DEVELOPMENT IN NINETEENTH CENTURY 353 



tion of diseased ovaries." All this vituperation was hurled at 

 McDowell; but time, as the great arbiter, has demonstrated that 

 \vliat was said in sarcasm has become a transcendent and mighty 

 truth. The noble character and the true grandeur of McDowell's 

 nature, and his high and lofty ambitions, are illustrated by the fact 

 that he had performed three successful ovariotomies, operations 

 never before undertaken by man, without heralding the victories 

 as triumphs of his personal ambition. In the early days of ovario- 

 tomy, McDowell, and Nathan Smith, the Atlees, Dunlap, Peaslee, 

 Kimball, Sims, and Thomas established and brought to the front an 

 operation against which the most bitter and scathing invectives were 

 aimed. These great men, who have placed this operation upon a firm 

 basis, deserve the gratitude of a nation, and of the world, since they 

 have thrown a flood of light upon this dark region of surgery, which 

 is now illuminated by the work of recent operators whose successes 

 are simply miraculous. 



Mayo Robson has contributed an article on the evolution of ab- 

 dominal surgery, a part of which has reference to the results ob- 

 tained in ovariotomy. He states that in Leeds Infirmary, in 1870- 

 1871, no case was reported under abdominal surgery. In 1901, or 

 20 years later, there were performed in the Leeds Infirmary 569 

 abdominal sections. In reference to ovariotomy, he states that about 

 1870 ovarian tumors were considered a variety of dropsy, and tapping 

 was resorted to as a means of transient alleviation. Thus, in 1870, in 

 St. Bartholomew's Hospital, London, there were only 3 ovariotomies 

 performed, with 100% mortality. In Guy's Hospital, London, 5 

 ovariotomies, with 60 % mortality. In St. Thomas' Hospital, London, 

 1 ovariotomy, with 100% mortality. In St. George's Hospital, Lon- 

 don, 2 ovariotomies, with 100% mortality. In 1875, ovariotomy 

 had such unfavorable statistics that tapping was done to defer 

 a radical operation. In 1875, in 12 cases of ovarian tumor, only 

 7 patients had an ovariotomy performed, and 5 died, thus giving a 

 mortality of 71 %. 



Now mark the contrast. In 1901, ovariotomy was performed 64 

 times, with 4 deaths, or a mortality of about 6 %. When it is con- 

 sidered that in these cases some were malignant, gangrenous, and 

 suppurating cases, the story seems incredible. Mouillin reports, in 

 1901, 57 ovariotomies in the hospital for women, with no death. 

 Richardson, of Boston, reports 93 consecutive ovariotomies without 

 a death. Ovariotomy in the aged shows most remarkable results; 

 thus Kelly has reported in his book over 100 ovariotomies in women 

 who were over 70, and operated upon by 59 surgeons, with only 12 

 deaths. This is a triumph of surgery that Ephraim McDowell fore- 

 shadowed in his courageous work. Sutton collected, in 1896, 11 cases 

 of ovariotomy in women over 80, with no deaths. 



