James Lawrence Little, m. d., 
A SKETCH OF HIS LIFE AND TIMES, 
by 
D. B. ST. JOHN ROOSA, M. D. 
Reprinted from the Transactions of the Medical Society 
of the State of New York. A Sketch of the Life of James Lawrence Little, M. D., and 
of the Twenty-Five Years in which he Practised Surgery in 
New York.'' 
By D. B. ST. JOHN ROOSA, M. D., LL. D. 
Communicated by the Medical Society of the County of New York. 
James Lawrence Little was born of Scotch-Irish and English 
ancestry, in the city of Brooklyn, February 19, 1886. He 
attended private schools in his native city until he was about 
twenty years of age, when he attempted to become a book- 
seller, and to this end was engaged as a clerk in a Fulton Street 
establishment kept by Mr. Riker. The firm that employed him 
had a stock of medical books as well as of general literature. 
The young clerk was soon so deeply immersed in the study of 
these books that he proved a very inefficient salesman, and he 
gave up his attempt in business. 
This inclination to the study of medicine had already been 
seen in young Little when he was a mere boy. After much 
cogitation as to the ways and means of getting a skull for the 
purpose of study, he finally approached a venerable African 
grave digger, who consented to furnish him with the desired 
relic, if he would bring twenty-five cents and a paper to wrap 
it in. Little secured the treasure on these terms, and return- 
ing home, took a peep at it, and, to his youthful horror, found 
that it was an unprepared skull looking upon him in the 
ghastly covering of facial integument and scalp. Fear got the 
better of his anatomical enthusiasm, and seeking a plan to 
get rid of what was now a source of dread at its horrible 
aspect, as well as of fear lest he might be found with such an 
unexplainable object upon him, he threw it into the waters of 
Wallabout Bay, and postponed his medical studies for a season. 
After leaving the bookstore, Little entered the office of Dr. 
Willard Parker as a private student, and at the same time he 
matriculated in the College of Physicians and Surgeons. After 
Dr. Little had become a distinguished surgeon, Dr. Parker 
gave the writer an account of how he nearly rejected him 
when he applied for entrance to his already crowded rooms. 
He was at first disposed to decline to receive another student, 
but he was impressed by the great earnestness of the tall and 
* Read before the New York Academy of Medicine, November 5, 1885. 2 
handsome young man, and he consented to take him. " But," 
continued Dr. Parker, " I never had occasion to regret my 
decision. Punctually as the clock struck nine, the dick of the 
young man's boots was heard upon the doorstep, and I got to 
recognize his step and to count upon him, whoever failed.'' 
The word click aptly describes the short and quick step, that 
many of Dr. Little's contemporaries will recall as one of his 
personal characteristics. 
After being in Dr. Parker's office more than two years, 
he successfully passed a competitive examination, and was 
appointed a junior assistant in Bellevue Hospital. This appoint- 
ment did not take effect until the following spring. Mean- 
while, in March, 1S60, he was graduated at the College of 
Physicians and Surgeons. He then resigned his position at 
Bellevue, and after examination he was appointed junior assist- 
ant in one of the surgical divisions of the New York Hos- 
pital. A resignation of a place in one hospital to take a similar 
one in another, was something unusual, and it was said at the 
time that it caused a little unpleasant feeling among the staff 
at Bellevue, for Dr. Little was well known to some of them, 
and to James R. Wood in particular, as a promising man 
whom it was not well to lose. 
Bellevue Hospital was just coming into some importance as 
a school of surgery, and chiefly through Dr. Wood's clinics 
and his prizes for anatomical preparations offered for compe- 
tition among the medical schools. Yet at that time, it could 
in no manner compare with the New York Hospital in fur- 
nishing opportunities to a surgical student It was an insti- 
tution belonging to the city, receiving only paupers to its 
wards, and it was governed by politicians. It had much more 
importance as a school of medicine than as one of surgery. 
John W. Francis was one of its consulting physicians, 
and occasionally gave a mellifluous and learned address in its 
amphitheatre, and Alonzo Clark, John T. Metcalfe and Ben- 
jamin VC McCready held clinics in the wards, while on Satur- 
days, there was a great crowd of students to witness the rapid 
and skillful surgical operations of the renowned pupil of Val- 
entine Mott, James R. Wood. Certainly any young doctor in 
medicine might have been honored by entrance into such a 
hospital. But the New York Hospital was a wealthy and 
private corporation, governed by some of the best laymen in 
the city, and, more than all, it was one of the most renowned 
schools of surgery in the world. 'In its amphitheatre Wright 3 
Post, and Kearney Rodgers had won their fame, and here Val- 
entine Mott, who was still living and lecturing upon surgery, 
had tied the arteria innominata. Mott was a consulting 
surgeon with Alexander H. Stevens, John C. Cheesman, and 
Alfred C. Post. Of these but one now remains, an honored 
link to connect us to the medical New York of fifty years ago.* 
The active members of the surgical staff were Gurdon Buck, 
John Watson, Thaddeus M. Halsted, Willard Parker, Wil- 
liam H. Van Buren, and Thomas M. Markoe. Of this num- 
ber but one now survives, and he happily in full vigor of 
mind and body. The old hospital was situated on Broadway, 
facing Pearl street, on ample grounds, nearly surrounded by 
grand old'elms. Its beautiful lawn, upon which tame deer 
might often be seen, was a surprise and delight to the stran- 
gers in New York, who came suddenly upon this break in the 
monotonous business buildings of a great city. 
The house staff was in a traditional state of excellent dis- 
cipline. Its members vied with one another in their care of 
their cases, and their dressings of fracture and ulcers were at 
once the delight and dismay of medical students, who followed 
the attending surgeons about the wards. It was not strange, 
then, that the young Little, especially when urged by his pre- 
ceptor, resigned his place in a hospital which had no past, for 
one whose annals, twenty-five years ago, were more full than 
perhaps any hospital in the land. 
In April, I860, Dr. Little began his duties at the New York 
Hospital as a junior walker. In April, 1885 he died. Hence, 
it may be truly said, that a quarter of a century bounded his 
professional career. What a twenty-five years it has been for 
medical and surgical science in New York and in the world I 
There were then three colleges, and perhaps eight hundred 
students and practitioners attending lectures in the College of 
Physicians and Surgeons in Twenty-third Street, the Univer- 
sity in Fourteenth Street, and the New York Medical College 
in Thirteenth Street. Bellevue Hospital Medical College existed 
only in the embryo of its medical clinics and James R. Wood's 
exploits on Saturday afternoons. Clinical instruction was in 
its infancy, and there were but two hospitals, at long distances 
from the colleges, where it may be said to have existed in a 
meagre way, and then, except when a great operation was to 
be performed, to be attended by not more than a score or 
so of the students. Now, there are added to the New York 
* Dr. Post also die J in February, 1886, a few months after this was written. 4 
and Bellevue, the great Charity Hospital on the Island, St, 
Luke's, the Roosevelt, the Presbyterian, Mount Sinai, and St, 
Vincent's ; these are all more or less used for clinical teaching, 
and two thousand or more students and physicians attend 
the lectures of the three colleges of our faith, the College for 
Women, the Post-Graduate School, and the Polyclinic. 
Among the most widely known of the teachers at the Col- 
leges were Parker, Gilman, Watts, St. John, and Joseph M. 
Smith, in Twenty-third Street ; John William Draper, Bed- 
ford, Paine, Van Buren, Post, and Metcalfe, at the University ; 
Horace Green, Fordyce Barker, Ogden Doremus, and Carno- 
chan, in the New York College ; while George T. Elliot, 
Charles A. Budd, Loomis, Jacobi, Thomas, Sands, Sayre weie, 
as would be said in Edinburgh, extra mural teachers, who were 
nearly within the walls. So great have been the losses by 
death in these names, that, as we recall them, the words of 
the Latin poet come at once to the mind : 
" Eheu fugaces Postume Postume, 
Labuntur anni." 
When Dr. Little entered the New York Hospital, the civil 
war had not broken out, although excited meetings of stu- 
dents had been held on account of the John Brown raid, and 
Southern students were being pledged not to return to North- 
ern cities for instruction. Terrible strife was soon to cause the 
erection of immense hospitals by the medical staff of the 
United States army, from whose records surgical literature 
was to be enriched to an extent not dreamed of by the sur- 
geons of this country. The battle-fields of Manassas, Shiloh, 
Gettysburg, and around Richmond, from their awful experi- 
ences, were to train a race of men which has caused Ameri- 
can surgery and medicine to take a higher place in the world 
than would have been attained by half a century of work in 
small civil hospitals, while the Sanitary Commission was to 
open up a field for the cultivation of sanitary science and of 
active benevolence hitherto unknown. 
When Dr. Little entered the wards of the New York Hos- 
pital, the thermometer was not generally used to show the 
temperature of the body. The laryngoscope and ophthal- 
moscope had just been placed in the hands of a very few 
specialists, but they were not at all employed in the New 
York general hospitals. 
There was but one hospital of any considerable importance 
for diseases of the eye and ear, and that had not one-half the 5 
number of patients it now has, although three similar institu- 
tions have been added to the charitable aud educational 
resources of the city. There were no training schools for 
nurses, and scarcely any trained nurses worthy the name. 
Those whom we had were chiefly males, with a strong prefer- 
ence for alcohol as a stimulant, who had been promoted from 
being patients to be nurses, while the women, in many instan- 
ces, had been scrubbers in the wards over which they pre- 
sided. Not but that there were some excellent nurses in 
those days, however. Pyaemia, erysipelas, and hospital gan- 
grene were then dreaded foes, and antiseptic surgery, if prac- 
tised in attempts at absolute cleanliness, was not understood 
as now, when patients, after operations, are saved, not as by 
fire, but as a matter of course. Marion Sims had just read 
his famous paper before this Academy upon silver sutures in 
surgery, and was about to found the Woman's Hospital, with 
Emmet as an assistant, and become the intellectual progenitor 
of men who with him created modern gynecology. All this 
Dr. Little sa w, and in much of it he was an active participant. 
New York, in 1860, had two or three medical journals, not 
of extended circulation, while an Ishmaelitish scribbler or two 
issued monthly bulletins in a style of medical journalism now 
happily extinct. There were two medical bookstores, called 
publishing houses rather by courtesy than as a matter of fact, 
for scarcely a New Yorker but Bedford and Dalton and Draper 
had written a medical book, and very few had even edited or 
translated one. New York scarcely claimed equal rank with 
Philadelphia as a medical centre. 
Now, New York boasts of three publishing houses where 
American medical books are issued, and that in considerable 
number. Her medical journals are more widely circulated than 
those of any other city in this country, and they are to be 
found by the side of the works of American medical men upon 
the library tables of the physicians of every nation. 
In the hospital Little gave promise of his future career. He 
was assiduous and faithful as an assistant, and suggestive and 
enthusiastic as a house surgeon. His humerous contemporary, 
Dr. Samuel W. Francis, remarked of him that even then there 
was multum in parvo. He reported many of the cases occur- 
ring in the wards in the American Medical Times. It was 
while in the hospital that he devised his method of making 
and applying plaster of Paris splints. It is not too much to 
say, that chiefly, if not entirely, through Little's efforts plaster- 6 
of-Paris splints became a practical application. Until thenr 
although much recommended, experience had shown that it 
was not well adapted for a surgical dressing. Little saw in 
plaster-of-Paris a material which, if properly used, would 
form that so much to be desired, an immovable and yet porous 
splint. Those of us who were associated with him remember 
his painstaking trials in preparing the plaster, in securing the 
proper consistency, and the material best adapted to take up 
the solution, the disappointment and failures until a splint 
was produced which convinced his colleague, the house sur- 
geon of the other division, and the attending surgeons, that 
the days of the starch apparatus-a favorite bandage of the 
hospital - were past. In using plaster-of-Paris as a splint 
instead of a bandage, he utilized the material as never was 
before done, and although it is possible that it will never have 
a widespread use, just as Dr. Little employed it, he gave an 
impetus to the subject which was perhaps the origin of the 
famous plaster-of Paris jacket. His paper upon the subject 
may be said to be classical.* 
During the civil war, on several occasions, Little's services 
were furnished to the Government. He was for a time sur- 
geon-in-chief to the hospital erected on the edge of the City 
Hall Park, and twice, at least, after great battles, he volun- 
teered with those other NewT York surgeons who went to the 
front at the call of Surgeon-General Hammond. Now, as 
then, the avenues to professional success as a teacher and con- 
sultant began at service in dispensaries and clinics. Dr. Little 
was engaged in such work from the days when he was a 
medical student and a substitute for the junior walker in the 
hospital until his death. One year after leaving the hospital 
he was appointed clinical assistant to Dr. Parker, who was 
then Professor of Surgery in the College of Physicians and 
Surgeons. In 1863 he was appointed a Lecturer in the College. 
His first course of lectures was upon "Fractures and their 
Treatment." These lectures were continued until 1868, when 
his chair was enlarged to that of " Operative Surgery and 
Surgical Dressings." 
Dr. Ijittle was very popular as a lecturer. His manner was 
exceedingly simple, in fact, at first distressingly so ; but it 
was earnest, and devoid of mannerisms and self-conscious- 
ness. One of our most successful teachers lately said to me, 
"Little did not merely tell the men to apply a flaxseed poul- 
*Transactions American Medical Association, 1867, Medical Record, 1874. 7 
tice, but he brought the flaxseed aud the cloth to the lecture- 
room and made the poultice before the class. Then they knew 
how it was done, for they had seen it." Indeed, his teaching 
was realistic to a degree. The man was thoroughly in love 
with his work. He was alive to every progressive tendency ; 
he travelled in no rut, but was always on the alert to s ssist in 
making surgery the exact science it is so fast becoming. He 
took great pains with the illustration of his subject by dia- 
grams and drawings, which were prepared by competent men 
under his directions with great care. An examination of his 
library after his death showed that he had ransacked the sur- 
gical pictures of Great Britain and the Continent to secure the 
best illustrations for his lectures. Certain it is, that not a 
little of the fame of his alma mater for thorough teaching 
was due to Dr. Little's lectures, although they were given in 
the summer term, and attendance upon them was not obli- 
gatory. They were continued for sixteen years, when he 
resigned from the position he held in the college as a lecturer 
on surgery, and as one of the staff of Professor Markoe-who 
has succeeded Parker-and accepted the appointment of Pro- 
fessor of Clinical Surgery in the University of New York. 
But Little's best qualities as a surgeon, a teacher, and an 
executive officer were seen after his appointment to the chair 
of surgery in the University of Vermont. This was in 1875. 
He had previously declined an offer of a similar chair in the 
Long Island College Hospital. He entered upon the work in 
Burlington with great zeal. There he found a medical college 
that still survived the vicissitudes of forty years, although 
those at Woodstock and Castleton, in the same State, had been 
abandoned. It had about sixty students. Little's keen per- 
ception of the possibilities of this field showed him that they 
were great. The lately elected President of the University, 
Dr. Buckham ; the venerable Carpenter, professor of practice ; 
with Thayer of anatomy, King of obstetrics, and Darling of 
anatomy, were fully alive to what lay in store for the Burling- 
ton Medical College. There was a reason for the existence of 
a medical college there. It was needed to supply the demand 
for medical education for a large number of young men from 
Vermont and Northern New York, who could not conveni- 
ently go to Boston, Philadelphia, or New York. 
The academical department, at the laying of whose corner- 
stone Lafayette had assisted, embraced in its faculty many 
soundly educated and cultured men, whose sympathies were 8 
readily enlisted for any good scheme for the cultivation and 
dissemination of human knowledge. They seconded the 
efforts of the president to give character to the various 
departments. The medical school acquired a certain dignity 
by its name, and it had that not unimportant advantage over 
the schools that formerly existed in the same State. Many 
young men, exceptionally well prepared by previous training, 
found it more convenient to study in Burlington, on account 
of the greater expense attending a long stay in a large city; 
and many practitioners of Vermont and Northern New York 
found the clinics and lectures of the medical deparment of 
the University, an accessible post-graduate school, which 
lighted up many a dark subject, and gave them a little recre- 
ation from their lonely and responsible duties as country phy- 
sicians. The Professor who went to Burlington from a metro- 
politan medical college, soon saw that he had as intelligent and 
as earnest listeners as at home, and that he must relax nothing 
in his efforts to teach his science and art. With the hearty 
co-operation of the President of the University, who presided 
at all the faculty meetings, and his own colleagues, Professor 
Little immediately began to devise plans for increasing the 
fame and usefulness of the school. By personal solicitations 
in many instances, he was largely instrumental in securing 
courses of lectures and clinics upon subjects not fully, if at 
all, embraced in the general curriculum, by specialists from 
colleges in our city. Then, Miss Mary Fletcher, acting largely 
upon the advise of President Buckham and Professor Car- 
penter, founded a hospital, and with a broad mindedness not 
always seen in those who found hosipitals, gave up its wards 
unreservedly to the teachers of the college. This was natur- 
ally of the greatest importance to the success of the school, 
for the day had passed when didactic lectures, unillustrated 
by subjects, were considered fit means of teaching medicine 
and surgery. Little's facilities for the performance of great 
operations were largely increased by the foundation of the 
hospital. His clinics were sought by crowds of patients from 
far and near. During the weeks that he lectured in Burling- 
ton, the streets of the city gave evidence, by the passing 
through them of numerous people with surgical dressings on 
some part of the body, and by the great accumulation of the 
mud-stained buggies of the practitioners of the adjacent towns, 
as well as by the over-filled wards of the hospital, that a great 
deal of surgical work was going on. Stimulated largely by 9 
Little's surgical feats, and by an executive capacity heretofore, 
from the want of an arena, not known to belong to him, the 
college grew apace in character, importance, and in the num- 
ber of students. A new building was given to the faculty in 
1884, by the late Mr. Howard, and when Dr. Little died, more 
than two hundred and twenty students in the class-rooms of 
the college mourned the loss of their professor of surgery. 
In an address commemorative of Darling and Little, Profes- 
sor A. F. A. King sketches the introduction of the latter to the 
class in a manner so graphic and descriptive of the man that 
it is here reproduced. Dr. King says : "I introduced him to 
the class, and I well remember his modest embarrassment, 
which would, however, have passed unnoticed by the students, 
had he not said in the course of his first disjointed remarks, 
'I'm a little nervous, as you see.' But a patient was intro- 
duced, a diagnosis made, an operation decided upon, and a 
knife handed to Professor Little, and I can tell you (as you 
know) he was not nervous then." 
To those of us who knew Little well, it was interesting to 
see this preliminary nervousness when a great operation was 
imminent. The quick, short steps, the restless tapping of the 
foot when he was preparing for his work, gave little promise 
of the bold, self-reliant man as he stood over the patient, per- 
haps reeking with the perspiration of surgical ardor, but yet 
with steady, skillful hand working in a manner that convinced 
any one competent to judge, that a life given into his care 
would be preserved and returned, were it among human possi- 
bilities. 
In Burlington as in New York, "Little's luck " became prov- 
erbial, for his operations, from causes that I am not able to 
analyze or define, were pre-eminently successful. A well- 
known surgeon in New York told me, in substance, that it 
was a prevalent opinion in St. Luke's Hospital, that it would 
be safe for Little to cut off a foot of an intestine, when another 
man could hardly touch it with a knife ; and yet he was defer- 
ential to a fault to the surgical opinions of his peers, ready to 
adopt their suggestions, and to give proper credit for them. 
He was a man who exhibited great common-sense as a sur- 
geon. He was not overtrained, but he knew how to get at the 
upshot of a case without being unduly anxious as to how 
Esmarch or Lister were doing that thing now. 
Dr. Little's chair in the University of New York was never 
fully satisfactory to him. His clinics there were held but for 10 
a part of the session, and he taught but once a week, although 
his classes were large, and the students, at least on one occasion, 
petitioned the faculty that his instructions might be continued 
throughout the session. The request could not be granted, on 
account of the pressure for time in which to give the whole 
curriculum. Three years after his acceptance of the position, 
together with six members of the former post-graduate faculty 
of the University, he resigned, in order, in conjunction, with 
them, to establish the 2Vew Ubrfc Post-Graduate Medical School. 
To this institution he gave the same hearty effort that he dis- 
played in Burlington. His lectures to graduates were, if pos- 
sible, better appreciated than by the under-graduates whom 
he had instructed since his early manhood. A doctor was to 
him a brother. Without quite knowing it himself, he acted as 
if he supposed that every man who sought or had acquired the 
degree of M. D. was as eager and honest in the pursuit of 
knowledge with which to save life and mitigate disease as he 
was himself. 
It is said that he always leaned toward the student, and 
possibly too much, when required to vote upon an examina- 
tion in the faculty at Burlington. This was not from any idea 
of lowering the standard of proficiency, but because he could 
not be made to understand that there were men who regarded 
medicine as a business, in which they were willing to embark 
with as little capital as could make a fair show. During these 
last three years he exhibited his best qualities of faithful work, 
and if, as Dr. Lloyd, one of his former office students and val- 
ued assistants, says, "he was inclined to throw' off his work 
on other shoulders, and less inclined to undertake long and 
serious operations," on account of some grave symptoms in his 
general health, it was not apparent to those of his friends who 
saw him only at intervals. The last public work he was 
engaged in was a meeting of the Post-Graduate Faculty, on the 
evening of March 31st, when he appeared in his usual health 
and spirits. At that meeting an incident occurred which was 
characteristic of the man. He felt impelled by his judgment 
to vote, on a question which then came up, contrary to his 
feelings. It was a question that might affect the interests of 
some to whom he was attached, and after he had voted and 
was found to be in the majority, he expressed his regrets that 
he should be obliged to vote for a policy which might prove 
detrimental to the interests of a friend, and he vainly sought 
for a compromise upon the subject. 11 
Dr. Little's services to St. Luke's Hospital were very great, 
and they were warmly appreciated by his patients, his col- 
leagues, and the management. He served one term of ten 
years, from 1868 to 1878, when he was retired under the rules 
to be made a consulting surgeon. In 1882 he was reappointed 
an attending surgeon, and held the position until his death. 
Little used to tell a story of an experience of his at St. Luke's, 
which well illustrates the maxim that "all men think all men 
mortal but themselves " He was to operate, on one afternoon, 
upon two cases for resection of the upper jaw. The first 
patient died upon the table from getting blood in the trachea, 
and Little sent word to the survivor that he wished to post- 
pone the operation for him. He was very much disappointed 
at the delay, and urgently insisted that Dr. Little should per- 
sonally visit him in the ward and tell him why he did not wish 
to operate upon him as appointed. The surgeon accordingly 
went up, and with some hesitation, on account of the probable 
effect upon the hopes of the candidate for an exsection, frankly 
told him that the first man was dead, and he did not feel like 
going on with a case of the same kind just at the moment. 
But instead of being daunted the patient exclaimed, "Oh, 
that's nothing ! I'm not afraid. The other man was a sickly 
fellow. I never thought he would get through. You operate 
on me, I won't die." As a matter of fact Little did soon oper- 
ate upon him, he got no blood in his trachea, and he did not 
die. 
In 1876 Dr. Little was appointed an attending surgeon to 
St. Vincent's Hospital, a position which he held when he died. 
Little always believed that the kind offices of the Rev. Vicar- 
General Quinn, one of the managers of that hospital, were 
largely instrumental in securing him this position. The Vicar- 
General was a priest in the wards when Dr. Little was house 
surgeon in the New York Hospital, and in his visitations to 
the sick and dying in the wards, had been struck by the com- 
manding presence, the assiduous and faithful labors of the 
young sprgeon. 
Of Dr. Little's surgical achievements in detail, I am not 
competent to speak, nor is it necessary that I should do so. 
They are indelibly recorded in surgical literature-at least in 
part, for of late years Dr. Little was somewhat regardless, 
from lack of time, perhaps, from his large and exacting public 
and private practice, to write as much as his friends might have 
wished. But I may say that he was the first American sur- 12 
geon to puncture the bladder with the aspirator for the relief 
of retention of urine. He simultaneously ligated the subcla- 
vian and carotid arteries of the right side, for aneurism of the 
first part of the subclavian. The operation for stone by vari- 
ous methods he had performed seventy-seven times, with a 
fatal result in but two cases. In hare-lip and strangulated 
hernia he also had a large and successful experience. 
He entered into the advances claimed to be made in antisep- 
tic surgery with great enthusiasm, and on his last visit to 
Europe, at the meeting of the International Congress in Lon- 
don, he investigated Lister's methods very carefully, and came 
back to carry out all the details of Listerism in capital opera- 
tions. 
He was a surgeon who looked round upon a far horizon. 
Very few' operations were foreign to his knife. Yet he was 
extremely appreciative of specialists, and while not needing 
their advice as much as some of those who have looked askance 
at them, he frequently sought their aid, and often publicly 
recognized their value in enlarging the field of exact knowl- 
edge. He himself used the ophthalmoscope, the laryngoscope, 
and other means of examination not always used by general 
surgeons, so that he was singularly competent to make an 
examination in any surgical case. In the practice of medicine 
also-for he by no means confined his work to surgery-he 
was suggestive in the matter of treatment, and had many cel- 
ebrated prescriptions upon which he drew with great readiness 
and accuracy. 
Little was a great admirer of his instructor, Willard Parker. 
He gave his first born the name of his preceptor. Dr. George 
Shrady styles him one of his worshippers. So great was this 
admiration when he left the hospital, that some of his friends 
feared he would be content to be an imitator and never strike 
out for himself. But he had Dr. Parker's art of making 
surgery fascinating to students ; he drew them about him 
in great numbers. Even if the clinical material for his hour, 
on any particular day, was scanty, the lecture would not 
betray the want, for what was there was made the subject 
of homely but important lessons. The capacity for dignifying 
the everyday work of surgical practice, for making apparently 
minor things and details assume their true importance, be- 
longed to him in a great degree. He could make a good clinic 
from material which some surgeons would not deign to spend 
a moment upon. Like Willard Parker also, he attracted to 13 
himself numerous office students, who almost invariably be- 
came much attached to him. 
Dr. Little was, in the good sense, a simple-minded man He 
loved to sit down in such places as the office at the hotel in 
Burlington, and, as he became warmed in his discourse, talk 
to plain laymen, who understood but half of what he said, of 
tumors and ligations, of resections and ovariotomies, and all 
without any idea of boasting of his own deeds, for he had not 
the faintest resemblance to a braggart, but he was so interested 
in surgery that, like Agassiz, who talked about his study of 
the skeletons of fishes to stage-drivers, he fairly bubbled over 
upon the subject. He was fond of the meetings of the profes- 
sion. Since its foundation, the New York Surgical Society 
was his favorite place for recounting his experience, and listen- 
ing to the discourse of distinguished men who organized and 
maintained this body. 
He was one of the signers of the address to the profession of 
the State against the re-enactment of the Old Code, and the 
movement to sustain the Medical Society of the State had his 
full sympathy and active cooperation. 
Social to a degree, he could be found late in the afternoon, 
in the conversation-room or at the monthly meetings of his 
club, with a cigar for himself and his neighbor, ready to dis- 
course upon any subject that was uppermost in men's minds. 
He gave great thought and spared nothing in the education 
of his two sons and a nephew. He had almost exaggerated 
ideas of the importance to a young man of an exact and thor- 
ough course of study in a college. He did not practice his pro- 
fession with an idea of amassing a fortune, but he conceived 
that it was better to thoroughly educate his sons, than to leave 
them the few dollars which a niggardly economy might have 
allowed a physician dying in middle life to put aside from his 
professional income. Before his death he had the great satis- 
faction of seeing his eldest son fully equipped and prosperously 
entered upon the practice of a lucrative profession. In his lat- 
ter years he interested himself very much in the study of china 
and bric-a-brac. It became a recreation to him to visit auction 
rooms, and he often came away with a rare bit of some kind. 
Galton describes a certain class of men as being incapable of 
advancing beyond a certain point in mental attainment, just 
as another class can only be developed physically to a certain 
inferior standard. Little was not one of these. As long a^he 
lived he grew in mental capacity. 14 
He was never satisfied with his own preparation for the study 
of medicine ; but while he did not enjoy the advantages of a 
college training that he appreciated so highly in others, he had 
that which no conventional curriculum can of itself furnish- 
a receptive, inquiring, and unbiased mind in science ; and so 
to merely scholastic attainments he might have well said as 
did John Hunter, when he heard that he was reproached by a 
rival with being ignorant of the dead languages, "I would 
endeavor to teach him on the dead body that which he never 
knew in any language living or dead." It has been said by 
one biographer of Dr. Little that he was a typical American. 
It is certainly true that his career is a striking example of how 
eminence in our profession may be attained by the resources 
of our own country. His education was wholly obtained 
within his own city. He had none of the advantages so useful 
to the best of men, so without use to many, which are to be 
obtained in British or Continental schools. But no man more 
than he appreciated the labors of foreign surgeons and pathol- 
ogists, no one followed more eagerly the medical literature of 
his time ; but he was fortunate enough never to acquire such 
a slavish esteem for the opinions of books that he ceased to 
think for himself. 
The sense of humor was fully developed in Dr. Little. From 
the busy, and sometimes weary life of a general practitioner, 
and from the society of his friends, he extracted much to give 
zest to his work. A joke at his own expense was almost as 
welcome as if at another's. He used to tell with great glee, 
and awakening much laughter as he did so, how a little trick 
of his to stop too prolix patients once got him into great 
trouble. He said that he had found a good device for inter 
rupting a needlessly long story on the part of a patient was to 
ask, in the midst of the long narrative, "Please let me see 
your tongue." He found that patients bore this interruption 
very well, and that in their eagerness to get the doctor's opin- 
ion of this index of the digestion, its wagging ceased. But on 
one evening a friend, who was in no sense a patient, was mak- 
ing a call upon him, and talked long, when Little was very 
tired. After a time, the doctor's mind wandered afar off from 
the discourse to the discussion of medical cases and questions, 
and, turning to his friend, who was in the full tide of talk, he 
asked with great gravity, " Please let me see your tongue." 
Little was never able to explain what happened when his 
friend had fairly taken in the meaning of this interruption. 
But you will demand an end to this desultory contempla- 15 
tion of the varied sides of our late associate's life and charac- 
ter. A quarter of a century was to be the limit of his profes- 
sional life. In the apparent ripeness not of old age, but of 
middle life, it was ordered that his work should end. As has 
already been intimated, he was actively engaged at a profes- 
sional meeting up to a late hour on Tuesday, March 31st, and 
on Saturday, April 4th, 1885, he was in the life beyond. In 
August, 1884, it was discovered that he was suffering from 
diabetes. I believe it is thought, by some authorities at least, 
that the debility induced by this disease, the existence of which 
was shown by the examination after death, made him less 
able to resist the acute affection from which he died. At any 
rate it had a sensible effect upon his apparent feelings and 
actions as observed by his intimates. His thirst was marked, 
and he became much fatigued upon slight exertion. But he 
continued his daily work, without creating a suspicion of the 
existence of any serious disease, in those who saw him only 
at intervals, until Wednesday morning, April 1st, when he 
called his friend Dr. Lloyd to his office, at about ten o'clock, 
and he found him with his head resting upon his hand, and 
complaining of a severe pain in the right iliac fossa. 
He asked Dr. Lloyd to attend to his clinic forthat day, while 
he proposed to make one or two calls in the afternoon. He 
then went up stairs and took a dose of cathartic medicine pre- 
scribed by himself. At noon he said he felt better, and he 
went out to try and finish some work, but he soon returned, 
complaining of severe pain. His family physician, Dr. John 
L. Campbell, was sent for in the evening ;* when Dr. Camp- 
bell arrived he ordered a do4e of castor oil, which he had seen 
relieve similar attacks in Dr. Little. The night passed with- 
out a movement of the bowels, and with a steady increase in 
the pain. Early in the morning he sent for Dr. Lloyd and 
gave him the necessary instructions in regard to his practice. 
When Dr. Campbell came for his morning visit he 'advised 
that Dr. Loomis be sent for in consultation, and when he 
came, although he thought there was beginning typhlitis, he 
advised a dose of calomel. He also had seen Dr. Little in sim- 
ilar attacks, which had been relieved by cathartics. 
No alleviation of the pain was obtained, nor did the bowels 
respond to the frequent calls made upon them ; and Friday, 
owing to the increase of the pain, it was found necessary to 
resort to the hypodermic injection of morphine. It was also 
noticed that there was a localized peritonitis, and when Dr. 
Campbell arrived, Dr. Sands was also called in consultation. 16 
By the time he arrived, in the afternoon, the inflammation of 
the peritoneum had become general, and it was a question 
whether it would be wise to operate. This was advised 
against, however, when the existence of the constitutional 
disease was fully considered. Although the hypodermic was 
used freely all Friday night, it was found on the morning of 
Saturday that the peritonitis was much aggravated. On this 
morning he sent for Dr. Lloyd, and when he got to the room 
he found him, in spite of the peritoneal inflammation, sitting 
in a chair by the side of the bed. As Dr. Lloyd entered the 
room he asked if he thought he looked much worse than the 
day before, and then immediately began to give instructions 
with regard to some business for the University of Vermont, 
which he thought ought to be attended to without delay. It 
was suggested to relieve the distention of the bowels by an 
aspiration, but he objected, and the matter was not urged. 
Dr. Lloyd, from whom I received these particulars, then con- 
tinues : " After remaining with him for. some time, I left to 
attend to the calls, and was probably absent about an hour. 
Upon my return I was met at the door by one of the servants, 
who asked me to hurry to the room, as the doctor was worse. 
Hurrying up stairs, 1 found Drs. Campbell and Powell already 
there, and that collapse had set in a few minutes before. Just 
before my arrival the doctor had asked Dr. Campbell, ' Doctor, 
don't you think a little digitalis would be good for this failing 
heart of mine ? ' Dr. Sands was also sent for, and arrived in a 
very few minutes ; but there was nothing to be done, and we 
now knew that the end was nearing fast. As I entered the 
room the doctor held out his hand with the expression, ' Llovd, 
I am going now ; ' and then, a minute later, again calling me 
by name, he said, ' I now realize the truth of what poor Beard 
said.'*" During all this time he was suffering intensely, but 
his mind was entirely clear, and his spirit undaunted by the 
fast approach of death. He summoned the household ser- 
vants and family about his bedside, and casting anxious 
glances at a clock that was in his chamber, he plainly showed 
that he was counting the moments that he still had to live. 
Having bid farewell to each one by name, and with the words, 
"I die in the Christian faith" upon his lips, there was a final 
instant of distress, when this brave man yielded up his spirit 
to the God who gave it. f 
* This refers to the words of the late George M. Beard, in which he expressed 
his regrets that he could not express the thoughts of a dying man 
+ At the autopsy a perforation of the vermiform appendix was found, and also 
a hardened mass of faeces, which was the probable cause of the ulceration ; and 
there were proofs in the condition of the liver and kidneys of the existance of 
diabetes.