Jefferson Medical College - Clinic Yearbook (Philadelphia, PA)

Page 23 text:

e Com lg utheijseg Zh ls . 111 ,er the heal. l70SEd by W fat SUISCOHS 1 at the Uni. mf Williams SS fflremost ,C that Gross lnt. In 1918 'ears of the , Cf I iS cast aside TSC the then Listerismf' :haracteristic ready to ac. en he intro- rethodg of incidence of educecl. But hen younger :off surgical in North Other pioneers also received sup- port and encouragement from Cross. Nicholas Senn, the great Chicago sur- geon, revealed that he had dedicated his major work on tumors to Cross be- cause the jefferson surgeon had en- couraged him when he was despairing over criticism of an article he had written early in his career. Cross praised the article and urged the young surgeon to go on to greater things. Cross knew first-hand the struggle for greatness, and how helpful encourage- ment could be. His own struggle began inauspi- ciously after his graduation from jeffer- son in 1828. Prospects were lean for a young physician in Philadelphia at that time, so Cross and his new wife returned to Easton-hardly the place to build an international reputation- where he began to practice. In his spare time he worked diligently, dis- secting cadavers Cobtained quietly D and writing. His output was volumi- nous. Within 18 months of his grad- uation he had translated four major works and published a total of 11,000 pages. Nulla tlie sine linea Cno day without writingl was his motto, and he stuck to it. After his initial effort at translation, he embarked on a career of original contributions, writing a text entitled Diseases anal Injuries of the Bones and joints. - Soon after his original Writings were published CPost hoc ergo propter hoc?D, Cross headed West to teach anatomy at the College of Ohio. He was 28 years old and had only S150 to his name. He later was appointed pro- fessor of pathological anatomy at Cin- cinnati Medical School. While there, he published Elements of Pathological Anatomy, the first book on this subject in English. The text gained him recog- nition in Europe, for he was soon in- vited to membership in the Imperial Medical Society of Vienna. Member- ship in the Clinical and Pathological Societies of London and the Medico Chiurgical Society of Edinburgh soon followed. The significance of Cross' work can be gauged by the reaction of Virchow, father of pathology. Thirty years after Elements was published, Cross was honored at a banquet in Vienna and Virchow, his host, dis- played a copy of the text, describing it as one of the prized works in his library. At the age of 35, Cross left Cin- cinnati for Louisville, where he taught surgery from 1840 to 1856. While there, he completed his System of Sur- gery, which biographers believe was his greatest contribution. It took two vol- umes to encompass the 2,300 pages and it established Cross as America's fore- most surgeon at that time. When he retired, it had gone through six edi- tions and had been translated into most major languages. Years later, Keen de- scribed the work as a mine of informa- tion, a textbook worthy of its author. It has been the companion and guide of many generations of students. - Cross accomplished much at Lou- isville, but in 1856 he decided to re- turn to Philadelphia where he could limit his practice to surgery. At the age of 51, he resumed his association with jefferson and, in his introductory ad- dress, made this commitment: Whatever of life and health and strength remain to me I hereby, in the presence of Almighty Cod and this large assemblage, dedicate to the cause of my alma mater, to the in- terests of medical science and the good of my fellow creatures. He remained active at jefferson for 26 years, operating, teaching and writing. On the eve of the Civil War, the War Department asked him to prepare a Manual of Military Surgery. Published in 1861, it was rushed to Union surgeons treating battlefield casualties. The Confederacy published a pirated edition, giving Cross full credit but regretting that conditions beyond our control prevented the usual reprint arrangements with the author. Ironically, Cross became a uni- fying force in medicine after the war, just as his surgical manual had been during the conflict. He was one of the major factors behind the election of a Tulane professor as the 30th president of the American Medical Association. According to reports at the time, Cross backed the election to help obliterate the effects of the war in the profes- sion. Cross took a leading role in the A.M.A., just as he did in scores of other societies. He was the prime mover behind establishment of an alumni association at jefferson and served as its first president-exactly 100 years ago. His professional stature was apparent from his election as president of the World Medical Congress, which convened in Philadelphia in 1876 as part of the centennial of American independence. He had been invited to address the International Medical So- ciety, which met in London several months after his death in 1884. In death, Cross left enduring marks on his alma mater. Not the least of these is the Alumni Association, which is the most active and generous medical group in the nation. His name is perpetuated through the Samuel D. Cross professorship of surgery, which was the first endowed chair at jeffer- son. Chalmers Da Costa, the first Cross professor, hailed his surgical predecessor as the author, the oper- ator, the scholar, the teacher, the or- ganizer, the scientist who came to the foremost position ever occupied by a surgeon in this country. . Other men have had such honors, have worked diligently and have writ- ten prolifically. Yet few are remem- bered as Cross is. One of the major reasons, perhaps, is the famous Eakins painting of The Gross Clinic. The pro- fessor was a perfect subject for such a painting. He was a strong personality, a stalwart Hgure with a- beautiful benignant countenance, according to Garrison. Eakins, master of realism, captured Cross' personality in oil and created an immortal work. The artist had a personal stake in the painting, for he had studied' anatomy under Cross as a special student at jefferson. It has been described by some art publications as possibly the most im- portant painting by an American. When unveiled, however, the realism of the operating room scene horrified contemporary audiences and the work was rejected for showing in an art exhibition. Now the gigantic canvas hangs Cwhen not on loan to museums for exhibitl in a place of honor outside McClennan Hall, dominating the entrance to the College Building. Re- productions of the painting hang in thousands of jefferson graduates' of- fices across the land. Each year, return- ing alumni can be counted on to repeat a poignant scene. Stopping under the priceless canvas with wife and children in tow, they look up reverently and recite the legend of Samuel D. Cross. Can there be any doubt why the lustre of that legend refuses to fade?

Page 22 text:

4,1464 , ,. .. . .-K' - ' ' - - .-in -1 - V 4. - .- --- . . H n- V VN V 0 4 A Wu- lqpw , W- ,,., ............ --- - - A N -.-- --.N . ,U l V , -.. ....-.f-..-..a-.. .----. er .J amuel D. Gross was more than an eminent alumnus, a preeminent alumnus or even an immortal alumnus. He is accepted generally as the great- est physician Iefferson has produced. Fielding Garrison, an authority on medical history, described Gross as the greatest American surgeon of his time. To many, he symbolizes Iefferson, dominating its past, reflected in its present and giving inspiration for its future. He came to Jefferson in its infancy-when the college was barely two years old and struggling for its very existence. When he retired in 1882, jefferson had a respected reputa- tion, built in large part on Gross prestige. Gross, life is testimony to the ability of genius to overcome obstacles. He was born a simple Pennsylvania Dutch farm boy near Easton, but be- cause his mind and his industry were irrepressible he became an interna- tional figure. His first obstacle was language, perhaps the most important academic tool. He spoke almost no English, since the family tongue was the peculiar German dialect spoken by the Pennsylvania Dutch. Gross not only gained mastery of English as a youth, but French, Italian, Latin and Greek as well. This was characteristic of the man: he performed the task at hand, then went beyond it. For the remainder of his life, he was an in- satiable reader and prolific author, working to within two hours of his death. Tributes to Gross have been boundless-both in number and source. Most significant are the assessments of his colleagues and students. A fitting example is the inscription on the urn containing Gross' cremated remains in Philadelphia's Woodland Cemetery: A master of surgery, he filled chairs in four medical colleges in as many states and added lustre to all. He recast surgical science as taught in North America, formulated anew its principles, enlarged its domain, added to its art and imparted fresh 1 f ' H fr '- .n 1 Zillafl - gf YR ' f -- Qkv. :I I-r .f T M l 1 - .mp - -. Nlhv 4. .1 .., impetus to its study. He composed many books and among them A System of Surgery, which is read in different tongues wherever the heal- ing art is practiced. That tribute was composed by W. D. Yandell, who went on to become one of the Midwestis great surgeons after studying under Gross at the Uni- versity of Louisville. Many consider William Williams Keen to have been Gross, foremost pupil, and there is evidence that Gross agreed with that assessment. ln 1918 Keen recalled the last years of the master surgeon when Gross cast aside strong prejudices to endorse the then struggling principles of Listerismf' This, of course, was also characteristic of the man. He was ever ready to ac- cept new knowledge. When he intro- duced rudimentary methods of antisepsis in his clinic, the incidence of wound infections was reduced. But many physicians, most of then younger than Gross, continued to scoff. g, D e recast surgical science as taught in North we - . 1 .. -V E, America 06561 Pi CII' ilioicholas geon, fevea his 1113101 W0 cause the li courfigefhin over critrcrsr Written C211 praised the surgeon T0 Gross lU1CW greatness, an ment Cotllfl 1 His owl ciously after son in 1828. young P11151 lllaf timer SC retumed tol build an i where he ll spare time l setting cada and writing. nous. Withi uation he l works and p pages. Null uithoutwrit stuck to it. translation of original o entitled Dis Bones and it It BH 2 Soon an were publisl 11091, Gros 3I18I0my at 1135 23 years lessor of pat Cinnati Meg he Publisher imma, th illlnlihglish. ' l gn ' vited tgn Midifal So: 33 in the E595 of Chmfgital 1 followed .I Work i Virchslrt Ears after T033 V- Was 3 a lenn n Played a C03 is one of lliral-yi

Page 24 text:

e transformed the tra- ditional role of the American physician abroad from that of humble student to that of honored teacher t is popular to credit chance-or what Sir Walter Scott described as the happy combination of fortuitous cir- cumstances -for significant discoveries in medicine, as well as other fields. Thus, many writers have been over- impressed by the elements of fortune underlying the contributions of Cfor lamesl Marion Sims to medicine and particularly to gynecology. The barest research reveals, however, that years of hard work and frustration underlay Sims' initial-and probably his most important-Contribution in this field, the first successful surgical procedure for repair of a vesicovaginal fistula. The importance of his discovery is un- contested. Prior to Sims' operation, wo- men with this condition were classified as incurable and became outcasts, for- saken by the families as well as society. Many of them wished for death, some died by their own hand. For two cen- turies before Sims, leading surgeons of Europe had been unsuccessful in de- vising a successful operation for the condition. That there was some element of chance in Sims' achievement is unde- niable, especially in view of the fact that in the early days of his practice he referred all patients with female problems to doctors specializing in this field-known derisively at the time among physicians as male midwifery. In 1845 Sims had been practicing 10 years but had not seen a single case of vesicovaginal fistula. Then in three months while practicing at Montgom- ery, Ala., he saw three female slaves with the condition and was forced to report to their masters that their plight was not correctable and they would never return to the fields. The proximity of the three cases was the first element of chance, the second was the accidental discovery of the lateral kneechest position for good visualization of the pelvic organs. Sims had been called to see a woman who had fallen from a horse and was com- plaining of back pain and pressure on her bladder and rectum. He decided after physical examination that the woman's uterus had been displaced by the fall and should be returned to its normal position. But he had no idea how to go about the procedure. He tried to recall a medical school lec- ture 'll years before and, accordingly, placed the woman on her knees and elbows and began to probe her pelvis with two fingers. Suddenly, she WHS relieved-and no one was more sur- prised than Sims. Maintaining his air of professional omniscience, he calmly removed h1S hand and said, You may lie down now. As she did there was an em' barrassing rush of air. Sims realized quickly it was merely expulsion of alr he had introduced during the proce- dure and he concluded it was atm0S- pheric pressure that had restored the uterus to its proper place. He 1m- mediately saw clinical application Of this phenomenon. lt could be used'tO make the walls of the vaginal C3Vlty visible. His thoughts turned to the young slave girl waiting at his home for a train back to her plantation. She was the third patient with the dreaded fistula whom he had seen in three months. He enthusiastically began to plan an and the c0Il5ldeI His Cafe' eaIlY se establish native I marked He ing I0 tackle S0 first C09 3 dCSCUl 3 Cleft . adult W' lutiollall sarcoma disfiguri when 52 operatioi successh mostly C for whi throught I His sign of I his way girl he s spoon, vl varyingl instrume famous l It hroug into viev to Opera fruslratir his Colle heforeh ated on . -leading MOIilg01 humane SPire the been Sidi fhe 184i Plalnedi dolllli, tl slavery, dlle fri t lbs linoi onli' llc Ilormal 3 Sin Opefalioi ini i. 3SSl1med Clothing to Peffe Until 15 llhg H CUIS- uCCef fill