gynecology


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gynecology

(gīn'əkŏl`əjē), branch of medicine specializing in the disorders of the female reproductive system. Modern gynecology deals with menstrual disorders, menopause, infectious disease and maldevelopment of the reproductive organs, disturbances of the sex hormones, benign and malignant tumor formation, and the prescription of contraceptive devices. A branch of gynecology, reproductive medicine, deals with infertility and utilizes artificial insemination and in-vitro fertilizations, where a human egg is harvested, fertilized in a test tube, then implanted into the womb. Some gynecologists also practice obstetricsobstetrics
, branch of medicine concerned with the treatment of women during pregnancy, labor, childbirth (see birth), and the time after childbirth. Obstetricians work to ensure that pregnancy culminates in the delivery of a healthy baby, without impairing the health of the
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. Surgical gynecology began to make progress in the 19th cent., when the introduction of anesthesiaanesthesia
[Gr.,=insensibility], loss of sensation, especially that of pain, induced by drugs, especially as a means of facilitating safe surgical procedures. Early modern medical anesthesia dates to experiments with nitrous oxide (laughing gas) by Sir Humphry Davy of England
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 and antisepsis (see antisepticantiseptic,
agent that kills or inhibits the growth of microorganisms on the external surfaces of the body. Antiseptics should generally be distinguished from drugs such as antibiotics that destroy microorganisms internally, and from disinfectants, which destroy microorganisms
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) paved the way for many advances. The American physician J. M. SimsSims, James Marion,
1813–83, American gynecologist, b. Lancaster co., S.C., M.D. Jefferson Medical College, Philadelphia, 1835. He practiced in Mt. Meigs, Ala. A surgeon of international repute, he introduced new operations and instruments (including a vaginal speculum)
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 was largely responsible for gaining acceptance of gynecology as a medical and surgical specialty. Until then there had been opposition to it on moral grounds from midwives, the clergy and the medical profession. In recent years, because of controversies over abortionabortion,
expulsion of the products of conception before the embryo or fetus is viable. Any interruption of human pregnancy prior to the 28th week is known as abortion. The term spontaneous abortion, or miscarriage, is used to signify delivery of a nonviable embryo or fetus due
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 and birth controlbirth control,
practice of contraception for the purpose of limiting reproduction. Methods of Birth Control

Male birth control methods include withdrawal of the male before ejaculation (the oldest contraceptive technique) and use of the condom, a rubber sheath
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, government has become involved in gynecological practice.

Bibliography

See Z. Rosenwaks et al., Gynecology: Principles and Practice (1987).

Gynecology

 

a science that studies the anatomical, physiological, physical, and mental characteristics of women and their disorders. Since sexual functions, including menstruation and childbirth, play a major role in the lives of women, gynecology in the narrow sense deals with the physiology and pathology of the genitalia and the prevention and treatment of diseases of the female genital tract. Gynecology is closely related to obstetrics.

The beginnings of gynecology are found in the written monuments of ancient India, ancient Greece, and ancient Egypt, as well as in the popular medical books of the Slavic peoples. The ancient Greek scientist Hippocrates (fifth to fourth centuries B.C.) described in detail the clinical symptoms and diagnosis of inflammations of the female viscera, as well as uterine tumors. He not only used local treatment but also thought it necessary to treat the whole organism. Special chapters in the works of Vladimir Monomakh’s granddaughter Queen Zoia (12th century) are devoted to gynecology. The studies of the 16th- and 17th-century anatomists, including the Fleming A. Vesalius, the Dane T. Bartholin, and the Dutchman R. Graaf, laid the anatomical and physiological foundation for the development of gynecology.

Gynecology became an independent science in the 18th century. The Russian physician N. M. Ambodik-Maksimovich devoted a great deal of attention to the physiology, pathology, diagnosis, and prevention of gynecological diseases in the first original Russian handbook, The Art of Midwifery (1784-86). The opening of gynecological clinics and higher medical schools in Russia and abroad contributed considerably to progress in gynecology. (The first gynecological division was organized in the obstetrical clinic of the St. Petersburg Academy of Medicine and Surgery in 1842.) In Russia these clinics were directed by A. Ia. Krassovskii, K. F. Slavianskii, and V. F. Snegirev. Gynecology began to be taught in all Russian medical schools in the 1880’s. Russian handbooks by M. I. Gorvits (1878), Snegirev (1884), and V. M. Florinskii (1870) were published. K. Pawlik and V. Rubeska in Czechoslovakia, R. L. Tait in Great Britain, A. Hegar and K. Schroder in Germany, J. E. Pean in France, and others made major contributions to gynecology in the 19th and early 20th centuries. Effective surgical methods for treating gynecological diseases were well developed by the end of the 19th century. (Among those who contributed to their development were the Russian physicians D. O. Ott and A. A. Kiter, the Germans E. Bumm, A. Döderlein, P. Zweifel, and F. Trendelenburg, the Scotsman J. Simpson, the Austrian F. Schauta, and the American J. M. Sims.) The results of the operations improved considerably after the introduction of asepsis. In 1903 the founder of gynecology in Russia, Snegirev, criticized gynecologists’ one-sided enthusiasm for surgery. He was the first to call attention to the relationship between a local process and the condition of the entire organism. Snegirev’s view was eventually adopted everywhere.

The development of bacteriology—particularly, the discovery of the causative agent of gonorrhea by the German physician A. Neisser (1879)—played an important role in establishing the etiological diagnosis of inflammatory diseases of the genitalia.

Great progress was made in theoretical gynecology in the 20th century. The Austrian physician A. Adler (1907) observed cyclic changes in the mucous membrane of the uterus. Gynecology advanced considerably in the early 20th century after the researches of the Russian scientist A. I. Timofeev, the Americans E. Allen and E. Doisy, and the Germans E. Aschheim and B. Zondek on the gonadotropic hormones of the pituitary body, which regulate cyclic changes in the female. The complex relations between the ovary, the pituitary body, and the hypothalamus and its cortex were clarified, and this contributed to the study of the physiology and pathology of the menstrual cycle. The discovery and synthesis of the hypophyseal, ovarian, and adrenal hormones and the study of the effect of the sex hormones on the female body led to the development of hormonal therapy for menstrual disorders (M. S. Malinovskii, E. I. Kvater, S. K. Lesnoi, M. L. Krymskaia, and K. N. Zhmakin).

The use of colposcopy proposed in 1925 by the German physician H. Hinselmann and of cytological examinations introduced in 1933 by the American scientist G. Papanicolaou broadened the diagnostic possibilities of gynecology. Great advances were made in the treatment of menopausal disorders. A radical operation for uterine cancer was developed and widely used (the Austrian scientist E. Wertheim and the Russians A. P. Gubarev, I. L. Braude, and S. S. Dobrotin). The development of gynecological surgery was promoted by progress in anesthesiology, use of antibiotics, blood transfusions, and effective control of shock and terminal conditions, as well as by improvements in surgical technique. Radiation therapy has been used to treat malignant tumors of the female genitalia. Researchers in the USSR and abroad are working on the physiology and pathology of the female genitalia and gynecological oncology (A. I. Serebrov, L. A. Novikova, and I. S. Kraevskaia in the USSR, H. Kratz in the German Democratic Republic [GDR], F. Novak in Yugoslavia, J. Holm in Great Britain, K. Klaus in Czechoslovakia, and T. Antoine in Austria). Studies are also being done on menstrual disorders and endocrine disturbances (Malinovskii, Kvater, Lesnoi, and Zhmakin in the USSR, H. Kratz in the GDR, G. Doderlein in the Federal Republic of Germany, I. Zoltán in Hungary, A. Ambreev in Bulgaria, and P. Guinet in France). Among those doing research on the mechanism of development and on the treatment of inflammatory diseases of the female genitalia are E. Aburel in Rumania, Zoltán in Hungary, W. Kucharczyk in Poland, and G. Grecci in Italy. Work on surgical gynecology is being done by M. S. Aleksandrov, A. E. Mandel’shtam, Braude, and L. S. Persianinov, D. N. Atabekov and A. M. Mazhbits are conducting research in urological gynecology, and studies in pediatric gynecology are done.

The principles of gynecological care, with an emphasis on prevention, that have been developed and introduced into medical practice in the USSR are widely recognized. The Soviet system of clinical observation and preventive checkups provides highly skilled care in hospitals and polyclinics and permits the detection of the early stages of certain diseases and the implementation of measures to control malignant tumors of the female genitalia.

The problems of theoretical and clinical gynecology in the USSR are discussed in the general medical literature and in specialized journals, including Akusherstvo i ginekologiia (Obstetrics and Gynecology, since 1936) and Voprosy okhrany materinstva i detstva (Problems of the Protection of Mothers and Children, since 1956). Specialized journals are published in the USA, Great Britain, France, Poland, the GDR, and other countries. Key problems in gynecology are discussed at international congresses. The First International Congress of Obstetricians and Gynecologists was held in Brussels in 1892. (It laid the foundation for the International Association of Obstetricians and Gynecologists.) Five congresses were held prior to 1913 in which Russian gynecologists participated. After a long interruption, the International Association of Obstetricians and Gynecologists was revived in 1954, and in the same year the First International Congress on Obstetrics and Gynecology was held in Geneva. Later, congresses were held in Montreal (1958), Vienna (1961), Buenos Aires (1964), and Sydney (1967). Soviet gynecologists took part in the work of these congresses and are members of the All-Union Society of Obstetricians and Gynecologists. Personnel are trained in departments of obstetrics and gynecology in medical schools, institutes for postgraduate medicine, and large regional and municipal hospitals.

REFERENCES

Makarov, R. R. “Ocherk obshchei istorii razvitiia akusherstva i ginekologii.” In Mnogotomnoe rukovodstvo po akusherstvu i ginekologii, vol. 1. Moscow, 1961.
Figurnov, K. M. “Istoriia razvitiia akushersko-ginekologicheskoi pomoshchi v Rossii i v SSSR.” In Mnogotomnoe rukovodstvo po akusherstvu i ginekologii, vol. 1. Moscow, 1961.
Braude, I. L., M. S. Malinovskii, and A. I. Serebrov. Neoperativnaia ginekologiia. Moscow, 1957.
Braude, I. L. Operativnaia ginekologiia, 2nd ed. Moscow, 1959.
Mandel’shtam, A. E. Funktsional’naia diagnostika v ginekologii. Leningrad, 1947.
Biologic und Pathologie des Weibes, 2nd ed., vols. 1-10. Berlin, 1951-55.

G. E. GOFMAN

gynecology

[‚gīn·ə′käl·ə·jē]
(medicine)
The branch of medicine dealing with diseases of women, particularly those affecting the sex organs.
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