B 3 1DM 221 
 
THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 OF CALIFORNIA 
 
 PRESENTED BY 
 
 PROF. CHARLES A. KOFOID AND 
 MRS. PRUDENCE W. KOFOID 
 
A MEMOIR 
 
 ON THE 
 
 LIFE AND CHARACTER 
 
 OF 
 
 PHILIP SYNG PHYSICK, M. D 
 
 BY 
 
 J. RANDOLPH, M.D., 
 
 Lecturer on Surgery, Member of the American Philosophical Society, one of the Surgeons 
 to the Pennsylvania Hospital, Member of the Philadelphia College of Phy- 
 sicians, one of the Consulting Purgeons to the Philadelphia 
 Dispensary, Honorary Member of the Phila- 
 delphia Medical Society, etc. etc. 
 
 PHILADELPHIA: 
 
 PRINTED BY T. K. & P. G. COLLINS, 
 No. 1 LODGE ALLEY. 
 
 1839 
 
PHILADELPHIA, February 21, 183D. 
 
 SIR: 
 
 In pursuance of a resolution adopted by the Philadelphia Medical 
 Society, at a meeting held on Wednesday, the 20th of February, 1839, it 
 becomes our duty to convey to you the thanks of the Society for the able 
 and highly interesting memoir on the life and labours of its late venerated 
 president, Philip Syng Physick, M. D., and to request of you a copy for 
 publication. 
 
 Permit us, sir, in performing this duty, also to tender you our own 
 assurances of the mournful pleasure with which, on that occasion, we 
 listened to the narrative of the life of a truly great and good man, with 
 whom we may no longer enjoy the highly prized happiness of personal 
 and professional intercourse. 
 
 With great respect, 
 
 We have the honour to be 
 
 Your obedient servants, 
 
 REYNELL COATES, 
 ISAAC HAYS, 
 THOMAS HARRIS, 
 Committee of Philadelphia Medical Society. 
 To 
 
 J. RANDOLPH, M. D. 
 
 t PHILADELPHIA, February 25, 1839. 
 
 GENTLEMEN: 
 
 It is with sincere gratification that I have received your letter, com- 
 municating the very honourable notice which the Philadelphia Medical 
 Society has been pleased to take of my efforts to delineate the life and 
 labours of its late lamented president, Philip Syng Physick, M. D. Agree- 
 ably to its request I place at your disposal a copy of the memoir for pub- 
 lication. Permit me to return you my grateful thanks for the nattering 
 manner in which you have conveyed to me the resolution adopted by the 
 Society. 
 
 I assure you that, if the portrait which I have attempted to draw be 
 recognised as a true and faithful copy of the original, the highest aim 
 which I had in view is attained. 
 
 I have the honour to be, 
 
 With great regard and respect, 
 
 Your obedient servant, 
 
 J. RANDOLPH. 
 To Messrs. 
 
 REYNELL COATES, 
 ISAAC HAYS, 
 THOMAS HARRIS, 
 
 Committee of Philadelphia Medical Society. 
 
TO THE 
 
 SHADE OF JOHN HUNTER, 
 
 THIS IMPERFECT SKETCH 
 
 OF THE 
 
 LIFE AND LABOURS 
 
 OF A 
 
 FAVOURITE AND ATTACHED PUPIL 
 
 IS 
 
 RESPECTFULLY CONSECRATED 
 
A MEMOIR. 
 
 GENTLEMEN : 
 
 Permit me to express my sincere acknowledg- 
 ments for the honour you have conferred, in ap- 
 pointing me to prepare a Memoir of the life and 
 character of the long venerated President of this 
 institution, the late Doctor Physick. 
 
 I am quite sensible, that the selection was ow- 
 ing rather to my connection w T ith the illustrious 
 deceased, and the close and intimate relation which 
 necessarily existed between us for a long series of 
 years, than to any peculiar ability I may possess, 
 of recording his many virtues and high qualifica- 
 tions. I am fully aware also, of the weighty 
 responsibility which that man assumes, who un- 
 dertakes to transmit to posterity a portrait, which, 
 well and properly executed, may serve as a light 
 and example to illumine and instruct succeeding 
 ages. The effort to accomplish this object I 
 consider, however, a duty which I owe alike to 
 you, and to the memory of Dr. Physick , and I 
 
8 A MEMOIR 
 
 shall endeavor to discharge my obligations in the 
 best possible manner consistent with my means 
 and abilities. 
 
 Most deeply do I deplore, in the commence- 
 ment of my task, the want of proper materials, 
 which, faithfully recorded, would enable Dr. Phy- 
 sick's great and exalted character fully to develop 
 itself. Many of you, Gentlemen, cannot be igno- 
 rant, that the subject of our memoir throughout 
 his whole life, entertained a most invincible re- 
 pugnance to appear before the public in the shape 
 of an Author. Sorry I am to say, that this feel- 
 ing existed with him to the day of his death, and 
 induced him to make an ardent request, and exact 
 the promise that none of his manuscript lectures 
 or letters should be made public. 
 
 The same modesty of feeling which he pos- 
 sessed to an extraordinary degree, and which forms 
 so principal an ingredient in the composition of a 
 truly great and noble mind, caused him also to 
 refuse to comply with the repeated requests which 
 were made to him, to furnish sufficient facts upon 
 which a sketch of his biography might be founded. 
 Upon one occasion only, after urgent solicitations 
 on my part, did he place in my possession some 
 dates and incidents of his life, with the permission 
 that I might make use of them ; he excused him- 
 self, however, from completing the materials at 
 
OF DR. PHYSICK. 
 
 that time, upon the plea of his ill health, and a 
 promise to furnish them at a subsequent period. 
 His disinclination to fulfil this promise was so 
 obvious that I did not feel myself justifiable in 
 renewing the application. 
 
 Philip Syng Physick was born in Philadelphia 
 on the 7th of July, 1768. His father, Mr. Edmund 
 Physick, was an Englishman, and was character- 
 ised for possessing strong mental powers, with 
 which were united strict integrity of principle, 
 and considerable knowledge of the world. Pre- 
 viously to the separation of the United States from 
 Great Britain, he held the office of Keeper of the 
 Great Seal of the Colony of Pennsylvania ; and 
 subsequently to the Revolution he took charge of 
 the estates belonging to the Penn family, and 
 served as their confidential agent. Doctor Phy- 
 sick's mother w r as a most estimable, pious wo- 
 man, who was blessed with a strong intellect, 
 and evinced throughout her life, great judgment 
 and decision of character. The Doctor never 
 ceased to feel and express, as long as he lived, the 
 greatest filial love and reverence for these honoured 
 parents. We have frequently known him to de- 
 clare, that he was convinced that whatever was 
 most useful and excellent in his character, was 
 attributable to the early lessons and impressions 
 which he imbibed from them. 
 
10 A MEMOIR 
 
 From such parents as these it must have result- 
 ed that the greatest care and attention would he 
 hestowed upon the education of their children. 
 It must be regarded as a fortunate circumstance 
 also that his father had succeeded by great indus- 
 try and attention to business, in accumulating a 
 property which, in those days, was looked upon as 
 considerable; and being thus in possession of ample 
 means, he was enabled to carry out to the fullest 
 extent, the plan of education which he designed 
 for his son. 
 
 In doing so, Dr. Physick informed me that his 
 father was influenced by a degree of liberality 
 very unusual in that, or indeed in any age. Dou- 
 ble fees transmitted to the teacher uniformly 
 testified the great importance which he attached 
 to a liberal education, and the value which he 
 thought should be set upon the sources from 
 which it epnanated. This was not only intended 
 for an encouragement to the instructor to use his 
 best endeavours on behalf of his son, but because 
 the donor believed it to be his duty to increase the 
 remuneration, inasmuch as the charges for tuition 
 in that day were so low that they could not be 
 considered as a fair equivalent for the services 
 rendered. 
 
 Mr. Physick placed his son, when eleven years 
 of age, in the academy belonging to the Society of 
 
OF DR. PHYSICK. 1 1 
 
 Friends, in south Fourth street, under the tuition 
 of Robert Proud. At this period Mr. Physick 
 resided in the country, upon the banks of the 
 Schuylkill, several miles from the city, upon an 
 estate belonging to the Penn family. In order to 
 facilitate the education of his son, he was boarded 
 in the city, in the family of the late Mr. John 
 Todd, the father-in-law of the present venerable 
 Mrs. Madison. Even at that early age the subject 
 of our memoir exhibited very strong indications 
 of those well regulated habits of order and method 
 which adhered to him so closely throughout his 
 life. In consequence of his family residing in the 
 country, he was permitted to go home every Satur- 
 day after the school broke up, for the purpose of 
 visiting them and remaining with them until the 
 following Monday morning. He then not unfre- 
 quently was obliged to walk into town, and some- 
 times through most inclement weather. Notwith- 
 standing this, he always succeeded in presenting 
 himself at school exactly at the time of its opening. 
 His teacher was so much gratified with this extra- 
 ordinary punctuality, that he took pleasure in 
 holding him up as an example to other boys, who, 
 though living in the vicinity of the school, were 
 too apt to be remiss in making their appearance 
 at the proper hour. 
 
 Young Mr. Physick remained at this academy 
 
12 A MEMOIR 
 
 until he entered the collegiate department of the 
 University of Pennsylvania. He then passed 
 through the usual course of studies prescribed in 
 that institution, and took the degree of Bachelor 
 of Arts in May, 1785. I am not aware that any 
 thing remarkable occurred during the period of 
 his collegiate studies. That he was a diligent and 
 exemplary student cannot for a moment be ques- 
 tioned. It is well known that he was particularly 
 successful in acquiring a thorough and intimate 
 knowledge of the classics, of which he retained 
 sufficient, amid all his engagements, to be able to 
 translate them with facility, to the time of his 
 death, 
 
 In June, 1785, one month after he obtained the 
 degree of Bachelor of Arts, he commenced the 
 study of medicine, under the superintendence of 
 the late Doctor Adam Kuhn, well known as the 
 pupil of Linnaeus, and a most distinguished and 
 successful practitioner, and then Professor of the 
 Theory and Practice of Medicine in the Univer- 
 sity of Pennsylvania. Of the particular motives 
 which influenced young Mr. Physick in the choice 
 of this profession I am unable to speak. It does 
 not appear that he at that period evinced any strong 
 predilection for this department of science. I think 
 it more than probable that he was principally go- 
 verned by the wishes of his father ; and so strong 
 
OF DR. PIIYSICK. 13 
 
 were his feelings of filial obedience that I am very 
 certain that he would at any time readily have 
 yielded his own wishes to those of his parents. 
 The following anecdote is traditionary in the 
 family. His father, whilst handling a knife, had 
 the misfortune to cut one of his fingers ; and the 
 wound proved to be so severe that he was obliged to 
 engage the services of a medical friend. Upon one 
 occasion his son begged of him to be permitted to 
 apply the necessary dressings and bandage to the 
 finger: his father consented, and was so much 
 surprised at the great skill and dexterity which 
 his son displayed in making the applications, that 
 he determined in his own mind to make him a 
 surgeon. 
 
 If it be true that we are indebted so exclusively 
 to Mr. Physiek for directing his son's attention to 
 the study of medicine, to what an immeasurable 
 extent does it not increase the amount of obliga- 
 tion and gratitude that we owe to him? 
 
 Dr. Physiek was remarkable throughout life for 
 possessing feelings of the most acute and susceptible 
 nature. It may be truly said of him that he pos- 
 sessed a soul feelingly alive to the miseries and 
 sufferings of others. I feel compelled to confess, 
 that I do not think Dr. Physiek himself could 
 support pain with the same degree of fortitude and 
 composure which we have sometimes met with in 
 
14 A MEMOIR 
 
 persons who suffered to an equal extent with him- 
 self; it is undeniable, however, that he was ex- 
 tremely unwilling to be the source of inflicting 
 pain upon others. This tenderness of feeling, 
 which adhered to him closely as long as he lived, 
 as I shall have occasion to show during the pro- 
 gress of this memoir, existed also in full force in 
 the days of his youth. He used frequently to 
 declare at this period of his life, that he never 
 could be a surgeon. Little was he aware, that he 
 would live to afford in his own person, a complete 
 illustration of the position, that the practice of 
 medicine and surgery, so far from hardening and 
 rendering callous the feelings, has a direct con- 
 trary tendency, and serves pre-eminently to soften 
 and refine them. His example also went far to 
 prove, in connection with the result of our whole 
 experience upon this subject, that in order for a 
 man to become a great and good surgeon, it is ab- 
 solutely necessary for him to possess to the fullest 
 extent, the best and kindest feelings of which hu- 
 man nature is susceptible. 
 
 The following incident, which occurred to Dr. 
 Physick, and which was in fact characteristic, may 
 not be deemed uninteresting. Soon after he com- 
 menced the study of medicine, it was announced 
 that an amputation would be performed upon a 
 certain day, at the Pennsylvania Hospital. His 
 
OF DR. PHYSICK. 15 
 
 preceptor, Professor Kuhn, wished him to witness 
 this operation, but understanding perfectly well 
 the peculiar temperament of his pupil, he gave it 
 as his advice that his father should accompany 
 him. His father did go with him, and fortunately 
 too, inasmuch as his son became so sick during 
 the operation that it was necessary to lead him 
 from the amphitheatre before it was concluded. 
 
 Dr. Physick continued to prosecute his medical 
 studies under the superintendence of Professor 
 Kuhn, for the period of three years. In those 
 days it was customary for the student of medicine, 
 previously to his obtaining the honours of the doc- 
 torate, to go through a much more extensive course 
 of reading than is now deemed necessary. By 
 the direction of his preceptor Dr. Physick read 
 through most diligently and faithfully, many vo- 
 luminous works of the older medical writers, 
 some of which, if not absolutely obsolete at the 
 present day, are only used as works of reference. 
 We have abundance of evidence which goes to 
 prove, that even at that early period of his life, 
 Dr. Physick evinced the most resolute determina- 
 tion to qualify himself by every possible means, for 
 assuming a most useful and honourable standing in 
 his profession : and there cannot be a question but 
 that he must have gleaned from amidst this great 
 mass of laborious reading, much valuable informa- 
 
16 A MEMOIR 
 
 tion, which he subsequently applied to a most ex- 
 cellent purpose. 
 
 It may be stated, that Dr. Physick's whole de- 
 portment during the period of his pupilage w T ith 
 Professor Kuhn, was so perfectly correct and satis- 
 factory, as to merit his entire approbation: it is 
 well known, too, that Dr. Physick cherished, as 
 long as he lived, feelings of the warmest affection 
 and regard for his venerable preceptor, and it was 
 a source of great gratification to him to know that 
 these feelings were reciprocated. 
 
 In addition to the instruction which Dr. Phy- 
 sick derived from Professor Kuhn, he also attended 
 at this same period the medical lectures delivered 
 in the University of Pennsylvania. He did not, 
 however, graduate in medicine in that institution. 
 The opportunities for the acquisition of profound 
 medical knowledge offered by the schools and hos- 
 pitals of this country, then in its infancy, were 
 too limited to satisfy either his conscience or his 
 ambition. He could not convince his mind that 
 his knowledge of medicine was sufficiently en- 
 larged to warrant him in assuming to himself the 
 deep and important responsibilities attendant upon 
 the practice of a profession which involved the 
 lives and happiness of so many of his fellow^ crea- 
 tures. In order for the more effectual completion 
 of his education, he entertained an ardent desire 
 
OF DR. PHYS1CK. 17 
 
 to visit Great Britain, and avail himself of the ad- 
 vantages which were afforded by the great schools 
 and hospitals of London and Edinburgh. His 
 father happily coincided with these views, and 
 determined upon accompanying his son. Accord- 
 ingly they embarked for Europe in November, 
 1788, and arrived in London in January, 1789. 
 
 I may mention that Dr. Physick's sole object 
 in visiting Europe, was that of acquiring medical 
 information. I doubt very much whether any 
 man ever visited that country with less desire or 
 expectation of partaking of its gaieties and amuse- 
 ments than himself. I repeat, with him the 
 grand consideration w r as the acquisition of know- 
 ledge : to this he applied himself with the most 
 ardent devotion, and never permitted amusements 
 of any kind to turn him aside from the pursuit 
 of it. 
 
 Fortunately for Dr. Physick, his father's con- 
 nections in London were such, that he was ena- 
 bled to introduce his son to some of the most 
 learned and polished society, both among the 110- 
 bility and gentry, of that great metropolis. An 
 intercourse of this kind created for him an influ- 
 ence and gave him opportunities by means of 
 which his cherished views were considerably pro- 
 moted. Any one who ever encountered Dr. 
 Physick must have been struck with the exceed- 
 3 
 
18 A MEMOIR 
 
 ing dignity and courteousness of his manner. For 
 this no doubt he was principally indebted to na- 
 ture. I am, however, of the opinion that it was 
 in some degree acquired and confirmed by his 
 association with the most elevated society whilst 
 abroad. By means of this same influence Mr. 
 Physick succeeded in securing the consent of Mr. 
 John Hunter, then one of the most celebrated 
 anatomists and surgeons of the age, to receive his 
 son under his immediate care and tuition. 
 
 I have reason to believe that Dr. Physick con- 
 sidered this as the most important era in his pro- 
 fessional life. He early became convinced of the 
 extraordinary advantages w T hich he might derive 
 from this connection with Mr. Hunter, and pro- 
 ceeded accordingly to devote himself with the 
 most ardent zeal to the study of practical anatomy 
 and surgery. By dint of constant and unwearied 
 application to his studies, aided also by a course 
 of unceasing and untiring dissections, he soon 
 made rapid advancement in the attainment of his 
 objects, and what was also of much consequence, 
 secured to himself the approbation and esteem of 
 his great master. Mr. Hunter, in fact, was so 
 well pleased with the zeal and industry, combined 
 with the correct deportment, exhibited by Dr. 
 Physick, that he took pleasure in acknowledging 
 him as a favourite pupil, and bestowed upon him, 
 
OF DR. PHYSICK. 19 
 
 in the most unreserved confidence, the full benefit 
 of his advice and experience. During this period 
 Dr. Physick attended regularly the lectures deli- 
 vered by Mr. John Clark and Dr. Wm. Osborne 
 on Midwifery. 
 
 Among the manuscript papers left by Dr. Phy- 
 sick which have fallen into my possession, I have 
 a note book, kept by him during his stay in Eng- 
 land, in which he recorded such facts and inci- 
 dents as came under his observation, which he 
 supposed might be of service to him subsequently. 
 I take the liberty of making two or three extracts 
 from these notes, in order to exemplify the careful 
 manner in which he performed this duty, and the 
 pains which he took to treasure up all the infor- 
 mation which he gained. 
 
 "February, 1789. Visited Mr. Hunter. In 
 the evening, after being entertained with tea, cof- 
 fee, and general conversation, Doctor Baillie exhi- 
 bited a preparation." He then goes on to describe 
 the preparation; which, although exceedingly inte- 
 resting to the medical profession, it would not be 
 proper to insert here. 
 
 "February, 1789. Mr. Home performed an 
 operation on a sheep which had the staggers, in 
 the following manner. After making a crucial in- 
 cision through the integuments of the cranium, 
 he applied the trephine, and removed a portion of 
 
20 A MEMOIR 
 
 the bone from the upper and middle part of the 
 cranium. When this was done, he introduced a 
 pair of small forceps, with which he extracted a 
 tasnia hydatigena. The effect was, that the sheep, 
 being set at liberty, stood on its legs, which before 
 it could not do. This, however, was only a tem- 
 porary amendment, as it died about twenty hours 
 after the operation was performed." 
 
 "November 15, 1789. Mr. Cruickshank re- 
 lated the particulars of a case of hydrothorax, in 
 which, upon opening into the right side of the 
 chest, he evacuated nine pints of water, and in 
 the left side there was found one pint. The lung 
 of the right side was compressed to a small size, 
 and instead of feeling spongy as common, it was 
 solid and fleshy, and quite incapable of being di- 
 lated by air, so that the respiration was carried on 
 by the left lung altogether. The patient, during 
 his life, was incapable of sitting or standing up, 
 feeling great pain when he attempted it ; but was 
 quite easy in bed when lying on his right side, 
 but could not lie on his left side. His pulse, for 
 near two months before his death, was quite regu- 
 lar, though before that time it had been otherwise, 
 and the apothecary who had attended him had 
 suspicions of hydrothorax. There was a swelling 
 in the abdomen, which was very painful to him. 
 This proved to be a cancerous tumour of the whole 
 
OF DR. PHYSICK. 21 
 
 of the omentum, which, being very heavy, when 
 he attempted to get up gave him the pain men- 
 tioned before." 
 
 "Mr. Cruickshank said that he saw a case of 
 hydrothorax where there was no pulsation to be 
 felt, either in the carotids, or in the arteries at the 
 wrist, or in the groin, nor could any motion be 
 perceived at the part where the heart is usually 
 felt pulsating ; and the patient continued in this 
 state for two months." 
 
 Dr. Physick continued to prosecute his studies 
 with the most exemplary perseverance and indus- 
 try, under the immediate superintendance of Mr. 
 Hunter, throughout the year 1789. On the first 
 of January, 1790, he was appointed House Sur- 
 geon to St. George's Hospital for one year, which 
 is the usual period of that service in the institu- 
 tion. This appointment he owed exclusively to 
 the patronage and influence of Mr. Hunter. The 
 advantages offered by such a situation to the stu- 
 dent of medicine, in the way of promoting and 
 facilitating his acquisition of practical knowledge 
 and skill, were of the most important character ; 
 and consequently they were much too well known 
 and appreciated not to cause the place to be sought 
 after by numerous applicants, most of wiiom, from 
 the circumstance of their English birth alone, it 
 might be supposed, could have exerted an influ- 
 
22 A MEMOIR 
 
 ence more powerful than that of a foreigner. 
 Here were exemplified in the most happy manner, 
 the important advantages which Dr. Physick de- 
 rived from the favourable impressions which Mr. 
 Hunter had imbibed respecting his general worth, 
 his talents, and his acquirements. These considera- 
 tions induced him unhesitatingly to exert the 
 whole of his influence in behalf of Dr. Physick, 
 who accordingly succeeded over all his competi- 
 tors. A few months after this period, Dr. Phy- 
 sick had an attack of indisposition, which was of 
 so severe a character that Mr. Hunter became 
 very uneasy and alarmed about him, and was on 
 the eve of insisting upon his return to America. 
 This attack, I have no doubt, was principally ow- 
 ing to the laborious life which he led, and the 
 close confinement to which he subjected himself. 
 Providence, however, for its own wise and benefi- 
 cent purposes, thought proper to restore him to 
 health, to the great delight and gratitude of his 
 parents and friends. 
 
 That it was during the period of his remaining 
 in St. George's Hospital that Dr. Physick acquired 
 a vast deal of that surgical skill and dexterity 
 which laid the foundation of his subsequent great- 
 ness, cannot, I think, for a moment be questioned. 
 Having his whole time occupied in administering 
 to the wants of such unhappy objects as were suf- 
 
OF DR. PIJYSICK. 23 
 
 fering from the effects of accidents or disease; 
 being constantly engaged in applying the necessary 
 bandages and dressings to fractured bones, disloca- 
 tions, wounds, and injuries of every description, 
 and seizing hold, as was his invariable custom, of 
 every such opportunity and occasion of making 
 himself minutely acquainted with the best and 
 most perfect manner of performing these services, 
 he soon became remarkably expert in all his mani- 
 pulations, and acquired a degree of experience 
 which increased greatly his stock of practical 
 knowledge. I think it will probably not be denied, 
 that Dr. Physick exhibited as great a degree of 
 neatness and dexterity in the application of ban- 
 dages and dressings as any other surgeon who ever 
 lived. 
 
 During the period of his services in this insti- 
 tution, he learned also the manner of constructing 
 and contriving several kinds of instruments and 
 apparatus, which he subsequently was the first to 
 introduce into this country, to the great benefit of 
 our art. 
 
 An anecdote frequently related to me by Dr. 
 Physick, connected with his early appointment to 
 St. George's Hospital, I trust I may be pardoned 
 for mentioning here, notwithstanding it has already 
 been promulgated from another source. His success 
 in obtaining this situation caused some slight de- 
 
24 A MEMOIR 
 
 gree of dissatisfaction on the part of some of the 
 disappointed applicants, who conceived that their 
 claims for the situation were stronger than his. 
 In consequence of this Dr. Physick clearly per- 
 ceived that they evinced an uncommon share of 
 curiosity respecting the manner in which he dis- 
 charged his duties, and that they were disposed to 
 scrutinise his actions with the greatest strictness. 
 A short period after commencing his services, a 
 patient was admitted into the hospital who had 
 had the misfortune to dislocate his shoulder ; the 
 head of the humerus was thrown downward, and 
 lodged in the axilla. Fortunately the accident 
 was quite recent. It so happened that at the 
 time the man was admitted the whole class were 
 in attendance at the house. They, of course, 
 were exceedingly anxious to witness the manner 
 in which the reduction would be effected, and 
 Dr. Physick was perfectly well aware that his 
 method of restoring the bone to its natural situa- 
 tion would be subjected to severe criticism. He 
 directed the patient to be seated upon a high 
 chair; he then proceeded to examine the injured 
 shoulder very particularly, and questioned the man 
 as to the manner in which the accident had oc- 
 curred. Whilst making these inquiries he placed 
 his left hand in the axilla, and taking hold of the 
 lower end of the humerus w T ith his right hand, he 
 
OP DR. PHYSICK. 25 
 
 made all the extension in his power; he then 
 suddenly depressed the elhow of the patient to 
 the side of his body, and in so doing, dislodged 
 the head of the bone, which glided instantaneously 
 into the glenoid cavity, very much to his own 
 delight, and doubtless also to the perfect satisfac- 
 tion of the class. 
 
 In relating this incident Dr. Physick never 
 seemed disposed to assume .to himself much merit 
 for effecting such a speedy reduction ; he rather 
 wished to communicate the impression that his 
 success was in great degree owing to all the cir- 
 cumstances of the case favouring an easy reduc- 
 tion. I was always of the opinion, however, that 
 his characteristic modesty induced him to under- 
 rate his services; and that his success in reducing 
 the dislocation so speedily, unaided, was princi- 
 pally owing to that unrivalled address and dex- 
 terity of which he subsequently proved himself 
 to be so completely a master. The treatment of 
 this case produced the most happy influence in 
 promoting the interests and comfort of the Doctor 
 during the remainder of his stay in the hospital. 
 He stated that from that time forward he always 
 enjoyed the uninterrupted regard and respect of 
 the medical class. 
 
 In January, 1791, the period for which he had 
 been elected to St. George's Hospital having ex- 
 4 
 
26 A MEMOIR 
 
 pired, he quitted the institution, carrying with 
 him the warmest testimonials from its proper 
 authorities, of his most excellent medical qualifi- 
 cations, and also of his general good conduct. 
 They went so far as to declare, that instead of 
 considering him to lie under any ohligations to 
 the institution, they considered the institution in- 
 debted to him for the many benefits he had con- 
 ferred upon its unhappy inmates, and for the 
 useful results which had been produced by the 
 employment of his singular zeal and abilities. 
 He now received his diploma from the Royal Col- 
 lege of Surgeons in London. 
 
 Soon after leaving St. George's Hospital, Dr. 
 Physick received from Mr. Hunter a mark of his 
 respect and esteem, which was gratifying to him 
 in the highest degree, and more particularly so as 
 it furnished the most conclusive evidence of Mr. 
 Hunter's entire confidence in his professional skill 
 and attainments. Mr. Hunter invited him to 
 take up his residence with him, to become an 
 inmate of his house, and to assist him in his pro- 
 fessional business ; he also held out inducements 
 to him to establish himself permanently in Lon- 
 don, and to pursue the practice of his profession 
 in that city. 
 
 .Notwithstanding the tempting nature of these 
 offers, and the great advantages which Dr. Phy- 
 
OF DR. PHYSICK. 27 
 
 sick might have derived from accepting them, it 
 did not comport with either his own designs, or 
 those of his father, that he should exile himself 
 from his native country. He, however, gratefully 
 accepted Mr. Hunter's offer to reside with him 
 until the period should arrive when, in accordance 
 with the plan previously laid down for the com- 
 pletion of his medical education, he was to visit 
 Edinburgh, in order to graduate in medicine in 
 the University of that city. In conformity with 
 this arrangement he remained with Mr. Hunter, 
 and rendered him every aid and assistance in his 
 power, not only in his professional business, but 
 also in the prosecution of his physiological experi- 
 ments, and the making of anatomical preparations, 
 until May, 1791, when he took his final leave of 
 London. I may notice that his father had, pre- 
 viously to this period, returned to America. 
 
 The parting between Mr. Hunter and Dr. 
 Physick was painful to the latter to an extreme 
 degree, and certainly the most distressing event 
 which occurred to him during his stay in London. 
 The ties which bound him to Mr. Hunter were 
 of no ordinary description. Mr. Hunter had not 
 only extended towards him the warmest friend- 
 ship and regard, but had also conferred the most 
 invaluable benefits upon him, by giving him the 
 advantages of his powerful aid and influence, and 
 
28 A MEMOIR 
 
 by promoting, by all the means in his power, his 
 medical researches. These obligations could only 
 be acknowledged on the part of Dr. Physick, by 
 the most sincere and ardent devotion to his beloved 
 preceptor. Indeed, I think I am warranted in say- 
 ing, that the admiration felt for Mr. John Hunter 
 by Dr. Physick amounted to a species of venera- 
 tion. Certain it is, that he never ceased to consider 
 him as the greatest man that ever adorned the 
 medical profession. Could his honoured master 
 have been permitted to witness the closing career 
 of his pupil, he would have felt himself amply 
 recompensed by the rich harvest of fame and use- 
 fulness which the latter had gathered, in conse- 
 quence of his valuable aid and instructions. 
 
 Immediately after his arrival in Edinburgh, Dr. 
 Physick entered with his usual ardour upon the 
 prosecution of his studies. He attended very dili- 
 gently the medical lectures delivered in the Uni- 
 versity, besides which he visited constantly the 
 Royal Infirmary, and was a careful observer of the 
 practice pursued in that institution, and witnessed 
 all the operations which were there performed. 
 In May, 1792, having complied with all the requi- 
 sitions demanded by the University, he obtained 
 the degree of M. D. The subject of his thesis 
 was apoplexy; and in compliance with the esta- 
 blished regulations he was obliged to write it in 
 
OF DR. PHYSICK. 29 
 
 the Latin language. The original manuscript 
 copy of this essay, which he first wrote in English, 
 is now in my possession, and it bears the most 
 satisfactory evidence of having been prepared with 
 a vast deal of careful attention. It is divided into 
 distinct chapters, and contains particular memo- 
 randa of the several authors to whom he wished 
 to refer. 
 
 In order to show the familiar knowledge of the 
 Latin language which Dr. Physick possessed, I 
 may relate the following anecdote. It is well 
 known that the examinations for a medical degree 
 in Edinburgh are conducted in Latin; and that 
 there are many applicants for the honour who do 
 not possess a sufficient knowledge of that language 
 to enable them adequately to make replies from 
 their own resources. In order to obviate this 
 deficiency, there existed in Edinburgh a class of 
 men termed grinders, whose occupation consisted 
 in preparing students, by a system of drilling 
 which should render them competent to reply to 
 such questions as in all probability they would 
 receive. It so happened that, a short time pre- 
 vious to the examinations, Dr. Physick was in 
 company with a fellow-student from this city, and 
 in reply to some allusion made by his companion 
 to these grinders, the Doctor stated that he should 
 not seek their aid, but that he was determined to 
 
30 A MEMOIR 
 
 rely upon his own knowledge of the language to 
 carry him safely through. His companion ex- 
 pressed much surprise at this statement, seeming 
 to consider it as a vain boast on the part of Dr. 
 Physick; and he intimated his doubts of the 
 Doctor's capabilities very clearly by the query: 
 Do you mean to say that you possess a sufficient 
 knowledge of the Latin to enable you to carry 
 on a conversation in that language? Dr. Physick 
 satisfied him completely, by instantly addressing 
 him in Latin, and continuing for some time to 
 reply to him in the same tongue. The infer- 
 ence to be drawn is, that his companion was in 
 all probability at that very time under the tuition 
 of a grinder. 
 
 Dr. Physick did not leave Edinburgh imme- 
 diately after obtaining his honorary title : he re- 
 mained there for a short period ; and the manner 
 in which he occupied himself may be fairly illus- 
 trated by the following extract, which I take from 
 his note book. 
 
 "June, 1792. Prepared for the house surgeon 
 at the Royal Infirmary, Edinburgh, an intussus- 
 ceptio, in which the ileum had passed into the 
 colon, and at last dragged down six inches of the 
 colon. Most probably there was a stricture form- 
 ed about the termination of the ileum, near to 
 the valve, as there were strictures in other parts 
 
OF DR. PHYSICK. 31 
 
 of the intestines. At present a stricture of the 
 ileum at this part certainly exists, hut whether 
 that did not arise from the hinding of the inverted 
 colon, and the inflammation consequent thereon, 
 I cannot he sure. I was not present at the dis- 
 section of the body, and the person who took out 
 the parts tore them very much." 
 
 Dr. Physick returned to his native country in 
 September, 1792; and commenced the practice of 
 his profession in Philadelphia. His office was 
 situated in Mulherry Street near Third. That 
 Dr. Physick entered upon his practical career un- 
 der the most favourable circumstances will, I 
 think, he readily admitted. I have already shown 
 that, in addition to his own extraordinary qualifica- 
 tions, he had enjoyed the most ample opportunities 
 of acquiring knowledge from sources distinguished 
 alike for their exalted character and superior excel- 
 lence. Nature also rendered her best aid for fit- 
 ting him pre-eminently, by all external advantages, 
 for the successful accomplishment of his objects. 
 His personal appearance was commanding in the 
 extreme. He was of a medium height ; his coun- 
 tenance was noble and expressive ; he had a large 
 Roman nose; his mouth was beautifully formed, 
 the lips somewhat thin, and he had a high fore- 
 head, and a fine hazel eye, which was keen and 
 penetrating. The expression of his countenance 
 
32 A MEMOIR 
 
 was grave and dignified, yet often inclined to me- 
 lancholy, more especially when he was engaged in 
 deep thought, or in performing an important and 
 critical operation. Dr. Physick rarely indulged 
 in excessive mirth ; he was, however, far from be- 
 ing insensible to playful humour, and on such oc- 
 casions his countenance would be lighted up by a 
 benign smile, which altered entirely the whole ex- 
 pression of his features. His manners and address 
 were exceedingly dignified, yet polished and affable 
 in the extreme; and when he was engaged in 
 attendance upon a critical case, or in a surgical 
 operation, there was a degree of tenderness, and at 
 the same time a confidence, in his manner, which 
 could not fail to sooth the feelings and allay the 
 fears of the most timid and sensitive. 
 
 The introduction of a young practitioner of 
 medicine to the notice of the community, is pro- 
 verbially slow; and not unfrequently, before he can 
 inspire a sufficient degree of confidence to lead to 
 his employment, a length of time is requisite 
 which, in some instances, produces bitter disap- 
 pointment, and occasionally even utter hopeless- 
 ness and despair. As might have been anticipated 
 there were but few professional calls made upon 
 Dr. Physick during the period of the first year 
 after he had established himself in this city ; and 
 it is highly probable that, notwithstanding all the 
 
OF DR. PHYSICK. 33 
 
 advantages of which he could boast, he would 
 have been obliged to exercise an enduring degree 
 of patience for a considerably longer period, were 
 it not that in the summer of 1793, Philadelphia 
 had the misfortune to be visited with that awful 
 calamity, the yellow fever. It is not necessary in 
 this place to give an account of the destructive 
 ravages caused by this epidemic. The most ample 
 and detailed description of the origin and progress 
 of the yellow fever, with all its concomitant cir- 
 cumstances, has been furnished from the very 
 highest source by one of the brightest luminaries 
 of the age ; one who was a most prominent and 
 efficient actor in the tragical scene; one whose 
 disinterested patriotism, brilliant imagination and 
 splendid acquirements endeared him to the hearts 
 of his countrymen, and one also who invariably 
 evinced himself the warm and constant friend of 
 Dr. Physick. Need I add the name of Dr. Benja- 
 min Rush ? 
 
 The occurrence of the yellow fever afforded to 
 Dr. Physick his first opportunity of proving to his 
 fellow citizens his entire devotion to his profes- 
 sional pursuits, his utter disregard of all personal 
 considerations which might interfere with the dis- 
 charge of his duties, and the fearless intrepidity 
 with which he exposed himself to danger, in order 
 to contribute to the safety of others. As a means 
 5 
 
34 A MEMOIR 
 
 of preventing an extension of the disorder by re- 
 moving, as far as possible, from overcrowded situa- 
 tions such as were attacked by it, and in order also 
 to afford an asylum and the most efficient treat- 
 ment to such as were destitute, the Board of 
 Health, in August, 1793, established the yellow 
 fever hospital at Bush Hill, and Dr. Physick hav- 
 ing offered his services, was elected by them phy- 
 sician to the institution. He immediately pro- 
 ceeded to the performance of his duties with the 
 most singular ardour and ability ; and during the 
 time he remained in the hospital rendered services 
 which were acknowledged to be of the most im- 
 portant character, and which served to secure to 
 himself the approbation and esteem of the com- 
 munity at large. Dr. Physick did not himself 
 escape without an attack of the fever. It however 
 yielded to the treatment employed, although I 
 heard him declare but a short time previous to his 
 death, that he did not think his constitution had 
 ever completely recovered from the shock which 
 it then received. 
 
 During a period of such general distress history 
 has at all times shown that the minds of the people 
 are very apt to become excited and inflamed ; and 
 some threatening indications of riotous conduct 
 having been exhibited whilst Dr. Physick was 
 serving in the Bush Hill hospital, he was created 
 
OF DR. PHYSICK. 35 
 
 an alderman by the Governor of the State of 
 Pennsylvania, for the purpose of enabling him to 
 quell them. 
 
 The notoriety which Dr. Physick obtained, 
 together with the favourable impression which he 
 produced during his residence in the hospital, en- 
 abled him to form associations which subsequently 
 proved of immense benefit to him in promoting his 
 professional success. Among others, I may men- 
 tion that our late fellow citizen, Stephen Girard, 
 who was at that melancholy epoch a member of 
 the Board of Health, and who rendered the most 
 important services throughout the epidemic, in 
 alleviating the miseries and providing for the 
 wants of the unhappy sufferers, conceived a last- 
 ing friendship for him. Stephen Girard subse- 
 quently became distinguished for the acquisition 
 of immense wealth, far beyond that of any other 
 person in our city. Whilst living, he performed 
 many acts of benevolence and charity, and in dy- 
 ing he made a bequest which will cause his name 
 to be transmitted to the latest posterity. The ser- 
 vices, however, rendered by Stephen Girard, dur- 
 ing the prevalence of the yellow fever, should 
 never be forgotten ; services which went to solace 
 the woes of the widow and the orphan, and which 
 form a still higher claim to the veneration of his 
 countrymen. 
 
36 A MEMOIR 
 
 Mr. Girard was well known to have been a 
 man of very eccentric habits and strong prejudices. 
 One of his peculiarities consisted in a general dis- 
 like of physicians. I always felt assured that this 
 prejudice was founded upon his ignorance, and a 
 vain belief that he knew as well from his own 
 experience how to treat diseases, as most men who 
 were regularly educated to the profession. He, 
 however, made a few exceptions ; and one of these 
 was Dr. Physick, to whom he always resorted for 
 medical advice and assistance, whenever he deemed 
 the case critical, as long as he lived. Mr. Girard 
 finally died a victim to his prejudices: he was 
 attacked with an inflammation of his chest, and 
 would not consent to lose blood until it became 
 too late. 
 
 Dr. Physick, I believe, was the first to promul- 
 gate the doctrine, which he founded upon his own 
 observations, that the yellow fever was not conta- 
 gious; he also fully coincided with Dr. Rush in 
 the opinion that it was of domestic origin. Dr. 
 Rush at first dissented from the doctrine of the 
 non-contagious character of yellow fever, but sub- 
 sequently became convinced of its truth and im- 
 portance. During the prevalence of the epidemic, 
 Dr. Physick, in conjunction with Dr. Cathrall, 
 made a series of post mortem examinations and 
 dissections, which were productive of the most 
 
OF DR. PHYSICK. 37 
 
 important results ; inasmuch as they went far, not 
 only in elucidating the true nature of the disorder, 
 but also in pointing out the best method of treat- 
 ment. These dissections proved, in the most satis- 
 factory manner, that the complaint possessed a 
 highly inflammatory character, and that the sto- 
 mach more particularly was the seat of great in- 
 flammation. They also established the most valu- 
 able therapeutic indications, by confirming conclu- 
 sively the superiority of the antiphlogistic method 
 of treatment, over that of an opposite character, 
 which had generally been employed. It is quite 
 apparent, from this notice of Dr. Physick's dissec- 
 tions of persons who had died of yellow fever, that 
 he preceded the celebrated Broussais in pointing 
 out the intimate relations which subsist between 
 the condition of the stomach and the production 
 of bilious and yellow fevers. It is well known, 
 that as far back as the period to which we are 
 alluding, Dr. Physick pronounced yellow fever to 
 be gastritis ; and he was so much influenced by 
 his opinions of the necessity of avoiding all causes 
 which could prolong or excite the gastric irritation 
 that in one instance he ascribed the death of a 
 patient labouring under this malady, to a relapse 
 produced by swallowing a small quantity of chick- 
 en water. 
 
 After leaving the hospital he removed to the 
 
38 A MEMOIR 
 
 city and gave his undivided attention to his pro- 
 fessional engagements. In the year 1794, Dr. 
 Physick was elected, by the managers of the Penn- 
 sylvania Hospital, one of the surgeons to that insti- 
 tution. This period may be stated to be the dawn 
 of his great surgical fame and usefulness. The 
 reputation sustained by the Pennsylvania Hospital 
 for a long series of years, not only on account of 
 the amount of benefits which it has conferred, but 
 also on account of its excellent administration, are 
 so well known as to render superfluous any enco- 
 miastic notice of it on my part. That Dr. Phy- 
 sick contributed largely to the support of its cha- 
 racter and reputation, can be readily shown by a 
 record of his services. It must be admitted, how- 
 ever, that his appointment to the hospital had a 
 considerable influence in promoting his success, 
 and leading to an extension of his business. The 
 situation enabled him to add greatly to his stock 
 of experience, and he also enjoyed from it the 
 most ample opportunities of perfecting himself in 
 the operative department of his profession. I 
 have already stated that in his manual procedures 
 he exhibited the utmost degree of neatness and 
 dexterity. Dr. Physick possessed pre-eminently 
 all the qualifications requisite for a bold and suc- 
 cessful operator. His sight was remarkably keen 
 and good ; his nerves, when braced for an opera- 
 
OF DR. PHYSICK. 39 
 
 tion, were firm and immovable; his judgment 
 was clear and comprehensive, and his resolutions 
 once formed, were rarely swerved from. In addi- 
 tion to these he owed much to his thoughtful and 
 contemplative cast of character, which induced 
 him to deliberate and reflect intensely upon all 
 the circumstances of his case, and to make elabo- 
 rately beforehand every preparation which might 
 become needful in the performance of his task. 
 
 In order to appreciate fully and correctly the 
 amount of contribution, made by Dr. Physick to 
 the department of surgery, it is important to keep 
 in view what was the imperfect condition of the 
 art in this country, at the period of his com- 
 mencing his professional career. It is well known 
 that the principles of science which should govern 
 the treatment of many disorders were in that day 
 very imperfectly understood. It is true that there 
 were some members of the profession, endowed 
 with great merits and learning, who devoted them- 
 selves especially to the cultivation of surgery. 
 These gentlemen were quite competent to the per- 
 formance of what were then considered the capi- 
 tal operations in surgery ; still it must be confessed 
 that not any one of them ever acquired the neces- 
 sary degree of skill and pre-eminence to create an 
 unlimited confidence in his abilities. In conse- 
 quence of this there was no head, no rallying point 
 
40 A MEMOIR 
 
 to surgery, an appeal to which, when once made, 
 should he regarded as decisive. We cannot feel 
 surprised at the comparatively insignificant posi- 
 tion which the science of surgery then held, when 
 we reflect that, prior to the appointment of Dr. 
 Physick, surgery was not taught in this city as a 
 separate and distinct department. The professor- 
 ships of anatomy and surgery were combined in 
 the University of Pennsylvania, and the duty of 
 teaching hoth hranches devolved upon one indi- 
 vidual. Under these circumstances it would have 
 been extremely unreasonable to expect an efficient 
 course of instruction when it is well known that 
 the usual period allotted to a course of lectures 
 upon either department, as now separated, is con- 
 fessedly too limited. 
 
 Soon after Dr. Physick's appointment to the 
 Pennsylvania Hospital, his mind became consider- 
 ably engaged in the consideration of a class of dis- 
 orders of which that institution then had, and 
 continues to have at the present time, its full pro- 
 portion, namely, ulcers. It is undeniable that the 
 treatment of these affections was in that day but 
 little understood by our surgeons. The method of 
 cure which they resorted to was for the most part 
 exclusively empirical. They were not generally 
 guided by correct scientific principles. In conse- 
 quence of this the treatment of ulcers was no- 
 
OF DR. PHYSICK. 41 
 
 toriously unsuccessful; and I am sorry to say, that 
 there are good reasons for believing that limbs 
 affected with ulcers were not unfrequently ampu- 
 tated, owing to their ignorance and inability to 
 accomplish a cure, which, under different circum- 
 stances, by means of judicious and skilful treat- 
 ment, might have been completely restored. 
 
 Dr. Physick devoted himself in an especial 
 manner to ameliorating the condition of this class 
 of the patients. He laboured most assiduously in 
 establishing a more correct and efficient method of 
 treatment ; and in a short time the results of his 
 practice were so evidently successful as to add not 
 a little to his rising fame and greatness. I have 
 been told that at a very limited period after com- 
 mencing his services, he had almost entirely cleared 
 the wards of the patients affected with ulcers. 
 His method of treatment in cases of inflamed and 
 irritable ulcers was exceedingly simple. He di- 
 rected the patient to be confined to bed, and to be 
 kept strictly at rest; and in cases where the ulcer 
 was situated upon a lower extremity, he caused 
 the limb to be considerably elevated. He next 
 directed that mild and soothing applications should 
 be made to the ulcer itself; arid in conjunction with 
 this he made use of proper constitutional treatment. 
 In cases where the ulcer partook of an indolent 
 nature, he always preferred effecting the necessary 
 6 
 
42 A MEMOIR 
 
 stimulation by means of local applications, whilst 
 the patient was confined to bed, to permitting him 
 to walk about, as sometimes recommended. 
 
 During the period of Dr. Physick's services in 
 the Pennsylvania Hospital, he made several valu- 
 able modifications and improvements in the treat- 
 ment of fractures. Without entering minutely 
 into the consideration of these, I may refer to his 
 modification of the celebrated Desault's apparatus 
 for the treatment of fractures of the thigh. By 
 increasing the length of Desault's splint, Dr. Phy- 
 sick has accomplished a most important object, in 
 causing the counter-extension to be made more 
 completely in the direction of the axis of the limb, 
 and also in keeping the patient more strictly at 
 rest. This apparatus of Desault, thus modified 
 by Dr. Physick, and with the block attached to 
 the lower extremity of the splint by Dr. Hutchin- 
 son, for the purpose of making the extension in 
 the direction of the limb, has been used in the 
 Hospital for a long series of years, with the hap- 
 piest results. Dr. Physick never ceased to regard 
 it as the most complete and successful method of 
 treating fractures of the thigh ever invented. 
 
 Fractures of the humerus occurring at or near 
 the condyles, are exceedingly apt to be followed by 
 a very unpleasant projection of the elbow. In some 
 instances the deformity is so great as to give rise 
 
OF DR. PHYSICK. 43 
 
 to most disagreeable consequences, more especially 
 in case the accident should happen to a young 
 female. To Dr. Physick is due the credit of 
 having invented a method of treatment which has 
 succeeded in many instances in effecting a com- 
 plete cure, without the occurrence of any de- 
 formity. This treatment consists in applying to 
 the injured limb two angular splints, which should 
 extend from near the shoulder down to the ex- 
 tremities of the fingers. In addition to this he 
 directs the patient to be kept in bed, "with the 
 arm flexed at the elbow, and lying on its out- 
 side with the angular splints, supported by a pil- 
 low." 
 
 In cases of fracture of the lower end of the 
 fibula, where the accident is accompanied with 
 dislocation of the foot outward, Dr. Physick was 
 in the habit, many years since, of treating the 
 fracture upon a plan precisely similar to that re- 
 commended by Baron Dupuytren. To which of 
 these gentlemen is due the priority of the inven- 
 tion, I am unable to say. 
 
 In the treatment of dislocations, the highest 
 commendation is due to Dr. Physick, for being 
 the first to carry into full effect a plan of treatment 
 which, although originally suggested by Doctor 
 Alexander Munro, of Edinburgh, was never put 
 into execution, as far as w r e can learn, prior to its 
 
44 A MEMOIR 
 
 employment by Dr. Physick. I allude to the use 
 of copious blood-letting, carried, when necessary, 
 even ad deliquium animi, in order to produce a 
 complete relaxation of the muscular system, and 
 thereby facilitate the reduction of the dislocated 
 bone. We are infinitely indebted to Dr. Physick 
 for having directed our attention to this method of 
 treatment, by means of which, in very many 
 instances, old and difficult dislocations have been 
 reduced, and limbs restored to usefulness, which 
 otherwise would have been irrecoverably ruined. 
 
 In the year 1794, Dr. Physick was elected one 
 of the physicians to the Philadelphia Dispensary : 
 he visited the sick of his particular district, and 
 performed his duties with the strictest fidelity 
 during the period he held this appointment. He 
 subsequently was chosen one of the consulting 
 surgeons to this same institution, and retained the 
 situation till the time of his death. 
 
 From a reference to Dr. Physick's papers, it 
 appears, that his professional engagements increased 
 very considerably in the year 1795. About this 
 period, it may be stated, that his prospects of 
 establishing himself successfully in practice be- 
 came exceedingly flattering. During the year 
 1795, he commenced keeping a journal of the 
 most remarkable and interesting cases which oc- 
 curred in his practice, more especially such as 
 
OF DR. PHYSICK. 45 
 
 possessed a surgical character. This journal is 
 continued up to the year 1810, although in conse- 
 quence of the multiplicity of his engagements 
 about this period, we have to regret, the number 
 of cases inserted is very considerably lessened. 
 The first case recorded in the note book, is that of 
 a lady affected with blindness from cataract. In 
 this case, he performed the operation of extraction 
 of the opaque crystalline lens, with complete suc- 
 cess, and restored his patient to sight. 
 
 I may mention here that Dr. Physick's favour- 
 ite operation for cataract was that of extraction. 
 He gave it a decided preference over all the other 
 operations, and always performed it whenever the 
 condition of the eye was suitable. He acquired 
 such a perfect degree of skill in extracting the 
 lens, that his operations were almost invariably 
 followed by success. I am of the opinion that 
 his operations upon the eye, in conjunction with 
 those for stone in the bladder, did as much in esta- 
 blishing Dr. Physick's great surgical character as 
 any others which he ever performed. Operations 
 of this nature, when successfully executed in that 
 day, were widely circulated. His first operation 
 of lithotomy was not performed, however, until 
 the year 1797. He subsequently performed it, as 
 is well known, in innumerable instances, with the 
 
46 A MEMOIR 
 
 most extraordinary facility and success. In per- 
 forming his first operation of lithotomy, he acci- 
 dentally divided with his gorget the internal pudic 
 artery. The hemorrhage from the wounded ves- 
 sel was exceedingly profuse. He immediately 
 compressed the trunk of the artery with the fore 
 finger of his left hand, and then passed the point 
 of a tenaculum under it ; a ligature was then cast 
 round it and firmly tied. This of course arrested 
 the hemorrhage, but the ligature included along 
 with the artery a considerable portion of the ad- 
 jacent flesh. In order to obviate this inconve- 
 nience Dr. Physick subsequently contrived his 
 celebrated forceps and needle for the purpose of 
 carrying a ligature under the pudic artery. Since 
 that period this instrument has been in general 
 use for the purpose of securing deep seated ves- 
 sels. It has twice been successfully employed in 
 performing the operation of tying the external 
 iliac artery ; in the first instance by the late la- 
 mented Doctor Dorsey, a favourite nephew of Dr. 
 Physick's, and one to whom he was ardently 
 attached, and in the second instance by myself. 
 No higher commendation could be bestowed upon 
 this instrument than may be inferred from the 
 numerous modifications which have since been 
 made of it. I must be permitted to declare, that 
 
OF DR. PHYSICK. 47 
 
 in my opinion, the original instrument, as designed 
 by Dr. Physick, has never heen excelled, either in 
 point of ingenuity or utility. 
 
 In order to facilitate the division of the pros- 
 tate gland and neck of the bladder, in performing 
 the operation of lithotomy by means of the gorget, 
 Dr. Physick suggested a valuable improvement to 
 the instrument as used by Mr. Cline, which has 
 since been almost universally employed in this 
 country, and has received the entire sanction and 
 approbation of our most distinguished surgeons. 
 A full description of Dr. Physick's gorget was 
 published in the first volume of Coxe's "Medical 
 Museum," for the year 1804, by Mr. R. Bishop, a 
 surgeons' instrument maker of high repute, then 
 living in this city. It is also noticed at length in Dr. 
 Dorsey's " Elements of Surgery." The modifica- 
 tion consists in having the gorget so constructed, 
 that a perfectly keen edge may be given to that 
 part of the blade which commences the incision, 
 and which is connected to the beak of the instru- 
 ment. For this purpose the beak and blade are 
 separable, and so arranged that the blade may be 
 connected to the stem and firmly secured by a 
 screw. Without this arrangement it is exceed- 
 ingly difficult to impart a fine edge to that part of 
 the blade which is contiguous to the beak, and 
 inasmuch as the incision of the neck of the blad- 
 
48 A MEMOIR 
 
 der is commenced at that point, the success of the 
 operation must necessarily be much influenced 
 by it. 
 
 During Dr. Physick's attendance at the Penn- 
 sylvania Hospital, in the year 1796, a case occurred 
 in which the patient, a young man, had laboured 
 under a suppression of urine for forty-eight hours. 
 The bladder was so much distended that it rose 
 above the umbilicus, and the patient was suffering 
 intense agony. Dr. Physick made repeated at- 
 tempts to introduce catheters of different sizes 
 into the bladder, in order to draw off the urine, 
 but without success. He next took a bougie and 
 succeeded in introducing it into the bladder, but 
 upon withdrawing the instrument, no urine fol- 
 lowed. The idea then struck him that he might 
 fasten the point of a bougie upon the extremity 
 of an elastic catheter, so as to conduct the catheter 
 into the bladder and allow the urine to flow 
 through it. He immediately carried his plan into 
 execution, and succeeded most happily in com- 
 pletely relieving his patient. Since then this me- 
 thod has been frequently resorted to with great 
 success, in cases where, owing to enlargements of 
 the prostate gland, strictures of the urethra, and 
 other causes, the common catheter could not be 
 passed into the bladder. Dr. Physick communi- 
 cated an account of this case to Dr. Miller, which 
 
OF DR. PHYSICK. 49 
 
 is published in the New York Medical Repository, 
 vol. vii. p. 35, together with his method of pre- 
 paring the instrument, and some experiments on 
 the treatment of gum elastic by spirit of turpen- 
 tine and ether; describing also a method of coating 
 catheters with gum elastic. A full description of 
 the bougie-pointed catheter is also given in Dor- 
 sey's Elements of Surgery. 
 
 In the treatment of strictures in the urethra, 
 Dr. Physick displayed the most enviable degree of 
 skill. It is true that he made the management of 
 this disorder a very particular study, and the tact 
 and dexterity which he exhibited in dilating a 
 stricture, was sufficient to excite the warmest ad- 
 miration. What department of surgery was there 
 which was not in some way or other enriched by 
 his labours ? Among his other contributions, how- 
 ever, let us notice his invention of an instrument, 
 in the year 1795, for the purpose of cutting 
 through a stricture which had refused to yield to 
 the ordinary methods of treatment. This instru- 
 ment consists in a lancet concealed in a canula, 
 which is passed down to the stricture, and then 
 the lancet is pushed forward so as to effect its 
 division. After the stricture is cut through, a 
 catheter or bougie should be introduced arid worn 
 for some time, in order to produce the necessary 
 permanent dilatation. The success attending this 
 7 
 
50 A MEMOIR 
 
 method of treating strictures, which have resisted 
 all other attempts at dilatation, has now become 
 so completely familiar, as to entitle it to he 
 considered one of the most important and useful 
 operations in surgery. It should he stated also, 
 that in some cases of complete retention of urine 
 from stricture of the urethra, this method of di- 
 viding the stricture hy means of the lancet has 
 obviated the necessity of puncturing the bladder 
 itself. 
 
 If I mistake not, Dr. Physick was the first who 
 pointed out to our surgeons the method of con- 
 structing the w r axed linen bougie. He informed 
 me that soon after his return from Europe he was 
 engaged in attendance upon a patient, in conjunc- 
 tion with his much esteemed friend Dr. Wistar. 
 It so happened that in the treatment of this case 
 there was occasion for a bougie of a particular size 
 and shape. Dr. Wistar regretted very much that 
 he did not possess such an instrument, and he ex- 
 pressed his doubts as to whether they would be 
 able to procure one. Dr. Physick told him that 
 he need not be uneasy, for that he would furnish 
 the instrument ; and accordingly he went to work 
 and constructed one himself of the precise kind 
 which they wanted, to the great surprise and grati- 
 fication of Dr. Wistar. 
 
 I may mention that in the treatment of stric- 
 
OF DR. PHYSICK. 51 
 
 tures of the urethra. Dr. Physick invariably pre- 
 ferred using waxed linen bougies of his own make 
 to either the metallic or imported gum elastic 
 bougies. He considered his own to be much the 
 most safe and valuable. It is proper, however, to 
 state, that the gum elastic bougies which were 
 imported into this country in that day, were of a 
 very inferior quality to those which we now have. 
 It is more than probable that even at the present 
 time there are but few surgeons who understand 
 the method of properly preparing the waxed linen 
 bougies, or who would take the trouble to make 
 them even if they were acquainted with the me- 
 thod. I do not hesitate to assert, however, that 
 from long practice and dexterity, Dr. Physick 
 acquired the art of making a more beautiful and 
 perfect instrument of this kind than any other 
 man living. A general account of the method of 
 preparing the waxed linen bougies is contained in 
 "Dorsey's Elements of Surgery." 
 
 During the years 1797, 1798 and 1799, the 
 yellow fever again broke out in our city, and Dr. 
 Physick was again found in the foremost rank of 
 those who had to contend against its ravages. 
 Whilst engaged in the performance of his duties 
 in the year 1797, he was attacked himself for the 
 second time, with the fever, and his illness w T as so 
 severe that for some time but slight hopes were 
 
52 A MEMOIR 
 
 entertained of his living. His recovery from this 
 indisposition was exceedingly slow, and he was 
 left in such an enfeebled state that he was advised 
 by his medical friends to make an excursion into 
 the country in order to recruit his strength. He 
 accordingly took this opportunity of paying a visit 
 to his brother, who was living upon a beautiful 
 farm, situated on the banks of the Susquehannah, 
 in Cecil county, Maryland. He was somewhat 
 amused, whilst performing this journey, at being 
 informed by an innkeeper on the road that Dr. 
 Physick of Philadelphia was dead. His health 
 was greatly benefitted during the period of his 
 sojourn with his brother, and it appears that he 
 conceived a warm attachment to the place ; inas- 
 much as after the death of his brother, many 
 years subsequently, he became the purchaser of 
 the estate, and during the latter years of his life 
 he was accustomed to spend a part of each of the 
 summers upon it. 
 
 During the prevalence of the yellow fever in 
 1798, Dr. Physick was again resident physician at 
 the Bush Hill Hospital ; and upon leaving the in- 
 stitution after the subsidence of the epidemic, he 
 was presented in a flattering manner by the board 
 of managers, with some valuable silver plate, as 
 an acknowledgment of their "respectful approba- 
 tion of his voluntary and inestimable services." 
 
OF DR. PHYSICK. 53 
 
 In the winter of 1798, Dr. Physick read a pa- 
 per before the "Academy of Medicine of Phila- 
 delphia," containing " Some Experiments and Ob- 
 servations on the mode of operation of mercury 
 on the body." This paper was subsequently pub- 
 lished in the New York Medical Repository, vol. 
 v. p. 288. The result of these experiments and 
 observations goes to disprove the opinion that the 
 different preparations of mercury produce their 
 effects on the system in consequence of their being 
 absorbed and carried into the blood. The experi- 
 ments made by Dr. Physick in order to detect the 
 presence of mercury in the blood and saliva of 
 patients undergoing salivation from that article, 
 were repeated by Dr. Seybert, but both were un- 
 able to discover the presence of the metal. 
 
 I have already stated, that in consequence of 
 the untiring zeal of Dr. Physick in investigating 
 the nature and phenomena of the yellow fever, 
 aided by the ample opportunities which he enjoyed 
 of prosecuting his researches, he was led to the 
 adoption of some views which were not only of an 
 interesting and novel character, but such also as 
 had a most important bearing in elucidating the 
 true pathology of the disease, and in establishing 
 in consequence more correct therapeutic indica- 
 tions. It was after the subsidence of the epidemic 
 of 1799 that he published in the New York Medi- 
 
54 A MEMOIR 
 
 cal Repository, "Some Observations on the Black 
 Vomit." In this communication he relates a 
 series of careful and well conducted experiments, 
 which prove most conclusively that the matter of 
 black vomit, so far from being poured out by the 
 vessels of the liver, as was the commonly received 
 opinion, is produced by a secretion from the in- 
 flamed vessels of the stomach and intestines. 
 These observations, showing that the effusion of 
 black vomit must be regarded as one of the modes 
 in which violent inflammation of the stomach has 
 a disposition to terminate, not only went far in 
 destroying the preconceived notions entertained by 
 many physicians, that the yellow T fever was a dis- 
 ease of debility, and that the black vomit was to 
 be regarded as a putrid phenomenon, but also con- 
 firmed most satisfactorily the propriety of the an- 
 tiphlogistic method of treatment. 
 
 The year 1800 formed a most eventful one in 
 the life pf Dr. Physick. During this year he 
 formed a matrimonial alliance with Miss Eliza- 
 beth Emlen, a highly gifted and talented lady, and 
 daughter of one of the most distinguished minis- 
 ters of the Society of Friends. By this marriage 
 he had four children, two sons and two daughters, 
 all of whom are now living. 
 
 In the year 1800, a request was made to Dr. 
 Physick in writing, by a number of gentlemen 
 
OF DR. PKYSICK. 55 
 
 engaged in attending the medical lectures delivered 
 in the University of Pennsylvania, that he should 
 lecture to them on surgery. Among these gen- 
 tlemen who so fully appreciated his extraordinary 
 qualifications, was included our present pre-emi- 
 nently distinguished Professor of the Theory and 
 Practice of Medicine, Dr. Chapman. 
 
 No man could feel more deeply the solemn re- 
 sponsibilities attendant upon such an enterprise 
 than Dr. Physick. After mature deliberation, 
 however, he determined to accede to their request, 
 and this may be dated as the period at which he 
 commenced his labours as a lecturer. 
 
 The following anecdote, related to me by the 
 Doctor himself, will exemplify the ardour and zeal 
 with which he entered upon the performance of 
 his duties, and it illustrates also most happily the 
 great advantages which may be derived from a 
 word of encouragement and approbation, coming 
 from a source in which entire confidence is re- 
 posed. 
 
 After preparing the lecture introductory to his 
 course, he committed it to memory. Among the 
 persons invited to be present at its delivery was 
 his valued friend, Dr. Rush. The scene was a 
 trying one to Dr. Physick. It was the first time 
 he had ever publicly addressed an audience. I 
 have been informed, however, that he acquitted 
 
56 A MEMOIR 
 
 himself extremely well. At the close of the lec- 
 ture. Dr. Rush stepped up to him and gave him 
 his hand, and congratulated him upon his success. 
 He then said to him very emphatically, "Doctor, 
 that will do that will do. You need not be ap- 
 prehensive as to the result of your lecturing I 
 am sure you will succeed." Dr. Physick never 
 forgot Dr. Rush's kind manner to him on this oc- 
 casion. He assured me that it exerted a consider- 
 able influence in strengthening and confirming his 
 resolutions to persevere. It is needless for me to 
 say that Dr. Rush's predictions respecting Dr. 
 Physick's ultimate success in lecturing were ful- 
 filled to the utmost. Five years subsequently to 
 that period, the Professorship of surgery was cre- 
 ated in the University of Pennsylvania, and Dr. 
 Physick was appointed to fill the chair. 
 
 In the year 1801, Dr. Physick received an ap- 
 pointment to the Philadelphia Alms House In- 
 firmary. In looking over his papers a short time 
 since, I discovered the letter which notified him 
 of his election. I am induced to insert the letter 
 in this memoir, inasmuch as it is somewhat pe- 
 culiar, and the terms in which it is worded, 
 evidently admit of the construction, that his 
 appointment carried with it unusual powers and 
 privileges. 
 
OF DR. PHYSICK. 57 
 
 "Jllms House, 16th Sept., 1801. 
 " ESTEEMED FRIEND I take the liberty to in- 
 form you that, by a Resolution of the Board of 
 Managers of the 7th inst., you were appointed 
 Surgeon Extraordinary, and on the 14th follow- 
 ing, one of the Physicians of this Institution; and 
 with sentiments of sincere regard 
 
 I remain your friend, 
 
 PETER BROWNE. 
 DR. PHILIP SYNG PHYSICK. 
 
 I am not aware that any similar appointment 
 has been made in that institution since that period 
 up to the present time. I remember distinctly 
 that he informed me on several occasions, that he 
 held the situation of Surgeon Extraordinary to 
 the Alms House Infirmary. 
 
 In 1802, he published a paper in the New York 
 Medical Repository, in which he communicates 
 the particulars of a case of hydrophobia. In this 
 communication he gives a circumstantial account 
 of the appearances which were observed upon dis- 
 section; and as a means of affording relief in simi- 
 lar cases, he suggests, in conjunction with other 
 remedies, the propriety of performing the opera- 
 tion of tracheotomy. The following quotation is 
 sufficiently explanatory of the views which he 
 entertained. 
 8 
 
58 A MEMOIR 
 
 " Reflecting on the symptoms which took place 
 in the case ahove related, it appeared to me, that 
 the dread of water arose chiefly from the convul- 
 sive or spasmodic contraction of the muscles of 
 the glottis, which rendered the patient unable to 
 breathe, and involved him in all the horrors of 
 impending suffocation. When asked why he could 
 not drink, he answered, that whenever he attempt- 
 ed to swallow any thing it took his breath away." 
 
 "Under the influence of these opinions I am 
 disposed to believe, that tracheotomy would have 
 saved my patient, at least for a time, if it had not 
 altogether prevented the fatal termination of the 
 disease. I cannot suppose that the spasms of the 
 muscles in hydrophobia would be attended with 
 much danger to life, were it not for their influence 
 in suspending respiration." * * * * 
 
 I am not informed that he ever had an oppor- 
 tunity of testing practically the value of the fore- 
 going suggestion, by the performance of the ope- 
 ration. 
 
 About this period, it may be said, that the 
 talents and acquirements displayed by Dr. Phy- 
 sick began to be extensively known and appre- 
 ciated, not only by the members of his own pro- 
 fession, but also by those who cultivated science 
 in general. I may mention, that in this same 
 year, (1802,) he was elected a member of the 
 
OF DR. PHYSICK. 59 
 
 American Philosophical Society, a well merited 
 tribute due to his rising greatness. 
 
 The year 1802 was also signalised by Dr. Phy- 
 sick by his invention and execution of an operation 
 which not only forms one of the most brilliant 
 achievements of modern surgery, but has also been 
 productive of the most beneficial results to suffer- 
 ing humanity. On the 18th of December, 1802, 
 he performed, in the Pennsylvania Hospital, his 
 celebrated operation of passing a seton between 
 the ends of an ununited fractured humerus, for 
 the purpose of causing a deposition of callus, and 
 thereby producing the consolidation of the broken 
 bone. The patient was a seaman, who had had 
 the misfortune to fracture his left arm, eighteen 
 months previously, whilst at sea ; and in conse- 
 quence of the bones not having united, the limb 
 was rendered nearly useless. At the expiration 
 of five months after the performance of the opera- 
 tion he was discharged from the Hospital perfectly 
 cured, his arm being as strong as it ever was. 
 Dr. Physick published an account of this case in 
 the Medical Repository of New York, vol. i, 1804; 
 and it was republished entire in the Medico-Chi- 
 rurgical Transactions of London, vol. v, 1819. 
 
 It so happened that, in the year 1830, 1 was re- 
 quested to visit a patient in Third street, who was 
 lying dangerously ill from an attack of remitting 
 
60 A MEMOIR 
 
 fever of a high grade. A few days after my 
 first visit, in riding past his door in company 
 with Dr. Physick, feeling very uneasy about the 
 condition of my patient, I requested the Doctor 
 to step into the house and see him with me, and 
 give me the benefit of his advice. He complied 
 with my request, and upon entering the sick 
 man's chamber he immediately recognised him as 
 the individual upon whom he had performed the 
 operation which I have just described, twenty- 
 eight years previously. Upon questioning the 
 patient he informed us that the arm which had 
 been broken was quite as strong as his other arm, 
 and that he had never sustained any inconvenience 
 from the operation. Eventually the man died ; 
 and having obtained permission to make a post 
 mortem examination, I procured his humerus, and 
 still have it in my possession, regarding it as one 
 of the most interesting and valuable pathological 
 specimens extant. At the place of fracture, the 
 two ends of the bone are perfectly consolidated 
 by a considerable mass of osseous matter, in the 
 centre of which there is a hole, showing the place 
 through which the seton passed. 
 
 Since the performance of Dr. Physick's first 
 operation in 1802, this method has been resorted 
 to with entire success in numerous instances by 
 himself and other surgeons, in effecting a cure of 
 
OF DR. PHYSICK. 61 
 
 ununited fractures, occurring not only in the hu- 
 merus, but also in some of the other bones. That 
 this operation, like all others, occasionally fails in 
 effecting the desired object, must be admitted: it 
 is, however, generally conceded that it possesses 
 many advantages over the method not unfrequent- 
 ly resorted to, of cutting down to the ends of the 
 bone and sawing them off, as recommended by 
 Mr. Charles White, of Manchester. 
 
 In describing that process M. Boyer declares 
 it to be "painful, terrifying, and of dubious event." 
 He once performed it on account of a preternatu- 
 ral joint, situated in the middle of the humerus ; 
 the limb mortified, and the patient died on the 
 sixth day. Independently of the greater hazard 
 attending this method of operating, it is unques- 
 tionably much more painful than Dr. Physick's; 
 and although occasionally it succeeds perfectly, in 
 many instances it has entirely failed. 
 
 It is a matter of much surprise and regret, that 
 Mr. William Lawrence, of London, a gentleman 
 distinguished for brilliant talents and extensive 
 learning, in speaking, in his surgical lectures, of 
 the different methods of operating for the cure of 
 ununited fractures, describes Dr. Physick's ope- 
 ration by means of the seton ; but owing probably 
 to a want of better information, seems disposed 
 to undervalue, in a most extraordinary degree, 
 
G2 A MEMOIR 
 
 the importance of Dr. Physick's operation, and 
 limits amazingly its successful results. 
 
 In order to correct the inaccuracy of Mr. 
 Lawrence's statement, and to do away the false 
 impressions which it might create, and as an act 
 of justice due to the distinguished inventor of the 
 operation, my friend, Dr. Hays published in his 
 valuable periodical, the American Journal of the 
 Medical Sciences, vol. vii, p. 267, a brief summary 
 of numerous cases of ununited fracture success- 
 fully treated by means of the seton. The majority 
 of these cases are published in the most celebrated 
 of the European Journals. I consider Dr. Hays's 
 publication to be a triumphant refutation of what 
 I believe to be Mr. Lawrence's unintentional mis- 
 statement. Dr. Physick was himself extremely 
 gratified at the able manner in which Dr. Hays 
 had vindicated the claims which he considered 
 his operation, for the cure of artificial joint by 
 means of the seton, justly to possess. 
 
 From a reference to Dr. Physick's private 
 journal, and from an inspection also of a note 
 book, or book of cases, kept by his nephew, Dr. 
 Dorsey, it is clearly evident that at the period to 
 which we are alluding, Dr. Physick was fully 
 occupied in attending to a most extensive and 
 laborious practice. In Dr. Dorsey's note book 
 are recorded the most interesting cases and opera- 
 
OF DR. PHYSICK. G3 
 
 tions occurring in the practice of Dr. Physick, to 
 which he was a witness. It is exceedingly proba- 
 ble, however, that during that period there were 
 but few operations performed by Dr. Physick, at 
 which Dr. Dorsey was not present; for in some 
 places I discover that he gives an account of im- 
 portant and capital operations performed almost 
 daily by his uncle. 
 
 It has always been a subject of deep regret 
 with the profession, that Dr. Physick should have 
 evinced throughout his whole life such an extreme 
 reluctance to the publication of the results of his 
 valuable observations and experience. The loss 
 which we have sustained in this respect is truly 
 incalculable. What a fund of knowledge has in 
 this manner been permitted to pass away, which 
 might have been happily applied to ameliorating 
 the wants and miseries of humanity. Strange as 
 it may appear, I unhesitatingly assert, that post- 
 humous fame was not sought after by Dr. Phy- 
 sick. I am well convinced, however, that in the 
 latter years of his life, he regretted very much 
 himself that he had not published more for the 
 benefit of his fellow beings ; but at this period his 
 disinclination and habits had become so confirmed 
 that it was impossible for him to change them. 
 
 From the paucity of Dr. Physick's printed 
 communications, and their considerable value, I 
 
64 A MEMOIR 
 
 make no apology for the manner in which I 
 briefly notice them. It has been necessary to 
 collect them from various Journals. I consider 
 it the less necessary to enlarge upon them, inas- 
 much as I have pleasure in saying, that my friend, 
 Dr. Benjamin Hornor Coates, is engaged in pre- 
 paring an edition of Dr. Physick's works, with 
 such commentaries on his doctrines and practices 
 as may appear necessary. 
 
 In Coxe's Medical Museum, vol. i, for the 
 years 1804 and 1805, I find there are published 
 by Dr. Physick three papers, communicating cases 
 occurring in his practice, together with practical 
 suggestions, and by Mr. Bishop two, giving an 
 account of improvements and modifications upon 
 instruments made after the directions of Dr. Phy- 
 sick. 
 
 In the first paper Dr. Physick communicates 
 the particulars of a case of varicose aneurism, oc- 
 curring at the bend of the elbow, in consequence 
 of the artery being wounded in the operation of 
 venesection. In this case the artery had been 
 punctured by the lancet being pushed into it 
 through the vein. The blood escaped from the 
 artery into the cellular membrane between it and 
 the vein, and formed a large pulsating tumour, in 
 which the particular thrill accompanying varicose 
 aneurisms was distinctly felt. The sac formed 
 
OF DR. PHYSICK, 65 
 
 out of the cellular tissue went on increasing in 
 size, until it became so firm that the blood was 
 forced from it into the vein through the puncture 
 in its lower side, with sufficient force to distend 
 it very considerably for two or three inches above 
 and below the sac. The size of the forearm 
 had much diminished, and the hand was con- 
 stantly cold. At length the skin covering the 
 swelling became so thinned that the patient's mind 
 became very uneasy from an apprehension that it 
 might suddenly rupture. In this state Dr. Wis- 
 tar and Dr. Physick advised that an operation 
 should be performed. 
 
 Dr. Physick proceeded in the following man- 
 ner. He divided the skin and cellular membrane 
 covering the swelling, and then dissected com- 
 pletely round the tumours. After this he tied the 
 trunk of the vein above and below its enlarge- 
 ment ; and next he tied the artery above and be- 
 low the sac. He finally dissected out the w T hole 
 of the parts between the ligatures, including the 
 aneurismal sac. Upon opening the sac its inside 
 was found every where incrusted with bony mat- 
 ter; but the artery was perfectly sound and natu- 
 ral. In three weeks the wound healed, and the 
 patient very soon recovered the entire use of the 
 limb. 
 
 The second publication consists of a communi- 
 9 
 
66 A MEMOIR 
 
 cation from R. B. Bishop, surgeons' instrument 
 maker, to Dr. Coxe, describing the gorget, as con- 
 structed according to Dr. Physick's plan. I have 
 already noticed this modification of the gorget in 
 a former part of this memoir. 
 
 The third publication contained in the Medical 
 Museum must be considered exceedingly valuable 
 and interesting, from the circumstance of its being 
 the first to announce to the profession a new me- 
 thod of treatment, suggested by Dr. Physick, for 
 the relief of a most formidable variety of disease, 
 and one which had previously baffled the skill of 
 the most experienced physicians. In this com- 
 munication Dr. Physick recommends the use of 
 blisters for the purpose of arresting the progress 
 of mortification. He states that he was induced 
 to resort to this practice from a knowledge of blis- 
 ters having been employed advantageously in cur- 
 ing erysipelatous inflammation ; a practice which 
 he learned from the late Dr. J. Pfeiffer. 
 
 In this paper Dr. Physick gives an account of 
 two cases of mortification which came under his 
 own notice, in which he applied blisters to the 
 mortified parts with the most beneficial effects. 
 He also publishes two letters, one addressed to 
 him by his friend, Dr. Benjamin Rush, and the 
 other by Dr. Church ; each of whom describes a 
 case of mortification in which he employed blis- 
 
OF DR. PHYS1CK. 67 
 
 ters, upon Dr. Physick's recommendation, with 
 perfect success. 
 
 It is scarcely necessary for me to add, that 
 since that period, blisters have been employed in 
 a great variety of cases, for the purpose of arresting 
 the progress of gangrene and mortification, with 
 the most successful results. As a local remedy I 
 believe a blister is entitled to a decided preference 
 over all others. In order for it to be effectual it 
 should be large enough to cover the sound parts 
 adjacent to the disease. 
 
 The fourth publication consists of a letter from 
 R. B. Bishop to the editor, in which he gives a 
 description of the curved bistoury, as improved 
 by Dr. Physick, for the operation of fistula in ano, 
 with a plate. This well known instrument, thus 
 modified by Dr. Physick, combines the advantages 
 of both the blunt and sharp-pointed bistoury. 
 Since the period of its invention it has been in 
 general use, and is mostly found in the common 
 pocket cases of instruments manufactured in this 
 city. 
 
 In the fifth communication Dr. Physick de- 
 scribes the history of a case of luxation of the 
 thigh bone forward, and the method which he 
 employed for its reduction ; and the paper is ac- 
 companied by a plate. Although this case is an 
 
68 A MEMOIR 
 
 exceedingly interesting one, I do not think it ne- 
 cessary to describe it more particularly. 
 
 I have already stated, that at the period when 
 Dr. Physick commenced his professional career, 
 the organisation of the medical department in the 
 University of Pennsylvania was so imperfect, that 
 the chairs of Anatomy and Surgery were com- 
 bined, and the duties of teaching both branches 
 devolved upon one Professor. In order to remedy 
 this acknowledged deficiency, in the year 1805, 
 the chair of Surgery was made distinct from that 
 of Anatomy, and Dr. Physick w T as elected, I be- 
 lieve unanimously, Professor of Surgery. 
 
 It should be borne in mind, that he had pre- 
 viously, in the year 1800, complied with a request, 
 made to him by a number of gentlemen engaged 
 in the study of medicine, that he would deliver 
 lectures on surgery. These lectures were de- 
 livered in the Pennsylvania Hospital ; and he ex- 
 hibited such positive and satisfactory evidence of 
 his fitness and entire competency to the task 
 which he had assumed, that his labours were 
 crowned with the most complete success, and he 
 very soon became exceedingly popular as a teacher, 
 and added greatly to his fame and celebrity. 
 
 It is more than probable that the position which 
 he now held as a lecturer on surgery, excited no 
 
OF DR. PHYSICK. 69 
 
 little influence in producing the change which 
 was made in the medical faculty. 
 
 I presume it will not be denied that, however 
 great the advantages may have been which ac- 
 crued to Dr. Physick in consequence of his being 
 appointed Professor of Surgery in the University 
 of Pennsylvania, the institution itself derived equal 
 advantages from his connection with its medical 
 faculty. It is very certain that, soon after he was 
 appointed Professor of Surgery, the number of 
 students who resorted to this city to attend the 
 medical lectures, increased to a prodigious extent ; 
 and although I freely admit that there were many 
 cooperating circumstances present which tended 
 to produce the same effect, and that his efforts in 
 behalf of the school were seconded by colleagues 
 who possessed talents of so refulgent a character 
 that the light shed from them has not yet passed 
 away, still it is worthy of record, that at the pe- 
 riod when Dr. Physick enjoyed the very zenith of 
 his fame and usefulness, the University of Penn- 
 sylvania had attained the acme of its reputation. 
 
 Having shown that Dr. Physick's efforts as a 
 private lecturer were attended with the most 
 entire success, we can readily believe that he was 
 quite ready and prepared to enter upon the duties 
 of his new appointment. Inasmuch, however, as 
 this situation opened to him a more extensive field 
 
70 A MEMOIR 
 
 of action than he had previously cultivated, he 
 felt himself called upon to make renewed exer- 
 tions. 
 
 It is almost impossible to conceive of the great 
 amount of labour which he was in the habit of 
 performing daily, during this period of his life. 
 He has frequently told me that it was his custom, 
 throughout the winter months, to rise at four 
 o'clock in the morning. This hour being too 
 early to disturb a servant, he was obliged to ar- 
 range his own fire. He would then sit down to 
 his desk and prepare his lecture for the day; after 
 which he would dress himself, and then take his 
 breakfast, and leave his house between eight and 
 nine o'clock, in order to attend to a most extensive 
 and laborious practice. In addition to all this, he 
 discharged his duties as Surgeon to the Pennsyl- 
 vania Hospital, and to the Alms House Infirmary. 
 He used often to remark, that in order to obtain 
 entire success as a practitioner of medicine, it was 
 necessary to work hard. He told me that in 
 London this idea was conveyed by the emphatic 
 
 expression "Doctor or Mr. is working his 
 
 way into business." It will be conceded that no 
 portion of his success ever came to him gratu- 
 itously; on the contrary, he made laborious exer- 
 tions to obtain it. 
 
 Dr. Physick's manner as a public lecturer was 
 
OF DR. PHYSICK. 71 
 
 grave, dignified and impressive to an extraordinary 
 degree. His style was clear and comprehensive, 
 simple yet chaste. He was uniformly careful ne- 
 ver to say too much. His choice of language 
 was remarkably good, and he possessed the happy 
 faculty of communicating knowledge agreeably 
 and well in as great perfection as any other man 
 I have ever heard lecture. Perhaps one great 
 reason for this was, that he never undertook to in- 
 struct others upon subjects which he did not clear- 
 ly comprehend himself. He attempted no display 
 of oratory ; neither did he permit his reason and 
 imagination to run wild in the regions of theory 
 and fancy. For these attributes he found much 
 better employment; he kept them constantly oc- 
 cupied in studying the realities of life, and in 
 reflecting upon the best methods of promoting the 
 welfare of his fellow creatures. His lectures 
 w r ere all carefully prepared and written out. He 
 did not at all approve of extemporaneous lectur- 
 ing; as he thought that in lecturing upon scientific 
 subjects, and more especially such as involved the 
 lives and happiness of our fellow beings, no man 
 had a right to place so much confidence in the 
 strength of his memory as is implied in that prac- 
 tice. 
 
 Dr. Physick's course of lectures on surgery 
 was pre-eminently valuable, in consequence of its 
 
72 A MEMOIR 
 
 being founded principally upon his own practical 
 knowledge and experience, and in consequence 
 also of his discarding all inferences drawn from 
 hypothesis ; besides which his lectures derived an 
 additional attraction and importance from the cir- 
 cumstance that his reputation for stern integrity 
 and strict veracity was so well known and esta- 
 blished, that whenever he asserted facts to be true, 
 they were implicitly believed. 
 
 As a letter-writer he w r as exceedingly exem- 
 plary and peculiar. I regret very much that I 
 have not the privilege of inserting a few of his 
 letters in this memoir, in order to let them speak 
 for themselves. His letters in general were re- 
 markably brief and pithy. Having said all that 
 he considered necessary for the elucidation of his 
 subject, he invariably stopped. I have frequently 
 known him to reply to a letter of three or four 
 pages closely written, in about as many lines. 
 He was excessively annoyed at receiving, and be- 
 ing obliged to read letters of an unmeaning and 
 unnecessary length. The same thing took place 
 with respect to books. I have often heard him 
 complain, that it was very hard he was obliged to 
 read through a volume of two or three hundred 
 pages, in order to get at ideas which might have 
 been embodied in ten or twenty. 
 
 The year 1809 has been rendered memorable 
 
OF DR. PHYSICK. 73 
 
 in the annals of surgery, by the invention and ex- 
 ecution of an operation by Dr. Physick, which, 
 for the brilliancy of its conception and the impor- 
 tant practical results which have ensued from it, 
 has excited admiration and attention throughout 
 the medical world. 
 
 In the month of January of the year 1809, Dr. 
 Physick performed his operation for the cure of 
 artificial anus, which, as is well known, eventuated 
 in the most complete success. To those who are 
 entirely unacquainted with the nature and condi- 
 tion of this loathsome malady, it is impossible to 
 convey any adequate idea of the many afflicting 
 circumstances connected with it ; suffice it to say, 
 that the unhappy sufferer is rendered disgusting 
 not only to himself, but also to all those around 
 him. I imagine there are but few who would 
 hesitate long in choosing between death and ex- 
 istence complicated with a train of such insup- 
 portable evils. What an immense amount of 
 obligation are we not under to him who, by the 
 force of his genius and profound acquirements, 
 was enabled to triumph over obstacles of such 
 fearful magnitude, and provide a remedy for such 
 a hopeless calamity ! We are happy to say, that 
 the debt of gratitude has not been left unpaid, 
 and that Dr. Physick has received the homage of 
 10 
 
74 A MEMOIR 
 
 the profession for having achieved this invaluable 
 discovery. 
 
 His method of performing this operation is now 
 so well known that it is not necessary for me to 
 communicate the details of it here. He w r as neg- 
 ligent in not making a printed publication of the 
 method at the moment of its discovery; he, how- 
 ever, publicly taught, in his surgical lectures, the 
 manner of performing the operation, and the prin- 
 ciples upon which it was founded, from the year 
 1809 until 1821, to classes of several hundred 
 medical students. 
 
 You are aware that some years subsequently to 
 the period when Dr. Physick first performed it, 
 one of the most distinguished surgeons of Europe, 
 the late Baron Dupuytren, performed an operation 
 upon a somewhat modified plan, but with similar 
 views, and founded upon precisely the same prin- 
 ciples; and that he claimed the merit of having 
 invented the method, and appropriated to himself 
 the consequent honours. It did not 5 however, by 
 any means comport with the views entertained 
 by the surgeons of our country, that the distin- 
 guished head of the profession should be dispos- 
 sessed in so unceremonious a manner, of honours 
 exclusively his own. Accordingly, in order to 
 place the matter in its proper light, my friend 
 Dr. Benjamin Hornor Coates, obtained from Dr. 
 
OF DR. PHYSICK. 75 
 
 Physick the date of the operation, together with 
 ample notes of the case, taken from his private 
 journal, now in my possession, and also procured 
 an account of the case as recorded in the manu- 
 script case hook of the Pennsylvania Hospital; 
 and then puhlished a full account of Dr. Physick's 
 operation in the North American Medical and 
 Surgical Journal for Octoher, 1826, together with 
 some valuahle remarks upon Baron Dupuytren's 
 method of operating, proving in the most satisfac- 
 tory manner that the justly celehrated French 
 surgeon promulgated the idea of the operation 
 long after Dr. Physick. 
 
 Notwithstanding, as might he supposed, Baron 
 Dupuytren exhihited reluctance to yield his claims 
 to this discovery, I am of the opinion, that pre- 
 viously to his death, he was fully satisfied that 
 Dr. Physick preceded him in its invention. 
 
 In the year 1835, Dr. Physick was exceedingly 
 gratified at receiving a letter from his relative, 
 Dr. Eohert E. Dorsey, then residing in Parrs, in 
 which he informed him that M. Eoux, the present 
 distinguished successor to Baron Dupuytren as 
 surgeon in chief to the Hotel Dieu, stated dis- 
 tinctly in a lecture introductory to his clinical 
 course on surgery, in the presence of Professor 
 Mott of New York, Dr. A. B. Tucker of this 
 city, and a large class of medical gentlemen, that 
 
76 A MEMOIR 
 
 to Dr. Physick was unquestionably due the ho- 
 nour of having invented the operation for arti- 
 ficial anus, which had been claimed by his prede- 
 cessor. Baron Dupuytren. 
 
 In the third volume of the " Eclectic Reper- 
 tory," for October, 1812, Dr. Physick published 
 an account of a new method which he had em- 
 ployed for the purpose of extracting poisonous 
 substances from the stomach. In this communi- 
 cation he furnished the particulars of two very 
 interesting cases, in which two children, twin 
 brothers of the age of three months, had been 
 thrown into a state of complete stupor, from 
 which they could not be roused, from having had 
 administered to each of them by their mother, 
 one drop of laudanum, in order to allay the rest- 
 lessness attendant upon whooping cough, under 
 which they were both labouring. It appears that 
 the vial from which the laudanum had been given 
 had contained, several weeks previously, nearly 
 one ounce of that medicine ; but in consequence 
 of having been left without a cork, it evaporated 
 away so much that the mother was only able to 
 obtain one drop for one of the children, and in 
 order to procure another drop, she put two drops 
 of water into the vial, and stirred it about so as 
 to obtain another drop, which she gave to the 
 other child. The poor mother was entirely igno- 
 
OF DR. PHYSICK. 77 
 
 rant of the immense additional strength which the 
 dose had gained, in consequence of the evaporation 
 which had taken place. 
 
 Each of these children had heen thrown into 
 convulsions. When Dr. Physick arrived at the 
 house, he immediately prescribed an emetic of 
 ipecacuanha, and directed it to be given at once. 
 This, however, could not be accomplished, as the 
 children were incapable of swallowing. "The 
 countenances of the children became livid, their 
 breathing very laborious, with long intervals be- 
 tween the times of each inspiration, and the pulse 
 in each very feeble. The pulse aiid respiration 
 had almost ceased; and, indeed, the pulse could 
 not be perceived, except a faint stroke or two, 
 after that kind of imperfect and convulsive inspi- 
 ration which is commonly observed in children 
 just before actual death, accompanied with a con- 
 vulsive action of the muscles of the mouth and 
 neck." Under these circumstances Dr. Physick 
 saw clearly that in order to give the children a 
 chance of recovery, no time was to be lost ; and 
 inasmuch as they could not swallow any thing, he 
 determined to inject an emetic into their stomachs. 
 For this purpose he introduced a large flexible ca- 
 theter down the oesophagus, and through it he 
 injected one drachm of ipecacuanha mixed with 
 w^ater, by means of a common pewter syringe. 
 
78 A MEMOIR 
 
 After waiting some little time for the operation of 
 the emetic, although in vain, as the stomach had 
 in both instances completely lost its power of ac- 
 tion, he injected a quantity of warm water, and 
 then withdrew it by means of the syringe. He 
 now repeated these operations again and again, 
 until he had washed out the stomachs thoroughly 
 and removed all their contents. 
 
 By the time these operations were completed, 
 however, all signs of animation in each of the 
 children were entirely lost. Discouraging as these 
 circumstances were, the Doctor determined to per- 
 severe in his efforts to restore life; and accordingly 
 he injected into their stomachs some spirits, mixed 
 with water, and a little vinegar ; and he also made 
 use of external stimuli. In a few minutes the pulse 
 and respiration returned in each child, and in the 
 course of a short time both were regularly per- 
 formed. The result of these cases was, that one 
 child expired the next morning, and the other 
 completely recovered. 
 
 In a note to this communication he states, that 
 the idea of washing out the stomach in cases 
 where large quantities of laudanum or other poi- 
 sons had been swallowed, occurred to him at least 
 twelve years previously, and that he had constantly 
 recommended it in his lectures. He states also 
 that his nephew. Dr. Dorsey, had performed the 
 
OF DR. PHYSICK. 79 
 
 operation of washing out the stomach in such a 
 case in the year 1809. At the time Dr. Physick 
 made this communication, he was under the full 
 impression that he was the earliest inventor of 
 this operation. In the same volume, however, of 
 the Eclectic Repertory, p. 380, there is published 
 a letter from him, addressed to the editors, in 
 which he says that he considers it an act of justice 
 to inform his medical brethren that the merit of 
 prior invention belongs to Dr. Alexander Munro, 
 Jr., of Edinburgh, who published it in his inau- 
 gural thesis, in A. D. 1797. Dr. Physick was 
 entirely ignorant of this fact until he saw it men- 
 tioned in Dr. Munro's work on morbid anatomy, 
 which he had but very lately received. 
 
 Conceding to Dr. Munro all the honour arising 
 from the discovery of this valuable method of 
 treatment, it must be admitted that Dr. Physick 
 is entitled to the grateful thanks of the commu- 
 nity for having introduced it into practice. It is 
 scarcely necessary for me to say that this operation 
 is now so completely established, as to constitute 
 it one of almost daily performance. It has been 
 attended, in innumerable instances, with the most 
 successful results; and by resorting to it, very 
 many wretched and unhappy beings have been 
 rescued from an untimely grave. 
 
 In the winter of 1813-14, Dr. Physick suffered 
 
80 A MEMOIR 
 
 from a severe attack of typhus fever. On this oc- 
 casion his illness was so extreme, that his medical 
 friends despaired of his life for some time. He 
 gradually got well, but his constitution never en- 
 tirely recovered from the shock which it then re- 
 ceived. It may be stated that from this period 
 he never enjoyed what might be called uninter- 
 rupted health. His powers of digestion became 
 exceedingly impaired, and from this cause ensued 
 a train of most unpleasant dyspeptic symptoms. 
 He became subject also to frequent attacks of ca- 
 tarrh, and his susceptibility to this condition in- 
 creased to such an extent that he was obliged to 
 observe the most rigid precautions in order to 
 guard against it. His method of treatment when 
 labouring under a severe cold, required confine- 
 ment to a warm room ; and in fact he accustomed 
 himself to a degree of heat in his apartments 
 which to many others was almost insupportable. 
 In addition to this he always employed the strict- 
 est antiphlogistic treatment, as regarded his diet 
 and his remedial agents. I was always of the 
 opinion, however, that he injured himself, and in 
 a measure produced the very enfeebled and pros- 
 trated condition of his system which attended him 
 during the latter years of his life, by the exces- 
 sively reducing system of treatment to which he 
 had recourse. 
 
OF DR. PHYSICK. 81 
 
 The small amount of food of which he would 
 sometimes permit himself to partake, is almost 
 inconceivable ; and this for many days together. 
 I frequently expressed to him my regrets respect- 
 ing the meagre diet he was using; and upon one 
 occasion I dissented roundly from the propriety of 
 such a course of dieting. He replied that he re- 
 gretted it very much himself, and that he wished 
 he could indulge in more generous living, hut that 
 he had accustomed his stomach for so long a time 
 to abstinence from rich food, that it was impossible 
 now to make any change. 
 
 About the period to which we are alluding he 
 began to experience certain unpleasant symptoms, 
 indicative of a diseased condition of the heart, and 
 which eventually terminated in organic affection 
 of that organ, and doubtless laid the foundation for 
 the hydropic complaint of which he died. 
 
 Among the complicated forms of disease to 
 which he was subjected, must also be enumerated 
 nephritic disorder, with calculous concretions in 
 the kidneys. It is impossible for language to de- 
 scribe the pain and agony which he frequently 
 endured from the passing of the small calculi 
 through the ureters into his bladder. Upon one 
 occasion, about ten years previous to his death, I 
 knew him to be for near two hours without any 
 pulse perceptible at the wrist, in consequence of 
 11 
 
82 A MEMOIR 
 
 intense suffering, caused by the lodgment of a small 
 calculus in the ureter. It remained fixed in this 
 situation for some days, and grew to the size of a 
 small pea ; it finally passed into the bladder, and 
 was discharged a few minutes subsequently through 
 the urethra. Had it remained in the bladder but 
 for a short period, it might have attained a size 
 too great to admit of its discharge through the ca- 
 nal ; and he would then have had, in addition to 
 his other evils, that formidable affection, the stone. 
 The practical knowledge and experience which 
 Dr. Physick derived from the careful and minute 
 attention which he bestowed not only upon every 
 department of his profession, but also, I may say, 
 upon each separate and individual case of disease 
 which came under his notice, enabled him to sug- 
 gest numerous modifications and improvements 
 which have exerted the happiest influence in ele- 
 vating the condition of our science. It would be 
 impossible, in a communication of this nature, 
 which has already exceeded the limits originally 
 proposed, to give even a brief outline of the many 
 valuable inventions for which we are indebted to 
 him. In order to do this, it appears to me, that 
 it would be necessary to review almost every pro- 
 fessional act of his life; because there was no form 
 of disease of which he undertook the management, 
 in which he did not exercise a tact and method of 
 
OF DR. PHYSICK. 83 
 
 treatment peculiarly his own. I do not mean to 
 say that in every case he prescribed a new reme- 
 dy, and one original with himself. My meaning 
 is that he invariably modified either the dose, or 
 the preparation, or the time of its administration, 
 or the method of its application, according to his 
 own proper and peculiar views. 
 
 It may not be deemed uninteresting to men- 
 tion the particulars of a case in which he was in- 
 strumental in preserving the life of a valuable and 
 distinguished lady, by the following simple treat- 
 ment. This lady was brought on to Philadelphia 
 labouring under an attack of dyspepsia of the most 
 aggravated character. The irritability of her sto- 
 mach was so great, that it had rejected every va- 
 riety and form of nourishment which could be 
 thought of, and her system consequently was so 
 much weakened and prostrated, that she appeared 
 to be absolutely dying of inanition. When Dr. 
 Physick saw her, after proposing a variety of arti- 
 cles, he asked her whether she had ever, since her 
 attack, tried to take milk. She replied that she had 
 often taken it, but her stomach very soon rejected 
 it. He then asked her whether she did not think 
 that her stomach would retain the half of one 
 tumblerful of milk. She said, no. He repeated 
 his questions. Would it retain one wineglassful ? 
 No ! Would it retain a tablespoonful ? No ! 
 
84 A MEMOIR 
 
 He then told her that he was under the impression 
 that she could retain in her stomach one teaspoon- 
 ful of milk; and accordingly he prescribed the 
 article for her, to be taken in that quantity, at re- 
 peated intervals. The lady adopted his views, 
 attended to his prescription, and was ultimately 
 restored to perfect health. 
 
 Among other improvements suggested by Dr. 
 Physick, I should mention, that in the Eclectic 
 Repertory, vol. vi, for the year 1816, he published 
 an account of a method which he had proposed 
 for forming ligatures out of animal fibre. He had 
 repeatedly noticed, that after the performance of 
 operations, the wound was prevented from healing, 
 and the patient was subjected to the greatest incon- 
 venience and distress, in consequence of the ordi- 
 nary ligatures, formed out of silk or flax, remain- 
 ing fixed in the wound for the period sometimes of 
 many weeks or even months. Under these cir- 
 cumstances, not only is the wound prevented from 
 healing and the patient's health injured, but in 
 order to remove the ligature by pulling at it from 
 day to day, patients have been subjected to a de- 
 gree of pain which, as they have been known to 
 declare, exceeded that of the original operation. 
 Dr. Physick considered it an object of extreme 
 importance to obviate these inconveniences ; and 
 accordingly he proposed the use of animal liga- 
 
OF DR. PHYSICK. 85 
 
 tures, by means of which an artery could be se- 
 cured for a sufficient length of time to cause the 
 obliteration of the vessel, and the ligature, being 
 decomposed and dissolved, would escape in the 
 course of a few days. 
 
 His views upon this subject will be fully ex- 
 plained by the following quotation. "Several 
 years ago, recollecting how completely leather 
 straps spread with adhesive plaster, and applied 
 over wounds for the purpose of keeping their sides 
 in contact, were dissolved by the fluids discharged 
 from the wound, it appeared to me that ligatures 
 might be made of leather, or of some other ani- 
 mal substance, with which the sides of a blood- 
 vessel could be compressed for a sufficient time to 
 prevent hemorrhage; that such ligatures would 
 be dissolved after a few days, and would be evacu- 
 ated with the discharge from the cavity of the 
 wound." 
 
 From this period he continued to employ ani- 
 mal ligatures almost exclusively up to the time 
 when he left off operating. I regret very much 
 that notwithstanding the advantages which these 
 ligatures possess, they are but seldom used by the 
 surgeons of the present day. I can attribute this 
 neglect of them to nothing but the slight trouble 
 attendant upon their preparation. 
 
 Some time subsequently to Dr. Physick's pub- 
 
86 A MEMOIR 
 
 lication upon this subject, it was shown that the 
 idea of preparing ligatures from animal fibre had 
 been suggested a long time previously by one of 
 the older surgeons. It is scarcely necessary for 
 me to say, that he was entirely ignorant of this 
 fact, and that at the time he was under the full 
 impression that the suggestion was novel when it 
 originated with himself. 
 
 Whilst upon the subject of ligatures, it may 
 not be amiss to give an account of a very inge- 
 nious contrivance, which Dr. Physick employed 
 for the purpose of facilitating the discharge of 
 ligatures which remained fixed in the cavity of 
 wounds, either in consequence of being penetrated 
 by new granulations, or from other causes. In 
 such cases he twisted the ligature very firmly, and 
 then secured it to the adjacent skin, by means of 
 a small strip of adhesive plaster. The effect of 
 this twisting is to tighten the noose at the ex- 
 tremity of the ligature, so as to compress com- 
 pletely the parts contained within it; and in addi- 
 tion to this, the natural tendency of the ligature 
 to untwist itself keeps up a constant action and 
 pressure upon the parts, and thereby causes ulcer- 
 ation. We have known several instances in which 
 ligatures which had been retained for a long pe- 
 riod in wounds, have been extricated by resorting 
 to this simple process. I may state that Dr. 
 
OF DR. PHYSICK. 87 
 
 Physick had strong objections to the use of silk 
 ligatures, and in cases where he did not employ 
 animal ones, he invariably preferred those made of 
 flaxen thread or bobbin. He was of the opinion 
 that silk ligatures were more apt to slip. 
 
 It is my impression that the period which we 
 are now commemorating may be considered as 
 that at which his professional engagements had 
 acquired their greatest extent. His preeminence, 
 both as a physician and a surgeon, was at that 
 time so generally conceded in this city, as to lead 
 to the greatest demand for his professional ser- 
 vices. In addition to this his surpassing fame 
 and reputation were so completely established and 
 so widely disseminated, as to induce strangers 
 from all parts of our country to resort to Phila- 
 delphia, in order to be benefitted by his skill and 
 experience. 
 
 It follows also as a natural consequence of his 
 exalted position, that many persons who could not 
 make it convenient to leave their homes, would 
 apply to him for his advice and opinions in writing; 
 so that in addition to his other labours, much of 
 his time was occupied in keeping up an extensive 
 correspondence. 
 
 I have already shown that his health was con- 
 siderably impaired ; and it is probable that about 
 this period he must have been deeply sensible of 
 
88 A MEMOIR 
 
 his increasing infirmities, inasmuch as he thought 
 proper, in 1816, to resign his situation as Surgeon 
 to the Pennsylvania Hospital. He had received 
 his appointment in 1794; consequently he served 
 the institution twenty-two years. Some time pre- 
 vious to this he had resigned his situations in the 
 Philadelphia Dispensary, and in the Alms House 
 Infirmary. 
 
 In the year 1819, Dr. Physick resigned his 
 chair of Surgery in the University of Pennsylva- 
 nia, and was transferred to that of Anatomy; 
 which had become vacant the preceding session by 
 the death of his nephew, Dr. John Syng Dorsey. 
 
 The premature death of the lamented Dorsey 
 plunged Dr. Physick into the deepest affliction, 
 and had the effect of creating a melancholy gloom, 
 which overshadowed the remainder of his exist- 
 ence. Dorsey, of all others, was most pre-emi- 
 nently fitted to cheer and solace the declining 
 years of his uncle. He had been regularly edu- 
 cated under the immediate inspection and super- 
 intendence of Dr. Physick, had imbibed from him 
 his early lessons of wisdom and of knowledge, 
 and at a more matured period of his life, adopted 
 to the fullest extent his principles and doctrines. 
 Advantages like these, aided by talents of a bril- 
 liant and comprehensive order, enabled Dorsey at 
 an unusually early period of his life, to assume 
 
OF DR. PHYSICK. 89 
 
 the most elevated and distinguished rank in his 
 profession. Relentless death, however, seized 
 upon his prey, whilst in the midst of his honours 
 and his usefulness. 
 
 It was always a source of deep regret with Dr. 
 Physick's immediate family and friends, that his 
 comforts in the evening of his days, and whilst 
 labouring under physical infirmities, should be so 
 greatly interrupted by translating him from the 
 chair of Surgery to that of Anatomy. We had 
 positive assurances from himself that the change 
 was contrary to his own wishes and inclination : 
 how far the interests of the institution to which he 
 belonged may have been promoted by it, I do not 
 mean to inquire. My own impression is, however, 
 and I believe I am not singular in the opinion, 
 that if he had continued in the chair of Surgery 
 up to the period when he retired from the Uni- 
 versity, it would have numbered in its catalogue 
 of students many more than it has ever shown. 
 
 In the Philadelphia Journal of the Medical and 
 Physical Sciences, edited by Professor Chapman, 
 vol. i, for the year 1820, Dr. Physick published a 
 communication, in which he gave an account of 
 the method which he employed for the removal 
 of scirrhous tonsils, and hemorrhoidal tumours, by 
 means of the double cannula and a soft wire. His 
 method consisted in strangulating the tumours 
 12 
 
90 A MEMOIR 
 
 completely by means of the wire ligature passed 
 through a. double cannula ; after which, instead of 
 allowing the instrument to remain applied, as was 
 formerly the custom, until the parts separated and 
 were thrown off, a process requiring a week or 
 ten days, it was his practice to remove the wire 
 at the expiration of twenty-four hours. Ample 
 experience has shown that this manner of remov- 
 ing these parts, must be considered a valuable im- 
 provement and modification of the old method of 
 permitting the ligature to remain on the parts un- 
 til they sloughed away. We can readily imagine 
 that the long continued irritation kept up by the 
 instrument would be productive of a degree of 
 pain and suffering from which it is desirable to 
 free the patient as soon as possible. 
 
 Some few years subsequently to this commu- 
 nication, he became convinced that the best and 
 most convenient method of removing scirrhous 
 tonsils consisted in their excision. He contrived 
 a very ingenious instrument for this purpose, and 
 also for excising the uvula ; a full description of 
 which, accompanied with a plate, was published 
 by Dr. Hays, in the American Journal of the 
 Medical Sciences, vol. i ; together with the very 
 interesting case of a young lady, afflicted with a 
 most obstinate cough, occasioned by an elongation 
 of the uvula, who was entirely cured by Dr. Phy- 
 
OF DR. PHYSICK. 91 
 
 sick, by means of the excision of a portion of that 
 organ. In vol. ii, of the same Journal, Dr. Hays, 
 its editor, published the description and plate of 
 a forceps, invented by Dr. Physick, and em- 
 ployed in certain cases to facilitate the extirpation 
 of the tonsil, by means of his instrument. The 
 forceps is so constructed, that "the tonsil may be 
 seized, and drawn through the aperture to any 
 distance that may be deemed proper; when its 
 extirpation can be immediately effected." 
 
 It is proper that I should state, that in cases of 
 hemorrhoidal tumour, where the complaint was of 
 long standing, when the lining membrane of the 
 rectum was much diseased, and where the tumours 
 were seated internally, Dr. Physick employed the 
 ligature for their removal, as long as he continued 
 to operate. Under the circumstances just men- 
 tioned, he considered this method of operating far 
 safer than using the knife, and greatly to be pre- 
 ferred. 
 
 The following extract, taken from his com- 
 munication on the use of the double cannula and 
 a wire, conveys a correct idea of his views upon 
 this subject. "I have for many years been in the 
 habit of performing the san? -> .kind of operation 
 for the extirpation of hemorrhoidal tumours. The 
 cannula used in this case should not be longer than 
 about two inches. When hemorrhoidal tumours 
 
92 A MEMOIR 
 
 are external and troublesome to the patient, almost 
 all surgeons, I believe, cut them off; but when 
 their attachments are within the anus, and the 
 tumour only protrudes in the act of evacuating 
 the faeces, then their excision would be attended 
 with great risk of hemorrhage. This some have 
 denied, but having twice witnessed the fact to a 
 very alarming extent, I wish on all such occasions 
 to guard against it. The extirpation of such tu- 
 mours can be performed safely by means of a liga- 
 ture of either vegetable or animal substance ; but 
 the most convenient and effectual I have ever 
 tried, is a wire drawn at once tight round its base, 
 by means of the double cannula. This gives mo- 
 mentary pain, but it is not in all cases so severe 
 as might be supposed. I am not able to account 
 for this circumstance ; but some patients make no 
 complaint whatever, even though two or three 
 tumours are operated on at the same time, while 
 others exclaim violently from its intensity. At 
 the end of twenty-four hours, and probably sooner, 
 the wire may be removed in the manner above 
 explained. The tumour will be found shrivelled 
 and black, and in a few days will be separated 
 and thrown off, under the application of a soft 
 poultice of bread and milk." 
 
 Much has been said respecting the intensity of 
 the pain accompanying the application of a liga- 
 
OF DR. PHYSICK. 93 
 
 ture to hemorrhoidal tumours. I have, however, 
 repeatedly performed this operation, and not un- 
 frequently the patients have expressed surprise at 
 the little suffering which they experienced. Dr. 
 Physick frequently related to me the case of a 
 gentleman on whom he performed two operations 
 for the removal of hemorrhoidal tumours. In the 
 one he used the knife, and in the other the liga- 
 ture; and the patient declared that the knife caused 
 him much greater pain than the application of 
 the ligature. It is proper to mention, however, 
 that in order to lessen the amount of pain, Dr. 
 Physick considered it extremely important to in- 
 clude within the ligature nothing hut the hemor- 
 rhoidal tumour itself. It is undeniahle that, in cer- 
 tain cases, the excision of hemorrhoidal tumours is 
 attended with the risk of fatal hemorrhage. It is 
 well known that cases have heen reported hy the 
 highest authority in surgery, in which this opera- 
 tion has been attended with the loss of life. 
 
 I should suppose that Baron Dupuytren's cau- 
 tions respecting this operation, in conjunction with 
 his directions for the suppression of the hemor- 
 rhage attendant upon it, would he quite sufficient 
 to deter a majority of surgeons from excising in- 
 ternal hemorrhoids. 
 
 The last paper written by Dr. Physick, which 
 I shall briefly notice, is one which he published 
 
94 A MEMOIR 
 
 in vol. iii, of the Philadelphia Journal of the Med- 
 ical and Physical Sciences, in which he communi- 
 cated the particulars of a case of carbuncle, with 
 some remarks on the use of the common caustic 
 vegetable alkali in the treatment of this disease. 
 In order for the better comprehension of his 
 views respecting the use of the caustic, he divides 
 the progress of carbuncle into three stages. The 
 first or forming stage is that in which the peculiar 
 inflammation exists in the cellular texture under 
 the skin. The second stage is that in which the 
 inflammation has terminated in the mortification 
 of the parts. In the third stage an ulcer remains, 
 attended, however, with no peculiarities. 
 
 He says, " In the first stage, all irritating treat- 
 ment appears to be injurious, by increasing the 
 peculiar inflammation then existing, and thereby 
 extending it." 
 
 " In the second stage, the inflammation having 
 ended in the death of the cellular texture in w T hich 
 it was situated, a process begins for making an 
 opening through the skin, to allow the dead parts 
 and acrid fluids to pass out. The commencement 
 of this process is pointed out by the appearance of 
 pimples and small orifices, as above described; and 
 it is at this period that the application of caustic 
 vegetable alkali upon the skin so perforated, and 
 on that covering the middle of the tumour, in 
 
OF DR. PHYSICK. 95 
 
 quantity sufficient to destroy it completely, proves 
 highly beneficial. In all the cases in which I 
 have used the caustic in this manner, the suffering 
 of the patient ceased, as in Mr. Wharton's case, 
 as soon as the pain from the caustic subsided. It 
 operates by destroying in a few minutes that por- 
 tion of the skin covering the mortified parts, 
 which, if left to be removed by ulceration, would 
 require several days for its completion, occasion- 
 ing the chief part of the pain and danger attend- 
 ant on and consequent to the disease." 
 
 In the year 1821, Dr. Physick was appointed 
 Consulting Surgeon to the Institution for the Blind. 
 
 In 1822, the Phrenological Society of Philadel- 
 phia elected him its President. 
 
 In 1824, he w r as chosen President of the Phila- 
 delphia Medical Society. He held this situation 
 until the time of his death. 
 
 In 1825, January 6, he was appointed a Mem- 
 ber of the Royal Academy of Medicine of France; 
 being, as far as I know, the first American who 
 ever received that honour. 
 
 In 1831, in consequence of his declining health, 
 he felt it incumbent on him to retire from the 
 active duties of the University ; and accordingly 
 he resigned his situation as Professor of Anatomy. 
 In acknowledgment of the extraordinary services 
 which he had rendered, in elevating the character 
 
96 A MEMOIR 
 
 of the school, and in promoting the advancement 
 of medical science, the institution, upon accepting 
 his resignation, conferred upon him the highest 
 honour in its power, by electing him unanimously 
 "Emeritus Professor of Surgery and Anatomy." 
 
 Not the least among the improvements effected 
 by Dr. Physick in the methods of treating diseases, 
 may be considered his management of affections 
 of the joints ; and more especially that condition 
 of the hip joint, known by the name of " morbus 
 coxarius, or hip disease." 
 
 I may mention generally, that his practice 
 consisted in the application of a carved splint, 
 which would keep the limb strictly at rest, and 
 prevent the least possible motion of the joint; and 
 also in the prosecution of a course of active and 
 long continued purging. 
 
 In the American Journal of the Medical Sci- 
 ences, No. xiv, February, 1831, I published a de- 
 tailed account of Dr. Physick's method of treat- 
 ing morbus coxarius, accompanied with a plate, 
 exhibiting the application of the carved splint. 
 The superiority of this method of treatment is 
 now so completely established in this country as 
 to lead to its adoption by the profession generally. 
 
 In October, 1831, Dr. Physick performed the 
 operation of lithotomy on Chief Justice Marshall. 
 This case was attended with singular interest, in 
 
OF DR. PHYSICK. 97 
 
 consequence of the exalted position of the patient, 
 his advanced age, and the circumstance of there 
 being upward of one thousand calculi taken from 
 his bladder. It is well known that for several 
 years previous to this period. Dr. Physick had 
 declined performing extensive surgical operations. 
 He felt somewhat reluctant to operate upon Chief 
 Justice Marshall, and offered to place the case in 
 my hands. Taking all the circumstances into 
 consideration, and knowing well that this would 
 be the last time that he would ever perform a 
 similar operation, I felt desirous that he should 
 finish with so distinguished an individual; and 
 accordingly urged him to do it himself. Upon 
 the day appointed, the Doctor performed the 
 operation with his usual skill and dexterity. I 
 do not think I ever saw him display greater neat- 
 ness than on that occasion. The result of the 
 operation was complete success. 
 
 It will be readily admitted that, in consequence 
 of Judge Marshall's very advanced age, the hazard 
 attending the operation, however skilfully per- 
 formed, was considerably increased. I consider 
 it but an act of justice, due to the memory of that 
 great and good man, to state, that in my opinion, 
 his recovery was in a great degree owing to his 
 extraordinary self possession, and to the calm and 
 13 
 
98 A MEMOIR 
 
 philosophical views which he took of his case, 
 and the various circumstances attending it. 
 
 It fell to my lot to make the necessary pre- 
 parations. In the discharge of this duty I visited 
 him on the morning of the day fixed on for the 
 operation, two hours previously to that at which it 
 was to be performed. Upon entering his room I 
 found him engaged in eating his breakfast. He 
 received me with a pleasant smile upon his coun- 
 tenance, and said, "Well, Doctor, you find me 
 taking breakfast, and I assure you I have had a 
 good one. I thought it very probable that this 
 might be my last chance, and therefore I was 
 determined to enjoy it and eat heartily." I ex- 
 pressed the great pleasure which I felt at seeing 
 him so cheerful, and said that I hoped all would 
 soon be happily over. He replied to this, that he 
 did not feel the least anxiety or uneasiness re- 
 specting the operation or its result. He said that 
 he had not the slightest desire to live, labouring 
 under the sufferings to which he w r as then sub- 
 jected ; that he was perfectly ready to take all 
 the chances of an operation, and he knew there 
 were many against him ; and that if he could be 
 relieved by it he was willing to live out his ap- 
 pointed time, but if not, would rather die than 
 hold existence accompanied with the pain and 
 misery which he then endured. 
 
OF DR. PHYSICK. 99 
 
 After he had finished his breakfast, I adminis- 
 tered to him some medicine : he then inquired at 
 what hour the operation would be performed. I 
 mentioned the hour of eleven. He said, "Very 
 well ; do you wish me now for any other purpose, 
 or may I lie down and go to sleep ?" I was a 
 good deal surprised at this question, but told him 
 that if he could sleep it would be very desirable. 
 He immediately placed himself upon the bed and 
 fell into a profound sleep, and continued so until 
 I was obliged to rouse him in order to undergo 
 the operation. 
 
 He exhibited the same fortitude, scarcely utter- 
 ing a murmur, throughout the whole procedure, 
 which, from the peculiar nature of his complaint, 
 was necessarily tedious. 
 
 Chief Justice Marshall survived this operation 
 some years, and finally died of a disease of an en- 
 tirely different character. Previously to his death 
 he laboured under very unpleasant symptoms, 
 which are frequently met with in advanced life ; 
 and in consequence of these, a rumour was 
 widely disseminated that he had a recurrence of 
 his old complaint, stone in the bladder. As this 
 was the last operation of much magnitude per- 
 formed by Dr. Physick, I feel desirous that it 
 should be correctly estimated; and,' inasmuch as I 
 am still not unfrequently asked whether Judge 
 
100 A MEMOIR 
 
 Marshall had not a return of the calculus, I insert 
 the following letter, addressed by Professor Chap- 
 man and myself to the editor of the Southern 
 Literary Messenger, in order to correct an erro- 
 neous impression of this nature, given by an ar- 
 ticle in a previous number of that able Journal. 
 
 Philadelphia, March 25, 1836. 
 
 SIR : A mistake, evidently unintentional, hav- 
 ing appeared in the February number of your 
 Journal for this year, we feel convinced you will, 
 upon proper representation, take pleasure in cor- 
 recting it ; as an impression so erroneous might 
 have a prejudicial tendency. Under the notice of 
 the Eulogies on the Life and Character of the 
 late Chief Justice Marshall, it is there stated that, 
 "for several years past Judge Marshall had suf- 
 fered under a most excruciating malady. A sur- 
 gical operation, by Dr. Physick, of Philadelphia, 
 at length procured him relief; but a hurt received 
 in travelling last spring seems to have caused a 
 return of the former complaint with circumstances 
 of aggravated pain and danger. Having revisited 
 Philadelphia in the hope of again finding a cure, 
 his disease there overpowered him; and he died on 
 the 6th of July, 1835, in the 80th year of his 
 age." 
 
 Now, sir, the above quotation is incorrect in 
 
OF DR. PHYSICK. 101 
 
 the following respect. Judge Marshall never had 
 a return of the complaint for which he was ope- 
 rated upon by Dr. Physick. After the demise of 
 Chief Justice Marshall, it became our melancholy 
 duty to make a post mortem examination, which 
 we did in the most careful manner, and ascer- 
 tained that his bladder did not contain one particle 
 of calculous matter. Its mucous coat was in a 
 perfectly natural state, and exhibited not the 
 slightest traces of irritation. 
 
 The cause of his death was a very diseased 
 condition of the liver, which was enormously en- 
 larged, and contained several tuberculous abscesses 
 of great size. Its pressure upon the stomach had 
 the effect of dislodging this organ from its natural 
 situation, and compressing it in such a manner, 
 that for some time previous to his death it would 
 not retain the smallest quantity of nutriment. 
 By publishing this statement, you will oblige 
 Yours, very respectfully, 
 
 N. CHAPMAN, M. D. 
 
 J. RANDOLPH, M. D. 
 To J. W. WHITE, ESQ. 
 
 I should state, that at an early period after 
 Judge Marshall's case, the operation of lithotripsy 
 was introduced into this country. Dr. Physick 
 became convinced of the extraordinary advantages 
 
10 A MEMOIR 
 
 which it possessed over that of lithotomy, and 
 yielded it the full support of his sanction and ap- 
 probation. 
 
 Among other contributions made by Dr. Phy- 
 sick to the department of surgery, I should men- 
 tion that we are indebted to him for making us 
 acquainted with the existence of preternatural 
 pouches, or sacs, situated at the lower extremity 
 of the rectum, just above the verge of the anus. 
 This form of disease, which is one of not unfre- 
 quent occurrence, is in many instances productive 
 of the most severe and distressing symptoms ; so 
 much so, that we have known patients labouring 
 under it declare that their lives were scarcely 
 supportable. The complaint is rendered more 
 perplexing also from the almost uniform absence 
 of all visible or external signs by which it may 
 be designated. It is only by a peculiar mode of 
 examination that its existence can be detected. 
 
 Those who wish to acquaint themselves more 
 particularly with this disease, I refer to the "Ame- 
 rican Cyclopedia of Practical Medicine and Sur- 
 gery," edited by Dr. Hays; in which is published, 
 under the head of Anus, a most able article, writ- 
 ten by my friend Dr. Eeynell Coates, giving a 
 minute and correct account of the nature and 
 treatment of these preternatural pouches, as col- 
 lected from Dr. Physick himself. 
 
OF DR. PHYSICK. 103 
 
 Before concluding the account of Dr. Physick's 
 labours I may state, that in a conversation with his 
 relative. Dr. R. R. Dorsey, a short time since, he 
 recalled to my remembrance a case in which Dr. 
 Physick had been eminently successful in allevi- 
 ating, by means of a novel contrivance, the suffer- 
 ings of a patient labouring under an enlargement 
 of the prostate gland. As Dr. Dorsey attended 
 this patient in conjunction with Dr. Physick, and 
 had a particular knowledge of his method of pro- 
 cedure, I requested him to furnish me with an 
 account of the case. He kindly acceded to my 
 wishes, and sent me the following letter. 
 
 DEAR DOCTOR: I furnish, as desired, a descrip- 
 tion of an instrument invented and used by Dr. 
 Physick, in 1835, in the case of a gentleman aged 
 70, who had suffered for years from an enlarge- 
 ment of the third lobe of the prostate gland. 
 Very truly yours, 
 
 R. R. DORSEY. 
 January 12, 1839. 
 
 " The end of a small flexible catheter was in- 
 troduced nearly to the bottom of a very thin sac 
 or pouch, three inches long, and an inch and a 
 half in diameter at the mouth. The edges of the 
 sac, which was prepared from the intestine of a 
 
104 A MEMOIR 
 
 sheep, were secured to the catheter by a fine silk 
 thread, wrapped around it with great care ; and 
 the material being as fine as the thinnest blotting 
 paper, adapted itself, when oiled, so closely to the 
 instrument, that the bulk of the whole was less 
 than that of a large sized bougie. 
 
 "After its introduction into the bladder, the 
 membrane was injected with tepid water, and the 
 mouth of the catheter being stopped with a peg, 
 it was gently, but with some firmness, retracted. 
 The consequent pressure at the seat of disease, 
 gentle and uniform, and from the nature of the 
 material used, as little irritating as possible, had 
 the happiest effect in repressing the enlarged lobe 
 of the gland; and afforded for many months, great 
 relief by facilitating the discharge of the urine. 
 Although the patient took a severe cold imme- 
 diately after the operation, he did not suffer more 
 than he had previously ; and on recovering from 
 its temporary influence, he experienced a relief 
 long unknown. The introduction of the instru- 
 ment was again practised after an interval of some 
 months, with great advantage. 
 
 " Much nicety is requisite in securing the edges 
 around the catheter, so that there may be no rough- 
 ness to cause irritation during its retraction. It 
 was also deemed proper to wind the end of the 
 thread loosely round the catheter and secure it to 
 
OF DR. PHYSICK. 105 
 
 the stopper. The material employed was pre- 
 pared and may be procured in France." 
 
 Dr. Physick informed me that he had been 
 equally successful in relieving another case by 
 means of the same contrivance. 
 
 In November, 1836, he was elected an honor- 
 ary fellow of the Royal Medical and Chirurgical 
 Society of London. The conferring of this ho- 
 nour was a full acknowledgment of his exalted 
 merits, and justly acquired reputation; and he did 
 not affect to conceal the high gratification which 
 he derived from its acceptance. 
 
 I have mentioned, in the former part of this 
 memoir, that the first case recorded in his private 
 journal is one in which he performed the extrac- 
 tion of the crystalline lens. By a singular coin- 
 cidence, it happened that the last operation ever 
 performed by Dr. Physick was for cataract, and 
 took place but a few months previously to his 
 death. He, however, never saw his patient after 
 completing the process ; the attack which ter- 
 minated his existence occurring on the afternoon 
 of the same day. 
 
 I ought to mention, by way of apology for his 
 engaging in any surgical operation whilst labouring 
 under such feeble health, that the circumstances 
 attending this case were exceedingly peculiar. 
 The applicant was a foreigner; Dr. Physick had 
 14 
 
106 A MEMOIR 
 
 operated upon his eye a year previously, and the 
 gentleman had remained in this city during a whole 
 year for the purpose of having the procedure re- 
 peated by him. He consequently felt it incum- 
 bent upon him not to disappoint his patient ; and 
 he was not the man to shrink from the perform- 
 ance of what he believed to be his duty, notwith- 
 standing, as he informed me, he was well aware 
 that death was impatiently waiting for his victim. 
 
 The date at which he performed this operation 
 was the 13th of August, 1837. I was present on 
 the occasion, and watched him with the most in- 
 tense anxiety. He was quite collected and firm, 
 and his hand was steady ; notwithstanding at the 
 time he was labouring under great mental and 
 physical suffering. Whilst witnessing this last 
 expiring effort in the cause of afflicted humanity, 
 I felt a melancholy conviction that this would be 
 the final act of his professional life, and that I 
 should never again behold him engaged in a sur- 
 gical operation. 
 
 From this period his complaint went on in- 
 creasing in intensity and violence. The symptoms 
 of hydrothorax became developed to a most pain- 
 ful extent, and he suffered extreme agony from 
 oppression at his chest and difficulty of breathing ; 
 so much so, that sometimes he became unable 
 to lie down in his bed for whole nights together, 
 
OF DR. PHYSICK. 107 
 
 but was obliged to stand upon the floor, supported 
 by assistants. In consequence of his increasing 
 illness, his old and well tried friend and associate, 
 Professor Chapman, was requested to visit him in 
 consultation with myself. His malady 5 however, 
 had assumed too uncontrollable a form ; and it re- 
 sisted the most strenuous efforts that professional 
 skill and affectionate attention could exert in his 
 behalf. 
 
 Some time previously to his death, anasarca took 
 place ; and in consequence of his remaining so 
 much in the erect position, his lower extremities 
 became enormously swollen and distended with 
 serum. The integuments at length gave way, 
 openings were formed, and these finally ulcerated 
 and became gangrenous. 
 
 The Father of American Surgery expired with- 
 out a struggle, on the morning of the 15th of De- 
 cember, 1837, at twenty minutes past 8 o'clock. 
 
 " He gave his honours to the world again, 
 
 His blessed part to heaven, and slept in peace." 
 
 To the preceding account of the professional 
 labours of Doctor Physick, I have but little to 
 add respecting his private life and character. It 
 is in fact rendered less necessary for me to dwell 
 
108 A MEMOIR 
 
 upon this point in his history, inasmuch as in the 
 several obituary notices of him which have ap- 
 peared from different sources, ample justice has 
 been accorded to him both as a man and a citizen. 
 It is with feelings of the most sincere gratification 
 that I proceed to mention the following eulogies 
 which were pronounced subsequently to the de- 
 mise of Dr. Physick; all of them expressive of the 
 deep sense which was entertained of his profound 
 acquirements and personal qualifications. 
 
 "A comprehensive minute, commemorative of 
 Philip Syng Physick, M. D., Emeritus Professor of 
 Anatomy and Surgery in the University of Penn- 
 sylvania," was prepared, under the instructions of 
 the Board of Trustees of the University, by Wm. 
 Meredith, Esq. This is replete with sentiments 
 which fully comply with the resolution of the 
 Board, " That a committee be appointed to prepare 
 and present, at the next meeting of this Board, a 
 comprehensive minute ; to state the long connec- 
 tion of the deceased with this University, and to 
 express the respect entertained for his able and 
 faithful services as a teacher, for his eminence as 
 a practitioner of medicine, and for the virtues 
 which adorned his private character." 
 
 When the intelligence of Dr. Physick's death 
 was received at Louisville, " resolutions were 
 adopted by the faculty and class of the Louisville 
 
OF DR. PHYSICK. 109 
 
 Medical Institute, to commemorate, by a discourse 
 prepared for the purpose, the invaluable services 
 and character of the deceased." The duty of 
 preparing this discourse devolved upon Professor 
 Charles Caldwell, one of the early friends and 
 associates of Dr. Physick. He discharged the 
 obligations imposed upon him with his usual skill 
 and ability; and delivered a discourse highly grati- 
 fying to the friends and connections of Dr. Phy- 
 sick. 
 
 At the request of the American Philosophical 
 Society, a Necrological Notice of Dr. Physick was 
 prepared, and presented at a meeting held in May, 
 1838, by Professor Wm. E. Homer. From Pro- 
 fessor Horner's long association with Dr. Physick 
 in the chair of Anatomy, it will be conceded that 
 he possessed peculiar advantages for the successful 
 accomplishment of his task. It is well known, 
 too, that he entertained an ardent affection for 
 Dr. Physick; and he has accordingly borne ample 
 testimony to his talents and acquirements. 
 
 We are also indebted to Professor Granville 
 S. Pattison, of Jefferson Medical College, for a 
 highly laudatory notice of Dr. Physick, contained 
 in an introductory lecture delivered before his 
 class, on the commencement of the session of 
 1838-9. 
 
 It must be admitted that, by the community 
 
110 A MEMOIR 
 
 at large, Dr. Physick's private character was but 
 imperfectly understood. This was owing to the 
 habits of perfect seclusion which he contracted, 
 and to the slight intercourse, other than profes- 
 sional, which he permitted himself to enjoy with 
 his fellow-citizens. It must not be supposed, 
 however, that this isolation arose from moroseness 
 of character or want of inclination to mingle with 
 society. A satisfactory explanation may be af- 
 forded by the entire self-abandonment with which 
 he devoted himself to his professional engage- 
 ments. In my opinion, this formed one of the 
 most striking and remarkable points in Dr. Phy- 
 sick's character. I doubt very much whether 
 history could show an example of a more pure 
 and absolute devotion to professional pursuits than 
 he exhibited. 
 
 In consequence of the reasons just mentioned, 
 he was supposed by some to be stern and unfeel- 
 ing, and wanting in the kinder sympathies of our 
 nature. There could not be a greater misappre- 
 hension. His feelings were tender and susceptible 
 in the extreme ; and could those persons who en- 
 tertained an opposite opinion have been admitted 
 behind the scenes, and to closer and more intimate 
 relations with him, they would have acknowledged 
 the great injustice they had done him in such a 
 surmise. Many instances might be cited, were it 
 
OF DR. PHYSICK. Ill 
 
 expedient to occupy the necessary time, in order 
 to illustrate Dr. Physick's extreme tenderness of 
 feeling. At an early stage of his professional ca- 
 reer, he performed a few experiments upon living 
 animals, with the view of determining some phy- 
 siological points. This formed a lasting subject 
 of regret to him as long as he lived ; and he could 
 not divest his mind of the idea that he had been 
 guilty of a useless as w r ell as a wicked act of cru- 
 elty. 
 
 Previously to his performing important surgical 
 operations, his feelings were so harrowed up, and 
 he experienced so much anxiety, that it was the 
 custom of his family to endeavour to prevail upon 
 him to execute such operations as speedily as pos- 
 sible, in order to relieve his mind. 
 
 To those who only saw Dr. Physick as the 
 bold and unflinching operator in surgery, his cha- 
 racter might have appeared cold and unfeeling, 
 and they might have thought him, 
 
 " Unlike to other men, 
 
 A snow-crown'd peak of science, towering high ;" 
 
 but to the few who knew him in his private cir- 
 cle the veil was withdrawn. It was in the gentle 
 charities of domestic life, as the tender and affec- 
 tionate parent, or the sympathising friend, that his 
 true character became revealed, and his heart was 
 
112 A MEMOIR 
 
 felt to be keenly alive to the kindest and softest 
 emotions of which human nature is susceptible. 
 He never appeared so happy as when surrounded 
 by his children and his family; and indeed I feel 
 assured that this formed one of the greatest consola- 
 tions to him in the midst of his protracted sufferings. 
 In his intercourse with his professional brethren 
 Dr. Physick's conduct was regulated by the strict- 
 est principles of honour and integrity. Whenever 
 he was called in consultation with other physicians, 
 without inquiring how exalted or humble their 
 positions might be, he was scrupulously careful to 
 avoid saying or doing any thing which could wound 
 their feelings, or prejudice them in the least in 
 the estimation of their patients. He invariably 
 stated his own opinions in a frank and manly man- 
 ner, and was ever willing to pay due deference to 
 the opinions of others. Upon all occasions he 
 was happy and ready to confer upon his fellow 
 practitioners the benefit of his advice and experi- 
 ence, whether the information desired had special 
 relation to themselves, or to those under their 
 charge. He was far removed above the meanness 
 of interfering with the patients of others; and 
 whenever he had it in his power to render a ser- 
 vice to a younger member of the profession, by a 
 word of encouragement or commendation, it was 
 cheerfully bestowed. 
 
OF DR. PHYSICK. 113 
 
 It was impossible that a man possessed of a 
 mind of so reflective and contemplative a charac- 
 ter as his, should not turn with anxious solicitude 
 to the doctrines of religion, and the contemplation 
 of a future state. Religion constituted, in fact, 
 the most engrossing subject which occupied his 
 attention during the latter years of his life. How 
 far he derived comfort and consolation from his 
 religious studies, it is not for me to say. I am 
 very certain, however, that a more pure and ardent 
 seeker after divine truth I never knew. As_ an 
 observer of the principles of strict integrity and 
 morality, I believe it will be conceded that he 
 was exemplary to a remarkable degree. He, how- 
 ever, arrogated nothing to himself from this source. 
 He expressed to me but a short period previous to 
 his death, that he possessed no merits of his own 
 to give him a claim to salvation. His humility 
 and self abasement upon the subject of religion 
 were extreme; and he was always willing and 
 ready to apply to any source, however humble it 
 might be, provided he thought he could be en- 
 lightened and instructed by it. 
 
 His course of reading upon theology was very 
 extensive; and unfortunately for him he read many 
 works of a conflicting and contradictory nature. 
 The effect of this upon one who had, during all 
 his life, been in search of indisputable evidences, 
 15 
 
114 A MEMOIR 
 
 was to create at times gloomy and desponding 
 views. Yet for very many years of his life he was 
 in the uniform habit of perusing, every morning, 
 a portion of the New Testament ; and when, in 
 consequence of his illness and increasing infirmi- 
 ties, he was incapable of so doing, his children 
 were constantly employed in reading this and 
 other works of devotion to him. During his last 
 illness he derived great pleasure and satisfaction 
 from the visits of his friend and pastor, Dr. De- 
 lancey; whose kind attentions toward him were 
 unremitting. I feel assured that the hopes and 
 promises of the Christian religion were the great- 
 est sources of consolation to him in the closing 
 hours of his life, and smoothed his passage to the 
 tomb. 
 
 THE END.