Dr. Battey’s Ovariotomy, 1872-1878
Author(s): Amber Nicole Brooks
Amber Nicole Brooks currently serves as the Nonfiction Editor for The Chattahoochee Review. Her work has appeared in The Rumpus, The Establishment, ArtsATL, Five Points, The Southeast Review, The Arkansas Review, Orange Coast Review, and The Collagist, among others. In 2007, a story of hers placed third in the Playboy College Fiction Contest.
Tags: 22-3, Discourse Analysis, Feminist STS, history of medicine, Hsyteria, Ovariotomy, Surgery, Women's Medicine“The reality is obviously a good deal more complex; disease is at once a biological event, a generation-specific repertoire of verbal constructs reflecting medicine’s intellectual and institutional history, an occasion of and potential legitimation for public policy, an aspect of social role and individual—intrapsychic—identity, a sanction for cultural values, and a structuring element in doctor patient interactions.”
Medical journals from the 19th century provide rich information about diagnoses, treatments, and contentions within the field at the time. It’s important to place these primary sources in historical context, and close study can also reveal broad trends in how diseases are framed at specific points in history. Specifically, there is a long history of attributing many diseases and symptoms to the female reproductive organs.1 For example, Terri Kapsalis explores the “wastebasket diagnosis” of hysteria through time, from Plato’s wandering uterus to Silas Weir Mitchell’s rest cure. From the years 1872 to 1878, Robert Battey’s normal ovariotomy, a surgical procedure to remove the ovaries, was publicized in various professional medical journals, such as the Atlanta Medical and Surgical Journal, Gynecological Transactions, and The American Practitioner. George J. Engelman published a piece in the Transactions of the American Medical Association titled “Difficulties and Dangers of Battey’s Operation,” which is ultimately an endorsement of the procedure. C.H. Rauschenberg published “Ovulation and Menstruation, and Dr. R Battey’s Operation of Normal Ovariotomy,” highlighting disagreement over the role of the ovaries in menstruation.
Through analysis of these primary sources from the late 19th century, we can note four broad observations: the sheer variety of diseases and illnesses attributed to the ovaries, the role of opioids in everyday use and medical procedures, the specific gaze adopted in the assessment of success, and contentions surrounding the surgical procedure in the professional field. These archival materials provide a rich bounty for further feminist rhetorical analysis. Rhetoric scholars, in particular, may be interested in how diseases are framed historically, insofar as medical discourse embodies and perpetuates cultural assumptions, and produces identities; specifically, rhetoric scholars may investigate portrayal of women’s bodies as pathologized throughout history and how these portrayals have real-world consequences for medical diagnoses and interventions, even today.
Diseases and Illness Attributed to Ovaries
The most interesting part of this analysis might be the sheer number and variety of illnesses attributed to the ovaries. These afflictions include but are not limited to cardiac malady, hemorrhages from stomach and rectum, paroxysm, nervous disturbances (Battey, “Normal” 322-325), vascular excitements, pernicious ovulation, ovarian neuralgia, ovarian insanity, nervous prostration, insomnia, vicarious menstruation from bowels, lungs, and skin (Yandell 3-13), suffused countenance, convulsions epileptiform in character, mania, hysteria, unbalanced mind (Battey, “Extirpation” 2-5). Battey argues that his normal ovariotomy is a last resort intended to treat diseases that cannot otherwise be cured by any other method. Somehow, removing the ovaries in order to prompt menopause is thought to be beneficial. The attribution of so many various ailments to the ovaries is not unlike misunderstandings about what causes and transmits disease throughout history. For example, we can look to the miasmatists for their misguided framing of cholera2 or to the various attempts to quell the transmission of malaria throughout time.3 Misunderstandings of illness and disease can come from lacking knowledge about vectors and microbes, and it can also come from concepts and frames that rest on long-held cultural assumptions.
One difficulty of looking at medical publications from the late 1800s is that further research is needed in order to fully understand the time-specific definitions of many terms. For example, what is ovarian insanity? What did it mean about doctors’ knowledge that rectal bleeding might be called menstruation from the bowels? Despite these difficulties of interpretation, the types of ailments described throughout these documents can fall into several categories: symptoms related to menstruation, descriptions of symptoms that seem to describe what we now call epilepsy, symptoms that seem to describe heart disease, symptoms that seem to indicate a type of cancer or infection, and symptoms that have to do with mood disturbances and emotional liability.
The Role of Morphia and Opium
The development of anesthesia in the 1840s, and antiseptic later in the century, facilitated a boom in surgery in the late nineteenth century (Porter 148). In his publications, Battey provides detailed accounts of his patients’ case histories as well as detailed accounts of the surgical procedure. Two important parts of the procedure, which are granted detailed descriptions, are the anesthetization of the patient before surgery and the pain relief treatment administered after surgery. For initial surgery, Battey used chloroform to sedate patients. Then, morphia and/or opium were used for pain management. In some of these cases, it appears that the patient already had a daily regimen of morphia (morphine): “For the past four months, she had been entirely bed-ridden and constant sufferer. She vomited her breakfast daily but retained nourishment at dinner and tea. She required each day two or more grains of morphia, and every night sixty grains of chloral” (Battey, “Extirpation” 7). One has to wonder if drug use was not the cause of various symptoms of these patients. Would periodic withdrawal from an opioid cause many of the documented complaints? Did doctors at the time understand the addictive properties and side effects of these various substances? Rhetoric scholars might consider how a focus on pathologizing women’s reproductive systems could obscure other areas of investigation.
The Gaze of Success
When writing about the success of the surgical procedure, Battey primarily records his own observations as a physician. However, Battey also, at times, folds in the perspectives and observations of husbands and other household members. For instance, “She now does unaided the house-work of her family” is touted as an indicator of success (Battey, “Extirpation” 4). Similarly, we can ask where the “definitely known” information originates in the following passage:
Does this operation impair the aphrodisiac power of the subject? I answer there is not reason to suspect this in any of my cases, and in most of them it is definitely known that such is not the result. There is no loss of the womanly graces, but on the contrary the patient gains flesh and becomes even more attractive. (Battey, “Extirpation” 19)
How does one measure womanly graces or attractiveness in medicine? What kinds of metrics are these, anyway? At the very least, we can assess that they are metrics accounted for, and devised, by men.
Contentions in the Field
From these archival documents, three contentions surrounding this procedure emerge:
vaginal versus abdominal surgery for removal of ovaries,
the role of ovaries in ceasing menstruation, and
the proper name of the procedure and the medical meanings of the words “normal” and “abnormal.”
For the first contention, Battey, after beginning with the abdominal surgery method, shifts to the vaginal surgery method, arguing that this is best. Engelman, although largely in support of Battey’s ideas, argues that the abdominal method is indicated in most cases (3-4). Rauschenberg, on the other hand, questions the very premise (and, therefore, purpose) of Battey’s procedure (1-2). Battey argues that his goal is to induce “change of life” by the removal of the ovaries, and that this will relieve the litany of otherwise uncurable diseases. However, Rauschenberg argues that the link between the ovaries and menstruation is not yet well-established and that removal of the ovaries may not necessarily cease menstruation (4). Throughout these publications, there is various discussion of the procedure title, whether normal ovariotomy is appropriate. In the Yandell and McClellan interview, Battey explains he has given up his initial name for the procedure but has yet to rename it (9). It seems the contention surrounds the word “normal,” as many of the ovaries Battey ends up removing are inflamed or cancerous: abnormal. Of course, the surgeon cannot know this until surgery, but this contradicts Battey’s premise that the normal (non-diseased) ovaries can cause a plethora of debilitating symptoms in women as a matter of course.
Questions for Further Research
Is Battey a maverick surgeon of his time, or is this level of experimentation typical?
Andrew Scull, author of Hysteria, certainly sees the popularity of this operation as a dangerous experimental period, describing that “a veritable mania for ovariotomy swept the United States” (89). Surgery, as a profession, was booming during this time, in part due to the introduction of anesthesia in the 1840s and the emergence of antiseptics, popularized by Joseph Lister in the mid-1800s (Porter 126). Further research is needed to better situate Battey in surgical history.
Many of these patients seem to have pre-existing “morphia” use. Do doctors at this time recognize the side effects and dangers of morphia?
It would be interesting to do a more in-depth study of the evolving medical understanding of addiction, and specifically opioid addiction, throughout time. In Battey’s time, we understand that women with means could easily take morphine or opium daily. How were withdrawal symptoms understood, if at all? What was the social context surrounding the use of these drugs?—what were the norms? When do controls on substances emerge, and why? What is the longer arc we see with doctors using and prescribing opioids? One could also take the contemporary opioid crisis as a starting point for analysis and move backwards with historical critique.
In the late 19th century, were doctors treating men’s nervous, cardiovascular, or mental disorders with removal of the testes?
It stands to reason that if all of women’s otherwise incurable diseases can be treated by removal of the ovaries, then, in tandem, all of men’s otherwise incurable diseases can be treated by removal of the testes. If, for example, it was thought that the removal of a woman’s ovaries would cure epilepsy (Battey, “Extirpation” 13), were men with epilepsy being treated with removal of the testes? More broadly, what was the medical consensus, at the time, regarding the functions of these organs? If no comparable treatment is found for men, then we can ask:
Where does Battey’s normal ovariotomy fit into the broader historical trend of targeting women’s reproductive organs as the source of many maladies?
Scull argues that “In this instance, the assault on the ovaries was in line with long-standing folk beliefs about the origins of women’s emotional liability, beliefs that had acquired a new veneer of scientificity with the development of reflex theories of nervous action” (90). This assertion dovetails nicely into research on contemporary manifestations of the hysterical woman4 in various discourses.
Battey’s normal ovariotomy provides a historical comparison for use with research on framing women’s diseases, and rhetoric scholars can investigate the historical trends and contemporary implications of the medical discourse surrounding women’s bodies. In what ways are women’s bodies characterized as inherently abnormal or pathological? In what ways are women characterized as liabilities due to their reproductive organs? In what ways are women’s bodies described and defined by the male-gaze? Where are the women’s voices and accounts, historically? Where are the women’s voices and accounts, within medical discourse, today? The scope of archival materials discussed here is limited by this researcher’s personal time, and there is undoubtedly much more material to uncover.
See Scull, Andrew. Hysteria: The Disturbing History. Oxford University Press, 2009.
See Johnson, Steven. The Ghost Map. Riverhead Books, 2006 and Rosenberg, Charles. The Cholera Years. The University of Chicago Press, 1962.
See Packard, Randall M. The Making of a Tropical Disease. Johns Hopkins University Press, 2007 and McNeill, J.R. Mosquito Empires. Cambridge University Press, 2010.
See Foucault, Michel. The History of Sexuality Volume I: An Introduction. Random House, 1978.
Battey, R. “Extirpation of the Functionally Active Ovaries for the Remedy of Otherwise Incurable Diseases.” Reprint from Volume I of Gynecological Transactions 1876. U.S. National Library of Medicine Digital Collections.
—. “Normal Ovariotomy.” Atlanta Medical and Surgical Journal. September 1872. Atlanta, Georgia: Plantation Publishing Company’s Press. U.S. National Library of Medicine Digital Collections.
Engelman, George J. “Difficulties and Dangers of Battey’s Operation.” Extracted from the Transactions of the American Medical Association 1878. Philadelphia, Collins Printer: 1878. U.S. National Library of Medicine Digital Collections.
Kapsalis, Terri. “Witches, Hysteria, and The Wandering Uterus, Or, Why I Teach ‘The Yellow Wallpaper’.” LitHub, 5 April 2017.
Porter, Roy. Blood and Guts: A Short History of Medicine. W.W. Norton and Company, 2002.
Rauschenberg, C.H. “Ovulation & Menstruation, and Dr. Battey’s Operation of Normal Ovariotomy.” Reprinted from the Atlanta Medical and Surgical Journal. Atlanta, Georgia: Dunlop & Dickson Job Printers. 1876. U.S. National Library of Medicine Digital Collections.
Rosenberg, Charles E. “Introduction: Framing Disease: Illness, Society, and History.” Framing Disease: Studies in Cultural History. Eds. Charles E. Rosenberg and Janet Golden. Rutgers UP, 1992: xv-xxvi.
Scull, Andrew. Hysteria: The Disturbing History. Oxford UP, 2009.
Yandell, D. and E. McClellan. “Battey’s Operation.” Reprinted from the American Practitioner for October 1875. Louisville: John P. Morton and Company. (Interview with Battey) U.S. National Library of Medicine Digital Collections.