The early Ovariotomists--pioneers in abdominal surgery.

WHEN I first embarked on the preparation of this address it was with the idea that Spencer Wells was the key figure in the development of ovariotomy-the operation for removal of an ovarian cyst. Possibly this may be true, but I soon discovered how much credit must be given to other workers in this field. It all began in 1809. It was in that year that a courageous woman-Jane Crawford-submitted to hitherto untried surgery at the hands of Ephraim McDowell of Danville, Kentucky. Little did they realize the far-reaching results of the "experiment"-as McDowell called it. Here is the story in his own words: "In December 1809 I was called to see a Mrs. Crawford who had for several months thought herself pregnant, with pains from which she could find no relief. So strong was the presumption of her being in the last stage of pregnancy that two physicians requested my aid in delivering her. "The abdomen was considerably enlarged; examination induced the conclusion that it must be an enlarged ovarium. Having never seen so large a substance extracted, nor heard of an attempt, or success attending any operation such as this required, I gave to the unhappy woman information of her dangerous situation. She appeared willing to undergo an experiment, which I promised to perform if she would come to Danville (the town where I live), a distance of sixty miles from her place of residence. This appeared almost impracticable by any, even the most favourable conveyance, though she performed the journey in a few days on horseback." McDowell then goes on to describe the operation-an abdominal incision nine inches long was not sufficient to allow removal of the cyst entire, so he partially emptied the cyst and then removed it, leaving the ligature on the pedicle protruding in the lower end of the wound, as was the custom in amputations. To quote him again, "In five days I visited her, and much to my astonishment found her engaged in making up her bed. I gave her particular caution for the THE ULSTER MEDICAL JOURNAL _111W, 'Isk, lime---,WWI _1WW_