History of medical practice in Illinois - Bushnell Historical Society

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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."
Obstetrics and Gyn ecology 223Eclampsia at this time was considered to be best treated by vena section,and chloroform was administered both pre- and postpartum. Twentyfiveper cent of the women who developed this disease died.A paper by Dr. B. H. Cheney in 1869 indicated that placenta previacentralis was treated in the following manner: A tampon was put into theuterus to detach the placenta and chloroform was given to relax the os.The patient had been taking whiskey as a stimulant As soon as the cervixwas sufficiently dilated, a Braxton-Hicks version was done. The baby diedand the patient barely recovered after a "fearful" loss of blood. Themortality incidence of this condition at this time was one out of threemothers and 50 per cent of the babies.1870-1880In the decade from 1870-1880, the management of obstetricalhemorrhageseemed to occupy more and more the attention of physicians interestedin obstetrics. In 1873, blood transfusion was just beginning to be triedin England and France. Controversy arose regarding the effects of this procedure,especially when animal blood was given human recipients. Seriousreactions were often noted and the procedure, therefore, was not endorsedby the obstetricians as a safe method to combat hemorrhages. Ponfic, forexample, noted hemolysis of red cells in a woman who died twenty minutesafter transfusion with lamb's corpuscles.Dr. J. B. Rood, in 1873, described the method of combatting postpartumhemorrhage by the injection of perchloride of iron in the uterus. Hot waterinjections were also used for postpartum hemorrhage, the water being keptat 100 F. Cold water had been found ineffective. Hot water was also usedfor controlling hemorrhage from abortion, placenta previa, fibroids andcarcinoma, and in cases of menorrhagia.In 1875, Dr. Joseph W. Freer reported on blood transfusions, includingthe use of defibrinated blood and artery-to-vein direct transfusion. Bloodtransfusion was also used in anemias and tuberculosis. In some instances,blood was stored 72 hours in the ice box before use. Thus we see thegermination of the idea of the blood bank. Early in the study it was notedthat deaths occurred from hemolysis of blood cells in some cases. Fataltransfusion reactions were well known long before the principles of bloodmatching were worked out and before the dangers of the procedure wereclearly recognized. This caused the procedure to fall into disrepute. It ismuch to the credit of these early pioneer obstetricians that blood transfusiondid not then come into general use in obstetric cases.In his paper Freer said that in case of danger from acute hemorrhage"so certain istransfusion of normal blood to resuscitate and restore lifethat we feel warranted in asserting emphatically that the practitioner in
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HISTORY OFMEDICAL PRACTICEIN ILLINO
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PREFACEVARIOUS members of the Illin
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Prefaceixall of its local health de
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PrefacexiDr. E. A. Piszczek, Chicag
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THEEDITOR'S FOREWORDperiod 1850 to
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Editor's Forewordxvand 650 he comme
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xviiiXVIII.XIX.Medical Bacteriology
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CHAPTER IINTRODUCTIONBy DAVID J.DAV
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Introduction 5Smillie 3 wrote on ep
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CHAPTER IIMEDICAL GEOGRAPHY OF ILLI
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Medical Geography of Illinois 9geol
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12 History of Medical Practice in I
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Medical Geography of Illinois 15had
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Medical Geography of Illinois 17of
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Fig. i. Places and regions in Illin
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Medical Geography of Illinois 21ref
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Medical Geography of Illinois 23Cha
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i„r»-l ll'urlnllli• A i!.n»Ut
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CHAPTER IIITHE HARDY PIONEER:HOW HE
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CHAPTER IVORGANIZATION OF THE ILLIN
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CHAPTER VIIINTERNAL MEDICINEBy GEOR
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History of Medical Practice in Illi
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CHAPTER XIIIOTOLARYNGOLOGYBy ALFRED
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CHAPTER XIVDERMATOLOGYBy B.BARKER B
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CHAPTER XVNEUROPSYCHIATRYBy OSCAR H
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CHAPTER XXIVMEDICAL JOURNALISM IN I
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APPENDIXMISCELLANEOUS NOTESAddition
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5ioIndexAntifebrin, 138, 139Antipyr
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5 1 * Index159, 163, 190, 284; Amer
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5HCollege of Medicine, University o
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516 IndexEpidemics, 5, 507Epileptic
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15 i8 IndexHarris, Dr. J. O., 115Ha
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5 2 ° IndexJacobson, Dr. Daniel Si
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522Index456, 457; Privately Endowed
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