Charles Clay – “Father of Ovariotomy”

The majority of the manuscripts that form the Manchester Medical Manuscripts Collection are arranged around 20 individual Manchester medical men who were responsible for their creation and/or collection.  One of these men was Charles Clay (1801-1893), a 19^th century obstetric surgeon who earned himself the sobriquet “The father of ovariotomy”.

Born in Bredbury in December 1801 Clay went on to serve an apprenticeship under the renowned Manchester obstetrician Kinder Wood (c.1785-1830), before studying at Joseph Jordan’s early Manchester Medical School on Bridge Street, and finally making the journey up to Edinburgh for a further two years of study where he became a member of the Royal College of Surgeons. From very early on the field of obstetrics was a big influence on his career and is reflected in the nature of some of the manuscripts that he owned which include copies of lectures from several notable individuals in the field including Thomas Young (c.1725-1783), Thomas Pole (1753-1829), Thomas Denman (1733-1815), William Osborn (1736-1808), and John Clarke (1761-1815).

However, standing out amongst the Clay manuscripts are those which represent his own work, the most significant being a casebook of gynaecology cases seen by him during the 1850s and 1860s, which details 82 individual cases of women suffering from ovarian cysts or tumours. It is the work represented in this particular manuscript that Clay became most famous for as he performed England’s first successful ovariotomy on 13th September 1842 removing a 17lb ovarian tumour from 45-year-old Mrs Wheeler of Ancoats, Manchester. Such procedures involving major abdominal surgery were very rare during this time owing to the lack of anaesthesia, and it should be noted that Clay performed 14 such operations before the widespread use of anaesthesia.

The cases featured in this volume would have been treated in Clay’s private practice in Piccadilly and there is a notable geographic spread of patients. In each case a great deal of information is supplied about the patient’s condition, early symptoms, advanced symptoms, the tumour, the operation, and her post-operative treatment. One of the earliest cases in the volume is that of 45-year-old Mrs Parsons of Stockport who had been ill for 3 years and had thus far been treated by means of a procedure known as tapping. This was a process whereby fluid would be drained from the affected area using an instrument known as the trocar; Mrs Parsons was tapped 7 times with approximately 35 to 37 pints being removed each time! She was operated on on 6th December 1855 when the tumour was described as “one large cyst, with solid masses with adhesions to colon, stomach, omentum & to the abdominal walls.” Clay himself seemed surprised by the success of the operation in this instance remarking “From the extent of adhesion, great emaciation and subsequent obstinate vomiting fears of the case being unsuccessful was entertained. The success of the case contrary to all expectation was very remarkable”.

Clay spent many years pursuing research into the ovariotomy operation and later the hysterectomy and is also credited with having performed Europe’s first successful hysterectomy in 1863, despite having first attempted the operation some 20 years earlier. Some people have credited him with having performed the world’s first technically successful hysterectomy, however, his patient died of an accident two weeks later and so the title went to an American surgeon. His work in this field is significant not only for being one of the first to attempt such operations, but also due to his relentless pursuit of the development of both the ovariotomy and the hysterectomy as well as efforts to normalise the idea of abdominal surgery.