Sterility and impaired fertility

To my surprise, he still uses cedure, the entire operation being performed from above. ventrofixation in some cases of prolapse, and describes two round ligament shortening operations and one of his own. Space prevents me from giving details on his operations for ovarian cysts, for relief of tubal closure by implantation, and for myoma and pregnancy. There are chapters on intestinal surgery, including on abdomino-vaginal excision of the rectum, drawing the The concluding chapters deal with postbowel through the split posterior vaginal wall. operative treatment, transfusion, postoperative complications of every variety, the repaii of ventral hernia, etc. Little more than mere mention of penicillin is made. Mortality statistics as well as remote sequelae conclude this volume, which is of unusual interest and value as it presents the experience of a master surgeon for more than 36 years. R. T. FKANIC. In a foreword to this volume on Sterility and Impaired Fertility,2 Lord Horder stresses the importance of this world-wide problem and refers to the distribution of the etiological factors over many fields of medicine. He suggests that constitutional factors are more important than anatomical factors, and while the problem is one for teamwork, most of the investigation may be done by the family doctor. Lane-Roberts and his co-authors assess In the preparation of this second edition, the significance and value of much new work in this field, suggest the use and interpretation of postcoital tests, especially the more recent invasion test, the technique of semen They also add new material in analysis, and the determination of pregnandiol in urine. the discussion of cyclical temperature records for the study of ovarian function, and in the use of cytological studies in determining ovarian function. The opinions expressed in the first edition as to the use of endocrine preparations as The use of these hormones is much therapeutic aids have shown a considerable shift. more precisely defined. The treatment of subclinical infections in the cervix, long recognized as a cause of subfertility, by the sulfonamides and penicillin rather than the cautery or other surgery is mentioned, and much attention is directed toward constitutional treatThe use of x-ray stimulation, particularly of ment in the elimination of toxic conditions. the pituitary gland, in the treatment of anovulation is also discussed. The authors bring out the legal, moral, and social aspects of artificial insemination by means of donated semen. While they agree that the short term effects may have been good, and that it has been an acceptable solution to many childless marriages, they caution the possible involvement of dysgenie factors. The text begins with a general survey of the problems and then treats the male factors in childless marriages in five chapters, comprising 162 pages. Chapter Five, on offers technical advice for the the male reproductive mechanism and its disturbances, urologist or andrologist in addition to much material which should aid the family doctor in his part of the problem. The two chapters concerning sterility in the female, on the investigation of the woman, and on treatment of the lesions which in her may be responsible for the impairment of her reproductive power are thoroughly considered. The authors, in discussing say that the probability that a given operation will operations to restore tubal patency, result in the restoration of fertility is presumably much lower than some given figures suggest. There is an excellent discussion on tubal insufflat,ion. There are nine appendices to the text and they bring out the technical details of examination of semen, study for pregnandiol, the biologic tests for pregnancy, and the invasion tests, and the study of waking temperature charts, and the technique, and the dangers, of ovarian and pituitary irradiation. There are many fine photomicrographs and roentgenograms among the illustrations. -%terility and Impeired Fertility, Pathogenesis, Investiggstion and Treatment. By Cedric LaneRoberts, C.V.O., M.S., F.R.C.S.. F.R.C.O.G., Gynaecological Surgeon, Royal Northern Hospital albert Sharman. M.D., Ph.D., M.R.C.O.G., Senior Assistant Surgeon, Royal Samaritan Hospital for Women, Glasgow; Kenneth Walker, M.A., M.B.. B.C.(CANTAB). F.R.C.S.. F.I.C.S.. Jacksonian Priseman and Hunterian Professor, Royal College of Surgeons, Andrologist. Philip Hill Parenthood Clinic; B. P. Wiesner, D.Sc., Ph.D.. F.R.S.E.. Consulting Biologist, Royal Northern Hospital ; Mary Barton, M.B., B.S., First Assistant to the Fertility Clinic, Royal Free Hospital. London. Paul B. Hoebcr, Inc., Medical Book Department of Harper & Brothers, New York and London, 194%

:

.Zm. .I. Obst. & Gym. March, 1949

612

The authors are to be congratulated on this new edition which offers an outstanding study of the problem in both partners in a childless marriage, with complete and detailed specificially defined indications for treatment, and for the instruction for investigation, family doctor a good interpretation of laboratory reports, and help in assessing and improving the constitutional problems involved. PHILIP

F.

WILLIAMS.

The third edition of Hunt’s Diseases Affecting the Vulva,3 appearing within eight Changes have years, shows how much appreciated the dermatologic approach has been. affected therapy mainly. The sulfonamides and penicillin have revolutionized the treatment of venereal disease and are of value in other conditions. Vitamin A is of value in hyperkeratoses; vitamin D in lupus vulgaris; podophyllin in condylomata acuminata. This monograph is of real value and assistance. R. T. FRANK. Gynaecological Histology4 by *Josephine Barnes consists mainly of 162 microscopic illustrations beautifully reproduced in black and white, with a commentary text. Both normal and abnormal tissues of the female genital tract such as are seen in gynecological practice are described and shown. Purposely, many rare conditions have been omitted as this is designed for the final year of the medical student. Between the short text and the detailed captions, a large amount of ground is covered. Therd is only one poor illustration, that is Figure 26, of adenomyosis. The classification of ovarian tumors is simple and adequate. The description of carcinoma of both the body of the uterus and of the cervix is very good. The final chapter deals with pregnancy. This is an admirable, simple laboratory guide which is equally good for both student and teacher. R. T. FRANK.

Gynecological and Obstetrical Anatomy5 by Smout, with chapters on the histology and endocrine control of the female by Jacoby, is in its second edition. In addition to a very detailed osteology with description of the pelvic types, the pelvic joints, the pelvic floor, its connective tissue and fasciae, the uterus, tubes, ovaries, and vagina are described both anatomically and histologically. The hormones and their actions are given in detail. The anatomy of prolapse of the genitourinary tract is described. Chapters on the lymphatics, innervation, the fate of the ovum, the placenta, and the anatomy of the fetus insofar as it affects childbirth are included. There are 185 illustrations including many colored plates and diagrams illuminating the text which is clear, informative, but dry and somewhat monotonous. R. T. FRANK. DonnB, specific

Two authors, casuistic; organism,

Calle and Restrepo, discuss leucorrheas in three finally, 700 cases of every variety of leucorrhea presented in a haphazard fashion.

divisions-trichomonas; including those

due

to

R. T. FRANK. *Diseases

Affecting the Vulva. By Elizabeth Hunt, B.A., M.D., Ch.B. (Liverpool). Honorary Consulting Dermatologist. South London Hospital for Women: Honorary Dermatologist, I-&IV Sussex Hospital for Women and Children, Brighton ; Temporarily Honorary Dermatologist, Royal Infirmary, Liverpool: Formerly Semor Medical Ol%er, Radium Institute and Hospfhl for Skin and Cancer Diseases, Liverpool; Acting Honorary Dermatologist, Royal Sussex County Hospital, Brighton. Third Edition, Revised. 211 pages. With 36 illustrations and 19 plates in colqur. The C. V. Mosby Company, St. Louis. 1945 4G.vnaeeolo&ml Histology. BY Josephine Barnes, M.A., D.M. (Oxford), M.R.C.P. (London), F.R.C.S. (England), M.R.C.O.G. assistant, Obstetric Unit, University College Hospital, London : Assistant Obstetrician and Gynaecologist, Elizabeth Garrett Anderson Hosptal : Surgeon, Marie Curie Hospital. Member Correspondent, Soci&& FranCaise de GynBcologie. With 162 illustrations. 242 pages. Harvey & Blythe, Ltd., London. 1946. ~Gynaecologlcsl and Obstetrical Anatomy. By C. F. V. Smout, M.D., M.R.C.S., Assistant Professor, Department of Anatomy: Sub-Dean and Tutor, Faculty of Medicine. University of Birmingham. With Chapters on The Histology of the Female Reproductive Tract and Its Endocrine Control. By J. Jacoby. M.D., Ph.D., Lecturer in Histology. Department of Anatomy, Utiversity College, Cardiff ; formerly. Department of Physiology, University of Birmingham. Second Edition. 248 pages, The Williams & Wilkins Company, Baltimore. 1948. eFhjo~ Genital08 Femeninos. BY Dr. Alonso Restrepo. Trabajos de la Academia de Medicina de Medellin. Reproduceion de “Anales de la Academia de Medicina de Medellin”. III Epoca-Vol. III-No. 2-Julio 104f3.