KENTUCKY’S ORTHOPAEDIC HERITAGE 

Alfred R. Shands, Jr., M. D.
Medical Director Emeritus
Alfred I. Du Pont Institute
Wilmington, Delaware 19899

            Presented at a Meeting of the Innominate Medical Historical Society, Louisville, Kentucky, May 24^th, 1974.

             Only two states in the Union, New York and Massachusetts, have a greater Heritage in orthopaedic surgery than Kentucky.  Without the brains which Kentucky contributed to the specialty in its early days, its development would have been greatly retarded.  The purpose of this paper is to tell you something about this heritage and these brains.

One of Kentucky’s adopted sons, born in New Jersey, was the greatest orthopaedic surgeon of the 19^th century; namely, Lewis Albert Sayre (1820-1900), of Lexington, a graduate of Transylvania of 1838.  Another of her sons did more than any other one of his period to take the specialty out of what was called its “buckle and strap” era, and bring it into the modern day practices; namely, Virgil Pendleton Gibney (1847-1927), of Lexington, another graduate of Transylvania of 1869.  A third son was more outstanding than any other of his time in developing the surgical aspects of the specialty; namely, Russell Aubra Hibbs (1869-1932) of Birdsville.  These three were all national and international shining lights of their day.  No lights shone brighter in the United States in orthopaedic surgery than these three from Kentucky.  Gibney and Hibbs were the heads of the two great orthopaedic hospitals of New York City, Gibney at the Ruptured and Crippled from 1887 to 1924 (37 years); Hibbs at the New York Orthopaedic from 1898 to 1932 (34 years).  Orthopaedics in New York City centered around their teaching and leadership.

            Before telling you about the lives and accomplishments of Kentucky’s orthopaedic surgeons, any historical talk on medicine in Kentucky, particularly surgery, should start with Transylvania and the University of Louisville Medical Schools and their two great surgeons, Benjamin Winslow Dudley (1785-1860) and Samuel David Gross (1805-1884) of which there were no greater in their times.  Both made many worthwhile and outstanding contributions to orthopaedic surgery.

            First Transylvania, where Kentucky’s medical teaching began in 1799, and the first medical degrees were awarded in 1818.  Before the school closed in 1859, 1,881 medical degrees had been given and 6,456 medical students had attended its classes – quite a record for that day.  In 1821, incidentally, Transylvania had become one of the largest Universities in the country, being about the same size as Harvard, but larger than Princeton or Dartmouth.  The Medical School was antedated on the United States by only four; namely, University of Pennsylvania, in Philadelphia, 1765, King’s College in New York, 1767, Harvard, in Boston, 1783 and Dartmouth, in Hanover, New Hampshire, 1798.  It was the first medical school in the Ohio Valley, or what was the West of that day.  The many outstanding doctors on the faculty were the drawing cards for the students.  One of the best histories of the Transylvania Medical School was written by Doctor Gibney’s nephew, Dr. Charles A. Vance, of Lexington, and was given as his Presidential Address before the Southern Surgical Association in 1945.  It was titled, “The Transylvania Medical Library.”  This article is a storehouse of information on early medicine in Kentucky.

            First concerning Benjamin Dudley.  He was born in 1785 in Spottsylvania County, Virginia.  His family moved to Lexington when he was very young.  He took his M.D. degree at the University of Pennsylvania in 1806 at the early age of 21, and then spent four years of study in England and Europe, mostly in Paris.  He must have been a very outstanding young doctor, because it is reported that when he was in France, Napoleon Bonaparte offered him the position of Surgeon-in-Chief of his army, a position which was later filled by the famous Baron Larrey.  When he came back to the United States, it is said that he had a foreign accent in his speech and French manners which he effected the remainder of his life.  He returned to Lexington in 1814 and was appointed Professor of Anatomy and Surgery at Transylvania in 1815, which position in Surgery he held until 1850.  He became world famous as a lithotomist and for his work on the removal of bladder stones.  He made many significant contributions to orthopaedic surgery. Including the use of roller bandages in the treatment of fractures and other conditions.  He was one of the first surgeons in the United States to trephine the skull for relief of epilepsy.  He was considered a pioneer in this field of surgery.  It is interesting that in his day, before antiseptic surgery, he stressed the use of boiling water in surgery, after a very careful preparation of the patient, a forerunner of Listerism.  He was an excellent operator, and was said by some to be unsurpassed as a teacher.  In 1850, at age 65, he retired to his home “Fairlawn,” outside of Lexington, and died in 1860 at the age of 75.

            Next, concerning Samuel Gross.  He was considered by some to have been the pioneer orthopaedist in the Ohio Valley as well as the greatest surgeon of that period.  He was a Pennsylvania Dutch extraction and graduated from Jefferson Medical College in Philadelphia in 1828 in its third class.  He taught in Cincinnati in the 1830’s and came to the University of Louisville in 1840 as a Professor of Surgery.  The University of Louisville Medical School was then only two years old.  The school was rapidly increasing in stature with its eminent faculty, and soon surpassed in prominence the Transylvania Medical School.  Some of Transylvania’s faculty went to Louisville to teach in the new school.  Doctor Gross left Louisville in 1856 to become the Professor of Surgery at Jefferson Medical College in Philadelphia, his alma mater.  He is more often in history associated with Philadelphia than Louisville, but the largest part of his great work was done in Louisville, and not in Philadelphia.  He is certainly one of Kentucky’s foremost medical sons of all time.  While he was here, he did the basic writing for his monumental “System of Surgery,” published in 1859, and the best surgical text in the 19^th century; it had six editions.  The writing of this book took 15 years and 12 of these years he spent in Kentucky.  In Louisville he wrote his book in 1851 on the “Treatise of Diseases of the Urinary Organs” and in 1854 his book “Foreign Bodies in the Air Passages,” both of which were classics.  It is interesting that after he left Kentucky he wrote an excellent “Manual of Military Surgery” which became very popular, being used by the surgeons in both the Northern and Southern Armies.  Gross’s first contribution to orthopaedic surgery was his book published in Philadelphia in 1830 when he was two years out of medical school called “Diseases and Injuries of Bones and Joints.”  This is the first orthopaedic book published in America.  He was the first to use adhesive plaster for extension in fractures and the first to use chloroform in Kentucky.  Gross received many, many honors.  He was the President of the American Medical Association in 1867.  He was one of the founders and first President of the American Surgical Association in 1880, remaining its President for four years.  He was elected the President of the International Surgical Congress held on our 100^th anniversary in Philadelphia in 1876.  He was one of the founders of the Kentucky State Medical Society in 1851 and its President in 1854.  He was very facile writer, a tremendous speaker and was in constant demand to talk at meetings.  There was certainly no one more respected and more looked up to in surgery in the America of his day.  As Sir William Osler (1849-1919) was the greatest physician of his period, so Gross was undoubtedly the greatest surgeon of his time.  He and his family never lost their love for Kentucky and its people.  In 1850 he was asked to be the Professor of Surgery at New York Medical School to succeed the eminent Valentine Mott.  He accepted.  However, he did not like the school, stayed only one year and returned home with his family to Louisville, much to their delight.  Kentucky will probably never have again as outstanding a physician in its medical family as Doctor Samuel David Gross.  Some say, and rightfully so, that he was the greatest surgeon of the 19^th century.

            Orthopaedic surgery was not an established specialty in the United States until the middle and latter part of the 19^th century.  Our first orthopaedic surgeon was Louis Detmold (1808-1894) who came from Hanover, Germany in 1837 to practice in New York.  At about the same time there was John Ball Brown (1784-1862) in Boston who founded in 1938 the first orthopaedic hospital, the Boston Orthopaedic Institution.  However, Boston did not become a national center of orthopaedic surgery until the end of the 19^th century and the beginning of the 20^th.

            In 1839 there came to New York from Lexington, Kentucky, Lewis Albert Sayre (1820-1900) who became the most outstanding orthopaedic surgeon of the 19^th century and was spoken of as the father of American orthopaedic surgery.  He was comparable to Gross in general surgery.  They were good friends.  Doctor Sayre had been born in 1820 in Bottlehill, New Jersey, the son of a wealthy farmer who died when he was ten years old.  He was taken to Lexington to be brought up by his uncle, David A. Sayre, a prominent banker and Presbyterian churchman who was childless.  It was his uncle’s desire that Lewis, who was like a son, should go into the ministry, but Lewis had his heart set on medicine and not religion.  Lewis took his medical degree in 1842 at the College of Physicians and Surgeons in New York.  In 1861, he was one of the prime movers in the organization of the Bellevue Hospital Medical College, and became the Professor of Orthopaedic Surgery, Fractures and Dislocations.  This was the first orthopaedic professorship in any American medical school.  One of the first evidences of Doctor Sayre’s keen interest in problems of orthopaedic surgery was in 1854 when he performed the second successful resection of the hip joint for tuberculosis in this country.  The greatest thing which Doctor Sayre did for orthopaedic surgery was the demonstration of the value of the plaster of Paris jacket in the treatment of tuberculosis of the spine (Pott’s Disease).  In 1874, he completely encased in plaster the entire trunk of a four year old girl with spinal tuberculosis.  Thus began the era of the plaster jacket which soon became known everywhere as the Sayre jacket.  It has been written that this was one of the greatest discoveries in orthopaedic surgery of all times, and that “many a mother and many a surgeon have blessed the name of Lewis Sayre for this plaster jacket, and that this method of treatment marks an era in the history of medicine.”  Doctor Sayre was very well known abroad, and quite popular in England.  In 1877, he wrote a book on “Spinal Disease and Spinal Curvature” while in England.  It was published in London and was dedicated to the medical profession of Great Britain which as he said had “received me with such great personal and professional cordiality.”  It was stated in Great Britain that, “By his forceful teaching, he did more than any other surgeon of his generation to establish the position of American surgery in Europe on a firm basis.”  Doctor Sayre had a very strong personality, an imposing appearance, and an authoritative speech which stamped him as a leader of the first magnitude.  However, he was a controversial figure, probably because of his frankness and sometimes because of his lack of tact and diplomacy.  He was spoken of by Lord Lister as being “the roughest of rough diamonds.”  His writings were prolific.  In 1876 he published what was then the best textbook in orthopaedic surgery, which had two editions; in 1869 he published a book on clubfeet which went through four editions, and in 1877 a book on the spine as mentioned above.  He states in one of his writings that he “must be permitted to question what is

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“In generosity and hospitality and in forcefulness of expression, he was a Kentuckian through and through, even if Bottlehill, New Jersey was his birthplace.  As a student, I became fascinated with his personality, and while in after years our paths diverged, my admiration for his genius never faltered.  I came to know his likes and dislikes.”  Doctor Sayre died in 1900 at the age of 80.  He had three sons, all of whom became orthopaedic surgeons, and one daughter.  It is interesting that his four children all had as their middle name their mother’s maiden name of Hall.  The oldest son, Lewis Hall, who was said to have been the most brilliant and most like his father, died at the early age of 30 from a fractured femur and hemorrhage.  His second son, Charles Hall, died at the age of 40 of a heart attack, and his third son, Reginald Hall, lived to be 70 and in 1898 succeeded his father as Professor of Orthopaedic Surgery at the Bellevue Medical College.  It is interesting that Reginald Sayre, who never married, was an excellent pistol shot.  At the time of his death, he was spoken of in the New York Times, first, as the finest pistol shot in the world, and second, as a well known orthopaedic surgeon.  After Dr. Lewis Sayre died, it was written in the British Medical Journal, “Few men in this generation accomplished so much for the relief of humanity and his name will go down to posterity with that of J. Marion Sims, as amongst the most distinguished benefactors whom the American medical profession has produced for the glory of medicine, and the good of mankind during this century.”  A wonderful tribute to a great physician, a pioneer in orthopaedic surgery, one of the greatest orthopaedic surgeons of all time, and a Kentuckian by adoption.

            The second most prominent in Kentucky’s orthopaedic heritage is Virgil P. Gibney (1847-1927).  Your speaker has a very personal interest in Doctor Gibney as his father trained under Doctor Gibney from 1892 to 1894 at the Hospital for Ruptured and Crippled (R&C) in New York, and your speaker was brought up in the Shands family thinking that there was no one else in the world quite as great as Doctor Gibney, and if you went to heaven, you would find him sitting on the throne right next to God.

            Doctor Gibney was born in Jessamine County, Kentucky on September 29^th, 1847.  His father was Dr. Robert A. Gibney, who was born in Lexington in 1816 and had taken his medical education at Transylvania; he was a general practitioner and an outstanding citizen of Lexington and Nicholasville.  Doctor Gibney’s mother was Amanda Weagley, of Fayette County, born in 1823.  Doctor Gibney’s boyhood was spent in central Kentucky where he received his early education in the schools of Nicholasville.  He had one year at Georgetown College, three years at Transylvania, where he received his A. B. degree in 1869, and 30 years later was given an honorary degree.  The first year of his medical education was taken at the University of Louisville, and the second year at Bellevue Hospital Medical College in New York where he received his M.D. in 1871.  At Bellevue he became greatly impressed with the work and lectures of the dynamic Lewis A. Sayre, and it was Doctor Sayre who definitely influenced him to go into orthopaedic surgery.  In 1871 he became the assistant physician and surgeon at the Hospital for the Ruptured and Crippled (R&C) under Dr. James Knight (1810-1887), one of New York’s pioneer orthopaedic surgeons.  In 1887 he succeeded Doctor Knight as the Chief Surgeon of this Hospital.  Doctor Gibney did not always agree with Doctor Knight, who was extremely dogmatic in his thinking and dictatorial in his methods of conducting the clinical services.  Particularly, he disagreed with Doctor Knight on the treatment of tuberculosis of the hip.  Doctor Knight kept no records and it was said his case histories were all in his head.  Doctor Gibney kept very careful records.  In 1884, without Doctor Knight’s previous knowledge, Doctor Gibney published a book “The Hip and Its Diseases” in which many opinions were expressed contrary to those of Doctor Knight.  Immediately, Doctor Knight asked for his resignation.  The great growth and accomplishments of the R&C took place under Doctor Gibney, and it soon became the foremost institution of its kind in the United States.  It is said that Doctor Gibney had a rare gift of the capacity of foresight for choosing capable associates – men who would become leaders in their respective fields.  The greatest of these was Royal Whitman (1857-1946) whom he brought from Boston as his assistant in 1889.  Doctor Whitman’s name is as famous as that of Doctor Gibney in orthopaedic surgery.  It is said that Doctor Gibney was the first to establish a comprehensive resident training program in orthopaedic surgery.  In 1921, 50 years after he had first become associated with the R&C, he was given a testimonial dinner.  On this occasion, Dr. Charlton Wallace (1872-1946) of whom I will speak later, said that Doctor Gibney had trained 134 residents.  At that time nine were professors of orthopaedic surgery, eight assistant professors, and 18 instructors in medical colleges, a record unequalled by any other teacher in orthopaedics.  All had left the R and C with the greatest admiration and respect for Doctor Gibney, for he was truly a great and enthusiastic physician, and a loyal friend to each one, including his father.  One of his associates wrote that of all his sterling qualities, the spirit of helpfulness and encouragement that he always showed toward the younger men stood out as the foremost.  Doctor Gibney was the first Professor of Orthopaedic Surgery in the New York Polyclinic Medical School in 1882, and in 1894 the first Professor at Columbia University College of Physicians and Surgeons.  He held this position until June, 1917, when he was succeeded by Dr. Russell A. Hibbs, about whom I will talk later.  Doctor Gibney was one of the founders and first Presidents of the American Orthopaedic Association and also it 25^th President.  Doctor Gibney was a prolific writer.  In addition to his well know book “The Hip and Its Diseases,” he contributed over 200 articles to the literature.  He was considered an authority in the treatment of bone and joint tuberculosis, to which subject one-fourth of his articles were devoted.  It is rather interesting that when Doctor Gibney became the Chief of the R&C, there was no operating room.  Doctor Knight believed that major surgery was not often necessary, and when it was necessary, it should be referred to general surgeons.  Immediately after Doctor Gibney took over as Chief, he provided for operating room facilities in the hospital.  Doctor Gibney was fearless in expressing his views, and usually swayed opinion by his diplomatic demeanor.  He was an indefatigable worker with untold energy, and never seemed to tire until his later years.  He was not considered by Royal Whitman to have been the best of surgeons, but he did possess unusual mechanical skill in the design of braces and the use of plaster.  Doctor Knight never believed in the plaster of Paris jackets of Doctor Sayre.  It was not until the 1890’s that plaster jackets were introduced into the R & C Hospital.  Doctor Gibney’s name is still attached to the adhesive plaster dressing for sprained ankles, spoken of as a “Gibney Boot” for which he disclaimed originality.  He said he had obtained the idea from an army surgeon in Texas.

            Doctor Gibney is said to have had a remarkable influence on his patients, most of whom adored him, and waited patiently for his round when his wonderful smile would at once make them feel better, and oftentimes do more good than medical treatment.  Doctor Gibney’s kindly disposition endeared him to everyone he came in contact with.  He was always encouraging the younger men and ever ready to help when called upon.

Doctor Gibney married twice, first in 1883, a school teacher, Charlotte Chapin, from Springfield, Massachusetts by whom there were two sons, Virgil, Jr. and Robert.  She and young Virgil died of diphtheria in 1887, which was the saddest blow in Doctor Gibney’s life.  His second wife was Julian Alvord Trubee, of Bridgeport, Connecticut by whom there were two daughters.  When Doctor Gibney died in June 16^th, 1927, the late Sir Robert Jones of England wrote “from my earliest recollection, Doctor Gibney’s name has been before me as one of the greatest pioneer surgeons in America.  He was beloved in the profession.  Amongst the many hundreds of Americans who came to me in this country, I have never heard a word but of affection in relation to him.  His mind and heart were above all petty things.  His views were broad and generous.  He had a good word to say, or was silent.  What an example of character and achievement to the younger generations of surgeons who looked upon him as the father of orthopaedics.  I always felt so impressed by his modesty in the old days, and I learned much from his teaching.”  When he died, in the Bone and Joint Journal was written, “Doctor Gibney is dead, but his memory liveth, and he lived because he was more than a surgeon.  He was a man with greatness in him.”

            I had the pleasure of editing a book called “Gibney of the Ruptured and Crippled,” most of which consisted of recollections of his son, Robert, about his father.  Doctor Gibney was one of the greatest Kentuckians who ever went to New York.  He was the organizer of the Kentucky Society of New York and was its first President.  A framed copy of “My Old Kentucky Home” always hung over the mantle in his office.

The third great orthopaedic figure from Kentucky is Russell A. Hibbs (1869-1932).  Doctor Hibbs was born in 1869 in Birdsville, southwestern Kentucky.  His mother was Emily Branch from North Carolina.  His grandfather was a Virginian, and had been a physician as well as a bishop in the Methodist church.  Doctor Hibbs worked on a farm in his early days.  He went to Bethel College in Russellville, Kentucky and then entered Vanderbilt University at Nashville where he received his academic degree in 1888.  His father encouraged him to be a doctor, and enrolled him at the Universidy of Louisville where he was graduated in 1890.  He then practiced in Texas for four years before going to New York where he served his first year in the Polyclinic Hospital.  An opening presented itself at the New York Orthopaedic Hospital for a physician to act as a superintendent and house surgeon, which position he accepted.  He started his first orthopaedic training under Dr. Newton Shaffer after going to this Hospital.  In 1898, upon the resignation of Doctor Shaffer, he became the Surgeon-in-Chief when he was 29 years old and continued in this position until after he died in 1932 at the early age of 63.  During this time he was a great leader of orthopaedic surgery in New York and in the country.  HeHe was responsible for the opening of the country branch of the New York Orthopaedic Hospital at White Plains in 1904 and the founding of the New Jersey Orthopaedic Hospital in 1903.  Before he went to the New York Orthopaedic, no major surgery had been allowed, as Doctor Shaffer believed that all major orthopaedic surgery should be done by the general surgeon, as did James Knight at the R & C.  Doctor Hibbs was an excellent surgeon which Shaffer and Knight were not.  His first great contribution to surgery was the technique he described for lengthening the Achilles and other tendons, a very original method.  His greatest surgical achievement came in 1911 when he described an operation for fusion of the spine for tuberculosis.  At the same time, Dr. Fred Albee (1876-1945) described the use of the bone graft for the fusion of the spine.  There was a great argument for many years as to who should have priority for the idea of spine stabilization in tuberculosis and which method was best.  Doctor Hibbs eventually won out, as his procedure turned out to be the most successful one of the two.  He described operations for muscle bound feet, and for a claw foot.  Doctor Hibbs was the first to emphasize the role played in low back pain by an unstable fifth lumbar vertebra for which he described a fusion operation.  In 1923 he described a fusion operation for scoliosis with a report of 59 cases; however, the first operation had been done in 1914.  In 1926 he described his method for fusion of the hip which is said to be his last great triumph in surgery.  In addition to his operations described for fusion of the spine and hip, he also described many satisfactory fusion operations for the knee, ankle, and other joints.  No one in early orthopaedic surgery did more to develop our surgical techniques than Russell Hibbs.

The lectures of Doctor Hibbs were said to have aroused the keen interest of all his students in orthopaedics and made his courses very popular.  He had a very strong personality which left its stamp on every young man who went through his training service.  Doctor Hibbs had the knack of dramatizing his subject, and imparting to his students something of his own enthusiastic interest.  During World War I, he served as a Major in the Medical Corps, and did a great deal of lecturing on orthopaedics at Walter Reed Hospital in Washington to the medical officers receiving training in orthopaedics.

Doctor Hibbs was a genius at organization and administration.  He developed his hospital into an institution unique in its efficient management.  It was written that his hospital was a monument to his honor, more enduring than brass, and worthy of the highest ambitions in which a mortal can aspire.  Doctor Hibbs died in September, 1932 at 63.

The last of Kentucky’s transplanted and famous orthopaedic sons I wish to talk about is Dr. Charlton Wallace (1872-1946), a cousin of Doctor Gibney.  He was born in Lexington on October 18^th, 1872.  His father was John B. Wallace, and his mother, Lucy Wilhoit Sims.  He went to Transylvania Academy and then to Transylvania University where he received his B. A. in 1894.  He took his medical degree at the College of Physicians and Surgeons at Columbia in 1898; he was elected to be the permanent president of his medical class, and indication of the great respect of his classmates.  He took his training in orthopaedic surgery at the R & C under Doctor Gibney.  He then assisted Doctor Gibney in his office practice and became an attending orthopaedic surgeon at the R & C.  His prime interest was always crippled children.  One of the great things which Doctor Wallace did in the New York area was to help to establish and become the Surgeon-in-Chief of the St. Charles Hospital for Crippled Children at Port Jefferson, New York.  He also was connected with the Sea Breeze Hospital at Coney Island, which was known for the treatment of surgical tuberculosis in children.  He was a member of the staff of the Reconstruction Hospital in New York, and in 1929 became the Surgeon-in-Chief of the New York State Reconstruction Home for Crippled Children at West Haverstraw, which has since become one of the great orthopaedic institutions of the country.  He was Professor of Orthopaedic Surgery at Cornell University Medical School for 22 years, from 1913 to 1935, and at the time of his death was Professor of Orthopaedic Surgery at the New York Polyclinic Medical School and Hospital.  He was the author of more than 20 articles on orthopaedic surgery, and many of these had to do with crippled children and their education.  He had been a very active member of the American Orthopaedic Association.  Doctor Wallace was an excellent speaker and teacher, and was extremely popular.  He died at his home in Chappaqua, New York on August 19^th, 1946.

We now come to two sons of Kentucky who practiced orthopaedic surgery in Louisville.  The first of these was Dr. Ap Morgan Vance (1854-1915), born in Tennessee in 1854 and graduated in medicine in 1878.  He first was in the office as an associate with the well known Dr. D. W. Yandell.  He was said by Dr. Irvin Abell to have been “the first in Kentucky to limit his practice to surgery, and for years the only one devoting special attention to orthopaedics,” in which it was stated he was especially adept.  He made many pioneer contributions,  including a subcutaneous femoral osteotomy for hip deformity described in 1888.  He also wrote on tenotomy for congenital clubfeet, and reported a brace for the treatment of tuberculosis and lateral curvature of the spine.  He was “one of the first in Kentucky to espouse the cause of asepsis and his operations were always characterized by the technique of a finished workman,” writes Doctor Abell.  He was offered many teaching positions, but chose, as he said, to remain “a free lance.”  He was a rugged individualist which won for him an enviable reputation in the esteem of his profession.  He was a great public spirited person.  He was one of the founders and chief benefactor of the Children’s Free Hospital in Louisville, in which a memorial ward was established after his death.  He was a member of the commission which erected the Louisville Public Hospital, which, it is written, was in a large measure a tribute to his efficient supervision.  He was one of the founder members of the American Orthopaedic Association in 1887, and in 1890 was its Vice President.  He was President of the Kentucky State Medical Association the year of his death in 1915.

The second most prominent Kentuckian who practiced in Louisville in more recent years was the much beloved William Barnett Owen (1880-1947) who many of you tonight must remember well.  Doctor Owen was born in 1880, in Hart County, Kentucky, the son of Mr. and Mrs. Jordan Owen who moved to Louisville in 1893.  He was graduated from Kentucky University Medical School in 1903, and went to New York to take his orthopaedic training under Doctor Gibney at the Hospital for the Ruptured and Crippled.  His wife was a niece of Doctor Gibney’s and was always spoken of by her many friends as “Miss Emily.”  Barnett began practice in Louisville in 1906, where the entire 40 years of his professional life was spent.  One of his great accomplishments was his part in the founding of the Kosair Crippled Children’s Hospital.  Early in his career, he realized the many advantages of having a hospital for crippled children.  In conjunction with the Kosair Temple of the Shrine, he organized the Kosair Hospital which was opened in 1925 with Doctor Owen as the Chief of Staff.  This position he held until his death in 1947.  Under his able direction and guidance, the hospital developed into a most modern institution of over 100 beds.  It soon had a very enviable national reputation.  He was Professor of Orthopaedic Surgery at the University of Louisville and Chief of the Orthopaedic Service at the Louisville General Hospital.  Barnett was a very active member of the American Orthopaedic Association, and also the Southern Surgical Association.  He was Chairman of the American Medical Association Orthopaedic Section in 1932, Chairman of the Southern Medical Orthopaedic Section in 1922, and President of the Clinical Orthopaedic Society.  Barnett Owen was not a prolific writer, but what he wrote was extremely well done.  Your speaker knew Barnett very well, and also knew about his many accomplishments for the crippled child in Kentucky, including the part he played in the founding of the Kentucky Crippled Children’s Commission and the Kentucky Crippled Children’s Society, both of which have been so effective in the State’s programs for the care and education of handicapped children.  He died in 1947 much too soon at the age of 67, and is certainly long to be remembered in Louisville and all of Kentucky for the great contributions he made to orthopaedic surgery and the crippled child.

There are two of Kentucky’s older sons I should like to mention, though not orthopaedic surgeons, contributed a great deal to the specialty.  The first of these is Dr. Walter Brashear (1776-1860), who became quite skilled and successful in the treatment of diseases of bones and joints and fractures.  When he was practicing in Bardstown in 1806, he performed the first hip joint amputation in the United States.  This patient was a negro boy of 17 who had a very bad fracture of the femur with severe lacerations of the soft parts.  He was also known for his success in trephining the skull.  Most of his life was spent in Lexington, being associated with the Transylvania Medical School.  He was born in 1776, and received his medical degree from the University of Pennsylvania in 1799, and died in 1860.  There is a story that on one occasion when he was in China in 1799 he amputated a woman’s breast, probably the first operation of its kind in China.  The woman was of noble rank, and it was said that for three days he stayed with his patient, being kept prisoner in the palace and if the woman had died, there was a good possibility that he would have lost his own life.  He knew this at the time he did the operation, so it must be said that he was fearless and had great courage.

In Louisville there was a Dr. S. E. Richardson, who was very interested in problems of bones and joints, and in 1840 published a very good essay on tenotomy with illustrated cases.  This was referred to in the textbook of Doctor Sayre, mentioned above.  I have not been able to find out anything else that he did, but the article is so well written that I am sure he must have had a very broad interest in the many problems of bones and joints.

Mention should be made of three others from Kentucky.  One was Doctor Gibney’s nephew, Dr. Charles A. Vance, of Lexington, a graduate of Transylvania of 1900, who decided after working with his uncle in New York that he would come back to Lexington to do general practice.  Later he decided to become a general surgeon, and he became a good one.

The second is Dr. Frank P. Strickler, of Louisville, who after spending a year as a resident (1915-1916) with Doctor Gibney at the Ruptured and Crippled Hospital, came back to Louisville, and became one of the outstanding, traumatic and industrial surgeons of your city.  Doctor Strickler I used to know and see at meetings of the Southern Surgical Association.

The third is Dr. Lewis Clark Wagner, who was born in 1895 in Nicholasville, took his M. D. at Johns Hopkins (1921) and after training at the R & C under Doctor Gibney, became his last office associate.  When Doctor Gibney died in 1927, Doctor Wagner inherited his practice.

I am sure there are many others I have not mentioned who should be included, for which omission I apologize.  Kentucky has a great heritage in medicine and few states can boast of as great a heritage in orthopaedic surgery as Kentucky, for which Kentucky should be justly proud.

In conclusion, I want to say what a pleasure it has been to have spoken to you tonight, and to thank the Innominate Club so much for inviting me to talk at their annual dinner on my favorite subject, our orthopaedic heritage.

I thank you.