HANDBOOK OF GYNECOLOGY FOR STUDENTS AND PRACTITIONERS BY HENRY FOSTER LEWIS, A.B., M.D. Professor and Head of Department of Obstetrics and Gynecology in Loyola University School AND ALFRED DE ROULET, B.Sc., M.S., M.D. Professor of Gynecology in Loyola University School of Medicine; Attending Gynecologist WITH ONE HUNDRED AND SEVENTY-SEVEN ST. LOUIS C. V. MOSBY COMPANY 1917 No201 267 1917 PREFACE From considerable experience in the class room and the clinic, we have seen the need for a handbook of gynecology whose text shall logically arrange and classify the material of the various subjects according to our modern views of etiology and pathology without undue repetition, and which can be primarily adapted to the needs of third and fourth year medical students, as well as the young practitioner who has not yet settled into a special field. It is often the reproach of a teacher or a writer on medical subjects that he does not realize the relative importance of his specialty to the rest of medical knowledge. We have tried to appreciate that gynecology is a lesser subject than medicine, surgery, or obstetrics, and have tried to prepare a book which will recognize, in its demands upon the time and energies of the student and reader, the proper rank of the specialty. We have omitted long descriptions of major operations and their technic. We have endeavored to formulate principles of surgery adaptable to the special work, but have made no attempt to prepare a book with every minor detail elaborated and illustrated. Gynecological operations are never the same, because the same conditions and indications do not arise in every case. Even in operative surgery, one should treat the sick patient by whatever means his judgment may consider best adapted to the individual case and circumstance. He should not label the disease first, and then prescribe a certain set procedure for its treatment. At best one can not properly learn technic, even that of the most brilliant operator, by reading his descriptions and studying his illustrations. The primary requisite is a good foundation of pathology, anatomy, and physiology; next, practice in assisting good operators at the bedside and at the table. We believe that the hospital-not the lecture hall-is the place to learn surgery. The lecture and the textbook can only supply the knowledge of principles, and can not profitably go too minutely into detail. Our classification differs from the usual one in textbooks on the subject. It has been evolved during twenty years of teaching. We have followed, as much as present knowledge will per 44248 mit, the lines of pathology. For instance, we treat of infection of various types as it affects the different tissues and organs of woman; of neoplasms, of traumas, of malformations, etc. We bear strongest upon the parts most commonly or typically affected by these influences. We have not followed the usual anatomical classification, going up step by step from vulva to tube, describing in detail each part until the peritoneum is reached. Gonorrhea is the same in the urethra, the cervix, or the tube, modified only in its manifestations by the special anatomical and physiological characters of the infected regions. Many of the drawings are from moulages prepared by us for the museum of the Obstetric and Gynecologic Department of Loyola University. These preparations are cast in wax from plaster impressions of actual cases. Many of the illustrations are also from specimens in the museum. In a work of this kind it is impossible to give complete acknowledgment of the sources of our knowledge or the authority for all our statements. We have listened, we have read, we have worked, we have observed, we have taught, and now we have written and drawn. The judgment is for the reader. We wish to express our appreciation of the value of association with such workers as Ries, Barrett, Hektoen, Herzog, Peterson, MacKechnie, Tarnowski, Martin, Lee and Hillis. HENRY FOSTER LEWIS, Chicago, Ill. |