History of medical practice in Illinois - Bushnell Historical Society

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230 History of Medical Practice in IllinoisIn 1886, Dr. W. W. Jaggard reported on the anatomical changes in thecervix and lower portion of the uterus during the course of pregnancy andlabor. This was based on the remarks of Braun, Schroeder, Bandl, Muellerand others with whom he had come in contact in Europe. This was the firstscientific exposition presented before the Illinois State Medical Society andmarked the beginning of the influence of the German schools on the thinkingof American obstetricians and gynecologists. Jaggard also discussedhyperemesis gravidarum, clearlyTwenty-eight uncontrollable cases were reported;indicating the part played by neurosis.14 of these women recoveredand 14 died. In 20 cases pregnancy was interrupted before theperiod of viability;16 recovered and 4 died. Rectal feeding, stomach tube,gavage, farradic current per rectum and painting the pharynx with cocaineall were used, as were blisters over the fourth dorsal vertebra, and chloralhydrate and bromides as sedatives. In patients with disproportion resultingin dystocia, forceps or version was tried; if they failed, craniotomy was performed.At this time eclampsia was thought to be due to the retention of endproducts of metabolism from retention of urine. Albuminuria was not alwaysfound, and it was emphasized that a normal kidney might be seeneven in a fatal case. Attention was called to spasm of the muscular wallsof the vessels and it was pointed out that pressure on the ureters mightcause obstruction. The condition was found to be more common inprimiparae and was treated by hot baths.Also in 1886 Dr. B. Ruppe of New York reported before the IllinoisState Medical Society a remarkable case of vesicovaginal fistula followingthree days after delivery in a patient with typhoid fever who was treatedin an equally remarkable manner: she was placed in a wash tub for 21 days,immersed in warm water, and at the end of this time the fistula had closedspontaneously.Dr. O. B. Will was Chairman of the Committee on Obstetrics of the StateMedical Society in 1889. In his Chairman's Address he discussed physiologicchildbirth as follows: "It nevertheless is subject to pathological conditionswhich develop because of her environment, parentage, occupation, education,moral and mental atmosphere, fashion and all the other demands ofthe age, and has thereby been forced to suffer a departure from the standardof perfection seen in nature's usually beautiful adaptation of means toends. Since this is so, it is necessary for practitioners of midwifery to beapprehensive in no small degree about normal childbirth and leads themto an exercise of judgment and art as a solution of this, nature's apparentlycorrupted problem."Dr. Will also referred to what he termed "that colossus of modern medi-
Obstetrics and Gynecology 231cine—the germ theory of disease." He insisted that organisms normallypresent in the generative tract were generally innocuous and that theproblem in lying-in hospitals at least, and probably elsewhere as well, wasto prevent the entrance of virulent organisms. To this end he recommendedscrupulous cleanliness and preparation of the patient before anyvaginal examination was attempted, and that both the doctor and nurseattending an obstetrical case use the most efficacious antiseptic known,namely, the perchloride of mercury in a strength not less than 1:1000, onthe hands, catheters, and the sponges used for external washing. Since hefelt that disinfection of the accoucheur's hands was most important, herecommended that particular attention should be given to the fingernailsand that, when they were about to be introduced into the vagina, theyshould be filled beneath their tips with soap scraped by them from thetoilet cake at hand. He considered soap to be of great value as it was thesafest lubricant available. "It istrue that most women escape infection ofsuch nature and in such way, but many do not, and the numerous instancesof death from chills and fever, malaria, inflammation of the bowels, milkfever and general debility,'from which so many women are reported asdying during the puerperal period are suggestive of the ignorance and carelessnesswith which these well known principles of modern medicine aretreated. It is a shame and a disgrace that such should be the case. It is worsethan that—it is a crime. ... It is now almost universally admitted thatthe finger should be inserted into the vagina as infrequently as possible.In fact, only frequently enough to secure the necessary knowledge of positionand progress, in view of the greater probability of thereby introducingseptic matter into the organism, even if the member has been rendered asinnocuous as possible. This precaution isparticularly valuable where thephysician accoucheur has been compelled, induties, to handle other cases of disease from which itthe multifariousness of hismight be barely possibleto secure a degree of septic contamination."As regards anesthesia, Dr. Will said: "It is not now considered necessaryto permit a woman to suffer and become nervous and excited over theso-called 'nagging' pains of the first stage of labor any more than those ofthe later and severer type. On the contrary, it is not considered a merematter of choice, but of justice and necessity." He stated that up totime, chloroform had been most freely used but that he had substitutedthe so-called A.C.E. mixture of alcohol, chloroform and ether in the ratioof 1, 2 and 3 parts. Chloral hydrate was also used and preferred by many,except during the last expulsive pains of labor. He felt, however, that thiswas more uncertain, too enduring in its influence, and positively unsafe;he had witnessed two deaths presumed to be from its use. It was his opinionthat the chasm between the advocates and opponents of the use of anes-this
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HISTORY OFMEDICAL PRACTICEIN ILLINO
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i3 Zvibxxtt to Br. 30. 3L ©abteTHI
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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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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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524IndexParkes, Dr. Charles T., 181
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3526IndexReed, Dr. Carlos I., 403Re
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History of medical practice in Illinois - Bushnell Historical Society

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