History of medical practice in Illinois - Bushnell Historical Society

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