The next great figure in Axnerican surgery was Ephraim McDowell, who came from what was then called the "Far West,n in Kentucicy. When young he went to a classical seminary, where he got a smattering of Greek and Latin, but did not conclude to study his profession until he was 20. He began reading medicine in Danville, Ky., but was finally sent to Edin burgh by his father. Here he came under the influence of John Bell, whose teachings made him what he became. He returned in 1795 and decided that there was a rare opportunity in Kentucky for an educated physician, in which niatter his foresight proved correct. In 1809, when he undertook the first and great historical (Ovariotomy,' he was already known as an ac complished and educated man, upon whose mind the teachings of John Bell had made a great impression. When Mrs. Crawford came to him, suffering from an ovarian cyst, he was ready to undertake her case despite the protests of others. The case terminated favorably, but it was not until he had performed a number of similar operations that he thought it best to publish anything on the subject. Even then his paper did not see the light as it should, and there was for a time a doubt in the minds of those who should have lcnown better as to whether his report was really authentic and whether he should be credited with this path finding expedient. He has been amply vindi cated, however, and this fortunate experience of his paved the way for many operations but for whose effects thousands of lives would have been sacrificed.
The next great figure was Valentine Mott. He was born in 1785, and was of Quaker par entage. He was a great classical student, and was well equipped for professional study when he began to study medicine. He then spent two years in Great Britain. especially in London, which was then rich in famous surgeons. Un der Hunter, Cooper, Abernethy and Charles Bell he acquired that fatniliarity with surgical anatomy which was a great help both then and in later years. He returned to New York in 1809, and his personal traits as well as his thoroughness quicldy brought him practice and made him known. He became the teacher of surgery in the Columbia School until he trans ferred his activities to the new school which re sulted from the union of Columbia and the College of Physicians and Surgeons, where. he lectured for 56 years, inspiring in his classes constant enthusiasm and eagerness for work. The influence of his insistence upon the im portance of anatomy still persists, and wat bril liantly demonstrated by his work upon the blood vessels. It is said that he tied more large vessels than any other surgeon living or dead. Perhaps his greatest achievement, at least the one that made him most famous, was ligature of the innominate artery. This first operation of its kind was not permanently successful, nevertheless it stamped the operator as a man of wonderful resource and daring. The first successful case belongs to another American surgeon, A. W. Smythe, of New Orleans, who
tied at the same time, the carotid artery in the necic. Again he won great repute by removing the entire clavicle for a large tumor. In 1827 he tied for the first time, successfully, the com mon iliac artery. The previous operation had been made by another brilliant American sur geon, Gibson, of Baltimore, whose patient un fortunately died of peritonitis. In 1835, quite broken in health, he made a tour of Europe, which had about it much of a triumph, inasmuch as he was everywhere received with eclat.
We have already recounted how John War ren served in the Revolution both as a surgeon and patriot. His son, John Collins Warren, was born in 1778, and was reared in an atmos phere of study and refinement. He was thor oughly educated for his work, in which he took the greatest pride, and, like Mott, had the advantage of the teachings and friendship of the most distinguished foreign surgeons. Two events of importance, in which he was conspicu ous, were the founding of the Massachusetts General Hospital, and the introduction into sur gery of the then new anmsthetic, sulphuric ether, of which vee shall have more to say be low. He was a bola operator and for his oper ations on bones, especially the jaws, he became famous. He gathered a memorable collection of his personal cases in his 'Surgical Observa tions on Tumors,' which are to-day most in structive. He was the founder of the large col lection of specimens now icnown as the War ren Museum, in Boston.
While Warren and Mott were malcing their great reputations in the East, it remained for Kentucicy to produce still another even greater than McDowell, in the person of Benjamin Winslow Dudley, born in 1785, who began life in an obscure way and who raised himself to eminence purely through his own attributes and strength of character. While quite young he made enough money, by a shrewd enter prise, to take him abroad where he remained several years, returning a polished and educated gentleman. Cooper and Abernethy in London, and Larrey in Paris, were men for whom he had much admiration and with whom he be came well acquainted. When he returned he was 29 years of age, matured and devoted to his science. As a measure of his success it may be said that in his first 100 cases of cutting for stone in the bladder he lost not one; a state ment that could be made by but few surgeons to-day. His early work in the surgical treat ment of epilepsy directed attention to what could be done in this almost hopeless disease, and his treatment for hydrocele by excision of the sac is in common use to-day. For 20 years he was prominent in the Transylvania Medical School, in Lexington, Ky., which was later merged into the College of Louisville. Dudley wrote very little, but his personal influence was extraordinary, and he was without doubt the leading practitioner of the West. He died in 1870.