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492
MODERN TIMES.
for ophthalmic practice. With the help of the ophthalmoscope
it became possible to examine the state of the refractive
media and of the fundus oculi. The meaning of
-amaurosis—which had previously been defined in a jocular
way as a disease " where the patient cannot see anything
at all—nor the doctor either" was now rendered more
intelligible * and the various diseases of the retina could be
differentiated. When the relation of these to certain
general diseases, such as BRIGHT'S disease, diabetes mellitus,
etc., was established, the ophthalmoscope acquired
importance as an aid to diagnosis in general medicine.
Midwifery proceeded on its natural course of development,
and by taking into consideration all the physiological and
pathological processes which occur in women, became enlarged
into gynaecology. The opinion came at last to be held
that pregnancy, parturition, and childbed are physiological
conditions, the course of which should be left to the management
of nature, so long as abnormal circumstances do not
•call for the interference of the doctor. LUKAS BOER, who
defended these principles, rejected the so-called preliminary
treatment, which in most cases acted injuriously, and proved
that presentations of the face, breach, knee, and foot do not
always require the art of the doctor, but that spontaneous
birth frequently occurs through the regulative powers of
nature.
The clumsy and complicated instruments of an earlier
day were simplified, and operative midwifery was confined
to those cases in which it was indispensable. It was discovered
how to diagnose a contracted pelvis by methodical
measurements, and how to estimate the influence of changes
of position and diseases of the uterus upon pregnancy and
parturition.
The pathology of the lying-in period was carefully investigated,
especially in regard to puerperal fever, a disease
-upon the pathogenesis of which a startling light was thrown
by the observations of the unfortunate SEMMELWEISS.
* A. HIRSCH : Geschichte der Augenheilkunde op. cit., S. 474.