ON the last day of 1867 I left the Hospital as House Surgeon, and in 1869 was appointed Assistant Surgeon. In 1870 I did my first ovariotomy, the second done in the Hospital, and the first successfully. It was, fortunately, a particularly easy case. The patient ran away from the Hospital, frightened by the fire which occurred in the east-end of the building about that time. As I was walking up the Marine Parade the evening before the operation, I met a retired elderly medical man, who strongly advised me not to attempt an operation, which was "scarcely justifiable," and might lead to unpleasant consequences to myself. I am not sure he did not mention "Coroner's Inquest." Considering the enormous mortality of hernia operations of those days, and the teaching that a wound of the peritoneum was almost certainly fatal, it is not to be wondered at that ovariotomy, when first introduced by Sir Spencer Wells, should have been received by the profession with a storm of abuse, and that all sorts of opprobrious epithets should have been applied to those who practised it. But this opposition was of short duration. The position of a woman, the subject of ovarian disease, in those days was terrible. After a painful illness of a year, or, at most, two, with all the miseries of dropsy, relieved perhaps from time to time by tapping, in those days a somewhat dangerous operation, she could only look forward to a fatal termination. It is not surprising, under these circumstances, that she should take the risk of an operation that would restore her to health, though that risk might be great.
The number of successful cases was at first very encouraging, and quickly became greater as the management of patients and the manner of doing the operation improved. Still surgeons had to feel their way. The initial difficulty was in diagnosis. Abdominal tumours having been looked on as beyond the reach of surgery, little pains had been taken to differentiate between the various forms, and mistakes were thus often made. Then the idea that patients required food soon after the operation was the cause of some failures. One by one errors of this sort were rectified, and the number of failures decreased. The greatest advance was, perhaps, the exchange of the clamp for the internal ligature, which marked a great advance in the practice of general Surgery. I well recollect a remark in one of the journals, that nothing but its success could justify such an unsurgical procedure as leaving a ligature in the interior of the body.