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This introductory chapter provides an overview of the history of ovariotomy and the significance the operation held within medicine and society. It reviews the place of ovariotomy in the historiography and particularly the interest the operation has garnered from scholars working on gender and women’s history. It then examines the distinctiveness of surgical innovation within medicine and shows how innovation might be used as a conceptual focal point to examine the history of ovariotomy more closely. The chapter sets out the structure of the book, arguing for a more chronologically expansive account of the operation, beginning with its roots in eighteenth-century medicine and which then assesses the changing status and identity of the operation throughout the course of the nineteenth century.

This chapter examines the early history of ovarian surgery taking the story back to the eighteenth century. During this time, the ovary was believed to have a complex pathology, which made it an object of curiosity within the burgeoning field of morbid anatomy. Chaotic, deceptive and at times astonishing due to the enormous size they could attain, ovarian tumours were seen to defy both bodily order and medical control. These difficulties precipitated an interest among English, Scottish, French and American medical practitioners as to the possibility of finding a surgical solution to the disease. The chapter argues that it was also the relative expendability of reproductive organs, in comparison with other ‘vital’ organs, which further focused attention upon them as a potential site of surgical intervention.

Chapter 3 brings together two medical innovations of the early nineteenth century which were to become deeply entangled: ovariotomy and the weekly medical press. This chapter focuses on the period between the 1830s and 1850s, a time during which the operation to remove diseased ovaries was given the appellation ‘ovariotomy’, and when the debate as to the justifiability of the operation was at its most polarised. For an increasingly vocal group of advocates, the operation was heralded as the beginning of a new era in surgery. For influential opponents, it was nothing more than a useless and possibly criminal procedure. The operation was subject from both its supporters and detractors to highly emotive ‘subjective’ accounts, which centred upon patient narratives, as well as to ‘objective’ statistical deconstructions.

By the mid-1860s, perceptions of ovariotomy—both within the professional sphere and beyond—were undergoing a rapid turnaround. In 1865, the publication of Thomas Spencer Wells’ , in which the surgeon detailed all 114 ovariotomies he’d performed, dramatically improved the reputation of ovariotomists and signalled a major rebranding of the operation from dangerous novelty to a symbol of Victorian skill and industry. As the operation’s status ascended, those who had risked their reputation to perform it became more vocal in their claims to credit for doing so. This chapter addresses those questions of priority, credit and intellectual property which adhered to the operation during the 1860s and beyond.

This chapter focuses on the financial implications of the operation for both patient and practitioner, paying particular attention to the period between 1870 and 1900 when there was increasing concern about the overuse of ovariotomy. The latter development is often read solely through changing notions of female pathology; this chapter offers a new approach to the period by situating the expansion of the operation primarily within a discourse of trade and business, which nonetheless was often gendered. The powerful financial connotations of ovariotomy were revealing not only of the ascendance of surgeons’ professional status (in which money played an implicit role) but also the pecuniary gains—and losses—that association with surgical innovation could bring.

This chapter argues for a new way of thinking about the history of surgical innovation that moves beyond simplistic dichotomies of diffusion and failure. Instead it offers an exploration of the ‘afterlife’ of ovariotomy, following the controversies that surrounded the operation towards the end of the century. By the 1890s, the term ‘ovariotomy’ had become increasingly uncertain in its meaning, as a range of other terms emerged to refer to new techniques in ovarian surgery that were being practised. Fears were also growing about the long-term effects upon women’s health of removing the ovaries. ‘Afterlife’ also refers to the formation of ovariotomy as an historical phenomenon during this time, even while it remained in contemporary practice. The historical narrative being developed was part of the innovation process rather than separate from it, as surgeons constructed accounts which posited the operation as an invention of their generation.

The concluding chapter argues for the need to nuance histories of surgical novelty and innovation beyond simplistic categories of success and failure and for the cultural and technological implications of surgical innovation to be seen as intertwined rather than separate. It addresses the usefulness of ‘innovation’ as an analytical category, responding to works which have critiqued ‘innovation-centric history’. It argues that no aspect of the innovation process can be treated as self-evident; and that which we might initially take for granted as being unambiguous about an innovation: its beginning, its ending, even its definition, are not necessarily so.