Woman’s Hospital of New York State

“One of the ultimately most controversial surgeries, yet one of the most common during the first decades at the hospital, was the splitting of the cervix. . . . [there was] a great expenditure of energy and attention spent on the cervix during these midcentury years. . (136) . . . The Irish predominated as patients at Bellevue Hospital as well as at the Woman’s Hospital of the State of New York (139). . . . Many Woman’s Hospital patients suffered lacerated perineums or recto-vaginal and Vesico-vaginal fistulas. Also common was uterine prolapse, often caused by multiple pregnancies (140) . . . . the theoretical underpinning of Sims’s and Emmet’s surgeries in the first years was a belief that pain in menstruation often emanated from a blocked or obstructed cervix that would not admit the menstrual flow. . . Symptoms and disease were thought to radiate from the newly glimpsed locus, the cervix uteri. . . . Incisions on the cervix were to Sims a prime example of the absolute utility of surgery over other therapies (144). . . . In the first years of the Woman’s Hospital, the surgeries on the cervix were more radical, involving incision on both sides of the external os per surgery. Results from the surgery were less than perfect (145). . . . As they wrote articles later, they applied newfound symptomatology and diagnoses to cases they had earlier acted upon within a somewhat different nosological framework. Dysmenorrhea, for instance, was a catch-all symptom suggesting need for the surgery. Anteflexion later was identified as the key symptom indicating need for the surgery; and finally endometritis, in the 1870s” (147). . . . The surgery developed ahead of a scientific rationale for it (149). . . . endometritis was added as a diagnosis to uterine and cervical flexure in the 1860s. . . .Both endometritis and metritis were diagnoses for visually inaccessible regions of the uterus” (150).