Curettage of the uterus : history, indications, and technique / by J.W. Ballantyne.

  • Ballantyne, J. W. (John William), 1861-1923.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Curettage of the uterus : history, indications, and technique / by J.W. Ballantyne. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    endometrium, for he spoke specially of its use for scraping out sarcomatous and cancerous growths in the cervix, rectum, and vagina; but Hegar and Kaltenbach and others did not hesitate to apply it to the interior of the uterus, and reported good results. To another American, T. G. Thomas (6), belongs the credit of having invented a curette less formidable than the above-named instruments, and equally efficacious in, at any rate, chronic hyper- plastic endometritis. Thomas's curette, introduced in 1874, consists of a wooden handle carrying a flexible shank of soft copper wire with a loop at the end, by means of which intra-uterine granulations could be detached and removed. The instrument, however, cannot be said to have acquired a reputation outside the United States till 1878, when Dr Paul F. Muudd (7) brought it prominently before the notice of the profession in this country by means of his paper communicated to our Society, and gave to it an impetus into popularity by quoting Thomas's saying that he had used it hundreds upon hundreds of times without the least ill effect therefrom. In the discussion which followed the reading of Munde's paper it was elicited that Professor Simpson had for many years been using Eecamier's curette without bad effects, but always with previous dilatation of the os, and that Dr Keiller had also for a long time been curetting with a blunt instrument in some ways resembling that of Thomas, but with a. strong feeling that the curette should be handled at all times with the utmost caution. This brings the history of uterine curetting up to the year 1878, when, to state the matter briefly, Edcamier's, Sims', or Thomas's curette was used, and uterine hgemorrhage, whether due to fungous endometritis, to retained products of conception, or to sarcoma of the corpus uteri, was practically the sole therapeutic indication for the operation; for scraping the cancerous cervix with the curette could scarcely be called a special use of the instrument. The operation was often performed without an anaesthetic, in the medical man's consulting-room or at his dispensary, and with or without previous cervical dilatation. It should also be noted as significant that Mund^ believed that the first and chief use of the curette was as a means of diagnosis. Prior to 1878 about half a dozen communications devoted to the consideration of the uterine curette had appeared, and the instru- ment was mentioned in only one or two gynecological text-books. Since 1878 one hundred and fifty-three papers and monographs have been published dealing specially with curettage, and of these fifty-five have appeared in France, forty-seven in the United States, nineteen in Germany, eight each in Great Britain and Belgium, five in Italy, two each in Eussia and Denmark, and one each in Spain, Norway, Switzerland, lioumania, Canada, Mexico, and Cuba. Further, the curette and its mode of use are now fully described in every gynecological treatise worthy the name. Of course this