Ephraim McDowell
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Ephraim McDowell (November 11, 1771 – June 25, 1830) was an American physician and pioneer surgeon. The first person to successfully remove an ovarian tumor, he has been called "the father of ovariotomy" as well as founding father of
abdominal surgery The term abdominal surgery broadly covers surgical procedures that involve opening the abdomen ( laparotomy). Surgery of each abdominal organ is dealt with separately in connection with the description of that organ (see stomach, kidney, liver, ...
.


Early life

McDowell was born in Rockbridge County, Virginia, the ninth child of
Samuel Samuel ''Šəmūʾēl'', Tiberian: ''Šămūʾēl''; ar, شموئيل or صموئيل '; el, Σαμουήλ ''Samouḗl''; la, Samūēl is a figure who, in the narratives of the Hebrew Bible, plays a key role in the transition from the bib ...
and Mary McDowell. His father was a veteran of the
French and Indian War The French and Indian War (1754–1763) was a theater of the Seven Years' War, which pitted the North American colonies of the British Empire against those of the French, each side being supported by various Native American tribes. At the st ...
and a colonel during the
American Revolution The American Revolution was an ideological and political revolution that occurred in British America between 1765 and 1791. The Americans in the Thirteen Colonies formed independent states that defeated the British in the American Revoluti ...
. In 1784 Samuel McDowell was appointed land commissioner and moved his family to
Danville, Kentucky Danville is a home rule-class city in Boyle County, Kentucky, United States. It is the seat of its county. The population was 17,236 at the 2020 Census. Danville is the principal city of the Danville Micropolitan Statistical Area, which include ...
. There, he presided over ten conventions that resulted in the drafting of the Kentucky Constitution.


Education

McDowell received his early education at the classical seminary of Worley and James, then spent three years as a medical student under Dr. Alexander Humphreys in
Staunton, Virginia Staunton ( ) is an independent city in the U.S. Commonwealth of Virginia. As of the 2020 census, the population was 25,750. In Virginia, independent cities are separate jurisdictions from the counties that surround them, so the government off ...
. He attended lectures in medicine at the
University of Edinburgh The University of Edinburgh ( sco, University o Edinburgh, gd, Oilthigh Dhùn Èideann; abbreviated as ''Edin.'' in post-nominals) is a public research university based in Edinburgh, Scotland. Granted a royal charter by King James VI in 1 ...
,
Scotland Scotland (, ) is a country that is part of the United Kingdom. Covering the northern third of the island of Great Britain, mainland Scotland has a border with England to the southeast and is otherwise surrounded by the Atlantic Ocean to ...
, from 1793 to 1794 and studied privately with John Bell. He never received a diploma, but in 1825, the
University of Maryland The University of Maryland, College Park (University of Maryland, UMD, or simply Maryland) is a public land-grant research university in College Park, Maryland. Founded in 1856, UMD is the flagship institution of the University System of ...
conferred on him an honorary M.D. degree.


Career

In 1795, McDowell returned from Scotland, settled in Danville, Kentucky, and began his practice as a surgeon. McDowell perfected the modern surgical technique of
lithotomy Lithotomy from Greek for "lithos" (stone) and "tomos" ( cut), is a surgical method for removal of calculi, stones formed inside certain organs, such as the urinary tract (kidney stones), bladder ( bladder stones), and gallbladder (gallstones), ...
, for removal of stones obstructing the urinary bladder. One of his most famous patients was James K. Polk, for whom he removed a
urinary stone A bladder stone is a stone found in the urinary bladder. Signs and symptoms Bladder stones are small mineral deposits that can form in the bladder. In most cases bladder stones develop when the urine becomes very concentrated or when one is ...
and repaired a
hernia A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Various types of hernias can occur, most commonly involving the abdomen, and specifically the groin. Groin her ...
.


First ovariotomy

On December 13, 1809, McDowell was called to see Jane Todd Crawford in
Green County, Kentucky Green County is a county located in the U.S. state of Kentucky. Its county seat is Greensburg. Green was a prohibition or dry county until 2015. History Green County was formed in 1792 from portions of Lincoln and Nelson Counties. Green was ...
, from Danville. Her physicians thought that Mrs. Crawford was beyond term pregnant. McDowell diagnosed an ovarian tumor. Crawford begged him to keep her from a slow and painful death. He then described her condition and that an operation for cure had never been performed. He said that the best surgeons in the world thought it impossible. Crawford said she understood and wanted to proceed. McDowell told her he would remove the tumor if she would travel to his home in Danville. She agreed and rode the 60 miles on horseback. On Christmas morning, 1809, McDowell began his operation. The surgery was performed without benefit of anesthetic or antisepsis, neither of which was then known to the medical profession. The tumor McDowell removed weighed . He determined that it would be difficult to remove completely, so he tied a ligature around the
fallopian tube The fallopian tubes, also known as uterine tubes, oviducts or salpinges (singular salpinx), are paired tubes in the human female that stretch from the uterus to the ovaries. The fallopian tubes are part of the female reproductive system. In o ...
near the
uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The ...
and cut open the tumor. He described the tumor as the ovarium and fimbrious part of the fallopian tube very much enlarged. The whole procedure took 25 minutes. Crawford made an uncomplicated recovery. She returned to her home in Green County 25 days after the operation and lived another 32 years. This was the first successful removal of an ovarian tumor in the world. As a
Presbyterian Presbyterianism is a part of the Reformed tradition within Protestantism that broke from the Roman Catholic Church in Scotland by John Knox, who was a priest at St. Giles Cathedral (Church of Scotland). Presbyterian churches derive their n ...
,August Schachner. 1921.
Ephraim McDowell, "Father of Ovariotomy" and Founder of Abdominal Surgery
'. Ephraim McDowell, "Father of Ovariotomy" and Founder of Abdominal Surgery, p. 4; 58
McDowell's response to this event was recorded in one of his biographies:
How is it that I have been so peculiarly fortunate with my patients of this description?, I know not; for, from all the information I can obtain, there has not one individual survived who has been operated, on elsewhere, for diseased ovaria. I can only say that the blessing of God has rested on my efforts.
All attempts at abdominal exploration before 1809 had resulted in
peritonitis Peritonitis is inflammation of the localized or generalized peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part o ...
and death. Descriptions of McDowell include phrases like "neat and clean" or "scrupulously clean." He was not only neat, but meticulous. In his report on the operation, he described the removal of blood from the peritoneal cavity and bathing the intestines with warm water. McDowell did not publish a description of his procedure until 1817, after he had performed two more such operations. This was widely criticized in the English surgical literature. There is evidence that he performed at least 12 operations for ovarian pathology. "Having never seen so large a substance extracted, nor heard of an attempt, or success attending any operation such as this required, I gave to the unhappy woman information of her dangerous situation. The tumor appeared full in view, but was so large we could not take it away entire. We took out fifteen pounds of a dirty, gelatinous looking substance. After which we cut through the fallopian tube, and extracted the sac, which weighed seven pounds and one half. In five days I visited her, and much to my astonishment found her making up her bed."


Personal life

In 1802, McDowell married Sarah Shelby, daughter of war hero and two-time Kentucky governor Isaac Shelby. They had two sons and four daughters. McDowell played a prominent role in his community. He was also a founder, original corporator, and member of the primary board of trustees of Centre College in Danville. McDowell became a member of the Philadelphia Medical Society in 1817. McDowell was the great-great-grandfather of General John Campbell Greenway, whose statue was placed in the National Statuary Hall Collection by the state of
Arizona Arizona ( ; nv, Hoozdo Hahoodzo ; ood, Alĭ ṣonak ) is a state in the Southwestern United States. It is the 6th largest and the 14th most populous of the 50 states. Its capital and largest city is Phoenix. Arizona is part of the Fou ...
in 1930. He was cousin to woman's suffrage leader Madeline McDowell Breckinridge. McDowell was a Presbyterian but became an
Episcopalian Anglicanism is a Western Christian tradition that has developed from the practices, liturgy, and identity of the Church of England following the English Reformation, in the context of the Protestant Reformation in Europe. It is one of the ...
and founded Trinity Episcopal Church in Danville, Kentucky, having donated the land for its first building.


Death

In June 1830, McDowell was stricken with an acute attack of violent pain, nausea, and fever. He died on June 25, most likely a victim of
appendicitis Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a r ...
.
New International Encyclopedia ''The New International Encyclopedia'' was an American encyclopedia first published in 1902 by Dodd, Mead and Company. It descended from the ''International Cyclopaedia'' (1884) and was updated in 1906, 1914 and 1926. History ''The New Inter ...
His wife died 18 years later. They were buried at "Traveller's Rest", the homestead of Isaac Shelby, south of Danville, Kentucky but were reinterred in 1879, near a monument dedicated to him in Danville.


Honors

* In 1879, a monument in his honor was erected by the Medical Society of Kentucky in Danville. * In 1929,
Isaac Wolfe Bernheim Isaac Wolfe Bernheim (November 4, 1848 – April 1, 1945) was an American businessman notable for starting the I. W. Harper brand of premium bourbon whiskey (a historically important brand currently owned by Diageo). The success of his distillery a ...
donated a bronze statue of McDowell by
Charles Henry Niehaus Charles Henry Niehaus (January 24, 1855 — June 19, 1935), was an American sculptor. Education Niehaus was born in Cincinnati, Ohio, to German parents. He began working as a marble and wood carver, and then gained entrance to the McMick ...
to the state of Kentucky for placement in the
U.S. Capitol The United States Capitol, often called The Capitol or the Capitol Building, is the seat of the legislative branch of the United States federal government, which is formally known as the United States Congress. It is located on Capitol Hill at ...
's
National Statuary Hall Collection The National Statuary Hall Collection in the United States Capitol is composed of statues donated by individual states to honor persons notable in their history. Limited to two statues per state, the collection was originally set up in the old ...
. The statue depicts the ovarian tumor that McDowell removed from Jane Crawford, sitting in a bowl on the table behind McDowell. An identical statue by the same artist stands in the rotunda of the Kentucky State Capitol in
Frankfort, Kentucky Frankfort is the capital city of the Commonwealth of Kentucky, United States, and the seat of Franklin County. It is a home rule-class city; the population was 28,602 at the 2020 census. Located along the Kentucky River, Frankfort is the pr ...
. * In 1959, on December 3, the U.S. Post office first issued a 4-cent
commemorative stamp A commemorative stamp is a postage stamp, often issued on a significant date such as an anniversary, to honor or commemorate a place, event, person, or object. The ''subject'' of the commemorative stamp is usually spelled out in print, unlike defi ...
honoring McDowell, in the Danville, Kentucky, post office, marking the 150th anniversary of the first successful ovarian operation. * McDowell's house, office, and apothecary in Danville are preserved as a
museum A museum ( ; plural museums or, rarely, musea) is a building or institution that cares for and displays a collection of artifacts and other objects of artistic, cultural, historical, or scientific importance. Many public museums make th ...
and are designated a
National Historic Landmark A National Historic Landmark (NHL) is a building, district, object, site, or structure that is officially recognized by the United States government for its outstanding historical significance. Only some 2,500 (~3%) of over 90,000 places liste ...
. * Ephraim McDowell Regional Medical Center in Danville is named in his honor.


References


Further reading

* * * Ridenbaugh, Mary Young.
The biography of Ephraim McDowell, M.D., "the father of ovariotomy.
'' (1890). New York, C.L. Webster {{DEFAULTSORT:McDowell, Ephraim 1771 births 1830 deaths Alumni of the University of Edinburgh American gynecologists American surgeons Centre College people Converts to Anglicanism from Presbyterianism People from Danville, Kentucky People from Rockbridge County, Virginia 19th-century American Episcopalians 18th-century American physicians 18th-century surgeons 19th-century American physicians 19th-century surgeons