This biographical sketch on Virgil Pendelton Gibney corresponds to the historic text, The Classic: Chapter XVIII. Operative Treatment in Chronic Articular Ostitis, available at DOI 10.1007/s11999-009-1165-3

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Richard A. Brand

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Biographical Sketch: Virgil Pendelton Gibney, MD, 1847-1927

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Biographical Sketch: Virgil Pendelton Gibney, MD, 1847–1927

SYMPOSIUM: PAPERS PRESENTED AT THE HIP SOCIETY MEETINGS 2009
Biographical Sketch
Virgil Pendelton Gibney, MD, 1847–1927
Richard A. Brand MD
Published online: 17 November 2009
 The Association of Bone and Joint Surgeons1 2009
Abstract This biographical sketch on Virgil Pendelton
Gibney corresponds to the historic text, The Classic:
Chapter XVIII. Operative Treatment in Chronic Articular
Ostitis, available at DOI 10.1007/s11999-009-1165-3.
Dr. Virgil Pendleton Gibney was born in Jessamine
County, Kentucky in 1847 [3]. Although born on a farm,
Gibney’s father, an immigrant from Northern Ireland, was
a general practitioner and also owned part of a retail store
to supplement the family income [11]. Gibney lost his ring
and little finger in an accident at age 11, but this evidently
did not stop him from pursuing surgery [11]. He obtained
his undergraduate education at the University of Kentucky,
from which he graduated in 1869. He then earned his MD
degree from the Bellevue Hospital Medical School in New
York City in 1871 [3]. (The Bellevue Hospital Medical
College was the first medical college in New York con-
nected to a hospital and in 1861 produced the first
outpatient department associated with a hospital, the
‘‘Bureau of Medical and Surgical Relief for the Out of
Door Poor’’ [1].) At age 24, in 1871, Gibney was appointed
an Assistant Physician and Surgeon to the Hospital for the
Ruptured and Crippled (the predecessor to the Hospital for
Special Surgery) (Fig. 1). According to Levine, ‘‘This was
a strange appointment as Gibney was a disciple of Lewis H.
Sayre, M.D., who represented everything that Knight was
not’’ [10]. (Knight, who served as the President of the
Board of the hospital, ‘‘had the personality of a surgeon but
ironically was vehemently antisurgery’’ [10]. Sayre, on the
other hand, was a cautious advocate of surgery in the new
Listerian age.) According to Sherk, ‘‘Knight forced Gibney
to renounce the idea of surgical treatment of musculo-
skeletal deformity’’ whereupon Gibney resigned and toured
European hospitals to more thoroughly study surgical
treatment [6]. (The reader should recall Knight had trained
and largely practiced in the days before anesthesia, anti-
septic surgery, fluid management, and blood transfusions.
Given the high mortality and complication rates of surgery,
Knight’s position was not so outrageous as it might
otherwise seem.) However, Gibney evidently returned to
the hospital because in the preface of his book in 1884 he
stated, ‘‘For thirteen years I have resided in the Hospital for
the Ruptured and Crippled, all of my time being devoted to
daily service in both the in-door and the out-door depart-
ments’’ (it was not unusual for physicians to reside in the
hospital) [5]. Undoubtedly, Gibney operated little in those
days:
‘‘The hospital is further known as an extremely
conservative institution. Dr. Jas. Knight, its founder
and surgeon in-chief, has been led by his extensive
experience to adopt a plan of treatment which coin-
cides, in many respects, with the definition I have
elsewhere given the term expectant’’ [5].
After Knight’s death, in 1887, the hospital board
appointed Gibney as surgeon-in-chief [12], a position he
held until 1925 when, owing to failing health, he stepped
down. On assuming the position his stipulations were to be
able to live outside the hospital and hold a private practice
and operate outside the hospital. Gibney in fact had the first
operating room installed in the hospital in 1889 [2]. He
became the first Professor of Orthopaedic Surgery at
Columbia Medical College.
R. A. Brand (&)
Clinical Orthopaedics and Related Research, 1600 Spruce Street,
Philadelphia, PA 19103, USA
e-mail: dick.brand@clinorthop.org
123
Clin Orthop Relat Res (2010) 468:308–311
DOI 10.1007/s11999-009-1166-2
Gibney was active in a number of organizations. He was
a founding member of the American Orthopaedic Associ-
ation in 1887, its first president, and the only individual to
serve twice as president (again in 1912) [11]. He became a
member of the New York Academy of Sciences in 1887,
and was a fellow of the American Medical Association and
the Pathological Society. He was a consultant surgeon for a
number of regional hospitals. He found time to publish
extensively: the collected papers occupy a volume over 5
inches in thickness (personal communication, Dr. David
Levine, The Hospital for Special Surgery).
This month we reproduce an abridgement of Chapter 18
from his monograph, ‘‘The Hip and its Diseases’’ [5],
published in 1884 (Fig. 2). By that time, Gibney was per-
suaded of the safety of surgery:
‘‘The question of surgery no longer turns on the
mortality of the operation. True, the danger in all
Fig. 1 A photograph of Gibney at age 24. (Courtesy of Hospital for
Special Surgery Archives.)
Fig. 2 The frontispiece of Gibney’s monograph, The Hip and its
Diseases.
Fig. 3 A photograph of Gibney in his
office during his mid 40s. (Courtesy of
Hospital for Special Surgery Archives.)
Volume 468, Number 2, February 2010 Biographical Sketch 309
123
surgical procedures is to be considered, yet antiseptic
surgery has contributed largely toward removing this
element. When I say antiseptic surgery has done this,
I mean that it has done so directly and indirectly.
Those surgeons who oppose Listerism have, in order
to maintain their position, grown more cleanly in
their operations, more careful, and more discreet. It is
seldom now that a patient dies of shock from an
operation…’’
Clearly, the dangers of surgery had been very real in
Knight’s day, but the advances associated with ‘‘Lister-
ism’’ and anesthesia had, by 1884, made surgery less risky
and more practical.
The concepts about and terminology of arthritis have
evolved over the centuries, but by the late 1800s they were
quite primitive by our current standards [4]. Even seem-
ingly clearcut distinctions such as septic from nonseptic,
and rheumatoid arthritis from degenerative arthritis were
not clearly made. Of course, the science of microbiology
had just emerged and we must recognize doctors simply
did not have the tools to make the distinctions. Gibney’s
Chapter 5, ‘‘Rheumatism of the Hip,’’ distinguishes rheu-
matism of the hip in the child and in the adult (‘‘chronic
rheumatic arthritis or malum coxae senile’’). The descrip-
tions of the cases, however, do not entirely conform to our
current understanding, and so in the former case there are
likely patients with acute or chronic juvenile rheumatoid
arthritis, tuberculosis, Legg-Calve-Perthes disease, late
sequelae of septic arthritis (when they survived), among
others. He also uses the term, ‘‘periarthritis’’ to describe
conditions limited to the soft tissues, undoubtedly of a
septic sort since he mentions acute cellulitis and abscesses:
‘‘Its (periarthritis) early recognition is also important, in
view of advantage to be gained by early incision of puru-
lent areas. These abscesses in children not suffering from
any malnutrition are harmless…’’ However, he distin-
guishes periarthritis from ‘‘similar conditions occurring in
connection with the second stage of a chronic articular
osteitis very insidious in its approach.’’
Today septic arthritis in children is typically diagnosed
early in industrialized countries, and we rarely see any
indolent forms. Gibney does not describe what happened to
those children with acute septic arthritis but I suspect many
died of sepsis in those days (childhood mortality was quite
high) and perhaps the diagnosis was not even made since
joint symptoms might have been overwhelmed by the
systemic symptoms. What percentage of these patients may
have survived and developed the indolent form seen by
Gibney is unknown, but clearly there were a substantial
number of patients with the problem. Gibney evidently
preferred an excision described by Sayre, one with a small
incision and with simple excision of the head and neck
depending on the amount of diseased tissue. This operation
differed markedly from the radical operations described
later by Girdlestone for treating tuberculous and pyogenic
arthritis [7–9]. Gibney described followup only in a few
patients in the chapter we reproduce (those sections
abridged), and they did well. We may presume, however,
from Girdlestone’s procedures a fair number of patients did
not respond to simple excision and rather required more
radical procedures involving de´bridement of the hip cap-
sule and muscle. Gibney’s descriptions do indicate how
surgeons managed patients with septic arthritis in the days
before the discovery of methods to identify bacteria and
well before antibiotic treatment.
References
1. Bellevue Hospital Center. Wikipedia. Available at: http://en.
wikipedia.org/wiki/Bellevue_Hospital_Center. Accessed October
20, 2009.
2. The History of HSS. The Hospital for Special Surgery Web site.
Available at: http://www.hss.edu/history.asp#1887. Accessed
October 20, 2009.
3. News Notes. J Bone Joint Surg Am. 1927;9:781–787.
4. Brand RA. 50 Years ago in CORR: Osteoarthritis of the hip in a
gorilla: report of a third case Robert M. Stecher MD CORR
1958;12:307–314. Clin Orthop Relat Res. 2009;467:305–307.
5. Gibney VP. The Hip and Its Diseases. New York, NY: Ber-
mingham & Company; 1884.
6. Gibney VP. The correction of deformity at the hip, the result of
disease: a study of the best methods and best positions. 1903. Clin
Orthop Relat Res. 2007;456:3–7.
7. Girdlestone GR. Arthrodesis and other operations for tuberculosis
of the hip. In: Milford H, ed. The Robert Jones Birthday Volume.
London, UK: Oxford University Press; 1928:347–374.
Fig. 4 A photograph of Gibney at age 77. (Courtesy of Hospital for
Special Surgery Archives.)
310 Brand Clinical Orthopaedics and Related Research1
123
8. Girdlestone GR. Acute pyogenic arthritis of the hip: An operation
giving free access and effective drainage. Lancet. 1943;241:419–
421.
9. Girdlestone GR. Acute pyogenic arthritis of the hip: an operation
giving free access and effective drainage. 1943. Clin Orthop
Relat Res. 2008;466:258–263.
10. Levine D. The hospital for the ruptured and crippled: Knight to
Gibney, 1870–1887. HSS J. 2005;2:1–6.
11. Levine DB. Gibney as surgeon-in-chief: the earlier years, 1887–
1900. HSS J. 2006;2:95–101.
12. Levine DB. The hospital for the ruptured and crippled, entering
the twentieth century, ca. 1900 to 1912. HSS J. 2007;3:2–12.
Volume 468, Number 2, February 2010 Biographical Sketch 311
123


50 Years ago in CORR: Osteoarthritis of the hip in a gorilla: report of a third case Robert M. Stecher MD CORR 1958;12:307–314. Clin Orthop Relat Res.

Arthrodesis and other operations for tuberculosis of the hip. In:

Joint Surg Am.

The correction of deformity at the hip, the result of disease: a study of the best methods and best positions.

The Hip and Its Diseases.

The History of HSS. The Hospital for Special Surgery Web site. Available at: http://www.hss.edu/history.asp#1887. Accessed

file:///data/remote/core/dit/data/Springer-OA/pdf/5c4/aHR0cDovL2xpbmsuc3ByaW5nZXIuY29tLzEwLjEwMDcvczExOTk5LTAwOS0xMTY2LTIucGRm.pdf

Biographical Sketch: Virgil Pendelton Gibney, MD, 1847–1927

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