None
When a patient has had an operation for vesicovaginal fistula it is of still greater moment that the bladder be not distended with urine. These patients for the first four days should void every four hours, or if voluntary urination is impossible they should be catheterized. After the second day the intervals between voiding may be somewhat longer. Most patients who have had opera- tions for vesical fistulas are able soon to urinate voluntarily. It is a good plan, however, to catheterize such patients at least once a day, for many of them retain a certain amount of residual urine. In none of our cases, either for cystocele or for vesical fistula, do we employ constant drainage. Catharsis. — On the morning following a plastic operation the patient is given I ounce of Epsom salts, and in the course of three or four hours a low soap- suds enema, except after operations involving the sphincter or rectum. At night the patient receives a compound rhubarb pill (gr. v) and on the follow- ing morning an enema, whether she has a voluntary movement or not. The cathartic pill at night and enema in the morning are repeated daily as a routine during the rest of the patient's stay in the hospital. In some cases, especially in private practice where there is great objection to the taking of enemas, this treatment must be modified somewhat by adding other cathar- tics. The results, however, are not as satisfactory as when the above routine procedure is carried out. After operations for complete tear we are not accustomed to move the bowels for nine days. Patients who have had this operation require the most unremit- ting care and expert nursing. Every effort is made to prevent a movement of the bowels, and for this reason the patient is kept on a restricted liquid diet without milk, though oysters, eggs, and jellies of various kinds are occasionally permitted. If there is active peristalsis the patient may be given 15 drops of tincture of opium. The bowels are moved on the ninth day by giving 1 ounce of castor oil fol- lowed in a few hours by a low oil enema (cottonseed oil, 4 ounces). After the first movement the bowels are treated in the same manner as in other plastic cases. Care of the Stitches. — Much of the success of a plastic operation depends on the care of the stitches, for any neglect of them is sure to be followed by sepsis. The first duty of the nurse is to irrigate the stitches after each urination or defecation with sterile water and to apply each time a fresh sterile pad to the parts. In the treatment of the vaginal stitches two methods are in vogue: one by which the stitches are let alone and the other by which they receive frequent Digitized by Microsoft® TECHNIC 735 cleansing douches. These may be called the dry and wet methods. We are very much in favor of the wet method, which is as follows: On the day following the operation vaginal douches of sterile water are given, two each day. This is continued throughout the convalescence. If at the time of leaving the hospital there is any leukorrheal discharge present, as there sometimes is as a result of irritation from stitches not yet absorbed, the patient is advised to take a douche each day or every other day for a week or two after reaching home. If siUiworm-gut stitches have been used in sewing up the ex- ternal part of the perineum, they should be removed on the ninth day, after which the patient is allowed to sit up. Her usual stay in the hospital is from twelve to fifteen days. By treating the wounds in the above way sepsis is very unusual in the ordinary plastic cases. Operations for complete tear, involving as they do the anus and rectmn, are more frequently comphcated by sepsis on account of the impossibility of keeping the wounds perfectly clean. The sepsis usually takes the form of a small localized stitch abscess which discharges and then heals rapidly, occa- sionally causing a minute temporary fistula. It rarely affects the ultimate func- tional result of the operation. Stitch abscesses during the first stage are best treated by hot applications of sterile salt solution, changed very frequently. Treated in this way the in- fections remain locahzed and often disappear without suppuration. If suppu- ration occurs the hot applications are continued until the pus discharges spon- taneously. Once or twice each day the small abscess is forcibly evacuated through the small opening by pressure with the fingers. With careful attention and cleanhness the wound soon heals without injuring the result of the operation. Silver wire stitches used in operations for fistula are treated as other vaginal stitches. They are not removed for two or three weeks. Digitized by Microsoft® Digitized by Microsoft® INDEX Abbe's operation for carcinoma of rectum, 371 Abderhalden's test for pregnancy and cancer, 81 in differential diagnosis of uterine my- oma and pregnancy, 274 Abdomen, fatty, ovarian cyst and, differen- tiation, 357 lateral waU, cellulitis in, 218 operations on, length of stay in bed, 730 preparation for, 723 support after, 730 suture material, 726 technical detail, 724 treatment after, 728 palpation of, 719 Abdominal bands, 131. See also Intestinal bands. cavity, sponge in, 725 hernia, 436 operation for, 673 myomectomy, 650 operation for anteflexion of uterus, 595 ptosis, 117. See also Enteroptosis. support after abdominal operations, 730 tumors, vitiligo associated with, 68 wall, operations on, 666 woimd, suture of, 727 Abortion, tubal, 444 treatment, 450 Abscess, ischiorectal, 236 of Bartholin's gland, 144 treatment, operative, 512 of kidney, 230 periurethral, 220 stitch, in plastic operations, treatment, 735 tubo-ovarian, 155, 211 Absence of Fallopian tubes, 386 of ovaries, 386 of uterus, 382 of vagina, 385, 463 Baldwin's operation for, 570 Graves' operation for, 567 operations for, 567 ovaries and, 47 Schubert's operation for, 570 47 Absence of vagina, treatment, 468 Accessory ovary, 386 Acid, benzoic, in cystitis, 226 boric, in cystitis, 227 trichloracetic, in dysmenorrhea, 456 Acne and menstruation, relation between, 67 at puberty, 67 Acromegaly from hyperfunction of hypo- physis, 56 Adams-Alexander operation for retroversion of uterus, 589 Addison's disease and genitalia, relation be- tween, 62 Adenocarcinoma of cervix, 286, 287 of endometrium, 303 of uterus, 303 sarcoma and, differentiation, 281 Adenocarcinomatous degeneration of uterine myoma, 269 Adenoma hidradenoides vulvae, 243 of endometrium, 208 of rectum, 372 Adenomyoma of Fallopian tubes, 362 of parovarium, 360 of round ligament, 364 of uterus, 277 of vagina, 256 Adenomyositis of uterus, 277 Adenosarcoma of parovarium, 360 of uterus, 280 Adhesions, attic, 132 pelvic, after gonorrheal salpingitis, 160. See also Pelvic inflammation, chronic. peritoneal, 112 from bacterial peritonitis, 112 from chemical injury, 113 from mechanical injury, 113 from surface necrosis, 114 from tuberculosis, 113 traumatic, 113 traumatic, from retroversion of uterus, 403 Adiposity after removal of ovaries, 49 as cause of sterihty, 488 Adrenalin in dysmenorrhea, 455 in hemophilia, 78 Adrenals, hyperfunction of, 62 737 Digitized by Microsoft® 738 INDEX Adrenals, hypertrophy of, after ovariectomy, 62 relation of, to genitalia, 61 Albarran's modifioation of Braquehaye's operation for vesicovaginal fistula, 557, 559 Albuginea of ovary, 32 Alexander-Adams operation for retroversion of uterus, 589 Alexander's operation for retroversion of uterus, 407, 588 internal, for retroversion of uterus, 583 Allingham's operation for hemorrhoids, 707 Alpha ray, 299 Amenorrhea, 499 castration as cause, 499 disturbances of glands of internal secretion as cause, 500 etiology, 499, 500 functional, 500 ovarian deficiency and, 48 extract in, 53 in constitutional diseases, 500 neuroses from, 94 of youth, 459 placental extracts in, 54 tuberculosis and, relationship, 500 Amceba urogenitalis, 196 Amphimixis, 24 Amputation of cervix, 522 Hegar's operation, 522 of uterus, 613. See also Hysterectomy. Anal fissure, 238 treatment, 239 fistula, 237 Elting's operation, 715 Graves' operation, 712-715 operations for, 712 treatment, 238 Anastomosis, ureteral, 698, 699, 700 Anemic heart, 85 Angioma, papillary, of vestibule, 247 Angiomatous degeneration of uterine myoma, 265 Angiosarcoma of uterus, 280 Anteflexion of cervix, pessaries for, 591 of uterus, 396, 421 abdominal operation, 595 Baker's operation, 593 diagnosis, 422 Dudley's operation, 594 etiology, 421 Graves' operation, 595 operations for, 591 pessaries for, 422, 591 Pozzi's operation, 593 suspension operation, 423 Anteflexion of uterus, symptoms, 422 treatment, 422 Anteposition of uterus, 397 Anteversion of uterus, 396 Antigonococcic serum, 173 vaccines, 173 Antitoxin, diphtheria, in cystitis, 226 Anus, atresia of, 390 imperforate, 390 prolapse of, 372 vaginal, 392 vestibular, 392 Appendicitis, acute gonorrheal salpingitis and, differentiation, 164 and movable kidney, association, 129 chronic, and menstruation, relation be- tween, 105 during labor, 106 pregnancy, 105, 106 relation of genitalia to, 104—106 Appendiculo-ovarian ligament, 104, 132 Appendix, retroperitoneal, 131 vermiform, relation of genitalia to, 104 Apron incision in fistula in ano, 713 Arbor vitse, 379 Argyrol in cystitis, 227 Arteriosclerosis, 86 as cause of uterine hemorrhage, 86, 87 Artificial impregnation in steriKty, 494 vagina, Baldwin's method of making, 570 Graves' method of making, 567 method of making, 385, 567 Schubert's method of making, 570 Ascites after operation for ovarian cysts, treatment, 358 associated with cancerous cysts of ovary, 356 with fibroma of ovary, 351 with ovarian tumors, 353 cysts of ovary and, differentiation, 356 tubercular peritonitis with, 179 Aspermatism, 484 Atresia of anus, 390 of cervical canal, 471 of follicle, 40, 323 cystic, 42 during pregnancy, 41 manner of taking place, 41 obliterating, 42 of h3Tnen, 464 treatment, 467 of rectum, 390 of uterus, 385 of vagina, 463. See also Gynatresia. Atrophy, genital, 468 cancer and, differentiation, 474 Digitized by Microsoft® INDEX 739 Atrophy, genital, complications, 471 diagnosis, 474 due to castration, 471 due to constitutional diseases, 471 etiology, 471 treatment, 474 lactation, 471 of ovaries, 48 of bladder, 473 of cervix, 469 of Fallopian tube, 469 of labia majora, 470 minora, 470 of ovary, 48, 470 as cause of changes during menopause, 23 pathologic, 48 of urethra, 473 of uterine fibroids, 266, 267 of uterus, 469 of vagina, 470 Atropin in dysmenorrhea, 455 Attic adhesions, 132 Auerbach's plexus, 110 Ausfallserscheinungen, 85 Azoospermia, 484 Backache, 115 in carcinoma of cervix, 507 in malposition of uterus, 507 in retroflexion of uterus, 505 in retroversion of uterus, 404 due to adhesions, 410 Bacteria as cause of cystitis, 220, 221 routes of infection, 221 of pyelitis, 231 mode of entrance, into bladder, 220, 221 to kidney, 230 Bacterial peritonitis, 112 Baker's operation for anteflexion of uterus, 593 Baldwin's operation for absence of vagina, 570 Baldy's operation for retroversion of uterus, 585 Baldy-Webster operation for retroversion of uterus, 409, 585 Ball myoma of uterus, 260 Bands, ileopelvic, 132 intestinal, 131. See also Intestinal bands. Bardenheuer's incision, 666 Barthohnitis, gonorrheal, 143 treatment, 144 Bartholin's glands, abscess of, 144 treatment, operative, 512 carcinoma of, 246 cysts of, 145, 246 Bartholin's glands, cysts of, treatment, 146 operative, 512 gonorrheal inflammation, 143 treatment, 144 operations on, 512 Bartlett's method of transplantation of fascia for postoperative hernia, 681 Basedow's disease. See Exophthalmic goiter. Bearing-down feelings, 507 Bed, length of stay in, in abdominal opera- tions, 730 Benzoate of soda in cystitis, 227 Benzoic acid in cystitis, 226 Beta ray, 299 Beyea's operation for enteroptosis, 124 Bichlorid of mercury in pyelitis, 233 Bicornuate uterus, 383 double, with double vagina, 382 Bilharzia hasmatobia of vulva, 196 Bladder, atrophy of, 473 calculus of, 369 diagnosis, 370 treatment, 370 capacity of, diminished, 223 carcinoma of, 368. See also Carcinoma of bladder. cysts of, 223 defects of, 386 drainage, in cystitis, 228 exstrophy of, 387, 388 treatment, 390 fissure of, inferior, 390 superior, 389 fistula of, 434. See also Fistula, vesical. gangrene of, 223 gradual dilatation, for limited capacity, 227 implantation of ureter in, 700 inflammation of, 220. See also Cystitis. irritablo, in retroversion of uterus, 405 mode of nntrance of bacteria into, 220, 221 operations on, 703 pelvic cellulitis after, 218 papilloma of, 367 treatment, 369 relation of genitalia to, 100, 101 stone in, 369 syphilis of, 229 tuberculosis of, 228 diagnosis, 229 treatment, 229 tumors of, 367 symptoms, 369 treatment, 369 ulcer of, 223 wall, sloughing, 223 Blastomeres, 347 Digitized by Microsoft® 740 INDEX Blood, appearance of, after menorrhagia, 80 after metrorrhagia, 80 coagulability of, influence of uterine and ovarian extracts on, 51 extravasation of, leukocytosis after, 80 regeneration of blood after, 80 in chlorosis, 77 menstrual, 76 amount lost, 20 non-coagulability of, 20, 76 regeneration of, after hemorrhage, 79, 80 relation of genitaUa to, 76 serum in menorrhagia of youth, 460 transfusion in hemophilia, 78 in menorrhagia of youth, 460 Blood-cysts of ovary, 327 Bloodless fold of Treves, 131 Blood-pressure, 84 Blood-vessels, pelvic, congestion of, during menstruation, 20 relation of genitalia to, 86 Bones and joints, relation of genitalia to, 115 Boric acid in cystitis, 227 Bowels, postoperative treatment, 728, 729 Braquehaye's operation for vesicovaginal fistula, 557 Albarran's modification, 557, 559 Breasts and ovaries, relation between, 65 condition of, during menstruation, 20 development of, at puberty, 18 enlargement of, at birth, 18 during menstruation, 18 influence of placenta on, 65 relation of genitalia to, 64 Broad ligament, fibromyoma of, 365 varicose veins in, 90 Brodel stitch, 691 Buboes after soft chancre of vulva, 183 Byrne's treatment of carcinoma of cervix, 301 Cachexia in carcinoma of cervix, 294 strumipriva, 60 Calcification of uterine myoma, 266 Calcium chlorid in hemophilia, 78 in menorrhagia of youth, 460 Calculus, vesical, 369 diagnosis, 370 treatment, 370 Callous stenosis of cervix, 483 Canal of Nuck, cyst of, 247 Cancer. See Carcinoma. Capsule, Gerota's, 687 Carcinoma, Abderhalden's test for, 81 as cause of sterility, 486 of Bartholin's gland, 246 of bladder, 368 Carcinoma of bladder, secondary, 368 of cervix, 284 age incidence, 289 backache in, 507 bleeding in, 292 cachexia in, 294 curetage for, 516 diagnosis, 294 elevation of temperature in, 293 etiology, 289 heat treatment, 301 in poor and ill-nourished, 292 incidence, 289 infection of lymph-glands, 296 invertent, 286, 288 Kronig's operation, 303 lacerated cervix and, differentiation, 427 leukorrhea in, 292, 498 mesothorium in, 298 metastasis, 293 metrorrhagia in, 504 operability, 296 operative treatment, 297 pain in, 293 palliative treatment, 302 parametritis and, differentiation, 217 pathology, 285 Percy's treatment, 301 prognosis, 294 radimn in, 298, 303 removal of specimen for diagnosis, 295, 296 Schauta's operation, 644^650 squamous-cell, 285 starting points, 287 symptoms, 292 treatment, medical, 298 operative, 297 palliative, 302 vaginal discharge in, 292 hysterectomy for, 644r-650 Wertheim's operation, 631-644 x-rays in, 298 of oUtoris, 250 of Fallopian tubes, 361 diagnosis, 362 etiology, 361 prognosis, 362 treatment, 362 of ovary, 339, 345 classification, 339 colloid, 346, 347, 348 cystic, 339 metastatic, 340 secondary, 340 solid, 339 Digitized by Microsoft® INDEX 741 Carcinoma of parovarium, 360 of rectum, 370 diagnosis, 371 prognosis, 371 symptoms, 370 treatment, 371 of uterus, 303 age incidence, 305 associated with fibroids, 307, 308 bleeding in, 307, 308 diagnosis, 309 fibroid and, differentiation, 273 genital atrophy and, differentiation, 474 gland hyperplasia of endometrium and, differentiation, 309 in well-to-do, 292 increase, 289 metastasis, 305 metrorrhagia in, 504 treatment, 311 Wertheim's operation, 631-644 of vagina, 251 diagnosis, 251 prognosis, 252 treatment, 252 of vulva, 243 diagnosis, 245 treatment, 246 operative, 512 Carcinomatous degeneration of ovarian cysts, 339 of uterine myoma, 269 Caruncle, urethral, 247 Castration. See Ovariectomy. Catamenia. See Menstruation. Catarrh, nasal, at menopause, 71 Catarrhal salpingitis, 152 Catharis, postoperative, in abdominal cases, 728, 729 in plastic cases, 734 Catheterization as cause of cystitis, 221 Cautery in rectal prolapse, 373 Cecum' mobile of Wihns, 118, 128 movable, and movable kidney, influence be- tween, 128 Cells, germ-, 380 Langhans', 313 lutein, 39 somatic, 348 theca-lutein, 328 Cellular tissue, paracystic, 214 parametrial, 214 paraproctal, 214 pelvic, anatomy of, 213 inflammations of, 214. See also Para- metritis. Cellulitis, pelvic, 213 after operations on bladder, 218 in lateral wall of abdomen, 218 Cervical canal, atresia of, 471 Cervicitis, 199 symptoms, 200 treatment, 200 Cervix, adenocarcinoma of, 286, 287 amputation of, 522 Hegar's operation, 522 anteflexion of, pessaries for, 591 atrophy of, 469 caUous stenosis, 483 carcinoma of, 284. See also Carcinoma of cervix. curetage of, 515 dilatation of, 514 ectropion of, 286, 291 elongation of, in procidentia of uterus, 418 epithelioma of, 285, 286 erosion of, 199, 286, 291, 426 operative treatment, 516 eversion of, 286 operative treatment, 516 fibroids of, 260, 261 glands of, 148 hypertrophy of, after lacerated cervix, 426 laceration of, 426. See also Laceration oj cervix. plastic surgery, 516 polsrps of, 282. See also Polyps, cervical. tuberculosis of, 178 ulceration of, 286, 426, 427 Chamberlain's pessary, 592 Chancre, soft, of vulva, 182 Child-bearing, influence of, on size and weight of uterus, 17 Childbirth, injuries due to, 426 Chloasma gravidarum, 68 Chlorosis, 77 and genital system, relation between, 77 blood-picture in, 77 Cholelithiasis, 107. See also Gall-stones. Chorio-epithelioma malignum, 311 and trophoblast, biologic resemblance, 316 bleeding in, 317 histology, 313 metastasis, 318 metrorrhagia in, 503 parametrial infiltration in, 321 spontaneous healing, 321 symptoms, 317 theca-lutein cysts associated with, 328 treatment, 319 of Fallopian tube, 362 Digitized by Microsoft® 742 INDEX Chorio-epithelioma of vagina, 253 Circulation, deficient, of genitalia, ovarian extract in, 53 organs of, relation of genitalia to, 83 Circulatory system, condition of, during menstruation, 21 Clamp and cautery operation for hemor- rhoids, 710 Climacteric, 22. See also Menopause. Climate, effect of, on menopause, 19 on occurrence of menstruation, 18, 19 Clitoris, carcinoma of, 250 hypertrophy of, 249, 250 tumors of, 249 Cloaca, 382 Coagulabihty of blood, influence of uterine and ovarian extracts on, 51 Coagulation of menstrual blood, prevention, 20, 76 Coaptation of wound edges in plastic surgery, 733 Cocain in dj'smenorrhea, 456 Cocainizing nasal mucous membrane, in- fluence of, on dysmenorrhea, 71 Coccygodynia, 508 Coccyx, pain in, 508 Coffeys' operation for enteroptosis, 124 for retroversion of uterus, 409 Coitus, heart sjTnptoms during, 84 unpleasant, 463 Colic, uterine, 505 Colloid carcinoma of ovary, 346, 347, 348 Colon, diverticulitis of, 233. See also Diver- ticulitis of colon. implantation of ureter in, 702 inflammation of, 233 Colpitis, 194. See also Vaginitis. Colpoplasty, anterior, Graves' method, 530 Colpotomy, vaginal, 575 anterior, 576 posterior, 577 Compact layer of uterine mucosa, 26 Complement fixation test in diagnosis of gonorrheal salpingitis, 163 Conception, physiology of, 23 Condyloma acuminata of vulva, 185 treatment, 186 Congestion, premenstrual, of uterine mucosa, 24 Connective tissue, pelvic, tumors of, 364 Consanguinity as cause of sterility, 489 Consciousness, 96 aware, 96 unaware, 96 Constipation at menopause, 73 in procidentia of uterus, 419 Constipation in retroversion of uterus, 405 Constitution, hypoplastic, 47 Constitutional changes during menopause, 22 diseases, amenorrhea in, 500 as cause of steriUty, 488 genital atrophy due to, 471 Copaiba, oil of, in gonococcal cystitis, 226 Corpus albicans, 39 luteum, 38 as organ of internal secretion, 45 cysts, 326 formation of, 38 macroscopic appearance, in various stages, 52 of pregnancy, macroscopic appearance, 52 period of regression, macroscopic appear- ance, 52 of ripeness, macroscopic appearance, S2 persistence of, pregnancy and, 46 proliferative period, macroscopic appear- ance, 52 size of, 39 vascularization period, macroscopic ap- pearance, 52 Credo's ointment in varicose ulcer, 718 Cretinism, 59 endemic, 61 Cri uterine, 515 Critical period of woman's Ufe, 23 Crystallizations of resistance, 134 Cumulus oophorus, 34 Curetage of cervix, 515 of uterus, 515 Curve of Ott, 92 Cystadenoma of ovary, 328 origin, 337 pseudomucinous, 330 origin of, 338 treatment, 332 serous, 334 origin of, 337 of parovarium, 360 Cystic carcinoma of ovary, 339 cystitis, 223 degeneration of ovaries as cause of sterility, 486 of ovary, 324 of uterine myoma, 264 follicle atresia, 42 sarcoma of uterus, 280 Cystitis, 220 bacteria as cause, 220, 221 routes of infection, 221 catheterization as cause, 221 Digitized by Microsoft® INDEX 743 Cystitis, course, 224 cystic, 223 diagnosis, 224 diphtheric, treatment, 226 etiology, 220-222 exfoliative, 223 gonorrheal, 222, 231 treatment, 226 urethritis and, differentiation, 224 hematogenous, 222 in old women, 229 operation in, 703 pathology, 222 polyposa, 223 prophylaxis, 225 symptoms, 224, 231 syphiKtic, 229 treatment, 226 tubercular, 228 treatment, 226 vegetans, 223 verrucosa, 223 vetularum, 229 Cystocele, 398, 412, 428 diagnosis, 429 Graves' operation for, 530 symptoms, 429 treatment, 430 Cystogen in cystitis, 226 Cystoma of ovary, 328 Cystostomy, vaginal, 703 Dudley's method, 703 Kelly's method, 704 Cystotomy, suprapubic, 703 Kelly's method, 703 Cysts, blood-, of ovary, 327 dermoid, of Fallopian tubes, 362, 364 of ovary, 342, 349, 350 malignant changes, 344 parthenogenesis, 346 of parovarium, 360 of pelvic connective tissue, 366 treatment, 367 echinococcus, of vulva, 246 nabothian, 150 of BarthoUn's glands, 145, 246 treatment, 146 operative, 512 of bladder, 223 of canal of Nuck, 246 of corpus luteum, 326 of Fallopian tubes, 362 of Graafian folhcle, 322 of ovary, 212, 322 ascites after operation for, treatment, 358 Cysts of ovary, ascites and, differentiation, 356 blood-, 327 carcinomatous degeneration, 339 dermoid, 342, 349, 350 maUgnant changes, 344 parthenogenesis, 346 diagnosis, 356 diastasis of recti muscles and, differen- tiation, 357 everting, 330 fatty abdomen and, differentiation, 357 follicular, 322 implantation metastasis, 33C inverting, 330 monolocular, 329 multilocular, 329 operation for, 656 parvilocular, 329 prognosis, 358 pseudomucinous, 330 origin of, 338 treatment, 332 rupture, 353 seed metastasis, 330 serous, 334 origin of, 337 symptoms, 353 torsion, 354 acute gonorrheal salpingitis and, dif- ferentiation, 165 treatment, 357 of parovarium, 359 treatment, 360 of vagina, 253 diagnosis, 254 etiology, 254 treatment, 255 of vulva, sebaceous, 183 parovaria!, 359 treatment, 360 perineal, 255 sebaceous, of vulva, 183 theca-lutein, 328 tubo-ovarian, 157 Davenport's treatment of dysmenorrhea, 457 Decidua, ectopic, 445 Deciduoma malignum, 311 Defecation, pain on, 509 Defects, congenital, of uterus, 382 developmental, 377 of ovaries and tubes, 386 of vagina, 385 of bladder, 386 Digitized by Microsoft® 744 INDEX Defects of development, 377 of urethra, 386 Degeneration, carcinomatous, of ovarian cysts, 339 of ovary, 212 cystic, 212, 324 as cause of sterility, 486 small, 212 of uterine myoma, 261. Tut tie's modification, 705 Electricity in chronic pelvic inflammation with adhesions, 170 in dyspareunia, 463 in papilloma of bladder, 369 in stricture of urethra, 220 in urethral caruncle, 247 Elephantiasis in Southern negroes, 188 of vulva, 188 Elongation of cervix in procidentia of uterus, 418 of uterus, 399 Elting's operation for anal fistula, 238, 715 Embolism, postoperative, 89 Embryologic development of genital organs, 377 of ovaries, 380 of uterus, 377 of vagina, 377 Emmet's denudation of tissues with scissors, 733 operation for complete laceration of peri- neimfi. Graves' modification, 547 for laceration of perineum, 433 Graves' modification, 538 for rectocele. Graves' modification, 538 of tracheoplasty, 428, 516 perineoplasty, Graves' modification, 538 Emphysematous vaginitis, 197 Enchondroma of vulva, 246 Endemic cretinism, 61 Endocervicitis, 199 as cause of sterility, 485 treatment, 492 curetage of cervix for, 516 gonorrheal, 148 chronic, 149 treatment, 150 Schroder's operation, 526 sjrmptoms, 200 treatment, 200 Endocervix, gonorrheal inflammation, 148 leukorrhea from, 150 Endometritis, 200 as cause of sterility, 485 chronic interstitial, 205 dysmenorrhoica, 452 exfoUative, 458 fibrinous, 458 gonorrheal, 151, 203 infectious, 202 treatment, 204 interstitial, chronic, 205 postmenstrual necrobiotic, 206 tubercular, 177 Endometrium, adenocarcinoma of, 303 adenoma of, 208 gland hsrperplasia, cancer of uterus and, differentiation, 309 gland hypertrophy, 207 treatment, 209 gonorrheal inflammation, 151 hypertrophy, 207 treatment, 209 infections of, 202 inflammation of, 200 menstruating, physiologic anatomy, 24 polypoid gland hjrpertrophy, 208, 502 polyps of, 283, 284 sarcoma of, 279 tuberculosis of, 177 Endosalpingitis, gonorrheal, 152 tubercular, 174, 175 Endothelioma of Fallopian tubes, 362 of ovary, 352 of rectum, 371 Enteroptosis, 117 acquired, 120 Beyea's operation for, 124 Coffey's operation for, 124 congenital, 121 diagnosis, 123 etiology, 117 predisposing, 119 Graves' operation for, 126 Digitized by Microsoft® 746 INDEX Enteroptosis, Lane's operation for, 124 mid-line, 119 Rovsing's operation for, 124 sjTxiptoms, 122 treatment, 123 gynecologic, 125 medical, 123 neurologic, 126 orthopedic, 123 surgical, 124 WHms' operation for, 124 Enterovesical fistual, 435 Epiphysis, relation of, to genitalia, 63 Epispadias, 387, 390 treatment, 390 Epistaxis during menstruation, 21 EpitheHal layer of primoridal follicle, 33 Epithelioma of cervix, 285, 286 of rectum, 371 of vulva, 245 Epithelium, germinal, 377 of ovary, 31 peritoneal, .-destruction of. 111, 112 bacterial infection as cause, 112 Epoophoron, 380 Ergot in menorrhagia due to uterine fibroids, 275 Erosio virginis, 498 Erosion of cervix, 199, 286, 291, 426 operative treatment, 516 Erysipelas and menstruation, relation be- tween, 67 Essential dysmenorrhea, 93, 451. symptoms, 496 Esthiomene of vulva, 187 treatment, 188 Ether pneumonia, 74 rash, 68 Eunuchoidism, 48 Eversion of cervix, 286 operative treatment, 516 Ewin perineal sheet, directions for making, 731 Examination of patient, 719 in private house, 722 Exanthemata, menstrual, 66 ExfoHative cystitis, 223 endometritis, 458 Exophthalmic goiter, 59 at climacteric, 58 question of marriage and reproduction in, 59 Exstrophy of bladder, 387, 388 treatment, 390 Extirpation of kidney, 691 Extirpation of kidney for injury of ureter, 701 Extra-uterine pregnancy, 442. See also Ectopic pregnancy. Extravasation of blood, leukocytosis after, 80 regeneration of blood after, 80 Eyes, condition of, during menstruation, 21 hemorrhage of, puerperal sepsis as cause, 70 relation of genitalia to, 69 Face, hair on, in middle age, 23 Facies, ovarian, 353 Fallopian tubes, absence, 386 adenomyoma, 362 atrophy, 469 carcinoma, 361. See also Carcinoma of Fallopian tubes. chorio-epithelioma, 362 condition of, during menstruation, 20 cysts, 362 defects, developmental, 386 dermoid cysts, 362, 364 endothelioma, 362 fibroma, 362 fibromyoma, 362 fibromyxoma cystosum, 362 gonorrheal inflammation, 151 in infantilism as cause of sterQity, 481 isthmus of, gnorrheal infection, 157 Ijonphangioma, 362 mucous polyps, 362 myosarcoma, 364 operations on, 656 papUloma, 362 sarcoma, 362 Taussig's operation for sterilization of, 661 tuberculosis, 174 tumors, 361 False vaginismus, 461 Fascia, retrorenal, 687 transplantation of, for postoperative hernia, 680 Bartlett's method, 681 Fat, accumulation of, after removal of ovaries, 49 Fatty abdomen, ovarian cyst and, differen- tiation, 357 degeneration of uterine myoma, 265 tiunors of vulva, 243 Fetalism as cause of sterility, 478 Fibrinous endometritis, 458 Fibro-adenoma of parovarium, 360 Fibroids of uterus, 257. See also Myoma of uterus. Fibroma molluscum pendulum of vulva, 243 Digitized by Microsoft® INDEX 747 Fibroma of PaUopian tubes, 362 of ovary, 348 ascites from, 351 of pelvic comiective tissue, 365 of vulva, 242 treatment, 243 retroperitoneal, 365 Fibromyoma of broad ligament, 365 of Fallopian tubes, 362 of infundibulopelvic ligament, 366 of pelvic connective tissue, 365 of round Hgament, 365 of uterus, 257. See also Myoma of uterus. of vagina, 256 of vulva, 242 Fibromyxoma oystosum of Fallopian tubes, 362 Fibrosarcoma of ovary, 351 Fissure in ano, 238 ' treatment, 239 of bladder, inferior, 390 superior, 386 Fistula, enterovesical, 435 in ano, 237 Elting's operation for, 238, 715 Graves' operation for, 712-715 operations for, 712 treatment, 230 intracervical, 434 operation for, 559 juxtacervical, 434 operation for, 559 rectovaginal, operation for, 552, 553 ureteral, formation of, 702 urethrovaginal, 434 uterovesical, operation for, 559 vesical, 434 diagnosis, 435 operations for, 553 symptoms, 435 treatment, 435 vesicocervicovaginal, 434 operation for, 559 vesico-uterine, 434 operation for, 559 vesicovaginal, 434 Braqueliaye's operation, 557 Albarran's modification, 557, 559 operations for, 553 Sims' operation, 533 Flatus vaginalis, 197 Flexion of uterus, lateral, 396 Floatiog kidney, 126 Fluid material, absorption of, in peritoneal cavity, 111, 112 Flushes, hot, after ovariectomy, 99 Fold, bloodless, of Treves, 131 genitomesenterio, of Reid, 132 parietocoMc, of Jonnesco and Juvara, 131 Follicles, Graafian, 32, 37 apparatus as organ of internal secretion, 45 atresia of, 40, 323 cystic, 42 during pregnancy, 41 manner of taking place, 41 obliterating, 42 bursting of, internal force for, 37 cyst of, 322 developing and ripening of, by ovary, 32 ripening of, 33 primordial, 33 epithelial layer of, 33 Foot strain, 115 Formalin in pyehtis, 233 Jurying pan incision, Kelly's, for' nephrec- tomy, 692 Functional amenorrhea, 500 incontinence of urine, KeUy's operation, combined with Graves' anterior col- poplasty, 536 monorrhagia, 460 Fungus of vagina, 196 Furunculosis of external genitalia, 67 of vulva, 183 Gall-bladder, operation on, during pelvic operation, 108 relation of genitalia to, 106 strawberry mottling of, 109 Gall-stones, 107 operation for, during pelvic operation, 108, 109 sjrmptomless, 107 treatment, 107-109 Gamma ray, 299 Gangrene of bladder, 223 GarruUtas vagina}, 197 Gartner's duct, 380 Gas, expulsion of, from vagina, 197 Gelatin solution in hemophiUa, 78 Genital atrophy, 468. See also Atrophy, genital. herpes, 67 neurosis, 95 of imaguiation, 95 of overvaluation, 95 treatment, ,98 psychoneuroses, 95 treatment, 98 spot, 71, 453 tuberculosis, 173 Digitized by Microsoft® 748 INDEX Genital tuberculosis as cause of sterility, 486 Genitalia, deficient circulation of, ovarian extract in, 53 eczema of, 67 effect of removal of hj^jophysis on, 56 embryologic development, 377 external, condition of, during menstrua- tion, 20 fmunculosis of, 67 Genitomesenterio fold of Reid, 132 Germ-ceUs, 380 Germinal epithelium, 377 of ovary, 31 Gerota's capsule, 687 Giantism from hyperfunotion of hypophysis, 56 Gilliam's operation for retroversion of uterus, 408, 580 Kelly's modification, 585 Mayos' modification, 583 Simpson's modification, 581 Gland hyperplasia of endometrium, cancer of uterus and, differentiation, 309 hypertrophy of endometrium, 207 treatment, 209 polypoid, of endometrium, 208, 502 interstitial, 328 Glands of internal secretion, relationship of gynecology to, 44 of ovary to, 44 Glandular ducta of ovary, 32 Gl^nard's disease, 117. See also Enterop- tosis. Glycerin and iohthyol in chronic pelvic in- flammation, 170 in vaginitis, 196 Glycogen production from uterine mucosa, 30 Goffe's operation for prolapse of uterus, 606 Goiter during labor, 58 during menstruation, 57, 58 during pregnancy, 58 exophthalmic, 59 at menopause, 58 question of marriage and reproduction in, 59 Gonococcus, 136 clinical peculiarities, 136 latent power; 137 Gonorrhea, 136, 140 in children, 138 serum treatment, 172 vaccine treatment, 172 Gonorrheal bartholinitis, 143 treatment, 144 cystitis, 222, 231 treatment, 226 Gonorrheal endocervicitis, 148 chronic, 149 treatment, 150 endometritis, 151, 203 endosalpingitis, 152 hematosalpinx, 157 hydrosalpinx, 155 inflammation of Bartholin's glands, 143 treatment, 144 of endocervix, 148 chronic, 149 treatment, 150 of endometrium, 151 of Fallopian tubes, 151 of Skene's glands, 142 metritis, 209 oophoritis, 211 parametritis, 216 peritonitis, 112 pyosalpinx, 153 salpingitis, 151. See also Salpingitis, gonorrheal. tubo-ovaritis, 154 urethritis, 140 cystitis and, differentiation, 224 stricture of urethra as result, 142 symptoms, 141 treatment, 142 vulvitis, 138 vulvovaginitis in children, 138 treatment, 139 Gonorrhoea isthmica nodosa, 157 Graafian foUicle, 32, 37 apparatus as organ of internal secretion, 45 atresia of, 40, 323 cystic, 42 during pregnancy, 41 manner of taking place, 41 obliterating, 142 bursting of, internal force for, 37 cyst of, 322 developing and ripening of, by ovary, 32 ripening of, 33 Grape-mole sarcoma of uterus, 279 Graser's operation for umbihcal hernia, 679 Graves' disease. See Exophthalmic goiter. method of anterior oolpoplasty, 530 of making artificial vagina, 567 modification of Emmet's operation for laceration of perineum, 538 for rectocele, 538 of Olshausen's operation for retroversion of uterus, 578 operation for anteflexion of uterus, 595 Digitized by Microsoft® INDEX 749 Graves' operation for complete laceration of perineum, 547 for cystocele, 530 for diastasis of rectus muscles, 669 for enteroptosis, 126 for fistula in ano, 712-715 for postoperative hernia, 680 for procidentia of uterus, 596 for umbilical hernia, 673 Gynatresia, 463 diagnosis, 467 etiology, 464 hematocolpos in, 466 hematometra in, 466 hematosalpinx in, 466 treatment, 467 operations for, 565 symptoms, 465 treatment, 467 Gynecologic operations, lung complications after, 74 Hair on face in middle age, 23 Hamamehs in menorrhagia due to uterine fibroids, 275 suppositories in hemorrhoids, 375 Headache during menstruation, 20 Hearing during menstruation, 21 Heart, anemic, 85 at menopause, 85 at puberty, 84 changes in, associated with uterine fibroids, 86 from hemorrhage from pelvic disease, 85 during cohabitation, 84 lesions associated with uterine myoma, 272 myoma of, 86, 272 relation of genitaha to, 84 Heat in acute cystitis, 226 treatment of carcinoma of cervix, 301 Hegar's operation for amputation of cervix, 522 Hehnitol in cystitis, 226 Hematocele in ectopic pregnancy, 444, 447, 448 pelvic, in ectopic pregnancy, 444 Hematocolpos in gynatresia, 466 Hematogenous cystitis, 222 Hematoma in ectopic pregnancy, 444 parametrial, 218 parametritis and, differentiation, 217 treatment, 219 Hematometra, 385 in guinea-pigs, production of, by injection of ovarian extract, 53 in gynatresia, 466 Hematosalpinx, gonorrheal, 157 in ectopic pregnancy, 444 in gynatresia, 466 treatment, 467 Hemophiha, 77 famihal type, 77 sporadic type, 78 treatment, 78 Hemorrhage from pelvic disease, changes in heart muscle from, 85 in carcinoma of cervix, 292 of rectum, 370 of uterus, 307, 308 in cervical polyp, 283 in chorio-epithelioma mahgnum, 317 in guinea-pigs, production of, by injection of ovarian extract, 53 in procidentia of uterus, 419 in tumors of bladder, 369 intestinal, at menopause, 73 of eye, puerperal sepsis as cause, 70 regeneration of blood after, 79 uterine. See Metrorrhagia. Hemorrhagic metropathies, vaporization in, 476 Hemorrhoids, 373 Allingham's operation for, 707 bleeding, during menstruation, 73 clamp and cautery operation for, 710 diagnosis, 375 dissection and ligation for, 707 etiology, 374 external, 374 internal, 374 interno-external, 374 operations for, 707 relation of, to pregnancy and labor, 103 thrombotic, 374 treatment, 375 Whitehead's operation for, 707 Hermaphroditism, 392 Hernia, abdominal, 436 operation for, 673 postoperative, 439 diagnosis, 440 Graves' operation for, 680 transplantation of fascia for, 680 Bartlett's method, 681 treatment, 440 shding, 373 umbilical, 438 Graser's operation for, 679 Graves' operation for, 673 Mayos' operation for, 679 Herpes, genital, 67 menstrual, 66 Digitized by Microsoft® 750 INDEX Herpes sexualis, 66 vesicae, 223 Hitsohmann and Adler on cyclic changes in uterine mucosa, 24 Horn, rudimentary, of uterus, 385 Hot flushes after ovariectomy, 99 House, private, examination of patient in, 722 Hyahne degeneration of uterine myoma, 261 Hydatid mole, 315 theca-lutein cysts associated with, 328 Hydatids of Morgagni, 362 Hydrastis in menorrhagia due to uterine fibroids, 275 Hydrocele muliebris, 246 Hydrometra, 305 due to closure of cervical canal, 472 Hydrops tubse profluens, 497 Hydrosalpinx, 169 congenital, 176 gonorrheal, 155 Hydrotherapy in enteroptosis, 123 Hymen, atresia of, 464 treatment, 467 intra-uterine closure, 464 Hyperanteflexion of uterus, 396 Hyperfunction of adrenals, 62 of hypophysis, acromegaly from, 56 giantism from, 56 of ovary, 49 Hyperleukocytosis and infection, relation be- tween, 78 and inflammation, relation between, 78 postoperative, 80 Hypernephroma as cause of precocious sexual development, 62 HyperpineaUsm, 63 Hyperplasia, gland, of endometrium, cancer of uterus and, differentiation, 309 Hypersecretion of ovary, 49 uterine bleeding from, 50, 51 Hyperthyroidism. See Exophthalmic goiter. H5rpertrophic changes in uterus before and after birth, 17 Hypertrophy, gland, of endometrium, 207 treatment, 209 of adrenal gland after ovariectomy, 62 of cervix after lacerated cervix, 426 of clitoris, 249, 250 pigment, and functions of pelvic organs, relation between, 67 polypoid gland, of endometrium, 208, 502 Hypofunction of hypophysis, 56 dwarfism from, 57 of ovary, 46 infantilism and, relation between, 47 Hypophysis, changes in, due to castration, 46, 47 in pregnancy, 56 diseases of, as cause of sterility, 488 effect of ovariectomy on, 56 extract of, value of, 57 hyperfunction of, acromegaly from, 56 giantism from, 56 hypofunction of, 56 dwarfism from, 57 relation of ovaries to, 56 to genitalia, 55 removal of, effect of, 55 on genital organs, 56 on pregnancy, 56 Hypoplasia of ovary, infantilism and, rela- tion between, 47 Hypoplastic constitution, 47 Hypospadias, 386 Hypothyroidism, 59 Hysterectomy, 613 complete, 624 steps of operation, 628 for uterine myoma, 275 in hemophilia, 78 neuroses after, 99 ovarian extract after, 53 procidentia after, 418 psychoneuroses after, 99, 100 supravaginal, 613 vaginal drainage after, 623 transplantation of ovarian tissue after, 664 vaginal, 628 for carcinoma of cervix, 644r-650 Hysterostomatocleisis, 562 Hysterotomy in uterine insufficiency, 477 IcHTHTOL in postoperative phlebitis, 89 in pruritus of vulva, 194 in vaginitis, 196 Ileoplevic band, 132 Imperforate anus, 390 Impregnation, artificial, in sterility, 494 Incision, apron, in fistula in ano, 713 Bardenheuer's, 666 for major operations on kidney, 691 for nephrectomy, 691 for suspension and minor operations on kidney, 684 Kelly's frying pan, for nephrectomy, 692 Pfannenstiel's, 667 transverse, in pelvic operations, 666 Incontinence of urine, functional, Kelly's operation, combined with Graves' anterior colpoplasty, 536 operation for, 535 Digitized by Microsoft® INDEX 751 Infantile myxedema, 60 ovaries, 479 uterus, 481 Infantilism, 477, 478 as cause of sterility, ovaries in, 479 tubes in, 481 uterus in, 481 etiology, 478 hypofunction of ovary and, relation be- tween, 47 hypoplasia of ovary and, relation between, 47 of uterus, 421 Infection and hyperleukocytosis, relation be- tween, 78 and leukocytosis, relation between, 78 external, resistance of peritoneum to, 111 of endometrium, 202 of metrium, 209 of ovary, 210 of uterine myoma, 270 of uterus, 209 value of omentum in walling off and local- ization of, 110 Infectious diseases, acute, acute septic vagi- nitis after, 116 relation of genitalia to, 116 endometritis, 202 treatment, 204 metritis, 209 oophoritis, 210 chronic, 211 etiology, 212 symptoms, 212 treatment, 213 Inflammation and hyperleukocytosis, relation between, 78 gonorrheal, of Bartholin's glands, 143 treatment, 144 of endocervix, 148 of endometrium, 151 of Fallopian tubes, 151 of Skene's glands, 142 of urethra, 140 of bladder, 220 in old women, 229 of colon, 233 of endometrium, 200 of large intestine, 233 of ovary, 210 of parametrium, 213 of pelvic cellular tissue, 214. of pelvis of kidney, 230 of peritoneum, pain from, 506 of uterus, 209 Inflammation of uterus, gonorrheal, 209 infectious, 209 tubercular, 209 of vagina, 194 of vulva, 182 pelvic, chronic, as result of gonorrheal sal- pingitis, 160, 167. See also Pelvic inflammation, chronic. relation of, to retroversion and retro- flexion of uterus, 160 Inflammatory processes, general, 182 stricture of rectum, 239 treatment, 241 Influenza and genitalia, relation between, 116, 117 Infundibulopelvio ligament, fibromyoma, 366 Injuries due to childbirth, 426 Insanity, influence of menstruation on, 95 Internal secretion, glands of, relationship of gynecology to, 44 of ovary to, 44 Interposition operation in prolapse and proci- dentia of uterus, 420, 599 Interstitial gland, 42, 328 as organ of internal secretion, 46 pregnancy, 442 symptoms and course, 449 Intestinal bands, 131 attic adhesions, 132 bloodless fold of Treves, 131 diagnosis, 135 genitomesenteric fold of Reid, 132 ileopelvic, 132 Jackson's membrane, 131 Lane's kink, 132 origin, 132 parietocolic fold of Jonnesco and Juvara, 131 points of formation, 134 sjrmptoms, 134 treatment, 135 diverticula, 233. See also Diverticula, in- testinal. hemorrhage at menopause, 73 stasis, 117, 122 Intestine, large, inflammation of, 233 relation of genitaUa to, 101, 103 Intra-abdominal bands, 131. See also Intes- tinal bands. Intracervical fistula, 434 operation for, 559 IntraUgamentary fibroid, 260 Intra-uterine closure of hymen, 464 Inversion of uterus, 399, 423 complete, 423 conservative operation, 610 Digitized by Microsoft® 752 INDEX Inversion of uterus, diagnosis, 424 incomplete, 423 Kiistner's operation, 610 myoma and, differentiation, 424 onkogenetic, 423 Spinelli's operation, 611 symptoms, 424 treatment, 424 Invertent carcinoma of cervix, 286, 288 lodin in cervicitis, 200 in chronic pelvic inflammation, 170 in condyloma acuminata of vulva, 186 in endocervicitis, 200 in gonorrheal inflammation of Skene's glands, 143 in membranous dysmenorrhea, 459 in pruritus of vulva, 194 in vaginitis, 196 Ischiorectal abscess, 236 Ischuria paradoxa, 101 Jackson's membrane, 131 Joints, relation of genitalia to, 115 Jonnesco and Juvara, parietocoUc fold of, 131 Juxtacervical fistula, 434 operation for, 559 Kaolin poultices in postoperative phlebitis, 89 Katz's theory of cause of ectopic pregnancy, 443 KeDy's frying pan incision for nephrectomy, 692 method of suprapubic cystotomy, 703 of vaginal cystostomy, 704 operation for functional incontinence of urine, combined with Graves' anterior colpoplasty, 536 for retroversion of uterus, 585 in uterine insufficiency, 477 teohnic of suspension of kidney, 688 Kidney, abscess of, 230 extirpation of, 691 for injury of ureter, 701 floating, 126 mode of entrance of bacteria to, 230 movable, 126 and appendicitis, association, 129 and movable cecum, influence between, 128 diagnosis of, 129 etiology of, 126 pyelography as aid in diagnosis, 130 symptoms, 128 treatment, 130 operations on, 684 Kidney, operations on, major, incision for, 691 minor, 684 incision for, 684 pelvis of, inflammation, 230 removal of, 691-697 suppurating, 230 suspension of, 684 KeDy's technic, 688 tumors of, ovarian tumors and, differen- tiation, 356 Kink, Lane's, 132 Knee-chest position, 722 Kraurosis of vulva, 190 treatment, 191 Kristeller, 493 Kronig's modification of Sampson's method of ureterovesical transplantation, 701 operation in carcinoma of cervix, 303 Krukenberg's tumor, 348 Kiistner's operation for inversion of uterus, 610 Labia majora, atrophy, 470 minora, atrophy, 470 Labor, appendicitis during, 106 goiter during, 58 Laceration of cervix, 426 carcinoma and, differentiation, 427 diagnosis, 427 Emmet's operation, 428, 516 hypertrophy after, 426 metrorrhagia in, 504 operative treatment, 516 symptoms, 427 treatment, 428 of perineum, 431 anatomic result, 431 complete, Emmet's operation, Graves' modification, 547 Graves' operation, 547 operation for, 547 Warren's operation, 552 diagnosis, 433 Emmet's operation, 433 Graves' modification, 538 symptoms, 432 Lactation, condition of uterus during, 471 sterility, 488 Lactation-atrophy, 471 of ovaries, 48 Lane's kink, 132 operation for enteroptosis, 124 Langhans' cells, 313 layer, 313 Layer, compact, of uterine mucosa, 26 Digitized by Microsoft® INDEX 753 Layer, epitheHal, of primordial follicle, 33 Langhans', 313 medullary, of ovary, 32 parenchymatous, of ovary, 32 spongy, of uterine mucosa, 26 Lead-and-opium lotion in postoperative phlebitis, 89 Leg, milk-, 87, 215 Legs, pain in, 509 varicose veins of, 90 Mayos' operation for, 717 operations for, 716 Leiomyoma of uterus, 257. Length of stay in bed in abdominal opera- tions, 730 Leukocytosis after blood extravasation, 80 and infection, relation between, 78 in absorption of products of degeneration in necrotic tissue, 80 postoperative, 80 Leukorrhea, 496 from endocervix, 150 in carcinoma of cervix, 292, 498 in cervical polyps, 283 in chronic endometritis, 151 gonorrheal endocervicitis, 150 pelvic inflammation, 167 in endocervicitis and cervicitis, 200 in erosion of cervix, 199 in gland hypertrophy of endometrium, 209 in retroversion of uterus, 405 in stenosis of vagina, 465 in tubercular endometritis, 178 in vaginitis, 195, 196 Levator ani muscle, 431 Ligament, appendiculo-ovarian, 104, 132 broad, fibromyoma of, 365 varicose veins in, 90 infundibulopelvic, fibroma of, 366 round, adenomyoma of, 364 fibromyoma of, 365 tumors of, 363 treatment, 364 Ligation of proximal end of ureter, 701 Lipoma of pelvic connective tissue, 366 of vulva, 243 retroperitoneal, 366 Liquor foUicuM, 34 Loins, pain in, 508 Lumbar pain, 508 trigonum, superior, 686 Lung complications after gynecologic opera- tions, 74 tuberculosis of, influence of menstruation on, 75 48 Lupus of vulva, 178 Lutein cells, 39 Lymphangioma of Fallopian tubes, 362 Lymph-glands, infection of, in carcinoma of cervix, 296 of peritoneum, 110 Lymphosarcoma of uterus, 280 Lynch's thyrotome in stricture of rectum, 241 Malabia and metrorrhagia, relation between, 117 Malignant chorio-epitheHoma, 311 degeneration of uterine fibroids, 267, 279, 281 Malposition of uterus, 394 as cause of sterility, 486 treatment, 489 backache in, 507 dysmenorrhea and, relation, 453 operations for, 578 Malthusian doctrine, 488 Mammary extract in menorrhagia, 65 in uterine bleeding, 65 glands. See Breasts. Mammin in menorrhagia, 65 in uterine bleeding, 65 Marchant's operation for rectal prolapse, 705 Masculine type, reversion to, during meno- pause, 23 Mayos' operation for prolapse and prociden- tia of uterus, 609 for retroversion of uterus, 583 for umbiUcal hernia, 679 for varicose veins, 717 Medullary layer of ovary, 32 Melanosarcoma of uterus, 280 Membrana granulosa, 34 Membrane, Jackson's, 131 Membranous dysmenorrhea, 457. See also Dysmenorrhea, membranous. Menopause, age occurring, 19 atrophy of ovaries as cause of changes during, 23 constipation at, 73 constitutional changes during, 22 diarrhea at, 73 digestive disturbances at, 73 disturbances of, placental extracts in, 54 eczema of, 67 exophthalmic goiter at, 58 heart at, 85 influence of climate on, 19 on thyroid, 58 intestinal hemorrhage at, 73 loss of ovarian secretion as cause of changes during, 23 Digitized by Microsoft® 754 INDEX Menopause, menorrhagia at, causes, 22 nasal catarrh at, 71 nervous symptoms of, 99, 100 nose during, 70 obesity during, 23 physical changes during, 22 psychic disturbances during, 22 psychoneuroses of, 100 reversion to masculine type during, 23 sexual impulse just before, 23 vasomotor disturbances of, S5, 100 Menorrhagia, 501 appearance of blood after, 80 at menopause, causes, 22 causes, 502 from uterine fibroids, 272 treatment, 275 functional, 460 in gland hypertrophy of endometrium, 209 in retroversion of uterus, 405 mammary extract in, 65 neuroses from, 94 of youth, 460 thjrreopriva, 58 Menstrual blood, amount lost, 20 non-coagulabihty of, 20, 76 changes in skin, 66 exanthemata, 66 exfoliation of uterine mucosa, 457 herpes, 66 saUvation, 71 Menstruating endometrium, physiologic anat- omy, 24 Menstruation, abnormalities of, 499 age occurring, 18 amount of blood lost during, 20 and acne, relation between, 67 and chronic appendicitis, relation between, 105 and erysipelas, relation between, 67 and ovulation, time relation between, 51 bleeding hemorrhoids at, 73 blood during, 76 cessation of, 19, 22 condition of breasts during, 20 of circulatory system in, 21 of digestive system during, 20 of external genitals during, 20 of eyes during, 21 of Fallopian tubes during, 20 of nervous S}'stem during, 20 of ovaries during, 20 of skin during, 21 of uterus during, 20 congestion of pelvic blood-vessels during, 20 Menstruation, diarrhea during, 73 disturbances of, in chronic pelvic inflam- mation, 168 in ovarian tumors, 355 in retroversion of uterus, 405 of mouth during, 71 of stomach and, relationship, 71, 72 duration of, 19, 20 effect of climate on occurrence of, 18, 19 of social conditions on occurrence of, 19 enlargement of breasts during, 18 of thyroid gland in, 20 epistaxis during, 21 estabUshment of, 18 factors which influence, 18 goiter during, 57, 58 headache during, 20 hearing during, 21 herpes, 66 increased activity of parotid glands during, 71 influence of disturbed psychic states on, 94 of nervous shock on, 94 of psychic excitement on, 21 on insanity, 95 on mental diseases, 94 on nervous diseases, 91, 94 on tuberculosis of lungs, 75 irregularity of, 19 neuroses from, 93 molimina of, 499 myoma of uterus and, relation, 273 non-coagulability of blood of, 20, 76 nose during, 70 nose-bleed during, 21 Ott's curve, 92 pains of, 21, 508. pelvic discomfort during, 20 performing pelvic operations during, 22 physiology of, 18 precocious, 21 in infants, 18 sense of weU-being during, 20 sexual impulse during, 21 suicide during, 94 tubal, 30 vasomotor disturbances during, 21 vicarious, 21 skin lesion from, 67 vocal cords during, 21, 75 voice during, 21, 75 wave theory, 91 Mental diseases, influence of menstruation on, 94 Mercury, bichlorid of, in pyelitis, 233 Mesothorium in carcinoma of cervix, 298 Digitized by Microsoft® INDEX 755 Metritis, 209 gonorrheal, 209 infectious, 209 tubercular, 209 Metropathies, hemorrhagic, vaporization in 476 Metrorrhagia, 503 and malaria, relation between, 117 appearance of blood after, 80 from arteriosclerosis, 86, 87 from hsrpersecretion of ovary, 50, 51 from uterine fibroids, 272 treatment, 275 in carcinoma of cervix, 504 of uterus, 504 in cervical poljrps, 504 in chorio-epitheUoma malignum, 503 in extra-uterine pregnancy, 444, 445, 447, 504 in lacerations of cervix, 504 in sarcoma of uterus, 281 mammary extract in, 65 Micturition, painful, 509 Mid-line abdominal ptosis, 119 Milk-leg, 87, 215 Mole, hydatid, 315 theca-lutein cysts associated with, 328 tubal, 444, 447 Molimina of menstruation, 499 Morgagni, hydatids of, 362 Morphin in carcinoma of cervix, 303 suppositories in hemorrhoids, 375 Moschowitz's operation for rectal prolapse, 705, 706 Mouth, disturbances of, during menstrua- tion, 71 ,_f Movable cecum and movable kidney, in- fluence between, 128 kidney, 126 and appendicitis, association, 129 and movable cecum, influence between, 128 diagnosis, 129 etiology, 126 pyelography as aid in diagnosis, 130 symptoms, 128 treatment, 130 Mucosa, uterine, compact layer, 26 cycUc changes in, 24 glycogen production from, 30 menstrual flow and, 28 postmenstrual involution of, 28 premenstrual congestion of, 24 spongy layer, 26 Mucous polyps of Fallopian tubes, 362 of vestibule, 247 Muller's ducts, 377, 382 failure of union, results of, 382 Muscles, recti, diastasis of, 436 operation for, 669-672 treatment, 437 Myoma, ball, of uterus, 260 cervical, 260, 261 heart, 86, 272 of uterus, 257 adenocareinomatous degeneration, 269 and menstruation, relation, 273 and pregnancy, relation, 272 and thyroid, relation between, 58, 59 angiomatous degeneration, 265 as cause of sterility, 487 atrophy, 266, 267 baU, 260 calcification, 266 carcinoma and, differentiation, 273 associated with, 307, 308 carcinomatous degeneration, 269 centrifugal, 258 centripetal, 258 changes in, due to passive congestion, 261 classification, 258 cystic degeneration, 264 degeneration, 261 diagnosis, 273 edematous degeneration, 261 etiology, 257 fatty degeneration, 265 frequency, 270 heart lesions associated with, 86, 272 hyaline degeneration, 261 hysterectomy for, 275 in well-to-do, 292 infection, 270 interstitial, 259 intraligamentary, 260 intramural, 259 inversion and, differentiation, 424 malignant degeneration, 267, 279, 281 menorrhagia from, 272 treatment, 275 menstruation and, relation, 273 metrorrhagia from, 272 myomectomy for, 275 myxomatoid degeneration, 264 myxomatous degeneration, 263 necrosis of, 265 operations for, 650 pain from, 508 pregnancy and, differentiation, 274 relation, 272 red degeneration, 264, 266 regressive changes, 266 Digitized by Microsoft® 756 INDEX Myoma of uterus, sarcomatous degeneration, 267, 279, 281 submucous, 260 subserous, 259 supravaginal hysterectomy for, 275 sjTnptoms, 271 thrombotic degeneration, 264 treatment, 274 uterine hemorrhage from, 272 treatment, 275 vasomotor symptoms, 86