Books and later journals record the rich story of medical milestones and progress.

Early medical education was by apprenticeship.  In time, established physicians offered private lectures in anatomy and surgery, but formal medical education did not occur in America until its first medical school was established in Philadelphia in 1765.

“It is easier to buy books than to read them, and easier to read them than to absorb them.”  - William Osler, BMJ, 1910

Outfitting an office for gynecological purposes required a specially designed chair, cabinet, lighting and instruments appropriate for the procedures performed.  

During the first half of the 19th century it was quite proper to conduct a vaginal examination while the patient was standing or recumbent. However, in all instances it was considered very poor form to expose the genitals unnecessarily. 

The one indispensable instrument in gynecology for both therapeutic and diagnostic purposes is the vaginal speculum.  The Greeks referred to this instrument as dioptera whereas the Romans called it speculum. Towards the end of the 18th century and throughout the 19th century, this instrument had undergone an extraordinary number of variations.

Extraordinary effort and a vast array of instruments were devoted to perfecting measures by which this formerly intractable condition could be successfully treated.

Specialized instruments were developed to address disorders of the female urethra and bladder.

All manner of devices were designed to introduce medications into the vagina and uterus and to irrigate same.

Intended for the application of medicinal agents and caustics

Served as applicators for a variety of substances to the uterus

Provided a reliable means for securing and manipulating the uterus during procedures

Were a simple means for ascertaining uterine size, displacement, flexion and the presence of intra-uterine polyps, etc.

Instruments designed to address malposition offered the operator a creative means for returning the uterus to the desired anatomic position

Stenosis was addressed by incising the endocervical canal or with by mechanical dilation

Gave purpose to a novel assortment of specialized instruments for conveniently scarifying and bleeding the cervix uteri

Once the uterus was sufficiently dilated a wide variety of instruments could be introduced to remove uterine tumors and polypi

The operation for removing the ovary was first performed in 1809 by Ephraim McDowell.  Subsequently, instruments were developed to enter the peritoneal cavity, evacuate and extract the cyst and to address the pedicle.

Successful hysterectomy was a long time in the making as it generally required entry into the peritoneal cavity at the risk of developing peritonitis.

Removal of the cervix alone was preferred early on as it was simpler to perform and avoided entry into the peritoneal cavity

Ones intended for gynecological surgery were generally long and slender with multidirectional jaws that could be reliably secured to prevent inadvertent loss of the needle