, his
prophetic eye caught some glimpses of the coming day which in old age it
was given him to see. Though engaged chiefly with the great things in
surgery, he deserves a place in the list of therapeutic reformers.

Much of the renown acquired for Kentucky by her surgeons was in the
treatment of calculous diseases. This State is believed to have
furnished almost as many cases of stone as all the rest of the Union.
Dr. Dudley stands the confessed leader of American lithotomists, heading
the list with two hundred and twenty-five cases. Of these he presents an
unbroken series of one hundred consecutive successful operations. He
used the gorget in all. He preferred the instrument invented by Mr.
Cline, of London. "In one case, when his patient was on the table, he
discovered that his accustomed operation was impracticable from
deformity of the pelvis, and while his assistants were taking their
positions resolved to make the external incision transverse, which was
executed before any one else present had remarked the difficulty."
Through this incision he removed a stone three and a half inches in the
long diameter, two and a half inches in the short, by eleven inches in
circumference. The patient recovered.

In an article contributed to the Transylvania Journal of Medicine by Dr.
Dudley, in 1828, he thus wrote of the trephine: "The experience which
time and circumstances have afforded me in injuries of the head induced
me to depart from the commonly received principles by which surgeons are
governed in the use of the trephine. In skillful hands the operation,
beyond the atmosphere of large cities, is neither dangerous in its
consequences nor difficult in the execution." In this remark Dr. Dudley
bore early testimony to the efficacy of aseptic surgery. He urged the
trephine in the treatment of epilepsy and applied it in six cases--in
four of which the disease was cured. The result in the two remaining
cases is unknown, because the patients were lost sight of.

Dr. Dudley believed himself to be the first surgeon who ever attempted
to treat _fungus cerebri_ by gentle and sustained pressure made with dry
sponge aided by the roller. Of the first cases in which he used it, he
wrote: "By imbibing the secretions of the part, the pressure on the
protruded brain regularly and insensibly increased until the sponge
became completely saturated. On removing it the decisive influence and
efficacy of the agent remained no longer a matter