A revered teacher, an influential author, and a skilled surgeon, Samuel David Gross (1805-1884) initiated many important advancements in medicine, particularly surgery. He formulated and taught the first hands-on, systematic approach to surgery in the United States.

One of six children, Gross was born to Philip and Johanna Juliana (Brown) Gross on July 8, 1805, on a farm outside Easton, Pennsylvania. Growing up in the heart of Pennsylvania Dutch country, Gross spoke German until the age of 12, and even after he learned English, his dialect retained a distinct German accent. His father was a farmer who died when Gross was nine years old. After that, his mother raised him, instilling strong moral values that stemmed from her devout Lutheran faith. As a child Gross spent a good deal of his time outdoors. He was very attentive to nature, studying the calls of birds, the habits of the local animals, and the indigenous plant life.

Gross received his early education at country schools. At 17, he decided to begin his studies in medicine. As was the custom of the time, he was paired with a practicing physician, Joseph K. Swift. From Dr. Swift he learned basic medical skills such as how to make pills, apply plaster casts, and bleed patients. He also assisted in surgical procedures and in childbirth. In his spare time he would study subjects such as anatomy as best he could. Feeling he needed more formal education, Gross abandoned his apprenticeship with Swift to enroll in school in Wilkes-Barre, Pennsylvania. He completed his general educational requirements at the highly regarded Academy in Lawrenceville, New Jersey.

In 1824 Gross returned to work once again with Swift in local practice. He planned to attend medical school at the University of Pennsylvania. But before he could do so, Gross was accepted as a private student of Dr. George McClellan, the father of the Civil War General George B. McClellan.

In 1828 Gross received his medical degree from Jefferson Medical College in Philadelphia, a school McClellan founded in 1825. His thesis was "The Nature and Treatment of Cataract." In the same year that he graduated he married Louisa Ann Weissell, a 20-year-old widow with one child. They would have six children of their own.

Translations and Original Works

After getting his degree, Gross remained in Philadelphia. He continued to work with McClellan and opened his own medical practice on Library Street, near Fifth Street. Business was slow during the first months of his practice. With few patients to see, Gross worked on translating French and German medical works into English. The translations he published included A Manual of General Anatomy (1828) by A.L.J. Bayle and H.L.G.M. Holland, A Manual of Practical Obstetrics (1828) by Jules Hatin, and A Treatise on the Nature, Cause, and Treatment of Contagious Typhus (1829) by V.J. von Hildenbrand. His most important and well-received translation was Elements of Operative Surgery (1829) by Alphonse Tavernier, the first treatise on surgical medicine published in the United States.

Believing that the United States needed its own body of medical literature, Gross stopped translating foreign texts and began to write original works. His first book, Treatise on the Anatomy, Physiology, and Diseases and Injuries of the Bones and Joints, was published in the fall of 1830. Although highly regarded by the medical profession, the book produced no income for Gross, who was still struggling to make ends meet.

To make more money, Gross in late 1830 moved his practice back to Easton, where he became more successful. He conducted important experiments on dogs regarding gunshot wounds in the abdomen. C.J. Parkes of Chicago later used his works. His similar experiments gained a wide audience. In 1832 Gross was chosen by the Easton Town Council to travel to New York to study Asiatic cholera, a disease recently introduced to the United States.

Elements of Pathological Anatomy

In 1833, with the recommendation of Dr. John Eberle, a former professor at Jefferson Medical College, Gross was appointed demonstrator of anatomy at the Medical College of Ohio. When Daniel Drake founded the Cincinnati Medical College two years later, Gross secured a position as a professor of pathological anatomy and chair of the department. There, based on a series of lectures, he created the first systematic study of morbid anatomy in the United States.

In 1839 Gross published his landmark work, Elements of Pathological Anatomy. It was the first time information on pathological anatomy was presented in a complete, systematic form. Primarily due to the book's great length, Gross had difficulty getting a publisher. It was published only after many rejections. Although the work was extremely popular and sold many copies, Gross received no profits from the sales of the first edition. Nonetheless, its publication earned him acclaim worldwide, and he became the most celebrated doctor in the United States. Elements of Pathological Anatomy was issued in several editions, and it remained the leading reference in its field for over 25 years.

When the Cincinnati Medical School closed in 1839, Gross accepted a position as the chair of the surgical department at the Louisville Medical Institute, later known as the University of Louisville. He remained in Louisville until 1850, then went to New York to take over the chair in surgery at the University of the City of New York. The following year he returned to Louisville. In 1856 he became professor of surgery at his alma mater, Jefferson Medical College, where he remained until the end of his life.

Other Influential Works

Over the course of his long career, Gross published numerous works that substantially influenced the development of a systematic theory and practice of medicine in the United States. In 1843 he published Wounds of the Intestines, an exhaustive clinical study based on animal research, again the first book of its kind to be published in the United States. In 1851 he gained recognition for his contribution to urology with his book A Practical Treatise on the Diseases and Injuries of the Urinary Bladder, the Prostate Gland, and the Urethra. The book was subsequently accepted as the primary authority in the field of urology. Two more editions, in 1855 and 1876, followed. His son, Samuel Gross, edited the latter. The book described the surgical method of cutting into the bladder to remove a calculus, an innovative procedure for which Gross gained even more attention. Gross was widely recognized for his skills as a surgeon, and people traveled long distances to have Gross perform bladder surgery on them.

In 1854 Gross published A Practical Treatise on Foreign Bodies in the Air-Passages. Again, Gross offered the first systematic approach to this medical procedure in the United States. The work served as the chief source in the field until the development of the bronchoscope, which allowed for more in-depth observation.

Gross published yet another highly influential work in 1859. His two-volume A System of Surgery: Pathological, Diagnostic, Therapeutic and Operative, went through six editions from 1859 to 1882. The first edition consisted of 2,360 pages and 936 illustrations; the last edition included 2,300 pages and 1,600 illustrations. In the Dictionary of American Biography, J. Chalmers Da Costa refers to the work as "the greatest surgical treatise of the day, and probably one of the greatest ever written." Da Costa describes it as "a veritable mine of information" and noted that it "gives evidence of the broadest scholarship and the most complete acquaintance with surgical literature, a philosopher's grasp of all surgical problems, and an immense clinical experience." Translated into numerous languages, the book was an immense success.

When the U.S. Civil War began, Gross produced A Manual of Military Surgery (1861), with a pirated Confederate version appearing in Richmond in 1862. Also in 1861, Gross edited a hefty edition of Lives of the Eminent American Physicians and Surgeons of the Nineteenth Century, and in 1868 he issued Memoir of Valentine Mott, a renowned American surgeon. In honor of the U.S. centennial, Gross published A History of American Medical Literature from 1776 to the Present Time (1876) and A History of American Surgery From 1776 to 1876, each important for its historical and bibliographical value. He also published John Hunter and His Pupils (1881), a biography of another medical pioneer.

Published posthumously, the Autobiography of Samuel D. Gross, M.D., with Sketches of His Contemporaries (1887) was edited by his sons and serves as a valuable history of 19th-century medicine. Along with his books, Gross conducted surgical clinics, addressed medical societies, and participated in medical debates. He also served as an editor for several medical journals, including the North American Medico-Chirurgical Review and the Louisville Medical Review, which he founded with T.G. Richardson in 1856.

Achieved Great Acclaim

The renowned doctor was immortalized in American culture as the subject of Philadelphia artist Thomas Eakins's painting, originally known as "The Portrait of Professor Gross." Eakins began his work in 1875, hoping to capture Gross in the midst of his surgical brilliance. The painting, which became a national icon of the times, is now known as "The Gross Clinic." It was first displayed at the Philadelphia Centennial Exhibition in 1876 and subsequently purchased by the Jefferson Alumni Association two years later.

Gross was one of the founders of the American Medical Association and served as its president in 1867. He was also the first president of the Philadelphia Pathological Society, vice-president of the German Surgical Society, and a member of the Philadelphia Academy of Surgery and the American Surgical Society. In 1876 he led the International Congress of Surgeons, held in Philadelphia. He also established a prize for original medical scholarship. Given every five years, the award was sponsored by the Academy of Surgery and became known as the Samuel D. Gross Prize. Gross held numerous honorary degrees from academic institutions around the world, including Oxford University, Cambridge University, the University of Edinburgh, and the University of Pennsylvania.

Active as a teacher and surgeon until the very end of his life, Gross died in Philadelphia on May 6, 1884. Just days before his death, he operated on a patient to remove a stone from the bladder. Although medical research has advanced tremendously since his day, Gross is still considered one of the greatest surgeons and one of the most important advocates for the advance of medicine.

Further Reading

• American National Biography, Volume 9, edited by John A. Garraty and Mark C. Carnes, Oxford University Press, 1999.
• Biographical Dictionary of American Educators, Volume 2, edited by John F. Ohles, Greenwood Press, 1978.
• Encyclopedia of American Biography, 2nd edition, edited by John A. Garraty and Jerome L. Sternstein, HarperCollins, 1995.
• "Samuel David Gross," Dictionary of American Biography, http://www.galenet.com (January 18, 2001).
• "Gross, Samuel David," Merriam-Webster's Biographical Dictionary, http://www.galenet.com (January 18, 2001).