Posts tagged: surgery

Joseph Murray, Bradford Cannon and Plastic Surgery

By , September 18, 2013

Joseph Murray (1919-2012) and Bradford Cannon (1907-2005) first met at the Army-run Valley Forge General Hospital during World War II. After the war, both returned to Boston (Murray to Peter Bent Brigham Hospital and Cannon to Massachusetts General Hospital) and had distinguished careers in plastic and reconstructive surgery. In the video below, entitled “Plastic Surgery at Harvard Medical School”, the two discuss their careers.

The video was produced by the Boston Medical Library as part of the series “Leaders in American Medicine”, and will be part of a Center online exhibit about the life and career of Joseph Murray, which will be available later this fall. The video is part of the Joseph E. Murray papers and was recently digitized.

The Center holds both the Joseph E. Murray papers (finding aid here) and the Bradford Cannon papers (finding aid here). For information regarding access to these collections, please contact the Public Services staff.

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Collection Highlight: Clusters of Manuscripts in Radiology, Hematology, Surgery, and More

Francis D. Moore, Joseph Murray, and George Thorn. Date unknown.

One of the Center’s acquisitions goals is to develop collections that are uniquely deep and rich in connections, providing a view into biomedical and public health disciplines, research areas, communities, and practices via published and unpublished sources– personal papers, professional association records, institutional archives, ephemera, images, and objects. Several of these clusters are well-known; the Historical Collection in Radiology, for example, encompasses rare books extending to the earliest development of radiology, manufacturers catalogs, images, scientific apparatus, and the records of the Fleischner Society and American and New England Roentgen Ray Societies, as well as manuscript collections including those of Felix Fleischner, Morris Simon, Merrill Sosman, Charles L. Dunham and Lauriston Taylor. The Center continues to build on this strong foundation and opened many of these manuscript collections over the past two years (see recent blog posts). More collections will be opened next year.

Another cluster of collections recently opened by the Center are those in hematology (the diagnosis, treatment, and prevention of diseases of the blood and bone marrow as well as of the immunologic, blood clotting, and vascular systems). The Harvard medical community was the site of some major advances in hematology, including William Parry Murphy’s research concerning various hematological diseases, notably pernicious anemia, leukemia, and diabetes mellitus. With George Richards Minot (1885-1950) and George Hoyt Whipple (1878-1976), he is credited with developing a treatment for pernicious anemia using a diet of uncooked liver, for which all three were awarded the 1934 Nobel Prize for Physiology or Medicine. Murphy later worked throughout his career to refine the liver extract developed by Edwin Joseph Cohn (1892-1953) and George Richards Minot for the treatment of pernicious anemia. In 1941, Cohn, working with T.L. McMeekin and John L. Oncley (1810-2004), developed a method of fractionating blood plasma proteins to extend the storage life of blood and use blood proteins more efficiently. More recently, William Dameshek is credited with proposing a technique for bone marrow extraction using a needle, collaborating in the first known multi-institutional chemotherapy trial, and developing treatments for various autoimmune diseases. With Yuet Wai Kan, David G. Nathan introduced the first prenatal diagnostic test for thalassemia and sickle cell anemia.  He is also known for introducing deferoxamine as an effective treatment of iron overload and hydroxyurea as a treatment for sickle cell anemia symptoms. Collections in boldface were recently opened; more collections are on the way (see blog posts for details).

Surgery is another area in which we are assiduously acquiring and striving to open collections.  Earlier this year, Joseph Murray‘s papers were opened to research, joining the collections of plastic surgery pioneer Varaztad Kazanjian, Edward Churchill, Elliot Cutler, Louis T. Wright, the first black appointed to the staff of a New York hospital, Maurice Howe Richardson and his son, Edward Pierson RichardsonWilliam Bovie, American Association of Plastic Surgeons, the New England Vascular Surgery Society, and many others.  We are currently processing the Judah Folkman and Dwight Harken collections, but are still seeking resources to prepare for research access the extensive personal and professional papers of Francis D. Moore. Of greatest concern are the number of living ‘greats’ whose papers have yet to be acquired.

Building the powerful research collections that fuel ground-breaking research demands the active support of the whole community– everyone from physicians, health professionals, scientists, administrators, lab managers, researchers, and all those who are interested in the advancement of knowledge.  In addition to surgery, we are currently collecting in genetics, immunology and infectious diseases, public health, and other fields. We rely on you to alert us to important collections and objects in your field that might be of interest, particularly where those materials might be at risk.

Want to know more about the Center’s holdings in your discipline? Go to the Harvard Library simple search portal, enter your keyword, and click on “Go.” Your findings will be delivered on a Hollis results page; there are many options to refine (narrow) results, including location (select ‘Countway’) and format (choose ‘Archives/Manuscripts’). For assistance, contact the Center’s public services librarians at 617-432-2170 or email to chm@hms.harvard.edu.

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Staff Finds: Joseph Murray and the Surgical Research Laboratory

By , August 17, 2012

Joseph Murray (far right) with Roy Calne (second from left), future 1988 Nobel Laureates Gertrude Elion and George Hitchings (third and fourth from left, respectively), and surviving transplant dogs.

Staff at the Center recently discovered notebooks from the Surgical Research Laboratory while processing the Joseph E. Murray Papers. Of particular interest are two notebooks detailing the work of Murray and his colleagues to refine surgical techniques for kidney transplantation in dogs, which lead to the development of the procedure used for humans. These notebooks date from 1952 to 1954; the first successful human kidney transplant, performed by Murray, took place in December 1954.

A sample detailing a renal autotransplantation procedure on a dog can be seen below. The notes include a description of the operation as well as a postmortem.

The Surgical Research Laboratory, located on the Harvard Medical School Quadrangle, was founded in 1912 by Harvey Cushing, surgeon-in-chief at the Peter Bent Brigham Hospital. The lab functioned as a place for animal-based surgical research, as well as a place for medical students to receive surgical experience. Members included Elliott Cutler, Carl Walter, Francis Moore, and Dwight Harken. Murray was director of the lab from 1952-1975. The lab closed in 2001.

The Joseph E. Murray Papers are expected to be opened to research in early 2013.

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MHL highlight: Civil War photography from the Army Medical Museum

By , June 26, 2012

Photograph and case history of Private Samuel Decker. He posed for this portrait at the Army Medical Museum along with the prostheses he developed after losing both hands to an artillery accident during the battle of Perryville. — vol. 5, image 5 (Click on image to enlarge.)

The Center for the History of Medicine recently digitized a remarkable collection of Civil War-era images titled Photographs of surgical cases and specimens. Nearly 150 years after it was first published, this six-volume set provides a sobering look at the state of the art in surgery during and after the war. The imagery in the collection is vivid, starkly illustrating the terrible effects of developing warfare technology on the human body, while the detailed case histories that accompany each photograph — recording the names and ranks of soldiers, specific battles, dates of injury, treatment narratives, and final outcomes — provide a wealth of medical and biographical information to scholars and casual readers alike.

Though versions of many of the individual images in the collection have been widely circulated, complete sets in bound volumes are extremely rare, and this is the first time that the entire collection, in its original form, has been made freely available to the public online.

Background & history

At the outset of the Civil War in 1861, the lack of experienced surgeons in the ranks of both the Union and Confederate armies represented a looming medical crisis. In 1862 the United States Army Medical Museum was formed, in part to advance practical research into new ways of treating and diagnosing the types of trauma that had become commonplace on the modern battlefield. Almost immediately after it was established, the museum’s first curator, Dr. John Hill Brinton, began collecting specimens from field hospitals and military grave sites. In the years that followed, individual portraits along with photographs of these specimens and accompanying case histories were disseminated to hospitals and medical institutions around the country.

(top) “Group of officers who have undergone amputation for gunshot injuries” from vol. 3, image 1. (Bottom) Minié ball embedded in skull at the Battle of the Wilderness — vol. 2, image 28.

In 1865, Lieutenant William Bell, who would later gain fame for his photographs of the American West, was appointed Chief Photographer of the museum. The artistic composition and quality of Bell’s work often bore greater resemblance to the celebrated portraiture of Matthew Brady than to standard, utilitarian medical photography. Under the direction of Brinton’s successor, Dr. George Alexander Otis, Bell photographed the portrait sitters and anatomical specimens in a studio at the museum, and was ultimately responsible for the majority of the images that comprise this collection.

Contents

The most common and deadly threat on the battlefield at the time was the gunshot wound, which was more prevalent and vastly more traumatic than in previous wars owing to the development of the “Minié ball.” A type of conical musket round, it could be rapidly loaded, then fired accurately and at a velocity high enough to cause devastating flesh wounds and shatter bone at great distances. Surgical cases and specimens includes an exhaustive variety of these types of wounds, illustrated through morbid specimens and portraits of surviving patients, with amputation or excision of joints comprising the majority of surgeries depicted.

This particular edition, which was sent from the museum to John Collins Warren, Jr., was likely assembled and published in the 1870s, and thus it also includes a number of civilian trauma cases from during and after the war that were considered relevant.

A word of caution to readers who wish to browse these books: many of the cases depicted involve extremely gruesome injuries that can, at times, be shocking to look at. Also, when reading the books online, it is important to note that each case history will appear on the page directly following the photograph it describes.

Volumes I-VI of Surgical cases and specimens were digitized by the Center for the History of Medicine as part of our ongoing contributions to the Medical Heritage Library.  A collaborative online collection of primary source materials held by some of the world’s leading medical libraries, the Medical Heritage Library presently contains over 35,000 individual volumes that cover a broad range of topics within the domain of medical history, including hundreds of items relating to various aspects of Civil War medicine. To read more about the MHL and its contributing partners, or to browse the collection, visit www.medicalheritage.org.

Report on the remarkable case of Captain Robert Stolpe, shot through the abdomen at the battle of Chancellorsville. After being wounded, Stolpe was forced to walk 1.5 miles back to a field hospital. A day later, the field hospital came under fire, and he had to walk another half mile with a portion of his lung protruding from the wound. Shortly after being admitted to a base hospital, he passed the musket ball in his stool and was found “walking about the ward smoking a cigar,” apparently having suffered no long-term, adverse health effects. — vol. 1, image 33.

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Digital highlights: Girolamo Fabrizio d’Aquapendente, early surgeon and anatomist, in two editions

By , December 18, 2011

Girolamo Fabrizio was a 16th century surgeon and trail-blazing anatomist, a well-known teacher, and an early expert in the science of embryology, which he investigated through a series of dissections on animal subjects.

Here at the Center, we recently digitized two posthumously-published, 17th century copies of his surgical writings. Both translated from the original Latin, these two books represent early editions of Fabrizio in Italian and German, which would have made his work available to the wider public, and cover topics ranging from the treatment of wounds and ulcers, to fractures, dislocations, and tumors. The two books are illustrated with engraved plates by Giovanni Georgi that show surgical instruments and apparatus as described in the texts, along with highly detailed anatomical preparations.

Taken together with the scores of early medical books that the Center has already digitized and contributed to the MHL, these two works offer a detailed glimpse into a vein of primary source material that memorializes the history of medicine as practiced by physicians from the Renaissance through the Enlightenment and beyond.

The Italian text, published in Padua in 1671, can be found here. The German, published in Nuremberg in 1673, is here.

You can visit the Medical Heritage Library online, which contains a growing catalog of over 13,000 individual, fully-searchable volumes, including many early works on surgeons, surgery, anatomy, and a wide range of diverse topics.

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Joseph Murray on the First Successful Human Organ Transplant

By , September 30, 2011

Dr. Joseph Murray

The current issue of Harvard Medicine features an essay by Dr. Joseph Murray reflecting on the first successful organ transplantation. Murray discusses how his service as an army surgeon during World War II helped influence the direction of his career, as well as describing the procedure and its aftermath. The transplant involved numerous surgical risks, but also raised additional issues:

This list of potential risks posed an ethical dilemma for us. While we routinely asked patients to incur some risk in order to achieve a benefit for themselves, none of us had ever asked a healthy person to accept this magnitude of risk solely for the sake of someone else. We consulted with experienced physicians within and outside of the Brigham, clergy of all denominations, and legal counsel before offering the option of transplantation. The team met several times with the family to describe in detail what was involved for Ronald and Richard. We advised neither for nor against the operation, and we stated the obvious: We could not know if it would work.

Joseph Murray (B.A., 1940, Holy Cross College, M.D., 1943, Harvard) was Professor of Surgery at Harvard Medical School and Chief of Plastic Surgery at Brigham Hospital and Children’s Hospital. He received the Nobel Prize in Physiology or Medicine 1990, for his work on organ transplantation. The Center holds the Joseph E. Murray Papers, 1919-1999. For information regarding access, please contact the Public Services staff.

Joseph Murray (third from left), performing the first successful organ transplant at the Peter Bent Brigham Hospital, Boston, MA, December 23, 1954.

UPDATE: The Harvard Gazette interviewed Dr. Murray about the 1954 transplant as part of a series celebrating Harvard’s 375th anniversary.

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Staff Finds: Thomas Dwight, Surveys on the Teaching of Anatomy

By , May 12, 2011

Thomas Dwight

Staff at the Center recently discovered a set of survey responses while processing the records of the Warren Anatomical Museum. The responses were to a survey of anatomy department course procedures conducted by Dr. Thomas Dwight, a member of the Anatomy Department at Harvard Medical School. The respondents include anatomy departments in medical schools throughout western Europe and North America. The responses vary in length from a few sentences to several pages. Samples from the survey can be seen in the slideshow below; the first image includes the questionnaire with answers, while images 2-4 are a longer set of responses, sent by the University of Michigan. Click on the image to see a larger version.

Dwight (M.D., Harvard, 1867), a grandson of John Collins Warren, succeeded Oliver Wendell Holmes as Parkman Professor of Anatomy at Harvard Medical School. A devout Catholic and the author of Thoughts of a Catholic Anatomist (1911), Dwight is considered the father of forensic anthropology in the United States. During his time at Harvard, he made valuable contributions to the development of the osteological collection of the Warren Anatomical Museum. He served as president of the American Association of Anatomists from 1894 to 1895 and was also a trustee of the Boston Public Library.

In addition to these records in the Warren Anatomical Museum, the Center for the History of Medicine also holds the Papers of Thomas Dwight (H MS c48). For information regarding access to these resources, please contact the Public Services staff.

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Digital highlights: a peculiar approach to healing, and an important early work on surgery

By , March 19, 2011

The Center for the History of Medicine has digitized nearly 400 works on the subjects of surgery and the treatment of wounds and injuries as part of our ongoing contributions to the Medical Heritage Library. Two titles of note, both from the Boston Medical Library collection,  recently passed through the scanning lab: Addinell Hewson’s 1872 work, Earth as a topical application in surgery, and Thomas Gale’s Certaine workes of chirurgerie (1563).

The arm of a patient 15 days after Hewson amputated his hand.

Hewson, a once noted Philadelphia surgeon, describes in detail his practice of using powdered clay both to pack infected wounds and as a topical, post-surgical application. The idea that introducing “earth” to open wounds might have presented any medical benefit was at odds with what were at the time new and increasingly widely accepted ideas about antiseptics. Interestingly, the successes in accelerating the healing process that he describes in the book have been attributed by at least one modern researcher to the probable presence of naturally-occurring antibacterial agents in the clay that would have been unknown to Hewson at the time, and which preceded breakthroughs in modern antibiotics by nearly 75 years.

Another noteworthy feature of Earth as a topical application is that it contains a striking series of woodburytypes depicting the post-operative state of four patients who Hewson treated. Viewable on pages 45, 51, 112, and 164, these portraits render his patients in an unusually stark and artistic light.

The wound man illustration from Gale's work on surgery.

The second title of note, Gale’s Certaine workes of chirurgerie, is the first printed book on surgery known to have been both written and published in English, a fact that sets it apart from the many English translations of foreign-language surgical texts from that era. It is a strange and whimsical work, composed in the form of a free-flowing conversation in which Gale discusses various maladies and their most suitable treatments with John Yates and John Feilde. In the course of the dialogues, Gale expounds upon various types of fractures (classifying them at times by their resemblances to the stalks of certain plants and vegetables), provides detailed instructions on the preparation of medicinal salves and unguents, and gives historical perspectives on then-current medical treatments.

A surgeon in the army of Henry VIII, Gale had first-hand knowledge of the traumatic injuries associated with 16th century warfare. Pictured at right, the title page of Certaine workes contains a commonly used thematic illustration that is generally referred to as “wound man.” Serving as a grim reminder of the perils that once faced soldiers of the late medieval and early modern eras, wound man was used in many early medical texts to depict the array of battlefield injuries common at that time. This version of wound man suffers simultaneous arrow-piercings, bones smashed by clubs, truncheons, hammers, and cannon balls; flesh rended by sword slashes and spear wounds, as well as various other grievous and unpleasant injuries.

Related topics:

surgery wounds and injuriesasepsis and antisepsis in surgerygunshot wounds

plastic surgeryfacial reconstructiondissectionanatomymilitary surgery

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