Frontier Surgeon Had Courage As Well As Skill
Ephriam McDowell, a frontiersman and famed surgeon, was described as a
heavyset man over six feet tall with a ruddy complexion and shining black
eyes. He was noted for his strength and agility, both of which no doubt
came in quite handily when he found himself riding on horseback through the
wilderness to see his patients, some of whom lived more than a hundred miles
away.
EPIIRIAM McDOWELL
1771-1830
(McDowell is a public surgical
ward on third floor.)
Ephriam McDowell was char
acteristic of the frontier days
and town in which he lived. He
was used to acting with free
dom, he had much initiative and
was a courageous—if not dar
ing—man.
Although he was born in Vir
ginia, McDowell’s family moved
when he was two to Danville,
Kentucky. And it was in Dan
ville that McDowell maintained
his private practice for over
thirty years.
To understand more fully why
McDowell’s surgery was so out
standing at the time it was per
formed, it is important that the
period and geographic setting
be understood.
It is estimated that Danville
had less than 1,000 inhabitants
at the time McDowell began
practicing medicine there, but
was, as a former capital of the
state, extremely active in the po
litical affairs of Kentucky and
was still considered one of the
state’s most important towns.
McDowell’s practice extended
over a hundred miles beyond the
town, and this meant many trips
that had to be made on horse
back through wild and unde
veloped country that offered not
only no roads but also the dan
ger of wolves and Indians. (As
late as 1810 a “scalp law” was
passed that allowed pay for the
scalps of wolves to encourage
their extermination.)
In a letter received by Mc
Dowell in 1793 from his brother
(McDowell was at the time out
of the country), the following
note of Indians was made:
“Dear Ephriam:
“. . . I have had letters from
Kentucky lately . . . Indians
are still very troublesome on
the frontiers from North to
South. A treaty has been
proposed by the government,
I suppose more with a view to
(luieting the minds of mem
bers who are averse to the
war, than an expectation of
peace. By every act the In
dians refuse treating on any
other terms than making the
Ohio River the line, whicli
never will be complied with
by the Government. The
President [General Washing
ton] has called on the State of
Kentucky for fifteen hundred
volunteers. It is said they
(with a considerable addition)
will march about the first of
next month. Reports say that
the commissioners who were
sent to treat with the Indians
are made prisioners and not
permitted to return ...”
As far as the few, and at best
incomplete, records show, Mc
Dowell never received an M.D.
degree; but three years before
his death the University of
Maryland gave him an honorary
M.D.
His first introduction to medi
cal education was at the age of
19 in the office of an eminent
Staunton, Virginia, physician.
Dr. Alexander Humphries.
At age 22, he went abroad
and entered the University of
Edinburgh, Scotland, considered
at the time to be the “very cap
stone of the pyramid of medical
education. ’ ’ He left Edinburgh
after a year, but remained in
Scotland to study under John
Bell, known as the “most able
and eloquent Scottish surgeon
of his day.”
While studying with the
famed Scottish surgeon, Bell,
McDowell was first introduced
to the study of the diseases of
the ovaries—in particular ova
rian tumors, the fact that these
usually resulted in death, and
the possibility in the future of
“relief through surgery.” The
study of the entire “ovarian
question” must have made quite
an impression on the young doc
tor ; for sixteen years later when
McDowell performed the first
ovariotomy, he said it was Bell’s
principles and suggestions that
impelled him to attempt the
operation, considered by most
surgeons of his day to be an im
possibility.
McDowell returned to the
States in 1795, after a year of
study with Bell, and settled near
liis family in Danville. It did
not take his fame long to spread,
nor his practice to grow; for
there was little “competition”
professionally (some sources
say that for a time he was the
first and only “qualified” sur
geon practicing medicine west
of the Alleghanies), he had al
ready established extensive con
nections in the area, and his
“foreign” training seemed to
have a somewhat dazzling effect
upon the townspeople and in
habitants of the surrounding
area.
Within a relatively short pe
riod of time, as his successes be
came known, McDowell’s prac
tice grew until it covered almost
the entire Southwest.
In the first years, he per
formed a variety of operations—
all well known to the surgery of
his day, such as those for lithot
omies (incision of duct or organ,
especially the bladder, for re
moval of stone), amputations,
tracheotomies, and hernias.
He was an especially skilled
lithotomist, and he performed
about thirty-two of the opera
tions without loss of life. One
of these was performed in 1812
on James K. Polk (later presi
dent of the United States), and
it is said that he “ever after
wards held in grateful remem
brance the surgeon who made
his career a possibility.”
IMcDowell had been in prac
tice almost fourteen years when
his most famous surgical case
became history. The patient, to
day known by name about as
well as her surgeon, was Mrs.
Jane Todd Crawford. McDowell
had been called to her home, lo
cated sixty miles from Danville,
to investigate ilrs. Crawford’s
abdominal swelling, first thought
to be caused by pregnancy.
Upon further examination, the
doctor realized that Mrs. Craw
ford’s condition indicated the
need for an immediate ovariot
omy (removal by surgery of an
ovary or of an ovarian tumor).
He knew well the dangers of
such an operation, but he also
knew that without tlie surgery
Mrs. Crawford would not have
long to live.
He presented the case to her,
explaining both sides of the is
sue, and stating his willingness
to try the operation if she would
come to Danville for it. She
agreed, and a date was set.
The result is history; Two
courageous people helped create
an entirely new frontier in sur
gery.
Seven years later, in his first
published account of the histori-
INTERCOM - 8