Gynaecology in General Practice

IN choosing as my subject for this address ."Gynaecology in General Practice," I want to reassure you. First of all, I wish to assure the gynaecological specialist that I do not presume to offer them instruction in their work; and to my fellow-general practitioners I give the assurance that I do not wish to appear to presume to be their mentor. The general practitioiner has seklomii the time for the systematic study of any speciality-he has to have a workinlg kiowvledge of themn all. 1 do think, however, that the modern trend amongst general practitioners is to fight shy of many conditions that (do not appeal to them as being straightforward medlical conditions. The reason for this may, no doubt, in large measure, be the lack of time I have already mentioned. The woman xvith "backache"-and goodness knows backache seems to be a too common affliction of the female sex-may require too much time spent on investigation. The easy path is to pass the patient over to the man who specialises in investigating the causes of backache, and this eagerness on the part of the general practitioner to avoid responsibility in these matters has two adverse effects. It has produced a type of patient who is "specialist minded," and who is quite sure that only a specialist is competent to deal with her case. Moreover, it robs the doctor of an important and intimate contact with those who, despite all we males may think, are nevertheless, in most cases, the actual heads of the household and who do, in truth, direct the medical policy of the family. A large number of the gynecological complaints met with in the consulting-room, though extremely troublesome and often almost disabling to the patient, are capable of being quickly relieved by simple measures not difficult to apply. This paper is based on the gyneecological complaints of 170 women met with in my own practice, and I endeavour to tell you of their complaints, the findings on examination, the treatment, and the end results. I have included only those cases which proved to be purely gynaecological, and in only a very few has operative treatment, when found necessary, been carried out by myself. it is essential that the patient's history be carefully enquired into-none of her complaints is too insignificant to note. Each patient must be treated with individual technique. Modesty, prudery, fear, domestic complications may …