American Exceptionalism and the American Surgical Association: The Rise of Surgery in the United States

Objective: To explore use of the notion of American exceptionalism by fellows of the American Surgical Association (ASA) (1880 through World War I) and how this proved instrumental in the rise of surgery in the United States. Background: American exceptionalism is the belief that the United States is innately different from other nations because of its economic, geographic, political, religious, and social foundations. Although, currently, the concept of American exceptionalism implies superiority, in its original 19th century connotation, the idea referred to the distinctive character of America as a free nation. Methods: An analysis of published literature along with unpublished documents to provide new knowledge and unique insight into the use of American exceptionalism by members of the ASA as they promoted their specialty. Results: Beginning with Samuel Gross's desire that the organization he founded represent "the genius of our republican institutions," to Frederick Dennis's declaration that "American surgery eclipses all other nations because of the wonderful adaptability of the American mind," plus Lewis Pilcher's explanation of how the "stimulating climate, prevailing religious tone, regard for learning, and pride of citizenship are the fruit of the American mind when turned to surgical problems," and ending with Edmond Souchon's 106 page article in the Transactions on surgical firsts, the ASA was the avenue that helped the nation's surgeons define and defend themselves. Conclusions: Use of the concept of American exceptionalism by fellows of the ASA was a key factor in the development of surgery in the United States.

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