Bigelow's writings in behalf of anaesthesia and in advocacy
of Morton's claim to the right of being held its discoverer,
cover a period of thirty years, 1846- 1876, and are historical.
They deal with every condition connected with the introduc-
tion of surgical anaesthesia.
EMINENT ALUMNI 843
The entrance of Bigelow into the "Faculty" of the Massa-
chusetts General Hospital was looked upon by that body as
little less than an unwelcome intrusion. His youth, his undis-
guised determination to change old customs, his independence
and aggressiveness, were all out of harmony with long estab-
lished formalities. We may accept the statement of Henry G.
Clark before the Massachusetts Medical Society on June 3,
1868: 'The world does not know, nor will it until the true
history of the use of ether in this case (Alice Mahon's, Novem-
ber 7, 1846) comes to be written, how near to a lost oppor-
tunity this was ; nor how much it was indebted for its triumph-
ant success to the sagacity, the adroitness, and the energetic
remonstrances against the obstructive etiquette and red tape
which imperilled everything, of the then junior, and now
senior, surgeon of the hospital, Dr. Henry J. Bigelow."
Here is an interesting bit from a message sent to W. Stur-
gis Bigelow by William J. Morton, the discoverer's son:
"Verbally, my mother thinks your father advised my father
to induce Warren to permit public experiment, hence Abbott."
Bigelow's test of the ether claims has come to be accepted :
It is safety, certainty, and completeness. He sent out the first
account which the old world had of the new discovery, and
he experimented with other anaesthetic agents in his endeavor
t'o find a local anaesthetic. From these experiments resulted
the knowledge that insensibility from the inhalations of nitrous
oxide gas is due to asphyxia, and that we must use large quan-
tities of the gas. He also discovered the anaesthetic proper-
ties of keroselene and rhigolene. Bigelow personally admin-
istered the ether at the Massachusetts General Hospital during
the year succeeding its first use. So identified became his
name with the subject that he was the only one suggested as
the appropriate person to give the dedicatory address upon
the completion of the monument in the Boston Public Gar-
den, June, 1868, erected to commemorate "the discovery that
844 HARVARD MEDICAL SCHOOL
the inhaling of ether causes insensibility to pain." Holmes
said before the American Academy of Arts and Sciences (Vol.
xxvi) : "Had Dr. Bigelow left no other record, the associa-
tion of his name with the great inventive discovery of arti-
ficial anaesthesia would preserve his memory to the latest
period of civilization."
Let us follow Bigelow through his hospital career before
describing the other achievements of his busy life. He was
a brilliant operator, fearless, full of expedient, ingenious,
dexterous and graceful, cool, alert and practiced. "To see
him operate was to recognize a master," says D. W. Cheever.
His familiarity with tools gave him a dramatic style of oper-
ating which dazzled novices. He taught them to make large,
free incisions, — one of his favorite maxims was, "When you
have a cut to make, make it." Although one of the most
adept in the handling of instruments, he gives this advice also
to students in "Fragments of Medical Science and Art," "Do
not identify surgery with the knife, — with blood and clashing
elegance. Distrust surgical intrepidity and boldness. If any
such epethets have any meaning, they are in bad taste, and
tend to give wrong impressions of scientific excellence. * *
* Surgery is not operative surgery. Its province is to save,
not to destroy; and an operation is an avowal of its own inad-
equacy."
In the hospital he disliked the drudgery and routine of post-
operative work. He placed the greatest confidence in his
house-pupils, and entrusted the after care of his patients to
them with confidence. Yet the slightest carelessness, or the
faintest sign of relaxing diligence, or the attempt to assume
responsibility, would bring upon the head of the unwise pupil
such a lesson that its repetition was never required. After
the favorite student passed into the ranks of practitioners,
Bigelow would follow him with unfailing interest, offering
unobtrusive advice, and sending him cases. Many men were
EMINENT ALUMNI 845
so assisted by the teacher who they thought could scarcely
have remembered them as house-pupils. "No allusion would
ever be made as to the source of this success, no gratitude
claimed, and no thanks allowed ;" such is the testimony of one
who publicly acknowledged his indebtedness to this generous
surgeon. In his services at the hospital Bigelow was con-
stantly displaying his inventive genius. H. H. A. Beach
says ; "There is hardly an instrument in the operating cases
of the Massachusetts General Hospital which does not show
some advantage gained from his working with it." Among
the more noticeable instruments modified or originated by
Bigelow are tourniquets for thigh, arm, and wrist; needle-
holders ; a sinus dilator ; handles for drills ; mouth-gags ; an
urethral-divulsor ; retractors for amputations; polypus for-
ceps ; compressors for aneurism ; torsion instruments ; artery
forceps with a device for discharging ligatures; autopsy tables;
an operating chair; apparatus for angular extension. Not-
withstanding the variety of this list Bigelow had such an
aversion to the placing of a surgeon's name on instruments
that few of his inventions were known outside the circle of his
hospital colleagues. In 1869, while in Europe, he purchased
at a cost of several thousand dollars a complete surgical out-
fit. These instruments he had arranged in four large mahog-
any cases which he presented to the hospital, together with
a sum of money for their perpetual replenishment and repair.
He was an inventive genius, and invention he l>elieved con-
sisted of three distinct stages: Tst. Think out clearly the
object it is wished to accomplish. 2d. Determine the com-
bination most likely to accomplish this. 3rd. Reduce the
mechanical combination to its simplest terms.
Among the l>est inventions of Bigelow is an autopsy-table
so arranged as to provide fur the disposal of gases and liquids
during post-mortem examinations, and an operating chair of
846 HARVARD MEDICAL SCHOOL
which it has been said it "could do anything but speak." This
was the chair which so interested Dom Pedro, Emperor of
Brazil, on his visit to the Massachusetts General Hospital in
1876, that he acquainted Augusta, Empress of Germany, with
its wonders, and she, in turn, asked for a set of working
drawings from which a similar chair might be reproduced for
the military hospitals of Germany. Bigelow received in re-
turn a volume of the prize work of Friedrich Esmarck, "Hand-
buch der Kriegschirurgischer Technik," bearing the holograph
inscription of Her Majesty.
In his hospital visits he was all attention. No idle gossip,
no unnecessary delay. Pain and unsatisfactory progress of
his patient received his immediate personal attention. He op-
posed "meddling," and was in the habit of allowing the dress-
ings on amputations to remain unchanged "so long as a solu-
tion of chlorinated soda, frequently applied to the outside,
would keep them odorless." The introduction of Listerism
at the Massachusetts General Hospital took place in the year
of Lister's first publication (1865) of his method. The story
goes that two amputations were done by Bigelow, and treated
with Lister dressings. His paper on Antiseptics* was one of
the earliest of such published in this country, but the great
advance came in his old age. He never practiced asepsis ade-
quately or appreciated it or gave it his confidence.
Bigelow opposed the establishment of separate wards for
the care of cases of skin diseases, at the Hospital, believing
that such a course would be detrimental to existing depart-
ments and would open up an avenue for separate wards for
other specialties. Another policy opposed by him was the
acceptance of fees from their hospital patients by the sur-
geons. The discussion of such questions, as well as a differ-
ence of opinion over certain hospital appointments in 1885, is
* " Boston Medical and Surgical Journal," June 5, 1879.
EMINENT ALUMNI 847
said to have led him to resign. The following letter tells his
story :
"TO THE TRUSTEES OF THE MASSACHUSETTS GENERAL
HOSPITAL:—
" GENTLEMEN : Having, at the expiration of forty years' service,
in pursuance of an intention I have for some time entertained, resigned
my position as Surgeon, you have done me the honor to appoint me to
the office of Emeritus Surgeon of the Massachusetts General Hospital,
without a vote in the Medical Board.
" I am aware that this is the first time in the history of the Hospital
this honor has been conferred, and I am very grateful to you for the
compliment. But although during the whole of my professional life the
Hospital has been one of my few permanent interests, and will continue
to be so, and although, as long as I felt convinced that I was of service
to the Hospital, I was reluctant to sever my connection with it, there are
reasons which compel me with regret to decline the honor.
" Whoever accepts the place of Emeritus Surgeon, with the privilege of
using the beds of the Hospital, yet without a vote in the Board of Physi-
cians and Surgeons, especially if this limitation is made at the expressed
wish of members of that Board, would naturally be expected to confine
his attention to the sick under his care. He would cease taking the
greater and active interest in the general welfare of the Hospital which
before had been his duty. He might even have to remain a mere spec-
tator, while still feeling a certain responsibility for what he did not ap-
prove. On these grounds I have decided to carry out my design, and
give up all connection with the institution.
" Will you permit me, in leaving, to call your attention to a few con-
siderations connected with the internal administration of the Hospital,
all the bearings of which may not be evident to those who are not familiar
with them practically. Were the late Dr. Whittemore still alive, T should
think this unnecessary.
' The Hospital at present is in a <tate of great efficiency, due to its
excellent management for a series of years, and to the thorough and wise
discipline maintained by its late admirable Superintendent, supported in
no doubtful manner by the Trustees. Its traditions and its charities are
at this moment as clean as are its walls and floors. Never have its u
fulness and its reputation been greater than now. For forty years there
lias been no friction in its working. Trustees and staff have always co-
operated t<> the same disinterested ends. And this would naturally last
so long as all questions of personal and private interest were banished,
a- heretofore, from any connection with the Hospital.
"The recent differences have been due to a gradually increasing diver
848 HARVARD MEDICAL SCHOOL
gence of views in the Board of Physicians and Surgeons. Some of its
members desire to see introduced into the Hospital certain new features,
which, although they might prove advantageous to some members of the
Board, others object to, on the ground that any such measures are injuri-
ous to a charitable institution. It is a familiar fact, for example, that
some members of the staff have a desire to use the institution as a home
for their private patients, and in that way make it contribute to their
professional emolument. In my opinion, any such change, however plausi-
bly introduced, will inaugurate for the Hospital an era of decline. An-
other measure relates to the continued attendence of the surgeons out of
their regular term of service. If this practice is once established, besides
leading to confusion in the duties of the house officers and attendants,
and otherwise impairing the discipline of the Hospital, it will in time,
through the repeated admittance of private patients of members of the
staff, inevitably bring with it the question of the payment of fees directly
or indirectly for medical or surgical attendance. Other measures may
be mentioned; one, making Sunday a regular operating day, to the great
inconvenience of the attendants of the house ; and recently another, re-
ducing the number of surgeons to four, instead of six, the number here-
tofore. I have thought it best for the Hospital to oppose all these meas-
ures.
" Knowing that of late years continued vigilence has been needed in the
Board of Physicians and Surgeons to prevent the initiation of any such
changes, I believe that the same viligence will now be needed on the part
of the Trustees. The institution has incurred no obligation to those upon
whom it has bestowed the professional distinction and the great profes-
sional advantages of its medical offices. Its Trustees should weigh care-
fully any measure which would tend to confuse the administration of a
great public charity with the promotion of private interests, or subordi-
nate its general discipline to private convenience. I am confident that a
clear expression of the views of the Trustees upon these subjects would
be of great advantage, for there should be no misapprehension about them.
" Again thanking you, gentlemen, for the honor you have done me, and
with my best wishes for the continued prosperity of the Massachusetts
General Hospital, " I am respectfully yours,
"February 18, 1886." " HenrY J " Bi ^low."
In order to consider Henry J. Bigelow's life as a teacher,
author, and public benefactor, it is now necessary to go back
to 1845. I" ^at year he succeeded Edward Reynolds as Pro-
fessor of Surgery in the Tremont Street Medical School.
Already he had been Instructor in Surgery and Chemistry at
EMINENT ALUMNI 849
that School for about one year. In his early connection with
the Tremont School he gave an illustrated course of lectures
on hernia. For this course he procured rooms near the Har-
vard School in North Grove Street. The lectures were illus-
trated by drawings, dissections and cases, and, as they were
set for the hour at which the lectures in chemistry were given
in the adjoining Harvard School, they proved too great a
counter-attraction for the students. This disconcerting popu-
larity caused displeasure on the part of the Harvard Faculty,
and the lectures were transferred to the Chauncy Place In-
firmary. The transference assured his election as successor
to George Hayward as Professor of Surgery at Harvard, and
he was chosen on April 28, 1849. This appointment proved
to be a great thing for Harvard. Bigelow's surgical ability
was generally acknowledged, and he had shown an interest in
teaching. He was the peer of any physician in Boston at that
time as a microscopist, and had a good knowledge of surgical
pathology. Besides, he had recently received an appointment
as Surgeon to the Massachusetts General Hospital which was,
and is yet, a great advantage to surgical teachers.
He was utilitarian in his teachings, as he was in everything
else. His style was terse, clear, epigrammatic, seldom ora-
torical. He put the subject vividly before his hearers, and
avoided confusing details. He believed that no branch of
education was more essential to the medical student than path-
ological anatomy; to him it was the corner-stone of medicine.
He was profuse in demonstrations both with living and dead
subjects, often making rapid dissections during the lecture,
which with his accomplishments as a draughtsman impressed
the idea presented in a way seldom forgotten. In discussing
any subject he followed no set rules, but gave the studenl what
was useful and material. Fie was as earnest in dealing with
simple ailments as he was in giving the details of major oper-
ations. He believed the greatest good was accomplished in
850 HARVARD MEDICAL SCHOOL
medical education by a constant restatement of undisputed
facts, and by a constant reference of those facts to some broad
principle. In this way, said he, sound judgment is developed,
and nothing is more essential in surgery than this quality of
mind. Without it skill becomes a dangerous weapon.
Another principle of Bigelow's was the value of sight alone
in the diagnosis of fractures. He taught that most fractures
and dislocations have characteristic deformities, and that noth-
ing is gained by their manipulation. Pain is thus avoided,
and to Bigelow few things were more essential than this. It
was to accomplish this that he threw himself into the exploit-
ing of surgical anesthesia. As to fractures, if more informa-
tion was wanted than could be got by inspection, then he ad-
vised etherization. For all surgical treatment his rules were
so simple that they could not be confused or forgotten. Many
practitioners can testify to difficulties in surgical practice from
which they have escaped by recalling some homely phrase or
example used by Bigelow in his lectures. Who ever heard
his words on the diagnosis and treatment of injuries of the
elbow, but has carried it always in mind thereafter? Who
has not found in his impromptu lectures in the ward, the acci-
dent-room and the old amphitheatre, the principles of future
action in practice when called upon suddenly to treat the emer-
gencies of daily experience? Underneath the apparently ele-
mentary nature of his instructions, and the decidedly prac-
tical nature of his teachings, there was a scientific love of
deeper things. With an instinct which followed every clue,
his position as teacher, as microscopist, as surgeon, gave him
abundant opportunities to pursue his research. He undertook
no operation without a previous regional exploration in the
dissecting room, hoping some better way might be found to
increase safety and effectiveness. Nothing escaped his ob-
servation, and lie was constantly striving to shed new light
upon old problems. Witness his exposition of stellate fracture
EMINENT ALUMNI 851
in the lower end of the radius, the mechanism of impaction
in fractures of the neck of the femur, the treatment of un-
united fractures, and of stricture of the urethra. Out of this
practice, this scientific spirit, this patient method, resulted his
two master-pieces, litholapaxy, and the explanation of hip
dislocations. Then there was his work of pathological re-
search in surgical affections. With an artist trained and em-
ployed by himself, he labored for years. Colored drawings
were made of gross and microscopic appearances, as well as
those representing micro-chemical examinations of the va-
rious specimens collected and examined. The drawings were
converted into permanent forms, and preparations were made
to illustrate his life's work. Then, to his dismay, the com-
pleted work of Lebert, "Atlas of Pathological Anatomy," ap-
peared. His object had been accomplished by another, and
his own drawings reverted to the uses of the class room. R.
H. Fitz says that "The beauty of some of these pictures is so
conspicuous, in virtue of color and outline, that one forgets
the repulsive nature of the object, and simply admires the
skill of the artist." These plates, when given to the Medical
School, bore the name of the artist by special stipulation of
the donor.
In his "Notes from Clinical Lectures on Surgery" (1851),
Bigelow shows a love for knowledge which is more than
utilitarian in its object. It was his practice to show a median
section of the head and neck every year to the students for
their instruction, as well as himself to study cleft palate, the
treatment of which was especially interesting him. In these
dissections he noticed the excessive turgescence of the mucous
membrane of the inferior turbinate, and its sudden collapse
while under inspection. From this observation resulted one
of the few additions to human descriptive anatomy made in
this country. He termed it "Turbinated Corpora Caver-
852 HARVARD MEDICAL SCHOOL
nosa."* The spongy nature of this tissue as first pointed out
by Bigelow gives the hint for the treatment now employed in
the use of the cautery for catarrhal and allied affections. The
anatomist, Holmes, said : "This discovery shows that Dr.
Bigelow looked with his own eyes. Thousands of keen-eyed
anatomists had been over the human tody to find something
that no one else had ever noticed. All that region had been
examined by tens of thousands who had never pointed out
that particular structure. It takes the born discoverer to do
such work, — the man who cannot be satisfied till he gets to
the bottom of things."
This same spirit led Bigelow to observe that the same hip
dislocations could be demonstrated year after year on the
same subject, notwithstanding the lacerations which the cap-
sule of the joint underwent. This refusal to wear out was
at first thought due to the protecting of the muscles. In 1861,
however, he noticed that the same conditions existed even
when the muscles were ruptured, the ligamentum teres broken,
and the entire capsule torn away, — with the exception of the
anterior part. That anterior part always remained as a strong
fibrous band, fan-shaped and slightly forked. Here was the
key to the problem of hip-dislocations and their treatment.
He read his observations before the Boston Society for Med-
ical Improvement in 1861. In 1864, before the Massachu-
setts Medical Society, he read a supplementary paper, and in
1865, he presented his third essay at the meeting of the Amer-
ican Medical Association. In 1869 he published a volume,
"Mechanism of Dislocations and Fractures of the Hip, with
the Reduction of the Dislocation by the Flexion Method."
Thus for eight years (1861-1869) he had worked patiently,
giving the whole medical world an opportunity to confirm,
contradict or anticipate him. The medical world took advan-
* " Boston Medical and Surgical Journal," 1875.
EMINENT ALUMNI 853
tage of its opportunities, but Bigelow's work withstood the
test. He had dispelled the darkness which had baffled the
researches of Sir Astley Cooper and others of former times.
Besides his concern with the introduction of surgical anaes-
thesia and hip-joint dislocations, Bigelow was to add another
triumph to his career, and again make humanity his debtor.
In 1878 he published his essay, "Lithotrity by a Single Oper-
ation." In England the school of lithotomy favored by Paget
was rapidly gaining the ascendency over that of Thompson.
Bigelow went to the root of the treatment. First he ques-
tioned the traditional authority for much of the practice con-
cerning lithotrity as then employed. He found erroneous the
belief that the baneful sequelae of the operation were due to
injury inflicted by the lithotrite, and not to the fragments of
stone left in the bladder. This made easy the second point
in his problem : prolong the operation, and get out all the
fragments; make it complete at one sitting. Civiale had re-
stricted each sitting to five minutes, and Sir Henry Thompson
to two minutes. Further experiments convinced Bigelow that
the urethra could be dilated sufficiently to employ "an evacu-
ator which should evacuate." For three years he labored in
experimenting, devising, improving and finally perfecting, an
instrument which would do two things — lessen the danger of
the operation, and shorten the duration of the treatment. The
results were made public in 1878. As with his discovery of
the Y ligament, Bigelow's statements were received with re-
lnctance; for a time the discussion was heated, but all men
came to recognize the truth ; and slowly, even Sir Henry
Thompson admitted that "Crushing stones at one sitting, and
removing all the fragments by the aspirator, has proved the
most successful operation ever practiced in dealing with very
large and hard formations." The "Rapid Lithotrity with
Evacuation," was published in the "American Journal of the
Medical Sciences" for January, 1878. In 1883 the National
854: HARVARD MEDICAL SCHOOL
Academy of Medicine of Paris awarded Bigelow the Argen-
teuil Prize of six thousand francs, the remaining four thou-
sand going to M. Theophile Anger, for another operation on
Peno-scrotal Hypospadias. In 1881 Bigelow was invited to
attend the International Triennial Congress of Physicians and
Surgeons in London. There he received an ovation, and was
made a member of the Clinical Society of London. At home
he was made Emeritus Professor of Surgery at Harvard, and
received from her hands the LL. D. in 1882.
In the Medical Faculty, Bigelow was an important factor.