History of medical practice in Illinois - Bushnell Historical Society

Obstetrics and Gynecology 221on the composition of the blood, in that the density of defibrinated bloodand serum diminished, and water, fibrin and phosphorized fat increased,and corpuscles and albumin were diminished. This was probably theearliest mention, at least in Illinois, of disturbed water balance duringpregnancy.Anesthesia (chloroform) had been discovered in 1847. It is, therefore,astonishing to note that in 1859 a series of 500 cases delivered under chloroformanesthesia was reported by Dr. D. W. Young. A careful analysis wasmade of the advantages and dangers of the procedure, and recommendationswere made for its use which might well be used today in obstetriccases. The dangers of the production of desultory labor were pointed out,together with the tendency to uterine relaxation postpartum predisposingto hemorrhage. The deleterious effect on the newborn baby was alsoemphasized with special mention of deaths due to respiratory failure. Dr.Young claimed that if chloroform were judiciously administered by puttingit on a loosely folded silk handkerchief in amounts just sufficient tostop pain, it would safely and successfully alleviate and annihilate thesuffering incident to childbirth. When given in this way, no illeffect wasnoted on the baby or mother, and in no case in his series did the anesthesiahave to be discontinued. He used about 6 ounces in six hours of labor.Some practitioners condemned the use of anesthesia in any case, implyingthat pain is a necessary accompaniment of labor. Others hailed it as agreat boon to suffering womanhood and used it to excess. Most of the menof this day, however, agreed that anesthesia had a place in obstetrics andshould be used cautiously for analgesia and only rarely for completeanesthesia. Evidently the bad effect of morphine to relieve the pains oflabor was well recognized, since it is seldom mentioned in their discussionson anesthesia.Gynecology was not as far advanced comparatively as obstetrics in thedecade from 1850 to i860. For example, the difficult problem of carcinomathen had to be met as best it could be with the limited knowledge of thecondition and equipment for its treatment. In 1859, Dr. William H. Byforddescribed cancer of the cervix uteri in a woman who had been bleeding irregularlyfor 18 months. He found a polyp which he attempted to ligate;this resulted in severe hemorrhage and some disintegration of the mass.Within four or five weeks this was reduced to the size of a hen's egg, whenanother attempt at removal was made. Biopsy showed it to be carcinoma.It was removed repeatedly as itrecurred and made defecation and urina-The technic followed was removal every two weeks by ec-tion difficult.crasseur with cauterization of the stump by caustic potash. The patientcomplained of relatively little pain. Postmortem examination revealedbladder involvement. In reviewing the case, Dr. Byford was frank enough