It was difficult to give the new operation a start in England. “It must be remembered,” says Sir Spencer Wells, “that, at that time of day, the mortality from all operations was much greater than it is now; that the sick and diseased were more passively quiescent under their maladies and less tolerant of any surgical suggestions, just as we ourselves find to be the case among the unroused population of an outlying agricultural district; that they were not buoyed up, as modern women are, by the histories and promises of painless extirpations under chloroform or methylene; and that, without any mawkish sentimentalism, surgeons themselves had to encounter the _peine forte et dure_ of their suppressed sympathy, and nerve themselves up to the infliction of the most deliberate and tedious eviscerative vivisection. The disease was looked upon as a mystery, and its ending in death as a matter of course; and, instead of being accompanied, as we now see it, by fretful resistance and chafings to escape, it only led to stolid endurance or religious submission; and on the part of the profession, to pity and endeavours to alleviate the inevitable misery. But M’Dowell was a free man, in a new country, clear from the conventional trammels of old-world practice, found his patients in the most favourable conditions of animal life, seems to have had one of those incomprehensible runs of luck upon which a man’s fate and reputation so often turn if he has the sagacity and energy to put such fortunate accidents to good account, and was happy, as those usually are who can afford or constrain themselves to wait, in finding suitable time, place, persons, and opportunity for working into fact the notions of his tutor, Bell. He lost only the last of his first five cases of ovariotomy, and thus, as it were, established at the outset what until recently was complacently regarded as a satisfactory standard of mortality for so serious an operation.”[9] As a surgeon M’Dowell was “cautious, calm, and firm, paying great attention to the details of his operations and treatment, and selecting and drilling his assistants with great care.” In 1879 a granite obelisk was raised to his memory in the cemetery where he was buried, near his home, in commemoration of his courageous and important work. Long after M’Dowell’s operations became known, a case was discovered as far back as August 1701, in which Robert Houstoun, a Glasgow surgeon, operated on a woman for a large tumour in a fashion somewhat anticipatory of modern ovariotomy. She recovered, and lived sixteen years afterwards. So often are anticipations of great improvements to be found, that it appears that the merit, like the difficulty of actually making a thing practicable and practised, is as great as, or greater than, that of discovery.