A series of twenty-five completed ovariotomies / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A series of twenty-five completed ovariotomies / by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    [Reprinted for the Author from the British Medical Journal, Dec. 14, 1889.] A SERIES OF TWENTY-FIVE COMPLETED OVARIOTOMIES. By ALBAN DORAN, F.R.C.S., Surgeon to the Samaritan Free Hospital. Notwithstanding all that has been written concerning ovario- tomy, there is yet more to be learnt about the subject. Between April, 1877, when I became assistant-surgeon to the Samaritan Hospital, and October, 1889,1 witnessed no less than 1,050 abdo- minal sections. I assisted in person at over half those operations, after clinical examination of nearly every patient, in Dr. Ban- tock’s wards. Yet, spite of that experience, which cannot be reckoned as limited, I should be sorry to speak too positively on any of the contested points relating to ovariotomy and allied pro- cedures. Practice of the operation, a searching investigation into every detail of nursing and after-treatment, and a close study of the records and statistical tables of experienced operators, are the chief agents in effecting progress. The cause of death in fatal cases must, whenever possible, be faithfully recorded. Every operator tends to put his trust in a system; he must find out how the system fails in every bad case, and must admit, if necessary, that the system may have been the cause of death. He must avoid a natural tendency to argue, on mere logical grounds, that his colleagues’ fatal cases are due to his colleagues’ respective systems, and that his own are to be explained by purely acci- dental circumstances for which his system and himself are in no way to blame. On the other hand, the less experienced operator must not take for granted that the success of a senior is due, as that senior may honestly believe and maintain, to his system. The senior’s brilliant results must depend, to a great extent, on his skill and experience, rather than on preference for the spray, or discarding of antiseptics, or treatment of peritonitis by opium or by purgatives. A few years ago, in the course of a discussion on the claims of eminent rivals, at the Royal Medical and Chirurgical Society, Mr. Savory observed that there was only one thing com- mon to both claimants. Their last cases were more successful than their first. This showed that success depended on the man rather than on his system. In my own practice I have taken what has been sent to me; some of the cases were easy, some difficult, I made no selection. To give full details of every case would be an impossibility. Yet since ovariotomy depends, perhaps, more upon matters of detail and care in after-treatment than any other operation, I have thought it advisable to append to the table a series of notes on matters of interest respecting each case. I regret that one im- portant and indeed essential factor, the efficacy of the nurse, can- not be estimated in statistical records.