Samuel Parkman's December 9 report.

Parkman's report on a reduction of the dislocated shoulder of a carpenter, named William Eckels, constituted the third classical report on etherisation published in the BMSJ.(69»»)   The patient's name was pulled from the MGH records by Hodges, who published it in his history of etherization.(70 »»)  According to Bigelow's tables, Parkman etherized two cases of dislocation in 1846, both reductions of the humerus; the first occurring on December 9th for treating Eckels, and the second on December 22nd for treating a 58-yr-old female. Parkman's historic paper on Eckels was abstracted by John Collins Warren in his monograph on ether, where the carpenter is identified by the statement that he had "already resisted powerful efforts for reduction without ether," a reference to a failed reduction at the hands of a private practitioner on the day prior to his entering the hospital.(71 »»)   Warren was impressed by the beneficial side effects of ether for relaxing the muscles "with a moiety of the power" required in reduction of a dislocated joint, but the greater significance of Parkman's classical report was in demonstrating the safety and utility of ether for even a minor surgery.

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Inhalation of Ethereal Vapor - Painless Reduction of a Dislocated Shoulder Joint under Its Influence. By S. Parkman, M.D., one of the Surgeons of the Massachusetts General Hospital. [Communicated for the Boston Medical and Surgical Journal.]

The attention of the medical profession having been so extensively called to many applications of the discovery of Mr. Morton, the following instance of its employment may not be uninteresting to your readers, as indicating a class of cases in which its use may be of the greatest value.

      A stout healthy carpenter applied at the Mass. General Hospital this afternoon, with a dislocation of the left shoulder. The accident happened last evening, from slipping on the side-walk. Ineffectual attempts were made this morning by a practitioner, at first unaided, and afterwards with the assistance of several other persons of fair bodily power, by means of a sheet, &c. In the absence of Dr. Hayward, the Visiting Surgeon of the Hospital, I was sent for to take charge of the case. The dislocation was sub-coracoid, presenting the usual appearances. The pullies and counterextending band being applied in the customary manner, the inhalation was commenced under the superintendence of the house physician, Dr. Bertody, by an apparatus furnished by Mr. Morton to the Hospital.

      After about two minutes its influence was seen to be established, indicated not so much by any decided apparent insensibility, as by a certain incoherence of manner, unattended, however, by any attempt at resistance or the like; the patient said he " had got enough." Traction was commenced, and after, say a couple of minutes, the head of the bone was seen to move, and at once entered the socket with an audible snap. During this time not a groan escaped the patient, neither was there the slightest resistance felt on the part of the muscles in the vicinity of the joint. The patient's manner continued slightly incoherent for a few moments, but he soon recovered himself, and denied having experienced the slightest pain, though he remembered the sensation of the snapping of the bone into its place. I need not say that having already experienced the pain of previous ineffectual and somewhat prolonged attempts, he expressed himself highly delighted and was profuse in his compliments.

      The power exerted by the pullies was very slight, and I feel confident that I could have reduced the bone, unaided by them, with my hands alone. I am in the habit every year of producing this dislocation, among others, upon the dead subject, for demonstration in the lectures of Dr. Warren, and it is worthy of remark with what ease these factitious dislocations are reduced; in fact it is hardly possible to handle the limb without the head of the bone flying into the socket-showing the muscular power to be the chief, if not sole obstacle in these cases in the living. In the instance above detailed, so utter was the abolition of the muscular power, and so easy was the reduction, that I was strongly reminded of my experiments upon the dead body.

      The application of this agent to this class of cases has undoubtedly suggested itself to every one who has seen its employment, and it only remains to apply it to a dislocated hip joint to add another to its triumphs. In cases of dislocations it will probably not only annul pain in the patient, but render unnecessary those violent exertions on the part of the surgeon, which are by no means agreeable to the by-standers to witness, or to himself, on a hot July day, to make.

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Why choose a junior Visiting-surgeon, and not a senior surgeon, to premiere the very first photograph of an ether operation? If the Ether Dome Daguerrotype No. 1 depicts an actual operation and the junior surgeon is Samuel Parkman, then the answer is predicated on what his family meant to Massachusetts General Hospital and the Boston and Harvard medical communities. Samuel Parkman was the third namesake of the ultra-rich land baron Samuel Parkman, the First. His father, Samuel Parkman II, was one of the founding fathers of Massachusetts General Hospital and the hospital's first elected Vice President, although he declined the honor. His uncle George was a prominent philanthropist, who donated the land and actively supported the construction of MacLean Hospital that later split off MGH, and he was the foremost benefactor to MGH. He also donated the land for the construction of Harvard Medical College. Finally, if Figure 1 were to be identified as George Parkman and not Bertody, it would be trace evidence that he authorized the ad hoc funding of the daguerreotype that day.

The pictorial correlates that might identify Ether Dome Daguerreotype No. 1 as a depiction of Parkman's reduction of dislocated shoulder include:   1.) Parkman poses as the lead physician with his hand on the surgical chair.   2.) Dalton is the etherizer.   3.) The carpenter Eckels positioned his body to favor his left dislocated shoulder (reversed in the daguerreotype).   4.) He presents the clinical posture for a dislocation by holding his injured arm securely in the grip of the opposite hand.   5.) The patient matches the physical description of a "stout healthy carpenter."   6.) Age of the patient is correct for a 30-yr.-old. 6.) Figure 1 may be Bertody.

Of the four enactment scenarios proposed, Parkman's is perhaps the strongest contender, considering that Dalton is the etherizer and Bertody, who monitored the etherization "by an apparatus furnished by Mr. Morton to the Hospital," is a good candidate for the Figure 1 attribution. The wording is quite clear that Morton was not available. A dislocated shoulder was a relatively minor surgery, devoid of complications, and provided a perfect opportunity to arrange a spontaneous photo-session. It was an unscheduled urgent care procedure, no other surgeries were on the docket that day and classes at Harvard were just beginning, so the bleachers were void of spectators. There was a lapse of three hours from the time of Eckels's admission at 6:00pm to the moment of his procedure at 9:00pm, affording ample opportunity for Hawes to gather his gear and arrive at amphitheater to set up his camera.(72)   Just as he had functioned previously for the Abbott operation, House-surgeon Charles Heywood was dispatched to summon Morton, whose dental office was conveniently located a few doors down from the Southworth & Hawes studio on Tremont Row. Morton and his family lived close by in accommodations provided by Gould, whose residence was also located on Tremont. For some reason, Gould arrived at the hospital but Morton was unavailable, and so either Dalton or Bigelow had to step in as the etherizer. Both men were well experienced in administering ether through their extensive experiments with a replica glass-globe, though neither men were named in Parkman's report. Completing the proposed scenario of an actual operation, the photograph was taken immediately post-op with Eckels dressed, but still groggy from the ether. It was early evening with only suboptimal spot-lights illuminating the surgical arena, thus explaining the deep shadows and stark highlights in the daguerreotype.

Because he published very little, Parkman's place in the Ether Dome saga was completely overshadowed by the Warrens, Hayward, and Bigelow. Moreover, his premature death so soon after the scandalous murder of his uncle, George Parkman, draped palls over the good offices of the Harvard Medical School and Massachusetts General Hospital, likely leading to the quiet suppression of the Parkman name and the daguerreotype.

69.)Parkman, S (1846), "Inhalation of ethereal vapor – painless reduction of a dislocated shoulder joint under its influence." In: Boston Medical and Surgical Journal; vol. 35, no. 20 (Dec. 16), 409-10.

70.) Hodges, RM (1891); p. 148.

71.) Warren, JC (1848); p. 46.

72.) Haridas, RP (2023); Recorded in the MGH case book. Eckels slipped and fell at around 10:00pm on December 8. Duration of the injury to time of cure was 20 hours. The information and clarifications on the chronology come from Dr. Rajesh P. Haridas by way of our personal correspondence.

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