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Our New England heritage
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ADDRESS
Our New England Heritage Bentley P. Colcock, MD, Boston, Massachusetts
Among the members of this Society are many of my closest friends. Among my richest memories are many associated with this organization. May I take this opportunity to thank you humbly and sincerely for the privilege of serving as your President. May I also take this opportunity to discuss with you a subject close to my heart and one which I believe concerns every member of this Society-our New England heritage. Perhaps the first word in the title of this address may sound presumptuous since many of us were not born in New England. But could we not be looked upon as New Englanders by adoption? If New England has given us the opportunity to have a long and satisfying professional life in one of her six states has she not, in a sense, adopted us? In our hearts, we feel we are New Englanders, and we share in that trust, that responsibility, which I have called our New England heritage. Webster’s Dictionary defines heritage as “something handed down from one’s ancestors or the past, a characteristic culture, tradition; the rights, burdens, or status resulting from being born in a certain time or place; a birthright.” Let me try to put in words what the New England heritage means to me. We can begin by taking a look at the kind of men who laid the foundations of this culture, this trust which we, as New England surgeons, have inherited.
From the Department of Surgery, Lahey Clinic Foundation, Boston, Massachusetts. Reprint requests should be addressed to Dr Colcock. Department of Surgery. Lahey Clinic Foundation, Boston, Massachusetts 02215. Presented at the Fifty-Second Annual Meeting of the New England Surgical Society, Portsmouth, New Hampshire, September 30. October 1 and 2, 1971.
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Our Cultural Heritage Just thirteen years after American civilization had established its first secure outpost on the soil of Virginia, it succeeded in establishing a second outpost 400 miles to the north. It was in a bleaker and more rugged portion of the continent, but it was given a name suggestive of tender and loyal memories-New England. Thus, within a brief period, the beginnings were made of those two great Colonial communities of English blood and speech: Virginia and New England. They had many things in common and many more things in contrast. They became the two great distributing centers of the English people in America. There were two classes of Englishmen in the seventeenth century: those resting upon their world’s attainments and those demanding a new departure. From the second class came the New Englanders. They were a prolific race; they married early, and, if the opportunity presented, married often. They rejoiced when they were blessed with many children. They were also a deeply excited class of Englishmen. They were men who were not looking for physical comfort, not tied to precedents, and not afraid of ideas. So historians have described the 21,000 persons who came between 1620 and 1640 to start New England. These first settlers assumed the right to think for themselves, the utility of thought and the duty to stand by the fair conclusions of their thinking, often at considerable cost. The proportion of learned men, even in those early days, was extraordinary. It is said that between 1630 and 1690, there were in New England as many grad-
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uates of Cambridge and Oxford as could be found in any population of similar size in the mother country. Many, like the first New England Hawthorne, landed with books in their hands or in their luggage. Probably no other community of pioneers ever so honored study or so revered the symbols and instruments of learning. Theirs was a social structure with its cornerstone resting on a book. Universal education seemed to them to be a necessity, and they promptly provided for it in all grades. By the year 1649 every colony in New England except Rhode Island had made public instruction compulsory. The learned class among them was indeed the nobility. A New England mother asked only that her son be a good Christian and a good scholar. Closely connected with this great trait of intellectuality was earnestness. Indeed, this seemed to have been not so much a separate trait of character, but an all pervading moral atmosphere in which every function of their nature breathed and worked. This intensity pervaded everything-piety, politics, education, work, and play. It was an earnestness that lifted them above human weakness, and it made them both victorious and sad. Cuppy [I] has described the story of the Pilgrims as follows: “. . . if you work hard all your life and behave yourself every minute and take no time out for fun you will break practically even, if you can borrow enough money to pay your taxes.” Thomas Jefferson [I] once said, “. . . I felt the ground shake under my feet at my first contact with New England Town Meeting.” Ethan Allen [1] declared, “. . . I am as determined to preserve the independence of Vermont as Congress is that of the Union; and rather than fail I will retire with my hardy Green Mountain boys into the caverns of the mountains and make war on all mankind.” In another New England state, it was said that if two New Hampshire men were not a match for the devil, they might as well give the country back to the Indians. As time went on, this cartilaginous matrix of conscience, work, thrift, shrewdness, and duty hardened and became bone. Massachusetts became what Audubon called the “reading state” [2]. Harvard College was established as the first American seat of learning, and the first printing press was set up in Cambridge. In an age of historians, it was natural that Boston should have produced Prescott, Motley, Parkman, and Henry Adams. The identification of New England authors with a public of their own ancestry was one of the causes for the appearance of such poets as Longfellow, Lowell, Whittier, and Holmes. Their words followed the pioneers westward and carried New England with them. It was a phenomenon of the nineteenth century that Yankee-
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born schoolteachers were found in all of the distant corners of the land, even in the deep South. For two or three generations, Boston was the literary capitol not only of New England but also of the nation, attracting minds from other regions and sometimes making New Englanders of them. To a considerable extent the latter is still true today and it is particularly so in medicine. Brooks [2] has described this region as follows: More than a province, less than a nation, New England has always had a certain coherence of its own, and from Cotton Mather to Robert Frost and E. E. Cummings it has shown the same consistency of character. For even when the coming of other races might have [altered] the original stock the characteristic traits continued to appear, so that literature in New England has possessed a special quality that one can distinguish easily and almost define. This quality has been made up of strains, manifested from the first, that appeared in less degree elsewhere in the country, among them a religious toughness that encouraged solid intellectual work, together with a fervent love of learning. At times a strong spirit of independence collided with a Calvinistic theology, such as the doctrine of predestination. Nancy Hale [3] relates the story of her great-great-grandfather, Lyman Beecher, of Lit&field. He had arranged to exchange pulpits one Sunday with a minister of a neighboring Connecticut town. . . . As the two divines passed each other on horseback on the road, the other said, “Dr. Beecher, is it not marvelous: since the beginning of time it was ordained that you and I should exchange pulpits today.” “Is that so?” cried Beecher, wheeling his horse about. “Then I won’t do it.” Miss Hale, who grew up with a strong England in her mind, has written:
sense
of New
. . . for if fact is the reasonable part of the truth, myth is its imaginative side. Much truth is in the myth, always. It is fact that has made New England great. But it is her myth-that blend of staunchness, brains, courage, toil, loneliness, wild beauty, independence, and style-that makes her children want to kneel to kiss her earth. Not to do so, of course; such behavior would seem most unsuitable, to a new Englander.
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confess that many times I have felt this same strong emotion as my plane touched down at Logan Airport. Let me turn your thoughts toward medicine with a reference to my favorite poet, Emily Dickinson. It has been said that Miss Dickinson was the quintessence of New England. Born in 1830 in Amherst, Massachusetts, she inherited from her father the marked individuality and love of independence characteristic of the Dickinsons as well as (under sufficient provocation) their gift for vivid and original expression. The fundamental understanding between father and daughter is revealed by her statement [4], “If father is asleep on the lounge, the house is full.” The Puritan was no behaviorist, and consciousness was never regarded as controlled by outward circumstances. For him the mind was its own and, in alliance with infinite power, could surmount any tangible obstacle. Emily Dickinson [5] was always less concerned with the “outer” than with the “inner weather.” In being herself and in fulfilling the law of her own being, she was expressing the essential qualities of a New England mind. She became a recluse, writing the poetry she did not publish and did not want to publish. Although she rarely left the confines of her room, she could, with amazing insight and feeling, write [4]: I
Surgeons must be careful When they take the knife! Underneath their fine incisions Stirs the culprit,-Life! Our Medical Heritage The first physician to settle in America was Dr Samuel Fuller, who was born in Norfolk County, England, in 1580. If, by chance, there were any itinerant physicians in New England before him, we can probably disregard them, since Fuller was the ship surgeon of the Mayflower. He delivered three babies and treated various illnesses during that first voyage with only two deaths. We can also picture his trials and frustrations during that first dreadful winter at Plymouth when scurvy, typhoid, smallpox, and possibly tuberculosis carried off half the settlers. For a considerable period he was the only physician in Massachusetts Bay and was often called to see the sick in Endicott’s colony at Salem and Winthrop’s at Boston. It is said that being neither bigoted nor argumentative he did much to allay the religious differences and animosities that existed between these two colonies. We might do well to note this aspect of our New England heritage. Nearly 100 years later in 1679, a son was born in the family of Dr Boylston of Muddy River, now
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Brookline, Massachusetts. Zabdiel Boylston was educated by his father and Dr Cutler, and he began his practice in Dock Square, Boston. The sixth epidemic of smallpox broke out in 1721. Before it had burned itself out, it had stricken 6,000 of the 11,000 inhabitants and had killed 900. The Reverend Cotton Mather, probably the most scholarly man in the community, had read an account of the inoculation for smallpox as practiced in Constantinople and published in “The Philosophical Transactions” of London in 1717. He called a conference of all the physicians of the town to debate the question of introducing this practice in Boston. None responded but Zabdiel Boylston. He promptly inoculated his son, age six, and would have offered himself had he not already been immunized by an attack of the disease. Popular indignation against such radical measures, not yet justified by long experience, ran high. All the other physicians allied themselves against the practice. There were threats of hanging. Grenades were thrown into Mather’s home, and for a few days Boylston was forced to hide from the violence of the mob. However, the clergy and a few enlightened citizens under the leadership of Cotton Mather supported him and the work went on; 280 persons were inoculated with six deaths. This mortality of 2.1 per cent was in sharp contrast to the death rate of 14 or 15 per cent in the community at large. Just reflect for a moment on what these two New Englanders have bequeathed to us. Mather, with his alert mind, saw the answer for the dire need of his fellow Bostonians in a clinical experiment carried out on the other side of the world. Boylston, a member of our profession, had the courage to lay on the line the life of his six year old son, his professional reputation, and indeed his own life to see that the people of his community received the kind of medical care he believed they should have. Perhaps we can best trace the influence of our New England heritage on members of our profession by a look at the men who carried it in their genes, those whose father, grandfather, and even greatgrandfather were not only New Englanders but also physicians. Here we strike a rich vein, one that reaches back far into the past and is likely to extend as far into the future. We can think of many examples, but let me cite just a few. The Warrens. Books have been written about the Warren family, and many of their accomplishments are familiar to all of us. The sustained high quality of this New England family illustrates medical heritage at its best. You recall Joseph Warren the fiery patriot, the leader of the Boston Tea Party, who, in the face of threats of hanging, entered Old South Church by the window and from the pulpit hurled
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defiance against the King and his government in spite of many British officers crowding the pulpit steps just a few feet away. On the day of the battles of Lexington and Concord, he hurried from the bedside of a patient in Dedham to help direct the pursuit of the retreating British. On June 17, he fell at Bunker Hill with a bullet in his brain. His younger brother, John, helped care for the wounded that day at Bunker Hill, and after the war he was commissioned to draw up a plan for a medical institution. As a result, Harvard College established three professorships, Warren in Anatomy and Surgery, Waterhouse in Theory and Practice, and Dexter in Materia Medica and Chemistry, the first faculty of the Harvard Medical School. John Collins Warren was graduated from Harvard in 1797. At first he showed little interest in medicine, and it was only after a year of what was then considered “unprofitable loafing” that he decided to apprentice himself to his father. He studied in London, where he became the lifelong friend of Sir Astley Cooper. He went on to Edinburgh, then the center of clinical teaching in the British Isles. Even then, this man, who was to show such prodigious industry and accomplish so much, wrote to his father [6]: “I hate study . . .” How many of us at that age have at times felt the same way. He became Professor of Surgery in 1815, conducted an enormous surgical practice, revised the pharmacopoeia, organized the Society of Natural Philosophy and the Anthology Club (later the Boston Athenaeum), and established the New England Medical Journal. With Dr James Jackson he founded the Massachusetts General Hospital in 1820 and served as its chief surgeon for thirty-three years. It was characteristic of the man that the following brief laconic statement was all he felt compelled to record about the dramatic event which took place there in October 1846 [6]: . . . I did an interesting
operation at the Hospital this morning while the patient was under Dr. Morton’s preparation to prevent pain; the substance employed was sulphuric ether.
It was his son, Dr J. Mason Warren, who had introduced Dr Morton to his father and who had also assisted him at the first operation under ether anesthesia. Holmes [6] said of the son: . . . this beloved, generous and affable man . . . never . . . lost sight of his great object to qualify himself for that . . . place as a surgeon which was marked name he bore.
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This strong motivating force continued. J. Collins Warren, the fourth surgeon of the name, studied with Lister in Glasgow and brought home to Boston the practice of antisepsis. He wrote on surgical pathology, edited an authoritative textbook of surgery, and became Professor of Surgery at Harvard. On his retirement he is said to have continued to use his professional, social, and personal prestige to promote the medical interests of his community. His son, ‘John, became a distinguished anatomist and is remembered for the impressive anatomic atlas which bears his name. The present chapter in this story of a great medical family has been written and is still being written by a man whom we all admire and respect, our recent president, Richard Warren. The same fundamental traits persist. As surgeon, teacher, editor, and a member of the Armed Forces of the United States, he has served his school, New England, and his country. He has served them faithfully and well as did his ancestors for generations before him. The Cheeuers. David Williams Cheever was of Puritan stock and was descended from a long line of ministers, teachers, and doctors. Ezekiel Cheever came from Canterbury, England, in 1637 and taught school for seventy years in Boston and its vicinity. He was one of the earliest and most famous of the masters of the Public Latin School. Four of these ancestors were graduates of Harvard and two were physicians. His grandfather, Abijah Cheever of Boston, was a surgeon in the Revolutionary War. His father, Charles Augustus Cheever, practiced medicine and surgery in a small New England town. There, with students around him, he dissected cadavers in his attic, prepared skeletons, and practiced new operations after reading their descriptions in the scanty literature of the period. When young David W. Cheever came down from Portsmouth, New Hampshire, to enter Harvard at the age of sixteen, he was already familiar with the classics, reading them with facility in the original, At Harvard he studied Italian with Longfellow, modern literature with James Russell Lowell, and natural history with Agassiz. Later, at Harvard Medical School, Cheever was particularly impressed by four of his professors, Storr in obstetrics, Clark in materia medica, Henry J. Bigelow in surgery, and especially Oliver Wendell Holmes in anatomy. To the lastwitty, brilliant, scholarly-he gave his allegiance and for him he dissected and dissected. It is not surprising that Holmes noticed him, and when the position of demonstrator of anatomy became vacant, he offered it to him. Thus began thirty-three years of teaching in Harvard Medical School. In 1864 at the age of thirty-three he was appointed surgeon to the
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new Boston City Hospital, the youngest member of the staff. On June 1, the hospital opened its doors, and on that day Cheever performed the first operation in the theater under the dome. Fifty years of service to the hospital as a visiting surgeon and consultant followed. He originated or revived many unusual operative procedures, including external esophagotomy for foreign bodies, removal of carcinoma of the tonsil through the neck, and resection of the hip. On the resignation of Henry Jacob Bigelow, he was given the Chair of Surgery in 1882. The appointment met with opposition because the professor of surgery, heretofore, had always been a member of the staff of the Massachusetts General Hospital. By his honesty, courtesy, and fairness, Cheever thoroughly demonstrated his fitness for leadership. His younger colleague and eventual successor, John Collins Warren [7], expressed it in these words: . . . I have often wondered whether the currents of academic life flowed as smoothly in other departments of the University as they did in ours when he was chief . . . his depth of character brought a serenity with it which permeated the whole staff, one and all of whom were glad to acknowledge him as leader. Thirty-three classes of Harvard Medical dents delighted in his teaching, the field was unrivaled. In him, the genius of the of the Public Latin School was dominant
School stuin which he old master again. Wil-
liam J. Mayo [B] wrote: . . . when I first went to Boston as a young man in surgery, I had the pleasure of attending Dr. Cheever’s lectures and clinics, where I learned lessons of enduring value. Dr. Cheever was a quiet, modest man, at once a brilliant operator* and a precise, sound, and conscientious surgeon. He made notable contributions to science which surgeons of this generation would do well to study. His lectures, which have been reprinted, are as readable and as much to the point today as when they were first issued in 1894. Cheever became President of the Massachusetts Medical Society and later the seventh President of the American Surgical Association. Lund [B] spoke of his presidential address as “the best prophecy for the future that I have ever read. He did not, as others less wise had done, state that surgery had already reached the limit of progress of which it was capable.” He began with the sentence [8], “. . . Fellows of the American Surgical Association, I believe that we
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are warranted in saying that the future of surgery is without limit.” Later, when the American College of Surgeons conferred on Cheever an honorary degree, John Collins Warren [9] described the scene as follows: . . . I saw him for the last time, in the robe of the order, he seemed to me to have come into his own again. The sombre folds of the academic gown served as a fitting setting to the grave and intellectual features of the man . . . during a pause in the proceedings arranged to allow him to retire, he passed slowly down the aisle, leaning upon a proffered arm, his assembled colleagues rose as one man to do him honor as a recognized leader in their chosen profession. David Cheever, the only son of David W. Cheever, was graduated from Harvard Medical School in 1901. The Harvard Medical Alumni Association Bulletin of July 1901 contained architect’s drawings for the new Harvard Medical School buildings on Longwood Avenue and a report of the Medical School Committee chaired by his father. This was followed by a list of the graduating class of that year; David Cheever, the son, was at the top with an average of 93.5 per cent [IO]. Needless to say, the influence of the father on the son was profound. They were Puritans, hard working and God fearing, not given to frivolity or to the easy life. Indeed, the older Cheever once ascribed his success to the quality of concentration. He wrote [IO], . . . one thing;\ only one thing; always one thing. A doctor, only a doctor, always a doctor. One school, one hospital; one pursuit, one profession. That has been my rule and my course. His son was a more gentle and perhaps a more broad-minded man. Like his father, he began his medical career as an assistant in anatomy at Harvard Medical School and later became a visiting surgeon at the Boston City Hospital. He was called to the Peter Bent Brigham Hospital by Harvey Cushing when that institution opened in 1913. In 1915 he served with distinction in the British expeditionary forces as Chief Surgeon of the Harvard Unit at Boulogne. After the war, he rose progressively in the ranks of the Medical School until he became Professor of Surgery in 1939. As a Boston surgeon, David Cheever touched all the bases. He was President of the Boston Surgical Society in 1932, the New England Surgical Society in 1930, and the American Surgical Association in 1940. In the long history of the American Surgical Association (founded in
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1880), no other son has followed his father in the presidency. The name of Sargent Cheever, his son, is familiar to any alumnus of Harvard Medical School. You can see that our New England heritage “gene” is a hardy one. The Homans. Let me mention one more New England family. I will begin with a contemporary of the older Cheever, John Homans, who was already the third with that name in direct transition. His grandfather had been graduated from Harvard College in 1772 and was an Army surgeon during the Revolutionary War. His father was graduated from Harvard in 1812 and practiced medicine in Boston. The grandson received his medical degree from Harvard in 1862 and began his career as a surgeon in the Navy and later in the Army during the Civil War. He is chiefly remembered for his pioneer work in surgery of the abdomen. With characteristic energy and courage he attacked the problem of ovarian tumors. His first five patients from 1872 to 1875 died. Then, in 1877, he applied the principles of Listerism at the Carney Hospital and the next five patients, operated on under the carbolic spray, all recovered. In 1882 he was appointed to the staff of the Massachusetts General Hospital, but with the provision that laparotomy was forbidden. This prohibition was only overcome when Homans and his younger colleagues demonstrated to all that the abdomen could be opened safely iising the new technic. The next Dr John Homans is a man whose career extended into our own time. He was born in 1877, was graduated cum laude from Harvard College with a bachelor of arts degree, and led his class at Harvard Medical School, graduating in 1903. Thereafter, he became a house pupil in surgery at the Massachusetts General Hospital for eighteen months and later an assistant to Maurice H. Richardson, then Moseley Professor of Surgery and the most prominent surgeon in Boston. It was Richardson who sent Homans to Baltimore in 1908 to work with a young genius by the name of Harvey Cushing. This led to his appointment to the new Peter Bent Brigham Hospital where he spent the rest of his professional life. From 1913 to 1946, Homans was a surgeon at the Brigham Hospital except for two years during World War I and one year when he was loaned to Yale Medical School as Professor of Surgery while Samuel Harvey was on a leave of absence. It was said that for a Boston Brahmin and a Harvard Professor to become in a single academic year one of Yale’s most popular and best remembered teachers was no mean achievement. This could well have been due to the very nature of the man, his rugged integrity, his devotion to learning, and his dedication to teaching. It was as if the “Honest John” Homans of the nineteenth centu-
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ry had returned in person to remind us of some old fashioned but essential New England virtues. As noted by his colleagues, Sosman and Newton [II], such a heritage may engender family pride, but for Homans it carried with it an obligation of accomplishment and the duty of service. The highlight of his career was the completion and publication of the Homans “Textbook of Surgery.” This book has been well described as a delightfully readable essay on surgery. It was my own choice for a textbook of surgery as a student at the University of Pennsylvania. Many generations of Harvard Medical School students and Brigham house officers have vivid memories of this unusual man. There are also many anecdotes concerning his wit, his peculiarities, and his temper. As usual, some of these may be apocryphal or at least distorted. One, which I can personally vouch for, happened in 1940 when I called Dr Homans to tell him that the American Board of Surgery had requested me to have him watch me operate. After I had repeated the reason for my call, he did remember that he had heard something about the matter. “Well, when do you want to do it?” I mentioned a 2 PM hour and he replied, “Now doctor, I still practice and I see patients at that hour.” I quickly changed it to 8:00 AM ‘and got this reply, “Now listen doctor, I don’t intend to disrupt my whole household and get up an hour earlier just to watch you operate. I will be there at 9:O0.” He was and he stayed throughout the operative procedure. Need I add that his son was graduated from Harvard Medical School in 1941 and served in the South Pacific during World War II. The New England Surgical
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There are many other examples of the powerful motivation provided by medical ancestors. For instance, a contemporary of the first John Homans of whom I spoke was Charles Burnham Porter. Born in Vermont in 1840, he was descended from Daniel Porter who became the progenitor of seven generations of physicians. I suspect, however, that many of you are already saying to yourselves, “Interesting, but it does not apply to me. I have no distinguished medical forebears.” Perhaps, like me, you were not even born in this country. Does this mean that we have no oligation where our New England heritage is concerned? Look at the man beside you. His name is probably not Warren or Cheever or Homans. But is he not known to be one of the “professional” sons of Edward Churchill, Arthur Allen, Leland McKittrick, Elliott Cutler, or Frank Lahey? Each of us must be aware of how much he owes to one or more great teachers of surgery such as these men, many of whom were themselves adopted sons of New En-
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gland. Does not the very fact of our membership in this Society impose upon us all a very definite responsibility? Here we are, a small group of 200 active members chosen from thousands of qualified surgeons throughout our six states. The young surgeons of New England will expect from us inspiration and guidance. What is more, they will not confine this to the field of surgical technic. Whether we know it or not, they will be influenced, for better or for worse, by the kind of example we set not only as surgeons, but also as men. The questions which we, as members of this Society, should ask ourselves are: Have I done my best to maintain the high standard set by those New England surgeons who have gone before me? How have I used by birthright? Organizations, like people, have a personality and character. Like people, these characteristics are the result of their origins, those who have influenced their lives, and their experiences. To me, the New England Surgical Society has always had a very special quality. The reasons for this are many. Let me mention just one which has impressed me often over the years. Even those members whose names have seldom appeared in the surgical literature have contributed a great deal to our Society. Almost without exception, they are men who have provided the finest surgical care the people in their part of New England have ever had. They are looked upon as leaders in their community, and their fellow citizens regard them as irreplaceable. On the wall of the auditorium of the New England Deaconess Hospital is a medallion dedicated to a
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great New England physician, the late Eliot Joslin, a man many of us have had the privilege of knowing. It reads: “Gladly would he learn and gladly teach.” I believe this brief statement lies. at the heart of “our New England heritage.” This is the trust that we have inherited. It is our responsibility to maintain this tradition as New England surgeons. Whether learning and teaching take place in a small community north of Bangor or in the Harvard Medical Complex makes little difference. The obligation is the same. In closing, may I remind you: From those to whom much is given, much is expected. References 1. Fadiman C (Ed): The American Treasury 1455-1955. New York, Harper &Brothers, 1955. 2. Brooks VW: A New England Reader. New York, Atheneum, 1962. 3. Hale N: New England Discovery: A Personal View. New York, Coward-McCann, 1963. 4. Bianchi MD, Hampton AL: The Poems of Emily Dickinson. Boston, Little, Brown, 1942. 5. Whither GF: This Was a Poet: A Critical Biography of Emily Dickinson. New York, Scribner, 1939. 6. Cheever D: Presidential Address. Forebears of the New England Surgical Society. 7ran.s New fng S;rg Sot 13: 53, 1930. 7. Lund FB: David Williams Cheever. New Eng J Med 220: 320,1939. 6. Cheever D: Master Surgeons of America. David Williams Cheever, 1631-1915. Surg Gynec Obstef46: 139.1926. Grad 24: 626, 9. Warren JC: David Williams Cheever. Harvard 1916. 10. Dunphy J: David Cheever, M.D. Harvard Alumni Bull 30: 30. 1956. 11. Sosman MC, Newton FC: John Homans, M.D., 1677-1954. Harvard Med Alumni Bull 29: 13, 1955.
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Our New England Heritage Bentley P. Colcock, MD, Boston, Massachusetts
Among the members of this Society are many of my closest friends. Among my richest memories are many associated with this organization. May I take this opportunity to thank you humbly and sincerely for the privilege of serving as your President. May I also take this opportunity to discuss with you a subject close to my heart and one which I believe concerns every member of this Society-our New England heritage. Perhaps the first word in the title of this address may sound presumptuous since many of us were not born in New England. But could we not be looked upon as New Englanders by adoption? If New England has given us the opportunity to have a long and satisfying professional life in one of her six states has she not, in a sense, adopted us? In our hearts, we feel we are New Englanders, and we share in that trust, that responsibility, which I have called our New England heritage. Webster’s Dictionary defines heritage as “something handed down from one’s ancestors or the past, a characteristic culture, tradition; the rights, burdens, or status resulting from being born in a certain time or place; a birthright.” Let me try to put in words what the New England heritage means to me. We can begin by taking a look at the kind of men who laid the foundations of this culture, this trust which we, as New England surgeons, have inherited.
From the Department of Surgery, Lahey Clinic Foundation, Boston, Massachusetts. Reprint requests should be addressed to Dr Colcock. Department of Surgery. Lahey Clinic Foundation, Boston, Massachusetts 02215. Presented at the Fifty-Second Annual Meeting of the New England Surgical Society, Portsmouth, New Hampshire, September 30. October 1 and 2, 1971.
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Our Cultural Heritage Just thirteen years after American civilization had established its first secure outpost on the soil of Virginia, it succeeded in establishing a second outpost 400 miles to the north. It was in a bleaker and more rugged portion of the continent, but it was given a name suggestive of tender and loyal memories-New England. Thus, within a brief period, the beginnings were made of those two great Colonial communities of English blood and speech: Virginia and New England. They had many things in common and many more things in contrast. They became the two great distributing centers of the English people in America. There were two classes of Englishmen in the seventeenth century: those resting upon their world’s attainments and those demanding a new departure. From the second class came the New Englanders. They were a prolific race; they married early, and, if the opportunity presented, married often. They rejoiced when they were blessed with many children. They were also a deeply excited class of Englishmen. They were men who were not looking for physical comfort, not tied to precedents, and not afraid of ideas. So historians have described the 21,000 persons who came between 1620 and 1640 to start New England. These first settlers assumed the right to think for themselves, the utility of thought and the duty to stand by the fair conclusions of their thinking, often at considerable cost. The proportion of learned men, even in those early days, was extraordinary. It is said that between 1630 and 1690, there were in New England as many grad-
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uates of Cambridge and Oxford as could be found in any population of similar size in the mother country. Many, like the first New England Hawthorne, landed with books in their hands or in their luggage. Probably no other community of pioneers ever so honored study or so revered the symbols and instruments of learning. Theirs was a social structure with its cornerstone resting on a book. Universal education seemed to them to be a necessity, and they promptly provided for it in all grades. By the year 1649 every colony in New England except Rhode Island had made public instruction compulsory. The learned class among them was indeed the nobility. A New England mother asked only that her son be a good Christian and a good scholar. Closely connected with this great trait of intellectuality was earnestness. Indeed, this seemed to have been not so much a separate trait of character, but an all pervading moral atmosphere in which every function of their nature breathed and worked. This intensity pervaded everything-piety, politics, education, work, and play. It was an earnestness that lifted them above human weakness, and it made them both victorious and sad. Cuppy [I] has described the story of the Pilgrims as follows: “. . . if you work hard all your life and behave yourself every minute and take no time out for fun you will break practically even, if you can borrow enough money to pay your taxes.” Thomas Jefferson [I] once said, “. . . I felt the ground shake under my feet at my first contact with New England Town Meeting.” Ethan Allen [1] declared, “. . . I am as determined to preserve the independence of Vermont as Congress is that of the Union; and rather than fail I will retire with my hardy Green Mountain boys into the caverns of the mountains and make war on all mankind.” In another New England state, it was said that if two New Hampshire men were not a match for the devil, they might as well give the country back to the Indians. As time went on, this cartilaginous matrix of conscience, work, thrift, shrewdness, and duty hardened and became bone. Massachusetts became what Audubon called the “reading state” [2]. Harvard College was established as the first American seat of learning, and the first printing press was set up in Cambridge. In an age of historians, it was natural that Boston should have produced Prescott, Motley, Parkman, and Henry Adams. The identification of New England authors with a public of their own ancestry was one of the causes for the appearance of such poets as Longfellow, Lowell, Whittier, and Holmes. Their words followed the pioneers westward and carried New England with them. It was a phenomenon of the nineteenth century that Yankee-
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born schoolteachers were found in all of the distant corners of the land, even in the deep South. For two or three generations, Boston was the literary capitol not only of New England but also of the nation, attracting minds from other regions and sometimes making New Englanders of them. To a considerable extent the latter is still true today and it is particularly so in medicine. Brooks [2] has described this region as follows: More than a province, less than a nation, New England has always had a certain coherence of its own, and from Cotton Mather to Robert Frost and E. E. Cummings it has shown the same consistency of character. For even when the coming of other races might have [altered] the original stock the characteristic traits continued to appear, so that literature in New England has possessed a special quality that one can distinguish easily and almost define. This quality has been made up of strains, manifested from the first, that appeared in less degree elsewhere in the country, among them a religious toughness that encouraged solid intellectual work, together with a fervent love of learning. At times a strong spirit of independence collided with a Calvinistic theology, such as the doctrine of predestination. Nancy Hale [3] relates the story of her great-great-grandfather, Lyman Beecher, of Lit&field. He had arranged to exchange pulpits one Sunday with a minister of a neighboring Connecticut town. . . . As the two divines passed each other on horseback on the road, the other said, “Dr. Beecher, is it not marvelous: since the beginning of time it was ordained that you and I should exchange pulpits today.” “Is that so?” cried Beecher, wheeling his horse about. “Then I won’t do it.” Miss Hale, who grew up with a strong England in her mind, has written:
sense
of New
. . . for if fact is the reasonable part of the truth, myth is its imaginative side. Much truth is in the myth, always. It is fact that has made New England great. But it is her myth-that blend of staunchness, brains, courage, toil, loneliness, wild beauty, independence, and style-that makes her children want to kneel to kiss her earth. Not to do so, of course; such behavior would seem most unsuitable, to a new Englander.
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confess that many times I have felt this same strong emotion as my plane touched down at Logan Airport. Let me turn your thoughts toward medicine with a reference to my favorite poet, Emily Dickinson. It has been said that Miss Dickinson was the quintessence of New England. Born in 1830 in Amherst, Massachusetts, she inherited from her father the marked individuality and love of independence characteristic of the Dickinsons as well as (under sufficient provocation) their gift for vivid and original expression. The fundamental understanding between father and daughter is revealed by her statement [4], “If father is asleep on the lounge, the house is full.” The Puritan was no behaviorist, and consciousness was never regarded as controlled by outward circumstances. For him the mind was its own and, in alliance with infinite power, could surmount any tangible obstacle. Emily Dickinson [5] was always less concerned with the “outer” than with the “inner weather.” In being herself and in fulfilling the law of her own being, she was expressing the essential qualities of a New England mind. She became a recluse, writing the poetry she did not publish and did not want to publish. Although she rarely left the confines of her room, she could, with amazing insight and feeling, write [4]: I
Surgeons must be careful When they take the knife! Underneath their fine incisions Stirs the culprit,-Life! Our Medical Heritage The first physician to settle in America was Dr Samuel Fuller, who was born in Norfolk County, England, in 1580. If, by chance, there were any itinerant physicians in New England before him, we can probably disregard them, since Fuller was the ship surgeon of the Mayflower. He delivered three babies and treated various illnesses during that first voyage with only two deaths. We can also picture his trials and frustrations during that first dreadful winter at Plymouth when scurvy, typhoid, smallpox, and possibly tuberculosis carried off half the settlers. For a considerable period he was the only physician in Massachusetts Bay and was often called to see the sick in Endicott’s colony at Salem and Winthrop’s at Boston. It is said that being neither bigoted nor argumentative he did much to allay the religious differences and animosities that existed between these two colonies. We might do well to note this aspect of our New England heritage. Nearly 100 years later in 1679, a son was born in the family of Dr Boylston of Muddy River, now
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Brookline, Massachusetts. Zabdiel Boylston was educated by his father and Dr Cutler, and he began his practice in Dock Square, Boston. The sixth epidemic of smallpox broke out in 1721. Before it had burned itself out, it had stricken 6,000 of the 11,000 inhabitants and had killed 900. The Reverend Cotton Mather, probably the most scholarly man in the community, had read an account of the inoculation for smallpox as practiced in Constantinople and published in “The Philosophical Transactions” of London in 1717. He called a conference of all the physicians of the town to debate the question of introducing this practice in Boston. None responded but Zabdiel Boylston. He promptly inoculated his son, age six, and would have offered himself had he not already been immunized by an attack of the disease. Popular indignation against such radical measures, not yet justified by long experience, ran high. All the other physicians allied themselves against the practice. There were threats of hanging. Grenades were thrown into Mather’s home, and for a few days Boylston was forced to hide from the violence of the mob. However, the clergy and a few enlightened citizens under the leadership of Cotton Mather supported him and the work went on; 280 persons were inoculated with six deaths. This mortality of 2.1 per cent was in sharp contrast to the death rate of 14 or 15 per cent in the community at large. Just reflect for a moment on what these two New Englanders have bequeathed to us. Mather, with his alert mind, saw the answer for the dire need of his fellow Bostonians in a clinical experiment carried out on the other side of the world. Boylston, a member of our profession, had the courage to lay on the line the life of his six year old son, his professional reputation, and indeed his own life to see that the people of his community received the kind of medical care he believed they should have. Perhaps we can best trace the influence of our New England heritage on members of our profession by a look at the men who carried it in their genes, those whose father, grandfather, and even greatgrandfather were not only New Englanders but also physicians. Here we strike a rich vein, one that reaches back far into the past and is likely to extend as far into the future. We can think of many examples, but let me cite just a few. The Warrens. Books have been written about the Warren family, and many of their accomplishments are familiar to all of us. The sustained high quality of this New England family illustrates medical heritage at its best. You recall Joseph Warren the fiery patriot, the leader of the Boston Tea Party, who, in the face of threats of hanging, entered Old South Church by the window and from the pulpit hurled
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defiance against the King and his government in spite of many British officers crowding the pulpit steps just a few feet away. On the day of the battles of Lexington and Concord, he hurried from the bedside of a patient in Dedham to help direct the pursuit of the retreating British. On June 17, he fell at Bunker Hill with a bullet in his brain. His younger brother, John, helped care for the wounded that day at Bunker Hill, and after the war he was commissioned to draw up a plan for a medical institution. As a result, Harvard College established three professorships, Warren in Anatomy and Surgery, Waterhouse in Theory and Practice, and Dexter in Materia Medica and Chemistry, the first faculty of the Harvard Medical School. John Collins Warren was graduated from Harvard in 1797. At first he showed little interest in medicine, and it was only after a year of what was then considered “unprofitable loafing” that he decided to apprentice himself to his father. He studied in London, where he became the lifelong friend of Sir Astley Cooper. He went on to Edinburgh, then the center of clinical teaching in the British Isles. Even then, this man, who was to show such prodigious industry and accomplish so much, wrote to his father [6]: “I hate study . . .” How many of us at that age have at times felt the same way. He became Professor of Surgery in 1815, conducted an enormous surgical practice, revised the pharmacopoeia, organized the Society of Natural Philosophy and the Anthology Club (later the Boston Athenaeum), and established the New England Medical Journal. With Dr James Jackson he founded the Massachusetts General Hospital in 1820 and served as its chief surgeon for thirty-three years. It was characteristic of the man that the following brief laconic statement was all he felt compelled to record about the dramatic event which took place there in October 1846 [6]: . . . I did an interesting
operation at the Hospital this morning while the patient was under Dr. Morton’s preparation to prevent pain; the substance employed was sulphuric ether.
It was his son, Dr J. Mason Warren, who had introduced Dr Morton to his father and who had also assisted him at the first operation under ether anesthesia. Holmes [6] said of the son: . . . this beloved, generous and affable man . . . never . . . lost sight of his great object to qualify himself for that . . . place as a surgeon which was marked name he bore.
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This strong motivating force continued. J. Collins Warren, the fourth surgeon of the name, studied with Lister in Glasgow and brought home to Boston the practice of antisepsis. He wrote on surgical pathology, edited an authoritative textbook of surgery, and became Professor of Surgery at Harvard. On his retirement he is said to have continued to use his professional, social, and personal prestige to promote the medical interests of his community. His son, ‘John, became a distinguished anatomist and is remembered for the impressive anatomic atlas which bears his name. The present chapter in this story of a great medical family has been written and is still being written by a man whom we all admire and respect, our recent president, Richard Warren. The same fundamental traits persist. As surgeon, teacher, editor, and a member of the Armed Forces of the United States, he has served his school, New England, and his country. He has served them faithfully and well as did his ancestors for generations before him. The Cheeuers. David Williams Cheever was of Puritan stock and was descended from a long line of ministers, teachers, and doctors. Ezekiel Cheever came from Canterbury, England, in 1637 and taught school for seventy years in Boston and its vicinity. He was one of the earliest and most famous of the masters of the Public Latin School. Four of these ancestors were graduates of Harvard and two were physicians. His grandfather, Abijah Cheever of Boston, was a surgeon in the Revolutionary War. His father, Charles Augustus Cheever, practiced medicine and surgery in a small New England town. There, with students around him, he dissected cadavers in his attic, prepared skeletons, and practiced new operations after reading their descriptions in the scanty literature of the period. When young David W. Cheever came down from Portsmouth, New Hampshire, to enter Harvard at the age of sixteen, he was already familiar with the classics, reading them with facility in the original, At Harvard he studied Italian with Longfellow, modern literature with James Russell Lowell, and natural history with Agassiz. Later, at Harvard Medical School, Cheever was particularly impressed by four of his professors, Storr in obstetrics, Clark in materia medica, Henry J. Bigelow in surgery, and especially Oliver Wendell Holmes in anatomy. To the lastwitty, brilliant, scholarly-he gave his allegiance and for him he dissected and dissected. It is not surprising that Holmes noticed him, and when the position of demonstrator of anatomy became vacant, he offered it to him. Thus began thirty-three years of teaching in Harvard Medical School. In 1864 at the age of thirty-three he was appointed surgeon to the
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new Boston City Hospital, the youngest member of the staff. On June 1, the hospital opened its doors, and on that day Cheever performed the first operation in the theater under the dome. Fifty years of service to the hospital as a visiting surgeon and consultant followed. He originated or revived many unusual operative procedures, including external esophagotomy for foreign bodies, removal of carcinoma of the tonsil through the neck, and resection of the hip. On the resignation of Henry Jacob Bigelow, he was given the Chair of Surgery in 1882. The appointment met with opposition because the professor of surgery, heretofore, had always been a member of the staff of the Massachusetts General Hospital. By his honesty, courtesy, and fairness, Cheever thoroughly demonstrated his fitness for leadership. His younger colleague and eventual successor, John Collins Warren [7], expressed it in these words: . . . I have often wondered whether the currents of academic life flowed as smoothly in other departments of the University as they did in ours when he was chief . . . his depth of character brought a serenity with it which permeated the whole staff, one and all of whom were glad to acknowledge him as leader. Thirty-three classes of Harvard Medical dents delighted in his teaching, the field was unrivaled. In him, the genius of the of the Public Latin School was dominant
School stuin which he old master again. Wil-
liam J. Mayo [B] wrote: . . . when I first went to Boston as a young man in surgery, I had the pleasure of attending Dr. Cheever’s lectures and clinics, where I learned lessons of enduring value. Dr. Cheever was a quiet, modest man, at once a brilliant operator* and a precise, sound, and conscientious surgeon. He made notable contributions to science which surgeons of this generation would do well to study. His lectures, which have been reprinted, are as readable and as much to the point today as when they were first issued in 1894. Cheever became President of the Massachusetts Medical Society and later the seventh President of the American Surgical Association. Lund [B] spoke of his presidential address as “the best prophecy for the future that I have ever read. He did not, as others less wise had done, state that surgery had already reached the limit of progress of which it was capable.” He began with the sentence [8], “. . . Fellows of the American Surgical Association, I believe that we
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are warranted in saying that the future of surgery is without limit.” Later, when the American College of Surgeons conferred on Cheever an honorary degree, John Collins Warren [9] described the scene as follows: . . . I saw him for the last time, in the robe of the order, he seemed to me to have come into his own again. The sombre folds of the academic gown served as a fitting setting to the grave and intellectual features of the man . . . during a pause in the proceedings arranged to allow him to retire, he passed slowly down the aisle, leaning upon a proffered arm, his assembled colleagues rose as one man to do him honor as a recognized leader in their chosen profession. David Cheever, the only son of David W. Cheever, was graduated from Harvard Medical School in 1901. The Harvard Medical Alumni Association Bulletin of July 1901 contained architect’s drawings for the new Harvard Medical School buildings on Longwood Avenue and a report of the Medical School Committee chaired by his father. This was followed by a list of the graduating class of that year; David Cheever, the son, was at the top with an average of 93.5 per cent [IO]. Needless to say, the influence of the father on the son was profound. They were Puritans, hard working and God fearing, not given to frivolity or to the easy life. Indeed, the older Cheever once ascribed his success to the quality of concentration. He wrote [IO], . . . one thing;\ only one thing; always one thing. A doctor, only a doctor, always a doctor. One school, one hospital; one pursuit, one profession. That has been my rule and my course. His son was a more gentle and perhaps a more broad-minded man. Like his father, he began his medical career as an assistant in anatomy at Harvard Medical School and later became a visiting surgeon at the Boston City Hospital. He was called to the Peter Bent Brigham Hospital by Harvey Cushing when that institution opened in 1913. In 1915 he served with distinction in the British expeditionary forces as Chief Surgeon of the Harvard Unit at Boulogne. After the war, he rose progressively in the ranks of the Medical School until he became Professor of Surgery in 1939. As a Boston surgeon, David Cheever touched all the bases. He was President of the Boston Surgical Society in 1932, the New England Surgical Society in 1930, and the American Surgical Association in 1940. In the long history of the American Surgical Association (founded in
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1880), no other son has followed his father in the presidency. The name of Sargent Cheever, his son, is familiar to any alumnus of Harvard Medical School. You can see that our New England heritage “gene” is a hardy one. The Homans. Let me mention one more New England family. I will begin with a contemporary of the older Cheever, John Homans, who was already the third with that name in direct transition. His grandfather had been graduated from Harvard College in 1772 and was an Army surgeon during the Revolutionary War. His father was graduated from Harvard in 1812 and practiced medicine in Boston. The grandson received his medical degree from Harvard in 1862 and began his career as a surgeon in the Navy and later in the Army during the Civil War. He is chiefly remembered for his pioneer work in surgery of the abdomen. With characteristic energy and courage he attacked the problem of ovarian tumors. His first five patients from 1872 to 1875 died. Then, in 1877, he applied the principles of Listerism at the Carney Hospital and the next five patients, operated on under the carbolic spray, all recovered. In 1882 he was appointed to the staff of the Massachusetts General Hospital, but with the provision that laparotomy was forbidden. This prohibition was only overcome when Homans and his younger colleagues demonstrated to all that the abdomen could be opened safely iising the new technic. The next Dr John Homans is a man whose career extended into our own time. He was born in 1877, was graduated cum laude from Harvard College with a bachelor of arts degree, and led his class at Harvard Medical School, graduating in 1903. Thereafter, he became a house pupil in surgery at the Massachusetts General Hospital for eighteen months and later an assistant to Maurice H. Richardson, then Moseley Professor of Surgery and the most prominent surgeon in Boston. It was Richardson who sent Homans to Baltimore in 1908 to work with a young genius by the name of Harvey Cushing. This led to his appointment to the new Peter Bent Brigham Hospital where he spent the rest of his professional life. From 1913 to 1946, Homans was a surgeon at the Brigham Hospital except for two years during World War I and one year when he was loaned to Yale Medical School as Professor of Surgery while Samuel Harvey was on a leave of absence. It was said that for a Boston Brahmin and a Harvard Professor to become in a single academic year one of Yale’s most popular and best remembered teachers was no mean achievement. This could well have been due to the very nature of the man, his rugged integrity, his devotion to learning, and his dedication to teaching. It was as if the “Honest John” Homans of the nineteenth centu-
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ry had returned in person to remind us of some old fashioned but essential New England virtues. As noted by his colleagues, Sosman and Newton [II], such a heritage may engender family pride, but for Homans it carried with it an obligation of accomplishment and the duty of service. The highlight of his career was the completion and publication of the Homans “Textbook of Surgery.” This book has been well described as a delightfully readable essay on surgery. It was my own choice for a textbook of surgery as a student at the University of Pennsylvania. Many generations of Harvard Medical School students and Brigham house officers have vivid memories of this unusual man. There are also many anecdotes concerning his wit, his peculiarities, and his temper. As usual, some of these may be apocryphal or at least distorted. One, which I can personally vouch for, happened in 1940 when I called Dr Homans to tell him that the American Board of Surgery had requested me to have him watch me operate. After I had repeated the reason for my call, he did remember that he had heard something about the matter. “Well, when do you want to do it?” I mentioned a 2 PM hour and he replied, “Now doctor, I still practice and I see patients at that hour.” I quickly changed it to 8:00 AM ‘and got this reply, “Now listen doctor, I don’t intend to disrupt my whole household and get up an hour earlier just to watch you operate. I will be there at 9:O0.” He was and he stayed throughout the operative procedure. Need I add that his son was graduated from Harvard Medical School in 1941 and served in the South Pacific during World War II. The New England Surgical
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There are many other examples of the powerful motivation provided by medical ancestors. For instance, a contemporary of the first John Homans of whom I spoke was Charles Burnham Porter. Born in Vermont in 1840, he was descended from Daniel Porter who became the progenitor of seven generations of physicians. I suspect, however, that many of you are already saying to yourselves, “Interesting, but it does not apply to me. I have no distinguished medical forebears.” Perhaps, like me, you were not even born in this country. Does this mean that we have no oligation where our New England heritage is concerned? Look at the man beside you. His name is probably not Warren or Cheever or Homans. But is he not known to be one of the “professional” sons of Edward Churchill, Arthur Allen, Leland McKittrick, Elliott Cutler, or Frank Lahey? Each of us must be aware of how much he owes to one or more great teachers of surgery such as these men, many of whom were themselves adopted sons of New En-
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gland. Does not the very fact of our membership in this Society impose upon us all a very definite responsibility? Here we are, a small group of 200 active members chosen from thousands of qualified surgeons throughout our six states. The young surgeons of New England will expect from us inspiration and guidance. What is more, they will not confine this to the field of surgical technic. Whether we know it or not, they will be influenced, for better or for worse, by the kind of example we set not only as surgeons, but also as men. The questions which we, as members of this Society, should ask ourselves are: Have I done my best to maintain the high standard set by those New England surgeons who have gone before me? How have I used by birthright? Organizations, like people, have a personality and character. Like people, these characteristics are the result of their origins, those who have influenced their lives, and their experiences. To me, the New England Surgical Society has always had a very special quality. The reasons for this are many. Let me mention just one which has impressed me often over the years. Even those members whose names have seldom appeared in the surgical literature have contributed a great deal to our Society. Almost without exception, they are men who have provided the finest surgical care the people in their part of New England have ever had. They are looked upon as leaders in their community, and their fellow citizens regard them as irreplaceable. On the wall of the auditorium of the New England Deaconess Hospital is a medallion dedicated to a
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great New England physician, the late Eliot Joslin, a man many of us have had the privilege of knowing. It reads: “Gladly would he learn and gladly teach.” I believe this brief statement lies. at the heart of “our New England heritage.” This is the trust that we have inherited. It is our responsibility to maintain this tradition as New England surgeons. Whether learning and teaching take place in a small community north of Bangor or in the Harvard Medical Complex makes little difference. The obligation is the same. In closing, may I remind you: From those to whom much is given, much is expected. References 1. Fadiman C (Ed): The American Treasury 1455-1955. New York, Harper &Brothers, 1955. 2. Brooks VW: A New England Reader. New York, Atheneum, 1962. 3. Hale N: New England Discovery: A Personal View. New York, Coward-McCann, 1963. 4. Bianchi MD, Hampton AL: The Poems of Emily Dickinson. Boston, Little, Brown, 1942. 5. Whither GF: This Was a Poet: A Critical Biography of Emily Dickinson. New York, Scribner, 1939. 6. Cheever D: Presidential Address. Forebears of the New England Surgical Society. 7ran.s New fng S;rg Sot 13: 53, 1930. 7. Lund FB: David Williams Cheever. New Eng J Med 220: 320,1939. 6. Cheever D: Master Surgeons of America. David Williams Cheever, 1631-1915. Surg Gynec Obstef46: 139.1926. Grad 24: 626, 9. Warren JC: David Williams Cheever. Harvard 1916. 10. Dunphy J: David Cheever, M.D. Harvard Alumni Bull 30: 30. 1956. 11. Sosman MC, Newton FC: John Homans, M.D., 1677-1954. Harvard Med Alumni Bull 29: 13, 1955.
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