Columljia IKnibcrsiitp in tfte Citp of ^to |9orfe CoQese of ^I^pgiciansi anb ^urseonsi 3^eference %ihvav^ Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/typicalamericanOOciti m jiilinUi fulili^iiiLg iLiigimJi^ Col^'ewTar^ ^^ ^t^wX^Z-^'-t^^/^O^^ A TYPICAL AMERICAN; OR, INCIDENTS IN THE LIFE OF DR. JOHN SWINBURNE OF ALRAN\\ THE EMINENT PATRIOT, SURGEON, AND PHILANTHROPIST. COMPILED AND PUBLISHED BY THE CITIZENS' ASSOCIATION. ALBANY, N.Y. : ISSUED FROM THE CITIZEN OFFICE. 1885. Entered according to Act of Congress, in the year 1S85, By JOSEPH R. McKELVEY, In the Clerli's Office of the District Court of the United States for the Northern District of New York. J\\V)o.^^. \-^^Jw(K^ ^, INTRODUCTION. In presenting this sketcli of the life of one of the most remarkable men of the period, — one in whom the people of Albany take the deepest interest ; who is esteemed by all classes, particularly by the men who were found at the front during the Rebellion ; and who, by his many kind acts to the poor, has endeared himself to them beyond all other men, — the citizens have no further apology than a desire to have the people at large know him as they know him. To him is given the strange title of " The Fighting Doctor," because of his many contests with error in every walk of life. These conflicts have all been in the interests of the people, — as a volunteer during the Rebellion ; in professional struggles to overcome malpractice and deformit}'^ in treating the sick and maimed ; and in private and political life to secure better government, and overcome corrupt political cabals. Aggressive yet tender and kind, he possesses all the char- acteristics of a true man, combined with a skill that places him at the head of his profession ; self-made, he thoroughly understands the wants of the people ; and possessed of a spirit of fearless independence, he has been by nature and circumstances well fitted to espouse the cause of the people at large without distinction of class. From the days of boyhood, when deprived of a paternal guide and director, up to the present time, his life has been a remarkable one, full of thrilling adventures and unprece- IV INTRODUCTION. dented achievements. Rising by his own efforts from ob- scurity to eminence, and from poverty to plenty, his life has been eminently that of a typical American. Every chapter in this life is a history of itself, and will be read with interest. In compiling it, the work has been some- what difficult, because the doctor has never kept any scrap- book, either of the contributions he has made to science, or of the many good things others have said of him. We have therefore been compelled to resort to public documents on file in the State and other public departments ; to the libra- ries ; to the press, as far as these could be reached con- veniently ; and to correspondence with those who knew him in the various walks of life. The doctor having but little to say of himself with reference to his life and doings, we have been enabled to learn comparatively little from him to assist in the work. In accordance with a resolution of the association, this work is respectfully presented to the public, believing that it will entertain and inspire a desire in others to emulate his example, however humble their position in life may be, as well as to make the people at large better acquainted with our brave, skilful, and humane fellow-citizen. CONTENTS. CHAPTER I. PAex Onb of Natuke's Noblemen 1 CHAPTER II. The Soldier's Fkiend 8 CHAPTER III. A Pkisonek of War 22 CHAPTER IV. Fighting for the Wounded 38 CHAPTER V. From War to Pestilence 58 CHAPTER VI. A Quartet of Plagues . . . '. 70 CHAPTER VII. Honest and Faithful 80 CHAPTER VIII. Under Two Flags 96 CHAPTER IX. The Wonder of Scientists 112 VI CONTENTS. CHAPTER X. PAQK Living on IIokse-ixesu 124 CHAPTER XI. RliVOLUTIONIZlNCi SUKOEKY 132 CHArTER XII. Conservative Sukgeky 147 CHAPTER XIII. Challenging the Ckitics 170 CHAPTER XIV. Medical Jukispkubence 184 CHAPTER XV. Praised and Slandered 226 CHAPTER XVI. The Fighting Doctor 240 CHAPTER XVII. A Plucky Leader 2G2 CHAPTER XVIII. Elected to Congress . . , 283 CHAPTER XIX. Swinburne's Dispensary 303 CHAPTER XX. Science devoted to Humanity 322 CHAPTER XXI. Behold the Man 339 A TYPICAL AMERIOAISr. CHAPTER I. ONE OF NATURE'S NOBLEMEN. Envious Rivals. — Brave and Philantliropic. — Sacrificing Comfort for Patriot- ism. — A Busy Life. — Tlirilling Adventures. — Self-made. " To be as busy as a Wallach woman, and do as little," was an old saying among the German settlers of Rouraania ; and the excuse given by the males for having wives was " to comb and keep them clean," as the men were a dirty, indolent, and cowardly set, except in the commission of such crimes as plundering, horse-stealing, and smuggling. For every neglect to live and act as human beings, they had an excuse. When the month of May arrived, — the proper season for planting, — they wasted an entire week in unmitigated idleness, under the supposition that their fruits would thereby be protected from the late frosts. These laggard husbands, however, were anxious tliat their wives should be alwa3's busy, and often frightened them into greater diligence bv pretending that a fairy visits every house early on the morning of Holy Thurs- day, and inflicts on them some dreadful affliction if all be not found in order. Among more civilized people, and particularly with this nation, there are those who possess the same char- acteristics as the Wallachs, always ready with an excuse for not answering promptly the calls of duty as patriots, citizens, or humanitarians. Such men are the most anxious to dispar- age the works of others, and would, if they could, bury far from the sight of the world every record of heroism of their day, and blot from the pages of history those ennobling acts in the lives of fellow-beings that will live in memory long Z A TYPICAL AMERICAN. after their cowardly and selfish lives have been forgotten. Yet, to the credit of this comparatively young nation, this class of envious persons is small, compared to the great whole, and of a much smaller ratio than might he looked for among the heterogeneous mass from all nationalities, who make up the great American nation, and constitute a people whose bravery and humanity outstrips any records of ancient or modern times. It is the acts of individuals that make history for the future, as their deeds operate for good or evil in their day and generation; and truly the history of this nation is bril- liant, as it is being written, with national acts of greatness, and individual deeds of daring and philanthropy, that obscure the most brilliant doings of the more ancient Spartan, or the chivalric deeds of the historian. In the bustle and excitement of our progressive life in America, we are too prone to overlook the deeds of men while they are living, and await, because of ambitious jeal- ousy for place and preferment, to render just tribute to the deserving, until the hand of death has laid cold the man the people should honor. When they have passed where earthly honors and mortal eulogies are as empty sounds to the de- parted, over their biers are pronounced the praises that should have been sounded in their ears while the senses were yet quickened to receive the grateful tributes. Not a month passes but history is repeating itself in giving to the world the sad tidings that some truly great man has pnssed away; and for a time the poisoned pen of partisanship is laid aside, ajid, the better nature prevailing in the presence of the dark spectre, a meed of praise is bestowed. But, alas! the just tribute to a worthy name is often too late, and only inspires the thought that merit has no rewards for the living to com- pensate for the sacrifices made. When another century has passed away in the life of the American Republic, what an array of valiant men will be found to have lived and acted prominent parts in the great free government on this continent ! Every page of history will sparkle with the names of men whose brilliant acts will shine out as startling constellations in the darkness of the ONE OF NATUKE'S NOBLEMEN. 8 struggles tlirough wliicli tlic couiitr}'- passed. Ever since the ludiiui Will- ill IGTr), that dovastatcd New England, when Capt. Cliurch of Massachusetts, and (Ja.pt. Dennison of Connecti- cut, became celebrated for their heroic ard(n" and fortitude, the list has constantly increased; and the acts of daring and self-denial have become grander as civilization has progressed, until in every emergency, in war and in peace, even the humblest citizens are performing acts that in other days would have caused them to be crowned with wreaths of glory. The peculiar and striking bravery of the truly American is inspired only by that intelligence which assures him he is right, and to the commission of deeds which his conscience di- rects and approves, as the love of freedom animated to deeds of heroism the band of men under Gen. Putnam at Long Island, who fought with such bravery, with Gen. Clinton attacking them in the rear, and the Hessians in the front, when they believed neither valor nor skill could save them from defeat. With us we have still living in active life, in the State of New York, one whose name will be in the future familiar among the votaries of science and the lovers of patriotism, and whose discoveries in the profession of his choice have already almost revolutionized the practice of surgery, and whose genius and skill will be honored by his profession for ages. His acts of intrepid bravery on the field of battle, his sympathy and care for the sick and wounded, his deeds of charity and benevolence among the poor, will be as familiar in the future as Ethan Allen's demand for the surrender of Ticonderoga is now, and his philanthropy will be as im- mortal as the poet has made Paul Revere's ride to Lexington from Boston. Brave as a Wellington, yet tender as a woman ; eminent as a surgeon and physician, yet plain as a man ; polished and learned as a gentleman, yet humble as a peasant; a hater of fraud, chicaner}', and dishonesty, j'et jealous of no man ; constantly moving about among the people, looking only to their interests, sacrificing time and money to make the condition of the masses better; supplying with a liberal 4 A TYPICAL AMERICAN. hand the wants of the poor, caring for their sick and unfortu- nate ; fighting error and corruption wherever he finds them, either in his profession or in government ; and sacrificing all personal comfort for the good of others, — is the man to whom we would lead public thought, knowing that the American people love the brave and humane, and only re- quire to be reminded, to awaken to the according of deserved honors. The truly Ameiican, Dr. John Swinburne, has a life which has no parallel or precedent in the combining of so many distinguished qualities in any one man, and is a prototype for others to emulate. As a patriot, tlie relinquishing of a very lucrative practice, second to no other physician in Albany County, and going to the front during the Rebellion as a vol- unteer surgeon without pa}^ was a sublime act, and endeared him to the hearts of his countrymen ; and his acts of bravery while there, have entered his name among the multitude of heroes of that period. His constant care of the sick and wounded on the fields of battle, and his never-ceasing efforts to have them comfortable, has made him an object of honor, and almost reverence, among the hundreds of his brave com- rades who felt his tender touch, or heard his kind words of sympathy, while they lay in pain and agony. His eminent ability as a surgeon, and his constant endeavor to cure the injured and save the parts wounded ; his aversion to tlie com- mon practice of cutting and amputating ; and his firm oppo- sition to having the noble fellows, wounded for their country, made subjects for experiments in cutting and amputating, — won for him the gratitude of thousands whose limbs weie not sacrificed, but saved to them, as well as the respect and esteem of all humane and honest surgeons, and caused him to be hated and envied by the ignorant charlatans who prac- tised human butchery and malpractice. There is something phenomenally grand in the active, self- denying, and busy life of Dr. John Swinburne as a surgeon in the field of battle ; as a health-officer, contending with the terrible diseases of cholera, small-pox, and yellow-fever, saving the people from their destructive ravages for years, ONK OF NATUItlCS N0I5I.EMICN. 5 and finding the means not I)lKK'H KItlKND. 9 and tlie pressing need there was at the front for one so skilled, promptly accepted the voluntary offering for his State and country; and, despite the earnest solicitations of the doctor's friends and patients, he was duly commissioned on April 7, 1862, a volunteer surgeon to care for the si(;k and wounded troops belonging to Ncw-Yoik State, and immediately left for the peninsula. Since that time, up to the present, the life of this remarkable man has been a continuous chapter of sur- prising personal achievements in military, scientific, and civil life, affording realities 'stranger than fiction in the active per- formances of a man impelled to exercise the gifts that God had endowed him with for the good of others. From the breaking-out of the Rebellion, up to the date of his commission, he had not been a passive looker-on in the first stages of the terribly wicked and cruel drama, nor a drone in the hive of loyalty's busy defenders. At the ver}-- opening of the fij'st tragic scene in the conflict, he was made chief medical officer on the staff by Gen. John F. Rathbone, and placed in charge of the sick in the Albany (N.Y.) depot for recruits, where, according to the report transmitted to Gov. Morgan by the then State surgeon-general. Dr. S. Oakley Vanderpoel, the result showed the wisdom of the appoint- ment. The surgeon-general stated in that report, " Dr. Swin- burne not only gave the sick soldiers his whole time and attention when needful, but, when it became necessary to put some seventy patients in another building, the same care and supervision were exercised." He further added, " The abstract accompanying this report is the best commentary of the fidelity and skill exercised by himself and his assistants," and then announced that up to that date, Dec. 13, 1861, " about three months, the whole number of cases treated by Dr. Swinburne during the period of his administration was fourteen hundred and twenty-seven, and the deaths only twelve." It will seem scarcely reasonable that one who, because of his prominence in his profession, held such a position as sur- geon-general of the State of New York, would, alter inditing such an official commendation, and others equally laudatory, 10 A TYPICAL AMERICAN. to which further reference will be made, because of pro- fessional jealousy, plot to undermine and destroy the repu- tation of the man he so praised. Yet it is true that in the hours of peace the mask of friendship was thrown off, and Dr. Vauderpoel became one of the chief actors in an ig- noble and bitter but futile effort to destroy the fame of the eminent phj^sician and surgeon, because he would not aid and abet error, nor cover up the professional and public short- comings and lack of integrity, of this man and some of his associates. The reader will pardon this digression, but will, by events that follow, see the connection in what occurred after Dr. Swinburne's military career, his success for years in fighting disease, and establishing as health-officer of the port of New York the best system of quarantine in the world, and win- ning a fame abroad such as was never bestowed on an Ameri- can surgeon. These successes aroused the envy and hatred of some professional men who stood at the bottom of the ladder of fame, without any ability to mount it, much less to reach the eminence Dr. Swinburne had succeeded in reach- ing, and recalls the Turkish tradition of Moses and the Israelites. The story goes, " that while the Israelites were marching to the conquest of the Promised Land, Moses, desirous of contemplating the wondrous works of God, set out to travel. He voyaged for thirty years in the east and west, in the north and south. After many wanderings in distant countries, the patriarch returned to his tribe ; but, in- stead of being received as the wisest man and the first of legislators, he saw his fame as a prophet and a traveller eclipsed by the gold of a banker. During his absence, there had risen up a man among the Israelites, — a man who had never ventured near the flames of Sinai, and had not the least admiration for the wonderful works of creation, but who had spent his days in ingenious speculation among the money- changers of the wandering children of Israel. Despising in his wealth the poor man, who returned from his travels, he would not recognize him as the lawgiver of Israel. In order to make him contemptible in the opinion of those who still TMIG SOLDIEli's FRIEND. 11 rctiiiiKid feelings of iX'sp(;(;l,;iii(l gnititude Un- tlie aueient leader, he instituted a proeews of law against hira, and suborned false witnesses. But these witnesses were stung in their con- sciences before tiie tribuTuil, and ])roclaimed the truth, and Moses triumphed, llie people again received him for their leader, while the earth opened and swallowed up the banker with all his wealth." The tradition is in many points analo- gous with the treatment of Dr. Swinburne by tlie "tribe" (one of whom had acquired wealth by what was considered questionable means) who controlled the Albany Medical Col- lege and some of the hos[)itals at that time, in that most, if not all, of them are without honorable fame or preferment now, while he is the most popular man in the State, as proven in the overwhelming majority with which the county of Albany has made him its "lawgiver" in the National Congress, and in having twice elected him mayor of the capital city of the Empire State. But to return to the story of his achievements in the fields of carnage and war. The commission given him by Gov. Mor- gan as a volunteer surgeon was applied for that he might have a broader field in which to exercise his universally conceded superior skill, and transferred him to a point where these qualities were eminently and urgently needed, and afforded opportunities to gratify his ambition to do much for his coun- try, and won for hira plaudits and honor few men acquired during his term of service. As an auxiliary volunteer sur- geon, he reached the headquarters of Dr. Tripler, medical director of the Arni}^ of the Potomac, at the White House, on the Pamunkey River, Virginia, on the 18th of May, 1862, and was by that officer assigned to the establishment of a hospital at that point. A letter in the " Albany Evening Times," dated White House, June 10, 1862, will give some idea of what the sur- geons had to contend with at that place, and the inadequate provisions made to care for the sick and wounded, — an emer- gency almost entirelv neglected. Dr. Swinburne, with Drs. Willard and Lansing of New York, and Hall and Page of Boston, were assigned to the establishing of a hospital there, 12 A TYPICAL AMKRICAN. where they succeeded, after one week, in erecting wall-tents sufficient to hold from twelve hundied to fifteen hundred patients. When they commenced their work, there were only a few tents up, while patients were pouring iu at the rate of from one hundred to one hundred and fift}'- a day. Indeed, there were nearly three hundred sick and wounded under the trees at the time, awaiting admission to a hospital, and a severe rain-storm approaching. Shelter was soon pro- vided. The next consideration was something to keep them from the ground, in the form of beds. Straw arrived, but it was found to be wet from the insufficient housing, like all Virginia economy ; but by means of India-rubber and boards they succeeded very well in keeping dry. The next day Dr. Baxter, brigade surgeon, sent in his private stock of hay (about four thousand pounds), and distributed it through the tents, in lieu of wet straw ; and thereby the patients were made very comfortable. The next thing to be attended to was food for these hundreds of sick. Now came the rub. It was not intended to make this point a hospital of any size, and hence no provision had been made for such an influx of patients; but the unhealthiness of the peninsula about York- town, Williamsburg, West Point, and other places, added to the almost constant exposure which our men endured, ren- dered them victims to malarious disease. What was to be done ? No fresh meat ; no kettles to cook it in if they had it; and no water, except what was brought in pails from springs a half-mile off. " I firmly believe [Dr. Swinburne wrote at that time] that more men will die who go home in this condition (remittent and typhoid fevers), from the insufficient knowl- edge of the physicians to whose care they are intrusted, of the character of this disease and the requisite for its removal, on the one hand, and, on the other, from the injury accruing from moving them in their feeble state, coupled with the closeness of the vessels in which they are transferred. Besides, during the stages of convalescence, the habit of lounging and drink- ing, to which they are inclined, adds very materially to the danger of collapse. On the contrarj^ if they are kept in open hospitals, like storehouses or wall-tents, and are supplied TIIK S()M»IKR\s kiuknd. 18 with proper nourisliment, stimulants, medicines, etc., tlie mortality of those recuavfMl before the sta^e of complete cerebral exliaiistion would be very small, — not more than one or two j)er cent, — while many of th(;m who had arrived at this stage of exhaustion could be saved. Nearly all the latter die (if moved to hospital ships) from syncope. I think the removal in this enfeebled condition is all wrong; and, under any circumstances, it would be far better, both for the troo])s and the government, to build large store- houses, sufficiently wide for two rows of beds and a spacious walk in the centre of the room Jor the nurses and surgeons; the rooms to be at least twelve feet between joints, the roof built after the old Dutch peak style. This structure could be built a few feet from the ground, and giating made in the floor all along the line of the middle of the building and be- tween the beds. The expense of this class of buildings would be very small where fine pine is so cheap. In this kind of hospital, with proper sanitary arrangements, medical attend- ance, etc., the mortality would be very small, while to the government millions of dollars would be saved. Out of three thousand sick I have seen, more than one-half are simply exhausted from sudden changes of heat and cold, long marches, wet, etc., and only require rest and appropriate food." The hospitals established at White House were in readi- ness none too soon. Hardly had the last peg been driven, and the anxiety of the surgeons been set at rest as to shelter and food, when the terrible battle of Fair Oaks sent them plenty of employment to occupy their minds and hands. On Satur- day night the brave bo3's began to come in in greater numbers, weary and wounded in every conceivable manner, shattered by shot and shell as only brave men could be, and bearing their terrible pains with a sublime heroism which cowards know not of. By those who were on the ground, it is reported that Dr. Swinburne worked from four o'clock in the morning until midnight, and was again at work the next morning at daylight. Into this carnival of death and destruction he had volun- tarily entered; and those who were so unfortunate as to be wounded, and yet so fortunate as to fall under his care, say his pleasant words of greeting and encouragement, with no 14 A TYPICAL AMERICAN. dismal forebodings and no sign of discouragement on his countenance, encouraged many a brave fellow to struggle through who would otherwise have given up and died. He believed, and infused the feehng into others, '■' that he who laughed most was surest to recover." With a heart as sym- pathetic as a child, and with a nerve only an approving con- science could insure, he moved from one to another in his humane work, encouraging all, and deceiving none. After the completion of his work at White House, he re- turned to Albau}^ on the 12th of June, 1862, the city papers announcing his arrival ; the "Albany Evening Journal " adding "• that he was anxious to return to the hospitals, but urgent calls at home might prevent his return." How little even his journalistic friends had divined the nature of this noble man, was apparent when they thought that there was any business of so important a nature that he could consider it of more importance than the demands of his country and its brave defenders, as was shown in an announcement in the same journal only two day's afterwards. Again he was commissioned by Gov. Morgan, not as an auxiliary surgeon, as befor6, but as medical superintendent of the wounded New- York troops ; and on the 14th of June, two days after announcing his arrival, the " Journal " said, — "Dr. Swinburne left this city last evening for Yorktown, to assist m attending upon the sick and wounded soldiers. The doctor came home much displeased at the manner in which our disabled soldiers were treated, and, obtaining letters here to the heads of departments such as he desired, started off immediately, hoping to remedy the existing evils. That the doctor will succeed, is beyond a question ; and that he will ultimately carry out his plans, there can be no doubt." These letters referred to were the commission as medical superintendent of the wounded New- York troops, and a letter of recommendation and indorsement from Gov. Mor- gan to Secretary of War Stanton. Equipped with these, he started for Washington, where the secretary indorsed the letter to United-States Surgeon-Gen. Hammond. That official promptly entered into an agreement with Dr. Swin- TIIIC .SOLDI Kit's KKIKNI). 15 burne for " nuMlicaJ aiifl surgical services to be renderef] in connection with the Army ot" the Potomac." In the letter to the secretary of war, (iov. Morgan said, — "No surgeon in the State enjoys a more deserved reputa- tion than he; and, from liis urbanity and uniform courtesy, 1 am sure tliat no misiuiderstanding can occur between tlie United-States authorities and himself." On his arrival at Fortress Monroe, he was requested by the medical director to take charge of the hospital at New- port News, — a proposition he declined on the ground that lively times were soon to take place on the peninsula, as the army drew nearer to the rebel capital, and that his desire was to be as near the front and the heat of battle as possible, where he would be able to effect the most good for the great- est number of sick and wounded ; that the demands and dangers were the incentives to make him the more anxious to be with the advance, as there was where his services would be in greatest demand. Dr. Swinburne had scarcely entered upon his duties, when he received a signal mark of distinction from the comman- der-in-chief, Gen. McClellan, who ordered him to repair to Savage Station, which was to be an important point in the approaching conflicts, and to establish there a depot for the wounded, giving him full powers for the carrying-on of his department, and full command over all the forces in that sec- tion so far as pertained to a surgeon in charge of the sick and wounded. He also issued the following order : — Headquarteks Army of the Potomac, Camp Lincolx, Va., June 20, I8(i2, Special Okder Xo. 186. Thirteen men of the Second Army Corps, ten from the Fourth Army Corps, and fourteen from the provisional army corps, will be detailed by the corps commanders to report to Acting Assistant Surgeon John Swinburne for duty at the hospital at Savage Station. On the requisition of Acting Assistant Surgeon John Swinburne, in charge of the hospital at Savage station, the subsistence department will issue such rations, and the quar- 16 A TYPICAL AMERICAN. terraaster's department will furnish such transportation, as may be required for that hospital. By command ]\Iajor-Gen. McCLELLAN. S. Williams, Assistant Adjutant-General. In connection with the establishing of the hospital at this point, one of the incidents illustrating his foresight was shown. In company with Gen. McClellan and Medical Director Tripler, he was at Savage Station, and said to the general, "You must have a depot here for the wounded," — " How do you know ? " asked, the general. " Well," said the doctor, " you cannot go to Richmond without a battle here : if you are victorious you will want a hospital here, and if you are defeated you must leave your wounded behind." The general answered, " You are not supposed to know any thing about such matters." — "Perhaps not," said the doctor, "in military parlance ; but I know, nevertheless." Soon after this conversation, the general carried out the suggestion, and issued the order. At the time this order was given, it was believed the year would be pregnant with the fate of the Republic, as the pre- monitions were that events were approaching a decisive ter- mination. McClellan's preparations around Yorktown, and for the advance on Richmond, were about completed ; and the imagination started back appalled, at the vision of slaugh- tered heaps, and garments rolled in blood, that rose in the future. The government, the officers in command on the field, the army, and the people, believed that in the few com- ing weeks the Army of the Poromac would pass through a terrible ordeal of war, and that the entire peninsula from Yorktown to Richmond would be a succession of desperate struggles, carnage and death. Both armies were in excellent condition, and anxious for the hoped-for final struggle, which the whole North and the army believed was to end in the fall of the rebel capital, the overthrow of treason, and the hasty and permanent suppression of the Rebellion, — a consumma- tion every royal heart prayed tlie God of battles would hasten, and which every traitor in the North feared, but hoped would not come about. TIIIO SOIiDIKR's FKIICNI). 17 No man in the army or in civil life realized more keenly the terrible tide of fire throngh wliich all the actors in this field were to pass, than did Dr. Swinbnrne, unless it may have been the commanding general, George B. McClellan, himself. That in no arm of the service was true patriotism, bravery, and courage more requisite than in the medical and surgical department, was well understood by the general. If the army was victorious, the wounded must often be left with the surgeons in the rear, subject to be harassed and besieged by enemies and adventurers. If it met with defeat, they would, in all probability, fall into the hands of the enemy. As near to the front and the field of battle as possible, the surgeon was wanted. In selecting for the supervision of this important duty on that anticipated and inevitable field of slaughter, the general had reason to place in Dr. John Swin- burne the utmost confidence as to his patriotism, bravery, and skill. The doctor knew the dangers and duties of the position ; but he was there from his love of country and humanity, and like many of his comrades, while realizing the dangers, never thought of shirking dut}^ but determined to offer his life as a sacrifice, if it were requisite. Events that followed proved his devotion and bravery, when to be brave was to ignore self for others, and demonstrated the wisdom of the general in his selection. From the evacuation, b}' the rebels, of Yorktown on 'Slav 3, to the retreat of the Union forces from Savage Station on June 29, the army bad passed through a baptism of blood, brilliant victories, and shattered hopes. During so brief a period the annals of history show no record of greater achieve- ments and personal acts of heroism than were there per- formed by our brave fellows, and none greater in self-denial and fearlessness of danger than that exhibited by the noble surgeon whose profession, and part in the conflict, was not to destro}" life or limb, and make widows, but to save the one, and prevent the other. The order was, " On to Richmond," and, as the Union chain was being drawn closer and closer around the Kebel capital, the times became more trvincr. Flushed with victorv at Yorktown, and the rout of the 18 A TYPICAL AMERICAN. enemy at ILmover Court-House, our gallant army swept on- ward. These were as a prelude to one of the most despei'ate battles so far fought on the peninsula, that of Fair Oaks, when the Rebel arm}', led by Hill and Longstreet, dashed down on our lines, determined, apparently, to annihilate our whole army. The mantle of darkness fell that Saturday night, as a funeral shroud, on a ghastly spectacle of the slain, who lay in heaps ; and, as a requiem over these dead, the breezes were laden with the moans of wounded on their gory bed, presenting a scene of which those wlio were not there, or remained in the quietude where war did not rage, can never dream, much less realize. Tlie following Sunday, June 1, presented a spectacle over which angels might weep, when over ten thousand men lay, by the cruel fates of war, among the dead and wounded, but over which the heart of the army bounded with joy, as these sad tokens were the proofs of a terrible conflict, and a gioiious victory for our forces. There was no rest for the doctor that Sunday. The New-York troops who were in the brigades of Heint- zelman, Kearney, Sickles, Meagher, Meade, Hooker, Sumner, Franklin, and P'rench, through these days of fire on the Chickahominy up to the seven-days' fight and battle of Sav- age Station, — where Dr. Swinburne, in the heroic discharge of his duty, became a voluntary prisoner of war rather than de- sert the wounded patriots in liis charge, — will never forget their comrades, or withhold from them the honor and praise they have earned. They owe to posterity and to the memory of the brave dead, that they should not take council from the "Albany Argus," — a journal which, at the very time they were sleeping in the swamps and miasma aronnd Richmond, declared the "war a failme," — and disband their Grand Army posts, but ever keep alive, and kindle anew, the memories of the heroism of the days of the '60's ; and, in bearing their scars as a proud heritage to their offs})ring, many of them will remember the surgeon who volunteered first his services, and then his lib- erty, and at the time possibly his life, for the benefit of the sick, wounded, and dying boys in blue. TIIK Hf)IJ)IICi:'s I'lMKNI). 19 Testiinoniiils of iip[)rociat.i()ii of liis services in military life were sliowin-ed on liiin not only l)y the press of the city of Albany, which took a iiatiii'ai loeal j)ri(l(! in his eminent ser- vices, but by the jjress of the country, the officials at the head of the National Government, and from those high in authority in the State Government. Soon after his arrival at Savage Station, he received the following official letter from headquarters in the State of New York: — State of New YoRif, Suroeon-Geneua-l's Office, Alijany, June 2o, 1802, Dear Doctor, — Your letters from Washington and Sav- age Station were both duly received, and read to the governor. He is very much gratified with the success you have met, and feels assured great good will result from your mission. I really wish you God speed and success. I assure you, your great labors are appreciated by your friends, and we all feel you are in a field where the greatest good will be accom- plislied. Truly yours, S. OAKLEY VANDERPOEL, John Savinburne. Surgeon-General. This, coming from the head of the medical department in the State of New York, was a grateful tribute, well earned, and but faintly reflected the feelings of the hearts of the people who knew the recipient. It was, however, but a snow- flake in the shower of compliments bestowed on him by press correspondents, historians, medical men, and others, who were eye-witnesses of his devotion and bravery before and after he was taken prisoner. A correspondent of the " New- York Tribune," writing from Mechanicsville under date of June 23, said, — " Dr. John Swinburne of Albany has recently been ap- pointed acting assistant surgeon-general, and has been as- signed to take charge of the hospital for wounded soldiers at Savage Station. Since j'esterda}^ he has caused to be put up tents to accommodate six hundred patients. Everything necessary for the wounded has been provided. During the week, additional accommodations for over two thousand men 20 A TYPICAL AMERICAN. will be provided ; so that the wounded will not be compelled to be out under the scorching sun by day, and the cold and heav}^ dew by night, as was the case at the recent battle of Seven Pines or Fair Oaks." The Rev. James J. Marks, a volunteer chaplain to a Penn- sylvania regiment, who, true to his mission, remained with Dr. Swinburne at Savage Station, caring for the sick and wounded, and was taken prisoner, said in the preface to his work entitled "The Peninsular Campaign, or Incidents and. Scenes on the Battle-Fields and in Richmond," — " This work is given to the public with many misgivings ; for it has been prepared by camp-fires, in the midst of hospi- tal labors, and on marches on the Rappahannock, in the mountains of Virginia, and under the pressure of exhausting hospital duties. In the haste of such compilation, I may have made criticisms too sweeping and seemingly too severe, as is intimated by my excellent friend. Dr. Swinburne; but let it be remembered that no man's vices in the army are pushed into such an odious and unendurable prominence as those of a self-indulgent, intemperate, and heartless surgeon. No one endures more and perils more than the faithful surgeon." In giving an account of the scenes of the seven-days' battles, or the second battle of Fair Oaks, which commenced on the 25th of June by the advance of Gen. Heintzelman's brigade, he says, — "The picture of the friendly interchange of papers and tobacco between the men of the two armies was changed to one of hatred, blood, and carnage. The opening of the slaughter was made by tlie advance of Gen. Hooker; the attacking column consisting of Grover's, Sickle's, and Robin- son's brigades, with Gen. Kearney protecting the left, and Col. Hicks, with the Nineteenth Massachusetts, on the right. Slowly and steadily the brigades advanced, the occasional shots of the advancing skirmishers changing to an incessant fusilade of infantry and the booming of cannon ; and shortly after, the clouds hung heavy with smoke, and streams of fire, and the whole line was engaged in the struggle of war." In speaking of a number of surgeons who at the battle of Fair Oaks had distinguished themselves by surgical opera- Tiiio soldikii'h FiiiF':Nr). 21 tions, among wlioin wore Drs. Page and Hull of lioston, Bliss of Michigan, and Swinburne of Albany, Dr. Marks said, — "The latter gentleman had been sent to the army by Gov. Morgan of New York to minister relief to the wounded sol- diers of that State, and to give thein the benefit of his emi- nent surgical abilities. To a most unflin(;liiiig hand he added the gentlest heart, always sparing when there was the least hope for a shattered liml), and by a thousand acts of kindness endearing himself to a multitude of sufferers." All correspondents at the front agree in their testimony that this volunteer surgeon from New York, who was there without any pecuniary compensation, and who has never soli- cited or received one dollar for his eminent services, was not satisfied with the simple dressing of wounds, but, over the unfortunate sick and disabled, exercised a mother's watchful- ness and care, always aiming to secure for them all the com- forts of life it was possible to secure. Unlike too many of the paid and heartless surgeons, he did not wait for the arri- val of the unfortunate to provide them shelter, but labored for these before they were in demand ; and, as a result, the wounded were unusually fortunate who came to his depart- ment. CHAPTER III. A PRISONER OF WAR. Retreat of tlie Army from Savage Station. — A Shocking Scene. - In tlie Hands of tlie Rebels a Volunteer Prisoner. — Eating from the Operating- Table. — The Surgeon and the Picket. — Loyal to the Core. — Return Home, and Cordial Reeei)tion. — Honored by the Enemy. — An Heroic and Daring Act. — A Ludicrous Sight. — Notices of the Press. The " American Medical Times," in an article during the war, said, — " To be in the medical service of the army is now a patriot's privilege, and we predict that it will soon become a higher honor than ever before to be a member of the medical staff of the American army." A war correspondent of the "New- York World," in writ- ing from the front, in referring to the provisions of a bill to abolish the office of brigade surgeons, said, — " It miglit seem a matter of regret that the surgical corps of the army should be reduced instead of being re-enforced ; and yet, on the other hand, it must be confessed, that, if bri- gade surgeons generally are on a par with those in the majority in the department of the South, the office may be abolished with little diminution in the professional acquirements and efficiency of the surgical corps. Some of them are unfit to hold any position demanding either soundness of judgment or rectitude of character." The criticism of the " World's " coi-respondent would apply with equal force to many of the surgeons in the department of the peninsula where it was found necessary to discharge from the service more than one or a dozen surgeons for incompe- tency, and want of character, still leaving a large number who would have made better butchers than surgeons. Of the class to whom the "Medical Times" refers. Dr. Swinburne belonged, although it is a question whether the service was A rUISf)NIOR OK WAll. 23 not more lioiiorcd hy his buiii;;' in it tliaii its lioiioring him. No iiitiiiuitioii of iricornpeteric}'' or imriK>nility was ever breathed against him ; and it is donbtf'ul whetlier any other gentleman attaelied to the medical and snrgieal ef)rj)s ever received such honorable mention as he did. On Sunday, the 29th of June, the Army of tlie Potomac retreated from Savage Station. It was found impossible to take with it all the wounded, and consequently thousands of these were to be left to fall into th(! hands of the enemy, to be treated by them as only i)risoners in Rebeldom understood. There were no military orders to compel Dr. Swinburne to remain ; and it was purely a question whether he would at the last moment look to liis own safet}', and do as others did, — leave these men to their fate, — or acting on the impulses of humanity, and love for the brave fellows, remain, and share their unfortunate lot. The people of the loyal States, and the army, had learned too truly to realize that to be taken prisoner was equivalent to an almost certain slow, torturing death; yet the doctor promptly responded to the impulses of his noble nature, and decided to remain with those in the hospitals. The announcement that this noble volunteer had risked his all, and was a prisoner, was received with sorrow as a great public loss. The press universally recited his many acts of bravery, and printed eulogies on his humanity. Of the place where he voluntarily elected to remain, the "Richmond Examiner" gave this description: — "The battle-field, surveyed through the cold rain of Wednesday morning, presented a scene too shocking to be dwelt on without anguish. The woods and the fields on the western side were covered with our dead in all the degrees of violent mutilation ; while, in the woods on the west of the field, lay in about equal numbers the blue uniforms of the eneni}'." It was a busy time for the surgeons, such as remained, for some time ; and one correspondent wrote that the brave Dr. Swinburne was untiring in his work, making in one day twenty-six exsections of the shoulder and elbow-joints, a number of amputations, and extracting a double handful of 24 A TYPICAL AMERICAN. bullets. • He had a bain and two sheds assigned him, and never left the operating-room while the wounded were being brought in. During the lulls, he ate his hard-bread and hom- iny, and drank his coffee, from off the operating-taV)le. In a letter to Gov. Morgan from the medical director of the army, officially announcing the capture of Dr. Swinburne, the director said, — "Dr. Swinburne was left with the wounded at Savage Station. The courage and devotion exhibited b}' Dr. Swin- burne will secure to him the deepest gratitude of those of the sick and wounded under liis charge, and the unqualified esteem of the public at large." The fortitude, heroism, and self-sacrificing spirit of Dr. Swinburne and some of his associates have been described by a writer, and incorporated in the " History of the Struggles at, and Retreat from. Savage Station." He says, — " By order of Gen. McClellan, Dr. Swinburne had been placed in charge of this station. And, while the army was near that point, there was an abundance of help to be had from the surgeons of the army ; but, after the defeat of our army at that point, most all the surgeons and nurses had been oixlered to their regiments or to other points. As the army was preparing to leave, and the rebels were preparing to cross the Chickahominy, most of the wounded had been removed. There were still one hundred and fifty of the most severely wounded remaining at the hospitals. To every officer on the ground it was well known that to remain there would place them, in a few short hours, in the very centre of a field of carnage, cut off from all means of escape ; and that becoming prisoners of war, with all the honors and privations such a fate was well sure to bring, was inevitable. Under these cir- cumstances, a number availed themselves of the last opportu- nity, and left with the army. " On Sunday morning, June 29, every thing was ready, and the march of the army in the direction of the James River was commenced. Tlie enemy was then crossing the river. On the bluffs overlooking the river was Meagher's Irish bri- gade. The general saw the situation, and the fate that must so soon overtake those in charge of the hospital, and sent Col. Burke of the Sixty-thiid IS'ew-York to urge the remov- al of all the inmates as speedily as possible, as the probabili- ties were now almost certain that in a few moments the enemy A riiisoNKit r)K wAit. 25 would rush up and [)liuifc tlicii- hattorics in the fields, and tlie lioiiso and barns would he sci/e\Iarch and April. On my passage down tiie James River yesterday morning, I met on board the boat Cliaplain James INIarks of the Sixty-third Pennsylvania Regi- ment, who was with Dr. Swinburne at Savage Station, and was taken prisoner, but since released. I obtained the following particulars in regard to Ur. Swinburne from him: — " Chaplain James ]\Iarks of the Sixty-third Pennsylvania Regiment re- mained at Savage Station with Dr. Swinburne. There were fifteen hun- dred wounded and sick there from the battles of Thursday, B'riday, and Saturday, June 26, 27, and 28. On Sunday night, the 29th, the enemy surrounded the place; but Sumner's division drove them back, and they retired towards James River. On IMonday morning, about seven o'clock, the rebels came in and took prisoners all of the wounded and sick, and al.-^o all our surgeons and nurses, leaving Dr. Swinburne in full charge, as be- fore. About twenty surgeons, of whom four or five were sick, remained to assist Dr. Swinburne in taking care of the wounded and sick During this day, and on Tuesday, five hundred more wounded were brought in. Dr. Swinburne's labors at this time were constant, presiding over all departments, directing all amputations, and securing the confidence and esteem of all the surgeons and tlie officers. After the battle of Tuesday evening on Malvern Hill, information was brought to Dr. Swinburne that his presence was immediately demanded in various hospitals on the battle- field. The doctor immediately' left, and, after going through various 32 A TYPICAL AMERICAN. divisions of the rebel army, found his way to the hospitals on Nelson's Farm, the scene of the battle on Monday evening, and assisted in all of the amputations. Thence he found his way to the battle-field on Malvern Hill, and assisted and gave counsel to the surgeons. lie then returned to Savage Station, and told his story to Chaplain Marks, who assisted him, obtaining such supplies as were needed, which were sent in rebel ambu- lances to the hosi^itals. Dr. Swinburne directed the return of the chap- lain several times, passed through the lines and divisions of the rebel army ■without molestation, and visited the hospitals beyond the White-Oak Swamps, carrying food and medicines. He remained in full charge at Savage Station as late as the 13th iust. Chaplain Marks was sent by Ur. Swinburne, in charge of seven hundred wounded men, to Richmond, on Sunday, the 13th inst. Subsequent to this, he did not see the doctor, but heard of his continued health, activity, and benevolence He speaks in the highest terms of Dr. Swinburne's talents, and skill as a surgeon. His ear was ever open to the complaint of the poorest soldier, and he was untiring in his exertions to promote the welfare of the sick and wounded. Among the rebels, he was looked ui^on as one of the noblest and best of . men." R. H. KING, JuN. Ou the 28th of July the " Times " said that the conduct of Dr. Swinburne was the theme of universal praise, and on the 30th said, — " Our citizens will be pleased to learn that by a telegram re- ceived last evening by Dr. Vanderpoel, Dr. John Swinburne, who was taken a prisoner at Savage Station while attending to our sick and wounded, has arrived at Fortress Monroe, en route for this cit}^ with Capt. McRoberts, Capt. Vanderlip, and Lieut. Becker, all of the Ellsworth Brigade." On the 2d of August the "Albany Evening Journal" an- nounced his arrival in Albany in these words: — " Dr. John Swinburne of this city, who has for several weeks been discharging the responsible duties of medical superintendent of New- York troops with so much devotion, came home this morning. All will recollect that Dr. Swin- burne was in charge of the hospital at Savage Station, nine miles from Richmond, when that station was taken by the Rebels, and that he voluntarily remained in charge. He, of course, became a prisoner of war; but, under an arrangement previously entered, physicians wei'C jiermitted to leave with- out restraint, lie could therefore have returned to the Union army; but he preferred to continue with our sick and A TRISONER OF WAR. 88 woiDuled, who, moro tlian ever, required liis siii)orvisinp care. It is proper to add tliat tluiy are now all, or lUiai'Iy all, away. We have spoken repeatedly of the humanity, skill, and brave- ry evineed by Di'. Swinburne in the performance of the service assif^ned him, — so honorable to his profession and the man. His opportunities and experiences have been of the nu)st varied character. He will be warmly welcomed back by onr citizens." A few days after his arrival home on sick leave, having been greatly reduced physically l)ecause of his incessant labors and the hardships endured while a prisoner of war, he received the following official letter : — State of Nkw York. Surgkox-Oeneuai/s Office, Albany, Au-;. 5, 1862. Sir, — I am requested by his Excellency Gov. Morgan to express his high appreciation of the services rendered by you while serving with the Army of the Potomac as medical superintendent of the forces from this State, and acting as- sistant surgeon of the United-States Army, and to return you thanks for the same. An expression thus officially made is not intended as in- vidious to the noble corps of volunteer surgeons who so promptly and faithfully gave their time, their energies, their professional abilities, and in some instances their lives, to ameliorate the sufferings of the wounded ; but that the posi- tion in which yon were placed by the authorities of the State, the peculiar circumstances which resulted therefrom, and the manner in which you conducted yourself, both pro- fessionally and as the representative, for the time, of your government, call for, as it is most cheerfully bestowed, the commendations and approval not only of the constituted authorities, but of a whole communit}', who have watched with vivid interest the responsibilities, privations, and labors to which vou were subjected. As the head of the State Medical Bureau, I cannot forego the opportunity of thanking you for the bright example your labors have furnished of conservative surgery upon the field of battle. Had you merely, in the performance of jouv labors, done all which humanit}- demands, you would have merited the com- pliment proffered, but to that you have added the exercise of high professional skill. When in a hospital of two thou- sand sick and wounded you amputated less than half a dozen limbs, but strove, rather, to save by exsection, you illustrated 34: A TYPICAL AMERICAN. and carried out the views of the most intelligent of the pro- fession. Wishing you, in your safe return to your family and friends, the enjoyment of a well-merited confidence, J am, with respect, your obedient servant, S. OAKLEY VANDERPOEL, Surgeon- General. JOHX SwiNBDRNE, M.D. Within the rebel lines Dr. Swinburne maintained the same deportment as within our lines, and treated the rebel officials, in his intercourse with them, with the same polite- ness as he did his own, refusing on all occasions to enter into any discussion on political or other questions that might engender any feeling that would work to the injury of those under his care, and was at times austere in enforcing the same course in those under him. On one occasion, in passing through one of the hospitals, he overheard one of the nurses discussing the situation with a rebel captain, the nurse ex- pressing sentiments such as a loyal soldier ought never to utter. The doctor stopped, and, turning to the nurse, said, " You are not here as a diplomat, to discuss questions you know nothing about ; neither are you a general with any military kiiowledge ; and, as for your ability to talk politics, you never had any. You are a nurse here, and to that busi- ness you are to attend strictly, or I will send you to your friends in Richmond, with whom you seem to sympathize." Among the rebel authorities he won the utmost esteem, and paid the same attention to their wounded as he did to our own. He had many of tiie rebel sick to look after, among them Col. Lamar of Georgia. Standing in front of the hospital one day. Gens. Orr and Jameson, and a number of other rebel officers, came up, and, saluting him, entered into conversation, the discussion turning on the war and prob- able results. After they were through, the doctor answered, " Gentlemen, I am here to take care of the unfortunate, not to discuss these questions. I came here because the North is right, and you are wrong. I know your movement is wicked, although many of you may be misled. You will have to yield, and it is only a question of time. For your sake and A PRISONER OF WAR. 3o ours, the North will never let yon succeed, if it should take twenty years to conquer you. Now, I am a volunteer prisoner, holding the order of Gen. Jackson to command of you safe protection into our lines whenever I desire to go; and I have but onere(picst to make of you, — as gentlemen, that you will not introduce this subject again, and that you will use your interests to have our wounded sent into our lines as rapidly as they become fit to travel. My views cannot be changed, and I do not think yours can be until you are thoroughly flogged." From that time out, he had a warm friend in Gen. Orr, who had learned to honor the brave man in what he had only known before as a skilful surgeon. This feeling of Gen. Orr was demonstrated afterwards, when want and necessity were killing the disabled much more rapidly than their wounds. In the hospital as a nurse was a Rev. Mr. R., who had formerly lived in Richmond. He insisted on going to that city, and placing the situation before the authoiities, alleging he knew the people, and knew he could induce them to alleviate matters. The doctor en- deavored to dissuade him, assuring him they would surely arrest and hang him as a spy. He, however, was obdurate, and persisted in going. After his departure, Gen. Orr rode up: the doctor detailed the circumstance to him, and asked the general to ride into Richmond and save the poor , say- ing he was only a harmless fanatic, and did not know enough to be a spy. The general did so, and, on returning, assured the doctor they had arrested the preacher, and were about to hang him when he (the general) arrived ; that he told the authorities the doctor's story, and the fellow's life was saved. Before the capture of Savage Station, and when the hos- pitals were being shelled, the doctor sallied out with a Hag of truce. For this he was summoned before Gen. Sumner, who denounced the act as in violation of military discipline, and said that the surgeon had no right to presume to go out with the flag without first receiving orders to do so, add- ing, "I shall have you cashiered." — "All right, general," said the doctor, " you can have me cashiered now, if j'ou want to. I don't know any thing about military law, but I 36 A TYPICAL AMERICAN. know enough to take care of my rights. You may kill me, just what the rebels were going to do, and that is all there is about it. I was looking out for my rights, as you will pretty soon for yours." He was not cashiered. There was not a military officer around Savage Station who was not always ready to afford the doctor all the pro- tection and assistance within his power; and when he applied to Gen. Stonewall Jackson for a pass to visit the various hospitals in the vicinity where our men were con- fined, the general, in granting him the pass to go wherever he pleased, in a very complimentary note referred to the doctor's skill and humanity, and informed him that he was not to be considered a prisoner of war, and that the pass would carry him safely through the lines, and into his own, whenever he desired to go. The doctor himself, in reporting from Savage Station to our government, at a time when feeling was the most intense and bitter, with reference to the treatment of the sick and wounded under his care, said, — "I feel assured that all the deficiencies and difficulties which we experienced were not the fault of Gen Lee, his officers, or his medical staff, since all the generals and medical officers with whom we were brought in contact weie unusu- ally attentive to the necessities ot the wounded and sick. But tliat there was a fault somewhere, there is no question ; and that fault I attribute to the inhumanity of the authorities at Richmond, which has been fatal to many of our wounded soldiers." His eminent skill and acknowledged ability made his services sought in every hospital in that section. On the morning of July 12, while passing Gen. McGruder's head- quarters, he was handed a letter directed to the general from Assistant Surgeon C.S.A., C. B. White, and dated Malvern Hill, in which the writer said he had several cases which needed capital operations. He added, " If Dr. Swinburne can come (I hear he is in the vicinity), I would like it." The doctor responded, and going to Malvern Hill, with Di-s. White, Chamberlain, and Jewett, performed all the opera- tions. A IMIISONICII OK WAU, 37 During his tei'm in R(3l)ol(l()m, tlic volnnteer surgeon's career Was marked by many incidents of daring. On one occasion his services were in demand at iMalvern Hill, whith- er he repaired. On his arrival there, he found the men were suffering for provisions. Without awaiting to send for these, he commenced a foraging expedition, and in the upper por- tion of a deserted house near by he found a hirge quantity of beans. Without waiting for any orders, or asking per- mission, he confiscated the " Yankee favorite berry ; " and in four liours the six luindred men were all at work regal- ing themselves on bean-soup. On the completion of his work at this hospital, he started back for Savage Station on foot about sundown, walking a distance of twelve miles without a guide, passing through the rebel lines several times without molestation, and arriving safely, — a feat to others seemingly impossible, and demonstrating that some unseen protector was alwa3's with the surgeon. Perhaps the only laughable part of the doctor's military career was during one of his trips back to Albany, when he boarded the steamer at New York, penniless and ragged, to beat his way to Albany. With an old slouched hat ; boots out at the toes, and run over at the heels ; pants of the latest cut (as the}^ were all cut to pieces) ; and an old blanket thrown over his shoulders, — this was the ludicrous condi- tion he was in when recognized by a member of a Broadway firm as he lay stretched on the deck, and fast asleep. The regular surgeon of the army had pay and stores to draw from to prevent such a condition ; but the faithful volunteer was without resources, and yet returned again to the front to undergo the same hardships. CHAPTER IV. FIGHTING FOR THE WOUNDED. Bold "Words to the Rebels. — Defects in the Medical Department. — Contro- versy with the Sanitary Coinmission. — Strange Anomaly. — Observations on Surgery. — A Brave Colonel killed by Malpractice. — Red Tape in the Army. — A Fearless Man. The treatment our sick and wounded were receiving was an all-ab.sorbing thought with this unselfish physician, and incited liira to make every effort for their relief. Under this feeling, he attacked the very highest in authority in the Con- federacy, always using polite but plain Anglo-Saxon English, that could not be misunderstood, and appealed to all the better feelings of manhood. To the Confederate Gen. Winder he wrote from Savage Station, July 24, 1862, — '' Now, if you judge this the kind of food furnished your sick and wounded prisoners North, or as in accordance with the usages of war among civilized nations, you are mistaken. I have had to buy fresh meat for soups, and bread to supply the deficiency, since we have no means of cooking flour suit- able to the sick. Now, I submit that flour and poor bacon are entirely unfit for the sick and wounded, since many have died from sheer exhaustion or starvation ; and many more will die unless better fed. Many of those taken to Rich- mond, and detained so long in the depot without proper attention, have also died. Now, sir, all 1 ask is to have the sick and wounded who have become the recipients of my care receive tiie attention due them as prisoners of war, agreeably to the usages of civilized people ; and that the surgeons to whose care they are intrusted be treated, not as felons, but in accoidanee with the precedents which have been established, and which you publish in all your papers, as the laws of the land. If we cannot be fed in accordance with the common usiiges of war, — in other words, if you have not the material Avith which to feed us, so as to keep us from starvation, — I feel assured that your elevated sense of FIGHTING FOR THE WOUNDED. 39 hiimanity will assist us to ro/.u-\\ our own lines, wliore we can l)(i ii,tt(!U(l(!(l to. I liav(! seen ami attcuidcd your sick aiiate Medical Society. This body of scientific men, after fully discussing the matter, and hearing his recommendations, gave them their hearty indorsement, and appointed Drs. Swinburne and S. D. Wil- lard a committee from that society, to confer with the gov- ernor, and to secure, if possible, an appropriation to carry out the design of obtaining more ample means for the relief of the sick and wounded New-York troops. Gov. Seymour, who then occupied the executive chair, feeling as he did a deep interest in tlie troops at the front, and knowing the eminent skill of the committee, gave them frequent and early hear- ings ; and, as a result, a bill was draughted appropriating two hundred thousand dollars to carry out the views suggested bj the volunteer surgeon. As soon as it became known among a certain element, who professed to be especially working for the wounded soldier, fk; I iTiNG KOii 'i'in<: vvoundrd. 41 tliut such a bill had been drauj^^hted, and Uic objects for whicli it was intended, there broke out a sJtrong opposition in the ranks of a selfish volunteer organization, whose desire to gain notoriety exceeded their love for the soldier. This spirit of jealousy might have been expected, to a certain degree, from the regular medical department of the army, because of their training, and the assumption that in war every thing connected witii the regular army was perfection, and, the greatest of all, that whatever they did was right, and that in- terference with their assumed superiority was to be regarded as an innovation not to be tolerated. But it was not from this source the opposition came, but rather from the execu- tive committee of the United-States Sanitary Commission, — a volunteer organization supposed to enjoy only the same privileges accorded to other volunteer organizations, or socie- ties of individuals, presumed to be working on the same humanitarian impulses. In their opposition, this executive committee pathetically invoked the aid of the then surgeon-general of the State, Dr. Quackenbush, to defeat the measure, alleging that " the National Government is the national soldier's best friend," and "that whatever has hitherto been effectually done to ben- efit the cause of the sick and wounded soldier, has been done hy increasing the force, irapi'oving the regulations, elevating the rank, or selecting more efficient presiding officers of the United-States Medical Department." This executive committee of a society claiming to be com- posed of volunteers who desired to help the government, and benefit the wounded soldier, and who were still anxious to obtain broader fields and an exclusive monopoly, made the strange and irreconcilable assertion in opposition to the bill, " that already the great beneficent general system of the gov- ernment in its medical department has been constantly embar- rassed by the well-meant efforts of benevolent associations, either representing States or communities, who have insisted in pursuing their humane work." They further advanced the absurd proposition, " that the National Government is making provision at this very moment to do for the New-York 42 , A TYPICAL AMERICAN. troops, and every other soldier, precisely what the bill pro- posed, but could not do so if the bill were passed."' The appeal to the surgeon-general, in closing, exposed the motives underlying the opposition, — that of jealousy, lest the States, in assuming to do their duty to their sick troops, might find a more certain and efficient channel than through the sani- tary commission. The3" stated that '' it [the commission] collects money on the largest scale ever known to volunteer benevolence, and gathers supplies in an equal scale of vast- ness." The reply of the committee, Drs. Swinburne and Willard, was prompt, cutting, and to the point. It said, among other things, — " The State clings to her citizen soldiers in the army. Her care for them is not lessened by their absence over the State line, and it is right it should not be. If committees from the cit}^ common councils and the village board of trustees visit them, and give them courage and hope, and help and good cheer; if the State sends committees to attend to their allot- ments ; if the Legislature provides that they may vote ; and if the State looks well to their pay, and secures it or advances it early, — if all these acts of kindness and care are mani- fested for the well soldier, how eminently proper and just, nay, how much more it is demanded by every consideration of humanity and good faith, that the thousands of feeble, maimed, and dying should be cared for, or at least inquired after, and their misfortunes alleviated in as kind and affec- tionate a manner as possible ! And yet, when this latter course is suggested by the benevolent and philanthropic of the State, whose means of information as to the actual necessities are unquestioned ; when a measure of relief is initiated, — the executive committee of the sanitary commission, under whose administration these neglects occur, as was admitted by their own confessions in leaving every thing they had to be de- stroyed, or fall into the hands of the enemy at Gettysburg, proclaim that "voluntary associations. State societies, and local committees have constantly embarrassed the medical department of the government." To this strange anomal}' of the sanitary commission, the committee from the New- York Medical Society very pertly replied, — KICflTINd FOR TIIK WOUNDKD. 48 " If tills he (rue, well iiiay the i)ef)i)le of this State siisj)eii(l efforts, and hy so doing send comfort and joy to the soldiers, the sanitary commission, and the medical department of the Army." To the cynical opposition of the commission, the committee make this cutting satire: — "After the seven-days' battles l)efore Richmond, not a single agent of the sanitary commission remained to cure for the sick and wounded, and not one of them was taken pris- oner. Their hospital supplies, deserted by their agents, were destroyed. The agents left at that time some live thousand sick and wounded to be cared for by the charities of the eneni}', who had nothing to supply their wants." This was a stinging rebuke, coming from a man like Dr. Swinburne, who had no honor to gain, and yet remained true to his mission, and was himself, while at his post of duty, taken a prisoner. There were no members of the sanitary commission taken prisoners at Savage Station, but there were several volunteers: among them, P'elix R. Brunot of Pitts- burgh, Penn., since an Indian peace commissioner under Presi- dent Grant, with twenty-foiir nurses fiom that city ; the Rev. Mr. Marks of Pennsylvania ; the Rev. Mr. Reed of Washing- ton, D.C. ; and a Mr. Howell of Chicago, and several surgeons. Two of the latter, Drs. Milnor and Sutton, exhausted from their labors among the sick and wounded at that station, finally perished from starvation in the hands of the enemy. The protest against the passage of the bill was made on March 11, 1864 ; and on the 30th, Gov. Seymour, in a commu- nication to the Senate, recommended that an ample api)ro- priation be made by the State for its sick and wounded troops. On April 24 the bill was unanimously passed by the Senate, and sent to the Assembl}'^ on the same day, and there passed without a dissenting voice, and before the sun went down was signed by the governor. During the controversy over the passage of this bill, Surgeon-Gen. Hammond used his official position in an attempt to frustrate the measure, and wrote to J. V. P. Quackenbush, M.D., surgeon-general of New York, — 44 A TYPICAL AMERICAN. Suroeon-CJenkrai/s Office, Wasuington, D.C, March 2, 1863. Sir, — I have the honor to acknowledge the receipt of your communieatifin of the 2r)th ult., enclosing the copy of a bill proposed to be eiiacted by the Legislature of the State of New York, and asking my views upon the same. I have read the bill very carefully, and, whilst admitting the correctness of tlie motive by which its framers have been actuated, J am satisfied, from much experience, that its chief effects will be to create trouble and confusion, to cause ill feeling between the representatives of the United States and the State, and to injure those whom it is intended to benefit. I am satisfied that no military commander who has the good of the troops at heart would allow any agent of any State to interfere in the manner proposed in this bill. It would be found in piactice wholly inoperative, and lead to the results indicated above, without any corresponding advan- tages being received. Doubtless there are deficiencies in the medical administration of the army, as there are in all other departments. Perfection is impossible of attainment ; but if I, with all my efforts, with the assistance of medical inspect- ors, medical directors, and over five thousand surgeons and assistant surgeons, together with the support of command- ing officers, and all branches of the Federal Government, and the control of over ten millions (dollars, doubtless) per annum, cannot reach it, I am certain the agents of the State of New York will not be able to do better. I therefore hope you will use your effoits to defeat this bill. I am not alone in my opinion in regard to it ; as all to whom I have mentioned it, including several officers of rank, agree with me that its passage would be most unwise. I hope you Avill excuse me for the freedom with which I have written. I am, sir, very respectfull}^ your obedient servant, WILLIAM A. HAMMOND, Surgeon-Oeneral. J. V. P. QUACKENBUSII, Surgeon- General of New YorTi^ Albanj', N.Y. The criticism, severe as it was, on the conduct of those who deserted the helpless brave in those trying days, had its effect, and was justifiable in Dr. Swinburne, as he, having remained and become a prisoner, had clearly won the right to condemn the cowardice of those who, acting on the motto KI<;HTFNC) KOIi Till-; WOUNDED. 45 tliat " self-pvesorvMtion was thn first law of iialiirc,'" l(;rt the twcslve hiindicMl brave nuMi at Sava<,'e Stiition. Ill tlic, 'rraiisactioiis of the New-York State Medical Soci- ety, siihinitted to tlie Le,L,Mshitiir(; in 1803, is a full report from Dr. Swiiibiinie diiriii<^ his iinprisonrneiit, with the corninuni- cations tliat passed between himself and the Confederate authorities with reference to the exchange; of prisoners, and his efforts for their comfort, as well as some severe strictures on the management of the medical department of the army. It also contains some able articles on resection of joints, and conservative surgery, on amputation when necessary, and the treatment of gunshot wounds. His observations at the front confirmed the opinion, pre- viously entertained, that there were by far too many amputa- tions performed in the treiitinent of those wounded in battle ; and that by the introduction of conservative surgery, if prac- tised throughout the army, two gi'eat ends would be secured, — the saving to the government of large amounts of money ; and, what was of pre-eminently greater moment, the saving to the wounded of their limbs, and thus preserving them as their Maker would have them, and not having them crippled for life. He believed, if one limb was saved to a man who would live ten years, the government would be benefited to the amount of -12,050 ; and that if one surgeon would save, during a great battle, ten limbs from mutilation, he would save to the government, on the basis of ten years as the media of life after wounding, $20,500. While this was a pecuniary consideration, he felt more keenl}-, from humanitarian princi- ples, a stronger desire to see the principles of conservation practised, feeling, that, if he could accomplish this, a great blessing would be achieved, and that he had been instru- mental in doing some good to his fellow-beings. In this his ambition has been in a large degree gratified in seeing this system very largel}' adopted, both in military and private practice, although he was strongly opposed at the outset by many leading surgeons who have since acquiesced in the humane practice. That he was eminently successful, has been demonstrated 46 . A TYPICAL AMERICAN. by the strongest arguments, — results. To show the wis- dom of conservation, and the brutality or ignorance of the old system, a few cases are cited from this State. Lieut. Felix Angus of Duryea's Zouaves, while making a charge at Gaines's Mills, was wounded in the right shoulder by a minie- ball. Several surgeons insisted on an amputation ; but he objected, saying he would rather die than lose his arm. Dr. Swinburne performed an operation of excision rather than amputation, and "four weeks later, I was in New York, riding in Central Park, and enjoying life as well as ever," he afterwards wrote to Dr. Swinburne. He also wrote to the doctor, " I consider myself under a lasting debt of gratitude to you for the benefit you have done me ; for you saved my arm, if not my life. As it was, you remember you took out my right-shoulder joint, and during the operation I felt no pain whatever." He afterwards raised and commanded Com- pany I, One Hundred and Sixty -fifth New-York (Duryea's second) Regiment. Dr. Julius A. Skilton, who was present at the operation, and afterwards dressed the shoulder at White- Oak Swamps, in writing to Dr. Swinburne, said, " I am sure it would have done you good to see the satisfaction with which he expresses his giatitude for the preservation of his limb, and the manner in which he handles his sword with it now." Lieut. Henry A. Wynkoop of Rochester was so severely wounded as to require the removal of the head and three inches of the shaft of the humerus ; and still, at the end of four weeks, he had so far recovered the use of the arm as to be serviceable, and to give a tolerably warm shake of the liand. Less than a year afterwards he wrote to Dr. Swin- burne from Rochester, — " I must thank you again for saving my arm ; and no money could make me feel as happy as this disabled arm does, thanks to your skill and kindness. The arm you operated upon was my right arm, and this letter is written with the same. After you left me at Fortress Monroe, my arm im- proved rapidly, and in four weeks not only was entirely healed up, but I was able to walk without in any way sup- porting myself. The wound never opened after it once healed up. I can use my hand as well as ever." FIOriTrNG FOR TIIK WOUNDKD. 47 The young gciitlciuiin is .still engaged in ii biinking-IiouKe near Rochester, and continues to write letters of gratitude to the sui-geon who saved his arm. In a volume of reminiscences of tlie war, a jiaper by Dr. Swinburne, dated July 23, 1863, in speaking of the losses of life occurring, as they did, not alone by the ravages of grirn- visaged war in their usual pliases, but in numerous instances from the want of care, disease, pestilence, and almcjst famine in ciunp and hospital, said : — "I'his awful destruction of life outside ihe usual course of war has been attributed by friends and supporters of the dif- ferent parties in the country, and by the followers of different officers, to as many different causes as there liave been par- ties or officers interested or implicated in the matter. Many of the alleged causes are truthful to a certain extent; but all of them are overdrawn, and very many more are entirely un- founded, disgraceful to those charging them, and only, arise out of the evident desiie of their supporters to heap unwar- ranted contumely upon the government, or the officers by them arraigned; and tliat, too, with a design theieby to fur- ther the still more evident and grossly ti'easonable intent to hinder the government in the s^^eedy and successful pros- ecution of the war, and thus give aid and comfort to the enemy in such a covert manner as to shield the authors from the penalty of open treason. "Foremost among these assigned causes has lieen the al- leged inefficiency in the conduct of the medical department of the service duiing this campaign. It will be recollected that the celebrated Dr. Tripler, an old arm}- surgeon, wlio.^e most valuable works on military surgery have justl}' attained a fame as world-wide as the subject itself, was medical di- rector of the Army of the I'otomac at that time. It has been charged, that, b}- reason of his neglect, the Arm}- of the Pe- ninsula was left without many things which were absolutely requisite for the proper administration of the medical depart- ment of that army; and that thus the soldiers, worn out by the fatigues of the march, weakened by exposure to severe storms and the dangerous miasmas of the swamps, and brought down to the hospitals by disease, were literally allowed to die from want of these necessaries, when they could have been promptly obtained at any time, it is said, upon proper call. This charge, it has occurred to me, is grossly unjust to one whose highest aim in life has been to 48 A TYPICAL AMERICAN. serve his country faithfully, and make himself a useful and shining ornament to the glorious profession he has adopted, and a lasting benefit to the human race. The office and duties of a faithful surgeon, even in civil life, is no sinecure ; and when a surgeon of noblest mind and purest purpose, impelled by love of country, has chosen to abandon even the emoluments to be derived from the practice of his profession as a civilian, and is willing, for the paltry pittance allowed by government, to assume the responsibilities, and devote his utmost energies to the duties, of medical director of an army so large as that over which Di-. Tripler had charge, it seems to me that even the pardonable anxiety of the friends of those dying under his charge is not excusable for a violation to- wards him of the ordinary rules of charity which are, in the Book of books, laid down for our conduct towards all men. " In m}^ own experience in the peninsular campaign, I found it at times difficult to obtain a sufficient supply of many mate- rials which were absolutely necessary for the proper care and cure of the sick and wounded, and, in fact, I was many times utterly unable to obtain articles most needed ; and yet I have had the most convincing proof that the medical director can- not be justly held responsible for this. The fault, I am con- vinced, lay nearer the government at Washington. To my mind, the surgeon-general (superior officer to the medical director) — having the means at hand at Washington for ascer- taining, if he did not know, the jjroportions of war the cam- paign was assuming; and knowing, as he must have known, the size of the army, the dangers by which that arni}^ was beset from the effects of the climate, the character of the country, and the probabilities of battle — was in duty bound to see that all necessary material was provided for the medical depaitment of the service ; and it would be but a sickly compliment (as it is an illj^-consoling excuse) for that officer to say that perhaps he did not realize all the necessities of the case. And yet the fact is patent that there Avas, during the whole of the campaign, a lack of supplies for the medical and hospital departments, which, without doubt, was the cause of more deaths than occurred by the other and more direct casualties of war. " After the removal of Dr. Tripler as medical director, the same lamentable state of affairs existed, and the same de- fects in the medical service, to a greater or less extent : as in the location of, and supplies for, the hospital at Windmill Point, where days are said to have elapsed before necessary food and medical bupplies were obtained, and where a great FIGHTING FOR TIIK WOUNDKD. 49 number of our men Hciiuilly died from lack of tliern ; the medi- cal history of the battle of Antietain, at which it is char^^ed by Dr. Ajj^iiew that at least five hiitidrcd men died from tlie want of medical supplies; the battle of Chancellorsvilh;, where thousands wei'e, it seems to me, needlessly left in the hands of the enemy, when they might and should have been trans- ferred to the other side of the river, and there received proper cure and surgical attendance. It is said, tluit, after this bat- tle, our brave wounded soldiers in many instances lay for days without proper food (and in some cases without any), and with no medical relief, many of them left to the tender mercies of the enemy, a large number of them dying from sheer neglect, and many others buried alive in fires occa- sioned by the contending armies in shelling the woods, and burning the Chancellor house." As medical superintendent of the wounded New- York troops, he was not only ever anxious and vigilant in caring for them, but, wherever he saw bad management, was prompt and fearless to call attention to it. In a letter to his Excellency Gov. Morgan, dated Fal- mouth, Va., Dec. 21, 1862, Dr. Swinburne again strikes some pretty hard blows at the head of the medical department of the army. He said, — " It may seem presumptuous in me to offer any suggestions to men of such eminent ability as are to be found directing the medical department of our armies. I shall, however, offer to 3'ou, as the executive of the Empire State, such sug- gestions as shall seem to me appropriate and just in the pres- ent emergency, and ^particularly as 3'ou have seen fit to honor me as the accredited medical representative of the State of New York, to look to the interests of our troops now in the field. I should therefore prove recreant to my dut}' were I not to make all the suggestions which I deem pertinent to their welfare. " In my judgment, there is something radically wrong in the manner in which surgeons are selected to fill certain positions. Merit or competency is in many instances en- tirely ignored, and seniority takes its place. ... As it is now, man}- of the more useful, intelligent, conservative, and handy operative surgeons are acting in a purely executive capacity, as superintendents of hospitals, directors of bri- gades, corps, and divisions, instead' of which they should be 50 A TYPICAL AMEKICAN. employed in selecting and deciding upon the operations to be performed, if any were requisite, and, if need be, to perform the operations in a manner most likely to give the patients the best chances of recovery. I know full well that there is a prevalent idea that the army is a good school for surgery. Now, while this is true in a certain sense, it is not so in another." As an instance of the misplacing of surgeons in the field, the doctor wrote, — "Take, for instance, our own Frank H. Hamilton, who consented to leave an elegant home, lucrative practice, and temporarily relinquished his position as teacher of surgery in Bellevue Hospital, to go out with a regiment of volunteers. What was the result ? He was soon misplaced by being made a medical director of a corps ; and that, too, where he was mainly useful as an executive officer, and where his pe- culiar talents could not be made available at the time of a great battle, when his genius would have relieved and saved many valuable lives. 1 mention this simply as one among the many instances in which talent is being constantly misplaced in this grand army, where there are thousands of the best men in the country, who command and obtain at home the best medical talent. Now, if these officers and men are will- ing to offer their bodies as a sacrifice to assist in saving our country from villanous treachery and rebellion^ I think they have a right to demand of our government the services of the most experienced surgeons, at any cost. In this respect our government has displayed the most sordid penuriousness." During the three days in June, 1862, while the wounded were being brought into Savage Station, the doctor performed twenty-two excisions of the shoulder and elbow. Of these, six resulted in good limbs ; two which would have resulted well, were afterwards amputated by others without cause : the others, being removed to the pest-houses or " tobacco warehouses " in Richmond, were lost sight of. In striking contrast to this humane system of conservative surgery, is a case given in the " Medical and Suigical Re- porter " of 1863. On Sunday, May 3, Col. Newman, of the Thirty-first New-York, was wounded in the left foot by a grape-shot; the ball passing obliquely upward from the left side of the foot, crushing the anterior part of the tarsus, and FIGHTINO FOR THE WOUNDED. 51 lodging just undei" the skin, hut not involving the ankle-joint. From t\voIv(! to lifteen hours after tlie injury was received, the hall was cxtrii,c,(,(!(I, ;ui(l th(! (colonel sent, after the wound was dressed, to the National Hotel at Washington; the surgeons at the front deciding tlie foot could he saved. On invitation of a nephew of Senator Wilkinson, Minnesota, Dr. Swinburne called on the colonel, and, coinciding with the opinion of the surgeons at the front that the foot could be saved, washed out the wound, and dressed the foot. In the evening the doctor called again, and was told by the colonel that an army surgeon had been in and said that the foot must be ampu- tated. As a friend, the doctor advised against amputation, and continued to wash and dress the wound twice a day. On the fourth day the inflammation had very considerably abated, and suppuiation had commenced; the wound in the skin and soft tissue had begun to granulate ; the whole appeared healthy ; and the constitutional symptoms had subsided. His appetite was good. He slept well, and experienced little or no pain except when the limb was moved. Dr. Spencer of Watertown, Dr. Green of New York, and five arnw surgeons of good standing, who saw the colonel, agreed with Dr. Swin- burne. On the 11th, however, he was told by Surgeon-Gen. Hammond, upon whom he called on business, that he (Ham- mond) objected to Swinburne visiting Col. Newman in any capacity, even as a friend; that the National Hotel, at which he was stopping, was located in a certain district in Wash- ington, and that an army surgeon had charge of the district ; that the patient belonged to such surgeon, and that he (Swin- burne) had no business to call in an}- capacity. At the spe- cial request of Col. Newman, Dr. Swinburne called again, in company with Dr. Spencer, and advised the colonel to get permission to go to New York, Dr. Spencer offering to accom- pany him. But the army surgeons decided against this course, and said he must have the foot amputated, or they would not attend him ; and that, if he did not submit to their decision in regard to him, he would be reported to the sur- geon-general for contumely, and dismissed from the service, the colonel assuring the doctor a friend of his had been thus 52 A TYPICAL AMERICAN. treated. The surgeon informed the colonel, he said, "that, if he did not submit, they would have to leave him, and that he should have neither pay nor medical attendance, but that they would strike him from the roll, and that they had the authority of the surgeon-general for saying this." The sur- geon also added to the colonel's friend, " If I find a citizen surgeon in the room looking at any of my patients, I'll kick him down stairs." These remarks were made by Ur. Clymer. The amputation, after much dallying, was finally made by Dr. Clymer, assisted by Surgeons De White, Swasey, Farrel, and Allen, notwithstanding the patient was rapidly improv- ing; and the colonel died. A friend of the colonel, writ- ing to Dr. Swinburne after the butchery of this brave soldier, said, " This noble soldier often expressed his thanks for your kindness, and could not convince himself, that, in handling and dressing his wound, any hands were as soft and delicate in their touch as yours." In reviewing the case in that fearless manner always char- acterizing the doctor's course when attacking malpractice on the soldier or private citizen, he raised these important points : — First, The surgeons on the field decided upon the propriety of not amputating the foot of Col. Newman ; that it could be saved without amputation. Second, That the injury was inflicted on the 3d, and the surgeons on the field decided not to amputate. When he arrived in Washington on the 8th, while the whole limb was tumefied, and absolutely shining with inflammation, the sur- geons in Washington wished to amputate. This was delayed from day to day, and still the foot improved, in spite of the depression of mind caused by the constant threats of ampu- tation. On the 13th they demanded amputation, and it was delayed, the same condition of things existing, and I learn the surgeons decided upon waiting for a few days. On the 16th Col. Newman was troubled with little pain. Meanwhile his wounds freel}^ suppurated ; and, in fact, his condition had con- tinued to improve, so that suppuration was free. On the 16th "the surgeons administered ether, and made a perfect examination" — of what? Wh}'-, a wound into which j'ou could easily put your thumb and all your fingers. This ex- FIGHTING I-'(;H THE WOUNDIOD. 63 iuniiiiitioii resulted (iis tlic; siirpj(;ons stilted) in firidinj:^ a small bit oi' l(!iitli(!r, and in wrenc]iinAGUK.S. 76 ance upon the Mctroi)o]itan Board of Health, or at tlie of- fice of the coniniissioiiors, and at the same time to be at his post at the boarding-station, or among the sick in tiic hiwer bay, he seemed ahnost omni])resent. No duty within bis power to perfbrm was neglected, and he looked after all under his care with a sleepless vigilance which seemed to kiirjw no fatigue, and experienced no relaxation while any thing le- mained to be done. What was said of him by a writer in de- scribing the services rendered by Dr. Swiid)urne as a sui-geon during the peninsular cain[)aign in the late Ivcbellion, might be said of him in reference to his labors under quarantine." They quoted ; — " Of this man I cannot speak in terms of too high praise. He was thoughtless of himself, foio'etful even of the wants of .... . . ft nature, untiring in his labors, uniting to the highest "ourage of man the tenderness of a woman and the gentleness of a child. lu that terrible hour when other surgeons were worn out and exhausted, no labor appeared to diminish his vigor. After days of toil, and nights of sleeplessness, he was as fresh and earnest as though he had just stepped forth from a night of quiet sleep. And while others became impatient, and had to escape from those scenes to seek repose, he, oper- ating for hours at a time, found relaxation and refreshment in going from tent to tent, counselling the surgeons, advising the nurses, and speaking words of cheer to the wounded and the dying." The latter portion of that part of the commissioners' report quoted is from a volume of reminiscences by the Rev. Dr. Marks of Pennsylvania, and, although quoted on a previous page, is repeated here simply' to demonstrate the high esteem in which he was held by every honest man wdth whom he came in contact, whether strangers, or acquaintances of years, and because, if the commissioners deemed this tribute from one of another State worthy of incorporation in a necessaril}' limited report, it is valuable enough to incorporate here. In 1867 yellow-fever was more destructive and wide-spread than at any previous period. That year two hundred and thirty-five vessels arrived in the port of New York from six- teen ports infected with the disease, and five hundred and seventy-three vessels from infected and doubtful ports were detained at quarantine for examination. During the year, 76 A TYPICAL AMERICAN. one hundred and fifty-two vessels were quarantined for sick- ness, with one thousand and thirty cases on board, of which three hundred and eight3^-four died. Twenty-eight of these vessels had small-pox on board, to which sixteen thousand six hundred and eighty persons had been exposed. Of these, twelve thousand nine hundred were vaccinated in quaran- tine ; and only four cases of sickness of any kind in the met- ropolitan district could be traced to infection from this large number of arrivals. Between the 18th of June and the 5th of November, 1869, two hundred and eleven vessels arrived from infected ports, twenty-seven of which had sickness on board. Nearly all had cargoes of a character calculated to carry and retain the seeds of infection. On board these twenty-seven vessels, ninety-two persons were sick with yellow-fever in the ports of departure, of whom forty-six died. Sixty other cases oc- curred during the passage, twenty-one of these proving fatal. The same vessels had twenty-five cases of other diseases on board. " These statistics," said the commissioners, " are scarcely without a parallel in the same brief time in the his- tory of quarantine ; and, in view of past experience, it seems hardly credible that all of the dangers attending the arri- val of so many infected vessels could have been confined to the limits of quarantine. Yet the commissioners are not aware that a single case of yellow-fever occurred on shore during this season ; and so little publicity was given to the fact of the arrival of so large a number of vessels from in- fected ports, that no uneasiness was at any time excited in the public mind." In their report for 1870, the commissioners said, — " Although that terrible disease which has become an annual visitor to our shores found a large number of victims among those engaged in our commerce with tropical parts during the past summer, our citizens, happily, escaped its rav- ages. The scourge of cholera, which made the years 1866 and 1867 memorable in the history of quarantine in the port of New York, sought its victims in other climes. The tide of emigration has continued without diminution, but has been unattended with the introduction of any foreign pesti- A QUARTET OT<^ IT.AOUEH. 77 lence to excite the apprehensions of the public. Many who enjoy the quiet of their own firesides, and are exempt from the visitation of pestilence, care little to inquire to whom they are indebted for such exemption. Resting? in fancied security amidst the luxuries of their own lionies, they little dream that they are surrounded 1)y j)erils which hourly threaten to bring foreign contagion to their doors, and they fail to appreciate the sleepless vigilance which protects them from the approaching danger." The season of 1869 was the last that Dr. Swinburne was in charge as health-officer; but, during the period he held that position, he accomplished a work, and established a quar- antine system, and facilities to suppress disease, which will remain as monuments to his scientific and executive abilities long after the present generation shall have ceased to be actors in the great drama of life, and the curtain been rung down on the last scene. Many who are prominent to- day will enjoy but a brief career of eminence, and be only as chimerical delusions, rapidly coming to the front, and as rapidly vanishing from memory ; while the name of Dr. John Swinburne, because of his great achievements in this and other walks of life, will be ingrafted in the pages of history among those who, while living, made the world greater, and whose memory will sparkle for generations to come, throwing on the future a reflection and splendor of achievements as brilliant and far-reaching as the rays of a setting sun that bathe and beautify the western horizon. One of the greatest obstacles with which he had to con- tend as health-officer, in his struggles with the plague of chol- era, was the avarice and deceit of traders and other nations, and the culpable neglect of our consuls abroad. Most all the vessels arriving at the port of New York during the cholera epidemic, from the countries where it raged, had clean bills of health ; and in but few instances did the consuls give any official intimation of its existence. During the prevalence of the disease in Paris, no official notice of its existence there was received ; and in 1867, when whole villages in Germany were being depopulated b}^ its ravages, vessels arrived from all the German ports with clean bills of health. 78. A TYPICAL AMERICAN. In contending with these diseases at quarantine, Dr. Swin- burne, as health-officer, was enabled by his scientific ability and deep research, in addition to the construction of the artificial islands, to arrive at a clear and definite knowledge of the diseases with which he had to deal, and thus was en- abled to transmit valuable information to the profession. He thoroughly demonstrated that neither the vessel nor the cargo carried the poison of either cholera, small-pox, or ship- fever, bat that the personal effects of passengers did. In cholera the greatest amount of contagion came from excre- tions. The bulkhead of a vessel separating the second-class passengers from the steerage passengers, and between their respective water-closets, where, for instance, they were sick in the steerage with cholera, and free from it in the cabin, was sufficient to prevent the contagion from spreading. Of the nature of yellow-fever, he discovered that the hold of a vessel, with its bilge-water, induced the disease in persons, and that vessels lying at docks infected with yellow-fever poisoned the district and the inhabitants. An important dis- covery touching this disease was that persons with clean clothing might be sick with yellow-fever in any place, and those around them not be affected, and that their vomit and defections were not dangerous. In other words, he held that the well might sleep with the sick, under circumstances of cleanliness, without danger of infection. He further came to the conclusion that dead bodies did not infect or propagate the disease, and that the same was true regarding clean vessels and clean cargoes. By the superseding of this gentleman, for partisan reasons, the State was the loser in a sanitary as well as financial point, as was proven afterwards. In 1870 and 1871 a number of ports with which our commerce was being carried on were suffering from an epidemic of small-pox; and from these ports the infection was brought to the city of New York, where in 1870, the first year after Dr. Swinburne left quarantine, there were two hundred and ninety-three deaths from this disease. The next year (1871) there were eight hundred and five deaths, — the largest record from small-pox in a A QUARTET OF PLAQUES. 79 century, the next largest being six liundred and eighty-one, in 1853. Jackson S. Shultz, president of tlie Board of Health of New-York City, of which Dr. Swinburne was an ex-officio member, said in substance, at a dinner given on his (Shultz) retiring from that ofiQce, that the Metropolitan Hoard of Health had not accomplished as much in two years as he exj)ected it would in one month, and that the quarantine under Dr. Swinburne had been the only successful branch connected with the board. CHAPTER VII. HONEST AND FAITHFUL. An Odious Comparison. — Artificial Islands. — Corruption in Quarantine. — A Political Trick. — Bleeding the State. Comparisons, while not always, are often odious, at least to some of the parties brought into comparison ; and while there is no desire to resurrect the misdeeds of men who have passed away, or who are long since no longer prominent, it is seemingly necessary, that for a better appreciation of Dr. John Swinburne's honesty, integrity, and ability as a health- officer, his administration should be contrasted with that of some of his successors ; and it is to be regretted that in the comparison the distinction is so marked as to make him ap- pear a giant along side of a pygmy, to at least one of his successors and traducers, scientifically as a physician, morally as a man, and in integrity to the people and the State as an official. The comparison is so odious that it must necessarily create some ill will and anger, although it would be impossi- ble to paint it in colors that would do justice, or describe it in language in any way adequate to convey the great differ- ence. Ill feeling, however, will only come from those who dare not publicly den}^ and have no defence. In drawing this comparison, it is well to state that the commissioners, a board under whom, the doctor had never served, six years after his retirement, in their report to the Legislature in 1876, said, — " Any apprehensions entertained at the beginning of the year, that Asiatic cholera would again make a lodgment in our bay, have not been realized : indeed, as one season after another passes, and the ravages of the once deadly scourge are averted, there is an increasing confidence in the ability of the quarantine authorities to at all times arrest its prog- IIONKST AND FAITilFUL. 81 resa at tlie p^ate of ilio rruiiropDlis. Wliile it is uncertain what a yoar may l)viii<^ forth, tlinro are now seemingly some grounds for this growing confidence. We have unrjuestion- ahly liere, in the harbor of New York, tlie most extensive and complete quarantine establishment in the world, — an estab- lishment which, properly c(mducted, affords every guaranty against the inroads of jjcstilenee which human exj)erience and forethought can devise. It is true tliat the artificial island system necessitated heavy expenditures, yet the since low rate of cholera mortality bears striking testimony to the wisdom, of our predecessors." Prior to the appointment of Dr. Swinburne, the quaran- tine facilities had been located on the mainland, to which the people were violently opposed, going to such extremes as to destroy the buildings used. When the health-officer proposed the erection of the two artificial islands in the bay for quarantine, the celebrated New- York engineer, Craven, declared the scheme eutopian, impracticable, and simply im- possible of carrying out. He was consulting engineer to the health-officer, and was the projector of the Croton Water- works, and chief engineer of the works up to the time of his death. When the work was well under way, and no longer a question of doubt, Mr. Craven declared it was the grandest piece of engineering skill of the age. The upper island w^as nameti Hoffman's Island by the commissioners, in honor of the governor under whose administration it was constructed ; and, by act of the Legislature, the lower island was named Swinburne Island Hospital. These artificial islands, con- structed in accordance with the recommendation of Dr. Swin- burne, were the first of that nature ever undertaken. In 1872, two years after Dr. Swinburne's time, what was known as West Bank Hospital was, b}' an act of the Legisla- ture, " hereafter to be known and designated as Swinburne Island Hospital," in honor of the efficient officer who had established it. For two 3'ears after this enactment. Dr. Van- derpoel persisted in calling the island West Bank ; and it was not until the Legislature, by a resolution twice adopted, unanimously insisted on the island being named as the Legis- lature had directed, — ''Swinburne Island Hospital," — that 82 A TYPICAL AMERICAN. the commissioners were able to compel the health-officer to comply with the law. Dr. Vanclerpoers attorney has since stated that that official had agreed with Gov. Dix, that, if he would re-appoint him health-officer, the island should be named Dix Island. The governor fulfilled his part of the agreement, but the health-officer was prevented by the Legis- lature from carrying out his part. The islands, as sliown in the illustration, are Swinburne Island, with Hoffman Island farther up the bay, and Staten Island in the background. The two islands are of the same size and construction, with the exception of the buildings. Swinburne Island is located on the lower bay, about two and a half miles south of Fort-Thomjjkins Lighthouse at the Nar- rows, and about two and a third miles from the Elm-Tree Lighthouse on Staten Island. The foundation is hexagon in' form, two of the sides being two hundred and sixty feet in length, the other four one hundred and sixty-one feet. The exterior of the crib-work is thirty feet in width at the base, twenty feet at the top, and twenty feet in height, and is con- structed of large timbers firmly fastened together and filled with small stones, the whole surrounded by a riprap of heavy stones. The superficial area of the structure is about two acres, while the area at the base of the riprap is over three acres; the extreme length at the top being five hun- dred and four feet, and two hundred and twenty-eight feet in width. To construct the island, nine thousand cubic feet of timber were required, and seventeen thousand cubic yards of stone in the riprap, five yards of stone to fill the crib, and fifty-six thousand four hundred j^ards of sand to fill the space enclosed by the crib-work. On Swinburne Island there are eight hospitals, each eighty- nine feet long, twenty-four feet wide, and twelve feet three inches from floor to ceiling, and all connected by a covered corridor. To supply the island with fresh water, there are twenty-two cisterns, capable of holding forty-four thousand gallons of water; the whole of the buildings being lighted with gas manufactured on the island from gasolene. The contract bid for the carrying-out of this experiment, ^ m ^ I w r > 'I I i ""^sX ^ li JIONEST AND FAITHKUL. 88 never before tried in any harbor, was $310,618, and no more tlum that anKjunt was paid. In Chapter 733, " Laws of the State of New York, 1872," it was enacted, " And the lower of the West Bank Islands, built under the direction of Dr. Swinburne, shall hereafter be known and designated as Swinburne Hospital Island." One of Dr. Swinburne's successors, persisting in calling the island Dix Island, and publishing diagrams of the island with that name in his reports, and also in the first volume of the "Report and Papers of the American Health Association," published in 1873, the Hon. Mr. Vedder, on Jan. 23, 1874, offered the following in the Assembly: — Whereas It is provided and declared in and by Chapter 733, Laws of 1872, that the lower of the West Bank Islands, built under the direction of Dr. Swinburne, shall hereafter be known and desigiuited as Swinburne Island Hospital; and Whereas The health-officer, in his report to the commis- sioners, in their report to the Legislature for said year, in disregard and defiance of said legislative provision and declaration, did refer to and designate said hospital other- wise than by its true name, thus tending to produce confu- sion in the records of the State ; and Whereas The Legislature at its last session, by joint reso- lution of the Senate and Assembly, did direct that the said report of the commissioners and health-officer should be so amended by striking out the name given by them to said hospital in said report, inserting in place thereof its correct statutory name, and also directed that in all reports and papers said island should be designated as Swinburne Island Hospital ; and Whereas The said health-officer and commissioners, in fur- ther disregard and defiance of said legislative provision and declaration, have, in their annual report for the year 1873, just submitted to the Legislature, again ignored said statu- tory name of said hospital, and have therein designated the same b}^ a name of their own selection, not sanctioned by law : therefore Resolved (if the Senate concur) That the said last-men- tioned reports be forthwith returned by the clerks of the Senate and of the Assembly to the commissioners of quaran- tine and said health-officer, and that they cause the same to be amended bj' striking out said unauthorized name of said hospital in said reports wherever the same occurs, and insert- 84 A TYPICAL AMERICAN. ing in place thereof the name given to said hospital in and by the hiw aforesaid, and tliat they return the same to the Senate, thus amended, within ten days from this date. On Jan. 9, Mr. Prince, from the Committee on the Judi- ciary, to whom was referred the resolution, reported in favor of the passage of the same, which report was agreed to ; and on Feb. 3 the resolution was reported as engrossed. On March 18 the resolution was adopted by a vote of sixty-seven in favor, to seven against. The cost of this island, with the hospital thereon, was four hundred and ten thousand dollars. The enacting by law, at this time, that in the great port of New York there should be a " Swinburne Island," was an unusual honor to bestow on a man who had never aspired to political fame or prefer- ment, and was intended as a mark of esteem that should be enduring, and become world-wide in reputation. It was voluntarily bestowed on the man who had conceived and executed such a perfect safeguard to the State, because of his faithfulness and honesty in the discharge of a duty affording such Opportunities to plunder the people at large, and the mercantile interests of the State of New York in particular. During his term in the office, every report of the commissioners contained eulogies of the most complimentary nature of the health-ofScer ; and these but expressed the views of the officials of the State in high positions, who were the guardians of the mercantile and commercial interests of the city of New York, and of the interests of the people at large. To peruse the reports during the period when Dr. Swin- burne was health-officer, and then for a number of years after he retired, is like being suddenly transformed from the genial warmth of a balmy, invigorating day in June, into the cold, dismal, and chilly breezes of a dark December night, — the first abounding in praises of Dr. Swinburne : and the other charging others prominent afterwards in the same respon- sible position with defiance of law; trickery in plundering the State of large amounts of money ; swindling the shipping interests of the city, and the commerce arriving in New-York HONEST AND FAITHFUL. 86 harbor; using the State steamers for the collection of whip news in tiie interest of the associated press, making no re- turn of the moneys received to the State, and recommend- ing the attorney-general tf) institnte an action for the recov- ery of the same ; illegally collecting fees from merchants for " medical attendance, and transporting the sick ;" the "divert- ing " of money appropriated by the Legislature; and the withholding of money due the employees of quarantine and others. If the quarantine established by Dr. Swinburne, and the commissioners working in unison with him, saved the people from plague, some of their successors determined that they would be worse than seven plagues in plundering the State treasury, and all with whom they had dealings. The virtues of one man are better understood when placed in contrast with the disreputable acts of another, as the fragrance of the rose is enjoyed after the senses have been attacked with the odor of Mephitis. In 1880, when the people began to realize how they had been plundered during the last dec- ade, it was a consolation to review the transactions at quar- antine for the previous decade, and feel the assurance that all men intrusted with great public interests were not rec- reant to their duties, nor faithless to the people. In their report in 1877, the commissioners said, — " When the supply bill of 1870 was printed and made public, not a little surprise was caused by the discover}' of a clause which transmitted the power of appointing, dismiss- ing, selecting, and licensing to the health-oflfieer. There- upon followed the organized exactions down the bay, which became such a terror to our mercantile interests during the seasons of 1870 and 1871." Under the general law of 1863, the commissioners had this power, and, as they were ignorant of the changes, the natural deductions are, that they were effected at the instance of the then health-oflfieer. Dr. Carnochan, by means only those con- versant with the manipulations of the lobby at Albany understand, whose "interests"' in such affairs are alwaj-s for those who have " designs," and are secured by " circum- 86 . A TYPICAL AMERICAN. stances." By this change it is apparent "in what a hurry some persons were to become rich " as soon as an honest, fearless man was out of the way, Dr. Swinburne being then in Europe. The same report said, — " When, in 1866, the law was passed providing for the building of the artificial islands, it associated the mayors of New York and Brooklyn with the commissioners of quaran- tine in their construction. In 1873 a five-line clause in the appropriation bill wiped out the connuission, and transferred all its powers and funds to the then health-officer, Dr. Van- derpoel, making him the construction board." To effect such an unprecedented and outrageous proceed- ing, there was unquestionably sinister motives to secure a collusion necessarily fraught with such dangers as this one was, and opening avenues to plunder. Such a power Dr. Swinburne never asked, and it is doubtful whether any honest man would covet it. By the statements of the com- missioners themselves, who M'ere in political sympathy with Dr. Vanderpoel, and not with Dr. Swinburne, the State had reason, as did the merchants of New- York City, and the owners and masters of vessels arriving in New York, to mourn the change that had been made from good to bad, and from bad to horrible. The intention and purpose was to have no portion of the quarantine on the mainland except the burying-ground ; and, to this end, buildings for the rcbidence of the health and other ofBcers were erected on Hoffman Island. Of these islands and quarantine, the commissioners said, — " The year which closes with the date of this report has witnessed the completion of the new hospital on West Bank (Swinburne Island). It may be justly regarded as one of the most important and successful undertakings ever entered upon by the State. The magnitude of the structure, and the obstacles which have been encountered in its erection, have been very little understood by the public; and but few know the extent of the provision which has been thereby made for the care of the unfortunate victims of disease who are brought to our shores." When these were completed, the Legislature, in 1873, when HONEST AND FAITHKI'I.. 87 it centralized all power in tlie liealth-ofTicer, appropriated a hundred and twenty thousand (h)llar.s for new grounds and residences for the health-officer and his assistants upon Stateu Island; and Hoffman Island, with its three massive brick buildings, became solely a place of detention for well pas- sengers ; and thus property costing the State at least four hundred thousand dollars, and how much more is not known, became practically of no benefit. ]n 1876 and 1877 the commissioners suggested that the quarantine residence and connecting property on Staten Island, which had cost the State a hundred and seventy thousand dollars, be sold, and the headquarters of quai'antine be transferred back to Hoff- man Island, where the original intent was to establish them. Certain it was that to have every part of quarantine as far from populated districts as possible was a wise, humane, and judicious scheme; and no other motive than the supplying of jobs could have been tlie foundation for having a new resi- dence erected on the mainland. Dr. Swinburne's successor, Dr. J. M. Carnochan, in his report for 1870, said, — " The completion of the new hospital at West Bank (Swin- burne Island ) has removed one of the greatest defects in the quarantine establishment at the port of New York. The old hospital ship, which had been in use since tlie destruction of the quarantine buildings on Staten Island, beside being ill suited to the care and treatment of the sick, had accommoda- tions for a very limited number of patients, and, Avhen over- crowded, was no doubt greatly detrimental to the lives and health of the patients, attendants, and nurses who were obliged to remain in the poisoned atmosphere of a crowded vessel. The value and importance of the new hospitals, and their adaptation to the necessities of quarantine, were fully apparent in the ejiidemic on Governor's Island, to M"hieh I have already referred. They afforded means for the prompt removal and isolation of the sick from the vicinity of the city to a place where they were surrounded witli every comfort. While the new hospital at West Bank may be considered one of the most important additions that could have been made to the quarantine establishment, it is not less necessary that the other structures intended as a place of detention for those who have been exposed to contagious and infectious dis- 88 A TYPICAL AMERICAN. eases should be completed without delay. . . . There is no doubt that in previous years many valuable lives have been sacrificed for the want of a place to which those who had been exposed to infection or contagion during the voy- age could have been transformed immediately upon their arrival at quarantine." And in his next report he adds, — " The present quarantine hospital at West Bank has an- swered admirably the purpose for which it was intended, and may be justly regarded as the most important addition which could have been made to the quarantine establishment. The pure air of the lower bay, the perfect ventilation of the hospitals, as well as the care and attention bestowed upon the sick, have all combined to promote their recovery and convalescence ; and it is not too much to say that during the year many lives have been saved which formerly would, no doubt, have been sacrificed." This gentleman's term, which for reasons it was thought would be of benefit to the State, was limited to two years, and the appointment of Dr. S. Oakley Vanderpoel followed. Of this official, the commissioners, after five years' inter- course with him, said, — " So long as the remuneration of the health-officer is left to exactions upon commerce in the shape of fees, just so long will he seek to retain as large a portion of the fees as possi- ble for himself, and pay out as little as possible for the State; and if the keeping of the quarantine establislunent in re- pair is to be thus left to his generosity, or to his biassed sense of its necessities, it will not be long before the State property will go to ruin." During the three years following the administration of Dr. Swinburne, when first Dr. Carnochan and then Dr. Vander- poel were the incumbents, there was an annual expenditure, amounting in the three years to $110,000, for the health- officer's residence, grounds, furniture, etc., — an amount ex- ceeding the entire appropriation for quarantine for the two years of 1864 and 1865 under Dr. Swinburne. In referring to the property at Clifton, Staten Island, — for the purchase of which, and the erection of buildings thereon, the Legislature in 1873 made the appropriation, — the commis- HONEST AND FAITHFUL. 89 sioners intimate, iliat, after the ainoiiiit ;ii)])i()j)i-iat('(l was ex- pended, the th(Mi health-olTicei's (Dr. VaiidiMpoel^ interest in keeping his residence in good condition vanished, and his ardor cooled. They report in 1878, "Since; tlien (1875) the commissioners have expended little or nothing npon these gronnds ; and, inasmuch as the health-officer has devoted no portion of his revenues to keeping up tlie property, it is in a dilapidated condition." About two hundred feet of the sea- wall fronting the grounds had been undermined, and fell, owing to the removal by the health-officer of gravel between it and low-water mark, to cover the walks around his resi- dence, at a loss to the State of over $2,000. Twice during his term was Dr. Vanderpoel the subject of investigation by legislative committees, — in 1873 and 1876. And at these investigations it was developed, " that in 1873, while the duties of health-officer had greatly fallen off, the expenses of quarantine had nearly doubled, being over $70,000 a year ; that the expense of furnishing the health- officer's house, and of paying the quarantine employees, had been laid on the State instead of on the health-officer; that the expenses had risen from $60 per patient in 1866, to $1,500 per patient in 1872 ; that the services rendered to vessels by the quarantine tugboats, the revenue from which should have been turned over to the State treasury instead of into the health-officer's pocket, was reduced by Dr. Vander- poel one-half ; that over $600,000 had been spent in partly finishing one of the islands in the lower bay, when $160,000 was ample to complete both islands ; that the State was made to pay over $20,000 per year for steamboats used in examining vessels, which should have been paid out of the health-officer's own fees ; and that the employees of the State were utilized in fumigating vessels (the fees of which amounted annually to a very handsome competency), making the State pa}^ $20 per week for a fishing-yacht, 'Gertrude,' besides charging the commissioners of emigration $75 per month for allowing their agent to use a quarantine boat in going on board emigrant vessels as a boarding-officer."' In the investigation of 1876 it was claimed that the health- 90- A TYPICAL AMERICAN. officer, Dr. Vanderpoel, had by some means secured appro- priations amounting to $702,000, of which 1690,000 had in some way been spent for liis benefit; and tliat 1139,000, phiced at his disposal for the construction of quarantine islands and buildings, had not been accounted for; that he had used the State tug " Fenton" to collect ship news from incoming vessels, receiving therefor i4,000 a year, which was pocketed, and by this speculation, five men, who formerly did this work, were thrown out of employment, and their families tlius deprived of support ; and that for the use of the yacht " Gertrude," worth but -$2,500, the State was charged $5,000 per year ; that the State wells, engines, and machinery in pumping water, which was sold at $20 per month, had been used without proper credit; that twenty-five tons of hay had been mowed in the burying-ground, and the money for which it was -sold retained; and that also anchors, chains, etc., had been sold in the same way. During the administration of Drs. Carnochan and Vander- poel, it was repoited that $760,000 had been expended to complete the buildings and facilities at quarantine; but all there was to show for the expenditure of this heavy amount, in further improvements than those completed by Dr. Swin- burne, was a boarding-station on Staten Island, worth less than $20,000, and three brick buildings on Hoffman Island, which could have been constructed for less than $30,000, much of the $700,000 mysteriouslj^ disappearing under the administration of the "new construction board," or one-man management, — a natural result where a scrupulous scientific officer of executive ability was removed to make room for one lacking in these requisites as a public officer. There was nothing of this nature ever intimated against Dr. Swinburne, who persistently refused, while health-officer, to handle one dollar of the State moneys, insisting that the commissioners of quarantine, and the construction board, were the proper parties to handle the funds ; and therein lays the sequel why one health-officer possibly grew so rich in a short time, while the other, after many years of arduous duty in the same position, retired comparatively poor, he having FIONEST ANF) FAITHFUL. 1)1 exi)ei)(lc(l over |>00,000 of liis own funds, ;it a tiinf; when gold was worth from two Imndred to two hundred and eighty, in the work he accomplished, — a snm for which tiic State has never reiinhnrsed liim. Tiie two artificial islands sug- gested by Dr. Swinhnrne were completed at the time he whs superseded by Dr. Carnoehan. On Swinburne, the lower island, all the buildings were erected, furnished, and com- pleted with the exception of painting, and Hoffman Island made ready for the buildings, at an aggregate cost of -iisTSO,- 000. When this scheme was proposed, it met with strong opposition from the press, some of them styling the proposi- tion as "Swinburne's folly," and for a time from tlie Legis- lature, on the ground that the outlay would amount to over $3,000,000 for the construction of this stupendous under- taking. These two islands were built in about twent}^ feet of water, at low-water mark, with three thousand miles of ocean beating against them, and averaging over three acres of land each. Among the pajjers to oppose the undertaking was the "New- York Herald," which years afterwards, when the cholera was discovered among the troops on Governor's Island, assured the public that ample provision for the sick, and the safety of others, was provided in the "salubrious little Swinburne Island." In their report dated Jan. 31, 1876, six years after Dr. Swinburne, the suggester and propagator of the scheme for the erection of artificial islands for quarantine, had been superseded, the commissioners said of Swinburne Island Hospital : — " When this artificial structure, having a surface base of three acres, was undertaken below the IN arrows, many were of the opinion that it would not withstand the action of the tides and currents, and vast bodies of ice which at certain seasons of the year are discharged through the Narrows. These fears hav^e not been realized. With some repairs, the foundations of the island are as firm as when first laid." To recapitulate briefly. During the six years that Dr. Swinburne held the position of health-officer of the port of New York, the appropriations aggregated ^861,027.19, out of 92 A TYPICAL AMERICAN. which was expended, on the ishmds and buildings, $750,000, and for whicii the State holds that amount of property, with the exception of certain furniture and other movable articles, valued at $25,000, supposed to have been spirited away by the rats since 1872. For the succeeding six years, under Cai-no- chan and Vanderpoel, the appropriations aggregated $1,264,- 478.16, or $403,450.67 in excess of the previous six years; and for this outlaj'^ the State has not exceeding fifty thousand dollars' worth of property. During his term as health-officer, Dr. Swinburne was but once summoned before a legislative committee. In 1868 com- plaint was made against him, and a committee appointed and instructed to investigate the office of the health-officer of the port of New York relative to his duties. The report, after a thorough investigation, was submitted March 18, 1868, and not only exonerated Dr. Swinburne, but complimented him on his open frankness, and willingness to have his department investigated. The seven members of the committee signing the report said, " Dr. Swinburne promptly responded to the notice, expressing an entire willingness that his official acts should be subject to the fullest scrutin}^ and investigation. Your committee proposed such general inquiries as seemed to be necessary to elicit such information as would enable them to determine whether there were any abuses, with the administration of his duties, which might be proper sub- jects of legislation. That the answers submitted by the health- officer to these inquiries satisfied your committee that there were many burthens imposed upon commerce in the adminis- tration of quarantine in the port of New York which very justly form the subject of complaint on the part of those en- gaged in it, but for which your committee is satisfied the health-officer is not responsible." The report of the commissioners for last year (1884) asked, in view of the threatened appearance of cholera on our shores, for an appropriation of $24,500 for quarantine ; and the New- York papers pertly remarked, " Give them the money, and call back the old officials," — a very natural request where the health of the people is in great danger, and one which HONEST AND FAI'I'IIFUL. 93 illuistnites that even political journalists believe at tinies in the doctiino of "the survival of the fittest" when the health of the people is in iuiniiuent daii^^er. And one of the leading journals of New York, in connnenting on the request, said, "Give them the appropriation, and then call back some of the old quarantine officials," — a very direct recommenda- tion of Dr. Swinburne, and the commissioners with whom he acted w^hen the country was before threatened with cholera. The health-officer, in his report last year, said, — "There is a saying that 'like causes jjvoduce like effects.' If this adage is necessarily true, then cholera will certainly secure a lodgment at some place in our country in the near future. The same causes which have existed on other occasions of this dreaded disease's approach to our shores doubtless exist now. It is the same disease that has decimated our population in times past. We have held the same and greater commercial intercourse with the stricken peoj)le in many localities. An immigration has existed for the year past, and still continues, far in excess of that which obtained during any previous invasion of cholera. " But, if like causes operate now to produce like results, those causes are better understood than formerly. The sani- tation of ships is more intelligently conducted, at least, tiian in the earlier visitations of the diseases. The agents believed to act as germicides or disinfectants are better understood. The cleansing of ships, and the disinfection of cargoes and baggage, are more thorough and efficient, because the agents employed can be more easily manipulated, moi-e readily con- trolled, and therefore successfully applied. Hence there is reason to hope that the disease, if not controlled where it has already developed, will be arrested at our maritime quar- antines." The condition of the quarantine of New York prior to the appointment of Dr. Swinburne and the removal of Dr. Gunn may be inferred from an editorial in the " American Medical Times " of Aug. 9, 1862 : — "It has been well said of tlie commissioners of health, that they 'perform the same relative service in regard to the public health as would a fifth wheel in the progression of a coach.' The principal duty assumed by the health com- missioners is the supervision of the quarantine. There is 94; A TYPICAL AMERICAN. here a wide field for useful labor, did they but apply them- selves industriously and conscientiously to the interests committed to their cliarge. It is but too well known that gross abuses have always existed in the manao-ement of our quarantine. The confidence of the public in that board, never strong, has been greatly weakened by its recent action, which sent yellow-fever afloat in this community. If we ac- cept the intimations of the ' Richmond-county Gazette,' this body is negligent of its duties, and allows the quarantine to be so managed as to render the occurrence of an epidemic of yellow-fever this summer not improbable. Vessels are allowed to come to the upper quarantine station with yellow- fever on board, and, immediately after the removal of the sick, the vessel has discharged its cargo at our wharves. Tlie conviction is firm, and rooted in the popular mind, that all of these organizations are subservient, not to the public interest, but to the interests of individuals or of party. And this con- viction is not based on any trivial circumstance, but has been the growth of years of observation of the grossest official malfeasance. They have seen a terrible epidemic approach the city with steady step ; but no barrier was raised to stay its progress, because the proper authority did not care to call together the Board of Health, justly esteeming the latter more dangerous to the public health than the former. It will re- quire something more than mere assertion to make it evident that the health commissioners do little else than give official sanction to the extortions of the health-officer." In another article, the "Times," in an editorial on the pros- pect of health reform in New York, said, — "Quarantine, managed for the pecuniary benefit of the few, is become a formidable obstruction to commerce, but a ready method of introducing epidemic diseases directly to the city. Disease of every form and variety stalks abroad unchecked and unrestrained by the ignorant and corrupt officials who disgrace the health department." The " Richmond-county Gazette," in 1862, in commenting on the defeat of the New- York health bill by the Legislature, said, — "We don't blame Dr. Gunn so much as Mr. Opdyke, if at all, seeing that he had a motive which, leaving supreme selfishness out of the question, might be called a candid one. His pocket was in interest to defeat the bill for at least an- HON EST AND FAITHFUL. 95 otlier yciir, should liLs good luck in diawing the prize of rich office continue under the next governor, as it htiH for four years under the j)resent. Dr. (iunn woidd have received, under the bill, about -'110,000 for the year. liy its defeat he is secured in $30,000 gross, and at lea^t *20,000 or $25,000 net revenue." "To put the right man in the right place would be a novelty in the history of quarantine," said the "American Medical Times." That was exactly what Govs. Seymour and Kenton did in appointing Dr. John Swinburne, as the history of quarantine before and after his term as health-officer undeni- ably demonstrates. That the right man was in the right place during Dr. Swinburne's term, was attested not only by the reports of commissioners years after liis removal, but by the Board of Health in 1873, wlien, in their report for that year, in giving the death and sick rates of the metropolitan and police districts of New York for the year, they said that in 1867, 18G8, and 1869 it fell to a minimum rarely if ever reached in that city ; the mean riitio for these three years being equivalent to about 26 in 1,000 annually, in a total population of 985,100, while in 1873 it was 29, in apopuhition of 1,000,000. During that period. Dr. Swinburne was, by virtue of his office as health-officer, a member of the Board of Health, and during 1867 had to meet small-pox, cholera, and yellow-fever arriving from a large number of infected ports. It was of 1869 that the commissioners said, "These statistics are without a parallel in the history of quarantine," and in 1870 said, "The scourge of cholera made 1866 and 1867 memorable in the history of quarantine." A most remarkable instance in his term at quarantine, and illustrating how thoroughly he was qualified to be the " right man in the right place," was, that during the entire time there was not a death from any of the diseases he met at quarantine among the employees, and no cases of sickness that he had heard of coming from the diseases, notwithstand- ing it was their duty to care for the sick, bury the dead, and cleanse and fumigate the vessels on which sickness liad existed. CHAPTER VIII. UNDER TWO FLAGS. Winning Laurels in other Lands. — Siege of Paris. — American Ambulance. — Only Successful Surgeon. — A Touching Scene. — Always at the Front. — Distinguished Installation. The change of scenes in the great drama of life, in which men and women are the actors, and where only the angels are allowed to be lookers-on, passed so rapidly, and presented in such rapid succession this remarkable and eminent man in the leading rdle^ that one is almost persuaded to believe that the presentation is the production, by the dramatist, of a mythical character drawn from the imagination. With a vast majority of human beings, the excitement, philanthropy, and danger attending the career of Dr. Swinburne, as recited in the chapters already given, would have been sufficient, in the life of any single individual of the most thoroughly patriotic, philanthropic, and American impulses, to afford material for a biography replete with thrilling incidents and eminent achievements. But the events following those already recited furnish a still more intensely notable period, eclipsing any previously enacted, and winning again for him a crown of glorj^ in other lands, of which every American may feel justly proud. Among the galaxy of names adorning the history of this nation in patriotism, science, the arts, and literature, a page is reserved and a niche provided to commemorate, as one of the most brilliant, the fame of Dr. John Swinburne. Of a clear night, when one turns the eye heavenward, the vision beholds the whole arch above studded with stars, sparkling as so many diamonds, each reflecting a greater or lesser degree of brilliancy. They are all stars, and differ only in their magnitude, while the number is countless; but, of all UNDKR TWO FLA(iS. 97 these constellations and celestial bodies moving around each other, there are but comparatively few sufTiciently grand to have specially called the attention of astronomers and the world. Occasionally, among these dwellers in ethereal space, there appears a comet, whose advent is a matter of wonder- ment, and whose luminous train presents a magnificent track over which it has passed, obscuring the others. More bril- liant it grows as it approaches its zenith, and then passes away, leaving an enduring remembrance of its magnitude and beauty. So it is with the dwellers on this terrestrial globe : some reflect no beauty; others, but a scarcely perceptible twinkling ; while others are like the swift-darting stars, mov- ing from one point to another, steadfast as the sun, and whose lives on earth leave a course behind them as brilliant as the comet, and as clear as the Milky Way. This class is limited. Only to a ver}^ few is it given to attain permanent brilliancy, and to be noted almost simultaneously in many nations and on two continents. Among this class we believe unwritten history for ages to come, both in this nation and in Europe, will enter the name of the man of whose valor on the field of battle for the preservation of his nation, of whose eminence and skill as a physician and surgeon, and of whose scrupulous honesty, executive ability, and superior science in a great official public position, we have been reciting a few incidents taken from actual life, and not drawn from imagination. Having been taken a prisoner of war, witnessed the misery there endured, and felt all the gnawings of privation and hun- ger, it would be but natural to suppose that an exercise of dis- cretion, said to be the better part of valor, would prevent him from again placing himself where he would possibly have to re-endure the same hardships. Yet, strange and anomalous as it may appear, this skilled physician and surgeon, with the recollections of his last military campaign as a prisoner of war, from which he had not wholl}' recovered, and but re- cently relieved from official duties amidst pestilence and dis- ease, voluntarily enters a city in another nation, whose walls were being surrounded by an enemy, to give by his skill aid to the sick and wounded, with no music but the tramp of 98. A TYPICAL AMERICAN. armed hosts, the bellowing of cannon, the bursting of shell, and the shrieks of the wounded and dying. When superseded as health-officer of the port of New York, at the opening of the reign of plunder under which New- York State suffered under Tweed, he returned to Albany, the city of his former residence, where he met with a recep- tion and greeting such as is accorded only the eminent and great. Among the first to give him a cordial greeting was the Albany Medical Society, who, to reflect public sentiment, and to express the honest feeling of the profession of the county at an official meeting on Feb. 7, 1870, unanimously adopted the following preamble and resolution : — " Whereas This society has been informed that Dr. John Swinburne has purchased his former dwelling-house for the purpose of removing his residence to this city : therefore " Resolved That the Albany-county Medical Society has heard with pleasure of his intended return, and extends to him a cordial welcome, and that the president and secretary are requested to write him a letter expressive of these senti- ments of this society." At the time of the adoption of this resolution, none better understood the ability, character, and standing of Dr. John Swinburne than this society of medical men, holding all kinds of political views ; and, when the letter was received by him, it bore the signature of almost every member of the society. The active life of constant professional anxiety, of unre- mitting toil and excitement, which he had passed through during the previous decade, had necessarily strained his ner- vous system to more than an ordinary tension ; and, when the hour of relief arrived, it was natural, at the thought of re- sponsibility being lifted from his mind, that, nature asserting its rights, he should desire relaxation and rest for a time; and, seeking a change of scenes, he left for a trip through Europe. But the fame of the great surgeon and physician had pre- ceded him ; and, soon after his arrival in London, he was apprised of the fact that his skilful services in the cause of humanity were as anxiously sought in the Old World as they UNDER TWO FLAGH. 99 were in the New. A new theatre of action was opened, upon which he entered, tliat gave a cliange of scenes pre-eminently more exciting than he sought, if it did not afford the recrea- tion and rest he crossed the Atlantic to secure. At this period, war, with all the horrors the doctor so well understood, was spreading over the fruitful valleys and along the beautiful rivers of France; and two nationalities, for whom the great American physician and surgeon entertained a feeling almost akin to that he felt for his own countrymen, were slaying each other in bloody conflict. When the clouds of war were gathering, and the murmurs were portentous of what followed, a large meeting of American citizens residing in Paris was held in that city on July 18, 1870, when it was de- cided that they as non-combatants would organize a system of " Help for the Wounded of All Nations" on strictly humanita- rian grounds, and elected as an executive committee Thomas W. Evans, M.D. (president), Edward A. Crane (secretary ),Col. James McKaye, Albert Lee Ward, and Thomas Pratt, M.D. As late as the 26th of August neither the French minister of war nor the representatives of foreign governments would guarantee to recognize the proposed American ambulance at any headquarters, asserting no special passports could be ac- corded it, and adding that all movements made by the ambu- lance must be at its own risk and that of its personnel. Besides these obstacles, there was a feeling among the French soldier}^ that all foreigners not attached to some branch of the French army were Prussian spies. This was the condition of affairs when three members of the committee, indorsed by Minister Washburn, visited London, and solicited Dr. Swinburne to accompany them to Paris and voluntarily take charge of the American ambulance, and introduce, for the sake of humanity, his system of conservative surgery which had proven so great a boon daring our civil war. It must, in this connection, be remembered, that every service to be rendered was to be voluntary, each person attached to the ambulance bearing all his individual expenses. Because of discouragements, the zeal in the movement had largely sub- sided ; but on the appearance of the committee in Paris, ac- 100 A TYPICAL AMERICAN. companied by Dr. Swinburne, a new vigor was infused into the movement, and it was restored to its activity. The doc- tor, when appealed to, did not stop to consider the merits of the questions over which these nations were exercised, and which they were endeavoring to settle by the cruel arbitra- ment of war: he thought only of the sick and wounded, who would " no longer be soldiers, but men," and, accepting the call, repaired to the gay capital, a city of excitement and communism, to take charge of the American ambulance. From his arrival in Paris on Sept. 7, 1870, to March 18, 1871, during the Franco-Prussian war, he found an ample field for the exercise of his natural promptings of humanity, tender- ness of feeling, and skilful abilities, all of which he exercised in such a manner as to win not only the praises of the French themselves, but of their enemies and all Europe, and to be honored with a rank such as few foreigners were ever ac- corded by the French Government. During his stay there, times were unusually exciting, even for Paris : the empire v/as destroyed, and the republic estab- lished ; the cry of " Vive I'empereur! " turned to bitter curses against the emperor and all his officers ; and the air was made to resound with the cry, "Vive la rdpublique! A bas I'empereur!" "The gayest city in all the world" became transformed into one of the most extreme suffering, the resi- dents being reduced to the eating of horse-flesh and similar food. In the winter season it was almost impossible to pro- cure fuel, the inhabitants dying of cold and starvation. To these sufferings were added the prevalence of small-pox. No person within the walls of Paris, during that period of suffer- ing, lived without enduring some, if not all, of these hard- ships, besides being constantly subject to slaughter by a communistic outbreak, or death from the bursting shells con- stantly falling in the city. From the closing of the gates on the 18th of September, to the capitulation and surrender in January, the heroic doctor was ever alert and at work. The scenes of want were hor- rible and beyond description, with no meat or solid food to eat excep horse-flesh and fat, the disagreeable odor which UNDER TWO FLAGS. 101 it gave out, while cooking, haunting the wliole city. Half the northern portion of the city had been transformed into ambulances, and places for the care of the sick and wounded, the Grand Hotel being turned into a huge hospital. The continuous fall of shells in the city, often bursting among the hos[)itals and ambulances, killing the sick and wounded and their attendants, was a trying ordeal for the non-com- batant volunteer American surgeon. The condition of that city where "our" philanthropic surgeon was performing voluntary service such as to excite the wonder of the people, and the admiration of the profession, may be faintly surmised by the state of affairs when the years 1870 and 1871 came together. For the last week in 1870 there were 3,280 deaths in the city, not including those in the hospitals, which were crowded. From 400 to 500 deaths were caused by small-pox weekly, while typhoid-fever and bronchitis were causing an equally great mortality. At that time, for food, the butchers bought large dogs at from 200 to 300 francs each, smaller ones bringing proportionate prices; cats varied in price from 9 to 25 francs each ; and a pair of camels sold, for food, for 4,000 francs. Dr. Swinburne, in the carrying-on of his work of mercy, had the active co-operation of his countrymen residing in Paris, and for his assistants chose men who were wholly ignorant of medicine or surgery, but who were in financial circumstances such as to enable them to devote their entire time to the work, and bear their own expenses. His chosen assistants were Frank M. O'Connell ; J. B. B. Cormack, son of the physician in charge of the English hospital, who desired that his son should be trained by the great Ameri- can surgeon ; Louis Winfield, a brother of Lord Powers of Powerscourt, Bray, Ireland; Gilead Peet, a literar}' student; Joseph K. Riggs, a brother of the then prominent Washing- ton (D.C.) banker, and Frank Riggs, a nephew, and now banker in Washington, D.C. ; and the two Bower brothers, proprietors of an establishment for the preparation and sale of chemicals used in laboratories. These gentlemen were absolutely ignorant of the methods to be used and the 102 A TYPICAL AMERICAN. services to be rendered by them in this new and voluntary field, all of whom rapidly acquired a proficiency in the treating of fractures and gunshot wounds, and the dressing of wounds, thus practically illustrating the theory of Dr. Swinburne in therapeutics, — that men whose minds were free from the old established rules and ethics of ancient, unenlightened, and traditional surgery, and who had not to exhaust time in unlearning what they had studied, became more easily better assistants. In a few days he had suc- ceeded in making better assistants of these gentlemen than many graduates of the Hotel Dieu, the greatest and oldest hospital in Paris, after years of training in the dressing of wounds, — a fact conceded by the French surgeons and the people. Of one of these assistants, Joseph K. Riggs, a writer quoted by Dr. Evans in his " History of the American Am- bulance in Paris," said, — " I never shall forget the surprise I felt on the yery day of the affair at Chevilly, at seeing Mr. Riggs in the operating- room, assisting Dr. Swinburne, then engaged in amputating a thigh, and that with all the sang-froid of a veteran sur- geon. Daily accompanying Dr. Swinburne in his visits, he soon qualified himself to discharge all the duties of a sur- geon's assistant, and became, perhaps, the most expert dresser in the ambulances." The work performed at the American ambulance was not done in secret, and the eminent surgeon did not put his light under a bushel. He was willing that all who were ready to profit might see for themselves, being particularly willing, the French journals said, to explain to the profession, and those engaged in alleviating pain, this simple yet grandly successful system of conservation in surgery. Among the almost daily visitors to the American ambulance were Minister Washburn, and the consul-general for the United States, Gen. Reed. Gens. Burnside and Sheridan, while in Paris, made frequent visits to the ambulance, expressing the greatest pleasure at the successful work there being done. Almost all the foreign notabilities who were admitted into Paris during the siege, or arrived in the city after the sur- UNDER TWO FLAGS. 108 render, heard of and visited this aniljulance. Among other prominent personages who honored it with tiieir presence was the Arcld)ishop of Paris (I)arboy), "who, after expressing his sincere thanks to tlie skilful surgeon Dr. Swinburne, who performed the operations, and to those who aided him, who brought as much of heart as of science to this generous work, left, after blessing all the tents, and the gentlemen connected with them," says "La Semaine Religieuse de Paris" of Nov. 26, 1870. So universal had become the renown of the celebrated American surgeon, and the work of the American ambu- lance, that it seemed all Paris was desirous of paying homage to those engaged there ; and it was no uncommon sight to see thousands of people standing in the avenues, looking in wonderment at the row of tents, one eye-witness stating that the Avenue L'Impdratrice, eight hundred feet wide and three miles long, was crowded from the Arc de Triomphe to near the Bois de Bologne for nearly two miles every pleasant day, to see what the Americans were doing. So loud were the praises bestowed, that the attention of the government was directed to it, and it became the object of many official visits, one by the military governor of Paris. Of this visit, says "Le Petit Moniteur" of Nov. 6, "Last Sunday Gen. Trochu visited the American ambulance, and expressed his complete satisfaction with the admirable installation of the dififereut services, as well as with the care taken of the wounded." After the close of the siege, and the declaration of peace between Germany and France, Dr. Swinburne, on March 18, 1871, took his departure from Paris; but the ambulance, and the gentlemen he had trained, remained, and did noble ser- vice in the era of blood that followed and deluged that city. Soon after his departure the gates of the city were again closed, and a reign of terror and plunder inaugurated by the nationalists and communistic elements, that continued with- out cessation until the capture of the city by the govern- ment. Men were arrested, and shot in cold blood, as was the Archbishop of Paris, whose only crime was his exalted posi- tion ; churches were sacked, the services stolen, the images 104 A TYPICAL AMERICAN. desecrated, and dressed in attire of the most diabolic and wickedly brutal nature ; and priests and the best citizens were thrown into prison. Nothing was wanting but the guil- lotine to complete the horrors of this barbarous and hellish state of affairs. The city was reduced to a condition of ab- ject terror in which no man was safe in life or property : the prisons were filled, the hospitals crowded with the sick and the wounded, the atmosphere heav}^ with the shouts of wild and maddened men and women, the streets red with human blood, and the highways and public buildings mined, and pre- pared for destruction ; for the commune had declared its in- tention to blow up and set fire to Paris rather than surrender. All avenues of escape were closed. Provisions were again run- ning short ; and M. Theirs had declared he had shut up the insurgents to perish like rats in their holes, while they, in turn, had declared their resolution to die, if need be, amidst the remains of their beautiful city. One scene in this carni- val of death between the forces in the streets of Paris, and the part the ambulance took in the affair, was given in the "London Times," and afterwards incorporated in McCabe's history. The writer said, " I waited in the entry of the am- bulance for an hour. I saw for a quarter of an hour one wounded man carried into the one I was near every minute, for I timed the stretchers by the watch. Looking into others, I could see the courtyards littered with mattresses and groaning men." Through all these scenes of blood and communism, the corps trained by Dr. Swinburne were true to their teach- ings to save, and continued their work of mercy. It was during this state of affairs that one of his assistants, Frank M. McConnell, at the personal risk of his own life, succeeded in enabling over thirty priests to escape from the city by attaching them to the ambulance, and attiring them as at- tendants in the ambulance costume ; thus enabling them to escape from the city, and thereby saving these Christian men from horrible deaths at the hands of the bloodthirsty mob. He was constantly in attendance on the archbishop up to the time the good man was shot. UNDER TWO FLAGS. 105 What a hriglit picture tliis conduct of r3r. Swinburne and his assistants, in working for humanity, presents, compared to the dark and bloody record to blot the fair escutcheon of American citzenship, as made by Cluseret and Whitton, the only two leaders among the insurgents claiming to i)e Ameri- can citizens ! The first were as that of angels from the re- gions of the blessed, on a mission of mercy; while the others were as emissaries of destruction, sent from the bottomless pits of Hades. The history of the work of Dr. Swinburne in Paris was fraught with unprecedented success, causing a just pride among the American residents of Paris, and drew forth uni- versal and honorable comment from those in official position, ^from authors, the press, and scientific men, who heretofore indulged the idea that America, while a great nation, was still, in the developing of science and scientific men, as a "babe in swaddling-clothes." The citizens of the capital city of the great State of New York feel a natural pride in read- ing these comments of other nations on the achievements of one of their fellow-citizens who is eminently of the people. Believing their perusal will arouse a similar feeling of pride, not only among the members of the profession he has so hon- ored, but in the hearts of every America-loving resident in Dr. Swinburne's native State of New York, we collate and condense a few from the man3^ Dr. Evans, in his " History of the American Ambulance," says, — "Every little coterie was ambitious to have its ambulance, which it could direct and talk about. Hospitals had their lady managers, whose sole qualifications were rank, wealth, and the unconquerable determination to keep at the head of fashion, through whatever singular paths it may lead. In these private establishments the doctor often played only an inconsideiable rdle. He did what he was told ; he was obedient and submissive; he was necessary- — and so was the scullion." In speaking of the successful treatment in the American ambulance, Dr. Evans said, " Dr. Swinburne's highly successful 106 A TYPICAL AMERICAN. exemplification of the benefical action of conservatory sur- gery, and of the re-formation of bone, excited the greatest interest among the medical men who visited the ambulance, in which oakum was employed in preference to lint, on ac- count of its antiseptic qualities, and compresses of hot water were mainly employed for dressing, to the exclusion of many of the usual applications. Of seven cases of amputation of the thigh, only four resulted in death ; while, at the ambulance established in the Grand Hotel, every case of amputation terminated fatally, just as is always the case in one deadly ward of the Hotel Dieu (the largest and oldest hospital in Paris), where scarcely a patient amputated has ever yet es- caped death from gangrene or pyaemia. At the ambulance of the Grand Hotel the deaths have been said to have ex- ceeded forty-five per cent of the number of cases treated. However this may be, the administration up to the present time (1873) has declined to make public its record. Now, in the far more economically conducted American ambulance, the proportion of deaths before the engagement at Bougert was only three and a third per cent." A comparison of the results obtained in the American ambulance with those obtained in other ambulances and hospitals show conclusively that the objects those in charge of the American ambulance desired to accomplish were at- tained, — that of demonstrating the excellence of their system of surgical conservation, and the superiority of tents over solid buildings in the treatment of wounds, as well as the importance of hygienic conditions as a means of preventing disease and effecting cures, — essentials so tenaciously insisted on by Dr. Swinburne during his service in our "unpleasant- ness." In paying tributes of praise to Dr. Swinburne and the spirit which impelled him and his associates, and in de- scriptions of the properties and facilities connected with the American ambulance, the press of Paris, official, scientific, religious, and secular, notwithstanding the exciting events that pressed upon their columns, seemed to vie with each other as to which should excel in complimentary notices of UNDER TWO FJ.AOS. 107 the American institution, its Huv^con, pc.rsonnely and installa- tion, a few of which we incorporate. In (lescrihinf^ a visit to the arnl)nlance, M. Picard, in an editorial in^'Electeur Libre" of Oct. 3, 1870, said, — "Yesterday we visited the .Vmerican ambuhince. Is it necessary that we slioiild dwell upon the scrupulous cleanli- ness of this ambulance, or the assiduous care with which our wounded are there treated? It is truly touchin(( to sec these foreigners of wealth thus giving themselves up without re- serve to this humane work. We have seen these gentlemen assisting the surgeons in their duties, holding the limbs of patients, and engaged in all the details of dressing wounds, and that, after having yesterday been under the fire of the enemy, to pick up these same wounded. These generous men would be unwilling to have us give their names to the public. All that we are able to say is, that their benevolent devotion and their indefatigable ardor assure to them the gratitude of France, whose friendship was long since gained by the States of the American nation." The humanitarian work of Dr. Swinburne and his corps of assistants was gratefully appreciated by the French people ; and in reflecting their opinions, " Le Reveil " of October, 1870, said, — "Never was a sacred work of sacred humanity better con- ceived, or better put in practice, than by this band of gener- ous and devoted men, who, able to find security everywhere else for themselves, their families, and their fortunes, have preferred to remain in our midst, to encourage us by their presence, and, with open hearts and open hands, to give us their sympathy, their aid, and their succor — fraternal and so practical — in the terrible crisis through which we are pass- ing." The " Journal Officiel de la Republique Francaise " (the oflScial journal of the French Republic), on Nov. 27, 1870, said in an editorial article on the American ambulance, occu- pying two entire pages of the paper, among other things, — " It is now understood how it is brought about that one may breathe under the tents only an air warm and healthful. And is there occasion for being astonished, that, as a conse- quence, where the American system is applied, everybody 108 A TYPICAL AMERICAN. should be absolutely ignorant, or as much as it is necessary to be, not onl}^ of what purulent absorption (scientifically called pytemia) and hospital gangrene may be, but even of the fever, which is not a necessary consequence of a wound ? " Every morning, Dr. Swinburne, a gentleman as modest as he is well informed, accompanied by his aids, attends to the dressing of wounds. Formerly port physician of the city of New York, he was travelling in Europe when the war broke out. His devotion has kept him here, to assume the noble task which he is fulfilling with such admirable skill. Aid Nature instead of affronting her, — such is their device; and such is henceforth, we know, that also of our greatest French practitioners. It is forever the admirable and simple expression of our own Ambrose Par^, ' I dress his wounds : God cures him.' " We hardly need to add, after all this, that at the Amer- ican ambulance every one is a declared partisan of conserva- tive surgery, that delicate art which is happily also in honor among us. " And now a word about those who extend these unre- mitting attentions to our wounded, who generously offer them these effective consolations. Shall they find us indifferent ? No. How could we fail to recognize that which they are doing for us, if it was only by showing how singularly prac- tical are the ideas of those excellent surgeons who have come from the other side of the Atlantic to [)lace at our service, with so much generosity, their incontestable science and their indefatigable devotion ?i " We shall be excused for having passed over in silence many technical details to which we might have usefully re- ferred ; but we should not have accomplished, even now, half our task, had we stopped only to enumerate the new curative expedients, perhaps still unemployed in France, — in a word, the innovations of every sort for which hospital science is indebted to the Americans." The " Union Medicale " of Feb. 4, 1871, said,— " Let us hope this new experiment will not be fruitless, and that it may confirm the results already obtained. While the genius of destruction multiplies its ravages, and accumulates 1 The writer is enthusiastic over the system of heating and ventilation. "The temperature," he says, "was uniform tlirougliout the whole lenj^th of the pavilion, ranging from 15° to 18° (Centigrade). In fact, nothing could be simpler or altogether more ingenious than the system of heating and ventila- tion employed here, for it is the system of heating whieh secures the veiUiiation." UNDER TWO FLAOH. 109 ruins, it is a consolation to believe that tlie genius of conser- vation — less jjowerfiil, alas ! — has been able at the same time to make a step for ward. We shall be ha[)i)y, if, in the midst of these bloody oi<^ies of force, we Jiave been able to save a lives more than formerly." This notice of the "Union Medicale," of the conservative surgery practised by Dr. Swinburne for six months in a city where are all the leading surgeons of Europe, is significant, coming as it does from a scientific journal which never draws conclusions, or advances a recommendation of any kind in medical ethics, until it has well tried the subject, and is posi- tive of results. Early in the siege, this at first called innovation introduced by the American surgeon, John Swinburne, began to draw attention as above the others of the numerous ambulances, and on Oct. 31 the " Paris Journal" said of it, — " We soon, however, began to hear it admitted, not only that the Americans were laboring most earnestly in a humane manner, but that unusual successes were rewarding their ef- forts. The American ambulance established in the Avenue Uhrich is one of those which, up to the present time, has given the best results in the curing of wounds. After the battle of Chevilly, Dr. Swinburne and his assistants obtained from the Prussians the restitution of a number of wounded French, all severely wounded; and their care has saved them all." One of the instructions to the ambulance attendants was to bring in the most severely wounded as quickly as possible. That this order was well carried out may be seen by an item in " L'Universe " of Nov. 1 : — "Upon the Flanders road, deserted and gloomy, obstructed at every step by trees which lay in the way, we met the American ambulance, always at the very front (au premier post) whenever it was a question of comforting courage in misfortune." "La Semaine Religieuse de Paris" said, — " Their ambulance may also be said to be a model of its kind. Setting out with the principle that hospital wards, where the sick are commonly heaped together, are, to use the expression of Cabanis, ' magazines of corrupt air,' the Americans have 110 A TYPICAL AMERICAN. lodged our wounded under tents grouped together in pictur- esque disorder, yet separate one from the other. The whole medical apparatus is carefully concealed : it only appears when indispensable. There are no herb-teas : these are replaced by wine. The drugs are purchased of the butcher, and the apothecaries are left to advertise." " Le Nationale " of Dec. 11, 1870, in an article, said, — "Among all these ambulances, whether old or new, which exist in Paris, there is one distinguished by its organization, and particularly by its system of installation, — the American ambulance." M. Lafarge, in a lengthy article on V ambulance Americaine, published in " Le Figaro " on Jan. 26, 1871, said, — " About halfway down the Avenue de I'lmp^ratrice, on the right, you perceive a number of tents — not a large number, a veritable little city of canvas : it is the American ambulance. You are at first surprised that the wounded can be treated almost in the open air ; but if you enter, you will very quickly change 3'our first impression. . . . Let no one fear that bron- chitis and other diseases of the respiratory organs have been occasioned by this practice. Facts have settled this question. ... In the very coldest weather, a sufficient tem- perature can be maintained inside of the American tents. During the severe weather of December, when the cold was ten or twelve degrees below zero (Centigrade), the tempera- ture was maintained within the tents at from + 12° to + 15°, and that without forcing the fire. . . . Go and visit the American ambulance : not only will you meet there with the most gracious reception, but you will obtain from the lips of the wounded themselves the expression of their lively grati- tude for the intelligent care they are receiving." Comments like these quoted, all from leading journals and authorities, speak volumes of themselves, and breathe praises such as the French press, always jealous to maintain the high- est positions for Frenchmen, never before bestowed on any for- eign surgeon. To comment favorably was but natural, under the circumstances, and might be expected from the grateful feelings and naturally complimentary Frenchmen ; but pla- cing the American surgeon's system of conservative surgery as eminently above their own, and one they would adopt in the UNDER TWO FLAGH. Ill future, was only accorded on pure merit, particularly as the press had their own ambulance, of which they were extremely jealous and ])roud. These press notices are rendered the more valuable when such eminent literary men as M. Sarcey, and such scientists as M. Desault, go still further in accord- ing the palm of excellence to Dr. Swinburne, his corps and ambulance. CHAPTER IX. THE WONDER OF SCIENTISTS. These People are our Masters. — Great Results with Small Means. — Conser- vative Surgery. — Remarkable Operations. — Surgeon Par Excellence. — Only Success. — The Field-Stretcher. Francisque Sarcey, a distinguished literary gentleman, in " Le Temps" of Dec. 21, 1870, and in his work entitled " La Si^ge de Paris," a book that ran through twenty-four editions in six months, said, — " I met, a few days since, one of the thousand acquaintances which every Parisian, a little known, has upon the Boule- vard, — a physician by profession, distinguished, I might also say celebrated, in a surgical speciality, and who, like most of his confreres.! is attached to one of our numerous ambulances. The conversation fell naturally upon the subject of ambu- lances. He was full of it ; and it happened also that I was a little acquainted with it, being very intimate witli one of those persons most occupied with the direction of the ambulance of the press. I had also studied with great care the remark- able work by Dr. Chenu, with the intention of making in my turn, and with his facts, a campaign against the organization of the medical service in our armies. " ' You are interested in this ? ' said he. ' Very well. And you have very probably visited the American ambulance ? ' " I confessed that I had not. " ' Then I must take you there. Ah, my friend ! those peo- ple there are our masters. How simple, ingenious, and prac- tical is every thing connected with its organization ! It is made of nothing, as we should say. Their installation has scarcely cost twenty thousand francs ; and they have a hospi- tal the most healthful, the most convenient, and the best fur- nished, — the model hospital, — the hospital of the future. Our most eminent physicians have visited this ambulance. I have met there Ndlaton, Record, Jules Guerhi, D(3marquais, and others. They have pronounced it excellent. Every physician in Paris should go and see, and convince himself Til 10 WONDER OF KOI I0NTI8TH. 113 with his own eyes of ilio Hiii)eriority or' the American instal- Lition. Th(! [)uhllc should conie to tlie rescue, that adminis- trative routine may he forced out of its al)siird j);i.tlis hy a vi b > - ^ b ^ ^ 2 p r o W ■-t •-1 _ f V f -*-'! THE WONDKIl OK SCIENTISTS. 115 by establisliing two siiriilur tent hosj)ital.s. . . . At the Ameri- can ambulance the deaths liave been only five percent; of seven amputations, only three have died; there has not been a single case of hosjiital gangrene, and not one case of f)uru]ent infection. These figures speak for tliemselves, and suiiice to demonstrate the superiority of the American system." M. N(3laton, one of the most illustrious representatives of French medical science, on a visit to the American ambulance, left on the visitors' book this significant indorsement : " You have here shown what great results may be obtained with small means." Jules Guerin wrote that he was happy to echo the same sentiment, as did Demarquais; and Baron Larry, before the Academy of Sciences, declared that the American hospital system was most complete and favorable. M. Ndlaton was the celebrated French physician and sur- geon called to examine the wound of Garibaldi, and who declared the bullet was still in the wound, indicated the time when it could probably be removed, and predicted a favorable result. This opinion was directly the reverse of that given by the English surgeon. Partridge, who, in his opinion, was supported by the Italian surgeons Porta and Barretti, and afterwards by Pirogoff, the celebrated Russian surgeon. Events proved N61aton was correct, and his opinion triumphed. By following his views, the physicians attending Garibaldi happily succeeded in removing the projectile. Partridge's visit and blundering surgery cost three thousand dollars ; while Nelaton, the true surgeon, went to Italy without fee or reward. Among the appliances more directly concerned with surgi- cal science, used at the American ambulance, and which found great favor among the surgeons of Paris in the treating of suppurating wounds, the merits of which were previously unknown in France, was the employment of oakum as a substitute for cliarpie ("lint"). "Indeed," Dr. Evans writes, "the interest taken by the medical profession of Pai'is in every thing which concerned the ambulance was \Qvy great. Scarcely a day passed in 116 A TYPICAL AMERICAN. which some well-known name was not entered in the list of visitors. No sentiment of professional jealousy was ever exhibited ; no exclusive feeling of nationality was ever mani- fested : there was but one sentiment, but one feeling, among all, — that inspired alike by an earnest desire that the history of the experiment might tend to the establishment of some new truth to the honor of science and the benefit of mankind from the first-fruits of a New World's experience, brought to the very shrines of venerated oracles, to there compete with the established principles of ancient tradition, and even with the practice of classic surgery." That these honors and expressions of gratitude from a notably brave and proud people were justly earned, may be realized from the actual results of the surgical treatment by Dr. Swinburne. Most, if not all, of the eminent surgeons had discussed the theory of conservation in the treatment of the wounded, but had failed to enforce it in practice, it was so foreign to the old-school system to which they had been educated. When introduced by the great American physi- cian and surgeon, it was absolutely regarded as an innovation rather than an advance in science. Yet these opinions and comments quoted prove how promptly the great scientific minds of that city availed themselves of the ideas and prac- tices they witnessed, with their good results, and in the interest of science, and for the good of humanity, declared their purpose to adopt them. They believed their surgeons were equally scientific with the great American, and indeed insisted the}^ were more proficient. Yet here were facts ; and the truly honest searchers after knowledge knew that theory, when contrasted with facts, vanishes as rapidly as the spar- kling dewdrop is kissed away by the rising sun. Here were results upon which these learned men were to decide as to the claims for pre-eminence for conservative surgery, and the simple means adopted in dressing wounds. The comparisons were conclusively convincing. At the American ambulance the most severely wounded were treated, because the corps of stretcher-bearers had specific orders, which were rigidly en- forced, to look after these, as they were in need of the earliest THE WONDER OF SCIKNTISTS. 117 possible attention ; and tlio American ambulance corps, be- ing always iirst to the front, picked up the most seriously wounded. And yet, of the £^7 surgical cases treated^ only 47 died, of all causes. Of these wounded, 12G received com- pound fractures, some having two or more comminuted frac- tures. During the siege, there were but 9 amputations of long bones; 7 of these being of the thigh, 5 of tiie wounds being through the knee-joint. The ambulance Rothschild, in charge of Dr. Job, situated on high ground, with all proper ventilation, and considered one of the very best in Paris, was provided with ample nourishment and food for the sick ; while in the other hospi- tals and ambulances it was about all those in charge could effect, when they secured sufficient nourishment to keep life in the patients, some of them failing even in this. Yet at this luxuriantly supplied hospital there were but 56 wound- ed men treated, 10 of them dying of their wounds. There were but 4 amputations performed, all proving fatal ; and in every case but 2, where the bones were involved in the wounds, all died. At the ambulance of the press, under M. D^marquais, 281 wounded were treated prior to Feb. 1, 1871; and of these, 63 ended in death. Of 16 cases of wounds of the upper extremities, 13 proved fatal. At the Barracks Hospital at Passey, of the 1,486 wounded treated, 347 died. To these results the medical profession of Paris, at least the learned, expert, and scientific portion, — and at that time it embraced eminent men from all portions of Europe, — would not allow prejudice to obscure their better judgment, and were not only willing, but anxious, to adopt this course, and re-learn how to treat the wounded. Among the celebrated surgeons in Paris during the siege, from other portions of Europe, was Charles Alexander Gor- don, M.D., C.B., who was sent to that city by the right hon- orable secretary of state for war of Great Britain. This celebrated English surgeon was the author of a number of works on military surgery and hygiene. In his work entitled 118 A TYPICAL AMERICAN. " Lessons on Hygiene and Surgery from the Franco-Prussian War," he quotes from M. Pirogoff, " that the extensive prac- tice of primary amputation has been abandoned, because sta- tistics prove, that, in gunshot wounds of the upper extremity, secondary amputation is as favorable as primary ; that the attempt to save the limb is not, therefore, made at the risk of life ; and that it is to the honor of modern surgery that but few amputations of the upper extremities were made." " Such," says Dr. Gordon, " are the views expressed by this eminent surgeon, and they deserve every attention. Perhaps nowhere," he adds, " so much as in the American ambu- lance, was extensive simplicity of arrangements carried out in the treatment of gunshot fractures : certainly in none were the results more satisfactory. Dr. Swinburne brought to his aid vast experience gained in the war of secession; but the most simple and extemporized apparatus seemed always to have been adopted by him. The appliances made use of depended upon the extent and position of the wounds ; but, as a rule, the more simple their construction, the better." This acknowledged eminent scientific authority, in discuss- ing the treatment in dressing the wounded, said, — " Whether used as an independent application or not, water had to be used for the purpose of cleansing the surface of wounds. Perhaps it was so to a less extent than in the English hospitals ; and, with every respect to our French compeers, there is some room for believing that a more extensive use by them of this simple element would have been to the advantage of the wounded. Moist and hot cloths applied, and covered with oiled silk, were much used in cases of wounds of the long bones or joints, and sometimes to the limbs after amputation. After excision of joints, these, placed along the whole extent of the limb, proved very grate- ful. Their employment was carried out to the greatest ex- tent in the American ambulance. . . . The degree of ease that such simple means will give is remarkable in the case of a wounded limb." In his summing-up of the results of treatments in the sev- eral hospitals and ambulances of Paris, he said, — " We had in Paris, however, in the American tent ambu- lance, undoubtedli/ the most favor able results of any^ taking into The American Ambulance Tents. Witl'i Improved System of Warming- and Ventilation. \ "N \ V Fig. I. — Elevation. YiG. 2. — Longitudinal Section. These cuts of Dr. Swinburne's Ambulance in Paris are taken from Charles Alexander Gordon's Work on "Lessons on Hygiene and Surgery from the Franco- Prussian War." Dr. Gordon is the author of several important works on military hygiene, and was sent to Paris during the Franco-Prussian War by the Right Honor- able Secretarv of State for War of the British Government. THE WONDER OF SCIENTISTS. 119 account the severity of the cases treated. Thus, out of 247 cases treated, there were 126 of compourid fractures, these occurriuf^ in 114 individuals ; yet the njortality auiong all was at the rate of 19 per cent." In commenting on the treatment of gunshot wounds, Dr. Gordon said, — " It is true that the method of treating gunshot wounds of the cliest, as practised by Dr. Swinburne, is condemned hy some surgeons. It is beyond question, however, that the re- sults obtained from it in the ambulance (American) in the Avenue de I'lmpdratrice during the siege were very satis- factory, so far as they went, and of a kind to justify its further adoption. It seems to me, therefore, that in future wars the treatment indicated is this: provided the bullet passes completely through the chest, elose the opening, as Dr. Swin- burne did, and so treat the patient. In several cases Avhere the missile had passed completely through the chest, and pen- etrated one lung, recovery took place with comparatively little constitutional disturbance, and with a rapidity that became matter of wonder. Some of the officers and men taken to that establishment (the American ambulance) with wounds of this nature, their respiration oppressed by blood- discharges from the pulmonary wound into the bronchice, and with blood and froth issuing from the openings in the chest during expi- ration, were treated in the simplest possible way, and success- fully. The usual treatment adopted by Dr. Swinburne was to hermetically close the outer opening by means of adhesive silk.i Little if any medicine was subsequently administered. In cases thus treated from the early periods of the wound, suppuration into the pleural cavities seemed to be averted. The results seemed to indicate that the effused blood was not necessarily a source of danger : that its action was not like that of a foreign body ; and that, as recovery progressed, it gradually became absorbed. In none of the cases thus treated were counter-openings made or required." He then refers to otlier cases treated on different plans, in which puriform effusions and hectic followed the couuter- 1 The plaster referred to by Dr. Gordon was Husband's silk adhesive plas- ter, placed over the -wound, adhering to the chest above the wound, and acting as a valve. The lower portion was kept moist by discharges, on expiration, allowing the blood and froth, pus, and other discharges, to be forced out, and then closing, allowing the air to come in through the mouth and windpipe, and not through the wound in inspiration ; and to this extent aloue was the wound hermetically sealed." 120 A TYPICAL AMERICAN. openings, and then death. In one, the bloody liquid with which the chest speedily became filled was pumped out, and the operation described as brilliant, but the patient died ; and in another, empyema occurred, the chest was punctured for the escape of fluid, and the patient also died. During this period of which Dr. Gordon writes, there were in and around Paris six hundred and thirty-four ambulances, in addition to ten hospitals, and at least three thousand sur- geons from all the nations of Europe, many of them holding the leading places among their professional brethren as physicians and surgeons. It is a remarkable feature in his work, that, out of this multitude of ambulances, he selected the American as the model one in its installation, on which to treat at length ; but a still more remarkable feature was his selection of numer- ous cases treated by Dr. Swinburne, out of the thousands, and the minutise with which he described their treatment and re- sults as of the most vital interest to science. In his book he devotes more space to the work of the American surgeon, and cites more of the cases treated by him, than by any other individual, or, indeed, the whole of the other surgeons com- bined. So necessar}^ does he consider it to be specific in the details of all the methods used by Dr. Swinburne, that he devotes much space to their description, and the appliances and methods used by Dr. Swinburne in placing the patient in bed, and introduces a plate of a common field-stretcher designed and used by the doctor for carrying the wounded from the field, and the treatment of fractures by extension, and upon which they can be treated until well. In describing this stretcher, he says, — " By means of a common brancard (" stretcher ") ingen- iously arranged by Dr. Swinburne, a soldier or officer with gunshot fracture of the femur can be carried with an advan- cing army over any extent of country. Upon one of the han- dles at each end, a bent iron arm, having an eye at one end, was fixed by means of a screw. It admitted of being moved along the handle, or from one end to the other, according to the seat or side of the injur}', and, from those at the head and foot of the extension and counter-extension, could readily be used. A mattress adapted to the dimension of the bran- 70 ^ =^ P 5". XT 1 > e p 3 — CL p n 01 -^ c^ ^- Is-" -'^ cu a o o ^ o 9 fD Ol O) p, 3 «■ "" ? 'T3 HJ c ' cr a H 3 < -1 o ■^ P O t- 2- p '- '!►*' 1^ CO I-" ^ r^ y-S > :^ 3 •Ti ^ 3 P3 1-^ I-* Ci pj ^, ci: 5 :2 pj ^ m Q P3 '-^ f-* cd ,-> X ^ i-i m P r^ CI- 00 o ■M o - GO 3? n CO E :. 3 < 3 g S t^^ 5 y THK WONDICR OK SCIENTISTS. 121 card being provided, transport of a wounded man can be readily effeeted, eitlujr by means ol' two hrancard'w.rs ("car- riers") or by placing;' the litter ujjon a wheeled conveyance. Tiie contrivance is I'lirther so su^roijstive in regard to a (conven- ient method of securing patients with fractured thigli-JKnies on shipboard, that it is commended to the notice of suigeons at sea. Hy means of a staple eye secured in the bulkhead, at either end of a bed, immobility of the ends of a fractured femur would readily be insured." This invention, when first conceived and designed by Dr. Swinburne, was submitted to the medical department of our Government during the Rebellion, and refused, for what rea- son those at the head of the department at that time only know. It was afterwards adopted and put in use by both the French and Englisli Governments. Dr. Gordon cites a case as a very remarkable piece of sur- gerj'', where a wound was received through the lower jaw, and effectively treated hy Dr. Swinburne, showing how such an injury may be treated so as to avert a great deformity. "A soldier was injured in the lower jaw, involving the front of the bone, by a bullet. The soft tissues were dissected back by Dr. Swinburne. The fragments of bone other than the very small ones, instead of being removed, were ingen- iously secured to the existing teeth by means of wires ; the ends of these being twisted off, and their ends protected by a case of wax. A frame was then fitted on to the chin, and moulded to its shape, oiled silk and bandages enveloping the whole. Recovery was progressive, and the deformity scarcely perceptible." This was regarded by the author as an exceptional and extraordinar}' case, and one requiring unexceptional skill in its management, and hence was given to the scientific world as an illustration of what great achievements the delicate science of surgerj^ may accomplish. With the surgeon who performed the operation. Dr. Swinburne, it was not new. A number of years before, the late Col. Jackson, formerly of the firm of Townsend & Jackson of Albany, fell from the win- dow of the second storj- of his residence on State Street to the sidewalk (a distance of fifteen feet), and, striking on his 122 A TYPICAL AMERICAN. head, crushed and fractured the entire jaw. B}' the use of the delicate wire, the shattered bone was brought to its phice and healed, leaving no deformity. He was afterwards killed in battle. "The eminent surgeons," said Dr. Gordon, "whom the writer had an opportunity of seeing operate, had several different methods of proceeding, and of performing the subse- quent dressing. In amputating the lower third of the thigh, a cut was made from the surface upwards and backwards, through the muscles on the anterior aspect of the part ; the posterior flap being afterwards made by transfixing, and cut- ting from within outwards. The flaps, both of which were equal in length, were retracted by means of a fillet, and the bone sawn across ; the vessels were then secured b}' ligature, hand-pressure on the main vessels having been kept up dur- ing the operation. It was remarked, however, that a con- siderable mass of tissue around the vessel was included, and that the double ligatures were generally used, both ends being cut off. The surface of the flaps, after being sponged with cold water or alcoholized water, were brought close together by silver wire and sutures ; linge fenetre^ soaked in gljxerine, was applied ; a large, soft compress to each aspect of the limb supported the flaps ; and a bandage applied from above downwards secured the whole. Other surgeons used the interrupted suture ; and Dr. Swinburne, in one case of amputation of the thigh, left the anterior flap much longer than the posterior : the line of union was thus quite at the back of the limb, and the stump provided was a soft one." In treating the merits of primary versus secondary amputa- tion, Dr. Gordon said, — " So far as tlie experience within Paris went, it simply con- firmed that of former wars, — that these operations must be performed before suppuration has set in, to give them a chance of success. It is pointed out, however, that primary ampu- tation cannot, under all circumstances, be performed. A wounded man may, as not infrequently was the case on the occasion of the great battles before Paris, be so benumbed by cold from protracted exposure upon the field as to put ampu- tation of a wounded limb out of the question, until such times THE WONDKR OF SCIKNTIST8. 123 as [lie powers of tlie body ai'o partly restorod by stimulants and otluir moans ; and, by tin; time; this has boon attained, the period for jjrimary amputation has passed. On the other hand, an amputation may, on some oeeasions, be performed with ultimate success upon a patient in a very great state of weakness." To sustain this latter assertion, he again referred to an operation performed by Dr. Swinburne as an extreme typical case, and said, — " A soldier was brought to the American ambulance in Paris, his leg carried away by a shot. Amjjutation below the knee was performed by Dr. Swinburne while the man was in a state of collapse, and pulseless. The man continued in this state for twenty-four hours after the operation; he then passed into delirium, which continued during four days, the stump being much disturbed in the mean time, the flaps gaping, and the bone projecting. Nevertheless, this man ultimately did well." The doctor himself, soon after his arrival in Paris, wrote to Dr. Bailey of Albany, — " Here I am, within a few rods of the inner fortifications of Paris. I had been in England, Ireland, and Scotland, visit- ing hospitals and other places of interest, until Inst week, when I received notice that I was wanted here. With Louis (my son), I immediately left for this place, where the Ameri- cans have establislied a hospital and ambulance corps out of American manufactures, including tents and about two hundred American patent beds, stretchers, etc. You would not blush for America, could you see these arrangements, and compare them w4th the English, or even the French. In truth, they are the admiration of the place. The soldiers say, if such accommodations were provided them, they would not mind being wounded. I have many things to say to you, on my return, in reference to surgery. Among them is* the fact that the sui-geons of Great Britain do not amputate for disease of any joint, but, on the contrary, resect. The result is, that more lives are saved, and less mischief results from the diseases, than from the old barbarous mode of amputation. Many a mutilated creature maj- bless the day that progress has its swav." CHAPTER X. LIVING ON HORSE-FLESH. Dainty Parisian Dishes. — The Best in Paris. — French Soldiers beg to be taken to the American. — English Compliments. — Most Popular Men. — Living on Horse, Cat, and Dog Flesh. — French Decorations. It used to be an old proverb that " Good Americans, when they died, went to Paris." It was true, a longing desire ex- isted with a large portion of the American people to visit the gayest city of the world, and enjoy its frivolities and sights for a period. But, at the time our noble-hearted philanthropist was drawn to the French capital, the events were more excit- ing, and the gay colors of uniformed regiments more impos- ing, than the traveller usually witnessed. When the iron cordon of the Prussians was drawn around the city, belching forth its fire, and giving to the inhabitants a grand but unde- sired brilliant pyrotechnic display, the position was not com- fortable. When provisions ran scarce, and all the beef had been consumed, and the menu consisted, in part, of horse and dog flesh, whose noxious exhalations, while being cooked, permeated the city, and when " pussy " was a delicate and de- licious dish, it was hardly the place for realizing the celestial aspirations of our pious Americans. But here in this dreamed- of paradise, turned into a purgatory, our humanitarian, Dr. Swinburne, worked with his usual zeal for the good of man- kind, without hope of pecuniary reward, as he did during our Rebellion, and by his great skill won a still greater name, even among those who were wont to believe nothing good could come out of the Western Nazareth. The English press, science, and people were ably repre- sented in Paris during the siege, and while always anxious to believe, and if possible make the world believe, that the best of men came from Britannia, they were at first inclined to LIVING ON HORSE-FLESH. 125 underrate tlie "star" from the West, that had ho siuldeiily appeared to the scientific world. As his works manifested themselves, they became dazzled by their brilliancy, and then chai-med, and finally admitted the superior skill of Dr. Swin- burne ; one English writer asserting that he must be a de- scendant of the Swinburns of Swinburn Castle, after whom the townships of Great and Little Swinburn, near Ilesham, in Northumberland County, were named. The prompt and efficient work of the American ambu- lance made such an impression on the correspondent of the " London Daily News," that in writing to his paper in Sep- tember, after referring to the others, he said, — "The English ambulance is now prepared to fulfil requisi- tions made upon it from any quarter ; and it may be of some use, provided the staff have not consumed, in the mean time, all the medical comforts in aiding the sick in the hospitals of the town and in the fortress. But I submit that it is not sufficient for a concern like the English ambulance to take its ease in its inn. and to intimate in a slipshod way, by casual journeys to the front, that it is in a condition to sup- ply requisitions." In a letter published in the " London Times " Sir J. T. Sin- clair said, " Except the Anglo-American ambulance, under an American physician, which is only partially connected with the National Society for Aid to the Wounded, I believe little good has been done by the English surgeons." Capt. Henry Brackenbury in a letter to the same paper, in describ- ing his visit to the English hospital, in charge of Dr. Frank, tells how Dr. May, attached to an American ambulance under Dr. J. Marion Sims, rode back with them in the dark to show to Dr. Frank a peculiar method of using some particular splint. This splint, and the methods of using it, were first introduced into practice by Dr. Swinburne. A correspondent of the " Loudon News," under date of Nov. 15, said, — " The ambulance in Paris which is considered the best is the American (under Dr. Swinburne^ The w-ounded are under canvas ; but the tents are not cold, and yet the venti- 126 A TYPICAL AMERICAN. lation is admirable. The American surgeons are far more skilful in their treatment of gunshot wounds than their French colleagues. Instead of amputation, they practise ex- section of the bone. It is the desire of every French soldier, if he is wounded, to be taken to this ambulance. They seem to be under the impression, that, even if their legs are shot off, the skill of the iEsculapii of the United States will make them grow again. Be this as it may, a person might be worse off than stretched on a bed, with a slight wound, under the tents of the Far West." He further adds in another issue, under date of Dec. 23, — " At the central ambulance of the Soci6t6 Internationale, the simplest operations are usually fatal. I'our out of five of those who have an arm or leg amputated die of pysemia. In the American tents four out of five recover." This compliment to the skill and ability of Dr. Swinburne, the only American surgeon in Paris at the time, and a very flattering reference to the lady assistants and to the Ameri- can women in general, were republished in the " Diary of a Besieged Resident in Paris." A Paris clerk of Messrs. Bowles & Brothers, London, who had been one of the corps of the American ambulance, in a private letter to his firm under date of Jan. 10, 1871, said, — " Of course 3'ou have heard of our success, — how the Amer- ican ambulance is the model ambulance of Paris ; and how few our losses are, compared with others. Dr. Swinburne is really the only surgeon in the place. It is no easy work, es- pecially after a battle like Champigny, where we had one hun- dred and thirty men come in in two days. I brought in the lirst wagon-load of six at four o'clock, and from that time until the next midnight we were bringing them in. Several were severely wounded, and died that night. Most of the men were severely wounded : we looked for that kind on the field. Dr. Swinburne seemed scarcely to sleep at all, and his aids and the ladies worked like Trojans. We had two Prussians: both were mortally wounded, and died soon after, though the last one struggled on three weeks. It was a wonderful case, for his pelvis was literally splintered. Splendid fellows, both of them, and it grieved us to have them die." LIVING ON HORSE-FLESH. 127 The most populiir foreign representative in Paris during the siege was the Anicriean minister, Wasiiburn, as waa Dr. Swinburne the most popular surgeon. Wherever either appeared, they were cordially greeted. On tiie 27th of Sep- tember, the " New-Yoik Herald's" correspondent said, "The American ambulance corps and Minister Washburn were loudly cheered on the streets to-day. The crowd was so dense, that the new police appeared on the Champs Elys1 ion of the arm to any cf)ii.si(loral)l(; oxiciit), and fiacture of the ulna, with mode of reduction and ti-eatnunit, nine weeks after the injury. 'J'his was tlie ease of a hoy l)elonf^inf( in Denmark, Lewis County, N.Y., who fell, and, striking on the left hand, produced a fracture of the ulna at the junction of the second and lower third, accompanied by a distortion which was not reduced. Six weeks after the accident, several pjhysicians and surgeons who were consulted advised non-inteiference. Two weeks afterwards Dr. Swinburne examined the arm at the seat of the fracture, when he found the ends of the ulna overlappe(I, and united at an angle of twenty-five de- grees, the upper fragment projecting beyond the line of the bone, so as to produce an oblong tumor of an inch in length, and lialf an inch in width, almost protruding through the skin. With a view to reforming this deformity, and restor- ing the usefulness of the elbow, the patient was placed under the influence of chloroform, and the ulna seized above and below the fracture, and by steady efforts the union broken up, and the extremities rendered movable. For ultimate success, it was necessary to maintain permanent extension, both to prevent overlapping of the ends of the ulna, and also to reduce and retain the head of the radius in position, as well as b}'^ a constant and permanent reductive effort to restore the symmetry of the joint, the bones being constantly forced towards their proper places, the effusion being absorbed by the pressure. To effect these requirements, an apparatus was contrived. A full description of the apparatus is given, and the principle involved, which, he said, may be illustrated very easily by simply jolacing a bit of board on the fore-arm, from the fingers to the elbow, fixing it at the joint with the other hand, and then flexing, when it will be seen that the splint extends two inches or more beyond the fingers. This splint, or apparatus, was applied Oct. 24 ; and on the 29th the patient was able to bend the arm to an angle of seventy- five degrees, so that the hand could be carried up to the mouth, with the limb of full length, and the head of the radius in its normal position. When the patient first came to Dr. Swinburne for treatment, the head of the radius rested 138 A TYPICAL AMERICAN. upon the anterior face of the humerus about one inch, and could not be dislodged till the ulna was broken and extended. Nine days after the splint was applied, the ends of the ulna were in perfect apposition, with perfect freedom of motion in flexion, extension, and rotation ; and the boy left for home. In that article he stated that extension could be obtained by two simple boards united by a hinge, and padded so as to be comfortable ; so that in cases of emergency an extemporane- ous appliance could be readily procured. In July, 1859, he contributed an article to the " Medical and Surgical Reporter " on the reduction of the dislocation of the humerus (arm-bone) five months after the accident. This was an interesting case. On the 28th of June, Anson Orrasby of Lewis County came under the treatment of Dr. Swinburne, twenty-three weeks and three days after the accident, to be treated for a dislocation of the left humerus from the shoulder by falling. On the day of the accident a physician treated the dislocation who believed he had suc- ceeded in restoring the head of the bone to its socket, and pronounced the joint perfect. Six weeks afterwards the same physician confirmed his former opinion, and volunteered to warrant a complete success. Nearly twelve Aveeks after the accident the same physician, on an examination, declared the shoulder had been re-dislocated, and labored three hours un- successfully to reduce it. Six weeks afterwards he went to Brovvnville and Watertown, Jefferson County, to seek surgi- cal advice, and was recommended by all whom he consulted to have no more attempts made at reduction, inasmuch as it was considered irremediable after so long a period of time. He afterwards applied to Dr. Swinburne, and the reduction was effected in three-quarters of an hour. The remarkable feature in this case, as set forth in the article, was that the length of time between the date of dislocation and reduction was more than twenty weeks, when it was considered that dis- locations are rarely considered reducible after three months, and that the deformity did not appear immediately after reduction, as is always the case in recent dislocations. The doctor, after detailing the methods adopted, asked, " Is it not REVOLUTIONIZING SURGKRY. 139 possible that siirfreotiH may he sometimes in error, in cases of long Htiuidiiig, IVoin tlii.s circuiTistiiiico, and tliat cases are sometimes ahundoned as irremediahle because of the impos- sibility of restoring immediate symmetry, whereas, by secur- ing the parts as accurately and firmly as possible, the deformity may gradually j)ass away, as absorption of deposited matter progresses, and the head of the bone settles more and more accurately into its natural position?" In the fourth volume of the same work is an interesting paper by Dr. Swinburne on the reduction of a dislocated humerus after eighteen weeks. On Oct. 13, 1859, William Sutliff of Brockett's Bridge, Herkimer County, was thrown from his wagon, and the arm near the shoulder-joint frac- tured. In two months after the fracture had been reduced he had gained the use of his arm, with the exception of utter inability to extend it from him, or raise it to a hori- zontal position. The attending physician, Dr. Walker, sus- pected the cause, and, on making a thorough examination on the 1st of January, discovered that the humerus was dislo- cated downwards and forwards. He was brought under the charge of Dr. Swinburne on the 18th of February, and on the 21st rendered insensible by means of chloroform. The relations of the morbid structures of the shoulder were accurately diagnosed ; the head of the humerus lying in the axilla, as in ordinary dislocations, downwards and forwards. The head of the bone was considerably thickened, and there were indications of great deposits of fibrine in and about the axilla ; so that the motion of the arm was greatly limited. Efforts were made to reduce precisely as in ordinary recent cases. But, undoubtedlj^ from obliteration of the glenoid cavity deposits, the head of the bone would not remain in situ when the extension and other reductive efforts were re- laxed. He then had recourse to permanent and constant means which he had made use of in similar cases with unex- pected results. About the 15th of May, Mr. Sutliff returned home under general instructions, and placed himself under the care of Dr. Walker, who afterwards wrote Dr. Swin- burne, — 140 A TYPICAL AMERICAN. "T continued the dressing you had applied, re-dressing about every otlier da}', till the 9th of April. ... I then discon- tinued all dressing, and advised him to use tlie arm moderately, which lie has been doing ; and he is now working some at his trade (boot and shoe making), chopping wood, planting, etc., and, on the whole, regards his case as a providential cure.'''' This paper, like others by the doctor, gives a minute and comprehensive detail of the case and the treatment, and is of interest to the profession. There are a number of cases similar to these to be found in the practice of Dr. Swinburne in the county of Albany, and other parts of the State, which would be termed remarka- ble if published in the books, but which have never been given to the public. As a sample, we give the case of Mr. William Doyle, a stove-manufacturer in the city of Albany, a gentleman weighing over two hundred pounds, as related to the writer by Mr. Doyle himself. In 1857 he was thrown on the Troy road, and the shoulder dislocated downwards, resting on the nerves. A professor in the Albany Medical College was called, and claimed that he had reduced the frac- ture. For several months afterwards Mr. Doyle suffered the most exci-uciating pain, with the flesh badly swollen and the skin colored. Unable to bear it longer, he called in Dr. Swin- burne, who, on an examination, found that the dislocation had not been reduced ; that the joint, instead of being in the socket, was off to one side ; and that the bones had grown together in this unnatural position. By the use of rubber extension and counter-extension. Dr. Swinburne tore the parts apart again, and properly reduced the dislocation to its normal condition, Mr. Doyle saying it required the power of ten men to break it apart. Notwithstanding the pressure was thus removed from the nerves, it was several months before the nerve-power of the hand was restored, or the pain sub- dued. He considers his ever having the use of his arm still a matter of surprise to him ; and although he has the use of his arm and fingers, and can lift with the arm as with the other, owing to the bone having so long rested while out of place on the nerves, he cannot put his hand to the back of his head, or hold it up for any length of time. REVOLUTIONIZING SURGERY. 141 Anotlier similar case was tliat of a Mrs. Jones, who was treated by a profcissor of the college and another physician for a dislocated slioiilder. Months afterwards it was exam- ined l)y Dr. Swird)unH! and another physician, and was found to be out of joint, and resting down on the nerve. The dis- location was then reduced ; but, owing to the time it had been out of joint, the nerve-power of the hand was destroyed. An action for damages was brought by Isaac M. Lawson against one of the physicians, and a verdict of two thousand dollars recovered. Another instance where the doctor was called to attend a similar professional error, as told to the writer, was that of a lady over seventy years of age, who had sustained a disloca- tion of the shoulder, and had been treated by another profes- sor and an assisting phj'sician, who dressed the shoulder in plaster of Paris. A month afterwards they removed the dressing, and declared it had been again dislocated. Six months after this. Dr. Swinburne was called by the lady's friends, and asked to remedy the wrong. Notwithstanding his desire to give comfort and ease to all, owing to the ad- vanced age of the woman, and the length of time that had elapsed, he declined to make the effort. These are but specimens that might be cited ad infinitum^ notwithstanding Dr. Swinburne's assertion "that the reduc- tion of dislocations has been made very simple : " and he sug- gests the adoption of one of two alternatives; i.e., that those who undertake the reduction of dislocations or fractures, or the treating of the sick or maimed in any manner, should either qualify themselves for the work, or refrain from in any emergency interfering with that most delicate creation of the Maker " so strange and wonderfully made." In the " Reporter " of December, 1860, he had an article on entomology pins versus metallic and other sutures. In this paper he presented the use of the pin as a universal substitute for all other forms of suture when applied to the external surface of the body, not even eccepting the metallic thread. They produce, he argued, no irritation of the tissues, and consequently do not interfere with the process of union, 142 A TYPICAL AMERICAN. though introduced at intervals no greater than a quarter of an inch. The introduction of small entomology pins, he chiimed, is attended witli but little pain in comparison with that produced by the passage of a needle and thread ; and, by the use of the pins, the edges of a wound can be ap- proximated in the nicest possible manner by means of the thread, as used in ordinary harelip operations ; so that union by the first intention is more sure to follow than in case of any simple, interrupted, or even qailled sutures. He added, " The advantages of this dressing are particularly manifest when applied to the face and head, obviating the necessity of adhesive plaster and similar appliances, and obtaining the most perfect approximation without special fear of erysipelas, unseemly cicatrices, or, in scalp wounds, the sacrifice of hair. For my own part," he said, " I am in the habit of using this dressing for every operation where it is important or desira- ble to obtain union by first intention, such as amputations of limbs, tumors, etc.: in fact, wherever the thread-suture is applicable, the pin is equally so. In consequence of its non- irritating character, I am in the habit of applying it where I should deem it imprudent to insert a thread." After treating fully of the benefits to be derived, both surgicall}^ and in mat- ter of cost, and giving a minute description of the method of using the pin, he concluded his article by saying, " After one year's constant experience with the pins, I should be loath to resume the use of the old suture." With that peculiar idiosyncrasy that actuated a portion of the Albany profession at that time, — a desire to find a flaw in the works or practice of Dr. Swinburne, — they cried, "Now we have him ! " and one of the number, ashamed or afraid to disclose his individuality, rushed into print with the idiom peculiar to them, and, under the cognomen of " Subscriber," said, "the communication was at least five 3^ears behind the times." The editor, after publishing " Subscriber's " com- ments, in a few lines at the end disposed of the criticism by saying, in substance, that, prior to Dr. Swinburne's article, there had been no articles published in which the use of the entomology pins was recommended as a universal substitute REVOLUTIONTZING SURGERY. 14'> for all kinds of sutures, and tlicn dropped the subject on the piinci|)le, ex nilulo nihil fit (" nothing comes of nothing";. In the large practice of Swinburne's Dispensary in Albany, no other dressing is used in these wards than pins, where thousands upon thousands have been used ; and the doctor has never seen any of tlio evil results of lockjaw, erysipelas, or other unfavorable results ; and, indeed, he has never, in all his extensive practice, had but three cases of lockjaw, and these were the result of dampness and cold in the homes of the patients. Brief and concise papers of valuable importance to the pro- fession, on other subjects pertaining to medical jurisprudence besides surgery, have been from time to time contril)uted ; among them, treatises on cholera, small-pox, and yellow-fever, and papers on short and displaced femur, the cause of retarded labor, cases of rupture of the uterus, and on errors of diagnosis in cases of pregnancy. On the last thesis he said, " Do not take the opinions of any one of the profession, nor of every person in it, or you will be constantly deceived ; do not interfere with a doubtful case of pregnancy, especially where the patient's health is not impaired by the cessation of menstruation." In 1859 he read a paper before the New-York State Medi- cal Societ}' on the treatment of fractures of the femur by simple extension, ignoring splints and bandages, and related the histories of twenty-five cases, which, in his hands, had resulted better, with more rapid recoveries, and more comfort to the patient, than he had been able to attain by any other means. In 1861 he presented another, in which he advanced the idea that the same method could be applied to the treat- ment of fractures of all the long bones with equal success ; and also that splints and bandages per se were useless, and in many instances worse than useless, if not absolutely in- jurious, except they are used as media by which the muscles are kept on a stretch, and even then should not be so used . as to nompress the soft tissues, or retard circulation. These papers attracted universal attention among the profession, and were, in addition to being published in the annual report of the society, republished in the New-York •' American Medi- 144 A TYPICAL AMERICAN. cal Times " and the Philadelphia " Medical and Surgical Re- porter." These articles, giving a treatment not commonly known to traditional surgery, aroused the slumbering Rip Van Winkles of the medical profession, who believed the doctrines were erroneous because they were not found in the books ; and to their author was the same spirit manifested as to Galileo when he declared that the world, rather than the sun, revolved. Among those to declare their unbelief in these articles, or the mode proposed for the treatment of fractures of the long bones by extension, was O. C. Gibbs, M.D. In these papers, Dr. Swinburne claimed, by actual experience, that the practical surgeon required no appliances for the treatment of fractures of long bones except such as are extem- poraneously made ; and that the same can be said of the treatment of fractures occurring in, or in close proximity to, any joint, such as intracapsular fracture of the neck of the femur, Colle's fracture of the radius, those involving the elbow-joint, the surgical neck of the humerus, compound dislocation and fracture of the ankle-joint, compound frac- ture of the tibia and fibula, etc. ; and that the same is true of diseased hip-joint, morbus coxarius, and also incipient knee- joint disease. " It has been said," said the doctor, " that accident makes the man,'''' and then asked, "Would accident make the man if he had not the knowledge to take advan- tage of the circumstances?" He added, "I can conceive how accident might give us wealth ; but accident developing wealth or social position, and accident developing one's mental and scientific resources, are two things quite separate and distinct." In treating of the use of splints and the necessity of ex- tension, he said, " All that Nature requires for perfect union of bone is rest and a moderate degree of excited action, while all pressure by splints, bandages, etc., only impedes the pro- cess of reparation ; and this pressure, in my opinion, is a prolific cause of non-union." The true use of splints, he held, should be to keep the frac- tured ends of the bone in apposition by placing the muscles on the stretch, and thereby making them the true splints. REVOLUTIONIZING SUROKRY. 145 The experiments of Held and others show that muscles are not susceptible of being stretched beyond their normal capa- city ; that, when so stretched, they are capable of bearing great lateral pressure without mucli deflection ; and any attempt at undue lateral pressure results in rupture of the muscular substance. "While Nature," said the doctor, "requires rest for bony union, she requires also perfect apposition for union without deformity. How is apposition to be effected?" he asked. " We start with the knowledge that a living muscle cannot be extended beyond its normal capacity, and that any attempt to go beyond this not only provokes resistance, but a tearing of the muscles. Take, for instance, a fractured thigh : exten- sion on the extremity b}' a strong man will stretch the mus- cles to their normal length only, which fact can be shown by the most careful measurement, thus proving that the danger of too much extension is only imaginary. Assuming the posi- tion," he said, "that the extended muscles act as permanent adjusters of broken bones, and are in reality the only means by which the fracture is maintained in apposition, I ask, Of what use are all the mechanical appliances and appara- tus called ' surgical splints,' if not to effect the above-named results ? The splint, beyond this, possesses no practical worth : on the contrary, it is apt, by its too careful adjust- ment, to impede the reparative process by interfering with the proper circulation of the proper part. . . . Then we may say that in extension the living muscles and other investments of the bone are the true splints, and that there is but little exception to this principle being universally applicable. As for myself, I employ this treatment indiscriminately, and I only ask my professional brethren who have the opportunity to try it, to do the same, and I am sure they will be able and willing cheerfully to bear witness to its entire efficiency, as have my friends, Drs. Thom of Troy, McLean of the Marshall Infirmar}', Troy, Whitbeck of West Troy, and Willard of Albany." He then proceeded at length to demonstrate minutely the ground taken, that fractures of the thigh or leg can be treated 146 A TYPICAL AMERICAN. effectively simply by a perineal belt, and extension from the foot, and asserted that the method challenges comparison with the results of the most complex machinery of splints and bandages, and proved his deductions from about thirteen years' experience in private practice in the treating of frac- tures to be correct, in that in over forty cases of fractures of the femur and tibia, by extension, in no instance was there a shortening of over half an inch (and this the result of inat- tention), while in a large majority there was no shortening at all. He claimed there were many objections to the proposed elastic extending and counter-extending bands with weights and pulleys : among these, that it admits of spasmodic contrac- tion of the muscles ; that it presumes all muscular tissues are equal in tone and strength, which he held was by no means the fact ; and that, were there to be applied a trifle too much weight, the object would be defeated by absolute separation of the bone. Up to the time that Dr. Swinburne presented this paper, we have failed to find in any of the medical journals any ac- count of where any surgeon had assumed to use extension for any fractures except that of the thigh, and of no attempts to treat the thigh without some of the long splints and ban- dages. And even now, with the experience that time has given, only the more advanced scientific men have adopted extension for all the long bones, and the dispensing of splints and bandages, except where plaster of Paris is used. A few years afterwards, in according " honor to whom honor was due," Dr. Louis A. Sayre, professor of surgery in Bellevue Hospital, said, "Dr. Swinburne was the first to introduce the principle of extension and counter-extension in the treatment of fractures before the profession." CHAPTER XII. CONSERVATIVE SURGERY. Only Advance in Forty Years. — Resection of Joints. — Condemning Ampnta- tion for Fracture.s. — Ingenuity and Common Sense. — That Young Sur- geon. — A Cliallonge not accepted. — No Splints, no Bandages. — Spicy Correspondence. — A Successful Hobby. — Convincing Proofs. — Human- ity's Friend. With many of the old practitioners in the science of the healing art, every attempt at progress in the philosophy of the profession, counter to what has been published in the books and accepted as established practice, is regarded as reductio ad absurdum; and every new induction or appliance is held as an experimentu^n crusis. But Dr. Swinburne believed the true physician and surgeon, while alwaj'^s availing himself of the best methods suggested by others, should always be watchful for even better methods, and, using his own practical observa- tions, be enabled to discover in this age of progress some means that may tend better to the accomplishing of the ends aimed at, fully realizing that in this branch of science perfection had not yet been attained. In private and hospital practice he had seen and taken an active part in many steps in advance. But a new theatre of labor had opened, and war gave him a greater opportunity, and again he made use of the knowledge acquired. That the experience of Dr. Swinburne in conservative surgery in his private practice and in hospitals, as well as in our Rebellion and in the Franco-Prussian war, was productive of good results, better than from any other method, was affirmed by Dr. S, D. Gross, professor of clinical surgery in Jefferson College, Pennsylvania, embodying this treatment in his surgical work ; and in one of his lectures before the students, entitled " Now and Then, or Forty Years Ago and Now," he said, in giving the names of men who had made 148 A TYPICAL AMERICAN. progress in siirger}^ " that the only progress made in the treatment of fractures during that time had been made by Dr. Swinburne and another." Less than forty years before Professor Gross made that statement, Benjamin Rush, M.D., professor of medicines and clinical fractures in the Univer- sity of Pennsylvania, published a work in 1835, nearly ten years before Dr. Swinburne commenced the study of medicine, on the diseases of the mind, in which he said, " The objects of fear are of two kinds, — reasonable and unreasonable. The reasonable are fear of death and surgical operations." He said, " The fear of a surgical operation may be very much lessened by previous company and a large dose of opium. Its pain may be mitigated by the gradual application of the knife, and, in tedious operations, by short intermissions in the use of it." In an address before the Albany Medical College in 1874, Dr. Swinburne said, " It is well known that the majority of surgical cases which a young practitioner is called upon to attend are fractures and dislocations. The reduction of the latter has been made very simple ; but, with respect to the treatment of the former, I propose to enter into a somewhat detailed history, especially in regard to the progress made in the application of principles. Looking back, we can easily recall with what dread and anxiety all kinds of fractures were once approached by the student of medicine. The danger of bad results, and, more especially, the comj)licated machinery deemed necessary to acomplish even passable results, were obstacles difficult for him to surmount." The attention of the profession was more than commonly attracted to conservative surgery during our Rebellion ; and in an article treating of surgery on the battle-field, the " Medical and Surgical Reporter " said editorially on Oct. 25, 1862, — " The temptations to perform capital operations are some- times very great, and particularly so to the young surgeon on the battle-field during a sanguinary engagement. Under these circumstances, conservative surgery offers its claims under great disadvantages. But a determined will may over- CONSERVATIVE SURGKUY. 149 come many seeming impossibilities, and limbs, and life too, be saved by delil)eratioti and care. Where there is a possil)ility that a limb may b(! saved, the patient should have the bene- fit of great deliberation before it is decided to remove it (a right conced(!d even a (jriminal). . . . We have been led into this train of thought j)artly by witnessing the results of the deliberation and forethought that characterized the manage- ment of the United-States Military Field Hospital at Savage Station, Va., while it was under the care of Dr. Swinburne of Albany, N.Y. His praise is on the lips of many of the wounded troops who were in that hospital, and who have since found their Avay to the iiospitals in this city [Phil- adelphia], We have seen limbs that were badly wounded, in which amputation seemed almost unavoidable, but which were saved in spite of all the disadvantageous circumstances that followed their dressing. A few daj^s ago we met one man belonging to a New- York regiment, who had the upper portion of the humerus shattered by a minie-ball. How few surgeons on the battle-field would have thought of any thing but amputf.tion in this case ! Yet exsection of the humerus was performed [by Dr. Swinburne], several inches of bone removed, and dressing applied ; and the man passed through all the ordeals mentioned above, and now has an arm that is useful for many purposes. He does not even ask his discharge from the army, but intends going home on a short furlough, and then entering the cavalry service, where he says he can manage his horse with the injured arm, and wield a sword with the sound one. How much better that than amputation at the shoulder-joint ! " In 1862 Dr. Swinburne presented another addition to medical and surgical literature in an able paper on resection of joints, and conservative surgery in place of amputation, where otherwise amputation would be considered necessary. This was published in the " Proceedings of the New- York State Medical Society " of 1863, and largely copied in the medical journals. The " American Medical Journal " of Nov. 4, 1863, said of it, — "The section on resection of joints, and conservative surgery, is an able defence of exsections as opposed to amputa- tions, and a judicious discrimination of the rules that should be observed in the selection of cases and performing the operation. We most heartiW concur in the opinions put 150 A TYPICAL AMERICAN. forward, and can only hope that they will be widely circulated in the army, where they must be productive of good results. The simple truth seems to be, that, in wounds of the upper extremities, amputations should rarely be performed. Moth- ing but life can compensate the loss of the arm. Without the overpowering weight of statistics which Dr. Swinburne brings to his aid, we should be prepared to accept his argu- ments as conclusive." Of the same paper the " Medical and Surgical Reporter " of Feb. 13, 1863, said,— " We commence in this number the publication of one of the most valuable and interesting papers we have ever given to our surgical readers. We refer to Dr. Swinburne's admir- able report. The paper is of especial value to surgeons in the array and navy just at this time, and we would call the especial attention of our numerous readers in the public service to it." In this paper Dr. Swinburne treated of resection of joints ; removal of the shattered fragments of the shaft, and sawing off the rough ends of the same ; amputation, when and where necessary in preference to resection or excision ; the relative mortality of the two operations as performed on the upper extremities; the cause of so much distrust as to the practica- bility of exsections in the field ; and held that the objections to exsections, partial or complete, on the field, are equally applicable to amputations, or any other severe operation, if not performed at the proper period. With reference to exsec- tions of the upper extremities, he argued that there were no circumstances which weigh against this operation that could not with equal propriety be urged against amputations. In the former operation, in the first or primary stage, the mor- tality is less than from the second or congestive stage ; so that, if either be performed in the congestive stage, the dan- ger of gangrene is at best as great from the latter as the former. The same is true of either, if performed in the third or suppurative stage. He claimed that it was not true that exsection predisposes the system any more to an attack of tetanus than does amputation, nor does the performance of either of them exempt the wounded man from this fearful CONSEKVATIVE SURGEUY. 151 disease : in otlier words, amputation is as often followed by tetanus as exsection. " Some," he said, " object to this opera- tion fexsection] because it requires so much time. Now, I contend, that, if we are good dissectors, it requires very little more time to excise a joint than to amputate. As instances of the rapidity with which these operations can be performed, 1 exsected four shoulder-joints, and ligatured the bleeding ves- sels^ in one hour. I trust that this is as rapidly as ^y one can amputate at the shoulder-joint. In my own operations," he added, "I have the satisfaction of stating to the world that I only amputated two arms, and they were torn off by shells or solid cannon-shot." He held, as a rule, that excision (in military surgery) should be confined to the upper extremities ; the shoulder and elbow being the principal parts upon which that operation should be practised, and never at the shaft. The treatment of compound and comminuted fractures of the thigh becomes a matter of serious consideration, since it involves many mt- portant points. "Excision of the shaft is evidently out of the question," he said, "since all die after the operation. The question then arises. Shall we amputate, or shall we treat such cases as ordinary compound fractures? I prefer the latter, and have from the first thought it the most reasonable treat- ment. The plan I propose is to treat the patient on a bed or stretcher ; extend the limb as near as possible to its normal length without giving too great pain ; retain it in that position by fastening to the foot of the bed or stretcher by means of adhesive plaster, as in ordinary compound fractures, as I have on various occasions illustrated ; make the counter-extension thereon by converting the bed or stretcher into an inclined plane by elevating the foot, against which the body impinges, fastened to the head of the bed or stretcher. To obviate in- version or eversion of the foot, place bags of sand on each side of the foot. There should be no bandage of the leg or thigh. If collection of matter should follow, free incision may become necessary to relieve constrictions, and to facilitate the discharge of such matter and spiculae of bone. Irriga- tion, or the application of cloths wet in cold or warm water. 152 A TVPrCAL AMERICAN. depending on the season of the year, must be continued to the limb until inflammation has passed off." W. van Steinburgh, M.D., siiigeon to the Fifty-fifth New- York State Volunteers, in his report, said, " Out of twenty- one cases of compound and comminuted fractures of the thigh, taken indiscriminately, nineteen recovered with toler- ably useful limbs. My plan of treatment has been by simple extension, as taught me by Dr. Swinburne." Of twelve amputations performed by Dr. Van Steinburgh, ten died; and, of thirteen excisions of the shaft, all but one resulted fatally. In the fifth volume of " Holmes's System of Surgery," by various authors, Carston Holthouse, surgeon to the West- minster Hospital, in a treatise on injuries to the lower ex- tremities, in the section on fractures of the femur, refers to the cases cited b}- Dr. Van Steinburgh, their treatment and results, and details the methods used. He fails, however, perhaps from professional jealousy, — a failing with many of the English as well as American surgeons, — to accord the credit of the practice so successfully adopted to Dr. Swin- burne ; notwithstanding, in the work from which he gleaned his information. Dr. Van Steinburgh was particular to say that the treatment, and mode of operation, were taught him by Dr. Swinburne. The information was taken by Holthouse from an article published by Dr. Swinburne, incorporating Dr. Van Steinburgh's original letter (see " Transactions Medi- cal Society, State of New York," 1864). In the " Report of the Transactions of the New- York State Medical Society," published in 1864, is another paper by Dr. Swinburne, on compound and comminuted gunshot fractures of the thigh, and the means for their transportation. He in- troduces a plate of a stretcher for counter-extension without splints. "To my mind," said the doctor, "a little ingenu- ity and common sense can overcome all obstacles. I have adopted this plan, and have given directions for the man- agement of this kind of fracture (of the thigh) in private practice. I have now treated about fifty patients, using the bed ordinarily met with in practice, instead of the stretcher. I know of many others treated by this plan, and in none have CONSKRVATIVJC SURGERY. 1 Tvi I known of an unr7 ing one liundred and eighty-five pounds, while engaged in raising a monument on July 20, 1869, had a derrick fall on him, and sustained a compound comminut(;d fiacture, the }>one ground, with great contusion of the femur at its upper third. He was treated by Dr. Swinburne by extension and counter- extension, without splints; and in four weeks the limb was firm, and in eight weeks he walked with crutches. When this man was presented before the society for examination, the best surgeons present could not say which had been the broken limb, and decided it was the other limb. Among the number of cases cited was that of James Mc- Kenzie, which was peculiar. On Feb. 22, 1854, he was ad mitted into the hospital witn a compound fracture of the left femur through its middle, and treated by extension and counter-extension by perineal belt and adhesive strips to the leg, without splints, b}' Dr. Swinburne. In consequence of the fact that the other thigh had been fractured previously, and was three-quarters of an inch short, the extension in this case was only made sufficient to accommodate the length of this leg to the other. In less than six weeks the exten- sion was discontinued, and in less than ten weeks he was dis- charged with legs of equal length. In addition to the cases presented for the examination of the society, and those cited, the redoubtable doctor, said a gentleman, who was present at the discussion, to the writer, offered to bet five thousand dollars that the methods pre- sented by him were more successful than any other, the win- ner to donate the money to some eleemosynary institution. But there were none present with sufficient confidence in their sj^stems to accept the wager, and they hedged b}'^ simply remarking that they were not in the betting-business. Five thousand dollars was too much for them to risk on a practice that has filled the land with deformities against a man and method where eager and anxious watching had failed to dis- cover a failure. In the forty cases of fractured thighs cited before the so- ciet}', and treated by the method laid down by Dr. Swinburne, there were no eversions or inversions of the foot, and no dis- 158 A TYPICAL AMERICAN. tortious of the thigh, and in but one was there any visible shortening. These cases were, with a couple of exceptions, taken from his hospital and private practice. Some of the fractures were oblique, some compound, some comminuted (in one case four inches of the bone being crushed in fragments). Two were cases where the thigh and leg were both fractured, and in all the results were considered i^erfect. Twelve were fractures within the capsular ligament, occurring in patients most of them over sixty years of age, and all treated with this method of extension, with results much better than could be expected, and which it would have been vain to expect under the usual treatment. The discussion of these papers was not confined to those present at the meeting of the society, but was continued for some time afterwards in the medical journals by the profes- sion. Over the nom de plume of "Splints," in a communi- cation to the "Medical Times," in a garbled report of the discussion, a writer said, — " Dr. Swinburne's object in thus bringing up the subject of extension in a new form before the profession is a laudable one : he is desirous of simplifying the treatment of fractures ; and, for the attempt which he has made to bring about that end, he certainly deserves a great amount of credit. He, however, has, I think, allowed his enthusiasm to lead him into error in regard to the adaptation of his principle to prac- tice ; which fact, being assumed, proves to my mind that the principle is erroneous. His honest efforts to prove the oppo- site state of things only shows how skilfully he can ride his ' hobby.' " Every good surgeon [he wrote] uses a splint for coap- tation of a fractured bone. In relation to the subject of ex- clusive extension, I must be permitted to make one remark, and that has relation to its use in fractures of the os bracJdi. Dr. Swinburne must pardon me when I give it. as ray convic- tion that he is indeed a bold surgeon to advocate a plan of treatment which is so universally acknowledged to result in non-union. In reference to the good results obtained by this practice as applied to this bone, I can only express my astonishment." The critic adopting this, to him, euphonic signature of " Splints," under which to cover his individuality, was under- CONSERVATIVE SURGERY. 1.09 stood to l)c none otlicr than Dr. Shrady, then editor of the " Times," and the father of a sjilint that was said by its author to be tlie best ever conceived, but which has long since been abandoned. These are specimens of what tlie "young surgeon" had to meet with in his attempt to improve the methods of treat- ing fractures ; but, as in his practice, he was equally success- ful in his arguments and theory, as time, " which proveth all things," has t^hown by the success that has attended him. Nor has the prognostication of Dr. Wood, that the doctor, after he shall have practised this method a few years, will change his views ; but, on the other hand, he has been more firmly convinced by years of practice that he was right, and has lived to see his methods triumph. In " The Medical Times " of April 20, 1881, Dr. Swinburne answers these incognito writers and critics, in which he says, — " When he (' F. F. ') said, upon the question having been raised as to what degree of extension or force may be borne without completely separating the fractured ends of the bone, ' Dr. Bly of Rochester related the results of his experiments on the leg of a dead sheep, and produced extension of the mus- cles to about one-half inch,' Dr. Bly should have fairly stated the difference between simple extension, on the one hand, and, on the other, of suspending weights until the integrity of the muscle was destroyed ; also the difference of dead and living tissue. I expressly say that the extension obtained by a strong man upon a broken thigh will not elongate it beyond its normal condition, and also expressly deprecate the pulleys and uprights, as they paralyze and elongate the muscles, and thereby destroy their usefulness as splints." In reply to " F. F.'s " assertion " that its author found it very difficult to defend his exclusive practice by simple exten- sion," he said, — " If good results in the treatment of a hundred fractures of the long bones, and also Dr. Thorn's experience as reported from the INIarshall Infirmary, is not a good practical drftnce, then I have found it difficult to defend the exclusive practice of my hohhy. His quotation, that I resort to lateral support IGO A TYPICAL AMERICAN. to the fractured limbs in particular cases, is untrue. I ex- pressly said that, where a lateral splint is used, it is only a means by which the extension is made and perpetuated, and not for lateral support. In the thigh there is no lateral sup- port used ; and in the article on extension I said that the treatment adapted to the femur is applicable to any portion of the thigh or leg." With reference to the remarks of Dr. James Wood, " F. F." said, — " The remarks of Dr. Wood constituted the most interest- ing event of the first day's session. Close attention was given to his remarks, which seemed to satisfy the obvious desire of all classes of practitioners, who fear the misapplication of judi- cial inquiry and prosecution for the correction of faults in surgery." To this Dr. Swinburne replied, — " No one could be more pleased than I with the frank, honorable, gentlemanly, and masterly manner in which Dr. Wood discussed the merits and demerits of simple extension. Though I defended what I knew was the true principle of the treatment of fractures, I was, nevertheless, anxious to hear the views of James R. Wood, That I had great confidence in my mode of treatment, is proved when I proposed (in the discussion which occurred between Dr. Wood and myself) to treat alternate fractures in any hospital (by his method), with any surgeon, and I would stake my reputation upon the re- sults by obtaining union in less time, and with better results, than could be obtained by the use of splints as commonly applied. As to the last clause, it surely does not apply in the present instance, as I have never been sued for malpractice, nor has there been any occasion even for the insinuation." In reply to "Splints," whose almost entire correspondence he characterized an evident perversion of facts and state- ments, the doctor said, — " As to the idea that ' he seeks to establish the absurd principle that muscles cannot be extended beyond their nat- ural length,' I maintain that any attempt to extend a muscle beyond its normal capacity not only provokes resistance, but a tearing of its substance (I mean the living, but not the dead tissue). Take, for instance, a fractured thigh : extension on the CONSERVATIVK SUltGKllY. 101 extremity by ;i stroiiL? iiiiiii (iiiul not with w(;ights and [)ul- leys) will stretch the muscles to tli(;ir normal length only; which fact can be shown by the most carci'ul measurement, thus [)roving that the danger of too much extension is only imaginary." He quotes from " Splints," — " I am not aware that Dr. Swinburne claims any originality in the matter; i.e., simple extension. He has, however, al- lowed his enthusiasm to lead him into error in regard to the adaptation of his principle to practice, whicii (being assumed) is convincing to my mind that the principle is erroneous : his honest efforts to prove the opposite state of thitigs only show how skilfully he can ride his hobby." To this the doctor replied, — " With reference to the first portion of the quotation, the principle of extension is acknowledged by all good surgeons ; while, with reference to his ' enthusiasm leading him into error,^ I think it is a good error when the results are so per- fect that it baffles a good surgeon to discover which of the two thighs had been broken, though the fracture was com- pound and comminuted, occurring in a man weighing one hundred and eighty-five pounds. What is true of this case is also true of all the others, and equally so of fractured tibia. As to the ' adaptation of his principle to practice,' instead of showing that the principle was wrong, practice only serves to make the principle more fully appreciated, and demonstrates to the world that it is not the kind of splint, but the mode and manner of the application of the principle involved." One critic thought the doctrines then laid down were dan- gerous to teach the students ; but the doctor, knowing his method was correct, was anxious that the profession, as well as the students, might be benefited by his over twenty years of experience, as he is now always ready to impart his knowl- edge, acquired after forty years' experience, to all who have in charge or are in training for the care of the sick and maimed ; and not onl}' a large number of the college students avail them- selves of this privilege, and are constantly in attendance at his large clinics, eagerly watching and listening to the man who has made no failures, but frequently regular practitioners of 162 A TYPICAL AMERICAN. years' standing are among those who come to leai-n of hhn. This paper, covering fifty pages of the Medical Society's re- port, also treats of fractures in or near the elbow-joint, with or without dislocation, and of the treatment of fractures of the clavicle by simple extension. Dr. Swinburne's attention was first drawn to the subject of treating fractures by extension, because of the many bad results he had seen from oblique, compound, and comminuted fractures of the leg ; and, being astonished at the number, he was led to investigate the cause, and examined specimens in a number of museums containing collections of broken bones, where he found all were more or less distorted, both laterally and longitudinally, with shortened tibias. He believed this was an age of progress, and that there were no results without cause, and that it was an obligation science owed to the people to discover the cause of these bad results. He knew that the first paths over our vast Western country were made by the buffalo, and then followed in by the Indian, but that as civilization, with its compasses and engineering genius, made its way through the country, the long-trodden paths of primeval days, over rugged hills and mountains, were ignored, and more feasible and rapid methods of transport brought into use. In his chosen branch of science, he did not desire to travel in the uncertain and crooked paths of tradition, nor in the dog-carts of more modern science ; but, like the travel- ler who takes the iron horse and easy coach over the steel track of civilization, he was anxious for the most comfortable, safe, and speedy cure of the maimed, leaving others, if they so desired, to travel in the path of the buffalo or the Indian ; and for this reason he was satisfied extension would obviate the dangers of lateral distortion, and, as far as the spasmodic contraction of the muscles would permit, overcome longitudi- nal distortion. This paper was also incorporated in Professor Gross's " Sur- gery," and had an unusually wide circulation in this country, and was extensively copied from in Europe. The cases presented and referred to in this chapter were at the time typical cases, treated by means not hitherto em- CON'SERVATIVI': SURGERY. 103 ployed, and resiiltiiif^ in success not anticipated in previous treatment. Tliey were then considered sur[)rising; but a still greater advance lias been made by him in his treatment by simplifying the metliods of extension, since that time;, with results more surprising, as n-ay be learned by a reference to the work in his dispensary. This j)lan for the treatment of fractures of the femur or the other long bones, witliout splints or bandages, was unknown to the profession at the time the paper was presented by Dr. Swinburne in 1850 ; and, although it was followed to some ex- tent in our Rebellion, its superiority was not definitely settled in military surgery, on account of the prejudices of the profes- sion, until during the Franco-Prussian war, where it was in every instance in the American ambulance followed by Dr. Swinburne with successful results and good limbs. The pro- fession had never, up to that time, recognized the necessity of extension for the approximation of bones other than the thigh ; and this fact was so conceded at a meeting of the Academy of Medicine in New York, as may be seen by refer- ence to the " Medical Times." Nor had they ever dispensed with splints or bandages. After a lapse of over twenty-five years since the publi- cation of the paper by Dr. Swinburne, it is shown and proved that the theories he then entertained were and are the nearest possible to the true ones; and it is also conceded — because of the unprecedented favorable results in his own practice, daily carried out, as well as by others who have adopted the system — that the principles then laid down, in 1859 and 1861, for the treatment of fractures of the long bones, — viz., that any fracture or fractures, of whatever nature or kind, occur- ring between the elbow and shoulder, or between the ankle- joint and pelvis, — can be successfully treated by the plan commenced by him in 1848, and which has — since its beino- given to the public, up to the present — been practised bv him, as well as his friends and many of the advanced and intelligent practitioners in surgery. In military suro'erv this treatment of fractures of the thigh, or otherwise as followed in the American ambulance at Paris durino- the 164 A TYPICAL, AMERICAN. Franco-German war in the winter of 1870 and 1871, was shown to be the superior and most successful, as attested to by the most eminent men of Europe, and quoted in another chapter. Professor David P. Smith of Springfield, Mass., while visiting in Edinburgh, Scotland, wrote, — " Fractures will be most successfully treated by tliose sur- geons who are best acquainted with anatomy and physiology, and know by experience what a bruised and perhaps lacer- ated limb can bear." As late as the latter part of 1861, the principle of extension and counter-extension in the treatment of fractures found no favor in Europe, Professor Syme of the Royal Infirmary, Edin- burgh, maintaining stoutly that the benefits supposed to be gained from the use of extension was a mere delusion ; for if extension was employed, he argued, the muscles were roused to resistance, and always overcame such force. With a large majority of the profession, devotion to estab- lished principles is a religious duty, from which it is almost a miracle to have them change. They hold that their princi- ples are right because they are traditional, and founded on facts, as taught them. They forget, or seem to, that in medical and surgical jurisprudence all the advance science has ever made in their or other callings was made by a few enthusiastic utilitarians in any age. In many instances, and indeed almost universally, correct and advanced principles have only been accepted in great emergencies as dernier ressort. The principle of conservation as applied to the limbs was but little discussed during the first years of our war, except by Dr. John Swinburne and a few others, the principal idea being the discussion of the best means of amputation, the purpose being to change the treatment of fractures from the carpenter-shop to the butcher's table. As an instance of what some of the medical journals contained from their most prominent contributors, we extract from the letters of a surgeon in charge of Fairfax Seminary Hospital, published in 1863; — CONSERVATIVK SUKfJKRY. 10.0 "The multitude of iitnputatious below the knee which I have performed, seen, and watched the results of, have con- vinced me that none of the ordinary metliods are the best ])ossil)le in any surcfory. ... In in}^ remarks I may have seemed to lay too mncli stress upon ray favorite method of amputation below the knee. I say emphatically that the advantages which I claim my method alone furnishes must be obtained if recovery is expected to foiiow." These were the sentiments of Dr. David P. Smith, who, in asking, " Shall amputation be performed in gunshot frac- ture of the femur from a conical leaden bullet?" said, — "From dissection of such injuries after they were removed by such amputation, I was, however, enabled very early to recognize the hopeless nature of such cases if left to them- selves." These statements were made in 1863, after two years' ex- perience in the war, and were answered by John T. Hodgen, surgeon in charge of the St. Louis City General Hospital, who said, — " Dr. Smith and myself have seen such cases under widely different circumstances, — he on the battle-field, and I in the hospital, after they had been removed thither hundreds of miles. There have been received at this hospital sixty-five cases of gunshot fractures of the os feynoris. Of these, eighteen have died, four remain under treatment in a fair way to recovery, and forty-three have recovered, and left the hospital with good limbs. It will be observed that the per- centage of mortality is less than twenty-eight, thus giving bet- ter results, so far as life is concerned, than amputation of the thigh would do, besides preserving useful limbs. The above statistics are startling to surgeons who have seen the terri- ble work done by the conical leaden bullet, and they will naturally cultivate a feeling of incredulity ; but to my mind these recoveries are not so incredible as that sixty-five men thus wounded should have escaped mutilation at the hands of those humane, patriotic, and time-saving surgeons, who, ' by order " or without it, flock to the battle-fields (^some days after the fight), who swarm on transports, and who rush to hospitals to gratify a morbid thirst for capital surgical opera- tions." 166 A TYPICAL AMERICAN. At a meeting of the United-States Array Medical and Surgical Society of Baltimore, held in February, 1863, the vice-president. Surgeon Z. E. Bliss, said, — " The operation of exsection of the joint as a mode of treatment of gunshot fractures involving the shoulder, elbow, and hip joints, has not, as yet, been fully tested ; but sufficient facts have been already obtained to prove that this operation often saves life, and preserves a serviceable limb." That our humane and patriotic fellow-citizen, Dr. Swin- burne, performed an active part in introducing conservative surgery into the army, and saving a host of lives and innu- merable deformities among those who were gallantly defend- ing the nation, may be drawn from a report of gunshot frac- tures read before the United-States Medical and Surgical Society of Maryland, and published in 1863. The paper was by Edmund G. Waters, M.D., acting assistant surgeon. He said, — " On the 21st and 25th of July, 1862, between four and five hundred sick and wounded Union soldiers were received into the National Hospital, Baltimore. Most of the wounded had been shot in the seven-days' light, and, being taken prisoners, were sent to Richmond. Among them was a num- ber with fractured thighs ; and a better opportunity has rarely been afforded to test the several modes of treatment in sec- ondary cases, after this kind of injury, than these presented. The writer regrets that he is not able to give the exact num- ber of amputations performed for this injuiy, but is able to state positively that only one patient recovered of the many who underwent the operation." He then gives the history of fourteen other similar wounds treated conservatively, all of whom recovered. One of these was a fracture in the neck of the bone. These wounds were all received in that portion of the field of battle where Dr. Swinburne was in charge, and where am- putations were not practised, but where conservation was the rule. The success of the doctor had, no doubt, much to do with inciting these efforts to save. In these instances cited, there is ample food for reflection by the profession, as well as CONSERVATIVK SURGERY. Ifj7 facts on wliicli to predicate a safe practice, unl<;ss tliey desire to exemplify the truth of Key's assertion, that "amputation is the List resource of the surgeon, at once tlie slielter and confusion of the surgical art." Even the best of surgeons seem slow to learn ; and it was not until 18G3 that Do Witt C. Peters said,— "The era of promiscuous surgery, both in military and civil life, has passed nearly, if not (piite, into oblivion. In discussing the important subject of compound fractures of the thigh, too little stress has hitherto been paid by surgical writers to the saving of limbs. Following the teachings of Dupuytren, Baudens, Hennen, Guthrie, and a host of others, we are too ready to admit that amputation is our sole reli- ance. They would have us believe that the patients who save their limbs, forever remain martyrs to a miserable exist- ence. Others inform us, amputation of the thigh is a danger- ous expedient, and in their hands has resulted in the maiority of cases fatally ; yet they carefully avoid entering into any details of their manner of treating fractures. The wonder to my mind is, that their patients ever recovered when laboring under this species of injury. The indications are to place the parts in a natural position, keep them immovable, and dis- pense with snug bandages and splints." This was coming pretty near up to Dr. Swinburne's princi- ple of treating without any splints or bandages, but with extension and counter-extension. One of the best authorities in the army said that no attempt had ever succeeded, that he had heard of, during the war, to conserve a limb where a com- pound fracture of the thigh had occurred, where proper exten- sion was not used. Dr. Swinburne, in a paper read before the Albany-county Medical Society at its annual meeting in November, 1874, and published in the Sunday press, said, — " As to the causes which have led to the changes of the methods in the treatment of fractures, they have been wrought principally in accordance with the scientific law of making the muscles the motive power. The knowledge of the principles of the muscles, and their importance in the management of fractures, came by experience in practice and in the dissecting-room. The uselessness and injurious effects 168 A TYPICAL AMERICAN. of bandages were, at an early period, a matter of firm convic- tion witii nie. The results obtained by the old-fashioned appliances were any thing but satisfactor3^ The upper parts were compressed to such a degree that all the soft tissues be- came a conglomerate mass. Muscles, nerves, vessels, cellular tissue, and investing membranes adhered to the bone, and, in time, were consolidated there. Months might, and often did, elapse after the union of the bone, before the soft parts would return — if, indeed, they ever did return — to their normal condition. The state of the muscles, when mad- dened by the goring, pricking, and tearing of the fractured ends of the broken bone, is one too often observed to necessi- tate a more than passing mention. The muscles, you will recollect, are thereby thrown into a condition of clonic spasm, which, sooner or later, becomes the cause of more or less longitudinal and lateral distortion. " The old practice was to overcome distortion chiefly by the appliance of splint and bandages : the modern practice is to extend the limb to its normal length, and to retain it in that position, with as little compression of the parts as possible. The results of the former method, even if favorable, which were rather less frequent than one could wish, were obtained by the complicated processes of the period ; the difficulty of dressing, the recurring redressing, and the adjustment of the apparatus and bandages, being incalculable, to say nothing of the pain, suffering, and inconvenience caused to the patient. By the simple method at present in vogue, the most satisfac- tory results are obtained, with little pain, with no distortion, and with little or no immobility of the soft parts. " Impressed by some such considerations, I was led, at an earl}^ period after graduating, to examine the subject imme- diately from the dead body ; and this examination clearly demonstrated that some other, simpler, and more efficient method could be devised. Various experiments upon frac- tured limbs of the cadaver and living subjects satisfied me that there was a principle involved in their treatment, which, being turned to the full extension of all the parts involved, would return the limb to its normal length and condition. It could be kept in place by the application of sufficient counter-extending force, without the use of splints in any shape or manner. This theory was put in practice in 1848, and proved an entire success." Experience has confirmed the doctor beyond all question, that the system he espoused nearly forty years ago is better CONSERVATIVE HtJIUJKRV. 160 than any before or since suggested ; and in his i)iactice, both civil and military (in two wars), he has practised it always successfully, and with better results than could be attained with any other method. If the assertion of the " Medical Times," always a great stickler for established rules, made in 1863, — "that practical surgery is evidently, at the present time, thoroughly committed to conservation," — is proven true, thousands who never saw, and perhaps never heard of, Albany's great physician and surgeon, will have good cause for thankfulness that Dr. John Swinburne lived, and inaugu- rated a system whereby pain is eased on the sick-bed, and limbs that otherwise would have been destroyed were saved, and deformity avoided. This alone would have been a life of usefulness rarely surpassed. CHAPTER XIII. CHALLENGING THE CRITICS. "Willing to back his Method with Money. — Preaching False Doctrine. — More Light wanted. — A Poor Excuse. — A Sharp Arraigument. The revolution in surgery that the doctor was aiming to bring about for the good of humanity was not only opposed by the lesser lights, but by some who had arrogated to themselves leadership, and, assuming the place of authors, conceived themselves infallible in this great science. But to none of them would the doctor yield a point, or admit superior skill. Among those who criticised his practice and methods was Professor P'rank H. Hamilton, the author of several works on surgery. In one of his works he took exception to Dr. Swinburne's system of extension, and was very positively challenged to make a trial, and test methods ; but the profes- sor, like Dr. Clarke, was afraid to practically test the skill of Dr. Swinburne, and declined to enter into a competition with one he knew was so aggressive and skilful. The correspond- ence passing between them demonstrates how slow profes- sional men are, at times, to accept any new or advanced ideas. The professor taught one theory, and the doctor practised another; and the latter, believing results were always the powerful arguments, sought a friendly competition to arrive at the best methods, and to this end challenged the autlior. The correspondence of the doctor, and the replies, are given as a public matter, and are as follows : — Professor Frank H. Hamilton. My Dear Sir^ — In the fourth edition of your work on fractures and dislocations, p. 412, you say, in speaking of fractures of the femur, " I cannot think it necessary to do more than allude to the practice of Jobert of Paris, and of CirALLKNfJIXO THE CRITICS. 171 Swinburne of Albany, who, rejecting side or coaptation splints altogether, have relied npon extension as means of support, and retention in the case of fracture of the shaft of ihe femur." Now, my dear doctor, T have since 1848 practised the plan you so incidentally mentioned for fracture of the thigh, and feel constrained to say that the results not only ijear out the treatment, but the patients are far more comfortable, and deformity far less likely to occur, than when dressed in any other manner. Not only have I pressed upon the profession the plans for treatment of the thigh, but also those for treat- ment of the other long bones ; viz., the arm, fore-arm, and leg. Therefore I propose for your consideration the following: that we each deposit with some third party from one thou- sand to five thousand dollars (the whole amount to go to some eleemosynary institution when the trial is decided;, and you taking a given number of fractures of the long bones before mentioned (whether simple, compound, comminuted, or com- plicated with luxation or other injuries, makes no difference), and I taking a like number, yours to be treated after your methods, mine after mine ; and if I do not get better results in a shorter space of time, with less pain to the patients, I am to be declared the loser; but, if I do gain such success, you to be the vanquished, and, as I said before, the treatment for fractures of the long bones, as advocated by me in several publications and in my lectures, to be advanced, and taught in the schools. I make this proposition, doctor, for the following reasons : first, for the benefit of those who are to come after us, and to whom will fall the care of these same injuries ; secondl}', because, living as you do in the metropolis, ample facilities can be obtained for making such a trial ; and, thirdly, because in all the works on fractures with which I am acquainted, more or less deformity of wrists, elbows, and fractures in other localities, are spoken of as the attendant evils of such acci- dents. The minor details we can arrange later, in case you see fit to accept my proposition, and also decide upon im- partial judges. Hoping I may shortly hear from you in regard to this matter, as I now am able to give the necessary time for such a trial, I remain, my dear sir, yours very truly, JOHN SWINBURNE. 172 A TYPICAL AMERICAN. New Yokk, Jan. 7, 1879. Professor John Swinburne. My Dear Sir^ — Having become convinced, after careful observation, that side or coaptation splints are, in a majority of cases of fracture of the shafts of the long bones, essential to the attainment of the best results, I do not think it neces- sary or useful for me to enter into the friendly contest which you propose. Very respectfully yours, FRANK H. HAMILTON. Albany, Jan. 20, 1879. My Dear Doctor, — I regret exceedingly that you should have declined ray projDosition to test the comparative value of our respective plans for the treatment of fractures of the long bones. Our methods differ radically, and the results claimed vary so widely as to require some explanation : otherwise but one conclusion remains, that one or the other of us must appear to be preaching false doctrine. Inasmuch as I am desirous of testing my treatment on a large scale, where competent and impartial judges can decide npon the results of this compared with other methods, I ask if you, as the author of a work on fractures, and a teacher of students, will afford facilities for the trial of a plan which has worked so favorably in my own hands. Inasmuch, again, as it is conceded that more than one-half of the fractures of the elbow result unfavorably, and as you, in the fourth edition of your work on fractures and dislocations, report a large majority of CoUes' fractures as imperfect results, it would seem as if some plan, simple and efficient, should be perfected at once, by which the profession would be enabled to obtain good results in all forms of fractures. I ask again if you and your friends are willing to join me in this essay, — an important step in the reformation already begun, and which is destined to revolutionize the whole treatment of fractures. The work I began in 1848, in private practice, is now bearing fruit in the treatment of all forms of fracture of the femur ; and so the methods of treating other forms of frac- tures will undergo a complete change at no distant time, despite any efforts to retard or hinder it. The more intelligent portion of the community are de- manding greater light on this subject. They are tired of, and disgusted with, the multiplicity of plans and apparatus (!IIALLENG1NC} TJIIO CiaTI(;8. 17 5 for tlie treatment of fractiires, and witli the want oi' an orderly body of clear and simple principles to guide them. They can endure no longer this hlind adherence to, and per- petuation of, the quasi-charhitanisin which has entered so largely into the subject. The classes of the Albany Medical College have, by a unanimous resolution, asked me to give them a synopsis of the treatment of all forms of fracture of the long bones, which I shall soon undertake to do; but, be- fore doing so, I should like to give you and other surgeons full opportunity of examining in person results as they occur under my treatment. If, therefore, you are disposed to afford me the opportunity, I will gladly avail myself of the privilege. Yours respectfully, etc., JOHN SWINBURNE. New Youk, Jan. 22, 1879. My Dear Doctor, — I shall be glad to see your practice and its results whenever it may be convenient for you to ■ show them to me; but, as I am alone responsible to ni}^ pa- tients for their treatment, I cannot employ, or permit others to employ in their management, methods or forms of apparel which an extended experience and observation have convinced me are not the best. Your error is in supposing that I have not seen fractures treated by the methods you prefer, and that I have no experience as to their results. Be assured, my dear doctor, I am as much interested as yourself in the improvement of this department of surgery, that I hope to avoid " charlatanry," and that I shall hail with- delight any thing which brings with it conclusive or substantial evidence of its utility or superiority. Yours very truly, Professor Swinburne. FRANK H. HAMILTON. Albany, March IS, 1ST9. Professor Frank H. Hamilton. Dear Doctor^ — Your note of the 22d inst. surprised me. It is impossible to show you my '' practice and results " in the treatment of fractures, if yon are unwilling to come to Albany ; for I am debarred by 3^ou and your friends from the treatment of fractures in the New- York hospitals. The words of your note are, " 1 cannot employ, or permit others to employ in their management, methods or forms of apparel 174 A TYPICAL AMERICAN. which an extended experience and observation have convinced me are not the best. Your error is in supposing that I have not seen fractures treated by the methods you prefer, and that I have no experience as to their results." Now, I have serious doubts about your having seen frac- tures properly and scientifically treated after my plan, if, as you say, the majority of the cases resulted badly. Jn Feb- ruary, 1861, I had the pleasure of showing many fractures of the several long bones to Dr. Sayre and other New- York sur- geons, and they pronounced them perfect results. All the cases which I have had before my medical class this and past winters, and all those of my colleague, have also been perfect results. I am in possession of equally favorable reports from other surgeons who follow this method. To be more definite, let us take a Colles'' fracture. In your work on fractures and dislocations, published in 1860, you report nearly sevent}^ per cent of failures in the treatment of these fractures. In the edition of 1871, over seventy per cent of failures are reported. I claim by my method a much better showing than this. To make my statement as concise as possible, I have never had a bad result in the treatment of a Colles' fracture, and have never seen a bad result where my plan was properly applied. Indeed, I have offered a pre- mium of five hundred dollars to any one who will produce a bad result from any form of fracture treated by me. In your work on the treatment of fractures, etc., you are very frank in confessing to so many bad results, especially while the major portion of the profession, including many professors of surgery, are obtaining equally bad results, without the grace and extenuation of confession. Taking such confession as a criterion, why, I ask, do you not speak out candidly, and warn the profession of the dangers attend- ing certain classes of fracture by my plan of treatment? The mistake you make is in supposing that I desire to attend your private patients : on the contrary, I assume there is plenty of material in the public institutions of New York for a proper test of the efficacy of my plan of treatment. Again : you assume my plan of treatment is productive of bad results. If that is what you mean, I am prepared to put up five thousand dollars, as previously proposed, as a test of our comparative results, to compensate persons in whom bad results may follow my treatment. In this com- pensation for bad results, to be judged upon the basis laid down in your works, or those of other prominent surgeons, I deem myself safe, after a complete perusal of your published CIlALLKN(ilNG THE CRITICS. ii-i works and occasional writings on the treatment of fractures in private, public, and military surgery, and a consideration of your confessed results. Yours respectfully, JOHN SWINBURNE. New Youk, March 20, 1879. John Swinburne:, M.D. M'l/ Bear Sir, — I had supposed that my last reply was sufficiently definite to have assured you that I was not dis- posed to accept any challenge, or to investigate your mode of treatment any further, except in my own way and at my own convenience. I will only add, before dismissing this correspondence, that when you say in your letter, "In your work on fractures you are very frank in confessing to so many bad results," — "to seventy per cent of fractures," — you convey the idea that those results were "bad," or "failures," which were not recorded as absolutely perfect, and that I intend so to say. If you will read ray books again, or whatever else I have written upon this subject, you will see that this is not my meaning, and that my language has never been capable of such a construction. I speak of results as perfect or imper- fect, but imperfect does not necessarily imply bad results, or failures. You have a right, if you choose, to call a result bad, or a failure, which is not in all respects perfect; but I do not. And this is not the fairness which one has a right to expect in a controversialist, where a matter of science is involved, when you say I confess to seventy per cent of bad results, or failures. And, further, it ought not to have es- caped your notice — if you have read, as you say you have, all of my published writings, including my treatise on frac- tures, and especially the preface to my paper on deformi- ties after fractures, published in the " Transactions of the American Medical Association " — that a majority of the cases referred to in the general summaries were not treated by me, although they had all been examined by me ; my pur- pose being, as I have repeatedly stated, to furnish, as far as possible, a fair estimate of what were the usual or average results in the hands of respectable physicians and surgeons. They are not, therefore, mi/ confessions. Intending no personal disrespect to you. I wish to say that I do not think it will prove profitable to continue, and I 176 A TYPICAL AMERICAN. have 110 time to devote to a further correspondence upon this subject. Yours truly, FRANK H. HAMILTON. Albany, April — , 1879. Professor Frank H. Hamilton. My Dear Doctor^ — I regret extremely that you, in your note of the 20th ult., decided on " dismissing this correspond- ence," because I am sure much good might come out of its cojitinuance. I regret, also, that you should have decided not to investigate ray mode of treatment of fractures any further, except in your own way and at your own conven- ience, because I am quite sure, if you did fully investigate it, your sense of fairness to the profession, and desire to obtain good results, would induce you to accept the true principle, and teach the same. I am very thankful that you added, before " dismissing this correspondence," that "a majority of the cases referred to in the general summaries were not treated by me, although they had been examined by me." Now, my dear doctor, I did not say they were treated by any one, but only assumed they were not treated by my plan. My statement runs thus : " In your work on fractures and dislocations, published in 1860, you report nearly seventy per cent of failures in the treatment of these fractures. In the edition of 1871, over sev- enty per cent of failures are reported." In this I say nothing as to who attended them. But you say it was your purpose " to furnish, as far as possible, a fair estimate of what were the usual or average results in the hands of respectable phy- sicians and surgeons. They are not, therefore, my confes- sions." It is presumable that both you, and the " respectable physicians and surgeons " mentioned, made the best results you could in each individual case. If not, why not? In the above-mentioned note you complain of my saying that you confess to seventy per cent of bad results, or " fail- ures." In this I may have spoken hastily. I hope to correct the statement by quoting your precise language. In your work on fractures and dislocations (ed. 1871), p. 281, you speak as follows of ninety-five fractures of the lower third of the radius : " Only twenty-six are positively known to have left no deformity, or stiffness about the joint." In this quo- tation no reference is made as to who was the surgeon, but OIIALLKNOINC; THE CRITrCR. 177 the inference might be driivvii that it was the work of "the author." I am pleased, therefore, to learn from your note that the c-iscs were not yours, because you coiift^ss in the next line that "it i.s probable, however, tijat the number of perfect results niiglit be somewhat extended." It is [jleasaut, I say, to hear this; but unforUiiiately, if we consult the two following pages ([)p. 282, 28-3), the illusion and the [jhiasure are at once dispelled. Your statements are as follows : " If we confine our remarks to CoUes' fractures, the deformit}'' which has been observed most often consists in a projection of the lower end of the vdna inwards, and generally a little fcu'wards. In a large majority of cases this is accompanied with a per- ceptible falling-oif of the hand to the radial side, while in a few it is not. After this, in point of frequency, I have met with the backward inclination of the lower fragment. Robert Smith found this displacement almost constant in the cabinet specimens examined by him ; and it is very probable that nearly all of the examples examined by myself would present more or less of the same deviation upon the naked bone." Again : " The fingers are quite as often thus anchylosed, after this fracture, as the wrist-joint itself, — a circumstance which is wholly inexplicable on the doctrine that the an- chylosis is due to an inflammation in the joints. Indeed, I have seen the fingers rigid after many months, when, having observed the case throughout myself, I was certain that no inflammatory action had ever reached them. Again, quoting Dr. Mott, and coinciding with him, " Frac- tures of the radius within two inches of the wrist, where treated by the most eminent surgeons, are of very difficult management so as to avoid all deformity : indeed, more or less deformit}'" may occur under the treatment of the most eminent surgeons; and more or less imperfection in the mo- tion of the wrist or radius is very apt to follow for a longer or shorter time. Even when the fracture is well cured, an anterior prominence at the wrist, or near it, will sometimes result from swelling of the soft parts." In sixty-six of the ninet3'-two cases of Colles' fracture, there was "perceptible deformity," or "stiffness about the joint," and oul^^ twentj^-six had no "perceptible deformity." Is it fair, then, for you to complain of m}' calling these sixty- six or seventy per cent of Colles' fractures " bad results," or "failures," simply because they were not treated by you, but were the " confessions " of other " respectable physicians and surgeons " ? 178 A TYPICAL AMERICAN. I judge, however, that you have treated some cases of Colles' fractures: for I find on p. 290 (ed. 1871) a cut of " the author's splint," which seems to be a pistol splint for the inside of the arm, and a plain straight deal splint for the dorsal portion of the arm, with accompanying directions for its use, and the dressings employed by "respectable physi- cians and surgeons ; " viz., compresses, bandages, etc. The advantages which the author claims for this splint are, " facil- ity and cheapness of construction, accuracy of adaptation, neatness, peimanency, and fitness to the ends proposed." And still the author does not claim that this apparatus in his hands, or in the hands of any one else, although it possesses all of these qualities, produces any better result than twenty- six out of ninety-two. In speaking of the treatment of Colles' fractures, "the au- thor " cautions the reader about the use of bandages, splints, etc., and goes so far as to assert, " I have no doubt that very many cases would come to a successful teimination without their use, if only the hand and the arm were kept perfectly still in a suitable position until bony union was effected." In this belief I think we are quite agreed ; but may I ask, Does "the author's " plan accomplish this without injury to the soft parts? He does not tell us, but only adds that "during the first seven or ten days these cases demand the most assiduous attention, and we had much better dispense with the splints entirely than to retain them at the risk of increasing the inflammatory action." Again on p. 292: "More than once, indeed, it has occurred that surgeons have been so intent on preserving fractures in their proper position, that the extreme constriction employed has actually caused destruction of the soft parts. A piece of advice which I have frequently given, and which I cannot too often repeat, is to avoid too much tightening of the apparatus for fractures during the first few days of its being worn; for the swelling which supervenes is always accom- panied by considerable pain, and may be followed by gan- grene." Then follows four pages of history of cases wheie gangrene supervenes on the use of bandages. With these facts before him, distinctly perceived and acknowledged, the author still persists in employing and recommending bandages, com- presses, etc., instead of treating his fractures so that there should be no danger from compression, and gangrene from retarded circulation. Since writing the above, I have received a letter from a lady of refinement and education, living in Auburn, N.Y., CHALLENGING THE CRITICS. 179 who some time in Nov(!ml)er, 1878, came to this city from iie.'ir Pliiladelphiii, and sent for me to redress h(;r l)roken arm. I round that about tiirec or four weeks j)r(ivious slie had fallen, and })r