Medical practice as it used to be

A reader draws my attention to a letter to the BMJ in March 1960

MARCH 5, 1960 British Medical Journal 729

Internal Tampons

SIR,- I attended a nice little girl to-day, aged 15, for vague genital pain. She was only a child, though she strove to be nonchalant like the Brave New World. I thought her trouble might have been due to the chafing of the diaper, as she had heavy periods. But she answered me No-" because I use internal tampons. All the girls at school use them and the mistress says it's quite all right." She then proceeded to show with pride and trepidation an example of the article she was using.

Surely, Sir, instrumentation of this sort is harmful in two ways at least: (a) psychologically for obvious reasons, and (b) physiologically ditto. Surely also it is a complete negation of one of the cardinal principles of surgery, i.e., to provide free drainage. I still meet in this enlightened era of welfare in general, and "guidance " clinics in particular, the unhappy child with a running ear whose mother has plugged it with wool, and sometimes I discover a pledget of wool that has lain stinking in the meatal canal for months. In my opinion the internal tampon should be classed as a dangerous appliance, not to be sold on demand over the counter at all and only to be prescribed on an E.C.1O for a very special occasion, as, for example, for an acrobat or knock-about dancer, whose livelihood might otherwise be at stake.

I am, etc.,

W. R. E. HARRISON.
Buxted, Sussex.

Dr Crippen welcomes gems like this.

More news arrives from 1960. How did Dr Harrison's female medical colleagues view the "problem" of internal tampons? Dr Paula Gosling does not mince her words:

March 19, 1960 British Medical Journal 879

Internal Tampons

SIR, -  Obviously Dr. W. R. E. Harrison (Journal, March 5, p. 729) is not a female who has suffered from menorrhagia. Only those who have experienced the misery of having to play games and do gymnastics hampered by the chafing of a soaking and malodorous sanitary towel can appreciate how very unpleasant it is. Internal tampons may not cure dysmenorrhoea, but at least they relieve one of the chafing and of the unpleasant smell, of which a fastidious girl is all too conscious: Males resent incontinence of urine as much as do females, but it never seems to occur to the disapproving male doctor that the woman who does not use tampons has to put up with an equally uncomfortable state for an average time equivalent of one-fifth of each year. Moreover, I very much doubt whether any man would tolerate such discomfort if any alternative offered. With regard to drainage, it is still accepted surgical practice to use a pack to drain a deep, dark cavity (for example, the perineal wound of a total cystectomy or an abdomino-perineal resection of rectum)- which is precisely what the vagina is. Few surgeons would accept a loosely applied surface pad as an alternative. I also find it difficult to see what psychological harm tampons can do to a normal girl. After all, most females sooner or later have to get used to foreign bodies being introduced into theirvaginas - and vaginismus and its minor variants in dyspareunia are still distressingly common complaints. If Dr. Harrison wishes to imply that the girl who uses tampons does so in order to obtain a perverted pleasure he is betraying a curious ignorance of female physiology: stimulation of the vagina arouses no erotic response at all unless it is preceded by adequate stimulation of the clitoris. In any case, those whose tastes lie in that direction will find plenty of other inserts besides tampons.

I am, etc.,


PAULA H. GOSLING.
Royal East Sussex Hospital
Hastings

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I wonder if either Dr Harrison or Dr Gosling are still alive? Does anyone know of them? I guess they are likely to be eighty or older, but it would be fascinating to hear their views now.