MEMOIR OF JOHN NEILL, M . D. [Extracted from the Transactions of the College of Physicians of Philadelphia, 3d Series, Volume V.] MEMOIR OF JOHN NEILL, M.D., LATE EMERITUS PROFESSOR OF CLINICAL SURGERY IN THE UNIVERSITY OF PENNSYLVANIA. Read before the College of Physicians of Philadelphia, Oct. 6, 1880. by I EDWARD SHIPPEN, M.D. [Extracted from the Transactions, 3d Series, Vol. V.] PHILADELPHIA: 1880. COLLINS, PRINTER. M EMOI R. Mr. President and Fellows of tiie College: I regret exceedingly that some one has not been found more capable than I am of discharging the duty devolving upon me to- night. To place a green wreath upon the grave of John Neill is a labor of love with me ; and yet I know full well that simple love and esteem give no claim to duty of this nature in this place. My only right to speak of our departed fellow and friend is conferred by an unbroken intimacy of thirty-five years; an intimacy begun in the relation of in- structor and pupil; continued as demonstrator and assistant; and confirmed as, in time, we became connections, and he the trusted and beloved family physician. And here I hope I may be pardoned if I recall that, with many honest differ- ences, and many warm debates, ii; the course of all those long years, I may say, in the presence of the dead, not a shadow of bad feeling ever passed between us; not the misunderstanding of a moment. This is a great deal to say of the life-long intercourse of any two men. We make no 4 such friendships in later life: The gaps made bj' death are then never filled ; and it is left for us only to mourn the departed—not, let us trust, without hope. John Neill, the ancestor of the subject of this notice, came to America from Tyrone, Ulster, Ireland. He had already studied law and had been admitted to the bar in his native country, and settled at Lewes, Delaware, and began the practice of his profession in 1739, soon rising to be one of the influential and distinguished men of his region. He had two sons, the elder of whom died sine j)role, but the second of whom, also named John, was the father of Dr. Ilenry Neill, long a successful practitioner in Philadelphia, and a fellow and an officer of this honorable body; whose portrait hangs in the northern hall of this building. John Neill M.D., the subject of our sketch, was the third son of Dr. Ilenry and Martha Duffield Neill, and thus came of a medical ancestry on both sides, as his mother was the daughter of Benjamin Duffield, M.D., and a near relative of the distinguished surgeon-general of revolutionary times, Dr. Jonathan Potts. I may, perhaps, be excused for devoting a few words to Dr. Benjamin Duffield, on account of his having been one of the originators of this College. An ancestor of the same name, Benjamin, came to this country in 1661, and pur- chased large tracts of land in Maryland, in Philadelphia, and in the manor of Morland, in Bucks County. Benfield, one of his houses, three miles from Holmesburg, is still standing. Without giving the intermediate links in the family chain, we may pass down a century, to the year 1758, when Benjamin Duffield, M.D.,the son of Edward, was born at Benfield. ITe graduated at the College in Philadelphia, which was afterwards to become the University of Pennsyl- 5 vania; and, in 1771, proceeded “A.M.,” his thesis being a poem entitled “Science.” lie at once began the study of medicine, but, owing to the state of the country, no diplomas were granted at the time he completed his course, in 1774. He, however, received certificates, signed by Drs. Morgan, Shippcn and Kuhn, that he had attended all the courses, and was duly qualified; as well as from the Physicians of the Pennsylvania Hospital, and from his preceptor, Dr. Redman. Dr. Duffield married Rebecca Potts, and his first public position was that of surgeon in charge of a military hospital at Reading, during the Revolution. After the war he settled in Philadelphia, where his knowledge of foreign languages, in which he was proficient, gave him an extensive practice among the many foreign families which had, by that time, settled in our city. In addition to his practice he conducted courses of lectures on midwifery, was Physician to the Yel- low Fever Hospital at Bush Hill, during the epidemic of 1793, and was also Physician to the Walnut Street Prison, where he delivered lectures on the Diseases of Jails and Hospitals. Dr. Duffield was a great wit, and a ready writer. The first volume of the Transactions of this College (of which, as I have said, he was one of the originators) contains one of his papers. He died in 1799, in his very prime, leav- ing two sons and three daughters. All of the latter married physicians. The eldest married the well-known Dr. Church; the second Dr. Henry Neill; and the third Dr. Martin, of Maryland, who was distinguished in the Councils of the State, as well as eminent in his profession. John Neill, thus honorably descended on both the paternal and maternal sides, was born in Philadelphia, on July 9, and was prepared for college at the well-known school of 6 Dr. Samuel W. Crawford, passing the examination for admis- sion to the University of Pennsylvania at the age of thirteen, though, on account of the regulations of that Institution, he was not permitted to actually enter the University until the following year. While in College, Dr. Neill was a diligent student, especially in the classics, the love for which he retained throughout life. Finishing his course with the second honor, the subject of his commencement address was “The Investigating Spirit of the Nineteenth Century.” After graduating from the Academical Department, in 1837, he at once entered the Medical Department of the University, and received the degrees of A.M. and M.D. in 1840, the sub- ject of his thesis being “ Diseases of the Eye,” a subject sug- gested, no doubt, by the fact that, previous to graduation, he had been appointed House Surgeon to Wills Hospital, where he remained two years, laying the foundation of that remarkable ability with which he ever after operated upon the eye and ear. Upon leaving Wills Hospital he was for some time a substitute for one of the resident physicians in the Pennsylvania Hospital, whence so many of our best men have derived invaluable practical instruction. Before settling down to practice, Dr. Neill made a voyage to the West Indies, in charge of a patient, at the same time recruiting his own health, which had been somewhat im- paired by his close devotion to his duties. In 1842 he began practice, and the private instruction of medical students; and in the autumn of the same year was made Assistant Demonstrator of Anatomy in the University, where he also assisted Professors Horner and Gibson in preparation for their lectures. At the same time he was a Vaccine Physi- cian, and Physician to a City District, under the Guardians of the Poor. In 1845 he succeeded Dr. Paul B. Goddard as 7 Demonstrator of Anatomy in the University, in which capacity, by the accuracy and clearness of his demonstra- tions, the neatness and delicacy of his dissections, and his magnetic power of communicating instruction, he drew together, perhaps, the largest class in Practical Anatomy which the University, up to that time, had ever seen. By permission of Professor Horner he recapitulated to this class the anatomical lecture of the day, occupying the amphithe- atre for this purpose. In addition to the great labor of lecturing, teaching, procuring material for dissection (then done with difficulty, great expense, and even danger), and beside attending to increasing public and private practice, Dr. Neill had, since 1842, been connected with Drs. Reese and Benedict in an association for the winter examination of students and for summer instruction, with a class which was always large, at one time numbering eighty. About the year 1846, these gentlemen revived the old “Philadelphia Medical Institute,” a well-known summer medical school of former time, which was founded by Pro- fessor Nathaniel Chapman, and which boasted among its former lecturers such distinguished names as Chapman, Hor- ner, Gibson, T. Harris, Dewees, J. Iv. Mitchell, Jackson, Hodge, and Bell. The Medical Institute was continued as a summer school until about 1850; Dr. Neill lecturing on Anatomy, Dr. Reese on Materia Medica, and Dr. Benedict on Obstetrics, the late Professor John F. Frazer being their colleague in chemistry. Dr. Benedict was, for the last year, replaced by Dr. Vm. Byrd Page. In 1847, Dr. Neill had been elected a Surgeon to Wills Hospital, and, during his tour of duty there, was always accompanied by an attentive class of students. In 1849, the Asiatic cholera visited us for the second 8 time, and Neill was Physician to the Southeast Cholera Hospital, which was established in the old Friends’ Meeting House, in Pine Street, above Front. During his service here he made the minute injections upon which was based the Report made to this College, and published in its Transac- tions, as we shall state more fully hereafter. While making these investigations he was himself attacked by the disease, was taken to the Hospital, directed his own treatment, and concealed the fact of his illness from his family and friends until the epidemic was over; explaining his prolonged absence by the plea of pressing business. As soon as he was able, he returned to his labors, and there are many of us who will remember his zeal, activity, and buoyancy amid the gloomy and depressing scenes of that dreadful summer. Dr. Neill was elected Curator of the College of Physicians on the 2d of October, 1849, being the first incumbent ever chosen for that important office, which he held for eight years. The Committee on the Museum at the time of his appointment consisted of Drs. Moreton Stills, Edward Hallowell and Isaac Parrish. At the regular meeting in November, Dr. Neill presented the first Curator’s report, stating that “since the last meeting of the College a case has been erected on the south side of the Hall” (of course in the old Hall), “to receive the first contributions to the Pathological Cabinet of the College of Physicians. The late Dr. Parrish, Vice-President of the College, was an industrious collector and conservator of pathological specimens; and the bulk of his cabinet, which served for the purpose of illus- trating his lectures, has been presented to the College.” To these were added, both at that time and afterwards, valuable contributions from the Curator himself. At the meeting of Dec. 4,1849, the Committee on Cholera, 9 of which Frofessor Samuel Jackson was Chairman, and Drs. Neill, IL II. Smith and Pepper were members, presented a report upon the injections of the intestines of patients dying of cholera, which had been made by Dr. Neill, as has already been stated. The Committee reported that “ the admirable manner in which he has performed this duty can be judged of by the beautiful preparations now upon the table, which he has presented to the College for its Museum.” The injec- tions were made with turpentine colored with vermilion, having failed when size and Canada balsam had been used. This had led, at first, to the supposition that the capillaries of the intestinal tract were destroyed by the disease; but the method devised by the investigator showed the perfect integrity of those vessels. A portion of healthy intestine, taken from the body of a patient who had died of pleurisy, was injected with the same fluid as a standard of comparison. These preparations speak for themselves; they form a ground- work for any future investigation, and those interested may find them in the Museum of this building. The whole series consisted of eleven mounted wet, and twelve dry prepara- tions, four fitted for the microscope, and seven drawings. An interesting discussion ensued upon the presentation of these specimens to the College. For several jTears after this, the Transactions contain frequent notices showing the activity and industry of the Curator, in spite of his many other imperative duties; but he was deeply interested in the work, and whatever he did he did with his whole heart. In 1852, three years after becoming Curator of the College, the subject of our sketch was elected one of the Surgeons of the Pennsylvania Hospital, which he served faithfully for seven years, with signal honor to himself and benefit to his patients, effecting more than one permanent improvement 10 in the art of Surgery. At this time his ability as a clinical lecturer and as a very skilful operator became conspicuous, so that he was gladly welcomed, in 1854, as an acquisition to the Faculty of the Medical Department of Pennsylvania College, then in Ninth Street, near Spruce, where he assumed the chair of surgery; and where he was associated with such men as Professors Francis Gurney Smith, J. II. Allen, John B. Biddle and David Gilbert—all of whom have passed away—and Professors Alfred Stilie and John J. Reese, who still survive, and hold enviable positions in the profes- sion. To enable Dr. Neill to become a member of this Faculty, Dr. Gilbert resigned the chair of surgery, and took that of obstetrics. About this time, too, with a view of extending the clinical opportunities of his students, Dr. Neill accepted the appointment of Surgeon to the Philadelphia Hospital at Blockley. Under the Faculty just named, the Pennsylvania College was making fair progress, and gaining steadily in reputation and in friends—everything going smoothly for five annual sessions—when a difficulty arose in filling one of its most important chairs; and the Faculty determined to resign in a body, in favor of the Faculty of the “Philadelphia Col- lege of Medicine.” These last were duly elected, and the “ Philadelphia College” thereby became extinct. This event took place in 1859. While Dr. Neill was a member of the Faculty of the Pennsylvania Medical College, occurred the resignation of Professor Wm. Gibson from the Chair of Surgery so long and worthily held by him in the University of Pennsylvania. A very influential body of friends urged Neill to become a candidate for the position, but several reasons prevented him from doing so. Of these the strongest, no doubt, was the consideration that it would not be fair 11 towards the Faculty to which he belonged, and which had secured his services by a special change in its organization. He thus was deterred from putting himself forward as an applicant for a chair for which he was acknowledged to be especially fitted, and which had been the legitimate object of his ambition. After his resignation from the Pennsylvania College, Dr. Neill devoted himself, for two years, to the building up of his private practice, which had too often been neglected for his public duties. Beside family practice, which at this time rapidty increased, he had numbers of cases of surgery, both at home and sent to him from a distance, often‘by former pupils. He also, not unfrequently, made journeys to perform important operations. Thus time passed, usefully, happily, and profitably, until that memorable Sunday in April, 1861, when the fall of Fort Sumter was telegraphed over the whole country, and Neill, as if by inspiration, felt that a long and bloody con- flict was at hand, and was confident that in such a case Philadelphia must, for many reasons, become a great centre for military hospitals. That same day, without consulta- tion with any one, he drove about the city in search of halls or public buildings adaptable to hospital purposes, and find- ing one on Christian Street above Ninth Street, formerly Moyamensing Hall, he obtained permission from the mayor, Mr. Alexander Ilenry, to take possession of it. Telegraph- ing and writing to Dr. Finley, then Surgeon-General of the Army, he obtained from him authority, as a contract sur- geon, to establish there a United States military hospital. About the same time the Home Guard was organized, and Neill was appointed Medical Director of that body, with the Christian Street building as the hospital of the guard, 12 and, by the terms of the general order, “also to be used for any others in the service of the United States, and to he governed by U. S. Army regulations.” As medical officers of the Home Guard there were appointed, in addition to the Medical Director, such well-known gentlemen as Drs. Fran- cis Gurnej7 Smith, S. Hollingsworth, John II. B. McClellan and Ellerslie Wallace, as surgeons, and Drs. John II. Brinton, George C. Harlan, John H. Packard and F. Wr. Lewis, as assistant surgeons. Very soon the establishment of the hos- pital became known throughout the city, and contributions of money and supplies came in freely ; and in a few days the first war hospital in Philadelphia was ready for the reception of the sick and wounded. It was thus with Neill in all matters, great or small, in which he was interested. Action very promptly followed conception, and this trait was one great cause of his ability in professional emergencies. When the disastrous battle of Bull Run took place, the director of the hospital was.authorized to put in action the machinery of government railroad transportation, and the capacity of the hospital was soon tested to its utmost—to the relief of untold suffering, and the saving of many lives. From time to time thereafter, as the emergency arose, Neill was authorized to secure and equip one large building after another; and to remodel and prepare them as general hos- pitals, with surgeons and their staffs attached to each. Some of these were among the largest in the country, and were used during the whole war. Neill, himself, was placed in charge of the hospital at Broad and Cherry Streets, where most of the cases arriving from the South were received, classified, and then transferred to other hospitals. The es- tablishment soon became noted for its discipline, cleanliness, and comfort. Here the sick and wounded found baths,clean 13 clothing, and the necessary food and delicacies all prepared for them, at any hour at which they might arrive; and necessary operations were performed with promptness, skill, and tenderness,either by the surgeon in charge, or by selected and trusty assistants. All these knew that the vigilant eye of their superior was upon them at all times, and that his unflagging industry and zeal made his frequent inspections anything but perfunctory. It is not necessary to dwell upon the medical and surgical history of those days. Many of us have them so impressed upon our memories that we shall only lose them with life itself; but we may, perhaps, mention one incident which tends to illustrate Neill’s promptness in duty. With him, to think was to act; and so great was his ability for organi- zation and administration, that in the shortest conceivable time he would bring order out of the direst confusion. Thus, on one occasion, he received a telegraphic order from the Secretary of War to be in readiness for some hundreds of sick and wounded—nine hundred, I think—then actually upon their way. The hospitals were all full to overflowing, but he at once secured a large storehouse, had it swept and arranged, necessaries supplied, and in a very few hours was ready to receive this large number of patients, with soup, coffee, bread, beds, medical stores and medical aid all at hand. The arduous labor of establishing and putting in working order eight hospitals was performed, we may say, gratuitously—for Dr. Neill was not commissioned as Surgeon of Volunteers until the fall of 1862, and up to that time only acted as Contract Surgeon, at $80 a month. His posi- tion in the Home Guard, as Medical Director, was purely honorary. It was in keeping with the nature of the man that he should have worked with such devotion, for so long 14 a period, without bestowing any consideration upon the pecuniary reward he was to receive for his labor. Upon the invasion of Pennsylvania by Lee’s army, in 1863, Dr. Neill was appointed Medical Director of the forces from that State, under General William F. Smith, U. S. Army. Many who hear me will remember those dark days, wThen the State House bell was tolling to summon volun- teers, and when all trades and professions, even the exempt, turned out to meet the approaching enemy; and when even venerable ministers of the Gospel were to be seen with in- trenching tools in their hands, throwing up works for the defence of our city, so near to occupation by the Southern forces. General Smith and his headquarters, with the most advanced of the improvised force, reached Carlisle about sunset, one evening, to find the place almost invested by Fitz Hugh Lee; and they had no sooner entered the town than he opened his batteries upon it. The volunteers had about thirty of their number wounded by shell, in a very few minutes, but, owing to the soldierly dispositions of General Smith, none were captured; and the Confederate force quietly drew off in the direction of Gettysburg, to fight the great battle of the war. Unaware of this movement on their part, and with the expectation of further casualties on the next day, Dr. Neill prepared Dickinson College—which had not escaped unscathed from the bombardment—for a general hospital; and passed the night in this work, and in collecting the wounded, having them cared for, and in in- sisting upon a more conservative treatment than some of the wounded seemed likely to receive at the hands of excited and inexperienced surgeons. The following day, headquarters 0 # marched to Pine Grove, and thence to Hagerstown—at each of which places Neill established hospitals, which were 15 afterwards of the utmost importance, and the fitting up of which involved immense labor and loss of rest. For meri- torious services in this campaign, he was brevetted Lieu- tenant Colonel. After the war, Dr. Neill was appointed Tost-Surgeon at Philadelphia, holding that office for some time; and then was made examiner of recruits, which position he retained until 1876. About the close of the war he became Consult- ing Surgeon to the Institution for the Deaf and Dumb; and also held the same position on the Staff of the Presb37terian Hospital—the establishment of which he was, I am informed, the first to suggest in a public and practical way. In 1874, when the Chair of Clinical Surgery was established in the University, Dr. Neill was elected to it by the trustees; and thus was fulfilled the crowning ambition of his life—a sur- gical professorship in his Alma Mater. He entered upon his duties with his usual ardor, and I feel sure that I am speak- ing within bounds when I say that no better lecturer on Clinical Surgery was ever heard in this city, which has pro- duced so many. Dr. Neill was much interested in, and a strenuous advocate of, an extended course of medical instruction, as now so hap- pily inaugurated. Unfortunately, he was permitted to give but one course of lectures, when he was attacked by the fatal disease which terminated his life. During two years of his lingering illness he was in total blindness, unable to distinguish night from day. He bore his affliction with a patience and resignation which was marvellous, and, during the whole of his long illness, uever uttered a complaint. He finally succumbed on the morning of February 11, 1880, in his sixty-first year. As soon as it was evident that his days of usefulness were over, Dr. Neill resigned his professorship, 16 and was made Emeritus Professor of Clinical Surgery in the University. In the course of his busy life, Dr. Neill found time, in addition to his notices in the Transactions of the College, to publish in the Medical Examiner (then edited by his brother- in-law, the late Dr. Samuel Hollingsworth), between the years 1849 and 1855, no less than twelve valuable articles, two of which at least—those on Treatment of Fracture of the Pa- tella, and on Extension and Counter-Extension in Fracture of the Leg—have passed into the literature of the profession. To the American Journal of the Medical Sciences he con- tributed, between 1842 and 1875, seven papers—all of which are of more than common interest. Early in his professional life, while actively engaged in teaching, he prepared and published three little works upon the Veins, Arteries, and Nerves, which had a great success. Their merit consisted in original drawings, colored, with the names placed upon the parts, instead of being referred to by numbers—rather a novelty then, and a great relief to the student. About the same time, in conjunction with the late Dr. Francis Gurney Smith, afterwards the distinguished professor of physiology, he compiled the well-known “Compendium of Medical Sciences,” Dr. Reese furnishing the parts upon Materia Medica and Chemistry. The work at once found its way into the hands of students in every part of the country, and was thus successful; hut Dr. Neill, in after years, frequently was heard to regret that he had ever been connected with a publication, however successful, which contributed so largely to make medical education superficial. Possibly he was over- sensitive in regard to this subject, but I feel hound to state what I know to have been his feeling. Just before his last illness he had projected a work upon the Principles of Sur- 17 gery, which he intended should be worthy of himself, and of the chair which he occupied. Unfortunately for the pro- fession, he had only completed the notes for the first chapter, when the great calamity befell which cut short a life from which many years of usefulness might reasonably have been expected. Dr. John Neill was a man of catholic mind—ever inter- ested in literature, art, politics, and the social topics of the day. He was a ready and pleasing writer, his style being remarkable for its curt, incisive sentences—divested of all redundancy or verbiage. With great powers of concentra- tion upon the subject of inquiry or interest at the moment before him, he was always true to his profession, giving it the first place. Although a conscientious and successful general practitioner, he was especially a surgeon—of surpas- sing skill in diagnosis, and ability in operation. He loved his profession for itself, and found high compensation in the consciousness that he had devoted to its pursuit all the energy and ability which he possessed. Its pecuniary rewards were, with him, always a secondary consideration; at times,indeed, entirely too much so. Dr. Neill’s most striking character- istics were quickness of apprehension, intensity of applica- tion, and perseverance in execution. Of these, perhaps, the most prominent was his intensity ; whatever he found to do, he did with all his might. His affections were warm, firm, and very fixed. He had strong prejudices—as most strong men have—but, once convinced of error, he was ever ready to yield them. He was a man of pure life; singularly modest, reverent, and holding an unswerving faith in the doctrines of Christianity, while most liberal in regard to forms of worship. Although of temperament somewhat unequal, at times 2 18 buoyant and hopeful, and at others much depressed, he was genial in manner, very generous, and given to hospitality. In both medical and surgical practice he might have been classed as soundly conservative, while always ready to give fair trial to methods and remedies which commended them- selves to his reason. Always cheerful at the bedside, as a matter of duty, he never failed to inspire his patients with hope as well as with entire confidence, often thus rendering them greater service than by the administration of remedies; and it seldom happened that he did not render a patient a personal friend. May we all be mourned as sincerely as he is!