Oscar H. Allis, M.D.

   H. Augustus Wilson M.D.

   James T. Rugh, M.D.

   James R. Martin, M.D.

   Anthony F. DePalma, M.D.

   John J. Gartland, M.D.

   Richard H. Rothman, M.D., Ph.D.
H. Augustus Wilson M.D. (1853-1919)
Clinical Lecturer in Orthopaedic Surgery (1892-1904)
and First Chairman (1904-1918)
Augustus Wilson was promoted to Clinical Professor of Orthopaedic Surgery in 1892. It would seem appropriate to regard this promotion as the exact point in Jefferson history when orthopaedics began the process of ultimate separation from general surgery. Support for this contention comes from Wilson's attitude, since he clearly regarded himself as an orthopaedic surgeon rather than a general surgeon. As early as 1887, he had published an article in the Proceedings of the Philadelphia County Medical Society that described a new method for preparing dry gypsum bandages used in the constmction of plaster casts. He was invited to join the fledgling American Orthopaedic Association in 1891 and was well regarded by his colleagues in this new organization. He served as Vice President in 1893 and President in 1902. He represented the first Jefferson orthopaedist to hold a major elected office in national orthopaedics. A Jefferson representative was not destined to secure a second major national orthopaedic office until 1979.

A significant reorganization of the Jefferson faculty occurred in 1904. Several disciplines, formerly regarded as part of general surgery, were identified as new and separate Departments. The minutes of the Administrative Committee meeting of November 28, 1904 (forerunner of the Executive Council) state "in view of the fact that the faculty is now composed of Professors who teach and examine in genito-urinary surgery, orthopaedic surgery and laryngology, it is suggested that the Professor of Practice of Surgery and of Clinical Surgery shall be relieved of teaching subjects pertaining to these branches."

Minutes of the Administrative Committee meetings before 1904 do not exist, so one can only guess the reasons for this faculty reorganization. It is probably accurate to surmise that a need was identified to enlarge the major faculty. An interesting question to consider is why Jefferson chose, in 1904, to decrease the responsibility of the Department of Surgery by creating three new Departments out of the fields that were traditionally considered surgical subspecialties. In many, if not most, medical schools, these evolving surgical disciplines were given some separate identity by simply designating them Divisions of General Surgery.

Whatever the reasons happened to be, this action of the Administrative Committee created a Department of Orthopaedic Surgery at Jefferson in 1904 and made H. Augustus Wilson its first Professor and Chairman. Jefferson thus became one of the first medical schools in the country to have a separate Department of Orthopaedic Surgery. It is somewhat ironic to note that despite the suggestion of the Administrative Committee that the Professor of Practice of Surgery and of Clinical Surgery "be relieved of teaching subjects pertaining to these branches," the Department of Surgery continued to dominate the treatment of fractures in Jefferson Hospital and continued to teach fracture principles to Jefferson medical students until about 1948.

Wilson, by all accounts, was a good teacher and an effective Department Chairman. He appointed J. Torrence Rugh (Jefferson, 1892) to serve as Assistant Professor of Orthopaedic Surgery in 1905 and Arthur J. Davidson (Jefferson, 1907) as Instructor of Orthopaedic Surgery in 1908. Both of these men figured prominently in the growth and development of the new Department. Treatment of orthopaedic deformities at this time was given mostly by physical manipulation, mechanical traction devices, and bracing. Not much in the way of open surgery was performed except by a few daring pioneers. References to surgical correction of deformity in the years around 1910 generally referred to the cutting of tight tendons performed through very small incisions. Rugh ultimately succeeded Wilson as Chairman in 1918, and Davidson remained in active teaching in the outpatient clinic until 1954. Arthur Davidson became a recognized expert in the care of foot problems and freely imparted his knowledge to students in the orthopaedic clinic. Unfortunately, he could never be persuaded to put his considerable knowledge into book form.
Writing in the 1936 Clinic Yearbook) Rugh made the following comments about these early years of orthopaedics at Jefferson:
"The outpatient clinic was organized by Dr. Allis and now forms an important part of the student's instruction. The first dispensary was in the amphitheater of the old hospital. Dr. James Manno of the class of 1887 was chief of clinic and cooperated with Professor Wilson until IR96 when he resigned to accept the orthopaedic professorship in the Medico-Chimgical College. During these years of Dr. Wilson's service, great advances were made in orthopaedics. The surgical phases of the corrective work increased and became more important. New procedures and discoveries regarding the prevention and correction of deformities added greatly to the success of the work in Jefferson."
Professor Wilson resigned the Chairmanship in 1918 and died of uremia on April 16, 1919. He had attained a national reputation in orthopaedic surgery that reflected favorably on Jefferson and its new Department. His obituary was published in 1919 in the Journal of Orthopaedic Surgery forerunner of the present Journal of Bone and Joint Surgery. Its author, Dr. R.W. Lovett of Boston, said: "I should say that the man's chief characteristics were earnestness, unselfishness, kind-heartedness and absolute devotion to a cause once undertaken. He was a man of ideas which he never sacrificed, his profession and his family filled his life, and he had few outside interests. He was a most indomitable worker and he had one agreeable trait, that of making the man with whom he talked think more highly of himself than he did before the conversation, for he seemed to look for the best that was in each man and to dwell on that side of his relation to each one."

James T. Rugh, M.D.

Thomas Jefferson University Hospital Department of Orthopaedic Surgery.