“Much of the renown acquired for Kentucky by her surgeons was in the treatment of calculous diseases”: Visions of the Past, Thanks to Gutenberg (III)

What’s the point of looking into old historical texts if not to explore texts about surgery? Thus, Gutenberg presents us with David Yandell’s 1890 treatise, Pioneer Surgery in Kentucky: A Sketch. * You know this is going to be illuminating. How drunk was everyone involved? Were Kentucky doctors still bleeding patients in 1890? Are they still in 2016?

The last question goes unanswered, sadly.

This is the start of the text:

1806. The earliest original surgical work of any magnitude done in Kentucky, by one of her own 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 laceration 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, 1806; the place, Bardstown; the surgeon, Dr. Walter Brashear; the assistants, Dr. Burr Harrison and Dr. John Goodtell; the result, a complete success. The operator divided his work into two stages. The first consisted in amputating the thigh through its middle third in the usual way, and in tying all bleeding vessels. 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 attachments, was then disarticulated at its socket.

It goes from there. Unfortunately, some of Kentucky’s finest didn’t stay in the Bluegrass. They traveled abroad and came under the influence of the Celestials, and no doubt their opium:

While among the Celestials he amputated a woman’s breast, probably the first exploit of the kind by one from the antipodes. Unfortunately 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 fortune, but brought him back to the calling in which he was so well fitted to shine. He moved, in 1813, 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.

Of course, anyone can secure a functional career in Lexington, even under the influence of opium, as Farley can attest.

Most of the book is a combination of somewhat disturbing tales of pioneer surgery and odes to the glory of sweet, sweet Kentucky. Such as:

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, however, 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 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 This marvel of work was done without the help of anesthetics 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 unpolluted 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 deepened 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.

I don’t doubt it, but thankfully we have turned this pure Kentucky water away from something as useless as surgery and toward something of far greater value: bourbon.

In all truth, this is kind of an interesting book if you are into reading about historical amputations. And who isn’t?

* I am proud to say that I am evidently one of four people who have downloaded this book.