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A contribution to the clinical and pathological anatomy of amenorrhea
REW3VS
223
AND ABSTRACTS
sons were nearly all young women without stigmata of hyperexcita.bility of the vegetative nerve system; persons with accidental eosinophilia were also excluded. Of the 9 diseased persons, six showed eosinophilia even when not menstruating. The results of the t’ests were that there was no noticeable increase of the total number of leucocytes during menstruation. An increase in eosinophilia was seen in 15 out of the 37 h’ealthy women, but in 14 there was a decrease. In the 9 pathologic tests, there was an increase of eosinophils in 4 cases and a decrease i:n 5. The lymphocytes increased. in-17 of the 37 healthy women, and decreased in 11 cases. In the 9 diseased cases, there was an increase of lymphocytes 5 times. The mononucleates increased over 1 per cent in 11 out of the 3’7 healthy cases, and decreased over 1 per cent in 7 cases. In the 9 ill persons 5 showed increase up to 1.5 per cent, and 2 cases decreased up to 1 per cent. AMERICAN
INSTITUTE
OF MEDICINE.
Novak and Graff: A. Contmribution to the Clinical and Pathological Anat#omy of be’norrhea. Zeitschrift fuer Geburtshilfe und Gynaekologie, 1921, Ixxxiii,
289.
This report is based on the examination of curettings from 111 cases of amenorrhea in women from fifteen to thirty-nine years of age. Fifty-eight of the cases were the so-called “war amenorrhea,” 16 cases presented marked grades of genital hyperplasia sufficient to account for the absence of menstruation, the others were distributed a,mong cases of genital and extragenital tuberculosis, superinvolution, severe psychic trauma, extragenital hemorrhage, climatic change, et.c. The authors found th:at even in the absence of menstrual bleeding, cyclic changes occur in the uterine mucosa which may be interpreted as the result of more or less complete ovulation. ‘Three histologic types may be defined: Mucosae which represent a definite phase of the menstrual cycle; well-preserved mucosae without sign of proliferative change (resting endometrium) and finally mucoSsaewhich show well-marked atrophy. Transitional types may be seen, cyclic changes and signs of atrophy found in the same specimen. The severity of the change did not always depend upon the duration of the amenorrhea. The condition of the en.dometrium allows conclusions concerning the anatomical and functional condition of the ovaries which are of importance in making a prognosis. Curettage appears to favor the reestablishment of menstruation. MARGARET SCHULZE.
Adler:
Melnom- and Metrorrhagk Wiener klinische Wochenschrift, 1921, xxxiv, 378. The author divides pathologic uterine bleeding into (1) Accidental and (2) Functional. The first group comprises bleeding due to erosions, polyps, carcinoma, etc. The second is concerned with the physiologic function of the {genital organs as in (a) adolescence; (b) myoma, adnexal disease, retroversion, etc. ; and (c) without gross pathology. Hitschman and Adler have shown that endometritis and metritis do not cause bleeding. The author believes that the bleeding is controlled by the internal secretion of the follicles in the ovary. Salpingitis is not accompanied by bleeding until the ovaries are affected by the inflammation, which causes hyperemia and increased physiolog-
223
AND ABSTRACTS
sons were nearly all young women without stigmata of hyperexcita.bility of the vegetative nerve system; persons with accidental eosinophilia were also excluded. Of the 9 diseased persons, six showed eosinophilia even when not menstruating. The results of the t’ests were that there was no noticeable increase of the total number of leucocytes during menstruation. An increase in eosinophilia was seen in 15 out of the 37 h’ealthy women, but in 14 there was a decrease. In the 9 pathologic tests, there was an increase of eosinophils in 4 cases and a decrease i:n 5. The lymphocytes increased. in-17 of the 37 healthy women, and decreased in 11 cases. In the 9 diseased cases, there was an increase of lymphocytes 5 times. The mononucleates increased over 1 per cent in 11 out of the 3’7 healthy cases, and decreased over 1 per cent in 7 cases. In the 9 ill persons 5 showed increase up to 1.5 per cent, and 2 cases decreased up to 1 per cent. AMERICAN
INSTITUTE
OF MEDICINE.
Novak and Graff: A. Contmribution to the Clinical and Pathological Anat#omy of be’norrhea. Zeitschrift fuer Geburtshilfe und Gynaekologie, 1921, Ixxxiii,
289.
This report is based on the examination of curettings from 111 cases of amenorrhea in women from fifteen to thirty-nine years of age. Fifty-eight of the cases were the so-called “war amenorrhea,” 16 cases presented marked grades of genital hyperplasia sufficient to account for the absence of menstruation, the others were distributed a,mong cases of genital and extragenital tuberculosis, superinvolution, severe psychic trauma, extragenital hemorrhage, climatic change, et.c. The authors found th:at even in the absence of menstrual bleeding, cyclic changes occur in the uterine mucosa which may be interpreted as the result of more or less complete ovulation. ‘Three histologic types may be defined: Mucosae which represent a definite phase of the menstrual cycle; well-preserved mucosae without sign of proliferative change (resting endometrium) and finally mucoSsaewhich show well-marked atrophy. Transitional types may be seen, cyclic changes and signs of atrophy found in the same specimen. The severity of the change did not always depend upon the duration of the amenorrhea. The condition of the en.dometrium allows conclusions concerning the anatomical and functional condition of the ovaries which are of importance in making a prognosis. Curettage appears to favor the reestablishment of menstruation. MARGARET SCHULZE.
Adler:
Melnom- and Metrorrhagk Wiener klinische Wochenschrift, 1921, xxxiv, 378. The author divides pathologic uterine bleeding into (1) Accidental and (2) Functional. The first group comprises bleeding due to erosions, polyps, carcinoma, etc. The second is concerned with the physiologic function of the {genital organs as in (a) adolescence; (b) myoma, adnexal disease, retroversion, etc. ; and (c) without gross pathology. Hitschman and Adler have shown that endometritis and metritis do not cause bleeding. The author believes that the bleeding is controlled by the internal secretion of the follicles in the ovary. Salpingitis is not accompanied by bleeding until the ovaries are affected by the inflammation, which causes hyperemia and increased physiolog-