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Moments in Surgical History
December 2001

Valentine Mott and the Beginnings of Vascular Surgery

Arch Surg. 2001;136(12):1441. doi:10.1001/archsurg.136.12.1441

VALENTINE MOTT (1785-1865) was among the most prominent of American surgeons during the first half of the 19th century. He initially apprenticed with his cousin, Valentine Seaman (1770-1817), but later obtained a medical degree at New York City's Columbia College (1806). Seeking further medical training in Europe, Mott departed for London in the early spring of 1807 and registered as a pupil at Guy's Hospital where he worked for 6 months with Astley Cooper (1768-1820). Following this he studied with other renowned London surgeons, including John Abernethy (1764-1831) at St Bartholomew's Hospital, William Blizard (1743-1835) at London Hospital, Henry Cline (1750-1827) at St Thomas', and Everard Home (1756-1832) at St George's Hospital. In 1808, Mott moved to Edinburgh, Scotland, where he worked with John Thomson (1765-1846), who held the chair of military surgery at the university, and John Bell (1763-1830), who was in the private practice of surgery.

A photograph of Valentine Mott (circa early 1860s) (author's collection).

A photograph of Valentine Mott (circa early 1860s) (author's collection).

Having received a great deal of technical expertise, Mott returned to New York City in 1809. Within 2 years, he was appointed professor of surgery at his alma mater, which soon merged with the College of Physicians of Surgeons of the University of New York. Mott remained at this new institution until 1826 when he helped found the Rutgers Medical College in New York City. He was chair of operative surgery until 1834 when he resigned owing to poor health. In early 1835, Mott left for an extended stay in Europe that lasted 7 years. During his travels, Mott was received by the most famous of European surgeons, describing his experiences in his book, Travels to Europe and the East (1842). Returning home, Mott became chair of surgery at the recently established University Medical College where he remained for 10 years. In 1850, ill health again forced him to retire, and he once more set out for Europe. After a year-long sojourn, a refreshed Mott reaccepted his old position at the University Medical College. Three years later and still in good health, he decided to permanently retire and spend his final years in humanitarian pursuits.

Mott never wrote any major surgical treatise. His only contribution in the form of a textbook was to supervise the translation from French of Alfred Velpeau's (1795-1867) 3-volume New Elements of Operative Surgery (1847). Mott had a repugnance toward medical writing and felt the time necessary to put pen to paper could be better spent in other professional activities. Throughout his career, Mott reported fewer than 30 surgical cases, but it was these technical triumphs that brought about his being regarded as the "father of American vascular surgery."

An extremely busy surgeon, Mott's lifetime vascular operative record was simply astounding. Among many technical triumphs, he performed the world's first reported attempt to ligate the innominate artery for aneurysm (1818), an early case of common carotid artery ligation prior to resection of the mandible (1822), the first successful ligation of the common iliac artery in the United States (1827), the first reported use of Pierre Brasdor's (1721-1797) technique of treatment of aneurysm by ligation of the artery immediately distal to the lesion (1829), a case of external iliac ligation (1831), the first attempt in America to ligate the subclavian artery within the scaleni muscles (1833), and the second successful reported ligation of the internal iliac artery in the United States (1837). Overall, he is believed to have ligated the femoral artery 57 times, the external carotid 51 times, the popliteal 10 times, the subclavian artery 8 times, the external iliac 6 times, the internal iliac artery twice, the common carotid artery twice, the common iliac once, and the innominate artery once. This is most remarkable when it is realized that Mott operated in a preanesthetic and preantiseptic era and without the benefit of blood transfusions. As Astley Cooper said of his pupil, "He has performed more of the great operations than any man living."