WHILST in the enjoyment of a grateful pride for the very distinguished place assigned me before this learned body- representing the ablest practical and scientific activities of the entire civilized world-I confess to a sense of distrust as to my ability to meet the requirement of this distinguished occasion. I appreciate it as the opportunity of my lifetime-not attained in the past, and with no reasonable expectation that it will be duplicated to me in the future.
While thanking you most heartily for this preferment, I beg to throw myself upon your kind forbearance and indulgence as I proceed with the duties of the hour.
And first of all, shall we not indulge a profound sense of gratitude to the all-wise Giver of all good and perfect gifts, that our lots and lives have fallen to us in these pleasant places of wonderful progress in all the departments of human activity. Never before in all historic humanity have we witnessed the like, whether by personal experience or history, in all that pertains to commerce, science, agriculture, law, statecraft, medicine, art, and last, but not least, the church.
One hundred years ago a prediction as to present results in all these departments would have entitled the prophet to serious consideration in the line of qualification for residence in a lunatic asylum. In statecraft the old modes of bitterness, strife and violence are giving way to the peaceful ones of gentleness, conciliation and compromise by means of arbitration. From present indications, the soldier must long beat his spear into a pruning-hock and his sword into a plowshare, when the nations shall learn war no more. May we not indulge the fond hope that the universal brotherhood of both nations and individuals is rapidly approaching?.
In science and natural history, we delight to do homage to such luminaries as Darwin, Huxley and our own brilliant Edison. In statecraft and political economy, we find such notable worthies as Bismarck, Gladstone and Lincoln.
In commerce and finance the merchant princes, financial kings and railroad magnates, have given an impetus to trade, transportation, travel and personal communication, by land and sea, never before dreamed of, and contributing a blessing alike to the peasant in his humble home, and the king upon his throne.
To the church, we are indebted for the humanizing and blissful graces given us by Christianity, and presented to us by the faithful, indefatigable works of Phillips Brooks, Surgeon, Talmage and Joseph E. Cook. I take pleasure her in placing great church-workers on the roll of honor. For whether we esteem Christianity a myth, a fiction or a reality; whether we be atheists, sceptics or religionists, it is simply absurd to deny that its elevating and ennobling influence, are the very foundation stones of our present progressive civilization, refinement and enlightenment.
In our own blessed profession, we are proud of and grateful for such noble, indefatigable workers as Virchow, Charcot, Sir Joseph Lister, Gross, marion Sims, Thomas, Ludlam, Helmuth, and last but by no means least, the immortal Hahnemann.
Many of these noble worthies have gone beyond; while they rest from their labors, “their works do follow them”.
In the last 2000 years, three events have transpired, and have exerted an influence upon human destiny, that to our limited ken, is simply incomprehensible and approaches infinity.
Reverently, devoutly, with no thought of comparison I mention the birth and the work of our Lord and savior Jesus Christ, who gave us a system of morals and benevolence, pure, sweet and gentle;, secondly, the life and public service of Columbus in the discovery of a new continent; thirdly, Hahnemann’s discovery of a new symptomatic and therapeutic chart, for the cure of disease. it does not matter whether we accept the claims and purposes of these three great events, without dissent or protest; or whether we enter protest to much or little; the fact remains that results have been incomprehensible to our finite ken.
Christ furnished a rule of life and conduct, with lofty aspirations without parallel, precedent or sequent. Columbus got an immortality in history by doubling the metes and bounds of the then known terra firma; Hahnemann got an almost equal immortality, by revolutionizing and upturning the destructive and heroical modes of old-time physic.
The sublime inspiration of a persistent, ever-prevailing idea, was present with each, and brought results corresponding to the inspiration. This inspiration of an idea, is the key-note in the history of every great and noble enterprise in life’s work. By the terms of my thesis I should be confined to the limits of the past year’s progress. But we find 1892 lapping backward into 1891, and forward into 1893, in such fashion as to make precise conformity difficult; we shall therefore roam and revel, when and where we please, in the abundance of opportunities around us.
There is a noteworthy tendency to simplicity in the management of utero-gestation, and the parturient and puerperal states. They are no longer to be regarded as states of disease, but as normal and physiological conditions, requiring neither medicine or manual manipulations; and should be trusted to a rational hygiene in its broadest sense. In labor the officious and vicious manipulations and handlings so often prevalent, should be condemned.
The obsterist with an aseptic hand, though a well-cleaned vulva, should ascertain the exact presentation and relative adaptation of parts to the process, and then largely leave the issue to dame nature’s efforts. We do not mean to ignore disinfectants as such; but above all and best of all we commend plenty of soap and hot water. Formerly the result as to mortality, was largely against hospital experience, as compared with private practice. Precisely the reverse is true now; and attributable to the scrupulously clean doctors, nurses and patients to be found in every well-regulated lying-in hospital.
The most enlightened are now engaged in an effort to dispense with the constant handling and manipulating heretofore in vogue; especially, among midwives, in the management of labor. In many cases this vice is not altogether chargeable to the obstetrical attendant. The patient being in pain, very naturally, with her friends, appeals to the attendant for help. This she expects him to do by keeping his hand constantly within the vulva. Women in confinement or approaching confinement, should be educated out of any such foolish demand or expectation.
In olden times, Ergot by its incautious use, was a fearful implement of destruction in the hand of practitioners of midwifery. It was especially the “help at hand” for the midwife. Its power for evil to both mother and child is so great that medical men of the best repute have practically abandoned it altogether as a parturient. The following aphorism from Prof. Pajot we fully indorse. He says:
“As long as the uterus contains anything, be it child, placenta, membrane or clots, never administer Ergot.” We are aware that not a few practitioners will give Ergot for inertia uteri after the delivery, but we insist that it should not be given unless the placenta is passed, and the uterus free of clots. Then its opportunity for legitimate use is as a haemostatic, in the prevention and cure of post-partum haemorrhage. Ergot was once designated as pulvis ad partum, but from its incautious use, it may well be named as pulvis ad mortem. Formerly we had no little trouble in the use of Ergot for the want of a permanent and reliable preparation.
Several preparations of the fluid extract are now obtainable which are excellent, but the preparation coming to us and called Ergotole, from Sharp & Dohme, of Baltimore, is the best, and will be found more efficient than any other. In this connection it may be well to mention hot water irrigations, as one of the best haemostatics in not only midwifery practice, but also in surgical practice. In cases of post-partum flooding, should hot water not suffice, its alternate use with ice-water injections may be serviceable as a means of startling the patulous sinuses into healthy contractions.
We have recently arrived at a much safer and better understanding as to the indication sand contra-indications, justifying and requiring the use of the forceps. Many a woman and child have been lost for the want of prompt and timely use of this valuable instrument; while others have been sacrificed by its incautious and premature application.
When the labor is protracted and mother or child in any danger from the delay, and the danger will cease with rapid delivery-if the circumstances are such that the forceps may be used-they are always indicated.
As a substitute for the Caesarean section, much interest just now is being exercised in behalf of symphyseotomy or synchondrotomy. Of course, this operative mode is not a novelty. It was proposed and practiced a very long while ago. First by De la Corrue in 1634, then by Sigault in 1768, and by Stolz modified into a pubeotomy. Winckel, of Munch, says of the operation:.
