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SURGERY AND OPHTHALMOLOGY 493
The diseases of the uterus, the ovaries, and the neighbouring
parts gave opportunities for operative interference, the
methods of which were now for the first time to be discovered.
Extirpation of the uterus in malignant affectionsof
that organ was already practised by MONTEGGIA,
OSIANDER, and others, and in modern times the operation,
has been perfected in points of technical detail.
The same is true of ovariotomy, which was for the first
time performed by MACDOWELL in 1809, and since then.
has been much improved as an operation. The operativetreatment
of prolapse of the uterus and vagina, as also the
operation for vesico-vaginal fistula—a condition formerlyconsidered
incurable—are also achievements of modern
times, and are chiefly due to the labours of JOBERT DE
LAMBALLE, MARION SIMS, G. SIMON, and other distin­
guished gynaecologists of our time.
3 The progress of medicine in the 19th century was not,
however, confined merely to improved methods of treating
the individual sufferer, but it brought home to the conscience
of the public the important relation borne bysanitation
to the State itself. No doubt this was associated
with political development, under the influence of which
the government of the State was reminded of its duty toprotect
society, and in every citizen s breast the sentiment
was aroused that he, as a member of the commonwealth,
had a duty to fulfil towards it, and was interested in its
welfare.
And thus forensic medicine, which was established and
advanced by A. HENKE, MENDE, CHRISTISON, CASPER,.
ORFILA, TARDIEU, and others, and State medicine, the
foundation of which was the work of PETER FRANK, were
added to the list of medical subjects in which instructionwas
given. What the former became for the Law Courts
the latter was intended to be for the Government—the
compendium of all the knowledge required by the medical
specialist when consulted by the authorities. Sanitary
control became expanded into hygiene, or care of the public