SURGICAL RETROSPECTION

Edward Bermingham and the Archives of Clinical Surgery America’s First Surgical Journal Ira Rutkow, MD, DrPH

Objective: To explore the life of Edward J. Bermingham (1853–1922) and his founding, in 1876, of the Archives of Clinical Surgery, the nation’s first surgical journal. Background: Beginning in the 1870s, American medicine found itself in the middle of a revolution marked by fundamental economic, scientific, and social transformations. For those physicians who wanted to be regarded as surgeons, the push toward specialization was foremost among these changes. The rise of surgery as a specialty was accomplished through various new initiatives; among them was the development of dedicated literature in the form of specialty journals to disseminate news of surgical research and technical innovations in a timely fashion. Methods: An analysis of the published medical and lay literature and unpublished documents relating to Edward J. Bermingham and the Archives of Clinical Surgery. Results: At a time when surgery was not considered a separate branch of medicine but a mere technical mode of treatment, Bermingham’s publication of the Archives of Clinical Surgery was a milestone event in the ensuing rise of surgery as a specialty within the whole of medicine. Conclusions: The long forgotten Archives of Clinical Surgery provides a unique window into the world of surgery, as it existed when the medical revolution and the process of specialization were just beginning. For this reason, the Archives is among the more important primary resources with which to gain an understanding of prescientific surgery as it reached its endpoint in America. Keywords: America’s first surgical journal, Archives of Clinical Surgery, Edward Bermingham, prescientific surgery, surgical specialization (Ann Surg 2015;261:812–819)

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eginning in the 1870s and continuing through the 1890s, American medicine found itself in the middle of a revolution marked by fundamental economic, political, scientific, and social transformations. For those physicians who wanted to be regarded as surgeons, the push toward specialization was foremost among these changes. An observer at the 1886 convention of the American Medical Association explained, “Doctors began to realize that, by devoting themselves to one branch instead of working up a general practice, they could often do more good, earn more money, and have less arduous work to perform.”1 Although medical care was dispensed by a patchwork of overlapping and antagonistic clinical factions, ranging from allopaths to eclectics to homeopaths, surgeons began to secure a measure of organizational unity and technical competency. This cohesion was accomplished through various new initiatives, many of which strengthened the idea of professionalism. For example, progress in science brought about a valid body of medical and surgical knowledge that led to state-sanctioned licensing standards and self-regulatory bodies such as the American College

Reprints: Ira Rutkow, MD, DrPH, 146 West 57th St, Apt 55B, New York City, NY 10019. E-mail: [email protected]. C 2014 Wolters Kluwer Health, Inc. All rights reserved. Copyright  ISSN: 0003-4932/14/26104-0812 DOI: 10.1097/SLA.0000000000000640

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of Surgeons and the American Board of Surgery. William Halsted (1852–1922) established a residency program at the Johns Hopkins Hospital that formalized the education and training of surgeons, and Samuel D. Gross (1805–1884) founded the American Surgical Association, bringing the concept of “organized” surgery to a national level. The rise of surgery also depended on another key initiative, the development of dedicated literature in the form of specialty journals to disseminate news of surgical research and technical innovations. It is a common belief that the Annals of Surgery, including its parent namesake the Annals of Anatomy and Surgery, was America’s earliest surgical periodical. Although it is true that the Annals of Surgery is the oldest continuously published journal in English devoted exclusively to surgery, it was not the first of its kind. The Annals was almost a decade away from its birth when, in 1876, Edward Bermingham (1853–1922) (Fig. 1) issued the Archives of Clinical Surgery, a publication he described as a “monthly periodical devoted to surgery, which includes all its special departments . . . original clinical papers by representative men . . . [and] covers a field hitherto untouched.”2 In fact, Bermingham’s Archives was the nation’s earliest surgical journal. Although the Archives of Clinical Surgery was short-lived, its standing is noted by the distinguished group of surgeons who authored and read its articles and the way its format and content served as a template for the specialty magazines that followed. [Until recently, original copies of the Archives were only available in a few select repositories. However, developments in digital scholarship, most notably Google’s historical book database (http://books.google.com), have made these same materials freely accessible to anyone with an internet connection.] Despite being the first surgical journal published in America, the story of the Archives of Clinical Surgery remains unknown, a victim of the passage of time. [It should be noted that in 1860, Bernhard von Langenbeck (1810–1887), professor of surgery in Berlin, established the Archiv f¨ur Klinishe Chirurgie. Recognized as the “German” Archives of Clinical Surgery, Langenbeck’s effort is not to be confused with Bermingham’s endeavor.] Yet, in the mid-1870s, an era when surgery was not considered a separate branch of medicine but a mere technical mode of treatment and specialization was a nascent concept, Bermingham’s Archives uniquely offered what Lewis Pilcher (1845–1934), editor of the Annals of Surgery, described as the raison d’ˆetre for a surgical journal: “By restricting itself to a special department, a periodical presents the happiest union of the elements needed for the best presentation of whatever may be of permanent value in that department.”3 How did it come to pass then, when the merits of antisepsis were first being debated4 and Gross was declaring “I am sure it requires only the smallest amount of brains to make a specialist,”5 that a 23-year-old recent medical school graduate brought out the nation’s first surgical journal? What were Bermingham’s plans and who were his financial backers? In what manner and to whom was a specialty journal marketed? Was the concept of a “surgical” periodical generally accepted or an idea ahead of its time? And, most importantly, once specialty journals such as the Annals of Surgery were firmly established, what was their role in surgery’s growth? A large measure of the explanations is found in the history of the Archives of Clinical Annals of Surgery r Volume 261, Number 4, April 2015

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FIGURE 1. Edward J Bermingham, circa 1915 (courtesy of the New York Academy of Medicine). Surgery and the life and pursuits of Bermingham, one of the country’s unsung surgical pioneers.

AMERICAN MEDICAL PERIODICALS, 1797–1876 Among the more significant developments of 18th- and 19thcentury medicine was the appearance of the periodical as a form of dedicated literature intended to bring greater timeliness to the spread of medical knowledge. In addition, it was through periodicals and their book reviews that errors in textbooks were corrected in an expedient manner. America’s physicians proved adept at exploiting this new style of journalism and, by 1860, more health-related magazines were published in the United States than almost all of Europe.6,7 As distribution times were reduced from months to days—the coming of the railroad, the steamship, and the telegraph were the most important factors—the periodical assumed an ever larger role in the education of the nation’s medical workers. “Medical journalism has become the principal means of recording and communicating the observations and ideas of those engaged in the practice of medicine,” wrote a doctor in 1876, “and has exercised a strong influence for the advancement of medical science and education.”8 Daniel Drake (1785–1852), professor of medicine in Cincinnati and one of the country’s most renowned physicians, was more to the point: “Even the village surgeon now cuts according to the newest fashion of some great transatlantic operator.”9 Most of the early medical journals had a limited budget and a small readership, usually fewer than 500 subscribers. There were varied reasons for the modest circulation size, but geographic sectionalism and a multitude of rival proprietary medical schools created  C 2014 Wolters Kluwer Health, Inc. All rights reserved.

Edward Bermingham and the Archives of Clinical Surgery

intense competition for readers.10 With separate medical communities desiring journals of their own, many periodicals tended to have a purely local character, nameless beyond the limits of their hometown. And, when an institution’s faculty was a magazine’s sponsor, questions concerning academic favoritism and claims of originality flourished. “It will not be out of place to state that many of these periodicals are conducted by professors in the service of their respective schools,” cautioned Gross, “a circumstance greatly to be lamented, inasmuch as it must seriously affect the independence which should characterize such publications.”5(p55) If the internecine bickering and charges of “cliquism, base puffery, and petty intrigues”11 were not troublesome enough, there was the issue of personal gain or, as John Shaw Billings (1838–1913), a surgeon and originator of the Index Medicus, clarified, “the desire to have a place in which the editor can speak his mind and attack his enemies without restraint.”12 In view of the rivalries and partisanship that plagued 19thcentury American medicine, it is not surprising that of the 350 American medical journals published between 1797 and 1876, almost 300 folded within months of their inception. Nevertheless, and despite the assorted obstacles and financial downsides,13 there were publishing successes. The American Journal of the Medical Sciences, established in 1828 and still in existence today, was reported to be a “source of profit to both Editor and Publishers.”14 Equally long lived is the Boston Medical and Surgical Journal, which in 1845 was said to “enjoy a wide circulation in every part of the country.”14(p139) It continues presently as The New England Journal of Medicine. Although many of the early journals incorporated the words “Surgery,” “Surgical,” or “Surgical Sciences” in their title, little attention was paid to the concept of surgery as a specialty. There were simply not enough physicians who wanted to or could afford to be full-time surgeons. As Gross reminded his peers in 1876, “It is safe to affirm that there is not a medical man on this continent who devotes himself exclusively to the practice of surgery.”15 In truth, in the listing of occupations in the country’s 1850 census, only 191 medical men were categorized as surgeons—in comparison, 40,564 were titled physicians.16 A decade later, the number of self-declared knifebearers had merely grown to 512.17 Even as late as 1885, when Pilcher launched the Annals of Surgery, he believed that his new surgical journal could not be “very popular” because, as he explained, “at that date the number of surgeons, as distinguished from general practitioners, was not very great.”18 The reality was that not until the 1890s and the acceptance of surgical antisepsis were doctors able to operate with any reasonable anticipation of success. Once this occurred, the push toward specialization accelerated, as numbers of surgical operations increased along with the pool of surgeons. It was no wonder then, a decade before Pilcher’s assertion, that members of the American Medical Association’s Committee on Medical Literature voiced their concern about the establishment of specialty journals. “It would seem,” wrote Lunsford Yandell (1837– 1884), professor of medicine at the University of Louisville and the committee’s chairman, that “the profession, much as it is disposed to favor a subdivision of labor in it, is not quite ready to sustain works devoted to specialties.”19 Into this surgical and journalistic minefield stepped a determined Bermingham along with his Archives of Clinical Surgery.

BERMINGHAM AND THE ARCHIVES OF CLINICAL SURGERY Edward John Bermingham, born in Dublin, Ireland, was the son of Patrick Twiss Bermingham (1830–1889) and Elizabeth Rutledge (1832–?).20–22 In 1856, the family emigrated to America and, after taking a train from Boston to Iowa City, linked up with members of a handcart caravan who were setting out on an arduous overland www.annalsofsurgery.com | 813

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trek to join Brigham Young (1801–1877) and his followers in the Utah Territory.23,24 Life in Zion (modern-day Salt Lake City) soon proved a disappointment and the Berminghams renounced their belief in Mormonism and moved to Florence (modern-day Omaha) in the Nebraska Territory, where other former members of the Church had settled. There, Patrick, a graduate of the University of Dublin, worked as a school teacher. After the end of the Civil War, the Berminghams relocated to Boston and finally to New York where they prospered as Patrick became one of the city’s first tax collectors and real estate agents. Edward attended the College of the City of New York (today’s CCNY) and, in 1873, received his medical degree with honors from the College of Physicians and Surgeons of Columbia University. As was common at the time, Bermingham supplemented his formal education by studying with a local physician. Willard Parker (1800–1884), who in his youth had been a private student with John Collins Warren (1778–1856) and one of the first “house surgeons” at the Massachusetts General Hospital, was the long-time professor of surgery at the College of Physicians and Surgeons. As Bermingham’s preceptor, Parker took a special interest in his prot´eg´e’s career and suggested that the new graduate complete a year of internship in New York, then tour the great hospitals of Europe, and finally return to join him as his office assistant. By late 1874, Bermingham was back in Manhattan working at Parker’s side. Not only did Bermingham learn the essentials of managing a physician’s office but Parker, a powerbroker in the New York scene, introduced him to the city’s medical and social elite. Earlier, when Frederick Barnard (1809–1889), president of Columbia College, was named editor-in-chief of Johnson’s New Universal Encyclopaedia25 —the 4-volume set became one of the most widely quoted sources of information in mid-19th-century America—he invited Parker to be associate editor of the section on medicine, surgery, and the collateral sciences. Parker, in turn, asked Bermingham to write a series of health-related articles for the Encyclopaedia, almost a dozen in all, on topics as varied as gangrene, obesity, and rheumatism.25(vol 4 ppviii-ix) It must have been a heady experience for the 21-year-old Bermingham to see his name listed on the contributors’ page of the second and third volumes along with some of the nation’s most eminent physicians, including William Hammond (1828–1900), past Surgeon-General of the US Army, Stephen Smith (1823–1922), professor of surgery at Bellevue Hospital Medical College, and the renowned J. Marion Sims (1813–1883), the incoming president of the American Medical Association. In addition to Bermingham’s responsibilities for the Encyclopaedia, he was busy preparing papers for the periodical literature.26–28 In early 1876, during the months that Bermingham was organizing the Archives of Clinical Surgery, something went awry in his relationship with Parker. Whether it was an acrimonious separation or a simple parting-of-the-ways is uncertain but a biographical listing of Bermingham from that time describes it thusly: “He began practice as an ass’t to his former preceptor, Dr. Willard Parker, in 1874; but this connection was soon after dissolved, and he has since been engaged in practice in the city of New York.”20(p170) According to a contemporary account, Parker was not known as a “book-maker” and his own cases had to be reported by “other members of the profession.”29 Clearly, Bermingham was an industrious and entrepreneurial individual. Perhaps, the older Parker was uneasy with Bermingham’s progressive publishing ideas. Little information is available concerning the split but 2 things are clear: when the fourth volume of the Encyclopaedia was published, Bermingham’s name was no longer on the contributors’ page and, in July 1876, on the 100th anniversary of the signing of the Declaration of Independence, the inaugural issue of the Archives of Clinical Surgery arrived on the nation’s surgical doorstep (Fig. 2). 814 | www.annalsofsurgery.com

FIGURE 2. Front cover of the March 1877 Archives of Clinical Surgery (courtesy of the New York Academy of Medicine). Earlier that year, Bermingham had sent an introductory leaflet regarding his new publication—he branded the magazine as the “pioneer periodical, in the English language, devoted exclusively to the Science and Art of Surgery”30 —to the publishers of the country’s major medical journals. “We have read the prospectus,” wrote the editor of the Nashville Journal of Medicine and Surgery, “and judging from the long list of eminent names that appear as contributors, we augur for it a general welcome from all over the country.”31 A writer for the Louisville Medical News was more pragmatic: “As the number of those in the profession who take special interest in purely surgical matters is comparatively small, it behooves all such to stir themselves that the journal may not lack for pecuniary support.”32 Long-term “pecuniary support” could only come from a stable readership— Bermingham set the subscription fee at a costly “4.00 per annum” (approximately $100 in 2013) and insisted that it be paid “invariably in advance”2 —but the angel financing came from his family’s largess. The name of the publisher was “Rutledge,” Bermingham’s mother’s maiden name, and the firm’s address doubled as Bermingham’s apartment.  C 2014 Wolters Kluwer Health, Inc. All rights reserved.

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Annals of Surgery r Volume 261, Number 4, April 2015

In an era of proprietary medical schools, dishonest diploma mills, and noxious nostrums, Bermingham was not beyond stretching the truth when it came to publicizing his wholly owned journal. “It has received the unqualified endorsement of most of the hospital surgeons and teachers,” stated Bermingham. “It is but necessary to refer to our list of contributors . . . to attest the character of the publication.”2 The list of almost 100 contributors was a veritable who’s who of American surgery. From Henry Bigelow (1818–1890) of Harvard to D. Hayes Agnew (1818–1892) of the University of Pennsylvania to Frank Hamilton (1813–1886) of Bellevue Hospital Medical College, it appeared that most of the nation’s leading surgeons were behind Bermingham’s venture.2(front matter) But, was it an honest claim? There is no evidence that these individuals were contacted by Bermingham, nor are they known to have ever endorsed the journal. At this early juncture, he did not even have an editorial board in place. Instead, Bermingham seems to have put together a list of well-known physicians, albeit illusory in its intent, and used this to jump-start his venture. It was not until October that names of editorial board members finally appeared in the Archives.30(front cover) Most of the “associate editors” were professors of surgery at lesser known American medical schools, such as the Missouri Medical College in St. Louis and the Pennsylvania College of Dental Surgery in Philadelphia. Thomas Ashby (1848–1916), a friend of Bermingham’s, also made it onto the editorial board despite being only a “resident physician” at the University of Maryland. At a time when the specialty of surgery and its component fields were still to be defined, Bermingham also named editorial “collaborators” in the areas of dermatology, laryngology, and orthopedics.30(front cover) Within several months, he enlarged the editorial board by adding surgeons from Dublin, London, and Paris and experts in gynecology and venereal diseases. How much responsibility any of these men had in the management of the journal is uncertain. Coincidental with the naming of an editorial board, the misleading contributors’ page was replaced with a list of individuals who had actually written articles for the July, August, September, and October issues. Unlike the members of the editorial board, the authors were a more impressive group. In the first volume alone, there were 7 future members of the American Surgical Association and other prominent surgeons, including Robert Battey (1828–1895) of Atlanta, John Julian Chisolm (1830–1903) of Baltimore, Paul Eve (1806–1877) of Nashville, and John Wyeth (1845–1922) of New York.33,34 With an editorial board in place and several issues published, the Archives began to attract favorable notice. Bermingham was quick to post these comments on the back cover of his journal.30(back cover) “It is carefully edited,” noted a writer for the Detroit Review of Medicine, “and will doubtlessly be handsomely supported by surgeons.”35 The editor for the New York Medical Journal was even more effusive: “The original papers are excellent, and the general appearance of the journal is all that could be desired.”36 That others admired the physical look of the Archives must have pleased Bermingham because much of his promotional campaign was focused on how the new journal was, in his words, to be “printed from new type, on heavy calendered paper” with “beautifully executed engravings.”30(back cover) Bermingham unabashedly claimed that the Archives was the “handsomest periodical published.”30(back cover) Bermingham might have been less than candid in his promotional schemes, but when it came to the Archives’ clinical content, he was noticeably ingenuous. “It contains original matter throughout,” declared Bermingham, “and nothing is accepted which has previously been published either in this country or abroad.”30(back matter) Although there was a well-established custom among the nation’s medical journals of selectively reprinting each other’s articles,  C 2014 Wolters Kluwer Health, Inc. All rights reserved.

Edward Bermingham and the Archives of Clinical Surgery

Bermingham remained true to his word. Whether it was Hammond’s injection treatment of vascular tumors37 or Smith’s essay on unrecognized dislocation of the shoulder joint,38 the pieces were concise, timely, and unique. The uniqueness became especially evident when articles from the Archives began to be cited in the widely quoted Half-Yearly Compendium of Medical Science, a book that came out biannually and summarized the most important and “always fresh” medical literature of the day.39 Bermingham divided the contents of the Archives into 7 sections: Lectures, Original Papers, Translations, Progress of Surgery, Hospital Records, Correspondence, and Bibliography (Book Reviews). Two sections stood out: Hospital Records, described as “special,” where “condensed histories of hundreds of important cases, which would otherwise be buried in the unpublished annals of the hospitals, are given to the profession annually through our pages,” and Progress of Surgery for “important discussions” to be “dealt with in a thorough manner, by men eminent in the various branches.”30(back matter) The Archives’ format, especially these 2 sections, would be imitated by some of the surgical journals that ensued. Indeed, Pilcher, who never specifically referenced Bermingham or the Archives in his writings, noted that, during the early years of the Annals, its section on “Index of Surgical Progress” was particularly important because it “supplement[ed] the dearth of original memoirs.”18(p311) Needless to say, what comprised surgery in 1876 was vastly different than even 2 decades later. By the mid-1890s, surgeons were well versed in the fundamentals of antisepsis and successfully performing operations on the abdomen and cranium. During those 20 years, specialization had taken hold and numerous surgical specialty societies were organized, including the American Gynecological Society (1876), American Laryngological Association (1879), American Surgical Association (1880), American Association of Genito-Urinary Surgeons (1886), American Orthopedic Association (1887), American Laryngological, Rhinological and Otological Society (1895), and the American Academy of Ophthalmology and Otolaryngology (1896). Hence, to read Bermingham’s Archives is to understand what surgery was like immediately before the scientific era and the transition to specialization. For this reason, the journal is among the more important primary resources with which to study the evolution of prescientific surgery in America. The Archives contains articles on orthopedic, gynecologic, and otorhinolaryngologic problems and essays on the breast, hernias, and aneurysms, but these were intermixed with commentaries on dermatologic conditions.40,41 Such an assemblage reflects the fact that prescientific surgeons only operated on problems they could visualize (ie, the skin and just below the surface); internal diseases were unapproachable. Bermingham declared that he wanted the Archives to be a “cosmopolitan journal . . . uncontrolled or uninfluenced by any local ‘ring.’”42 Yet, elements of favoritism were apparent. For example, Bermingham assured his readers that book reviews were by an “able corps of impartial reviewers.”30(back matter) Nonetheless, an overtly biased 13-page review of Lewis Sayre’s (1820–1900) Lectures on Orthopaedic Surgery and Diseases of the Joints43 appeared in the October 1876 issue.44 Sayre was professor of orthopedic surgery at the Bellevue Hospital Medical College and soon-to-be president of the American Medical Association. His Lectures was to become a classic in American medicine—it was also translated into French, German, and Spanish—and received glowing praise in other journals.45 Unfortunately, the review in the Archives was filled with ad hominem attacks: “We regret that our author,” wrote the anonymous reviewer, “has placed himself in a position, where so much that is due to others is allowed, by inference, to reflect credit on himself.”44(p162) Sayre was outraged and asked that the “unjust charge[s] be withdrawn.”46 www.annalsofsurgery.com | 815

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FIGURE 3. Advertisement in the December 1879 Hospital Gazette for the Medical Mailing-Directory of the United States (courtesy of the New York Academy of Medicine). Others joined in a letter-writing fracas,47 but Bermingham soon ended it with a curt note that said the argument had devolved “upon personal grounds, rather than as a scientific discussion” and he would no longer publish any correspondence on the matter.48 Why Bermingham allowed this imbroglio to occur is uncertain, but Sayre’s reputation was sullied, as some now forgotten and, probably, inconsequential dispute in New York medical politics played out. Regrettably, the one-sided denunciation of Sayre seemed to uphold Billings’ concern that in proprietary journals enemies could be “attack[ed] . . . without restraint.”12 Besides the issue of partiality, the question of personal gain was another concern. Proprietary ownership allowed an editor/owner to use his magazine for what Billings termed “indirect advertisement.”12 In effect, academics was mixed with self-interests and it became 816 | www.annalsofsurgery.com

difficult to separate the two. Although Bermingham was not a major offender, he did occasionally use the Archives to further personal business. In December 1877, Bermingham, through the guise of an editorial, announced the organization of a “hospital for diseases of the rectum.”49 The facility was known as the Good Samaritan Hospital and its services were offered gratis to the poor. However, the only member of the surgical staff was Bermingham, who then used the pages of the Archives to extoll the virtues of his latest enterprise.50 Before long, the Good Samaritan Hospital was defunct as Bermingham’s entrepreneurship turned to other projects.

“Special Notice to Subscribers” When Bermingham started the Archives, it is unknown whether he believed the journal would be profitable. Nonetheless, most  C 2014 Wolters Kluwer Health, Inc. All rights reserved.

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medical periodicals published during the mid-19th century showed a loss of revenue and, within 1 year, the Archives apparently proved no exception. In the August 1877 issue, a “special notice to subscribers” appeared in which Bermingham explained that at a recent meeting of the Association of American Medical Editors in Chicago, the number of existing medical magazines was deemed “too large.” Whether Bermingham attended the conference is uncertain, but he told his readers that he agreed with the assessment and, at “considerable sacrifice,” would streamline the Archives by incorporating it into a new publication, The Hospital Gazette and Archives of Clinical Surgery. The Gazette would be published at the “unusually low price of $1.50 per annum, including postage” and be more generalized in its reporting on health care.51 The swift demise of the Archives also brought an end to its editorial board as Bermingham assumed unilateral control.52 Once the Archives lost its status as a free-standing surgical journal, the number of articles authored by prominent surgeons decreased with the exception of those by Hamilton.53 By late 1879, the Archives was no longer part of the masthead and, the following year, the magazine was renamed The Medical Gazette, A Weekly Journal of Medicine, Surgery and the Collateral Sciences. References to the Archives grew sparse and the nation’s first surgical journal was soon consigned to memory. It was also in 1879 that Bermingham decided to publish another journal, one intended strictly for a lay audience. Public Health explored the relation between disease and health, both for the individual and the public, but the magazine survived for only July and August of that year.54,55 It is curious that the end of the Archives and the beginnings of the Gazette coincided with Bermingham’s 18-year-old brother Charles (1862–1909) taking over the family’s publishing reins. Rutledge & Company became Chas. L. Bermingham & Company and finally Bermingham & Company, a middling-sized publishing house with offices in New York and London and a catalogue emblazoned with the family’s intriguing Latin motto, “Ne tentes, aut perfice” (“Do

FIGURE 4. The New York Throat, Nose and Lung Hospital, circa 1910 (courtesy of the New York Academy of Medicine).  C 2014 Wolters Kluwer Health, Inc. All rights reserved.

Edward Bermingham and the Archives of Clinical Surgery

not attempt, or else accomplish”).56 As was the case with the promotion of the Archives, hyperbole was a constant in Bermingham & Company’s advertising. The Berminghams claimed the Gazette had the “largest circulation of any medical journal in this country”57 and, even more, that it was the “largest medical journal published in the world.”58 Neither boast was factual, as the Gazette was simply another of the countless bland medical magazines that populated that era. The periodical was phased out of existence in 1883, only to be replaced by the Aesculapian. The Aesculapian, under the sole editorship of Edward, lasted less than a year. In a final but distressed attempt to establish financial stability, he informed prospective readers that for the time being “no form of subscription is necessary.” Instead, Edward asked that anyone interested should “simply enclose Two Dollars, by registered letter, money order, or postal note” to him in New York and trust that they would receive copies of the Aesculapian.59 When their journals failed to generate satisfactory revenues, Edward and Charles tried other publishing ventures. In December 1879, they announced the preparation of an “important” compendium of names and addresses of “upwards of 80,000” practitioners of medicine in the United States. The anticipated 1200-page volume was advertised as a “reference book” and a “mailing list” for “medical publishers, surgical instrument makers, manufacturing pharmacists, wholesale druggists, medical schools, and ALL WHO WISH TO REACH THE MEDICAL PROFESSION”60 (Fig 3). However, the concept of direct-mail and the nation’s physicians was not unique to them—the nation’s first directory of doctors’ names and addresses had been published in 187461 —and the Berminghams’ compendium, despite extensive promotion in the Gazette, never materialized. The book publishing side of Bermingham & Company was also a financial burden. Edward wrote 3 works under the Bermingham label.62–64 Two were praised65,66 and one was panned.67 But none sold well. Even when established physicians such as Hamilton and Hammond or an emerging surgical talent such as Joseph Bryant (1845–1914)—he would later operate on President Grover Cleveland (1837–1908) for a sarcoma of the upper jaw—authored books under the Bermingham name, it did not help the company’s bottom line.68–72 Edward’s publishing difficulties were also hampered by another surgical/political reality. During his meteoric rise and fall, Edward relied on the “old guard” of influential New York surgeons for guidance. These men, including Hamilton, Parker, Henry Sands (1830–1888), and William Van Buren (1819–1883), were no longer around for advice and support as Edward’s writing career floundered. By the late 1880s, the Bermingham family was out of the publishing business.73 Charles pursued other opportunities, and Edward went on with his professional life, no longer as an author, editor, and publisher, but as a specialist in otorhinolaryngology. In 1891, Bermingham purchased several dwellings on East 57th Street, remodeled them, and established the New York Throat, Nose and Lung Hospital74,75 (Fig. 4). Two decades later, he built an adjoining pavilion that, along with the city’s nearby Central Park, doubled as a “summer camp” for patients with tuberculosis.76 He spent the remainder of his career expanding the institution as both surgeon-in-chief and chief executive officer as his scientific writings lessened and became limited to diseases of the nose and throat.77–81 Although Bermingham neither achieved lasting recognition as a medical editor nor was he associated with any major otorhinolaryngologic societies, his name continues on as the inventor of the Bermingham nasal douche.77(p38) The device was highly regarded and labeled as the “best form of douche for use”82 in an era when cleansing of the nasal cavities was fashionable. Interestingly, modern versions of this relic remain available on numerous health care–related Web sites. By his mid-50s, Bermingham’s health had deteriorated and, in 1907, he spent 6 months in Germany to recuperate at Bad Nauheim, the health spa noted for its famed hot salt springs. He continued on a www.annalsofsurgery.com | 817

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downward course and, 15 years later, died at the age of 69 from diabetes and cardiac disease.83–85 Bermingham married Jeanette Russell (1856–1932)86 in 1878. They had no children and management and ownership of the New York Throat, Nose and Lung Hospital was left to members of their extended family. In 1928, the facility, renamed the Midtown Hospital, was described as “inadequate and in need of repair,” but no funds for modernization were available.87 The board of managers sold the site—the old building was razed by the buyers—and used the money to acquire a lot on East 49th Street.88 One year later, a new 6-story Midtown Hospital opened with the stated intent to “aid business houses in conserving [the] health of their employees.”89 Arch Bermingham (1890–1981), son of Charles, led the Board of Managers, helped by a $100,000 bequest from the estate of another trustee.90 For almost a half-century, the Midtown Hospital prospered and broadened its services but, by the late-1970s, the institution was considered outmoded and superfluous in Manhattan’s growing health care market. The building was shuttered and sold for more than $5 million as the location was turned into a luxury high-rise condominium.91

CONCLUSIONS In the late 1880s, an article in the widely read Popular Science Monthly noted that “specialization is the order of the day” and “the number and variety of specialty journals are daily increasing.”92 At the same time, even Pilcher, despite conceding that the number of surgeons “was not very great,”18(p310) considered the “field for special surgical journalism . . . ready to be occupied.”93 Ready it was as the number of surgical specialty journals exploded. Led by the Annals of Surgery (1885) and the American Journal of Ophthalmology (1884), the Journal of Cutaneous and Genito-Urinary Diseases (1887), the International Journal of Surgery and Antiseptics (1888), the American Journal of Surgery and Gynecology (1890), and the Annals of Otology (1896), to name just a few, these periodicals helped guide their respective specialties during their embryonic phase of development. Along with the published proceedings and transactions of the specialty societies, whether it was presenting technical breakthroughs or updating society happenings, the journals were critical in establishing the scientific and professional boundaries for their emerging specialties. With regard to Bermingham and the Archives of Clinical Surgery, he had the correct idea but at the wrong time. Without a suitable number of surgeons as subscribers, there could never have been adequate revenues to justify continued publication of the journal. As a new sole owner, Bermingham did not have the monetary wherewithal that an already established publisher such as J. H. Chambers & Company had when they backed the Annals of Surgery. Notwithstanding the financial considerations, Bermingham was simply several years too early relative to the beginnings of surgery as a specialty. The same was true for Achilles Rose (1839–1916), Bermingham’s schoolmate at the College of Physicians and Surgeons of Columbia University, who brought out the country’s second surgical periodical, the International Surgical Record, in July 1880. Rose’s effort survived 3 months before it too was turned into a more general medical magazine, the International Journal of Medicine and Surgery. Despite its brief existence, the publishing of the Archives was a milestone event in the history of surgery in America. Its 14 issues attracted the attention of the most prominent surgeons in the country, both as authors and as readers. In 1890, James Pilcher (1857–1911), Lewis’ younger brother and a renowned medical editor in his own right, ensured the Archives of its place in medical lore when he labeled it the “first American surgical periodical” and told of how the journal “expired soon after its birth from lack of support.”94 To study the Archives is to have a unique window into the world of surgery as the medical revolution and the process of specialization were first 818 | www.annalsofsurgery.com

occurring. The Archives, in many respects, served as a crucial link in the evolution from proprietary, unscientific periodicals to the professionalized, scientific efforts of the Annals. And this progression in the literature guided the development of the professionalization of surgery as a whole. As a result, and despite its being little remembered, the significance of the Archives of Clinical Surgery to the rise of American surgery needs to be recognized.

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Annals of Surgery r Volume 261, Number 4, April 2015

29. Atkinson WB. Parker, Willard. In: The Physicians and Surgeons of the United States. Philadelphia: Charles Robson; 1878:483. 30. Bermingham EJ. Archives of Clinical Surgery. Arch Clin Surg. Oct 1876;1:back cover. 31. Archives of Clinical Surgery. Nashville J Med Surg. 1876;17:282. 32. A new journal. Louisville Med News. 1876;1:311. 33. Rutkow IM. American Surgery: An Illustrated History. Philadelphia: Lippincott-Raven; 1998. 34. Rutkow I. The education, training and specialization of surgeons: turnof-the-century America and its post-graduate medical schools. Ann Surg. 2013;258:1130–1136. 35. Editorial. Detroit Rev Med. 1876;11:585. 36. The Archives of Clinical Surgery. N Y Med J. 1876;24:214. 37. Hammond WA. Three cases of the successful treatment of vascular tumors by injection with the fluid extract of ergot. Arch Clin Surg. 1876;1:123–124. 38. Smith S. Unrecognized dislocations of the shoulder joint. Arch Clin Surg. 1876;1:33–34. 39. Brinton DG, ed. Half-Yearly Compendium of Medical Science: A Synopsis of the American and Foreign Literature of Medicine, Surgery, and the Collateral Sciences, for Six Months—Part XIX.—January, 1877. Philadelphia: Medical Publication Office; 1877:preface, 143, 179, 211. 40. Bermingham EJ. Index to volume I. Arch Clin Surg. 1877;1:355–358. 41. Bermingham EJ. Index to volume II. Hosp Gaz/Arch Clin Surg. 1877;2:337– 340. 42. Bermingham EJ. A retrospective glance. Hosp Gaz/Arch Clin Surg. 1877;2:323. 43. Sayre LA. Lectures on Orthopaedic Surgery and Diseases of the Joints. New York: D Appleton; 1876. 44. Analytical and critical reviews, Lectures on Orthopaedic Surgery and Diseases of the Joints, by Lewis A. Sayre, M.D. Arch Clin Surg. 1876:1:150–162. 45. A S. Reviews – Lectures on Orthopedic Surgery and Diseases of the Joints. Am J Med Sci. 1876;72:171–180. 46. Sayre LA. Correspondence. Arch Clin Surg. 1877;1:352. 47. Wyeth JA. Correspondence—observations upon a criticism. Arch Clin Surg. 1877;1:316–322. 48. Bermingham EJ. Note. Arch Clin Surg. 1877;2:40. 49. Bermingham EJ. Editorial—hospital for diseases of the rectum. Hosp Gaz/Arch Clin Surg. 1877;2:321–322. 50. Bermingham EJ. Good Samaritan Hospital, New York—report of surgeon for three and a-half months ending May 1st 1878. Hosp Gaz/Arch Clin Surg. 1878;3:281–282. 51. Bermingham EJ. Special notice to subscribers. Arch Clin Surg. 1877;2:200. 52. Bermingham EJ. Cover. Hosp Gaz/Arch Clin Surg. 1877;2:201 53. Bermingham EJ. Index to volume III. Hosp Gaz/Arch Clin Surg. 1877;3:401– 404. 54. Billings JS, ed. Index-catalogue of the Library of the Surgeon-General’s Office, United States Army—Vol. VI., Heastie-Insfeldt. Washington, DC: Government Printing Office; 1885:625. 55. Notes—“Public Health.–A Weekly Journal Devoted to the Preservation of Health: E.J. Bermingham, A.M., M.D., editor. New York, $2 per year. Vol. 1, No. 1, July 5th, 1879.” St Louis Courier Med. 1879;2:91. 56. Bermingham & Company. Descriptive Catalogue of the Medical and Surgical Publications of Bermingham & Company. New York: private printing; 1884. 57. Bermingham EJ. New subscribers. Med Gaz. Oct 2 1880;7:front matter. 58. Bermingham EJ. Our enlargement. Med Gaz. 1880;7:9. 59. Bermingham EJ. Special notice. Aesculapian. Jan 1884;1:contents page. 60. Bermingham EJ. Medical mailing-directory of the United States. Hosp Gaz. Dec 20 1879;6:front matter.

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Edward Bermingham and the Archives of Clinical Surgery

61. Butler SW. The Medical Register and Directory of the United States. Philadelphia: Office of the Medical and Surgical Reporter; 1874 (an updated edition appeared in 1878). 62. Bermingham EJ. Disposal of the Dead: A Plea for Cremation. New York: Bermingham & Co; 1881. 63. Bermingham EJ. An Encyclopaedic Index of Medicine and Surgery. New York: Bermingham & Co; 1882. 64. Bermingham EJ. Practical Therapeutics: A Compendium of Selected Formulae and Practical Hints on Treatment. New York: J R Bermingham; 1885. 65. R JG EJ. Reviews. Art. XXV.—The Disposal of the Dead. A Plea for Cremation by Edward J Bermingham, M.D. Am J Med Sci. 1881;164:541. 66. Reviews and Notices. An Encyclopaedic Index of Medicine and Surgery. Edited by Edward J. Bermingham, A.M., M.D. Med Rec. 1883;24:415. 67. Book Reviews. Practical Therapeutics.., by Edward J. Bermingham, A.M., M.D. JAMA. 1885;5:643. 68. Hamilton FH. Fracture of the Patella: A Study of 127 Cases. New York: Bermingham; 1880. 69. Hamilton FH. Health Aphorisms, and an Essay on the Struggle for Life Against, Civilization, Luxury, and Aestheticism. New York: Bermingham; 1882. 70. Hamilton FH. Conversations Between Drs. Warren and Putnam on the Subject of Medical Ethics With an Account of the Medical Empiricisms of Europe and America. New York: Bermingham; 1884. 71. Hammond WA. Sexual Impotence in the Male. New York: Bermingham; 1883. 72. Bryant JD. Manual of Operative Surgery. 2 vols. New York: Bermingham; 1884. 73. Business changes. New York City. Am Bookseller. 1883;14:212. 74. The New York Throat, Nose and Lung Hospital. In:Walsh JJ. History of Medicine in New York, Three Centuries of Medical Progress. Vol III. New York: National Americana Society; 1919: 865. 75. Tempting tables and booths, opening at Sherry’s of the fair for the Throat and Nose Hospital. New York Times. December 13, 1893. 76. Hospital camp for tuberculosis. New York Times. July 3, 1910. 77. Bermingham EJ. Chronic Nasal Catarrh, and What the General Practitioner Can Do for It. New York: Chambers; 1893; p. 38. 78. Bermingham EJ. The Edison current for cautery purposes. N Y Med J. 1893;57:98–99. 79. Bermingham EJ. Abscess of the nasal septum. Med Age. 1893;11:102–103. 80. Bermingham EJ. Hypertrophic rhinitis. N Y Med Times. 1895;23:78–85. 81. Bermingham EJ. Rhinological don’ts—what not to do in nasal affections. Trans Texas State Med Assoc. 1895;[27th annual session]:270–275. 82. Nasal catarrh. Woman’s Med J. 1903;13:264. 83. Deaths—Edward John Bermingham. JAMA. 1922;79:491. 84. Obituaries—Dr. Edward J. Bermingham. New York Times. July 18, 1922. 85. Noted surgeon dies suddenly. New York Evening Telegram. July 17, 1922. 86. Obituaries—Mrs. Edward J. Bermingham. New York Times. December 15, 1932. 87. Hospital sale is approved. New York Times. July 7, 1928. 88. Midtown Hospital buys site. New York Times. October 12, 1928. 89. Midtown Hospital to open Wednesday. New York Times. September 21, 1929. 90. Helme will aids Midtown Hospital. New York Times. May 6, 1931. 91. Realty news; site sold, 87 units to be built on 49th St. New York Times. April 5, 1981. 92. Philpott HJ. Social sustenance. III.—specialization. Pop Sci Monthly. 1887;31:613. 93. Pilcher LS. Twenty-five years of medical editorship. Proc Amer Med Editors’ Asso. 1907;[38th annual meeting]:59. 94. Pilcher JE. The annals and achievements of American surgery. JAMA. May 3, 1890;14(spec ed):635.

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Edward Bermingham and the archives of clinical surgery: America's First Surgical Journal.

To explore the life of Edward J. Bermingham (1853-1922) and his founding, in 1876, of the Archives of Clinical Surgery, the nation's first surgical jo...
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