CORRESPONDENCE. 
Reprinted from the Journal of the American Medical 
Association. January 31st, 1885. 
To'the Editor of the Journal of the American Medical Asso- 
ciation ; 
Iii the Journal of the 3d inst. appears a statement 
from Dr. E. W. Jenks, of Detroit, claiming to have 
been the principal in making an operation which I 
performed and reported to the Journal of the 29th 
of November last. Dr. Jenks says: " I was waited 
on by Dr. Ranney on the 6th of October last, and 
received from him a description of the case referred 
to, and a statement of his relations to it. He had 
assumed charge of it, and had advised an operation, 
which he had engaged himself to undertake. It was 
one the importance of which he fully realized, and 
the realization convinced him of the advisability of 
having present at the operation some operator of ex- 
perience." 
This much is true, though I did not call upon 
Dr. Jenks with the intention of asking him to be 
present at the operation. I had not seen him since 
his removal from Chicago. He had written me from 
Chicago a friendly letter announcing his purpose of 
returning to Michigan. In view of our old acquaint- 
ance and cordial relations, I called on him, as stated 
above. In the course of the conversation at the time, 
I mentioned to him that I was going to perform 
ovariotomy on the next day but one. The doctor 
asked me if I had everything I wanted. I replied 
by saying that I would have before leaving the city. 2 
li Have you a. large steamer?" asked the doctor. I 
said that I had not, but had small ones which I in- 
tended to use. "Mine is all in order," said Dr. 
Jenks, "and you can use that." He seemed to want 
me to take it, and I was "charitable" enough to do 
so. I said I would have to provide myself with a 
larger trocar than I had, and he said that he had an 
extra large one which he would lend me. He spoke 
of some other instruments it might be desirable to 
have in certain emergencies. He was very cordial 
and his hospitality was ample. I finally said: "Doc- 
tor, there is not much money in this case, and, while 
I do not want to insult you, I will say that if you 
will come down and help me, I will divide what 
money conies out of it." He accepted the offer. 
I invited him, however, as a matter of professional 
courtesy and professional policy, knowing that should 
the case result fatally, "every fool would be med- 
dling," and " busybodies speaking things which 
they ought not." I was treating other patients at 
Grand Ledge at the time, and could manage the case 
in question with less trouble than I otherwise could. 
There was nothing said about my not wanting to 
"appear as a dead-head in the enterprise," nor did 
I ask him to " let me do as much as possible." 
In the course of the conversation, from something 
the doctor said, I feared, that, on the strength of my 
invitation, he considered himself "engaged to oper- 
ate," as he states in his letter to the Journal. So, 
in order that there might be no misunderstanding, I 
said: " Doctor, I expect to operate myself: I want 
you to help." He then asked what part I wanted 
him to do. I said, " Whatever may be required 
as we go on with the operation." He then re- 
marked that he presumed there would be enough 
for both of us to do. Said he: " I would like to 3 
make the first incision. To this latter remark I 
made no reply, nor did I deem the matter of any 
importance, though he has since urged it as a strong- 
point. 
Before leaving Dr. Jenks' house, I said to him that 
it might be well, if he had no objections, for me to 
take along the trocar, so that I might have it in case 
he should not come. lie replied by saying that he 
would come. Early on the day of the operation I 
visited the patient, but before leaving Lansing, ar- 
ranged with Dr. Post to come later on the cars, and 
that in case Dr. Jenks came to accompany him to the 
residence of the patient. Dr. Post asked me if the 
operation would be delayed in case Dr. Jenks should 
not come? "Certainly not," said I. Drs. Post and 
Jenks met on the train and came to the house to- 
gether. Dr. Jenks says that he subsequently learned 
that the fact of his intended presence had been care- 
fully kept from the knowledge of both the family of 
the woman and the local profession. Though the 
matter was of no special importance, I did mention 
it at the first opportunity I had, and also the fact that 
my large IFe/rh* atomizer" belonged to Dr. Jenks. 
On his arrival, however, he was not slow to investi- 
gate its running, and to call attention to the fact 
that the " machine " was his, and we were not al- 
lowed to forget the fact, for beftre leaving the house 
lie in one way or another, called attention to the fact 
four different times. (Price of steamer $11.25.) Dr. 
Jenks did not see the patient till everything was ready 
for the operation, nor until I assisted the patient to 
the operating table. The husband of the patient 
informs me, that after the patient was placed on the 
table, Dr. Jenks called him one side and asked him 
if he was aware that his wife might not survive the 
operation? The husband told him that I had so in- 4 
formed him. Dr. Wright informs me that Dr. Jenks 
then called him one side and asked him if the family 
were aware that the patient might die on the table? 
I submit that it was not Dr. Jenks'business nor duty, 
but my own, to advise the friends of my patient of 
the dangers of the operation. I did not ask Dr. 
Jenks or any one else to " confirm " my diagnosis. 
Dr. Post administered the ether, after which I marked 
with an " indelible " pencil the site for the abdominal 
incision, and remembering Dr. Jenks' request to let 
him make the first incision, I handed him the knife 
and asked him to make it. He cut near to the linea 
alba and said he could not find it. I then took a 
probe and felt for, found it, and slightly opening the 
peritonaeum, passed a grooved director, and together 
we opened it to the full extent of the external incision. 
We both explored the tumor. Through a large rup- 
ture in the cyst the doctor "prodded " round, as I 
suppose, to find another cyst, which, by exploration 
with my hand, I found did not exist. The doctor 
says; "After the tumor had been sufficiently reduced 
to permit its extraction, I applied Storer's shield at 
the junction of the pedicle and the cyst." Now, if 
it will be of any consolation to him, 1 will admit that 
the shield should be included in any inventory that 
might be made of the instruments he brought, but I 
do most emphatically deny that it was used, or that 
there was any occasion for its use. 
I first grasped the pedicle with my right hand, and 
lifted with my left the remaining portion of the tu- 
mor through the incision. As it emerged from the 
abdomen it tended to draw forcibly the pedicle, and 
its weight made it difficult to hold. At this juncture 
I politely requested (but did not "instruct") Dr. 
Jenks to remove a portion of the tumor I was hold- 
ing in my left hand, in order to diminish its weight, 5 
while we should secure the pedicle. This he did. 
Then, without any " instruction," though by a polite 
request from me, he handed me a pair of compressing 
forceps, They having concave jaws, would not com- 
press the pedicle, so I requested him to hand me for- 
ceps that would tightly compress it. He then handed 
me a pair whose blades were less concave, but were 
still too much so to produce the necessary pressure. 
Dr. Jenks then applied a pair of straight-jawed for- 
ceps, but as they were adjusted to one side of the 
pedicle, I politely requested him to apply a pair of 
forceps to the other side. Accordingly he applied a 
pair which included a portion of the pedicle already 
compressed, but not reaching to the opposite edge of 
the pedicle; so I requested him to adjust a pair to 
include that portion not compressed by the first two, 
which he did. The jaws of the compressing forceps 
first adjusted were long enough to have completely 
compressed the pedicle had it been well adjusted, 
which, owing to hurry, poor eyesight, or some other 
cause, he failed to do. After the three large forceps 
were adjusted, I had my hands full to manage them 
and the pedicle, especially as I had to look after an- 
other large pair of compressing forceps, which Dr. 
Jenks, without "instruction," or even polite request 
from me, attached, early in the operation, to the 
walls of the abdomen, from which it was dangling. 
It was applied to a capillary vessel, which did not 
even emit a jet of blood when cut. It was done be- 
fore I could get to it with artery forceps to twist it. 
These forceps caused a large slough, and endangered 
the life of the patient, and would have proven fatal 
only for the fortunate circumstance that the perito- 
naeum healed by first intention. With all these 
instruments in place Dr. Jenks handed me Storer's 6 
clamp shield, and " instructed " mo to adjust it, but 
I politely informed him I hadn't room, and handed 
them back, and they were not applied. These 
instruments were all the doctor's, and were selected 
from a nice variety of others, the most of which, 
by the way, looked very bright and new. 
The doctor says that the tumor was multilocular 
instead of unilocular. I do not know how he ascer- 
tained that to be true except that "ovariotomists of 
experience would expect it to be from its size, and 
after having discovered the peculiar consistency of 
its contents," notwithstanding his remark, after we 
were well along with the operation, that he feared 
the tumor was malignant! Had the "experienced 
ovariotomist " then discovered more than one cyst? 
Dr. Jenks says: "After severing the stump, I 
cauterized the end thereof with my Paquelin's thermo- 
cautery." I never before witnessed such an ostenta- 
tious display of instruments. I submit that it was 
not essential to mention how the metal was heated 
except to give notice that Dr. Jenks has a Paquelin's 
thermo-cautery. I had at hand every instrument and 
dressing required. I had disinfected my sponges and 
boiled my silk thread after arriving at the house in the 
morning. The doctor brought a large number of 
instruments, at his own instance, but not by my 
request. He seemed desirous of having them used in 
the operation. He was the most " forward " assistant 
I ever saw at an operating table. Though his offi- 
ciousness was distasteful to me as it was, 1 think, to 
all present, and though his vanity blinded him to the 
rights and merits of others, I thought, as he was my 
guest, there was no harm in humoring his conceit by 
letting him "swash," not thinking he was attempt- 
ing as "flat a burglary as ever was committed," and 
if I permitted him to do more than assistants usually 7 
■do it was through politeness and courtesy on my 
part. The carbolic acid, aether, disinfected gauze, 
mackintosh, and wire used were my own, as were 
part of the instruments employed. 
The doctor in referring to the removal of a por- 
tion of the tumor which had escaped into the abdo- 
men, undertakes in a most presumptuous way to 
"damn me with faint praise," and says that I ren- 
dered him valuable assistance in the dexterous 
manipulation of the sponge; that he is under obliga- 
tions to me, etc. ' Others are under still greater 
obligations to me for the same, for at least two 
pounds of the material was removed after Dr. Jenks 
proposed to close the wound, which he says he closed 
by means of silver wire. Now that was done by 
myself as much as by him, as we assisted each other 
in that, as in about all other parts of the operation, 
except when the patient bled terrifically from the 
■cite of an adhesion, when the doctor stepped back 
from the table and exclaimed; " Doctor she is bleed- 
ing to death;" repeated the exclamation and added: 
"if you can do any thing for her, do it." To this I 
made no response but soon had the haemorrhage 
under control. 
Now at this juncture had the patient died, would 
Dr. Jenks or any one else have claimed that he was 
the principal in the case? I would not have done 
so, certainly. He speaks of the patient's recovery 
being due to my carrying out his instructions? 
"What strong meat does this our Ceasar feed upon," 
that he, in his conceited pride and pedantic ignor- 
ance, lavishes upon me his "instructions" which 
were as gratuitous as they were presumptuous, and 
which were not heeded by me in the least. 
I assumed the responsibility of, and met every 
emergency in the case, notwithstanding Dr. Jenks' 8 
effort to "grasp the skirts of happy (?) chance" to 
add to his waning laurels as a specialist. 
True it was something to have come from Detroit, 
but Dr. Jenks' experience and observation should have 
taught him, ere this, that " promotion cometh not 
from the east nor from the west." I think I am 
safe in saying that I have done as much difficult and 
successful surgery as has Dr. Jenks. I never engaged 
him or any one else to operate for me. I have been 
assisted, however, by men, who, in my estimation, 
were more able, but who never arrogated to them- 
selves the credit of operating for me, even though 
they may have made, in the modesty of true science, 
a polite suggestion; nor do I think they have felt 
their dignity so weak, as to be impaired by acting as 
such assistants. 
The first I was made aware that Dr. Jenks claimed 
the case, was conveyed to me in the following letter: 
Grand Ledge. Nov. i, 1884. 
Dr. Geo. E. Ranney : 
Dear Sir-Dr. Messenger, of this place, has just shown me 
a report of my mother's case, published in the "Medical Age" 
of Detroit, which was sent him by Dr. Jenks, of Detroit. The 
report says that Dr. Jenks made the operation, and mentions your 
name, among others, as one of the assistants. What does that 
mean ? We certainly did not employ Dr. Jenks to make the 
operation, and the report seems unjust to you, and certainly con- 
trary to the facts as I observed and understood them. 
Yours truly, 
James E. Taylor. 
Grand Ledge, Mich., Nov. i, 1884. 
Geo. E. Ranney, M. D., Lansing, Mich.; 
I observed a statement in the Detroit Medical Age, that Dr. 
Jenks, of Detroit, removed an ovarian tumor from Mrs. Edwin 
Taylor, of Grand Ledge, on the 8th of Oct., which statement was 
indeed a surprise to me. As I had treated her for some time 
previous, and even up to the time the operation was performed, 
and being informed by Mr. Taylor that he had employed you to 
perform the operation, and knowing nothing of Dr. Jenks, or 9 
that he intented to be present, I certainly considered her your 
patient, and undoubtedly the other physicians who assisted con- 
sidered it likewise. I being present at the operation, do not see 
wherein Dr. Jenks could possibly claim the honor of performing 
said operation, and I write you for information. 
Respectfully yours, 
A. J. Wright, M. D. 
Dr. Davis heard that the operation was credited to 
Dr. Jenks, and left word with the husband of the pa- 
tient that he would like me to call on him some day 
when convenient. I accordingly did so, when he ex- 
pressed surprise that Dr. Jenks should have claimed 
to have made the operation. I then asked him to 
express the same in writing. He was then in haste 
to answer an urgent professional call, and said he 
would write it as soon as he got home and send it by 
mail. He 'accordingly sent me the following letter: 
Grand Ledge, Nov. 12, 1884. 
Dr. Ranney : 
Dear Sir-I was present and assisted you in a case of 
ovariotomy on Mrs. Taylor, of Grand Ledge. I understand the 
case has been credited to Dr. Jenks, but I cannot imagine for 
what reason. From the first I regarded you as the responsible 
one and principal in the case. Your truly. 
W. A. Davis, M. D. 
The above are statements made " in the interest of 
truth and honesty," by all present at the operation 
save one, whose verbal statement, with his permis- 
sion, I would be glad to quote. 
Geo. E. Ranney. 
Lansing, Jan. 12, 1885.