A system of gynaecology by many writers / ed. by Thomas Clifford Allbutt ... W.S. Playfair.

  • Thomas Clifford Allbutt
Date:
1897
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Licence: Public Domain Mark

Credit: A system of gynaecology by many writers / ed. by Thomas Clifford Allbutt ... W.S. Playfair. 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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    Another landmark in the history of the development of modern gynaecology was the publication by Dr. Tilt, in 1850, of his book on the subject of Ovarian Inflammation; later the same writer put for- ward the following propositions: — 1. That the recognised frequency of inflammatory lesions in the ovaries and in the tissues which surround them, is of much greater practical importance than is generally admitted. 2. That of all inflammatory lesions of the ovary those involving destruction of the whole organ are rare; while the most numerous, and therefore the most important, may be ascribed to a disease that may be called either chronic or subacute ovaritis. 3. That, as a rule, pelvic diseases of women radiate from morbid ovulation. 4. That morbid ovulation is a most frequent cause of ovaritis. 5. That ovaritis frequently causes pelvic peritonitis. 6. That blood is frequently poured out from the ovary and the oviducts into the peritoneum. 7. That subacute ovaritis frequently initiates and prolongs metritis. 8. That ovaritis generally leads to considerable and varied disturb- ance of menstruation. 9. That some chronic ovarian tumours may be considered as aberra- tions from the normal structure of the Graafian cells. Much of the pathology involved in these propositions of Tilt was sound, and has stood the test of time and more extended research; and though, as in propositions three and four, his teaching is not nowadays accepted, yet by it a considerable stimulus was given to the study of ovarian pathology, and in testing the truth of his assertions more and more light was gained. Morbid conditions of the tubes had been but little studied in Tilt's time, and the relation of tubal disease to ovarian inflammation was hardly appreciated; had tubal pathology been better understood, probably less weight would have been attached to morbid ovulation as a cause of pelvic disease. The year 1854 marked a fresh epoch in the evolution of gynaecology; then it was that the great war of uterine displacements and pessary- manufacture began. Hodge in America, Velpeau in France, and Graily Hewitt in England, stood forth as champions of the immense impor- tance of malposition of the uterus in th& causation of pelvic disease. How strongly the theory was urged may be judged by Velpeau's state- ment : I declare, nevertheless, that the majority of the women treated for other affections of the uterus have only displacements, and I affirm, that eighteen times out of twenty, patients suffering from disease of the womb, or of some other part of this region, — those, for instance, in whom they diagnose engorgements, — are affected by displacements. Graily Hewitt, again, showed in his writings and teachings the enormous importance he attached to displacements of the womb; in his well-known work on Diseases of Women he formulates the following opinions: —
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