THE 
NEW YORK MEDICAL JOURNAL, 
A Weekly Review of Medicine. 
Published by 
D. Appleton & Co. 
Edited by 
Frank P. Foster, M.D. 
LEADING ARTICLE. 
INVERSION OF THE UTERUS. 
It is to be presumed that few, if any, of our readers are unmindful of the de- 
gree to which original contributions to the advance of gyntecology have been 
made in our own country. The American is decidedly in his element when a 
mechanical problem is to be solved, and the gynaecology of the present time turns 
so largely on the mechanical adaptation of means to ends that our pre-eminence 
in that branch of the medical art is not to be wondered at, especially when we 
consider, too, that it was here that the interest and enthusiasm now felt in the 
specialty all over the civilized world practically took their rise. 
Making all allowances for these considerations, however, it is not a little 
remarkable that there should be one particular form of injury of the uterus, for 
the repair of which almost every important step has been taken in this country— 
and that, too, an affection recognized in all its gravity from time immemorial, 
and not, as in the case of cervical laceration, one that was really first brought to 
light here. Prominent among the procedures that have taken their rise in 
America for the restoration of the inverted uterus to its normal state, we may 
mention the late Professor White’s plan of effecting reduction by the action of 
sustained elastic pressure on the body of the organ; Dr. Emmet’s method of 
making a partial gain pave the way to final success, by sutures passed through 
the cervical lips and subtending the fundus; Dr. Noeggerath’s happy thought 
of taking advantage of the natural action of the muscular tissue by indenting 
first one horn and then the other ; Dr. Thomas’s bold and direct solution of the 
problem, how to dilate the cervix, by approaching the orifice from above through 
an abdominal incision; Dr. Watts’s device for accomplishing dilatation from above, 
without laparotomy, by carrying the fingers into the hollow of the inverted organ 
by way of the rectum ; and, finally, the latest expedient, described in this issue 
of the Journal, by means of which Dr. Browne has succeeded, in an obstinate 
case, in dilating the cervix through an incision penetrating the uterine wall. 
All these procedures are rational, and each has proved successful in actual 
practice. They are all in the highest degree creditable to the gentlemen with 
whom they originated, and they are no less creditable to American medicine. It 
is scarcely to be supposed that the list of possible devices likely to prove available 
is yet exhausted, but certainly great strides have been made in that direction, and 
whoever brings a new expedient into play not only makes the positive achieve- 
ment, if he succeeds, of swelling the record of triumphs, but often holds out to 
others a suggestion that is pretty sure to be followed up and made the most of. 
[Reprinted from the New York Medical Journal, November 24, 1883.] 
R.