BONE AND JOINT SURGERY xxix
and demonstrated its value to his colleagues, including Moore, then pro- fessor of surgery, in Buffalo, in a number of cases including difficult hip- joint dislocations.
The modern operative treatment of osteomyelitis is usually credited to Brodie, but Nathan Smith ("Philadelphia Monthly Journal of Medicine and Surgery," 1827, vol. i) operated at an earlier date. His description of the pathology and symptoms is interesting and his suggestions as to trephining early in the disease and removal of sequestra later in the disease by Hey's saw and bone forceps, does not differ greatly from modern practice. His son, T. Morven Smith ("American Journal of the Medical Sciences," 1839, vol. xxiii), later called attention to the value of his father's method which had attracted little attention in surgical centers, and reported four successful operations. But antedating even Smith, are the operations of Benjamin B. Simons (" Carolina Journal of Medicine, Science and Agriculture," 1825, vol. i), who reports a series of six cases in which sequestra were removed by Hey's saw or trephine and seven cases of trephining and removal of dead bone from the medullary cavity of long bones.
Brain operations were very seldom performed except for fractures of the skull, before the time of the introduction of anesthesia. Benjamin Winslow Dudley deserves mention as one of the first surgeons to success- fully trephine for the relief of epilepsy. He operated upon his first case in 1819 and afterwards reported six successful cases of trephining for this condition ("American Journal of the Medical Sciences," 1832, vol. xi). Dudley was also a famous lithotomist, having operated upon two hun- dred and seven cases with the loss of only six patients. Dudley was born in Virginia in 1785. He studied under Sir Astley Cooper, Abernethy and Klein; in Paris under Baron Larrey and Boyer. He was professor of surgery in Transylvania University, Lexington, Kentucky, and he performed successfully practically all of the operations in surgery which were known in his day.
In 1858 Carnochan ("American Journal of the Medical Sciences," 1858, vol. xxxv), of New York, reported his method of resection of the superior maxillary nerve beyond Meckel's ganglion for neuralgia.
Probably the first operation for brain abscess was by Benjamin B. Simons ("Carolina Journal of Medicine, Science and Agriculture," 1823, vol. i). The abscess followed a fall and injury of the skull. The patient lay comatose for about six months when a superficial abscess was opened. Simons did not see the patient until twelve months after the accident. He found pus escaping from a small opening, trephined and evacuated a large abscess. At the time of the operation, he inserted his finger into the cavity in the brain for about two inches and found that by making
