Emergence of endometriosis in North America: A study in the history of ideas
Batt, Ronald Elmer
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This dissertation is first and foremost an intellectual history, a history of a disease, and a history of ideas. It is the history of a family of chronic müllerian diseases in women told from a scientific and clinical perspective within the context of the emerging specialty of morbid pathological anatomy in Austria and Germany and the specialties of gynecology and gynecologic surgical pathology in Germany and the United States of America. Following the lead of John A. Sampson, I use the term endometriosis to include all members of a family of five benign müllerian diseases that continue to provide intellectual and therapeutic challenges to scientists, clinicians, and patients. Like all chronic diseases, the five müllerian diseases - endocervicosis, adenomyosis, endosalpingiosis, endometriosis, and müllerianosis - existed before they were recognized and described. For just how many years, generations, centuries, or millennia will be explored. To the best of my knowledge, a scholarly history of endometriosis of this scope has not been written. This study fills that void. For chronic diseases hidden within the interior of the human body during the nineteenth century most nosographic descriptions were founded on morbid pathological anatomy. Only near the turn of the twentieth century was it possible to correlate clinical observations and surgical pathology. However, at no point was nosographic description of endometriosis founded on causation. Serendipity, technology, and individual case histories played an inordinate role in the discovery and emergence of the five müllerian diseases. A genealogy of ideas can be traced as investigators in one generation influenced those in succeeding generations. Key Words: endometriosis, adenomyosis, endosalpingiosis, endocervicosis, müllerianosis, müllerian diseases, history of disease, Rokitansky, Chiari, von Recklinghausen, Lockyer, Cullen, Sampson, Goodall.