BIBLIOGRAPHICAL NOTICES.
A Practical Treatise on Inflammation of the Uterus and its
appendages, and on ulceration and induration of the Neck of the
Uterus. By James Henry Bennett, M. D., Member of the
Royal College of Physicians; Physician Accoucheur to the
Western General Dispensary, &c. &c. Second American, from
the second London edition. Philadelphia. Lea & Blanchard,
1850.
We have here presented to us a reprint of a volume already well
known and well received by the profession on its previous issue ;
and though nominally a second edition, it is in reality a new work.
In it is presented to the reader a complete history of inflammation
in all the organs and tissues which constitute the uterine system,
as elucidated by the application of physical investigation to the
study of uterine diseases. The opportunities enjoyed by the author
as house-physician to the Parisian hospitals St. Louis, Salpetriere,
and Notre Dame de la Pitie, together with his connection with a
large dispensary, have afforded him the means of accumulating
experience that entitles him to be heard as an authority upon the
subjects of which he treats. Dr. Bennett, however, is evidently a
hobby rider; and although we doubt not he may have the discrimi-
nating tact and judgment that enable him to detect the existence
of inflammation and to know when to apply his favorite remedy
of cauterization aright, there is, to our minds, a danger that those
into whose hands the work will fall, viz., the younger members
of the profession, may not be equally fortunate, and hence ill
effects may follow, as we know they have in one instance, from
the incautious use of this agent. This, we conceive, to be the
more likely to occur, from the circumstance that Dr. B. states in
his preface, that he has endeavored to demonstrate “that inflam-
mation is the keystone to uterine pathology, and that unless the
phenomena which it occasions be recognised and taken into consi-
deration, all is doubt, obscurity, and deception.”
With this preliminary observation, by no means offered in dis-
paragement of the able treatise before us, we proceed to lay before
our readers an analysis of its contents.
The first two chapters are occupied with the consideration of
some preliminary matters, and an excellent account of the anatomy
and physiology of the uterus. Chapter III. is occupied in the con-
sideration of acute metritis, in the non-puerperal state, and in the
different form of acute, chronic and internal metritis. Chapter
IV. treats of inflammation and abscess of the internal appendages
in the puerperal and non-puerperal state. The next five chapters
treat of inflammation and ulceration of the neck of the uterus
in the virgin ; during pregnancy ; during and after abortion and
parturition ; in advanced life ; and accompanying uterine polypi,
and fibrous tumors of the uterus. Chapter XI. treats of inflamma-
tion of the vagina and vulva. Chapter XII. is on the connection
between inflammation of the uterus, or its neck, and functional
derangements and displacements of the uterus, leucorrhea, amen-
orrhea, dysmenorrhea, menorrhagia and uterine hemorrhage gene-
rally ; sterility, abortion, prolapsus, anteversion, retroversion,
retroflexion, chlorosis, hysteria.
In this chapter, a most valuable one by the way, a recapitula-
tion of the facts presented to the reader in the preceding chapters
is laid before him, thus presenting to him the real nature of
those morbid states, in a large proportion of the cases in which they
are observed.
Chapters XIII. and XIV. are devoted to the consideration of
syphilitic ulceration of the neck of the uterus, and the diagnosis
of cancer of this organ. Chapter XV. and last is occupied with
the consideration of the treatment of the different forms of disease
as enumerated in the preceding pages. In the treatment of simple
inflammation of the neck of the uterus we are glad to have Dr.
Bennett’s testimony in favor of alum, which he declares to be the
most efficacious of medicinal astringents next to nitrate of silver.
It has always been a favorite with us, in the form of injection in
the proportion of a drachm to a pint as recommended by Dr. B.
The proper mode of administering vaginal injections is also insisted
upon; viz., upon the back with the hips elevated. The mode in
which such remedies are often employed either in the erect or sit-
ting posture, is worse than useless.
We have said that the chief agent relied upon by Dr. Bennett in
the treatment of these various inflammations was cauterization. It
is not to be supposed, however, that this is his only treatment; the
various adjuvants resorted to by every rational practitioner, as
leeches, hip baths, injections, &c., are all employed by him. It
would be in vain for us, in a limited article like the present, to do
justice to the excellencies of Dr. Bennett’s work; enough has been
said and shewn of its contents to prove our favorable opinion of
the doctrines and practice inculcated, with the cautions that
we have thought it necessary to present to the young practitioner
in relation to the use of caustics.
To the work is added an Appendix, “On the physical examina-
tion of the Uterus and its appendages,” in which full and explicit
directions are given for its conduction ; together with a synopsis
of three hundred cases presenting uterine symptoms, treated at the
Western Dispensary.
In relation to physical examination, either digital or specular,
Dr. B. believes that the laudable sense of propriety which prevents
our seeking such an exploration, is often carried much too far. In
this we agree with him, taking it for granted that such an
examination would not be hinted at where the attendant did
did not conceive it to be absolutely necessary. It is this
“ laudable sense of propriety” that has been so sorely shocked
by the recent efforts of a professor of obstetrics, in one of our
schools, to teach demonstrative midwifery, and that has aroused
such a storm of virtuous indignation against him. We confess we
have been unable to discover wherein the enormity consists, and
have not failed to uphold his course, believing, that conducted as
we know his demonstrations were, such teaching cannot fail to
prepare the student more completely for his responsible station, than
any amount of didactic lectures. We commend to those who are
disposed to view this matter in a different light, the manly and
dignified defence of the proceeding as published under the editorial
head of the March No. of the Buffalo Journal.
In concluding our notice of Dr. Bennett’s work from which we
have wandered a little, we desire to express our warm appreciation
of its merits, and our sincere belief that it will not fail to be a most
welcome guide to all who may be so fortunate as to secure it.