Clay, Charles (DNB01)

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CLAY, CHARLES (1801-1893), ovariotomist, born on 27 Dec. 1801, was second son of Joseph Clay, a corn factor, of Arden Mills, Bredbury. near Stockport. He was an articled apprentice of Kinder Wood, a surgeon of much repute connected with the Manchester and Salford Lying-in Hospital (now St. Mary's Hospital), and from the practice of his master he acquired a familiarity with midwifery and the diseases of women which he afterwards turned to good account. He attended the practice of the Royal Infirmary at Manchester, and in 1821 matriculated at the Edinburgh University, though he took no degree. He qualified as licentiate of the Royal College of Surgeons of Edinburgh in 1823, and then settled at Ashton-under-Lyne, acting for a time as medical officer of health for Audenshaw.

He moved to 101 Piccadilly, Manchester, in 1839, was admitted an extra-licentiate of the Royal College of Physicians of London in 1842, and on 13 Sept. in this year he removed successfully an ovarian tumour weighing thirty-six pounds. It is said that the operation was completed in ten minutes. It brought him immediate fame, and such practice that in 1848 he published a series of forty cases of abdominal section, of which thirty-three were performed for the removal of ovarian tumours. He was compelled about this time to relinquish the more arduous duties of his profession, though he still continued to operate ; and in 1865 published a paper in the 'Lancet,' giving an account of 111 cases of ovariotomy, seventy-seven of which had heen successful. There appear to be no records of any further results, but Clay wrote in 1880 that he had performed nearly four hundred operations, though he does not say they were ovariotomies, nor does he enter into detail as to their nature. In 1845 he removed the uterus with a fibroid tumour, and thus anticipated Eugène Kœberlé by nearly a quarter of a century.

Clay also wrote in 1846 on the therapeutic value of inspissated ox-gall. He was the first in this country to cure varicose veins with Vienna paste in the manner recommended by Stanislas Laugier (1799-1872). He invented a speculum for the better performance of the operation of squint, and he reported the results of his treatment for vomiting during pregnancy, and by the administration of the mineral acids in diabetes. He served the office of president of the Manchester Medical Society, and was at one time the senior medical officer and lecturer on the principles and practice of mid-wifery at St. Mary's Hospital, Manchester.

Early in life Clay was much interested in geology and archaeology, and spent much of his time in collecting fossils. He had a large collection of early works on mid-wifery and gynaecology, many of which he gave to the Manchester Medical Society and to the Obstetrical Society of London. He also gathered together upwards of a thousand editions of the Old and New Testament, the collection being sold by Messrs. Sotheby in 1883. In 1871 he was president of the Manchester Numismatical Society. He wrote a work on the currency of the Isle of Man, from its earliest appearance to the time of its assimilation with the British coinage, and he formed a collection embracing every known coin in the kingdom of Man, which was sold for 1001. He also made one of the largest collections ever formed of the copper and silver coinage of the United States, which was afterwards purchased by the American government for 800l. Early in his career Clay was the editor of the 'Ashton Reformer.'

Clay died at Poulton-le-Fylde, near Blackpool, on 19 Sept. 1893. He was twice married : first, in 1 823, to the eldest daughter of John Vaudrey, surgeon at his old home, Bredbury, near Stockport. He had three children by her, but they, with their mother, died before he left Ashton-under-Lyne in 1839. He married, secondly, a daughter of Joseph Boreham of Haverhill, Suffolk.

Clay may fairly be regarded as the father of ovariotomy as far as Europe is concerned ; indeed, Peaslee says of him (Ovarian Tumours, New York, 1872, p. 272), 'To Dr. Charles Clay of Manchester, however, more than to all other operators the credit belongs of having placed the operation of ovariotomy on a sure foundation.' Fehr calls him 'the original hero of the operation.' When Clay performed his first operation ovariotomy had been done by Ephraim McDowell (1771-1830) and others in America less than twenty times ; about ten successful cases had been published by different provincial surgeons. John Lizars (1783-1860) had met with such ill-success in Edinburgh that he had not persevered in his endeavours, and no surgeon had performed the operation successfully in London. It showed, therefore, a grasp of surgical principle, and an unusual boldness of thought and action for Charles Clay, then a general practitioner, without a hospital or other official position, to commence the systematic performance of a novel operation of such magnitude, discountenanced as it was by most of the leading surgeons. Partly from these causes, and partly from the fact that the published accounts of the cases were said to be wanting in detail, Clay never influenced the opinion of the medical profession so widely as might have been expected from his knowledge, his ability, and his experience. He felt keenly this want of public recognition, which culminated in an unseemly wrangle in 1880. Clay has the further merit that he advocated the use of a long incision through the abdominal wall, a method which, though it was not quite novel, was held by his contemporaries to be incorrect. He was also the first (1843) to employ drainage in abdominal surgery, and he brought into use the term 'ovariotomy,' which, it is said, was suggested to him by Sir James Young Simpson [q. v.]

Clay's works were: 1. 'The British Record of Obstetric Medicine and Surgery for 1848 and 1849,' Manchester, 1848-9, 8vo. Clay was himself the principal contributor to these two volumes, which contain many interesting articles, with translations of rare and valuable monographs upon obstetric medicine and surgery. The further issue was discontinued, as the venture proved unsuccessful financially. 2. 'The Results of all the Operations for the Extirpation of Diseased Ovaria by the large Incision from 13 Sept. 1842 to the present Time,' Manchester, 1848, 8vo. 3. 'The Complete Handbook of Obstetric Surgery,' London, 1856, 12mo ; 3rd edit. London, 1874, 8vo. 4. 'Geological Sketches and Observations on Fossil Vegetable Remains, &c., from the great South Lancashire Coal Field,' London, 1839, 8vo. 5. ' History of the Currency of the Isle of Man,' 1849, 8vo. 6. ' Proceedings of the Manchester Numismatic Society, conducted and edited by Charles Clay, President of the Society,' 1871-2, 4to.

[Contemporary Medical Men, by John Leyland, Leicester, 1888; Brit. Med. Journ. 1880; obituary notices in the Lancet, 1893, ii. 815, and in the Transactions of the Obstetrical Society of London. 1894, xxxvi. 100; additional information kindly given by Dr. Lloyd Roberts of Manchester.]

D’A. P.