[7] Researches, Chemical and Philosophical, chiefly concerning Nitrous Oxide and its Respiration. By Humphry Davy. London, 1800.
[8] Lancet, 1870, History of Anæsthetic Discovery.
[CHAPTER XVI.]
SIR SPENCER WELLS AND OVARIOTOMY.
Thomas Spencer Wells, whose career in the revival of the operation of ovariotomy has attracted very widespread attention and interest, was born in 1818, being the eldest son of Mr. William Wells of St. Alban’s, Herts.
Without being formally apprenticed, he enjoyed many of the advantages of the old apprenticeship system, under an able country practitioner, Michael Thomas Sadler, of Barnsley, Yorkshire. Subsequently he spent a year with a parish doctor in Leeds, attending the Leeds Infirmary, and Hey’s and Teale’s lectures. The session 1837-8 was passed in Dublin, and there Graves and Stokes largely influenced the young surgeon. Continuing his course of culture in varied fields, he went to St. Thomas’s, London, and was a zealous pupil of J. H. Green, Travers, and Tyrrell. Here he obtained a prize for the best reports of post mortem examinations. Becoming a member of the College of Surgeons in 1841, he entered the navy as assistant-surgeon, and spent six years in the Naval Hospital at Malta.
In 1853 Sir Spencer Wells settled in practice in London, and in 1854 became attached to the Samaritan Hospital, then a dispensary for the diseases of women. At this time Sir Spencer states he knew less of this branch of the profession than of any other. In his younger days he had attended an unusual number of midwifery cases, but latterly his practice had been almost exclusively surgical, with a strong tendency towards ophthalmic surgery. It was at this time that he first became interested in the subject that has made his name so widely known.
From time immemorial the ovaries of women have been subject to diseased growths and fluid accumulations, for which there was scarcely a remedy, except when fluid could be drawn off through one or more punctures, and fatal results were the almost inevitable sequel of these diseases. Towards the end of the seventeenth and beginning of the eighteenth centuries, several medical men proposed to remove the diseased organ by an incision in the front wall of the abdomen. William Hunter in 1762 put forward a method by which this operation, otherwise full of danger, might be rendered feasible; and John Hunter, lecturing in 1785, favoured the idea of removal, considering that the opening would not necessarily constitute a highly dangerous wound. In 1798 Chambon, in a book on diseases of women, published at Paris, strongly argued in favour of the operation. Although it does not appear that he ever himself performed it, he says, “I am convinced that a time will come when this operation will be considered practicable in more cases than I have enumerated, and that the objections against its performance will cease.” John Bell also has a share of credit in this matter, for in his lectures on surgery at Edinburgh in 1794 he dwelt with much force on the practicability of removing ovarian tumours by operation. It was reserved, however, for a pupil of his, Ephraim M’Dowell, from Virginia, to perform the first modern operation of ovariotomy for disease. He settled in practice in Kentucky in 1795, and in 1809 carried into effect this novel operation upon a middle-aged woman, who survived to complete her seventy-eighth year in 1841. Thus an American had the glory of first boldly starting in the new path.
It was difficult to give the new operation a start in England. “It must be remembered,” says Sir Spencer Wells, “that, at that time of day, the mortality from all operations was much greater than it is now; that the sick and diseased were more passively quiescent under their maladies and less tolerant of any surgical suggestions, just as we ourselves find to be the case among the unroused population of an outlying agricultural district; that they were not buoyed up, as modern women are, by the histories and promises of painless extirpations under chloroform or methylene; and that, without any mawkish sentimentalism, surgeons themselves had to encounter the peine forte et dure of their suppressed sympathy, and nerve themselves up to the infliction of the most deliberate and tedious eviscerative vivisection. The disease was looked upon as a mystery, and its ending in death as a matter of course; and, instead of being accompanied, as we now see it, by fretful resistance and chafings to escape, it only led to stolid endurance or religious submission; and on the part of the profession, to pity and endeavours to alleviate the inevitable misery. But M’Dowell was a free man, in a new country, clear from the conventional trammels of old-world practice, found his patients in the most favourable conditions of animal life, seems to have had one of those incomprehensible runs of luck upon which a man’s fate and reputation so often turn if he has the sagacity and energy to put such fortunate accidents to good account, and was happy, as those usually are who can afford or constrain themselves to wait, in finding suitable time, place, persons, and opportunity for working into fact the notions of his tutor, Bell. He lost only the last of his first five cases of ovariotomy, and thus, as it were, established at the outset what until recently was complacently regarded as a satisfactory standard of mortality for so serious an operation.”[9]
As a surgeon M’Dowell was “cautious, calm, and firm, paying great attention to the details of his operations and treatment, and selecting and drilling his assistants with great care.” In 1879 a granite obelisk was raised to his memory in the cemetery where he was buried, near his home, in commemoration of his courageous and important work.
Long after M’Dowell’s operations became known, a case was discovered as far back as August 1701, in which Robert Houstoun, a Glasgow surgeon, operated on a woman for a large tumour in a fashion somewhat anticipatory of modern ovariotomy. She recovered, and lived sixteen years afterwards. So often are anticipations of great improvements to be found, that it appears that the merit, like the difficulty of actually making a thing practicable and practised, is as great as, or greater than, that of discovery.