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THE INCIDENCE of and mortality from cervical cancer in the United States have decreased dramatically over the past 40 years, in part because of early diagnosis and treatment of cervical cancer precursor lesions. The success of cervical cytological screening has served as a model for early diagnosis of other types of cancer. Although numerous studies have shown that lack of cytological screening is a major risk factor for the development of invasive cervical cancer, 1-3 it is important to emphasize that none of the screening, diagnostic, or therapeutic techniques used in medicine are perfect. Accordingly, a few women will develop cervical cancer despite adherence to accepted screening protocols . In addition, problems inherent with sampling, interpretation, and effective clinical follow-up preclude total prevention of cervical cancer. In recent years it has become evident that the cost and morbidity associated with the detection and treatment of low-grade cervical lesions have escalated, probably

The instinct of self-preservation is probably the strongest characteristic which we see exhibited throughout all the animal kingdom; nor does this tendency of living things to remain alive seem to be entirely due to an instinct, but there seems to be a constant effort on the part of the tissues themselves to prolong and preserve that series of phenomena which we call life, entirely independent of any volition on the part of the individual. We find this effort displayed not only in the animal kingdom, but in the vegetable as well. We see the seeds of small plants and vines, having taken root in unsuitable places, sending out their shoots through cracks and chinks in walls to gain the sunlight; the roots of trees curving around rocks and obstacles, and even displacing these by the exertion of considerable force, to reach the rich soil below. Nor does nature alone seem

The word endometrium should be used to refer to the mucous membrane which lines the body of the uterus. The mucosa of the cervical canal is anatomically and physiologically a different structure, and although it may properly be called endometrium, usage more or less restricts that term to the mucosa of the body of the uterus. The endometrium is intimately connected with the musculature of the uterus and its circulation is greatly influenced by changes which occur in the blood vessels of the myometrium and by the tonicity of the uterine muscle. The endometrium is continuous with the lining membrane of the tubes and with the epithelial layer of the cervix, therefore, it follows that the endometrium is influenced by all inflammatory affections, displacements, new growths and congestions of the genital organs. By some it is held that the term endometritis (inflammation of the endometrium) should be applied only to

It is with a feeling of great diffidence that I bring before this section such a common-place subject as endometritis, but I feel justified in doing so from the fact that, taking at random six different modern text-books, I find given twenty-seven different kinds of endometritis; out of these twenty-seven varieties, there is no one variety which is mentioned in each text-book. There are three varieties (exfoliating, gonorrheal and septic) which are mentioned in four; four varieties (atrophic, hypertrophic, simple chronic and fungous or fungoid) in three; eight varieties (hemorrhagic, hyperplastic, glandular, interstitial, polypoid, simple, tuberculous and senile) in two, and ten varieties (catarrhal, decidual, menstrual, diphtheritic, infectious, syphilitic, virginal, puerperal, putrid and villous-degeneration) mentioned once each in six different text-books. If gynecologists were earnest, serious students to-day and just beginning their gynecologic studies, they would throw up their hands in despair at twenty-seven different diseased conditions of one small