In December of 1809, Ephraim McDowell performed an abdominal surgery, and successfully removed a large ovarian tumor. This was many decades before Anesthesia was invented, and at a time when making an incision to cut open abdomen, was a medical no-no. Further, McDowell performed this surgery at Danville, Kentucky. At that time, it was the farthest-west state of US, better known for its wilderness. This surgery is as remarkable as the fact that in 1809, McDowell did not have a formal medical diploma, required to practice medicine.
Early days lading up-to 1809
Born in 1771, McDowell was 19 when he started studying medicine. He entered a two year preceptorship with Alexander Humphreys in Virginia. At that time, Dr. Humphreys was known as an excellent surgeon and the premier lithotomist in the country, who suggested that McDowell should obtain a formal medical education. In 1793-94 he attended medical lectures at the University of Edinburgh, Scotland, took some private lessons, but returned back to Kentucky before obtaining a formal medical qualification.
In 1795 McDowell started his medical practice, and was well recognized. He was performing amputations, operating strangulated hernias, performing lithotomy, drainage of abscesses, resection of parotid tumors, and even tracheotomy. McDowell belonged to an influential family, his father Samuel was one of the founders of Kentucky, and his wife Sarah was daughter of the state’s Governor.
Account of his first successful ovarian surgery
His patient Jane Todd Crawford, a 45 year old lady thought that she was pregnant with twins. Her abdomen was swollen, and was gradually becoming bigger. When she did not deliver, even after a year, her family consulted McDowell. It took McDowell a three day 60 mile journey to see his patient, and it was a large ovarian growth, he pronounced. McDowell suggested a surgery, for which Crawford would need to come to his clinic.
McDowell performed the surgery on 25th December 1809, a Sunday. While patient was asked to sing hymns, she was also given moonshine and laudanum, followed by a few sips of barley water whiskey. While Christmas festivities filled the air, so did a critical crowd of about 100 people. It is suggested that McDowell could be killed, if the surgery failed.
The surgery was however a successful one. Over next 25 minutes, McDowell opened the abdomen, displaced intestines, removed 15 pounds of gelatinous material from the cyst, ligated Fallopian tube, and excised another 7.5-pound cyst sack. Warm water was used to irrigate the abdomen, and abdomen was closed with silk sutures. McDowell’s patient Crawford lived on for 32 more years, outliving McDowell himself.
McDowell described his first surgery, many years later in 1817. He had performed at least two more similar surgeries till then. This delay in reporting, was in part because he felt that his writing ability was inadequate, and he expected the universal criticism he received from the medical community. He had difficulty finding a journal that would publish such an impossible feat. Ultimately, the Philadelphia Eclectic Repertory and Review published his report.
Accolades and Brickbats
McDowell died of Acute Appendicitis in the year 1830. About two decades later, a biographer Samuel Gross, popularized his memory, so much so that he is hailed as a hero in Kentucky. In 1920s, a doctor August Schachner wrote another biography, and included various other accounts, including from Mary Young Ridenbaugh, McDowell’s grand-daughter. Some believe that McDowell’s biography hide some other facts.
McDowell also describes in his own descriptions, that he also operated ovarian growths, on at-least three other “enslaved” women. McDowell was himself a slave owner, and it is alleged that his success hides his failed surgeries, many of which may have been experiments on enslaved women. In the pre-anesthetic and pre surgical asepsis era (prior to 1840), abdominal surgery was a taboo as it was a sure death.
McDowell is often compared with J. Marion Sims – Father of Gynecology. In 2018, New York City removed Sim’s statue from Central Park, as he had extensively operated and experimented on “black enslaved women” to perfect his gynecology surgery skills. McDowell’s statue however continues to adorn US Capitol, and his house in Danville Kentucky is a much visited Museum.