Fin de Siècle: Marvels of the Age

  • Thomas S. HellingEmail author
  • Daniel Azoulay


Across the Atlantic surgery had entered a new era. “[T]he progress of surgery in the past twenty years is one of the marvels of the age. Anaesthetics [sic] and the outcome of antiseptics have stimulated the phenomenal development of this branch of medical sciences” so proclaimed Dr. Ernest Lewis in his presidential address before the Southern Surgical and Gynecological Association in 1896 [1]. And to that effect, American surgeon William Williams Keen (1837–1932), Professor of Surgery at the Jefferson Medical College in Philadelphia, had encountered a 53-year-old woman in February of 1897 who had noticed a tumor “at the pit of her stomach” 5 years ago. Keen was a well-educated physician, having attended Brown University as an undergraduate and Jefferson Medical College, graduating in 1862. However the year prior he had been sworn into the Army as assistant surgeon. Shortly thereafter he found himself near Manassas Creek for the first engagement of the American Civil War. “My experience in this battle,” he later wrote, “is a good illustration of the utter disorganization … of our entire army at the beginning of the war” [2]. After his graduation from Jefferson in March 1862 (apparently a two-year course of study) Keen returned to military duty until the end of the war, caring for the horrible wounds, gangrene, and secondary hemorrhages that the times before antisepsis created.


  1. 1.
    Lewis ES (1897) The President’s address. Trans Southern Surg Gynecol Assoc 9:1–8Google Scholar
  2. 2.
    Keen WW (1905) Surgical reminiscences of the civil war. Trans Coll Phys Philadelphia 27:95–114Google Scholar
  3. 3.
    Warner JH (1998) Against the spirit of system. Johns Hopkins University Press, Baltimore, p 304Google Scholar
  4. 4.
    Keen WW (1892) On resection of the liver, especially for hepatic tumors. Boston Med Surg J 126:405–409CrossRefGoogle Scholar
  5. 5.
    Keen WW (1897) Removal of an angioma of the liver by elastic constriction external to the abdominal cavity, with a table of 59 cases of operation for hepatic tumors. Pennsylvania Med J 1:193–204Google Scholar
  6. 6.
    Keen WW (1899) Report of a case of resection of the liver for the removal of a neoplasm with a table of seventy-six cases of resection of the liver for hepatic tumors. Ann Surg 30:267–283CrossRefGoogle Scholar
  7. 7.
    Kousnetzoff M, Pensky J (1896) Sur la Resection Partielle du Foie. Rev Chir 16:954–992Google Scholar
  8. 8.
    Tillmanns H (1901) A textbook of surgery. Appleton and Company, New York, pp 79–80Google Scholar
  9. 9.
    Paquelin C-A (1876) Sur un Nouveau Thermo-Cautere. Compt rendus seances de l’Academie des Sciences 82:1070Google Scholar
  10. 10.
    Suckley G (1858) Notes on the practice in the hospitals of Paris: the “Ecraseur”, “electric cautery”, Maisonneuve’s method of diviving strictures, etc. Atlanta Med Surg J 3:656–670Google Scholar
  11. 11.
    Keen WW, White JW (1899) An American text-book of surgery for practitioners and students. W.B. Saunders, Philadelphia, pp 780–784Google Scholar
  12. 12.
    Kocher T (1907) Chirurgische Operationslehre. Jena, Gustav Fischer, pp 829–833, quotes 831, 832Google Scholar
  13. 13.
    Wagner FB (1989) Thomas Jefferson University: tradition and heritage. Lea & Febiger, Philadelphia, p 539Google Scholar
  14. 14.
    Tiffany LM (1890) The removal of a solid tumor from the liver by laparotomy. Maryland Med J 23:531Google Scholar
  15. 15.
    Tiffany LM (1890) Surgery of the liver. Boston Med Surg J 23:557Google Scholar
  16. 16.
    von Bergmann E (1893) Zur Cauistik der Leber-Chirurgie. Verhandlungen der Deutschen Gesellschaft fur Chirurgie, 22nd congress. Berlin, August Hirschwald, pp 218–238Google Scholar
  17. 17.
    Pantaloni JA (1899) Chirurgie du Foie et des Voies Biliares. Institut de Bibliographie Scientifique, Paris, p 184Google Scholar
  18. 18.
    Körte W (1905) Beiträge zur Chirurgie der Gallenwege und der Leber. August Hirschwald, Berlin, pp 261–267Google Scholar
  19. 19.
    Terrier F (1901) Chirurgie du Foie et des Voies Biliares. Felix Alcan, Paris, 32, 199Google Scholar
  20. 20.
    Doyen E (1892) Quelques Operations sur le Foie et les Voies Biliares. Arch Provinc Chir 1:149–178Google Scholar
  21. 21.
    Ceccherelli AB (1894) Nuovo Processo di Sutura per l’Emostasi del Fegato. Atti d. Cong. Med Internaz Sez Chir 4:188–191Google Scholar
  22. 22.
    Segale G (1900) Nouveau Procede pour l’Hemostase du Foie au Moyen d’une Suture Speciale Enchevillee. XIIIe Congrès International de Médecine. Masson, Paris, pp 254–259Google Scholar
  23. 23.
    Anschütz W (1903) Uber die Resektion der Leber. Sammlung Klinischer Vortrage, Chirurgie, pp 451–530Google Scholar
  24. 24.
    Wendel W (1911) Beitrage zur Chirurgie der Leber. Arch f Klin Chir 95:887–894Google Scholar
  25. 25.
    Tinker MB (1935) Liver resection: case report and advantages of radiocutting. Ann Surg 102:728–741CrossRefGoogle Scholar
  26. 26.
    McDill JR (1912) Bloodless surgery of the liver: an experimental study of the possibility of excision of maximum amounts of liver tissue, with the usual instruments at hand in any hospital. Trans Am Surg Assoc 30:106–119Google Scholar
  27. 27.
    McDill JR (1912) Bloodless operations on the liver. Ann Surg 56:333–335CrossRefGoogle Scholar
  28. 28.
    Garrè C (1907) On resection of the liver. Surg Gynecol Obstet 5:331–341Google Scholar
  29. 29.
    Miln DC (1964) James Hogarth Pringle, 1863-1941. Br J Surg 51:241–245CrossRefGoogle Scholar
  30. 30.
    Pringle JH (1908) Notes on the arrest of hepatic hemorrhage due to trauma. Ann Surg 48:541–546CrossRefGoogle Scholar
  31. 31.
    Ponfick E (1890) Ueber leberresection und leberreaction. Verhandl Deutsch Gesellsch Chir 19:28Google Scholar

Copyright information

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.University of Mississippi Medical CenterJacksonUSA
  2. 2.Centre Hépato-BiliaireHôpital Universitaire Paul BrousseVillejuifFrance

Personalised recommendations