John B. Murphy, Theodore Roosevelt, and the W. B. Saunders Company

JOHN B. MURPHY, THEODORE ROOSEVELT, AND THE W. B. SAUNDERS COMPANY JOHN L. DUSSEAU* John B. Murphy (see fig. 1) was one of America's wisest and most effective surgical teachers; but his fiery temperament and belligerent egomania clouded during his lifetime and obscure even today the fact that he also made significant contributions to the progress of healing disease and repairing trauma through surgery. In 1849 at St. Mary's, a tiny log church in Appleton, Wisconsin, a circuit-riding priest united in marriage Michael Murphy and Anne Grimes, immigrants brought to America by Ireland's potato famine. The couple went home to the 60 acres of rich farmland Michael had cleared in back-breaking labor and to the spacious log cabin he had built for his bride. On December 21, 1857, their sixth and last child was born, John Benjamin Murphy, a restless child who would become a restive, defiant man unable to brook opposition or suffer fools lightly. His mother, intensely ambitious and better educated than most Irish immigrant women, saw clearly that in America education was necessary not only to success but to solid accomplishment as well. She shared her son's early interest in medicine and, realizing that something more than a cursory apprenticeship was the lodestar of achievement, encouraged him to work his way through Rush Medical College and an internship at Cook County Hospital. He then practiced surgery with Dr. E. W. Lee but was attracted by the magnet of Vienna, at that time the world's leading medical center. He studied there for 2 years and returned to Chicago in the spring of 1884 to embark on a distinguished and sometimes embattled surgical career. In worldly matters he displayed an obdurate pigheadedness and grasping zeal, but he was never reluctant to change medical views that did not conform to his own experimental findings. This essay could not have been written without recourse to Loyal Davis's invaluable biographyJohn B. Murphy (Putnam, 1939) and is based in part on the author's An Informal History of the W. B. Saunders Company. ?Address: 609 Fox Fields Road, Bryn Mawr, Pennsylvania 19010.© 1989 by The University of Chicago. AU rights reserved. 003 1-5982/89/3202-06 14$01 .00 212 I John L. Dusseau ¦ John B. Murphy and Theodore'Roosevelt Fig. 1.—John B. Murphy: Stormy Petrel of American Surgery. (Courtesy National Library of Medicine.) Perspectives in Biology and Medicine, 32, 2 ¦ Winter 1989 | 213 V Fig. 2.—The Murphy button. (From Medical Record, 1892.) His animal experiments were carried out at home amidst many difficulties and without sophisticated laboratory equipment. The value of his discoveries should not bejudged against the standards of today's investigative and operative techniques but against the backdrop of his own time and circumstance, for our present was his unknown future. Resection of wounded intestines was then regarded as a dangerous and usually fatal undertaking; and it was often observed that the mortality following such procedures was much greater than when the healing process was left to the body's natural resources. In 1826 Devans, a surgeon of Marseilles, had described a method of effecting end-to-end union by rings of silver or zinc in the treatment of transverse wounds, but the rings did not solve the problem of infection. Murphy's button (see fig. 2) was an ingenious extension of Devans's principle that avoided sepsis and the dangerous exposure of lengthy surgery. Its discovery resolved an ancient surgical difficulty and stimulated men's minds to fresh ideas and further research. In the late nineteenth century, few surgeons appreciated that operation without septic complications would vastly extend the scope of surgery; but Murphy did, and the best-known of his surgical contributions revolutionized gastrointestinal surgery by making possible anastamosis and approximation of portions of the intestine without sutures. Murphy told of his experience with the button in a lengthy article in the Medical Record in 1892 (42:665) and described boldly what he had accomplished : "To lessen the risk to the life of the patient, I have devised a mechanical means to dispense with the need of sutures, the necessity of invagination, the possibility of non-apposition...