at the Fitzsimons Army Medical Center.]] Surgery (from the cheirourgikē, via , meaning "hand work") is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, to help improve bodily function or appearance, and sometimes for religious reasons. An act of performing surgery may be called a surgical procedure, operation, or simply surgery. In this context, the verb operate means performing surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The patient or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who performs operations on patients. In rare cases, surgeons may operate on themselves. Persons described as surgeons are commonly physicians, but the term is also applied to podiatric physicians, dentists (or known as oral and maxillofacial surgeon) and veterinarians. Surgery can last from minutes to hours, but is typically not an ongoing or periodic type of treatment.

The term surgery can also refer to the place where surgery is performed, or simply the office of a physician, dentist / oral and maxillofacial surgeon, or veterinarian.

Definitions of surgery

Surgery is a technology consisting of a physical intervention on tissues.

As a general rule, a procedure is considered surgical when it involves cutting of a patient's tissues or closure of a previously sustained wound. Other procedures that do not necessarily fall under this rubric, such as angioplasty or endoscopy, may be considered surgery if they involve "common" surgical procedure or settings, such as use of a sterile environment, anesthesia, antiseptic conditions, typical surgical instruments, and suturing or stapling. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being excised (e.g. laser ablation of the cornea) or to a radiosurgical procedure (e.g. irradiation of a tumor).

Types of surgery

Surgical procedures are the commonly categorized by urgency, type of procedure, body system involved, degree of invasiveness, and special instrumentation.

Based on timing: Elective surgery is done to correct a non-life-threatening condition, and is carried out at the patient's request, subject to the surgeon's and the surgical facility's availability. Emergency surgery is surgery which must be done promptly to save life, limb, or functional capacity. A semi-elective surgery is one that must be done to avoid permanently disability or death, but can be postponed for a short time.

Based on purpose: Exploratory surgery is performed to aid or confirm a diagnosis. Therapeutic surgery treats a previously diagnosed condition.

By type of procedure: Amputation involves cutting off a body part, usually a limb or digit. Replantation involves reattaching a severed body part. Reconstructive surgery involves reconstruction of an injured, mutilated, or deformed part of the body. Cosmetic surgery is done to improve the appearance of an otherwise normal structure. Excision is the cutting out of an organ, tissue, or other body part from the patient. Transplant surgery is the replacement of an organ or body part by insertion of another from different human (or animal) into the patient. Removing an organ or body part from a live human or animal for use in transplant is also a type of surgery.

By body part: When surgery is performed on one organ system or structure, it may be classed by the organ, organ system or tissue involved. Examples include cardiac surgery (performed on the heart), gastrointestinal surgery (performed within the digestive tract and its accessory organs), and orthopedic surgery (performed on bones and/or muscles).

By degree of invasiveness: Minimally invasive surgery involves smaller outer incision(s) to insert miniaturized instruments within a body cavity or structure, as in laparoscopic surgery or angioplasty. By contrast, an open surgical procedure or laparotomy requires a large incision to access the area of interest.

By equipment used: Laser surgery involves use of a laser for cutting tissue instead of a scalpel or similar surgical instruments. Microsurgery involves the use of an operating microscope for the surgeon to see small structures. Robotic surgery makes use of a surgical robot, such as the Da Vinci or the Zeus surgical systems, to control the instrumentation under the direction of the surgeon.

Terminology

surgery names often start with a name for the organ to be excised (cut out) and end in -ectomy.

Procedures involving cutting into an organ or tissue end in -otomy. A surgical procedure cutting through the abdominal wall to gain access to the abdominal cavity is a laparotomy.

Minimally invasive procedures involving small incisions through which an endoscope is inserted end in -oscopy. For example, such surgery in the abdominal cavity is called laparoscopy.

Procedures for formation of a permanent or semi-permanent opening called a stoma in the body end in -ostomy.

Reconstruction, plastic or cosmetic surgery of a body part starts with a name for the body part to be reconstructed and ends in -oplasty. Rhino is used as a prefix for "nose", so rhinoplasty is basically reconstructive or cosmetic surgery for the nose.

Reparation of damaged or congenital abnormal structure ends in -rraphy. Herniorraphy is the reparation of a hernia, while perineorraphy is the reparation of perineum.

Description of surgical procedure

At a hospital, modern surgery is often done in an operating theater using surgical instruments, an operating table for the patient, and other equipment. The environment and procedures used in surgery are governed by the principles of aseptic technique: the strict separation of "sterile" (free of microorganisms) things from "unsterile" or "contaminated" things. All surgical instruments must be sterilized, and an instrument must be replaced or re-sterilized if it becomes contaminated (i.e. handled in an unsterile manner, or allowed to touch an unsterile surface). Operating room staff must wear sterile attire (scrubs, a scrub cap, a sterile surgical gown, sterile latex or non-latex polymer gloves and a surgical mask), and they must scrub hands and arms with an approved disinfectant agent before each procedure.

Prior to surgery, the patient is given a medical examination, certain pre-operative tests, and their physical status is rated according to the ASA physical status classification system. If these results are satisfactory, the patient signs a consent form and is given a surgical clearance. If the procedure is expected to result in significant blood loss, an autologous blood donation may be made some weeks prior to surgery. If the surgery involves the digestive system, the patient may be instructed to perform a bowel prep by drinking a solution of polyethylene glycol the night before the procedure. Patients are also instructed to abstain from food or drink (an NPO order after midnight on the night before the procedure, to minimize the effect of stomach contents on pre-operative medications and reduce the risk of aspiration if the patient vomits during or after the procedure.

In the pre-operative holding area, the patient changes out of his or her street clothes and is asked to confirm the details of his or her surgery. A set of vital signs are recorded, a peripheral IV line is placed, and pre-operative medications (antibiotics, sedatives, etc.) are given. When the patient enters the operating room, the skin surface to be operated on, called the operating field, is cleaned and prepared by applying an antiseptic such as chlorhexidine gluconate or povidone-iodine to reduce the possibility of infection. If hair is present at the surgical site, it is clipped off prior to prep application. The patient is assisted by an anesthesiologist or resident to make a specific surgical position, then sterile drapes are used to cover all of the patient's body except for the head and the surgical site or at least a wide area surrounding the operating field; the drapes are clipped to a pair of poles near the head of the bed to form an "ether screen", which separates the anesthetist/anesthesiologist's working area (unsterile) from the surgical site (sterile).

Anesthesia is administered to prevent pain from incision, tissue manipulation and suturing. Based on the procedure, anesthesia may be provided locally or as general anesthesia. Spinal anesthesia may be used when the surgical site is too large or deep for a local block, but general anesthesia may not be desirable. With local and spinal anesthesia, the surgical site is anesthetized, but the patient can remain conscious or minimally sedated. In contrast, general anesthesia renders the patient unconscious and paralyzed during surgery. The patient is intubated and is placed on a mechanical ventilator, and anesthesia is produced by a combination of injected and inhaled agents.

An incision is made to access the surgical site. Blood vessels may be clamped to prevent bleeding, and retractors may be used to expose the site or keep the incision open. The approach to the surgical site may involve several layers of incision and dissection, as in abdominal surgery, where the incision must traverse skin, subcutaneous tissue, three layers of muscle and then peritoneum. In certain cases, bone may be cut to further access the interior of the body; for example, cutting the skull for brain surgery or cutting the sternum for thoracic (chest) surgery to open up the rib cage.

Work to correct the problem in body then proceeds. This work may involve: excision - cutting out an organ, tumor, Frail elderly patients (score of 4 or 5) have even worse outcomes, with the risk of being discharged to a nursing home rising to twenty times the rate for non-frail elderly people.

History

At least two prehistoric cultures had developed forms of surgery. The oldest for which there is evidence is trepanation,

The Greek Galen was one of the greatest surgeons of the ancient world and performed many audacious operations — including brain and eye surgery — that were not tried again for almost two millennia.

In China, Hua Tuo was a famous Chinese physician during the Eastern Han and Three Kingdoms era who performed surgery with the aid of anesthesia.

In the Middle Ages, surgery was developed to a high degree in the Islamic world. Abulcasis (Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi), an Andalusian-Arab physician and scientist who practised in the Zahra suburb of Córdoba, wrote medical texts that shaped European surgical procedures up until the Renaissance.

In Europe, the demand grew for surgeons to formally study for many years before practicing; universities such as Montpellier, Padua and Bologna were particularly renowned. Guy de Chauliac was one of the most eminent surgeons of the Middle Ages. His Chirurgia Magna or Great Surgery (1363) was a standard text for surgeons until well into the seventeenth century. By the fifteenth century at the latest, surgery had split away from physic as its own subject, of a lesser status than pure medicine, and initially took the form of a craft tradition until Rogerius Salernitanus composed his Chirurgia, laying the foundation for modern Western surgical manuals up to the modern time. Late in the nineteenth century, Bachelor of Surgery degrees (usually ChB) began to be awarded with the (MB), and the mastership became a higher degree, usually abbreviated ChM or MS in London, where the first degree was MB, BS.

Barber-surgeons generally had a bad reputation that was not to improve until the development of academic surgery as a specialty of medicine, rather than an accessory field. Basic surgical principles for asepsis etc., are known as Halsteads principles

Modern surgery

Modern surgery developed rapidly with the scientific era. Ambroise Paré (sometimes spelled "Ambrose") pioneered the treatment of gunshot wounds, and the first modern surgeons were battlefield doctors in the Napoleonic Wars. Naval surgeons were often barber surgeons, who combined surgery with their main jobs as barbers. Three main developments permitted the transition to modern surgical approaches - control of bleeding, control of infection and control of pain (anaesthesia). ; Bleeding: Before modern surgical developments, there was a very real threat that a patient would bleed to death before treatment, or during the operation. Cauterization (fusing a wound closed with extreme heat) was successful but limited - it was destructive, painful and in the long term had very poor outcomes. Ligatures, or material used to tie off severed blood vessels, originated as early as ancient Rome, and were improved by Ambroise Paré in the 16th century. Though this method was a significant improvement over the method of cauterization, it was still dangerous until infection risk was brought under control - at the time of its discovery, the concept of infection was not fully understood. Finally, early 20th century research into blood groups allowed the first effective blood transfusions. ; Pain: Modern pain control through anesthesia was discovered by two American dental surgeons, Horace Wells (1815–1848) and William T. G. Morton. Before the advent of anesthesia, surgery was a traumatically painful procedure and surgeons were encouraged to be as swift as possible to minimize patient suffering. This also meant that operations were largely restricted to amputations and external growth removals. Beginning in the 1840s, surgery began to change dramatically in character with the discovery of effective and practical anaesthetic chemicals such as ether and chloroform, later pioneered in Britain by John Snow. In addition to relieving patient suffering, anaesthesia allowed more intricate operations in the internal regions of the human body. In addition, the discovery of muscle relaxants such as curare allowed for safer applications. ; Infection: Unfortunately, the introduction of anesthetics encouraged more surgery, which inadvertently caused more dangerous patient post-operative infections. The concept of infection was unknown until relatively modern times. The first progress in combating infection was made in 1847 by the Hungarian doctor Ignaz Semmelweis who noticed that medical students fresh from the dissecting room were causing excess maternal death compared to midwives. Semmelweis, despite ridicule and opposition, introduced compulsory handwashing for everyone entering the maternal wards and was rewarded with a plunge in maternal and fetal deaths, however the Royal Society in the UK still dismissed his advice. Significant progress came following the work of Louis Pasteur and his advances in microbiology, when the British surgeon Joseph Lister began experimenting with using phenol during surgery to prevent infections. Lister was able to quickly reduce infection rates, a reduction that was further helped by his subsequent introduction of the techniques of Robert Koch (such as the Steam Steriliser, which proved more successful than the carbolic acid spray that Lister had been using previously) to sterilize equipment, have rigorous hand washing and a later implementation of rubber gloves. Lister published his work as a series of articles in The Lancet (March 1867) under the title Antiseptic Principle of the Practice of Surgery. The work was groundbreaking and laid the foundations for a rapid advance in infection control that saw modern aseptic operating theatres widely used within 50 years (Lister himself went on to make further strides in antisepsis and asepsis throughout his lifetime).

Surgical specialties and sub-specialties

General surgery

*Cardiothoracic surgery

*Colorectal surgery

*Paediatric surgery

*Plastic surgery

*Vascular surgery

*Transplant surgery

*Trauma surgery

*Breast surgery

*Surgical oncology

*Endocrine surgery

*Skin surgery

Otolaryngology

Gynecology

Oral and maxillofacial surgery

Orthopaedic surgery

Neurosurgery

Ophthalmology

Podiatric surgery

Urology

Some other specialties involve some forms of surgical intervention, especially gynaecology. Also, some people consider invasive methods of treatment/diagnosis, such as cardiac catheterization, endoscopy, and placing of chest tubes or central lines "surgery". In most parts of the medical field, this view is not shared.

Patronage

The patron saints for surgeons are Saint Luke the Evangelist the physician and disciple of Christ, Saints Cosmas and Damian (3rd century physicians from Syria), Saint Quentin (3rd century saint from France), Saint Foillan (7th century saint from Ireland), and Saint Roch (14th century saint from France).

See also

Anesthesia

ASA physical status classification system or pre-operative physical fitness

Biomaterial

Cardiac surgery

Surgical drain

Endoscopy

Hypnosurgery

Jet ventilation

List of surgical procedures

Minimally invasive procedure

Perioperative mortality

Robotic surgery

Surgical Outcomes Analysis and Research

Surgical Sieve

Trauma surgery

Reconstructive surgery

Governing bodies

American College of Surgeons

American Academy of Orthopedic Surgeons

American College of Foot and Ankle Surgeons

Royal Australasian College of Surgeons

Royal Australasian College of Dental Surgeons

Royal College of Physicians and Surgeons of Canada

Royal College of Surgeons in Ireland

Royal College of Surgeons of Edinburgh

Royal College of Physicians and Surgeons of Glasgow

Royal College of Surgeons of England

Qualifications in the UK and Ireland

Fellowship of the Royal College of Surgeons

Membership of the Royal College of Surgeons

References

External links

Dr Rustom Plastic Surgery Guide - Ask Your Questions

Dr. Cynara Coomer Prepares You for Surgery: Ask the Right Questions

Surgery Videos from the American Medical Videos Journal

*

:This article is about the Quaker philanthropist. For the institutions named after him, see Johns Hopkins University and Johns Hopkins Hospital.

Name	Johns Hopkins
Birth date	May 19, 1795
Birth place	Anne Arundel County, Maryland, U.S.
Death date	December 24, 1873
Death place	Baltimore, MD, U.S.
Occupation	Entrepreneur, Investor, Philanthropist, Abolitionist
Religion	Society of Friends (Quakerism)

Johns Hopkins (May 19, 1795 His first name, Johns (not John), was a family name. His great-grandmother, Margaret Johns, married Gerard Hopkins, and they named their son Johns Hopkins, a not-uncommon naming convention at the time; his name was then passed on to his grandson. His parents were Samuel Hopkins (1759-1814), of Anne Arundel County, and Hannah Janney (1774-1864), of Loudoun County, Virginia.

In 1807, the Hopkins family, who were members of the Society of Friends (Quakers), emancipated their slaves, which meant that the formal education of Johns, then 12, had to be interrupted in order to help out on the plantation. Moreover, his help was needed because he was the second oldest of eleven children and, as their local Friends society had decreed, the family freed only the able-bodied slaves, and had to provide for the less able-bodied slaves, who would remain at the plantation and provide labor as they were able. In 1812, at the age of 17, Hopkins left the plantation and went to Baltimore to work in the wholesale grocery business of his uncle, Gerard Hopkins. While living with his uncle's family, Johns and his cousin, Elizabeth, fell in love, but the taboo against the marriage of first cousins was especially strong among Quakers. Neither Johns nor Elizabeth ever married. Still, just as he would continue to provide for his extended family throughout his life and posthumously through his will, Hopkins bequeathed a home for Elizabeth, where she lived until her death in 1889.

Whitehall Plantation is now known as the Walden Community (Crofton, Maryland), however the house, since restored and modified, is located on Johns Hopkins Road, adjacent to Reidel Road. The heavily landscaped house is surrounded by Walden Golf Course, and contains a historic marker.

Philanthropy

Living his entire adult life in Baltimore, Hopkins made many friends among the city's social elite, many of them Quakers. One of these friends was George Peabody, who was also born in 1795, and who in 1857 founded the Peabody Institute in Baltimore. Other examples of public giving were evident in the city, as public buildings housing free libraries, schools and foundations sprang up along the city's widening streets. On the advice of Peabody, some believe, Hopkins determined to use his great wealth for the public good.

The Civil War had taken its toll on Baltimore, however, as did the yellow fever and cholera epidemics that repeatedly ravaged the nation's cities, killing 853 in Baltimore in the summer of 1832 alone. Hopkins was keenly aware of the city's need for medical facilities, particularly in light of the medical advances made during the war, and in 1870 he made a will setting aside seven million dollars - mostly in B&O; stock - for the incorporation of a free hospital and affiliated medical and nurse's training colleges, as well as an orphanage for colored children and a university. Many board members were on both boards. The hospital and orphan asylum would each be overseen by the 12-member hospital board of trustees, and the university by the 12-member university board of trustees. Johns Hopkins' bequest was used to found posthumously the Johns Hopkins Colored Children Orphan Asylum first as he requested, in 1875; the Johns Hopkins University in 1876; the Johns Hopkins Press, the longest continuously operating academic press in America, in 1878; the Johns Hopkins Hospital and the Johns Hopkins School of Nursing in 1889; the Johns Hopkins University School of Medicine 1893; and the Johns Hopkins School of Hygiene and Public Health in 1916.

Johns Hopkins' views on his bequests, and on the duties and responsibilities of the two board of trustees, especially the hospital board of trustees led by his friend and fellow Quaker Francis King, were formally stated primarily in four documents, the incorporation papers filed in 1867, his instruction letter to the hospital trustees dated March 12 1873, his will, which was quoted from extensively in his Baltimore Sun obituary, and in his will's two codicils, one dated 1870 and the other dated 1873.

In these documents, Hopkins also made provisions for scholarships to be provided for poor youths in the states where Johns Hopkins had made his wealth, as well as assistance to orphanages other than the one for African American children, to members of his family, to those he employed, black and white, his cousin Elizabeth, and, again, to other institutions for the care and education of youths regardless of color and the care of the elderly, and the ill, including the mentally ill, and convalescents.

John Rudolph Niernsee, one of most famous architects of the time, designed the orphan asylum and helped to design the Johns Hopkins Hospital. The original site for the Johns Hopkins University had been chosen personally by Hopkins. According to his will, it was to be located at his summer estate, Clifton. However, a decision was made not to found the university there. The property, now owned by the city of Baltimore, is the site of a golf course and a park named Clifton Park. While the Johns Hopkins Colored Children Orphan Asylum was founded by the hospital trustees, the other institutions that carry the name of "Johns Hopkins" were founded under the administration of the first president of the Johns Hopkins University and Johns Hopkins Hospital, Daniel Coit Gilman and his successors.

Colored Children Orphan Asylum

As per Johns Hopkins' instruction letter, the Johns Hopkins Colored Children Orphan Asylum (JHCCOA) was founded first, in 1875, a year before Gilman's inauguration, now the founding date of the university. The construction of the asylum, including its educational and living facilities, was praised by The Nation and the Baltimore American, the latter stating that the orphan asylum was a place where "nothing was wanting that could benefit science and humanity". As was done for other Johns Hopkins Institutions, it was planned after visits and correspondence with similar institutions in Europe and America.

The Johns Hopkins Orphan Asylum opened with 24 boys and girls. Under Gilman and his successors, this orphanage was later changed to serve as an orphanage and training school for black female orphans principally as domestic workers, and next as an "orthopedic convalescent" home and school for "colored crippled" children and orphans. The asylum was eventually closed in 1924 nearly fifty years after it opened, and was never reopened.

Hospital, University, Press, and Schools of Nursing and Medicine

As per Hopkins' March 1873 Instruction Letter, the School of Nursing was founded alongside the Hospital in 1889 by the hospital board of trustees in consultation with Florence Nightingale. Both the nursing school and the hospital were founded over a decade after the founding of the orphan asylum in 1875 and the university in 1876. Hopkins' instruction letter explicitly stated his vision for the hospital; first, to provide assistance to the poor of "all races", no matter the indigent patient's "age, sex or color"; second, that wealthier patients would pay for services and thereby subsidize the care provided to the indigent; third, that the hospital would be the administrative unit for the orphan asylum for African American children which was to receive $25,000 in annual support out of the hospital's half of the endowment; and fourth, that the hospital and orphan asylum should serve 400 patients and 400 children respectively, fifth, that the hospital should be part of the university, and, sixth, that religion but not sectarianism should be an influence in the hospital.

By the end of Gilman's presidency, Johns Hopkins University, Johns Hopkins Press, Johns Hopkins Hospital and Johns Hopkins School of Nursing, and Johns Hopkins School of Medicine, and Johns Hopkins Hospital Colored Children Orphan Asylum had been founded, the latter by the trustees, and the others in the order listed under the Gilman administration. "Sex" and "color" were major issues in the early history of the Johns Hopkins Institutions. The founding of the School of Nursing is usually linked to Johns Hopkins' statements in his March 1873 instruction letter to the trustees that "I desire you to establish, in connection with the hospital, a training school for female nurses. This provision will secure the services of women competent to care for those sick in the hospital wards, and will enable you to benefit the whole community by supplying it with a class of trained and experienced nurses".

Women's most well known success after the founding of the nursing school was their requirement that they be allowed to attend Johns Hopkins medical institutions after they provided funds that made possible the opening of the School of Medicine in 1893. Five African American women were among the first women enrolled in the Johns Hopkins University's undergraduate school in 1970. Kelly Miller and Frederick Scott were the first persons of African descent to attend the Johns Hopkins University's graduate and undergraduate schools, respectively. Frederick Scott was the first graduate of African descent from Johns Hopkins University, and he, Robert Gamble, and Kenyan-born James Nabwangu were the first graduates of African descent from Johns Hopkins University's undergraduate school, and Johns Hopkins' medical schools respectively. Those employees holding jobs in the service sector are those of African descent who have the longest and most continuous history at the Johns Hopkins Institutions.

Legacy

)]] Following Hopkins' death, the Baltimore Sun wrote a lengthy obituary which closed thus: "In the death of Johns Hopkins a career has been closed which affords a rare example of successful energy in individual accumulations, and of practical beneficence in devoting the gains thus acquired to the public." His contribution to the university that has become his greatest legacy was, by all accounts, the largest philanthropic bequest ever made to an American educational institution.

Johns Hopkins' Quaker faith and his early life experiences, in particular the 1807 emancipation, had a lasting influence through out his life and his posthumous legacy as a businessman, railroad man, banker, investor, ship owner, philanthropist and a founder of several Institutions. From very early on, Johns Hopkins had looked upon his wealth as a trust to benefit future generations. He is said to have told his gardener that, "like the man in the parable, I have had many talents given to me and I feel they are in trust. I shall not bury them but give them to the lads who long for a wider education"; his philosophy quietly anticipated Andrew Carnegie's much publicized Gospel of Wealth by more than 25 years.

His philanthropy, banking and other business practices were founded neither on slavery nor on the separate but unequal racism of the post Civil War years of his life. In this vein, integral parts of his legacy, as an emancipator, a founder of an orphan asylum for African-American youths, a staunch advocate of abolitionism and of quality care not just for those physically ill, but also for the elderly, the poor, no matter their age, sex, or color, and the mentally ill, have by and large been overlooked, even in the institutions that carry his name.

In 1973 Johns Hopkins was cited prominently in the Pulitzer Prize winning book The Americans: The Democratic Experience by Daniel Boorstin, former head of the Library of Congress. From November 14, 1975 to September 6, 1976 Hopkins portrait was displayed at the National Portrait Gallery in an exhibit on the democratization of America based on Boorstin's book. In 1989, the United States Postal Service issued a $1 postage stamp in Johns Hopkins' honor, as part of the Great Americans series.

References

External links

Genealogical Records on Marylanders

Thom and Jacob discuss his love for his cousin and Quaker traditions

In his 1887 memoir, Baltimore and the Nineteenth of April, 1861: A Study of the War, George William Brown city Johns Hopkins as a wealthy Union man in Baltimore, a city with strong Confederate and Southern leanings

In The Chronicles of Baltimore: Being a Complete History of "Baltimore Town" and Baltimore City from the Earliest Period to the Present Time published in 1874, John Thomas Scharf cited the 1873 instruction letter to the hospital trustees and a city council resolution thanking Johns Hopkins for his philanthropy. Thom's biography and New York and Maryland newspapers were sources that published parts or all of this letter

The Institutional Records of The Johns Hopkins Hospital Colored Orphan Asylum

Abstract Johns Hopkins Dream for a Model of its Kind: The JHH Colored Orphans Asylum", 2000 Conference International Society for the History of Medicine BY Dr. P. Reynolds

Grave site of Johns Hopkins

Graveside ceremony for Johns Hopkins

Baltimore and the Nineteenth of April, 1861: A Study of the War, the memoir of George William Brown then the mayor of Baltimore city, later a member of the university board of trustees of the Johns Hopkins University

The Chronicles of Baltimore: Being a Complete History of "Baltimore Town" and Baltimore City from the Earliest Period to the Present Time published in 1874 by John Thomas Scharf

"If He Could See Us Now: Mr. Johns Hopkins' Legacy Strong University, Hospital Benefactor Turned 200 on May 19, 1995", Mike Field, the author, contradicts this statement

Chronology, Nursing school

The Institutional Records of The Johns Hopkins Hospital Colored Orphan

Abstract Johns Hopkins Dream for a Model of its Kind: The JHH Colored Orphans Asylum" By Dr. P. Reynolds

"If He Could See Us Now: Mr. Johns Hopkins' Legacy Strong University, Hospital Benefactor Turned 200 on May 19, 1995" by Mike Field a writer for the Johns Hopkins Gazette. Field, Thom, and Jacob called Johns Hopkins an abolitionist. See also The Racial Record of Johns Hopkins University in the Journal of Blacks in Higher Education, No. 25, Autumn, 1999, pp. 42-43/ JSTOR

Johns Hopkins, Maryland State Archives

"The History of African Americans @ Johns Hopkins University" See in particular the chronology and the paper by Danton Rodriguez.

Category:American businesspeople Category:American abolitionists Category:American philanthropists Category:Johns Hopkins University Category:University and college founders Category:People from Baltimore, Maryland Category:People from Anne Arundel County, Maryland Category:American Quakers Category:1795 births Category:1873 deaths