Adapted from Hall, J. N. "Clayhill Parkhill, Anatomist and Surgeon" in Annals of Surgery (May 1902; 35(5): 674-678)

The surgery of America in those days was still in the masterly grasp of those great surgeons who, in the bloodiest war of modern times, had advanced their profession to an enviable position. In practically every city of the land, the leading surgeon was a man who, after Antietam, Gettysburg, and Cold Harbor, had amputated, perhaps, scores of limbs in a single day. The young man thirsting for a place in surgery, stood no chance in the race with men whose operative work in a single day had exceeded all that he might hope to do in ten years.

As a result, the surgery of the country in 1885 was in the hands of men already getting past middle age, and not easily adaptable to new things; as fine a class of surgeons, nevertheless, as ever honored the profession of any country.

Meanwhile the times had changed. Under the stimulus of the work of Lister, antiseptic surgery had been born. The older men watched the younger ones as they fearlessly invaded field after field upon which they had never dared to tread, and they hesitated in their work. The knowledge of bacteriology had been their undoing. A few of these men, conspicuously Keen, of Philadelphia, and Conner, of Cincinnati, adapted themselves to the new order of things; the great majority of them were crowded out by the younger men.

And had these excellent men, thus crowded out of their field of activity, done nothing for surgery? Let us look briefly at their work. After one of the great battles, perhaps 100 amputations were performed. Experience had taught them that in the serious wounds of the extremities, without amputation, 75 percent died; with immediate amputation, 75 percent lived. In other words, amputation avoided fifty deaths in each 100 cases, chiefly from septicemia, pyxemia, erysipelas, secondary hemorrhage, and hospital gangrene. But the new surgery made unnecessary most of these amputations, practically annihilated all these causes of death, and yet saved most of the limbs. Competition under these circumstances was out of the question.

The older men then stepped aside so far as operative surgery went; but the magnificent knowledge of non-operative surgery which these men had attained, executive ability of the first order, and the power of handling large bodies of men, left them still invaluable to the profession and the world. As an illustration of this point, note that as the great railroads pushed westward, almost every one had as chief surgeon one of these able men. Mercer of the Union Pacific, Livingston of the Burlington, and Bancroft of the Denver and Rio Grande, may serve as examples. During the transition period of which I speak, although the young men carried on their operative work independently, they continually sought the counsel of these older men in broad surgical questions, in their fractures and dislocations, and in many other non-operative parts of the field of surgery for which an incomparable experience had so magnificently fitted them.

Adapted from Hall, J. N. "Clayhill Parkhill, Anatomist and Surgeon" in Annals of Surgery (May 1902; 35(5): 674-678)

The surgery of America in those days was still in the masterly grasp of those great surgeons who, in the bloodiest war of modern times, had advanced their profession to an enviable position. In practically every city of the land, the leading surgeon was a man who, after Antietam, Gettysburg, and Cold Harbor, had amputated, perhaps, scores of limbs in a single day. The young man thirsting for a place in surgery, stood no chance in the race with men whose operative work in a single day had exceeded all that he might hope to do in ten years.

As a result, the surgery of the country in 1885 was in the hands of men already getting past middle age, and not easily adaptable to new things; as fine a class of surgeons, nevertheless, as ever honored the profession of any country.

Meanwhile the times had changed. Under the stimulus of the work of Lister, antiseptic surgery had been born. The older men watched the younger ones as they fearlessly invaded field after field upon which they had never dared to tread, and they hesitated in their work. The knowledge of bacteriology had been their undoing. A few of these men, conspicuously Keen, of Philadelphia, and Conner, of Cincinnati, adapted themselves to the new order of things; the great majority of them were crowded out by the younger men.

And had these excellent men, thus crowded out of their field of activity, done nothing for surgery? Let us look briefly at their work. After one of the great battles, perhaps 100 amputations were performed. Experience had taught them that in the serious wounds of the extremities, without amputation, 75 percent died; with immediate amputation, 75 percent lived. In other words, amputation avoided fifty deaths in each 100 cases, chiefly from septicemia, pyxemia, erysipelas, secondary hemorrhage, and hospital gangrene. But the new surgery made unnecessary most of these amputations, practically annihilated all these causes of death, and yet saved most of the limbs. Competition under these circumstances was out of the question.

The older men then stepped aside so far as operative surgery went; but the magnificent knowledge of non-operative surgery which these men had attained, executive ability of the first order, and the power of handling large bodies of men, left them still invaluable to the profession and the world. As an illustration of this point, note that as the great railroads pushed westward, almost every one had as chief surgeon one of these able men. Mercer of the Union Pacific, Livingston of the Burlington, and Bancroft of the Denver and Rio Grande, may serve as examples. During the transition period of which I speak, although the young men carried on their operative work independently, they continually sought the counsel of these older men in broad surgical questions, in their fractures and dislocations, and in many other non-operative parts of the field of surgery for which an incomparable experience had so magnificently fitted them.