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Kentucky's pioneer lithotomists / by A.H. Barkley. Barkley, A. H. (Archibald Henry), 1872- 400dpi TIFF G4 page images University of Kentucky, Electronic Information Access & Management Center Lexington, Kentucky 2002 b92-83-27375734 Electronic reproduction. 2002. (Beyond the shelf, serving historic Kentuckiana through virtual access (IMLS LG-03-02-0012-02) ; These pages may be freely searched and displayed. Permission must be received for subsequent distribution in print or electronically. Kentucky's pioneer lithotomists / by A.H. Barkley. Barkley, A. H. (Archibald Henry), 1872- C.J. Krehbiel, Cincinnati, O. : 1913. 159 p. : ports., facsims. ; 21 cm. Coleman Signed by author. Ephraim McDowell -- Benjamin Winslow Dudley -- James Mills Bush -- Robert Peter -- Absalom Driver, the janitor of Transylvania university medical obert Peter -- Absalom Driver, the janitor of Transylvania university medical hall. Microfilm. Atlanta, Ga. : SOLINET, 1993. 1 microfilm reel ; 35 mm. (SOLINET/ASERL Cooperative Microfilming Project (NEH PS-20317) ; SOL MN02917.03 KUK) Printing Master B92-83. IMLS This electronic text file was created by Optical Character Recognition (OCR). No corrections have been made to the OCR-ed text and no editing has been done to the content of the original document. Encoding has been done through an automated process using the recommendations for Level 1 of the TEI in Libraries Guidelines. Digital page images are linked to the text file. Surgeons Kentucky Biography. Lithotomy. McDowell, Ephraim, 1771-1830. Dudley, Benjamin W. (Benjamin Winslow), 1785-1870. Bush, James Mills, 1808-1875. Peter, Robert, 1805-1894. Kentucky's Pioneer Lithotomists BY A. H. BARKLEY, M. D., (HON.) M. C. LEXINGTON, KY. MEMBER American Medical Association, Congress Surgeons of Nortk America, Mississippi Palley Medical Association, Kentucky State Medical Society, Kentucky Palley Medical Society, Fayette County Medial Swciy. C. J. KREHBIEL COMPANY, Publishers CINCINNATI, OHIO 1913 COPYRIGHT 1913, BY A. H. BARKLEY, M. D. This book is most respectfully dedicated to the Pioneer Surgeons of Kentucky, who contributed so much to the advancement of surgery in this country. This page in the original text is blank. Preface T HE author, in presenting this little book to the profession, was prompted to do so some time ago by being pre- sented with many interesting specimens, diplomas and instruments, along with much valuable information, by Miss Nannie M. Bush, a daughter of Dr. J. M. Bush, who knew these great surgeons and was thoroughly conversant with their lives. It is only proper that some recognition should be taken of these men and their achievements, and to this end the author has in a feeble way attempted to place before the profession the incidents which occurred in their lives. He feels much indebtedness to Miss Bush, to Prof. L. E. Nollau for excellent photographs, and also to Miss Dalton, the typist who rendered much valuable aid. A. H. BARKLEY. Lexington, Ky., 138 North Upper Street. This page in the original text is blank. Illustrations PAGE i. Dr. Ephraim McDowell .................. 19 2. Lithotomy Instruments which McDowell used when he operated on President James K. Polk ............. 3. McDowell's Residence and Office in Danville, Kentucky ............................. 45 4. Monument erected to Dr. McDowell by the Kentucky State Medical Society ....... 47 5. Dr. Benjamin Winslow Dudley ........... 57 6. Portable Microscope purchased by Dr. Dud- ley in Paris in i812 .................... 77 7. Instruments used by Dr. Dudley .......... 8i 8. Forceps used by Dudley in Lithotomy Opera- tions ............................. ... 83 9. Stones removed by Dr. Dudley ........... 87 10. "........... 89 I1. ............................... 9 3 12. ...... 95 13. Fairlawn, the Residence of Dr. B. W. Dudley 99 14. The last Resting Place of Dr. B. W. Dudley. .ioi IS. Dr. James M. Bush . . i09 i6. Lithotrites purchased in Paris by Dr. James M. Bush ............................... 123 17. Degrees conferred upon Dr. James M. Bush.. 127 18. Honorary Degree from the Medical Society of Lexington ........... ................ 1 29 i9. Degree from Transylvania University ...... 133 20. Diploma from the Medico-Chirurgical Society of Kentucky ..........................' 35 2I. Residence of Dr. James M. Bush ........... 139 22. Grave of Dr. James M. Bush .............. 141 23. Dr. Robert Peter ........................ 147 24. Transylvania University Medical Hall ...... 53 25. Absolom Driver, Janitor Transylvania Med- ical Hall ..............................' 59 This page in the original text is blank. Introduction This page in the original text is blank. Introduction IN presenting the facts concerning Ken- tucky's Lithotomists, it is appropriate and just that something should be said regarding the time in which these great men lived, and the environment which set its impress upon their character. The picture is full of meaning, dignity, and simplicity. During a portion of their career, Kentucky was still a section of Virginia. The grounds on which they played as children were occupied by their fathers under what was known as a "Tomahawk Claim." Beyond lay end- less leagues of shadowy forest. Illinois had not yet been admitted into the sisterhood of states. The vast do- main west of the Mississippi had not been explored. The city of St. Louis was but an outpost for traders. The Introduction name of Chicago had not yet been coined. Fort Dearborn, occupied by two compa- nies of United States troops, marked a roll in the prairie among the sloughs where stands today the Queen and Mis- tress of the Lakes. Cincinnati had not yet taken her place on the map, but was known as Fort Washington. General Pakenham had not attempted the cap- ture of New Orleans, and General Jack- son, who was to drive him with his troop- ers back to his ships, was unknown to fame. Wars with Indians were of fre- quent occurrence. The prow of a steam- boat had never cut the waters of a west- ern stream, and the whistle of a locomo- tive was unheard in this section. There were only two avenues by which Ken- tucky could be reached from the East. One was by the Ohio River; the other was the Wilderness Road, blazed by Daniel Boone. The former was covered by keel-boats, flat-boats and canoes. The latter was traversed on horseback or on foot; no wheel had broken it or been broken by it. The fathers of these three great west- I 2 Introduction ern surgeons followed this road after crossing the Alleghenies. They were a clear-eyed, bold and adventurous people. They wrested the land from the natives, made it secure by their arms, and by the toil of their hands fitted it for its present civilization. It was in such an atmos- phere that these heroes in the ruddy exploits of surgery were reared. From such ancestors they drew the dauntless courage which was so often put to the test in their achievements, the fame of which will never be effaced by the fingers of time. One is tempted to tarry yet awhile in the silver moonlight of the years that are no more, but echoing in our ears come the warning words of Horace: "Est brevitati opus, ut currat sententia." 13 This page in the original text is blank. Chapter I Ephraim McDowell This page in the original text is blank. CHAPTER I EPHRAIM MCDOWELL EPHRAIM McDOWELL was the ninth child, born to his parents, Samuel and Mary McDowell, on No- vember ii, 1771, in RockbridgeCounty, Virginia. He came to Danville, Ken- tucky, with his father, at the age of thir- teen, after a most perilous trip through a country seldom traveled. After en- countering many hardships and suffering much privation, they finally reached their destination, Danville, Kentucky, then the Athens of the West. There is an old saying that blood will tell; and yet previous accounts of Mc- Dowell seem to make little or no men- tion of the significance of the surname. It is a modification of the Gaelic Mac Dughall, or Mac Dougall, meaning son or descendant of the dark stranger. The name was given over ten centuries ago i8 Kentucky's Pioneer Lithotomists to Danish settlers in Galloway, that part of southwestern Scotland which gave birth to the Revolutionary leader, John Paul Jones, and the very district where Robert Burns sleeps the dreamless sleep that knows no waking. To this day there are McDowells in the western Scottish borderland, whose motto is, Vincere vel mori. Among the English and Scottish adventurers who settled upon Irish estates confiscated by the Crown were the pro- genitors of the subject of this sketch, and it was from the Emerald Isle that a later generation set sail for America. Finally the surgeon with the Scottish surname finds himself in the new Kentucky home. When McDowell was a mere child he showed traits that were destined to evolve a great man. He developed early into a strikingly handsome young man, being tall, very erect, black-eyed and of gracious manners. He was indeed a commanding figure in any circle in which he chose to move. He was a splendid conversationalist, well informed on all the leading topics of the day, a great lover of music, although not himself a Dr. Ephraim McDowell This page in the original text is blank. Kentucky's Pioneer Lith/otomists 21 musician, a strong admirer of everything pertaining to nature, and more especially of flowers, for which he had unusual fondness. In fact, he was a man of fine sense, with a well-poised mind and keen perceptions, readily appreciative of every- thing that was good and beautiful. Shortly after coming to Kentucky he entered school such as the neighborhood at that time afforded. Later he went to Georgetown, Kentucky, twelve miles north of Lexington, where he entered the well-known school of Worley and James. Here he remained, closely applying himself for some time, and later went to Staunton, Virginia, where he began the study of medicine in the office of Dr. Humphrey. He studied daily under Dr. Humphrey for two or three years. Little is known of Humphrey, except that he enjoyed a good reputation and had a large practice. McDowell met, in Staun- ton, Dr. Samuel Brown, who was also a student under Humphrey. Like many other Scots, he had a ready wit, enjoyed a joke, and would take a delight in playing innocent pranks on 22 Kentucky's Pioneer Lithotomists his friends. He was fond of such athletic sports as were indulged in in those days. It is said of him that while attending school he early became the leader of those contending for athletic honors. While studying in Edinburgh he easily outclassed all rivals at foot racing. In fact, one of the Edinburgh papers at that time said of him, "He has a superb physique, is lithe, and of almost Hercu- lean strength." Such was a notice that appeared after he had defeated a half- dozen of the best runners in Scotland at that time. McDowell was a diligent worker, and always kept in mind one thing, that he expected to study medi- cine, and to this end he trained himself most carefully. In short, McDowell practiced what Pope preached in the familiar lines: "A little learning is a dangerous thing; Drink deep, or taste not the Pierian spring." Chapter II Ephraim McDowell pursues the Study of Medicine abroad This page in the original text is blank. CHAPTER II MCDOWELL PURSUES THE STUDY OF MEDICINE ABROAD A FTER leaving Staunton, Virginia, in company with Samuel Brown, Mc- Dowell went to Edinburgh, Scotland, in 1793, where he and Brown entered the University and attended lectures during the years I793 and 1794. While attend- ing the University he placed himself under the renowned surgeon, John Bell, under whom he took a special course. Dr. Bell at that time was not connected with the University, but conducted a private Quiz, and many of his students, more especially McDowell and Brown, afterward ac- quired a national reputation. McDowell was devoted to John Bell, whom he esteemed most highly, and in after life he frequently referred to Bell as his "accomplished instructor," and it may be said, without fear of contradic- z6 Kentucky's Pioneer Lithotomists tion, that the idea of removing an ovary had its inception when Bell was lecturing on diseased ovaries, and spoke of the utter futility of the methods of treat- ment then in vogue to relieve such a con- dition. In the course of his address he intimated that operation might relieve the trouble, and at the same time relieve the patient. During this course of lectures, Bell spent much time on "stone in the blad- der." McDowell became much inter- ested, as he did in all things pertaining to medicine, but especially so in this. Among other things Bell told them about stone was the fact that it was found in people residing in a limestone country. This impressed McDowell, as he came from a country where limestone was abundant. He saw John Bell operate for stone twice, and in both instances successfully. Mc- Dowell saw much while in Edinburgh that was of great interest and help to him in after life, as the clinics were the largest of any university abroad, and the faculty was composed of men of great reputation. Such were the conditions Kentucky's Pioneer Lithotomists 27 under which McDowell pursued and com- pleted his medical education. It might be added that keeping Mc- Dowell abroad worked quite a hardship on his father, who was a man in moderate circumstances, and in letters written McDowell by his father he was always admonished to make the best of what money he sent him. This page in the original text is blank. Chapter III McDowell returns from Edinburgh and begins Practice in Danville, Kentucky This page in the original text is blank. CHAPTER III MCDOWELL RETURNS FROM EDINBURGH AND BEGINS PRACTICE IN DAN- VILLE, KENTUCKY A FTER a long and rough voyage, Mc- Dowell finally landed in this country and went direct to Danville, Kentucky, to begin the practice of medicine in 1795. Coming as he did at that time from one of the foremost schools of medicine in the world to a place like Danville, where few practitioners could boast of attend- ing t"he best schools in this country, to say nothing of going abroad to study, at once placed McDowell in the front rank of his profession in the community in which he lived, not uninterfered with, however, by envy and jealousy. His reputation rapidly spread throughout the South and West, and it was only a short time before he was acknowledged to be the best surgeon west of Philadelphia. 32 Kentucky's Pioneer Lithotomists McDowell read Nl the current medical literature and bought new books, which he frequently consulted. He possessed a good library for the time and spare mo- ments usually found him reading. He never would operate on any case, how- ever trivial, without consulting the best surgical thought. It cannot be claimed for him that he was a highly educated man. He possessed, however, a good share of common sense, was a man of keen perceptions, had an inquiring mind, a retentive memory, and exercised judg- ment in everything that he undertook. He was a man of pleasing manners, especially so in the sickroom, quiet, gen- tle and unassuming, never forcing his opinions on others, as is sometimes the case with men who occupy positions of like character and dignity. He had strong convictions, and when he felt he was right nothing could shake him, although willing to be convinced of error. It is said of him that when called into consultation, he acted with the ut- most fairness to the physician, the pa- tient or his friends, never losing sight of Kentucky's Pioneer Lithotomists 33 the fact that the patient had certain rights; that is, that the patient should know his true condition when possible. He abhorred deception and would promptly refuse to meet a doctor in con- sultation who was known to practice in an unprofessional way. Above all else, he despised quacks and charlatans, and under no circumstances would he meet them. He had enemies among some of the best professional men, not because of any unprofessional act of his, but because of the jealousy that is apt to sprout in the heart of frail humanity. Animosity, happily, grew less as time went on, and his true worth became known. He made friends and held them to him. He had the happy faculty, so necessary in the medical profession, of remembering names and faces. For in- stance, a lady came to Danville to con- sult him regarding herself. When she visited the doctor, he, without hesita- tion, called her by name and asked about the health of her sister, upon whom he had operated a number of years previous. 34 Kentucky's Pioneer Lithotomists He was a man of exemplary habits, and was never known to use profane lan- guage or to indulge in coarse or vulgar stories. He did not use tobacco and often said he could not conceive how any person could chew the weed. He would occasionally take a small glass of cherry bounce or whisky after he had experienced any unusual exposure. He was, however, very temperate in all things, even in eating, in which so many overindulge. By this time McDowell had acquired a wide reputation as a surgeon and felt the need of a helpmeet. He was intro- duced to Miss Shelby, a daughter of Governor Shelby, a charming and highly educated young woman. Their friend- ship finally developed into true love, and in i8oz they were married at the home of the bride's parents, a few miles from Danville, Kentucky. McDowell's people were strict Pres- byterians, and why, with such influence, he did not affiliate with them is not known. While he was religiously in- clined, he did not become a member of Kentucky's Pioneer Lithotomists 35 any church until after his marriage to Miss Shelby. Her influence over him was great, and shortly after their union he joined the Episcopal Church, of which his wife was a devout member. There- after he took a great interest in church affairs. He contributed liberally toward its support, as is attested by the fact that he donated the grounds upon which the Episcopal Church in Danville now stands. His home life was pleasant. He was a devoted husband and loving father, and notwithstanding his extensive prac- tice, which often called him a hundred miles or more from home, and would cause him to be absent for days, he never lost sight of the family circle. Indeed, all his spare time was spent in the bosom of his family, often surrounded by loving and admiring friends. He found much satisfaction in beauti- fying his home, and would watch with interest and profit the development of his stock and the cultivation of his land. He had an overseer for his farm, as it was impossible for him to devote his 36 Kentucky's Pioneer Lithotomists time to his farm, owing to his large prac- tice. He owned slaves, as did every Southern gentleman at that time, but did not traffic in them, as he never thought it right to separate families. His slaves were devoted to him, as he ministered to their wants, never forgetting that they wee human. McDowell had many warm friends in Danville, and occupied an enviable place in the community, being one of the orig- inal incorporators and curators of Center College. He was also a prominent church- man, and, in fact, co-operated in every movement for the betterment of the community. Still, he had many things to annoy him. For instance, some of the negroes were afraid of him and would seldom venture out after dark unless it was known he was out of town. They believed he possessed some supernatural power and would cut them up for pas- time. This was instilled into them by their masters who did not like him. An- other story that irritated him was that Mrs. McDowell had been poisoned by a medical student in the doctor's office, Kentucky's Pioneer Lithotomists 37 who was alleged to be none other than a young woman dressed in man's cloth- ing. This story was accepted by some of the credulous, and not until after the student had married and become a father would they believe otherwise. Most eminent men have to endure the tattle of a small town. McDowell was considered by all com- petent judges to be the most expert man with the scalpel in the whole South and West in his day. He performed many difficult operations with success. He had already gained a great reputation by the time he performed the operation of Ovariotomy on Mrs. Crawford, and while this brought him into the limelight, it also provoked adverse criticism. In- deed, the fact that he really did perform the first Ovariotomy was not settled until some years afterward. He exer- cised good judgment, and never per- formed any operation, however trivial, without consulting the best authorities, rehearsing each step in the operation with his assistants. He usually had two or three students whom he required to 38 Kentucky's Pioneer Lithotomists give a succinct account of the anatomy of the parts involved in the operation as well as the technic as practiced in that day. Aside from his reputation as an Ovari- otomist, he also was widely known as a Lithotomist, and probably had the best record of any man at that time practic- ing Lithotomy. He performed twenty- eight operations for Lithotomy without a single death. This record was probably not equalled by any of his contempora- ries and by few even at the present day. All these operations he performed for stone in the bladder up to I828, and among this number was one patient who afterward became prominent. This was President James K. Polk, who came to Danville, Kentucky, in i812, and placed himself under McDowell. Polk was sev- enteen years old and after undergoing the operation known as Lateral Lith- otomy, he returned home entirely re- stored to health., He had suffered from stone in the bladder since he was eleven years old, and upon arriving in Danville he weighed, it is said, eighty-five pounds. Kentucky's Pioneer Lithotomists 39 So great had been his suffering and so much was he impaired in health, that McDowell kept him for some time before operating, preparing him for the ordeal. This was his practice in every case. Polk wrote McDowell a letter dated from Maury County, West Tennessee, December 3, i812, in which he informed McDowell of the progress of his cure and feelingly expressed his gratitude for the services which he had received at the noted surgeon's hands. The bad or- thography and worse grammar contained in this letter constitute a strong contrast to the contents of one which he wrote to McDowell fourteen years later when he represented Tennessee in the Congress of the United States. The second was written with accuracy and even eloquence. McDowell had met Polk before, for when he was five -years old McDowell cured him of a hernia-we are not told by what method, but probably by pres- sure, which was extensively practiced in those days. The instruments that Mc- Dowell used in his operation on Polk are shown on page 41, and were given by 40 Kentucky's Pioneer Lithotomists McDowell to Dr. B. W. Dudley, of Lex- ington, Kentucky, and Dudley later gave them to his partner, Dr. Jas. M. Bush, in whose family they have been since Dr. Bush's death, until Miss Nannie M. Bush presented them to the author, along with many other treasures belong- ing to Drs. Dudley and Bush. It may be said of Ephraim McDowell that he was certainly "a man among men." He was a man who used his tal- ents to the best possible advantage and accomplished much thereby. When we stop to think of the time in which he lived, the meager opportunities for inter- course with other physicians, the poor facilities for travel, the crude ideas they had of certain diseases, the unsettled state of many things that pertained to medicine, arid above all, the fact that anaesthesia was not known, it is difficult to comprehend the depth of his native genius. It has been declared that were it pos- sible for such men as McDowell and his contemporaries to come back, they would not know how to conduct themselves in Kentucky's Pioneer Lithotomists 41 Lithotomy Instruments which McDowell used when he operated on President James K. Polk This page in the original text is blank. Kentucky's Pioneer Lithotomists 43 a modern hospital. This is not a tenable view from the fact that they accom- plished so much with so little outside help; for it must be remembered there were no research laboratories or other sources of help such as we now enjoy, and it is not possible to conceive what they might have accomplished had they been more fortunately situated. Too much credit cannot be given such men, as it is largely through their pioneer ef- forts that many of the sound surgical principles practiced at the present day have been evolved. The later years of McDowell's life were spent on a beautiful farm which he purchased near Danville, Kentucky. He died on June 20, i830, after a brief ill- ness, of what the attending physicians diagnosed as acute inflammation of the stomach. He died surrounded by his devoted wife and family. His death occurred toward the close of the eve- ning, and it was one of the most heavenly of all midsummer twilights. Fanned as it were by the zephyr breezes, the spirit of this great and good man passed from his earthly possessions. 44 Kentucky's Pioneer Lithotomists When the great surgeon had passed away, the medical profession of this country had sustained a great loss, and many a sigh was heaved when the sad thought came that it would be a long time before his mantle would find worthy shoulders. He has been followed by many Lithotomists and Gynecologists whose work has added luster and fame to American surgery; but it is doubtful if the names of any of them will last longer than that of this kindly western surgeon, who chose for his life's work a place far removed from the populous centers of surgical thought. It is to be hoped that the time will never come when the name of such a benefactor will be buried in oblivion. The illustration on page 45 shows Mc- Dowell's home and office in Danville, Kentucky, where he first began practice. The house is still standing, though in rather a dilapidated condition. To the right will be seen a small one-story build- ing. This was his office, and it was in this office, in the front room, where he performed most of his Lithotomies and Kentucky's Pioneer Litltotomists 45 ' And; . z00am At. This page in the original text is blank. Monument erected to Dr. Ephraim McDowell by the Kentucky State Medical Society This page in the original text is blank. Kentucky's Pioneer Lithotomists 49 where he operated on James K. Polk, hlow afterward became President of the United States. It was also in this same room where he operated on Mrs. Craw- ford for Ovariotomy for the first time in the history of the world. The idea of erecting a monument to McDowell for his many achievements as a surgeon originated with the late Dr. John D. Jackson, also of Danville, Ken- tucky. Dr. Jackson brought this to the attention of the American Medical So- ciety and also before the Kentucky State Medical Association. Dr. Jackson died, however, some time afterward, but funds were raised throughout the country, and at the dedication many notable men occu- pied seats on the platform, such as Drs. Samuel D. Gross, Whittaker, Seely, Ayres, Stevens, Lewis A. Sayre and V. P. Gibney, besides members of the Ken- tucky State Medical Society, the Gov- ernor of the State and others notable in their respective vocations. The dedication of the monument took place on May 4, i879, in Danville, Ken- tucky. The monument is a tall shaft 50 Kentucky's Pioneer Lithotomists of Virginia granite. A bronze medallion of McDowell adorns one side and be- neath the medallion is his monogram with the words, "Honor to whom honor is due." On the front is inscribed, "A grateful profession reveres his memory and treasures his example," and on the opposite side are the words, "Erected by the Kentucky State Medical Society, i879." On the western face is inscribed his place and date of birth and the date of his settlement in Danville, Kentucky. The monument is located near the center of the city in a small park. At the dedication of this monument the late Dr. Samuel D. Gross delivered an eloquent address. The late Dr. Cowl- ing presented Dr. Gross with the "door- knocker" from McDowell's front door. Gross responded in a most touching man- ner, saying he would ever keep sacred the memento presented to him on this memorable occasion, that it would be placed under lock and key with other valuables which he prized, that it should always remain in his family, and would ever be dear to him, as around it clustered Kentucky's Pioneer Lithotomists 51 so much medical history of an almost forgotten past. In bidding farewell to this valiant, kindly healer of men, it will not harm us to glance at the simple picture of Hope thrown upon the screen by Byron- "White as a white sail on a dusky sea, When half the horizon's clouded and half free, Fluttering between the dun wave and the sky, Is hope's last gleam in man's extremity." This page in the original text is blank. Chapter I Dr. Benjamin Winslow Dudley This page in the original text is blank. CHAPTER I DR. BENJAMIN WINSLOW DUDLEY No man ever lived, however great his achievements, whose place could not be filled. With the passing of McDowell from the surgical world there was re- moved a man who stood in a class by himself, and it was many years before the gap in the surgical ranks was filled; but it was filled, and by a man who per- formed many wonderful feats for his time. This man was none other than Dr. Benjamin Winslow Dudley. Dr. Dudley was born in Spottsylvania County, Virginia, April 12, 1785, and like McDowell he came to Kentucky with his father, Ambrose Dudley, when but a little over one year of age. Dudley's people in Virginia were held in high es- teem, and his father was widely known as a Baptist minister, logical and elo- quent. 56 Kentucky's. Pioneer Lithotomists Dudley's parents settled to the east of Lexington, Kentucky, on May 3, 1786, after their arrival from Virginia. They moved into Lexington in I797, when young Dudley worked in a store owned by Samuel and George Trotter. Dudley also went to a school such as one might expect among pioneers, and early in life became interested in thera- peutics and the cognate branches of sci- ence. Thereafter he was placed under the tutelage of Dr. Frederick Ridgley, who was at that time a well-known physi- cian in the West. Dr. Ridgley practiced physic in Lexington, Kentucky, and after taking young Dudley into his office to study medicine he gave him every ad- vantage, being always careful to explain and make clear the problems that the ambitious youth did not readily com- prehend. Dr. Ridgley was himself a well educated man, and it can be readily seen that under such a man Dudley ac- quired considerable knowledge of medi- cine before entering a Medical College. It is not known how long he read medi- cine before he entered college, as it was Dr. Benjamin Winslow Dudley This page in the original text is blank. Kentucky's Pioneer Lithotomists 59 the custom then, as in later years, for a boy to place himself under a private preceptor. Not much is known of the boyhood days of Dudley; indeed, it may be said that he had none, as he entered upon the study of medicine at an unusually early age, and applied himself so closely to his studies that he had little time for the usual sports and pastimes indulged in by lads of his age. Dudley was a man of medium stature, very erect, with a fair complexion and a pleasing voice, his face being marked by lines which indicated a strong character and his head such as would indicate to a phrenologist an influential and original mind. At all times he was exceedingly polite and was in the habit of using the broad "a" in his pronunciation. He was a man of intense likes and dislikes. He made friends slowly, but when he made a friend he made one for life. He treated his enemies, who were few, with a cordial hatred. He despised deception and quackery and always stood for what seemed right and just in all dealings with 6o Kentucky's Pioneer Lithotomists his fellow man. He affiliated with no secret orders and was not a member of any church, though he always kept a pew and attended, when possible, the Episcopal Church in Lexington. Dr. Dudley, in i821, fell in love with Miss Short, a daughter of Major Peyton Short, and soon they were married. To them were born three children. There are times when the pen is mightier than the sword or lancet, and the poet's pen is usually mightier than the surgeon's. Let Tennyson, therefore, sum up this domestic idyl as he does in Lockley Hall: "Love took up the harp of life and smote on all the chords with might." Chapter II Dudley enters the Medical College This page in the original text is blank. CHAPTER II DR. DUDLEY ENTERS THE MEDICAL COLLEGE A FTER receiving what information he could while under Dr. Ridgley, he entered Transylvania University, and later in the Autumn of i804, he went to Philadelphia. While there he attended the lectures given by Rush, Barton, Physic, Shippen, Woodhouse, and Wis- tar. It was while pursuing his studies in Philadelphia that he met Daniel Drake, John Esten Cooke, and William H. Rich- ardson, all of whom were subsequently his colleagues in the Medical Depart- ment of Transylvania University. After taking one course of lectures in Philadelphia he returned to Lexington, Kentucky, where he engaged in the prac- tice of medicine with Dr. Fishback, until it was time for him to resume his studies in the Fall. He returned to the Medical Department of the University of Penn- sylvania, and after completing his second 64 Kentucky's Pioneer Lithotomists course of lectures he graduated from that institution in March, i8o6, just two weeks before he reached the age of twenty-one. Upon receiving his degree of Doctor of Medicine from the University of Penn- sylvania in i8o6, he returned to his home in Lexington, Kentucky, to begin the practice of his profession. He rented an office, consisting of one room, which was scantily furnished, on Mill street, then and for a long time afterwards known as "Calomel Row," at the corner of Mill and Church Streets. Here he continued to practice for a few years, until he felt the desire to go abroad that he might perfect his education. In i8io he completed his plans for a trip abroad and had saved some money. He purchased a flat-boat, loaded it with produce, and floated down the Ohio River to the Mississippi, and on to New Or- leans, where he sold his boat and its cargo, and this time he invested in a cargo of flour. This he billed to Gibral- tar, which he reached some time in i8io. There and at Lisbon he disposed of his cargo at a large advance. Kentucky's Pioneer Lithotomists 65 The opportunities he had sought were now at hand. He hastened through Spain and France to Paris. While there he heard Baron Larrey recite his won- derful military experiences. 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 Depu- ties when Napoleon entered the build- ing at the close of his disastrous Russian campaign. He saw the Emporer mount the Tribune. He heard him begin his report with the portentous words, "The Grand Army of the Empire has been annihilated." (After remaining in Paris nearly three years, he crossed the English Channel to observe surgery as practiced in Lon- don. While there he listened to Aber- nethy as he dwelt with all his wonted enthusiasm on his peculiar doctrine. He heard him reason it, he saw him act it, and came away believing him to be the highest authority on all points relating to surgery. He witnessed Sir Astley Cooper operate, and habitually desig- 66 Kentucky's Pioneer Lithotomists nated him as the most skilled and grace- ful man in his work he had ever beheld. After spending four years in Paris and London, profiting by the instructions of Cooper, Dupuytren, Larrey, Bayer, Du- bois, Cline, Abernethy, Cuvier and others, and serving a term in the largest hospital in London, he was honored with the de- gree which constituted him a member of the Royal College of Surgeons, a dis- tinction and honor enjoyed by compara- tively few surgeons in America at that time. When he had accomplished the pur- pose of his mission abroad, and spent six months traveling in Italy and Switzer- land, his pecuniary resources were nearly exhausted. He had in the course of his travels abroad collected from time to time many rare and valuable mineral specimens which he prized and had ex- pected to bring home with him, along with a collection of books and instru- ments. These he had in the Custom House in London preparatory to his sail- ing for America; but before he started the Custom House burned and he lost everything. Chapter III Dr. Dudley returns to Lexington, Kentucky, and resumes his Practice This page in the original text is blank. CHAPTER III DOCTOR DUDLEY RETURNS TO LEXINGTON, KENTUCKY, AND RESUMES HIS PRACTICE D UDLEY returned to Lexington, Ken- tucky, from abroad in the Summer of i814, and at once settled down to practice his profession. His manners were those of a Frenchman, but in med- ical doctrine and practice he was decid- edly English. The laity were quick to detect that he had improved his time while abroad, and it was but a very short time before he stood in the front rank of his profession, his opinion being much sought and highly regarded on all ques- tions pertaining to surgery. His profession had become the en- grossing object of his thought, and he applied himself to it with undeviating fidelity. He made himself its slave. One of his most intimate friends wrote of him, "He had no holidays, he sought no 70 Kentucky's Pioneer Lithotomists recreation, and no sports interested him." His thought, he had been heard to say, was always on his cases and not on the amusements around him. Upon his return to Lexington he found it in the grasp of a severe epidemic of typhoid fever, the same as had prevailed in other states. This disease was fol- lowed by the formation of abscesses in the muscles of the body, legs and arms, and these were at times so untractable that amputation was deemed necessary to relieve the trouble. Recalling the use he had seen made of the roller bandage while abroad, in the treatment of diseases of the leg, he resolved to try it on the first abscess case that presented. He did so, and his results were so astounding to him that he decided to give it an ex- tended trial, which he did with success. He had few equals at bandaging, and was so thoroughly convinced that the bandage had a distinct place in the treat- ment of certain diseases that he regu- larly gave lectures to the students in Transylvania Medical School on the art of bandaging and its therapeutic value. Kentucky's Pioneer Lithotomists 71 The tide of practice had by this time turned toward him. He demonstrated that he was a thorough anatomist, and his reputation soon became national. No medical school had been founded west of the Alleghenies, and the need of such a school was felt on every hand. Transylvania had already an established reputation and only needed a Medical Department to make it complete, so in I817 the Trustees met and added this to the University. Dr. Dudley was made its head and appointed to fill the chairs of Anatomy and Surgery, which subjects he lectured on with credit to himself, profit to the institution and interest to the students, until i844, when he resigned the Chairof Anatomy, but retained that of Surgery until I850. It can be said without fear of contra- diction that while Transylvania Medical School had many very learned men con- nected with it, the name of Dudley was the one that gave to the school a certain amount of prestige which the others did not. He was instrumental in its devel- 72 Kentucky's Pioneer Lithotomists opment and directed its policy. The students regarded him as the foremost man in the faculty. That he had colleagues whose mental endowments were superior to his, he him-' self at all times fully admitted. He made no pretension to oratory, was not a logi- cian, and had neither humor nor wit; and yet he had the power to enchain the stu- dents' attention and impress them with the value of his instruction and greatness as a teacher, and he bore off the palm from all the gifted men who taught by his side. He was always, in the presence of his class, not only a model teacher, but a dignified, urbane gentleman ever ap- proachable, but at once repelling any attempt at familiarity, and never for the sake of causing a laugh would he indulge in coarse or vulgar stories. Dudley's hold on the public was as great as on the classes, for people came to him from all over this and the mother country to consult him, because they thought that he did certain things better than anyone else, and some things that others could not attempt. Kentucky's Pioneer Lithotomists 73 Dr. Dudley was connected with Tran- sylvania Medical College from its incep- tion to its end. When he resigned in i850, he was made Professor Emeritus. During his connection with the College he lectured to six thousand four hundred and fifty-six students. Of this number there were one thousand eight hundred and eighty-one graduated from Transyl- vania to go forth to practice the art of healing. While Professor of Anatomy and Sur- gery in i8i8, there arose a misunder- standing between himself and Dr. Daniel Drake over a postmortem examination of an Irishman, who had been shot dur- ing a fight. Sharp pamphlets passed be- tween them, which resulted in Dudley's challenging Drake to fight a duel. De- clined by Drake, the challenge was ac- cepted by his next best friend, Dr. Wm. H. Richardson, who was also connected with the Medical College, occupying the chair of Obstetrics. The duel resulted in Dudley's shooting Richardson in the groin. Richardson would have bled to death had it not been for Dudley's ac- 74 Kentucky's Pioneer Lithotomists curate knowledge of anatomy. Dudley asked permission to check the bleeding, which he did by pressure of his thumb until the vessel could be tied, thus saving Richardson's life and making him a life- long friend. He wrote but very little, and this was at the urgent request of his colleagues and for the Transylvania Journal of Medicine, a quarterly which first ap- peared in Lexington, Kentucky, Febru- ary, I828. In the first Volume of the Journal may be found Dudley's first paper, a most remarkable article on the cause and treatment of epilepsy. He believed it was caused by pressure due to fracture and demonstrated that it could be cured by trephining. He op- erated on five successive cases, which resulted in perfect cures. He was one of the first, if not the first, to use the trephine for this trouble. In the same paper he also suggested that Fungus Cerebri could be cured by means of dried sponge compresses, and is said to have cured an aggravated case by this method in five days. Kentucky's Pioneer Lithotomists 75 In the second monograph, published in the same journal, he gives an account of an original and successful operation for Hydrocele. One of his dissertations gives a very lengthy account of the uses of the roller bandage in gun-shot wounds, fractures, etc. He wrote still another article on the roller bandage and its uses in ulcers, contusions, laceration, and ef- fusions. One of the ablest and most interesting contributions he ever wrote was on "Calculus Disease." These subjects are all that we have any account of his writing upon, and why he did not leave a record of his extensive and valuable work can only be explained by the fact that his elementary education was deficient, and he was not ready with his pen. Besides, he had a very large practice, which occupied most of his time. Few men in his day devoted themselves to any particular branch of medicine, but Dudley tried as far as possible to do surgery, and always let it be known that he preferred surgical cases to all others. He was in the front rank, and in fact he 76 Kentucky's Pioneer Lithotomists was in advance of his time. He was one of the first to condemn blood-letting and considered each blood-letting to cut short the patient's life one year. He admired Abernethy more than any other of his foreign teachers, and his opinions naturally took color from this eccentric Englishman. Like him, he be- lieved in the constitutional origin of local diseases, but his practice was some- what different. )Like Abernethy, he gave his patients blue pills at night, but he omitted the black draught in the morn- ing. He thought an emetic was better and for this purpose gave tartarized antimony. Between the puke and the purge he restricted their diet to stale bread, skimmed milk and water gruel. This was his usual preliminary treatment before any operation, and post operative it was repeated several times. While he did not care so much for medical cases, nevertheless he enjoyed an enviable reputation as a physician, though as we see things today, this would not perhaps be saying much. He improved upon the barbaric treatment Kentucky's Pioneer Litliotomists 77 Cd Z. 00 0. I I I, - II I 1 771 I This page in the original text is blank. Kentucky's Pioneer Lithotomists 79 of disease then in universal favor. He wholly discarded one of the most ef- fective means by which doctors succeeded in shortening patients' lives. This was just before those biological dawnings which were soon to break into the full light of physiological medicine and the rational system of therapeutics based thereon. (It is not improbable that as a watcher in that night of therapeutic darkness, when doings of the best strike us with horror, his prophetic eye may have caught a glimpse of the coming day, which in old age was given him to be- hold. Though engaged chiefly with prob- lems that pertained to surgery, he de- serves a high place in the list of thera- peutic reformers. Much of the reputation acquired for Kentucky by her surgeons was in the treatment for "stone in the bladder." At that time Kentucky furnished more cases than all the rest of the states put together. Dudley stood at the top, the confessed Lithotomist of the world in his generation. He operated on 225 8o Kentucky's Pioneer Lithotomists cases for stone, losing only three out of this number-a most remarkable record even at the present day with anaesthesia, improved technic and well-equipped hos- pitals, which he did not have. He per- formed one hundred consecutive opera- tions for stone without a death. The late Dr. Lewis A. Sayre, of New York, once expressed a desire to see some of Dudley's work, so he communicated with his friend, the late Dr. W. W. Daw- son, of Cincinnati. Dawson made Sayre's wants known to Dudley, who extended an invitation to him. Sayre came to Lexington in company with Dawson, and Dudley had saved three cases of "stone in the bladder" for operation. The patients were brought strapped to a table, without anaesthesia. Dr. Dud- ley operated on the three cases, remov- ing three large stones in such quick time that Sayre said had he turned his head to the right or left he would have missed the whole operation, so dexterous and skillful was Dudley with the gorget and forceps. He used the gorget in all operations 3 U A-Lj7 Instruments u i. Silver Catheter. 2. Retractor. 3. Urethrotome. 4. Calculus Extractor, where cal- culus becomes lodged in urethra. sed by Dr. Dudley S. Calculus Extractor-Used in ex- tracting fragments of stone from the bladder. 6. Caustic applicator. 7. Flexible siver catheter. 8. Urethral dilator. 19MMOMP111-F 11 II!; INOW1110d . --- Ir -AIL , - 21MONEW-up- - I i I This page in the original text is blank. Kentucky's Pioneer Lithotomists 83 Instruments used by Dr. Dudley s-6. Forceps used in extracting calculi from the bladder. 7. Tenaculum forceps. This page in the original text is blank. Kentucky's Pioneer Lithotomists 85 for stone, and preferred the instrument invented by McCline, of London. He always performed lateral lithotomy. Never would he use the lithotrite, always maintaining that lithotopaxy was not a safe operation. It is related that when one of his pa- tients was placed on the table for an operation for stone he at once saw that he could not do his usual lateral opera- tion on account of a deformed pelvis, and while his assistants were taking their positions he resolved to make the ex- ternal incision transverse, which he did before any one of his assistants had no- ticed the deformity. Through this inci- sion he removed a stone three and one- half inches in its long diameter, two and a half in its short diameter, and eleven inches in circumference. The patient entirely recovered and returned to his home in Eastern Kentucky. "Dr. Dudley was noted for his kind attention to the poor who applied to him for relief from their troubles. He never charged a poor person, but made the "well-to-do" and rich pay him well for 86 Kentucky's Pioneer Lithotomists the service rendered. He had a proper sense of the value of his professional services. Once he was called to a village near Lexington to a patient in labor, who was the wife of a man made rich by marriage. At that time most of the one- hundred-dollar notes in circulation in Kentucky were issued by the Northern Bank of Kentucky at Lexington. On the reverse side of the bill was the letter "C" in Roman capital. This letter was so large and round that it looked like a bull's eye, and in local slang it was so called. The visit over and the doctor ready to leave the house, the young father handed one of these bills to him. Eyeing it closely for a moment, Dr. Dudley said, "Another bull's eye, if you please." , The stones whose photographs are on pages 87 to 95 were,.with two excep- tions, removed by Dr. Dudley from patients from all parts of the country. The two cases in this series not operated on by him were operated on by his part- ner, Dr. Jas. M. Bush. These specimens were presented to the author by Miss Nannie Bush, a daughter Kentucky's Pioneer Lithotomists 87 Stones removed by Dr. B. W. Dudley Each stone is numbered and its composition is written on the cardboard holding the stones. The chemical analysis and mounting was done by Dr. Robert Peter This page in the original text is blank. Kentucky's Pioneer Lithotomists 89 Stones removed by Dr. B. W. Dudley This page in the original text is blank. Kentucky's Pioneer Lithotomists 9' STONES REMOVED FROM THE BLADDER BY DRS. B. W. DUDLEY AND J. M. BUSH. Nos. 3 and 4. Urate of ammonium and phosphate of lime. No. 5. Urate of ammonia. Mr. Tourman, New Albany, Indiana. No. 6. Urate of ammonia. From prostate of boy from Alabama. No. 7. Urate of ammonia. No. 8. Oxalate of lime. No. 9. Uratc of amnmonium. From boy ig years, Nicholas County, Ken- tucky. No. io. Urate of ammonium. From Mr. Taylor, Licking region, Ken- tucky. No. Ii. Cystic oxide. No. 12. Cystic oxide. From patient from mountains of Virginia. No. 13. Oxalate lime. No. 14. Oxalate lime and some triple phosphate. No. iS. Oxalate lime. From Merritt Whit, Knox County, Kentucky, November 5, 1847. No. t6. Oxalate lime. No. 17. Urate of ammonia. No. 18. Urate of ammonia. Boy from Versailles, Kentucky, by Dr. Bush. No. 19. Urate of ammonia. No. 20. Oxalate of lime. Benjamin Bryant, Shelby County, Kentucky. October 21, 1849. No. 21. Oxalate of lime. Marcellus McDaniel, Scott County, October Is, 5849. (This last specimen was Dr. Dudley's 188th operation.) No. 22. Calculus from bladder of whale, presented by Dr. J. Flint, Louis- ville, Kentucky. No. 23. Oxalate of lime. No. 24. Oxalate of lime. No. 25. Urate of ammonia. No. 26. Urate of ammonia. No. 27. Fusible phosphate. No. 28. Fusible phosphate. No. 29. Plaster casts of stone taken from patient. Specimen was given to patient. No. 3o (a). Plaster casts of stone taken from patient. Specimen was given to patient. Nos. 30 (b) and 31. Urates of ammonium, negro, near Louisville, Ken- tucky, 5834. No. 31 (b). Urate of ammonia, from urethra, young man, Harrison, Ken- tucky, 1847. Nos. 32 and 33. Urate of ammonium. From Oscar Hickle, aged 82, Athens, Tennessee, April 2, 1847. No. 34. Urate of ammonium, boy, Resor, Warsaw, Kentucky, age 7 years. No. 35. Urate of ammonium. 92 Kentucky's Pioneer Lithotomists No. 36. Oxalate lime. NO. 37. Phosphates, negress, who died of typhoid. No. 38. Phosphate and oxalate lime. Patient from Illinois. No. 39. Carbonate of lime. From kidney of bullosk. Presented by Dr. L. D. Spragins, Virginia. No. 40. Oxalate of lime. No. 41. Urate of ammonia. Boy from Tennessee. No. 42. Urate of ammonia. Boy 4 years old. Nos. 43 and 73. Uric acid and urates of ammonia, litme and soda. These 30 calculi were removed by Dr. Dudley from the same patient. No. 74. Phosphates. From hog's bladder. No. 75. Phosphates-Salivary calculus-T. M. Ridge, of Missouri. By Dr. Bush. No. 76. Quartz and fragments of glass passed by a negress. No. 77. Uric acid. Mr. Williamson, 1872, Lincoln County, Kentucky. No. 78. Uric acid, plus urates of ammonism, passed by a patient from Marion County, Kentucky. No. 79. Oxalate of lime and fusible phosphates. Nos. 8o and Si. Urate of ammonium surrounded by oxalate of lime. No. 82. Triple phosphate. Nucleus is piece of decayed bone. Boy, 1820. No. 83. Urate of ammonia. Young man from Lexington, Missouri. No. 84. Oxates of lime. From Mr. Mott, aged 35, from Mississippi. No. 85. Oxates of lime. From young man from Missouri. No. 86. Carbonate of lime and magnesia. Bladder of jackass. No. 87. Oxate of lime. Mr. Moore, Nicholas County, Kentucky. No. 88. Glass tube containing fragments of calculus. From Mr. Mentelle. No. 89. Uric acid. Amon Brock, age 6o, Clay County, Kentucky, April 27, 1848. No. 90. Animal matter. Bladder of hog. No. 93. Urate of ammonia. No. 92. Urate of ammonia. No. 93. Oxalate of lime. Negro man, Williamson County, Tennessee, October 15, 1849. No. 9. Fatty concretions. Taken from parotid gland after the man had been dead i6 years (removed in dissecting room). No. 95. Animal matter and phosphates. Negro man. By Dr. Bush. From same man No. 3 1, whom Dr. Dudley had operated upon. No. 96. Foreign substance nucleus, plus triple phosphates. Taken from Mr. Steel. No. 97. Nucleus a bean. Taken from same patient as No. 28. No. 98. Nucleus oxalate of lime. Franklin Barclay, Madison County, December 4, 1848. No. 99. Urate of ammonia. After death from patient from East Tennessee. Weight, )A of pound. No. ioo. Nucleus triple phosphate of ammonia and magnesium and lime. No. sot. Urate of ammonia. Removed by lithotrity by Dr. Bush from Mr. Hardy, Mobile, Alabama. Kentucky's Pioneer Lithotomists 93 X . f 000 ff a :X Xt: S E E:::ff :E 0 00S:a a aa a a :0yy:: :0VX a a a :; 0 gf-; , ggQX : ;:W5feCXAV0S 0 ; W;000 X it0 00! ayEf''SeW . W 0'1 CV: 0; g , a a 2 tt t0000 a a A: : ff : :: 00000:0000:0;00000f: Atf ; 0 S ; t00 S !R! g 0 f f A d St V t 00 0: 0,:0S S ) ;:::: :: :000::::: :: :::000::0:0:00:0:0:00::0't;00000:::::00:00:0:0:Sff: ffi, t0000000 0 'ffff 0;f d;;f:tffftu00X00 dXffffttU X ff f ;000 S S0: f ;S; f t t000000000000000,0000 X ;:; f 0'V000 f; : : 0 a d;::ffE000: 0000 00000::; :: ::t000:: f :; : 0 : 0000000000SEt: : : tV: yL : :: ; ; : S a Stones removed by Dr. B. W. Dudley This page in the original text is blank. Kentucky's Pioneer Lithotomists 95 Soereoeby Dr B. XV. Dudley a This page in the original text is blank. Kentucky's Pioneer Lithotomists 97 of Dr. Bush. The stones were in the museum of Transylvania Medical Col- lege, where they remained until it burned in I863. Dr. Bush, according to his daughter, rushed into the building when it was in flames, and against the protests of his friends, rescued these lithic tro- phies. According to Dr. C. C. Graham, who was Dudley's pupil at that time, he performed his first operation for "stone in the bladder" on a little boy in Paris, Kentucky, eighteen miles north of Lex- ington, early in I8I7. The second opera- tion was on Mr. S. Owen, of Lexington, Kentucky, on November i9, I817. The operation on Owen was the first operation for stone ever performed in Lexington. kWhen Dudley resigned from the posi- tion of Professor of Surgery in Tran- sylvania Medical College, he retired to his beautiful suburban home, now known as "Fairlawn," to spend the rest of his days, doing only such practice as he chose to do. "Fairlawn" is a beautiful place, with its large and commodious house, surrounded by an emerald lawn 98 Kentucky's Pioneer Lithotomists on which stand large spreading oaks. One can well picture Dudley enjoying his well earned and much needed rest. Dr. Dudley contributed thousands of dollars to public improvement and to private charities. Although he never-kept accounts against his patients, he amassed a comfortable fortune. His latter days were passed in the society of his children and grandchildren, surrounded by all the comforts which a large estate and a devoted family could provide. He contracted poison some years pre- vious to his death, while operating, and never entirely regained his health. He died suddenly after about ten hours' ill- ness on Thursday, January 20, i870, of apoplexy., If Martial had been acquainted with Dudley, if he had known that this sur- geon possessed many of the choicest qualities of his English ancestry, surely the gifted Roman would have penned for him this epigram: "Sit tibi terra levis, mollique tegaris arena." bc X -To I. U -E Ci This page in the original text is blank. Kentucky's Pioneer Lithotomists ioi The last Resting Place of Dr. B. W. Dudley This page in the original text is blank. Chapter I James Mills Bush This page in the original text is blank. CHAPTER I JAMES MILLS BUSH IT was Voltaire who casually remarked, "Tous les genres sont bons, hors le genre ennuyeux." This is good sense; so in order to avoid needless dullness the reader will be spared many details that might be recorded in a biographical sketch of one of Dixie- land's exponents of lithotomic science. James Mills Bush was the third and last lithotomist whom Kentucky pro- duced. He was born at Frankfort, in May, i 8o8, his parents calling them- selves Philip and Eliza Bush. His grand- parents, Philip and Maria Bush, emi- grated from the city of Mannheim, Baden, one of the homes of Schiller, to Winches- ter, Virginia, about 1750. Bush's parents had emigrated to Kentucky and settled at Frankfort. Of several children,' there are only two whose history is known; io6 Kentucky's Pioneer Lithotomists Joseph H. Bush, the popular artist, and his brother, Jas. M. Bush, the subject of this sketch. Bush was first educated at Danville, Kentucky, where he graduated from Center College in I828, and afterward studied medicine and surgery with the celebrated Dr. Alban Goldsmith, of Louis- ville. As a mere lad, he seems to have acquired the art of concentration of thought, which was so helpful to him in after life. He graduated at the head of his class at Center College, for study to him was not so laborious, as it was to his fellow students. He took a keen in- terest in all the literary societies while in college. He was fond of reading and was considered the best informed student in Danville. Bush was a man of most courtly man- ners, dignified and refined, very witty, and enjoyed a good clean joke. After his graduation from Center College and after reading medicine for a considerable time, he moved to Lexington in i830. He was a most exemplary man. He never used tobacco in any form or intox- Kentucky's Pioneer Lithotomists 107 icants of any kind. He was exceedingly fond of the theatre, and always went when he could find time. A devout member of the Episcopal Church, he took unusual interest in all matters that pertained thereto. This page in the original text is blank. Dr. James M. Bush This page in the original text is blank. Chapter II Bush enters the Medical School This page in the original text is blank. CHAPTER II BUSH ENTERS THE MEDICAL SCHOOL A FTER his removal to Lexington, in I 830, he at once entered the Med- ical College of Transylvania. He was peculiarly well prepared to enter upon the study of medicine at this time, as he had received instruction from such an eminent preceptor as Goldsmith. Bush had heard and read much of Dud- ley and his work, and he resolved to place himself under Dudley, if possible, while in college. In this he was success- ful. He studied under his direction and became his confidential student. To Dudley he became attached by an affec- tion and esteem which was warmly re- ciprocated by his instructor. As a student he was remarkably dili- gent, and the thesis he wrote before graduation, embellished with drawings and illustrations of no inconsiderable 114 Kentucky's Pioneer Lithotomists merit, is still to be seen in the library of Transylvania University. He became Dudley's prosector, and he seems to have made drawings of the dissection of the Axilla more accurate than any in existence at that time. Bush was always in the best of spirits, and this, together with his courtly and affable manner, made him a favorite with all the professors who were connected with the College at that time. In i833 he graduated from Transyl- vania Medical School with the reputa- tion of being the best anatomist in the College, professors not excepted. Many an anecdote, humorous or pa- thetic, might be told concerning the young man who was not yet thirty years of age, but those who have read the fore- going pages might feel tempted to cite the caustic prayer of Guerrini: "Dominedio ci salvi Da i libri troppo lunghi." Chapter III Dr. Bush engages in the Practice of Medicine This page in the original text is blank. CHAPTER III DR. BUSH ENGAGES IN THE PRACTICE OF MEDICINE A FTER his graduation in i833, Bush was soon made prosector and dem- onstrator in Anatomy, an office which he held with signal ability until I837, when he was officially appointed adjunct Professor of Anatomy and Surgery. In i844 he became full Professor of Anat- omy, Dr. Dudley retaining the Chair of Surgery. In the position as Professor of Anatomy he continued until the dis- solution of the Transylvania Medical School in i857. His appointment as demonstrator of Anatomy so soon after his graduation was indeed a distinct honor for a man so young, but when his great attainments in his chosen profession were considered, all acknowledged the honor conferred upon him was justly deserved. ii8 Kentucky's Pioneer Lithotomists In i85o Dr. Bush and some of his as- sociate professors went to Louisville and assisted in the establishment of the Ken- tucky School of Medicine. Then he be- gan lecturing at Transylvania in summer and at Louisville in winter. He resigned the Louisville professor- ship after three years and returned to Transylvania, remaining there until just before the commencement of the Civil War in i86o. During all this time Dr. Bush gave undivided attention to the practice of medicine and surgery, for his was a temperament so full of vital energy and dislike of repose that he found most rest in most work. Bush was a scholarly man, and his writings on medical themes always at- tracted attention and were widely read. He made many valuable contributions to medical and surgical literature, some of which can be found in the volumes of the Transylvania Journal of Medicine, while others of his articles were published in the Philadelphia and New York jour- nals of medicine and surgery. He aided more than anyone else in giving to the Kentucky's Pioneer Lithotomists ii9 world the extraordinary experience of Dr. Dudley in the practice of lithotomy, for which that great surgeon had a world- wide reputation, and in the practice of which Dr. Bush proved himself to be a most worthy successor. As a teacher, Dr. Bush showed the quality which marked him through life- that of clear-headedness. He was dis- tinct in his enunciation of principles, exact in his demonstrations, and without pretense of oratory was always interest- ing and lucid to his students, by whom he was very much liked. As an instructor in the dry and technical science of Anat- omy, he attained an enviable reputation. This was to be expected from his intimate acquaintance with the subject, his love for it, and the grip of which his mind was capable in dealing with such intricate though demonstrable truths. In i839 Dr. Bush went abroad at the instance of the trustees of the College, and spent most of the summer in Lon- don and Paris, where he purchased many valuable books and instruments for the College. Britain and France were the I20 Kentucky's Pioneer Lithotomists Meccas of all ambitious and discrim- inating practitioners. It was the custom of Bush and Dudley to divide the students in the Medical Department into groups and each would alternate in entertaining them. In this way each budding medico was brought into closer contact with the professors and with each other, thus affording them the pleasure of spending a pleasant eve- ning. This practice was continued by Dudley and Bush as long as they were connected with the school. As a pro- fessor in Transylvania Medical School in its palmiest days, he is remembered by those students who are now living, though far advanced in years, and who profited by his teachings. Dr. Bush formed a partnership with Dr. Dudley, which was only dissolved by the death of the latter. They had quite pretentious offices for that day, as they were the acknowledged surgeons of the West. Many patients came from far and near to reap the benefits of their extensive knowledge. It not infrequently happened that patients would be brought Kentucky's Pioneer Lithotomists i2i to Bush's door lying on a "shuck bed" or on straw in a cart drawn by oxen which had traveled a hundred miles or more. No hospitals were in Lexington at that time, so he would send them to Mrs. Beatty, an old lady with whom he had arranged to keep such patients as he might send until he was ready to operate upon them. Mrs. Beatty lived at the corner of Walnut and Third Streets (the latter was then known as Winchester Street). She cared for a large number of patients sent her by Bush during her residence there. After the operation she would minister to their wants as best she could under the guidance of Dr. Bush. Thus it may be considered that this was the first hospital, if it may be so called, established in Lexington, Ken- tucky.' Already allusion has been made to Dr. Bush's wonderful lucidity. On one occa- sion a young woman from the town vis- ited the classroom and found Bush lec- turing to his class on the heart and cir- culation. After listening for a short time she fainted. Upon being carried to an I22 Kentucky's Pioneer Lithotomists adjoining room she revived and said that he made the subject so clear to her that she actually saw her own heart. While Bush was known all over this country as a splendid surgeon, his chief reputation lay in the wonderful dex- terity and skill with which he executed the operation for stone in the bladder. When Dr. Dudley retired in i850 from the field of his brilliant achievements as a surgeon, Bush had the courage to take up his work, and for many years held possession without a rival. ) When its use was feasible, Bush preferred the lithatrite to the gorget, though he often used the latter, doing the lateral opera- tion as Dudley had taught him. The photographs of forceps and litho- trites shown on pages 83 and I23 were pur- chased by Bush in Paris and used by him. It can be authoritatively stated that Bush performed more Litholopaxies than all the rest of the surgeons in the West. In this operation he was particularly successful, performing 2io Litholopaxies with only four deaths. He performed lithotomy 97 times with a loss of two. Kentucky's Pioneer Lithotomists 123 Lithotrites purchased in Paris, France, by Dr. Bush and used by him This page in the original text is blank. Kentucky's Pioneer Lithotomists 125 He bought all modern instruments and had a larger collection and more books in his library than any two surgeons west of the Alleghenies. He enjoyed the confidence of his pro- fessional brethren because they knew his ample knowledge of medicine in all its practical departments, his diagnostic acumen, and his rational judgment in cases were to be depended upon at all times. He won their admiration and love by his absolute fairness in all pro- fessional relations. He walked along the broad and open pathway of medical sci- ence, illuminated by justice and truth. He scorned with a bitter scorn all those men who tried to win success by defam- ing other members of the profession. He despised charlatanry, whether practiced openly or by men who claimed to be gentlemen and regular members of the profession. Dr. Bush was married in i835 to Miss James, of Chillicothe, Ohio, with whom he lived a life of unalloyed peace and happiness. To them were born three children, Thomas J., Dudley, and Nannie I 26 Kentucky's Pioneer Lithotomists M. Bush. After the Medical College burned in i863, he purchased the ground on which it had stood, at the corner of Second and Broadway, and erected one of the handsomest homes then to be found anywhere in the South. Here he had his office and residence until his death. Dr. Bush was a close and keen ob- server, to which was due his remarkable accuracy in delivering the pathology of a given case. He was probably better known than any other man in Lexington, and had more friends and fewer enemies -and this is the highest praise that can be bestowed upon any man.) Bush possessed a singularly well-bal- anced mind. His intellectual powers were of the highest order; his perceptive faculties were keen, quick and clear, enabling him to make accurate observa- tions upon disease and other subjects to which they were directed, separating the true from the false, the real from the hypothetical. He had the genius of versatility, that inborn, indefinable ele- ment called talent. These more purely Kentucky's Pioneer Lithotomists 127 Degrees conferred upon Dr. James M. Bush. No. s. Diploma admitting Dr. Bush a Fellow of the Society of Phil- osophy and Letters, presented to him July 3, 1829. ou 2. Testimonial from students who studied Anatomy under Dr. Bush. No. 3 and 4. Diplomas given Dr. Bush by Center College. This page in the original text is blank. Kentucky's Pioneer Lithotomists i29 Certificate of Honorary Membership in the Lexington Society of Medicine given March I, 1833 This page in the original text is blank. Kentucky's Pioneer Lithotomists 131 mental powers were so coordinated and impelled by the physical forces of the nervous system as to render him com- petent to achieve definite results in any department of intellectual work. They were discerned at an early date by his sagacious preceptor, Dr. Dudley. He saw that Bush possessed the precise combination of mental powers to make a great surgeon, and he did not hesitate to lay wide open to him his own exten- sive field of business. Dr. Bush was frequently honored by scientific bodies, as may be seen by glancing at the different diplomas on page 127 given him in recognition of his scientific and professional attain- ments. In July, i829, he was admitted as a "Fellow of Philosophy and Letters" and was presented with a diploma (see page 1I27). He had conferred upon him on March i6, i833, the honorary degree of Doctor of Medicine by Transylvania University (see page I33). In the same month and year he was made honorary member of the "Lexington Society of 132 Kentucky's Pioneer Lithotomists Medicine" (see page 129). This society had enrolled among its membership some of the foremost men of their day. Dr. B. W. Dudley was its President at the time the degree was conferred on Bush. The meetings of this body were conducted with seriousness and dignity and along purely scientific lines. During the ex- istence of the Medico-Chirurgical Society of Kentucky he was made an honored member. This society was among the first State Societies for the advancement of Medicine and Surgery formed west of the Alleghenies. On page 127 may be seen a photograph of a testimonial signed by a large number of medical students for the fidelity with which he discharged the important duties of Lecturer on Anatomy. Everyone who knew him conceded him candor. Above all, he had the highest type of personal honor and dignity, a life above reproach, a spirit with aims always noble, and always pursuing them by means worthy of the object, endowed with a noble heart ever softened by the cry of distress, and pained even to agony Kentucky's Pioneer Lithotomists 133 Honorary Degree of Doctor of Medicine given Dr. Bush by Transylvania University March i6, 1833 This page in the original text is blank. This page in the original text is blank. Kentucky's Pioneer Lithotomists 135 Certificate of Membership given Dr. Bush by the Kentucky Medico-Chirurgical Society This page in the original text is blank. Kentucky's Pioneer Lithotomists 137 when the relief of suffering was not within the power of his art. Bush was for twenty-eight years an honored and valuable member of the American Medical Association. He lived a useful life, and when his sickness be- came known throughout the country, and especially in his home city, there came a feeling over all classes that some indefinable danger was imminent, and that the accustomed safeguard would be wanting if the great surgeon were taken away. He died on the morning of Feb- ruary 14, 1875, from diabetes, a disease from which he had suffered some months prior to his death. Upon the death of Dr. Bush there appeared from an un- known pen, in memoriam, the following lines: "The icy rain drifts drearily; Dark clouds are sailing low; The wind sobs sadly, wearily, Burdened with human woe. But, remember, ye who wrestle With the mighty grief today, 'Neath the cold, green fields nestle, Blue lies still beyond the gray. 138 Kentucky's Pioneer Lithotomists "Shadows fall where ye must enter. Bow beneath them; they will pass As the shadows of the winter From the gardens and the grass. Summer's golden pictured story Springs from ruin, mould and dross; Germs of grief bear fruits of glory In the shadow of the Cross. "Heart-chains break for they are mortal, But a strong Hand holds each link, And they draw us towards a portal That is nearer than we think. For its silent, mystic splendor Is unveiled by Love and Faith, Saith our Master, wise and tender; And He meaneth what He saith. "Sorrow's darkest mines all shimmer With rich gold; her sterile sand Gleams with jewels; do not murmur; They were hidden by His hand. Ye shall find this priceless treasure Cleansed from stain and safe from loss, Heaped unto you without measure, Overshadowed by the Cross." 0i HI 4)45 4 U45 Cl) . This page in the original text is blank. Grave of Dr. James M. Bush This page in the original text is blank. Chapter I Dr. Robert Peter This page in the original text is blank. CHAPTER I DOCTOR ROBERT PETER T HIS book would be incomplete with- out mentioning those whose lives and daily work were so intimately asso- ciated with these great surgeons. Doctor Robert Peter was born at Launceston, Cornwall, on January 2I, I805. His family were distinguished for their learning. His parents emigrated from England to this country when he was about twelve years old, landing at Baltimore and later settling in Pitts- burg, Pennsylvania. While Peter was still a youth, he was placed in the whole- sale drug house, conducted and owned by Charles. Avery, of Pittsburg. There he began to lay the foundation for his chemical education, a branch of science in which he afterward shone with bril- liancy. He took a course at the "Rensselaer i46 Kentucky's Pioneer Lithotomists Institute Scientific School" at Troy, New York. Here he acquired the title of "Lecturer on Natural Sciences." Sub- sequently he lectured to small classes in Pittsburg, on chemistry. While in that city he was made a member of the "Pitts- burg Philosophical Society" and deliv- ered a series of lectures before the latter body. During i 830-3 i he lectured on Chemistry at the Western University of Pennsylvania. In i832 he moved to Lexington, Ken- tucky, to become a partner with the Rev. Benjamin 0. Peter in an "Eclectic Institute." This latter institute was located at West Second Street, on the site where "Hagerman College" now stands. Shortly after his arrival in Lex- ington he was made adjunct Professor in Chemistry to Dr. Yandell. After serv- ing in this capacity for some time he was made Professor of Chemistry at Morrison College in March, i833. Dr. Peter studied medicine in Tran- sylvania Medical School for one year, receiving the degree of "Doctor of Med- icine." He soon found, after practicing Kentucky's Pioneer Lithotomists 147 Dr. Robert Peter This page in the original text is blank. Kentucky's Pioneer Lithotomists i49 a short while, that he did not like the practice of medicine, and retired to en- gage in a more congenial pursuit. In i838 he was made Professor of Chemistry and Pharmacy in Transyl- vania Medical School which had been started only a few years previous. It was here, in the discharge of his duties, that he met and became intimately as- sociated with Dudley and Bush. He was connected with the school until its close. Dr. Peter was a great admirer of Dud- ley and Bush, and often watched these surgeons while at work, being often called upon to make analyses of specimens sent him by these illustrious men. The stones whose photographs are shown on pages 87 to 95 were all examined care- fully by him at the instance of Dudley and Bush, in order to ascertain their composition, which he did with his usual scientific accuracy. Dr. Peter mounted the stones on pasteboard, as is shown in the photographs, giving the composition and in many instances the names of the persons from whom the stones were re- moved. Both Dudley and Bush had an 15o Kentucky's Pioneer Lithotomists idea that if a careful chemical analysis were made of the stones removed by them, that some conception as to the cause of their formation might be gained, and it was this that prompted Dr. Peter to examine every stone sent him, a tre- mendous task, running as it did into the hundreds. One can readily appreciate the great assistance Dr. Peter was to these surgeons from the fact that he was not only a highly cultured man and possessed of good knowledge of medicine, but was one of the best known chemists in this country. Dr. Peter was a most indefatigable worker, often saying that he would rather "wear out than rust out"-a wish that was gratified. He retained his vigor of mind and body up to a very short time before his death, which took place at "Winton," his beautiful home, eight miles north of Lexington, Ky., on April 26, i894. With grace and dignity he had worn what Shakespeare, in his Henry VI, called "The silver livery of advised age." Kentucky's Pioneer Lithotomists i5i One who was associated with him for a great number of years and knew him intimately, said: "Intense devotion to physical science and work of the lab- oratory, purity of speech and modesty of manner, fidelity to all duties, domes- tic, professional and civic, his long and illustrious career in educating so many thousands of the young, and in setting before them a model worthy of their imitation and remembrance-these were the traits, this was the service that crowded his busy life of nearly ninety years with honor, admiration and re- nown." This page in the original text is blank. Kentucky's Pioneer Lithotomists I 53 Transylvania University Medical Hall Second Street and Broadway, Lexington, Kentucky. Built in 1839. Burned, 1863. This page in the original text is blank. Chapter II Absolom Driver, The Janitor of Transylvania University Medical Hall This page in the original text is blank. CHAPTER II ABSOLOM DRIVER-THE JANITOR OF TRANSYLVANIA UNIVERSITY MEDICAL HALL THIS unique old character was a Vir- ginia negro; and just how or when he came to Lexington is not known. It seems that after the establishment of the Medical College in Lexington, Kentucky, the trustees experienced some difficulty in securing the services of a janitor who would discharge the duties satisfactorily. After some discussion, the matter was placed in the hands of Doctor Dudley, who was then Dean of the College. After casting about for a proper man to fill the position, he finally selected "Old Absolom," as he was familiarly known. Absolom held the position of janitor up to the time of his death, which oc- curred a short while before the College burned. Absolom took great pride in arranging the operating room and hav- ing everything in readiness for Doctors Dudley and Bush, often being called x58 Kentucky's Pioneer Lithotomists upon to assist in holding the patient while the doctors performed the opera- tion, as anaesthesia was not known at that time. Another duty which Abso- lom was required to perform was that of securing "stiffs" for the dissecting room, presided over by Dr. Bush. So expert was he in the performance of this par- ticularly gruesome duty that the College never lacked material for dissection. No, it was not this old Southern darkey who wrote this limerick, but he would if he could: "There once were some learned M. D.'s, Who captured some germs of disease, And infected a train, Which, without causing pain, Allowed one to catch it with ease." Absolom was scrupulously polite, al- ways deferential to his superiors, who treated him with great consideration. At the time his death was announced the faculty assembled in the "Hall" of the Medical College and passed resolutions of respect, as he had held the position of keeper of the Medical Hall for many years with unswerving fidelity to his masters. Kentucky's Pioneer Lithotomists 159 Absolom Driver, for many years Janitor of Transvlvania Medical Hall