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If a competitor can prove that he has utterly ruined every sort of medical private practice in a large city except obstetric practice and the surgery of accidents, his claims are irresistible; and this is the ideal at which every M.O.H. should aim. But the profession at large should none the less welcome him and set its house in order for the social change which will finally be its own salvation.
Adams had translated from the Greek the works of Paul of Ægina, the father of obstetric surgery, and printed the first volume. It was totally unnoticed, for in fact there were no means by which the village surgeon could get it brought under the notice of the scattered members of his profession who desired to possess such a book.
Burrall mentions a case of labor without apparent liquor amnii, delivery being effected by the forceps. Strong records an unusual obstetric case in which there was prolongation of the pregnancy, with a large child, and entire absence of liquor amnii.
Outside of obstetric practice the injury is quite a rare one. There is a case of death from a ruptured clitoris reported by Gutteridge. The woman was kicked while in a stooping position and succumbed to a profuse hemorrhage, estimated to be between three and four pounds, and proceeding from a rupture of the clitoris. Discharge of Vaginal Parietes.
The question of sterility comes up frequently in our time, especially among cultivated and intellectual people. Persistent failure to conceive we term absolute sterility; persistent failure to carry pregnancy to a successful end, we call relative sterility. The latter is an obstetric problem and can usually be dealt with successfully. So can the former in about forty percent of the cases.
In desperation and fully believing in the efficacy of this treatment as the best means of permanently alleviating his pain, the crippled Scotchman heated a poker and applied the cautery himself. We have already mentioned the marvelous instances of Cesarean sections self-performed, and in the literature of obstetric operations many of the minor type have been done by the patient herself.
The Sunday-school teacher, the kindergartner, the day nursery manager, the fresh air charity agent, the district nurse, the obstetric nurse, the church almoner, the city missionary, the relief agent, the head of the mothers' meeting, the guild teacher, the manager of the boys' brigade or girls' friendly, all these will have touched the family at some point, but will never have taken the trouble to make a picture of the family life as a whole, and of the effect of their charity upon it.
But for centuries they monopolized, by custom, one branch of practice, the obstetric; and that, together with the occasional treatment of children, and the nursing of both sexes, which is semi-medical, and is their monopoly, seems, on the whole, to have contented them, till late years, when their views were enlarged by wider education and other causes.
The first examination he could take was in midwifery and the diseases of women, and he put his name down to be a clerk in the ward devoted to feminine ailments; since it was holiday time there happened to be no difficulty in getting a post as obstetric clerk; he arranged to undertake that duty during the last week of August and the first two of September.
They find the interval too great between vulgar superstition and an absolute renunciation of it; they imagine they take a wise medium in compounding with error; they therefore reject the consequences, while they admit the principle; they preserve the shadow and throw away the substance, without foreseeing that, sooner or later, it must, by its obstetric art, usher into the world, one after another, the same follies which now fill the heads of bewildered human beings, lost in the labyrinths of incomprehensible systems.
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