History of medical practice in Illinois - Bushnell Historical Society

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232 History of Medical Practice in Illinoisthetics in labor, which had been both wide and deep, had disappeared.Regarding the administration of chloroform or the A.C.E. mixture he hadthis to say: "The administration of chloroform should not be carried tocomplete anesthesia. Just enough should be given to modify the pain—notenough to produce unconsciousness. It is a pretty safe rule to pour a littlechloroform on a sponge and give it to the patient herself to inhale a littlewhenever she feels the pain, the sponge dropping from her hand if shegets too much. The time for its use is at the beginning of the expulsivepains, when they become severe, and its exhibition should cease immediatelyupon expulsion of the head." 15What seems to have been the first mention of a case of air embolism inIllinois is described thus: "A young physician of our city, of the homeopathicpersuasion, and possessing perhaps somewhat above the average intelligenceof his 'school,' undertook to assist dilatation of the uterus in acase of confinement by the use of Barnes's dilator. The latter was introducedpresumably in the proper position, and pumped full of air. In a fewminutes the woman gave evidence of asphyxia, and soon expired. Uponwithdrawal of the instrument it was found to have burst during the processof distention. The case was subsequently made the subject of a coroner'sinquest, at which was taken the evidence of the attending and otherphysicians, together with that of the husband and neighbors of the de-the time of the operation and death." Theceased, who were present atfollowing is self-explanatory and for that date was highly instructive:"Being called upon by the coroner March 12, 1889, to perform an autopsy 16upon the body of Mrs. Angenora Opdycke, at the vault in Springdalecemetery, we found that the deceased had been dead some four or fivedays, decomposition having set in. Upon opening the abdominal cavity,we found that the uterus contained a male fetus, apparently at full term,the placenta partially detached from the walls of the uterus, and twoor three coagula of blood. Presentation normal, and allthe pelvic organsfree from any evidence of disease or injury, and that death was caused bythe introduction of atmospheric air into the uterine sinuses." This wassigned by D. W. Magee, M.D., and J.D. Furry, M.D.The coroner's jury reported: "After hearing the report, testimony, andopinions of several physicians, we cannot find that any blame attaches tothe doctor. At the same time, taking into consideration the fatal resultsin this case, we are inclined to condemn the use of this dilator when expandedwith air."15 It would seem that history is repeating itself and that the newest importation fromEngland is not at all new to Illinois. There is a trend at present toward the use oftrilene administered by the patient with a specially devised mask which falls away assoon as the patient begins to get too much anesthesia.16This was one of the early autopsies in Illinois.
Obstetrics and Gynecology 233That the idea of the use of prophylactic forceps was not new is attestedby this statement from Dr. Will in 1889: "As to the use of the forceps inordinary labor, my sentiments and practice, as those of the age, are reflectedin the Clinical Reporter: 'It should be graven on the mind of everypractitioner that the forceps is always permissible in the second stage oflabor if the expulsive efforts of nature have from any cause ceased. Whenthe first stage of labor has terminated, the os being fully dilated, the membranesruptured, and no complications present, as tumors, cicatrices, etc.,it should be borne in mind that any delay in the process of delivery is dangerous.If the delay be caused by inertia, impaction or exhaustion, thecomplication and danger are increased with each moment that the use ofthe forceps is neglected.' "A sidelight on the practice of the time appears in this report of Dr. Will.It was his practice to use forceps to prevent the too rapid extrusion ofthe head over the perineum at the end of the second stage, and he said:"I do not believe it possible for any accoucheur to properly judge of thepressure on, and thoroughly protect, the perineum, without having it insight. This is an essential point in the treatment for the prevention oflacerations. Whether the patient be in the lateral or dorsal position,clothing being slightly raised on one side permits the necessary observation.The patient is rarely aware that this is done, and if she is, does not objectwhen she knows for what purpose it is done." Thus it is seen that theold custom of delivering women under a sheet to protect their modesty wasstill practiced in a modified degree in Illinois as late as 1889.1890—1900In 1890, Dr. L. A. Molone, reporting on gynecology, indicated that medicalwriting on this subject had recently been greatly stimulated and thatit had been estimated that about 18 articles a week appeared in the literature.He felt that few surgeons had the courage to report failures, and hecited one man who had 14 fatal ovarectomies before his first successfulone. Similar results had followed other gynecologic operative procedures.What may be regarded as the first case of endometriosis of the abdominalwall was reported as a case of vicarious menstruation in a woman whobled each monthly period from the scar of a laparotomy wound followingremoval of an ovarian cyst. The explanation of this phenomenon givenby the doctor reporting the case was that probably a portion of the fallopiantube had been caught in the abdominal scar and that some of the menstrualblood escaped thus at each period.Dysmenorrhea was treated by dilatation of the cervix with good resultsin 1 1 out of 13 cases.Dr. Molone advised careful observation inthecases of pelvic abscess and
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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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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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