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Chapter 14- Archival Objects, pp. 641-660

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l.!======ArchivaI======!J Objects George FredericR COORe (1756-1812) and His SRuIl

How could the skull of a Shak espearean ac tor stage. At age s ix, he sa w a puppet show and sev­ who d ied in 1812 beco me part of Jefferson's leg ­ eral representations b y strolling actors. This cre­ end and l ore? The bizarre circums tances of th e ated a taste fo r reading plays which his mother flamboyant life o f G eorge Frederi ck Cooke and encouraged . He s tud ied all h e c ould p rocure. the odyssey of hi s s kull comprise a t ale worth tell­ A th eatrical gro up was formed a mong hisschool ing in d etail . The severa nce of his head divides fellows and acted out in a deserted bam at first for the famous actor's career into two parts : Before their o wn amusement. On ga ining confidence they and after Death. put on a public performance , none o ther than Ham­ let in w hich he took the pa rt of Horati o. This wa s Life And Acting Career seen and approved b y so me Ed inb urgh actors, and their appla use increased his e nthusiasm . Cooke

Lesend end Lcre 642 theatrical productions. On a stop at , he was immensely impressed by the actor Carrick, then at the height of his career. At age 20, he joined a theatrical troop and made his debut in London at Haymarket Theater in the character of Dumont. Although unnoticed and neglected, but not dis­ couraged, he was spurred. on to further effort that later wou ld be crowned with success. The next ten years (age 22 to 32). were spent trav­ eling throughout the Kingdom, from town to town ga ining expe rience and sha rpening his talents. Cha nce took him to wh ere he first came into prominence as Philotas in a curious old play called TheGrecian Daughter. Garrick was retiring at this time and Cooke was Fig. 2. George McClellan, M.D. (184 9-19 13), Chaimun of gaining reputation in the provincial towns. He Applie d and Topographic An.atomy (1905/1913), first came to where he soon rivaled John jeffersonian 10 acquire the Cooke skull. Kembl e at Drury Lane. At Kemble's own sugges­ tion they began to act together, with Kemble al­ his Richard lll . At curtain time Cooke was not to ways taking the lead pa rt. Cooke played the ghost be fou nd. The tru ant tu rned up five weeks later, to Kemble's . Hen ry to his Richard III and played magnificently and was immediately for­ Edm und to his KingLear. given. It became more and more frequent that an ­ Kembl e once accused Cooke of a faulty memory nouncement had to be mad e that the star actor was and Coo ke said: " I will not hav e your faults fa­ suddenly ind isposed . The culprit was alcohol. He thered upon me, and hang me if I don't make you played less frequ ently, but when he did it was bet­ tremble in your pumps some da y yet." He mad e ter than anyone else. His face was very expressive good that threa t. and his eye as interpretive as his tongu e. In solilo­ By 1801 (age45), Kemble saw Cooke perform as quy he had no peer. Richard III, which beca me his mos t famous role, His friends were fair wea ther ones who encour­ and recog nized him as a dangerous rival. Coo ke's aged his eccentricities. After some triumphs, he Richard III was a triumph with critics and the au ­ distributed his mon ey to the poor and needy. On dience. Cooke was not over-elated by this success one occasion in a barroom he tried to engage a and studied hard in other roles such as Shylock, stranger in a fist fight . The accosted one said:"You lago, and Macbeth. He always acknowl­ take ad vantage of me because you are rich and I edged Kemble as his superior, but others agreed am poor." Cooke withdrew a large sum from his they were equal. In Richard III and Iego. Cooke pockets and threw it into the fire. "Now I am as was unsurpassed . Kemble excelled in nobleness poor as you, so come on at me." He once chal­ of presence, but Coo ke was superior in power and lenged a well known pugilist to a fight but was compass of voice, as well as qui ckness of action. tossed bodily ou t of the tavern. With a poker, The first season of Cooke's success seemed to Cooke broke some windows and sa id :"I have auger tha t middle age would be one of fame and taken pains to see through my error, so please let financial security. The story is pleasant to th is me back in." point. The sad fact is that his nomadic life led him While d ru nk, Cooke en listed in the army, bu t a into the companionship of bad associates whose friend purchased his discharge.He spent the fall influ ences he could not resist. At the opening of and winter of 1807 in a d ebtor 's prison, bu t the his second season there was a filled auditorium for following spring played before the greatest mon ey

Archival Objects 643 Legend and Lore 644 house of Covent Garden. Because of a growing feeling of helplessness in combating his need for alcohol and to escape ri­ valry with other actors in , Cooke accepted an offer from Thomas A. Cooper, Manager of the New Theater, to come to America. He was smuggled out of because of breaking a contract with his manager. Aboard the sailing packet Columbia he arrived in in November, 1810, to perform in the Old Bowery Theater. The customs charged 20 cents for a per­ mit to land his baggage. Cooke condescended to appear only on condi­ tion that GodSave the King be played before every performance, for which the audience stood and cheered on 17 consecutive nights. He played as Richard III before capacity houses which netted more than $25,000, a good ly sum for those days. Cooke's salary for a ten month's contract was ap­ Fig. 4. Skull of , first shakespearean actor from England to perform in America. (In archives of Tho­ proximately$400 a week. Soon after arrival he was mas Jefferson Unwersity). told that President Madison wished to see him act. He refused to play before "the contemptible King painted him in the role of Richard of the Yankee Doodles." Ill. This imposing portrait may be seen today in Cooke's Toryism grew as his popularity in­ the Pennsylvania Academy of the FineArts

Fig. J. Portrait ofCooL:e as Richard III by Thomas Sully in Penn­ A postmortem examination was performed by sylvania Academy of the Fine Arts. three physicians of which the youngest was Dr.

Archteet Objecrs 645 John W. Francis. The latter had a collection of skulls At the time of Cooke's burial, the absence of a and added Cooke's (Fig. 4) to his collection by de­ head was still not known, bu t from the rotting capi tating him at the autopsy. This would not be coffin a phalanx either of a toe or finger fell to discovered until a later date. the ground . Kean interpreted it as part of the dic­ Our erra nt actor was buried in the Stranger's tatorial finger that Cooke used so convincingly VaultofSt. Paul's Cemetery in New York City amid in his acting. much ceremony. Flags flew at half mast. Shops Kean took the finger (or toe) bone of Cooke to cIOSt.~. TheGovemor and Mayorof NewYorkCity, England, where he had it mounted and displa yed along with other notables, attended his funeral. At on his mantel at home. Legend has it that when­ that time there were no secular cemeteries and ever he passed the bone he genuflected, much to people were buried in the yards of the church to the increasing annoya nce of Mrs. Kean. With little which they belonged. Coo ke, who was witho ut understandi ng of her husband's artistic tempera­ religious affiliation, had to be placed within the ment and perhaps some jealousy over his rever­ Stranger's Vault, which was an enclosure at the ence for the bone, she ordered her maid to throw edge of the graveyard. the repugnant object into the river. In a rage, Kean In 1821, anothe r British actor, , vowed he would not go upon the stage again. This who was a fanatical ad mirer of Cooke, obtained conveniently coincided with his official retirement. permission from Bishop Hobart of New York City Some yea rs after erection of the monument to to have Cooke's body moved to the center of Cooke, a compa ny was playing Hamlet in New York the graveyard and arranged erection of a monument and needed a skull for the gravedigger 's scene. Dr. to his honor and memory (Fig. 5). The marble was Fra ncis, known to have the finest collection of dolomite, of soft nature, and on it was inscribed: skulls in the City, was called upon to loan one. The property man poi nted in the collection to the one 'Three kingdoms claim his birth ofCooke as most desirable. Dr. Francis demanded Three hemispheres pronounce his worth." to be in the audience to watch it closely. That night in the Bread and Cheese Club, Dr. Francis disclosed Fig. 5. Monument 10 GE'Org~ Frederid. Coo ke in St. Paul's to several friends the true identity of the skull . The Churm yard, New York, erected 10 his memory by Brilish ac­ lor, Edmund kE'an. secret was thus out. When Dr. Francis died he left the skull and some papers giving its history to his son, Dr. Va lentine Mott Francis. In September, 1888, the younger Dr. Francis, while in Newport, Rhode Island, slipped on the deck of a yacht and injured his head. It so hap­ pened that he was attended by Dr. George McClellan for this mishap. Dr. McClellan, a grad u­ ate of Jefferson Medical College in 1870, was the grandson of George McClellan, the founder, a nephew of Genera l George Brinton McClellan, Commande r of the Union Army of the Potomac, and brother of Elizabeth McClellan, an au thority on thea trical costumes. He would later 0905-13) serve as Chairman of Applied and Topographic Anatomy at Jefferson. During convalescence from

Fig. 6. Portrait of Geo rge McClell;m lin [efferson art collec­ lion) showing Cooke skull in lower left.

Legend and Lore 646 Archival Objects 647 to his wi dow. He had been ca red for by Dr. Ross V. Patterson (Fig. 7) , a s ub-dean at j efferson Med ical College, who also became the physician for Mrs. McCl ellan . At her death in 1922she willed the s kull t o him. Dr. Patterson kept the skull in his h ome a t 212 6 Spruce Street in P hiladelphia. He n ever married and bequeathed his estate to jefferson a t h is d eath in 1938. A d om estic servant found the skull hid ­ den u nd er his bed and delivered it to the j efferson Medical College Library, It finally took a n h ono red position in a suitable case in the arc hives. Fig. 7. RossV. Piltt e~ , M.D., SC. D.. Ll.D. lDean, 191f.t-381, On the strength of Dr. Patterson's will, jefferson second J effe~ian 10 acquire lhe Cooke skull. has resisted requests for the donation or l oan of the s ku ll. Some have fe lt it should be retu rned to the accident Dr. Francis one day summoned Dr. the headless body in S t. Pau l's graveyard. The McClellan and a few friends for a formal presenta­ Actors Guild , the Fo lger Shakespearean Museum tion of the Cooke skull to his physician wi th pa­ in Wash ington , D.C., the College of Physicians of pers of verification . "As Fate has deprived you of Phil adelphia, a nd l ately the Walnut Street Theater owning my sku ll," orated Dr. Francis, '1 shall sub­ would be desirous recipients. With stitu te it by another." respect to a req uest from the latter it was felt that it wa s not in As drama would have it, when the skull was the e thics of the medical profession to display a handed to McClellan a too th dropped out and f ell human body part for purposes o f entertainment. to the floor. O ne of the gentlemen in the group What about hi s phalanx at the bottom of a river in picked it up and asked if it might be sent to his England and the tooth in th e Players Club? actor friend, . McClellan on granti ng It is unlikely th at joh n Chalm ers Da Costa permission requested th at he be given th e letter of (JMC, 1885) a nd fir st Sa mue l D. Gross Profes­ acknow ledgmen t if Booth wrote one, since h e was sor of S u rgery (1910-31) ever saw the Cooke also a n autograph collector. Booth's reply was in skull, but what he said in his poem, The Skeleton, a t elegram: " Thanks fo r Cooke's tooth ." Booth would have app lied. presented the Cooke tooth to the Players Club of New York City w here it r esides a mong other "Behold t his ru in! lis a skull memorabilia of the theater. Once of life 's ethereal spirit full. Dr. McClellan (Fig. 6), a sc holarly w ho This narrow ce ll was life's retreat. later wrote books on RegionalAnatomy (1892) and This space was thought's mysteri ous seat. Anatomyin Relation to Art (901), beca me interested Wh at wondrous p ictures filled this s pot. in Cooke's history. jefferson's archives contain his What thoughts of memori es lo ng forgo t. IS-page s ingle-spac ed article, The Strollin g of a Nor grief, nor pain, nor hope nor fear Player'sHead, which h e prepa red asa lecture in 1904 Has left o ne trace o f record here ." from t he biographical material of Dr. Francis as well as othersources. Some attempts were made to st eal References this skull. On one occasion, t he doctor's office was 1. McClellan. George: The Strolling of a Player's Head. ransa cked and several other skulls t aken, but the Typed manu script 0 5 pages), dated November. 1901, one of Cooke had been hidden elsew here . in archives of Thomas Je fferson University. 2. TIchenor, George: Odysseyof Q At M cClell an's death in 1913 , the sk ull passed Skull. Theater Guild Magazine, December, 1930,p.14-1 8

Lesend end Lo re 648 Historic Surgical Instruments at Jefferson

The his tory of surgical instruments is synchro­ times. When one considers that these instruments nous with that of itself. Instruments make evolved slowly, it is easy to believe that a great the surgery possible, and progress in the craft variety were in use as far back as 1000 B.c. may be d ivined by noting the improvements in Jefferson is fortunate to have in its archives a design and variety. collection of more than forty instruments from ex­ cava tions in Herculaneum. This flourishing Ro­ In struments From Herculaneum man City was buried in lava during the eruption of Mt. Vesuvius in 79 A.D. The lava was ideal for During the Roman era, surgery, including ob­ preservation of metal, since it was impervious to stetrics and ophtha lmo logy, atta ined a high stage water that would have resulted in rusting. The in­ of technol og y. Excavations a t Pompei a nd struments (Fig. 1)are composed of bronze in which Herculaneum revealed over 200 different kinds of the blue and yellow coating is the result of the ac­ instruments, many of which were highly special­ tion of the sulfur in the lava. Design of the instru­ ized. They even closely resembled some models ments reveals tha t the Romans had a surprisingly of present d ay patterns. The scissors, forceps, ten­ ad vanced knowled ge of human anatomy, despite acula, trephines, trocars, as well as male and fe­ the fact that Galen 0 31-201 A.D.), the authority in ma le ca theters, demonstrate that p roduction of sophisticated instruments date back to ancient Fig. 1. Instrurmonls l'lc.-valed .-1 Herculaneum.

Archival Objects 649 Fig. 2. Bone inslrulTlffits of S .D. G~.

Fig. 3. litholomy knife, wit h ce nter inscription: "'This knife, much wom down, was used by Professor S.D. Gross in alleasl 40 lat eral lithotomies. It was presented by me to Dr. C. H. Mastin, October 7, 1887." S.W. Gross

The side inscription readse-Pre­ se nsed by Dr. Willi am M. Mastin, Mobile, Alabama. to the Must"Um of 'f'fff'rson Mf'dical Coilege,.oI1Phil.ldelphi.ll, June 1, 19 1&."

Fig. 4. Amput ation instruments of S.D. Gross.

Legend and Lore 650 medi cine for man y centuries to come, stud ied Throughout the 1870s the abdomen was rarel y anatomy from apes, dogs, cows and pigs. en tered except for severe trauma or evisceration. The Hercu lanean collection, which contains in­ The common major operations were mastectomy struments of all types, was obtained originally by for cancer, lithotomy for bladder stone. amputa­ Mr. Daniel Baugh, a member of the Board ofTrust­ tion for gang re ne, a nd sequestrecto my for ees 0 89&-1921) probably in the early 1900s. Mr. osteomyelitis as portrayed in The Gross Clinic. Most Baugh was much interested in archeology and was operations were for surface tumors or abscesses a founder and Presid ent of the Archeo logy and and usually performed in the home. Paleontology Association. He purchased the in­ Dr.Gross made num erous contributions to sur­ struments at a time when such objects were al­ gica l technique, but these consisted mainly of lowed to be taken out of their respective countries modifications rather than revolutionary proce­ and be placed in museums or private collections dures. The instruments used by Gross and de­ in the United States and elsewhere. Mr. Baugh picted in the figures would fail to reveal the extent presented these instruments to Dr.Orville Horwi tz, of his technical innovations, - tracheotomy forceps Professor of Urology 0904/ 12). After the death of for extraction of foreign bodies from the air pas­ Professor Horwitz in 1913, they were given to Dr. sages, special catheters for draining urin e when Thomas Stellwagen, Jr. by George Q uinta rd mixed with blood, tourniquet for compression of Horwitz. Dr. Stellwagen who was Chairman of the vessels of the extremities during amputation. Urology (1930-35) presented them to the Museum instrument for extraction of foreign bodies from of jefferson Medical College. the nose and ear (for many yea rs used in doctor's A detailed description or even a listing of the house call bags), and forceps for arterial compres­ instruments in the collection is not necessary. Some sion for hemorrhage from deep seated vessels. He of them had uses that are not understood. today, advocated the use of stay sutures to prevent wound Some were not actually used for surgery, but for dehiscence. wiring the ends of bones in disloca­ the administration of powders. Insight into a bet­ tion of the sternoclavicular and acromioclavicular ter understanding of this collection may be ob­ joints, laparotomy for rupture of the urinary blad­ tained by consulting Surgical Instruments in Greek der, operative correction of ingrown toenail, use and Roman Times by john Stewart Milne, M.A., M.D. of adhesive plaster for skin traction in treating frac­ (Oxford at the Clarendo n Press, 19(7) which is in tures of the lower extremities. di rect operation for the jefferson archives special collections. inguinal hernia by suturing the pillars of the ex­ ternal ring. treatment of ganglia of the hand or foot Instruments Of Samuel D. Gross by subcutaneous division of the cyst, suturing the accidentally divided tendon of the hand, and am­ Dr. Samuel D. Gross witnessed many changes putation for senile gangrene of the lower extrem­ in the practice of medicine and surgery during his ity above the knee. experience of54years <1 828-82). The last 26of these The instruments of Dr. Gross are especially valu­ occurred in jefferson Med ical College where his able not only because they were used by such an fame as "the grea test American Surgeon of his emin ent surgeon. but also because of their signifi­ time" was at its zenith. It is likely tha t the surgical cance in being depicted in The Gross Clinic by Tho­ instruments depicted in the forefron t of The Gross mas Eakins, considered as a historic relation of Clinic in 1875 by the artist, Thomas Eakins, are medicine to art. those preserved in jefferson's archives (Figs. 2, 3, and 4). It would not happen until the decade of Civil War Instruments the 1880sthat surgery would benefit from the prin­ ciples of an tiseps is as elucida ted by Lister in 1867 The accepted treatment for a gunshot wo und of bu t whi ch were taking so long for acceptance. an extremity during the Civil War was amputa-

Archival Objects 651 f iJ:,. s. Ci\-il War amputation kit.

Legend and Lore 652 tion. An amputation kit was necessary for every operating surgeon on bot h sides of the conflict. Museu ms and Civil War exhibi ts contai n these in­ struments and the jefferson Archives is no excep­ tion (Fig.5). were instructed to perform the primary operation within 24 hours and prefer­ ably complete the procedure within 15 minutes. The anesthetics used were ether and chloroform, usually the latter. Statistics reveal that the mortal­ ity for prompt primary amputation was 28 percent, but if delayed the rate was 52 percent, pr,actically double. For relief of pain the surgeons used mor- phine and opium freely. fig. Eo. Handsome boll, of dK-ny wood, (or inslrume11ts ofw.w. • eee. In 1861 , at the start of the Civil War, Samuel D. Gross visited the battle field at Shiloh, Tennessee, Instruments Of W .W. Keen and also examined the wounded on government steamboats at Pittsburg Landing. In little over a Dr. W.W. Keen in his 95 years of life (1837-1932) week he was able to pub lish his Manua l ofMilitary witnessed many changes and improvements in the Surgery which was pirated by the South at Rich­ practice of medicine and surgery. In broad out­ mond one year later. D.J. julian Chisholm also line, since his graduation from Jefferson Medical wrote his MallualofMilitarySurgery for tileSllrgeons College in 1862, there was a shift from total de­ oftheConfederateStatesAnny which was also widely pendence on the five senses for diagnosis to the used by the South. The most devastating defect in aid of laboratory science, bacteriology, and roent­ the treatment was the absence of antisepsis or asep­ genology, as well as the combating of infection by sis, since Lister did not first promulgate his prin­ Listerian antisepsis. ciples until 1867. Man y thousands of lives were Dr. Keen could be consid ered the greatest stu­ lost to infection and septicemia. dent of Samuel D. Gross, and likewise a legend in The amputation kit (Fig. 5) was removed from his own lifetime.In 1887, he was the first in the battlefield at Fair Oaks, Virginia. It passed into America to successfully remove a large brain the hands of Thomas Sydenham Reed (JMC, 1846) tumor with surviva l of the pa tie nt for thirty and eventually into jefferson's archives.It contains yea rs. In 1892, he resected the left lobe of the three saws (one large, one small and pointed, and liver and around this time was one of the first four a Giglichain saw); three long guillotine knives (one surgeons to perform cholecystectomy and advo­ double edged and two single edged); a bone cut­ cate its use in treating gallbladder disease. In 1893, ter; one rasp /curette; five small scalpels of slightly he participated in the secret operation upon Presi­ different shapes; two small forceps; one long ex­ dent Grover Cleveland for a cancer of the roof traction forcep; one long curved probe; two tre­ of the mouth. phines; one ligature ca rrie r; a nd one hook. Keen's surgica l instruments were extensive and The mention of Civil War surgery conjures up complete for practically all the known procedures the names of jonathan Letterman OMC, 1849) who of his era (Figs. 6, 7, and 8). He devised special initiated the system of removing the wounded ones for use in the operation for President Cleve­ from the field during the actual battle, and Ninian land that are not in the jefferson collection. While Pinckney OMC, 1833), who outfitted the first Navy an inventory of the various layers of instruments hospital ship, The Red Rover, and staffed it with may seem superfluous, their historic significance Catholic nuns for nursing care. warran ts such a listing:

Archival Objects 653 Box 1 • Manufactu red by TIeman 2 scalpels Plain forceps Upper Half. Deep Lid Empty space Tooth forceps Awl Skull drill Double hook Ernptyspace Rongeur Curved pliers Pen knife scalpel Curved dissecting Scraper Smaller skull drill scissors Large awl Large saw Empty space Locking forceps Small saw Instrument handle Suture materials, Pliers vaca nt place straight pins in box

Upper Lid of Upper Half Deep layer Medium saw 2 GigHsaw handles Rongeu r Tenaculum Small saw Hack saw Medium saw Wire carrier Minute saw Wide blade for hack saw Paracentesis trocar Empty deep Small hatchet saw 3 chisels (straight, space on left curved, triangular) Empty space (for 2 spring Surgical pliers Large rongeur 5 drills need les) Medium rongeur 2 small retractors Package of needles Large stone extractor Empty small box Lower Body of Box Peep Layer 9 assorted rongeurs Straight chisel Stay suture needle holder Handle Curved chisel Empty space Large curved needl e Mallet GigH chain 2 Right angle retractors !lllJQ Upper layer Upper Layer Empty space 2 empty spaces 5 chisels Slanted scalpel Toothed forceps Hatchet saw 2 rongeurs 2 elevators Plain forceps Locked forceps 1 Curette Thick handled scalpel Locked forceps 3 Guillotine knives 4 sma ll scalpels 2 aw ls Needle holder Double hook Large scalpel Need les, suture materials, Straight chisel Scalpel wax, gigli chain in deep box Curved chisel Hook Empty space Bscalpels Awl Ligature canier BoxTwo Lower Layer Upper layer Hack saw Straight pliers Small empty box Curved pliers 4 small scalpels 2 Needle point lancets Mallet Straight rongeurs Ivory handle probe Grooved director Trephine 2 retractors 4 straight scalpels Small chisel Curved rongeur Empty space Curved scalpel Urethral dilator Empty space Small saw Hook Forceps Artery compressor GigJisaw in center box Saw edge scalpel Need le holder Empty box

Legend and Lore 654 Fig. 7. Inslrumeonts of W.W. Krt'n.

.Fig...... 8. Inslruments of W.W.

Arc hival Objects 655 Fig. 9. Inslrumen ls or John Chalmen DaCosta.

Fig. 10. Instrumenls or fohn Chalmers DaCosta.

The nineteenth century was impressive not only Instruments Of for the advances in the art and science of surgery, John Chalmers Dacosta bu t in the sop histication and improvements for the man ufactu re of surgical instruments. The subse­ Jefferson's surgical legend continued through quent subdivisions of the practice of general sur­ Samuel D. Gross to W.W. Keen and thence to John gery into specia lties,associated with the multiplic­ Chalmers DaCosta. Although each was a giant ity of operations, has resulted in a variety of in­ in his own right, eac h had peculiar tal ents struments previously unimagined . that ma rked him apart. Gross was famous

Lesend end Lore 656 for his textbooks, Keen for his pioneering opera­ Surgery (1894-1931), and was Jefferson's first Gross tions especially in neurosurgery, and DaCosta for Professor of Surgery (1910-31). The Mayo broth­ his oratory. A thread of thi s legacy is woven ers, in the early 19205, proclaimed him to be the through their instruments. greatest teacher of surgery in America. The strikingdifference in DaCosta's instruments The protege of Dr.DaCosta was ThomasA. Shal­ (Figs. 9 and 10) is in their greater delicacy and el­ low (JMC, 1911) who was his clinical assistant and egance. It mu st be pointed out that DaCosta lost performed many operations for him towards the an eye due to injury at the age of nine and that he end of his life. Shallow succeeded DaCosta as the suffered from rheumatoid arthritis which disabled Gross Professor of Surgery (1939-55). By this time, him during the last eleven years of his life 0 922­ su rgeons used the large variety of instruments 33). Despite these handicaps he edited Gray's owned and supplied by the hospital. Anatomy (1905), published ten editions of Modern The Old Oneratine Table

Like the Cooke Skull,"the old operating table" his own operations. That part of the story is best took part in many dramas in a sense just as color­ told in his own words. ful. The Cooke Skull functioned in life and death "This table, we assistants were told by Profes­ in a fantasy world of the theater. The "old operat­ sor S.W. Gross, was mad e in the ea rly fifties of the ing table" functioned in a real world of life and last centu ry, and has since then been repaired and d eath in the hospital. What if each could talk or freshened up once or twice. It stood originally in commingle their tales! the arena of the upper lecture room of the old Tenth Why should a wooden operating table - old, StreetCo llege, the room that was used for anatomy worn and scarred - be worthy of veneration? It is lectu res, obs tetrical lectu res and surgical clinics. At not artistic or beautiful. It is not regarded because that time we had no hospital. We did not have a of its sturdy construction or mere ability to sur­ hospital until 1877. When an operation of mod er­ vive the years. The simple fact is that it starkly ate severity was performed, an assistant returned projects almost a century and a half of Jefferson the patient to his home in a cab and the surgeon tradition and heritage in tan gible form. It is in­ and assistants provided subsequent care. For the deed !h£ old operating table, one used by Samuel treatment of more severe cases, a room was rented D. Gross. It is the very one depicted in The Gross on the third floor of the southwest comer of Tenth Clinic (1875) and the William Smith Forbes (1905) and Sansom Streets, a room which was accessible paintings in the Eakins Gallery. from the operating room and which was pleasantly "Facts Con cerning the Old Operating Table" is placed over a cigar store and an oyster saloon. a fascinati ng chapter in The Papers and Speeches of When a severe operation had been performed, the John Chalmers DaCosta. As the first Samuel D. Gross patient was taken into the small ward which con­ Professor of Surgery (1 910-31), famed teacher, au­ tained a few bed s. He was cared for by the SU T­ thor, orator, surgeon and historian, he is respon­ geon and assistants and was nursed by relays of sible for saving it from oblivion . AJefferson gradu­ students during the days and nights. The profes­ ate in the Class of 1885, he promptly joined the fac­ sor of surgery always furnished the students a mid­ ulty, assisted the great surgeons in his early years, night lunch of oysters, cigars, and beer. When the and subseque ntly used the table many times for Sansom Street Hospital was opened in 1877, the

Arc hival Objects 657 surgery was performed mainly for the treat ment of wounds and superficial abscesses, for amputa­ tions, tumors, aneurysms (proximal ligation), s tone in the urin ary b ladder, empyema , tracheotomy, and trephining o f th e s kull f or depressed fra cture or extradural abscess. Mastectomy was performed for cancer but with little h ope fo r cure. Cerebral localization was unknown,and it w as be lieved th at the brain, like the liver, functioned as a whole. Abdominal surgery hard ly e xisted except f or wounds, intestinal obs truction or strangulated her­ Fig. 1. The -ou Operaling Table. ... f nia. Operations for appendicitis, g allstones or k id­ ney s tones w ere yet to be thought of. Jefferson College was the second medical college Quoting aga in from DaCosta : " I think ofth e men in Am erica to have its own hospit al. This table who have operated upon that ta ble or who have (Fig. 1) was moved int o the arena o f th e hospital. stood by it and deli vered lectures. I seem to see It stood t here for many yea rs; in f act , it was ve ry before me the stro ng, h andsome face of the elder grad ually displaced . Some surgeons dung to it, Gross as he kneels upon one knee at the f oot of though others had taken t o more modem appli­ that table operating for stone i n the b ladder - that ances. It disappeared and could not be found. I marvelous o perating surgeon,Joseph Pancoast, full condu cted a searc h for it and d iscovered it d own of energy, the embodiment of decision, a man of in the b asement being used to ho ld oil ca ns and whom I h ave spoken before as having had an ey e various sorts of waste. ' Apo llo tending the s heep as quick as a fl ashing s unbeam and a ha of Admetus! nd as light ' I r escued it, had it brought up to th is as a floating perfume. room and t old the c lass about it . The C lass of 1916 "Thestem, rather grim faceof the yo ungerGross had th e table cle aned up and repaired and put as he operated for cancer of the bre ast and dev el­ a plate upon it ( Fig. 2); and th e C lass of 1 917 oped his views as to a rad ically cu rative operation had placed upon it th e a dditional t ablet (Fig. for ca ncer; views which became largely th e foun ­ 3). so it has fi nally attained an honored and d is­ dations of our modem methods. John H . Brinton, tinguished old age." who a mputated with more precision and ligated Wh en t he opera ti ng table fir st a rr ived a t with more anatomical accuracy th an a ny other sur­ Jefferson, Thomas Dent Mutter was the Professor geon of hi s time in Philad elphia. That sp lendid of Surgery (1841-56)and Samue l D. Gross was s till operating surgeon, Levis, a man with a marvelous in Louisville. Gross must have used it through out mechanical i ngenuity in correcting difficult dis­ the entire 26 years of t eaching in hi s alm a mater placement in fr actures a nd in m ain t aining t he 0 856-82) . Purified ether had just been produ ced bones in proper position. The s upreme diagnostic commercia lly (852) by E dward R. Squibb , a ability of th at prince of kindly a nd manly gentle­ Jefferso n graduate in the C lass of 1845. Gross had men, Dr. W. Joseph Hearn, and that greatest o f operated fo r 25 years s ince h is g raduation (828) mod em American s urgeons, W .W. Keen. without this "grea test blessing t o mankind ." At "Among other fi gures that come before me , this time, pain. t he grea test horror of surgery, be­ some of whom operated, some of wh om lectured came alleviated and chloroform soon thereafter are Theophilus Parvi n, J. Ewing Mears, Frank also bec ame ava ilable. Gross would liv e into the Maury, Nic holas Senn, J.M. DaCosta , Roberts era o fListerian antisepsis 0 867> butTIle Gross Clinic Bartholow, William S . Forbes, Oscar H. Allis, J.M. shows that as late as 1875 , he ha d n ot a dopted it . Barton, Robert F. Weir, Charles B. deNancrede, During the early years of the o ld opera ting table, Thomas Bryant of London, Thomas Annanda le of

Legend and Lore 658 Fig. 2. Plaque placed upon the -Old Operating Table" by Ihe Clas.s of 1916.

, SAMUEL V . GROSS JOSEPH PANCOAST SAMUEl W.CROSS JOHN H. BRI NTON RICHARD J.lEVrS FRANK MAURY W. JOSEPH HEARN w. W. KEEN J . CHAL MERS DA COS TA ( THEOPlil L VS PA RVIN _ ~ S IR WI.LLlA: Fig. 3. Plaque placed upon the "O ld Operating Table" by the Class of 1917.

Archival Objects 659 ~fil li nK T.J ble" fig. 4. Re-slorM (1982) "Old in spectat niche for a fibrosarcoma of the neck; Annandale of of Gross Conference Room in Surgery Dep.artment of the Col­ lege. Edi nburgh for a sarcoma of the base of the skull, splitting the entire bony palate and sepa rating the , Professor von Esmarch of Kiel, Profes­ two sides to gain access to the sea t of disease; Faure sor Faure of , Sir William MacCormac of Lon­ of Paris for extensive ad hesions of the abdominal d on,Sir Morrell Mackenzie of Lond on (the noted cavity; Sir William MacCormac of London for re­ laryngologtst ), John Wyeth 01 New York, W.H. moval o f a s tone fr om the blad d e r by the Pancoast and many others. suprapubic operation; and Dawbam of New York "I have seen the hand of Roberts Bartho low and for recurrent dislocation of the shoulder. The writer the hand of j.M. DaCosta laid on this table during of this article had the honor of operating many the delivery of lectures . By this table Marion Sims times on this table." DaCosta further stated that stood and addressed the class. Bryant of London the old operating table "should be held, cherished, spoke upon aneurysm; Durham of London upon and cared for as a precious relic as long as the artificial anus; Sir William Macewen of Glasgow school shall stand ." abou t abscess of the brain; and Lorenz of Vienna When the 1025 Walnut Street College Build ing operated upon severa l cases for congenital dislo­ was opened in 1929, the old operating table was cation of the hip. Sir Morrell Mackenzie, the lon­ displayed in the Scott Library for many years. don laryngologist, lectured and paid in th at Eventually, however, it was again placed in stor­ lecture a great tribute to Pro fessor j . Solis­ age and in 1969 moved with archival material into Cohen, and Wyeth of New York made one of his a room in the basem ent of jefferson Alumni Hall. very early demonstrati ons in the use of his pins When the Samuel D. Gross Conference Room in for the p revention of hemorrhage in amputa tion the Department of Surgery on the sixth floor of the of the hip joint. College wa s established in 1982, there was provi­ "On this table Hans Kehr operated for gallstones sion for a special niche to house the table. The employing the huge incision he advocated; Weir moldings of the base were repaired and President of New York operated for stone in the ureter; Sir Bluemle aided in the re-platin g of the plaques at Watson Cheyne for movable kidney; Nicholas Senn the ends of the table (Fig. 4). For the foreseeable for fracture of the patella; Professor von Esmarch future, this venerable relic is safely ensco nced .

Lesend and Lore 660