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unton \n is r Wuiiam Ua Tsov L» \KE 3\ Saep ov IIakqlcy Sir Arbahinot Lane Sir Georoe 11 Makiss Robert Milw Sir ICTef t Ev Movmhan Mrtt JAAi Ru «tok Pareeb Sir IIarouj Stiefs IRr L\M ^ir Miiu Ait Irfeasb ur C Wn ESl ER G\Ni: COLOG\ AND OBS-TCTI ICS Uf CRICA Frans T \ndrfvss Brooe W \sspac« W E Isifon } M Bupi C anmn \ B\r Rtrt llf Slf AN J Uo LLT J^\e SEYBO\£e Ix POY Br OVW IJCNKf I Utto D Ji r Ct ARE TUOMk Sb Ceilfn Edvari P Pams J se ( B Pe Lec R ibfre L D cei wv A ri ji\n U r wa E C Ped l EA l Uro Ll R Vf EST Cil AB ES S Li DE* I ALU E» Pivi JIF Y OEORCfcf Etfc If RS / Kf Vl IC Ooi E Sl TII E Goaiios Barto C Ui» t Uowaro V I Eii\ Feorav L*i.c L } Lad sae If !Ltwis Frisk W Lynch ^^Al TE»^ 'Mavtov L L AIoyttome a f EORCe C Vosi er ff ESRYl \rwj an G onocll V w Ch rees E Paodo k Charies B Ienri e l Uia vpert RS v /ojln 0 Pola Charles B Reld b waro Revnol s Ejil Rus John x Samp )v FT ‘^ure^v Ivtcjf ARD r Siiir i Wit UAMS St nf \Ulu m E STi; DDjr Diu ffc r\ Intt TT ''OUTff Vr Rl CV II T VTL Mv* Eli INDIA KEOUt NATl I Dax ci:mto cri \r\ surgei \ AMERICA Whuam I Baum X\ji»av T Bccneio Joseph L Bo ii« John R Cait-K Cila les IJ Chet ood Jojl 1/ C^wis ii m Jb fs fxi UARD L Keyfs Jr Glst \ Kooschtr F Xseissel b ssrosa I r a i Sc Jtai DT } Br N-Ttpv Souf R b \ Thom* nau u\ n, n jj J K Thomso Waller L W Breui ia He h CIS P It \ B Rorfrt IJfrb t Cranvule Mac C \asn loj/ I ir \ L INTI \D N,4, INFFI NVTIOWI \nsri \CT or SURCFP\ COVSUni NC EDITORIAL STAI F— Ciis Tivuf u ORTHOI r me surc f i \ \MII m I) IB Sim CVWDV \ M if I b Ilf RB rt I fl C ircu\ C\RI H KFDBLO't— C«EAt \DOUn JURTUNC— Uo E-i TOt NOiwv j AMCs* P n TZCr K.\l.the bladder and espeaally in c ten \e operations f r carcinoma of the uterus with nvolvemenl f the bladder the transplanlaiion of th ureter into the intest ne is the only operation wh ch will render enatenc tol rable The dange s of an ascending pveloncphntis are not very great and arc e cntuallv o e come The author repo ts three cases of i an pi ntation of the ureters int ib int s t ne which were traced for many yea s AQ tb e pal nls suffered from post h ch in most cases will mount to a removal of nra tically one half the bladder W hen the tumor is on the nterior surface the bladder 1$ bisected late ally and xcised down to the internal sphincter ^Vhen the tumor involves the lateral w Us the bisection is made f om before backward in the median Une and the line of bladder exc on made just above the ureteral onficc or as in tumors involving the ureter In the growths involving the ureteral segment the bi ection is the same but the line of excision is just back of the internal sphincter with transplania l on of the ut ter Turn rs occurring at the fundus n nr the insertion of the urachus should be remo ed w th the urarhus and attached dvcnttious tissue e tness peritoneum et up to the n vel Tumors occurring m that part of the fundus vrh ch covered bv pec toneum should be removed \ ith the attach d per toneum lumo s n the ureteral s gment sh uld be re mov ed w th the ureter end attacl ed and the ureter divided only after the mass has been entirely f eed and h ngs from the ureter as a pedicle Of a series of seventy fiv e patients treated by the auth by th s method of segmental resection tw niy se en di d in the hospital after the opera lion twentv ha c re urrences or extensions by meta tasis and twenty eight are without sgns of recurrence f m two to e ght years after the opera ti n He "BY L SA^•ro En MD Joseph E A Case of Total Extirpation of ti e Bladder iff ff f^)* ’f fariili RC Thiji» luf'tratc (Irhllcrtta U snl chan s jl foi as 1 ilin if 1 fro T- rrcii!

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Ider catheter Micro- cop caltv the un e from the left kidney was clear That from the right kiln v (vaginal urine) showed numerous co]on bacilli Tbcr s.b( kidney which was removed under ether a »■ the I w s small a d showel the vellowish hue surface of nephritis and di tention of the caheesof itspel is ih p tient ma le an uneventful recovery the fistula h big spontaneously The sc ond ca was lliat of n 4S vear-old woman who afte an operation fo a neopi m of the uterine cervw unnaled through the vagma At inter mittent penods small quantity of unne drained from the elhra Cystoscopic exami ation showed the bladder to be normal and revealed the ureteral Orifices pi nlv In the right ureter catheter was arrested at cm and in the left at 10 era no Unne drained from either catheter The base of the vagina sho ed a s ft ci ainx with two open logs on the right and left Into the nght fi tula fron which urine was welling a ound was read ly pas d upward The \ r y showed th t the catheter asinth nght ur ter The function of the nght and left kidneys as determine f separately tn the same m nnera 1 the first ase No u me df i ed f om the bladder The functio f the r ghi ki Iney was t vi e that ol the lelt The untie from the right Iv dnev was mfectel while th t f om the left was cle \t a other exarm ition the bladder w s found to con tain 75 c cm of u ne wh c)i showed 6 3 gr of urea Sa I TO Palua MD GYNECOLOGY and 7 2 gr of chlorides The intermittent presence of bladder urine indicated that the ureter was not transverselv sectioned but had a lateral slit which I ernutted the escape of unne into the bladder in certain attitudes of the bodv The author consilered that a plastic operation would endanger the function of the good nght Lid ney and therefore advised the patient to wear a urinal These two cases empha lae the importance of making tests of the renal function before operation IS decided upon Waiter C Burke T M D ADNEXAL AND PERI UTERINE CONDITIONS Moulonguet Doldns P The Gland of inicnial Se creti nof thclluman Ovary (La gt n Icisi roll n t dc 1 ai e hum ) C cototi 19 3 x 29 Inscsenty fis teases of ovaric remosedbt oieta lion the author found the gland of icilemal secretion of the ovary in lipoid bodies which ate most numer ous m the ovarian stroma and present a1 0 though less numerous in the corpus luteum In different ovaries there vas considerable lif Terence m their number and sze but the were al avs present a fact not true of the corpus luteum In the authors opinion the physiology of the ovary is limited to the function of reproduction The variation m the ovarun gland seems to be the cause of certain structural dt 0 erences Mucous hvperplasia of the uterus and fibroid are often associated with hyperplas a of the ovarv Ovarian hv-perplasia results f om an increase m the number of the hpoid bodiesoryellov masses nd ertensive development of the external cellular layer of ibe corpus luteum On the other h nd uterine hxmor ihages though at times associated with hyperplasia of the ovary seem ery often to be indef Wndcnt of o anan change* Saivato w Pviu M D ilomung Intrap ntoneal Itaemorrhages of Ova Tlan Ong n (L htmo gies t ap I les d gi 0 at n e) G c f i 1923 ™ 3 9 The author epo ts two cases of intrapentoneal hsmot hage due to a follicul r cast of the ovary The first v as that of a 38 year old woman who fol lowing a normal menstrual period continued to b\ ed fert two weeks A tumor was madie out to the t ght of the cul dc sac After an exploratory punc lure in i hich blood as obtained a laparotomy was p foro ed The tubes ere normal but the nght ovary was found to form part of a hamiatocele Subsequent sections demonstrated the absence of p egn ncy The second case i as al 10 t id nt cal vith the first except th It the e V s almo t entire absenc f ovarian substance Theoretical cau es given for the cond tion arc Vanierts M 3 Bllateral Cystic Epithcliomaof tl Ovary Extirpation with Cure at tbe End she exp enced a chill lasting twenty minute \n up and down tern peraturep rsistedf ten davaand on the tenth day there w rc four chills an!temperature of l Ot degrees r Asoftap al systol c murmur asnotef Dlood cultures sho ed fourteen cotomes to each cube centimeter Thes lire minute ( bout t mm in diameter) colorl $ n d transparent and sho d about ib m typical hxmogi binoph I wtb dark red accumulations of h-cmogl bin for a for the tcachinc of milwncs \t first It rcceiicl a preal leal of rntici m an I lion but in the Last fci Mjrs hat Iwen acc Metl the rceo nilion It lc*cr\es The (Health Hoarlhas refuse I to a Imit to pnet ee ana woman who is n t a Kra luate of tl is schot I or a simibr tih ^ abroad a Stan 1 which has ha 1 a cl ci le IN benefeial effect on the rt=«n re luce I frora one third to one fourth of the entire number The han llmi; of normal ra s of lalior I \ mi I urs who are propcrl) trainc 1 has rilocel the maternal mortal t) from cpsi$ and the number of still!irths an 1 eae Infections Criminal nliortion has also been Krrat U lecrcase I an 1 onl.iiions The practical traininj: shoul I con til m atten lance at 100 cases of conf ne ment The tm 1 ife shout I nea r lie pcrmittc I to take chif RC of pnmipir us w men an I shou!I be re quire I to present all cases for a prenatal examina tun in order that a proper lllaenl^is of pripnanca an I lalior ntas be male 1) a metical consultant \afpnal an 1 rectal eaamiiiations shoutl be pro hil ited Ml cats in s hich labor continues for twenta f ur hours without Ictiscr} shoul I lcctor shoul I follow deliv encs con loctc 1 bj milwivcs I uw itn I C » m M !remain free from t£t d\e The agreement bet ecn the inj ction tesla a d the spread of sesical tuberculosis shows thit the tubcrcul SIS siru is carried through th hmph channel Therefore freedom of the tr one from tnsohemen C u of importance m the didcrenliil dl gno I and ihcprescnccof suhmucousnodulfson th \crtc* and in the mobile i arts is a sign of tuber culo I STEirmt f2) Ire Iciitxrs Tulicrculo is of the llladd rad Mdn y (Wise J N nt b kulos ) 47 I r dm t d d l h C io h } Ch 19J3 lithe roentg n picture the no mal bladder sho s d f iite rc Rulant) in out Lne la the tuberculo Lbd ler an irregularitv m shape 1 evident on the sideinvo Ued Inched cuasion of Freudenbergs pap r Keen XFR fcpoftf I on ijo cases of renal tuhcrcutosis Tlercia associated inv Uement of the blad J rin 90 p r cent of the male genual a m 40 per cent and of tl c f Dial gen ta Jia to 2 per cent The iromec Late mortal l of nephrcctomv w as 8 5 per cent and th late mo talitv tulbin a period of three )car$ aii pe cent In some ol the cases the cure haa pers sled (or fifteen sears In jx percent m tur tionisertire Iv n rmal In half of the cases with \ si al tuber culosis the Had ler condition became cerrplcte)) cured (olio mg the operation One t Oman operated upon subsequ ntly w ent through three normal pre nancies I rs NCft stated that though the diagnosis is dim cult an exploratory mcis on should be made only la the most severe cases The postoperative treatirent IS of the greatest importance but local treatmctit of the bladd r should be gi cn onl when alter from three t six months there is bo benefit from the opcrati n Wosxi Dio stated that he has recently come to better unde standing of the ind cati ns for tuberculin treatment This is in Jicated only in the ea ly stage of tl cmfxt on and lo reader cases of bilateral tuber culosis op ble Xccord ng to Bs RTn the c d results re influ cnccd nd crscl ears and only one bail V etc ben Cted 0 e fou th of them d cd within the fir I ve r I olio mg unilat ral n phrcctoni} preg nancy i well borne Redncr port d a case of tuberculous horseshoe kidney half of which he removed.

The patient was sti U ell after t entycars \o£Lc:i.iu r • C( mmrnf l\ M trad* of Ctirrrnt Ijicraturc \ Ibl li 'sraphv of Currtnr Llirraturc JI til i-e H 40 K» ■os'r• 55 Ul two U rm t t 3 II ih MI 6 I«C3 \ II 3 I 1 3 I HRs Ml « \ 0?M 11 J M 3 M O 7 M A 43 M k I L 9 Ml n L 39 Me b R S MU Ml M N II 1 I 4 M 1 k II k 5 Ml \ 1 C 4 M tj L 61 M \ 54 M II k 1 3 MU K H 04 M fc 04 M k J M nf M M t 1 0 \ 9 I T N K I C \ \ B \ s R N k h W « k Ih 64 N m 4* kk I k \ M 4 R Olb ht I 4 O t \ I () I d 4 P pi \ 4 r IP 4 P pc II 4S I h II (Vi I 4 1 I l»ch G 3 S I m C 4 R II iol II M s5 k Ami" y C J 1 1 49 k k F U 38 k » I I!Background: #fff Foreground: #000 Primary Pale: #8cf Primary Light: #18f Primary Mid: #04b Primary Dark: #014 Secondary Pale: #ffc Secondary Light: #fe8 Secondary Mid: #db4 Secondary Dark: #841 Tertiary Pale: #eee Tertiary Light: #ccc Tertiary Mid: #999 Tertiary Dark: #666 Error: #f88 /*{{{*/ body a a:hover a img h1,h2,h3,h4,h5,h6 h1 h2,h3 .button .button:hover .button:active .header .header Shadow .header Shadow a .header Foreground .header Foreground a Selected Unselected Contents Contents .button #sidebar #sidebar Options input #sidebar Options .slider Panel #sidebar Options .slider Panel a #sidebar Options .slider Panel a:hover #sidebar Options .slider Panel a:active .wizard .wizard h1 .wizard h2 .wizard Step .wizard Step.wizard Step Done .wizard Footer .wizard Footer .status .wizard .button .wizard .button:hover .wizard .button:active .wizard Changed .wizard .changed Locally .wizard .changed Server .wizard .changed Both .wizard Found .wizard To Server .wizard From Server #message Area #message Area .button .popup Tiddler .popup .popup hr .popup li.disabled .popup li a, .popup li a:visited .popup li a:hover .popup li a:active .popup Highlight Break div .tiddler .default Command .shadow .title .title .subtitle .toolbar .toolbar a .selected .toolbar a .selected .toolbar a:hover .tagging, .tagged .selected .tagging, .selected .tagged .tagging Title, .tagged Title .tagging .button, .tagged .button .I ' □b i ' International Abstract of Surgery SUPPLEMENTAR\ TO Surgery, Gynecology and Obstetrics EDIIORS Franklin H Martin W D Chicago p ROf Paul Lect NE Paris France Sir Berkfliy Moyniman KCMG CB Leeds England Su MRER L Koch P Abstract Editor Volume WXVin Jan\iar\ to /une fg 4 pubushed by THE SURGICAL PUBLISHING COMP\Ni OF CHICAGO Fs l5^ iutt I R£D» bic \ Wk Si-rv \b THUBUEWBr VAV Joun TBime itwt BBrv TR VViut A«n BBt VSU^PE PAVm Ctt Ek EX UK Cbisleit Ko Btx T C Co T G xco Rv ^o^^El.^.procedure f choree Th nrueked hem;," .u S^ * l\ri I N MIOWI MJSII \C1 Of ns M \ril u h oil if rt u It t a i; seven cases Upon eiamination the glands removed at operation provcl negative I roni the stud of the c cases the authors dra f the following conclusions The application of ra hum renders nou opcrahle cases operable 7 It makes it possible to perform an operation le s vtcnsive than the Wertncim hysterectomy 3 It reduces the chance of recurrence 4 Operation after radium therapy is yuslifed b cause It permits postoperativ radium treatment and the removal of organs or chains of gland m vrhich involvement is suspecte 1 S IVVTOSE 01 p AUIV M D Aumy Kare Forms of Sarcoma of the Uterus (A p pos d i; Inues f tnea nr ) ila s tc m le I uterus) P ti i e ifhi H ty H 4 t r 1914 j8o Three unusual cases of sarcoma of the uterus are reported vu (t) a myosarcoma v hieh had (level opcdeaclusivcl) attbeeap osc of the anterior I p of the cerv t (2} an enormous sarcomatous evst im planted in the (uniius of the uterus and (j) " coma of the body of the uterus assoc ated v ith an epithelioma of the cervia In the frst case the sarcoma presented at th cervix and bad the appear anceof a cervical polyp in the vagina In the second cas the growth was found at operat on dlilcrsof thick chocolate colored liquif v ere evacuated from It The third tumo described was found at oper tion On a 30 vear ofd woman for ep Chclioma of tfc cervix In every nstance the sarcomatous nature of the gro th w as d mon trated by histologic exam n tl OO ^ TO 01 P CMS M I \o Iie C latellxmorrlia Se Ina Ca cof Subtolal llyaterecc my i Pmorr -a t d m un c «o di liter ct m suhtoul ) i h di csl I f 9 3 X 0 The author rejorts a case in which a severe hxroorrhage occurr d th rteen davs after hvsl r cctomv just as thcpatient asbcingdischargedlroui the hospital A sccondarv 1 p otomy reveal d \ bleed ng left uterine artcrv I'h was 1 gated and the patient recovered After excluding t auma errors 1 surgeal tech nique alterations m the blood vess I v alts hamo phdi and secondary inf ction the author conies to the conclusion that the himo h ge was due to a trophic isturbance of the tissues f the cervic I stump due to the beat on Cotte Four Casesof Ur t roraglnaf Fistula Follow fng Ilystercaomy (Q i c d fi tules utitfro- V ginales c n»feuti es a 1 hysterectom J L 9 th 1913 XT 3S In one case in which the ureter was accidentally sectioned durng a hvste cctomy the author im pi nted It into the I ladf r In three other cases of involvement of the ureter in which this was impos sible he performed a homolateral nephrectomy He bcle esth timplant li n 1$ theprocedureof cho ce whcn LVi.r It IS po sjt le I-oy LLl)va Ml J Cayet Two Case of Uretcro \aglnal Fistula Fol lowing Ilysterect my (1) ut a le tv tules urf W o- aginaln 0 c^cut rsi [h stfrect me) iy * 9 J 36a Tive Afst case was that of a woman 4} years of age Ilyst CFcctomy was fo Uowe 1 1 y phlebitis which Persisted for two months and bv the development of a ur tero vaginal fistula Urine passed by both the urethraan I the vagina Permang natesolution injected into the I ladder hi not pass by the va gina rbe vaginal fistulous orifce was not distinct ly made out Cystoscopv shoved the bladder to have an accentu ted right lateral hom The left ureteral onfice as ea ily catheterired and gave clear urine In the right ureter the catheter pene trated only 4 cm an!