Pelvic Tuberculosis in Australia

Correspondence Pelvic Tuberculosis in Australia To the Editor: In the article by Drs. :M. Leo Bobrow and James _-'\. Batts published in the JOURNAL of December, 1952 (Vol. 64, No. 6, p. 1242), a statement is made that we estimate the frequency of pelvic tuberculosis in .Australia to be 1 per cent. Then follows a criticism said to have been made by Dr. Sharman, that our low figure is due to not having removed sufficient endometrium. Dr. Sharman lives in Scotland where there is a notoriously high incidence of tuberculosis, and indeed has never enquired from us how we diagnose pelvic tuberculosis in .Australia. However, we would like to state that all our patients have a complete curettage of the endometrium under general anaesthesia in the premenstrual phase of the cycle. In addition, first day menstrual blood is examined by culture or by inoculation for tubercle bacilli, and in some cases an emulsified strip of endometrium has been injected into a guinea pig. Our aim is to find the tubercle bacillus wherever possible and not to rely on histological evidence of giant-cell systems located in the endometrium. In conclusion, it may interest your readers to know that pelvic tuberculosis is now on the increase in .Australia, and that this inc1·ease is largely found in the refugee or immigrant population from Europe. The .Australian Government is at present implementing a large immigration project. In the Sterility Clinic at The Women's Hospital (Grown Street) Sydney, the eombina· tion of a patient with an unpronounceable name and damaged tubes is a signal for a full ~nvestigation for pelvic tuberculosis. In the last seven years there have been 2,920 new patients seen at the Clinic, of whom 12, or about one in 240, have presented evidence of tuberculosis. This is an increase on the figure of one in 600 found here before the recent war amongst native-born .Atistralians. One wonders, for a young and developing race, whether it is not equally important that the new female immigrant be screened for pelvic tuberculosis as well as for the pul· monary lesion. ALAN GMKT, M.R., B.S., F.R.C.S., L.M., M.R.C.O.G. ROBERT :MACKEY, M.D., B.S., D.G.O., M.R.C.O.G. THE \VOMEN 1S HOSPITAL,

CROWN STREET, SYDNEY, .AUSTRALIA

FEB. 16, 1953

Failure to Give Credit to Pioneer Contributions in Obstetrics To the Editors: J: have observed with considerable displeasure a growing tendency on the part of writers of articles in the field of obstetrics to ignore original references either in the body of their articles or in the bibliography listed at the end. Naturally, my attention has been ealled to this by the failure of particular authors who have written on subjects which have especially interested me. If one pursues the investigation of this matter, one :finds 933