xt798s4jmj6b https://exploreuk.uky.edu/dips/xt798s4jmj6b/data/mets.xml Yandell, David Wendel, 1826-1898. 1890  books b92-131-29322785 English Printed by J.P. Morton & Co., : Louisville : Contact the Special Collections Research Center for information regarding rights and use of this collection. Surgeons Kentucky. Surgery Kentucky History. Pioneer surgery in Kentucky  : a sketch / by David W. Yandell. text Pioneer surgery in Kentucky  : a sketch / by David W. Yandell. 1890 2002 true xt798s4jmj6b section xt798s4jmj6b 


              A SKETCH.

         By DA VID WN'. Y ANDELL, 1M.D.,

          PRINTED B' , S'jIN P. MIORTh' . 11Atl'IANY.



            DEIVEIIED AT THE


       WASHINGTO. DC C.. MAY 13. I89o.



                  A SKETCH.

to chronicle the lives and achievements of Kentucky
Pioneers in Surgery, I shall not attempt the resur-
rection of village Hampdens or mute inglorious Mil-
tons. The men with whom I deal were men of deeds,
not men of fruitless promise.
   It may with truth be said that from Hippocrates
to Gross few in our profession who have done en-
during work have lacked biographers to pay liberal
tribute to their worth. In justice to the unremem-
bered few, I turn back the records of medicine for a
century, and put my finger upon two names that in
the bustling march of science have been overlooked,
while I try to set in fuller light two other names of
workers in that day, which have and will hold an
exalted place in history. The worthies to whom these
names belong were pioneers in civilization as well as
in surgery. I shall introduce themn in the order of
their work.
   i8o6. The earliest original surgical work of any
magnitude done in Kentucky, by one of her own


Pi4Pwmer Szurgery il Kentucky.

sons, was an amputation at the hip-joint. It proved
to be the first operation of the kind in the United
States. The undertaking was made necessary because
of extensive fracture of the thigh with great lacera-
tion of the soft parts. The subject was a mulatto
boy, seventeen years of age, a slave of the monks of
St. Joseph's College. The time was August, i8o6;
the place, Bardstown; the surgeon, Dr. Walter Brash-
ear; the assistants, Dr. Burr Harrison and Dr. John
Goodtell; the result, a complete success. The oper-
ator divided his work into two stages. The first con-
sisted in amputating the thigh through its middle
third in the usual way, and in tying all bleeding ves-
sels. The second consisted of a long incision on the
outside of the limb, exposing the remainder of the
bone, which, being freed from its muscular attach-
ments, was then disarticulated at its socket.
   Far-seeing as the eye of the frontiersman was, he
could not have discerned that the procedure by which
he executed the most formidable operation in surgery
came so near perfection that it would successfully
challenge improvement for more than fourscore years.
   Hundreds of hips have since been amputated after
some forty different methods; but that which he intro-
duced has passed into general use, and (though now
known under the name of Furneaux Jordan's) re-
mains the simplest, the least dangerous, the best.



Pioneer Surgery in Kentucky.

   The first genuine hip-joint amputation executed
on living parts was done by Kerr, of Northampton,
England, 1774. The first done for shot wounds was
by Larrey, in 1793. I feel safe in saying that Brashear
had no knowledge of either of these operations. He
therefore set about his work without help from prece-
dent, placing his trust in himself, in the clearness
of his own head, in the skill of his own hands, in the
courage of his own heart. The result shows that he
had not overestimated what was in him. But whether
or not Brashear had ever heard or read a description
of what had been accomplished in this direction by
surgeons elsewhere, the young Kentuckian was the
first to amputate at the hip-joint in America, and the
first to do the real thing successfully in the world.
  Dr. Brashear seems to have set no high esti-
mate on his achievement, and never published an
account of the case. Had he done so, the art of sur-
gery would thereby have been much advanced, his
own fame have been made one of the precious herit-
ages of his country, and, what is better, many valu-
able lives would have been saved.
   Eighteen years after the Jesuits' slave had survived
the loss of his limb, the report of the much-eulo-.
.gized case of Dr. Mott appeared.
   Dr. Brashear came of an old and wealthy Catholic
family of Maryland. He was born in February, 1776.



Piirneer Surgery bi Kentucky.

His father journeyed to Kentucky eight years later,
and cleared a farm near Shepherdsville, in Bullitt
County. Walter was his seventh soil, and was there-
fore set apart for the medical profession.
   When a youth he was enrolled in the literary de-
partment of Transylvania University, where it is said
he ranked high as a scholar in Latin. At the age of
twenty he began the study of medicine, in Lexington,
with Dr. Frederick Ridgely, a very cultivated physi-
cian and popular man, who had won distinction in the
medical staff of the Continental Army. After two
years spent in this way, he rode on horseback to Phil-
adelphia, and attended upon a course of lectures in
the University of Pennsylvania. At this time Rush,
Barton, and Physick were teachers in that venerable
seat of learning. His was a restless nature, and after
a year spent in Philadelphia he shipped to China as
surgeon of a vessel. While among the Celestials he
amputated a woman's breast, probably the first exploit
of the kind by one from the antipodes. Unfortu-
nately for science, he there learned the method used
by the Chinese for clarifying ginseng, and thinking,
on his return home, that he saw in this an easy way
to wealth, he abandoned the profession in which he
had exhibited such originality, judgment, and skill,
and engaged in merchandising. Twelve years of
commerce and its hazards left him a bankrupt in for-



Pzneer Surgery bi Kentucky.

tune, but brought him back to the calling in which he
was so well fitted to shine. He moved, in I813, from
Bardstown to Lexington, where he at once secured
a large practice, especially in diseases of the bones
and joints. He was thought to excel in the treatment
of fractures of the skull, for the better management
of which a trephine was made in Philadelphia, under
his direction, which, in his judgment, was superior
to any then in use.
   The same temper which led him to leave Phila-
delphia without his medical degree, sail to China, and
afterward enter commerce, again asserted itself, and
he forsook for the second time his vocation. With
his family he now moved to St. Mary's Parish, Loui-
siana, and engaged in sugar - planting. During his
residence in the South he served his adopted State in
the Senate of the United States. He employed much
time in the. study of the flora of the West. " During
the winter of i843-4, when Henry Clay was on a visit
to New Orleans" (says a writer in the New Orleans
Medical and Surgical Journal), " we had the pleasure,
together with some twenty-five physicians, of spend-
ing the evening with him at the house of a medical
friend. While at the table one of the company pro-
posed the health of the venerable Dr. Brashear, 'the
first and only surgeon in Louisiana who had success-
fully performed amputation at the hip-joint.' Mr.



Pioeer Surgery in Kentucky.

Clay, who sat next to Dr. Brashear, with characteristic
good humor, immediately observed, 'He has you on
the hip, Doctor,' to the great amusement of Brashear
and the rest of the company."
   Dr. Brashear was a man of fine literary taste and
many and varied accomplishments. In conversation
he was always entertaining, often brilliant. His
voice was pleasant, his manners affable. In stature
he was short; in movement, quick and nervous. But
in the make-up of the man one essential of true
greatness-fixedness of purpose-had been omitted.
He lacked the staying qualities. He was "variable
and fond of change."   "His full nature, like that
river of which Alexander broke the strength, spent
itself in channels which led to no great name on
earth." By a single exploit, at the age of thirty, he
carved his name at high-water mark among the elect
in surgery. Most of his life thereafter he wasted in
desultory labors. As the learned Grotius said of his
own life, he consumed it in levities and strenuous
   He died at an advanced age at his home in Loui-
   i809. Three years after Brashear had won his un-
paralleled success at Bardstown, a practitioner already
of wide repute as a surgeon, living in Danville, a
neighboring village, did the second piece of original



Pioneer Surgery in Aentucky.

surgical work in Kentucky. It consisted in removing
an ovarian tumor. The deed, unexampled in surgery,
is destined to leave an ineffaceable imprint on the com-
ing ages. In doing it Ephraim. McDowell became a
prime factor in the life of woman; in the life of the
human race. By it he raised himself to a place in
the world's history, alongside of Jenner, as a bene-
factor of his kind; nay, it may be questioned if his
place be not higher than Jenner's, since he opened the
way for the largest addition ever yet made to the sum
total of human life.
   So much has been written of this, McDowell's chief
work, that I feel it needless to dwell upon it. All stu-
dents of our art are familiar with it as presented by
abler hands than mine. What I shall say of him,
therefore, will relate rather to his life and general
work than to the one operation by which his name
has come to be the most resounding in all surgery.
This is a much more difficult task than at first it
might seem to be, for McDowell made no sketch of
himself, nor have his brothers or his children left us
any record of his life. Even his early biographers
failed to gather from his surviving friends those per-
sonal recollections of the man which would now be
of such exceeding interest to us all. An authentic
life-size portrait of Ephraim McDowell, as he was
seen in his daily walk among men, can not now be



Pioneer Surgery hi KAentucky.

made. The materials are too scant; the time to col-
lect them has gone by. A profile, a mere outline
drawing, is all that is possible to-day. The picture
I have attempted, therefore, will be found deficient in
many details which have passed into general accept-
   It is known that he came of a sturdy stock, his
blood being especially rich in two of the best crosses-
the Scotch - Irish.  His great-grandfather rebelled
against the hierarchy of his time, and enlisted as a
Covenanter under the banner of James I. After hon-
orable service, he laid down his arms, gathered his
family together, and came to America. It was in
honor of this ancestor that the'subject of the present
sketch was named.
   The maiden name of his mother was McClung. She
was a member of a distinguished family of Virginia.
McDowell was born in Rockbridge County, Virginia,
on November ii, 1771. He was the ninth of twelve
children. His father, Samuel McDowell, was a man
of note and influence in the State, and was honored
with many positions of trust. In I773 he removed
with his family to Kentucky, settling near Danville.
He was made judge of the District Court of Ken-
tucky, and took part in organizing the first court
ever formed in the State. He lived to see his son
confessedly the foremost surgeon south of the Blue



Pnoscer Surgery in Kenturky.

Ridge. But it was not given to eyes of that day to
see that the achievements of the village operator had
illuminated all the work which has since been done
in the abdominal cavity, that one had grown up and
toiled in their midst,

      "Whose influence ineffable is borne
      Round the great globe to cheerless soul; that -earned
      Ill talrkness for this answer to their needs.'

   Ephraim's earl) education was gotten at the school
of the town in which he lived. He conlpleted his
school studies at an institution of somewhat higher
pretentions, situated in a county near by. No anec-
dotes are preserved of his childhood. During his
school-age he clearly preferred the out-door sports of
his companions to the in-door tasks of his teachers.
On quitting school he crossed the Alleghanies and
became an office pupil of Dr. Humphreys, of Staun-
ton, Va. After reading under this preceptor for two
years, he repaired to the University of Edinburgh.
The Scotch metropolis was then styled the "Modern
Athens." It afforded opportunities at that time for
acquiring a medical education the best in all the
world. It w-.as then to the medical profession what
Leyden had been in the days of Sir Thomas Browne,
what Paris became when Velpeau and Louis taught
there. He entered the private class of John Bell,
whose forceful teachings and native eloquence made



12  Piwer Surrgery in 7Kentucky.

a lasting impression on the mind of his youthful
hearer. It has been said that McDowell conceived
the thought of ovariotomy from some suggestions
thrown out by this great man. The only distinction
he is known to have won while in Edinburgh was that
of having been chosen by his classmates to carry the
colors of the college in a foot-race against a profes-
sional. In. this it appears he was an easy first. He
came away without a diploma. But what was of far
greater value than a degree, he brought back the an-
atomical and surgical knowledge which was to place
him in 'he front of his profession.
   He returned to Kentucky in I795, and settled
among the people who had known him from boy-
hood. His success was immediate, and yet Dr. Sam-
uel Brown, who knew him in Virginia, and was his
classmate in Scotland, had said, when asked of him:
" Pish! he left home a gosling and came back a goose:"
In a little while he commanded all the surgical oper-
ations of importance for hundreds of miles around
him, and this continued till, some years later, Dudley
returned from Europe to share with him the empire
in surgery.
   In 1802, fully established in his profession, and
with an income which rendered hini independent, he
married Sarah, daughter of Governor Isaac Shelby.
   In i8oq he did his first ovariotomy. He believed



Pziongeer Surgery hi Kentucky.

the operation to be without precedent in the annals of
surgery, yet he kept no note of it or of his subsequent
work. He prepared no account of it until i817. This
appeared in the Eclectic Repertory. It was so meagre
and so startling that surgeons hesitated to credit its
truth. He had not mastered his mother tongue. The
paper was thought to bear internal evidence of its au-
thor's having " relied upon his ledger for his dates and
upon his memory for the facts." The critics from far
and near fell upon him. The profession at home cast
doubt upon the narative. The profession abroad ridi-
culed it. For all that, McDowell kept his temper
and his course, and when he finally laid down his
knife he had a score of thirteen operations done for
diseased ovaria, with eight recoveries, four deaths,
and one failure to complete the operation because of
   It would be neither fitting nor becoming on this
occasion, and in this presence, to speak in detail of
the technic observed by McDowell in his work.
That has long since passed into history. I may, how-
ever, be permitted the remark that the procedure,
in many of its features, is necessarily that of to-
day. The incision was longer than that now usually
made, and the ends of the pedicle ligature were
left hanging from the lower angle of the wound.
But the pedicle itself was dropped back into the



Pioneer Surgery in Kentyucky.

abdomen. The patient was turned on her side to
allow the blood and other fluids to drain away. The
wound was closed with interrupted sutures. This
marvel of work was done without the help of anes-
thetics or trained assistants, or the many improved
instruments of to-day, which have done so much to
simplify and make the operation easy. McDowell had
never heard of antisepsis, nor dreamed of germicides
or germs; but water, distilled from nature's unpol-
luted cisterns by the sun, and dropped from heaven's
condensers in the clean blue sky, with air winnowed
through the leaves of the primeval forest which deep-
ened into a wilderness about him on every hand, gave
him and his patients aseptic facility and environment
which the most favored living laparotomist well
might envy. These served him well, and six out of
seven of his first cases recovered. He removed the
first tumor in twenty-five minutes, a time not since
much shortened by the average operator.
   It was not alone, however, in this hitherto un-
explored field of surgery that McDowell showed
himself a master. His skill was exhibited equally
in other capital operations. He acquired at an early
day distinction as a lithotomist, which brought to
him patients from other States. He operated by the
lateral method, and for many years used the gorget in
opening the bladder. At a later period he employed



Pmoeer Surgery Mn Kentucky.

the scalpel throughout. He performed lithotomy
thirty-two times without a death. Among those who
came to him to be cut for stone was a pale, slender
boy, who had traveled all the way from North Caro-
lina. This youth proved to be McDowell's most
noted patient. He was James K. Polk, afterward
President of the United States.
   Dr. McDowell's "heart was fully open to the les-
son of charity, which more than all men we should
feel," and he dispensed it with constant remembrance
of the sacred trust imposed upon us. Yet he had a
proper appreciation of what was due his guild from
those whose means allowed them to make remunera-
tion for professional services. He charged 500 for
an ovariotomy that he went to Nashville, Tenn., to
do. The husband of the patient gave him a check,
as he supposed, for that sum. On presenting it,
the doctor discovered that it was drawn for  I,500
instead of 500, whereupon he returned the check,
thinking a mistake had been made. The grateful
gentleman replied that it was correct, and added that
the services much outweighed the sum paid. When
the fact is borne in mind that the purchasable value
of money was much greater in the first than in this
the last decade of the century, it will be seen that
the " father of ovariotollny," at least, set his successors
in the field a good example. This is made conspic-



Pioneer Surgery in KAenhtcky.

uous by the fact that Sir Spencer Wells has seldom
charged a larger sum, and has declared pound;ioo to be
a sufficient fee for the operation.
   In person Dr. McDowell was commanding. He
was tall, broad-shouldered, stout-limbed. His head
was large, his nose prominent and full of character,
his chin broad, his lips full and expressive of deter-
mination, his complexion florid, his eyes dark-black.
His voice was clear and manly; he often exercised it
in recitations from Scotch dialogues, when he would
roll the Scotch idiom upon his tongue with the read-
iness of a native. He was fond of music, especially
comic pieces, which he sang with fine effect, accom-
panying his voice sometimes with the violin.
   He was a man of the times, taking an active inter-
est in the affairs of the community in which he lived.
He had many books for that day. Cullen and Syden-
ham were his chief authorities in medicine; Burns
and Scott in literature. He was fond of reading, yet
he was inclined to action rather than study.
   He placed great reliance on surgery and its possi-
bilities; he placed little trust in drugs. He coun-
selled against their too liberal use. In truth, he did
not like the practice of medicine, and turned over
most of his non-surgical cases to his associate in bus-
iness. In manner he was courteous, frank, consider-
ate, and natural. He was a simple, ingenuous man.


Pioneer Surgery in Kentucky.


His great deeds had given him no arrogance. His
was a clean, strong, vigorous life. His spirit re-
mained sweet and true and modest to the last. He
lived a God-fearing man, and died on June 25, i830,
in the communion of the Episcopal Church.
   i813. While McDowell was so busily engaged in
his special line of surgery, his colaborers elsewhere in
the State were not idle. Four years after his first
ovariotomy, the first complete extirpation of the clav-
icle ever done was accomplished by Dr. Charles Mc-
Creary, living in Hartford, Ohio County, Ky., two
hundred miles, as the crow would fly, farther into the
wilderness. The patient was a lad named Irvin.
The disease for which the operation was done was
said to be scrofulous. Recovery was slow but com-
plete. The use of the arm remained unimpaired, and
the patient lived, in good health, to be forty-nine
years old.
   In i829, sixteen years after the back-woods sur-
geon had achieved his success, Professor MIott repeated
the operation, also on a youth, with a like fortunate
result, and, believing he was first in the field, claimed
the honor of the procedure for the United States, for
New York, and for himself. He termed it his " Wa-
terloo operation," not, however, because it surpassed,
as he declared, in tediousness, difficulty, and danger
any thing he had ever witnessed or performed, but


PzxIneer Surgery inA Kentucky.

because, as it appears, it fell on the i8th of June, the
anniversary of the battle of Waterloo.
   Mott's operation required nearly four hours for its
execution, and the tying of forty vessels; but after all
it proved to be not a complete extirpation; for the
autopsy, made many years later, showed three quar-
ters of an inch of the bone at the acromial end
still in its place. Yet the case passed quickly into
the annals of surgery and added much to the already
great renown of the operator. To this day it is re-
ferred to by surgical writers as " Mott's celebrated
case," and the description of his procedure is often
given in his own words.
  McCreary removed the entire collar bone, and that
while a young practitioner, living in a village com-
posed of a few scattering houses, situated in a new
and sparsely settled country, where opportunities for
cultivating surgical science were necessarily rare, and
the means for acquiring anatomical knowledge neces-
sarily small.
   The only published report of 'McCreary's case is
from the pen of Dr. Johnson, in the New Orleans
Medical and Surgical Journal for January, I850. The
account, though all too brief, clearly establishes the
date of the operation, its successful issue, and the
removal of the entire bone.
   It is greatly to be regretted that more is not



PiOnlecr Surgery bit A nnucky.

known of 'McCrearv's personal and professional char-
acter. He is said, by one who met him    often, to
have been a serious, thoughtful man, given to study,
devoted to his calling, and fatally fond of drink, to
which he fell a victim wshen but thirty-seven years
of age.
   i814. A younger man than either of those I have
attempted to sketch, Dr. Benjamin 'Winslow Dudley,
now came upon the stage. He, too, was the son of a
pioneer. His early training was much like that of his
contemporaries.  Like Brashear, he had instruction
in the office of Dr. Ridgely. Like him, he had at-
tended lectures in the University of Pennsylvania.
Unlike him, he carried away its diploma. This he
did in i8o6, just two weeks before he Rvas twenty-one
years old. He came home, opened an office, and of-
fered his services to the public. The public gave
him little business. He was deficient either in the
knowledge or in the self-trust necessary to professional
success. McDowell was located in a village hard by
-was applying himself mainly to surgery, and was
already in full practice. Dudley resolved to still bet-
ter qualify himself for the work he was ambitious to
do. He longed to go into the hospitals and follow the
great teachers of Europe, but lacked the means. To
get these he made a venture in trade. He purchased
a flat-boat, loaded it with produce, headed it for New



Pioneer Surgery zag Kentucky.

Orleans, and floated down the Kentucky, the Ohio,
and the Mississippi rivers to the desired port. He
invested the proceeds of his cargo in flour. This he
billed to Gibraltar, which he reached some time in
i8io; there and at Lisbon he disposed of it at a large
   The opportunities he had sought were now near
at hand. He hastened through Spain to Paris. While
there he heard Baron Larrey recite his wonderful
military experience. He made the acquaintance of
Caulaincourt, "the Emperor's trusted minister."
Through him he was present with Talma and
John Howard Payne in the Chamber of Deputies
when Napoleon entered the building at the close of
his disastrous Russian campaign. He saw the Em-
peror mount the tribune. He heard him begin his
report with these portentous words: "The Grand
Army of the Empire has been annihilated."
   Remaining in Paris nearly three years, he crossed
the Channel to observe surgery as practiced in Lon-
don. While there he listened to Abernethy as he
dwelt with all his wonted enthusiasm on his peculiar
doctrine. He heard him reason it; he saw him act it,
dramatize it, and came away believing him to be " the
highest authority on all points relating to surgery, as
at once the observant student of nature, the profound
thiniker, and the sound medical philosopher." He



Pioneer Surgery bil Kentucky.

always referred to him as the greatest of surgeons.
He saw Sir Astley Cooper operate, and habitually
designated him as the most skilled and graceful man
in his work he had ever known.
   He returned to Lexington in the summer of i8I4,
"in manners a Frenchman, but in medical doctrine
and practice thoroughly English." The public was
quick to detect that he had improved his time while
away. " His profession had become the engrossing
object of his thought, and he applied himself to it
with undeviating fidelity. He made himself its slave."
One who knew him well wrote of him: "He had no
holidays. He sought no recreation; no sports inter-
ested him. His thoughts, he had been heard to say,
were always on his cases, and not on the objects and
amusements around him." He found Lexington in
the midst of an epidemic of typhoid pneumonia, the
same that had prevailed in the older States. This sin-
gularly fatal disease was followed by a "bilious fever,
characterized, like the plague, by a tendency to local
affections. Abscesses formed among the muscles of
the body, legs, and arms, and were so intractable that
limbs were sometimes amputated to get rid of the
evil." Recalling the use he had seen made of the
bandage, while abroad, in the treatment of ulcers of
the leg, Dudley applied this device to the burrowing
abscesses he saw so frequently in the subjects of the



22           Pionrer Surgery inl Kencturkk.

fever. The true position and exceeding value of the
roller bandage were not so generally recognized then
as now. Dr. Dudley was no doubt himself surprised
at the success which followed the practice. This suc-
cess probably led him to urge that wide application of
the bandage with which his name came in time to be
so generally associated.
   The tide of practice now set full toward him. He
had come home a thorough anatomist. With oppor-
tunity he exhibited surpassing skill in the use of the
knife. His reputation soon became national.
   No medical school had at that time been founded
west of the Alleghanies. The need of such an insti-
tution was felt on every hand. Transylvania Univer-
sity, already of established reputation, was in oper-
ation. It required only a school in medicine to make
it complete in its several departments. The trustees
met ill i8I7 and added this to its organization. Dr.
Dudley was made its head and appointed to fill the
chairs of anatomy and surgery. A small class of stu-
dents assembled in the autumn. At the commence-
ment exercises held the following spring, W. L. Sut-
ton was admitted to the doctorate-the first physician
given that distinction by an institution in the West.
Troubles arose in the faculty. Resignations were sent
in and accepted. Dr. Richardson, one of the corps,
challenged Dr. Dudley. A meeting followed. Rich-


Pioneer Surgery in Kentucky.

ardson left the field with a pistol wound in his thigh
which made him halt in his gait for the rest of his
life. The year following a second organization was
effected, which included the two belligerent teachers.
  The history of the Medical Department of Transyl-
vania University-its rise, its success, its decline, its
disappearance from the list of medical colleges-would
practically cover Dr. Dudley's career, and would form
a most interesting chapter in the development of
medical teaching in the Southwest. But it must suf-
fice me here to say that Dr. Dudley created the medi-
cal department of the institution and directed its
policy. Its students regarded him from the begin-
ning as the foremost man in the faculty. That he
had colleagues whose mental endowments were supe-
rior to his he himself at all times freely admitted.
He is said to have laid no claim to either orator-
ical power or professional erudition. He was not a
logician, he was not brilliant, and his deliverances
were spiced with neither humor nor wit.   And yet,
says one of his biographers, in ability to enchain the
students' attention, to impress them with the value
of his instructions and his greatness as a teacher, he
bore off the palm from all the gifted men who, at
various periods, taught by his side.  A friend and
once a colleague described his manner while lecturing
as singularly imposing and impressive. " He was



Pioneer Surgery in Kentucky.

magisterial, oracular, conveying the idea always that
the mind of the speaker was troubled with no doubt.
His deportment before his classes was such as further
to enhance his standing. He was always, in the pres-
ence of his students, not the model teacher only, but
the dignified, urbane gentleman; conciliating regard
by his gentleness, but repelling any approach to famil-
iarity; and never for the sake of raising a laugh or
eliciting a little momentary applause descending to
coarseness in expression or thought. So that to his
pupils he was always and everywhere great. As an
operator they thought he had distanced competition.
As a teacher they thought he gave them not what was
in the books, but what the writers of the books had
never understood.  They were persuaded that there
was much they must learn from his lips or learn not
at all." His hold upon the public was as great as that
upon his classes. " Patients came to him from afar
because it was believed that he did better what others
could do than any one else, and that he did much
which no one else in reach could do."
   During the larger part of Dr. Dudley's life few
physicians in any part of America devoted themselves
exclusively to surgery. The most eminent surgeons
were general practitioners all-round men. In this
class Dr. Dudley was equal to the best.  In one
respect, at least, he took advance ground-he con-



Pioneer Surgery in Kentzucki.

demned blood-letting. He was often heard to declare
that every bleeding shortened the subject's life by
a year.   Admiring Abernethy more than     any of
his teachers, his opinions were naturally colored
by the views of this eccentric Englishman. Like
him he believed in the constitutional origin of local
diseases, but his practice varied somewhat from that
of his master. Like him he gave his patients blue
pill at night but omitted the black draught in the
morning. He thought an emetic better, and secured
it by tartarized antimony. Between the puke and
the purge his patients were fed on stale bread,
skim milk, and water-gruel. And this heroic practice
he pursued day after day, for weeks and months
together, in spinal caries, hip caries, tuberculosis,
urethral stricture and other diseases.
   I said that as a physician he was equal to the
best. As we see things to-day this would not, per-
haps, be saying much; but in fact he was better
than the best. Negatively, if not positively, he im-
proved upon the barbaric treatment of disease then
in universal favor. He wholly discarded one of the
most effective means by which the