Considerations in regard to the treatment of displacement of the uterus / by J. Matthews Duncan.

  • Duncan, J. Matthews (James Matthews), 1826-1890.
Date:
[1854]
Catalogue details

Licence: Public Domain Mark

Credit: Considerations in regard to the treatment of displacement of the uterus / by J. Matthews Duncan. Source: Wellcome Collection.

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    is not brought many degrees nearer a logical issue by this unequalled ])assage of arms; and it must be gratifying to reflect, that there is another bar by which the question will be tardily but solidly decided, namely, that of the general suffrage of the profession. The chief difficulties to be kept in mind in the question before us, may be enumerated as follows :— 1. The well-known facility of all patients, and especially of females, inducing them to admit their feeling relief from treatment without good grounds. Every physician must have observed this in a thou¬ sand different circumstances; and there can be no doubt it is much more liable to happen when the physician enjoys great notoriety or eclat. In the case before us, this amiable failing in females is aided by the novel character of the treatment, and the imposing aspect of the instruments. 2. The impossibility of deciding the gravity of the affection. The symptoms calling for relief in the cases considered are, painful feel¬ ings of various character and site. For the description of these feelings, and the estimation of their intensity, the physician is com¬ pletely at the mercy of his patient, and is very liable to form mis¬ conceptions on the subject. Nervous and hysterical females will probably exaggerate in their statements, and not a few will under¬ estimate their sufferings. Nor can it be forgotten that malingering, of a modified kind, is not very rare among women in good society. 3. The impossibility^ of deciding what symptoms, in any case, are due to the simple displacement, and of separating these from what are caused by the engorgement or inflammation of the womb, by irritability^ of the womb, or of the neighbouring organs, or by other more obscure neuralgic conditions. Under this head may be mentioned the confusion apt to arise in discussing this subject, from physicians looking at and describing cases from different “ points of view.” The case of a Lancashire lady, which was lately the occasion of a professional correspondence, may be taken to illustrate this point. The lady was apparently one of a class who have confidence in different doctors and practices by turns, and whose statements can therefore be of little scien¬ tific value. Her case was diagnosed in London by some eminent obstetricians, as one of fibrous tumour in the back wall of the uterus. In Edinburgh, it was diagnosed by^ a very eminent accoucheur, as retroversion. If the case had come into my hands, I should possibly have thought it was neither a case of fibrous tumour nor of retro¬ version, but of enlargement of the uterus. All these statements may have been correct and consonant, although at first sight different. The lady may have had an engorged and retroverted uterus, with a fibrous tumour in tlie posterior v/all, and different phy^sicians may have seen reason to ascribe the symptoms complained of to one or other of these different unnatural conditions. It humbly appears to me that the great error in this case was the assertion of an exclusive diaynosis 1)v one practitioner as amiinst another. The