Percival Pott wrote a treatise on the necessity of amputation in certain cases, and in this he strongly refutes the opinion of a Prussian army surgeon who maintained that in almost any case it was not necessary to amputate. The title of the treatise in which this opinion is expressed is “De membrorum amputatione rarissime administranda, aut quasi abroganda.” Shortly afterward Dr. Tissot, of Lausanne, Switzerland, spoke in even stronger terms against this surgical procedure, even going so far (see his treatise entitled “Sur l’inutilité de l’amputation des membres”) as to urge surgeons to abandon the “murderous and cruel method of amputation”—Pott’s criticism of the views expressed by these two writers is most charitable: “However, as we must suppose that the doctrine which these gentlemen have promulgated arose from humane motives, and upon a conviction of its being well founded, we must at least applaud their intention, though we cannot approve their judgment.”

Astley Cooper was born at Brooke, in Norfolk, England, August 23, 1768. As a boy he was fond of all the sports that are commonly cultivated at English schools, and even at that early age he manifested a bold and enterprising spirit, and yet at the same time he was noted for his social and friendly spirit. His biographer, Pettigrew, who witnessed many of the operations which Sir Astley performed at Guy’s Hospital in the earlier years of his career, speaks in strong terms concerning the impression which he made upon the regular pupils and the casual physicians who from time to time attended him on his rounds through the hospital:—

I can never forget the enthusiasm with which he entered upon the performance of any duty calculated to abridge human suffering. This enthusiasm, by the generosity of his character, his familiar manner, and the excellence of his temper, he imparted to all around him—the pupils imbibed the same spirit; and the extent of the obligations of the present and of after ages to Sir Astley Cooper, in thus forming able and spirited surgeons, can never be accurately estimated.

He was the idol of the Borough School—the pupils followed him in troops, and, like to Linnaeus, who has been described as proceeding upon his botanical excursions accompanied by hundreds of students, so may Sir Astley be depicted traversing the wards of the hospital with an equal number of pupils, listening with almost breathless anxiety to catch the observations which fell from his lips upon the several cases presented to his view. But, on the days of operation, this feeling was wound up to the highest pitch—the sight was altogether deeply interesting; the large theatre of Guy’s crowded to the ceiling—the profound silence obtained upon his entry—that person so manly and so truly imposing—and the awful feeling connected with the occasion—can never be forgotten by any of his pupils. The elegance of his operation—without the slightest affectation—all ease—all kindness to the patient, and equally solicitous that nothing should be hidden from the observation of the pupils—rapid in execution—masterly in manner—no hurry—no disorder—the most trifling minutiae attended to—the dressings generally applied by his own hand ... Sir Astley was, at that time (about 1805–1810), decidedly one of the first operators of the day, and this must be taken in its widest sense, for it is intended to include the planning of the operation, the precision and dexterity in the mode of its performance, and the readiness with which all difficulties were met and overcome.

SIR ASTLEY COOPER
(Copied from a print in the possession of the New York Academy of Medicine.)

Among the contributions which Sir Astley made to the science of medicine the following deserve to receive special mention:—In 1798 he published the report of a remarkable case of strangulated hernia in which a part of the abdominal viscera was protruded into the left cavity of the chest, through an opening in the diaphragm. The viscera were much displaced from their natural situation, and the great arch of the colon, together with a large portion of the omentum, was pushed through the aperture in the diaphragm. The existence of this opening, which represented a congenital malformation, was first ascertained after death. It seems almost needless to add that, even if this unusual condition of the parts had been known during the patient’s lifetime, no possible means of relief could have been afforded.

Another of Sir Astley’s contributions—one, namely, which he published in 1804—deals with the subject of inguinal hernia, a topic concerning which very little was known before Cooper’s time. The Spanish surgeon, Gimbernat, had—it is true—published at a still earlier date a masterly description of the anatomy of the parts concerned in this form of hernia, but the fact had been entirely forgotten until Sir Astley called attention to its importance. Mr. Lawrence, the distinguished English surgeon, makes the statement (1806) that “no complete description and accurate delineation of even the common kinds of hernia, as the inguinal, femoral, and umbilical, existed previously to the late excellent works of Camper, Cooper, Scarpa, Hesselbach, Cloquet and Langenbeck.”

In Vol. I. of the Transactions of the Medico-Chirurgical Society (1808) will be found a report, by Sir Astley, of two cases of aneurism of the carotid artery. Pettigrew says that the first of these two cases was treated by ligature upon the vessel—the first of the kind on record, and establishing a practice which has since been pursued and successfully adopted. The second one of the two cases mentioned at the beginning of this paragraph—also a case of aneurism of the carotid—was treated by ligature and with a completely successful result. This patient lived until 1821, at which time Sir Astley published an account of the dissection made by him of the parts involved in the region of the earlier aneurism.