History of medical practice in Illinois - Bushnell Historical Society

Obstetrics and Gynecology 215ward, impelled by the pioneer spirit of the times to seek their fortune in therapidly expanding development of the Mississippi Valley. A considerablenumber had started teaching in an entirely separate branch of medicine,such as anatomy or the theory and practice of medicine. Therefore, theybrought to their obstetric classes a broader outlook on the subject eventhan is sometimes seen in obstetric departments in medical schools of thepresent day. In general, they were well prepared as compared with otherdepartments of the school, but were forced to teach without clinical materialsince there were no beds setaside in the hospitals of the time forobstetric patients. Didactic lectures were used to convey their ideas to theirstudents who entered practice without having any practical experience inobstetrics except what they might have gained from a preceptor.It may be said, then, that the general pattern of obstetric practice duringthis early period was that of the general practitioner delivering patientsin the home and meeting complications as best he could with the meagrefacilities available. He had no trained assistants, either nursing or medical,to aid him; anesthesia was not in general use, and the mortality rates formothers and infants were high.By 1880, according to Dr. G. W. Nesbitt of Sycamore, 4 Chairman of theCommittee on Obstetrics of the Illinois State Medical Society, medicaleducation had advanced steadily in most other branches but had laggedbehind in obstetrics. Most of the teaching was by didactic lecture withlittle or no practical experience for the student, although the teachers werecompetent. He felt that the schools should provide proper training andpractical experience, and he suggested that the faculties of the Illinoismedical colleges through the Illinois State Medical Society bring the matterbefore the Association of American Medical Colleges. He felt that eachmedical school should have a lying-in hospital attached where undergraduateand postgraduate students could serve in outpatient deliveryservice for which a special fee could be charged; that patients be required toregister for this service one month before going into labor; that the servicebe under the direction of competent instructors and that a special clause onthe diploma of the medical student would testify to the fact that he hadhad practical training in midwifery under their direction. Thus, it is seenthat a small town country doctor in Illinois in 1880 was farther ahead in histhinking on proper teaching of obstetrics than anything that had been proposedor at least had been put into operation in thiscountry up to thattime.By 1886, Dr. E. Ingals advocated endowed faculties for the medicalschools, and entrance examinations to cut down the numbers and to improvethe quality of medical students. He thought also that the Board of* Transactions of the Illinois State Medical Society, 1880.