THE 
History of Abdominal Section in Albany, 
WITH A 
REPORT OF SEVENTY-FIVE CASES. 
By Albert Vander Veer, M. D., 
Professor of Surgery in the Albany Medical College, Fellow of the British 
Gynecological Society, Attending Physician Albany Hospital. 
Read at the Meeting of the Medical Society of the State of New York, 
FEBRUARY, 1888. 
Reprint from the Transactions of the Society for 1888, and the Annals of Surgery, May, 1888. 
Albany, N. Y.: 
Burdick & Taylor, Printers. 
1888. THE 
History of Abdominal Section in Albany, 
WITH A 
REPORT OF SEVENTY-FIVE CASES. 
By Albert Vander Veer, M. D., 
Professor of Surgery in the Albany Medical College, Fellow of the British 
Gynecological Society, Attending Physician Albany Hospital. 
Read at the Meeting of the Medical Society of the State of New York, 
FEBRUARY, 1888. 
Reprint from the Transactions of the Society for 1888, and the Annals of Surgery, May, 1888. 
Albany, N. Y.: 
Burdick & Taylor, Printers. 
1888. THE HISTORY OF ABDOMINAL SECTION IN 
ALBANY, WITH A REPORT OF SEVENTY- 
FIVE CASES*. 
By ALBERT VANDER VEER, M. D., 
PROFESSOR OF SURGERY IN THE ALBANY MEDICAL COLLEGE, FELLOW OF THE BRITISH GYNE- 
COLOGICAL SOCIETY, ATTENDING SURGEON ALBANY HOSPITAL. 
Believing that the time has come when every case of abdom- 
inal section should be reported, I have endeavored to give in 
this paper an accurate report of the work done in Albany. 
While I could wish that this history presented better results, I 
am convinced that it fairly represents the early struggles of 
this branch of surgery in this country. 
Though the mortality was great during the first years of our 
work in this line, I am satisfied that, by an honest presentation 
of facts, we can convince our patients and their friends that 
we have reached such a degree of success as to be able to 
offer them every encouragement to have an early operation. 
I believe it to be the duty of every operator to collect from his 
own medical territory every case, favorable or not, and give it 
to the world, and I venture to predict that the statistics so 
collected will demonstrate the fact that there must and will be 
surgical centres for doing this branch of surgery. Undoubt- 
edly the success that has attended the operation of ovariotomy 
in England, has been largely due to the few operators who 
have been engaged in the work, and to the fact that the 
country there is not so vast, but that the afflicted English 
woman has been able to reach these centres promptly, and by 
the success that has followed her sisters have also been induced 
to undergo an early operation. Our American women are 
entitled to this same degree of confidence and hope, and, Amer- 
ican operators can now give it to them. 
I think I will be supported in my opinion that ovarian cases 
* Read at the Annual Meeting of the Medical Society of the State of N. Feb., 1888. 4 
Albert Vander Veer. 
are more numerous among the laboring classes and those of 
moderate means than among the wealthy. Hence the item of 
expense must be considered by nearly all who are so afflicted, 
and as the expense of reaching and remaining in great medical 
centres is so great, many will be deprived of the relief they 
might obtain were they able to go beyond a moderate distance 
from their homes. For this difficulty we have but one remedy. 
Owing to the great extent of our country, we must have, for 
doing this work, a proportionately greater number of operators 
and surgical centres than are required abroad. 
While there will be some who will rise to eminence in this 
field, a large proportion of the labor must be done by the more 
modest workers. As America is first in much that pertains to 
progress in science and art, I am convinced that she will soon 
lead in the practice of abdominal surgery, and I believe that 
this period will be reached during the lives of some who are 
here to-day. This practice is in its infancy, and as it pro- 
gresses, we will find as good original thinkers and workers, and 
as skillful operators as can be found in England, France, Ger- 
many or elsewhere. 
It is, at the present time, possible for the general surgeon to 
be a success as a general practitioner in medicine; but who- 
ever attains any great degree of success in abdominal surgery 
must largely sacrifice all other interests and become a spe- 
cialist. 
In an experience more limited than that of some of my con- 
freres, personal sacrifices have taught me this, and the study of 
the professional lives of such men as Atlee, Peaslee, Kim- 
ball and others who are yet living and are earnest workers, 
impresses me most profoundly that such is the fact. 
Many owners of the vast wealth of this country are inter- 
ested in this branch of our work and in the promotion of all 
the interests of our profession. Many have already sought to 
aid us by endowing medical schools and hospitals. Let us 
encourage the good work, and wherever and whenever we can, 
consistently with the dignity of our profession, let us secure 
such material aid as shall enable us to advance the interests Abdominal Section. 
5 
of medical science and contribute to the relief of suffering 
humanity. 
Case i. The first recorded case of ovariotomy performed by an 
Albany surgeon, was done in the Albany hospital very soon after its 
organization, by Alden March, December io, 1849, The case is 
reported in the Transactions of the Medical Society, of the State of 
New York for 1850. It gives some striking points when reviewed 
at the present time. 
The patient recovered, though the first ligature slipped, and about 
a pint of blood escaped into the peritoneal cavity, which was cleaned 
out with sponges, after the pedicle had been secured a second time 
by transfixion. In the report of the case, he speaks of the dangers 
of adhesions in such cases ; also of the operation being in its infancy, 
and the possibility that surgeons might be tempted to do it too often, 
This patient was in excellent health three years after the operation. 
The doctor does not in any of his cases refer to the use of the clamp. 
In his cases he seems to have worried much in making a diagnosis 
between solid tumors of the uterus and ovarian multilocular cysts. 
Table I, gives all of Dr. March's cases as well as the results of other 
operators. 
Case 2 was thought by some of the counsel present to be ascites. 
Dr. March made a free abdominal incision. No ascites. Tumor 
multilocular ; large sac opened ; dark ropy fluid escaped ; and from 
several small cysts, a white, jelly, egg-like looking fluid. Owing to 
the many and firm adhesions, it was thought best not to attempt 
removal. Dr. March states the intestines were then returned and 
incision closed. Patient did well for two or three days, but it is not 
stated whether she recovered. 
Case 3. Dr. March supposed he had an ovarian tumor to deal 
with, exposed the tumor, thrust in his trochar, but to his great disap- 
pointment, got only blood, and then discovered that it was a vas- 
cular fibroid ; the bleeding was very free, incision in abdomen was 
closed, and patient died in forty-two hours, 
Case 4 was tapped first March, 1857, and 21 pounds of a brownish 
ropy fluid removed. Second tapping done in May, with similar 
results. Third tapping in the beginning of July. August 26, fourth 
tapping, 25 pounds removed, and then an injection of 8 oz. alcoholic 
tr. iodine was injected into the empty sac. Many adhesions were 
found on exposing the cyst, thought to be due somewhat to the use 6 
Albert Vander Veer, 
of the iodine. On account of the vascular condition of the adhe- 
sions and their great extent, it was thought best not to go on with 
the attempt to remove the tumor. A seton was put in the walls of 
the cyst (a portion of which was removed) and brought out of the 
lower end of incision. The latter was closed by interrupted sutures. 
In the operation, chloroform and ether were used. Adhesive straps, 
compresses and bandage. When the injection of iodine was made 
use of, Dr. Thomas Hun placed in the mouth of the patient a thin 
slice of potato which showed evidence of iodine absorption in about 
fifteen minutes. 
Case 5, as Dr. March states, was really an exploratory incision to 
determine the nature of the growth, it having been diagnosed ova- 
rian in New York. Doctor M. thought otherwise. Was found to be 
a very solid vascular fibroid from fundus of the uterus. Fluid was 
peritoneal dropsy. Incision closed, and patient died in twenty-four 
hours. Was much emaciated and exhausted before the operation was 
commenced. 
Case 6, see table. 
Case 7 was a very creditable operation. No sponges used in peri- 
toneal cavity. No severe loss of blood. Wound closed by inter- 
rupted sutures. Patient died on the third or fourth day from peri- 
tonitis. 
So far as I am able to learn from his notes, and the hospital 
records, Dr. March did abdominal section seven times. As 
stated, his first case was a complete success. His careful study 
of cases as to diagnosis and proper selection as to the time and 
method of operating, and line of treatment, impresses one very 
profoundly. Dr. March was an intensely honest man and an 
expert in palpation, and yet he does not hesitate to report his 
experience in tapping a fibroid for an ovarian cyst, the case 
afterwards passing into the hands of Dr. Atlee for an explora- 
tory incision, from which the patient recovered. 
It was no reflection upon him, however, that he was not 
aware of the importance of cleanliness of sponges, instruments, 
etc., and by reason of the pathology and want of knowledge 
in his day of such cases, that he did not make his work a suc- 
cess. He did much, however, to advance the operation, and 
often stated that he had no doubt but that in time it would 
become a successful and established step in surgery. Abdominal Section. 
7 
Case 8. Dr. S. H. Freeman, of this city, tells me that Dr. W. F. 
Atlee, of Philadelphia, operated some time in 1850, in Montgomery 
street, and that he was assisted by Dr. March ; that at the time, the 
operation attracted great attention both from the profession and the 
public. The patient, however, did not recover. 
Case 9. The next to follow in doing the operation was Dr. J. V. 
P. Quackenbush, who operated successfully at a private house in 
Gloversville, N. Y., August 3, 1869, and he was greatly rejoiced in 
seeing his patient recover. The doctor's only anxiety seemed to be 
in keeping the bowels from moving, in which he succeeded by the 
use of opium, the first movement taking place the thirteenth day after 
operation. 
Case 10. Dr. Quackenbush probably performed the first Caesar- 
ean section done in Albany. The case is reported at length in the 
Transactions of the Medical Society, of the County of Albany, vol. iii, 
P- 3°- 
Case ti. This next case was unsuccessful, and discouraged him 
greatly, and is now reported for the first. He was well up in the 
manner of making a diagnosis and method of doing the operation. 
Yet, it is on record, that he mistook an ovarian case for one of preg- 
nancy, and this worried him. 
Cases 12, 13, 14 and 15. Dr. E. R. Peaslee, while professor in the 
Albany Medical College, was the operator. He operated in the 
amphitheatre of the Albany Hospital in two cases, and upon one in 
a private room, all of whom died ; two from peritonitis, and one from 
immediate hemorrhage. Dr. S. H. Freeman informs me that Dr. 
Peaslee operated on a private patient (at her house) of the late Dr. 
J. V. Lansing in the fall of 1871, and that the patient recovered. 
These cases are reported for the first time in my tabulation. He 
used the silk ligature in each case, and dropped the pedicle back. 
I have seen many operators, but never one so careful and painstak- 
ing as Dr. Peaslee, and had he had the advantages offered to-day in 
antiseptic surgery, he would have been the " Tait " of America in 
his successful work. 
Dr. Peaslee's third case was such, that, had it occurred at the pres- 
ent time, seeing our patient sinking so surely, we would not have 
hesitated to open up and see, or find the trouble. 
Case 16. Dr. Lewis Balch, Professor of Anatomy in the Albany 
Medical College, was the next successful operator. He operated at 
St. Peter's Hospital November 28, 1876, and the patient recovered. 8 
Albert Vander Veer. 
The only unusual feature of this case was the character of the fluid, 
consisting of a very viscid liquid, in which were suspended a large 
number of pea-shaped bodies made up of sebaceous matter. Dr. 
Munde, in a recent article (Amer. Jour, of Obst., etc J describes 
four similar cases. 
Case 17. Recorded by Dr. S. B. Ward in Albany Medical Annals, 
vol. iii, p. 327, is very remarkable and notes are given in full. " Mr. 
T.B., set. 38, inmate of the penitentiary, on 30 years' sentence Tor 
counterfeiting, on July 10, with suicidal intent, cut his abdomen, 
tried to divide the right carotid, and then severed the left brachial 
artery an inch above the elbow. He did this in his cell at night, 
and was not discovered until next morning. Dr. H. R. Haskins, 
surgeon to the penitentiary, found him exsanguinated to the last 
degree, with no pulse at the left wrist and very little at the right. 
There was a wound one and one-quarter inches long over the left 
brachial, but the artery was not in sight; one in the abdomen sev- 
eral inches long, extending from a little to the left of the umbilicus 
to the ensiform cartilage, through which protruded tjie stomach, 
large and small intestines, with omentum, which was gashed in sev- 
eral places and a distinct amount of fecal matter was vm the skin, 
the viscera having been further cut after protrusion. Tlxe intestines 
were cold and dry, somewhat adherent, and had fuzz from the blanket 
sticking to them. Being apparently moribund, the parts were wiped 
with a dry handkerchief, and after an hour returned, immediate 
attempt causing hiccough and severe pain, and the wound closed 
with eight sutures, not through the peritoneum, broad bands of 
plaster being applied around the trunk. The other wounds, bleed- 
ing having ceased, were brought together with plaster only. He 
was kept steadily under the influence of morphia, and after forty- 
eight hours was removed to the prison hospital. For four days he 
did not raise his head or move hand or foot. At the end of that 
time sutures were removed, the wounds having nearly healed by 
first intention, about an inch of abdominal wound being still open, 
but healed at the bottom, when I saw him, Dr. Ward states, July 27, 
by the kindness of Dr. Haskins, who gave me permission to use the 
history of the case. This has gradually filled by granulation. He 
has had very little pain and no evidence of peritonitis at any time. 
The tongue has been clean, the pulse always below 100, and the tem- Abdominal Section. 
9 
perature never notably above normal. Morphia was discontinued 
on the eleventh day, and the bowels moved voluntarily on the four- 
teenth, A firm cylindrical mass occupied the place of the brachial 
artery where it is wounded, two inches above pulsation being felt. 
Pulsation is perfectly plain in the left radial, showing that collateral 
circulation is established. He was returned to duty November .1, 
The knife used was one he made from the steel spring which goes 
in the shank of a lady's gaiter, its blade three-eighths of an inch 
wide, two inches long, thick, pointed and well ground. Suicide was 
probably attempted under an insane delusion." 
Death would probably occur in such a case from hemorrhage, 
shock or peritonitis. The completeness of division of the brachial, 
with a possible bending of the elbow, checked the hemorrhage ; the 
warmth of the weather, with covering of the blanket, prevented 
shock from cold ; as to peritonitis, the intestinal wounds being 
inflicted after protrusion, no fecal matter probably entered the peri- 
toneum, and from long exposure, all oozing had ceased before their 
return, the wounds being already closed by exudation begun, but the 
greatest factor in preventing peritonitis was the copious bleeding. 
About one year after his recovery, Mr. T. B. again attempted sui- 
cide by cutting his throat. I was called to see him in consultation 
with Dr. W. H. Murray, physician to the penitentiary, and found 
that he had used very much the same kind of a knife as in the former 
attempt, with one in each hand had cut both ways, severing com- 
pletely the trachea, and cutting into the oesophagus, and had bled 
very freely from the cut superior thyroids, which I at once ligated. 
I closed the wound in the oesophagus with fine silk sutures, and the 
trachea with silver wire, bringing the external soft parts carefully 
together, securing good drainage. He made a rapid and excellent 
recovery, and continued to do his work in a faithful and careful man- 
ner. He was pardoned by President Cleveland, June 30, 1887, his 
time of service being shortened by his good behavior. He was in 
excellent condition of health, his former wounds giving him no 
trouble whatever. The theory of his case always was that he had 
been unjustly imprisoned, there being no law against making steel 
plates for engraving, for which he was paid. 
Case 18. Was the case of Dr. LeRoy McLean, of incision into 
the bladder, so ably reported in the Medical Record, vol. 15, p. 126, 
1879. 
Case 19. An exploratory incision, by Dr. S. B. Ward, May 13, 10 
Albert Vander Veer. 
i88o. The adhesions were so severe that it was found impossible to 
remove the tumor. The incision was closed. She made a good re- 
covery from operation, but finally died from exhaustion, June 20, 
1880. The history of this case does not state as to her having been 
tapped before the operation. Tumor was multilocular. 
Case 20. Operation by Mr. Tait, September 10, 1884. This is a 
remarkable case. Reported in full in Albany Medical Annals, vol. 
6, p. 1. 
The operation was for ovarian tumor and uterine myoma, both 
of which were removed. The pedicle was treated by Tait's circular 
wire clamp. It was found after the operation that a portion of the 
bladder wall had been included with the pedicle by the clamp, and 
visical fistula followed. 
On the 30th of November, 1884, the fistula was entirely healed, 
and the patient had perfect control of the bladder. Examination of 
the bladder revealed a firm cicatrix extending from near the umbili- 
cus to the symphysis pubis, and no trace of the fistula could be dis- 
covered. 
May 1, 1887, the patient called at my office for examination. I 
found that she had been in excellent health since her recovery, but 
that, for the past year, she had been developing a hernia from the 
lower point of the cicatrix as large as my fist. I ordered her a truss, 
which has given complete satisfaction. 
Case 21. Operated on by Mr. Tait for the removal of uterine 
appendages, is reported at length in Albany Medical Annals, vol. 5, 
p. 6, and again as to further result by myself in the American Jour- 
nal of Obstetrics, May, 1887. 
Case 22. Is a successful recovery from ovariotomy by D'r. Frank- 
lin Townsend, Jr., and reported fully in Medical Annals, vol. vi, p. 
342. 
Case 23. Operated on April 10, 1887, by Drs. Fisk and Morrill. 
Mrs. S., aged 23 years, married eight years ; no children. Noticed 
small swelling about four years ago, gradually increasing up to date. 
No trouble with menses till April, 1887, then had pain, color very 
pale. The large cyst was connected with left ovary. Right ovary 
inflamed and slightly enlarged. After preparing patient, operation 
was performed. Drs. Fisk, Morrill, Classen and Willard present. 
Straight incision from umbilicus to pubes, four inches in length. 
Some adhesions found. Three pints of fluid removed by aspirator. 
Another small cyst of broad ligament found and removed. The Abdominal Section. 
11 
pedicle was two inches broad and one and a half inch thick. Left 
ovary removed. Patient rallied nicely from operation. Died April 
21, from exhaustion. 
Case 24. Abdominal section for ovarian cyst. Operation Febru- 
ary 2, 1876, by Dr. W. E. Milbanks. Mrs. E. D., aged 61, married, 
native of the United States, and by occupation a housewife. Family 
history good, as far as learned. General health good, although suf- 
fering at time of operation severely from dysnoea and dyspepsia, due 
to distention. On February 2, 1876, abdomen was opened, at Home- 
opathic Hospital, and cyst with contents, weighing forty pounds, 
removed. Few adhesions. Pedicle treated by clamp. Drainage 
introduced and wound closed. Patient went on very well until 
morning of the third day, when abdomen became tympanitic and 
temperature rose to 102° F. Abdominal cavity was washed out and 
temperature fell to 100.50 F., but tympanites continued and consid- 
erable tenderness developed. Patient gradually sank and died on 
the fifth day. No autopsy. 12 
Albert Vander Veer. 
£ 
Name and 
Residence. 
Names of Operators 
and Medical 
Attendants. 
Date. 
* Married or 
Single. 
§0 
Time since 
first noticed. 
Disease. 
Operation. 
Remarks. 
I 
Mrs.W. J. P., 
Granby, Mass. 
Alden March. 
Dr. Munroe. 
Dec. io, '49 
49 M 
5 
3 ys 
18 lb. multilocular ovarian 
cyst. 
One ovary removed ; silk liga- 
ture, and brought out lower 
angle of womb * R. 
Trans, of N. Y. S. Med. 
Society, 1850. 
2 
Mrs. J. R., 
Monson,Mass. 
Alden March. 
Unknown. 
Mar. 7, '50 
39 M 
1 
Multilocular ovarian ; many 
adhesions. 
Exploratory incision ; sac tap- 
ped, fluid removed, then all 
closed.* 
Not reported. 
3 
Miss B., Had- 
ley, Mass. 
Alden March. 
Unknown. 
Oct. 21, '51 
26 S 
3 ys 
Soft fibroid. 
Incision closed; death in 42 
hours.* D. 
Not reported ; supposed ova- 
rian; trochar thrust in; free 
bleeding. 
4 
MissM. K., 
Troy, N. Y. 
Alden March. 
Unknown. 
Oct. 3, '57 
23 S 
4 
16m 
Multilocular ovarian ; many 
adhesions. 
Exploratory incision.* R. 
Not reported. 
5 
Miss R., Ger- 
mant'n, N. Y. 
Alden March. 
Unknown. 
June 17, '58 
.9 s 
5 ys 
Vascular uterine fibroid. 
Exploratory incision.+ D. 
Not reported. 
6 
Miss A., Mad- 
rid, N. Y. 
Alden March. 
Unknown. 
June 8, '67 
28 s 
2 ys 
Multilocular ovarian ; some 
anter. 
One ovary removed ; pedicle 
small tied and ligatures 
dropped.* D. 
Not reported ; died in 51 
hours. 
* Hospital. + Private house. 
R. recovered. D. died. 
TABLE I.-ABDOMINAL SECTION. Abdominal Section. 
13 
7 
Mrs. D. P.„ 
Smithfields, 
Mad.Co.,N.Y. 
Alden March. 
Unknown. 
April 18, '68 
M 
2 
I 
2 ys 
Multilocular ovarian ; few ad- 
hesions. 
Left ovary removed ; pedicle 
small, tied and ligatures 
dropped.* D. 
Not reported. 
*8 
9 
Mrs. E. P., 
Gloversville, 
N. Y. 
J. V. P. Quackenbush. 
Dr. Brach. 
Aug. 3, '69 
20 M 
28m 
Munro cystic ovarian tumor; 
few adhesions. 
Right ovary removed ; liga- 
tured pedicle and dropped.* 
R. 
Not reported. 
IO 
Mrs. M., Al- 
bany, N. Y. 
J. V. P. Quackenbush. 
Dr. Northrop. 
Nov. 23, '71 
30 
I 
Deformity pelvic ; 1st child. 
Csesarean section.* D. 
Med. Annals, Vol. Ill, p. 31. 
II 
Mrs. B. K„ E. 
Albany, N. Y. 
J. V. P. Quackenbush. 
Nov., '74 
35 M 
i yr 
Ovarian tumor; many adhe- 
sions. 
+ D. 
Not reported. 
12 
Miss M. A. E., 
Root, N. Y. 
E. R. Peaslee. 
N. L. Snow and 
Vander Veer. 
June 27, '71 
iS s 
2 
1 yr 
40 lbs. simple ovarian cyst; 
very few adhesions. 
One ovary removed ; silk liga- 
ture and dropped.* D. 
Died in 3 days ; peritonitis. 
13 
Miss B. O'R., 
Albany, N. Y. 
E. R. Peaslee. 
J. H. Arrnsby. 
Aug. 15, '71 
3S s 
20 lbs. multilocular. 
One ovary removed ; silk liga- 
ture and dropped.* D. 
Died in 4 days ; peritonitis. 
M 
Miss E. McE., 
Albany, N. Y. 
E. R. Pearslee. 
U. G. Bigelow. 
Aug. 21, '71 
32 s 
1 yr 
18 lbs. multilocular. 
One ovary removed ; silk liga- 
ture and dropped.* D. 
* Hospital. + Private house. 
R. recovered. D. died. 
Secondary hemorrhage from 
being in pedicle which had 
been twisted during opera- 
tion in. D. 18 hours. 
$ Dr. S. H. Freeman, of this city, tells me that Dr. W. F. Atlee, of Philadelphia, operated sometime in 1S50 in Montgomery srteet, and he was assisted by Dr. 
March ; that at the time the operation attracted great attention, both from the profession and the public. The patient, however, did not recover. 14 
Albert Vander Veer. 
1 
Name and 
Residence. 
Names of Operators 
and Medical 
Attendants. 
Date. 
A"-*?. 
Married or 
Single. 
£ 
8 
I Time since 
first noticed. 
Disease. 
Operation. 
Remarks. 
F 
16 
Miss M.McM. 
Albany, N. Y. 
Lewis Balch. 
J. M. Bigelow. 
Nov. 18, '76 
33 
S 
3 ys 
16 lbs. multilocular. 
One ovary removed ; clamp 
long pedicle.* R. 
Not reported. 
»7 
Tom Ballard, 
Albany Pen'ry 
Tom Ballard. 
Dr. Haskins. 
July 10, '78 
36 
M 
Suicidal incision, abdomen. 
Left media line 7 in. long. 
Penitentiary cell. R. 
Albany Med. Annals, Vol. 3, 
P- 327. 
18 
Miss A., Al- 
bany, N. Y. 
Leroy McLean. 
Oct. 7, '78 
24 
s 
5 ys 
Multilocular ovarian ; some ad- 
hesions. 
Median incision; one ovary, 
silk lig. to pedicle.+ D. 
Med. Record, Vol. 15, p. 126 
1872. 
19 
Mrs. B. S., 
Albany, N. Y. 
S. B. Ward. 
May 13, '80 
42 
M 
4 
2 ys 
Multilocular ovarian ; some ad- 
hesions. 
Exploratory incision.* D. 
Not reported ; died June 20, 
1880, from exhaustion. 
20 
Miss A. C., 
Albany, N. Y. 
Lawson Tait. 
Drs. Boyd and 
Vander Veer. 
Sept. 10, '84 
31 
S 
■4 y 
Solid ovarian tumor and uter- 
ine myoma. 
Hysterectomy ; Tait knot.* 
R. 
Albany Med. Annals, Vol.6 
p. 1. 
* Hospital. + Private house. 
R. recovered. D. died. 
TABLE I.-Continued. Abdominal Section, 
15 
21 
Miss B„ Al- 
bany, N. Y. 
Lawson Tait. 
Dr. Boyd. 
Sept, ti, '84 
33 
s 
19 y 
Cystic degeneration ovaries. 
Convulsion before menstrua- 
tion. 
Both ovaries removed ; Tait 
knot.* R. 
Albany Med. Annals, Vol. 6, 
p. 6. 
22 
Mrs. K. D., 
Columbia Co , 
N. Y. 
Franklin Townsend. 
Dr. Pruyn. 
Oct. 23, '84 
3i 
M 
♦ 
6 m 
Multilocular ovarian; adhe- 
sions right side. 
Both ovaries removed ; Tait 
knot.* R. 
Albany Med. Annals, Vol. 6, 
P- 342- 
a3 
Mrs. P., Al- 
bany, N. Y. 
S. Fisk & F. D. Morrill 
F. D. Morrill. 
April 10, '87 
23 
M 
4 ys 
Ovarian cyst, left ovary. 
Left ovary removed ; ligated 
pedicle and D. 
Not reported. 
24 
Mrs. E. D., 
Greenbush. 
S. Fisk & F. D. Morrill 
W. E. Milbanks. 
Feb. 26, '76 
61 
M 
7 ys 
Ovarian cyst. 
Removal cyst and ovary.* D 
Not reported. 
* Hospital. + Private house. 
R. recovered. D. died. 
$ Dr. S. H. Freeman informed me that Dr. Peaslee operated on a patient (at her home) of the late Dr. J. V. Lansing's in the fall of 1871, and that the 
patient recovered. 16 
Albert Vander Veer. 
About 1870 I began to give much thought to the subject of 
ovarian tumors and the best method of operating. In my 
post-mortem work, I had had an opportunity of doing the oper- 
ation three times upon women who had died of this disease. 
One was a case of dermoid cyst. One had been tapped a 
number of times, and presented many adhesions,which afforded 
me a source of much study later on. One other case gave me 
a chance to enucleate the tumor after Dr. Miner's method. 
In 1874 and 1875, I had the good fortune to see Sir Spencer 
Wells operate in a number of cases; also, through the great 
kindness of Mr. Knowlesly Thornton, I was granted the privi- 
lege of seeing the former, as well as his own cases under after 
treatment. I shall always remember the awe and care with 
which we used to enter the rooms of these patients after the 
operation at the Samaritan Hospital, and what a fight was 
being constantly made to keep down the high temperature of 
most of them. At the time of which I speak, Mr. Thornton 
was just beginning, and I can assure you, gentlemen, he was 
a greatly discouraged man. Some four or five of his first 
cases in succession proved fatal, and it required at one time a 
good deal of encouragement from Mr. Wells to induce him to 
go ahead. How great the contrast with his present splendid 
record. 
My first case for operation (excluding the ones turned over 
to Dr. Peaslee, and who had either been sent or came to me 
for operation) was now offered by my friend Dr. Beach, of 
Gloversville. It was the case of Mrs. H. S., aged 65, having 
a large tumor of several years' growth. I operated in a poor, 
forlorn, wooden house, with the worst possible surroundings. 
The tumor, when removed, weighed eighty-six pounds. The 
patient, we judged, not quite so much. 
Between this time, August 14, 1877, ar*d October, 1878, I 
did six operations under various favorable and unfavorable 
surroundings, all at private dwellings. 
Cases 2, 3 and 6 were like the first done at private houses 
and under very unfavorable conditions. In cases four and five Abdominal Section. 
17 
I did my utmost to carry out Listerism in such a way as to 
make success assured. 
Case 5, is, I believe now, the first death reported in this 
country from carbolic acid poisoning. 
Cases i, 3 and 6 were feeble women and exceedingly unfor- 
tunate subjects for operations. 
I had now done six sections, or rather complete operations 
without a success. I had practiced every method, and exer- 
cised every care known to me to bring success. Three of these 
cases were favorable for operation and it seemed to me ought 
to have recovered. 
Is it astonishing that I was greatly discouraged, and about 
determined to give up my abdominal work? My wife and 
friends tried to comfort and encourage me. My enemies were 
doing their best to destroy my reputation, not only in this line 
of work, but in my general surgical operations. These cases 
had been sent to me from various points throughout the state, 
and opportunities were being offered me which I hoped would 
prove successful. 
About this time, one of my patients, now living in New York, 
consulted me regarding her mother, a resident of Albany, whom 
I was treating for ovarian tumor. I told her that, in view of 
the weak condition and feeble family history of the patient I 
did not think the case a good one for an operation. She con- 
cluded to take her mother to New Yo.ik, and Dr. J. Marion 
Sims thought best to operate, and the patient recovered. I 
must say frankly that my surgical pride was greatly touched 
in the good result following Dr. Sims' skill. 
Soon after this, cases seven and eight, both of them wretched 
ones for operation, came under my care. One of them had 
been refused by Dr. T. G. Thomas, when presented for opera- 
tion. Surgical ambition and friends advised me to try again. 
I did so, and they both died, and would, I am sure, under any 
method of treatment, at the present time. 
New cases were sent me, notwithstanding my wretched fail- 
ures. I temporized with some, tapping in only one instance, 18 
Albert Vander Veer. 
although I well remember that both Mr. Wells and Dr. Peaslee 
at this time advised one tapping to clear very thoroughly the 
diagnosis, and then, you all remember how much effort was 
made by examination of fluid obtained, to tell the nature of 
the growth, etc., etc. Some cases were sent to other opera- 
tors, but I was not happy. My friends failed not in offering 
consolation. My patients were not unwilling at any time to 
trust to my skill. Each of my patients had lived long enough 
to give me great hope of their recovery. What was I to do ? 
I had read carefully the results of many others in this field 
of surgery, and from all that I could glean, J was impressed 
that the most advanced and successful worker was Mr. Lawson 
Tait, of Birmingham, and thither I went in the spring of 1884. 
The first results of that trip I embodied in a short paper enti- 
tled, " Some Personal Observations on the work of Mr. Law- 
son Tait, F. R. C. S.," read before the Medical Society of the 
State of New York, February, 1884, and published in the 
American Journal of Obstetrics, Vol. XVIII, No. 7, 1885. 
As I studied Mr. Tait's method, I gained impressions, and 
learned points, for which I must say I am profoundly grateful. 
Nor does increase of years, or the study of other men's ways 
and works, change my views. Mr. Tait's fearless way of operat- 
ing imparts confidence to any looker on. Then too, his frank 
manner of conversing relative to the patients he has on hand 
and under your own observation gives one great instruction. 
Then let me say candidly that I never have seen any opera 
tor perform the toilet of the peritoneum so carefully as he. 
Though he works rapidly, yet, he never forgets or neglects any- 
thing. I have yet failed to see any manner of securing the 
pedicle equal to his Staffordshire knot. Then, who does more 
thoroughly the washing of the peritoneal cavity, when required, 
than he. The simplicity of his way of making and completing 
an abdominal section charmed me from the beginning to the 
end. I returned to my field of work determined to try again 
in the direction in which my ambition led. 
I had then prepared in the Albany Hospital two rooms, as 
previously described*, and on October 14, 1884, did my first 
successful case of ovariotomy. 
* Ibid. Abdominal Section. 
19 
Table No. i, comprises all the operations clone by other 
operators than myself, since the first operation, December io, 
1849, UP to April 10, 1887. I am quite positive that the list 
is complete and correct. In this table there have been of com- 
plete ovariotomies 17, with ten deaths and seven recoveries; 
exploratory incisions (the latter including Dr. Quackenbush's 
case of Caesarean section, and Tom Ballard's suicidal section), 
with three deaths and three recoveries, and one case doubtful 
as to the result. 
In connection with this table, the study of the report in full 
of the cases is worthy of consideration. 
In table No. 2, I have tabulated all my own cases. It will 
be observed that there have been 26 ovariotomies, with nine 
deaths and seventeen recoveries. Removal of uterine appen- 
dages, 8 cases, seven recoveries and one death. Exploratory 
incisions, 17, with eight deaths and nine recoveries. 
It will be observed that my fearfully unfortunate cases in 
the beginning of my work has told sadly against my percent- 
age as a whole. Yet of my last eighteen cases of ovarian cysts 
there have been seventeen recoveries and one death, and that 
complicated with cancer. 20 
Albert Vander Veer. 
4 
Name and 
Residence. 
Medical Attendant. 
Date. 
Married or 
s' 
£ 
e 
| Time since 
first noticed. 
Disease. 
Operation. 
Remarks. 
I 
Mrs. H. S., 
Gloversville. 
N. Y. 
Dr. Beach. 
Aug. 14, '77 
65 
M 
6 
3 ys 
Large multilocular ovarian 
cyst, 86 lbs.; few adhesions. 
One ovary removed ; silk liga- 
ture to pedicle and dropped. 
+ D. 
Not reported. 
2 
Mrs. V. K. F., 
Albany, N. Y. 
Dr. Perry. 
Nov. 4, '77 
*9 
M 
9 m 
Multilocular ovarian, 18 lbs. ; 
few adhesions. 
Right ovary removed; silk liga- 
ture after Peaslee.+ D. 
Not reported. 
3 
Mrs. E. L., 
Albany, N. Y. 
Dr. Murray. 
Nov. 15, '77 
- 
M 
I 
18m 
Multilocular ovarian, 40 lbs. ; 
very many adhesions. 
One ovary removed ; silk liga- 
ture and dropped; pedicle 
very short.f D. 
Not repotted. 
4 
Miss B., Chat- 
ham Center. 
N. Y. 
Dr. Collier. 
Nov. 27, '77 
22 
S 
1 y 
Multilocular ovarian cyst, 20 
lbs. 
One ovary removed; silk liga- 
ture and dropped ; pedicle 
very short.+ D. 
Died on 19th day from small 
abscess in lungs. 
5 
Mrs. G. B. E., 
Binghamton, 
N. Y. 
Dr. Griffin. 
Aug. 20, '78 
26 
M 
2 
3 
yrs 
Multilocular, 41 lbs. 
One ovary removed ; Well's 
clamp + D. 
Reported Hospital Gazette, 
Vol. 6, 1879, p. 371. 
6 
Mrs. B. K„ 
Sullivan Co., 
N. Y. 
Dr Winters. 
Oct., '78 
43 
M 
3 
2 
3 ys 
Multilocular ovarian, 36 lbs. ; 
estimated few adhesions. 
One ovary removed ; Well's 
clamp.+ D. 
Not reported. 
• 
7 
Miss S. R. M., 
Cobleskill, 
N. Y 
Dr. Myers. 
May 26, '80 
20 
S 
5 
2 ys 
Multilocular ovarian, 40 lbs.; 
many adhesions 
Right ovary; silk ligature after 
Peaslee.* D. 
Not reported. 
TABLE IL-ABDOMINAL SECTION. Abdominal Section. 
21 
8 
Mrs. M. J. S.„ 
Kingston, 
N. Y. 
Drs. Schoonmaker and 
Smith. 
Aug. 
6, '83 
45 
M 
7 
I 
4 ys 
Large multilocular, 58 lbs.; ad- 
hesions very many and firm 
in cavity of pelvis. 
Silk ligature after Peaslee and 
clamp.* D. 
Not reported. 
9 
Mrs. A. W., 
Worcester, 
N. Y. 
Dr. Vander Veer. 
Oct. 
'84 
32 
M 
I 
I 
3% 
ys 
Unilocular ovarian cyst, 36 lbs. 
Both ovaries removed ; Tait 
knot.* R. 
Reported Am. 
No. 7, 1885. 
Jour. Obs. 
IO 
Mrs. E. J„ 
Whitehall. 
N. Y. 
Dr. Holcomb. 
Nov. 
6, '84 
62 
M 
I 
1 yr 
Unilocular ovarian cyst, 25 lbs. 
Both ovaries removed ; Tait 
knot.* R. 
Do. 
Do. 
11 
Mrs. C. A., 
Slingerlands, 
N. Y. 
Dr. D. C. Case. 
Nov. 
21, '84 
34 
M 
4 yr 
Double Hydro-Salpinx. 
Both ovaries removed and ap- 
pendages ; Tait knot. 
Do. 
Do. 
12 
Miss J. H., 
West Troy, 
N. Y. 
Dr. Van Vranken. 
Nov. 
28, '84 
56 
S 
12 y 
Uterine fibroid ; severe hem- 
orrhage. 
Unsuccessful attempt to re- 
move appendages.* R. 
Do. 
Do. 
*3 
Mrs. J. G. R., 
Albany, N. Y. 
Dr. Vander Veer. 
Jan. 
8, '85 
43 
S 
3 
10 y 
Severe hemorrhage and ova- 
rian pain. 
Unsuccessful attempt to re- 
move appendages t D. 
Do. 
Do. 
14 
Miss M. F„ 
Ballston, N.Y. 
Dr. J. DeZouche. 
April 
2, '85 
5° 
S 
7 ys 
Multilocular ovarian cyst. 41 
lbs. 
Both ovaries removed ; Tait 
knot.* R. 
Not reported. 
15 
Mrs. J. L., 
Schenectady, 
N. Y. 
Drs. Hull and Faust. 
April 
3, '85 
48 
M 
5 
21 in 
Unilocular ovarian cyst, 29 lbs. 
Both ovaries removed; Tait 
knot.* R. 
Not reported. 
16 
Miss E. C , 
Albany, N. Y. 
Dr. Freeman. 
April 
21, '85 
45 
S 
1 yr 
Unilocular ovarian cyst with 
disease, 15 lbs. 
Both ovaries removed ; Tait 
knot.* D. 
Not reported. 
* Hospital. + Private house. 
R. recovered. D. died. 22 
Albert Vander Veer. 
i 
Name and 
Residence. 
Medical Attendant. 
Date. 
A/W. 
Married or 
Single. 
R 
3 
4 
I Time since 
first noticed. 
Disease. 
Operation. 
Remarks. 
17 
Mrs. M. H., 
Binghamton, 
N. Y. 
Dr. Booth. 
June 11, '85 
33 
M 
3 ys 
Soft ovarian cyst; severe hem- 
orrhage . 
Unsuccessful attempt to re- 
move appendages * D. 
Not reported. 
18 
Miss B. C., 
Knox, N. Y. 
Dr. Vander Veer. 
Sept. 21, '85 
28 
S 
14 y 
Cyst left broad ligaments. 
Removed right ovary and tube; 
Tait knot.* R. 
Not 1 eported ; death fron 
peritonitis on fifth day. 
J9 
Mrs. E. L., 
Watervliet, 
N. Y. 
Dr. Lothridge. 
Feb. 19, '86 
3° 
M 
3 
1 yr 
Unilocular ovarian cyst; 27 lbs. 
Both ovaries removed ; Tait 
knot.* R. 
Not reported. 
20 
Miss E. C., 
Albany, N. Y. 
Dr. Boyd. 
Mar. 25, '86 
26 
S 
nm 
Unilocular ovarian cyst; 17 lbs. 
Both ovaries removed.* R. 
Not reported. 
21 
Mrs. J., 
Worcester, 
N. Y. 
• 
Dr. Leonard. 
May 17, *86 
47 
M 
5 l» 
Multilocular ovarian cyst, 20 
lbs. 
One ovary, right, removed.* 
R. 
Not reported. 
22 
Miss H. L. C., 
Hudson, N.Y. 
May 26, '86 
27 
S 
3 ys 
Simple ovarian cyst, 23 lbs. 
One ovary, right, removed * 
R. 
Not reported. 
23 
Miss M. B., 
Albany, N. Y. 
Dr. LaMoure. 
May, '86. 
24 
S 
10 y 
Dysmenorrhea with epileptic 
convulsions. 
Both ovaries and appendages 
removed ; Tait knot.* R. 
Reported in Am. Jour. Obs. 
May, 1887. 
TABLE II.-Continued. Abdominal Section. 
23 
24 
Mrs. B. T., 
Chesterville, 
N. Y. 
Dr. Mallery. 
Oct. 
1, '86 
42 
M 
8 ys 
Fibrocystic tumor uterus. 
Hysterectomy; tumor large; 
Tait clamp.* D. 
Not reported. 
*1 
Miss M. C., 
Rensselaerv'e, 
N. Y. 
Dr. Lanehart. 
Oct. 
6, '86 
19 
s 
5 ys 
Dysmenorrhea and epilepsy. 
Uterine appendages ; Tait 
knot.* R. 
Reported in Am. Jour. Obs 
May, 1887. 
26 
Mrs.A.M.G., 
Albany, N. Y 
Dr. Vander Veer. 
Oct. 
13, '86 
62 
M 
9 
9 in 
Unilocular, 37 lbs. 
Right ovary ; Tait knot.* R. 
Not reported. 
27 
Mrs. S. M., 
Comstock, 
N. Y. 
Dr. Vander Veer. 
Oct. 
21, '86 
26 
M 
2 
1 yr 
Unilocular, 13 lbs. 
Both ovaries ; Tait knot.* R. 
Not reported. 
28 
Miss M. O'C., 
E. Albany, 
N. Y. 
Dr. Vander Veer. 
Oct. 
28, '86 
42 
S 
5 ys 
Fibroma from left hornuterus. 
Removed ; pedicle secured by 
ligature and dropped.* D. 
Many and strong adhesions 
to small intestines. 
29 
Miss E. R., 
Schenectady, 
N. Y. 
Drs. Fuller and 
Ellwood. 
Nov. 
18, '86 
18 
s 
7 m 
Tuberculosis of peritoneum. 
Exploratory incision.* R. 
Not reported ; cure. 
30 
Miss K. S„ 
Gloversville, 
N. Y 
Dr. Beach. 
Jan. 
13, '86 
33 
s 
18 y 
Hystero-epilepsy, dislocation 
and pain in left ovary; cystic 
degeneration. 
Removal appendages, both 
sides; Tait knot.* R. 
Reported Am. Jour. Obst. 
May, 1887. 
3» 
Mrs. E. R., 
Pittsfield, 
Mass. 
Dr. Winship. 
Jan. 
20, '87 
49 
M 
2 ys 
Supposed either ovarian or fibro 
cystic ; was solid tumor right 
ovary. 
Enucleation ; many ligatures 
to vessels.* D. 
Not reported. 
* Hospital. + Private house. 
R. recovered. D. died. 24 
Albert Vander Veer. 
| No. 
Name and 
Residence. 
Medical Attendant. 
Date. 
X/ir. 
Married or 
Single. 
| No. of Children. 
| No. Tappings. 
I Time since 
| first noticed. 
Disease. 
Operation, 
Remarks. 
32 
Miss A. P., 
Argyle, N.Y. 
Dr. Still. 
Feb. 4, '87 
35 
S 
9 ys 
Bleeding fibroid. 
Unsuccessful attempt to re- 
move appendages.* R. 
Reported in Am. Jour. Obs. 
May, 1887. Patient im- 
proved. 
33 
Mrs. M. K., 
W. St'kbridge 
Mass. 
Dr. Race. 
Feb. 10, '87 
7° 
M 
6 
3 
16m 
Multilocular, 42 lbs. 
Removed both ovaries; Tait 
knot.+ R. 
Not reported. 
34 
Mrs. M. D., 
Albany, N. Y. 
Dr. Milbank. 
Feb. 11, '87 
54 
M 
.4 ys 
Fibroma with multilocular ova- 
rian cyst. 
Exploratory incision ; sac fast- 
ened to incision and drained.+ 
R. 
Not reported; patient died in 
five weeks from symptoms 
meningitis. 
35 
Miss M. L., 
Albany, N. Y. 
Dr. Vander Veer. 
Feb. 17, '87 
IO 
S 
8 m 
Tuberculosis peritoneum. 
Exploratory incision.* R. 
Not reported; patient died 
later ; tubercular pneumo 
nia. 
36 
Mrs. A. B., 
Albany, N. Y. 
Dr. Vander Veer. 
Feb. 25, '87 
33 
M 
I 
18m 
Double salpingo-oophoritis. 
Removed left ovary and tube ; 
Tait knot.* R. 
Not reported ; right ovarj 
so adherent could not re 
move. 
37 
Mrs. S. J., 
Albany, N. Y. 
Dr. Bigelow. 
Mar. ii, '87 
33 
M 
3 
5 ys 
Multilocular ovarian cyst, 12 
lbs. 
One ovary ; Tait knot.* R. 
Not reported. 
38 
Miss D. D., 
Albany, N. Y. 
Drs. Boyd, Lewis and 
Vander Veer. 
Mar. 15, '87 
38 
S 
3 ys 
Fibroma and peritoneal dropsy. 
Exploratory incision.* R. 
Not reported. 
TABLE IL-Continued. Abdominal Section. 
25 
39 
Miss M., 
Albany, N, Y. 
Dr. Bigelow. 
Apr. ai, '87 
25 S 
9 in 
Unilocular cyst, 13 lbs. 
Both ovaries removed ; Tait 
knot.* R. 
Not reported ; Sinus from in- 
cision. 
4° 
Mrs. M.C. H., 
Albany, N.Y. 
Dr. Vander Veer. 
Apr. 28, '87 
47 M 
2 
22 m 
Unilocular cyst, 20 lbs.; some 
adhesions. 
Right ovary removed ; Tait 
knot.* R. 
Not reported. 
41 
Miss L. H., 
Cobleskill. 
Dr. L. Cross. 
Sep. 17, '87 
42 M 
4 
2 m 
Multilocular ovarian cyst, 35 
lbs. 
Removal cyst and ovary.* R. 
Adhesions slight ; not re- 
ported. 
42 
Mrs. J. W. 
Dr Whitcomb, 
Greenwich, N.Y. 
Sep. 19, '87 
55 S 
2 ys 
Ovarian cyst, 15 lbs. 
Removal cyst and ovary.* R. 
No adhesions ; not reported. 
43 
Miss B. D. B., 
Ballston, N.Y. 
Dr. Lawrence. 
Ballston, N.Y. 
Oct. 3, '87 
20 S 
5 ys 
Renal cyst. 
Removal right kidney and cyst 
* R. 
Reported N. Y. Med. Jour- 
nal. 
44 
Mrs. F. O., 
Kishaton,N.Y 
Dr. Seldon, 
Catskill, N. Y. 
Oct. 7, '87 
40 M 
2 
4 ys 
Suppurating ovarian cyst. 
Sac adherent, tapped and sac 
stitched to abdominal wall.* 
R. 
Not reported elsewhere. 
45 
Miss E. C. W. 
Rensselaerv'e, 
N. Y. 
Dr. Mueller. 
Oct. 10, '87 
34 M 
4 m 
Two fibrous and soft myxoma ? 
Exploratory; nothing done.* R 
Not reported. 
46 
Miss F. E. H. 
Ballston, 
Oct. 17, '87 
46 S 
12 y 
Chronic intestinal obstruction. 
Exploratory; relieved constrict 
ing bands.* R. 
Not reported. 
47 
Miss L. J. I.., 
Schenectady, 
N. Y. 
Dr. Pierson. 
Oct. 28, '87 
45 S 
6 ys 
Uterine fibroid. 
Tubes and ovaries removed.* 
R. 
* Hospital. + Private house. 
R. recovered. D. died. 
Not reported elsewhere. 26 
Albert Vander Veer. 
•< 
Name and 
Residence. 
Medical A ttendant. 
Date. 
Married or 
Single. 
5 
8 
1 
1 Time since 
| first noticed. 
Disease. 
Operation. 
Remarks. 
48 
Mrs. D. R. 
Dr. Bassett. 
Oct. 31, '87 
38 M 
I 
4 ys 
Colloid cancer of ovary. 
Growth removed.* D. 
Death third day from ex- 
haustion and peritonitis. 
49 
Mrs. M. J. O. 
Dr. E. Elwood. 
Nov. 13, '87 
40 M 
I 
8 ys 
Uterine fibroid. 
Removal of tubes and ovaries.* 
D. 
Death on third day from pe- 
ritonitis. 
5° 
Mrs. M. R., 
Fair Haven, 
N. Y. 
Dr. J. H. Reilly. 
Nov. 15, '87 
35 M 
2 
5 ys 
Hemato-salpingitis. 
Both tubes and ovaries re- 
moved.* R. 
Not reported. 
51 
Mr. S. V. V., 
Amsterdam, 
N. Y. 
Dr. E. T. Rulison. 
Dec. 2, '87 
22 S 
6 ds 
Acute intestinal obstruction. 
Removal of Meckel's diverticu- 
lum; division of bands.* D. 
* Hospital. + Private house. 
R. recovered. D. died. 
Death from heart-failure on 
the third day. 
TABLE II.-Continued. Abdominal Section. 
27 
Of the cases tabulated in table No. 2, the following have 
been selected as having some unusual and interesting features : 
Case 24. Mrs. B. T., get. 42, married ; admitted to Albany Hospi- 
tal Sept. 16, 1886. Married 22 years. Became pregnant 17 years 
ago, but aborted. Has never been pregnant since. She has men- 
struated once in three weeks ; used to be attended with a good deal 
of pain before menstruation and for several days after. Eight years 
ago noted the appearance of a tumor or lump in the right ovarian 
region. There used to be an almost constant pain and soreness on 
that side. Would get up feeling well in the morning but during 
afternoon would suffer so much as to be obliged to lie down. As 
tumor increased in size she noticed pain was less severe. Tumor 
had of late increased in size very rapidly and oppressed her very 
much, causing difficulty in respiration. At times appetite was very 
poor ; she was otherwise healthy and of a cheerful, hopeful disposi- 
tion. Diagnosis, fibro-cystic tumor of uterus. Operation hysterec- 
tomy, done 12 M., Oct. 1, was over two hours duration owing to the 
great number of adhesions and hemorrhage ; Tait clamp used ; 
glass drainage tube. She recovered very well and was cheerful, but 
gradually sank and died at the end of 48 hours. Had this patient 
been operated on early, she would certainly have recovered with her 
splendid courage. 
Case 29. Miss E. B., aet. 18, admitted to Albany Hospital Nov. 17, 
1886 ; discharged Dec. 1,1886, improved. Patient says that she has 
always been healthy until last April, when she noticed an enlarge- 
ment of the abdomen. She had some pain in back of dull heavy 
character. Lost appetite, but her bowels were regular ; no trouble 
passing urine. She menstruated at 14 years of age and has been 
regular ever since, except one time last summer, when she went two 
months over her time. Last two periods have been regular. Tumor 
seemed to enlarge for a time and then diminish, but for the last two 
months enlarged very rapidly. Abdominal section was performed 
Nov. 18, 1886. The abdominal cavity was completely fdled with an 
ascitic fluid and a tuberculous growth of left ovary discovered ; the 
omentum and peritoneum are covered with tubercular points or 
cones. Her mother died of phthisis while the patient was in the 
hospital. After exploration, incision was closed and patient recov- 
ered rapidly. She was not told as to a tumor having been removed 
until six months after, when she was greatly surprised. There was 28 
Albert Vander Veer. 
no return of the dropsy and she has continued in excellent health in 
every respect. 
Case 33. Abdominal section at West Stockbridge Centre, Mass., 
Feb. 10. 1887. Mrs. M. K., set. 70, always healthy, mother of six 
children. Passed menopause normally. Began to enlarge 16 months 
ago. Had peritonitis a year ago. 
Tapped Sept 30, 1886, 36 lbs. fluid. 
" Dec, 10, " 40 " 
" Feb. 1, 1887, 22 " 
Operation " 10, " 40 " 
It was a cyst of the broad ligament of the left side, and append- 
ages of that side were removed with it. Appendages of the right 
side also removed ; slight cystic degeneration. Extensive, adhe- 
sions and very vascular. Paquelian cautery used on several points. 
Many were ligatured, but oozing was from so extensive a surface 
that abdominal walls were brought together in median line overlap- 
ping each other, and kept there by pads. Incision closed with nine 
deep sutures and three superficial ones. Rallied well from opera- 
tion ; highest temperature 101.40 on evening of second day ; com- 
batted with aconite and opium mixture, and ice to nape of neck, and 
ice cloths to forehead ; considerable nausea, but no serious vomiting, 
for which morphine, ice, soda and sinapism were used. Liberation 
of gas always lessened or relieved nausea ; small hypodermics given 
as indicated. Passed catheter twice, after which patient empted 
bladder for two days, and was drawn again for the following three 
days. Gave enema 26 hours after operation, and gas liberated, 
much to the relief of patient. Gave enema through rectal tube the 
evening of the second day, and repeated at times, and though passed 
higher up and enema retained for hours, nothing but a trace of feces 
followed. On fifth day (to allay a threatened vomiting) gave one- 
fourth grain podophylin and one-tenth grain calomel, and repeated 
every six hours until five doses were given, when bowels indicated 
activity, and moved on the sixth day. Nausea was completely re- 
lieved, sutures removed on fourth, fifth and sixth days. A little dis- 
charge from incision, but iodoform dressing used, and union took 
place. On second day commenced the use of quinine as a tonic, and 
gave pepsin with diet. Gave hot water, iced milk, milk punch, 
gruel, cracker and hot tea, beef tea, oyster broth and toast. Patient 
made a good recovery. Has since gone out visiting her friends, 
some of whom live six and seven miles from her home. Operation Abdominal Section. 
29 
was done at patient's house after room had been prepared with 
great care by Dr. C. H. Race, her family physician. 
Case 38. Exploratory abdominal section. Uterine fibroid. Oper- 
ation March 15, 1887. Miss D. D., set. 36, single, native of the 
United States and by occupation a merchant. Family history good. 
Three years ago noticed growth in the abdomen, which continued 
to increase until time of operation. Abdominal incision showed a 
uterine fibroid, size of a child's head, adherent to viscera and abdo- 
minal parietes. The incision was carried above fibroid, and fifty- 
two pounds of ascitic fluid drawn off. Wound closed without 
removal of fibroid. Patient recovered from exploration, but abdo- 
men has refilled with fluid many times, and she has been tapped 
about every two weeks since. 
January 19, 1888, I inserted a silver drainage tube for permanent 
drainage. 
Case 44. Abdominal section for suppurating ovarian cyst. Oper- 
ation Oct. 7, 1887. Mrs. F. O., set. 40, married, native of the United 
States, and by occupation a housewife. Family history good. Patient 
has had several attacks of pneumonia, and typhoid fever once. 
First menstruation at thirteen, last in March, 1887. Mother of two 
children ; both labors uncomplicated. Four years ago tumor first 
discovered, then the size of a child's head, and located on left side. 
It grew slowly until last June (1887), since which it has increased 
very rapidly. Patient's bladder very irritable ; has rapidly lost flesh 
and strength. Abdomen very much distended by fluctuating tumor. 
Hard bodies could be felt upon vaginal examination in the cul de- 
sac of Douglas. 
Operation done in general operating room of hospital, class of 
Albany Medical College present. Cyst exposed, found adherent 
but tapped. The fluid (15 pints) was found to be very offensive pus. 
This patient had never been tapped. The cyst walls were so adhe- 
rent to the viscera that enucleation was not attempted. The open- 
ing into the sack was stitched to the abdominal wound by continuous 
suture. In closing abdominal wound opening to sac was lost. How- 
ever, rubber drainage was introduced in superficial wound. Reaction 
came on very slowly, but after second day patient did well. Tem- 
perature never rose above 99.50 F. No pus drained from wound. 
Cyst slowly refilled and was aspirated Nov. 9, 1887, removing a pint 
of pus. Patient left hospital the next day and, although knowing 
her condition, was full of hope, had good appetite and had gained 30 
Albert Vander Veer. 
considerable strength. Saw her attending physician, Dr. Seldon, of 
Catskill, Jan. 23, 1887. He states that he has twice tapped patient 
during last month, removing in all twenty pints of pus. Incision 
and permanent drainage, together with washingout, has been urged, 
but the patient is so unfavorably situated that the suggestion has 
not been carried out. 
Case 45. Exploratory abdominal section. Two fibroids and a 
supposed soft myoma. Operation Oct. 11, 1887. Mrs. E. C. W., 
set. 34, married, native of the United States, and by occupation a 
housewife. Family history is decidedly tubercular. Patient never 
has been strong. First menstruation at thirteen, scanty and painful. 
Has suffered from amenorrhea since, at times. No children, no mis- 
carriages. Was treated in 1883 for ulcers of cervix. June 5, 1887, 
was the date for the return of her menstruation, but no flow appeared. 
On June 25, 1887, patient noticed a tumor in left iliac region. It 
has grown rapidly since. On the morning of July 7, patient noticed 
a slight show. Breasts have become large and tender, areola pig- 
mented. I gave the patient a very careful examination at my office, 
and was in much doubt as to her condition, taking into full consid- 
eration the probability of a normal or extra-uterine pregnancy ; also 
of fibroid or fibro-cystic tumor. 
Upon consultation and examination by Drs. Boyd, Townsend and 
myself, per vaginam, a natural cervix could be felt high up and a 
mass at the left side of the uterus distinctly made out. A sound 
was introduced and uterus apparently found three inches long. 
Upon abdominal palpation a hard tumor was found on the left side 
and a softer one (semi-fluctuant) on the right side. No absolute 
signs of pregnancy could be obtained. An exploration was decided 
upon after proper explanation of case to patient, her husband and 
friends, extra-uterine pregnancy being strongly suspected. 
Abdominal incision revealed two very dense fibroids upon the left 
of the uterus sub-peritoneal in character and the remainder of the 
uterine tissue, especially upon the right side, seemed involved in a 
soft myoma. Adhesions were very general. No further operation 
being advisable, abdomen was closed. 
Patient went on well till fifth day, when some localized peritonitis 
developed and rapidly became general. On evening of sixth day 
abdominal wound opened in consequence of great distention of 
bowels, due in part to peritonitis and obstructive pressure of fibroids. 
A large dressing was saturated with serous effusion. Wound was Abdominal Section. 
31 
brought together by strapping. Next morning drainage was intro- 
duced. Peritonitis subsided in a day or two, and case went on to 
recovery. Discharged from hospital Nov. 8, 1887. Abdominal 
wound completely healed. November 13, I visited her at a friend's 
home on Madison avenue, and found her presenting a very good 
condition of health. Able to move about house and cheerful. 
Advised the use of electricity, and requested her to let us know 
later on how she progressed. 
December 24, Dr. H. F. C. Mueller, of Rensselaerville, visited me, 
and stated that he had been called to attend Mrs. W. a few days pre- 
vious. Arriving at her house he found her partially delivered of a 
six months' foetus. The doctor delivered the placenta. Noticed 
quite an enlargement of the abdomen remaining. He also stated that 
she was then (December 24) doing well. 
Case 46. Exploratory abdominal section. Stricture of descend- 
ing colon. Operation October 17, 1887. Miss F. E. H., aged 46, 
single, native of United States, and by occupation a dressmaker. 
Family history good. When fifteen years old had severe attack of 
dysentery, following later by general peritonitis, since which she has 
suffered, more or less, from abdominal pain and difficult defecation. 
For last twelve years has only been able to secure movement of 
bowels by use of very large enefnata. The stools were not formed 
and contained much mucus and blood. Upon physical examination 
a tumor could be found about the size of an apple just above Pou- 
part's ligament on the left side. The uterus seemed free from 
growth. No stricture of rectum could be found. The abdomen 
was opened, and what appeared to be the tumor was found to be a 
dilated portion of the descending colon bound down to the iliac fossa 
by adhesive bands. These bands were loosened up and colon re- 
leased. Where the constricting bands had been thrown across the 
colon there was considerable narrowing of the lumen of the bowels, 
due to cicatrical tissue. It was decided to do neither a colotomy 
nor a resection at this time, and the wound was closed. Patient 
recovered from operation nicely, and November 5, 1887, went back 
to private room under care of general nurse. 
The obstruction to bowels was very greatly relieved. Patient now 
passes well formed motions with little discomfort and without use of 
laxatives or enemata. 
Case 47. Abdominal section. Removal of tubes and ovaries for 
relief of uterine fibroid. Operation October 28, 1887. Recovery. 32 
Albert Vander Veer. 
Miss S. J. S., aged 45, colored, single, native of the United States 
and by occupation a cook. Patient was of the tubercular diathesis; 
a sister has a uterine fibroid. Previous health good. Menstruation 
normal until beginning of present trouble, six years ago. At that 
time a diagnosis of fibroid was made and she was treated by ergot 
subcutaneously with considerable improvement. During spring of 
1887 hemorrhage returned with great violence, being practically con- 
tinuous. She was confined to her bed nearly all the time. Elec- 
tricity externally-and per vaginam was faithfully tried without bene- 
fit. The usual medicinal treatment was also tried without palliation 
of trouble. 
Finally, the removal of tubes and ovaries, or a hysterectomy, was 
determined upon. Abdominal incision was made; tumor, which was 
very large and adherent, had no pedicle that could be reached. 
Tubes and ovaries were removed, ligated by Tait knot. Consider- 
able trouble was experienced in closing the wound on account of 
very thick and fat abdominal walls. Two rows of sutures were intro- 
duced. She flowed for forty-eight hours after operation quite 
severely ; there has been no return since. 
The abdominal wounds gave a great deal of trouble, the borders 
sloughing freely, multiple abscesses formed about stitch-holes, con- 
valescence was very protracted, but she finally left hospital January 
18, 1888, feeling well and with none of her old symptoms. Tumor 
has apparently shrunken some already. 
Case 48. Exploratory abdominal section. Carcinoma colloid. 
Operation October 31, 1887. Mrs. D. R, aged 58, married, native 
of the United States, and by occupation a housewife. Patient's 
mother died of cancer ; a sister from phthisis. She has never been 
strong; had one child ; one miscarriage. Menstruation dysmenor- 
rheal; first at 16, menopause at 47. 
Over four years ago was told by her family physician that she had 
an ovarian cyst. I saw case two years ago and then could make out 
a well defined growth of right ovary which was regarded by me at 
that time as cancerous. It continued to grow slowly until two 
months prior to operation, since which it has increased rapidly. 
Has suffered much from abdominal pain of late, together with 
nausea. 
The abdomen was filled with large, apparently fluctuating tumors, 
irregular in shape, abdomen had dome-like appearance, upon per- Abdominal Section. 
33 
cussion general dulness save in the lumbar region. A diagnosis of 
probable ovarian cyst was made. 
Abdomen was opened, short incision, and as peritoneum was 
incised a yellow gelatinous material oozed out. Incision rapidly 
enlarged and ten pints of same material removed together with a 
considerable mass which was ligated and removed. Abdomen was 
flushed with warm water by syphon. Wound closed. Drainage - 
glass tube-introduced. 
Patient reacted slowly, but became entirely conscious. She exhib- 
ited no courage after operation. On second day signs of peritonitis 
developed, and patient gradually sank, and died the third day after 
operation. 
Autopsy held eight hours later. Peritoneum congested and cov- 
ered with lymph. Nearly a quart of fluid in pelvis together with 
fragments of growth. Liver, stomach and kidney normal. No fur- 
ther examination made. 
Case 50. Abdominal section for removal of tubes and ovaries in 
hzemato-salpinx. Operation November 15, 1887. Mrs. M. R., aged 
35, married, native of England, and by occupation a housewife. 
Patient has the tubercular diathesis. Family history otherwise good. 
Previous health good. Menstruation normal until beginning of pres- 
ent illness. Mother of two children. One miscarriage five years 
ago, from which illness dates. After miscarriage suffered from fever, 
severe pelvic pain, menorrhagia, metrorrhagia, and has been bedrid- 
den. Was operated upon at Woman's Hospital, New York, three 
years ago, by Dr. Thomas for lacerated cervix. Condition improved. 
Menorrhagia and metrorrhagia again returned. Now flows severely 
at irregular intervals. At times, previous to an attack, a tumor may 
be felt just over Poupart's ligament. This disappears after hemor- 
rhage. 
When patient entered hospital, a few days before operation, the 
tumor could be felt. The next day patient began to flow severely, 
great pain resembling uterine colic. As flowing continued tumor 
disappeared. Per vaginam the dilated tubes could be felt. 
Abdomen was opened, short incision, somewhat adherent, tubes 
and ovaries removed. Tubes dilated. Patient made an uninter- 
rupted recovery. There was slight show for a day during third 
week after operation. 34 
Albert Vander Veer. 
CONCLUSIONS.-To one who has watched and studied care- 
fully the different methods suggested for performing ovario- 
tomy, there comes the thought of gratitude in knowing that 
so much progress has been made within a comparatively few 
years. Much that was rubbish has been rejected, and we stand 
to-day as surgeons doing this operation on the best of all 
ground, surgical simplicity. If you ask me, to whom are we 
indebted the most for this, I say, very earnestly, Mr. Lawson 
Tait. First, in the proper preparation of sponges, and cleanli- 
ness in the care of instruments ; secondly, in the quiet of a 
well-regulated private hospital, with intelligent and correctly 
trained nurses. 
That abdominal section will at times, of necessity, have to 
be performed at the house of the patient, and without proper 
surroundings, cannot be denied, but in such instances the spray 
of carbolic acid should not be entirely ignored, nor the free 
washing of the woodwork with the solution of bichloride of 
mercury, and the removal of all unnecessary furniture in the 
preparation of the room. 
Beyond a doubt rooms can be provided in a general hospital, 
and, if kept only for such work, are thoroughly safe for per- 
formance of the operation, and yet one cannot help believing 
that a strictly private hospital for such work is, perhaps, the 
best. The doing of such an operation at the home of the 
patient increases the risk of non-recovery. In this respect, 
however attentive the surgeon may be, and however good the 
attendance of the trained nurses employed, still the friends of 
the patient will in some way bring about an interference that 
is disastrous too frequently. 
In the treatment of fibroids, one cannot help indorsing all 
of Mr. Thomas Keith's writings, governed by his experience, 
which has been so extensive. Supra vaginal hysterectomy is 
an operation that is likely to grow less frequent, but, in the 
use of electricity we have a curative agent that promises to be 
of great service. 
My experience leads me to believe that aside from the soft 
myomas, the removal of the uterine appendages does have the Abdominal Section. 
35 
desired effect in bringing about the menopause and saving the 
life of patient from the exhaustion of severe hemorrhages. 
Finally, I wish to record my regrets at the criticisms which 
surgeons in this country have made upon Mr. Tait's work. I 
am sure did they know the man better, and understand his 
methods more thoroughly, they would be more charitable in 
the future than they have been in the past.