- Joshua Taylor Bradford and the Transatlantic Revival of Ovariotomy in the Mid-Nineteenth Century
Writing in the late nineteenth century, Kentucky historian Richard H. Collins noted that he found it “a remarkable fact and coincidence in medical history” that Ephraim McDowell “originated” ovariotomy and Joshua T. Bradford “excelled the whole world in successfully practicing it.”1 McDowell laid the foundation for abdominal surgery in Europe and the United States when he removed a twenty-two-and-a-half-pound fibrous ovarian cyst from Jane Todd Crawford at his office in Danville, Kentucky, in 1809. By the time McDowell died in 1830, he had performed thirteen procedures with four deaths.2 Over the next three decades, those who dared follow “the father of ovariotomy” experienced an unacceptably high mortality rate of between [End Page 59] 40 to 75 percent and that discouraged others from attempting any more operations.3
The advent of chloroform and ether encouraged a few valiant surgeons in Great Britain and the United States to revive the procedure in the early 1840s. Over the next four decades, six giants in the field of ovarian surgery emerged in the United States: John and Washington Atlee, Edmund Randolph Peaslee, Gilman Kimball, Alexander Dunlap, and Joshua Taylor Bradford. Bradford proved he was a worthy successor to McDowell by performing thirty-one ovarian operations with only three deaths, a “record of achievement, unparalleled in all the world before the days of modern surgery.” The highly regarded Kentucky surgeon Lunsford P. Yandell declared that Bradford “stood first among surgeons everywhere—Europe and in our own county.”4 As Yandell noted, Bradford’s inventiveness did not occur in a vacuum. There was a communal and academic awareness among European and American surgeons, and that loosely knit community did not allow the vast Atlantic Ocean to deter them from debating practices or sharing knowledge through correspondence, published reports, and actual visits. Bradford was part of an incongruous mix of colleagues in the Ohio Valley, the northeastern United States, and Great Britain who made ovariotomy an acceptable procedure between 1842 and 1865.
Like most surgeons in the first half of the nineteenth century, Bradford was influenced by medical traditions that originated at the University of Edinburgh in Scotland. The alumni of that school were prominent in the establishment of a medical school at the College of [End Page 60] Philadelphia (University of Pennsylvania) in 1765.5 Graduates of that school in turn helped build important medical schools in Lexington, Cincinnati, and Louisville. The printing press had already removed many of the limits on learning, and the students and faculty found the Ohio River and the National Road kept them in touch with trends along the eastern seaboard and beyond. The advent of the steam-powered rotary press in the 1840s advanced that exchange of knowledge tremendously, and personal interaction improved greatly with the building of the Baltimore & Ohio Railroad and the introduction of transatlantic steam vessels.6
Edinburgh and London were the most important sources of knowledge about opening the peritoneal cavity to treat ovarian dropsy (ovarian tumor filled with fluid). That underpinning began with the work of Robert Houston, of Glasgow, Scotland, who first made an exploratory abdominal incision to remove an ovarian tumor in 1701. Houston’s work was further developed by William and John Hunter. William Hunter was a famous eighteenth-century Scottish anatomist and obstetrician who determined the relationship between maternal and fetal blood systems. His younger brother John eclipsed him and is known as the father of experimental surgery and surgical pathology. Edinburgh professor John Bell was well acquainted with the Hunters. Like them, he recognized the relationship between anatomy and surgical practice, and it is generally accepted that Bell suggested to Ephraim McDowell and other students in 1793–94 that the surgical removal of a diseased ovary might meet with success.7
An introductory article to an 1895 medical text, System of Surgery, noted that “the surgeon of 1800. … had only just learned to ligate arteries and treat wounds.” The profession had “little more knowledge [End Page 61] than had Hippocrates of the chief causes of danger after operations … and [that meant the surgeon] groped wildly...