over fifteen pounds," whilst in his own cases one weighed six pounds, aud the other ten. Now let lis examine for a moment these cases. It is a well settled principle that rare- ly, if ever, in tlie early .stages of ovarian tu- mor, is the constitution or the general health much disturbed. Why operate, then, where the tumor had only attained to six or ten pounds? The danger is greater, whilst the necessity of the operation is less. My reading and study of the eases of the most successful operators, as well as my own experience, have taught me that there are two extremes in the time at which we should 0];>erate, both of which should be avoided. The one is where the tumor is small: the other where the operation lias been delayed- so lojig that the size of the tumor and the decline of the general health- render it hazardoiis to operate. In the first place, I hold that in pro- portion to the increased size of the tumor, all other things being equal, -will its pressure iipon the adipose substance about the parietes of the abdomen produce its absorption, and tlie friction of the tumor against the peri- loneum accustom it to that usage which ren- ders it less sensitive : and less liable to take on inflammation. The same principle holds good in preg- nancy — in the earlier stages of it. before the vomb has filled the abdomen, abortion, mis carrias''^. or I'rematnre labor, accidentally or superinduced, is laio\\-u to be more dangerous that at the fidl period of utero gestation. 1 have now been engaged, directly or indi- MEDICAL PIONEERS OF KENTUCKY. 161 rectly, in nine operatioio^, all but one of which have been suceessfnl, and yet the smallest tu- mor weig-hed twenty-four pounds, the largest sixty. There is, then, in this operation, as in most other things, a "happy medium," which, if arrived nt, will insure the greatest degree of success. I might cite an instance in tlie West similar to that of Prof. i^Fott, where the failure and errors of leading surgeons hover yet, like an incubus, over the operation, but it might seem like the child reproving the parent from whom he had received valued lessons too sac- red to be cancelled. There are other operations which have been much more fatal than ovariotomj', yet thejr are regarded as legitimate. When the ligature was tied around the ia i:ominata the ninth time, with a fatal effect in - every case. Dupuytren attempted it the tenth time with the same result. And after it had been performed the thirteenth time, all end- ing in death, the celebrated surgeon, Mr. Lis- ten, whose dictum characterized ovariotomy as "belly ripping," attempted the ligature of the arteria innominata with the same fatal re- sult. And yet the same surgeon, with manj' others, legalize this operation up to the six- teenth failure, without one case of success. Yet ovariotomy, with her increasing tri- urnphs, is condemned In Mr. Merriman's list of twenty-three cases of Cnes.nrian operations. Londov Lancet, vol. i, 1851. p. 319, comprising all the opera tions in the British Tsles, from 1738 to 1820, in but one case did the mother survive the op- eration, and we find among the operators the names of John Hunter and John Bell. Mr. Radford, in a subsequent report, says'. "Jj-iit two out of fifty cases of Csesarian opera- tion, which occurred in Great Britain and Ireland, have recovered from the operation." And what is strange, one of these two, the first case ever operated on successfully to the mother, was operated on with a razor by an Irish midwife IMary Donnelly. Mr. Solly says that death from ovariotomy up to 1846 were only one in 31/2- Dr. Atlee makes the mortality only 261/2 per cent. ; Dr. Kobert Lee, over 37 per cent. ; Mr. Phillips, over 39 per cent. ; Dr. Cormack, over 38 per cent.; Dr. Ashwall 's table, over 36 per cent.; Dr. Lyman, in his table, savs three-fifths of the operations are unsuccessful.. Mr. Church- ill says, "undoubtedly the mortality is very great, but a mortality nearly, if not quite as great, is not considered a fatal objection to other operations." "If." says he, "we takf; the major amputations of the limibs (primary and secondary,") it appears that in Paris, ac- cording to Malgagne, the mortality is up- wards of one in two; in (rlasgow, it is one i" 21/2 ; in the British hospitals it is one in 31/^." As to amputation of the thigh, Mr. Syme ob- serves, "the stern evidence of hospital statis- tics shows that the average frequency of deaths is not loss than from sixty to seventy per cent. ; of 987 cases collected by Jlr. Phil- lips, 435 proved fatal, or 44 per cent. Mr. Curling states, on referring to a table of amputations performed in the hospitals of London from 1837 to 1843. "I find 134 cases of amputation of the thigh and leg, of which 55 were fatal, giving a mortality of 41 per cent." Of 201 amputaitons of the thigh, per- formed in Parisian hospitals, and reported by "Malgagna, 126 ended fatally. In the Edin- L'urgh hospital 21 died out ' of 53. Even if we take much larger numbei-s we find the mor- tality very high. Dr. Inman has collected 3586 cases of amputation generally, primary and secondary, from accident or disease, and the deaths are one in 3 1-10. In 4937 cases published by Mr. Tennick. the mortality is one in 3 1-15. The result of the amputation at the hip- joint is still more unfavorable, Mr. James Cox- has shown that, out of 84 cases, 26 were suc- cessful, and 58 unsuccessful. Again: take operations for hernia, Sir A (,'ooper recoi-ds 36 deaths in 77 operations, and Dr. Inman 260 in 545. Or. the ligature of large arteries, of which ."'Jr. Phiilins has collected 171 cases, of which 57 died: Dr. Inman 199 cases, of which 66 died. Of 40 cases of ligature of the sub- clavian artery, 18 proved fatal; the ligature of the innominata has been fatal in every case. So that, taking the mortality of Dr. Lee's estimate, it is not higher in ovariotomy than in that of other operations, which are admit- ted to be justifiable notwithstanding. I might, with equal propriety, refer you to the comparative statistics of Prof. Simpson. Dr. Atlee, and Dr. Buchanan, together with many others, but I trust the present are suf- ficient to convince you that the operation is not such a monstrous innovation on the dig- nity and legitimacy of surgical practice as some are wont to teach. OPERATIONS IN KENTUCKY. The following is, T believe, a complete col- lection of all the cases which have been oper- ated on in Kentucky up to the present date. Some of them, you will see, are without any detail, notwithstanding I have addressed cir- culars, as well as private letters, to the opera- tors. Those of them contained in Dr. Lyman's report, I sh,ill, for the sake of convenience, copy as condensed by him, the object being merely to give the leading characteristics of each particular case : 1. Bnekner — Mrs. W. — ^Two solid tumors felt throueli the abdominal parietes ; the upnei- very movable; the other -wedged in the pelvis, and felt through rectum and vagina; opera- 162 KESTVCKY MEDICAL .IDVEXAL. tiou June, 1848; incisiou from umbilic-us to nithin an 'iich of symphysis; pedicle of the upper tumor attached to the lower, ligated. and removed ; pedicle of lower tumor origin- ating in the left Fallojjian tube ; ligature around the diseased left ovary ; pedicle of tu uior ligated in four ecjiial parts; no adhesions; died sixth day of peritonitis. 2. Buekner — Aged thirty-nine ; several children : operation January 31st. 1850 ; in- cision eight inches: numerous adhesions; liga- ture around the pedicle; tiimor of the right ovary removed : ligature fell thirtA'-uiutli day; alarming symptoms, hut the patient eventually recovered. 3. Blaclcaian. — Tapped several times; op- eration December 22, 1855 ; adhesioi:s slight ; ovarian tumor of twonty-two pounds remov- ed ; no bad sjTiiptoras after: recovery. 4. Bush. — Xet published ; no report ; died. 5. Bayless. — 31rs. Dredden. age 31 ; opera- tion September. 1849: disease of seven years' standing; tapped seventeen times; incision ten inches: numerous adhesions, particularly around the tapping point. There was no dis- tinct pedicle on either .side, to guide the ap- plication of a ligature. It was all a confused mass. Tumor multi-locular; weight eighteen pounds besides the tappings; ligature fell at the end of the eleventh month ; recovered. 6. Bradford. .T. J. — ^Not published: no re- port: died. 7. Bradford, J. Taylor. — ^liss H.. ^lays- licb, Ky.. single, ase 21 ; twelve years" gro^rth. having commenced at nine yeai-s of age. after scarlatina : menses appeared at twelve and continued regular ; variety of treatment : health failing; operation June 14. 1853: in- cision eighteen to twenty- inches, between en- si form and ])ubis: adhesions to omentum: cyst tapped, extracted, and double ligatures passed through the pedicle left ovary; forty- one pounds, containing, attached to inner v.all. bony plate, var\'ing in size from_ a pin's head to a saucer, with one large piece of bone embedded in the wall of the sae; up to six- teenth dav : lisature fell sixth week ;_ recover- ed. S. Bradford, J. Taylor.— ^NEss M.. Mil- ford. Kv., aire 20; menses regular; thirteen months ' standing ; progress rapid ; n^ver tap- ped : operation Jiuie 4. 1856: incision ten inches: tumor very vascular: cyst originated on broad ligament half inch from left ovary; ovaiy healthy and or normal si.ze : ovary re- moved ■svith cyst ; no adhesions ; tumor weigh- ed twenty-four pounds, double ligature pass- ed through pedicle: ligature fell fourth week: recovered. 9. Craig.— :\rrs. H.. age 26: one child; menses at 15; at 16 had suppression from, cold, and never regular after: complicated with ascites, which disappeared several times under treatment ; operation April 22, 1854 ; tentative incision three inches, extended to serobiculus: adhesions previously diagno.sti- ca ted ; tapped cyst ; found contents too thick to pass through canula : adhesions to oment- um and mesentery; double ligature through pedicle : left ovary ; recovered i?i seven weeks : solid parts eleveTi and three quarter pounds. ] 0. Dunlap. — ^Irs. B., age 37 ; five chil- dren: one year's gi'owth ; tapped four times in last sis months; operation ^faroh 24, 1853; incision from umbilicus to pubis, twelve inches; adhesions slight; cyst evacuated: solid portion size of child's head; evacuated; dou- ble ligature to pedicle: thirteenth day walk ed across room ; ligature fell in three weeks ; left ovarv: t^drtv-seven pounds; recovered. 11. Prof. B. W. Dudley.— Not published; no report : died. 1 2. Dudley, E. L. — Not published : no re- port ; died. 13. Dudley. E. L. — ^Xot published; no re- jiort from operator ; operation abandoned ; pa'iient recovered, X. B. — Received report from Dr. Dudley. April 7.. too late for report, 14. Evans, A. — Xot published; no report ir'om operator: patient died. 15. Evans. A. — Xot published: no i-eport; recovered. 16. G^ross. — ^liss D.. age 22 ; menses regu- laj": eighteen mionths' gi'owth; tapped three galloiLs three weeks before operation. June 1?*, 1 849 ; incision three inches above umbilicus to pubis, one foot: right ovary; adherent, red. and vascular; ligature around the pedicle. v,-hich was narro^\-. and though tied with *' great firmness," it came ofl: after removal of the tumor; a large artery was secured, and another ligature applied around the pedicle, and one of the divided bands of adhesions. "^^liieh showed a disposition to bleed, was liga- tured also. The menses appeared for two days, tlie thirteenth day. and though the case looked promising, she died in four weeks of peritonitis: enelysted tumor nine pounds. 17.— -^liller, — Age 37; four months' growth; tapped previous week: operation April 6, 1848: inci,sion. umbilicus to pubis: adhesions: two of the cysts tapped to rediice the size : tmnor drawn out. and single liga- ture passed through pedicle ; tumor removed, and remaining vessels of broad ligament se- cured separatel.v; weight nine pounds and a Cjuarter: last ligature came away thirty -first day; recovered. 18, ^re^fillen, — Xot published; no report: died. X. B. Promised report, but did not receive it. 10. ^FcDowell. — ^fi-s. Crawford: opei-a lion Dei'ember, 1809; incision on left side, 1h)-ee in;'hes from and parallel to rectus: nine inches long: ligature around pedicle : tumor MEDICAL PIONEEL'^ OF KENTUCKY. 163 opened, and fifteeu pounds of gelatinous sub- stance removed pedicle divided and sac ex- tirpated : whole weight twenty-two pounds a2id a half: in five days, the report says, she was able to make her own bed, and in twenty- five days she went home. 20. McDowell. — Negress; after three or four years of mercurial treatment incision -vas made as in previous case ; adhesions to bladder and uterus preventing, its removal; the tumor was incised and gelatinous matter, and a quart of blood escaped ; recovered from the operation; in two years the tumor was as large as ever. 21. IfcDowel]. — Incision in linea alba, an inch below umbilicus to within an inch of pubis; ligature around pedicle; incision ex tended two inches above umbilicus, and a '•'scirrhas ovarium." M-eighing six pounds re- ii.oved. She was well in two 'weeks, with ex- ception of the ligature, which fell in five; re- covered. 22. McDowell.- -.'\pril 1, 1837: incision as in last case ; ligature slipped, followed by pro- fuse hemorrhage ; vessels tied separately ; some of them were cut through by the liga- ture finally p-issed a ligature around the ped- iile again, ,nnd stitched it down; recovered from the operation, but was not in good health afterwards. 23. 3rc,Dov.'ell.— Operation May 11, 1P29 ; ]n\n been under the treatment for others for eighteen months, with supposed ascites; treat- ment continued awhile ; she was then tapped,' and thirteen quai-ts of gelatinous fluid remov- ed ; in two months tapped again ; and then discovered th.'=' tnmor; in a few months 'wa,? tapned Ihe third time, Avhen the incision was erdarged snfficipntly to introduce a finger, to settle th'^ diagnosis: tapped a fourth time, shortly before the operation; length of incis- ion not mention^^d : tied the pedicle, also a band of uterine adhesions, and removed the tumor; left ovary; died in three days of peri- ionitis. 21. ]*.IcDowel]. — Fifty-three ..years of age; operation 1 822 ; incision six inches in linea alba ; bloody serum gushed out and continued to flow until the sa*" was emptied; edges of wound approximated by interrupted sutures: the adhesions to the peritonenm being of such a character as to induce an abandonment of the operation; wound healed 'at the end of live weeks- patient lived twenty years after the operation ; enjoyed good health, Presi- dei;.t Jackson was present at this operation, and the details were furnished Dr Gross bv Dr. James Overton, who was present at th« operation. 25. ^McDowell. — ^Miss Plasters: operation May ]2, 1823: incision whole-length of linea alba ; finding the tumor so large that it could not be removed entire, the sac was punctured. The morbid mass was then lifted from its bed, a jiQ-ature having been previously cast around its footstalk, or uterine attachment ; the edges of the wound were carefully closed in the usual manner, and the woman put to bed; for fifteen days after the operation there was a bloody, puti'id discharge from the wounds, supposed by Dr. McDowell to be sloughing of the oraeniurn. Patient entirely recovered. Dr. Gross is mdebted to Dr. W, C. Gait, for Liany years a distinguished practitioner of .Louisville, for tlie details of this case. 26. Smith. — Age 30; two children; menses regular: operation May 24, 1823; incision, umbilicus to within an inch of pubis; no ad- liesions; sac emptied of several pints of ■'watery matter," and with some difficulty ex- li'acted; ligature around the pedicle; right ovary of "scirrhus appearance;" menses re- turned profusely in five days; ligature fell twenty-flfth day; has been well since, except for pain in loins and abdomen during. men- strual periods. 28. Smith. — Case successftd. (Cooper's Surgical Dictionary.') 29. Smith. — Patient died of secondary hemorrhage from relaxation of the ligature some days after operation. (Cooper's Surgic- al Dictionary.) 30. Smitli ' & McDowell.— Patient had ascites, for ^\hich she had tapped herself iiinety timics. Both considered the diagnosi.s as certani. but, on opening the abdomen, no ovarian tumor was found ; a mass of intes- tines, only, conglomerated by adhesions. She died. ..AN..'\LYSIS OF KENTUCKY CASES. It will be observed in the details of the Kentucky cases, that many of them are in- complete in prominent points of statistical in- terest. In the eighth case of Dr. McDowell, five of which were published by himself, in but one is it stated whether the right or left ovarj^ was the seat of disease, whether any were fibrous, etc. Others again have failed to give the dura- tion of the disease, whether married or sin gle, whether they had borne children or not. age, etc. ' ! ' In consequence of 1his omission on the part of those who have reported the cases, and the failure of others to report the unpublished cases as solicited by me, it will be impossible for me to give you anything like a complete analysis of them. I have stated the result of seme of the unpublished cases on reliable au- thoritv, and if in any instance, it is incorrect, it will be no less a regret to me than to the operator. T will note some of the leading points of interest so far as ( have been able to get them. Oiit of thirty operations performed iji K-^'.> 164 KENTUCKY MEDICAL JOURNAL. Xxu-ky, nineteen recovered and eleven died, iiearl.y two-thirds being successful. Of the thirty operations for the removal of the tumor, it was completed in twenty-five; in five it was not completed. Of the five cases in which the tumor was not removed, two recovered and three died. In the five cases where the operation was abandoned, the cause of the failure is report- otl in but two, one from adhesions to the blad- der and litems, and one from peritoneal ad- hesions. In one ease, No. 30, no tumor was found: '■'a mass of intestines conglomerated by ad- hesions," accompanied \>y ascites. In one case, No. 30, the patient tapped her- self ninety times. In but four eases is the cause of death given : three were from peritonitis, and ou'^ from hemorrhage. In twelve cases, so far as stated, there were adhesions, or one in ever^^ two and a half. In but two cases was the short incision prac- ticed. In one case, No. 8, the cyst formed on the broad ligament, and not in the ovai'v, weighed twenty-four pounds. In one case, No. 9. accompanied by ascites. In case No. 5. the ligature did not faU un- til the eleventh month. No. 5, disease of seven years' standing. No. 7. disease of twelve vears' standing. No. 7. disease commenced three years before the menstraal discharge occurred. No. 7, contained a large piece of bone em- bedded in the sac with numerous particles of bony excrescences on the anterior superior part of the sac. No. 7, the disease commenced at nine years of age. It seems in the three hundred eases report- ed by Dr Lyman, that this case of mine. No 8;) of his table and No. 7 of Kentucln^ cases, was the eai-liost ppriod at '\\hich the disease commenced: and, on i^age 127 of his report. liC 'i.lludes to it doubtingly. and says, if the "account may be relied on." I have no idea Tlia+ Dr. Lvman made this allusion with any uiK-harit-able intention, and I have no rebuke to offer, further than to reassert its correct- ness, and that the family physician. Dr. B. r. Duke, of ■^fnyslick, Ky.. and the mother of ihe younsr lady will bear te.stimonv to the fact. But further: two yeare ago I saw a Httle girl in Utopia. 0., four years old. ^^■hose abdomen ■was wonderfully distended. She walked about, but tottered as she went. She complain- ed but littl"^, except from over-exertion or the ivfiuence of cold when there would be some tenderness or soreness of the bowels. The gen- c-v.-d health was good, and in strana-e contrast with tb.e enormity and extent of the disease. for T believe then the contents of the abdo- men ^^•ould have weighed twenty pounds. On exam-ination of the tumor, I found it filling vp every part of the abdomen, fluctuation was distinct, percussion was dull at every point, e.K^tept on the opposite side to which she was l.ving, neai- the spine. 1 learueil fi-om the mother that one year be- fore, she obser%^ed a swelling as large as a goose-egg in ihe right groin. She complained lacire Ihcn than sinC(V continued to enlarge, iriclining for some months to the right .side, until one day, in her ovm language, the ■'swelling was all over her bowels." To me it was a clear case of ovar'an tumor. I have never met with one of which I was surer. I advised tapping and intended to follow it \-.ith iodine in.jections. bandage of "Mr. Brown, etc. : but, for a time, tlie family postponed it. In the meantime they removed to Cincinnati, since which time, with all my curious interest in the case. I have not been able to hear one word. In the Nf'}r Yorl; Jotinial of Medicine, 1854, may be found a case of ^Ir, Cox. where a "heaHhy nursing infant" died of con^iils- ions; the ovaries were found dropsical. Mayor* — a case of a child seventeen days old, when. the ovaries were dropsical. Londrin Lnncet. vol. 2, 1845. p. 120 report of Royal Society'- of London, 1805, Mr. Charles Pedro reports a case where the ovai-ia were found wanting. Patient died at twentv-nine years of age. Since circumstances noticed in preface in- duced mf^ to change the chai'acter and ma- terial of this i-epovt. T had intended to report the cases of Dr. Dunlap aiid myself in detail, but as this report has already gone beyond my c;"deula1 ion, and as three of our operations are noticed in the Kentucky cases, and others of ours and my own, easuallv alluded to by way or* illustration in the chapter on diagnosis and elsewhere, it were nov seemiiarly useless. It might seem that these cases were picked or selected, as peculiarly adapted to the oper- ation. This inay be true to some extent. Let us examine: In one i\nss Harrison. No 7. of Ker.tuckv cases, one of ITentuelo-'s most distinguished surgeons a name that was "mightier" than ".Elam, -Ihe chief of our mite." sent this in- torestina- yoimg lady, iri the bloom of youth, to her friends, there to "shuffle off this mortal coil." as a hopeless case. After the operation she returned home from .Anofusta to her parents. Not long after I ctiancod to meet her on board a steamboat on the Ohio river. I never shall forget that bounding step and weeping face, which moved •jiy heart by the testimonies of her gratitude : aiid if there he anything which in\ites the love and ambition of the generous heart, or MEDICAL PIONEEBS OF KENTUCKY. 165 inspires an emotion wortliy of our glorious triumphs in scienee, it is that of bearing "healing on our own wngs. " of giving '■'("■.eauty for ashes, the oil oP joy for mourn- ing, and the garment of pi-aise for the spirit of heaviness." In anothei- case. Mrs. Lastly, of Ports- mouth, Ohio, Br. Kimball, of Lowell, Massa- chusetts, a surgeon of considerable notoriety, opened the abdomen, and finding the adhes- ions, as he thought, insuperable, closed up the wound, and abandoned the operation. Dr. Dunlap and 1, one year after, examined the case patiently, deliberately, and carefully, and operated successfully. See page — . In the one of these two cases the disease was of twelve .years' standing, and the tumors weigh- ed forty-one pounds In the other the tumor weighed fifty odd pounds, and reqinred twelve ligatures to the adhesions. It may save reflection hei'e to state, that contrary to the positive agreement made by Dr. Duulap and myself wlnlst in partnership, we attempted the removal of an appai'ently justifiable, if any are, ease of fibrous tumor of the uterus in a patient in Iowa, not ovar- ion tumor, which proved unsuccessful. I did not see the patient luitil the morning of the operation, but through the imploring entreat- ies of the patient and the attending physicians, as well as some recent published cases of the siieee.ssful removal of the uterus. Dr. Dunlap v."as prevailed iipon to take the ease. I am as much respon.sible as he, and I mention this case because the bad as well as the good cases in surgery should be known, and to steel you to adhere to your opinions if well founded, in- d.'-pendf^nt of those who are not so responsi- ble. T have but little desire to indulge in idle speculation about the propriety of the opera tion; facts and figures are to decide the ques- ticm, and if. 'by a principle of arithmetic, ad- dition, multiplication and subtraction we give to each fact and figure its proper bear- ing, the answer will come out right. The op- posers of Ovariotomy argue as though the iiiipro^'ements in diagnosis were finished, and the safest mode of operating had gained its acme. When the electric fluid was conducted iron the cloud by the kite of Dr. Franklin, it did not stop there, or, but for a time, and iiow we find 't leapinc from city to city as the iQedium of conversation. Soon its submarine cu.rrents ■\A^11 relate to us the transactions in all Europe an hour ago. The great propell- ing power, which was first discovered escap- i;ig from the "mouth of a tea-kettle." Avas first applied to river steamers, now it "moves like a thing of life" over the Atlantic. And S{> every improvement has been gradually de- veloped from one .legree of perfection to an- other. If you will examine the statistics since 1850, but more particularly since 1853, you will find, by comparison with previous opera- lions, that the mortality has diminished, and why "I Simply by the better developed state 0." the diairnosis, and the improved means of operating. The operation in itself is said bv some to be a simple one. I have never view- ed, or found it so : there are innumerable dif- ilculties which sometimes arise, which not one in ten of the medical books, not even Mr. Brown, in his late work on the "Surgical Dis- cjises of Women/' hints at It will be found by the statistical tables of Dr. Atlee and Dr. jjyman, that about twenty-five per cent, die from hemorHiage. How many ■^vi-iters or op- erators can you su'tinion. who regard the eon- ditiou of the pedicle when the ligature is ap- jdied as a matter of any consideration, whether it shonld be upon the stretch, or how? 1 have met with but one in my reading, Mr. Solly, and none in my intercourse who at first sight .so regarded it. The pedicle, but more particularly the ligament of the ovai-y is very extensible and elastic. If the tumor be lifted out with mnch force, or by any movement which places the pedicle on the stretch, so juuch so. that it does not contract before the li.gature is applied, that part of it which is most extensible when it does contract, is apt to slip throu.gh the ligature, and still, mthout close examination, look as though all was right. Once on turning the stump of a ped- icle up to see if it was bleeding, I saw a part of the pedicle contraetiua' A^dthin the ligature. I reflected much about this circumstance, and not nntil T read Mr. Solly's case, did T fully undertsand it.* Manv cases, I have no doubt died from this cau.se. Prof. G. W. Bayless' jMJs.sourl case, Mr. Bi'own's, and many other's, struck me as losirrg their lives from this cause. I lioped to speak of some of the leading feat- lu'cs of the operation, it is now out of my power. In conclusion, I have to say to the IMedical Association, that it ■will be recollected by soirre of its members that most of my leisirre tirrre for two entire year's was devoted to the col- lection and classification of statistics on C>var*iotorav. But a few weeks before the meeting of the Convention, Dr. Lyman, of I^oston, published a circular report embrac- ing about the same number of cases, and as Lis cases and mine were gathered frora the same sources. I was driven to the necessity in the very short time, to write the present re- port or fail to make one. This is all the apology T have to make for 1he report as you find it. trusting that your "generosity will forgive 'what your good sense may see amiss." *London Lance':, vol. 1846, p. 442, ]66 KENTUCKY MEDICAL JOVTl\AL. DOCTOR FRANCIS E. POLIN. By RoBT. C. McChord, M. D. Lebanon. As is now geijerally known by the medical profession of Kentucky, the first Ca3sarean Section ever performed in this- State was donc- in 1852, near Sprinj;:field, by Dr. Francis E. T'olin, of that count\'seat town. Dr. Polin was born at Spring-field, Septem- lier 8, 1S27, and he died there January 2, 1860. He came of a race of highly respectable physicians and his literary and medical ad- \antasres were tl^e best that the time afforded. ^vilh Dr. Thomas J. ^lontgomery to see Mrs. Alary Brown, Mdio resided in the country near Sj)ving-field. who had been in labor forty hours, during which time her physician had r.iiide several unsuccessful attempts at de- liscry. She was a robust, health.y woman, thirty-seven years of age, and the motlier of si.\ children. A hydrocephalic head was pre- sontina:, and the child iieinp; dead, it was punc- tured and tlie bones at the base of the skull ti'ushed, but it was found impossible to de- liver the child on account of its immense size. As a last resort it was determined to do a DOCTOR FRANCIS E. POLIN 1827—1860 After graduating in medicine he began prac tidng in ipartnei'ship with his father. Dr. John Polin, at Springfield. Dr. Polin died at the early age of thirty - three, ])ut he had already established an en- viarle reputation for his individuality and courage in professional work, in spite of the aiicnsation of his rivals that he was often v.fkless. Tie was especially efficient and skill fui in his snrgienl work. During the month o" December, 1852. when he was only twenty- five years old. he was called in consultation CiBsai-eau Section, which was done by Dr. Polin, assisted by Dr. ^Montgomery, in an hum- ble country home and with surroundings whioli were far from favorable. ' ' The abdomen was opened by a median in- cision exte!iding from a point tv.o inches above the pubes to the pit of the stomach, l-lie child was removed from the womb by a longitudinal incision, and proved to be a n.ojistrosity weighing twenty-five pounds. The incision in the xiterus was closed by L I tried silver wire ^sutures, recently brought MEDICAL PIONEERS OF KENTUCKY. 167 irito use by Dr. J. Marion Sims, and the cciges of the abdomiiial wound brought to- gei.her by alternate interrupted sutures o? silver wire and flax thread. The woman was* ei!.tirely well i)i about a month and lived to a very advanced age. dying about 15 years ago. She became the mother of two chil- dren after the operation, and suffered no in- convenience from the presence of the silver wire, except that during the pi-egaancies she Lad some uterine pains. —.ever perhaps has there been a more inter- esting or lovable man in the medical histor,\ oi" Kentuckv- than Dr. Imke Pryor Blackburn. Born on a Woodford county farm, July 16, 1'ay, he was warmly pressed by the people of Versailles to locate among them. This Sjilendid service in the face of danger, ren- dered the citizens of Versailles, brought him deserved distinction at the very beginning of Ids professional career. He removed to Ver- 16S KENTUCKY MEDICAL JOURNAL. aajlles ai:d soon established au extensive aud JiiL-rative praetice. "Dr. Jiiaekbui-n was a large, haudsome liian with a eountimanee as open aud kindly ;.s Sir Walter Scott's," .said a professional luan who knew him intimately in talking of Ljm recently. "Tender-hearted, generous, fearless, frank, indifferent about wealth, whol- ly unpretejiding, with great good sense, and lavge experience and noteworthy success in his profession. He was a man of decided eon- vieiions and rarely failed to chamijion them." 1x1 1846 Dr. Blackburn moved to Natchez, iliss., and soon acquired a large and lucra- tive practice and gained considerable distinc- tion over a great part of the South. In 1848 when yellow fever appeared in New Orleans, he was Health Officer at Natchez and the city ituthorities directed him to establish a quaran- tine, which he did effectually', and became so iiuerested in the sufferings of the marines for whom the Government did not provide, as well as h\indreds of others, that he built a h.ospital at his own expense, in which he again established a reputation for personal daring, professional skill and genuine philanthropy. (xov. AMiert Y. Brown, member of Con- gress from Mississippi, presented the ease of l-'r. Blackburn in Congress and stated that the necessities of a marine hospital at Natchez were so. great, that one of his constituents, at his own expense and risk had taken charge of large numljcrs of the sufferers. A bill was at once passed providing for the erection of the Natchez Hospital, finally resulting in the e.itablishment of ten other .similar institutions over the coimtrj'. Dr. Blackburn was ap- ].>ointed by the Government surgeon of the new hospital, and for a number of years held that position both in the State and Marine Hospitals at Natchez. He early advanced the theory of exemption from Asiatic cholera by the use of pure soft water and had long been a believer in the transmissibility and infection of yellow fever, and in 1854 protected Natchez from that dis- ease when it prevailed in the surrounding countr.v by a rigid quarantine. So well was the po\^'er vested in him used, that the fever was kept completely out of the county and people soon afterwards presented him with a handsome silver service inscribed "from the jieople of .A.llen County" as a token of their gratitude for his rigid and successful enforce- ment of the quarantine in 1854. Tn 1857 Dr. Blackburn went abroad to visit the principal hospitals of England, Scot- land, France and Germany, his wife having died several years previously. In Paris he met iliss Julia IM. Churchill, of Douisville, T\y., youngest daughter of one of the most distin- guished citizens of the state. In November of that year, on their return to America, Dr. Blackburn and Miss Churchill were married, and located in Nov/ Orleans where the doctor resumed practice with his usual exceptional success and popularity. When the war broke out he had, far in advance, espou.sed the cause of the South, and, in fact, was one of the original secessionists. He was at once attached as surgeon, to the personal staff of Gen. Sterling Price and the Ijegislatnre of Mississippi, put fifty thousand dollars in his hands to be applied to the bene- fit of the suffering soldiers of that State, wherever he might find them. Ill 1864 at the request of the Governor- General of Canada, he went to the Bermuda Islands to look after the suffering citizens and soldiers, and on bis vray was very flatteringly receivecl by the Governor-General of New Br.inswick and Nova Scotia, also by Sir Ad- miral Hope of the British Squadron, and his services were afterward favorably recognized by the Queen's Court of Admiralty. In 1865 the yellow fever spread among itan.v families in the vicinity of Fort Wash- ington on Long Island, from an infected ship, and Dr. Blackburn, then being on a visit in New York, was invited by the Mayor to give ills aid to the afflicted district, which he did, refusing all proffered compensation for his services. He went to Arkansas in 1867, I\Irs. Black- burn owning a plantation there, and for a 1 period he engaged in planting, but in 1873 Di'. aJid Mrs. Blackburn returned to Kentue- l;y and resided in Louisville, where he en- gaged in the practice of his profession. In 1878 yelloav fever in epidemic form again swept the South and the usual panic followed. Memphis, Nashville, St. Louis, Cin- ( innali and most other cities in this general latitude qu.arantined against the people fur- ther Soutli. Some Louisville physicians claim- ed this was a needless precaution, that yellon fever could not exist so far north. Among th.ein was Dr. T. S. Bell, a learned leader of jvicdical thought in his day in the West, and a man of vei-v' positive convictions. Dr. Blackburn took the opposite xiew. claimed that yellow fever had in fact existed further north, than Louisville, had genera- tjons before decimated the population of Philadelphia, and contended that it would Irreak out in Louisville if there was no quar- antine against it. The discussion waxed warm. The two men, good friends, became almost estranged. Dr. Bell's view seemed to appeal re most of the citizens and the city govern- ment, and the gates of the eit.v were thrown wide open. The refugees from the infected distrietb' cam.c in large numbers. Weeks passed and there were no new cases. The citi?ens of Louisville were greatly praised for their courage and hiunanity. A quarantine against our southeni kinspeople, it was said, would be heartless, Dr. Bell was the hero of MEDICAL PIONEKm OF KENTUCKY. 169 Ike hour. By general concert a demonstra- lion of public confidence was planned. A great concourse gathered in the old Ex- position Building at Fourth and Chestnui streets, which rang with cheers as Dr. Bell was escorted to the stage by foremost citizens ti; receive a gold medal from the people. Dr. Blackburn 's opinion was discredited, but he persisted that he was right, claiming thai frost alone would prevent the spread of the disease in Louisville. Then cam.e reports that yellow fever was in Hickman and in other points in Western Kentiiclr\r, near the ^"'Tississippi and Ohio, where infected patients had been brought up the river. At first the reports were pooh- poohed in Louisville and elsewhere, but soon liie truth could not be deiiied. Scores were dying at Hickman and undoubtedly of yel- low fever. Dr. Blackburn had not waited for this faci to he accepted by the people of Louisville, nor Ic say "I told you so," to tliem and to Dr. In^Jl. He had advocated a rigid quarantine to wave the well, but his heart was with the suf- fering victims. On receipt of the first news from Hickman he went there and for weeks exposed his life for the welfare of the peo- ple nor did he leave until frost came amd the last case had ended, 'I'hen two gold medals were made. They are now amongst the valued relics of the Filson (.ijub. On one of the medals is this inscript- lion : "1878. Testimonial of Love and Grat- ilude from Southern Refugees," On the other, this: "Luke P, Blackburn. M. D,, for his devotion to the people of Hick- man, Ky,, and other southern cities during the plague of 3878"; and on the reverse side, " iton tihi Kolun-, sed patriae et hiinianitati." The people of Kentucky were prompt to i-ecognize the fine heart and courage he had shown, Dr, Blackburn was the Hero of Hick- man and surely no title of honor was ever more fairly won. There was an approacliing election for governor. Eminent, able and respected men, familiar with political methods, aspired to the office. Some suggested that the state's high- es office and honor should be given to the "Hero of Hickman." Dr. Blackburn was wholly unversed in politics and guileless as a boy, but opposition was dro^Mied by the votes of' the people and he was' overwhelmingly elected G-overnor of Kentucky. His good sense and character made him an admiralile governor. He knew men and his appointments were excellent. Having no "axe to grind" he left adndnistrative details to the men he appointed to fill the various offices, and after all these are the two great charac- teristics of a good chief executive. .Across the street from the Governor's man- sion at Frankfort was the penitentiary then run much like a bull pen. The old buildings reeking with filth, immorality and disease, were outrageously over-crowded. Such con- ditions were then accepted as a matter of course for convicts. Modern ideas of prison reform had not permeated the public mind. But Governor Blackburn's great heart made him see, and his good sense and unyielding courage enabled him to right the cruel wrong. He asked the legislature for a prompt ap- propriation for extra quarters for the crowd- ed prisoners. It delayed. He asked again and the body debated and delayed. Legisla- tors opposed spending money on convicts. Gov. .Blackburn demanded ciuick action and was answered only by debates. Then he de- termined to act himself. He notified the Leg- islature that unless it forthwith granted re- lief, he would from day to day pardon and turn loose convicts until the whole number left could receive proper accommodations. The legislature was incensed, and still delay- ed. The pardons began; public opinion sup- l-orted the Governor, the Legislature surren- dered. The extra buildings were ordered and built. On one day, fourteen of the pardoned convicts were borne on cots past the Gover- nor's mansion, all of them in the last stages of tuberculosis, and all requesting to be al- lowed to be carried by the house of the chief executive that they might have the privilege of thus paying their respects to the Gover- nor and his Lady. Dr. Blackburn should be known as the father of prison reform in Kentucky. In this he was far ahead of his time. Another pio- ]ieer reform in the state prison initiated by his equally big hearted and covirageous wife a.nd always encouraged by him, was a Sun- <.lay school for the convicts, an institution which has growni with the years which has rendered priceless benefit to many of them and valuatile service to the state. After his term of office had ended, Gover- nor Blackburn, still seeking to further the welfare of his fellowmen, determined to de- vote his remaining years to founding a saaia- torium for the sick. It was established and or)erating in the suburbs of Louisville when death ended Viis really noble career in Frank- fort, September 14, 1887, His excellent wife survives him, universal- ly esteenied and beloved. 70 KENTUCKY MEDICAL JOURXAL. DOCTOR PTNCKNEY THOMPSON. By J. N. IMoCoRMACK, M. D., Bowling Green.' Dr. Thoinpson, justly entitled to be known OS "The Father of the' State Board of Health of Kentucky:"' and one of that State's most distintini.shfd and honored physicians, was hoiii in Livingston County, in this State, ot substantial North Ca.rolina parentage, April 15. 1828. and died at his home in Henderson April 11, 1807. give his student and assistant many hospital and otlier advantages of great practical value. He graduated from this Louisville school in 1853, in the same class with Dr. D. W. Yan- dtll and several others who made enviable j:ames for themselves and at once located at. Henderson where for forty-four years he en joyed a large and lucrative practice and was Widely l-mo'.vn as a highly influential citizen and churchman. Wliile, as was the custom of that day, he DOCTOR PINCKNEY THOMPSON 1828--1897 active Sanitarian who was largely instrumental creation of the State Board of Health, fifteen years of its existence. nd its President for the first After the meagre advantages for a literary ediTcation afforded hy the common schools of that day the ambitious >'Oung man spent two years as a student of medicine in the office of one of the best physicians of his native coun- ty, at the end of wbicli time we find him ma- triculated as a student in the IMedieal Depart- ment of the University of Louisville and a pj'ivate pupil of Dr. T. G Richardson, demon- strator of anatomy in lliat institution, who ir> ffter years attained to such eminence as a burgeon in New Orleans, and w!io was able to v.«s a general practitioner., and did a number of successful lithotomies, and tracheotomies and similar operations. Dr. Thompson is just- ly entitled to go down in history as one of Kentucky's first and most distinguished sani- tai'ia.us. He wrote and was mainly instru- uienta] in secui-ing the law creating the State I'.oai'd of Health, in the .spring of 1878, was yj'pointed one of its charter membei's by Gov- ernor 3TcCreary and was elected its first presi- dent, a position which he filled "ndth signal ril>ilitv and efi^ieiencv for sixteen vears, cover MEDICAL PIONEEL'S OF KENTUCKY 171 ]i)g tho formotive and most trying i:)eriod of its Jiisto'-y. Yellow fever was epidemic in the Souili when the Board was created and in f'Pite of the exercise of all the precautions then kn'own to sanitarians reached Hickman, Jiowling Green and I.onisville the following year, causing a high rate of mortality and great public alarm. When the small appropriation made for the Board was ex- liiiusted, Dr. Thompson generousl.y jDrovided tiie funds to comijat the disease, visiting Hick- DOCTOR LEINIUEL C, PORTER. By J. N. JTcCoRMACK, M. D., Bowling Green. Dr. Porter was born near Scottsville, Allen Ojunty, Kentacky, Januaiy 7, 1810, and died fi*- his home in Bowling Green on January 1, uScS7. He came of excellent Maryland and Vir- ginia ancestry and as his father was a pros- perous farmer and business man he gave his talented son all of tha educational and social iidvantages of his section of the country in DOCTOR LEUMEL C. PORTER 1810-1887 ; of the leading practitioners and surgeons of Green Ri' iuan and other infected districts and person- ally supervising the quarantiiie and other re- strictive meas'ores. jis part of this work he .;cujat.oii.s ol uv. uiiarles uaiuvveil, an im- iM'ctisiou ol tnese iwo cusimgLusnea men, lui- j)iJea I'atiier tlian expresscu, vvaien i-eiiiciuiea wiin and was ai! luspiraiion lo liini to tne end oi liis days. -Nature iiad dealt Idniliy witli Dr. Porter iu cveiy way. iie Had a coiumanamg tace ana Jigure a.'Jd ail oi tne native dignity, courtii- ntS3 and grace oi manner, and studious care oi tiie person, wiiicJi marJietl tlie gentleman ct the oid school brom early lite an omniv- ovous reader and close oDserver ot affairs, tiiere was added to his tund of knowledge an unostentatious teJicity and charm of express- ioii wliicli made iiim a center of attraction m aiiy circle. AVitli such a personality and abil- ity, and with the usual oijportunities Lexing- ton Jiad furnisJied for professional study and observation, at the close of wliat would now be culled a post-graduate course, he chose Bowl- ing Green as a permanent location for prac- tice, soon took higli rank in his calimg and was for more than half a century one of tne lead- ing surgeons and consultants of a large part oi the Ureen and Barren iiiver country, and the iciol of such a following that almost a tiiird oL' a century after his death, his name, his acLiieveinents and charity, and his forceful, piquant saying are still pleasant memories with a large population who never saw him. ijooking back over a long experience with and study of him in the sick, consulting and operating room, after all the only places for ii, j-eal test of a practitioner of our art, and taking into consideration the scantiness of accurate .scientilie knowledge and absence of tiie p.iodern aids to diagnosis which handicap- j)ed the physician of that day, his insight into his cases and his resourcefulness and suc- cess in meeting conditions by either medical or surgical means, or hy watchful waiting, seems the more remarkable as the years go by. As a student, he rejected the heroic medica- tion of that day, which reached its ma.ximuni iu the teachings of Dr. John Esten Cooke, one (•f ihe professors in Transylvania, always us- ing drugs sparingly, his original and inquir- ing mind reserving doubts of any powerful rirug until its value had been proven by the experience of many trained obsei-vers. Practicing upon a poi^ulatiou essentially rural, and in his earlier 3'ears very sparse, to a degree he ^nade flie advantages compensate for the disadvantages in efforts for the solu- tion of problems more different and often im- possible of solution in cities or crowded com- inunities. As an instance of his acute powers of observation and sagacity, he demonstrated (■a;'jy in his practice that smallpox was not communicable until the lieginning of the pus- t.ilar stage of the eruption, the end of the iifth daj-, since confirmed by thousands of ob- servers, but even yet, although of the utmost practical importance in managing outbreaks of this disease, taught in few medical schools and text-books. An earnest advocate of universal Aaccination, on nccount of an experience, now- confirmed by health officials everywhere, that a large percent of bovine virus from the best pi'oduccrs on the market either becomes v-.liol]y inert or loses much of its protective i-alue by subjection to a high temperature in transit or in storing, he used only humanized virus obtained from the arms of maidens or children whose fam.ily histories were person- ally known to him, as the State Board ot Health now officially advises be done, e.speci- ally in countiy districts and toA^-ns where the virus cannot be kept on ice. He insisted that \accination was practically universal, in the youth at least, under the humanized virus regime, that it caused less local and constitu- tioxial disturbance and gave far greater pro tectJon than bovine virus, and that the hue and cry against it was not only a part of a c.)mraercial war led by the large concerns pro- ducing boYine virus, but that it was largely responsible for starting the anti-vaccination craze 'which had become so well organized and po^verful since bis day. in addition to lithotomies, herniotomies, amputations and other operations in which he liad been carefullj^ trained, Dr. Porter seems to have given evidence of the same originality and boldness in other fields of surgery as Piarked liis career in the practice of internal medicine. He did several nephrotomies, nine traeheoi orrdes for foreign bodies in the air- passages, and performed the same operations many times for so-called croup and diph- theria. In this o])eration, he discarded and anathematized the trachea tube, because it would be likely to interfere with the escape of the foreign bodj' ivhen this did not occur at the time of the incision, and for the far stronger reason that the tube Avas itself a for- eign body which would greatly increase the danger of pneumonia and other inflammatory miseliiefs. Instead, he inserted two deep sutures in each .side of the incision some dis- tance from its ends, carefully avoiding the iivacous membranes in doing so, protected the skin from pressure by small pads outside of the sutures and stretched the opening well by tying the threads back of the neck, the only dressing used being a damp silk handkerchief laid on the wound to keep it moist and to act as an air-strainer ; these sutures being used to close the incision when the time came for do- ing this. Anotlier simple and highly useful operation devised by him in early life, to which he is entitled to the claim of priority', so far as the writer can ascertain, and at my suggestion ]-erfected in technique by Dr. W. L. Rodman, of Philadelphia, and reported to the surgical section of the American Jledical Association MEDICAL PIONEEKS OF KENTUCKY. 173 gliortly before he was elected President of that liody, was one for the evacuation of the blad- der in eases of impermeable stricture or other ol.istruction of the urethra. Failing to intro- duce a catheter or bougie, in the use of which he was an expert, he thrust an extra large tro- car into the bladder, just above the pubis and well below the reflection of the peritoneum and, before much of the urine was allowed to escape, inserted a rather hard gum catheter — not a iSIelaton — well into the bladder through the canola, drained off the balance of the urine, removed the ivorj' tip from the distal end of the catheter, withdrew the canula, stopped the opening in the catheter with a well fitted cork, tucked the loose end of it uiider the loop of adhesive plaster on the bel- ly, and advised the patient to remove the stoijper and empty the bladder every six hours until the urine Howed freely through ihe urethra, when he was to return for a ]u'oper treatment of the cause of his trouble. As se(?n through the dim vista of the long ago when we were so closely associated in practice and friendship, more like grand- father and grandson than as partners, and af- ter a long life since in close professional and personal touch with leading medical men of our own and otlier countries, the writer is convinced that, but for a philosophical indif- ference to what he termed the bauble of a posthumous reputation, as a maii, as an orig- inal thinker .-iud as a physician and surgeon, i'ew of our forbears were better entitled to a pLice among the "Medical Pioneers of Ken- tucky" than the subject of this sketch- LIST OF ILLUSTRATIONS PAGE Doctor Ephraim McDowell FroDtispiece Doctor Ephraim McDowell.. A later picture... 10 TE.iVEi.ERs Rest 13 The Graves of Doctor and Mrs. McDowell. . 17 The First Ovariotomy 18 Facsimile Letter of Dr. McDowell 20-23 Doctor .Iohx D. Jacksox 3-1 The Monument 26 Doctor Sa.muel D. Gross 27 Doctor Richard O. Go-m^iNG 42 Doctor Lewis A. Sa\-re 43 Cambus Kenneth, the Home of McDowell.... 46 The MoDovteli. Family Crest 47 Transylvania University Medical Hall 50 Doctor Samtel Brown 53 Doctor Be.v.t.\mix W. Dudley 5G "FAIRL.4WX," The Home of Dr. Dudley 60 The Dudley Gr.wes .' 62 Doctor Daniel Drakh 64 Doctor John Esten Cooke 67 Doctor William H. Richardson 70 Doctor Cihrles Wilkins Short 71 Doctor Luxsford P. Yandell, Sr 7."> Doctor -Ja.mes M. Bush 76 pagt. The Home of Dr. Bush, in Lexington 77 Doctor Robert Peter 7fl Doctor He.vry M. .Skillman 81 Old Medical Dept. University of Louisville.. 82 Doctor -James M. Bodine 83 Doctor William H. Wathen 86 Doctor Lunsford P. Yandell, Sr.. 2nd picture. . 90 Doctor Drake. 2nd picture 91 Doctor -John Esten Cooke, 2nd picture 92 Doctor Charles Caldwell. 2nd picture 93 Doctor Samrel D. Gross, An earlier picture.... 94 Doctor Austin Flint, Senior 96 Doctor Sajiuel il Bemiss 97 Doctor Tobias G. Richardson 98 Doctor Henry Miller 99 Doctor Theodore S. Bell 10! Doctor D.wtd W. Yandell 103 Doctor Willia.m L. Sutton 110 Doctor Lewis Rogers 123 Doctor Walter Brashear 138 Doctor Joshua Taylor Bradford 140 Doctor Francis E. Polix 166 Doctor Luke P- Blackburn 167 Doctor Pincksev Thompson 170 Doctor Lemuel C. .Porter 171 INDEX ^^nderson, W. W., biography of Bradford by, 140. Apology of linndon Medico-Chirurgica] Review to Ephraint McDowell, 12, 29, 48. Bailey, William, S4; picturt- of, 84; member of faculty of Hospital College of Medicine, 87; member of faculty of University of Louisville, 85. Bell, Theodore S. biography of, 100; picture of, 101. Bemiss, Samuel M., picture of, 97. Birth of the State Medical Society, 110. Blackburn, Luke P.. biography of, 167; picture of, 167. Bodine, James M.. 83; picture of, 83; member of faculty of Kentucky School of Medicine, 86. Bradford, Joshua Taylor, tribute to by Gross for brilliant record in reviving ovariotomy, 32, 38; biography of, 140; picture of, 140; report on ovariotomy by 142. Brashear. Walter, biography of by Coomes, 132; picture of, 138; tirst successful hip-joint amputation done by, 133. Brown. Samuel, first medical teacher in the second medical college in the United States, 51; picture of, 53; refer- ence to by Yandell, 89 Buchanan, Joseph, appointed in Transylvania faculty, 55. Bush. James M., biography of, 76; picture of, 76; Home of 77; tribute to by Rogers, 132 Caesarian Section first case done in Kentucky, 166. Caldwell, Charles, appointed in Transylvania faculty. 54: biography of, 72; pictures of, 72, 93. Cooke, John Esten, biography of, 66; picture of, 67, 92. Ccomes, M. F., biography of Brashear by, 137. Corrpspondence about dedication of the McDowell Monument, 44. Cottell, Henry A., biography of Dr. Drake by, 63 ; biography of Dr. Cooke by, 66 ; biography of Dr. Caldwell by 72 ; biography of Dr. Bell by, 100. Cowling, R O., presentation address of, 41; picture of, 41. Cra^rford, Mrs., whose intelligence and courage made the success of ovariotomy possible, 12 ; tribute to by Mc Dowell, 18, 20; by Gtoss. 28; by Sayre, 44; by Mc- Murtry, 37, 47. Drake, Daniel, asr.istant to Gross in establishing claims of McDowell as the first ovariotomist, 27; appointment in Transylvania faculty, 13 ; resigns 53 ; biography of, 63 ; pictiire of. 64, 91; enters faculty of Louisville Medical Institute. 95. Duel between Dudley and Richardson, 59. Lnidley, B. W., appointed professor of anatomy and surgery in Transylvania, 52; biography of,' 56; picture of, 56; home of, 60 ; grave of, 62 ; member of faculty of Ken tucky School of Medicinn, 86; Duel with Richardson, 59. Eve, Paul F., enters faculty of the University of Louisville, 98; generously retires 98. Facsimile of McDowell Letters, 25-28. Flint, Austin, Sr., enters faculty of University of Louisville, 96; picture of 96. Flint, Joshua B., enters faculty of Louisville Medical Insti tute, 93. Goodman, H. M., biography of Dr. Miller by, 99. Grcss, Samuel D.; part in rescuing name and fame of Mc Dowell from obscurity, 8 ; his McDowell dedicatory ad- dress, 26-41: accepts door knocker from the McDowell residence. 41; tribute to by McMurtry, 49; pictures of, 27, 94; enters the faculty of the Medical Department of the University of Louisville, 84 ; assists in organizing St.ite Society. 110 : early president of State Societv. 120: first to use anesthetics in Louisville 129. Groups in this volume, T. The McDowell Group, 3-48; IT. The Transylvania Group, 50-81; III. The Louisville Schools Group, 82-107; IV. The General Kentucky Group, 108-172. Hip-joint amputation, first successfully done by Brashear, 133. Hifr.lory of Medicine in Kentucky by Rogers, 123. Holmes, Oliver Wendell, letter of regret of, 44. Hospital College of Medicine, 87 ; faculty of, 87. Jackson, Andrew, assists McDowell in one of his ovario tomie.s, 13, 49. Jackson, John D. tribute to by McMurtry, 8, 9 ; biographical sketch of McDowell by, 11; plea for monument to Mc Dowell bv, 12-17; biographical sketch of by McMurtry, 24; picture of, 24; his credit in securing the monu- ment voiced by Gross, 87; tribute to by Rogers, 125. Kentucky School nf Medicine, 85 ; faculty of, 86. Kentucky, the General Group of, 108-172. Kentucky University, Medical Department, 88 ; faculty of, 88. Li/ars, John, first to attempt an ovariotomy in Europe, 29. Louisville Medical College, 87; faculties of 87. Louisville Medical Institute, 83, 89, 93; charter granted, 94. Louisville Medical Schools Group, 82-107. McChord, Robert C, biography of Dr. Pollin by, 166. McDowell, Ephraim, pictures of, 1, 10; foreword to group of, 8; Jackson's biography of, 11; marriage of, 13, 49- first grave of, 17 ; paper on extirpation of diseased ovaries by, 18 ; fac simile of letter of, 25 ; dedicatory address on, 26; the monument to, 26; centennial ora- tion on, 46; home of, 46; family crest of, 47; the apoV ogj' to, 12, 29, 48: liberality and high character as a citizen, 36; tribute to by Rogers, 125. McCormack, J. N., general introduction. 5; foreword Mc- Dowell group. 8; foreword to general Kentucky group, 108; biography of Dr. Blackburn, 167; of Dr. Thompson, 170; of Dr. Porter. 171. McDowell Group, 3-49. McMurtry, Lewis S., asked to write history of medicine in Kentucky, 5; thanks to. 7; made chairman of McDowell monument committee and his work thereon 9 ; his bi- ography of Jackson, 24; success of efforts for the mon- ument, 26-46: address at the Centennial Celebration of McDowell's tlrst ovariotomy, 46 ; foreword to Louisville Medical Schorls Group, 83-89. Medical Department of Kentucky University, 88: faculty of, 38. Medical Department of the University of Louisville, 82 ; chartered, 96 : picture of, 82. Medical History of Kentucky, facts in, by Rogers, 123. Medical Literature of Kentucky, by Yandell, 134. I N D E X— Continued Members of the State Medical Society in 1856, 117. Miller Henry, enters faculty of University of Louisville, 99; biography of. 99; picture of, 99. Officers of the State Medical Society from 1851 to 1017, 120-2, Ovariotomy. McDowell's priority in, 3-49; history of in Louisville by Yandell, 135 ; Bradford's great report on, 142-165; Lizars work in, 144; Clay as an operator in, 145. Overton. -Tames, elected in Transylvania faculty, 52. Parvin, Theopholis, letter of regret, 45. Peter, Robert, foreword to Transylvania University Group 50: sketch of Dr. Brown by, 53; of Dr. Ridgely, 54; of Dr. Richardson, 69: of Dr. Short. 70; of Dr. Yandell, Sr., 74; of Dr. Bush, 76; biography of by Col. Durrett, 78; picture of, 79. Polin, Francis E., biography of, 166: picture of, 166. Polk, James K., operation upon by McDowell 35. Porter, Lemuel C, biography of. 171; picture of, 171. Presentation address by Cowling, 41. Presidents and Secretaries of the State Medical Society from 1S51 to 1917, 120-2. Proceedings of first annual meeting of the State Medical Society, 111; of second annual meeting, 114. Richardson, Tobias G., picture of, 98. Richardson, "W. H., appointed to chair of obstetrics in Tran- sylvania, 52; biography of, 69; picture of 70: tribute to by RofANY Incorporated IVIANUF'ACXURERS SF»E:CXA.CI_ES and EYE GL^^VSSES F'ovirtH and CHestnut Louisville, Kentucky BURR M. OVERTON, Pharmacist Prescriptions Filled Promptly DAY OR NIGHT TRY US S. W. Cor. Third and Avery, Louisville, Ky. Special Attention to Out-of-Town Orders MEMBER OF THE FLORISTS TELEGRAPH DELIVERY AUGUST R. BAUMER ....FLORIST.... Masonic Temple Fourth and Cliestnut Both Phones Louisville, Ky. KEXTrCKY MEDICAL JOUliXAL. .... PHYSICIANS' DIRECTORY D. Y. KEITH J. PAUL KEITH DRS. KEITH 8z: KEITH A Modernly Equipped X-Ray Laboratory Kadiotherapy, fluoroscopy and radiography. Latest improved Coolidge tubes for the treatment of malignancy, leukemias, lupus and all forms of skin lesions in which radiotherapy is indicated. Suite 730 Atherton Building Louisville, Kentucky DR. CURRAN POPE Pope Sanatorium LOUISVTTiTiF,, KY. FOR SALE ; T am desirous of selling my property in Padueah. 'composed of residence and of- ilee, and have an active practice. Will sell for cost of building and lot. Will he glad to introduce to practice. Address; Dr. W. H. Parsons, Padncah, Kentucky. GUINEA PIGS FOR SALE Price, 50 Cents Each (F. 0. B. Bowling Green, Ky.) No order.s taken for less than two pigs ADDRESS JOE B. SLBLETT 1031 Chestnut St. Bowling Green. Ky. DR. J. C. HOOVER, Surgery, Diseases op Women and Consultations. Hoover-Foster Building Telephone 67. Owensboro, Ky. If you have any office eqiii]> ment or practice for sale, in- sert an advertisement in the JoURXAL. DR. L. S. McMCJRTRY SuTTE 542 The Atherton. Cor. Fourth and Chestnut Sts. Louisville, Ky. Telephone, Main 1700. Hours, 11 to 1. POSITION WANTED Position as Dietitian in a modern hospital wanted by a young woman, who is a a college graduate and has had hospital and teaching ex- perience in Dietetics. Excellent references. Address, "A. T. R.. Ken- tucky Medical Journal. Bowling Green, Ky. KENTUCKY MEDICAL JOUBNAL. F»HYSICIANS' DIRECTORY DR. W. HAMILTON LONG, Weissinger-Gaulbert, ANESTHESIA AND ANALGESIA, SURGICAL OBSTETRICAL AND DENTAL Telephones: City 6463; South 2980. Louisville, Kentucky. DR. J. GARLAND SHERRILL, 542 Atherton Building, Hours: 11 to 1. Louisville, Kentucky. DRS. AUD & McKENNA, SURGERY Suite 500, Atherton Bldg., Louisville, Kentucky-. Both 'Phones 1300, Hours 11 to 1, and by Appointment. DR. JOHN D. TRAWICK 820 Starks Building, Louisville, Kentucky, SURGERY OF CHILDHOOD Hours: 1] to 1. Phone, Main 27. H. A. DAVIDSON, B. S., M. D., 820 Starks Bldg. Louisville, Kentucky. Special Attention to Obstetrics and Gyne- cologic Surgery. Hours : 10 to 11 A. M., and 4 to 5 P. M. Consultation by appointment only. DR. C. W. DOWDEN, — DIAGNOSIS 400 Atherton Bldg. Louisville, Ky. Office, 526 Fourth Ave. Hours: 11 to 1. DR. JOHN R. WATHEN, Practice Limited to General, Abdominal and Gynecological Surgery. Telephones — : Office: Main 842; City 690. Res. : South 1660 ; City 3971. If you have any office equipment or practice for sale, insert an advertisement in the Journal. JOSEPH A. SWEENY, M. D., The Atherton Practice Limited to Diseases of the Digestive System. Hours: 9 to 1 By Appointment. DR. CHARLES FARMER, Suite 308 Masonic Building, Louisville, Ky. Cumberland Phone, Main 242 Home Phone, City 880. Hours: 2 to 3. DR. JETHRA HANCOCK, PRACTICE LIMITED TO GENITO-URINARY DISEASES AND SYPHILIS. N. E. Cor. Second and Chestnut Sts. Hours 1 to 4 P. M. Louisville, Ky. KENTUCKY MEDICAL JOURNAL. F»HYSICIAIMS' DIRECTORY DR. GRANVILLE S. HANES. \ INTESTINAL AND RECTAL DISEASES, | iEasonic Building, Louisville, Ky. DR. BERNARD ASMAN, Atherton Building, Fourth and Chestnut, Sts., Louisville, Ky. 12 :30 to 2, and by Appointment. DR. GEORGE A. HENDON, PRACTICE LIMITED TO SURGERY | 600 Atlierton Building, Both 'Phones: Highland 475; Bast 475. Hours 11-12 M. DR. A. DAVID WILLMOTH, SURGERY AND DISEASES OF WOMEN. Suite 403-405 Masonic Bldg., Fourth Ave., & Chestnut St., LouisviUe, Ky. Hours: 2-5 and by Appointment. Both 'Phones Office and Residence. DR. CLAUDE G. HOFPJLAJ^, Atherton Building. Both 'Phones. PRACTICE LIMITED TO UROLOGY, Hours : 10 to 1 and 5 to 6 Sundays; 10 to 1 and by Appointment. DR. GUY P. GRIGSBY, Suite 612-14-16 The Atherton, Cor. Fourth and Chestnut Sts., LouisviUe, Kentucky. Both 'Phones, ]\Liin 2100 ; City 773. Hours : 11 to 1 and by Appointment. DR. EMMET F. HORINE, ANESTHESIA AND DLAGNOSIS 1036 Bardstown Rd., Louisville, Ey. Both 'Phones. Hours : 4 :30 to 6 :30 P. M. and by Appointment. DR. BARNETT OWEN, ORTHOPEDIC SURGERY Office: 400 Atherton Building. Hours: 11-1 and by Appointment. Telephones, Cumb.. Main 2604; Home City 2604, Louisville, Kentrucky. DR. LEE KAHN, PRACTICE LIMITED TO GENERAL AND ABDOMINAL SURGERY. Atherton Bldg. Louisville, Ky. Both Phones, Office and Residence. — DR. ISL CASPER, SURGERY AND GYNECOLOGY Starks Bldg. Louisville. Ky. Hours : 1 to 2 and by Appointment. DR. CHARLES G. LUCAS, 700 Atherton Building, LouisviUe, Kentucky. Hours: 9 to 1. Afternoons and Sundays b^' Ap- pointment. DR. WALTER DEAN LEVI, PRACTICE LIMITED TO DISEASES AND SURG- ERY OF THE EYE, EAR, NOSE AND THROAT. Starks Bldg., Fourth and Walnut Sts., LouisviUe, Kentucky. DR. EDWARD SPEIDEL, OBSTETRICS 710 Atherton Bldg. Louisville, Ky. KENTUCKY MEDICAL JOURNAL. ■you cannot foresee the ^ future, but you can provide against its possibilities. You will be happier for the knowledge that in case of disability or accidental death you have made certain provision for yourself and dependents. Physicians' Casualty Assn. of OMAHA, NEBRASKA OFFICERS:— D. C. BRYANT, M.D.. Pres.. D. A. FOOTE, M.D.. Vice-P.es., E. E. ELLIOTT. Sec'y-Treas. A mutual accident association for physicians only. Fourteen 5-ears of successful operation. Over 8500,000 paid for claims. $5,000 for accidental death; $25.00 weekly in- demnity. Cost has never exceeded $13.00 per year per member. NATIONAL IN SCOPE. Membership fee of $3.00 covers current quarter. Standard policies coutain- ins; entire contract — no reference to by-laws. The Physicians' Health Association pays in- demnities for disability due to illness instead of accidents. An important protective in- surance for physicians. Send for circular, E. E. ELLIOTT, Sec, 304 City Nat'l Bank Bldg., Omaha, Neb. Uncontrollable Hiccup Arrested by the Ocu- locardiac Reflex. — The young man was com- pleteh' exhausted by the inc-ess'ant hiccup which liad tormented him for over twenty-four hours, liromids gave no relief and a dose of morphin only, a brief respite. A sedlitz powder caused jtiiieh discomfort but did not arrest the spasms of the diaphragm as hoped. Flexing the thighs on the abdomen to force up the viscera, massag'e, and rliythi.Tsic traction of the tongue also proved futile. But the hiccup stopped at once when the eyeballs were compressed as for the oculocardi- ac reflex. The radial pulse grew slow, the hic- cup stopped, and the exhausted man dropped to sleep at once. A return of t!ie hiccup next day was aborted by the same procedure. It also proved effectual in a case of hiccup from pitru- lent pleurisy. Campaign Diarrhea. — When entire regiments are taken with diarrhea for a few days, without special characteristics, Hanns thinks that the food is to be incriminated. The exercise and out- of-door life keep the men hungry and they over- eat. Then some chilling at night proves the last straw. The reason why the diarrhea develops in epidemic form is because theopportunities for overeating occtir to all alike, ripening- of fruit, etc. There were never any complications in the hundreds of cases he has encountered. Persisting Fistulas with Osteomyelitis from War Wounds. — Dujarier and Despardins advo- cate a special center to which these intetrainable fistula cases can be sent for specialist treatment. Their success with such cases has practically realized a center of the kind, as they report 80 per cent, cured by their operative measures in sixty-nine cases. The interval between the war wound and their intervention was from ten to 1 wenty-one months in most of the cases and in none was less than four months. The cure after their intervention was complete in from three weeks to six months, averaging from two to four months. In the few cases of failure some cause was discovered later in nearly every instance, a scrap of cloth, a sequester or an overlooked focus of osteitis. The abstract department of this Journal de ('rirurgie fills eighty-eight pages, and illustra- tions accompany many of the summaries. The indexing of .articles interesting the surgeon in international literature fills an additional thirty- six pages. Mercury Oxycyanid in Abortive Treatment of G-ouorrhea. — Colombino has discarded silver nitrate in abortive treatment of gonorrhea as it is irritating to the urethral mitcosa. Potassium permanganate also is of little use, he thinks, in tlie early stages, although valuable in the second or (bird week. Mercury oxycyanid, on the other hand, is effectual and nonirritating, as he has demonstrated in over 100 cases. He irrigates the urethra with a tepid one per thousand solution the first day, then repeats the rinsing with a 0.5 per cen. solution morning and evening thereafter for two days, then once a day. The cure is usu- ally complete in nine or ten days: the gonococei generally disappear by the third day. This laethod is indicated especially when the gonococei are restricted to the anterior urethra and not more than 48 hours have elapsed since the patient noted the first symptoms. Repose is good but not indispensable with this drug, but excite- ment, stimuLants and heavy work should be avoided. Absorption of the Roots of the First Teeth.— In examining large numlbers of "milk teeth," I.uciani noticed that the normal absorption of the roots occttrred completely only when the pnlp of the tooth was in normal condition. The physiologic integrity of the tooth is indispens- .Tblc; he declares, in preparation for the normal pi'ocoss of second dentition. All his evidence proclaims the importance of preserving the vital- ity of the pitlp of the first teeth until they are ready to drop off from absorption of their roots. KEXTUCKY MEDICAL JOURXAL. rji k 1- r XV - *^*«"« Phone 536 Dr. Weirick's Sanitarium Formerly Dr Broughton's Sanitarium ESTABLISHED ISOl For Opium, Morphine, Cocaine and Other Drag Addictions, Including Alcohol and Special Nervous Cases Methods easy, regular, humane. Good heat, light water, help, board, etc. Number limited to 44. A well kept home. Nervous-Mental Department in charge of Dr. W. L. Ransom. Address DR. G. A. WEJRICK:, Superintendent 2007 S. Main St. Rockford, 111. •5- J * ^ •fc ^3i9^BlB&^lHtt OCONOnOWOC HEALTH RESORT t OCONOMOWOC, WISCONSIN f ^ --' ' '-'^H^^H^^^^B Three hours from Chicago on C. Mil. & St. Paul Railway J ^^^^r^3^^mK^^^^^EisKi liH BUILT AND EQUIPPED FOR TREATMENT OF | • HP^4HHHil^^SS NERVOUS DISEASES J New and Especially Equipped Psychopathic Department •{• f B^- ^SbM For Acute Mental Cases T f L ABSOlDiay HREPROOF ARTHUR W. ROGERS, B.S., M.D., Resident Physician in Charge ? THE CINCINNATI SANITARIUM FOR MENTAL A.ND NERVOUS DISEASES Incorporated 1873 F. W. LANGDON. M.D., Medical Director. EMERSON A. NORTH. M.D.. Resident Physician. A strictly modern hospital fully equipped for the scientific treatment of all nervous and mental affections. Situation retired and accessible. For details write for descriptive pamphlet. B. A. WILLIAMS. M.D., Resident Physician H. P. COLLINS. Business Manager. Bo:ac 4, College Hill, Cincixmati, Ohio No need to qoestioc reliabilitA- of onr advertisers — all answering ails mention this Jouk.n'al KENTUCKY MEDICAL JOURNAL. ♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦ I IT IS RECOMMENDED I ^ ♦ ^ E\TRY business man recommends the service of the Cumberland ^ ^ Telephone & Telegraph Company. The physician needs it. It places jou ^ ■# in direct communication with every important city and town in the ♦ ^ United States. Local service always the best. The demand is for com- T T prehensive telephone service. 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Individual Instruction in the following branches : Major and Minor Surgery Rectal Diseases Hernia (local anesthesia) Anesthesia Cystoscopy (male and female) Phvsiral Diatfnosis Urethroscopy and Endoscopy Physical Diagnosis Neurology and Neurological Surgery Infant Feeding and Diagnosis (brain, spinal cord, peripheral nerves) Tuberculosis (pulmonary, glandular, bone) Dermatology (skin pathology) Drug Addictions and Toxemias Gynecology (operative ; non-operative) Diseases of Stomach (dietetics) Eye, Including Refraction, Ear, Nose, Throat X-Ray and Electro-Therapeutics State particular information desired when writing. Address inquiries to JOHN A. WYETH, M.D., LL.D., President of the Faculty or MR. JAMES U. NORRIS, Superintendent. No need to queetion reliability of our advertisers — all are gu aranteed. When answering ads mention this JoUBNAL KENTUCKY MEDICAL JOURNAL. YOU CAN SAVE YOUR LINEN By letting us do your laundry work. We have been in business so long that we know just how to avoid the many troubles which you have probably met with in sending work to laundries. ^ ■ i^COftPOSATce, H9 135 S. THIRD STFIKE7 OotH Phones 1068 l-iouisvllle, Ky. Elm wood Sanitarium Dr. Nevitt's Sanitarium LEXINGTON, KENTUCKY ^ For the Treatment of Mental and Nervous Diseases, Drug Addictions and Alcoholism. Approved Therapeutic Methods. Hydrotherap.v, Manual, Vibra- tory and Electric Massage. Trained "S^urses and Attendants. The Sanitarium is well equip- ped with every modern conven- ience and comfort aud free from institutional atmosphere. The grounds are beautiful, contain- ing twelve acres of well shaded Bli'e Gkass. situated on West Main St., just out of city limits. Terms reasonable. For further information, ad- dress, C. A. NEVITT, A.M., M.D. Medical Director Late Supei-iiilendeiit E. K. Asylum i -I PTFTTTTR For Office Needs | JL ^-^ *- ^ '^ *^ WRITE FOR I I For Blank Books I 1 WRITE FOR -— ^ >>Kiir.rvjK ^ K Incorporated 8^ I Office Furniture phone main 1788 Classy Printing | No need to question reliability of our advertisers — all are guaranteed. When answering ads mention this Joitbnal. KENTUCKY MEDICAL JOUBNAL. Mulford Antipneumococcic Serums For the Specific Treatment of Lobar Pneumonia Lobar pneumonia is caused chiefly by the pneumococcus, of which there are three different fixed types and a fourth group, including possibly twelve different types. Types I and II arc responsible for about 70 per cent of cases, with an average mortality, without serum treatment, of from 25 to 30 per cent. With serum treatment the mortality of Type I has been reduced to from 5 to 8 per cent. Type III is responsible for from 1 to 1 5 per cent of cases, with a death rate of 50 per cent. Group IV is responsible for from 15 to 20 per cent of cases. These usually follow a milder course, only 10 to 15 per cent resulting fatally. Mulford Antipneumococcic Serum Polyvalent is highly protective against pneumonia caused by Type I, and contains antibodies against Types II and III. The serum is tested and standardized by tests on mice; 1 c.c. must protect against 500,000 fatal doses of Type I cultures. The polyvalent serum should be used immediately on diagnosis of lobar pneumonia where type determination is impossible. The dose is from 50 to 100 mils (c.c.) intravenously, repeated about every six to eight hours until the patient successfully passes the crisis. Most cases will reqidre 300 mils (c.c.) or more. It is safe to administer the serum intravenously in large and repeated doses. When the serum is injected intramuscularly, the results are slower and less effective. Mulford Antipneumococcic Scrums tre furnished in packages containing syringes of 20 rails (.c.c.) each, and in ampuls of 50 mils (c.c.) for intravenous injection. Mulford Specific Agglutinating Pneumococcic Scrums for laboratory diagnosis are furnished for each of the three types, in lo-mil (c.c.) ampuls sufficient for about 20 tests. Mulford Pneumo - Serobactcrin Mixed is an efficient prophylactic against lobar pneumonia. It is supplied in packages of four graduated syringes. A, B, C. D strength, and in syringes of D strength separately. H. K. MULFORD CO., Philadelphia, U. S. A I I i I No need to question reliability of our advertisers — all are guaranteed. When answering ads mentic KEXTIfKY MEDICAL JOURNAL. I Surgical Instruments, Hospital Equipment f • and Laboratory Supplies • I I I 1 Don't Practice False Economy ^ Efonoiuy in all lines is desirahle : but it is false economy for physicians to al 2 low their equipment to deteriorate, i The Sales Manager of one of the larger ijistrjmeiit eomi^anies, writing on this 9 ----- -- I I Tliese tinics demand better equipment, and the exiienditnre of )nore time and i)icrgij ill the practice of medicine. Many physicians have been called to the colors. Their absence puts additional obligations on physicians at home ; and the latter shcidd equip themselves to meet the increased demands on their time and medical knowledge. subject, savs: I " I see in the future, and I hope that my vision is not faulty, a great need § A for Hospitals — for Hospital Equipment. Possibly 25,000 of cur best doctors m. are going to War. This means that the remaining doctors must be better I • i equipped so that they may take care- of a larger amount of patients. It also ! J means that more people will be taken care of in Hospitals than in private J f homes, because one doctor would be able to take care of more people collected I § together in a Hospital thpn he co'ald scattered broadcast over a communitj'. " m I A Special November Issue I I In order to give the manufacturers and distributers of Hospital Equipment, f ! Surgical Instruments, and Laboratory Supplies, an opportunity to present their H announcements to our readers, we have invited them to make use of this issue. m We include in the category of Surgical Instruments all operating utensils, eabi- A « nets, tables, sji'inges, atomizers, hot water bags, leather cases, bags, etc. ; and ! J among Laboratory SuiDplies, apparatus for urinalysis, blood counts, miei'oscopes, " i ovens, and all kinds of porcelain and glassware equipment for laboratories of 9 physicians, Sanitariums, et cetera. Hospital equipment comprises himdreds oi i specially manufactured articles such as unifo"mE, beds, furniture, operating out tits, sterilizers, foods, etc., etc. Physicians Requested to Read the Announcements A Our readers eomprise the majority ,of the med'cal profession. AVe want them to Ivnow where they can obtain the latest improved facilities for the practice of medicine. We therefore invite the atlention of our readers to the sections of our JorRNAL Avhich tell them iinir and nhrrs the "tools" for their work can be ob- tained. We assure them that all the goods advertised in this Journal are believ- ed to be exactly as represented. Don't practice false Economy in these times. "Buy from others, and you will be equipped so that others may buy from you." FRANK S. BETZ CO.. Ha.-nmond, Indiana. THEO. TAEEL, Louisville, Kentucky. DAAaS AND GEC'K, Brooklyn, New York. W. T. BERRY SURGICAL INSTRUMENT CO., Louisville, Kentucky. SOITTHERN OPTICAL CO^MPANA", Louisville, Kentucts^ DRS. KEITH AND KEITH, Louisville, Kentucky. TAYLOR INSTRiniENT CO., Rochester. N. Y, I VICTOR ELECTRIC COAIP \NY. ''hicago. Illinois. KENTUCKY MEDICAL JOUBNAL. Digestive Disturbances In infants can usually be traced to faulty or improp- er food. These disagree- able conditions are success- fully overcome by prescrib- ing -^cuJLTScnd&n. EAGLE BRAND CONDENSED MILK TI-iE OFtlC^INAt- wliicli is made from the highest quality of raw ma- terials by the most modern and sanitary methods of manufacture — guarantee- ing a finished product — that at all times is clean, wholesdrne and dependable for Infant Feeding. Samples, Analysis, Feeding Charts in anv language, and our 52- page book "Baby's Wei fa re ," will be mailed upon receipt of professional card. Borden's Condensed Milk Company "Leaders of Quality" Est. 1837 New York Extra- Grade Oat Flakes 2260 Calories For 12 Cents Quaker Oats is today a mar- vel of economy. Eggs cost nine times as much per unit of nutrition. The average mixed diet costs four or five times as much. Yet Quaker Oats is the highest grade of oat food. It is flaked from queen oats only — just the rich, plump oats. We get but ten pounds from a bushel. this selection. Because of Quaker Oats stands su- preme in fla- vor. Because of that flavor, it stands first the world over. Even at twice this price, a better oat food is im- possible. The Quaker Qafs (pmpany Chicago (1757) KENTUCKY MEDICAL JOUFXAL. ATTENTION ; • LABORATORY SERVICE FOR PHYSICIANS t I We make EVERY USEFUL AND ACCEPTED TEST • punctuallvt competentlv for modem fees S WASSERMANN Test, controlled by the best method, the I HECHT-GRADWOHL TEST URINE ANALYSES " AUTO-VACCINES PASTEUR TREATIVIENT( mail course) Send for fee list, literature, containers, free of charge CINCINNATI BIOLOGICAL LABORATORIES 19 West Seventh Street Cincinnati, Ohio DIRECTORS: DR. ALBERT FALLER, DR. R. B. H. GRADWOHL KENTUCKY MEDICAL. JOURNAL. Official Organ ol the Kentuclcv I^edical .A^sociaiton ""pHE Journal is a publication which belongs to the State iledical Association, and all matters of interest of the State Association belong to The Journal. The original contributions are from tlie best and most scientific men in the State. Reports jf all the count}' societies are published. The Journal stands for : Progressive scientific medicine. The highest type of state medicine. Complete organization of the medical profession for the promotion of health and sanitary laws for the public good. ADVEa*TISE3VlE3VrS The Journal carries only advertising matter which is reliable and pharmaceut- icals which are approved of by the Council on Pharmacy and Chemistry of the Ameri- can I\Iedical Association. It aims to give its advertisers fair treatment and value re- ceived for every cent they pay, not for pity but straight business. W'.^ D ^,T ■^. 'h/^\^ ^ ^ -i* ^^lii