ADDRESS IN OBSTETRICS AND DISEASES OF

WOMEN.

OBSTETRIC AND GYNECOLOGICAL LITERATURE, 1876-1881.

BY JAMES R. CHADWICK, M.D.,

MASSACHUSETTS.

INSTEAD of following the routine custom of presenting in this address the advances that have been made in the department of obstetrics and gynecology during the past year, I propose to ask your attention to a statistical consideration of the whole volume of literature upon this branch of medicine during the past five years. I shall present a quantitative analysis of this literature with reference to nationalities, and shall finally sketch the rise and fall of the interest evinced in certain special topics, as shown by the number of separate publications and journal articles published in each successive year. These enumerations I am enabled to make by utilizing the annual Indices of the Gynecological and Obstetric Literature of all Countries, published under my supervision in the Transactions of the American Gynecological Society. The Index for the year 1876 only covers the last six months of the year, and is therefore of but limited utility. The Index for the year 1879 is in print, but is not yet published; that for 1880, though on cards, and now in course of preparation for the printer, has nevertheless proved available for my purpose. The space of time covered by my review is, unfortunately, limited to five, or, more strictly speaking, to four and a half years, so that my sketches of the different topics can in no instance embrace more than a brief epoch in the life-history of any method of treatment, operation, or theory. Such a numerical analysis of current literature, if it could be made to cover a longer term of years, would, I am convinced, show some strange mutations in the popularity of certain topics,

and would dampen the ardor of many authors who have sought to attain immortality by propounding new theories, devising new operations, and, above all, by inventing new instruments. Of course, the number of articles published upon a given new topic is not, in every instance, an accurate test of its merit. Many new ideas are of such nature as to appeal to a limited audience. A new therapeutic remedy or a new operation, on the other hand, is pretty sure to meet a warm reception. Its life history may then be outlined somewhat as follows: an article is written, recounting the success obtained by its author in the treatment of a certain condition by a new operative method. Immediately it is tried by many practitioners, who hasten to publish their results, particularly if favorable, when they may expect to derive renown or practice from being early identified with the innovation. Articles multiply rapidly, the operation has been forced upon the attention of the whole profession; soon its charm of novelty wears off, and the number of papers would rapidly diminish, were it not that the negative or unfavorable results obtained begin to be published; the true merits of the operation are gradually reached, and finally it is either adopted as part of the traditional store of operative procedure, or is renounced and forgotten. A familiar recent instance of this course of events is observable with regard to incision of the cervix uteri for dysmenorrhoea, advocated many years ago by Sir James Y. Simpson. This operation at once appealed to the mechanical instincts of the profession, was taken up with avidity, was advocated in all the medical journals of the world, was variously modified by different operators, each of whom sought by numerous papers to have his special method adopted; opponents soon raised their voices; the operation was shown conclusively not to be followed by the promised relief in many cases, and, moreover, to be fraught with some danger. To-day this operation is rapidly passing into oblivion. It is still performed in cases of extreme stenosis, but is recognized as inadequate to afford relief in the vast majority of cases for which it was formerly recommended. My table shows a progressive decrease in the number of papers on this subject during the past five years. A similar fate may safely be predicted for several operations now held in high esteem, such as the operation for laceration of the cervix uteri, Freund's method for the complete extirpation of the cancerous uterus, Porro's Cæsarean section followed by excision of the uterus, etc.

OBSTETRIC AND GYNECOLOGICAL PERIODICALS.

Before passing to an analysis of the whole volume of literature, let me direct your attention for a few moments to the special periodicals, including journals and society transactions, devoted to this branch of medical science :

Number of Periodicals devoted to Obstetrics and Gynæcology, 1876-1880.

This table shows that the total number of periodicals has increased in the five years from thirteen to twenty-two, nearly sixty per cent.; that the American have increased one hundred per cent., the French fifty per cent., the German thirty per cent.; that Belgium, Italy, and Denmark have entered the lists with one periodical each, and that England and Spain have remained unchanged.

The twenty-two periodicals being published in 1880 are as follows:

Titles of Periodicals devoted to Obstetrics and Gynecology published in 1880.

Country.

America.

First pub-
lished.

1869

1869

1873

Title of Periodical.

American Journal of Obstetrics and Diseases of Women and Children. Editor, Dr. P. F. Mundé. 8vo. Quarterly. New York.

Philadelphia Obstetrical Society Transactions. Secretary, Dr. W. H. H. Githens. 8vo. Uncertain. Philadelphia.

Obstetrical Journal of Great Britain and Ireland, with an American Supplement. American Editor, Dr. J. V. Ingham. 8vo. Monthly. Philadelphia.

Country.

First pub.
lished.
1877

Title of Periodical.

American Gynecological Society Transactions. Secretary, Dr. J. R. Chadwick. Svo. Yearly. Boston.

Obstetric Gazette. Editor, Dr. E. V. Stevens. 8vo. Monthly. Cincinnati, Ohio.

Homœopathic Journal of Obstetrics and Diseases of Women and Children. Editor, Dr. H. Minton, of Brooklyn. 8vo. Quarterly. New York.

Obstetrical Society of London. Transactions. Hon. Secretaries, Dr. J. Williams and Dr. C. Godson. 8vo. Yearly. London.

Edinburgh Obstetrical Society Transactions. Secretaries, C. E. Underhill, M. B., and C. Carmichael, M. D. 8vo. Yearly. Edinburgh.

Obstetrical Journal of Great Britain and Ireland, including Midwifery and the Diseases of Women and Children.' Editor, Dr. A. L. Galabin. 8vo. Monthly. London. Gazette obstétricale. Rédacteur, Dr. E. L. Dupuy. 8vo. Fortnightly. Paris.

Journal des sages-femmes. Rédacteur, H. Fontan. 4to. Fortnightly. Paris.

Archives de tocologie, des Maladies des femmes et des enfants nouveau-nés. Rédacteur, Dr. De Soyre. 8vo. Monthly. Paris.

Annales de gynécologie (maladies des femmes, accouchements). Rédacteur, Dr. A. Leblond. 8vo. Monthly. Paris.

Revue médico-chirurgicale des maladies des femmes. 8vo. Monthly. Paris.

L'Obstétrique.2 Rédacteur, Dr. A. Mattei. 8vo. Monthly. Paris.

Archiv für Gynækologie.

Redacteurs, Dr. Credé and

O. Spiegelberg. 8vo. Uncertain. Berlin.

Zeitschrift für Geburtshülfe und Gynäkologie. Redacteurs, C. Schröder, H. Fasbeuder, A. Gusserow, L. Mayer, in Berlin. 8vo. Uncertain. Stuttgart.

Centralblatt für Gynäkologie. Redacteur, Dr. H. Fehling, in Stuttgart, Dr. H. Fritz, in Halle, A. S. 8vo. Fortnightly. Leipzig.

Gynækologiske og obstetriciske Meddedelser. Udgivne af F. Horwitz. Half-yearly. Kjöbenhavn.

Annali di Ostetricia, ginecologia e pediatria. Editore, Dott. C. Alessandro, Universita di Modena. 8vo. Monthly. Milano.

Sociedad ginecològica Española. Anales. Secretario, Sir D. A. R. Rubi y Pacheco. Svo. Monthly. Madrid.

1 Discontinued after vol. viii., No. 12, December 30, 1880.
2 Terminated on the death of the editor, 1881.

Country. Belgium.

First pub-
lished.
1880

Title of Periodical.

Journal d'accouchements. Écho de la Maternité de Liége. Rédacteur, Dr. N. Charles. 4to. Fortnightly. Liége.

In 1876 was published the Zeitschrift für Geburtshülfe und Frauenkrankheiten. Rédacteurs, Dr. E. Martin and Dr. H. Fasbender, vol. i., 8vo., uncertain, Stuttgart, which was converted into the Zeitschrift für Geburtshülfe und Gynäkologie in 1877.

In 1879 was published by the New York Obstetrical Society, Transactions for the years 1876, 1877, and 1878. 8vo. Vol. I. Uncertain. New York. 1879.

The special periodicals may be regarded as one gauge of the degree of interest taken in this branch of medicine in the dif ferent countries.

Certain characteristics distinguish the publications of the different countries. For instance, those of Germany contain more contributions to the science of medicine, whereas those of America contain more papers of a practical nature; those of France are more controversial, being more essentially the organs of separate cliques, etc.

OBSTETRIC AND GYNECOLOGICAL SOCIETIES.

Another means of estimating the relative prominence of this brauch of medicine in different countries is an enumeration of the special societies.

1 In this list are included the general societies which have sections specially devoted to obstetrics and gynæcology.