within a few years became known throughout all the western and southern states as the best surgeon in his entire section of the country. During this time his practice extended in every direction, persons coming to him from all the neighboring states, and he frequently making long journeys on horseback to operate upon persons whose conditions would not permit them to visit him at his home. As far as known, he was in the habit of performing every surgical operation then practised. In lithotomy he was es- pecially successful, and was known to have operated, up to 1828, twenty- two times without a single death. He operated many times for strangulated hernia, and did successfully various amputations and other operations, in- including tracheotomy.
In 1809, fourteen years after he began practice, he was sent for to see a Mrs. Crawford, living in Green County, Kentucky, some sixty miles from Dan- ville. McDowell found her to be afflict- ed with an ovarian tumor, which was rapidly growing and hastening to a fatal termination. In the language of Prof. Gross: "After a most thor- ough and critical examination. Dr. McDowell informed his patient, a woman of unusual courage and strength of mind, that the only chance for relief was the excision of the diseased mass. He explained to her, with great clear- ness and fidelity, the nature and haz- ard of the operation; he told her that he had never performed it, but that he was ready, if she were willing, to undertake it, and risk his reputation upon the issue, adding that it was an experiment, but an experiment well worthy of trial." At the close of the interview Mrs. Crawford declared that any mode of death, suicide excepted, was preferable to the slow death which she was undergoing, and that she would submit to any operation which held out even a remote prospect of relief. Mrs. Crawford was forty-seven at the time of the operation, and died on Vol. II— 9
March 30, 1841, aged seventy-eight years. It was not until seven years afterwards, and when he had twice repeated the operation, that McDowell published an account of it. In 1816 he prepared a brief account of his first three cases, a copy of which he forwarded to his old preceptor, John Bell, who was then travelling on the Continent for his health, and had left his profession- al correspondence in the charge of Mr. John Lizars. The communication failed to reach Mr. Bell, and another copy of the report was forwarded by McDowell to Philadelphia for pubhca- tion. The report appeared in the "Eclectic Repertory and Analytical Re- view" for October, 1816.
Two additional cases completed this report, all three patients making com- plete and prompt recovery.
Three years later (October, 1819) McDowell reported in the same journal two additional cases. It will be ob- served that seven years elapsed from the time he first operated until he made his publication, when he was enabled to add two more successful cases. That so long a time should have been allowed to elapse was most probably due to the surgeon's natural aversion to writing. Perhaps the manner in which this report was made did much to provoke the criti- cism with which it was received. Dr. James Johnson, the very learned editor of the " London Medico-Chirurgical Re- view," was especially severe and satirical in his criticisms.
How many times during his career McDowell performed ovariotomy is not now certainly known. Dr. Jackson re- ports him to have made a long horseback journey in 1S22 of some hundreds of miles into middle Tennessee, to do an ovariotomy (successful) upon Mrs. Over- ton, who lived near the Hermitage, Pres. Jackson's house. The only assistants he had were Gen. Jackson and a Mrs. Priest- ly. The former seems to have been great- ly pleased with McDowell, and took him to his house as guest. Dr. William A. McDowell, for five years his uncle's pupil