International clinics

International clinics

a series In these of 70 cases cases of salpingitis only 13 per cent had normally patent hydrosalpinx rsas found much of sterility and salpingitis, ...

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a series In these

of 70 cases

cases of salpingitis only 13 per cent had normally patent hydrosalpinx rsas found much of sterility and salpingitis,

tubes. more

frequently than was detected by bimnnunl examination. The author believes that salpingography should be used in all cases of sterility for three reasons, namely: it demonstrates the condition of the uterine cavity and tubes, it has some therapeutic value because pregnancy follows in about 10 per cent of all the tests, and if au Salobstruction is shown the test constitutes the most certain therapeutic guide. pingography may also be used after an attack of snlpingitis has subsided and folPhotographs of 70 x-ray plates illowing conservative operations on the tubes. lustrate the various normal and pathologic conditions found by the author. An extensive bibliography is appended, and it is gratifying to see that the references are not limited to one language. There is no doubt that salpingography is a valuable aid but 270 cases iu the experience of a single individual in a maximum of seren years (the test w:ts discovered by Sicard and Forestier in 1923) that at least some of the tests were probably done needlessly. In spite of the excellent results reported by many individuals, there is definite danger in the USC of this test even when the cases Furthermore, bimanual examination combined are selected with scrupulous care. when necessary with the Rubin tubal patency test (which is much safer than lipiodol injections) will give the desired information in the large majority of cases. Salpingography should be reserved for :I relatively small number of cases.

In the present edition of this valuable little book, E+r@tiiik~ng i,~ die Gy?~iikologticha Diagnostik,8 the author has made no significant changes. The book is divided into three parts, the first of .which is devoted to the anamnesis and general condition of the patient, the second deals with the technic of making an examination and includes the use of special procedures, and the third and largest part of the book is concerned with gynecologic diagnosis. The matcria.1 is discussed not according to the various gyneeologic ailments but according to the different genital External examination is considered first, and then in order the various organs. afllictions of the vagina, the uterus, the adnexa, the pnrametrium and finally the pelvic peritoneum (perimetrium) . As the title indicates, the book deals almost exclusively with the question of diagnosis. The text is considerably clarified by 159 very clear and instructive illustrations. This book should prove to be of great help to general practitioners and medical students. -4. P. Greenhill. This volume, International Clinics,7 contains a number of valuable articles but the only ones of interest to gynecologists and obstetricians are the following: Katherine H. Coward in a paper on “Recent tiesearch on the Vitamins and Its Clinical Applications, ” mentions the use of vitamin A in the treatment of puerpcral septicemia. The benefits derived from the use of this vitamiu in pneumonia led Among Green and Mellanby to administer this vitamin in cases of puerperal sepsis. 24 patients treated without vitamin A, only two recovered, but all five patients who received this vitamin lived. Foods rich in vitamin D and especially cod-liver oil, irradiated olive oil, and radiosterol (irradiated ergosterol), help to produce normal dentine while diets poor in this factor tend to produce hypoplastic dentine (Mellanby). Vitamin E (Evans and Burr) is necessary for the nourishment of the fetus and for the growth of the young rat. 6Einfuehrung






die Clinics.




1929. Vol.



By Wilhelm Series.



Ed. 4.

B. LIppincott




of Biological A second article of interest is by J. II. Burn ou “ Standardization Products ” in which the author discusses the standardization of ncoarsphenamine, insulin, pituitary extract, and ovarian hormone. The only paper devoted exclusively to a gynccologic snhject is on “Visualization of the Uterus and Tubal Cavities,” b.v Albert Mathieu. 1162 is very enthusiastic about intrauterine lipiodol injection and This is an unusually in a period of three years has used the test in over 200 c:tses. large series for one individual in such :I short period of time, and in some cases at least, perhaps a correct diagnosis could have been made without this test. The author describes his technic in detail and points out the dangers and contraindications of this proeedurc. Among the indications for this procedure he mentions “the differentiation of acute and chronic salpingitis.” I see no necessity to en&t the aid of a lipiodol injection for this purpose and furthermore believe a lipiodol injection in the presence of acute wlpiugitis may lead to dangerous results. Mathieu admits “there are a sufficient number of reports of accidents, apparently due to the method, to call for the exercise of caution and for the proper selection of cases. ’ ’ Beautiful illustrations enhance the value of this paper. There is no doubt about the value of intrauterine lipiodol injectioas for making a correct diagnosis but the procedure slrould be limited to very carefullv selected eases.


P. Greenhill.