With the organization of the new medical school at the University of Chicago in 1927, Dr. Phemister entered upon the most significant work of his career. The university asked him to undertake the task of organizing a department of surgery, whose members were to devote all their time to teaching and investigation as well as to clinical work. Convinced that this concept of a full-time medical faculty was an important new principle, Dr. Phemister accepted the challenge.
While awaiting the completion of the buildings of the university clinics, he went to Europe for further study. In London he began his work on operative shock, a subject to which he made contributions of the greatest importance through the subsequent years.
With the opening of the University of Chicago School of Medicine, came the most productive years of his career. Not only did he make many contributions to knowledge, but by his example, he stimulated others who came under his influ- ence to do likewise. His research on bone tumors, infections, bone growth and repair, bone trans- plantation and aseptic necrosis of bone radically altered the surgical care of patients with skeletal disorders. Although bone and joint disease remained his primary interest throughout his life, other fields too were affected by his investiga- tions. He was the first successfully to remove the esophagus, in case of carcinoma, with re- establishment of continuity by anastomosis with the stomach. His studies on the formation and constituents of gallstones were fundamental. His early recognition of the need for blood replace- ment in surgical shock helped to revolutionize the surgical management of patients injured or con- valescent from operation and made possible the greatly expanded surgical treatment that we know today.
Dr. Phemister’s own accomplishments in the medical sciences would alone be sufficient to earn him a high place in medical history. He was most profoundly influential, however, as a teacher. His personal qualities of intellectual honesty, tireless energy, generosity, dignity, and simplicity deeply affected all who came in contact with him. He taught always by example, whether dealing with undergraduate students, residents, or staff doctors. His forthright honesty and con- stant striving for improvement in knowledge and methods stimulated generations of students.
To the many scientific societies in which he took an active part, he brought the same high qualities.
Dr. Phemister’s achievements won him every recognition in the medical world. He occupied positions of distinction in the surgical societies of the United States and in international associa- tions. Many foreign societies conferred honorary memberships upon him. These honors he received with characteristic humility and always with a deep sense of obligation. His greatest personal satisfaction was to observe the growth and success of a student or an associate.
On December 28, 1951, the medical world was saddened by the death of Dallas B. Phemister.
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Who’s Who in Orthopedics
Nikolai Ivanovich PIROGOFF
1810–1881
Nikolai Ivanovich Pirogoff was one of the great- est surgeons of the nineteenth century. He is not well known in the English-speaking world since his contributions to the surgical literature were written in Latin, Russian, French, and German and have not been translated into English. His eponym is attached to an osteoplastic amputation of the foot in which the heel pad is affixed to the distal tibia utilizing a portion of the os calcis to form an end-bearing stump. In Russia, he had an enormous influence on medical practice and education.
Pirogoff was born in Moscow, the 13th child in
his family. After a private primary education, he
was admitted to the University of Moscow to
study medicine. Then, as now, universities
were centers of liberalism and opposition to
conservative governments. It was during his student days that Pirogoff developed a progres- sive point of view. The standard of medical edu- cation at the University of Moscow at that time was very poor. After graduation, he was selected for further training at the University of Dorpat in Estonia, where the teachers were mostly German.
He stayed there for 5 years and during these years he studied anatomy and experimental surgery. He then had the opportunity to study for 2 additional years in Berlin and Gottingen.
Upon his return to Russia in 1835, Pirogoff hoped for an appointment as professor of surgery at the University of Moscows but was forced to accept a similar but less prestigious position at Dorpat. He stayed in this position for 5 years, with only a leave of 5 months for study in Paris in the clinic of Velpeau. In 1840, he became professor of surgery at the Medico-Chirurgical Academy in St. Petersburg. During the next few years, he established a reputation as the leading surgeon in the community as well as an outstanding teacher.
With a mind always open to new ideas, he was one of the earliest European surgeons to adopt the use of ether anesthesia. In 1847, he described the administration of ether per rectum to produce anesthesia.
During the war in the Crimea, Pirogoff was made the Surgeon General in charge of the medical establishment in Sevastopol. With the help of the Grand Duchess Elena Pavlovna, he was able to introduce female nurses into the military hospitals at the same time Florence Nightingale was doing so in the British military hospitals. The collaboration of Pirogoff and the Grand Duchess laid the groundwork for the estab- lishment of the Russian Red Cross. Pirogoff was the first surgeon to use plaster of Paris dressings for the treatment of fractures in war casualties. On the basis of his experience, he believed that open fractures should be immobilized in plaster of Paris dressings as quickly as possible and before evacuation to the field hospitals. The results of his work in the Crimea were incorporated in his book,
Principles of General Military Field Surgery.The period immediately after the Crimean war was one of frantic activity. During this period, Pirogoff published the description of his osteoplastic amputation (1854), a three-volume book on clinical surgery (1851–1854), and his important atlas of cross-sectional anatomy (1852–1859). This latter work, based on sections taken through frozen cadavers, was introduced as a teaching tool. It opened a new approach to the
visualization of anatomic relationships and was widely adopted. Cross-sectional anatomy participated in the general decline of interest in gross anatomy on medical school curricula, but the introduction of computed tomography and nuclear magnetic resonance scans has revived interest in this aspect of gross anatomy.
In 1856, tired of the political battles and intrigues of the medical school, Pirogoff resigned his position and became the inspector of educa- tion of southern Russia. In this role, he traveled extensively and made a valiant effort to improve the educational system under his direction. Retir- ing 5 years later, he spent the next 5 years living in Berlin and Heidelberg. Upon returning to Russia, his liberal, western views were out of step with the trend toward conservatism following the assassination of Alexander II, and he retired. He died of a cancer of the mouth.
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