From Midwives to Medicine: The Birth of American Gynecology by Deborah Kuhn McGregor

Author:Deborah Kuhn McGregor [Deborah Kuhn McGregor]
Language: eng
Format: epub
Published: 2007-09-22T23:57:00+00:00

FIGURE 10. Anterior view of female pelvis. In Henry Gray, Anatomy, Descriptive and Surgical, 10th Eng. ed. (Philadelphia: Lea Bros., 1883). (From the Special Collections, Southern Illinois University School of Medicine.)

FIGURE 11. Ancillary view of female pelvis. In Henry Gray, Anatomy, Descriptive and Surgical, 10th Eng. ed. (Philadelphia: Lea Bros., 1883). (From the Special Collections, Southern Illinois University School of Medicine.)

While Peaslee and Thomas each took issue with Gardner's descriptive diagnoses of various patients and his remedies, Sims was more sympathetic to Gardner. He appeared to take a middle road, characterizing cases in which pessaries had served patients well. At the same time, Sims described patients who only recovered from uterine displacement by the surgical incision of the cervix. One of the ultimately most controversial surgeries, yet one of the most common during the first decades at the hospital, was the splitting of the cervix, originally performed with a kind of knife, later revised to a technique using scissors.

Throughout the first volume of the Bulletin, Sims's emphasis was on facilitating conception and pregnancy. In one case he described a patient who wore a pessary only long enough to conceive, and went on to bear a child and enjoy fairly good health, particularly as represented by the placement of her uterus. For Sims, good health and ability to conceive and bear children were all one in the lives of women. For his part, Gardner, like Sims, discussed early surgeries at the Woman's Hospital-examples from 1855 of cervical incision-and voiced his hearty approval and willingness to duplicate the surgical methods employed by Sims.''-8

In the first volume of the New York Academy of Medicine's Bulletin is a paper from the spring of 1862 by Augustus Gardner on the "Amputation of the Cervix" (the same meeting where Sims presented his paper on vaginismus). His paper was but a small part of a great expenditure of energy and attention spent on the cervix during these midcentury years. "Amputation of the Cervix Uteri" addressed treating a variety of symptoms, from a prolapsed uterus to leukorrhoea-cases, Gardner said, both "local and reflected," by removing at least part of the cervix.29

At the Woman's Hospital in the first years of its existence, Sims and Emmet frequently resorted to amputation or excision of the entire cervix (that which protruded beyond the vaginal wall). Although case records indicate success with these surgeries-"cured"-problems still ensued during recovery. There was, at the same time, an accumulation of knowledge from experience, a realization, for instance, that the cervix was not entirely expendable. Once, while operating in the presence of Valentine Mott, Sims accidentally perforated the abdomen of a woman and was forced to think quickly, rapidly closing the wound and managing to save her life.

Sims eventually saw that pregnancy could not follow the excision of the cervix, and he became much more tempered in his use of the operation, virtually abandoning it by the 1860s. Emmet wrote in his text that since 1865 "I have not resorted to [amputating the cervix], in consequence of seeing .

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