means of a 30 C.C. glass syringe. By means of a ‘I-tribe ho connects the manometer between the syringe and .cannula. The syriugc is filled with CO? from a tank, allowing the gas to disp!ace the piston. In order to detect ccrvieal leakage, the patient is placed in the Trcndelenburg position and the vagina filled with water after the cannula is introduced; thus any escape of gas v\~~ould be detected by bubbles rising in the water. SSI the capacity of uterus and tubes varies between 5 and 15 cc., Furnies argues that an excess amount of gas over 30 cc., is: superfluous. R. E. WOBUS. Winter: is&e
Causes and Wochenschrift,
Treatmelnt of Sterility 1921, xlvii, 733, 765
in the Female. and 79T.
Dcutsche
Mcdizin-
Winter finds he is much moi’e frequently consulted regarding sterility than formerly. He ascribes this, not to an actual increase in the condition, but t’o an awakening consciousness among married couples that sterility is . an abnormal state. The physician has also taken a more active interest in this condition, which he formerly regarded as more or less hopeless. In the past, the woman was nearly always thought to be yea.rs the man has come in for hi.s share of the blame, which Various investigators found azoospermia in from 25 tmo 33 examined, and oligospermia in from 11 to 8’5 per .cent,. To adds cases of necrospermia, in which the spermatozoa are sluggish.
at fault, hut in late is not ineoneiderablc. per cent of husbands these groups, Tmnter either dead .or very
As absolute causes of sterility in the female, Winter enumerates severe tubal infections and ovarian atrophy. Other causes, such as steuotic o’s, malpoeitions and infantile uterus, he considers as only relative. These causes include almost every gyneoologie condition, wherefore, a most thorough examination must be made and one after the other excluded. He divides his cases into primary (virginal) sterility and secondary sterility, following previ.ous conception and tabulates I55 cases in which the cause was determined as follows: PE:IMAKY CAUSE
Infantilism Stenotic OS Malpositions Perineal tears Mnexal diseas,es Catarrhal conditions Paraand perimetritis
SFXONDARY
STERILITY
STERILITY
PER
PER
CEKT
CECI’T
12
30
6
20
20
35 2.3
14
20 15
He analyzes the various possible causes of sterility and suggests appropriate treatment. Since various ovarian extracts are capable of producing menstruation in hypofunction of the ovary, he advises their m~plopment in certain casesI, as well as thyroid and lother organ extracts) but adds that their use is still in the cxperimental stage. He dots not mention hyperaeidity of t,he secretions nor undernourish rnent as causes. The results of treatment are admittedly dieicouraging. Of 22; cases1 treated for sterility which he was able to follow up, only six women, or 27 per cent conceived. In the successful cases the presumable cause of ,the sterility was endomctritis in two, colpitis in one, stenotic internal 05 in two instances, while in one case the cause w,as not ascertained. R. E. WOBUS.