Dr. Lewis Sayre: The 19th Century Surgeon Who Cured Kids by Hanging Them From the Ceiling
- Jun 3, 2024
- 4 min read
In November 1874, a four year old boy was carried into Dr. Lewis Sayre's office in New York with a paralysed leg and a spine curving badly to one side. Sayre's solution sounds less like medicine and more like something out of a torture manual. He suspended the boy by the arms and head, stretched his spine straight while he hung there, and wrapped him in a wet plaster of Paris bandage from armpit to hip. Once it dried, the boy walked out in a rigid cast that would hold his spine in place for months. It worked, or at least it seemed to, and for the next fifty years doctors around the world did more or less the same thing.
From Kentucky to Bellevue
Sayre was born in 1820 in Bottle Hill, New Jersey, now called Madison, into a family with deep local roots. His father died when he was ten, and an uncle in Lexington, Kentucky, a banker, took him in and hoped he'd follow him into finance. Sayre had other ideas. He enrolled at Transylvania University in Lexington, then headed back east to New York City to study medicine properly at the College of Physicians and Surgeons. He graduated in 1842 with a thesis on spinal irritation, a subject that would end up defining the rest of his career.
He spent a decade as a prosector, preparing bodies for anatomy demonstrations, before moving his practice to Bellevue Hospital in 1853. In 1861 he became the first professor of orthopedic surgery in the United States, a title that didn't really exist as a specialty before him. He trained hundreds of students over the following decades and held the position until 1898.
The Jacket That Bears His Name
The suspension and plaster technique became known as the Sayre jacket, and it's genuinely his most lasting contribution to medicine. Patients with scoliosis or Pott's disease, a form of spinal tuberculosis, were hung from a specially built frame by their arms and sometimes their head, which pulled the spine straight under the patient's own body weight. While suspended, Sayre or an assistant would wrap them tightly in bandages soaked in plaster of Paris. Once it hardened, the patient could move around fairly normally while the cast held everything in the corrected position.
Sayre described the method himself in his 1877 book Spinal Disease and Spinal Curvature, detailing dozens of cases including the four year old boy from 1874. He wasn't shy about the results, writing them up in exhaustive clinical detail alongside photographs and illustrations, some of which show patients mid suspension, hanging from straps in what looks like a very grim gymnastics routine.
The jacket wasn't universally loved. Some contemporaries, including fellow orthopedist Newton Melman Shaffer, argued plaster was a poor fit for Pott's disease specifically and pushed back publicly on Sayre's methods. Modern orthopedists looking back doubt the technique permanently cured much of anything, though most agree it likely eased symptoms and gave deformed spines external support they otherwise wouldn't have had. Either way, it stayed in standard use well into the 1920s, decades after Sayre's death.
The Hip Surgery Nobody Had Managed Before
The spine wasn't Sayre's only specialty. In 1854 he performed the first successful operation in the United States to cure hip joint ankylosis, a condition where disease or injury fuses the joint solid. He removed part of the femur to restore some movement, a procedure he went on to repeat dozens of times over his career, including demonstrations in front of European medical societies during a tour in 1871. It wasn't an easy fix. Roughly half his hip surgery patients in the early years died from the operation itself, and only some of the survivors regained real flexibility, which meant plenty of doctors preferred to avoid it in favour of non-surgical options whenever they could.
The Doctor Who Stopped Cholera at the Docks
Between 1860 and 1866, alongside his surgical work, Sayre served as a health officer for New York City. He worked out that sailors arriving on incoming ships were bringing cholera into the city and pushed through quarantine measures to stop it spreading further, at a time when most other American ports weren't bothering with anything similar. New York largely dodged the epidemics that hit other cities during this period, and Sayre's quarantine work was a significant part of why. He also helped secure compulsory vaccination programs in the city, another unusually forward thinking move for the era.
A Legacy That's More Complicated Than It Looks
Sayre also became one of the most prominent American voices promoting circumcision in the second half of the 19th century, though not for the reasons it's performed today. He believed a chronically irritated foreskin could cause problems in completely unrelated parts of the body, including paralysis and epilepsy, and recommended circumcision as treatment. The theory has been thoroughly discredited since, but Sayre's advocacy, delivered with the same confidence and thorough documentation he brought to his spinal work, helped embed the procedure in mainstream American medicine for generations, long after the original medical justification fell apart.
Sayre co-founded the American Medical Association in 1847 and served as its president in 1880. All three of his sons became orthopedic surgeons and worked alongside him, and his daughter Mary Jane helped manage his publications. He kept working until close to his death in 1900, by which point the specialty he'd essentially invented from scratch had become a standard part of American medical schools. If you're curious about other doctors who reshaped their fields through sheer stubborn experimentation, Dr. Harvey Cushing's work transforming brain surgery follows a similar arc a few decades later.
