MEDICAL SCIENCES.

By Dr. Edmond Souchon, Professor Emeritus of Anatomy, Tulane School of Medicine; read at the Meeting of the Louisiana Historical Society on December 15, 1915.

A BIOGRAPHIC STUDY.

By original contributions is meant something new that has never been done before by somebody else.

It is physically utterly impossible for people engaged in the prosaic money-getting pursuits to realize, even faintly, the tremendous significance that the intellectuals-that is, those engaged in the sciences, literature and the arts, attach to the word original. To have done something original, ever so little, is to them the supremest achievement. They feel as if by creating something new they are singled by the finger of God from the common herd and lifted up by the great Creator himself, to be one of the anointed. Thousands of wretched deluded mortals have suffered eternal poverty in the mad hope to attain this goal, ever vanishing to so many of them like the mirage in the desert. Worse than all, many have inflicted pitilessly the most cruel privations in that attempt, upon those they should love the most, their wives and children.

The supreme and lofty contempt of the often dirty, hirsute creatures, oddly clad, shown by the ordinary money people is something stupendous.

For some time past I have been devoting much time to the study of Original Contributions of America to Medical Sciences. I was exceedingly happy and proud to find that Louisiana, with twenty-nine original contributors comes on a par with the great old populous cultured city of Boston which presents also twenty-nine original contributors.

All the contributors belong to the City with but one exception, that of Dr. Francois Prevost of Donaldsonville, who was the first to perform Cesarean Section in America in

about 1830. Cesarean Section is an operation consisting in cutting through the belly and the womb to remove a child when the natural passages are obstructed. He operated four times successfully, losing but one mother, and operating twice on the same woman.

In the New Orleans Medical and Surgical Journal of June, 1879, page 933 is a record of Cesarean operations that have been performed in the State of Louisiana during the present century, by Dr. Robert P. Harris of Philadelphia. Dr. Harris says:

As the State of Louisiana has the honor, so far as it is possible to ascertain, to have been the pioneer in Cesarean Section in the United States, so also is she to be credited with the largest number of operations, and the longest record of successes, of any of the States. In fact, after a laborious search covering some ten years, by which the number of cases recorded has been more than doubled, I have reason for believing that in no section has there been a larger proportion of the lives saved. Nine cases are all that were published in the medical journals of our country, as having been operated upon in the State; and of these but one was fatal to the mother, although four of the children perished.

At present we have no record earlier than that of Dr. Francois Prevost, who was born at Pont-de-Ce, in the South of France, about the year 1764; graduated in medicine at Paris; settled in San Domingo; was driven out during the insurrection; escaped to Louisiana, and spent the balance of his days at Donaldsonville, where he died in 1842 at the age of 78. How early in his career in Louisiana, he performed the operation of Cesarean Section, I know not, but do know that he was at last credited with the four cases I have given him. As he was a bold operator, and was 67 years old when he operated on the fourth case, it is probable that he may have had others prior to the first on our record, for he was engaged in an active practice for more than thirty years, in a district in which rickets was not uncommon as

a case of dystocia. Dr. Prevost pointed out to Dr. Cottam, a boy 6 or 7 years old as one of the results of his Cesarean deliveries.

Dr. Thomas Cottam, now of New York, became the successor in practice of Dr. Prevost, in 1832, and fell heir to his books and instruments at his death ten years later. In letters received from him in March and April, 1878, says Dr. Harris, and at a subsequent personal interview, I obtained the accounts of Prevost's cases. Dr. Cottam stated that there could be no question as to the performance of the two operations on the same woman, with safety to herself and children. Dr. Prevost being an old man when Dr. C. first met him, and of a peculiarly reticent nature, will account for the latter not having been fully informed upon the Cesarean cases of the former. In one case (1831) Dr. Francois Prevost operated on a woman, a black, a slave of Madame Cadet Marous, aged about 28 or 29, named Caroline Bellau or Bellak, in second labor; the first child, a male, having been delivered, as nearly as can be ascertained, by craniotomy and evisceration. Dr. Prevost made his incision in the left side of the abdomen, and removed a female child, that lived, grew up, married, and was residing a few years ago in New Orleans. The child was a mulatto, and Dr. Prevost gave it the name of Cesarine, and stipulated with Madame Marous that if it lived it should have its freedom, which was acceded to and subsequently given.

Caroline made a good recovery, as the operation was elective, and performed in good season, and lived until Cesarine was nearly grown up. Dr. Cottam first saw them both in 1832, and examined the cicatrix of the former. The mother is described by some of her contemporaries as "a rather stout, black woman, who carried herself erect."

A curious plantation rumor was started about this woman, at the time of the operation or soon afterwards, to the effect that she had been operated upon in the same way some six or seven times; and this was found to be still credited a year ago among some of the old quondam slaves

of the time, then living in the vicinity. It required a long search, writes Dr. Harris, and numerous letters and interviews, before the facts could be separated from the fiction in this case, for which I am much indebted to Dr. John E. Duffee, of Donaldsonville, Dr. Cottam, and others."

It was quite a daring feat for a country doctor to perform such an operation and quite in keeping with Dr. McDowell, of Kentucky, who boldly first performed an ovariotomy. It is truly most remarkable that two of the most formidable operations in surgery were performed by two country doctors without hospital training of much consequence. Those two great men were the founders of abdominal surgery which has reached such a grand position in modern surgery. It is eminently and most undoubtedly an American product.

Dr. Dubourg, who practised in New Orleans in the thirties, is credited by Dr. Ernest S. Lewis, of this city, to be the first to have performed vaginal hysterectomy, but this is also claimed for others, specially Dr. T. Gaillard Thomas, of New York. Vaginal hysterectomy is the removal of the womb through the natural passages. Dr. Dubourg was an old surgeon of the Imperial Guard of Napoleon. I could obtain no further data regarding this bold surgeon who performed a capital operation surely without knowing that anyone had preceded him in America.

Dr. Charles Aloysius Luzenberg (1805-1848) was the first to remove a portion of gangrenous intestines in a case of hernia and to suture the end of the bowel successfully. He was born in Verona, Italy.

Although a foreigner (Italian) Charles Luzenberg, a great surgeon of New Orleans may be claimed by America, for his father, an Austrian military commissariat, left Germany when his son was fourteen and settled in Philadelphia, sparing no expense to complete the fine education the boy had begun in Landau and Weissemberg. Attending the lectures and operations of Dr. Physick brought out still more young Luzenberg's surgical genius.

A paper which appeared in the tenth volume of the "American Journal of Medical Sciences" and the "Revue Medicale" for 1832 proves that if Luzenberg did not first bring into notice what was then a new idea, that is, of excluding light in various variolous disorders to avoid pox marks, he at all events revived it.

Two whole years, 1832-4, were spent studying in European clinics, particularly under Dupuytren, and on his return to New Orleans, full of zeal and schemes for improving surgical and medical procedure, he built the Franklin Infirmary, later the Luzenberg Hospital on Elysian Fields Street and there did operations which brought patients from afar to get the benefit of his skill. Among such operations was the extirpation of a much enlarged cancerous parotid gland from an elderly man. This case, reported in the "Gazette Medicale de Paris," 1835, brought a commendation with a resolution of thanks to the author and enrollment as corresponding member of the Academie de Medicine. Soon after, he excised six inches of mortified ileum in a case of strangulated hernia. The patient was put on opium treatment and in thirty-five days the stitches came away and he entirely recovered. One other operation he took special interest in doing was couching for cataract and in this he had brilliant results.

When Luzenberg had his hospital on a permanent basis. his next idea was a Medical School. Being influential, and also friends with the State Governor, this project, with the help of his medical confreres, was soon embodied in the Medical College of Louisiana with himself as dean, ad interim, and professor of Surgery and Anatomy. He was the first professor of Surgery of the University of Louisiana. He founded the Society of Natural History and the Sciences and to it bequeathed a rich collection of specimens. When the Louisiana Medico-Chirurgical Society was legally incorporated he was, because of his help in forming it, chosen first president. It held brilliant meetings at which the French and English physicians of the State met to exchange