He always performed the lateral operation with the gorget, and never until by previous preparation—by diet and medicine—he had brought the system of his patient to a proper state.[18]
Then, with good nursing under his immediate direction in wholesome private lodging, the incision healed up by the first intention. Although the stone may have been so large that much effort was required to withdraw it through the incision—sometimes even attended with laceration—the patient was on his feet again in a surprisingly short period of time. The Doctor justly attached great importance to the preliminary constitutional preparation of his surgical patients.
A notice of two of his earliest operations of this kind is given in the Kentucky Gazette for Saturday, November 19, 1817. The one—the first he performed in Lexington—on Mr. S. Owen, of that place, and the other, "some time ago," on a little boy in Paris, Kentucky, which, according to Doctor C. C. Graham—who was his pupil at that time—was the first operation for stone performed by Doctor Dudley. He never used lithotrity or seemed to approve of that operation.
Another surgical specialty was his great use of judicious and regulated pressure by means of the roller bandage in the cure of abscesses, in the control of inflammation, in the treatment of fractures, aneurisms, etc. No surgeon probably ever used it so extensively or so successfully. Few, even of his pupils, seemed to be able to apply it with the skill and judgment which characterized their preceptor.
He was also an earnest advocate of the patient use of hot water—as hot as could be borne—in the control of inflammation. Where other surgeons resorted to poultices he applied hot water.
He was not ready with his pen; because, probably, of early neglect in the practice of composition. What he wrote was mostly at the urgent solicitation of his colleagues, and for the columns of The Transylvania Journal of Medicine, a quarterly which first appeared in Lexington February, 1828.[19] It was then edited by his colleagues, Professors Cooke and Short; subsequently by Professor Yandell, then by Professor Peter, more lately by Professor T. D. Mitchell, and lastly by Professor Ethelbert L. Dudley.
In the first volume of this Journal appeared Doctor Dudley's first paper, a most remarkable article, showing by cases in his practice that epilepsy may be caused by pressure on the brain, the consequence of fracture of the skull, and, as demonstrated by five successive operations, might be cured by trephining, a fact and experience in surgery then entirely new, for which Doctor Dudley is entitled to the honor of discovery and demonstration.
In the same paper is communicated a novel and successful method of treatment of fungus cerebri, by means of dried sponge compresses. Doctor Dudley stated that by this means he had cured fungus cerebri within the space of five days.
In a second paper, in the next number of this volume, he gives an original and successful operation for hydrocele. In the fourth number he began an extensive article on his peculiar uses of the roller bandage in gunshot wounds, fractures, etc., which he continued through several volumes of the Journal. In the second volume he had given an interesting article on the use of the roller bandage in the treatment of ulcers, contusions, lacerations, effusions, etc. In the fifth volume he continued his remarks on epilepsy as treated by the trephine. In volume sixth he published a record of his experience in the treatment of Asiatic cholera in Lexington. In the ninth he continued his observations on the bandage and its very successful application in the treatment of fractures. A most interesting and valuable article on Calculous Diseases from his pen appeared in the same volume, illustrating not only his great practical skill but his courage and quick and clear judgment in cases of emergency. Volumes ten and twelve contained reports of his operations in lithotomy; volume eleven, a paper on Fractures and Calculous Diseases.
In the elegant and generally correct Memoir of Doctor Benjamin W. Dudley, published by the late Lunsford P. Yandell, M. D., in the American Practitioner, 1870, these are stated to be the only writings of our late distinguished surgeon; but Doctor Dudley subsequently published three elaborate and highly valuable surgical papers, to wit: