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medicine and biomedical sciences in modern history
BELLY-RIPPERS, SURGICAL
INNOVATION AND THE
OVARIOTOMY CONTROVERSY
SALLY FRAMPTON
Medicine and Biomedical Sciences
in Modern History
Series Editors
Carsten Timmermann
University of Manchester
Manchester, UK
Michael Worboys
University of Manchester
Manchester, UK
The aim of this series is to illuminate the development and impact of
medicine and the biomedical sciences in the modern era. The series was
founded by the late Professor John Pickstone, and its ambitions reflect
his commitment to the integrated study of medicine, science and tech-
nology in their contexts. He repeatedly commented that it was a pity
that the foundation discipline of the field, for which he popularized
the acronym ‘HSTM’ (History of Science, Technology and Medicine)
had been the history of science rather than the history of medicine.
His point was that historians of science had too often focused just on
scientific ideas and institutions, while historians of medicine always had
to consider the understanding, management and meanings of diseases in
their socio-economic, cultural, technological and political contexts. In
the event, most of the books in the series dealt with medicine and the
biomedical sciences, and the changed series title reflects this. However, as
the new editors we share Professor Pickstone’s enthusiasm for the inte-
grated study of medicine, science and technology, encouraging studies
on biomedical science, translational medicine, clinical practice, disease
histories, medical technologies, medical specialisms and health policies.
The books in this series will present medicine and biomedical science
as crucial features of modern culture, analysing their economic, social
and political aspects, while not neglecting their expert content and con-
text. Our authors investigate the uses and consequences of technical
knowledge, and how it shaped, and was shaped by, particular economic,
social and political structures. In re-launching the Series, we hope to
build on its strengths but extend its geographical range beyond Western
Europe and North America.
Medicine and Biomedical Sciences in Modern History is intended to
supply analysis and stimulate debate. All books are based on searching
historical study of topics which are important, not least because they cut
across conventional academic boundaries. They should appeal not just to
historians, nor just to medical practitioners, scientists and engineers, but
to all who are interested in the place of medicine and biomedical sciences
in modern history.
Belly-Rippers,
Surgical Innovation
and the Ovariotomy
Controversy
Sally Frampton
Faculty of English
University of Oxford
Oxford, UK
© The Editor(s) (if applicable) and The Author(s) 2018. This book is an open access publication.
Open Access This book is licensed under the terms of the Creative Commons Attribution
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He wrote succinctly and would not tolerate misuse of the English
language—to the patient who asked ‘Do I need surgery, Sir?’ he replied,
‘Everyone needs surgery, Madam, what you need is an operation!’
Obituary of Lord Russell Brock, surgeon. (1903–1980).
In loving memory of Jo Wright.
Acknowledgements
ix
x Acknowledgements
1 Introduction 1
7 Conclusion 213
Bibliography
221
Index 261
xiii
List of Figures
xv
xvi List of Figures
Fig. 5.1 Table taken from the fifth edition of Jukes de Styrap’s The
Medico-Chirurgical Tariffs, a popular reference manual for
general practitioners and young surgeons and physicians,
published in 1890. Even though ovariotomy was no longer
new, it remained more expensive than comparatively riskier
operations such as hysterectomy, nephrotomy or splenotomy,
and was the only operation to appear on de Styrap’s extensive
list with a note in the maximum fee column that suggested an
almost unlimited price tag upon a private procedure, denoted
by the insertion of ‘and upwards’ (Credit Wellcome
Collection CC BY) 143
Fig. 5.2 Caricature of the Parisian ovariotomist Samuel Pozzi
by the cartoonist Hector Moloch (Alphonse Hector Colomb),
1909 (Credit Private collection of Nicolas Bourdet) 157
Fig. 6.1 Number of articles in which ‘ovariotomy’ is cited in the Lancet
and British Medical Journal (1880–1939) (Source Elsevier
Science Direct Database (http://www.sciencedirect.com)
and The BMJ online archives (http://www.bmj.com/archive)
(accessed 29 August 2013)) 178
Fig. 6.2 Arthur Giles, A Study of the After-Results of Abdominal
Operations on the Pelvic Organs: Based on a Series of 1000
Consecutive Cases (1910). Part of Giles’ table showing
the results of operations that involved the ‘Total Extirpation
for Ovarian Tumours’. Giles provided one of the most
detailed accounts yet of the long-term effects of ovariotomy
and other forms of ovarian surgery (Credit Wellcome
Collection CC BY) 184
Fig. 6.3 Illustration showing the difference between conservative
sectioning with preservation (left) and radical extirpation
(right) of the ovary, from American surgeon Howard
A. Kelly’s Operative Gynecology, vol. 2 published in 1906.
This image, taken from a fairly straightforward case of
enlarged cysts, belied the frequent complexities that arose
in conservative surgery, particularly concerns that diseased
tissue was often being inadvertently preserved
(Credit Wellcome Collection CC BY) 189
CHAPTER 1
Introduction
A Gendered Operation?
Within the history of ovariotomy, one does not have to look too hard
to find affirmation that the operation was used experimentally and irre-
sponsibly and that vulnerable women were operated on in circumstances
where their consent is questionable. That the procedure was used, on
occasion, to ‘cure’ maladies like hysteria, presents troubling questions
about the way invasive medical procedures were being used to control
female behaviour. Historians have been rightly attentive to the connec-
tions the operation reveals between normative gender values and exper-
imental and risky surgery. Indeed, the operation served as an important
tool for women’s historians in the latter half of the twentieth century,
especially those intent on exposing patriarchy within the medical realm.
For feminist activists Barbara Ehrenreich and Deirdre English, for exam-
ple, writing in America in 1978 amid second wave feminism and an
expanding women’s health movement, the operation was a clear indi-
cation of the repressive sexual politics of the Victorian era. Removal
of the ovaries was, as they evocatively put it, part of the ‘gynecologist’s
exotic catalog of tortures’.10 Ehrenreich and English set the scene for
histories which viewed the operation as primarily configured upon sur-
gical mismanagement—or at the very least over-management—of the
female body. Ornella Moscucci’s The Science of Woman (1990), Thomas
Laqueur’s Making Sex (1990) and Ann Dally’s Women Under the Knife
(1991), while less polemical than Ehrenreich and English’s work, all iden-
tified the introduction of ovariotomy as a fundamental moment in the
medicalisation of women, through which cultural notions of feminin-
ity were embedded into surgical practice.11 More recent scholarship by
1 INTRODUCTION 5
Ovariotomy and Innovation
This book does not negate the importance of gender as a means of ana-
lysing ovariotomy. But it must be considered as one of multiple aspects at
work in the introduction of the operation. In this study, it is innovation
which is my conceptual focal point. Ovariotomy is one of the most sig-
nificant and yet most accessible historical examples of the complexities of
innovation in surgery; symbolic of the hopes and fears of the surgical pro-
fession, its performance was embedded in a network of ideas and ideals
about the role of surgery in society. How was surgical innovation defined,
diffused and understood? In this book, I seek to go beyond the polari-
sation, which has, until recently, been common in historical writing on
surgery, with ‘social’ histories on one side, which often only pay lip ser-
vice to the technical aspects of operations, and heavily technical accounts
on the other, which can marginalise social and cultural considerations.15
In this way, it speaks to recent works by historians like Thomas Schlich,
Christopher Crenner, Claire Brock and Sally Wilde in attempting to
6 S. FRAMPTON