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Ephraim McDowell (1771-1830)

Ephraim McDowell was the grandson of an Irish Protestant who emigrated to the United States. He was born inStamp of Ephraim McDowell Virginia in 1771 and moved to Kentucky in at the age of 13 years when his father took up an appointment as a judge at Danville. He started his medical training in the states before moving to Edinburgh in 1793 where he was taught by Alexander Munro and John Bell. He returned to Danville in 1795.

His claim to fame is that he was the first surgeon to perform an elective laparotomy. In 1809 he was called to see Mrs. Jane Todd Crawford in a log cabin in Motley's Glen, Green County. She had a large ovarian cyst and underwent on elective oophorectomy on Christmas day (without anaesthesia). It was performed with the simplest of instruments in the front room of McDowell's house and surgery. The whole procedure took 25 minutes. She made an uncomplicated recovery

McDowell did not immediately publish the results of this procedure. He was not a prolific writer and waited until he had performed two further operations in 1813 and 1814 before publishing a report in 1817. This was widely criticised in the English surgical literature. There is evidence that he performed at least twelve 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."

McDowell E. Three cases of extirpation of diseased ovaria. Eclectic Repertory Anal Rev. 1817; 7:242-4.

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