History of medical practice in Illinois - Bushnell Historical Society

222 History of Medical Practice in Illinoisto admit that the caustic potash did not help in the treatment of the conditionand might actually have done harm.1860—1870Relatively little information can be gleaned from this decade as medicalpractice and teaching were so disrupted by the Civil War. However, itsignificant that all deliveries, except major obstetrical operations, weredone in the home since there were then very few hospitals in the state andthese were largely intended for surgical cases. As already stated, bacteriologywas practically unknown and, of course, not taught in any medicalschool. There was no electric light or other strong illumination. All obstetricoperations were done on a low bed or on a kitchen table, without properanesthesia, and with the untrained assistance of the husband or neighborwomen in the great majority of cases. Few of the doctors had any surgicalexperience or training, except that gleaned from injuries treated in theirown practice or that of a colleague. Picture the plight of one of these generalpractitioners alone with his patient's family in a lonely farm house at3 A.M.; an exhausted woman in labor about whose physical make-up andprenatal course he knows nothing and whose baby is showing signs ofsevere distress. A difficult forceps delivery is indicated which would try theskill and exhaust the strength of a DeLee or Williams, but this practitioneris forced into doing an operation which he knows he is incompetent to do.Thus can one arrive at a realization of what obstetrics of that day mightimply. 11Some of the men, even at this early time, had a keen insight into thebasic problems of obstetrics. For example, Dr. DeLaskie Miller, Professorof Obstetrics and Diseases of Women and Children at Rush Medical College,writing on puerperal sepsis in the years 1861-1864, thought the causewas "zymotic." He advised that parturient females should not be placedcontiguous to patients with puerperal fever, erysipelas or gangrene. Heheld that the disease spread from contact with clothing, the surface of thebody and the breath of attendants. He questioned the advisability of havinga lying-in hospital, and felt that most women were safer if delivered ina cabin. He felt strongly that physicians should give up caring for infectedcases if they were to take care of other pregnant women. In his opinion,bloodletting, which was freely practiced at this time, was worthless inpuerperal disease. Miller advised that chlorine solution be used in thevagina or even in the uterus, either in the form of vapor or solution, buthe relied chiefly on general support.is11Some indication of the remuneration for obstetric service in Chicago can be gainedfrom the fact that a Dr. Wanzer in 1849 charged fifteen dollars for a maternity case. It isalso interesting to note that a Mrs. Robertson had a very lucrative practice in obstetricsbut no medical degree. One historian calls her the "feminine Hippocrates."