Contributions to British Gynaecological Society : session 1902-3 / by J. Halliday Croom.

  • Croom J. Halliday (John Halliday), Sir, 1847-1923.
Date:
1903
Catalogue details

Licence: In copyright

Credit: Contributions to British Gynaecological Society : session 1902-3 / by J. Halliday Croom. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    13/76 (page 7)
    closer acquaintance with the mechanicism of labour and an early recognition of pelvic deformities has made it possible for the practitioner now to avoid a sacrificial operation by the induction of premature labour, or the performance of Caesarian section, and to recognise the necessity of these operations and to undertake their performance while the patient is yet unexhausted and her tissues uninterfered with, and not to wait as formerly, till the patient is exhausted by futile attempts to deliver in some other way. Caesarian sec- tion, thanks entirely to the work of the gynaecologist, has made enormous advances. It is now possible to deliver a woman with extreme pelvic deformity by this method, or its various modifications, with a very small mortality indeed ; whereas at the beginning of the century the mortality could not be much less than go per cent. Perhaps the greatest of all improvements is not in opera- tive obstetrics, though that is great enough, but rather prevention. One is struck with the enormous advance of preventive medicine generally in all directions ; the preven- tion of smaU-pox, typhoid, diphtheria, and so forth. But preventive medicine has advanced in obstetrics as well. At the beginning of the century puerperal fever was the scourge of our lying-in hospitals. Now the death-rate has been reduced in properly-conducted hospitals, so far as puerperal septic fever is concerned, to practically nil. It is true that in private practice it seems to go on unabated. Dr. Culling- worth has drawn up statistics pointing out this very sig- nificant fact. To what are all these advances due ? What has made those advances possible ? In the first place, anaesthesia has made it possible to perform the operations to which I have had occasion to refer with greater care and skiU, and has helped materially to make Caesarian section the success it is. And the other potent factor in rendering these opera- tions safe, and in reducing mortality, is the almost universal use of antiseptics in hospitals and in private practice. All the operations to which I have referred were prac-