The interesting story of “Sutures in Ancient Surgery”

During a recent 2024 lecture I delivered to a group of engineers at Medtronic, I met with Jack Kennedy, an engineer, past student, and a good friend. Jack and I share a passion for medical history. He has a very interesting collection of antique sutures and books related to the topic. He gifted me a collection of antique photographic prints in a leather-like folder with gilded letters. The name of the work is “Sutures in Ancient Surgery”. Jack was kind enough to sign and dedicate this gift that now holds an important place in my library.

For those who know me, I cannot have a book without looking into its history. What I found was incredible! The findings are in the following areas and topics:

1. The history of the Davis and Geck suture company.

2. Lejaren à Hillier, main photographer of “Sutures in Ancient Surgery”

3. The content of the publication, images, and controversy

4. Missing prints

1. The history of the Davis & Geck company

Davis & Geck (D&G) was founded in 1909 by Charles T. Davis and Fred A. Geck, along with Frank D. Bradeen, and Benjamin F. Hirsch. Interestingly, Fred Geck left the company only a few months after its formation, but the company kept his name.

Located in Brooklyn, NY., the company specialized in the development and manufacture of surgical sutures along with various other medical products. Over the years the company changed ownership and has changed its name a couple of times. In 1930, the company was acquired by American Cyanamid after a trial between Charles Davis and his wife. This particular spot in the company’s history includes a murder, prison, lovers, and a trial. If you are interested, read the story of the company at UConn’s and SNAC web pages (see “sources”).

D&G was acquired by Sherwood, and later by the Tyco Corporation where it was renamed Syneture. Tyco Healthcare became Covidien, Ltd., which was later acquired by Medtronic, where it is today.

In 1970 Davis & Geck introduced Dexon, the first synthetic absorbable suture, followed shortly by Ethicon (J&J) sutures with Vicryl. Since then, research and development in the Medtronic line of sutures makes this company one of the world leaders in wound closure.

2. Lejaren à Hillier, main photographer of “Sutures in Ancient Surgery”

Lejaren à Hillier (1880-1969), was born in Milwaukee. He studied at the School of the Chicago Art Institute; his interest was classical fine arts. His studies and activities drew him to experimenting with photography and novel techniques for the times, where he mixed photography and painting. He became a famous commercial photographer.

One of his most exciting works was that of “tableaux vivants” (living portraits), where he would stage actors and innovative lighting techniques to represent scenes that he would later edit with paintings or use different photographic development techniques to obtain the appropriate mood. His work soon caught the attention of companies that used these tableaux vivants in commercial printings for brochures or newspapers.

Hillier was approached by D&G and the project of “Sutures in Ancient Surgery” was born. Starting in 1927 and all trough 1950, D&G sales representatives would present their customers (physicians and surgeons) with the “latest” image, ensuring an open door when they showed up at the doctor’s office. The doctors were also presented with a leather-like folder to maintain their collection. The number of prints varied each year, and it is interesting to note that none were published during the long years of WWII.

According to JTH Connor, a total of eighty three portraits were published. These show medical scenes that range from prehistory, trough Egypt, Greece, Rome, the Middle Ages, the Renaissance, all the way to the 19th century. The list of individuals portrayed is itself worth of research, as all of them in one way or another influenced medicine and surgery. Albucasis, Avicenna, Celsus, Fallopius, Fabricius, Galen, Harvey, Hunter, Rhazes, and Vesalius are but some of the tableaux vivants created for D&G.

Hillier was criticized for the lack of accuracy in some of the portraits as well as the person depicted, but the ideas for the topics were not his. The consultant used by D&G to suggest the topics was Samuel Harvey (1886-1953), who himself studied under the tutelage of famous neurosurgeon and medical historian Harvey Cushing (1869-1939).

Some of the images were later published in a book by Hillier (“Surgery through the ages”, 1944) showing other tableaux made for other medical publications.

3. The content of the publication, images, and controversy

Each tableaux vivant depicted a scene of history of surgery, with a short description of the individual and their accomplishments. In general, these descriptions are accurate, but very short. The objective was to allow the doctor to read the text, admire the image and leave time for the medical representative to deliver their presentation of a particular product.

Each page was printed in black and white, on a high quality paper measuring 12 by 9 ? inches. The paper itself was originally lightly yellowed to denote that this was an historical image. In fact, many doctors believed that these were reproductions of antique paintings, which they were not! The image itself was 6 ? by 5 ? inches.

In some images it is clear that the background was painted. In fact, the image of Hyeronimus Fabricius Ab Aquapendente (157-1619) published in 1927, shamelessly copies part of the background of the 1555 title page of the Fabrica of Andreas Vesalius (1514-1564), or one of the many plagiarisms of the same book.

The controversy today lies with a number of women depicted with their nude breasts. In one case, (“Aspasia”, published in 1933) the photograph depicts five women including Aspasia, all of them showing a naked breast. Although “Sutures in Ancient Surgery” is criticized for this easy depiction of nudity, only 30% fall in this category.

Adding Aspasia of Miletus to this collection of physicians also brought criticism, not only for the nudity, but for the fact that Aspasia is a legendary figure whose life is in question as well as her place in Greek society. Some say that she was a prostitute and the regent of a house of ill repute, other say that she was a teacher of philosophy along with Socrates and that she was married to Pericles. Others say that she never existed, yet her name and life has been used in a novelized two-tome book. Why was she selected for this collection? No one knows.

Following are some images from "Sutures in Ancient Surgery".

4. Missing prints

Because these prints were presented as loose-leaf items to the doctors, many of them have been lost. Some historians comment that doctors would frame these images and use them in their offices, so a complete collection of the 83 photographs is extremely difficult to find. In once case, it is known that a hospital had the complete collection framed in one of its hallways (Sobieszek, 1988) which hospital, or what happened to that collection is unknown.

Today, the “Sutures in Ancient Surgery” folders found for sale in antique libraries have a varying number of prints, all of them incomplete. Some universities list them in their libraries and in one case, they have only three prints in their collection!

My research has been able to find the names of 76 of the tableaux vivants in this collection, but I have not been able to find the names of seven of these prints.

The folder that I received from Jack Kennedy contains 75 prints, and I am looking for the last eight including that of Teodorico Borgognoni, year of printing unknown.

If you have any or know of someone that owns a few in this collection, please contact me. I prepared an PDF file with the prints I have as well as those I do not. You can download it here.

Once again, thanks to Jack Kennedy for his addition to my collection. It has been an interesting research and I look forward to the next one!!

Sources:

1. UConn library Archives and Special Collections: Davis and Geck company records.

2. SNAC-Social Network and Archival Context: Davis and Geck Company.

3. “Soak it up: Examining bioabsorbable polymers in healthcare” Medical Plastic News

4. “The striking social tableaux vivants of Lejaren à Hillier” J.T.H. Connor. Hetkoen International

5. “Photography view; when tableaux vivants flowered in the magazines” Gene Thorton. The New York Times. March 2, 1986.

6.”Tableaux Vivants: A Long History of Recreating Art” Karolina Dzimira-Zarzycka. Daily Art May 1, 2020

7. “Medical History’s Moment in Art Photography (1920 to 1950): How Lejaren à Hillier and Valentino Sarra Created a Fashion for Scenes of Early Surgery” Journal of the History of Medicine and Allied Sciences, Volume 72, Issue 4, October 2017, Pages 381–421

8. “Aspasia” Wiki.org

9. “The Art of Persuasion: A History of Advertising Photography” Sobieszek, Robert A. 1988

10. “Aspasia” A Romance of Art and Love in Ancient Hellas” Mary J Safford German) Robert Hamerling (Translator) 1882. NY. W.S. Gottsberger, Publisher.

11. “Lejaren A. Hillier Photography Collection” University of Texas, Harry Ramson Center.

You can read the original article with additional images here.