Excerpt from Glasgow Medical Journal, 1898, Vol. 49
It is everywhere recognised that the grouping and study of special cases together is the proper method of gaining an exact knowledge of disease, and certainly for our students the difficulties of gyn?cology are only to be mastered by an assiduous study of a considerable number of cases brought under their notice. It is unfortunate that our students should have to go to Berlin or some other Continental city for instruction in this subject, when material for their study is as plentiful at home, and needs only to be brought together to be of use to them. Perhaps, when we have our remodelled infirmary, some regard will be paid to the needs of this department.
During the summer half year, which, owing to cleansing arrangements, consisted only of four months, we had 68 cases under our care, making in all 176 cases in the year.
Metritis is, of course, the disease which gives us the highest percentage of cases. Of this there have been 9 cases in the summer months, making 30 cases throughout the year, or about 1 in every 6. For this disease our ordinary treatment is the hot douche and curettage of the endometrium. If the uterus is much enlarged, we combine with the curettage an excision of wedges of tissue from the anterior and posterior lips of the os. These operations, and the rest which the patients have while in the ward, benefit them to a considerable extent, but I have never the same feeling of satisfaction after treating a metritis as I have after, say, the removal of an ovarian cyst. There is not, by any means, the same certainty that you have cured your patient. Perhaps it is the case that a uterus once diseased can never again be perfectly healthy, but if restoration of function is any test of the health of an organ, that test has been frequently satisfied in the case of the uterus after operation for metritis.
Next in frequency after metritis comes cancer of the uterus Of this we have had 7 cases, or 10 3 per cent, nearly the same proportion (11 per cent) as in the first six months of the year, These proportions indicate the frequency of this disease. In none of the 7 cases was it possible to extirpate the disease and we had to be content with merely palliative measures To my mind there is no better illustration of the danger of neglecting little things than the advanced stage at which cancerous disease comes under our care.
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