A practical treatise on inflammation of the uterus, its cervix and appendages : and on its connexion with uterine disease / by James Henry Bennet.

  • Bennet, James Henry, 1816-1891.
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on inflammation of the uterus, its cervix and appendages : and on its connexion with uterine disease / by James Henry Bennet. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    assistance ; and certainly, no mode of investigation is so likely to enable us to arrive at a correct knowledge of the morbid changes which are taking place in a concealed organ as the ocular inspection of the organ itself. That such an inspection is not only possible, but in most cases perfectly easy, was, no doubt, discovered in a very early period of medical history. We continually see the uterus falling, by its own weight, or by the laxity of its means of support, to such an extent as to merely require the separation of the labia to be seen, or as even to protrude externally. From the examination of the womb thus prolapsed to the use of some mechanical means of opening the vulva and vagina, so as to allow the eye to reach the lower segment of the uterus when the organ is not prolapsed, there is but a step. That step was made probably more than two thousand years ago. Although the fact is not generally known, it is nevertheless quite certain, that ocular inspection of the cervix uteri by instrumental means was known to the ancients, perhaps from the earliest times ; and its having subsequently fallen into complete abeyance, along with the information obtained through its means, is a singular circumstance in the history of medicine, which can only be explained by the peculiar social conditions through which medical science has since passed. Paulus JEgineta alludes to the 5:o**pa, or dioptra, in several parts of his work, as to an instrument in general use. In the section on ulcer- ation of the uterus,1 he states that the ulceration is to be detected by the dioptra; and in that on the treatment of abscesses of the womb,2 there is a long account of the way in which the instrument, evidently a kind of bivalve speculum, is to be used. This well-known author lived in the seventh century, but he was more a compiler than an original writer ; and, according to Mr. Adams, the learned translator and commentator of his works, this part of his description of uterine diseases is mostly taken from Aetius, who, in his turn, professes to have copied from writers who lived at a much earlier period, such as Archigenes and Asclepiades. Xot only was instrumental examination of the uterine neck known to the ancients, but they were evidently familiar with this mode of investigation. This fact is satisfactorily proved by the practical information respecting diseases of the cervix uteri which they pos- sessed—information which they could only have acquired by the ocular demonstration afforded by the use of the speculum. Thus, in the section of Paulus ^Egineta's work on Ulceration of the Womb, to which I have alluded,3 we find inflammatory ulceration of the cervix 1 The Sydenham's Society's edition of the works of Paulus jEgineta, vol. i., p. G24. 2 Ibid., vol. ii. pp. 885. 6. 3 Ibid., vol. i. pp. 624, 5:—The uterus is often ulcerated from difficult labour, extraction of the foetus, or forced abortion or injury of the same, occasioned by acrid medicines, or by a defluxion, or from abscesses which have burst. If, therefore, the ulceration be within reach, it is detected by the dioptra, but if deep-seated, by the dis- charges : for the fluid which is discharged varies in its qualities. When the ulcer is inflamed, the discharge is small, bloody, or feculent, with great pain ; but when the