1909 BJOG: an International Journal of Obstetrics and Gynaecology  
E. ROEXH, Basle (Zentralb. f. Gyn., 190&, No. 49), reports that in the Women's Hospital at Bask scopolamine morphia has, since 1905, been systematically adininistered before every narcosis more than 2,000 times, with most satisfactory results and without causing any alarming symptom in a single instance. The patients were given one gramrn of veronal on the evening before the opcrstion and, one hour before it, a single dose of scopolamine hydrobromide 0'0005, with morphia muriate 0'015. The
more » ... ate 0'015. The acceleration of the pulse noticed by Siebert did not occur except after extensive operations and Boesch therefore attributes it to the trauma of the operation and not to t,he effect of scopolamine. Atresia Vaginae, with Haematornetra, Haematosalpinx, and Haernatovarium. ABnAM BROTEERS (GynaekologisclLe Rundschau, 1908, Heft 24). The patient, aged 21, had never menstruated. Pain and an abdominal swelling extending up to the umbilicus were present. Under an anadhetic this swelling could be differentiated into two distinct cysts. These were removed, and were found to consist of a thick walled uterus, distended with fluid, and a large monocystic ovary filled' with blood. The vagina was absent, and the cystic uterus and ovary showed the results of menstruation extending over 4 years. Reviewing the literature on the subject Brothers quotes the opinion of Veit and Sagel that many ca8es of so-called congenital atresia are really acquired after birth and are due to adhesions resulting from vaginitis. Brothers, during the last twenty years, has collected 164 cases of retention of menstrual blood. I n 145 of these cases the retent.ion was primary and due to malformation of the Mullerian ducts, or to intra-uterine adhesions ; secondary retention from acquired conditions was present in 19 cases. The genital canal was single in 80 cases, and double in 65 cases of primary retention. Reviewing the history of the treatment of congenital atresia during the last 20 years Brothers concludes that the best method of dealing with these cases is by laparotomy, which appears likely to be the operation of choice in the future. Removal of t,he uterus and the tubes and ovaries is more satisfactory than leaving the uterus with an ill-developed vagina. One hundred and sixty-four references are given in the literature of the subject. E. SCOTT CARMICHAEL. Postclimacteric Haemorrhage due to relative Hypothyroidism. C. C. WALLIN (Jour. Amer. Med. .4ss., vol. li, p. 2157). Physiological antagonism between the internal secretions and the thyroid and ovaries has been recognised in a general way for some time. Bandler attributes many of the nervoud sypmtoms arising in adolescence and a t the climacteric to "relative thyroidism" by whlch term is signified a failure on the part of the ovaries to produce enough secretion to neutralise entirely the product of the thyroid. When the normal balancc is disturbed in the direction of deficiency of the thyroid secretion, i.e., " hypothyroidisnx," Wallin considers that auch an alteration may give rise to uterine hsmorrhagc, and quotes a case. in which a patient some years after a somewhat early menopause developed symptoms of general nervousness and enlargement of the thyroid, together with uterine hmnorrhage, all of which symptoms were alleviated by the administration of thyroid extract. C. NEPEAN LONCRIDGE. Journal of Obstetrics and Gyncecologg The Permanent Results of the Alexander-Adams Operation. W. HANNES, Breslau (Zentrnlb. f. Gyn., 1908, No. 49), abstracts from a dissertation by Pretschker the following statistics of the Breslau Frauenklinik relating to the years 1898 t o 1906 inclusive. Since 1900 the operation has been done in Edebohl's and Goldspohn's way, with opening of the processus vaginalis peritonci. Among 71 women who were subsequently examined there were only 3 (4.2 per cent.) in whom the retroflexion had recurred. Pregnancy had taken place in 28 j 3 9 4 per cent.) who altogether had had 51 normal confinements. There were ten instances of abortion but all were independent of the operation : in one instance there was syphilis, in another the abortion was induced, and 7 women who aborted also carried to term. There was only one case of hernia in the cicatrix of the wound but that was bilateral. He concludes that for perfectly mobile retroflexion, or such as can be made so, the Alexander-Adams operation fulfils all requirements. Bilateral Paralysis of the Crural Nerve after Gynzcological Operation. K. MEXDEL and B. WOLFF (Berliner kl. Wrhns., 1908, No. 48) report that in a woman, aged 34, on whom, under narcosis, an operation was performed for the removal of an adnexal tumour, a .svere paralysis of the crural nerve on both sides supervened. This cannot he supposed t o have been due to the anaesthetic; it must have been caused by injury t o tho nerves owing t o the position of the patient during the operation.
doi:10.1111/j.1471-0528.1909.tb12826.x fatcat:doyybsr4wjb3jegfzhsbt2j3py