AMERICAN 
OVARIOTOMIES 
HORATIO R. BIGELOW, M.D., 
Washington, D. C. 
Reprinted from The American Journal of Obstetrics and Diseases 
of Women and Children, Vol. XV., No. II., April, 1882. 
NEW YORK: 
WILLIAM WOOD & COMPANY, PUBLISHERS. 
1882. AMERICAN OVARIOTOMIES. 
Some months ago, I addressed circular letters to the following 
gentlemen, requesting full answers to a list of questions, which 
appear below: Drs. Sims, Thomas, Emmet, Goodell, Byford, 
Aoeggerath, Munde, Bozeman, Homans, Dunlap, Kimball, 
Murphy, J. Ford Thompson, Chadwick, Ehrieh, Skene, Battey, 
Wilson, Wile, McGuire, Howard, Dawson, Reamy, and some 
others. 
Questions: 
1. Number of operat ions. 
2. Married or single. 
3. Age. 
4. Nature of tumor. 
5. Aspiration or not. 
6. Duration. 
7. Preliminary treatment. 
8. Anesthetic used. 
9. In how many cases was oper- 
ation commenced and 
abandoned. 
10. Operation used, laparotomy, 
etc. 
11. Listerism or not. 
12. Size of tumor. Multiple or 
not. Adhesions. 
13. Clamp or ligature. 
14. Drainage. 
15. After-treatment. 
16. Result. 
17. Cause of death. 
18. Remarks. 
In addition to these letters, the editors of several medical 
journals were kind enough to introduce a short notice in their 
publications, requesting the profession to furnish me with any 
statistics they might have. The results have been embodied in 
this paper, which will, I trust, be valuable as the only attempt 
at a thorough classification of American ovariotomies yet pub- 
lished. I desire to express my grateful appreciation of the 
kindness of those medical gentlemen, who have taken time 
from large and remunerative practices to furnish me with 
their statistics, and to convey my recognition of the courtesy 
of the editors who aided me. In a just balancing of results, 
or in the consideration of the death-rate from operations, 
it is well to bear always in mind that some ovariotomies are 
commenced, but further procedure abandoned in consequence of 
unexpected embarrassments. Others are fully finished, though 
with an almost hopeless residt staring the surgeon in the face. 
An honest list of fully completed ovariotomies will necessarily 
increase the percentage of fatal results. Many cases of opera- 
tions instituted, but never carried out, in which the patients 
eventually die of the disease, are not placed on record. This is 
unfortunate, because it is unjust to those who tabulate even- 
case or who complete every operation when once attempted. I 
shall first report the cases as sent me; then give each an indi- 
vidual analysis, and close with a general analysis of all the sta- 
tistics. The cases are reported in the order in which they were 
received. 
Cases of John Homans, M.D., Boston. 
Dr. Homans’ first live cases were performed without Lister- 
ism, and were all fatal.  
Date. 
o 
Length of 
Incision. 
o . 
i 
E-i 
o 
Place of 
Operation. 
H 
O 
55 
O 
O 
a 
o 
< 
Adhesions. 
Treatment of 
Pedicle. 
£ o 
a 
S£ 
is 
J 
a 
w 
a 
M 
Remarks. 
6 
Feb 27, 
Carney Hosp . 
s.. 
16 
4J in. 
Slight and vascular to 
Tied in halves 
21 lbs 
Recov. 
Well, strong, and working hard in 
1877. 
omentum. 
with carbolized 
rapid. 
1878. Catamenia regular since 
catgut. 
August, 1877. 
7 
Mar. 30. 
<< 
s.. 
20 
5 in. 
Almost universal to an 
Do. 
29 lbs. 
Recov. 
Went home at the end of four weeks. 
1878. 
terior and lateral ab- 
Catamenia regular since May, 1878. 
dominal parietes. 
In November, well and strong; has 
gained twenty pounds in weight. 
8 
Aug. 81. 
it 
w. 
58 
4 in. 
To uterus by strong and 
Do. 
20 lbs. 
Recov. 
Went home at the end of four weeks. 
9 
1878. 
Sept. 17. 
1878. 
t < 
w. 
6( 
4 in. 
thick vascular bands. 
Delicate cellular adhe- 
No pedicle 
24 lbs. 
Recov. 
Went home on sixteenth day. 
sions to envelope, like 
imme- 
those of an easily sepa- 
diate. 
rable fatty tumor. 
10 
Sept. 29. 
“ 
M. 
24 
H in- 
Slight peritoneal; exten- 
Tied as in other 
14 lbs. 
Recov. 
Went home on twenty-first day. Peri- 
1878. 
sive omental. 
cases. 
rapid. 
tonitis and purulent inflammation of 
the cyst walls at time of operation. 
11 
Nov. 8. 
Boston 
s.. 
48 
4 in. 
Strong and intimate to pe 
Do. 
424 lbs. 
Death. 
Death from shock in fourteen hours. 
1878. 
ritoneum, pelvis, mes- 
entery, and intestine 
12 
Dee. 28. 
Northfield,Vt. 
M. 
47 
5 in. 
To intestine and omen- 
Tied with catgut- 
Not 
Recov. 
A burst papillomatous cyst; perito- 
1878. 
turn. 
without trans- 
deter- 
nitis, with patches of lymph on 
fix ion; several 
mined. 
• 
the peritoneum, and considerable 
circular liga- 
ascites were present. Patient had 
tures applied. 
been vomiting, and had hectic 
• 
fever for two weeks. A piece of 
cyst wall, adherent to intestine, 
was cut out with scissors, and left 
• 
i 
otherwise undisturbed. 
Dec. 18, 
Stoneham, 
W. 
62 
5 in. 
Exploratory incision. 
Tumor not removed 
Recov. 
Tumor solid and lobulated, attached 
1878. 
Mass. 
to sacrum, ileum, and uterus. 
Fluid (40 lbs.) ascitic. No opiate 
• 
Carney Hosp.. 
Slight. 
required. 
13 
Nov. 26, 
s.. 
24 
6 in. 
Tied with carbo- 
12 lbs. 
Recov. 
Both ovaries removed. Menstrua- 
1879. 
lized silk, and 
tion regular, but more painful 
dropped back. 
than before ovariotomy. One cyst 
dermoid. 
14 
Dec. 21, 
s.. 
33 
4 in. 
Omental and intestinal. 
Do. 
25 lbs. 
Recov. 
1878. 
15 
Feb. 8, 
1880. 
Boston 
M. 
39 
4 in. 
None 
Do. 
25 lbs. 
Recov. 
16 
Mar. 7. 
1880 
Carney Hosp.. 
M 
28 
3 in. 
None 
Do. 
27 lbs. 
Recov. 
Cyst of the left broad ligament. 
17 
Mar. 23, 
1880. 
Taunton 
M. 
37 
3£ in. 
Slight 
Do. 
20 lbs. 
Recov. 
18 
Apr. 1. 
Carney Hosp.. 
S.. 
18 
5 in. 
Universal and intimate 
Tied as above, 
45 lbs. 
Recov. 
Adhesions burnt off with Paquelin’s 
1880. 
to anterior parietes. 
and burnt off 
cautery. 
Fall River ... 
and slightly to omentum 
with Paque- 
lin’s cautery. 
19 
Apr. 17, 
1880. 
M 
48 
3 in. 
None 
Do. 
lbs. 
Recov. 
20 
Apr. 29. 
1880. 
Carney Hosp.. 
S.. 
58 
24 in. 
None 
Do. 
14 lbs. 
Recov. 
21 
May 18, 
Mt. Holly, Vt. 
M. 
38 
34 in. 
None 
Do. 
50 lbs. 
Recov. 
1880. 
22 
July 10, 
1880. 
Boston 
M. 
57 
4 in. 
None 
Do. 
48 lbs. 
Recov. 
23 
Julv 15, 
1880. 
Carney Hosp.. 
S.. 
47 
4 in. 
None 
Do. 
18 lbs. 
Recov. 
Cyst of left broad ligament. 
24 
July 31, 
< i 
M. 
47 
6 in. 
Intimate and recent to 
Do. 
11 lbs. 
Recov. 
The omentum turned up and laid on a 
1880. 
omentum and intes- 
carbolized towel, and the intestines 
1 
tines. 
turned downwards towards the 
pubes during the removal of the 
cyst. 
Bigelow : American Ovariotomies. 
Bigelow: American Ovariotomies. 6 
X. 
25 
20 
27 
28 
29 
30 
31 
32 
ti 
H 
< 
Place of 
Operation 
ii 
o 
H 
c 
Y, 
6 
M 
M. 
M 
M. 
M. 
M. 
M. 
8.. 
Age. 
•Length of 
Incision. 
A DIJESIONS. 
Treatment of 
Pedicle. 
°« 
H O 
W S3 
C D 
uH 
£ 
25 lbs. 
23 lbs. 
51 lbs. 
39 lbs. 
40 lbs. 
20 lbs. 
>16 lbs. 
38 lbs. 
j Result. 
Remarks. 
Dig. 1, 
1880. 
Aug. 21. 
1880. 
Aug. 22, 
„ 1880. 
Sept. 1, 
1880. 
Sept. 2, 
1880. 
Sept. 7. 
1880 
Sept. 23, 
1880. 
• 
Oct. 2. 
1880. 
Carney Hosp.. 
Woburn, Mass. 
Auburndale . 
Carney Hosp.. 
• • 
30 
29 
29 
46 
47 
27 
33 
48 
34 in. 
6 yi. 
6 in. 
8 in. 
7 in. 
6 in. 
4 in. 
5 in. 
None 
Tied as above, 
and burnt off. 
with Paque- 
lin’s cautery. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
• 
Do. 
Recov 
Recov. 
Recov. 
Death.. 
Recov. 
Death.. 
Recov. 
Dermoid cyst. 
Papilloma. 
Forty ounces of serum removed by 
aspiration from the left thoracic 
cavity on the fourth day after 
ovariotomy. 
Exhaustion on fifth day. Very hot 
weather. 
Fluid gelatinous. 
Shock. Papilloma. 
Sixty-five pounds of ascitic and 
ovarian fluid removed by tapping 
within the last three weeks before 
operation. 
Almost universal and re- 
cent to parietal perito- 
neum. 
Slight. 
To peritoneum, small 
intestine, and dia- 
phragm ; firm a nd 
old. 
None 
Intimate and old, or con- 
genital, to small intes- 
tine, mesentery and 
uterus: in fact, incor- 
porated with them. 
Recent to anterior peri- 
toneum. 
Universal, old and new, 
to peritoneum. 
> 
33 
Oct. 6. 
Carney Hosp.. 
W 
38 
34 in. 
Solid, old. to uterus, 
Tied as above, 
154 lbs. 
Recov. 
Cyst more or less enucleated. 
1880. 
omental, and pelvic. 
and burnt off. 
with Paque- 
lin’s cauterv. 
34 
Oct. 23. 
“ 
M 
45 
2 
4 in. 
None 
Do. 
104 lbs. 
Recov. 
1880. 
35 
Nov. 6. 
“ 
W 
31 
24 in 
None 
Do. 
21 
a lbs. 
Recov 
1880. 
30 
Nov. 18. 
t < 
s. 
31 
6 
in. 
To intestine and uterus. 
Do. 
18 
lbs. 
Recov. 
The portion of the cyst adherent to 
1880. 
bowels was cut out and left behind. 
37 
Nov. 28, 
“ 
w 
52 
3 
in. 
i i 
Do. 
30 
lbs. 
Recov. 
1880. 
38 
Jan. 6. 
“ 
s. 
26 
5 
in. 
None 
Do. 
14 
lbs. 
Recov. 
1881. 
* 
39 
Jan. 20, 
ii 
s.. 
38 
5 
in. 
None 
Do. 
154 lbs. 
Recov. 
1881. 
• 
40 
Jan. 27, 
ti 
w 
63 
5 
in. 
To both Fallopian tubes 
Do. 
9 
4 lbs. 
Recov. 
Dermoid cyst Considerable ascites. 
1881. 
and to sigmoid flexure 
41 
Apr. 5, 
i i 
s.. 
40 
6 
in. 
None * 
Do. 
5 
lbs 
Recov. 
Dermoid cyst, and attached to this a 
1881. 
spindle-celled sarcomatous tumor. 
A uterine fibroid, two pounds 
weight, also removed. 
42 
Apr. 14. 
11 
M. 
40 
44 in. 
None 
Do. 
36 
lbs. 
Recov. 
1881. 
43 
Apr. 16, 
i i 
51 
42 
8 
in. 
Parietal, intestinal, and 
Do. 
Death.. 
Died of exhaustion on the third day. 
1881. 
omental. 
Very severe operation. Tumor 
very vascular and nearly solid. 
44 
Apr. 17, 
“ 
M. 
29 
44 in. 
Strong and old: anteri- 
Do. 
42 
{ lbs. 
Recov. 
Both ovaries removed. 
1881. 
oily. 
45 
May 5. 
tt 
M. 
34 
4 
in. 
None 
Do. 
26 
ibs. 
Recov. 
1881. 
46 
May 22. 
Free Hospital 
M. 
39 
5 
in. 
None 
Do. 
12 
lbs. 
Recov. 
Much ascitic fluid. 
,881. 
for Women. 
47 
May 26. 
Carney Hosp.. 
M. 
42 
7 
in. 
Verv vascular; anteri- 
Do. 
15 
lbs. 
Recov. 
Considerable hemorrhage during ope- 
1881. 
orly and to omentum. 
ration. 
Bigelow : American Ovariotomies. d 
fc 
Date. 
Place of 
Operation. 
o 
H 
S 
a 
Age. 
fa . 
o K 
a 2 
H c/3 
a g 
Adhesions. 
Treatrent of 
Pedicle. 
fa 
O • 
cc 
H O 
a a 
S a 
H 
h4 
a 
■ 
a 
Remarks. 
o 
K 
O 
£ 
48 
June 8. 
Carney Hosp. 
M. 
10 
4| in. 
None 
Tied as above, 
and burnt off, 
10 lbs. 
Recov. 
Cyst dark blue, very vascular. In 
appearance resembling the fetal 
1881. 
with Paque- 
lin’s cautery. 
side of a placenta. 
49 
June 9. 
Boston 
M. 
42 
4 in. 
None 
Do. 
13 lbs. 
Recov. 
1881 
50 
June 11, 
1881. 
Carney Hosp.. 
M. 
51 
4 in. 
None 
Do. 
34f lbs. 
Recov. 
51 
June 21, 
Boston 
S.. 
18 
4 in. 
Anteriorly and to omen-, 
Do. 
25 lbs. 
Recov. 
1881. 
turn. 
52 
June 30, 
1881. 
Carney Hosp.. 
w. 
55 
6 in. 
None 
Do. 
13 lbs. 
Recov. 
Tumor cancerous. 
53 
July 7, 
a 
s.. 
30 
5 in. 
None 
Do. 
8 lbs. 
RecoV. 
Pedicle slipped from clamp before 
54 
1881. 
July 11, 
1881. 
23 
it was burnt off, and in order to 
pick it up and secure it, the inci- 
sion had to be enlarged. Cyst of 
broad ligament. 
i ( 
M. 
4 in. 
None 
Do. 
lbs. 
Recov. 
55 
July 25, 
1881. 
“ 
s.. 
14 
3 in. 
None 
Do. 
Ilf lbs. 
Recov. 
56 
July 27, 
1881. 
Boston 
s.. 
49 
3 in. 
None 
Do. 
12 lbs. 
Recov. 
Both ovaries removed. 
57 
3ept. 1. 
1881. 
Carney Hosp.. 
s.. 
24 
3 in. 
None 
Do. 
2* lbs. 
Recov. 
Cyst of the left broad ligament. 
56 
Sept. 8 
1881. 
Carney Hosp. 
s. 
25 
7 in 
None 
Tied as above 
and burnt of 
13 lbs 
Death. 
Cause of death: acute mania on 
the eighth day. A careful au- 
Sept. 11 
with Paque 
lin’s cautery. 
topsy, by Dr. W. W. Gannett, 
showed everything healthy and 
going on well in the peritoneal 
cavity. Hereditary insanity in 
the family. Dermoid cyst. 
59 
M. 
41 
5 in. 
Anteriorly to parietes 
Do. 
33 lbs. 
Recov. 
1881. 
and to uterus. 
60 
Sept. 18 
w. 
51 
3£ in. 
Anteriorly to parietes. 
Do. 
39 lbs. 
Recov. 
1881. 
61 
Sept. 27, 
1881. 
Taunton, Mass. 
M. 
60 
5 in. 
None 
Do. 
10 lbs. 
Recov. 
Some ascites. 
62 
Oct. 4, 
1881. 
Boston 
M. 
45 
7 in. 
Universal anteriorly and 
laterally. 
Do. 
80-90 
lbs. 
Recov. 
Considerable ascites which is count- 
ed in the weight. 
Boston 
63 
Oct. 5, 
1881. 
W. 
45 
6 in 
None 
Do. 
22 lbs. 
Recov. 
Both walls of bladder incised. No 
ill effects. 
64 
Oct. 24, 
Merrimac, 
Mass. 
S.. 
57 
6 in. 
Intestinal 
Do. 
5£ lbs. 
Recov. 
A portion of sac adherent to bowels 
left behind. 
1881. 
65 
Oct. 29, 
Boston 
M. 
48 
4 in. 
Slight lateral and ante- 
Do. 
49 lbs. 
Recov. 
1881. 
rior. 
66 
Nov. 15, 
1881. 
a 
W 
47 
3£ in. 
None 
Do. 
25£ lbs. 
Recov. 
67 
Nov. 19, 
Concord, N. II. 
W. 
73 
6 in. 
To peritoneum, omen- 
Do. 
20 lbs. 
Recov. 
The age of the patient did not pre- 
68 
1881. 
Dec. 1, 
Provincetowm 
M. 
52 
turn, and intestine. 
Burst cyst. 
vent a very rapid recovery, 99.4° F. 
being the highest temperature. 
6 in. 
Do. 
35 lbs. 
Recov. 
Abdomen filled with gelatinous ma- 
1881. 
Mass. 
terial—colloid—which had original- 
ly come from a burst dermoid cyst. 
69 
Dec. 18, 
Free Hospital 
S. 
30 
7 in. 
To intestine and pelvic 
Do. 
10 lbs. 
Death. 
Both ovaries removed. The outer 
1881. 
for Women. 
peritoneum. 
surfaces of the tumors of a brown 
color, and beginning to decay. 
Bigelow : American Ovariotomies. 
Bigelow : American Ovariotomies. 10 
Bigelow : American Ovariotomie>. 
“ Tlie above list contains all the eases of completed ovariotomy 
that 1 operated on from February, 1877, to December 18th, 
1881. Besides these completed cases, I have made three 
exploratory incisions, and closed the wound after thoroughly 
investigating the tumor. All of these cases recovered; so 
that we have for completed and attempted ovariotomies 
thirty-live cases, with three deaths (for 1881.) I have also 
operated for the removal of uterine tumors three times. 
Once successfully (Case 41 of this table), and twice with a 
fatal result, both of the latter being incompleted operations. 
One of the deaths in this table (No. 58) ought not to be 
accounted a death from ovariotomy, for everything in the 
abdominal cavity was going on well, as shown by autopsy. 
The patient’s parents and family were more or less insane, and 
she developed acute mania, with the delusion that she had com- 
mitted the unpardonable sin, and that there was no forgiveness 
for her. It would be improper not to report the case, however, 
and so I have called it a death from ovariotomy. Clinically, 
the wounding of the bladder in No. 63, without the least unfa- 
vorable consequence or the slightest retardation of convales- 
cence, and the age of No. 67 (seventy-three years), with a 
normal and rapid recovery, are worth noting. I have also 
done colotomy successfully, making the permanent opening 
in the pubic region.” 
Of the employment of Listerism, Dr. Homans says: 
“ These cases, so far as they go, are a proof of the great value 
of the antiseptic method, or Listerism. I like this latter name 
because it is concise and identifies Lister’s name with the mag- 
nificent principle which he has discovered and the method 
which he lias introduced. The number of cases is small, but I 
am very sure that the percentage of recoveries is much higher 
than it would have been without Listerism, and the ratio is 
about what may be expected in cases done antiseptically by an 
experienced operator.” 
Concerning the use of the clamp and ligature, he writes as 
follows: 
“ I generally cut out and leave behind any portion of the cyst 
intimately adherent to a coil of intestine ; it is better to do this 
than to run the risk of rupturing the bowel or causing hemor- 
rhage from its surface, which it is not easy to control. I have 
always followed Mr. Spencer Wells’ advice not to yield to the Bigelow : American Ovariotomies. 
11 
temptation to remove a fibroid from the uterus during an ova- 
riotomy; the desire to do so is very strong, but I think the 
safer way is to leave them alone, and, although I have once or 
twice seen them well pediculated, I have not meddled with 
them. I always compress the pedicle with Dawson’s clamp (a 
very simple and powerful instrument, which has done me good 
service); then burn off tbe pedicle with Paquelin’s cautery; 
tie with a double ligature (in the sulcus made by the clamp)• 
remove the clamp, and drop the stump. I do this because two 
of tbe most successful operators, Drs. Keith and Bradford, have 
used, one the cautery and tbe other tbe ligature, and so I use 
both. I dare say that either would be sufficient, but 1 see no 
objection to my method, and am satisfied with it. I never use 
catgut for tying the pedicle, but always carbolized silk. I lost 
a case from hemorrhage after tying with catgut, and have never 
used it since.” 
Cases of Dr. J. Marion Sims, New York. 
Steamer Germania, off Queenstown, 
November 1st, 1881. 
My Deak Dk. Bigelow:—I am truly sorry I cannot give you 
the information you wish about my ovariotomies. I have been 
moving over the world so rapidly and so often in tbe last live 
years that I fear I have lost my records entirely. I can only 
say that I have not lost a case since I began the use of Listerism 
—twelve cases. I have operated in all forty-five times, with 
nine deaths. These deaths all occurred between the eleventh 
operation and tbe thirty-third, while 1 was connected with the 
Woman’s Hospital. Thus:—Thirty-three operations and nine 
deaths before Listerism; twelve successful operations under 
Listerism. Gave ether in every case except three, to whom I 
gave nitrous oxide gas—one of these under gas one and a half 
hours, another nearly one hour, another twenty minutes. The 
cause of death in every case was septicemia, except one, which 
died of peritonitis. 
(Vises of Dr. W. 11. Byford, Chicago. 
Chicago, November 24th, 1881. 
Dear Doctor:—Your letter of the 18th inst. is received. I 
commenced operating for the removal of ovarian tumors in 
1861. The first ten years I only operated about twenty-five 
times. The notes of these were burned in the great fire of 12 
Bigelow : American Ovariotomies. 
1871. Since then, I have operated sixty-nine times, making in 
all ninety-four operations. In the first sixty-two, I used chloro- 
form as an anesthetic, and, when practicable, used the clamp; 
in the other cases, I tied with silk and returned the pedicle, al- 
lowing the ligature to hang out of the wound large enough to 
act as a drainage, like a siphon. I did not employ any of the 
processes belonging to the antiseptic method in these sixty-two 
cases. In these were included, monocystic, polycystic, and sev- 
eral dermoid tumors. The results in these cases were 66 per 
cent of recoveries. The deaths were from shock, exhaustion, 
and peritonitis. Within the last two years, I have operated 
thirty-two times, and have used sulphuric ether as the anesthetic 
exclusively, as also the antiseptic measures, as detailed in the last 
edition of my book on diseases of women. In that number, I 
have met with almost every variety of tumor. All had been 
tapped or aspirated by others or myself. The preliminary 
treatment, where any was employed, consisted in such measures 
as would improve the blood—tonics and full nutritive diet. In 
all of these, I ligated the pedicle with strong silk, cut the silk 
short, and returned the whole, closing the wound. Employed 
no drainage. The patients were married and unmarried, and of 
all grades of social position. Thirty of these recovered, and 
four died. The operation was the abdominal section. Two of 
the four which proved fatal died of exhaustion, one from 
septicemia, and one other from a peculiar conditioh of the blood, 
in which hemorrhage from the wound showed that fluid to be 
entirely incapable of coagulation. Several of the above cases 
were double ovariotomies ; one of these was cured of epilepsy of 
twelve years’ standing. 
Analysis :—Total number of operations, 94. Percentage of re- 
coveries in first sixty-two cases,66—in the last thirty-two cases, 87- 
Average total percentage of recoveries, 76+. Listerism em- 
ployed in 32 cases. In thirty-two cases, the operation was pre- 
ceded by tapping or aspiration. 
Cases of Dk. II. P. C. Wilson, Baltimore. 
1. Number of operations. 9. 
2. Ages. 32, 56, 39, 56, 40, 19, 38, 36, 31. 
3. Married or single. 7 married, 2 single. 
4. Nature of tumor. 3 compound multilocular, 2 single 
cyst, 4 multilocular. Bigelow: American Ovariotomies. 
13 
5. Tapping prior to operation or not. 2 tapped, 7 not 
tapped. 
6. Preliminary treatment. Brisk purgative second night before 
operation. Sometimes an opiate, oftener bromide of potash in 
large doses; night before the operation, 15 or 20 grains quinine ; 
on the morning of the operation, a good glass of milk two 
or three hours before the operation, and an ounce of whiskey 
just before the chloroform. 
7. Anesthetic used. Chloroform always. 
8. Listerism or not. Listerism in 4 ; not, in 5. 
9. Size of tumors. 42 lbs., 26, 30, 25, 20, 33, 28, 50, 35. 
10. Adi lesions. Very extensive in 4, moderately so in 3, not 
at all in 2. 
11. Ligature or clamp'. Clamp tirst 5, ligature last 4. 
12. Drainage. Not a single case. 
13. Results. 7 recovered, 2 died ; 1 death was from cancer. 
14. Cause of death. Shock. 
15. Duration of operations.. Average, 1 hour. 
16. Remarks. In one case, the operation was performed 
when four months advanced in pregnancy. Another recovered 
and went to term, and was safely delivered of a healthy child, 
now living. One fatal case was that of a woman who had been 
repeatedly tapped, and was near to death before she was 
brought to me for an operation. I operated as the only hope 
(though slim). Both fatal cases had been tapped—one was a 
single cyst of forty-two pounds, the largest single cyst, but one, 
that I have found on record. 
Analysis :—Number of operations, 9. Average age, 38 
years. Listerism in 4 cases. Percentage of recoveries, 77+. 
Average size of tumors, 32 lbs. 
Cases of Dr. P. J. Murphy, Washington, 1). C. 
1. Number of operations. 8. 
2. Married or single. 3 single, 5 married. 
3. Nature of tumor. 6 multilocular. 
4. Tapped or not. 5 tapped prior to operation, 3 not tapped. 
5. Preliminary treatment. No preliminary treatment. 
6. Anesthetic used. Squibb’s sulphuric ether. 
7. Operation. Laporatomy. 
8. Listerism or not. Listerism in 3 cases. 
9. AVeight of tumors. Tumors varied from 16 to 46 pounds, 14 
Bigklow: American ()rariotomies. 
Adhesions iii all cases, in 6 very slight, especially in those tapped 
prior to operation. 
10. Ligature or clamp. Ligature in every case. 
11. Drainage or not. Drainage. 
12. Results, 7 recoveries, 1 death. 
13. Cause of death. Pneumonia. 
14. After-treatment. The after-treatment consisted in keep- 
ing the room at an equal temperature of 85°. Liquid diet, consist- 
ing of milk, gruel, beef-tea, and stimulants if necessary. Opium 
was not administered unless much pain was complained of, and 
then it was given in rectal suppositories (Morphiae suloh., gr. ; 
Ext. belladomue, gr. (V). If the bowels were not moved after the 
fifth day, an enema of soap-suds with hot olive-oil was adminis- 
tered. In two cases where the carbolized catgut ligature was 
used to close the incision, ventral hernia followed, owing to the 
too quick absorption of the gut. I have since used silver wire. 
Analysis.—Recoveries, 7; deaths, 1 ; percentage of recove- 
ries, 88. 
Cases of Du. Wm. C. Wile, Sandy Hook, Ct. 
1. Number of operations. 3. 
2. Ages. 44, 49, 53. 
3. Nature of tumor. 2 unilocular, 1 multilocular. 
4. Tapping or not. 1 tapped thirteen times, 1 not tapped, 
1 tapped once. 
5. Preliminary treatment. Supporting treatment, paying 
especial attention to the regulation of the secretions. 
6. Anesthetic used. Squibb’s ether. 
7. Operation. Laparotomy. 
8. Listerism or not. No Listerism. 
9. Size of tumor. 1 medium, 1 large, 1 very large. 
10. Adhesions. Extensive in 1 case, moderate in others. 
11. Ligature or clamp. Ligature. 
12. Drainage or not. No drainage. 
13. Results. All recovered. 
Drs. Anita E. Tyng, of Providence, Rhode Island; E. E. 
Montgomery, of Philadelphia; and (4. R. Skinner, of Cedar 
Rapids, send reports of successful operations, each one case. Lis- 
1 terism used in all three cases. Bigelow : American Ovariotomies. 
15 
Cases of Dr. Hunter McGuire, Richmond, Va. 
d 
Medical 
Attendance. 
Date. 
Condition. 
Adhesions. 
Treatment 
of Pedicle 
| Weight of 
Tumor. 
Length of 
Incision. 
Result. 
Subsequent 
History. 
s 
CO 
— 
H 
CO 
■3 
Nature of 
Tumor. 
Anesthetic. 
! Duration of 
Operation. 
| Age. 
1 
Hosp... 
July 1, 
1871. 
M. 
Visceral, omental, 
parietal. 
Ligat. 
80 lbs... 
6 in. .. 
Died in 
16 hrs. 
Shock 
No 
C y s t o id 
cancer 
Chlor o- 
form 
1* hrs 
52 
2 
44 
May 27. 
1873. 
S. 
Parietal 
Cl’nip 
60 lbs.. 
Not rec. 
Recov. 
Well 
Drainage 
No. 
Multiloe. 
Do. 
35 min. 
48 
3 
Not rec. 
Aug. 30, 
1873. 
M. 
Extensive parietal 
4 4 
35 lbs... 
5 in.... 
4 4 
Died of fever in 
1874. 
Drainage 
Ovar i a n 
cvst. 
A. C. E. 
Not rec. 
45 
4 
Hosp... 
Oct. 2, 
1873. 
M. 
Extensive visceral 
and parietal. 
4 4 
40 lbs... 
Not rec. 
Died... 
Exhaustion 
No 
Multiloe. 
cyst. 
4 4 
49 
5 
Not rec. 
Dec. 11. 
1875. 
M. 
Parietal 
4 4 
Not rec. 
34 in... 
Recov. 
Still living and well 
No 
Not rec.. 
Not rec 
40 min.. 
30 
6 
‘ 4 
June 12, 
1»76. 
S. 
4 4 
U 
58 lbs.. 
Not rec. 
4 4 
Died of cancer of 
stom. 13 ms. after 
No 
Multiloe 
cyst. 
A. C. E. 
Not rec. 
25 
7 
4 4 
Sept. 19, 
1876. 
S. 
Visceral and parie- 
tal. 
4 4 
45 lbs... 
7 in 
4 ( 
Well in 1879 
No 
Do. 
4 4 
1| hrs 
21 
8 
4 4 
Jan. 19, 
1877. 
s. 
Extensive visceral 
and parietal. 
4 4 
Not rec. 
Not rec. 
4 4 
Died six months 
after. 
No 
Colloid 
cancer. 
44 
Not rec. 
27 
9 
Hosp... 
Oct. 23, 
1878. 
M 
Slight 
i 4 
4 4 
44 
Still well 
No 
Multiloe. 
cyst. 
4 4 
44 
— 
10 
44 
Dec. 31, 
1878. 
M. 
None 
a 
4 4 
Died .. 
Peritonitis 3d day. 
No 
Do. 
“ 
44 
50 
11 
44 
Dec. 27, 
1878. 
M. 
Slight 
— 
“ 
4 4 
4 4 
Exhaustion 3d day 
No 
Do. 
44 
44 
54 
12 
“ 
Mar. 5, 
1880. 
M. 
None 
Cl’mp 
40 lbs... 
Recov. 
Still well 
Yes 
U n i 1 o c. 
cyst. 
C. & E. 
4 4 
40 
Cases of Dr. Hunter McGuire, Richmond, Virginia. 16 
Bigelow : American Ovariotomies. 
»—*• >—*- 
CO 00 Oi Of 03 
No. 
a 
o 
~ ~ CD 
y 
Medical 
Attendance. 
Nov. 15, 
1880. 
May 6, 
1880. 
Nov. 2, 
1881. 
Mar. —, 
1878. 
Mar. —, 
1878. 
May 1, 
1880. 
July 24, 
1871. 
Date. 
g GO W. 02 g GO. GO 
Condition. 
Visceral and parie- 
1 tal. 
Visceral and parie- 
tal. 
'None 
INone 
|None 
Visceral and omen- 
tal. 
Adhesions. 
era- 
- - - - - * so 
e+ 
Treatment 
of Pedicle. 
20 lbs... 
15 lbs... 
100 lbs.. 
Not rec. 
44 
4 4 
(4 
Weight of 
Tumor. 
Or to to to CO 05 
K*- lop- N*- X< 
M. g. 5 3 
3 3 3 3 ~ : : 
• : • S i • 
• ; ; p r ! 
Length of 
Incision. 
w o 
- - - ® £• 
- - - o - - 2 
o &■ 
< : 
Result. 
Exhaustion 2d day 
Shock and exhaus- 
tion 19 hrs. after 
Bronchitis and pe- 
ritonitis 7tli day 
Well 
Well 
Well 
Well 
Subsequent 
History. 
Yes 
Yes 
No 
Yes 
Yes 
Yes 
No 
Listerism. 
Dermo i d 
cyst. 
Cy sto id 
cancer. 
Uni lo c. 
cyst. 
Not rec.. 
Multiloc. 
cyst. 
Do. 
Fibro-c’st 
uterus. 
Nature of 
Tumor. 
C 
c 
c 
c 
c 
c 
c 
Anesthetic. 
40 min.. 
2 hrs... 
1 hr... 
Not rec. 
40 min.. 
40 min.. 
2 hrs.. 
Duration of 
Operation. 
io to to to CO iC iO 
<| a »-*■ co cn 
Age. Bigelow : American Ovariotomies. 
17 
Case 19 is fully reported in the Philadelphia Medical Times, 
1871, in which Dr. McGuire cites all the cases of fibro-cysts of 
the uterus which he could find up to that period. 
Analysis of Dr. McGuire’s cases. 
Total number of cases, 19. Married, 10 ; single, 9. Average 
age, 84 years 4 months. Average weight of tumors reported, 
49 pounds. Ligature in 8 cases, clamp in 11 cases. Listerism 
used in 6 cases; drainage in 2 cases; of the 0 cases in which 
Listerism was used, 2 resulted fatally. Results: deaths, 7; re- 
coveries, 12. 
Dr. Edward Borck, of St. Louis, reports two cases of ovari- 
otomy, one successful and one unsuccessful. Listerism used in 
both cases. 
Cases of Dr. T. Gaillard Thomas, New York. 
Report of Dr. T. G. Thomas’s cases of completed ovariotomy 
extending over a period of eighteen years, from 1868 to 1881. 
All cases are reported except those in which removal of the 
tumor was found to be impossible. 
Number of completed ovariotomies, . . . 199 
Single, ........ 65 
Married, . . . . . . . . 184 
Age. Youngest, L8 years ; oldest, 69 years. 
Nature of tumor. 17 carcinoma or cysto-carcinoma, 7 der- 
moid cysts, 3 ovarian fibroids, 10 parovarian cysts, 25 ovarian 
inonocysts, 10 solid colloid tumors, 127 multilocular colloid 
cysts. 
Anesthetic. Bichloride of methylene, 2 cases ; nitrous oxide 
gas, 2 cases; chloroform, 8 cases ; ether, 187 cases. 
Listerism employed in about 67 cases. 
Clamp used in 103 cases; ligature in 96 cases. 
Entire uterus removed four times with ovarian cystoma. 
Adhesions existed in all but 50 cases. 
Long incision in 25 cases; short in 118; medium in 56. 
Results : 49 deaths ; 150 recoveries. 
Causes of death: Acute mania, 2 cases ; tearing away of pe- 
dicle on fourteenth day by violent effort, 1 case ; persistent 
vomiting, 2 cases; hemorrhage, 3 cases; capillary bronchitis, 2 
cases; pneumonia, 1 case; exhaustion, 1 case ; uremic convul- 
sions, 1 case ; shock, 3 cases; septicemia, 22 cases; peritonitis, 
10 cases; gangrene of intestines, 1 case. 18 
Bigelow : American Ovariotomies. 
After-treatment. The patient is kept free from pain by opi- 
ates, administered by mouth, bowel, or skin; given beef-juice 
and milk as nutriment; and high temperature is controlled by 
quinine in large doses, by mouth or rectum, and by Kibbee’s 
method of cold affusion. 
The profession will notice the large percentage of cancers in 
these cases of Dr. Thomas. It is often customary to leave out 
any mention of such cases in ovariotomy tables. Honest tabula- 
tion, however, demands that everything should be reported. 
Since going to press, Dr. Thomas has had four successful 
cases of ovariotomy, bringing his total up to 203 cases. He has 
also completely removed the uterus in eleven cases, with six 
recoveries and five deaths. It seems to me that such results 
furnish the best answer to the denunciation of this operation by 
Dr. Hichet, before the Academy of Medicine at Paris. Dr. 
Thomas writes: “There are three circumstances under which 
complete extirpation of the uterus may now be regarded as 
legitimate and often a necessary procedure: first, where it is, 
after Freund’s method, removed on account of malignant dis- 
ease ; second, where, as an addendum to the Cesarean section, it 
is practised after Porro’s plan; and third, where it is extirpated 
to render practicable the removal of tumors, either of solid or 
cystic character, which take their origin in its tissues, or arising 
in the ovaries, form attachments to it too firm to be broken.” 
Cases of Dk. Paul F. Munde, New York. 
Number of operations, 3; recoveries 2 ; one monocyst, one 
polycyst, and one cyst of broad ligament. Ages : 33, 45, 22. 
I. Nov., 1875. Single, 33 years. Monocyst. Aspiration fol- 
lowed by peritonitis, inflammation, and suppuration of cyst. 
Ovariotomy on eighth day. P. 120 ; T. 102. Marked improve- 
ment after operation. Clamp ; drainage ; frequent irrigation of 
peritoneal cavity. Did well until fifth day, when pyemic parotitis 
of right side developed. Death of septic pyemia on sixtli day. 
II. Jan., 1882. Married, 22 years, nullipara. Supposed 
monocyst of ovary. Not tapped. On operation proved to be 
cyst of right broad ligament. Bulk of cyst was removed, 
remainder sewed into abdominal wound. Drainage-tube. Con- 
tents of cyst about 10 pints. Recovery. March 15th, wound 
closed, all but slight fistulous opening at sac. Bigelow : American Ovariotomies. 
19 
III. March, 11, 1882. Married, 45, multipara. Large semi- 
solid poly cyst, simulating librocyst of uterus. Hot aspirated, 
except at operation. Previous spontaneous rupture of one cyst; 
no reaction. Large adhesions to bladder, omentum, etc. Pedi- 
cle dropped ; ligature and Paquelin. Tumor, 34 lbs. Listerism, 
except spray. Sutures removed on twelfth day. Recovery. 
Cases of Dr. G. Kimball, Lowell, Mass. 
Humber of operations. 267. 
Results. Recoveries, 202 ; deaths, 65. 
Average age. 40 years 9 months. 
Married. 203. 
Hature of tumor. Multilocular, 196 ; unilocular, 69 ; solid, 2. 
Adhesions. 187 ; involving uterus, 4. 
Ruptured cysts. 11 (5 recoveries). 
Both ovaries removed and diseased. ' 8. 
Tapped or aspirated. 35. 
Ho pedicle (involving broad ligament). 4. 
Pedicle ligated, stump dropped back, and ligature brought 
outside, 85. 
Pedicle ligated, stump dropped back, and ligature cut short, 24. 
Clamp, 158. 
Treatment. Antiseptic, carbolic spray, 75. 
Cause of death. Tetanus, 5; secondary hemorrhage, 2; 
shock, 2 ; nephritis, 2. 
Septicemia or peritonitis (or both). 156. 
Renal hemorrhage. 2. 
In two cases ovariotomy was performed twice on the same 
person ; in one instance the second operation was after the lapse 
of thirteen months. In the second instance the operation was 
performed after the lapse of thirteen years. Recoveries from 
second operation in both cases. 
Cases of Dr. A. Dunlap, Springfield, Ohio. 
Springfield, Ohio, January 23d, 1882. 
Dr. Bigelow. 
Dear Doctor:—I have performed ovariotomy 169 times. 
First operation, September 17th, 1843; the last, January 
11th, 1882. Successful operations, 134; unsuccessful, 35. 
Both ovaries removed at one operation 4 times, with 3 re- 
coveries and 1 death. Both ovaries removed at two operations, 
live years apart. Unmarried at time of first operation; mar- 
ried three years at time of second. Recovery. One operation 20 
Bigelow : American Ovariotomies. 
for one ovary and one subperitoneal fibroid at the same time. 
Result—recovery. The fibroid about the size of a hen’s egg. 
The smallest tumor weighed fourteen pounds; the largest 
weighed one hundred and thirty-six pounds. One fibroid and 
bony tumor of the ovary, with small pedicle, weighed one hun- 
dred and six pounds. One operation not concluded on account 
of the malignant nature of the growth. Have had two patients 
bear twins after one ovary was removed. In both cases there 
was one male and one female. One successful operation after 
a failure to remove a tumor occurred. Cicatrix six inches long. 
Recovery. . . . 
Literature of Sporadic Cases, 1878-1881 
DATF 
Name of Operator 
or Reporter. 
Journal. 
DATE 
Name of Operator 
or Reporter. 
Journal. 
1878 
Chas. T. Reber. 
Col.& Clin.Rec. 
J’ly 
E. P. Bennett.. 
Ibid. 
“ 
I. S. Cleveland 
Cin.Lan.&Clin. 
W. W. Dawson 
Ob. Jour.Cin’ti. 
4 4 
L. P. Davis.... 
Med.&Sur.Rep. 
44 
W. T. Ridenour 
Toledo M.&S.J. 
44 
G. J. Engel- 
Am. Jour. Ob.— 
44 
J. J. Sternreide 
Med.&Sur.Rep. 
mann. 
3 cases. 
4 4 
MaryH. Hionip- 
Ibid. 
it 
W. B. Erdman 
Cin.Med. News. 
son. 
it 
S.M. Thompson 
Trans. T e n n. 
Aug 
None. 
1879 
Med. Soc. 
Sep. 
J. I. Dyer 
Medical Record 
Jan 
H. C. Wyman. 
Detroit Lancet. 
“ 
T. Lipscomb... 
Tr.Med.S.Tenn. 
Feb 
E. T. Blackwell 
Med.&Sur.Rep. 
44 
E. E. Montgom- 
Med.&Sur.Rep. 
“ 
W. S. Brown.. 
Boston Med. & 
ery. 
Surg. Jour. 
a 
J. Rivers 
Pacific M.&S.J. 
4 4 
J. Eliot 
Nat. Med. Rev. 
i 4 
C. Shepard .. 
Detroit Lancet. 
i t 
MaryH. Everett 
U.O. Med.Inv’t. 
4 4 
A. Van DeVeer 
Hosp. Gazette. 
4 4 
H. L. Hodge... 
Tr Path.S. Phil. 
4 4 
T. B.Wilkerson, 
Va.M. Monthly. 
i 4 
D. Prince 
Rich. & Louis- 
Oct. 
A. L. Clark.... 
Chi. Med.Times 
ville Med. J. 
4 4 
Ed. Ohio Med. 
2 cases. 
Mar 
L. McLean .... 
Medical Record 
Record. 
Apr 
W. H. Baker .. 
Boston Med. & 
4 4 
L. L. Slator... 
N. C. Med. J. 
Surg. Jour. 
4 4 
B. W. Taylor.. 
Tr.S.C.Med.Ass 
( 4 
W. H. May.... 
Western Lancet 
Nov 
E. T. Blackwell 
Tr.Med.So.N. J. 
May 
G. Dowell 
Va.M. Monthly. 
4 4 
R. M. Delzell.. 
American Prac. 
“ 
E. S. Dunster.. 
Mich. Md.News 
44 
T. M. Drysdale 
Am. Jour. Ob. 
4 4 
Engelmann.. .. 
Am. Jour. Ob. 
44 
T. A. Emmet.. 
Ibid. 
44 
J. Fewsmith, Jr. 
Ibid. 
4 4 
O. A. Horr.... 
Tr. Maine M Ass 
44 
Gillette 
Ibid. 
“ 
C. C. Lee 
Am. Jour. Ob. 
4 4 
J. B. Hunter... 
Medical Journ. 
“ 
A. R. Smart.. . 
Toledo M.&S.J. 
44 
W. T. Lusk ... 
Am. Jour. Ob. 
4 4 
J. M. Snook .. . 
Mich. Md.News. 
44 
Noeggerath.... 
Ibid. 
Dec 
W. H. Baker . 
Boston M.&S.J. 
44 
W. Vai’ian 
Med.&Sur.Rep. 
4 4 
W. H. Mays... 
W estern Lancet 
J’ne 
Bernays 
St.Lo. M. &S.J. 
1880 
“ 
Engelmann.... 
Tr,Med. S. Phil. 
Jan 
J. Bvrne 
Proc. Med. Soc. 
44 
C. C. Lee 
N. Y. Med. J. 
Kings Co., 
44 
W. H. Parish.. 
Tr. Ob. Soc. Phil. 
Brooklyn. 
44 
C. Shepard 
Detroit Lancet, 
“ 
D. Eve 
Southern Prac. 
10 cases: 6rec., 
Feb 
D. Maclean... 
Tr. Mich.M.Soc. 
4 deaths. 
44 
H. H. A. Beach 
Boston M.&S.J. 
4 4 
A R. Smart ... 
Med.&Sur.Rep. 
44 
G. E. Bensom. 
Medical Record Bigelow: American Ovariotomies. 
21 
DATE 
Name op Operator 
or Reporter. 
Journal. 
DATE 
Name op Operator 
or Reporter. 
Journal. 
1880 
Dec 
W. Lomox .... 
Trlnd.Med.So. 
Feb 
F. D. Cunning- 
Va.M. Monthly. 
“ 
J. Robbins 
Med.&Sur.Rep. 
Mar 
bam. 
W. F. McNutt. 
W esternLancet 
1881 
Jan 
E. C. Mann... 
Medical Record 
i 4 
W. Fox 
Tr.Wis. M. Soc. 
“ 
M Michel 
N.C. Med. Jour. 
t 4 
K. Hoegh 
Ibid. 
4 » 
Noeggerath.. 
Medical Record 
4 « 
W. N. King... 
Ohio Med. Rec. 
“ 
T. P. Seeley.... 
Chic.M.J.&Ex 
44 
W. T. Lusk. . . 
N.Y.Med. Jour 
Feb 
Bernarp 
St.Lo. M.&S.J. 
4 4 
H. Palmer 
Tr.Wis. M. Soc. 
44 
A. E. Bigelow.. 
Med.&Sur.Rep. 
4 4 
L. J. Wireback 
Med.&Sur.Rep. 
t 4 
Garrigues 
Medical Record 
Apr 
W. T. Briggs .. 
Nashville Jour. 
Mar 
S. T. Davis 
Tr. Med. So. Pa. 
44 
O. 0. Burgess.. 
M. & S. 
Western Lancet 
4 4 
4 4 
I. A Ray 
Reamy 
T. G. Morton .. 
Ann. Anat & S. 
Obs. Gazette. 
44 
A. F Cabot 
Boston M.&S.J. 
Apr 
Penn.Hos Rep. 
44 
C. C. Lee 
Medical Record 
J. H.Van Eman 
St.Lo.Cour Med 
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W. Lomax .... 
Cin.Lan.&Clin. 
May 
W. H. De Witt 
Obs. Gazette. 
May 
W. F. NcNutt. 
WesternLancet 
W. T. Helmuth 
Med.&Chir.Qu. 
W.F. Atlee.... 
Am.J.Med.Sci. 
4 4 
J. B. Hunter.. 
N.Y. Med. Jour. 
(4 
H. Clarke 
Boston M.&S.J. 
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Geo. Porter. ... 
Tr.R.I.Med.As. 
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W. R. Gillette. 
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44 
C. B. Powell... 
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44 
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C. C. Lee 
Whitwell. 
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WesternLancet 
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S. S. Todd. 
Med.& Sur. J. 
Kan Med Index 
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J. H. Wyeth. 
J’ne 
W. T. Helmuth 
N.Y Med Times 
J’ne 
Battey 
British M.&S.J 
44 
T. B. Wilberson 
Va.M. Monthly. 
“ 
G. J. Engel 
Boston M.&S. J. 
J'ly 
4 4 
4 4 
R. F. Bang 
Medical Record 
t4 
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W. R. Gillette . 
N Y. Med. Gaz. 
D. Campbell... 
P. Gresham.... 
Boston M.&S.J. 
Am.M.Bi-w’kly 
44 
C. A. Kirkly.. . 
Toledo M.&S J. 
“ 
W. O. Roberts. 
American Prac. 
4 4 
C. C. Lee 
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4 4 
E. Younkin.. . . 
Am. Med. Jour. 
J’ly 
G. C. Smythe.. 
Gregory 
American Prac. 
St. Lo. M. &S J. 
Aug 
P. P. White.... 
St. Louis. 
BuffaloM.&S.J. 
Aug 
W. F. Atlee. 
Am. J.Med.Sci. 
T. B. Wilkerson 
IN. C.Med. Jour. 
T. M. Drysdale. 
Tr.Ob.8oc. Phil 
Sep. 
4 4 
B. F. Dawson.. 
Am. Jour. Ob. 
“ 
T. A Emmet.. 
Am. Jour. Ob 
T. E S a 11 e r- 
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“ 
W. T. Lusk... 
S. S. Wells .... 
Ibid. 
Tr. Am.Gyn.So. 
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thwaite. 
P. V. Schenck 
Am. Jour. Ob. 
Sep. 
E. Miller .... 
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Oct. 
N. M. Baskett. 
St. Lo.M.& S.J. 
Oct. 
W. F. Cheno 
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Gaillard’s Med- 
Nov 
J. M. Batten... 
G. J. Engel- 
P i tts burgh M.J. 
Trans. Am.Gyn 
with. 
Gregory 
ical Journal. 
St.Lo.Cour Med 
44 
mann. 
Geddings. 
Soc.—2 cases. 
Nov 
Bard well 
Cin’ti Ob. Gaz. 
J. F Heustis.,. 
Tr Med. Ass. Ala 
Dec 
J. L. Crawford 
Medical Record 
«• 
W. B. Rogers.. 
Miss. Val. Med. 
44 
F. W Entriken 
P. L Hilsman.. 
Toledo M.&S.J. 
Tr.Ga.Med.Ass 
Dec 
None. 
Month.-3 cases 
Cases of Dr. Wm. Goodell, Philadelphia. 
Philadelphia, January 15th, 1882. 
My Dear Dr. Bigelow :—With this letter I send you a 
table of every one of my cases of ovariotomy. I am too busy to 
write as fully on the subject as you asked me; but in justice to 
myself a few explanations are needed. 
In the first place: I have had but two cases of exploratory 
incision, in which the tumor proved to be ovarian, and in which 22 
Bigelow : American Ovariotomies. 
tlic operation was not undertaken. In eacli there was extensive 
malignant disease of the peritoneum and of all the pelvic or- 
gans. One of them was a patient of Or. K. Horner, of Gettys- 
burg, Pa., the other a patient of Or. J. A. Murphy, of Wilkes- 
barre, Pa. The former recovered from the operation ; the 
latter died a few days later from intestinal obstruction, but 
whether due to the operation or not is uncertain. 
Secondly, in not a single instance have I ever begun an 
operation without wholly completing it by the removal of the 
cyst. In other words, I have not one incompleted or one aban- 
doned operation to report. 
Thirdly, I have always contended that, for a surgeon to 
decline to operate on any case of ovarian tumor because it is 
not a promising one, is virtually the same thing as if he had 
operated on the case and had lost it. Acting on this principle, 
no matter how desperate the condition of the woman, 1 have, in 
not a single instance, refused to give the sufferer her only chance 
for life. In this statement, I am sure that Drs. Mays, Marcy, 
Heal, Harlow, Dawson, Baer, Shaetfer, and Sheppard will bear 
me out. This regard for the woman, and disregard for my 
statistics, has swelled my list of fatal cases, and has given me 
one death on the operating table ; but, on the other hand, it 
has enabled me to restore to life two women who had been 
abandoned by other surgeons. 
I have also labored under the other disadvantages of having 
performed many of my operations- in a general hospital, viz., 
that of the University of Pennsylvania, and a large number of 
them at such a distance from Philadelphia that I did not again 
see the woman after the operation. 1 have also repeatedly per- 
formed the operation in the country, with no other assistants 
than those who had never even seen the operation. All these 
facts must, therefore, be taken into consideration before a just 
comparison can be made between my results and those of other 
operators who have special hospitals for the purpose. 
Of my sixty-one cases, up to date, twenty-two were operated 
upon in a general hospital with six deaths. Eighteen were 
operated upon at their homes, but too far away for me to 
attend them afterwards ; and of these, seven died. Eleven were 
operated on at home, and had my subsequent care ; of these I 
lost four. Ten were operated on at my private hospital with 
but one death. This single fatal case in my private hospital Bigelow : American Ovariotomies. 
23 
was one of malignant disease of both ovaries. They were 
everywhere adherent, and, in addition, had so coalesced that the 
womb was imbedded in the mass, and had to he enucleated. 
Dr. R. P. Harris, who witnessed this operation, deems it the 
most difficult one of the many he has seen. Had a drainage- 
tube been used, the woman would probably have recovered, 
only, however, to have died at a later period from a return of 
the disease. My private hospital is so near me that I am able 
to see my patients at least four times a day, until the period of 
danger is passed. By being on hand to meet the emergencies, 
I have on two occasions saved the life of my patient. To this 
fact, and to that of its being a special hospital, and, therefore, 
aseptic, do I attribute this success. 
I have not yet given up the spray, nor shall I do so until 
Keith, now that he has abandoned its use, can report another 
series of seventy-odd successive cases of recovery. While it 
may not be essential in private practice, I do not see how it 
can be dispensed with in the foul wards of a general hospital. 
In conclusion, as I look back upon my cases, and contrast the 
mortality of my earlier operations with the better showing of 
my later ones, I am more than ever impressed with the con- 
viction that in no other capital operation does a growing experi- 
ence tell more than in that of ovariotomy. 
Very faithfully yours, 
Wm. Goodell.  
6 
Name of Previ- 
ous Medical 
Attendant. 
Age. 
Condition. 
Number of 
Children. 
Previous 
Tappings. 
Date of 
Operation. 
Place of 
Operation. 
cc 
55 
O 
So 
H 
X 
a 
< 
Side & Treat- 
ment of Ped- 
icle. 
Size and Na- 
ture of Tu- 
X 
0 
Length of 
Incision. 
Drainage. 
Result. 
Cause of 
Death. 
Remarks. 
1 
Dr. B F. Baer, 
40 
M. 
3 
Sept. 28. 
Hosp 
Pari etal 
L. clamp. 
30 lbs. 
Short. 
Cloth- 
Recov 
Philadelphia. 
1876. 
and 
omental. 
tent. 
2 
Dr. W. S. Stew- 
art. Philadel- 
22 
S 
0 
Mar. 14, 
1877. 
Hosp . . 
Pelvic. 
Ti. Li vat. 
2 lbs.. 
6 6 
Lieat. 
66 
Cyst removed by vaginal in- 
cision. The ends of the 
phia. 
ligature were brought out 
of the wound for drainage 
purposes. 
3 
Dr. .T. M. Ride-p. 
50 
M. 
4 
38 
Mar. 22, 
Home. 
Omental. 
L. Clamp 
4 His.. 
Long. 
Dea h 
Inter- 
Did well for twelve days, 
Camden, N. 
J. 
1877. 
parietal 
fib’oid 
nal 
when she secretly got out 
and pel- 
of 
hem 
- 
of bed, and was seized with 
vie 
ovary. 
or’ge. 
pain and collapse. 
4 
Dr. H 11 Long- 
24 
Q 
1 
Oct. 23. 
Hosp.. 
lhs 
Short. 
6 6 
Senti- 
My first operation under the 
streat. Borden- 
1877. 
and 
L. Ligat. 
cemia 
spray, and my last with the 
town N. .T. 
omental. 
clamp 
5 
Dr TI.Y. Evans, 
50 
\V. 
2 
1 
Mar. 
1. 
Home. 
Univer’al 
R. Ligat. 
Malig. 
Long 
Glass 
6 6 
Peri- 
No antiseptic precautions; 
Philadelphia. 
1878 
L. Ligat. 
poly- 
tube. 
toni’is 
abdominal wall very fat; 
cyst. 
the ligature ends were 
brought out of wound. 
6 
Dr. H. H. Mit- 
76 
M. 
6 
2 
Sept. 
2, 
Home. 
Pariet al 
L. Ligat. 
Poh 
r. 
Short. 
6 6 
Ex- 
No antiseptic precautions. 
chell, Elkton. 
Md 
i878 
and 
vesical. 
cyst. 
h'us 
n 
In this case and in all the 
following ones the liga- 
• 
tures were cut close to the 
knot. 
7 
Dr. B. f\ Baer, 
53 
S.. 
Oct. 27. 
Hosp . 
Exten’ve 
R 
Do 
Long. 
6 6 
Peri- 
Spray used in this case and 
Philadelphia 
parietal. 
-4 
ton’tis 
in all the succeeding ones. 
8 
Dr. J. E. Bau- 
44 
W. 
6 
} 
May 31, 
Home. 
Pari e t a 1 
L 
46 lbs. 
Lone-. 
man, Telford, 
1879. 
and 
Col- 
scooping out contents with 
9 
Pa. 
omental. 
loid. 
the hand. 
Dr. K. Horner, 
55 
S. 
1 
June 15. 
Hosp . 
Exten’ve 
L 
35 lbs. 
66 
G lass 
66 
Gettysb r g h, 
parietal, 
tube. 
10 
Pa. 
omental. 
Dr. L. J. Deal, 
40 
M. 
4 
1 
June 26. 
Home. 
Univer’al 
R 
Puru- 
66 
6 6 
\ 
forlorn hope—already in 
extremis from septicemia 
Philadelphia. 
lent 
cemia 
poly- 
caused by the old-fashion- 
11 
Dr. Jacob Rob- 
40 
M. 
1 
Sept. 21. 
66 
Parie t a 1 
R 
cyst. 
71 lbs. 
66 
Reoov 
ed tapping. 
erts, Philadel- 
and 
L 
phia. 
omental. 
12 
Dr. B. F. Baer, 
46 
W. 
7 
2 
Oct. 26. 
Hosp.. 
Parietal 
R 
40 lbs. 
6 6 
Glass 
66 
Philadelphia. 
and 
tube. 
omental. 
13 
Dr. E. Dawson, 
Frederica, Del. 
35 
M 
2 
Dec. 7. 
66 
None ... 
L 
Large 
col- 
Short. 
• 
66 
Malignant colloid; the cyst 
had burst before the opera- 
loid. 
tion. She recovered, but 
died shortly after return- 
14 
Dr. R. A. Clee- 
45 
M 
3 
1 
Dec. 28. 
Home. 
6 6 
R 
Large 
poly- 
cyst. 
T .on v. 
66 
ing home. 
man, Philadel- 
L 
• 
15 
plna. 
Dr. Emil Fiscli- 
52 
M 
6 
1 
Mav 2. 
66 
Parietal 
R 
Solid 
66 
Septi- 
A 
peritonitis and liemor- 
er, Philadel- 
1880. 
and 
L 
poly- 
cyst. 
75 lbs. 
16 
phia 
Dr. W. Goodell. 
47 
M 
1 
Mav 9. 
Hosp .. 
intestinal 
Univer’al 
R 
6 6 
6 6 
66 
the aspiration. 
col- 
before the operation; a for- 
17 
Dr.D. 0. Crouch. 
59 
M 
Sent. 6. 
Pr’vate 
66 
R. 
loid. 
Malig 
poly- 
6 6 
6 6 
6 6 
midable operation. 
Curwensville, 
Pa. 
Hosp. 
L 
1 VI X V/ X AX A X VIIX VfXV 1 (1 U1V71 1 y 
drainage-tube ought to 
18 
M 
cyst. 
have been used. 
Hr. H. Li Sharp. 
35 
2 
1 
Sept. 11. 
Home. 
Exten’ve 
R 
Larve 
Short. 
Medford, IS'. J. 
omental. 
Bigelow : American Ovariotomies. 
Bigelow : American Ovariotomies. o 
fc 
Name of Previ- 
w 
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Remarks. 
19 
Dr. J. K. Kane. 
24 
S.. 
1 
Sept. 16. 
Home. 
Covered 
R.. 
Large 
Short. 
Both ovaries were evidently 
imbedded in the tumor, 
which wTas removed by 
Wilmingt o n, 
Del. 
by 
broad 
L 
tube. 
20 
Dr. H. Kratz, 
ligament 
enucleation. 
50 
M. 
4 
Sept. 25. 
4 4 
Firm 
L 
30 lbs. 
Long. 
A very long incision was 
here needed on account of 
Hilltown, Pa. 
omental 
Semi- 
and 
parietal. 
solid 
poly- 
cyst. 
65 lbs. 
the solid nature of tumor. 
21 
Dr. L. D. Har- 
67 
S.. 
3 
Nov. 28. 
44 
Univers’l 
L 
Short. 
Over twenty ligatures need- 
ed She recovered from 
22 
low, Philadel- 
phia. 
Dr. N. J. Coop- 
er, Stockton, N. 
49 
parietal. 
tube. 
opei’ation, but died seven 
weeks later from a malig- 
nant growth of liver. 
M. 
5 
Dec. 4. 
4 i 
Omental 
L 
10 lbs. 
<< 
(l 
and 
oligo- 
23 
uterine. 
cyst. 
Dr. T. J. Birch, 
Port Carbon, 
29 
M. 
3 
Dec. 5. 
Hosp.. 
Omental 
L 
20 lbs. 
< t 
4 i 
and 
24 
Pa 
pelvic. 
Dr. A. Marcy, 
45 
M 
7 
Dec. 9. 
Home. 
Univers’l 
R 
Puru 
Long. 
Glass 
Death 
Ex- 
Patient already in extremis 
from septicemia; contents 
Camden, N. J. 
1 
L 
lent 
tube. 
liaus’n 
cyst 
of cyst abominably offen- 
of 
sive. Both ovaries were 
paro- 
vari’m 
involved in the tumor and 
removed. 
25 
Dr. H. P. Van 
54. 
M. 
4 
Dec. 11. 
Home. 
Exten’ve 
L 
Large 
oligo- 
Short. 
Recov 
Valzah, clear- 
parietal. 
field. Pa. 
cyst. 
20 
Dr. L. G. Bauer, 
Philadelphia. 
47 
M. 
3 
10 
Dec. 18. 
<4 
Omental. 
L 
Small 
Short. 
4 4 
Both ovaries and one parova- 
rian cyst were removed. 
R 
poly- 
27 
Dr. Smith Full- 
cysts. 
35 
M 
Jan. 22, 
4 4 
Omental, 
parietal, 
L 
Large 
solid 
Short. 
Death 
Peri- 
The tumor was malignant, 
and had to be enucleated 
er, Uniontown, 
1881.' 
tonit’s 
28 
Pa. 
Dr. J. H Chand- 
and 
intestinal 
* 
cyst. 
out of broad ligament to 
get a pedicle. 
43 
M. 
2 
1 
Jan. 29. 
Pr’vate 
Omental 
L.. 
Medi- 
Short. 
Recov 
ler. Centre- 
Hosp. 
R 
um. 
ville, Del. 
29 
Dr. A. Y. Cole- 
44 
M. 
2 
Feb. 19. 
Home. 
Omental 
R 
Large 
poly- 
Short. 
a 
There was much ascitic fluid, 
and the womb was much 
man, Limerick 
and 
Square, Pa. 
pelvic. 
cyst. 
enlarged by multiple 
fibroids. 
30 
Dr. W. D. Me- 
27 
M. 
3 
1 
Feb. 21. 
Hosp.. 
None.... 
L 
Small 
Short. 
i 
Had been bed-ridden for two 
Gowan, Ligo- 
nier. Pa. 
R 
poly- 
cysts. 
years; is now well 
31 
Dr. W har t o n 
22 
S.. 
Mar. 2. 
Pr’vate 
44 
I, 
Small 
Short. 
4 4 
Cyst of each ovary, and also 
of left parovarium. 
Was in a critical condition 
Sinkler, Phila. 
Dr. L. D. Har- 
Hosp. 
Home. 
R 
32 
30 
S.. 
1 
Mar. 9. 
Omental 
L 
Large 
poly- 
cyst. 
Short. 
Death 
Septi- 
cemia 
low, Philadel- 
and 
R 
from septicemia at the time 
of the operation. 
33 
phia. 
parietal. 
1 )r. S. Weir Mit- 
24 
s.. 
1 
Mar. 23. 
Pr’vate 
Pelvic 
L.. 
Oiigo- 
cyst. 
Short. 
Recov 
The right ovary had to be 
enucleated. 
chell, Philadel- 
phia. 
Hosp. 
and 
R 
omental. 
34 
Dr. G. S Ger- 
60 
M. 
5 
Mar. 29. 
Hosp.. 
Omental 
L 
Large 
mono- 
Short. 
<< 
hard, Ardmore, 
Pa. 
cyst. 
35 
Dr. F. C. Shep 
pard, Philadel- 
phia. 
40 
M. 
9 
1 
Apr. 5. 
44 
Omental 
R 
Large 
col- 
Short. 
(4 
The cyst had burst some 
time before the operation. 
I tapped once, but got no 
and 
L 
parietal. 
loid. 
fluid. 
Bigelow: American Ovariotomies. 
Bigelow : American Ovariotomies.  
6 
Name of Previ- 
ous Medical 
« 
a 
o 
H 
£4 • 
0 
ft as 
ij Q 
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a «< 
Place of 
Operation. 
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36 
Dr. J. R. Chand- 
ler, Cent’v’le, Del 
Dr. G. Mays, 
Philadelphia. 
40 
M. 
Apr. 
20. 
None. 
L 
Col- 
Short. 
Recov 
Hosp. 
Home. 
R 
loid. 
37 
34 
M. 
2 
Apr. 
21. 
TTnivers’l 
R 
Puru- 
Long. 
Glass 
Death 
Ex- 
A desperate case, in which a 
pelvic abscess had occurred, 
lent. 
tube. 
hau’n 
opening into the bowel, and 
matting the cyst to the in- 
testines. For several days 
after the operation, feces 
escaped through the drain- 
age-tube. 
38 
Drs. D. Hayes 
Agnewand W. 
44 
M. 
2 
1 
May 
10. 
ii 
R 
T ,arp-e 
Short. 
Recov 
Goodell. 
39 
49 
M. 
9 
May 
14. 
<4 
Parietal 
L 
Large 
poly- 
ter. Worcester, 
Pa. 
cyst. 
40 
Dr. F. Swartz- 
32 
M. 
May 
17. 
Pr’vate 
Pa.ri et.al 
L 
fleshy 
poly- 
Lone. 
<( 
lander, Doyles’- 
Hosp. 
and 
town. Pa. 
intestin’l 
cyst. 
41 
Dr. A. Schaeffer, 
Lewis town . 
38 
S.. 
Mav 21. 
Home. 
TTnivers’l 
R 
Solid 
Loner. 
Death 
Shock 
A forlorn hope, bed-ridden 
for months, and reduced to 
L 
che’sy 
cysts. 
Pa. 
extreme emaciation. She 
died on the table. 
42 
Dr. T. R. Hayes, 
Bellefonte, Pa. 
45 
M. 
7 
3 
June 
2. 
Hnsn 
Omental, 
parietal, 
L .. . 
Solid 
T ,on c. 
Recov 
Although the tumor was 
pronounced a round-celled 
col- 
and 
loid. 
sarcoma, the woman is 
doing well. 
intestin’l 
20 lbs. 
4 
S Dr. E. L. Duer 
2£ 
S. 
1 .. 
. June 2 
. Hosp. 
. lExten’vc 
I 
. 1 Larg 
Rgco1 
parietal 
R 
• I oligo 
4' 
! Dr J. Pittman 
Tarboro. N. C 
5C 
S. 
.June 7 
Pr’vat< 
Hosp. 
■ Broad 
ligament 
L 
cyst 
Large 
Short 
< i 
unilo< 
ular. 
of broad ligament, and had 
to be enucleated. Two 
45 
uterine fibroids were also 
Dr. John Fay, 
61 
M 
8 
1 June 18 
Home. 
Omental 
R 
Lare-e 
removed. 
parietal, 
46 
Dr. T. V. Cran- 
dall, Phila. 
62 
W 
. Sept. 5. 
Pr’vate 
pelvic. 
None.. 
R 
25 lhs 
47 
29 
M. 
Hosp. 
L 
A 
. u. ae a. r ii, 
2 ... 
Oct. 9 
Do. 
Omental 
T, 
Solid 
fih’nirl 
Very 
R. 
48 
Dr 
J. R. Haney, 
50 
M. 
3 
Oct. 20. 
Hosp.. 
Exten’ve 
R. 
18 lbs. 
ass 
Recov 
parietal. 
cyst; 
tube. 
49 
Dr. R. W. Deaver, 
Germant’n, Pa. 
37 
M. 
j 
Oct. 22. 
Home. 
Parietal. 
L 
65 lbs. 
Col- 
44 
i 4 
50 
Dr. E. W. Wat- 
son, Phila. 
Dr. Geo. P. Yost, 
Loganville, Pa. 
Dr. Lloyd, Yard- 
ley vi lie, Pa. 
50 
w. 
Oct. 24. 
i i 
Omental, 
L 
20 lbs. 
ii 
4 i 
51 
35 
M. 
1 
3 
Oct. 29. 
Hosp 
parietal. 
Omental, 
parietal, 
pelvic, 
uterine. 
None.... 
R.. . 
R 
30 lbs. 
15 lhs 
ii 
n 1 
was uermoia. 
52 
15 
W. 
2 
Nov. 5. 
Home. 
R 
ii 
tube. 
Death 
i-EiX- 
liau’n 
An exceedingly difficult ope- 
ration ; many ligat u r e s 
needed. 
53 
10 f 
5. . 
L 
uuwuru fvei- 
R 
Li 
ley, Phila. 
vsiiieniai 
and 
io lbs. 
Long. 
Glass 
i i 
Iwo large pedunculated ute- 
rine fibroids were also re- 
moved. 
Solid fibroid of right ovary, 
with ascites. 
54 
3r. W. C. Simp 5 
son, New Brigh- 
ton, Pa. 
4 
n. 
8 
Nov. 12. 
dome. ] 
parietal, 
''lone 1 
* £ 
lbs.. 
Short 
i i 
I 
If 
Solid 
broid 
Bigelow: American Ovariotomies, 
-Bigelow : American Ovariotomies. 30 
Bigelow : American Ovariotomies. 
Name of Prf.vi 
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Remarks. 
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55 
Dr. T. D. Dunn, 
Philadelphia. 
86 
M. 
2 
i 
Nov. 14. 
Hosp . 
None 
R 
10 lbs. 
Short. 
Recov 
L 
Col- 
56 
Dr. W. Goodell. 
27 
M 
Nov. 17. 
44 
Pelvic, 
omental, 
intestin’l, 
L 
20 lbs. 
Short. 
Glass- 
Death 
Shock 
A very difficult operation; 
both ovaries and the womb 
R 
tube. 
were glued together in one 
and 
mass, and had to be sepa- 
uterine. 
rated. 
57 
Dr. W. Goodell. 
32 
M. 
3 
Nov. 25. 
44 
Very ex- 
tensive 
L 
Poly- 
cyst. 
Long. 
<• 
Septic 
peri- 
Two cases of erysipelas were 
in the building at the time 
parietal. 
45 lbs. 
tonitis 
of the operation. 
58 
Dr. B. F. Baer, 
Philadelphia. 
20 
s 
i 
Dec. 8. 
44 
None .. 
L 
15 lbs. 
Long. 
Recov 
R 
Col- 
loid. 
59 
Dr. W. C. Dix- 
on, Pliila. 
36 
M. 
2 
Dec. 17. 
u 
Intestin- 
R 
20 lbs. 
4 4 
4 4 
Each ovary so incorporated 
with the womb that the 
al, pelvic 
uterine. 
L 
m 
latter organ was also re- 
moved. 
60 
Dr. M. H. Green, 
Phila. 
40 
s 
Dec. 31. 
Pr’vate 
Hosp.. 
Intes- 
L 
15 lbs. 
Short. 
44 
Cyst of parovarium, with 
corresponding ovary flat- 
tinal. 
tened in its wall. 
61 
Dr.R. P. Harris, 
Phila. 
50 
M. 
1 
Jan. 10, 
1882 
Home. 
Slight 
omental. 
L.. 
30 lbs. 
Long. 
4 4 
Semi-solid colloid cyst. 
c’lloid 
In the foregoing tables, the weight of the cyst and of its contents have often been guessed at. The letters S. M., and W. denotes 
respectively single, married, and widow. The letters R. and L. mean the right and left ovary, and the letter which precedes indicates 
the larger cyst. Bigelow: American Ovariotomies. 
31 
My next paper will contain statistics of Drs. Peaslee,W. L. Atlee, 
Nathan Bozeman, Pallen, Drysdale, Storer, and of other practi- 
tioners whose reports have not been received in time for this 
communication. I shall then give a tinal analysis of all the 
cases, together with their results, and shall briefly discuss the 
question of Listerism. I shall also quote opinions of all leading 
ovariotomists as to preliminary treatment, and the arrangements 
to he made prior to the operation by the assistants.