DR. W.W. Blackman succeeded to the house and practice of Dr. Wells in Brooklyn, N. Y. Some months ago Dr. Blackman presented these old manuscripts to Dr. H. A. Roberts, who had deemed some of them well worth printing for the consideration of the present -day thinker.-ED.
THe tendency of physicians of our school, at the present time, appears to be to drift away from confidence in the specific remedy to effect needed cures, and to resort to other means for their attainment, often , perhaps, where the greater promise of good was in the specific, if discovered and applied according to the requirements of the law which control cures. This tendency is especially marked in their dealings with certain classes of disease, from which specific remedies have been largely ruled our, in favour of those which are either wholly mechanical or empirical. In these, they say, the specific does not do. It fails. Why? Is there a class of diseases, or classes , which exist out side the pale of natures law of healing?
If there be such a law, then the pretense that there are disease so existing, which are more safely, surely, and speedily cured by other means than those sanctioned by this law, is only a bald absurdity. But, it may be said, “there are diseases which have already developed changes of tissues or of tissues when they are presented for treatment, and other which have displaced or distorted important bodily organs, and to expect restoration of these from internal administration of specifics is simply absurd, and to attempt this is only to waste time,prolong suffering, and play the fool. These are cases which require surgical interference, or mechanical appliances,” “And this seems to be regarded as self evident, and the specific remedy is laid aside in favour of these which are often less efficient, and always more painful and uncertain.
This tendency is now more prevalent in treating cases of disease in the department of gynecology than in other department of practical medicine. Disease of the uterus and ovaries in many of their forms it is pretended do not respond to specific remedies as do the disease of other organs, and therefore a different treatment is required for their relief.
These organs, besides beings subject to inflammation and neuralgic affections like other bodily organs, are liable to mechanical displacements, and adhesions, and flexions, which internal medication is not capable of remedying, or in its nature is the least adapted to the accomplishment of this end.
We object to this talk, first that these organs involved in this class of affections are, as are other organs, parts of a general whole which, when made subject to disease, were put into the relationship of law as to the agents which in their nature were made to be the curatives of the diseases to which these organs were made liable. That all the organs of the body are equally, and in all their ailments, under the dominion of this law, and that the female organs of reproduction are not by their nature, functions, or responsible to the general law, the same as are the disease of other organs, and respond to the impress of their specific curative as readily and satisfactorily as do the affections of other bodily organs.
But, it is said, “Many of these ailments in the peculiar province of the gynecologist are in a important degree made up of mechanical conditions, for example, prolapsus, versions and flexions of the uterus, and displacements, of the ovaries, etc., and do not these necessarily, by their very nature , required mechanical means for their speediest and most perfect cure?” Let us see how this is. Take a case of simple prolapsus to illustrate the matter. If the uterus has fallen from its natural position, there must have been a cause for this, There must have been facts preceding this from which it has resulted. The tissues which, in their natural state of tension and elasticity, hold this organ in its place, have become relaxed to a degree where they are longer equal to this function, and the displacement is the necessary result.
In other words, the nutrition of these tissues became defective , and as a consequence they became enfeebled, and the mechanical conditions we are called to remedy is only a result. The vital change preceded the mechanical, in the sequence of morbid phenomena, and before any radical cure of the case can be effected , this vital defect is to be removed, and the removal of the course. The cure is to come to that which is back of the mechanical element of the case will follow as an matter of course. The cure is to come to that attempts to cure these cases by mechanical evils, and from which it has had its origin. This explains why it is that attempts to cure these cases by mechanical evil, and from which it has had its origin.
This restoration can be effected best, if not only,by the proper administration of the specific remedy. Versions and flexions are in the uterine fibre itself,and not so much in that of adjacent tissues. The principle of cure in these is the same, and no more dependent on mechanical or other means outside of those required by the law than it is in prolapsus. In all, the problem is alike , to restore a defective nutrition to a normal healthy state.
It is self evident that this must be a vital process, and not in any part a mechanical one, and that this will be best accomplished, if not solely, but by means which act directly on the life forces of the part involved in the evils to be removed. The resort to the introduction of foreign bodies to replace a lost tonicity of tissue can only have had origin in a shortsightedness or ignorance of the principles of pathology and cure involved in the treatment of such cases.
In confirmation of ;the views here presented of the dominion of law in the province of gynecological practice, and as illustrative of the power and efficacy of the specific remedy, even in cases the most unpromising if judged form the mechanical point of view, we are permitted, by the kindness of Mrs. Dr. S. E. Dunlevy, who makes the treatment of gynecological cases a specialty, to make use of the following case which has recently been under her charge.
For the purpose for which it is here given there could hardly be one more perfectly confirming the philosophy and practice we have here advocated. The condition of the affected organ was ascertained, both before and after treatment by ocular and mechanical exploration by Mrs. Dr. D. and found in the condition about to be stated. Her testimony as to what she discovered in both examinations can be taken with utmost confidence, her practical experience having made her an expert in such examinations.
Miss C., now 32 years of age, when 18 had a fall the result of which was she became a permanent invalid. At the time of the fall she was conscious of local injury in the pelvic region, had ever after pain there, with sense of weight and dragging down. Pain, heaviness and dragging down in the left ovarian region. Burning, aching and cramps in the abdomen; heat and pain in the top of the head, with sense of tightness, as if screwed together; coldness, in waves on top and through the head where it felt the tightness; worse from using the eyes.
Weakness of memory, vertigo. Would fall in spasms; at times could only walk when led; if she attempted to step would fall; afraid to walk in the street alone, as she would feel like falling in an open cellar, or any place where she might see open space. Pain over the brow when using the eyes; eye-sights weak, could only read with glasses; appetite poor; bloated uncomfortable feeling after eating. Shootings up the rectum and vagina, like a knife; painful urination; urine hot, and passed but a few drops at a time, with continued desire to pass more.
Uterus was found both flexed and retroverted, and firmly adherent in its abnormal position, so that when force was applied to return it to its place, when this was withdrawn the organ returned to its retroversion as if forced by an elastic band. Uterus inflamed. Cough with pain and soreness in the chest; pain and soreness in the intercostal muscles. Severe dull ache in back and left hip, with burning pain extending through left ovary and external genitals, and inside of the leg as far as the knee; had to sleep with the limb drawn up.
The spine was painful at first in the lumbar region when bent; this afterwards extended to top of the head; the spine was hot and with swelling on each side of it, it could not bear the least touch; tenderness to pressure in five lower lumbar vertebrae; considerable lateral curvature of the spine. Pain in the left shoulder blade constantly. Involuntary jerking of the arms; she knew the arm was going to jerk, but had no power to prevent it; would jump up and throw up both hands and then sit down quietly; easily startled, and jumps. Pains and soreness posteriorly in the lower limbs, especially along the tendo Achilles. Feet stone cold, ache up to the knee, and feel as if fanned from the hell to the knee. When trying to walk felt as if something were dragging her back; and a dragging down sensation constantly.
