McDowell, Brown and Dudley Among Pioneer Physicians

By James Clell Neace - 2000

An act of Congress in 1864 founded the National Statuary Hall in Washington, D.C., to honor deceased citizens, who had "performed distinguished service." Each state was invited to contribute statues of two such residents. Kentucky's two statues were placed there in the year 1929. Do you know the names of the two Kentuckians honored?

One honoree was Henry Clay (1777-1852), of Lexington, "The Great Compromiser." Clay's three compromises, in the years 1820, 1833, and 1850, delayed the American Civil War for decades.

The other honoree was Ephraim McDowell (1771-1830), of Danville, "The Father of Abdominal Surgery." He did an "impossible" surgical operation and put Pioneer Kentucky on the map, medically (1).

Like most other Kentuckians of their day, both Clay and McDowell were born in Virginia and came to Kentucky at an early age. McDowell was 12 years old, when his father moved the family to the frontier village of Danville, Kentucky, in 1783. (Fort Boonesboro had been built only eight years, when the McDowells arrived at Danville.) Clay was also 12 years old, when he first came to Kentucky.

In the years 1793 and 1794, young Ephraim studied surgery at Edinburgh, Scotland, then a Mecca for medical students from the world over. In the year 1795, Dr. McDowell returned to Danville and set up a highly-successful medical practice there. He remained in Danville for the rest of his life.

In the year 1809, Dr. McDowell performed the operation that made him world famous. Before we go into the details of this remarkable feat, let us review a few historical details relating to the conditions under which he performed the operation.

At that time, people knew absolutely nothing about germs. Patients, while undergoing surgery, were merely given a bullet to bite. Anesthesia, antiseptics, antibiotics, and aseptic surgery had not yet been introduced. Louis Pasteur (1822-1895), in the 1860s, first showed that fermentation, putrefaction, infection, and souring were all caused by germs or microbes. Joseph Lister (1827-1912), in the year 1865, founded modern antiseptic surgery, when he used carbolic acid as an antiseptic and did heat-sterilization of instruments used for operations. William Morton (1819-1868), in the year 1846, introduced anesthesia, when he extracted a tooth using ether.

The "impossible" operation performed by Dr. McDowell was a team effort, by doctor and patient, requiring strong people. Both doctor and patient met this criterion. The Kentucky frontier was settled by a hardy breed of people who believed in themselves; a people inured to hardships and danger. As we shall later see in this report, arduous conditions on the Kentucky frontier led to the development of a number of new medical procedures. Pioneer settlers faced shortages and new challenge on every hand necessitating numerous improvisations and inventions.

In the winter of 1809, a 47-year-old woman named Mrs. Jane Todd Crawford, who resided in Green County, sought treatment for what appeared to be an overdue pregnancy. Dr. McDowell diagnosed the problem as an ovarian tumor that was rapidly becoming terminal. He confided to Mrs. Crawford that he had never known of an ovariotomy being performed. He told her of the dangers and intense pain involved. Undaunted, she bravely told him to go ahead and cut it out.

The operation was performed in Dr. McDowell's own home, on Second Street in Danville. An ovarian tumor, weighing 22.5 pounds, was removed from Mrs. Crawford. Five days later she was able to leave her bed. Not only did Mrs. Crawford survive; she lived for 31 more years.

Today the historic house where Dr. Ephraim McDowell performed this remarkable feat, is listed in the National Register. It has been restored and converted to a museum, open to the public.

Historic Transylvania University, founded in 1780 by the Virginia Legislature, opened near Danville in 1783 (and moved to Lexington in 1788), became a training ground for early Kentucky medical men. The trustees established a medical school there in 1799. Dr. Samuel Brown, who had studied medicine in Edinburgh, in the same class with Ephraim McDowell, was appointed professor of chemistry, anatomy, and surgery.

Dr. Brown introduced vaccinations in Kentucky, at a time when they were not yet in general use in the Ivy-League schools on the East Coast. By the year 1802, he had vaccinated over 500 people in and around Lexington, more than had been performed in all the rest of the world, up to that time.

Benjamin W. Dudley (1785-1870) was brought by his family to Kentucky from Virginia, when he was one year old. He studied medicine in Europe, mainly in Paris. Dr. Dudley began medical practice in Lexington in 1814, where he exhibited great skill with surgical scalpels and showed consummate knowledge of anatomy. He soon acquired a national reputation as a surgeon.

At a time when no one had heard of germs, Dr. Dudley boiled all of his surgical instruments in water. He performed life-saving operations on aneurysms (ballooning of walls of arteries), using ligatures (tie-off with thread). He trepanned (sawed out circular discs) five skulls to remove pressure on the brain.

In 1817, Dr. Dudley was asked to organize the medical department at Transylvania. Under his leadership, the Transylvania medical school grew rapidly and soon equaled or exceeded the medical departments in the Ivy League schools on the East Coast (2).

Dr. Dudley became the world's leading surgeon for the removal of bladder stones. His remarkable skill is demonstrated by the fact that of his first 100 patients, not one died as a result of the operation; an unparalleled success. Many surgical procedures, first developed by Dr. Dudley, are still universally employed by the world's physicians (2).

Walter Brashear (born 1776) moved with his family to Kentucky from Maryland in 1784, at the age of eight. He graduated in medicine at Transylvania. In the year 1806, Dr. Brashear performed the world's first successful amputation at the hip joint. This was also the first successful surgical work of such magnitude ever done in Kentucky; Dr. McDowell's famous operation came three years later.

After McDowell's successful ovariotomy in 1809, a number of the world's foremost surgeons tried to follow his lead, but soon abandoned this operation as too painful and too deadly. Then, along came Dr. Joshua T. Bradford, who revived ovariotomy in 1842. Dr. Bradford (1817-1871) was born in Bracken County, Kentucky. In the years 1842 to 1856, he performed his first seven ovariotomies without a single death; a remarkable feat, considering that this operation had a mortality rate of 75% in all the world's cases that had been reported, up to that time.

Dr. Daniel Drake (1785-1852) was another influential physician reared in Kentucky. He practiced in Cincinnati, where he founded the Medical College of Ohio in 1821. He later founded the medical departments of both Miami University and Cincinnati College.

Different writers (1,2) have speculated on the underlying causes of such spectacular success shown by so many early Kentucky surgeons. Holmes (1) states that the astounding courage and faith demonstrated by McDowell and Crawford were a reflection of life on the Kentucky frontier. Only the strongest and bravest people had dared to go settle there, in the first place, and frontier conditions quickly weeded out the faint-hearted from among them.

Related articles found in earlier issues of The Kentucky Explorer: (1) November, 1987, p. 35; (2) March, 1992, p. 18; (3) February, 1993, p. 55; (4) May, 1996, p. 7; and (5) August, 1996, p. 44.
James Clell Neace, 377 Freedom Road, Blackville, SC 29817-4533, is a native of Breathitt County, Kentucky, and is a regular contributor to the Kentucky Explorer.