The Ethics of Medical Homicide and MutilationO'Malley, Austin
Religion
The Ethics of Medical Homicide and Mutilation
O'Malley, Austin
Medical ethics
_probably_ cured, but no physician can guarantee the cure so as to
take the responsibility of the decision. Not one physician in five
hundred can make these tests himself, because physicians in general
lack the special training and the means to make them. As the effects
of gonorrheic infection in a woman are so appalling, any woman who
wittingly marries a man who has had gonorrhea is very rash, and the
man who takes the risk of infecting such a woman is a rascal.
A physician is obliged to let a woman who innocently is about to
marry a "cured" gonorrheic know of the man's condition, as in a
case of supposedly cured syphilis. Taber Johnson, Noble, and other
authorities, say no one can tell when a gonorrheic is absolutely
cured.
In women infection of the cervix uteri occurs in about 80 per
cent. of the cases of acute gonorrhea, and in 95 per cent. of all
chronic cases. The infection may extend up into the uterus at the
menstrual period or just after parturition. In the cervix, owing
to the histologic formation, the disease tends to chronicity,
but the inflammation within the uterus is much more likely to
subside naturally. Chronic gonorrhea of the endometrium is usually
accompanied by tubular infection. The infection of the uterus may be
superficial or it may extend down into the underlying myometrium.
The inflammation extends from the endometrium to the Fallopian
tubes and beyond, causing salpingitis, pyosalpinx, hydrosalpinx,
tuboövarian abscess, tuboövarian cysts, and pelvic peritonitis. The
most frequent form of tubal gonorrhea is pyosalpinx, or pus tube.
In the acute stage of tubal infection the tubes become elongated
and swollen, and the mucous surfaces within are covered with
a seropurulent exudate. This condition is called salpinx or
salpingitis. When the condition advances so far that the external
abdominal ostium of the tube is closed, a pyosalpinx forms. The
pyosalpinx may be quite large. A hydrosalpinx is like a pyosalpinx,
with both tubal ends sealed, except that its content is a serous or
watery fluid. When infected material escapes through the distal end
of the tube, perioöphoritis develops, and the ovary becomes adherent
to the tube and other adnexa. More commonly only the surface of
the ovary is affected, but frequently the infection gets into the
body of the ovary and causes oöphoritis. The ovary then swells and
there is a tendency to the formation of retention and other cysts,
or an abscess of the ovary. A tuboövarian cyst is a hydrosalpinx
in communication with an ovarian retention cyst, and a tuboövarian
abscess is a like formation.
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