In 1853 Sir Spencer Wells settled in practice in London, and in 1854 became attached to the Samaritan Hospital, then a dispensary for the diseases of women. At this time Sir Spencer states he knew less of this branch of the profession than of any other. In his younger days he had attended an unusual number of midwifery cases, but latterly his practice had been almost exclusively surgical, with a strong tendency towards ophthalmic surgery. It was at this time that he first became interested in the subject that has made his name so widely known. From time immemorial the ovaries of women have been subject to diseased growths and fluid accumulations, for which there was scarcely a remedy, except when fluid could be drawn off through one or more punctures, and fatal results were the almost inevitable sequel of these diseases. Towards the end of the seventeenth and beginning of the eighteenth centuries, several medical men proposed to remove the diseased organ by an incision in the front wall of the abdomen. William Hunter in 1762 put forward a method by which this operation, otherwise full of danger, might be rendered feasible; and John Hunter, lecturing in 1785, favoured the idea of removal, considering that the opening would not necessarily constitute a highly dangerous wound. In 1798 Chambon, in a book on diseases of women, published at Paris, strongly argued in favour of the operation. Although it does not appear that he ever himself performed it, he says, “I am convinced that a time will come when this operation will be considered practicable in more cases than I have enumerated, and that the objections against its performance will cease.” John Bell also has a share of credit in this matter, for in his lectures on surgery at Edinburgh in 1794 he dwelt with much force on the practicability of removing ovarian tumours by operation. It was reserved, however, for a pupil of his, Ephraim M’Dowell, from Virginia, to perform the first modern operation of ovariotomy for disease. He settled in practice in Kentucky in 1795, and in 1809 carried into effect this novel operation upon a middle-aged woman, who survived to complete her seventy-eighth year in 1841. Thus an American had the glory of first boldly starting in the new path.