diana; Dr. G. W. Bayless, of Missouri; and Prof. F. G. Smith, of Philadelphia. I am also under obligations, for similar reasons, to Prof. Bush, and Prof. Peter, of Lexington; Dr. Galt, of Louisville; Dr. Robertson, of Nicholasville; Wallace W. McDowell, of Danville; Dr. Gardner, of Woodsonville; Dr. Chipley, of Lexington; Charles F. Wing, Esq., of Greenville; R. B. Brashear, Esq., of Louisiana; Dr. J. M. Mills, of Frankfort; and Dr. Bemiss, of Bloomfield.

Little appears to have been published by Kentucky surgeons and physicians prior to the establishment of the "Transylvania Journal of Medicine and the Associate Sciences," at Lexington, in 1828. In the first volume of that periodical is contained, if my information is correct, the first contribution to professional science ever made by Dr. Benjamin W. Dudley, at that time, and for many years subsequently, the able and distinguished professor of anatomy and surgery in the Medical Department of Transylvania University, the oldest, and, for a number of years, the most celebrated and successful school of Medicine in the valley of the Mississippi. The publication of the journal in question opened a new avenue to the practitioners of the Southwest for the communication of their observation and experience to their brethren in other portions of the country, and we accordingly find that there is not a volume of it that does not contain original papers, upon medicine and its cognate branches, of more or less interest and value. The surgical material, however, which has been thus furnished is, it must be confessed, with few exceptions, comparatively meagre; consisting, as it does, for the most part, rather of isolated cases and facts than of connected and well-digested monographs. Dr. Benjamin W. Dudley and his immmediate pupils are the chief contributors, and it strikes the reader as not a little singular that many of the articles which appear in the pages of the Transylvania Journal, are filled with the details of this distinguished surgeon's own cases, or of cases expressly designed to illustrate his doctrines and practice. I know not of a similar instance of the kind in the United States, where the influence of a preceptor has excited so strong and reverential a devotion on the part of his pupils, or whose teachings have sunk more deeply into the hearts and minds of his hearers.

I do not believe that Dr. Rush, the ablest and most eloquent professor of medicine in his day in this country, enjoyed so wide and controlling a popularity as Dr. Benjamin W. Dudley, or that his doctrines and practice were received with as much enthusiasm, confidence and oneness of feeling as were those of the Western Corypheus of Surgery, in the palmiest days of his usefulness and renown. Such devotion is, indeed, rare in any country, but especially in this, where every one is disposed, from his earliest childhood, to think and to act for himself; where, in short, “nullius addictus jurare in verba magistri." It exhibits Dr. Dudley's popularity in a light, alike flattering to his own feelings, and creditable to those of his pupils.

Dr. Ephraim McDowell, another of Kentucky's illustrious surgeons, never contributed anything to any Western periodical. The only papers, in fact, which he ever published were two short ones in the seventh and ninth volumes of the Philadelphia Eclectic Repertory, detailing several of his cases of ovariotomy, at that time so incredulously received by his professional brethren, but which have since created for him a world-wide celebrity. Dr. Brashear, another surgeon of distinction, never wrote anything for our medical journals.

In the prosecution of my labors, I do not deem it necessary to adopt any particular chronological arrangement: this, indeed, would be impracticable. As marking the first great epoch in Kentucky Surgery, I shall begin with the subject of ovariotomy; considering, afterwards, in regular succession, the lesions and operations of particular regions and organs of the body.

OVARIOTOMY.

To Kentucky belongs the honor of having furnished to the world the first case of extirpation of the ovary, for organic disease of this organ. This honor is justly and exclusively due to the late Dr. Ephraim McDowell, of Danville. From a paper published by this gentleman in the seventh volume of the Philadelphia Eclectic Repectory, it appears that his first operation was performed in December, 1809. It is not known, with any degree of certainty, how often Dr.. McDowell repeated this operation

his published cases amount only to five, but there is reason to believe from what I have learned from his nephew, Dr. William A. McDowell, that he performed it not less than thirteen times.

During the progress of my labor, as Chairman of the Committee on Surgery, of this Society, I have, in consequence of letters addressed to various gentlemen in Kentucky, Ohio, and Tennessee, been made acquainted with the particulars of three cases more, which, added to those published by Dr. Ephraim McDowell himself, increase the aggregate to eight. It is to be deeply regretted that Dr. McDowell did not keep a record of his operations, or communicate the results to his professional brethren. Such a contribution would not only have greatly enhanced his own reputation, as a bold and original surgeon, but it would have conferred an inestimable boon upon suffering humanity.

As the operations in question reflect the highest credit, not only upon Kentucky, and upon Kentucky's illustrious surgeon, but upon the United States, and as they have been mainly, if not exclusively, instrumental in directing the attention of the profes sion, both in America and in Europe, to a subject which has, of late years, elicited so much interest, research and skill, it is proper that I should give a brief analysis of them, in order, more especially, that the world at large may know what knowledge and science, when aided by intrepidity and dexterity, may accomplish even in a backwoods settlement of Kentucky. Dr. McDowell's first three cases are published in the seventh, and the last two in the ninth volume of the Philadelphia Eclectic Repertory.

Dr. M Dowell's first operation was performed upon Mrs. Crawford, of Kentucky, in December, 1809. The tumor inclined more to one side than the other, and was so large as to induce her professional attendant to believe that she was in the last stage of pregnancy. She was affected with pains similar to those of labor, from which she could find no relief. The wound was made on the left side of the median line, some distance from the outer edge of the straight muscle, and was nine inches in length. As soon as the incision was completed, the intestines rushed out upon the table; and so completely was the abdomen filled by the tumor that they could not be replaced during the operation,

which was finished in twenty-five minutes. In consequence of its great bulk, Dr. McDowell was obliged to puncture it before it could be removed; he then threw a ligature round the Fallopian tube, near the uterus, and cut through the attachments of the morbid growth. The sac weighed seven pounds and a half, and contained fifteen pounds of a turbid, gelatinous looking substance. The edges of the wound being brought together by the interrupted suture and adhesive strips, the woman was placed in bed and put upon the antiphlogistic regimen. "In five days," says Dr. McDowell, "I visited her, and, much to my astonishment, found her engaged in making up her bed. I gave her particular caution for the future; and in twenty-five days she returned home in good health, which she continues to enjoy."

It will not be uninteresting here to state, that Mrs. Crawford, at the time of the operation performed upon her by Dr. McDowell, lived in Green county, Kentucky, from whence she removed, sometime afterwards, to a settlement on the Wabash river in Indiana, where she died, March 30th, 1841, in the 79th year of her age. There was no return of her disease, and she generally enjoyed excellent health up to the period of her death. She had no issue after the operation. Her youngest child, our worthy citizen, Mr. Thomas H. Crawford, who has kindly communicated to me these facts, was born in 1803, nearly, or quite, six years before the operation.

The second case was that of a negress. The tumor is stated to have been very large, and so firmly adherent to the bladder and uterus as to render any attempt at extraction perfectly futile.

The operator, therefore, contented himself with making a free incision into it with a scalpel, to let out its contents, which were of a thick, ropy and gelatinous character, The incision was of the same length, and made in the same situation as in the preceding case. Upwards of a quart of blood was lost in the operation. The wound, which was dressed in the ordinary manner, healed without any untoward symptom. The woman remained well for nearly five years, when the tumor began to increase again, and in twelve months it was as large as before the operation.

The third operation was performed in May, 1816. The sub

ject was a negro woman; and the ovarium, which was much enlarged, could be easily moved from side to side, to the left of which, however, it was adherent. Dr. McDowell made an incision into the linea alba, from an inch below the umbilicus to within an inch of the pubes, and then extended the opening towards the right side, about two inches above the former point, to afford himself more room. He next passed a ligature round the Fallopian tube, and " turned out" the left ovary, which was found to be in a scirrhous condition, and to weigh six pounds. The wound was dressed as in the preceding cases, and the woman was well in two weeks, though the ligature did not come away under five weeks. No mention is made of the manner in which the adhesions were overcome.

Dr. McDowell performed his fourth operation in April, 1817, upon a colored woman from Garrard county, Kentucky; removing a scirrhous ovary, weighing five pounds. The incision was made near the linea alba, but its extent is not mentioned. The ligature slipped from the Fallopian tube, after its division, and, in consequence, a great loss of blood took place. Several arteries were then tied; but this not arresting the hemorrhage, a large ligature was passed round the whole stump of the tube, and secured in the most careful manner. Although the woman was much exhausted, she happily recovered, but did not fully regain her health. "This, though the smallest ovarium I have ever extracted," says Dr. McDowell, "was much more troublesome to the patient than in any previous case. Besides experiencing severe lancinating pains in the parts, she was seldom able to discharge her urine without getting almost on her head, in consequence of the tumor falling down into the pelvis, and compressing the

urethra."

His fifth recorded operation, was performed by Dr. McDowell on the 11th of May, 1819. The patient, likewise a negress, and the mother of one child, was from Lincoln county, in this State, and was supposed by her physician to be laboring under ascites, as the tumor was very large and fluctuating. After having given her hydrogogue medicines for some time without any benefit, Dr. McDowell tapped her, and drew off thirteen quarts of thick, gelatinous fluid. The operation was repeated in two months, and it