Dr. Gerald B. Kara,¹ former Executive Surgeon and Director of Ophthalmology at the New York Eye & Ear Infirmary, set the stage depicting the period of time during which the Infirmary came into existence and expressed an appreciation of the bravado and strength of conviction displayed by the two young founders:

   Queen Victoria, was one year old. King Louis XVI was the King of France. Napolean was languishing in exile on the Island of St. Helena. Maine was admitted to the United States as its twenty-third state. The flag of Spain was still flying over Florida. James Monroe was the President of the United States, DeWitt Clinton, the Governor of New York State. New York City had 150,000 people.¹

     Slavery existed in New York City. Many of the houses were wood, and therefore fires were frequent. There was no sewage system, and refuse was dumped into the Hudson and East Rivers, mostly at night. Philadelphia was the medical center of the country.

      In Europe, Paris and Vienna had been world renowned for surgery, but in the early 1800's London became the center of world surgery. America had "inherited" English traditional medicine and surgery, and many surgeons throughout the world, including Americans, visited London to learn and perfect their skills. The major textbooks of medicine were British.²

     No steam-powered vessel had yet crossed the Atlantic.

     In this article, although emphasis will be placed on the development and evolution of the Department of Otolaryngology of the New York Eye & Ear Infirmary, it is impossible to separate the very significant achievements within the Department of Ophthalmology. Indeed, the very beginning of the Infirmary's rich history was based on diseases of the eye. Scattered throughout will be a time line of developments in the United States to serve as a reference of activities occurring at the Infirmary.