[From Schurigio: Lithologia Historico-Medica, Dresden, 1744.] ANNALS OF MEDICAL HISTORY

New Series, Volume VII May, 1935 Number 3 DR. BENJAMIN WINSLOW DUDLEY* By W ALLER 0. BULLOCK, M.D.

LEXINGTON, KY.

AMILY tradition in Spottsylvania County (Virginia) has it that towards over the Cumberland Mountains into the end of the war Kentucky, Ambrose was on hand to of the Revolution bid them God speed, and five years a company of Co­ later (March, 1786) he himself with lonial troops was family of wife and seven children, stationed in the slaves, livestock and household goods, little town of Fred­ took up the now well worn “trace” ericksburg on the Rappahannock. through Cumberland Gap, and arrived The young captain of his company, at his destination in Kentucky in whose home was in the country May, nearly two months later. nearby, on hearing Baptist Parson Benjamin Winslow, the seventh Lewis Craig preaching from behind child of Ambrose and Annie Parker the bars of his prison—he was not Dudley, first began to “inhale the licensed by the state—became con­ slow poison that surrounds our planet” verted, was baptized in the presence on April 12, 1785. He was, therefore, of his troops, resigned his commission not quite a year old when his parents and devoted the remainder of his life took him away from their old Virginia to the saving of souls. farm. He learned to walk while cross­ Young Captain Ambrose Dudley, ing the Cumberlands. from now on Baptist Parson Dudley, Of his childhood and early school­ and Parson Craig remained forever ing, nothing is known, but being one strong friends and there is reason to of the large class of famous men believe that the influence of Craig had whose fathers ministered to the souls much to do with Brother Ambrose’s of men, it is to be inferred that the migration to Kentucky. Parson shared with Benjamin his When Craig led his traveling church stock of knowledge. Transmitted to of 500 members from their homes him likewise by his father was the *Read before the John Bradford Society, April 4, 1934. quality of leadership, for it has been Returning to his native state he said that the Parson ruled his flock began to practice his profession when of “Particular Baptists” at Bryan the western urge struck him. So in 1790 we find Dr. Frederick Ridgely among the early doctors of Lexington where he continued to practice until 1822 except for the period when as Surgeon General he served with General Wayne in his successful cam­ paign against the Indians. He was one of the first two teachers of Trans­ ylvania Medical Department (1799). After completing his schooling, such as it was, and serving for a time as clerk in Trotter’s store the Parson placed Benjamin Winslow in the office of Dr. Ridgely to learn what he could from him. How long this period of apprenticeship continued is not known, but it was long enough to establish lasting relations of mutual respect and friendship. In 1803 we find Dudley, while under the preceptorship of Dr. Ridgely, recorded as a member of the Lexington Medical Society. In the fall of 1804 we find him matriculated in the Medical School of the University of Pennsylvania in Station with no gentle hand. Philadelphia. Among the students Of the schools in the wilderness there at that session were three men, at this period his contemporary Daniel Drake, Richardson and Cook, who Drake has given a pitifully accurate were later to be associated with him picture,* but they did possess one sig­ at Transylvania. On his return to nal advantage: they eliminated quickly Lexington in the spring of 1805 Dudley all but those determined to learn. In entered the office of Dr. James Fish- 1797 the Parson moved to Lexington; back, a versatile doctor, lawyer, writer here Benjamin had a better chance to and preacher, who was also at one learn his three R’s. time one of Transylvania’s medical A young Marylander had just fin­ teachers. Returning to Philadelphia ished his tutelage under a worthy in the fall he completed his course and practitioner of Delaware when the received his degree of Doctor of Revolutionary War broke out. Attach­ Medicine the following March. Ham­ ing himself to a company of volunteers pered by defective schooling there is he enlisted and continued throughout nothing to indicate that at this period the war serving as an army surgeon. he was in any way above the average; * Pioneer Life in Kentucky by Daniel nor is there any evidence that he was Drake. impressed by his medical teachers. Returning again to Lexington in the line of endeavor; the glamour of latter part of March, 1806, just victory and superiority was over all— two weeks before his twenty-first no wonder Dudley was captivated birthday, Dudley entered into the and fell in with the spirit of his practice of medicine and while (from surroundings and that he acquired his ledger) he seems to have done French habits and mannerisms that fairly well, he was not satisfied. were to remain with him to the end. In 1809 Transylvania made an Paris with its vast hospitals and effort to establish a complete course abundant material presented much in Medicine and Dudley was given the to interest the student of medicine in chair of Anatomy and Physiology. It 1810. appears to have been this experience Pinel was getting old but could be that caused in him the determination seen daily at the Salpetriere where he to fit himself for a career of surgery had removed the chains from those and teaching. miserably sick of mental disease. A not uncommon practice in Ken­ Dupuytren, assistant surgeon at the tucky of that day, especially among Hotel Dieu, was well started on a the legal profession, was that of career of tremendous surgical activity going to New Orleans with a flat boat that was to win for him world-wide load of produce (whisky, hemp, flour fame as an operator and a fortune of a and nails) and setting up as commis­ million and a half dollars, leaving his sion merchant in that city. Often name to an instrument still in use rewards were large. Dudley, risking and to a deformity of the hand. his savings in such an enterprise, was Bichat had been dead eight years, successful enough in a short time to yet in his brief but meteoric life of purchase a ship load of flour. Some­ thirty-one years, he had blazed trails time in 1810 he sailed and sold it at that were to become the well-traveled Lisbon and Gibraltar (probably at roads of histology and pathology and war time prices to the British then in had done much to place the French possession of the coast). Hastening teaching of anatomy in a position of across Spain he went direct to Paris. preeminence that was retained for Fifteen years before “a whiff of more than half a century. grape shot” had put an end to the Boyer and Dubois contributed their mad carnival of terror, had abrogated share and are mentioned by Dudley the Divine right of insurrection and with admiration, especially Dubois. had set Bonaparte on a triumphal At the Invalides in the intervals military career that was to place him between campaigns could be seen and on the throne of the Bourbons. At this heard Larrey, the great and good time Paris was the capital of Europe; Dominique Jean, Baron, Larrey, the the Emperor of the French and his greatest military surgeon of all time of Austrian wife were living at the whom Napoleon wrote in his will: Tuileries; France was at peace with “He was the most virtuous man I Europe except in the Peninsula where have ever known.” Britian and the Spanish peasants Of all men in France, aside from kept up a persistent nagging conflict; Napoleon, it was Larrey whom Dudley the spirit of Paris was electrical; a new most admired and it was from him power was making itself felt in every that he undoubtedly derived many ideas that were to serve him so well had fallen upon the shoulders of a man in his surgical practice. To mention who has been described as an irritable, but a few there were: (i) Gradually cranky, wise and lovable genius, John applied pressure for hernia of the Abernethy, surgeon at St. Bartholo­ brain. (2) Discarding of greasy oint­ mew’s. In personality and influence, ments and pastes in the treatment of Abernethy towered far above his wounds. (3) The principles of muscu­ more successful competitors. His lec­ lar relaxation obtained by the applica­ ture rooms were always crowded with tion of the circular bandage. (4) Not eager students. He taught from na­ waiting for a line of demarcation in ture, from experience, as well as from progressive gangrene. (5) Meddlesome the book and he expounded John interference with the healing of wounds Hunter. It was Abernethy to whom by too frequent dressings. Dudley looked as authority in all Dudley was in Paris at the time of matters of surgical philosophy and Napoleon’s ill-fatecl Russian invasion, this authority with him was final. was there on that fateful December Astley Cooper, surgeon at Guy’s night in 1812 when the Emperor Hospital, became Sir Astley after returned and through the influence removing a wen from the head of of Caulaincourt was present when the George iv. He was regarded in his day Emperor addressing the Deputies be­ as the most skillful surgeon in the gan by saying “The Grand Army of world. His work on tumors of the the Empire is annihilated.” He used breast is one of the milestones of often to say that this was the most breast surgery and his volume on impressive experience of his life. It has hernia, from an anatomical stand­ been said that he was offered a staff point, has never been excelled. Dudley position in Napoleon’s army, but he studied Cooper, not only as an opera­ preferred to return to America. tor and teacher, but probably also, Leaving his apartment in the rue de as that most desirable object, a Colombier after becoming thoroughly success. saturated with the teaching and tradi­ As has been often stated, Dudley tions of Paris, Dudley went to London did not have a brilliant mind, but where he remained for about a year, knowing what he wanted, limiting living in Bow Lane. There were three himself to that alone, devoting his men in London who influenced pro­ whole time and attention to that one foundly all his surgical life. They were object, he developed a peculiarly re­ Cline, Abernethy and Cooper. tentive memory of all experiences Henry Cline, surgeon at St. Thomas’ bearing on that subject and later an Hospital, was the only man in all ability to describe simply and directly London willing to help Jenner in all such experiences. proving the efficacy of vaccination. And so in the summer of 1814 we From Cline Dudley learned much find him once more in Lexington where about lithotomy. It was Cline’s gorget he is to spend the rest of his life. But he always used in entering the bladder it was not the same Dudley who left it and it was also from Cline that he got four years before. Fully conscious of the idea of trephining for epilepsy, his powers he came to win. the beginning of brain surgery. All who have written of Dudley say The mantle of the immortal Hunter that he was not a student. While this is true in a literary sense, his capacity Dr. Dudley and my sister (Anna), who for learning by observation and experi­ were married on the 10th inst., have ence more than compensated for this arrived here. . . . They return imme­ deficiency. He had a considerable diately to Lexington where Dr. Dudley’s knowledge of Anatomy and was well business requires his constant attention. grounded in the principles of Surgery. He ranks higher than any other man in the western country as a surgeon and He had vigorous health and strength. has been singularly fortunate in some of He had ambition and great industry. the most important operations. He had a sense of publicity, of show­ manship without which only a genius And again five years later (Decem­ of the first class may obtain full ber 4, 1826). recognition in his generation. He also Dr. Dudley is surely a very excellent had a capacity for intrigue which he anatomist and a capital operator. He has was to use without reserve to secure performed, 1 imagine, more of the great his ends. operations in surgery than Dr. Physick— Lunsford P. Yandell says of him: and has become more singularly fortunate in them. He has that pleasant agreeable His profession had become the engross­ manner which so strongly characterized ing object of his thoughts, and from Dr. Wistar with whom he may compare that time on until age made it necessary very creditably as a lecturer. for him to relax his labors, he applied Within a year of his return Dudley, himself to it with undeviating fidelity. I am sure I have never known a physician with James Overton and Rev. James who made himself more a slave to his Blythe, began teaching Anatomy and profession. He had no holidays. He sought Surgery, Medicine and Chemistry, in no recreation; no sports interested him. a vacant room in Trotter’s warehouse and continued these courses until 1817 To one so equipped, success, full and when Transylvania took over the immediate, could not be denied. When enterprise and enlarged the course to he came to Lexington in 1814 he found include Materia Medica and Obstet­ in the west none to meet his challenge rics. Daniel Drake and Wm. H. save Ephraim McDowell of Danville, Richardson were chosen to fill the whom he quickly distanced in the respective chairs. Before the end of minds of his contemporaries. He soon the session temperamental differences acquired a proficiency in operating had developed acute antagonisms. which rapidly developed into out­ Result, Dudley had shot and wounded standing skill. Richardson. Overton, “disgusted with That he proved himself in the eyes medical politics, had moved to Nash­ of his associates and the people at ville.” Drake had refused to fight with large more than equal to the tasks that Dudley for what he regarded as confronted him is evidenced by the sufficient reasons and issued from fact that within a period of six years Cincinnati an appeal to the Justice he was the acknowledged leader in his of the Intelligent and Respectable chosen field throughout the west. People of Lexington, a scathing tirade Dr. C. W. Short, Hopkinsville, in which Dudley is pictured variously Kentucky, writing to his Uncle Wm. as an ignoramus, a bully, a liar and Short in Ballston-Spa, N. Y., under what not, and concluded by saying, date of June 16, 1821 says: “The obligations of official duty might compel me to associate with such a was successful. Charles Caldwell and man, but nature would defend me Samuel Brown were added to take the against his friendship.” places of Overton and Drake. Both the Dr. Graham, friend, student and additions were cultured broad-minded demonstrator for Dudley, in a letter to men. Caldwell, a phenomenon of Dr. Peter says the dispute arose over industry, was of wide information, a an autopsy on an Irishman who had wordy controversialist, of handsome died as the result of a head injury. pleasing personality, a ready speaker Following this dispute there was an ex­ with a ponderous elocutionary style, change of pamphlets in which Dudley a superlative egotist, often comparing appeared at a disadvantage to Drake. himself to Benjamin Franklin, boast­ However, says Graham, Dudley chose ing even that his autobiography was another method of obtaining satisfac­ longer than Franklin’s. But in spite tion and challenged Drake to a duel. of all his boasting, or perhaps because In the course of the dispute charges, of it, he was widely and favorably involving the veracity, not only of known and he has the credit of being Drake but also of Blythe and Richard­ the first in America to teach Medicine son, were brought by Dudley. Drake at the bedside. He was perhaps the refused to accept the challenge which most useful acquisition the school was, however, accepted by Richard­ possessed in its early days. In his son. The duel resulted in Richardson autobiography he thus describes his being severely wounded, the femoral associates: “I had under my direction artery being severed. Dudley, with one of the most miserable faculties of permission of his antagonist, who medicine, or rather the materials of would have speedily bled to death, which to form such faculty, that placed his thumb on the vessel at the the Caucasian portion of the human groin and controlled the circulation family can well furnish or the human until Richardson’s surgeon could se­ mind easily imagine.” Of Dudley he cure and tie the artery, an act of says: “The fourth professor though surgical instinct. perhaps the most mcagerly endowed Graham describes the preparation of the whole by nature, was the only for the duel. He and Dudley for several one that was qualified and resolutely nights before hand would assume determined to work.” positions in diagonally opposite cor­ Samuel Brown, the other addition, ners of the room over Dudley’s shop was one of the first medical faculty of and rehearse the details. Dudley said 1799; was a cultured experienced he wished to fight in a green suit he physician- a fluent talker and a man had bought in Paris. Graham, without of high principles. He had in 1802 Dudley’s knowledge, cut all the but­ applied vaccination to a whole com­ tons from the outside to reduce munity “before Jenner could get the conspicuous sights to his adversary. confidence of the people of his own No attempt seems to have been country.” made to conduct regular classes in This group got along about as well 1818-1819, but in the latter year, as could be expected for eighteen under the presidency of Dr. Horace years. In 1825 Brown quarreled with Holley, a fifth attempt to launch Dudley and left. Drake returned in a medical school with a full faculty 1823 and left again in 1827. C. W. Short was added in 1825 and John faculty urged the trustees to seek the Esten Cook took Drake’s place in enactment of a law giving to the 1827. The number of students in­ college the right to the bodies of creased from 37 in 1819 to 262 in 1835 criminals legally executed and of those and in 1837. dying in the penitentiary. (It was Young Vesalius, who three hun­ naively argued that this might have a dred years before, on moonless nights deterrent effect on persons contem­ fought with savage dogs beneath the plating crime.) Dudley’s work as gibbets of Montfaucon for the bones professor of Anatomy was greatly of criminals to complete his articulated hampered by this continuous dearth skeleton, was hardly more zealous of cadavers. He was wont to say he than the youths of the early Transyl­ would rather be damned than to meet vania Medical School in securing their his class, so unprepared was he. anatomical material. Sometime in 1834 Dudley seriously Lexington was never a village. From proposed to the faculty that the its beginning as a frontier trading medical school of Transylvania be post it was a self-contained little city moved to Louisville, a town then of with a cocky individuality, but the some thirty thousand and rapidly little city of 1820-1850 contained few growing. The faculty in unanimous of the derelicts whose mortal remains, agreement was pledged to secrecy in larger cities, find their way to the until plans could be perfected. Certain slabs of the dissecting rooms. of their number, however, were so One of the earliest students, Dr. enthusiastic that they talked openly Christopher Graham, whose observa­ and were active in their efforts at tions are often more entertaining than removal, incurring thereby the resent­ accurate, has left us the record of ful hostility of the trustees and the several episodes of this resurrection good citizens of Lexington. Dudley period. So enthusiastic were the fol­ was active in the movement until late lowers of this nocturnal pastime that in 1836 when he deserted the cause, graves for a long time were closely leaving four of the six members of watched, so closely in fact that it was the faculty “on the spot.” In March, sometimes impossible to secure enough 1837, the trustees declared all chairs material to carry on the anatomical vacant, dismissed Caldwell, who had work. In fact it was this particular been most active, and failed to reap­ lack that was largely responsible for point Yandell and Cook. The following the decline of the school. year Dr. C. W. Short voluntarily In September, 1823 Dr. Dudley joined the group in Louisville. During addressed the trustees asking for the deliberations Dudley announced sufficient money to purchase a team to the trustees that he would resign and wagon and to employ a reliable if Caldwell or Yandell were reap­ man to go to Louisville for bodies. pointed. At this time, in the minds of He stated that Cincinnati had made the trustees, Transylvania without it impossible for him to secure material Dudley was unthinkable. For the next in that city and that the year before thirteen years of his life Transylvania he had broken down his own team in was Dudley and Dudley was Transyl­ this work of transportation. (The sum vania and he saw to it that at all times requested was $1500.) In 1829 the there was some outstanding medical man in the faculty, in some instances Louisville and Cincinnati and breathed himself personally guaranteeing to the its last in the year 1857. trustees the salary of such incumbent. In the thirty-five years of its John Eberle, N. R. Smith and Elisha existence as a medical school Transyl­ Bartlett were the most distinguished vania’s roster of teachers includes of this group. such leaders of medical thought and One of his obsessions was that the practice as Brown, Caldwell, Drake, chairs of Anatomy and Surgery should Cook, Yandell, Eberle, N. R. Smith be held by one professor on account of and Bartlett, a truly remarkable the close association of the subjects. group. Three of them Osler places It was this notion, persisted in for among the first five of their day. To twenty-five years, that was respon­ them, students from all the South and sible for much of the dissension that West came to prepare themselves in continually rocked the faculty, being Medicine, but there was one who in the chief or secondary cause of the the minds of the students outshone resignations of several of its valuable all the rest and that was Dudley. Less members. Dudley wanted no one endowed by nature than many of around who would or could in any those mentioned, less educated, with­ way offer any show of competition. out brilliancy or wit, he held the He refused even to consider the attention of his students completely appointment to the chair of Anatomy from the beginning to the end of the of Dr. George McClellan, one of the session. The students might fail to be ablest anatomists of his day, but impressed by the good sense of Drake, finally consented to allow Dr. Bush, might yawn at the stilted rhetoric of his friend and assistant, to take the Caldwell, or slumber during the read­ chair although his work as demonstra­ ing of lectures by Short, but their tor had been far from satisfactory. interest never flagged during Dudley’s This when Dudley was fifty-nine years lectures. His knowledge of his subject was comprehensive. His language was old (1844). simple and direct without effort at In 1850 he resigned his professor­ adornment; his voice clear and sonor­ ship though he continued for several ous. His experience, vast and varied, years to operate and to visit patients was so catalogued in his mind that from his home at Fairlawn on the it was instantly available to illustrate outskirts of the town to which he had his theme. His teaching was positive moved in 1846. and without reservation or doubt, his Anna Short Dudley died in 1827 and manner dignified and impressive. Aid­ Dr. Dudley never remarried. In 1866 ing in this was his subject, Surgery, he moved to the house of his son W. with the appeal to the young man of a Ambrose Dudley in the city where he doer and of expert craftmanship, died on the 20th of January, 1870. He and finally and not to be omitted was is buried beside his wife in the “the bloody drama of the operation,” Lexington cemetery. in which he was the chief actor, the Transylvania Medical School, de­ perfect artist. prived of its chief, was unable to com­ Dr. Bedford Brown (1892) describ­ pete in the unequal struggle against the ing Dr. Dudley says: “In his black more fortunately situated schools of broadcloth suit, swallow tail coat, unvarying white necktie, silk hat, the Royal College of Surgeons, Lon­ clean shaven face, dignified demeanor, don.* Here the author describes five gray hair, Dr. Dudley might have cases of traumatic epilepsy operated been mistaken for a well ordered on by the trephine with entire relief respectable clergyman.” His personal in three and improvement in the appearance was the beau ideal of other two. These cases are among the neatness and cleanliness and the pleas­ first, if not the first, in this country ant smile that so often adorned his so treated. On account of the fre­ face might lead one to mistake his quency of remote evils he councils temper which was quick and irascible. more frequent operation in depressed In movement and gait he was quick fractures of the skull. He says also and decided. He was frugal and that collections of encapsulated fluid abstemious in all things. Morally and are probably more frequent than was physically he was without fear. thought and he further states: “It Few men, says Brown, possessed rather appears to constitute a matter more acute and clearer powers of of astonishment that arguments in observation, more penetrating fore­ favor of removing pressure from its sight, more accurate views of the [the brain’s] surface should be thought practical side of all surgical questions, necessary.” or had profited more richly by personal This paper, as do the rest of his experience than Dudley. “As an opera­ writings, reveals an independence of tor, for cool, deliberate, calm self­ thought and action characteristic of possession, unfaltering courage under the man. Other matters touched on by difficulties, precision and dexterity in him concern the subjects of the band­ handling the knife, Dr. Dudley was age, calculous disease (stone in the unsurpassed in his day.” bladder), hydrocele, aneurysms, and Amidst the heart-rending screams cholera. All of them have the assump­ of his patients, he was never thrown tions of his day regarding causation off his balance, but would remark: but are emphatic and clear when it “Let them scream—it is a relief of comes to treatment. nature.” But when, unable to stand Everyone has a hobby of some sort; further the pain of the operation, the Dudley’s hobby was the roller bandage patient would struggle, a command and in his hands it became an agency was uttered in a voice not to be mis­ of importance equal to, or greater, understood: “Be still, Sir, or I’ll send than the knife. His skill in its applica­ your soul to Hell in half a second.” tion was the result of assiduous The order would be obeyed. practice and thoughtful consideration Dudley perhaps would have left of the nature of the affection and the us nothing in writing had it not been part affected. The smoothness of its for the urging of his associates. At any application and the degree of pressure rate, we find the first article of were regulated to a nicety. It was not a the first number of the Transylvania procedure to be delegated to an Journal of Medicine, 1828, is entitled assistant but a delicate operation for “Observations on Injuries of the the master hand of the surgeon him- Head” by Benjamin Winslow Dudley, * Dr. Dudley was admitted a member of professor of anatomy and surgery in the Royal College of Surgeons on January 7, Transylvania University, member of 1814 by examination. self. He used it in the treatment of all No cerates or ointments were ever fractures of the extremities except employed. Perhaps some day in the those of the forearm and by securing future some unknown surgeon will muscular relaxation, adjustment of discover a new method of treating the broken bones was obtained and many surgical affections, which will maintained by posture alone. be far superior to those of the present, That his results in this field were and that method may well be the excellent is evidenced by a letter from roller bandage. his nephew, E. L. Dudley, who in He was the first in this country to 1849, writing from Paris, makes com­ ligate the carotid for pulsating exoph- parison very unfavorable to European thalmus and his ligation of the sub­ practice with splints and clumsy ap­ clavian was the first of its kind in the paratus and the then new starched West. His operations on the eye roller (the forerunner of the plaster included those for cataract. He seems bandage). to have done both needling (discission) The roller bandage he also employed and extraction of the lens and these, in many other conditions: gunshot as all other critical operations, were wounds, acute and chronic inflamma­ preceded by a period of conditioning tions, ulcers, milk-leg, lacerations and to be described later. contusions of all kinds and extent, and He seems to have performed ovari­ aneurysms. In the treatment of the otomy but once and that with fatal latter affection in peripheral arteries result. he was able to maintain the circulation He was a strong opponent of indis­ in the extremities and reduce the flow criminate bleeding but employed it in of blood into the sac by graduated what he considered suitable cases. pressure of the bandage until cure It is as a Iithotomist that Dudley was effected in all cases but those with was most widely known. His first impending ulceration. In his treatment operation for stone was performed in of bone felons it makes one shudder 1817 and in the course of his practice when he writes of compressing the patients came from all over the land swollen finger in his hands for from to get the benefit of his skill. His two to five minutes to reduce its size reputation in this line transcended before applying the bandage, and yet national borders. He always performed he says one must be careful, after the the lateral operation and always used bone comes away, not to compress the gorget of Cline. The details of his too tightly lest the finger or thumb operations have been clearly and become too long. He was once threat­ accurately described in the sketch ened with suit because of such result. of Dudley by Bedford Brown (1892), After amputations the bandage was one of his pupils (1846). the only dressing and union by first Dr. Dudley did not dislike writing, intention was the rule. Often no he hated it. His desk was disordered, vessels were tied, compression alone with letters and papers in confusion. by the bandage being relied on. The His work was finished when his second dressing was a week later. The patient died or was cured. Only a few bandage was of plain calico or muslin accurate notes were made and these and when rolled was moistened with in cases of unusual interest. He relied spirits and again just before using. on his memory; so much the worse, for it has furnished his critics with regimentation was continued until ammunition to shoot at his claims as nearly a normal condition as possi­ and has raised a question of doubt as ble was reached. to accuracy in the minds of the Bedford Brown further tells us that dispassionate searcher for facts. his “neatness and cleanliness did not Dr. Graham said he never lost a end at the personal limits—they were case of lithotomy. Dr. Brown says the principles in the practice of his pro­ number was three; Gross says the fession that he held sacred and never claim was six or seven but he did not to be departed from.” Always before believe it; Dr. Bush said the number operating, his patient had a thorough was four. bath. Dr. Peter, who was closely asso­ In some way Dudley got the idea ciated with Dudley for the last twenty that water contained impurities injuri­ years of his professional life and of ous to wounds and that boiling the w’hose accuracy there should be no water rid it of these impurities. It was doubt, makes the statement that “he his practice to use only boiled water performed the operation of lithotomy and that copiously on wounds of all 225 times losing only about 2 per kinds, clean and infected. Pads soaked cent,” nor do I find after much study in boiled water were used as com­ any reason to doubt these figures. presses on wrounds enclosed in his When one considers the state of roller bandage. His instruments before surgery in general in his day his results using were also washed and rinsed are nothing less than amazing. Con­ with boiled water. sider, however, the following facts: Here we find an able surgeon who he was a firm believer in the teachings by some accident or instinct had of Abernethy; that nearly all local grasped the essentials of modern surgi­ diseases were of systemic origin or were cal practice half a century before the aggravated by systemic derangement. principles underlying them had been Dudley says: “ The preparation nec­ revealed. His results, therefore, from a essary for and the treatment consequent modern standpoint are entirely credi­ to all critical operations is even more ble. So satisfied was he with his results important than the greatest skill in the that he never changed his methods, use of instruments.” In his preoperative nor is there evidence that he ever treatment, which lasted from a few used anesthesia. During the dreadful days to three months, the diet was cholera epidemic of 1833 in which he strictly regulated and the stomach, did yoeman service his cleanliness and liver, bowels and kidneys were treated his use of cistern water, which he by appropriate doses of calomel, ipe­ considered next in purity to boiled cac (or tartar emetic) and copious water, preserved his entire family draughts of water. During this period from the disease. Knowing nothing of the action of the heart and lungs was bacteria, Dudley attributed his success watched. The condition of the tongue, to the fact that in the Ohio Valley, and breath, the skin, the eyes, the people, places, and things had not urine and excreta was carefully noted, been contaminated by the effluvia of as was also the state of mind and the human concentration which so vitiated appetite and general state of vigor, the air of the European hospitals. To and this system of observation and the writer it would seem that there was something present in the Ohio of Kentucky, the drunken hero of the Valley and absent from the European cholera of ’33, who always addressed hospitals that was responsible for Henry Clay as Henry, who sold these results and that something was himself alive to a negro woman and Dudley himself. his body after death to Dudley for Although generous to his poorer dissection. On his deathbed he sent patients Dudley accumulated a con­ for Dudley and asked him to forgive siderable fortune. His largest fee for the debt. This was done. lithotomy is said to have been five To such a character human relations thousand dollars. Once upon a time are always positive; on the one hand Dr. Dudley operated for stone upon a unswerving loyalty or abject submis­ boy whose father was unable to pay at sion; on the other vitriolic hatred— the time. He was told he might pay never indifference. for it when he could afford it. Some Some of the pamphleteering dog­ sixty-five years afterwards the patient fights of his day contain real gems of died in the West and stipulated in his invective. Dr. James C. Cross, who will that the heirs of Dr. Dudley be had undoubtedly conducted his chair paid the usual price for such an in an able manner but who was a operation with 6 per cent interest. person of poorly assembled moral The late Mrs. Charles W. Short re­ fiber, was unceremoniously kicked out ceived the bequest and donated the of the faculty in 1844, a few days same to the Good Samaritan Hospital after suggesting that Dr. Dudley give to equip a room in his memory. He up one of his professorships. His reply always loved Lexington and after 1814 to the “Statement of Facts,” etc. left it only twice, once a trip for his concerning his dismissal is presented health in 1829 and once a visit to in an altogether convincing fashion. Europe in 1831. He refused to con­ This reply is directed at Dr. Dudley sider a call to the surgical professor­ but his reference to Dr. Peter is ship in Jefferson Medical School of worthy of preservation as a model. Philadelphia. Were I, however, in a fit of indiscretion, In politics Dudley was an ardent no matter from what cause, to gratify supporter of the Whig cause and of his the vanity of this little compound of friend, Henry Clay, and in times of repugnance, prejudice and disgust, by need on election day he would as­ magnifying him into an object of sufficient semble his cohorts, bring them to the importance for serious or special notice, polls and see that they voted “right.” the notoriety he would gain would be In matters of religion he was not nothing more than a temporary phos­ much concerned (he had no imagina­ phorescence like that which surrounds tion) yet as a testimonial to his a decomposing carcass in the dark, that strength it must be said that through­ is dispelled by the first beams of the out the hectic period of sectarian rising sun and exposes to view the dis­ gusting source of the mephitic radiance. controversy in which he lived, his position of leadership was never chal­ Of his pupils, many of whom lenged on account of this indifference. achieved more than local prominence, Among his admiring friends was only two will be here mentioned. One that tragic character immortalized Joshua Taylor Bradford of Augusta, by James Lane Allen, King Solomon Kentucky, became the most success­ ful ovariotomist of his day; his mortal­ 7. Transylvania Journal oj Medicine (1828- ity was io per cent (1840-1870). The 1850). 8. Pamphlets by Dr. Dudley, Dr. D. Drake, other was Crawford W. Long, the Drs. R. Peter, Mitchell and Richardson discoverer of ether anesthesia; and and Dr. Jas. C. Cross. surely anyone who had to do with the 9. Yandell, Lunsford, 1870. Kentucky medical education of Long might well M. J., 1917. say, as did Simeon of old, “Lord, let 10. Gross, Samuel D. Autobiography, now thy servant depart in peace.” Phila., 1892. 11. Peter, R. Medical Department, Transyl­ vania. Louisville, Filson Club Pub., Sources 1905. 1. Minute books of Trustees of Transyl­ 12. Brown, B. Trans. South. Surg. & Gyn. Assn., 1892. vania University. 13. Graham, Christopher. Letter to R. 2. Minute books of Faculty of Medicine, Peter. Transylvania University. 14. Drake, D. Pioneer Life in Kentucky. 3. Files of Lexington Intelligencer. 1870. 4. Files of Observer and Reporter. 15. Pratt, M. E. Dudley—Pratt Families. 5. Files of Kentucky Gazette. 16. Barkley, A. H. Kentucky’s Pioneer 6. Short, C. W. Letters to Wm. Short Lithotomists. 1913. (Filson Club). 17. DaCosta, J. C. Speeches and Papers.