The Treasurer's Accounts were audited by Professor Simpson and Dr James Ritchie, and found correct, and on the motion of Professor Simpson a cordial vote of thanks was unanimously accorded to Dr Craig by the Fellows of the Society.

II. The Society then proceeded to the election of Office-bearers for the present session, and the President announced the result as follows:-President, Dr J. Halliday Croom; Vice-Presidents, (Senior) Dr R. Milne Murray, (Junior) Dr N. T. Brewis; Treasurer, Dr Wm. Craig; Secretaries, Dr J. Haig Ferguson and Dr W. Fordyce; Librarian, Dr R. Milne Murray; Editor of Transactions, Dr J. W. Ballantyne; Members of Council, Dr J. B. Buist, Dr W. N. Elder, Dr Hamilton (Hawick), Dr Fraser Wright, Professor Simpson, Dr Alex. Ballantyne, Dr Melville Dunlop, Dr F. W. N. Haultain.

III. The following gentlemen were elected Ordinary Fellows of the Society-H. S. Ballantyne, M.B., C.M., B.Sc., Ashton, Eskbank; E. E. Porrit, M.B., C.M., City Hospital.

IV. The resignation of Dr Harkness, Market Drayton, was intimated and accepted.

V. VALEDICTORY

ADDRESS: RESPONSIBILITIES

OF

THE MEDICAL ATTENDANT IN OBSTETRICAL AND
GYNECOLOGICAL CASES.

By ALEX. BALLANTYNE, M.D., F.R.C.P.E.

GENTLEMEN,-The time has come for me to vacate this chair, which two years ago your kindness and goodwill did me the very great honour to ask me to occupy, and which by your courteous forbearance you have allowed me to fill till now.

The change of Presidents marks off, perhaps, more than anything else, distinct periods in the history of the Society, and is usually taken advantage of by the retiring President as a time for a more or less complete stocktaking.

In a valedictory address it seems peculiarly appropriate that we should first of all glance over our list of Fellows and note the names of those touched by the effacing finger of death. That now, when they have bid farewell to this life, we should keep in grateful remembrance what they did for us and for our profession. Young and old, and of many nationalities, they make up an unusually large number at the end of my Presidency. We have to deplore the loss of no fewer than seven of our Honorary, two of our Corresponding, and eleven of our Ordinary Fellows.

DR GEORGE BATTEY.

Just two years ago our Society was made the poorer by the death of Dr George Battey of Rome, Georgia, whose name will

remain notable as long as Gynecology exists, as fortunately the name 'Normal Ovariotomy,' which Battey gave to the operation now bearing his name, was universally condemned.

The extirpation of the ovaries for otherwise incurable disease, apparently suggested itself to his mind after the prolonged study of a single case of amenorrhoea from absence of the uterus, with intense suffering at the menstrual periods, ultimately exhausting the patient and causing death. He regarded the fatal issue as the result of an excessive menstrual molimen unrelieved by menstruation. Hence he conceived the idea that by removing the ovaries he would produce an artificial menopause, and by its production relieve or cure the patient. Although the conjecture was erroneous which led him to propose the operation, the procedure itself has been, as we know, successful in effecting a cure in suitable cases. As with all innovations, when the proposition was made by him, it encountered great opposition, and apparently received no encouragement; yet so convinced was he that it was right, that when he had a second case presenting similar symptoms, he, in August 1872, removed both ovaries by Abdominal Section. Fortunately, the result was recovery of the patient and her complete restoration to health. The subsequent success of this method of dealing with such cases is a matter of medical history. Marion Sims, but most prominently, Lawson Tait, placed its safety and utility beyond a doubt. Perhaps in these days when ovaries are got rid of on comparatively slender pretexts, it is well to bear in mind that Battey stated emphatically that the operation should only be done as a dernier ressort. 'This much,' he says, 'is due to the dignity of our calling; this much is due to humanity, to decency, and to public morality.'

It is interesting for us to remember that Dr Battey was a guest at our meeting in July 1881, and that he then detailed a case of extra-uterine pregnancy upon which he had operated.

SIR THOMAS SPENCER WELLS.

The name of another Honorary Fellow, and of a still greater Gynecologist than Battey, appears in our death list. The prolonged struggle, which finally ended in the general adoption of Ovariotomy as the only way of dealing effectively and even safely with cystic disease of the ovaries, is long since passed, and the last remaining and most conspicuous of its early advocates, Sir Thomas Spencer Wells, died in the end of January of this year. All who know the history of this operation must acknowledge the very great share Wells had in popularising it and inducing others to perform it.

Before 1858, when Wells did his first completed ovariotomy, Clay in England, beginning in 1842, and the two Atlees in America-John in 1843, and his more famous brother Washington in 1844-had continued, in the face of all opposition, to carry on an

unchecked career of operating as suitable cases presented themselves.

Many others had done the operation, some several times—but either disheartened by failure, or from the want of cases or lack of opportunity, nothing of any moment had been done anywhere before 1842, excepting always the series of cases operated upon by the Father of Ovariotomy, Ephraim M'Dowell, in the early part of the century. And even up to the time Wells began to operate, Clay and the two Atlees almost alone fought for the very existence of the operation. Of this trio, America even acknowledges in the person of Peaslee in 1872, that 'to Dr Charles Clay of Manchester, however, more than to all other operators, the credit belongs of having placed the operation of Ovariotomy upon a sure foundation, and at length overcome the opposition in England to Ovariotomy in his fairness in reporting his cases, in his scholarship, and especially by his success.'

Two years before Wells began, Clay had performed the operation seventy-one times, with an average of seventy-five per cent. recoveries in his last thirty-one cases. With this average also he ended his career as an Ovariotomist after performing the operation four hundred times.

In 1854, Wells, previously an assistant-surgeon in the Royal Navy, was appointed to the Samaritan Hospital, and had assisted Baker Brown in his eighth case of Ovariotomy, which ended fatally.

When the Crimean war broke out he again joined the Navy, but became attached to the Army, and there learned, to quote his own words, 'that a man's abdominal walls might be lacerated by fragments of shell, his intestines protruding and covered with mud, so remaining for several hours, and yet, after careful cleansing of the cavity, and accurate closure of the wounds, complete recovery was possible,' which, he adds, 'made him much less afraid of abdominal wounds.'

This experience doubtless neutralised to some extent the depressing effect of the knowledge that Baker Brown, whom he had previously assisted in his eighth case, had had seven deaths out of nine ovariotomies. Probably, also, it led him to think of the feasibility of the operation, and induced him to journey to Manchester in 1857, and to be present at one of Clay's operations. At this visit he made many inquiries, and subsequently corresponded with Clay about the operation. Having then, as has been said, ascertained by observation in the Crimea (what indeed Blundell, more than twenty years before, had been assured of from experiment, and had stated that the peritoneum was more tolerant of injuries than was generally supposed'), and favourably impressed by seeing Clay operate, and by his interview and correspondence with him, he, in the end of 1857, essayed to operate. This operation, however, was uncompleted-Baker

In

Brown apparently dissuading him from going on with it. February 1858, he completed his first ovariotomy, and was congratulated by West on its complete success.

In judging of Wells' career as an Ovariotomist, the time, place, and circumstances in which his operations were performed must be kept in view. Undoubtedly these were all favourable to the man who could command success. 'Is there any one,' says John Hunter, 'whom difficulties dishearten and bend to the storm? that man will do little. Is there any one who will conquer? that man never fails.' In such a spirit Wells began his work at Ovariotomy. He was fortunate in the time, inasmuch as the great success of Clay was known to those who cared to learn, and he, as we have seen, acquired the knowledge from Clay himself; fortunate in place, where material was plentiful and spectators numerous; and fortunate in the circumstances that he had the whole field to himself, and was already known to a large professional circle in London, who watched his career with interest. Like most epoch-making men, he was energetic, decided, and combative, qualities which fitted him to grapple with any difficulty as well as with great opposition. An accomplished writer, he fought with his pen as powerfully as he demonstrated with his knife. He invited spectators and courted criticism, and spared no labour in reporting his operations and advocating their performance. Everything he acquired from observation or got from others he used for perfecting his results. And so, as he says, 'by careful consideration of all sources of possible danger and by progressive improvements in details,' he, like Clay before him and like all other successful ovariotomists, reduced the death-rate from these operations as his experience increased. As I have already said, two years before Wells began, Clay could show a death-rate of one in four; yet with few exceptions, among whom was Sir James Simpson, who, as you all know, gave the name to the operation in 1844, Clay preached to deaf ears and demonstrated to eyes which would not see. And doubtless the experience of the operation in London, and especially in London Hospitals, as well as many other places in Britain, had been most discouraging. Such was the position of affairs when Wells began.

His early cases were not more successful than the early cases of Clay, yet such publicity did he give them, and with such power did he advocate the claims of the operation, that he compelled men to listen, and at length converted them to his views. And it was this, rather than any exceptional brilliancy of operating or its results, that carried him to the foremost rank of Ovariotomists, and made him, even more than Clay, the great Apostle of Ovariotomy. None can doubt that experience is a most important element of success in all the severer operations, and certainly Ovariotomy is no exception. This experience, in his first few years, Wells had more than any man at that time, doing one hundred and

fourteen Ovariotomies in the first six years of operating. Notwithstanding this, at that time, quite exceptional wealth of experience acquired in so short a time, and the publicity attending it, it may be questioned whether the so-called Revival of Ovariotomy' would have come so soon but for the influence of Clay. Wells himself acknowledges that Clay's tables of cases contributed more than any other books and pamphlets to form professional opinion, to awaken interest, and to instruct those who had not before thought upon the subject. And it may also be doubted whether the Revival would have been so complete but for the third strong siding champion, Keith, who began operating in 1862, and whose altogether marvellous results were, according to Sims, 'the wonder and admiration of surgeons all over the world.' In 1866 his superiority over Wells as an operator was shown in the results, that notwithstanding the greater experience of Wells (the most important factor in success, others things being equal), Wells in his first one hundred and fifty cases had forty-seven deaths; while Keith in his first forty-eight cases had only eleven, a result which in some measure prepared the profession for the astounding record of seventy-three ovariotomies without a death, and ninety-seven recoveries out of one hundred cases, verifying what he says, 'that this long-despised operation is now the safest of all the great surgical operations,' while it contrasts in a wonderful way with the result of cases totalled by Dr Gross in 1872, of one thousand four hundred and eight cases collected from various native and foreign sources, which showed a mortality of twentyfour per cent. I regret that leisure is not at my command to ascertain what percentage of deaths there has been of late years, but I have no doubt that now, in 1897, it is still the safest of all the great surgical operations.'

EBB AND FLOW IN THE SOCIETY.

But Obstetrics have suffered more than Gynecology by the deaths of Dr Kidd of Dublin, Dr Lusk of New York, Dr Pajot of Paris, Dr Stadtfeldt of Copenhagen, and Dr Braxton Hicks of London, all exceptionably able teachers and writers in the department of medicine which they had chosen for their life. work. It is impossible for me to do more than name them as well as the two Corresponding Fellows, Dr Martin of Haddington and Surgeon Lieutenant-Colonel Blair Brown. To this already heavy list fall to be added, as I have previously mentioned, no fewer than eleven of our Ordinary Fellows. But while in this we have an abiding sense of loss, we have in our present list of Fellows the welcome assurance that our losses, however great, are not irreparable, and that indeed thirty-five Ordinary Fellows having been elected during my Presidency, the places of those who are gone have been taken by others as well fitted to carry on the work of the Society. A still more convincing proof that