Removing Ovaries to Treat Women’s Pelvic Pain
The Biography of Dr. Robert Battey
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As I waited for those attending to arrive, my mind wandered to my operation and the reason to be cutting out this woman’s ovaries. It had never been done before, yet here we were. I was firm in my belief this poor woman with the menstrual like nisus continuing all the time, who was never better even when menstruating, had the general perturbation that cause her to have severe fits or convulsive attacks that would come on for hours even with the morphine. I occasioned to think it was possibly something sinister but was assured that some women improve when facing the change of life. Was this not the same change, just sooner. It had to be this, and we were about to remove the offending organs. I had presented to the Medical Association of Georgia for hours and received a positive report from Chairman Dr. Bozeman, it is fair to say the members were my acquaintances and this awareness may have stifled the import of the report from my erstwhile colleagues. Julia was awake and when asked, again said she was agreeable for the operation, that she could not continue with the way things were going and accepted her fate. I recall my thoughts - “The only alternative is the change and it is that this patient earnestly prays for as a relief for the …monthly sufferings.” Julia had become dependent on 1-2 grains morphia daily for some years now and there was nowhere else for her to go. We proceeded then to get ready. It was already exceedingly hot and all assembled were sweating heavily so we had to proceed. She lay on the dining table at first to hear the prayer. I had asked Judge Augustus R. Wright to say a prayer for Julia at the head of the table. Dr. Hoyt began the chloroform. On my direction the family drew back to the front room. Martha had prepared the sutures and instruments soaked in Labarragues solution for decontamination. I had washed with warm water and soap but added the Labarraques to ensure cleanliness. The room was full of the stale odor. Chloroform was poorly taken at first with Julia bucking wildly when the first attempt was made for the incision. Dr. Hoyt was unsettled as he seemed uncertain of his task. This passed and I proceeded to make a vertical incision on her abdomen, put pressure to stop oozing and then removed her ovaries. Although the first was easily found, secured and removed, the left was tethered to something but came out eventually. Both appendages were secured with silk sutures. I cut both sutures close to the knot. I used three wires to close the abdomen. The procedure over I made my way to clean the abdomen of blood and helped hold Julia down when the bucking started again once the chloroform was withdrawn. Julia was allowed to stay on the table for the first but later moved to her room. I made arrangements to stay in the home for her convalescence. Having done this, I affirmed my decision in my notes by recording the right ovary was releasing an egg and I had held the precious body in its moment of ovulation for the first time ever. I had prevented another convulsive attack by removing that ovary.
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About the Book
The book is the biography of Dr. Robert Battey (1828-1895) who, in 1872 in Rome Georgia, USA, operated on a woman with severe pain and removed her ovaries. He did the operation under the threat of homicide should she have died. She did survive and Battey and his operation became a famous internationally. There were no other effective treatments available for severe pelvic pain other than narcotics and chloroform. He also believed in the ovarian control of uterine bleeding, and the peculiar ‘pertubations” affecting general health. Although he attempted to keep the indications of surgery for those with the most severe pain, the “Battey Operation” became a widespread procedure. The indications were not understood and included the poorly defined hystero-epilepsy and menstromania. The operation became discredited before his death in 1895. Battey’s personal life and medical practice is reviewed. Analyzing his correspondence, case reports and voluminous medical publications indicate that he was a caring physician who was dealing with women suffering from severe pain sensitivity and likely endometriosis - conditions unknown at the time. Now, the complex picture of women’s pelvic pain sensitization is understood to be associated with persistent and unrelenting pain, anxiety and depression, tenderness in the skin and abdominal and vaginal muscles and co-morbidities of migraine and arthralgias. Endometriosis is the most common cause of this condition. Current medical and surgical care are now based on suppression of ovarian function or if that fails, surgical removal.
About the Author
Dr. John Jarrell is Emeritus Professor Obstetrics and Gynecology, University of Calgary, Calgary, Alberta Canada. He has been a clinician, researcher and author of more than 100 articles in peer reviewed literature. He was an active member of the Pelvic Pain Group of the Calgary Chronic Pain Centre for more than 20 years. The areas of research have been on how health practitioners identify and manage the presence of pelvic pain sensitization in an interdisciplinary programme.