The Long Lost Speech: Letter Offers Glimpse Into 19th Century Surgery
By Nancy Semin Texas Medicine February 2019


The fifth floor of the Texas Medical Association building in Austin houses an archival collection of thousands of books, photographs, and artifacts documenting the rich history of Texas medicine. And there’s always room for more.

That’s what unexpectedly happened in October, when TMA staff found an 1892 hand-written letter tucked away in the pages of an old medical journal.

Its author was a prolific physician named John Wesley Carhart, MD. The letter, which was the basis for a speech Dr. Carhart presented to the Texas State Medical Association in 1892, discusses the surgery of a 10-year-old boy who had been suffering from a brain tumor on the left side of his head.

The speech gives modern-day physicians a look at the tools and techniques surgeons used more than 100 years ago. Even at the time these seemed primitive to Dr. Carhart, an inventor and writer who spent decades as a minister in the Northeast and Midwest before studying medicine and moving to Texas in his 50s.

On the path to medicine

Dr. Carhart was born in 1834 near Albany, New York, entered seminary in nearby Charlotteville, and thereafter found work as a Methodist pastor. But that would turn out to be a side-job. Dr. Carhart also patented a steam engine valve for which he received thousands of dollars, and a few years later he was awarded a patent for a needle protector for sewing machines.

A staunch supporter of the temperance movement, Dr. Carhart passionately preached against the dangers of both alcohol and tobacco from his pulpit. This apparently put him at odds with numerous congregants and resulted in frequent relocations to other towns in search of work.

By the age of 46, Dr. Carhart was starting to grow restless. He already had published two books of poetry and written his autobiography when he decided to abandon his ministry.

At that time, Dr. Carhart decided to change careers radically. As a youth, he was fascinated by medicine, so at midlife he shifted from a spiritual vocation to a scientific one. He began his studies at nearby Berkshire Medical College in Massachusetts and later transferred to the College of Physicians and Surgeons of Chicago, graduating in 1883 with a medical diploma.

Two years later, Dr. Carhart and his family relocated to Texas, where the peripatetic doctor practiced in Lampasas, La Grange, Austin, and San Antonio. In addition to caring for patients, the general practitioner with a focus on skin and nerve diseases forged professional ties with other physicians. Appearing before the Texas State Medical Association meeting in Tyler on April 27, 1892, Dr. Carhart presented a paper entitled, “A Case of Brain Surgery.”

A chronicle of medical progress

One hundred and twenty-six years later, this hand-written speech resurfaced in the TMA archives. Dr. Carhart’s 1892 letter in slanted cursive is visually elegant, but by today’s standards, it’s cumbersome to read. Fortunately it was also typed up and published in the Transactions of the Texas Medical Association of that same year.

In those pages, Dr. Carhart shares the surgical story of 10-year-old Ben De Long. A tumor had developed on the left side of his head, and its excision by a “quack,” in Dr. Carhart’s words, only complicated the patient’s symptoms. The boy began experiencing spasms of the right hand and arm. As these grew worse, other physicians were consulted, and surgery was agreed upon.

Dr. Carhart was invited to attend the procedure, which took place in 1891, and he later presented on it to share the information with his peers. He carefully details cuts made on the skull and the use of a mallet and chisel to remove two to three inches of bone. The doctors involved all made note of a dark-colored tumor beneath the meninges. Following its removal, the patient was placed in a plaster-of-paris skull cap and discharged from the hospital a month later.

Though the surgery was successful, Dr. Carhart seemed to recognize the primitive conditions under which it was performed. He would later remark, “With these splendid examples before us, it is impossible to foretell the future of brain surgery, which, as yet, is but in its infancy.”

The presentation was not Dr. Carhart’s first, and likely not his last.

In 1889 he presented another paper to the Texas State Medical Association in San Antonio: “Tyrotoxicon and Peptotoxine,” a rumination on digestion. Dr. Carhart believed tainted dairy products were the common culprit in stomach ailments. In 1891, he had represented Texas at the American Medical Association in Washington, DC, and two years later, he returned to that city to serve as one of 10 assistant secretaries at the first Pan American Medical Congress.

In the history books

Unsurprisingly, medicine alone could not retain Dr. Carhart’s interest, and he continued to write stories that were published in local newspapers. He later began advocating for social justice across the state. He recognized improved sanitation practices could dramatically improve quality of life and pushed for civic reforms. He also published what would be his final book, Under Palmetto and Pine (1899), a fictional story about racism and poverty of African Americans in Texas.

Near the end of his life, he began to receive recognition for his early mechanical inventions, and in 1903 he was dubbed the “father of the automobile” by a periodical called Horseless Age.

On Dec. 21, 1914, Dr. Carhart’s remarkable life ended. He is buried in Austin at the Oakwood Cemetery. His spirit and legacy live on to this day. Replicas of his inventions are displayed at a United Kingdom motor museum, and his achievements are chronicled extensively at the Texas State Historical Association.

His hand-written 1892 speech is now a part of the Texas Medical Association’s esteemed archival collection.

Tex Med. 2019;115(2):36-39
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Last Updated On

February 04, 2019

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