Book Review

Robert C. Hinckley and the Recreation of ”The First Operation under Ether. ”

N Engl J Med 1994; 331:281July 28, 1994

Article

Robert C. Hinckley and the Recreation of ”The First Operation under Ether. ”
By Richard J. Wolfe. 182 pp., illustrated. Boston, Boston Medical Library in the Francis A. Countway Library of Medicine, 1993. $22..

There are times, however rare, when the reader takes in a text while wondering about the imaginative life of its dedicated author. Such is the case with Richard Wolfe's reconstruction of Robert Hinckley's “The First Operation under Ether.” Wolfe has gathered a seemingly infinite number of facts to document a painting that is little known -- or so this reviewer thought until Wolfe set the record straight. Hinckley's painting is “almost a model of a surgical operation and as such is probably reproduced more in print than any other American painting in its class.” It hangs in the lobby of the Countway Library of Medicine, which receives so many requests for its reproduction in magazines and on television that “it is on the way to becoming the most widely viewed medical painting of modern times.” For almost 30 years Wolfe has been the curator of rare books and manuscripts at the Countway, and his punctilious respect for documentation marks him as a man who does not play fast and loose with the truth. This is important, for Hinckley's canvas is a combatant in a contest between two American medical centers of historic importance: Philadelphia and Boston.

Hinckley's magnum opus (measuring 2.5 m by 2.9 m [8'2“ by 9'7”]) depicts an operation performed in 1846 at Massachusetts General Hospital to remove a vascular tumor from the jaw and lower neck of the patient, Gilbert Abbott. Had the tumor been benign and attached to the gum, only alcohol would have been needed for sedation. But Abbott had to be strapped into a surgical chair so that he would not choke on his own blood during the long procedure. The delicate operation could hardly have been performed without sulfuric ether, a barely tested anesthetic recently discovered by William Morton. Morton hoped to patent his discovery under the name Letheon, but hospital officials would not allow him to use the compound again until he revealed its chemical nature. Today the importance of Morton's discovery is recognized each year in Boston on October 17, the anniversary of the operation. Ether Day marks the advent of the painless surgery that helped make Massachusetts General Hospital the leading institution of its kind within 50 years of its founding, in 1811.

In American art-historical circles, pride of place has until now been given to Thomas Eakins's “The Gross Clinic,” which shows an operation for osteomyelitis in 1875 at Jefferson Medical College in Philadelphia. In Thomas Eakins: The Heroism of Modern Life (Princeton, N.J.: Princeton University Press, 1983), Elizabeth Johns established Eakins's ascendance, but thanks to Wolfe, her vaunted claim for Eakins (“no American artist ever painted a work of such intellectual scope”) is shown to be quite simply unfounded, her privileging of Philadelphia unwarranted. (Dr. Samuel Gross was one of the last physicians to advocate bloodletting.) Indeed, I take Wolfe's refusal to cite Johns to be his gentleman's way of skirting a dilemma. The point is not which painting is greater, for here “The Gross Clinic” triumphs, but which operative precedent has more importance, and here surgical anesthesia wins hands down. Hinckley paid homage to this fact when he interviewed those who knew the participants and labored over his canvas for 11 years, from 1882 to 1893, to achieve factual accuracy.

At the confluence of medicine and art history, we need a meticulous standard of scholarship that is wedded to fidelity to the facts. Wolfe's monograph provides the model, and the wealth of reference material in his footnotes is the next incumbent's starting place.

Phoebe Lloyd, Ph.D.
Texas Tech University, Lubbock, TX 79403