RICHARDSON 977 RICHARDSON wrote abdominal surgery grew pari passu. He frequently attended medical societies, and wrote for journals covering a wide range of subjects. He was original, incisive and notably frank in acknowledging mistakes. One of his first papers describes a gas- trotomy in 1886, for a set of false teeth low down in the esophagus. He opened the stom- ach and pulled the plate out through the car- diac end and through the stomach, the first gastrotomy for the removal of a foreign body in the esophagus. In 1887 he reported fifteen laparotomies; in addition to the case just mentioned nine were ovariotomies. When R. H. Fitz (q. v.) pointed out the re- lation of the appendix to perityphlitis and peri- tonitis, Richardson was quick to see its surgical importance and became an early champion of operative treatment ; his relationship with Fitz remained intimate through life. In 1892 he was able to draw conclusions from eighty-one of these cases, forty of which were treated by operation; in 1894 he had 181 cases, and in 1898 as many as 757. From the study of his acute cases he was early convinced of the need for the removal of an appendix, the subject of previous attacks. His numerous papers on the appendix educated the profession in the diag- nosis and the demand for early surgical intervention. Numerous papers also testify to his keen interest in diseases of the gall-bladder and biliary system. His first successful cholecys- totomy was published in 1889. A second paper in 1892 reported ten operative cases. From this time on the diagnostic and surgical difficulties presented by these cases formed the subject of repeated communications, which re- main a substantial part of the foundation on which surgery of the biliary tract rests today. His various papers cover nearly the entire range of abdominal surgery, as well as other surgical subjects. Papers may be particularly mentioned on the stomach, pyloroplasty, pylorectomy and espe- cially a successful total gastrectomy (1898); on pancreatitis and pancreatic cysts; on in- testinal obstruction, intestinal resection, lateral anastomosis and idiopathic dilatation of the colon; on omentopexy, and on tuberculosis of the m.esenteric glands ; on nephrectomy, neph- rorrhaphy, renal stone; intra-peritoneal cyst- otomy, ureteroplasty, ureteral implantation ; on ovarian tumor with twisted pedicle, extra- uterine pregnancy, the surgical treatment of fibroids, and cancer of the uterus. He was at one time much interested in cranial and nerve surgery, shown by writings on brain tumor, removal of the Gasserian ganglion, nerve suture and spasmodic torticollis. Other subjects were: "Diverticulitis of the Oesoph- agus, With Two Cases of Successful Resec- tion," "Cancer of the Breast and Acute and ' Chronic Empyema." Later studies deal more with surgery in its wider aspects, its dangers and responsibilities; the relation of the surgeon to his patient, and his profession ; the importance of an alert con- servatism. In these he sounded a note of warning to a profession flushed by its successes in the new fields. A systematic treatise on surgery of the ab- domen was planned and partly worked out, but never finished. His most comprehensive arti- cles were a contribution to Park's "Surgery by American Authors," 1895 ; on "Surgery of the Abdomen and Hernia," and to "Dennis' System of Surgery" in 1896 on "Surgery of the Ali- mentary Tract." He had a large practice, and never sought to make life easy, being ever ready to respond promptly to any call to operate in nearby towns or at a distance, trips both time-con- suming and exhausting. He subscribed to and used the Corey Hill Hospital, Brookline, in 1904, but in the later years he distributed his patients in several small hospitals. Added to a strenuous private practice were hospital practice and teaching in the medical school, and the result was that day after day was spent in vain effort to catch up with his en- gagements ; writing was done custoinarily in the early morning, or at intervals between operating. As a teacher has talents lay in clinical lec- tures and demonstrations, and he was at his best demonstrating a case, or an anatomical region, or a method, before students, illustra- ting by rapid accurate blackboard sketches, often using both hands. His personality in- spired and stimulated students, and few will forget his insistence on the responsibilities and dangers of surgery, and on the importance of exact knowledge of anatomy and living path- ology. Dr. Richardson, as a member of the Amer- ican Medical Association, was chairman of its surgical section, in 1904, a member of the Southern Surgical Association, and president of the American Surgical Association in 1902, and a charter member of the International Surgical Society. Physically he was well adapted to the strain and demands of his life. As a young man his strength and endurance were remarkable, and
