Читать книгу The Little Book of Medical Breakthroughs - Dr. Naomi Craft - Страница 27

In modern medical practice, the vaginal speculum is indispensable for examining the vagina and cervix.

In the past, if a woman survived the experience of giving birth, she was lucky if she escaped suffering from the damage caused to the tissues around the birth canal for several years. Many women became incontinent of urine and sometimes of faeces, too; in some cases, the supporting muscles and ligaments became so badly stretched or torn during childbirth that the uterus slipped down into the vagina as a result of gravity, causing a prolapse.

Women were often too ashamed or embarrassed to seek help in such cases. It was considered improper to examine a woman’s genitals and so intimate examinations were not routine. As a result, doctors had limited experience at diagnosis in these areas.

The tools available for examining women internally were primitive and most doctors relied on touch to make a diagnosis. Although speculums have been in existence since ancient times, it was not until the 18th century that interest grew in improving the equipment used for more detailed examination of women.

One surgeon who was keen to help these women was James Sims (1813– 1883), a general practitioner from Alabama, United States whose first speculum was fashioned out of a pewter spoon, which held the vaginal walls open so it was possible to examine the birth canal. Known as the Sims Speculum, the resulting prototype has gone on to inspire one of the most widely used instruments, and is still in use today.

Sims has been lauded and criticized with equal measure. He has been called the Father of Gynaecology in the United States and his statue graces New York’s Central Park. At the same time, though, Sims has been criticized because a lot of his work in helping women damaged in childbirth was the result of repeated experimental surgery he carried out without anaesthesia on three black slave women. Once he had perfected his surgical techniques, he carried out surgery on white women suffering from the damage caused by childbirth – but with these women he used anaesthetic.

The first bivalved speculum was introduced in 1801 by Joseph Claude Recamier (1774–1852). Numerous modifications were made on Recamier’s original design, including the Sims speculum (left), a simpler form of the more popular speculum in use today (right).