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If statistical studies throw any light on maternal mortality, it is certain that:Six or seven women out of every thousand confined die from causes directly or indirectly related to pregnancy, labor and the puerperium.There has been no improvement in maternal mortality records in the United States during the past ten years. In 1915 the maternal mortality rate in the registration area was 6.1, in 1920, 8, and in 1927, 6.7 per thousand births. Such statistics in the face of the advances made in prenatal study and supervision suggest that women are not receiving clean or scientific intrapartal care and that something is wrong with the teaching and training given to the undergraduate.More than 40 per cent, or two fifths, of all maternal deaths are due to infection, supposedly a preventable cause, while 27 per cent are chargeable to the toxemias and eclampsia, also preventable conditions. Of the

In 1909, I presented before this Section a report based on a study of the records of 300 cases occurring in my personal services, in which resection or conservation of an ovary had been done. Since that time a large number of secondary operations have been necessary for the relief of symptoms caused by the retained or the resected ovary. These explorations have given me a wider insight into the living pathology of the ovary or the part of the ovary which was retained in the effort at conservation.While I am still convinced that the importance of the ovary to the woman cannot be overestimated (not only is it the primary and all important organ in the reproductive cycle, but it regulates and controls the perfect attainment of development, growth and function in the individual woman, and its retention is essential to sex perpetuation), yet I must conclude from

In 1926 we presented before the American Gynecological Society an analysis of a year's experience with the blood sedimentation test as a diagnostic and prognostic sign in gynecologic conditions, and from these studies we drew the conclusions that in this test we have another aid in the diagnosis of infection, which, when frequently repeated and correlated with the clinical history, temperature curve and the white cell changes, is a valuable index as to when to operate, as well as a sign of prognostic value. The value of any test will depend on its simplicity, its applicability and the additional information which it affords over other diagnostic methods or when correlated with them.Since the appearance of that paper, sedimentation tests have been done on every patient admitted to the gynecologic wards of the Long Island College Hospital. One of the resident staff has been assigned to this work and more

Just a year ago, through the publication of an article in the lay press describing painless labor as conducted at Freiburg, the interest of the women of this country was awakened in the so-called "twilight sleep," and since that time women have been calling for its general adoption, while the profession, as a whole, has refused its endorsement, claiming that the merits of the method are not proved. It is my purpose in this brief paper to present the facts, without prejudice or bias, based on a most careful study of this form of amnesia in both Europe and America.Before taking up a consideration of the method, its indications, advantages, and limitations, we must settle whether a woman is entitled to relief frompain in labor, for some claim that because labor is a physiologic process there is no need of using anything to ameliorate suffering. With this I

Sections of the torsioned siderevealed a marked hyperplasia and hypertrophy of all the several coats of the uterus, i.e., endometrial, muscular and serous. There was a marked increase in the number and of the blood vessels. There was also an actual increase in the elastic tissue ratio of the blood vessels while the connective tissue ratio of the entire organ was grossly increased.

The meagerness of the literature on conservative surgery on the ovaries, when these organs are the seat of neoplastic formations, has prompted me to analyze the cases in which I have performed operations in the last nine years, and of which detailed records, noting the pelvic conditions and symptoms at the end of one and two years, have been kept.Do the remote results of conservative surgery on a diseased ovary warrant us ir resecting such an organ? This is the question which the surgeon must answer daily, at the operating table. On the one hand, ablation in a young woman has many unfortunate physical and psychical results; while the preservation of a part of one or both ovaries renders the symptomatic cure of the patient uncertain, and a secondary operation may be necessary.The reasons which have been advanced in favor of conservatism are

The proper management of suppurative tubal disease in the young woman often taxes the judgment of even the experienced surgeon. When to operate, so as to afford the patient the greatest margin of safety, and how to operate, to obtain the best end-results, are questions that should be definitely settled. On these questions the surgeon and gynecologist, however, seem to hold different views. The gynecologist has learned from bitter experience that time alone sterilizes the tubal content and that when sufficient time is allowed, Nature is competent, to a considerable degree, to absorb and regenerate the function of many of the involved structures. We have also learned that different bacteria, each having a different life history, have a decided influence on the operative prognosis.Simpson and I have promulgated and taught these rules as to the time for operation: 1. Radical abdominal procedure should never be done in the presence