History of medical practice in Illinois - Bushnell Historical Society

228 History of Medical Practice in IllinoisIn the year 1883,a vaginal hysterectomy was performed in Peoria forcomplete procidentia of the uterus which had been prolapsed continuouslyfor six years and intermittently for twelve years. The operation was doneunder ether anesthesia and took one hour and ten minutes. No repair wasattempted, but the denuded posterior vaginal wall and the posterior surfaceof the bladder became adherent to each other and closed off the vagina,thus providing support for the abdominal viscera. The patient sat up alittle at the end of five weeks, easily walked across the room alone in sevenweeks and went home in two months!Dr. Charles Warrington Earle stated in 1885 that postpartum hemorrhagecould be treated by the farradic current with excellent results. Thepractitioner was advised to stay by the patient's bedside for at least an hourafter delivery to assure himself frequently that the uterus was contractingfirmly.Up to this time carbolic acid had been used as an antiseptic for intrauterinedouche. Bichloride of mercury 1:1000 largely replaced it but therewas evidence that some cases showed mercurial poisoning following its use.Eclampsia was now beginning to be better understood, and the relationshipof albuminuria to the disease was noted as an effect rather than acause. The good rules for prenatal care which were laid down were muchlike ours of today:Use of tonics and iron for the blood.Liberal diet.Stimulation of functions of the skin to relieve tensions of the kidneys.Examination of the urine for albumin after the fifth month or earlier, ifthere is probability of renal disease.Warm bathing in water 108 to 1 io° was believed to be of great value andwould not cause premature labor.Force fluids and milk diet.Purgatives and diaphoretics.Induction of labor when these means failed to improve the threateningcerebral symptoms.There were 480 deaths from eclampsia reported in Boston from 1867 to1876; the Chicago statistics were said to be worthless.Management of retained placenta and membranes was well described.A period of Avatchful waiting, often trying Crede expression, was advised,supplemented if necessary by gentle traction on the cord. If this failed, thesterile vaginal examination was resorted to, assisting the exit of the placentafrom the uterus by helping with the fingers of the examining hand. Thedanger of removing a densely adherent placenta was pointed out. Procrastinationin the delivery of the placenta after a few hours, even if there wasno hemorrhage, was considered to be unwise because operation might haveto be performed later in the presence of severe infection. The use of anti-