Editor’s note: As part of the regular “From the Archives” column, the Bulletin will be publishing vignettes regarding important key individuals and events that have played influential roles in the history of the American College of Surgeons (ACS). These essays will be written by members of the ACS Surgical History Group, led by LaMar S. McGinnis, Jr., MD, FACS.
Prior to founding the American College of Surgeons (ACS) in 1912, Franklin H. Martin, MD, FACS, practiced gynecologic surgery in Chicago, IL. He achieved professional and personal distinction by presenting clinical and research papers at national meetings and befriending leaders in the field. He developed a large practice and was prominent within the Chicago medical community.
Ovarian transplant
In 1901, a 29-year-old woman contacted Dr. Martin because her fallopian tubes and ovaries had been removed for dysmenorrhea a year earlier, and she could not bear children. She believed her life and her prospects for marriage were ruined and asked Dr. Martin if he could transplant into her the ovaries of another woman who needed to have them removed. After performing unspecified experiments on animals, he agreed to perform the operation.
When she saw him a year later, Dr. Martin told her the procedure was experimental and that she had to assume responsibility if it failed. She consented and found a boarding place near the hospital.
One month later, Dr. Martin found a donor who agreed to the procedure. After the operation, he wrote:
The operation in all of its details was satisfactorily performed from the standpoint of my prearranged technique and the patient recovered promptly. Monthly reports were received on this and similar cases. They revealed that the monthly function was restored to a degree in the early months, and that the unpleasant symptoms of premature menopause were materially lessened.*
Dr. Martin subsequently performed this procedure on several women, reporting two more cases of heterotransplantation and five cases of homotransplantation in 1908. His initial enthusiasm was dulled, however, when none of the patients began to menstruate normally. After an extensive review of the literature in 1917, he concluded, “In spite of the perhaps overenthusiastic conclusions of a few workers, neither homo- nor heterotransplantation has as yet justified its use in human surgery.”†
New standards
Since Dr. Martin performed these operations, the ethics of human experimentation have been carefully defined. An institutional review board would not have approved his project as described. Dr. Martin did not understand that his experiment was doomed because the transplanted ovary had no blood supply, nor did he know about the post-transplant rejection process that is currently combated through immunosuppression.
It was not until 2008 that the recipient of a whole ovary transplant delivered a healthy baby. The ovarian vessels were anastomosed using microsurgical techniques, and immunosuppression was unnecessary because the donor was the recipient’s identical twin. Success eluded Dr. Martin and his courageous patient, but they had set the stage for the scientific advances that enabled another surgeon to bring happiness to a childless couple more than a century later.
*Martin FH. Fifty Years of Medicine and Surgery. The Surgical Publishing Company of Chicago; 1934:277-279.
†Martin FH. Progress in the study of ovarian transplantation and ovarian secretion. Surg Gynecol Obst. 1917; 25:336-346.
