On the relations between medicine, surgery, and obstetrics in London / by Robert Barnes.

  • Robert Barnes
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: On the relations between medicine, surgery, and obstetrics in London / by Robert Barnes. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    <loes not rest with the obstetric physician. The words, if rigor- ously interpreted, might forbid him to remove a polypus or to apply cautery, actual or potential. If he goes so far as this, it is by tolerance, not by right. Latterly some relaxation has been granted. The obstetric physician is nowallowed to deliver a woman by Cesarean section. But he must be very sure that the woman is pregnant, for he is forbidden to remove ovarian or uterine tumors, and a, fortiori other abdominal tumors, by abdominal section. He is not allowed even to make an exploratory incision. Like Minerva, he is expected to come forth fully equipped, with- outgoing through the ordinary processes for acquiring knowledge. And even this concession of Cesarean section is liable to be re- voked or limited. For example, it remains to be seen how far the surgeons would recognize the propriety of performing the Porro-Oesarean operation. As this involves the removal of the uterus and ovaries, it would be prohibited under the strict in- terpretation of the rule which forbids the obstetric physicians to practise ovariotomy. And even if liberality were stretched to the point of permitting such an operation in a hospital, it must still be obvious that practice under a system of surveil- lance and control by men necessarily unable to appreciate fully the history of these cases, must be destructive of that spirit of independence and enterprise which is the very life of medical progress. Ihe surgeon at St. Bartholomew’s also performs the operation foi vesico-vaginal fistula. A curious arrangement was made with regard to perineal operations. If required for relief of pro- lapsus uteri, the obstetric physicians might do them; if for incon- tmence of feces and flatus, then the surgeons claim the operation. V nit a nice distinction! how ingeniously the line is drawn just between wind and water! Is it never transgressed by the other?11 °n the °Ue hand or by the ^stetric physician on the The utility of these rules maybe tested from three points of view irst, the patient’s. Can it be contended that it is good for t lge doctor Ufc the critical moment of treat- ment. Is it reasonable to suppose that the knowledge of the -case 1 n i s origin development, and progress, which had been gadually acquired by the first doctor, can suddenly be transferred to the second doctor who steps in to take possession of the case f° „10 purP°se of Slu‘gieal treatment ? Is it not clear that each of the two, studying half of the case only, will be imperfects irioe to Hierient? is <&• ^£?2 >v,th the responsibility which properly attaches to the
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