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

  • Barnes, Robert, 1817-1907.
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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    struments lie must use. To use them skilfully, he must exercise them frequently and in the greatest variety of operations that fall within the range of his department. Not only is this exercise necessary to the acquisition of mechanical skill, but it is not less necessary to the acquisition of full and accurate knowledge of the art he practises.. Let us now define the scope of obstetric medicine. In my ad- dress as President of the Obstetrical Society in 1865 (Obst. Trans., 1866), I submitted the following as the proper definition: “The Avork of the obstetric physician embraces the treatment of the diseases of the female generative organs, including the disorders and lesions, general and local, which result from pregnancy and parturition.” I do not see how limitation can be made narrower than this. An exactly parallel definition accords to the ophthalmic sur- geon co-extensive command, medical and surgical, over the eye. Why should not the like measure be dealt out to the obstetric physician P Why should the one be privileged to roam over the entire pathological field of his department, uncontrolled in his operations, and the other be crippled in his clinical work of re- search and treatment ? Again the only apparent plausible argument crops up: Is it because the one possesses the rank of surgeon, whilst the other is a physician ? In every essential respect, the arguments in favor of the one apply with equal force to the other. It has been urged that the surgeon, by general exercise in operations, ac- quires more skill in operations than can be attained by a man whose operations are restricted to a particular region of the body. The proposition is not without plausibility, but it does not cpver the case in contention. Why is it that the eye has, of late years, been almost exclusively intrusted to a special surgeon ? Is it not possibly because he is supposed to acquire peculiar skill by ex- ercising it upon a single organ ? Does not this argument apply with at least equal force to the obstetric physician ? If the surgeon is permitted to say: “The obstetric physician must turn over to us all operations,” by parity of reasoning the physician might say: “ The obstetric physician must turn over to us all that requires medical treatment,” for example, puer- peral fever, which is not more a consequence of labor than is a slough of the vagina resulting in cicatricial atresia or in vesico- vaginal fistula. Now, this mode of reasoning, logical though it be, would lead to the annihilation of the obstetric physician—a mamfest redudio ad absurdum. It leaves the obstetric physician without an apology for his existence. ^