- Email: [email protected]
Reviews of new books
Department
of Book Reviews
CONDUCTEDBY RJJBERT T. FRANI~
Reviews of New Books GYNECOLOGY The book written by Kappis on the Prophylaxis and l’rmtment of Opevatiw I)angerss is well worth while. It assembles and digests much of what is known on these subjects, with full regard to our increased knowledge in normal and pathological physiology and biology. The surgical profession should be grateful to the author for his laborious work and for having assembled within the covers of one book what is generally known of this field which may he summed up under the resistance to versus the dangers of operation. Of operative deaths 45 to 55 per cent are due to the underlying diseases as for example, carcinoma, peritonitis, severe injuries. Of possibly avoidable risks, pneumonia, bronchitis, lung abscesses, etc., take 17ye per cent of victims. In accord with others, the author finds an increase of thrombosis and embolism. His mortality from these unavoidable accidents in 1923 was 1.6 per cent; in 1930, 8.6 per cent; in 1931, 6.5 per cent. General poor condition causes 9 to 14 per cent of deaths as for instance the cachexia seen in carcinoma of the stomach. In addition, deaths are due to infection, especially peritoneal, mistakes in diagnosis or wrong indications. At least 1 per ecnt of deaths are due to cerebral hemorrhages and some remain undetermined even at autopsy. A large amount of space is devoted to the preoperative evaluation of the risk in which constitution, age (both young and old), intercurrent physiological conditions such as menstruation and pregnancy, diseases including Basedow, Addison’s disease, thymolymphatic status, etc., play a considerable role. Certainly in sclected cases, functional heart tests, careful examinations of the lung, determination of the liver function, of kidney function, of blood disturbances, and changes in the basal metabolism must bc thoroughly considered. Dangers incident to the operation itself and immediate sequelae are next taken up, including the selection of the anesthetic, immediate preoperative preparation, care to be taken against leaving foreign bodies in the wound. Even such apparently minor matters as the avoidance of injury in giving injections either subcutaneous1.y or intravenously, are discussed in detail. The avoidance of operative shock and collapse, as well as their treatment are fully discussed. Deaths on the operating table, air embolism, intracardiac injections and cardiac massage are described. The next division concerns itself vtith after-treatment. The author believes in carefully graduated but sufficient morphine injections postoperatively. He then takes up such matters as loss of fluids, feeding, movement of the bowels, the qorbeugung
Georg Thieme,
und
Bekiimpfung
Leipzig,
1433.
der
Operationsg~fahrcn. 777
Van
Prof.
Dr.
M. Kappis
778
AMERICAN
JOURNAL
OP
OB~WWRI(:S
ANI)
U-Y-i
WOLOQY
avoidance and trcatmcnt of cardiac, pulmonary anI1 otlicr c,Jlnj~licatir~nb us \Vell as alkalosis, tetany, singultus, parotitis, psyc>hoees, et!*. h ~:ulic’luding portion of this division deals with the after-treatment of sl~cial arran after ol~rratione on the head, face, thorax, breasts, abdomen, ct~. This book of ov
Referring to the fact that tho majority of gynecological patients begin their careers, so to speak, in the ofRcc of a private practitioner and that many of them must eventually bc treated by special apparatus or handled with an unusual degree of skill by the gynecologist, Kiistuer!+ ftrels that the most important divisiou of gynecology is early and exact diagnosis. In obstetrics, as well, he regards pre-knowledge of abnormalities, possible c~ornplications and early recognition of pathological conditions a sine qua non. To this end he has compiled in table form the diagnostic points in a series of gynecological and obstetrical conditions These tables arc supplemented for the most part by beautifully colored plates or very capably executed black and white drawings correlating the tables. For gynecology he has arranged thirty-six tables boginning with malformations and congenital deformities of the urogenital system, continuing through inflammations, tumors, displacements, diseases of the tubes and ovaries, peritonitis, fistulas and gonorrhea. The tables vary in length and breadth as to the number of conditions which may affect a certain part. Symptomatology, etiology, pathology, bacteriology, clinical course, differential diagnosis, prognosis and changes in function arc given. Obstetrics begins with diagnosis, continues through abortion, and positions of presentation. Four charts on the toxcmias, complications of labor, puerperal sepsis and diseases and injuries of the newborn are included. Such a manner of presentation, stripped of nonessentials. will give to the practitioner a quick and striking picture to assist him in making an early and exact diagnosis. 1)‘11II,IP
F.
w’rr,l~raMs.
The fifth edition of v. Jasehke and Pankow’s Lehrbuch drr Gytiikolopie~~ is a large volume of 759 pages, costing 40 marks. Nine years have elapsed since the last edition was published. Tho two authors represent a continuation of the clinics of v. Rosthorn and of KrSnig. The book is designed mainly for the student and practitioner. Debatable subjects and subjects of special interest to the specialist are not emphasized. Consequently operative technic is only dealt with in a most summary fashion. On the ot,her hand, the connection between gynecology and general medicine is emphasized throughout. General gynecology is dealt with in 262 pages, while the pathology and therapy occupies 460 pages of the volume. The anatomy is short but good. The same may be said of the embryology and physiology. Next the hygiene of the female and woman as a patient, are discussed. The treatment of functional and allied conditions by means of hormone therapy is, to say the least, over-enthusiastic and uncritical. The second portion of the book is well written, informative, but rather difficult to read as it is too ample for the student and too general for the specialist, In WyniLkolo~isQhe
Dr. Heinz Lehmann. Sehrbueh
FUnfte
und
KUstner. MUnchen, Auflage.
der
Oeburtsbilflicke
65 Tabeilen 1932. GymSkologie.
Verlag
van
Diagnostik
mit .Julius
Van
72 farbken
in
und
Dr. Rud. Th. Springer, Rerlin,
Tebellenlorm.
schwamen v. Jaschke 1033.
Von Abbildungen. und
Dr.
Professor J. 0.
Pankow.
F.
BOOK discussing cluded
diathermia, that
it
must
The illustrations siderable literature the vast majority
hydrotherapy be bewildering
779
REVIEWS and
radiotherapy,
to the
so many
details
are
in-
beginner.
are especially good, well selected and well executed. Conin the form of footnotes adds value to the book although in of cases only the Gcrmau litcraturc has been taken into account. R. T. FKASK. OBSTETRICS
Ten Years of Obstetrios and Gynecology in Primte Pm&ml] has been offered largely to furnish a series of private cases for comparison with hospital statistics. The statistical summaries will undoubtedly be useful in such comparative deductions. The text is divided into two parts, obstetrics, regarding 1750 cases, and gynecology, discussing 1345 cases with 1733 diagnoses. This material has been arranged in groups with figures, comments and in some instances, for the purpose of illustration, detailed case histories. As all scientific and controversial matter is omitted, the book will be found The reduction of complications as entirely clinical and eminently practical. noted in the first chapter stresses the importance of good prenatal care. Simple measures sufficed for most vomiting of pregnancy cases, but one therapeutic abortion was done. Grave vomiting in advanced pregnancy with toxic degeneration of the liver is well discussed, and a characteristic history appended. The Voorbees’ bag for lateral, and cesarean section for central placenta previa are recommended. No mention is made of transfusion or of packing after delivery in placenta previa or in premature separation of the placenta, although the author mentions (p. 21) that postpartum hemorrhage is a frequent and dreaded complication in the latter. Transfusion appears in the index but by a typographical error evidently refers to a wrong page. The author treats his toxemias conservatively and is prompt in terminating pregnancy in the presence of a threatening cclampsia. Cardiac complications are very briefly discussed. There is no mention of the Wassermann reaction in the cases of unusual edema of the fetus and placenta. Decomposition and extraction of frank breeches is done at once on full dilatation. The author discusses the out the perinenm ” and is preferring relative merits of episiotomy and of “ironing the formcr. Medical induction was found useless and rupture of the membranes and insertion of a No. 4 Voorhees’ bag routinely practiced. A delivery table with elevator lower section, and roller top section is described and illustrated. The old-fashioned stirrups are seemingly used in operative deliveries. Discussing ,analgesia and anesthesia the author believes the danger of morphine to the newborn is overrated. Perineal repairs arc performed under infiltration anesthesia, novocain. There were 431 instrumental deliveries in the 1750 cases. The modern tendcncy toward earlier interference is supported. Low or Simpson forceps were used 207 times, axis traction in 29, and Kielland in 195 cases. The author is enthusiastic over the Kielland forceps and devotes six pages to their use. In contrast podalic The vectis is resurrected. Ninety-five cesarean version receives a scant page. A clinical ?Cen Years of Obstetrics and Gsnccolosy in Private Practice. of 1760 obstetrical and L345 gynecoIogica1 eases, with comparative anaiYses of of the larger groups, and detailed case histories of some of the more important less common conditions. By John L. Rothrock, A.B.. M.D.. F.A.C..S. Formerly ciate Professor of Obstetrics and Gynecology, Univrersity of Minnesota: Former ber of the Miller Clinic and Chief of the Obstetrical and Gynecological Services Charles T. Miller Hospital. Pages 204, and 9 Illustrations. Paul B. Hoeber New York, 1933.
report many and AssoMemof The Inc..
Thorns has written a fascinating bro~hurc entitled Chqtm-s ia dmeri~u:crn obStft~rif’S.1~ He? describes the American midwifery in a most vivill fashion. Then he takes up the first obstetrics published in America by Samuel i:at.Ll, 1807. The introduction of ergot i*lto obstetrics by John Stearns, under the na10c of “pulvis parturicns,” is of interest. Among other mcll-kuown figurcss. William Potts Dewces and Oliver SZ’codtIl Hol~nes arc piciurcd. 1 chapter 031 cephalic version introduced by M. R. Wright and in conclusion the int.roducticin of cthcr in cI~iltll~irth ljg Walter Chsnning, are given. eilrlt'
Thorns has succeeded in putting life and color into these historical sketches:: to a degree which should induct even rcndors not particularly intercstrd in mvdical history to rcncl these pages with pleasure, profit, ant1 a feeling of pride t’c)r~ what the early Anlcrirsxn obatct,rici:uns have dtrr~c. R. 1’. ~‘C.IXW. The usual comparative studies in IA~hryology and Cytology have been div. l~arded by Lucien and Vcrmcliu il: th?+r Twasli.w olb the Rwn46m &i%sn.l!: The first part of the book is dcvotcd to Spermatogcnesis and oagenesis from the origin of the germinal gland in the embryo to the fully matured adult cells ‘?hapters in Amtricnn ObsteLdcn. i:. tf. Thomas, Springfield, 1:~ Hcrbcrt Tlloms. 1933. “L’Oeuf Wumain et BBS Annexes Pm! Mmmice Lueien. Professeur d’anatcrmie et Henri Vermek, Professeur aa&& d’obst6trique B la Facult6 de M&%&E de Nrtncu. Preface du F?-ofesseur Couvelnire, Membre de I’Acaddmie de Bb&%&%?. Pa?33 1%: nnrl Avcc 7S A$urcs. Q. Doin & Qe, Paris, 1033.
COOK
781
REVIEWS
capable of union. A note on sterility makes practical use of their observations. There is a full exposition of the sexual cycle completely in accord with the most recent anatomical and physiological researches, references to which are frequent. The rhythmic cycle of the fallopian tube, shedding of cilia, granulation of cells, and hemorrhage following closely the uterino cycle is described, as is also the vaginal cycle. The physiology of nidation, its variants, inciuding multiple pregnancy and the The manner and time of development of associated phenomena are discussed. the appendages, membranes and placenta and the physiological significance, f(ll t.he embryo, from a nutritional aspect are given fully. The very early human ova and embryos reported in the literature since Peter’s ovum are listed and classified as to development. The final ehaptcr takes up the circulatory mcchanism. This assembly of facts, by an anatomist and an obstetrician, is a good basic slatement of the present status of human embryology, and will make an excellent rtlfcrence book. FIIII‘IP
E’.
ViIr,r‘IaM
s.
De Lee’s Obstetricsl4 continues to bc one of the outstanding contributions on this subject in the English language. Since 1913, it has gone through six editions, oath with careful changes to keep it up to the present stale of our Bnowiedge, and a number of reprintings in addition. This ne’w edition is a volume of 1165 pages and contains many changes as well as a number of new iilustmtions. Do Lee has more and mere taken cognizance of two methods of delivery, the one, strictly hospital in the hands of specialists, and most often applied to the abnormal cases; the other, in the hands of the general practitioner where delivery is performed in the home, n-hich requires an entirely different viewpoint and much more noninterference. De Lee divides eclampsia into true toxemia, acute nephritis, chronic nephritis and malignant hypertension. As the cause of this symptom complex is unknown, his classification is as acceptable as any other. He believes in allowing the patient to deliver herself. A carefu1 review of borderline conditions, involving problems of internal medicine, has been performed, including tuberculosis, diabetes, heart disease and syphilis. The frequent use of illustrations based on motion picture films is employed. These would be more useful if the pictures were larger. The Literature has been kept up to date. As heretofore, this volume is of great value both to the practitioner ant1 obstetrician because of the immense experience recorded in its pages as well as the mei.iculous care employed in constant revisions. R. T. FIMPJB. This medium-sized volume on I”ractionZ Obstelrics~j admirably fulfills the aim of the author to produce a text midway between a eomplcte reference book and a compendium. Stripped of any unnecessary verbiage and omitting all scientific discussion, the present-day ideas and practice are given, concisely and succinctly, in Tvell-spaced chapters, with plenty of excellent illustrations. It is a suitable book for the student days or the years of early practice, and has a simplicity of presentation 14The
Saunders
“Lebrbuch
and Practice of Obstetrics. Co.. Philadelphia, 1933.
Principles
der
Prektischen
Geburtshilfe
Dr. Sigfrid Hammerschlag. Direktor der Berlin-NeukSlln. Seite 290: mit 101 teils Stuttgart. 1933.
By fiir
Joseoh
Studierende
B. De Lee. nnd
Arzte
Ed.
Brandenburgischen Landesfr&enklinik farbigen Abbildungen. Ferdinand
6, W. B. Von
Prof. Enke.
in
The obstetric conditions iu tho twl)i(:s which are ina terially dX’erent from those of the West in respect to anatomy, c.limatc, and diet are described in this lboak by Green-Armgtagc dealing with Mi,dzoife~!/ ill, fkt’ ~/.opics.~~ I ! had Lww written not only for the Indian stmhnt but for the medical mau, with :I ~vestclrn education, beginning practice in eastern or tropical countries. Tlw sub,jctl matte1 follows the usual divisions of t,he aroragc textbook, and is presented in :I crisll, staccato style, a concise form to help students to whom Englisll i3 iutlcr8l :I fowigu language. Among the racial difference s it, is noted that the head of the oriental fetus mcasurcs a quarter of an inch less in all important diameters, than the Europcan fetus; that the generally contractccl, round inlet, ljelvis is quite common in India and the funnel pelvis is very common. As osteoJllnlacia and rickets RW frequent diseases in India all varieties of contracted pelvis are often seen. Tho average maternal mortality is 4 par cent, and complications oeEur in SO lbcr cent of the cases. Lack of prenatal care is practicallv universal in India; lhc authors supply excellent rules for anteuatal and postnatal cart’, the chapter, on the latter is especially good. A dietary for Europc~aris resident in India is listed as well as one for natives. This has been drawn up with a view t.o lessenThe ing the many complications which may he referred t,o dietary defi~ianaicr. authors are conservative in t,heir trcatruout of toxemias. Tlw2y rcfvr to an unusual frequency of pelvic abscess following ectopio pregnancy, whcthcr operated upon or not. Among the tropical conditions quite .t’ully discussed are the anemias of preg, nancy, frequent anit severe, and a cause of much morbidity and mortality, malaria, kala-azar, tetany, dysentery, osteomalaoia in its various stages. Thry find morbid changes occur quite early in multiparas, a para iv nftcn being a greater problem than in her first pregnancy and delivery, all duo to tropical habits and diseases. l?ifty per cent of puerpcral pyrexias are duo to tropical disease’, Cosarcnrl section and at times the dil~crcntial diagnosis of sepsis is clifhcult. occurs once in every forty cases in the Eden Hospital. The authors state that, having given the Kielland forceps an estcnded trial they do not rrcommentl it. The fow illustrations use11 demonstrate> ccphalopelvic disproportion. ~4 gra.1) 1~: Tll~ 1 book i- .’ 2L vA:y c,hart is used to bring out all the points of antenatal earc. good manual on obstetrics, and is interesting in its portrayal of the manifold difficulties under which obstetrics is practiced in India. k”fllLIP
F.
WILLIAMS.
A most interesting subjcet was taken up by the Ukranian Congress of Obstot. and Gynceology at Kiew, dealing with the expericnec resulting from the L~~beraltiation of Induci7l.g Abort2:oc in %IIW Soviet lZ@~~olic.j i The subject has been considered of such interest that the German GeseZko7mft fiir Gebmtshilfe I(;& G?/nii/;oZo,gie instructed Professor A. Ms.ver of Tiibingrn to supervise the transrics
laA Textbook of Midwifery in the Tropics. By V. B. Green-Armytage. M.D., F.R.C.P. (Land.), F.C.O.G., Lt.-Col., I.M.S.. Chevalier of the Legion of %Ionotir; Order of the White Eagle of Serbia: Professor of Midwifery and Gynecology. Cc&cut& iXedica1 College, and Surgeon to the Eden Hospital for Women, Calcutta, and P. C Pp. 282: 7 Illustrations and 1 Chart. Dutta, M.B., F.R.C.S., D.G.O.. Captain I.M.S. The Book Company, Ltd., Calcutta, l&73. l’Erf&rungen titder Freigabe der Boh~ngersa~tsaar0~~~ in der BewWRepublik. Werausgegeben von Profe488or Dr. A. Mayer, Univer~itllts~auenk~~~ fn Tiibingen. Veflag von Ferdinand En&e, Stuttgart, 1933.
78.1
BOOK REVIEWS
lation and bring out this study in the form of a monograph which appeared as a supplement to the Zeitsclmift fiir Geburtshilfe wnd Gytikologie (Volume 104). The Ukranian Congress met in 1927. The report contains many independent papers which deal rvith the social indications fcr induction of abortion, the limitation of abortion to the first three months of pregnancy, the reasons for inducing abortion. The main indication appears to be economic stress which in most instances has been determined by a Commission. At jirst, certain hospitals were indicated as “Abortaria” but later, when the bed capacity was found insutiiciant, private clinics were permitted to accept patients for this purpose. There has been a steady increase in induced abortions since 1913. Of the patients seeking abortion, there is some difference in different committees, but in general up to 80 per cent of them are married. In consequence of the liberalization, charlatans and lay abortionists have greatly decreased. In spite of the diminution of clandestine abortions and the fact that the procedure is entirely in the hands of the medical profession, the medical dangers appear to be ever present, including infection, injuries, and many others. prom 1922 to 1926 the number of all abortions rose from 53 to 80 per cent of births in the city of Moscow. This pereentage included likewise an increase of induced abortions from 12 to 261/2 per cent. The various technics which apparently are far from being standardized were discussed by different speakers, Some stress was laid on contraception as a proper means of limiting the necessity of abortion. As yet, no political or economic change in the incidence of population has been noted. The Congress adopted resolutions in which it noted that there was an increase in the number of induced abortions both in the cities and in the villages; that there was a marked decrease in clandestine abortions with a definite decrease in morbidity and mortality; as yet no decrease in the number of the population has been shown; that the medical dangers had not decreased. Hence the procedure should be limited to hospitals and trained medical men, and that because of the dangers in inducing abortion, the use of contraceptives is greatly favored. R. T. FR.ANK. The Law Agabnst Abortions by William J. Robinson is frankly propaganda. No one who knows the life of the author can doubt his bona fides and yet some of its contents is, to say the least, startling. The whole basis of the book, as stated in the first chapter, is the demand for complete and total abrogation of any law against abortion. Robinson is strongly in favor of contraception or prev.eneeption, as he calls it. Re acknowledges that abortion is an evil, but a necessary one. This tract is cleverly written in flamboyant style but contains many well worth-while truths. The point of vita and overemphasis will startle and antagonize many readers. R. T. FRAXK.
Briquet’s OperaWe Obstetricsls should be exceedingly valuable to those interested in obstetrics, if only for its beautiful format and illustrations. Although the author’s ‘?l!he manded.
1933.
UPaul
Companhin
Law
By
Briquet
Against
William
Editora
:
Abortion,
Its
J. Robinson.
Obstetricia
National,
0,peratoria.
Perniciousness
Demonstrated
The Eugenics Publishing (Portuguese.)
1932, Sao Paula.
Brazil.
and
Its
Repeal
De-
Co., Inc., New York,
First and Second
Editions.
Corkill’s work on Midwifery ale16 Infmt Care22 is based on lectures to midwives and graduate nurses which the author has given for a number of years, and is offered as a working manual for handling obstetrical CDSCR alone or as an assistant to a physician. The primary aim of the book has been to elaborate the rules and regulations of the New Zealand Department of Health, and the Midwives’ Registration Board, for the purpose of reducing tho dangers of infection during labor and the puerperium. An aseptic technique has been standardized throughout the hospitals of New Zealand by the Dcpartmcnt of Health. This standard is presented an<1 ,4s a matter of note, puerperal sepsis reasons given for every step reconunendcd. is no longer the chief cause of maternal mortality in that Dominion. The plain and simple language of the book and the full explanations should make it a very good manual for the prcclinical obstetrical course for a medical student. Practical demonstrations in minor laboratory work and antenatal cart are given for the benefit of the midwives who evidently constitute a group Chloroform seems to be entirely dissimilar from our conception of midwives. the anasthetic choice in New Zealand. R,ickets is rarely seen. Several chapters are devoted to the infant, emphasis being placed on breast feeding, but with full details for artificial feeding. The end of each chapter has a concise summary, with rules of responsibility to the patient and the physician. The author states that under certain circumstances in placenta preria the midwife may rupture t,he membrnncs or even insert a vaginal pack. To avoid unnecessary consultation calls by the midwife the author has devoted considerable space in explaining the various causes of delay in labor. Throughout the book the emphasis is laid on the prevention of sepsis and an appendix is devoted to the Department of Health rules for disinfecting of rooms and equipment used in infected cases. The graduate unusual
caliber of the instruction nurses until one realizes training and must carry
seems unusually complete for midwives and that for the most part these are women of on many complicated labors alone. I?&ILIP
F.
WILLIAMS.
The tenth edition of De Lee’s Obstefrics for iVurses?3 has been brought to date. Besides the general nurse, it aims to teach the advanced nurse teacher of nurses as well as the pupil nurses themselves. Particular notice is given to obstetrics in the home as more than 50 per of all deliveries occur outside of hospitals. The book is a very well-balanced description of obstetrics for nurses shows the known qualities of De Lee as a teacher and experienced clinician. R.
up and cent, and
T. FR~\NI<.
of almost 500 pages contaius the cha~rman’s report and the followmostly in monographic form, of Faators and Caluses of Fetal, Newborn, antI MaternaL Morbidity md Movtality.~~ Acute Infectious Diseases in Pregnancy, Labor and the Puerperium by Dr. J. P. Greenhill of Chicago; Syphilis and ing
This volume 22 studies,
A New Zealand Course. A practical and Infant Care. of pregnancy and labour and the care of the infant, conformlaid down by the Nurses and Midwives’ Registration Board of F. Corkill, M.C., M.D., M.R.C.P. (Ed.), Lecturer to Nurses and Board of New Zealand ; Senior Honorary Physician, Wellington Honorary Physician to Truby King-Karitane Hospital, WellingNew Zealand Obstetrical Society. Pp. 410. Coulls Somerville New Zealand, 1932. =Obstetrles for Nurses. By Joseph B. De Lee. Ed. 10, Thoroughly Revised. W. B. Saunders Co., Philaddphia, 1933. aFetall, Newborn, and Maternal Morbidity and Mortality. Report of Sub-Committee 4 of Section I, B of the White House Conference on Child Health and Protection. Hugo Ehrenfest, M.D., Chairman. D. Appleton-Century Company, New York, 1933. ~Lectares
on
Midwifery
manual on management ing with the syllabus New Zealand. By T. Midwives’ Registration Children’s Hospital ; ton; Member of the Wilkle, Ltd., Auckland,
by JGIUCS Robert MeCord 11t' .\(i:tntn : l’ulmun:tr\: ‘l‘:~l)~~r~*ulosis it] l’r,‘g naney by Dr. Otto II. Schwarz of St. l,~kiid; l’:unsitic lnfr!*tions (‘omplicating hegnancy by I)r. Fknest C'arroll Faust and ih. JCdw~rtl L:w~ 1< ina wf NIX Orleam: Heart I&case and Pregnancy 1)~ Dr. N’illinm X’. tZt,rrick c:t’ New York City : Xcphritis Complicating I’r~gn:~ncy by- lb. ,Tcllm I\:. IIarri;; c,< Nadisorl ; ‘I’oscmi:l Problem by Dr. George TV;. Kosmak of XC\\ \‘ork City; l)istt:ts,>s of thp Tcaeth xrul Gums in Pregnnnq I)y George II. \I-antl~l, i).l).S., of C’hicng(i; TTterincl i21nzer and Pregnancy by Dr. John A. MeGlinn of Philadelphia; DisCas IIf Endocrines and cif Blood i’omplic~ating I’reguarrcy 1,s J.)r. llol,rrt I). Mrlsr~! of Tlua Ma>15 (‘linic. Rochester; Induction of l,abor With Sp&~l Consideration (11’ .$rtifici:tl Rupture of Membranes by I)r. -6. lan F. Guttmnchcr of Rnltimore; F0Wcps ilIld Cexarcsn SCVtion by Dr. E. 1). Pluss of Iowa City; _~~nc4hesin and !&in ICc~liVf in Obxtet.rick I>? Dr. Carl II. Davis of Milwnukccs in eoopoation with Drs. 1. I).. Rill, John IV. Harris, Arno B. Luckhardt, and Ralph M. N’atcri;; l3cn~r iu t.Iic, l’urrp~7?um 1)~ 1)r. W. E. Caldwell of Xcw York C!it>-; Non-Fellrile Complicaiions of ihe I’urrp~riom b, Dr. William C. Danforth of Evanston: I'ropr I’ostpart~um t.:art* tiy I jr. C’lmrit~+ Edwin Galloway of Evanston; Tnfluencc of Xatcrnal Pelvic Therapeutic Irradiation of Philadelphia : en the Health of the Subsequent Child I)y IIr. Douglas I’. Sfurphy Emc’ry Studdiforrl of Sc\r Fetal Mortality in Breech Presentations hy Dr. Will&m York City; Relation of Birth Trauma 10 3~~onatal Mortality and Infant ,\[orbiditT Julmediatct (‘arc ut’ ihr Pu’ewborn by Dr. by Dr. IIugo Ehrenfcst of St. Louis; .Joscph I,. Baer of Chicago; The Import,anee of (!omplete :1nr1 Accur;rti* i’vrtificntes of Birth and Death in the Prevention of Jlaternal and Early lnfsnt Mortality by ljr. Richard A. 13olt of Cleveland; Al)ortiou in Veldtion to Fc?tal and Xatornal Welfare by Dr. Fred J. Taussig of St. :T,ouis. In fairly systematic form for all the more common diseases found in pregnant women, the erect oi’ pregnancy on thtl 1~aun1 COIITSG of thci disease is discussed, 2nd 2s well tllc inliuence of the disease on the course of pregna.ncy and on the fetus The problems <)f prevention :~ad of interruption of pregnancp in the in utero. in detail with due ionsitleration of special interest of the mother arc discxssed methods of delivery required under ccrt:\iu conditions. This full list of articles contained in the volume and of the competent. men contribut,iug them, bcttcr than any detailvd description of their rich contents, will furllish a.11 adquat(; i&a, concerning the immense prdctiaat value of this book for the obstetrician and especially for cvrty l~ractitioner doing obstetric work. I'r~g~ancy
(if
L1r:st..
f'(~f~%.s~ri wwrs the subjett from mere This ~rhaustivc St-Udy of llrc Fe:rilitic side of the problem has not been permitted 10 possible angle. The scientific overshadow the practical aspect and :I. full clinical ennsideration is presented, with the author’s ideas often elucidated by appropriate case hiatorirx The book There are many photographs showing the I.liuii:al n.ppliis profusely illustrated. cation of the directions prescribed for pelvimetry and ceybalometry, and a num bor of clear and distinct roentgenograms. The racial The historical review portrays in a sonso the history of obstetrics. differences shown in the widely gathered ethnological studies have a praetiesl importance in our international population trend. One can agree with the author that the average native white female pelvis in private practice ia smaller than The far-reaching influences in the standard set by the -4meriean f!ommittec.
A Practical Manual of Pelvimetr’y s’J!he Pelvis in Obstetrics. eluding C&pters on Roent@znolo&al Measurement by Julius Consuiting GynecobgiSt, Hastings ZItlLsfite Hospftal ; Atiaing cologlst, Sydenham Hospital. Pages 325, 140 Illustrations. 91 Inc., New York. 1933.
and Cephalometry In.Jal‘chh. &$I?.. F.A.C.S.. WstetrieTsn and GymTables. Prtui B. Ho~%F,
BOOK
787
REVIEWS
the development of the abnormal pelvis are well presented; in these the effects of modern civilization and its corrolaries have had their part. The classifications enumerated are based upon changes in form, etiology, and degree of deformity. Each is discussed with explanatory remarks. The author notes several varieties of the funnel pelvis, a deformity which has been well studied by American obstetricians. Methods of external and internal pelvimetry are considered from the standpoint of their practical application. The various instruments suggested are pictured’and their use described. The author feels that simple methods, intelligently employed, give just as valuable information as some of the complicated devices recommended. The diagnosis of cephalopelvic disproportion, which is the crux of the whole problem, is the subject of a very able chapter. The author favors elective cesarean section in most borderline cases. Those uncertain of obstetric diagnosis may study this chapter with profit. The book concludes with chapters on roentgenographic pelvimetry and cephalometry. He discusses his own method of calculation, as well as the use of the Thorns’ grid, and states various obstetric indications for use of roentgenologic studies. It would be quite surprising to learn that any reference to the pelvis in the world’s literature has been overlooked, for there is appended to the text a bibliography of twenty-seven pages. Possibly the only criticism of such an outstanding collection of references might bc that it was not classified into groups referable to the subdivisions of the text. This book is such a splendid work of reference and of practical detail that it will be found of value to anyone teaching or practicing obstetrics. P’HILIP
F. WILLIAMS.
RADIOLOGY A,“r’D RADIOTHER.APY In the foreword of Liittge’s monograph on Forcq% Operdion irb Rb’ntgan Pictnre~zfi Wintz outlines the advances in roentgenology, during the past fifteen years, and remarks upon its application to obstetrics; the diagnosis of pregnancy, pelrimetry, cephalometry, disproportion, birth meehanism and forceps delivery. Liittge in the text reviews the history and methods of obstetrical roentgenology. .9 broaoening of the indications for forceps extraction, and the prerequisites, are described. He discusses mensuration of the pelvis, the effect of altered positions of symphysis upon the inlet and the relationship of the abnormal inlet upon the meehanmnl. In the chapter on the mechan;cs of forceps delivery he brings out the differences in the mechanics of birth when pressure is made from above and when traction is made from below, particularly in regard to the rotation of the head and the attitude of the child during the contractions of the uterus and traction on the forceps and the rotation of the various parts of the vertebral column. He shows the deviations in birth mechanism from normal in forceps deliveries, particularly with reference to the theory of Sellheim and the observations of Warnekros. The indications and the limitations of forceps in hospital and home practice are outlined in table form. Thirty-four roentgenograms portray clearly and accurately serial pictures of births, rotation of the head in spontaneous delivery and with forceps extraction. His conclusions seem amply substantiated on careful study and comparison of the serial pictures. P’HILIP F. WILLIAMS. TZangengeburt hilfe, Gyniikologie Erlangen. Mit
Reinhardt,
im Rlntgenbild. Von Dr. Werner LUttge. Privatdozent ftir Geburtsund R&tgenologie, Oberarzt an der UniversitiLts-Frauenklinik in 7 Abbildungen und einem Atlas von 34 Kunntdrucktnfeln. Ernst
MYinchen, 1933.
Item The next written examination and review of case histories for certification by the American Board of Obstetrics and Gynecology will be held, according to location of applicants, in various cities of the United States and Canada, on Saturday, December 9, 1933, at 2 P.M. For application blanks and further details, address, Paul Titus, M.D., Secretary, 1015 Highland Building, Pitt,sburgh, Pennsylvania.
of Book Reviews
CONDUCTEDBY RJJBERT T. FRANI~
Reviews of New Books GYNECOLOGY The book written by Kappis on the Prophylaxis and l’rmtment of Opevatiw I)angerss is well worth while. It assembles and digests much of what is known on these subjects, with full regard to our increased knowledge in normal and pathological physiology and biology. The surgical profession should be grateful to the author for his laborious work and for having assembled within the covers of one book what is generally known of this field which may he summed up under the resistance to versus the dangers of operation. Of operative deaths 45 to 55 per cent are due to the underlying diseases as for example, carcinoma, peritonitis, severe injuries. Of possibly avoidable risks, pneumonia, bronchitis, lung abscesses, etc., take 17ye per cent of victims. In accord with others, the author finds an increase of thrombosis and embolism. His mortality from these unavoidable accidents in 1923 was 1.6 per cent; in 1930, 8.6 per cent; in 1931, 6.5 per cent. General poor condition causes 9 to 14 per cent of deaths as for instance the cachexia seen in carcinoma of the stomach. In addition, deaths are due to infection, especially peritoneal, mistakes in diagnosis or wrong indications. At least 1 per ecnt of deaths are due to cerebral hemorrhages and some remain undetermined even at autopsy. A large amount of space is devoted to the preoperative evaluation of the risk in which constitution, age (both young and old), intercurrent physiological conditions such as menstruation and pregnancy, diseases including Basedow, Addison’s disease, thymolymphatic status, etc., play a considerable role. Certainly in sclected cases, functional heart tests, careful examinations of the lung, determination of the liver function, of kidney function, of blood disturbances, and changes in the basal metabolism must bc thoroughly considered. Dangers incident to the operation itself and immediate sequelae are next taken up, including the selection of the anesthetic, immediate preoperative preparation, care to be taken against leaving foreign bodies in the wound. Even such apparently minor matters as the avoidance of injury in giving injections either subcutaneous1.y or intravenously, are discussed in detail. The avoidance of operative shock and collapse, as well as their treatment are fully discussed. Deaths on the operating table, air embolism, intracardiac injections and cardiac massage are described. The next division concerns itself vtith after-treatment. The author believes in carefully graduated but sufficient morphine injections postoperatively. He then takes up such matters as loss of fluids, feeding, movement of the bowels, the qorbeugung
Georg Thieme,
und
Bekiimpfung
Leipzig,
1433.
der
Operationsg~fahrcn. 777
Van
Prof.
Dr.
M. Kappis
778
AMERICAN
JOURNAL
OP
OB~WWRI(:S
ANI)
U-Y-i
WOLOQY
avoidance and trcatmcnt of cardiac, pulmonary anI1 otlicr c,Jlnj~licatir~nb us \Vell as alkalosis, tetany, singultus, parotitis, psyc>hoees, et!*. h ~:ulic’luding portion of this division deals with the after-treatment of sl~cial arran after ol~rratione on the head, face, thorax, breasts, abdomen, ct~. This book of ov
Referring to the fact that tho majority of gynecological patients begin their careers, so to speak, in the ofRcc of a private practitioner and that many of them must eventually bc treated by special apparatus or handled with an unusual degree of skill by the gynecologist, Kiistuer!+ ftrels that the most important divisiou of gynecology is early and exact diagnosis. In obstetrics, as well, he regards pre-knowledge of abnormalities, possible c~ornplications and early recognition of pathological conditions a sine qua non. To this end he has compiled in table form the diagnostic points in a series of gynecological and obstetrical conditions These tables arc supplemented for the most part by beautifully colored plates or very capably executed black and white drawings correlating the tables. For gynecology he has arranged thirty-six tables boginning with malformations and congenital deformities of the urogenital system, continuing through inflammations, tumors, displacements, diseases of the tubes and ovaries, peritonitis, fistulas and gonorrhea. The tables vary in length and breadth as to the number of conditions which may affect a certain part. Symptomatology, etiology, pathology, bacteriology, clinical course, differential diagnosis, prognosis and changes in function arc given. Obstetrics begins with diagnosis, continues through abortion, and positions of presentation. Four charts on the toxcmias, complications of labor, puerperal sepsis and diseases and injuries of the newborn are included. Such a manner of presentation, stripped of nonessentials. will give to the practitioner a quick and striking picture to assist him in making an early and exact diagnosis. 1)‘11II,IP
F.
w’rr,l~raMs.
The fifth edition of v. Jasehke and Pankow’s Lehrbuch drr Gytiikolopie~~ is a large volume of 759 pages, costing 40 marks. Nine years have elapsed since the last edition was published. Tho two authors represent a continuation of the clinics of v. Rosthorn and of KrSnig. The book is designed mainly for the student and practitioner. Debatable subjects and subjects of special interest to the specialist are not emphasized. Consequently operative technic is only dealt with in a most summary fashion. On the ot,her hand, the connection between gynecology and general medicine is emphasized throughout. General gynecology is dealt with in 262 pages, while the pathology and therapy occupies 460 pages of the volume. The anatomy is short but good. The same may be said of the embryology and physiology. Next the hygiene of the female and woman as a patient, are discussed. The treatment of functional and allied conditions by means of hormone therapy is, to say the least, over-enthusiastic and uncritical. The second portion of the book is well written, informative, but rather difficult to read as it is too ample for the student and too general for the specialist, In WyniLkolo~isQhe
Dr. Heinz Lehmann. Sehrbueh
FUnfte
und
KUstner. MUnchen, Auflage.
der
Oeburtsbilflicke
65 Tabeilen 1932. GymSkologie.
Verlag
van
Diagnostik
mit .Julius
Van
72 farbken
in
und
Dr. Rud. Th. Springer, Rerlin,
Tebellenlorm.
schwamen v. Jaschke 1033.
Von Abbildungen. und
Dr.
Professor J. 0.
Pankow.
F.
BOOK discussing cluded
diathermia, that
it
must
The illustrations siderable literature the vast majority
hydrotherapy be bewildering
779
REVIEWS and
radiotherapy,
to the
so many
details
are
in-
beginner.
are especially good, well selected and well executed. Conin the form of footnotes adds value to the book although in of cases only the Gcrmau litcraturc has been taken into account. R. T. FKASK. OBSTETRICS
Ten Years of Obstetrios and Gynecology in Primte Pm&ml] has been offered largely to furnish a series of private cases for comparison with hospital statistics. The statistical summaries will undoubtedly be useful in such comparative deductions. The text is divided into two parts, obstetrics, regarding 1750 cases, and gynecology, discussing 1345 cases with 1733 diagnoses. This material has been arranged in groups with figures, comments and in some instances, for the purpose of illustration, detailed case histories. As all scientific and controversial matter is omitted, the book will be found The reduction of complications as entirely clinical and eminently practical. noted in the first chapter stresses the importance of good prenatal care. Simple measures sufficed for most vomiting of pregnancy cases, but one therapeutic abortion was done. Grave vomiting in advanced pregnancy with toxic degeneration of the liver is well discussed, and a characteristic history appended. The Voorbees’ bag for lateral, and cesarean section for central placenta previa are recommended. No mention is made of transfusion or of packing after delivery in placenta previa or in premature separation of the placenta, although the author mentions (p. 21) that postpartum hemorrhage is a frequent and dreaded complication in the latter. Transfusion appears in the index but by a typographical error evidently refers to a wrong page. The author treats his toxemias conservatively and is prompt in terminating pregnancy in the presence of a threatening cclampsia. Cardiac complications are very briefly discussed. There is no mention of the Wassermann reaction in the cases of unusual edema of the fetus and placenta. Decomposition and extraction of frank breeches is done at once on full dilatation. The author discusses the out the perinenm ” and is preferring relative merits of episiotomy and of “ironing the formcr. Medical induction was found useless and rupture of the membranes and insertion of a No. 4 Voorhees’ bag routinely practiced. A delivery table with elevator lower section, and roller top section is described and illustrated. The old-fashioned stirrups are seemingly used in operative deliveries. Discussing ,analgesia and anesthesia the author believes the danger of morphine to the newborn is overrated. Perineal repairs arc performed under infiltration anesthesia, novocain. There were 431 instrumental deliveries in the 1750 cases. The modern tendcncy toward earlier interference is supported. Low or Simpson forceps were used 207 times, axis traction in 29, and Kielland in 195 cases. The author is enthusiastic over the Kielland forceps and devotes six pages to their use. In contrast podalic The vectis is resurrected. Ninety-five cesarean version receives a scant page. A clinical ?Cen Years of Obstetrics and Gsnccolosy in Private Practice. of 1760 obstetrical and L345 gynecoIogica1 eases, with comparative anaiYses of of the larger groups, and detailed case histories of some of the more important less common conditions. By John L. Rothrock, A.B.. M.D.. F.A.C..S. Formerly ciate Professor of Obstetrics and Gynecology, Univrersity of Minnesota: Former ber of the Miller Clinic and Chief of the Obstetrical and Gynecological Services Charles T. Miller Hospital. Pages 204, and 9 Illustrations. Paul B. Hoeber New York, 1933.
report many and AssoMemof The Inc..
Thorns has written a fascinating bro~hurc entitled Chqtm-s ia dmeri~u:crn obStft~rif’S.1~ He? describes the American midwifery in a most vivill fashion. Then he takes up the first obstetrics published in America by Samuel i:at.Ll, 1807. The introduction of ergot i*lto obstetrics by John Stearns, under the na10c of “pulvis parturicns,” is of interest. Among other mcll-kuown figurcss. William Potts Dewces and Oliver SZ’codtIl Hol~nes arc piciurcd. 1 chapter 031 cephalic version introduced by M. R. Wright and in conclusion the int.roducticin of cthcr in cI~iltll~irth ljg Walter Chsnning, are given. eilrlt'
Thorns has succeeded in putting life and color into these historical sketches:: to a degree which should induct even rcndors not particularly intercstrd in mvdical history to rcncl these pages with pleasure, profit, ant1 a feeling of pride t’c)r~ what the early Anlcrirsxn obatct,rici:uns have dtrr~c. R. 1’. ~‘C.IXW. The usual comparative studies in IA~hryology and Cytology have been div. l~arded by Lucien and Vcrmcliu il: th?+r Twasli.w olb the Rwn46m &i%sn.l!: The first part of the book is dcvotcd to Spermatogcnesis and oagenesis from the origin of the germinal gland in the embryo to the fully matured adult cells ‘?hapters in Amtricnn ObsteLdcn. i:. tf. Thomas, Springfield, 1:~ Hcrbcrt Tlloms. 1933. “L’Oeuf Wumain et BBS Annexes Pm! Mmmice Lueien. Professeur d’anatcrmie et Henri Vermek, Professeur aa&& d’obst6trique B la Facult6 de M&%&E de Nrtncu. Preface du F?-ofesseur Couvelnire, Membre de I’Acaddmie de Bb&%&%?. Pa?33 1%: nnrl Avcc 7S A$urcs. Q. Doin & Qe, Paris, 1033.
COOK
781
REVIEWS
capable of union. A note on sterility makes practical use of their observations. There is a full exposition of the sexual cycle completely in accord with the most recent anatomical and physiological researches, references to which are frequent. The rhythmic cycle of the fallopian tube, shedding of cilia, granulation of cells, and hemorrhage following closely the uterino cycle is described, as is also the vaginal cycle. The physiology of nidation, its variants, inciuding multiple pregnancy and the The manner and time of development of associated phenomena are discussed. the appendages, membranes and placenta and the physiological significance, f(ll t.he embryo, from a nutritional aspect are given fully. The very early human ova and embryos reported in the literature since Peter’s ovum are listed and classified as to development. The final ehaptcr takes up the circulatory mcchanism. This assembly of facts, by an anatomist and an obstetrician, is a good basic slatement of the present status of human embryology, and will make an excellent rtlfcrence book. FIIII‘IP
E’.
ViIr,r‘IaM
s.
De Lee’s Obstetricsl4 continues to bc one of the outstanding contributions on this subject in the English language. Since 1913, it has gone through six editions, oath with careful changes to keep it up to the present stale of our Bnowiedge, and a number of reprintings in addition. This ne’w edition is a volume of 1165 pages and contains many changes as well as a number of new iilustmtions. Do Lee has more and mere taken cognizance of two methods of delivery, the one, strictly hospital in the hands of specialists, and most often applied to the abnormal cases; the other, in the hands of the general practitioner where delivery is performed in the home, n-hich requires an entirely different viewpoint and much more noninterference. De Lee divides eclampsia into true toxemia, acute nephritis, chronic nephritis and malignant hypertension. As the cause of this symptom complex is unknown, his classification is as acceptable as any other. He believes in allowing the patient to deliver herself. A carefu1 review of borderline conditions, involving problems of internal medicine, has been performed, including tuberculosis, diabetes, heart disease and syphilis. The frequent use of illustrations based on motion picture films is employed. These would be more useful if the pictures were larger. The Literature has been kept up to date. As heretofore, this volume is of great value both to the practitioner ant1 obstetrician because of the immense experience recorded in its pages as well as the mei.iculous care employed in constant revisions. R. T. FIMPJB. This medium-sized volume on I”ractionZ Obstelrics~j admirably fulfills the aim of the author to produce a text midway between a eomplcte reference book and a compendium. Stripped of any unnecessary verbiage and omitting all scientific discussion, the present-day ideas and practice are given, concisely and succinctly, in Tvell-spaced chapters, with plenty of excellent illustrations. It is a suitable book for the student days or the years of early practice, and has a simplicity of presentation 14The
Saunders
“Lebrbuch
and Practice of Obstetrics. Co.. Philadelphia, 1933.
Principles
der
Prektischen
Geburtshilfe
Dr. Sigfrid Hammerschlag. Direktor der Berlin-NeukSlln. Seite 290: mit 101 teils Stuttgart. 1933.
By fiir
Joseoh
Studierende
B. De Lee. nnd
Arzte
Ed.
Brandenburgischen Landesfr&enklinik farbigen Abbildungen. Ferdinand
6, W. B. Von
Prof. Enke.
in
The obstetric conditions iu tho twl)i(:s which are ina terially dX’erent from those of the West in respect to anatomy, c.limatc, and diet are described in this lboak by Green-Armgtagc dealing with Mi,dzoife~!/ ill, fkt’ ~/.opics.~~ I ! had Lww written not only for the Indian stmhnt but for the medical mau, with :I ~vestclrn education, beginning practice in eastern or tropical countries. Tlw sub,jctl matte1 follows the usual divisions of t,he aroragc textbook, and is presented in :I crisll, staccato style, a concise form to help students to whom Englisll i3 iutlcr8l :I fowigu language. Among the racial difference s it, is noted that the head of the oriental fetus mcasurcs a quarter of an inch less in all important diameters, than the Europcan fetus; that the generally contractccl, round inlet, ljelvis is quite common in India and the funnel pelvis is very common. As osteoJllnlacia and rickets RW frequent diseases in India all varieties of contracted pelvis are often seen. Tho average maternal mortality is 4 par cent, and complications oeEur in SO lbcr cent of the cases. Lack of prenatal care is practicallv universal in India; lhc authors supply excellent rules for anteuatal and postnatal cart’, the chapter, on the latter is especially good. A dietary for Europc~aris resident in India is listed as well as one for natives. This has been drawn up with a view t.o lessenThe ing the many complications which may he referred t,o dietary defi~ianaicr. authors are conservative in t,heir trcatruout of toxemias. Tlw2y rcfvr to an unusual frequency of pelvic abscess following ectopio pregnancy, whcthcr operated upon or not. Among the tropical conditions quite .t’ully discussed are the anemias of preg, nancy, frequent anit severe, and a cause of much morbidity and mortality, malaria, kala-azar, tetany, dysentery, osteomalaoia in its various stages. Thry find morbid changes occur quite early in multiparas, a para iv nftcn being a greater problem than in her first pregnancy and delivery, all duo to tropical habits and diseases. l?ifty per cent of puerpcral pyrexias are duo to tropical disease’, Cosarcnrl section and at times the dil~crcntial diagnosis of sepsis is clifhcult. occurs once in every forty cases in the Eden Hospital. The authors state that, having given the Kielland forceps an estcnded trial they do not rrcommentl it. The fow illustrations use11 demonstrate> ccphalopelvic disproportion. ~4 gra.1) 1~: Tll~ 1 book i- .’ 2L vA:y c,hart is used to bring out all the points of antenatal earc. good manual on obstetrics, and is interesting in its portrayal of the manifold difficulties under which obstetrics is practiced in India. k”fllLIP
F.
WILLIAMS.
A most interesting subjcet was taken up by the Ukranian Congress of Obstot. and Gynceology at Kiew, dealing with the expericnec resulting from the L~~beraltiation of Induci7l.g Abort2:oc in %IIW Soviet lZ@~~olic.j i The subject has been considered of such interest that the German GeseZko7mft fiir Gebmtshilfe I(;& G?/nii/;oZo,gie instructed Professor A. Ms.ver of Tiibingrn to supervise the transrics
laA Textbook of Midwifery in the Tropics. By V. B. Green-Armytage. M.D., F.R.C.P. (Land.), F.C.O.G., Lt.-Col., I.M.S.. Chevalier of the Legion of %Ionotir; Order of the White Eagle of Serbia: Professor of Midwifery and Gynecology. Cc&cut& iXedica1 College, and Surgeon to the Eden Hospital for Women, Calcutta, and P. C Pp. 282: 7 Illustrations and 1 Chart. Dutta, M.B., F.R.C.S., D.G.O.. Captain I.M.S. The Book Company, Ltd., Calcutta, l&73. l’Erf&rungen titder Freigabe der Boh~ngersa~tsaar0~~~ in der BewWRepublik. Werausgegeben von Profe488or Dr. A. Mayer, Univer~itllts~auenk~~~ fn Tiibingen. Veflag von Ferdinand En&e, Stuttgart, 1933.
78.1
BOOK REVIEWS
lation and bring out this study in the form of a monograph which appeared as a supplement to the Zeitsclmift fiir Geburtshilfe wnd Gytikologie (Volume 104). The Ukranian Congress met in 1927. The report contains many independent papers which deal rvith the social indications fcr induction of abortion, the limitation of abortion to the first three months of pregnancy, the reasons for inducing abortion. The main indication appears to be economic stress which in most instances has been determined by a Commission. At jirst, certain hospitals were indicated as “Abortaria” but later, when the bed capacity was found insutiiciant, private clinics were permitted to accept patients for this purpose. There has been a steady increase in induced abortions since 1913. Of the patients seeking abortion, there is some difference in different committees, but in general up to 80 per cent of them are married. In consequence of the liberalization, charlatans and lay abortionists have greatly decreased. In spite of the diminution of clandestine abortions and the fact that the procedure is entirely in the hands of the medical profession, the medical dangers appear to be ever present, including infection, injuries, and many others. prom 1922 to 1926 the number of all abortions rose from 53 to 80 per cent of births in the city of Moscow. This pereentage included likewise an increase of induced abortions from 12 to 261/2 per cent. The various technics which apparently are far from being standardized were discussed by different speakers, Some stress was laid on contraception as a proper means of limiting the necessity of abortion. As yet, no political or economic change in the incidence of population has been noted. The Congress adopted resolutions in which it noted that there was an increase in the number of induced abortions both in the cities and in the villages; that there was a marked decrease in clandestine abortions with a definite decrease in morbidity and mortality; as yet no decrease in the number of the population has been shown; that the medical dangers had not decreased. Hence the procedure should be limited to hospitals and trained medical men, and that because of the dangers in inducing abortion, the use of contraceptives is greatly favored. R. T. FR.ANK. The Law Agabnst Abortions by William J. Robinson is frankly propaganda. No one who knows the life of the author can doubt his bona fides and yet some of its contents is, to say the least, startling. The whole basis of the book, as stated in the first chapter, is the demand for complete and total abrogation of any law against abortion. Robinson is strongly in favor of contraception or prev.eneeption, as he calls it. Re acknowledges that abortion is an evil, but a necessary one. This tract is cleverly written in flamboyant style but contains many well worth-while truths. The point of vita and overemphasis will startle and antagonize many readers. R. T. FRAXK.
Briquet’s OperaWe Obstetricsls should be exceedingly valuable to those interested in obstetrics, if only for its beautiful format and illustrations. Although the author’s ‘?l!he manded.
1933.
UPaul
Companhin
Law
By
Briquet
Against
William
Editora
:
Abortion,
Its
J. Robinson.
Obstetricia
National,
0,peratoria.
Perniciousness
Demonstrated
The Eugenics Publishing (Portuguese.)
1932, Sao Paula.
Brazil.
and
Its
Repeal
De-
Co., Inc., New York,
First and Second
Editions.
Corkill’s work on Midwifery ale16 Infmt Care22 is based on lectures to midwives and graduate nurses which the author has given for a number of years, and is offered as a working manual for handling obstetrical CDSCR alone or as an assistant to a physician. The primary aim of the book has been to elaborate the rules and regulations of the New Zealand Department of Health, and the Midwives’ Registration Board, for the purpose of reducing tho dangers of infection during labor and the puerperium. An aseptic technique has been standardized throughout the hospitals of New Zealand by the Dcpartmcnt of Health. This standard is presented an<1 ,4s a matter of note, puerperal sepsis reasons given for every step reconunendcd. is no longer the chief cause of maternal mortality in that Dominion. The plain and simple language of the book and the full explanations should make it a very good manual for the prcclinical obstetrical course for a medical student. Practical demonstrations in minor laboratory work and antenatal cart are given for the benefit of the midwives who evidently constitute a group Chloroform seems to be entirely dissimilar from our conception of midwives. the anasthetic choice in New Zealand. R,ickets is rarely seen. Several chapters are devoted to the infant, emphasis being placed on breast feeding, but with full details for artificial feeding. The end of each chapter has a concise summary, with rules of responsibility to the patient and the physician. The author states that under certain circumstances in placenta preria the midwife may rupture t,he membrnncs or even insert a vaginal pack. To avoid unnecessary consultation calls by the midwife the author has devoted considerable space in explaining the various causes of delay in labor. Throughout the book the emphasis is laid on the prevention of sepsis and an appendix is devoted to the Department of Health rules for disinfecting of rooms and equipment used in infected cases. The graduate unusual
caliber of the instruction nurses until one realizes training and must carry
seems unusually complete for midwives and that for the most part these are women of on many complicated labors alone. I?&ILIP
F.
WILLIAMS.
The tenth edition of De Lee’s Obstefrics for iVurses?3 has been brought to date. Besides the general nurse, it aims to teach the advanced nurse teacher of nurses as well as the pupil nurses themselves. Particular notice is given to obstetrics in the home as more than 50 per of all deliveries occur outside of hospitals. The book is a very well-balanced description of obstetrics for nurses shows the known qualities of De Lee as a teacher and experienced clinician. R.
up and cent, and
T. FR~\NI<.
of almost 500 pages contaius the cha~rman’s report and the followmostly in monographic form, of Faators and Caluses of Fetal, Newborn, antI MaternaL Morbidity md Movtality.~~ Acute Infectious Diseases in Pregnancy, Labor and the Puerperium by Dr. J. P. Greenhill of Chicago; Syphilis and ing
This volume 22 studies,
A New Zealand Course. A practical and Infant Care. of pregnancy and labour and the care of the infant, conformlaid down by the Nurses and Midwives’ Registration Board of F. Corkill, M.C., M.D., M.R.C.P. (Ed.), Lecturer to Nurses and Board of New Zealand ; Senior Honorary Physician, Wellington Honorary Physician to Truby King-Karitane Hospital, WellingNew Zealand Obstetrical Society. Pp. 410. Coulls Somerville New Zealand, 1932. =Obstetrles for Nurses. By Joseph B. De Lee. Ed. 10, Thoroughly Revised. W. B. Saunders Co., Philaddphia, 1933. aFetall, Newborn, and Maternal Morbidity and Mortality. Report of Sub-Committee 4 of Section I, B of the White House Conference on Child Health and Protection. Hugo Ehrenfest, M.D., Chairman. D. Appleton-Century Company, New York, 1933. ~Lectares
on
Midwifery
manual on management ing with the syllabus New Zealand. By T. Midwives’ Registration Children’s Hospital ; ton; Member of the Wilkle, Ltd., Auckland,
by JGIUCS Robert MeCord 11t' .\(i:tntn : l’ulmun:tr\: ‘l‘:~l)~~r~*ulosis it] l’r,‘g naney by Dr. Otto II. Schwarz of St. l,~kiid; l’:unsitic lnfr!*tions (‘omplicating hegnancy by I)r. Fknest C'arroll Faust and ih. JCdw~rtl L:w~ 1< ina wf NIX Orleam: Heart I&case and Pregnancy 1)~ Dr. N’illinm X’. tZt,rrick c:t’ New York City : Xcphritis Complicating I’r~gn:~ncy by- lb. ,Tcllm I\:. IIarri;; c,< Nadisorl ; ‘I’oscmi:l Problem by Dr. George TV;. Kosmak of XC\\ \‘ork City; l)istt:ts,>s of thp Tcaeth xrul Gums in Pregnnnq I)y George II. \I-antl~l, i).l).S., of C’hicng(i; TTterincl i21nzer and Pregnancy by Dr. John A. MeGlinn of Philadelphia; DisCas IIf Endocrines and cif Blood i’omplic~ating I’reguarrcy 1,s J.)r. llol,rrt I). Mrlsr~! of Tlua Ma>15 (‘linic. Rochester; Induction of l,abor With Sp&~l Consideration (11’ .$rtifici:tl Rupture of Membranes by I)r. -6. lan F. Guttmnchcr of Rnltimore; F0Wcps ilIld Cexarcsn SCVtion by Dr. E. 1). Pluss of Iowa City; _~~nc4hesin and !&in ICc~liVf in Obxtet.rick I>? Dr. Carl II. Davis of Milwnukccs in eoopoation with Drs. 1. I).. Rill, John IV. Harris, Arno B. Luckhardt, and Ralph M. N’atcri;; l3cn~r iu t.Iic, l’urrp~7?um 1)~ 1)r. W. E. Caldwell of Xcw York C!it>-; Non-Fellrile Complicaiions of ihe I’urrp~riom b, Dr. William C. Danforth of Evanston: I'ropr I’ostpart~um t.:art* tiy I jr. C’lmrit~+ Edwin Galloway of Evanston; Tnfluencc of Xatcrnal Pelvic Therapeutic Irradiation of Philadelphia : en the Health of the Subsequent Child I)y IIr. Douglas I’. Sfurphy Emc’ry Studdiforrl of Sc\r Fetal Mortality in Breech Presentations hy Dr. Will&m York City; Relation of Birth Trauma 10 3~~onatal Mortality and Infant ,\[orbiditT Julmediatct (‘arc ut’ ihr Pu’ewborn by Dr. by Dr. IIugo Ehrenfcst of St. Louis; .Joscph I,. Baer of Chicago; The Import,anee of (!omplete :1nr1 Accur;rti* i’vrtificntes of Birth and Death in the Prevention of Jlaternal and Early lnfsnt Mortality by ljr. Richard A. 13olt of Cleveland; Al)ortiou in Veldtion to Fc?tal and Xatornal Welfare by Dr. Fred J. Taussig of St. :T,ouis. In fairly systematic form for all the more common diseases found in pregnant women, the erect oi’ pregnancy on thtl 1~aun1 COIITSG of thci disease is discussed, 2nd 2s well tllc inliuence of the disease on the course of pregna.ncy and on the fetus The problems <)f prevention :~ad of interruption of pregnancp in the in utero. in detail with due ionsitleration of special interest of the mother arc discxssed methods of delivery required under ccrt:\iu conditions. This full list of articles contained in the volume and of the competent. men contribut,iug them, bcttcr than any detailvd description of their rich contents, will furllish a.11 adquat(; i&a, concerning the immense prdctiaat value of this book for the obstetrician and especially for cvrty l~ractitioner doing obstetric work. I'r~g~ancy
(if
L1r:st..
f'(~f~%.s~ri wwrs the subjett from mere This ~rhaustivc St-Udy of llrc Fe:rilitic side of the problem has not been permitted 10 possible angle. The scientific overshadow the practical aspect and :I. full clinical ennsideration is presented, with the author’s ideas often elucidated by appropriate case hiatorirx The book There are many photographs showing the I.liuii:al n.ppliis profusely illustrated. cation of the directions prescribed for pelvimetry and ceybalometry, and a num bor of clear and distinct roentgenograms. The racial The historical review portrays in a sonso the history of obstetrics. differences shown in the widely gathered ethnological studies have a praetiesl importance in our international population trend. One can agree with the author that the average native white female pelvis in private practice ia smaller than The far-reaching influences in the standard set by the -4meriean f!ommittec.
A Practical Manual of Pelvimetr’y s’J!he Pelvis in Obstetrics. eluding C&pters on Roent@znolo&al Measurement by Julius Consuiting GynecobgiSt, Hastings ZItlLsfite Hospftal ; Atiaing cologlst, Sydenham Hospital. Pages 325, 140 Illustrations. 91 Inc., New York. 1933.
and Cephalometry In.Jal‘chh. &$I?.. F.A.C.S.. WstetrieTsn and GymTables. Prtui B. Ho~%F,
BOOK
787
REVIEWS
the development of the abnormal pelvis are well presented; in these the effects of modern civilization and its corrolaries have had their part. The classifications enumerated are based upon changes in form, etiology, and degree of deformity. Each is discussed with explanatory remarks. The author notes several varieties of the funnel pelvis, a deformity which has been well studied by American obstetricians. Methods of external and internal pelvimetry are considered from the standpoint of their practical application. The various instruments suggested are pictured’and their use described. The author feels that simple methods, intelligently employed, give just as valuable information as some of the complicated devices recommended. The diagnosis of cephalopelvic disproportion, which is the crux of the whole problem, is the subject of a very able chapter. The author favors elective cesarean section in most borderline cases. Those uncertain of obstetric diagnosis may study this chapter with profit. The book concludes with chapters on roentgenographic pelvimetry and cephalometry. He discusses his own method of calculation, as well as the use of the Thorns’ grid, and states various obstetric indications for use of roentgenologic studies. It would be quite surprising to learn that any reference to the pelvis in the world’s literature has been overlooked, for there is appended to the text a bibliography of twenty-seven pages. Possibly the only criticism of such an outstanding collection of references might bc that it was not classified into groups referable to the subdivisions of the text. This book is such a splendid work of reference and of practical detail that it will be found of value to anyone teaching or practicing obstetrics. P’HILIP
F. WILLIAMS.
RADIOLOGY A,“r’D RADIOTHER.APY In the foreword of Liittge’s monograph on Forcq% Operdion irb Rb’ntgan Pictnre~zfi Wintz outlines the advances in roentgenology, during the past fifteen years, and remarks upon its application to obstetrics; the diagnosis of pregnancy, pelrimetry, cephalometry, disproportion, birth meehanism and forceps delivery. Liittge in the text reviews the history and methods of obstetrical roentgenology. .9 broaoening of the indications for forceps extraction, and the prerequisites, are described. He discusses mensuration of the pelvis, the effect of altered positions of symphysis upon the inlet and the relationship of the abnormal inlet upon the meehanmnl. In the chapter on the mechan;cs of forceps delivery he brings out the differences in the mechanics of birth when pressure is made from above and when traction is made from below, particularly in regard to the rotation of the head and the attitude of the child during the contractions of the uterus and traction on the forceps and the rotation of the various parts of the vertebral column. He shows the deviations in birth mechanism from normal in forceps deliveries, particularly with reference to the theory of Sellheim and the observations of Warnekros. The indications and the limitations of forceps in hospital and home practice are outlined in table form. Thirty-four roentgenograms portray clearly and accurately serial pictures of births, rotation of the head in spontaneous delivery and with forceps extraction. His conclusions seem amply substantiated on careful study and comparison of the serial pictures. P’HILIP F. WILLIAMS. TZangengeburt hilfe, Gyniikologie Erlangen. Mit
Reinhardt,
im Rlntgenbild. Von Dr. Werner LUttge. Privatdozent ftir Geburtsund R&tgenologie, Oberarzt an der UniversitiLts-Frauenklinik in 7 Abbildungen und einem Atlas von 34 Kunntdrucktnfeln. Ernst
MYinchen, 1933.
Item The next written examination and review of case histories for certification by the American Board of Obstetrics and Gynecology will be held, according to location of applicants, in various cities of the United States and Canada, on Saturday, December 9, 1933, at 2 P.M. For application blanks and further details, address, Paul Titus, M.D., Secretary, 1015 Highland Building, Pitt,sburgh, Pennsylvania.