When Hays began his career in medicine and ophthalmology, in the earlydecades of the 19th century, ophthalmology was firmly ensconced in the provinceof general surgery. Philip Syng Physick, Hays' teacher at the University ofPennsylvania, was one of the foremost general surgeons of the day, yet hepracticed, wrote about, and taught ophthalmology to an extent that he wasconsidered one of the foremost eye surgeons of his day. Many decades later,David Hays Agnew, MD, professor of the Principles and Practice of Surgeryat the University of Pennsylvania in 1871, was preeminent in ophthalmologyin his practice, writing, and teaching. Similarly, Samuel David Gross, anothersurgical great, professor of surgery at Jefferson Medical College, was alsoproficient in the surgical treatment of the eye. The latter 2 surgeons wereimmortalized in paintings by Thomas Eakins (The Agnew Clinic and The Gross Clinic), but it was not eyesurgery that was pictured. It was the breast and an extremity, more commonlywithin the province of the general surgeon.