AMONG THE MOST TECHNICALLY demanding and awe-inspiring surgical operations performed in antebellum America was a resection of a tumor of the maxilla by Horatio Jameson in 1820. At a time when anesthesia and antisepsis were still unknown, Jameson's case was the first of its kind to be reported in the young nation's medical literature. James Underwood was 26 years old when he consulted Jameson about a "large tumour on the maxilla superior of about thirteen months duration." Jameson recommended extirpation but several other physicians suggested otherwise, and Underwood returned untreated to his farm. Ten months later, Jameson was asked to reexamine Underwood and found him in a "most deplorable condition." The tumor had grown so large that Underwood was unable to sleep and in imminent danger of suffocation. Jameson told the young man that he had little choice but to undergo an operation.
Rutkow IM. Horatio Jameson and a "Mouth Stuffed in a Wonderful Manner". Arch Surg. 2002;137(11):1315-1316. doi:10.1001/archsurg.137.11.1315