History of medical practice in Illinois - Bushnell Historical Society

Obstetrics and Gynecology 227cases, where there was no chance for successful operation, be used to proveor disprove the benefits to be expected from this remedy. History hastended to repeat itself many times since.Other gynecologic procedures being advocated were trachelorrhaphy inseverely lacerated cervices, and repair of birth injuries at the time of deliveryrather than at a later date. Dysmenorrhea was being treated by Germancamomile tea, electricity, viburnum compounds, mechanical dilatationof the cervix and removal of polypslIn 1882, Dr. Edward W. Jenks of Chicago claimed that the work ofAmerican gynecologists was superior to that of European gynecologists whowere slow or unwilling to give credit to advances made by Americans.Garsnier, writing in the Dictionaire Annual of Paris in1882, stated thatthere was a tendency in America to think that all disease stemmed from theuterus and that a similar idea had prevailed to some extent in France. Itwas his opinion that the American Gynecological Society was unlike anythingin France and predicted that it would have a far-reaching effect inadvancing gynecology in America. In discussing the Emmet operation oftrachelorrhaphy, Garsnier warned against the idea that all gynecologiccomplaints would be benefitted by repairing a cervical tear, if present; theprophylactic value of the operation in preventing epithelioma was pointedout, especially if the patient had a predisposition to cancer by heredity.He suggested that the use of Listerism during ovarectomy was too toxic onthe peritoneum. However, he advocated the use of carbolic acid spray onthe table and instruments, and soaking the sponges in carbolic acid afterthey were soaked in sterile water.Complete hysterectomy for carcinoma was just beginning to be advocated.Dr. Christian Fenger wrote an excellent paper on the subject, publishedin the January 1882 issue of the American Journal of Medical Sciences.Several published reports stressed the following points: Freundfavored abdominal total hysterectomy because of the difficulties encounteredin vaginal hysterectomy. Playfair thought the abdominal operationwas too complicated, but admitted that an early diagnosis would make itmuch more available. Long before abdominal hysterectomy was beingdone, Blundell, an early obstetrician, removed the uterus vaginally in fourcases. Mortality from removal of the uterus for all causes was 75 to 80 percent, and for fibroids was 50 per cent. The operation was advised only as alast resort in a patient suffering extreme pain. The Beatty operation forremoval of the ovaries when the fibroid uterus could not be removed wasalso used for dysmenorrhea and neurosis, showing that the relationship betweenthe endocrine activities of the ovaries and the stimulation ofendometrial growth during the menstrual cycle were appreciated by thesesurgeons.