EARLY OVARIOTOMY; ITS PRACTICAL NECESSITY
Journal of the American Medical Association (JAMA)
medium, then to the high operation, learning in each case the meaning of "axis traction." It is unfortunate for the student's comprehension that the "axis traction" is so universally used to mean high operations or inlet operations. All traction made by forceps must be axis traction, whether their application be made at the pelvic brim, the pelvic cavity or at the pelvic outlet. Hasty, jerky and impulsive movements made by the student when using the forceps should bring from his teacher words
... his teacher words of correction. A lack of knowledge of, and ex¬ perience in, the important matter of applying the for¬ ceps, characterizes the work of the young, and some¬ times the older practitioner as clumsy and dangerous. Practical work in obstetrics should be required of each student before graduation, and to enable him to apply what he has learned from his text-book and his teacher he should be required to keep a systematic record of each case attended. In this way he can learn what can not be taught so well in the classroom ; the characteristics of true and effective labor pains and of anomalous and inefficient pains; the indications for the application of forceps and the contraindications for their application. The record sheet should make a part of the year's course, and of the final examination, as an evidence of his fit¬ ness to practice obstetrics. The requirement of record keeping impresses the student with the importance of supervising each case that may come to him for care. It helps him to form systematic habits of thinking and of making observations that must contribute to a suc¬ cessful practice, and to the science of obstetrics. In the pathologic laboratory, room should be made for the study of disease and unhealthy conditions so frequently met with in pregnant and lying-in woman. In order to make his work useful and with a given purpose, clinical re¬ ports of cases, including pathologic studies made in the laboratory, may be required of the student. Thus: equipped at graduation, he is in a condition to malee a post-graduate course in some good The time has long gone by when the growth of ovar¬ ian tumors was watched until they attained enormous proportions and were finally tapped to prolong the life of the doomed victim. Such tumors are almost extinct. We very rarely see them. The time has also passed, when ovariotomy was delayed until every other means, including repeatedtappings, had exhausted the patient's strength and the operation was then performed as a last resort. The comparative safety of the operation, the inevitable growth of the tumor if left alone, and the possible later complications are facts so well known to physician and layman, that consent is readily obtained for early removal.