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COPYRIGHT 1995 Smithsonian Institution
The woman in the backwoods Kentucky cabin had been suffering excruciating labor pains, but still the baby wouldn't come. When the ninth and then the tenth month passed with no sign of birth, her doctors summoned the surgeon said to be the best on the frontier, Dr. Ephraim McDowell of Danville, Kentucky. The year was 1809.
From the perspective of today, the medicine practiced in the late 18th and early 19th centuries was medieval. Anesthesia was unknown. The best medical minds considered purging and bleeding to be the most effective remedies for fevers; in extreme cases, as much as four-fifths of a patient's blood was drained off. Surgery was limited to simple operations on the extremities, where vital organs would not be exposed to infection.
Dr. McDowell, examining the poor woman by candlelight, realized quickly that she wasn't pregnant. She had a large ovarian tumor. The prevailing medical wisdom, he explained to her, was that she would inevitably die in a year or maybe two. Some physicians, he added, had contemplated surgery in such cases, but none had tried it. Opening the abdomen, they believed, was certain to result in a fatal infection of the abdominal wall. McDowell, however, thought there was a chance that an operation could result in a complete cure. If she was willing, he told her, he would operate, but it would require a 60-mile trip by horseback to his home. She agreed to do it.
The doctor knew that he could lose his practice and perhaps even be prosecuted if the woman died. His partner at first declined to assist him, and the townfolk talked of forcibly preventing him from...
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