for the exclusive treatment of surgical affections did not exist anywhere in the world prior to the one founded by Marion Sims in New York (1855), as given in "Sims' Autobiography," where Sims worked, assisted by Sister Margaret, and with Thomas Addis Emmet as his coadjutor. The Chicago Hospital for Women and Children was opened in 1805, and A. Reeves Jackson formed the Women's Hospital of the State of Illinois in Chicago, in 1870. Two followed in Philadelphia, the Kensington Hospital founded in 1883, by Howard A. Kelly, and the Gynecean Hospital founded in 1888, by Joseph Price and Charles B. Penrose. In New England, the Northeastern Hospital for Women and Children (Roxbury, Massachusetts) opened in 1863; the Free Hospital for Women was founded by Dr. W. H. Baker, in 1876.
The Work of Individuals.
With all these adjuvant agencies at their command, activities born of the very spirit of the times, it arouses no special wonder when we note that decade by decade earnest, inspired workers have come forward to aid in pushing the new specialty onwards to perfection. Two distinct lines of surgery sprang up and converged under one head, they were the intra-abdominal affections — tumors and inflammatory diseases, and the vaginal diseases mostly treated by plastic surgery.
It would be tedious, simply following a chronological order, to trace the advances, decade by decade, so I will preferably take up certain important topics and refer briefly to the work done under each head by some of the more prominent individuals, regretting that time and space prevent my attempting to do justice to all, for of many it may justly be said, as we may say of our great leaders to-day, they were but primi inter pares. The topics considered will be ovariotomy, fibroid tumors, normal oophorectomy, extrauterine pregnancy, pelvic inflammatory disease.
Vaginal plastic operations constitute another field which has yielded abundant fruit to the gynecological surgeon. We will consider vesico- vaginal fistulæ, lacerations of the perineum, lacerations of the cervix uteri, rapid dilation of the cervix, uterine displacements, cystitis and pyelitis.
Ovariotomy. — McDowell (1771-1830), by his operation in 1809, cut gynecology as a specialty, by Cesarean section, ex utero matris, the successful major operation prophetically heralding the advent of all similar, minor procedures destined to follow in its train. ("Philadelphia Medical Repertory and Analytical Review," 1817.)
Nathan Smith (1762-1829), in 1821, one of the most original pioneer surgeons this country has ever seen, also independently conceived and executed this great operation. Ovariotomy was tried with varying success by A. Goldsmith, J. A. Gallup, D. L. Rodgers and J. Bellinger in
